Tag Archives: Kendall Thomas

“Cc…: CCC,” part 15

[Kendall Thomas, in continuation from “Cc…:  CCC, part 14]

My point here is that the landscape of “international AIDS” in the U.S. is, first and foremost, a psychic space whose field of action is the interiorized projection (Rorty’s “sentimental education”) that allows Americans to “feel” that they are part of the global culture of concern about the HIV pandemic.  Needless to say, the heightened sensitivity of the American public to the imagined pain of those who are living with (and dying from) AIDS in other parts of the world has yet to take the form of a collective public demand that the U.S. government increase its support for international treatment and prevention efforts.  (Tellingly, the Kaiser Foundation survey I mentioned earlier found that nearly half of those polled doubted that more money would result in any meaningful progress in the struggle against AIDS in Africa.)  If anything, the “international turn” in the U.S. domestic discourse on HIV/AIDS has served as an alibi for not addressing the intranational scandal of HIV infection and illness on our own shores.  Consider the following state of affairs.  The U.S. continues to record about 40,000 new infections each year.  Roughly one-half to two-thirds of the 800,000 to 900,000 Americans with HIV/AIDS do not receive regular medical care.  Up to one third of Americans do not know that they are infected.  African Americans, who represent 12% of the U.S. population, make up 47% of new AIDS cases.  African American women account for nearly two thirds of the new AIDS cases among women in the U.S.  Some 56% of the African Americans living with HIV are not on combination drug therapy.  They are 1.5 times more likely not to get preventive treatment for PCP.  Although they represent only 15% of the total U.S. population under the age of 13, African Americans make up 62% of the nation’s pediatric AIDS cases.  Half the new AIDS cases among young people between the ages of 13 and 19 are among African Americans.  AIDS continues to be the leading cause of death for African Americans between the ages of 25 and 44.  A recent study of young men who have sex with men suggests that in parts of the U.S., one in three gay African Americans are infected with HIV, a rate fully comparable to that of the hardest hit African countries.

Does this mean that AIDS analysis and activism in the U.S. should turn inward and cut itself off from the rest of the world?  Not at all.  I am not urging a narcissistic return to the isolationism that has characterized too much of the history of the U.S. response to HIV/AIDS.  I am saying that in engaging with the question of where to act now, we in the U.S. have a responsibility to continually think the global around the axis of the domestic.  We have a responsibility, too, to develop and defend a radical vision of solidarity across the mental borders that AIDS sentimentalism has drawn between the international pandemic and the intranational epidemic.  In my view, the measure of those of us who live in the U.S. must be taken by our willingness to fight AIDS as fiercely at home as we do abroad.

Kendall

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“Cc…: CCC,” part 14

I’ve been thinking about the original question Deb posed about how we might read and respond to the “concluding imperative” of Piot’s preface to the UNAIDS report:  Now act!”  Ensuing discussions have raised other questions that are nested in Piot’s injunction (I’m thinking in particular of Gregg’s intervention, which, as Deb notes, takes up the issues of “What,” “Who,” and “When”).  I keep returning, though, to a question (or rather a set of questions) that, to my mind, is at least as urgent as the questions of agency and temporality on which Piot’s imperative invites reflection.  That question is simply this:  “Where?”  Where is the space or field or geography of the action(s) “we” are enjoined to take?

The document in which Piot’s injunction appears is called the Report on the global HIV/AIDS pandemic.  The nominative anachronism of this title is worth remarking, since it takes us back to an earlier time in the history of the naming practices that have enveloped the life of the virus (which, as Cindy Patton has recently reminded us, includes the pre-history before “The Name” of the virus itself).  We all remember the moment in the 1990s when we began to speak of the “HIV/AIDS epidemic” as the “pandemic,” in order to register the emerging consciousness that this was a cluster of epidemics that covered, or would soon come to cover, the entire world.  In the U.S. context, this new nomination has over time had the important and salutary effect of opening the national consciousness about HIV/AIDS.  My sense is that U.S. based global AIDS activists have been able to use the language of an international HIV pandemic to expand the domestic discursive space accorded to HIV.  The recognition that “we are not the world” has enlarged the national conversation about AIDS on issues from U.S. government spending abroad to the drug pricing policies of the transnational pharmaceutical corporations.

This shift in the U.S. public imagination has increasingly made it impossible not to think about HIV/AIDS in international terms.  Surely that is a good thing.  However, it would probably be a mistake to read too much into the broadened public perception of the AIDS crisis in the U.S.  For example, a recent survey by the Kaiser Family Foundation found that a majority of Americans are able to correctly identify Africa as the region of the world with the largest population of people living with HIV/AIDS.  However, only a minority of those surveyed believed that the U.S. government should be more involved than it has been in responding to AIDS in Africa.  To paraphrase Richard Rorty, the “globalization” of the U.S. public’s perception of AIDS has meant little more than an increased interest in “hearing sad and sentimental stories.”  During the first two decades, the “face” of AIDS in the American mind was the headshot of the “ravaged” Rock Hudson or the “courageous” Ryan White; by the third, that “face” belongs to the “frail” South African Nkosi Johnson.  In many ways, the image of the “international AIDS pandemic” in the collective U.S. consciousness serves  much the same purpose as that of “international human rights”:  it is a tool (to borrow again from Rorty) for “manipulating sentiments, [for] sentimental education.”

[Kendall Thomas’ e-mail continues in the following post]

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“Cc…: CCC,” part 2

Dear Gregg, John, Jack and Kendall,

I hope this message finds each of you well, wherever and whenever it reaches you.  I hope, too, that it will serve to initiate an e-mail exchange about the virus and the pandemic that will appear at the conclusion of my recently completed The Brevity of Life:  What AIDS Makes Legible.  The manuscript, parts of which some of you may already have had a chance to read, and others surely not as yet, includes as the volume’s proposed frontispiece a photograph of Felix Gonzalez-Torres’ “Untitled” (Perfect Lovers), dated 1987-1990, an installation that features two apparently identical clocks hung side by side, barely touching one another, and synchronized such that both read “2:43:58” (or “14:43:58”).

 

My hope was that Gonzalez-Torres’ work, photographed in situ, would resonate with a citation I was considering as an epigraph for the book:  Peter Piot, Executive Director of the Joint United Nations Program on HIV/AIDS (UNAIDS), writing in his “Foreword” to the Encyclopedia of AIDS that “the worldwide AIDS epidemic has become a permanent challenge to human integrity and solidarity.  Given the scale of suffering, given the proven effectiveness of several approaches, and given the prospect of furthering other human goals through the fight against AIDS, an expanded response makes ethical and practical sense.  Instead of letting AIDS turn back the clock, let us use our response to the epidemic to turn humanity’s clock ahead.”

Now John, who was kind enough to take the time recently to read the manuscript and to respond with characteristic generosity and insight, wondered in an e-mail to me whether Piot’s language in this instance set a tone in keeping with the chapters that follow.  I take the liberty of citing from John’s message:  “Peter Piot [citation]:  for me it set the wrong tone, starting your book like that – I’m sure I’m carrying around too much baggage vis a vis UNAIDS and that very mainstream don’t really rock the boat agenda…. Couldn’t you start with Seneca – maybe juxtaposed with Ben and his phone card?” **

John’s thoughtful and wide-ranging response reached me on July 15, as I was reading the Report on the global epidemic  just released by UNAIDS.  Writing in the report’s preface, Piot notes that “In 2001, the world marked 20 years of AIDS.  It was an occasion to lament the fact that the epidemic has turned out to be far worse than predicted, saying ‘if only we knew then what we know now.’  But we do know now.  We know that the epidemic is still in its early stages, that effective responses are possible but only when they are politically backed and full-scale, and that unless more is done today and tomorrow, the epidemic will continue to grow….  The time has come to put all the pieces together.  Plans have been made.  Needs are clear.  Solutions are available.  Now act!”

With your permission, I would like to take Piot’s language in the preface to the UNAIDS report as a provisional point of departure for our exchange.  In what context or contexts do you place this brief exercise in historiography on Piot’s part?  More specifically, perhaps, how do you read and respond to its concluding imperative?

With my thanks in advance, and warm regards,

Deborah

** John here alludes to one of the epigraphs to the prologue, which cites Ben, a long-time seropositive man who tells the New York Times that he feels like someone with a phone card who knows that at some point he will hear the inevitable “you have two minutes left.”

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“Cc…: CCC,” part 1

As I wind down the project of making most of the manuscript of The Brevity of Life public in the form of a series of blog posts, in preparation for some research and writing in a different vein, I feel compelled to add to the chapters already reproduced a final postscript of sorts, which is arguably the most valuable part of the book in its historiographic function.  It takes the form of an e-mail exchange that took place between July and September of 2002, initiated by me and made possible by Gregg Bordowitz, John Greyson, Jack Lewis and Kendall Thomas, who generously agreed to take part.  I will record it in this and the next several posts, under the title “Cc…:  CCC.”  The “Cc” is self-evidently grounded in the structure and operation of a group e-mail exchange.  “CCC” is an acronym for “complex continuing care,” the parlance commonly used in North American tertiary care centers to designate a relative level of medical intervention (relative to “acute care,” for example, or “sub-acute care”).  The process of designating such levels of care involves “RIW,” short for “relative intensity weighting,” and is intimately associated with resource allocation.  In the Canadian public health care system, level-of-care designations derive from an assessment of the clinical and medical supports required to treat a particular “case mix.”

The archive has always been a pledge, and like every pledge, a token of the future.    

 Jacques Derrida, Archive Fever:  A Freudian Impression, 1995, 18

Chiefly on the basis of the five exemplary instances they analyze [Felix Gonzalez-Torres, Derek Jarman, Herve Guibert, Aaron Shurin and Stephen Andrews], the foregoing posts make the case that in order to read what HIV/AIDS makes legible we must first of all and among other things recognize the differential temporalities inscribed in the virus and the epidemic-turned-pandemic, and likewise in their artifactual remains.  The wager that underwrites The Brevity of Life is that only a labour of reading attentive to the multiple specific structures and operations of time enables a responsible reconsideration, now and henceforth, of the grave challenges with which the global crisis persists in confronting us.

In making public the exchange transcribed in the following posts, the participants ask the reader to take account of the complex temporalities that traverse it.  Derek Jarman’s reflections on the difficulty of translating HIV/AIDS, whether in autobiographical or more broadly historiographical terms, onto film may help make legible here a fundamental incommensurability between the multiple temporalities of a pandemic that continues to outstrip our best efforts to make sense of what is occurring today (and what it may portend for the future) and a mode of production – in this case, electronic mail – whose impact over time remains, for us, an open question.  As Derrida observes in Archive Fever,

Electronic mail today, even more than the fax, is on the way to transforming the entire public and private space of humanity, and first of all the limit between the private, the secret (private or public), and the public or the phenomenal.  It is not only a technique, in the ordinary and limited sense of the term:  at an unprecedented rhythm, in quasi-instantaneous fashion, this instrumental possibility of production, of printing, of conservation, and of destruction of the archive must inevitably be accompanied by juridical and thus political transformations.  [17]

With much at stake – psychically, socially, politically – the participants in this exchange accepted the risks entailed in the terms of a tacit contract struck first of all among themselves, but in effect with their eventual readers as well.  The willingness of Gregg Bordowitz, John Greyson, Jack Lewis and Kendall Thomas to take part, in the knowledge that these virtual communications circulated initially among a handful of trusted friends and comrades in the spirit of a conversation would be transcribed and subsequently consigned to the public sphere bespeaks an extraordinary generosity, a readiness to assume the attendant burdens (among them, perhaps,a sense of vulnerability, an unaccustomed hesitancy, an unanticipated resistance to the format) for the sake of the matter at hand.

“I wonder if any of this will be remembered; probably not.”  Jarman’s musing in the journal entry that serves as the epigraph to “Archive of Devastation (Derek Jarman’s Blue, Part 1), brought to bear on e-mail communications, might translate as a kind of optimism according to which we typically assume that the electronic script on which we are increasingly reliant is invariably ephemeral, short-lived, impermanent, never fully realized – indeed, that it is bound to disappear, sooner rather than later, that it is in the process of disappearing even as we hit “Send.”  Our utilization of a postal technology that seems to court oblivion opens up a certain freedom to muse, to hypothesize, to risk the kinds of formulations that may or may not stand the test of time, and do not pretend otherwise.

The participants can only hope, then, that readers of their exchange will respect the terms of the contract on which it rests, however uneasily:  that the latter will assume responsibility for discerning and seeking to negotiate the variable temporalities and rhythms involved, and honour the spirit in which this joint venture was undertaken.

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