Medical Examiner

Dangerous Rhetoric

Why are some Ebola patients portrayed as criminals, others as heroes?

A cleaning crew sanitizes the apartment where Ebola patient Thomas Eric Duncan was staying before being admitted to a hospital on Oct. 6, 2014, in Dallas
A cleaning crew sanitizes the apartment where Ebola patient Thomas Eric Duncan was staying before being admitted to a hospital on Oct. 6, 2014, in Dallas.

Photo by Joe Raedle/Getty Images

Thomas Eric Duncan was the first person to die of Ebola in America; Craig Spencer is the first case of Ebola in New York City. With only a handful of cases in the United States, attention is rightly being paid to the measures being taken to prevent further spread of the deadly disease. But as we take all appropriate physical precautions, we should not forget that there is a different kind of danger. It lies in the way that we talk about Ebola and, most importantly, its victims. And there is a stark and troubling contrast in the way that people talked about Duncan and the way that they are talking about Spencer.

By all accounts, Duncan acquired Ebola by performing an act of nobility and grace: He assisted a pregnant woman who was badly ill. He said from the start that he did not think she had Ebola but that she was simply suffering from pregnancy complications. And so he therefore said on his health screening form upon departing Liberia for America that he had had no contact with anyone with the disease. Now, after his death, it is generally accepted that he was telling the truth as he understood it. But when he was first identified, the situation was very different.

On Oct. 2, the Liberian government announced that it might seek to prosecute him upon his return to Liberia “if it is determined that he made a false declaration.” The ambiguity of that “if” was immediately eviscerated by Ellen Johnson Sirleaf, the president of Liberia, who proclaimed, “The fact that he knew and he left the country is unpardonable. … [He] put some Americans in a state of fear, and put them at some risk.” Headlines blared that “Ebola Patient in Dallas Lied on Screening Form,” with the qualification “Liberian Airport Official Says” relegated to an afterthought.

Once this accusation spread, the public, particularly in Dallas, began calling for action—and in fact began literally calling the office of the Dallas district attorney, as if reporting a crime rather than repeating a false allegation leveled against a dying man. The DA’s office subsequently announced, again in a story that hit virtually every major media outlet, that it was contemplating charging Duncan with aggravated assault with a deadly weapon, for having “exposed the public to a deadly virus knowingly which would be criminal intent.” Concern had morphed into suspicion, then accusation, then prosecution, and finally conviction in the court of public opinion. Duncan had gone from being the victim of a deadly disease to being the wielder of a deadly weapon.

Even some of the seemingly boilerplate language used to describe Duncan was fraught with accusatory rhetoric. He was the man who, we read everywhere, “brought Ebola to America.” There is an insinuation of intentionality, one that is embedded in the very grammar of the phrase. And his identity was thereby changed from a man who suffers from a disease to the potential infector of an entire nation. As his role as “patient zero” was overstated, his role as individual sufferer was undervalued.

The phenomenon of seeing those infected with Ebola as carriers rather than as sufferers can result in some regrettable choices of words, with even worse conceptual connotations. On NPR, Rice University professor Bob Stein casually said that “our borders are being besieged with people who may have diseases like Ebola.” Worse, the Washington Post ran an op-ed after Duncan’s diagnosis declaring that “airports should be screening for Ebola the same way they screen for terrorists.” But there is a categorical distinction between those two entities. Terrorists are people, with intentions; Ebola is not. The person with the disease loses his definition as a human being while at the same time the disease is personified, endowed with a destructive will. The result is that the patient and the disease become essentially conflated.

The low point in insensitivity (we can only hope) was reached in a series of tweets by former South Carolina GOP executive director Todd Kincannon. He responded to an Associated Press story about Duncan by saying that “people with Ebola in the US need to be humanely put down immediately.” He cast Ebola victims as animals; they are not euthanized, they are “put down.” They may in fact be of even lower status than that: A crowdfunding site set up to help pay Duncan’s hospital bills raised only $50 in its first five days. On the same site, pets needing surgery regularly raise thousands of dollars.

While the language used about and toward Duncan was abhorrent, the contrast with the stories about Craig Spencer is striking. Virtually every headline is sure to refer to Spencer as “NYC Physician” or “New York Doctor.” USA Today ran a story proclaiming “N.Y. Doctor With Ebola ‘a Dedicated Humanitarian.’ ” Every article about him is quick to mention that he was in Guinea working with Doctors Without Borders.

No headlines accuse Spencer of “bringing” Ebola to New York City. There are no insinuations that he should not have entered the country when or how he did. (The strongest condemnation of Spencer may be a piece in the New Republic with the subtitle “Why Don’t Americans Just Stay Home When They’re Sick?”—which is ignorant and insensitive but not quite at the level of charging him with assault.) He is not depicted as a terrorist besieging our borders. No one has suggested that he should be put down.

There may be a number of ways to explain the difference in the rhetoric used for Duncan and Spencer. Duncan was the first person to be diagnosed in America—perhaps panic in the face of the novelty accounts for the strong language, which has since diminished as we have become accustomed to the idea of the disease in this country. Perhaps there was some sort of subconscious national realization that the way Duncan was talked about was simply inappropriate, such that we would not repeat those mistakes again with the next Ebola patient. Perhaps.

It is, however, hard not to think that Duncan and Spencer were talked about differently because of the ways in which they are different. The unemployed foreign black man was rhetorically positioned as a criminal, a terrorist, an animal. The wealthy, white American doctor is a humanitarian hero.

In Duncan’s last days, Jesse Jackson went to Dallas to check on Duncan’s medical care. There was a brief period when it was insinuated that Duncan may have received less than the best care possible, with race being a potential factor. But the relative merits of Duncan’s medical treatment are no longer in question. His rhetorical treatment, on the other hand, was undeniably less than satisfactory. And when it is held up against that of Spencer, it is hard to avoid the conclusion that Duncan was treated differently because of who he was.

Historically, the dehumanization of people with illness has been used to legitimize any number of atrocities against vulnerable groups. The accusation that minority communities spread disease has been a staple of both anti-Semitic and homophobic discourse, from the Black Plague to the AIDS crisis. By recasting Ebola victims as Ebola collaborators, we provide a justification for neglecting, and even rejecting, the most vulnerable members of our community.

If we talk about those who suffer from Ebola differently depending on factors beyond their control—be they race, socio-economic status, or nationality—we create a hierarchy in which some lives are valued more highly than others. In the lopsided rhetoric about Ebola patients, we risk losing our humanity.

Read more of Slate’s coverage of Ebola.