OPSEU In Solidarity banner

Labour Reads: ‘Inflamed: Deep Medicine and the Anatomy of Injustice’ by Rupa Marya & Raj Patel


Howard A. Doughty, Steward, Local 560

As an OPSEU/SEFPO activist for more than 50 years and a local union office-holder for more than 40, I’ve taken my share of attacks by management and sometimes even from co-workers with opinions different from mine. The result? A thick, almost impenetrable, skin though not (I hope) a wholly shrivelled heart; still, I’ve tended to side with an old friend and former colleague who sometimes snarled, “You want to reduce stress? File a grievance!”

My impatience with “burnout” and similar complaints from co-workers, however, has diminished with SARS-CoV-2. It has mellowed me some. So has a concept that’s sensitized me to the pain of others: “moral injury.”

Like many war-time advances in physics, chemistry, and medicine that have led to innovations in transportation, communications, surgical procedures and psychiatry, our worst instincts have had occasionally yielded unanticipated benefits. So, we now acknowledge the clinical disorder of PTSD―once called “shell shock.” Its definition has recently been expanded to include moral injury―a psychological condition arising from witnessing, being complicit in, or being coerced into performing acts that we know are morally wrong. It’s not a personal crisis of faith; it’s a harm that’s done to us by forcing us to be stupid and cruel.

PTSD is a reaction to immediate physical injury inflicted by others. Moral injury is unrelated to physical safety, but attacks our belief in ourselves as moral people in a moral world.

Social workers, health care workers, correctional officers, college teachers and others whose jobs include assessing people under our care or supervision are regularly told to comply with rules and sometimes to enforce policies or mete out punishments that are inconsistent with our beliefs and the core values of our professions.

As an educator, I’ve been engaged in a constant struggle against many toxic trends in education. I have tried to mitigate efforts to corporatize the colleges and transform them into discount department stores of cheap knowledge. Because I’ve refused to quit, I’m sure I’ve suffered oodles of moral injury (hence my thick skin), but it’s scarred me as well. Of course, if I hadn’t persisted, I might be in even worse shape because I’d either be carrying more guilt as a quitter, or back in my first job as an apprentice lens grinder―also a disappearing skill!

There are plenty of books about how to cope with or rationalize resignation to lousy working conditions. To these, I still say, “Nuts!” They may be crucial in a crisis, but they can also add the insult of shame to the injury imposed by the authorities. They finesse the root causes of alienation and powerlessness in the workplace. What’s needed is a political economy of moral injury that places blame on the policies and practices of those in power. Until that happens, however, an excellent way to diagnose the disease is reading Inflamed.

Marya and Patel examine our bodily reactions to stress as well as the social and environmental determinants of anguish. The prestigious medical journal, The Lancet, says Inflamed is a “revolutionary book that calls for courageous action to dismantle those structures that harm the health of people and the planet and to rebuild ones that centre care.”

There is no finer mission statement than that for public servants and we can start by resisting orders that do public harm and also causes us self-harm. In language more to my liking, Molly Young writes in Vulture, “It maps the connections between public health, social injustice, economic disparities, climate change, and ancestral trauma, making the case that our crappy world needs a new medical paradigm.”

When we stop beating ourselves up, we can start straightening ourselves out!

Rupa Marya & Raj Patel, Inflamed: Deep Medicine and the Anatomy of Injustice. (New York, NY: Farrar, Straus & Giroux). 496 pages. ISBN: 9780374602529