This is the second post in a ten-part series for Spectrum’s 2015 Summer Reading Group. Each post will be drawn from chapters of the book Unclean by Richard Beck. You can view the reading/posting schedule here.
We were all scared, the physician told us. But failure was not an option. If we did not prove that a hospital could safely and successfully treat an Ebola patient, we knew that the public panic would spiral out of control.
Last year, I attended a seminar by an intensive-care physician who had helped lead the team of nurses, physicians, and other personnel that cared for Dr. Craig Spencer during his battle with Ebola at Bellevue Hospital in New York City. Through the summer prior to his arrival, the healthcare personnel had drilled endlessly with personal protective equipment for the inevitable arrival of an infected patient. Several scares with suspected Ebola patients had further tested their preparedness. But once Dr. Spencer arrived in the isolation unit, there was no longer room for error. Nurses in Texas had likely become infected through errors using or removing their protective equipment, so the team at Bellevue could not afford to repeat those mistakes.
Despite assurances by the Center for Disease Control (CDC) that Ebola was known to spread only through contact with body fluids of a symptomatic patient, the public and media became hysterical when they learned Dr. Spencer had ridden the subway and gone bowling (even though he had followed CDC guidelines in simply monitoring his temperature daily). Even the healthcare team experienced discrimination both during and after caring for Dr. Spencer – not only from the general public, but from other workers at the hospital. Nurses were turned away at hair salons and had to deal with frightened neighbors; many slept in the hospital, refusing to go home for fear of infecting their families.
My father was supposed to visit me that week, but after watching the news (and despite my assurances that New York was not in danger!), he cancelled his flight. I was upset because I knew the risk was minimal to none. Yet I could not blame anyone for being afraid of a disease that is incurable and often lethal. But why did my father and most of the public act in a way that was at odds with what they knew intellectually? Why was everyone so disgusted by Dr. Spencer even though he had followed the CDC guidance and had not put people at risk? How do we think and feel about contagion, and why does it sometimes lead us to act in ways that seem irrational?
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In Chapter 2 (“Contamination and Contagion”) of Unclean: Meditations on Purity, Hospitality, and Mortality, Richard Beck outlines the logic of contamination, examines its link to the emotion of disgust, and investigates potential problems that may arise when we apply contamination logic to social, moral, or religious situations. As described in Chapter 1, disgust is more than just a feeling of distaste. It is a most fundamentally a “food-aversion system” that monitors the boundary of the body and rejects offending substances, preventing us from ingesting potentially contaminated foods or placing toxic substances in or on our bodies. It also monitors the environment for sources of contamination and pollution: we feel disgust at the sight or thought of things we deem contaminated such as dead bodies, vomit, or feces.
In the case of Ebola, our reflexive disgust and desire to avoid contact with those substances is appropriate and protective because the virus is in fact spread through contact with contaminated body fluids. On the other hand, the public hysteria over the fact that Dr. Spencer rode the subway shortly before becoming symptomatic was unfounded because the Ebola virus is transmitted through body fluids, not air or surface contact.
While certainly fear, mistrust, and a lack of knowledge influenced the way the media and public responded to Dr. Spencer’s trek through public transit and to his caretakers, their response aptly illustrates how we think about contamination. As described by Beck, the four major characteristics of contamination logic are as follows:
(1) Contact: Contagion is spread by any kind of contact.
(2) Dose-insensitivity: Any hint of a pollutant can cause harm, no matter the concentration.
(3) Permanence: Once contaminated, always contaminated.
(4) Negativity dominance: Pollutants are “stronger” and will contaminate a pure object, rather than the pure object purifying the contaminated object.
In the case of Ebola and many infectious diseases, our mental shortcuts (heuristics) about contamination are in some ways a reasonable approximation of how the disease is actually spread. Ebola virus can be spread by contact with even a small amount of contaminated body fluids (contact contamination and dose-insensitivity), and blood containing the virus will contaminate a sterile glove (negativity dominant). On the other hand, contamination is not necessarily permanent, as equipment can be sterilized and people who test negative for the virus are not contagious, or dominant: placing a virus-contaminated glove in autoclave, a machine that sterilizes equipment at high temperature and pressure, will render it noncontagious.
What the public reaction to Ebola demonstrates is that our subconscious understanding of contagion does not always match reality. Our intuitive logic of contamination can be problematic or harmful even when applied to an infectious disease if the generalizations do not match the biological transmission mechanism. In the case of Ebola, fear, ignorance, and erroneous reasoning led to public panic, discrimination against Dr. Spencer’s healthcare workers, and vilification of a man who had risked his life to treat Ebola patients.
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The Bible uses many metaphors for goodness and evil, including metaphors of purity and contamination. Yet if our heuristic understanding of contamination for an actual infectious disease can be so wrong, what problems can arise from invoking contamination logic and the accompanying emotion of disgust to situations of religion, faith, sin, and spirituality?
As described in Chapter 2 (and illustrated by the hysteria in New York over Ebola), the emotion of disgust is “governed by a unique set of rules [and] is often immune to reason and rationality.” Beck describes several core characteristics of disgust: (1) it is a boundary psychology that (as outlined in Chapter 1) monitors the openings and borders of the body to prevent dangerous substances from entering (such as feeling disgust at the thought of placing chewing gum from a subway floor in one’s mouth); (2) it is expulsive, prompting withdrawal, avoidance, rejection, expulsion, or elimination of dangerous or polluted substances (vomiting out the aforementioned gum); (3) it is promiscuous in that during a “sensitive period” in early childhood it can become linked to variety of stimuli that are not necessarily related to food (such as a feeling of disgust at the thought of touching a sweater described as having been worn by Hitler); and (4) it involves magical thinking in that we assess contamination by making “causal judgments that defy the law of physics” (such as that brownies shaped to look like dog feces are contaminated and inedible).
Beck notes in particular how similar the logic of contamination is to “sympathetic magic,” in which there is assumed to be a “causal connection” between similar objects (such as a voodoo doll and person) that has nothing to do with the laws of physics. For example, in one experiment, people refused to consume brownies shaped like dog feces or lemonade served from an unused and sterilized bedpan. A visual similarity was enough to trigger feelings of disgust.
Furthermore, the emotion of disgust also extends beyond food into the moral sphere. In a second experiment, people refused to try a sweater described as having been worn by Hitler, and they even expressed discomfort at being in the same room as the sweater. The experiment suggested that people “tend to think about evil as if it were a virus, a disease, or a contagion. Evil is an object that can seep out of Hitler, into the sweater, and […] into you.” The problem, Beck notes, is that “When we do this the logic of contamination is imported into the moral discourse and judgment [and] we begin to worry about contact.”
Beck warns that “although contamination monitoring is at root healthy and adaptive, we should worry when judgements of contamination are extended into the religious, moral, and social domains.” The problem is that “just about any behavior judged to be sin could activate disgust psychology, subsequently importing contamination logic (e. g., contact fears) into the life of the church.”
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Beck gives multiple examples of the dysfunction that may result from invoking the metaphor of contamination when speaking about sin. In particular, sexual sins are almost exclusively characterized as violations of purity. Because contamination logic implies that “once polluted, always polluted,” even a single sexual sin can become “emotionally traumatic due to the judgment that permanent, non-rehabilitative ruin has occurred.” Because in church discourse, the terms virginity and purity are often used interchangeably, a person’s first experience of intercourse – particularly outside of the socially acceptable context of marriage, but perhaps even within it – is spoken of as a “loss of virginity” and therefore an irrevocable, permanent forfeiture of purity. Thus, people struggling with past sexual choices may come to “carry an enormous load of guilt, shame, and self-loathing.” Additionally, the oft-repeated idea that all sins are equal (dose-insensitivity) may perversely discourage attempts to change; if one sin and many are equivalent, and a single sin is enough to irrevocably lose purity, why bother fighting?
He further examines problems may occur when we apply contamination logic to social contact. For example, the Pharisees criticized Jesus for eating with sinners (contact contamination) because they assumed that contact would contaminate Jesus (negativity dominance). As Beck notes, this type of thinking is a problem for a missional church because contamination logic suggests that “contact with the world defiles the church”. He observes, “Given this logic, the only move open to the church is withdrawal and quarantine, separation from the world. In short, many missional failures are simply the product of the church following the intuitive logic of disgust psychology.”
* * *
Beck does not acknowledge that in some cases, the metaphor of purity/contamination may be appropriate, and I found myself wishing he had explored the reasons why this has become a dominant metaphor in our conversation about spirituality or sexuality. Nevertheless, his incisive critique of allowing disgust to govern social, religious, or moral interactions speaks directly to the Seventh-day Adventist Church.
The Adventist church claims as its mandate the Great Commission to “Go ye therefore, and teach all nations” (Matthew 28:19)—and yet it encourages its members to attend Adventist schools, live in Adventist communities, socialize with Adventist people, and even work in Adventist institutions. Even more paradoxically, as it pours time and treasure in striving to evangelize and attract more members, it simultaneously seeks to purge its ranks of those who fail to conform to its list of ideas. In light of the recent events at the General Conference (including the rewording of the fundamental beliefs specifically to exclude alternate interpretations of marriage or creation), many of us may be wondering why the church—which is supposed to be the body of Christ, a hospital for sinners, and an embodiment of unconditional love on earth—is often instead judgmental and exclusionary.
Beck argues that a subconscious invocation of disgust psychology and out-of-context application of contamination logic may in part be responsible for why churches cease to be welcoming and hospitable communities. I would suggest that the Adventist church’s obsession with doctrinal, theological, and personal purity has handicapped its ability to reach out.
Like the Pharisees, Adventists often isolate themselves from “the world,” fearing that attending secular schools or otherwise contacting “sinners” will result in becoming “worldly.” While this may not be an entirely unfounded worry, it becomes problematic when fear of contact or desire for purity results in a lack of hospitability to or even rejection of visitors or members who do not appear “holy” (or do not seem to becoming “holy” quickly enough). Thus, our attempts at “revival and reformation” can instead result in withdrawal and rejection or “hit-and-run” evangelism rather than long-term community engagement. How can a community that is trying so hard to be holy risk contamination by interacting with the outside world?
Beck suggests that the solution may partially lie in recognizing that “Jesus is… positivity dominant. A missional church… [follows] Jesus into the world without fears of contamination.” And yet he warns that this is a “deeply counterintuitive position… The missional church will always be swimming against the tide of disgust psychology, always tempted to separate, withdraw, and quarantine.”
* * *
What I found most powerful and thought-provoking about Chapter 2 of Unclean was not Beck’s exposition on the problems with applying contamination logic to non-food/non-infection situations, but his exposition on the deep emotional response we have to objects or people we deem contaminated. Most of us know that heuristic thinking can lead us astray and attempt to refrain from stereotyping based on race, gender, or ethnicity. But what Unclean made clear is that the emotion of disgust—triggered by things we deem contaminated using a heuristic and error-prone logic—is largely independent of conscious thought. Things that we know to be perfectly safe (such as brownies in the shape of dog feces) can still trigger disgust. Disgust is a powerful motivator of action, even when we know our actions are irrational.
What, then, is stronger than the emotion of disgust? Love.
When we love, we do things we would once have found disgusting: change diapers, touch lepers, or don protective gear and treat vomiting, bleeding Ebola patients. Love was my father, on Christmas Eve, de-clogging a toilet filled with feces and menstrual blood that overflowed onto the bathroom floor.
Yes, there is truth to the idea that ideas spread socially, and there is wisdom in the advice to avoid bad company. But the problem with invoking contamination logic and disgust psychology is that, in the overarching story of the universe, it is not correct. In fact, the entire message of the gospel overturns the logic of contamination: sin is not permanent, love overcomes hatred, and goodness wins in the end. Rather than spending the majority of our energy monitoring our social borders, trying to expel heretics and avoid contamination, we need to understand the vision of the New Testament in which tares are allowed to grow with the wheat (Matthew 13:24-30) and Peter is commanded in a vision to break down barriers between Jews and the “unclean” Gentiles (“Do not call anything impure that God has made clean," Acts 10:15, NIV). When the circumcised Jewish believers criticize him for socializing with Gentiles, he relays his vision about being commanded to “kill and eat” unclean animals and, upon waking, being commanded by the Holy Spirit to visit Cornelius Caesar, a believing Gentile. He says to his critics, “So if God gave them the same gift he gave us who believed… who was I to think that I could stand in God’s way?” (Acts 11:17, NIV).
I long for the church to view itself not a pure fortress on a hill—composed solely of doctrinally impeccable people defending themselves against the depredations of the sinful outside world – but rather like good family: a place where people know they are loved and feel safe to explore, make mistakes, change their minds, and grow in their imperfect understandings of the world. The church is not wrong in thinking it has much to offer the world, but it would be wise to take the advice from Covey’s Seven Habits of Highly Effective People: “Seek first to understand, then to be understood.” People open themselves to listen only after they feel safe, secure, loved, and heard.
If the church truly wants to be a hospital for sinners and not just a club for saints, it needs to realize – like the brave healthcare workers of the Ebola epidemic—that caring for people in need involves contact and sometimes risk: risk of contagion, contamination, or change. It might involve hearing ideas that are different, ideas that might even change the way we see the world. It might involve moving to a city and actually getting to know some non-Adventist people. It might involve some deep introspection as to why we are so very fearful of difference—and whether those fears are well-founded. It might mean being worrying less about theological purity and behavioral perfection and more about loving mercy, acting justly, and walking humbly with God.
Karen Ong is a graduate student and physician/scientist-in-training in New York City who attended Adventist schools from kindergarten to college. During her time in New York, she has witnessed one small earthquake, two hurricanes, and preparation for Ebola. She studies mathematical epidemiology and researches the spread of antibiotic-resistant bacteria in hospitals.
Ortega, R. et al. “Putting On and Removing Personal Protective Equipment.” N Engl J Med 2015; 372:e16.
Spencer, C. “Having and Fighting Ebola — Public Health Lessons from a Clinician Turned Patient.” N Engl J Med 2015; 372:1089-1091.
This is a companion discussion topic for the original entry at http://spectrummagazine.org/node/7006