Thursday, August 30, 2012

Mini-Hiatus: Back to School

Well, it's back-to-school time here at Tech, which means prepping for two new classes for me. This semester will be my first semester back to teaching my own class since spring 2009, and the first time in an undergraduate classroom since Spring 2011, when I was the TA for Grant Writing. It's exciting mostly. I'm teaching two courses: Literature, Medicine, and Culture and Technical Writing. Two totally different classes. Two totally different groups of students. Two totally different preps.

Oh, and I'm writing a dissertation and finishing an article. It's a busy time.

Anyhow, blog posts will probably be short and delayed in coming days/weeks, but I am trying to stay current with Twitter, so please follow me there @hylawrence for my updates and thoughts on vaccines, health, and medicine, particularly H3N2v, which I'm currently fascinated by and terrified of.

And speaking of fear and disease, no one really does it better than Jezebel:


Monday, August 13, 2012


Okay, so I intended to write this blog post about the newest information circulating on the H3N2v flu that has picked up significantly this summer. Because that seems pretty important and scary as we approach flu season.

But instead, I find myself compelled to write about Zombies.

Almost two years ago now, a group of undergraduate students in the VRG conducted a survey about flu and flu vaccine practices among undergraduates. The survey consisted of multiple choice as well as fill-in-the-blank questions that elicited narrative responses, allowing the students to do both quantitative and qualitative analyses on the results (the resulting poster can be found on the VRG website here).

One of their observations from the narrative responses was about Zombies. A couple of the narrative responses in the survey said something about vaccines turning people into Zombies, which they then connected to the movie I am Legend, where (if I recall correctly) a cancer vaccine turns people into Aombies. Or something like that. At the time I remember us all initially thinking that the respondents, while clearly trying to just be funny or mess around with the survey, had really hit on a connection that was surprising--that there were other fictional connections between diseases, viruses, and vaccines and Zombies.

So, imagine my surprise when I was looking for information on the CDC's website the other day on H3N2v and saw a blog category called "Zombies" alongside other completely serious categories like "Anthrax" and "Zoonotic Disease."

Apparently they have used a Zombie attack as a preparedness scenario, with the recommendation that people "Make a Plan. Get a Kit. Be Prepared." for a Zombie attack, which is the same recommendation FEMA has for any kind of preparedness. Here are just a few of the links on the CDC and Zombies:

And, in case you have ever thought, "Wow, I wish that the CDC would write a novella about the possibility of a Zombie attack and what I might do to be prepared for it," you will be happy to learn that there IS a Zombie novella written by the CDC about the possibility of a Zombie attack and what you might do to be prepared for it:

So, I thought all of this was kind of strange, but I know that some people are kind of fascinated with Zombies and like to talk about them a lot and watch movies about them and things like that, so I thought it was maybe just some strange person's sense of humor driving this odd basis for a preparedness scenario.

But, apparently this was a big thing earlier this summer (which I somehow missed). Of course, Colbert has the best coverage of the story:

But it also got coverage from some other news outlets:

I guess a rash of crimes that involved cannibalism somehow awakened fear of Zombie-like behavior, which then somehow got connected to the "tongue-in-cheek" Zombie scenarios created by the CDC, which then necessitated a STATEMENT by the CDC that it “does not know of a virus or condition that would reanimate the dead (or one that would present zombie-like symptoms)” (quotation from RT article).

I don't know what I have to say about all of that just yet, but I end on the following reflection:

In a presentation I did for the Association for Business Communication (ABC) three years ago, I analyzed FEMA's "World Upside Down" PSA, which uses the metaphor of a world "turned upside down" as the impetus for encouraging families to be prepared for disaster.

In that analysis, I argued that the nonspecific nature of the outcome of that metaphorical emergency was rhetorically problematic--that it kept the idea of disaster preparedness in a fictional realm whereby people could not imagine that they would be victims of a major disaster or what the consequences of that disaster might be. Without relaying some kind of situated exigence for disaster preparedness (like, do you know what would happen to your pet if you had to evacuate your home in an emergency? or do you have the materials to shelter-in-place? or how would you reunite with your family after an emergency during a work day?), the PSA relays a general message that something bad could happen at any time, and it might be a good idea to have supplies around in case that happens. Most people know that already, I argued.

But, was I wrong? The Zombie scenario seems to do another version of the same thing, although I admit it's much catchier. You see the widget or poster or t-shirt with "Prepare for the Zombie Apocalypse" on it, and it least it catches your eye. Makes you say "what?" Creates an impression, a curiosity that the "world upside down" doesn't. But, in the end, does it produce the same, imagistic, metaphorical, but ultimately unrelatable effect? Does it venture too far into the ridiculous to be taken seriously? I'd be curious to ask them what kinds of responses they have gotten to these campaigns. I wonder if maybe my assessment is too harsh--that maybe it is better to create a nonspecific notion of preparedness in peoples' minds so that they can apply the need to prepare to whatever they think is most pressing or most applicable to their situation.

This has to be a question across any kind of preparedness issue, whether it is disaster preparedness or public health. It also asks a basic question of the Health Belief Model: what motivates people to take the officially-sanctioned actions to protect themselves? In rhetoric, we might ask, what combination of ethos, pathos, and logos will persuade the public to believe official recommendations and be motivated to take action? Will a believable spokesperson help? A fear tactic? Data on disaster likelihood and related necessities? With both "world upside down" and Zombies, we've abandoned the world of logos and possibly ethos and are left with pathos--either the impetus to be afraid of or laugh at the scenario presented that rouses the audience to attentiveness. And it might do that. But does it promote action? A genuine question, for me at least.

Monday, August 06, 2012

Gardasil: Gender, Science, and Public Rhetoric

There's a lot to say about Gardasil controversy. It brings up many of our favorite problem subjects that invite polemic from all sides--sexuality and sex practices, sexual behavior of girls, women's health, efficacy of vaccines, rights to refuse vaccines, et cetera.

This "Comment" piece I read today in The Guardian, "To deny schoolgirls a cervical cancer jab on religious grounds is scandalous" (quick side note, I absolutely LOVE the difference between calling a vaccine a "jab" instead of a "shot") brought the issues of gender as well as scientific versus public rhetoric to light in what I thought were some very interesting ways.

Gardasil vaccine controversy has some significant differences from your garden-variety MMR vaccine refusal or flu vaccine skepticism for one major obvious reason: until recently, the vaccine was chiefly marketed as the "anti-cervical cancer" vaccine, and hence was only advertised (and FDA-approved) for girls and young women.

Yet, HPV infection causes more than cervical cancer and affects more than women--HPV is the cause of genital warts in both men and women, is more common among men than women, and causes throat and anal cancers in both sexes. (See this and this and this for some NYT coverage of new research about the prevalence and consequences of HPV infection in both sexes as well as this research published in the Journal of Clinical Oncology on HPV infection and throat cancers.) Now it is recommended for both boys and girls as young as 9. The vaccine is still only recommended until age 26.

Doctors were only ever interested in Gardasil as cancer prevention, not as one against genital warts or other non-sex-specific problems that arise from HPV infection, so the product was always intended for women and girls. Possible uses for boys and men emerged later.

This, to me, is an interesting space where scientific and public rhetorics clash.

On the one side, you can see the trajectory of thinking in the scientist's brain here: Isn't it amazing that a virus causes cancer? We can vaccinate against viruses. Wouldn't it be amazing if we could vaccinate against that virus, hence eliminating cancer? What kinds of that virus cause the most cancer, giving us the biggest bang for the buck? Oh, 4 virus types cause 70% of cancer in the cervix. Let's vaccinate against those. Only women have cervixes. Let's only do clinical trials on them. Wow, the vaccine works! And it's approved! Yay, science! (Or something like that.) In this sense, this is truly groundbreaking stuff with incredible implications for the future of virology and cancer research.

Yet this incredible discovery looks very different in the (bright, unforgiving) light of public opinion. The message goes from being "this vaccine can prevent cancer" to "you should vaccinate your daughter against this sexually transmitted disease." Uh oh. That will (and did) revive every argument ever created about sexual behavior and gender-based expectations.

Not only did that result in an initial negative reaction among parents (along the lines of "my daughter will never have sex outside of marriage, so she doesn't need to worry about this") but gender continues to be central in public debates about the safety, efficacy, and availability of Gardasil.

I'm not going to even try to capture all of the arguments how unsafe Gardasil is. Just Google "Gardasil Injury" and you'll see hundreds of websites, videos, blogs, organizations, support groups, etc. that have all amassed to argue that injuries from Gardasil vaccination span a range of problems, from acute, severe reactions to long-term chronic illnesses that have destroyed healthy girls and vibrant families. Women are, in these narratives, innocent victims of a scientific community that demanded compliance, injured countless women, and remains insensitive to their pain.

Those who support the vaccination also use gender to argue for increased availability of the vaccine; as the article in The Guardian demonstrates, advocacy for the vaccination is seen as protection of women's health, and lack of access to the vaccine is seen as further intrusion of the state into the health issues of women, echoing public debates we have about abortion and contraception. By both sides of the debate, girlhood and womanhood are used to create claims of coercion and victimization by entities that either demand that they do or do not get the vaccine.

For all of these reasons, and many more, Gardasil functions as a fantastic example of how science and the public clash over vaccinations when scientific discoveries become divorced from the realities of their public purpose. I wonder how the (continuing) lessons of Gardasil will (or will not) impact the next new vaccine and the sex-based distinctions researchers make as their products are developed, tested, and marketed for targeted populations.