HIV and its cultural mutation

Diseases mutate—culturally.

Europe in the 19th century experienced an alarming epidemic of tuberculosis. One out of four reported deaths involved such symptoms as coughing, fever, and weight loss attributed to mycobacteria tuberculosis which usually affect the lungs, but can also inhabit the spine, the central nervous system, and the lymphatic system. Until the discovery of the antibiotic streptomycin after World War II, TB was an incurable ailment believed to sap the body’s energy. The resulting loss of weight and slow death of the sick body lent TB an ethereal nickname: consumption.

Before science found effective prevention of TB through hygiene, there was a widespread medieval belief that those afflicted were vampires whom people blamed for the successive deaths among family members. They were supposed to visit the survivors and feed on their blood. As late as the 19th century in New England, the bodies of TB victims were exhumed and the internal organs burned, ostensibly to prevent them from further vampiric murders.

Aside from the changed perceptions across historical periods, diseases also mutate as they spread to other cultural geographies. A reaction to the rationality and mechanization during the Industrial Revolution, the Romantic movement of the late 18th century until the 19th century transformed TB into a noble disease, an ailment that refined the soul. Consumption became a badge of honor for the artist who wouldn’t compromise his genius for a comfortable life. It signified the victory of genius and the bohemian over the cunning of capitalist wiles.

Tuberculosis was stylized as death in the cold garret, underneath the thin blanket. John Keats, trained as a surgeon, exemplifies the romanticized image of the poet who left security for a parsimonious vocation of verse-writing. Dead at 25, he left a relatively smaller—but widely appreciated—body of writings. His impoverished life (and his death, especially) lend respectability to TB as a slow dying that invites the artist to the deeper recesses of creativity. TB hid from the healthy the euphoria of the here and now—the sensitivity to the simple joys of nature that the Romantics extolled.

On the eve of Good Friday of 1896 in a French Carmelite monastery, a 23-year-old nun returned to her cell. Lying in bed, she felt a “bubbling stream mounting to my lips.” The following morning, her handkerchief was soaked with blood—an unmistakable symptom of tuberculosis. Before she died the following year, the nun finished her spiritual autobiography, universally known as “The Story of a Soul.” Twenty-seven years later, statues and pictures of this nun were reverently enshrined in churches after her canonization as St. Therese of the Child Jesus. TB became a modern martyrdom.

Diseases pass on their notoriety and—at times—sublimated representation to other disorders. A review of the history of tuberculosis demonstrates the cultural construction of diseases as medical discourse intertwines with proliferating literary and religious ethos. Maladies feed on statistics, just as they also prosper through metaphors.

In our time, AIDS as a “gay disease” is still a stigmatizing invention that refuses to retire. We still explain HIV through military terms, like “invasion” of our defense system, but we also ambivalently classify it as a disease of the effeminate. Just as a disorder is made truthful by statistics, so does it stigmatize once it is deployed by competing ideologies.

On the rising number of HIV and AIDS cases, Fr. Melvin Castro of the Catholic Bishops’ Conference of the Philippines has commented: “Figures from the Department of Health will show that most of the HIV cases are men having sex with men. Is condom the solution or is it a change in lifestyle according to the will of God?” Since I am no good with figures, I leave it to the anal-retentives to supply numerical data (like the size of a condom’s pore vis-à-vis the diameter of a virus, etc.). Instead, I tell stories that defy the figuratives associated with the sick, especially people living with HIV (PLHIV).

Like other competing discourses, the narratives on tuberculosis grafted here do not feign innocent presence. They insist on the social construction of illness. Just as there are good metaphors, there are also others that hurt. Belief in HIV/AIDS as a gay disease adds to our national health problem because it jeopardizes government programs aimed at quelling the virus. If we assent to this trope, we stigmatize the test and discourage others (men and women, gay and straight) from availing themselves of free HIV testing. I bear witness to the stigma one must interiorly dispel to get tested. It seems that being in the clinic can be judged as a spectral admission of one’s closely guarded perversity. I am classed prior to the blood result—hence the silence that pervades the clinic, and the chatter of unvoiced speculations in one’s mind about the patient sitting across the room.

I knew that St. Therese died of TB. While preparing for this essay, I accidentally found out that this celibate woman is also the patron saint of people with HIV/AIDS. I’m not into holy trivia, but I’m glad we are taking baby steps away from demonization of the virus.

In 1978, Susan Sontag provocatively claimed that “illness is not a metaphor, and that the most truthful way of regarding illness—and the healthiest way of being ill—is one most purified of, most resistant to, metaphoric thinking.” It’s debatable whether we can really think without metaphors. But we can without the bad ones.

Cyril Belvis is writing his dissertation for PhD, Philippine studies (University of the Philippines Diliman). A literature professor, he advocates zero stigma of fellow PLHIVs.