Abstract
Facts about the increased corporatization of medical care in the United States are offered here in order to trace their impact on patients and their care. The culture of medicine, as it has been impacted by a corporate ethos, is also addressed, including aspects of physicians’ training that make it difficult for them to empathize with their patients’ struggles, and the gradual evolution of practices that view patients as isolated, impaired “organ systems” targeted for siloed treatments. Narratives from patients who report their encounters with an alienating system are discussed from a perspective that focuses on patients’ resulting self-experience. Finally, three cases of chronically ill patients who engaged in psychoanalytic treatments in the context of their experiences with “not care” are examined in depth.