Human Meme

In 2002 a public health director in Newark asked me whether I knew the word nosocomial. I did not. Nor did any of the graduate students in the room I taught the following week. Nosocomial means hospital acquired. It names the illness a patient walks in without and walks out carrying, and medicine has owned the word for more than a century and worn it smooth. This episode is about what a word like that is built to do. Say hospital-acquired infection often enough and it becomes a line item. Call a death a mortality outcome and you have moved it into a spreadsheet, where it can be totaled and compared and discussed on a Tuesday afternoon without anybody's voice breaking. That is cultural code. It replicates, it gets taught, and every time it is spoken it lets decent people look straight at a horror and feel almost nothing. From there the episode goes to Vienna in 1847, to a basin of chlorinated lime, and to a doctor whose colleagues destroyed him for proving that they were the weapon. Then it follows the shape out of the hospital and into the prison, the asylum, the classroom, the parish, and the faith that promised to carry its people out of the world and kept that promise the only way it could. One note on the failed test in this episode. Failing my own rule made the finding harder on hospitals than my original claim was. If that portion of the infection rate is not an irreducible floor, then more of it can be prevented than I had credited, and the institutions have less cover than I gave them. The longer account is in the blog piece is available on BolesBlogs.com DO HARM: Nosocomial Disease and the Institutions That Manufacture the Harm They Promise to Cure is available now from David Boles Books in Kindle and paperback, with a free PDF edition to download. Facts matter.

Every rehearsal room I have ever loved kept two smells on staff: scorched coffee and radiator dust. In one of those rooms, years ago, an actor I call Curtis in the book crossed the floor toward me at the end of a long afternoon. He stepped over the spike tape, past the folding table with its script piles, and he stopped inside the working distance that theater people keep the way sailors keep respect for water. Then he said six words, "I want to be your friend." A grown man, saying a sincere and costly thing to another grown man. And I laughed. Two seconds of laugh. Then I answered him with five words of my own: "Haven't we always been friends?"

Twelve thirty-three in the afternoon. Monday, April 28, 2025. The electrical grid of the Iberian Peninsula loses fifteen gigawatts of generation in about five seconds. Spain and Portugal go dark together. Trains stop between stations, on viaducts, in tunnels. Airports fall back on diesel. The Madrid fire service alone logs a hundred and seventy-four elevator rescues. The national tax portal goes down and stays down until Wednesday. Police officers stand in dead intersections and run the traffic with their hands. The shopkeepers who stayed open made change the way their grandmothers had, out loud, coin by coin. Clerks did the arithmetic in their heads while the registers sat blank. Officers directed two capitals' worth of cars with a grammar of gesture older than the signal light. Everything rented from the wire stopped that afternoon. Everything carried kept working.

The book is history, and the book is news, and the seam between those two things is the subject. Here is the oldest voice in it. In May of 1881, the city of Chicago passed an ordinance declaring that any person "diseased, maimed, mutilated, or in any way deformed" could be fined for being seen on the public way. Being visible was the offense. The law rode the railroads west after that, and in 1889 it arrived in Lincoln, Nebraska, which adopted the Chicago wording nearly letter for letter, down to the dollar fine and the commitment to the county poor farm. Omaha followed a year later. I grew up in Lincoln. I performed on television there as a teenager. Nobody told me my city had once made it a finable offense for certain bodies to stand where I stood. That silence is one of the reasons this book exists.

For most of Western history, the word art meant something wider and harder than it means now. Ars in Latin, techne in Greek: a principled, teachable discipline of making and doing, judged by its work. The family album that held the painter also held the physician, the pilot, the general, and the geometer. When Aristotle wrote the Poetics, the small treatise that barely survived antiquity through a cellar, a conqueror's cargo hold, and a chain of translators from Baghdad to Latin Europe, he pulled six working parts out of tragedy: plot, character, thought, diction, song, and spectacle. Mythos, ethos, dianoia, lexis, melos, opsis. Six load-points where a made thing carries weight, and where it can be built sound or built rotten. Then, in the eighteenth century, a wall went up.