Blood, Organs, and Viruses
Rather than begin the first major chapter of this book with a shattered city, I begin it with a shattered body. In 1914, Benjamin Cardozo wrote one of his first opinions for the New York Court of Appeals, in a case brought by Mary Schloendorff against the Society of New York Hospital.1 In this case, Schloendorff argued that the hospital had performed unnecessary and dangerous surgery on her without her consent. Cardozo’s opinion in this case has been extraordinarily influential in the jurisprudence of bodily integrity in the United States,2 but this is not why I bring it up. Instead, I want to look more carefully at the way in which Schloendorff’s story was told. As Paul A. Lombardo has pointed out in an essay on the uncertain legacy of the case, one aspect of Schloendorff v. Society of New York Hospital that is almost never mentioned—especially given the valorization of the decision as the source of every United States citizen’s right to bodily inviolability—is that Schloendorff herself lost both the case and the appeal. Moreover, as Lombardo continues, Schloendorff “had no ordinary tumor . . . [I]t was a fibroid mass in her uterus and the operation done against her will was a hysterectomy.”3
All of this might seem like a strange place to start a discussion of disaster, ecstasy, and the gift of life that occurs at their intersection. There is, however, a backstory to Schloendorff’s lawsuit that makes it relevant to this book: although the doctors cut Schloendorff’s uterus out of her in New York, and although the case was heard in Cardozo’s jurisdiction, the condition that led these doctors to their diagnosis had initially manifested itself shortly following Schloendorff’s experiences in the 1906 San Francisco earthquake. Both the newspaper reports of the trial and the court transcripts dwell on this moment. In the newspaper, for example, she is, according to Lombardo, depicted as,
an elegant and dignified lady on the witness stand. Having survived the San Francisco earthquake in 1906, she suffered from “nervous shock.” After entering the hospital in January 1907 she was prepared to leave when “some of the medical staff suggested that she undergo an examination” to determine her “exact physical condition.” Mrs. Schloendorff “had a lump in her side” for five years and “of which her nurses knew.” A doctor suggested an “ether examination” saying that she was too nervous to examine otherwise. To this she also consented, but stipulated that there be no operation at that time. The surgeons called the lump a “phantom tumor” and gave her the impression that it might be due to nervousness. On recovery from the effects of the ether, Mrs. Schloendorff found that the surgeons had made incisions in her back and abdomen. In consequence, she testified, her fingers developed gangrene and she lost the use of her right arm.4
In the court transcript, Schloendorff’s first words on the witness stand were: “I lived prior to November, 1906 in the City of San Francisco, California. I lived there nearly all my life . . . [M]y physical condition in the fall of 1906 was, I might say, perfect. The earthquake of San Francisco occurred on April 18, 1906. Well, I was greatly frightened and nervous, of course.”5 As Lombardo notes, “this admission of ‘nervousness’ following the great earthquake was reiterated by several later witnesses, not as the explanation for Schloendorff’s stomach problems, but as the basis for arguing that she was noncompliant as a patient and unreliable as a witness.” 6
Embedded within the ignored story of Mary Schloendorff’s forced dismemberment 7 and sterilization at the hands of the New York medico-legal establishment, in other words—a story that is in turn usually embedded within a triumphalist progress narrative of embodied rights and liberties—is an even quieter tale of the San Francisco earthquake. Before the earthquake, Schloendorff was in perfect health. After the earthquake, she became nervous and hysterical. As a result of this hysteria she was (1) incapable of having a real tumor or feeling real pain (but emphatically capable of having a phantom tumor and feeling phantom pain);8 (2) incapable of granting or denying real consent to a medical operation (but, again, capable of granting or denying phantom consent); and (3) incapable, once the case came to trial, of giving real testimony (but capable of giving phantom testimony to the newspapers). The quietly central San Francisco earthquake, that is, became meaningful in this scenario only once the gory, violent ecstasy of one of its many subjects had been trotted out and displayed.
My point in starting with this vignette is not so much to highlight the various brutal conclusions that follow from the rhetoric of hysteria—although this case is obviously an excellent example of the logic of this rhetoric. Nor is it even to point out the sadism inherent in the common wisdom that linked the onset of hysteria to periods of crisis or disaster. Rather it is to repeat that—even here—the subject in ecstasy endowed the earthquake with meaning. And in particular, the gendered subject in ecstasy was invoked in these discussions—a gendered subject who had in fact been in the process of definition and narration many decades before Cardozo made her an object of law.9
In 1899, for example, a writer for a popular U.S. monthly wrote that “women are always more alarmed than men” during earthquakes, that “many of them have a feeling of sea-sickness,” and that “I never yet saw a female otherwise than frightened out of her wits during an earthquake.”10 A decade earlier, a more professional medical journal differentiated between the postdisaster somatic effects produced by hysterical fear, and the postdisaster somatic effects produced by external physical stimuli. During the Charleston earthquakes, for example, there were,
sundry sensations closely resembling those ordinarily produced by the shocks of electro-magnetic batteries, viz., prickling sensations, “needles and pins,” feelings beginning in the fingers and toes and extending up the arms and legs. Many of these occurred in adult males, and in children of both sexes, too young for any “hysteroidal” element to prevail. I do not think that all these sensations should be ascribed to fear, or to purely nervous disturbances.11
Finally, by the early twentieth century, four years before Cardozo wrote the Schloendorff opinion (but when the case was already in the New York court system), these popular and medical interpretations of hysteria and disaster had become the basis for new political and legal analyses of rights and gender. As one scholar noted in a discussion of the “Effect of Earthquake on the Emotions,” for instance,
with the inhibition of man’s reason, his instincts take its place, and it would seem that many of our instinctive actions are not much different from those of the brute . . . [O]ne phenomenon in this connection is almost embarrassing to mention, in view of the present growing sentiment in favor of women’s rights and woman suffrage. It appears from the effects of the recent earthquake on the American people, that human reason is more readily inhibited in the gentler sex and in children than in men . . . [T]his distinction is implied in the wording of one report which states that “men were excited, women and children frightened” . . . [I]n no case is a man mentioned as having been specially afraid.12
Earthquakes, that is, affect women by terrifying them—and terrifying them so completely that they are dizzy and nauseated, out of their wits, and devoid of reason. This fear, moreover, is the result of internal hysteroidal stimuli, often bearing no relation to what is going on outside. Men, contrarily, are influenced solely by physical and measurable (“electro-magnetic”) stimuli produced by natural phenomena. The response of men is not hysteroidal—it is in fact quite reasonable given that their bodies are being acted upon by external forces. Men are incapable of fear, of being out of their wits—and are motivated into useful action by a controlled excitement. As a result, the women’s rights movement—the process by which women in the United States were articulating their political and legal identities13—is called into question. Earthquakes make women hysterical. Women are thus unfit political and legal subjects.
Again, my point in mentioning these three examples of what is by now a welldocumented genre of law, medicine, and misogyny is not simply to provide one more example of the problematic foundations of political, legal, and medical structures in the United States. Instead, I am trying to resituate the Schloendorff case and to draw some provisional conclusions from it about the relationship between disaster and legal subjectivity. As I noted in Chapter One, there is an assumption in legal studies that law demands and insists upon a bounded, rational subject—and indeed the passage above, questioning “women’s rights and woman suffrage,” rests squarely upon that foundation. Here, however, we can see an example of just how fragile that assumption is.
No matter how rational Mary Schloendorff appeared to be—no matter how calmly she repeated her story and provided witnesses to back it up—the law asked that she be beside herself and devoid of reason. Her case, the doctrine of bodily integrity that derived from it, and above all the disaster that contextualized it in many ways could not make sense unless she was in ecstasy. Much like the metaphor of disaster that became concrete over the late nineteenth and early twentieth centuries, the ecstatic subject that defined this disaster became similarly concrete in the Schloendorff case. The subject of disaster law is in part a hysterical one—she is out of her mind. Not only can this subject be chopped into pieces, therefore, not only can she be made physically and concretely ecstatic, 14 but arguably she also must be. Rhetorically, this is what motivated the doctors who dismembered Mary Schloendorff, the victim of disaster, and—rhetorically—this is what motivated Cardozo, who turned these doctors into the heroes and defenders of every citizen’s right to bodily integrity.
I suggest as well that this is likewise what has motivated the transfer and transplant of various bodily fluids and body parts during moments of disaster. This chapter is not actually about Mary Schloendorff and the right to bodily integrity. It is instead about giving blood, about donating organs, and about spreading disease during and after earthquakes. More particularly, it is about the legal and political narrative of this postcrisis rearrangement of what has been called “living matter.” Throughout this chapter, therefore, I argue that when law is called upon to regulate the transfusion of blood, the transplant of organs, and the transmission of disease, the subject of this law is—quite concretely—in ecstasy and off-center. The subject is dismembered Mary Schloendorff. The disaster becomes intelligible when its legal and political subjects are quite physically beside themselves.
I argued in Chapter One that the subject in ecstasy—although familiar to regimes of biopolitics—is in many ways the opposite of the biopolitical subject. Unlike homo sacer, the ecstatic subject is spiritually over determined, defined by anything but bare life. I must add now that the subject in ecstasy is likewise involved in a very distinct variation on the “gift of life”—a variation that is far removed from the biopolitical regulation of bare life and death. Indeed, I make the case in this chapter that blood transfusions and organ transplants, that milk distribution and disease control, are precisely the same thing that hysterectomies, gangrenous limbs, and hysteria control were in the Schloendorff case: the concrete realization of subjects beside themselves. In no way the endpoint to a politics of bare life, these processes are rather the starting point to a law and politics of ecstasy.
Most scholarly analyses of contemporary transfusions and transplants nonetheless ordinarily see them as paradigms par excellence of (1) the triumph of Descartes’ rational subjectivity or (2) the success of biopolitical power networks. What I do in this section, therefore, is first summarize a few examples of these analyses, and then explain how my interpretation of the postdisaster rearrangement of living matter engages with and diverges from them. With that in mind, I begin with Emiko Ohnuki-Tierney’s 1994 discussion of organ transplant and brain death in Japan, the United States, and Europe. In this discussion, Ohnuki-Tierney argues, first of all, that “transplant technology leads to a series of transgressions of received categories in almost all cultures—life and death, animate and inanimate, human and non-human animal, self and other, and nature and culture.”15 At the same time, there is a definite disjuncture, she claims, between the “cultural meaning” of transplants in European countries and their cultural meaning in Japan—especially since the “need for donated organs” has led to the “construction of brain death” as a human being’s final moment.16 “The conceptual bedrock of brain death,” according to Ohnuki-Tierney, is “the cherished principle of [European] culture, especially in the Enlightenment philosophy espoused by intellectuals since the seventeenth century . . . whereby rationality is the most important criterion for humanness. As a corollary the brain—the seat of rational thought—occupies the most prominent place among the body parts.”17 In Japan, contrarily, Ohnuki-Tierney argues that the inactive brain initially “represented a prolongation of life rather than, as it has come to be viewed in some Western countries, a prolongation of the process of dying.”18
The result of the predominance of what Ohnuki-Tierney sees as the European model is thus the creation of a “hybrid human,” a subject “whose identity is solely based on rationality located in the brain.”19 As both Ohnuki-Tierney and others have pointed out, however, this triumph of the rational subject—this privileging of the bounded, self-conscious, autonomous individual—rests squarely upon the complete disintegration of any bodily boundaries between the self and others. Margaret Locke, for example, has suggested that (rational) existence and non-existence have become infinitely complicated over the past decades “because there are now those patients whose dying and living become inextricably linked through serendipitous coincidental failure of their body parts.”20 Organ transplant, in other words, assumes first, the primacy of bounded, self-conscious, rational subjectivity—Cartesian existence in all its grandeur, and second, a series of blurred bodily borders that make this rational subjectivity possible. Rational subjects exist, that is, because their bodies have disintegrated.
This relationship between mind and body is something of a departure from Descartes’ notion that the body must be curbed and controlled by the mind. The Cartesian subject, after all, enacted his rational will precisely on the unruly passions of his body. With the disappearance of the body altogether, this will becomes meaningless.21 The absurdity of a Cartesian subject existing in the presence (or absence) of the modern and contemporary body became so pronounced throughout the late twentieth century, that a number of scholars—drawing on Foucault’s theories of disciplinary power networks and, more so, biopower—tried to describe transplants and transfusions in a vocabulary of biopolitics rather than in a vocabulary of rational autonomy. These discussions relied in particular on Foucault’s point that contemporary political structures take the population or species, rather than the individual, as their subject—and argued that organ transplants are thus much more about making populations live than they are about not letting individuals die. Braidotti, for instance, states that the notion of “organs without bodies,”
marks a planetary transaction of living matter carefully invested to keep the species alive and healthy and white. In a perverse twist, the laws of unity of the “subject” result in the human being lending its organic components to many a prostitutional swap: the part for the whole. “Organs without bodies” marks the transplant of and experimentation with organs in a cynical, postindustrialist simulacrum of “the gift.”22
Again, Braidotti’s point is primarily a point about the medico-legal shift in focus toward the population—its life, its health, its racial purity—and away from the dispensable individual. At the same time, she also notes the “perverse” way in which the unity of the subject enters this new domain—the valorization of its wholeness leading to “many a prostitutional swap” of bodily parts.
What I suggest, however, is that although these critiques of the rational subject and its role in transfusion and transplant—these analyses of the biopolitical bad faith that motivates the transfer of living matter—are important ones, there is more going on here than simply biopower in high gear. First, the rational subject deprived completely of its body has been, I believe, insufficiently well theorized. What, after all, is a subject—“rational” or not, outside of its body, deprived of its body, linked, if anything, to a small pile of detached body parts—if not a subject in ecstasy? This is the very definition of bodily ecstasy. What I argue, therefore, is that although couched in a rhetoric of Cartesian boundedness, and ostensibly valorizing the self-conscious, rational individual of the Enlightenment, both the notion of brain death and the transplant regimes that have been built up around it assume above all ecstatic, eccentric subjects—subjects beside themselves.
Moreover, given that the assumption and invocation of these subjects precede the transplants and transfusions, the transplants and transfusions are arguably nothing more than concrete, physical manifestations of their subjects’ ecstasy. It is not, in other words, that there is a perceived need for blood and organs to keep the population healthy or the subject sane, and that brain death is in turn invented to respond to this need. Rather it is that the subject in ecstasy is invented, and methods of reifying this subject—transplants and transfusions included—are in turn brought into play. This is, I believe, the only way to explain the massive outpouring (or “donating”) of blood and organs that almost always follows disasters—often despite explicit statements on the part of political and medical authorities that they already have an excess of each.
If we turn to more general discussions of life, politics, transplants, and transfusions, we can see this process in action. Pheng Cheah, for instance, has discussed the rhetoric of the prosthesis—the transplant—in the context of neocolonial politics. Starting with Hegel’s argument that survival—political or otherwise—involves “limiting the organism’s relation to alterity,” and that “life is thus the subject’s power to overcome its other by containing it within itself as a contradiction that can be sublated,”23 he makes the following point:
the organic body remains self-supporting precisely because the prosthesis has been organized and made an integral part of its proper self. In contradistinction, a bad prosthesis acts as a conduit that makes the body vulnerable to hostile foreign elements. Instead of becoming an organic member of the body, it opens the body to external forces and even makes it dependent on them . . . [T]he neocolonial state is the deadly prosthesis par excellence.24
In a very different context, Butler paints a nonetheless similar picture of transplants, transfers, and prostheses. Addressing the counterintuitive rhetoric of the natural and the artificial in medical responses to intersexed individuals, she notes, first, that in the case of intersexed individuals “the norms [that] govern intelligible gender are those that can be forcibly imposed,” and that “the malleability of gender construction . . . turns out to require forceful application.”25 At the same time, however, “the ‘nature’ that endocrinologists defend also needs a certain assistance through surgical and hormonal means,” leading to a situation in which “nonnatural intervention in anatomy and biology is precisely what is mandated by nature.”26 As a result, she concludes, “malleability is . . . violently imposed. And naturalness is artificially induced.”27
Although each of these passages is part of an argument that is in many ways quite distinct, each also highlights a key aspect of the relationship between transplants and subjectivity. In the universe that Cheah is describing, a good transplant results in the organism (the nation) overcoming the foreignness of the prosthesis (the state)—it results in the establishment or reestablishment of a self-contained, bounded whole. A bad transplant, contrarily, results in a tension, a deadly competition, between the foreign prosthesis (the state) and the organism (the nation). From the point of view of the organism, the foreign prosthesis becomes a conduit for further foreign invasion and for a further erasure of bodily and political boundaries. Put bluntly, a good transplant produces a rational subject (a healthy nation-state); a bad transplant produces a subject both physically and politically shattered, beside itself, in ecstasy (a neocolonial nation-state). More to the point, however, it is the bad transplant that is assumed and then created—like Mary Schloendorff’s shattered body—by international legal systems.28 It is thus once more the subject in ecstasy that becomes, quite physically, the subject of law and politics.
Similarly, the intersexed individuals invoked by Butler are above all subjects beside themselves. The very contradictions, the very illogic, inherent in making intersexed subjects potentially bounded subjects—the enforced malleability of gender, the artificially induced naturalness of sex—indeed emphasize the impossibility of them ever being bounded, self-conscious actors. The body parts added or removed from the intersexed individual remain foreign, impossible to overcome or to subsume into an identifiable whole—physical manifestations of a shattered subjectivity, even as this subject becomes the focus of (a quite relentless) law, politics, or medicine. Like the neocolonial nation-state, therefore, the intersexed individual is indicative of a complicated and fraught relationship between transfusions, transplants, and transfers on the one hand and the ecstatic subject of law on the other. I suggest throughout the remainder of this chapter that the gift of life—the transfer of fluids, body parts, and bacteria that follows on a crisis—is a means of making this subjectivity concrete. Both the donor and the recipient become ecstatic, and in their ecstasy produce the disaster’s political meaning.
The transfusion of blood and the donation of organs are very much twentieth-century phenomena—each becoming widespread or commonplace only in the 1930s and 1960s, respectively. Long before the turn of the twentieth century, however, the possibilities inherent in each motivated a great deal of scientific research—research which in turn set the foundation for the later field of physiology. The issues raised by nineteenth-century researchers into blood and organs continued to frame conversations about the nature, use, and moral value of bodily fluids and body parts well into the twentieth century. Key to their investigations were questions about which fluids or body parts were alive and which were dead, which could be transferred between humans and animals (or among nations and races) and which could not, and—as a direct corollary to these earlier questions—which processes were beneficial to individuals, nations, or states, and which were not.
Claude Bernard, for example—one of the founders of the modern field of physiology and a tireless investigator into the nature of organs and bodily fluids—was particularly interested both in their relative “life” and in their species-specific qualities. With regard to the first, he argued that blood constantly renews itself, that it is always young, but that one could no more rejuvenate organs via contact with young blood than one could rejuvenate an elderly person by feeding him a child’s diet.29 At the same time, however, Bernard continued that if the organs are sick, the blood will become sick, and that even if one were to remove this weak blood, one could never regenerate it.30 With regard to the question of species-specific fluids, he notes that an animal whose blood has been removed will fall into a state resembling death, but that if the blood is reintroduced in time, the animal will revive—and that this is the birth of the transfusion.31 Once again, however, he adds a caveat: although one can revivify the tissues of one animal using the blood of a different species, transfusions between different species of animal cannot be successful.32
In the Ottoman Empire, similar research was being carried out on the nature of blood, bodily fluid, organs, and their transferability. As early as 1836, for example, the bodies of criminals who had died in prison were being dissected in anatomy lessons,33 and throughout the 1820s and 1830s discussions about the character and the life-giving or life-preserving potential of blood and other fluids were widespread. As one early nineteenth-century scientist, Şanizade Mehmet Ataullah, noted, blood is a flowing matter, it has the power to feed and revive (ihya etmek) every type of body, it is made up of two fundamental types—one resembling milky water and one dense and red—and under a microscope one can see that it is composed of globules (i.e., cells).34 Later on, Ottoman researchers were talking more specifically about the feasibility of transfusions, and asking pointedly what differentiates a live organism from a dead one.35 With regard to blood itself, for instance, Mehmet Şakir, a student of Claude Bernard, argued that it is entirely possible to move blood from one person’s veins to another person’s, that in a blood transfusion, one part of the fibrin (the clotting protein) is separated, and the part that remains is given to the recipient of the blood, and that if appropriate blood is not found for a transfusion, then pure water should be given in place of the blood that has been lost.36
In England, scientists were likewise engaged in research on the nature of blood as a living fluid. As an article in Blackwood’s Edinburgh Magazine put it, the appropriate question to ask at the time was “what is meant by blood being alive”—especially given that so many physiologists had a difficult time conceiving of “a living liquid.”37 The answer, according to the article, was that “it is not the liquid which is alive, but the cells floating in that liquid, and these [one must] regard as organisms.”38 Again, these issues were being addressed in countless laboratories throughout the nineteenth and early twentieth centuries—and their conclusions have been analyzed by a number of historians of science. My particular interest in this early research on blood and blood transfusion is thus less its role in the broader narrative of modern scientific method and more its relationship to the elaboration of political and legal subjects. So I pause here to highlight the implications of these studies—especially to the extent that they demanded a reevaluation of the bounded, self-conscious, rational subject that had become, by this time, the assumed subject of modern law and politics.
Most fundamentally, nineteenth-century research on blood and its transferability raised the possibility of something (aside from a fetus)39 that could be (1) a part of the body, (2) taken from the body, and (3) upon its escape from bodily borders remain both alive and self-contained. The “living fluid” dilemma raised by earlier scientists—the idea of something being both living and devoid of borders—was in fact resolved with the invention of cells as organisms, clotting mechanisms, and their relationship to the body from which they were derived. Second, and equally important, the science of transfusion redrew the lines that separated species, groups, and individuals. The fact that blood could always distinguish one species from another species, but that it only sometimes distinguished one human group from another—in one case linking individuals through the gift of life, and in another case separating them through “incompatibility”—raised questions about the national and racial categorizations that were already in place by the early nineteenth century. Having demonstrated that blood could be alive and self-contained, that it could rejuvenate and revivify, and that it could potentially serve as a means of distinguishing one (political) group from another (political) group, the research on transfusion made possible a situation in which blood itself could become more important to a nation or a state than the body that had contained it.
Almost immediately upon the development of blood typing and arm-to-arm transfusions in the first decades of the twentieth century,40 for example, various anthropologists and social scientists attempted to link blood groups to preestablished “ethno-anthropological” categories. A Turkish dissertation published in 1946, for instance, sought to determine whether Turkish racial characteristics could be predicted by blood typing,41 eventually coming to the disappointing conclusion that there was “no correlation” between “physical and racial traits” and blood groups in Turkey.42 At the same time, the contradictory nature of blood—something that in its very ability to save life made it something worth killing for—was becoming quite obvious to minority groups and marginalized groups in various nation-states. As Luise White has argued in the context of late twentieth-century East African narratives of the gift of life,
if blood is taken to be universal, then its power to terrify comes from that; if blood is taken to be a gendered bodily fluid, then the loss of blood is far more alarming to adult men than to adult women. But in either case, blood is the most ambiguous of bodily fluids; according to context it can signify life or death . . . [S]tories about bloodsucking firemen cover a wide geographic range, from the East African coast to eastern Zaire . . . [M]any of these narratives contain generic fire brigade vehicles; more often than not, captured people were put into a vehicle and taken away, sometimes to be kept in a pit in the local fire station, “the property of the local government.”43
Here, in other words, blood in its universalizing capacity to join all members of humanity together is just as potentially violent as blood in its exclusionary capacity to draw distinctions—in this case gender distinctions as opposed to “ethno-anthropological” distinctions. It represents, as White notes, both life and death. More to the point, it represents both the potential whole (humanity, the nation, the healthy individual) and the potential part (blood taken from the individual, transferred from one person to another for the sake of the nation or humanity). Finally, blood represents both the state’s duty to provide bodily fluids to each and every citizen, and the threat inherent in that duty—the need to isolate certain citizens, certain bodies, as sources of that fluid. Both the Turkish dissertation and the African narratives of fire brigades as vampires44 thus play up the twentieth-century potential of the nineteenth-century research on transfusion—the disintegration of isolated physical bodies in the name of an abstract whole, the concrete manifestation of the subject beside itself.
Narratives of organs and body parts removed, transplanted, or turned into prostheses were equally ambivalent. Again, organ transplants and blood transfusions were scientifically as well as politically bound up in one another—Bernard, for example, insisted on the mutual interdependence of healthy (young) blood and healthy (young) organs. More broadly, the question of living versus dead tissues and organisms—of which bodily fluids or body parts were “alive” with the power to rejuvenate, and which were “dead” with no power at all—remained a key one, central to the breaking down of bodily borders and boundaries in the apparent name of an abstract rational whole. Finally, body parts as well as blood could be accepted or rejected—could, in their exchange, play up simultaneously the universal commonality of the human species and the exclusionary lines drawn among individuals and groups.
At the same time, the removal and exchange of body parts and organs, almost more than the transfusion of blood, came to represent the subject in ecstasy in the early twentieth century. In an article written on the “aesthetics of dismemberment” in France following the First World War, for example, Amy Lyford has suggested that there was a direct connection between the destruction and construction of body parts and prostheses on the one hand and the politics of war and reconstruction on the other. In analyzing the Val-de-Grace hospital and museum of medicine, and its influence on the surrealist movement, for instance, she argues that “body parts had already been turned into aesthetic objects for national consumption by the early 1920s, although at Val-de-Grace the body-in-pieces symbolized France’s regeneration rather than its destruction.”45 She continues that this artistic “emphasis on dismemberment suggests a proposal to recast the state’s rhetoric of reconstruction in language that reasserted the carnal horror of war.”46
With regard to more general themes of dismemberment, Lyford notes that in Max Ernst’s collage, “Altar of the Fatherland,”
historical memory emerges from an altar made of severed limbs, and the female figure kneeling at that altar pays homage to the leg before her as if it were a religious icon. As her lips caress the leg that juts from a wall above her, the woman presents herself as a dutiful, obedient subject. She worships at the altar of male mutilation and, in this way, Ernst’s interpretation of French History [l’Autel de la Patrie] critically reinterprets the individual’s relationship to the state . . . [T]hrough prose and gesture, the collage graphically underscores the weirdness of the State’s implicit demand that trauma be lauded as if it were national triumph.47
Again, Lyford’s starting point in both of these passages is that there is something strange or unexpected about associating healthy political systems with dismembered bodies or isolated body parts, that the state’s insistence that body parts—the “carnal horror of war”—be valorized is contrary to notions of national triumph or reconstruction. I suggest, however, that what we are seeing here is simply one further manifestation of the ecstatic subject and its political potential.48 In both representations, there is a distinct coming together of the science of transfusion and the politics of ecstasy. Indeed, these surrealist statements serve as a good jumping-off point for talking in more detail about further variations on the relationship between transplants or transfusions on the one hand, and the political subject in pieces on the other—this time explicitly in the context of natural disaster.
Before I turn to my case studies, I must mention that transfusion and transplant technologies only became widespread in the middle part of the twentieth century, and so my discussion will be limited for the most part to their role in the 1999 Istanbul earthquake. Nonetheless, I must contextualize this late twentieth-century narrative of blood, disaster, and body parts within two earlier accounts—the first a failed transfusion of sorts that followed the 1906 San Francisco earthquake, and the second a successful transplant of sorts that followed the 1922 Tokyo disaster. In the first, a “respectable” San Francisco citizen, A. W. Hussey,
came to the station at the Hall of Justice and told how, at the direction of a policeman whom he did not know, but whose star number he gave as 615, he had cut the arteries in the wrists of a man pinioned under timbers at St. Katherine Hotel. According to the statement made by Hussey, the man was begging to be killed, and the policeman shot at him, but his aim was defective and the bullet went wide of the mark. The officer then handed Hussey a knife, with instructions to cut the veins in the suffering man’s wrists, and Hussey obeyed orders. Chief of Police Dinan directed that Hussey be locked up. There was no opportunity to investigate his story, but police believe that the awful calamity rendered him insane, and that the incident reported to them had no existence excepting in his imagination.49
This incident clearly has little to do with the science of transfusion or with the gift of life. Even so, however, it is clearly a narrative very much embedded in the rhetoric of blood, law, and ecstatic subjectivity that I described above. There is, for example, first of all, the shifting aside of the formal, legal relationship between citizen and police officer in favor of an informal, biological relationship between citizens. When the police officer fails to maintain, via the bullet, an appropriate distance between himself and the trapped citizen, he hands the knife to Hussey and orders him to engage in a far more intimate political interaction. It is precisely the voice of the law, in other words, that demands the abandonment of any formal legal relationship.
As soon as this not-legal relationship is established, however, it is turned into fiction, into something unthinkable. Hussey, it turns out, was insane. What happened to him happened only in his imagination. Like Mary Schloendorff, that is, Hussey is ecstatic, not quite real. But also like Schloendorff’s, Hussey’s ecstasy and eccentricity by no means disqualified him from becoming the normative subject at the center of the disaster. Rather, the transformation of Hussey from respectable citizen to ecstatic madman, the transformation of the man pinioned under the timbers from citizen in need to figment of Hussey’s disordered imagination, and the transformation of the letting of blood from act of pity to deranged fantasy were all necessary political transformations in the articulation of disaster law. They all began with the prototypical moment of political subject formation: the hail (real or imagined) of the police officer.50 But far from initiating any rational process of subjection, far from reinforcing the relationship between law-giving officer and law-abiding citizen, this process unraveled Hussey’s subjectivity. At the moment of the hail, Hussey became shattered, the man under the timbers became imaginary, and bloodletting became the only effective means of political interaction. The policeman’s hail, that is, turned Hussey into an ecstatic subject, who in turn served as an explicit model for how the police might interact with other citizens struck by the “awful calamity.”
Nearly fifteen years later, during the Tokyo earthquake of 1922, we can see similar narratives being created around the removal and transfer of body parts. Once again, I rely on only one anecdotal incident here, but this incident is indicative of a broader trend that will play out more obviously in the 1999 Istanbul earthquake. This story, like the story in San Francisco, is set following the fire that ripped through Tokyo after the first shocks of the earthquake had passed. In addition to destroying most of Tokyo’s houses and businesses, this fire likewise trapped and killed thousands who were left in the wreckage, including 32,000 people who had taken refuge in a central part of the city. In photographs taken after the fire, bodies are described as “touching each other as far as the eye could see,” and a monument was later “erected there of cement made from the ashes of the dead.”51 Prior to the construction of this monument,
those who came over the ashes when the fires had exhausted their fury found in this field a solid mass of dead, with twenty thousand still standing on their feet, held up by the other dead around them . . . [I] visited this field of death two weeks later, when the last of the fifty thousand dead of Honjo were being thrown into the rough crematorium erected there . . . [B]efore these bins passed a row of mourners, dry-eyed, silent, and stony-faced. [They] . . . shuffled in wooden clogs over the cinders, each selecting indiscriminately from the bone heaps one or two small fragments which were placed ceremoniously upon wooden trays.52
Once again, this story has very little to do with the science of organ transplant or the technology of the prosthesis. Just as Hussey’s bloodletting did, however, it can nonetheless tell us something important about the nature of body parts and subjectivity during and after moments of disaster. Again, what occurs in this story is a situation in which, first, the self-contained, bounded body is proved to have nothing to do with any sort of healthy, politically meaningful wholeness. The bodies left by the fire are separate enough to be distinguished by “touching each other,” distinct enough to be still standing, but it is precisely the separate, self-contained nature of the burned bodies that makes them horrific. It is thus the duty of both the mourning families and the government, first, to break the bodies up into indistinguishable parts—“selecting indiscriminately” from the bone heaps—and, second, to join these bodies together into a politically meaningful whole. The monument made of cement from the ashes of the dead is a hyperbolic variation on the Ernst collage—it is simultaneously a physical expression of shattered subjectivity and, explicitly, a monument, the thing that produces the disaster’s meaning.53 The removal, replacement, and transfer of body parts—the erasure of any borders separating one body from another—serves unambiguously to commemorate subjects beside themselves and their role in making the earthquake and fire intelligible.
If we jump ahead to the end of the twentieth century, these themes play out much more obviously and are much more directly linked to actual blood transfusions and organ transplants. There are, in fact, two major aspects of the Turkish response to the 1999 disaster that I address here—the first is the decision of the Health Minister, Osman Durmuş, to refuse blood donations from Greek and Armenian donors, and the second is the fear of the “organ mafia” that appeared in the mass media. Each gets at a key aspect of disaster and subjectivity, and each forges a link between legal ecstasy and its concrete realization in the bodies of citizens. Both the fear of Greek and Armenian blood and the fear of bandits who might steal one’s internal organs are motivated by a distinct legal and political regime focused above all on subjects beside themselves.
Osman Durmuş’s decision to limit blood donations prompted almost immediate protest both within and outside Turkey. Durmuş himself, a member of the far right Nationalist Action Party (MHP), was reviled as a provincial racist, who in no way represented mainstream trends in Turkish politics, and was called upon to explain himself and, in some newspapers, to resign. Although Durmuş’s reaction to the threat posed by foreign blood was, without question, radically nationalist, racist, misguided, and based in the worst sort of mid-century pseudoscience, however, I suggest that it is also a clear and logical conclusion to a century-long transnational politics of disaster. Indeed, in many ways Durmuş can be seen as the inheritor of the decision reached by that emphatic liberal, humanist, Judge Cardozo. A disaster had struck Turkey, tens of thousands of citizens had died, and Durmuş’s response was to insist upon the realization of the subject in ecstasy, the threat of the bad prosthesis, and the ways in which each could make the earthquake politically intelligible.
If we consider, for example, Durmuş’s initial statement together with the speeches he made in response to the criticism leveled at him, we can see a definite pattern developing. Less than a week after having turned away the offer of blood from the Greek and Armenian governments, Durmuş was attempting to rationalize his decision, first of all by arguing that he “could have been ignorant” of the importance of both giving and receiving blood, that it was “impossible for him to know everything,” and that in any case this was “not the time to go looking for guilt.”54 He continues, however, by defending his initial statement, insisting that he was not against Greek and Armenian help per se, but that he remained critical of “unneeded help”—that “in place of material that we don’t need,” foreign governments should instead send help that is asked for.55 In direct response to the accusations of racism, he stated:
I don’t discriminate against doctors according to their nationality. In the beginning, we needed surgeons, but now we don’t. We don’t need Greek blood—which is to say that we don’t need any blood. Because blood can’t be kept longer than 21 days. It’s a waste and extravagance (israf oluyor). Thankfully, thousands of volunteers have donated blood. Right now, the need has passed. I’m saying this so that [the blood] doesn’t go to waste. And this is my request: if one day I’m hurt and I need blood, give me blood from any nationality.56
In the months that followed, Durmuş continued to defend his position, turning the initial refusal of blood into a broader political point, while nonetheless declaring his friendship to the Greek and Armenian people. Accusing the Turkish press of launching a smear campaign against him and spreading “false news,”57 Durmuş argued that “Marxists” in particular were using the “blood issue” to sow dissension.58 In oblique response to Durmuş’s declarations, the Greek government issued a statement a month later, following an earthquake that struck Athens: “We’ll Take Turkish Blood.” This statement was immediately juxtaposed in the Turkish press to Durmuş’s unpopular decision.59
Again, the most obvious interpretation of this series of statements and events is that Durmuş is racist, that he tried and failed to rationalize his racism, and that the Greek government used the opportunity a month later to play up their own tolerance and cosmopolitanism. Unquestionably, all of these things are true. However, the incident is also more complicated than that—raising questions about blood, political identity, and the gift of life that for the most part remain unanswered. First, for example, we might ask why Durmuş preferred Turkish blood. Certainly he did prefer it—even when he explained his initial refusal of Greek and Armenian donations, his reason was that Turkish volunteers had already donated enough blood, and so foreign donation was unnecessary. The foreign blood would go to waste. Given the choice, therefore, Durmuş would always take Turkish blood before foreign blood. Why should this be?
Second, and perhaps more important, why should the response to the earthquake both within and outside Turkey be to give blood—indeed to give far more blood than was needed? Why do people want to give blood to victims of disaster in a way that they do not—as Durmuş pointed out—want to give food or money? Finally, why should there be such an outcry over the refusal of blood? If Durmuş had refused donations of food or money from the Greek and Armenian governments, there would undoubtedly have been some consternation, but his decision would never have become the international incident that his refusal of blood became. So in addition to asking why people immediately give blood, even when it is unnecessary, we might ask why people should be so offended when their blood is refused.
With regard to the first question, it is worthwhile to take Durmuş’s statements about context, international friendship, and his personal beliefs at face value. Durmuş states, before anything else, that this is not the time to be allocating blame. He reminds the Turkish population that Istanbul is in a crisis situation, that the western part of Turkey is a disaster area, and that his decision should be judged according to this context. His position, in other words, is a product of the earthquake—and his unapologetic preference for Turkish blood is something directly related to the crisis situation. Indeed, he emphasizes the importance of context when he states later that personally he would be happy and grateful to receive a blood donation from an individual of any nationality. There is a difference, he is saying, between the widespread, general transfusions that occur following a disaster and a transfusion that might occur following a private accident. The former demands Turkish blood, the latter healthy blood of any provenance. And it is for this reason, he implies, that there is no contradiction between declaring his friendship to the Greek and Armenian people on the one hand and refusing to accept the gift of life from them on the other. As a private individual, he would be grateful for foreign blood. As a politician, he has nothing but respect for foreign governments. In a crisis situation, however, he uses his role as a public figure to keep the Turkish blood supply “pure.”
My point here, again, is not that this position is any less racist than a straightforward declaration that all Greek and Armenian blood, no matter what the situation, is tainted. Neither is my point that Durmuş and his party did not take advantage of the crisis to try to push through policy that they would also be very happy to see operating in day-to-day circumstances. I do, however, think that there is an important assumption about the relationship among blood, disaster, and political subjectivity that underlies these statements, and that transcends both Nationalist Action Party policies and Turkish politics in general. People respond to disaster situations by opening their veins—by deliberately and self-consciously erasing the boundaries between their own bodies and the bodies of others. Politically responsible citizens, in other words, make sense of a disaster by becoming physical manifestations—on a mass scale—of the subject in ecstasy. Their ecstatic subjectivity makes the disaster meaningful—it brings the earthquake to life.
This is a very different process from the giving and receiving of blood on a private, individual level. If we think about what Durmuş was trying regulate in the days following the crisis, it was arguably less the purity of the blood supply—which in any case was already made up of donations from a variety of sources—and more the process of opening veins and erasing bodily boundaries. Durmuş was making a statement about which citizens could effectively destroy their bounded selves in the name of a common whole—which citizens had the right to blur their bodily borders and become physical manifestations of disaster law’s norm—and which (noncitizens) could not and did not. It was for this reason that the excess foreign blood was both a waste and an extravagance. It bore no relation to the ecstatic subjectivity demanded by Turkish disaster law. If anything, it was a menace to this subjectivity: if the Turkish subject in ecstasy made the disaster meaningful on a national level, the foreign subject in ecstasy threatened to turn it over to international ownership. Durmuş was thus not so much protecting Turkish racial purity as he was protecting the independence of the Turkish legal and political system. If the subject in ecstasy was internationalized, so too would be the law and politics of disaster that took this subject as its starting point.
This entanglement of apparently abstract legal or political norms and concrete bodily processes can likewise explain the seemingly inexplicable insistence on giving blood—and excess blood—during crisis situations—and the intensity of the anger that we see when this blood is refused. Giving blood, I argue, is more than just a rational, self-conscious decision to make blood available to victims of disaster. If giving blood were only about supplying an existing need, then arguably donors would stop giving once it was clear that enough blood was available—and they would greet news of their blood’s refusal with relative equanimity. But donors do not stop giving when news arrives that the need for blood has been met. And they do not meet news of the gift of life’s refusal with anything approaching equanimity. Rather, this news is met with anger—anger verging on political hysteria.
The rhetoric of the gift of life in this situation thus very much represents an abandonment of rational subjectivity—an embracing of the subject in ecstasy and an attempt to make this subject concrete. What matters in this rhetoric of the gift of life is the process of breaking down bodily boundaries, of producing intermingled political and legal subjects, and of making the disaster intelligible. Like Longinus’s subjects beside themselves, the blood donor becomes the normative subject of law and politics. When the gift of life is refused, therefore, so too, in part, is the donor’s political existence—an insult quite definitely worthy of anger. Whereas it is true, in other words, that yes, giving blood is an act of humanitarian concern, it is also more than that. Understanding blood donations only in terms of this concern indeed begs the question as to why people want to give blood—and especially why they want to give blood more than they want to give, say, money or food.
Moreover, this attitude toward the mixing of living matter and political subjectivity has likewise incited the fear of and fascination for the “organ mafia” that operates during and after disasters. As one article in the Turkish press, titled “Warning: Organ Mafia in Search of Homeless Children,” states,
after the looters, after the opportunists, and after the sorrows of the catastrophe, now the organ mafia has begun work. In a statement from the Bolu Crisis Center, we are informed that a 30 person group has been kidnapping children in the disaster area for use in the organ trade. According to the statement, the group is operating in the areas most badly hit by the 17 August earthquake, targeting children without relatives or whose families were trapped under the wreckage . . . [T]he group’s basic goal is to procure organs from homeless children, and according to the [government] statement: “citizens should be warned and act with care against people with this sort of bad intent.”60
In a second, more personal, account published on the one-year anniversary of the earthquake, a woman shows a reporter a photograph of the son she lost in the disaster. The reporter then tells the harrowing story of the woman’s unsuccessful search through over 400 hospitals—and then morgues—for her son. The article, however, ends on a “hopeful” note: “if my son didn’t fall into the hands of the organ mafia, he is living.”61
What makes the organ mafia particularly horrific, in other words, is not just that it harvests organs, but that it (1) targets children who have lost their families, (2) sells these organs on an illegal market, (3) bypasses political and legal structures, and (4) produces a political death far more horrific than any biological death that might land a body in a morgue. Rhetorically linked to looters and opportunists, the organ mafia represents the unthinkable moral depths to which an individual—and those whom that individual targets—might sink in a crisis situation.
Again, though, I pause to interrogate the fear and the horror that greet these stories of organ theft. Like looters,62 the organ mafia takes advantage of the weak and the miserable—people who have already suffered far more than the average citizen ought. More than that, though, the work of the organ mafia plays up the fragility of political identity during moments of crisis. Children without families can disappear. And once they disappear, their body parts are worth more than their bodies as a whole. The victims of the organ mafia become like the bodies of those presumed kidnapped and held in the East African fire stations—the property of a group that values living matter more than it values life. Their dismemberment in turn serves no purpose in the broader politics of disaster, and thus bars these victims from both the reality of the crisis and the reality of political life during this crisis.
The organ mafia, that is, terrifies because it dismembers bodies for rational purposes—because it does understand the gift of life to be a self-conscious, understandable exchange. Unlike the transplants and transfusions that occur under the auspices of political and legal structures in crisis—transplants and transfusions that are predicated precisely upon an irrational and shattered subjectivity—the transplants undertaken by the organ mafia are about the transfer of living matter alone. Far from rendering concrete the ecstatic political subject and thereby endowing the disaster with meaning, the work of the organ mafia dissociates dismemberment from political and legal structures altogether. The rhetoric of organ transplant in this scenario, in other words, rests on two assumptions: the first is that appropriate organ transplant is the result of a politics of ecstasy; the second is that inappropriate organ transplant is the result of a politics of bounded rationality.
A final, if less obvious, manifestation of the postdisaster gift of life is the spread of disease and infection that occurs at moments of crisis. Indeed, a case can be made that the transfer of viruses or bacteria is as key to the elaboration of disaster law as the transfusion and transplant of bodily fluids and body parts are—that the containment, control, and regulation of diseases are as productive of the subject in ecstasy as the regulation of blood and organs is. I suggest in this section that the law of disaster defines this particular variation on the rearrangement of living matter in precisely the way that it defined transplants and transfusions before: postearthquake disease control is, first, about creating concrete expressions of subjects beside themselves so that, second, the disaster can become intelligible. If we articulate disease control in the vocabulary of the Schloendorff case, we might say that all disease codes as hysteria during a disaster, and that in turn both the infected political subject and the political subject in danger of infection are hysterical, beside themselves, and thus produce the disaster’s political meaning.
This relationship between earthquakes and disease has been a point of discussion among scientists and political theorists for at least the past two centuries. Not content with pointing out that epidemics often follow on the heels of disaster, for example, a number of nineteenth-century scholars and scientists posited a direct linkage between the “physical phenomenon” that was the former and the “physical phenomenon” that was the latter. As Noah Webster wrote in 1800,
the comparative mildness and infrequency of pestilential epidemics in the more civilized parts of the world, in modern times, and the prevalence of the doctrine of the importance of contagion, has produced a degree of inattention amounting almost to forgetfulness of the principles which usually govern the course of such diseases.63
He continues by arguing, first, that there is a direct historical connection between “pestilential epidemics and sundry other phenomena of the physical world,” second, that “the phenomenon most generally and closely associated with pestilence is an earthquake,” and third, that it is indeed difficult to find “an instance of a considerable plague, in any country . . . which has not been immediately preceded or accompanied with convulsions of the earth.”64 In another article, a year later, he raises the example of the Lisbon earthquake and notes that “the great earthquake, which destroyed Lisbon in 1755, was followed by a distemper so fatal as to raise an alarm in England, and an order was issued by the government for all ships from Portugal to ride quarantine.”65 A contemporary memoir that includes personal anecdotes from the Lisbon disaster operates according to the same assumptions—the author remembering that he “contracted a fever” from the “intolerable stench from the dead bodies,” and that as a result he “avoided passing near certain places, where the stench was so excessive that people began to dread an infection.”66
None of these discussions of disease and disaster is particularly unique for the time—each is predicated on well-received doctrines of miasmas, pestilential space, and infection that I discuss in more detail in Chapter Four. For now, though, I highlight one key aspect of the relationship between the two that is elaborated here, and that sets up a framework for later nineteenth- and twentieth-century policies of postdisaster disease control. Both Webster and the anonymous memoirist produce what is at this point a familiar story of civilization, disaster, and in this case plague. According to Webster, “considerable plague” is (a) always the result of “convulsions of the earth,” and (b) only occurs (“now”) outside of “more civilized parts of the world.” What we have here, in other words, is a situation in which if there is considerable plague in a certain region or among a certain population, there must also have been an earthquake that prompted that disease—an earthquake that in turn shifted the affected region or population to the margins of civilization.
Disease, that is, proves the existence of an earthquake even if there is no other indication that an earthquake actually happened. The diseased subject or the subject under threat of disease thus becomes simultaneously the subject of disaster law—in need of regulation and control—and also proof that the disaster struck in the first place. When boats from Portugal are quarantined to protect civilized spaces such as England, therefore, and when visitors to Lisbon avoid certain parts of the city to evade the stench and the threat of infection, more is going on than simple precautionary measures. Like the transfusions and transplants undertaken during crisis situations, disease control measures here are less about rational cost/benefit analyses and more about creating a certain type of political subject. The quarantined individual is a concrete manifestation of the eccentric subject—an enforced expression of the subject at the margins, offstage, not part of civilization. At the same time, the vaccinated individual is a concrete manifestation of this subject’s ecstatic counterpart. Each is the norm of disaster law, each is a variation on Schloendorff in her hysteria, and each—eccentric and ecstatic—is proof that the disaster occurred.
The striking similarity in disease control measures effected by vastly different governments at the end of the nineteenth and the beginning of the twentieth centuries thus has less to do with common approaches to stopping the spread of infection and more to do with a common understanding of subjects beside themselves. Following the 1895 Istanbul earthquake, for example, the Ottoman government immediately took measures against the spread of cholera by, first, issuing a decree that only boiling water be used in hospitals and, second, subjecting all school children to health control.67 In the days following the disaster, the Sultan issued a number of further decrees attempting to regulate the health and hygiene of those homeless citizens who were forced to sleep in open areas and gardens. Citing in particular the possibility that “last year’s cholera microbe might reappear,” the government insisted on special policies of “cleanliness,” on the “disinfection and purification” of people as well as places, and on the sale of only clean and ripe food and drink.68
Ten years later, in San Francisco, the military regulations and decrees issued to halt the spread of disease were similar. As Major General Adolphus W. Greely, the commanding officer in charge of earthquake relief, noted later, “the conditions under which lived many, outside of the army camps, were often insanitary, and it was speedily evident that concentration into large camps under military supervision would best insure the public health.”69 Within the camps, “samples of water in common use were collected weekly and cultures made therefrom to determine its potable safeness,” while “every resident of a camp who would consent was vaccinated. As to those refusing, it seemed best under the conditions of the public mind to defer compulsory vaccination until small pox should break out in some camp, which it did not.”70 Indeed, Greely insisted that these “precautions, along with lines recommended by the medical officers of the Army, served as preventives against the development of sporadic cases [of infection] into an epidemic.”71 In the “General Orders” issued in the days following the earthquake, the population of San Francisco was reminded that: “our greatest danger in the future may be expected from unavoidable insanitary conditions, and every person is cautioned that to violate in the slightest degree the instructions of the sanitary officers would be a crime that could have no adequate punishment.”72
At the same time, there were those, according to journalist James Russell Wilson, who were already outside the realm of consent and punishment, and who were thus beyond the regulations of the military officers. In a personal account of his experiences during the earthquake, Wilson writes that,
we went to Agnews . . . and found the asylum in ruins and 200 demented creatures buried there. It was a sight to transfix one with horror to see scores of mad men and women strapped to trees all over the grounds, crying, shrieking, and cursing. Ordinarily troublesome in their way, the excitement of the falling building made them mad indeed, and their uncanny looks and fiery eyes were terrible to behold. Nothing could be done for them, as there was no place to put them, and every sane man, woman, and child available was digging to release the other unfortunates buried in the ruins.73
Finally, the 1923 Tokyo-Yokohama earthquake prompted similar disease control responses, but effectively eradicated Wilson’s neat division between the mentally capable who could be concentrated into camps, and the mentally incapable who remained scattered and disorganized throughout the shattered asylum grounds. In Japan, “homeless people over sixty years and those under sixty years who were imbecile, blind, or otherwise defective, or were invalids, were taken to the Tokyo Asylum for the Aged,”74 along with “pregnant women,” whom “the municipal authorities . . . promptly housed . . . in a temporary hospital.”75
I talk in more detail in Chapter Four about the division of space into camps, hospitals, and asylums. For now, I look more closely at the rhetoric of infection itself and at the disaster law that developed around this rhetoric. First, we can see as early as the 1895 Istanbul earthquake that disease during a crisis situation takes on additional or alternate meanings—that postdisaster disease is not quite the same as disease in day-to-day circumstances. “Last year’s cholera microbe,” for example, is a different kind of threat now that disaster has struck—its potential destructive capacity deserving of more effective regulatory measures than its actual destructive capacity deserved the year before. Like the implied distinction between day-to-day blood transfusions and blood transfusions in crisis situations, there is a definite divide here between the familiarity of last year’s cholera and its reappearance under the guise of a postearthquake plague. Moreover, the immediate targets of the emergency decrees are schoolchildren and the homeless—people ordinarily at the margins of legal and political discourse, or at least present only as silent, passive objects of the law. Indeed, it is precisely the marginal figure, the figure offstage, who is of particular interest to antiepidemic decrees—the eccentric subject who reveals the degree of the microbe’s danger.76
As the military decrees following the San Francisco earthquake and the political responses to the Tokyo disaster make clear, however, even nonmarginal, nonvulnerable populations are gradually turned ecstatic in the days following the destruction. It is not, in other words, just that those figures ordinarily at the margins of legal discourse become suddenly of interest during moments of crisis. More than that, the law of disaster and the control of postdisaster epidemics is aimed at turning all political subjects into marginal figures, of making each and every citizen a child, a vagrant, or a hysteric. As Greely insisted in his discussion of military rule in San Francisco: (1) conditions outside of the camps were productive of disease, and (2) all individuals were thus threats to themselves and others until they became subject to camp protocol—until they submitted to what was essentially the regime of the hospital or the asylum. Even consent to medical treatment became the fantasy of consent to medical treatment that surrounds the child or the lunatic—Greely will “only” insist upon nonconsenting vaccination when he, as an authority figure, deems that such vaccination is necessary.
Likewise, in the statement issued directly to the population of San Francisco, the unhygienic citizen—in other words the citizen who does not submit to camp protocol—is effectively placed beyond the realm of law. Being unsanitary is described as a crime “that could have no adequate punishment,” a crime that transcends notions of innocence and criminality, and a crime that therefore shifts its perpetrator to the realm of the insane. Like the lunatic, the unhygienic citizen simply cannot be defined by ordinary, day-to-day notions of punishment. Just as those within the camps are marginal figures, made children or vagrants by the intensity of the regulatory regime under which they live, those outside the camps likewise become marginal because they are “insanitary”—and for all intents and purposes insane. And as a result, the insane themselves—those “poor demented creatures”—become in many ways irrelevant. Mary Schloendorff is hysterical. A. W. Hussey is hysterical. The respectable citizens of the city are all hysterical—and thus the hysterics themselves have literally no space to be insane. They have become identical to the general population—a situation made all the more explicit by the Japanese government’s decision two decades later to focus above all on the homeless, the elderly, the pregnant, and the imbeciles as the new eccentric subjects of antiepidemic law.
By the end of the twentieth century, this postdisaster tendency toward the creation of marginal, eccentric subjects had become far more pronounced. Following the 1999 Istanbul earthquake, for example, the Turkish media, in response to government warnings, was quick to point out that the “greatest danger” to earthquake victims was inadequate health protection, and that it was of the utmost importance that citizens therefore know and make use of government information about the prevention of infection. Among other measures adopted to protect the health of Turkish citizens and to stop the spread of hepatitis A, dysentery, and typhus, the government decided to “empty” dangerous areas and construct hygienic camps to shelter the victims.77 Within these camps, citizens might avoid such threats as kidney failure resulting from toxins in untreated water,78 and be given inoculations against diseases carried by rats frequenting the city centers.79
At the same time, the camps—like those in San Francisco—could not prevent the more psychological manifestations of postdisaster plague and infection. The “psychic trauma” experienced by children in the days and weeks following the earthquake, for example, became a medical condition in and of itself—deserving of special treatment, particularly to the extent that these sleepless and depressed children refused to return home:
if there is no risk, the decision should be taken to return home. Children may not want to enter their houses. This can pose a big problem for families. It’s necessary to re-introduce our children to their homes. This should be limited to five to ten minutes. Repeat this a number of times during the day. Then extend the time to one to two hours.80
Women likewise experienced frightening psychosomatic illnesses, resulting in an overall “decline in male births.” Citing the work of British, Danish, and American specialists, a number of Turkish newspapers noted that “great stress raises the number of female births and lowers the number of male births,” that if a woman experiences a natural disaster such as a fire, flood, or earthquake before conception or in the first few days of pregnancy, the likelihood that she will have a boy diminishes, and that, according to at least one researcher, “psychological shock will effect sexual activity, fertility, and hormone production, will cause a decline in sperm quality, and will increase the likelihood of miscarrying a male embryo.”81
In this late twentieth-century take on the prevention of postearthquake infection, in other words, we can see precisely the emphasis on the eccentric subject—precisely the insistence on mobilizing law to create the eccentric subject—that we saw before. The center—be it the city center, the center of the disaster area, or the domestic center—was either actually dangerous or perceived to be so. Illnesses—viral, bacterial, mental, or otherwise—afflicted those who remained on the scene. If one refused to leave the scene, to go offstage, the result was the ecstasy of infection, the blurring and breaking down of bodily borders. On the one hand, therefore, citizens were encouraged to marginalize themselves, to enter camps, to be subject to regulation as simultaneously threatened and threatening beings. On the other hand, children especially had to be reintroduced to their homes. Traumatized and hysterical, these children were eccentric to themselves, frightened of the very spaces that should be the center of their lives. Their refusal to enter their homes and the medical advice on reintroducing them thus revealed the paradoxical centrality of the off-center subject and the role of this subject.
More so, however, the disease that afflicts women in crisis, and afflicts them such that they can give birth only to girls, turns both these women and their daughters into the normative subjects of disaster law. Like Webster’s “pestilential epidemics,” the decline in male births in this analysis is—above all—scientific proof that a disaster occurred. Even without any other indication of shock, illness, or hysteria on the part of the mother, the birth of a girl in a disaster area will now always be suspect—will always be possible evidence of a more pernicious, widespread trend toward nervous mothers and miscarried male embryos. Women who give birth to girls following an earthquake are therefore in many ways concrete expressions of the turn to the “feminine,” as the eccentric, in times of crisis—they are the marginal, unknowable subjects analyzed by Braidotti who, in their very marginality and hysteria, prove that the disaster occurred. Scientifically, these women and their daughters become the eccentric, fantasy subjects who prove that the disaster happened (even in the absence of any other evidence).
The widespread success of blood transfusions, organ transplants, and disease control is ordinarily held up as evidence of the twentieth-century triumph of the rational, bounded subject. Judge Cardozo’s decision in Schloendorff v. Society of New York Hospital is likewise usually analyzed as the prototypical twentieth-century decision, a decision that privileges above all the self-conscious, thinking citizen and his82 inviolate bodily borders. Each in a different way has been seen as a validation of the Cartesian universe—each a political or legal confirmation of the sane, lucid individual’s ability to control his disorderly, disruptive body.
What I have done in this chapter is challenge these interpretations of transplants, transfusions, and the legal narratives that surround them. Without necessarily throwing out the rational subject altogether, I tried to complicate the progress story—to link blood transfusions, organ transplants, and disease control to blood letting, dismemberment, and failed prostheses—to suggest that these transfers of living matter and these gifts of life are not as clearly connected to the bounded, self-conscious individual as they might initially appear to be. Especially to the extent that they are defined by the law of disaster, these processes are quite definitely playing multiple roles—providing necessary relief to the suffering while also providing countless concrete expressions of the ecstatic, eccentric, subject of disaster, the subject whose unintelligibility makes the disaster in turn intelligible.
Indeed, the contradiction between Cardozo’s opinion—the vindication of every citizen’s right to bodily integrity—and Mary Schloendorff’s actual—gory—fate is possible only given this more complicated reading of the gift of life. It was precisely the San Francisco earthquake that made Schloendorff’s dismemberment possible—and that in turn allowed this dismemberment to be read as the triumph of a humane, rational legal system. And arguably, Cardozo’s opinion did represent the triumph of a humane, rational legal system. It was the triumph of a legal system, however, that took as its normative subjects those subjects in pieces, in ecstasy, hysterical, and beside themselves.
If we turn, for example, to a second, equally influential opinion written by Cardozo a decade later, we can see this same tendency toward valorizing the ecstatic, shattered subject as the legal and political norm. Indeed, we can see in this case the beginning of a distinct overlap between the apparently unique, ad hoc world of the disaster and the apparently continuous, well-formulated world of ordinary law. Cardozo’s 1928 decision in Palsgraf v. Long Island Railroad is usually read as a foundational discussion of negligence in the same way that his decision in Schloendorff is read as a foundational discussion of the right to bodily integrity. In it, Cardozo reverses a lower court’s decision to grant Helen Palsgraf damages for injuries she sustained after an explosion occurred on the Long Island Railroad track.
In concluding this chapter, however, I discuss Palsgraf less as an example of U.S. tort law in action and more as an example of the interconnectedness of disaster law and everyday law. The details of the case make clear, as do the details of Schloendorff, that Cardozo was not a judge particularly impressed with women’s claims that they should remain free from bodily harm.83 Whereas the lower court recognized in the Long Island Railroad accident a distinct act of negligence, Cardozo emphatically did not. As far as he was concerned, Palsgraf had not demonstrated effectively that her rights84 had been violated during the explosion, and thus she did not merit damages.
More important to my own argument, though, is the language in which Cardozo and his fellow judges expressed their opinions of Palsgraf’s claim. It is indeed worth pointing out that despite the fact that Palsgraf is now quite literally a textbook case in torts classes in the United States, and despite the fact that the usual lesson to be learned from studying the case is a lesson about intent, cause, proximate cause, and effect, Cardozo himself rarely uses an explicit vocabulary of negligence in his opinion. It is instead in Judge William Andrews’ dissent that most of the talk of intent, cause, effect, and general negligence occurs. Cardozo, rather, speaks a strange, if now familiar, language of “bodily security.”
Whereas Andrews, for instance, argues that negligence is “a wrong not only to those who happen to be within the radius of danger but to all who might have been there—a wrong to the public at large,”85 Cardozo argues that “the plaintiff as she stood upon the platform of the station might claim to be protected against intentional invasion of her bodily security. Such invasion is not charged.”86 Whereas Andrews emphasizes the inherent “illogic” of trying to delimit “proximate cause”—the extent to which “because of convenience, of public policy, of a rough sense of justice, the law arbitrarily declines to trace a series of events beyond a certain point,” and the extent to which “this is not logic. It is practical politics”87—Cardozo emphasizes the “futility” of tracing a violation of bodily integrity rights to a separate violation of property rights.88 Finally, Andrews states specifically of Palsgraf’s claim:
the only intervening cause was that instead of blowing her to the ground the concussion smashed the weighing machine which in turn fell upon her. There was no remoteness in time, little in space. And surely, given such an explosion as here it needed no great foresight to predict that the natural result would be to injure one on the platform at no greater distance from its scene than was the plaintiff . . . [U]nder these circumstances I cannot say as a matter of law that the plaintiff’s injuries were not the proximate result of the negligence. That is all we have before us.89
Cardozo, meanwhile, in what is again a perhaps unexpected echo of his Schloendorff opinion, stated:
negligence is not a tort unless it results in the commission of a wrong, and the commission of a wrong imports the violation of a right, in this case, we are told, the right to be protected against interference with one’s bodily security. But bodily security is protected, not against all forms of interference or aggression, but only against some.90
While Andrews, in other words, talks about time and space (cause, effect, proximate, and not proximate), Cardozo remains immersed in his vocabulary of bodily security, bodily boundaries, and the ways in which these boundaries might or might not be violated. This disjuncture in language is indeed so great that at times reading the decision together with the dissent is like reading responses to two completely separate fact patterns.
And yet, neither Cardozo nor Andrews seems bothered by this discrepancy in vocabulary. Although they disagree vehemently with one another, each refers to the opinion of the other in his own opinion, and each presents himself as arguing an opposing point based, nonetheless, on identical terms, givens, and assumptions. The fact that they appear to be speaking completely different languages does not enter the picture.
It is for this reason that I conclude this chapter with an examination of Helen Palsgraf’s claim. The assumption in Palsgraf that a discussion of “proximate cause” is no different from a discussion of “bodily security” is arguably as odd as the assumption in Schloendorff that the right to bodily integrity can best be exercised via its violation. I suggest, however, that just as the contradiction in Schloendorff was resolved—if rendered no less disturbing—when we recognized the normative function of the subject in ecstasy and the quiet centrality of the San Francisco earthquake, so too this discrepancy in Palsgraf is resolved when we consider the possibility that both Cardozo and Andrews are once again attempting to articulate a Schloendorff style political subjectivity. Both Schloendorff and Palsgraf point to a distinct collapse of disaster law and everyday law—and a collapse most clearly manifested by the subjects that each case takes as its norm.
If we think about what precisely disturbed Andrews, for example, it was first and foremost the irrationality of trying to describe accidents in the language of law. Andrews recognized that as soon as law admitted these limitations of rational language—even if only in the apparently narrow field of tort law—there came into existence a much more general arena, known to exist but unintelligible, that was likewise inexpressible. In his extended definition of proximate cause, he was thus arguing in a quite universal way that there is a point, an illogical, arbitrary, inexpressible point, at which cause and effect can no longer (legally) operate. There is a point at which the field of the intelligible is separated from the not-field of the unintelligible. And in the particular case that he was hearing, Helen Palsgraf occupied that point.91 Even as Andrews attempted to extend the boundary of the intelligible to include Palsgraf, therefore, he was forced to recognize that this extension was arbitrary and subject to failure—that Palsgraf was effectively excluded from the universe of the rational, offstage, and eccentric to herself.
That Cardozo then reinforces Palsgraf’s eccentricity not via Andrews’s vocabulary of time and space but rather via a vocabulary of bodies beside themselves simply plays up the simultaneity of this physical, spatial, and temporal existence. Cardozo and Andrews were in fact speaking the same language—a language, however, not of cause and effect, not of rational systems of rights, but of ecstatic and eccentric subjectivity. Indeed, the primary difference between the two was that whereas Andrews recognized the irrational endpoint to legal rationality, Cardozo chose to ignore this endpoint and to displace the hysteria onto his shattered women plaintiffs. Just as in Schloendorff, however, in Palsgraf too, this move was ineffective. Far from placing the rational, autonomous, self-conscious figure at the center of law and politics, Palsgraf, like Schloendorff, demonstrates the relentlessly normative function of the unbounded subject, the subject in ecstasy. Just as Schloendorff’s shattered body became the paradoxical centerpiece of Cardozo’s articulation of the right to bodily integrity, Palsgraf’s shattered body became the paradoxical foundation upon which twentieth-century U.S. narratives of public safety and negligence were built.
When I say, therefore, that disaster law and ordinary or everyday law have gradually become identical—and that Palsgraf is an ideal example of this process—I am making a quite specific claim. It is not just that accidents are like small catastrophes—each demanding a legal response but each at heart irrational, unintelligible, and incapable of legal articulation. Nor is it just that in foundational cases like Schloendorff, there is often a disaster, the San Francisco earthquake, lurking the background. Nor is it even that the gift of life in its various manifestations is both something that occurs every day, under ordinary circumstances, and something that demands a future accident or catastrophe. More so, it is that as disaster law and everyday law are elaborated alongside one another—each producing and assuming the same ecstatic, eccentric political subject—each requires the existence of Mary Schloendorff and Helen Palsgraf.