Book Report: Our Malady

55. Timothy Snyder, Our Malady: Lessons in Liberty from a Hospital Diary (2020) (11/7/21)

In December 2019, the author suffered a burst appendix, which in turn caused a liver infection, which created an emergency situation leading to several operations. The instigating conditions went undetected, in both Germany (where he was lecturing on totalitarianism, his academic specialty) and back home in the U.S., and several weeks after his lecture and the initial treatments, Snyder ended up in an emergency room in his hometown of New Haven, Connecticut—and then in protracted care and recovery. "In five hospitals over three months, between December 2019 and March 2020, I took notes and made sketches. It was easy to grasp that freedom and health were connected when my will could not move my body, or when my body was attached to bags and tubes."

His first response to his predicament was rage: 

The rage was beautifully pure, undefiled by an object. I was not angry at God; this was not His fault. I was not angry at the doctors and the nurses, imperfect people in an imperfect world. I was not angry at the pedestrians moving freely about the city beyond my chamber of twisted sheets and tubes, nor at the deliverymen slamming their doors, nor at the truckers blowing their horns. I was not angry at the bacteria celebrating the bounty of my blood. My rage was directed against nothing. I raged against a world where I was not. . . .
     The rage was pure me, my wish to be a sound not an echo, to compose not decompose. It was not against anything, except the entire universe and its laws of unlife.

He did not die, however. And his second response to his predicament was a "mood that sustained me in a different way: a feeling that life was only truly life insofar as it was not only about me." This reminded me of the last book I reported on, where our connectivity to all things, all beings, all moments, all possibilities is paramount. The profound notion that we are not, ever, truly alone. We rely on an entire web of experience and trust and help to survive well. Both rage and empathy, solitude and solidarity, served to help him back on his feet

The above-quoted words are from the prologue. Snyder continues into an introduction, "Our Malady" ("our system of commercial medicine, dominated by private insurance, regional groups of private hospitals, and other powerful interests, looks more and more like a numbers racket"), where he compares the U.S. against other, more socially responsive nations. The book thus becomes a treatise on freedom—thoughts of which Snyder is rarely far from. 

America is supposed to be about freedom, but illness and fear render us less free. To be free is to become ourselves, to move through the world following our values and desires. Each of us has a right to pursue happiness and to leave a trace. Freedom is impossible when we are too ill to conceive of happiness and too weak to pursue it. It is unattainable when we lack the knowledge we need to make meaningful choices, especially about health.

I would suggest that this statement applies to all manner of "ills" in our society—but yes, Snyder's focus is on health and our "commercial medical" establishment, which is not focused on health so much as on profit. 

Four "lessons" follow (and granted, they are the bulk of the book, so my report is skewed): (1) Health care is a human right; (2) Renewal begins with children; (3) The truth will set us free; and (4) Doctors should be in charge. In these, he again compares the U.S. system with, in particular, the Austrian system, with which he is familiar, focusing on treatment of "the whole person" versus treatment, usually as quickly as possible, of symptoms (guess which applies to which country). He looks at the U.S. response to the covid pandemic, which was hitting just as he lay in the hospital. He weighs philosophical questions, and the power/political establishment, and how the individual really cannot survive, or at least thrive, without a supportive social network.

It is a sobering read, and although he ends with a conclusion titled "Our Recovery," it's hard to see this country actually recovering (and again, one can easily apply that across a spectrum of ills). Health care is, in fact, one reason we are strongly considering a move to Europe, where ordinary people actually seem to matter.