(On Immunity: An Inoculation. Minneapolis, MN: Graywolf Press, 2014)
In July of 2014, employees at the Centers for Disease Control and Prevention discovered, in a cold storage facility unused for decades, several vials that contained living strains of the smallpox virus. When confronted with the proximity of a contagion assumed to be remote in both place and time, most Americans understandably responded with outrage and thinly veiled terror. Normally I do not get caught up in the fervor that these kinds of stories create—casual dismissal of serious large-scale threats is perhaps endemic to my generation—but I was at the time reading Eula Biss’s new account of vaccines and disease, On Immunity: An Inoculation. Suddenly, every news program and internet forum was an active theater in the very same war that I was reading a detailed history of. The situation was fluid, and no one truly knew the extent of the threat that had been lurking, right under our noses, inside a random storage closet in Bethesda. But one thing that the 24-hour news cycle made clear to me was the same general sentiment at the heart of Biss’s book: our fear of these microscopic viruses, and of the epic scale on which they can potentially disrupt our society, is perhaps the rawest and purest fear a person can experience.
Although On Immunity concerns itself with a specific medical debate—the question of a link between vaccination and mental defects—it is, in its heart, an investigation of human fear in the face of lethal enemies that exist all around us, but that we cannot see. Writing soon after the birth of her first son, a pivotal time for a child’s developing immune system, Biss details the many contentious decisions that must be made, as well as the psychological effects that all the doubt and uncertainty has on a new parent. In one passage, she muses over her indifference to the startling murder rates connected to firearms, while fretting incessantly over the danger posed by paint chips on her son’s bedroom wall. It is a familiar and relatable paradox because, as she says:
If we understand ourselves as living in a world of unseen evils, the immune system, that largely conceptual entity devoted to protecting us from invisible threats, will inevitably take on an inflated importance and a distorted function.
Guns might offer a grizzly and violent perception of death, but the deepest fear is reserved for that which creeps stealthily into our bodies and turns our own cells against us. “Our fears are dear to us,” she concedes, and when challenged by conflicting information, such as the greater danger posed by violent crime or automobile accidents, “we tend to doubt the information, not ourselves.”
Biss’s suggestion is that this kind of thinking stems from an inherent distrust of the external, of anything we might differentiate from ourselves as “other.” Much of the book’s tension and intrigue is derived from how this suggestion intersects with—or more often, crashes into—her new responsibilities as a mother. When her son is ready to be weaned off of breast feeding, this dilemma is more fully realized, and affects the mother even more than it does the child:
As long as a child takes only breast milk, I discovered, one can enjoy the illusion of a closed system, a body that is not yet in dialogue with the impurities of farm and factory. Caught up in the romance of the untainted body, I remember feeling agony when my son drank water for the first time. “Unclean! Unclean!” my mind screamed.
The intensity of this base fear is so strong that even the life-giving miracle of water becomes suspect, tainted, potentially devious. The foundation of life itself is not to be wholly trusted.
This is, of course, an unsustainable attitude; a moment of weakness. There is no protection from interacting with the outside world, and no chance to remain indefinitely in a sealed bubble. One of the great strengths of Biss’s work is how she embraces this theme of community and champions the role of a collective social body in the fight against disease. This is the counterbalance to all her fretful anxiety, the note of hope and harmony that rings out over the chatter of fear. “The boundaries between our bodies begin to dissolve here,” she writes. “Donations of blood and organs move between us, exiting one body and entering another, and so too with immunity, which is a common trust as much as it is a private account.” This is in reference to what she calls herd immunity, the idea that mass vaccinations are essential to controlling a virus’s ability to move between hosts, and thus the most pragmatic means we have of eliminating contagious diseases.
It is a comforting conclusion, and one which strikes me as distinctly American, to think that the invisible enemies lurking around us can be conquered through collective action and a gung-ho spirit. The first step is acknowledging a foundational mistake in the way we conceptualize disease—that it is a polluted foreign entity defiling an otherwise pristine biological system. “We are all already polluted,” Biss writes. “We are crawling with bacteria and we are full of chemicals.” But rather than use such bold statements to stoke the flames of our instinctual terror, as so many talking heads gleefully did during the CDC debacle, she instead offers a rallying cry to disband the Us-and-Them mentality that underlies much of vaccination skepticism. We are, Biss reminds us, “continuous with everything here on Earth. Including, and especially, each other.”
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Cory Johnston is the Books Editor for The Literary Review.