Labours of Love by Madeleine Bunting evaluate – a humbling ebook about care | Society books
D.During my chemotherapy, I wrapped my bald head in a scarf and stumbled slightly uncomfortable into the shops. White vans stopped to let me cross the streets. The pressed assistant of the cooperative came out from behind the cash register to help me pack. During these months I was looked after by countless people; The friendliness of strangers often overwhelmed me.
What “care” means is a big issue. It happens everywhere. In the daily maintenance of life in households and families as well as in public institutions or social organizations that are steeped in their own stories and traditions. It’s deeply intimate and deeply cultural at the same time. Paid or unpaid, the quality of care in our lives is nothing less than sociality itself: it is an index of how we survive as a society and as a species. It tells us how important we are to human life.
These essential existential questions are at the heart of Laboratories of Love. Madeleine Bunting’s book could easily have turned into an angry polemic or a valley of tears. It’s neither, though angry and very moving. She meant it as a warning of a “crisis of unprecedented scale” in the delivery of health and welfare services across the UK. With the advent of the coronavirus, his eloquent plea for change has become even more urgent.
Laboratories of Love combines the techniques of social inquiry – Bunting was a former Guardian journalist – with heartfelt ethical inquiry. For five years the author shadowed caregivers, nurses and doctors in the public and private sectors, in the health sector and in so-called “social welfare”. She took part in staff meetings and general practitioner consultations. She spoke to charities, parents of disabled children, small businesses in the care industry, and contract workers and caregivers at home. She volunteered for short stays in nursing homes and spent time in hospices.
Listening, say their respondents, makes up nine tenths of the job. Nursing is about paying attention. It takes time and focus
The certificates she collects constantly confirm what is meant by “good” care. Listening, say their respondents, makes up nine tenths of the job. Nursing is about paying attention. It takes time and focus and trust. It’s not always about action; it is often wordless. It cannot be easily measured. In other words, care is often priceless. However, in a modern, industrialized society like ours with a growing population, it often has to be paid for and passed on to us by those we do not know.
Like her respondents, Bunting believes that caring is innate in humans. It is reciprocal and is a therapeutic use of the self. Vulnerability, she writes, is a form of connection. One of the prompts for the book was her own experience of losing control and autonomy as a young mother caring for a newborn as her father gradually died. Her imagination of complete independence collapsed. Your feminism had to be rethought.
Bunting describes the erosion of care as a principle and practice on many fronts. It gives detailed statistics, but much of the overview will be terribly familiar. Austerity has wiped out social services and brought the funds to the point. The shortage of nurses has reached critical proportions. Face-to-face contact is constantly being hampered by the market mechanisms of “efficiency” and financial accountability. “Compliance” and new regulations increase the impersonality. (One nurse continues to call everyone on the ward “amiable” despite a well-intentioned ban on caresses by the hospital team.) Computer technology puts everyone behind a screen and carries the burden of “data management” for nurses or applicants. A nurse fills out a form for each patient every hour. Kate, the mother of an autistic child, desperate to have to treat her son as a failure to get a high score on the 50 or so pages of the Disabled Housing Allowance Application.
She treats the marketing of care as a product. “Care packages” are “delivered”; Satisfaction questionnaires are ubiquitous – nurses are accused of not showing enough “empathy”. “Convenience” and “Availability” become the mantras; General practitioners who are open seven days a week are now a “service industry”. With the increasing medicalization of society, a consumer mentality promotes a feeling of entitlement: a patient clicks on the nurse with her fingers to attract attention.
In the past, care work was women’s work (care has long suffered from the association with an idealized female role of self-sacrifice). Considered purely intuitive, relational, and routine, it is often belittled by medicine ‘s emphasis on the rational or scientific. This “crushing” opposition strengthens the hierarchies of pay and inequality of status. However, nursing involves complex activities. Pete, a ward nurse, needs medical knowledge and an understanding of individual needs to order the right mattress for a patient. He spends hours doing paperwork. Every aspect of his job is shaped by technology and budget.
Caregivers are exhausted from excessive workload and long shifts. John, a Health Care Assistant (Nursing Assistant) for over 15 years, is paid £ 10 an hour. He supplements his hospital salary by working in the supermarket on Sundays. Temporary agency work in particular can be both lonely and precarious. As a contract worker, Kelly was endlessly moved. She received no sick pay, vacation entitlement or travel expenses. After only three hours of training, she bathed, lifted, and treated strangers. When she switched to home care, she was appalled by the regime and shocked to see a worker wash the face of a client who was soundly asleep. Eventually she went to get a job in a shop.
Sculptor Luke Perry’s medical staff installed in a park near Birmingham pays homage to caregivers during the coronavirus pandemic. Photo: Jacob King / PA
Many of the worst paid caregivers who speak bunting come from faith. Can secular humanism, she asks, regard caring as an ethical imperative?
Short sections between chapters on the history of each keyword – care, empathy, kindness, compassion, compassion, dependency, suffering – provide food for thought. As love proceeds, we learn to listen. Bunting draws on an impressive range of quotes and arguments, from Rilke to Paula Rego; from Walt Whitman (who worked in the overcrowded military hospitals during the American Civil War) to Martha Nussbaum and feminist nursing philosophers.
When asked how care was devalued, Bunting does not idealize the past. Home care, she claims, has long been “in custody”; The welfare state was not designed for our aging population. The history of domestic service in the UK and abroad casts a long shadow over nursing work. After doing her best to deal with it, an openly disillusioned graduate felt obliterated by her job in high-end homes. One customer simply addressed her as a “supervisor”.
More of us live longer. The “slow death” of our time with a long age, interrupted by falls or strokes, is putting increasing pressure on the NHS (including increasing deaths of the elderly in the emergency room). Almost a third of the daycare centers have closed and in other parts of the country “care deserts” have opened up. Nonetheless, “geriatric care” remains a source of rich choice in the private sector that is apparently recession-proof, especially for foreign investors.
In the face of a second wave of Covid-19, there are other proposals for reinvestment in the care industry, for reshaping welfare, and for collective solutions that could reevaluate care jobs. Bunting can only briefly address this. The need to make places and names in the book anonymous also has its drawbacks. But activists will find a lot of grist for their mill.
Working love is a beautiful achievement. It’s full of humanity. I found it extremely exciting and, although the word is unpopular, humiliating. Although often exhausted from the Sisyphic work of “rolling back fear,” the caregivers she speaks to remain infinitely curious about her patients or clients and want to hear life stories. They often belittle their efforts – “it’s nothing,” they say. “It’s a privilege.” But they do the work that really matters.
• Alison Light is Radical Romance: A Memory of Love, Sorrow, and Comfort is published by Penguin. Labor of Love: The Crisis of Caring is published by Granta (£ 20). To order a copy, go to guardianbookshop.com. Shipping costs may apply.