Managing Diabetes. Jeffrey A. Bennett

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Managing Diabetes - Jeffrey A. Bennett Biopolitics

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AIDS’s unruly mnemoscape. Apocalypse and its dialogical partner utopia are pervasive in the queer canon, operating as two sides of the same coin to mobilize LGBT publics. The pink triangle and the rainbow flag, for example, are both emblematic of LGBT movements, but it is the more obtrusive and ominous triangle that is ubiquitous in AIDS’s legacy.13 Projections of grief and uncertainty can be found in everything from public art to political manifestos to postmodern theories of identity. Focusing on ACT-UP’s imposing visual politics, Thomas Long observed the group’s provocative graphics “attempt to assess the tactical and strategic instrumentality of apocalyptic discourse” to arouse rage and action.14 Peter Dickinson took the relationship between AIDS and apocalypse as a starting point, contending, “the problem with abstract theorizing about AIDS is that it frequently lacks a subject, a body, a corpus, a corpse. This would seem to be even more the case when theorizing AIDS as apocalypse.”15 The AIDS Memorial Quilt, Tony Kushner’s polemic Angels in America, and Larry Kramer’s anthology about the early 1980s titled “Reports from the Holocaust,” all point toward apocalyptic impulses that dwelled beneath the socio-production of AIDS.16

      Despite the dire nature of these predispositions, apocalyptic discourse paradoxically imparts agency to those grappling with crises. A breakdown in meaning leaves open a void to be filled, an ascription of purpose that allows people to interpret events and act on them accordingly. Scholars note that apocalyptic rhetoric energizes a feeling of control over uncertain conditions, even if this clout is figuratively fashioned in a manner that is not politically practical.17 Contemporary appropriations of apocalyptic speech rarely follow the formal characteristics born in religious genres. Rather, modern-day “secular” or “civil” forms of apocalypse are derived from historically contingent appropriations of these worldviews for addressing anxieties in the present.18 A simple phrase like “an impending sense of doom” might capture the spirit of such secular inclinations. The expression lends itself to shifting political needs (such as environmental issues or affective political attachments) more so than it does religious dogmas. Fragmented and formally displaced, tropological appropriations of apocalypse discern the malaise of traditional laws and the breakdown of social orders.19 As the voices in this chapter decrying the analogy to diabetes exhibit, the apocalyptic highlights a temporal disorientation, where the present both fails to bring the past to “utopic completion” and represents a deterioration of collective goals.20 Apocalyptic attitudes stress the dissolution of long-standing group practices and the inability to realize communal aspirations. The individuation of privately managing the body solves neither the problems presented by AIDS nor collective neglect, inciting renewed calls for vigilance and care until the epidemic recedes once and for all. As we shall see, these themes surface with regularity in comparisons to diabetes.

      Advancements in retroviral therapy and access to life-saving drugs made life with HIV less cumbersome for people in positions of privilege as the millennium passed. The panic and strong motivation to combat AIDS—and with it, homophobia—heralded the feasibility of a prolonged life in what some have hailed as a post-AIDS era. No longer relegated to the margins of the polis or the shadows of scientific neglect, HIV was slowly reconfigured into a chronic condition. To be sure, plenty of barriers continued to disenfranchise those living with HIV. Draconian measures that prohibited those who were HIV-positive from entering the United States remained in place. The criminalization of people with HIV who failed to disclose their status to sex partners was (and to some extent remains) widespread. The economic realities of an incongruent and segregated healthcare system presented institutional obstacles for scores of patients. To this day, fears over HIV contamination continue to prevent men who have sex with men from donating blood.21 Still, much positive change ensued and queer critics began raising questions about the ways paranoia inflected the tenor of discussions about HIV and, by extension, queer lives.

      If apocalypse constitutes one early framework for contemplating the AIDS crisis relevant to the analogy with diabetes, then the tropes of “paranoia” and the “reparative” mark the second. Even as queers had substantive reason to cede some fears about HIV, paranoia continued to unfold with conspiracy theories about genocide, lurid tales of bug chasing and gift giving, and scandalous stories about life on the “down low” in communities of color.22 In a widely circulated essay, Sedgwick pursued a controversial thesis about a paranoid style that had crept into activist and academic queer work. Using as her starting point the rapid uptake of AIDS conspiracy theories, Sedgwick expressed concern about an intellectual predilection that had lost its critical edge and often reproduced the very structures of oppression that queer scholarship sought to tear down.23 Sedgwick found that paranoia had come to occupy a daunting presence in queer studies, which sought to expose homophobia in even the most progressive of instances. She humorously expounded on the embrace of paranoia, reflecting on the pervasive utilization of Paul Ricoeur’s “hermeneutic of suspicion,” even in the face of political conditions that suggested otherwise.24 Sedgwick argued that paranoia had essentially become methodological: It embraced gloomy affects, was highly anticipatory of the future, and its boisterous negative critiques allowed for no surprises. In short, a paranoid perspective bestowed answers before the questions were even asked. Why, Sedgwick speculated, did queers repeatedly turn to a paranoid predisposition of the world in the face of social, medical, and political advancement? To her, queers were more than happy to elect the monogamy of paranoia over the polyamory of difference and the realities of medical enrichment. Ultimately Sedgwick questioned whether this “uniquely sanctioned method” really made queer lives better or simply provided ready-made conclusions for assorted phenomena. In its place, she called for reparative techniques to cultivate innovative and subversive meaning-making practices that would foster productive strategies for navigating convoluted situations.

      Paranoid and reparative reading strategies are not necessarily dichotomous and scholars, including Sedgwick herself, have intimated that anxiety might actually underlie each. Just as apocalyptic discourse can strongly imply longing for utopia, both paranoid sensibilities and reparative desires can stem from the unpleasantries of everyday life, each cruising unrealized dreams in the face of ideological stasis or queer ambivalence about the nature of progress. And, to be sure, paranoia envelops many management frameworks related to both HIV and diabetes because there is no guarantee that ritual care will necessarily prolong one’s life. Indeed, Sedgwick speculated on the bleak future of an HIV-positive friend in a segment of the paranoia essay that focuses explicitly on reparative tendencies.25 Paranoia persists in HIV vernacular, being a recurrent referent in everything from disputes about queer hook-up apps to the anxieties expressed over pre-exposure prophylaxis (PrEP), which has shown to be resoundingly effective in preventing HIV transmission when adherence is maintained.26 If reparative critiques were underscored by “weak theories” that privileged localize knowledges, AIDS discourse circles back to universal predispositions that centralize paranoia and trauma. The dialectical pairing of apocalypse and utopia, and that of paranoid and reparative, linger in the queer corpus, even if subtly, when HIV is the object of study. Recent developments in queer theory, however, have moved in the direction of precarity and the chronic suffering of populations at the hands of state agencies and capitalist orders. It is not so much that HIV need be fatal, but without proper access to care and modern medicine, perilous circumstances leave people at risk. The analogy to diabetes becomes even more pronounced when this figurative turn is made.

      Precarity is a new key word in the critical queer lexicon, emerging concurrently in activist and academic contexts. The concept has been articulated to phenomena as disparate as terrorism and the emergent creative class, although the term was not even listed in some English dictionaries just a few years ago.27 Scholars engaging the idea of precarity seek to unmask operations of power that exploit vulnerable communities and advocate for ethical imperatives to counteract irreparable harm. In Judith Butler’s words, precarity designates “politically induced conditions in which certain populations suffer from failing social and economic networks of support and become differentially exposed to injury, violence, and death.”28 Butler contends that precarity is performatively crafted; only those who are able to reiterate sanctioned cultural norms will be recognized as human to those in power. Without such recognition, no agency is afforded to marginalized people, and the capacity to be undone by oppressive regimes is actualized. The reverberations of apocalypse/utopia and paranoia/reparative resonate

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