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When they were crowdfunding for their start-up money, it was a no-brainer for me to choose this book as the thank you for my donation, as I had interviewed the author Baijayanta Mukhopadhyay last September (not about the book) and been very impressed by his radical, thoughtful reflections, as a physician who practices mainly in remote communities in northern Ontario and Quebec and who is active on issues of health justice.
The book itself is very short, and made up of a series of brief, thoughtful, readable meditations on practices and systems of medicine in today's world, and on how power pervades them. There is lots of specific content that I could draw out and reflect on, but I think I'll stick with making two main observations about what this book does that you don't often find elsewhere.
The first is the kind of insight it provides into questions of medicine and health.
There's a lot of writing out there about health that claims to be coming from one or another sort of critical place, but in my opinion a lot of that, particularly a lot that aims for a lay audience, leaves a great deal to be desired in a number of respects.
Often, such writing is very arbitrary in terms of what it is skeptical about and what it accepts on faith. It is also quite common for it not to have much at all to say about power, or to have things to say about power but to demonstrate relatively little understanding of how power works even in general. For instance, to be rightfully concerned about the power that pharmaceutical companies hold within the health system, but to make claims about their behaviour that really don't make any sense with respect to how large capitalist enterprises work.
Of greatest concern to me is the fact that such writing often seems to have little insight in particular into how health systems and practices work, and how that relates to social relations of power and oppression.
Now, given the nature of the society we live in, the combination of an impulse to resist how medical systems subordinate us with a lack of knowledge about how they actually work is pretty understandable, and there is a tendency to be scornful in the face of such stances that we really do need to keep in check. That said, though, just because it is understandable doesn't take away from the fact that such approaches can easily translate into courses of action that aren't necessarily very useful, or that are even actively harmful.
In contrast, this book is relentlessly critical and very accessible to lay readers, and it is grounded in a really solid understanding of how power works in general in our society and of how the practices, discourses, and relations that constitute the medical system work.
Part of how the book does this ties into the other feature I want to highlight: It models a kind of critical reflection that we all can and should engage in, but that we so seldom actually do, about the systems and circumstances we find ourselves embedded in.
What better way to develop a radical analysis of the world than to follow the example of this book and start from where we are, from the systems and practices and encounters and relations that fill our everyday lives? The book combines careful attention to the author's own experience as a physician with an active openness to the experiences of people who are differently situated in the same contexts, particularly those with less power within the medical system -- both other professionals and patients -- as well as to a range of critical writings about it.
Crucially, Mukhopadhyay demonstrates a tendency towards humility in situating his own experience with respect to these other sources of insight, and a willingness to admit his own complicity in systems that dominate, which I think is absolutely central to building a politically solid picture of how the world works and deciding how to intervene to change it. Both for those of us who are writers and want to develop knowledge for broader circulation, and also for those of us who are more focused on informing the decisions we all have to make about our own lives, this kind of situated critical reflection is an inspiring example that we can all learn from.
The book has a mildly melancholy feel to it, which perhaps not everyone would prefer, but which to me felt very appropriate to the content. My main source of dissatisfaction about the book was that I wish it was longer -- much longer! -- and I definitely hope that the author continues to find time in amidst his medical work and his political work to write.
In any case, I hope it gets read widely, and that many are able to benefit from the way it combines being short and readable with presenting a kind of grounded radical insight into health and medicine that is far less common than it should be.
This book review originally appeared on A Canadian Lefty in Occupied Land and is reprinted with permission.
Scott Neigh is a writer, media producer, and activist based in Hamilton (formerly Sudbury), Ontario, and the author of two books examining Canadian history through the stories of activists. He is the host of Talking Radical Radio which brings you grassroots voices from across Canada.
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