Is Your Doctor Going the Way of the Family Farm?
I used to be a farmer. I should say, I used to be a farmer the way farmers used to be. I raised pigs, chickens, goats, and cows. I tried to raise ducks and geese, but they flew away. I had a quarter-acre garden and grew acres of buckwheat and corn. I helped the neighbors put up their hay, cut their wood, and tap their trees for a share. I butchered my own livestock, made cheese, and picked and pressed my own apples. I built barns, walked fences, pruned grapes, and fixed my own truck and tractor when they were broken down, which was often. That’s how I used to be a farmer.
That’s not the way people farm anymore; not usually. Farming is now a big business. They have big tractors, big fields, big silos, and big, big, big debt. Farmers are often employees, answerable to people who are not farmers and have never seen the farm; people who sit in glass towers in the big city and move money around.
I had a small farm. The most livestock I had at any time were thirty-five pigs, a couple dozen chickens, ten goats, and a couple of cows. Farms these days have thousands of swine, tens of thousands of hens, hundreds of milk cows, and seldom any goats. But they will have only one kind of livestock on each farm. Everything is specialized and ruthlessly efficient.
I started farming when farming had already begun to change. I should have realized it then when some neighbors started to cut down the hedgerows to make big fields, so they didn’t waste time turning their big tractors around. I kept mine for the windbreak and the fence line, and because I liked the way they looked and the sanctuary they gave to wildlife. The big farms spread chemical fertilizer and confined their critters to crates. My livestock spread the fertilizer for me because I let them wander over a pasture. The big farmers spray weeds. I hoed them.
They practice what they call scientific farming. By scientific, they mean they choose one thing that can be measured by the end of the season, like yield per acre, and devote everything to improving that. They don’t take into account the pollution they cause, the people they displace, or how the food tastes. This is sloppy science.
They profit from an economy of scale. I didn’t make much money. But, with growing my own food, building my own house, and having no debt, I didn’t need much money. Six thousand a year was all we needed to pay the bills.
Industrial farming has been a good thing, they tell us. It has made food cheap. Maybe; but let me tell you what else it’s done. It put most people out of the farming business and they had no good place to go. It destroyed farm towns and polluted farm country. When I returned to Bath, NY, where I used to farm, stores were vacant, and buildings were in disrepair. Where marginal land was once pasture, it’s now grown to brush. The principal employers are opioids and crystal meth. The people are bitter and xenophobic. Farming country and farm folk are not what they used to be.
Why do I bring this up here, where we write about mental health and the art of therapy? For one, to say there’s a mental health crisis in farming communities, and it’s not caused by drugs, genetics, or a chemical imbalance in the brain. There’s nothing wrong with the people. The devil is the economy, businesses, and policymakers who care about nothing other than immediate profits and efficiency. But mostly I bring it up because farming is not the only thing I’ve done. I’ve also been in the healthcare field, mental health in particular. I see health care going the same way.
For the past eleven years, I’ve been a mental health therapist in private practice, which is the healthcare equivalent of the family farm. Before that, I was more than twenty years in a community clinic that got taken over by a sprawling corporation, what I came to call a head-shrinking factory. I began with a caseload of twenty-five and ended up with two hundred twenty-five. In school, I was taught to let people talk, set their own goals, and cultivate the wisdom within them. In the head-shrinking factory, I was told to apply what they call evidence-based practices, reduce symptoms, and get them back to work. Understanding is sacrificed for efficiency.
The day the corporation told me I had to start doing my paperwork while I was seeing clients, I knew I had to go. Now, when I visit my doctor, that’s what he does. He sits at a computer and types as I talk. Then the computer tells him what to prescribe, what tests to run, and what other specialists to send me to. They say industrial medicine gives the public more access to better care. I haven’t seen that, but I’ll tell you what else it does. It reduces patients to quantifiable symptoms and healthcare workers into unthinking and unfeeling machinery. Can we really call it care when the humans are removed?
I urge anyone who’s a healthcare worker or patient to take a drive out in the countryside. Get far enough out of the city to where city people don’t have their vacation homes, into flyover country. Look around. If you can find a diner that’s open, stop and chat. See the buildings falling into ruin, the monstrous monoculture fields where no one lives, and the people without hope, overlooked until they can’t take it anymore. In a few years, you, too, will be entirely shoved to the margins like them. Is that what you want?
Written By:
Keith R Wilson is a counselor in private practice in Rochester, NY. He has published self help books, novels, and many articles focused on mental health, psychotherapy, and relationships
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