“Were we this sick?” In conversation with Rupa Marya, author of Inflamed: Deep Medicine and the Anatomy of Justice
WORDS BY RAJEN BHATT
IG: @FRKSE_DIVSERIES
Rupa Marya
Co-authored by political economist Raj Patel and physician Rupa Marya, Inflamed: Deep Medicine and the Anatomy of Injustice (2021) is a book that uncovers the hidden relationships between our health and the injustices of our political and economic systems.
When I took Inflamed with me on vacation in February 2023, it was to a sunny and ostensibly relaxing place. The intent was to relax and be present with my wife – but I don’t know how to relax. I read the book within 4 or 5 days and I found myself speaking incessantly about it. This is how I relax.
I have been anticipating hitting the metaphorical snooze button for most of my life; the result of constant deadlines, stress, and existing in a modern world that is anything but relaxing. Rupa’s words resonated with me and I find myself thinking obsessively about how everything is raising my corporeal inflammation: irate drivers, rude colleagues, existential dread, to name a few.
I had the pleasure of speaking with Rupa about her work. Among many things, Rupa is an activist, a musician and a doctor. Her goal in her work is to create a culture of care. She is a co-founder of Do No Harm Coalition, a collective of health workers committed to addressing disease through structural change. Rupa also works with the Deep Medicine Circle which is a “collective of farmers, elders, physicians, healers, herbalists, ecological designers, scholars, political ecologists, movement workers, educators, youth, storytellers and artists who adhere to earth-based, ecofeminist principles of organising, with participatory circles of decision-making.” She also works and lives on a farm with her family, “growing the best medicine we can for people who need it the most.”
At the time of this writing, the Palestinian people, of whom 50% are children, are being bombed in Gaza and denied basic human rights in Gaza and the West Bank. It’s hard not to think about the chronic inflammation of injustice heaped on people in Palestine and all over the world. I look back on this conversation to help me make sense of the insanity.
—
Rajen Bhatt: Rupa, Could you describe the book for people who don't really understand what the title is referencing?
Rupa Marya: Sure, I was just wondering why you took it with you on vacation. I wouldn't consider it a good read for vacation.
RB: I don't know how to relax!
RM: The book is about how structures and systems that have been set in place over the last 600 years of the last wave of colonial capitalist expansion around the world have caused damage to our bodies, damage to the earth and damage in our societies, and we look at how the immune system's response to damage or the threat of damage is the inflammatory response and how a lot of the chronic diseases I see as a doctor in our patients, in people living in the modern industrialised context and societies that have been arranged through capitalist arrangements of power, are these diseases are driven by these structures and not by any sort of genetic predisposition or poor choice in diet and exercise alone.
The book is an opportunity to look at levels of diagnosis that [co-author] Raj Patel and I talk about. That's a higher order of what we tend to look at in medicine where we just look at people's bodies and we maybe will look at their molecular pathways. What we're doing here is zooming out and looking at other invisible things like the structures of our society that will predispose so many people on the planet to diabetes through a toxic food system, through the ubiquitous presence of debt and the stress, and the trauma that so many people have experienced on planet earth.
“We're living with histories, chronic histories of oppression, of police violence, state violence, white supremacist ideologies…[these] create a chronic damaging signal to the body. Our bodies respond through chronic inflammatory disease.”
RB: There's one thing in the book that you reference, which is the idea of having a care revolution. I think I understand that inflammation can be healthy, but then too much of it can be horrible. What are things we can do immediately to start ameliorating the effects of this thing which is rooted in this capitalistic system with respect to the urge to keep moving forward, even though there's a ceiling?
RM: I think that practising and developing and solidifying networks of mutual aid is a really critical step, a first step, because that can allow us to imagine to stop participating in the economic workforce that creates and recreates the system. So the strike wave that we're in right now globally is a huge one. Seeing so many people around the world, working people, withholding their labour in order to exert an influence on the material circumstances of their working environment.
When I look at the people who inspire me, around Indigenous sovereignty movements they're not looking for a glorified Marxist revolution of workers around the world. They're looking for a different paradigm of living and a living that's based in systems of reciprocity and care. To me, that really is what anchors it. My interest as a person who's of Punjabi descent, born and raised here in occupied, unceded Ohlone territories, is “what was this place like before?” How do we start to negotiate and move and chip away and re-imagine and reawaken - to remember the ways in which our ancestors did things and also we can learn from new ways of being that we've never had an opportunity to see what existed before. The inflammatory response, as you said, is actually a healing response. So when you have a paper cut, it mobilises our internal body's ability to heal a wound. And when that wound is healed, that response goes quiet. But when the wounds keep coming as they do in a situation where we're living with toxic air from air pollution, we're living with the debt that everybody incurs in this modern society. We're living with land theft. We're living with histories, chronic histories of oppression, of police violence, state violence, white supremacist ideologies in the world that, in places, have been overrun by European settler presence. So these kinds of things, when they compound, create a chronic damaging signal to the body. Our bodies respond through chronic inflammatory disease. When we do engage in mutual aid, when we do reach out to each other across these divisions that have been drawn to make us support the system more than one another, we start to feel the possibility of other realities. And so the care revolution really is a place of world making, which is why the work of artists coming together with scientists and the world of caregivers is something that must happen in a rhizomatic and intricately interdisciplinary place. It requires new kinds of tools that most of us weren't raised with.
“Is what you are doing an act of care for something more, for some beings more than yourself?”
RB: Well said. I have some friends who are involved in mutual aid networks, but unfortunately they have gotten into a habit of looking at things that are not rooted in any kind of scientific discourse. How does the average person start looking at these things critically if they aren't doctors or in the medical field? How do we start approaching some of these holistic things while at the same time, what do we look for to be able to differentiate against this sort of snake oil sales of nonsense, essentially?
RM: This is a very interesting thing. So we think about the most vaccinated group in the United States - the people who were probably the most legitimately afraid of massive government rollout of something that will be injected in the body is native people who were forced into sterilisation, for whom the medical industrial complex continues to be a place of harm. They are the most vaccinated group in the United States. Why? Because they watched a ton of people die.
Before we had the vaccine, where the virus hit the hardest was in places like the Navajo Territory. These are groups of people who have accumulated the toxicity of so many centuries of damage. Then you put COVID on that body. That is a match on dry tinder. They knew that and they recognised that. They protected themselves. The act of vaccinating was always understood to be an act of protecting elders, the language keepers, the culture bearers not just an act for oneself. That is the hallmark of getting the sense whether someone's politics around eating organic or the wellness work that they do is a right wing or libertarian vibe or something else. Is what you are doing an act of care for something more, for some beings more than yourself? I don't eat organic simply because of the purity of my own body as if I were like a separate nation. I eat organic because I don't want to see people getting poisoned in the fields. I've watched a lot of people die of bizarre cancers in the hospital who were children of farm workers or farm workers themselves. I eat organic because I know that the soil is being poisoned, the air is being poisoned. I eat organic because that is what I, if I can't afford it, I grow. It's important to me to know that food is being grown in a way that is in reciprocity of care with the earth and all the beings that make that food happen.
I noticed that in the beginning of the pandemic all these folks who were postulating that, you're just not healthy if you're wearing a mask - that you should just be somehow - it was very ableist and often classist and often racist messaging when we were watching Black and Latinx and Indigenous people getting hit so hard by the virus. It's important to just examine where the impetus for not vaccinating comes from. There are groups of Black Nationalists - some of whom I spoke with, some communities of Nation of Islam - who wouldn't inject themselves with the vaccine. Their dissent is different than the dissent of someone who doesn't want to violate the nationhood of themselves because of some notion of, you know, white supremacist purity.
I think that underneath this, a lot of these things are questions of care. And who do we have a duty to care for? And do we actually care for people beyond our own identity group or our own self? That is a really important question to ask. In thinking about care too, from not just a “oh, I need to watch out for myself” place.
“Axes of oppression generate inflammatory disease, not only for the oppressed, but also for the oppressor.”
RB: In thinking about demographics, is there anything with regards to South Asians you could speak on such as heart disease, hypertension, etc. with regards to the idea that modern medicine is colonialist in some way?
RM: I can't really speak to all South Asians, obviously, but I do think that from our context, understanding how caste oppression and Hindu nationalism impacts people - it’s just as toxic as the white supremacy that many South Asian diasporic people have encountered. In the United States, it's odd to me to see a bunch of brown people embracing and welcoming Trump. Espousing a white nationalist agenda… synergy with Modi and the Hindu nationalist projects. Axes of oppression generate inflammatory disease, not only for the oppressed, but also for the oppressor. You can't live in a state where you're oppressing other people and expect somehow not to be impacted by the damage that you yourself are inflicting upon others.
That is something we talk about a lot in the last chapter of our book – the penultimate chapter on the neurological system about interconnectedness – and the understanding of ourselves as being more than our individual selves, the network of identities. It's exciting to see the anti-caste bill going through the California legislature here. Understanding that caste oppression is deeply entrenched in the tech industry here where there are a lot of South Asians in the Bay Area [California]. It's exciting to see the presence of young Sikh people speaking about the importance of Punjabi autonomy and having places where Sikh people aren't being oppressed in their own homelands. Understand that these moves for autonomy existed before the modern nation state of India was created to be part of the world economic order in the fall. The collapse of the British colonial empire - it's not like they all just left. They left the same colonial capitalist structures in place and intact – India would serve those agendas. So when we think about the decolonial project of India, we're nowhere near it. We've just become our own oppressors internally.
People will focus on these syndromes of what is called metabolic syndrome. We have diabetes, we have heart disease, we have all these things, high blood pressure, strokes. But why do we have those things? Have we always had those things? When we were eating our ancestral grains of millet, were we having those things when we weren't poisoning the ground of Punjab with these toxic chemicals brought to us by the Rockefeller Foundation and shoved down our throats? Were we this sick? Did we have a cancer train back then? No. Did we have a train back then? The rivers, the soils, the places in what's now called India – these areas have been rich and biodiverse and healthy and thriving for thousands of years. But the modern colonial reality that exists there now has led to death and air pollution and disease, not only of the soils, but of the people. Reclaiming our right to live with healthy air, with healthy water, with healthy farming practices as the incredible farmers protests have shown us that we have a right to these things and it has been completely suppressed by the modern nation state. Not only in India, but around the world.
Deep Medicine Circle, rooftop garden
RB: That's really interesting. How do we continue to have this sort of care revolution? Like, what are some things that you've done for your own community in the Bay Area to alleviate some of problems of living in the toxicity of living in the industrial age?
RM: Most of the work I'm doing right now is with the Deep Medicine Circle, which is a group of us that are organising collectively to address hunger in our communities. For me as someone of Sikh ancestry, it feels so good. It feels so primally good in a way I can't even articulate, to be putting my life force and energy behind growing food in a healthy way supporting farmers growing food in a healthy way to just give it away.
We're growing the best medicine we can for people who need it the most. Every few months we go survey the communities we're serving this organic produce to, to ask them what they want us to grow. So we're growing heirloom varieties of culturally relevant foods from around the world and just giving away thousands of pounds. Last year we did 36,000lb of food and this year we're on task to do about 72,000lb of food. Now it looks like another farm wants to come on board. Starting to spread this idea that actually we could have a food system where farmers are paid amazingly to steward the land, to heal the land and feed the people. You get climate benefits, you get clean air, you get clean water, you get healthy soil, sink more carbon and everyone gets fed. We could pay for that, just like we pay for the city lights to be on, just like we pay for the sewage to be taken out of a city. We can pay for everyone to be fed and to be fed in a way that benefits the whole ecosystem and the urban environment.
That's what I'm working on with the Deep Medicine Circle. I enlisted my husband. I married a farmer. I wouldn't call myself a farmer, but thank you, that's a big honour. I don't have that title. I get to learn alongside them, but it's been 10 years learning with my husband. I still wouldn't call myself a farmer. He is an incredible farmer and all the farmers who are working with us are all devoted, passionate, skilled, incredible teachers. We were growing food on a one acre rooftop in Oakland. We're bringing food from a 38 acre land back project on the San Mateo coast. Those are ways in which we're starting to address. How do we bring food as medicine for people? How do we then teach people how to grow food if that's what they want to learn to do and get them reconnected to the earth? Then partnering with community groups in the areas where I live and work where they’re trying to shut down a foundry, the AB&I foundry in Oakland. We shut that down. It was great. They've been working for 10 years, but when we all kind of put our heads together, it was a sustained campaign to get them out of Oakland and they're gone. It just shows the tactics and strategies to mobilise so that people can have the right to clean air.
“I'm so grateful for my dad who raised me here in this area and for my mom, who continues to love and support me…even though they tried to make me a good Indian girl… And I became like a radical.”
RB: My wife is also very much into growing food. We try to grow as much as we can.
RM: Yeah. It's all super doable.
RB: I want to just talk briefly about other projects outside of this farming project. What are you working on? And I know you also are a musician. Are you working on any new music?
RM: I have been inspired to write a song for the first time in three years. Just recently. I'm trying not to say I'm writing music because I don't want to jinx it. But it's been like drinking through the fire hose of human suffering the last three years as a frontline doctor. I don't tend to write music when I'm encountering trauma. I tend to write music when I feel at peace. I do feel at peace. In the fall on the farm. In that place where we get to be together and grow food and that's been really beautiful. I'm also writing stuff. I keep thinking of things that need to be written. Right now it's just been grand proposals to get everyone well-funded so that we're paying our farmers like healthcare workers, which is our goal. There's a lot of that happening right now. And I've been asked to write a book by an editor. I'm starting to think through what exactly that should be. I think it's going to be a song – a song in prose. The book I wrote with Raj Patel was a heavy intellectual load and required an extreme amount of detailed reading, analysis, interviewing, writing, synthesising, rewriting. This project I think will be much more of the way I write music. It’s a lot less analytic and a lot more abstract.
RB: Very cool. Do you have any closing words or any acknowledgements?
RM: I acknowledge my, my ancestors. I'm so grateful for my dad who raised me here in this area and for my mom, who continues to love and support me…even though they tried to make me a good Indian girl. They really tried. They sent me to an all girls school hoping to make me like a good Indian girl. And I became like a radical. I don't think they knew what to do with me. But they've loved me through it. I'm just very grateful for them. You know what it means to love the earth and be in service. It just feels awesome. I feel grateful for my heritage. I feel grateful because it's a rich food heritage and it offers me a chance to think about what my children are going to be like.
RB: Thanks again for taking the time to talk with me and I really look forward to seeing all the projects you are working on. Your farm is inspiring me so much. I want to turn my whole backyard into a farm.
RM: You should definitely come visit. We say that our work on the farm is a 252 year song cycle. So it was 252 years that Portola landed in these lands. Then we arrived 252 years later on the land. So we're saying that this is a 252 year song cycle that involves soil data and water data and gathering. We are understanding how we heal as a group of humans. Imagine if we met our native friends outside of the realm of colonised relationships. What would it be like if we encountered each other culturally as people? What would we have learned? How would we have been here on stolen land? So those are ways of imagining. That's where I feel like it's not just a song, it's like an opera.
About Rajen
Rajen Bhatt is based out of Boston, USA and records and performs music under various monikers including FRKSE. He sometimes operates the Divergent Series imprint in between teaching math to 15 and 16 year olds and reading books on theology and metaphysics. He appreciates mid-90s hip-hop and mid-90s death metal in equal measure.