Healthcare for All Coalition demonstration in Toronto on March 31, 2023
Healthcare for All Coalition demonstration March 31, 2023, Credit: Healthcare for All Coalition / Healthcare for All Coalition Credit: Healthcare for All Coalition / Healthcare for All Coalition

“Art is not a mirror held up to reality, but a hammer with which to shape it.” – Bertolt Brecht

As a kid I loved listening to Bobby Darin crooning “Mack the Knife” (1959 #1 on the Billboard charts) with its dramatic pauses and wonderful orchestration.

But it wasn’t until I saw the Three Penny Opera at Stratford (2002) that I discovered the true origins of this catchy tune.

Written by Bertolt Brecht in 1928, The Threepenny Opera is a satire of the post-war rise of capitalism in post-Victorian London exploiting the labour of the under classes.

It’s also about Macheath, or Mack the Knife, the cunning, yet exceedingly charming, crime lord introduced to the audience through the earworm that Americans were crazy about – ironically, not long after McCarthyism tried to destroy Brecht.

Turns out Brecht was a prolific German playwright, poet, theatre practitioner, and self-proclaimed communist with an intense interest in the structures and processes of capitalism and its effects on politics, public policies, and workers’ lived experience.

Brecht believed, and wrote extensively, that the arts can play a significant role in transforming society. He used ‘Epic’ theatre and poetry to promote critical reflection on the current state of affairs as well as to provoke political action to change the status quo.

April is poetry month! The perfect time to reflect on four recently translated poems by Brecht and their relevance to what is happening across Ontario with regards to the Ford government, privatization of health care, demonization of unions, and exploitation of workers.

Dennis Raphael, PhD; William McGregor, MA; and Martin Horn, MA are in the throws of publishing, Beyond Empathy to System Change: Four Poems on Health by Bertolt Brecht in the Journal of Medical Humanities.

These poems were written while Brecht was in exile in Svendborg, Denmark in 1933 after Hitler declared a state of emergency effectively ending democratic rule in Germany.

They were virtually unknown until John Willet translated them into English starting with The Worker’s Speech to a Doctor (1996).

Initially, it was mistakenly thought that Brecht was recounting the toll poverty takes on the human body and spirit. However, a new English translation by Tom Kuhn and David Constantine (2015/19) reveals that The Worker’s Speech is all about class struggle.

The Worker’s Speech to a Doctor

We know what makes us ill.
When we’re ill word say
You’re the one to make us well
For ten years, so we hear
You learned how to heal in elegant schools
Built at the people’s expense
And to get your knowledge
Dispensed a fortune
That means you can make us well.
Can you make us well?
When we visit you
Our clothes are ripped and torn
And you listen all over our naked body.
As to the cause of our illness
A glance at our rags would be more
Revealing. One and the same cause wears out
Our bodies and our clothes.
The pain in our shoulder comes
You say, from the damp; and this is also the cause
Of the patch on the apartment wall.
So tell us then:
Where does the damp come from?
Too much work and too little food
Make us weak and scrawny.
Your prescription says:
Put on more weight.
You might as well tell a fish
Go climb a tree
How much time can you give us?
We see: one carpet in your flat costs
The fees you take from
Five thousand consultations
You’ll no doubt protest
Your innocence. The damp patch
On the wall of our apartments
Tells the same story.

When Raphael and his co-authors read the three poems that followed The Worker’s Speech to a Doctor, they discovered these works were even more avant-garde. That prompted them to craft questions to ignite critical thinking and initiate necessary discussions.

For The Worker’s Speech consider:

  1. What is the author referring to when he states, “It is the same cause that wears out our bodies and our clothes”? Hmmmm? Could it be capitalism?
  2. What are the reasons the worker states, in response to the prescription to gain weight, “You might as well tell the reeds to keep their feet dry. ”Hint: think ‘healthy living/eating’ and blaming the victim.
  3. What is the tone of the poem towards the doctor? Why does the poem adopt this tone?
  4. What are some of the issues the poem has raised for you?

Call to a Sick Communist

We hear you have been taken ill with tuberculosis.
We entreat you: see this
Not as a turn of fate, but
As an attack by the oppressors, who
Exposed you, poorly clothed and in damp housing
To hunger. That is how you were made sick.
We charge you take up the struggle at once
Against sickness and against oppression
With all possible cunning, rigor, and tenacity
As a part of our great struggle, which
Has to be waged from a position of weakness
In utter misery, and in which
Everything is permitted which will aid our victory, a victory
Which is the victory of humanity over the scum of the earth.
We await your return, as soon as possible


  1. What do you make of the term “communist” used in the title?
  2. How would you respond if the term used was “socialist” instead of “communist”?
  3. What other diseases are caused by poor living and working conditions?
  4. Who would these ‘oppressors’ have been in 1937? How about in the present?
  5. How do these ‘oppressors’ come to cause these conditions?
  6. What are the struggles to be taken up?
  7. What concrete actions can be undertaken to rectify the situation?

The Sick Communist’s Answer to the Comrades

Comrades, by hunger, poor housing and inadequate clothing
I was made sick and removed from your ranks.
I immediately took up the struggle for my recovery.
I declare to everyone who sees me
The cause of my sickness
I explicitly name the guilty ones.
At the same time I wage the struggle against the sickness funds
Who seek to cheat me at every little turn.
I wage the struggle from my sickbed.
I have informed myself about the liabilities of the hospital
The daily abuses committed against sick members of the oppressed classes.
I apply every resource which will help me
Recover my good health.
And so, although stricken and wounded
I have not left your ranks. I will stick with you
Until my last breath. I have no thought of yielding.
I beg you
Continue to depend on me.

Consider the following:

  1. What are some of the problems with our current health care system?
  2. What are some of the groups especially disadvantaged by how it works?
  3. What are some of the forces that prevent the provision of accessible universal health care?
  4. What concrete actions can be undertaken to rectify the situation?

Call to the Doctors and Nurses

Now to you, doctors and nurses. We suppose
There must be some amongst you
Few perhaps, but some all the same, who
Remember their obligation to those who
Have a human face. These amongst you
We challenge to support our sick
In their struggle against the sickness funds and the practises of the hospitals
With regard to the oppressed.
We know, in order to do that you will have to
Take up the struggle against others too, the compliant tools
Of exploitation and deception. We ask that you
Look upon these as your own enemies. By so doing
You are, after all, only waging your own struggle against your own exploiters
Who threaten you every hour with that same hunger
That has brought our comrade low.
Join our struggle!

Discussion questions:

  1. How do you think doctors and nurses and other health workers think about issues of marginalization and oppression?
  2. How are doctors and nurses able to assist in joining to address these issues?
  3. How have you thought about the commonalities of your struggles with those of others?
  4. What do you take away as a health worker from reading these poems?

The links between Brecht’s work and the rise of fascism are obvious. Those links are also mirrored in what is happening in Ontario as well as other Conservative-governed provinces across Canada.

The once favoured class of doctors and nurses has been issuing warnings not only of what is happening within public health care and the long-term care industry, but across society. Think Decent Health and Work Network, Healthcare for All National Coalition or Ontario Health Coalition.

In fact, reviewers for the Journal of Medical Humanities said, “The authors allude to minimum government intervention in the operation of the market economy. And yet, the neo-liberal era would appear to be more defined by government proactively acting as an agent of the private sector and corporations. The merger of the state with corporate power is by definition, a form of fascism, and a linkage the authors may wish to develop with Brecht’s own era.”

Conservatives and Liberals alike are acting as agents of the private sector and corporations enacting deregulation, privatization, corporate tax cuts, changes to enshrined legislation like the Canada Health Act and Greenbelt Act – all in the name of profit.

These are ways the state has merged with corporate powers, aka corporate fascists in the case of developers, grocery moguls, the oil and gas industry, telecommunication and banking monopolies.

“Poetry can engage people and promote understanding the world and the forces that shape health,” Raphael shared with

“A Worker’s Speech to a Doctor has been used to raise issues about living conditions and their effects upon health. However, the three additional poems by Brecht make explicit his critique of capitalism and how it not only sickens people, but wraps the provision of health care.”

Brecht’s four poems are so relevant to what is happening across Canada today and makes crystal clear that capitalism needs to be radically reformatted or replaced.

Endnote: After 1938 Brecht lived in the United States.

In 1947, Brecht was called before the House Un-American Activities Committee (HUAC) where he told the truth and denied official membership with any Communist Party.

Brecht then returned to East Berlin where he and his wife, actress Helene Weigel, established the Berliner Ensemble Theatre.


All poems reprinted from The Collected Poems of Bertolt Brecht by Bertolt Brecht, translated by Tom Kuhn and David Constantine. Copyright © 2019, 2015 by Tom Kuhn and David Constantine. Underlying copyright © Bertolt-Brecht-Erben / Suhrkamp Verlag. Used with permission of the publisher, W. W. Norton and Company, Inc. All rights reserved.

Doreen Nicoll

Doreen Nicoll is weary of the perpetual misinformation and skewed facts that continue to concentrate wealth, power and decision making in the hands of a few to the detriment of the many. As a freelance...