sue

My aunt died today, apparently of neglect by a rehab facility in Florida. She was rushed to an ICU with infected bedsores, and the hospital was so shocked by the state they found her in that they’re initiating some kind of criminal investigation into the facility. Who knows what will happen. I imagine we’ll have to push for a thorough investigation, though it must’ve been pretty bad for the hospital to be taking action unbidden. She was no vision of health but I have to assume other patients are experiencing similar neglect.

There won’t be a funeral, so, that’s it. No condolences needed, we weren’t close. If we were, I’d write some memories of her here, but all the ones I have are no good (she did love her cats, so there’s something). I’m just noting that this happened because it feels like someone should, and I doubt anyone else will.

Case Study of 1

A red ticket-dispenser in the psychiatric department instructs me to take a number and wait until it’s called. So, I do.

I am trying one last time to get mental health treatment. At least, that’s what I said two months ago to trick myself into following through on it. Suppressing doubts about whether this latest attempt would work, I looked up my health insurance’s list of local mental health care providers. The first few weren’t taking new patients. The next two said they didn’t take my insurance, even when I said I was sure they did. The next one was a hospital. The receptionist said there was no room for new patients. I told her that I could wait if needed and no, I am not suicidal, but I need help. She found me an appointment in two months’ time.

So two months later, I’m here. Another hour and I’m called to the registration desk. The receptionist says she isn’t sure if they take my insurance, and to go to the financial counseling department and then come back. Her coworker disagrees, so she just calls the counseling department instead, who confirm the hospital takes the insurance. The receptionist hands me a yellow paper square with my new number—“We call people by numbers here, not names,” she says—and instructs me to wait. The paper has a big “1” written on it. A good sign, I think, looking at the overflowing waiting room.

A nurse calls out “1” an hour later and I pee in a cup and return to waiting. Thirty minutes later, a therapist appears, asking for “1.” She seems nice, though she doesn’t look up from her computer when she asks if I’ve ever tried to kill myself. But when I tell her I how I’m doing, she tells me she is sorry and I decide that she sounds like she means it. We schedule a follow-up and she walks me to the psychiatrist’s office.

I enter and begin repeating the answers I’ve just given the therapist to the standard mental health questions. No, I am not suicidal. I live with roommates. I do not have children. If I’m out with friends, I can definitely down a few drinks, but that happens maybe once a week. I work full-time. I have tried Wellbutrin and Effexor, but they did not work. I am desperate for something to work and willing to do what is needed to get better. I am trying to be responsible.

***

I blame the medical bills.

They pile up in a corner of my room, collecting cobwebs under the bed. Every few months, I gather them up, opening a few. There are doubles, triples, of the same bill, differing only in their dates. Others are solo, lone socks in the pile. I consider using them all as wallpaper.

After I was hospitalized with a particularly nasty skull fracture a few years ago, something snapped; suddenly, I could barely call a doctor. It might have something to do with the way the hospital treated me—a nurse said that they had all believed I was uninsured and had given me “different” treatment because of it—but I think it’s the bills’ fault. They started showing up mere weeks after I was discharged. They never slowed down, no matter how often I wrangled with my insurance company on day-long phone calls. I was broke, and the bills broke me.

So after the first hospitalization, hospitalization became my health care strategy. If you have a severe injury, the hospital will find you a primary care physician and force you to book an appointment. For the skull fracture, they did likewise for a psychiatrist, among other specialists to deal with the aftereffects of the injury.

It seemed great, but my enthusiasm waned when I left the hospital. Each doctor is a co-pay, and that’s if you’re insured. Without insurance, my first hospitalization would’ve cost $39,000 (I made $10 an hour at the time). With it, I was still on the hook for a few thousand dollars. Dizzying diagrams of future appointments and work schedules began to dot my notebooks alongside unworkable budgets. But I was unwell, so I lost track. Within months, I was missing appointments. Soon enough, I couldn’t remember the doctors’ names.

Eventually, I was without care again until being hospitalized in a new city, New York, where I’d just moved. I had no doctors here, and my mental health was declining precipitously. I chose to interpret this turn of events as a gift.

After a false start—I went to a hospital in my neighborhood, Bushwick, only to be discharged because the doctors “couldn’t figure out what was wrong”—I found a hospital rich people go to that accepted my insurance. My wish had been granted: I’d lock down future doctors. Thank god for my prematurely decomposing body.

It didn’t work out. The doctors were understandably focused on my physical ailments. When I mentioned other health problems, they told me to wait until I recovered to worry about the rest of it.

The night I was discharged, I was groggy, floating on morphine. I had complications that required the procurement of an ambulance to drive me home. Follow-ups were scheduled hastily as I was rushed out the door. Someone from the hospital called with the PCP’s information while I was horizontal, strapped to a stretcher. I scribbled the information on the back of my discharge papers. When I got home, I realized the pen had been out of ink.

Despite this, I found the doctor. I couldn’t remember any details about the appointment, but I returned to the upper-east-side hospital and spent a day asking administrative employees for help. Finally, a saintly woman in a tucked-away office, packed with precarious piles of papers, the Office of Historical Memories or something, tracked down the information.

As it turned out, the PCP was actually a clinic; I was seen by different doctors-in-training every time. It was rushed, and no one seemed to have notes. I asked for a psychiatry referral. They told me they couldn’t do that, and to find a psychiatrist myself. After further prodding, they offered the numbers of two psychiatrists. I again scribbled this information on the back of medical forms and left.

They remain in my room, a monument to the vast reserves of the human spirit—I, of course, never got an appointment. The first time around, it took me a year, maybe two, to disappear from the health care system post-hospitalization. This time, it took weeks.

I spent a year like this. I’m fortunate to have never had the type of depression that brings suicidal thoughts and extreme highs and lows; mine is the flat-line variety. Someone who takes days to respond to a text message does not have the ambition required to die—no thanks, sounds like work. But the depression got worse than I’d believed it could. And the bills kept arriving! The calls from unknown numbers multiplied. Once a month or so I answered one. Every time, it was a debt collector.

***

So I am here, making a good-faith shot of it, answering the psychiatrist’s questions.

We get through all of them. After a brief silence, she says she cannot prescribe me medication. When I ask why, she informs me that I am an alcoholic, and antidepressants do not work with alcohol. I say I am aware of the “don’t drink on meds” rule, and if it’s really the case that the medication will not work if I drink, then so be it, I’ll drink lemonade at parties. “I am desperate, and willing to do what it takes to get better,” I restate.

“You could not quit drinking if you tried, and you will not try,” she says. She has known me for twenty minutes at most. “I will likely recommend you get addiction treatment, which entails three appointments a week, and then you can get on an antidepressant.”

Perplexed, I tell her I do not need addiction treatment, that I sometimes go weeks without a drink, and besides, I work full-time and what with my whole exhausted-depressive thing, there is no way I could follow through on three appointments a week. I think about a family member who was court-ordered to attend AA meetings three times a week after an arrest, and how little the judge cared that he might lose his job for taking that much time off. This is criminal, I think.

She says that she will add to her notes that I am in denial about addiction, and if I’d like to get my blood work done so she can see the results and formally decide what treatment to recommend, I can do so. In the meantime, can I quantify my drinking for her notes on my alcoholism, she asks.

“Would you say you take like, ten shots?” She actually says this. I can’t speak, so I laugh. She is withholding medication I need as a perverse moral means-testing, because I mentioned I get drinks with friends once a week. The only possible outcome, should I refuse to go along with it, is that I will go untreated, or will lie about my drinking habits to a future psychiatrist if I ever get to see one. She must know this.

“It took me so long to get this appointment,” I say.

She stands and gestures to the door.

I get the blood work done. As I leave, I stare at the room of waiting patients, some of whom were here when I arrived six hours ago. This is a hospital for poor people. I can’t stop wondering how many of them this psychiatrist will also withhold medications from unless they, too, agree to whatever preconditions she chooses. How many other doctors like her are there? The rich and the poor use drugs at the same rate, but there is no doubt in my mind this woman sees everyone here as an addict or a criminal and is determined to punish us for it. There are no consequences for her, but some of us will die.

I think about last year, at the Bushwick hospital. I doubt there were any millionaires in that packed emergency room. They’d discharged me late at night, on a cocktail of painkillers but still pulsing with pain, to walk home.

These hospitals are located in the heart of the city’s gentrification but apparently those who can, avoid them. I’d never step foot inside one of those places, friends say when I describe my day. Everyone knows not to go to those hospitals. But I didn’t, and neither did the hundreds of other people who were in the psychiatric department this morning. “Why are these places packed if everyone knows this?” I think, to distract from other thoughts, about how, exactly, I will wait out the months it will take to get a new appointment, with a new psychiatrist, in Manhattan.

Anyone reading this likely knows health care is a gruesome, deadly separate-but-equal system in the United States. Anyone who can avoid these hollowed-out institutions on which so many working-class people rely is acting quite reasonably in doing so. They are carceral and dangerous—sometimes filled with literal toxins, as if this country needed more symbolism. They kill us, even if we kill ourselves. They tell us we are criminals, and we agree—a plea deal is the best anyone can get. They say we are addicts, and we wonder whether we must be addicts if we are to survive. None of this is news, it’s just another data point. These are hospitals in the richest city in the country, but the funneling of resources away from them reproduces segregation—it’s how they got this way in the first place. And it is worse elsewhere.

I don’t have any proscriptions beyond what many people are already doing: pushing for universal health care so at least we can get rid of the damn financial counseling department and all the co-pays (today’s experiment left me $45 poorer), funding long-term mental health care, and otherwise creating a world with less alienation, less poverty, shorter workweeks.

I’m just mad, and the stakes are so high. US life expectancy has dropped for the third straight year, in part because more people are killing themselves. If I were the suicidal type, this might be the end of my rope. (I cannot insist enough that I am not, please do not worry.) I just wish all of it would be classified correctly, as murder: the mistreatment, the abuse, the insurance mix-ups, the lack of access in the first place, the disdain, the bills, what that psychiatrist did today. It’s homicide, on a mass scale: take a number, wait until it’s called.

Left-Wing Language for Your Right-Wing Needs!

Because I hate myself, I’ve been spending a lot of time lately watching language created by the left get taken up by the right. Conservatives are wielding the language masterfully, leaving many well meaning progressives disoriented and asserting the righteousness of any cause that comes packaged in the correct words, forgetting that language is meant to advance our goals, to serve us, not the other way around.

I’m not the first to note that a lot of activists today are fixated on language and that with this comes a fear of saying the wrong thing and getting iced out of a movement. The flip side of this is that when someone speaks the right words, we assume it means they’re one of us. But there’s a problem: language can be learned by anyone, it can be taught in business seminars and in online forums. If we don’t subordinate language to the material changes we’re fighting for, we lose the ability to draw clear lines between us and them.

Who’s Doing This?

Zionists are the cutting edge when it comes to hitching progressive language to reactionary ends. For the past few years, the attention of the American Zionist movement has been focused on college campuses. Campuses are bellwethers of broader political trends, making what happens on campus important for those concerned with future societal developments. For Zionists, it’s the growth of pro-Palestine groups and the BDS (Boycott, Divest, and Sanctions) movement that’s the most worrying. Their response is a case study in the use of left-wing language by right-wing assholes.

Take the first #StopBDS Conference hosted by the Israeli mission to the UN and World Jewish Congress at the UN headquarters in New York this week (that’s right: a UN conference with a hashtag in the name – welcome to 2016). As Rania Khalek reported from this gathering of the trolls, the speakers struck a repetitive message: “Speak left,” said Frank Luntz. “Speak the language of the left,” reiterated Yosef Tarshish, chairperson of the World Union of Jewish Students.

What does a Zionist “speaking left” look like? On campus, it means yoking one’s Jewish identity to support for Israel and then claiming to feel “unsafe” in response to pro-Palestine organizing. The impulse to make this claim comes from the rise of progressive students demanding ‘safe spaces’ for members of oppressed identities. While I’m not opposed to this, as it comes from the long and ugly history of violence against the oppressed by those with privilege, as I’ve said before, this demand is becoming one of the prefered tactics of campus Zionists.

A letter sent out by the university chancellor to UC Santa Cruz students offers a great example. Here’s an excerpt:

“On our campus, which has a long and proud history of student engagement in critical issues of equity and social justice, I want to be sure we acknowledge differences of opinion and work to maintain civility in the midst of turmoil.

In student government, as is their right, the Student Union Assembly this week voted to reinstate a resolution urging the University of California to divest from Israel. The Boycott, Divestment, and Sanctions (BDS) movement has generated passionate opinions on both sides.

I’m concerned this resolution will have a chilling effect on individuals within our campus community. However unintentional, its passage may create an environment in which some of our Jewish students feel alienated and less welcome on our campus.”

The chancellor invokes the campus history of social justice, positioning himself as a progressive. From there, he brings up the student union’s resolution in favor of BDS and insists this may make Jewish students feel “alienated” and “less welcome.”

More accurate would be to say the resolution could make Zionists feel unwelcome. But the chancellor’s conflation of Jewish identity with support for Israel allows him to invoke a discourse of safety for oppressed identities as the bludgeon that it often becomes; a human shield, as it were, against criticism. That this conflation inflames anti-Semitism is curiously not a concern of these douchebags, who are happy to pretend all Jews support Israel. Much better to take what power you can from the discourse of oppressed groups and use it to cover for support for an apartheid state. And that’s what makes black Zionists like Chloe Valdary doubly valuable for Israel, as they can make additional claims to the need for safety, cynically counterposing black and Palestinian struggles – a particularly coveted trait when these movements are forging stronger ties.

To take another egregious example, let’s look at Hillary Clinton’s campaign.

A while back, Clinton’s team produced a chart of “intersections.” Indecipherable, it invoked the necessary know-how of the language of intersectionality as a signal to voters: “Clinton’s with it,” it shouted. No matter that the chart was absurd and that Clinton’s policies have and will continue to reinforce, not undo, oppression. No matter that Clinton doesn’t even pay her interns, who more likely than not are overwhelmingly women.

As she asked at a campaign rally in February, “If we broke up the big banks tomorrow…would that end racism? Would that end sexism? Would that end discrimination against the LGBT community? Would that make immigrants feel more welcome?”

“No!” her audience responded, but this cheeky remark was to a strawman – no one, not Bernie Sanders, not even weirdos on the internet, claims it will. But it’s enough to know the language for Clinton, to “speak left” as Luntz put it.

Fortunately, most working people aren’t fooled by this insincerity. We want redistribution. We want real feminist and antiracist gains: abortion on demand, universal health care, union protections and a $15 minimum wage for home care and fast food workers, defunding the police and an end to mass incarceration. Clinton won’t offer these but her cynical deployment of the language of the left is a feignt to pretend otherwise, and a quick look at the unbearable Clinton supporters penning articles about her radicalism is evidence that this is convincing a fair number of voters.

Why Does This Matter?

As usual, Adolph Reed Jr said it best: “[identity] politics is a class politics, the politics of the left-wing of neoliberalism.” What he means by it is that rather than countering a strawmanned ‘class-first’ politics – the ‘break up the banks and stop there’ fantasy evoked by Clinton -the language of identity politics is elastic enough to incorporate the bourgeoisie along with the working class, particularly when it uncritically links identities to political ideologies.

It’s how we get the “black misleadership class” in Reed’s terms, bourgeois African Americans purportedly speaking on behalf of “the black community.” By pretending this community isn’t internally riven by class divides, this essentialized view of a definitionally progressive blackness lets the black bourgeoisie fill the symbolic role of a black voice, immune from criticism by their allies, who are told to shut up and listen, not question the political credentials of the speaker. This doesn’t just cause chaos at the level of institutional politics, though it does that too. It also opens up space for incoherence and misleadership in movements.

As Douglas Williams put it, “we have gotten to a point where any critique of tactics used by oppressed communities can result in being deemed “sexist/racist/insert oppression here-ist” and cast out of the Social Justice Magic Circle.” While Williams is writing of the need to build a broader, more effective movement, the phenomena he’s referring to – the belief that the oppressed shouldn’t be criticised – is not only linked to a condescending belief that oppressed groups can’t argue their views, it hands a cover to conservative projects as long as they’re led by members of an oppressed group.

Teach for America is one of the most prominent organizations to take advantage of this opening. As Drew Franklin detailed at Orchestrated Pulse, Teach for America faced a “race problem” in the wake of the devastation of the New Orleans public school system. In Franklin’s words, this led it to “re-brand itself as a Civil Rights organization. Selling such an image necessitated a new class of political operatives, one that was “majority-led by the oppressed group.”” Yet again switching out the substantive and often socialist demands of the civil rights movement for symbols, TFA could claim membership under the umbrella of social justice just as long as it had enough people of color on its payroll and knew the right words to use.

I can’t help but think that was the purpose of a recent event hosted by TFA Massachusetts. Titled “#StayWoke: Social Justice through Hashtag Activism,” the event promised to help attendees struggle for racial justice, even as the organization hosting it eviscerates black communities across the country. Want to know someone who looks like he attended one of these trainings? Twitter CEO Jack Dorsey, pictured here wearing a shirt that reads #StayWoke while speaking with TFA alum and black misleader-par-excellence Deray McKesson despite the fact that Twitter has a severe diversity problem.

And that gets to the heart of the issue. Neoliberalism, capital, or university administrations have no problem accommodating symbols. New language can be learned by hiring a social justice consultant, new faces can coexist with old in high places, granted the majority remain shut out. It’s calls for redistribution that don’t jive with the status quo but these are ignored in favor of those demanding the easily assimilable.

Aviva Chomsky skillfully addresses this in the context of the university in a recent piece. “While schools have downplayed or ignored student demands for changes in admissions, tuition, union rights, pay scales, and management prerogatives,” she writes, they’ve incorporated the more symbolic and individualized demands “into increasingly depoliticized cultural studies programs and business-friendly, market-oriented academic ways of thinking.” Those demanding changes of language – apologies, inclusive rhetoric, an end to microaggressions – are recognized while those advocating for prison divestment  or an increase in material support for students from oppressed groups are shut out.

The critical stance I and the writers I’m quoting adhere to isn’t a condemnation of anti-racism or feminism as such – I support both the symbolic and redistributive demands of college students. Rather, as Ben Norton wrote in a post on Reed and identity politics, it’s “a condemnation of a politics that is centered on social constructs, like race or gender, rather than on material conditions.” If we focus our politics around achieving material changes, this necessarily entails fighting oppression wherever it appears. But to hitch this struggle to redistribution prevents those opposed to this project from claiming the mantle of social justice.

Where Does This Leave Us?

First and foremost, we shouldn’t blame those confused by this rhetoric – indeed, I was one of them until very recently. These are people who want progress but are being sucked into the morass of conflations of identity and politics. This is concerning not only because of its lack of strategic efficacy but also because it burns people out. To be always on, to have your identity, your cultural preferences, your social circle and your dating life all bound up with and signifying your politics is a recipe for exhaustion. And I’ve seen it happen: either these activists enter into non-profits and lose sight of radical movement work altogether, or they give up completely, shifting into a consumption or lifestyle politics. If we want stronger movements, we need to argue against these politics.

But for those in positions of power – people like Luntz or Clinton, groups like TFA – cynically emptying out the force of these anti-capitalist words, we should be merciless in denying them access to this cover. Where those in power seek to insulate themselves from criticism by invoking the language of the left, we need to insist on placing these words back in the context from which they came: the struggle against capital and for the oppressed. By refusing to bestow any magic on words, we can render them useless to the powerful and in doing so, make the sides in this fight unmistakably clear.