Bed pan stories
“Yet in the different voice of women lies the truth of an ethic of care, the tie between relationship and responsibility, and the origins of aggression in the failure of connection.”- Carol Gilligan.
This piece will stray away from, but not abandon, the discussion about navigating public space with reduced mobility. This time let’s take a little peek into private spaces (ok, let me admit it now: this sounds more fun than it is!J)
After the initial shock and pain of this injury has worn off, the first thing that hit me is how dependant I am on others for the most basic things. The excretory system takes on a whole new dimension. Mundane things like shitting and pissing become a chore. When loved ones stick a bed pan under you and clean you up after, one is forced to break personal boundaries with those people or realize that the boundaries don’t actually exist.
While admitted at the general ward at the AIIMS Trauma Centre, the class pyramid could be seen and felt. I was at the very top. But class wasn’t the only difference between me and the other patients. With one exception, almost everybody else I could see around me were men. All of these men were being taken care of by women, presumably their mothers or wives. While in the hospital, I had four friends, (two men, two women) taking turns as my primary caregivers. Every time the curtain was pulled shut so I could pee, any one of them could have come out to empty the bed pan. The four friends told me that the fellow patients and their attendants would joke with them when they were leaving saying ‘duty over??!!’. No one could figure us out: not the hospital employees, not the patients, and definitely not the other caregivers. Not only was there the eternal mystery of what relationships exist between these people and me, but also a mild scandal when men walk out with my bed pan.
Care and its Ethics
In the early eighties, Gilligan and Kohlberg among others popularised the concept of ‘Ethics of care.’ (http://books.google.co.in/books?id=XItMnL7ho2gC&printsec=frontcover&dq=in+a+different+voice,+gilligan&hl=en&ei=HJFQTKHdIofQca3nzY0H&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCsQ6AEwAA#v=onepage&q&f=false; http://books.google.co.in/books?hl=en&lr=&id=33OpldPlDgQC&oi=fnd&pg=PA3&dq=ethics+of+care,+disability&ots=bYbWgGuEd_&sig=vcWNtUArt-POf0KYvSu8fw5DSYc#v=onepage&q=ethics%20of%20care%2C%20disability&f=false)
In a nutshell, the ‘ethics of care’ is about the need to acknowledge that we are all interdependent on one another. Some of us are more vulnerable than others at various points and it is important to consider each of our personal or political choices in terms of the vulnerability of others. Based on this, every context should be considered from the perspective of the care-needs of all those involved. Interdependence in this context includes everything from everyday physical and emotional needs to the larger picture within existing systems which hold within them a range of interdependence(s).
Feminist perspectives towards the ‘ethics of care,’ have added a gender analysis to care in the private realm. There is an attempt to evolve an ethics that acknowledges our interdependence while not taking the existing systems of care as default. This perspective encourages leaving room for challenge and exploration within these interdependent relationships. In addition to this ‘interdependence’ also counters the default vehement ‘independence’ of many other theories both progressive and otherwise (from utilitarianism to Marxism and some feminisms). As it turns out, tension between individualism and the collective comes out when these theories are applied to care.
In an attempt to explore precisely this politics, within feminist queer spaces in India, some of us have been, thinking, writing and attempting to live lives that question existing systems of family and kinship as our default support structure. Further, the attempt is also to create a range of alternatives or at least a realm, theoretical and practical, that makes space for such exploration. Many of us who’ve been part of this thought process realize the responsibility that comes with it and the immense effort that it takes. It isn’t the dreamy, charm of hippie communes that we want to replicate, but a reliable support structure that sees us through upheavals, social, political, economic and inter-personal. The few days in the AIIMS Trauma Centre ward were one such moment. It moved me to see the strength of these structures (or relationships or arrangements) and the ease with which they can exist and step up in the times of need. In this structure there aren’t assumed roles. It is a conscious choice to not have a default care-taker. The discussions of division of labour of the care were had collectively and decisions were made based on the comfort of everyone and a range of practicalities. This collective decision making process is an important exercise because of the physical and emotional work that goes into care-taking.
I believe that caretaking always looks easier than it is. One of the things I’ve come to realize over this period is that there is a difference between primary and secondary caretakers. I’ve noticed that the primary care takers are the ones who’ve taken the time and the effort to tune in to the needs of someone who is physically different from them. In my case, I move differently now. For instance, our home in Chennai has many levels, a fact that has not occurred with such intensity to any of us before. Given the circumstance, many a times, it wasn’t me who would latch on to a possible mishap while hobbling, but my mother who is currently my primary care-taker who troubleshoots most of the obstacles that would interfere with my limited mobility. It is clear to me that it must take a lot of mental space to move around and think like someone who hobbles around with a walker while she walks around with both her legs.
In short, care-taking is taxing labour that we all need to do at some point or the other. This labour most often falls on the shoulders of kin and especially women. In fact, when men do intimate care- giving like picking up bedpans, they are looked at with admiration at best or a raised eyebrow at worst. We need to acknowledge that all of us do or will need some kind of care at some point or another. With this acknowledgement, we need to evolve a way of thinking about this that is radical and practical.
Firstly, I think that it is important to break down the charade of ultimate independence. Interdependence means that we need to learn to trust another person with our bodies. These two ideas run counter to each other. We need to find ways in which we can live our independent lives while creating systems in which we acknowledge the need for interdependence. Second, we have to work with existing systems of care differently or create new support structures of care for those who are disabled (permanently or temporarily), or aged or ill and in a myriad other circumstances. If this is our political project, then we also need to think substantially about evolving unself-conscious systems of interdependence at all levels so that we are all taken care of.
Personally, the ‘ethics of care’ and ‘interdependence’ has become another part of a broader political worldview. This injury and this time to think has strengthened that thought process. It is hard to ignore the possible oppression of the reverent belief in un-thought out independence of oneself and others. The ‘ethics of care’ in many ways then could be a theoretical as well as a tangible basis for the argument that we need to not only deconstruct default, assumed support structures of family and kinship, but rework them and create newer more egalitarian ones. In the South Asian context, maybe our dissent against existing support structures and the default, oppressive systems of care has moved us away from thinking, reflecting and speaking about care itself. A different perspective would include not only the need to make room for new loves, political structures and non-normative laws but also to let us choose who cleans our bed pans.
There are a range of other aspects to explore in this context; workers who perform the labour of ‘care’; the political implications of caretaking in existing and newer structures in terms of class, caste, region, religion, sexuality, gender etc warrant a number of discussions. The question of the role of the state in providing adequate and free care to all irrespective of the family structure is another case in point. The fact that there is a government hospital in this country like AIIMS where anyone can receive good medical care with relative ease is something to consider.
One could go on and on, but this, however, is just a brief note to initiate a conversation.