Ariane Schröder, Biological Inf(l)ections of the American Dream: Contagious Disease and Narrative Containment in U.S. American Literature and Culture (Zurich: Lit, 2020), 312 pp.

The current COVID-19 pandemic is showing, once again, the relevance of studying epidemic diseases from a biocultural vantage point that integrates biomedical and cultural studies perspectives. COVID-19 inspired both a hitherto unknown effort among global biomedical researchers to tackle the disease and a global popular search for cultural meaning in the pandemic. Tellingly, not only have socio-political discourses looked to past epidemics such as the 1918 “Spanish Influenza” but also reiterated traditional patterns of epidemic response such as blaming an outside origin, imposing public hygiene measures, or engaging in neo-colonialist maneuvers for priority access to vaccines. These multi-faced responses poignantly illustrate the entanglement of biomedicine, politics, and culture.

In light of COVID-19, Ariane Schröder’s Biological Inf(l)ections of the American Dream offers a timely contribution to the growing body of biocultural scholarship that engages with knowledge production in life sciences and cultural studies to analyze their interaction in selected epidemic occurrences. Proceeding from an understanding of literature as “one of the main vehicles for an aesthetic expression of the epidemic experience” (6), Schröder seeks to explore how medical and literary narrations provide insights into American culture’s dealing with epidemic diseases. Given the scope of this topic, the book wisely undertakes a series of case studies of how factual and fictional texts depicted selected epidemics and their impact on individuals and communities from the late eighteenth to the late twentieth century. As its subtitle, Contagious Disease and Narrative Containment in U.S. American Literature and Culture, suggests, Schröder’s volume focuses on the dual meaning of “contagion” as a biomedical and metaphorical influence or transmission enabled by physical or social interaction. Its core argument claims that American biomedical and cultural texts engage in a “fantasy of containment” (7) of epidemics and the human identities connected to them. Based on this assumption, the book explores how medical and cultural texts about epidemics generate “a biological inflection of the American Dream that places those considered as contagious outside of the American national body, both physically […] and rhetorically” (7).

Following the book’s introduction and embedded in a biocultural critique of scientific knowledge production, chapter two defines and charts the epistemology of the concepts of “health,” “disease,” “contagion,” and “epidemic.” Schröder examines how the “fantasy of containment” informs not only Western—and specifically American—biomedical discourses on contagious diseases but also technologies and practices of responding to epidemic threats, including literary representations as a way of cultural meaning-making. She specifically explores how these discourses, practices, and representations medically pathologize socio-cultural alterity, frame othered populations as culpably contagious, and exclude them from the “national body.” Literary texts, Schröder argues, particularly function as “gestures of repair” toward mainstream audiences by validating their identities and exculpating them from disseminating diseases.

Chapter three opens the series of case studies with an exploration of discourses on the 1793 yellow fever epidemic in Philadelphia. Schröder argues that this incident challenged both American medicine and society. She studies this impact through the lens of the medical publications of pioneer physician Benjamin Rush and the poetry of Philip Freneau, with brief discussions of other literary texts like Charles Brockden Brown’s novel Arthur Mervyn (1799). Schröder shows how Rush’s theory of a local origin and environmental spread of yellow fever empowered Philadelphians to somehow protect themselves by means of personal hygiene and inspired urban renewal through public sanitation. She argues that this approach revolutionized American medicine by emancipating it from British science, which suggested a foreign origin and human-caused dissemination of the disease. Freneau’s poetry not only reiterates and culturally translates Rush’s approach but complements his medical perspective with a poignant cultural critique of the societal responses to the epidemic. By reading Rush’s and Freneau’s writings alongside each other, Schröder demonstrates how the 1793 yellow fever epidemic produced a certain “convergence of poetic and medical cultures” (96). Her analysis would have been even more poignant, had she offered a more detailed close reading of her chosen literary works.

Benjamin Rush would discredit himself by treating yellow fever through medical intervention on the patient’s body at all costs. A similar approach also informed U.S. policy on leprosy in nineteenth-century Hawai‘i. In chapter four, Schröder convincingly establishes how the emerging discipline of “tropical medicine” drew on the Biblical stigma of leprosy to reframe this disease, endemic in Hawai‘i at the time, as a quasi-epidemic. Driven by an imperialist desire for political and economic control in the Kingdom of Hawai‘i, American medical authorities argued that leprosy endangered the survival of Indigenous Hawaiians to legitimize the violent removal and lifelong quarantine of Hawaiian—though not American—lepers in the leper colony of Moloka‘i. This chapter convinces particularly through its close reading of a series of travelogues and short stories by Jack London, which uses leprosy as a lens to address the American presence in Hawai‘i. Schröder poignantly shows how these texts’ socio-medical portraits of leprosy in the islands oscillated between euphemistic justifications of the Moloka‘i colony to critiques of American imperialism and the racist double standards of its medical policy.

Race, as well as gender and social class, also shaped the medical and societal discourses on tuberculosis in the United States, which is the subject of chapter five. Like leprosy, tuberculosis was endemic until the mid-twentieth century but widely perceived as an epidemic. Schröder persuasively shows how shifts in medical knowledge and cultural context changed the semantic meaning of the disease. Lacking stigmatizing symptoms and associated with White higher-class individuals, medical and social discourses viewed tuberculosis as a “disease of the Self” until medical knowledge of its microbial origin changed its connotation to that of a “disease of the Other” (156), specifically ethnic minorities and the poor. Schröder demonstrates this shift through shorter close readings of various literary texts, ranging from Harriet Beecher Stowe’s Uncle Tom’s Cabin (1852) to Eugene O’Neill’s Long Day’s Journey into Night (1952). Although Schröder’s analyses are convincing, they would have profited from a focus on fewer texts that also discuss how genre conventions tie in with social and medical discourses. The most inspiring sections of this chapter address how socio-medical concepts of human identities inform literary depictions of tuberculosis among different genders, classes, and ethnic groups, exploring how cultural and medical representations interact in pathologizing socio-cultural otherness as deficient and culpably contagious.

A causal connection of human identity and culpability also informs the biomedical and cultural discourses about AIDS, which became epidemic in the United States in the 1980s. Identified as a sexually transmitted infection, AIDS in the USA became “semantically linked” (204) to non-heteronormative sexual orientations and practices. In chapter six, Schröder demonstrates how this socio-medical framework informs the above-mentioned “fantasy of containment” (7) even in the literature emerging from the much-affected American gay community in the 1980s. Applying the theoretical framework of heteronormativity to a study of AIDS discourses is not new, and neither is Schröder’s choice of the most influential pieces of 1980s’ gay AIDS writing, Larry Kramer’s play The Normal Heart (1985) and Randy Shilts’s novel And the Band Played On (1987). Complementing these sexually conservative, White male- and middle-class-focused works with texts inclusive of other social experiences with AIDS would have provided for a more complex discussion. Nonetheless, Schröder’s reading of Kramer’s and Shilts’s works convinces by demonstrating how they articulate heteronormative positions as they simultaneously shift the pathologizing distinction of “guilty” spreaders and “innocent victims” (218) of the AIDS epidemic from the gay / straight divide to differences of identity conception within the gay community.

New socio-medical demarcation lines also inform discussions of biomedical and cultural contagion in the aftermath of 9/11 that Schröder discusses in her epilogue. This incident, she argues, initiated a paradigm shift from attempts to contain epidemics to a “‘preemptive biopreparedness’” (256) to anticipate threats of contagion. As her case studies have shown, and the current COVID-19 era confirms, notions of what constitutes an epidemic threat and responses to contain it have been profoundly shaped by socio-cultural assumptions and political ideologies as much as by scientific knowledge. Schröder’s individual case studies have been well-discussed in previous studies, and the difficulties of comparing, say, a singular yellow fever outbreak in Philadelphia and more than a century of tuberculosis across the USA reveal a structural weakness of her book. Yet, Schröder’s exploration of American disease responses and representations through the lens of contagion and containment render her monograph a valuable contribution to biocultural studies in general and a timely subject in particular.

Astrid Haas (University of Central Lancashire)