INFECTIOUS ENTANGLEMENTS Literary and Medical Representations of Disease in the Post ...

287 Pages·2010·0.72 MB·English

by  Shalini Khan

INFECTIOUS ENTANGLEMENTS
Literary and Medical Representations of Disease in the Post/Colonial Caribbean
by
Shalini H. N. Khan
A Thesis Submitted to the Department of English
in conformity with the requirements for
the degree of Doctor of Philosophy
Queen’s University
Kingston, Ontario, Canada
November 2010
Copyright © Shalini H. N. Khan, 2010
i
Abstract
This study engages with select disease narratives of the Anglophone Caribbean
through the lens of post/colonial theory, cultural criticism and the social history of
medicine. Focusing on the biological image and metaphor of infection, as opposed to its
more popular associations with hybridity and creolization in post/colonial theory, I argue
that disease discourses facilitate more complex iterations of identity than the less
dynamic, more static categories of ‘race’ (black versus white), cultural affiliation
(British, Indian, African or West Indian) or political identity (coloniser versus colonised)
and propose a theory of infectious entanglements, by which I demonstrate and interrogate
complex and transphenomenal representations of West Indian identity across ‘racial’,
cultural and political boundaries. Primary texts include eighteenth- and nineteenth-
century medical tracts on leprosy and tropical fevers; contemporary medical and cultural
texts on HIV/AIDS; and works of fiction by writers such as Harold Sonny Ladoo
(Trinidad/Canada), Frieda Cassin (Britain/Antigua) Lawrence Scott (Trinidad/Britain)
and Jamaica Kincaid (Antigua/United States).
My literary, cultural and historical analyses of biological representations of
leprosy, tropical fever and HIV/AIDS suggest that each disease facilitated the
construction of multiple cordons sanitaires, whose conceptual boundaries intersected and
overlapped in different ways. These points of entanglement, I demonstrate, are useful
sites for interrogating post/colonial constructions of identity in light of the relative
fluidity of some boundaries (such as changing ideas about who is infectious and who can
become infected, as with HIV/AIDS and leprosy) and the hardening lines of others (such
as intersecting ideas about tropical fever, pathogenic environments and the emergence of
ii
medical cartography). More importantly, such intersections sometimes revealed the
entanglement of medicine and other organs of post/colonial authority in past and ongoing
othering projects and their legitimising roles in the articulation of essential difference.
This dissertation is divided into three parts, each focusing on a particular disease
that is iconic in post/colonial narratives about the Caribbean. Part 1 focuses on leprosy,
Part 2 on tropical fever and Part 3, framed as a conclusion to this study, focuses on
contemporary narratives of HIV/AIDS in the context of earlier narratives of leprosy and
tropical fevers.
iii
Acknowledgements
I owe debts of gratitude to the many persons who have supported me in different
ways during the preparation of this dissertation. In particular my supervisor, Chris
Bongie, offered expert advice and cheerful encouragement from the conceptual stages of
this project through its completion. His meticulous editing and timely, insightful
commentary have contributed to improving the quality of this work.
Jazz and Payal opened their homes to me on my various visits to Queen’s and,
along with other friends in Kingston, Vancouver and Trinidad, offered support,
camaraderie and delightful diversions to make the dissertation process all the more
enjoyable.
My family’s support has been unstinting. Their interest in my work and their pride
in my achievements have been humbling and uplifting. While Clare did not see this
project to its completion, her quiet, steady support continues to inspire me. In particular,
Steven has been my constant with whom I have been at home as our geographies and
identities shifted over time. Out of our many conversations spawned several early ideas
that eventually evolved into some of the conceptual metaphors I use in this project. His
love, friendship, sense of humour, intelligence and generosity of spirit have sustained me.
Finally, I dedicate this dissertation to my parents, Kheeria and Narine: “islands
can only exist/ If we have loved in them.” Thank you for inspiring in me a passion for
learning and books and for your unconditional love and support across the years.
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Table of Contents
Abstract i
Acknowledgements iii
Chapter 1: Introduction
Infectious Entanglements and Representations of Disease 1
Part 1: Leprosy
Chapter 2: ‘The Disgrace of Art’: Representing Leprosy in Pre-Emancipation
Medical Texts 24
Chapter 3: Out of Place: Lepers and Leprosy in Frieda Cassin’s With Silent Tread 60
Chapter 4: Leprosy and Ruins in Lawrence Scott’s Night Calypso 100
Conclusion to Part 1 136
Part 2: Tropical Fever
Chapter 5: ‘The Disease Most Fatal to Europeans’: Tropical Fever in James Lind’s
An Essay on Diseases Incidental to Europeans in Hot Climates 138
Chapter 6: Fever and Anti-Myth in Harold Sonny Ladoo’s No Pain Like This Body 175
Conclusion to Part 2 215
Part 3: HIV/AIDS
Chapter 7: This ‘chupidness’: Representing HIV/AIDS in Jamaica Kincaid’s
My Brother 219
Works Cited 258
1
Chapter 1
Infectious Entanglements and Representations of Disease
A late nineteenth-century wood engraving titled A Mosquito Curtain for the
Soldier’s Rest depicts a recumbent soldier in a tropical forest with a mosquito net over his
head. The details of the image are noteworthy: it is dark; the soldier is alone; he is
prostrate on the ground; trees and other plants loom over his resting figure, creating a
strange and threatening environment that leaves him in a vulnerable state. The mosquito
net, however, protects him from an insidious danger: the hidden mosquitoes that would
feed on the unsuspecting and the unprepared. Acting as a barrier between the tropical
forest - a pathogenic space according to nineteenth-century medicine - and the soldier - a
representative of colonial order and discipline - the net demarcates safe and unsafe spaces
and defines the boundaries of order and disorder in the context of colonial narratives that
represent the tropics as wild and unruly and in need of being tamed.
Order-making imperatives and ideas about vulnerability are prominent themes in
my study of representations of leprosy, tropical fever and HIV/AIDS in the Anglophone
Caribbean - a study that ranges over time from pre-emancipation medical tracts to
post/colonial literary texts that include works of fiction and a memoir. Focusing on
representations of disease as biological phenomena rather than on disease as a metaphor
for other concerns,1 I argue that disease narratives facilitate more complex iterations of

1 While Caribbean and other writers have meaningfully appropriated images and metaphors about
biological disease in non-biological contexts - Derek Walcott’s invocation of “the leprosy of empire” (l 10)
in his poem “Ruins of a Great House” is a case in point - in this study I focus on metaphors of disease only
as far as they remain connected to the original image of biological infection, while also tracking the manner
in which such metaphors sometimes leak into a more general discourse that associates epidemiological
trends with essentialist biological and/or cultural characteristics.
2
identity than less dynamic categories of ‘race’ (black versus white), cultural affiliation
(British, Indian, African or West Indian) or political identity (coloniser versus colonised).
This study is an attempt to engage with select disease narratives of the Anglophone
Caribbean through the lens of post/colonial2 theory and cultural criticism for what they
might reveal about hitherto understudied aspects of colonial and post-colonial experience
in a manner that does not privilege the psychological legacy of colonialism over its
material effects, in this case, the disease experiences of Caribbean peoples.3
Representing Disease
The sustained and cohesive representations of illness that I will be referring to as
‘disease narratives’ emerge out of a network of cultural values and beliefs that ascribe
meaning to phenomena such as infirmity, death, madness and physical deformity.4

2 The term post/colonial in this study draws attention to the uneasy and awkward entanglement of pre and
post independence narratives associated with the former British West Indian colonies and is indebted to
Chris Bongie’s invocation of the term in his introduction to Islands and Exiles: The Creole Identities of
Post/Colonial Literature. I use the term post-colonial in this study to refer solely to the historical period
after independence.
3 The colonial experiment in the Caribbean resulted in complex varieties of racial intermixing, land
clearing, geographic re-settlement and new disease experiences. Alongside the highly theorized political
and cultural legacies of colonialism there exist whole categories of experiences that require a different
theoretical focus, such as on biological or environmental phenomena, as recent trends in eco-criticism,
animal studies, and disability studies have begun to provide. My focus on post/colonial disease narratives is
another such attempt to contribute to current conversations on the post/colonial Caribbean by focusing on
the role of disease narratives in constructions of Caribbean identity.
4 Medical anthropologists such as Peter Morley, for example, argue that systems of medicine are culture
based and grounded in the belief systems of a particular community. For Morley, this is also true for
Western biomedicine (what Morley calls Western allopathic medicine) though its patients are less aware of
the beliefs and values associated with this system of medicine than participants of folk systems that do not
compartmentalise medicine from other cultural domains (15). The concept ‘disease’ is necessarily
connected to a particular culture of medicine and, as such, is also connected to the value system of a
particular culture. For science historian Charles Rosenberg this is clear. He notes that ‘disease’ may refer
to:
. . . a biological event, a generation-specific repertoire of verbal constructs reflecting
medicine's intellectual and institutional history, an occasion of and potential legitimation
for public policy, an aspect of social role and individual - intrapsychic - identity, a
sanction for cultural values, and a structuring element in doctor and patient interactions.
(xiii)
3
Representing disease both as biological reality and as metaphor denoting undesirable
condition, disease narratives are characterised primarily by anxieties about potential
infection or a desire to be healed of a present affliction. For cultural theorist Sander
Gilman “the fear of collapse, the sense of dissolution, . . . contaminates the Western
image of all diseases” (1). Indeed, as I demonstrate in this study, disease narratives focus
on individual and/or communal anxieties relating to illness ranging from the perceived
threat of biological infection to ideological fears about vulnerability and cultural
contamination. These anxieties are often entangled in the narratives with the result that
fears of biological infection are often expressed simultaneously as fear of the other.
As I demonstrate in this study, the “fear of collapse” that Gilman identifies as
characteristic of Western representations of disease is also applicable to disease
narratives associated with non-Western cultures. As we will see, the motif of collapse and
vulnerability is a common thread in all of the texts that I examine, including colonial
disease narratives by British physicians and those by Caribbean writers such as Harold
Sonny Ladoo, whose representation of tropical fever is entangled in Indian/Hindu
narratives of disease. Indeed, while disease anxieties might be represented differently
across cultures, ultimately such anxieties hinge upon a fear of collapse. In Hindu sacred
scripture such as the Ramayana, for example, illness is associated with the susceptibility
of human flesh to the corrupting ways of the world. The gift of perfect health, such as

Rosenberg argues that, “[i]n some ways disease does not exist until we have agreed that it does, by
perceiving, naming, and responding to it” (xiii). These multiple meanings associated with disease, however,
all depend on culture specific contexts. Indeed, the collective agreement to name the disease and to respond
to it in community sanctioned ways underscores the enmeshment of what we call disease in the ethos of a
particular community. For further commentary on the values associated with Western biomedicine see
Robert A. Hahn’s Sickness and Healing: An Anthropological Perspective and Ivan Illich’s Medical
Nemesis: The Expropriation of Health. Caribbean anthropologist Michel Laguerre’s influential monograph
Afro-Caribbean Folk Medicine is a well-researched and engaging anthropological study of the values
associated with a specific folk-medical culture of the Caribbean area.
4
what the sage Vishvamitra bestows upon Lord Rama, is a gift from the gods and a reward
for Rama’s perfect virtue (vol. 1 54). Narratives such as these, as I demonstrate in my
treatment of anti-myth in Ladoo’s No Pain Like This Body, align illness literally with
collapse of the self but also allegorically as evidence of a compromised spirituality.
The disease narratives of so-called New World peoples demonstrate a fear of
collapse that sometimes responds to the experience of colonialism. No Pain Like This
Body, for example, engages with the Indo-Caribbean community’s ambivalent
relationship with the prior Indian homeland during the period of colonial indentureship.
The disease narrative in Ladoo’s novel articulates a response to this ambivalence partly
through its representation of disease in relation to images of collapse and vulnerability
that are meaningful in the context of Indian sacred narratives such as the Ramayana.
In other texts, such as Lawrence Scott’s Night Calypso, the leprosy narrative
involves a critique of the missionary arm of colonial enterprise. Frieda Cassin’s With
Silent Tread, on the other hand, engages with the disease anxieties of whites in Britain
and the West Indian colonies in the late nineteenth century. While Jamaica Kincaid’s My
Brother is set in the post-colonial era the memoir interrogates HIV/AIDS as a colonial-
type narrative in the manner in which it fixes the identities of particular peoples and
places in relation to others and facilitates particular constructions of otherness.
Not surprisingly, the relationship between disease and colonialism is a common
theme in the disease narratives of post/colonial peoples worldwide in the aftermath of
colonial encounter. Nigerian writer Chinua Achebe’s association of the white man with
albinism in his novel Things Fall Apart and, more recently, Indian writer Arvind Adiga’s
depiction of the horrific inefficiency of the colonial hospital in the 2008 novel, The White
5
Tiger, are cases in point. The Kiowa myth and Aimé Césaire’s invocation of colonialism
as disease - discussed below - are further examples of the close association of disease and
colonialism that are relevant to my discussion of disease narratives in the post/colonial
Caribbean.
The Kiowa myth, narrated by historian Alfred Crosby, is another example of
disease anxiety associated with collapse. Recollecting an historic experience and
narrating the American tribe’s devastation by smallpox, the Kiowa myth personifies
disease as an intimate companion of the European coloniser.5 As with the Ramayana, the
myth evokes disease in terms of collapse, here recounted as significant loss of life and the
depletion of the tribal community. More particularly the narrative demonstrates both a
literal and discursive connection between the tribe’s experience of disease and its
experience of colonisation such that the myth may be read as both a literal depiction of
the tribe’s experience with smallpox as well as an allegory of its experience of
colonialism as humiliation, defeat and suffering.
The discursive connection between disease and politics is also evident in the
post/colonial Caribbean in the work of artists and public intellectuals who have, from
time to time, also depicted aspects of colonial conquest and settlement in relation to
images of sickness.6 In Discourse on Colonialism Aimé Césaire writes: “[A] civilization

5 The story is narrated as a conversation between an elder of the Kiowa tribe and the character Smallpox.
Smallpox speaks: “ ‘I come from far away, across the Eastern Ocean. I am one with the white men – they
are my people as the Kiowas are yours. Sometimes I travel ahead of them, and sometimes I lurk behind.
But I am always their companion and you will find me in their camps and in their houses’ ” (qtd. in Crosby
Ecological Imperialism 207). Explaining that he brings death and destruction to men, women and children,
Smallpox proclaims: “ ‘No people who have looked at me will ever be the same’ ” (208).
6 A few prominent examples include Frantz Fanon’s psychoanalytic engagement of black people’s
dependency and feelings of inferiority in Black Skin, White Masks; Edgar Mittelholzer’s My Bones and My
Flute, in which images of infection and inoculation are connected to narratives about the colonial past; and
Edward Kamau Brathwaite’s The Arrivants, which evokes scattered but connected images of sickness to
describe the experiences of the New World African.