Placing Blame for Devastating Disease

Abstract

Placing Blame for Devastating Disease Dorothy Nelkin (bio) and Sander L. Gilman (bio) in october 1985 a long article entitled "panic in the west: or, what Hides Behind the Sensationalism of AIDS" appeared in Literaturnaya Gazeta, the official journal of the Soviet Writers Union. Shortly thereafter the journal printed a detailed interview on the same topic with Professor S. Drozdov, the director of the Research Institute of Poliomyelitis and Encephalitis in Moscow.1 The theme of both articles was the same—AIDS was the result of a virus, man-made by the biological warriors at Fort Detrick, Maryland, in conjunction with the scientists at the Centers for Disease Control in Atlanta, Georgia. That blame for this dread disease was placed on a political adversary is not very surprising in light of the freeze on American-Soviet relations during the summer of 1985. More fascinating are the associations evoked by the political cartoonist for Pravda, D. Agaeva. His cartoon represents an American general paying for a test tube of AIDS virus supplied to him by a venal-looking scientist. Swimming about in the test tube, representing the power of the AIDS virus, are a multitude of tiny swastikas; the dead, the victims of AIDS, appear in the cartoon as concentration-camp victims, their bare feet echoing the death-camp photographs of bodies stacked like cordwood with only their feet showing. Placing the blame for AIDS on America worked only until the Soviets, in the climate of glasnost in late 1986, admitted that they too had indigenous cases of the disease. But during 1985 and early 1986 [End Page 335] the Soviet press was projecting an image of the United States as fascist and degenerate. Some Russians viewed homosexuality as a pathological reflex of late forms of capitalism and AIDS as a reflection of Western government and society. Thus, in one powerful image, the Pravda cartoonist managed to draw an association between American imperialism, Nazi fascism, and dread disease. The placing of blame has been a pervasive theme in the popular discourse on AIDS. Since 1981, when the first case of AIDS was identified, blame for the disease has been placed variously on dangerous lifestyles, on immoral behavior, on intravenous drug use, on "poppers," on the CIA, on dioxin and Agent Orange, on government policies, on Haitians (by the American media), or on Americans (by the French). Blaming has always been a means to make mysterious and devastating diseases comprehensible and therefore possibly controllable. Even when disease was routinely assumed to be caused by "God's will," "the Lord's wrath," or "occult influences," people looked for the behavior that was to blame for divine judgment and retribution. It is commonly assumed that modern scientific understanding of infection and contagion has neutralized such folkloric views of disease, that the political and moral judgments that were so characteristic of premodern societies are relics of the past. But diseases are never fully understood. And so we still make moral judgments for misfortune. We still point the finger of blame.2 In a situation of communal anxiety, locating blame for disease is in effect a strategy of control. If responsibility can be fixed, perhaps something—discipline, prudence, isolation—can be done. Locating blame is in effect a quest for order and certainty in an anxious and disruptive situation. It is a particularly pervasive syndrome when science and medicine are perceived as impotent. Thus the rhetoric of blame is most evident today in the discourse on the causes of diseases such as AIDS or cancer, while historically it appeared in discussions of leprosy, syphilis, or plague. These are situations where medical science has failed to serve as a source of definitive [End Page 336] understanding and control, so people try to create their own order and to reduce their own sense of vulnerability. In effect, placing blame defines the normal, establishes the boundaries of healthy behavior and appropriate social relationships, and distinguishes the observer from the cause of fear. Categories of blame often reflect deep social-class biases. Illness is frequently associated with poverty and becomes a justification for social inequities. But blaming is also a way to create psychological as well as social boundaries. For...