'The Biology of History': Antibiotics, Resistant Bacteria and the Human Effect. An Interview with Hannah Landecker
Hannah Landecker and Andrea Núñez Casal
To supplement the publication of 'Antibiotic Resistance and the Biology of History' in Body & Society, Andrea Núñez Casal, MPhil/PhD candidate at Goldsmiths, University of London, interviews the author, historian and sociologist of science Hannah Landecker, Professor of Sociology and Director of the Institute for Society and Genetics at UCLA.
Some background
Image: Hannah Landecker
When I was an undergraduate student doing a biological sciences degree, you were not supposed to have microbes in your body. However, as Hannah Landecker has pointed out, twenty-first century biology is a very different body of discourse and practice compared to the biology of the twentieth century (2005). Although I studied biology in the twenty-first century, the academic programme my teachers followed reflected the epistemic, ontological and empirical characteristic of the twentieth century biology. Like I said, I learned that microbes were not supposed to be found in the human body. Their presence was a clear sign of pathology. In that case, you were ill; you had a viral or bacterial infection (archaeal or protozoan infections are rare). The only way of treating bacterial infections is with antibiotics. Antibiotics do not work with viruses despite the fact that they were and are often prescribed without evidence of whether the infection is bacterial, viral or there is an infection at all. But if you went untreated, doctors say, you would be in risk of developing a sepsis, a life-threatening condition caused by the spread of the infection via the bloodstream. This is a worst-case scenario though, but after all, it is a possibility. And in health and disease, as much as in other spheres of life, to be on the safe side is to minimise risk. Notwithstanding the (bio)value of antibiotics for curing otherwise deathly infections, the life sciences and, particularly, the fields of microbial ecology and immunology has changed very rapidly over the last 5 years: Antibiotics are no longer the holy grail of modern medicine or the 'miracle drugs' that we were told they were by medical practitioners, physicians and public health authorities since the mid- twentieth century, when they became commercially available for the general public. Conversely, antibiotics should be now used with precaution, moderation and only if they are prescribed by a medical professional. The thing is that now we know that antibiotics destroy the balance of 'the human microbiome', a term that designates the genetic material carried by the human microbiota, which is the particular community of microbes residing in and on the human body including bacteria, archaea, viruses, microeukaryota. Likewise, in the twenty-first life sciences, microbes are no longer considered as 'pathogens' or 'deadly intruders', ideas that have pervaded scientific discourse and public imagination since Louis Pasteur's experiments corroborated and popularised the germ theory of disease in 1878 by which microbes were correlated with disease. Microbes are now in the body and indeed in astonishing quantities: microbial cells in the human body outnumber human cells by 10 to 1. Although the human microbiome is a relatively new area of study and thus its foundations are being established as I am writing this introduction, there is enough evidence to affirm that microbes are vital players in health and disease. In fact, microbes are literally everywhere: inside and outside the body of human animals, non-human animals, plants, in the soil, air, organic and inorganic surfaces, and they might be in other planets as well – the Panspermia hypothesis holds that the origins of life on Earth are to be found in extra-terrestrial microorganisms that unintentionally arrived in the Earth via the collision of a meteoroid or asteroid containing them. In the light of this, one wonders why should we kill microbes with antibiotics if they are so vital for life? This is, bluntly put, the rationale behind modern science. In fact, it is not just that antibiotics, or as Hannah calls them 'antilife', destroy the beneficial microbes living in and on the human body (i.e. the human microbiota). The use of antibiotics creates something worse than the imbalance of the microbiome. It creates antibiotic resistance. Antibiotic resistance, in turn, affects the ecological milieus of the Earth.
Antibiotic resistant bacterial strains are the result of anthropogenic activities. Human efforts to get rid of microbes during the second-half of the twentieth century have led to an unexpected and unwanted consequence of global dimensions: the escalation of resistant bacteria that are 'immune' to antibiotics. Are we heading back to the pre-antibiotic era, when (now) common infections such as bronchitis or cystitis were causes of premature death? But why should humanities and social sciences scholars be preoccupied by these matters?
In the interview, Hannah Landecker illuminates why antibiotic resistance along with other related issues are imperative questions for contemporary critical thought. She provides an accessible introduction to some of her key reflections on antibiotic resistant bacteria, the 'biology of history' and the Anthropocene.
ANC: Your article 'Antibiotic Resistance and the Biology of History' (2014) examines the phenomenon of antibiotic resistant bacteria, often considered by biomedical specialists, public health authorities and policy-makers as a 'global threat' and thus as one of the grand challenges of contemporary medicine. To my knowledge, this is the first in-depth study in critical science studies and the social sciences more broadly of what we might call the 'biosocial' aspects of resistant bacteria.
You frame antibiotic resistance as “a problem for cultural critical theory of life, health and the body” claiming its relevance for “historical and cultural theories of events and bodies” (2014: 1). Why have you become interested in the topic?
HL: My interest in this topic was really sparked by teaching about it. In 2010, I had to come up with a syllabus for the new introductory course to a new undergraduate major at UCLA that I helped found called Human Biology and Society. The course was supposed to show how contemporary problems of science and society could not be understood nor solved without learning and cooperation across domains such as genetics, microbiology, sociology and philosophy. I chose antibiotic resistance because it offered a chance to teach scientific content about cells and genes and evolution at the same time as teaching social or critical content about industrial agriculture and the history of medicine. At first I was just reading and talking to my colleagues in microbiology to learn enough to teach about it, but then I was quickly hooked, in part because the content was changing under my feet even as I was walking into class to teach it, both in terms of the relevant science and in terms of the political and medical landscape of antibiotic resistance as a news phenomenon. Put simply, it made me wonder what it meant to know about antibiotic resistance.
I have to push back a little though on the idea that I’m the first in science studies or social science to take on antibiotic resistance. The work of Paul Farmer on antibiotic resistant tuberculosis as a practical, social, and ethical issue has been massively important for changing how people in science and politics and global health see the issue. The anthropologist Erin Koch has done beautiful ethnographic work in Georgia, studying the science and culture and politics of antibiotic resistant tuberculosis; Melinda Cooper’s work both on René Dubos and on biotechnology hold important insights into the discourse of manipulating bacteria for economic productivity; and I teach every year using an article on the political ecology of antibiotic resistance by the anthropologists Kathryn Orzech and Mark Nichter. Robert Bud’s book on Penicillin also takes on the history of antibiotic resistance in great detail. And although his concerns lay in other aspects of microbial life, Stefan Helmreich is the person who really began to elaborate horizontal gene transfer as a concept with rich theoretical importance for thinking about kinship and temporality and connection in social science (all of these are cited in the article’s bibliography). I have learned a great deal from all of these scholars, and I hope that what I’ve done both synthesizes and builds on their contributions.
Maybe because antibiotic resistance seems such a visceral issue to me, and because of my immersion in the logic of the science, I think I have a stronger sense than any of these authors of these biological transformations to bacteria and bacterial ecologies as historical and cultural events that are incredibly specific to our time: the crossing point of industrialization and the medical control of infection. And this conjuncture, at which we see the materiality of history and the historicity of matter, makes me rethink the historical event or the relationship of human history and biology. The angel of history has MRSA, you might say.
ANC: How do you think about the role of the humanities and the social sciences in debates around antibiotic resistance?
HL: Your use of the word “role” implies that you want to know what this work will do, in a practical sense. I do not expect that my article will help solve the problem of antibiotic resistance in the world in a direct manner. The literature attempting to produce solutions by changing biology and behavior and pharmaceuticals and therapies and so on is enormous, mind-bogglingly so. I think that sometimes scholars in critical social theory confuse critical problems with practical problems. Of course they’re interrelated, and it is always important to understand something in order to have any hope of coming up with workable solutions to it. But sometimes it’s OK to say that thinking deeply about and through this topic is useful or plays a role because it teaches us something about history and about concepts and about knowing and manipulating the biological world, not because it immediately helps solve the problem of antibiotic resistance right now with practical advice on reducing prescription rates or finding new antibiotics. Of course, social scientists who understand human behavior and the politics of regulation of antibiotics as growth promoters, and medical historians who understand how medical practice is shaped by reliance on these therapies and health economists who understand the costs all have immensely important practical contributions to make – this is a human social problem as much as it is a scientific or technical problem. I don’t want to pretend that I’m doing both with this one article. Here I am interested in the theoretical richness of a changing and historically reflexive science of antibiotic resistance.
ANC: Antibiotics have an ambivalent nature since their power to cure bacterial infections is tied with its capacity to create new ones, to increase the virulence of pre-existing infections and to disrupt ecological milieus with repercussions that go beyond the human body. Such paradoxical characteristic of antibiotics remind me to what French philosopher Jacques Derrida, coming from Plato's Phaedrus, called 'pharmakon' (Derrida, 1981): an ambivalent entity with its own opposite within itself, remedy and poison at the same time. Can antibiotics be formulated and be properly understood as 'pharmakons'?
HL: Well that’s kind of an answer phrased as a question, isn’t it! Since I haven’t thought very much about the ‘pharmakon’ concept, you’re probably better positioned to tell me whether antibiotics can be understood in this way than I am. But one thing I would say is that perhaps the “remedy and poison” opposition is too simple for antibiotics. Can we see the reshaping of frequency of antibiotic resistance traits in human commensal bacteria by antibiotic ingestion as the opposite of treating a sinus infection? I see antibiotics as ambivalent entities that are participating in a far larger number of biological historical processes than was ever anticipated by their initial mobilization as killers of pathogenic bacteria in individual patients. Some of those processes are very quick and some are very slow, and some are acting at a very local level and some are active in a cumulative and ecological scale. I don’t know that the pharmakon concept allows for this kind of heterogeneous temporality and multiple scale of action rolled into an entity. Or that “poison” is the right description for the knock-on effects of antibiotic use.
ANC: As you demonstrate, antibiotic resistance is neither a recent phenomena nor restricted to the biological domain: samples of ancient DNA evidence the existence of soil bacteria that “harbour both capacity to make antibiotics and capacity to live with antibiotics” (2014:20). On the other hand, since the mass production of antibiotics began in the 1950s, antibiotics have been used for “maintaining army manpower diminished by venereal diseases (Neushul, 1998 in Landecker, 2014:6), for treating lethal infectious diseases and in the food industry, allowing the industrialisation of livestock, to name a few. Penicillin resistant bacteria were detected in 1942 just one year after the first patients were treated with penicillin (2014: 9). Interestingly, you show that even someone as distant from the medical profession as the political philosopher Hannah Arendt echoed the worrying effects of antibiotic on the human body almost 60 years ago (ibid).What, do you think, are the reasons for the simultaneous realization of antibiotic resistance and the apparent lack of action to change the massive production and use of antibiotics?
HL: Sometimes we think contemporary crises have never happened before. The phenomenon of human outbreaks of antibiotic resistant pathogenic disease has certainly been happening with increasing frequency, but it was already in the news periodically throughout the latter part of the twentieth century. Arendt was likely reading René Dubos’ work on bacterial-human ecology (The White Plague was first published in 1952) or responding to local news stories about antibiotic resistant disease outbreaks in New York. In The Human Condition, she’s thinking through science and technology very explicitly and drawing on other scientific writing, for example from the physicist Werner Heisenberg, so it isn’t so surprising. And perhaps speaks to your first question as well: I’m not the first person to think about antibiotic resistance as a feature of the human condition as thus quite properly in the domain of the human sciences!
I think that antibiotic resistance was seen as a sporadic and mutation-based occurrence specific to one antibiotic and one strain or species of bacteria at a time, for many decades. There was a lot of confidence in antibiotics and in the ability to discover or synthesize new and better ones well into the 1970s. There was also a lot of confidence in human power over biology with the rise of genetic engineering, which itself was done by reusing the genes and enzymes of bacteria. It was not until a theory of antibiotic resistance as a systemic property of all antibiotics and all bacteria, and the technical means to understand genomic shifts at the scale of populations that the problem of antibiotic resistance took on its contemporary form. However, there’s still quite a lot of confidence in drug discovery – just look at the enthusiasm just recently around a new era of bioprospecting in the soil for new antibiotics, now that there’s a technique for finding antibiotic molecules without first having to culture the bacteria in the lab.
ANC: You have examined how scientists are theorizing that the process of industrialisation has changed in tempo (acceleration) and mode (horizontal gene transfer) the evolutionary history of bacteria. The infective transmission of resistant bacterial genes is developed across species (microbes-non human animals-human animals) and at a collective level. Moreover, my microbiota harbor antibiotic resistance traits whether I personally take antibiotics or not. While this indicates an entanglement of different life forms it also reflects the negative effects that some forms of life (predominantly human) exert on other life forms (Helmreich, 2009). In the article you coin the notion of 'the biology of history': “how human historical events and processes have materialized as biological events and processes and ecologies” (2014: 2).
Do you think that 'the biology of history' can be located in a specific historical moment, for instance in the mass production of antibiotics in the 1950s, or is it co-constituted along with the history of biology?
HL: In some ways you are asking me how generalizable this concept is, beyond antibiotics and antibiotic resistance. At the end of the article, I argue that the same sort of analysis could be done in terms of synthetic hormones and endocrine-disrupting chemicals. These too occur at a very specific nexus: biopolitics and industrialization. These too share the recursive structure in which the effects of previous modes of knowledge (in endocrinology) become the new center for knowledge production about hormones and biology. Thus endocrine disruption, like antibiotic resistance, comes to reorganize the very science from which it sprung because of the manifest changes in bodies and processes at large scale. The venture to control infection, health and reproduction in populations combined with the manufacturing and marketing revolution is seen in both cases. It’s important to note that all kinds of industrial scales are coming together here, including the scale of food manufacturing and production, which leads to antibiotic use not just in humans but on apples and bees and cows and fish ponds. There’s of course been a lot of work on biopolitics and biopower, and rather separately a lot of work on risk society. These two intersect in the twentieth century in ways that haven’t been thought through very much: the scale of industrialized biopower, the way it manifests in the material world not just in bodies but between them and not just in humans but in the infrastructures of life. So I was trying to speak with some specificity to this nexus in the twentieth century and its outcomes in the twenty-first, and not to all times and places. This concept is I think particularly good for thinking about the twenty-first century in relation to the twentieth. So it is generalizable far beyond antibiotics themselves and it's a story at a scale that begins well before the 1950s, but at the same time I am not sure that it is so good for rethinking the 12th century. I don’t know enough about other periods to extend the claim in that way.
ANC: Has the notion of 'the biology of history' evolved from your book Culturing Life (2007), particularly regarding ideas and practices of plasticity and flexibility of the living?
HL: In some ways this article is a corrective to my previous scholarship, which I see as being unwittingly won over by the control and mastery narrative of the late 1990s in biology and biotechnology. I have a much stronger sense now of biological matter as its own thing, and that you can control it and not control it both at the same time. Or that interventions have multiple lives of their own. It’s not that I think the book was wrong, just partial in ways that I couldn’t see at the time. One can tell one story/history of biotechnology and it is absolutely right and correct. But at the same time and in the same room there are many other stories operating perhaps at different temporal and spatial scales that are just not stories of the intentional mobilization and control and harvesting of biological plasticity and flexibility. By this I don’t mean to make the obvious point that there are always unintended consequences. I also don’t want to offer some kind of mystical heroicization of life as always exceeding our accounts or interventions. But I do think there is something very interesting and particular to biological science in the sense that we work on the basis of what we know, and what we know then itself manifests as the biology we work on, which is particularly the case when scientific or technical knowledge becomes part of the milieu in which life goes on.
ANC: You have argued elsewhere that “an archaeology of twentieth century sciences specific to the conditions of possibility operating in today's research settings is a necessary complement to studies of the contemporary moment” (2005). Bringing back the previous discussion on 'The Biology of History' (question 4 and 5), can the latter be consider not just as critical term in the social studies of contemporary life sciences but also as a methodological perspective which combines historical and ethnographical methods thereby creating a balance between historicity and reality of the contemporary moment (Latour, 1996)?
HL: Yes. Nicely put.
ANC: There seem to be an increasing trans-/multi-/cross- disciplinary interest in the Anthropocene, a term originally coming from the geological sciences. The principal reason the Anthropocene has caught the attention of life scientists and social scientists alike is due to its very definition, namely the effects of human agency in the transformation and remaking of the bio-chemistry and ecology of the planet Earth. In the social sciences and humanities for instance, commentators such as science studies scholar Bruno Latour (2013, 2014), anthropologist Philippe Descola (2013) or cultural theorists Joanna Zylinska (2014) and Adrian Mackenzie (2014) have engaged with this issue, albeit from varied perspectives. In the introduction of your article you write that “[b]acterial life today is appearing as a specific instantiation of the biology of the Anthropocene”, what do you take the 'Anthropocene' to mean?
HL: I mean it very much in the sense you’ve put forward here: as a name that people are giving to the idea that there is a distinctive epoch in which human activities become visible as geological forces, reshaping landscapes, ecologies and climate. However, climate change isn’t the same as biological change, though obviously they are interrelated. It’s a useful term and it is obviously an attractive thematic for many scholars of different kinds to think together with, so I was interested in following along with this train of thought but not about climate or geology, but the insides of a million billion cells. Embarrassingly late in the process of writing this article, I came across Dipesh Chakrabarty’s insightful and well-known article called “The Climate of History,” which says some of the things I wanted to say about natural history in relation to human history but with much greater expertise in historical theory. At the same time, climate is not the same as biology, and there is not exactly the same kind of recursivity to climate science as I’ve identified in medicine and microbiology. Thus I hope that I’ve added a specific element about biology and biological time and change to the general conversation.
ANC: The Anthropocene is just one of the many examples of the exciting moment critical thought is experiencing, especially for those working at the intersections of the life sciences and the social sciences. For instance, the microbiome, regenerative medicine, synthetic biology or epigenomics are fields in which the pre-existing binary oppositions between the organic and inorganic, the cultural and the natural are being called into question. Cultural theorist Lisa Blackman has suggested that “what we might call a paradigm of co-constitution, co-enactment and co-evolution is also a direction that work across body-studies is taking, so there seems much potential here for collaboration and dialogue with science and medicine” (2010: 4). I am thinking as well in the recent work on how the social affects the biological or the so-called 'biosocial' by anthropologists Margaret Lock and Vinh-Kim Nguyen (2010), Tim Ingold and Gisli Palsson (2013), sociologists Maurizio Meloni (2014) and Nicholas Rose (2013), or philosophers of science Evelyn Fox-Keller (2010) and John Dupré (2012). Do you think that we can talk about a departure from the professionalisation and isolation of disciplines that has characterised 20th century (Western) academia? If so, to which extent is this new integrative approach reformulating the large-scale collaborations of the 17th, 18th and 19th century among natural scientists, historians, physicists, chemists and so on (Vermeulen, 2013)?
HL: Well, as I said above, the very reason I came to work on antibiotic resistance was that it seemed a topic that necessitated a trans-disciplinary approach. In that very first quarter of the course I was telling you about, I subjected the poor students to antibiotic resistance, endocrine disruption, and obesity – in ten weeks! We’ve since scaled back in our ambition to solve the world’s problems with interdisciplinary pedagogy in ten weeks or less, but the point is that there are many issues of human health and society and the body and the environment that are showing up traditional disciplinary boundaries and limitations as obstructive. In general we are seeing much more openness and fluidity in the life and social sciences about and around the social and the biological at all kinds of levels. At the same time, everything doesn’t just collapse into everything else. There’s a sentence in the work of the philosopher Georges Canguilhem, where he’s talking about the work of neurologist Kurt Goldstein and biologist Jakob Von Uexküll in a previous era when people were getting very excited about doing away with binaries around organisms and environments, in which he says that, “For knowledge to remain possible, within this organism-environment totality there must appear a nonconventional center around which a range of relations opens out” (Canguilhem, 2008, 177). First, I think it’s a necessary corrective to current enthusiasms to realize that there’s a long and interesting history to the doing away of binaries and the transcendence of boundaries, and in fact some binaries seem to have only a long history of being overcome – but here they still are, still being overcome. Second, I very much like this sense of a “nonconventional center” and a set of relations opened out by the act of re-centering. It is as much a methodological prompt as anything – it pushes one to ask of an emergent object such as the microbiome, what range of relations is opened by this scientific concept and object that was not accessible before in older models of humans and microbes. So it isn’t so much a question of going back to previous eras and configurations so much as older periods perhaps suddenly seeming newly relevant or resonant again because of unexpected affinities in ways of thinking or perceiving the world opened out by changing centers of attention and action.
ANC: To conclude, there is a very relevant and timely issue for critical studies of science arising from your article: the difficulty to maintain previous conceptions of life as individualising and organisms as discrete entities (2014: 25). Is there an epistemic, and possibly ontological, shift in the 21st century life sciences?
HL: Absolutely, and more than one such shift (the authors you bring up in question 9 of course have lots to say on that very subject). It’s an exciting time and endlessly interesting and of course also a bit morbid and terrifying sometimes. I think some members of my family have grown tired of discussing the latest in antibiotic resistance over dinner.
Hannah Landecker's article 'Antibiotic Resistance and the Biology of History' is part of a forthcoming Body & Society Special Issue on 'The New Biologies: Epigenetics, the Microbiome and Immunities', edited by Lisa Blackman. The article is available Open Access here.
Literature cited
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Hannah Landecker holds a joint appointment in Life and Social Science at UCLA, where she is an Associate Professor in the Sociology Department and Acting Director of the Institute for Society and Genetics. Landecker uses the tools of history and social science to study contemporary developments in the life sciences, and their historical taproots in the twentieth century. She is currently working on a book called American Metabolism, which looks at transformations to the metabolic sciences wrought by the rise of epigenetics, microbiomics, cell signaling and hormone biology. Her prior published work includes Culturing life: How Cells Became Technologies (Harvard 2007) on the history of cell culture technologies, and numerous articles addressing the use of film in life science.
Andrea Núñez Casal is a MPhil/PhD candidate at Media and Communications Department, Goldsmiths, University of London. Her PhD research, entitled 'Excursus on the Immune System: Differential Bodies and Entangled Environments in the 'New Biology' of the Microbiome', is supervised by Professor Lisa Blackman and funded by Obra Social “la Caixa” Foundation.
