Our October LMCC meeting took place on Wednesday, October 25 at 5:45pm in UNC’s newly renovated HHIVE Lab (Greenlaw 524)
and via Zoom. We discussed Contagious: Cultures, Carriers, and the Outbreak Narrative by Priscilla Wald (Duke UP, 2008). Specifically, we discussed:
- “Introduction” (pp. 1-28)
- Chapter 1: “Imagined Immunities: The Epidemiology of Belonging” (pp. 29-67)
- Optional reading: Any additional chapter of your choice
If you missed the meeting, you can still access the text on the Readings page of this site!
You can also access the recording of our meeting here.
Our next meeting will take place on Wednesday, November 29 at 5:45pm in UNC’s HHIVE Lab, Greenlaw 524. If you can’t attend in person, you can attend in real-time via our usual Zoom link. We will send out an announcement soon with more information for that meeting.
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Wald, Priscilla. Contagious: Cultures, Carriers, and the Outbreak Narrative. Duke UP, 2008.
Some key passages:
“Introduction” (pp. 1-28):
Discussing SARS in 2003: “Accounts of prior disease outbreaks helped epidemiologists identify and respond to the problem. Such accounts also supplied points of reference for journalists seeking to inform the lay public about the spreading infection. Even medical researchers relied on their knowledge of similar microbes as they worked to understand the unfamiliar one. As these precedents allowed experts to make sense of a new situation, they also shaped what they saw and how they responded” (1).
“Contagion is more than an epidemiological fact. It is also a foundational concept in the study of religion and society, with a long history of explaining how beliefs circulate in social interactions…. [T]he circulation of microbes materializes the transmission of ideas. The interactions that make us sick also constitute us as a community. Disease emergence dramatizes the dilemma that inspires the most basic human narratives: the necessity and danger of human contact” (2).
The outbreak narrative: “The outbreak narrative—in its scientific, journalistic, and fictional incarnations—follows a formulaic plot that begins with the identification of an emerging infection, includes discussion of the global networks throughout which it travels, and chronicles the epidemiological work that ends with its containment” (2).
Goal of the book: “Outbreak narratives and the outbreak narrative have consequences. As they disseminate information, they affect survival rates in contagion routes. They promote or mitigate the stigmatizing of individuals, groups, populations, locales (regional and global), behaviors, and lifestyles, and they change economies. They also influence how both scientists and the lay public understand the nature and consequences of infection, how they imagine the threat, and why they react so fearfully to some disease outbreaks and not others at least as dangerous and pressing. It is therefore important to understand the appeal and persistence of the outbreak narrative and to consider how it shapes accounts of disease emergence across genres and media. That is the project of this book. I am motivated in this work by my conviction that an analysis of how the conventions of the outbreak narrative shape attitudes toward disease emergence and social transformation can lead to more effective, just, and compassionate responses both to a changing world and to the problem of global health and human welfare” (3).
“The masks depicted what SARS threw into relief: human beings’ futile efforts to defend themselves against the threat of illness in the daily interactions made global by contemporary transportation and commerce. Human networks became the conduits of viral destruction” (4).
“The Newsweek account accounts fostered ‘medicalized nativism,’ a term coined by the historian Alan Kraut to describe how the stigmatizing of immigrant groups is justified by their association with communicable disease; it implies the almost superstitious belief that national borders can afford protection against communicable disease” (8).
“…the disease is associated with dangerous practices and behaviors that allegedly mark intrinsic cultural difference, and it expresses the destructive transformative power of the group” (8).
“The temporal frame implicit in the description of certain practices as ‘primitive’ obscures the understanding of those practices as expressions of poverty. While the social and spatial transformations of global modernity exacerbate this poverty, the intrinsic temporality provided by the use of ‘primitive’ enables contradictory representations of global modernity in media accounts of SARS: global networks as both threat and solution” (8).
“The physiological metamorphosis of human carriers turns them into representational figures of the fact, the danger, and the possibilities of human interdependence in a shrinking world” (9).
“As they simultaneously forecast the imminent destruction and affirm the enduring foundations of community, they offer myths for the contemporary moment, which explains the imaginative hold and the persistence of the story that I am calling ‘the outbreak narrative.’ The consequences in all of these realms when medicine meets myth is the subject of this book” (10-11).
“When communicable disease makes it dangerous to congregate and life threatening to minister to the sick, such collapses [of social relations, rituals, and institutions] are not surprising. And the psychological numbing attendant on disasters of great magnitude compounds the dissolution of social organization” (11).
“[The] word contagion literally means ‘to touch together’, and one of its earliest uses in the fourteenth century referred to the circulation of ideas and attitudes. It frequently connoted danger or corruption. Revolutionary ideas were contagious, as were heretical beliefs and practices. […] The medical use of the term was no less metaphorical than its ideational counterpart. The circulation of disease and the circulation of ideas were material and experiential, even if not visible. Both displayed the power and danger of bodies in contact and demonstrated the simultaneous fragility and tenacity of social bonds” (12-13).
“Human carriers teach the shared lesson of psychoanalysis and bacteriology: that human beings lack self-knowledge. Like Oedipus, we do not know who—or what—we are. It is what makes us dangerous, and it mandates new codes of conduct…. The earliest identified human carriers analogously dramatized the need for new ways of being in a world of newly identified microbes and increasing human contact…. Human carriers readily became scapegoats: examples of the transgressions of the group for which they symbolically suffered” (17).
“As narratives such as The Decameron demonstrate, the social experience of disease, the image of communicability, and the materialization of interdependence that characterize depictions of epidemics suggest an epidemiology of belonging through which people might experience their emergence as ‘a population.’ The idea of contagion was demonstrably formative for the experience of ‘community’ in the early years of bacteriology, when Freud and Durkheim were writing” (18).
“Epidemiologists build on precedents from previous outbreaks that they hope will make future outbreaks comprehensible, and ultimately preventable, or at least containable. When epidemiology turns an outbreak of communicable disease into a narrative, it makes the routes of transmission visible and helps epidemiologists anticipate and manage the course of the outbreak. In that transformational capacity, the epidemiological narrative is, like the microscope, a technology, and it is among the epistemological technologies that delineate the membership and scale of a population” (19).
“Epidemiology dramatizes human beings’ mortal struggle with their environment, social and biological” (21).
“These formulations projected a narrative logic onto epidemics, and the role of epidemiology was at once to read and to write the epidemic as a story of detection with predictive value. Narrative was thus central to epidemiology, which marked the conjunction of art and science, where it epitomized the most profound faith in human achievement” (23).
“…the twentieth century witnessed increasing US. Economic and political dominance in the institutionalization of ideas about global health worldwide By the end of the century, cultural production would reinforce the importation of these ideas. The ‘outbreak narrative,’ while not exclusively a U.S. phenomenon, is part of that production. Its circulation across genres and media makes it at once the reflection and the structuring principle of scientific and journalistic accounts, of novelistic and cinematic depictions of communicable-disease outbreaks, and even of contemporary historical studies of the central role of communicable disease in human history” (26).
“Tracing the evolution of these characters and the narratives that feature them is central to my aim in this project, which is to understand the appeal and consequences of stories about disease outbreaks and disease emergence generally. The outbreak narrative is conventional and formulaic, but it is also always evolving. Stories of disease emergence in all their incarnations are so powerful because they are as dynamic as the populations and communities that they affect” (28).
Ch. 1: “Imagined Immunities: The Epidemiology of Belonging” (pp. 29-67):
“An expanding human population worldwide meant that human beings were living and working in previously uninhabited places and coming into contact with unfamiliar or dormant microbes, which in turn globe-trotted by hitching rides in hosts—human, animal, and insect—using the variety of transportation networks that constitute the global village. Those networks also helped to produce social and political transformations that were of particular interest to social scientists” (30).
“Fictional accounts of outbreaks did more than reflect and convey they lessons of science; they also supplied some of the most common points of reference, which included social transformation and disease emergence in their own right” (31).
“As fictional outbreak accounts dramatized the scenarios of disease emergence, they consolidated the conventions of the familiar story. In this chapter, I will chronicle the circulation of the language, images, and story lines through scientific and medical publications, journalism, fiction, and film to document how they became conventional and to introduce the narrative they produced in the process. That narrative links the idea of disease emergence to worldwide transformations; it interweaves ecological and socioeconomic analysis with a mythic tale of microbial battle over the fate of humanity. The outbreak narrative fuses the transformative force of myth with the authority of science. It animates the figures and maps the spaces of global modernity. It also accrues contradictions: the obsolescence and tenacity of borders, the attraction and threat of strangers, and especially the destructive and formative power of contagion” (33).
“I mean to designate how the outbreak narrative articulates community on a national scale, as it depicts the health and well-being of those legally within the borders of the state as a mark of their belonging. The outbreak narrative is a powerful story of ecological danger and epidemiological belonging, and as it entangles analyses of disease emergence and changing social and political formations, it affects the experience of both” (33).
“Emerging infections offer proof that the industrialized and technologized North cannot afford—economically, socially, politically, and medically—not to think about health globally” (34).
“This convention is part of the vocabulary and geography of disease emergence. An infection may be endemic to an impoverished area, but it emerges when it appears—or threatens to appear—in a metropolitan center of the North. That is why microbes can be simultaneously ‘primordial’ and ‘emerging’” (34).
“Microbes tell the often hidden story of who has been where and when, and of what they did there. Contagion, that is, charts social interactions that are often not otherwise visible, and the manifestation of those contacts and connections is another important feature of outbreak narratives” (37).
“The human contact materialized by the spread of a communicable disease reveals an interactive and interconnected world. It makes visible the nature of those exchanges that are often concealed; communicable disease offers records of desire, of violence, of sexual commerce, all of which are especially apparent in sexually transmitted diseases. The outbreak narrative incorporates those records as it fashions the story of disease emergence” (38).
“The outbreak narrative is itself like the epidemiological map and the electron microscope, a tool for making the invisible appear; it borrows, attests to, and helps to construct expertise. The points on the epidemiologist’s map and the organism under the researcher’s microscope make little sense without the story that is told about transmission. And that story cannot account for the spread of the disease without registering the interactions that bear witness to the connections of human communities, which are conceived simultaneously on local, national, and global scales. The outbreak narrative manages the consequences, as it makes sense of, what the communicable disease makes visible” (39).
“An ecological view of disease emergence held that newly surfacing infections marked human beings’ coming into contact with new microbes—microbes into whose environments an expanding population ventures (as they clear forests, for example), microbes whose animal-host populations suddenly grow because of environmental changes (such as an increase in the numbers of deer mice, which carry hantavirus), and microbes that mutate for a verity of reasons, including the proximity of pigs and ducks in some agricultural practices” (40).
“The earliest wave of fictional outbreak scenarios in the 1990s did not embrace a change in worldview. Although they often espoused an ecological perspective, they dramatized the human irresponsibility that caused outbreaks in a series of violations…. Neither the analysis of the problem nor the imagined solutions entailed a radical shift in perspective” (41).
“Nothing better illustrates the reluctance to accept Nature’s indifference toward human beings and the turn from the ecological analysis in accounts of emerging infections of all varieties than the seemingly irresistible tendency to animate a microbial foe…. Scientists emphasize the microbes’ lack of conscious agency. But the animation of the microbe invariably surfaces during the course of these accounts…. In discussions of infectious disease, microbial agency thus slides imperceptibly into enmity, especially in descriptions of specific outbreaks” (42).
“It is not unusual for a virus to be described as a foreigner or even an immigrant…. The metaphor reinforces the association of strangers, particularly immigrants, with disease outbreaks” (42-43).
“The mystical response is evident in descriptions of the earliest visualizations of viruses, which introduced scientists to a new life form—to something, in fact, that challenged their very conception of life, since viruses could only sustain themselves and reproduce inside of a host cell. They existed in a liminal state, a kind of suspended animation, when outside the host cell. The awe of being in the presence of a new life form, or perhaps of a life form that could alter the way science conceptualized life, characterized many early descriptions of viruses and survives in how they are depicted in the outbreak narrative” (43).
“Emerging infections in these accounts are paradoxically a product of global modernity and an indication of a return to a primitive past, a world not only without antibiotics (within the memory of people who are still alive today), but one in which medicine offered treatments that were often no more effective than prayer and witchcraft” (44).
“That temporality also characterizes representations of the geographical places that are typically associated with these diseases and that seem to spread with them: timeless, brooding Africa or Asia, the birthplace of humanity, civilization, and deadly microbes” (44).
“With its ‘African or Asian heritage,’ the ancient microbe incarnates the place of its ostensible origin, which spreads, with the disease, to the site f its outbreaks…. Such formulations implicitly constitute disease outbreaks as the incarnation of a timeless and diseased ‘Third World’ leaking, through the microbes, into the metropolises of the ‘First World’…. This rhetoric stigmatizes impoverished places as it obscures the sources of poverty and of the ‘uneven development’ that characterizes globalization” (44-45).
“Outbreak accounts give microbes a natural history in the primordial landscape of the developing world; they offer a contemporary analysis in their depiction of a careless human intrusion on a discrete, prehistoric ecosystem combined with the poverty and violence that appear endemic to these regions. Omitted in their distant histories and contemporary analyses, however, is the history of colonialism and decolonization” (46).
“But without an analysis of how communicable disease, along with poverty and violence, contributed to the construction of the geographical idea of the Third World, even accounts that acknowledge how the politics of colonialism and decolonization produced contemporary conditions can reproduce the geography of disease that is such a consistent feature of the outbreak narrative” (46-47).
“The outbreak narrative is haunted by the unacknowledged legacy of decolonization and its expression in disease emergence; it promotes instead an understanding of communicable disease as a cause rather than an expression of social formations throughout history” (47).
“Implicit in the history of tropical medicine is the image of tropical places as dangerous and diseased and of disease as resistant to the civilizing project. Disease is not on the side of the colonizer in this case; the colonizer, in fact, is an intruder. Medicine, by contrast, is part of the civilizing process, an expression at once of colonial power and the benefits of the colonization” (50).
“The outbreak narrative reinforces national belonging through more than the identification of the health of the population with state institutions. The depiction of contagion offers a visceral way to imagine communal affiliations in national terms” (51).
“The outbreak narrative manifests that fascination as well, and it reveals points of intersection between those genres: the nationalist implications of the germ theories and the incorporation of communicable disease into the imagining of the nation” (51-52).
“As communicable diseases depict global connections, and the ecological perspective of the germ theories stresses communal transformation, the conspicuously imagined community is certainly in danger of dissolution. Yet, from its fragility—its tenuousness—it also derives power, reminding its citizens that the community, and all of the benefits it confers on them, is contingent on their acts of imagining, just as the literal health of the nation depends on their obeying the regulations set in place by medical authorities” (53).
“While outbreak narratives proliferate in periods of major demographic shifts and increased social contact, their mappings do more than register the related anxieties surrounding contagion and assimilation. They address even as they express those anxieties, materializing the microbial communions that mark the theology of the imagined community as communicable disease transforms a social group into a mystically connected biological entity” (53-54).
“Long before the sources or routes of transmission could be identified, of course, communicable diseases were blamed on foreigners, strangers, and travelers as well as other internally marginalized groups. Yet the discovery—or, as Bruno Latour argues, the invention—of microbes made it possible to document the routes of transmission and the existence of healthy human vectors of disease, turning the stranger/carrier into the scientific fact of a medical threat and the embodiment of the fundamental paradox in the principle of community” (56).
“As the carrier of both unfamiliar microbes and genes, then, the stranger is at once dangerous and necessary. As the potential distributor of those microbes, even the non-alien carrier functions as a kind of stranger, the figure who must be identified, contained, and reintegrated. The community articulated through disease is balanced precariously between its fear and exclusion of strangers and its need for them, poised anxiously between desired stasis and necessary flux” (56-57).
“The ever-present health threat, in other words, signals at once the (presumed) need for the power of the state to regulate its borders and protect its citizens and the limits of that power. Outbreak narratives derive their subtle and complex power less by sustaining the language of crisis than by invoking the precariousness of the imagined community; that precariousness empowers the individual and elicits what I see as a consensual act of imagining” (58).
“In some of the less subtle outbreak narratives, the germs overtly challenge Americanism rather than humanity—or, humanity conceived through the terms of Americanism” (63).
“Science and viruses may well know no boundaries, but national borders reassert themselves in the monitoring and treatment of epidemics and in the political economy of disease. The nation’s job is to safeguard its citizens, reclaiming its own as it reestablishes the stability of the community” (65).
“If epidemiologists map the imagined community of the global village, charting infectious diseases as they cross national borders, the depiction, as much as the management, of those diseases reinforces the boundaries. The use of disease to imagine as well as regulate communities powerfully enacts the most anxious dimensions of national relatedness. The inextricability of disease and national belonging shapes the experiences of both; disease assumes a political significance, while national belonging becomes nothing less than a matter of health. With their powerfully defining ambivalence, those terms mandate the dangerous necessity of the stranger and the representational technologies by which that stranger is brought into the community” (67).
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Note: The featured image for this post is from Wald, p. 39: “General McClintock (Donald Sutherland) sees ‘the worst of it’ in Outbreak (dir. Wolfgang Petersen, 1995).”