At present, we’re all potentially subject to impairment and intense suffering at any time. This could come in the form of a sudden illness, a traffic accident, or a shrapnel-filled bomb. Many of us don’t worry about this sort of thing too much until we find ourselves in a stretcher or pass out on the kitchen floor; many others live in continual terror of injury, disease, and death. Vulnerability structures society, as the fear of disability and pain compels people to show up to work and to tolerate or collaborate with the police state that promises security through surveillance and discipline. Economics dictate access to safety and healthcare; even with insurance, doctor visits and prescribed drugs often leave poorer folks broke and in debt.

Different kinds of harm and risk prompt very different responses. The specter of terrorism – exemplified by public bombings – causes panic, horror, and elaborate government reaction. The death of three and injury of over two hundred recently lead to martial law in Boston. However, the Boston area witnesses hundreds of automobile-accident fatalities annually without any similar mobilization. While you can perhaps attribute some of these differences to aesthetics and concentration of harm, the discrepancy aligns with a logic of power that values lives based on their status in hierarchies of wealth, race, ability, age, gender, and so on.

While money cannot (yet?) fundamentally challenge human frailty, the rich – and only the rich – get full access to cutting-edge treatments and comfortable accommodations while they endure the negative interactions of genes and environment that haphazardly affect us all. It’s when trauma – specifically violence – impacts the wrong people that troops appear. From Leon Czolgosz’s assassination of William McKinley in 1901 to Christopher Dorner’s attack on the Los Angeles Police Department, the powers that be freak out when violence flows up, not down, the hierarchy. Inequality means the bulk of us must be more vulnerable than those on top.

The current healthcare system in the United States – the scope of my experience – presents little reason to expect a technical solution to frailty any time soon. To the contrary, it commonly resembles a stereotypical medieval torture chamber more than a bacta tank or Star Trek infirmary. The first thing nurses typically do is stick the patient with a needle in order to draw blood for testing and put in an intravenous line. With difficult veins, this process becomes excruciating but they proceed regardless. The rationality of the emergency room transforms human beings into objects defined by vital statistics and extractable, analyzable substances. While emergency medical professions try to reduce pain, that’s a decidedly secondary concern. As long as you stay alive, they’re satisfied. If the required tests – a spinal tap and snot-sucking flu screening, for example – cause agony, so be it. You’re just a single individual, after all, and there’s always somebody sicker than you.

If such suffering necessarily led to understanding and improvement, techno-triumphalism might still be in order. Even though having my ankle and wrist broken by a car crash was one of the hardest things I’ve gone through to date, my treatment got the basic job done. I spent a month or two in an electric scooter but I’m walking again today. Unfortunately, that’s about as good as modern medicine gets. In other cases, especially tricky ones, doctors often don’t have a clue and just spit out standard therapies in the hope that something works. Generic approaches that produce passable aggregate results and bureaucratic imperatives predominate in the hospital. I discern limited genuine comprehension of the human organism. In that realm, we’re just scratching the surface. Remember that medical mistakes likely cause tens of thousands of deaths each year.

Considering the above, I value transhumanist outrage at the status quo but find the orientation toward technofixes unfulfilling. Insisting that our lives should, can, and will be radically better, transhumanism contains the essence of the revolutionary spirit. I want to nurture this sentiment while simultaneously separating it from hypothetical developments such as nanotechnology and artificial general intelligence. Let’s keep those desires in mind but not base our plans and politics on them. Let’s seriously contemplate how we can approximate what we want – universal liberty, abundance, comfort, creativity, and curiosity – out of available materials.

To that end I advocate community and individual struggle against hierarchy, oppression, and inequality as the path to human improvement. As an alternative to actually existing industrial capitalism’s fixation on novelty, luxury, and excess or the state’s fascination with discipline and regulation, I propose an emphasis on baseline necessities and comforts like housing, clean water, nutritious food, public transportation, and the best healthcare possible. I’m now less interested in making healthcare more efficient – a commonly cited goal – than I am in making it more compassionate and less stressful. The same applies to labor. While sustainability is a must, I don’t want to optimize output at the expense of mental health.

A recent free-healthcare event I participated in as part of (un)Occupy Albuquerque serves as an embryonic instance of what I hope to see. Acknowledging our shared vulnerability and the uncertainty as well as desirability of imagined technological remedies, let’s enhance the human condition by transforming society to minimize suffering and maximize pleasure. There’s no reason to wait.