While my third-year clerkship was on hold due to COVID-19, I engaged in a somewhat non-traditional curricular project: an exploration of pandemic films. I find the intersection of film and medicine fascinating. Films read and reflect our zeitgeist, social trends and cultural fears, and serve vehicles for ideological dissemination, education, and misinformation. The study of films that depict health-related topics can provide insight into societal beliefs, fears, and ideas that influence medical practice. A population’s psychological response to pandemic-related stressors plays a key role in perception of, and adherence to, prevention and control measures. Fear is a key element of this response and is influenced by cultural scripts, such as those perpetuated in films, that tell us what to be afraid of. Movies both reflect and reinforce collective anxieties and, immersed in the fear and uncertainty surrounding COVID-19, I wondered what understandings I might glean from cinematic outbreak narratives. The societal ideologies and anxieties films respond to often go unacknowledged by the audience, and I was surprised during my literature review and film analysis by the many layers of meaning I had previously been unaware of.
Three personal take-aways:
- My conceptualization of contagion is geographical and influenced by a pervasive association between disease and social difference.
Contemporary outbreak films simultaneously celebrate globalization as a source of prosperity for the so-called “Third World,” while also situating it as the source of transnational contagions. They conceptually divide the world into “infected” regions, Africa, Asia, South America, and “non-infected but infectable” Europe and North America. This is not a simple, objective reflection of epidemiology. In these films the concept of contagion is invested with malevolent intent, an invasionary force, carried by “dangerous,” stereotypically-coded racial or social “others” that must be regulated and socially controlled.
When I think about an infectious disease, I picture an epidemiological map. My mental map is colour coded – high incidence/prevalence marked by red, low by green. Reading about outbreak films, I was struck by all the unconscious meanings attached to this simple visual: red-hot-contaminated-bad, green-cool-safe-good. My worldview has undoubtedly been influenced by growing up in a “green” zone, where most contagions are considered a “foreign” threat, carried by people who are in some way different from me.
I initially, (naively), considered the anti-Chinese rhetoric and anti-immigrant, white supremacist, and xenophobic conspiracy theories surrounding COVID-19 to reflect the views of certain radical individuals that I in no way identified with. Knowing the impact that stigma can have in terms of distress, social marginalization, the creation of barriers to healthcare, and the potential to generate distrust of health authorities and healthcare providers, I worried about the damage that others might cause in perpetuating it. I neglected to acknowledge the systemic nature of the problem, the deep-seated narratives and beliefs that have shaped, and continue to shape, all facets of society. In identifying some of these within outbreak films, I recognized some of my own beliefs and fears, and the ways in which I had unintentionally been contributing to social stigma.
- I am not immune to fear
Since March I’ve often found myself envisioning worst-case-scenarios; with associated images, both semi-realistic (e.g. crowded hospitals and riots), and unrealistic (e.g. zombies) plucked from films I had seen in the past. Post-apocalyptic outbreak films make the breakdown of social order, and the subsequent end of the world seem plausible, even inevitable, positioning disease as a mechanism for societal destruction. They fuse the believability of science fiction with horror, echoing visual memories of societal trauma. Often they leave viewers with the message that without social order, people are reduced to their base instincts and become potential threats.
While civil unrest, rioting and mass panic are frequently displayed on screen, widespread antisocial behaviour does not usually occur in a real pandemic situation, and supportive, prosocial behaviours are more common. COVID-19 has caused societal disruption on an unprecedented scale, yet largely communities have (figuratively) come together. The rise of “care-mongering,” is a far cry from the messages of post-apocalyptic films.
Fear can be used as a cue to estimate risk, and excessive fear can lead to overestimation. As a future physician, I am expected to be objective, and even with the privilege of my education, I found it difficult to keep my expectations of the evolving COVID-19 situation grounded and scientific. I am not immune to sensationalism. My initial conceptualization of catastrophe neglected to acknowledge on one hand, human capacity for resiliency and positive collective action, and on the other, that disease doesn’t need to cause an apocalypse to have a devastating impact, especially on vulnerable groups and individuals within an already unjust society.
- My experience during this pandemic has highlighted my privilege
I see elements of my identity and experience reflected in the outbreak films I studied, which privilege those of the white middle-class. Meanwhile these films largely ignore the experience of individuals and groups that are most vulnerable in a pandemic, including: people with disabilities; black, indigenous, people of colour; people needing housing or facing food insecurity, women and children fleeing violence, single parents, the LGBTQ2I community, the elderly, and people in correctional institutions.
I have been privileged to continue to work towards becoming a physician these past few months. I have access to emerging scientific literature, and medical knowledge that enables me to more easily spot inaccuracy and hyperbole when I encounter outbreak narratives in film, television and other media. Even so, I am not immune to their influence.
Outbreak films visualize the invisible as a form of inoculation, projecting images of contamination because if one can see it, one can avoid it. Maybe this holds true for the often overlooked meanings that these films contain. By looking closely at the collective fears they respond to, the ideologies they endorse, the perspectives they prioritize and the ones they ignore, by leveraging them as tools for discussion, perhaps one can make any harmful messages they contain a little less contagious.