March 9, 2015

On Immunity by Eula Biss

I will admit it: until recently, I was one of those parents whose children weren’t vaccinated due to my concerns about a number of toxic ingredients found in vaccines. But then when people started sharing vitriolic and expletive-filled Facebook statuses and tweets about “fucking anti-vaxxers” whose children deserved to die of smallpox, they really convinced me, and I finally came around and saw the error of my ways.

Okay, none of the above is true. First, because my children received their vaccines on schedule. But mostly because the described scenario doesn’t exist—no one’s going to change her mind in this climate. The rhetoric surrounding the vaccine “debate” is so inflamed and divisive that as it stands that there is no hope of reconciliation. I also have some sympathy for parents who doubt the safety or necessity of vaccines. While I have absolute trust in my doctor and her advice, and in the importance of vaccines for public health, I was one of the many people who put down that fear-mongering story in The Toronto Star last month on the HPV vaccine and said, “My kids are never going to get that.” And then the whole furor blew up, and I saw how we’d been played.

Which is the point at which I decided to read On Immunity by Eula Biss. Biss, poet and award-winning essayist, wades into the vaccine issue, not to seek a middle-ground—because she acknowledges that there isn’t one; the science is conclusive; her own child is vaccinated—but to seek context, to create something richer than a polemic. More than a book on “issues”, even, this is a book on language and metaphor, about how both frame the way we understand our bodies and our world, and about vaccinations and immunity might serve as a metaphor for America and the world today. “And it has vampires in it,” so notes the blurb on the back by Rebecca Solnit. Because, yes, this book is blurbed by Rebecca Solnit AND Anne Fadiman, which makes it basically a non-fiction holy book. And it is oh so very good.

Biss begins with the myths and fairytales, those stories in which “parents…have a maddening habit of getting tricked into making bad gambles with their children’s lives.” Including the myth of Achilles whose mother seeks his immortality. Biss writes, “Immunity is a myth, these stories suggest, and no mortal can ever be made invulnerable,” and considers the desperate ways in which parents seek to protect their children from their fates.

Her son was born as H1N1 panic spread across the world, around the same time my elder daughter was. I remember lining up for hours at Metro Hall downtown for the flu vaccines we were eligible for because we resided with a member of the vulnerable segment of the population. “It was not a good season for trust,” Biss writes, as financial markets were crumbling and many people were considering the response to the H1N1 panic to be overblown, a plot by big-pharma, the vaccine’s components considering dubious by many in the chattering-mother set.

Biss invokes Bram Stroker’s Dracula, a story that serves as a metaphor for disease. “What makes Dracula particularly terrifying, and what takes the plot of the story so long to resolve, is that he is a monster whose monstrosity is contagious.” And the story, she continues, is as much about the problem of evidence and truth as it is about vampires. How do we ever know what we know?

Public health, Biss notes, is rarely seen by members of the middle class as intended for “people like us.” She uses the example of prominent anti-vaccine campaigner Dr. Bob Sears who writes of the hep B vaccines, “This is an important vaccine from a public health standpoint, but it’s not as critical from an individual point of view.” Biss explains, “In order for this to make sense, one must believe that individuals are not part of the public.” But such a limited perspective is hardly novel, Biss shows shows, with historical epidemics thought to be the scourge of foreigners and outsiders (like Dracula!), and poor black people forced at gunpoint to be vaccinated in Kentucky a century ago. Historically, vaccination of those living in poverty would have benefited the wealthy, whereas the tables have now turned—the vaccination of children who live in privilege now serves to protect the vulnerable (in terms of income level and health). Biss extends her examination of this switch: “If it was meaningful for the poor [historically] to assert were not purely dangerous, I suspect it might be just as meaningful now for the rest of us to accept that we are not purely vulnerable. The middle class may be ‘threatened’, but we are still, just by virtue of having bodies, dangerous.”

But we feel threatened, we do. Here, Biss returns to poor season for trust, and explains how risk perception has more to do with fear than quantifiable risk. “Perhaps what matters,” Biss quotes the scholar Cass Sunstein has saying, “is not whether people are right on the facts but whether they are frightened.” And we certainly live in a culture of fear, which is ever heightened. Which has recently manifested in a paranoia against chemicals, countered with a strange faith that nature itself is benevolent. But vaccines, note Biss, reside where between the two: “vaccines are of that liminal place between humans and nature—a mowed field.” She further complicates the issue by using the example of the Americas’ native populations, decimated by disease after the arrival of Europeans: “Considering this course of events ‘natural’ favours the perspective of the people who subsequently colonized the land, but it fails to satisfy the ‘not made or caused by humankind’ definition of the term.”

Nothing is straightforward, and science writing, and misperceptions of science writing, skews things. Did you know that there is no causal link between DDT and cancers? I didn’t. I read Rachel Carson’s Silent Spring, her book that sparked a revolution by suggesting there is no boundary between the human body and its environment, and while this is indeed the case, and while spraying DDT from airplanes over towns and vast tracts of farmland is indeed dangerous and does irreparable damage to ecosystems, Silent Spring‘s greatest legacy, as noted by journalist Tina Rosenberg, is that it’s “killing African children because of its persistence in the public mind.” Malaria has resurged in countries where DDT is no longer used against mosquitos. While Carson recognized the utility of DDT for disease prevention, Biss writes, “the enduring power of her book owes less to its nuances than its capacity to induce horror…. Like the plot of Dracula, the drama of Silent Spring depends on emblematic oppositions.”

Biss traces the origins of vaccines to folk medicine, practiced by women until they were pushed out of their positions of power in their communities by the medical establishment (men who pushed women into unsanitary hospitals to have their babies, many of whom would die there because these doctors didn’t know to wash their hands). Biss notes the strange relationship between anti-vaccine mothers and vaccination itself, both born out of the same anti-establishment systems that seek/sought to undermine women and their intuitive knowledge vs. scientific fact. This is certainly not a story about emblematic oppositions after all. But still, not a reason to turn away from science altogether. We need science, notes Biss, via Donna Harraway. “Where it is not built on social domination, science can be liberating.”

My very favourite part of this book, whose every bit I appreciated so much, was the end-note to page 8 (and it’s a testament to the goodness of On Immunity that I read its notes in entirety. I didn’t want the book to end). Biss writes something that reads like an echo of my introduction to The M Word, about motherhood being one’s occupation and preoccupation in the early days, about all those conversations about motherhood between new mothers making sense of their world, which is also the world. And this is what I find so exciting about this book, that such a work of literature can be from those “productive and necessary” conversations.

Biss notes:

“These mothers helped me understand how expansive the questions raised by mothering really are… I am writing to and from the women who complicated the matter of immunization for me…In a culture that relishes pitting women against each other in ‘mommy wars,’ I feel compelled to leave some traces on the page of another kind of argument. This is a productive, necessary argument—an argument that does not reduce us, as the diminutive mommy implies, and does not resemble war.”