Toxic Shock. Sharra L. Vostral
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humans, Homo microbis, may better reflect the makeup of human beings and the “microscopic companion species” laced throughout our bodies that are intrinsic to who we think we are as humans. Heather Paxson, an anthropologist who studies food, offers “microbiopolitics” to frame the ways in which “microscopic biologic agents” configure not just our microbiome, but also politics in public health and food safety, and how humans arrange structures of power.51 Furthermore, Helmreich describes “symbiopolitics” as a term to refer to “the densely political relations among many entangled living things—not just microbial—at many scales.”52 I build on symbio- and microbiopolitics and argue that we must also engage these organisms as users with technologies in and of the body.
Instead of referring to bacteria as residents or inhabitants as they are also sometimes called, claiming bacteria as constituents acknowledges their greater agential power. For instance, constituents in political districts allow elected officials to represent their interests; the will of individuals is not always followed, but nonetheless inherent to the structure is the assumption that constituents should have a voice in larger political dynamics. Bacteria should not be afforded something akin to citizenship rights; however, keeping bacterial agency in the frame of larger health systems would serve humans well. By thinking about bacteria as constituents of the human body, a more robust, complex, and all-encompassing understanding of human-bacterial relationships emerges. Labeling bacteria as constituents avoids the problematic constructions of the “host” body in which a universal male bears the burden of feeding the greedy invaders. Never mind that the body is not a feminine hostess (also problematic in other ways), in which the body simply becomes the site for ungrateful and usually unwelcome guests. The more accurate description is that some bacteria are simply part and parcel of being human—Homo microbis—and considering them as constituents affords them a bit of recognition in the larger body politic.
Bacteria, and, for that matter, any unwanted organism that threatens to do harm, accumulate meanings of “the other” by the language used about them. For example, my father, an agronomist, often described a weed as a “plant out of place.” As a child, I was comforted that the weed was still a plant that might do well somewhere else, just not alongside a corn crop. My critical reading now recognizes the power of labeling a plant a “weed,” which disparages one plant while simultaneously naturalizing the legitimacy of another. This construction of a species “out of place” is prominent to descriptions of many ecosystems. Banu Subramanium, a scholar of race, gender, and science, discusses the political costs of describing these out-of-place organisms in racialized terms, and the prejudices laced into tropes such as “invasive species” versus “native species.” This proclivity of naming conveys information about systems and structures of power.53 How bacteria have been labeled and described in reference to colonization is a political description as well. Reading bacteria through postcolonial and indigenous studies changes the frame of reference. The colonizers (in this case human bodies) take on the assumption that they are the colonized and translate indigeneity onto themselves.54 The (formerly) indigenous bacteria assert their sovereignty, form colonies and rebel, taking on the pejorative role of an invader. In this model, the body is not a holistic ecosystem, but an empire that has claimed its primacy and indigeneity, and thereby exerts dominance, power, and control to eliminate its unwanted subjects. Even language to reduce MRSA in hospital intensive-care units refers to “universal decolonization strategies.”55 Language paints an antagonistic picture of bacteria, an enemy that science and medicine must thwart.
Moving away from this a bit, and assuming that microflora are contingent communities with agency, one way to rethink the relationship of bacteria and bodies is with a feminist analysis. Feminism provides a means to examine nontraditional communities and those excluded or devalued by dominant power structures, and it reveals biases that tend to privilege one group while simultaneously dismissing another. A feminist-studies reading of TSS focusing on S. aureus as a marginalized community of the body demonstrates not only how bacteria are overlooked, but also the detrimental consequences of doing so. This framework provides a more inclusive reading of the body, not only as a microbiome, but also as one with constituent communities that may be affected in different ways by technological interventions. As one commenter about the microbiome project on the NPR Shots health blog noted, “What if the microbes stage a revolution? Or go on strike? Would they vote Dem[ocratic] or Rep[ublican]? What effect do the TSA scanners have on them?”56 Though these comments are meant to be humorous, the writer captures the sentiment that we do not control our microbes, and we need to think more comprehensively about how technologies affect them and, in turn, how these interactions may affect us.
In fact, these technological encounters with the microbiome can have reactive and unexpected consequences. I contribute the term “biocatalytic technology” to better interpret, analyze, and understand technobiological interfaces. Biocatalytic technologies are those technologies that are not primarily dangerous to humans, but have the potential to catalyze microbial activity that may result in harm because of their use. For example, the microbial activity may precipitate an infection located at cellular interfaces and crevices of hip replacements, or it could produce toxins deadly to human organ systems. The dual analysis requires one of technological agency and microbiopolitics. This means looking at bacteria as constituents of the human body, with the potential to interact with technologies and become biocatalytic agents. The term “biocatalytic technology” offers a way to understand the actualization of reactive tampon technology with constituent bacteria. The term also provides language to interrogate those technologies that seem safe, yet still may precipitate other forms of harm because of their use.
Not only is it possible for technologies to catalyze change, but the bacteria can also interact with them as unanticipated technological users. This is an important conceptual departure because only humans are presumed to be technological users. There is much hand-wringing by engineers and designers about non-users, who tend to be characterized as stubborn and unwilling to accept progress or change. Sally Wyatt, who studies digital technologies, has argued for more robust understandings of non-use. She identifies four types of non-users: (1) resisters, who do not want to use a technology; (2) rejecters, who have voluntarily stopped using a technology; (3) the excluded, those for whom the technology was not initially intended; and (4) the expelled, who have stopped using the technology involuntarily.57 These categories are extremely helpful in understanding why technologies are not adopted, and they move beyond blaming the non-users for their misguided ways. The flip side is to imagine an unwanted or unintended user. For example, a whale as a “technological bystander” becomes an unintended nonhuman user of low-frequency sonar, which is harmful to its existence.58 In the case of TSS, the S. aureus bacterium became a nonhuman unintended user of tampons, able to exploit the technology. The superabsorbent tampons served its interests, and the bacterium capitalized on them to grow and flourish. As biocatalytic agents, bacteria become the reimagined users of technology.
It is important that scientists, engineers, and designers move beyond a mechanical understanding of the body to envision it as a robust ecosystem with bacterial constituents that have the potential to become users. Researchers must ask how medical and bodily technologies will interact with bacterial constituents. This approach challenges the current embrace of nanotechnology and its applications for human health and welfare. Tinier in size than one-celled bacteria, these technologies may become objects to them. This is not a moot point; there is a new menstrual pad in development that incorporates nanofibers.59 This new pad may be a wonderful innovation, but we are not asking about the nonhuman users and what they may do with the technology.
The technobiological illness of TSS engages the two nonhuman entities of tampon and bacterium as necessary and vital cofactors.60 Furthermore, the powerful biocatalytic relationship between technology and bacterium was not just overlooked (since this would imply willful disregard) but, worse, it was unimagined as a possibility because the tampon was presumed to be inert. In addition, menstruation was dismissed as an insignificant fluid of a leaky mechanical body fixed with a menstrual plug. Even James Todd, who first identified and published results about TSS in 1978, lamented that “it should have been obvious that the group of young women with ‘vaginitis’ were of menstruating age and, in fact, three of our original patients, in retrospect, were menstruating at the onset of their illness, but we missed completely the possibility of any connection with tampon use.”61 In some ways, it was refreshing