Modern totalitarian movements, whether of the right or of the left, have been peculiarly—and revealingly—inclined to use disease imagery. The Nazis declared that someone of mixed “racial” origin was like a syphilitic. European Jewry was repeatedly analogized to syphilis, and to a cancer that must be excised. Disease metaphors were a staple of Bolshevik polemics, and Trotsky, the most gifted of all communist polemicists, used them with the greatest profusion—particularly after his banishment from the Soviet Union in 1929. Stalinism was called a cholera, a syphilis, and a cancer. To use only fatal diseases for imagery in politics gives the metaphor a much more pointed character. Now, to liken a political event or situation to an illness is to impute guilt, to prescribe punishment.
This is particularly true of the use of cancer as a metaphor. It amounts to saying, first of all, that the event or situation is unqualifiedly and unredeemably wicked. It enormously ups the ante. Hitler, in his first political tract, an anti-Semitic diatribe written in September 1919, accused the Jews of producing “a racial tuberculosis among nations.” Tuberculosis still retained its prestige as the overdetermined, culpable illness of the nineteenth century. (Recall Hugo’s comparison of monasticism with TB.) But the Nazis quickly modernized their rhetoric, and indeed the imagery of cancer was far more apt for their purposes. As was said in speeches about “the Jewish problem” throughout the 1930s, to treat a cancer one must cut out much of the healthy tissue around it. The imagery of cancer for the Nazis prescribes “radical” treatment, in contrast to the “soft” treatment thought appropriate for tuberculosis—the difference between sanatoria (that is, exile) and surgery (that is, crematoria). The Jews were also identified with, and became a metaphor for, city life—with Nazi rhetoric echoing all the Romantic clichés about cities as a debilitating, merely cerebral, morally contaminated, unhealthy environment.
To describe a phenomenon as a cancer is an incitement to violence. The use of cancer in political discourse encourages fatalism and justifies “severe” measures—as well as strongly reinforcing the widespread notion that the disease is necessarily fatal. While disease metaphors are never innocent, it could be argued that the cancer metaphor is a worst case: implicitly genocidal. No specific political view has a monopoly on this metaphor. Trotsky called Stalinism the cancer of Marxism; in China in the last year, the Gang of Four have become, among other things, “the cancer of China.” John Dean explained Watergate to Nixon: “We have a cancer within—close to the Presidency—that’s growing.” The standard metaphor of Arab polemics—heard by Israelis on the radio every day for the last twenty years—is that Israel is “a cancer in the heart of the Arab world” or “the cancer of the Middle East,” and an officer with the Christian Lebanese rightist forces besieging the Palestine refugee camp of Tal Zaatar in August 1976 called the camp “a cancer in the Lebanese body.” The cancer metaphor seems hard to resist for those who wish to register indignation. Thus, Neal Ascherson wrote in 1969 that the Slansky Affair “was—is—a huge cancer in the body of the Czechoslovak state and nation”; Simon Leys, in Chinese Shadows, speaks of “the Maoist cancer that is gnawing away at the face of China”; D. H. Lawrence called masturbation “the deepest and most dangerous cancer of our civilization”; and I once wrote, in the heat of despair over America’s war on Vietnam, that “the white race is the cancer of human history.”
“[The Jew’s] power is the power of money which in the form of interest effortlessly and interminably multiplies itself in his hands and forces upon nations that most dangerous of yokes.… Everything which makes men strive for higher things, whether religion, socialism, or democracy, is for him only a means to an end, to the satisfaction of a lust for money and domination. His activities produce a racial tuberculosis among nations.…” A late-nineteenth-century precursor of Nazi ideology, Julius Langbehn, called the Jews “only a passing pest and cholera.” But in Hitler’s TB image there is already something easily transferred to cancer: the idea that Jewish power “effortlessly and interminably multiplies.”
AIDS quickly became a global event—discussed not only in New York, Paris, Rio, Kinshasa but also in Helsinki, Buenos Aires, Beijing, and Singapore—when it was far from the leading cause of death in Africa, much less in the world. There are famous diseases, as there are famous countries, and these are not necessarily the ones with the biggest populations. AIDS did not become so famous just because it afflicts whites too, as some Africans bitterly assert. But it is certainly true that were AIDS only an African disease, however many millions were dying, few outside of Africa would be concerned with it. It would be one of those “natural” events, like famines, which periodically ravage poor, overpopulated countries and about which people in rich countries feel quite helpless. Because it is a world event—that is, because it affects the West—it is regarded as not just a natural disaster. It is filled with historical meaning. (Part of the self-definition of Europe and the neo-European countries is that it, the First World, is where major calamities are history-making, transformative, while in poor, African or Asian countries they are part of a cycle, and therefore something like an aspect of nature.) Nor has AIDS become so publicized because, as some have suggested, in rich countries the illness first afflicted a group of people who were all men, almost all white, many of them educated, articulate, and knowledgeable about how to lobby and organize for public attention and resources devoted to the disease. AIDS occupies such a large part in our awareness because of what it has been taken to represent. It seems the very model of all the catastrophes privileged populations feel await them.
Of course, between the perennial official hypocrisy and the fashionable libertinism of recent decades there is a vast gap. The view that sexually transmitted diseases are not serious reached its apogee in the 1970s, which was also when many male homosexuals reconstituted themselves as something like an ethnic group, one whose distinctive folkloric custom was sexual voracity, and the institutions of urban homosexual life became a sexual delivery system of unprecedented speed, efficiency, and volume. Fear of AIDS enforces a much more moderate exercise of appetite, and not just among homosexual men. In the United States sexual behavior pre-1981 now seems for the middle class part of a lost age of innocence—innocence in the guise of licentiousness, of course. After two decades of sexual spending, of sexual speculation, of sexual inflation, we are in the early stages of a sexual depression. Looking back on the sexual culture of the 1970s has been compared to looking back on the jazz age from the wrong side of the 1929 crash.
Medicine changed mores. Illness is changing them back. Contraception and the assurance by medicine of the easy curability of sexually transmitted diseases (as of almost all infectious diseases) made it possible to regard sex as an adventure without consequences. Now AIDS obliges people to think of sex as having, possibly, the direst consequences: suicide. Or murder. (There was a trial run for the conversion of sexuality to something dangerous in the widely diffused panic about herpes in the United States in the early 1980s—and herpes in most cases is merely awful, erotically disqualifying.) The fear of AIDS imposes on an act whose ideal is an experience of pure presentness (and a creation of the future) a relation to the past to be ignored at one’s peril. Sex no longer withdraws its partners, if only for a moment, from the social. It cannot be considered just a coupling; it is a chain, a chain of transmission, from the past. “So remember when a person has sex, they’re not just having it with that partner, they’re having it with everybody that partner had it with for the past ten years,” runs an endearingly gender-vague pronouncement made in 1987 by the Secretary of Health and Human Services, Dr. Otis R. Bowen. AIDS reveals all but long-term monogamous sex as promiscuous (therefore dangerous) and also as deviant, for all heterosexual relations are also homosexual ones, once removed.
Fear of sexuality is the new, disease-sponsored register of the universe of fear in which everyone now lives. Cancerphobia taught us the fear of a polluting environment; now we have the fear of polluting people that AIDS anxiety inevitably communicates. Fear of the Communion cup, fear of surgery: fear of contaminated blood, whether Christ’s blood or your neighbor’s. Life—blood, sexual fluids—is itself the bearer of contamination. These fluids are potentially lethal. Better to abstain. People are storing their own blood, for future use. The model of altruistic behavior in our society, giving blood anonymously, has been compromised, since no one can be sure about anonymous blood received. Not only does AIDS have the unhappy effect of reinforcing American moralism about sex; it further strengthens the culture of self-interest, which is much of what is usually praised as “individualism.” Self-interest now receives an added boost as simple medical prudence.