Full transcript
0:04[music]
0:09[music]
0:16Hello everyone. I welcome you to my
0:18course introduction to medical
0:20humanities. We are at week seven lecture
0:2331. And in this particular lecture I am
0:27going to deal with something that all of
0:30us are responsible for the idea of
0:33caregiving. The responsibility of
0:35caregiving considering in India we have
0:38a community-based living there is this
0:42component of care that either we have
0:44experienced or we have rendered in that
0:48case the care crisis is an important
0:51construct in medical humanities that we
0:54have to highlight the title of my
0:57lecture today is the care crisis in
1:00Indian narratives and a quick overview
1:02of what I'm going to talk about. Now we
1:05define care and care crisis today follow
1:08it up with what are the features of care
1:11crisis and for analysis of this
1:14phenomena in medical humanities. I take
1:17up two narratives. One is the discussion
1:20of Piku and the other one is clear light
1:24of the day which is a novel by Anita
1:26Desai and make also a comparative
1:29analysis of the both with particular
1:32reference to how the care crisis
1:34phenomena works in both the narratives.
1:38Now what is care
1:41on your screen? Care is physical,
1:45practical, emotional and relational
1:48labor.
1:50What does this mean? This means that it
1:52involves your physical
1:55self. It involves your physical
1:58participation.
2:00It's very practical in the sense that
2:02what is it that you can do and what is
2:03it that you cannot? It's emotional.
2:08It is somebody who you are emotionally
2:11attached to most of the times because we
2:13are doing caregiving for somebody in our
2:17family. Hence, it's an emotional side
2:20also to the caregiving process and it's
2:24a relational labor.
2:27In the absence of a very structured
2:31process of caregiving in India, most of
2:36the times it is family members who
2:38become part of the caregiving process
2:42and it is therefore a labor which is
2:46mostly within the caregiving network of
2:49family members and relatives. And it
2:53involves who? children, elderly, sick
2:58and mostly it can be both unpaid or
3:02paid. Now when we talk about care
3:05crisis, it's a disruption of this
3:08network. It's a situation in which the
3:12demand for care exceeds the capacity of
3:15the society to provide it fairly and
3:18equally. Now when you talk about care as
3:22a system of the family which is
3:27operating at a very microcosmic level,
3:31you find that
3:33what a person can do physically,
3:35mentally, emotionally
3:38is central to how you proceed.
3:42Now if someone is not ready,
3:45there can be fatigue. Therefore, this
3:48care crisis emerges because care has
3:51been systematically undervalued and
3:55reorganized under neoliberal capitalism.
3:58So earlier it was supposed to be just
4:00there not recognized at all but within
4:03the neoliberal uh capitalism care is
4:07considered to be something which is a
4:10labor either paid or unpaid. So in the
4:13context of India within the family
4:16circuit it is mostly unpaid labor.
4:19Another theory that we have to know
4:21before we proceed to the analysis of
4:23both the narratives is the ethics of
4:26care. Now Nell Nodings talks about care
4:29being relational responsive moral
4:33practice not rulebound but contextual.
4:36So even within our family circuit of
4:39networks, who we will care for depends
4:43on how emotionally attached we are to
4:47them and what kind of equation we share.
4:51So it's not that there is a standard
4:53parameter, a standard kind of a table
4:56chart which you have to follow. It's a
4:58very relational activity. It depends
5:00from person to person and it depends on
5:04person's ability as well. Now this in
5:07that sense becomes predominantly
5:10feminized and undervalued because we are
5:13a patriarchal country. So the moment
5:16this kind of caregiving process comes at
5:19home the responsibility lies with the
5:22woman of the family and therefore the
5:25labor around it is mostly unpaid. The
5:30home is the site where systemic failures
5:34are observed. Like I said, most of the
5:36times the
5:38families are patriarchal in nature and
5:42therefore home is the center of its
5:45practice. The female of the house takes
5:47the lead in caregiving process. I also
5:51write that personal is always also
5:53political. Uh so the very idea that a
5:58woman is assigned to do this caregiving
6:01job is also political in nature because
6:03it deprivives her from taking up
6:06something which is paid. And in this
6:09context there is so much of labor
6:11involved but it is not paid. And finally
6:16no amount of effort is sufficient and
6:20therefore it is the lifeblood of
6:23society. but still going unnoticed and
6:26that is why it's important we talk about
6:28ethics of care. What is it that you
6:31think of in this direction?
6:34Now in the Indian family setup like I
6:36said mostly we have joint family
6:40community- based living but with the
6:43urbanization taking place there are
6:45nuclear families that are coming up and
6:48uh that's why the care network the
6:52family care network which was very
6:54prevalent in the earlier times is now
6:57into shambles and that is why probably
7:00when we think of the element of care.
7:04Now it is into crisis.
7:08There is also a phenomena called care
7:10penalty. On your screen you can see the
7:13definition uh which Nancy Four talks
7:16about. She says economic disadvantages
7:20arising from caring responsibility fall
7:23hardest on women.
7:26Again it's talking about the aspect in
7:28which caregiving done by women does not
7:32have any financial implication.
7:36And like I said earlier and Dowling
7:38talks about it in great detail how care
7:41work is undervalued and invisibilized.
7:45So the condition of possibility for
7:50everyone else's productivity. So while
7:52everyone else is in the traditional
7:55sense of the term productive, this
7:58person, this woman who is involved in
8:01the caregiving is actually not being
8:04productive because it does not yield to
8:06any kind of uh economic aspect.
8:10The first film that I take into
8:12consideration is Piku. Many of you must
8:14have seen this. If you haven't, please
8:16go ahead and watch it this weekend. Uh
8:19it's a film about uh it is a film
8:22directed by Shujit Sarkcar and
8:26focuses on Piku Banerjee an architect a
8:30a very dynamic kind of an architect 30
8:33years of age single-handedly managing a
8:36widowed and hypochondric father named
8:39Bhaskar. [snorts] Now the film's most
8:42focused tension is around caregiving.
8:46Piku is responsible for looking after
8:49her father who is in many ways obsessed
8:54with bowel movements. Now when you try
8:58to analyze the film on the surfacial
9:00level, these bowel movements look like
9:04there is an obsession and they are used
9:06to employ uh a kind of a comic aspect to
9:11caregiving. But if you analyze it
9:16further, if you dig further, you know
9:18that these ball movements are actually
9:22related to not just that aspect but they
9:27they are also about complex
9:30u equation that happens when caregiving
9:33is a responsibility which is
9:35single-handedly
9:37done by somebody and in this PU is
9:40oscillating. She has refused to marry
9:43because she doesn't want anything to be
9:46prioritized more than her father's
9:48health in uh and therefore care is not
9:52warm sentimentality but cotian
9:55exhausting labor.
9:57So every day she's planning, she's
10:01taking care of whatever uh is required
10:04of her father's routine and care
10:10is not glorified here in this film and
10:12that is what I like about this film.
10:15Medically and empirically there are many
10:16researchers which are talking about uh
10:19caregiving in terms of fatigue uh
10:22exhaustion but
10:25in a community living we have always
10:29glorified care.
10:31So how do you bring it to the routine
10:33task? This film does the job. So you
10:36find that care is a daily grind. She's
10:38doing that every day. Uh and it's not
10:40very dramatic event. So morning
10:42arguments are about laxatives. doctor
10:44appointment, dietary supervision and all
10:47these things are constituting Picu's
10:49life. So caregiving is central to how
10:53Piku observes or
10:56prioritizes her father's caregiving.
10:59Picu's father Bhaskar is double blind.
11:02Double blind. Why do I say? Because he
11:04wants Piku to be free. He's very proud.
11:08He keeps boasting of her daughter's
11:10achievements, how independent she is.
11:14But every decision that Piku makes is
11:19carefully protected or
11:24within the structures of her father's
11:28health not being compromised
11:32mobility. when I was discussing
11:34disability aging into disability if you
11:36go back to that lecture you'll find how
11:39I discussed that mobility also gets
11:42compromised uh when somebody is aging in
11:45this uh case in the case of Piku we find
11:48a road trip being taken to Kolkata uh
11:52and that briefly exposes the care
11:54dynamic where we find that Piku cannot
11:59simply leave and her mobility is always
12:02conditional depending on how much her
12:05father can accommodate. Dowling writes
12:08about it as care traps those who perform
12:13it which means again that you are free
12:16but you are everywhere in the chains of
12:18that thought of caregiving.
12:22I'll quickly take up few dialogues on
12:24your screen. The first is Piku belongs
12:27to me. She's my property. Bhaskar says
12:31that Piku belongs to me. She is my
12:34property.
12:36So the personhood aspect
12:39is sidelined to certain extent when
12:42Bhaskar makes such a claim about Pico
12:46and and in another instance he says if I
12:49die what will you do when I die you'll
12:52be free. So he knows that Picu is
12:59constantly worried about his care and
13:02therefore despite knowing the fact that
13:06you know she's tied up with the
13:09responsibility of his caregiving he just
13:11doesn't know how to process a life
13:14without Piku and therefore Piku is not a
13:18typical Indian daughter she's
13:20independent she speaks her mind she
13:22doesn't need a husband to survive. So he
13:26says when she's uh when somebody asks
13:29about Picu's marriage plans, he says no
13:31no uh she uh she's independent. She
13:34speaks her mind. She doesn't need a
13:36husband to survive. And why does she's
13:37why does he say that? Because probably
13:40somewhere if she gets married and leaves
13:44the whole system of caregiving will be
13:47uh compromised. So the contradiction is
13:50in the film narratives. So Bhaskar does
13:52champion uh the Piku's independence but
13:55her independence is only possible within
13:58the constraints of his care. So
14:00therefore she's free in speech but not
14:03free in practice and we find the gender
14:06dimensions definitely very prominent in
14:09these lines.
14:12So what does the film normalize and what
14:14does the film critique? Four points I
14:16make here that Piku because she's the
14:19daughter of the family and she's the
14:21only one in the close family dynamics.
14:26She is the default carer. There are no
14:28siblings she has. Her professional
14:32decisions also that she makes also
14:34revolve around the needs of her father
14:38and she doesn't want to get married
14:40because if she gets married the
14:42caregiving responsibility of her father
14:46might take a back seat. So the emotional
14:49labor and the physical labor that she's
14:52putting on every day is rendered
14:54invisible. So that is what the film
14:56normalizes and tries to reflect on the
15:01surface. However, the film also can be
15:05utilized to critique Bhaskar's emotional
15:08dependency as a tyranny. So if you
15:13remember I was talking about spousal
15:17beriement in Manet Gandhi Konahimara and
15:20goodbye. And if you go back to that film
15:23I discussed that how sometimes the space
15:27of vulnerability
15:29becomes the space in which
15:33the aging person reflects more anger,
15:37more rigidity.
15:39the the fetish not to change anything
15:43and trying to control the situation. So
15:46here in Bhaskar too we find that kind of
15:49a phenomena in which he's just not I
15:53mean he wants the control to himself
15:56and when that journey takes place there
15:58is a journey I spoke about from Delhi to
16:01uh Kolkata.
16:03So there is Rana who is driving uh the
16:05vehicle. He names the exploitation that
16:08Piku cannot and he clearly uh red flags
16:13it. Now
16:17in this case also we find that Bhaskar
16:19is very proud of Piku. He talks about
16:21her independence, her uh extraordinary
16:26career, everything. But
16:30at no point of time you will find that
16:32she prioritizes her career. So female
16:35autonomy remains conditional on what is
16:39not required for the family or else
16:42everything which is the aspiration of
16:45female can be compromised because the
16:49structure of the family has to hold
16:51tight and therefore the film ends with
16:54grief not liberation. Ambiguity is its
16:58critique. The second narrative that I
17:01choose is Anita Desai's clear light of
17:03the day and it is primarily about beam
17:06das. So the novel is set in Old Delhi
17:11across the partition era
17:15and
17:17a contemporary moment of family reunion
17:21is when the novel opens you find that
17:23there are a lot of people who have come
17:26but the novel is not about that. It is
17:28about Beim Das a history teacher who has
17:32never left the family home. And why has
17:35she not left? because she is the primary
17:38caregiver for her brother Baba. Now Baba
17:43and once nursed her tubular brother Raja
17:45through a dangerous illness.
17:48Her elder sister Tara married and left.
17:50Her brother Raja left for Hyderabad and
17:54her aunt Mira Masi drank herself to
17:56death but Beam stayed. So Beam is now
18:02looking after her brother. And if you
18:06follow the novel, you find that just
18:08like Piku, Beam's life is also
18:11structured around those who require her
18:15caregiving. So it's the brother who
18:17require her caregiving and she's
18:20constantly into that. She says that
18:22Baba's disability is never medically
18:25named. His gramophone records assert
18:28will within radical dependency. Now
18:33Baba is not the case but a presence once
18:37BIM organizes her life around it. So not
18:40just the person but the idea of
18:42caregiving around how beam operates her
18:48day-to-day life is central narrative of
18:51clear light of the day. I'll take up two
18:55excerpts from
18:57the novel and discuss. So Desai writes,
19:02"Oh, I never go anywhere. It must seem
19:05strange to you and Bakul who have
19:08traveled so much to come back and find
19:11people like Baba and me who have not
19:14traveled at all." And the second, now I
19:18understand why you do not wish to marry.
19:21You have dedicated your life to others,
19:24to your sick brother and to your aged
19:26aunt and your little brother who will be
19:29dependent on you all his life. You have
19:32sacrificed your own life for them.
19:37So these two lines primarily
19:41showcase that BIM
19:44has but engaged her entire life in
19:49caregiving and got engrossed or
19:52internalized that caregiving to the
19:55extent where her life doesn't have any
19:57meaning without she employing herself
20:02into that labor. So for her it's not
20:06labor at all and uh thisai subverts the
20:10expected responses. What does she say?
20:12She says that there is no gratitude in
20:15that uh whole episode. Bim reacts with
20:18astonishment at this horrendous speech.
20:20She's quite astonished when somebody
20:23says oh you I know why did you did not
20:25wish to marry and you have dedicated
20:27your life to others. She says and it's
20:29not sacrifice at all. It is something
20:32what remained. I mean I have everybody
20:34else left and this was there and I had
20:37to take the responsibility. So for her
20:40it is like a matterof fact situation not
20:42a choice she made is something Anita
20:45Desai highlights in uh the clear light
20:48of the day if you read it in between the
20:51lines
20:52there is also a character of Mira Masi
20:55who became widow and came to their house
20:58and she uh pretty much took over
21:00everything of the Das household. She was
21:03cooking, supervising and holding the
21:05family together while others played
21:09bridge which is a card game. Uh she has
21:11received no wages, no recognition and
21:14she wasn't even cared but eventually she
21:18becomes alcoholic and uh one excerpt I
21:23bring it here in which she says won't
21:25you get me your father's brandy bottle
21:27from the sideboard? A drop, just a drop
21:30in my tea. I do need it. It might help.
21:33It isn't safe. So, Miraam Masi uh is an
21:38important character in the novel. And
21:40you find that she's most radical figure
21:43of care exhaustion. So, I was discussing
21:46the term care fatigue. This is also
21:48another uh term care exhaustion. We
21:50almost use it simultaneously in the
21:53medical humanities gaze. And when she
21:56breaks down, her breakdown is not just
21:59personal. In fact, it was very much
22:01predicted because the system was
22:06overutilizing her. And therefore, we
22:08find that Dowling's argument that
22:11providing care under duress erodess a
22:13person's ability to care for other
22:16people is
22:18literally how we find Miramasi's life.
22:23We quickly do the uh comparative
22:25analysis. Here it is Piku and here it's
22:29clear light of the day 2015 and 1980.
22:32The primary caregiver Piku in the film
22:35Piku and uh she's daughter to an aging
22:38father whereas in clear light of the day
22:41Bim is uh caring for Baba Raja and
22:45Miraasi. The form of care that is
22:48provided is in both the cases I mean
22:52while
22:54physical, emotional, mental health,
22:57mental support is given you can also
23:00find daily bodily care, diet, health,
23:04mood because I told you the film is
23:06about Bahascar's obsession with bowel
23:09movements. I use the word obsession but
23:11for him it is a natural thing. So even
23:15maybe I'm using the word because it
23:18shows uh in the film like that but
23:21probably it's the social construct for
23:23him that is the natural it is about
23:25nursing emotional support and long-term
23:28guardianship the cost
23:31she doesn't marry Piku doesn't marry and
23:34makes several compromises professionally
23:37in clear light of the day also we find
23:40no marriage and no departure. She
23:45doesn't leave home and intellectual
23:48suppression as well.
23:51What is the voice of the carer in Piku?
23:53Like I said, the voice is very loud. She
23:57is not glorifying at any point of time
24:00the caregiving. So, it's loud. It's
24:02assertive but ultimately powerless. In
24:06clear light of the day, it's dry,
24:08sardonic, furious, but ultimately immo
24:13in both the cases. Male beneficiary
24:16Bhaskar uses freedom rhetoric to bind
24:19whereas Raja leaves after care is given.
24:23Baba cannot reciprocate. So there is no
24:26acknowledgment as well of the care that
24:29is given to the person. Resolution death
24:35of the father brings grief plus relief.
24:37ambiguous but if you go back to the line
24:39that is what Bhaskar says Tara's return
24:42enables Bim to articulate but not escape
24:46so when Tara comes back his her sister
24:48comes back she can actually feel relief
24:51but she's so used to that setup of
24:55caregiving that probably there'll be no
24:57escape uh one theorist that I can quote
25:00here is Carol Gilligan and in a
25:02different voice she argued that women
25:04develop a care ethic through
25:06socialization but feminist critics note
25:09that this naturalizes what is in fact
25:12coercion. These texts perform this
25:15critic. So it looks like it's a
25:17responsibility. There is a socialization
25:20process that is happening. It may have
25:21been conditioned like that. But actually
25:24it is one way of coercion is something
25:27um Carol Gilligan points out and we have
25:29to look at the whole caregiving aspect
25:32from that perspective as well.
25:35Uh finally let us conclude. Uh both the
25:40texts talk about female as primary
25:43caregiver and male as primary care
25:48receiver.
25:51Both texts
25:53center women as default carers not by
25:56personal failure but by structural
25:59default. Dowling talks about it in its
26:02literary form. He says uh that this is
26:05not a choice they made because there is
26:08there was no other choice to be made.
26:10They went ahead and did that. In clear
26:14light of the day we find the ancestral
26:17home
26:19and in the case of Piku the Delhi uh
26:23flat they are not private refuge they
26:25are sites where public failures in
26:29elderly care are privately absorbed. So
26:33both are centered in Delhi but you find
26:38that despite an urban setup there is no
26:43structural
26:45space of caregiving so that there is any
26:48other person who takes the
26:50responsibility of caregiving. Finally uh
26:54we can say that these texts are not
26:57merely cultural products. They are
27:00diagnostic instruments that make legible
27:03what medicine and social policies have
27:07not addressed. So this complex layering
27:11of
27:13how a film talks about caregiving in
27:17terms of fatigue in terms of exhaustion
27:20in terms of sometimes also burden apart
27:24from its glorified discourse of
27:26responsibility
27:28and love and emotion and something that
27:31we are bound to do I think uh they are
27:34clear-cut departures towards more
27:36inclusive narrative. Thank you.