Thanks to The School of Writing at The New School, as well as the tireless efforts of their students and faculty, we are able to provide interviews with each of the NBCC Awards Finalists for the publishing year 2014 in our 30 Books 2014 series.
Haley Sledge, on behalf of the The School of Writing at The New School and the NBCC, interviewed Eula Biss about her book On Immunity: An Inoculation (Graywolf Press), which is among the final five selections, in the category of Criticism, for the 2014 NBCC awards.
Haley Sledge: I was first introduced to On Immunity in a graduate seminar. We’d just finished another book of yours, Notes from No Man’s Land, which was also nominated for an NBCC award — and won. Our professor, Craig Morgan Teicher, gave us xeroxed copies of the first few sections of On Immunity, including the part where you assert that we “owe each other our bodies,” which becomes a major concept and point of investigation in your discussion of vaccination. If you have always acknowledged your body’s role in, and, thus, responsibility to your community, where did that originate from? How does this assertion inform or influence discussions of bodily autonomy and control, specifically in regards to feminist discussions concerning our culture of entitlement towards women’s bodies?
Eula Biss: In Notes from No Man’s Land, I was already thinking about the question of what we owe each other, but I don’t think I had fully arrived at this idea that we owe each other our bodies. It is, I think, such a challenging idea that it took me some time to get there. And yes, like you, I struggled with what this idea might mean for women. When I immersed myself in anti-vaccine literature, I began to notice that some of the stories I was reading resembled date-rape narratives. These were stories told by women who regretted that their children had been vaccinated and the stories often included a phrase like, “I said no, but it was too late,” or “I didn’t want it, but I didn’t say anything because I was afraid.” And, indeed, the whole concept of “consent” in the context of vaccination is quite charged. Vaccination does involve a penetration, and it can trigger our feelings about other unwelcome penetrations. But when I say “we owe each other our bodies” I don’t mean that we owe other people trespasses on our bodies. What I mean is something more along the lines of, “we all live downstream.” I mean that we only have our bodies because of the debts we owe to other bodies. I also mean that if we hold a belief, a value, an ideal — a commitment to social justice, for instance — we must enact that belief through our bodies. And this enactment can be empowering. I once felt like something was being done to me when I was vaccinated, but I now think of it as something I’m doing — a choice I’m making that is aligned with my personal ethics.
But yes, this question of autonomy is challenging. Being pregnant and going through childbirth and breastfeeding changed the way I conceived of my bodily autonomy. When a vulnerable person is dependent on your body, you do lose some autonomy. Or, more accurately, you lose some of the illusion of autonomy. For me, motherhood was a clarifying experience. It helped me see how caring for other people, and sustaining other people, can call our bodies into service in ways that are sometimes uncomfortable. And this brings us back to the conundrum at the heart of your question — our bodies belong to us, and they do not belong to us. This paradox can be especially complicated for those of us who have known sexual subjugation, or those of us who are living the legacy of slavery. But understanding, intimately, what it is to be bodily vulnerable can inspire us to align ourselves with other vulnerable groups — those who are HIV positive, those who are very young, those who are very old, etc. This is where vaccination becomes socially radical.
From the beginning, I conceived of On Immunity as a conversation with other women about, among other things, sexism. There is a culture of entitlement, as you say, toward women’s bodies, but one way to resist that culture, for us, as women, is to refuse to act entitled to other people’s bodies. To refuse, for example, to assume that other people should bear the burden of a system that keeps us all free from disease.
HS: One vaccine that I’m particularly interested in, especially as it relates to the previous question, but that you only briefly touch on in the book is the HPV vaccine. Did it feature prominently in your research, or were you more concerned with early childhood vaccinations? What are your thoughts on the controversy surrounding the vaccine, specifically, the fear that receiving the vaccine will encourage promiscuity? What about the vaccine’s marketing targeting young women more than young men?
EB: I did do some research on HPV, in part because I’m interested in viruses that cause cancer. A number of viruses, including HPV and hep B, are carcinogenic. But what is unique about HPV is that it is the sole cause of cervical cancer. In this country, about 12,000 new cases of cervical cancer are diagnosed each year and about 4,000 women die from it every year. Some people don’t think that’s a significant enough number of deaths for us to vaccinate against HPV. But, as an oncologist told me, “You only have to see one case of cervical cancer to be convinced that one case is too many.”
When people get diagnosed with cancer, their communities often rally around them, offering money and food and other help. In the same spirit, we can rally around women before they develop cervical cancer by shielding them from HPV through widespread use of the vaccine in both girls and boys. The vaccine does have benefits for boys, in that it can help prevent throat cancer, but I also think it’s an opportunity for boys to participate in women’s health.
I can think of about a thousand things that strike me as more likely to inspire sexual activity than getting a vaccine, but that fear is out there. And it’s prevalent enough that a study was done to determine whether vaccinated girls engage in sex earlier or more frequently than their unvaccinated peers — they do not.
HS: I can’t help but feel that there is a connection between the history of women’s experience with medicine and women resisting the vaccination of their children. How much, do you think, of that particularly dark history, in conjunction with contemporary women’s experiences — especially concerning gynecological care before children and obstetric care — informs their decision to vaccinate?
EB: Very much. Even those of us who are not very familiar with the history of how women’s bodies have been treated by physicians (with menstruation, pregnancy, and menopause all being regarded, at one point or another, as forms of dysfunction or disease) have sensed that history in the way our bodies are now treated in medical contexts. I saw a midwife for all my prenatal care, but that didn’t save me from being told at one point that I wasn’t gaining enough weight and told at another point that I was gaining too much — the message being suspiciously similar to the prevalent cultural message that my body, specifically my weight, is a problem, and that, fat or thin, something is wrong with me. So yes, there’s that. And then there’s the fact that medical care was once women’s work, and was wrested away from women, so that, until very recently, women were actively excluded from medicine as a profession. Taking all these things into consideration, I don’t think it’s hard to imagine why a woman might feel suspicious of the medical system in general, and might be attracted to the idea of regaining control over preventative medicine — traditionally the purview of wise women, midwives, and mothers — by making her own decisions about vaccination and refusing the advice of doctors.
HS: Was your examination of metaphor and the categories of language that we use to conceptualize the mechanics of our bodies, immune systems, and vaccines the result of your research, or were you previously interested? What were your most helpful sources in this investigation, especially when you examine the use of military language?
EB: I’ve been interested in metaphor since before I began writing. My mother is constantly reading the metaphors around her — in fairytales, religious rituals, movies, conversation, everything — and I learned that impulse from her. Shortly after I began taking poetry courses in college, where we very frequently discussed metaphor as a literary device, I read Susan Sontag’s essay Illness as Metaphor. That book remains important to me, and Sontag’s suspicion of military metaphors has stayed with me. But my work in On Immunity was also influenced by James Geary’s treatise on metaphor, I is an Other, and Emily Martin’s anthropological studyFlexible Bodies, which is very attentive to the metaphors, particularly military metaphors, we use to think about our own health.
HS: At one point in the book you discuss the “rabbit-hole” of research and how overwhelming it can become. How did you decide you were finished with your research, especially with the variety of literature that you employ? How did research for this book differ from No Man’s Land? What were the most difficult or upsetting aspects or points in your research, and, conversely, the most joyous?
EB: I never felt finished with the research. In fact, the more I learned, the less I felt I knew. This book is, in part, the story of a quest for knowledge. But knowledge is more of a process, really, than a product. And knowledge is, by its nature, always incomplete. My research for this book included interviewing people with expertise in immunology and infectious diseases and I was often struck, in those conversations, by their humility around knowledge — they were very frank about what they themselves did not know and quite open about what was not known by anyone in their field. I remember asking an influenza expert a question about chicken pox and he told me that I would have to talk to a chicken pox expert about that question — I did, but I also left that moment thinking, hmm, if this infectious disease expert and professor of medicine is unwilling to answer this fairly basic question because he doesn’t feel like he knows enough, what does that say about my audacity in thinking that I might teach myself everything there is to know about all this?
I was initially very frustrated by my sense that I would never be able to learn everything I needed to know to write this book, but I eventually came to a place where I didn’t feel frustrated so much as deeply humbled. As an essayist, I’m a generalist — I’m not a medical writer or even a science writer — and I believe that generalists like me play an important role in making different kinds and sources of knowledge talk to each other. We’re communicators and synthesizers. But the research I did for this book gave me a newfound respect for experts. After struggling to make sense of everything I was reading, it was such a thrill to talk with someone who had a deep understanding of the subject and could put what I had been reading into context. Often, I discovered that there were things I had been completely misunderstanding and my entire way of thinking would be rearranged by one conversation. And that’s the thing — information isn’t very hard to come by. But information doesn’t become knowledge until it’s contextualized and understood in relationship to other information. Learning how scientists do this helped me understand how collaborative scientific investigation is — scientists are constantly working in teams and building off of each other’s knowledge and refining each other’s work and accomplishing, together, things that no one mind could accomplish alone. Here, again, is another beautiful example of our interdependence. We owe each other our bodies, and also our minds.