Pedagogy

The COVID pandemic is the latest in a series of new infectious diseases that have broken out almost every year since the beginning of this century, making public health once again a global concern:  Severe Acute Respiratory Syndrome (SARS), H1N1 and swine flu, dengue haemorrhagic fever, Middle Eastern Respiratory Syndrome (MERS), ebola, Zika and Nipah virus disease. With the development of vaccines and antibiotics in the first half of the twentieth century, epidemics had seemed to be a thing of the past. The last major pandemic had been the Spanish Flu outbreak of 1918-1920. When the World Health Organization declared in 1980 that smallpox had been eradicated, it was hailed as an “unprecedented achievement in the history of public health” (WHO 1980). This story of medicine’s triumph over the microbial world, however, was cut short with the emergence of HIV/AIDS in the 1980s: AIDS, as Mark Honigsbaum notes in The Pandemic Century, “forced scientists to confront the hubristic assumption that medicine was on the verge of conquering infectious disease” (165). Most of the pathogens that have emerged since then are of zoonotic origin, from increased contact with animal hosts due to deforestation and urban development. Once the animal-human barrier is crossed, the pathogens are transmitted rapidly across the world through international travel. COVID-19, for example, spread from Wuhan in China to more than 114 countries in just three months from January to March 2020, causing about four thousand deaths and two hundred thousand infections.

In May 2020, in the midst of the first COVID lockdown, I gave a pre-recorded talk for the English department at the University of Hyderabad on the plague outbreak in U.R. Ananthamurthy’s Samskara. In the course of writing it I thought of designing a course on Indian epidemic narratives, and I thank the department for giving me the opportunity. There was hardly any literature on epidemic narrative as a genre and Indian stories in particular, though the pandemic had revived interest in classic texts like Daniel Defoe’s Journal of the Plague Year and Albert Camus’ The Plague. There was Priscilla Wald’s Contagious, published in 2008, but it was an empirical study of American narratives dealing specifically with the event of outbreak. Given that we were then going through one of the worst pandemics in recorded history, and, moreover, one that has generated an unprecedented corpus of stories in print, cinema and social media, I realized the urgency and value of such a course. When I offered it once again the following year, I redesigned it to make its focus clearer. In the sections that follow I will discuss the redesigned course in terms of (I) conceptual framework and (II) organization of course content; in concluding section (III), I will suggest how it can be modified for an Indian Writing in English programme.

I

Epidemics are contingent events that put unprecedented stress on a community’s medical and moral resources. They are random and unpredictable; they cause death, bodily suffering and economic distress on a large scale; and they put to test the community’s capacity for enduring in the face of crisis. This, lest we forget, was what we all went through in the initial COVID years. As such, they symbolize what Clifford Geertz calls “chaos” – “a tumult of events which lack not just interpretations but interpretability,” that threaten “to break in upon man … at the limits of his analytic capacities, at the limits of his powers of endurance, and at the limits of his moral insight” (100, italics in original). If the first response to an outbreak is incomprehension, as Charles E. Rosenberg (1989) explains, the second is the effort to make sense of it and to formulate collective strategies to mitigate its effects. Rosenberg presents the structure of an outbreak as a three-act drama, the first being its acknowledgement as a crisis, the second being the creation of a frame of explanation to manage its randomness, and the third the adoption of disease control measures based on how its cause comes to be understood.

I have argued elsewhere that there are two broad paradigms for making sense of an outbreak, naturalistic and magical, based on two different theories of causation, biomedical and cosmological (18). The naturalistic paradigm holds that it is caused by factors such as the human body’s relation to its physical and microbial environment: it is the aetiology underlying biomedical explanations in public health (though literate medical traditions in India like ayurveda and unani are also naturalistic, they do not deal with public health). The magical paradigm holds that an outbreak is caused by non-natural factors such as the anger of a deity or an ancestral spirit provoked by a transgression of the cosmic order – the aetiology on which cosmological explanations of outbreak are built. By cosmos, I mean the entire material and symbolic universe that we inhabit with other beings natural and supernatural. Collective measures to mitigate the crisis derive from these two aetiologies and their explanatory paradigms: in the first case they involve rituals of appeasing the deity or spirit or of invoking their aid, in the second therapeutic regimes and preventive practices like wearing masks, quarantining infected persons and maintaining social distance. Both are effective in their different ways, one addressing epidemic panic and moral uncertainty and the other addressing bodily health. Though magical-cosmological styles are often dismissed as ineffectual and superstitious, they have, as Marcel Mauss says of magic in general, “a special kind of effectiveness, quite different from their mechanical effectiveness” (25). The distinctions that I make between magical-cosmological and naturalistic-biomedical, however, are only schematic – actual frames and practices in any society often draw on both to varying degrees, in a manner more heterogeneous than any schema would suggest.

In constructing the significance of an epidemic outbreak, narratives draw on the aetiologies and explanatory frames prevalent in particular historical and cultural contexts. As such, they draw on one or both of the types I discuss above. This provides the basic theoretical argument of the course, while other arguments pertain to narrative mode, time-space representation and emplotment. The magical-cosmological style uses a mode of narration that is primarily mythic, and its quintessential example is the liturgical narrative of epidemic deities like Sitala, the goddess of smallpox. In many of the stories or kathas of Sitala that are recited during her worship she appears to her devotees in dreams and visits their homes to lie down in the hearth, which must be left cold overnight. The devotees invoke her by singing her praises and receive her with an offering of stale food and curd, a fare that is cooling (her name means ‘cold’). She rewards them with protection from disease if she is appeased, or unleashes the pox on them if angered by an invocation or reception improperly performed. The narrative unfolds, thus, in a mythic landscape that is timeless and spatially unspecific – a katha usually begins with ‘Once upon a time in a land …’. In contrast, the naturalistic-biomedical style uses a mode that is realistic, its quintessential example being the epidemiological report and media story that document the time-space of emergence, transmission patterns and rates, and statistics of morbidity and mortality – data that are objective and verifiable. Literary narratives and fiction films lie in between these polar types, drawing on both modes. Ananthamurthy’s Samskara, thus, provides two explanations for the deaths in Durvasapura. For the brahmins of the agrahara they are the outcome of “Naranappa’s untimely death” and their “dereliction of duty in not performing his final rites,” while for Manjayya they are caused by the plague bacillus which Naranappa carries from Shivamogge, “and plague spreads like wildfire” (89). In style it hovers between realism and myth, an apt instance being the ending of the story when Praneshacharya wanders into the chariot festival at Melige.

Time-space representation, or what Mikhail Bakhtin calls “chronotope,” is integral to narrative, since it is in time and space, real or imagined, that events and acts unfold: “In the literary artistic chronotope, spatial and temporal indicators are fused into one carefully thought-out, concrete whole” (84). It is what links the represented world of narrative to the real time-space that we inhabit: “The work and the world represented in it enter the real world and enrich it, and the real world enters the work and its world as part of the process of its creation, as well as part of its subsequent life, in a continual renewing of the work through the creative reception of listeners and readers” (254). Myth constructs time-space as symbolic, while realism constructs it as factual. The chronotope of epidemic in any given narrative, accordingly, lies between these two polar forms, represented (as I have mentioned above) by the liturgical story on the one side and the epidemiological report on the other.

By ‘narrative’ I mean any text that organizes a sequence of events and actions both causally and chronologically towards a closure. The events may be objective, as in historical, biomedical and media accounts; subjective, as in memoirs; or imaginary, as in short stories, novels and films. What links these distinct genres of narrative is emplotment, or the structuring of the plot. To explain this I draw on arguments from Paul Ricoeur’s Time and Narrative and Hayden White’s Tropics of Discourse. White’s argument is that the distinction commonly made between history and fiction, the one ‘real’ and the other ‘imagined,’ becomes irrelevant insofar as the organization of the plot is concerned. Both follow the same procedure: “The events [in a historical narrative] are made into a story by the suppressing or subordination of certain of them and the highlighting of others, by characterization, motific repetition, variation of tone and point of view, alternative descriptive strategies, and the like – in short, all of the techniques that we would normally expect to find in the emplotment of a novel or a play” (84, italics in original). All narratives draw on a repertoire of “story types that we conventionally use to endow the events of our lives with culturally sanctioned meanings” (88). Putative differences between history, memoir and fiction collapse, as they all organize their events and actions in accordance with plot structures already given in culture. In a telling phrase, he calls historical narratives “fictions of factual representation” (121, italics added). Ricoeur, drawing on Aristotle’s theory of mimesis or artistic imitation, comes to a similar conclusion. He divides the process of mimesis into a sequence of three parts: mimesis₁ refers to the cultural con-figuration of events and actions in reality, mimesis₂ to their re-figuration in narrative emplotment, and mimesis₃ to their trans-figuration in the process of reading, achieving thereby an “intersection of the world of the text and the world of the reader or hearer” through which narratives make sense (54-71). Both history and fiction, as representations of the world, unfold in this tripartite process that links our experience of reality with its figuration in culture on the one side and the text on the other: “The historian, as writer, addresses a public likely to recognize the traditional forms of the art of narration. These structures are not therefore inert rules. They are the forms of a cultural heritage” (168).

Narratives of epidemic, to conclude this section, construct its meaning and significance through the emplotment of events, time-space configurations and narrative modes derived from cultural memory of past epidemics, built on aetiologies and paradigms prevailing in particular cultures at given historical moments. In both narrative and sociocultural understanding, which mutually condition and shape each other, an epidemic comprises a staged sequence that begins with acknowledgement of outbreak and is followed by comprehension of its cause and evolution of strategies to mitigate its effects. An interdisciplinary approach to epidemic narrative, built on concepts from literary as well as social and cultural theories, can enable us to appreciate its generic forms, its relation to lived experience, and its relevance in times of epidemic crisis.

II

The course was divided into three segments: (i) conceptual framework, (ii) stories of outbreak, and (iii) biomedical and cosmological narratives. Readings for the first segment, which I have outlined above, were: Charles E. Rosenberg’s “What Is an Epidemic? AIDS in History” and “Disease in History: Frames and Framers”; an extract from Mikhail Bakhtin’s “Forms of Time and of the Chronotope in the Novel”; a chapter from Paul Ricoeur’s Time and Narrative, vol.1 (52-87); and my essay “Epidemic Narratives: Two Paradigms.” To understand two associated pairs of concepts, ‘disease’ and ‘illness’ and ‘curing’ and ‘healing,’ it included extracts from Andrew Strathern and Pamela J. Stewart’s Curing and Healing: Medical Anthropology in Global Perspective (6-15, 20-23, 218-225) and Cecil B. Helman’s “Disease versus Illness in General Practice.”

The second segment began with a reading from Priscilla Wald’s Contagious: Cultures, Carriers, and the Outbreak Narrative (1-28). Wald’s argument is that the outbreak narrative has a distinct generic form most suited to new diseases or diseases that had not hitherto achieved epidemic proportions. It “follows a formulaic plot that begins with the identification of an emerging infection, includes discussion of the global networks throughout which it travels, and chronicles the epidemiological work that ends with its containment” (2). Wald discusses a wide corpus of literary, cinematic, journalistic and scientific accounts to illustrate this. Given that the diseases they deal with are usually new, outbreak narratives are informed not so much by the memory of past epidemics as by images of holocaust and apocalypse. Outbreak narratives in literature and film are typically recent, like the novels of Robin Cook (Outbreak, Contagion, Invasion, Vector and Pandemic) and films like Wolfgang Petersen’s Outbreak and Steven Soderburg’s Contagion. The primary texts in this segment were a chapter from Ahmed Ali’s novel Twilight in Delhi recounting an outbreak of Spanish flu (229-233); two stories from the newsmagazine India Today by Supriya Bezbaruah, “SARS: Mass Attack” and “SARS Alert: Why India Should Be Scared”; and Aashiq Abu’s fiction film on Nipah outbreak in Kerala in 2018, Virus. Though the segment did not include COVID stories in its core readings students were encouraged to write assignments on them, some of which were quite original and insightful.

The third segment comprised narratives that construct epidemic events in the biomedical-realist and cosmological-mythic styles. The segment began with an epidemiological report, William G. Eggleston’s “Oriental Pilgrimages and Cholera” and Alfred C. Reed’s disease travelogue “Medical Sketches in the Orient,” followed by Susan Wadley’s translation of the kathas of Sitala in her essay “Sitala: The Cool One.” The objective of this segment was (a) to highlight the differences between the two styles and (b) to show how they coexist often in the same narrative. The other texts were: a chapter from Narayan’s novel Kocharethi: The Araya Woman (40-50), U.R. Ananthamurthy’s Samskara, Fakir Mohan Senapati’s short story “Rebati,” Satyajit Ray’s film Ganashatru, extracts from Kalpana Jain’s journalistic account of the HIV/AIDS epidemic Positive Lives, and the first Indian feature film on AIDS,  Mahesh Manjrekar’s Nidaan. These narratives show how epidemics are imagined in complex ways, drawing on both scientific and religious ideas, often within the same text as either alternatives or as conflicting views. In Kocharethi, for instance, both frameworks are presented in the form of medical pluralism, while in Samskara, “Rebati” and Ganashatru the scientific is used to criticize and dismiss the religious paradigm as irrational and regressive.

III

The central theme of the course was that narratives shape the cultural understanding of epidemic, even as they draw their ideas from it. This dialectical relation between narrativization and cultural repertoire is what produces the heterogeneity and transformability of epidemic knowledge. An epidemic outbreak may be a biological event, but it is rarely experienced solely as such. Both narrative and culture draw on objective and scientific as well as subjective and allegorical frames of explanation, as they unfold in the gap between the apprehension that epidemic provokes and its comprehension. The study of epidemic narratives (more generally, the social understanding that they draw on) calls for an approach that is interdisciplinary as well as a broader definition of narrative that can include a range of genres and media. It was with this in view that the course included epidemiological reports, media stories and films alongside texts that were literary in a conventional sense.

The course can be redesigned for a programme in Indian Writing in English by changing the core readings in segments two and three, without changing its interdisciplinary character. The segment on conceptual framework, which draws on literary theory (Ricoeur, Bakhtin), medical anthropology (Strathern and Stewart, Helman) and history of medicine (Rosenberg) can be retained as such. The IWE corpus can be expanded to include translations as one may not find many texts in English, especially with regard to past epidemics. (J.G. Farrell’s The Siege of Krishnapur, though written by a British author, recounts in part an outbreak of cholera in a colonial outpost during the Revolt of 1857. Ashoke Mukhopadhyay’s A Ballad of Remittent Fever, originally written in Bengali, is about outbreaks of cholera, plague, typhoid, malaria and kala-azar in early 20th century Calcutta.) The AIDS epidemic generated a number of stories in India, though far less than those in the US, England, Canada and Australia – one reason being that in the latter countries it primarily affected a gay community that had acquired by then immense cultural capital and access to publication. AIDS Sutra, an anthology of writing sponsored by the Bill and Melinda Gates Foundation and Avahan, includes narratives in English by authors like Sunil Gangopadhyay, Salman Rushdie and Shobhaa De. And, as I have mentioned above, COVID has generated an impressive source of narratives that capture well our experience of the ongoing pandemic.

Epidemics are complex bio-cultural phenomena that call for an approach based on both objective knowledge and subjective experience. The human sciences (medicine, sociology and anthropology) provide the former, and the humanities (especially literature) the latter. In their interdisciplinary convergence with the human sciences, the humanities can leverage critical insights into the experience of epidemics that science must suppress as a methodological necessity. The pedagogic value of such a course lies in this – the explication of a crucial dimension of social phenomena that cannot be explicated by the more objectivist human sciences.

WORKS CITED:

Akhavi, Negar, editor. AIDS Sutra: Untold Stories from India. Random House India, 2008.

Ali, Ahmed. Twilight in Delhi: A Novel. Rupa, 2007.

Ananthamurthy, U.R. Samskara: A Rite for a Dead Man. Translated by A.K. Ramanujan, Oxford University Press, 1976.

Bakhtin, M.M. “Forms of Time and of the Chronotope in the Modern Novel.” The Dialogic Imagination: Four Essays, edited by Michael Holquist, University of Texas Press, 1981, pp. 84-258.

Bezbaruah, Supriya. “SARS: Mass Attack.” India Today, April 8-14 2003, pp. 45-48.

Bezbaruah, Supriya and Nidhi Taparia, “SARS Alert: Why India Should Be Scared.” India Today, April 29 – May 5 2003, pp. 18-25.

Camus, Albert. The Plague. Translated by S. Gilbert, Penguin, 1960.

Contagion. Directed by Steven Soderberg. 2011.

Cook, Robin. Outbreak. G.P. Putnam’s Sons, 1987.

___________. Contagion. G.P. Putnam’s Sons, 1995.

___________. Invasion. Berkley Publishing, 1997.

___________. Vector. G.P. Putnam’s Sons, 1999.

___________. Pandemic. Pan Books, 2019.

Das, Dilip K. “Epidemic Narratives: Two Paradigms.” Pandemics and Epidemics in Cultural Representation, edited by S. Venkatesan, A. Chatterjee, A.D. Lewis and B. Callendar. Springer, 2022, pp. 13-27.

Defoe, Daniel. A Journal of the Plague Year. Heritage Press, 1968.

Eggleston, William G. “Oriental Pilgrimages and Cholera.” The North American Review, vol. 155, no. 428, July 1892, pp. 126-128. https://www.jstor.org/stable/25102418.

Farrell, J.G. The Siege of Krishnapur. Wiedenfeld & Nicolson, 1973.

Ganashatru. Directed by Satyajit Ray. National Film Development Corporation of India. 1990.

Geertz, Clifford. The Interpretation of Cultures: Selected Essays. Basic Books, Inc., 1973.

Helman, Cecil B. “Disease versus Illness in General Practice.” Journal of the Royal College of General Practitioners, vol. 31, 1981, pp. 548-52. PubMed Central, PMCID: PMC1972172.

Honigsbaum, Mark. The Pandemic Century: A History of Global Contagion from the Spanish Flu to Covid-19. Penguin, 2020.

Jain, Kalpana. Positive Lives: The Story of Ashok and Others with HIV. Penguin, 2002.

Mauss, Marcel. A General Theory of Magic. Translated by Robert Brain. Routledge Classics, 2001.

Mukhopadhyay, Ashoke. A Ballad of Remittent Fever. Translated by Arunava Sinha. Aleph, 2020.

Narayan, Kocharethi: The Araya Woman. Translated by Catherine Thankamma. Oxford University Press, 2011.

Nidaan. Directed by Mahesh Manjrekar. Pan Pictures, 2000.

Outbreak. Directed by Wolfgang Petersen. Arnold Kopelson Productions and Punch Productions, Inc., 1995.

Reed, Alfred C. “Medical Sketches in the Orient.” The Scientific Monthly, vol. 31, no. 3, 1930, pp. 193-216. https://www.jstor.org./stable/14970.

Ricoeur, Paul. Time and Narrative, Volume 1. Translated by Kathleen McLaughlin and David Pellauer. The University of Chicago Press, 1990.

Rosenberg, Charles E. “Disease in History: Frames and Framers,” The Milbank Quarterly, vol. 67, supplement 1, 1989, pp. 1-15. http://www.jstor.org/stable/3350182.

__________________. “What Is an Epidemic? AIDS in Historical Perspective.” Daedalus, vol. 118, no. 2, 1989, pp. 1-17. http://www.jstor.org/stable/20025233.

Senapati, Fakir Mohan. “Rebati.” The Greatest Odia Stories Ever Told, selected and translated by L. Mohapatra, Paul St-Pierre and K.K. Mohapatra, Aleph, 2019, pp. 204-214.

Strathern, Andrew and Pamela J. Stewart. Curing and Healing: Medical Anthropology in Global Perspective. 2nd ed., Carolina Academic Press, 2010.

Virus. Directed by Aashiq Abu. OPM Cinemas, 2019.

Wadley, Susan S. “Sitala: The Cool One.” Asian Folklore Studies, vol. 39, no. 1, 1980, pp. 33-62. http://www.jstor.org/stable/1177516.

Wald, Priscilla. Contagious: Cultures, Carriers, and the Outbreak Narrative. Duke University Press, 2008.

White, Hayden. Tropics of Discourse: Essays in Cultural Criticism. The Johns Hopkins University Press, 1978.

WHO (World Health Organisation). Declaration of Global Eradication of Smallpox. 1980. https://apps.who.int/iris/bitstream/handle/10665/155528/WHA33_R3_eng.pdf.

Illustration by Guru G. for IWE Online.