Mere Life and the Infected Body: The Implications of an Ethnography of Hepatitis

By Chris Kortright

With the events of 9-11 and the proceeding "War on Terrorism," there is a feeling that we are in a new time – within a new state of things. We are in a state of emergency, which is represented by the Patriot Act, but is this state of emergency we are in just those of state politics towards terrorism? We can see a similar representation of security articulated by the state towards the issue of diseases. In my work on Hepatitis, there are articulations of epidemics that can only be curbed by state intervention. This intervention is centered on the surveillance and tracking of individuals and communities to monitor both moral behavior as well as immunization. In one case an informant of mine said, "We have the ability to nearly stop Hepatitis B, but the problem is the community; they don’t know what’s best. We need to be proactive; we need to make sure immunizations happen." So, the question needs to be asked are we in a different the state of thing? If we turn to Giorgio Agamben’s work on the "War on Terror" or Nick King’s work on Biosecurity, we can see that the answer is clearly no; the state(s) of emergency we face are actually the rule[1].

One of the strengths we have as anthropologists of science, which to me means anthropologists of the state and capitalism, is that we use ethnography to look at the particular articulations and practices to understand larger constellations of power. I believe the importance of starting with the exception in the state of emergency – whether it is legal or medical – is that it creates a very different object to understand the relationship between the state and the "citizenry." The process of exclusion and inclusion can be understood as an articulation of violence that preserves the law. In response to this violence, the health advocates I have contact with, especially left-leaning advocates, usually argue that to remedy this violence there needs to be an act of inclusion that integrates the excluded into the liberal state medical system. The analysis is usually that of structural systems and "how to fix" these systems; there is never a questioning of the totality of the present state of things. I argue that an ethnography of "mere life," or those in the space of exception will bring out the structural violence, but will not offer a position of reform; instead, "mere life" only offers a possibility complete rupture with the present state of things – i.e. the state and capitalism.

To understand the state of emergency as an essential component of the state, German Marxist and critical theorist Walter Benjamin analyzed the link uniting violence and law in his essay "Critique of Violence." I will move from this essay to show that the exclusion that occurs in the state of emergency – whether legal or medical – is essential to the creation of a new and radical politics that breaks with the present state of things.

In Benjamin’s analysis, there is a dialectical oscillation between the violence that posits law and the violence that preserves it. Benjamin argues that when the rule of law is established, it does not separate itself from violence and that law is not established as contradictory or in contrast to violence. In other words, violence does not become the antithesis of law; instead law becomes the control of the means of violence in the process of class struggle. Benjamin argues that law is the power over the act of violence. In his historical analysis, lawmaking is state making, so lawmaking becomes an act of violence. For Benjamin, the establishment of the rule of law is the establishment of the rule of violence.[2] The state of emergency is the temporary suspension of the rule of law. In this temporary suspension, the state can intervene in the lives of its citizens in a manner that seems contradictory to the law because it is suspended for the moment. To use an extreme example during this period, an individual can be shot because they are out after curfew in the wake of Hurricane Katrina. Usually this action would be considered contrary to the law, but in the name of security and safety, the shooting of this individual, which is in contradiction with the spirit of the law, is seen as the protection of the state and its laws. As such, the concept of "rights" becomes secondary to the preservation of the state – even a liberal democratic state.

In the case of Hepatitis, normal ideas of rights and privacy are suspended in the name of preserving the public’s health. According to the Center for Disease Control and Prevention, Hepatitis B and Hepatitis C are serious diseases caused by viruses that attack the liver. These viruses cause lifelong infection, cirrhosis of the liver, liver cancer, liver failure, and death. The Center for Disease Control and Prevention has a database that has the names of newborn children and immigrants with both viruses. This information is then accessible to other state institutions, which means individuals can then be denied access to things like education or entrance into the country. In one case, a group of Hmong immigrants were denied entrance into the United States from a Thai refugee camp because they were placed in the category of "infected." By testing positive for Hepatitis B, they were placed in an excluded position and their agreements with the US government tied to the post-Vietnam situation of the Hmong was suspended. Benjamin makes the distinction that even laws that are not directly violent, like contract law, are still violent because they strengthen and preserve the state, which maintains legitimacy through the exploitation of the excluded and exploited. So, even the laws that "just" track disease rates are still violent because they still maintain the process of excluding the sick and poor. This statement does come across as very black/white. I’m not saying that all attempts to track diseases are violent, but in agreement with Benjamin, I’m saying that even benign laws are violent because they are constructed and preserved through force and power that is the violent underbelly necessary for the functioning of democracy.

To understand the processes in the state of emergency and its relationship to disease, we need to place Benjamin’s analysis in dialogue with French theorist Michel Foucault. In Foucault’s later work, he analyzed two distinct ideas. The first was the study of political techniques – like the science of policing – used by the modern State. This exploration centers on how the State assumes and integrates the care of the biological life of individuals. His second exploration was the "technologies of the self." Here he looks at the processes of subjectivization, which binds the individual to their identity and consciousness. These two ideas create a political double bind, which is constructed by individualization and the totalization of structures of modern power. It is here at the intersection between the two models of power – legal and biopolitical – where we find Benjamin’s "mere life." In this figure, we can find the exclusion and inclusion from the legal system – at the same time.

Benjamin finds a connection between violence and law; in his articulation, violence becomes the real content of law. The link between violence and law becomes the figure of "mere life." He argues that "mere life" is the connecting point – via the human being – between legal violence and natural violence. There, the infected – excluded, tracked, monitored, and denied care – becomes the population in the exception; they are excluded from the liberal laws either for their own good or the good of the community. Benjamin writes, "For blood is the symbol of mere life."[3] "Mere life" becomes the biological human that can be taken without consequence. By "taken," Benjamin means actively killed, but I argue that the state’s negligence and active exclusion of infected individuals and communities is an act of taking lives without consequence. "Mere life" is represented as solely biological through its materiality of tissues and blood because it becomes excluded from the moral and political realms. If junkies die of liver cancer caused by Hepatitis C, there is not a call for structural change based on either moral or political grounds. The deaths are represented as repercussions for lifestyle choices and thus, not a social or political issue.

It is this figure in the exception that interests me. "Mere life" creates a void that cannot be represented by the state. The deaths of junkies and immigrants from liver cancer become hidden through statistics and reports, and rarely are they seen as anything besides the results of lifestyle choices or primitive living conditions. Hidden under the freeways and in shooting galleries or tucked away in immigrant ghettos and refugee camps, these people whose deaths and painful illness goes excluded are examples of the ignored violent underbelly of the liberal state. The important aspect of understanding this underbelly, and why I turn to Benjamin, is that the violence cannot be reformed because the violence and death are necessary for the formation and preservation of the state itself. "Mere life" becomes the figure and central position where we can begin creating structural changes beyond reform.

Ethnography offers us a practice that can explore "mere life." It, also, offers me a way to examine and analyze the functions and practices of both capitalism and the state as they are played out and experienced everyday through the lives of individuals. Thus, by diving deep into the fragments – the daily manifestations of violence and discipline, we can begin to produce different possible understandings of the modern state. Anthropologists of science, or at least medicine, need to move their analysis to the particular practices of violence, which manifest in both totalitarian and liberal states. By understanding the fragments where "mere life" in constituted, it is possible to see the articulation of Foucault’s position between his two poles of analysis. By making "mere life" our object of study and utilizing the analysis of both Foucault and Benjamin, we see that there is no room for reform because the figure of "mere life" and the violence in the exception is necessary for all states totalitarian and liberal alike. The only option to create a space without violence and exclusion is to move beyond the state-capital-citizen relationship to a relationship between people that is not mediated and managed by the state or capitalism.



[1] Walter Benjamin (2002) "On the Concept of History" Selected Writings Volume 4. Cambridge: The Belknap Press of Harvard University Press (389-400)

[2] Walter Benjamin (2002) "Critique of Violence" Selected Writings Volume 1. Cambridge: The Belknap Press of Harvard University Press p. 248

[3] Walter Benjamin (2002) "Critique of Violence" p. 250