By Emma Louise Backe
Spider-Man: No Way Home is an adventure further into Marvel’s Phase 4 Multi-Verse, but the movie itself has some surprising messages about public health and the impulse of a curative heroism.
After Mysterio reveals Peter’s identity to the world—his last act of sabotage after framing Spiderman for the drones he launched in Far From Home—Peter scrambles to maintain some sense of anonymity, for himself, for his family, and most importantly for his friend Ned and girlfriend MJ. Attempting to retcon this identity reveal, Peter seeks out Doctor Strange, who offers to complete a simple forgetting spell that would wipe any memory of Peter Parker as Spiderman from the world. Yet at the prospect of losing that intimacy with his Aunt May and his friends, Peter balks, shifting the parameters of the spell. Strange contains this warped spell, but the incantation nonetheless summons villains from other universes, with other Peter Parkers (Tobey MacGuire and Andrew Garfield). These villains include Dr. Otto Octavius/Doc Ock (Alfred Molina), Dr. Norman Osborn/Green Goblin (Willem Dafoe), Max Dillon/Electro (Jamie Foxx), Flint Marko/Sandman (Thomas Hayden Church), and Dr. Curtis Connors/Lizard (Rhys Ifans). As Peter attempts to capture these big bads (known in the Spiderman Universe as the Sinister Six), he also learns about the unfortunate outcomes of their encounters with the Spidermen in their own universes. Even if it’s not by Spiderman’s hand, Electro, Doc Ock and Osborn all die in their respective franchises. So while Doctor Strange is eager to send each one back to their universes—revenants who have been brought back to life only to die again—Peter thinks there might be a better solution. After Norman Osborn seeks refuge at a Soup Kitchen where Aunt May works, she confides in Peter that he must help these “lost souls.” Norman, in particular, is not only lost in alternative spatio-temporal universe, but more psychologically adrift. This diagnosis from Aunt May is presaged by a separate internal dialogue between Norman and his alter-ego, Green Goblin. The parallels to schizophrenia and multiple-personality syndrome here are not subtle. Corralling the villains into a New York condominium, Peter sets out on the quest to “cure” each one, substituting traditional fisticuffs for a more rehabilitative approach to neighborhood do-gooding.
The cures that Peter attempts to create, with the help of some Stark Technology, function as magic bullets—a serum or an antidote for each villain that will rid them of their superpower, and, in the case of Osborn and Ock, presumably their villainy as well. In the case of Doc Ock this is a little more straightforward: in Sam Raimi’s Spiderman 2, Dr. Otto Octavius created mechanical arms to help with his fission reactor, but the chip which allowed him to control the arms—rather than the arms controlling him—broke. Octavius’ death drive later in the movie, as he assumes the villain mantle of Doc Ock—we are led to believe—comes from the mechanical arms, rather than some latent Id the arms simply served to supplement. So Peter’s cure is to fix the broken chip, essentially returning Octavius to himself—silencing the voices of the arms. None of the other cures that Peter develops are explained in any detail. The serum for Dr. Curtis Connors had already been developed by Andrew Garfield’s Spiderman (The Amazing Spider-Man). But as an audience we’re simply supposed to assume that between the technological marvel that is Stark technology, and the combined genius of three Peter Parkers, a cure for each villain could surely be developed and weaponized from a lab.
While I admire the decision to try to help each of Spidey’s foes—particularly since the Avengers have never met a problem they don’t try to punch their way out of—the curative ideal that Spiderman peddles tells us a lot about how the US in particular addresses public health problems, the medical and social ills that the country chooses to “cure” or address through vertical, top-down tactics. The approach Peter tries to use in No Way Home demonstrates this magic bullet model, one which attempts to simplify the complicated, multidimensional dynamics of illness into a one-size-fits all pill or technological intervention. Peter’s method for a cure essentially presents an overly medicalized idea of recovery which brackets out what are often referred to as the social, structural, and political determinants of health (Dawes 2020; WHO 2010).
In public health, there are two approaches that are often used when addressing a disease or ailment within a particular geographic location, or community. The vertical approach is a top-down model, one that tends to focus solely and specifically on the vector of transmission (i.e. the cholera contaminated pumps of Jon Snow) or a medical solution to a disease or virus, like vaccination. This vertical approach was successful in almost eliminating previously life-threatening illnesses like polio, syphilis or Smallpox (Mark & Rigau-Perez 2009; Wan & Zhang 2020). Indeed, the success of the polio vaccine program in the US, and globally, led to an increasing investment in the idea of a “magic bullet” or “magic pill” approach to health, where pernicious and life-threatening ailments could be solved reasonably quickly entirely through a highly technical, medical approach like vaccination (Packard 2016). Science essentially helped to win the fight against highly infectious diseases in the 20th century, and the success of these global vaccination programs seemed almost magical.
Yet this approach to vaccination or treatment through a biomedical cure to disease doesn’t always work, both in terms of the availability of “magic pills” and the historical and structural contexts where public health programs get rolled out. In formerly colonized countries, where vaccination programs were used to experiment on colonial subjects and slaves, a great deal of distrust around Western vaccination initiatives still exist (Nichter 1995; Obadare 2005; Vaughan 1991; White 2000). Most of the initiatives around treating malaria have taken a vertical approach—through heavy investments in pharmaceutical companies like GlaxoSmithKlein and international initiatives like the WHO’s Global Malaria Program or Bill Gates’ Malaria Vaccine iniative—by attempting to develop antimalarials, or distributing mosquito nets to areas in the Global South that are most vulnerable. Yet this vertical approach to malarial disease transmission has been largely unsuccessful, in no small part because it fails to account for the environmental, structural and social conditions that make communities vulnerable to malaria (Nading 2014), or even how communities would use the mosquito nets they were given. Despite Bill Gates’ huge investments in attempting to eradicate malaria, “some of the major difficulties in malaria prevention in Africa are related to a lack of public understanding of the mode of malaria’s trans- mission, the popular belief that malaria cannot be prevented, suspicion of medical malaria treatments, and the frequent misuse of bednets. These observations confirm what the failure of the malaria eradication program launched in 1955 has demonstrated: namely, that any malaria prevention program should be based on the local social and cultural features in which it aims to operate” (Cuetos 2013, 51).
Given these local social and cultural features of health, a horizontal model represents a more holistic approach to health which seeks to recognize and address what is referred to as the social, political and structural determinants of health. A horizontal model not only looks at vectors of transmission (mosquito to human), or the mechanisms by which a body’s natural immunity can be amplified using vaccine technology. A horizontal model also considers the entire ecosystem in which conditions of health, or poor health, are structured and produced, including the natural environment, the housing and urban or rural landscape, the diets and access to certain kinds of food in particular areas, the jobs of people within a particular community, the working conditions of those jobs, in addition to the accessibility of health care, the acceptability of health care (does the health care system align with the beliefs and values of the community), and the affordability of health care. A horizontal model recognizes that while you might be able to treat a disease once someone’s become infected, or inoculate citizens to prevent further infections, poor health outcomes also tend to cluster around communities of a lower-socioeconomic status, in places that might experience higher rates of environmental toxicity and have less access to comprehensive medical care. This applies not only to highly infectious diseases like malaria, but also to more chronic, non-communicable diseases like diabetes or asthma. Often times medical treatment is not enough, particularly if the treatment itself is too expensive. The entire ecosystem in which some people are privileged enough to be healthy and stay healthy, and others are often consigned to ill health due to location and socioeconomic status, needs to change.
To be sure, the United States has provisionally invested in some elements that would involve a horizontal approach to health care, like welfare, Medicare and social security. But these systems—which attempt to provide additional support to individuals and families struggling with poverty, chronic illness, disability, and/or unemployment—have been historically underfinanced and under-resourced, leading to highly fragmented and confusing bureaucracy of care (Davis 2006; Goode & Maskovsky 2002; Gusterson & Besteman 2009). Veterans returning from wars overseas often struggle to get regular access to health care, in particular mental health care or assistance with housing instability (Hester 2017). First-responders exposed to dangerous chemicals struggle to prove “causation” for their medical issues and are subsequently denied health care coverage. Individuals on disability—including, for instance, Peace Corps volunteers who develop disabilities during their service—often only receive $20,000 a year, which hardly covers that cost of living for most American citizens. The stipulations and requirements for those on welfare or attempting to access these other parts of the social safety net are often so punitive, or administratively confusing that they make it more challenging, not less, for people to access basic medical care and support (Crane et al. 2002; Hansen et al. 2014; Knight 2015; Williams 2010). Given Aunt May’s volunteer work at a local soup kitchen, and Peter regularly mentioning that he doesn’t have the money to afford something like a new computer, the cracks in these social support programs would be obvious to Spiderman.
It’s this very soup kitchen that Norman Osborn stumbles into, after smashing his Green Goblin mask. Throughout the first Spiderman movie (2002), Osborn is seen in conversation with this Green Goblin alter ego, a persona that is increasingly paranoid and hostile. Drawing upon the familiar parallels of Dr. Jekyll and Mr. Hyde, Osborn becomes corrupted by this internal monologue, the maniacal laugh of the Green Goblin meant to signal Osborn’s increasing mental break with reality. Aunt May pulls Peter aside to tell him that Osborn is “lost up there,” pointedly tapping on her temples. The serum Peter tries to create for Osborn yet again adopts the vertical model, one which medicalizes or pathologizes mental health. Medicalizing mental illness means that we tend to treat conditions like depression or schizophrenia as purely biological problems and subsequently treat them through medication or pharmaceuticals (Dumit 2012). While medical treatments can be hugely beneficial to help manage symptoms, this medical model doesn’t look at the social dimensions of mental illness. These dimensions can include the social and situational contexts that a person with depression might be dealing with, for instance a global pandemic, and experiences of stigma that might be associated with mental illness. SSRIs are not necessarily going to change the personal history, social world or situational factors that might also be contributing to mental health challenges. Although therapy is often supposed to be coupled with medication, counseling is often inaccessible to low-income communities.
Similarly, a medical model treats the issue of mental illness as internal, or individualized, presuming a normative model of mental health, in which those who experience mental health challenges are understood as neurodivergent. The responsibility to “get better,” in this medical model, tends to moralize mental health, as well as a patient’s compliance to a treatment regimen. “Bad patients” are those that don’t take their medications on time, or choose to forgo medication altogether, particularly if the side-effects outweigh the risks. In these cases, access to certain grants, jobs, and housing opportunities become contingent on remaining under the careful surveillance of medical care, and remaining gainfully employed. In extreme cases, this can even lead to chemical carceration (Fabris 2011) in the forms of institutionalization or conservatorships of people with disabilities like in the case of Britney Spears (see episode on Britney at Death Panel pod). It’s not accidental that many villains—in the Marvel movies and beyond—often equate villainy with madness or neurodivergence. While our media has gotten better as sensitively depicting mental health, “crazy” villains like the Joker—note how Batman imprisons all his foes in Arkham Asylum—only reinforce the idea that mental illness is both deviant and dangerous.
But a social theory of disability—including neurodivergence—does not place the blame of illness or recovery on the individual. Rather than placing the “problem” of disability on the individual, the social theory of disability indicates that ideas around impairment or loss have more to do with social and structural conditions than they do with physical or cognitive traits. The issue is how a society responds to constructs or ideas of disability, and the ways these ideologies—often premised on the assumption of a default, able-bodied person—impact the kinds of urban environments, learning spaces, cultural reception and professional opportunities people have. Basic accessibility measures demonstrate the ways that systems can be easily modified to account for difference, and many in the disability or crip community pointed out at the beginning of the pandemic that they’d already demonstrated and figured out ways to work remotely under uncertain circumstances. Indeed, this is the argument about deafness that Echo, or Maya Lopez offers Clint Barton in Hawkeye—that he has grown to rely too much on hearing aid devices, a technical fix to hearing in what are eminently social, interpersonal interactions.
Yet the solution to the “disabling” conditions that Lizard, Doc Ock, and Norman Osborn present themselves with relies on a pill or an injection, in most cases administered to the villains against their will. Even in Doctor Connors’ attempt to alter his limb difference, he unintentionally transforms his entire body into a Lizard. Even on a day to day basis, many members of the crip community discuss feeling dehumanized by social perceptions of their disability, treated as less than human because of physical, psychological or cognitive difference.
This technology of a “cure” also matters in the context of understanding experiences with chronic illness. Many individuals with chronic illness will never be “cured”—they manage their symptoms, but the medical system tends to focus on palliative care in contexts where conditions will be life-long (Manderson & Smith-Morris 2010). People with chronic illnesses that can be more “hidden” might struggle to be seen as requiring or deserving care—these “invisible” illnesses don’t register as evident suffering in the same kinds of ways as more evident health issues. Some people with chronic illnesses, particularly illnesses that are poorly understood by the medical community like Lyme disease or endometriosis, will have their pain dismissed, or don’t appear “sick enough” to receive additional treatment and care. In the vertical, magic bullet approach, the focus on a technical fix does nothing to help the day-to-day conditions that people with chronic illnesses face, or help to alleviate some of the structural issues that might aggravate someone’s pre-existing condition. Rather than thinking of recovery in a linear and predictable manner, people with chronic illnesses often live in more of a temporal loop, with flare-ups and periods of remission—but the idea of a complete and total recovery isn’t feasible or possible. Even for those who might have experienced “mild” cases of COVID-19, you are still vulnerable to long-COVID, which is being increasingly considered as a form of disability under the ADA.
This representation of a magic bullet cure all—heroizing a top-down approach to care—in Spiderman: No Way Home is specifically conflated with symbolism of American exceptionalism. It’s not coincidental that the final fight of the movie, when all the Spiders-Men try to combatively cure the villains, takes place on the Statue of Liberty. Lady Liberty, in addition to her traditional flame, is now holding Captain America’s shield. Just as the first Spiderman movie was supposed to feature a scene of Tobey MacGuire web-slinging between the Twin Towers, the directors of No Way Home have clearly chosen to center American iconography associated with that nationalist ideologies of freedom and protection. Spiderman’s vertical approach to care, in this way, is specifically aligned with an ethos of American values and American justice.
All of this matters because we are still in the midst of a pandemic and the US has almost exclusively invested in a vertical approach—that of vaccination. We could have distributed free masks and tests to every home; disbursed regular payments to citizens to offset financial losses; incentivized and ensured that people could stay home and remain healthy; and invested in more training and resources for front-line workers including teachers. Essentially we could have radically rethought how we invest in all the other forms of social infrastructure needed to help people stay safe and healthy, rather than pushing a “return to normal” ethos that was already perpetrating health discrimination and inequity. And a system that already wasn’t working for those with disabilities and chronic illness. Instead the US government prioritized getting people back to work, emphasizing labor and productivity over other kinds of collective care.
Even the idea that “some people will just get sick” with “milder” variants like Omicron misrecognizes that health risk is inequitable, and that many American citizens quite literally cannot afford to get sick. The head of the CDC, Rochelle Walensky, even made a statement on Good Morning Americaabout being “encouraged” by the fact that, “The overwhelming number of deaths—over 75 percent—occurred in people who had at least four comorbidities, so really these are people who were unwell to begin with.” Her statement was quickly met with anger by disability advocates who pointed out that Walensky essentially made it seem as though the deaths or severe illness of people with chronic conditions or disability is acceptable, or something that the US government has accepted as an “encouraging” eventuality of a global pandemic. As Disability Rights Education and Defense Fund (DREDF) Director Susan Henderson stated, “Messages from the head of the CDC must convey that all lives are valuable, and the loss of any life from COVID-19, whether it is the life of a person with a disability, an older adult, or a 32-year-old with no known disabilities, is a tragedy.” The idea that individuals with disabilities, co-morbidities or chronic illnesses are less valuable and worthy of saving, or that their deaths are insignificant, is not that different from arguments made by Eugenicists in the 19th and 20th centuries. Rather than promising to protect and ensure health for all, what many Americans are hearing is that they are responsible for staying healthy—and yet their only option to access protection is through vaccination. Meanwhile, front-line health personnel or essential workers are referred to as “heroes,” and yet heroes without sufficient support to make their heroism safe or sustainable.
Indeed, by investing all our time and resources into vaccination, the US and the international community based in the Global North also chose to prioritize intellectual property (IP) over equitable vaccine distribution around the world. By limiting access to vaccines to countries in the Global South, this vertical approach to global health has led to what many are referring to as vaccine apartheid. Indeed, this very kind of covetous isolationism when it comes to aid is one of the central tensions driving Black Panther, and Killmonger’s desire for Wakanda to assist those throughout the African diaspora. Despite the inequitable distribution of vaccines in the developing world, many of the countries in the Global South have weathered the pandemic better than expected precisely because they have had to develop horizontal approaches to previous health epidemics like dengue fever or Ebola.
Governments’ decisions to tactically support the health of certain populations, while letting other populations and communities die represents what Michel Foucault (1978) refers to as thanatopolitics. While thanatopolitics can refer to the more passive forms of inaction by states or governments to not intervene in health crises (think about HIV and AIDS here—see also Jasbir Puar’s Right to Maim), Achille Mbembe’s necropolitics (2019) refers to the ways that populations are strategically targeted for death, in particular populations in the Global South. Biopolitics, thanatopolitics, and necropolitics are all theories that indicate the ways that modern nation-states were historically created to protect the health of their subjects and/or citizens, and yet have increasingly scaled back health support systems, leading to structures of neglect and abandonment that consign more and more people to “death worlds.” Ostensibly, Avengers: Endgame (2019) was about fixing the arbitrary nature of who got to live and who got to die. And yet No Way Home brings the franchise right back to individualized, rather than collective and collaborative care in light of tragedy.
Don’t get me wrong: the idea of trying to rehabilitate rather than Hulk-smash the villains is an engaging one. Yet the villains of some of Marvel’s most recent adaptations often emerge from critiques of the status quo, whether that’s related to universe-wide resource scarcity (Thanos) or access to housing and assistance for communities post-blip (Falcon and the Winter Soldier). As Ted Chiang points out, superheroes are often more interested in defending the status quo than a radical transformation of system of governance. When presented with complex, geopolitical stakes, the Marvel movies and shows regularly diagnose the problem with individual villains, rather than structural conditions. The issue is that Peter tries to science his way out of what are eminently complex social issues that cannot and will never be solved through a magic pill. They require us to think differently, on a longer time scale, about what is means to cure and who we think needs to be cured. And perhaps most importantly, what it means in conditions of dis-ease when the only options are a magic bullet or death.
 Another aspect of disability dehumanization is the trope of the supercrip (Schalk 2016), in which individuals with disabilities are imbued with almost superhero magical qualities (Daredevil, Toph from Avatar: The Last Airbender) but often peddled as “inspiration porn” to the ableist community.
 (For more in-depth discussion about what it’s like to live with chronic illness, check out Bitch Media’s series “In Sicknessseries “In Sickness.”)
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