I recently finished reading Eula Biss’ award-winning On Immunity: An Inoculation.
A confession: at one point, I bought only expensive dairy products at Whole Foods because I was skeptical of our local dairy industry. I thought, if I paid more for my yoghurt, the cows would be treated better. I also thought: “It can’t be good for me, to eat another animal’s pain – when they’re in pain, maybe they produce some substance that’s bad for me to ingest.” As though pain were like DDT.
It’s not.
My intentions, of course, were good: I love dairy products and have a passing knowledge of industrial farming. I felt some guilt about what it takes to create dairy, and when I read one story about possible animal cruelty within regular farming practices, I wanted to assuage that guilt. (In hindsight, a slight paranoid overreaction.)
Turns out, there are too many unknowns to be able to assuage one’s guilt fully; and some market factors one cannot control besides. Whole Foods, despite marketing campaigns full of rhetoric about sustainability and social responsibility, is a for-profit company whose shares you can buy on the NASDAQ. It’s a nice shopping experience and it’s beautiful in there, but, at the end of the day, it’s a fancy grocery store selling expensive products to relatively high-earning people who want things that seem “healthy” or “pure”.
Many, many people cannot afford to shop at Whole Foods: does this make them less pure or less healthy? Should they feel guilty about consuming cheaper dairy? In making the choice to shop at Whole Foods so I could feel better about my food choices, I’d determined my choice was superior to Suzy Q’s, with her Wal-Mart milk.
I was also making this choice despite having conducted an evaluation of the production of regular grocery store dairy products vs. the production of Whole Foods dairy products. I believed the Whole Foods marketing without having done any independent evaluation myself.
I was being an ignorant snob, in other words, and Whole Foods was laughing all the way to the bank.
I still like shopping at Whole Foods sometimes. But I do it now because I like it or it’s convenient, and I’m a little embarrassed that I do. It’s hardly an act of altruism; it’s because I like nice things, like their hot food bar macaroni and cheese, which is a dream. I don’t give a flying fig if it’s organic or not.
I tell you this now so you know: before I’d read On Immunity, I’d done a fair amount of thinking about ideas of “purity” and “health”, as well as about vaccines. Not only have I received countless vaccines, I’d also heard enough terrible stories to give me a healthy respect for them. When my much-older aunt had to stay home from school because there was no polio vaccine yet and there’d been an outbreak. When my father had meningitis as a baby and my grandmother was terrified she’d lose him. Who wouldn’t jump at the chance to be spared that?
On Immunity is long, reflective and unstructured; it explores many aspects of vaccines, health, and vaccine-deniers. Vaccines, which can be seen as unnatural or foreign, work for two reasons: 1) because our immune systems respond to them (and what a wonder that is! that our immune systems will learn to protect us when exposed to that which would do us harm!) and 2) because our bodies are not our own; we are connected. We may have the illusion of independence, but we are not: we need food to eat, we need water to drink, we needed the cells from at least 2 other humans to be created, “we have more microorganisms in our guts than we have cells in our bodies”, and when many bodies have immunity against a disease, they can prevent its spread, moreso than one body can alone. “Vaccination works… by enlisting a majority in the protection of a minority.” Biss offers, before writing this:
Immunity is a public space. And it can be occupied by those who choose not to carry immunity. For some of the mothers I know, a refusal to vaccinate falls under a broader resistance to capitalism. But refusing immunity as a form of civil disobedience bears a striking resemblance to the very structure the Occupy movement seeks to disrupt – a privileged 1 percent are sheltered from risk while they draw resources from the other 99 percent.
Damn, girl. Right? Those are some strong words. She doesn’t open with that, of course – she’s much more thoughtful and gentle – but there it is.
Biss looks at why some might feel they are immune from disease already, despite not having been immunized. She also looks at why some are afraid of vaccines themselves, and at length on what we consider “toxins”.
She writes thoughtfully of the Hepatitis B vaccine, which some have questioned a need for. Prior to giving birth to her son, Biss visited a pediatrician and asked about the vaccine. “Hep B was a vaccine for the inner city, he told me, designed to protect the babies of drug addicts and prostitutes. It was not something, he assured me, that people like me needed to worry about.”
She reflects:
The belief that public health measures are not intended for people like us is widely held by people like me. Public health, we assume, is for people with less – less education, less healthy habits, less access to quality health care, less time and money.
Yet, this belief persists in spite of evidence to the contrary:
One of the mysteries of hep B immunization is that vaccinating only “high risk” groups, which was the original public health strategy, did not bring down rates of infection. When the vaccine was introduced in 1981, it was recommended for prisoners, health care workers, gay men, and IV drug users. But rates of hep B infection remained unchanged until the vaccine was recommended for all newborns a decade later. Only mass vaccination brought down the rates of infection, and it has now virtually eliminated the disease in children.
The concept of a “risk group” Susan Sontag writes, “revives the archaic idea of a tainted community that illness has judged.” Risk, in the case of hep B, turns out to be a rather complicated assessment. There is risk in having sex with just one partner, or travelling through the birth canal. In many cases, the source of infection is never known. I decided, before I knew how much blood I would lose in childbirth, that I did not want my son to be vaccinated against hep B. I did not belong to a risk group at the moment he was born, but by the time I put him to my breast I had received a blood transfusion and my status had changed.
The example is stark: Biss became high-risk not because she lived a certain lifestyle, but because she received a blood transfusion during a medical emergency. So it’d be easy to think: “That won’t happen to me; I’m above that. What are the odds that I’d need a blood transfusion?”
But we’ve seen that vaccinating only “high risk” groups does not work. We cannot profile for risk – it affects us all. And when something terrible happens, you’ll be thankful blood banks and blood donors exist – you’re not going to care if the meat they ate was hormone-free.
The Sontag quote mentions an “idea of a tainted community that illness has judged”. Later, Biss writes of attitudes towards the AIDS epidemic: “All of us who grew up during the AIDS epidemic were exposed to the idea that AIDS was a punishment for homosexuality, promiscuity, and addiction.” Perhaps the AIDS epidemic, and attitudes towards it, have influenced attitudes towards vaccination, she proposes: I myself am still uncomfortable with needles, and I wonder if it’s a vestige of my childhood fear of the epidemic, when it was repeated “needles are dirty, needles are dirty”. (No heroin for me, guys.)
On some level, many think they can control for illness. Biss links that to the AIDS epidemic directly, but the attitude is widespread. She writes: “I am healthy, we tell each other, meaning that we eat certain foods and avoid others, that we exercise and do not smoke. Health, it is implied, is the reward for living the way we live, and lifestyle is its own variety of immunity.”
Many healthy people believe they are in control of their own bodies; that the choices they make will make them stronger. Sometimes this is true. Like your immune system trains to fight a virus by practicing with a vaccine, your muscles will respond to training – you can run or bike faster with practice. You can lose or gain weight with diet. What you consume can affect you (hello, scurvy).
For pregnant women, of course, this is especially true. Pregnant women are especially connected to others; history is full of stories of pregnant women inadvertently harming their unborn by drinking alcohol to excess (though we don’t know exactly how much that is), or taking the wrong medication (thalidomide, my God!). What they consume can do particular types of lifelong harm. It’s terrifying.
“Intuitive toxicology”, an oxymoron if there ever was one, is a term used to describe how many people assess the risk of substances – what is, and what isn’t “toxic”. For toxicologists, any substance can be toxic in excess – even water. “But most people prefer to think of substances as either safe or dangerous, regardless of the dose. And we extend this thinking to exposure, in that we regard any exposure to chemicals no matter how brief or limited, as harmful.” Biss notes. Many fear vaccines because of the chemicals in them, like traces of formaldehyde, which is naturally occurring and already exists in us in small doses.
“The pollutants we have come to fear most” Biss writes, “are the products of our own hands. Though toxicologists tend to disagree with this, many people regard natural chemicals as inherently less harmful than man-made chemicals. We seem to believe, against all evidence, that nature is entirely benevolent.”
“I had already practiced some intuitive toxicology before my pregnancy, but I became thoroughly immersed in it after my son was born. As long as a child takes only breast milk, I discovered, one can enjoy the illusion of a closed system, a body that is not yet in dialogue with the impurities of farm and factory.” Biss confides, yet: “Our breast milk is as polluted as our environment at large.”
Because nothing, not even breast milk, is formed in isolation. It contains microscopic amounts of whatever is in us, which is everything. Which is why, to a certain extent, tropes like “natural”,”organic” or “toxic” can be very flawed.
Indeed – I thought about this when I stopped regularly shopping at Whole Foods and Farmers’ Markets. I’d not wanted to contribute to the pollutants affecting marine life in waterways – the nitrates from fertilizers that caused algae blooms that ultimately killed fish and other life. I thought organic produce wouldn’t do such a thing.
But organic fertilizers (like manure, compost, or bone meal), contain nitrates too. I didn’t know my chemistry. “Natural”, “Organic” and “Toxic” have fluid definitions, depending on their contexts.
After all, as Biss notes, disease itself is “natural”: “It is only when disease manifests itself as illness that we see it as unnatural… When a child’s fingers blacken on his hand from Hib disease, when tetanus locks a child’s jaw and stiffens her body, when a baby barks for break from pertussis… then disease does not seem natural.”
For me, this passage from On Immunity was moving:
… the word toxic now condemns the chemical evils of our industrial world. This is not to say that our concerns over environmental pollution are not justified – like filth theory, toxic theory is anchored in legitimate dangers – but that the way we think about toxicity bears some resemblance to the way we once thought about filth. Both theories allow their subscribers to maintain a sense of their own health by pursuing personal purity.
Then:
Purity, especially bodily purity, is the seemingly innocent concept behind a number of the most sinister social actions of the past century. A passion for bodily purity drove the eugenics movement that lead to the sterilization of women who were blind, black or poor… Quite a bit of human solidarity has been sacrificed in pursuit of preserving some kind of imagined purity.
How? Well, as she’s offered several pages before, “paranoia very frequently passes for intelligence.”
It was excellent, the book was excellent – even for people like me, who have little patience for the vaccine skeptics who are her target audience. It was excellent even for people like me who already roll their eyes when they see “non-toxic” on a label, as though the FDA and Health Canada don’t exist. (They must do their job so well, people have forgotten they’re there?)
I mentioned a couple of weeks ago that we’d been following a case here, about a little boy who’d died of meningitis. The details are gruesome – meningitis is a terrible disease – and apart from not having him vaccinated for that illness, his parents sought only naturopathic treatment once he had fallen ill – giving him hot peppers, garlic and horseradish – instead of antibiotics or anti-inflammatories.
Of course, it made me think of my grandmother’s distress, and the impulse I’d have, to throw everything I could at my son’s disease: whatever the doctor prescribed; whatever the child would eat or drink; blood, sweat, tears, prayer, hysterical wailing in the hospital parking lot.
Using only horseradish, garlic and prayer to treat such a grave illness made me think again of Neil deGrasse Tyson: “The good thing about science is that it’s true whether or not you believe in it.”
The couple was convicted of failing to provide the necessaries of life for their son.
Biss writes:
“One the the appeals of alternative medicine is that it offers not just an alternative philosophy or an alternative treatment, but an alternative language. If we feel polluted, we are offered a ‘cleanse’. If we feel inadequate, lacking, we are offered a ‘supplement’. If we fear toxins, we are offered ‘detoxification’…
“Most of the pharmaceuticals available to us are at least as bad as they are good… True as it may be, 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. This word implies a medicine untroubled by human limitations, contrived wholly by nature or God or perhaps intelligent design. What natural has come to mean to us in the context of medicine is pure and safe and benign. But the use of natural as a synonym for good is almost certainly a product of our profound alienation from the natural world. “
Anything can be “natural”, everything can be “toxic”, nothing is “pure” – not even a newborn child, covered in life-giving bacteria and messy fluids. Words like “purity”, “toxic” and “healthy” are often not used scientifically – they are not precise.
I’ve said before that so much of science, as I see it, is anchored by a love of humanity in all its forms. Why else would anyone seek any “cure” for what ails us? Why would anyone apply a method to rigorously assess why a group is getting sick, and not simply say: “they’re being punished for homosexuality!”
What, precisely, makes this milk “better” than that milk? What will this milk do for our bodies that that milk won’t? What will this substance do to our bodies that that substance won’t?
And we learn this, together, through testing. Many bodies testing, over and over. To learn things, we must band together – just as our bodies must band together to stop the spread of a disease, all the impurities, imperfections and toxins among us.
