It’s a Sin shows us what it’s like to feel the medical gaze in times of pandemics

It’s a Sin is a new drama series (Channel 4 and HBO) written by Russell T Davies which chronicles the lives of a group of (mostly) young gay men in London throughout the 1980s. It is one of, if not the only, dramatic depiction of the impact of AIDS in Britain in this time (outside of soaps) and is funny, joyous, enlightening as well as tragic. Although produced before the emergence of covid-19 it has some striking parallels with our current circumstances.

Early in the story many characters don’t (or don’t want to) believe that AIDS really exists. The prospect of a deadly illness which seems to target gay men, is passed through sex and is described as both a transmissible virus and a cancer seems too far-fetched. We can easily see how it could appear like a wet dream of conservative Christian fundamentalists. It is almost too convenient for there to emerge an illness which targets a group and set of sexual practices which they already consider to be dangerous or evil as Baptist pastor and right wing political activist Jerry Falwell famously claimed.

As acceptance of the existence of AIDS grows so too do the conspiracy theories around where it originated, how it is transmitted and how people can be protected from it. Theories are pushed on how it jumped from animals to humans, that it was created in a lab to target gay people and its global spread was initiated by a flight attendant. Inaccurate and dangerous methods of preventing or treating AIDS, such as drinking battery acid, also spread amongst the community.

One strand of the drama relates to how this group of people deal with the consequences of having an increasing amount of their lives dominated by this illness. This not only applies to those individuals diagnosed with HIV or AIDS but everyone considered to be at risk (at the time when the series is set this is essentially all gay men). In one of the earlier episodes one character who manages a bar throws out an activist trying to raise consciousness about the virus by distributing pamphlets and flyers. He is thrown out of the bar not just because (at that stage) the manager doesn’t believe in the condition but also because it is bad for business and they don’t want their social spaces infected with bad news about such an illness. We see characters going for tests and waiting for results (or avoiding them), worrying about past encounters when they might have passed it on to someone else and generally scrutinising the behaviour themselves and others. What we see is the impact of the “medical gaze” on the community, their relationships with one another and on them as individuals.

The “medical gaze” is a concept originally taken from Michel Foucault’s 1963 book The Birth of the Clinic. It refers to the power wielded by medical institutions to look at and into human bodies and define their reality and what constitutes normal and pathological. When the characters in It’s a Sin were denying the reality of the disease or desperately attempting dangerous or ineffective home-made treatments they were not only trying to battle a destructive and terrible illness but also to wriggle out from underneath the medical gaze. We sometimes welcome the eye, hand or ear of the medic and crave the certainty of their verdict on our painful or troubling experience. This gives us access to a potential route out to a better, more comfortable or satisfying life but no one wants their whole existence to be defined by a medical condition. This is even more so when the definitional gaze of the doctor might mean a death sentence (as it did for many in the time covered on the TV series).

Central to Foucault’s thesis is that it is only through incorporating death, specifically the dead body, into medical practice that the body becomes subject to the “medical gaze”. This is because, in an era before X-ray, MRI or CT scans, the only way to reveal the workings of the human body was to cut it open and this could only be done extensively to corpses. But prior to the 18th-century this was rarely permitted due to legal and religious constraints. After doctors heeded the call to “open up a few corpses” their professional gaze could permeate deep into the body and subsequently the living body came to be seen through the lens of the dead. As Foucault claims:

“[When] seen in relation to death, disease becomes exhaustively legible, open without remainder to the sovereign dissection of language and of the gaze. It is when death became the concrete a priori of medical experience that death could detach itself from counter-nature and become embodied in the living bodies of individuals”

While Foucault’s concern here was with the professional knowledge of medics perhaps something similar can be said for the role of death in how we experience the application of the medical gaze onto ourselves. Such deadly conditions as AIDS encourages us to integrate the medical gaze more comprehensively into our assessments of ourselves and others. Our bodies, behaviours, relationships and social networks come to be seen through their potential proximity to death. In one of the final scenes of the series a character suggests that many people continue to engage in risky behaviours because of the shame internalised from the stigmatising views of others partly the result of their fear of lives they don’t understand and the perceived proximity to the illness.

We are currently facing a different pandemic but one which has also encouraged us to accept a medical gaze onto many areas of our lives; to see our behaviours, relationships, workplaces and homes in relation to the biomedical risks they might pose.  We have started to let death become incorporated into the bodies of the living in order to protect ourselves and others; lets hope we can soon let it retreat.