Monday, November 23, 2009


"Since bacteriologists and their advocates worked to locate, record, and track carriers, rather than to alleviate the conditions in which diseases like typhoid flourished, [Mendlesohn] argues, the carrier state they theorized maintains, as it exemplified, the bifurcation between the scientific and the social." (78)

The story of Typhoid Mary, Wald argues, is fundimentally one of "the metamorphosis from an individual to a social being" (78). The individual is monitored for the sake of the whole (nation), and removed from 'free' individual existence so they may be placed under the careful watch of experts, who will contain the disease. The monitoring of individuals is not something that simply takes place on a higher level; it manipulates the national affect to instill each individual with a sense of duty for the greater nation, to keep themselves clean and watch for potential outbreaks.

The sort of dissonances in the figure of the 'individual' here is quite bizarre. At each level, individual bodies are threatened by the outside; the individual is both a 'responsible citizen' and a global threat requiring containment; the nation is dependent on outsiders, immigrants, for diversity and population health, but faces the danger of microbes potentially carried by these people; the individual nation's "recognizable self" is threatened: "the sovereignty, the home, and, by extension, the larger community, the nation, by which that 'self' is defined" (82).

As mentioned above, Wald attributes these dissonances to a metamorphosis from the individual to social being that takes place the moment a carrier is infected; it is in this sense that Mendlesohn's argument comes into play, as we can now see that, indeed, the existence of discreet contagions is completely ignored in the arguments above, as the actual disease can only be represented in the social being as a node within the social being, an individual. This approach misses "structural inequalities" (to borrow a term used often by students met in D.C.) that literally breed the diseases; as a sort of probabilistic sink that one enters or is born into, poverty creates a certain set of conditions around the individual that can probably not be escaped (but could certainly be appropriated), a set of conditions that generally tends to be conducive to disease. (Note: it is in this sense that Wald reveals herself as a liberal following Thomas Pogge, who sought to explore Rawls' assertion that the institutions of society should always be most beneficial to the least advantaged people, to equalize natural contingencies)

So the problem is in the way the system of global health is constructed, the various initial rules being used to describe it. So, two questions: first, how can the medical world construct a new outbreak system to deal with said structural inequalities, and second, how can one find a general set of rules to revise systems broken by their ignorance of various social forces? Yes, a perfect system is impossible, but exploring methods of revising systems to cohere with morality could have some powerful consequences.

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