Inflamed: Deep Medicine and the Anatomy of Injustice

by Rupa Marya, Raj Patel

Overview

Raj Patel, the New York Times bestselling author of The Value of Nothing, teams up with physician, activist, and co-founder of the Do No Harm Coalition Rupa Marya to reveal the links between health and structural injustices—and to offer a new deep medicine that can heal our bodies and our world.

The Covid pandemic and the shocking racial disparities in its impact. The surge in inflammatory illnesses such as gastrointestinal disorders and asthma. Mass uprisings around the world in response to systemic racism and violence. Rising numbers of climate refugees. Our bodies, societies, and planet are inflamed.

Boldly original, Inflamed takes us on a medical tour through the human body—our digestive, endocrine, circulatory, respiratory, reproductive, immune, and nervous systems. Unlike a traditional anatomy book, this groundbreaking work illuminates the hidden relationships between our biological systems and the profound injustices of our political and economic systems. Inflammation is connected to the food we eat, the air we breathe, and the diversity of the microbes living inside us, which regulate everything from our brain’s development to our immune system’s functioning. It’s connected to the number of traumatic events we experienced as children and to the traumas endured by our ancestors. It’s connected not only to access to health care but to the very models of health that physicians practice.

Raj Patel, the renowned political economist and New York Times bestselling author of The Value of Nothing, teams up with the physician Rupa Marya to offer a radical new cure: the deep medicine of decolonization. Decolonizing heals what has been divided, reestablishing our relationships with the Earth and one another. Combining the latest scientific research and scholarship on globalization with the stories of Marya’s work with patients in marginalized communities, activist passion, and the wisdom of Indigenous groups, Inflamed points the way toward a deep medicine that has the potential to heal not only our bodies, but the world.

Product Details

ISBN-13:	9780374602512
Publisher:	Farrar, Straus and Giroux
Publication date:	08/03/2021
Pages:	496
Sales rank:	669,583
Product dimensions:	5.80(w) x 8.70(h) x 1.60(d)

About the Author

Dr. Rupa Marya is a physician, an activist, a mother and a composer. She is a professor of medicine at the University of California, San Francisco, where she practices and teaches internal medicine. She is a cofounder of the Do No Harm Coalition, a collective of health workers committed to addressing disease through structural change. At the invitation of Lakhóta health leaders, she advises the Mni Wichoni Health Circle, an Indigenous-led health sovereignty project at Standing Rock decolonizing food and wellness. She is the cofounder of the Deep Medicine Circle, a women of color-led, worker directed organization healing the wounds of colonialism through food, medicine, story, restoration and learning. Through the Deep Medicine Circle, she leads the Farming is Medicine program, an innovative reparative food system example, which starts with moving land back to Indigenous hands and farming under their sovereignty, centering values of reciprocity, mutual benefit and reintegration into right relationship with one another and the web of life. She has toured twenty-nine countries with her band, Rupa & the April Fishes, whose music was described by the legend Gil Scott-Heron as “Liberation Music.”

Raj Patel is an award-winning author, film-maker and academic. He is a Research Professor in the Lyndon B Johnson School of Public Affairs at the University of Texas at Austin. He worked at the World Bank and WTO, and has been teargassed on four continents protesting against them. A James Beard Foundation Leadership Award winner, he has testified about the causes of the global food crisis to the US, UK and EU governments, and is a member of the International Panel of Experts on Sustainable Food Systems. He is the author of Stuffed and Starved, the New York Times bestselling The Value of Nothing, and the coauthor of A History of the World in Seven Cheap Things, all of which have been translated and taught across the world, as have his scholarly publications in economics, philosophy, politics, and public health journals. His first documentary, filmed over the course of a decade in Malawi and the United States, is The Ants & The Grasshopper. He is a board member of the Deep Medicine Circle.

Table of Contents

Introduction 3

As the World Burns 4

Diagnosis: Dia (Apart) + Gignoskein (to Know) 9

Pillage and Plunder 13

But Modern Medicine Is Great 18

Deep Medicine 22

The Anatomy of Injustice 26

1 Immune System: I Am Because You Are 29

The Immunes Strike Back 34

Metchnikoff and the Macrophage 39

The "Broken Windows" Theory of Immunology 45

The Art of Healing 50

A Wound That Never Heals 52

Fighting Fire with Fire 55

History Is Written in the Body 64

Cultivating Community Immunity 70

2 Circulatory System: Salmon Are the Pump 75

Flows of Silver, Flows of Debt 79

Debt as a Choke Point 87

An Introduction to the Biochemistry of Stress and Inflammation 90

Cardiovascular Disease as an Inflammatory Disease 95

Downstream Ecosystem Death 97

Salmon Are the Pump 99

Living Wage and Debt Relief 105

3 Digestive System: The Forest Within 111

The Enchanted Forest 113

The Gut Microbiome: A Guide to the Forest 119

Seeding the Forest 125

Tending the Forest 128

Web of Life and of Death 134

How to Colonize a Blue Zone 140

Decolonizing Our Guts 145

4 Respiratory System: The Last Thing You Smell Is a Forest Fire 149

How Forests Burn 153

Size Matters 157

The Fantastic Voyage of PM_2.5 161

Investment Climate Change 166

Breathing Truth to Power 170

5 Reproductive System: Rematriating Strawberry Fields 181

Reproducing Colonization: Witches and Healers on the Frontline 187

What Sky woman Knew 195

The Agonies of OB/GYN 202

On Strawberry Fields and Seeds and Schools 208

Condolence and Rematriation 214

6 Connective Tissue: Beyond Border Medicine 227

The Skin's Border Patrol 231

The Color of Medicine 240

Medicine's Master Race 246

Tokenism vs. Transformation 251

How to Decolonize a Hospital 254

The Edge Effect 259

7 Endocrine System: Building a New Normal 267

Liquid Anatomy 271

You Give Me Fever 276

The New Normal 278

The Tragedy of the Built Environment 281

The Opposite of Stress 285

A Political Anatomy 288

8 Nervous System: The Web of Life 293

Subterranean Solidarity 298

The Tree of Life 301

Inflammaging 303

Justice Is the Medicine 308

The Mind Outside Your Brain 311

Composting Our Grief 315

The Original World Wide Web 317

Mushroom Medicine 320

Systems of Care 324

9 Deep Medicine: Making the Body Whole 329

Modern Medicine Is a Prison, Abolition Is the Cure 331

Beyond the Self for Deep Medicine 335

Double Wampum 337

A Culture of Care 349

Notes 353

Acknowledgments 463

Index 467

Editorial Reviews

05/24/2021

Physician Marya, cofounder of the Do No Harm Coalition, and University of Texas research professor Patel (The Value of Nothing) examine the social and environmental causes of ill health in this thought-provoking treatise. Taking eight bodily systems in turn, they explain the basic functions of each system and how nongenetic factors contribute to malfunctions. For example, the section on the immune system describes how “age-related diseases of chronic inflammation,” such as diabetes and Alzheimer’s, have been linked to cellular damage caused by “stress, trauma, and environmental toxicity,” and why “historically oppressed groups,” such as Blacks and Indigenous Americans, had higher death rates from Covid-19. Turning to the respiratory system, Marya and Patel note that “working-class people are more likely to be exposed to higher levels of pollution and are more likely to have diseases driven by inflammation that makes that exposure more lethal.” In the book’s final section, they propose “deep medicine,” a holistic practice designed to personalize the relationship between the patient and healer while “resisting colonial cosmology,” as a means of healing illness and liberating individuals from the “prison” of oppressive systems. Though highly technical at times, this is a persuasive argument for the need to address the systemic problems that plague people’s minds and bodies. Agent: Kristine Dahl, ICM Partners. (Aug.)

Publishers Weekly

★ 08/01/2021

Most social justice movements have recognized that the health of oppressed people is worse than the health of those in power. This well-written, compelling book expands on that idea with the concept of "deep medicine," which looks at health disparities brought on by colonialism, politics, and capitalism. Marya (medicine, Univ. of California, San Francisco; founder of Do No Harm Coalition) and Patel (Sch. of Public Affairs, Univ. of Texas, Austin; Stuffed and Starved) write that human health is impacted by one's environment and exposome (a measure of everything an individual is exposed to in a lifetime), so poor living conditions, poverty, environmental destruction, and oppression all have health effects. They examine the exposome's impacts on different organ systems (immune, circulatory, digestive, respiratory, reproductive, endocrine, nervous) and connective tissue, and conclude by calling for a new medical culture of care that looks at the total environment and community, not just the individual. Particularly moving chapters highlight health care inequality in the United States that particularly affects Black Americans and Indigenous peoples; examples include racial disparities in COVID-19 infection and recovery rates. VERDICT An excellent book for anyone concerned with health, community, or the environment. The accessible writing will draw readers in.—Margaret Henderson, Ramona, CA

Library Journal

2021-06-02
A passionate exploration of world poverty, racism, injustice, and colonialism that draws a parallel to inflammation.

Marya is a physician, professor of internal medicine, and activist, and Patel is a professor of public affairs and nutrition and the author of the 2010 bestseller The Value of Nothing. In this collaboration, the authors explain that when tissues are damaged or threatened, our immune system sends cells and molecular messengers that attack invaders, repair damage, and restore the body to health. Sometimes, “the response doesn’t switch off, and the result is a chronic inflammatory state. When that happens, the body’s healing mechanism is transformed into a smoldering fire that creates ongoing harm.” We suffer more chronic inflammation as we get older, and external factors (environmental toxins, stress, malnutrition) are the leading causes. The authors are far from the first to stress chronic inflammation’s role in cancer, heart disease, diabetes, colitis, mental illness, dementia, and even aging, although they give it perhaps more credit than it deserves. They are rigorous scientists, so readers will learn a great deal as they describe human biological systems, focusing on the damage inflicted by inflammation but casting a wide thematic net. The chapter on the reproductive system eschews parallels with inflammation in favor of linking colonialism to the oppression of women. The obligatory how-to-fix-it conclusion will leave some readers scratching their heads. Having described a world of Orwellian awfulness, the authors propose not mass action but “deep medicine.” They write that individuals can be healthy “only when the entire community is also healthy…this is achievable only through social, economic, political, ecological, and cosmological spheres working in an integrated fashion for the benefit of all.” This may remind older readers of the ideals of universal harmony and spiritual growth that marked the 1960s, but the authors are persuasive in most of their arguments about the deleterious physical and mental effects of capitalism and colonialism.

A valiant effort to link medicine and injustice: thought-provoking, knowledgeable, and ripe for debate and further study.

Kirkus Reviews

"A work of exhilarating scope and relevance to this infected moment in the body politic. Inflamed mixes medicine, argument, and metaphor into a post-pandemic poultice: reading it is the first step in the deep medicine it prescribes. What a rare and powerful experience to feel a book in your very body."
—Naomi Klein, author of On Fire: The (Burning) Case for a Green New Deal

"Inflamed is a must-read, and not just for food system workers, medical practitioners or policy makers. It is rare that a book can bind such a variety of information into a cohesive, readable and highly relevant narrative. Inflamed is a wonderful jumping-off point for those who want to quench the flames of injustice and imbalance. And it is a field manual to guide us in avoiding the thought processes and practices that got us into this mess in the first place."
—Forbes

"Inflamed is structured as a political anatomy, a new and illuminating approach to diagnosis that identifies the root causes of our pathologies, both in our bodies and in the world around us. Marya and Patel describe in compelling detail the links between bodily processes and larger historical, economic, and political conditions through a tour of the immune, circulatory, digestive, respiratory, reproductive, endocrine, and nervous systems . . . A revolutionary book that calls for courageous action to dismantle those structures that harm the health of people and the planet and to rebuild ones that center care."
—Aletha Maybank, The Lancet

“Inflammation is both the metaphor and the stated subject of this ambitious interdisciplinary tome co-written by Patel, a journalist and activist, and Marya, a physician and composer. Together they map the connections between public health, social injustice, economic disparities, climate change, and ancestral trauma, making the case that our crappy world needs a new medical paradigm.”
—Molly Young, Vulture

"A sweeping global survey . . . Required reading . . . Inflamed’s rich portrait of the anatomy of injustice should be assigned to every pre-med, medical, and nursing student."
—Wendy Johnson, The Boston Review

“Most social justice movements have recognized that the health of oppressed people is worse than the health of those in power. This well-written, compelling book expands on that idea with the concept of ‘deep medicine,’ which looks at health disparities brought on by colonialism, politics, and capitalism . . . An excellent book for anyone concerned with health, community, or the environment. The accessible writing will draw readers in.”
—Margaret Henderson, Library Journal (starred review)

"Science and medicine are often treated as fields that are subtracted from social movements, separate from the struggle for power that billions of human beings are embroiled in and abstracted from the material conditions around us. Luckily for us, Rupa Marya and Raj Patel are out here making these connections and encouraging us to see these as processes we all must take ownership of as we fight to have control of our surroundings. This book is on fire."
—Boots Riley, frontperson for The Coup and writer/director of "Sorry to Bother You"

"A critique of the wreckage of capitalism and colonialism for our time—beautifully written, storytelling at its best. This book can change your life."
—Roxanne Dunbar-Ortiz, author of An Indigenous Peoples’ History of the United States

"At once empathetic and skeptical of power, [Inflamed] is bold and searching in its examination of the ways in which the human body has exhibited the consequences of a specific economic and political system . . . 'Settler ideologies have circumscribed the imagination,' they write. The future is creative work."
—Sarah Jones, The Nation

"Inspired by the work of Frantz Fanon and Michel Foucault, among others, the authors examine the 'myriad ways' systemic injustice impacts mind and body under the stress of eugenics, exposure to various kinds of trauma, and medical dehumanization. This is a powerful, knowledgeable, and important work about the dangerous connection between health and societal injustices and how it can be resolved."
—starred review, Booklist

"Inflamed is utterly fascinating, and beyond that, spiritually potent. At times, it feels almost visionary. In these pages, as in our world, everything is connected. For readers seeking promise and meaning while struggling to survive through the COVID-19 pandemic, our environment's rapidly intensifying collapse, and the plagues of systemic racism and global inequality, this book offers a wise and welcome interpretation. It argues that the web of life can be restored, and that harmony, and collective liberation, is possible."
—Texas Observer

"At last! A book about medicine and healthcare that is holistic in the broadest sense in that it integrates histories of colonialism, conflict and inequality with alternative forms of knowledge. And all that while remaining compellingly readable and engaging."
—Amitav Ghosh, author of Jungle Nama

"Physician Marya, cofounder of the Do No Harm Coalition, and University of Texas research professor Patel (The Value of Nothing) examine the social and environmental causes of ill health in this thought-provoking treatise . . . a persuasive argument for the need to address the systemic problems that plague people’s minds and bodies."
—Publishers Weekly

"A passionate exploration of world poverty, racism, injustice, and colonialism that draws a parallel to inflammation. . . thought-provoking, knowledgeable, and ripe for debate and further study."
—Kirkus Reviews

“This gracefully intertextual book spans many realms of knowledge—infectious disease, abolitionist thought, short-sighted colonial cosmologies, immunology, the function of debt—to offer an explanation for the surge of inflammatory illnesses across the world . . . the book reconceptualizes inflammation as the result of wide-ranging injustices, which the colonized medical system has long overlooked . . . An important read, Inflamed calls for deep medicine, and a refiguring of our body as existing in a world that continually shapes us, for better and worse.”
—Greta Moran, Civil Eats

"The title makes clear that our current practice of medicine, one that was largely developed in tandem with colonialism, can and will be improved by considering the human experience as a whole, reconnecting to our histories and communities, 'uncovering a path to a future where health in its broadest terms might be possible.'"
—The Observer

"The book explores one area of our lives that has been subject to colonization: that of medicine. The authors provide both a practical and metaphorical exploration of the impacts of colonization through the idea of inflammation - inflamed bodies, an inflamed society, and an inflamed planet. Their insights help us to dismantle colonization in our institutions and in our minds while building new connections and ways of being through what the authors call 'deep medicine'."
—Upstream

From the Publisher