REVIEW OF DAVID B. SCHWARTZ, WHO CARES? REDISCOVERING COMMUNITY. (WESTVIEW, 1997).

Kenneth Westhues

Catholic New Times, 31 May 1998; on the web by permission, August 2003

Child care, health care, elder care. How routinely, unthinkingly, we say the word, as if caring were what the formal structures established for this purpose really do, and as if these structures were the main way care is given. Wrong on both counts, says Schwartz.

There is no citation here to philosopher Milton Mayeroff's On Caring (Harper & Row, 1971), which remains a classic statement of the meaning of the word. The gist of it is dialectical recognition of the other both as an extension of oneself (with concerns that deserve the same attention as one's own) and as a separate being (thus entitled to privacy, autonomy, and respect for decisions that may differ from one's own).

Schwartz names other giants on whose shoulders he has stood to make this perceptive appraisal of where caring is and is not to be found. Seymour Sarason, the chief intellect behind community psychology, is one. John McKnight, author of Careless Society (Basic Books, 1995), is another. So, too, Wendell Berry, the farmer-prophet of local democracy who wrote What Are People For? (1990). Mainly, Schwartz builds on Ivan Illich's critical analyses of care by professionals, especially David Cayley's 1989 interviews with Illich in the CBC's Ideas series.

As Illich writes in his introduction, this book complements earlier exposés of how uncaring it is to segregate and institutionalize handicapped people, placing them under the control of credentialled therapists. The effects can be the opposite of those intended. Already in 1976 Illich referred to the "iatrogenic pandemic," the severe threat to health that doctor-caused illness constitutes.

In his introduction, Illich also highlights the important way in which Schwartz's book goes beyond those of his predecessors: by showing how our preoccupation with formal systems of care has blinded us to "the widespread readiness of ordinary people to provide individual handicapped persons with lifelong hospitality." Schwartz's key contribution is to demonstrate that the most prevalent and effective forms of caring, both for the handicapped and more generally, are not professional but neighbourly, not expert but friendly, not formal but informal, and rooted in the remnants of community that persist amidst all our bureaucracies.

The best parts of this book, maybe of any book, are the stories that illustrate the underlying argument. Schwartz begins with a friend of his named Gerald in Pennsylvania, who looks out his office window and observes a woman about to jump to her death from a bridge across the Susquehanna River. Gerald grabs his phone to dial 911, seeking to call into action the official crisis-intervention system in place. Before he can complete the call, he sees a city bus turn onto the bridge on its accustomed route. The bus slows down, then pulls over so that its accordion door is right next to the woman. The door opens, the driver's arm reaches out, and the woman is pulled inside. The bus moves on.

Our world, so Schwartz demonstrates, is full of bus drivers and other citizens who do not wait for "human services systems" to care for people. They do it themselves, often without pay, and usually in a way that responds more promptly, efficiently and effectively to people's actual needs.

There is the case of Nancy, who, on account of cerebral palsy, has lived in a nursing home for 40 years. Some social workers and friends who truly care about her get her out of the home into her own apartment. Then she gets cancer and is about to die. Unable to care for herself, she faces return to the institution. A network of friends from her church prevent that, take turns staying with her, and give her a gift she has wanted all her life: a room painted canary yellow, the colour of her choice.

Schwartz is not doctrinaire. As a psychologist, psychotherapist, and intellectual, he has spent his working life searching for practical ways to get disabled people—and all of us—the care we need. He does not favour drastic spending cuts on social services. He rejects the current panacaea of "volunteerism." His penultimate chapter is entitled "Six Useful Ways to Support Hospitality." The most basic is "promoting asking: connecting strangers who are unlikely to meet." In the final chapter, "What Can One Person Do?" Schwartz suggests practical ways of doing these six things.

Despite its lament for the loss of community in the advanced capitalist societies, this is a hopeful book. Who knows what might happen if we took Schwartz's advice: looked around us, struck up conversations with people unlike ourselves, and got to know them by name?