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Beyond Empathy to System Change: Four Poems on Health by Bertolt Brecht

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Abstract

Bertolt Brecht’s poem “A Worker’s Speech to a Doctor” is frequently cited as a means to raise awareness among health workers of the health effects of living and working conditions. Less cited is his Call to Arms trilogy of poems, which calls for class-based action to transform the capitalist economic system that sickens and kills so many. In this article, we show how “A Worker’s Speech to a Doctor,” with its plea for empathy for the ill, contrasts with the more activist and often militant tone of the Call to Arms trilogy: “Call to a Sick Communist,” “The Sick Communist’s Answer to the Comrades,” and “Call to the Doctors and Nurses.” We also show that, while “A Worker’s Speech to a Doctor” has been applied in the training of health workers, its accusatorial tone towards health workers’ complicity in the system the poem is critiquing risks alienating such workers. In contrast, the Call to Arms trilogy seeks common ground, inviting these same workers into the broader political and social fight against injustice. While we contend that the description of the sick worker as a “Communist” risks estranging these health workers, our analysis of the Call to Arms poems nevertheless indicates that their use can contribute to moving health workers’ educational discourse beyond a laudable but fleeting elicitation of empathy for the ill towards a structural critique and deeper systemic understanding in order to prompt action by health workers to reform or even replace the capitalist economic system that sickens and kills so many.

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Fig. 1.  A Worker’s Speech to a Doctor

Copyright © 2019, 2015 by Tom Kuhn and David Constantine. Underlying copyright © Bertolt-Brecht-Erben / Suhrkamp Verlag. Used with permission of the publisher, W. W. Norton and Company, Inc. All rights reserved

Fig. 2.  Call to a Sick Communist

Copyright © 2019, 2015 by Tom Kuhn and David Constantine. Underlying copyright © Bertolt-Brecht-Erben / Suhrkamp Verlag. Used with permission of the publisher, W. W. Norton and Company, Inc. All rights reserved

Fig. 3. The Sick Communist’s Answer to the Comrades

Copyright © 2019, 2015 by Tom Kuhn and David Constantine. Underlying copyright © Bertolt-Brecht-Erben / Suhrkamp Verlag. Used with permission of the publisher, W. W. Norton and Company, Inc. All rights reserved

Fig. 4. Call to the Doctors and Nurses

Copyright © 2019, 2015 by Tom Kuhn and David Constantine. Underlying copyright © Bertolt-Brecht-Erben / Suhrkamp Verlag. Used with permission of the publisher, W. W. Norton and Company, Inc. All rights reserved

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  • 08 July 2023

    Incorrect placement of figures and formatting issues.

References

  • Adams, Zoe, and Anna Reisman. 2019. “Beyond Sparking Joy: A Call for a Critical Medical Humanities.” Academic Medicine 94 (10): 1404. https://doi.org/10.1097/ACM.0000000000002871

    Article  PubMed  Google Scholar 

  • Bamforth, Iain, ed. 2003. The Body in the Library: A Literary Anthology of Modern Medicine. New York: Verso.

    Google Scholar 

  • Bann, Maralssa, Savannah Larimore, Jessica Wheeler, and Lauren Olsen. 2022. “Implementing a Social Determinants of Health Curriculum in Undergraduate Medical Education: A Qualitative Analysis of Faculty Experience.” Academic Medicine 97 (11): 1665–72. https://doi.org/10.1097/ACM.0000000000004804

    Article  PubMed  Google Scholar 

  • Baum, Fran, Belinda Townsend, Matthew Fisher, et al. 2022. “Creating Political Will for Action on Health Equity: Practical Lessons for Public Health Policy Actors.” International Journal of Health Policy and Management 11 (7): 947–60. https://doi.org/10.34172/ijhpm.2020.233

  • Beagan, Brenda L., Anna MacLeod, Michelle Owen, Tara M. Pride, and Kaitlin R. Sibbald. 2022. “Lower-Class Origin Professionals in Canadian Health and Social Service Professions: ‘A Different Level of Understanding.’ ” Social Science & Medicine 309 (September): 115233. https://doi.org/10.1016/j.socscimed.2022.115233

  • Beech, Bettina M., Chandra Ford, Roland J. Thorpe Jr, Marino A. Bruce, and Keith C. Norris. 2021. “Poverty, Racism, and the Public Health Crisis in America.” Frontiers in Public Health 9:699049. https://doi.org/10.3389/fpubh.2021.699049

  • Beech, Matt. 2017. “Neoliberalism, New Labour, and the Welfare State.” In Liberalism and the Welfare State: Economists and Arguments for the Welfare State, edited by Roger E. Backhouse, Bradley W. Bateman, Tamotsu Nishizawa, and Dieter Plehwe, 118–30. Oxford: Oxford University Press.

    Google Scholar 

  • Benach, Joan, Juan Michael Pericàs, Eliana Martínez-Herrera, and Mireia Bolíbar. 2019. “Public Health and Inequities under Capitalism: Systemic Effects and Human Rights.” In Philosophical and Methodological Debates in Public Health, edited by Jordi Vallverdú, Angel Puyol, and Anna Estany, 163–79. New York: Springer.

    Chapter  Google Scholar 

  • Berkowitz, Seth A. 2023. “Health Care’s New Emphasis on Social Determinants of Health.” NEJM Catalyst Innovations in Care Delivery 4, no. 4 (April). https://doi.org/10.1056/CAT.23.0070

  • Bezruchka, Stephen. 2022. Inequality Kills Us All: COVID-19’s Health Lessons for the World. New York: Taylor and Francis.

    Book  Google Scholar 

  • Bodner, Aidan, Sarah Spencer, M. Ruth Lavergne, and Lindsay Hedden. 2022. “Exploring Privatization in Canadian Primary Care: An Environmental Scan of Primary Care Clinics Accepting Private Payment.” Healthcare Policy 17, no. 3 (February): 65–80. https://doi.org/10.12927/2Fhcpol.2022.26727

  • Boyle, Mark, James Hickson, and Katalin Ujhelyi Gomez. 2023. “An Unequal Pandemic: Neoliberalism, Variegated Vulnerability, and Uneven Disease Burdens.” In COVID-19 and the Case Against Neoliberalism: The United Kingdom’s Political Pandemic, 155–179. Cham: Springer International Publishing.

  • Brecht, Bertolt. (1937) 2019. “Call to Arms.” In The Collected Poems of Bertolt Brecht, edited and translated by Thomas Kuhn and David Constantine, 701–703. New York: Liveright Publishing Corporation.

  • ______. (1938) 2019. “A Worker’s Speech to a Doctor.” In The Collected Poems of Bertolt Brecht, edited and translated by Thomas Kuhn and David Constantine, 700–701. New York: Liveright Publishing Corporation.

  • ______. (1945) 2019. “On the Critical Attitude.” In The Collected Poems of Bertolt Brecht, edited and translated by Thomas Kuhn and David Constantine, 927. New York: Liveright Publishing Corporation.

  • ______. (1948) 2001. “A Short Organum for the Theatre.” In Brecht on Theatre: The Development of an Aesthetic. Edited and translated by Steve Giles, Marc Silberman, Thomas Kuhn, and John Willett. New York: Hill and Wang.

  • ______. 2001. Brecht on Theatre: The Development of an Aesthetic. Edited and translated by Steve Giles, Marc Silberman, Thomas Kuhn, and John Willett. New York: Hill and Wang.

  • Bryant, Toba, and Dennis Raphael. 2020. The Politics of Health in the Canadian Welfare State. Toronto: Canadian Scholars’ Press.

    Google Scholar 

  • Burton, Tom. 2022. “Pandemic Deaths to Reduce Australia’s World-Leading Life Expectancy.” The Guardian, November 10, 2022. https://www.afr.com/politics/federal/pandemic-deaths-to-reduce-australia-s-world-leading-life-expectancy-20221110-p5bx4k

  • Cadigan, Sean T. 2017. Review of Public Sector Unions in the Age of Austerity, edited by Stephanie Ross and Larry Savage. Labor 14 (2): 147–48.

    Article  Google Scholar 

  • Carr, Sandra E., Farah Noya, Brid Phillips, et al. 2021. “Health Humanities Curriculum and Evaluation in Health Professions Education: A Scoping Review.” BMC Medical Education 21:568. https://doi.org/10.1186/s12909-021-03002-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Capers, Quinn, Leon McDougle, and Daniel M. Clinchot. 2018. “Strategies for Achieving Diversity through Medical School Admissions.” Journal of Health Care for the Poor and Underserved 29 (1): 9–18. https://doi.org/10.1353/hpu.2018.0002

    Article  PubMed  Google Scholar 

  • Carrdus, Anna. 2000. “The Uses of Rhetoric in Brecht’s Svendborg Poems.” In Brecht’s Poetry of Political Exile, edited by Ronald Spiers, 135–51. New York: Cambridge University Press.

    Google Scholar 

  • Case, Anne and Angus Deaton. 2020. Deaths of Despair and the Future of Capitalism. Princeton: Princeton University Press.

  • City University of New York. 2022. “MPH in Community Health in Collaboration with UAH.” Degrees and Programs. Accessed April 25, 2023. https://sph.cuny.edu/academics/degrees-and-programs/mph-program-with-university-of-alcala/mph-in-community-health-in-collaboration-with-uah/

  • Clark, Chase, and Alex Grant. 2023. “One Million Canadian Youth Want Communism.” Fightback, March 7, 2023. https://www.marxist.ca/article/one-million-canadian-youth-want-communism

  • Conway-Hicks, Siobhan, and Janet de Groot. 2019. “Living in Two Worlds: Becoming and Being a Doctor among Those Who Identify with ‘Not from an Advantaged Background.’ ” Current Problems in Pediatric and Adolescent Health Care 49 (4): 92–101. https://doi.org/10.1016/j.cppeds.2019.03.006

    Article  PubMed  Google Scholar 

  • Corbyn, Jeremy. 2022. “Free Market Capitalism Has Led to the Most Grotesque Inequalities in the World.” EFSYN, January 23, 2022. https://www.efsyn.gr/politiki/synenteyxeis/328882_jeremy-corbyn-free-market-capitalism-has-led-most-grotesque

  • Crawford, Paul, Brian Brown, Charley Baker, Victoria Tischler, and Brian Abrams. 2015. “Health Humanities.” In Health Humanities, edited by Paul Crawford, Brian Brown, Charley Baker, Victoria Tischler, and Brian Abrams, 1–19. London: Palgrave Macmillan.

    Google Scholar 

  • Damsgaard, Janne Brammer. 2021. “Integrating the Arts and Humanities Into Nursing.” Nursing Philosophy 22 (2): e12345. https://doi.org/10.1111/nup.12345

  • Davis, Christopher R., and Jed D. Gonzalo. 2019. “How Medical Schools Can Promote Community Collaboration Through Health Systems Science Education.” AMA Journal of Ethics 21 (3): e239–47. https://doi.org/10.1001/amajethics.2019.239

    Article  PubMed  Google Scholar 

  • Dellasega, Cheryl, Paula Milone-Nuzzo, Katherine M. Curci, James O. Ballard, and Darrell G. Kirch. 2007. “The Humanities Interface of Nursing and Medicine.” Journal of Professional Nursing 23 (3): 174–79. https://doi.org/10.1016/j.profnurs.2007.01.006

    Article  PubMed  Google Scholar 

  • Dennhardt, Silke, Tavis Apramian, Lorelei Lingard, Nazi Torabi, and Shannon Arntfield. 2016. “Rethinking Research in the Medical Humanities: A Scoping Review and Narrative Synthesis of Quantitative Outcome Studies.” Medical Education 50 (3): 285–99. https://doi.org/10.1111/medu.12812

    Article  PubMed  Google Scholar 

  • Dobson, Hannah, Charles B. Malpas, Aidan J. C. Burrell, et al. 2021. “Burnout and Psychological Distress amongst Australian Healthcare Workers during the COVID-19 Pandemic.” Australasian Psychiatry 29 (1): 26–30. https://doi.org/10.1177/1039856220965045

    Article  PubMed  Google Scholar 

  • Donohoe, Martin T. 2009. “Stories and Society: Using Literature to Teach Medical Students about Public Health and Social Justice.” International Journal of Creative Arts and Interdisciplinary Practice, no. 8 (October): 1–21. http://phsj.org/wp-content/uploads/2007/10/Stories-and-Society-IJCAIP1.pdf

  • ______. 2012. “Using Literature to Teach Medical Students about Public Health and Social Justice.” In Public Health and Social Justice: A Jossey-Bass Reader, edited by Martin T. Donohoe, 597–608. San Francisco: Jossey-Bass.

    Google Scholar 

  • Encyclopaedia Britannica Online. 2022. “Epic Theatre (Dramatic Genre).” Last updated October 31, 2022. https://www.britannica.com/art/epic-theatre.

  • Engels, Friedrich. (1845) 2009. The Condition of the Working Class in England. Oxford: Oxford University Press.

  • Esping-Andersen, Gosta. 1990. The Three Worlds of Welfare Capitalism. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • ______. 1999. Social Foundations of Postindustrial Economies. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Farmer, Paul. 2004. “An Anthropology of Structural Violence.” Current Anthropology 45 (3): 305–25. https://doi.org/10.1086/382250

    Article  Google Scholar 

  • ______. 2013. To Repair the World: Paul Farmer Speaks to the Next Generation. Edited by Jonathan Weigel. With a foreword by President Bill Clinton. Berkeley: University of California Press.

  • Farmer, Paul, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. 2006. “Structural Violence and Clinical Medicine. PLoS Medicine 3, no. 10 (October): e449.

  • Farrell, Coleen. 2019. “ ‘We Know What Makes Us Ill.’ Poverty, Homeless, and Health in the Poetry of Bertolt Brecht.” Medium, #MedHumChat No. 6, March 14, 2019. https://medium.com/@colleenmfarrell/we-know-what-makes-us-ill-1d802394ff52

  • Fisher, Matthew, Toby Freeman, Tamara Mackean, Sharon Friel, and Fran Baum. 2022. “Universal Health Coverage for Non-communicable Diseases and Health Equity: Lessons from Australian Primary Healthcare.” International Journal of Health Policy and Management 11, no. 5 (May): 690–700. https://doi.org/10.34172/2Fijhpm.2020.232

  • Freeman, Linda H., and Cathy Bays. 2007. “Using Literature and the Arts to Teach Nursing.” International Journal of Nursing Education Scholarship 4 (1): 15. https://doi.org/10.2202/1548-923X.1377

    Article  Google Scholar 

  • Freudenberg, Nicholas. 2021. At What Cost: Modern Capitalism and the Future of Health. New York: Oxford University Press.

    Book  Google Scholar 

  • German, Carol P. 1986. “Using Literature to Teach Nursing.” Journal of Nursing Education 25 (2): 84–86. https://doi.org/10.3928/0148-4834-19860201-15

    Article  Google Scholar 

  • Giles, Steven, and Thomas Kuhn, eds. 2015. Brecht on Art and Politics. London: Bloomsbury Publishing.

    Google Scholar 

  • Glahn, Philip. 2014. “Early Exile: ‘Singing about Dark Times,’ 1933–41.” Chap. 4 in Bertolt Brecht. Chicago: Reaktion Books.

  • Gonzalo, Jed D., and Greg Ogrinc. 2019. “Health Systems Science: The ‘Broccoli’ of Undergraduate Medical Education.” Academic Medicine 94 (10): 1425–32. https://doi.org/10.1097/ACM.0000000000002815

    Article  PubMed  Google Scholar 

  • Hanna-Attisha, Mona. 2018. What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City. London: One World.

    Google Scholar 

  • ______. 2021. “A Single Ohio Hospital Reveals All That’s Wrong with American Health Care.” New York Times, April 8, 2021. https://www.nytimes.com/2021/04/08/books/review/the-hospital-brian-alexander.html

  • Harvey, Michael. 2021. “The Political Economy of Health: Revisiting Its Marxian Origins to Address 21st-Century Health Inequalities.” American Journal of Public Health 111, no. 2 (February): 293–300. https://doi.org/10.2105/AJPH.2020.305996

  • Higgs Paul, and Graham Scambler 1998. “Explaining Health Inequalities: How Useful Are Concepts of Social Class?” In Modernity, Medicine and Health: Medical Sociology towards 2000, edited by Graham Scambler and Paul Higgs, 82–99. London UK: Routledge.

    Google Scholar 

  • Hofrichter, Richard. 2003. “The Politics of Health Inequities: Contested Terrain.” In Health and Social Justice: Politics, Ideology, and Inequity in The Distribution of Disease, edited by Richard Hofrichter, 1–56. San Francisco: Jossey Bass.

    Google Scholar 

  • Institute for Economic Affairs. 2021. “67 Percent of Young Brits Want a Socialist Economic System, Finds New Poll.” Institute for Economic Affairs Media, July 6, 2021. https://iea.org.uk/media/67-per-cent-of-young-brits-want-a-socialist-economic-system-finds-new-poll/

  • Jones, Anne Hudson. 2013. “Why Teach Literature and Medicine? Answers from Three Decades.” Journal of Medical Humanities 34 (4): 415–28. https://doi.org/10.1007/s10912-013-9241-9

    Article  PubMed  Google Scholar 

  • King, Lawrence, Gábor Scheiring, and Elias Nosrati. 2022. “Deaths of Despair in Comparative Perspective.” Annual Review of Sociology 48:299–317. https://doi.org/10.1146/annurev-soc-030320-031757

    Article  Google Scholar 

  • Kuhn, Tom. 2000. “Visit to a Banished Poet: Brecht’s Svendborg Poems and the Voices of Exile.” In Brecht’s Poetry of Political Exile, edited by Ronald Spiers, 47–65. Cambridge: Cambridge University Press.

    Google Scholar 

  • Kuhn, Tom, and David Constantine. 2019. The Collected Poems of Bertolt Brecht. New York: Liveright Publishing.

    Google Scholar 

  • Kumagai, Arno. K., and Thirusha Naidu. 2019. “The Cutting Edge: Health Humanities for Equity and Social Justice.” In Routledge Handbook of the Medical Humanities, edited by Alan Bleakey, 83–96. New York: Routledge.

  • Kumagai, Arno. K., and Delese Wear. 2014. “ ‘Making Strange’: A Role for the Humanities in Medical Education.” Academic Medicine 89, no. 7 (July): 973–77. https://doi.org/10.1097/ACM.0000000000000269

  • Lawrence, Robert. 2019. “Promoting Social Justice Through Education in Public Health.” In Social Injustice and Public Health, 3rd ed, edited by Barry Levy, 421–35. New York: Oxford Academic.

    Google Scholar 

  • Lepley, John. 2022. Review of Deaths of Despair and the Future of Capitalism, by Angus Case and Anne Deaton. Review of Radical Political Economics 54 (3): 383–90. https://doi.org/10.1177/04866134221093098

    Article  Google Scholar 

  • Levins, Richard. 2003. “Is Capitalism a Disease? The Crisis in US Public Health.” In Health and Social Justice: Politics, Ideology, and Inequity in the Distribution of Disease, edited by Richard Hofrichter, 365–84. San Francisco: Jossey Bass.

    Google Scholar 

  • Liebertz, Scott, and Jason Giersch. 2022. “Perceptions and Assessments of Socialism versus the US System: Experimental Evidence.” The Social Science Journal, June 6, 2022, 1–13. https://doi.org/10.1080/03623319.2022.2066878

  • Markowitz, David M. 2022. “Gender and Ethnicity Bias in Medicine: A Text Analysis of 1.8 million Critical Care Records.” PNAS Nexus 1, no. 4 (September): pgac157. https://doi.org/10.1093/pnasnexus/pgac157

  • Martín-Martín, Alberto, Enrique Orduna-Malea, Mike Thelwall, and Emilio Delgado López-Cózar. 2018. “Google Scholar, Web of Science, and Scopus: A Systematic Comparison of Citations in 252 Subject Categories.” Journal of Informetrics 12, no. 4 (November): 1160–77. https://doi.org/10.1016/j.joi.2018.09.002

  • McCartney, Gerry, Mel Bartley, Ruth Dundas, et al. 2019. “Theorising Social Class and Its Application to the Study of Health Inequalities.” SSM-Population Health 7 (April): 100315. https://doi.org/10.1016/j.ssmph.2018.10.015

  • Medvedyuk, Stella, Piara Govender, and Dennis Raphael. 2021. “The Reemergence of Engels’ Concept of Social Murder in Response to Growing Social and Health Inequalities.” Social Science and Medicine 289 (November): 114377. https://doi.org/10.1016/j.socscimed.2021.114377

  • Meili, Ryan. 2017. A Healthy Society: How a Focus on Health Can Revive Canadian Democracy, 2nd ed. With a foreword by Roy Romanov. Saskatoon, SK: Purich Books.

  • Moniz, Tracy, Maryam Golafshani, Carolyn M. Gaspar, et al. 2021. “How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review.” Academic Medicine 96 (8): 1213–22. https://doi.org/10.1097/ACM.0000000000004118

    Article  PubMed  Google Scholar 

  • Morley, Georgina, Jonathan Ives, and Caroline Bradbury-Jones. 2019. “Moral Distress and Austerity: An Avoidable Ethical Challenge in Healthcare.” Health Care Analysis 27:185–201. https://doi.org/10.1007/s10728-019-00376-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Moudatsou, Maria, Areti Stavropoulou, Anastas Philalithis, and Sofia Koukouli. 2020. “The Role of Empathy in Health and Social Care Professionals.” Healthcare 8 (1): 26. https://doi.org/10.3390/healthcare8010026

    Article  PubMed  PubMed Central  Google Scholar 

  • Muller, Jessica, and Dennis Raphael. 2021. “Does Unionization and Working under Collective Agreements Promote Health?” Health Promotion International, December 13, 2021, daab181. https://doi.org/10.1093/heapro/daab181

  • Murthy, Vivek. 2022. “Confronting Health Worker Burnout and Well-Being.” New England Journal of Medicine 387:577–79. https://doi.org/10.1056/NEJMp2207252

    Article  PubMed  Google Scholar 

  • Ocasio-Cortez, Alexandria. 2022. “AOC: Capitalism Is ‘Not a Redeemable System for Us.’ ” Interview by Andy Serwer. Yahoo News, February 3, 2022. https://ca.news.yahoo.com/aoc-capitalism-not-redeemable-system-110000599.html

  • Parker, Stephen. 2014. Bertolt Brecht: A Literary Life. London: A&C Black.

    Book  Google Scholar 

  • Penn State College of Medicine. 2023. Health Systems Science. Accessed April 26, 2023. https://med.psu.edu/health-systems-science

  • Popay, Jennie, Margaret Whitehead, and David J. Hunter. 2010. “Injustice Is Killing People on a Large Scale—But What Is to Be Done about It?” Journal of Public Health 32, no. 2 (June): 148–49. https://doi.org/10.1093/pubmed/fdq029

  • Rafferty, Anne M. 2018. “Nurses as Change Agents for a Better Future in Health Care: The Politics of Drift and Dilution.” Health Economics, Policy and Law 13, no. 3–4 (July): 4475–91. https://doi.org/10.1017/S1744133117000482

  • Raphael, Dennis, and Toba Bryant. 2022. “Emerging Themes in Social Determinants of Health Theory and Research.” International Journal of Health Services 52 (4): 428–32. https://doi.org/10.1177/00207314221109515

    Article  PubMed  PubMed Central  Google Scholar 

  • ______. 2023. “Socialism as the Way Forward: Updating a Discourse Analysis of the Social Determinants of Health.” Critical Public Health, February 15, 2023. https://doi.org/10.1080/09581596.2023.2178387

  • Raphael, Dennis, Toba Bryant, Piara Govender, Stella Medvedyuk, and Zsofia Mendly‐Zambo. 2022. “Desperately Seeking Reductions in Health Inequalities in Canada: Polemics and Anger Mobilization as the Way Forward?” Sociology of Health & Illness 44, no. 1 (January): 130–46. https://doi.org/10.1111/1467-9566.13399

  • Rayner, Jeremy, Susan Falls, George Souvlis, and Taylor C. Nelms, eds. 2020. Back to the ’30s? Recurring Crises of Capitalism, Liberalism, and Democracy. Cham, Switzerland: Palgrave Macmillan.

    Google Scholar 

  • Roderick, Peter, and Allyson M. Pollock. 2022. “Dismantling the National Health Service in England.” International Journal of Health Services 52 (4): 470–79. https://doi.org/10.1177/00207314221114540

    Article  PubMed  PubMed Central  Google Scholar 

  • Rosenhaft, Eve. 2006. “Brecht’s Germany: 1898-1933.” In The Cambridge Companion to Brecht, 2nd ed., edited by Peter Thomson and Glendy Sacks, 3–21. Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Ross, Stephanie, and Larry Savage, eds. 2020. Labour under Attack: Anti-unionism in Canada. Halifax: Fernwood Publishing.

    Google Scholar 

  • Rozsa, Matthew. 2021. “A New Book Asks Whether Capitalism Is Compatible with Public Health. (The Answer Is No).” Salon, March 14, 2021. https://www.salon.com/2021/03/14/a-new-book-asks-whether-capitalism-is-compatible-with-public-health-the-answer-is-no/

  • Saad, Lydia. 2019. “Socialism as Popular as Capitalism among Young Adults in U.S.” Gallup, November 25, 2019. https://news.gallup.com/poll/268766/socialism-popular-capitalism-among-young-adults.aspx

  • Sacks, Glendyr. 2006. “A Brecht Calendar.” In The Cambridge Companion to Brecht, 2nd ed., edited by Peter Thomson and Glendy Sacks, xv–xxv. Cambridge: Cambridge University Press.

    Google Scholar 

  • Saffran, Lise. 2014. “ ‘Only Connect’: The Case for Public Health Humanities.” Medical Humanities 40 (2): 105–10. https://doi.org/10.1136/medhum-2014-010502

    Article  PubMed  Google Scholar 

  • Sanders, Bernie. 2023. It’s Ok to Be Angry about Capitalism. New York: Crown.

    Google Scholar 

  • Scheiring, Gábor, David Stuckler, and Lawrence Kind. 2020. “Deindustrialization and Deaths of Despair: Mapping the Impact of Industrial Decline on Ill Health.” Political Economy Research Institute (PERI), Working Paper No. 530, November 30, 2020, University of Massachusetts. https://doi.org/10.7275/27137530

  • Schneider, Eric C., Arnav Shah, Michelle M. Doty, Roosa Tikkanen, Katharine Fields, and Reginald D. Williams II. 2021. Reflecting Poorly: Health Care in the US Compared to Other High-Income Countries. Fund Reports, August 4, 2021. New York: Commonwealth Fund.

  • Schnell, Mychael. 2023. “House Passes Resolution Denouncing Socialism, Vote Splits Democrats.” The Hill, February 2, 2023. https://thehill.com/homenews/house/3841636-house-passes-resolution-denouncing-socialism-vote-splits-democrats/

  • Sedas, Ana Christina. 2021. “Biosocial Analysis of Migration and Health in Mexico, LAC and Beyond: Exploring the Right to Health for People on the Move Before, During and Beyond the COVID-19 Pandemic.” Master’s diss., Harvard Medical School. https://dash.harvard.edu/handle/1/37368601

  • Statistics Canada. 2022. “Experiences of Health Care Workers during the COVID-19 Pandemic, September to November 2021.” The Daily, June 3, 2022. https://www150.statcan.gc.ca/n1/daily-quotidien/220603/dq220603a-eng.htm.

  • Sumner, Rachel C., and Elaine L. Kinsella. 2021. “Grace under Pressure: Resilience, Burnout, and Wellbeing in Frontline Workers in the United Kingdom and Republic of Ireland During the SARS-Cov-2 Pandemic.” Frontiers in Psychology 11:576229. https://doi.org/10.3389/fpsyg.2020.576229

  • Trachtenberg, Zev. 1995. “Rousseau’s Critique of Catharsis.” In Rousseau and Criticism, edited by Lorrinae Clark and Guy Lafrance, 195–204. Ottawa: North American Association for the Study of Jean-Jacques Rousseau.

    Google Scholar 

  • University of British Colombia. n.d. Master of Public Health. Accessed April 26, 2023. https://spph.ubc.ca/programs/mph/

  • University of Toronto. 2023. “Social Accountability.” Global Health & Equity. Accessed April 26, 2023. https://dfcm.utoronto.ca/social-accountability

  • Vgenopoulou, Ioanna, Vasiliki Adamopoulou, and Foteina Tzavella. 2015. “Sociological Factors that Influence Access to Primary Health Care (PHC) Settings.” International Journal of Occupational Health and Public Health Nursing 2 (3): 13–20.

    Google Scholar 

  • Waitzkin, Howard. 2018. Health Care Under the Knife: Moving Beyond Capitalism for Our Health. New York: Monthly Review Press.

    Google Scholar 

  • Wald, Hedy. S., Jonathon McFarland, and Irina Markovina. 2019. “Medical Humanities in Medical Education and Practice.” Medical Teacher 41 (5): 492–96.https://doi.org/10.1080/0142159X.2018.1497151

  • Westbrook, Mansa, and Michael Harvey. 2023. “Framing Health, Behavior, and Society: A Critical Content Analysis of Public Health Social and Behavioral Science Textbooks.” Critical Public Health 33 (2): 148–59. https://doi.org/10.1080/09581596.2022.2095255

    Article  Google Scholar 

  • Whiteside, Heather, Stephen McBride, and Bryan Evans. 2021. Varieties of Austerity. Bristol: Bristol University Press.

    Book  Google Scholar 

  • Williams, Gareth H. 2003. “The Determinants of Health: Structure, Context and Agency.” Sociology of Health & Illness 25, no. 3 (April): 131–54. https://doi.org/10.1111/1467-9566.00344

  • Winlow, Simon, and Steve Hall. 2022. The Death of the Left: Why We Must Begin from the Beginning Again. Bristol: Policy Press.

    Book  Google Scholar 

  • Woolhandler, Steffie, David U. Himmelstein, Sameer Ahmed, et al. 2021. “Public Policy and Health in the Trump Era.” The Lancet 397 (10275): P705–53. https://doi.org/10.1016/S0140-6736(20)32545-9

    Article  Google Scholar 

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Acknowledgments

The authors greatly appreciate the support provided by Dr. Tom Kuhn of Oxford University for this endeavor and his permission to reproduce the poems from his and David Constantine’s Collected Poems of Bertolt Brecht. The comments provided by the anonymous reviewers were very helpful.

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Authors and Affiliations

  1. Graduate Program in Health Policy and Equity, York University, Toronto, ON, Canada

    William MacGregor

  2. Montreal, Canada

    Martin Horn

  3. School of Health Policy and Management, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada

    Dennis Raphael

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  1. William MacGregor
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Correspondence to Dennis Raphael.

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This manuscript is original content that has not been submitted elsewhere. Because this article provides an analysis of existing published literature, it is our understanding that the statements regarding ethics approval and patient consent are not applicable to our submission. Permission to reproduce the poems was provided by the publisher, W. W. Norton and Company, Inc.

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Endnotes

1 The liberal welfare states (for example, Australia, Canada, the United Kingdom, and the United States) provide modest benefits such that the State usually provides assistance when the market fails to meet citizens’ most basic needs (Esping-Andersen 1990, 1999). Their political and social history is one of dominance by business interests resulting in the population relying on the employment marketplace rather than the State as the source of economic and social security. These liberal welfare states are the least developed in terms of provision of citizen economic and social security. Changes since the mid-1980, which have seen even greater dominance by business interests, have led some to now call these nations neo-liberal welfare states (Beech 2017).

2 The merger of the State with corporate power is, by definition, a form of fascism, a linkage that has drawn attention to the similarities between the contemporary scene and the 1930s Weimar Republic, in which Brecht wrote prior to his exile (Rayner et al. 2020).

3 Martín-Martín et al. (2018, 1175) show that Google Scholar “finds significantly more citations than the WoS Core Collection and Scopus across all subject areas.” It was also found that Google Scholar surpasses Web of Science and Scopus in its coverage of literature in the social sciences and humanities.

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MacGregor, W., Horn, M. & Raphael, D. Beyond Empathy to System Change: Four Poems on Health by Bertolt Brecht. J Med Humanit 45, 53–77 (2024). https://doi.org/10.1007/s10912-023-09801-5

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