Abolition, the medical-industrial complex, & covid-19

Neighborhoods could have isolation centers, for caring for sick community members, so that they can recover safely, and not infect their neighbors. But "leftists" need to eat brunch, so we left this crucial work to the state — and now, instead of humane isolation centers, we have jails.

a small band-aid, put on top of a large crack in the asphalt sidewalk
image description: a small band-aid, put on top of a large crack in the asphalt sidewalk. photo by Luis Villasmil.

content warnings:
the medical-industrial complex.
the prison-industrial complex.
"leftist" hypocrisy.

I'm walking up the stairs and I feel the sweat dripping down my forehead.

I am so tempted to wipe off the drops, but I have gloves on. I am wearing a well-fitting N95 mask, and I don't want it to get wet. I'd just jogged my way to the gas station to pick up a pack of Newports for one of my patients, who is isolating at the isolation site.

He is not allowed to leave. Security guards on each floor. This is the closest to a jail I have worked in.

It's not merely the structure, but the concept and ideology of "care", that lays the foundation of medical "health" "care" in usameriKKKa.

Being a doctor has always been akin to being a cop.

That is what we are trained as. From medical school, we are trained to suck up, hierarchy beaten into us (literally, in my case), bred to obey, so that eventually we may exercise the power vested in us on the poor "unhealthy", "sick" people we will "care" for.

But I am a traitor.

After years of sucking up, boot-licking, trying to “do good”, I finally learned that this entire system is a fucking scam, and it is being kept in place by its foot soldiers: doctors.

That is when I spoke up.

And I was instantly ostracized.

They hate me, doctors.

Anyway, me buying a pack of ciggies for this man who is now trapped in this isolation center is my way of making myself feel like I am doing something good. More than a small "fuck you" to the system, it's because I know how it feels to need a smoke. I smoked heavily for around 12-15 years. Quitting took a long time. I finally stopped 3 years ago. I would later learn that my ADHD was a major driver, and without nicotine, I would have a hard time focusing. Dopamine kick aside, ciggies were my friends. The smoke, my buddy. I would damn well need my friend if I was thrown into complete isolation for 10 days, too.

Data after data shows how isolation fucks up our brains, even long-term damage — depression, suicide, anxiety, PTSD.

These are all Unhoused people, 99.9% Black people. They are all poor as fuck, and almost everybody has multiple medical conditions, everybody has mental health conditions. This patient has called a bunch of times, and the nurse said he was "aggressive" and "uncooperative".

Whenever I hear those words, I know that this person needs something, and they are being told to fuck off. So they speak up and boom, get labeled.

"What do you need, brother?" I ask straight up.

"I need some damn cigarettes, man," he says loudly, so my insensitive doctor ass can hear him. "I am losing my mind in here."

"I got you," I quip back, cursing myself 'cause I still haven't ordered them in bulk, thank you ADHD.

"Which ones you need?"


"Cool, gimme like 20 minutes, but then I need to talk to you.
Sound good?"

It's not a prerequisite, but this is the position I'm thrown in. I need to do an intake and a physical, make sure that he doesn't need buprenorphine (Suboxone), and make sure that he won't go into alcohol withdrawal if he's cooked up here for long. I need to see if he will qualify for Paxlovid.

And most importantly, I need to do a note and bill, so that our overlords can make a boatload of money.

"I don't know how you deal with them, Dr. [redacted]," says the nurse.

"Them" "These people"

This lingo is common in medicine.

Now your "social justice" academics won't use these words in their inaccessible papers, but come out into the real world with me one day.

Shit is fucked.

Social workers, nurses, RNs, doctors — hating and abusing poor Black people is how medical folks bond.

Taking out your frustrations on helpless people, turns out, is how we have decided to cope with being cogs in this murderous system.

It's been 20 minutes since I've been gone.

Turns out, he's been cussing out the staff while I was gone, threatening to leave the site, leave against medical advice.

The problem is, he will not be allowed back into a shelter if he doesn't complete the isolation period.

Now, you won't find a bigger proponent of isolation centers than me.

I've spent the last 3 years screaming at the world about how simple it could be for us to control this pandemic, if communities were empowered enough to take matters into their own hands.

Neighborhoods could have isolation centers, and use them to care for sick community members, so that they can recover safely, and not infect their neighbors.

But, you see, our "leftists" and "radicals" have vacations to take, and parties to attend, and they need to take as many unmasked selfies as possible, 'cause how else is usameriKKKan imperialism supposed to grow.

So we left this crucial work to the state, and now, instead of humane isolation centers, we have these jails.

Where people are given the choice to either isolate and basically risk worsening mental health, PTSD flares, etc. — or end up on the streets, so the police can harass and abuse them.

And this young man who is fresh out of jail and seems to be having a panic attack and is screaming for help — he is going to get called "aggressive", so that he can be kicked out.

All will be good, then.

Kick out anybody who advocates for themselves.

None of the staff is trained in crisis response (aka "de-escalation"*), by the way.

*水仙 shuixian's explanation, on edited word choice:I chose "crisis response" instead of "de-escalation" here, because the latter is, in my opinion, a carceral and ableist term. It blames the person for being in crisis — for being "escalated".

Nobody really wants to work here. They are expert escalators. Like the beloved police. So I sort of know how high the stakes are.

He is cranky 'cause he needs ciggies, he is having a PTSD flare, and he knows no one is gonna give a fuck, so why even try being vulnerable?

"Hey. It's me." I knock on the door.

He opens the door very little and looks at me.

"Here you go, man.
And listen, you can't tell anybody about this, okay?
This is between you and me, alright?"

He nods.

He seems calmer already.

"Okay, I'll wait outside while you smoke for a bit. Can we talk then?"

He closes the door.

I go to check in on a few other folks in the meantime.

Five minutes later, I knock gently.

He opens up.

"How you been doing, man?"

"What do you want, doc?" he goes.

"I just wanna know if you're okay. You sound like you're having a rough time," I say, as I try to make eye contact through my face shield.

"This is like the cell, man," he goes, as he sits down on the chair, and puts his hands on his head.

I sit down on the ground, in front of his room. I had told the security guard not to come close. They know by now that I don't want them around when I'm talking to patients.

This might be a jail, but I'm not a cop.

"When did you get out?" I ask.

"Two weeks ago, man.

How can they put people in here?

They leave the food hanging on the door.
They got these security guards and shit.
We can't talk to anybody.
We can't leave.
This room is dark.
There's nothing to read.

I feel like the walls are closing in on me, man.

And then these nurses got the audacity to tell me I'm being "loud"?

"I feel like I'm dying in here, man."

He keeps going.

Releasing trapped tension as he speaks.

His voice now calmer.

He knows he can't be loud with the guard on the floor.

I have zero fucking clue what it feels to be him.
All I can see is the pain on his face.
His body tense.

Him holding back tears, like men are taught to.

That part, I know well.

"Damn. I'm sorry, brother."
Is all I can respond with.

He cusses out the staff more.

I sit there just listening.

It has taken me years to get to this point of not getting activated when somebody is screaming. And I still continue to fuck it up in my personal life.

He goes quiet.

We sit there in silence.

I go —
"I don't know what to say, dude. But can I say something?"

He looks up, giving silent acknowledgment.

"These people don’t give a fuck about you, man.
I don't want you to lose your mind in here, but if you leave, they won’t let you in the shelter, either.
They know what they're doing."

“Damn, man. So it is a jail," he goes.

"Yeah." I say.

We chat for a bit more.

My entire schedule is now fucked.

I have to see more patients, and leave in time to get home.

But this interaction gave me some peace.

We sit and talk shit about the system, cops, doctors.

We try to figure out if he can actually stay here safely.

Isolation is no fucking joke.

We know how bad shit can get.

And if, and when, his mental state declines, we know how we will circle back into psych wards, the streets, drugs, prison again.

The entire system is connected.

By design.

The medical "health" "care" system, the homelessness-industrial complex, the prison-industrial complex, all of it: they are the same.

He ultimately says he feels better after talking and the ciggies.

I am going to get him something to read. And if he feels like it's getting bad, then he will leave. I teach him how the system works, and we figure out how to navigate the system, how to play the system, not get played.

I can tell he feels better. You know why, it's 'cause he has somebody in his corner now. Somebody willing to conspire with him, to protect him.

This is what care can look like.

He knows I'm risking shit. I think he respects that.

More importantly, he trusts me.

That's when healing can begin.

Patients (I hate that word, by the way) cannot trust doctors.

Because we are fucking cops.

To be a doctor is to exercise power over people.

To be a healer is to build power WITH people.

We end our conversation with bumping fists.
We would have hugged, but COVID-19.

I get back to work, and now I have to fight the impulse to lose my mind if I hear another racist word from the nurses. I pray I don't. I don't need the other docs hearing about this. I have to make deals with the devil daily.

As I'm doing my notes and checking social media on and off, I start getting angry.

Why the fuck does he have to go through this shit, on top of everything else?

I mean, I know why.

As COVID-19 keeps spreading, as more and more people get sick, it is folks like this young man who keep getting fucked over.

I see posts of liberals — er, I mean, "leftists" — at brunch.

Some of them are self-professed "abolitionists".

COVID-19 has been over for them for a while.

Not for this young man.

He is hanging on by a thread. He is getting sucked in deeper and deeper into the vortex of the police state. The victims of COVID-19 are getting more and more specific.

The myriad impacts are getting more and more focused on Black, Indigenous, Disabled, Unhoused communities.

Most of this city doesn't even know that such medical facilities exist.

They don't care.

Unhoused people become Disabled, and Disabled people become Unhoused.

And then they all get cut out of our daily lives.

Out of sight, out of mind.

He will have to finish his 10 days here, and he will suffer the impacts of isolation, and then maybe the lingering disability of Long COVID-19.

Meanwhile, people claiming to care about people like him, will keep pretending COVID-19 is over.

They will get sick and isolate for 5 days per CDC guidelines, or worse, not get tested at all.

They will not be put through inhumane isolation and treatment.

As more and more people get sick, more and more will become Disabled, lose their jobs, become Unhoused, and then get shunted away from society.

And the vast majority will simply look away.

How fucking enraging.

Before we end our conversation, I ask him: "Who is your support system?" — feeling shitty as soon as the words left my mouth.

He kept looking at the floor, and said, "Nobody, really."

I had parroted this question, and as soon as I said it, it hit me.

Obviously, he does not.

It's been 3 years since my partner became severely Disabled and bedbound, and I saw how everybody abandoned them. And as their health got worse, we both have lost any and all community we used to have.

I regret asking that question.

It was like pouring salt on his wounds, and a grim reminder of how fascism works by ultimately isolating sick, Disabled, poor, Unhoused people.

Removing them from society.

I won't be able to forget his face.

I don't want to.

Fuck all of you who have moved on.

Explain to me how letting COVID-19 rage on is helping abolish the prison-industrial complex.

It is not.

It is expanding it, in myriad ways.

Carceral violence is increasing.

This is just one minute example of what people are going through.

Our "leftist" principles, our "abolitionist" ideals, all fall flat if we don't LEARN TO UNDERSTAND ableism.

We don't understand what militant care means.

We ignore a mass disabling event.

We let the war on Black and Indigenous people, on ALL people of global majority, on poor people, on working class people, on Disabled people, on incarcerated people, on Unhoused people, on sick and immunocompromised people — I can keep goingwe let this war go on.

We can choose to end this.

And we need to.

Enough is enough.

Khoyadoc (pronouns: he/him/his) is an oppressor caste South Asian, western-medicine-trained physician, currently living on stolen Piscataway Lands. He is working to fight against COVID-19 imperialism.

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