Jul 19, 2020

STAY SAFE: The Abuse and Neglect of Care

Sinead Murphy

The global ‘lockdown’ has sought to defy our capacities for analysis, with its shock-and-awe impact on what has been our way of life. I begin, then, with a more banal scenario, which makes for rather dull reading, but from which it is possible to scale-up to an understanding of ‘Covid19.’

My six-year-old son, Joseph, is Autistic, and in the second year of his schooling at a ‘mainstream’ institution. Towards the end of February of this year, I received a phone call from his teaching assistant, about the application of Vaseline to his lips. A banality, to be sure, and yet those who care for young people with Autism will know that no detail in the cut and thrust of daily life is too banal to become of material importance to the comfort of everyone around.

That morning, I had noticed that Joseph was beginning to suffer from chapped lips – in the windy northeast of England, not very unusual. Everybody knows, of course, that if you do not use some kind of protective balm, you have to be very disciplined to resist the urge to moisten chapped lips with your tongue; everybody also knows that this serves only to worsen their condition.

As with many aspects of life, however, this mundane one, when in play in the context of Autism, is potentially much more serious. It is not possible to explain to Joseph that he must not lick his lips. If you are in time, you can apply the appropriate balm, although it is also not possible to explain to Joseph that he ought not to rub this off immediately.

Neither is this something that you can simply, physically, prevent him from doing, as you can prevent his dismounting a chair, for instance; you can hold back his arms to stop him, but he cannot, during that time of restraint, be brought to accept it as he can be brought to accept having to remain on a chair; the call of the sensory is simply too overwhelming, and the distress of being asked to ignore that call, simply too profound.

So, the hope is that you have caught the drying lips in time, that your applications of balm are sufficiently frequent, and that the residue that remains from its being every time wiped away is enough to soothe and to defuse the situation.

If things do not work out well, the chapped lips, within a few hours, become sore, at which point Joseph adds to his constant licking of them an equally constant rubbing at them with his hand and his sleeve, which causes them to become more sore, and leads him to begin to be distressed by this soreness and to indicate that he would like it to be removed, although any attempt to soothe it – applying some kind of cream – will be resisted and cause further distress and will be undone by more immediate rubbing.

The worst result is that a large patch of Joseph’s face, around his mouth, becomes cracked and bleeding, affecting his ability to eat and drink comfortably and generally to be in the world with any ease, none of which can be discussed with him or explained to him. The whole situation can last as long as two weeks. Hence, on the morning in question, I applied Vaseline to Joseph’s lips a number of times before school.

When we arrived at the doorway of his classroom and were met by his teaching assistant, I explained the situation, applied more Vaseline myself then and there, and handed over the tub, indicating that I wished it to be used regularly throughout the day. Joseph’s assistant was aware of the potential gravity of the situation, and readily agreed.

Then, later that morning, I received the phone call, letting me know that, having seen the tub of Vaseline being produced and used, another teacher had questioned whether Vaseline was named in Joseph’s file as a product that could be applied to his skin and whether I had read through and signed any document that proved that I was accepting of such a product being administered by designated members of staff at the school.

The answer to these questions was no, and no, and so I received a call to inform me that no further application of Vaseline could be made to Joseph’s lips without my having first signed a paper to testify that this was something I agreed to.

I drove to the school, was talked through a printed form, which I signed, and after which the Vaseline was used as I wished it to be, but at least ninety minutes had passed in the interim, during which Joseph’s lips had deteriorated from lack of attention, and a situation that might have lasted one day went on to last, in this case, about five days. But more disturbing to me, during that time, than the sight of Joseph’s broken lips was the consciousness of what had made them so, of the defining aspects of this so-banal slice of his institutional care.

Most defining of all: the abdication of care, for the sake of a more explicit enterprise, one that, unlike the lowly duties of care, admits of protocols and their documentation, regulation, assessment and review. This enterprise is an offshoot of care, or it would seem to be, but is so overgrown as to suck the life out of care in rendering it salient and fit for insertion into the institution’s documentary boxes.

This is the enterprise, not of care, but of safety, an achievement that is apparently related to care – perhaps even to the most careful of care – but that actually works against the grain of care, in its mission to bring clarity to that which would remain in the shadows and to pin down that which can only run free; in its determination, in short, to administer care to its death.

For, the enterprise of safety is an enterprise that trades on the careful management of that to which care is essentially indifferent: risk, in all its measurable gradations, as what is, without question, to be averted.

It is the rendering salient of risk, then, that is the great achievement of our institutions’ focus on safety; risk, abroad as avoidable and to be avoided, and fear of which lends to every instance of its documentation and planned mitigation the heady sensation of salvation, of the certainty that we do, after all, really care.

Next to this, the unheralded banality of plain old care offers little indeed to satisfy.

But all of that was many months ago, between which time and now, the northeast of England, like most other regions, became a ghostly place to live – no more encounters at the doorways of classrooms; no more classrooms, no more doorways, no more encounters. As the global media bombarded us with the threat to us all posed by the ‘Coronavirus,’ the government instituted responses to that threat that, only a few weeks before, were surely utterly unimaginable.

The crisis, we were constantly reminded, was a fluid one, and fact not that easy to distinguish from all the hype. But one thing at least was very quickly undeniable: the stunning readiness, on the basis of almost non-existent data, with which the populations of previously-advertised-as ‘liberal’ democracies accepted an erosion of their most fundamental liberties, such that their sitting at the bedside of a dying relative, their strolling at the beach with a friend, their sharing a glass of wine with a neighbour, their sitting on a park bench to watch as the world goes by, were, all of them, banned, perhaps even punishable by arrest, imprisonment and fines.

The readiness, you see, is all; how prone we were shown to be, how poised, for the comprehensive dissolution of our arrangements for living. So prone, so poised, that this ‘unprecedented’ situation simply must have had its precedents.

And so it had. Not least in the matter of Joseph’s Vaseline. Surely a trivial affair when compared with the ‘Covid’ crisis, and yet with precisely the same characteristics as have played out in the new disease.

Most obviously, of course, there is that salience of risk and wholesale aversion to it, which made the furore around Joseph’s Vaseline as it made the furore around ‘Covid19’; whatever the virus’ toll will finally be, remarkable almost immediately was how naturally it came to us all to posit its spread and then move to avoid it.

So naturally, and so untempered by any weighing up of the risk of the virus against the prospect of economic, social, personal and political upheaval, that the identification and avoidance of risk is clearly, for us, by now a second nature. We have been, this time, so apt to see a threat and move without hesitation to escape it, that we are revealed as a population already set-up to hedge against risks that are placed in stark relief, at the expense of attending to anything else.

Certainly at the expense of attending to our care.

Affected by our aversion to the perceived risk of the spread of ‘Covid19’ was just that suffocation of care by safety that was notable in the scenario of Joseph’s Vaseline. Anyone might have expected that the ‘Covid19’ virus would have called for the exercise of especially assiduous care, over those who contracted it or who might have contracted it and were the most vulnerable to its effects – data suggests that that was, in the main, people who were over seventy and who already suffered from a serious disease.

This heightened requirement for care would have made demands on us personally, of course, as well as on government structures, equipment and personnel.

And yet, taking care of the vulnerable was not the dominant response to ‘Covid19,’ which, from its first appearance in our midst – here in the UK and in most places around the world – prompted, not so much the care of those vulnerable as measures to ensure the safety of us all.

Perhaps for the first time in history, those who were healthy found themselves quarantined too, with the injunction to Stay Safe trading between distanced friends and families as if we were all of us somehow in danger.

And this direction of our energies towards our safety did not only cause us to neglect our duties of care: as in the case of Joseph’s Vaseline, it constituted a direct erosion of their very possibility, our concern for everyone’s safety actively stifling many of our hopes of being cared for at all, by each other and by the organizations in which we also deposit that responsibility.

For all that our attention was oriented towards the efforts of ‘key workers’ on behalf of us all and to ad hoc upsurges of support for each other, it is not possible to deny that the overriding effect of this pandemic obsession with our safety was exposition and active depletion of the many ways in which we still did exercise vestiges of care over one another – it is not simply, then, that we did not for a while have the time or the energy to care; many aspects of care were explicitly out of bounds, against the rules, unsafe.

Visits to the isolated elderly: unsafe; honouring the dead and their survivors: unsafe; support for the disabled: unsafe; even life-saving treatment for cancer: unsafe. So many aspects of care, not just overlooked but outlawed, or, at the very least, rendered vaguely ill-advisable.

Even that gate which you might have held open, only a couple of weeks before, so that the woman behind you with the push chair and the shopping bags might the easier pass through, was allowed to swing shut on her approach; this most mundane piece of care, become somehow unsafe.

And when the gate banged closed, we did not look behind sheepishly or apologetically, or perhaps we did so only for a short while, as we only smiled for a short while at those from whom we moved two metres away. For, very quickly, our lack of care for one another came to be exercised triumphantly, as proof of our keeping each other safe. Which is the great recompense of trading care for safety. It enables what taking care of one another does not offer. It enables us to signal our righteousness, to show it, to measure out how much we really care and then declare it to the world.

Care would circulate indistinctly, you see, and is not nearly so satisfying to our managerial sensibilities, which require rigid markers not implicit understandings, and whose impulse always is to refract our interactions through some apparently neutral sign system, though such a system works mostly to block those interactions under the aegis of their mere refraction.

It is this that explains the debacle of Joseph’s Vaseline, as the banal add-on duty of applying it a few times to his chapped lips was so readily forsaken for the opportunity to signal how good his school is at keeping its students safe, in the ready-and-waiting slots on generic documents, appropriate for submission to regulatory bodies that have the remit to award a school as ‘outstanding’ if the signals of its really caring are sufficiently loud and clear.

Nothing hidden, nothing unacknowledged, nothing unrewarded: the unhistoric practices of care exchanged for the blazoning signals of our Staying Safe.

If there is anything unprecedented about the current crisis, it is not its stifling of our care of each other by its overwhelming concern for our safety – our care of each other has long been thus stifled.

It is that it renders so blatant the tension that exists between the false friends of safety and care as to have made the reneging upon care of each other itself the signal of our concern for each other’s safety, bypassing the bureaucratic language and the documentation that were still required in the case of Joseph’s Vaseline, in which simply not applying the balm did not yet suffice to show how much we really cared; when we steered clear of one another during the ‘lockdown,’ when we did not visit our neighbour, when we avoided helping to carry the bags or to open the door, when we did not hug or kiss or even shake each other’s hand, every minute and miserable deletion of the rituals of care was itself the siren of our great and global virtue.

Care, then, has been well and truly stifled, literally right before our eyes, by our ever-growing need of being seen to care. And no easier way of being seen to care than to signal our concern for our safety – false friends indeed, safety and care, when pursuit of the one implies the same thing as shameful neglect of the other. No care is care enough now that is not its hyperbolic signal; no care is care enough now that is not to be seen and from afar; no care is care enough now that is not the highly visible promise of our safety.

High-visibility is a well-established trope in our society, a growing phenomenon well before the arrival of ‘Covid19.’ As we have wandered lonely, it has long been a host of neon that has gladdened our gaze – whole swathes of high-visibility arm bands and gilets and jackets and backpacks and bottles and hats and gloves and socks and shoes, worn at all times of the night and day, under the highest of suns, and in the most remote of country retreats.

As if visibility, unaugmented, is just not visible enough; as if one is hidden in plain sight, unseen…and therefore unsafe, the curious link between being seen and being safe forged by a line in outdoor apparel. Our common-or-garden being in the world, not seen enough so not safe enough – not on the commons, not in the gardens.

Groups of children, in the morning light, skipping in high-visibility hand-in-hand the few short steps from their breakfast club to their school. Only the chance that Staying Safe affords us, to show how much we really care, can explain this garish excess; only our growing need to show that we care, to see that we care, to wear our caring hearts on our sleeves.

PPE is an acronym newly tripping off our tongues, but we have been in Personal Protective Equipment for quite some time, drawn by the beautiful simultaneity of its ensuring our safety and signalling our care, loath to take it off, lest, with it, we doff that certainty, ever more difficult to establish, that we care and are cared for.

But when everyone is neon, what then? What ultra high-visibility will be our signal then? How, then, will we see that we care? How far are we from calling forth the dangers from which we must keep each other safe, just so our signals can grow brighter and more brash, just so we can be sure we really care?

Or, are we there already? One and a half million people died last year of Tuberculosis – a highly infectious and preventable disease of the lungs. ‘Covid19’ too is a clear and present danger, but is it not also a concoction, a phantasm of extraordinary threat to merit the signalling of extraordinary care? It is certainly a land of opportunity: as the risk of unaugmented visibility is compounded now by the risk of unfiltered respiration, the chance to signal how much we really care opens onto new and fertile territory.

Hence the scramble for a mask to wear over our mouth and nose. Hence the rash of home-spun copies – in the colours and patterns of shirts no longer worn to work – fashioned with enterprise by a population that has long been unable to bear the unproclaiming diffuseness of care, a population that does not care and does not feel cared for if the sirens of salvation do not sound.

And sound loudly – the business of signalling, yet another of our society’s inflationary sectors, requiring ever more salient signs, ever louder sirens, to be seen and heard over the general glut and clamour. When the distances are increased so the signals can and must increase too.

Across a chasm of two metres or more, you had better be and you can be very loud and clear. So we step away from each other – further and with greater ceremony every day. And we don the masks of dubious protection and drown out the despair of lives that have just been cancelled with an almost hysterical display of our virtue: breathing itself, now riddled with risk, and the chance to Stay Safe, that is, to signal how much we really care, abroad as never before.

It is curious, though, is it not, that the eyes are allowed to stay open. Hardly a coincidence, that the eyes are the last to go. Nil by mouth; nil by nose; nil by ears too, long plugged with their pacificiers. But the eyes, wide and alert. Darkness falling over our other senses, and not so gradually, but the eyes left to see, floating cartoonishly, disembodied. After all, nothing that is not seen can be believed.

You can look, then, all you want. But you certainly cannot touch. The mask that leaves the eyes, partnered by the gloves that take the hands, sheathing them in a surgical second skin that is so much cleaner than the first one. Even winter gloves, loose woven; even kitchen Marigolds, flapping about the wrist. Anything but the skin that can touch and be touched, though the virus cannot pass through it as it can, we are told, enter via the eyes.

In the UK at least, it is the mantra of midwives and mothers-to-be: skin to skin with your baby, and not a moment to lose. Talk is of forming a bond, of easing anxieties, and, ironically, of protecting against infection. But the talk is almost wild, its rationale lying well below the reasoning, in a latent awareness that care must be established, and quickly, before all hope of connection is blocked, before this new being loses its immunity to signal, for which immunity we pine without knowing it.

We anticipate our own renewal by this virgin life, gloriously unable to see; to forgo, for a few precious moments, the heavy heavy work of being seen to care, and, simply, to care. And we sense that skin to skin is the way to do it, the way to be infected by unseeing, unsignalling care, and that time is not on our side, though the all-importance of immediacy is cold comfort to those women who give birth too anaesthetized to care. We still sense it, then: that care lives on the skin. That to care needs the touch of skin to skin – even if our rush to establish that care in the moments immediately after birth shows that we also sense, and desperately, that the chance to care does not come around very often…

Or, indeed, ever again. For, now that the gloves are on, what is to become of care?

When you cannot touch at all, when you are not even within touching distance? Can you care for someone if you cannot touch them? You can signal your care for them, sure; in fact, to signal well, you had better be at a distance; the further, the better your broadcast. But care, from a distance? Care, at arm’s length? What of caressing, stroking, holding, lifting, massaging, washing, rubbing, kissing, the skin to skin encounters of care?

We say that we are touched by someone, if what they say or do or are or have been awakens us to care. We care when we touch and are touched. But now this touch is against the rules.

Even to stand close enough to touch, even potentially to touch: infectious, unsafe.

A final stab from its false friend: safety renders care into contagion. The first product to sell out at the beginnings of the virus-crisis was hand sanitizer, as we washed and washed our skin that might touch and be touched, scrubbed it so hard that it dried and cracked and flaked away, casting our last hopes of care to the four harsh winds. When Stay Safe is Stay Clean, care is only the filth it would slough away.

This virus is certainly a reality, even if it is a fairly mundane one. But it is also an imaginary construct, a chimera of our desperate need for control, a fantasy of the extreme blockage and rigid management of all that is diffuse and runs free.

The virus, in other words, is care, our control-society’s hallucination of care: lethally indistinct and wildly circulating. Control-society’s nightmare, become the dream of ultimate containment.

As for touch, we are consigned now only to its simulation, to ‘keeping in touch,’ with the technologies so conveniently at the ready, to that barely-touch that the screens of our devices will tolerate, to that contempt-for-touch that is all they will endure.

Two centuries ago, when other institutions, of education and of health, began to be established, care was so obviously anathema to institution that we shied away for a while from attempts to manage it, content merely to oversee the dissolution of its varied pre-industrial forms, in which care circulated in households and communities in a manner constitutive of their fabric, in which care made part of the ‘commons’ – those unregulated, those diffuse resources, that are now under watchful lock and key.

The population of England at this time, plucked from its care-commons and without an institutional substitute, succumbed quickly to an average lifespan of only twenty years. But, in time for nurturing a stronger, longer-lived workforce, and in time to assuage escalating lobbying against the atrocity of its living conditions, early hesitation in instituting care at last came to an end and care was admitted on condition of its close confinement, within the walls of a new institution, a soft institution unlike those of health and education: the institution of the home, which, for all that we are used now to regarding it as a space natural to human life, is, as we know it at least, an invention of the nineteenth century.

People before then had a roof over their head, of course, and prepared food and slept soundly and gave birth and died away, but all of this was done in spaces quite unlike the enclosed, specialized, cordoned off, curtained in, home of the Victorian era.

Even as late as the early nineteenth century, houses, including large and rich houses, were built to contain relatively few rooms, with relatively huge windows and doors, wide casements and balconies, their inhabitants enjoying a mixed economy life that was outward-looking, public.

It took the beginnings of the effort to institutionalize care for the home as we know it to emerge, a domestic space for the simultaneous exercise and containment of care, staffed by a new kind of worker – another invention of the institutional age: the homemaker, a woman, a shadow of her former self, whose life was destined for the very first time to remain systematically unseen. It was with tremendous caution, then, that care entered into our institutional society, curtailed to the shadows of effort and enterprise, unsignalled inevitably, for care does not admit of signal, without price or wage, indistinct still, but stripped of its other essential aspect, for it had ceased to circulate, being kept within the walls of the purpose-built family home.

Only once care could be safely let out again – only once care could be rendered distinct, that is, made subject to the criteria and strategies and regulations and assessments that are the other side of the coins of price and wage – did the home begin to be established in a more visibly institutional way.

Care once again ventured out of doors, but it no longer circulated freely and was no longer indistinct, the care of children, old people and those with special needs being gradually accorded its price – the lowest of prices, of course, for care is still potentially the gravest threat to the society of control. So entered the care home, an institution whose rendering distinct, open to measurement and monetization, of the achievement of care sounded the death knell of care.

The care home: staffed, of course, almost exclusively by women, who trade duties of care in their own home for duties of care in a more explicitly institutional home, and who use care homes to care for their own children and old people in order to care for those who have traded being cared for by the unseen and unpaid work of women in their family for being cared for by the hardly seen and hardly paid work of women they have never met.

The care home, and its more recent underbelly, home care, in which the newly-distinct taking of care re-enters the home that had incubated it for so long, completing the circle of non-care to which care has been consigned by our society, so that those women who might have cared for their own families in their own homes, indistinctly though contained, instead care for other women’s families in other women’s homes, distinctly and still contained.

The pushing around of care between women in the shadows or just out of the shadows of life and work, a low-temperature laundering of the life of care by women who increasingly cannot care.

For, of course they cannot care – how could they? They do not know your old father and mother. They do not know your small baby. Drawn from the ranks of the most disadvantaged and signalled as all but worthless, they must simulate an effect – care – to which the institution in which they work is opposed.

A survey in 2018 by University College London, which questioned staff at care homes all across the UK, found that there is abuse and neglect in nine out of ten of them. No surprise. A study from ten years before, quoted by Silvia Federici in her essay on ‘Eldercare,’ found that half of those working in care homes in the US made use of food banks to feed themselves and their families.

These women are tired. They are hungry. They miss their parents and children, and are expected to care for the parents and children of others. Of course, they neglect and abuse. Just as most women do, in their situation…

Shortly after I gave birth for the first time, I received a communication from the UK National Health Service – a leaflet, on steps to take if you felt the impulse to shake your baby. I tossed it away. Shake my baby? Shake that tiny, sleeping being, so reliant, so sweet?

But a baby does not always sleep and is not always sweet. And after interrupted nights and days of taking care of a baby with colic, who was crying for no reason that I could understand in a home to which nobody came during the day, I experienced, for the first and not the last time, the impulse to shake him, from frustration and exhaustion and a loss of any sense of connection with a world in which the normal rules apply.

I think that many new mothers experience this, locked up – locked down – in a home whose carceral effect is so belied by its advertisement as a place of warmth and care that you have not even the consolation of resenting your prison but must look to yourself to explain your temptation to abuse and neglect.

New mothers are not vindictive any more than care workers are. But when you are installed in institutions of care that actively annihilate the possibility of care and yet expect you to imitate it in the shadows of life: that will make an abuser out of anyone.

Care is abused in the home. Care is neglected in the home. For, the home has strangled care’s vital components: circulation and indistinctness; commonness and immeasureableness. In the home, care, which can only run free, undergoes its double containment.

Which made it all so very fitting, that it was to our home to which we were expected to retreat, not, of course, for our care, but for our safety. Our home, in which we were ordered by our governments to STAY, in which we were ‘locked down’ – a term from the carceral system to which the home has always been apparently juxtaposed. Prisoners in our own homes – the idea used to express a contradiction.

But, of course, it never really did, as those women could have told us who have stayed and worked in homes for years and years. Home is the prison that was being prepared for us all along; destined, having killed all the ways that we might care, for its seamless repurposing as the institution of our safety, all that is left to us once care has been put beyond our reach.

Meanwhile, the great and tragic irony is that it was in the care homes that you were most likely to die with ‘Covid19.’ In these repositories of the old and the infirm, where should have begun our protection of the population from the virus, the obvious ‘front line’ from its very beginning.

In the care homes, they died by their thousands, falling silently into that chasm between the false friends of safety and care, not safe because they needed to be cared for, not cared for because all we could do is Stay Safe. Died in their thousands, without the touch of a human hand, while Do Not Resuscitate documents did their deathly rounds.