On June 3rd, 2019, The New York Times reported on the largest measles outbreak in the United States in 25 years. An article in Popular Science explains how pockets of outbreaks were predictable, due to low vaccination rates. The efficacy of debate and education through social media platforms is questionable, but one thing is clear: possessing zero understanding of another’s perspective is not helpful. You can’t bludgeon another person into believing as you do or engender agreement through insult. Understanding cultural fears, and how fear and anxiety produce attitudes, is where we must begin in order to effect change. We must understand the relationships between fear, trust, power, and perceptions of risk. Do you have anti-vaxxers in your life? If yes, then you must read On Immunity: An Inoculation, by Eula Biss. This book is a salve for our times and a tool for change.
On Immunity: An Inoculation is about vaccination; yet, this is an oversimplification. More broadly, Biss addresses our culture’s fear and anxiety. As an essayist, Biss blends memoir with scholarship, channeling New Journalists such as Joan Didion, and confessional poets, such as Sylvia Plath and Adrienne Rich. Despite, or because of, her use of personal experience and subjective emotion, Biss interrogates our collective fears with rigor. Why do many people believe that public health measures are not meant for people “like them”? What is the relationship between risk and fear? Ultimately, this book is an investigation into the mechanisms of trust and power, and the concepts of self and other. Calling on thinkers and cultural products including mythology, Dracula, Kant, Marx, Star Trek, Haraway, Sontag, medical historians, legal scholars, and government reports, among others, Biss presents a careful critique of recent fears, calling on us to examine cultural myths and their persistence.
In an interview in The Rumpus, Biss explains, “Both of my last two books have been interested in fear, in our tendency to fear things that don’t pose us a threat and interested in where fear intersects with other attitudes, like racism — where fear is a product of racism or an extension of racism or a complement to racism.” In addition to tracing the history of inoculation and vaccination, throughout On Immunity Biss explores the fear of vaccines, the meaning of trust, the problems of evidence and truth, perceptions of risk, and the embodiment of public health goals: “There is some truth, now, to the idea that public health is not strictly for people like me, but it is through us, literally through our bodies, that certain public health measures are enacted” (28). Vaccination is a space that defies conventional ideas of borders and boundaries: between bodies, and between bodies and the environment. Biss argues, “we are no cleaner, even at birth, than our environment at large. We are already polluted” (76). The concept that bodies have boundaries and borders is incomplete, as is the binary understanding of natural and unnatural. Biss writes, “Vaccination is a kind of domestication of a wild thing, in that it involves our ability to harness a virus and break it like a horse, but its action depends on the natural response of the body to the effects of that once-wild thing” (41). The misunderstanding of the self as a pure, bound individual fuels paranoia of contamination by the other. Biss explains, “But risk perception may not be about quantifiable risk so much as it is about immeasurable fear. Our fears are informed by history and economics, by social power and stigma, by myths and nightmares” (37). In tracing the implications of these misunderstandings of bodily purity and nature, Biss articulates a more nuanced understanding of vulnerability and the danger of bodies. Accurately understanding this vulnerability and danger is necessary for understanding immunity and inoculation.
The book consists of a series of many brief unmarked sections, linked together by repeated themes and overlapping topics. Like the intellectual investigation within the book, the shape of the text is multi-faceted. Topical investigations are framed by personal experience, situating the writer’s entry into the research. In addition to memoir, Biss takes the reader through a dearth of history and scholarship. Biss writes about motherhood, “I was not prepared for the labyrinthine network of interlocking anxieties I would discover during my pregnancy, the proliferation of hypotheses, the minutia of additives, the diversity of ideologies” (23); it is this network, this proliferation, that Biss analyzes.
The combination of memoir and scholarship may strike uninitiated readers unfavorably, but the work is brilliant. Commenting on a critique of her approach, Biss explains in an interview, “In trying to talk about fear and anxiety I’m coming close to a prejudice that people have about women, and once you get close to that, people cease to be able to see clearly, and the prejudice consumes whatever is happening on the page.” In short, if readers bristle at personal contemplation, at the nuances of daily motherhood, they should assess their relationship with the stereotype of the hysterical mother. Expecting great thinkers to silence or obfuscate their subjective position in the world is wrongheaded; mother and scholar, mother and thinker, mother and cultural critical are not mutually exclusive pairings. Embracing and showcasing the entirety of one’s intellect — the approach of Biss, along with other essayists such as Leslie Jamison and Maggie Nelson — is political. It shouldn’t have to be, but it simply is because of all that has come before. Academic and scholarly conventions are only conventions. Especially, conventions do not lay claim to knowledge-creation or effective communication.
The short sections of prose may at first seem fragmented, but ultimately Biss creates a deep, abiding synthesis of the fears and cultural myths in our society, a synthesis peppered with critique and careful contemplation. A keen observer and researcher, Biss examines metaphors around immunity throughout time: vampirism, the herd, a factory, and war, among others. Biss explains in The Rumpus, “I got into the metaphors in part because I wanted to expose them as flawed or problematic metaphors. And this goes back to Susan Sontag who made the point that if we’re thinking about something through a metaphor that’s flawed, our thinking is going to be flawed. And so I wanted to expose some of these metaphors as inaccurate and bad tools.” Broadly, Biss examines vampirism in popular culture. Specifically, Bram Stoker’s Dracula provides a cohesive thread throughout the book; in this way, Biss traces our collective fears and anxieties through multiple aspects of culture, deepening our understanding of how these fears manifest around vaccination.
The cover of On Immunity: An Inoculation, is an early seventeenth century painting, “Achilles Dipped in the River Styx.” The image of Achilles’ mother attempting to protect his body, but leaving his heel vulnerable, reflects the fears of motherhood that Biss weaves throughout the book. The mother, individually, attempts to protect the infant, but her attempt is incomplete. Similarly, Biss highlights the massive volume of information out in the world and the collaboration required to evaluate it; one individual cannot assess it all. Adding to this necessary collaboration, Biss contributes an inoculation against misinformation, which she names in the subtitle of the book.
Disease and information both wield power, both incite fear, but it’s important to remember that “We are each other’s environment. Immunity is a shared space” (163). Examining history and facts is valuable, but so is interrogating cultural beliefs and patterns of thought: “What will we do with our fear? This strikes me as a central question of both citizenship and motherhood” (152). An inoculation: this book is a resource for readers in their own lives, which sets it apart from many books about medical history. Lucky for us, Biss forges a new path in the genre.
Biss, Eula. On Immunity: An Inoculation. Minneapolis, MN, Graywolf Press, 2014.
Koven, Suzanne. “The Big Idea: Eula Biss.” The Rumpus. 17 November 2017.