Care under capitalism is always care under contradiction, because you cannot, in the final analysis, prioritize both profits and people. You can say you do. You can write it into mission statements. You can print it on glossy posters with smiling nurses and gentle hands and soft-focus old people looking meaningfully into the middle distance. You can call it “person-centred care” or “holistic care” or “compassionate service delivery” or whatever other management-approved incantation is currently being passed around the boardroom like a tray of stale biscuits. But at the end of the day, when the numbers come in, when the spreadsheet opens, when the staffing ratios are discussed, when the invisible god of “efficiency” clears its throat, someone has to choose. And capitalism chooses profit.
That is not an accident. That is the machine working as designed.
Care is not naturally a commodity. Care is older than markets, older than states, older than money, older than the smug little men in suits who imagine civilization began when someone invented quarterly reporting. Care is what keeps babies alive, what holds the dying, what feeds the sick, what tends the wounded, what sits beside despair and says, without drama, “I am still here.” Care is the warm animal basis of human life. It is not glamorous. It is not scalable in the stupid tech-bro sense. It cannot be infinitely optimized without being destroyed. It takes time. It takes attention. It takes bodies. It takes nervous systems. It takes people willing to enter the suffering of others without turning away.
Capitalism looks at that sacred human exchange and sees labor units.
That is the obscenity.
Under capitalism, care is not honored; it is mined. The caregiver’s compassion becomes a resource to be extracted. Their patience becomes a cost-saving mechanism. Their moral commitment becomes the thing management quietly relies on while refusing to fund the system properly. Nurses stay late because patients need them. Support workers absorb chaos because someone has to. Teachers buy classroom supplies because the kids still need learning. Parents destroy themselves because the children still need love. And the machine smiles its dead little smile and calls this dedication.
No. It is exploitation wearing the mask of virtue.
Capitalism is a cancer on humanity and Mother Earth because it grows for the sake of growth, consuming the very body that sustains it. It devours forests and calls it development. It poisons rivers and calls it productivity. It burns out caregivers and calls it workforce resilience. It hollows communities and calls it market adjustment. Like cancer, it does not know when to stop. It mistakes expansion for health. It takes living tissue and turns it into tumor.
And still, care persists. That is the miracle. Not because capitalism supports it, but because human beings are better than the systems that trap them. We keep caring in the ruins. We keep feeding the fire. We keep wiping mouths, holding hands, changing sheets, listening to the lonely, laughing in staff rooms, smuggling tenderness through the cracks.
But let us not confuse survival with justice.
A humane society would not treat care as a cost centre. It would place care at the heart of civilization. It would ask not “How little can we spend?” but “What does human dignity require?” It would understand that care is not a luxury added after profit has had its feast. Care is the feast. Care is the ground. Care is the only thing that makes any of this worth saving.
In aged care, the cruelty is quieter. It does not always arrive as obvious brutality. It does not always shout. More often, it hums under fluorescent lights, ticks in wall clocks, rattles in meal trolleys, hides in documentation, call bells, understaffed corridors, and the soft institutional smell of disinfectant, boiled vegetables, continence pads, and human waiting. So much waiting. Waiting to be toileted. Waiting to be turned. Waiting for medication. Waiting for lunch. Waiting for someone to answer the bell. Waiting for family who may or may not come. Waiting, finally, for death.
And the loneliness. God, the loneliness.
Not abstract loneliness. Not the poetic kind one gets on a rainy Sunday with a cup of tea and a Nick Drake song playing in the background, though there is room for that too, I suppose, because the heart is ridiculous and will romanticize almost anything if given half a chance. I mean the plain, bodily loneliness of old people sitting in chairs with blankets over their knees, looking toward doorways. The loneliness of someone who has outlived their spouse, their friends, their house, their garden, their car, their former body, their authority, their privacy, their name as it once existed in the mouths of people who loved them. The loneliness of being surrounded by staff and still being unseen.
As a student nurse, I saw how easily a human being becomes a task.
Mrs. So-and-so needs feeding. Mr. So-and-so needs pads changed. Room 12 needs obs. Room 7 is calling again. Room 3 is “behavioural.” Room 18 is palliative. Language collapses the person into the job required of them. And yes, work has to be organized. I understand that. I am not naïve. Bodies are heavy. Time is short. Staff are exhausted. The morning does not care about your spiritual philosophy. Breakfast arrives whether you are enlightened or not.
But still. There were people who would not have been fed if someone had not sat down and fed them.
That sentence should haunt us.
Not because staff did not care. Most of them did. That is the unbearable part. The cruelty was not usually in the hearts of the workers. The cruelty was in the structure that made care impossible and then asked everyone to pretend it was being delivered. There I was, a student, barely knowing what I was doing, spooning food into the mouth of another human being because otherwise their meal would sit there cooling in front of them, untouched, as if hunger could be solved by tray delivery. As if nutrition were complete once the plate had arrived. As if eating were not an intimate act requiring patience, attention, timing, trust, and tenderness.
Feeding someone is not menial. It is sacred. It is one of the first forms of love any of us ever receive.
And then there were the deaths.
People like to talk about dying with dignity, but dignity requires witnesses. Dignity requires presence. Dignity requires someone to notice that a life is ending and not treat it as one more pressure in an already impossible shift. I saw residents dying alone because everyone was too busy to sit by their side. Again, not because the staff were monsters. Because the system had made monsters of the schedule. Because the clock had eaten compassion. Because capitalism had measured everything except what mattered.
A person can live ninety years, survive wars, marriages, childbirth, grief, work, betrayal, laughter, Christmases, gardens, mortgages, secrets, sins, kindnesses, and then die in a room while the hallway keeps moving.
That is not a failure of individual morality. That is a civilizational wound.
And yet, even there, in the wreckage, care appeared. A hand held for thirty seconds. A face washed gently. A joke shared with a resident who still had a wicked sense of humour. A spoon lifted slowly. A blanket tucked around thin legs. A student nurse sitting beside someone because no one else could, feeling both useless and absolutely necessary.
That is where I learned something capitalism can never understand: care is not efficient. Care is faithful. It does not scale neatly. It does not maximize output. It abides. It stays. It says, in the small language of the body, you are still here, and I am still here, and for this moment, you are not alone.
There is something almost obscene about being taught care by young women already half-eaten by the system.
I followed them around as a student nurse: women twenty, thirty years younger than me, and yet somehow older in the eyes, older in that particular way caregivers become old when they have seen too much suffering and still have to smile at the next patient, answer the next bell, check the next chart, catch the next crisis before it spills over and becomes a reportable event. They were young enough to still be at the beginning of their lives, or what should have been the beginning, and yet some of them already carried bodies marked by the work: tumors, strokes, eating disorders, depression, anxiety, chronic fatigue, nervous systems tuned to perpetual alarm because the ward never really lets you come down. The body keeps the score, yes, but in healthcare the body also keeps the staffing ratios.
And still they cared.
That is the part I cannot get past. Not the suffering alone, though God knows there was enough of that, but the fact that they kept showing up with skill, wit, competence, tenderness, and this almost unbearable moral seriousness. They could be funny as hell in the nurses’ station, sharp, dark, irreverent, running on coffee and adrenaline and whatever scraps of sleep they had managed to steal from the wreckage of their personal lives, and then they would walk into a patient’s room and something in them would soften. Not become fake. Not become sentimental. Just soften. Their hands knew what to do. Their voices changed. Their faces opened. They could explain, assess, reassure, redirect, medicate, comfort, document, de-escalate, and somehow notice the small thing that mattered: the untouched meal, the worried daughter, the old man trying not to look scared, the patient who said “I’m fine” in exactly the tone that meant they were not fine at all.
This is not “unskilled labour.” Anyone who says that should be made to run a ward for twelve hours while their bladder screams, their blood sugar crashes, and three different people need them urgently at once.
I watched young nurses trying to be charge nurse for fifty beds with eight HCAs to help, as if that were a reasonable human task rather than a controlled experiment in moral injury. Fifty beds. Fifty vulnerable bodies. Fifty stories. Fifty medication profiles. Fifty families. Fifty possible disasters waiting politely behind curtains. And somehow the system treats this as normal. Not ideal, perhaps. Not perfect. But normal enough to keep doing it. Normal enough to budget around. Normal enough to explain away with words like “pressures,” “constraints,” “workforce shortages,” and “service delivery.”
There it is again: the language of the machine.
Because capitalism does not see these women as bearers of wisdom. It does not see their intuition, their emotional intelligence, their clinical judgment, their capacity to hold chaos without collapsing. It sees hours. Rosters. FTE. Productivity. Compliance. Risk management. Market value. Their compassion becomes a resource. Their empathy becomes a lubricant for an underfunded system. Their dedication becomes the invisible subsidy that allows the machine to keep grinding while pretending it is still humane.
They are mined.
That is the word. Mined.
Their bodies are mined for labour. Their kindness is mined for patient satisfaction. Their intelligence is mined for institutional survival. Their sense of vocation is mined to cover structural violence. The system digs into them and extracts care, and when they are depleted, anxious, sick, burnt out, injured, or simply unable to continue, it shrugs and replaces them with the next bright-eyed graduate who still believes love will be enough.
Love is not enough when the system is designed to consume it.
And yet I do not want to write them only as victims, because that would be another theft. They were not merely crushed. They were magnificent. That is what makes it hurt. They had a kind of practical grace I recognized immediately, even as I stumbled around in my student awkwardness, trying to look useful, trying not to be in the way, trying to absorb ten thousand things at once. They were fast because they had to be, but within that speed there was art. The way they turned a patient without making them feel like furniture. The way they read a room before anyone had said a word. The way they could be firm without being cruel, gentle without being weak, efficient without entirely surrendering their humanity.
Capitalism did not create that beauty. It feeds on it.
A decent society would protect such people. It would surround them with enough staff, enough time, enough pay, enough rest, enough reverence. It would say: these are the ones who hold us when we are frightened, sick, incontinent, confused, ashamed, dying. These are the ones who stand at the borderlands of the body. These are the ones who keep the human world from becoming merely biological.
Instead, we run them off their feet and call it a career pathway.
And somewhere in all of this, I followed them, older than many of them by decades, supposedly beginning again, supposedly learning the trade, but often feeling that I was witnessing a sacrament being desecrated. Because what I saw in them was holy. Not pure. Not perfect. Better than pure. Human. Tired, funny, skilled, wounded, compassionate, sometimes pissed off, sometimes radiant, sometimes barely holding it together, but still turning toward suffering instead of away.
That is care.
And that is what the market cannot understand: care is not a product. Care is not a KPI. Care is not a revenue stream. Care is one human being refusing to abandon another. And every system that exploits that refusal is living off stolen light.