Just as the “Ebola Scare” is leaving the headlines and at a time of year when millions of Americans engage in the annual consideration of whether or not to receive the influenza vaccine, Eula Biss’ (shown) new book, On Immunity — An Inoculation, offers a different perspective on the ongoing debate over vaccination. The two sides of the debate over immunization have often been seen as being held by inflexible absolutists, with partisans accusing their opponents either of risking a pandemic by ignoring immunization, or endangering a generation of children because of the purported risks posed by the immunizations themselves. Biss, an English professor at Northwestern University, comes at the debate from a different angle, and evaluates the debate over immunization through the lens of myth and a climate of fear that animates both sides of the debate.
Throughout On Immunity, Biss ruminates on her role as a mother and her desire to preserve the life and health of her child. The author’s willingness to examine her own motivations and fears lends a deeply personal character to the entirety of the book. Although replete with insights and argumentation from both sides of the immunization debate, Biss continually anchors her writing both in the immanent details of her own family and the transcendent narratives of myth. The cover of On Immunity is adorned with Ruben’s masterful Achilles Dipped Into the River Styx, and Biss returns to that myth on several occasions. The author relates to Thetis’ desire to preserve her son from injury — but the story of Achilles is a reminder that all men are mortal, and the efforts of all parents to infallibly shield their children from harm is fundamentally flawed.
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Far from being an apologist for “Big Pharma,” Biss is empathetic to the concerns of critics of immunization. However, Biss is also far from being a reflexive opponent of immunization, and finds fault with many of the objections that are raised against the science behind vaccination. In Biss’ words:
The debate over vaccination tends to be described with what the philosopher of science Donna Haraway would call “troubling dualisms.” These dualisms pit science against nature, public against private, truth against imagination, self against other, thought against emotion, and man against woman.
The metaphor of a “war” between mothers and doctors is sometimes used for conflicts over vaccination. Depending on who is employing the metaphor, the warring parties may be characterized as ignorant mothers and educated doctors, or intuitive mothers and intellectual doctors, or caring mothers and heartless doctors, or irrational mothers and rational doctors — sexist stereotypes abound.
Rather than imagine a war in which we are ultimately fighting against ourselves, perhaps we can accept a world in which we are all irrational rationalists.
Biss notes that the current debate over vaccination is far from a recent development; Britain’s Compulsory Vaccination Act of 1853 and George Washington’s decision to impose smallpox immunization on new recruits beginning in 1775 are two examples of government policy entering into the vaccination debate. Biss observes that “vaccination is a precursor to modern medicine, not the product of it. Its roots are in folk medicine, and its first practitioners were farmers. Milkmaids in eighteenth-century England had faces unblemished by smallpox.… Folk knowledge held that if a milkmaid milked a cow blistered with cowpox and developed some blisters on her hands, she would not contract smallpox even while nursing victims of an epidemic.” The earliest form of inoculation — variolation, which purposely infected a person with a mild case of smallpox — was common in the Americas by the early 18th century; indeed, as Biss explains, “inoculation” entered English usage as a medical term as a way of describing variolation by means of a concept borrowed from plant cultivation.
In a culture that has become profoundly risk averse, the debate over vaccination often reduces to a duel over the risks of different courses of action. As Biss observes, “The idea that our medicine is as flawed as we are is not comforting. And when comfort is what we want, one of the most powerful tonics alternative medicine offers is the word natural.… But the use of natural as a synonym for good is almost certainly a product of our profound alienation from the natural world.”
While Biss’ work is often thoughtful, nevertheless it is flawed by what appears to this reviewer to be a surprisingly unreflective anti-capitalist tic. Thus, for example, Biss seems to blame capitalism for the existence of the anti-immunization viewpoint:
Our cynicism may be justified, but it is also sad. That so many of us find it entirely plausible that a vast network of researchers and health officials and doctors worldwide would willfully harm children for money is evidence of what capitalism is really taking from us. Capitalism has already impoverished the working people who generate wealth for others. And capitalism has already impoverished us culturally, robbing unmarketable art of its value. But when we begin to see the pressures of capitalism as innate laws of human motivation, when we begin to believe that everyone is owned, then we are truly impoverished.
It almost appears that Biss uses “capitalism” as a synonym for “evil,” since the evils that she bombastically attributes to capitalism exist outside of any economic system. The ruination that has accompanied socialized medicine has amply demonstrated that repudiating capitalism has not improved medicine, it has simply led to the rationing of medicine and the implacable forces of government determining who will — or will not receive medical care.
The author’s ill-considered forays into economic theory flaw a book that otherwise has much to commend it. Biss subjects the “preindustrial nostalgia” of critics of vaccination to a helpful critique. She also subjects Rachel Carson’s Silent Spring to a surprising — though somewhat muted — criticism. Carson’s fear-mongering concerning the purported carcinogenic character of DDT is specifically refuted: “Numerous studies on factory and farm workers with high DDT exposure failed to find an association between DDT and cancer. And studies of specific cancers found no evidence that DDT increased the incidence of breast cancer, lung cancer, testicular cancer, liver cancer, or prostate cancer.” Implicitly, the DDT-cancer scare anticipates the more extreme claims of modern opponents of vaccination. By thus criticizing Carson, Biss calls into question much of the fear-mongering that is the stock and trade of environmentalists.
In short, Biss’ On Immunity in certainly not immune to criticism; on occasion, the author ranges far from areas where she may claim the expertise to substantiate her claims. In her own words, we are all “irrational rationalists.”
Photo of Eula Biss: Slowking4/gallery2014-4
Eula Biss, On Immunity — An Inoculation, (Minneapolis: Graywolf Press, 2014). Hardcover. ISBN 978-1-55597-689-7. 205 pages. $24.00
