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The Rich and the Healthy

The rich and the healthy misunderstand poverty and sickness. They see only a line to be crossed between too little and enough, between sickness and health. But there is poverty without imminent starvation, and sickness not prey for cancer or infection. The fear of death is easy to sympathize with; but the rich and the healthy never understand what it means to have to choose.

Torture is not about pain; it is about humiliation and violation. Those who succumb to torture do not succumb because of the pain, but because of the horror, because such things can really happen. Your mother never taught you that someday you might be given over naked and helpless into the hands of your enemies and left to their devices. Subject to torture, you cannot believe what is happening to you. It is never your will that breaks; it is always your mind.

Poverty also warps the mind. The lives of the rich and healthy branch out like trees or deltas. The world lies before them like a menu, where they choose not just what to do, but who to be. They are free to indulge or abstain. The poor and sick run on rails, along routes chosen by others. Where they are going depends on nothing but where they came from.

The old company store model is the extreme. But what is better about wages so low that you can survive only by shopping for food that destroys your health as it prolongs your life? To be poor, if not starving, is still to have to make such unbelievable choices: food or health, a safe home or crushing debts, enough hours for a decent wage or knowing your children on sight; and when you go to a doctor, or the hospital, or to beg from your insurer – your money or your life.

There is a syndrome of poverty that results from walking such mazes, like the inanition of an animal punished repeatedly and capriciously. Hope is the leavening every mind requires to imagine, to try, to dare, to build; but it does not take very much poverty to crush hope out of a person. This living with eyes taped open, in vigilance as unsleeping as it is certain to be unavailing, in awaiting the disaster you know is coming but cannot stop, is known in the poor as laziness.

The poor must make do, when they can get them, with damaged or dying machines: old cars that fume and guzzle, a dishwasher that uses so much electricity you can only run it once a week, a chainsaw that spits chips and stutters, but whose blade you cannot afford to replace or have sharpened.

The same is true of their bodies. Even in the most enlightened societies it is the right of the poor, not to be healthy, but to be healthy enough for work, or at least not to draw attention. Even when medicine can do nothing for them, the rich and the sick may enjoy an excusing diagnosis, even if just a syndrome without treatment; they have idiopathic as a marker for the diseases we recognize but do not understand. But for the poor, what the first test does not show, does not exist. There are no follow-ups, no referrals. They cannot fight. It is in the autopsies of the rich and vocal in their sufferings that new diseases are discovered; it is therefore strange, but likely true, to think that there are afflictions only of the poor stemming from malnutrition, stress, or hard labor, which have never been and never will be named, for they silence their victims.

This is the way of the world; the alternatives known so far are worse. The disappearance of visible poverty from parts of the first world is partly the result of fitted blinders (not just a cowardly unwillingness to see the problem – the visibility of the poor only discourages investment, and worsens their plight), and partly the result of globalization, which segregates classes in their own countries.

My interest here is sociological, because all civilizations have the poor in common, and the poor of all civilizations are alike. Details of costume, language, and climate aside, all hovels are really one hovel, and all unskilled labor is really one vast project, now building a pyramid, now digging a canal; now sewing shirtwaists, now sewing jeans. In thinly populated hunter-gatherer societies, or in civilizations with money to hand, there is room for culture, room to work out what it means to be human; but the poor are always and everywhere worn down to the same nub: what we all are in the end, at the last, at the core.