At a recent Worldmakers gathering, a distinction surfaced that has stayed with me because it feels vital to the future of healthcare.
The conversation emerged within a broader exploration of the worlds we inhabit, and the worlds that, in turn, inhabit us.
Drawing from Heidegger’s work, the group explored the distinction between the technological world and the poetic world. Later, in conversation with Jason Frasca, Iain Kerr offered another way of framing it: the world that is for us and the world that is with us.
Heidegger warned of the danger of a world understood exclusively through use. In such a world, everything appears as standing reserve; something waiting for us to extract, activate, optimize, or consume. A forest becomes timber waiting to be harvested. A river becomes hydroelectric potential. Even human beings become resources.
The ecological, social, and spiritual exhaustion of modern life is not separate from this way of seeing. It is one of its consequences.
If we look closely at ordinary experience, most of what we call “the world” now appears in this way: the car waiting to transport us, the light switch waiting to illuminate, the phone waiting to connect, the alarm waiting to wake us. We live surrounded by stored energy awaiting activation.
This orientation quietly trains us to believe that life itself should function this way — immediately available, responsive to demand, organized around utility. Everything is an object and we are the forever subjects.
But there are other ways of being in the world.
You feel it in a garden, where nothing meaningful can be rushed. A flower does not bloom on command. A bonsai cannot be optimized into maturity. I felt it reading a book on Japanese woodworking in which a master described spending ten years selecting the wood for a project. Not because he was inefficient, but because he understood himself to be participating in a living relationship rather than extracting a resource.
This distinction between for us and with us has surfaced in healthcare for years, though often in reduced form.
On the surface, it appears as the shift from paternalistic medicine toward collaboration: moving from healthcare delivered to passive recipients toward care shaped with patients, families, and communities. This matters deeply.
But I suspect this methodological shift conceals a more profound question.
Even collaborative healthcare often remains trapped inside a world fundamentally organized for us. We still imagine health as something provided, delivered, managed, accessed, optimized, or consumed. We still train clinicians to think primarily in terms of intervention, control, efficiency, and resource allocation.
It is not accidental that so much of healthcare is experienced as waiting.
As I write this, I am waiting for an MRI for my shoulder. After that, I will likely wait for treatment. Everywhere in the modern world, people are waiting for some form of healthcare.
And while waiting feels frustrating, it reveals the underlying logic of the system: healthcare exists as a storehouse of resources we hope to access when needed.
Even our reforms rarely challenge this assumption. We debate how to distribute resources more efficiently. We pursue technological solutions to reduce delays. We seek fairer access. But the underlying metaphor remains untouched: healthcare as something for us.
What happens if, as Iain suggested, we interrupt this world?
What if we blocked the assumption that healthcare is fundamentally a system of provision? What if we allowed another world to emerge, one in which care is only possible through with-ness?
This is difficult even to imagine because we possess so little language for it. Which may be why many people turn toward Indigenous traditions and other cosmologies that never fully separated humans from relationship, reciprocity, and mutual participation. It is not incidental that colonial violence was enacted largely by people who could only perceive the world as existing for them.
I do not claim to know what a truly with us healthcare world would look like. But I suspect it would begin by recognizing that life itself does not operate through isolated provision. Life is always mutual. Ecologies co-create one another. Bodies are relational processes. Care emerges through participation, responsiveness, dependency, and shared becoming. Not collaboration as a contractual arrangement between separate actors, but as a co-arising.
Something in that possibility feels profoundly alive to me.
It suggests forms of healthcare we do not yet fully understand — forms less obsessed with extraction, management, and delivery, and more attentive to participation, tending, reciprocity, and relationship.
That feels worthy of our attention.
What does this surface for you?
What might healthcare look like if it moved beyond the metaphors of resources, providing, and delivering? What becomes possible in a world organized less around what is for us and more around what is with us?