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“Inflamed: Deep Medicine and the Anatomy of Injustice”: Extended Interview with Dr. Rupa Marya

Web ExclusiveAugust 02, 2021
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In an extended interview, we continue our conversation with Dr. Rupa Marya, co-author with Raj Patel of the new book, Inflamed: Deep Medicine and the Anatomy of Injustice, which examines the social and environmental roots of poor health. “We need to understand that it has to be a multimodal response to this pandemic,” says Dr. Marya. She also discusses the influence of Indigenous resistance on the creation of this book, and how this matters today in understanding the fight to stop the Dakota Access pipeline and Enbridge’s Line 3.

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report, The Quarantine Report. I’m Amy Goodman, as we continue with Part 2 of our look at the book Inflamed: Deep Medicine and the Anatomy of Injustice. It’s by the best-selling author Raj Patel and Dr. Rupa Marya, associate professor of medicine at the University of California, San Francisco, where she practices and teaches internal medicine. She’s co-founder of the Do No Harm Coalition, a collective of health workers committed to addressing disease through structural change.

Thanks so much for continuing this conversation with us. Dr. Marya. Why don’t you start off by talking about how you and Raj Patel came together to write Inflamed and what exactly “deep medicine” means.

DR. RUPA MARYA: Yes. Thank you for having me again, Amy.

Well, Raj and I have been friends for several years. We met at an event where I was playing with my band, Rupa & the April Fishes, and he was dressed up as a GMO tomato. We were protesting Monsanto’s environmental terror. And I had just given a talk. When we came up with the idea of the book, I had just given a talk at the University of Texas, Austin, where he was there, on my work looking at racism and state violence as health problems. This was back in 2016 or 2017.

I had been working with the Frisco Five, who were on hunger strike protesting the police violence in San Francisco. I was accompanying them on that hunger strike. And California Native people called me out to Standing Rock as the response to the protest against the Dakota Access pipeline was becoming increasingly violent. When I was out there, the Lakota, Dakota community members, the grandmothers asked me to stay and help form a clinic to decolonized medicine, which quickly turned into a clinic and farm, the Mni Wiconi Clinic and Farm, which we’ve been working on for several years under Indigenous leadership.

And so, Raj heard this talk and said, you know, in our conversation as he drove me to the airport, as we were thinking about, you know, the work that I’ve done in medicine and in activism and in — and in music, frankly, because the music is what really opened the doors to these different communities and allowed me to enter these conversations that physicians don’t normally have with community members. And it was through those relationships that I have learned to lead in my work by following their direction.

So, Indigenous communities who are shutting down the pipelines — right now Line 3, also Dakota Access pipeline — Indigenous communities here in Ohlone territory who are protecting the West Berkeley Shellmound, in spite of the California Supreme Court ruling that it can be turned into condos and more, you know, commercial sites — people can go to Shellmound.org to learn about that work.

But Raj drove me to the airport, said, “You know, we should really write a book.” And for me, as a physician, you know, listening to Cori Bush just talk, Representative Cori Bush, you can really see the violence of capitalist society in the bodies of our unhoused people. If you look carefully, you can map an architecture of an anatomy of our dysfunction as a society in the bodies of our people who are suffering most brutally under colonial capitalism. And Raj’s experience being a political ecologist, an economist, a food systems thinker, an activist who works with peasant movements around the world, we just felt we could say something together that neither of us could say alone.

And so, we worked on looking at this intuition I had through traveling around the world with my band and seeing that places that were suffering the brunt of colonialism were the ones that expressed inflammatory diseases most profoundly. And I started, back in that time, to call it, you know, a colonized syndrome, and then have learned subsequently, as the science is showing us, especially, most interestingly, microbiome science is showing us, how the ecologies around us, the biodiversity or lack of biodiversity, the stress, the trauma, all of these things have become part of the exposures in our bodies, and they tune our bodies. Our bodies are responding to these things through inflammatory disease.

And so, it was a real honor to work with Raj on this project and to offer the world and offer people a way of understanding what we’re seeing right now as a — through an analysis of systems, because the reductionist mode of Western medical science is not appropriate. It’s not actually able to understand or address the systemic-level failures we’re seeing right now, whether it be pandemic or climate change.

And we’re seeing that right now with Delta. You know, we’re being told, “Vaccinate, vaccinate, everyone,” as if the vaccination — you know, it’s important that people do get the vaccine, that it does lower the rates of severity and hospitalizations, but people who are vaccinated right now are infected with Delta, and they’re spreading it. And so, we need to change the messaging. We need to understand that it has to be a multimodal response to this pandemic. There must be universal basic income so that people can stay home and isolate. There must be eviction moratoriums. There must be, you know, places where we can dismantle the kinds of violences that are encoded in capitalist society, so that people can be healthy.

AMY GOODMAN: What about simply Medicare for All, something has been proven for people 65 and above?

DR. RUPA MARYA: Absolutely.

AMY GOODMAN: It seems that while COVID is getting enormous attention in the corporate media, as it should — and the issue is just, you know: How do you stop the next surge? When this particular pandemic subsides, if it does — I mean, you think about the coverage in the media. It’s, you know, you have the talking heads speaking, and then every five or six minutes a commercial for health insurance, for a drug, particularly drugs, you know, Big Pharma. But this bigger discussion of how you make your — how you lift the health of a nation, what about that right now? And what would it mean, as you look at COVID, exposing the anatomy of racial injustice in this country? How does Medicare for All fit into this?

DR. RUPA MARYA: Absolutely. So, Medicare for All is essential for addressing our health disparities. And we know that here in California. We’re working on the Healthy California for All Commission to advance a model of healthcare in California that does not involve private healthcare insurance. The American people are done with the financial abuse from the private healthcare industry. Medicare for All and single-payer healthcare provides us with an opportunity to keep those resources within the healthcare system, so that that money is going to fund patient care to improve health outcomes. It’s not going to healthcare executives.

We see here in California that it’s healthcare executive lobbyists who are determining our COVID policy. So, while we were on the frontlines at UCSF in the hospital, you know, arguing for weekly testings, so that we weren’t unknowingly passing the virus to our patients, arguing for certain kinds of PPE, we’ve learned that it was a lobbyist, a healthcare executive lobbyist, who actually had the ear of the governor and the health — the secretary of health here to determine our policy. And that needs to stop, because it did not prioritize the health of workers or the health of patients. It prioritized the profits of the healthcare industry.

And so, we need to restructure and reconfigure our society at the most basic level. And Medicare for All is a great way to do that. We know that Medicare itself is what desegregated hospitals in the United States. So it plays a major role in advancing healthcare equity. So, if we talk about healthcare equity as an important thing — and everyone’s talking about it right now, health equity — we can’t just add it on as a feature of a system that was constructed for health inequity, which is colonial capitalism. You have to start decolonizing medicine. You have to start decolonizing our society, which means a restructuring and reconfiguring of how resources are flowing and how decisions are being made. And that is absolutely spot on. We do need Medicare for All, and quite urgently.

AMY GOODMAN: Well, Dr. Rupa Marya, clearly a conversation that needs to continue. Thank you so much for being with us, physician, activist, mother, composer, co-author with Raj Patel of the new book Inflamed: Deep Medicine and the Anatomy of Injustice.

To see Part 1 of our discussion with Dr. Rupa Marya and Raj Patel, go to democracynow.org.

But we’ll go out of the segment with music by Rupa & the April Fishes, whose music was described by the legendary Gil Scott-Heron as “liberation music.”

The original content of this program is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. Please attribute legal copies of this work to democracynow.org. Some of the work(s) that this program incorporates, however, may be separately licensed. For further information or additional permissions, contact us.

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