Q: When do you want to be sick?

A: When being sick means you live a better life than the healthy.

       At the start of Chapter 4 of Life Exposed, Adriana Petryna describes the citizens of Korosten', a city located in the territory designated by the Ukranian government as Zone Three. Radiation levels in that area are twice as high as what would be considered "normal", and each citizen carries around a "dosimetric passport" that is a record of their status as Chernobyl sufferers and of their level of radiation exposure. When the person's radiation dose exceeds the yearly limit set by the government, they become eligible for free relocation to government housing in a more "ecologically clean" area (p83). Thing is, most people choose not to move. They'd rather stay and enjoy the government-provided benefits of free public transportation, free medical assistance, and reduced rent. This trend isn't isolated to the one city. One editorial in a paper for Zone Three inhabitants, authored by some unnamed civil servant, laments how people are actually selling the new houses provided to them through the resettlement program and returning to their deserted homes (p86). It would seem that, despite all the effort put into obtaining the statuses of sufferer and disabled, the actual threat of radiation isn't great enough to make them move!

       To really understand why this seems so wrong, we have to go back to medical anthropology 101, looking at what Petryna calls the "sick role". When an individual gets sick, he or she enters in a contract with the rest of society. Society agrees not to blame the sick person for their illness, and also absolves them of any outside responsibilities for the duration. In return, the sick person promises not to malinger, and to comply with expert advice on how to get better. A lot of the social issues surrounding certain diseases arise when either side perceives a violation of this contract - for example, in the case of STIs where there's a persistent view that they are the fault of the person. Similarly, the legal structure surrounding those affected by Chernobyl radiation actually encourages individuals to get sicker! As one of Petryna's associates puts it, "Here, the worst is to be healthy." The material benefits of being sick are worth more than the social obligation to be healthy (p85-86). From society's perspective, these sick individuals aren't holding up their end of the bargain - they're not actively trying to get better!

     Yet, from these individuals' perspective, society isn't doing its part either. Being "sick" should be effortless, a burden thrust upon you by nature. Yet, in both pre- and post-collapse Ukraine, being sick requires a lot of effort. It is a right that must be earned, through meticulous tracking of your own physical condition and medical tests and disease symptoms, and through leveraging that information in a legally meaningful way to obtain the "disabled" status. As Petryna writes, "To be sick meant that one had to be equally motivated to work to obtain permission to be sick" (P90-91). The result is a complete inversion of the traditional "sick role", wherein a wide variety of social and political and economic factors come together to create a system where it's easy but bad to be healthy, and where it's hard but desirable to be sick.

Petryna, Adriana. Life Exposed: Biological Citizens after Chernobyl. Princeton, N.J.: Princeton UP, 2002. Print.