This summer, I attended 2024 UNC’s Burch Field Research Seminar on Infectious Disease through the lenses of science and literature. Many people (understandably) seemed confused about how literature and biology were relevant to each other, especially how literature was relevant to infectious disease (admittedly, allegories and amino acids are seemingly quite distinct). However, I found that both fields were invaluable contributors to a deeper understanding of how science functions in a society, and how a society itself impacts science, especially with infectious diseases.
My cohort spent our mornings discussing the microbiology and history of cholera, plague, smallpox, vaccination, and penicillin with UNC Biology professor Dr. Ann Matthysse before transitioning to exploring cultural meanings of sickness and healing in literature and other media with Exeter University English professor and HHIVE lab collaborator Dr. Michael Flexer. Our afternoons were spent exploring London’s rich history and the cultural backdrops to health and science with visits to the theaters, monuments, and museums.
I found that the media we engaged with helped me understand the cultural context of science in London and how culture often influenced science directly. For example, in our biology course, we read Steven Johnson’s The Ghost Map about the London cholera outbreaks in the nineteenth century and how John Snow spent years accumulating evidence that cholera was being spread via the water. His work was routinely rejected by Miasmists, who believed that bad air caused disease.
One of the many reasons miasma theory persisted is apparent in the literature from the time that our class read. Indeed, consider one of the most famous lines from Charles Dickens’s Bleak House:
“Fog everywhere. Fog up the river … where it rolls defiled among the tiers of shipping, and the waterside pollution of a great (and dirty) city.”
Rapid industrialization belched smelly, polluted gas into London, and a crammed pre-sewer city constantly stunk from the massive piles of excrement. The symbolism is clear: in the minds of 19th-century Londoners, something was wrong with the air. And so, miasma survived, and science stalled.
Some of the best learning happened when our excursions and texts came together. For example, in our biology class, we read how the scientific story of penicillin is retold to fit an“archetypal quest story,” which underscores how our “narrative impulse” can confound history. A quest story calls for a hero, and Alexander Fleming becomes that in our collective imagination. Case in point, as I walked through the crypt of St. Paul’s cathedral, I found a tomb marked AF (not HF or EC, for his colleagues Howard Florey and Ernst Chain who put in the work to turn Fleming’s lab curiosity into the basis of modern medicine), and the London Science Museum calls Fleming a “hero.”
This myth inflates Fleming’s status, which makes it difficult to question his scientific expertise. The Science’s Museum’s plaque addresses the rising burdens of antimicrobial resistance (AMR) by noting that “Fleming warned then about the dangers of resistance to the new cure. This “Fleming warned us” sentiment is commonly repeated in papers attempting to tackle AMR and comes with an implicit condemnation of the consumer for not listening to the hero/expert who tried his best to save us from ourselves. However, Fleming warned that the greatest danger of penicillin was that people would “underuse” them. We know today that overuse is the true anthropogenic driver of AMR. Antimicrobials today are overprescribed and overused, and I can’t help but wonder what impact our protagonist had in entrenching the doctrine of overuse into our medical system.
Regardless, he clearly has an impact today: the papers that attempt to explore solutions to AMR adopt the condemnation of consumer misuse. Narratives that place the blame on the consumer assume that the consumer is the problem that needs to be fixed while ignoring other drivers of AMR, such as antimicrobial overuse in wastewater treatment and agriculture, climate change, and antibiotic dosing regimens that are too long/too high. Indeed, some research points to the overemphasis of individual responsibility in fighting AMR. As we forge a path forward, we must understand our past missteps: something we cannot do with a cloudy narrative.
I’m thankful for the insights into the complex interactions between science and society that I have gained in this program, and I realize I could not have reached this depth of understanding without the multifaceted approach. Diving into the biology, the literature, and the city itself shaped my understanding and ultimately is what made the experience so enriching.
Sophia Vona is a junior studying biology, English, and chemistry. She is on a pre-medical track and hopes to use her understanding of how language and culture shapes science and health in order to be a passionate provider and solve complex problems in the field of health care. At HHIVE she aids Dr. Kym Weed in analyzing the rhetoric and narrative framing of antimicrobial resistance (AMR) and how it influences AMR policy, action, and inaction. She is personally interested in the individualization in rhetoric of AMR and how its influence on the science and health of AMR today.
To learn more about the Burch Field Research Seminar on Infectious Disease and other Burch Seminars, visit the Honors Abroad & Away website.