DONALD COXE February 9 2004


DONALD COXE February 9 2004


How did coughs, sniffles and wheezing become anti-social behaviour?



THE OTHER DAY, I had reason to be in a Toronto hospital, for the first time since we all began to suffer from what I like to call PostTramautic SARS Syndrome. Perhaps you’re familiar with this condition: sufferers exhibit a painful self-consciousness about coughing or sneezing in public, and worry excessively that they have just slaughtered 10 innocent people on the GO Train by expelling droplets of saliva. Alternatively, they worry excessively that other people will suspect them of carelessly putting others at risk by sneezing or failing to wash their hands.

It’s a social neurosis, I suppose, like the anxiety one feels when one’s dog has just pooed in the neighbour’s flower bed and one didn’t happen to remember to bring a plastic bag on one’s walk. There are some things that are just not done. At least, not anymore.

I was reminded of PTSS when I walked through the front doors of North York General Hospital one cold, sunny morning and immediately saw a sign warning visitors to go away if they had a fever or a cough. This is a somewhat ironic announcement to see in a hospital, but times have changed. I had neither a cough nor a fever, and although I did sniffle a couple of times in the car because I was catching my son’s cold, I had to come in to the hospital because my daughter was having day surgery.

I tentatively approached the reception desk, where two young hospital staffers inquired whether or not I had recently been in contact with anyone who was ill. I shook my head no, figuring that my son didn’t count, because he so obviously had a garden-variety cold, as opposed to, say, SARS. The staffers had me sign in, and then watched me carefully, as if I might suddenly flush with fever, which I guess would be tantamount to producing a pistol and trying to rob them. When I had finished writing down who I was and where I was going, I straightened up and unzipped my jacket, and then—cue the theme music from Jaws—l sneezed. My nose began running. I glanced self-consciously at the staffers, wondering if I could still proceed to the pediatrics waiting room upstairs. They gazed back at me, unsmiling, but said nothing.

On the way to the elevator, I noticed two SARS preparedness seminar announcements tacked to the walls. In the gift shop, the latest Toronto Life magazine sported a dramatic cover story about Toronto being the ground zero for the next worldwide, viral pandemic. A doctor cruised past with a newspaper folded in the crook of his arm, featuring a front-page headline about avian flu and the danger of global infection.

The scene evoked the opening pages of a


around with invisible, psychological perimeter fences that we do not wish to see breached’

Michael Crichton medical thriller, like The Andromeda Strain or something, where ominous hints of coming plague shadow ordinary ailments in everyday life. Once I was seated in the crowded, stuffy waiting room for day surgery, my body found it necessary to plunge me into a full-blown sneezing fit, at which point I felt like the guy in a commercial for cough drops currently playing on TV, who hacks away at one end of the bus while every other passenger crowds into the other end in abject horror, as if cowering away from bubonic plague.

Mortified, I began to dash off to the bathroom every time I needed to sneeze, only to return to my seat, again and again, as idiotic as Mr. Bean, and attempt to comport myself with a nonchalant dignity. As I did so, I thought about the cough drops commercial, and wondered when we had come to believe it endearingly plausible, rather than wholly plausible, that a person cough-

ing in public could cause a stampede.

There has, I suppose, always been a little bit of Howard Hughes in each of us here in North America. Blended in with our practical approach to warding off germs, one also detects a decidedly neurotic fear of cooties. It seems to be a fear of Stuff Out There that cannot be controlled or kept at a distance: mess, germs, crap, noise, dust, unsavoury smells—all of the things that shock Canadian tourists when they travel through cities like New Delhi and Beijing. It is the chaos of poverty and the tumult of large populations, which we affluent Nordics have never had to face. In fact, we covet our personal space and stroll around with invisible, psychological perimeter fences that we do not wish to see breached. Last year, I was lined up behind a well-coiffed woman at an ATM, minding my own business and daydreaming, when she suddenly whirled around and said: “Do you mind not standing so close to me?” I was so surprised that I started to laugh. I just hope she never has to ride on the Mexico City subway.


cooties can be located, I think, in that larger fear of intermingling with strangers’

As if to contain ourselves within our fences, we completely overdo our personal hygiene as well, compared with everyone else on the planet. If you think an obsession with cleanliness is perfectly rational from a health standpoint, it is not. In the last couple of years, research has suggested that the excessive use of anti-bacterial soaps in handwashing, in addition to the overuse of antibiotics, has led to lowered immune systems. So toss that argument overboard.

The fear of cooties can be located, I think, in that larger fear of intermingling with strangers. And infection is a perfect metaphor for violated personal space. How else, after all, do we explain the far-diminished attention we pay to the perils of mosquito-borne West Nile virus, which infected over 10,000 Americans and Canadians last year, hospitalizing thousands and killing 233 of them, including 10 in this country? So an interesting question is, what will happen to our

wary public harmony if we get hit with a fresh wave of infectious, human-to-human disease? What if the avian flu, or next year’s version of same, arrives in Vancouver or Toronto direct from Southeast Asia?

Will we plunge even further into a kind of sublimated xenophobia, where germs become the metaphor for our fear of the ‘unruly hordes’? Will obsessive-compulsive

handwashing and overall health hysteria continue to take the place of this deeper fear of disorder, change, tumult, immigration? Or will we flip in the opposite direction, and begin to express an overt hostility to (or paranoia about) our much-celebrated Chinatowns and Little Indias and the like? Let us hope that pragmatism and self-awareness win the day. I?il