Books Features

Bodies of/and Knowledge

On a recent trip to Paris, I couldn’t keep my eyes off the roof tops, always searching for the smallest windows near the top of the buildings, openings into the rooms and worlds of people who died during the 2003 European heat wave.   By the numbers, 200 Parisians are expected to die at home in a given August; 900 Parisians died at home in August 2003, many up near the gables (207).  Architecture, we have learned, can harbor structural violence.

I was also compelled to move through the city in a new way, mindful not only of which arrondissement I was in, but also of which quartier within a particular arrondissement. This kind of placement also mattered in the summer of 2003. Deaths were distributed throughout Paris, occurring in rich districts as well as those recognized as poor. Despite the best laid plans of Haussmann in the rebuilding of Paris in the mid-nineteenth century, poverty in Paris today is distributed vertically as well as horizontally. The poorest districts of the city are in the outskirts, pushed there by Haussmann’s urban development initiatives to improve sanitation, water supply and other unquestionable public health goods. But this didn’t fully eliminate poverty and vulnerability in the city center. Within a particular arrondissement, particular quartiers are poorer than others, and this is reflected in health outcomes — if mapping and accounting tools have sufficient granularity (98). Vertically distributed poverty is even harder to capture. Pushed upward by building practices and codes that permit habitation in small, barely ventilated upper rooms, many without plumbing, poverty lives on in central Paris — often just above swank apartments and shops. Exacerbated by the zinc roofs loved by tourists, the heat in room upper rooms reached literally unbearable levels in August 2003.  Paris has a truly deadly charm (188).

Richard Keller draws out these patterns of spatialized vulnerability — and the enduring problems of accounting for them — in his new book, Fatal Isolation.   It is a remarkable book, with many provocations.

The potentially devastating human health impacts of heat waves were well known before 2003, and it literally isn’t rocket science to recognize that upper rooms will be hotter than those below. It nonetheless was days into the heat wave in Paris in August 2003 before the medical and public health community recognized that they were dealing with what would come to be recognized as the worst natural disaster in France’s history.   And the special hazards of life in upper rooms — often lived in by people also struggling with addiction, mental illness, or other cumulative factors — still remains under-articulated (108). France’s InVS epidemiological surveillance unit (with responsibilities akin to the US Centers for Disease Control) did studies confirming that verticality matters; those who lived on Paris’ top floors were shown to have been four times more likely than their neighbors on lower floors to die in August 2003 (108). The numbers were even worse if the rooms were especially small, and without a bath or shower. Habitual lack of social interaction also dramatically increased vulnerability and complicated accounting of deaths.  But even those who lived alongside those who died couldn’t pull all these factors – and their cumulative effects — together. If someone was alcoholic, HIV positive, or just brutally poor, people tended to describe their deaths as having “nothing to do with the heat” (169). Slow disaster — injury through accretion — is hard to recognize, much less articulate in official forms. Multiple determination, weighted by history, doesn’t easily make sense.

Keller gives life to the numbers. He describes how and where people who died during the heat wave lived, people whose bodies weren’t claimed by kin or friends, people who didn’t register in all senses of the term. Keller started with death counts and registries, turning his critique of numeration and aggregative accounting into an impressive, not-so-matter-of-fact method. Beginning in the “poor section” of Paris’ public cemetery, Keller then visited the buildings and neighborhoods where the unclaimed dead had lived, talking to neighbors and landlords.  What he learned in his conversations allowed Keller to craft powerful anecdotes about individual lives that stay with a reader, giving flesh and personality to abstractions, working at a different angle from those that produce generalizations of vulnerable groups, offering a different kind of insight into health disparities than that offered in usual public health accounting.

The 2003 European heat wave thus becomes memorable, prompting basic and important questions in what I have come to think of as “disaster analytics:” How — across times and places — is injury produced, recognized, legitimated, disavowed, addressed? What vulnerabilities and injuries must we anticipate in our late-industrial times? What modes of knowledge production can help us make sense of these times and vulnerabilities?

Knowledge and associated social contracts are problems throughout Keller’s story. The spatialized vulnerability that he describes was, in part, produced by Haussmann’s initiatives to improve public health in Paris by design. Critical historical studies of Haussman’s work in turn created other invisibilities, directing attention to horizontal rather than vertical distributions of poverty, indirectly contributing to the inability to recognize crisis on Paris’ upper floors in the summer of 2003. Epidemiological mappings and aggregations of the 2003 crisis pointed to strong associations between old age, poverty and heat wave vulnerability, leading to new and important public health programming — while also deflecting attention from forms of heat wave vulnerability other than those linked to age. Important work to codify understanding of particular groups as “vulnerable” works against recognition of other, often emergent forms of vulnerability; Keller describes people in these not-yet-categorized spaces as “forgotten.”

Keller’s stories of individuals who died during the health wave draw out important differences, but these stories, too, aren’t complete, or completely reliable. Neighbors told Keller stories about people that couldn’t possibly have happened — blaming the heat weave for the death of one elderly woman that Keller later learned had died the year before, for example. As Keller rightly points out, it isn’t only the facts that matter; memories — even if flawed — are important evidence in their own right. Accounting for disaster is not and should not be expected to be matter-of-fact. But the problem of knowledge remains, and is at the center of Keller’s story, as in all stories of disaster, though sometimes latent.

I’m left sobered, inspired, and questioning ways we can make new sense of disaster, fast and slow. As Keller emphasizes, aggregation and abstractions leave a lot out, while doing important work. Aggregations and abstractions allow us to see things that can’t be seen at street level (or even from the gables). But they leave out the quotidian, the stuff of everyday life that enriches both explanation and empathy, and capacity to imagine things done otherwise. Ironically, given the posterior status of the qualitative and anecdotal in policy and practice, it is stories such as the ones Keller provides that help me imagine what “mitigating” disaster vulnerability could really look like. But such stories can’t help us anticipate disaster, and recognize it as it emerges. The granularity is off. Yet we need this anticipatory capacity ever more in our late industrial times.

Heat waves again riveted the world in the summer of 2015, with clear links to climate change. India and Pakistan, Japan, Israel, and the southeastern United States were particularly effected. In Delhi, temperatures reached 122 degrees Fahrenheit (50 degrees Celsius); roads melted. In many places (including Alaska), the extreme heat ignited fires. Extreme temperatures are an increasingly persistent problem, exacerbating already out of control energy consumption. Routine summer heat is also expected to increase quite dramatically, calling for massive retrofitting with air conditioning capacity, as happened to some extent in Paris over the last decade. And with more air conditioning, new risks are generated; air conditioning can facilitate the spread of communicable diseases, for example. Solutions and cures create their own cascades of problems.

What kinds of knowledge production and social contracts can sustain us in such times? The studies that help us understand climate change, and both routine and extreme temperatures are extraordinarily complex and aggregative. Individual data points literally make no sense. And both the methods and findings provoke and deserve debate. Translating scientific findings of this sort into public health programming is even trickier. But it must be attempted. The social contract undergirding this translation will also need to be re-thought — continually.

Late industrialism urgently calls for ambitious attempts to make sense of globally distributed injury (associated with climate change or toxic contamination, for example), with an eye for the way injuries play out at the local level, and can be addressed on the ground. Complex modeling and simulation will be essential; historical and ethnographic insight will make modeling and simulation data meaningful and actionable. As Keller emphasizes, thinking in terms of aggregation is part of the problem. We need different knowledge forms (historical, ethnographic, quantitatively-observed, modeled, simulated) to run side-by-side, working kaleidoscopically, allowing us to move between different ways of seeing — displacing tendencies to hierarchically order or conflate them.   Recognizing that isolation (of people as well as forms of knowledge) is fatal.


Kim Fortun is a cultural anthropologist and Professor of Science and Technology Studies at RPI. Her research and teaching focus on environmental risk and disaster, and on experimental ethnographic methods and research design.  Fortun is the author of  Advocacy After Bhopal: Environmentalism, Disaster, New World Orders (University of Chicago Press, 2001).