CIIS Public Programs Podcast

Transcript

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[Cheerful theme music begins] 

This is the CIIS Public Programs Podcast, featuring talks and conversations recorded live by the Public Programs department of California Institute of Integral Studies, a non-profit university located in San Francisco on unceded Ramaytush Ohlone Land. 

According to renowned political economist Raj Patel and physician and activist Rupa Marya our bodies, our societies, and our planet are inflamed. In their recent book, Inflamed, Raj and Rupa reveal the links between health and structural injustices—and offer a new deep medicine that can heal our bodies and our world. In this episode, Raj and Rupa are joined in a rich, unique conversation with CIIS professor Charlotte María Sáenz as they illuminate the hidden relationships between our biological systems and the profound injustices of our political and economic systems.  

This episode was recorded during a live online event on March 8th, 2022. A transcript is available at ciispod.com. To find out more about CIIS and public programs like this one, visit our website ciis.edu and connect with us on social media @ciispubprograms. 

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Rupa Marya: Hello, thank you.  

Raj Patel: Howdy. 

Charlotte María Sáenz: Hi. It is such a pleasure to be here with two of my colleagues, friends, compañeros. Thank you, Raj and Rupa, for coming over to the conversation tonight. Really thankful for this- for this opportunity to talk about your book. I thought I would start with just explaining a little bit about the structure of your book to our audience who might not have read it so far, just to explain what it looks like.  

You divide your chapters into body systems as well as ecosystems of our territories. And in this way, engage in a conversation about their relationship. In Abya Yala, which is another name for this continent on which we live, the Americas. Abya Yala is the name the Kuna people of Central America give to this land also known as Turtle Island. We use a term, cuerpo de territorio in Spanish, which is commonly understood in these territories. It means literally, body territories and it's spoken together. And it's a way to reflect that relationship of our bodies and our territories and the body as the first territory. So, I thought about this concept, cuerpo de territorio, body territory, when I opened up your book, and, and saw the way you had structured it and I'm just going to read a few of the chapter headings so that our audience has an idea of what I'm talking about.  

Chapter 1: Immune system: I am Because You Are. Chapter 2 Circulatory System: Salmon are the Pump. Chapter 3 Digestive System: The Forest Within. Chapter 4 Respiratory System: The Last Thing You Smell is the Forest Fire. Chapter 5 Reproductive System: Rematriating Strawberry Fields.  

And so on, I could go on, but there's twelve chapters or nine chapters, but it is so beautifully illustrates this concept of body territory of cuerpo de territorio. Our bodies are enmeshed with our territories, as with our societies. So, with that concept on the table, I'd like to ask you what is inflamed in our bodies, and our territories, and our societies? How has inflammation happened to you and those close to you? And we can start with Rupa.  

Rupa: Thank you Charlotte. Inflammation is, is in a, you know, it wasn't really a metaphor we were looking for. It was paying attention to what's happening in the world around us. In my work as a physician at UCSF as a hospital medicine doctor, I have a great privilege of being able to sit at the bedside of so many people in, you know, this area and to learn from their experiences about why they're getting sick and who's getting sick and how people are getting sick. So, you get to see this, this really intense look at what we call the bleeding edge of society, who's hurting and how they're hurting.  

And through, you know, my work in music and working as a composer and going to different territories and organizing with different groups around social justice and health. I started to see these patterns emerging of certain kinds of diseases. I started calling colonial syndromes, like, oh, it's interesting that these patterns of diabetes and rheumatoid arthritis, and cardiovascular disease and Alzheimer's and cancer are really over expressed- substance use disorders- in these communities that are just being smashed through structures of social oppression. And what we come to know now is all of those diseases have inflammation as a part of their profile. So, the immune system is reacting in a way that leaves this chronic inflammatory response, running, not in the face of an infection or not in the face of something that we like, multiple paper cuts. But this is what social oppression is. It's like thousands of paper cuts that never heal. And so, the inflammatory response in the body keeps running and the inflammatory response in the body is our body's way to heal as a healing response. And when there is something acute like a paper cut the inflammatory response is mobilized. It's a part of the immune system and it goes to heal that wound. But when damage keeps coming or the threat of damage keeps coming which provokes a stress response, what we see is chronic inflammation smoldering like a fire in the body.  

And we started to think about, you know, what are the things causing that damage. Raj and I were looking at that and how are those related to the things we're seeing damaging our societies, like our social connections and responsibilities to one another and how are these same structures also damaging the Earth and the patterns that we're seeing on the Earth's body. So, there were some like beautiful moments, you know, in my, in my work with my husband, Benjamin Fahrer studying about soil. This morning, I was up 4am reading soil reports, and just loving every delicious moment of studying cation exchange capacity, and percent base saturation, and what's happening in the soil is so much like what's happening in our lungs and in our kidneys and in our gut and when you see that as a, you know, as a doctor as I look at that and I start to realize, oh, this is a body. This is a body that is moving in response to us, and this is actually a body that is a part of- that we are a part of. That we are an extension of, we are an incarnation of, so that consciousness was really a beautiful experience to come to through our conversations together.  

Charlotte: Thank you. Raj?  

Raj: I'm not sure what to say after that. I mean that beautiful arc of thinking about inflammation and how we’re, you know, I mean how our bodies and territories are experiencing it. In part I don't know what to say because I'm still working through and dealing with trauma. And part of that trauma is the trauma we all bear. I think the trauma that I bear circumstantially is that I'm talking to you from Austin, Texas, which is on among others, Comecrudo land, which was then part of the Comanche Empire, which then became the state that fought for slavery twice and named its capital city after a slaver. So that burden of trauma is, you know, just sort of in the background and then it's made worse by the various kinds of ass-hattery of, and I want to see that in ASL, but the stupidity of the folk in our capitol building and then this morning, while the 3:00 in the afternoon in South Africa, today, a comrade was murdered by the ANC as he was engaging in agroecology, he was laying irrigation pipe. He was an activist in the eKehana- in the eKehana settlement, you know the chapter that you mentioned that I am because you are, comes in part from the idea of Ubuntu. And we spoke to the South African Shack Dwellers Movement to learn about this idea of Ubuntu. The idea that we become together through our relationships as Rupa was saying and today I under Nagila who was a leader in one of the communes there was killed as he was irrigating and watering the land. So that kind of fire, he was fired upon by the ANC thugs, the ANC licensed thugs, who came into the settlement in Durban is the kind of fire that, obviously, we were experiencing in the, the news around the horrors of Ukraine, but also the ongoing horrors in the Sahel and in sub-Saharan Africa, and the Middle East and around the world.  

And so, to think about how inflammation tears us apart is always difficult and I think part of the work of this book was an exercise in not just diagnosis, of storytelling, of understanding, the right way of narrating antecedent causes to be able to tell us why it is that we feel, and we experience what we feel. But also, as a vision to try and then get to the right kind of treatment. And that idea of inflammation and a diagnosis is something that we understood earlier on, but you understand it every day that little bit better as you understand the traumas that inflict and afflict our bodies, and our communities every day worse.  

And so, the story of inflammation and the story of diagnosis I think is something that we were excited to be able to share with everyone because diagnosis is itself a form of storytelling. Diagnosis is how it is that you assemble certain bits of other people's knowledge that have become your knowledge and then narrate how it is that certain people are in the middle of a story of suffering, but at the end of that suffering will come soon because of the application of your medicine of your food of your treatment of your care. And what we do when we think about diagnosis thinking about inflamed, is to stretch that story much further back and to beings who have historically been excluded from being considered as beings and -  

Charlotte: Can you talk a little about that history, Raj? You know, how did we get here? You know, what is this long story? This history of Rupa mentioned colonial capitalism, and it maybe this is a term to unpack a little bit. What, what is colonial capitalism? I mean, weren't- aren't we done with colonialism? Isn't that something that happened, you know, a long time ago? So, why speak of colonial capitalism now?  

Raj: Well, because colonialism happens every day just as capitalism does. You know, my kids here in Texas are taught, not only that we are one nation under God, but that the state of Texas is something to be celebrated and they are taught this every day despite the fact that the United States contains hundreds of nations and this state fought for slavery twice. So why is it law that they are repeating two kinds of lies every day if it weren't necessary to do it in order to instantiate in their minds and in everyone's minds the normality of colonial capitalism?  

So, I mention that the colonialism part is something that isn't done and dusted, but neither is the capitalism part. Capitalism is always incomplete. It is always supported by communism. The love that we feel for each other, the care that we give one another, the ways that we hold one another not just with our care for other humans, but our care for other beings in the web of life. That kind of communism makes capitalism possible. And again, capitalism every day tries to make us forget that in fact, it is that, that sort of mutuality that sustains the exploitation and extraction that has brought us to the precipice of the sixth extinction. 

Charlotte: I'm wondering how colonial capitalism shows up in your world Rupa in terms of the [Rupa: Everyday!] medical industrial complex? Like how does that look like in the hospital and in your world?   

Rupa: Yeah. So, what we did in our book is really trace back the time and place where relationships were rearranged to serve the agenda of the people who stand to benefit from this system. The colonial capitalist system that we live under today. That exist today. That is the reason why homeless folks and unhoused folks, are swept up by police, that their belongings are put into the trash. It's the reason why brown and Black people are shot by the police. It's the reason why, you know, a doctor who happens to be Black, who happens to have Covid in a hospital, Susan Moore, is sent home without the appropriate follow-up and ends up dying. These things are not just whoops look at that mistake. These things are actually all interconnected.  

It's the reason why, you know, urban Indigenous people in San Francisco are the least employed group of people. It's the reason why we have the kinds of health disparities we see across the board. Whether you're talking about influenza and people saying, oh well, now we're in this stage of Covid, where it's just going to be like influenza. Well, if you look at the disparity rates of influenza, they're the same as the health disparity rates we see with Covid-19. And Black, brown and Indigenous people die. Other people don't die as much.  

And so, these are things that we see in the data all around us, but the way in which we're taught to understand the data, or look at the data, it becomes very atomized so that you actually don't see the patterns and you don't understand why they are that way. And so, that's where we did that work for our readers is to go back in time to see how those things were rearranged, why they were rearranged and what is the consequence? So, if inflammation is the body's response to damage, what we show is that society structured through colonial capitalism, including the hospital, which is one of the, you know, major projects of colonialism, that those structures are creating damage for everybody. But Black and brown and Indigenous people bear the largest brunt, people who are undocumented, people who are made to be insecure and desperate so that their labor can be exploited through this economic system. Those people are going to bear, the biggest, you know, take the biggest hit.  

So, you know, when this land and our lands, our homelands were colonized. It was the missionaries, the medics, and the military who were doing that work, and the medics were there not to, you know, help, you know, the poor brown people who were suffering from the onslaught of exposure to new diseases, but they were there to keep the colonists healthy enough to be able to exploit and extract resources and labor and it was only when they noticed that the brown people being sick, made, you know the work less efficient or then put the colonists at risk of becoming sick themselves that that work of taking care of that labor pool became or that, that group of people became a part of the project. And so, when we look at that and we understand those legacies in those structures, and how patriarchy, white supremacy and all the axes different, axes of oppression are recreated it, actually in every institution constructed through colonial capitalism. Then we don't, you know, we don't, we don't have to be surprised when we see the kind of health outcomes that we do when we see the kind of workplace disparities that we do when we see Black faculty leaving academic medicine because it's just too racist for them to stay and when we see, you know, Black medical students, you know taking over their instruction on health of the society health and the society at our institution to teach the teachers, and to say, actually, this, this isn't right. This isn't, you know.  

So, these dynamics, these, these axes of power are part of the colonial capitalist reality. And it's important to understand it and name it so that we can actually be effective in addressing it. So that we're not just talking about structural determinants of health and feeling, you know, patting ourselves on our back that we named that person, a person can't get food. We start looking at all the systems around, why people can't get food. Why people are malnourished, and we start changing them. And so that really, when you get the right diagnosis, then you are pointed to the right treatments. When you are left with a minimal like a diagnosis that shuttered off from historical context or dynamics of power. Then you get these little tiny tweaks, which is what you know, let's say our California government is obsessed with like little tiny tweaks so that we don't get real health, real benefit for all people.  

Charlotte: One of the things that was so striking about your book is your ability to weave together all of these long-term histories looking at the systems in their complexity, in their historicity, but also in their interrelationship. And, and there's also this, this look at communities and looking at ourselves as parts of belonging to each other. How is that different, or rather.  

I want to ask about the myth of the self-sufficient individual because I want to also get into how that's happening now in our time right now with this pandemic. But for what is this myth of the self-sufficient individual and what do you mean when you say the modern liberal individualism? What does that mean? Maybe Raj, you can explain some of the history, the history behind that. How did we get to this place where it's just something people don't even see about themselves? It's just the way it is, like what are ways in which you know, historically we can make this evident?  

Raj: So, the rise of individualism is the consequence of a series of choices made by bourgeois capitalist sover the long history of capitalism. Because if you're going to discipline labor, if you're going to buy people and sell them then the unit of account, and the unit of sale is the individual body. And that idea that you are buying the labor of, or indeed buying all of an individual person as a unit of product, rather than a being in a web of life is both the psychic shift that you need in order to start selling people, but it is also, what capitalism requires in order to begin modern accounting, to begin the idea of to this body a salary is paid or to this body a return is paid.  

So, the idea of the modern liberal individual stems from the long history of individuation, that comes through capitalism and its operations, particularly its operations seeking and forming a working class. Now that's important because what we, what we have then is philosophy that shores up and moves forward the idea that there are certain beings that can be put to work and certain beings that can think. We talked a lot about Descartes, for example, in this book as the sort of officializer. He doesn't originate the idea of the mind-body dualism. But because he's positioned where he is in the nexus of European trade and finance, his ideas become a license to, to understand certain beings as thinking beings and other beings as incapable of thought. So, you know, his approach to animals, for example, is famously that dogs and you know other parts of the web of life, and not, genuinely capable of suffering because they are not possessed of souls because they are in important ways, divorced from that and God has vouchsafed that distinction.  

So, all of this is to say liberal individualism comes from a long history in the origins of capitalism. And because we're so used to this idea of the injured individual being us because we have been schooled in it as the result of 600 years of history, then all of a sudden it becomes easy in the modern day to blame individuals for social problems. And I mean, I think Rupa’s examples of, you know, of patients turning up living with the consequences of social conditions forced upon them. And yet under the modern medical complex and under modern liberal capitalism, it is the individuals who are to be blamed and to be treated as noncompliant. But I wonder if you can talk about that a little bit more Rupa?  

Rupa: Yeah, when I look at, you know, the bodies of my patients who are being actively subjected to the terrors of modern capitalism. You can see how the bodies are responding. You see, you know, I think about my patients who are unhoused. You see traces of how social conditions are generating, you know, the swelling of the legs because in San Francisco there is no place to sit or lie down on, in, on the sidewalks. You see the cracking of the skin, you see the dermatitis and, you know, redness of the shins, you see the, you know, infestation of, you know, bugs and other like lice and problems like that. You see people who decide to use substances like methamphetamine, so they can stay awake at night, so they're not harassed by the police or jumped by other people in the street. Then you see an unraveling of the psyche and people's ability to, you know, keep their minds together because of the use of these substances that disrupt their sleep wake cycle and then put them into these really frenzied states. You see the damage from the methamphetamines on the heart and all these things.  

You could look at it as you like. Oh, you know, you really shouldn't be, you know, addicted to these substances, or you can talk about it as like an individual choice, but when you see the circumstances that that body is being forced to experience because of the lack of care in our society. These aren't choices. These are not, this is not freewill. This is how the body is being predestined to these poor outcomes. So that's, you know, probably, you know, one extreme measure.  

And another one is just my, you know, my colleague, who had a heart attack in her 40s, with no cardiovascular risk factors because she happens to be a doctor working as a hospitalist and carries a lot of medical debt. So, debt in itself is a driver of chronic inflammation, diabetes itself is a chronic inflammatory disease. So how have the structures of finance and the tools of finance that run this capitalist system, that puts every single one of us into debt so that we can live in a house or so that we can go to school or so that we can see the doctor for, you know, just crying out loud. It's just crazy. So, all these people walking around carrying that debt, that drives the chronic inflammatory response. So how much of our diabetes is related to that debt? How many of our heart attacks?  

Forty percent of heart attacks occur in people with no traditional cardiovascular risk factors, and we've seen the studies come out now with Covid in this like era of Covid that the, you know, there's a rise in these heart attacks that are happening from stress. And it's real and debt is, you know, one of these big drivers in this society and so it makes me think, you know and imagine well, what if we had a world that was actually shaped by care? So, if these things are driving such toxicity in our bodies, what if we redesign our world with this knowledge, that we understand that this was, you know, stolen land that, we understand that we are guests on stolen land, that we understand how to take care of one another, what our responsibilities to each other and to the, to all the living entities around us. And so what I learned most, what was sort of the big surprise for me in this book and writing it was that, the way we learned about the immune system in medical school and we structured our book like an anatomy text, right with these, as you, as you read the chapter titles, you know, you learn the immune system is there to recognize self versus other, right? It's already a colonial framework that Descartes set up for us. It's there to fight off the invaders, it's there to defend the territory, the nationhood of the self, right?  

But what we really understood as we were researching, you know, reading upwards of a thousand references, is that the immune system is there to harmonize our bodies with the conditions around our body. Instead of the conditions around our body are toxic and traumatizing as Raj described with his community member who was killed. If that is our reality. Our bodies are going to respond with inflammation. And so, knowing that the corollary is well, then what happens if we design a world with care? What happens if we prioritize systems that won't create that kind damage for anybody and don't throw our community members under the bus as a couple people try to get ahead? And when do we start to understand and label and position our whole social systems to recognize that people who do throw others under the bus to get ahead are actually sociopathic that that that's where the real will and agency of pathology lies. Not in the person, who's trying to, you know, figure out how to eat. And all they have is crappy choices because they live in a food desert.  

So that's, you know, that's what we're hoping to impart in this, but that, that understanding of the immune system is, you know, it is not a sectioned off system. It's in this beautiful choreography with our integument and in our respiratory system and with our nervous system and our endocrine that they're all in mesh. They're all queered, that's not these discrete boxes. And that these phenomenon are actually reverberating, they’re harmonizing with the world around us with what we call the exposum, or the sum of our lifetime exposures. So that for me as a doctor was the real, you know, eye-opening moment.  

Charlotte: You're talking about all of these ways in which the historical wrongs of these systems are landing on bodies differently. I mean, on all of us, of course, but largely colonized people, Indigenous peoples, Black bodies, and now we have this pandemic. So, I'm just to bring it to like our current moment of the pandemic. These past two years. I mean this is not like new, this has been going on for five hundred plus years. But what are the particular ways that inflammation is showing up in this pandemic? And, and how is, how is some of these tensions that we've that you've addressed already around individualism and, you know, in contrast to some of the community care that you're suggesting is the way forward or out? Or to change some of these damaging systems, what are some of the tensions that have come up in this pandemic that have exacerbated and shown us that this history is alive and well, still today? 

Rupa: Raj do you mind if I start this? Well, Covid it was quite a surreal experience to be writing this book as the pandemic was unfolding. And as we went through the first year, and I was in the hospital and taking care of patients. And the data was coming out that you know, it was provoking a severe inflammatory response in Black, Indigenous and Latino bodies. Disproportionately. Also, in people of precarious socioeconomic status. And so that experience of, you know, here comes Covid. It shows us how this idea that the immune system is harmonizing us to our world works.  

So, if you are being, if your body's being tuned or harmonized to an oppressive reality where you're exposed to air pollution and intergenerational trauma and can't, you know, get a loan for a home. You have precarious living. You have all these things to generate stress and trauma. Covid comes along and just it's like lighting a match and boom on, you know, it's just ready to burn. The body is ready to burn and that was a very, you know, what that leads to or what the led us back to was the work of a German physician, Rudolf Virchow, who back in the revolution of the 1800s was articulating, that, you know, disease, he was asked to look at a Typhus epidemic and he's like, you know, Typhus is not caused, these diseases are not caused by the organism themselves. They're caused by the body's reaction to the organism and the body that is primed through social oppression is a body that's ready to light on fire. It's a body that's ready to react in all these ways that generate the disease that we see. Bodies that are able to be, you know, tended to differently. Don't react in the same ways. So, if people have, you know certain things.  

And what Virchow prescribed for the typhus epidemic were things like allowing people to speak their own language. He was fighting against German imperialism. He was arguing to decolonize Europe away from German imperialism. Let people speak their own language. Let them organize in worker coops, really work on supporting agriculture. Build roads, you know, these kinds of improved schools, tax the rich, give money to the poor. These kinds of things were the prescription for a Typhus pandemic and that- or epidemic.  

And that's the same thing with Covid. And unfortunately, because we live and have been conditioned in the liberal mindset. All you hear coming out are, especially tragically through some of our own doctors at UCSF, are these hyper individualized approaches that don't actually show an understanding of how the health of one is dependent on the health of all. And that we have to re, we have to come, we have to develop greater understandings of what health actually is. It's not an attribute of an individual. It's a description and a phenomenon that emerges when systems are working well together. It's an emergent phenomenon and we have really missed an opportunity with Covid especially here in San Francisco because we laud ourselves, you know, pat ourselves on the back that we've done such a good job while 8,000 people were forced to sleep outside. Not only during the peaks of the pandemic but during AQIs that were totally toxic for human health. Not even that would inspire, you know, our mayor to let thousands of people into like the 30,000 vacant hotel rooms in San Francisco and that to me is deeply tragic. It shows how invested we are in the system of colonial capitalist mindset and the individual mindset that we cannot in the face of these kinds of threats. We cannot shift and change. And to me, it means there needs to be more suffering and that makes me very, that makes my heart very heavy, and I don't want to see that because I've seen it up close and it's not. It's very tragic, it’s very hard.  

Charlotte: I love what you said about the health of one is the health of all, and how does that relate to vaccines? 

Raj: Rupa do you want to take that. Or I mean, I'm you- [Rupa: You can take it Raj.] Well, I mean just before we get to the vaccine question then, I do want to just add a coda about whose bodies were allowed to burn because you know, we've, this idea of fire is important in understanding who gets protected from the flames and whose bodies are the layer of insulation to protect those people. Here in Texas, our lieutenant governor was happy to sacrifice himself, though, he didn't sadly die. He managed to survive. But encourage older people to, you know, to, they've had their time, he said he suggested and what needed to happen was, they need to sacrifice themselves so that the economy could flourish. And in order that the economy do well, look at the two hot spots in Texas. That were zones of high rates of Covid, fatality, one were prisons and the other was meat slaughterhouses. Now, that is sort of the argument that we were making in the book that in fact, there are beings, who are considered less than human, who are considered whose, membership of the web of life in ways that don't count as essentially, white and middle class. License is there being tossed onto the flames as a way of protecting the rest of society. And society, there defined in a very narrow way as essentially, rich white folk. Now that's important because A: you think about vaccines the global South was denied vaccines. And it was only what today, possibly yesterday that Moderna which we all paid for. The Moderna vaccine, which the US taxpayers chipped in massively to fund, admitted that, okay, fine, we won't enforce our patent rights, you know, just as their share price was tanking because it was clear that they weren't going to be making any money from this anyway anymore. So, you know, the I mean, the sort of pathetic idea that it's people in the global South people of color, people who are incarcerated, animals, and the migrant workers, and women workers who predominantly represent slaughterhouse workers in Texas are the ones whose bodies don't matter.  

Now, that thinking translates over into thinking about vaccines, because it is particularly weird, that only in the United States. Do you see a sort of left vaccine hesitancy. Everywhere else in the world people hate the pharmaceutical industry. In South Africa, they have particular reason to hate the pharmaceutical industry because so many people died because of HIV AIDS, medicine patents. And yet, they take the vaccine not because they love them, these manufacturers or they have any deep regard for them. But because they recognize that this is what we do when we care for each other. We take a little bit of risk, so that everyone who is unable to avoid being exposed to this virus is cared for.  

That doesn't feature in large parts of sadly, in what appears to be the American liberal left and that's not surprising because of everything we've said about liberal individualism. But it's not surprising also, because even before Covid, we had people buying organic food, not because they care about worker exposure to pesticides, but because they care only for their bodies being a temple. And, you know, they hate Monsanto not because of the evil that it has done historically to people of color around the world, but because they might in some way, be exposed to its toxins as an individual phenomenon. And that's why so many folks on the left hold in higher esteem their hatred of these corporations and they do their care for other human beings whose lives they see not or care not for. So that's how it, you know, this idea of care gets subsumed under liberal, individualism in capitalism, and we see it in surprising parts of the left and particularly in the foodie left, for whom this book is in part addressed as a slap upside the head.  

Charlotte: So, what does decolonizing individualism and science and medicine look like?  

Rupa: Well, it's, you know, abandoning this myth of liberal individualism and understanding that health cannot occur without engaging the whole systems around the bodies around us, including our histories, including our present realities and structures. It requires admitting, you know, not throwing science away, but broadening who gets to be sharing the science. What kind of science is happening and who the peers are. For medicine in particular it's removing the physician from the position of authority over other people's bodies and really centering people's experiences through their bodies and through their lived experience through their health, in their communities. And it is working together not only with other healthcare providers, but also different kinds of healing traditions, and different kinds of ways of nurturing ourselves that bring us wellness, that actually create a healthy exsposum. It is really wrangling with the corporate capitalist structure of medicine in this country. It's taking it directly on and taking it down because we can't have a system that functions for everybody when that has been controlled by you know, the profit interests of whoever, whoever it is. When we look at the pandemic response in California to me, it's an atrocity how many people died, you know, and a large part of that sloppiness came from the fact that our health care response, our secretary of health was, you know, forced to listen to healthcare executive lobbyists instead of the nurses and patients and doctors on the front line. So that's why we ended up with nurses in trash bags. That's why we ended up with nursing care ratios that were horrific. That's why nurses and doctors were being told to go back to work even though we were infected and then they reversed their position after an outcry.  

And so, I think that, you know, decolonizing medicine and decolonizing science, really is understanding, you know, how history and lines of power have shaped our understanding and going back and being very conscious about untangling these things. It's not to throw these things away. It's to make them better and to make them serve everybody. And that's been a, you know, a wonderful thing to see, you know, as I talk with Irish scientists who are very interested in decolonizing their homelands and also the science and the way that they're talking about, you know, microbiology and ecology and weaving together, bringing in more interdisciplinary study and ways of knowing. There's so much to it and it's a lifetime of work, but the most important thing is that it's not something that we can do alone, that it's something that we have to do in communities and that we have to do collectively. And for me, that's the best. That's the best part about it is that it's a creative, iterative, and justice-oriented process.  

Charlotte: Raj, anything to add?  

Raj: Well, I mean the good news is there's lots of history to draw on here. We're recording on March, the 8th 2022, which is International Women's Day. And that was a day that was founded by a bunch of New York socialists in the early 1900s. So, New York, the Socialist Party of New York is what the organization that apparently is credited with coming up with the idea of Women's Day. And that's important and interesting in part because it involves a recognition from working-class movements that in fact, you know, class and patriarchy go together, class objection and patriarchy go together. And I think that's the idea that there are contours of, the capitalism enforces contours of power over who gets to be cared for and who has to do the caring. That's really important if you're interested in decolonizing. Decolonizing is about the re- extending of ideas of care of tendrils of care, back to where they might have been, and that's vital if we're interested in a very deep medicine of care and of decolonization.  

So, in the book, we look at some of the great de-colonizers who are medics. People like Franz Fanon the great Algerian theorist, activist, and psychiatrist who tried to decolonize medicine but in the end walked away from the hospital because as he said often, quote, “the doctor owns the land” end quote. And that's important because again, this is about how capitalism shoots through and prevents our capacities for care and requires that we come to the land in a new way, not through ownership but through stewardship, through caretaking, essentially and Rupa and I were having a conversation with an Ohlone Elder who a Ramaytush Ohlone Elder who was talking about being not an owner of land, but a caretaker of land. Now that caretaking is, I mean, it's a wonderful word when you peel it apart, to actually take care, rather than to be to be denied. The right to be able to caretake is really vital. But in order for that to happen, we need gender equality. We need the end of patriarchy. We need the end of capitalism so that the land can be caretaken, but caretaken over generations, rather than owned in perpetuity by a few.  

Charlotte: I'm thinking about this decolonizing and reconnecting and I'm also thinking about the role of Indigenous science and other ways of approaching science. What are some simple actionable ways that people can, everyday people, you know, people who are so busy with their lives, mothers, you know, people who may not have a chance to read your book. What, what are some actions that they can take, maybe even immediately to counter inflammation, both in their bodies and their territories, their communities?  

Rupa: Well, I think you know, the work of mutual aid in our communities in our neighborhoods is so critical and important. So that, that act of just caring in our immediate vicinity, in our immediate, like the circles that we already have. If it's possible to set up or extend those systems of care, are really important because they show us and remind us how much we actually do care for each other and how powerful it is when we work to intentionally braid those relationships further. So, when I think of colonization and colonialism, I think of the fracturing of relationships of care. So, when I think of decolonizing, I think of reasserting those relationships of care, whether it's to the seeds, or to the land, or to our Indigenous communities, or to our elders, to our children, to our people who've been neglected who are those who are suffering with mental illness or suffering with, you know, chronic disease. So, you know, that would just be a simple way of engaging that work of remembering and practicing care.  

For myself, I think that the work of, you know, spending time with elders is really important, spending time listening to stories, spending time telling stories. These are things that have really been lost. And that's not the same as, you know, doing a podcast or even listening to this. It means sitting with people around a fire. It means sitting with people in a community, it's sitting outside for those who are vulnerable, especially now, Covid hasn't gone away, but being together in ways that are safe and healthy and can reconnect us by seeing each other and by asking what our more vulnerable communities need to be healthy and well. 

Raj: Yeah, and I mean, and I should have mentioned Charlotte of course, you were there at the conversation in the Deep Medicine Circle when we were hearing about caretaking. But I mean it's hard when one's asked for simple things to do because what counts as simple under capitalism is always so complicated. So, you know, we're told, oh you know, a simple thing you can do is have a metal straw and a tote bag and eat kale. And, you know, I have metals, have several metal straws and tote bags and I do eat kale. I go to farmer’s markets, some of my best friends are white people but it's, this is not enough. You need more than just actions of consumerism which are presented as simple because all the violence happens nowhere near you.  

And so to think of simple things under the aspect not of capitalism, but of the web of life is rather different. And that's why I really appreciate the work that you Charlotte and Rupa are doing at the Deep Medicine Circle, which is about connecting. And this doesn't feel simple at all. This feels really difficult. The work of rematriating land doesn't feel simple. The work of finding community, of digging our hands into the dirt, of reconnecting with the web of life, not just as individual therapy in the Berkeley vein, but instead, as part of a process of collective healing. It doesn't feel simple and that's because capitalism has made it hard, but I just want to embrace the fact that you know, what capitalism makes us believe is simple is difficult and its opposite is the work that you're doing, and I just want to just bow to you and thank you for that work.\ 

Charlotte: Oh, thank you. 

Rupa: I want to just, can I just piggyback on that for just a sec? [Charlotte: Yeah, definitely.] Cause Raj really hit it because your question was about what individuals can do, and what kinds of transformations need to happen ASAP on this planet, is something that individuals can't do. It must happen collectively, and it must happen through organizing and it must happen now, and it is not an easy task. But there are these examples and these projects that are already happening all over the world to start, moving the consciousness and moving power.  

So, when we're talking about decolonizing as we talk about abolition, as we talk about these things, these aren't just cute ideas for the left to chew on and feel good about ourselves that we have a new language. These are about reassigning power. These are about redistributing resources and land. These are about global reparations, and these things have to happen and there is no individual who can do that. So, what is the work right now is the work of, you know, getting and community in organizing and organizing in small ways and in big ways and, you know, and it and yeah, so it is and that's what was really powerful in the book in writing in conceptualizing about this idea of deep medicine. That it is not a medicine that's there for an individual. It's not there for you to, you know, meditate and feel better about, you know, now I feel more calm about the fact that the planet’s on fire. No amount of meditation is going to make that any better, but a whole bunch of organizing and shifting of power will.  

Charlotte: Thank you Rupa, thank you Raj.  

Rupa: Thank you Char. 

Raj: Thank you.  

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Thank you for listening to the CIIS Public Programs Podcast. Our talks and conversations are presented live in San Francisco, California. We recognize that our university’s building in San Francisco occupies traditional, unceded Ramaytush Ohlone lands. If you are interested in learning more about native lands, languages, and territories, the website native-land.ca is a helpful resource for you to learn about and acknowledge the Indigenous land where you live. 
 
Podcast production is supervised by Kirstin Van Cleef at CIIS Public Programs. Audio production is supervised by Lyle Barrere at Desired Effect. The CIIS Public Programs team includes Kyle DeMedio, Alex Elliott, Emlyn Guiney, Jason McArthur, and Patty Pforte. If you liked what you heard, please subscribe wherever you find podcasts, visit our website ciis.edu, and connect with us on social media @ciispubprograms. 
 
CIIS Public Programs commits to use our in-person and online platforms to uplift the stories and teachings of Black, Indigenous, and other people of color; those in the LGBTQIA+ community; and all those whose lives emerge from the intersections of multiple identities.  

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