The Anarchist in the Cancer Center

There are certainly frustrations associated with being an anarchist and working as a nurse.  The entire health care system, like the rest of society, is riddled with authoritarian relationships, corporate penny-pinching and profit-taking, and intrusive government regulations.  The state believes that individuals are not capable of taking care of themselves so it requires licensing of healthcare providers and institutions and prevents people from purchasing most drugs without a doctor’s note.  Besides restricting the number of health care providers and limiting people’s choices in seeking treatment, licensing and prescribing laws institutionalize the hierarchical relationships between doctors and nurses, nurses and patient care techs, and, perhaps most importantly, between those providing care and those receiving it.

I had evolved into an anarchist and individualist before I graduated from nursing school, so I knew what I was up against from the beginning of my career.  But, 40 years later, I remain happy with my choice of an occupation.  I love the work I do and enjoy my relationships with most of my patients and some of my co-workers, including physicians and even some of the administrators.  Besides enjoying my day-to-day work duties and the interactions with patients, I find my areas of specialty, cancer care and infusion nursing, intellectually stimulating, as well.  I get to work in a chemotherapy infusion center, a radiation oncology department and in the office of a group of gynecologic oncologists.  In these various roles I do all sorts of nursing work: I educate, counsel and comfort patients; I support and educate other health care workers: and I work closely—largely collegially—with physicians, nurse practitioners and physician assistants in planning and managing patient care.  This job works for me.

Promoting Autonomy

Over the years I have tried to live out, as well as I can within the constraints of statist health care, my individualist and anarchist values.  In my relationships with my patients, this largely takes the form of making sure the people I care for are knowledgeable enough about their illness and their care options to play a role in determining their treatment.  All too often patients blindly follow the orders of their physicians, simply because they are physicians.  While their treatment plans are generally ones I agree with, I believe people should know why they are getting the drugs or radiation they are receiving, how the treatment works, and what the side effects or other downsides are.

Patients sign form after form declaring they are giving informed consent to this or that treatment or procedure, but most of them are ill-informed, at best.  This is usually not the fault of any individual, but the result of a combination of things: physicians unable to take the time to fully explain treatments, other health care workers who are not knowledgeable enough to answer patient’s questions, and patients who are overwhelmed by their diagnosis and really do not hear or understand what they are being told.  I see it as my job to make sure patients get the information they need when they are most ready to absorb it, so they can understand what is happening to them and make truly educated decisions.

I spend a lot of time explaining to people how to prevent or treat symptoms caused either by their disease or by the treatment they receive from me and others.  Again, whether because they weren’t told how to respond to them or didn’t “hear” what they were told, patients often tolerate treatable conditions, including significant pain, without seeking help from their physician or other healthcare workers.  Something that complicates this piece of my work are the widespread myths about pain medication and addiction, made much worse recently by the so-called “opioid epidemic” which I wrote about in this zine last year.  It is not uncommon for doctors to undertreat people’s pain and for patients to avoid taking narcotic analgesics because they are afraid they will become “addicted.”   This is largely because of the crap the government has been peddling for years about “dangerous” drugs, as well as the punitive laws which sometimes scare well-meaning physicians into denying their patients adequate treatment.  I consider counteracting misconceptions about pain relievers to be a key part of serving my patients well.

I like to think that by encouraging patients to be active participants in treatment planning, enabling them to take charge of maintaining their own health and comfort, and prompting them to question the prevailing myths and “expert” opinions with which they are presented, I promote their independence and autonomy, even if it is only in this one area of their lives.

Nurses as Workers

The other part of my working life where I try to put at least a little anarchy into action is as a union activist.  When I was a grievance officer in my chapter, I spent a fair amount of time advocating for nurses who had gotten into some form of trouble with the boss.  I sat in on disciplinary meetings with nurses and managers, filed grievances as needed and helped people navigate the human resources and payroll bureaucracy when errors were made or people’s contractual rights were violated.  There is a huge disparity in power between management and labor, and unions, for all their faults, add a bit of protection for workers so that some limits can be placed on the ability of managers to discipline, discharge, and generally beat up on workers.  While I no longer work as an “official” grievance officer, I still take part in particularly difficult grievance cases, and continue to be on the union team during contract negotiations and related discussions.  Helping folks out and standing up to the powers that be can be enjoyable. 

But there are also problems with traditional trade unions.  For one thing the contract we sign with the hospital enshrines management rights and the power differential between those who own and run the hospital and the rest of us.  The union is left in the position of just making sure that the boss doesn’t go too far.  We can never challenge, at least through contractual means, the hospital’s power to manage and give orders to the people who do the real work.

Perhaps the biggest problem is that few members actually take part in the life of the union.  A few of us do all the work and negotiating and phone calls, while most people never do any more than vote for officers or participate in contract ratification, if they do even that.  Unions, even traditional AFL-CIO organizations, often have relatively democratic structures, at least on the local level, and have the potential to be a means to fight hierarchical organization and increase the power of individual workers, but they never seem to actually achieve this.  Just as in other institutions and organizations in society at large, there are those in the unions who seek to wield power and influence over others while fattening off the (often mandatory) dues of members, and those who are unwilling or unable to speak truth to power and stand up for themselves.  Corrupt union officials and passive, apathetic members are both to blame for the sorry, hierarchical internal state of most unions.

And finally, the relationship between union and management is regulated extensively by the government, so both sides can appeal to the state to settle disputes when they can’t come to an agreement on their own.  Sometimes the resolution favors the hospital and sometimes it works to the advantage of the union, but in either case it serves to reinforce the control of the process by government, something that is anathema to this anarchist.

What I Would Change?

Inasmuch as I think that the philosophy and scientific basis of allopathic medicine are largely valid, I would hope that much of the work I do would still be done in some form in a free society.  People will still get cancer and require treatment, and, however ineffective allopathic therapies are at times, there is no system of healing that works better.  Of course, preventing illness in the first place works even better at preserving health, but that requires effort on the part of individuals.  While I like to think that free people might take more responsibility for their own well-being and live more healthily in order to stay well and avoid having to deal with physicians and nurses, I’ll believe it only when I see it.

What must change, however is the hierarchical way in which this care is provided.  That will require getting rid of professional licensure and other barriers to entering the healing occupations.  Eliminating licensing by the state and regulation of practice by government boards would do away with the enforced doctor‑nurse-technician-patient hierarchy and allow consumers and providers of health care to contract for services however, wherever, whenever and with whomever they like.  It would also allow providers to team up and practice jointly without one or some giving orders and others simply obeying.

We also have to eliminate the prescription system which keeps individuals from choosing and using the treatments they would like.  This system forces patient to see state-licensed providers for even the simplest and safest medications, driving up costs and bolstering the image of the physician or other provider as parent or priest.  People should be free to ingest, inject or smoke whatever they like without having to get the approval of a state-appointed expert before doing so.  This would include all drugs, including narcotics, stimulants, hallucinogens and other medications which are and have been irrationally demonized by the state, the news media and much of the medical establishment.  Besides freeing up access to medicines in this way, we should also do away with laws granting patent protection and other intellectual “property” rights.  These statutes allow drug manufacturers to charge exorbitant fees for the medicines they produce, an expense which is a key driver in the ever-increasing cost of health care.

Labor laws should be abolished, as well, so that in situations where there are bosses and bossed, the bossed would not be prevented by the government and its police from really taking on the powers that be.  This society and its laws have institutionalized the concept that some people involved in a business should have the legal right to own it and run it, while everyone else is relegated to the status of mere employees who can be dismissed at will.  This idea that some stake-holders in an enterprise should have powers and privileges that are denied to others, including the ones who do the actual work and bring in the money which the bosses pocket disproportionately, is widely believed in this society.  This belief needs to be challenged by anarchists so that people begin to question and reject it.  Once people have come to see the injustice of capitalist ownership and management, the legal framework and enforcement mechanisms which uphold and defend this economic system can be confronted and defeated by those who are its victims.

Until Then

I have laid out above a few basic components of a strategy for changing the current model of health care in the united states into one more suited to free, autonomous individuals, whether they are receiving or providing care.  I recognize that it is unlikely any or all of these changes could take place without a more widespread, revolutionary, change in the rest of society.  Abolishing government, and with it the hierarchy and inequality it enforces, is the only way I can see any real, sustainable change taking place.  Meanwhile, I intend to keep on caring for and empowering my patients and their families, and doing my best to make people think about how health care could be provided in a more humane, respectful, and libertarian way.

Reflections on the Revolution in Spain

In advance of a trip to spain earlier this year, I decided to read a up a bit more on the spanish civil war and social revolution of the 30s. I had, over the years, already read some on this period, largely writings by those sympathetic to the anarchist movement, and what I had learned had left me quite skeptical of the methods and intentions of these anarchists, as well as those who wrote so glowingly of them.  Their defenders took great pains to excuse their decidedly authoritarian approach to organizing and social relations in general, citing war conditions as a justification for the surrender of basic anarchist principles.

What I found with further reading did nothing to change my outlook. Continue reading

Letter to anchorage anarchy

Dear Joe,

I forgot to say in my last letter that the New York IWW Arts Branch was organized by Mel Most, an old-time anarchist now sadly forgotten, Judith Malina and Hannon Reznikov, and Bob Fass.  Mel suddenly died, and that took the wind out of our sails.  A movie about Bob Fass was recently released (I missed it but heard it was good).  Hannon died young…  Judith is still going strong, heading for 90!  Thanks for reprinting the article from The Storm, great individualist mag edited by Mark Sullivan, several issues co-edited by

Yours truly,

Peter Lamborn Wilson

The Fall of the House of Labor

Since the last issue of this zine, in which I critiqued labor unions, these organizations have been prominently in the news again.  The biggest stories have been about the passage of a “right-to-work” law in Michigan and the Hostess bankruptcy, which many have blamed on greedy unions.  Labor is clearly under attack from business owners and politicians, and these two events, happening so closely together, have prompted me to once again devote most of the space in the December 2012 issue of anchorage anarchy to a consideration of the labor movement. Continue reading

Union of Egoists

Individual anarchy has often been treated as an interesting idea, but one with little bearing on practical group work.  However, during the late sixties in San Francisco, an individualist anarchist labor union (or “non-union” as it was later called) was organized with features unique in american labor history.

Initially, we were a small group of social workers who revolted against an AFL union, local 400, after repeated instances in which the AFL failed to act on issues.  These issues included firings without pretext with five minutes notice, refusal of the labor council to fund publication of the social services newsletter, DIALOG, and the dismissal of a worker for visiting North Vietnam during personal leave.  Continue reading

Letter to anchorage anarchy

Good article on unions.  I agree—and have been a member of several over the years, including a short-lived IWW Arts Branch in NYC, with members of the Living Theater and WBAI (Pacifica).  It’s no accident that Stirner spoke of a union of self-owning ones as the only possible strong (or even militant) organizational form for individualist anarchists.  Our Italian Leftwing Stirnerite guru “Brand” Arrigoni used to say the same, as did George Sorel (before he lurched to the Right).  See also Bob Black’s excellent article on the IWW in the new magazine Modern Slavery.   Unfortunately we now seem to be nearly as far removed from the possibility of a real radical labor union, as from Proudhon’s Mutualism or Landauer’s version of Kropotkin’s anarcho-federalism.  As the whole Movement of the Social appears moribund, no other organizational form seems possible for us but the “gang”—or as I once tried to put it more elegantly—the Tong.  But how to organize a “secret society” in an age without secrecy (a.k.a. privacy)?  Anarchist anthropologists like David Graeber and James C Scott talk about reversion to “earlier” economic forms such as swidden gardening—or even “the Gift”—but I sense no willingness amongst modern anarchists to embrace the luddism which would be required to “leave Civilization behind” to any real extent.  Individual revolt alone seems to remain possible—every moment lived outside the Technopathocracy is an act of propaganda by the deed.

Desperate Times,

Peter Lamborn Wilson

For the Union Makes Us Strong?

Several times over the last few years I have participated in a Mayday pageant here in Anchorage.  This is a staged reading of a script written by a local National Labor Relations Board (NLRB) staff attorney.  The narrative traces the development of the american labor movement from the Knights of Labor in the nineteenth century through the 1930s, focusing on two key moments in the history of american labor unions: the Haymarket events in 1886 and the passage of the Wagner Act.   It is a fun occasion where participants include labor union members, folks from Occupy Anchorage, and other local troublemakers.   It is an opportunity to interact with other union members and movement activists and provides a bit of generally unknown and ignored labor history to those who attend.  And to my mind, the positive depiction of anarchists in a performance geared toward regular working folks is more than welcome.

However, despite his largely accurate retelling of the circumstances surrounding Haymarket and sympathetic portrayal of the libertarian workers and organizers involved, I disagree completely with the primary message that the author wishes to convey to the performers and audience—that the National Labor Relations, or Wagner, Act (NLRA) is the logical and appropriate culmination of the efforts of the radical labor movements of the past.  Continue reading

THE PRINCIPLES OF EQUIVALENTS, LABOR FOR LABOR; THE MOST DISAGREEABLE LABOR, ENTITLED TO THE HIGHEST COMPENSATION.

The following essay was written and published as a pamphlet by Josiah Warren in Boston in 1865.  The author participated in a number of anarchist communities in the nineteenth century, and wrote and lectured extensively, advocating non-statist solutions to social problems and economic rather than political methods of social change.  He also strongly influenced writers such as Stephen Pearl Andrews and Benjamin Tucker, who perhaps did more than anyone else to disseminate the ideas of the anarchist individualists of the nineteenth and early twentieth centuries.

I have corrected apparent typos and changed some of the archaic spelling found in the original, but have left the punctuation, italicization, and capitalization as the author intended them to be.

A direct exchange of Labor for labor between the laboring or useful classes, measured by the time employed and according to the disagreeableness or Costs of the labors performed, would convert Time into capital; and all would have an abundance [of] “capital.”  Money would represent Labor or its products as bank notes now represent metals; and, instead of being the blind, stupid, unintellectual accident that it now is, the holder of Labor Notes would know what he could get for them from day to day and from year to year.  Estimates of the labor in different products once obtained  by investigation, might remain unchanged for many years, unless new and better modes of production should reduce their Costs.  Consequently, all ruinous fluctuations in prices would be at an end, and all speculations upon them would be knocked in the head; and “profits in trade” being abolished, ruinous competition and the principal cause of modern wars would cease to be.

The burthen of necessary labor would be reduced to from one to perhaps three hours a day (according to the style of living,) for each person.  All anxiety about future sustenance would be dispelled—with this security of condition, the motive for large accumulations would die away, and the degrading scramble for “money making” would come to an end.

The hardest worker would be the richest person, without reference to sex, color, or nation, and in the common, vulgar estimation, would be the most  “respectable”: then there will be as great a rush into the useful pursuits as there has been to shun them and force them upon the weak and defenseless.  We now see the origin of all forms of slavery and the legitimate remedy for them.

It is folly to expect that men will prefer starved, ragged, insulted labor, however useful it may be, rather than an easy situation with a sufficient income and the respect of their fellow men; nor is it surprising that the ranks of respected professions are crowded till they are forced to live by fraud, that we are over run with speculators, thieves, defaulters, counterfeiters, burglars, robbers, incendiaries, rapacious officials and other vagabonds, or that the bible is tortured into the defense of slavery and poverty by those who are revelling in idleness and luxury; or, that when the opportunities for speculation and office holding opened by one war are all filled, the nest step is to get up another war.  This pandemonium miscalled “society” will continue as long as men are tempted to live by profitable crimes, rather than starve in useful pursuits.

Let not this word Cost be misunderstood: it has no reference to the money that has been given for any thing, but it refers to the trouble it has cost; whether it be painful exertion of body or mind—anxiety, sacrifice of any kind; in short, the endurance of any thing that is disagreeable is here called Cost.

This idea or principle would probably give the highest salary to the scavenger; because he is least respected and because his labor is otherwise, perhaps, the most disagreeable; while it would give comparatively nothing to ignorant officials because they get compensated in glorification.

All will be workers or live upon benevolence.  The whole burthens being thus distributed, the share of each will be so light and so “fashionable” people will prefer to do that little, rather than take the trouble of encroaching upon their neighbors; then the great excuse for aggressive governments will not exist, and their very costly if not very valuable services can be dispensed with.

Labor for labor, is not labor for land nor for any of the metals found in it, nor for wood or coal nor for any other of nature’s spontaneous products except so far as labor has been bestowed upon them, or in transferring them; but it opens the prospect of homes and comforts to those who have been deprived of them by the want of a principle for the regulation of prices.   In short, a direct, equitable exchange of labor between the useful classes, just in proportion as it progresses, will cheapen common money and finally render it worthless, and invest Labor with all its products, and all the power and  “respectability” that material wealth can confer; and all that constitutes good or successful society will be within its reach.  None need be excluded—those who have no useful business can learn one when opportunities are opened and this principle opens the opportunities.

The greatest of all considerations is, that by making the cost of labor the limit of price, every one becomes interested in co-operating to reduce the cost and consequently, the price of every thing; and thus men will be employed in lightening each others’ burthens through mere self interest, which is now so destructive.  Thus does this simple but sublime justice out strip the sagacity of legislators and solve for humanity the greatest of all human problems—turning every man’s hand to work For, instead of against his fellow man!

Harmonizing the material interests of men will harmonize the feelings and action of individuals and nations; and the reign of permanent peace, plenty and successful society will have found their root in simple, scientific Justice to Labor!

It is this harmonization of interests that has always been aimed at by the profoundest statesmen, and it is the great central ideal of Communism; but it has been mistakenly sought in Combining or Uniting those interests!  But, where interests are United, all have a right to a voice in the management of them; but the natural and inevitable diversity of minds growing out of the Individuality of each, immediately develops itself and inaugurates conflict and confusion that have only two possible terminations—Despotism or Disintegration.  If despotism is adopted, its first act is to make war on this natural Individuality and to demand unhesitating obedience, loyalty or conformity; the governed must have neither eyes, tongues, brains nor life; they must all suddenly become of one pattern according to the master’s orders, like so many dried herrings upon a stick, and those who decline the prescription are gentiles, schismatics, heretics, outsiders, outcasts, rebels, traitors, outlaws; to be expelled, crucified, excommunicated, imprisoned, shot or hung; and whom any may plunder or murder with impunity, or perhaps “make money” by taking them alive to be murdered or tortured according to the will of the master!  Government by a “majority” is worse than that of some despotisms, because it annihilates Individual responsibility; which, is the  only reliable regulator of human intercourse.  All these evils are the natural consequences of the first blunder or “original sin” of Uniting instead of harmonizing the interests of men!

If the planets were all united or bound together by artificial means, it would result in collisions, darkness, destruction and death, corresponding to what are now seen and always have existed in all artificial organizations of men, from that of the smallest partnership to that of a nation, just in proportion to the number and magnitude of the interests at stake and the mental diversities of the persons involved.  War has been waged against this diversity from first to last, for thousands of years and every means to enforce conformity have been exhausted; and now, there is more individuality than ever, and it is more clearly seen than ever that it is the very germ of all improvement, order and peace among men–that this is the stone so long rejected by the builders that is to become the head of the corner—that it is the very “key to the age”; that to persecute it is to deny the persecutor’s right to differ from the persecuted and it is making war upon humanity’s instinctive struggle to correct its own most fatal blunder.  But personal individuality being adverse to artificial organizations, they must be abandoned before much progress can be made.  They originated in the purposes of attack or defense; but the principle of equivalents neutralizing all motives for attack, would render defense unnecessary.

What we want is Co-operation or coincident action between all the human race without “entangling” our materials interests or our responsibilities, and thereby subordinating man to the ignorance and cruelty of man.  The principle of equivalents enables us to attain these long sought and unspeakably important ends.  It lifts us up out of the chaos of political systems, into a clear, bright atmosphere that enables us to discern the direct road to true order and repose.

The subject is inexhaustible, but a very few words must suffice here.  What has been said against organizations was thought necessary as caution against the continuance of a dangerous and costly mode of defeating the ends in view.

Coincidence of thought, feeling or purpose, makes us society for each other; but there is no power on earth that can make us so beyond this limit.  The principle of Equivalents producing this coincidence in our material interests, abolishes the principal elements of repulsion and contest and gives us a reliable basis of calculation which will continue for a long time to surprise the student of human problems with solutions too beautiful and too sublime for expression here.

It is believed that this idea of labor for labor originated in England.  Its practical development in this country has been an unwavering life purpose during the last thirty eight years, in a series of noiseless experiments, as the chemist conducts his analyses in his laboratory or as the mechanic tests his machine in his own sanctum before he presents it broadly to the public.  There is scarcely any kind of business between men, to which the principle has not been successfully applied.  The conclusion from these experiments is, that as this principle, together with others necessary to its operation, require to be studied like any other exact science, in connexion with practical illustrations in the business of life, the best way to inaugurate the movement is by establishing Industrial Colleges for young and old, right among the people in any or every town and neighborhood, upon Individual responsibilties and with Individual means, with such aid as may be voluntarily offered free from all defeating conditions.  Not attempting to form or organise societies any more than we would organize or form the fruit upon a tree: but inviting all people to look into the movement and co-operate with it so far as they may find it for their moral or material internal interest to do so, but no farther: trusting to the Coincidence of these interests to change, by degrees, the character of what is now called civilization.