April – May 2020
The bruise is a purple knot. We put arnica cream on it, though I’m never quite sure if that’s to help with the ache or to minimise how violet-brown it gets. We chase her up and down the corridor in the flat, for a bit excitement and exercise, only this time she tripped on a toe and went headlong into the side of a cupboard door. We had been going to the field nearby to kick a ball around and chase each other around the broken glass and cigarette butts, until the field is lopped in half by a high wooden fence, and the next day several large white temporary tents go up behind. The parent WhatsApp groups are abuzz a day later, after the jokes about it being a craft fair or music festival, who knows what chemicals they will use, infected bodies coming through the area, the ground will be tainted, they didn’t even ask us if it was ok to put up a temporary mortuary.
We go, after that, to the cemetery across the road, to visit the pond where there are carp and terrapins, next to the Traditional Crematorium, which has a sign over its entrance reading the Chapel of Remembrance. We toss bits of cracker and rice cake into the pond; I try to make sure she crumbles it small enough as the carp just suck it in wholesale and I don’t want them to choke. We aren’t meant to feed them, or the ducks in the bigger pond nearby, as it is said to attract rats. I’m sceptical about that, until the day I see two forearm-sized ones splashing in the shallows like excited puppies.
I go to the shop nearby to pick up a few things we’re missing: bananas, beans, and the things I’ve forgotten I actually do need around like crisps and biscuits. I am wearing gloves and a mask over my mouth, shifting aisles according to where people are, until a woman comes along pushing a kid in a plastic car as wide as the space between shelves. I can only side against the cans, splaying my shoes, until they get past without any a nod. As I struggle to decide which flavour of crisp might satisfy this deeper calling, I hear a man at the front counter – don’t care. I’m OLD. Close to dyin anyway.
I am washing vegetables; some I just dip in the soapy water, others, like plums or tomatoes with dips in the tops, I give a scrub with a sponge. Make sure you rinse those properly, my partner warns, the soap is carcinogenic. The video that had prompted our veg-washing was fairly comprehensive, the man wearing plastic gloves, how to be safe doing your shopping. I ask my dad for an opinion: It’s an extreme measure. However, it would reduce a very low risk to extremely low risk. A few days later, he sends me an article about doctors who aren’t washing their shopping. I forward it on to my partner, but I don’t ask after and she never mentions it. We keep washing. When he asks about it, my dad says, well, it was a family doctor, not a virologist who they quoted in the article. It’s somewhere between a statement and a joke.
He gets ill a few days after that. His only contact that they could think of had been Moe’s, the run-down sports bar where he and his colleagues would hang out in every Friday after work. Since lockdown, they’ve each been going there every Friday to pick up pizza and wings, head home and then Zoom together. Moe’s had become the epidemiologists’ local, they don’t want it to go out of business.
When we were asked what our parents did as kids, I took a wayward pride in saying my mum was a nurse, my dad an epidemiologist. I didn’t even know what an epidemiologist was, I just knew it sounded different. My parents had moved to Atlanta in the early ’80s because the Center for Disease Control was based there. I never saw any other doctors growing up, could never get away with pretending to be sick. The matter of factness, the informal diagnoses rub off on you. It’s taken me a while to understand how my understanding of medicine is mixed up with paternalism, my sense of independence underwritten by this care.
I could pretend I know what epidemiology is by now, as well. But it’s hard to unpick that from decades of fuzzy knowledge, from the peculiar feeling that I actually have medical knowledge too, after being raised by two people who met in a lab chopping the heads of rats, as they like to tell the story. I know the epidemiologist deals in managing risk: the circumstances of a disease outbreak, rates of infection, manifestations of the infection, the effectiveness of any given vaccine. I also know it’s a long-term gamble with other people’s lives. My dad had a range of T-shirts and badges worn over the years of campaign after campaign: End Polio by 2000; Polio-Free by 2010, 2020, etc.
The Austrian historian Ivan Illich once told an audience of nurses, ‘I am not a nurse and, emphatically, I do not care about health. I teach about the history of friendship and the history of the art of suffering.’ Illich had been invited to speak at the conference in 1994 as the author of Limits to Medicine (1976), his book on the counterproductivity of the medical profession. When I first came across the book, I was captivated by his tracing of the limits of how we see the world today, where, as he described it, the need for hygiene and health outstripped the need to be human. Doctors were the contemporary priest and lawyer combined, he argued, depriving people of their own self-knowledge, creating a dependency on being diagnosed, treated, deemed to be in good health. I ignored the more libertarian implications of his argument – bureaucratic interventions into health end up being merely self-serving, creating more illness than anything else – listening only to the other parts that chimed with what I saw as a common-sense view of the world: the scientific paradigm had gone too far. We’re reliant on creams, pills, solutions, certainty.
I worked for a long time at a food shop, where customers would ask about the benefits of eating things that aren’t pasteurised. I would end up saying something along the lines of it being less manipulated, more alive, better for you. Not that I knew exactly what was going on, what went in or came out. In circles flirting with microbes, you’d meet people who extended those fuzzy benefits to the immune system, that consuming a wide enough range of bacteria and fungi would mean that we had no need for vaccines. I was sympathetic, but balking inwardly, my upbringing pulling me back. Maybe I’d never even conceived of it as an individual choice, something one person could choose not to do. I’d taken it as a given: something that, if you lived among people, it was implicitly part of the shared fabric. The notion of not needing vaccines is a lovely one, but the realities of living with people is another. In On Immunity (2014), Eula Biss writes about navigating the fears and doubts around vaccinating her child, and at one point notes that it is more in affluent places with high vaccination rates that you find anti-vaccination attitudes: wealthier countries, she writes, have the luxury of entertaining fears the rest of the world cannot afford.
There’s a point early on in On Immunity where Biss describes looking after her newborn child during the 2009 H1N1 influenza pandemic: ‘Colleges were daily sterilizing every “high-touch” surface, while I was nightly boiling every object my child put in its mouth. It was as if the nation had joined me in the paranoia of infant care.’ It was mid-March this year when I recalled this passage, where every interaction, every surface and wake was seen as a source of contamination, and beyond hovered a beckoning abyss. It called back a few summers ago as a new parent, being not just amidst the spiralling possibilities of exposing a new body to the world, but the greater vertigo of suspicion. Beyond the sterilising, steaming, wiping, pocketing anything that had come in vicarious contact with the idea of the ground, was the searching: the forums, parent groups, websites, where any red spot or lotion had at some point, somewhere, led to an extreme situation. In such a sea of ideas, splashing in panic, you end up numb.
Illich’s cynicism – that, ultimately, medicine does more harm than good – has been bothering me the past few weeks, but at this point particularly, where lockdown and isolation are being staged out unevenly in different parts of the world, and any sort of potential vaccine for the rona – as I have heard it alluringly referred to, like a band or a recreational drug – is yet to arrive. I’m ambivalent: to me it seems obvious that we need intervention. But it also seems obvious that people could just use common sense. And I remind myself, again, that my own ‘sense’ is formed by years of stern looks and factual ruminations lost on uncomprehending ears. A vaccine is hung on to like some sort of solution, a switch that will enable things to return to what was. A vaccine is also just another virus, one with acceptable risks, and one that might never arrive. It would seem we are, until then, stuck with each other. Loosed into the world, we are asked, as we always were, how much we trust each other; or, in some cases, how much you’re willing to thrust your trust in yourself on other people. The social contract is more visible to more people than usual right now. That doesn’t mean everyone wants to read it.
Illich, in that 1994 lecture, admitted he was wrong. What got him suspicious in the first place was that the biggest buyers of Limits to Medicine were, and continue to be, medical schools. His book had imagined that people might read it and still be able to opt out of such a system. Illich, in the lecture, says the fault of his argument wasn’t that he had been mistaken, but that he had underestimated it, that society itself had changed. The world had become even more controlled, the choice to opt out of the medical system obliterated. Illich is sniffy, aloof to his audience of nurses, as he goes on: ‘I can smell you are on the point of being co-opted.’ In this shiny, cybernetic world, he argues, the human is seen as a closed loop, where suffering is held under a tight rein, but so, too, is happiness, as two sides of the same coin. I suspect that only someone who has been raised safely in the confines of managed risk might be able to emphatically not care about health.
Someone on the street’s WhatsApp group posts, ‘The covid-19 its a big lie. Its all bullshit.’ The next day, a parent sends on a petition that demands that the local council enforce social distancing more post-lockdown. I wonder, seeing these, whether a sense of risk is relative to what has touched you directly. But then it’s the directness that seems to be slipping away at the moment. I don’t need to explain how tame, how restricted my experience is, while also trying to understand how we are still at risk, between risk, within risk, hovering somewhere nearby, as ever. Already having been co-opted, the risks are people, things. The masks and gloves hang waiting by the front door.