America's healthcare system is at a critical juncture. Once known for high-quality care, our healthcare system is increasingly failing patients and its own independent providers. As a physical therapist, I am witnessing firsthand how large hospital systems are reshaping healthcare delivery—and not for the better.

I own and operate a physical therapy clinic which has been serving my community for more than forty years. We accept MediCAL, Medicare and many other insurance providers. We deliver care to the young, the old, the wealthy and the unhoused. My clinic is a lifeline for people facing mobility challenges—injury, surgery, degenerative disease and plain old aging. 

We treat our patients in a one-on-one setting applying manual therapy techniques in tandem with individualized therapeutic exercises. This direct and individualized approach leads to better patient outcomes compared to the “patient mills” we are being replaced by, wherein unlicensed individuals “treat” multiple patients at once in a gym.

Since the 1990s there has been a 40% decrease in reimbursement levels to independent PT practices like mine, with the most significant drop occurring since the onset of the pandemic. In fact, in my city there are only two independently run PT clinics remaining. The others were bought out by health conglomerates and hospital systems. 

More than ever before, independent physical therapy clinics are being forced to either close or sell to hospital systems. The reason? Hospital systems charge substantially more for identically billed services, simply because they're hospitals. Additional hospital fees generate pay for the therapist and staff working there and they are in on it. The clinic owners often feel forced to sell their clinic to make a buck too, instead of losing money all the time. The impact on patients is severe.

When seeking physical therapy, many face months-long wait times. Often, they unknowingly end up at hospital-owned outpatient clinics where they pay significantly higher out-of-pocket costs for care they could receive at an independent clinic. The cruel irony is that independent clinics typically offer longer treatment sessions and more personalized care at a fraction of the cost.

The ”facility fees” problem

How do hospitals justify these higher charges? They use "facility fees”— additional charges they justify as essential services, regulatory compliance, and infrastructure costs. However, hospital-owned outpatient clinics operate independently and don't carry such overhead costs; yet they are allowed to charge the hospital rate.

Global real estate as a financialized asset is the biggest commodity in the history of mankind. Unsurprisingly, hospital systems are increasingly functioning as real estate enterprises with their CEOs behaving more like property moguls than healthcare administrators. In high value urban areas, hospital systems use their real estate holdings as collateral for loans and expansion, while leasing properties to independent providers at premium rates. They also benefit from substantial tax credits from local governments, depleting public resources that would otherwise fund essential services like public transportation, housing programs and infrastructure.

The impact on our commons is staggering. In the San Francisco Bay Area alone, four "non-profit" hospital systems control real estate assets totaling more than $31 billion, with Kaiser and Stanford showing remarkable asset growth in recent years. This consolidation comes at a heavy cost to the public treasury. Why? Because these funds originate from avoided taxes, taking public funds which would otherwise be collected by cities to care for the unhoused, build public transportation, strengthen public education and on and on.

There is hope for change. Eighteen states have adopted "site-neutral" reimbursement policies, requiring equal payment for the same service regardless of location. California is not one of these states. In May 2023, the US House of Representatives passed a healthcare transparency package consisting of six bills. Two of these, the “PATIENT Act” and the “Lower Costs, More Transparency Act” would prevent Medicare from reimbursing off-campus hospital departments at higher rates than independent physician offices providing identical services. The American Hospital Association estimates these changes could reduce hospital reimbursement by $50 billion over ten years—but more importantly, it would redirect funds back to independent healthcare providers and public budgets at the municipal and county levels. 

California initiatives gathering support

The California legislature is presently proposing several bills that advance site-neutral payment reform. These initiatives have garnered support from patient advocacy groups, professional associations and policy makers who correctly argue that the status quo amounts to a giveaway of public funds and a watering down of services by aggregated providers. 

The for-profit hospital industrial complex claims that revenue reductions from these proposed laws could cause some hospitals to shut down outpatient programs or other service lines, diminishing patient access to care. Meanwhile, hospital systems continue aggressively acquiring properties and clinics, further consolidating their market power. While the Centers for Medicare & Medicaid Services (CMS) await full Congressional approval of these new legislative reforms, eighteen states have already successfully passed legislation to address facility fees charged by health systems for services. 

As Democratic Socialists we must understand what is at stake if we maintain a system that prioritizes hospital expansion and real estate acquisition over affordable, accessible care. 

We must demand that our representatives enact policies that level the playing field for independent healthcare providers—benefitting our communities. 

We must educate ourselves and our communities to dispel the myths constructed by the medical industrial complex and its many lobbyists. We must organize to ensure that legislation at the federal level already enacted in support of site-neutral reimbursement is enforced.

On Wednesday February 19, hundreds of federal workers and allied protestors rallied outside of the San Francisco Tesla showroom against Elon Musk’s ongoing attacks on public services. Among the crowd were federal workers who are fighting back against cuts and layoffs from “DOGE” (Department of Government Efficiency). The rally was part of a national day of action to “Save Our Services” organized by the Federal Unionists Network (FUN), a grassroots coalition of rank-and-file union activists.

For months President Donald Trump, working hand in hand with Musk, has been bulldozing the public sector in order to pay for tax cuts for the richest Americans. This means gutting our social safety net, rolling back vital protections, and pushing out hundreds of thousands of essential federal employees. Some of the high profile targets of dismantlement include the Department of Education, the Consumer Financial Protection Bureau, and U.S.A.I.D. Tens of thousands of probationary employees have been fired across over a dozen agencies.

The protest in San Francisco was led and emceed by FUN organizer Mark Smith, president of the National Federation of Federal Employees Local 1 and DSA member. Speakers included Kim Tavaglione, Executive Director of the San Francisco Labor Council, who said, “This is not a Democrat issue, this is not a Republican issue, this is a worker issue.” She continued, “Our entire society rests upon this fight. We need to get bigger and stronger, and show them that we’re not gonna take this shit no more.” Other speakers included the author Rebecca Solnit, who delivered brief remarks in solidarity: “We love you, we thank you, we know you take care of us and this incredibly complex system they’re trying to break.” 

Some of the signs held by protestors included: ““Fire Musk,” “Save Our National Parks,” “Workers Over Billionaires,” and “DOGE is a coup!” San Francisco DSA was well-represented in the crowd. 

To get involved with the movement to protect public services, visit the FUN website and join their rapid response network: https://www.federalunionists.net/

In September I wrote about ongoing East Bay DSA reading/discussion groups called Labor 101: Socialists and the Labor Movement.  These groups have been very useful in helping new members and members less familiar with labor to understand and be able to discuss some key ideas—why workplace organizing is essential, how we define the working class, and the role socialists can play in the labor movement, among other topics.  Some of the participants have become organizers in their own workplaces or started working with our local Emergency Workplace Organizing Committee (EWOC) to support other workplaces in organizing; many have become active members of the EBDSA Labor Committee. (More information about the groups is in the September California Red article.)

Since the COVID years these have been in-person groups but in April we are going to try an all-Zoom group. We’ll start on Thursday, April 10 from 6:00-8:00 pm and meet weekly. We have some EBDSA members who live too far away or take care of children or relatives, or have mobility problems; we’re hoping this gives more of an opportunity for participation. 

We are also hoping that the Zoom format can mean participation by members of other chapters. Some chapters may not have anything like this and members from around the state are encouraged to join us. We’ve tried to organize our materials so that a group leader has some guidelines, a timetable, and notes for each session. If you’d like to try leading a group for your chapter, attending this would be a great way to start.

We’d also love to have some members of other chapters that already have or are developing something like this to join us. Whether or not you can participate, please look at our materials, give us feedback and send us anything you’ve developed.

• Sign-up form for the April all-Zoom series     

• Flyer for the April all-Zoom series                

• Outline and reading list    

• Notes for group leaders     

Contact us for access to the whole folder

Greetings from Brenna and Brian, your at-large disabled comrades in residence, freshly arrived from the great lurking California Internet!

Now that a fascist coup is being executed against this country, we think it useful to fortify ourselves with the survival wisdom of our forebears, mining their strategies for overcoming horrible things in solidarity. Many in our socialist movement are already accomplished survivors, though our voices can be hard to hear. Disabled people like us have always had to hack reality in ways unthinkable to the ableds. We long ago learned to embrace "Nothing about us without us," including the universal health care we all deserve and continue to fight for. Solidarity has been at the core of our friendship for over a decade. Courage, like fear, is contagious. We have caught it from each other repeatedly. We'll use this column to keep catching it from others and sharing it with you. 

Bedrock Bodies

My (Brian's) disability began at birth, and I've had to learn the lessons of endurance and maintaining personhood in a world aligned against you and yours that are common to both the disability and antifascist communities. While you would hope that a progressive neuromuscular disease like mine might take a break from eating my muscle tissue to pursue equitable healthcare, childcare, and justice for ethnically cleansed Palestinians, in reality it's the sort of "progressive" that only makes things worse—nominally moving forward but ultimately drifting in a regressive direction. Call it “the Clinton strain of infirmity”. 

But my loss is also my gain in the armor it has bestowed upon me, an armor particularly suited to these cruel times. While the disease of my body may have no treatment and no cure, the disease plaguing my country is far from hopeless. We have solidarity, imagination, and a shared humanity on our side already, not to mention the bedrock knowledge common to disabled people that hope can become action, trial can become triumph, and strength can grow from nothing, like a fiery island birthed from the darkest ocean floor.

Some of us stumble into this bedrock knowledge later in life. In my thirties I (Brenna) was in the middle of a thriving career focused on the legal and policy needs of marginalized people in the Bay Area when my physical symptoms began eroding my sense of normalcy. I ignored them as long as I could, like the busy young fool I was, until they simply took over and ignoring them wasn't an option. Things got grim. I had to stop working and put all my energy into surviving excruciating pain. At a certain point in my advancing personal debility, I became unable to take in useful information about my medical condition, as all the words that might bring me answers started to sound like screaming regardless of the medium of delivery, and the only message I could hear was: Something inconceivably awful is happening to you, and nobody is able to stop it. Sound familiar, political friends? I also began to experience frequent vertigo, not so much a spinning sensation as that of wearing roller skates on the deck of a ship violently overcome by a stormy night sea. 

Finding your way to solid ground when everything is in massive upheaval is no small thing, but anchoring to bedrock knowledge helps. For me, I've learned to spend time daily deepening my awareness that we are all extraordinary living organisms profoundly connected to each other by biology, affect and circumstance. Staying alive to this transcending reality provides strength and perspective even amid the horrors of our current political moment. It helps me notice that the cooperation and connection that is innate to human functioning is always achieving more in everyday solidarity than the destructive cruelty of capitalism and fascism. Grounding in the fascinating fact of simply existing in your own body (have you noticed how rare humans are in the vastness of the known universe?) in the context of community (look at all us silly people bumbling around together on this watery spinning rock!) means more peace and focus, even in turbulent times, even during shock and pain.

Coming in From the Margins

With the return of the malignant magpie-in-chief to the oval office, I (Brian) quickly found myself in a place of stagnant voyeurism. Likely owing to a lifelong love of history, I became a curious bystander to an avalanche of events that didn't care if I'd read The Origins of Totalitarianism or believed that an unhealthy dose of narcissistic detachment might save me from a world where disabled people like me died first, whether by Hitler's order or Covid's rationed care. And, anyway, the Resistance of 2017 had done well enough without me. 

But now I am opting to reject the false comfort of this toxic dissociation, replacing acquiescence with action. Our national politics is at a watershed moment—a recurrence after remission, a lost function in an already failing machine, and a challenge right in my literal wheelhouse. 

The question for someone in a body like mine is, how to plug in to larger social movements? I'd been a card-carrying member of DSA since the first Trump administration, but never found my place among my likeminded comrades. From my wheelchair, I can't fix working class brake lights to fight police harassment, or shout truth to power through my ventilator. Just showing up to a meeting or protest with comrades is life-threatening for me and many others, with deadly respiratory viruses still circulating everywhere and masking so uneven. 

Yet it's not enough to stay on the sidelines when fascism also imperils our lives. So while I might not be able to physically block the levers of capitalism, I do still have my eyes and can write using eye-gaze technology. When I was a kid, the technologies that today make it possible for me to write or breathe or exist didn't themselves exist.  

Indeed, if there's one thing our disabilities have taught us, it's that we're only ever one metaphorical software fix away from a brighter and more survivable future. While for years it didn't seem possible, my (Brenna's) access to new medicine and therapies has meant less time immobilized by pain and more energy to invest in organizing for collective power. Now, with this shared column we intend to contribute to the healing political algorithm DSA crafts for a more livable future. We'd both rather be drops in this mighty socialist ocean than a couple of tears drying alone on a sidewalk that only gets hotter in silence.

So that's what we'll be exploring as the Horrible Things Subsubsubcommittee here at California Red: how to survive them (the horrible things) together. With your help, we plan to dig deep and excavate the wisdom of other marginalized people who have built and advanced community power even when it felt impossible, when the very infrastructures of survival seemed arrayed against them, and when they too felt more than a little impaired and rudderless. We believe that no matter the circumstances, everyday people, especially disabled people like us, can together drive change and answer our own hardest survival and societal questions. We'll be articulating and celebrating that timeless, stabilizing and radical spirit here in this column. 

So send us your own insights and provocations (disabled comrades, this especially includes you), dig in, and stay tuned!

The Tenderloin: Sex, Crime, and Resistance in the Heart of San Francisco by Randy Shaw, Urban Reality Press, 2025

"Any city that doesn't have a Tenderloin isn't a city at all."
—Herb Caen, longtime San Francisco Chronicle columnist 

Few San Francisco neighborhoods have had more ups and downs than the 33-block area still called “The Tenderloin”—a name that derives from the late 19th century police practice of shaking down local restaurants and butcher shops by taking their best cuts of beef in lieu of cash bribes.

At various periods in its storied past, the Tenderloin has been home to famous brothels, Prohibition-era speakeasies, San Francisco’s first gay bars, well-known hotels and jazz clubs, film companies and recording studios, and professional boxing gyms. 

In 1966, trans people hanging out at the all-night Compton’s Cafeteria staged a militant protest against police harassment three years before the more famous LGBTQ uprising at the Stonewall Inn in NYC. During the last decade, the Tenderloin has become better known for its controversial side-walk camping, open-air drug markets, and fentanyl abuse.

The failure of municipal government to deal with those social problems— in a residential neighborhood for working-class families with 3,000 children—contributed to recent electoral defeats of a district attorney, city supervisor, and San Francisco’s second female and African-American mayor.

For the past 45 years, Randy Shaw has been a fixture of the place as co-founder of its Tenderloin Housing Clinic (THC). After graduating from law school nearby, Shaw became involved in fights for tenants’ rights and more affordable housing at a time when blue collar neighborhoods in San Francisco were starting to gentrify.

A Unionized Non-Profit

The THC, which now employs 200 SEIU Local 1021-represented staff members, began to acquire and develop its own network of Single Room Occupancy (SRO) buildings in the Tenderloin, as an alternative to run-down private landlord-owned ones. 

Today, THC provides subsidized housing and wrap-around services to several thousand of the city’s most needy tenants—who might otherwise be among the social outcasts living in the surrounding streets. Shaw estimates that the Tenderloin has a higher percentage of housing in nonprofit hands than any central city neighborhood in the nation, an arrangement that safeguards its distinctive character as an economically mixed neighborhood with many low-income people among its 20,000 residents.  

In this second edition to his book, The Tenderloin: Sex, Crime and Resistance in the Heart of San Francisco, Shaw recounts how this multi-racial working-class enclave managed to survive, if not always thrive, amid a city dominated by tech industry wealth and privilege. 

That history of neighborhood resistance to displacement is also on display at the Tenderloin Museum (TLM). Created ten years ago, with much help from the author, this venue for community-based, historically-inspired cultural programming now operates under the direction of Katie Conry. 

In her Forward to Shaw’s book, Conry describes the TLM’s many art shows, special exhibits, theatre productions, walking tours, and other public programs that have drawn 50,000 people to a downtown area many out-of-town visitors (and locals) are told to avoid. On April 11, for example, the THC is hosting a new production of The Compton’s Cafeteria Riot to commemorate that “collective act of resistance” and “the on-going fight for transgender rights.” (For ticket info, see: https://www.tenderloinmuseum.org/the-comptons-cafeteria-riot-play)

Community Benefits Agreements

DSA chapters fighting gentrification—or trying to make sure its benefits are more equitably shared—will find Shaw’s book to be an invaluable guide to effective activism around housing issues. It illustrates how persistent and creative grassroots organizing can challenge and change urban re-development schemes designed for the few, rather than the many. In too many California cities, it’s the latter who continue to get pushed out and left behind in the name of “neighborhood improvement.”

A central case study in The Tenderloin is the author’s account of how community residents won a pioneering “community benefits agreement” (CBA) with three powerful hotel chains. In the early 1980s, Hilton, Holiday Inn, and Ramada wanted to build three luxury tourist hotels adjacent to the Tenderloin. Given the city’s pro-development political climate at the time, these hospitality industry giants expected little organized opposition to their plans. Then Mayor Diane Feinstein lauded them for “bringing a renaissance to the area.”

However, as originally unveiled, their blueprint would have transformed nearby residential blocks by “driving up property values, leading to further development, and, ultimately the Tenderloin’s destruction as a low-income residential neighborhood.”

An Organizing Case Study

Among those faced with the prospect of big rent increases and eventual evictions were many senior citizens, recently arrived Asian immigrants, and longtime residents of SRO buildings in dire need of better ownership and management. Fortunately, this low-income, multi-racial population included some residents with “previously unrecognized activist and leadership skills” that were put to good use by campaign organizers, like Shaw, who were assisting their struggle. 

During a year-long fight, hundreds of people mobilized to pressure the city Planning Commission to modify the hoteliers’ plans. As Shaw reports, the resulting deal with City Hall created “a national precedent for cities requiring private developers to provide community benefits as a condition of approving their projects.”

Each of the hotels contributed $320,000 per hotel per year for twenty years for low-cost housing development. They also had to sponsor a $4 million federal Urban Development Action Grant (UDAG) for the acquisition and renovation of four low-cost Tenderloin SROs. In addition, each hotel had to pay $200,000 for community service projects, and give priority in employment to Tenderloin residents. 

Four decades later, community benefits agreements of this sort are not so unusual. But, in the absence of major new federal investment in public housing built with union labor, they are still much needed.  

Where tax breaks or rezoning encourages various forms of private development today, the only way to win additional low-income housing units, living wage jobs, local hiring, or preservation of open space for public use is through grassroots campaigning by community-labor coalitions, aided by sympathetic public officials. 

Otherwise mayors and city councils under the thumb of developers will simply offer financial incentives with few strings attached—whether the project involved is a new hotel, casino, shopping center, office building, or luxury apartment building.

Organizers’ optimism

Back in the Tenderloin, as Shaw reports in the conclusion to his book, residents in recent years have had to mobilize around basic public safety issues.  Pandemic driven economic distress flooded their neighborhood with tent dwellers, drug dealing, and street crime that added to small business closures, drove tourists away, and made daily life hazardous for longtime residents (except when state and local politicians cleaned things up for high-profile gatherings like the Asia-Pacific Economic Cooperation leadership meeting in S.F. two years ago).

Nevertheless, the author ends on an optimistic note (characteristic of organizers): “New restaurants and small businesses are again opening in the Tenderloin. Street and crosswalk changes make the neighborhood among the city’s most walkable. New housing has increased the Tenderloin’s population…” 

But, Shaw reminds us, residents of this urban enclave must still fight to achieve “the quality of life common to other San Francisco neighborhoods,” while “protecting an ethnically diverse, low-income, and working-class community” with a storied past and always uncertain future.

Don't Get Burnt: Lessons From Radicals About Sustainable Organizing
by Brenna Silbory

While success in radical politics can provide an exquisite degree of shared euphoria, not to mention significant and even revolutionary material gains for movements and communities, defeats and disappointments are also ubiquitous. Some defeats are mundane, but others can change and separate even the most driven, committed and productive people from political work altogether through the constellation of painful experiences often summarized as "burnout."

These organizers' psychologically charring experiences and the resulting metaphorical ashes may be largely invisible to, or even exiled from, the movements whose revolutionary fires they once proudly shared. The loss in these cases is mutual: movements grow weaker with every needless organizer casualty, and people who burn out while engaged in solidarity work can suffer intensely in isolation. As California DSA State Committee member Michael Lighty put it, "Pacing ourselves as activists to ensure we are active for the long-term and have a full life that includes downtime may be the greatest challenge for deeply committed DSA activists. The temptation to be all-in all the time within DSA can mean activists burn brightly, but briefly -- moving on to other organizations, other places or out of the movement."

Is burnout inevitable given the enormity of struggle radical movements face? Is it preventable? How? Is it possible to heal burnout while continuing to fight difficult political battles? Exploring these and many related questions, Hannah Proctor's Burnout: The Emotional Experience of Political Defeat (Verso 2024) is a tender historical collage of the complex and common experiences of difficult emotion among radicals across generations and continents. Its full picture poignantly depicts the very depth and breadth of humanity that ultimately motivates Left organizing for liberation and collective power. It also provides sobering, provocative and hopeful implications for advancing the sustainability and development of Left organizing.

The Personal is Political, Interpersonal, Spacial and Temporal

The concept of burnout was originally developed to describe the "phenomenon of fatigue and encroaching cynicism among people who devoted their spare time to projects that sought to transform society" particularly in the "militantly compassionate" free clinics first established in San Francisco in the late 1960s and related projects like hot lines, queer centers and crisis intervention efforts.

Critically, Burnout distinguishes between "forms of mental suffering that arise from living in the given structures and systems of the world and those that arise from fighting against those structures and systems." Starting with the Paris Commune of 1871, Proctor draws from scholarship and historical accounts as well as fiction and film, with the understanding that "the motley array of anarchists, social democrats, socialist feminists, Maoists, Communist Party apparatchiks, black nationalists, ultraleft militants and libertarians that populate these pages would have vehemently disagreed with one another on many issues."

Indeed, the scope of her study is extraordinary. Accounts from the UK and US focus on the 1960s to the present, include the Civil Rights Movement's Student Non-Violent Coordinating Committee (SNCC), feminist collectives, the Black Panthers, Students for a Democratic Society, the Weathermen, the UK miners' strike of 1984-5, ACT UP during the AIDS crisis, Black Lives Matter, and the 2019 and 2020 campaign defeats of Jeremy Corbyn and Bernie Sanders respectively, among others. Outside of the Anglosphere, the book also gleans from post-1917 Bolsheviks, Maoist land reformers in China, the Algerian anti-colonial experience, the Pinochet regime's targets in Chile, Vietnamese war survivors, Indonesian communists persecuted under Suharto, the Arab Spring's aftermath, and others around the world.

The resulting collage is more than a catalog of suffering because it is impossible to separate the hardship movement participants endured from the dynamism, collective joy, revolutionary achievements, and rich interpersonal connections that often accompanied it. However, burnout in this depiction is a commonplace, even though its thorough examination and prevention in political movements is not. The book fills a significant hole and invites further study.

Burnout is a particular threat to the most committed radicals, including individuals who achieve extraordinary revolutionary objectives. For example, among Russian Bolsheviks post-October Revolution, "After years of hardship and struggle, bodies failed, but exhaustion was also psychological, prompted by political disappointments, the disorientation of shifting from insurgent opposition to ruling elite, and, for some, despair over the course the new society was taking." Party defections and suicides were widespread, especially following purges and brutal suppression of political efforts party leaders deemed counterrevolutionary. These leaders themselves frequented Soviet sanitoria to attempt to recover from exhaustion and assorted nervous conditions.

The twentieth century's Civil Rights Movement in the United States, for all its successes, also produced widespread burnout, including among SNCC activists. According to a movement psychiatrist, their depression "frequently emerged only after prolonged periods of political engagement during which its effects were successfully kept at bay. This slow gestation made symptoms, when they finally emerged, difficult to treat." Meanwhile, the long-term, "unglamorous but necessary forms of organizing upon which political change depends" formed what SNCC's Ella Baker aptly deemed and exemplified as "spadework."

Anyone who has spent prolonged time working physical soil with a literal spade knows how it can leave you weary and aching all over. In many cases, political radicals labor against the most extreme forms of brutal, deadly and totalizing repression. The complex interplay between individual and shared experience of such repression is frequently challenging to navigate in movement circles.

Even outside of life-threatening contexts, exhaustion in political spadework can give rise to in-fighting, which further imperils group success. Bitterness can result from abusive in-group dynamics, like coercive forms of "self-criticism," objectification of radicals as mere militant "tools" undeserving of their own complex and valid emotional lives, and a multiplicity of betrayal experiences. Trauma can arise from life-changing events that overwhelm and change body and mind without adequate stabilizing support, not only due to torturous violence, but also the pressure-cooker of functioning in a relational context harshly shaped by broadly oppressive social and political forces.

Possible Antidotes

Burnout is not a self-help or how-to manual but its wide-ranging treatment of the phenomenon does provide a cornucopia of possible antidotes. By overlaying divergent communities and events across common features of political burnout like moribund meloncholia and nostalgia, depression, exhaustion, bitterness, trauma, and mourning, Proctor further extracts and develops themes like "anti-adaptive healing," "patient urgency," and "mournful militancy."

Proctor follows bell hooks in declaring "her desire to ‘politicize movements for self-recovery’ by recognizing systemic causes of psychic distress." Drawing from anti-colonial, abolitionist, feminist and other scholars and Left movement leaders, she develops and advocates for the pursuit of "anti-adaptive healing." This refers "not only to the contradictory endeavor of striving to heal psychic wounds in a wounded and wounding social reality (without affirming its structures in the process), but also acknowledges the psychic damage that can be incurred by fighting to transform social reality (so as to make it less psychically wounding)." Both internal and external realities cause suffering and so shifting both are important to healing, even as it "was always already too late to be a perfect revolutionary."

In spite of her skepticism of the psy-disciplines, Proctor acknowledges that some individual psychotherapeutic approaches can bear fruit, especially those that validate and explore common experiences of (survivors') guilt and self-castigation around perceived personal "weakness" in the context of collective struggle. Though she doesn't cite it, the Power Threat Meaning Framework developed in recent years by British psychologists and mental health service users and other providers might be of particular interest to radicals seeking alternative models for understanding and healing psychic distress in the context of political repression. The Framework's starting point is to inquire how power is operating in your own life, and how it has affected you.

Framing the "conflict between social struggle and weariness [as] a conflict between urgency and patience," Proctor returns repeatedly to the theme of "patient urgency." Living in the sliptream of time is tricky. Simultaneously navigating collective trauma due to past events, the brutality of a repressive present, and demands for a more livable future requires an expansive relationship to time. The Black Panthers' "survival pending revolution" mutual aid model continues to influence movements' efforts to organize for change while easing hardship in the present. Intersectional recognition that the intergenerational consequences of capitalist repression are not evenly distributed across identities invites load-shifting away from those particularly vulnerable to burnout. Even the "respite gained from withdrawal" from grueling Left political work is only ever partial so long as the social conditions that prompted it persist. Better are efforts like the solidarity clinics set up during Greece's 2010 anti-austerity uprisings under a framework of "networked reciprocation," a form of mutual aid that recognizes "carers also needed to be cared for." Otherwise, they burn out.

IWW leader Joe Hill's defiance on his way to his execution famously gifted generations with the slogan "Don't mourn, organize!" But Proctor investigates the psychic costs of not mourning. She gently argues "militancy cannot function as a substitute for mourning but instead results from the socially enforced disavowal of grief." She advocates instead for "mournful militancy," which makes space for emotional ambivalence. Radical communities that can do this together are more likely to retain organizers than those who shame sufferers. During ACT UP's survival struggles amid the AIDS crisis, "celebratory nightlife and group experiences as forms of care" advanced collective joy amid sickness and death, making space not only for grief and love but anger sufficient to galvanize action. "When mourning is obstructed, mournful militancy smashes through the poisonous complacency of the murderous present." It is "not a lament but a demand."

Shifts in perspective also can provide portals to healing. A Pinochet regime survivor's love of astronomy and the ancient light of the stars provided a path through the time-melting features of trauma and its psychic fragmentations: "She found she could mitigate her own personal pain by looking into the galaxies which gave her a different sense of time and cycles of existence." And the "disappeared" who the regime dumped out of airplanes were part of this, even in death: "the stardust in the skies is materially no different from the fragments of bone scattered across the desert."

We are all part of an enormous, even transcendent, continuum. Even when we drop out or expire, what we are part of lives on, through each other and the worlds we build and share. This awareness opens up freedom to rest when we need to and heal as we must, without compromising our political commitments.

Burnout isn't necessary or good for organizing, and political organizations, including ours, are wise to create cultures and processes that reduce it. We can enhance, rather than undermine, our fellow comrades' well-being, even as we engage, and overcome, difficult struggles.

California DSA is running our introductory “California DSA 101” sessions every couple months. Whether you are a new member, considering DSA membership, a veteran activist or just wish to widen your worldview out to a bigger picture, this ninety-minute presentation is for you. The next session will be held on March 30 at 11 am on Zoom. 

The presentation, run by local and state DSA leaders, features a slideshow in five parts.  The first three sections address basic questions: What is capitalism? What is socialism? and What is DSA? The fourth part consists of a condensed overview of the state’s political and labor history. 

Following the election late last year we revised the presentation to reflect the changed political landscape, with a new section toward the end on what fascism looks like in twenty first century America.  Because this isn’t pretend fascism we’re facing. It’s the real thing.

We augment the slideshow with breakout rooms for small group discussion along the way and reserve time at the end for Q&A.  The participant feedback has consistently said we are on the right track. 

We have had a big jump in attendance numbers for California DSA 101 this year, reflecting an understandable dismay at the election results and a healthy desire by attendees to find an organizing space in this historical moment as the curtain descends on American democracy.  With the Democratic Party leadership mostly in confused disarray after its neoliberal election strategy’s catastrophic failure, there is a hunger for answers that make more sense than ‘doing the same thing, only better’. 

It will take a powerful mass movement to defeat the fascist forces in control of the federal government. California DSA does not have the resources to lead that mass movement, but we certainly have the ability to help build it.  Our 101 program is a part of that contribution. We look forward to seeing you at the next one on March 30. 

“If you don’t like the news, go out and make some of your own.”

~ Wes “Scoop” Nisker

[Note: The April 5 National Day of Action, spearheaded by Indivisible, is not endorsed by DSA. However, we thought it important to inform California DSA members of events like this as the resistance to Trump’s fascist agenda grows. — Editors]

Since he was sworn in for the second time last January 20, Trump has dominated the news cycle with his plan to crown himself king ala Charlemagne, and we have groaned with disgust, horror and bile. We’ve dreamed of a pushback equal to the task, big enough and powerful enough to slap that self-satisfied smirk off that orange face. That day is coming soon – April 5.

All the local actions imagined and coordinated by grassroot activists built the infrastructure and confidence to spread the notion that not only did this have to be done, but could be done. 

So when various groups started to coalesce around a date, April 5 made sense. Not too soon so organizing had no time, yet not too far off to lose momentum.  

This is a nationwide mobilization to stop the most brazen power grab in modern history. Trump, Musk, and their billionaire cronies are orchestrating an all-out assault on our government, our economy, and our basic rights—enabled by Congress every step of the way.

They want to strip America for parts—shuttering Social Security offices, firing essential workers, eliminating consumer protections, and gutting Medicaid—all to bankroll their billionaire tax scam. They’re handing over our tax dollars, our public services, and our democracy to the ultra-rich.

Bring a friend. Send the notice out to your lists. There will be more of these. If we don’t fight now, there won’t be anything left to save.

Check out the HANDSOFF national listing of events.
Find an event near you in California.

Thorn West: Issue No. 228

State Politics

• Former Orange County congress member Katie Porter is the most recent candidate to announce their candidacy for California governor. Current governor Gavin Newsom will be unable to run in 2026 due to term limits.

• Governor Newsom interviewed Steve Bannon on his newly launched podcast. It is the third episode to feature a friendly interview with a member of the far right.

City Politics

Los Angeles chief administrative officer Matt Szabo predicted a $1 billion budget shortfall in the next fiscal year in a presentation before city council, projecting the need for “thousands” of layoffs of city employees. The current fiscal crisis was precipitated by raises for LAPD officers, and is exacerbated by police liability claims. Mayor Karen Bass, released a statement warning that her draft budget for the upcoming fiscal year, due to be released within a month, will represent a “fundamental change in the way the City operates.”

Health Care

• As Republicans discuss cutting billions of dollars in Medicaid funding over the next ten years. Capital & Main projects the devastating cascading effect this will have on health care in California.

• Medi-Cal, California’s implementation of Medicaid, is $6.2 billion over budget, a result of rising pharmacy costs, and increased participation in the program. The state has borrowed from its reserve fund to partially make up the shortfall.

• There was a diagnosed case of measles in LA County last week, in a patient who had just flown into LAX. Press release from the LA County Department of Public Health here.

Police Violence and Community Resistance

• Recordings made by an LAPD officer in the department’s Recruiting Division captured a stream of racist, sexist and homophobic comments from multiple officers across dozens of conversations. A probe is underway.

• [CW: police violence] LAPD officers shot and killed an unarmed driver during a traffic stop last week.

• Amid a budgetary crisis, advocates worry about the future of a successful pilot program that diverts emergency mental health calls to an unarmed crisis response team. LA Forward is hosting a zoom call to organize a defense of the program, here.

• Sheriff Robert Luna is suing the Los Angeles County’s Civilian Oversight Commission, seeking to withhold documents related to deputy misconduct that the commission has subpoenaed.

Housing Rights

• Funding for a federal emergency rental voucher program, which provides assistance to tenants facing homelessness, is projected to run out in the upcoming fiscal year.

• An audit has revealed that LAHSA, the organization which currently provides homelessness services across LA County, has been lax in tracking its use of funds. LA Public Press provides further details on plans at the city and county level to restructure how homelessness services are provided.

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