On Dessa and the Novartis Brand of Biomedical Engineering: Part 5
Examining the intersections of music, politics, the personal, and monopolized healthcare.
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The following is the fifth, and final!, post of a serialization of an essay concerning monopolized cancer therapy and the hip-hop artist, Dessa - among other things.
If you haven’t already, you can read the first posting here, the second posting here, the third posting here, and the fourth posting here.
For those monopolized healthcare nerds out there, Part three and this Part five are your jams. (I recommend reading them sequentially, since that’s what makes the most sense, but who am I to tell you what to do?) Enjoy!
VI.looks like gender’s over race came back faith is a hammer with a book for a handle and people in power can edit the past can put your hands behind your back to read you someone else’s rights first the sirens then the lights that looks like your ride
– Dessa, “Ride”1
For your consideration:
To those around the world who have made their voices heard on these issues — particularly our associates — we hear you and we see you. Our promise today is an acceleration of both existing diversity and inclusion efforts, as well as implementation of new ones. This is the beginning of a new, purposeful journey to engage in these issues and help right the wrongs of history.2
Thanks, Novartis, for that boilerplate corporate drivel regarding the movement for black lives. But here’s why I don’t believe you:
Communities of color have less opportunity for access to quality healthcare. People of color are also more likely to be forced to live in impoverished areas where they are exposed to more health hazards and have less access to healthy food products. Whether its being exposed to lead poisoning in Flint, Michigan, or living in close proximity to factory farms that dump toxic animal waste, or working in agriculture and being exposed to pesticides, or living in a food desert with limited or no access to fresh, whole, nutritious foods; communities of color are too often impoverished, vulnerable to environmental degradation, and lacking sufficient healthcare. As such, they are disproportionately affected by health crises
As pointed out in an article in the Democratic Left magazine, “Although there are environmental factors, lack of healthcare coverage is a major cause of these health disparities. African Americans, who have lower incomes than non-Hispanic whites, are more likely to be uninsured. Thus, they put off receiving care, forgo routine doctor visits, and cannot afford the prescription medicine that could help them.”3 The disproportionate poverty in these communities is often due to the fact that these communities do not have the same kind of generational wealth built up as the rest of the country and, due to a myriad of factors – underfunded education, punitive police practices, housing discrimination, job discrimination, the diseases of poverty – are systematically locked out from being able to ascend the socioeconomic ladder.
You know what would go a long way towards remedying these inequalities? Institution of universal healthcare free at the point of service and thus a dissolution of private health insurance companies; a refusal to allow pharmaceutical companies to patent and own life-saving drugs and therapies at the expense of patients’ money and lives; enforcement of antitrust laws to breakup big, monopolistic pharmaceutical companies.
But none of those things would be good for Novartis’ bottom line. So they won’t support it. And they’ll just say that governments are the ones in charge of ensuring quality healthcare in their own countries, so don’t look at us, we’re just a big corporation trying to make some money. According to Novartis’ own statement of values, they say that “governments are primarily responsible for establishing functioning health care systems,” and that governments need to play their part by “ensuring sufficient funding of health systems.”4 Yeah, that’s great, but here’s the problem – Novartis just can’t stop itself from bilking patients by setting the highest possible prices, as well as – get this – defrauding taxpayers and government-funded healthcare systems!
In 2020, Novartis paid $678 million to settle a fraud lawsuit over bribes the company gave to doctors to get them to prescribe drugs owned by Novartis. This scheme went on for over ten years. Doctors were treated to lavish meals, gifts, entertainment, and vacations all on Novartis’ dime with the express purpose of inducing these doctors to sell their drugs. And who paid for these drug prescriptions? Well, most of them were paid by Medicare, Medicaid, and VA benefits – the U.S. taxpayers, you and me.5 This is not the only case.
In 2010 Novartis paid $422.5 million to settle a whistleblower lawsuit against it for having, again, bribed and paid kickbacks to healthcare professionals to get them to prescribe Novartis’ drugs to their patients.6 What happened to all that free-enterprise horseshit? Shouldn’t a company be able to sell its drugs by offering a better product instead of bribing doctors? Novartis behaves more like a cartel intimidating and conniving its way out of actually competing with other companies. Nobody went to prison for this fraud, as would be expected in a country where corporations and Wall Street can do whatever the fuck they want with impunity but if you possess a single gram of crack you’re going to prison for the rest of your life.
After these lawsuits, Novartis got itself a new CEO, Vas Narasimhan, a former researcher at the company, and it now says that it’s more committed to its stated ethics and values. Trying to apply ethics and values to a private for-profit pharmaceutical company is like trying to mix oil and water. The very nature of its business is both undemocratic and unethical.
Novartis doesn’t give a shit about equality or affordability in healthcare. It only cares about expanding its market to as many people as possible. It will only behave in ways that do not threaten its business model. This means that it will vigorously hold onto its patents and argue for its right to charge people whatever it thinks is appropriate, and it will work with governments to ensure that this remains the case in perpetuity.
Besides lack of healthcare, do you know what else communities of color disproportionately suffer from? Criminalization of drug use. Hundreds of thousands of people are incarcerated in this country for non-violent drug offenses. In 2008, of those serving prison sentences for non-violent drug offenses, over 62% were black.7 You know what would go a long way towards remedying that problem? Full legalization of marijuana and decriminalization of all other drugs. You know, to treat drug use as a health issue instead of a criminal justice issue. But do you know who doesn’t support that? Pharmaceutical companies and their strange bedfellow – private prison corporations.
As Dean Baker points out, “Pharmaceutical companies that produce pain relief medication have been leading the fight against medical marijuana . . . There can be major consequences for public health as patients take stronger and more addictive medications when marijuana may be an effective treatment.”8 Pharmaceutical companies are no different than street drug dealers staking out their territory, pushing their products onto the populace, bribing doctors, and making sure that no other alternatives are available – and if those illicit drugs are available, making sure that you’re put in prison for using them. Sorry, street drug dealers are different – they mostly get criminalized, whereas pharmaceutical companies are completely immune from criminal charges and have the express support of entire Western governments. One could argue that the opioid epidemic, orchestrated by these drug-pushing corporations and exacerbated by poverty and cultural despair, has been just as damaging as the morally bankrupt war on drugs.
Here’s a little story. I have a roommate who works at a café. One of his coworkers recently spilled boiling hot cooking oil all over his hand. He went to the hospital with second-degree burns. The doctor prescribed him opioid pain medication. This man is a former heroin addict. He has been going to a methadone clinic and remained sober from heroin for over a decade. And now he’s been prescribed an opioid, no questions asked. Like it was candy. What the fuck? Good luck man, hope you don’t overdose.
Pharmaceutical companies are completely aligned with private prison companies on this issue. As journalist Glenn Greenwald writes, “Prison companies have been expending vast resources to combat drug policy reform. The corporations fear an end to their greatest source of income: the incarceration of hundreds of thousands of citizens for nonviolent drug offenses.”9
When you, Novartis, are on the same side as corporations that are playing a key part in the evil mass incarceration system, I have no reason to believe a single word you say as you make shallow, virtue-signaling pronouncements of “we hear you, we see you.” These statements mean nothing. They are the carefully selected words of an HR department trying to cover its own ass.
I would love to hear a company like Novartis actually name the systems of oppression. Let them contort themselves as they speak in the liberal language of equality out of one side of their mouth and out of the other side they whisper for favors, good tidings, and cooperation from government contracts, private health insurance companies, anti-labor litigators, and private prison companies responsible for our expansive carceral state. Our resources are given over to corporations so they can sell them back to us as they see fit, completely beyond the scope of democratic control, and thus worsening our unbearable inequality – the very kind that Novartis says it is devoted to “help right.”
This privatization and resulting public resource depravation has caused the worst inequality this country has ever seen as well as the destruction of our key infrastructure. As Levon Helm, the drummer and one of the lead singers of The Band said after visiting his birthplace in rural Arkansas, “They sure are killing this country, I know that. My hometown is gone, I mean it’s just gone. There ain’t been a new bridge or a new road or school. The only thing they build is jailhouses.”10
How dare these companies speak in the language of equality when their whole business model is predicated on wealth extraction, on destruction of social services, on privatization of public goods. As jobs are moved overseas and human bodies are commodified in captivity, the prison industry takes over entire communities.
The imprisoned radical Mumia Abu-Jamal described this phenomenon perfectly:
This prison system is here to stay. The poor and the destitute feed it. It is the empire’s solution to the economic crisis. Those who are powerless, who have no access to diminishing resources, get locked away. And the prison business is booming. It is one of the few growth industries left. It used to be that towns didn’t want prisons. Now these poor rural communities beg for them. You look down the list of the names of the guards and see two or three with the same last names. This is because fathers, brothers, spouses, work here together. These small towns don’t have anything else.11
Profit motives must be extricated from the healthcare industry and from criminal justice. Profit seeking will necessarily perpetuate fraud, inequality, and injustice. Corporations will look for ways to cut costs regardless of the consequences for workers and the larger public. As professor Elizabeth Anderson notes:
[W]hen prisons are converted from public to private, for-profit enterprises, guards simultaneously suffer huge wage cuts and large increases in violent assaults by prisoners, because their employers also cut staffing levels so low that not enough guards are available to control the prisoners. Inmate attacks on staff in federal prisons increase by 260 percent.12
This fervor for privatization is based on a false notion that private industries are more efficient and therefore produce better services than government systems. But as we have seen recently, when privatization is applied to public goods and services, we get energy infrastructure in Texas that fails on a mass scale during winter storms, resulting in people freezing to death and the survivors being charged tens of thousands of dollars for energy bills. We get a reduction in spending on upkeep and repairs of powerlines, resulting in faulty equipment in California that causes fires which destroy entire towns, such as Paradise, California which suffered 85 deaths at the hands of the energy monopoly PG&E. Such examples are legion. Many books have been written just on how our privatized healthcare system makes us sicker, poorer, and deader.
With privatization, we also get corporate media outlets that fail to question political power centers; we get private military contractors – a polite euphemism for mercenaries – that perpetuate violence abroad in order to justify their existence; we get prisons that rely on a steady stream of inmates to do slave labor; we get monopolized pharmaceutical companies that dictate their maxims on a global scale. Mercenaries need someone to kill. Private prison companies rejoice in recidivism. Healthcare companies have little incentive to cure their patients. A foreign “military-aged male,” a powerless prisoner, and a sick patient are all paychecks. If a company like Novartis was actually serious about their equality statements, they would cease to be a for-profit business.
Not only does Novartis have a stock-standard statement on the Black Lives Matter movement, they and every other odious corporation has a whole diversity, equity, and inclusion program. Novartis is devoted to ensuring equal gender representation in management by 2023.13 Fuckin’ great. But do you know who would benefit disproportionately from Medicare for all and the abolition of medical patents? Women.
Not every woman is going to be able to be a successful, high-level pharmaceutical employee with employer-sponsored healthcare. What of the rest? As the writer Natalie Shure points out, “Women live longer than men, spending years on a fixed income during the phase of their lives when care is most expensive, leaving them open to critical gaps uncovered by Medicare or Medicaid.”14 I had this same point driven home to me while I was working at a food bank and passing out food at a mobile home park. An elderly woman who lived there and was volunteering to distribute food pointedly told me, “You men need to take better care of yourselves. You work yourselves to death and then you leave us women alone to fend for ourselves.” She pointed out to me all of the women who were receiving food and who lived alone in their advancing years. They were lucky if they had a family member who could help take care of them. The burden of caring for elderly family members often falls on their women children, causing them to miss work or become fulltime unpaid caregivers. And that’s just fine as far as the pharmaceutical industry is concerned.
As Shure points out, in the same way that universal access to paid maternity leave, birth control, and abortions helps to level the playing field for women in the workforce,
[U]niversal access to free healthcare from the point of use would do much to liberate women from the yoke of bosses and family members and reduce the amount of suffering to which they or their families can be subjected. By relieving U.S. women from being forced to consider healthcare as a budget item or a reason for marriage or domestic partnership, we can guarantee women more autonomy and freedom when it comes to their time, stress, and family choices.15
Medicare for all and lower drug prices would also be beneficial for labor unions and worker-led movements – organizations which could represent everyone, not just rich pharmaceutical executives. Currently, labor unions cannot sustain their demands of healthcare benefits for workers in a monopolized system that continues to drive medical costs through the roof. And when unions try to secure healthcare benefits by accepting bad concessions where benefits are cut for new union members in order to preserve them for current members, a wedge is driven between working-class people who receive these benefits and those who don’t. Fighting instead for Medicare for all will remove this particular divide-and-conquer problem. As pointed out in the Democratic Left magazine: “Unions find it hard to champion their members’ decent benefits when most other workers are losing theirs.”16
But companies like Novartis don’t support these measures. Universal healthcare, patent abolition, and monopoly breakups would drive down their prices. So they just support diversity quotas in their hiring practices so that the makeup of their odious business is more colorful and feminine. This is the same mentality that the military, CIA, and other intelligence agencies use to recruit more diverse personnel. It allows the military to commit war crimes against black and brown people abroad and justify its actions because those war crimes are being committed by black and brown Americans. The most recent defense spending bill, passed with overwhelming bipartisan support, claims that it makes policy changes that, “mirrors society and promotes a more diverse and inclusive military,” even expanding the Junior ROTC program to now include eighth graders.17 Isn’t that wonderful? Now we can have black-trans-bisexual-13-year-olds training to become military officers and leading exploited working-class kids into their valiant soldier’s life of war crimes and psychological devastation.
Having equal representation within systems of death and oppression does not make those systems any less odious. As Barbara Ehrenreich wrote after the revelations of the abuses and torture at Abu Ghraib prison, famously perpetrated by both men and women:
The struggles for peace and social justice and against imperialist and racist arrogance, cannot, I am truly sorry to say, be folded into the struggle for gender equality. What we need is a tough new kind of feminism with no illusions. Women do not change institutions simply by assimilating into them, only by consciously deciding to fight for change. (. . .) In short, we need a kind of feminism that aims not just to assimilate into the institutions that men have created over the centuries, but to infiltrate and subvert them. To cite an old, and far from naïve, feminist saying: “If you think equality is the goal, your standards are too low.” It is not enough to be equal to men, when the men are acting like beasts. It is not enough to assimilate. We need to create a world worth assimilating into.18
Capitalism is extremely adept at turning any one of us into monsters regardless of our identities and backgrounds. Our corporate state can only function if there is a permanent underclass. Wars of aggression are fought in order to maintain U.S. empire by siphoning other countries’ resources and making sure those countries remain appropriately subservient to U.S. mandates; while at home, people of color and the poor are subjected to daily injustices and indignities. If people try to fight back against oppression, police brutality, and the degradation of their human rights, then they are labeled as criminals and terrorists and thus further deprived of their rights. It’s okay for the state to commit mass murder abroad, nobody goes to jail for the millions of dead Iraqis, Afghanis, and Yemenis. But if people try to defend themselves against militarized police forces at home, they are surveilled, thrown in jail, or murdered.
When a mass shooter goes on a rampage and destroys the lives of dozens of people, he is rightly imprisoned or even killed in order to stop his rampage. But when the state violates international laws, treaties, and the sovereign rights of nations by engaging in wars of aggression, when it violates its own constitution by waging war without congressional approval and this war causes the death and injury of millions of people, when it establishes a global kidnapping and torture system and throws people in prison without charges or a trial, when U.S. citizens are murdered in drone strikes without any due process, then who is imprisoned? What law officer stops the state from continuing its murderous rampage? How may the victims of these crimes seek and gain restitution and justice?
The state violence that is perpetrated abroad is also visited upon the state’s own citizens in the form of police violence, mass incarceration, criminalization of dissidents and whistleblowers, and mass domestic surveillance. The people most harmed by these domestic acts of state terror are people of color. When marginalized people organize themselves and try to protect their communities, they are demonized as unpatriotic traitors whose acts of self-defense are characterized as unjustifiable – in contrast to the wholly justifiable wars of aggression and profit perpetrated by the state. Howard Zinn described this disgusting hypocrisy during the civil rights movement:
Are the security needs of the United States in the world more pressing than the security needs of the black person in the ghetto? If the U.S. violence in the world is justified because of “danger” to its way of life, then surely the black person can justify violence because with him the danger is not just approaching; he is already encountering it; it has already harmed him.19
And yet, self-defense against state violence is never countenanced by those in power. People must either submit to it or else be imprisoned or murdered. Civil rights leaders such as Fred Hampton, Malcolm X, and Dr. King are gunned down. Whistleblowers such as Daniel Ellsberg, Edward Snowden, Chelsea Manning, and Julian Assange are labeled as enemies of the state and thus imprisoned or banished. These figures are allies of the people, and thus necessarily they are enemies of the state, because the state in its current form is an enemy of the people. And the state has slowly become synonymous with corporations, an essential tenant of fascism.
The rule of law applies only to the citizenry of the state, most particularly to the mass of poor and powerless citizens. The rule of law does not apply to the state itself or to its corporate masters. Wall Street is constantly bailed out and given slaps on the wrist for the fraud it perpetrates on the country, while regular people lose their savings, are evicted from their homes, and become criminalized for sleeping in their cars or out on the street.
The dominant ideology of neoliberalism, which every corporation wholeheartedly believes in, is not a friend of the poor and working class. Every diversity, equity, and inclusion statement made by these companies must be viewed with suspicion. To put it simply, if a corporation is saying it, that means it isn’t threatening to them. As the journalist Aris Roussinos wrote in regards to corporate responses to the Black Lives Matter movement: “Are we to believe that the entire oligarchical and corporate class which runs Western economies are submitting themselves to a moment of real revolutionary force, or instead that they recognise in it a powerful source of counter revolutionary power against the inchoate political uprisings of recent years?”20
Corporations are attempting to substitute identity politics for actual, substantive change. They think that they can get away with their deprivations so long as enough of us are brought under their banner. But this does not get rid of the very real pain which they cause, the victims which they inexorably create. A CEO is still a CEO no matter what gender or color. As Cornel West said, “we tried black faces in high places, it didn’t work.”
The ruling class is seeing the threats which they have created rising up all around them and they will pull every trick in the book, short of taking full responsibility for their actions, to assuage the rage that is coming. But they will never truly transform themselves because they benefit immensely from the way things are. However, their profit-seeking systems are unsustainable. They create too much animosity among a populace that sees their lives torn asunder. An economic system that relies upon the subjugation of whole countries creates many dangers for itself. The oppressed will never cease fighting back in whatever ways they can.
For example, right now in Haiti there are protesters fighting against what they see as an illegitimate U.S.-backed president, Jovenel Moïse. Typically, if the U.S. supports a particular foreign leader it is because that leader is sufficiently deferential to U.S. hegemony, even at the expense of the welfare of their own citizens. These are the words of one of the Haitian protestors:
We, the young people, are the path to the liberation of Haiti. We will continue fighting until we regain sovereign status. Because we know that it is the Americans, foreign powers, the Organization of American States, and the U.N. who are supporting President Jovenel Moïse, it is they who support these thieves. I send a message to Joe Biden and to them: I know that our resources interest them, but we continue fighting to regain our sovereignty.21
This is not difficult to understand. When people feel that they are oppressed, they will fight back. This is an innate human expression of self-determination. It is the reason why a “war on terror” is destined for never-ending failure. War and occupation give every reason for the besieged citizens to resist the occupying forces with all of the might they can muster. As Erik Edstrom, a West Point graduate, combat veteran, and former platoon commander in Afghanistan writes in his book Un-American: A Soldier's Reckoning of Our Longest War:
The people who were trying to kill me weren’t international terrorists. They weren’t attacking me because “they hate our freedoms” or some other bullshit Bush-era line. They were angry farmers and teenagers with legitimate grievances. Their loved ones, breathing and laughing minutes before, had been transmuted before their eyes into something unrecognizable. Like someone hit a piñata full of raw hamburger meat. They were now little more than stringy sinew and bloody mashed potatoes dressed up in tattered rags. That’s what rockets fired from a pair of U.S. Kiowa helicopters do to civilians.22
Military violence that perpetuates such dire grievances abroad creates its own everlasting enemies. And an economic and political system that enforces depravation, resource extraction, and surveillance upon foreign adversaries will eventually turn domestic and eat itself. The actions we commit abroad are but dress-rehearsals for the systems of control we bring back home. James Baldwin had a keen understanding of this when he wrote:
For a very long time, for example, America prospered – or seemed to prosper: this prosperity cost millions of people their lives. Now, not even the people who are the most spectacular recipients of the benefits of this prosperity are able to endure these benefits (. . .) they cannot, or dare not, assess or imagine the price paid by their victims, or subjects, for this way of life, and so they cannot afford to know why the victims are revolting. (. . .) Furthermore, it is ultimately fatal to create too many victims. The victor can do nothing with these victims, for they do not belong to him, but – to the victims. They belong to the people he is fighting. The people know this, and as inexorably as the roll call – the honor roll – of victims expands, so does their will become inexorable: they resolve that these dead, their brethren, shall not have died in vain. When this point is reached, however long the battle may go on, the victor can never be the victor: on the contrary, all his energies, his entire life, are bound up in a terror he cannot articulate, a mystery he cannot read, a battle he cannot win – he has simply become the prisoner of the people he thought to cow, chain, or murder into submission. (. . .) The representatives of the status quo are sickened and divided, and dread looking into the eyes of their young; while the excluded begin to realize, having endured everything, that they can endure everything. They do not know the precise shape of the future, but they know that the future belongs to them.23
The representatives of the status quo know what is coming. They have failed to address the inequities they perpetuate. Instead of submitting themselves to democratic control, they will grip ever more tightly to their systems of power and will extract all that they can before the world goes up in flames. They will adopt our language as their own. They will seek out representatives of populist movements that they can buy out and control. This form of coopting is especially insidious. As journalist Chris Hedges points out, “The elevation of women, people of color and those with different sexual orientations to managerial positions in the oligarchic state is not an advance. It is a species of corporate colonialism. It is branding. It is the substitution of cultural politics for real politics. [emphasis added]”24
These corporate placating actions come at the expense of any real reckoning with what these elites have wrought. As inequality soars, environmental degradation continues unabated, forever wars enjoy bipartisan support, and a two-tiered justice system criminalizes those who speak out while protecting those who perpetrate fraud and mass murder, the powerful retreat into Versailles-like underground bunkers.25 They believe in their greed and consider themselves the chosen few, looking on with disdain at the lower classes, caring not for the coming catastrophe: “apres mois, le deluge,” after me comes the flood.
This class-based rage is essential for understanding our current sociopolitical climate. You do not get to where we are now, with violent right-wing populist movements gaining traction and power, without political figures being able to capitalize on economic anxieties and all of the attendant repugnant views that come along with those anxieties.
Here’s a little story. In 2016 I was attending school at Southern Oregon University. This school is the poster child for liberal, inclusive policies. Other universities would look to SOU for guidance with implementing diversity, equity, and inclusion programs. I was in the theater department at SOU, a traditionally liberal, artsy major in an already liberal-leaning school. It was here that I was first introduced to the concept of stating your gender pronouns. There were regular drag shows, pride events, and “erotic balls.” It was here where I first heard someone complain that old gay white men were not sufficiently radical by virtue of their cisgender identity. It was in that town where I attended the first Women’s March in 2017.
While I was happy to be exposed to these viewpoints, and have since seen many of these inclusion strategies adopted at other theater companies that I’ve worked at, I was also happy to not be living on campus while going to school. I lived in a low-income housing complex in Medford, Oregon – a decidedly much more conservative and poor city with high crime rates and meth problems. It was in this building where I received perhaps the most illuminating educational experience during my two years in Oregon. I saw some of the lowest of humanity, people who are invisible, people who would be ridiculed or feared by my classmates. I lived with them, and as such I saw their undeniable humanity, their undeniable worthiness of the same care, consideration, and resources as anybody else. I knew that the people I was living with would consider the language of my classmates and professors to be utterly alien, even intolerable to listen to.
I also remember going to the bucolic pond at Lithia Park in Ashland and meeting a man named Squirrel. This man was itinerant looking. He was older, perhaps in his mid-sixties, with a grey goatee and a shabby leather hat. His voice and manner of speaking reminded me very much of Charles Manson, only slightly less batty. Squirrel came to the pond every day to feed bread to the ducks. He had given names to the three ducks, who had learned to expect bread from Squirrel. “Hi ducks!” he would exclaim, and the ducks would paddle over to him as fast as they could. “Their names are Bully, Sneaker, and Daffy,” he told me. Bully was so named because he would chase the other ducks away from the food. Sneaker would try to sneak up behind Bully to get the food. And Daffy just looked like Daffy Duck.
Squirrel complained to me about being lonely. “All these young hippies get all the ladies. It’s because they have weed,” he said. Squirrel told me that the cops harass him. “I can’t sleep anywhere. They don’t like me in the jail. They always send me back.” Squirrel told me that he was looking for a job. “I’m living in the back of a Mexican restaurant right now and doing dishes for $4 an hour.” Squirrel said he was getting desperate. “I should go down there,” where he was referring to I do not know, “with a .45 and point it at the guy’s head and tell him to give me a job.”
The day after the presidential election of 2016 was a dour day on campus. Everything felt subdued. My first class that day was an intro to theater class full of incoming freshman. Many people were crying. We spent the whole class talking about the election and its import. People were understandably despairing and afraid. They felt as if hatred and bigotry had triumphed. A friend of mine wrote to me:
I got really scared when Trump became elected. I laid in bed and cried the whole night. I wasn’t scared for myself, I was scared for my family. Growing up in such a white little town, my parents got a lot of hate for being together. Like god forbid a fucking brown girl to marry a white man. How silly is that? I would get scared my mom would get screamed at and she did. She went in to work the next day with a Confederate flag hung up on her front door. I was scared my grandpa would be deported. I still am scared. I am scared my family would get split up.
This is a real fear and it has a real foundation to it. People in historically marginalized groups had every right to be afraid given the horrible rhetoric preceding the election. But the problem with the way the election was largely depicted was that it treated racism, bigotry, and homophobia as the cause instead of a symptom. I looked around at my grieving classmates, their adherence to liberal pieties, and I couldn’t help but think about the impoverished, addicted, religious, and disabled people that I lived with. I thought about Squirrel. That man was ready to POINT A GUN AT ANOTHER MAN’S HEAD just to demand a job. You cannot tell someone in that situation that they need to be nicer. You cannot wag your finger at someone like that and tell them that their problem is that they’re just a stupid racist. That way of defining the problem solves nothing. Finer, educated people being shocked that the country voted against decency speaks to how utterly disconnected they are from their fellow citizens.
What can help explain the unleashing of bigotry and hatred? Professor Ronald F. Inglehart, whose Evolutionary Modernization theory wins the award for least compelling and most likely to overstate itself but which I nevertheless mostly agree with, posits that a society’s perceived existential security is closely related to that society’s values. Very basically, Inglehart argues that if existential and economic security are precarious, then a society is more likely to emphasize materialist values, namely: hard work, traditional gender roles, collectivism, subordination to authority, religiosity, etc. However, if existential and economic security are firm, then a society is more likely to emphasize post-materialist values, namely: secularization, self-expression, tolerance of diversity, democratic participation, etc.
Based on responses to his World Values Survey, Inglehart concludes: “To a remarkable degree, a society’s values and goals reflect its level of economic development.”26 But he also emphasizes a complicating factor, that cultural change in a society is not simply economically deterministic but also influenced by its own particular history. He says a society’s cultural traditions and belief systems have “remarkable durability and resilience.”27 This is how you can get nations, such as Ireland or the U.S., both with strong religious backgrounds, that have relatively high existential and economic security but comparatively lower levels of secular-rational values.
This leaves us with the proposition that any progressive policies and labor organizing must take into account economic security as well as cultural and social issues such as gender and racial equality. These two areas must go hand in hand in order to achieve lasting and widespread change. One without the other leaves us with a shaky foundation.
Policies which focus solely on economic development run the risk of perpetuating historical inequalities along gender and racial lines, such as what we saw with some New Deal programs not giving a fair shake to black Americans and leaving many blacks to fend for themselves against the terror of Jim Crow and the devastation of redlining. On the other hand, policies which focus only on gender and racial equality are liable to perpetuate the globalist capitalist nightmare we currently live in which doesn’t care what color or gender you are, it will still make you subservient to the almighty dollar.
The fact is that if people are anxious about their economic security, then they are much more likely to display authoritarian parenting styles, bigotry, and adherence to traditional gender roles. This even applies to minority and disenfranchised groups. As historian Lillian Faderman demonstrates, in the U.S. in the 1950s there were strong class distinctions between lesbian subcultures. Working-class lesbians largely fell into the “butch” and “femme” categories, mirroring the traditional gender roles of men and women in the dominant hetero culture. “Roles were in a sense the path of least resistance within the communities of young and working class lesbians,” Faderman writes, “They provided the subculture with a conformity and a security that answered longings that mirrored those of heterosexual America, in which all members of the subculture had been raised.”28 This working-class conformity to traditional gender roles is in accordance with Inglehart’s findings that lower economic security is associated with emphasizing materialist values.
These working-class lesbian values stood in contrast to the middle-class lesbians of the time, who were much more egalitarian in their relationships. Since middle-class lesbians were very much a part of the dominant parent culture, having successful careers and passing by as straight women, any attempt by them to behave in overtly lesbian ways as the butches and femmes were doing would have been disastrous for their carefully cultivated lifestyles.
But more than that, these class differences brought up a fascinating question and dynamic. Namely: which side was truly the more radical? Faderman explains that the two classes resented each other over how the other side displayed themselves. She references a middle-class lesbian who, “like many lesbians outside of the working class, was troubled not only because butches were aesthetically displeasing to her, but also because it seemed to her that butches acquiesced to conformity by looking stereotypically like males just because society said those who loved women were supposed to be male.”29 And on the other side, the working-class lesbians felt that the middle-class “kiki” lesbians were the conformists. “The disdain was mutual,” Faderman writes, “Butches and their femmes thought these ‘kiki’ women were the ones who were buckling under by dressing like conventional women. It was something of a class war.”30
Who was the more transgressive? The ones who openly cross-dressed and went out to lesbian bars? Or the ones who formed egalitarian relationships between women that were much more equal than what could be found in the dominant hetero culture? Whatever your answer to this question, the fact remains that lower and working-classes – the economically anxious – are more likely to adhere to or imitate traditional gender roles and values.
Another point worth examining, and which the lesbian-feminist movement of the ‘70s can be used to explain, is that economic anxiety is likely to cause the prioritization of certain social demands at the expense of others. In the 1970s, the radical lesbian-feminist movement was largely populated by white women. Lesbians of color felt suspicious of the movement because it seemed to relegate race issues aside in preference of gender.
But as Faderman explains, lesbians of color would have had much to gain from the lesbian-feminist movement given the lack of acceptance of homosexuality in black and brown communities. She writes that “homosexuals were generally more outcast in those communities than in many white communities, because the minority racial and ethnic communities tended to be working class and particularly rigid about machismo and sexuality.”31 Again, an economically anxious community is less likely to be welcoming towards difference and pluralism.
But lesbians of color felt that race issues were more important than strictly feminist issues. Faderman quotes one Latina lesbian, who became disillusioned with the largely white lesbian-feminist movement, as saying: “We are fighting for survival – jobs, housing, education, and most importantly struggling for a sense of dignity in a country dominated by whites . . . Our problems are immediate, not long range.”32 Here we see lesbian-feminist demands for gender equality subordinated in preference for more immediate needs related to “survival.”
And more than this, lesbians of color felt that a movement based on biological gender could have an ugly side. Faderman writes, “As minority members in a racist society, they also believed that there was a danger in attributing patriarchal corruption to biological maleness. Any kind of argument based on biological determinism was bad, they recognized, since it had often been used by racists to ‘prove’ the inferiority of minorities.”33 And indeed, the lesbian-feminist adherence to biological determinism was so strong that it often led to radical lesbians treating transwomen as outcasts and spies worthy of disdain, saying “a man is a man, no matter what.”34
The point here is that, while calls for progressive policies are important and necessary, those demands must speak to people’s lived experience and to the economic degradation that they see happening all around them. We must have a shared language with people based on our economic realities. Otherwise, progressive policies can be written off as bourgeoisie ramblings by highly educated, elite white folks who know nothing about suffering. As Barbara Ehrenreich points out:
It’s easy for the liberal intelligentsia to feel righteous in their disgust for lower-class white racism, but the college-educated elite that produces the intelligentsia is in trouble, too, with diminishing prospects and an ever-slipperier slope for the young. (. . .) One of the worst mistakes this relative elite could make is to try to pump up its own pride by hating on those – of any color or ethnicity – who are falling even faster.35
I would love to watch a liberal college student explain their socio-cultural ideology to the people I lived with in Medford; to the old woman in a wheelchair with incessant tremors, to the drugged-out couple running around the halls trying to scream themselves back down to some level of sobriety, to the toothless man who pissed in the washers and dryers, to the fucker who stole my birthday present package from my doorstep. That’s not to say that social and cultural issues are not important. Of course they are. We are seeing upticks in violence against the LGBTQ community, particularly against transwomen. State legislatures across the country are attempting to pass anti-trans legislation. Black transwomen sex workers are disproportionately criminalized using archaic “crimes against nature” laws. These attacks against the community must be fought against.
But you are not going to solve those issues by scolding the poor and disenfranchised, by antagonizing people who could be your allies in the movement, by failing to acknowledge the environment that led people into the arms of hatred in the first place. Are those people any less worthy of resources because they don’t have the same views as you? Are those people not entitled to the same fundamental human rights as you? Do those people not have any place in a movement that seeks to upend the powerful, immoral ruling class? If adhering to sociopolitical dogmas is a precondition to being a part of a broad-based, leftist, progressive movement, then that movement is going to have few friends, and mostly impotent ones.
You simply cannot remedy people’s willingness to vote for a demagogue without first acknowledging the symptoms which led them there in the first place. As journalist Glenn Greenwald said in an interview:
You can’t explain what’s happening in the United States, what’s happening in western Europe, what’s happening in Brazil, simply by writing everybody off who voted that way as being a neo-Nazi, or a fascist, or a white nationalist. What they’re looking at are their lives and they’re turning against the ruling class and the dominant ideology, and whoever can come and demagogue and promise to destroy the ruling class they validly blame for their eroding security and for the future of their families, the fact that more Americans up to 30 years old are living with their parents than at any time since the Great Depression, people can’t start families until they’re 35 or 40 years old and maybe then have one child, maybe, if they can scrape together enough money. You get out of graduate school or you go to get a PhD, you’re $150-200,000 in debt and the only jobs you can get are thirteen dollar an hour research jobs with no healthcare. People are furious. Their communities have been stripped of their factories and their jobs have been shipped overseas. Their communities are racked by opioid epidemics and high rates of depression and suicide. These are crucial factors in explaining political realities of how people are voting and why they are voting that way.36
And as we have seen, this rage, a very legitimate and understandable rage, has foreboding consequences. White supremacist groups are becoming more widespread and violent. Police forces openly protect capital and property at the expense of human lives. The pain and depravation that people of color have been subject to in this country since its inception is now being visited upon more members of the white working and middle-classes. People are running into the arms of hate and division. How do we respond to this? Do we choose to antagonize the already powerless? Do we get into shouting matches with poor dumb rednecks? Do we argue amongst ourselves over esoteric Marxist theory?
Or do we work to wrest power away from the ruling elites? Do we work to overthrow illegitimate forms of control such as the totalitarian corporate stranglehold on our atrophied democratic systems of government? Do we choose instead to organize labor along class lines and build collective power? As Chris Hedges writes, “If we do not reincorporate the unemployed and the poor back into the economy, giving them jobs and relief from crippling debt, then the nascent racism and violence that are leaping up around the edges of American society will become a full-blown conflagration.”37 This isn’t just a question of tactics. This is a larger question of properly defining the problems so that we may effectively define the solutions. What we come up with has existential implications.
The United States has gone so far over to the right in terms of economic and foreign policy that legitimate demands for social issues such as gender and racial equality are being subordinated for the immediate demands of housing and jobs. We cannot allow this to be a zero sum game. We can and must fight for all of these things at once. But you cannot accomplish true gender and racial justice without tearing down the ruling neoliberal order. You cannot ensure job security for the LGBTQ community without strengthening labor unions which fight for job security for everyone. You cannot ensure a kinder, more civilized society – one based on free expression and self-actualization, community and solidarity, peace and prosperity – when millions of people aren’t even sure where their next meal is going to come from.
only the rich are afforded– Dessa, “551”38
Here’s the thing: There should not be any private, for-profit healthcare companies, health insurance companies, pharmaceutical companies, or biomedical engineering companies. Anything that is remotely related to the public health and well-being must be publicly funded and administered by public organizations. Or, at the very least, patent protections must be abolished so as to extricate the profit motive from new drug development. Otherwise, healthcare is nothing but a bloated protection racket, a cartel, a den of gangsters bilking their sick customers for all they’re worth and flaunting the blood money in our faces.
It does not matter what corporate stance Novartis takes on the movement for black lives, or how many free treatments it is forced to give away, or how hard it works to expand its market around the globe; none of this changes the fact that Novartis is in the business of making money. It is just one large corporation among a team of corporations that are beyond the reaches of democracy. It is a prime example of corporate tyranny over the lives of people who have no other alternatives.
It’s not just the drugs and therapies themselves that corporations own. They also control all of the attendant infrastructure and bureaucracy that goes into administering their treatments. There are many logistical issues that come with these complex CAR-T therapies and other cell therapies. A private company called TrakCel was founded to get in on the process of tracking, documenting, and ensuring accurate identification along the supply chain of cell therapies.39 Hospitals and doctors do not have the required funding and institutional knowledge to institute these processes themselves. And so we are forced to rely upon private industry at every step of the process.
But if the state could administer its own CAR-T therapies, and if we had universal healthcare free at the point of service, then taxpayer money would go directly towards the administering of these treatments. There would be no private company upping the price in order to give its CEO an obscene bonus. There would be no private insurer weaseling its way in to take its cut. If we made a commitment to fund our healthcare institutions for the good of the public, and not for the good of sprawling corporations, then we could truly transform the way healthcare is thought about in this country – not as a commodity, but as a human right.
If you’re a private company that utilized a publicly funded organization to develop your technology, such as in the case with Novartis and MIT and the University of Pennsylvania, then that technology should now be in the public domain and no longer protected under exclusive patents.
“But Kody! What about innovation? And IP protections! Companies can’t be expected to innovate if they can’t protect their technologies and be rewarded with more profits!”
Research and development would be much more open and expeditious if patent protections did not exist. Medical innovations are often initiated by public organizations and universities. Taxpayer money takes on the risk of research and development. The public should be the beneficiaries, not the corporations.
“But wait! What about the funding the public organizations got from the private companies to do that research?”
The monetary support given to public institutions in these partnerships needs to be weighed against the profits that these private companies stand to gain from these relationships. And the public institutions would have no need for corporate capital and equipment if the state chose to value and fund public health instead of wasting trillions of dollars on military interventionism, imperialism, and death. As a side note, my other cousin, the aerodynamics engineer, he works for a company in San Diego called General Atomics, a war-profiteer that makes and sells unmanned combat drones to militaries both domestic and abroad. Why give a shit if the products you engineer and manufacture end up killing people, am I right? Best not to think about it and just go surfing along those San Diego beaches and pick up some more chicks instead.
The state has lots of money from our enormous GDP and tax revenue. It just needs to spend it on the proper things. Imagine if the profit motive was dissolved from the hospital industry. Rural hospitals with low patient levels could be properly funded and receive sufficient support to the point where they could administer complex CAR-T therapies. Hospitals wouldn’t have to fight over patients. Patients could feel confident that they are receiving quality care no matter which hospital they go to.
The state could also save money by doing away with the bloated bureaucratic costs of the private, middle-man, insurance-based healthcare system. And on top of that, using antitrust law to breakup pharmaceutical monopolies would bring drug prices down and save a taxpayer-funded healthcare system billions of dollars. As Zephyr Teachout explains, “Driving down prices is much harder when the government is negotiating with a powerful monopoly than when it is negotiating in a competitive market.”40
“But Kody! Your cousin and his partner wouldn’t be able to own two houses if Patrick didn’t work for a healthcare system that was based on profit motives!”
That is exactly the point.
That. Is. Exactly. The. Point.
But I mean, come on, what’s wrong with making a little money? After all, I’m sure Patrick is not responsible for bribing those doctors, bilking the U.S. taxpayers, or lobbying for increased patent protections. He’s just a single cog in the machine, man. What’s the harm? Hey, why begrudge someone getting as much coin in their pockets as they can before the world burns to a crisp, right? Patrick is just a guy who got a good degree that afforded him the opportunity to work in the industry that he loves and to have a successful career at it. He’s helping people get access to life-saving cancer treatment, for goodness’ sake!
But is that a sufficient excuse for continuing to work at a company that has such obviously odious business practices? It’s not a question of what kind of work pharmaceutical companies engage in. It’s a question of how they engage in that work; of what the nature of their business model is. The fact that it is even a business in the first place is a problem when it comes to matters of public health.
Sure, these companies have the cure for cancer, sometimes they’re forced to give it out for free when they can’t manufacture it at the proper FDA specifications. But let’s remember that these therapies are patented and held exclusively by a private company that charges hundreds of thousands and even millions of dollars for some of these treatments. Novartis’ treatment for spinal muscular atrophy costs a whopping $2.125 million for a single therapy, making it the single most expensive drug ever sold.41
And these treatments are not widely known in the public consciousness. Partially because not many people need these treatments in the first place, but also because many people cannot get access to these treatments even if they do need them. Every time I tell someone about CAR-T therapy, they react the same way that I did when I first heard about it years ago. They are surprised that such an effective therapy even exists and they are just as surprised that they hadn’t heard of it before.
Perhaps if more people knew about the fantastic possibilities of cell therapy then there would be a greater public outcry for their privatization to be dissolved, in much the same way we are currently seeing with Covid-19 vaccines. Hell, I consider myself to be fairly well in the know about what’s going on in the world. But I probably never would have heard about CAR-T therapy if my cousin wasn’t literally in bed with a Novartis employee!
Do you motherfuckers really need two houses? When the San Francisco Opera gets back up and running can I scrounge some tickets from you guys so that I can watch a bloated tart stand still and belt an Italian aria on top of a ridiculous set that cost way too much money to build and is going to be an absolute bitch for the technicians to changeover after the show?
Oh hey, also, I don’t have health insurance. But I do pay my taxes every year. I’m sure some of my dollars have found their way into Novartis’ coffers somehow, just like the millions of other people in this country who are uninsured or underinsured. Who’s going to save me if I happen to get cancer from our increasingly toxic and carcinogenic environment? Shall I beg you, Patrick? Please, Pat, as the cousin of your beloved partner, can you get Novartis to make me a deal to spare my life? You and I go way back. I’ve got so much to live for, you see. I’ll even settle for one of those out-of-spec treatments. I only need 50% of my T-cells to be viable, maybe even 40%. It’s better than nothing! Please, Patrick, I’ll take anything you can give me. What do you say? Pretty please?
Fuck that horseshit. No more begging. No more scraps. Eat the fuckin’ rich. When the revolution comes, we’ll be starting with the CEOs. To put it simply, the people in power better start allowing the possibility for the peasants to earn more than just breadcrumbs, or else the peasants are going to extract by force the back pay that is owed to them, with interest.
VII.
Culture institutes a few virtues
Capital comes and brings moral confusion
But do anything long enough
And the body gets used to it– Dessa, “Rome”42
I have never met a ghost; never felt some unseen presence residing in the house. Instead, my ghosts are people I once knew in my life. None of them existing in bathrooms or in closets, but instead taking up space in the fabric of my gray matter. In the same way that I was afraid to go to my ex’s wedding in that dream I had because I did not want to be confronted with the fact of her continuation beyond my own memory of her, my ghosts remain ghosts because they are locked away, untended to, not allowed to venture on their own outside of the confines of my perception.
Confronting ghosts is an exercise in confronting pain and fear. It takes work. It involves the practice of humility; to see someone else for who they really are and not for what you want them to be. This is the same kind of work that is required to fall in love with someone beyond mere sentimentality, beyond mere fever and delusion. It is the same kind of work that is required to appreciate an artist, a rapper, a writer beyond mere fandom; to recognize them as a complex human-being capable of making mistakes, sometimes grievous ones. It is the same kind of work that is required to recognize your familial connections to systems of power and oppression, and then do something about it.
This kind of work requires diligence and patience – and an adherence to the notion that things can get better, must get better, because this physical world is all we’ve got. Don’t expect another shot. Collective rebellion against systems of oppression and death is an affirmation of humanity. Noncompliance with and obstruction of immoral machinery is an act of spirituality that goes beyond just ourselves and our own small, insignificant personal pleasures. Physical acts of resistance are the only avenue we have left to ensure our continued existence, let alone a life actually worth living.
If you want to exorcise your ghosts, then you must allow them to live as they truly are; not as papered-over memories, but just as you yourself exist, warts and all. You could try to bury them away, keep them locked in unmarked boxes, or do what Dessa did and zap them into oblivion with the help of an fMRI machine. Or you could do the work to sublimate them, to bring them into the light and find out what they really mean. Either way, be prepared for your ghosts to catch you off guard when you haven’t paid them their deserved attention.
In 2019, annual net sales for Novartis reached $47.4 billion. According to their own numbers, these sales were tempered by generic competition by just 1 percent.43
Dessa and the crew are still writing and releasing new music. She recites poetry from inside her apartment now.
Since the outbreak of Covid-19, myself and many other live entertainment professionals have been out of work. But we continue to do what we can to keep the fires going. Our time is important. I have been using my time to take stock, get back into writing, tend to people, and try to bring to light the ghosts inside my head and make my relationships with them a bit more democratic. It’s been working out so far.
A few months ago, I reached out to my ex and asked if she would be interested in catching up. It turned out that she had moved several states away. But she would be coming back to town to visit her family, and so she offered to get drinks at a local brewery while she was here.
It was surreal to see her again. Just as it was surreal to kiss her that very first time after seven and half years of friendship. During our conversation, she and I both lamented the fact that we were no longer friends. And we both started to cry. We left the brewery for some privacy and talked inside her car. This reenacted the many times during high school when she drove me home and we parked in front of my house and talked for many hours.
After we said goodbye and she drove away, I got in my car, started to drive, felt some kind of finality, and I wept. I wept in such a way that I had not wept for many years. I went back to my current partner’s bed and I cried over her. I told her that I didn’t want her to worry. It was just good and emotional to see my ex again.
A few weeks ago I went to see another Dessa show. She was playing in Santa Cruz at a small venue downtown called the Catalyst. Hers was the last concert I paid to see before the pandemic and now the first concert I paid to see since the pandemic.
I, of course, stood at front center again, just about a foot below the stage. I am happy to report that Dessa’s shows are in just as fine a form as ever. She’s still got that smooth control over the audience. Although I do have some beef with the audio guy at the Catalyst for muddling up the vocals.
And I finally got that book signed by her.
Thanks, Dessa.
In the course of writing this essay, I reached out to 51 different professors, researchers, grad students, and faculty members across several universities including MIT, Berkeley, Harvard, and the University of Pennsylvania. Out of those 51 inquiries, only a single person responded with anything substantive. Another person took the time to tell me, as rudely as they could, how little time they had to even give me the time of day, let alone respond to my questions, and that they had no interest in sharing their perspective on medical research funding. Thanks a lot, asshole.
However, I also reached out to Professor Noam Chomsky with similar questions regarding the medical industry. Mr. Chomsky is not a medical doctor, but he is well-versed in the issues regarding privatization of social services and the consolidation of undemocratic corporate power. Mr. Chomsky did respond to my questions and he steered me towards Dean Baker’s work on the subject of patents in the medical field. So thank you, Mr. Chomsky. Your response was gracious and very helpful. Keep up the good fight.
All y’all medical doctors and bioengineers can kindly fuck off into your pipettes, jerks.
Except you, Patrick. You’re family.
Dessa, lyricist, "Ride," performed by Dessa, by Lazerbeak, produced by Andy Thompson, on Chime, Doomtree Records, 2018, compact disc.
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