Cultural studies/science studies/american studies How should we understand the fear and fascination elicited by the accounts of communicable disease outbreaks that proliferated, following the emergence of hiv, in scientific publications and the mainstream media? The repetition of particular characters, images, and story lines—of Patients Zero and superspreaders, hot zones and tenacious microbes—produced a formulaic narrative as they circulated through the media and were amplified in popular fiction and film. wald The “outbreak narrative” begins with an emerging infection, follows it through the global net- works of contact, and ends with its containment. Priscilla Wald returns to the early years of microbiology and “Typhoid Mary,” to the advent of virology and Cold War “alien” infiltration, and to body snatchers and the hiv/aids pandemic to show how evolving ideas about contagion Contagious and horror coalesced in the outbreak narrative. These stories of disease emergence have conse- quences. They can affect survival rates, contagion routes, and economies. They can promote or mitigate the stigmatizing of individuals, groups, locales, behaviors, and lifestyles. Contagious shows how the stories we tell circumscribe our thinking about global health and human inter- actions as the world imagines—or refuses to imagine—the next Great Plague. Contagious “Contagious is a magnificent book, notable for its prose, its expansiveness, its courage, and its creativity.”—rita Charon, founder of the Program in Narrative Medicine, Columbia University Medical Center Cultures, Carriers, and “Rippling across the span of the twentieth century, Priscilla Wald’s book traces the trajectories the Outbreak narrative of ‘outbreak narratives,’ stories about the spread and conquest of contagious diseases. With beautifully crafted prose, Wald shows how the scientific and fictional, social and microbial intermingle as outbreak narratives confront an essential paradox: that human connectedness both imperils and saves us. Contagious is essential reading for science studies, for the field of literature and medicine, and indeed for anyone interested in the social, discursive, and cultural implications of epidemiology.”—n. katherine hayles, University of California, Los Angeles “Priscilla Wald stunningly demonstrates how epidemics are forms of cultural autobiography, telescoping stories of outbreak and contagion that are reflected in our myths, symbols, arche- types, and social networks. Beautifully written and passionately argued, Contagious is required reading for those interested in learning how our diseases shape the ways we think about our- selves and our relationships and how our desires to be close to other people overlap with our anxieties about being infected by them.”—Jonathan Michel Metzl, author of Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs Priscilla wald is Professor of English at Duke University. She is the author of Constituting Americans: Cultural Anxiety and Narrative Form. a John hope Franklin Center book duke university Press duke Box 90660, Durham, NC 27708-0660 www.dukeupress.edu Priscilla Wald CONTAGIOUS A John Hope Franklin Center Book ∫ 2008 Duke University Press All rights reserved Printed in the United States of America on acid-free paper $ Designed by C. H. Westmoreland Typeset in Warnock Pro with Gotham display by Keystone Typesetting, Inc. Library of Congress Cataloging-in-Publication Data and republication acknowledgments appear on the last printed pages of this book. In loving memory of Stanley I. Wald Contents Acknowledgments ix Introduction 1 1 Imagined Immunities: The Epidemiology of Belonging 29 2 The Healthy Carrier: ‘‘Typhoid Mary’’ and Social Being 68 3 Communicable Americanism: Social Contagion and Urban Spaces 114 4 Viral Cultures: Microbes and Politics in the Cold War 157 5 ‘‘The Columbus of aids’’: The Invention of ‘‘Patient Zero’’ 213 Epilogue 264 Notes 271 Works Cited 323 Index 353 Acknowledgments It is with great pleasure that I acknowledge the people, communities, and organizations that have enabled me to write this book. I have been ex- tremely fortunate in finding so many generous and passionate interlocutors who have challenged me to think ever more deeply about the questions that intrigued me and to push past my own assumptions to see those questions in new ways. I have learned more from them than I can put into words and could not have gotten this far without them. I regret that I do not have space to acknowledge everyone to whom I owe thanks, but please know how grateful I am to all of you. I would like to thank the Cornell University Society for the Humanities for the fellowship support that gave me time and resources to work on this project as well as a wonderful community in which to do so. Special thanks to Mary Pat Brady, Laura Brown, Kate McCullough, and Shirley Samuels for the intellectual and social camaraderie during that year and beyond. I have been especially lucky in having had assistance that went well be- yond research from Monique Allewaert, Lauren Coats, Nihad Farooq, Erin Gentry, Meredith Goldsmith, Elizabeth Klimasmith, Gretchen Murphy, Eden Osucha, and Britt Rusert. Every aspect of the book is better because of their research skills, thoughtful commentary, and helpful insights. Thanks as well to Katherine Buse for patient and timely research assistance in the final days of copy editing. For conversations that significantly improved this book and every other aspect of my work, I wish to thank Srinivas Aravamudan, Houston A. Baker Jr., David Brady, Rachael Brady, Sherryl Broverman, Ana Mari Cauce, Vin- cent Cheng, Robert Cook-Deegan, Kathryn Cook-Deegan, Lauren Dame, Wai Chee Dimock, Michael Elliott, Lisa Freeman, Susan Gillman, Gerald Graff, Theresa Goddu, Sally Hicks, Karla F. C. Holloway, Howard Hor- witz, Kelly Jarrett, Ranjana Khanna, Frances Kerr, Karen Krahulik, Mary Layoun, Marilee Lindemann, Joshua Miller, Joycelyn Moody, Dana Nelson, Marjorie Perloff, Charlotte Pierce-Baker, Janice Radway, Jennifer Reardon, Augusta Rohrbach, Teemu Ruskola, Karen Sanchez-Eppler, Laurie Shan- non, Maeera Shreiber, Nikhil Singh, Barbara Herrnstein Smith, Martha Nell Smith, Shawn Michelle Smith, Maura Spiegel, Charlotte Sussman, Nancy Tomes, Marianna Torgovnick, Maurice Wallace, Rebecca Wanzo, Lisa Weasel, and Deborah Elise White, and to remember lovingly and gratefully Gila Bercovitch, Charlotte Bonica, and Gillian Brown. The members of my writing groups at Columbia University, the Univer- sity of Washington, and Duke University made the process of writing richer and much more fun than it would have been without them. For their com- mitment to the kind of collective vision and friendships that come out of such groups, for their engaged responses to my work, and for sharing their work in progress with me, I thank Linda Green, Zita Nunes, Maggie Sale, Karen Van Dyck, Judith Weisenfeld, and Angela Zito; Christine DiStefano, Susan Glenn, Angela Ginorio, Caroline Chung Simpson, Matthew Sparke, and Shirley Yee; Ann Anagnost, Lucy Jarosz, Susan Jeffords, Victoria Law- son, Lorna Rhodes, and Laurie Sears; Elena Glasberg, Cannon Schmitt, and Dana Seitler; Anne Allison, Adrienne Davis, Laura Edwards, and Maureen Quilligan. For invaluable and generous advice, criticism, and much-needed encour- agement on early drafts of the material in this book, I thank Dale Bauer, Jodi Dean, and Gordon Hutner, and, at later stages, Nancy Armstrong, Thomas Ferraro, Elaine Freedgood, Sean Metzger, David Palumbo-Liu, Julie Tetel, and Gregory Tomso. I also thank Rita Charon and the anonymous reader for Duke University Press for their careful and gracious reader’s reports, which improved the manuscript considerably, and Jan Boltman for her excellent editorial eye. I am fortunate to have the opportunity to work with the marvelous staff and editors at Duke University Press and have wit- nessed the care shown to every book that comes through the process. Special thanks to Pam Morrison, Steve Cohn, Ken Wissoker, and the ever- patient Reynolds Smith. For cheerfully agreeing to read endless drafts and have one more conver- sation about minutiae, big ideas, and everything in between, for insights and inspiration offered without my having to ask, and for kind words and laughter when I most needed them, heartfelt thanks to Cathy N. David- son, David Eng, Amy Kaplan, Robert Mitchell, Kathy Psomiades, Maureen Quilligan, and Alys Eve Weinbaum. x Acknowledgments Three people have been more than patient during the many years in which I was working on this project. Even when they were young and wondered if Mom were in the office or out of town, Evan and Nathaniel Donahue were generous, loving, and accepting. With Joseph Donahue, they have taught me to laugh, to care, to think and to learn in ways I could not have imagined, and to notice and celebrate the most important aspects of life. During the years of this project, Evan and Nathaniel have grown into insightful readers and thinkers as well and have contributed their consider- able wit and wisdom to this project. To my most treasured companions and inspirations, Joseph, Evan, and Nathaniel, I express here in writing what I hope I convey to you daily: how grateful I am to you for who you are and how much you have inspired and taught me about everything. Acknowledgments xi Infection in the sentence breeds. —EMILY DICKINSON Introduction When the World Health Organization (who) issued a global alert on 12 March 2003, the especially virulent and ‘‘unexplained atypical pneu-