to people in chronic pain, or those living with incurable illness, we often end up minimizing their experience. We end up expressing our doubt in the face of their certainty, which only compounds the extent to which pain separates the person experiencing it from the wider social order. The challenge and responsibility of personhood, it seems to me, is to recognize personhood in others—to listen to others’ pain and take it seriously, even when you yourself cannot feel it. That capacity for listening, I think, really does separate human life from the quasi-life of an enterovirus.
I give viral meningitis one star.
PLAGUE
THE OTHER DAY, in the midst of a global disease pandemic, I called my pharmacy to refill my Mirtazapine prescription. Mirtazapine is a tetracyclic antidepressant medication that is also used to treat obsessive-compulsive disorder. In my case, it is lifesaving. So anyway, I called my pharmacy only to learn the pharmacy had closed.
I then called a different pharmacy, and a very sympathetic woman answered. When I explained the situation, she told me everything would be fine, but they did need to call my doctor’s office before refilling the prescription. She asked when I needed the medication, and I answered, “I guess in a perfect world, I’d pick it up this afternoon.”
There was a pause on the other end of the line. At last, stifling a laugh, the woman said, “Well, hon, this ain’t a perfect world.” She then put me on hold while talking to the pharmacist, except she didn’t actually put me on hold. She just put the phone down. And I heard her say to her colleague, “He said—get this—he said in a perfect world he’d pick it up today.”
In the end I was able to pick up the prescription the following afternoon, and when I did so, the woman behind the counter pointed at me and said, “It’s the perfect world guy.” Indeed. It’s me, the perfect world guy, here to regale you with a plague story—the only kind I find myself able to tell at the moment.
* * *
In 2020, I read about almost nothing except pandemics. We often hear that we live in unprecedented times. But what worries me is that these times feel quite precedented. For humans, being in uncharted territory is often good news, because our charted territory is so riddled with disease, injustice, and violence.
Reading about cholera in the nineteenth century, for instance, one finds many precedents. Amid fear of the disease, misinformation was widespread and common: Cholera riots broke out in Liverpool as rumors spread that hospitalized patients were being killed so that doctors could have corpses to dissect.
Then, as in 2020, opposition to public health measures was rampant. One American observer wrote in the nineteenth century that isolation measures “embarrass with unnecessary restrictions the commerce and industry of the country.”
Then, as in 2020, the rich abandoned cities en masse: As the wealthy fled New York amid the cholera outbreak of 1832, one newspaper wrote, “The roads, in all directions, were lined with well-filled stage coaches . . . all panic struck, fleeing from the city.”
Then, as in 2020, outsiders and marginalized groups were blamed for spreading the illness. “By means of Irish vagrants from Sunderland, the cholera has been twice brought among us,” read one English account.
Then, as in 2020, the poor were vastly more likely to die. In nineteenth-century Hamburg, the poorest people were nineteen times more likely to die of cholera than the richest people. This statistic has only worsened: In the twenty-first century, poor people are thousands of times more likely to die of cholera than rich people. Cholera kills at least ninety thousand people every year, even though there is a safe and effective vaccine and the disease is almost always survivable with proper fluid replenishment. Cholera continues to spread and kill not because we lack the tools to understand or treat the disease as we did two hundred years ago, but because each day, as a human community, we decide not to prioritize the health of people living in poverty. Like tuberculosis,* malaria, and many other infectious diseases, cholera is only successful in the twenty-first century because the rich world doesn’t feel threatened by it. As Tina Rosenberg has written, “Probably the worst thing that ever happened to malaria in poor nations was its eradication in rich ones.”
Disease only treats humans equally when our social orders treat humans equally. That, too, is precedented. After plague, caused by the bacterium Yersinia pestis, swept through England in