Whatever else Susan Sontag did, she gets a ticket into heaven for Illness as Metaphor (link to isbn.nu).

For those who haven’t read this invaluable little book, here’s a thumbnail: She looks at medical conditions are treated as moral problems instead of as diseases. Her examples are tuberculosis and cancer, and in a later supplement, AIDS.

The telling point she makes is this: If an illness is both threatening and mysterious, so that it can kill or disable at any time but is not understood or curable, its cause will be assigned to something socially determined. TB was thought to result from too passionate and expressive a personality, and sufferers were told to lie down and stop reading poetry and having romances. Later, cancer was ascribed to holding in , and patients were blamed for not expressing themselves.

In both of these cases an inexplicable affliction was linked to a social prejudice, and without evidence this was accepted. And in both cases the patient’s behavior was blamed. It’s easy to see why AIDS was added in her supplement. Another mysterious and threatening ailment was entirely blamed on moral and social problems, so that the actual biological problems were poorly investigated and patients were blamed and ostracized.

Since cancer and AIDS are still deadly and mysterious in affluent societies, the problem remains. Any theory that presents a moral enemy as the cause of these diseases will be accepted by the appropriate group. If your group dislikes pharmaceutical companies, governments, synthetic chemicals, homosexuals, meat, science itself, or any other socially contentious force, then moral certainty will be applied to medical uncertainty.

Some of these fears may be accurate. Cancers can be caused by trace amounts of metals or chemicals, or by radiation. Birth defects and crippling illnesses result from exposure to toxins and infectious agents in pregnancy. People did get AIDS because governments and medical agencies chose not to screen transfused blood, and people died of AIDS because of malign neglect by the same authorities.

But the problem remains technical at its heart, and not moral. Sassafras oil is a natural herbal carcinogen. Deadly nuclear radiation can cure cancer. AIDS doesn’t care if your behavior is socially approved; it justs kills you. Magical thinking will sometimes solve your problem, but it’s more likely to make things worse for yourself and others.

A post today by ofmonsters reminded me of some of the current villains in the alt-culture world: vaccination, cow’s milk, refined sugar, white flour, processed foods, the Western diet, gluten, “toxins,” etc.

Some of the things in this list are bad news for people with particular medical problems. Other things in this list are worthy of investigation for basic personal health: too much processed food and dairy and a diet rich in meat will in general make people less healthy, for example. And some of them are meaningless. “Toxins,” for example, always refers to some nebulous and poorly defined environmental evil that must be cleansed, rather than to actual known toxic substances, all of which are different from each other. White flour has less fiber in it, but is not otherwise evil. Refined white sugar and brown sugar and honey and rice syrup have different flavors but provide the same dangerous blast of calories.

The vaccination fear is paranoiac. Vaccination is a symbol of government power, scientific arrogance, and threats to children. In a state of ignorance it’s understandable that someone would fear this. Without vaccination we have piles of dead children and later piles of dead adults. It’s not negotiable. Tagging vaccines with autism (another poorly understood and incurable affliction) gave the whole counterculture a perfect condensed symbol for their dislike of white coats, compulsory medical treatment, and the medical-industrial complex. But they’re wrong, and being wrong about vaccination threatens everyone.

What I have to say to these fearful people is this.

1) Read Sontag, or at least work at understanding the concepts she talks about. Watch out for moral certainty when you’re solving medical problems.

2) Your fears of government, pharmaceutical companies, toxic substances, radiation, bad diets, dangerous assumptions built into Western culture, and the centralized corporate meat-centric incompetent business of Big Food are all completely legitimate. There are deadly problems and bad people and very poorly organized institutions.

So we do have big problems, and the problems are similar in kind to the ones you’re seeing. The problems, however, do not result from science. They result from bad engineering and wickedness. The scientific method is how we know these things went wrong. That’s why we know that heavy metals in our food are bad, and that factory farming kills, and that it’s better to cut down on the cow’s milk and eat more fiber, and that cancer can result from contamination of food and water.

The scientific method is also why we know that vaccination is a good idea, that sassafras is a carcinogen even though it’s natural, that “toxins” means many different things and not one, that chelation is a dangerous treatment for specific situations, and that white sugar and honey will give a diabetic the same dangerous load of concentrated calories. It’s also how we found out that stomach ulcers were often caused by an infection and not by “stress.”

The antidote to unreasoned panic is not less science, but more. The scientific method is, to paraphrase Churchill, the worst way of interpreting illness except for all of the other methods tried. This includes the method Sontag clearly outlines. If someone says that the illness is due to “stress” or “toxins” or “Western diet” or “gay lifestyle” or “the government,” stop and watch closely.

Choosing an attractive moral or social cause for your terrifying unexplained problem may feel satisfying. Don’t take the bait.