Elliot Greiner

UW

10-27-13

Disease and Photography

Images of disease have been, for the majority of human history, important

documents with which to study illnesses and pathogens, as well as the cultural

structure they bring about. Anna Perez Hattori, in her article “Re-membering the

Past: Photography, Leprosy and the Chamorros of Guam,” analyzes pictures of leper

patients in early 20th century Guam. The afflicted are seen sitting in uniformed

positions with each exposing the affected body parts, “as medical photography

guidelines instructed.”1 The process by which the lepers were documented held

scientific merit, but little emotional depth. Harshly lit, starkly depicted, leprosy was

shown only as a biological anomaly, and the people behind it overshadowed by their

disease. The images can be frightening, gory, and hard to look at, but the subjects

who spurred their creation are habitually neglected, and their legacy carried on only

by1 their sickness. The Guam photographs were “captioned only with the patient’s

case number,”2 referred to simply as male and female.

Pictures of illnesses, while oftentimes uniform on the surface in their presentation

of distress and human unrest (battered bodies, lifeless eyes, characteristic deathbed

1 (Hattori, “Re-membering” 306)2 (Hattori, “Re-membering” 306)

setting), are still swathed in differences, ranging from how people display fear, to

how they go about dealing with the pathogen. Hidden amongst the frame are clues

into which the psyche of the times can be analyzed, how people began to react to the

onslaught of disease. Furthermore, the ways in which photography has adapted

from a presenter of distress into a provider of relief are notable. Images of the

plague scourges of the middle ages, photographs of the 1918 flu pandemic, and iron

lung children serve as a warning to the audience. In a wordless chorus the images

detail the fate of an illness’ sufferers; caveats relying on both panic and voyeurism.

These images have lost the seizing power of their moment perhaps, but still convey

a sense of horror, as the plague, the flu, yellow fever, measles, Ebola, and a battery of

tropical diseases all lay poised to strike the lines of global travel. Though these

pictures, just as the leprosy images from Guam, seldom honor their human subjects.

Stills become deterministic, focused on the dire consequences of infection,

promoting almost a primitive sense of survivalist instinct towards the particular

disease.

However, in line with changing cultural precedents, photography has begun to

show a different side in presenting disease. Pictures of the sick are not solely used

for study or demonstration anymore, but for coping. Pictures from the late 20th

century, and early 21st, show a shift in society’s demeanor towards the image of

disease, and the ways in which the afflicted are remembered. It can be argued that

while once primarily used as a harbinger of fear and warning, images of disease

have, in our contemporary climate, transgressed into a method of coping, both

personally and culturally.

To go about gathering insight on the subject, I will look at the records spanning

centuries, first starting with Hans Holbein prints of the black plague dating to the

middle ages, and reaching to The National Archives and their images of the 1918

Spanish Flu Pandemic. As some of the first modern photographs of pandemics came

from this time, the images are unique in documenting a modernizing world in the

midst of biological catastrophe. The March of Dimes’ collection of Polio images and

posters will also be utilized at the organization was the first to solely combat the

disease. Life Magazine’s collection of AIDs images, as well as Robert Mapplethorpe’s

photographs will be use to study the relationship between AIDs and photography. I

will also analyze Richard Vokes’ article, On Ancestral Self-Fashioning: Photography in

the Time of AIDS, which documents how AIDs patients have begun to use

photography to cope with their terminal illness. This demonstrates photography’s

evolution from a harbinger of bad news into a form of catharsis.

Peter Burke’s book Eyewitnessing will also be used for methodological reference,

particularly Chapter 8, which is briefly surmised in the byline: every picture tells a

story. This is especially true within my area of probing, and Burke’s methods of

analyzing these photographs- keeping in mind how fresh their impact was at the

type of printing- gives grounding to my research.

Artists, engravers, and photographers have

steadied their craft over pandemic scopes in the past,

with no pretense. What was shone was to some extent

an actual scene, as genuine as they came, nightmares

stuck in the amber of an artist’s instrument. Famed

German artist Hans Holbein created a series of

woodcuts personifying the plague, manifesting the

scourge into the skeletal reaper, who in Figure 13, is

seen abducting a child from her parents. An upturned

hourglass is observed in the lower right hand corner, deeply

contrasting with the routineness of the situation.

In Figure 24, another of Holbein’s

woodcuts sees the plague claiming a duke,

and again, features an upturned hourglass,

this time in the top left of the image. The cuts

show how plainly the plague struck, coming

into any situation, however normal, and took

away anybody, however innocent or

important. The horrific manner in which

3 (Holbein, Dance of Death, http://chnm.gmu.edu/cyh/primary-sources/186)4 (Holbein, The Duke, godecookery.com/macabre/holdod/holdod13.htm)

Fig 1: Hans Holbein Woodcut, “Dance of Death”

Fig. 2 Hans Holbein Woodcut, “The Duke”4

plague mortality is depicted strikes one as deterministic, displaying what the artist

believed to be an impossible aggressor. Furthermore, most people in the middle

ages could not read or write. Other than word of mouth and personal experience,

images such as Holbein’s would have been an average European’s only way of

understanding the plague.

The Italian writer Boccaccio once said that plague victims "ate lunch with their

friends and dinner with their ancestors in paradise." The disease’s swift infiltration

of the body, and subsequent destruction, moved with remarkable speed. Its

presence left the distinctive buboes, sacks of dead flesh and blood, sweeping off of

the bodies of the afflicted. Figure 35, an image out of the Toggenburg Bible (1411)

shows two afflicted with the plague watching as a priest prays for their well being.

In this case, the importance of the image is highlighted by not only its location, but

also its design. By this time the disease had garnered enough cultural presence to be

placed into the Bible. Furthermore, the use of lapis dye for the blue signifies

importance, as blue was the most expensive dye to buy. The disease frightened

enough people on its own, with out the aid of art or literature. However the

expensive measures gone into cataloging it for history seems to hold that the images

held serious meaning to Europeans. The plague struck during the advent of the

printing press, and would come to be one of the first diseases able to capitalize on

people’s fears through its use.

5 (Toggenburg Bible, 1411)

Having viscously attacked Europe, Asia, and Africa for the remainder of the

millennium, the plague was eventually phased out by upgraded hygene and

medicine; it would not be until 1918 that people once again met a pathogen on par

with the plague. Fresh from the European battlefields of World War I, the Spanish

Flu struck with ferocious efficiency, killing more people than died in the war. The flu

was airborne and transmitted by coughing and sneezing, as well as by lingering on

unwashed surfaces. Some reports state that the disease was so severe the average

lifespan in the United States was recessed by ten years6. In the end 25 million died of

the illness, though modern analysis continues to uncover more deaths.

The photography that emerged from the flu pandemic was some of the first

to capture a pandemic from the lens of a camera. In the US, a stark reality had begun

to settle. Facemasks became a mandatory fashion accessory, funerals could only be

held for fifteen minutes, and stores could not hold sales. Police forces patrolled in

masses, fining all who broke the rules. Their presence on the streets evolved form

6 (“The Influenza Pandemic of 1918”)

Fig. 3

an aesthetic garnish on street corners and crosswalks, to a perpetually uniformed

watchdog outfit.

Figure 47 documents a morning in December of 1918, when Seattle’s police

department lined the streets in their uniformed jackets and facemasks. Each

officer’s fist is characterized by clenched fingers and shadow-stained knuckles

angled towards the street. The sky is bleached from camera flash. Particulates of

snow and rain invisibly sift through the air, making themselves known on the black

sleeves of the men. They are positioned in incremented lines, with each unit being

capped by an officer of higher rank, distinct only by the flattened nature of their

7 (National Archives, http://www.archives.gov/exhibits/influenza-epidemic/records-list.html)

Fig. 4 Seattle Police Department December 1918

hats. Faces cannot be seen, however, the nature of the men and their situation seem

grim.

The picture depicts a harsh state of affairs, with most expressions of

individuality having been cut out. In the midline of the photo, a glinting strand

follows, composed of police badges rendered nameless by glare. In a sense, it pulls

the officers down right next to civilians. They have gun licenses, extraordinary

capabilities awarded by the law, but are just a feeble in the eyes of the flu; in essence

nobody is safe.

The laws upheld by the police were plastered across cities as posters, urging

citizens to maintain salubrious behavior in plain, stark design. This safety poster

campaign was one of the first American actions against the flu, as well as one of the

first public health measures of its kind. Figure 58 shows a grizzled, presumably sick

gentleman in front center, standing amid a group of youthful Americans. On the left

stand the general populace, and on the right soldiers. The sick man is antagonized,

treated as a weapon of war. The poster suctions the humanity out of him, telling the

man to cover up his cough and nothing more. In this way the government views the

populace as war machinery, and the sick people as attacks on this machine; subtlety

suggesting them to be attacks against the wellbeing of the country.

8 (State of Nevada, 1918)

Similarly to the Spanish Flu, Poliomyelitis, or Polio,

struck the US in the early to mid 20th century. Initially limited

to small outbreaks affecting handfuls of people, the disease

stepped onto a larger platform in 1916, infecting 27,000 in the

US. Similarly to the flu, public reaction was panicked, with

many fleeing out of cities to the country. Mostly seen in

children, the disease rendered many of its sufferers paralyzed

or with diminished motor functions. Figure 69, a poster,

erected during the New York City outbreak of 1916, is symbolic of the thinking of

the time. Just as in the coming flu epidemic, stores, theaters, and schools were all 9 (March of Dimes, [Poster 1916.] repr. National Museum of American History. http://amhistory.si.edu/polio/timeline/)

Fig 5

Fig 6

shut down. However, unlike the Spanish Flu, Polio hung around for decades, and

began to infect adults as well as teenagers; Franklin Roosevelt was stricken with

Polio at age 39.

Due to Polio’s longevity in American life, culture began to grow accustomed

to its presence. After the 1920’s pictures of Polio were not strictly downtrodden

depictions of an illness and its sufferers. Figures 710 and 811 both show a different

side of human interaction with Polio- and also one seldom seen towards any

previous disease. In both images 20th century icons are seen with Polio victims, in

figure 6 Elvis, and 7 Franklin Roosevelt. The juxtaposition of sick children with these

men not only brought hope to those who looked at the pictures, but heightened

awareness towards the illness. In Elvis’ left hand he is holding a sing for the

nonprofit March of Dimes. The organization was started by Roosevelt to combat

Polio, by raising money and awareness towards the disease. Similar to the Elvis

picture, the organization created many similar images to spur action against Polio,

and exhibited large vaccination campaigns in the 1950’s and 60’s. Unlike the

Spanish Flu campaigns, the March of Dimes images show disease to be beatable, and

those afflicted to be just as human as the rest.

10 (March of Dimes [Elvis Presley, 1957] repr. Elvis Info Net. http://www.elvisinfonet.com/interview_joannekelly.html)11 (Assosiated Press [FDR, ca. 1932]repr. Nation Public Radio. http://www.npr.org/blogs/health/2012/10/16/162670836/wiping-out-polio-how-the-u-s-snuffed-out-a-killer)

Figure 7, featuring FDR, shows the president holding hands with a polio

sufferer. Taken during his first presidential campaign, the picture highlights how

even the most powerful live within the context of Polio. While he tried for years to

mask the severity of his paralysis, Roosevelt began to acknowledge it publicly

towards the end of his presidency. Having Polio placed in such a public sphere aided

in creating a less hostile connotation towards the disease, and in turn helped evolve

the photography of illness and disease into a more hospitable entity.

The March of Dimes’ images help to spur unprecedented philanthropic

donations, which in turn led to funding for Jonas Salk’s vaccination. “Within just a

few years of being licensed, the Salk vaccine decreased the number of polio cases in

the United States by fifty percent. By the early 1960s, the number of Americans

contracting polio fell to a few thousand annually.”12 The pictures managed to create

an emotional presence strong enough to promote donations and charity towards

polio research. Historian David Oshinsky said, “[The Polio] vaccine vindicated

twenty years of giving dimes, twenty years of volunteering. It was a victory for

millions of faceless people who had done what they could to end the scourge of

polio.”13 The images managed not only to function on a personal level for polio

victims, but on a broader level for the American populace, entertaining polio as a

beatable entity.

12 (“Polio Crusade”)13 (“Polio Crusdae”)

After Salk launched his vaccine in the 1950’s, a regression occurred that

marked polio’s half-century hold on America finished. However, only a few years

afterwards a burgeoning disease began to take root on the east coast. With only a

handful of American cases before the 1980’s the disease began to multiply,

particularly in New York and San Francisco, shooting through the American male

homosexual community. AIDs, as the disease came to be colloquially known,

Fig 7: Elvis in 1957 Fig 8: FDR with Polio sufferer during his first presidential campaign

ushered in a new era of American and global health, rising to become the largest

pandemic known to mankind.

In his article On Ancestral Self-Fashioning: Photography in the Time of AIDS,

Richard Vokes analyzes the dynamic between photography and Aids, demonstrating

that patients in the final months of their lives came to terms with their situation

through a modernistic take on photography. The images provide “catharsis, Vokes

writes, for those coming to terms with a personal loss, while on the other they

confer upon the deceased an ongoing “presence or “agency,” in the lives of the

living.”14 Extending deeper into the field, Vokes argues all photographic portraiture

to be attributed to death in some fashion. Citing Roland Barthes, Vokes calls it a

“spatial immediacy and temporal anteriority.”15 A photograph captures an instant,

fettered to it by light and ink, while its subject lives on to eventually die.

The figure in a picture “lives” forever, extending beyond the mortality of its

subject. A woman who died last week can still be seen smiling beside a rosebush, the

virus multiplying inside of her unseen and –as far as the picture goes- nonexistent. It

is in this way that photography has come to trump disease where science cannot.

For someone in the throes of a terminal illness, very little can be done to treat the

physical degradation of the body, and the mind becomes the most important part to

look after.

14 (Vokes 356)15 (Roland Barthes, Image, Music, Text, 1977, qt in On Ancestral Self Fashioning: Photography in the Time of AIDs.)

In her now famous pictures of AIDs victim David Kirby- first circulated in the

November 1990 issue of Life Magazine- Therese Frare captured the skeletal Kirby as

he died inside the huddled embrace of his family (Figure 916). A volunteer at the

Pater Noster House, an AIDs hospice in Columbus, Frare began to take pictures of

the patients, developing an interest with Kirby and his family. The images she took

are haunting, with Kirby’s physical degradation similar to depictions of a starved

and crucified Jesus, but were nonetheless requested by the family. In his final

months Frare regularly photographed Kirby and his family, right up until his death.

A picture of David Kirby in his final moments and a picture of a man dying of the

Spanish Flu initially ring out to be both quite disturbing, however, Frare’s pieces

find juxtapose the dying man with members of his family, adding in an emotional

content often unseen in historical documents.

16 (Frare)

Figure 9: David Kirby and his family, April 1990

Biologically humans are social animals, and whereas many depictions of

disease rotate around a focal point of just one person, images such as those of Kirby

show the process of disease in the context of a group struggle. This element in turn

comes to encapsulate much more than a death or a disease, but a family. In somber

reflection the outline of life is distorted, with a son dying before his parents, and

allows introspection. With images of the past, victims of disease were construed as

simple bodies. There was no question to the person’s life, or the circumstances

leading to his or her death. There was no room for introspection. Frare’s picture,

while saddening, allows for a thought process to take place, for AIDs to be made

sense of, and in turn allows one to cope.

Famed photographer and artist Robert Mapplethorpe also explored the

introspective pathways of AIDs as he succumbed to the disease. Diagnosed in 1986,

Mapplethorpe’s already heavily homoerotic work began in small part to form

around his mortality. Figure 1017, Mapplethorpe’s “Self Portrait” from 1988 shows

the artist dressed in black, off center against a black background. His chest blends in

to the background, with only his head and hand materializing into the foreground.

He holds a staff capped off with a skull. The reference seems to show a gradual

decline, and eventual submission to death. Mapplethorpe himself looks gaunt and

skinny, with disillusioned eyes and long hair. The artist would die a year after this

17 (Mapplethorpe)

portrait was taken. His work shows a singular viewpoint, and one taken from the

dying individual. To look at the picture is not entirely to look at a dying man, but to

appreciate his presence and acknowledge the future without fully giving into it.

While physically black and white, the psychology behind it is hardly so.

The representation of disease throughout the years has centered mainly on

an illness’ potency, and not on the emotional aspect of sickness. Images have not

allowed room for an emotional coming to terms on part of the grieving and sick, and

forgo inquiry into the person(s) depicted. However, from a cultural evolution

towards more progressive interpretations of illness, people have come to take

solace in pictures of the ill and dying. In the 21st century, photography has come to

Figure 10: Robert Mapplethorpe “Self Portrait” 1988

serve as a memorial to diseased individuals, especially those stricken with diseases

currently prominent on the medical stage, such as cancer and Alzheimer’s. The

opening lines from a recent Mail Online story summarize photography’s

contemporary impact well: “When photographer Mark Edwards' mother June was

diagnosed with Alzheimer's disease, he decided to chart the effects of the illness to

help him cope with his grief.”18 Aided with iPhones and digital cameras, people

today can easily track something like an illness, and find emotional depth in place of

a cure. Unlike the photography of the past century, today’s pictures function beyond

science, for patients and their families who, in many cases, come to reflect on the

pictures long after their subjects are gone.

18 (Bates)

Bibliography

Bates, Claire. “An intimate portrait of Alzheimer's: How the disease slowly stole my mother away” Mail Online 7 March. 2011. Web. 27 Oct 2013.

Burke, Peter. “Visual Narratives.” Eyewitnessing: The Uses of Images as Historical Evidence. Ithaca: Cornell Univ. Press, 2001. Chs, 7, 10.

Frare, Therese. Untitled. Nov. 1990. Life Magazine. Web 8 Nov 2013.

Holbein, Hans. "The Dance of Death [Woodcut]," in Children and Youth in History, Item #186, http://chnm.gmu.edu/cyh/primary-sources/186 (accessed November 13, 2013). Annotated by Shona Kelly Wray

Holbein, Hans. The Duke. 1536. Web. 13 Nov 2013.

Hattori, Anne Perez. “Re-membering the Past: Photography, Leprosy, and the Chamorros of Guam.” The Journal of Pacific History 46.3 (Dec. 2011): 293-318. Web. 12 October 2013.

Mapplethorpe, Robert. Self-Portrait. 1988. Tate. Web. 10 Nov 2013.

Vokes, Richard. “On Ancestral Self-Fashioning: Photography in the Time of Aids.” Visual Anthropology 21 (2008): 345-363. Web. 12 October 2013.

Policemen in Seattle wearing masks made by the Red Cross, during the influenza epidemic. 1918. The National Archives. Web. 10 Nov 2013.

“Polio Crusade” Writ. Sarah Colt. American Experience. PBS. 2009. Television.

Spanish Flu Public Health Poster. 1918. State of Nevada. Web. Nov 10 2013.

“The Influenza Pandemic of 1918.” Standford.edu. 1997. Web. Nov 7 2013.