The Body is the Setting

The last time I was hospitalized, I wasn’t certain I would make it out again. I don’t remember the name of the doctor or any of the nurses. I can barely recall their faces. What I do remember is: the long wait in a crowded hallway, the disdain of staff turning blame towards me, the stutter of my panic when I realized that they would keep me alive but they would never believe me. My experience of violent, de-personalizing care is typical, especially as a disabled person. If writer, nurse, and past smoke and mold contributor M. K. Thekkumkattil’s work makes one thing clear, it’s that it doesn’t have to be this way.

Thekkumkattil draws from their experiences in critical care nursing, anti-genocide organizing, and kink community building to stitch together a vision for a future where care is freely given and received outside of the loci of the medical-industrial complex. The work is as imaginative as it is pragmatic. When asked about how people can wrap their heads around an idea as seemingly radical as hospital abolition, Thekkumkattil counters easily. For so many people, in so many places, hospitals already don’t exist—for rural people and poor people and trans people and mad people and, and, and. Thekkumkattil and I sat down to discuss the tender arguments laid out across their two new releases, the chapbook Weaving Liberation and their debut essay collection The Sexuality of Care: On Nursing, Kink, and a Future Without Hospitals. From the world building power of kink to the insistence of being in solidarity with Gazan healthcare workers, our conversation returned again and again to the simple fact that our liberation requires our ability to be in loving relation with one another.

This interview was conducted over video in April 2026. It has been lightly edited for concision and clarity. 

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Luke Sutherland: Early on in the Sexuality of Care, you say that “the body is the setting of [your] attention.” A lot of my work also revolves around questions of the body, which makes me curious not only about how your practice centers the body, but also where this artistic attraction to the corporeal comes from.

M. K. Thekkumkattil: I appreciate that you pulled out that sentence because when I was revising the book, I learned a vertical revision process from my teacher Meredith Talusan. As you go through each pass of the manuscript, you pick one thing that you’re looking for, and I was highlighting setting. What I realized was that I actually had very few descriptions of setting in the book overall. Part of me was like, since all these things take place in the hospital, do I have to describe the hospital room each time? But then I realized that actually the setting is really the body. That is what I’m spending my time with, that’s the structure in which I’m making an impact when I’m nursing. There’s so much description of the body, of how bodies work, how bodies move, how bodies respond. I realized that that is both the artistic attention that I’m writing into and where I put my attention in nursing. 

There’s also a relationship between body and land in the book and in my previous work around how bodies reflect and absorb the land and how our relationships between our physical bodies and the land are not distinct. I’ve written in the past about homeland relationships and thought a lot about how bodies are also sites of home for ourselves. 

To be made into a hero is really dehumanizing. It not only dehumanizes us, but it creates a dichotomy that disempowers people from their own care, or from participating in their own care.

LS: I found a lot of personal connection points to The Sexuality of Care, not only as a disabled person but also in the parallels between nursing and my profession, public librarianship. Obviously the content of what nurses and librarians do is quite different, but something that rang true to me is the valorization of both fields. Certainly when the COVID-19 pandemic first began, it was kind of everyone’s mantra that nurses are heroes. You specifically use phrases like “virtue script” and “savior complex” to describe this phenomenon. In my field, the librarian-scholar Fobazi Ettrah coined the phrase “vocational awe” to describe a very similar experience. 

This line runs through The Sexuality of Care, but it’s also present in Weaving Liberation. I’d argue that one of the biggest, most obvious failures of the virtue script is in the murder of healthcare workers in Gaza. What does this set of assumptions do to us as workers, and what does it do to the people that we serve?

MKT: I don’t think this made it into the book because it was too hard to write about, but there was a point in the early pandemic when they put up all the healthcare heroes banners outside work. There was one night when I went down to the cafeteria to grab a snack, and the door to the cafeteria had a poster of a black and white drawing of a toddler. In the toddler’s hand was a nurse in a superhero uniform as a toy. I was so fucking offended, and that stayed up for years. When I left, it was still up. It’s a really dehumanizing thing, to have our profession be made into a toy that’s being played with by a toddler. To be made into a hero is really dehumanizing. It not only dehumanizes us, but it creates a dichotomy that disempowers people from their own care, or from participating in their own care.

This is more clear in the history of doctoring, where doctors are put on a pedestal. There’s so much that’s been said about decision making and how, over time, there’s been a move towards people making their own decisions and not just being told what to do by a doctor, but that dynamic still exists in so many different ways in healthcare work. The kinds of nursing I’m talking about in The Sexuality of Care are very intense, but there are so many specialties in nursing. Specialization does require training and experience, but there’s also so much we do as care workers that is very generalizable, skills that if our society prioritized them, anyone could learn and do not require speciality equipment. So there’s a way that the centralizing of care into these speciality institutions keeps people from learning or participating in their own care, or being able to envision themselves as whole people who can make decisions about their bodies. That is one thing that I really wanted to include, the way that being made into a hero keeps everybody else from taking on those responsibilities or those roles. 

When I think about how healthcare workers in Gaza have been murdered, I think about a webinar with Dr. Ghassan Abu-Sittah I was in very early on in the escalation of the genocide. He ended the webinar by saying, “Come to Gaza. My point in talking to all of you is to invite you to consider what we do after this escalation ends. Come to Gaza. We need people to rebuild.” That was really helpful for me to hear. I have not been to Gaza at this point, but the invitation makes the work that we have to do so much more tangible and takes the work of my colleagues in Gaza off of this pedestal. It’s like, oh yeah, this is work that all of us can do, that all of us can participate in. We can be a part of each other’s lives in really material ways.  

LS: You mention your experience of writing with a group of other healthcare workers throughout The Sexuality of Care. I wonder, being in a space like that, how did that open new avenues in your writing? What did it make possible for you artistically that didn’t feel possible before?

MKT: It made writing about nursing possible entirely. I had written about nursing very, very little in any way that could be seen by other people prior to that. In that writing group, none of us are in the same specialties, not all of us are nurses, but the shared understanding that we are participating in a violent system was profoundly helpful to be able to write about these tensions. Not only did we share an understanding of the violence, but also around how we have been groomed professionally to be care workers in ways that were very beneficial to the capitalist system, beneficial to the people making money off of sick people. The virtue script helps underpay people who are in professions that are valorized. Being among people who understood that, who understood we’re just people, we’re messy, we’re complicated, we’re not special in a way that the culture was making us out to be—it allowed me to process a lot of the violence that I have been a part of.

My ancestral relationship to collectivity has meant that a lot of my journey has been around recognizing, embodying, and claiming selfhood outside of the collective.

One of the core essays in The Sexuality of Care, “I Would Let You Hit Me Once,” was also in the zine we made together, In the Future There Are No Hospitals. It was written in response to one of our monthly prompts: “What is the relationship between healing and violence?” A question like that, I don’t think it could have easily happened outside of a writing group, and that response couldn’t have happened outside of the framework of, ‘okay, I need to make something for this month, and also I’m obsessed with this question and can’t stop thinking about it.’ 

LS: The idea of community segues into a tension I thought about a lot while reading The Sexuality of Care, and that’s present in Weaving Liberation too. Collectivism and its variants come up in both books—the collective, collectivist, etc. There’s a real complication in the text surrounding that word. On the one hand, you write about the collectivism of your natal family, which came with this prescription of bearing children and the inheritance of the caste system. You even describe the caste system as “imagin[ing] all people as part of a communal body.” On the other hand, the books are also very invested in the ideas of collective power, of collective grief. Anyone who has been involved in any type of liberatory politics has heard the expression collective struggle. How do you sit with that word and the complications it might bring?

MKT: The struggle between individualism and collectivism, as a Malayali raised in Jersey within the US, is very present. Most of the arguing, fighting, and conflict between myself and my parents was related to that inside-my-home versus outside-my-home tension. I write about this a little in [The Sexuality of Care], but in 2017 I biked across India and really understood where my parents were coming from in a way that I hadn’t before. That reshaped my relationship to that tension. I’m also part of a healing community, a spiritual community. My relationships within that spiritual community have helped me understand that the relationship between individual self and collective is really individual itself in some ways, in that my ancestral relationship to collectivity has meant that a lot of my journey has been around recognizing, embodying, and claiming selfhood outside of the collective. A  lot of people in the United States, a lot of white people in particular, are raised with very individualist notions—like, the family is all that matters. It’s very nuclear family based. There’s a real reason why a lot of movements focus on collectivity, but I don’t think collectivity is the only answer. I don’t think it can be one thing or the other because there is violence, messiness in both. I think there is a way that healing required me to grapple with that, and not romanticize either side of this kind of binary. It’s not something that I struggle with anymore–I’ve found my way in the in between. 

We were resisting because we needed to, not because we were going to make media.

LS: In Weaving Liberation, you bring up the idea of an archive as a collective. The subtitle of the book is even “an archival chapbook.” It gathers together emails, action transcripts, and other ephemera related to organizing for Palestinian liberation in the place where you live. You explicitly tie the goal of the chapbook to the lineage of ACT UP New York, in the way that they heavily documented their actions. Just to tease that collectivism line a little further, how did you see that playing out in a structural sense, in how you formed Weaving Liberation?

MKT: That book came directly out of my organizing community. It is something that I put together not really expecting it to get published. Where I live on Dena’ina land, there had not yet been a solidarity movement for Palestine in a way that resonated with me personally. A fifth of the population where I live is Indigenous. There’s a deep history of Indigenous resistance, and there are deep ways that Indigenous struggles where I live are very parallel to and connected with Palestine. Coming from Jersey and from being a teenager who was involved in a lot of anti-war activism on the East Coast, a lot of my role here was just being like, hey this specific form of anti-war organizing has been done before! Can we do these things, can we do something? A lot of what transformed me in that process was around trust, around trusting my community, and around being able to say I’m not from here, there is a lineage of Indigenous resistance that I have so much to learn from, and also, I want to resist genocide against Palestinians in this moment. I want to create and collaborate with people here. 

When I put together the chapbook, a huge part of what I was putting together was this archive because it felt really valuable and important to be able to take stock of what we had done over the last year, none of which could have happened had there not been other people to say yes, let’s do this. It’s so bizarre to have my name on the spine of the book, because none of this was created in isolation. Everything in that chapbook comes from being in relationship with the land, with the co-organizers, with the people who gave enthusiastic yeses. It also comes from having that experience of being in anti-war communities that truly kept me alive as a teenager. And so I think the collective archive in a place like where I live is so meaningful, because I don’t live in a major coastal city. I don’t live in a place where the histories are well-documented or visible in a large-scale way. People outside the state weren’t paying attention to what we were doing. We were resisting because we needed to, not because we were going to make media. The fact of us coming together to be with each other was the point and has created a community that continues. 

LS: It feels as if all of The Sexuality of Care is building towards the final essay, “In the Future There Are No Hospitals”: a final argument for the abolition of hospitals as we know them. Since the 2020 George Floyd uprisings, I think it’s fair to say most people who are even a little plugged into the news have brushed up against the idea of prison or police abolition. I also think that if I stopped a random person on the street right now and asked them to imagine a future where there were no hospitals, it might be a difficult task for them. I’m curious both about what lineages you drew on to think about the abolition of hospitals and a radically different way of caring, and also about your approach in steering the book towards this argument. How do you present a vision that’s outside of a lot of people’s imagination?

MKT: In a really direct way, I was thinking through this with other careworker-writers. For a very short period of time we were reading Are Prisons Obsolete? by Angela Davis and thinking about hospital abolition in very explicit ways with each other. My editor Jeanne Thornton really encouraged me to write into the ways in which hospitals already don’t exist now. Where I live there are only a couple of hospitals, and if you are from a place even more rural, you have to be flown to one to get specialized care. If you live in a village, you are often getting care on telehealth from a doctor who flies in every couple weeks or from community health aides who are trained in a very specific way to provide rural care. We can also think about the targeting of healthcare systems in Palestine, the ways that medical care, supplies, and gas continues to be rationed. There are lots of places where there are no hospitals in our present, and where people have to care for each other in ways that are outside of this hospital-centric framework. 

When I think of lineage, I think of blood sisters, the lesbians who donated blood to primarily gay men with AIDS who were being devalued systemically and having their care rationed. I think about how people have cared for each other in insurgent, decentralized ways outside of hospitals and the medical-industrial complex (MIC). I also think about how the book is very influenced by my relationship to India and Kerala. The way that I have understood my ability to imagine a world outside of the one I currently live in comes directly from a relationship with my homeland. There’s other places where people do things so fucking differently, where none of what is considered normal here is considered normal there. Yes, there is a history of nursing and hospitals in India, but that history is colonial. That history did not exist like a hundred fifty years ago, when there were no hospitals as we know them today. The idea that hospitals within the MIC are abnormal institutions is one that I think I’ve always felt really deeply in my bones, even if I didn’t have the research or the historical knowledge to back it up. And of course there’s also ayurveda and what we call complimentary or alternative medicine in the US. I cannot remember a time when I did not have an auntie who was putting a powder on my head to deal with an ailment or an uncle who, instead of going through chemo, was relying on ayurveda. Not to say that’s better or worse, not to say those are things I engage in now, but alongside having nurses in my family, I also had people who were practicing other kinds of medicine. There are lots of ways that the medical-industrial complex has been made strange to me.

There’s other places where people do things so fucking differently, where none of what is considered normal here is considered normal there.

And of course, disabled folks have been writing about how fucked up the MIC is for forever. There’s a much richer body of work around anti-psychiatry and psychiatric survivorship, but if you crossed out “psych ward” and put in “hospital,” you can see how the same violence is happening and is not necessarily being talked about in the same way. In terms of craft, I wrote that final essay with my friend—shout out Amanda Machado. I wrote a lot of the book on writing dates with her. She is not a healthcare worker, and I remember her reading the first draft of the last chapter and being like, “This scares me. I need help getting through this.” It was helpful to write with her in mind too and consider, how can I walk someone through this who does not have the intimate experience of being in the violence of the healthcare system however many hours a week for their job? 

LS: When you were talking about the fact that there already aren’t hospitals in a lot of places, it brought to mind how, even in areas where there allegedly are hospitals, trans healthcare bans have made them nonfunctional for so many people. Thinking about informal HRT networks that exist in my communities and which I’m positive are all over the place—it really echoes there.

Reading your work made me wonder how we can enter that imaginative space where we can think about a liberatory future. It’s one thing to say abolish hospitals, and it’s another to think about what comes after that. In The Sexuality of Care, you offer kink as one world-building tool. Reading about nursing in the context of kink brought to mind a phrase you sometimes hear in BDSM communities, “hurt without harm.” How can we use kink as a world-building tool in general, but especially when we’re dreaming up a more liberatory future?

MKT: I’ll start by saying that the “hurt without harm” thing is something that I struggle with. There’s a way in which we cannot control how we harm each other, or how hurt will or does become harm. For me, harm tends not to be a helpful framework around which to act or not act. What I think about more is risk-taking and the ways that kink encourages us or demands that we take risks, that we risk the potential of both hurt and harm in ways that can be useful to thinking about hospital abolition and liberation in broader ways. Kink, on a very practical and embodied level, can increase the window of tolerance for discomfort. It can allow us to take on personas, to enter different embodied states that are not our normal lives, and then to grapple with: How does that actually feel? What do I like and not like about that? What do I need to be in that state, and what do I need to leave it? Some of the people I love the most are often grappling with widening their window of tolerance for discomfort in an interpersonal way, in moving through conflict, in changing a pattern in their life. They’re also simultaneously going to the dungeon and experiencing states that are uncomfortable or painful or even really loving. Even being able to receive care and love in a negotiated way can be a kind of discomfort that requires negotiation, skill, and practice. In the book I’m talking more about negotiation and consent, but I think kink allows us to also imagine and scheme together. 

Even being able to receive care and love in a negotiated way can be a kind of discomfort that requires negotiation, skill, and practice.

When I was talking about how my organizing community came together, it’s mostly freaks. Many of the people I organize with are also people who I go to the dungeon with. They’re people who I have planned kink scenes with, with whom I’ve negotiated what we need to show up to do whatever it is we’re going to do together. Then, the next day, we’re at an organizing meeting asking what we need to do to care for each other on the streets, to make sure that as many people as possible can show up in a way that does not leave them traumatized or does not leave anybody in a position they are not consenting to. We have aftercare planned for all of our protests, and that comes directly from kink. My friend Eleanor is always like, I love hearing people who I’ve never seen in a dungeon ask, “What’s the aftercare plan?” It’s so sweet. There’s a very direct relationship there in the ways that organizing and dungeon scenes intertwine. 

My thinking around this has been really shaped by my friend aya iwa. She is also a nurse and a writer and kinky. We’ve talked about how we don’t envision a world of care where there is no violence. We also don’t envision a world where there is no trauma. Those are things that are inevitable. Rather than thinking about the end of traumatized people, we should be thinking through what we need to be in relationship with each other. Maybe it’s about healing or maybe it’s just about having a good time.  

We don’t envision a world of care where there is no violence. We also don’t envision a world where there is no trauma.

LS: The final chapter, “In the Future There Are No Hospitals,” includes a hypothetical case of care in a post-hospital world—how it would unfold, what it would look like. It’s a very generous offering to help people imagine that possible future. In the interest of pushing against the edges of our current imagination, I wanted to give you something of a speculative question. If we can pretend for a moment that we’re doing this interview in the future this chapter speculates, I would ask you: What was a hospital? 

MKT: A hospital was a place people would go when they didn’t know what else to do. Someone looked at you and tried to figure out if you were dying or not. Then you may or may not have been brought into a backroom where you may or may not have had all your things taken from you. You waited a long time for anything to happen, even if you were dying, maybe in a hallway or an area that’s curtained off from other people. You might have heard someone dying next to you. There would be a flurry of people coming in who drew your blood, checked your heart, and did tests. They may or may not have told you what they were doing or introduced themselves as they were running around. They would decide if you stayed or went, you had no role in that. You would be either “streeted” or “treated.” If you ended up staying, you’d be taken to another room. Every twelve hours you’d have different people interacting with you. You’d pick up on some of the dynamics between people, but you probably wouldn’t pick up on everything. You’d generally like most of the people, but there would probably be a few that you really didn’t like. Things would happen to you but often not with you, sometimes explained and sometimes not, depending on how sick you were. It would be very different if you were not awake or if you were made to go to sleep. You could either leave by dying or by being discharged or by walking out if you didn’t want to be there, which most people didn’t do, but it was a valid option. 

How would you describe hospitals?

LS: Coming from me, a chronically ill person who has been hospitalized in life threatening situations before: a hospital was somewhere where I went when I was dying in order to have the metaphorical hole patched but never filled. I would encounter a burst of people, usually not introducing themselves, or if they did I wouldn’t remember. They would tell me a lot of prescriptive advice I already knew. They would try to make me alive enough to leave. And then I would never see them again. That’s how I remember hospitals.