The Body as Revolution: Che Guevara on Social Medicine and Personal Health as a Political Act

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“If the body is not the soul, what is the soul?” wrote Walt Whitman in his heroic revolt against the lasting tyranny of Descartes, whose dismissal of the body and disdain for the soul may be the single most damaging ideological misstep of modernity. Long before we had evidence that the body is where we heal the traumas of being, that it is our mightiest instrument of sanity and joy, that “the mind narrates what the nervous system knows,” Whitman ministered to disfigured soldiers as a volunteer Civil War nurse, knowing what we still, in our age of disembodied intellects, deny — that the body is the frontline of our values, the revolutionary battleground on which all of our ideas and ideals are won or lost. A century later and a hemisphere over, a young medical student mounted his motorcycle to tour his continent, an inhaler in his battered backpack. Along the way, Ernesto “Che” Guevara (May 14, 1928–October 9, 1967) dreamt up a revolution on the scale of the world, the fundaments of which — a refusal to accept the givens, a defiant will to take charge of the possible — he had learned on the scale of the body.Born two months premature and almost immediately afflicted with bronchial pneumonia, Ernestito was a sickly, chubby child who wore heavy glasses to correct for his astigmatism and carried a vaporizer at all times to ameliorate the regular attacks of asthma so severe that his mother home-schooled him until the authorities demanded he enroll in a state school. He did, but his attendance record was punctuated by frequent asthma-induced absences, sometimes lasting weeks, during which his mother continued to tutor him, teaching him French. From the moment he learned to read, books had been his solace through the long and lonely quarantines, and now he was reading the poetry of Baudelaire and the novels of Émile Zola in the original. But with each paginated portal into another world, he suffered the tension of a mind so free, so limitless, captive to the limitations of the body. Just as the young Beethoven had resolved to “take fate by the throat” as he began losing his hearing, Ernesto took his destiny in his own hands. He fasted, became fastidious about his everyday diet, started swimming, took to the outdoors, trying to find his limits, to push them, sometimes so hazardously that his friends had to carry him home wheezing. As a teenager, he joined a local rugby team coached by a young biochemistry and pharmacology student several years his senior, who became a close and dear friend. During practice breaks, Ernesto would sit with his back against a light post reading Freud and Faulkner, Dumas and Steinbeck, beginning to think about what it means and what it takes to be free — thoughts that would deepen and complicate a decade later as he witnessed the hunger, poverty, and disease throughout South America from his motorcycle, thoughts that would lead him to approach the body politic of the world with the same defiant will to change the givens, to prevail over the forces that keep people unfree. In the high summer of 1960, having anchored one major revolution and inspired many, Che Guevara addressed young doctors at the inauguration of a new training program at Cuba’s Ministry of Public Health. Although much of his speech, appropriately titled “On Revolutionary Medicine,” speaks to the particular conditions of Cuban society in the wake of the revolution, pulsating through it are timeless insights into the deepest meaning of health for any person and any society in any epoch. The Human Heart. One of French artist Paul Sougy’s mid-century scientific diagrams of life. (Available as a print.)Arguing that a revolution aims to create “a new type of human being,” that this is “the greatest work of social medicine,” and that “social change demands equally profound changes in the mental structure of the people,” he throws a gauntlet at Descartes with the intimation that the body is the substrate of the mind — for a person and for a people. Health, he argues, is a personal responsibility that has political power, which in turn makes it a collaborative intention:For one to be a revolutionary doctor or to be a revolutionary at all, there must first be a revolution. Isolated individual endeavour, for all its purity of ideals, is of no use, and the desire to sacrifice an entire lifetime to the noblest of ideals serves no purpose if one works alone, solitarily, in some corner of America, fighting against adverse governments and social conditions which prevent progress.[…]The battle against disease should be based on the principle of creating a robust body — not creating a robust body through a doctor’s artistic work on a weak organism, but creating a robust body through the world of the whole collectivity, especially the whole social collectivity.Art from The Human Body, 1959.He envisions the best possible fruition of revolutionary personal and public health:One day medicine will have to become a science that serves to prevent diseases, to orient the entire public toward their medical obligations, and that intervention is only necessary in cases of extreme urgency to perform some surgical operation or to deal with something uncharacteristic of that new society we are creating.Paradoxically, this collective triumph hinges upon the personal responsibility of the individual, who (as Eleanor Roosevelt also knew) is the fulcrum of all social change:As for all the revolutionary tasks, fundamentally it is the individual who is needed. The revolution does not, as some claim, standardize the collective will and the collective initiative. On the contrary, it liberates man’s individual talent. What the revolution does is orient that talent.[…]If we know the direction in which we have to travel, then the only thing left for us is to know the daily stretch of the road and to take it. Nobody can point out that stretch; that stretch is the personal road of each individual; it is what he or she will do every day, what a person will gain from their individual experience, and what they will give of themselves.donating = lovingFor seventeen years, I have been spending hundreds of hours and thousands of dollars each month composing The Marginalian (which bore the outgrown name Brain Pickings for its first fifteen years). It has remained free and ad-free and alive thanks to patronage from readers. I have no staff, no interns, no assistant — a thoroughly one-woman labor of love that is also my life and my livelihood. 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