On hunger and care

1,510 words of judgement for some little kid who's never going to read this

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Emily Guendelsberger’s On the Clock reminded me of the last time I wanted to say something mean to a stranger’s child.

I was waitressing at 12 Baskets Cafe, an experiment in community building in Asheville, and a volunteer who looked to be about 12 (guessing ages is so hard! but the point is he was a child) came over and asked me how many meals I’d served that day, in the tone of voice that lets you know you’re in a competition.

I shrugged and said I had no idea. He pressed. I demurred. He boasted that he’d served, I don’t remember how many, but a lot of meals. You know, to let me know that I was slacking and he was killing it.

While I could have tried to explain that throwing plates of food in the direction of people at a frantic pace was not exactly how community building worked, I was not confident in my ability to resist rolling my eyes or letting my voice betray that I thought he was a twit. Instead I tried to say “that’s great” without sounding sarcastic. Then I skedaddled.

I kept feeling his disapproving eyes on me from across the room every time I spent whole minutes chatting with people and teasing the regulars and going outside to make sure the dogs (who had to wait outside because of the health code) had enough water and love and table scraps.

Bentley, above, is a service animal so he got to come inside with us.

In On the Clock, Guendelsberger talks about how companies like McDonalds assign specific amounts of time — in seconds — to each task and display clocks prominently to encourage competition between employees. While keeping a smile on their face, of course.

Those who don’t keep up get fired.

Another delightful joy of modern minimum wage work is algorithmic scheduling, where employee needs are ignored completely. They’re given schedules that vary dramatically from week to week and are often posted the day before they start. If they end up short staffed, it’s the responsibility of the employees on that shift to simply work harder.

The modern business treats customers and employees alike as machines, without individual needs, desires, or worth. It’s easy for them and it saves them money. They can demand maximum productivity all day, every day. It’s not their problem when employees can’t keep up.

They don’t owe employees anything beyond minimum wage. Employees are on their own to figure out health insurance, child care, and eldercare in this precarious life.

In venues like McDonalds and Amazon, the toll of this sort of corporate mindset is borne mostly by the employees.

Sure, maybe your order is wrong. Maybe a disgruntled employee did the sort of things angry people do. But mostly they’re the ones who are getting evicted, leaving medical issues untreated, and worrying about the repercussions of choosing between going to work or leaving a parent with advanced dementia home alone.

When these sorts of business practices enter the medical field, things become a dystopia for everyone involved.

Few people will count nursing homes under the banner of utopian visions, but that’s where they belong.

When Harriet Tubman founded the Home for Aged & Indigent Negroes, she wasn’t aiming to take those who were no longer worth their salt and shove them somewhere to die out of view. She had a utopian vision based on dignity and care.

And then, long story short, came the hedge funds.

Floor staff in nursing homes are paid to do tasks that can be checked off a list, in a designated number of minutes.

The nursing home stories on UpWorthy and The Mighty that make people go “aww” are stories of unpaid labor.

The sort of labor that is not only unpaid, but puts people at risk of getting fired when it doesn’t make it into a heartwarming social media story. They are not checking off enough boxes during their shifts when they stop to treat patients like people.

Care is inefficient.

So people get unnecessary feeding tubes, because there’s no time to pay someone to sit and feed them. People who get restless when ignored are given drugs to “relax” them. People wither in the way that we wither when we are treated like a body, like the physical manifestation of someone’s to-do list.

A to-do list that means rent won’t get paid if it’s not completed in time. And there’s never enough time, by design, to make sure employees aren’t slacking off and ensure maximum profits.

Thirty years ago, the plight of Romanian orphans deprived of human contact made headlines around the world.

Orphanages were utopian, too, once. They brought children in from the streets. But then they turned into gulags, where children were kept alive but not loved.

If you have been to a nursing home, you know what this looks like.

Up until a few weeks ago, if you were a resident in a nursing home and had “visitors,” you were probably fed by the hands of those visitors. Those visitors ensured your medications were given properly, untangled the cause of side effects, and reduced the likelihood of over-medication. Those visitors did your laundry and made sure you had clean sheets and took precautions against bedsores and combed your hair.

Those visitors performed all the care that hedge funds and corporations had decided were harming profits.

People confide in me that they are overwhelmed by providing care at home. They can no longer perform the physical labor of lifting someone so many times a day. They cannot provide the 24/7 care that is necessary. But they don’t want to abandon their loved one to a nursing home.

My dark reassurance is that having someone in a nursing home doesn’t mean you provide any less care than when they live at home. It simply means you provide care in a different way.

It means you can go home and sleep through the night. You can go to work without worrying about scheduling a PCW. You can shower without wondering if there is a fire in the kitchen. You are still the primary caregiver.

The haunting story of the Romanian orphans is a vivid warning of what happens in the case of “caregiver absence.”

Now, with nursing homes on lockdown to slow the spread of the novel coronavirus, every resident of a nursing home is someone without visitors. They are all Romanian orphans.

There are fewer staff on the floor than ever and now they are expected to do their paid work, perform the labor of “visitors,” and coordinate video calls for residents.

Staff who manage to meet these impossible demands are celebrated as saints and heroes.

Staff who fall short of these absurd expectations are berated and derided as abusive, heartless, willing to neglect the frail and leave them to die in their own filth.

Can a feeding tube really provide a meal?

A meal is so much more than the nutrition it provides our bodies. It does not simply fill our bellies so chemicals signal to our brain to turn off the feeling of hunger.

A meal is seeing a familiar face with a smile. It’s being told what’s on the menu today, by someone who remembers you don’t like peas and warns you they’re in the chicken pot pie. It’s someone explaining your options in a way you understand and taking the time to figure out what you’re asking for. It’s someone coming to sit and chat with you once the rush dies down. It’s catching up on the gossip with the people at your table. It’s laughing with friends.

A meal is about being seen, accepted, and cared for. It’s sharing something, be it a cookie or a story.

I pity anyone who thinks a feeding tube (or soylent!) is an adequate replacement for a meal.

Those people are the ones calling the shots and writing up the rules of our world.

The answer is not more volunteers or even more staff on the floor. It’s not hiring different people or making them sit through workshops. It sure as shit isn’t more surveillance and supervision.

The answer is to let go of the clock and the lists and the idea that this is a race.

Games are fun when they’re just games.

Competing so you can pay your rent is not fun, it’s not a game. It’s deeply cruel to the staff who are forced to “play” and to the residents who are being denied the care they need and deserve.

Care is not charity. Love is not something extra, if there’s time for it.

On March 16th, a man who was old enough to be high risk of the coronavirus joked that it was a mercy for people in nursing homes to be taken out quickly. They’re already living a fate worse than death.

It’s a common sentiment, even if it sounds crass. How many of our parents and grandparents have joked that we would rather someone smother them with a pillow or shove them off a cliff than put them in a nursing home? Or let them live longer than their ability to control their bowels?

It’s no wonder that nursing homes become sites of horror when they exist within a culture that does not view life as worth living if you need assistance with the activities of daily living.

It’s no wonder that life doesn’t feel worth living when people who need assistance are treated as an unprofitable chore.

The magic of history is the reminder that this was not inevitable.

Life doesn’t contain clear narratives. Scientific management and a world dictated by algorithms were not the only potential outcome.

They are not the only potential future.

They’re not the only potential present.

We can do things differently.

But things won’t be different when our children are taught that care can be quantified.

Thornne is ready to take the time to see and accept people for who they are.