RevolutionZ
RevolutionZ
Ep 366 Trumpisms, Socialisms, and WCF Health Gets Personal
Episode 366 of RevolutionZ starts by considering a phrase frequently borrowed, nowadays, the phrase "like never before," and then moves on to a word nowadays being used more frequently and positively than in quite some time, the word "socialism." Regarding the former, why are we mimicking the verbal priorities of the Orange Monster? Can we avoid that? Regarding the latter, are people using the word "socialism" to talk about outcomes or to talk about institutions? Can we do the latter? After exploring those questions a bit, we move on to the main focus of this episode, another chapter, chapter thirteen, of the forthcoming book The Wind Cries Freedom.
This time Miguel Guevara elicits from the doctor, Barbara Bethune, and the nurse, Emiliano Farmer, both of whom we met last episode, more about their experiences and the lessons they take from their health work and organizing. They consider the hospital as a living case study. They describe the pipeline of suffering—pollution, price-gouged meds, avoidable illness and more—and also the subtler currents of class status that dictate tone, attention, influence, time and income. They examine the role of the “coordinator class” of hospital managers, doctors, lawyers, and other coordinator class members who don’t own capital but oversee labor and monopolize empowering circumstances. For many working-class people, these are the faces of power they see every day. That’s why polished condescension can push workers toward leaders who “feel real,” even when those leaders actually harm workers, Trump being a prime example. The interviewees explain how the left stumbles when its language and posture mirror coordinator class norms and when it sidesteps a hard truth: removing owners without changing the structure of empowering tasks just juggles bosses.
A candid conversation with a doctor and nurse becomes a turning point. The doctor admits to class bias toward those below, then embraces balanced job complexes so no group monopolizes empowering tasks, self-management so decision-making matches those affected, and remuneration for effort and sacrifice to attain equity. The nurse arrives at the same aims but after admitting class hatred for those above. Alongside all this, a personal story from the doctor about her "aphantasia"—living without a mind’s eye—shows how unseen differences among people distort what we treat as normal. Her honesty presents a lesson in humility: people edit their self-understanding to belong, and professionals do the same to protect hierarchy. Real organizing requires honesty about the impulses and structures that make empathy sustainable.
The interviewees connect these and related ideas to action: confronting big pharma, building rural and school-based care, reforming medical education, and ending toxic internship culture. The National Nurses March in their time stands out as a catalyst, proving to many that mass participation can thaw numbness and turn moral clarity into practical wins. If participatory society means anything, it must show up at the bedside and in the break room as shared power, dignified work, and decisions made by those who live their consequences. There is actually much more as well...
Hello, my name is Michael Albert, and I am the host of the podcast that's titled Revolution Z. This particular podcast episode is titled WCF World Health Gets Personal. It is from chapter 13 in my still evolving book now scheduled for spring release. It is titled The Wind Cries Freedom An Oral History of the Next American Revolution. In recent episodes, when I have mainly offered an excerpt from the oral history, I have begun with a kind of brief, I guess sort of a sidebar treatment of some current issues. Two episodes back, it was the Epstein Connections. And last episode, I discussed my current writing mood by way of offering a brilliant article by Ava Duvernay that described her recent writing mood, which largely matches my own. Except that she presented it better than I could. So this time I include here, before gritting on to chapter thirteen from the Wind Cries Freedom, two very brief comments on phenomena in our own current world and time. I try to say things in these brief intro comments that aren't commonplace, that aren't available all over, and that you haven't heard nineteen times before. First, how many times have you heard the phrase like never before in recent weeks? Not just from the malevolent orange monster, but from all manner of directions, from mainstream media, podcasters, advertisers, and even progressive and left outlets and actors. This is yet another nauseating dynamic of our times, and it is, at least when I encounter it, for me, truly annoying. It is repetition becoming normalized, and in this case, it is people of all sorts echoing Trump as if Trump is our exemplar, our leader, our buddy, the massive unparalleled intellect of our times, like he claims. As if he is so bright and so wise that we should all talk like he talks. We hate him, we ridicule him, and yet we copy him? We even mimic him? And in that way, however slightly we ratify him? What's up with all that? I know it's just repetition creeping into us, but really, can't we avoid it? Now, for full disclosure, I have to admit that there are times when the phrase like never before, does fit, though not as Trump uses it, of course, which is to manipulate and confuse by exaggeration and massive lying. Here is one situation the phrase does fit. We are now encountering a sadistic, hypocritical, manipulative, lying, unjust, and deadly presidential behavior like never before. Trump is a blot on humanity like never before. So even as we resist, even as we demand much better, can we stop getting sucked into talking like him? All of us, but especially we who fervently want him gone? Yes, we need to talk to the audience that hears him, the audience that still thinks he is the best or even just a true, viable path to better times, but not by mimicking his rotten methods. It is perhaps a small thing, repeating his verbal ploys, or is it? And here is a second modestly concerning trend of verbal usage that I would like to briefly mention. It is hard not to notice that the word socialism is appearing steadily more often in steadily more places. Some who use the word aim to register dismissal or hate. Others who use it aim to register alignment and to celebrate. Socialism appears in polls, socialism as epithet, socialism in Gracie Mansion, socialism to bury forever, yet again, or to elevate, dare I say it, as never before. That so many people seem open to using the word socialism, or even say they are socialist, seems unmitigatingly good. But is there also a problem? What is this thing socialism that people say they favor or they hate? Sure, socialism's advocates say it is this and that and also the other, and they have in mind all good or all bad things. But those good or bad things are predicted outcomes of having socialism, not the features of socialism itself. Do people using the word know and favor features that they believe can yield the good things they want or the bad things they do not want? Or is there silence or confusion about what can achieve the good or bad things? And I don't even mean what can win the new conditions that will yield the good or bad things, I mean what are those new conditions? Put differently, is the current spreading and growing use of the term socialism a verbal process that is moving citizens to the left or is it moving the meaning of the term to the right? I don't know. It's worth thinking about. Is the positive part of the trend more than saying I'd like people to be better off, to have more justice, more equity, more health care, better housing and education, and less climate catastrophe? Or even that I'd like some policies that move toward those ends? If it is more than that, in the sense of saying here are the new institutions I want in place of our rotten ones, what are those new institutions? For that matter, what are the rotten ones? I don't know what the various users of the word socialism actually have in mind. Is my doubt about the words you users unfair? You tell me, if you ask your neighbor or your sibling, your parent or your child, your workmate or your schoolmate, you ask someone who has been using the word socialism whether to attack or celebrate the concept and its substance, you ask what socialism is, what they mean they want when they say they want socialism or what they reject when they say they reject socialism? What do they say? What do they answer about what it is? For that matter, honestly, what does even a highly committed socialist activist say he or she wants? Activists, myself included, say we need to plant the institutional seeds of the future in the present. What are the institutional seeds of socialism? Does what the word is becoming even have seeds? Even have institutions? Something to think about. Now, about all this, Miguel Guevara and his eighteen interviewees express themselves rather differently than I have been encountering in our place and time. So to get on with the main focus of this episode, Miguel Guevara, the interviewer, here solicits further substance about health care and work that continues from their last chapter's comments from Emiliano Farmer, the nurse and Barbara Bahune, the doctor, who go deeper and still more personally into the innards of health and class. It starts with Miguel asking, Emiliano, what pushed you to broader radicalism beyond your own job here in the hospital in Chicago? General class anger. Yeah, that was there, loud and clear. But it wasn't just abstract theory. No, it was day to day stuff. You're on a hospital floor and you're watching things. Pollution comes in through a patient's lungs. Monopoly priced meds come in through the IV. You see the way doctors talk down to people. They discuss disease like they're solving a math problem. They patch up bulletin wounds like they're some kind of glorified mechanic working on a car. And you ask yourself, how many times can I just nod along and not blow a fuse? And here's the kicker. The overdoses, the hunger, the obesity, the addiction, they're not mysteries. They're not equations too complex to crack. They're symptoms of a system built for something other than human dignity. So what do you do? Sit back and chart vitals? Or do you start connecting the dots? Curable diseases kill millions because poverty is rampant. And what do we do? It made me radical, sure, but more than that, it made me curious. I wanted to know how this mess ticked. And when you figure out it ticks on profit and elite status at the expense of patients, it's hard not to get revolutionary. That's my honest truth. Miguel asks, so okay, what was your own personal attitude toward doctors? What did you feel needed to be done regarding the inf interface between doctors and nurses? A few doctors, I like them somewhat. They knew their stuff when it came to kidneys or viruses. That's their field, their turf, like a physicist with quantum mechanics. But get them talking about the social dynamics of a hospital, or the way power flows through the system, or how poverty prevents prevention. Forget about it. Some of them were as clueless as a first year undergrad poking around with a multimeter. At the convention, we had this session, nurses and doctors. It got repeated later all across the country. The point was simple. Get honest or get nowhere. No equations, no graphs, just real talk. One nurse would stand up, usually someone like me, and toss the first stone into the pond. Not a grenade, just a stone, and the ripples, oh they come fast. Now sure, we could have held a safe little meeting, vented our joint anger at profit hungry hospitals, patted ourselves on the back. Easy enough. But that wasn't the whole picture. We also needed to talk about the class divide inside the hospital. About how the structure of the hospital wasn't just dysfunctional, it was stratified. Did our attributes require the hierarchy, or did the hierarchy bake in our attributes? These sessions, every one of them, were like watching a complex system under stress. Things would heat up for sure, but there was also movement. You could see the gears start to turn in people's heads. It wasn't just about venting frustration. It was a realization that we were standing in the middle of a problem that needed dismantling from the inside out. We had to bring doctors, lawyers, what we called the coordinator class into the mix, sure. But we couldn't let them drive the bus. That's how you end up rebuilding the same old hierarchy hidden under a few new slogans. That day, I think a lot of us, nurses, saw the writing on the wall. This issue of class dynamics inside the hospital and beyond, it was our job to put it on the table. And no, it wasn't going to be easy. Doctors defended their status like Newton defended his calculus. They thought they were naturally equipped to lead. That we, the nurses, were either grateful or misguided. Miguel asks, I know this wasn't new, but were nurses alone in addressing this? Or had it arisen in other ways and realms as well? Not new at all. This kind of tension had been floating around for ages, like some unsolved problem people kept ignoring because they didn't like its implications. Every now and then it would pop up, somewhere in the footnotes, but never center stage. Now why nurses? Well here's the thing. Our jobs weren't sufficiently efficient to beat all the independents out of us. Unlike someone stuck on an assembly line doing the same motion for twelve hours, we had to think on our feet, talk to people, make at least a few decisions. It meant we were still working class, still subordinate, but with just enough room to breathe that we could imagine something different. Teachers were kind of the same way. But don't get me wrong, it still hurt. It still twisted your self image. You don't just shrug off social conditioning like it's a lab coat. Once we did get that glimpse, though, of how things could be different, we tried to speak up. That's when the real trouble started. You didn't want to alienate folks with technical skills. You needed their participation. But if you pushed too hard, they'd circle the wagons and defend their status quo like it was their thesis. So we held back. We censored ourselves. Even when we tried to make these class dynamics visible, when we decided okay, let's have this conversation publicly, the options were limited. On the left, your loudest megaphone is usually media, meetings, conferences. But this particular issue, even on the left, it was like trying to publish an unpopular theorem. Everyone acts like it's either irrelevant or incomprehensible. Miguel asks, why? Because like any deeply ingrained system, people are trained to see the system as normal. Doctors don't wake up thinking today I'm going to exploit my co-workers. They think I earned this, I studied, I save lives. And sure, they did study, they do save lives, but the system rewards them not just for the work, but for their position in the hierarchy. Try telling them that, and it's like introducing a new variable into an old formula. They'll do everything to cancel it out. Mainstream media doesn't often question private ownership of workplaces. That's not a bug. It's the design. You've got media mobile sitting on top, pulling the strings, and guess what? They're not in the business of undermining their own thrones. So the topic doesn't just get soft pedaled, it gets erased, vanished, poof. Same thing with the coordinator class. You don't hear about that either, not from the big guys, and frankly, not much from progressives either. The folks who organize left wing conferences, the people who get invited to speak, well let's just say they aren't usually flipping burgers between sessions. They're highly educated, fluent, sharp, and sure they know a lot. But why do they know so much? Because they've got the kinds of jobs and backgrounds that give them time, resources, and practice to swim in all this rhetoric and theory. They've got the language down cold. Trouble is that's the same reason working class folks start tuning out. The language isn't just hard, it's alien. It comes from another planet. Quite often, it is even designed to be obscure more than it is designed to reveal. Now let's flip that. Working people, the ones with grease under their nails and backaches from real labor, they might not have read the books, but they live the consequences. They know things too. They just don't get the microphone, they don't get the pen, the keyboard, they don't get to set the agenda. This isn't mysterious. Elites defend their positions. People protect what benefits them. So when we finally did get media criticism of private ownership, it came from outlets that weren't owned by the very people who'd lose from that criticism. You've seen the same thing play out across the board. White run organizations, not so great on race. Male dominated boards, they're not winning awards for feminist breakthroughs. So is it any wonder that in nonprofits or so called radical media that mirror the familiar top down structure, with editors and bosses and everyone else towing the line, you never hear about another class between workers and owners. People don't like being criticized, especially when it pokes at their identity, their sense of self-worth, their paycheck. And when the left media is largely run by people from the coordinator class because of how those jobs work and who gets to do them, you end up with a whole world of coverage that just doesn't see its own biases. It's like trying to measure the mass of a neutrino with a bathroom scale, completely mismatched tools. But then RPS comes along and starts kicking the tires. And suddenly this stuff starts bubbling to the surface. We already knew that movements had made big gains on race, gender, sexuality. Not enough, sure, but undeniable progress. Say something racist or sexist at a meeting, you'd be shown the door. But class, class was another story, especially this murky stuff between worker and owner, where another class, the coordinator class, sits perched in the middle, shaping outcomes but escaping critique. Miguel asks, What about the Trump supporters? Why were they so deeply, justifiably angry about their economic conditions, about the lies they'd been fed by politicians and the media, and yet somehow loyal to a billionaire whose disdain for them was visible from orbit? Well, here's the weird part. They were class conscious, just not the way Marxists sketch it out. Their gut anger wasn't about some abstract bourgeois class they never met. It was about the real people they interacted with day in and day out, the bossy administrators, the gatekeeping lawyers, the know it all doctors, the smug managers, the elite talkers who claimed to speak for the people, but who always somehow spoke to them instead. These folks, the coordinator class, make up around twenty percent of society. They don't own the factories, but they do tell the people working there what to do. And for working class people, those are the faces of power. Those are the gatekeepers they see, the voices they hear, the people they serve and resent. Miguel asks, did you feel this way yourself? Even now? And back then too? Absolutely. It's not abstract. It's everyday life. I've seen it, I've lived it, we all have. You don't bump into Jeff Bezos at the clinic, but you do run into the intake administrator who treats you like you're wasting her time. You deal with doctors who think you're dumb, lawyers who assume you can't follow a contract, managers who explain things like you're a kid. And sure, we want our kids to become those professionals, to rise up and out, but deep down, that just underscores the whole mess. It's envy and resentment side by side. Everywhere you go, the street, the mall, the hospital, you see the same dynamic, different clothes, different speech, different atmosphere. Expectations. They float while you slog. You get used to being told what to do, told how to behave, and that habituation shapes you. Not just what you earn, but who you become. Behavior is a hell of a teacher. So is the absence of teachers, the absence of resources. Roughly forty percent of the United States is barely literate, some completely illiterate. Naturally, they have less information at their disposal. Sayero, when you boil it down, the people we see most visibly causing the pain, most directly enforcing the rules, most disregarding our reality, they're not capitalists. They're the coordinator class. Miguel asks, but how does seeing all that explain anything about what you call leftist relative lack of success reaching out to working class constituencies? Think back to Trump's fans. They weren't blind to his flaws. They just didn't care. Because compared to the slick, polished, polite society liberals who talked down to them, Trump felt real. He was crude, sure, offensive, absolutely, but he didn't pretend. That mattered. He didn't use the polished, patronizing tone they associated with every quote progressive school principal, city planner, HR director, and campaign rep, whoever told them what to do. He felt like a person, not a manager, not an overseer. That's the paradox. Trump's supporters hated elites, but the elites they could see were coordinator class elites, college educated, well spoken, smirking. Trump? He was rich, but he talked like them. Or so they believed. He was quote honest, not because he told the truth, but because he didn't hide who he was. They saw him as a guy who'd throw a punch, not schedule a panel discussion. Sure it was tragic, misguided, sometimes fueled by bigotry, but their antipathy toward the folks who ruled over them day to day, that was legit. And sadly, a lot of the left didn't get it. They kept using language and mannerisms that screamed coordinator class, rules, codes, virtue singling, none of it landed well. So long before the first RPS convention, many of us were already starting to tune into this insight. If we wanted a movement that actually reached working people, we had to reckon with this class divide within the left, not just outside it. Miguel asks, but why didn't progressives and radical ideas gain deeper traction in working class communities? Why didn't the far more accurate accounts that left thinkers had long offered about working class conditions and the far more consistent history of left organizers standing with labor resonate more than the rants of a billionaire blowhard who treated workers with open contempt? I face that too. I mean it really bugged me. How could it be that decades of organizing left so many working class men and women ready to follow this smiling fascistic maniac? The question itself wasn't new. But suddenly the stakes were. Now one explanation, never stated outright, but definitely implied, was that the workers, especially white and male worrens, but not only them, were just too dumb, too stubborn, or too easily led to ever arrive at progressive, let alone radical positions. And let me tell you something. That explanation, even when it stayed tucked away behind someone's eyes or hidden in their tone, was a big part of the problem. Huge part. We realized that the problem wasn't just the past six months or the latest scandal or whatever circus was on TV. It was decades, fifty years at least, and during all that time something was off, something that honestly made a lot of us squirm when we had to look at it straight on. Our movements, activist movements, left movements, they didn't look, feel, or sound like they came from workers. They often didn't even try. We came off, whether we meant to or not, like we were anchored in a whole different world, a world of coordinator class values and behaviors. Fancy words, uptight vibes, a style and tone that said yeah, yeah, workers hooray, but we know what's best. And guess what? Workers saw right through that. They heard screw the one percent from the stage, but the body language, the smirks, the word choice, they all whispered to us I'm not one of you. And let's be honest, it wasn't just a few folks, it was a lot. We realized something kind of embarrassing. To a lot of working people, we activists seemed more like future managers, lawyers, doctors, the kind of people who hand you forms, issue you finds, or talk down to you in waiting rooms than like allies. And it showed. Now if you're reading this and your first reaction is, hey, that's not me, maybe slow down and take another look. We all carry baggage we don't see. We talked a good game about profits and private ownership, but how often did we even mention the relationship between our class or the class we were headed for and the working class? How often did we even ask do we really want to eliminate this class difference too? Miguel asks, why then were so many leftists surprised that our underlying differences, compounded by our own dismissiveness and condescension, became a towering barrier to unity, even to the basic act of listening to one another with a shred of empathy or understanding. Now this is the part that to me is almost scientifically fascinating and frustrating. For decades, women and black activists had been incredibly perceptive and articulate about the structures of oppression they faced, how it shaped attitudes, institutions, interactions. It was all there cultural condescension, material exclusion, elitism. You'd think that that same set of insights about interpersonal dynamics could be extended to the class dynamics between coordinators and workers. Same features. But somehow it just didn't happen. Not much, not widely, year after year, decade after decade. That light never got shined in that corner. And then finally, some things began to change. The elections in twenty sixteen and all and after, the voices of nurses, of teachers, of folks from the working class who had had enough, all pushed the issue to the surface. What had been lurking around the edges of the left's consciousness now started to move center stage. And in RPS it mattered, in our sessions with the doctors and beyond. Miguel asks, Barbara, from an interview in her hospital office, as a doctor here in San Francisco, how did you feel about nurses? Then and later? It's not easy to say, but I must. Back then I looked down. I didn't name it that way. I would have said I respected them. I would have said I supported them. I had nurse friends, just as some said they had black friends or gay friends, or even slave friends once upon a time. But in my soul I saw them as less, as folks who had wanted what I had and had come up short. If I thought of them at all, it was as helpers or people to help, not as equals, not as minds and hearts with power of their own. It was at the convention, bless that storm, that the veil began to fall. This nurse named Emiliano stood up, his voice full of thunder and sorrow, and he said doctors, can you see how your view hides from you the gigantic volume of our talent that is stifled to maintain your hospital hierarchies? Can you see how your advantages disadvantage us? If society didn't quash desires, most nurses could do some doctoring. And if being a doctor didn't appeal to some of us or wasn't in our range of talents, we could do other empowering tasks. It is disgusting for society to have relatively few people do all the empowering tasks and then use their structurally enforced empowerment to make the rest of us believe we deserve less. I will never forget those words. They shattered something in me. And in that brokenness light came pouring through. I saw how the world's way of organizing work, its rows and ranks and rigid lines was smothering brilliance. I saw how I had become a guard at that gate. At first I couldn't hear it, my ego turned away, but then I found a way to listen. I called on a language I already knew. I compared it to racism, something I had long understood, something I had fought. I saw that white people had inherited advantage, and in that advantage they had written the lie we deserve this. Others do not. I saw that I was doing the same. I was saying doctors are worthy, nurses are not, and it broke me. The dominant always tell a story to stay on top. The story says we are good, they are not. We are capable they are not. First we take their tools, we ridicule their lives, we crush their aspirations, then we say they have no talent. It is cruel, it is cunning, and it is common. But in that pain of seeing came a revelation. Maybe everyone isn't meant to be a doctor, but everyone is meant to do something empowered, something complex, something that lets them grow and give, and many, many nurses, perhaps most, could be doctors, and those who wouldn't choose that path could walk other paths just as uplifting. The problem wasn't their limitation, it was the limitation imposed on them by a world afraid to share power. It wasn't just our habits, it was the very design of our workplaces that bent us toward injustice. The rules, the roles, the rituals, they conspired to convince us that only a chosen few should speak, should lead, should decide. I remember a quiet moment. Someone played John Lennon's working class hero. His voice came through the speakers like a sermon. I sat and listened, and I wept. As soon as you're born, they make you feel small by giving you no time instead of it all, till the pain is so big you feel nothing at all. And it went on, and I realized I had helped make others feel small, and that was a sin I could not carry forward. Miguel asks, did these class issues affect your views on economics more broadly? I had brushed past the ideas of RPS economics before, and child I brushed hard. I scoffed. Balance job complexes, pay for the time you labor, the burden you bear, the soul you give, self management for all? Come now, I thought, let's not drift into fantasy. I could see plain as day the owners were a cancer on the body of society. Owners twisted medicine, poisoned food, hollowed out homes. They made me grind my teeth at night. So yes, I wanted to see them gone. I believed myself to be revolutionary. I was ready to sweep them out like yesterday's trash. But if I'm honest, I thought once they were gone, people like me would step up. We would take over. Be in charge. I didn't say it out loud, but the thought lived inside me like an old hymn owners out, we ascend, and workers, well, they'd still be below, because that's just how the world works, isn't it? That was the rhythm that I had been taught since childhood. That was the sunrise of my prior social truth. Workers obey, thinkers lead. And I was among the thinkers. And so I marched proud in my so called radicalism, not knowing I was carrying the master's tools in my knapsack. I remember the day that old rhythm got broken. It was after the soul shaking session with the nurses. I wandered into a talk. Lydia Lawrence, with a voice like stone on water, was speaking on RPS economics. She laid it all out, steady and unflinching, shared decision making, equity of circumstances, justice in the very bones of labor. When she finished, I didn't just clap. I stood, I walked to her, and I said, I'm sorry. She looked at me puzzled, tender eyed. Why? she asked. And I said, For years I dismissed your vision as impossible. Not because I studied it, not because I knew it, but because I didn't want to know it. My place in the class structure, my high perch blinded me. I never gave it a fair hearing, and now I see why. I feared what it would ask of me, so I'm sorry. Lydia smiled like someone who'd been waiting a long time to hear the truth spoken out loud. She said, Quote, we are all twisted and fed by our upbringings, schooling, and social roles. It is no sin to absorb elitist or submissive habits. The sin is to cling to them after we understand them. Lord, that struck me deep. I felt my guilt rise like a fever, and then, with her blessing, I let it break. I breathed, I forgave myself, and then I set to work trying to speak this truth in a voice that could be heard. That was my next mountain. Miguel asks, can I change the focus for a bit? I have heard that you have a kind of rare disability. I think it might be termed, and I wonder if you mind if I ask what that is, and whether it has had any impact on your political commitments. Yes, it's true. I do carry something unusual. It's hard to explain and often harder for people to even believe. It's called aphantasia. I have no mind's eye, none. When I close my eyes there's only darkness, no shapes, no colors, no pictures of loved ones or old homes, no numbers written in space, no visual memory you can see and wrap yourself in like a warm coat on a cold day. Nothing. That is hard to imagine, says Miguel. Yes, I am told it is, because most folks live with an inner gallery. They can call up images, play scenes like old movies, but I lived without that. I see just fine with my eyes, but inside it's like the curtains are always drawn, and I always even know this condition had a name, that it wasn't just how everyone is, until years after I'd been living with it. I thought everyone was just being poetic when they said quote, picture this in your mind. I didn't know they literally meant it. But this absence, it gave me something too. It made me feel the world harder, it made me listen deeper. Without a canvas in my mind, I leaned more into the living moment, into the sound of a voice, the weight of a silence, the ache of injustice. I could see freedom inside my mind. I had to fight to see it made real. And perhaps in its own strange way, that's why I could no longer tolerate a world where only a few got to steer the ship, while the rest were left to row in silence. I had to believe in something better, not because I could picture it, but because I needed it to live. And like I said, some people don't believe me, but it is by now well documented, and it isn't just pictures I can't summon summon behind my eyes, though that I suppose is the loudest silence. I cannot conjure a smell in my mind, I cannot hear a tune. No music plays within me when the room grows silent. I can listen to a song played aloud, yes, and I hear it, I recognize it. Similarly, I see your face, I know it, and if you look different today than yesterday, I might well notice. But the moment I turn away, your face disappears. I cannot recall it. Not tomorrow, not next week, not two years from now, unless I lay my eyes upon you again. Same goes for a song, no mind's ear either. I can see someone ten hundred times and still not hold them in my mind's sight. I can listen to music, love it with all my being, but still I cannot call it back to play within me. I can sing along while it's on, and if you miss a lyric or shift a note, I will likely know. But once it stops, I cannot hear it anymore. I can recognize familiar people, those etched into my hours, but I cannot see them in my mind, and this absence it spills over. It steals memory, leaves it scattered and soft. But what struck me deepest, what reached into the bones of my thinking and changed the rhythm of my beliefs was realizing I didn't know I was different. They say maybe two percent live like I do, though it may be less, because what I carry is particularly severe. And yet I was nearly sixty before I knew its name, before I knew I was different. I lacked something others took for granted. I can't tell you the ways I do the things that you do with your mind's eye. Once I understood what I lacked, I had to sit with others, ask questions, learn what it is they see and hear and feel behind closed eyes. And then a revelation came, slow and heavy as some summer thunder. I had lied to myself for decades, not out of cruelty, not even knowingly, but out of a hunger to be normal, to belong. The signs of inner mental life were everywhere, in movies, in books, in the way people described love, dreams, fear, but I turned away. I must have trained myself not to notice the signs I lacked something that they had. I could pass as unblemished, no one would see, but I had been editing my own self perception, painting over the missing strokes to preserve that pic the picture of myself I apparently needed to believe in. That taught me something precious, how strong our unseen stories are, how they twist thought, how they bend what we call truth. I came to understand how self delusion, so often the child of defense, of wounded pride, of fear of being seen too clearly, can take hold of good people, and I grew more patient with it, in myself and in others. And another thing bloomed from that knowing. It may not be your question, but it lives close by. What is the range of human being? What is the full stretch of our minds? If I had such a great difference inside me, one not named, not seen by others, Not even recognized by me for decades, and how many other people are out there with other differences dancing beneath the surface unknown and unspoken? We know we are born with different eyes, different tongues, different hands and different speeds of thought, but what are those quiet, vast chasms no one has ever mapped? I wonder still. Miguel asks, there is a lot there to think about. But finally, Barbara, I have been asking folks if they could tell us an event or campaign that particularly moved them during the emergence of RPS. So can you do that, please? You might think it would be something in my own garden, those powerful pharmaceutical protests, the healing hospital occupations, and yes, those and many others in the House of Health stirred my soul. But the truth, I've long been a lover of the silver screen. Stories move me. Images stay with me in ways I cannot see in my mind, but I can feel. So I have to say the film, The Next American Revolution, the beautiful rupture of that Oscar night, and then most of all, the Hollywood strikes left me deeply inspired. Some of it was joy, poor, pure and simple, born from admiration and long held passion for film. But beyond that, I felt the deep rumble of class truth rising from these events. That call to confront the great divide, the naming of coordinators and workers, the challenge to job privilege. I felt it all, and I thought we in medicine, we too could rise like that. We must. I did not think I was alone. I believe the hospital renovations movement that came not long after walked in the footprints of those artists. Their courage lit a path we were just beginning to see. Miguel asks, Emiliano, from his session in Chicago, healthcare is partially about what goes on in hospitals, but it is also about the companies that provide medicine and about how the rest of society's institutions produce health or illness. What were some of the early inclinations about each? Well, the class stuff, seeing how hierarchy worked inside the hospital was huge. And same with what we already knew about race and gender. But here's the thing. You work in a hospital. Every day you see the consequences of people getting crushed, pollution, price gouging on meds, kids shot or addicted or starving, and it builds up. You either shut yourself down so you can function, which, by the way, is basically what you're trained to do, or you get mad enough to do something about it. You can't see this stuff over and over without breaking a little, or maybe you do break, but instead of folding inward you fight back. Unless that is you numb yourself out. I remember going to India once, way back, maybe a little before all this, a political conference. I'm in Mumbai riding around with this revolutionary guy. We're hitting stoplights and getting swarmed by people begging. Hard to describe unless you've lived it. Kids, elderly, sick, in your face, and I'm falling apart just watching, hearing. Meanwhile, my host, calm, chatting, like nothing's going on. So I ask him how can you stand this? And he tells me straight up I don't see it anymore. I can't see it. I had to turn it off. And he wasn't lying. He had to do that, because if he didn't, the scale of suffering would freeze him in place, paralyze him. To tune out was a survival mechanism. But and this is important, most people who go that route lose something else too. They get cold, not just protected, numb. And once you lose the ability to feel, to empathize, you're not just avoiding pain. You're also helping to maintain the system that creates it. He wasn't like that. He was the rare exception. But still, it stayed with me. Another time, talking to a well known new left activist, she told me something that clicked. Back in the sixties she could feel everything, rage, hope, grief, because she had ways to act on it. You feel something, you march, you organize, you're right. But years later, those outlets closed up. And since she couldn't do anything with the intensity she still felt, she had to shut it down, tune it out. Same dynamic, different place. Miguel asks, and this is why MAGA leaders said empathy was an enemy, we have too much? Exactly. Empathy breaks the machinery. Empathy says, hey, that guy matters, and systems of oppression can't survive if too many people actually believe that guy matters. So of course they frame empathy as weakness. But here's the thing, in my hospital, I realized we were living the same dynamic. Again, different words, different setting, but the same basic survival logic. You tune out emotionally to stay sane. In context it makes sense. It is deemed wise, essential. But if everyone does it, you end up reinforcing the same system that's driving people into misery in the first place. Miguel asks, seems like a na a nasty call de sack for resistance. It is. It's a trap. You either go numb to survive, or you feel too much and can't act. Yes, and what really helped to short circuit this awful cycle, where people tune out suffering just to survive, is large scale activism. Big enough and deep enough that it gives people space to actually feel again. Feel empathy, feel outrage, feel hope. Miguel replies. Coming from the other side, it reminds me of imperial soldiers, everyday police, even well meaning leftists, too often brushing aside the humanity of those they're up against. They reduce people to something less than human, pigs, vermin, not out of malice alone, but to make it easier to carry out their orders, their oppression, even their rebellion. The logic is disturbingly similar. Yes, I believe it is the same trick. You don't want to believe you're hurting another person, so you change how you see them. The second you convince yourself they're less than human, the easier it is to shoot, crack skulls, pass cruel policies or just look away. In the health realm, that same logic ran deep. It was literally taught to doctors, especially surgeons, tune out to be a good doctor. So we pushed back. We boycotted on healthy products. We went after farmer execs who bribed doctors to overprescribe. We demanded single payer care, rural health expansion, and school based treatment programs. Some of it was organizing, writing letters, marching, but a lot of it, maybe the most important part, was proving it was possible not to not be a jerk, possible to pay attention, to care, possible to act without arrogance. That spirit came to a head with the National Nurses March. Two hundred thousand of us traveled to and marched in Chicago. Tens of thousands more walked off jobs across the country. It wasn't just the size of it, though that was stunning. It was the tone, the feel of it, the teachings, the chance, the energy, anger, hope, and dignity all boiling over. That march lit the fire for everything that followed. It helped launch campaigns to change medical school curriculums. It targeted toxic internship culture, turning that hazing nonsense into something actually supportive. It created real change, but it also created a path for more change, and most of all, it reminded us that it was still possible to be good to each other, that we didn't have to keep crawling through the muck we'd been thrown into. Miguel asks, Can you tell us of a very personally pivotal event for yourself over the years? Sure. It's not something I usually talk about, and honestly, it wasn't pretty, but okay. Back when RPS was gaining strengt steam, I was at work doing my job, and yeah, talking politics with anyone who'd listen. Nurses, sure. A few doctors, even some patients. I didn't push, but I didn't hide it either. So one day I'm in the cafeteria having lunch with a psychiatrist I'd worked with. We knew each other, had a decent rapport. My nursing work felt focused on mental health, so we had collaborated many times. But that day, things got heated. We were talking about broader campaigns, nothing personal, and something I said hit a nerve. He took what I said to me he didn't care enough, that he was classist toward working people. What I said wasn't about him personally or even about psychiatrists, but that's what he heard. And to be fair, after thinking about it later, I suspect I didn't hide my feelings very well. I was frustrated with the way most professionals dismissed worker concerns. And if you looked at my face or heard my tone, I bet it showed. Anyway, suddenly he jumps up, leans over the table, practically on top of me, nose inches away, yelling, red faced, furious. I really thought he was gonna punch me. He called me cold, manipulative, power hungry, said he was the one who cared about people, that he treated patients with dignity, that I didn't understand anything. It stuck with me, not just because of the intensity, but because it raised two hard questions. One, how do you talk about class dynamics, especially coordinator versus worker stuff, without making people shut down and take it as a personal attack? And two, why did he react so strongly? This was a guy trained to stay calm under pressure. It wasn't like I accused him of something awful. It was more like I poked something he already feared was true. That's what I think set him off. If what I'd said had felt ridiculous to him, he would have just laughed. But it didn't feel ridiculous. It felt plausible. It rang a little too close to home. And that taught me something else. Sometimes the people who are closest to seeing a hard truth, who have maybe started to suspect it themselves are the ones who fight you hardest when you name it out loud. It's almost like they're fighting to keep themselves from having to fully see it. I bet a lot of folks in RPS have stories like that. Hopefully we all learned from them. Ultimately, about health care, we asked basic questions. What's making people sick? Who's profiting from that? What would actually help? Not just patch up damage, but change the system so the damage didn't happen in the first place. And that worked, like flipping on a light switch in a dark room, and of course it didn't stop at the hospital or clinic door. And so ends the chapter, and thus this episode. A presentation like never before. I couldn't stop myself, from a book that conveys an oral history of a revolution in another time and another place, very, very much like our own, which seeks to attain a participatory society, which some of its advocates prefer to call participatory socialism, thereby revealing what they mean institutionally as well as strategically by their use of that term, me included. And so, all that said, this is Michael Albert, signing off until next time for Revolution Z.