selected as the chair of surgery, the youngest person there at age 31. he got his medical degree 21 and the oldest member of the faculty would be charles makes it took over chess obstetrics. they have clashed before. >> you can watch this and other programs online at booktv.org. >> from the 2014 fall for the book festival help in fairfax, virginia, eula biss talks about her book "on immunity" next on booktv. she was the recipient of the mary roberts rinehart award recentered feature at the festival to a woman writer specializing in nonfiction. this is a little under one hour. >> wonder things we did in building the festival was we started for awards, the award for encouraging reading, the poets award for poetry, the

fairfax prize for lifetime achievement in fiction, and tonight we're giving away the mary roberts rinehart award for a woman who writes in nonfiction. the goal in creating the award was to try to focus attention on works that were important. add-on writers whose works are important. and to bring riders and readers together. so this is celebratory but also very much part and parcel of what the festival is about. eula biss who teaches at northwestern has won numerous other awards, called sandburg literary awards, the jackson writers award, and nonfiction prize, a national book creating circle award. she's a google time fellow. we thank you very much for coming and accepting what is a humble price compared to the others you have one. the previous books are "the

balloonists" came out in 2002 and "notes from no man's land" which came out in 2009. tonight we will have her note from "notes from no man's land" and the newest one "on immunity." to cite her credit though it's only the beginning point of noticing her importance as a writer. what i note in her work our juxtapositions, a kind of self-contained irony that fills our lives. she just identifies these and focuses the bright light that i'm looking at, focus the bright light of her attention on them in ways that makes us aware of them and makes it impossible for us to ignore them. she's engaging and entertaining at the same time in her work. she's probably most noteworthy though because she tackle such vital issues. in reviewing her first book,

"the balloonists," a beautiful blending of narrative style, dialogue, brief anecdotes and narrative theories, eula biss navigates through complex relationships, uncharted territory. however, with one important distinction. she offers no set destination and no pre-drawn conclusion. instead, "the balloonists" is a continuation of life's unresolved arguments. the key insight we are all connected. she begins "notes from no man's land" with a history of a little-known flight that was put up by city council members and other public officials over the first telephone poles that wind up in this country. easy thing today's battles about obamacare are kind of like

weird, imagine town officials cutting down telephone poles because they didn't want the phone coming into their community. the telephone company had to go to the rather extreme measures of putting guys on the top of the polls to sit there to keep them from being cut down until the lines actually got stretched, anthony became protected by law. but until the line was stretched to the bull you could cut the pole down. fascinating. that's what i mean about juxtaposition. here we are, how can you live without your cell phone, right? and when the phone first came out, they'll couldn't sell it and people were opposed to it. it's that can juxtaposition i found just compelling about her work. another element. an essay in no man's land she points out the constructed nature of our lives and does

this with the own life. she tells how a plumber helped her when she first moved to new york, getting her refrigerator and fixing pashtun one that was stolen and does his and his self mocking joke in which he says before she could get downstairs and get into your apartment, someone had stolen it. and a parenthetical, the truth is she was painfully lonely in their first days in new york and she couldn't the refrigerator up to apartment because she did know anybody who could help her get it up to her apartment, and she lived in a building with no elevator so she couldn't move it. when she asked the landlord for replacement, he said look, take the place or find somewhere else to live. she had nowhere else to go so she stayed and she made it work. she is a truth teller in this way. she makes of life truth with with which we can make our vital connections. her newest book starts with her

own motherhood, grows out of that, and her desire to protect her new son. she links the urge to the broader impulse we all have into the myth and fairy tales in which mothers and fathers desire to protect their children and provide happy lives for them, but instead leave them with an unprotected heel, for example. or unwittingly give into the devil instead of protecting them. she writes of the consequences of our unknowing ask. she goes on to observe that quoting, the belief that public health measures are not intended for people like us is widely held by many people like me. the simple fact we need germs in order to enable a child's immune system to become functional so he's shouldn't completely sanitize ourselves even if we could. she traces the way some people see compelling immunization as too much government authority. that they don't trust. she also notes how that grows out of the state easily

translating to a kind of body, the body of the state. its arms, legs, a head of government. so you can see how a body and the government sort of become mixed. in the final paragraph she writes, we might imagine ourselves as a garden within a garden. i hope you were going to read the last paragraph. the outer garden is no beaten and no rose garden either. it is a strange and there is as the in the garden of our bodies were we host on guide and viruses and bacteria of both good and bad disposition. this garden is unkempt bearing both fruits and those. perhaps we should call it a wilderness or perhaps community is sufficient. however, we choose to think of our social body we are each other's environment. immunity is a shared space. a garden we tend together. to the best of ideas as a journalist, i had a mentor whose

criteria for calling someone smart was if they could keep two thoughts in their head at one time. by charlie's measure, eula biss is not only smart, she's also a uniquely empowering writerly person because through her work she not only put support more than two thoughts, but three or four thoughts. she enables us to hold them all in our head at the same time. i'm very happy and pleased to be able to present to you the mary roberts rinehart award for a woman working in nonfiction. [applause] >> thanks for that incredibly generous introduction. this is a tremendous honor for

me, one that's particularly meaningful because of who mary roberts rinehart was. she was a working mother, a trained nurse, and incredibly prolific writer, the author of the work that inspired batman, and an advocate who spoke publicly about having breast cancer when cancer was still unmentionable. so i hope that something of her legacy might be reflected in the book that i'm about to talk about. this is "on immunity" which is due out in two weeks, and i'm going to read a few passages from the beginning since you know the end now. so i'm going to start at the very beginning and skip around a bit. the first story i ever heard about immunity was told to be by my father, a doctor, when i was

very young. it was the myth of achilles, whose mother tried to make him immortal. she burned away his mortality with fire in one telling of the store, and achilles was left impervious to injury airport except his heel, were a poisoned air would eventually wound and kill them. in another telling him the infant achilles was immersed in the river styx, the river that divides the world from the underworld. his mother held her baby by his heel to dip in the water, leaving again one fatal vulnerability. when rubens painted the life of achilles, the river styx is where he began. bats fly across the sky of the painting and the dead ride a ferry in the distance. achilles dangles from his mother's hand by one plump leg with his head and shoulders entirely underwater. this is clearly no ordinary bath. the three headed hound who

guards the underworld lies curled at the base of the painting with a baby's body meets the river, as if the baby is being plunged into the beast. conferring immunity, the painting suggests, is a perilous task. to prepare her children for the hazards of life, my own mother read grimm's fairy tales allow to us every night before bed. i don't wome remove the brutalio which those tales are famous as vividly as i remember their magic, the golden bears growing in the castle garden, the boy in no bigger than a thumb, the 12 brothers who became 12 swans. but it didn't escape my notice as a child that the parents in those tales have a maddening habit of getting tricked into making bad gambles with their children's lives. in one story a man agrees to trade with the devil whatever is standing beyond his mill. he thinks he's giving away his appletree, but to his dismay he finds his daughter standing beyond the mill.

in another story a woman has been long for job becomes pregnant and craves a plant called rapunzel that grows in the garden of that wicked enchantress. the woman since her husband to steal the plant and when he is caught he promises their future child to the enchantress, blocks the growth away in a tall tower with no door. but maidens locked in powers will let down their hair. and so was in the greek myths my mother read to me later. akin to it heard an ominous prophecy could not keep his daughter childless locking her in a tower. zeus visited her in the form of a shower of gold that left her pregnant with a child who later killed the king. when infant oedipus left on a mountainside to die was saved by shepard, he was not saved from the prophecy that foretold he would kill his father and married his mother. and feed it, achilles mother,

could neither burn nor drown his mortality. a child cannot be kept from his fate, though this does not stop the gods themselves from trying. achilles mother, a goddess who married a mortal heard a prophecy that are found her son would die young. she made every effort to divide this prophecy including dressing achilles as a girl during the trojan war. after he took up a sword and was discovered to be a boy, his mother asked the god of fire to make a shield for him. this shield was emblazoned with the sun and moon, the earth and ocean, cities at war and peace, fields plowed and read, the universe with all its dualities was achilles shield. the story my father told me when i was young was not the myth of achilles, he reminds me now, but another ancient story. as my father relates the plot, i understand why i confused the two. they hear of this story is made

immune to injury by bathing in the blood of a dragon, but a leaf clings to his body while he bathes, leaving a small spot on the back where he is unprotected. after having been victorious in many battles, he is killed by one blow to that spot. immunity is a myth, these stories suggest, and no mortal can never be made in vulnerable. the truth of this was much easier for me to grasp before i became a mother. my son's birth brought with it an exaggerated sense of both my own power and my own powerlessness. i found myself marketing with fate so frequently that my husband and i made a game of it, asking each other what disease would give our child for prevention against another, a parity of impossible decisions of parenthood. when my son was an infant i would hear many variations of all that matters is that he is safe. i would wonder whether that was indeed all that mattered nearly as often as i would wonder if i

could keep them safe. i was certain that i didn't have the power to protect him from his fate, whatever it might be. but i was determined nonetheless to avoid the bad gambles of the grimm's tales. i would not let my child be cursed by my own carelessness or cupidity. i would not axially say to the devil, you may have what is beyond the middle, only to discover that what is standing beyond the mill is my child. i'm going to skip ahead now so that we can get to the vampires a little faster. in 1881 and bill titled the vaccination vampire warned of the universal pollution delivered by the vaccinate or, known to feed on the blood of babies, the bad -- the vampires became a metaphor who inflicted wounds on infants. bloodsucking monsters of ancient folklore were hideous but

victoria vampires could be seductive. the macabre the sexuality of the vampire traumatized the fear into something sexual in the activactof vaccination, and inst was only reinforced when sexually transmitted diseases was spread through arm to arm vaccination. victoria beckham buyers like the taurean doctors were associated not just with corruption of the blood but also with economic corruption. having virtually invented the paid profession and being almost exclusively available to the rich, doctors were suspect to the working class. bram stoker's dracula is of the bloodthirsty joo. he keeps -- bourgeois. he keeps gold coins in his council. if this difficult the region as a vaccinated. of all the metaphors adjusted in the clinical pages of dracula, disease is one of the most obvious.

dracula arrived in england just as a new disease might arrive, on a boat. he summoned towards the rats in his infected evil spreads to the first woman he bites to the women she feeds on unwitting that night. what makes dracula terrifying and what takes the plot of the story so long to resolve is that he is a monster whose monstrosity is contagious. germ theory was widely accepted by 1897 when dracula was published, but only after having been ridiculed earlier in the century. the suspicion that microorganisms of some sort cause disease have been around for so long that the figure was already considered outdated by the time louis pasteur demonstrated the presence of germs in the air with his court and on court flasks of sterile broth. among the vampire hunters to pursue dracula, sterilizing his coffin so he cannot take refuge in them are two doctors who

initially disagreed on their diagnosis. the younger doctor can bring himself to believe in vampires despite the evidence so the older doctor delivers an impassioned speech on the intersection of science and faith. let me tell you, my friends come he says, but there are things done today in electrical science which would've been deemed unholy by the very been who discovered electricity who would themselves not so long before had been burned as wizards. he then goes on to evoke mark twain. i heard once of an american who so defined faith, that which enables us to believe things which we know to be untrue. he meant that we shall have an open mind and not let a little bit of truth check the rush of the big truth like a small rock does a railway truck. dracula is as much about this problem, the problem of evidence and truth as it is about

vampires. in proposing that one truth may derail another invites an enduring question. do we believe vaccination to be more monstrous than disease? deep within every man there lies the dread of being alone in the world, forgotten by god, overlooked among the tremendous household of millions upon millions, kierkegaard wrote in his journal in 1847. that was the year he finished works of loves and which insists that love is known not through words but only by its fruits. i read the first 50 pages of works of love in college before giving it up out of exhaustion. in those pages kirkegaard unfolds the commandment you shall love your neighbor as yourself, parsing it almost word by word so that after exploring the nature of love he asks what is meant by as yourself, and then what is meant by your

neighbor. and then what is meant by you shall. overwhelmed, i stopped reading shortly after kierkegaard asked, who then is one's neighbor rex which he answered in part with neighbor is what philosophers would call the other, that by which the selfishness and self loved is to be tested. i had read enough of the point to be troubled by the idea that one must enact one's beliefs and perhaps even embody them. from somewhere deep in my childhood i can remember my father explaining with enthusiasm the principles behind the doppler effect as an angus the past our car. when we watched the sunset over the river where we lived, he described as scattering, the removal of the shorter wavelengths of light by the atmosphere that results in reddish clouds and grass that looks more intensely green at dusk. in the woods he dissected an owl pellet for me and reassembled from it a tiny skeleton of a mouse.

my father marveled at the natural world far more often than he talked about the human body, but blood types were subject on which he spoke with some passion. people with the blood type o. negative explain can only receive a transfusion blood that is on negative but people with no negative blood can give blood to people of any other types it that's why person with type o negative is known as a universal donor. my father would then reveal that his blood type was own negative, that he himself was a universal donor. he gave blood, my father explained, as often as he was allowed because blood of his type was always in demand for emergency transfusions. i suspect my father they've maye already known then what i would only discover later, that my blood is type o negative. i understood the universal donor more than ethics and a medical concept long before i knew my own left eye. but i didn't yet think of that

ethic as an ingenious filtering of my fathers catholicism through his medical training. i was not raised in the church and endeavor to communion, side was not reminded of jesus offering his blood so we might all live when my father spoke of the universal donor. but i believe even then that we owe each other our bodies. every time a father went out in a boat, he took a life preserver with his name and organ donor printed usually on a in permanent ink. it was a joke in which he believed quite sincerely, when it got me to drive a gave me this its eyes from his own father. you are responsible not just for the car you're driving, but also for the car ahead of you and the car behind you. learning to drive all three cars is daunting and inspired an occasional paralysis that plagues my driving to this day. but when i turned my license i signed my name under organ

donor. the very first decision i made for my son, a decision in acted within moments of his body coming free of mine was to the donation of his umbilical cord blood to republic bank. at 30, i only donated blood once back in college when i was reading kierkegaard. i wanted my son to start his life with a credit to the bank, not the debt i already felt. and this was before i, a universal donor, would become the sole recipient of two units of blood in transfusion after my son's birth. blood of those precious type drawn from a public bank. if we imagine the action of a vaccine not just in terms of how it affects a single body but also in terms of how it affects the collective body of the community, it's fair to think vaccination as a kind of banking of immunity. contributions to the bank our donations to those who cannot or will not a protected by their

own immunity. this is the principle of heard communities and mr. herd immunity that mass vaccination becomes far more effective than individual vaccinations. any given vaccine can fail to produce immunity in an individual and some vaccines like the influence of vaccine are less effective than others. but when enough people are vaccinated with a relatively ineffective vaccine, viruses have trouble moving from post to post in ceased to spread. sparing both the unvaccinated and those in vaccination has not produced immunity. this is why the chances of contracting measles can be higher for a vaccinated person living in a largely unvaccinated community than they are for an unvaccinated person living in a largely vaccinated community. the unvaccinated person is protected by the bodies around her, bodies to which disease is not circulating.

but a vaccinated person surrounded by bodies that host disease is left vulnerable to vaccine failure. we are protected not so much by our own skin, but by what is beyond it. the boundaries between our bodies begin to dissolve here. donations of blood and organs move between us exiting one body and entering another and so with immunity which is a common trust as much as it is a private account. those of us who draw on collective immunity all our health to our neighbors. -- oh. i think i will do one more excerpt and then take some questions. the belief that public health measures are not intended for people like us is widely held by many people like me. public health we assume is for people with less, less education, less healthy habits, less access to quality health care, less time and money. i've heard of mothers in my

quest suggest that the standard childhood immunization schedule groups together multiple shots because poor mothers will not visit the doctor frequently enough to get the 26 recommended shots that we need. no matter any mother, myself included, might find so many visits daunting. that we seem to be saying of the standard scheduled is for people like them. in an article from mothering magazine, the journalist expresses outrage that newborn infants are routinely vaccinated against hepatitis b and wonders why she was encouraged to vaccinate her daughter against a quote sexually transmitted disease she had no chance of catching? hep b. is transmitted not only by sex but through bodily fluids so the most common way that infants contract to be is from the mothers. babies born to women who are infected with hep b. and mothers can carry the virus without the

knowledge will almost certainly be infected if they are not vaccinated within 12 hours of birth. the virus can also be passed through close contact between children, and people of any age can carry it without symptoms. like human papilloma virus and a number of other viruses, hep b. is a carcinogen and is most likely to cause cancer in people who contract it when they are young. one of the mysteries of hep b. immunization is the vaccinated only high-risk groups which was the original public health strategy did not bring down rates of infection. when the vaccine was introduced in 1981, it was recommended for prisoners, health care workers, gay men, and iv drug users. but rates of hep b. infection remained unchanged until the vaccine is recommended for all newborns a decade later. only mass vaccination brought down the rates of infection, and it is now virtually eliminated

the disease in children. the concept of a risk group revives the archaic idea of a tainted community that illness has judged. risk in the case of hep b. turns out to be a rather complicated assessment. there's risk in having sex with just one partner, or traveling through the birth canal. in many cases the source of infection is never known. i decided before i knew how much blood i would lose in childbirth that i didn't want my son to be vaccinated against hep b. i did not belong to a risk group at the moment he was born, but by the time i put into my breast i have received a blood transfusion and my status had changed. when the last nationwide smallpox epidemic began in 1898, some people believed that whites were not susceptible to the disease. it was called -- were was

associate with immigrants, italian edge or mexican bump. when smallpox broke out in the city, police officers were sent to help enforce the vaccination of italian and irish immigrants in the tenement. when smallpox arrived in middlesboro kentucky go in the black section of town who resisted vaccination was vaccinated at gunpoint. these campaigns did limit the spread of the disease but all the risk of vaccination which at that time could lead to infection with tetanus and other diseases was distorted by the most vulnerable group at the poor were enlisted in the protection of the privileged. debates over vaccination then as now are often cast as debates over the integrity of science. though they could just as easily be understood as conversations about power. working-class people who resisted britain's 1853 provision for free mandatory vaccination were concerned in

part with her own feedom. faced with fines, imprisonment and the seizure of the property if they did not vaccinate their infants, they sometimes compared the predicament to slavery. vaccination like slavery raises some pressing questions about one's rights to one's own body. but as the historian has noted, anti-vaccinators were often more interested in evolution as a metaphor for individual liberty than they were in the cause of the shared purpose. it was not in the recklessly selfish spirit of john brown who was hanged with his sons for the doomed effort to free slaves that white workers resisted vaccination. anti-vaccinators were quick to draw on the political motives or rhetorical value of the slave or of the colonized african in britain. ever quicker still to claim the suffering of white english citizens took precedence over that of the oppressed elsewhere.

their primary concern, in other words, was with people like them. in her history of that movement, she returns off into the idea that vaccine resisters other bodies not as potentially contagious and dangers to the social body but is highly vulnerable to contamination and violation to their bodies were of course both contagious and vulnerable. but any time and place where the bodies of the poor were seen as a liability to public health, s. dangerous to others, it felt to the poor to articulate their vulnerability. if it was meaningful than for the poor to assert that they were not purely dangerous, i suspect it might be just as meaningful now for the rest of us to accept that we are not purely vulnerable. the middle class may be threatened but we are still just by virtue of having bodies dangers. even the little bodies of

children which encourages us to imagine as absolutely vulnerable are dangerous in their ability to spread disease. think of the unvaccinated boy in san diego, for instance, who returned from a trip to switzerland in 2008 with a case of measles that infected his two siblings, five schoolmates and for children in his doctor's waiting room. three of those children were infants too young to be vaccinated, and one had to be hospitalized. i'm vaccinated children, a 2004 analysis of cdc data reveals, are more likely to be white, have an older married mother with a college education and to live in a household with an income of $75,000 or more, like my child. i'm vaccinated children also tend to be clustered in the same areas, raising the probability that they will contract an illness that can then be passed once it's in circulation to under vaccinated children.

under vaccinated children many children have received some but not all of the recommended immunizations are more likely to be blocked, two of the younger unmarried mother, to have moved across state lines and to live in poverty. vaccination works, my father explained, by enlisting a majority in the protection of a minority. he means the minority of the population that particularly, that is deeply vulnerable to a given disease. the elderly in the case of influenza. newborns in the case of pertussis. pregnant women in the case of rubella. but when relatively wealthy white women vaccinate our children, we may also be participating in the protection of some poor black children whose single mothers have recently moved and have not as a product of circumstance rather than choice fully vaccinated them. this is a radical conversion of the historical application of vaccination which was once just another form of bodily servitude

extracted from the poor for the benefit of the privileged. there's some truth now to the idea that public health is not strictly for people like me, but is through us, literally through our bodies that certain public health measures are enacted. i'm going to stop there. [applause] >> thanks. thinks that much. and if there's time and patience, happy to answer questions. [inaudible] >> i don't blame you if you don't want to be on c-span. [laughter] >> how long did it take you to research your book, and where

did you find the major sources of information? >> sure. took about five years. i started shortly before my son was born, and he is five and a half now and for the first so for years all i did was research. i didn't write very much for the first two to three years. my sources of information came from all over. i started by talking with other parents and reading what other parents were reading, what people were recommending to me. i moved from there into reading articles in medical journals, reading histories of vaccination. so you heard some of that evidence. reading anthropological works, looking at the vaccination, reading a textbook on

immunology, which was harder than i expected. and then i moved to doing interviews. i talk to immunologists and toxicologists and pediatricians, and medical ethicists. so i talked -- that was probably the most gratifying an interesting part of my research was talking to people who held expertise in this wide range of areas to vaccination is interesting to me because it brushes up against all of these other areas, and so i was also, i also found myself thinking about environmental issues and issues of pollution and, chemical pollution and issues of governments, and what it means to be a citizen. so i was also talking to philosophers and people who helped me think about the conscience and what it means to have a conscience. so the research was really wide

ranging for me. some of it was very technical and based in medicine and required that i get a lot of help from people who have expertise in medicine, and then a lot of it was, was more kind of social in nature and historical. >> that's my student, my former student from northwestern all grown up now. >> i was wondering, how did you after writing the book go to make sure all the research was still accurate after u.s. through all the filters? >> that's a great question. i expect nothing less from you.

so how did i make sure that everything was still correct when i finished? partly i have help in that there was a copy editor who is doing some fact checking and to flag stuff. i also went back myself and double checked all my sources but i also had two separate scientists read the book. one of the scientist was a source of mine, but i also found a scientist who was not a source of mine to read the book for accuracy. and despite all that effort, not everything that's in this book is absolutely accurate, and i know that because some of the things that i was writing about changed so quickly that even though this book is only going to come out in two weeks from now, the situation with polio, for instance, in the east has changed so quickly that much of what i said about polio being

here is no longer true. most everything that i said is a vast understatement of what is now actually going on with polio. because in the six months or so since the text was finalized, a lot has changed. i also made a reference to the bullet anywhere i was talking about the last round of ebola that happened when i was in high school, but this round of ebola, which i'm not sure we'll read the way i mean it to read now that this new crisis has emerged. but those are the kinds of things that is the inevitable fallout of something that still happening. so i did everything i could do to make sure that the information that i was using in here was accurate to my knowledge, and to the knowledge of the people that i showed the book to. i don't doubt for a minute that

i probably got something wrong. even just today i was going through a fact checking process with the new york times magazine which was revealing to me how much judgment is involved in fact checking, and how many people have to weigh sometimes contradictory information, on a deadline can decide what is going to be the fact that appears in this piece. so there's also a great area there that's difficult and challenging. thanks, karen, for that question. >> so it's a huge topic, and a lot of research as you said, so my thoughts are, there's also the personal aspect of the. your father was a physician and to talk about you feel strong about immunization, and so i'm

thinking, how do you come in your writing process, or in your mind before you wrote, did you kind of had a narrative story, like my father was a physician and you believed in it and you have a son and your a son and your bleeping immunization coverage, then tried to incorporate all that research and apply to the story, or did the research and form the narrative? >> that's a great question. i'm trying to think about what actually happened. i think the process for this book was that i was living a lot of questions, and those questions drove both the inquiries that have engaged in and the form and structure of the book. so it was less but i decide to work with a narrative or work with some information than i decide to work with some questions. and those questions drove me sometimes into narrative, yes.

one of the questions that i had at some point in this research, at some point i wasn't really, my research wasn't complete yet. i done enough to see that as far as i could tell there was no compelling reason that i yet turned up not to vaccinate my son. but there were still questions that i had, and i vaccinate him and i vaccinate him on schedule, but a little part of me was still nervous. one of the questions that i had that continue to propel me through the research and through this book is why am i doing this? why am i faxing them on schedule if i'm not 100 -- vaccinating him on schedule if i'm not 100% certain beyond a shadow over thathat there's nothing bad coud happen to them from this? that question not at me for a while and propelled me actually into a line of inquiry that got me talking to my sister, reading

philosophy and talking to my sister who's a philosopher and who teaches ethics at the loyola baltimore. we had this long discussion about conscience and what a conscience is. i realized at the end of the conversation that oh, the answer to that question is why i'm doing this even though i'm not 100% sure that my son will not be harmed is that it's a matter of conscience for me. and i think i would have trouble facing my father, not in life, but in my heart and mind facing him if i hadn't turned up an extraordinarily compelling reason not to do this thing that i knew, not just important to him but also i think it went beyond imports. it arranged into a territory --

ranged into a territory in the morality that i've been raised to understand and to act from. and so if i is going to step outside that kind of moral action i felt that i needed a really good reason to do. so that's an example of a question that drove into aries i did not is going to go, and some of those areas involved talk about my father so that second out of read from where i'm inflicting on him talking about blood types and some of the conversations that we had about learning to drive. that was coming out of the question that i had, okay, what is it about my upbringing or my moral sense or the ethics that i've been trained in that's making me uncomfortable with not engaging in what i have come to see as kind of a civic duty. and and there's another question, another section in your that is also driven by that same question.

there's much more research-based so the narrative sections and then there was a section where i researched the anti-vaccination in victorian england. and the people who resisted vaccination in that time period called themselves conscientious objectors and it's action the first widespread usage of that term. looking to be used in the context of war, but the first really widespread uses was in the context of vaccination excise really interested in the fact that that term conscience had appeared in this very early anti-vaccination movement, and i wanted to figure out okay, if what i'm feeling i'm calling conscience and of what they're feeling they were calling conscience, but it's leading to two different decisions, what's going on? are we working with two different understandings of conscience or are we just in two different historical periods? what's happening? that was another question that

drove me deeper into research and information. does that answer your question? >> do you find that questions of ethics and morality tend to drive a lot of your choices for topics? >> yes. i seem to not be able to get away from them. i don't tend to nestlé go there but i guess those questions i may, or i find them. i was a little bit surprised when i started working on this book. i felt that it would be a real departure for my last book. i was writing about race, racism and racial identity in my last book, "notes from no man's land" but in many ways it was an exhausting subject to work with for as long as i worked with it.

and it did raise a lot of difficult questions and provoked a lot of self-examination that was difficult self-examination. i think i was under the delusion that i started writing this book that because i was riding in this new kind of subject matter territory because i find about science and medicine that i was somehow escaped that kind of inquiry, those kinds of questions or those kind of moral and ethical issues. but that delusion did not last incredibly long. it didn't take me very far into the writing of this book before i started coming up against some of the same question that had emerged in "notes from no man's land" but even sometimes in a similar context. there are issues of race and privilege definitely come up around the vaccination, and class as well. the whole history of vaccination and anti-vaccination movement is

really steeped in issues of class. and so not only did i not escape those questions but i realized towards the end of writing this book in many ways it was picking up on some of the issues that my last book had left off and taking them the way i see it a little bit further, and sometimes into more specific territories. i think one of the things my last book suggested to me as a thinker was this possibility that one can be born into privilege or one can acquire privilege, but one can still choose to live that privilege in a retentive way. but that was -- redemptive. that was wide, vague knowledge that emerged out of that book and i think this book forced me to look at a specific instance where someone might be in a position of privilege where they

could make a choice that could either help or hurt another person. and those were the terms that i was looking at vaccination and. and i don't think this book would be what it was without the book before it. i think a lot of the thinking about morality and ethics was done in the first book and kind of primed me for this one. at some point i would like to get away from it, because it's always tricky territory to be. i think it's the reason nobody ever laughs at me reading. i don't get to be funny about how to talk about how to be good. any other questions? >> did you get much into issues

where the containment of the disease is not really based on vaccination but more like ebola currently where there is no vaccine or murderers where it seems to be sanitary control -- mers? was it something you also will dealt with? >> yeah. i look at some of that historically. so i look at some of the ways that we contain diseases before we had vaccine for certain diseases, but the disease that i really became interested in and did quite a bit of research on was malaria. said this was a disease that kills hundreds and thousands of children in africa and leaves many other children mentally disabled. and that we have no vaccine for, no effective vaccine yet. there's a couple in the works but there's not yet won that's available for practical use. and one of the things that's

upsetting about looking at how malaria is dealt with and contain and treated is that in the absence of a vaccine, we need to make a lot of the public health measures and bald with compromises. one of the more effective ways of containing malaria in africa is the use of ddt to kill and prevent the reproduction of mosquitoes that spread malaria. and when ddt use fell off for a number of decades, malaria research in some countries. and now certain countries in africa, especially south africa and have put ddt back into use and have seen really good results in terms of containing malaria. and reducing the number of cases. but as we know there's some significant environmental

fallout from using ddt. there's reasons why ddt is not a great solution. it's unfortunately one of the few effective things that we have to contain malaria with. i think one of the beauties of vaccination is in many cases it does not involve the kind of massive compromise that something like widespread ddt use does. that doesn't mean it's absolutely perfect or that there's no compromise, and there are risks to vaccination, and children to have side effects. but the good that is done in comparison to the harm is tremendous. >> a final question? we have books for sale in the

back which you'll be happy to sign. >> thanks so much. [applause] [inaudible conversations] >> booktv is on twitter and facebook, and we want to hear from you. tweet us, twitter.com/booktv, or post a comment on our facebook page, facebook.com/booktv. >> you are a whopping 27 years old. unit finished middle school but you're just getting started in your ph.d efforts in microbiology in antwerp. a mysterious test tube sample showed up in terrible condition and you fg