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The Metaphors of AIDS: Attitudes Revealed in the Discourse of the Medical, Popular Media, and AIDS Advocacy Communities Kevin Paul Sime Iowa State University

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The Metaphors of AIDS: Attitudes Revealed in the Discourse of the Medical, Popular Media, and AIDS Advocacy Communities Kevin Paul Sime Iowa State University Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1996 The metaphors of AIDS: attitudes revealed in the discourse of the medical, popular media, and AIDS advocacy communities Kevin Paul Sime Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the English Language and Literature Commons, and the Rhetoric and Composition Commons Recommended Citation Sime, Kevin Paul, "The metaphors of AIDS: attitudes revealed in the discourse of the medical, popular media, and AIDS advocacy communities" (1996). Retrospective Theses and Dissertations. 14375. https://lib.dr.iastate.edu/rtd/14375 This Thesis is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. The metaphors ofAIDS: Attitudes revealed in the discourse of the medical, popular media, and AIDS advocacy communities by Kevin Paul Sime A thesis submitted to the graduate faculty in partial fulfillment of the requirements forthe degree of MASTER OF ARTS Department: English Major: English (Rhetoricand Composition) Major Professor: Margaret Baker Graham Iowa State University Ames, Iowa 1996 Graduate College Iowa State University This is to certify that the Master's thesis of Kevin Paul Sime has met the thesis requirements of Iowa State University Signatures have been redacted for privacy Ill Dedication Quitesimply, thisthesis is dedicated first andforemost to mymother who died Friday, August 19,1994. This was theweekend before I began working onmy Master's Degree. Sheinstilled in me the love of reading andlearning which continues to shape my life to this day. She alsotaughtme, muchas myfatherhas and continues to, the importance of quiet, honest, hard work, and theimportance offaith, family, andfriends. She sacrificedmuch in order to help me achievemy goals and rarely said a word. I also wantto notethe special contributions of my father, mybrother, and my sister. It is my fatherwhohas taughtme kindness andhimiility, faith in God, andwho continues to inspire me withhow profoundly a quietfaith in others and service towards them can impactthis world. Quietheroes suchas he go far too unnoticed and undervalued. My brotherhas taughtme the importance of family, the powerof the human will, and how to believe in myself; as much as we foughtin the past, I doubtthere is anyone who loves me moreor whobelieves in me more. He is muchof the reasonI have made it thisfar. Mysister has taught mehowto laugh, howto hug, andhowto enjoy life. Her grace and maturity continue to amaze me. rd also like to dedicate this to Pam Gamine at the AIDS Coalition ofStory County. Pam first gaveme the opportunity to work as a volunteer and started me down the road that led to this thesis. She is an extraordinarywoman who has truly made a difference in this world. A drive to Ames to meet her is well worth the trip. Finally, Fd like to dedicate this to everyone on my committee—especially to MartyGraham. Together they put up withmyfalse starts and "grandvisions" to help me tum this into something mildlycoherent. Any shortcomings in this piece are in spite of their hard work and insightful comments. Completion of a thesis represents many things, but perhaps most importantly, it represents the beliefof many people in the writer andthe cumulative sacrifices of thse peoplewhichmake the whole affairpossible. It is to thosenamedabove andto many others who have believed in me and sacrificed for me that I dedicate this work. May the pages that follow not giveyou a headache... IV TABLE OF CONTENTS INTRODUCTION CHAPTER 1. TRADITIONAL RESPONSES TO BOTH MISUNDERSTOOD 13 AND SEXUALLY TRANSMITTED DISEASES—THE FIVE TRADITIONAL METAPHORS CHAPTER 2. THE EARLY METAPHORS OF AIDS, PEOPLE LIVING 23 WITH AIDS, AND ALOOK AT PAST METAPHORS OF STD'S CHAPTERS. MEDICINE AND THE MEDIA—THE CONSTRUCTION 34 OFTHE STORY OF AIDS AND THE CREATION OF ITS CURRENT METAPHORS 66 CHAPTER 4. CONCLUSION 70 BIBLIOGRAPHY APPENDIX A. "FOUNDING STATEMENT OF PEOPLE WITH AIDS/ARC" 74 APPENDIX B. "CDC DEFINITION OF AIDS/CRITERLV FOR ARC 76 APPENDIX C. "NEWS MEDIA COVERAGE OFAIDS" 78 APPENDIX D. "TIMELINE OF THE PLAGUE: AMEDICAL, POLITICAL, 79 AND MEDIA HISTORY OF AIDS" INTRODUCTION Kenneth Keniston relates how, in the first planning meeting for the Daedalus journal's issue "Living With AIDS: Part II," an "eminent" microbiologist proclaimed that "the first thing to understand about AIDS is that it is a biomedical problem" (Keniston ix). The room of scientists and physicians quickly nodded their heads in agreement. Yet, as Keniston notes, even in this relatively like-minded the "problem metaphors" quickly multiplied: "AIDS is a public health problem, a political problem ... [and] a moral problem" were just a few ofthe metaphors which came pouring out" (ix). AIDS, ofcourse, is many things, yet almost without thinking AIDS was defined as one thing until that definition was challenged. We need to do more challenging and to realize why AIDS so often has just one definition. Defining social construction and how it relates to AIDS Part ofthe fi"equent convergence on one definition comes firom the way in which our understanding ofAIDS and the medical definition ofAIDS itselfis socially constructed. Keniston contends that AIDS is socially constructed in two ways. First, our understanding of ADDS as it relates to our lives is sociallyconstructed in the way that any disease is, whether the disease is chicken pox, influenza, or syphilis. "[W]e assign meaning to the condition ... in a broaderfi"amework of traditional meanings, appealing (andsometimes not so appealing) metaphors, and convincing theories" (x). But, as Keniston contends, the definition ofthe disease itselfis sociallyconstructed. For example, determining when someonehas "full blown"AIDS vs. "just" having the HIVvirus is accomplished largely by an individual developing aset number ofsymptoms, a set number ofinfections, all ata set level of severity. That is, the definition is established more through socially agreed "trigger points" than a specific, consistent roster ofsymptoms. All ofus like tothink we can depend on the medical community forexact answers and, certainly, they have come through many times. But science is notalways as objective as it claims to be and science has often yielded far from "exact" answers. Science depends a good deal upon consensus to reach its answers, and even scientists basepart oftheiranswers upon socially constructed definitions and assumptions; AIDS, as I will show, illustrates this all too well. Regardless ofthe exact process and theexact degree ofsocial construction in defining ADDS, Keniston's admonition is worth heeding in dealing withAIDS from any perspective: If we misdefine AIDS, we risk shaping ineffectual or coimterproductive policies. To define AIDS as 'God'sjudgment ona society that does notlive bytherules,' as does Rev. Jerry Falwell, directs us towards blame, penitence, and moral reform astheonly effective responses to this affliction. To see AIDS asanentirely biomedical problem deflects us from promoting behavior changes that could limit itstransmission. To view it as a problem likely to be solved inthenear fiiture undermines theresolve neededto live with ADDS for decades andgenerations. We musttherefore weigh competing social coiKtructions ofAIDS against what we know about this condition andagainst whether they promote policies that canreduce thedamage HTV causes, (xi) Early onAIDS was constructed bythemedical community asa "gay male disease" caused bysexual promiscuity and "killer sperm." This definition was highly socially constructed; that is, it was based largely ona small quantity ofmedical evidence anda significant amoimt ofstereotyping ofpeople who are gay—all woven into moral judgments about homosexuality and sexually transmitted diseases. Perhaps if some ofthese assumptions had been recognized and critiqued, perhaps ifthe process ofdefining AIDS had not been left so completely to the medical community—no matter how well intentioned some ofthe members may have been—and perhaps if some of the moralizing in constructing this definition had been left out, more productive and comprehensive responsescould have been developed sooner. The words of social historian Allan Brandt ring quite loudly inthis regard; "A socie/y's response to those who are ill, itsemployment oj medical discoveries and resources, isclosely relatedto itsmost basic assumptions and beliefs " (Brandt 4)[italics added], Brandt further contends that [f]undamental to the notionthat disease is sociallyconstructed is the premisethat it is profoundly shapedby both biological and cultural vanables. Attitudes and values concerning disease affect the perception ofits pattern oftransmission, its epidemiological nature. Only if we understand the way the disease is influenced by social and cultural forces ... can we effectively address its biological dimension. A 'social construction' reveals tacit values, it becomes a symbolfor ordering and explaining aspects ofthe human experience. In ihis light, medicine is notjust affected by social, economic, andpoliticalvariables—it isembedded in them. (5)[italics added] As Conradpoints out in his 1986 study, "The Social Meaning of AIDS," "AIDS, due to this sociological naming process,
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