Motherhood, Medicine, and a Bit Too Much Metaphor

Like the best of essays, Eula Biss’ On Immunity: An Inoculation is hard to pigeonhole. It’s at once a memoir of maternal anxiety, an exploration of the metaphors that have been used to explain illness and vaccination, and a sympathetic rebuttal to the arguments of anti-vaccination activists.

Biss suggests that much opposition to vaccination stems from a view of the body as a “homestead” rather than an interconnected part of a community. When people say they don’t need vaccines because of the strength of their immune system, they ignore that people with weaker immune systems—those who may not be able to receive vaccines—depend on the vaccination and immunity of others to reduce their chance of exposure to disease. Public and private health, she writes, are inseparable.

In this book’s warmest passages, Biss details the love and worry she feels for her son, whose birth prompted her research on vaccination: “Every day with a child, I have discovered, is a kind of time travel. I cast my mind ahead with each decision I make, wondering what I might be giving or taking from my child in the future.

On Immunity follows not an argument or narrative but a wandering trail of research and meditations. Biss guides us along, pointing out findings from literature, medical research, and the dregs of the internet, occasionally stepping in to introduce herself. Her skepticism and self-deprecation evoke Joan Didion’s. She recalls of her youthful self: “I had read enough to be troubled by the belief that one must enact one’s beliefs, and perhaps even embody them.”

It’s often frustrating to see vaccination given the poetic treatment (the author is a poet as well as an essayist). Biss renders a bitter pill—you need to vaccinate your kids—in prose as slow and sweet as melted molasses, crawling towards more musings and factoids instead of conclusions.

In her hands, metaphor and simile become ends in themselves, rather than means of explaining. In turn-of-the-century Britain, she writes, “[i]nformation was moving in new ways, reaching people it had not reached before. This was also a time in which new technologies were rapidly emerging and changing the way people lived. A time, in other words, not unlike our own.” This is as true—and as mundane—as saying that both modern and ancient Israel suffered from turmoil. Described generally enough, anything can be “not unlike” anything else.

Yet this book’s gentle, meandering nature makes me hope it’ll find its way onto the reading lists of anti-vaccine activists including, say, Andrew Wakefield, who published the first study “linking” vaccines to autism.

The rhetoric of anti-vaccination activists often draws immediate dismissal. Everyone who participates in public discourse has the duty to rebut misinformation, especially that which can harm people. But contempt only makes things worse, as it’s so often aimed not at misinformation but the people who believe it. Seeing a door slammed in their face and their character impugned, anti-vaccination activists cast themselves as underdogs and their critics as persecutors. They them grow more ardent, prompting more contempt.

Biss steps outside the cycle, acknowledging the legitimate concerns of anti-vaccination activists before refuting their arguments on their own ground. Yes, capitalism is pervasive and often corrupting, she writes, so she can see how vaccines may appear to be a profit-driven scam. But vaccines aren’t as profitable as other drugs, and the vaccination system is one “in which both the burdens and the benefits are shared across the entire population. Vaccination allows us to use the products of capitalism for purposes that are counter to the pressures of capitalism.”

And while Biss understands distrust of the medical establishment—it’s often reflected prejudice as much as hard science, particularly when treating women—she distrusts the paranoia that sees a system-wide conspiracy as well. Describing the research of theorist Eve Sedgwick, she writes, “paranoia very frequently passes for intelligence. As Sedgwick observes, ‘to theorize out of anything but a paranoid critical stance has come to seem naïve, pious, or complacent.’ She does not believe that paranoid thinking is necessarily delusional or wrong, but only that there is value to approaches that are less rooted in suspicion.”

The metaphor of inoculation suggested by this book’s subtitle isn’t fully applicable. Protection against fear, particularly unfounded fear, requires continuing learning and conversation, which can’t be administered by a doctor.

Though marred by its eagerness for metaphor, On Immunity has the potential to start a conversation about vaccination among its most fervid critics, acknowledging their concerns and gently rebuking their fallacies.

–Published September 30th by Graywolf Press


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