*Prologue
For a long time I had been completely invisible on forums, living a very comfortable, muddled life in the real world, so I rarely thought about revolutionary causes. Recently I wondered why I came to the association and realized one important reason: my experiences in a hospital. This was the first time I truly saw the face of capitalism. Under the influence of propaganda from the reform faction, the “hospital” in my mind was always tied to “saving lives” and “reverence for life.” But since I actually worked as a nurse in a hospital, that view was completely overturned. It turns out this is not “public welfare” but “business”; there is no “benevolence”—only “wolfishness”; patients aren’t people but lambs to be slaughtered, and medical staff aren’t “angels in white” but tools for a capitalist hospital to make money.
First, my past experiences. I am the eldest son and the grandson of a family that used to be small capitalists exploiting workers; I have lived a pampered, indulged life, detached from society and class struggle. In such a family, I grew up selfish, narrow-minded, self-reliant, and adaptable. Because I avoided labor and did well in school, I developed parasitic and hierarchical thinking, and perhaps related to the family’s clothing business, I in high school desired to study art, to become a fashion designer, to be a glamorous “upper-class person.” But at that time, my family’s investment almost led to bankruptcy, and my parents could not支持 this “free-spirited” fantasy economically or ideologically, so they strongly advised against it, following a neighbor’s suggestion that I apply to become a nurse—a field that was “stable, easy to employ, high pay.” At the time I did not get what I wanted, so I did not exert myself; looking back, that was perhaps the most correct decision they ever made, given their economic base and class characteristics as former bankrupt small capitalists.
After three years in a decaying university life, in my senior year I finally began to engage with society. In late 2019 I started an internship, and by year’s end there was an outbreak, but the hospital let interns stay home, so I hadn’t truly experienced the suffering of people during the pandemic as a nurse. After graduating in 2020, I went to work at a local hospital, which happened to be undergoing a “6S reform.” It was the first time I saw the essence of capitalist medicine from the hospital’s “backstage”: management became increasingly “scientific,” but the aim was not to save lives; just like capitalist production, it was to raise exploitation efficiency and grab more profits. To implement these reforms, the hospital hired two “teachers” from Shenzhen to issue orders, and temporarily established a “6S Office” led by the head of nursing. The actual reform tasks were carried out entirely by doctors and nurses themselves, who bound themselves with even more “advanced” and “firm” shackles, and the hospital did not pay laborers any extra wages. I, a newly hired nurse, was chosen to be a “6S officer,” running errands for the leadership (including but not limited to arranging meals for the “teachers,” making PPTs, learning 6S standards and conveying them to each department, managing and distributing reform supplies). Although annoying, it was far lighter than actually doing nursing work. The nurses had to do their primary caring and treatment work, and also find time to clean and organize cluttered departments, even though their own work was already exhausting. At that time my thoughts and life were still far from the people; I was basically doing clerical work in the hospital, and I even ran a small business modifying clothes on Xianyu, which brought in one to two thousand yuan per month. After the 6S reform ended, I was transferred to the Human Resources Department, and finally to the ICU. Although I faced some oppression, after work I would still slip into sexual gratification and dream of getting rich through small-business ventures. The income from the small business grew, and so did this mindset, so at the beginning of 2021 I chose to resign. I initially thought I would achieve “personal emancipation,” but little did I know it would be a path toward the decay of the petty bourgeoisie.
After resigning, my life mostly limited itself to home, because orders and raw materials were all handled by mobile phone, not taking much time, and processing was a small portion done by me; most of it done by my father. My clients were either the upper bourgeois or capitalists, and only such people could afford goods priced at many times the wages of ordinary workers. In this practice of pursuing only my own “one acre of land,” my thinking and life grew more decadent, drawing nearer to the bourgeois class. I remember at the start of the 2020 outbreak, I saw how people in Wuhan suffered, and still doubted and criticized the reform faction’s social system. But after I resigned to do small production, even during the pandemic I only cared about whether the delivery service was operating because that affected whether my small production could continue. While other workers saw incomes drop dramatically and life became precarious, as long as deliveries kept running, I could still earn several thousand to tens of thousands in profit per month. In my spare time I spent hours watching videos, styling myself, gaming on social platforms, and going out with friends to drink and eat meat. At that time I was no longer satisfied with a monthly income of 20,000–30,000 yuan; I wanted to “get rich overnight.” So I deposited 10,000 yuan on a cryptocurrency platform as tuition, only to have the reform faction regulate cryptocurrency and I ended up losing more than 6,000 yuan and quitting. Then I had a girlfriend from high school I started dating after graduation; as my worldview shifted toward the bourgeois, I also developed an asset-owning mindset toward women as commodities to be used for my own pleasures, and eventually I abandoned her to seek a partner who better fit my status. During the New Year that year, a university buddy who was in sales came to visit; he lived a life of extreme decay, often drinking and singing with customers and even visiting prostitutes. Under his influence and my reactionary worldview, we engaged in prostitution together…
In such decayed, parasitic life I often felt aimless, because my life was built on the orders of those customers; if orders paused for a while and there was no income for one or two weeks, I feared I could not sustain this life. I began to question and tire of this life of indulgence, but whenever orders came again, I would settle back into ease, numbing myself with pleasure. The petty bourgeoisie “both hopes to rise among the wealthier stratum and fears falling into the proletarian or even beggar’s state.” Upward, I knew the current “capital” was not enough to catapult me into becoming bourgeois; downward, I did not want to lose my comfortable life. I longed for answers and a way out, and I recalled a QQ group I had randomly joined after the pandemic began—there I saw the public exposing the reform government’s crimes of trampling people in Wuhan, and I wanted to know the truth of society, to understand what the long-taught “Socialist China” really was. But because I lived a privileged bourgeois lifestyle, I could not fully empathize with the suffering of people during the pandemic; even after joining the group, I only occasionally checked it, treating it as a place to “learn the truth.” Afterward I resumed small production, life became comfortable again, and I only opened it occasionally. In this rhythm of “panic—pleasure—panic,” whenever orders dropped or after heavy indulgence I felt an alarming emptiness, I increasingly wanted to “get something” from this group.
I went to the hospital again; this was my first time to see capitalism’s medical essence from the perspective of healthcare workers: exploiting and coercing patients.
After this time in the hospital, because I had left a good impression on the leadership last time, I was not immediately sent to frontline clinical work, but placed in the HR department handling hospital staff records, then kept there as an auxiliary. Having grown up in a small-producer environment and, over the past year, having dealt with various bourgeoisie, I had become very shrewd; I disliked office politics but could handle it well, and life continued to be comfortable. It was also because the leadership found me temporarily useful. Later I was transferred again to the Nursing Department for a while, and when our county’s pandemic controls were fully relaxed, the infection rate in our county surged, and the hospital was crowded with patients. Because of nurse shortages, I was assigned to the clinical department. Even though the day before I had a fever of 39°C, the Nursing Department’s orders had to be followed. Since I am male and had previously been in the ICU, I naturally returned to that familiar ICU ward. The day before work, I was pulled into the ICU group chat again, and soon a former colleague asked how I was doing, saying: “If you can’t handle it tomorrow, don’t force yourself; your body is yours.” The ICU lobby and corridors were filled with patients’ families; I changed into my nurse uniform and entered the ward, and another colleague asked if I had “caught it,” handing me a medical isolation mask and saying, “Your body is yours—take care of yourself at work.”—before this she and other nurses had already endured the torment of high fever while on duty. I endured 12 hours with my fever subsiding to below 38°C, wearing a mask and face shield which made breathing very difficult, while giving IVs, injections, feeding medicines, cleaning feces and urine, turning patients, patting backs… During that time my steps moved across a ward with just a dozen beds, and by the end my phone showed more than 18,000 steps.
ICU work is repetitive and mechanical; nurses follow doctors’ orders to perform various care and treatments, and every medication and treatment is labeled with dosage frequency, time, route, etc. Besides strictly following these instructions to treat patients, we also record vital signs every half-hour or hour, and if there are emergencies or abnormal trends, the nurse must report to the doctor to adjust orders in time. ICU runs on a “two shifts, with a night shift” system, with three people per shift (at most one intern), each person responsible for 3-4 patients. If there are too many patients, the team leader will contact the head nurse to call in staff to “assist,” and even at 2–3 a.m. those called must get up and work. ICU nurses are essentially on standby 24 hours. I could not stay up late or sleep as I used to, because it would make the next 12 hours even harder. Day shifts allow only a half-hour break for meals; night shifts, when your patients aren’t being treated, you can rest for one or two hours (to prevent the head nurse from sudden inspections we would brace ICU doors with a transfer bed before going to sleep), but in the middle you still have to wake up to measure blood pressure and glucose, and record vital signs at regular intervals. If one or two patients arrive that night, there’s no chance to sleep. We would create patient files, check skin condition, connect monitoring devices, establish IV access, draw venous and arterial blood for testing, and, when necessary, insert a nasogastric tube and a urinary catheter… all while still paying attention to other patients and providing basic care. After such night shifts I felt as if my skin had been peeled off; off work, I would not even want to say a word to my family. Sometimes after night shifts we would attend morning meetings or rounds, and the winter wind on the way home would leave me completely exhausted, and I would collapse into bed only for a few hours of rest.
At that time I often felt I was a tool executing orders, and patients were like machines in need of repair. The bourgeois hospital’s treatment methods were crude and outwardly focused on quick fixes rather than root causes: if there was inflammation, they used anti-inflammatory drugs; if blood pressure was high, they used antihypertensives; if the heart stopped, adrenaline and cardiac compressions were used. Much depended on the patient’s own body to recover; it could be said to be “leave it to fate” (and most importantly, even if there was some “special medicine,” only those who gained surplus value from exploitation—a bourgeois class—could afford it). If a treatment failed, the patient could only be declared dead, and the family, after taking away the body, faced a large medical bill. Some impoverished families could not even reach this step. In our secondary hospital ICU, daily discharge costs ran into two to three thousand yuan; at a top-tier hospital, it could reach three to five thousand or even ten thousand. “A doctor’s mouth, a nurse’s legs,” added to “the patient’s money.” Under immense financial pressure, those poor families could only persist until ruin, give up treatment, and take the patient home. These patients, lacking professional monitoring and life support, mostly died within a few days to at most half a month due to worsening illness; some could not even make it home before dying in the ambulance. Even if the family wanted to continue treatment, if there was no money in the account, not a single pill could be prescribed. During the New Year, many cases involved alcohol-related incidents: drunk driving, alcohol-induced brain hemorrhage, or vomiting while asleep after heavy drinking. I once witnessed a 13-year-old boy with a purple face being carried by ambulance into the hospital, his body cold, his airway full of vomit. On Valentine’s Day, we also admitted a young female patient with garlic breath due to organophosphate pesticide poisoning; colleagues said that every year on Valentine’s Day and Qixi Festival hospitals receive such patients… During this ICU period, I saw and heard too many things that contradicted the “carefree years” I had previously believed existed, proving not everyone lived as I did with “no worries.”
During one morning meeting around the New Year, the department chief and head nurse excitedly said: “Congratulations, our department’s revenue last year surpassed 90 million.” I still remember how nauseated I felt upon hearing that, recalling the ancient saying “Better to have medicine on the shelf than for people to be sick in the world.” I developed a deep hatred for the reform faction’s capitalist hospital. But whenever I returned home to talk with my family about hospital matters, they would say, “Just take care of yourself.” If I said work was too tiring, they would reply, “It’s not you who’s tired,” and tease me about whether there were pretty girls in the department. At the time I still didn’t understand Marxism; I simply expressed dissatisfaction from a personal standpoint, but their words actually compelled me to obey and uphold the oppressive system. Later one day the ICU head nurse asked me to talk, hoping I would write a “department assignment” for the Nursing Department, telling me that after I was assigned to a department I could get bonuses for the department (by the way, my salary at that time was a little over 2,000 yuan, after social insurance and housing fund, I took home about 1,750 yuan). But I had already heard from colleagues that this place was hard to work in, physically exhausting and full of office politics. Because small production still yielded over ten thousand a month at the time, compared to a nurse who only lived by her own labor, I considered myself a free small producer who could escape the oppression of labor exploitation. So I did not accept the head nurse’s approach; I told her, “I don’t lack money,” and then asked the Nursing Department head to transfer to another department.
Not long after, I received notice from the Nursing Department to move to other departments. Although I did not stay in the ICU for long, I encountered more people, and I realized more clearly that in a capitalist society, healthcare workers are not “angels” but low-paid workers, part of the most oppressed segment of the working class. In ordinary wards, the work is basically to administer IVs in the morning and to measure patients’ temperature and blood pressure, record excretions, tidy the ward, and give the定点 anti-inflammatory drug before leaving. It is not as busy as the ICU. We often have time to chat with colleagues, mostly women, so talk inevitably turns to family matters. Once I teamed up with an older colleague who was very skilled at venipuncture; after giving IVs to patients in the morning, we sat in the hallway chatting. I had seen on her Moments that she had two little boys, and asked about it. She told me that before these two boys, she had a girl (she paid money to have a baby seen in a hospital), but her in-laws did not approve of an abortion. She then went to a temple to “tie the baby” and gave birth to a boy, but did not return to the temple to “pray,” so she had another boy in a second birth. She then wanted another girl but was afraid to have another child. At that moment I thought, “It’s already X year, how can people still believe in this feudal superstition?” She also said that after work she still had to take care of two children and cook, while her husband only helped with some housework on weekends. Another colleague said her child is currently studying at an arts college, needing 3,000 yuan monthly living expenses, which after monthly wages are paid quickly get exhausted, and then they live on Huabei (a credit service). Once we were dining together and heard about experiences in the Fangcang cabin hospital, where people were often hungry and cold, delivering meals, medications, and measuring temperatures on electric three-wheeled bikes, losing several pounds a month; but the promised “subsidies” from superiors were never paid. In the past I had already realized that the old petty bourgeois lifestyle would collapse; I had seen that my comfortable life was built on the suffering of others, but because I was deeply attached to the life I had, I did not want to join the proletariat. If I only remained in the past, I would never move forward. Recently, the association has been discussing proletarianization, and I should align with the association’s path, resolve to break with the past, and transform my thinking under wage labor.
