Published on February 6th, 2015 | by Marie Curran2
ON IMMUNITY: A Conversation With Eula Biss by Marie Curran
I recently gave birth to a daughter, and became a mother. Throughout my pregnancy, I saw both a doctor and certified midwife practitioner. I wanted to pick and choose my care—yes to the ultrasound, no to the hospital birth—as if I was clearing a rugged trail between “conventional medicine” and “natural birthing,” obtuse as those terms are. I read up on alternative vaccine schedules for my baby, as well. Though, I did not exactly know why I was afraid.
I did not know then how much what I contemplated as a personal choice could have such profound effects on the health of others. As a frightening measles outbreak continues in California, the latest victim a baby too young for the vaccine, and debates about individual rights are waged across social media platforms, it’s clear, maybe more than ever, that a vaccination, or the lack of, has serious public implications.
Eula Biss’ new book On Immunity: An Inoculation is a slim volume weaving together research, literary reflection, and personal narrative. She explores immunization from its risky roots as folk experimentation to the highly effective vaccines we know today.
I read On Immunity with my newborn daughter suckling and snoozing at my breast. Though I had gone into my planned homebirth with confidence, complications ensued. I was able to stay home, but for the safety of my baby and me, the midwife intervened in shockingly invasive ways.
I felt I had been broken into, not only in body, but also in mind. While reading On Immunity and grappling with the humbling trauma of birth, I began to obsess over what it means to be a “natural mother.”
On Immunity is clear: Biss, who is faculty at Northwestern University, author of three books, and mother to a young son, is a strong proponent of fully vaccinating on schedule. Yet she knows, personally, the fear of immunization that has existed since its inception and is still a powerful cultural force. Many mothers are pausing, like both Biss and I did, before consenting our children to government-recommended vaccinations.
“I was writing the book that I had wanted to encounter, but hadn’t,” Biss told me.
Biss began researching vaccines during her son’s infancy, which coincided with the global H1N1 outbreak. She found the popular literature from both sides of the question insulting, and decided to dig deeper.
It’s hard to discuss vaccination without thinking about the “mommy wars,” or without being hit by the bullets of judgment. Biss is an antidote to this culturally ingrained vitriol and defensiveness. One of On Immunity’s readers was one of her closest friends who held different beliefs concerning vaccination.
“I think it’s a real testimony to what is possible in terms of friendships between women who don’t agree with each other, that she and I could work on this book so closely and that it didn’t become fraught.”
This is a beautiful picture, but how can the embrace of a kind of parenting pluralism go wrong? What about public health concerns? I’ve held onto a “natural” or “crunchy” status as a breastfeeding, cloth-diapering mother. However, several weeks after my daughter was born, I decided she would follow the CDC vaccination schedule.
How many “unnatural” moves are you are allowed to make before being considered an “unnatural” parent? Can this “crunchy mama” movement contribute to the health of all American children, or is it an elitist labeling game?
Biss grew up in the home of a physician who generally prescribed her good food and exercise before medicine. And Biss has some problems with the way many people are using the word “natural.” She told me,
“Most of us don’t live in close communion with the natural world and that allows us into this romantic space where we make a fetish of it. But if you strip the parts away of this ‘natural parenting’ movement that have become commodified—oh, I’m buying this product—there’s the philosophical side, which is a resistance to a lot of interference with the body and its ability to heal itself.”
Biss praised the movement’s emphasis on preventative medicine—nutrition and exercise, listening to the body’s cues—as a vital part of parenthood. It’s a practice that primarily happens in the home.
“I think that’s why we feel vaccination is encroaching on our territory, because we are the main providers of preventative medicine,” Biss told me. Yet she asserted that vaccination is an integral part of a philosophy of prevention, because it keeps people, especially children, out of hospitals, and off of medications.
“Nutrition, exercise: these are things parents and mothers are responsible for… Then there’s this complement, that’s provided by pediatricians. It enables this philosophy rather than challenging it. It lessens the probability that you need to take your child to the hospital with pneumonia that developed as a complication of chicken pox, or meningitis that developed as a complication of invasive HIB.”
She told me about her farmer aunt, who lives intimately with the land around her. “It’s a hard life. She is less prone than anyone I know to romanticize nature. On the subject of vaccination she feels it’s ridiculous that someone would turn down the opportunity to be made immune. This is someone who hasn’t had health insurance and has lived far from medical care on a farm her entire life. To her, that sort of preventative medicine is an incredibly useful part of her lifestyle.”
So, why are so many mothers’ default responses, mine included, a bristling at and bucking of convention?
Biss says our medical system evolved from a paternalistic model—father knows best—to a consumerist one—the customer is always right (98-100). I often felt condescended to or rushed by doctors.
There were some vaccination posters plastering the walls of my county’s health department office, which I mentioned to Biss. Each poster featured a child who had died from a vaccine-preventable disease, and sported a grim and glib line of warning. Sad as these posters were, I felt defensive for reasons I couldn’t pinpoint. Biss responded,
“I was looking through some similar posters that were aimed at preventing fetal alcohol syndrome. A worthwhile message, but the delivery seemed offensive. There was a picture of a hugely pregnant woman chugging wine, directly from the bottle. It’s a parody.”
Both posters, she concluded, were assuming dumb audiences. But in On Immunity, Biss proposes a counter model of “maternal” care, which she describes as a relationship that is built on nurturing while still respecting medical authority.
When Biss expressed concerns to her then-breastfeeding son’s digestion to his pediatrician, she listened well, and was able to diagnose him with cow’s milk allergy.
“We have a dialogue,” Biss said. “Both of us are gaining information. She’s looking for my observations, and I was looking for her knowledge of infants and how they express discomfort and pain.”
Mothers are caught in the middle—derided for fears but surrounded by fear-mongering. On Immunity has received widespread praise, but some of it is carefully packaged with painful digs. For example, one review of On Immunity, which sports a large photo of a smirking Jenny McCarthy, compliments Biss’ craft while essentially questioning why the book was worth writing in the first place.
The critic puzzles that well-educated Biss, as a physician’s daughter, ever felt vaccine anxiety, and then explored that trepidation deeply enough to turn it into a book. It’s implied that it is a pity Biss had to waste her time researching a non-subject for an audience of women like me.
Biss responded, “I saw a dismissal of what I think are completely legitimate concerns. Should women be a little skeptical of the medical establishment? Probably yes, considering the last five hundred years of medical history. It is reasonable for us to have some reservations about government-issued recommendations? Yeah, if we’ve been paying attention to politics in our lifetime.”
In the New York Times a mostly positive review is peppered with words like “humid” to describe her tendency to use personal anecdotes and “moist” to critique her prose, although her prose is also praised as sometimes “dry.” Biss didn’t want to be trivial, especially over good publicity, but the adjectives nagged at her. She wasn’t sure why until she talked to her sister who is an ethics scholar.
Her sister told her the Ancient Greeks considered men dry, but referred to women as wet or leaky, and not only to describe the fluids they physically produced. This leakiness accounted for loose emotions, which were societally abhorrent.
“When she put that term in historical context I was able to stand back from both of those reviews and say, oh yeah, what I’m responding to is sexism. It’s because this is actually the sexism that I wrote this book in response to. It’s reappearing here now even in places where the book is being praised… I wanted to write against that sexism.”
While most mothers aren’t interested in denying science, many, myself included, seek out care from professionals who can at least acknowledge that the medical establishment has sometimes erred in the past.
Though I had turned away from aggressive blogs and dramatic posters, it was talking with my daughter’s kind doctor, listening to friends’ experiences, learning about Pakistani women who risk their lives to vaccinate children against polio, and reading Biss’ accounts of her own parenting struggles that spoke to me, and opened me up to the evidence that now informs my actions. For me, emotional and critical thinking were woven together, inseparable, throughout this process.
“I think On Immunity may be a book that speaks from the inside to the inside, rather than from the inside to the outside, and that is valuable. I’ve always admired Toni Morrison for not assuming a white audience, for not feeling that she has to translate the blackness of her characters for a white audience.”
Perhaps certain people just won’t get it, Biss hinted. Perhaps the experiences of women, like me for instance, who read her book and change their mind, are what matter. We need what Eula Biss has offered in On Immunity: narratives that affirm empathetic examination of a broken past and careful consideration of what makes a better future for all children.
(Photos of Marie Curran and her daughter)