There is a well-established literature concerned with applying the humanities and arts in the education of health care and public health workers and in some cases the public. The vast majority of these efforts aim to improve health care by promoting empathy, sympathy, and sensitivity towards patients.

Rather less effort, however, is devoted towards having health care and public health workers as well as the public comprehend, much less act to change, the living and working conditions that are both the fundamental root cause of illness and make managing it difficult.

Using the arts and humanities to suggest how society – including the economic system of capitalism — could be transformed to promote health is even less common. German playwright and poet Bertolt Brecht’s works can be excellent resources in efforts to accomplish this goal.

Bertolt Brecht was a self-avowed communist who spent decades exploring the structures and processes of capitalism and their effects upon all aspects of life.

He produced an extensive repertoire of plays, poems, prose, and other works concerned with politics, public policies, and the lived experiences of individuals in the 20th century.

The quality and diversity of his poems leads many to consider him one of the premier German poets of the 20th Century. Brecht authorities David Constantine and Tom Kuhn see him as among the best three or four poets in all of German literary history.

One example of how his works can promote understanding of how living and working conditions under capitalism cause illness is provided by his 1938 poem “A Worker’s Speech to a Doctor.”

In the poem the worker under examination rebukes his physician’s suggestion that the solution to his health issues is simply to gain weight:

When we come to you

Our rags are torn off

And you tap around our naked bodies.

As to the cause of our illness

A glance at our rags would

Tell you more. It is the same cause that wears out

Our bodies and our clothes.

The poem explicitly directs attention to the living and working conditions associated with living in poverty. However, its implicit attack on the economic system of capitalism usually goes unnoticed.

While we found 70 instances where “A Worker’s Speech” was used to discuss the importance to health of living and working conditions, in no case was there an attempt to substantively examine and critique the capitalist economic system that sickens and then kills so many.

In contrast to the implicit critique of capitalism in “A Workers Speech”, three other Brecht poems written around this same time explicitly make this argument.

Brecht’s 1937 Call to Arms Trilogy expresses a more militant and critical tone. “Call to a Sick Communist,” “The Sick Communist’s Answer to the Comrades” and “Call to the Doctors and Nurses” – identifies the source of his illness, the commitment to continue the struggle, and a call for support from the doctors and nurses:

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.

The Sick Communist’s Answer to the Comrades

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.

Call to the Doctors and Nurses

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.

In our article “Beyond Empathy to System Change: Four Poems on Health by Bertolt Brecht” to be published in The Journal of Medical Humanities, we provide complete texts of the poems, analysis of their content, and discussion questions that raise fundamental issues concerning the nature of capitalism, its effects upon health, and the means of moving towards a post-capitalist socialist society.

We urge readers to apply these poems and discussion questions with their colleagues, students, and other communities. We also urge looking at Tom Kuhn and David Constantine’s 2019 Collected Poems of Bertolt Brecht, published by Liveright, which is chock-full of Brecht’s thought-provoking insights into health and its determinants, the nature of society, capitalism and socialism, and the means of transforming society.  To obtain a pre-print of our Journal of Medical Humanities paper, please contact Dennis Raphael at

Dennis Raphael is a professor of health policy and management at York University in Toronto, Canada.

William MacGregor is a PhD student in the Graduate Program in Health Policy and Equity, at York University in Toronto, Canada.

Martin Horn is an independent researcher in Montreal, Canada. 

Image: Bertolt Brecht (CC BY-SA 3.0 DE)