One recent evening, I was in my apartment getting ready for my night shift in the Cardiac Care Unit at a major hospital in New York City. It was 7 p.m., two hours before my first shift, and I was recounting how many patients were admitted in the unit with acute hypoxic respiratory failure due to Covid-19. As thoughts about the coronavirus tumbled in my mind, someone outside began hollering and banging pots. The cacophony surged, the voices multiplying and echoing through the air.
I looked out of the window and over the hill that my apartment rested on, gazing at a part of the Bronx that sprawled before me. The bellowing seemed to be coming from the apartments below. “The world has gone mad,” I thought. It wasn’t surprising that, given the current state of affairs, people had decided to start screaming en masse.
Only later did I learn, from a video on Instagram, that I had witnessed an act of solidarity with health care workers. At first, as a first-year resident in internal medicine, I felt joy and appreciation. We’re notoriously overworked and underpaid, our labor repeatedly exploited. We’re at the bottom of the physician hierarchy, often excluded from decisions that impact us and pacified with Friday pizza days, superficially cheery emails from hospital leadership, and “committees” designed to listen but not act on our raised concerns. Only 10 months into my three-year medical training, I was already feeling dispirited, so I welcomed the gratitude.
But a part of the narrative soon began to disturb me. Lionizing slogans—“Health Care Heroes,” “Thank you for risking your life for us,” “Salute our brave soldiers”—are becoming popular at a time when conditions for health care workers are worsening by the day. When our society’s appreciation for health care workers swells into a kind of hero-worship, it becomes too easy to avoid confronting the structural failures that have been exposed by this pandemic.
In 1884, Friedrich Engels published The Condition of the Working Class in England, a sweeping critique of Europe’s Industrial Revolution. The German philosopher laid bare the dreadful working conditions of urban English workers in the shadow of rapid urbanization and industrialization, connecting their long hours of work in unsafe environments to the exponential spread of infectious disease, unprecedented levels of malnutrition, and dismal livelihoods. The analysis Engels offered was ultimately one of capitalism:
When one individual inflicts bodily injury upon another, such injury that death results, we call the deed manslaughter.… But when society places hundreds of proletarians in such a position that they inevitably meet a too early and an unnatural death … when it deprives thousands of the necessaries of life [and] knows that these thousands of victims must perish, and yet permits these conditions to remain, its deed is murder.… No man sees the murderer, because the death of the victim seems a natural one, since the offence is more one of omission than of commission.
But murder it remains.
Millions have suffered throughout history under the guise of economic development, but the blade of Engels’s condemnation slices the veins of American society even today, bleeding the same truth. His declarations became particularly clear to me when I witnessed the chaotic responses of governments and hospital administrations to the Covid-19 outbreak. The Trump administration is failing to respond to the crisis as the president’s political decisions hinge on ego, ignorance, and denial. New York Governor Andrew Cuomo captured public attention with an illusion of effective leadership while gutting billions from the state’s Medicaid budget. Despite the pandemic’s exposing the fragility of American health care, Democratic leaders still refuse to support policies that would widely improve outcomes and guarantee health care for all.
In New York City hospitals, nurses are forced to wear trash bags as personal protective equipment, or PPE; resident physicians are given Yankees ponchos for protection; staff are asked to repeatedly reuse N95 masks; and physicians are denied testing and forced to return to work. This has caused infection to spread among health care workers, as many fall critically ill or die. A 37-year-old ENT resident in his final year of training in Michigan recently died, and in my own hospital, nurses have been admitted into intensive care units for coronavirus-related complications. Other hospitals are ruthlessly firing physicians who speak out about PPE shortages, cutting the salaries of seasoned emergency medicine physicians, and firing nurses for wearing their own masks. In classic American fashion, many physicians and nurses are now turning to GoFundMe pages to raise money for PPE—and being punished for it—while elected officials across both parties languish. Meanwhile, hospital CEOs are self-quarantining in their Florida vacation homes: protected, safe, and distant.
Rather than interrogate on a political and institutional level why our working conditions remain hazardous, our society is glorifying the struggle through hero narratives. We are applauded for endangering our lives to help others, but in reality, there is seldom a choice. We’re not willingly working unprotected every day; we have to. We have student loans to pay off, mortgages to cover, and families to support. If we don’t report every day to our hospitals, despite the lack of protections, we risk our livelihoods. In this sense, we’re not heroes as much as we’re desperate and bound, trapped in disempowering working conditions and with few alternatives because we’ve sacrificed too much time and money to pursue our professions.
The Covid-19 crisis also reveals how health care workers are closer to workers in the food, delivery, and agricultural industries than we are to CEOs and business owners. The struggle for safe work environments, hazard pay, and health care coverage by Amazon, Whole Foods, and Instacart employees are shared by health care workers who are denied these provisions by our hospital administrations. Nurses in New York City who have held protests share much in common with postal service workers, teachers, Detroit bus drivers, and Verizon employees, all of whom are organizing for economic justice and better safety. By investing in these causes, we can change the material conditions that have caused us to be labeled heroes.
Public empathy is important and valued at a time like this. Without it, our suffering would be ignored even more, and we’d feel more burned out and demoralized. Health care workers, however, need the type of solidarity that grounds itself in labor struggles, that appreciates the connectivity between us and other workers across the country, and that understands that we are paralyzed by our employers as much as by our political systems. When Chris Smalls, an Amazon warehouse worker, led an organized strike for better worker safety at the facility on Staten Island, he was fired. When Travis Watkins, a mechanic at General Motors, reported to his co-workers that management was not informing employees of a possible Covid-19 outbreak, he was fired. When Dr. Ming Lin, an emergency medicine physician, advocated on social media for better protections at a Seattle hospital he worked in, he was fired. The threats to worker safety are not only in abstract political spheres; they are more imminently within our workplaces.
Public energy should then refocus on worker struggles and collective action. In Philadelphia, health care workers and activists are demanding the reopening of Hahnemann Hospital, a facility that was shut down late last year by its multimillionaire owner, Joel Freedman, to make room for lavish condominiums. When an overwhelming number of patients began to strain surrounding hospitals because of Covid-19, he began negotiations with city officials for its reopening but then walked out after demanding $1 million per month that the city could not afford. Similarly, nurses and staff at Provident Hospital in South Side Chicago are protesting a sudden shutdown of its Emergency Department at a time when poor black Americans are disproportionately impacted by the pandemic. In other parts of the country, workers at General Electric successfully protested to urge the company to make ventilators, employees at an American Axle plant in Michigan walked out after the company failed to disclose that one of its workers tested positive for the coronavirus, and activists in New York are organizing tenant rent strikes and mutual aid programs in hard-hit communities.
Engels’s assertions could not be truer today than they were more than a century ago: The death of health care workers on the front lines of this crisis is a kind of murder, one that demands sweeping change. As our government and employers fail us, community activists are organizing grassroots movements to advocate for workers’ needs. The ideological challenge is to move away from pedestalized martyrdom and toward action that ensures protected and healthy lives for all. The truth is, nobody wants to be a hero. We just want to be safe.