A Symposium on Disease


A Symposium on Disease

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What we talk about when we talk about virality

William Burroughs called language a virus as early as 1962, in The Ticket That Exploded, but it’s not clear whether he ever actually wrote the words “Language is a virus from outer space.” Laurie Anderson thought he did when she sang the same words in 1986, in any case, and since then the sentence itself has, arguably, gone viral.

The word virus came into Middle English from Latin, where it meant slime, venom, or poison. In the eighteenth and nineteenth centuries, doctors used it to mean any infectious agent, applying it to smallpox, which is a virus according to modern understanding, but also to syphilis and typhus, which aren’t. (Edward Jenner, who figured out that people who got cowpox wouldn’t get smallpox, discovered vaccination—literally “cow-action”—without knowing why it worked or what a virus was.)

Decades later we recognize viruses as small arrangements of big molecules, with DNA or RNA at the core. Unlike other infectious agents, viruses cannot reproduce on their own; they hijack a host cell and cause it to copy their DNA or RNA, in turn instructing the host cell to make the rest of their few parts. Some viruses, like Ebola, do so very rapidly, until the host cells burst; others hang out in their hosts and reproduce slowly, even harmlessly. If you wanted to invent a virus that would stick around forever, your best bet would be something less like Ebola, which kills hosts and can prompt quarantines, and more like the common cold, whose hosts generally survive to keep passing it on.

Because viruses are, in a sense, information— genetic instructions adapted to some other, larger thing that must work to transmit them—they make an especially good analogy for the spread of ideas, or words, or media properties. Rebecca Black’s song “Friday” didn’t spread itself; lots of people had to view it and share it. Indeed, like a work of art, a virus is only ambiguously or figuratively a living thing. “Are you too deeply occupied,” Emily Dickinson asked a correspondent, “to say if my Verse is alive?” Dickinson’s verse continues to live, as a virus does, because we reproduce it. Whatever the verse or the video or the meme does to us causes at least some of us to pass it on.

Words can work the same way (see meme, for instance, or viral), insofar as we choose to use them, although—and this was part of Burroughs’s point—you get deep into the philosophical weeds once you ask in what sense we choose to use language at all. Language, though composed of nonliving things (words), might be said to enter and “infect” the mind of a learner; once it’s in there, barring brain disease, it can’t get out, and, like the common cold, it spreads by casual interaction—i.e., speech.

Neal Stephenson’s popular cyberpunk novel Snow Crash (1992) took Burroughs’s metaphor of language as virus about as far as it can go. His plot relied on the fact that DNA, RNA, computer code, neurochemical signals, and human language are all means of transmitting information, and can all affect us without being consciously understood. The novel’s bad guys, led by a televangelist, “infect” the citizenry with information transmitted and reproduced as a recreational drug and as computer code; once infected, people understand, obey, and spread a language that can change their personalities and beliefs.

Snow Crash plays not only with the idea that language in general, and languages in particular, spread like viruses, but with other metaphors drawn from it. On one hand, business franchises and viruses “work on the same principle,” as one character explains: “you just have to find a sufficiently virulent business plan.” (The Oxford English Dictionary finds the phrase viral marketing first used in reference to the Apple Macintosh computer, released only three years prior to the novel’s publication.) Conversely, Stephenson suggests, an institutionalized orthodox faith is to emergent, charismatic faith much as cowpox is to smallpox: a relatively tame one can protect us from its own virulent strain.

Ideas are not really viruses, but they spread as viruses do—from person to person, at differential rates. Some ideas help us protect one another from real viruses (washing our hands, getting a flu shot). Others do the reverse. Half-baked notions about epidemic contagion, and a failure to understand that not all viruses spread the same way, shaped US politicians’ response to Ebola in 2014, and, with a far higher body count, to HIV/ AIDS beginning in the 1980s. Seth Mnookin’s 2011 book, The Panic Virus, performed a kind of epidemiology on the idea that vaccines cause autism. Once out in the world, and however often discredited, that idea behaved like an infectious agent itself, becoming endemic in certain communities, mutating in ways that protected it from doctors’ sustained attempts to wipe it out, and generally doing a great deal of harm. In On Immunity (2014), essayist Eula Biss describes parents’ decisions not to vaccinate their children as both a mistake of fact and a symptom of privilege: “If I exercise privilege,” she explained to an interviewer, “I may not hurt [my son], but his body serves as a vector for disease.”

The Centers for Disease Control reported fifty-five cases of measles in the United States in 2012, and over six hundred before the end of 2014. If we’re going to go on referring to things as “viral,” we should take care to know what a virus is, and how viruses work, and how we can protect one another from the damage real ones can do.

Stephanie Burt

The War on Terror: delayed symptoms

More than a decade later, it’s still unclear who actually said the words. We think we know that, in 2004, they were said to the journalist Ron Suskind, who published them in the New York Times Magazine. We know that there are perhaps half a dozen members of George W. Bush’s first-term war council who might reasonably be considered suspects. They are not all the way gone, this cast of defective vulcans, men whose acronyms and abstractions and daisy- cutter diplomacy terraformed nations and upended or just ended a great many lives both half a world away and much closer.

The world we live in still bears the bruises they left, but it is difficult, from our present distance, to remember these people with any degree of specificity. It is, anyway, maybe not worth trying to remember which was who, or how; which was the one with the neat beard who never spoke on the record, which was the bald one and which the one with the crisp LEGO-man brush cut, which the one indicted for lying to Congress a generation earlier, which the professorial one, which the leatherette lifer with the consultancy. The thing is that any one of them could well have been the one who said, to Suskind:

We’re an empire now, and when we act, we create our own reality. And while you’re studying that reality—judiciously, as you will—we’ll act again, creating other new realities, which you can study too, and that’s how things will sort out. We’re history’s actors… and you, all of you, will be left to just study what we do.

It’s hard to say that these words—which also serve as the epigraph for The Infernal, Mark Doten’s vicious and commanding first novel— have aged well. Their delirious vanity is no less shocking after a decade during which they’ve been proven more or less true; the curdled contempt shot through the statement—judiciously, as you will—has only ripened toward a fuller toxicity in the intervening years.

That is, everything predicted by this anonymous speaker—it sounds a bit like Cheney, but so did a great many things in US politics in October of 2004—more or less came to pass, and all the various bad actors who might have said these words mostly escaped shame and censure, easing into low-impact board memberships and sinecures or spreading like a stain into the private sector. The wars went on, and go on, without them, and there is still the sense that the rest of us are chasing after what these men so casually set in motion. The world they made and unmade, along with the feeling of that pursuit, is something like the subject of The Infernal, and the result is every bit as uneasy as it must be.

That deep and sorrowful unease—the wide current of grievance and wrongheaded righteousness in the culture, the sense of things unattended and unspooling at the margins, a certain globalized violence forever trying the locks and hunting for a way in, and the resulting bunkered inwardness of people who know they are very well watched and not especially well protected— has suffused the most memorable novels about the War on Terror years. Tom McCarthy’s icy Remainder embedded its critique in a meticulous evocation of the era’s pot-bound claustrophobia; Heidi Julavits leaned into the abstraction and paranoia that filled in the era’s new gaps in The Effect of Living Backwards; Joseph O’Neill simply wrote a beautiful novel, Netherland, about sad people in an upended world. Doten certainly does not skimp on the ambient unease in The Infernal—to be clear: he really does not skimp on any variety of unease—but he plugs into a different, doomier thing.

Some of this is simply a result of how the book is shaped. Doten introduces his dramatis personae—a cast that includes Iraqis and Americans variously shredded by war, and wildly fictionalized versions of real and recognizable figures such as Attorney General Alberto Gonzales, Osama Bin Laden, former US viceroy L. Paul Bremer III, and Mark Zuckerberg—and then turns them loose in a world scarred by real war and haunted by a ravenous, omnipresent, predatory technology whose dystopian specifics are Doten’s own creation. These characters’ stories are pried, painfully, from a badly burned boy who has been discovered in Iraq’s Akkad valley, through the use of a murderous device called the Omnosyne. The voices that The Infernal comprises are all within this dying burn victim; when the Omnosyne has finished extracting them, the emptied boy will die. The Omnosyne’s inventor and master is Jimmy Wales. In our world, Wales is best known as the creator of Wikipedia; in Doten’s, he’s a tech-savvy version of Hannibal Lecter, a remorseless multiple murderer freed from decades of solitary confinement to wring every voice from the suffering boy. The Omnosyne, too, is coming apart, as a result of which the child’s stories are shot through with gouts of random numbers and letters, encrypted data or mere noise. There, as throughout The Infernal, information overwhelms more than it informs. “We have everything—have it all perfectly,” Wales writes in his log. “But we don’t know where it is.”

What Wales extracts from the boy, at the cost of his life, is by turns comic and obscene. As in Remainder, reiteration and recurrence first haunt the broader story, then devour it. Every story line is bent, and most every storyteller eventually broken, from within or from above, by similar strains of vanity and delusion and weaponized narcissism. Nothing in The Infernal recurs quite so stubbornly or mercilessly as violence and death, and suffering comes in different ways for different characters: an Iraqi nurse is bled dry by the predations of war; an unraveling veteran unravels; Bin Laden blithely causes the death of one devoted boy after another through increasingly slapstick means; Bremer exults in his ignorance and idiosyncrasy as Baghdad’s skyline seethes and burns outside the window. But suffering comes, universally, and it just keeps coming.

Despite Doten’s legitimately thrilling inventiveness and wild, dark humor—and, more rarely, his empathy—none of this is any more fun than it sounds. But entertainment is not the task Doten set himself here; he’s after something darker and more difficult. Doten has created an impressionistic map of the atomized imperial realities of the War on Terror, and it is every bit as harrowing to consider as the inane and bloodthirsty era it depicts. Crucially, though, he does not do this work with the neutered, judiciously-as-you-will passivity presumed in that Cheneyite aside; he rejects the realities that the War on Terror’s architects have given us to chase, and goes in search of his own. That refusal, which is both bigger and braver than it seems at first, is what gives The Infernal its power. It’s a start.

David Roth

Lifestyles of the gluten-intolerant

Last April, 822 Kickstarter backers pledged $94,587 to launch a national magazine called Gluten-Free Forever. GFF, as it is known for short, is thus the rare contemporary magazine that the public is willing to pay to read, yet its success is hardly surprising. One out of every 141 people in America has celiac disease, the condition aggravated by gluten, but around 30 percent of us are currently trying to avoid the protein. Gluten-free is not so much a diet, or a disease, as a fad that has appropriated the rhetoric of illness to legitimize a lifestyle—sparking a massive industry with merchandise for every niche, from bakeries and beauty products to blogs, cookbooks, and dining guides. And magazines.

The name Gluten-Free Forever declares the magazine’s intention to reify the fad, or the condition from which it springs, as an eternal category of human identity. But what, exactly, does it aim to commit to immortality? Most restrictive dietary regimens are founded in some sort of worldview—eating animals is wrong, processed food is not nourishing—but the gluten-free population shares only a negative personal preference based on trying to avoid discomfort. (Even the supposed health benefits are scientifically shaky: there’s not yet any definitive medical proof for non-celiac gluten sensitivity.) But this is not a movement that seeks identity in ideas; if it is at least notionally rooted in a diagnosable condition, it stands to reason that gluten-free should be a culture of feeling, not thinking—and that its adherents should derive identity not from personal philosophy but from personal pathology.

Gluten-Free Forever is noticeably skewed toward reflecting what its readership wants to read about itself. For one thing, its overall tone and format could be described as “insistent normalcy”: the first issue conspicuously features foods usually banned by gluten-free diets (pie, pasta, sourdough); every article seems to have some version of the claim that this doesn’t taste like gluten-free food—this actually tastes like good food. In the realm of healthy living, this is a culinary coup d’état, reframing as it does the very idea of the diet as personal indulgence instead of self-denial.

For another, the magazine, which is unapologetically high-end and unusually lavishly designed, given the soccer-mom aesthetic of the genre—while competitors Go Gluten Free, Delight Gluten-Free, and Gluten-Free Living all featured cookies on the cover of their holiday issues, GFF’s first issue has chef Lena Kwak posing like a menacing kabuki dancer, face colored ghostly white with gluten-free flour—states as its editorial mission to showcase “just how easy it is to live a gluten-free lifestyle, full of world-class food and indulgent travel experiences.” Its recipes double as characterization tools that point to a well-rounded social life, their headlines offering an unrestricted parade of human moods: “Weeknight Warriors,” “Spread the Love,” “Happy Ending,” “Paella: the Instant Party!” Some are partially framed as travel stories, inviting the reader on a journey to the “chef ’s table” for a potluck or to a cottage to make whole-grain pasta. Among these glowing visions of gluten-free glamour, celiac or not, who wouldn’t want to join?

Indeed, it could be argued, with tongue only half in cheek, that GFF is an elegant pitch to sign up for a disease. But that’s the point of its curious rhetorical alchemy: by excising all the negative symptoms of celiac disease from the conversation, the magazine works to turn the illness at the heart of gluten-free culture into a positive lifestyle choice—a choice to be healthy, to feel better. “The only things I gave up were physical discomfort, exhaustion, [and] some unwanted pounds,” the editor tells us in her opening letter. “I looked better, felt better and ate better.” It’s hard to say whether that’s completely true, but it’s also hard to argue with those results.

Theodore Gioia

Tomorrow’s epidemic of forgetting, today

Too often we get caught up in the utilitarian aspects of the apocalypse. We wonder what we will need—canned goods, shotguns, bars of gold, hand sanitizer?—as though imagining a video game, as though the right items will help us make it past Level End-of-the-World. What we don’t ask is what memories we will need to make it through the end of days, how we will safeguard the past.

Perhaps we don’t ask these kinds of questions because so many of our fantasies of the apocalypse come with the hope of a clean slate. Most people will die, and those that remain will face a hard existence, but they will be free to walk away from their old lives and reinvent themselves. It’s a fantasy as old as Genesis: with a big enough flood, one gets to start over completely. All of Noah’s bad credit and debts, the embarrassing things his coworkers know about him, the lies he told his first girlfriend and never got around to correcting—all those vanish with enough rain and destruction.

But no disaster is ever so complete, and the aftermath is always messier than we want. There are always traces of the past, lingering memories interfering with our fantasies of rebirth. A recent spate of literary apocalypse novels focus on our relationship to memory, most notably Emily St. John Mandel’s Station Eleven and Colson Whitehead’s Zone One. In Mandel’s novel, the survivors of a catastrophic flu gather to create a Museum of Civilization, a living love letter to all that’s lost; the protagonist of Zone One does manage to mostly reinvent himself, but most of the post-virus zombified are doomed to replicate the mindless tasks and jobs they held in life. The past, it seems, clings to us even after the deluge, like trash and carrion revealed at low tide.

Add to these literary apocalypses Laura van den Berg’s Find Me, one more novel that mines the tension between cataclysm and remembrance. In van den Berg’s end-times scenario, the epidemic tearing through the population is a prion disease somewhat similar to Creutzfeldt-Jakob, one that destroys not just cognitive functions but also memory. As the protagonist, Joy Jones, explains early on,

it is an epidemic of forgetting. That much is known. First: silver blisters, like fish scales, like the patient is evolving into a different class of creature. Second: the loss of memory. The slips might be small at first, but by the end the patient won’t remember the most basic details of who they are. What is a job? What is a staircase? What is a goldfish? A telephone? A spoon? What is a mother? What is a me?

Quarantined in a hospital in the middle of Kansas for patients who’ve been exposed to the disease but don’t yet present symptoms, Joy and her fellow inmates do their best to follow two basic rules: “1. Don’t get sick. 2. Don’t get driven insane by empty time.” Those not killed by the disease of forgetting must fight the disease of boredom, in its own way almost as dangerous. With limited human contact, and more limited access to the outside world—even internet time is restricted—the hospital becomes increasingly claustrophobic, and, as in Boccaccio’s Decameron, telling stories and remembering the past are means of waiting out the plague. But here they are also means of pushing back against the disease: if to forget is to present symptoms, then to remember is to live.

But even if Joy appears to be immune to the disease of forgetting, there are gaps in her memory: abandoned by her mother shortly after her birth, she lacks access to whole chunks of her past. It’s only in the wake of the epidemic, via a previously unknown aunt’s dying wish, that she comes into possession of a photograph of her mother, and a few scraps of information about her. Thus, amid a contagion of forgetting, Joy begins the process of reconstructing a past she has never known. The purpose of the hospital, we gradually understand, is not to find a cure so much as to wait out the deluge with a privileged few: the familiar fantasy of starting fresh, one Joy rejects as she begins pushing back against the rupture of the past.

After escaping the hospital, Joy travels through streets turned “rivers of brown slush,” over “ghosted” sidewalks, and on highways where horses run wild—a world not so much apocalyptic as paused in a state of perpetual unease. Van den Berg is at her best building landscapes that are subtly insidious, where tire swings come to look like nooses and snakes emerge from roadkill, but they read less as science fiction than as extrapolations of the world we already live in. During one internet session, Joy finds herself browsing abandoned places: an empty power plant in Belgium, an abandoned hotel in Colombia, an underwater city in Shicheng, a train station in Detroit: relics of a former world that seem to be waiting for some god to wipe everything clean once again and start over, condemned in the meantime to bear witness to the past. “These places were not created by the sickness,” she tells us, “just as the gap in my own memory was not created by the sickness. This was all done long before.”

Colin Dickey

The brutal democracy of AIDS

No one knows exactly how many people died in the early years of the AIDS epidemic, but according to some sources, by the end of 1986, the virus had killed around twenty-four thousand people in the United States. AIDS gained serious momentum in 1987, the death count almost doubling in just one year. Another twenty thousand or so succumbed to the illness in 1988. Angels in America, the play Tony Kushner wrote in two parts between that year and 1992, and which takes place between 1985 and 1990, occurs on “the very threshold of revelation,” before the country woke to find an epidemic raging.

In less than a decade AIDS turned a newly liberated, sexually adventurous gay community upside down, but the grim shadow it cast—not just the body count but the punishing co-infections and symptoms as well—had obscured other forces propping it up: bigotry, inequity, repression, meanness. Kushner knew that disease—like love, oppression, and, one of the play’s primary preoccupations, national identity—is spectral, often imperceptible, as it moves through societies. Accordingly, he treats AIDS as more than just an illness: a thoroughly modern plague, it is the entirety of the people afflicted, and the people who love or despise them. Its impact is arbitrary but not accidental.

Early in the play, central character Prior Walter takes off his coat to show a Kaposi’s sarcoma lesion to Louis, his live-in partner of four and a half years, calling it “K.S., baby… The wine-dark kiss of the angel of death.” (No one says the word AIDS until the end of act I.) Louis then bails on Prior out of fear, self-loathing, and guilt. It’s difficult to understand and accept what he’s done, but his departure animates Prior. After Louis leaves, two of Prior’s ancestors (both also named Prior), who were “carried off ” by plagues past, visit to remind him that this isn’t the first time a statistically significant number of people have succumbed to a fatal, contagious disease.

The ancestral Priors are ghosts, heralds for the cohort of angels about to descend on the earth. Because God has abandoned them for the human world, Kushner’s angels see something painful and diseased about human notions of social and technological progress. They come not to offer hope or wisdom, but to question the value of our drive for forward motion: the messy history of America shows how much contradiction is bound up in “progress,” and, as character after character in Kushner’s play reminds us, change is often painful. “It’s all gone too far,” Prior explains, acting as prophet on their behalf. “Too much loss is what they think.”

So, through magic and prophecy—burning books, visions, ungodly erections—the angels do not bring change from on high, but instead seek to thwart it, and with it the specters that control all humans: nations, oppression, disease. At a time when twenty thousand people were dying every year, the idea that “we should stop somehow, go back” must have been a comforting, if futile, fantasy. But Kushner engages with it earnestly. In his notes on “Perestroika,” the second part of the play, he’s adamant: illusions should be real. Even the romantic and outdated one that we might dig in our heels and stop time’s forward march. “The moments of magic—all of them— are to be fully realized, as bits of wonderful theatrical illusion.” The wires can show, that is, but the angel of America should really fly. (Seriously, Kushner continues in the stage notes, productions should add tech time to make her airborne.)

One of the most effective ways the play engages with the illusory and the fantastic is Kushner’s use of split scenes: Louis announces his intention to move out, while a closeted gay Mormon character asks his wife to move to Washington with him; in a diner, Louis delivers a zealous and unintentionally racist rant on democracy in America, while Prior hallucinates that a holy book is breaking through the floor and bursting into flames. These scenes grow in frequency and intensity as the characters’ lives intertwine and their lapses into dream, prophecy, and hallucination become more frequent. After Louis fires off his rant, he asks Belize to tell Prior that he loves him; Belize, the nurse and sometimes drag queen who acts as the play’s conscience, and who tolerates Louis’s presence just to be able to argue with him, responds, “I’ve thought about it for a very long time, and I still don’t understand what love is. Justice is simple. Democracy is simple. Those things are unambivalent. But love is very hard.”

It’s a banal statement, but still apt. In order to lurch past this moment of disease toward something that even mildly resembles healing, our notion of love will have to change along with science and society. Angels in America, though often brimming with idealism and emotion, is not a sentimental play. Kushner knows that love alone isn’t the cause or the solution, but that we are all the time together, tangled and intersecting, and that our condition is as democratic as it is cruel. “The way you give love is the most profoundly human part of you,” Kushner told the New Yorker in 1992. “When people say it’s ugly or a perversion or an abomination, they’re attacking the center of your being.”

He meant bigotry, of course, but a virus that proliferates through expressions of illicit love can easily look like an attack on identity, too. Love, we realize, is political, which doesn’t mean it can’t also be deeply reactionary; the play is an attempt to reconcile even the most narrow, claustrophobic strain of love with the human tendency toward evolution and innovation. For Kushner, just being in a gay relationship is no guarantee of a more evolved or compassionate affair, no promise of being able to transcend generations of painful attachments. But there is still strong, healing love in the world, Angels in America suggests. It’s not god-given, though: instead, like social progress, like most worthwhile things, it’s born of tension and resolution.

Radical as the idea was in the early 1990s, the modern gay-rights movement has almost normalized the message that love is political. Sure enough, politics—like the legal definitions of love and family— have progressed since then; so has science. We can look back and assess the changes the angels tried to deter: the present isn’t necessarily better, but it feels inevitable. (Likewise, the fact that Angels in America is an HBO miniseries feels like a foregone conclusion.) Today people with the virus are HIV-positive, and some live for decades on powerful anti-retrovirals. We have Pre-Exposure Prophylaxis, or PrEP, which, if taken every day, prevents infection in people who are HIV-negative. And, like the angels’ futile attempts to fight progress, a small but vocal contingent of gay men have criticized others for using PrEP—for pushing forward and changing their relationship to the disease.

At the end of the second half of the play, some characters have spun off and others have reconnected, bickering and ranting in their usual ways. Prior, who has rejected the inducements of the angels to fight the forward movement of time, has survived for five years with AIDS. As he addresses the audience, firmly on the side of progress and cautious hope, the politics of gay love seem inexorable, almost beside the point. “This disease will be the end of many of us,” he says, “but not nearly all, and the dead will be commemorated and will struggle on with the living, and we are not going away. We won’t die secret deaths anymore.” He’s right. AIDS has changed. It is a live thing. “The world only spins forward.”

Nicole Pasulka
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