The protagonist, Consuelo "Connie" Ramos, lives in Spanish Harlem and is framed as a violently unhinged woman after defending her neice against her niece's pimp.

Her punishment?

Placement in a NY mental hospital, where she is drugged into a submissive state.

Connie - an intelligent and resilient-against-the-odds woman - is labled at the mental hospital as:

- violent

- incapacble

- irrational

The more we learn of Connie, we see her life has been marred by a series of physical, emotional & sexual abuses - at the hands of individuals & the state.

Throughout, we see Connie endure a cyclic setbacks, worsened by constant economic insecurity and state enforced "help."

She works hard to escape poverty, but an unexpected pregnancy forces her to leave college.

She suffers again and again...

Her lover murdered by police.

A botched illegal abortion.

Her child taken by the state.

Her niece's economic insecurity leads her to prostitution.

We learn Connie doesn't need a mental institution.

She needs:

Fiancial stability

Food

Shelter

Love

Family

Companionship

Community

The world is stacked against Connie and there seems to be no escape.

Until...

During times of stress, Connie slips into communication with a future being - Luciente. Through time-travelling, Luciente shows Connie an idyllic future for humanity over 100 years away.

Power structures are toppled - there is no xenophobia, sexism, poverty, homelessness.

Connie slips between these worlds - her personal history and current state in a mental hospital - and Luciente's utopan potential future.

We see glimpses of a potential communal future - an alterative vision of love, parenting, food, land use, living structures, medical care.

Even in this future, formerly powerful factions seek to insatiably gather power & capital.

We ping pong between these world's with Connie & Luciente, seeing the life Connie has and the life that could exist if we rose up and stopped accepting harmful social structures.

After escaping the mental institution and being caught, Connie is forced into an experimental brain surgery to make her permanently submissive through neurologic emotional control.

Her refusal is ignored.

There is no consent to the experiment.

But there are complications.

Her perfectly reasonable anger at her situation and treatment by the state is deemed the problem.

Medical imprisonment & experimentation upheld as the "cure."

We see medicine & medical experimentation as carceral tools of oppression - used against those in non-ruling groups.

The book highlights major bioethics issues related to social determinants of health, consent, research ethics, trauma-informed care, and medically mediated social harm.

Without digging up the roots of social disparities, we cannot achieve health. @_Eric_Reinhart's call for "abolition care" brings these issues together beuatifully.

https://twitter.com/_Eric_Reinhart/status/1624461286506389507

So if you've never read Marge Piercy's Women on the Edge of Time - check it out at your local library.

It's abolitionist message as relevant to medicine today as in 1976.