British Pakistani writer Hanif Kureishi achieved fame in the 1980s with his novel The Buddha of Suburbia and his screenplay for the film My Beautiful Laundrette. In 2022 he suffered a fall which left him with spinal injuries and partly paralysed, unable to move his limbs. He now writes – or rather dictates – a weekly Substack, ‘The Kureishi Chronicles’, which he describes as ‘a weekly dispatch from my hospital bed’. In a recent post, Kureishi reflected on his ‘fraught’ relationship with one of the live-in carers who are, in his words, ‘indispensable to my survival’.
Hanif Kureishi (via www.independent.co.uk)
It occurred to me that, in this brief piece, Kureishi highlights, in raw and experiential terms, some of the themes that have been central to debates in care ethics, and which we’ve discussed on recent episodes of the podcast, while also posing questions which offer something of a challenge to care theory. Although he’s appreciative of the assistance that his carer provides, Kureishi certainly doesn’t romanticise the relationship of carer and cared-for:
There is no doubt that these relationships can get fraught... She knows a lot about me – she overhears my private conversations, and even comments on them - and I know little about her...When you are forced to live with someone else, you are reluctantly enclosed in an unfolding drama, replete with characters, conflicts and turns of events... When you have a spinal injury, you are necessarily inserted into a nest of new relationships, none of which you’ve chosen.
As well emphasising the often unchosen character of the caring relationship, Kureishi also reflects on the sheer strangeness of the connection, with its odd combination of intimacy and distance:
The etiquette is not clear, there is no practical guidance as how to live with a stranger, except to be polite and tolerant, which is a strain, at least for me... We can’t discuss books, politics or sport, yet we are together all day, from seven in the morning until eight in the evening... She knows a lot about me – she overhears my private conversations, and even comments on them - and I know little about her, I maintain a distance.
I was particularly struck by this sentence:
I spend more time with her than I do with anyone else, apart from Isabella [his partner], and yet we barely know one another, and only have my body in common.
Recent work in care ethics, building on the pioneering writings of Maurice Hamington (interviewed on Episode 6 of the podcast), has emphasised the embodied nature of care, and has tended to highlight the positive aspects of bodily interaction. By contrast, Kureishi’s perception that there is nothing but his body connecting him with his carer draws attention to the impersonal character of their relationship.
Care ethics has also foregrounded dependence and relationality as being central to what it means to be human, reacting against the perceived emphasis on autonomy and independence in mainstream moral philosophy. But Kureishi is horrified at his newly dependent state:
All of this brings back memories of an earlier dependency and vulnerability, being a baby and then a child, with wishful thoughts of throwing off the caregiver and finally becoming sovereign. Having been independent once, it is depressing to be flung back into this previous state. This is of course most people’s fate, unless you were lucky enough to have never been born.
A similarly unromantic account of the relationship between carer and cared-for featured in another recent article, by the journalist Mary Wakefield, writing about Alice, an elderly neighbour whom she regularly visits:
I know straight away, from the look on my friend Alice’s face, whether it’s a ‘bad carer’ day. Five years ago Alice had a fall and she can’t now do stairs, so she lives just on the second floor of her maisonette in north London. When I drop round, the carer is usually in the kitchen and Alice in her bedroom/sitting room next door. If it’s a bad carer day, she’ll look towards the kitchen, do a thumbs-down sign, purse her lips and shake her head, then she’ll wriggle her shoulders – hoity toity – to indicate that she feels bossed about.
Mary Wakefield (via @TheSpectator on X.com)
Wakefield is perhaps more understanding of the carer’s perspective than Alice, but she is also keenly aware of the poor care that the latter often has to suffer:
I suppose infirm 88-year-olds often need to be bossed about in a way. There are 960,000 people in this country, taken care of at home like Alice, and they need to be dressed, fed, heaved on and off the portable potty chair. But Alice isn’t making up the bad carer days. She’s a beady old cockney who doesn’t complain lightly, and if she’s nervous of a carer, it means she has reason to be. On ‘bad carer’ days her hair is unbrushed and knotted and when she asks for tea, she’s told no, so as to minimise potty trips. She’s often had cheese sandwiches for both lunch and dinner, I notice, and she stays all day in her nightie. I had thought a reluctant carer might be particularly grateful for visitors, but it’s the surly ones who want me out quickest, and glare until I leave.
As in Kureishi’s account, the unchosen character of the caring relationship is again to the fore:
Alice knows full well she is in a hostage situation. She’s entirely dependent on the care company the council employs, and appeasement is all she has.
Coincidentally, Kureishi’s and Alice’s carers, or at least those mentioned in the two articles, are both Nigerian women, a reminder of the fact, often highlighted by writers on care like Joan Tronto, that much frontline caring work is undertaken by poor, migrant women. However, Kureishi’s and Alice’s opinions of their respective carers differ markedly from each other. Here’s Kureishi:
My carer is Nigerian, in her early-thirties and with braids. She is short, squat and strong, and lives at the top of the house. When she is not working for me or her other ‘clients’, she works in a male prison, where she is an expert on restraint. Sometimes she demonstrates how to pin down an angry murderer on one of my sons.
By contrast, here’s Wakefield’s view of Alice’s carer:
But there is a bright side, which is Kay. Kay is in her early twenties and she’s from Nigeria, and she arrived in 2023 when carers were suddenly allowed in under the skilled worker scheme. For the last year Kay has been Alice’s semi-regular carer, and she’s a godsend. When Kay has been round, Alice’s hair is brushed and gleaming and put up in a series of eccentric accessories; she has tea and she smiles. ‘Kay gives me a kiss,’ she tells me, delighted.
While both Kureishi and Wakefield understand the constraints under which the two carers operate, and the unchosen nature of their involvement in these relationships of care, the contrast between the two women (while allowing for the inevitably subjective character of their portrayal in these accounts) conveys something about a key aspect of ‘good’ care. For Wakefield, it’s Kay’s respect for Alice’s unique personhood that makes all the difference:
Kay says it’s important to honour the old and that she treats Alice the same way she would treat her own grandmother. If there were more carers like Kay, it would all be almost bearable.
The concluding sentence of Wakefield’s article reflects the writer’s particular view on the subject of assisted dying (see this post). But it also usefully highlights the way in which ‘good’ care can invest an individual life, even one that no longer has value for the world at large, with meaning:
Alice’s life has value when Kay’s been around – it’s important that anyone too ardent about euthanasia understands this.
Header image: from ‘Drawing in care homes’ by Abel Kesteven