Critical dialogue on Healthcaring

by Lawrence Diller and Marcia Rothenberg

from Jump Cut, no. 21, Nov. 1979, p. 29
copyright Jump Cut: A Review of Contemporary Media, 1979, 2005

Health Education and Welfare
by Lawrence Diller, M.D

I write in response to Marcia Rothenberg's review of HEALTHCARING FROM OUR END OF THE SPECULUM ("Good Vibes vs. Preventive Medicine," JC 17). She seems to have missed the point.

Education is liberation. As long as profit dictates the medical system, the needs of those without money and privilege, i.e., the poor, women, third world peoples, will go unfulfilled. HEALTHCARING by Denise Bostrom and Jane Warrenbrand says that women (and by implication, men) need no longer be abused by the system on the basis of ignorance and helplessness. I have been on both sides of the doctor-patient relationship and an educated questioning patient inevitably elicits attention and respect from his/her doctor. If HEALTHCARING is anti-male, it is only because the medical profession which was exclusively male for many years sought to mystify and dominate their female and male patients. Education is strength, the knowledge of one's own body. There is nothing mysterious about the female cervix, and self-examination with a speculum sheds great light — as one woman in HEALTHCARING declared, "Is that all he's looking at?"

Armed with education, one person helps another and self-help groups engender an empathy outsiders can't provide. Self-help groups are not the only means of good health care delivery, but for some these centers may allow for an atmosphere of caring and comfort that couldn't be generated elsewhere. These clinics encourage participation in health care and preventive programs. Does a nurse-midwife program offering natural deliveries at home or in a hospital "ignore the social and economic realities of the world," as Ms. Rothenberg states? Such a program meets female self-help criteria yet brings closer those likely to avoid contact with health providers.

Furthermore, HEALTHCARING presents self-help and self-education in an importantly positive light which I think is proper for this kind of not only informative but energizing film. The "good vibes" of this film were probably not unintentional; there has been too little to cheer about in the past, and seeing other women feeling good about themselves might be one of the catalysts needed to urge people forward. For Ms. Rothenberg to attack the film as "irresponsible and reactionary" is being as negative and pessimistic as the hardened bitter realist usually is. I don't think that's the kind of film Bostrom and Warrenbrand had intended to make nor the kind of feelings they had hoped to generate with their viewers. The world is a tough place no doubt, as Ms. Rothenberg clearly states, but there is definitely a place for a documentary that not only educates but makes you feel good as well. HEALTHCARING does both quite effectively.

Ms. Rothenberg and I have no argument in viewing the problems of our nation's healthcare system as being rooted in the economics of profit and all should work to improve or more likely restructure its organization entirely. Until these changes occur, films such as HEALTHCARING will provide people with the impetus towards education and confidence to minimize the abuses they might suffer.

Postscript. There are several errors in the article, Obviously the picture of Ms. Warrenbrand and Ms. Bostrom appeared at the bottom of page 3. The Women's Clinic was not in Connecticut but in Sommerville, Massachusetts. The final celebration was in front of the Columbia School of Nursing. The reviewer should pay closer attention to details if she uses them in her review.


Marcia Rothenberg replies

It is not I, but Dr. Diller, who has missed the point. I made two points in my review: one concerning the value of the film and one concerning the politics of counter-cultural revolutions.

As far as the film is concerned, I indicated that it was a poor example of a film celebrating the value of self-education and self-help. It reduces the real value of these attempts to "good feelings" and smugness. As I said, with the exception of the Chinatown scene, there is little demonstration of how and who is educated, how people get together to struggle for better health care. Dr. Diller's joy at the "demystification" of what the doctor sees at the other end of the speculum does not come from the film.

The general political point: "education" alone is not liberation. The nature and extent and context of education are important. The film does nothing to educate people as to the nature of the system or what can be done to make significant changes in people's lives. It miseducates them and fosters illusions as to how much individual efforts can change anything except for the privileged few.

As I said in my review, there has been some education and consciousness-raising taking place as a result of the counter-cultural health movement, but at best it affected only a small portion of the population, primarily white middle-class students. I work at Cook County Hospital in Chicago, where the masses of the poor and minorities in Cook County go for their medical care. It is these masses of people I am concerned about. I see no relief for them in good vibes. They have to gain control of the system which oppresses them.