“Plague” is the principal metaphor by which the AIDS epidemic is understood. And because of AIDS, the popular misidentification of cancer as an epidemic, even a plague, seems to be receding: AIDS has helped to divest cancer of much of its aura of shame, of the unspeakable.
Plague, from the Latin plaga (stroke, wound), has long been used metaphorically as the highest standard of collective calamity, evil, scourge—Procopius, in his masterpiece of calumny, The Secret History, called the Emperor Justinian worse than the plague (“fewer escaped”)—as well as being a general name for many frightening diseases. Although the disease to which the word is permanently affixed produced the most lethal of recorded epidemics, being experienced as a pitiless slayer is not necessary for a disease to be regarded as plague-like. Leprosy, very rarely fatal now, was not much more so when at its epidemic height between about 1050 and 1350. And syphilis has been regarded as a plague—Blake speaks of “the youthful Harlot’s curse” that “blights with plagues the Marriage hearse”—not because it killed often but because it was disgracing, disempowering, disgusting.
It is usually epidemics that are thought of as plagues. And these mass incidences of illness are understood as inflicted, not just endured. Considering illness as a punishment is the oldest idea of what causes illness—an idea opposed by all attention to the ill that deserves the noble name of medicine. Hippocrates, who wrote several treatises on epidemics, specifically ruled out “the wrath of God” as a cause of bubonic plague. But the illnesses interpreted in antiquity as punishments, like the plague in Oedipus, were not thought to be shameful, as leprosy and subsequently syphilis were to be. Diseases, insofar as they acquired meaning, were collective calamities, and judgments on a community. Only injuries and disabilities, not diseases, were thought of as individually merited. For an analogy in the literature of antiquity to the modern sense of a shaming, isolating disease, one would have to turn to Philoctetes and his stinking wound.
The most feared diseases, those that are not simply fatal but transform the body into something alienating, like leprosy and syphilis and cholera and (in the imagination of many) cancer, are the ones that seem particularly susceptible to promotion to “plague.” Leprosy and syphilis were the first illnesses to be consistently described as repulsive. It was syphilis that, in the earliest descriptions by doctors at the end of the fifteenth century, generated a version of the metaphors that flourish around AIDS: of a disease that was not only repulsive and retributive but collectively invasive. Although Erasmus, the most influential European pedagogue of the early sixteenth century, described syphilis as “nothing but a kind of leprosy” (by 1529 he called it “something worse than leprosy”), it had already been understood as something different because it was sexually transmitted. Paracelsus speaks (in Donne’s paraphrase) of “that foule contagious disease which then had invaded mankind in a few places, and since overflowes in all, that for punishment of general licentiousness God first inflicted that disease.”
Thinking of syphilis as a punishment for a person’s transgression was for a long time, virtually until the disease became easily curable, not really distinct from regarding it as retribution for the licentiousness of a community—as with AIDS now, in the rich industrial countries. In contrast to cancer, understood in a modern way as a disease incurred by (and revealing of) individuals, AIDS is understood in a premodern way, as a disease incurred by people both as individuals and as members of a “risk group”—that neutral-sounding bureaucratic category which also revives the archaic idea of a tainted community that illness has judged.
Of course, not every account of plague or plague-like diseases is a vehicle for lurid stereotypes about illness and the ill. The effort to think critically, historically, about illness (about disaster generally) was attempted throughout the eighteenth century: say, from Defoe’s A Journal of the Plague Year (1722) to Alessandro Manzoni’s The Betrothed (1827). Defoe’s historical fiction, purporting to be an eyewitness account of bubonic plague in London in 1665, does not further any understanding of the plague as punishment or, a later part of the script, as a transforming experience. And Manzoni, in his lengthy account of the passage of plague through the duchy of Milan in 1630, is avowedly committed to presenting a more accurate, less reductive view than his historical sources. But even these two complex narratives reinforce some of the perennial, simplifying ideas about plague.
One feature of the usual script for plague: the disease invariably comes from somewhere else. The names for syphilis, when it began its epidemic sweep through Europe in the last decade of the fifteenth century, are an exemplary illustration of the need to make a dreaded disease foreign.1 It was the “French pox” to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese. But what may seem like a joke about the inevitability of chauvinism reveals a more important truth: that there is a link between imagining disease and imagining foreign-ness. It lies perhaps in the very concept of wrong, which is archaically identical with the non-us, the alien. A polluting person is always wrong, as Mary Douglas has observed. The inverse is also true: a person judged to be wrong is regarded as, at least potentially, a source of pollution.
The foreign place of origin of important illnesses, like drastic changes in the weather, may be no more remote than a neighboring country. Illness is experienced as a species of invasion, and indeed is often carried by soldiers. Manzoni’s account of the plague of 1630 (chapters 31 to 37) begins:
The plague which the Tribunal of Health had feared might enter the Milanese provinces with the German troops had in fact entered, as is well known; and it is also well known that it did not stop there, but went on to invade and depopulate a large part of Italy.
Defoe’s chronicle of the plague of 1665 begins similarly, with a flurry of ostentatiously scrupulous speculation about its foreign origin:
It was about the beginning of September, 1664, that I, among the rest of my neighbours, heard, in ordinary discourse, that the plague was returned again in Holland; for it had been very violent there, and particularly at Amsterdam and Rotterdam, in the year 1663, whither, they say, it was brought, some said from Italy, others from the Levant, among some goods, which were brought home by their Turkey fleet; others said it was brought from Candia; others from Cyprus. It matter not from whence it came; but all agreed it was come into Holland again.
The bubonic plague that reappeared in London in the 1720s arrived from Marseilles, which was where plague in the eighteenth century was usually thought to enter Western Europe: brought by seamen, then transported by soldiers and merchants. By the nineteenth century the foreign origin was usually more exotic, the means of transport less specifically imagined, and the illness itself had become phantasmagorical, symbolic.
At the end of Crime and Punishment Raskolnikov dreams of plague: “He dreamt that the whole world was condemned to a terrible new strange plague that had come to Europe from the depths of Asia.” At the beginning of the sentence it is “the whole world,” which turns out by the end of the sentence to be “Europe,” afflicted by a lethal visitation from Asia. Dostoevsky’s model is undoubtedly cholera, called Asiatic cholera, long endemic in Bengal, which had rapidly become and remained through most of the nineteenth century a worldwide epidemic disease.
Part of the centuries-old conception of Europe as a privileged cultural entity is that it is a place which is colonized by lethal diseases coming from elsewhere. Europe is assumed to be by rights free of disease. (And Europeans have been astoundingly callous about the far more devastating extent to which they—as invaders, as colonists—have introduced their lethal diseases to the exotic, “primitive” world: think of the ravages of smallpox, influenza, and cholera on the aboriginal populations of the Americas and Australia.) The tenacity of the connection of exotic origin with dreaded diseases is one reason why cholera, of which there were four great outbreaks in Europe in the nineteenth century, each with a lower death toll than the preceding one, has continued to be more vividly remembered than smallpox, whose ravages increased as the century went on (half a million died in the European smallpox pandemic of the early 1870s) but which could not be construed as, plague-like, a disease with a non-European origin.
Plagues are no longer “sent,” as in biblical and Greek antiquity, for the question of agency has blurred. Instead, peoples are “visited” by plagues. And the visitations recur, as is taken for granted in the subtitle of Defoe’s narrative, which explains that it is about that “which happened in London during the Last Great Visitation in 1665.” Even for non-Europeans, lethal disease may be called a visitation. But a visitation on “them” is invariably described as different from one on “us.” “I believe that about one half of the whole people was carried off by this visitation,” wrote the English traveler Alexander Kinglake, reaching Cairo at a time of the bubonic plague (sometimes called “oriental plague”). “The Orientals, however, have more quiet fortitude than Europeans under afflictions of this sort.”
Kinglake’s influential book Eothen (1844)—suggestively subtitled “Traces of Travel Brought Home from the East”—illustrates many of the enduring Eurocentric presumptions about others, starting from the fantasy that peoples with little reason to expect exemption from misfortune have a lessened capacity to feel misfortune. Thus it is believed that Asians (or the poor, or blacks, or Africans, or Muslims) don’t suffer or don’t grieve as Europeans (or whites) do. The fact that illness is associated with the poor—who are, from the perspective of the privileged, aliens in one’s midst—reinforces the association of illness with the foreign: with an exotic, often primitive place.
Thus, illustrating the classic script for plague, AIDS is thought to have started in the “dark continent,” then spread to Haiti, then to the United States and to Europe, then…. It is understood as a tropical disease: another infestation from the so-called Third World, which is after all where most people in the world live, as well as a scourge of the tristes tropiques. Africans who detect racist stereotypes in much of the speculation about the geographical origin of AIDS are not wrong. (Nor are they wrong in thinking that depictions of Africa as the cradle of AIDS must feed anti-African prejudices in Europe and Asia.) The subliminal connection made to notions about a primitive past and the many hypotheses that have been fielded about possible transmission from animals (a disease of green monkeys? African swine fever?) cannot help but activate a familiar set of stereotypes about animality, sexual license, and blacks.
In Zaire and other countries in Central Africa where AIDS is killing tens of thousands, the counterreaction has begun. Many doctors, academics, journalists, government officials, and other educated people believe that the virus was sent to Africa from the United States, an act of bacteriological warfare whose aim was to decrease the African birth rate, which got out of hand and has returned to afflict its source. A common African version of this belief about the disease’s provenance has the virus fabricated in a CIA-Army laboratory in Maryland, sent from there to Africa, and brought back to its country of origin by American homosexual missionaries returning from Africa to Maryland.2
At first it was assumed that AIDS must become widespread elsewhere in the same catastrophic form in which it has emerged in Africa, and those who still think this will eventually happen invariably invoke the Black Death. The plague metaphor is an essential vehicle of the most pessimistic reading of the epidemiological prospects. From classic fiction to the latest journalism, the standard plague story is of inexorability, inescapability. The unprepared are taken by surprise; those observing the recommended precautions are struck down as well. All succumb when the story is told by an omniscient narrator, as in Poe’s parable “The Masque of the Red Death” (1842), inspired by an account of a ball held in Paris during the cholera epidemic of 1832. Almost all—if the story is told from the point of view of a traumatized witness who will be a benumbed survivor, as in Jean Giono’s Stendhalian novel Horseman on the Roof (1951), in which a young Italian nobleman in exile wanders through cholera-stricken southern France in the 1830s.
Plagues are invariably regarded as judgments on society, and the metaphoric inflation of AIDS into such a judgment also accustoms people to the inevitability of global spread. This is a traditional use of sexually transmitted diseases: to be described as punishments not just of individuals but of a group (“general licentiousness”). Not only venereal diseases have been used in this way, to identify transgressing or vicious populations. Interpreting any catastrophic epidemic as a sign of moral laxity or political decline was as common until the later part of the last century as associating diseases with foreign-ness. (Or with despised and feared minorities.)
The assignment of fault is not contradicted by cases that do not fit. The Methodist preachers in England who connected the cholera epidemic of 1832 with drunkenness (the temperance movement was just starting) were not understood to be claiming that everybody who got cholera was a drunkard: there is always room for “innocent victims” (children, young women). Tuberculosis, in its identity as a disease of the poor (rather than of “the sensitive”), was also linked by late-nineteenth-century reformers to alcoholism. Responses to illnesses associated with sinners and the poor invariably recommended the adoption of middle-class values: the regular habits, productivity, and emotional self-control to which drunkenness was thought the chief impediment.3 Health itself was eventually identified with these values, which were religious as well as mercantile, health being evidence of virtue as disease was of depravity. The dictum that cleanliness is next to godliness is to be taken quite literally.
The succession of cholera epidemics in the nineteenth century shows a steady waning of religious interpretations of the disease: more precisely, these increasingly coexisted with other explanations. Although, by the time of the epidemic of 1866, cholera was commonly understood not simply as a divine punishment but as the consequence of remediable defects of sanitation, it was still regarded as the scourge of the sinful. A writer in The New York Times declared (April 22, 1866): “Cholera is especially the punishment of neglect of sanitary laws; it is the curse of the dirty, the intemperate, and the degraded.”4
That it now seems unimaginable for cholera or a similar disease to be regarded in this way signifies not a lessened capacity to moralize about diseases but only a change in the kind of illnesses that are used didactically. Cholera was perhaps the last major epidemic disease fully qualifying for plague status for almost a century. (I mean cholera as a European and American, therefore a nineteenth-century, disease; until 1817 there had never been a cholera epidemic outside the Far East.) Influenza, which would seem more plague-like than any other epidemic in this century if loss of life were the main criterion, and which struck as suddenly as cholera and killed as quickly, usually in a few days, was never viewed metaphorically as a plague. Nor was a more recent epidemic, polio.
One reason why plague notions were not invoked is that these epidemics did not have enough of the attributes perennially ascribed to plagues. (For instance, polio was construed as typically a disease of children—of the innocent.) The more important reason is that there has been a shift in the focus of the moralistic exploitation of illness. This shift, to diseases that can be interpreted as judgments on the individual, makes it harder to use epidemic disease as such. For a long time cancer was the illness that best fitted this secular culture’s need to blame and punish and censor through the imagery of disease. Cancer was a disease of an individual, and understood as the result not of an action but rather of a failure to act (to be prudent, to exert proper self-control, or to be properly expressive). In the twentieth century it has become almost impossible to moralize about epidemics—except those that are transmitted sexually.
The persistence of the belief that illness reveals, and is a punishment for, moral laxity or turpitude can be seen in another way, by noting the persistence of descriptions of disorder or corruption as a disease. So indispensable has been the plague metaphor in bringing summary judgments about social crisis that its use hardly abated during the era when collective diseases were no longer treated so moralistically—the time between the influenza and encephalitis pandemics of the early and mid-1920s and the acknowledgment of a new, mysterious epidemic illness in the early 1980s—and when great infectious pandemics were so often and confidently proclaimed a thing of the past.5 The plague metaphor was common in the 1930s as a synonym for social and psychic catastrophe. Evocations of plague of this type usually go with rant, with antiliberal attitudes: think of Artaud on theater and plague, of Wilhelm Reich on “emotional plague.” And such a generic “diagnosis” necessarily promotes antihistorical thinking. A theodicy as well as a demonology, it not only stipulates something emblematic of evil but makes this the bearer of a rough, terrible justice. In Karel Capek’s The White Plague (1937), the loathsome pestilence that has appeared in a state where fascism has come to power afflicts only those over the age of forty, those who could be held morally responsible.
Written on the eve of the Nazi take-over of Czechoslovakia, Capek’s allegorical play is something of an anomaly—the use of the plague metaphor to convey the menace of what is defined as barbaric by a mainstream European liberal. The play’s mysterious, grisly malady is something like leprosy, a rapid, invariably fatal leprosy that is supposed to have come, of course, from Asia. But Capek is not interested in identifying political evil with the incursion of the foreign. He scores his didactic points by concentrating not on the disease itself but on the management of information about it by scientists, journalists, and politicians. The most famous specialist in the disease harangues a reporter—“The disease of the hour, you might say. A good five million have died of it to date, twenty million have it and at least three times as many are going about their business, blithely unaware of the marble-like, marble-sized spots on their bodies.” He chides a fellow doctor for using the popular terms, “the white plague” and “Peking leprosy,” instead of the scientific name, “the Cheng Syndrome.” He fantasizes about how his clinic’s work on identifying the new virus and finding a cure (“every clinic in the world has an intensive research program”) will add to the prestige of science and win a Nobel Prize for its discoverer. He revels in hyperbole when it is thought a cure has been found (“it was the most dangerous disease in all history, worse than the bubonic plague”), and he outlines plans for sending those with symptoms to well-guarded detention camps (“Given that every carrier of the disease is a potential spreader of the disease, we must protect the uncontaminated from the contaminated. All sentimentality in this regard is fatal and therefore criminal…”).
However cartoonish Capek’s ironies may seem, they are a not improbable sketch of catastrophe (medical, ecological) as a managed public event in a modern society. And however conventionally he deploys the plague metaphor, as an agency of retribution (in the end the plague strikes down the dictator himself), Capek’s feel for public relations leads him to make explicit in the play the understanding of disease as a metaphor. The eminent doctor declares the accomplishments of science to be as nothing compared with the merits of the dictator, about to launch a war, “who has averted a far worse scourge: the scourge of anarchy, the leprosy of corruption, the epidemic of barbaric liberty, the plague of social disintegration fatally sapping the organism of our nation.”
Camus’s The Plague, which appeared a decade later, is a far less literal use of plague by another great European liberal, as subtle as Capek’s The White Plague is schematic. Camus’s novel is not, as is sometimes said, a political allegory in which the outbreak of bubonic plague in a Mediterranean port city represents the Nazi occupation. This plague is not retributive. Camus is not protesting anything, not corruption or tyranny, not even mortality. The plague is no more or less than an exemplary event, the irruption of death that gives life its seriousness. His use of the plague metaphor, more epitome than metaphor, is detached, stoic, aware—it is not about bringing judgment. But as in Capek’s play, characters in Camus’s novel declare how unthinkable it is to have a plague in the twentieth century…as if the belief that such a calamity could not happen, could not happen anymore, means that it must.
The emergence of a new catastrophic epidemic, when for several decades it had been confidently assumed that such calamities belonged to the past, would not be enough to revive the moralistic inflation of an epidemic into a “plague.” It was necessary that the epidemic be one whose most common means of transmission is sexual.
Cotton Mather called syphilis a punishment “which the Just Judgment of God has reserved for our Late Ages.” Recalling this and other nonsense uttered about syphilis from the end of the fifteenth to the early twentieth centuries, one should hardly be surprised that many want to view AIDS metaphorically—as plague-like, a moral judgment on society. Professional fulminators can’t resist the rhetorical opportunity offered by a sexually transmitted disease that is lethal. Thus the fact that AIDS is predominantly a heterosexually transmitted illness in the countries where it first emerged in epidemic form has not prevented such guardians of public morals as Jesse Helms and Norman Podhoretz from depicting it as a visitation specially aimed at (and deservedly incurred by) Western homosexuals, while another Reagan-era celebrity, Pat Buchanan, orates about “AIDS and Moral Bankruptcy,” and Jerry Falwell offers the generic diagnosis, that “AIDS is God’s judgment on a society that does not live by His rules.” What is surprising is not that the AIDS epidemic has been exploited in this way but that such cant has been confined to so predictable a sector of bigots; the official discourse about AIDS invariably includes admonitions against bigotry.
The pronouncements of those who claim to speak for God can mostly be discounted as the rhetoric regularly prompted by sexually transmitted illness—from Cotton Mather’s declarations to recent statements by two leading Brazilian clerics, Bishop Falcão of Brasilia, who declares AIDS to be “the consequence of moral decadence,” and the Cardinal of Rio de Janeiro, Eugenio Sales, who wants it both ways, describing AIDS as “God’s punishment” and as “the revenge of nature.” More interesting, because their purposes are more complex, are the secular sponsors of this sort of invective. Authoritarian political ideologies have a vested interest in promoting fear, a sense of the imminence of takeover by aliens, with consequent loss of power—and, real diseases are useful material. Epidemic diseases usually elicit a call to ban the entry of foreigners, immigrants. And xenophobic propaganda has always depicted immigrants as bearers of disease (in the late nineteenth century: cholera, yellow fever, typhoid fever, tuberculosis). It seems logical that the political figure in France who represents the most extreme nativist, racist views, Jean-Marie Le Pen, has attempted a strategy of fomenting fear of this new alien peril, insisting that AIDS is not just infectious but contagious, and calling for mandatory nationwide testing and the quarantine of everyone carrying the virus. And AIDS is a gift to the present regime in South Africa, whose foreign minister declared recently, evoking the incidence of the illness among the mine workers imported from neighboring all-black countries: “The terrorists are now coming to us with a weapon more terrible than Marxism: AIDS.”
The AIDS epidemic serves as an ideal projection for First World political paranoia. Not only is the so-called AIDS virus the quintessential invader from the Third World. It can stand for any mythological menace. In this country AIDS has so far evoked less pointedly racist reactions than in Europe, including the Soviet Union, where the African origin of the disease is stressed. Here it is as much a reminder of feelings associated with the menace of the Second World as it is an image of being overrun by the Third. Predictably, the public voices in this country most committed to drawing moral lessons from the AIDS epidemic, such as Norman Podhoretz, are those whose main theme is worry about America’s will to maintain its bellicosity, its expenditures on armaments, its firm anticommunism, and who see everywhere evidence of the decline of American political and imperial authority.
Denunciations of “the gay plague” are part of a much larger complaint, common among antiliberals in the West and many exiles from the Russian bloc, about contemporary permissiveness of all kinds: a now-familiar diatribe against the “soft” West, with its hedonism, its vulgar, sexy music, its indulgence in drugs, its disabled family life, which have sapped the will to stand up to communism. AIDS is a favorite concern of those who translate their political agenda into questions of group psychology: of national self-esteem and self-confidence. Although these specialists in ugly feelings insist that AIDS is a punishment for deviant sex, what moves them is not just, or even principally, homophobia. Even more important is the utility of AIDS in pursuing one of the main activities of the so-called neoconservatives, the Kulturkampf against all that is called, for short (and inaccurately), the 1960s. A whole politics of “the will”—of intolerance, of paranoia, of fear of political weakness—has fastened on this disease.
AIDS is such an apt goad to familiar fears that have been cultivated for several generations to build social consensus, like fear of “subversion”—and to fears that have surfaced more recently, of uncontrollable pollution and of unstoppable migration from the Third World—that it would seem inevitable that AIDS be envisaged as something total, civilization-threatening. And raising the disease’s metaphorical stature by keeping alive fears of its easy transmissibility, its imminent spread, does not diminish its status as, mainly, a consequence of illicit acts (or of economic and cultural backwardness). That it is a punishment for deviant behavior and that it threatens the innocent—these two notions about AIDS are hardly in contradiction. Such is the extraordinary potency and efficacy of the plague metaphor: it allows a disease to be regarded both as something incurred by vulnerable “others” and as (potentially) everyone’s disease.
Recently the same mythologists who have been eager to use AIDS for ideological mobilization against deviance have backed away from the most panic-inspiring estimates of the illness. They are among the most vocal of those who insist that infection will not spread to “the general population” and have turned their attention to denouncing “hysteria” or “frenzy” about AIDS. Behind what they now consider the excessive publicity given the disease they discern the desire to placate an all-powerful minority; in the willingness to consider that “their” disease could well be “ours,” further evidence is seen of the sway of nefarious “liberal” values and of America’s spiritual decline.
Making AIDS everyone’s problem and therefore a subject on which everyone needs to be educated, the antiliberal AIDS mythologists charge, subverts our understanding of the difference between “us” and “them”; indeed exculpates or at least makes irrelevant moral judgments about “them.” (In such rhetoric the disease continues to be identified almost exclusively with homosexuality, and specifically with the practice of sodomy.)
“Has America become a country where classroom discussion of the Ten Commandments is impermissible but teacher instructions in safe sodomy are to be mandatory?” inquires Pat Buchanan, protesting the “foolish” proposal made in the report of the recent Presidential Commission on the epidemic, chaired by Admiral Watkins, to outlaw discrimination against people with AIDS. Not the disease but the appeals heard from the most official quarters “to set aside prejudice and fear in favor of compassion” (the words of the Watkins Report) have become a principal target, suggesting as they do a weakening of this society’s power (or willingness) to punish and segregate through judgments about sexual behavior.
More than cancer but rather like syphilis, AIDS seems to foster ominous fantasies about a disease that is seen as marking both individual and social responsibilities. The virus invades the body; the disease (or, in the newer version, the fear of the disease) is described as invading the whole society. In late 1986 President Reagan pronounced AIDS to be spreading—“insidiously”—“through the length and breadth of our society.”6 But while it is the pretext for expressing dark intimations about the body politic, AIDS has yet to seem credible as a political metaphor for internal enemies, even in France, where AIDS—in French le sida—was quickly added to the store of political invective. Le Pen has dismissed some of his opponents as “AIDS-ish” (sidatique), and the antiliberal polemicist Louis Pauwels said that lycée students on strike last year were suffering from “mental AIDS” (sont atteint d’un siaa mental). Neither has AIDS proved of much use as a metaphor for international political evil. True, Jeane Kirkpatrick once couldn’t resist comparing international terrorism to AIDS, but such sallies are rare—perhaps because for that purpose the cancer metaphor has proved so rich.
This does not mean that AIDS is not used preposterously as a metaphor, but only that it has a metaphoric potential different from that of cancer. When the movie director in Alain Tanner’s film La Vallée Fantôme (1987) muses, “Cinema is like a cancer,” and then corrects himself, “No, it’s infectious, it’s more like AIDS,” the comparison seems lumberingly self-conscious as well as a decided underuse of the metaphor of AIDS. Not its infectiousness but its characteristic latency offers a more distinctive metaphoric use. Thus the Palestinian writer Anton Shammas in the Jerusalem weekly Kol Ha’ir, in a fit of medical, sexual, and political fantasy, recently described Israel’s Declaration of Independence of 1948 as
the AIDS of “the Jewish State in the Land of Israel,” whose long incubation has produced Gush Emunim and…[Rabbi Meir] Kahane. That is where it all began, and that is where it all will end. AIDS, I am sorry to say, despite my sympathy for homo-sexuals, affects mainly monoerotics, and a mononational Jewish State contains by definition the seeds of its own destruction: the collapse of the political immune system that we call democracy…. Rock Hudson, who once was as beautiful as a Palmachnik, now lies dying long after the dissolution of the Palmach. The State of Israel (for Jews, of course) was indeed once beautiful…
And even more promising than its connection with latency is the potential of AIDS as a metaphor for contamination and mutation. Cancer is still common as a metaphor for what is feared or deplored, even if the disease itself is less dreaded than before. If AIDS can eventually be drafted for comparable use, it will be because AIDS is not only invasive (a trait it shares with cancer) or even because it is infectious, but because of the specific imagery that surrounds viruses.
Virology supplies a new set of medical metaphors independent of AIDS which nevertheless reinforce the AIDS imagery. It was years before AIDS that William Burroughs oracularly declared, and Laurie Anderson later echoed, “Language is a virus.” And the viral explanation is invoked more and more often. Until recently, most of the infections recognized as viral were the ones, like rabies and influenza, that have very rapid effects. But the category of slow virus diseases is growing. Many progressive and invariably fatal disorders of the central nervous system, and some degenerative diseases of the brain that can appear in old age, as well as the so-called auto-immune diseases, are now suspected of being, in fact, slow virus diseases. (And evidence continues to accumulate for a viral cause of at least some human cancers.) Notions of conspiracy translate well into metaphors of implacable, insidious, infinitely patient viruses.
In contrast to bacteria, which are relatively complex organisms, viruses are described as an extremely primitive form of life. At the same time their activities are far more complex than those envisaged in the earlier germ models of infection. Viruses are not simply agents of infection, contamination. They transport genetic “information,” they transform cells. And they themselves, many of them, evolve. While the smallpox virus appears to stay constant for centuries, influenza viruses evolve so rapidly that vaccines need to be modified every year to keep up with changes in the “surface coat” of the virus.7 The virus or, more accurately, viruses thought to cause AIDS are at least as mutable as the influenza viruses. Indeed, “virus” is now a synonym for change. Linda Ronstadt, explaining why she prefers doing Mexican folk music to rock ‘n’ roll, recently observed: “We don’t have any tradition in contemporary music except change. Mutate, like a virus.”
So far as “plague” still has a future as a metaphor, it is through the ever more familiar notion of the virus. (Perhaps no disease in the future caused by a bacillus will be considered as plague-like.) Information itself, now inextricably linked to the powers of computers, is threatened by something compared to a virus. Rogue or pirate programs, known as software viruses, are described as paralleling the behavior of biological viruses (which can capture the genetic code of parts of an organism and effect transfers of alien genetic material). These programs, deliberately planted onto a floppy disk meant to be used with the computer or introduced when the computer is communicating over telephone lines or data networks with other computers, copy themselves onto the computer’s operating system. Like their biological namesakes, they won’t produce immediate signs of damage to the computer’s memory, which gives the newly “infected” program time to spread to other computers. Such metaphors drawn from virology, partly stimulated by the omnipresence of talk of AIDS, are turning up everywhere. (The virus that destroyed a considerable amount of data at the student computer center at Lehigh University in Bethlehem, Pennsylvania, in 1987, was given the name PC AIDS. In France computer specialists already speak of the problem of “le sida informatique.”) And they reinforce the sense of the omnipresence of AIDS.
It is perhaps not surprising that the newest transforming element in the modern world, computers, should be borrowing metaphors drawn from our newest transforming illness. Nor is it surprising that descriptions of the course of viral infection now often echo the language of the computer age, as when it is said that a virus will normally produce “new copies of itself.” In addition to the mechanistic descriptions, the way viruses are animistically characterized—as a menace in waiting, as mutable, as furtive, as biologically innovative—reinforces the sense that a disease can be something ingenious, unpredictable, novel. These metaphors are central to ideas about AIDS that distinguish this illness from others, such as cancer. For though the fears AIDS represents are old, its status as that unexpected event, an entirely new disease—a new judgment, as it were—adds to the dread.
“Some will allow no Diseases to be new, others think that many old ones are ceased; and that such which are esteemed new, will have but their time: However, the Mercy of God hath scattered the great heap of Diseases, and not loaded any one Country with all: some may be new in one Country which have been old in another. New Discoveries of the Earth discover new Diseases…and if Asia, Africa, and America should bring in their List, Pandoras Box would swell, and there must be a strange Pathology.”
—Sir Thomas Browne,
“A Letter to a Friend, Upon Occasion of the Death of his Intimate
It is, of course, unlikely that AIDS, first identified in the early 1980s, is a new disease. Most probably it has been around a long time, and not only in Africa, though it is only recently (and in Africa) that the disease has reached epidemic proportions. But for the general consciousness it is a new disease, and for medicine, too: AIDS marks a turning point in current attitudes toward illness and medicine, as well as toward sexuality and toward catastrophe. Medicine had been viewed as an age-old military campaign now nearing its final phase, leading to victory. The emergence of a new epidemic disease, when for several decades it had been confidently assumed that such calamities belonged to the past, has inevitably changed the status of medicine. The advent of AIDS has made it clear that the infectious diseases are far from conquered and their roster far from closed.
Medicine changed mores. Illness is changing them back. Contraception and the assurance by medicine of the easy curability of sexually transmitted diseases (as of almost all infectious diseases) made it possible to regard sex as an adventure without consequences. Now AIDS obliges people to think of sex as having, possibly, the direst consequences: suicide. Or murder. (There was a trial run for the conversion of sexuality to something dangerous in the widely diffused panic about herpes in the United States in the early 1980s—and herpes was merely awful, erotically disqualifying; hardly lethal.) The fear of AIDS imposes on an act whose ideal is an experience of pure presentness (and a creation of the future) a relation to the past to be ignored at one’s peril. Sex no longer withdraws its partners, if only for a moment, from the social sphere. It cannot be considered just a coupling; it is a chain, a chain of transmission, from the past. “So remember when a person has sex, they’re not just having it with that partner, they’re having it with everybody that partner had it with for the past ten years,” runs an endearingly gender-vague pronouncement made in 1987 by the secretary of health and human services, Dr. Otis R. Bowen. AIDS reveals all but long-term monogamous sex as promiscuous (therefore dangerous) and also as deviant, for all heterosexual relations are also homosexual ones, once removed.
Fear of sexuality is the new, disease-sponsored element in the universe of fear in which everyone now lives. Cancer-phobia taught us the fear of a polluting environment; now we have the fear of polluting people, which AIDS anxiety inevitably communicates. Fear of the Communion cup, fear of surgery: fear of contaminated blood, whether Christ’s blood or your neighbor’s. Life—blood, sexual fluids—is itself the bearer of contamination. These fluids are potentially lethal. Better to abstain. People are storing their own blood, for future use. The model for altruistic behavior in our society, giving blood anonymously, has been compromised, since no one can be sure about anonymous blood received. Not only does AIDS have the unhappy effect of reinforcing American moralism about sex. It further strengthens the culture of self-interest, which is much of what is usually praised as “individualism.” Self-interest now receives an added boost as simple medical prudence.
All rapid epidemics, including those in which there is no suspicion of sexual transmission or any blaming of the ill, give rise to roughly similar practices of avoidance and exclusion. In the influenza pandemic of 1918–1919—influenza is a highly communicable disease, caused by an airborne virus (transmitted by way of the respiratory system)—people were advised against shaking hands and urged to put handkerchiefs over their mouths when kissing. Police officers were ordered to put on gauze masks before entering a house where people had become ill, as many police officers do today when making arrests in the slums, since AIDS in the United States has become increasingly a disease of the urban poor, particularly among blacks and Hispanics. Many barbers and dentists wore masks and gloves, as dentists and dental hygienists do now. But the great influenza epidemic, which killed twenty million people, was an affair of fifteen months. With a slow-motion epidemic, these same precautions take on a life of their own. They become part of social mores, not a practice adopted for a brief period of emergency, then discarded.
With an epidemic in which there is no immediate prospect of a vaccine, much less of a cure, prevention plays a larger part in consciousness. But campaigns to keep people from getting ill run into many difficulties with diseases that are venereally transmitted. There has always been reluctance in American health campaigns to communicate information about ways of having safer sex. The US Guide for Schools issued in late 1987 by the Department of Education virtually refuses to discuss reducing risk and proposes abstinence as the best way of safeguarding against AIDS, recalling lectures given soldiers during World War I that chastity was the only safeguard against syphilis as well as part of their patriotic duty in fighting the Hun. 8 Talk of condoms and clean needles is felt to be tantamount to condoning illicit sex, illegal chemicals. (And to some extent it is. Education about how to keep from getting AIDS does imply an acknowledgment of, therefore tolerance of, the ineradicable variousness of expression of sexual feeling.)
European societies, less committed to sexual hypocrisy in their public edicts, are unlikely to urge people to be chaste as a way of warning them to be prudent. “Be careful. AIDS.” And “AIDS. Don’t die of ignorance.” The specific meaning of these generalities to be seen on billboards and in television spots throughout Western Europe for several years (it cannot be long before they are almost as common here) is: Use condoms. But there is a larger meaning in all these messages about being careful, not being ignorant, that will hasten the acceptance of this kind of public service ad in the US as well. Part of making an event real is just saying it, over and over. In this case, to say it over and over is to instill the consciousness of risk, the necessity of prudence as such, prior to and overriding any specific recommendation.
Of course, between the official hypocrisy and the increasingly fashionable libertinism of recent decades there is a vast gap. The view that sexually transmitted diseases are not serious became most widespread in the 1970s, which was also when many male homosexuals came to see themselves as something like an ethnic group, one whose distinctive folk-loric custom was sexual voracity, and the institutions of urban homosexual life became a sexual delivery system of unprecedented speed, efficiency, and volume. Fear of AIDS enforces a much more moderate exercise of appetite, and not just among homosexual men. In the United States sexual behavior before 1981 now seems part of a lost age of innocence—innocence in the guise of licentiousness, to be sure. After two decades of sexual spending, of sexual speculation, of sexual inflation, we are in the early stages of sexual depression. Looking back on the sexual culture of the 1970s has been compared to looking back on the jazz age from the wrong side of the 1929 crash.
One of the messages of the society we live in is: Consume. Grow. Do what you want. Amuse yourselves. The very working of this economic system, which has bestowed such unprecedented liberties, most cherished in the form of physical mobility and material prosperity, depends on encouraging people to defy limits. Appetite is supposed to be immoderate The ideology of capitalism makes us all into connoisseurs of liberty—of the indefinite expansion of possibility. Virtually every kind of advocacy claims to offer first of all or also some increment of freedom. Not every freedom, to be sure. In rich countries freedom has come to be identified more and more with “personal fulfillment”—a freedom enjoyed or practiced by oneself for oneself whatever involvement with others one may have. Hence much of the recent discourse about the body, reimagined as the instrument with which to enact, increasingly, various programs of self-improvement, of the heightening of powers. Given the imperatives about consumption and the virtually unquestioned value attached to the expression of self, how could sexuality not have come to be, for some, a consumer option: an exercise of liberty, of increased mobility, of pushing back limits. Hardly an invention of the male homosexual subculture, recreational sexuality without risk is an inevitable feature of the culture of capitalism, and was guaranteed by medicine as well. The advent of AIDS seems to have changed all that, irrevocably.
AIDS magnifies the force of the quite different yet complementary messages increasingly heard by the people in this society who are accustomed to being able to provide pleasures for themselves. More and more of them are drawn to programs of self-management and self-discipline—diet, exercise. Watch your appetite. Take care of yourself. Don’t let yourself go. Limits have long been set on the indulgence of certain appetites in the name of health or ideal physical appearance—voluntary limits, an exercise of freedom. The catastrophe of AIDS suggests the immediate necessity of limitation, of constraint for the body and for consciousness. But the response to AIDS is more than reactive, more than a fearful, and therefore appropriate, response to a very real danger. It also expresses a positive desire, the desire for stricter limits in the conduct of personal life. There is a broad tendency in our culture, an end-of-an-era feeling, that AIDS is reinforcing; an exhaustion, for some, of purely secular ideals—ideals that seemed to encourage libertinism or at least not provide any coherent inhibition against it—in which the response to AIDS finds its place.
The behavior that AIDS is stimulating is part of a larger often grateful return to what is perceived as “conventions,” like the return to figure and landscape, tonality and melody, plot and character, and other much vaunted repudiations of difficult modernism in the arts. The reduction in the imperative of promiscuity in the middle class, a growth of the ideal of monogamy, of a prudent sexual life, is as marked in, say, Stockholm, with its tiny number of AIDS cases, as it is in New York, where the disease can accurately be called of epidemic proportions. The response to AIDS, while in part entirely rational, amplifies a widespread questioning that had been rising in intensity throughout the 1970s of many of the ideals (and risks) of enlightened modernity; and the new sexual realism goes with the rediscovery of the joys of tonal music, Bouguereau, a career in investment banking, and church weddings.
The mounting panic about the risks of recreational and commercialized sexuality is unlikely to diminish the attractions of other kinds of appetites: boutiques are expected to fill the buildings in Hamburg recently vacated by the Eros Center, which closed for lack of clients. Sexual exchanges are to be carried out only after forethought. Routine consumption of drugs that boost energy for mental work and for verbosity (cocaine use also rose throughout the 1970s among the middle class) has played its part in preparing for the neocelibacy and waning of sexual spontaneity common among the educated in this decade. Machines supply new, popular ways of inspiring desire and keeping it safe, as mental as possible: the commercially organized lechery by telephone (and in France by “Minitel”) that offers a version of anonymous promiscuous sex without physical contact. And strictures about contact now have their place in the computer world as well. Computer users are advised to regard each new piece of software as a “potential carrier” of a virus. “Never put a disk in your computer without verifying its source.” The so-called vaccine programs being marketed are said to offer some protection; but the only sure way to curb the threat of computer viruses, experts agree, is not to share programs and data. The culture of consumption may actually be stimulated by the warnings to consumers of all kinds of goods and services to be more cautious, more selfish. For these anxieties will require the further replication of goods and services.
Epidemics of particularly feared illnesses always provoke an outcry against leniency or tolerance—now identified as laxity, weakness, disorder, corruption: unhealthiness. Demands are made to subject people to “tests,” to isolate the ill and those suspected of being ill or capable of transmitting illness, and to erect barriers against the real or imaginary contamination of foreigners. Societies already administered as garrisons, like China (with a tiny number of detected cases) and Cuba (with a significant number of the already ill), are responding more rapidly and peremptorily. AIDS is everyone’s Trojan horse: six months before the 1988 Olympics the South Korean government announced that it would be distributing free condoms to all foreign participants. “This is a totally foreign disease, and the only way to stop its spread is to stop sexual contacts between Indians and foreigners,” declared the director general of the Indian government’s Council for Medical Research, thereby avowing the total defenselessness of a population nearing a billion for which there are currently no trained hospital staff members or treatment centers anywhere specializing in the disease.
His proposal for a sexual ban, to be enforced by fines and prison terms, is no less impractical as a means of curbing sexually transmitted diseases than the more commonly made proposals for quarantines—that is, for detention. The incarceration in detention camps surrounded by barbed wire during World War I of some thirty thousand American women, prostitutes and women suspected of being prostitutes, for the avowed purpose of controlling syphilis among army recruits, caused no drop in the military’s rate of infection—just as incarceration during World War II of tens of thousands of Americans of Japanese ancestry as potential traitors and spies probably did nothing to prevent espionage or sabotage. That does not mean that comparable proposals for AIDS will not be made, or will not find support, and not only by the predictable people. If the medical establishment has been on the whole a bulwark of sanity and rationality so far, refusing even to envisage programs of quarantine and detention, it may be in part because the dimensions of the crisis still seem limited and the evolution of the disease unclear.
Uncertainty about how much the disease will spread—how soon and to whom—remains at the center of public discourse about AIDS. Will it, as it spreads around the world, remain restricted, largely, to marginal populations: to the so-called risk groups and then to large sections of the urban poor? Or will it eventually become the classic pandemic affecting entire regions? Both views are in fact being held simultaneously. A wave of statements and articles affirming that AIDS threatens everybody is followed by another wave of articles asserting that it is a disease of “them,” not “us.” At the beginning of 1987, the US secretary of health and human services predicted that the worldwide AIDS epidemic would eventually make the Black Death—the greatest epidemic ever recorded, which wiped out between a third and a half of the population of Europe—seem “pale by comparison.” At the end of the year he said: “This is not a massive, widely spreading epidemic among heterosexuals as so many people fear.” Even more striking than the cyclical character of public discourse about AIDS is the readiness of so many to envisage the most far-reaching of catastrophes.
Reassurances are multiplying in the United States and Western Europe that “the general population” is safe. But “the general population” may be as much a code phrase for whites as it is for heterosexuals. Everyone knows that a disproportionate number of blacks are getting AIDS, just as there is a disproportionate number of blacks in the armed forces and a vastly disproportionate number in prisons. “The AIDS virus is an equal-opportunity destroyer” was the slogan of a recent fund-raising campaign by the American Foundation for AIDS Research. Punning on “equal-opportunity employer,” the phrase subliminally reaffirms what it means to deny: that AIDS is an illness that in this part of the world afflicts minorities, racial and sexual. And about the staggering prediction made recently by the World Health Organization that, barring improbably rapid progress in the development of a vaccine, there will be ten to twenty times more AIDS cases in the next five years than there were in the last five, it is assumed that most of these millions will be Africans.
AIDS quickly became a global event—discussed not only in New York, Paris, Rio, Kinshasa but also in Helsinki, Buenos Aires, Beijing, and Singapore—when it was far from the leading cause of death in Africa, much less in the world. There are famous diseases, as there are famous countries, and these are not necessarily the ones with the biggest populations. AIDS did not become so famous just because it afflicts whites too, as some Africans bitterly assert. But it is certainly true that were AIDS only an African disease, however many millions were dying, few outside of Africa would be concerned with it. It would be one of those “natural” events, like famines, which periodically ravage poor, overpopulated countries and about which people in rich countries feel quite helpless. Because it is a world event—that is, because it affects the West—it is regarded as not just a natural disaster. It is filled with historical meaning. (Part of the self-definition of Europe and the neo-European countries is that it, the First World: is where major calamities are history-making, transformative, while in poor, African or Asian countries they are part of a cycle, and therefore something like an aspect of nature.) Nor has AIDS become so publicized just because, as some have suggested, in rich countries the illness first afflicted a group of people who were all men, almost all white, many of them educated, articulate, and knowledgeable about how to lobby and organize for public attention and resources devoted to the disease. AIDS also seems the very model of all the catastrophes privileged populations feel await them.
What biologists and public health officials predict is something far worse than can be imagined or than society (and the economy) can tolerate. No responsible official holds out the slightest hope that the African economies and health services can cope with the spread of the disease predicted for the near future, while every day one can read the direst estimates of the cost of AIDS to the country that has reported the largest number of cases, the United States. Astonishingly large sums of money are cited as the cost of providing minimum care to people who will be ill in the next few years. (This is assuming that the reassurances to “the general population” are justified, an assumption much disputed within the medical community.) Talk in the United States, and not only in the United States, is of a national emergency, “possibly our nation’s survival.” An editorialist at The New York Times intoned last year: “We all know the truth, every one of us. We live in a time of plague such as has never been visited on our nation. We can pretend it does not exist, or exists for those others, and carry on as if we do not know.” And one French poster shows a giant UFO-like black mass hovering over and darkening with spidery rays most of the familiar hexagon shape of the country lying below. Above the image is written: “It depends on each of us to erase that shadow” (Il depend de chacun de nous d’effacer cette ombre). And underneath: “France doesn’t want to die of AIDS” (La France ne veut pas mourir du sida).
Such token appeals for mass mobilization to confront an unprecedented menace appear, at frequent intervals, in every mass society. It is typical of modern society that the demand for mobilization is kept very general and the reality of the response falls well short of what seems to be demanded to meet the challenge of the nation-endangering menace. This sort of rhetoric has a life of its own: it serves some purpose if it simply keeps in circulation an ideal of unifying, communal practice that is precisely contradicted by the pursuit of accumulation and isolating entertainments urged on the society’s citizens.
The survival of the nation, of civilized society, of the world itself is said to be at stake—claims that are a familiar part of building a case for repression. (An emergency requires “drastic measures,” et cetera….) The end-of-the-world rhetoric that AIDS has evoked does inevitably build such a case. But it also does something else. It offers a stoic, finally numbing contemplation of catastrophe. The eminent Harvard historian of science Stephen Jay Gould has declared that the AIDS pandemic may rank with nuclear weaponry “as the greatest danger of our era.” But even if it kills as much as a quarter of the human race—a prospect Gould considers possible—“there will still be plenty of us left and we can start again.” Scornful of the jeremiads of the moralists, a rational and humane scientist proposes the minimum consolation: an apocalypse that doesn’t have any meaning. AIDS is a “natural phenomenon,” not an “event with moral meaning,” Gould points out. “There is no message in its spread.” Of course, it is monstrous to attribute meaning, in the sense of moral judgment, to the spread of an infectious disease. But perhaps it is only a little less monstrous to be invited to contemplate death on this horrendous scale with detachment.
Much of the well-intentioned public discourse in our time expresses a desire to be candid about one or another of the various dangers which might be leading to all-out catastrophe. And now there is one more. To the death of oceans and lakes and forests, the unchecked growth of populations in the poor parts of the world, nuclear accidents like Chernobyl, the puncturing and depletion of the ozone layer, the perennial threat of nuclear confrontation between the super-powers or nuclear attack by one of the rogue states not under super-power control—to all these, now add AIDS. In the countdown to a millennium, a rise in apocalyptic thinking may be inevitable. Still, the amplitude of the fantasies of doom that AIDS has inspired can’t be explained by the calendar alone, or even by the very real danger the illness represents There is also the need for an apocalyptic scenario that is specific to “Western” society. And perhaps even more so to the United States. (America, someone has said, is a nation with the soul of a church—an evangelical church prone to announcing radical endings and brand-new beginnings.) The taste for worst-case scenarios reflects the need to master fear of what is felt to be uncontrollable. It also expresses an imaginative complicity with disaster. The sense of cultural distress or failure gives rise to the desire for a clean sweep, a tabula rasa. No one wants a plague, of course. But, yes, it would be a chance to begin again. And beginning again—that is very modern, very American, too.
AIDS may be extending the propensity for becoming inured to vistas of global annihilation which the stocking and brandishing of nuclear arms has already promoted. With the inflation of apocalyptic rhetoric has come the increasing unreality of the apocalypse. A permanent modern scenario: apocalypse looms…and it doesn’t occur. And it still looms. We seem to be in the throes of one of the modern versions of apocalypse. There is the one that’s not happening, whose outcome remains in suspense: the missiles circling the earth above our heads, with a nuclear payload that could destroy all life many times over, that haven’t (so far) gone off. And there are ones that are happening, and yet seem not to have (so far) the most feared consequences—like the astronomical Third World debt, like overpopulation, like ecological blight; or that happen and then (we are told) didn’t happen—like the October 1987 stock market collapse, which was a “crash,” like the one in October 1929, and was not. Apocalypse is now a long-running serial: not “Apocalypse Now” but “Apocalypse From Now On.” Apocalypse has become an event that is happening and not happening. It may be that some of the most feared events, like those involving the irreparable ruin of the environment, have already happened. But we don’t know it yet, because the standards have changed. Or because we do not have the right indexes for measuring the catastrophe. Or simply because this is a catastrophe in slow motion. (Or feels as if it is in slow motion, because we know about it, can anticipate it; and now have to wait for it to happen, to catch up with what we think we know.)
Modern life accustoms us to live with the intermittent awareness of monstrous, unthinkable—but, we are told, quite probable—disasters. Every major event is haunted, and not only by its representation as an image (an old doubling of reality now, which began in 1839, with the invention of the camera). Besides the photographic or electronic simulation of events, there is also the calculation of their eventual outcome. Reality has bifurcated, into the real thing and an alternative version of it, twice over. There is the event and its image. And there is the event and its projection. But as real events often seem to have no more reality for people than images and to need the confirmation of their images, so our reaction to events in the present seeks confirmation in a mental outline, with appropriate computations, of the event in its projected, ultimate form.
Future-mindedness is as much the distinctive mental habit, and intellectual corruption, of this century as the history-mindedness that, as Nietzsche pointed out, transformed thinking in the nineteenth century. Being able to estimate how matters will evolve into the future is an inevitable byproduct of a more sophisticated (quantifiable, testable) understanding of process, social as well as scientific. The ability to project events with some accuracy into the future enormously augmented what power consisted of, because it was a vast new source of instructions about how to deal with the present. But in fact the look into the future, which was once tied to a vision of linear progress, has, with more knowledge at our disposal than anyone could have dreamed, turned again and again into a vision of disaster. Every process is a prospect, and invites a prediction bolstered by statistics. Say: the number now…in three years, in five years, in ten years; and, of course, at the end of the century.
Anything in history or nature that can be described as changing steadily can be seen as heading toward catastrophe. (Either the too little and becoming less: waning, decline, entropy. Or the too much, ever more than we can handle or absorb: uncontrollable growth.) Most of what experts pronounce about the future contributes to this new, double sense of reality—beyond the doubleness to which we are already accustomed by the comprehensive duplication of everything in images. There is what is happening now. And there is what it portends: the imminent, but not yet actual, and not really graspable, disaster.
Two kinds of disaster, actually. And a gap between them, in which the imagination flounders. The difference between the epidemic we have and the pandemic that we are promised (by current statistical extrapolations) feels like the difference between the wars we have, so-called limited wars, and the unimaginably more terrible ones we could have, the latter (with all their appurtenances of science fiction) being the sort of activity people are addicted to staging for fun, as electronic games. For beyond the real epidemic with its inexorably mounting death toll (statistics are issued by national and international health organizations every week, every month) is a qualitatively different, much greater disaster which we think both will and will not take place. Nothing is changed when the most appalling estimates are revised downward, temporarily, which is an occasional feature of the display of speculative statistics disseminated by health bureaucrats and journalists. Like the demographic predictions, which are probably just as accurate, the big news is usually bad.
A proliferation of reports or projections of unreal (that is, ungraspable) doomsday eventualities tends to produce a variety of reality-denying responses. Thus, in most discussions of nuclear war-fare, being “rational” (the self-description of experts) means not acknowledging the human reality, while taking in emotionally even a small part of what is at stake for human beings (the province of those who regard themselves as the menaced) means insisting on unrealistic demands for the rapid dismantling of the peril. This split of public attitude, into the inhuman and the all-too-human, is much-less stark with AIDS. Experts denounce the stereotypes attached to people with AIDS, and to the continent where it is presumed to have originated, emphasizing that the disease belongs to much wider populations than the groups initially at risk, and to the whole world, not just to Africa.9 For while AIDS has turned out, not surprisingly, to be one of the most meaning-laden of diseases, along with leprosy and syphilis, clearly there are checks on the impulse to stigmatize people with the disease. The way in which the illness is such a perfect repository for people’s most general fears about the future to some extent renders irrelevant the predictable efforts to pin the disease on a deviant group or a dark continent.
Like the effects of industrial pollution and the new system of global financial markets, the AIDS crisis is evidence of a world in which nothing important is regional, local, limited; in which everything that can circulate does, and every problem is, or is destined to become, worldwide. Goods circulate (including images and sounds and documents, which circulate fastest of all, electronically). Garbage circulates: the poisonous industrial wastes of St. Etienne, Hanover, Mestre, and Bristol are being dumped in the coastal towns of West Africa. People circulate, in greater numbers than ever. And diseases. From the untrammeled intercontinental air travel for pleasure and business of the privileged to the unprecedented migrations of the underprivileged from villages to cities and, legally and illegally, from country to country—all this physical mobility and interconnectedness (with its consequent dissolving of old taboos, social and sexual) is as vital to the maximum functioning of the advanced, or world, capitalist economy as is the easy transmissibility of goods and images and financial instruments. But now that heightened, modern interconnectedness in space, which is not only personal but social, structural, is the bearer of a health menace sometimes described as a threat to the species itself; and the fear of AIDS is of a piece with attention to other unfolding disasters that are the byproduct of advanced society, particularly those illustrating the degradation of the environment on a world scale. AIDS is one of the dystopian harbingers of the global village, that future which is already here and always before us, which no one knows how to refuse.
That even an apocalypse can be made to seem part of the ordinary horizon of expectation constitutes an unparalleled violence that is being done to our sense of reality, to our humanity. But it is highly desirable for a specific dreaded illness to come to seem ordinary. Even the disease most fraught with meaning can become just an illness. It has happened with leprosy, though some ten million people in the world, easy to ignore since almost all live in Africa and the Indian subcontinent, have what is now called, as part of its wholesome dedramatization, Hansen’s disease (after the Norwegian physician who, over a century ago, discovered the bacillus). It is bound to happen with AIDS, when the illness is much better understood and, above all, treatable. For the time being, much in the way of individual experience and social policy depends on the struggle for rhetorical ownership of the illness: how it is possessed, assimilated in argument and in cliché. The age-old, seemingly inexorable, process whereby diseases acquire meanings (by coming to stand for people’s deepest fears) and inflict stigma is always worth challenging, and it does seem to have more limited credibility in the modern world; the process itself is being questioned now. With this illness, one that elicits so much guilt and shame, the effort to detach it from loaded meanings and misleading metaphors seems particularly liberating, even consoling.
October 27, 1988
As noted in the first accounts of the disease: “This malady received from different peoples whom it affected different names,” writes Giovanni di Vigo in 1514. Like earlier treatises on syphilis, written in Latin—by Nicolo Leoniceno (1497) and by Juan Almenar (1502)—the one by di Vigo calls it morbus gallicus, the French disease. (Excerpts from this and other accounts of the period, including Syphilis: Or a Poetical History of the French Disease  by Girolamo Fracastoro, who coined the name that prevailed, are in Classic Descriptions of Disease, edited by Ralph H. Major .) Moralistic explanations abounded from the beginning. In 1495, a year after the epidemic started, the Emperor Maximilian issued an edict declaring syphilis to be an affliction from God for the sins of men.
The theory that syphilis came from even farther than a neighboring country, that it was an entirely new disease in Europe, a disease of the New World brought back to the Old by sailors of Columbus who had contracted it in America, became the accepted explanation of the origin of syphilis in the sixteenth century and is still widely credited. It is worth noting that the earliest medical writers on syphilis did not accept this dubious theory. Leoniceno’s Libellus de Epidemia, quam vulgo morbum Gallicum vocant starts by taking up the question of whether “the French disease under another name was common to the ancients,” and says he believes firmly that it was. ↩
The rumor may not have originated as a KGB-sponsored “disinformation campaign,” but it received a crucial push from Soviet propaganda specialists. In October 1985 the Soviet weekly Literaturnaya Gazeta published an article alleging that the AIDS virus had been engineered by the US government during biological warfare research at Fort Detrick, Maryland, and was being spread abroad by US servicemen who had been used as guinea pigs. The source cited was an article in the Indian newspaper Patriot. Repeated on Moscow’s “Radio Peace and Progress” in English, the story was taken up by newspapers and magazines throughout the world. A year later it was featured on the front page of London’s conservative, mass-circulation Sunday Express. (“The killer AIDS virus was artificially created by American scientists during laboratory experiments which went disastrously wrong—and a massive cover-up has kept the secret from the world until today.”) Though ignored by most American newspapers, the Sunday Express story was published in virtually every other country. As recently as the summer of 1987 it appeared in newspapers in Kenya, Peru, Sudan, Nigeria, Senegal, and Mexico. Gorbachev-era policies have since produced an official denial of the allegations by two eminent members of the Soviet Academy of Sciences, which was published in Izvestia in late October 1987. But the story, according to many reports, is still being repeated—from Mexico to Zaire, from Australia to Greece. ↩
According to the more comprehensive diagnosis favored by secular reformers, cholera was the result of poor diet and “indulgence in irregular habits.” Officials of the Central Board of Health in London warned that there were no specific treatments for the disease, and advised paying attention to fresh air and cleanliness, though “the true preventatives are a healthy body and a cheerful, unruffled mind.” Quoted in R.J. Morris, Cholera, 1832 (Holmes and Meier, 1976). ↩
Quoted in Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (University of Chicago Press, 1962). ↩
As recently as 1983 the historian William H. McNeill, author of Plagues and Peoples, started his review of a new history of the Black Death by asserting: “One of the things that separate us from our ancestors and make contemporary experience profoundly different from that of other ages is the disappearance of epidemic disease as a serious factor in human life” (The New York Review, July 21, 1983). The Eurocentric presumption of this and similar statements hardly needs pointing out. ↩
Reagan’s affirmation through cliché of the frightening reality of a disease of other people contrasts with his more original denial of the reality of his own illness. When asked how he felt after his cancer operation, he declared: “I didn’t have cancer. I had something inside of me that had cancer in it and it was removed.” ↩
The reason that a vaccine is considered the optimal response to viruses has to do with what makes them “primitive.” Bacteria have many metabolic differences from mammalian cells and can reproduce outside the cells of their host, which makes it possible to find substances that target them specifically. With viruses, which bond with their host cells, it is a much more difficult problem to distinguish viral functions from normal cellular ones. Hence, the main strategy for controlling viral infections has been the development of vaccines, which do not “attack” a virus directly (as penicillin attacks infectious bacteria) but “forestall” infection by stimulating the immune system in advance. ↩
The other side of this refusal to give instructions about practices that would be less risky was the feeling that there was something less than manly in submitting one’s sexual life to the guidelines of safety and prudence. According to Hemingway’s fantasy, in Death in the Afternoon (1932): “Syphilis was the disease of the crusaders in the middle ages. It was supposed to be brought to Europe by them, and it is a disease of all people who lead lives in which disregard of consequences dominate. It is an industrial accident, to be expected by all those who lead irregular sexual lives and from their habits of mind would rather take chances than use prophylactics and it is a to-be-expected end, or rather phase, of the life of all fornicators who continue their careers far enough.” ↩
“AIDS cannot be stopped in any country unless it is stopped in all countries,” declared the retiring head of the World Health Organization in Geneva, Dr. Halfdan Mahler, at the Fourth International Conference on AIDS (Stockholm, June 1988), where the global character of the AIDS crisis was a leading theme. “This epidemic is worldwide and is sparing no continent,” said Dr. Willy Rozenbaum, a French AIDS specialist. “It cannot be mastered in the West unless it is overcome everywhere.” In contrast to the rhetoric of global responsibility, a specialty of the international conferences, is the view, increasingly heard, in which AIDS is regarded as a kind of Darwinian test of a society’s aptitude for survival, which may require writing off those countries that can’t defend themselves. A German AIDS specialist, Dr. Eike Brigitte Helm, has declared that it “can already be seen that in a number of parts of the world AIDS will drastically change the population structure. Particularly in Africa and Latin America. A society that is not able, somehow or other, to prevent the spread of AIDS has very poor prospects for the future.” ↩