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SARS and Illness Narratives: An Examination of an Epidemic
by
© Jon D. Lee
A thesis submitted to the
School of Graduate Studies
in partial fulfillment of the
requirements for the degree of
Doctor of Philosophy
Department of Folklore
Memorial University of Newfound land
August 2008
St. John' s Newfoundland

Abstract
One of the largest recent disease outbreaks began in November of 2002. .....hen the
first cases of a disease that wou ld soon be know n as SARS began spreading in Ch ina.
Since then. the SA RS coro navirus has achieved infamy seldom seen among diseases.
s.....eeping through medi a and Internet sources to create a panic that left thousands of
people halfway around the .....orld wearing surgical masks in attempts to protect
them selves from perceived harm.
The goal of this dissertation is to examine and understa nd the narratives that
people told about the SA RS outbreak- the rumors. gossip. legends. jo kes. and other
forms of oral communication. Examining these narratives will provide insights into why
peop le believe the things they do about disea..es, and why narratives both shape and are
shaped hy disease.
A key concept included in this examination involves the reasons behind the
exaggerated. and in many cases disproportionate reactions exhibited by the puhlic. Tied
lip in these reaction.. were issues of race and cthnicity. personal and familial protection.
and fear. all of which were directly influenced by oral narratives. as well as by
information gathered from media sources. Ultimately. sources such as newspapers and
news broad casts can be blamed for the larger part of the hysteria that surrounded the
outbreak. But oral narratives were also culpable. and so a second thrust of this work will
be to examine what steps can be taken to coun teract. or po..sibly preempt these ...ources of
information.

Ultimately. it is the goa l of this work to demonstrate that the types of narratives
that circulated during the SARS outbreak closely resem bled narratives associated with
other diseases. thereby estab li..hing a template or typology of di..ea..e narratives. The
existence of such a typology would mean that medica l and health personnel. respon ding
to future d isease out brea ks, would be able to bette r predict the fonns of narrative that
wou ld arise . and would thus be better able to respond to the panic and xenophobi a that so
often accompany epidemics.
iii

Writing any list such as this is stressfu l. to say the least. I began researc hing this
project almost exactly five years before completing my first draft . and in that lime I no
doubt discussed my various and ever-changing ideas with hundred s of people. Dozens
more helped me in subtler ways. It lakes a village 10 raise a child . as the saying goes. and
it took the support and encouragement of everyone around me 10 help me create this
work . The impulse to therefore include in this section anyone and ever yone I' ve talked to
since March of 2003 is strong.
More stressfu l still. after narrowing down this list of contribu tors, is the task of
plac ing them into some sort of order. Whose name should be first? Will i offen d anyo ne
by placing the ir name last? By leaving them out altoge ther. even if by accident? To this
last question I can only say, I tried my best to include everyo ne, and if a name is nOI on
this list il is only due to my idiocy. and not because I did ne t appreciate what thai person
did for mc.
As for ranking names by importance, I have concluded that any such feat would
he self-defea ting. I cannot say. for the most part. that nne person helped me more than
another. Like the butterfly in Ray Bradbury' s "A Sound of Thunder: ' the removal of any
one perso n from the histor y of this project could result in catastro phe. The lists of peop le
that make up the rest of this section will therefore berandom. written down as they
occurred 10 me. with no differentiations made as to importance or usefulness .
iv

Save one. I mel my wife. Lynncttc. only a few months before beginning this
projec t. She has, in faith and love beyond my com prehension. remained beside me
throughout my strugg le to bring this work to light. offering condolences where necessary
and. as was more often the case. Drill-Sergeant-like encou ragement during my periods of
sloth and torpor . For putting up with me (and putting me up. given my graduate student's
salary) . I will never adequate ly be able to express my gratitude . Thank you. my love.
In random order . then. I also wish to thank the following people .
None of this could have been possible-quite literally- without the time and
space volunteered me by my interviewees: Jennifer Lim. Angel and Rosita Lim. Luis
Tan. Mike Larse n. Jonathan Gou ld. Annie Ferraro . Mayee Ramrattan. Ju..tin Aitcbeson.
Ann Mora n. Seny Zamora. Benjamin Sandler. and Heather Read. For answering my
quest ions. providing me with data and new avenues of research . and for making me
realize import ant aspects of my research that even I wasn' t aware of. 1am foreve r
indebted.
My former roommat e Robert "Robbie D" Dennis was instrumenta l in not only
helping me procure a place to stay while I conducted my research in Toronto . Canada.
but for introducing me to one of my informant s. and for providing me with bibliographic
resources. Robert' s sister. Hollie, and her husband. Michael Peter Carte r, were kind
enough to o ffer me a bed and an Internet connect ion in Toronto, and more importantly.
free use of their coffee maker.
My friends and fellow graduate students in the Folklore Departme nt at Memorial
University of Newfo undland also deserve to be mentioned . and none more so than Lynne

McNeill and Andrea Kina. Together. the three of us suffered the long road East. and
logged hundreds of hours of encouragement. diversion. ideational dissection, and support.
Without Lynne. I could not have written sections of chapter six; without Andrea, I would
not have survived chapter two.
Many of the professors in the Folklore Department buttressed me at one time or
another, and none so much as Diane Goldstein. dissertation advisor extraordinaire. who
challenged me at every tum and forced me to greatly hone my mental skewers.
Committee members Paul Smith and Cory Thome provided additional assistance.
slipping important mailings and printouts into my mailbox and otherwise providing new
ideas and sources of material. Martin Lovelace, who served as Department Head for most
of the years I was physically present at MUN, offered constant encourag ement. and more
importantly. bel ieved in me enough as an educator to consistently offer me course s to
teach. In addition. Dr. Lovelace was generous enough to step in last-minute as a
committee member when circumstances left Dr. Smith unable to continue. Philip Hiscock
performed brilliantly in his role as teaching mentor, and offered better bibliographic
ndvice than even my Chicago Style Manual. Peter Narvaez's CD Some Good Blues
played constantly in the background. as did his theory lectures from Folk 6030. Diane
Tye' s clarifications of proper dissertation format and length kept me buoyant during
mental storms. And the patience and grace of departmental secretaries Sharon Cochrane
and Cindy Turpin cannot be underestimated for keeping me out of trouble. for helping me
organize my academic life. and for providing me with the resources I needed to make it
from one class to the next.
vi

MUN was not the only univers ity to provide me with useful folklor istic mentors.
Jeannie Thom as. Sieve Siporin. and Barre Toelken of Utah Slate University are
singu larly respons ible for not only gelling me intereste d in this disci pline in the first
place . but for writing me the leiters thai gOIme accep ted into MUN. and for con tinuing to
sho w their loyalty by writing me the dozens of letters of recommendation that I have
thrown their way in my search for gainful employment. Mikel Koven and Elliott Oring
have given me helpful feedba ck on conference papers. sometimes providing jaw­
dropping alternate views of key elements that have forced me 10 reconsider large parts of
theories. And I can only send out a broad "than ks't to the dozens of folk lorists-both
professionals and students-who have come up to me at conferences and offered
positive. unso licited reviews of my papers.
Outside of the acade mic world . no two peo ple have been more influentia l and
supportive than my parents. David and Jan. Together with my grandmot hcrs-c-Ruth and
Will a-c-they have provided shou lders strong enough on which to suppo rt the worl d. For
assistance both financial and emotional. I offer the followin g prayer: May your beer be
forever cold and never fiat. Gracias.
I also wish to extend my appreciation 10 every one who has eve r enco uraged me to
write. regardless of ge nre. Special mention must be given here to Sam Green. Micha el
Donovan. Bill Holm. Bill Kloefkorn . Robert Hodgson Van Wagoner. Primus St. John .
1.V. Brumm els and Eddie Elfers at Logan House Press. Charles Cuthbertso n. Robin
Parent. Micah Schicker . Chris Okelberry, Ian Brod ie. and Jodi McDavid .
vii

Finally. a note for the fallen. Ellen Meloy. Lcslic Norris. and Ken Brewer-c-all
wonderfu l people. all brilliant writers. all fast fricnds-did not make it to see the
completion of this work. I know they would have been proud to see me succeed. From
whatever vantage point they're watching me. I hope they're smiling.
viii

Abstract
Ac knowledgmen ts
Chapter
I. The Yellow Brick Road
Tab le of Contents
2. Folklore. Media. and Medicine 25
Folklore and Folkloristic Materials 29
iv
Contemporary Legends 32
Health Panics 39
Race and Racialization oW
Risk and Risk Assessment 47
Media Theory 53
SARS and Official Medicine 61
3. Chronicle of a Health Panic 73
4. SARS and AIDS: A Comparison of Etiological Legends 145
5. We Gather Together: SARS and Public Space 167
6. Private Actions in Public Spaces; SARS and Paradigm Violations 193
7. "Please Receive Communion Through Your Hands": Personal and
Communal Mediation of Stigma in the 2003 SARS Epidemic 214
8. The Cause and the Cure; Folk Medicine and SARS 243
9. Full Circle: The Recycling of Disease Narratives 275
10. Epilogue: ...And the World Moved On 293
ix

References Cited
Appendix
1. A Contribution Towarda Typology of Disease Narratives
297
334

What has been will be again.
what has been done will be done again;
there is nothing new under the sun.
- Ecclesiastes 1:9
Chapter 1: The Yellow Brick Road
In 2003. for a frantic few months. a virus spread across the world with a fury that
seemed apocalyptic. This novel disease came from China. but quickly slipped that
country's boundaries to bound halfway across the world in a matter of only a few hours.
Its speed left doctors and researchers gasping in the wake. struggling to throw up walls
hath physical and intellectual against the assault. But these reactions were as nothing
compared to the fear that gripped the nations of the world. who were suddenly confronted
with a strange. invisible. and unexplained foe that killed one out of every five people it
touched.
Panic ensued. Thousands of people were involuntarily quarantined. Thousands more
simply chose to stay home. rather than risk catching the new virus from a coworker or
stranger. The tourism industry ground to a near-halt. Airlines. theaters. restaurants.
hotels. and other businesses shew'ed record profit losses. Chinatow ns all over North
America were virtually empty. And people were dying: not only laypersons. but doctors
and nurses too. cut down by the very disease they were strugg ling to understand.

For a frantic few months, the virus was everyw here. Even when not physicall y
present, its name was everyday writ large on television screens and the covers of
newspapers: Severe Acute Respiratory Syndrome, known fur better by its acrony m.
SARS. Headlines screamed the death tolls. The 9 o'clock news mopped out the new
geographica l mens where the virus had spread overn ight. Radio announce rs warned
people to wear their protective masks and avoid public places at all costs. The messages
were impossible to avoid. SARS equaled fear. SARS equaled the unknown. SARS
equaled the uncontroll able. SARS equaled death.
And then, almost as suddenly as it had arrived , the virus disappeared. No cure or
vaccine prompted its departure; no great medical breakthrough hastened the world
towards a SARS·free future. Instead, in the end, the simple measures were what proved
most effective: isolating the contaminated, regular temperature checks. public
announcements on proper hygiene measures. vigilance. There were those who predicted
that the virus would return, but their warnings have so far proved ground less. As of early
2008, a full four years after the last cases of SARS whimpered out of exis tence, there
have been no relapses, no new outbreaks . The virus ex ists now only in test tubes in
highly-guarded facilities, and in the memories of those who surv ived.
There are thousands of questions that could be asked about an epidemic such as
this. Where did it come from? Why did it appear? Why didn't it prove more lethal'? Is
there a cure? Will it ever return? Medicine has answered many of these questions, as will
be revealed in these pages. However, there are many more questions that lie beyond the
normal interests of virologists , and many perspectives that do not appear in the pages of

such prestigious publications as the British Medical Ioumal and the l ournat ofthe
American Medical Assoc iation. For instance. what is the storymaking process that
underlies the disease narratives that circulated among laypersons? Why was SARS so
prone to these kinds of narrative constructions? What do these stories reveal about
popular conceptions of disease?
Questions such as these deserve answers as dee ply investigated as the conclusions
that appear in medical journals. precisel y because the kinds of questions that the
layperson asks about a novel disease are the same questions that a virologist asks about it.
That is. am I vulnerable. who is infected. and how can I assure my safety'?The answers
that come from such questions may ultimately be different. and even highly
contradictory. This. however. does not lessen the importance of the questions. The act of
understanding anythin g that is new is accomplished initially by creating for that novel
item a story. and that story is created by taking what is already known about a similar
item and laying that knowledge over the rough form of the unfamil iar. All of our
beginnin gs arc the same; there is nothing new under the sun.
The juxtapos ition of medicine and folklore that drives the study of these questions
is initially problematic and confusing. Medicine is. after all. the rationalized. highly
scientific study of the body and of those objects that attack it. Medicine is seen as austere.
detached. objective. Its practitione rs are regularly accused of dehum anizing their
subjects. of treating living. breathing human beings as little more than broken vessels
whose wants and needs. opinions and cultural mores arc irrelevant and unwelcome .
Medicine is good at treat ing diseases. shoddy at treating people. What could this

disciplin e possibly have to offer in the way of understanding how humans think and act.
behave and react? Folklore. on the other hand. is the study of culture . a discipline
dedicated to understanding the reasons behind many aspects of human thought and
action. behavior and reaction. Folklore is grounded in the human condition. and its
practitioners highly value the wants and needs. opinions and cultural mores of the people
they study. And any folklorist who attempts to make a medical diagnosis is obv iously
overstepping the bounds of her training.
Rather than being oppos ing constructs . these theoret ical stances can in fact
function well together . dovetailing into a mechanism that can-at least in certain areas­
provide answers that either discipline by itself could not. Medicine can tell us how to
transplant an organ: folklore can tell us why some ethnic groups refuse such lifesaving
procedures. viewing the organs as the seat of the soul. and what may be done to deal with
such situations. In contrast. folklore can tell us that people have used the foxglove plant
since the middle ages to treat various maladies: medicine can tell us the name of the
plant's relevant medicina l compounds, and provide standardized. safe preparations of
them to treat individuals with atrial fibrillation. In the arcus where these disciplines meet,
it is safe for both practitioners to wander. and to point out questions and answers the
other side may not have considered.
It was in this spirit that I began my study of SARS, I became aware of the
outbreak at roughly the same time and in the same manner as most everyone else in
Canada: I heard about it on the news. Stationed safely as I was at the time on the isolated
island uf Newfoundland. I wasn't particularly conce rned about the outbrea k, and

experienced only a slight bout of concern when the virus crossed the Atlantic and
surfaced in Toronto. Far more important to me at the lime were the aftereffects of the
destruction of the Twin Towers on 9111, which had happened only a few months before.
and the beginn ings of the war in Iraq on the 19lh of March. 2003. Com pared to the War
on Terrorism. a smal l virus seemed rather an odd thing on which to place so much
attention.
It therefore caught my eye when this smal l virus qu ickly overtook headlines
everywhere. and the word "SARS" became at least as common in news reports as
ment ions of Saddam Hussein. Comb ined with this was work I wa.. do ing as a Research
Assistant at Memorial University of Newfou ndland (MUN). where my adviso r, Dr. Diane
Go ld..rein. had recen tly finished revisions on hcr then-unpublished book. OIlCf!UpOIlA
V;nu (Utah State University Press. 20(4). I was privileged to read galley drafts of this
hook. and as..istcd Dr. Gold..rein in rhe constructio n of its index. The combination of
the..e events was fonuit cu s. and soon led to my wondering whether SARS would make
for as good of a ..ubject for study as A IDS had been for Dr. Gold..tein. I discussed the
..ubjcct with her. and. encouraged to pursue it. began my research.
I pause here to explain the presence of the following. largely per..onal and
..ubjccuv c narrative in what is otherwise a ..cholarly work. Bruce Jackson. in Fieldwork.
criticizes schol ars for their fieldwork effort s. He docs so not only bccau ..e he finds their
methods flawed . hut their academic reports devoid of emotions and scrubbe d free of any
mentio n of failure. Jack..on writes. "Thousands of folklore studies are based on
fieldwork; only a few of those studies include commentaries on how and why the

fieldwor k was done or tell us much about moments the writers found interesting or
memorab le.... Folklorists report their successes. net their failures" (1987, 13· 14).
Jackson says that the absence of this informationin scholarly articles is potentially
hannfu l to students . who receive from such studies the impression that any failure in
fieldwork means that the fieldwo rker herself is a failure . The absence of this information
is al..o deleterious to the project as a whole becau..e pure objectivity is impossible. as is
ensuring that every relevant question has been a..ked. every pertinent re..earch path
followed to its furthest ends.
In other words. there is no such thing as flawless fieldwork . There will always be
questions that went unasked. or informants who went un-contacted(or even unnoticed) .
Additionally, the metaphorical "lenses" through which any fieldworker views a topic­
lenses based on cultural and familial morals. personal likes and dislikes. and even what
mood the fieldworker happens to he in at that moment-s-color and shape the questions the
ficldworkcr asks, and thus the responses that the informants give. Looking at this from a
different angle. when I ask an informant if they have heard any jokes about SARS. I am
telling thai informa nt that I) I am only interested in hearing about SARS. and not any
other disease. and 2) I am only interested in hearing jo kes, and not any other oral form.
Even simple questions thus drastically limit the answers a researcher is likely to receive.
So, recognizing my own flaws and fallibilities. and in the interests of as best a full
disclosure as I can manage (changing only a few names to protect certain ident ities), I
present the following, being a description of my fieldwo rk. I hope this account will not
only provide readers with a glimpse of the problems that I encountered (and my solutions

to them). hut will offer to the newer students of the discipline a document which proves
that even worst-case scenarios can result in good data. There is nothing wrong with
making mistakes; the only failure lies in failing to learn from them.
My initial efforts in studying SARS-detailed in sharper relief in chapter three­
were to log on daily to severa l websites (principally CNN.com, Yahoo.co rn. and
MSN.com). beginning in April of 2003. and print off any news article that mentioned
SARS. Isolated as Newfoundland is, this seemed to me the best method for procuring
news of the world. and I kept up the task for almost two years. Other forms of research
during this time were limited, and mainly relegated to reading various and sundry
acade mic texts. Coursework and other requirements of the Ph.D. resulted in a significant
gap between the outbreak and most of the interviews.
Thus, my search for interviewees in the Toron to area actually began sometime in
January or February of 2005. though I was not scheduled to travel to the area until the
summer of the same year. I thought it prudent to begin early. The fieldwork that I was to
conduct over the summer would be the largest project of its kind that I had ever
undertaken. and I did not take the task lightly. I began my search for interviewees as
many students often do: by asking everyone I knew if they had any contacts who would
be willing to talk to me. Severa l did. and passed along the pertinent contact information.
I spent the next few months slowly making my way through the list that my initial
efforts had generated. weeding out those potential informants who had no wish to speak
to me. profusely professed their ignorance of anything relating to SARS. or otherwise
made it clear that they would not be comfortable being interviewed. Where possible. I

asked these people if they had an y co ntacts they wou ld be willing 10 share with me before
we co ncluded our discus sions. and a small handfu l did . I also ruled out interviewin g
an yone not in the immediate Toron to area. as my budget was 100 small to afford
extensive travel. or eve n the renting of a car. Wher e I thought relevant . I placed the
names of these non-Toronto residents on a "potential telephon e intervie ws't Iist.
Though it seems incredible to me now. the medi um-sized li",t of potential
inform ants that I had gathered through friends and colleag ues was , by May of 2005.
pared down 10 only seven confirmed interviewees. By this time I had also established that
my fieldwork dale s in Toronto would be July 8 10 1·1.. so I set about workin g on a suitable
series of questio ns thai I could ask my interviewees. as well as procuring the appro priate
recording equ ipment. A Irip to Wal-Mart so lved the latter prob lem . resulting in a Son y
Walkm an cass ette player/re corder with a rather ineffect ive bui lt-in microphone. but an
exte rnal. plug-in mic that proved 10 be of exce llent quality in my run-throu ghs.
Th e summer months passe d quickly. and all too soon J uly loom ed. I made one lust
round of co nfirmation emails and phone ca lls in lute Jun e. and was pleased to note that all
seven informants we re sti ll plann ing on meet ing with me. I was particu larly excited about
three of them : Anne. Bob. and Caro l (whose names have all been cha nged to protect the ir
identities). Anne was a nurse in the Toronto urea during the SARS outbreak. and though
she was nOIemployed at any of the hospita ls that were the most heavily affected . she had
ment ioned in ou r earlier con versations that she had a few good stories to tell me. Bob was
a student ar a Toron to-ar ea University. and the friend of Bob ' s who had given me his
email address had as..ured me thai Bob had at least one incred ible story to tell about life

in Toronto dur ing the SARS scare. Finally. Caro l was the director of an International
Students program at a major Toronto university. and had teased me on the phone with
promises of the horror stories that she and the university' s Asian students had faced
during the crisis.
So. eagerly anticipat ing the stories these people were to tell me. I hoarded a plane
on Jul y 8 m and arrived in Toronto in the late evening of the same day. For residence I had
secured a spare room in the apartment of the sister of a former roommate of mine. and
after settling in. walked around the neighborhood to acquaint myself with the landscape
(it being too late in the night by this point to bother people with phone calls). The next
mornin g-Saturday. Jul y 9 th _ I began to contact my informants to book my meetings.
I do not profess belief in portents and omen s. Nevertheless, I was unsettled when
the first phone number I dialed brought neither answer nor voice mail. and the person
who answered at the second number had never heard of the informant I was seeking.
Unbelievably. my day only cont inued to decline from there. Anne did answer the
phone. but became instantly nervous and unwilling to talk. Whereas earlier she had
remarked that she had several stories to relate. she now cla imed that she didn' t remember
much about thc outbreak. and doubted that anything she could contribute to my study
would be of much usc. I politely disagreed. remarki ng that any story about SARS was
important. and that even the smallest mention of it would be worth my time. But Anne
still hedged. and thus began ten minutes' worth of my attempt ing us courteously and
professionall y as possible to get Anne to agree to meeting with me. All of my attempts
were rebuffed. and it quickly became obvious that this interview was simply not going to

pan out. I thanked Anne for her time and gu..'e her my numb er in case she chan ged her
mind. and moved on.
My next ca ll went to Bob . who had already agreed to meet with me durin g the
afternoo n of the followin g day-Sunday. J uly 10 th • Bob also answered the phone. but
when I introd uced myself. he informed me that he had forgot ten that he was going to a
rock n' roll co ncert on Sund ay afternoo n. I offe red to meet with him ear lier or later in the
day. but he replied that he wouldn't be avai lable. Neither would he be available during
the week. bec ause of classes and his even ing jo b. Neither. in respo nse to my last-ditch
effort. would he be ava ilable if I immed iately took the subway to his bouse: he was go ing
into the co untry for the da y. Feelin g increasingly sus picio us. I left Bob my number in
case his schedule cleared. and dialed up the next person on my list.
Anoth er no answer. Then an answering machine . Finally. I phoned Carol. The
only numbe r I had for her was her office number at her university. but I had used it
befo re. and knew it to be correct. The last time we had talked (which was only two weeks
ea rlier) . I had informed Ca rol that I woul d be arriving on a wee kend, and we had agree d
that I should leave my co ntact inform ation on her message manager . which she wou ld
retrieve whe n she ca me to work on Monday morning. But when the message manage r
picked lip. a recorded voice informed me that Carol was no longe r affiliated with that
univer sit y: she had taken a job elsew here. No conta ct information was provided, nor was
the location where she bad begun her alternate employment.
There followed a franti c few hours in which I repea tedly ca lled back the pho ne
number.. of the two people who hadn 't picked up, dialed se..'eral numbers at Carol' s
10

university to try and find her forward ing information. and scoured my notes for
interviewees that I might have missed. or phone numbers that I might have written down
incorrectly. Eventua lly. I was simply forced to acknow ledge the reality of the situation:
all seven of my confirmed interviews had fallen through .' It was now early eveni ng on
the 9 th of July. and my plane left early the morning of the l.flh_ meaning I sudden ly had
only four days to comp letely recon..truct my fieldwork efforts . find new interviewees. and
conduct my interviews.
So Jtoo k the onl y course of action that ..eemed reaso nable: I called the one person
I knew who lived in Toronto and a..ked her if she'd be interested in meeting me at a bar
for a drink or eigh t.
The person I called was Jillian Gou ld. Jill ian had started the Ph.D. program at
MUN at the same time I had. and had taken her Co mprehensive Exams at roughly the
same time as well. She had moved to Toronto some months earlier in pursuit of a job and
10 conduct her fieldwork-in addition to being closer to her family. who lived in the area.
I reasoned that if anyone were capa ble of sympathizing. it would be Jillian. She was.
luckily for my liver. unavailable that evening. but invited me over to her house for dinner
Oil the night of Mond ay the eleventh. In response to my tales of fieldwork woes. she
mentioned that her roomm ate. Jennifer. had lived in Toronto during the SARS outbreak.
and might be able to give me a few stories. At the time. this information actually proved
more discouraging than anything: somehow. Jillian had slipped my mind in my earlier
, Though this was on ly a fatalistic reaction at this point. it ultimately proved to be true.
Despite repeated calls over the next few days. I never did get anybody to pick up the
phone at the two houses that lacked an..wering machines. and the informant who did have
an an..wering machine never called me back.
II

cas ings of friends and colleag ues with contacts. so when I hung up the phone I found
myse lf curs ing my own idiocy at not calling the one person I knew who actually resided
in the city in which I was doing my fieldwork.
The next two days passed slowly. The people with whom I W:L\ staying had full­
time jobs. so were rarely home. and Toronto was in the midd le of a summer heat wave
that left me literally dren ched with sweat if I stayed outside for longer than ten minutes.
Try as I might. I could not think of anothe r way to resurrect my fieldwork than hope
l illian' s roommate wou ld be able to recommend a few people. I had by now thorough ly
exhausted my Toronto-urea connections . and I was-and still am--entirely
uncomfortable with the idea of engag ing random peop le on the street in conversation on
the off chance that one of them might have a story to tell me. Yes, there were probably
other avenues open. but none occu rred to me at the time. So for the first two days of my
fieldwork trip, rather than conduct the interviews that I had planned for the previous four
months. I sat in a non-air-conditioned apartment and slowly sweated through my clothes.
Mond ay eventually meandered in. and late in the afternoon I packed my record ing
equipment into a backpack and set off for lilli an's. Upon arrival. my host informed me
that not only did Jenni fer have a few stories that she' d be willing to share, but that
between the two ofthcm they' d thought up a few other people I could talk to. I was
eluted. and for the first time since Satu rday felt like things might still have a chance of
turning out all right. So immediately after dinner I hauled Jennifer into the living room.
set up my equipment. and plunged in.
12

--- .--- - - - - -_._- ------
That first interv iew taught me two vcry important lessons. FiN. I learned that it' s
a bad idea 10 set up an intervie w right next to the only phone in the house. Second. I
learned that the list of Questions I'd prepared for these interviews was fur too long. I'd
been working on this list for a few weeks. and by the lime I arrived in Toronto I'd
managed to ro me up with three typed. single -spaced pages ' worth of Queries. I asked
Jennifer every single one of them . thinking at the time that I was making sure that I
gleaned every relevant piece of information possible. What ended up happening was that
the interview took the better part of ninety minutes. and by the end Jennifer was visibly
exhausted and beginni ng to beg off answeri ng the more difficu lt questions . I fell terrible
abou t this. and when we were finished I apologized and told her that I'd no idea the
process would be so lengthy and draining.
Luckily. she was a good sport. I say this because she respond ed to my apologies
by tellin g me that her parents were in Toron to during the outbreak, and were interested in
talking to mo-e-she' d called them earlie r in the day. after Jill ian had told her what I was
resea rching. Better still, I was then told that Jillion' s brother was also in Toronto in 200 3.
and that he was available for an interview. Excited, I immediately rang both parties and
secured interviews for the followi ng day.
Jennifer' s parents-Angel (pronounced ON-hell, with a Spanish accent) and
Rosita-c-were wonderful interviewees. Theirs was the first interview I had ever conducted
w-ith two people at the same time, and despite their occasio nally talkin g ove r each other
(which produ ced an almost untranscribable mess on audiocassette), they told wonderfu l
13

stories. To my delight. halfway through our interview Angel excuse d himself to call Luis,
a friend of his, as it had occu rred to him that Luis wou ld make a good interviewee.
And so he did. Luis knew few spec ific narratives about SARS. but was very
op iniona ted as to why ou tbreaks should be taken serious ly. When I asked him if he'd
heard any SARS jokes , he told me that there was noth ing funny about people dying . My
interviews with Luis, Angel and Rosita marked a significan t shift in my orientations to
the kinds of quest ions I was asking. The list that I had created was almo ...t sterile in its
exami nations of the out break. with most of the question" following the form of "d id you
hear x?" and "what was your opi nion of yT Despite all the research that I had so far done
on SA RS. the question of ethnici ty had never fully permeated my understanding of the
material. That is to say. while I was aware that racism had been a part of the outb reak. it
had blind ly never occurred to me that I might be interv iewing people of Asian desce nt
(Jenn ifer. Ange l. Rosita. and Luis were all Chinese-F ilipino). The questions that I had
prepar ed were in no way insensitive to race and ethnicity. hut they did fail to adequately
address it. and so halfway through my chat with Angel and Rosita I began ad-fibbing
questions to try and incorporate these deta ils. Talking with Luis forced me to further
consider these facts, and as well, revealed to me that some of the questions I was asking
(for instance. " Have you heard any jok es about SARS,?,,)could be interpreted as
inscnsitlve-c-cspe cially if asked to someone who had lost a friend or family mem ber to
the virus. J wus fortunate to catch this before I offended anyone, but the reali zation still
came as a shock.
14

When I returned to my apartment later that afternoon. another pleasa nt surprise
awaited me. Robb ie. the former roomm ate of mine whose sister's spare room I was
currently ..lcepin g in. had tracked down a budd y of his named Mike, who was an El\1T in
Toronto durin g the SARS crisis. Mike wou ld be shewi ng up for dinner in an hour. and I
cou ld interview him afterwards. That intervie w turned out to be one of the most
informative of my entire fieldwork process. at least in terms of what was going on in the
city from a medica l perspecti ve. But Mike was not ju ..t a member of the med ical
communi ty-he had also been a patient, as he was one of the first peop le quarantined for
SARS in Canada (though he had never actua lly cont racted the virus] . My interview with
Mike was ..o engros..ing that I completely forgot abo ut the li..t of questions lying nex t to
my elbo w, and instead spent our entire talk merely urging him to tell more stories.
The next morning. I hopped on the subway and rode to Brown' s College . where
Jilli an' s brother Jonathan worked. My interview with him focused mostly on his
percept ions of life in Toro nto dur ing the crisis. and resulted in a few good sound bites.
Then. as I was packing my cassette recorder into my hackpack. Jonathan mentioned that
his department's secretaries. Annie and Mayce. might he good to talk to. li e walked me
out and introduced me, and I spent the next hour weav ing and bobbing my way from one
secretary to the other. trying desperately to capture their stories through the stream of
students that kept running through the office. Finally. ju st before I left the building.
Jonat han re-emerged from his office and hauled me to the rear of the room. where he
introduced me to Justin. Unfortunately. I had only brought a single tape to the meeting in
my hurry to leave the apartment that morning. and as I had already filled almos t the entire
15

tape between Jonathan and his secretaries. I only had enough space for Justin to relate a
single narrative. Still. I was satisfied: in three days I had conducted nine interviews.
which was a far cry from the utterly blank and useless tapes I had been dreaming of since
Saturday.
In my heart, however, I suspecte d that nine interviews would not provide enough
material for an entire dissertation. So after I returned to Newfoundland. I went back
through the notes that I had made while in Toronto and discovered three potential
contacts who had escaped my notice during my three-day interviewing whirlwind. The
first was Ann, who was Jillian' s aunt. I sent Jillion an email to see if it would be
accep table for me to give Ann a call. and made that call on the 2i h of July. Ann's
connection to the SARS crisis was that her husband had been hospitalized for a possible
case of pneumo nia during the beginning weeks of the outbreak. It turned out that her
husband was fine. and had not contracted the corcnavirus. but Ann's stories of what it
was like visiting her husband in the hospital showed the strain that medical staff and
hosp ital visitors were under.
My second contact was Sony. who had been referred to me by Angel and Rosita.
as well as Luis. Seny was Filipino. and worked for a major corpo ration in the Toronto
area. I was initially planning on Seny's interview to also be by telephone. but late in the
month realized that a wedding I was going to in Ontario might coincide with Seny's
being able to be interviewed in person. I would have to squeeze the interview in during
the short time I would be in Toronto proper (roughly the few hours on either end of the
trip when I would be arriving at or departing from the airport). but the quality of the
16

interview would make the trip worth my time. As easy us it W:lS to conduct the telephone
interview with Ann (and similar long-distance interviews that I'd done for other projects).
the results were never of the same value as the face-to-face meetings . So I called up Seny.
and we agreed to meet at her office in the early afternoon of the 3 nJ of August. Seny
proved to be an exce llent interviewee. whose reco llections of the SARS outbreak were
vivid. Her stories were engrossi ng and detai led. and I left her intervie w wishing that more
informa nts were as intelligent and well-spoken.
I still at this point wasn't quite satisfied with the number of interview s I had
conducted, so upo n returning to Newfoundland I got hack in touch with Jennifer. my first
interviewee. who had mentioned that her boyfriend would be an ideal perso n to talk to.
Benjami n W :l S the third of the potential contacts that I had noticed in my notes. and
Jenn ifer was happy to provide me with his phone number. Benjamin' s life is more
heavily detailed in chapter five of this work, but it should he noted here that at the time I
interviewed him. he W:l S working as a bartender in San Francisco. Thus, the only
interview ing method available to me was the telephone. After severa l false starts, I
eventually managed to get in touch with Benjam in. and interviewed him on August 17 111 •
As has already been made evident. virtually my entire fieldwork process ended up
hcin g a series of serendipitous moments. But Benjamin' s interview stood out even among
those, for he had spent 2003 in Ch ina, traveling and filming sections of the Yangtze River
for an independent, self-financed docum entary. Benjamin's descriptions of the lives of
the villagers who resided on the banks of the Yangtze ended up being critical for the
17

creation of large parts of chapters five and six of this work, and gave me valuable insights
into the roles of race and ethnicity in a disease outbreak.
I did have one further lucky break that merits mention. When the school semester
at MUN started in early September of 2005, our departmen t held its annua l "meet and
greet" orienta tion, in which all faculty and student members introduced themse lves and
gave brief biographies. Having spent August transcribing my interviews-a process that
would take me until December to completc-c- I took the opportunity to announce during
this orientation session the topic and nature of my research, and asked that anyone who
had any SARS-related stories please contact me. At the sess ion's end, a new graduate
student named Heather Read approache d me and noted that she had lived jus t outside of
Toronto in 2003, and that her mother was a nurse in Ontario during the outbreak. Heather
expressed interest in being interviewed, and I ju mped at the chance, sitting down with her
on the 9 th of September for the better part of an hour. Heather' s recollections, especially
those involving her Asian roommates. helped to further my theories on the nature of race
and cthnicity in outbreaks. evidencing as they did the blatant racism present in Toronto
dur ing the SARS crisis.
And thus ended my series of interviews. I did announce in all of my classes for
the next two years that I would be interested in talking to anyone who had any SARS­
related narratives, but only one student ever expressed interest. Unfortunately, that
..student had to drop out of school altogether some weeks later due to a medica l
emergency, and I never saw him again. Still, my efforts in the summer of 2005 netted me
thirteen interviews, totaling some 300+ pages of transcrip tions. I had at one point
18

cons idered revisiting Toronto in 2006 for additional interv iews. but decided against such
an excursion. partially becau se of budge tary restrictio ns. and partially because it seemed
to me after transcribing my interviews that I already had enough information to write
about for quite some time. Indeed . my transcriptions exceed the length of this
dissertation.
Creat ing those transcriptions also revea led to me the importance of the directions
I was forced to take. and the questions I was compe lled to consider. following my initial
fieldwork meltdown. Though it was neither plan nor intent-nor even noticed at the
time-the li..t of interviewees I brought with me to Toronto consisted entirely of
Caucas ians. While I no do ubt would have gathered considerable and importan t
information from such a group. my data would have been largely homoge nous. reflect ing
the attitudes and perce ptions of people who in many ways stood on the outside of the
outbreak. being rarely-if ever-forced 10 confront the realities of being jud ged for the
co lor of their skin or the shape of their heritage. But as the first four peop le I intervie wed
belon ged to a community and ethnicity that had been heavily stigmatized. I was forced to
change Illy horse midstream. as it were. and reflect upo n their experiences.
Look ing back. this shift in approach sent shockwaves through what I had assumed
w'ere carefully constructed ideas. and affected virtually every aspect of this project.
Because of those first four interviews. there is not a single chapter in this dissertation that
docs not. in some way. consider the effects of xenophobia and racism during the
epidemic . In many ways. my being confronted with the narratives of peop le from
stigmatized comm unities and ethnic ities was the single most important factor in the
19

shaping of everything that was to come from my efforts. II wou ld not he unreasonab le to
declare that th is dissertation would have been poorer without such refoc using.
Other aspects of my fieldwo rk also forced me to change my ideas . As I have
already mentioned. my interview with Luis made me realize the dangers inherent in
asking for jokes about SARS from people who may have had friends and relatives perish
from the di...ease . Mike proved an excellent and willing source of information in this
aspect. and also gave me insights into the medical community that I might not have
gotten otherwise . And my phone conversation with Benjamin gave me a glimpse into the
very heart of the count ry that was blamed for the outbreak. provid ing me with data that
allowed me to make a ca...e for the existence of para llel reactions to the virus, regardles...
of place . cthnicny, and status. So while my interviews with J CIl . Angel. Rosita. Luis. and
Scny were perhaps the most important in terms of red irecting my thoughts. they we re not
the only factors that prove d critical.
The work that hJS resulted from my researc h effo rts has taken some three yea rs 10
wr ite, and will, I hope, shed light on an area of folklore that has so far gone unnoticed . I
also trust that the theori es and ideas I put forward here are useful to other scholars, as
wel l as 10 stude nts of both folkloristics and medicine .
This wor k is organized JS a series of studies, introd uced hy a large amo unt of
background material to familiarize the reader with the subject and perti nent scho larly
ideas . Chapter two begins this theore tical orientat ion with an overv iew of three key areas
that are especially rele vant in the examination of SA RS. These areas are those of folklore.
the media. and SARS. Taking these topics one at a time. chapte r two first examines the
20

theoretical standpoi nts in the field of folklore that dea l with folk medicine. health pa nics.
and legends. and the intersections bet ween the se areas. The chapt er then mo ves to the
field of media theo ry. not ing key works that describe the relat ion ship bet ween media
presentation of topi cs and public react ion to those topi cs. where in many cases the
med ia' s slant on the report co lor!' and shapes publi c react ion. Finall y. the narrati ve moves
to the world of SARS. and provide s a glimpse at the writin gs of people who wor k within
the field of medi cine and science, and wha t the ir react ions were to the out break.
C hap ter three provides a chro nicle of publ ic inform ation for the SARS crisis. The
focus of this chapt er is twofold . simul taneously presenting the outbrea k as it was revea led
to the publi c through vario us media sources. and as well. sho wing the medic al versio n of
the epidemic as revealed through vari ous academic journ als. The ultim ate goal of this
chapter is to demo nstrate that there were key dif ferences in wh at the publ ic was rec eiving
VeNlS what the med ica l world was discove ring and anno unci ng. Espe cially in the areas
of published rumor and legend. the story of SARS tha t the pu blic rece ived from the
media in 2003 was not the story that the medical establi shme nt was telli ng, This chapter
will set the stage for the exa minatio ns thai will occupy the cen tral studies of this boo k.
Cha pter four begins this series of studies. and focuses Oil etiologicallegends .
Dozens of narrative s dea lt with the origin of SARS, including why it arrived and where it
cam e from . Providing glimpses at legends as wide ly varied as gov ernment con spi rac y
theories and animal origin stories. this chapter will demo nstrate that the narratives that
aros e du ring the SARS outbreak clo sel y resemb led the narra tives that arose durin g the
init ial years of the AIDS epidemic. In doin g so. this chapter attem pts to esta blis h the firs t
! I

in a series of arguments that ultim ately demo nstrate that disease narrat ives do not spring
out of nowh ere. hut are in..teed recycled from prev ious outbreaks.
Chapte r five moves the examin ing lens from the field of etiological legends to
narratives that deal with gathering places. Beginning with an hi..torica l ove rview of
narratives concern ing the negative consequences of eating in Chine ..e restaurants. the
chapter then moves to the world of SA RS. where the modem and historica l narratives are
once again found to he similar in tone and plot. These modem narratives are then
exami ned as they appeared in media sources. and a.. well. a.. they appeared in their oral
form... as related to me by my interviewees. Beginning a theme that will thread
throughou t the rema inder of the book. this chap ter then addrcs ses the racial and eth nic
fears that such narratives caused. and their consequences.
Chapter six continues the investigations into the xenophobic nature of SA RS
narratives by examining those legends and rumors that involved individuals conducting
private actions in public spaces. Many of the narrat ives that circulated during the
outbr eak had at their roots incomprehension as to the different meanings that cultures
place Oil act ions. These misunderstandings and miscommu nications led to scenarios in
which Asians were wrongly blamed for misconduct. when in fact the conduct was
co mplete ly appropriate according to Asian standards. Such blame was not j ust the
province of the public: medi a sources assisted in the spread of negative rumors by not
only publishing those rumors. but by continually printing stories that fome nted anti­
globalis t sentiments.
22

Chap ter seve n uses the lens of stig ma theory to further examine the racis m and
xenophob ia that came packa ged with the coro navirus. Espec ially useful in this chapter is
the work of Ervin g Goffmun. whose studies of stigma brought the subject to the academic
com munity as a whole. However, Goffman's theo ries of stigma are found to he lacking in
key areas when held up to the types of stigma expe rienced by my interv iewees during the
SARS outbreak. This cha pter therefore highlights these underdeveloped areas , pointing
out avenues for furthe r class ification rubrics, and suggesting new crite ria for the types of
stigma that cou ld he studied.
Cha pter eigh t exam ines the state of folk med icine during the outb reak. Seve ral
SA RS cures are noted and discussed, and the types of these cures arc com pared to the
preventat ive and cu rative measures employed by laype rsons during other epide mics, such
as AIDS . In addition, this chapter looks at the longstanding battle betwee n folk and
"o ffic ial:' "Western:' or "hospital " medicine, and the interconnection !'> and fragmented
pathways that lie between these realms. More specifical ly. this section addresses the
reasons why folk medicine has rema ined a vibrant. and even growing presence in the
modem wor ld, suggesting that the medical establishment may be doing itself and its
patients a great disservice by attem pting to quash the publ ic' s interest in it.
Chapter nine is the last study, invol ving an in-de pth scrutiny of the nature and
probl em of rumor and legend in d isease outbrea ks. These form s of narratives have by this
point been proven to he deleterious and damaging, and this deman ds the question of what
can be done to prevent or stymie their spread. Unfortunate ly, the answer to th is question
i.. difficult , for rumors and lege nds have proven to be noto riously difficu lt to erad icate.

However. there have been some recent studies that may have shed new light on possible
solutions to these problems.
SARS is, by all appearances, a dead disease. It existed during a specific period of
time. then vanished. Like the Latin language. it provides scholars with a perfect specimen
to examine. an ideal. non-evolving thing-in-a-boule that can be placed under a
metaphorical microscope and seen from end to end. all of its connections fixed and
unchanging. even if yet undiscover ed. The following series of examina tions arc by no
means exhaustive in scope. but will hopefully provide at least a ray of light in a
previo usly dark chambe r. and give voice to people whose stories would have otherwise
been forgotten.

Cha pter 2: Folklore. Medi a, a nd Medi cin e
One of the largest recent disease outhreaks hega n in Nove mber of 2002. when the
first cases of a disease that would soon he known as SARS began spreading in China.
Since then. the SARS coronuvtrus has achieved infamy seldom seen among diseases.
swee ping through media and Intem et sources to create a pan ic that left thousands of
people halfway around the world wearing surgica l masks in attempts to protect
themselves from perceived harm. Extrao rdinarily. the virus's non-age-adju sted mortality
rate was. overa ll. only one in five ("Researc h puts Sars [sic ]..... 20(3 )-a significant risk.
but noth ing compared to the 90% rate of the Ebola virus. or even the 22% rate (in
Canada) of common pneumococcal pneumonia. neither of which have a media frenzy to
parallel that of the SA RS virus.
The ultimat e goa l of this dissertation is to exa mine and understand the narra tives
that people told about the SA RS outbreak-the rumors. gossip . legends. jokes. and other
form s of oral communication. Exam ining these narratives will provide insights into why
peop le believe the things they do about diseases. and why narratives both shape and are
shaped by disease. But in order to begin such an examina tion. we must first contcx tua lize
the study of diseases and medicine as a whole within the fields of folklore. media studies.
and medicine. Examining existing literature on healt h models. belief systems. disease
panic. and other areas will provide us with a background appropriate to the study of a
nove l disease by providing common theoretical ground and language.
25

Any theore tical orientalion regarding SARS must by necessity be
multidi sciplinary, for the greate r portion of spec ific information about SARS exists
outside the acade mic field of folklore. Within the field, Diane Golds tein' s recent boo k
Once UPOII1I vtms: AIDS Legends and Yema cular Risk Perception (2()()4)contains one
paragrap h thai briefly discusses the simi larity between SA RS and A IDS narrative s.
Norine Dresser' s websi te I" F OCI H contains a one -page section under its "Online
Multicultural Manners" on SARS rumors (Dresser :!()()4). Monica Kropej listed a few
Slovenian SAR S rumors in her 2003 ISCLR paper (Kropcj 2003) . and both
urbanlcgcnds.com and snope s.com. if they can be cons idered authoritative. contain
article s debunk ing some of the current SAR S legends. Beyond that, not much is
avai lable. As of laic 200 7. no majo r book by a folklorist has dealt exclus ively with the
subject. and an MLA International Bibliography searc h for articles on "SA RS" returned
only three relevant hils: IwOfrom the field of linguistics. and one from sociology. written
in a dialect of Chincsc.? none of which were relevant to my focus. There arc a few
sources other than these within the field- sources thai somehow escaped the eyes of the
MLA-hut they are few and far between.
This is not 10say that the field of folklore cannot offer anything toward the study
of SARS. In fact. there are many sources that offer widely varied theoretical standpoints
that can ultimately be applied to this topic-the work simply involves looking at those
theor ies in new lights. demonstrating how the ir tenets arc also applicable to areas outside
those initially determined by their creators. What needs to be made clear, however, is that
::!The MLA citat ion provided an English summary for the Ch inese article.
26

a study of any disease such as SARS-which ex isted not on ly in the vernac ular health
percep tions of the layperson. but in severa l other real ms. such as science and medicine­
must take into accoun t those other areas. As such. the focuses of this chapter will be
threefo ld. eac h sectio n being particularly relevant to the arguments that will occupy this
thesis. First. I will exa mine the work within the field of folklore (or work that is regularly
used by folk lorists). especially as these top ics relate to rumor. legend . and health panics.
Second. I will look at work that attempts to analyze and construct theor ies involving the
med ia. including newspapers . magazines. and televised news broadcasts. Finally. I will
investigate the medica l and health-related rea lm. delving into work written by doctors.
nurses. scientists. and other profess ionals who work primarily within the realm of
medicine.
These are not the on ly three realms of importa nce in the study of SARS. but it
docs seem to me that they are of prim ary co ncern in the matter. since many of the
probl ems with and confusions about the disease that resulted in panic and xenophobia
cam e from the co mmunications (or lack thereof) that took place betw een these area s. For
exa mple. it took the scientific com munit y some lime to iso late the SARS coronavirus and
[ocate its source in the Chine se civet cat. During that time muny hypotheses were
adva nced within the scientific co mmunity conce rning such details , and. as is the natur e of
scientific work. some of those hypotheses were ultimat ely proven incorrec t. Regardless
of their potential for being co rrect. however. media sources reporte d every piece of news
they cou ld glean from the scientific com munity. their quest for deta ils driven by an
informat ion-hungry pub lic that purchased in mass quant ities any newspaper with the

word "SARS" in its headli ne. And the infor mation-hungry publi c abso rbed those facts,
leading to lay people discussin g the problems amongst themselves.
Several areas of concern crop up in this scen ario. as brietl y (and therefore
inaccurately) as it has been stated here. For one. there are distinct levels of vocabulary in
all three layers of this pictu re. from the highly technical medica l ja rgo n of the sc ientific
community. to the simplistic vocabulary employed by most newspapers. to the wide ly
varied communication styles used by laypeople. Th e problem is that the med ia- which
has arguably the si mplest language of the three-is the main source of communication
betwee n the sc ientific and lay co mmun ities. Any inform ation that co mes from the
scie ntific community must therefore be pared down to its bare bones and rephrased in
such a fashion as to make it "understandable" to the ge neral public. Co nsiderab le loss of
nuance and meaning is the result of such paring, a co nsequence that ca n res ult in
miscommunicat ion and misunderstanding.
A second area of conce rn in this scena rio is the accuracy and co mpleteness of
information as it flows from one source to anot her. In addition to the problems mentioned
in the previous paragraph. the med ia is a problematic source of information precisely
beca use it is a business, and therefore has as a primary interest the crea tion of prof it.
News stories that will sell newspapers will get published as a result. while news stor ies
that are of lesser interest (or impact) will be put as ide. pushed to later pages of the paper ,
or left uncovered altoge ther. So while the announce ment of. say , lemmings having bee n
discovered as the carr iers of SARS wou ld rank high on the list of "publishable material."
the retraction of th is information at a later date might or might not be co nsidered as
28

--- - - - - - - - - --- -----.--,-----
cultural belief systems and how they lead people 10perceived differences in risk-related
activities when it comes to contrac ting the virus (Flaskerud and Calvillo 1991: Flaskerud
nod Rush 1989; Harwood 1981: Trotter and Chavira 1981. ctc.). Even the subject of
AIDS as a punishment from God has not gone unnoticed (Flaskerud and Rush 1989:
Mays and Cochran 1987). And while SARS stilllacks folklorist ic works on these topics,
vernacular discourse. legend. and communication are overflowing with untapped.
unrecorded exa mples.
Because of the wide-ranging natures of these texts. illness-narra tivity research
also provides a wealth of indirect information on SARS . The recent movement in this
crea. for instance. towards viewing health narratives as models for illness and health
action (Good 1994: Mattingly 1998 ) is especially relevant. as it provides a means to look
at SARS narratives as keys to complex cultural belief systems. Lauric Stanley-
Blackwell's 1993 article on Acadian good-Sa maritan legends and the New Brunswick
lepro..yJ epidemic of the 1840s is an excellent work detailing the link between health and
legend, demonstrat ing how the narrativ es used by communitie.. were "therapeutic... they
dcmysrificd the disease. mitigated its harshness, and combated the pervas ive notion that
the disease was an hereditary scourge among the Acadian population" (33). And Gillian
Bennett' s article "Bosom Serpents and Alimentary Amphibians: A Language for
Sickness" demon strates how legends serve as mediators of health crises, allowing those
.1 The Icons "le pro..y" and "leper " are widely considered offensive and politically
incorrect. The preferred term is "Han..en's di..case:' which will be u..ed hereafter, exce pt
when directly quoting a source.
30

affl icted a means of understanding their diseases -c-how they came to he ill and how they
can recover ( 1997).
Another theoretical approac h that will prove crucia l in exami ning SARS
narratives is that espoused by David J. Hufford in T1,,: Terror That Comes in the Nighl:
A" Experience-Centered Study of SlIpen wIlIraf Assault Traditions . In examining the
cxi..renee of "Old Hag" narratives.' Hufford found that. contrary to what had been
previously written . the "Old Hag tradition contains elements of experience that are
independent of culture" ( 1982a. 15). In further examining previous literature on the
subject. and on other supernatural phenomena . Hufford found that research into folk
belief contained a disturbing set of assumption s. three of which he found most pernicious :
( I) That stateme nts which do not appear to allow for materialistic interpretation
may be rejected out of hand; (2) that "the folk" arc always poor obse rvers and
consi..tently confuse subjective with objective reality-a confusion which the
scholar can unravel rather easily at second hand; and (3) that informants therefore
cannot maintain mcmorates separate from legends. (1976. 73)
Because of assumptions such as this. Hufford created a new hypothesis. the "exper ience-
centered approach," which he explains as essentially following the rule that. when
collecting data. "we should suspend our disbelief and not start wondering immediately
what really happened- that is. what would he an explanation we could accept" (Hufford
1976. 73· 4). Instead. we should begin our fieldwork from the stance that the material we
are abo ut to receive is coming from "accurate observations interpreted rationally" (l 982a.
.. The "Old Hag" is the name given in Newfoundland. Canada. to a phenomenon that
typically cons ists of an individual waking sometime during the night. but finding him or
herself to be temporarily paralyzed. This is often ucccmpunied by the sen..arion of
pressure on the chest (often leading to feelings of suffocation). as well a" hallucinat ions
of supernatural beings entering the room.
31

xviii), and as such. "When an informant relates a bizarre but believed experience. we
should try to ask some of the questions that his friends and neighbor s might. as well as
those that occur to a university professor" ( 1976. 74). Th is valuing of informant belief
systems and narratives is as critical in dealing with disease narratives as it is in
researching supernatural phenomena.
Contemporary Legends
Beyond these genera l orientation... any approach to the exami nation of the
narratives surrounding SARS must begin with the legend genre. Contemporary legends.
as defined by Patricia Turner. are "unsubstantiated narratives with traditional themes and
modem motifs that circulate in multiple versions and are told 4lS if they are true or at least
plausible" ( 1993. 5). and are characterized by "pe rsistence. pervasiveness and
persuasiveness" (Kapferer 1996. 246). The oral passage of a legend is "often
fundamentally a political act" (Ellis 200 1, xiv). a fact that is closely tied in with Ronald
L. Baker' s assertion that "mass culture nourishes legendry-providing it with fresh
subject matter and spreading its dissemination" ( 1976. 367). According to Jan Brunvand.
the maintenance of legends is based on three criteria: "Strong basic story appeal. a
foundation in actual beliefs. and a meaningful message or moral" ( 1981. 10 ). and as
Tamotsu Shihutani has stated. the genre advises. cautions. and informs with speed and
authority ( 1966).
Much of the field of legend research is. in fact. directly relevant to the study of
SARS, since my examinations of the coronavirus largely entail dissections of the
narratives that surrounded it. such as legends, rumors. jo kes. gossi p. etc. Legend theory
32

that specifical ly deals with disease and illness is particularly relevant. providing a
background for subsequent discussions about novel illnesses. In this sense. a relevant
starting point lies in a small work by Frances Cattermole-Tally that originally appeared in
the "Topics. Notes and Comments" section of the journal Folklore in 1995. In this.
Cauermole-Tally discusses the Fantasies and realities surround ing the intrusion of non­
human organisms into the body. Beliefs in the possibility of such intrusions go "far back
in history and [are] almost world wide" (89). and transcriptions (or at least descrip tions)
of the stories that accompany them have appeared in folkloric texts for decades. For
instance. Thomas R. Brendle and Claude W. Unger's Folk stedicine ofthe Pennsylvania
Germans: 71,e NOII-OccIIlt Cures, published in 1935. mentions the Pennsylvania
Germans' usc of the word "wo rm" to describe intestina l parasites such as the tapewo rm
(qtd. in Catterr nole-Tally 1995. 89-90). What is critical about Cuttermole-Tally's article.
however, is not its descriptions of historical beliefs in animal intrusions. hut its discussion
of the problems inherent in many folkloristic works concerning those beliefs. "Fears of
worms or reptilian forms existing in one' s body are not without basis," Cuttcrmole-Tally
warns: "Just as many physicians often ignore or dismiss belief ...· about diseases. so most
folklorists overlook or ignore the reality that diseases might be caused by animals
residing in the human body" (Cattcrmolc-T ally 1995, 90, emphasis in original).
This call for what is essen tially academic belief. or at least willing suspension of
disbelief. in the beliefs of others is well-evidenced in Adrienne Mayor's "The Nessus
Shirt in the New World: Smallpox Blankets in History and Legend: ' Mayor ' s article
starts off by recognizing that smallpox blanket stories "may be based on historical fact"
33

( 1995.55). and moves from there into an exa mination of the historical consequences of
these stories. Echoing v eronique Cumpion- Vincenr's earl ier observations thai
contamin ation fears often involve elements of xenophobia (qtd. in Mayor 1995. 67).
Mayor notes that "in poiso n-garme nt legends of Europe . India. South Ame rica. the
Unitcd Slates. and elsewhere. those who are Others in terms of race. culture . nat ionality.
ethnic group . religion. gender. status. class. eth ics. and "0 on. are held responsible for
contaminating clo thing' (Mayor 1995 . 67). These examination" of the racial stereotypes
presen t in smallpox blan ket stories are furthermore extended to other illness narratives.
Mayor not ing especially the similarities between legends surrounding "ma llpox and
AIDS . Both narrat ives. for exa mple. ex hibit themes of "moral responsibility. blaming
victims ... • [undl tfatal gift ' motifs" (1995. 56). as well as "morally ambiguous situations"
( 1995. 68 ) that blur the boundaries of acco untab ility. It is. however . the theme of "Others
as contaminating strangers" ( 1995. 72) to which Mayor kee p" returning- a theme that
will appea r aga in and again in the discussions of SA RS that will appea r in subseque nt
chapters.
Xenophobia such as that which app ears in Mayoc' s work may in part come from
what Bill Ellis has noted of legend-telling: that it can bc seen as the "communal
exp loration of socia l boundaries" (l990b . 3 1). where members of a gro up define and
demarcate their borders. A consequence of such demarcation can be the exclus ion of
those mem bers who are deemed not to fit communal norm " and expectations. In "Organ
The ft Narra tives." Veroniqu e Camp ion-Vincent ap plies the exa mina tion of xeno phobic
responses to narratives conce rning the theft of body parts. especially in relation to baby

parts and stolen corneas (both of which come from Sout h America). and kidneys (in
Europe and North America). " Legends and rumors:' she says. "thrive on the degree and
intensity of belief" ( 1997.7). and narratives that involve outsiders stealing body parts
from children provide an opportune medium for the nourishing of intense beliefs. In a
separate essay . Campio n-Vincent expands on these points to bring out the nature of these
fears of outsiders, saying. " In a state of crisis in which the established value system of a
group or society seems at stake . it is easier to cope with anxiety if it becomes fear of
someone who can be held responsible' (2005 . 105). noting at the same time that the
belief in stories such as these is in part explainable by their not relying on "fact or
reason:' and therefore being unaffec ted by them (2005 . 106 ). The full extent of
xeno phobic sentiments is usually downplayed in reports by popular media. but oral
narratives are not so tame. and make apparent the full spectrum of sent iments.
Cumpion-Yinccnt's articles are important for more than just their discussions of
xenophobia. Along the way. the articles also touch on reasons beh ind the ex istence of
rumor and legend. creating a theoretical framework for the understandin g of the basic
human needs that drive the creation and promul gation of such narratives. Quoting Neil
Aschcrson. Campion-Vincent slates that "rumor exists because it fills a need. 'The need
for an interpretati on which suddenly and magically strings toget her disconnected fears
and hopes. nostalgia and hatreds and displays them in a single significa nce' .. ..· ( 1997.
32). Narrat ives such as these provide a means of expressing deep-seated emot ions that
may not be socially accep table in other forms of communication. Simon Bronner
discusses one exampl e of this in his exam ination of children 's contagion folklore. wherein
35

he finds that the "coo lies complex" came out of associat ions with polio, but ex isted
among children as a means of "playfully dramatiz]ing] the dread of the disease," while
simultaneously examining the modem logics of appearance and clean liness in associatio n
with health (1990. 107).
Laurie Stanley-Blackwell's aforementioned work on New Bnmswick narratives
concerning Hansen's disease shows a different purpose for legends. In her work, the
stories are not told by one set of people about another. but by one set of peop le about
themselves. In this case, the legends mitigate the fears associated with the disease. and
attempt to explain its prescnce in a way that removes the focus of blame from the local
population. specifically by claiming that the disease came from elsewhere as a result of
travelers. In making such narrative claims, the local people create "a humanized and
indigenous aetiology for leprosy" ( 1993. 39). Diane Goldstein presents yet another view
of this. noting that the AIDS legend tradition "betrays our obsession with origins,"
where in the underlying themes of popular legends all revolve around a single concern:
"establishing a first-a source for this thing that made our world change so irreversi bly"
(2004.77).
Another way legend theory can be used to exa mine health-related concepts is by
utilizing its ability to discuss rationally and logically the vernacular theories that surround
disease and cure. These vernacular theories are often scorned by the "officia l" medical
community. but this does not necessarily result in their being abandoned by the
layperson. Gillian Bennett gives an excel lent example of this in relation to bosom
36

serpents and other animal s bel ieved to be able to reside inside the human bod y. Bennett
claim s that these narratives form
... a complete language for talking about sickness . They are a metaphor-come- true
which allows a rational aetiology to be deduced from the centra l image and a
logical cure devised. But they are also a means whereby lay persons may talk
informedly to each other and to the ir therapists about the nature and course of the
sufferings. Best of all. they are a means thro ugh which the efficacy of the various
medica l alternatives may be debated. The doctor need never have the last word
(though he often does even here). The stories are there to be told. to demonst rate
that no mailer how many times patients arc told that their sufferings are
imagi nary. in the end the scoffers will be confou nded and the patient will be
dramatically vindicated. ( 1997.239)
Regardless of the purpose beh ind the legend. the narrative itself continues to be
spread because it "resonate ls ] with the life circums tances" of the narrator and audienc e
(Bennett and Smith 1996. xxii). Elissa R. Henken exemplifies these themes in her article
"Escalating Danger in Contemporary Legends: ' especially as the narratives she choos es
10 study exhibit fears of Others. Her main purpose is to demonstrate that legends scem to
be changing in two ways in the modern world: first. the amount of danger a victim faces
in a legend seems to be larger and more life-threateni ng now (as compar ed to. say.
legends in the 1970s); and seco nd. that there appears to be a moveme nt away from
justifiable or merited punishment in these narrativ es. This second topic is well-
demonstrated in the "welcome to the wonderful world of AIDS" legends. where Henken
suys that. in contrast to previous narratives where A IDS victims could be blamed for
promiscuity in having contr acted the disease. "that legend has been largely superseded by
legend s in which the victim. unwillingly pricked by an Hl v -infccted needle. has simply
gone to the movies or used a payph one or soda machine or gas pump" (200 2. 26 1). No
longer is it necessary in legends to justi fy a victim's plight by having them take a course
37

of action deemed immoral or inappropriate by community standards. Instead. we now
have narratives where even those who are innoce nt of any crime are potential victims.
Such "changes in punishable behavior appear clearly linked to changes in a group's
morals" (2002 . 259). possibly e,..idencing a shift caused by the nature of modem society.
where "shame appears to be losing its strength a, a social control and peop le are
rewarded for publicly humiliating themselves on television" (2002. 27 1-2). As such.
legend, emp loy increasingly harsher punishments for violators of social and communa l
noons in order to remain relevant. and furthermore need to empha..ize the negative
consequence, of inappropriate acts by demonstrating that even innocent people are not
safe. In legends. it is no longer accep table for the public to assume themse lves protected
from harm by their po..itive actions.
Paula Treichler' s 110"' to Have 111eor)';11 t/ll Epidemic provides an exce llent
summarization of many of the points that have so far been addressed. Concerning the
origins of AIDS narratives. she states that, given the uncertainties that revolved around
the disease' s origins. transmission vectors. curability, and other unknowns. "it docs not
seem unreasonable thut... people' s imaginations give hirth 10 many different conceptions"
( 199lJ. 16), Reactions to these stories vary widely. depending on multiple factors. hut the
narratives arc important as a whole because they are evidence of a cultural " St' IIW " of
truthfulness (1999, 1(4 ). For instance. Treichler slates that "so me of the idiosyncrat ic.
unreasonable. apparently demented meanings annburedto AIDS provide important
insights into how people make sense of the world. collectively and individually. and how
language works in culture. They reveal sources of mistrust. resistance . fear. and
38

discmpc wermcnt" ( 1999. 222). Such narratives. especially as they exist in the fonn of
conspiracy theories, offer empowermen t to their narrators in knowing secre t and
dangerous information. which helps exp lain why these narratives "of blame and causation
circu late geographically with astonishing case" (1999 .220). Bordia and DiFonzo provide
additiona l reasons for this transmis sibility in the ir discussions of rumor . wherein they
note that uncertainty and anxiety are key 10 the spread of rumo r. especially as that rumo r
applies to topics of perso nal relevance. and that there seem to he three motivations to the
spread of rumors : "fact-finding, relationship-building. and self-enhancement" (2005. 88).
Considering these factors. it should come as no surpri se that rumors have been close ly
linked to the spread of "violence. prejudice. and discrimination" (Knopf. qrd. in Fine
2005 .2).
Health Pan ics
A spec ific subset of legend-related material that is directly related to the
investigation of SARS narratives includes theories about panics. such us health. moral.
and Satanic panics. Panic was omn ipresent in the SA RS outbreak. and the theories that
arise in ucudcmic literature about other areas will prove helpful in examining the 2003
epidemic. Jeffery Victor defined a "rumor panic" as "a collect ive stress reaction in
response to a belief in stories about immediate ly threatening circumstances." and said
abou t them. "a rumor pan ic in a community can be identified by the ex istence of widely
occurring fear-provo king behavior" (1993.59). Moral panics appea r frequent ly in
soc iety. and may be novel. but have also been seen to appear. then submerge into an
39

almost-unnoticed state before reemerging decades later. sometimes with such force that
they enact legal and socia l changes in response (Cohen. Stanley 2002).
Bill Ellis has written widely about Satanic panics and devil-worshippers. His 1990
article "The Devil-Worsh ippers at the Prom: Rumor-Panic as Therapeutic Magic" restates
his theory that "one function of legend i.. to 'name' previously undefined threats and by
so doing gain psychological control over them" (3 1), which is a variation on his
"communal exploration of social boundaries" theory stated earlier in this chapte r. Ellis'
most relevant point in this article is his summarizat ion and extension of work done by
Joel Best. Best. Ellis explains , in studying the exaggerations of the numbers of abducted
children reported by organizations and individuals. finds that the problems behind these
inflated numbers lie not in the facts that a claim exists. but in the reasons "people find for
justifying draw ing certain conclusions from the facts" ( 1990.29). People' s percept ions of
a problem. then. arc more influential in their summariza tions of the problem than are the
actual facts. Accordingly. these perceptions should be the main focusof study for
problems involving especially panic-related narratives, for as Ellis points out. when
closely examined. many of these perceptions ami claims tum out to not be " irrational,"
but evidential of deep-seated fears and anxieties. And as devil-worshippers are often
synonymous with "cults" in the public consciousness, then David Frankfurter's
paraphrasing of Claude Levi-Strauss provides an excellent parallel commentary:
"Cults... are 'good to think with' when people arc anxious about cultural decl ine.
subversion. and evil" (2003 . Ill ).
40

peop le character ized the act of mast urbat ion as derogatory, dangerous, and in severe
cases , deadly. Men in partic ular were pain ted as be ing highly suscept ible to the act. their
sex ual drives "hard to control" and "fragile , read ily damaged by a moment's
carelessness" ( 1992.387). These works succeeded in being popular for two rea...ons. First.
the tracts that attempted to discount them were filled with what flail calls "ambiguities"
(1992. 386). where authors seemed unsure of their claims. undermined their own
arguments. or otherwise stymied discussions. Second. the works that did succeed d id so
largely because they built on already-existing belief systems about the negative potential s
of masturbation. As Hall says. "So loaded was the subject with negative connotations that
any reassurances seem to have been far less audible than the slightest hint of potential
harm" (1992.387).
Kathleen Wood ward provides an exce llent addition to the examination of pan ic in
"Stat istical Panic," wherein she exa mines the role statist ics play in creat ing fea r and
anxiety. Statistics are pointed out as being equi table to risk, especially when it comes to
health . In our modem socie ty we are surrou nded by figures and facts that tell us. for
exa mple. the likelihood that we will contract breast cancer, or fait down a ni ght of stairs,
or be eate n by sharks. Statistics is. in fact. "a discour se of risk. We are at risk. it seems, of
anything and everyt hing" ( 1999, J79). One of the many problems Wood ward points out
co ncerni ng statist ics is that they are too eas ily read in a nega tive sense. and often pro mote
"a sense of forebod ing and insecurity" ( 1999. 180 ). So. for exam ple. if someone is told
that they only have a one in ten million cha nce of being eaten by a shar k. the message
that can end up being made clea r is not that it is ext raordinarily unlikely for such an event

to occur. bUI simply that such an event ClI1l possihlv occur. Given this fact. and the
statistic-rich nature of the modem world. Woodw ard claims that. in some ways. our lives
are essentially a series of statistical panics. one occu pying our minds for a fleeting
mom ent until another moves in and shoves out the first one. and so on. The panic that can
be caused by statistics is especia lly acute. largely because of the uncerta inty intrinsic to
the statement : "What in fact panics us. howeve r. is that we cannot be certain of our own
future . howe ver much (it has been ) quanti fied ... for us" (1999 . 187). In the end.
Woodw ard claims that. follo wing the work of Ulrich Beck. industria l society has been
replaced hy the risk society. where "What we fear is risk itself' (1999 . 180).
The last few articles have moved towards panic spec ifically associa ted with health
issues. Margaret Humphreys' "No Safe Place: Disease and Panic in Amer ican History"
brings this transition to its fullest. shedding light on modem instances of fear and anxiety
related 10 such epid emics and health scares as cholera. malaria. heart di..ease. and the
200 1 mailing of anthrax-laden letters. among other s. II i.. Humphr eys' contention thai
modem Americans have largely forgotten what it means to "feel that our place is
contaminated. diseased. and unsafe" (2002. 845). and so scares such as the anthrax ­
mailings often resu lt in panics disproportionate to their actual morbidit y. Such react ions
are not solely limited to North America. nor to novel anxiety' inducing health situations.
In fact. Humphreys states that. in general. "diseases do not cause panic in direct
proportion to their morb idity and mortality. a fact that seems counterintuitive" (2002.
846). and illu..trates this by not ing that women are far more afraid of breast cancer than
heart disease. despite the latter being far more prevalent and deadly.
43

Humph reys also notes that the "crossing of boundar ies" (200 2. 847) as it relates to
diseases passin g both real and artificia l borders is ce ntral to panic . She co mments. "The
scariest d iseases are traveling diseases. Strange plagues that threate n the place of
sanctuary arouse the most fear. Th is is particularly true when the disease can be tracke d"
(200 2.850) . and adds that there is a direct correlation between the speed of morta lity and
the esca lation of panic. Th e spread of panic . however . is directl y dependent upo n the
spread of informa tion (or disinform ation) surrounding the disease. and the media plays a
role in this circulation. Humphr eys even goes so far as to claim that "disease panic and
the news media forrn their own generative circle" (2002 . 846). where the panicked public
demands more informa tion from the media. and upon its presentation. such information
begets more panic. which creates a call for more information . etc.
Race an d Racializal ion
Humphreys' art icle is important in anoth er aspect: its discussion of racial themes .
Panic. she says , begets racism and xenop hobia . particularly because of the "cro ssing of
boun da ries" mentioned ea rlier. Diseases that come from else w'here arc blamed upo n the
peop le who inhabit the coun try of the disease' s or igin. Erecting bound aries arou nd our
own homes is an "inev itable response to a travel ing. panic disease" (2002 . 850) . but also
res ults in the format ion of psycholo gical boundari es between "us" and "them" and the
creation of the "Others" category noted in Mayor' s discussion of the Nessus shin. The
quaranti ning and avo idance of these Others is the co nsequence of such bound aries, and
has numerou s historica l examples. including the quarant ining of San Franci sco' s
Chinatown during the bubonic plague epidemic of ) 9tJ.t , and various fears assoc iated

with imm igrating Jewish people in 1892 (who were tied to typhus). and Italians in 19 16
(who were blamed for polio) (2002. 852).
The racia l comments present in Humph reys' work correspond with what Charles
L. Briggs has noted: that "narratives about ep idemics make racia l and ...exual inequalities
seem natural-c-as if bacte ria and viruses gravitate toward populations and respect social
bou ndaries" (2005 . 272). This "racialization." defined by Om i and Winant as "the
extension of racial mean ing to a previously racia lly unclassified relationship. social
practice. or group" ( 1986. 6-t). can be seen as a consequence of living in the modem
world as dc...cribed by Marrin-Barbe ro. where we do not have socie tie...with media . bUI
media constructs that shape society ( 1987). In this sense. the narratives thai appear in the
media influenc e the way professionals and laypersons perceive the health system. both in
terms of its practit ioners and how it relates to the non -medical sectio ns of the population.
The same could be said of how the population perceive s disease. Any new virus or
bacterium that has its origins in a foreig n country is immediately. irrevocably tied to that
place and the people who live there. and thus AIDS becom es synonymous with Africa,
SA RS with China. etc. At the same time thai these diseases become synonymous with
race. they can also reshape racial boundaries. changing the way laypersons and
profe ssionals perceive others (or Others. after Mayor). Such changes arc not necessarily
irrcvocable-c-few peop le today would still assoc iate Jewish people with typhus- but they
can provide ruts in the road. as it were. into which future discussions of the connections
between disease and race can slip. As Briggs says . "Producing narratives of race. disease.
and ...pace involves the collaboration of biomedical profe...sionals, publ ic health officia ls.
45

politicians. reporters. and. often . anth ropologists. Such narratives can he firml y in place
before an epidemic has begun . there by shaping epidemiological investiga tions.
preventinn and treatment regimes. and long-term effects" (2005. 277).
Alan Kraut' s Silent Travelers: Gem's. Gelles. and 'ht' "lmmignm r ,\tellace"
provides a secon d look at issues of race and disease. strong ly demonstrating the
histo rically assumed Jinks between immigrants and ep idemics . especially regardi ng
tube rculosis . cholera. and the bubonic plague. The reality of the situatio n. Kraut argues. is
not that the immigrants were nece....arily carriers of diseases. but that the condit ions they
were forced to live in (many of them being explo ited for cheap labor) were of such poor
quality and sanitation that disease often resulted. American citizens. then. were largely to
blame for the outbreaks for the ir negli gence in creating decent living situations for these
immi grants. Despite this (or rather. because of a lack of understandin g of this). the
immigrants continued to be blamed as carriers and spreaders of diseuse- a stigma that
has carried forward ever since. as evidenced by Haitian peoples being accused of
propagat ing the AIDS virus in the 1980s (Kraut 1995. but see also Fairchild 200 3;
Markcll999; and Marks and Worboys 1997). Raciulizut ion such as this finds an easy
scapegoat in the form of people who arc alread y stigmatized in some way or another.
whether as pros titute. criminal. foreigner. or some other illegal and/or immor al label: "in
many of the del iberate-infector narrat ives. the aggressor is portrayed as a member of a
threatening ethnicity or social group-e-a group already thought to have eroded morals"
(Go ldstein 2004. -18).
46

Risk and Risk Assess ment
The panic and racia lizat ion that is often present in legends can be seen as part and
parcel of risk-determining decisions made by the lay public. Defined by Mary Douglas.
"risk" is "the probab ility of an even! combined with the magnitude of the losses and gains
that it will entail" ( 1992.40). The determination of risk inherentl y involves the creation
of "boundaries" between one group and another . or more prec isely in relation to SA RS.
between oneself (or an extended peer group) and a group of people seen to be more at
risk of contracting the disease (Gilman 1988)"Ri..k is a key concept in the ..tudy of not
only legends, but health beliefs as expre ssed in legend ... as the narrativ es that come from
situations deemed pote ntially harmful by the lay public offer direct in..ights into the
co llective psychological frameworks present during periods of stre..s and anxiety . Risk
c..timation is a natural response to tension. indeed a crit ical facili ty required to functio n
properly. However, it is also an act that has proven prob lematic for authorit ies ..ccking to
quell panic. Not only does risk estimation lend to panic and racialism, but identifying and
understanding the underlying causes of such actions can he difficult, and "official"
communication designed to suppress and subduc those act ions can have the oppos ite
effect. Many academic models of risk-related behavior fail to take into acco unt cultural
and personal meanings of "ris k," "s usce ptibility," and "risk reducing behavior," instead
attempting to assign generic mode ls and definitions 10 individuals- an act that can result
in the same sentence having different meaning s for researcher and rescarc hce (Go ldstein
2004 , 163). William Leiss and Douglas Powell have further noted that:
Research has suggested that effort s to con vince the public abou t the safety and
benefits of new or existing techno logies... rather than enhan cing public
47

confide nce. may actually amplify anxieties and mistrust by denying the
legitimacy of fundamenta l social concerns. The public carries a much broader
notion of risk. one incorporating. among other things. account ability. economic s.
values. and trust, (2()()4. I I )
Leiss and Powell point directly to the confusion of basic definitions

curious to note the disdain some branches of official medicine have towards folk
medicine. as the logics that have created these two strands of thought. while different in
their conclusions. arc similar in their approaches and even methods. Ultimately. all
epidemiology starts as folk epidemiology: the constructio n of stories about novel
diseases. Some of these stories end up as beneficial and others arc ultimately proven
incorrect. but as has already been stated. the story-making PIlX'eSS is the same for both
groups of people: am I vulnerable. who has the disease . and how can I not get it'!
Despite such similarities. the historica l debasement of folk medicine by officia l
medicine is well documented. On a larger scale. folk belief as a whole has been
frequently deemed as little more than supersti tion and belief in magic and the
superna tural (Honko 1964: Mullen 1969). Folk medicine. however. seems to attract
specia l attention when it comes to official scorn. David Hufford has succinctly
summarized the academic disparagement of folk beliefs with the phrase "w hat I know. I
know: what you know. you only believe" ( 1982b, 47), a stance that varies in its public
expressions from outright contempt to sincere. but misguided attempts to "reeducate" the
public. Efforts in this latter area often assume patients to be "empty vessels:' who. as
described by Bonnie Blair O' Connor •
.. .in the absence of medically accepted knowledge about health and illness. are
assumed to have I/ O knowledge about them as a basis for making choices or taking
action.... The conception of patient education thus frequently operates on the
basis of an extremely simplistic view of its mission: "co mmunicate success fully
with people so they will understand their health problems (usually as we. not they.
define them) and they will want to change their behavior".. .. When the proposed
changes do not occur. or when they come about very slowly, the cause is
generally interpreted as "resistance to change" and defined as a "prob lem" which
is located in the "target population: ' ( 1995. 177)
49

heavily refined over the course of time to acco mmodate new ideas and fine-tune current
ones-including abandon ing altogether ideas that have been found to be injurious or
ineffective. Systems such as these are in fact " logical" and "rational: ' in that they have
been created ba..ed on evidence gathered from long-term observat ion and experience
(Hufford 1984). Lay health systems arc indeed greatly different from the modem Western
models. but these differences, while recognized , have been largely ignored or overlooked
in their importance and rationale. For instance , while Western models place almost all of
their value on objective experience-to wit, the absence of disease and the proper
functioning of bodily processes-lay health models place their emphasis on subjec tive
experience : that the subject has feelings of good health, such as being energetic, pain­
free, and able to perform daily routines (Calnan 1987). Such concepts arc part of a
group's "cullural constructions of reality: ' where the worldvicws of a people define and
..hapc how they react to themselves and others

Many theories and models have been created in attempts to help Western doctors
better understand their patient s. none perhaps more effect ive than the Health Belief
Model. This mode l. developed by sociologists. "holds that the factors affecting health­
relate d beha..-ior (on the part of laypersonsI are perceive d ...u...cept ibilny to and serious ness
of a given health threat. percei ved benefits and barriers to a given course of health­
promot ing or remedia l action and (interna l and exte rnal! cues impe lling action "
(O'Connor 1995. 19 ). Decisions. then. are being made on an internally logical and
rational system. In the prese nce of an injury . several factors are considered. and a
decision made based on what the patient (and perhaps his/her family) fee ls is the most
appropriate course of action. If a particular course of treatment. whether it be traditiona l
or hospital-be...ed. is deemed overly stressful or potentially more inju riou s than the injury
itself. then that course of treatment is removed from the list of opt ions. This manner of
thinking is not that different from what takes place in a doctor' s office: if a patient has an
infection. the doctor considers a possible range of treatments. concludes that an antibiotic
regimen is idea l. but upon finding out that the patient is allergic to penicillin. opts for a
drug free of that compound. The logic in hoth systems is clear. Lay health systems
merely rely partially on traditional remedies-remedies that arc considered superstitious
or magico -rcligious by doctors. and so are disparaged. The arguments that arise becau se
of this disparagement would be minimalized if doctors were able to incorporate lay health
belief systems into their practice. recognizing not only their permane nce in worldw ide
cultures. but their cultural importance. When these belief systems are not only perma nent.
52

ut indica tive of the choi ces peop le may he likely to make given a health problem. it only
makes sense for w estern medicine to attem pt to understand them .
MEIIIA T HE ORY
More cou ld be said conce rning the relevance of folkloristics to the study of
SARS. but in the interests of space we move from here into an examination of theor ies
surrou nding the media. focusing especia lly on newspapers and televisio n. An
understa nding of theoretical works in this area is especially important in the case of the
SARS outbreak. as many people relied heavily on media sources for informatio n. and
thus the biases and quirks that are an inhere nt pan of a news source are often passed on to
the public. sometimes with less-than-desirable consequences. Leiss and Powell have
noted the vacuum-ab horring nature of the public when it comes to informat ion. and have
identified media sources as a component in the filling of such vacuums. In this sense.
event s that arc reponed by media sources "become the sub..tantial basis of the publi c
framing of. .. risks" (2004. 3 1). including both inflammatory comments from doo msayers
and the soothing tones of politicians who assure that there is nothing to worry about.
Specifically in reference to the SARS crisis. J. Kurlbcrg, writing in the
Correspondence Section of the jou rnal A('ta Pediatr. noted that public response in
Sweden to the outbreak had been so widely affected by media reports that even
healthcare wor kers' reactions had been compromised. Karlhcrg gave as evide nce the case
of a lIong Kong mother and child who arrived in Sweden in April of 2003 for a vacation.
Soon after land ing. the ten-month-old son developed a high fever. and the mother
attempted to have him exam ined at a hospita l in Stoc kholm. She was forced to wait
53

out side (in 3 0 C tempe ratures) for twen ty minutes, then told to take the boy to a different
hospital. Upon arriva l there. the woman was told to wait in her car, where she was met by
a doctor dressed in protec tive clothing. who looked

inflamma tory articles in the press. From a folkloristic perspect ive. the role of mass media
in di....eminating legends has long been recognized. Degh and Vazson yi noted in 1973
that med ia is perha ps the "greater part" of the transm ission of ...uch narratives . after they
...pend the initial and ...mallc r part of their ex istence being pa...sed oral ly (37) . Only a few
years later Robert Mitchell noted the majo r role that media played in
"compounding ... rumors that served a...a ...ub ...titute for informa tion through 'formal news
channels" ( 1979. 40 ). and both Bengt af Klintberg and Jan Brunvand have remarked on
the rapidity in which legends are spread by media sources , the report s adding to the
entertainment value of the narratives. as well as their plau ... ibility (Brunvand 198 1;
Klintberg 1981). Perhaps all of this is best summarized by Elliott Dring. who said. "At
the bou ndary of the legend is not the myth or Marchcn with which it is forever being
compared ... At the boundary of legend is news...that is. the reports. acco unts.
...tatements. and ...torie...that we read daily in our newspapers" ( 1996.337).
Moving specifically into the realm of media coverage of ep idem ics. we find that
the literature still has much to say about the influence of news reports on the public.
Steven Epstein has noted that the media' s continual usc of a spec ific ...ct of reporters and
"experts" to discuss a situation not onl y mirrors "the internal ...tratiflcation of a social
movement or a scientific community. but can even constr uct such hierarchies" (1996.
335). In this sense, media reports cannot be seen as simply a record of the events in an
epide mic. but mu ...t be con ... idered a funct ional part of those events, both ...haping them
and be ing shaped by them. If a media source desig nates Doctor X as an "expert" on the
topic and continually u...es his sound bites (pcrhap...bccau ...e he i......imply mo re photogenic
55

or better at paring down complex jargon into easily-understandable speech than his
peers). then Doctor X literally become s the "expert" on the subject in the eyes of the
public-s-despite the fact that he might not know as much as Doctor Y......ho is simply not
as effective at communicating with media sources.
Seen in this light. the role of the media in outbreaks is far more complex than
might be assumed. This is compounded by the ba..ic nature of ncws sources- specifically
newspapers- which is that they are businesses attempting to sell their product (though
even televised news reports compete with the reports being delivered on other channels
for viewers). As such. the coverage of the thousands of ncwswonhy events that take place
around thc world on a daily basis is not only curtailed by access to information
concerning those events. but economic jud gments about which of those events will be
seen as the more interesting by the public. and will thus sell more product. Elizabeth Bird
has commented 011 the nature of this relationship at length. stating specifically that:
News reflects and reinforces particula r cultural anxietie s and concerns. It goes in
waves: many scholars have demonstrated. for exa mple. that waves of reponing
about teenage suicide or child abuse do not necessarily reflect actual change s in
the rates of these problems. Rather. they reflect waves of interest. and in tum feed
the anxieties that have produced the interest in the first place. ( 1996.47)
What appears in the pages of newspapers and thc special reports on the evening news
cannot thus be assumed to be an unbiased and accurate reflection of daily events. Instead.
it must be thought of as a subjective representation of them. sifted through numerou s
political. economic. social. and cultural filters.
The effect that the media ultimatel y has on the public is contentious. There are
some who argue that the narratives dispersed by media sources are ultimatel y helpful-
56

after all. the media docs disseminate useful. correct information on a regular basis.
including articles that debunk popular misconceptions. or warn of the negative
consequences of certain actions. The title of Marshall Goldberg 's 1987 article epitomizes
this stance : ''T V Has Done More to Contain AIDS than Any Other Sing le Factor:'
Goldberg 's piece is a defense of television-based AIDS report ing. arguing that. despite
the problems to the contrary (inaccuracy . sen..ationali..m. etc.). television has ultimately
done the world a service in pre..enting information about the di..ease. having taught the
basics of transmission. susceptibility. and prevention . This article is admitted ly not
scholarly. appearing a.. it did in the pages of TIl Guide, but as it was written by a
physician and appeared in the pages of a magazine with a purported circulation of 16.3
million in 1989 (Jones 1989). it was no doubt considered authoritative by many of its
readers.
On the other side of the argument lie these who claim that the narratives
circulated hy the media have done varying degrees of harm. largely due to their
inaccuracy. misunderstanding of key concepts. or misrepresentation. Benjamin Radford
provides an exa mple of the sometimes-inaccurate nature of news reports in his article
"Ringing False Alarms; Skepticism and Media Scares," Radford only briefly mentions
SARS in his work (as an exa mple of a disease that is regularly given "ala rmist
headlines"). However. he does present four major stories that appeared in newspapers
between 1990 and 200 1. including missing/exploited children. racist church fires. the
dangerous nature of bounty hunters. and the 200 1 ca..e of a Nigerian "slave ship". In all
four cases. the nature of the threats and the numbers assoc iated with them were gross ly
57

ove r-exaggerate d by the media-e-especially in the case of the slave ship. which turned out
10 be an innocuous ferry transpo rting job-hunting (and free-living) teenagers to Co tonou.
The most exagge rated fact. however. was the prese nce of mis...ing or lost children. a
number estimated by the U.S. Department of Justice to read 400.000 eac h year.
However. a study by the Crimes Against Children Research Center found that 73% of
those children were home within twenty- four hours. and the larger numbe r of the
remaining ch ildren were abscon ded with by a parent . usua lly the result of a divorce. In
fact. betwee n 1990 and 1995. the National Center for Missing and Exploited Children
hand led only 5 15 cases of children abducted by strangers (Radford 2005). Thus. the
media cannot be assu med to consistently provide accurate repo rts.
A seco nd. and perha ps mo re serio us take on the negative aspects of media is
given by Paula Treichler. who states:
We can point out that docum enting a scenario in print does not make it so. But
who arc the "we:' and to whom are we po inting this out? And what do we expect
10 accomplish? A scenario that cas ts "the media" or "the gove rnment" as
complicit in duping the public about AIDS will nOI be dislodged by network news
reporting or a lectu re from the U.S. surgeon general. Evidence. facts. the asse rtion
of authority: none of these will function to discredit

The first is Peter Washer' s "Representations of SARS in the British Newspapers:' which
appeared in 2()()4.w asher's study entailed a close examination of news articles appearing
in all major Sunday national newspapers in the UK for a four-week period following the
16 th of March. 2003. Any article that mentioned SARS was noted. coded for any of
twenty -four key themes. and entered into a qualitative software database. Washer' s first
observation upon examining his result.. was that:
In the very first reports of SARS on 16 March, all the articles referred to the new
illness as a "killer bug" or to a "myste rious" "lethal" "deadly pneumonia virus" .
Th is new "threat" was de scribed as "moving at the ..peed of a jet" and people
affected were not respondin g to traditional treat ments. Combined with adjectives
like "un treatable" were some graphic descriptions of how the "victims' lungs
..well and they suffocate". (2()()4,2565)
For the first two weeks of the period Washer studied . new..paper articles revolved arou nd
..cvc ral thcmes. including the origin of the disease, the attempts by Western doctors to
com hat it. the search for a "pati ent zero: ' and the idea that SA RS could he the next
plague. By the third week. however. only three types of story domina ted the papers : I)
Chinese corruption and inefficiency; 2) the death of a major researcher, Dr. Carlo Urbani.
w-hocontracted SARS while in Thailand; and 3) the negative effects of SARS on the
econom y. By the fourth week the onl y major thread left was the discussion of global
economies in light of the epidemic. Constantly mixed in with these threads over the four-
week period , however. were comparisons of SARS to other diseases. such us A IDS.
Ebola, and Spanish Flu. These comparisons are important because all of those diseuses
came from somewhere other than the UK-in other words, the newspapers were
constantly pointing out how recent outbreaks all came from elsewhere. This reporting
contributed to the UK's xenophobic reaction: "the social repre..entation of SARS
59

esonates with represe ntations of infectious diseases throughout histor y: we lay the blame
for the new threat on those outside one's own com munity. the 'o thcr' " (2QO...1. 2570 ).
Stephe n L. Muzzaui's " Bits of Falling Sky and Global Pandemics: Moral Panic
and Severe Acute Respiratory Syndrome." gives an even harshe r criticism of the media's
hand ling of the ep idemic . espec ially in regards to foreign peoples . Muzzuui states :
The media 's construction of Asian communities as breed ing grounds of contagion
was not focused exc lusive ly on Canada. Rather. news coverage in the United
States saturated viewers with images of East and Southeast Asians wearing masks
and creati vely-fra med camera angles provided footage of deserted Chinatowns in
American urban centers. further fueling the stigma . (2005. 123)
Muzzaui unequivocally blames the media for cove rage that was "lillie more than
sensationalis m and xenophobic fear-mongering" (2005 . 12..n.and that con tributed to the
"victimization of already disenfranchised groups" (2005 . 125).
By far. then. the majority of voices cited here agree that the med ia. while
valuable. arc ofte n guilty of inflammato ry exaggerations. inaccurate statements. and in
regards 10 disease outbreaks. fear-mon gering. This last detail should be kept in mind as
we move into the final section of this chapter: a review of the theories and articles
specifically surrounding SA RS. The articles that fill the final section of this chapter are
almost exclusively written by doctors. nurses. and medical researchers. and have
appeared in the pages of scientific and medicinal journals. whether as articles or
commentaries. As a whole these articles represe nt the ovcra rching thoughts and ideas of
the men and women on the "fro nt lines" of the battle aga inst SARS. including not on ly
scientific op inio n. but also personal concern. As such. these articles may be considere d a
litmus test for the psychologica l profi le of the scie ntific and hcalthcare com munities. in
60

In Canada. a study conducted out of the Univers ity of Toronto's Departm ent of
Psychiatry on the psychological impact of SARS on hospital workers also found that
nurses were more likely to report having felt stress . Furthermore. heah hcare workers who
dealt with pat ients who had (or were suspec ted of having) contracted SARS reported
greater amounts of stress than their peers. The study con nects these responses to not only
the fear of contracting SARS. but also to social isolation and job stress. and recommends
that interven tion attempts in times of future outbreaks should focus on all three of these
orcas. rather than just on the fear of the disease itself (Maunder et al. 2QO...l). Another
study of the reactions of heahhcare workers to the crisis examined the react ions said
workers had to having been quarant ined. Unsurprisingly. fin ny of these healt hcare
workers expe rienced feelings of fear. loss. and frustration. hut some were also equally
conc erned about their forced inability to do their job-i.e. to help others in a bcalthcare
capacity. The study concludes by again reco mmendin g changes he made to pol icies in
case of future outb reaks. specifical ly noting that better literature 0 11dealing with
infectious diseases. as well as stress management. be made available (Rob ertson et nl.
20(4). Many of the conclusions of this study were echoed in an ex.amination of the
psychological and occupational impact of SAR S at a teaching hospital (Mount Sinai) in
Toron to. During the first four weeks of the Canadian outb reak (the span of time
investigated in this study). eleven healthcare workers at the hospital contracted SAR S.
and the hospital did set up seve ral health support interventions for these employees.
However. the infected workers still reported feelings of loneliness. anger. and fear. as
well as conce rn about the effects of their being quarantined on family members and other
62

hospital staff In contrast . healthcare workers who were not infected with SARS reported
heigh tened stress responses when it came to treating those workers who were infected (as
opposed 10 regular patients). and increased apprehension over spreading the virus to
family members (Maunder et al. 2(03).
A different set of studies examined the reactions of non-healthcare workers {i.e.
the pub lic) to the outbreak. specifically regarding their opinions about interacting with
the hcahbc are community. A study in Taiwan found that the public' s utilization of
medical services as a whole decreased drastically during the outbreak. with inpatient care
droppin g by 35.2%. and ambulator y care by 23.9%. Even the field of dentistry was
affected. experienci ng a 16.7% reduction in the number of patients. Given these numbers .
the authors of the study warned that the healthcarc commu nity should not overlook the
possibility of collateral. unreported health issues during times of crisis (Chang et al.
2(04). A similar study of a major teaching hospital (Prince of Wales Hospital ) in Hong
Kong reached comparable conclusio ns. in that almost all areas of the hospital' s
emergency department expe rienced significant decreases in the number of patients
reporting health concerns. The authors noted that trauma cases. minor cases , and the
mean daily attendance all decreased by up 10 fifty percent. The only areas not affected by
the outbreak were I) patients requiring immediate care. and 2) the number of patients
disc harged against medical advice. In the former area. the number remained the same, bUI
in the latter. the numbers actually decreased. meaning that fewer patients were leaving
without first securing the doctor 's permission. Fear was noted as the driving force beh ind
these changes. as well as possible changes in commu nity behavior. where membe rs of the
63

public took better care of themselves so a.sto preclude any necessity of entering a
hospital (Man et al. 2003).
One editorial. written in Canada in the summer of 2003. shortly after Toronto had
been removed from the World Health Organization's travel advisory list. also mentioned
the widespread fear. but firmly located the source of that fear in the media. This should
come as no surprise. given this chapter ' s previous section on media theory. But this
article in particular . which appeared in Ctinicul Nunillg Research, placed significant
blame on news sources:
The way in which the media report news about infectiou s diseases often tends to
increase anxiety because the focus of certainty is frequent ly the number of deaths .
There have even been suggestions that some of those issuing bulletins about
SARS may want to increase press circu lation. boost ratings for particu lar TV
news channels. highlight pressure for better access to health funding. or even
make political headlines. Whatever the underlying reasons for generating
publicity about SARS. there has been an immense response of fear in the genera l
public and the panic that death is imminent for all who contract the disease.
(Hayes 2003. 3(0 )
Regardless of whether or not the claims made by Hayes were valid or truthful. their
placement within this editorial demonstrates that even within the medical community. the
media were being blamed for fear-mongering. Hayes. however. is not so polemic as to
claim that the media is the only source of fear. noting that the medical community is also
at fault. Among other details. Hayes notes that the masks that hcalthcare workers w'ere
required to wear. while greatly decreasing their chances of contracting the virus. were
seen by some nurses as a "barrier between individuals" (2003. 30 1). and a catalyst for
negative reactions in nurse-patient interactions.

In fact. if one word were to be used to describe the reactions repo rted in almos t
every piece of collected literatur e conce rning psychol ogical reac tions to the out break. it
would he "fear." Most of the articles dealt with the negative effects of fear. such as
heightened anxiety of infecti ons spread ing during commercial air travel . with a similar
apprehens ion building over the possibility of using airlines 10 disperse bioterrorism
age nts-s-a possib ility that was made clear as a resul t of SAR S (Alexander. D.r\. 2003:
Karwa . Currie and Kvetan 2005: Mangili and Gen drea u 2005). Other articles detai led the
public' s co nfusion and fear caused by the disrupt ive measures that Toronto had to
enforce to dea l with the outbreak-s-measures that were made the more disruptive beca use
oft hc city's lack of a plan for such an occurrence. meaning that the proces s was bumpy.
sometimes contradicto ry. and bewilderingly altered from week 10 week (Lim et al. 2()()..t ).
Yet other articles noted the stigmatizat ion of Asian-American co mmunities while other
races rema ined untouched (stigmatically) by the publi c. a situation that resulted in the
stigmatized communities avoid ing or dela ying seeking health care (Person et al. 20(4).
Two twists on this recognition of almost-universal fear were. first. a co mmentary abou t
undergraduate medical stude nts in Toronto. who were frustrated that the out break had
resulted in their not being permi tted to enter teaching hospitals in late Mar ch and early
April of 2003 . a situation that man y students felt ham pered their educa tion (Clark 2(03).
Second. an articl e from the Center for Epidemiology and Biostatistics at the Schoo l of
Publi c Health in Hong Kong pointed out that the panic caused by SARS result ed in a
public far more concerned with their collective health. and thus more likely to follow the
65

preve ntative measures recommended by healthcare worker s and govern ment officia ls
(Lau et al. 2003).
Not all articles dealt with fear. of course . and M. Oren's study of quaran tine
measures provides a useful segue betwee n discussions of fear and matters of a more
abstract nature. Oren 's article does acknow ledge the presence of fear in the public. but
from a more quali tative perspect ive. noting that informing the public of medical matters
crea tes a di lemma between warning of a potent ial threat-a significant source of stress
creation in regards to the public-and ascertaining the likelihood of that threat actually
occurring (i.e. waiting to sec if the outbreak actually occurs before sending out warnings).
Wh ile this is a significant eth ical quandary . Oren points out that conta ining a potential
outbrea k at the start is far more effective than react ing to it once it has spread throughout
a community. and as such. weighs in favor of adva nce warnings (2()().t).Singer et al. also
discuss some of the ethical situations that arose because of the outbreak. including the
ethics of quarant ine (individual liberties versus protecting the public); the balance
between protecting private informat ion and revealing necessary medical informati on;
hcalthcurc workers' di lemma s over their duties to help the infected. which raises the
chances of those workers' families contracting diseases that the workers may bring home;
patients whose necessary surgeries were postponed because of restrictions that limited the
number and type of people who could enter hospitals during the outbreak; and the
quest ion of how to dea l with outbreaks in a global community, wh ich includes issues of
travel. responsibility. transpare ncy. and honesty (2003 : sec also Bernstein 2003 and
Smit h et al. 2()()..t). Singe r et al.'s paper makes no attempt to provide answers to these
66

ques tions, instead merely attemp ting to present issues that must be dea lt with by the
healthcarc community. However, the article docs poin t to the fact that man y researchers
and medica l profes..ionals were conce rned with ethics , and eager to discuss them.
Othe r researchers and doctors were more interested in discussing the physica l
problems that occurred in attempting to treat patients and prevent the spread of the
coronavirus. Oren's above-noted artic le was positive in its evaluation of quaramines as
effective measures, but other healthcare professionals were not so optimistic. One of
these was Richard Schabas, a former Chief Medical Officer of Health for Ontario, and
Chief of Staff at Yor k Central Hospital during the SA RS outbreak. In a review pub lished
in the Canadian Medical Association Journal . Schabas unflinchingly pointed out the
posit ive and negat ive ways with which the out break had been dealt. delivering an
especially deflat ing co mmentary on quarantines:
Ontario's response to SAR S has been energ etic. Unfo rtunate ly, however. it
appears to have been based on unachievable expec tations, specifically, that
quarantine would eliminate the disease. Let's be realistic. Quaran tine plays an
importa nt but limited role in the co mmunity con trol of respirator y infections. II
ca n reduce the impact of an outbreak but, accordi ng to our ex perience with other
respirator y diseases, it won' t sto p transmission entirely. (2003, 1432)
Instead of massive quarantines. which Schabes says do little more than drain public
hea lth resources, he recom mends a program of ge neral surveilla nce. accompanied by
public and professional education. Quarantines do still playa role in this new rubric of
disease contr ol, but a lesser one, implemented only when necessary.
J. Levett took an even darker view of what co uld have been in the art icle "Severe
Acute Respiratory Syndrome (SARS): Loud Clang of the Leper's Bell:' Leven stated that
the case with which the coronavirus rapid ly ..pread between continents ..hould have been
67

a wake -up call for hea lth professiona ls and organizations worldwide . The articl e. which
appe ared in December of 2003 . foreca ..t two po....ible futures for the outbreak (which had
gone into a recession by this time): a ..uccc....ful co ntainment. or a worst-case scenario
invo lving massive outbre aks. The latter situat ion was es pec ially trou bling for Leven . who
clai med that Euro pean health services would not be able to cope with the sudde n strain.
The article ended with a ca ll for the establishment of a Europe an Union Ce nter for
Disease Co ntrol (2003).
Finally. for the bleake..t side of the outbrea k... orne resea rchers pointed out the
po.....ibilitics of SARS being used as a model for bioterrorist act ivities. Th is scenario was
glo..sOO over in a previous paragr aph in this chapter. but de..erves more examination here .
A.C . Shurtle ff. writin g for the Investigational Drugs journal. reported on a "cries of
forum .. in 2()()4designed to addre ss the possibilit ies that some recent emerging infective
disca..es could be possible agen ts of biot errorism. and what ..tcps could he taken if such a
sce nario occurred . Abo dis cussed in these forums were genetic engineering method.. to
circumve nt or enhance the immun e system. the creation of vacci nes and immune
therapie s. and the deart h of new antiviral drugs (2004). Th e seriousness of these forums is
perhaps best demonstrat ed in a different article. wherein the discu ssions revolved around
the possi bilit ies present in anthrax and smallpo x being used a" agent" of bioterro rism .
Here. D.K. Bhalla and D.B. Warheit gave a history of the purpo seful misu se of biological
agents. beginning with infect ed cadave rs bein g thrown into the water sources of oppo sing
armies in medieva l tim es. and cont inuing until the present day. with the anthr ax-mailing
"care" of 2001 . Bha lla and Warheit noted that both anthrax and smal lpox are classi fied a"
68

category A agents by the Centers for Disease Control and Prevention. a spot reserved for
those agen ts that could cause the most hann after deliberate introduct ion into society . The
great danger of living in the modem age. they note, is the relative ease with which
orga nizations can sometimes acquire such agents. the cheapness of their manufacturing.
and the ease of thei r delivery . International treaties limiting the availability of such agents
arc helpfu l. and more are created ever y year. However. Bhalla and Warheit concluded
that the on ly logical (and necessary) tack is to develop new strategies for the earl y
detection of harmful -agent dispersal. and new treatment strategies for the long -term
survival of the infected (20Q...t). Given the nature of this messa ge. it is eas y to see why
Shurtleff' s article carries such weight: relea sed into society on a massive scale. SA RS
could be devastating. and easily overwhe lm the available medical services. as Levett
warned earlier in this sect ion.
Ending this rather morb id section on a lighter note, nne notes that not all
researchers lambasted gove rnments and hcalthcare communities for failing to take 3 more
expedited or effectivc approach in dealing with the out break. C. Liu . while admitting the
Chinese govcmrncnt' « initial failure to report SARS. pointed out that China was
ultimately successful in containing the epidemic. and praised his Chinese colleagues for
their efforts (200) . And two Hong Kong dentists pointed outlate in 2004. in the Journal
of the American Dental Assoc iation. that despite up to one-third of health care workers in
some cou mrics con tracting SARS from their patients . not one dental healt h care worker
ever beca me infected through a dental setting. The authors gave as reaso ns for this
curiosity the universal health control measures standard in the dental community. as well
69

as the relative non-infectiou s nature of the coro navirus in the early stages of individual
infections. and recomm end that the dental co mmunity maintain its curre nt b ..eI of
infection control measures (Sa maranayake and Pciris 2()()..l).
A final ..cct ion in this chapter di..cu....e....rudies of discase rumors. and the theo ries
that have been forwarded to discuss the propagation of viru..es in an epidemic.
Interestingly. and bring ing us back to the more folklore-oriented sect ion that began this
cha pter. many of these scient ific theories attempt to solve the complex mathematical
equations involved in virus propagation by treating the virus as a rumor that exists in
small- world networks. Mathematically. it seems. the two fonn .. spread in similar fashion.
and one can thus be used to discuss the other. Historically. researchers investigated this
relationship using zero dimensional mode ls. where d ifferent "subpopulations" are mixed
equally. interacting with other subpopulations in proport ion to their size. However. as
Kupcnn an and Abramson pointed out in 200 1 (building on the work of OJ . Watts and
S.II. Strogatz). such models do not accurately reflect the dispersal of real-wo rld
subpopulations. and as such. they propose adopting "s mall-world" models. which are
neither dependent on the subpopulations being well-mixed. nor on lattices of groups.
Such reorganization produced a clear difference in tenus of epidemiology: the small­
world model s produced results evidencing a much faster epidemic propagation than
earlier models- resuhs that better resembled what occurs in the real world (200 1). Using
these small-world models. and building on work that Kuperman and Abramson began in
the above essay. D.H. Zanette pointed out that "en epidemic like model. which can be
interpreted as the propaga tion of a rumor. exhibits critical behavio r at a finite randomne..s
70

of the underl ying small-world network" (2001. n.p.). In other words. that there exists a
critical point in the existence of a "rumor" where. if it docs not die out in the
neighborhood of its origin. but spreads over a finite fraction of the population. its ability
to propagate further grows geometrically and dynamically. Such conclusions bring 10
mind Oren' s statements (given earlier in this chapter) that it is far more effect ive to
contain an outbreak earlier. rather than later.
A different model for calculating socia l and biological contagion arrived in 2004.
proposed by P.S. Dodds and OJ. Watts. This modclused most of the work from ex isting
frames. but included the memory of individuals as part of its calculations. Novel in its
approach. for this marked the first time that human memory of exposure was explicitly
made part of contagion studies. the work of Dodds and Walts showed that there is a
strong correlation between the contagion models used in the social sciences (i.c. rumors)
and in epidemiology (i.e. disease). whereas they had previously been thought to be
largely incompatible:
Our model suggests. however. that in reality these IwOkinds of contagion models
may not be entirely distinct. We venture the possibility that some infectious
diseases may spread in a fashion similar to social contagion processes. For
example. two exposures to an agent sufficiently close in time may infect an
individual with higher probability than would be expected if the expos ures acted
as independent events. (2005. 598)
A second point of theoretical importance in this discovery lies not at the beginni ng of the
contagion process. but at the end. In addition to studying individuals who contract
diseases. Dodds and Watts also studied people who recovere d and became permanently
immune afterwards. and found "that epidemics inevitably die out but may be surprisingly
persistent when individuals possess memory" (2005. 587; hut sec also Dodds and Walts
7 1

20(4). NOIcd mainly in relation to biological models. this statement has great relevancy
when combined with the social science world. where "epidemic' refers to "rumor:' the
result being that the model s used in this article de monstrate some of the reasons why
narratives abo ut a disease continue to exist long afte r the disease has vanished.
This brings to a clo se our discussions of theories. Realistically. the hundred-some­
odd sources that were used to construct this chap ter represent only the tip of a vast
iceberg . Each section-folklore. media. and SARS--could be expa nded to hundreds of
sources by itself. and there are arguabl y more sections that could he added to provid e this
work with a better grounding. But as stated at the beg inning of this chapter. the sections I
have chose n to use here represe nt what I see as the three main areas of discussion that
will occupy the remainder of this volume. Incomplete as these sections may be. they still
represent a large cross-sectio n of the work that has been done. and will prov ide an
understanding of the areas from \\..hich the rest of this work will launch forth.
72

Chapter 3: Chronicle of a Health l'unic
The origins of the SARS virus can be traced to China's Guangdong province.
though it was some months after the disease's initial outbreak in the Western world that a
full timelin e could be constructed. Secrecy on the pan of the Chinese government is the
main reason for this. followed closely by the difficulties of reverse-trac ing public disease
pathways. But even after locating the earliest-known exam ples of human-related SARS.
investigators were still left questioning where the virus had come from before entering
the human population: viruses aren' t created ex nihito. so the disease had to haw its
origins elsewhere. But where? An anima l'? Which anima!'? And how did the virus manage
to cross thousands of miles of land and open water to almost simultaneously spring up in
Hong Kong. Hanoi. and Toronto . but miss the places in between?
This chapter will he a discussion-albeit brief-ofthese issues. A full-scale
timelinc is not necessary for the purposes of this dissertatio n, but more to the point.
would add potentially several hundred pages of largely irrelevant information. It is.
however, necessary to cover the basics: to skip a rock over the pond and point out how
the brief ripples this causes intertwine. The materials I usc to create this cha pter largely
consist of newspaper clippings, and the methods 1used for gathering them can be seen in
some ways as evidence of public concern about the disease at various points in time.
For the better part of two years-c-April 20:.>3 to summer 2005-1checked various
online newspapers and news sources such as CNN.com. f\lSN .com, and Yahoo.com on
an almost-daily basis, printing every article that contained in any way the word "SARS."
73

The results of this effort have produced a stack of paper some seven inche...high,
containing literally hundreds of journalistic contributions. The bulk of these articles ,
however. were printed betwe en April 2...... 2003 (the first day I began this task) and Jul y
2...... 2003 ; these three months together compromise over half of the pile. The decrease in
ava ilable articles after this point in time can be seen as evidence of the wane in public
interes t in the disease in concordance with the virus' s declining worldw ide presence . July
2 nd , 2003, for example, is the day the World Health Orga nization removed Toronto from
its list of infected cities. Not coinci dentally , North American news sources began
focusing their attentions elsewhere afterward . By 2QO..t it was difficult to co llect more
than two or three articles a week, and the last of the series of regularly published
stories-at least on the website s I chec ked-sputtered out in July of that same year.
Subsequent journ alistic contributions do exist. of COU f'>e, but dwindle to sporadic
thrashings, barely managing one or two contributions a month .
What results from these efforts-the bulk of this chaptcr-c-can therefore be ...een
as a chronicle of publ ic. media -based information concerni ng the outbreak: that is, the
select ive progression of events based on journalistic wonts and biases, which arc
themselves largely based on considerations of assu med public interest. In other word s.
and as has already been discussed, newspapers print stories that sell. The narratives that
construct the media' s version of events are therefore extremely suspec t. for though this
version does contain much that is true and factual. it also bends at times towards the
sensat ional at the cost of object ivity.
74

Peter washe r. in his article "Representations of SARS in the British
Newspapers," adds another facet to the suspect nature of the media 's version when he
says:
But beyond the realist global epidemic of (the disea ..e) SARS lies the
globalizatio n of the phenomenon of the SAR S panic, where the saturation and
..peed of the world news media' .. coverage leads to the (suppos ed) r iskposed by
SARS being socially constructed on a globa l scale. And yet despite the moderni ty
of the med ium, the message is almost comfo rtingly familiar: The social
representat ion of SARS resonates with representations of infecuous di..ea..es
throughout histor y: we lay the blame for the new threat on tho..e outside one ' ..
own community. the 'ot her ' . (2004 , 2570)
Though Washer' s exami nation of SARS -re1ated newspaper articles COWrhows particular ..ubjectivity in continually
presenting SARS as a threat to the publ ic, but simultaneously assuaging that public
through the process of "ot hering" with reass urances that the average reader was in no
danger.
Why then include (he following timeline, a.. rife as it is with biases'! Because the
media was in many cases the primary di....cminutor of data for much of the public. and
large scctors of the population can he said to have been direc tly influenced by what (hey
heard on the evening news or read in the morni ng paper... Many of my informants said
that their tclcvi..ions wwe turned on constantly throughout the SA RS epidemi c, and
always tuned to a local news channel. And if the news reported rumors, then it seems
only log ical that those rumor " became part of public consciousness.
At the same time, it is important to remember that the ver..ion of SARS as
represented through media cove rage is not the only way to organize the data. In fact.
75

there may he dozen s of potential versio ns-personal. cult ural. etc.-ull filled with biases
and excl usio ns bused on what was and what was not seen us impo rtant. For the purposes
of thi s chapter. two of these vers ions stand out: not only that represented in the media. but
abo that represen ted in medici ne. Media sou rces may have bee n the primary source of
inform ation for the public. but journalists were not. for the most part. the people on the
front lines of the outb reak figh ting to understand the disease. treat its victims. and prevent
its further sprea d. This honor goes (0 the doctors. scienti ..ts. and hcalthcarc workers who
spen t tho..e few months risk ing their own lives- and sometimes dying- to save the rest
of us. So thro ughout this chapter. the media's version of SARS will be periodica lly
interrup ted by a side discussion of the medic al versio n. as represented thro ugh the articles
that were being pub lished in the British Medical Journal and Tile Lancet, Thi s
co nstructio n will allow for a glimpse at the differences in focus between these two
sou rces of information. show ing that what one source co nsiders important is not
necessaril y seen as such by another.
Epidemics fade. This is the natural progression of such things. Equally true is that
epidemics rise. and when this happen s. rumors begin: where the disease came from ; who
is respo nsible for it: how long it will take to find a cure; how virulent it is. But in order to
sec the co nnect ions between rumor and fact. it is first necessary 10 lay dow n said facts.
that we may have a co rkboa rd on which we can later pin our analyses. Lei the following
timclinc . then. be ou r board.
In mid -Febru ary of 2003. China's governmen t repo rted 305 cases of atypica l
pneumonia in the Guangdong prov ince . Five of these cases resu lted in deat h. hut the
76

Chinese government refused to say much more about them . Despite this secrecy. the
World Health Organization (WHO) learned on Febru ary 10 th that such cases had been
occu rring with so me regularity in Chin a since at least Nove mber of 2002. China 's
gove rnment reassured them that these were not significant. and on Februa ry lotU, issued a
statement claiming that the disease was unde r contro l (''Timcline for SAR S" 2003).
On February 21.t. 200 3. an elderly professor from Chi na's Guangdong province
checked into the Metropole Hotel in Hong Kong. having traveled there to attend a
wedd ing. The professortook a room on the ninth floor of the hotel. l ie had a rough and
fever. and soon infected twe lve other guests at the hotel. possibly by sharing elevators
with them. These guests then left the hotel. trawling to Vietnam. Ca nada. the United
Slates . and Singapo re. Th ey carried the virus with them. infecting people in these new
co untries. and thus spread the disease much more rapidly and efficie ntly than virtually
any other illness in human history (Gouds mit 2()().t. lotO-lotl ).
Within days these travelers and their infected victims began arri ving in hosp itals.
complaining of sym ptoms such as fever. coughing. and shortness of breath, Puzzled
med ical staff attempted to interpret these symptoms.nv they seemed in some ways 10
indicate flu. but also pneumoni a. It took only five days for docto rs in Hong Kong to
realize thi s was a separate disease altogether. and 10 give this set of symptoms its ow n
name : on February 26 111 the world was introduced to Severe Acute Respiratory Syndrome.
or SARS. Other cases soo n followed. and only two da ys later the first reports of this new
disease emerge d fro m Vietnam . Less than two weeks later-on March It h -the WH O
issued a global health ale rt to health-care workers. stat ing that a new flu-like disease was
77

spreading and seemed to he highly contagio u... Two days later the disease was reported in
Toronto, and the day after that the WHO issued an emergency travel advisory. warning
that the new disease was spreading worldw ide. At this point such guidelines did not
restrict travel to any specific part of the world. but merely advised travelers to be wary of
SARS sym ptoms and to report to airport personnel if any fellow pa.ssengers showed signs
of ..uch symptoms r-Tlmetine for SARS" 2003).
On March 18 th • German doctors made the first step in identifying the physical
structure of this new vims, claim ing to have found evidence of a param yxovirus in blood
samples taken from a patient who had SARS. Scientist!"in 1I0ng Kong. who found
evidence of the virus in two other patients. confirmed this. The paramyxoviru s belonged
to a family of viruses that can cause. among other diseases, measles. The findings
reported in Germany and Hong Kong were immediately noticeable to medical staff
worldwide. as pneumonia can be a comp lication of the measle.. ("Timeline for SARS"
2IX))).
On March zo", Hong Kong officials hypothcsized that the global spread of SARS
might have had its origins in a guest at a local hotel. Using this , epidemiolog ists were
uhle to truce the illness back to the old professor from Guungdong, and thence to China.
An entirely new avenue of study opened. and the search for the origins of SARS moved
to this new country. The Chinese government made the investigation official on March
21" by formally asking for help from the WHO in investigating the outbreak in the
Guangdong province (v'Timeline for SARS" 2003). A team of WHO experts traveled to
the region on April 7 th • bUI was hampered significantly by the secretive nature of the
78

clinical presentatio n of the virus was noted to "suggest an illness of variable severity
ranging from mild illness to death. The speculation is that the most severe illnesses occur
among first level contacts of an index case" (Zambon and Nicholson 2(03). However. the
article stopped short of attempting to locate an origin for the breakout. noting only that it
appeared to be linked to the aforementioned cases in Guangdong province. Rather than
providing a hopef ul ending, or even a guess. the article ended with a sobering description
of the state of affairs:
The techniques of tracking a new disease parallel those of tracking a war and
involve documenting death and detritus. progressing up blind alleys. reporting
spectacular highlights. and asking unanswerable questions. emphasizi ng that
emerging infectious diseases and mortal combat may still have much in common.
Our mastery of the microbial world is less complete than we might imagine and
more subject to chance interactions in the environment than we might care to admit.
(Zambon and Nicholson 2003. 678)
It was at roughly this point that I began to take notice of this outbreak as a possible
area of study and commenced my daily gathering of news articles. The chronicle of
public information that follows from here is my own. though the skeleton behind it comes
from official sources. It should be noted that, because the news agencies and websites I
checked were North American in origin. most of the articles I gathered either concerned
themselves exclusively with North American issues about SARS. or if they considered
foreign countries. were written by North Amcrican journalists or the Associated Press.
Bias is thus very possible. but I will endeavor to cover the story from nil fronts.
We begin, somewhat naturally. with more examples of quarantine. On the first of
April. American Airlines Flight 128 from Tokyo was quarantined briefly on the tarmac at
San Jose International Airport in California after five passengers reported SARS·l ike
81

sym ptoms (Sloan 1(03). On the same day. the first suspec ted SARS case wax repon ed in
Australia. the first three cases were reponed in Indonesia. a Malaysian hospital said it had
quarantined seve ral suspected patients for a number of days. and Singapore reponed three
new cases after scree ning processes at airports led nurse!'.10 send seve n people to
hospitals . At this point in time some 1770 peoplein five countries had been diagnosed
with SARS. and sixty-fou r had died ("US holds plane .. ." 2003) .
The WHO declared a travel advisory on Apri l 2 nd • asking potentia l passengers to
"consider postponing all but essential trave r' to Hong Kong and Guangdong Province .
China . The U.S. Center for Disease Control echoed these concerns , adding Singapore and
Hanoi 10 its list. Canada managed to avoid the list. having convinced the CDC that the
spread of the disease in Toron to had been checked (Cohe n, Jon 2003) . A day later, the
reside nts of the quarantined apart ment block in Hong Kong were relocated to isolation
camps after the initial quarantine proved ineffective . U.S. President George Bush echoed
concern over infectious spreaders. issuing an exec utive order on April 4 lh that permitted
the quarantining of healthy people suspected of having SAR S, but not yet displaying
symptoms ("T imeline for SARS" 2003).
The British Medical Journal was curious ly devoid of SARS-related articles on the
5 1h of April, as was The Lancet. It was, admittedly, too early in the epidemic fur scie ntists
to have begun publishing papers descr ibing the ir work with the disease, but in BM]'s first
April ed ition. the only mention of the disease came via a report in the journal's "News"
section . For the most pan, this ankle reviewed the death tolls and gave a brief histor y o f
the WHO 's actions in respond ing to the crisis. But there were two important pieces of
82

information revealed: first. that microbiologists at the University of Hong Kong believed
that they had isolated the virus involved in the outbreak as a corcnavirus (a finding which
agreed with similar studies at the U.S. Cente rs for Disease Contro l): and second. that the
same Hong Kong team had alread y provided hospitals in the 1I0ng Kong area w ith a
simple test for the virus. based on polymerase chain reactions (though the test was noted
by the team' s spokesperson as being in its initial stages. and therefore still in need of
fine-tuning). The article was very clin ical in its presentation of this information. and all of
its sources were medical: there was no mention of rumor or goss ip. only data and
argument s about that data (Parry 2003a).
As mentioned above. April 7 lh was when a team of WIIO investigators traveled to
Guangdong province to ascertain the origin of SARS . On AprilS 1h • Chinese doctors made
a statement to the effect that there were more SARS cases in China than the government
was reportin g. As if proving the logic behind this statement. Hong Kong reported forty
new SARS cases a day for the next three days in a row. The WHO investigators made an
initial report on April 9 11 \ declaring that China might be withholding informa tion about
SARS ("TimcJine for SARS" 2(03). Initial forays into discovering the disease vectors
responsible for the mass contamination occurring in Hong Kong led health officials to
state that cockroaches might be responsible for carrying the disease from one residence to
another. as reported by Yahoo ! News (Lyn 2003a). Worldwide. the effects of public
concern over travel were already being felt: Australia's Qantas airlines. for example. cut
IJX)(}jobs-or 3% of its workforce-on Wedncsay. April 9 Lh • and carriers such as
Finland's Finnair. Germany's Deutsche Lufthan..a. Japan Airline.. System Corporation.
83

All Nippon Airways. Hong Kong' s Cathay Pacific Airways. Korean Air. and Garuda
Indonesia reported financial losses and cuts in flights ("SA RS hits airlines ... .. 2(03 ).
The April It h editions of the British Medical Journal and The Lancet were
equa lly as lacking SARS-related information as the editions published the previous week.
In The Lancet, on ly a single news article existed. The BMl had little more. consisting
mostly of a news piece, penned by the same author as the April 5 th BMl news piece.
which was once again clinical in its reporting. using official sources as its references and
avoid ing discussion of rumor and hearsay. The article gave the death toll. and remarked
that the argument over the cause of the disease had come down to isolating whether the
coronavirus identified the previous week was the sale cause. or whether it was operating
in conjunction with another factor to create the symptoms associated with SA RS. Also
noted was the WHO' s declaration thai the disease did come from one of China's southern
provinces. but that they could not yet confirm whether there was any link between
animals and humans in the disease's transmission (Parry 2003 b). The onl y other ment ion
of SARS in the April 12 th edition of BMl came in the obituary of Dr. Carlo Urbani, the
WHO official who brought the disease to the world ' s attention. and who died from
SA RS-related complications on the 29 1h of March ("Ca rlo Urbani" 2(03).
Apri l 14 th marked a banner day in the scientific and medical study of this new
disease, with Canadian scientists success fully sequencing the DNA of the coro navirus
believed to be responsible for the outbreak. Scientists in the Netherlands confirmed a da y
later that a coron avirus was indeed responsible for SARS. According to an MSNB C.com
report, the It h of the month was another day of discovery, with Hong Kong officia ls
84

eporti ng the infection vectors of the apartme nt complex where a quarter of the territory' s
1.300 cases were identified (the same complex whose residents had earlier been relocated
to isolation camps). SARS had. accordi ng to their investigations. spread thro ugh a leaky
sewage system ("T imeline for SARS" 2(03).
Closer to home. it was also on this day that Memor ial University's International
Centre notified its students via email that the Canad ian Embassy in Beijing. China would
be closing to the public for a full week: "No visa applications can be submitted; no
interviews will be conducted; no documents can be picked up in person during this
period. Service by mail will continue." Intemational students-especially those students
from Vietnam, China, Hong Kong. Singa pore and Taiwan- were also advised to check
the latest updates from Heahh Canada hefore traveling home (Intemat ional Student
Advisor 2003). In a follow-up flyer distributed camp us-wide at Memorial University on
April 22 od • all students arriving from Hanoi, China, Hong Kong. Singapore and Taiwan,
and any students "who may have had d ose contact with a person with suspected or
probable SARS" were encouraged to chec k their temperature daily for three weeks and
self-monitor for cough, shortness of breath, or difficulty breath ing (Studen t Health
Service 2003).
On the mainland. worshippers in Toronto attending mass on Good Friday were
either asked to or voluntarily changed their religious rituals. avoiding dipp ing their
fingers in holy water, receiving bread in their hands instead of on their tongues. bowi ng
to the cross instead of kissing it. and avoiding altogether the sharing of wine. Choir
members with sore throats or coughs were even asked not to sing, as the act could spread
85

expectorant-and thus disease-c-over the congregat ion. On Easter Sunday-e-cc nsidered
by many the most import ant celebration of the church-Bishop John Boissormeau of the
Catho lic Archd iocese of Toronto excuse d from attendi ng mass those who were sick or in
quarantine because of SAR S (Brown. DcNecn L. 2003).
The April 19 lh edition of the Briti.." Mediall Journal contained yet another news
story. this one remarking on how the virus' spread was difficult to contro l (Parry 2oo3c).
but it also marked the first time that month that the virus appeared in an article elsewhere
than the "News" sect ion. In fact. the journal's first sect ion. "This week in the 8MJ: ' had
as its opener a blurb titled "Seve re Acute Respiratory Syndrome Demands Strict
Control:' The blurb itself was only a short summary o f the contents of the two pieces in
the journal that did disc uss SARS . but it see ms indicative of the larger state of affairs that
it opened the edition. Abo indica tive was that the first of these two pieces. a lengthy
editorial. opened the "Editoria ls" sect ion. The editorial itself was written by the Deput y
Director of the Enteric. Respirator y and Neurological Virus Laboratory at London ' s
Health Protection Agency, and summarized the scie ntific advancements that had been
made in the investigation s of the coronaviru s since it was broug ht to the atte ntion of the
Western world. SARS was noted to almost certainly he caused hy a coronavirus. but that
there see med 10 be some assoc iation between the disease' s symptoms and a human
mctapncumovirus that was isolated in 200 1. with a note that laboratories aro und the
world were racing to check these correlations (Zambon 2003).
The second major piece in the April 19 th ed ition of the 8MJ was a profession al
paper by two researchers at the University of Hong Kong, one a professor and the other a
86

physician. The paper was short . but reviewed Hong Kong' s da ily-rising number of deaths
from SARS. summarized laboratory and pathological findings. recommended courses of
treatm ent. and provided a list of precautions for doctors to take when treating the SARS ­
infected. Much of the paper was thus review. but the recommendations for treatment and
preventi on did cover new ground . includin g the advocating of quarantine as the best
method of inhibitin g the disease' s spread. and the note that public education of propcr
hygiene measures would be critical in dealing with the outbreak (Chan-Yeung and Yu.
2(0)).
The April 19 lh edition of The Lancet was similarly focu sed on SA RS. but
conta ined eve n more works relevant to the outb reak. In total. seven of the edit ion' s fifty­
six articles were devo ted to the disease : one ed itorial . two commentaries. one article . one
news piece. and two "Correspondence" letters. All of these pieces were clinical in nature
and tone. discussing infection con trol measures and the identification of the coronavirus
as the possi ble source of the infection.
On the other side of the ocea n. China faced increasing pressure and cr iticis m over
its lack of openness in d iscussing SARS and revea ling pertinent and timely information.
In respon se. the Chinese gove rnment promised to be more open. and on Ap riI 20 ,h •
reported the number of SA RS cases in China as rising from 1.512 to I.H07.and fired the
Beijing health minister and mayor ("T imcline for SARS" 2(03). A report filed by
journalist Dexter Roberts on April 2 1 st does not show evide nce of this new openne ss,
however: in attempting to interview a Beijing doctor about SARS. Roberts was told. " I
am not allowed to talk about my countr y' s public health ... . I' m sorry-c-but the ministry
87

The Ia..t few days in April conti nued to bring bad new.. to re..idcnts of the Toro nto
area. On the 22"". The Center s for Disea..e Contro l and Prevention sent specialists to the
city to help contain the spread of SARS. Toronto having been deemed key in succe....ful
North American containment. At this point in time ..orne sixty-six hospital workers had
b en listed a.. probable or suspected SARS cases. their numbers comprising almost 25%
of the 259 SARS cases in the province. 7.000 peoplein thc Toronto area had been
quarantined. There were only fifty-seven ca-..es of SARS reported elsewhere in the
country. and all fourteen SARS -related deaths had occurre d in Toronto ("CDC team
arrive.....·· 2003 ). The very next day. the WHO extended their travel advisory to cover.
among other place... Toronto. giving this Canadian city the dubiou.. honor of being the
only location outside of Asia to have warranted ..uch a warning ("New SARS travel. ..·•
2QO.t). Reaction to this new advi..ory wa....wift and. in some cases comful. Toron to
Mayor Mel La..tman went on record as saying. "Let me be d ear; it' afe to live in
Toro nto. and it' s safe to visit Toronto" ("City of Toronto .v." 2(03). Despite such
rea....uranccs. major league baseball teams were advised against visiting ho..pitals. using
public transportation. mingling with crowds. and signing autographs ("'MLB issues
guidelines..... 2003). and high-profile players like Alex.Rodriguez of the Texas Rangers
made public statements to the effect that they would confine thcmsclvcs to their rooms
between games to avoid po..vible exposure (" Rodrigucz. Rangers..." 2(03).
The effects of the WHO warning were seen almo..t immediately. the travel
advisory being for many the final factor in canceling travel plans to the already-suspect
city. Store owners reported busine..s falling by half literall y overnight. and traffic in
89

shopp ing malls ground to a near-hall. Hotels, already under strain. found customers
cance ling reservations: some hotels had their occ upancy rates drop to 20% or lower.
Co nve ntions were ca nce lled en masse . Air Cana da was hit espec ially hard . the travel
advisory coming only three wee ks after it had been forced to file for bankruptcy as a
res ult of losses sustained due to the war in Iraq. Planes arriv ing in Toron to after April
23 N were almo ..t empty. Most telling . however. were the words of J. J. Johnston. chief
economist at the Royal Bank of Canada. who said. "Our feeling is that probably now
ISA RSI is going to take about a half percent off of the national growth rate for the second
quarter : ' Bad for bu..incss. indeed ('"Toronto' s eco nomy take s.. : ' 2(03).
Other areas of the wor ld suffered similarly. On Apr il 23 N , Beij ing ordered 1.7
million prima ry and seco ndary students to stay home until May thoOn April2-l lh • a
major hospital in Beijin g was sea led off unde r gove rnmen t orders . the 2.300 peo ple
inside forced into quarantine until furth er notice (''Timeline for SARS" 2(03). Th e
International Air Transport Association. the govern ing body ove r intern ational flights.
pred icted that SARS would cost the industry some $ 10 billion do llars. and would affect
airlines on every major continent ("SARS hits A..ian... ·• 20(3). Officia ls overseeing the
2004 Ol ymp ics in Athen s. Greece began question ing the process of admitting seve ral
hundred thousand athletes and visitors into the cou ntry, anyone of whom co uld be
infecte d. and d id not imm ediately rule out postponing the games (Bondy 2(XJ3).
Even the United States-largely untouched by SARS . with only thi rty-nine
proba ble cases and no dea ths- felt the effect s. Ch inatowns in every majo r U.S. city
repo rted ..luggis h busines s. with restaurants and other Chine..c-run businesses saying
90

which showe d that the death rate among those younge r than 55 was 3.6 perce nt. while
18.9 percent of those aged 65-75, and 28.6 percent of those older than 75 succumbed
(Vedantam and Stein 2(03 ). A CNN.co m survey conducted on April zs"showed that
public perceptio n of the disease was also one of pessimism; in answer to the question.
"Have we seen the worst of SARST' 30.858 of 39.544 voters. or 78%. answered "No",
Yet at the same time. a small but grow ing numb er of report s detailed successes.
On Tuesday. April 22 rnl , Hong Kong allowed 200.000 seco ndary stude nts to retu rn to
schoo l after a three-week stale-enforce d absence. under co nditio n that they wear masks
and lake their temp eratur es daily (primary students. however. were told to still remain at
home). Thi s decision might have been made in light of reports from Hong Kong' s health
officials that noted a decline in the numb ers of new SA RS cases for three days in a row
("C DC team arrives ... " 2003). Later that month, Vietnam was given official recog nition
by the WHO for being the first co untry to effectively co ntrol the disease, with no new
cases appearing in two wee ks (" How Vietnam beat. ..' 2003). And in the most pro mising
state ment yet, on April 28 th a WHO official stated that he believed the worst of SARS
was ove r in Vietnam. Canada, Singapore and Hong Kong (though China still remained a
large problem). Canada seemed espec ially promi sing, as no new cases had been reported
out side of a hosp ital in twelve da ys ("W HO: Worst of ..." 2(03). As a direct res ult of this,
the WHO lifted the travel ad visor y for Toron to on the last day of the month. Finally,
banks around the worl d report ed that SARS had done something they'd strugg led to
achieve for yea rs: it had led people to do their banking onl ine. Thi s allowed banks to save
92

costs by "trimming branch networks and cutting payrolls." a."conducting business online
was cheaper for banks than business done in person ("SARS drives online.. ... 2003).
While April' s last issue of The Lancet had only two pieces on SARS-a news
article and Dr. Carlo Urbani's obituary. the last issue of the British Medical Journal
published in April had no fewer than seven pieces about the disease. None of these pieces
were peer -reviewed papers-two were "News" pieces. three appeared in the "Personal
Views" section. one was a "Le tter," and the la..t wa.. a review of the website.. that various
officia l sources such as the WHO and the CDC had set up to discus.. SARS- but every
section that had a piece on SARS opened with it. The news reports detailed that the
corcnavirus had been definitively identified as the source of the outbreak (parry 2oo3d).
and summarized the disease' s progression in Canada (Spurgeon 2oo3a)-neither of
which offered any great insights into the medical community. However. it was notable
that the three pieces in the "Personal Views" section constituted the entirety of that
section. a clear signal that SARS was uniquel y aligning the medical communit y. One of
these "Personal Views" deserves specia l consideration. for it marked the first time in the
IJMJ thai the connection between racism and SARS as promulgated by media sources
was openly discussed (Schram 2003). Additionally. the "Letter" that appeared in the
same edition noted the problems that Chinese foreign exchange students were having
when attempt ing to return to school after vacations (Wong, Ian 2003) . Thus. for the first
time since SARS was given a name. the BMJ had begun to pay attention to the role of
rumors in the progression and effects of the disease.
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Still. the disease had not yet been eradicated. and the worldw ide eco nomy was
suffering as a result of global panic. A poll in early May revealed that almost half of
Americans bel ieved an outbreak was likely in their country. though only 8% of
respondents were serious ly concerned about it ("Poll : SARS epidemic ..... 2003). Reports
from Hong Kong were mixed. some claiming that the outbreak had peaked. while others
discussed concerns scientists had over mutations of the virus and relapses among
patients. not 10 mention the five-fold increase in dea ths over the previous month r-SA RS
relapses stump .. ." 2(03). In Beijing. the government ordered elementary and middle
schools 10 remain closed for a further two weeks, issuing an additional threat of
punishment to these home-quarantined in Taipei who had violated their sentences.
Taiwanese hospitals groaned under the strain of SARS cases, which had tripled to 116 in
the past ten days. On Sunday, May 4 111 alone. thirteen new deaths were reported in Asia:
seven in China. five in Hong Kong. and one in Singapore (Foreman 2(Xl3a).
On May 4 111 • WHO officials in Hong Kong reported a significant breakthrough in
the tracing of disease vectors. as data from recent studies showed that the SARS virus
could live for up to four days in human waste-s-four days for diarrhea and two days for
urine or fecal matter. Hong Kong scientists had long suspected that the virus could live in
sewage. and was at least partly responsible for the contamination of an entire apartment
complex after sewage pipes leaked. but had no proof. The WHO' s findings confi rmed
these suspicions, and necessitated entirel y new worldwide containment strategies.
Japanese researchers made a similarly important report the same day. recording the
presence of live viruses on a chilled plastic surface four days after their placement.

Again. this finding necessitated global changes, us health officials now understood that
the virus could survive for dozens of hours on. say, a refrigerated bottle of soda. On a
positive note. CNN .com reported that experiments with basic househo ld cleaners
demonstrated the virus dying within five minutes of exposure to chlorine bleach. offering
a sim ple household strategy to prevent infection ("WHO sheds new... .. 2003).
The brightness of this message apparently failed to find purchase in China. as
villagers protesting the local government's SARS policy in Zhejian g province stormed
local offices. breaking windows and office furniture and assaulting officials. Beij ing
officia ls. perhaps in fear of mass retribution . sent policemen to guard eighty reservoirs
around the capital city to protect the drinking water supply from SARS contamination
(Foreman 2003b). Hospitals in the capital also suffered from public fear as scores of
support staff quit their jobs. Their timing couldn' t have been worse. as China reported
160 new cases of SARS and nine new deaths at the same time. and there was no
indication of a leveling-off of the infection rate. In fact. Chinese officials expressed
public concern about rural health-care resources. especially as migrant workers fled the
capital for their hometowns. increasing the possibility of new disease vectors (vlto spitals
in China... " 20(3). Chinese Premier Wen Jiabao called the situation "grave" and warned
that "arduous work" was ahead if China was to contain the epidemic. The same day, 138
new cases and eight more deaths were reported in the Chinese media rChinc: SARS
hattie..... 2(03). The following afternoon. f\lSNBC.com reported that Beij ing citizens.
fearing that domestic animals such as dogs and cats might have been respons ible for
spreading the virus. had killed or abandoned hundreds of pets in recent weeks: some
95

communities had apparently begun demanding such action (though these rules were not
authorized by local government) ("SARS drives Chinese... .. 2003).
Hopeful Asian exchange students felt the repercussions ofChina's situation.
learning on May 6 th that the University of California at Berkeley would not be accepting
around 500 students from China (as well as Hong Kong. Taiwan. and Singapore) for the
summer session (" Berkeley turns away.,.." 2003). Other U.S. educatio nal facilities soon
followed 'mil. John Holden. president of the National Com mittee on United Stales-China
Relations, said on May t h that he was "not aware of any (exchange I progra ms that are
going forward at the moment. or plan 10 go forward over the summer," and some Asian
exchange students already in the U.S. forfeited trips home over fears of not being allowed
to return for school in the Fall C"SARS impacting higher.. ,'"2003).
The first two editions of 17Il' Li mn " published in May had eleven SARS-rclated
articles between them. including three fast-tracked and peer-reviewed "Research Lcucr s"
that revealed the results of studies designed to investigate optimal diagnosing methods. as
well as treatment and preventative measures. News articles made lip the bulk of the
remaining pieces"as did editorials concerning China' s failure to deal adequately with the
disease in late 2

tempera ture of all inco ming passengers (a high body temperature signaling possible
infect ion). The system seemed to work. as thirty-seven passengers were ident ified in only
a few days. The U.S.• however. relied mos tly on the abilities of agents 10 recognize
telltale symp toms in passengers- high fever . dry cough. and breathing troub le r-Federcl
age nts trained.,.." 2(03). On May 9 th • Italy becamethe first count ry in Europe to
introduce ob ligatory checks on all incoming passengers from Ch ina. reserving the right to
also check those arriv ing from European cou ntries "where they may have made
connections from Asia" (vltaly to chec k.:" 2(03).
Global efforts such as these were markedly fewer at this point . bUIseem ed even
more necessa ry within a few days . On Monday. May I2 lh • the WH O adde d India 10 its list
of cou ntries with !'.U!'.PCClOO cases of SA RS after a man arr ived at a ho..pital in Ca lcutta
with a feve r and cough (this after declari ng the cou ntry free of the disease only a few
days earlier) (" One 'probable' SARS ..... 2(03). In China. the number of d iagnosed cases
passed SJX)Oon the same da y. with seventy-five new cases and twelve deaths added to
the list. Ta iwan recorded a record number of new cases. confirming eig ht death s and
twenty-three infect ions. "the highest one-day rise for the area since the outbreak two
month s ago" ("China SA RS numb ers..... 2(X>3). Taiwan' s information came on the heels
of a Taiwanese Interior Mini stry report detailing the diffi culties in fight ing the disease
beca use local.. refused to cooperate: fort y-two percent of peop le who were suppose d to
reg ister with local health offic ials after arriving at airports neglec ted such duties.
Officials were also having troub le kee ping track of the 23.000 people in quarantine (most
of whom were disease-free), and had so far "pent S350,(X)()on 2,(X)() video came ra!'.that
97

were installed inside the homes of quarurnined residents. In Tai pei alone. some 200
reside nts disappeared, breaking quarantine. after their housing projec t was closed
follow ing the discover y of a body and two people suspected of having SARS. As Loh I·
l•-bcng. a former dep uty ambassador to the U.S. said in regards to this , "E veryone in
Taiwan thinks he', 'pedal and smart-why should he observe the rules'! He knows the
police won't strike him or arrest him" (McNeil Jr. 2003).
Again. however . there were a number of success stories . Though the rest of China
was still strugg ling. Beij ing declared on May 9 1 1\that its efforts to contai n the outbreak
appeare d 10 be successful: the number of new reported daily cases had decli ned from 70­
80 per dny- a pre- May 2 nd plateau-e-tc 30-40 per day. Medical staff were also
contracting the disease less frequent ly. drop ping from a daily average of 15.8 percent to
6.3 in the same period ("'Beijing hopefu l of.. :· 2003). For the excha nge student' who had
previously been told they would not be accepted into U.S. programs- slight relief carne
when the University of California at Berkeley resc inded part of their ear lier ban and
announced it would allow roughly eighty students from China. Hong Kong. and Taiwan
to attend school over the summer (though the school still planned on harring ove r 500
others) ("Berkeley eases SARS.. : ' 2003). China also announced that SARS would not
delay the launch of its first manned space n ight later in the year (t'Chi na: SARS won 't..
20( 3), and in a public statement cove red by Yahoo ! News, Russia' s Vitaly Zverev. head
of Moscow' s Virus Research Institute. asserted that the SARS scare was overp layed. that
Russia would not have an outbreak. and that " 100 grammes of vodka' was the best cure
(" Russ ian experts downplay... ·· 2003).
98

Good news also came from the medical front. as a laborator y study in Germany
suggested that a modified vers ion of an experimental drug designed originally to treat the
common cold might be useful in blocking the SARS virus from reprodu cing. A similarity
in protease enz ymes betw een SARS and the rhinovirus the drug was intended to treat
provid ed the link. though no studies had yet been conducted on the viability of such
hypotheses (Recer 2(03). The origin of SARS. however. was still very much a puzz le for
researchers worldwide. As cove red by MSN BC.com. a growing number of experts
believed that it might have come from an animal. but had few leads on which animal
might be to blame. Some said it might be a bird, draw ing such conclus ions from a 1997
outbreak of the flu in Hong Kong that was spread by poultry and resulted in the
slaughtering of 1.4 million chicken s in containment efforts. Other researchers eschewed
the animal theo ry altogether and said that SARS might simply he a mutation of a
previously-harmle ss human virus. Researchers had earlier hoped that the decodin g of
SARS ' genetic makeup would help eliminate such concerns and point 10 a specific
human or non-human origin, but the results proved inconclusive r-Origm of SA RS..."
2IX))).
For Toront onians. probahly the best news of all arri ved e n May 14 th • when the
W}IO officia lly removed Onta rio' s capita l from its list of areas with "recent local
transmission: ' as twenty day s had passed since the last reported case of SARS was
isolated in Canada . According to the WHO, this meant that "the chain of transmission
Iwas) considered broken." after 321 probable or suspected case!'.and twent y-four death s
("Wil D: SARS no longer. .... 2(03). Onl y a score of people in the country remained
99

active cascloads, and five of those were released from hospitals the day before this
announce ment, leaving only sixteen active cases in Canada ("Canada 's active SARS.. "
2003; "Update #57 - Severe..... 2003).
In most of China, neither the news nor the mood seemed as optimistic. In Beijing,
desp ite the successes reported earlier in containing SARS, MSNBC.com reported that the
governmen t found it necessa ry to crack down on rumors about the disease that were
being spread by mobile phone messages. A new tracking system helped officials locate
those who sent over 100 such rumors an hour-rumors which included that Beijing
officials were ready to instate martial law, that crop dusters were spraying the city with
disinfectants at night, and that smoking and drinking helped ward off SARS. This new
tracking system quickly resulted in the detaining of a dozen peop le by city police ("Ch ina
checks SARS.. "· 2003). At the same time, Yahoo! News covered the government of
China's increasing fight with the populace over widespread use of the occ ult to ward off
the disease. The officially atheist commun ist government. which had attempted to rely
heavily on science, found itself confronted with peop le who hired sorcerers, lit
firecrackers, burned fake money, and practiced other such "magical" rituals to protect
themselves. There were even rumors of a child born with the ability to speak who
prophesied that "gree n bean soup" would prevent infection-a rumor that drove the sale
of mung beans up sharply in large parts of the country (Ang 2003a).
In the midst of this panic, China's Supreme Court, faced with the increas ing
problem of enforc ing quarantines, threatened imprisonment for up to seven years for
quarantine violators, and a possible death penalty for those who caused death or injury by
100

deliberately spreading the virus. The first arrest under these new laws came the day of the
annou ncement, when a doctor in the northern city of Linha was charged with having
previously violated quaran tine. resulting in the infection of more than 100 people. The
doctor's punishme nt was a maximum sentence of three years (Bcdee n 2003a). These
drastic measures drew immedia te criticism from the U.S. and international human rights
groups ("US criticise d China ... .. ::!(03). and China 's worldwide standing wasn't helped
by a WHO declaration that China 's doctors were still under-reporting SARS infeetions­
a criticism that had been plaguing the count ry since early April (Ansfleld and Peng
2003). Perhaps because of this, President Hu Jintao of China said in an interview the
following day that "We are ready to further strengthe n our cooperat ion with Russia and
the whole international community in prevention and treatment of SARS,"
acknowledging that more financing, better research, and coord inated efforts would help
in stopping the epidemic (Chuang 2(03).
At the same time, there were increasing numbers of reports detailing a lack of
concern in other areas of the world, or at least a perception that the SARS epidemic had
been overblown. While large numbers of Asian exchange students were being denied
entrance into U.S. universit ies, there were American exchange students in China who
chose 10 stay and study, ignoring the calls of parents and educators who urged them to
return home. There were also U.S. educators who were frustrated that their universities
had cance lled planned research trips to China ("S ARS impacting higher.,." 2(03). In
mid-May, two U.S. doctors pointed out to a jou rnalist that the West Nile virus had been
more deadly, killing 2lWpeople in the U.S. and Canada in 2002 (SA RS, at this point, had
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only claimed the lives of twenty-three people in Canada. and none in the U.S.). One of
these doctors-c-Dr. Paul Epstein of the Harvard Medical School Center for Health and the
Globa l Environme nt-s-sa id. "T he attention focused in recent weeks on SA RS is
extraordinary and. it can be argue d. excessive" (Fox 2oo 3a).
Reactions such as these may be. at least in the U.S.. somewhat understandable:
the stales had managed to avoid contamination for the most part. and had not seen a
sing le fatality resu lting from the epidemic. There was a seriou s concern among members
of the Cen ters for Disease Cont rol and Prevention ove r the capacities of U.S. hosp itals to
deal with a large -scale epidemic. should one occur . a.. ho..pitals lacked the neces..ary
quantities of nega tive pre....ure rooms/infection contro l rooms to deal with widespread
con tamination. but even CDC members adm itted that the current measures seemed to be
working ("U .S. hospitals ready.. ." 2(03). Public reactions to the disco..e were influenced
in large part by media reports. and many news articles had headlin es such as "So Far.
U.S. Succeeds in Containing SARS" (Ycc 2003a). and "CDC Doctor Suspected of SARS
Recovering" (Yce 2003b). all of which painted a po..itive picture. Jud ging by the news
articles co llected during the last half of May. the United Stat es had things under control:
there was no need to worry.
Across the border. however. the virus once again reared its head. Canada 's recent
thirty-day dearth of outbreaks. which had provided Ont ario' s cap ital city relative freedom
from WHO and CDC scrutiny. proved an unreliable measure o f success : on May 2)rd.
Toront o hea lth officia ls revealed that they were looking into twenty-five poss ible new
ca..cs. Thi s new outbreak covered two ho..pitals-St. John' s and North York General -
102

and prompted the CDC to reissue their Toronto travel alert three days after lifting it. Of
those infected, two of the North York patients had already died, and three of the SI.
John ' s patients were in critical condition. Microbiologists studying the new outbreak
were not immediately clear how this new outbreak had spread, and assumed all vectors as
potentially infectious: health care workers, family members, even other patients. Toron to
officials issued a statement declaring that anyone who had passed through North York
betwee n April 22 11d and May I3 lh , and SI. John' s Hospital since May l SI should
commence self-monitoring and immediately call a Toronto Public Health hot line to
identify themselves: it was expected that over 1.000 people met these criteria (v'Toron to
reports 25..... 2(0).
Three days later the source of this new outbreak was revealed. taking the form of
a ninety-six-year-old man who died on May 1, 1 after two attacks of pneumonia. The man
was not isolated from other patients at the time of his admittance because hospital staff
did not associate his pneumonia with SARS; indeed, the assoc iation was made only after
the second outbreak. At the same time, the WHO placed Toronto back on its list of SARS
hotspots. having made the decis ion after eight more probable cases and three new deaths
were revealed ("Toronto reveals SARS.. ... 2(0). Toronto officials. investigating the
matter. acknowledged that there could have been some thirty to forty cases that had gone
undetected during the "dry" period between outbreaks (Huang 2(0)a).
The last week in May revealed a Toronto once aga in under worldwide scruti ny.
Scarborough Hospital housed about twenty SARS patients. ten of whom were med ical
staff. while other members were under home quarantine. Hundreds of staff were under
103

workin g quarant ine, and spent their days wearing N-95 masks-s-under orders to change
them every four hours-and taking the ir temper atures twice daily. all while interactin g
with patients. Staff members were also advised not to sit close together in the nurses'
loun ge. and to keep a scat between themselves in the cafeteria (Gardner 2003).
At Toronto' s Rouge Valley Cent enary hospital. four patients died during the
week , all suspected of being SARS -related (though autopsies hadn't yet revealed the
cause ). No sign of infectio n had been seen in urban or suburban areas. hut many hospitals
bore signs warnin g of SARS . and had the ir main doors taped shut. allowing entrance onl y
through their emergency wards . The Canadian Federation of Nurses Unions moved its
annual meeting to 51.John' s, Newfound land. in response (Wroughto n 2003) . Province­
wide. the number of probable cases rose dramatic all y: from twelve on Wednesday the
28 lh • to twenty-nine on Thursda y. to forty-three on Friday, and to forty-six on Saturday.
Over 150 additional peop le were being monitored closely as possible victims. Canada 's
thirtieth victim died on Thursday. and hy this time in Toronto . more than 7,000 peo ple
had been qua rantined, including 440 health care worker s and 1.500 people assoc iated
with a high school. Still, Canadian Health Min ister Ann Mcl.cllnn reassured the public
that ..It is not getti ng worse ... This second cluster has probab ly peaked and we are on the
way out of this" ("Ca nada fears new .: ' 2(0 3). Onl y June would tell whether her
predicti ons were accurate .
In most of Asia and the surrounding areas. the news was mixed. At roughly the
same time the UK announced its first confirm ed SARS case ("'UK has first.. : · 2003).
China reported that the disease had entered the countryside. where million s of people
104

lived in towns that were almost entirely unprepared and unequip ped to fight an outbreak.
The worst of it seemed to have been located "in Qingxu. 270 miles southwest of Beijing.
where dozens have caught the disease and several have died ." Only twenty miles away in
Taiyuan. there were an est imated 300 cases and fifteen deaths. though the provincial
government only acknow ledged 162 of the cases and seven of the deaths . More telling
was a report from a governmenta l spokesperson who said that Shanxi hospita ls needed
453 more respirators-on top of the eighty already existent (Pomfret 2003).
These reports came the day after the Chinese cabinet passed a 52.56 billion fund
to help the impoverished pay for treatme nt. to help modernize impoverished hospitals.
and to support research. However. many people in Qingxu (and. it can be assumed. in
other parts of China) doubted they would ever have access to that money: one local
interviewee told a reporter from the WlHh illglO11 Pos that "A peasa nt's life in China has
never been worth anything:' and referred to a general belief that local officia ls had stolen
funds intended to alleviate poverty. Officials were so worried about such reactions and
the spread of SARS that they began to han migrant workers from return ing home. But
with 1.3 billion people, enforcing such a han was almost impossible; there had already
been reports of patients known to have SARS lleeing to their homes, preferring to die
there than in the hospitals, which many believed were useless (Pomfret 2003).
Also alarming were reports from jo urnalists that rural regions didn't seem to
understand the danger of SARS. and were not following governmental notices to
disinfect public buildings. Even in hospitals, those with SARS· like symptoms were kept
in waiting rooms with SARS -free patien ts until doctors were free to sec them.
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Govern ment officers also seemed to misunderstand the importance of quarantine: in
China, local officials ....'ere expecte d to visit party secreta ries in hospitals, a tradition that
may have led to the initial outbreak in Qingxu. Communist Party secretary Yue Shoubin
contracte d SA RS in Beijing, was hospita lized in Qingxu, and was visited in the hospital
by severa l members of a de legation. at least two of whom subsequently tested positive for
SARS, and one of whom died (Pomfret 2(03).
Despite their earlier agreement to be more open, Ch ina censo red a CNN
International report on May 15 th , refusing to allow it to air because it "pos itions a
negative cove rage of China," accord ing to one official. The seven -minute segment
criticized the govcmments handling of the SA RS crisis. pointed to inadequate health
care systems, and accused the government of orderi ng docto rs to underreport the number
of SARS cases (Florf.ruz 2003). Two days later, Beijing reporte d four new deaths and
nineteen new cases. rais ing the nationwide total to 282 deaths and 5,2 19 cases. The
WHO, however, warned that these numbers might be higher (" Key Developments
With .:' 2(03).
Less than a week later, the WHO lifted the travel advisory on Ch ina's Gua ngdo ng
province. demonstrating that at least parts of China were making progress (though
Beijing had reported twe nty new cases per day for four days straight). The WIIO's
actions came on the heels of a possible breakthrough in determinin g the origin of SARS,
as covere d by CNN.com: Hong Kong researc hers said the virus might have come from
civet cats . considered a delicacy by some Chinese ("WHO lifts HK..... 2(03). By the end
of the month. Yahoo! News was reporti ng that prov incial officials in Guangz hou.
106

Guan gdong had orde red sellers at markets to remove civet cats from their cage d wares. as
well as snakes. bats, badgers and pangoli ns, all of which had been identifi ed as possib le
carriers of the SARS virus. Farm s that raised exo tic species were told 10 qua rantine their
livestock. Viola tors were threate ned with fines of up to S J2.000 . Such measures seemed
effective: Guangdong province had not reported a single new ca..e of SA RS in a week.
China as a who le showed signs of improving as well: on the last day of the month . on ly a
single new case was reported. along with four deat hs-all in Beij ing. The number of new
ca..es had thus dropped by ove r 90% since the beginning of May. prompting Beijing to
cut from its list ninc of the sixteen ho..pitals set aside exclusive ly to treat SARS. Though
il was still too early to make defin ite conclusions. China appeared 10 be containing the
outbrea k (Bodeen 2003 b).
May in Hong Kong. although nowh ere ncar as worrisome as in China. still proved
hectic. Five peo ple died of SARS on May It h • raising Hong Kong' s tota l number of
deaths to 243 (" Key Developments With ..:· 2(03). The WHO lifted its travel advis ory
over the region on May 3 1'I. though thirty more deaths had been registered since the Itho
In an odd turn of events. the virus proved a boon for businesses here: managers at
restau ran ts reported that open-air dining patios were at capacity. and some restaurants
had to hire addit ional staff to keep up with demand. Accord ing 10 one news articl e. this
cou ld he traced to locals seeking fresh air and open spaces , two co mmod ities seen as
healthfu l and lack ing in the overcrowded cities. Loca ls seeking less crowded areas also
mean that bike rental shops ofte n rented out their en tire stoc k. and park attenda nce surged
107

y 75%. Atlea...t one business that rented ou t plots of land for peo ple to try their hands at
organ ic fanning said business was up by 700 % (Wong. Margaret 2003 '1).
At the end of May in Hong Kong. the government pa...sed laws designed ( 0
promote hygienic pract ices (and thus ward off SARS) among public ho using tena nts by
pu ni...hing them for failing to keep their resi dences clean . Under these laws . which wou ld
come into effect in August of 2003 . tenants would face eviction if they recei ved sixteen
penalty points in a two-year period. Point-induci ng viola tion s included drying clothes in
public areas . ...pitti ng. littering. throwing objects out of window s. and keeping pets . The
Hong Kong Soc iety for the Prevention of Cruelly to Anima ls viewed the latter of these
offe nces as dangcrous-c-espccially since havi ng a pel warranted a live -po int pcnalty ­
and warned that such laws might lead to a surge in an ima l aba ndo nment (""HK
government defe nds ... ·· 2003).
Singa pore appeare d (0 be on e of the bright spot s. largel y than ks to some of the
str ictest anti-SARS measures in the world. At the end of Ap ril. Singapore had the wo rld's
fourth-highest death rate, with twenty-eight co nfirmed mortalit ies. But by the middl e of
May. the co untry had gone ov er two week s witho ut report ing a new case. and
go vernment officials we re hop eful the city wo uld he decl ared SARS-f ree by the WHO.
Such a turnaround came thank s to the quarant ining of over 3,(XX) peo ple, tem porary
schoo l closures. barring visitors at hospitals. and checking people's temperatures at
borde rs. Co mplications arose when twe nty-...eve n peo ple. including three nurscs, at the
cou ntry's largest menta l hospital were isolate d wit h SARS-Iikc symptoms on May l-tth
t-Pres b SA RS out brea ks ..:' 2003). Three days later. however. there were still no
108

co nfirmed cases; the outbreak seeme d to have been a false posit ive (" Key Developm ent s
With ..... 2003). Then, one day shy of the "twenty days free of new cases" mark set by the
WilD to qualify a coun try as free of SA RS. a single Malaysian man was positively
diagnosed . Offi cia ls were disappointed. but still positive about the development; one case
in twe nty days was considerably bette r than the large num ber of deaths reported in Apri l.
"Si nga pore should take th is in its stride:' said Health Minister Lim Hog Kiang (Chuang
2(03).
The last two weeks of May did not prove as benevolent in Taiwa n. Ranked the
second-highes t country in the world in terms of number of new cases repo rted on a da ily
bas is. Taiwan faced increas ing criticis m over the way authorities were handlin g the
SARS crisis. Th ese co mplaints concerned "disorga niza tion. lack of effective crisis
management planning and political bickering: ' and eve ntua lly led to Health Minister
T wu Shiing -jer resign ing his position . By mid-month. 274 peop le had tested positive for
SA RS in Taiwan, and dozens of new cases we re report ed daily. Hundreds of doc tors and
patients in two hospitals in and around Taipei were quarantined, and a hospital in the
sout hern city of Kaohsiung migh t, by itself . have had dozens of cases. though officers
said they cou ldn' t be sure until the end of a ten-day incubation period. Sources close to
the Taiwanese government told reporters that the battle was at a crossroads: "u nless
officia ls move quickl y to con tain the outbreak in hosp itals and do a more effective job of
tracing co ntacts of suspected patien ts. the epidemic risks taking a further tum for the
worse. with potentially serious co nseq uences for the co untry's health-care syste m"
("Ta iwan hea lth chief ..... 2(03).
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Onl y four da ys later. Ta iwan became the country with the fastes t-grow ing
casc load of SARS patient s in the world. On May 20th alone. thirt y-nine new cases we re
report ed. and twelve new death s, the latter brin ging the island's toll to fifty-two. Thi s
marked the third da y in a row where the number of reported cases had set a record .
Taiwan was still third on the list of worst-hit co untries (follow ing China and Hong
Kong). but was the on ly co untry where the number of daily cases was still rising ("SARS
tall y soa ring .. ... 2003) . O ver the next two days. eight death s and 120 new cases we re
report ed. but there were 99 1 sus pected cases that had yet to be co nclusively diagnosed.
Members of U.S. team s assessing Taiwan ese SARS contro l procedur es weren' t even
safe; one man, despite follo wing all recommended precaut ions, was transferred to the
U.S. via air ambulance after developi ng SARS -like symptoms ("T aiwan SAR S cr isis.. ..
2003).
Despite the direness of the situation. Taiwan rejec ted an off er from China to help
co ntro l the outbreak . cla imin g that everyt hing was under control. The rejection ca me on
the same da y as health officers announced twent y-two new cases and twel ve fatalities,
brin gin g the island's death to ll to seventy-two. By co mpariso n. on the same day, China
announced seve n deaths and six teen new cases. In its official reject ion, Taiwan criticized
China for inter fering with inte rnat ional attempts to help , as well as blockin g Taiwan from
becomin g a memb er of the WHO (Huang 2oo3b) . The cases that Taiwan did announce
did not includ e severa l hospit al patient s who had not passed the ten-day incubation
period , raising the possib ility of dozen s of new cases (" New SARS deaths... " 2(03). The
last article in Ma y. dated Monda y. May 26 lh , announced no death s. but fifteen new cases,
110

and Taipei' s health bureau chief Chiou Shu-ti'v resigning over a major outbreak in a city
hospital. Shu-n's departure marked the third official to resign over SARS ("Ca nada,
Taiwan wrestle..... 2(03). It did appear, however, that a turning point had passed; the
number of cases per day was dropping.
Taiwan was not the only entity negatively affected. Businesses all over the world
reported losses, and none worse than the airline industry. Thomas Andrew Drysdale,
regional director for the International Air Transport Association, called the situation "A
crisis of major proportions," and stated that 9/1 1, the Iraq war, and Britain' s foot-and­
mouth-disease combined hadn't done as much damage to the airline industry. Estimated
worldwide losses topped SIDbillion, and SARS had only been on the global scene for
nine weeks (t'Airlines: SARS worse.. ... 2003). Northwest Airlines alone reported losses
of $ 1.6 billion between January 1" and May 31"', and had 10 furlough 1,093 pilots and cut
17,000 other jobs. Just to maintain profitability. the airline was also seeking over $ 1
billion in wage, work rule, and benefit concessions from the remaining workers ("SA RS
triggers more... .. 2(03 ).
Airlines were not the only businesses to suffer. Worldwide, tourism was down,
and business travel was stymied as workers avoided meetings. A survey of 2,015
Japanese companies that conducted business in Asia revealed that roughly 70% reponed
financia l damage. The largest numbers came from China. where 86% of Japanese
businesses had been affected, including the temporary closing of two plants after five
workers were diagnosed with SARS. In other areas of Asia, 85% of Japanese businesses
I II

in Hong Kong reported dama ges. with 84% in Singapore. 39% in Indonesia, and 38% in
Thailand making similar claims ("Japan Businesses Report..." 2(03).
Internet business, however. was booming. as consumers relied more on methods
of shopping thai avoided crowded marketplaces. As covered by CNN.c om. in China,
" Internet sales had risen as much as 60 percent at firms pitching jo ke books. antiseptic
cleaners or DVDs to keep the housebound clean and entertained during the virus-induced
panic" ("'SARS driving shoppers.. .' 2003). One store, which in 2002 sold roughly I(X)
million yuan worth of goods (about $ 12 million U.S.). reported daily sales of 500.000
yuan in Apr il and May. or roughly an 182.5% increase in sales. Another business
reported April sales doubling from 2002, and expected May sales to triple ("'SARS
driving shoppers... " 2(03).
For the medical community. the last half of May brought breakthrough s in
discoveries of viral transmission vectors and origins. Though there were alread y reports
that SARS might prove a reoccurring disease with seasonal patterns. cropping lip during
flu seasons over the next few years (Miles 2003; Ross 2(03 ). researchers were still
hopeful that the virus could be understood and eradicated. By mid-May, some researchers
were already focusing on the animal markets in Guangdong Province. theorizing that the
virus might have anima l origins. Other researchers pointed alit the similarities between
human air travel and hauling animals long distances in cattle cars; under such conditions,
animals often contract "shipping fever: ' characterized by cough. pneumonia. and
mucosal drip. all caused by a coronavirus. Perhaps. these researchers said. we arc
creating the perfect situation for viral spread: "When animals arrive from other locations
112

and commingle. you see disease outbreaks : ' remar ked Linda Saif. professo r of food
animal health at Ohio State Univers ity (Fox 2003b) . And there were theories that were
seen by most of the virology comm unity as ridiculous. such as the CNN.com report of a
British scien ti...t claiming the SARS virus may have outer space origins (Compton 2(03).
However. these theories could not be entirely ruled out becau ...e there was no hard
evidence either way .
Such evidence arrived on May 2.J 1h • when re...carchcrs in 1I0ng Kong announced
they had found evidence of the SARS virus in three small mammal s. one of which was
the civet cal. It was still too ear ly at this point to determine whether the animals gave the
virus to huma ns or caught it from them (though one of the ...rudy's leaders . microb iologist
Yucn Kwok-yun g, stro ngly believed it was the former). But WHO expert Dr. Francois
Meslin still declared the findings "quite exciting" CCat delicacy cou ld... .. 2(03). Further
evidence was added when SARS antibodies were found in five traders of wild animals
who had not developed symptoms of the disease. meani ng I) they contracted the d isease
some time ago. and 2) the virus appeared to have mutated into a more lethal form since
the traders caught it (based on genetic studies) ("SAR S antibodie s found.. ." 2003 ). By
May 28 lh • researc hers in 1I0ng Kong openly declared that the virus jumped from animals
to humans because of these antibod ies. Their findings " indicate workers caught the virus
from the animals. developed a mild form of the disease. hut then the virus mutated into a
more virule nt form before it was passed to other people : ' according to Shcnzhen
microbiologist li e Jianfan ("Evidence SARS.. :· 2003).
113

Thus. by May' s end, though a vaccine was still a long way off. significant
discoveries had enlightened many of the mysteries surrounding SARS. In addition,
according to the numbers of new cases reported daily. humans appeared to be contai ning
the epidemic. May certa inly ended better than it began.
In The Lancet , the last three editions published in May had sixteen SARS -related
articles between them. including several research letters. editor ials. and commentaries.
Once again, all of these articles were clinical in nature. The only glimpse of a piece that
might look at the non-medical world's impressio ns of the disease carne in the form of an
article tilled "SA RS, Lay Epidem iology. and Fear," published in the May Ir:edition.
The article even began promising ly, summarizing the increase in stress and fear in a
German hospital's outpatient depart ment, which was said to be due to a graph published
in a local newspaper. In this newspaper, a jo urnalist had attempted to lay dow n an
exponent ial curve on the outbreak, predicti ng an increasing surge in case numbers over
the next few months. However. the remainder of '·SARS. Lay Epidemiology , and Fear"
was an academic discussion of the failure of the jou rnalist to understand disease
prediction methods, including examples of the difference between exponential and linear
graphs. and the failure of graphs to take into account basic prevent ion and intervention
measures (Razum et al., 2003).
The British Medical Journal has not been mentioned for some time in this
timcline. Recall that the last issue published in April of 2003 contained no less than seven
pieces on SARS. all of which opened the sections in which they were published. Such
proliferation proved almost a last-gasp effo rt. as the numbers of pieces that appeared
114

sub..cqucntly dropped off greatly. There were only twelve SARS·related pieces in the
five i..sues of 8MJ that were published in May: nine news articles, two reviews. and one
short blurb that appeared in the journal' s "Filler" sect ion. Few of the..e t.....elve pieces
offered any key insights into SARS. Even the May 3 N edition of the journal. publi...hed
only a .....cck after the SARS+heavy edition of late April. contained only ne.....s article...
about the outbreak: one noting that SARS may have peaked in Canada. Hong Kong. and
Vietnam (Parry 2oo3e). one covering Canada's a.....urance that it .....a...a ...afe place to visit
(Spurgeon 2oo3b). and the la..t covering UK Health Secretary Alan Milburn' s waming
that SARS could ...till affect the UK (Eaton 2003). None of these articles mentioned
rumors. legends. or gossip. Only t.....o .....eeks later. the May It h edition of the 8MJ
contained only one ne .....s article and one "Review," (actua lly a ...hort. personal account of
life in China by a ...enior lecturer in international health at the In..titute of Child Health in
London. England: see Hesketh 2(03 ), and both of these pieces were located in the bottom
two entries in their categories. The news that the UK had its first ca..c of SARS (Parry
2(X>3 t) did appear as the second news story in the May 24 lh edition, but another news
piece in the same edition-this one about Chinese scientists testing wild animals to find
the host of SARS (Gottlie b 2003}-wao; almostthe lu...t entry. And the final May edition
of the RMJ only had one SARS-related entry: a news story that detailed the resurgence of
the virus in Toronto (Spurgeon 2003c).
June brought a breath of fresh air to many countries. a...worldwide the SARS
epidemic was in decline. Taiwan. after becoming the only country in the world with
grow ing cascloads. successfu lly adopted quarantine and mon itoring policies and brough t
115

its numbers down drastically. One of the more stringent measures adopted made news on
June I, when Taiwan instituted a nationwide ten-day temperatu re check policy. Families
everywhere-80% of which had thermometers, and nearly as many were willing to
cooperate. according to surveys-were asked to monitor themselves daily and report
anomalies. For those few who didn't have thermometers. there were 6,000 designated
community pharmacies that would provide the service. Only four people were diagnosed
with SARS on the first day of the month--demonstrating that the virus was already in
decline- and the numbers went down from there ("Taiwan launches national. ,.' 2003 ).
By the middle of the month, the WHO lifted the travel advisory against Taiwan.
The UN health body commended Taiwan for its recent proactive stance, a large
difference from the widespread condemnation of Taiwanese infection control systems
that were handed down some five weeks earlier ("WHO lifts Taiwan..... 2003). Lastly,
and almost a coda to Taiwan ' s struggle with SARS, on the 18 th of June two Taipei
doctors were charged with "covering up SARS cases that allowed the deadly virus to
spread through a Taipei hosp ital, leading to the island's first and worst outbreak"
(vTaiwun Doctors Charged..." 2(03 ). Prosecutors sought an eight-year sentence for both
Wu Kung-wen. former superintendent of the Taipei Municipal Ho Ping Hospital. and Lin
Jung-ti. the same hospital' s head of infectious diseases. Accord ing to Taipei District
Court prosecutor Chen Hon-da, "The investigation shows the defendants neglected their
duties and failed to take necessary infection control measures, causing the deaths of
several medical workers and allowing the epidemic to spread" (vTuiwan Doctors
Charged, " .. 200Jl,
116

Wednesday. June 18 th also marked the third day in a row Taiwan had not report ed
any new SA RS infections . There wou ld be three more cases and one more death before
Taiwan was given the all-clear on July s", but for now the tally stood at 697 infected and
eight y-three dead . making the bland the third -worst hit area behind mainland China and
Iiong Kong (v'Iuiwan Doctors Char ged .. .·· 2003).
In Hong Kong. June began ominously. with three new infection" and three new
deaths reported on the first day of the month . One of the fatalities was a female ward
attendant who was involved in treating some of the city's first victim s. These new
numbers brought Hong Kong' s total to 28 1 deaths from 1.743 cases . 1,3 18 of those
patient s had been released from the hospital. leaving eighty-three still in treatment . and
twent y-seven of those in intensiv e care ("l long Kong report s...·· 2003) .
Over the next nineteen days. fifteen people perished. There were also twel ve new
cases reported. hut all of those came on the second day of the month. meanin g that by
June zo", Hong Kong was only days away from receiving the WHO' s twenty-day "all
clear" stamp of approval. June 20 rn was also the day Hong Kong and Chinese health
officials met to discuss a system wherein the former would rece ive prompt health reports
from the mainland. hopefully thus avo iding future epidemic s ("·II K. China Discuss..
20(3) .
On Monday. June 23 00 • the WHO removed Hong Kong from its list of SARS ­
infected areas. At the same time. the WHO warned Hong Kong' s health official s of the
possible reoccurrences of SARS if guards were let down too early. drawing a direct
comparison to Toronto' s resurgence of disease (Wong. Margaret 2003h ). All that
117

emained now was for the region to revamp and re-stimulate its damaged economy.
According to MSNBC.com. Hong Kong' s unemplo yment levels had recently reached a
record 8.3 percent. and businesses all over the city were feeling the impact of the
diminished tourism industry. To combat the fear still present among locals and tourists,
Hong Kong' s government installed dispensers filled with antibacterial sprays in
government buildings and busy areas. and carted in high-tech temperature scanning
devices to major areas of activity such as jewelry trade fairs, airports. and border
crossings (Allen 2003). It took time, but Hong Kong did recover.
China. once the most-infected nation in the world. ended May with an entire week
of single-digit reports of SARS cases , and began June by going twenty-four hours
without a new case- the first day since April zo"it had been able to do so. No one died
during the period either. and so China' s figures remained at 5.328 infected and 332 dead.
Life returned to normal as well. with Yahoo! News reports confirming regular traffic
jams and a distinct lack of face masks on buses and in crowded areas ("No China
SARS... " 2(03).
In mid-June, while not officially removing China from the list of SARS-infected
countries. WHO members said that China appeared to have SARS under control. Th is did
not mean thai there had been no reported cases since the first of the month; indeed. there
was one reported case the day before the WHO statement surfaced. and roughly one
person had died every day in China from SARS since the beginning of the month. The
WHO statement in this case was based on data that suggested that China was no longer
exporting SARS: its borders had been made impermeable to the disease. The WHO did
118

state that there was still much work to he done in China. however. There were still many
questions as to the disease' s origin. and contagion vectors-that is. who gave the virus to
whom-were murkier in China than almost anywhere else. Some 70% of patients
diagnosed with SARS in Beij ing since May 1'1did not know from whom they had
contracted the virus ("SA RS under control.. ... 2(03).
What didn' t appear to need work was controlling the apparent source of the virus:
the wild game markets and concomitant businesses. Wild game restaurants in Shenzhen.
south China, had been virtually empty for two weeks, some of them despite entirely new
menus that did not feature their standard exotic fare. The markets themselves had faced
similar fortunes: Xinyuan. Guangzhou'« largest wild game market. was now composed of
empty cages , and not of eager buyers, a scene that pleased those who monitored and
attempted to halt wildlife trade (Young 2oo3a).
A scene that pleased the WHO was that of Singapore. which was removed from
the list of SARS-affected countries on the last day of May. Singapore had only 206 cases
and thirty-one deaths before controlling the outbreak. and June was mostly given over to
planning contingencies for future outbreaks. Singapore was especially proactive in
attempting to stymie future reoccurrences of SARS. and planned on implementing
mandatory temperature checks for workers at shipyards. factories . and construction sites
in mid-June. as well as revamping health forms to include recent travel itineraries,
possible contact with SARS-infected people, and current health states. Providing false
information on such forms could result in fines of up to $5.797 and six months' ja il time
("S ingapore May Jail..... 2(03).
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So successful were the anernpts in Asia to control the epidemic that on June It h
the WHO stated that SARS might be coming to an end. Worldwide. only seven new cases
were reported on June n". and though there were still a few places in the world where
the disease remained uncontrolled, the general consensus was that the end was near
(Grauwels 2003).
June' s successes, however. were not equal for every area of the world. While Asia
seemed to have its problems mostly under wraps, Toronto was still in the middle of its
second resurge nce of disease . On the first day of the month, fifteen people had suspected
cases of SARS, bringing the number of second-resurgence probable cases to forty-six.
and 150 others were close ly monitored as possible victim.. r-Canada waits for. .: · 2003).
By Monday. the number of active cases jumped to fifty-two. and the death toll rose by
one. The number of people in quarantine did drop by 2,(XX) people. bringing that total
down to 5.300. hut Ontario's public health commissioner. Dr. Colin D'Cunha. still said
that the province was in a state of "h ypcrvigilancc." and earlier had acknowledged that at
least some of those quarantined had violated their isolation orders ("Anot her SARS
death ..: 20(3 ).
Thesc problem.. with.quarantine violators continued, bringing constant threat of
public exposure to the virus. Ontario health minister TOllYClement became so frustrated
that at one point in early June he threatened to chain people to their beds if they didn' t
follow their isolation orders. He wasn't serious. but his concerns highlighted the
problems Toro nto was facing in controlling the outbreak, and new laws did provide for
fines of up to 53,650 for violators. By the lOthof June the number of active cases had
120

isen to over sixty. and some 6.800 people-an additional l,Sao since the first of the
moruh-c-wcre in quarantine. These figures did not. however. include the 5,000 health care
employees under working quarantine who were required to wear masks, gowns, and
gloves in public. and remain isolated during off-hours ('"Penalize quarantine violators"
200 3).
Almost unbelievably. the Ontario Ministry of Health had to issue a warning to
Toronto hospitals in early June reminding them to comply with provincial anti-SARS
directives. Officials in the Ministry had received reports from nurses at Mount Sinai
Hospital complaining that they had been ordered not to comply with directives that
required them to wear masks, gowns. and gloves-c-contradic tions that meant the possible
exposure to and quarantining of infants, new mothers, and one hundred health-care
employees . At North York General Hospital, nurses complained that their concerns about
SARS re-emerging had been largely ignored by senior staff. and a nursing association
official additiona lly reported that staff had been ordered to tell callers that facilities were
SARS-free. even if said staff believed otherwise ('"Editorial: Eves needs..:' 2003).
More bad news arrived on the to"of June when provincial officials reported that
they had been investigating a new possible SARS cluster in Whitby. Ontario, located
roughly fifty kilometers east of Toronto. If positive. this would have been the third cluster
in Ontario (the first two being the primary and secondary Toronto outbreaks). This new
group of suspected SARS victims consisted of fifteen people who were at the Lakeridge
Health Corporation dialysis unit. all of whom had developed fevers and respiratory
problems. Adding to the severity of this news was the report that a North Caroli na man
121

Taiwan rema ined on the list at this point. and as stated earlier, it was cleared three days
later. The epidemic was contained.
It should come as no surprise. then. that few articles about SARS appeared in the
British Medical Journal in June. and July brought only a single entry: a news story in the
Jul y Ii h edition cover ing the WHO ' s announcement that SARS was over (Fleck 2(03).
There was one major discrepancy to these statements: the June 21' I edition of the 8MJ
was SARS-themed. the cover sporting magnified photographs of the virus and hearing
the heading, "SARS: understanding the coronavirus." The journal carried only a single
news article relating to the disease (evidence that the outbreak was waning). but it did
hear two peer-reviewed papers. nine "Letters," and two reviews. The papers and
"Letters" were all clinical in nature and tone, discussing the positive and negative
strategies adopt ed by various organizations in dealing with the outbreak. and lessons that
could be applied to future diseases in light of what had been learned on a global level in
dealing with SARS. This SARS-themed 8MJ . howeve r. seems out of place when looked
at in the context of the surrounding editions, few of which mentioned the disease (in fact,
only one out of the next five issues referenced it: the aforementioned Jul y Ii h news
entry).
The Lancet did continue to print SARS -related articles throughout June and Jul y.
though in increasingly smaller numbers. The first two issues in June had four articles
each (though two of these eight articles were "News In Brief ' blurbs), But the last two
issues only had three articles between them. and one of those merely mentioned SARS in
the context of a recent ser ies of attacks on the WHO' s health system performance since
123

eponed probl em s moving ware s in Asia. not ing that cell phon e and semiconductor sales
were at new low s (t'Global tech giants.. :' 2(03). In Singapo re. consumer prices as a
whole fell .7 percent in June. desp ite retailers offering rna....ive "a les to lure cu..tcmcrv
("S inga pore prices fall... ·· 2(03).
In Cana da. the S52 ·billio n-do llar touri..m industry was hea vily shake n by the
W HO ' s trave l ad viso ries aga inst Toronto. But Toronto was not the on ly city affected. no r
was On tario the only provi nce to suffer. PEL New Brun..wick. Manitoba. Alberta. and
British Col umb ia also saw a dec line in tou ri..m. and ho tels. restaurants. and touri..t
attraction.. in all five provinces showe d lower profit". Even the Formula On e race in
Montreal-c-an eve nt that norm ally filled al l 20.()(x)of Mon treal' s hotel roo ms with fans­
wa ..n' t ab le to draw its regu lar crow d. Altogether. Ca nadian Tou rism Co mmission
spo kes wo ma n Isabelle Des Cbencs estimated nationw ide lo..se.. at 5300-500 million ove r
the ..hort term. with larger los..cs probable over the ne xt year (t'Ca nadian touri..t
industry.. : ' 2(03).
Air Canada might have been able to claim the largest Canadian losses fro m the
epidemic. and wa s definitely the hardest-hit airl ine in the world, Air Ca nada filed for
bankruptcy protect ion in April afte r reporting 5 150 million in losses due to flight
cancellations. and May bro ught a further 5200 milli on drop in gro.... rece ipts. with similar
lo..scs ex pected for June. Summer bookings were abo weak. leading many to be lieve that
the lo..scs mig ht continue 10 come for some month" ("SA RS fears co ntinue .. .' 2003).
June did. however. look bright for further research on the or igins and
developments of SA RS . Chine ..e animals were alrea dy ..trongly suspected as having
125

passed the virus 10 humans, and in mid-June Yahoo! News covered the WHO' s launching
of a new series of studies designed 10 lest the connection between SARS and other animal
species. The civet cat was already strongly suspected as being the antagonist in the
equation ('"WHO to conduct. .." 2003). The same day also brought an announcement
from Chinese researchers that a potential test for SARS. using antibodies to diagnose the
virus. had been created. Until this point. doctors had been forced to rely on signs of the
disease. such as high white blood cell counts and damaged lungs- signs which could be
misleading (Young 2003 b).
Mid-June also marked a two-day gathering of health officials from around the
world to discuss how to deal with future viral epidemics. Much had been learned from
SARS in terms of controlli ng outbreaks. but delegates were quick to point out that things
could have gone better: Shigeru ami, director for the WHO in the Western Pacific
Region, said, "The SARS epidemic is now coming under control but the fight is by no
means over. SARS is not defeated. other new diseases will threaten us in the future. we
must be better prepared next time" ("Health officials ponder..... 2(0 3). The success of
this gathering was mixed. as the I,OOO-plus attendees left with few new ideas on the
origin of the virus or how it should be eradicated (Krishnan 2003).
What did come of the studies laking place around the world were warnings that
future outbreaks of SARS might be entirely possible, some perhaps as early as a few
month s away. Some theories suggested that there might be a large reservoir of SARS
viruses in China' s animal population that could cross over into the human populat ion at
any given time. Other theories said that the disease was now so widespread that it might
126

e impossible 10 ent irely co ntain. and that it might spring up again during flu seaso ns.
such as wintertime. Man y people also pointed to the rece nt increases in globa l trade of
animals and plants. and the cress-contaminat ion that occ urs from spec ies unintentionall y
let loose in foreign coun tries as problemat ic (Chinoy 2003; Lodge 2(03).
Whether or not such theo ries were valid. what was clear was that SARS had
chan ged the way the wor ld thought abou t disea se. One example of this lay in attempts to
netwo rk thousa nds of personal com puters around the world to form a massive
supercomputer that cou ld be put to the task of crunching drug molecules . Under such a
volu nteer -base d prog ram. the co mputers in peop le's homes and offi ces co uld. during
spare cycles. he downl oaded with so ftware thai wou ld allow them to look for drug
molecules that would bind with disease-associa ted proteins- in essence . to look for
vacc ines and cures . Such netw ork ing was projected to cut the time needed to find
promising dru gs from 1.5 years 10 a few months (Buckle r 20(3).
Thi s reccnccptuali zation of disease was wides pread, In Singapore. a popular
television character named Phua Chu Kang released . with the support of the Health
Ministry. an anti-SA RS rap CD. The lyrics encouraged locals 10 maintain good hygiene
to stop the spread of viral agen ts through phrases such as "S ARS is the virus that I just
wan t to minus" and "Don' t 'kak-pu i' [spit] all over the place, you might us well 'kak-pui'
on my fuce" ("Singapor e' s hip-hop ..:' 2(03). Rarely, if ever , had governments utilized
such methods to spread knowledge. The CD was released just after a ser ies of
crack do wns on public spilling, which had long been a fineab le offe nce in Singapore-
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one CNN.co m news story detailed a man ....'ho was fined $290 for sp itting in a sho pping
district (Szcp 2003a).
Publ ic effo rts to increase awareness and hygiene hadn ' t just stopped at sp itting. In
Singapore. workers at food stalls and construction sites .....ere given twice-dai ly
temperature readings . as were staff at more than one hundred of the city" s hotels.
W idespread pub lic leaflets encouraged people to wash their hands . The govemrnent abo
lau nched a "Happy Toilet" program which gave starred ratings to all public toilets.
informing people of those faci lities that did not meet cleanliness standards. And ear lier in
June. in a move tha t brought mass criticism. health officials began culling the city's
80.00D-plus stray cats in response to China's civet cat-S ARS link stud ies (Szcp 2003a).
O n July 5 th • the W HO decl ared the global SAR S out brea k over after removing
Taiwan from its list. WHO Director General Gro Harlem Brundtland was quick to remind
peo ple. ho.....eve r. that the virus co uld undergo resurge nce jus t as qu ickly if peo ple were
not ca reful: there were still some 200 SARS patie nts in hospitals aroun d the wor ld. any
one of whom

10 recovery seemed clear. and even more likely as Roche Holding AG. the wor ld' s
biggest diagnostic finn. de veloped along-sought- after lest for SARS in mid-July (Shield s
2003). Fast-forward a month. and articles were already hearing head lines such as "The
vanished virus." a piece in TI,e Guardian that came out the same day that China released
its last two SARS patients from the hospital ('The vanished virus" 2003). Warnings
about viral resurgence still abounded. but for many. life had already returned to normal.
Despite these warnings. there were no new SARS cases for the rest of 2003. The
one case thai initially appeared to be an exception to this was announced in Singapore on
September 9 th ("Timeline: Sacs [sic] virus.. 2003). The case involved a postdoctoral
student who worked as a laboratory technician on the Wc...t Nilc virus. Reaction to this
possible new infection was immediat e. but WHO officials were initially unsure of not
only how the man contracted the virus-since his work did not include contact with
SARS-hut whether he actually had the disease. as his symptoms did not include lung
infections or respiratory problems ("Q&A : Sars [sic]" 2(X)3). Health official s in
Singapore confirme d the case as SARS-related. but simultaneousl y staled their
uncertainty about whether this new case signalled a return of SARS. or whether it was
merely an isolated incident resulting from a laboratory accide nt (Szcp 2(X>3 b).
Because of these uncertain ties and the lack of classic symptoms. the WHO
declar ed their refusal to classify the man' s illness as SARS. Instead of reassurin g the
public. this action in some ways only served to increase tension. drawing worldwid e
attent ion towards the difficultie s of diagnosing the disease. Singapore stood behind their
positive diagnosis. citing the two rounds of polymerase chain reaction and serology tests
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conducted on the patient. Th e WHO. co untering such claims. pointed to the small marg in
of error endemic to such tests. Singapo re' s minister of stale for heahh added to the
mudd le hy showing studies that demons trated that five percent of SARS patients durin g
the last outbreak developed a fever, but did not go on to deve lop the disease (Szep
2003 b).
A local investigation into the two laboratories in which the postdoctoral stude nt
worked revealed that one of them did, indeed. abo co nduc t research on SA RS, and thus it
was possible that the studen t had co me into contact with the virus. Logs sho wed that the
studen t visited this lab three days before becomi ng ill. Both lahs were closed in response,
and forty-one people were quarant ined. The WHO , howeve r, still maintained its pos ition
and declared the case "not an international public health co ncern:' say ing travel to
Singapore was safe {Szep 200 3c). Their position seemed validated the next day when the
student co ntinued to recove r from his illness. He had no fever for five days. and the
hosp ital slated him to be released within a few days- a rapid recover y that only further
confirmed the WHO' s suspicions that the man did not have full-blown SARS (Szcp
21XJ3d ).
In response 10 the case-and desp ite the WHO' s dcclurat ions-c-u team of
intern ationa l ex perts was sent to Singapore on Septe mber 15 th 10 investigate the mailer.
Th e team co nsisted of an eleven-member panel cha ired by a WHO biosafet y ex pert, hUI
also co ntained mem bers of the U.S. Centers for Disease Co ntrol and Prevent ion
("S ingapo re, Foreign Expert s... " 2(03). The results of their study, released a wee k later,
stated the case the res ult of a lab acc ident and verified that the stude nt co ntracte d the
130

virus while on the job. Genome sequencing co nfirmed the similarities bet ween the lab
sample and the strain tha t infected the researcher. The stude nt him..e1fh ad fully recovered
by this poin t and had bee n disch arged fro m the hospital. hut the lab where he co ntrac ted
the di..ease wa.... hut down, and the SA RS virus samples conta ined therein ordered
des troye d (Wo ng, Jacqu el ine 200 3).
The study al..o poin ted to a few troub ling detai ls. The acc ident that caused the
student' .. infec tion was the result of cross -contamination between West Nile and SARS
viral samples, ind icating inap propriate proce dure .. in handl ing samples. Antony Della­
Porta. the WHO biosafety expert, stated tha t ..It's obv ious the labs put in enormous effo rt
and d id a fantastic jo b during the SAR S outbreak, but it led to some inco nsis tenc ies
where labs were not rea lly prep ared to handle organisms at tha t level: ' and reco mmende d
stricter guidel ines for lab researchers (Wo ng, Jacquel ine 2003).
At roug hly the same time that Singapore was dealin g with these problems. Hon g
Kong' s Chinese Universit y announced it would be finan cin g a top-le vel SARS
laborator y. desig ned to he fully mo bile and available for usc with in a few months. Suc h a
lab wou ld hopef ully mak e deal ing with future outbreaks far easier, and the planned level ­
three status (the hig hes t international safety grade) would pre vent such occu rrences as
Singa pore's leak t-Hong Kong uni versity.. : ' 200 3). Add itiona l safe ty measures taken by
Hong Kong as a whole included an alert sys tem and increased numb ers of staff at bo rder
checkpoi nts to scree n travelers, in addition to building a center for disease control to
"speed up laborator y tests, strengthe n cont act traci ng and disease invest igations:'

measures against future outbreaks. making sure there were at least 300 rooms with
isolation facilities and an extra 1.290 beds (Luk 2(03).
But perhaps the best news to come from Hong Kong arrived on September 25 111 •
whcn CN N.com covered the announcement that the HIV drug Kalctra. when used in
combination with ribuvirin. had been shown to significantly reduce mortality rates among
SARS victims. Hong Kong hospitals immediately announced that all future SARS
patients would be treated with this cocktail for this reason. as well as the drug
combination reducing the need for steroid use. These announcements came on the tail of
a series of criticisms of Hong Kong' s earlier methods of treatment. which centered
around a cocktail of steroids and ribavirin-not including Kalctra-c-which many experts
deemed ineffective ("Hong Kong to use .." 2003). The new drug combination seemed to
silence critics.
Such a development was no doubt welcome after continued reports that SARS
would likely resurface in future months (Walsh 2(03). The WHO only added fuel to the
fire by announcing that many SARS-Iike disease s were likely to crop up in the next
century, and that mankind needed to prepare for them (Kataria 2(03). As if proving this
statement true, lIong Kong had a small scare in the last few days of the month when
seven men were quarantined after developing high fevers and upper-respiratory-tract
infcctions. Though all seven were soon cleared-thcir symptoms were not SARS­
related- the incident did underline the possibility of a real situation (Sisc i 2(03).
One of the immediately noticeable themes in post-SARS media reports concerned
the assignation of fault and blame. One exa mple of this came from Canada. whose nurses
132

declared Ontario unprepared to deal with a future outbreak due to lack of govern menta l
direction r-N urse, Say Toronto.. ." 2003). Such finger-poi nting was not isolated to North
America . A report released in early Octobe r, 2003, chided Hong Kong for "significant
shortcomings" in the ear ly phases ofSARS, implying that had Hong Kong ' s airports been
better controlled. the virus might not have escaped as it did to more than thirty nat ions
worldwide. Hong Kong residents specifically criticized their government and Chief
ExecutiveTung Chee-hwa for their slow responses. but the report-put together by "an
outside panel of experts 't-c-avoided giving specific names, listing instead Hong Kong' s
"poor links between the health department and private and public hospitals , ineffec tive
chains of command. a lack of cont ingency plans, poor infection control in hospitals and
staff that were not properly trained," while at the same time recog nizing that Ch ina's
secrecy concerning the virus played a large pan in these shortco mings (Bray 2003:
"S ARS report faults..... 2(03).
Other report s faulted the treatments given 10 patients. By the second week in
Octobcr-c-burely three month s after the WHO declared the out break containcd-c-dozcns
of former SARS patients in Hong Kong and China were found to be suffering from
avasc ular necrosis, a form of bone degeneration caused by the ribavir in/steroid cocktail
administered In all infected victims (Lyn 2003b).
Still other reports pointed 10 Chin a' s animal trade market. Banned in May by the
Chinese govern ment after reports that the SARS virus may have come from wild ani mals,
the markets and concomitant anima l trade industry were legalized again in August after
Chi nese expe rts failed to verify the anima l-origin theory . In post-SARS China. the
133

eported cases of children transmitt ing the virus to adults, no evidence of infected
mothe rs transmitting the virus to their unborn children. and no incidences of children
infecting other children ("Report : SARS ...·· 2003).
The last two days of Octo ber brought a flurry of news . the most optimistic of
which carne from the CDC . who stated that the chances of containing a new outbreak of
SARS were much improved. thanks largely to improved global alert systems ("Cha nces
of Containing..... 2003). At the same time. they caut ioned others not to relax their
vigilance. re-emphasiz ing the possibility that the virus could return in the winter months.
Add itional warnings took the form of cautionary rem inders that there was yet no test that
would positively identif y SA RS in the first days of infection (" Keep up the guard..."
!OO3).
A second series of reports had a decidedly pessimistic tone. First came a study
from the U.S. Centers for Disease Control and Prevention that stated China unnecessarily
quarantined thousands of people in its efforts to prevent the spread of SA RS. According
to the study. it was unnecessary to quarantine some two-thirds of the 30.000 peop le
ultimately isolated in Beijing ("China Quarantined Too Many.v." 2003 ). A second study
found that house cats and ferrets could become infected and pass the disease on to other
anima ls. No evidence was found in the study to prove or dispro ve that the virus could be
transmitted to humans from these animal s. and researchers argued publicl y for both sides
(Kahn ! OO3).
The final cautionary tales for October came from Taiwan . whose doctors worri ed
that SARS coul d eas ily return among the three million people expec ted to fall ill during
135

flu seas on. Su lh-jcn. the directo r-gene ral of Taiwan's Center for Disease Cont rol . stated
that the pcuk of the seas on was December 15 th • und Taiwan wou ld resum e temperature
checks in pub lic places by that date to watch out for early signs of an outbreak (v'Fuiwan
Says SARS . .. ·· 2003 ). At the same lime. Health Minister Chen Chie n-jcn dec ided to
retract ear lie r laws requiring com pulsory face rna..ks and blanket quarantines . Suc h
mea..ure.. had earlier proved so frigh tening tha t one man committed suici de afte r learning
thai his fami ly had been diagnosed with SARS . and a woman had threate ned 10 ju mp out
of her ho..pital windo w whe n faced with Taiwan ' s mandatory ten -day qua rantine (Wu
2(X>3). October ..eem cd to end in amb ivalence. the numbe r of po..itive and ca utio nary
articles roughl y balancing.
Con sidering this, the rest of 2003 seemed mild. Indeed . news report s see med to
lessen cons ide rably in Nov ember and December. The only major report I was able 10
gather for these mo nths co ncerned a SA RS vacci ne trial in China. Announ ced in late
November. the human trials (scheduled to comme nce in 2(04) car ne after week s of
studying the effects of ....'eakcned coronaviruscs on animals- stud ies that had shown the
vaccin e very effective on monkeys (t'Ch ina plans SA RS..... 20( 3). In the first phases of
anim al testing. the six rhesus macaques tha t were infected all showed "a de tectable
immune syste m respo nse" against the SARS coronaviruscs -c-a result promising enou gh
to warrant testing the vacc ine on animals more susce ptible to the virus. such as ferrets.
The vaccine not onl y showed promise. bUIco uld he produ ced chea ply. Dr. Andrea
Gambone. head of the re..earch learn cha rged with de veloping the vaccine. sa id that " it
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can be produced in a mill ion vaccine doses easily at very low cost" ("SARS trials Iift.. :'
2(03). If October had ended in ambiv alence. December ended in victo ry.
January of 2W. however. began in fear. By the 12 lh day of the month . there were
three new cases of SARS in China . all in the Guangdon g province. and two scie ntists
researchin g the disear..e in Taiwan and Singapore had also contracted the disease. The first
Chin ese cas e appeared on January 5 th • when a thirt y-two-year-old television prod ucer
somehow contracted the disease. Doctors were puzzled by his case as he had no regular
contact with wild animals. The seco nd case-though it was still only suspected as
SARS-was a twent y-year-old waitress who worked at a restaurant that served dishes
containing exotic foods such as the civet cat. By the time the third case arrived-a thirt y­
five-year-old male suspected of contra cting the virus-the T.V. producer had been
discharged from the hosp ital. but the fear of a new outbreak had already spread.
Guan gdon g official s had already begun a mass culling of civet cats-an effort started in
late 2003 with the revelation of a possible link between the animals and SARS-hut the
exterminations redoubled in effort to the point that one official at the Guangzho u Anti­
SA RS Office told a CNN .cnln reporter that " Basically. most of the civet cats in
Guangdo ng have been slaughte red" (v'Third suspected SARS .. .' 2()()..l).
Mass culling of civet cats was not the only precautio nary measure taken in light of
the new human case s: city cleaners made regular street-sweeping excursions. and
exterminators targeted rats. cockroac hes. flies. and mosquitoes as potential disease
spreaders. The Guangzhou newspaper Y(llI gcht'ug Evening N t'I\'J reported that a city-wide
effort to eliminate rats drew over 10,000 peop le. and warned that more than ten tons of
137

poison-la ced grain had been dep loyed in "millions of placcsv througho ut Guangzhou to

The uncertain ty surrounding this new series of infections did liule to curtail public
constern ation. In a new series of mass cullings, thousa nds of raccoon dogs were gathered
and exterminated to prevent future outbreaks. The WIIO team, having barely arrived in
the province, had yet to determine any connections between the three exta nt cases, and
Dr. Robe rt Breiman did little to assuage fear when he said. "There is certainly no
smoking gun at the moment with any of the three cases that wou ld enable us to say
precisely where they got it.. .. II's still a little bit of a mystery, a bit of what you might
call a jigsaw puzzle and at some point I have a feeling this will all rome together and
maybe be fairly obv ious, but at the moment it's not clear" ("'Origin of ncw. ,;" 2()()..l).
Public perception of this new strain of coro navi rus was only exacerba ted when
two China Southern Airline flight attendants were quara ntined in a Sydney hospital after
returning from China with sore throats and a fever ("'Australia probes two.. : ' 2()()..l).
Their story qu ickly turned positive. as they were released only two days later. on January
16 th • Also on that day. Dr. Robert Breiman announced his WHO team' s initial findings.
which pointed strongly toward an animal origin for this new strain of coronavir us. Their
virolog ic forays uncovered traces of the virus in the restaurant where the twenty-year-old
waitress worked. and anim al cages in the back of the restaurant that were known to
contain civet cats all tested positive for SARS. Breiman also countered his own earlier
public statement in the same interview, stating that the one confir med case of SARS in
2()()..l-the TV producer-seemed "mild er" than the 2003 strain (McDonald 2()().l;
"SA RS virus uncovered .. :' 20Q..t).
139

Anhui. where the mother lived. By the time this news became public knowle dge .
howevcr. both cases were actually weeks old: the nurse cont racted SARS on April S 1h •
and the mother died of SARS-relnted complications on April 19 1h (though the Chine se
Mini stry of Health didn 't publicly confirm this death until the last day of the month) .
Once again. Chinn had kCPI its outbreak secret for a period of lime. and news reports
were quick to point out the consequences of such secrecy in the 2002-2003 outbreak
(""China adm its fif!\t.. : · 200·t; "Two SA RS cases ..:· 20(4).
These new cases wou ld prove to be the last. There was little SARS-related news
in May. save one report that the Chin ese huma n vaccinc trials had been successful. the
study's fou r volun tcers in good condition four days after inoculation (··SARS: Human
vaccine.. ." 2()().l). and a second report that Toronto' s tourism industry was recovering
rapidly (vforonto is back .. ." 2QO..l.).
June' s news was equally light. On the first day uft he month . China announced it
would discontinu e its daily SAR S report as there had been no new cases since the April
outbre aks. and the last SA RS-relnled patient was discharged from the hospita l on May
31sl (t'Chin n 10 stop... ·· 2004 ). Beijing shut down its anti-SARS headquart ers the same
day ('"Beijin g shuts anti-SARS .. :· 20(4).
The rest of the month ' s reports were cong rutulutory in nature: a review of
Toronto's 2003 measures to control the outb reak applauded the cit y on its efforts
(Doheny 2(04): an announcement that scientisis had developed a new method of
detect ing SA RS utilizing a chip that wou ld reduce the length of molecular testing from
one week dow n to three days r-S cfenu- rs Say Develop... ·· 2(04); and an Associa ted
141 J

10 leave them ou t as my arguments deal mainl y with public narratives. and because the
narrati..:es that I did reco ver do not extend past this point in time. My purpo se in creating
such an extended (though admitt edly incomp lete) histor y us this was to create a
corkboard on which I can now proceed to pin the narratives that will become the focus of
the remaining chapters of this work. II is unnecessary to cont inue expan ding this
corkboard. as there arc no narratives past thi.. point in time that deal with the limited
topics with which the media continu ed to report .
There is still one final aspect 10 consider before we move on. and that is the
differences between the media and medical timclincs. Though I on ly examined the
articles thai compri sed the medical timclinc between late March of .2003and the end of
July four month s later. it should be obvious that the pages ofthc Briti."" Medical Journal
and nit,Lancet were almost entirely absent of the rumors, legends. and goss ip that so
permeated newspapers and televised news report s. This is. of course. 10 be expected:
these journals arc scientific in nature. their articles peer-reviewed and carefull y selected.
Still. it is odd that even the news reports that appeared in these journals were free of
disease narratives. focusing instead on an unbiased. accurat e representatio n of facts as
expressed through raw data and summariza tions of key events. Such reportin g stands in
sharp contrast to the news stories published by Yahoo! News. l\lSNB C.com . and
CNN.com. all of .....'hich relayed vernacular narratives. Wh ile the media' s timeline
obviously draws in part on the med ical establi shment' s tell ing of the outbreak. the
medical establishment can hardly be said to recip rocate. These differences in focu s
co incide with what Peter Washer has noted: that "beyo nd the realist global epidem ic of
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(the:d isease) SA RS lies the globalizu tion of the phenomenon of the SARS panic, where
the satura tion and speed of the world news media' s co verage leads to the (supposed) risk
pose d by SARS bei ng .\'Od el/y constructed on a globa l ..calc " (2()().t, 2570) . Th is is not to
...ay that thc med ical timel ine is the "rea list" version. bu t it doc s poin t out that the media's
construction of eve nts co ntributed far more to the socia l con struction of the disease tha n
did its counterpart.
If media sources did nOI exist . or were scvcrely wea kened in influence, and
humans were forced to tum to the page...of academic journals to ret rieve new s on
epidemics. woul d there be as many rumors? The an ...wers to a question ...uch as this can
only ever be spec ulat ive. and wo uld no dou bt vary widely and be argued over
vehe me ntly . But the very fact that a ques tio n such as this cou ld be aske d poi nts to the
corr ela tion between media sources and rumors . Keep ing this in mind, let' ...move into our
first ...tud y.
1-1-1

also true that origin stories have been present in other disease outbreaks. AIDS etiological
narratives have focused on "government cons piracies. African or Haitian AIDS. ' patient
zero' type characteristics. supcrbugs transmitting the virus through bites. Land] hundred-
year-old AIDS cases" (Golds tein 2(X)..t, 77). and arguments over where AIDS came from
and who is to blame for it parallel simi lar speculations about "the bubonic plague.
smallpox. syphilis. and ...influenza" (Go ldstein 200·t, 78). It is the purpose of this chapter
to explore the simi larities between these narrat ives- primarily between AIDS and SARS.
though other diseases will not be ignored-pointing out how. in many cases. the
narratives arc so analogous as to make it seem that the differenceslie o" ly in the name of
the disease .
Wc begin with a look at AIDS. Being a disease that has made newspaper
headlines for a quarter of a century. it should come us no surprise that AIDS has spawned
more origin theories than would comfortably fit in even a largish book. And there have
been dozens ofthese largish books published about them. Goldstein' s 011('(' Upon tl Virus
contains a litany of etiolog ical legends. and the bibliographic entries in chapter 4 of that
hook alene constitute an extraordinary panoply of sources. Specifically. Gold stein states
that there have been three main theories concerning the origins of AIDS :
I. that AIDS has developed from a natural disease previously existing only in
some other species of animal. which has recently managed to infect humans thus
triggering the epidemic ... : 2. that AIDS has developed from a much older human
disease not previously noted by science. either because it has always been
confined to a small group with an acquired immunity or because it has only
recently become virulent...: [nndl J. that AIDS is a man-made virus manufactured
either accidentally or deliberately in a laboratory. (Go ldstein 2(X)..t. 80)
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Bonnie Blair O'Connor' s Healing Tradition... while primarily focusing on the alternative
medicinal responses of the public to AIDS, still mentions the belief.. that I) the di..ease
came from God, whether as a punishment (as in for the gay communit y as penalty for the
licentiou..ness of their lifestyle) or a test of faith. and 2) the disease is the result of
witchcraft practiced again..t the inflicted. including action.. of "evil spirits, demons, the
Devil and witches" ( 1995. 152). Paula Treichler, in How 10 Ha ve Theory ill tJll Epidemic.
notes humankind's continued attempts to blame AIDS on ..omecne else: African
countries blaming other African countries: the U.S. blaming Africa; Ru....ia considering
the di..ease a foreign problem attributable to the CIA or Africa: Caribbean and American
peoples believing the disease came from U.S. biological testing: and the French saying it
originated from an American pollutant (1999. 29-30). Patricia Turner's 1993 / Heard /t
lIIrougll tile Grapevine: Rumor in Afr ican American Cutture disc usses the beliefs held by
African-Americans that AIDS was created as a CIA biowcapon (mirroring thc Russian
belief noted in Treichler), and Gary Alan Fine has extens ively discussed "the allegations
that government conspiracies exist to create or spread the IIIV virus" (2(X)5, 5). So
numerous arc AIDS ..origins" that early attempt ... (0 categorize the supposed sources alien
referred to them as the "4 Hs": homosexuals (especially men), hypodermic needles.
hemoph iliacs, and Haitians (sec Bennett 2005a. 128-9).
Many (If these narratives share threads of conspiratorial paranoia. There arc
numerous examples of stories that revolve around notions of purposeful germ warfare,
where man-made bill-weapons have been set upon certain ethnicitics. countries, and even
age groups. Paul Smith. in '''AIDS- Don' t Die of Ignorance'; Exploring the Cultural
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Co mplex of a Pandemic: ' summarizes exa mples of what he calls a "whole belief system
which focuses on how AIDS developed : ' some of which include that it ",; .is an out-of-
contro l germ warfare virus... it has been put in the fluoride in our water.. .1and) in the
U.S.A.. the Centre for Disease Control put it in K-Y Jell to get at all the homo...exua ls"
( 1990.7-1). Another example of this line of thought can be found in Vanessa Gamble's
"Under the Shadow of Tuskegee: African Americans ami Health Care:' published in the
American Journal of Public Heahh, in which appears the following:
Beliefs about the connection between AIDS and the purposeful destruction of
African Americans should not be cavalierly dismis sed as bizarre and paranoid .
They are held by a significan t number of Black peop le. For exa mple. a 1990
survey conducted by the Southern Chris tian Leaden-hip Conferencefound that
35% of the 1056 Black church members who responded believed that AIDS was a
form of genocide. (1997. 1775)
The beliefs of these respondents. by the way. are justified by history: one of the more
infamous experiments in the la...t one hundred years wa ... the 1932-1972 Tuskegee
Syphilis Study. " in which [-lOO ) African American men who had syphilis were studied to
follow the natural course of the disease. without being given any information about it nor
any trcutmcnt even after antibiotics became avuilublc" (Whatley & Henken 2000. 83).
Thus. for African Americans. believing in AIDS as a bio-weupon could be seen as little
more than a shift in terminology.
Again. AIDS is not the only disease other than SARS to boast etiological legends.
nor arc such legends confined 10 modem epidemics. Pre-Revolutionary France' s houts
with plague. and the nineteenth century's cholera problems generated many accusations
of "voluntary spreaders of the illness. poisoners of fountains. greasers of doo r knobs.
perverse doctors. nurses or grave diggers. killing vaccincc'' tncrce 2003. as quoted in
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for seve ral pages, but it is not my intention to give an exampic of every type of
etiological legend found in the history of disease, nor is it to re-hash what has already
been discussed at length by numerous authors. It is my intention to demo n..trate in this
chapte r that SARS is abo bursting with story. and has many of the same tales told of it
that other disea ..cs share . I am not. it should be made clea r. claiming that there i... a SA RS­
relate d narrative that corresponds to any given narrative from any given di...ea ...e. I am
..taring that SARS has. in its short life. gained a number of etio logical legends. all of
which hear striking rese mblances to those narrative .. found in other diseases.
I collected origin narrat ives from the Internet. from published news sources. and
from perso nal interv iew... in the course of my researc h. Few of these narratives are ... irnilar
at the sentence level- meaning that individual details vary widely and little resemble
those found in other narratives-c-but at the story level they fall mainly under three
headings: "Conspiracy Theories." "Experiments Gone Wrong" (recog nizing the oft-times
thin line that can separate these 1\\'0 categories). and "Animal Origins:'
In fact. I have so few concrete examples thai do not ti t into these categories that
only one seems discussable: that SARS is extraterrestrial in origin. This theory comes
from Cardiff University' s Chandra Wickramasinghe and lute astronomer Fred Hoyle. The
story-repone d in the British tabloid Tile Slin-is that SAR S is an outer-space microbe
that entered Earth' s atmosphere via a cornet or meteorite. This is actually an extension of
a long-debated and non -mainstream scientific theory known as "panspe rmia:' or the
hypothesis that life on Earth began from an extra-solar source. What is perhaps most
interesting about this origin theory is that it did gain some cred it in the scientific
150

community: microbiol ogist Milton Wainwri ght from Sheffield Univers ity has stated that
the expansion of the SARS virus appears to follow general schemes laid down by
panspermic theor ists.
In an email to MSNBC' s Cosmic Log, Brig Klyce of the Cos mic Ancestry
Website furthers his hel ief in Hoyle and Wickra masinghe's hypothesis, writing that the
two scientists "proposed that the link betwee n new flus and China was caused hy the jet
stream's bump over the Himalayas a long time ago... I think it's quite plausible, and
could acco unt for the SA RS epidemic as well" (Boyle 2003). Klyce likens the spread of
SARS to that of the Spanish Flu. which "first struck soldiers in outdoo r training camps in
the Midwest. Later, it struck around the world almost simultaneo usly. but took weeks to
travel from N.Y. to Boston ... And it spread to isolated indiv iduals who never carne into
contact with any infected perso n" (Boyle 2003).
Also interesting in relation to this is a statement from Francis Plumm er, d irector
of Canada's National Microbiology. who voices his doubts concerning the corona virus
origin of SARS. Plummer' s statements, made in April of 2003, revealed that labora tory
work had onl y been able to find evidence of the SARS microbe in 40 % of Canada's
SA RS patients, and that some who tested positive for SA RS showed no symptoms (Boyle
20(3 ). Plummer' s work was later prove n incorrect, with more advanced testing resulting
from better knowledge of the disease. hut suc h state ments seemed on ly to fuel the "SA RS
from the stars" move ment for a short time.
When it comes to conspiracy theories and experiments gone wrong. however.
SARS hulgcs at the scams. Even the acro nym by which the disease is referred to has been
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appropriated in the popular medium to fit in with conspiratorial musings. the letters said
to sta nd for "Saddarn's Aweso me Retaliation Strategy" instead or-Severe Acute
Respiratory Syndro me" (Glazer 2(03). While this appropriation seems to be done most ly
for humorous reasons- as an SMS, or Sho rt Message Service, joke-it still demonstrates
the possibilities inherent in conspiracy. A IDS. too, has such acronymic exam ples: in
1986, young men in Zaire rewrote "S IDA," the Frenc h word for AIDS, to stand for
'''Syndrome lmaginairc pour Dccoumgcr l'Am our " (Imaginary Syndro me to Discourage
Love)" (Wha tley & Henken 2000, 82). The motivatio n beh ind this was twofold. some
believing "that Europea ns were using stories of an imaginary disease to discourage
Africans from being lovers and that (their] motivation stemmed from jea lousy:' wh ile in
America. African-American communities used much the same redefinition to disc uss a
belief that they were being given misinformation 10 prevent them from reproducing
(Whatl ey & Henken 2000, 82).
The appropriation of the SARS acronym does not see m to be the result of any real
fear of Middle-Eastern retaliation (even the one that directly refere nces Saddam Hussein
seems more humoro us than fearful). but there are other conspiracy theories that do appear
to stem from genuine concern. and these range from concerns over govern mental control
to fears of biowca pons. An excellent exam ple of the for mer comes from the website
"Educate- Yourself: ' which contains a section on "E merging Diseases." In this, the
author-"Montalk"-specifically states that SA RS is "simply part of a hostile agenda
imple mented by the world's political and military elite to keep earth's population locked
dow n and under cont rol" (Mo ntalk 2(03). Discussions of the methodo logies implemented
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y the gove rnment to enable such an outcome center around the extreme measures taken
by health officials to prevent mass outbreaks in Toronto in 2003. Montalk ' s view.
however. is that SARS was not dangerous at all, but was promoted as such by the
governmcnt-with the help of tile WHO-to "tenderize" the public into "acce pting
increasingly restrictive cur bs upon their freedoms" (Montalk 2(03). This SARS "test
run," as Montalk refers to it. was a means by which the Ameri can gove rnment could pass
laws that wou ld allow them to quarantine anyone suspected of being infected , as well as
lockdow n entire cities- laws that could be reinforce d at any time with only the slight est
"clev er media hype of any manufactured disease" (Montalk 2003). The entire Toronto
epidemic is furthermore cla imed to be nothing more than a test-targeting exercise in
economic destruction (thoug h the webpuge does not state why the US gove rnment would
specifically target a Canadian city for this purpose).
This. however, is not the only SARS conspiracy theo ry fo und on this wcbpage.
One of the other two examples relates to a larger concept of disease being the possible
result of "v ibrational frequencies" broadcast to a target popu lation via "audio or
microwave subliminals'' (Montalk 2(X)3). This theory does fit into the "fear of
bioweapon" category, Montalk stating at length that:
Because one' s mental and emotional states playa large part in immuni ty. these
subliminal programming techniques would merely have to implant nega tive
tho ughts and emotions in order to pry open a gap in a person ' s awareness for
viruses to then successfully invade the physical bod y. Also. through sheer hysteria
psychosomatic illness can result. a phenomenon which I don 't do ubt has played a
hand in Asian SARS cases. (Montalk 2003. emphasis in original)
The webs ite is not d ear on who is broadcasting these signals. or their purpose in do ing
so. The only hint comes from a suggestion that wc arc all "s upporting the medical
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..ocicty" by watching television- the prima ry tool used to broaden..t these vibrat ional
frequencics.
The ..econd con..piracy theory forwarded by Montalk entails "chenurails,·· or
chemicals that the military has been sprayi ng in our «kic.... ince. accord ing to Educa te­
Yourself. 1998. Visible as vapor-trail-appearing ..treaks of white in the sky. Montalk
claims these chemtrails contain many harmful sub..tancc.. purpo ..ely placed there by the
military . including "immune suppres ..ing chemicals. such a.. ethylene dibromide...radar
and microwave reflective metallic sub..tance (sicI. like barium or aluminum...dielectric
hollow polymer fibers ... land) viral and bacterial vectors remnants [vic] of genetic
engineering and replication procedures used to construct the pathogen ic vectors:' the
ultimate purpo ..e of which is to "sup press human evo lution on a physica l. mental. and
spiritua l level" by performing "tge ne thera py' upon targeted popu lation.. by spraying
them with viral vectors capab le of shutting down the DNA activa tion process in those
infected" (Montalk 2(03). SA RS is not specifica lly stated in this sect ion as being the
re..ult of chcmtrails. but it seems clear that the author docs link the two in terms of the
immune-suppressing effects of the chcmtruil chemicals: we contract SARS because our
immune syste ms have been artificially lowered to sub-s tandard levels .
Not all SARS-re lated co nspiracy theories exhibit the same leve l of organization­
specific blame and paranoia us do those of Montalk. In fact. concern over the vague
nature of the virus was so wides pread in the early ..tagc of the disease that "healt h
officia ls were initially forced to que ll consp iracy theor ies about SA RS being an act of
terrorism" or biological warfare ("SARS outbreak... ·· 2003). a fact noted in a high-profi le
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Australian newspaper. And while some of these rumors did place the blame for the virus
on a specific source, others left the question open-ended. or merely pointed fingers in the
general direction of a geographical region, such as the Middle East or Avian continent.
An exce llent exa mple of this latter fonn of non-specific blaming comes from a
blog entitled "SARS Paranoia: ' wherein the author refutes rumors of the virus being
man-made and a biological weapon. The rumor in question quotes Nikolai Filarov. head
of Moscow' s epidemiological services . who gives the following as grounds for SARS
being man-made: "the composition of SARS is unkown [sic] ... there is no vaccine
available for SARS ... 'The virus. according 10 Academy of Medicine member Sergei
Kolcsnikov. is a cocktail of mumps and measles, whose mix could never appear in
nature?' (Cindy 2003). Nowhere is there a mention of who or which organiza tion could
have masterminded such a fusion of diseases-simply an announcement that it couldn' t
have been done without man' s help.
Astutely, the author of this article-"Cindy"-points out firstly that the
compos ition of SARS is known. presenting the reader with a link to a .pdf document of
the virus's genome. and secondly, makes a direct comparison of this conspiracy theory to
a mid· 1980 ·s rumor that the government had released a "gay" virus (i.e . AIDS) into
bathhouses to rid the "mid of homosexuals. "Of course," she says, "that wasn't the case.
If H1V had gotten as much publicity in it's [sic] first six months of known infection, we
might have a cure by now. Personally, I have a greater fear of coming down with a plain
old cold then [sic ] of contracting the SARS virus" (Cindy 2003). Regardless of the
dubitable nature of the HIV-publicity claims. it is very apparent that by the time this blog
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wax publi shcd-c-v May 2003-SARS-a,,-con"piracy was already entrenched in the public
consciousness. and at least a few peo ple were noticing similar ities betwee n these new
narratives and those they 'd heard abo ut other diseas es.
A seco nd exam ple of this non-specif icblaming cernes from The Rumor Mill
News Reading Room . In an art icle ent itled "S ARS Kills 50% Patient" Over 65 - Perfect
Age-Specific w eapon," the author-c-t'Jzakovic't-c-bcgms by Quoting legitimate WHO
data showing that the SAR S deat h rate was higher than origina lly estimated , and
mortality rates varied by age: "50 % for patients of 65 years or older , 15i}. for peop le from
45 -64, 6'K for patient s from 25-W, and below 1% for patients old (sic ) 25 years or
young er" (Izakovic 2003). Furth er legitimate data is then presented in the fonn of
summarizations of studies publi shed in the UK medical jo urna l The Lancet. which found
that the SARS "co rona virus (sic) samples collected from patients do not show the
mutation s and are remarkably stable" (Jzukovic 2003 l, though lzekovic docs not make
the nature of these mutat ions clear. What he docs clea rly summarize arc The Lancet-
reporte d findings that the stability of the virus poin ts to the strong possibi lity of a viable
vacc ine bein g soon developed.
From this poin t in lzakovics thread, speculation takes over, and I find it
necessary to repr int the entirety of his three-para grap h conclusio n, exac tly as it appears in
his essay :
From this report it is clear that SAR S is not a Chinese bioweapon designed
to target enemy forces becau se it. practically, docs not affect popu lation below 25
which makes bulk of any armed forces. Even co mmanding structure thai is made
most ly of people under oWis safe without any specia l measures.
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On the other hand, stab ility of virus shows that it is ne t a natural mutat ion
and allows for secure vaccine for those in targeted age group that must not
become victims.
Sta bility and age specific death rate. an perfect weapon for age selective
cu lling of older popu lation world -wide . (Izakovic 2003. errors in original)
Again . there is no specific mention of the origin of the virus-simply that it cou ld not
have been natura lly formed . Interestingly. lzakovic' s website . www.deep..pace-t.com.
mention.. not only the chcmtrails-us-disea ..e-origin theory spoken of by Montalk. but the
theory that A IDS was developed by the U.S. government as a method of thinning the
black population-another example of a sing le author using roughly the same narrati ve to
describe multiple disease origins.
So far. the examples I have used implement non-specifi c blame -that is. they say
that while someo ne some where i.. clearly responsible. the authors either do not know
who m to blame. or decline to specula te. There are. however . equally as many exam ples
that do point a figurative finge r at a specific gro up.
The first exam ple here comes aga in from the Rum or Mill News Reading Room .
and is actually a respon se to Montal k' s discussions of chcmtr ails. On the 29 th of
Decemb er. 2(Xn, "Hobie" posted an article declaring that viruses arc in fad so lvents: that
man-made chemica ls in our environment arc causing disease, Hobic' s information co mes
from an article by "A ajun os [sic: actua lly Aajo nus ] Vondc rplanitz," in which this author
cla ims that viruses don't dest roy ce lls. they merely show up whe n ce lls are destroy ed. and
exist primari ly as so lvents that "ca rry toxins into the bloods tream for disposal" (Hobie
2(03). Hobie furthe r quotes an ankle by Jim West. who state s: "The orthodox SA RS
paradigm completely omits and amid.. tox icology for good reason: SA RS disease
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symptoms are ident ical to pesticide and air pol lution disease symp toms. And these
poisons co rrelate in time and place with SAR S epidemics' (Hobie 2(03).
The po inted finge r in this art icle is found later in the extensive quo te from J im
Wes!"s article: airlines are the ones responsible for the outbreak. The reason'? " Airlines
routinely apply pest icides 10 airpla nes. especially tho..e on A..ian routes" (Hobie 2(03),
and the..e pesticides are causing people to become ill. AI least part of West' s claim can be
co nfirmed: a CDC "Travelers' Healt h' release doc s ..tate Ihut many countries requ ire
disinfection of inbound flights. and that the acceptable methods of d i..infecting planes arc
to "eit her spray the aircraft cabin with an aero ..olized insectici de (usually 2% phenothnn)
while passen gers are on boa rd. or treat the uircraft -s [sic ] interior surfaces with a resid ua l
insect icide while the aircraft is em pty" (Ce nters 2006), Thi s C DC release doc s note that
so me flight crew member s have repo rted reac tions 10 the spraying-rashes, lung
irritat ion s. tingling and numbness of extre mities-c-but is qui ck to note "there are no data
10 suppo rt a cause-a nd-e ffec t relation ship" (Cen ters 20(6). und that the WHO declared
this method of disinfection safe in 1995.
A sec ond example of a bla me-specific cons piracy theo ry-agai n from the Rumo r
Mill New s Read ing Roo m-s-comes from author "Rayclan." whose chose n title for his 28
A pril 2003 article details many of the und erl ying issues : " Is SA RS the Bio-Wecpo n I
Was Told Ab ou t in the Early 90s?" Rayelan hegins his article by quo ting from legitima te
news sources such as the Birmingham Post-Herald. who stated in an article " It may he
thai some indi vid uals have a ge netic qu irk that makes them more efficient spreaders of
the virus. some have said, Ot hers specula te that some ethnic or environmental difference
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may acco unt for the hot spo ts" (Raye lan 2(03). A seco nd quote from a legitimate source
comes from the journal Science, which has a detailed paper in its March 1997 edition
concerning a successful ge netic reco nstruction of the virus responsible for the 1918 flu
ep idemic that killed betwee n 20 and 40 million peo ple worldwide. Usi ng information
such as this, Rayelan bui ld!'> an hypothesis that SA RS is, in fact. the newly-cultured 1918
flu virus. and has been genetically altered to infect primarily people of Asia n desce nt.
From here, Rayelan reminds us that many of the North American peoples might
have Asia n DNA as well, as a Disco very Channel program he recen tly watc hed sugges ted
that Nort h, Central and South Amer ica might have been settled by Asia n peoples cross ing
the "Alutian [vic ] Islands" during the last Ice Age. Thus, it is en tirely possi ble that man y
North Ame ricans who do not appear to have any Asian blood in them will be affecte d by
the virus. and so SARS might be part of what Rayclan terms "The Great Dying"; an
Arma geddon -like scenario in which four-fifths of the world's popu lation per ish. Unde r
this scenario, SA RS migh t only be the first in a series of viral waves sent crashing again st
the shores of humanity (Rayela n 20(3)"
Those responsi ble for these viral waves varies, dependi ng largely (apparently) on
who and how man y arc affec ted: if the virus stays mainly within China's borders, then it
was released there by the United Slates in an attempt to slow the progress ion of China' s
economic and politica l importance. However. if thc virus spreads to other nation s and
proves fatal for mill ions, then it was created and released by what Rayelan terms the
"NWO"-New Wor ld Ord er- whose purpose is to weaken the wor ld's population to the
poin t where no nation will be able to withstand the installment of a "One Wor ld
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Government" For reasons not fully fleshed out in this article. Rayclan claims that China
and the former Sov iet Union are the primary members of this New World Order. and
their main target is the United States-the only nation strong enough to withstand their
geopo litical advances.
A conspiracy theory that in many ways echoes the cataclysmic suspicion present
in Rayelan' s narrative comes from Dr. Leonard Horowitz. DMD. MA. MPH . Dr.
Horowitz' s contributions to these proceedings are in many ways singular. for he brings to
the table not only an impressive list of degrees. but is a Harvard graduate in public health.
an "expert in the fields of medical sociology. behav ioral scienc e. and emerg ing diseases"
(Horowitz 2()()..1). and claim s ten bestsell ing books on the subjects of conspiracy . In the
latest of these works. Emerging Yiruses: AIDS c..

simi lar to what Rayclan ment ions: that their "likeliest purpose is in facilitating evol ving
eco nomic and politic al agendas that ultimatel y includ e targe ting approx imately hal f the
worl d's cu rrent population for elimination" (Horowi tz 20(4). This is a requ ired step in
achiev ing globa l domination beca use a sma ller. more frightened popu lation is easie r to
con trol: as Dr. Horowitz poin ts out. we have already learned via the Homeland Security
Act that popu lations under duress are more likely to agree to limitations in freedom in
exchange for grea ter protection-i.e. governmental power and control.
Not all blame-specific conspiracy theories exhibit this level of cataclysmic
paranoia. Th e last two examples in this sect ion are rather mild in compari...on to
Rayela n' s and Dr. Horo witz' s narratives. as neither of them involve glohal attem pts at
wor ld domin ation . Th e first comes from the Assoc iation for Asian Research. which
publi ...hcd an article in late May of 2003 co ncern ing a rumor crea ted by Beijin g of ficia ls
that SARS was not Ch inese in origin. hut had in fact appeare d in the United States in
Februa ry of 2002 . The rumor appear ed in at least four major Hong Kong newspape rs in
early May of 2003 . at least one of which-the Well W{'; Po- is a recog nized mouthpi ece
for the Chinese Communi st Part y. Accordin g 10 the rumor. an American woma n in either
New Jersey or Philadelph ia (depending on the newspaper) fell ill with flu-like symptoms.
then developed acute pneumonia and ex pired within hour s of hospitalization. Th e Well
Wi'; Po was the chief ..ource for the transmiss ion of this rumo r, which pers isted amon g
Co mmunist party officials in Hong Kong despite repen ted denials not only by the U.S.•
hut by other Hong Kong newspape rs. some of who m accurat ely repo rted thai the U.S.
ca...e was not SARS. but meningitis. The rumo r even made its way to the Guangdong
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provin ce, where Provincia l Governor Huang Huahua ment ioned the 2002 Amer ican-
based case of "SARS" during a governmental meetin g in earl y May (Lin 2003).
The last case of a blame-specific conspiracy theory comes from the interview I
conducted with Angel Lim in Jul y of 2005:
Angel: Yeah. I had a friend. we used to get together during Satur day. and
he used to tell me, told me once that SARS originated from the States. the U.S­
The reaso n is because Canada is not a friend o f U.S. Like. when they go to war in
Iraq, Canada didn't go to war to Iraq with the U.S. So that's why the U.S. hates
Canadian. So they produce this SARS to kill some people in Canada.
Jon: Okay. And the seco nd part of that had to do with the Philippines.
Angel: Oh . the Philip pines. yes. He also told me that the Philip pines is
very close to China . and also very close to Hong Kong. And. I think there's only
two people died during the SARS outbreak. right? And aga in. the reason is only
two people has d ied is because the Philippines and the U.S. arc friends. And that's
the reason too.
Jon: So [in] both of these. the U.S. is almost trying 10 get reven ge on the
Canadian s.
Angel: Yes. yes. Right. right. (laughs)
Jon: And because the Philippines are good friends with us. we protect
them .
Angel: Very good friends. yes. They are protected . (200 5)
Echoed in Angel' s narrat ive are many of the concerns that have fueled the conspiracy
theories we have looked at in this chapter: distrust of governments and overly-powerful
organizations, fear of the unknown , conce rn over OIlC ' S own mortality (as well as friends
and family). and apprehen sion at the loss of persona l privacy, all intermingled with points
of blame and counterblamc.
The final category of etiolo gical legends is "Animal Origins ." Diane Gold stein
gives us a succinct summary of the types of beasts that have been assoc iated with the
spread of the A IDS virus: .....monkeys of various types. regional origins. and colors
(African green monk eys, blue monkeys. red monk eys, green-eyes monkeys.
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house cats and ferrets were named as potent ial spreaders of the di..ease. And still the list
grew: in January of 2()()..l. in response 10 the threat of a new outb reak. Guangzhou
officials ordered exterminators to sweep the city' s ..trccts clean. focusing especially on
rats. cockroaches. Flies, and mosquitoes. Finally. at the same lime. government officials
also banned the breeding. sale. distribution. and consumption of civet cat, raccoon dog.
and badger.
My interviewees were also asked if they had heard any origin stories concerning
SARS. Only four of them recollected any of these that involved animals. and they were
surprisingly unified : all four narrati..es circulated around China 's exotic animal markets.
Three of those four interviewees-Angel and Rosita Lim. and Seny Zamora-s-even
specifically ment ioned the civet cat as the animal associated with the spread of the virus."
The fourth interviewee. Jennifer Lim. had this to say: " 1think the one that stayed with
me. with regards to the origin. was that it came from animals. that it had to do with
the...dose contact with exot ic animals in China. like monkeys or geese or something like
that. Just exotic animals. that they were being eaten. or that they were being kept as pets.
or for medicinal uses" (Lim. Jennifer 2(05). Later in the same interview. Jennifer
defended her belief in these narratives by comparing their veracity 10 established fact
concerning the origins of other diseases:
Just because.. .I guess Ebola I think has been sort of linked with monkeys. if I' m
correct, and that I think I sort of also know thai there are certain viruses or
diseases that run through anima l!'. and don't affect them, but then due 10 the sort of
l'l Technicall y. Angel and Rosita said "c ivet rats" and Scny said "cavot cat:' bUI il seems
obvious that they all meant "ci..'et cat," the errors in termino logy no doubt due to my
a..king them in 2005 to recollect the name of an animal they probably hadn't heard in
over a year.
ItH

inc..reas ingly. increasing contact betwee n humans and animals, that we're all of a
..uddcn being expo ..cd to things that have, that might lay dormant in animals. but
..omc how affec t us differently. (Lim. Jenni fer 20( 5)
So while my informa nts ultimately only ca me up with a few sources . they do seem
unified in their ideas. no doubt the result of having hea rd this information from the local
media . And at least one of tho..e informants recognizes that her narrat ive has been shaped
hy her exposu res to simi lar narratives abou t other diseases.
The purpose of this cha pter has been to point out the similarities between these
etiologica l legends. both within a single epidemic ..uch a.. SARS and aero....the disea ..e
spec trum . II ...hou ld be clear afte r these investigation.. that diseasc-relatcd con ...piracy
theories and animal orig in legends do indeed share much in common, and that many of
the narratives found withi n a single epidem ic c1o...ely resemble narratives thai have
sprung from other infectious outbreaks.
There is one final point that can be made co ncerni ng the narratives exa mined
here. While SARS and AIDS legends do share much in common. there is at least one
critical d ifference: while the conspiracy theories that arc ..ccn with other diseases arc
relevant and similar to the ones that are found with SARS, SA RS docs have speci fic
characteristics that shape those theori es in spccificways. being that it waxed and waned
with such rapidity that it becam e diffi cult to ide ntify a potent ial target group. SARS was
never prese nt on a global scale long enough to be directly linked to one group of peo ple,
a fact reflected in the ever-shifting "targets" mentione d in co nspiracy theories: SA RS was
created to kill the elder ly; SARS was created to kill the Chinese ; SARS was crea ted to
kill Canadians: SA RS was created to kill everyone. In contrast. A IDS, in its early stages.
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was linked almost exclusively to the homosexual popula tion. creat ing a direct sense of
"target:' if not "creator" (though this. too. could he argued as definite. considering the
num ber of legends surrou nding the divine origin of AIDS). The amorphousness of the
legends present in SA RS may be due to the sense that the d isease never had a chance to
run its full course : even into the summer of 2()()..J. newspapers were still running stories
about the big outbreaks of SA RS expected during the upcoming winte r-e-ourbreak s that
never came , Whatever the cause. the effect was definite : a series of conspiracy theorie s
that stumble over each other-and somet imes them selves. as with Rayelan' s narrative ­
in attempts to place blame and merit. The consequent multiplicity of potentially targeted
peoples. while confusi ng. does by itself revea l an interesting under lying facet of
conspiracy theories : that even if there is not a clear sense of who is being targeted. there
is always a passio n for the conspiracy itself.
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Cha pter 5: We Gat her Toget her: SARS and Pub lic Space
The common threads between SARS narratives and the genre of contemporary
legcnd as a whole arc not limited to AIDS. or to diseases in general. While the previo us
chapter focused on etiological legends and the commonali ties between those related to
SARS and other diseases, the current chapter focuses on issues of physical locations
where large numbers of people congregate. These gathering places, especially those
pertaining to and involving people of Asian descent. were the nexus of many SARS
narratives. providing a seeming feeding ground for public rumors. Especially releva nt are
Asian food establishments. such as Toronto' s Ruby Chinese Restaurant. which collapsed
financially due to rumors of a SARS -infected chef.
For the purposes of this chapter . I define a gathering place as any stable business.
organization. or conglomerate of smaller businesses that are fixed in space. Restaurants.
marketplaces. bars. and malls fit under this definition. as de schools and hospitals.
Mcagban Morris has noted exactly this in "Things To Do With Shopping Centres."
wherein she states. "The use of centres as meeting places (and sometimes for free warmth
and shelter) by young people. pensioners. the unemployed and the homeless is 3 familiar
pan of the socia l function [of those tocatcsj -. often planned for. now. by centre
management (distribution of benches. video games. security guards)" ( 1999.397). I leave
aside for the moment discussions of mobile locations and businesses such as airp lanes.
busses. and taxicabs. as those will be a central focus of the following chapter. Also
temporarily set aside will be those buildings that cons titute integral parts of these motile
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usin esses. such as airports and bus terminals. A non-motil e gatheri ng place may thus be
thought of a a buildin g or collec tion of businesses that are largel y immob ile or
tempo rally table: they are located at the same phy...ical space at any point in time
(ass uming the busi nesses are still viable). and do not. as a critical part of their ope ration....
offer transportation services to the pub lic.
Such businesses are widely prese nt in con temporary legends, and many specific
exa mples of lege nds center around persons of Asian descen t- such as the numerous
narra tives invo lving the d iscovery of vario us parts of rodents or domestic pets in the
refrigerators or meals of Chin ese restaurants. Just as one of the unde rlying concerns
present in the "Chinese Restaurant" legend (and its variants) is the con traction of disease .
SARS brought abo ut the creat ion of dozens. if not hundreds of rumors conce rn ing the
dangerou s potent ial ju xtaposition of large numb ers of people. Asian or otherwise. and the
coronavirus. These new SARS legends not onl y bear ...triking resemb lances to the
vers ions that have been around for decades. but carry the same basic warn ing: beware of
other people.
There arc also. as we have seen in the previou s chapters. numero us legends
concerning the contraction of AIDS by an unwitting victim. One of the key differen ces
between A IDS and SARS is that. while the former is almost exclusive ly co ntracted
through bod ily fluid exchange- mainly blood and semen-the latter virus is airborne .
and thus it is possible for a person to become infecte d by only be ing in the same physical
loca tion as a carr ier. No matter how unli kely the chances of this happening (one
new...letter proclaimed that the average perso n had a better cha nce of winning the
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Powcrfialllottery than of contracting SARS from standing next to a coughing strunger-c-
see New Milford Visiting Nurse Assoc iation 2(03). the possibility is there. and this
seems to have mutated the nature of many of the "gathering place" narratives that SARS
borro wed from the contemporary legend genre.
First. however. we take a look at non-SARS gathering place legends as a whole.
exami ning the key features and stories that make up these narratives. An easy way to stan
such an examination is through an exam ple. and so I offe r the following. being an extract
from an 1888 poem titled "My Other Chinec Cook:' by James Brunton Stephe ns;
"Go. do as you are bid: ' I cried. "we wait for no reply;
Go ! let us have tea early. and another rabbit pic!"
Oh. that I had stopped his answer! But it came out with a run;
"Last-a week-a plenty pupp y; this-a week-a puppy done!"
Just then my wife. my love. my life. the apple of mine eye,
Was seized with what seemed "mal-dc-mcr.t'c-r'sick transit' rabbit pie!
(Brunvand 1986. 102)
This poem is admittedly problematic as an opening exa mple for several reasons. mainly
that the action docs not occur in a gatherin g place. and there is not an explicit mention of
disease as a consequence of action (though the wife' s becomin g ill after learning the
species of animal she has been eating hints in that direction). However. the overt
stereotyping and racism present here docs closely resemb le what might he found in a
more modem version of the legend. and we still have the basic theme of Asian people
serving forhidde n (by Western standards) foods to unsuspecting patrons.
An example that more closely resembles the gathering-place narratives outlined
above comes from author Mark Twain. who related in Chapter 50lof Roughing It . a near-
encounter with rodents at the grocery store of one Mr. Ah Sing in Virginia City. Nevada.
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After sampling and enjoying Mr. Sing' s brandies. T wain and his co mpanio ns were
offered "a mess of birds' -nests: also. small. neat sausages. of which we could have
swallowe d several yards if we had chose n to try. but we suspected that each link
contained the corpse of a mouse. and therefore refrained " (2003 . 353) . lA.G. Roberts. in
Chit/a to Chinatown. offers an eve n mo re modem and exe mplary narrative. gathered from
the pages of Saga staeazine. where a reader reca lls her husban d wanting 10 get Ch inese
takeout despit e stories which were "rife of people who ate Chi nese food getting bones
stuck in their throa ts which were later identified not as chic ken bones . but cats' or even
rats' hones" (2002 . 178).
These last two narratives very adequately summarize the Ch inese restaura nt
legend as it has appeared for severa l decades now . Paul Smith, in The Hook ofNasty
u gt'fIlJ.\'. gives what might he the ideal. Platonic form of the narrative: a group of friends
arc at a Chinese restaurant enjoying their food when one of them hegins 10 choke. The
victim is rushed to a loca l hospital where a surgeon removes a small hone from his or her
throat. The hone is sent for analysis. and the returned report slates that it came fro m a rat.
As Smith co ncludes the story, "The public health department immediat ely visited the
restaur ant 10 inspect the kitchens and in the fridge they found numerou s tins of cat food ,
half an Alsat ian dog and several rats all wailing to be served up" (Smith 1984. 54 ).
Th e ending to this version of the story neatly tics together the mystery of tile rat
bone' s ori gin with the distrust of foreig ners thai see ms to plague co mcmpo rary legends.
or what Smith ca lls "our irrational fear of the unknown and exo tic imp inging on our
traditional way of life" (S mith 1984. 54 ). Even bette r. Smi th's end ing gives the reader a
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sense of the true disgusting nature of Ch inese restau rants: that they not only eat rats. but
dogs and cat food as well . Thi s legend. as Sm ith states. has been circulating in the British
Isles since the 1950 ·s. and is well-known throu gh Europe as a whole- though the
ethn icity of the offend ing restaur ateu rs docs vary. as doc s the denouement: some times the
meat served to the patron s is in fact their own pet dog. coo ked up for them as the resu lt of
a language harrier with a fore ign waiter who interp reted "Feed my dog" as "Feed me my
dog: '
In the examples given so far. the co nnect ion betwee n gathering place and disease
has been inferred. for the most pan: the closest any victim has gotten to being " ill"
invo lved choking or vomitin g. both of wh ich are co nditions that can he eas ily and
rela tively quickly remedied . Other legend s are not so timoro us about the dangers of
gathering places. A searc h in July of 2007 of snopcs.c om's index using only the word
'"A IDS"' turned up at least five examples. Consider. for instance. the legends abo ut AIDS-
infected needles stuck into the seats at movie theaters at just the precise angles so as to
penetrate into unsuspecting patrons' derrieres. Variants of this legend that involve
needles in puyphonc coin slots. or taped 10 gas pump handles wou ld also apply. if
telephone booth s and gas stations are co nsidered as tempo rally-d isplaced gatheri ng places
(i.c . while at any given time only one person may be occ upying the space. over the course
of a da y several dozen peop le will have occupied il).7 A fourt h example (coun ting the
payphon e slo t and gas pump handle variants as separa te narratives) invol ves lII V-
7 For an exa mina tion of this phenomenon as recog nized and utili zed in traditional
practice. sec Lynne McNeill' s upcomin g art id e "Portable Place...: Serial Co llabora tion
and the C reation of a New Sense of Place" in We.\tan Folklore 66.3/4.
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pos itive blood being slipped into ketc hup dispens ers at restaur ants. and a fifth involves
mv-pc sit ive semen turni ng up in the ga rlic sauce at a local pizza jo int. C learly, gat heri ng
places and AIDS go hand- in-hand: what bette r way for the antagonist to infect others but
to place the vim ...in a loc ation where dozens of peop le can 't help bu t come into contact
with it every day? It is this same logic that might be found in legends surrounding
Church's Chicken, as detailed by Patricia A. Turner in t Heard It Tlmmgh the Grapevine:
that the Ku Klux Klan had put either spices or drug .. into the chicken "thai would cause
..terili ty in black male caters " (1993, 139).
It ..hou ld be ex plic itly stated here that the con ..cqucruial resu lts of being in a
gathering place are not always inten ded. Many legends do invo lve victims coming to
intentional harm at the hands of an antago nist-c-i.e. A IDS-i nfected needles left in public
places-bu t others involve vict ims suffering unin tended misfort une. The Chinese
resta ura nt stor ies mig ht fall und er this category, depend ing on how the story is told and
where it is set. Rat s, cats, and do gs all have long and recogni zed histories as food stuffs in
China-cspecially in the southern pro vinces (c.f Rob erts, J.A.G. 2002, 20)-and some
restaurants in China still serve rats in modem times. as reported in the Wall Stree t
JOl/rIlal in 199 1 (c.f "C hinese restaur ant rats.. :' 1994 ). It is conceivable for a Western er
to wander into this resta urant and order a dish wit ho ut knowin g its nature. and the logica l
reve rse of this happen s in some legends: that a Chinese cook in No rth Am erica. no t
knowing that rats arc /101 eate n here. pe rhaps because he docs not speak English. simply
continues to lise them in his mea ls as he has always do ne.
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It is also entirely poss ible that the relevanc y of the danger in the gathe ring place
ha.. Iinle to do with disease . Many contempo rary legends detail public-space harm that is
devo id of mention (or inference ) of viruses or bacteria. but specifically mention
dangerous anima ls. such as "The Haple.... Waterskier: ' or "T he Incautiou.. Sw immer : '
both of which involve water-sport participant .. at local lakes or ..wimmin g holes who dive
or fall into a bed of water mocca sins (or some other specie.. of water-bound poisonous
snake)"Also included in this category are the multipl e variant s of animal-in-store­
merchandi se legend s: "The Snake in the Blanket:' "The Spider in the Yucca: ' "Spiders in
Cacti:' "Snake.. in Dry Good s:' "T he Creepin g Comforter:' and "Snakes Alive'," to
name a few (c.f Brunvand 1986: Brunvand :!()()..t).
Finally, contemporary legend is abo full of narratives that involve non-disease ­
related public-space harm caused by other human s. Because the numbers of legends that
fall under this catego ry arc numerous. I will limit my exa mples to only a few. and focus
specifica lly on those that occur in shop ping malls. Outside of the workplace . malls arc
one of the most commonly-visited public gathering places for the general populace. The
larger malls in North America arc designed to easily accommodate seve ral thousand
people at any give n point in time, and even small-scale malls can comfort ably fit a
hundred patrons . Such spots as these are rife for legend. It is human nature to be
suspicious of those we don 't know (de Vos 1996). and in malls , we arc surrounded by
scores upon scores of unfa miliar souls. any of whom may-at least in lcgcnd-c-turn out to
have ulterior motive s. So it should come as no surprise that narratives such as this one
have been making the round s:
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I ju...t heard on the radio about a lady that was asked to sniff a bottle of
perfume that another woman was selling for S8.00 (In a mall parking lot). She
told the story that it was her last bottle of perfume that sells for S49.00 but she
was getting rid of it for only S8.00. sound legitimate?
That's what the victim thought. but when she awoke she found out that her
car had been moved to another parking area and ...he was missing all her money
that was in her wallet (total of S800.(XJ). Pretty sleep for a ...niff of perfume!
Anyway. the perfume wasn't perfume at all. it was some kind of ether or
strong substance to cause anyone who breathes the fumes to black out. (Brunvand
200-t 245)
The protagoni ...t's ultimate motive in thi......tory-rubbery-is fairly benign . when
compared to some of the other fates that befall people in ...hopping malls. Take. for
examp le. the following plots of legends: women getting abducted after being lured into
the parking lot with promises of cash and fame if they' ll appear in a comme rcial being
filmed outside: ankle-slashers hiding under people's cars; the man who helps fix the
woman's mysteriously Oat tire turns out to have a knife and length of rope in his
briefcase: ...mall girls go rni...sing. to be found a half-hour later drugged. disguised. and
being smuggled out of the mall to be sold into white slavery rings: and a small hoy goes
missing. to be found minutes later in the bathroom. surrounded by black gang members
who have kidnapped him so they can castrate him. The list could extend for page...and
pages.
What is clear. however. is that gathering places arc commonly equated with
danger in contemporary legends. Nowhere is this me re present than in SARS. though it
should be immediately noted that the narratives that will follow are not limited 10 the
legend genre. but include hoaxes. rumor. and gos...ip: the critical commonality is the
gathering place. One crucia l difference betwee n the legends that have been discussed so
far in this chapter and what is 10 follow is that while the link between gathering places
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and dange r in contemporary legend may be either overt or merely suggested. and while
the nature of that danger may be human. animal. or viral in origin. SARS narratives are
marked by a luck of ambivalence: the danger is definite, the danger is here. and the
danger is other people.
As cha pter three 's timeline detailed. widespread public knowledge of the
existence of SARS can be definitively traced to February zs". 2003. when an emerging
Chinese disease was given its now-infamous namc. The earliest any citizen of Canada
could have come into persona l contact with the disease inside that count ry was roughly
two weeks later. the first reports of SARS coming from Toronto on the l-tlhof March.
Two weeks after that. Chinese businesses in Toronto were already feeling the effects. An
article in thc Toronto Star on the 29 th of March noted that Toronto' s Pacific Mall-North
America' s largest indoor Asian shopping mall-was virtually empty. with some stores
claiming sales drops of seventy percent (Oliveira 2003). This is quite a feat for a 4

March. thousands of Ontarians had been ordered into self-quarantine. and the WHO had
asked Canada to begin screening passengers for SARS. Desp ite the low numbers of
Canadian cases and dea ths. the public had learned from local and worldw ide
governmental warni ngs that the potential for SARS was massive. and responded in kind.
Part of this response included the dissemi nation of rumors. and according to mercha nts at
the Pacific Mall. the sing le largest source of rumors was the Internet (Oliveira 2003).
Also affected by this point in time was Toronto's Ruby Chinese Restaurant. and
again the staff pointed towards email as the source of their problems : "Some lawless
people spread rumours through the Internet that a staff member from our restaura nt
contracted the virus:' said Frankie Lee. a spokesperson for the restaurant. " In addi tion to
attacking our business' image. they cause d unnecessa ry public panic and affected the
whole

placed under immediate quarantine. The hoax triggered massive and widespread panic:
already frightened by the March 3'''' news that an entire apartment complex had been
placed under quarantine. Hong Kong residents swept grocery store shelves dry of canned
and preserved goods. and financial and stock markets plummcted-c-inc luding the Hong
Kong dollar. Local authorities were forced into immediate action to counter the rumors.
Director of Health Margaret Chan making a public statement that there was "no plan to
declare 1I0ng Kong an infected area. We have adequate supplies to provide the needs of
1I0ng Kong citizens and there is no need for any panic run on food" (Lyn 2003c) .
The same day. a reporter for CNN residing in Hong Kong noted the drastic
cha nges in the public that had happened in only the last week. The presence of surgical
facemasks, he noted. had increased from ncar-zero to near-ubiquitous: he had even taken
to wearing one. despite his initial skepticism of their usefulness. Most telling for the
perception of danger in gathering places was an account from a Hong Kong friend of his
who had traveled to his company's Singapore offices for business. Upon arriving. he was
"politely requested' not to enter the offices. as news of his arrival hold frightened local
employees (Havcly 20(3 ). In the desire to provide for the safety of those who were
forced to gather in groups because of business. even the most remote possibility of
infection had to be countered.
Back in North America. an apparent April Fool's jo ke posted on a Massachusetts
Institute of Technology website in Bou on.Massachusens. caused an uproar simi lar in
nature- though not in scope-to the one in Hong Kong. The website claimed that an
emp loyee of the China Pearl restaurant had been infected with SARS. and advised against
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visiting Chinatow n in general. Again. those who read the warning heeded its advice and
pa....sed it on to others-though it is unclear whether that was out of belief or a simple
"better safe than sorry" mindset. The effect on the Chinese community was immediate.
the China Pearl restaurant's business dropping by seventy percent overnight . and other
businesses in the area report ing similar damage . As one article put it. "There can actually
be legal parking spaces found in Chinatown throughout the day. a clear sign that the April
Fool's joke has damaged the normally bustling businc's community " ("Chinatown
businesses hurt..." 2(03). Local business leaders were. after a few weeks. able to correct
the situatio n. thanks in pan to a seminar conducted at the China Pearl to denounce the
rumors. and fact sheets printed up by health officia l... and dissemina ted to Boston' s
businesses and schools.
Next door to Massachusetts. New York' , Chinatowns reported similar rumors.
some of which were also attributed 10 April Fool's jo kes. Though none were considered
humorou s by the business owners who were affected by them. one in particular was
immediately damaging:
For those of you who cal in chinatown Isic ]. plcusc be advised for that
[sic ] SARS has hit that area. As of today I heard that the owner's sorus) & the
enure staff of the restaurant BO KY located on Bayard st. [sic] bIt Mou &
Mulberry SIS.has been infected with the SARS [sic]. The owner was infected &
has passed away recently due to what have seemed to be Ilu like symptoms. I
think its [vic] best that you either stay away from that area or cat in,
Please pass this along for those who I might have missed. (Emery. David
2(03)
This rumor. circulated not only on the Internet. but by New York' s Chinese press. who
had picked it up off the web. came as quite a shock to Mr. Chivy Ngo. owner of the 8 0
Ky. who received condolence calls and flowers from even close friends. Though all of the
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umors were quickly dealt with. the damage had been done: the public stopped coming.
Even store owners were prey to the fear. Kay Cheng. the manag er of New York ' s
Exce llent Pork Cho p House. admi tted 10 a reporter thai he stayed in his house on his days
off. too afraid to leave lest he catch the bug (Saulny 200 3).
Businesses continued to falter around the globe as Apri l marched on. On the third
day of the month, TIle AXe. an Australian newspaper. picked up a Reuters story thai
carefu lly detailed the Hong Kong scenario. The picture it painted was grim : businesses of
all types were being forced 10 drastical ly alter their daily routines because of customer
lossc... Ca lifornia Red. one of Hong Kong' s largest karaoke bars. normal ly bust ling with
activity. was forced 10 temporarily close three of its twelve outlets-s-and this after
spe nding 11K S I million (US S I28.2(0) 10 disinfect the parlors. buy disposab le paper
caps for thei r microphones. and publicize their clean-up efforts. Normally-crowded
marketplaceslike the Causeway Bay were now pop ulated by spar..e. mask-wearing and
fast-moving groups. Local gyms were nearly empty. and the few clients who did still
exercise wore masks while doing so. Receipts at bars and restaurants in the trendy Lan
Kwai Fong district were down by forty percent or more from the same period a year
earlier- normally one of the busiest tourist seasons. as visitors come from ove rscas to
watch the Hong Kong Seve ns rugby tournament. Restaurants of all types reponed so few
customers that many establishments closed down their buffets to stem food spoilage.
City-wide. employees worked half-shifts or took unpaid leaves of absence to avo id being
laid off because of the losses. Yu Pang Chun. chairman of the Hong Kong Retail
Management Associat ion. called it "the worst crisis we've had. worse than the Asian
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financial crisis. the bursting of the dotcom bubble and the 9/1 I attacks in the US" ("Hong
Kongcrs shun..:· 2(03).
On April 8 of 2003 . ABC News reported on the eco nomic losses in Boston. New
York. and San Francisco. revisi ting many of the bu..messes reported on earlier in this
chap ter. Their investigatio ns still showed wides pread fear of public places. as evide nced
by mostly -em pty stores across the nation. Chinato wns in many major cities were hit
especia lly hard. Boston' s Chin a Pearl restaurant was still at this point suffering from the
April Fool 's jo ke mentio ned earl ier. and estimated their business was still suffering from
..eventy percent losses. Surrounding stores were expe riencing a simi lar backla ..h by
a....ocia tion. Across the country. San Francisco sales of ..urgical rna..h . rubbing alcohol
swabs. and latex glove, were brisk. but restaurants. grocery stores and tourist shops
weren' t faring well. The only positive note WJs that Chivy Ngo's Bo Ky restaurant in
New York had rebounded from its initial losscs, thanks to comm unity leaders and news
reports exposing the hoax (Emery. Theo 2003).
April' s news also brought report s of other Asian markets suffering losses in
California. The first of these arose in Sacram ento County. the rumors this time focusing
on Wclco' s Fruitridge and Del Rio Avenue stores, both ow ned by brothers Jimmy and
Tomm y Phong. Spread initially and predominantly by email, the hoax claim ed that
Tomm y had died of SARS. his wife was in critical condition in the hospital . the
employees at both stores were all infected. and police had been forced to shut the
businesses down. Sacramento Count y Health Officer Glennah Troche t was quick to
stym ie the rumor in an interview. noting that Sacramento Coun ty as a whole had only a
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single case of SARS. and that case I) was unrelated to any Asian market. and 2) had been
handled efficiently. with the patie nt recovering well. Neverthel ess. locals began avoid ing
not only the Phong brothers' businesses. but surround ing establishments as well. Hoang
Van Nguyen. a resident of the area. stated that he had stopped shopping in local stores
bec ause the message frightened him: "S ince this stuff is going on. I have been reluctant to
go there as much as I used to" (Griffith 2003 ).
The second California-related rumor sprung up several hundred miles south in the
city of San Gabriel. located in Los Angeles count y. An ema il versio n of the rumor closely
matches that found in relation to Mr. Ngo's Bo Ky restaurant in New York. though with
different details and a longer plea for action:
The SARS disease has spread to our neigh bor . Today 4·3· 2003. the police
has [sic] shut down Hawaii and San Gabr iel Superm arket due to the employee
somehow got hit by this virus. Also one of the chief [sic ] at Capital restaurant in
Alhambra also got this virus. The Sam Woo restaurant in the FOCUS plaza was
close [sic] early today to avoid getting it.
Friends. please take care of yourself [sic] and your family. Avoid going to
ASIAN areas !l! This is very serious about life and death and spreading them 10
the love [sic] one. Pay dose attention to the Chinese newspaper and be alert about
this deadly virus. Please pass this message to all of your friends so they can
protect their love [sic] one too. (Emery. David 2(03)
The article that covered this story-gathered from the debunking website
urbante gend s.about.co m--opened its comments section with a quote from an Agence
Francc-Pressc d ispatch: "Fe ar of the SARS virus is becoming a more dangerous epidemic
than the disease itself:' This indeed seems true. as the article went on to note that. as of
mid-April. not on ly had all of the rumors been found wanting for truth. but vno cases of
SA RS [bad] been found in any Chinat own in the United States" (Emery. David 2003 ).
Despite this. version s of "SARS in Chin atown! " rumors had been collected in San
181

Francisco. Las Vegas. Sacramento. and Basion (Emery. David 2CMJ), as well as
Honolulu. Hawaii (New Milford Visiting Nurse Association 2(03). Canada had also been
hit by rumor emails at this point. of course. and the narrative popped up across the
Atlantic only a few days later. when Britain' s Chinese restaurants began suffering losses
in customers. prompting atleast one establishment 10 place an advertisement in a Chinese
newspa per denyi ng that staff members had contracted the virus (Vasagar 2(03).
This wasn' t to be the end of the SARS rumor mill's run. Possib ly the worst of the
individual scenarios I collected happened at the end of April 2003. when a man at the
Taipei Municipal Hoping Hospital (TMHH)-already beleaguered by rumors of SARS
dcaths-c-reacted to an apparently untrue story thai his wife had contracted SARS by
hanging himself. TMHH staff. reacting to both the untrue SARS rumors and the true
suicide rumor. attempted 10 force their way out of the hospital when authorities scaled it
off to investigate the man's death. Within a matter of hours the incident was brought to
the attention of a US CDC official slaying in Taiwan. who immediately reported back 10
his headquarters that the entire city was "out of order." It look the intervention of Lee
Luug-tcng, Deputy Director-General of the Department of Health in Taipei, to set matters
straight. though that only happened after two CDC officials visited the TMHH to assess
the situation (Chen 2(03).
Rumors such as these spread throughou t Asia. but affected China most heavily.
Hospitals in Beijing were quaranti ned on what seemed a weekly basis in April. and
workers refused 10 show up for shifts. Restaurants. theaters and shopping malls stood
empty. Elementary and middle schools closed for two weeks. Some universities confined
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..tudcnts to cam pu.. 10 prevent anyone from bringing in the virus. Entire villages near the
city were block aded by citizens who refused to allow outsiders to enter. fearing the
fKls..ibility of an outbreak. Tho se who were able left the city. and pes...ibly the count ry. So
dcva...tating were the rumors and concomitant fear that by early May. Citigroup had
lowered its estimate of Ch ina' s :2003 economic growth from 8% 10 6.5% ( Beech :2003).
Nowhere in the world was the link betwee n gathering places and fear ..0 omnipresent.
The SARS narrati ves used in this chap ter have 10 this point been gathered from
media sources and the lntemet. and have been placed in a rough chrono logical order. I
will ..top my examination of rumors from these sources at this point-e-bot h in this chap ter
and in the SARS timeline-c-as it ...hould be obvious by now that many SA RS narratives
do exhibit a correlation betwe en danger and gathering places. In addilion. most of the
collec ted narrat ives from media and Internet sources thai arose after early May of 2003
follow the same basic format as the examples I have already listed: empty shopping
malls. grocery stores. and restaurants. most of which arc located in predo minantly Asian
section.. of large cities.
There i.. still one group of narratives remaining to he examined: those gathered
from lily informants. Some of these narratives follow the same bu...ic format as those that
have already been listed. but there are a few that ...tand out. whether they arc unique or
simply excellent examples of their kind. One informant. Mike. was working as an EMT
in Toronto during the outbrea k. Mike mentioned the abandone d nature of Chinato wn
(though he could not recall avoiding it him...elf. nor cou ld he rememher any of his friends
pllrpo..c1y not going to those areas) . but mo..t pre....ing nrc his experiences a.. a parame dic
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during this time. and how he was perceived by thc public. Some of Mike' s narratives
were second-hand: stories from other medical personnel concerning patients in hospitals
and nursing homes whose families did not visit them during the outbreak. But the larger
number of his stories involved persona l experiences. especially when he was working in
his capacity as a paramedic.
Mike was quarantined in mid-March because hc had entered Scarborough Grace
hospital without wearing a mask and gown. He had been authorized to do this. but was
informed a fcw days later that all personnel who had not been protected. despite the
authorization. were to enter into quarantine. When he returned to work "about seven-and­
a-half days" later. his working environ ment "progressed sort of from wearing masks in all
calls to wearing a mask and gown; up to mask. gown. gloves; then double-gow ning.
double-gloving. face shields. hoods: and then other calls wc worc full Tyvck suits. so full
head-to-toe. sort of like the fellows in the E.T. movie" (Larsen 2005). Aside from the hot
and stifling nature of such protection. Mike commented that public reaction to medical
personnel was affected dramatically by these suits: "There was sort of an air of
apprehension. there was an ' I don' t know' to it. and of course media. all the footage. the
transfer footage. the response footage. we're the guys outside, so we're the easiest ones to
videotape. to record in our big hoods and gowns and masks. and so there' s the association
there" (Larsen 2005). Additionally. Mike recalled "people... walking towards me. and
crossing the street. even though I was by myself and there were no patients around. there
was no one ill. Or people cover ing their face in their elbow. sort of the pit of their elbow.
or holding their jacket sleeves and whatnot over their face. sort of to prevent themselves
184

from breathing in ncar me" (Larse n 2005). Mike' ...mother. by simple dint of a......ocia tio n.
was also treate d differently at work. as she wa...ccns tamly que...tioncd by cowo rkers and
manager...as to when was the last time she had ...cen Mike. a...her answer cou ld mean
po...... ible enda nge rment for peop le in her of fice bui lding .
But the mo...t extreme cascs of fea r were reported to me by my interviewees Angel
and Ros ita Lim. Angel freely reported being ...o concerned about contracting SARS that
his fears went well beyond mere gathering place ....and included quite literally any public
space out side of his house . For "around ...ix or seven month ..·· Angel and Rosita
"basically... sta yed home. Like even Saturday we neve r [went] out:' and they "tried to
amid peop le co ming to the house " (Lim. Angel and Rc sita 2005) as well. Angel ...eern...to
have bee n the main source of these actio ns. as described by his wife : "For me. I' m not a
worrier. but it affec ted me beca u...e it affecte d IAnge lI. prcu y much. beca u..c he o he.
we didn' t go out anymore . He ...toc kcd up on water. He had thi...great big sign po ted on
the hou ...c: ' Wa..h your hands.' (laugh) Even the children' ...friends, if they came. plea...e
wash their hands" (Lim. Angel and Rosita 2(05 ). Ro...ita. however. wa...not without her
ow n source...of conce rn. admittin g that ...he would have been wary to enter funeral parlor...
during the outbrea k.
Angel. on the other hand. offered a large list of place...he avo ided: malls, movie
hou...cs, restaurants, and medical facilitie...: "So one thing. you know. I' m afraid to go to
the cl inic. like if you arc sick. fike if you have colds, you would amid going to ...ce the
doctor... bccuu se who knows. somebody before you has seen the doctors and left
...omc thing . and then you go to see the doctors and you migh t have SARS" (L im. Angel
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and Rosita 2(05 ). Angel's avoidance of public places was made eas ier by the fact that he
had reiired by this point, a fact he used to his advantage when grocery shopp ing-the one
activ ity he could not avoid: .., go 10 [get] groce ries, but during not the rush hour. I try to
avo id when there arc times that there are lots of peop le" (Lim, Angel and Rosita 2(05).
Angel did recall a friend of his- also retired-whose fear even outstripped his own: " A
good friend, he didn't go to see his barber , and he was, his hair was long and he had so
many, because he was afraid" (Lim, Angel and Rosita 2(05).
So great was public fear of SARS that even sneezing in a gatheri ng place war..
likely to cause a react ion, as related to me by Jonathan Gou ld:
I was studying at Robart' s Library at the Univers ity of Toronto, and it was a
packed room, and I sneezed, and I heard a girl under her breat h at the table say,
"SARS: ' this panic everyone had. And it was hard to tell how much it was just a
pure jo ke on her part, if she was just goofing around, or if she really... l mean,
when you' re in this enclosed space, I can imagine that, there is that kernel of fear,
you know, you're kidding but. r.who knows what's around? (2005 )
Jonathan ' s narrative is exemplary for its reve lation of the nature of fear. As Jeannie
Thom as remarked in Featherless Chickens. lAllighillg \Yom,'", and Serious Stories.
laughter can be caused by "the broaching of the taboo and emotionally charged topic of
death" ( 1997, 46). Joking beha vior can co me from the same wellspri ng of emotion. and
Jonathan' s remarks make this clear: was the girl who said "SA RS" really joking, or .....'as
she serious? Or was it a lillie of both?
Another issue that is relevant to many of the narratives presented in this chapter is
that of "po pular ep idemiology:' defined by Phil Brown as "the process by which
layperso ns gather scientific data and other information. and also direct and marshal the
knowledge and resources of experts in order to understand the epidemiology of disease"
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(Brown 1992.269). Brown points out that a key differen ce in interpre ting disease
between "professionals" and "laypcople" iiithat the ferme r focu s on d isease processes.
while the latter arc more concerned with personal experiences of the illness. Thes e
divergent approaches to disease often result in consi derable discord betwee n the two
parties, where neither is entirely willing to meet thc other at that group 's worldvicw.
Professionals are proc laimed as being too clinical and detached in their focus. while
laypcople are acc used of being too unscientific and subjective . Laypco ple. howev er. can
be extremely aggressive in their demand s for data. and in situations where the scientific
world fails to meet those needs, they will search for data from other groups. and even
create their own groups (sometim es comprised at least partially of syrnpatheric
profess ionals) to conduct studies appropriate to the ir demands.
Brown even presents a set of stages that arc common to popular epidemio logy.
These stages reflect processes that occur during investigation , of correlations between
pollutants and health effects-not diseases and health effects-but many of the stages
still apply. They arc as follows:
I) A group of people in a contaminated community notice separately both health
effects and pollutants.
2) These residents hypothesize something nut of the ord inary, typically a
connection betwee n healt h effects and pollutants.
3) Community residents share information. creating a common perspect ive.
4) Co mmunity residents. now a more cohesive group. read abou t. ask around .
and talk to government official s and scientific experts about the health effects
and the putative contaminants.
5) Residents organize groups to pursue the ir investigation.
6) Go vernment agencies conduct official studies in response to commu nity
groups' pressure. These studies usually find no association between
contaminant s and health effects.
7) Community groups bring in their own experts to conduct a health study and to
investigate pollutant sources and pathways.
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8} Community groups engage in litigation and confrontation.
9} Co mmunity groups press for corrobo ration of their findings by official expe rts
and agencies. (Brown 199 2. 269·70)
In the SA RS narrati ves that have been prese nted in this chapter. many of these stages
appcar-c-especially if. in addition to "gov ernm ent offic ials" and "scientific expert s: '
media sources are added to the list of groups con sulted and brought in by laypersons.
What also needs to be made explici t is that. in many cases. there is only the need for there
to he a perceived correlation between cause and effect .
Unde r these criteria. the stages may be applied to SARS narratives as follows:
I} A group of peop le notice separately a set of well-publicized health data
associat ing SARS with people living in China. and the existe nce of local
people of Asian ethnicity .
2) These people hypothesize something out of the ordina ry. name ly a connect ion
between SA RS and any person of Asian ethnicity .
3) People share this information via oral and electronic means. creating a
com mon connection and a community based around fear.
4) This new community. now a more cohesive group. read s about. asks around.
and talks to media sources. local officials. and other group memb ers about the
correlation between Asian peoples and SA RS.
5) The community reorganizes the media.....ia supply and dema nd economics.
into an entity ded icated to providing infcrm ano n about Asian peop les and
SARS .
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6) Gove rnment age ncies, in response to waxi ng xenophob ic pressure , issue
offic ial denials of the presence of SARS in local Chinatowns and Asian
neighborhoods.
7) Co mmunity groups bring in further examples from their own expcrts-c-i.e.
media sources and first-hand and/or "friend-o f-a-friend" testimony-to
respond to the denials .
8) Community groups continue to engage in confrontation with Asian peoples,
mostly via avoidance of them. their busines ses, and their neighborhoods.
9) Community groups may press for corroboration of their findings by official
experts and agencies. but m3Yalso simply sec the dcscncdncss of Asian
restau rants and neighborhoods as am ple evide nce of the verac ity of the link
between Asian peop les and SARS.
The comparison of SARS narratives to the rubr ic crea ted hy Brown is perhaps force d.
and the resulting schema does n' t functio n as linearly as docs the orig inal. Man y of the
SA RS stages may he happening simultaneously. while Brown stated that his stages
usually occurred sequentially. Th is is largely beca use Brown is writing about a situation
where the perceived connection between health effec ts and po llutants turned out, on
officia l exa minati on, to he an actual connect ion. As such, he docs not co nsider the
rami ficat ions to his set of stages that would co me from the co nnection being proven false.
In othe r words. his stance does not dea l with false -positive narratives, and thus he is
never forced into a situation where his theo ries must take into account why disease
narratives can exist despite their incorrectness. What comes from taking such factors into
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acco unt is a realization that disease narratives ca n form their ow n authoritative grav ity.
That is. the exi..renee of a rumor abou t SARS being loca ted in an Asian neighborhood or
bus iness can be ..ccn by laypersons as providing its own proof: the narrativewouldn't
e xist if it weren't true (or . at least. if it weren 't true some where), Brown doc s concede
that "lay inve..tigators may pursue specific inquiries with their own agenda in
mind ... [emphasizing ] certain health data and (minimizing) other reports " (Brown 1992.
278) . but he never con ..iders the ramifications to his theonc.. that woul d come from the
collected data be ing incorrect. but not recognized as such. Popular epidemiology can be
based on the gathering of accurate. pro vable data . but it docs not ha ve to be.
Th is is not to say tha t Brown' s conclusion.. and theories are witho ut merit. for he
docs prese nt rub rics tha t are valua ble in study ing disease narra tives . Especially releva nt
arc his co mments on the question of how it is possible to know whethe r lay invest igat ions
provide acc urate information . Though even in th is ..ection Brown limits his co mments to
defending the layperson' s findings . rather than discuss ing what wou ld happen if they
were pro ven inco rrec t, he still offer s a posit ive message about the importance of paying
attention to lay investigat ions. He states:
Public hea lth officials wo rry tha t some communities might ex aggerate the risks of
a hazard. or be wrong abou t the effects of a substance . Yet if this occ urs. it must
be seen in context: community fears arc too ofte n brushed aside and data has been
withheld. G iven the increa sing cases (or at least recogni tion of those cases) of
techn ological disaste rs. dru g side effects. and scientific fraud , public sentime nt
has beco me more critical of sc ience . In respon se. lay claims may be erroneo us.
But thi s is the price pa id for past failures and pro blems . and is a cou nterva iling
force in democratic participati on .... Exaggerated fears may be unders tood as
sig ns of the need to expand publi c hea lth prote ction. rathe r than jus tifica tions to
op po..e lay involveme nt. Even if a co mm un ity makes inco rrect conclus ions, their
data ba..e may still rema in usefu l for different analyses. (Brown 199 2, 278)
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Relating these comments back to SARS. we might say that Brown would be of the
op inion that disease narratives are important to study because I) they offer a glimpse into
lay understa ndings of disease. and 2) the study of such a data base can reveal to medical
profess ionals methods of better interacting w ith the public . We will return to these two
points aga in and again throughout the remaining chapters. expanding them to offer
examples of the insights that can be gained. and how professionals can use these insigh ts
to improve their communicative skills .
Though the full scope of narrative s that arose around SARS conta ins many entries
that do not involve fear of gathe ring places. there are a significant number that do. as has
been seen by the previous disc ussions . The very nature of SAR S facilitated and
exacerbated the crea tion of these stories. being an airborne virus that was. even early in
its existence. already humm ing with real stories of the now-deceased who had do ne
nothin g more endangering than occupying the same elevator space as a contagious
individual. Many of my informants reported feeling "trapped" by fear: a sentiment that
seems to run throughout the narratives I collected from the Internet and from media
sources. Reaction was immediate and widespread. to the extent that within a month 's
time of the word "SARS" makin g its first newspaper headlin e. rumors and hoaxes
conce rning infected individuals working in restaurants. malls. and other gathering places
arose in places as distant and different from each other as Beijing and New York. I clo se
this chapter with a quote from my informa nt Luis Tan. who perhaps best summarized
what it was like 10 live in fear of gatheri ng places:
11 was a really scary time for everybody. ltlimirs your movemen t. and you're not
free. You feel you're not free when you go outside the door . You want 10 go here
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and then you think. "Oh. because of SARS let's avoid this: ' If somebody put the
chain on you that you are [on] the leash, y()Uknow, you can only go so far and so
much, that's how you feel. (Tan 2(0 5)
192 J

Cha pter 6: Pr ivate Actions in Public Spaces: SARS and Paradigm Violat ions
According to Linda C. Garro. "to understand the impact of illness ... on a person's
life. it is ncce s..ary to develop an understanding of the narrat ive context" ( 1992. 133). In
othe r words . any true study of the action.. unde rtaken by a group suffer ing from an illne..s
must lake into account "the mean ing thai they place on these action s" (Calnan 1987. 8).
In the SA RS epi dem ic of 2003. publ ic transportation becameanathema. with airports in
Toronto. Singapore. Au stralia. and numerous othe r coun tries showing marked decrease..
in passengers. Man y narratives expres..ed fear and co ncern over long -di..ranee and
interco ntinental travel . Plane . trai n. and bus-related services suffe red as a resu lt.
Howe ver. the flow of inform at ion betwee n countr ies. due largely 10 the Intern et and
medi a sources . increased greatly. Thi s led to a curio us ..ituation in which, though
inform ation al globalizat ion waxed prolifi c. cultural and socia l globa lization was st ilted:
the wide spr ead diffusion of technology tha i enabled publ ic kno wledge of foreign affairs
only served 10 make people wary of other cultures 411 best. At its wo rst. this technolog y
made possible the circulation of narratives thai proved entirely counte rproductive to
cultural global ization throug h the rapid diffusion of inaccurate ethnic information. Ma ny
of the..c e rroneous narrat ives ult imately dea lt with the concept of private action s
performed in publ ic spaces as sources of endanger ment. and these narrat ives will he the
foc us of this study . The ultimate goa l of this chapter is to demonstrate that the anti­
globaliza tion narrati ves present in SARS were intricatel y and insep arabl y linked with
193

incorrect cultural stereotypes, and these were ultimatel y the result of w'idespread
incompetence in determi ning the meanings other cthnicities placed on actions.
As James L. Watson said. "Glo balization is a process that is replete with ironies.
One of those ironies hides behind the SARS crisis: a premodern agricultural system-c.
based on pigs. ducks. chickens. and centuries -old technology-c-could well tum oUIto be
the greatest threat to the postmodern globa l system" (2005. 202). A second irony is that
the ultimate tally of SARS- Ihe 9 16 fatalities-is in hindsight highly disproportionate to
the reactions and conspiracy theories. as indeed these reactions arc in response to most
diseases . Our concep tions of globa l security arc thus largely skewed . Jeanne Guil lemin.
in discussions on the nature and realities of biorerrorism. notes that biologica l warfare
"by humans against humans has been rare and historically inconsequential" (qtd. in
Watson 2(X>5. 202). and that by far the larger number of disease-related death s come from
nature.
Given these two ironies. we can quickly establis h thai diseases such as SARS are
not only a consequence of globalization. hut arc in fact to be expected because of it.
Many of the largest novel epidemics of the last one hundred years-AIDS, SARS. Avian
Infl uenza. Ebola-c-and still more of the most common historical and modem diseases-a-
malaria. rubies. salmonellosis. trichinosis. typhus- arc all zoonotic in nature. resulting
from human-animal microbial transfer. Those parts of the world where such transfers arc
the most likely 10 lake place are deve loping world-c-vprcmodcrn," as Watson calls them
above-areas. places like China's Guangdong province or Africa's Congo. Historically.
these places were isolated from other parts of the world. and thus non-airborne infectio us
19-1

diseases had far fewer chances to spread. Today. it takes little more than a plane ride for
these diseases to spread halfway aroun d the globe. So while globalization theorists in the
19

populat ion whi le SARS was waxing and waning: contaminated n ights. busses. airport s.
hotel s. etc. If one of the markers of global izat ion is the increased ability to travel quickly
to distant places. then businesses and modes of transport ation that sup port this ability
ca nnot help but be inexorably intertwined with the narrat ives- both good and bad-that
surro und globalization.
Of co urse. one conse quence of plac ing these businesses at the cen ter of the
problem is that the employees of these businesses arc also placed there . Rumors and
realiti es involving so-ca lled SARS "superspreadcrs " who worked for the airline indus try
were common in newspapers . and as such were sprea d ora lly by those who read abo ut
them . One such case involved a single airline attenda nt named Esther Mok who is
believed 10 be the "index case" for more than 160 of the Singapore infectio ns in April of
2003. Infected herse lf by a man who caught the disease in Hong Kong. th is flight
attendant is know n to have unsuspectingly passed on the virus to do/ ens of passengers.
including nne man whos e genera l poor healt h. including diabetes and kidne y disea se.
masked his symptoms. making it poss ible for him to infect at least forty doctors. nurses.
patien ts. and guests in two wards of the Singa pore Gene ral Hospital befor e his SA RS-
posit ive status was caught ("A re some better.,." 2003).M
M Mok's story parallels that of another supersprcadc r: Gactan Dugas. the so-ca lled
"patient zero" of the AIDS outbreak . who used his capa cities as a night attendant for Air
Canada to travel the world and purpo sely infect peop le with the AIDS viru s. At least nne
report stales that seventeen percent of the first 2"8 AIDS cases in the U.S. were linked to
Dugas (see Goldstein 200·k 113· 115). Though Mok did not purposely infect people with
SARS. the co nsequences of her actions were jus t as severe . and the fact that she. like
Dugas. was a flight attenda nt provide s the two narratives with an ee rie sim ilarity.
1%

passengers was a doc tor who had been treating SARS patients in Singapore only days
ea rlier. Ultima tely none of the flight's four hundred passengers tested pos itive for SARS.
but the story still made headlines (Cohen. Naik. and Pottin ger 2003 ). Lookin g at the
history of SARS. it may easily be said that had thc airline industry not existed. the disease
wou ld have never had the impact it did .
My own research has turned up severa l narratives concerning the negative effect s
of globalization on ethnic identit ies and disease panic. Man y of the people I intervi ewed
mentioned general fears of traveling by bus. plane. and train . but two interviews in
parti cular stand out as exemplary. The first was conducted in late Septembe r of 2005 with
Heather Read. During 2003 . Heather was livin g in Hamilton. Ontario . attending
university. but making regu lar trips to see both her brother in Toronto (rou ghly an hour ' s
drive northeast) and her parents in Ajax. Ontario (an additional half-hour 's drive
northeast).
Heather repo rted that Toronto' s outbreak had very little effect on her day-to-day
life. Hami lton being far enough away that its reside nts only "got the tail end of the
paranoia" (Read 2(05). Her visits to her family. however. we re another mailer. especially
since her mother worked in a caretaking capacity at the time. Heather described her
mot her as "a lillie bit of a hypochondriac. I think bcca u:..c of her medical train ing ... . She
works in a nursing home. so she had to go through the who le experi ence of gow ning up.
putting on mask [sic] every day that she went to work" (Rea d 2(X)S). This consta nt
reinforcement of care and precaution. as well as natu ral parent al instincts. Jed Heather' s
mother to reque st her children take as much ca re in their lives as she was forced to in
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hers. Among other details, one care package Heather received from her parents included
"socks, some barbecue sauce. some ja m.. .a book I had left behind... a hairbrush:' and a
package of medical-grade filtering masks accompanied by a note that read "I'd like you
to please wear them when you go outside" (Read 2005).
The largest response. howeve r. came when Heather wanted to go home for a
weekend . In Heather' s words:
To do that I'd have to take a GO bus, which is the common public transit system
between Hamilton and Toronto. and I think [mother] had jus t been reading about
how they had been tracing SARS to the initial spread being on an airplane . and so
she got really paranoid about me taking any kind of public transit. and said. ··No.
you're not allowed to ro me home. If you're gonna come home. we"Il co me get
you in the car: ' (Read 2005)
In total. the drive her parents made to have Heather avoid the public transit system totaled
six hours: 1.5 hours' drive from Ajax to Hamilton times four. This is double the time it
would have taken Heather to make the trip by bus. hut the security her mother felt in
having Heather avoid this method of transport was worth the time and effort.
Th is first narrative deals heavily with disease panic and the length to which some
people went to protect themselves and loved ones, but Heather' s second narrative
combines this panic with ethnic identity. creating a narrative that reveals much about the
mindsct of the general population. During 2003, Ileather was living with two roomm ates:
one male, one female. both Chinese. As Heather says. " it was interesting going out with
them because... if they coughed ever they'd get some strange loo ks" (Read 2(05). These
reactions didn't seem to bother the male roommate. who because of allergies would
sneeze often in public. and would immediately afterwards engage Heather in a jo king
banter that Heather recounts as beginning with "Ha ha ha: you have SARS" (Read 2(05).
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But Heather' s female roommate, "Rita:' was more heavi ly affected by the
situation, espec ially co ncerning how she was perceived by the pub lic. Even though this
roo mmate was not overly concerned about the outbreak, laughing at Heather' s mother's
contributions of face masks to her daugh ter's care package, she was still stigmatized
beca use of her ethnic identity:
She lived in downtown Toronto, and wou ld go back between Hamilton and
Toronto frequen tly. She, when she was on the subway, she 'd sit, ...he'd describe
several times sitt ing down beside ...omebody and having them get up and move
over. And so I think that's ...she started driving her car a litt le bit more often
because that ju ...t started to make her uncomfortable. (Read 2(05)
The effects of this ...tigrna tization were not isolated to Rita: the re...t of her family also
experienced similar react ions (as did some of my Filipino-Chinese informants). In Rita' s
family's case, reac tions aga inst their being Chinese were ...trong eno ugh that the whole
fami ly po...tponed an important trip to Ch ina to attend a wedding because of fears that
they wou ld not be allowed back into the co untry.
The ...cco nd of my intervi ews that is particularly penin cnt ro the current
discussions was with a man named Benjam in, who at the lime I interviewed him in mid -
200 5 was working as a bartender in Sa n Francisco, California. According to Benjam in,
there was not a great reaction against SARS in the Sa n Francisco area, other than
Chinatow n experiencing "somewhat of a lull" (Sa ndler 2(X)5), as w'3S co mmon in many
Chinatow ns across North America. But during the summer of 2003-frnm roughl y May
15 th to Ju ne 15 th - Benjamin was traveling through China's Hubei prov ince and its
neighbor. Chongqing mun icipality. Benjamin admits that man y of his friends and family
in the States had urged him to cancel his trip, and it had taken him quite some time to
200

convince them that his travels would not lead him into any viral danger. His fami ly had
fallen into the general mindset that anything Asian was dangero us, and it took
Benjamin' s interven tion to show them how their fears were "exacerbated by their lack of
knowle dge of China and how big it is. and maybe the lack of preciseness about how
concentrated the cases were" (Sandler 2005) .
Benjamin' s purpose in China was to pursue a personal project of his involving the
Three Gorges Dam. Though a barte nder by trade. Benjamin had a keen interest in the fate
of the people who lived along the banks of the Yangtze River. and since December of
2001 had made severa l trips to Ch ina to take videos for a photo-docu mentary . His 2003
trip was especia lly important for him as it allowed him to witness the closing of the slu ice
gales at the Three Gorges Dam on June t''. which permanently blocked the natural now
of the Yangtze and starte d the buildup of the reservoir behind the dam-a reservoir that
didn't completely fill umil Iate 2008. and now ultimately stretc hes some 375 miles,
covers over t ,3oo archaeological sites, and has resulted in the displacemen t of betwe en
one and two million people (wikipc dia.orgj.
Benjamin' s documentation of this act and the conse quences that would eventually
come of it meant that he spent May and June of 2003 traveling along the length of the
Yangtze, encountering dozens of villages that had rarely seen outsiders. He had read that
many of these small villages were actively blockading their streets to prevent foreigners
and travelers from entering beca use of the SA RS outbreak, and the fact that "travelers
were dub bed the carriers of the disease" (Sa ndler 2005) by locals weighed heav ily on his
mind:
20 1

That \....as something that reall y fueled my fears at first. because I was going to be
go ing to a lot of small towns in rural China that do n't sec a lot of foreig ners , and I
was worried that I would see a lot of. that I would be met with fear of getting
SARS. you know. from me .... Well that was what I was worried about I mean.
because I was dubbed. I wou ld be a traveler. coming, going from one place to
another place. possibly picking some thing up from one place and bringing it to
anot her. As would any travele r within China. you know. a Chinese traveler as
well. (Sandler 2005)
On the other hand. once inside those towns , Benjamin recalled rarely seeing anyone
weari ng a face mask. He placed the numbe r at "maybe one out of ever y IO,(XXl, " and
Quite often the masks people were wearing were "dirty and falling off' (Sandler 2005) .
According to these reports. people in China evidenced the same reactions to
foreigners as did people in North Ame rica: people of different ethnic identity. or
strangers in general, were suspect: local, familiar people were less so. This is especi ally
apparent in Benjamin ' s descr iptions of travelin g along the Yangtze. Villages far preferred
having outsiders stay as outsiders-even to the point of openly barricading their
bordcrs-c-but peop le inside those villages were free to do as they chose, and were not
considered harmful .
This sharp division is in contradiction of the realities of viruses and disease
vectors. for it lakes little effort for an airbo rne disease to cross a man-made barricade .
Even blood -borne diseases may cross through the act ions of insects and roden ts. As in
Edgar Allen Poe's "The Masque of the Red Death: ' no barrier is impenetrable . and
disease can creep inside even the best-maintained walls. Worse. once inside that barrier.
the virus can multiply quick ly and eas ily. The common co ld is more present in winter
precisely because humans ...pend ...0 much time indoors and in contact with other people
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during the cold months. and this situat ion provides the perfect breeding ground for
disease.
We have to. howeve r. draw the line somewhere. and attempt to make as much of a
divi sion betwee n those who are potentia lly diseased and those who are "known" to be
healthy . In the case of ..mall villages in central China. the location.. for the..e Jines are
ohv iou..: the town limits . These lines are seeming ly independent of race. age. and sex . All
that needs to be known is who is from the town and who is not. Even if it i.. recognized
that such geographical barriers are frail. their exi..tcnce ..till provides relief. and may in
fact help greatly 10 keep out that which is not wanted . In large cities . the possibilities of
such geographical barriers grow excee dingly ..mall. It is po....ible to quarantine houses or
apartme nt com plexes or even whole cities. but the people living inside those citie.. still
have to go about their daily dut ies. including working. shopping. and even using public
transportation to access the more remote parts of the city. People living in these
circumstances will thus be constantly surro unded by the potentially diseased . Wher e
geog raphical barriers fail or arc impossible. lines are instead drawn aro und those who are
unknown or different. and around race. sex. and age. and so strangers and other
ethnicitics becom e the targets of suspicion.
The basic ideas behind these separations were recognized and laid out as ear ly as
1959 by William Hugh Jansen. who designated his theory the "esoteric-exo teric factor in
folklore." Acco rding to this. "the esoter ic app lies to what one group thinks of itself and
what it supposes others think of it. The exoteric is what one group thinks of another and
what it thinks that other group thinks it thinks" (Jansen 1959. 206·7). Esoteric though ts.
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then. arc turned inward... ponde ring the self; exoteric thoughts are about others.
Furthermore. esoteric thought s stem "from the group sense of belonging and [serve] to
defend and strengthen that sen..e" (Jansen t959. 207). As a result of this. Jansen claims
that smaller groups are more likely to have stronge r esoteric ele ments.
The..e arguments are visib le within the narratives given by Heather and Benjamin.
Heather' s statement-in itself a collection of ..mailer narratives about several peop le­
demo nstrates especially well how Jansen' s theories apply to at least two different
cthnicities . On the one hand. we have Heather' s interactions with her mother (as..uming a
fami ly constitutes a folk group, as per Dundee" definition of "folk" as "unv group oj
people whatsoever who share at lea..t one common factor" (qtd. in Oring 1986. l,
cmphasi.. in original», which demonstrate her mother'.. perceptions of her own family as
"safe:' and Torontonians as a whole as "dangerous:' Interesting in this case is the
grouping of. including Toronto's Census Mctropofitan Area. roughly 5 million people
into a single category. regardless of age, sex. or race. On the other hand. we have
Heather's reports of what her Chinese roommates experienced during the SARS
outbreak. i.c. the incidences of people avoiding them Oil busses and subways. which are
d early cuscs of Asians a !'> a whole being stigmatized a!'> potential carriers of disease.
Benjamin' s reports show similar Ilcxibilnies in the lines between who is
considered safe and who is considered unsafe. The very comments that Benjamin chose
to open hi!'> story wilh- " J was worried... that I would be met with fear of getting SARS,
you know, from mc"- are an exce llent summarization of the esoteric factor. Benjamin
knowing hi!'> own SARS-ncgative status. but recognizi ng that the people he would

encoun ter might possibly see him as dangerous. Switching groups for a moment, it is
perfectly clear from Benjam in's narratives what the exoteric thoughts of the sma ll
villages he encountered along the Yangtze were, namely that other people are dangerous.
regardless of who they are. Here, as in the case of Heather' s discuss ions with her mother,
age, sex, and race are irrelevant.
In both cases involving the disso lution of racial and ethnic lines in the
determi nation of who is possibly diseased and who is not. we find that the groups making
the determinat ions are relatively small: Heather' s family and Chinese fishing villages.
The abso lute determinations of Asians as potentially diseased that were exper ienced by
Heather' s roommates occurred in situations where the deciding group was amorp hous,
and large. Not just a bus-full of people made the determination. but Torontonian society
as a whole. Jansen' s original esoteric-exoteric arguments did not include discussions of
disease, hut it docs seem that they apply. Sma ll groups have stronger esoteric elements,
and are more easily capable of grouping large numbers of people of varying identities
into an "o ther" category. while large groups have weaker esoteric clements (perhaps a
consequence of the amorphous nature of the group. where it is more difficult for one
member of the group to know what every other member is thinking or doing). and more
frequently draw lines along race and ethnic borders.
These narratives may also reflect a different kind of fear. as discussed by Mikel J.
Koven in his article '''Buzz Off!' : The Killer Bee Movie as Modern Belief Narrative:'
Koven hypothesizes that "killer bee" movies. which involve swarms of genetically­
altered bees racing up from South America and attacking U.S. border towns, may reflect
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acia l undertones and anxieties. Moreover, there arc atleast two races of peop le alluded
to in these stories as being fearful and Other. One of these races is obv ious. given that the
hccs in question arc ofte n referred to as "Africanizcd" or " Brazilian:' and so Koven states
that "Specifically with Irw in Allen's [mo vie ] The Swann .... the Brazilian honeybee
seems 10 act as a metaphor for wh ite paranoia abou t African -Americans in the U.S:'
(Koven 200 1. 6). Howe ver. Koven states that a secon d race may be alluded to in these
stories. if certain key contex tua l facts are noted -c-specifically that the decade in which
mnny of the killer bee movies and books were popularized (the 1970s ) was also the end
of the Vietnam War. As suc h. Allen' s nit: Swarm ( 1978) and Jack Laflin's novel nit'
Bees ( 1975) may also be reflectio ns of the American people 's growing hesitat ion with
Vietnam. as well as their embarrass ment at not having secured a concl usive victory.
Koven states:
Implicit in these narrat ives is the idea that the United States needs a military
victory to coun ter their defeat in South East Asia , See n racially. the bees co uld
even be seen to repr esent the Viet Cong themselves-the bees' yellow and black
markings represent ing both the racial stereotyping of East Asia ns as "y ellow"skin
colored and the black of the Viet Co ng uniform s. These military victories
over the bees Iin the movie and the novel I ca n therefore be seen us symbolic
victories against a Vietnamese that the American military machine could not
defeat in rea lity. (Koven 200 1. 10)
If SARS narratives are exa mined in the same vein. then it becom es immediately apparent
that many of Koven' s co nclusions ca n be applied, Not only arc many of the SA RS
narratives ove rtly racist in tone and message. but eve n in those narra tives that exclude
ment ion of race and focu s specifically on transm ission vectors-such as Heather' s
mot her's co ncern over the virus being spread by airpla ne and bus-racial undertones may
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still be present because SARS came f rom China. In fact. it may be said that the
coronavirus is a metaphor for the Chinese. or perhaps Asian peoples as a whole.
Such a hypothesis stands in line with many of the sentiments pervading the
United States today. revea ling deep-seated distrust of the Chinese. While the U.S. has not
had a major military battle with China. it has several other factors that influence public
perception. First among these is the ever-present reminder that China is a Commu nist
country. and as anyone who grew up during the Cold War was taught. "Communist
countries are evil." Then there arc the frequent news stories relating China's Human
Rights violations. A quick Google.corn search for "China human rights violation:' for
example (though without the quotation marks). resulted in a stagger ing 9.5 million
webpages. Economic concerns also come into play here. such as the incr easing amounts
of money the U.S. government borrows from China. or the outsourcing of jobs by U.S.
businesses to Asian countries. And. of course. there are the perennial concerns with
immigrants-Asian or othcrwis e-c-moving into U.S. cities and taking jo bs from U.S.
citizens. Other exa mples could be brought in to strengthen these tics further, but such
efforts arc hardly needed. These few illustrations alone evidence the strained relations
between the U.S. and China. Like killer bee stories being a metaphor for U.S. relations
with Vietnam. SARS narratives reflect American opinions about the Chinese.
Examined under yet another light these narratives reveal concern over actions
performed out of place. or more specifica lly. private actions performed in public places.
Mary Douglas. in discussing the concept of din and its relative mctaphor­
unclea nlincss-notes that the very notions society holds about hygiene are relative:
107

"Shoes are not dirty in themselves. but it is dirty to place thcm on thc dining table: food is
not dirty in itself. but it is dirty to leave cooking utensils in the bedroom. or food
bespattered on clothing: similarly. bathroom equipment in the drawi ng room ... out-door
things in-doors; upstairs things downstairs...·• (Douglas 1988. 35-36). In SARS
narratives. many of the underlying fears involve similar matters of sanitat ion and objects
out of proper place. What separates SARS narratives-and disease narratives in
general-is the object which is considered to be out of its proper place: the infecting
agent. in this case the SARS virus.
Though disease narrati ves have many forms and come in multiple varieties. they
can all be ultimately traced back to this infecting agent. whether it appears on a needle or
razor blade. is present in semen or saliva. or can be transmitted only through bodily fluids
or through the very air we breathe. It is interesting to note that. while Douglas states that
food is dirty when present in the bedroom or on clothing (implying that food is sanitary
when located in the kitchen and on plates). there arc no such defin ite lines for infecting
agents. The SARS virus is clearly seen as dirt y in all the narratives collected for this
study, hUI the best line that can he draw-n10 identify where it docs and docs not belong is
between anywhere else and me. That is. while the "improper" location for the virus can
he definitel y identified as the narrator' s persona l space. or perhaps the personal spaces of
a small group of people surrounding the narrator. the "propcr'tlocation is rarely spoken.
and is instead left as an ambiguous. amorphous location that is to be found anywhere
other than where the narrator currently stands.
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If the location of the narrator is sacrosanct. and is the "improper" location for the
virus. then it stands to reason that any actio ns that cause a virus 10 enter the perso nal
space of the narrator are abo improper . Sneezing and coug hing. for example. are widely
recog nized as methods of transmitting d iseases. Even sma ll children are told to cove r
their mouths and noses when performing such actions . Public and widespread knowledge
of scient ific germ theory may be inaccurate and incomp lete by medical standards, but it is
sufficie nt to recognize that sudden expu lsions of breath from the lungs can resul t in the
airborne dispers ion of disease-causing materials . which is one reason why people prefer
not 10 shake the hand of someo ne who has jus t sneezed into that hand.
Sneezing is. in add ition. a private act ion. Not only is it recognized as a poten tial
spreader of disease. and thus something that should be shielded from the rest of the world
hy the hand or handkerch ief. but it is an involuntary act ion-something that cannot be
controlled. Sneezing results in the tempo rary loss of the sneczc r's hold ove r his or her
own bod y. The eyes involuntarily squeeze shut. and the respiratory syste m is subverted
from its normal job of supplying the body with oxyge n and is instead given over to the
single. uncontrollable work of expe lling a large amount of air forcefu lly and rapidly.
Sneezing leaves a person at his or her most vulnerable: sightless and powe rless. To a
great extent. the only action a person is capable of performing while sneez ing is. in fact.
sneez ing. Speec h. visio n. and activities involving highly-co ntrolled muscle movements
(painting. running. playing a musical instru ment. typing. ctc.) arc all greatly hindered. if
not made out right impossible. and it may be argued that even thought processes are
retarde d. Sneez ing leaves us naked. It should come as no surprise that we hide our faces
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when we sneeze, or excuse ourse lves from conve rsations to tum around (if given
sufficie nt warning). and sometimes apologiz e for our act ions afterwards.
In SARS narratives, the private nature of act ions such as sneezing or co ugh ing
(the latter also marked by a soc ially-i mposed covering of the mouth) are made all the
more relevan t beca use they are performed in pub lic spaces. Heather' s interactions with
her male Chinese roo mmate upo n hi" sneez ing in public-c-vl la ha ha: you have SARS"­
show at least some leve l of awareness concerning the danger of such an action . Heather
menti on" that such an exc hange was "t rivializing" the otherwise serious nature of a
sneeze in the middle of an epidemic, an act ion that fits three of Jeannie B. Thomas' four
funct ions of laughter, in this case "inco ngruity," "su perio rity." and "recognition of a
taboo topic" (Thomas 1997.43). Thomas' defin ition of " incongruity" is especially
relevant in relat ion to this scenario: "this thing that is out of place here" (Thomas 199 7.
48). The ju xtaposition of private action and public space creates the same recognition of
uncle anlin ess as is presen t in Mary Douglas' quote. i.e. things that arc out -of-place are
dirt y. And while a sneeze by itself might not bring about a large response. when
combined with its diseas e-spreading potentia l cnul the outbreak und general panic over
SA RS. the act ion creat es an immediat e and noticeabl e reaction .
The fina l layer in these narratives is that of stereotyping ethnicities, or outsiders
and strangers . as diseased or disease ca rriers. The attribution to an ethnic gro up of either
careless or purpo sefu l introd uction of a disease into a previo usly-sa fe co mm unity adds
the final nail to the coffi n. as it were. Not only arc these peo ple different. but they arc
dirty. they act inappropriately. and they arc harming us. The stereotypes and reactio ns
210

present in SARS narratives are laid out especia lly well by Jcn. a Chinese -Filipino
informant I interviewed in Toronto in 2005 :
There was one time I was on a bus and ... at that point we were living in
Scar borough. which is. it' s made up of a lot of immigra nt co mmunities. and there
are a lot of Chinese peop les who are prima rily in the northe rn area of
Scarborough. going into Markham- Markham is a huge Ch inese community. I
think primaril y from Hong Kong and Taiwan-and I was on the bus one day . and
1 was sitting bes ide this Caucasian girl. and this black guy sitting besi de her . and
they. I think were teen agers. thereabou ts. and I thin k I coughed. No. I didn't
cough. the girl startcd.fikc. fake coughing beside me. and the guy beside her was
kind of gigg ling. but in an uncomfortable way. and I felt that to be son of a joke.
like because I was As ian. and because we were in Scarborough. and because we
were on a bus. they were making fun of the fact that I was Chi nese . I co uld
possi bly have SARS... . Maybe it was an oppo rtunity to ... a reason for thei r
stereotypes. Like for them to have certai n stereotypes. it was a perfect opportunity
for them 10 co me out with jo kes about it. (Lim. Jen 2(05)
In this particula r instance. there was not eve n a spec ific actio n such as a co ugh or sneez e
to incite the respo nse. All thai was needed was simply the presence of an individual
perce ived 10 be from a dangerous group.
The ultimate causes of narratives such as this arc many. and depend on socia l as
well as familial factors. but sociologist Stephe n L. Muzzani places much of the bla me
squarely on informational globalizatio n as it is present in the media. In an exa mination of
media reports of SARS. Muzani notes that many of the articles present in popular
newspape rs were sensationalistic at best. repo rting excl usively a ll negative occurr ences
such as deaths. quarantines. business failures. and masses of masked faces. li e states.
"this type of co verage made SARS appear far more wides pread. co ntagious. and
dangerou s than it truly was. It also served to tea r away the thin ami flimsy venee r of
'tolerance' in America. revealin g dee p-seated racism and xenop hobia" (2005 . 123).
Asians as a whole beca me "folk de vilv," or what Stanley Co hen ca lls "unambiguously
211

unfav orable symbols" (200 2. 41) beca use of their associat ion with the d isease. Thu s. it
may be argued that experiences such a, the ones su ffered by Jen and Rita (Heather's
female roo mmate) are direct co nsequences of Ii..-ing in an era when a news report filed in
Ch ina can appear in an American newspaper only hours later.
Terr y Ann Knopf pointed out over thirty years ago that rumor often begets
violence. prejud ice. and disc rimination. and as legend overla p' rumor ( 1975). the same
Qualities can he said of it. In the modem era. where rumor and legend spread-for the
first time in history-c-faste r than the speed of sound. the real ities of Knopf' s cla ims
beco me ever-more apparent . Narratives such as the ones prese nt in this chapte r represent
the worst oflegend and rumor. The ease with which information is passed between
disparate parts of the modern worl d has at times resulted in significant benefits for
humank ind. but it has also enabled the widespread and rapid diff usion of panic and
negative stereotypes. The public reactio ns and revulsion s experienced by Jen. Rita. and
Benjamin were no doubt fueled. at least in part . by rumor and legend. Simil ar react ions
occu rred around the wor ld. where it was only a mailer of week s. perhaps days. before
SARS becam e inext ricably . globally linked with Asians, The result ing narrat ives left
Asia n-Ame ricans who had never set foot outside North America accu sed (however
lightly or humorously) of being potential infectors. In cases such as these. informational
globalization promulgated pejorati ve stereotypes. In other cases. know ledge of the
ex istence of SARS resulted in the mass-labe ling of stra nge rs and outsiders as dangerou s.
somet imes resulting in the literal barricadin g of those peoples from entering into towns.
By "rucial izing illness" (Muzaui 2005. 125) in this manner. the world was left in the
2 12

midst of a wave of racism that was not only widely practiced by "official" news sources,
hut publicly encouraged and tolerated.
213

Furth ermore. it is my co ntention that many of the collected narratives do not fit neatl y
into the categories ass igned by stigma literature. especially as seen in the wor k of Erving
Goffman.
"S tigmas." archaically. were brands burned into the skins of slaves or criminals
for identification purposes. Modem defi nitions of the word have branched out
dcnotatively. referring to several types of blemishes rangin g from crucifi xion wound s to
common birthmarks. However. the connotations of these modem renditions still evide nce
many of the term's negative archaic implications . To be stigmatized-to be marked-is
to be labeled as somehow wro ng or impure . E..pecially as the term is used in reference to
medicine and disease. stigma is characterized by discri mination . negative labellin g.
os trac ism. and excl usio n (Goffman 1963: Kleinman and Lee 2(05). St igma. in this sense.
affect alllevels of society. and results in such varied problems as workplace losses in
produ ctivity. violations of basic human right s. med ical non -comp liance. the scapcgoating
of marginal groups. familial breakdown. and individual suffer ing (Klein man and Lee
2( 05). At best. being stigmatized mean s being perceived differen tly. At worst. it mean s
personal and financial ruin. and can lead to suicide.
Various defin itions of the more modem meanings of vstigmu' have been
forw arded. some of the earliest attempt s co ming from Erving GotTman: first. "The term
stigma ... will be used to refer to an attribute that is deeply discreditin g" (Goffman 1963.
3); and seco nd. from later in the same book. "an undes ired differen tness from what we
had anticipated" (Goffman 1963. 5). Gerhard Falk expa nds on this by exp laining the mos t
co mmo n modem American uses of the word. where 'vstigma' and 's tigmatization' refers
215

to an invisible sign of disappro val which permi ts insiders to draw a line around
'outsiders' in order to demarcate the limits of inclusion in any group" (Falk 200 1, 17).
Thou gh not actua lly providing a dictionary definition of the word. Falk' s comments do
clearl y demonstrate the nature of what it is to be stigmatized: it is to be set apart and
marked somehow as unclean or unhealthy.
The initial statements in this chapter regarding the nature and discussion of stigma
are based on Goffm an' s 1963 book Stigma: Notes 01 1 the Management of Spoiled Identity.
At the time Goffm an wrote his book. stigma studies were relatively new. The preface to
Stigma states that much of what had been done in the field before the publication of
Goffman' s book had come from social psychology, and even there the field was hardl y
"over a decade" old (Goffman 1963. n.p.). The footnote on the same page that
summarizes the previous decade' s work on stigma references five psychologists. but only
one sociologist, and tellin gly, it is one of the psychologists whom Go ffman speci fically
highlights as having provided the most useful data (Goffman 1963). Goffman'x efforts
were thus in many ways the seminal attempts to introduce the field of stigma to the
discipline of sociology. The arguments throughout the remainder of this chapter are based
largely on Stigma not only because it was perhaps the first book to attempt to codify and
set down rules for the academi c study of stigma. but because almost every more-recentl y­
written source I consulted for the preparation of this chapter referenced Goffm an' s work .
Unfortunately, Goffmon' s meditations on the natu re and mechanisms of stigma do
not. in several key ways. include discussions of the types of stigma that were associated
2 16

with SAR S. Fur instance. Goffman gives the followi ng as.the three ma in "types" of
stigma:
First there are abominations of the body-thc various physical de formitie s. Nex t
there are blemi shes of individua l character percei ved as weak will. domineering
or unnatura l passions. treacherous and rigid beliefs. and dishonesty. these being
inferred from a known recor d of. for example . menta l disorder. impri sonment.
addiction . alcoholism. homosexuality. unemp loyment. suicidal attempts. and
radical political behaviour. Fina lly there are the tribal stigma of race. nat ion. and
rel igion. these being stigma that can be rrunsmiued through lineages and equa lly
contaminate all members of a family . (Goffman 1963. -t)
I give thc full quo te here. rather than a summarization. to show exactl y the arguments
Goffman makes and the types of stigma that hc lists. carefull y broken down into their
sections and supporting exam ples. But eve n a cursory glimpse shou ld suffice to show that
Goffmcn's list does not include the stigma that is associa ted with many dise ases.
Briefly summarize d. the types of stigma above ca n be broke n into the categor ies
of I ) ph.Him l deformities. 2) charac ter flaw ... and 3) tribal association. Polio and
Hansen' s disease. both of which Goffman uses as exa mples of the first category. are
indeed diseases. but in these instan ces physical defor mities O(..'ClIr as a side effect of an
untreated viral or bacter ial infect ion. respectively. In other words. Goffman's inclusion of
these diseases into 1* spectrum seems based not on the presence of the infecting age nt-
to wit. the polioviru s or the Mvcoh acter ium 1('prlU,that ca uses Hansell' s disease-s-but on
the prese nce of the dis figurements that co me abo ut as the result of these infect ing age nts.
There ca n be lillie argument that those who co ntracte d SARS in 2003 were stigmat ized.
hut the SARS virus did not cause the kinds of physical disfigurements or deformities
present in Go ffman's catego ries. Like those infected with AIDS, SARS victims initially
appeared on the surface to be no different than anyo ne else. It was not unti l very late in
2 17

the progression of the disease that the similarities cease d. and even then this was not due
to physica l deform ities. but to high fevers and respiratory prob lem... SAR S victims. then.
were stigmatized not beca use of the presence of any visua lly-distinguishing features. but
simply beca use of the presence of an invis ible infecting agent. Thus it seems that
Goffman's types of stigma merits a fourth category: the injected. which includes anyo ne
who is curren tly (or. we coul d argue. has ever been) host to any virus. bacte rium. fungus.
para..ite. etc.. deemed in sorne way offensive. dangerous. contagious. or di..gusting by the
public .
But even with the inclusion of this fourth category. there is still at lea..t one key
form of stigma within the SA RS ep idemic that is not adequate ly described: the
stigmatization of perfectly healthy individuals such a.. hcuhhcare workers and A..ians.
The stories of these group.. of people have been di..cussed elsewhere in this work. so I see
no poin t 10 reiterate them here. exce pt to say that hcalthcurc workers and Asians were
stigmatizcd-c-most of them wrongly-as potential d i..ease carriers. It is this last concept
that is missing from Go ffman' s list: the potenti al of someone to belong to a stigmatized
category. All of the exa mples used by Goffm an to support hi.. arguments come from
peop le who arc aireadv recog nized as members of the stigmatized categories into which
they have been placed. and actuall y have the cond itions for which they have been
stigmatized: peop le with Hansen' s disease and amputees for being "de formed"; suicides
and drug add icts for having recognized character flaws: African -Americans for belongi ng
to a different race. None of Goffman' s exa mples incorporate the idea of potentiality, or
the fear or worry that someo ne who is not immediate ly recog nized as being a member of
2 18

could affect large numbers of people , because his argume nts indicate thai the range of
this "co urtesy stigma" extended only to the reaches of the family.
Goffm an also approaches the concept of the potentially discreditable in his
discussions of the differences betwe en the "discredited" and the "d iscred itab le" (fro m
which arguments I constructed the term "po tentia lly discreditable") . According to
Goff man. the "discredited't label can be app lied to someone whose "differentness" from a
"normal" person is immediately visible or already known about. People suffering from
Hansen's diseas e easily fall into this category because of the disfigu ring natu re of the
disease , as do people who are widely and publicly recogni zed as homosexuals.
murderers. unem ployed. etc. The label "disc reditable" is applied to someone whose
differentness "is neither known about by those present nor immediately perceivable by
them" (Goffman 1963. 4 ), i.e. a person with Hansen' s disease who is able to hide his
disfigurement s under his clothes, or a murderer (homosex ual. unemp loyed person. etc.)
who is nor suspected of being such. While this latter category of the "di scredit able" docs
admit the possibilities of the unseen stigmatic, it is still bused on the presence of a
differentness. The discreditable person is only someone whose discrediting attributes
have not yet been d iscovered. Nowhere in this two-part paradigm exists the possibility of
a perfectl y health y, unsullied PCf'>OIl being wrongly stigmatized,
The narrowness of this view has since been updated. Kleinm an and Lee, for
instance. state that it is not "surprising that stigma assoc iated with SARS quickly
transferred to ethnically Chin ese communities in many pans of the world" (Kleinman and
Lee 2005 , 181). and note the historical commonness of such transferences. Among other
220

examples, Kleinman and Lee point to a study sponsored by the American Medical
Assoc iation in the late 1800s which investigated "the hypothesis that Chinese women
were spreading a unique and particularly virulent strain of so-called Chinese syphilis"
(Kleinman and Lee 2005, 18 1). They also note the torching and razing of Chinese
neighbourhoods in both Hawaii and San Francisco after the bubonic plague surfaced in
those areas in 1899 and 1900, respectively. despite the lack of any evidence of an Asian
origin of the disease. Gerhard Falk describes this kind of stigma as "soc ietal deviance":
"a condition widely perceived. in advance and in general. as being deviant" (Fulk 200 I,
22). In thc two exa mples cited by Kleinman and Lee. this societal deviance is apparent in
the automatic assumpti on of Chinese culpability. In these cases . the condition perceived
as being deviant is simply the condition of being Chinese. Falk' s descriptions of the
nature and origin of stigma prove far more capable here of accounting for the widespread
stigmatization of Asian peoples in the 2003 SARS epidemic. for rather than attempting to
break down the roles of the stigmatized and their reasons for being placed into negative
categories. Falk simply states that "stigma and stigmatization can occur whenever and
wherever some people find behaviour or characteristics of other people offensive and/or
reprehensible" (Falk 200 1. 24).
Having spent the first part of this chapter examining the nature of stigmatized
individuals and the reasons behind their stigmatization. we now tum to the reactions the
public has towards them. In this area. the literature is fairly consistent, and reads more
like an extended series of variations on a theme. As Kleinman and Lee state. the
stigmatized individual can expect "disc rimination. negative labelling. menacing societal
22 1

esponses such as ostracism and exc lusion. and even violence" (Kleinman and Lee 2005.
173), In responding to the stigmatized. thc public constructs a mind-set to create what
Coffman calls a "st igma-theory": "an ideology to explain his inferiority and account for
thc danger he represents. sometimes rationalizing an animosity based on other
differences . such as those of socia l class" (Goffman 1963.5). In discussing this reaction.
Falk notes that Emile Durkheim claimed that the "function of creating a boundary in any
human group is group solidarity " (Falk 2001. 32). and furthermore summari zes Edward
Sapir's recognition of stigma and stigmatization-producing language as "

they arc different. and we know they are differe nt because they are labelled. Such a self-
fulfilling prophecy explains in large part the continued presence of long-stand ing
stereotypes. We "know" that Mexicans are lazy because they are Mexicans. and all
Mexicans are lazy; we "know" that the Irish are drun kards because they are Irish. and all
Iri..h people arc heavy drinkers. Obviousl y. it is difficult for an individua l in a stigmatized
community to escape such labelling . for the very fact that they are a member of that
community "proves " the label to be correct. all evidence to the contrary notwithstanding.
Sim ilarly. the existence of a label on a stigmatized commu nity can be used to "prove" the
culpabi lity of that commun ity for any related offences . If the Chinese were historically
blamed for Chinese syphilis and the bubonic plague. they can also easily be blamed for
other. newer diseases. for the existence of the older stories "proves " that they are dirty.
disease-laden people.
Finally in our discussio ns of the literature. we examine how the reactions of those
who have been stigmatized have been described and accounted for. I again tum to the
\\'OTk of Goffman. and begin this section with an extensive quote from Stigma:
How does the stigmatized person respond to his situation'! In some cases it will be
possible for him to make a direct attempt to correct what he sees as the objective
busis of his failing. as when a physically deformed person undergoes plastic
surgery. a blind person eye treatment. an illiterate remedial education. a
homosexual psychotherapy"... . Here proneness to "victimization" is to he cited. a
result of the stigmatized person' s exposure to fraudulent servers selling speech
correction. skin lighteners. hody stretchers. youth rc..torcrs ...cures through faith.
and poise in conversat ion. Whether a practical technique or fraud is involved. the
quest. often secret. that results provides a ..pccial indication of the extremes to
which the stigmatized can be willing to go. and hence the painfulness of the
II Though it bears lillie ramification to the overall thrust of this chapter . it should be
pointed out that in the curre nt. post-millennial era the notion of a homosexua l seeking
treatment for "his failing" is quaint at best. and at worst. homophob ic and dosed-minded.
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situation thatleads them to these extre mes .. .. The sng matizcd individual can also
attempt to correct his conditi on indirectly by devoti ng much private effo rt to the
mastery of areas of activity ordinarily felt to be closed on incidental and physical
grounds to one with his shortcoming . Th is is illustrated hy the lame perso n who
learns or re-learns to swim. ride. play tennis. or f lyan airplane. or the blind perso n
who beco mes an expert at skiing and mountain climbing.... Finally . the person
with a shamefu l diffe rentness can break with what is called reality. and
obstina tely attempt to employ an unconventional interpretation of the character of
his socia l identity. ( 1%3 . 9-10)
I have included a quote as extensive as this for two reason s. First and foremost. it
is important to notice here-as with his arguments about the nature of stigmatization-
that Goffman is only dealing with the reactio ns of people who actually ha ve a cond ition
or differ entness that has led them to be placed into a stigma tized category. The above
quo tation lists only three of some fourtee n react ions Goffman catego rizes. hut all of his
exa mples follow the forma t of this quote. and are of people trying to cope with or fix
their real differences. What is missing from these arguments is. again . the notion of the
f' (lw lt ;all y discre ditab le: in this case . the perfectly healthy individ ual who has been
wrongly placed into the category of those who arc suspected of being infected with
SARS. It might he true that the reactions of these individuals arc in part the same as those
staled by Goffman as reactions of people who have been categorized based on an actual
diagnosis of SARS. but the point is far from semantic. There nrc definit e differences
between the two groups of peop le on enough levels 10 warrant their separation. For
example. while those who have and have not been infected with SARS may both chafe at
their being included in a stigmatized category . and be th may feci the placement and
concomitant reactions of the public unwarra nted. the reasons behind such reactions are
va..tly differ ent. \Vhile individuals who have been infected with SARS may feel their

stigmatization as undeserved and unpleasant for a number of reasons- their having
successfully fought off the disease. their rejection of the diagnosis. their rejection of or
lack of understanding of the serious nature and contagiousness of the infect ion. general
stubbornness. ctc.c-fhe individuals who have not been infected with SARS feci their
being stigmatized is undeserved precisely because they have not been infected with
SARS . So while the reactions of these two groups may be similar. the reasons behind
their actions are different enough to warrant their being categorized separately.
Secondly. I have included an extended section from Goffma n'.. work because it is
also important to point out the commonalities and differences between his theoretical
reaction.. and the real-life reactions reported by those stigmat ized in the SARS ep idemic.
Restating Goffman' s theories on stigmatized individ uals' reactions to their situations in
the above quotation reveals three areas: I) direct correction of the failing through surgery.
therapy, or education; 2) mastery of activities thought 10 be difficult or impossible. given
the stigmatized individual's condition: and 3) the employment of an "unconventional
interpretation of the character of his social identity" (though this last point is left
unexplained and without an example. making it difficult to ascertain Goffm an' s exact
meaning), As previously stated. however. there arc at least fourteen points in total to
Goffmans list (a more careful reader may find more, but Goffman'.. luck of sub-headings
or numbered entries. combined with the stream-of-consciousness style writing employed
in Stigma. makes exact count difficult). Briefly. the remaining eleven reactions arc as
follows. noting that these do not form a sequence of progress ion. nor docs every
stigmatized individua l experience them all:
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4) stigma as an exc use for ill success:
5) stigma as a blessing in disguise;
6) (ofte n followi ng from number 5) stigma as evidence of rhe limitations of
"non-nab";
7) avoiding contact with "normals":
8) paranoid feelings. such as hostility. depression. and anxiety:
9) uncertainty about status and placement when in contact with "normals":
10) having to be constantly self-conscious and calculating about first impressions
when meeting "normals":
ll ) feeling that everyday accompl ishments are misinterpreted or exagge rated by
"normals." as in whe n people are amaze d that a blind man can make his own
dinn er. or excuse the failures of the stig matized because of their situa tion. such as
making it "okay" for someone with a learning dis abil ity to nOIunderstand;
12) feelin gs of invasio n of privacy. as when peop le with amputated limbs are
stared at:
13) defen sive co wering; and
14) hostile brav ado (Goffman )963: Low 20()4).
II is not my intent ut this point to go through all fourteen poin ts and co mpare them
indiv idually (0 (he reac tions I collecte d during my fieldwork. for such an effort would be
ultimately self-defeating and pointl ess. The sma ll range of expe riences narrated by my
inforrnu nts does not constitute a suffic iently large exam ple 10 prove or disprove
Coffman's theo ries. It is. howeve r. my inten t to move from here into a series of studies of

those narratives. and hold them individua lly up to Goffman's fourteen points show ing
how each docs or does not fit. Such an effort will be strained in many ways. as none of
my informants ever contracted SARS and are all thus only potentially discredita ble. while
Goffman's theories all center on those who actually had the conditions for which they
were stigmatized. However. the results will shed new light on the proverbia l cave wall. as
it were. and thus are worth the effort.
It is first. however. useful to examine Goffman's points from a different light. for
not all of them apply to the studies undertaken in this chapter. Recall that the ultimate
efforts here are to examine the ways that stigmatized individuals and commun ities
mediated the fears associated with SARS. Mediation. by definition. is an act of
agreemen t. compromise. or reconciliation. usually conducted between two parties in an
attempt to strike some accord or peace (dict ionary.corn). Used as it is in this chapter. the
word still carries the meanings of reconciliation and peace. but the act of mediation docs
not necessarily occur between two physical parties. Instead. it can he an internal strugg le.
where a conscious effort is made to come to some inner peace. For many of my
interviewees, these efforts were made to balance the stresses associated with being
stigmatized: "mediation:' as I use it here. is a loose synonym of the infinitive "to cope:'
The act of mediation is thus a positive act. a movement toward learn ing to
constructively deal and live with a given situation or circu mstance. By elimination. then.
any act that is not positive is not one of mediation. A negative act is destructive. not
con..tructive. An exam ination of Goffman's fourteen points reveals that the majority of
them arc in fact destructive or negative. Ten of his fourteen points lit into this category .
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Only points one, two, five, and six (from the above list) nmy qualify as positive,
constructive reactions to being stigmatized: direct correction of the failing; mastery of
difficult or impossible activities: stigma as a blessing in disguise; and stigma as ev idence
of the limitations of "normals."
Though Goffman gave no ev idence in Stigma that he intended his list to be all-
inclusive. it seems obvious from this analysis that there is much that could be added to it.
especially as his ideas are so heavily weighted in favour of the negative and destructive.
For exa mple, a basic and common method of alleviating the tensions of stressful
situations makes virtually no appearance whatsoever in Goffman's book: the concept of
humor as relief. Take the following exce rpt from the interview I conducted with Jonathan
Gould as example:
My cousin by marriage. his mom was coming in. He must be like thirty, his early
thirties. He was picking up his mom at the train station, and when she got off the
train when he met her, he was wearing a mask, and he was all serious and he
quickly handed her a mask and gloves to put on. telling her how dangerous
everything was. So after a while. when she was wearing the mask and the gloves.
then he started laughing and told her he was just joking. it wasn' t necessary. But
the whole family wanted to kill him. they thought it was, he was a real jackass for
scaring his sixty-year-old mother like that (laughs). (Gould 2(05)
As Elliott Dring says, the distrihution of tension in a narrative is the key to its
interpretation as humorous or non-humorous. A humorous narrative requires some
tension to make the topic interesting. but too much tension or emotional involvement for
either the narrator or audience cancels out the humor. Jokes about cancer can be
humorous. but are probably less so if your sister died of it (see Dring 1992. 12-13).
Jonathan' s story is a perfect examp le of this concept: for the cousin, the tension in the act
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of tricking his mother was appropr iate for the determination of the act as humorous. But
for the family, the tension exceeded those levels.
Humor is, of course. relative. and it should come a... no ...urpri...e that a narrative
...uch a... this would be seen as humorous by some-including Jonathan. as ev idenced by
his laughter-but as disturbing and inappropriate by others . Jonathan himself recog nized
the breaking point in this equation in a sepa rate ...ectio n of his interview. when he
di..cussed a trip he too k to visit his sister:
Yeah. we jok ed abo ut it. about not telling peop le when we'd got to Newfoundland
that we had just come from Toronto. becau..e it was in the middle of the SARS
hysteria. In the cab or.. .just anywhere. like our first couple of days there. I'd
forgot all about this, there was jus t so much fear that. we wanted to jo ke abo ut it
with people. hut we were afraid that some people would jus t leave the room
(laugh). It' s crazy. (Gould 2005)
A similar comparison of the tensions involved in the creation of humor came from my
interview with Luis Tan. When asked if he remembered hearing any jokes abou t SARS.
Luis' first rcsponse was. "No. Because people I deal with. peop le.. .everybod y too k it
ser iously. Evcrybody look it seriously. Because how can you make c jo kc when you see
peop le dying and there' s no cure? You yourself gel scared. 10 0 . You ju st hope and pray
thalthis will stop and there will be a cure for this particular disease" (Tan 2(05 ).
Howe ....cr. Luis acknow ledged that there were peop le in Toronto who did employ humor
in their response s to the crisis. and said of them:
Well. they might have the ir own reaso n. But in my opinion. maybe some people
want to.. .because everybody's too ..erious, they want 10 make a lillie. they want
to make people relaxed or... they maybe make jo kes like that. But I don' t think
in..ide them. whee ver makes that. I don' t think they have a bad intention of
putting the real meaning on it. because it' s a serious matter. (Tan 2005)
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The poi nt is that people used hum or to medi ate fea rs du ring the SARS cris is.
Sev eral of my info rmants related humoro us sto ries. jok e....or anecdo te...abo ut their
expe rience s with the outbreak. Recall from the previous chap ter tha t Heather and her
Chine ...e roommate regularly and openly joked about con tracting the discase-v'Ha ha:
you've got SA RS"-in response to coughing. Mike, the Efl.1T. recalled ...evcral in...tances
where humor was used as a coping mechanism by peop le in the widely-stigmatized
health profession. First. M ike recalled at least two instances of the SA RS acronym being
appropriated and recontextualized to comment on the outbreak. Though he had lost the
new definition of one of the reco ntext ualiznt ions by the time I interviewed him in 2005.
he did reca ll that it had ...omething to do with "'Summe r Recreation' ... some th ing abou t
getti ng 3 vaca tion throu gh qu arantine"-but co uld not remember wha t the rest of the
lett ers stood for. li e did. howe ver. quite clearly recal l peo ple jo king that SARS stood for
"S hit ty Acute Respir ator y Sy ndro me:' in re...ponse to the quarantines and hassles.
Mike' s largest contribution to this discussion was an extende d section of
interview relat ing ho w he and his colleag ues in the health profession used humo r to cope
with the stresses of the outbreak. His narrative, which I present here in full, revea ls much
about how a st igmatized community uses such a respon se:
Jon : And what about SA RS jo ke...'! lmcun.Ict' s start off, did yo u hear
many jokes dur ing this time about SA RS?
Mike : Goodness. SARS jo kes specifically. No. peopl e used it in hum or .
yo u know there W3S some jest. mostly beca use peop le were nervo us and anxio us.
and certa inly in my pro fess ion we were. we have a hit of a wide sense of humor.
yo u know. wh at else can you do whe n you're stuck in a ma-..k and gown and
headdr ess all afternoo n? I can' t think of anyt hing offha nd. There was a lot of
humor. peop le tried to keep it light. but. .
Jon: Not any form ali zed jokes like. " Knock . knock ?"
230

Mik e: " Knoc k. knock:' or "What do you get when you have a SA RS
pauc m. . .... No.
Jon: 50 it was mostly ju st like. a situation woul d come up. there wou ld be
tens ion. and someone would make a jo ke to break the tension of the situation?
M ike: (affirmative noise ) I remember walking into a bar. this bar on
Yonge Stree t. where the y call Bingo and it's offensive and it's sort of a char ity
game for hum or. It' s also a bit of a sho w. And walk ing into the bar and. "Oh.
there' s Mike. and he' s got SAR S: ' you know . and people wou ld tum around. Or .
one rea lly good one that I used to do. and I still do all the time . is if we
[hcalthcare practitioners) get into an elevator. let' s say in a busy office town
downtown where you get fifteen people in the elev ator . and )'ou (mak es coughing
noise). and someo ne. "S AR5 : ' And people gigg le or they cover their face. When
we wou ld get into elevators and peo ple would cover their mouth s. you know .
there ' s no patient . it's ju st us goin g up to a ca ll. you'd (ma kes cou ghin g noi se)
ju st to sort of. you kno w. a ruse. But.. .
Jon: And it sounds like all of these. they're not cruel. they're used to kind
of acknowledge in some way the seriousness of the disease by. . .
M ike: (affirmative noise) It' s wh at' s on e ver yone's mind . and when you
get in an ele vator with two guys who arc in ma sks . gowns. gloves and e yegogg
les and headdre ss. e veryo ne ' s thinking about it. You can' t. you know .
elevato r' s quiet eno ugh. they're all. the y know what' s go ing on. Everyoncs
thin king abou t it.
Jon : And you might as we ll make a jo ke out of it rather than have
everyonc..
Mike: Lighten the mood . yeah.
Jon: Oth er jo kes. humorou s situat ions'!
Mike: Humorous situa... whenever I put the full-body white suit on.
because downtown Toro nto we mostly wore masks and gloves and gowns. but
you could put the white full-body suit on. and peo ple in public would look at you
just like you're insane. you look like the Michelin Man . so it was funn y to do that.
And there were times when you'd wa lk in some place and. just to watch. just to
watch peop le' s react ion to you order co ffee. you know. white gown. Th ere wa s an
ema il that went around as we ll tha t was "SARS On Icc: ' versus "Stars On Icc."
where someone had taken pictures of. all these stillshots of the "S tars On Icc"
peop le doin g thei r ice dancin g. and then cut-and-pa ste or painted 0 11gowns and
gloves and masks on these people. Just stupid things. but they' re cute nonethel ess.
(La rse n 2005)
In Mike' s narra tive. not on ly is the active. spoken usc of humor as a co ping mechani sm
apparent. but also the impo rtance of learning how to interpr et situat ions as humorous. It
wou ld be easy to react negat ivel y to walking into a coffee shop and havin g the pub lic
231

" look at you jus t like you're insane: ' but Mike see ms to stress in his interview that such a
react ion is ultimately self-defeating. Negat ivity only begets negativity: stress on ly bege ts
more stre ss. Mike comments on this further later in the interview:
It' s really important not to lose sight of the fact that we've been going for
thousands of years with all kinds of diseases and plagues, and there's so much
hype. I don 't mind , I guess , and I have a very ope n sense of humor. Certainly
peop le who were losing family membe rs to the disease might not find it funn y,
probabl y won 't. But, and again, that's a manc r of perspect ive, and from the
perspective that I have, having had to deal with it, having bee n accuse d of havi ng
SARS, hav ing people cover their face when I wal k arou nd, my neighbors in my
apartment building neve r came by to see me. I don' t mind, myself. I think that's
norm al. Peop le react to any kind of stressf ul situation, often with extremes, and
often with the extremes of nervou sness. humor, laughing. They cut the stress by
making a jo ke. (Larse n 200 5)
Humor, then, is a natura l react ion to stressfu l situations. The spec ific types of
humor shown in these pages fall main ly under the classi fication of "ga llows humor: '
defined by Amoni n J. Ob rdlik as "humor which aris es in co nnection with a precar ious or
dangerou s situation" (Obrdl ik 1942, 709 ). Ob rdlik wrote the article in which this quote
appcnrs as a sociological study of gallows humor as it appeared in Cze chos lova kia dur ing
its WW II Naz i invasion and occupation. The correlations between this event and the
SARS outbreak may he slim (though epidemics arc often referred to in militaristic terms.
and it is no stretch to say that SARS " invaded" Ca nada ), hut Obrdlik's co mments on the
nature (If anti-Nazi jokes in Czec hoslovakia still find purchase when applied to a modem
disease crisis. Obrdlik says:
Peop le.. .found in anecdotes an intelle ctual and emotional escape from the
disturbing realities. It was symptomatic that the more ominous the news co ming
from invaded Aus tria. the more numerous and pointed were these anecdotes. Th ey
bec ame a means of soc ial con trol in that they bolstered the mora le of the Cz ech
peop le. and, although they were so often but the ex press ion of wis hfu l thinking,
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their impo rtance as a compens ation for fear cou ld not be overest imate d. tObrdlik
1942. 710)
These co mments co incide with what James A. Thorson has said of gallows humor: that it
··... is both intentional (not circumstan tial) and has a copi ng motive . It is hu mor that is
generated for a reason. Thai is. it's not just a funny thing that happened. like mourners
with no place to go: rather . gallows humor is created knowingly and for a purpose"
(Thorson 199 3. 18). And since . as Ob rdlik noted. this type of humor seems 10 be more
common the stro nger the negative entity that enac ts it. the proliferation of black and
gallows humor in hospital settings shou ld come as no surprise (see Bosk 1980: Kuhlman
1988: Maxwell 2003: Sayre 200 1: and van Wormer and Docs 1997).
There we re other activi ties that similarly evide nced the usc of humor as a co ping
mechanism in deali ng with the SARS outbreak. The animated telev ision progra m South
Park. for instance. aired an episode on Apnl Jo" of 2003 titled "Re d Man' s Greed:' in
which a gro up of Native Americans attempted to dr ive out the reside nts of the town of
South Park to enable the destruction of the town and the subseq uent co nstruc tion of a
superhighway connecting their reser vation ' s casino to Deliver. Co lorado. The Native
American s' first few attempt s were all stymied by the tow nsfolk

South Park, of course , can on ly he used as evidence that humor was used to
respond to the SARS crisis: show creators Trey Parker and Matt Sto ne did not belong to a
stigmatized community. But public efforts such as the irs were not limited to Ame rican
televisio n. As Toromonians as a whole constitute a stigma tized group. Toro nto's 2005
Fringe Festival provided the ultima te exa mple of a stigma tized comm unity respo nding to
their situation throug h lISC of humor. The Festival hosted. among its many productio ns.
the musical "SA RS ical," written by Brando n and Kurt Firla (aka the Rumo li Brothers)
and Waylen Miki (aka the Severe Acute Repertory Theatre Company). The show mocked
the marketing of the SARS epidemic through skits and songs. two titles for the latter
being " I Kissed the SA RS Babies" and "Tee n in Quara ntine." The original prod uction
was met with scorn by many critics. who were offended by the show's light-hearted
stance on death and disease, hut ticket sales were strong enough that it was picked up by
Toronto' s Factory Studio Theatre in 2006 for a seco nd run. and in late 2007 was being
revamped for a full-scale production (Pedersen 2006: ..SA RSical..... 2(06). Aga in, the
poin t is simple: stigmatized individuals used humor as a coping mech anism during the
SA RS ep idemic.
Restating my earlier point. this use of humor as a coping mechan ism is large ly
absent from Coffman's work. This is not to say that it is cntirelv abse nt. for the concep t
of humor does make a few brief appeara nces. For exa mple. in responding to a stigma,
Goffman notes that. "In addition to matter-of-fuctness. levity is also recomm ended"
(196 3, 116). and provides as illustration. quoting Macgregor. ct ul.. the story of a woma n
whose face had been damaged by beauty treatments. and who dealt w-ith such scarr ing by
234

Toro nto. it is very likely that at least some of the parishioners kne w someone who was.
Heather doc s state that Prayers of Intercession arc a regu lar pan of this partic ular
church's services. and so it vwo uld just have seemed like a natu ral. normal thing" to
include SARS victims into the recitation (Read 2005 ).
The two rema ining narrat ives make the fear -media ting nature of church practices
quite appare nt. and as well. evidence the extents to which people were willing to niter
basic rou tines to pro vide for their own safety . These two narratives are especially releva nt
beca use be th come from the highly-stigmatized Filipi no-Chinese community in and
surrounding Sca rbo rough . Luis Tan. for exa mple. reca lled the following:
When the SAR S was at its peak. meaning you sec people die here and there . you
try to [avoid] restaurants ... publ ic places as much as possible you avoid . Even in
the chur ch. the priests always say. normall y you shake hands when you say
"Peace he with you:' even the prie st was tellin g peo ple just to he cautious. we just
greet each other. "Peace be with you: ' instead of shaking hands. Those are the
preca utions that even in church was good pract ice. Th at was at the height of the
SARS crisis. (Tan 2(05)
A seco nd narrative. which both encapsu lates and ex pands upo n Luis' entry. co mes from
interviewee Seny Zamora. who related to me the follow ing story about her church.
showi ng how even holy ground can become tainted by fear:
Scuy: So it' s like. if you have [SARSI. almost you feci that you' re
doom ed, People recover. but because it was so contagious. that they can spread it
by. say. air, coughing, sneezing and everyth ing. right? So whatever you hold.
right? So you' re being paranoid . wash your hands. "Happy Birthda y!" washing of
the hands.... (laugh) People don 't even want to shake hands even church. right?
In the Ca tholic. I' ve been pure Cath olic. I don't know. but when we have the mass
you go around, you turn and you shake hands. right'! Peopl e. the priest would say.
"Ok ay. becau se of the SARS, you just how your head ." (laugh) So peo ple bow
their head. And also you're going to the church. you have the holy wate r and the
"1" on your forehead and you make the sign of the em..s. They took out the holy
water! (laugh)
Jon: No holy water at all?
137

Se ny: No. Because it conta minates the qui ckest. They' re say ing that SARS
is spread by hold ing. like the handv, so you always need to was h yo ur hand s after
co ntact. physic al contact . no nobod y shoo k hands.
Jon: What abo ut co mmunion'! Wa.. that altered at all'!
Se ny: I thin k they stopped. yeah. because the priest had . .. usua lly
sometimes people sip com mun ion through the mouth . right '! So the priest made
this announcement. "Please receive communion through your hands :' (laugh)
Jon: Did they even pass out the little. the wafers '!
Seny : They passed out the wafers . but through the hands , But not. net . . .to
get at the priest hold ing it. because the saliva wou ld cau se the SARS . right ? So if
you stopped putting communion and the host into the mouth. righ t. but just done it
through the hand. right '! So everything was like that.
Jon: Did the wine disappear as well?
Sen y: Yeah. the wine disappeared, They didn't... wel l. the wine was there .
hut then ..orne peop le. there were some churches that they offered wine for the
communio n guys to drink. but that stopped for a while. 'Cause when you go to
communion. some churches offe r wine separately from the wafers and the bread,
(Zamora 2005)
Sc ny' s co mments ev ide nce a meta phorical "line in the sand" in rela tio n to dange r
and gatheri ng places. The dese rtedness of bus inesses and large areas of Toronto-c-such as
Chinatown- is indicative of high le vels of con cern and fea r. but many of the
establis hments that were largel y empty during the SA RS crisis were of an ulti matel y
entertai ning. dispensable natu re. People do not immed iately need to cat at resta uran ts. nor
do they imm ediatel y need to go to the movies or shop for clo thes . These are all activ ities
that cun safely and eas ily be at least te mporarily done away with. and their absence
provide s min ima l disrup tion 10 the basic. day-to-da y workings of the household ,
However . there are act ivities that need to be performed on a regular basis. and for the
religious ly devou t. Sunday morning churc h is as critica l to the soul as bread is to the
bel ly. Many of Seny 's congregation con tinued to atte nd mass during the 2003 ou tbrea k
because of this. bUI there sti ll existed at tha t church the potential of a dangerous
juxtapo..ition between large numhers ofpcople and a con tagious . deadly virus . Since
238

ceas ing to attend church was not an option. offi cial services were altere d to reduce the
poss ible avenues of disease transmissio n. Physical con tact with other human bein gs was
either eliminated altoge ther or. where that was not possi ble (as in the pass ing of
com munion wafers). kept to a minimum and performe d in ...uch a manner as to redu ce
po...sible co ntact with "dangerous" body fluids like saliva. The methods that churc h-goers
and church officia ls cho...e to deal with this problem highlight the extents to which they
were willing to endange r them selves for the sake of what were perceived as basic needs.
Such changes in church activit ies evidence a paradigmatic need for security. as
reflec ted in the alterat ions of perso nal actions and behaviours . and ...imultaneously a
...yntagma tic need for stability. as the intended meanings beh ind the actions remai n
cons tant despit e the changes. Scarborou gh ' s Filipi no-Chin ese co mmunity was heav ily
stig matized dur ing the SAR S outbr eak. and the membe rs of that co mmunity were aware
of their stigmutization. Futhcrmore. the members of that community were affected by that
...tigmati zation. and many of them attemp ted to avoid conta ct eve n with members of their
own community-as evidenced by Ange l' s statement in chapter five that he hardly left
his home for six month s. Luis' narrative abo ut parishioners bein g a...ked not to shake
hands wh ile saying " Peace he with you" is a perfec t example of how membe rs of a
stigmatized co mmunity dealt with the fear that encapsulated their lives. The churchgoing
sentiments of broth erl y love and well-wishing arc ...till present . as the mem bers of the
co mmunity ...till recognize the import ance of grou p solida rity. but the actions have bee n
altered in response to the threat of disease and contamination to facilitate the safety of
indi viduals. Scny's narra tive evide nces similar reactions: the recognition of others is still
239

prese nt. but the act i.. change d from a handshake to a bow of the head. Similarly. the
recep tion of communion and the concomitant rel igious experience and import ance are
still present. parishioners simply recei ve the wafers in their hands . rather tha n throug h
the ir mouths . Senys comments do evidence at least one alteration that falls outside of
this catego ry-the complete remova l of holy water from the fonts, with no apparent
attempt to rep lace it with a different action or gesture-but even then I would argue that
the overall meaning of the religious nature of church participation has not changed.
Scny's comments do not demonstrate that the absence of holy water changed her
churchgoing experiences on any fundamental level. especially as she continued to attend
church during the out break. Nowhere in Seny's narrative is the alteration of these actions
and behaviours anno unced as a nega tive experience . Instead. the alte ratio ns simp ly see m
to be acts that thc parishioners accep ted as co nseq uence of the outbreak -acts that only
change d the ways ch urch was conducted on a physical level. but not the way church was
ex perienced on a religious level.
Returnin g to Goffman' s list. only point two-s-ma stery of nctivitics thou ght to be
difficult Of impossi ble. given the stigmatized individual' s condition-e-appears 10 apply to
the churchgoing ex periences report ed by Luis and Scny. But aga in, Goffman's co mments
arc focused only on those who actua lly have the co ndit ions for which they have been
stigmat ized, Furthermore. the examples Goffman uses to support th is point-lame peo ple
learning to play tennis and blind peop le learning to ski-all focus on the impossibilities
assumed to accompany significant losses of physica l capa bilities such as sight or
movement. Both Seny and Luis are perfect ly healthy indi viduals who had full control of

-- - - ---- ------_._-- - - _.. _--
their facilities. both mental nod physical. Nor can the act of attending church be thought
of as a dif ficul t or impossible physical activ ity for a healthy indi vidual. Once again.
Go ffmcn's po ints do not offer adequ ate headings for the categorization of the respo nses
reported by peop le durin g the SARS outb reak.
But then . when it co mes to SAR S. Goffman's reliance on the usc and
categorization of individuals who actua lly have the conditions for which they have been
stigmatized mea ns that the larger numbe r of his argume nts cannot be used (0 examine
public reactions to the outbrea k. unless his arguments are dccontex tualized or otherwise
twisted 10 fit the situation. One of the few of his statements that doc.. see m to apply to the
respon ses given 10 me by any of my informants is that "since the stigmatized perso n is
likely to be more often faced with these [awkward social) situations than we are. he is
likely to beco me the more adept at managing them" ( 1963, 19). Jokes and humor provide
exactly this type of stigmatization management. as do the churchgoing narratives
provided by Seny and Luis. But even here, there arc reported actions that do nOI see m to
til into this neat statement. Does Angers ncar-comp lete avoidance of peop le for six
months constitute an adept social management strategy'? What about the public' s
uvciduncc of Chinatown and Asian-thcmcd or -cricntcd businesses? Of non-Asian­
oriented businesses such as theatres and airports'! What about reports from interviewees
who said they avo ided funerals (Sen y) and Slopped shopping for birthday presents
(Heather's mother. as reponed by Heather) durin g the outbreak'! Do these actually
constitute "adept' socia l management strategies, since they generally entail the complete
avoidance of social situations? Wouldn' t an adept social management strategy email

learning how better to successfully navigate social situations. rather than avoid them
uhogether?
As seems dear by now, Goffman' s work on stigma-while influential and
groundbreaking-in many ways does not provide an adequate framework for the study of
SARS narratives and communities stigmatized by SARS. Goffman's lad of a general
category for those stigmatized by disease, and the similar lack of a category for the
potentially discreditable, means that the larger portion of the stigma-related narratives
collected for this study are left without a neat slot to fit into. And even when forced into
the study despite this problem. Goffman's heavy emphasis on stigmatized individuals'
"l'gillin' reactions to their situations means that many of the collected narratives that
exhibit positive mediatory actions are similarly left unshclvcd and uncategorized. Even a
small study such as the one conducted here demonstrates the necessity of the inclusions
of humor and other more positive reactions to Goffrnan's lists, and a larger, book-length
study would no doubt find more areas hitherto uncovered. Sociological analyses of
stigmatized individuals and communities have revealed much about the nature of stigma.
Folkloristic, exper iential analyses call reveal yct more, and should he conducted more
frequently. as there is much that our field can add to these arguments.
242

Cha pte r 8: T he Ca use a nd the C ur e: Folk :\h.'d icin e und SA RS
When confron ted with a disease . it i'i a natura l human reaction to want to escape.
Self-preservation is deeply ingrained in our psyche. Barr ing this possibility. the next
logical step is to find a wa y to prevent the dise ase from affectin g us. And if those
attempts fail. we then begin to search for ways to heal ourselves. and to rid our bodies of
the invading forces . The SARS outbreak provides a uniqu e opportunity for examining all
three of these appro aches . because the border-crossing and airborne nature of the virus
led to situations in which individuals found thems elves suddenly confronted with a
disease tha t only a few hours earlier had not exi sted in their neighbourhoods, or even
countries.
The escapist reactions of the publ ic in respo nse to the outbreak have already bee n
covered in the examinat ions of desert ed restaurants. airports. and neighbourhoods. This
chap ter ope ns a new foru m in looking at the ways peop le respond ed to the encroaching
co mo navi rus when escape was not an option. whether for econo mic, personal, politica l.
or ot her reason s. Wh at will result from these studies is proo f that SA RS is unique in the
types of c ures that were created by the layperson in response to the threat of disease.
We first. however. begin with a look at the history of the study of cures and
remedies in medicine. Exam ining previo us work on the subject will prov ide background
infor ma tion that will prove use ful in demonstrat ing why SA RS is unique. It will also
provide a necessary loo k at how the study of folk remedies has changed over the past 120
2·0

years. thus presenting data thai will frame the theo retical approaches taken in this
chapter.
Discussions of the natures of cures and remed ies present in folk medicine are
numero us. having occup ied volumes' worth of scholars hip and covering areas as diverse
as philosophy. psycho logy. and ethnopharrnacology. Much of the early work in folk
medicine was text-oriented. in keeping with the philosophies present in the field of
folklore at the time. and consisted largely of long lists of collected remedies for various
problems. One example from this era will be a sufficient illust ration . William George
Black ' s Folk-Medicine: A Chapter ill The History ofCulrllrt'.lhe preface of which dates
the work to 1883. but which was reprinted in 1967. is an excellen t example of such an
approac h. His work contains chapters on both "Personal" and "Animal" cures. as wel l as
the importance of charms. saints. colors. numbers. the sun and the moon. magic writi ngs.
rings. and various forms of "domestic folk-medicine." thai altoge ther cons titute some 130
pages of a 220-page book . The scholarship necessary to prod uce such voluminous lists is
impressive. and the categories Black form s to organ ize his collections are useful. bUI
from the current perspective the work as a whole is lacking such critical contextual
information as the beliefs and values of the practitioners of these cures and remed ies. A
typica l passage from Black' s work. chosen at random, reads:
To avert the destruction of an entire drove it is still known that the burial of one
cow alive may be usefu l. More cruelly. there are instances of a cow being rubbed
ove r with tar. and driven forth from the stricken herd. The tar is set on fire. and
the poor animal is allowed to run till death puts an end 10 its sufferings . To bum to
death a pig has been recomm ended by a wise woman of Banffshire as a cure for
cattle d isease. The ashes were to be sprinkled over the byre and other fann
buildings. (Black 1967. 74 )

While Black docs list the source for his infonnation- Lccky' s History of England ill the
Eighteenth Century, which is itself citing Mitchell' s Superstitions of North-We.H
lIigll!{md!j- no further information concerning the practitioners of such traditions is
forthco ming. Pessimistically. Black' s work at times reads as little more than a list of
curious or barbaric and outmoded trains of thought in folk medicine. such as the
paragraph that succeeds the above-quoted one, which is devoted entire ly to examples of
human sacrifice-as-cure from history and begins with the subjective sentence "Human
sacrifices are, happily, now rare" (Black 1% 7. 74).
Black' s work did advance the study of folk medicine in its own way. for in his
textua l studies of cures and remedies he contradicts earlier sociological thought that "al l
primitive theories attribute disease and death to the spirits of the dead" (Black 1967. 205).
Instead. Black advances the theory that there arc three main "primitive explanations" of
disease, which arc. in order of most to least common and important, "( I) the anger of an
offended external spirit; (2) the supernatural powers of a human enemy; and (3) the
displeasure of the dead" (Black 1967. 205). the studies of which can lead mankind to a
greater understanding of itself. While these theories may no longer be considered correct.
they still evidence a progression in analytic thought. But in terms of contextual analyses,
Black' s work falls short of current standards.
Fast-forward almost a century. and the textual analyses practiced almost to
exclusivity by Black arc slowly giving way to more context-based approaches . Text­
based studies do still appear in print. (cf Brandon 1976: Emboden 1976: Fox-Baker
1981: Guerra 1976: Lacourcie re 1976; Radbill 1976: Smith. Truman 1981; Stallings and
245

Tilton 1981: Sullivan 1981: Vogel 1976). and one of the more prominent tcxtuali sts of
the last thirty years was Wayland D. Hand. His 1980 MII!(iw l ,\It'theine: TIle Folkloric
Component ofMedicine ill 'he Folk Belief. CUMom. and Ritual of 'he Peoptes ofEurope
"tid Amaim. a collection of twenty-three of Hand's articles on folk medicine. consists
almost entirely of text-based studies. Like Black, Hand i' meticulous in citing the sources
of his data. but rarely docs the reader get a look into the lives of the people who practiced
these medicines. For all of its excellent research. ,\ItI!(im l ,\Ietli eill t' offers three hundred
pages of various cures and remedies. and virtually no discussion of the practitioners.
This is not to say that Hand' s work was not important in advancing the field.
What William George Black was able to do in terms of codif ying and orga nizing folk
medicine in the latter part of the 19 th century, Hand did for the middle third of the zo".
His essays greatly detail how folk medicine can be broken into distinct categories of
CUTes and remedies, and he provides numerous examples for each of his groupings. Hand
docs claim in an essay written in 1975 that "the magical clement in folk curing is a
somewhat neglected field in folk medicine" (Hand 1980. I). a statement that seems
exagge rated given the lengthy tracts devoted to it by Black. hut other of his theories
provide interesting insights into the field as a whole. For exa mple, in his discussions of
the "conditions and circumstances that may enhance the [magical I folk medical act or
insure its success:' Hand chooses to categorize his entries hy "the adverbs of time.
manner. and place" (iland 1980. 2). Under these discussions. Hand avoids the normal
pattern of naming a malady and then listing possible cures for it. instead choosing to look
at. for example. cures that take place at crossroads. regardless of the malady they arc

designed to treat. A reshuffling of categories such as this illuminates similarities between
widely dispersed items. allo wing researchers to make connect ions that were previously
hidden. 1o And so Hand provides lists of cures categorized not by disease. but by how.
when and where they are administered .
Hand' s work was also usefu l in expa nding the field of study to all areas of
humankind. rather than jus t focusi ng on third-world or impove rished peoples . In an
article on disease aetiology. he states that:
IForrest E.) Clement's seminal paper on the causes of disease deals largely with
ideas held within the primitive communi ty in various parts of the world. yet for
almos t all of his five main theories of the cause of disease (sorcery. breac h of
taboo , disease-o bject intrusion. spirit intrusion. soul loss) parallels can be add uced
from medical and folk medical aetiologies that derive from people of high culture.
modem as well as ancient. (Hand 1980. 251)
Present within this quote is not only a more modem and inclusive version of Black' s
"pr imitive explanations" of disease. but the idea that it is not only the "pr imitive
community" that continues using such explanations. Instead. humankind as a whole is
correctly po inted out as maintaining these belief s. and thus limiting research in the
manner evid enced by Clement only impoverishes folk loristic understandin g of the topic.
Within Wayland D" Hand' s lifetime-though not evidenced as being practiced by
him in the works cited in this chapter-a critical shift in the field of folklore came with
the insistence that context-based studies would provide even greater understanding of a
given area. The presence of this con text-based approa ch is eviden t in Bruno Gebhard' s
10 Such efforts are not confined to the study of folk medicine. and have proven useful in
other area...of folklore. David Buchan' s article "Propp 's Talc Role and a Ballad
Repertoire" (Jol/nwl of American Folk/ore 95.376) provides the same ...c rt of
illumination·through·ca tego rical-reshufni ng for the field of ballad study. ultimately
proving that Child ballads separa ted by dozens of numbers have virtua lly the same plot.
247

The shift from text to context resulted in an exp losion of articles in the 1970s and
' 80s centered 0 11the reasons patients used cures. rather than just the cures used by
patie nts. Attemptin g to exa mine the field of folk medicine from the viewpoint of the
practitioners and consumers forced academics to look at the "why" of the situation­
more succinc tly asked ax. wh y are peop le still using folk. or "unofficial" remedies in an
era do minated by the success of scienufic. "official" med icine? After all. by 1980
scientific medicine had eradicated smallpox. drastically reduced throu gh vaccines the
number of yearly deaths from disease . transplanted human hearts . kidneys . and lungs. and
delivered the first test-tube baby. In light of such astounding achievements. why wou ld
peop le still tum to mag ic and religion for medical help. much less the weed s growi ng in
the ir back yards?
Some of the earliest efforts to answer this question came in the form of scient ific
studies of the folk medicines themselves. George G. Meyer' s 1981 article "T he Art of
Healing: Folk Medicine. Religion and Science" devotes part of its length to a summary of
the studies that have tested the pharmacolo gic properties of various plants. Specifi cally
ment ioned is Ortiz de Montclla no. ....'hose work in the mid· '70s found thal of twenty-five
plants commonly used in Aztec folk medicine. sixteen were proven in laboratory studies
to produ ce the cla imed effects. and four more had poss ible activity (the rema ining five
were nonactive). In addition. Meyer notes J. L. Dinzs study of plants used by curanderos
which concludes that most of the remedies make "pharmacologic se nse" (Meyer 1981.
10 ). The ultimate goa l of studies such as these is stated to be proving that folk medicine
docs often make "scientific sense:' and that many of the plants arc specificall y chosen

after long periods of investigation by curanderos and the ir globa l co unterparts. As such.
folk med icine ought 10 be taken more ser ious ly by scie ntific medicine.
Pharmacologic efforts such as these we re relatively common throughout the
1970s and ·SOS. Much of the wor k of Social Scicnti ...t Virgil 1. Vogel. for instance. was
devoted to studies of the efficacies of Native American medicines. His opus magnum in
this respect is American Indian Medicine , a 1990 pub lication thai approaches six hundred
page s in length. almost nil of it devo ted to the pharmacologic ...tudies of various plants .
Ralph W. Moss' s 1991 Cancer Therapy: TIlt' independent COIISlIIlIeT'S Guide 10 NOll­
Toxic Treatment & Preventionand 199 8 Herbs Against Catlct'rdid much the same wor k.
tho ugh for the more tight ly-focused field of herbal cance r therapies. And my own
Master ' ...thesis look a similar. admittedly text-based pharmacologic approach 10 the study
of the effectiveness of herbs co mmon to four popular folk-based cancer treatments (Lee
2(XJ1). demonstrating that studies such as thi...nrc still being undertaken in the new
millennium.
However. the strengths of George G. Meyer' s article lay not in the summaries of
other authors' works. but in the statement thai "cle ments of folk medicin e. religiou s
healin g, and scientific med icine need to be incorpor ated into all healing practices. Indeed.
when integration has not occurr ed. the patient will seck sepurutc care in all these areas"
(Meye r 1981. 7). While pharmacolog ic studies that prove the ult imate scie ntific
effectiveness of remed ies arc a step in the right direc tio n. the ultimate goa l of folk
medicine research shoul d be patient-or iented. and Meyer' s statement direct ly reflects this
philosophy. Researchers and medical practitioners need to take into account the beliefs
250

and att itudes of the patien ts. because d isrega rding them only leads to situat ions where the
patients seek add itional help elsewhere. The prob lem with this approac h occurs when the
types of help sought by the patients prove harmfu l or contrad ictory. such as in the case of
herbs that counteract or prove toxic in conjunction with hospital -based treatments and
medica tions . In a conversation with Lynnette Lee. a Radiation Therapist at Massachusetts
General Hospital. she commented that patients receiving radiation therapy for cancer. for
example. arc supposed to amid foods containing antioxidants. as such compounds inhibit
or negate the effectivenevs of the radiation-but many patients begin taking antioxidant-
rich vitamin pills after a cancer diagnosis because they believe such efforts will prove
beneficial. If for no other reason than safety. then. the beliefs and attitudes of the patient
must be taken into accou nt. and medical pract itioners needto learn to address such issues
with tact and opcn-ruindcdness.
Further steps in building the patient-oriented approac h examined both the
similarities between the folk and scientific medical systems. and the structure and nature
of folk medicine as a whole. Sometimes these approaches were used simultaneously. or
within the same article. to build an extended series of bridges between the fields. The
Nord ic Research Symposium of 1981, held in Kuopio. Finland . resulted in sever al
published articles central to these points. Tuula Vaskilampi. working out of the
University of Kuopio in Finland. looked at both scientific and folk medica l syste ms in his
article "Culture and Medicine: ' Vaskilampi' s sociological ana lysis. according to Caro l P.
.. .suggests two fundame nta l elemen ts in all medica l systems : I) a cognitive and
ideo logical sub-system. and 2) an organizational sub-system . The former
251

enco mpasses perce ptions of disease etiology. explanat ions of illness. the natural
,..curs e of illness. and treatment. The organizational sub-system includes soc ial
relations . especial ly between patient s and heale rs. as well as legal entitlements
and constraints. (MacCormack 1982. II)
In stating that both folk and scientific medical syste ms contain these elem ents.
Vaskilampi is pointing out the rationalit y and complexity of such systems. stating in
much the same way as proponent s of the pharmacolo gical approac h do that folk medical
system s arc far from the simpleminded and illogica l bits of quackery that they are so
frequently assumed to be. Instead. folk systems can boast the same levels of comple xity
and ingenu ity as scientific systems. and their treatments are just as well researched.
The remainder of'Va skilampi's article provides an excellent exa mple of the study
of folk medicine as a whole. specifically attempting to organize and de fine common ideas
within the field. despite the differences in values that com e with cros s-cultu ral
philosophies. Natu re is staled as a highl y-valued idea within folk medicine. especially in
the sense of the whole ness and liveliness of natural things. Such a value is present within
such diverse medic ines as "vegetarism. homeopathy. hcrbalism . naturopathy. osteopathy
and spiritual healin g" (Inglis. qtd. in Vaskilampi 1982. 4 l, but despite the variety of such
medicin es, the ultimate meanin g and impo rtance of nature is that it is "seen as containing
message s and truths of deep emotional impac t" (Twigg. qtd. in Vaskilampi 1982.4).
"W holeness ' is another concept com mon to folk medicine s. the study of which
reveals much about the reasons folk medicine s remain popular in the modem era .
Wholeness is "expressed in the em phasis of the balance of the bod y and the mind . The
aim of care is to treat the whole person and not only symptoms of the disease. We find
health in the harmon y between individu al and nature and universe" (Inglis. qtd. in
252

Yuskil am pi 1982. 4·5). Wher e scientific medicine is often criticized for treat ing the
disease and carin g little for the patient-or perha ps better slated. focusing on the sing ular
disease 10 the excl usion of all other po..sible and multiple healt h-re lated issues- folk
med icine exa mines the person as a who le. Sti ll prese nt in these examinations is the
importa nce of treat ing the body. but folk med icines are also will ing to examine the spirit
and soul.
In total, Vaskilampi states that "The cultu ral conte nt of belief systems involves
severa l positively valued ideas: nature. wholeness. purity . humanity and individualism
These ideas arc beco ming salient in other spheres of life. too . They form co untertrends to
the rcductio nistic technolo gical development which many people reject as unsa tisfactory"
(Vaskilarnpi 1982, 12). Folk medicine. then. provides more than the simp le ext irpat ion of
virus and bacter ium of fered by hospit als. In..tend of being trea ted as anonymo us broken
and empty vesse ls that must be quickly and all-too-oft en surgica lly repaired. practitioners
of folk medicines treat people as full and impo rtant hea rers of life who must be slowly
and carefully mended from the inside out using a variety of largely non-invasiv e
..trategics.
Bente Alvcr. another participant in the Nordic Research Sy mposiu m. carried this
idea to a cleare r co nclusio n in "Folk Medicine as an Ope n Med ical Syste m." wherei n she
states that "T he reaso n so man y peopl e seek treatm ent by nltemative mea ns is that folk
medicine i.. an open system capable of respo nding to human needs as they arise in space
and time in co ntrast to offic ial med icine which is locked into a system of a priori
a....urnptions " (Alve r 1982. 12-1-5). Alver specifically states that there are four types of
253

-- - - - - - - - - ---- - - - - - - -
illnesses that most frequentl y result in the consultation of folk healers: "c hro nic
illnesses... fatal illnesses...various psyc holog ical db-orders ... I.1and conditio ns which
acco rd ing 10 [he physicians are not illnesses at all" (Alvc r 1982. 130). In each of these
cases the scien tific medical system is seen as failing the sick and inflicte d by either not
effec tively treat ing the disease. or by reject ing the patient 's c1aim of disease. Alvers list
may actually be too restrictive. for it does not include the various folk medic ines used to
treat such eve ryday prob lems as up...et stomachs and hangnails. bUI it doe.. illuminate the
underlying issues of cold and clinical di..ranee thai freq uently accompany stories of
hospit al "bits.
Two more articles are needed to fully demo nstrate the transition from the text-
based to the context-based app roach. Th e first is another of Bente Alver' s articles. 'The
Bearing of Folk Belief on Cure and Healing: ' this one published in 1995 in the Journal (if
FolkloreResearch. Alver 's discussions in this art icle co nstitute a fuller and more
extended version of the argumen ts made in her earlier article, building on her previous
concepts to flesh out the patien t-ce ntered nature of folk medicin e. One of A lvers first
points in this article is to outline not only the importa nce of folk medicine as a whole, but
the importan ce of the beliefs inherent to folk medicine as they appl y to the broader
concept of culture:
In all cul tures. people's percept ions and bel ief systems regarding health are
closely tied to fundamental values, such as those concerned with the maintenance
of life and the loss of life and to certain conception s of "the goodlifc." Therefore.
the resea rch domain with in which one deals with people's beliefs relating to
disease and treatment is highly import ant for our understand ing of cultu re seen as
a totalit y. (Alver 1995,22)
254

Folk medicine. then. ontoge netically recapitulates the phylogenetic development of the
larger culture. the former enca psulating and mim icking the import ant aspects of the latter,
but on a relat ively sma ller scale. A lvers statement.. on this matter arc given as
unidi rectio nal. but it seems apparen t that they ca n he reverse d. and thus an understa nding
of culture ca n lead to a strong impres sion of what a researc her might find upon first
encoun tering that cu lture ' .. folk medicine. Cultu res that. as a whole. emphasize the
quality of life over the qua ntity of it will carry those altitude s over to their folk
medicines.
The impo rtance of such a statement lie.. in the differences betwe en folk and
..cicnufic medicines. as hinted at in Alvcr"s earlie r work. but restated in this later article
as follows :
Man y peo ple feel they are being helped with in the folk sector . Th ey report that
they lead more functional lives than they had before treatment. have grea ter
..uccc ..s in what they do. and are happier. On the whole. they desc ribe an
improved general condition. However. their doctor s seldom feel convinced. The
doctors. whose judg ment stems from a biological perspect ive, u..ually conclude
that the patient is as sick as befor e. though sometimes they will concede that the
patient is experiencing a good period, espec ially in the case of the chronically ill
or those with life-threaten ing sick nc..scs. (A Ivcr 1995, 26)
Ultimate ly. folk medicine and scientific medicine attempt to treatthe various maladies
that plague humanity, but the approaches taken differ va..tly in their co ncepts of what
con stitutes "health" and "c ure:' Folk medicine. as we have seen, mimics culture as a
whole. and thus concepts found in the culture as a whole are likely to also be found
with in the domains of folk medici ne. It is because. in part. of such similarities that folk
medici ne is the easier form of treatment to slip into ; it.. conce pts arc familiar and friendl y.
Scie ntific medici ne. on the other hand. preci sely because it is based solely on reason and
255

logic. hypothesis and laboratory-based proof. and emotional suppressio n in favor of co ld.
hard facts. is not seen as reflecting culture as a whole. Its concepts are alien and clinical.
and it\ pract itioners prone to disrega rd anything that docs not co incide with their schoo l-
learned worldvicw .
Alver. in desc ribing such differ ences . uses the work of several scholars to
supp lement her own :
Health disorders have a biophysical as well as a socio-cultural a..pect. In medica l
anthropology these two features are designated di..case and illness. Disease is
viewed as the biologica l disturbance in the bod y. while illness refers to the
cultural and social meaning attributed to the disorder (Young 1982). One may
visualize the two aspects graphically as partly over lapping one another and join tly
constituting the total health field with a particular culture (Hastrup 1984: Elsa..s
and Hastrup 1986:10-1 1). On the whole. profe..siona l medicine is oriented toward
disease. while the folk (la y) sector has its orie ntation toward illness. The medical
strategic.. in relation to disease are designated curing, while tho..e in relation to
illness are termed healing (Hastrup 198-1: Kleinman 1980:82). (Alver 1995.25)
Such a radica l d iffere nce in philosophy freque ntly serves to alienate the layperson. who
feels that his or her needs are not being met by the scientific approach . Drawing these last
few con cepts together- folk medicine as a smaller vcrsion of culture and the differences
between folk and scientific medicin e-s-Al ver completes her arguments with the
followin g:
In a modem folk belief system. health and quali ty of life arc connecte d to
concepts like harmon y and balance. Sickness is linked with disha rmony and
disequilibr ium: it is understood as a luck of balance within the body. as a
disequilibr ium between bod y and soul. and between human beings and the
immediate environment. Also. it may be seen as a lack of balance between human
beings and the "fo rces." Healin g. then. involves help to d islodge the cause of the
appa rent disequilibrium and to re-instate harmony. (Alvcr 1995. 28-9 )
Alvcr goes on to state tha t concepts such as these. when large enough. can he adapte d to
ideas present in scie ntific medicine. but the empha sis ..cern.. to he on the larger scale.
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Individual treatm ents are ncr often seen as pan of this balancing act. a view thai only
serves 10 further distance the relativity of scientific medicine to the life of the ave rage
person.
Alvcr does recognize the importance of scientific med icine. of course. and
acknowledges its marked ability to treat and cure many diseases. what she docs say in
re-pon..e i.. thai ..ciemific medicine "dea ls with sickness in terms of how. while
alternative medicine asks u'hy" (Alver 1995. 31). and note.. that while each of these
questions are importa nt. human beings are only satisfied when they have answers to both
of them. And so the con tinued presence of folk medicine can once aga in be attribu ted 10
its meeting needs that are not adequa tely addressed by scientific med icine.
The last article that needs to be mentioned in this section comes from Bonnie B.
O'Connor and David J. Hufford. Published in Erika Brad y' s 200 1 book Ifl'ali llg Login :
Cutture all d Medicine ill Modern Health Betief Svstems. "U nderstanding Folk Medicine"
provides a succi nct overview of the field . and echoes many of the state ments made by
previous scholars in regards to the reasons folk medicine remains valid and present in
modem socie ty. O'Connor and Hufford state:
However. it is precisely the health promoting capacities of any system or
therapeutic modality that are of grea test impo rtance 10 its propo nents and users.
People dealing with health prob lems are typic ally quite pragmatic in approaching
and eva luating any form of treat ment or remedy: if il ...ecms ne tt o wor k. or
produces effects thai are 100 unp leasant. ittends to be rejec ted; if it seems 10
work. it lends 10 be supported and retained in the repertoire of hea ling resou rces
likely to be tried again (and reco mme nded to others). This pragmatism ope rates at
both individual and collect i..'e levels. Folk healing tradit ions' reputations for
efficacy . based on aggregate observa tion and exper ience. are cen tral to the ir
pers istence and co ntinued vitality. (O'Connor and Hufford 2001. 15- 16)
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Important to note here is the underlying notion that folk medicine is not without logic or
reaso n. Its treatments are chosen carefu lly and specifica lly. eva luated over long periods
of time by hundreds. if not thousands of practit ioners and patients, and only absorbed into
the category of useful treatme nts if such long-term obse rvations conclude them worth
their merit . Folk medicine is thus the ultimate patient-centered approac h. especially
consi dering the abandonment of treatments deemed too harsh. Not only is folk medicine
interested in heal ing. it is interested in doing so in a manner comfortable to the patient.
O'Connor and Hufford also attem pt a brief list of the common practices found in
folk medicine-much like William George Black attempted over a century earlie r. The ir
list is much shorter . however, as they free ly acknowledge that "the enormous diversity of
American folk medicine makes it imposs ible to enumera te every therapeutic practice
found in every system" (O'Connor and Hufford 200 1, 28). Instead of listing cures based
on such categories as "sa ints," "co lors," and "numbers," as Black did, or even on such
broader categories as "time, manner. and place," as did Wayland D. Hand, O'Connor and
Hufford simply state that "there are... broad com mon categories of preventative and
therapeutic modalities in use across systems, including physica lly applied therapies,
medicinal herbs and other naturally derived substances, sacramental objects, and prayers
and other religious and spiritual actions" (O'Connor and Hufford 2(XJI, 28), the article
then providing a hrief paragraph for each of these modalities that lists exa mples of the
treatmen ts that might fall under them.
What O'Connor and Hufford do describe in the clos ing paragraphs of their article
are the links betwee n folk and officia l medici nes. They state that most peop le use folk
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medicine more frequentl y than offic ial medicine. and that these people continue to use
folk medicin e while being treated by doctors and other practitioners of official medic ine
for the same illness. Oftent imes. these doctors are not aware of such practices. This is
made all the more complex by the fact that peop le are often recommended hy their folk
healers to seck treatment from hospitals . and these folk healers will sometimes enter the
hospitals to continue their methods of treatment after or even while the patient is
receiving treatment from hospital staff. "The conventional medical model:' O'Connor
and Hufford conclude. "can be incorporated rather easily along with folk models of
illncs s, and in some in..ranees may even serve to reinforce them" (O'Connor and Hufford
200 1.32). Folk medicine is thus more than willing to accept the presence and wj..dom of
scien tific med icine. but suc h an att itude is still a long way from be ing reciprocated. This.
100. makes folk medicine the easier choice for the public: not only is it "comfortably
consonant with their general worldviews" (O'Connor and lI uffon.l 20(» . 32). but it is
more adaptable and willing to recognize the benefits- and sometimes super ioritie..--{)f
other systerns of healing.
Tak ing all of these articles into acco unt. one secs the history of folk medicine as
varied. but generally pointin g toward contcxtuality. especia lly within the field of folklore.
The larger proportion of modem ..cholars have adop ted a patient-oriented approac h in
their ..tudics. focusing on the beliefs and attit udes of their interviewee.. regarding the
treatments they u..c and the disease s for which they are ..elected. This patient-oriented
approach appears across the wide field of folk medici ne. and has been applied to
numerous health is..ues, both psychological. spiritua l. and corporeal . Applying such
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theories to SARS is at first blush no different than applying them to any other health
issue, for the prim ary purpose of such investigations is simply to gain an understand ing
of the interview ee 's culture, worldvi ew. mindsct . etc . To atleast some extent, many of
the same questions cou ld eve n be asked of a SA RS interviewee: How do you treat this
disca ..e? where did you learn of these treatments? wh y are the y important to you? What
do they mean to you'! Why do you u..e them?
From ano ther perspective, to at least some ex tent the answers to these quest ions
might he the same for SARS as they would be for any other di..ea..e. Alver ' s concl usions
that folk medicine co ntinues to present itself in modem culture because it fills niches and
answe rs question s that scientific medicine docs not arc also applica ble to SA RS, even
though thi s disease did not exis t when Alver penned her texts. Interviewee answers to a
question such as "Why do you use these treatments?" or eve n more basically, "What
treatments do you use?" co uld therefo re he ex pected to exhibit anti-medica l
establishm ent and/or pro-natur e sentiments. Take, for example, the following excerpt
from my interv iew with Ange l and Rosita Lim:
Jon: What did you do to prevent yourselves fro m getting SA RS?
Angel: Preventing, like, avo id going to public places, like mall. like movie
houses, restaurants spec ifica lly, restaurants. because they say that if you ate
something and you. they did n't wash the dishes w'ell. yOll know , you easily get
SARS from eatin g [with] , like, utensils they didn 't wash well. 50 we try to avoid
going to the mall or the fast food s or restaur ant.
Rosita: Also, this fear, good thing we didn' t have to go to, but this fear of
going to fune ral parlors . If somebody had died and you don' t know why they
died ..
Angel: Yeah , yeah.
Rosita: ...the SAR5 they said that if you were even in the funeral parlor
you might get sick. (laugh ) Or some how transmit.
Ange l: So one thing, you know, I'm afraid to go to the clin ic, like if you
are sick, like if you have colds, you would amid going to see the doctors. because

who knows. so mebody before you has seen the doc tors and left somet hing. and
then you go to see the docto rs and you might have SA RS. So that's one point. we
are afraid 10 go to the docto rs. Even lif l we. we arc sick . (Lim. Angel and Rosita
2(05 )
Clearly present in Angers narratives-especially in the last paragraph-is the distrust of
the medical community. Angel saw cl inics not as places of healing . but as place s where
people were likely to get sick. .....hether that illness came from the medica l profe ssionals
or from other pat ients. For Angel . the word "ho spital" became synonymous with "dirty ,"
or perhaps "diseased:' and as such . hospitals became place s to amid. Such fears were
ca used and exacerbated by the medi cal profe ssion ' s apparentlack of co ntrol over the
virus: eve n after news broke wor ldwide abou t the co ronavirus having spread from Ch ina.
SARS continued ove r the next few weeks to spread els ewhere . The World Health
Organization. poss ibly the face most readily ident ified as respo nsible for containing such
outbrea ks. seemed to be losing the battle . On a smaller level. hospita ls and clinics also
expe rienced grea t difficulties in co ntaining the virus-cvide nced by the numerous
instances of doctors. nurses. and other patien ts contrac ting the disease from infected
patients. Avoiding restaurants and funerals seems a natural exte nsio n of such a negative
perception. for if trained medical pro fessional s have not proven them selves capable of
preventing the spread of SA RS. what ass urances of safety could a waiter or funeral
director poss ibly of fer'? In light of such failings. the only acce ptab le respon se for Angel
wax to take matters into his own hands.
The reaso ns why patients "take mailers into the ir ow n hands"- a phrase used here
in the larger . metaphorica l sense of "removing some or all of the decision -making powe r
from Western medicine in treating illness and discase't-c-are the crux of modem .
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contextua l folk medicine study. The reasons stated hy my interviewees as to why they
chose these approac hes over, or at lea...t in conju nct ion with Western medici ne, are
exact ly those forwarded by Alver and O'C onnor & Hufford: Western medicine. at least in
some small part, is failing them, and folk medicin e has the capabi lity of offering more
sound shori ngs.
Angel's avoiding the medical clinic because of a perce ived risk of contracting
5A R5 is just one example of this failure . When I asked my informant Luis Tan abou t his
precau tionary measures , he responded, 'There is the the mo...t su ...ccpuble is if your
resistance is low. 50 what we did during tho...e time...i we tried to boost our immune
system by taking vitamin pills and extra milligrams or capsu les or tab lets of vitamin C.
Those are the... and then don't over work yourself, that way your resista nce won' t go
down" (Ta n 2(05). Luis' response is subtler than Angers, as Luis never open ly admitted
to discontent with Western medicine. He did admit to being afra id dur ing the outbreak,
hut seemed to bel ieve in the power of local hospitals and global medica l worke rs to
combat the virus. Luis also watched the news and read local newspapers daily, following
and appa rently completely trusting any advice given to him from those "o fficial" sources.
However. his inclusion of vitamins in his dai ly regime, and especially his notions of
overwork ing oneself lead ing to decreased resistance, still indicate that ...omehow hi !'>
needs hadn 't been fulfilled by those official sources.
What is interesting to note about 5 AR5-what, in some small part sets it apart,
and what may explain Luis' actions-is that almost all of the examp le...of folk medicine
mentione d either by my interviewees or through Internet and media sources were
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preventatives . and not curatives. My thirteen interviewees specifically discussed having
either used or see n others use the following precautionary measures, in orde r of most to
least noted:
I) masks or other covers of the mouth and nose while breathing (ten mentions);
2) avoid ing places (nine mentions);
3) wash ing hands/antibacterial sanitizing hand gels (seven mentions) ;
4) tied at two each were
a) taking vitamins
b) not shaking hands. and
c) using herbs:
5) and tied with only one mention each were
a) using Windex as a surface dis infecting agent
h) altered communion practices. and
c) daily washing of clothes.
The reasons for such a proliferation of preventative medicines and efforts-to the virtual
exclusion of curative medicines and efforts- arc no doubt multiform . One of the largest
reasons is also the most obvious: not many people contracted SARS. and far fewer died
of it. Under such circumstances. "cures" make far less sen..e than "p reventatives," a"
there is little need for a "cure" to a disease that has not yet affected a large number of
peop le: preventing it from getting to them is sufficien t.
If. for example. the list of cures and preventatives for AIDS and SA RS are
compa red. the natures of these differences are more appare nt. AIDS. of course. has
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dozens of pre.....entat i.....e measures that could be taken. Whatley and Henken give sc .....eral
examp les.I ! including that "A shower afte r sex reduces the risk of getting AIDS "
(Wha tley and Henken ::!OOO. 88); "Withdrawa l by a man before orgasm preve nts
transmission of HIY" (Wha tley and Henken 2()(X). 88); that on ly anal sex transmi ts
AIDS. and therefore vaginal sex is safe (this contrasted with the oppos ing belief that only
gay men get the d isease through anal intercourse. so it is safe for heterosexual cou ples to
practice anal sex to prevem contracting it vaginally); and that a I;10 dilution of bleach
....·iII kill the virus (which is true for surfaces on which bodily fluids have spilled. but is
misinterpreted by women who use this dilution as a douche).
In terms of cures for the virus. Wh atley and Henken note the belief that a man can
cure himself of AIDS by having sex with a virgin and "g iving away" the disease to her-
a belief that surfaced in rape trials of lil Y pos itive men in Zimbab we and South Africa in
the 1990s (Wh alley and Henken 2000). A news report from MSNS C.cOln. dated
February ::!oth. 200 7. covered the story of Gamb ia' s President Yahya Jammeh claiming
that he had a cure for the virus. consisting of a green herbal paste that he rubbed on the
ribcugcs of victims. followed by the ingestion of a bitter yellow liquid and two bananas
("Ga mbia' s President.. : · 2(07). Jonath an Campbell. who states himself to he a "Health
Cons ultant" in Boston. MA. writes of one Dr. Ian Brighthope. whose book The AIDS
Fi ghta.\' details his success ful use of zinc and mass!vc oral and intraveno us doses of
vitamin C to cure patients (Campbell n.d.). Pam Rotella' s webs ite. devo ted in roughly
equal pan s to vegetarian coo king. cons piracy theor ies. travelogues. and stories about
I! Readers should note that the examples that follow vary in accuracy and efficacy. and
should not be undertaken withou t first consulting a doctor .

4) Tremclla (white fungu.. and ..ilver ear). 5) Chrysanthemum . and 6) Androgruphis
(Dresser 2(04): a concoction that requires boiling 10 grams of dead silkworms and to
grams of cicada skins in water with five herbs for 20 minutes and drinking the water for
"even to ten days (Dresser 20(4); that having the Ace of Spades with Saddam Hussein' s
face on it will keep away SARS (r'Bouncin' around... ·· 2(05): etc. etc. etc.. including. of
course. the ever-present surgical Iacema..k. Pessimistically. one might wonder if there is
anyt hing that doesn 't keep away SARS.
Conversely. "cures" for SARS are few and far between. The televi..ion ..how
South Park. a.. noted in chapter 7. did claim satirically that the cure for SARS was a
combin ation of chicken noodle soup. Da}Quil. and Sprite. However. real-life "cures" arc
more difficult 10 find. As previously mentioned. not one of my informants was aware of a
"cure." A scouring of the Internet reveal.. that there was at least one in..tance of a Hong
Kong religious group claimin g that drinking hydrogen peroxide would rid the body of the
vim.. (Cline 2(04). as well as a web..ite claiming that hydrogen peroxide cured not only
SARS. hut ..evcra l other ailments (McCabe 2(03). Further surfing revealed a claim that
intravenous vitamin C would cure SARS (similar to the above claim about an AIDS cure)
(Cathcart n.d.), us well as that a man named Clive Harris claims to be able to cure SARS
(as well as Ebola. cancer, malaria. AIDS. heart problems, and other diseases) because he
has learned how to "download the Mother lode of energy fields. then (separateI them.
then further [tailer] each individual's need to the specific energy form needed." which
apparently resolves "e nergy field" problems in patients and allows the body to naturally
kill off the virus/bacteria/etc. (Clinic Clive Harris n.d.). There was also mention of a
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doctor who claimed that "u ltraviolet blood irradiation therapy" wa.. effec tive again..t viral
pneumonias (Gupta 2003). Finally. one web..ite wa.. written by a man who claimed that a
process called "Schlenzbath' was effect ive in treating almo..t any disea..e. including
SARS. The process involved sitting in water heated to -tI degrees Ce l..iu... or I05.8F
(with a note that "Li ndenbl uetcn or Lime blo....om" herb.. could be added to the water for
greater effectivcnessI, unti l the body ' s internal tem perature-as measured by a fever
thermometer-s-reached between 39 and -to degree .. Celsius. or 102.2-IO-tF. At thi.. point
the patient wa.. in..tructed to lie do wn, wrapped heavi ly in towels. for the better part of an
hour, or until their body tempe rature returned to norma l t'-There's An Ancient Cure.. ..
n.d.}.
Several notes should be made concern ing these "cure..:· First. lack ing any specific
exa mples of cures from interviews or the initial investigations I cond ucted, I was forced
to tum to the Internet for materials. I conducted my research by using one of thc
lntcmcr's most-frequent ly-used search engines-Google-and selected the searc h term
"S ARS cure" (though I om itted the quotation marks) as the most obvious opt ion,
reasoning that these wou ld be the first words the avera ge web-surfer would think to usc.
Goo gle returned some 774 ,(X>o results, and I elected. in the name of thoroughness. to scan
through the first two hundred-a far greater number than the average wcbsurfcr would
choose to look through. U And while I was able to locate five distinct cures through these
11 In fact. at least one ethnographic study of ..eve ntecn individual s using ..earch engines
concluded, in part, that "The majority of partic ipants never clic ked beyo nd the first page
of ..earch results. They tru..ted search engi nes to prese nt only the best or most accurate.
unbiased results on the first page .. .. 88 percent of the result links selected were located
on the first page: ' and "not onc participant explo red search result.. beyo nd the fifth
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methods . this should by no means be taken as evident ial of a panop ly of easily-locatable
remedies. My investigations took several hours. and were exhausting to the point that I do
not believe many people would choose to repeat them. Second. and tied in with the first
point. by far the larger number of the websues I had to look through to find these "folk"
cures were. in fact. legitimate website, from legitimate sources about legitimate scientific
advancements in the search for a vaccine or cure . Many of these websites included
published reports by the WHO. the Food and Drug Admini stration (FDA). or the Federal
Trade Commissio n (FfC) on the status of scientific progress in laboratories around the
world. Third. along with these legitimate reports of potential cures were dozens of
websitcs warning the public about spam emails containing claimed SARS preventions
and treatments. and noting the 2003 FDA and FfC crackdown on such bogus email s.
Given these three points. it seems unlikely that any member of the public in search of a
SARS cure on the Internet would be able to locate one without first coming across
several dozen wehpages noting that a) there is no cure for SARS. b) vaccines take years
to develop. and c) many people have been scummed hy bogus claim s of "cures" that
turned out (0 he little more than sinkholes for naive consumers' moneys.
A fourth note docs not involve the nature of the surfed-through wcbsites. but an
examination of the discoveredvcures." A close took ut the remedies mentioned in the
previous paragra phs will reveal that only the first of these- the Hong Kong religious
group's suggestion of ingesting hydrogen peroxidc-c-invol....es the claim of curing only a
single disease. The rest of the entries all revol ....e around treatments that are claimed to be
delive red page" (Marable 20(3 ). At ten links per page. my research took me through page
twcmy-c-four times the research of the most hardy of Marable' s individual s.
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panacea". curealls for virtually any malady.l-lSARS seems related to them only in the
sense that it is a disease. and these trea tments cure all diseaxes. In this light. the claims
that these treatments cure SA RS can only be seen as the post -event addition of a disease
to an already- long list of maladies that can be cured. In other word... the statu .. of these
treatment .. a" SA RS cure" is on ly margina lly related to SARS itself. as the treatment s
were not specifically formulated to deal with the coro navirus , but were crea ted long
before hand in an effort to rid the body of any illnc..s. Any new disca ..e that might come
along is simply added to the treatment's list of "treatable ailments ." since the eureall
nature of the treatment entails its being able to cure anything, includ ing diseases that have
not yet ..urfuccd.
It is possible. of course. that I have mi....ed ..omething in my resea rch. and that
there is, some where. a folk SARS cure that was created specifically to treat SARS. But
given that none of my informants were aware of one. and that a large quantity of effort on
my part did not result in a positive hit. it seems safe to say that a legitimate exam ple of a
SAR S cure is difficult to locate. Again. I believe this to he a function of the coronaviruv's
limited presence in public consciousness. combined with its com paratively low mortalit y
rate.
More important than my academic analysis of the types and numbers of cures and
prevent atives for SA RS. however. arc the op inions of the people who would have been
surrounded by them. Interviewee Jen Lim. who identified herself as Filipino with strong
1-1 However. even the ingestion of hydrogen peroxide ha.. been historically claimed a" a
curcall-c-see not only the aforementioned McCabe 2003. but Douglass 1992: Leb eau
200 1: t\kCahe 2()()..l; and Trud eau 2007. The "Clin e' article "imply did not mention this
connection.
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Chinese roots. was quite vocal about her op inions of these remedies . Asked what she
though t about the idea of people attempt ing self-treatment to ami d contracting SA RS•
...he rc...ponded by using an example from her own culture:
Jen : Again. it' s sort of part of that human need for self-preservation. But
it"...entirely possible that you wou ld, I mean in the Chinese cultur e. you
would ...animals and their bod y parts are sort of linked to human attributes of
...trcngth. and so I could see how people would think up. "Oh . if the bull is
immune. or if the monke y was immune, that if we took"- and I think that's like
what they base vaccine s on, that you take a part ... of the animal where it's the
animal that is not affected or impacted and apply it to yourself. and that somehow
you obtain their qualit ie...of immunit y.
Jon: So it seems to you like a very rational decision to try and trent
yourself for a disease by using part of an animal that seems immune to the
di...ease'!
Jen: I think becau se it doe s have a scientific basis. and that it is also rooted
in these old medical pract ices, then yes. it fulfils both an old tradition of drawing
upon nature, but it also does have a basis in science, in modem science. (Lim,
Jennifer 2005 )
Jon' s proclivities toward empathy are strongly apparent here. as she s ems to take some
care in not judging the practitioners of these remed ies. Interestingly, Jcn claimed to have
been mostly unaffected by the outb reak, and changed little about her hab ib . She never
....'Orea mask. did not see the need to take extra vitamins or herbs. and did not change her
daily routines-which included walking through Chinatow n to get to work, When
pressed. the only thing she could recall having felt hesitant about was hypotheticall y
travel ing to Asia .
However. her genera lly non-judgme ntal attitude evid enced some wear when
asked if she knew anyone who had avoid ed public places dur ing the outbreak:
Jcn: I think my dad . I don't know if I can say that up to that point we ate
regularly at Chinese restaurants. because we do n't reall y eat at Chin ese
re...taurant s anym ore. bUI I can't say if that wa... the date or period . But my dad ' s
son of a clean freak, and so is my younger brother. Charl es, And I think for sure
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my dud said. "Okay, let' s not cat at Chinese restaurants." Because he docs have
the perception that Chinese restaurants are not us clean. just regularly anyway. as
other restaurants.
Jon: Kind of an awkward question. considering it' s your father. but what
did you. or do you. think of peop le who avo id those kind of places'!
Jen: I think it's whatever a person is co mfortable with. I mean. I sort of
did feel as though it was unfounded. I mean. it was discrimin atory. it is
discrimin atory. I don 't know. I don' t think I judged him on it. or I think my
brother. Cha rles. would nct. c.you know. he' s also kind of a neat freak. and I think
he avoided (Toronto' s public transportation system ] because of that. (Lim.
Jennifer 2(05)
Jcn is dearly tom here betwee n her ope n-mindedness and what she sees as discrimina tory
behavior. This is made all the more conf using for her because of her ethnicity. and the
fact that her father. who was born in the Philippines and whose paren ts were born in
China. has these discrimin atory attitudes about peop le from his own culture. In an
outbreak such as SARS . it is not surprising to see lines such ::IS these being renego tiated.
As we have already seen. anyone perceived to be of Asian cthnicity was treated poorly
because of it. but Jeri's father' s actions show that this d iscrimination was not limited to
outsiders fearing Asians. In fact. even somc Asians feared contact with other Asians. and
thus it seems that outbreaks such as this at least temporarily disturb the cohesiveness that
might exist within a comm unity. When one's neighbor might be carrying a potentially
deadly virus. one lends to avoid that neighbor. regardless of his age, sex, or race. Disease.
it may be said. is the great leveller: it makes everyone afraid of everyone else.
Not nil of my inform ants evidenced such positive attitudes toward the use of folk
med icine. While no one actually spoke negatively and seriously about peop le using herbs
and teas to treat themselves, there were informants who joked about the methods they
saw people using. Mike. the EMT. recalled several times having people cross the street
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when they saw him co ming towards them in his medical unifo rm. "ev en though I was by
myself and there were no patie nts around. there was no one ill. Or people covering the ir
face in their elbow. sort of the pit of their elbow. or holdin g the ir jacket sleeves and
whatnot over thei r face. sort of to prevent themselve s from breathing in ncar me" {Larsen
2(05). Asked what his opinion was of the efficacy of such a pre ventative method . Mike
jokingly dism issed it as a "put garlic in your sock and tie it over your head kind of thing "
(Larse n 2(05). Coincidentally. Mike did later reca ll a rumor about a method of creat ing a
bette r facernask that involved stuffing the standa rd musks w ith garlic and laic- an act
that crea ted what he referred to as a mask looking "like a big do ily or a Maxi-Pad stuffed
with hems " (Larsen 2(05) that peo ple .....ould anernpt to breathe through . In general.
Mi ke' s reactions to the panic he saw in 2003 followed this same sort of good -natured
fun-po king, though it is important to note thai he did not ultima tely sec these methods as
poi ntles... Whi le the act ual efficacies of these various methods might be questionable.
Mike did quickly point out. when asked what he thoug ht abo ut peo ple who avoi ded
public places:
I mean, paranoia strikes deep. People avoid ed Toronto as a whole. The number of
out-o f-prov ince Iicense plates you saw that summer was few and far between.
You can't blame one ... peopl e would like to blame China. and you ca n't do that.
You can't blame the Guangdong province or the physicians there. or the
rcprcscntativcs from that country . I guess peo ple were responding out of their
own fears and conce rns. (Larse n 2(05)
Mike' s final comments here echo Jeri's feeli ngs about Chinese medicine. and in ge nera l.
this is the viewpo int that mo..t of my informants held : that scared individuals should not
he judged for trying whatever they felt might help .
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There were differing opinions, such as one gathered from my informant Seny
Zamo ra. Asked if she remembered hearing of any teas or vitamins that people took to
prevent themselves from contracting SARS, she responded, " I don't think we had any of
those. No, I don't think we had any of those. Because it was an unknown disease. right?
It was [a ] very new disease. So it wasn't something that you can strengthen your body to
fight against. because it was still unknown" (Zamora 2005). The media may have heavily
influenced Sony' s unique take on these matters, as she admitted to watching televised
SARS updates "all the time.. .even at work" (Zamora 2005). and most of the informat ion
she remembered gathering came from these sources . Seny's opinions-that folk
medicines cannot be used to treat diseases until those diseases arc understood-stands in
sharp distinction to the opinions of the rest of my interviewees. and moreover. seems to
parallcl the operations of official medicines. That is. while the response of folk medicine
to the SARS crisis was to offer a large list of potential preventatives (as per my earlier
list). the respo nse of official medicine was to try and stop the disease from spreading until
the coronaviruss genome could be sequenced. allowing for the search for drugs that
could halt or eradicate it altogether. Put more simply. official medicine's policy in the
SARS crisis was to stop it from getting worse until more was known about the virus.
Scny' s remarks thus more resemble the action sequences of official medic ine than folk
medic ine- though they are an interesting hybridization of the two. as she still apparently
believed in the importance and validity of folk treatments.
At the same time, however. it is hardly possible to say in the modem era that any
response by folk medicine i.. not in some way a hybridization of folk and officia l
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Chapter 9: Full Circle: The Recycling orHisease Narra tives
The disease-related narratives that have filled the pages of this thesis have b en
collected from hundred s of oral and written sources. have in some cases existed for
scores of years. and have circulated in dozens of countries. In addition. these narratives
have been told at varying times about a significa nt number of diseases. as outlined in
chapters three and four. The SARS narrat ives alone constitute an adequate cross-section
of the rumors. goss ip. legends. jo kes. and other ora l forms that circulated duri ng the 2003
outbreak. bUIwhen placed against the narratives about AIDS. Hansen' s disease.
influenza. syphilis. etc.• patterns begin to emerge. Like photo mosaics. where thousands
of individual photos are grouped by shade. pancm. and coloring to form a single larger
picture. the individual disease narrati ves in this thesis construct a larger representation of
reality. This new. larger picture can bc interpreted in multiple ways. but underlying all of
these is how this new picture is representatio nal of the health beliefs of millions. if not
billions of people.
This is. of course. not to say thai everyone has the same beliefs-c-uny statement 10
thai effect would he made in ignorance of decades of scholarship. It is to say that. at least
concer ning novel diseases. there arc certain sets of narratives that people lise to discuss
the presence of illness. 10 mediate their fears of it. to come to terms with it. and to
otherwise incorporate its presence into daily routines. Past experience with disease docs
influence future perception (see Duffin and Sweetman 2006 ). Some of these narratives
evidence a harsher. more paranoid view of reality than others. some are open ly racist and
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xenophobic. and some are more co ncerned with issues of treatment and prevention than
blame. but all revo lve aroun d a sing le emot ion. evidenced in its many forms : fear .
Let's look at this mosaic again . but from a d ifferent ang le. taki ng into accou nt the
narrative I have created . If all of the individual narrat ives that comprise this larger picture
arc borne of fear. and if all these narra tives can he separated into a finite ...ub...et of
mediating reac tions . and if the narratives in these ...ubscts can be org anized by common
themes and elements. then it is possib le to establish at least a basic typo logy of disease
narra tives . This docs seem to be the case . and though this volume is one of the first to
exam ine SARS narratives at length in relation to this method of organization. it is not the
first volume to recognize the existence of such a method. As Diane Goldstein 'iays in the
Introd uction to Once UPOIIA Vin l.\':
As I write this introduct ion. anot her deadly disease. SARS (Severe Ac ute
Respiratory Syndro me) has hit the worl d stage . In these initia l weeks of the
outbreak of the disease. one cannot help but notice thaI epide miologists and the
ge nera l publ ic alike have become obsesse d with story making. While mem bers of
the public engage in rumors about who has the disease. places and people to
avoid. mandato ry quarantines. and gove rnment health conspiracies.
epide miolog ists create and recreate plots that they hope will establish link s of
tran smission . Both sets of stories mirror the narratives discussed in this volume.
They ex plore notions of animal or igins. supcrinfcctors. hidden carriers. and
num erous other themes entren ched in our stories abo ut AIDS hut also seen in
reaction to virtu ally any devastating disease we have experienced historical ly.
Alread y. only a few wee ks into the SARS outbreak. we can sec how story comes
to define risk. (2004. xiv )
Narratives . then. arc re-circula ted from one outbreak to the next. mod ified not in their
themes. but in the specific details necessary to link the narratives to curre nt situations.
An exa mple of a sing le narrative that exe mpl ifies this proce ss of modification is
the "blood libel" legend . This legend is at least two thousand Yl'ar.. old. and in its earliest
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forms was ei ther anti-Se mitic. descri bing the murder of Ca tholics by Jews. or ann­
Ca tholic , describin g the murder of Roman children by recen t co nverts to Catholi cism. In
bot h cases the murders were do ne rituall y. as part of reli gio us ceremonies. In the several
cen turies that have passed since this lege nd's ince ption. many different groups have bee n
accused of ritual murder. and the narrative has been altered to fit. Communists. Chinese
people. nco-pagans. Satanists. and gang members have all bee n fingered as guilty of suc h
crimes . In eac h case . while the ma in theme of ritual murder has remained. the spec ifics of
the story have been altered: names. date s. place s. and othe r details have beenupda ted to
increase the story's rele vance. be lievab ility. and impact (Alexander. Tamar 1987: Benn ett
2005h: Dund cs 1991 : Rives 199 6).
It is true that not every disease narrativ e has a history as lon g as the blood libel
legend . or with as man y permutations. But a significant eno ugh number of these
narrat ives do contain suffic ient examples to allo w for the co nstruc tion of a typology (see
Ap pendix I). The impo rtance of such a typo logy is that not only will it allo w scholars 10
cross- reference and ex amine previous narrativ es. hut also it will presen t to those scholars
a list of co mmo n themes and clem ents that can he expected to appear in futur e outbreaks.
More spec ifically. since xenop hobia is a common cle ment in the narrati ves that have
already been collected. it is logical to assume that it will also he a co mmon clem ent in
future narrati ves. Or. since most major outb reaks have resulted in co nspiracy theori es
abo ut gove rnmental decep tion. secrecy. and miscondu ct. it ca n be ass umed that future
outbreaks will co ntain similar theories. Recognizing that patte rns such as this do ex ist.
and arc relat ively easy to isolate. is a boo n for health care workers e verywhere who arc
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forced to deal with the negative effects of such narratives. Understand ing that any new
diseu...e outb reak is going to result in conspiracy theories. xenophobic gossip. etio logical
arguments. and so forth. and that these will appear in a finite number of permutauons,
allows health workers the opportunity to better prepare themselves for the onslaught.
An initial examinat ion of this idea also points to the possibility of this information
being used to counter such narratives even before they arc born. But narrative forms such
as lcgcnds-c-cspccia lly contemporary legends-and con...piracy theories arc notoriously
difficu lt to eradicate post-creation. and while knowledge of impending racist narratives is
beneficial. predicting the exact narrative forms that ...uch racism will take in future
narrat ives is an extraordinarily complex task. and perhaps even an impossible one. It is
conceivab le that this could be accomplished by taking a sample of narrati ves that have
been collected about a disease (or possibly about a series of diseases). and statistically
analyzing those narratives for the distribution and occurrence of key themes or motifs.
The results of such a study. while they would not predict narrative forms. would at least
provide markers for common elements. However. such a study is beyond the scope of this
work , not to mention my current abilities and resources.
What elm be addressed here is the possibility of eradicating or countering
narratives that already exist. This is not a new ideo. having been discusse d in academic
circles for the last few decades. The problem. as has already been stated, is that narratives
have a troubling tendency to exist: "cry little seems to affect them. Kimmel and Keefer
discove red in regards to AIDS rumors thnt their transmission was strong ly linked to the
anxiety caused by the rumor: that is. the more anxious someone felt about the information
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contained in the rumor. the more likely they were to pass it on. In addition. those rumors
that were seen as personally consequential and relevant were more likely to be believed,
and thus cause anxiety ( 1991). Spreading rumors is thus a purposive action for both
narrator and narratec (Bordia and DiFonzo 2(05) . This information alone points out the
difficulties inherent in eliminating a narrative : any rumor (and presumably some other
narrative forms such as legend and gossip) that is deemedimportant or pertinent enough
to provoke a fearful reaction is very likely 10 be passed on. Such is the nature of peop le.
Wc naturally want to warn those close to us about danger,
But rumor-telling is not an action that merely involves uuempting 10 protect those
close to us. It is abo a social act. shaped by the com munities we have beenraised in. We
think in patterns that have been taught to us by friends and family (Fine and Khawaja
20(5). Rumors arc in this sense understood within the context or-toea! meanings and
recent histories" (White 2005. 2oll), and "are drawn from a store ofhi..torical and
contemporary allusions that have been kept alive and given new and renewed meanings
by the fractiou s arguments of diverse social groups" (White 2005. 244). Rumors are often
grounded in prejudices and misunde rstandings so old that they are not recognized as
being inaccurate, so any attempt to challenge the rumor inherently challenges belief
systems and ingrained ideas.
Making the issue of dealing with racist rumors more difficult is that, as Gary Alan
Finc has noted. the modem world has proven their model breeding ground:
The transformation of the global economy and the expans ion of transnational
migration pauems have proven to be a rich SO UH.'C of rumor and fears for national
identity. Moreover. eve n in thc most remote comers of the globe peop le are
increas ingly awa re of diversity. With expanding migration between developing
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and developed nations , the character and act ions of migrants have beco me more
salie nt. As the homogeneous cultures of indus trialized nation -stales mutate.
beco ming more multi cult ural. rumors that target recent imm igrants (legal or
illegal. tem porary or perm anen t) frequ ently appea r. These wor kers bring their
ow n cultural patterns, including such diverse maile rs as food prefe rences,
standa rds of clea nliness. public decorum. sexuality. fami ly dyna mics. and
religious beliefs. These patterns of behavior and disp lay may co ntrast with those
of the receiving natio n. leading to mis understa nding . suspicion. and mistrust.
Observations of cultural diversity are tran..formed into rumo r alleging that these
cultural choices are immoral or dangerous. Thc majori ty transforms even ts. ..orne
real and some imagined. into patterns of dep ravity through truth claims reported
in rumor. (F ine 2005. 3-l)
Deal ing with rumors in this light seems a truly Herculean task. for not only can racis t
sentiment .. be deep-seated. but they can also be cont inually aggravated by the influx of
fore ign peoples into "our" territory. lt is not even necessary that a narra tor believe a
rumor to have some impetus for passi ng it on---o nly a bel ief that the events in the
narrative could have happened (Fine and Khawaja 2(05).
Moving beyo nd rumor . Veroniq ue Campion-Vincent has noted the popularity of
co nspiracy theo ries. and how they are used "to provide meaningful and accura te
ex planations of the world's condition:' and nrc "part of an every day strugg le to make
sense (If a rapid ly changing world" (Cam pion-Vincent 2(X)5. 103). In additio n. these
narrati ves arc used- wittingly or not- to increase group cohesion throu gh the naming of
enemies. These enemies can be other races or cthnicit ics. but they ca n also bc members
of different classes within the ethnic ity of the co nspiracy theorist. Fine has remarked that
the telli ng of anti-gove rnment consp iracy theories reveals "uncerta inty abo ut procedural
democ racy... (the narratives ] frequ entl y reflect thc inchoate disaffection of citizens.
diverti ng allegia nce. butlacking any positive program of change" (Campion-Vince nt
2005.5). In these senses. consp iracy theo ries constitute important and cr itical avenue.. for
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the discussion of unknown situations. providing form and shape to. and release from.
stress. Like rumors. conspiracy theories exist because they serve a purpose. and because
the need for informational vacuums to be filled is strong enough to support the existence
of the narrat ive.
Not surprising ly. then. those articles that have dealt with the issue of eradicating
rumors and conspiracy theories are mixed in their judgments of the effectiveness of any
given method. Bill Ellis discusses several methods in his essay "Legend/AntiLegend:
Humor as an Integral Part of the Contemporary Legend Proce ss," beginn ing with the note
that most scholars have focused their efforts on the birth and spread of such narrati ves.
rather than on their demise. He then states:
Only three factors. according to Fine and Turner. combine to make a rumor (or
legend) disappear: boredom. saturat ion of the community. and intervention of
social interest groups.... That is. legends are news. and when everyone has heard
them. they cease to have the attraction of novelty. and so when more credible
information is available. they have no reason for being. (Ellis 2005. 123)
So one possible response to the question of eradicating a narrative is to simply wait it out:
it will eventually get rid of itself. Proof of this is found in the SARS outbreak. As soon as
the virus disappeared and ceased to make headlines. the stories died. This tack. however.
is problematic in the case of an outbreak. where the narrative can cause massive
psychological. and even real-world damage hefore it ceases to circulate. In such instances
it would be better to contain the narrative to the largest extent possib le. Waiting for the
legend to take care of itself is also problematic because. as we have already seen with the
blood libel legend. there are narratives that. some two thousand years after their creation.
arc arguably more popular than ever. And as we have also already seen. narratives are
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continually reshaped. and are almost infinitely flexible in their ab ility to he adapted to
new situations. Quot ing Fine and Turner again. Ellis notes that "so me legends may not
die so much as they dive, that is. remain latent in the communi ties in which they
circulate. ready to he verbalized later as a social need arises" (Ellis 2005.123-4.
cmpha..i.. in original).
If waiting for the legend to die out is not an option. then the next logical ..rep is to
ancmpr to force it.. early demise. Again. Ellis provides us with exce llent scholars hip on
effort.. that have been made in this direction:
Fine and Turner concede that fonn al rumor control has had "mixed success:' and
in any case there are no control data available to determine what might have
happened in the absence of such efforts. Official denials do no harm. they
conclude. but whether they in fact do shorten the duration of rumors by providing
"authoritative informat ion" is unclear .... Some research by Jean-Noel
Kapferer...on the Mickey Mouse LSD legend. in fact. suggests that forma l effo rts
to debunk legends arc not especial ly convincing and may in fact commun icate the
rumor to those who have not yet heard it. If the authority challenging the legend is
seen as a low-credibility source. then taking time 10 deny a claim suggests that it
may be doing so 10 cover up its own culpability. (Ell is 2(Xl5. 12-t)
Additionally. as Renard points out. Western postwar generations have been found to be
more likely to question and distrust governments. and arc thus more receptive to
conspiracy theories and other such negative narratives (Rcndard 2(05). Further problems
with official denials ore pointed out by Patricia Turner ( 1993). who notes that African-
Americans often dismiss such denia ls-c-such as the C IA creat ing AIDS. or the KKK
owning Church's Fried Chicken-s-because of deep-seated di...trust of a primarily while
government and economy . Because of this. any attempts to deal with rumors and gos...ip
mu..t not only take into account the tenacity of such narratives. but race and ethnic
relations that may prohibit or lessen the effectiveness of communications.
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One potential avenue for dealing with unwanted narratives is the antilegend, a
parody narrative designed to counter a lege nd by presenting its information in a
humorous. satiric. or scomful light. By "creatively distorting" (Ellis 2005. 124) the
narrative structure of a legend. the antilegend can prove more effect ive in demonstrating
the logical flaws and absurdities present in legends, Ellis note that antilcgcnds have. at
times . prm'en effective . citing the Good Times com puter virus legend. whose aruilegends
have not only fairly effectively halted the circu lation of the original legend. but have
proven more popular in the long run than the original legend (Ellis 2005), The problems
with untilcgends, however. are I) that they have been found to exist co mfortably beside
the original legends. com menting on them rather than negating them (Degh 1995. cited in
Ellis 2005 ). and, 2) "the dynamics of the nntilegend require a conduit that supports both
belie f in and skepticism about some of the clements of the legend on which it is based"
(Ellis 2005. 135), In other words, in order for an amilcgend to succeed. there must
already be some skepticism about the original legend, or at least an environment in which
a skeptical altitude can be fostered. Given the right circumstances. then. an antilcgcnd
might prove effective. In the case ofTumer' s African-American dismissal of official
denials. however. an antilegend would stand far less of a chance of succeeding in
negating the original legends. as those legends ex ist because of deep-seated distrust and
strong emotions. There are few chinks in such armor for an antilegend to sink into.
Similarly. it is questionable whether an antilegend would prove effective in dealing with
narratives that espouse racism and xenophobia. Such sentiments arc al..o deep-seated, and
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test was rc-udmini stcred. and this time the participants misidentified 15% of the incorrect
statements as true. while the percentage of correct statements wrongly idcnufied as false
remained stable. These findings were nOIunexpected. the authors exp laining that the
huma n brain has a tendency to assume that familiar stateme nts arc truc-e-which explains
why the number of false positives increased. as well a.. why the number of false negat ives
d id not (Schwarz cr at. 2007).
A ..econd ..tudy-reponed in the same article-expo..ed groups of "younger
adu lt.. and "o lder adu lt.. participants either once or three times to statements that were
clear ly marked as "true" and "false". The subjec ts were then tested immedia tely on the
contents, and again three days later. In almost all cases. the number of true ..tarcmcnts
misidentified a.. false was low. and rose only marginally over the three-day wait (by
roughly 6% across the board . by my estimate). However. the resu lts for the number of
false statements misidentified as true varied widely-not only over time. hut also
accordin g to age. The young adults who were only given the informat ion once increased
their incorrect answers from 10% to 24% over the three-day period. while the young
adu lts who were given the information three times only increased their error s from 7% to
14%. showing that. for younger adults. increa sed repetit ion improved accurat e recall. For
the older adults. however. the numbe r of errors for those who heard the information once
remained steady at 28% between days one and three. while the older participants who
heard the information three times actually increase d their numbe r of incorrect responses
over time. from J7% on day one to 40% on day three-..hewin g that. for older adults.
increased repetition lessened accurate recall. Schwarz ct al. state that this is the result of
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the dccrca..cd memory function of older adults. which forces them to rely more on
"fami liarity" as evidence of truth than recollection of accurate facts (Sch warz et al.
2(07).
Additio nal psychological ..tudies add to the co mplexities of rumor perception.
Weaver. Garcia. and Schwarz determined that. not only docs repetition increase the
likelihood of a statement being determined as prevalent among a group. but the statement
docs not have to be made by all members of that group. In fact. an outsider who only
hears a statemen t repealed by one member of a group is ju..t as likely to assume that
state ment holds true for all members of the group us if the participant had actualtv heard
it from all members. And within that group. participants were more likely to agree with
that frequently repeated statement. even though they knew it came from only one member
(Weaver. Garcia, and Schwarz 2(07).
Finally, a study by Mayo. Schul. and Bum..tein exa mined the effects of time on the
memor y of certain statements. The researchers gave particip ants a series of descriptions.
then examined recollection over time bused on the presence of "hi-polar" and "uni -polar"
negations. Briefl y. "a hi-polar description has a well-defined oppo site construct which is
easily accessible. whereas a uni-polar description docs not" (Mayo. Schu l and Burnstein
24.440). An exa mple of a bi-polar description might be "wa rm:' which has the easily­
understandabl e opposite of "cold." whereas a uni-pola r description would be
"respo nsible:' The word "respo nsible" docs not have an easily-accessib le opposi te; the
most immediate antonym is "not responsi ble" or "irrespo nsible:' which is linguistically
far closer to the parent word than "bot" is 10 "coldv-c-and in fact "not responsible" and
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"irr esponsible' both contain the parent word in the negation. The results of the study
found that. while 83% of respon dent s accurately remembere d the hi-polar description
"not warm" as meaning "not warm : ' only 62% accura tely remembered the lini-polar
desc ription "not responsible't-c-the other 38% misrcmcm bcrcd it as "responsible " {Mayo.
Schul and Burnstein 2004. ++t). In real- wor ld terms. this study gives reasons for why
people who are cleared of cri minal charges are still stigmatized afterwards: so meo ne who
is decl ared "no t guilty of harassmeIll" is more likely to he remembered as "guilty of
harassment" due to the uni -polar nature of the word "harassment: ' In fact. the study
co ncludes in part that. at times. it is far better to amid de nying a false claim altogether.
Instead. a more effect ive approach i-,to crea te a new. positi ve claim that makes no
refere nce to the false claim-i.e. sayi ng " I am innocent" instead of " I am not guilty:'
The implications of these studies in terms of rumor negotiation are vast. As we
have see n. many rumor control methods have been historically ineffect ive. and have often
res ulted in the dispersal of incorrect infor mation. rather than its correction. Th e above
studies help provide reaso ns for such results. and point in a direction of act ion that. at
least theoretically. should provide rumor debunk ers with a better outcome. Not all rumor s
arc harmful. of co urse. and thus not all merit such attention as might result in their
demise. But for those rum ors that are dangerous or harmful. there are a few strategies that
ca n be em ployed to help cou nter their effects. Summarizing the information laid out in
the previou s paragraphs. we come up with the followin g series of state ments: I) if we
naturally ass ume that familiar statements are true. and 2) we tend to misrc membe r false
state ments as true. and 3) if hi-polar descrip tions arc better remembe red than their uni-
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polar coun terparts. then 4) accurate. oft-repea ted, positive descriptions are obviously
superior to rc-hashings of narratives followed by denials of veracity. Stud ies would be
needed to confirm these conclusions. but I would suggest that. in the case of a selec tion
of disease narratives. the following courses of action would find better results:
I) Instead of denyi ng the presence of SARS in an Asia n neighbo rhood.
city officia ls coul d comment that the disease has equally affected all
parts of the city; or alternately. that SA RS has only been discovered to
exist in other cities (if there is no evidence that the virus has broache d
city limits).
2) Instead of denying that AIDS can be given away by having sex with a
virgin (or any other harmful. unofficial course of action). health
officia ls could comme nt that the only proven treatme nts are the FDA­
recognized drugs.
3) Instead of denying that smoking preven ts people from contracting
SARS. healt h officials cou ld com ment that the best courses of action
are to wear a mask, avo id crowded places. and stay away from peop le
who are already infected.
4 ) Instead of denying consp iracy theories about the origin of AIDS. health
off icials could comment that current evidence points toward an animal
virus that has adapted to humans as the source of the infections.
In each of these cases , the negat ive rumor has been bypassed entirely. and the answers
instead rely on repea ting acc urate. positive information. Inaccurate information is neither
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epeated nor summarized, to avo id its further spread. For hest resu lts, the accurate,
posit ive information should be repea led frequent ly to hel p so lidify its public recogniti on
and fam iliarity, Any phra se tha t begins with "X is not true" shou ld he avoid ed altoget her.
as should. in general. the wor d " not," as it too ofte n lead s to con fusio n. espec ially whe n
used in conjunct ion with uni-polar de scriptions. Response to rumors sho uld he rapid. for
best resu lts. and where poss ible. prese nted by people who have some recognized
autho rity. eit her on a loc al or national leve l.
Who sho uld these authori ties be"!Ch urch leaders, mayors. polic e and doc tors arc
all finc can did ates. However. individually. these peop le have only limited exposure to a
sma ll section of a city. In orde r to get the ir messages across. a dispersal system is
n e ded-c-one that is nearly ubiq uitou s. high ly visible, and frequently used . Such a sys te m
already ex ists: the media. Co nsider this select ion from my interview with Luis Tan :
Jon : Accord ing to what you saw. how did the public react to the outbrea k?
Luis: Based on what I see. I said. you cou ldn't go on the bus. Peopl e tried
to avoid sneez ing and cou ghin g. (laughs) Tha t was very, very obvio us sight you
ca n see in the publi c. Even in churches or public places. people sneez ing. peopl e
try to tum their head awa y. you kno w? (laughs) lr' s rea lly ver y scary during that
time. Becau se espec ially new spape rs sny that it can be transm itted by. when you
sneeze. saliva or something from your nasal excretion. Th ose arc the things I
remem ber qu ite well.
Jon: Do you think that the react ions that you did sec from peop le were
justified, or did you th ink they were over don e?
Luis: I don 't think it' s overdone. It' s just hum an nature to be cautious. It' s
norma l. You try to avoid. you know ? Especia lly newspapers. how this can be
co ntracted. then they tell you what to do, what to avoid, We just follow most of
this from what we heard in the news.
Jon: So were you following the new s fairly regularl y'?
Luis: Oh yeah. You open the TV , you hear SAR S stor ies. You see the. you
read the newspaper . you have SARS stor ies front page. It' s almos t. eve n in the
wo rkplace. the company sends out memorandum. and if yo u visit the hospital or
...omct hing .. .the company is ver y [u nders tanding ]. they' re okay you can ha ve
a...what do you ca ll this. you secluded yourself. there i...a term for that. .
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Jon : Qua rant ined?
Luis: Quarantined yourse lf. yeah. We were even told that if you vi..it like
this. the bank would be very, very [understandin g ]. As a mailer of fact. I ha ve a
coworker that. withou t knowing that. she visited certain hospital. and then ..he
self- quarantined herself at home for x number of days. She got paid. everything
was ... she worked from horne. things like that. Most companies are very
sympat hetic. they support peop le. thei r emp loyees. (Tan 2005)
Another example. this one from Angel and Rosita Lim. who gave the following when
asked if they had heard any rumors about the origin of SARS:
Rosita: Well for us. there's always it's coming from civet rats or
some thing from China. so that's in our mind that that's where it cam e from. And
then it moved to li an g Kong. and one person from Hong Kong brough t it over.
That was very clear in my mind. that was what eve rybody kept saying. I did n't
hear any other sources, did you?
Angel: That's the only one. yes.
Rosita: Because it was very clea r. they kept saying. "This is exact ly where
it came from" (Lim. Ange l and Rosita 2(05)
In fact. of the fourtee n people I interviewed. thirtee n mentioned that media so urces
provided them with at least part of the informat ion they'd gathered abo ut the coro navirus,
and several informants stated that media sources prov ided them with the larger part of
their critica l information. II is true that some of this information wasn't correctly
reca lled-the SARS virus came from the civet ca l, not the civet "rat." as Rosita stated-
hut even here the wrong answer is still very close to the right onc. More importantly,
Rosita' s an..wcr ..till demon strates the powe r of media sources in dispersing informat ion.
Th ese find ings agree with at least two studies of the SARS cris is. The first was
conducted in Qatar. and examined the knowledge. altitudes. and practices of the peop le of
the region in respo nse to the outbreak. The resea rchers handed out quest ionnaires at
airpo rts and health ce nters. and ultimate ly received 1.386 respo nses. The resu lts showed
that 73% of respondents were aware of the high ly-infectious nature of SARS. 69.9 %
290

ecognized that close contact with an infected person was a primary transmission vector.
and 67.4% knew that a high fever was the first symptom of infection. Roughly half of the
subjec ts reported having gained most of their knowledge of SARS from media sources­
primarily television and radio programs (Bener and AI-Khal 2(04). The second article
detailed the results of a study of community responses in Hong Kong to the SARS
outb reak. The study consisted of a number of telephone surveys conducted during the
crisis. examining the measures people thought effective in preventing the spread of the
virus. Of the 1.397 participants. 82% rated mask-wearing as effective in preventing
infection. 93% said the same for hand-washing. and 75% said the same for home
disinfection- and these numbers remained constant throughout the epidemic. The
researchers concluded that govern ment and media-based dissemination of accurate
information in a timely manner was responsible for the high numbers of people who
provided knowledgeable answers and who so quick ly adopted the appropriate SARS
prevention measures (Lau et 'II. 2(03).
The media thus does work. at least in the sense of being an effective vehicle for
the distribution of information. The problem lies only in the type of information that is
dissemin ated. Following the steps laid out in this chapter would greatly increase the
dispersal of accurate information. and inhibit the spread of negative and harmful rumors.
Additionally. using local spokespersons recognized for their honesty and authority 0 11the
matter would increase the chances of this accurate information being trusted and
believed. Knowing that certain narratives are more likely to appear in epidemics. health
officials could better prepare themselves for the kinds of rumors and goss ip that they
291

would encounte r. and perhaps even prepare a short list of accepted responses-a-much like
the four examples give n earlier. Again. real-wo rld tests need to be conducted to prove or
di..prove the..e Iheorie.., but the ..implicity and c1canl ines.. of the logic that brings us 10
the..e theo ries is compelling. With any luck , the next outbreak-whatever it may bring­
will he better dealt with in light of the..e conclu sions .
292

Cha pter 10: Epilogue: ...And the World :\lnH'd On
As I write this epilog ue in Boston. Massachusetts. in late Februa ry of 2008. the
coronavirus is but a distant memory . Since it:'.last fluttering in early 200·1..the virus has
faded into thc background. a.. have many of the narrat ives that accompanied its existence.
It is still possib le that SARS is lurking in the bodies of civet cats and other wild anima ls.
waiting only for that one chance to make again the leap between species and wreak havoc
on the world. However. there is nothing in the public consciou ..nes.. to ..uggest the
slightest concern over such an occurrence. Even now, only five years after SARS was the
biggest story in the world. I find people looking at me quizzica lly when I expla in my
researc h topic. and I have even had to remind people of what SARS was on more than
one occasion. It has been three years sincc I remember seeing the word "SARS" in a
newspaper headline. and longer still since I'v e heard anyone voluntarily bring up the
outbreak in conversa tion-c-exccpt for friends and colleagues asking me abou t the
progress of my research. The world has truly moved on.
Or has it'? While SA RS itself may he forever wiped from the earth. the fears and
attitudes that underscored the narratives that sprang lip around the disco..e are a.. present
now as they have ever been. Racism and xeno phobia still seethe just under the surface of
humanity. and legend s-though they may currently focus more on computer than
biological viruses-c-are ubiquitous. As evidence of both of these. one needs only to tum
to the Internet. The popular website snopes.com. for examp le. currently (as of the 28 th of
Fehruury. 2008) li..ts legends about Presidcntia l Cand idates Burack Oha ma and Hillary
293
-

Clinton as its second and eighth "Hottest Urban Legends: ' respectivel y. All six of the
legends about Obama. the U.S: s first black candidate, that arc listed on the website are
either openly racist and xenophobi c or otherwise question hililoyalty to the United States.
A number of the legends about Clinton are markedly anti-femini..t,
Just aliequally, the media is as guilty now of exaggera ting and overstating facts a..
they were in 2003. In the la..t two weeks. the local "7 New.. New England" television
news show has run several promotiona l commercials for "Specia l Reports" that seem
little more than attemp ts at fear-mongering for profit. Each commercial ha.. been more
lurid and exaggeratedly important than the la..1. with ..ubjccts such as the dangers of
badly-manufactured playground equipm ent, armrests on chairs at local movie theaters
that laboratory tests have revealed are swarming with bacteria, and non-inspected and
un..afc semi trucks trawling our roads at highway ..pccds (ready to break down and hurl
part.. everywhere at any given moment!) . American novelist and polemicist Upton
Sinclair is reported to have once said. "It is difficult to get a man to understand something
when his salary depends upon his not understanding it." In the current climate, it seems
more appropriate for this to be modified to instead say, " It is difficult 10 get a journalist
not to make a big deal out of a little situatio n when his salary depends upon his making a
big deal out of it." It is important that med ia sources begin to recognize their roles in
..preading rumor and legend, and the damage that they can cause. By repeating racist
nurratives-c-cven if only as examples-newspaper and televisicn joum ali..rs. as well as
their editors and managers, are complicit in the hate crimes and xenophobia that follows.

But such blame cannot be solely placed upon jou rnalists and media sou rces. They
arc indeed selling a probl ema tic product. but they can only kee p se lling it because
someo ne is buying. We. the people. arc creati ng the informa tion vacu ums that these
xeno phobic narrat ives fill. and if fingers are to be poin ted anywhere . they should point
toward the pub lic. Wh y then place so much emphasis on having media sources alter the ir
practices. when the prob lem lies with tho..e who dema nd the narratives'! Because it is far
easier to ask a score of busi nesses 10 change than it is to demand the ..arne from millions
of individuals. For if the forme r task seems daunting. the latter is truly Sisyphean.
The purpose of this thesis has been 10 demonst rate the links between disease
narratives. to study the various vectors through which those narra tives have been
transferred. and to examine the effec ts that these narra tives have had on the world. It
seems to me that disease pan ic and racism are 10 diseas e narratives as the chicke n is to
the egg: each exists because of the other. whirling together in a ge nerative dance that
began long before living memo ry. and will continue to ex ist long after the child hom
today dies of old age. But it is not enough to say that these narratives define us. Th ey li re
us: body and soul. flesh and idea. mora l and ethic. a co nnectio n that gocs beyond mere
metap hor. And j ust as these narratives are our friends and homes, they arc also our
enemies. and the things we hale and fear. Whcn in story we cruc ify and ridic ule Others
for being dif ferent. we reveal to the wor ld our true fuccs-c-the ones that arc on ly loosely
held hac k otherwise by our co ncerns over po litical co rrectness and maintaining socia l
niceties.
295

I believe tha t disease narratives arc vastly unrcgardc d by health offic ials. Not only
do they revea l what peo ple be lieve about a specific disease. but studying the m on a larger
sca le reveals ovcrarching beliefs that pass between diseases. high lighting areas of
concern and cul tural importance that do not always coincide with those espoused by
doctors and scientists. Unders tanding these differences ....ill icad to improved
communications be tween laypersons and medical personnel. It may also point to
preventive measures that could be undertaken by entities such as the World Health
Organizat ion to preemptively combat the racist and xenophobic narratives that come out
of epidemics.
The prob lem. ho weve r. lies less in understanding wha t the narra tives say about
peop le than it does in getting the appro pria te officia l sources to conceive of these sto ries
as anyt hing other than. we ll. stories. The only way to ach ieve this is for the medical
profession 10 begin think ing of patients as inte lligent. reasoni ng bei ngs ....he arc equa l
participants in health-related decisions. rather tha n just as bodies thai must be made we ll.
Or as Bonnie Blair O'C onnor has said. "This will require the ca pacity of health
prof essionals to accept the pat ient as an active co-s hapc r of the relationship and of healt h
care cho ices and actions. rather tha n as a limited partn er to whom va rious dut ies arc
merel y dele gated " (1995. 193). O nly by incl uding the puticnt-c-and his or her stories-in
the eq uation call doctors tru ly begin to und erstand how to help peo ple. rath er tha n just
treat disease.

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A IDS 264.265
SARS 263
Hosp ital Gowns
SA RS 184
Hydrogen Perox ide
SARS 266
Kaletra
AIDS 132
SARS 132
Mon ey, Burning of
SARS 100, 265
;\Iun g Bean s
SA RS 265
Plants (Ge ner ul/Un speclfled )
Cancer250
Publi c Spitting, Pr eventi on of
SARS 127
Radio Frequencies
AIDS 265
Cancer265
Schlenzhath
Various/Gcneral lllncsscs 267
Sex With A Virgin
A IDS 264
S moking
SA RS HX1, 265
So rcerers
SARS 100. 265
Sprite
SARS 233
Teas (Various)
SARS 265-266
Tyvek Suits
SA RS 184
Ultr a violet Blood Irradiation Th er ap y
Pncumonias 266-2 67
Vinegar
SARS 265
Vilamins
AIDS 264
SA RS 262, 263. 265. 266
Vodk a
SARS 98
Washin g Clo thes
335

A IDS 147
SUI'EKSI'KEAIIEKS
AIDS 196
SARS 196-197
340