(I wrote this in 1998 for the journal Bad Subjects. I am reprinting it here, unedited, because the Bad Subjects website has been down for what feels like years. Looking at it now, I realize the third paragraph has the style of the fiction I wrote briefly in the mid-90s. It's also interesting to look back into my past, since as I type this, my wife and I are retired and doing pretty well because she worked at an HMO for 15 years.)
Dirty Laundry: Wherein a trip to the laundromat leads to ruminations about health
I'm at the laundromat. Five quarters to wash a load of clothes, another three or four to dry them. I have lots of loads. I come every two weeks; we have a washer and dryer, but the dryer has been broken for months going on years, and even though it probably wouldn't take much to get it fixed, and even though I detest the laundromat, every two weeks I trudge down with load after load of dirty laundry.
I sit at a table while the clothes get clean, reading Dostoevsky on my Palm Pilot. At the table to my left, a woman does her banking while she waits for her own clothes to finish. The manager of this laundromat is an older guy who moves very slowly from one end of the room to the other. He moves so slowly, I've come to think of him in my mind as Uncle Joe, after the character in Petticoat Junction. Some say he lives in a room hidden behind the dryers. Every once in a while when I am washing clothes, the owner comes in to collect the change from all the machines. He banters with Uncle Joe, as if they were old friends. In Berkeley, owners like to think they treat their workers as equals. In the far corner, a man sits staring at the washing machine that holds his clothes. Every few minutes, he gets up, goes over to the wash basin stuffed into his corner, and washes his hands. Then he returns to watch his machine, until he again gets the desire to wash his hands in the basin. He does this a dozen times, two dozen times. The washing machine with his clothes never seems to finish, but perhaps he doesn't mind, as this gives him more time to clean his hands.
I decide to step outside for a bit, to get some fresh air. I go to the parking lot and walk over to my car. A man is sitting in a car parked next to mine; he is listening to talk radio and coughing up mucus into a cruddy handkerchief. Across the street, a middle-aged woman stands on the sidewalk, smoking a cigarette. We're an unhealthy lot. I go back into the laundromat, where my dirty laundry gets clean. There is always lots of dirty laundry at the laundromat. I check on my clothes and go back to "Notes From the Underground."
Laundromats are public places. But they are not exactly the town square, not really the site for communal gatherings. Revolutionaries wouldn't meet in laundromats to plot their insurrections. Long ago, when I was first married, my wife and I had one of those meaningless spats that allowed each of us the chance to prove that, married or not, we were still separate individuals. I decided to run away from home. Since I only had a couple of bucks to my name, I decided to head for the closest laundromat. I knew it was open 24 hours a day. I knew I could hide there. I knew there would be no revolutionaries to ask me troubling questions. It was the laundromat.
I'm still married. I'm still going to the laundromat. I see many unhealthy people in the laundromat, who I assume are fighting personal demons, as we wash our hands and do our banking and relax in our rooms behind the dryers. It's a public place, but I never speak to anyone. A friend told me recently that she has begun trying to strike up conversations in the laundromat. I wonder why she bothers, even as I am impressed by her efforts.
Public places are important, even or perhaps especially anonymous public places like laundromats. For the ever-growing number of people who are abandoned by more traditional outlets designed to help the poor and infirm, laundromats provide a momentary refuge from the rest of the world. Of course, I am only guessing at this, for unlike my friend, I don't talk when my dirty laundry is out where people can see it. I go back to my Dostoevsky and imagine what kinds of lives my fellow laundromat inhabitants lead.
Even in this public place, we are all on our own, with our Russian literature and our checking accounts and our hand-washing rituals. When it comes to our health, physical and spiritual, we are on our own. The sick of America need our laundromats, which are open 24 hours a day, whether or not you've got health insurance, whether or not you're stable enough to get from one day to the next without your mind exploding.
"Lord, you don't know the shape I'm in."
-- The Band, "The Shape I'm In"
These days, it seems like individuals are responsible for their own health. One of the most treasured aspects of some jobs in the USA is health insurance. Without it, you are at the mercy of your body and your pocketbook. Without it, you are on your own. I rely on my wife's group insurance plan at her work, which allows me membership in an HMO. A few years ago, she was free-lancing, and so she had to arrange her own insurance. There was no group plan, and her new plan wouldn't take me with her. I am not healthy. My cholesterol is too high, my blood-pressure is too high, I have a history of migraines and my lungs aren't too good, and I get kidney stones every few years. I am a bad risk. What to do? Eat better. Get more exercise. Improve my mental attitude. Drink many gallons of water every day. Piss it out all night long. I am responsible for my own health; if I get sick, and I don't have health insurance, and I don't have extra money lying around, I will just have to stay sick. Better to take matters into my own hands, make myself healthy, so I don't have to worry about insurance.
Of course, if I don't take matters into my own hands, then my poor health is my own damn fault, and if that's the case, then why should the government worry about me? God helps them that help themselves. Pull yourself up by your proverbial bootstraps. Like the hand-washer, like the man living among the clothes dryers, I am responsible for my situation. If I don't like it, I can make it better. This is America. Don't wait for someone else to take care of you; do it yourself. The rest of the country has more important things to do.
It is perhaps a useful metaphor for the health of the country, that we so often act as if people are as healthy as they want to be, as if illness were purely a function of the decisions we make as individuals. We think of our own health as something distinct from the health of other people. A more holistic approach to health might look to an ailment in one part of our body as something which affects the body as a whole; we would indeed look to make the weakest members of our society stronger. But America rejects the holistic approach. No matter how many sick people walk the streets of America, the so-called healthy assume that their own apparent good fortune is all that matters. We are on our own. If you have the money, you buy a washer and a dryer, so you never have to air your dirty laundry in public.
The flaws in this "system" should be obvious, and thus it is no wonder that "alternative" medicine is on the rise. And it is easy, too easy in fact, to assume that such an alternative must be viable, even crucial, to a healthier public, on the level of the old saw that the enemy of my enemy must be my friend. On the one hand we have for-profit "health" in a capitalist society, rooted not only in profits but in the omnipresent (and therefore questionable, for anything so closely tied to the capitalist menace must be challenged) "Western science." On the other hand, we have an "alternative." To what precisely it is an alternative hardly matters, as long as it is presented as the enemy of my enemy.
And so increasing numbers move towards this alternative, often leading to startling cultural dislocations, as in the case of Isaac Hayes, Mr. Hot Buttered Soul himself. One week Hayes, in his role as Chef on South Park, sings about how delicious are his spicy chocolate balls. The next week, he appears on the cover of Alternative Medicine magazine, touting the wonders of the Master Cleanser. "For nearly a month," we are informed, Hayes gave himself a cleansing fast where "he drank six to 12 servings a day of a blend of water, lemon juice, cayenne pepper, and maple syrup." Which certainly qualifies as an alternative to chocolate balls, if nothing else. Is this the proper alternative to a life of dirty laundry? Can we ride Master Cleanser into the millennium, proud and victorious over a health system that has abandoned so many?
"The Twentieth Century has not been particularly kind to me"
-- Bob Mould, "I Hate Alternative Rock"
There are at least three areas where Alternative Medicine falls short. Granted, in at least two of these areas, mainstream medicine fails as well, but this should not prevent us from exercising our critical thinking skills in the analysis of the alternative. First, though, it is worth noting that the problems I describe here relate to what we might call the "alternative mainstream," systems of thought whose opposition to standard capitalist medical practices is more apparent than real. As is true in so many areas, excellent work is being done at the grass-roots level to help improve the health of the many Americans forced to the fringes of society. But, as is also often true, such work is largely neglected, by both the mainstream and "alternative mainstream" media, in favor of the Master Cleanser version of alternative medicine.
One initial problem is that the insistence on personal responsibility for one's own health that often pops up in discussion of alternative medicine is -- or should be -- more limited than it actually is. A smoker might be well advised to give up cigarettes as part of an attempt to improve their own health. But can you blame the patient for having germs? For getting cancer? For being born with a weak this or an impaired that? Do we blame the patients when they don't get better? The mainstream health system, with its emphasis on the doctor/expert, may give too much power to that expert, but with that power comes responsibility, and failure results in blame. Alternative medicine, taking power away from the experts and giving it to the patient, also transfers responsibility (and blame) to that patient. It isn't any different from conservative social theory that blames the poor for their own plight. You aren't sick because you have a disease which might be cured with a pill; you are sick because you haven't fully integrated your mind and body into a whole. It's your own fault.
Second, it must be noted that whatever alternative medicine is opposed to, it is not an alternative to capitalism. Alt-health gurus are as interested in making a buck within the system as more traditional doctors. This relates to the previous problem: your poor health isn't the fault of the for-profit health system of capitalist societies, it's the fault of the "dis-eased" patient who hasn't accepted their holistic reality. Whether it's colonics or vitamins, aromatherapy or shark cartilage, someone is always ready to make a buck off of your anxieties about health.
Most importantly, though, is the rejection not only of problematic aspects of the Western science tradition, but of important and vital aspects of that tradition. In particular, the frequent absence of systematic analysis such as double-blind testing means that far too many alt-health claims are rooted in the anecdotal and the unverifiable. That some people are susceptible to vague claims is understood; that people concerned about their health might be particularly willing to believe that something might improve their lives is also understood. What is hard to understand, though, is why anyone (including leftist cultural critics) who is ready to attack complex social problems with critical thinking strategies, would turn their brains off when it came to the relative merits of aromatherapy versus a visit to the doctor for a drug prescription. We are back to our old saw: the Age of Reason and the glorification of Science and Progress is so clearly problematic that the absence of concrete scientific data regarding the value of something like aromatherapy is seen as a positive. Aromatherapy proves it is the enemy of Science (my supposed enemy) by existing outside Science, which makes aromatherapy my friend. That this is nonsense is only part of the story. What is especially sad is how often this means that otherwise intelligent people risk their very lives in the service of "alternative" health notions.
"You took my joy, I want it back"
-- Lucinda Williams, "Joy"
Me, I take pills. My cholesterol has been high for at least 20 years. I've lost weight and I've gained weight, I've been in good shape and I've been in bad shape, I've eaten crappy food and I've eaten healthy food, and through it all, my cholesterol remained high. About a year ago my doctor prescribed something called Lipitor. Within months, my cholesterol reached normal levels for the first time since I can remember it being checked. I have had severe headaches ever since I can remember (and I can remember stuff from 40 years ago). I tried acupuncture and I tried meditation. Then my doctor prescribed Beconase, a topical nasal spray steroid. I haven't had a headache since.
Meanwhile, I avoid the worst of the self-flagellation that comes from blaming the victim. Yes, I need to take care of myself; yes, I am responsible for my health. But my headaches aren't a result of pent-up aggression, they are (happily, I can now say "were") a result of sinus problems.
To enjoy good health is to enjoy life. A life full of joy, this is a goal many of us would love to achieve. But while lip service is paid to the notion of joy, there is actually very little joy in American health. Not from the alt-med crowd, with their endless Thou Shalt Nots and their Maple Syrup diets and their victim-blaming philosophy. Living on Master Cleanser for weeks on end is a way of placing health ABOVE joy; it mistrusts joy, assumes that we are better off being miserable but "healthy" than we are being some combination of joyful and healthy.
But neither is there joy in the laundromats of America. It's hard to find joy living behind the dryers. Good health isn't any easier to find. The cholesterol medicine I take is paid for by our healthcare plan. The actual cost of the pills is about $135 a month. Without health insurance, I'd still have high cholesterol. And too many Americans, too many people across the globe, are without guaranteed health care of one kind or another.
No health care, no joy. No joy, and we're in the underground with Dostoevsky. Our collective laundry is still dirty. We can wash our hands as many times as we like, but we can't get rid of the depression that accompanies the helplessness and joylessness of the modern health care "system." We need to demand our joy.
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