Fatal Isolation

Fatal Isolation The Devastating Paris Heat Wave of 2003

by Richard C. Keller

University of Chicago Press, 2015
Cloth: 978-0-226-25111-0 | Electronic: 978-0-226-25643-6
DOI: 10.7208/chicago/9780226256436.001.0001

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ABOUT THIS BOOKAUTHOR BIOGRAPHYREVIEWSTABLE OF CONTENTS

ABOUT THIS BOOK

In a cemetery on the southern outskirts of Paris lie the bodies of nearly a hundred of what some have called the first casualties of global climate change. They were the so-called abandoned victims of the worst natural disaster in French history, the devastating heat wave that struck in August 2003, leaving 15,000 dead. They died alone in Paris and its suburbs, and were then buried at public expense, their bodies unclaimed. They died, and to a great extent lived, unnoticed by their neighbors--their bodies undiscovered in some cases until weeks after their deaths.

Fatal Isolation tells the stories of these victims and the catastrophe that took their lives. It explores the multiple narratives of disaster--the official story of the crisis and its aftermath, as presented by the media and the state; the life stories of the individual victims, which both illuminate and challenge the ways we typically perceive natural disasters; and the scientific understandings of disaster and its management. Fatal Isolation is both a social history of risk and vulnerability in the urban landscape and a story of how a city copes with emerging threats and sudden, dramatic change.

AUTHOR BIOGRAPHY

Richard C. Keller is professor in the Department of Medical History and Bioethics at the University of Wisconsin–Madison. He is the author of Colonial Madness: Psychiatry in French North Africa, also published by the University of Chicago Press, and editor of Unconscious Dominions: Psychoanalysis, Colonial Trauma, and Global Sovereignties.

REVIEWS

"Fatal Isolation is a riveting account of the social, cultural, and political forces that made France so vulnerable during the historic 2003 heat wave, and a cautionary tale about the dangers of urban life on an overheated planet. Along the way, Richard Keller takes up deep and unsettling questions about what we can and cannot know about the recent past. It's a memorable, haunting book."

— Eric Klinenberg, author of Heat Wave: A Social Autopsy of Disaster in Chicago

"When does urban social policy become thanatopolitics? In Fatal Isolation the 2003 Paris heat wave becomes a site for thinking about excessive, anonymous, forgotten death. Keller goes in search of corpses in a space without narrative, and brings back valuable fragments of anecdotal lives. This is a dense and compelling history with implications for France and beyond."

— Dana Simmons, author of Vital Minimum

"Masterful. Keller synthesizes disparate sources of information into an impressive new explanation of the heat-wave deaths. More broadly, he demonstrates how social status, not only geographical location, predicts survival during natural disasters."

— Science

"Engaging, provocative, and often chilling. . . . Fatal Isolation is a perfect example of how history and theory can complement each other to work through extreme and traumatic events."

— Somatosphere

"Keller adds some historical flavor to his social autopsy by discussing Paris’ social history of risk and vulnerability going all the way back to the cholera epidemic of 1849. He covers a lot of ground, and while his analysis of the local and national response (or the lack thereof) to this disaster is important, one aspect of his study stands out as particularly interesting: how Paris’s distinct architecture compounded the effects of the heat wave on the city’s most vulnerable citizens."

— Natural Hazards Observer

"Keller’s underscores the problems that arise when a society relies too heavily on metrics to manage the health of its aging population. As a historian of medicine, he is well equipped to guide us through a history of modern France’s public health infrastructure that dates back to the late eighteenth century. After reading Keller’s powerful indictment of the 'unnatural' causes of mass death during the Paris heat wave of 2003, we are left with the question of 'what now?' Due to global warming, extreme weather events are likely to become the norm in the twenty-first century. For Europe’s elderly, along with other vulnerable populations, such as immigrants and refugees, there is little time to waste for creating new kinds of housing to meet the environmental challenges of the twenty-first century."

— Reviews & Critical Commentary

"This is an imaginative book that shows the powerful intellectual contribution that social history can bring to the study of public health. The individual histories make for moving, heartbreaking reading. And when these stories are combined with historical analysis of urbanization and dehumanization, especially of the aged, the result is clear: The marginalization of those claimed by the catastrophe was no accident."

— Bulletin of the History of Medicine

"Keller’s book is an innovative work. Besides offering a valuable description of the intricacies of a public disaster, it also shines a broader spotlight on French society and institutions and the ways they do or do not function to assist and protect citizens."

— Isis

"Keller has produced a lucid and compelling study that should be read by anyone interested in environmental catastrophes and in some of the most pressing social and demographic challenges facing European societies today, chief among them aging and attitudes toward
the elderly."

— Journal of Modern History

"Fatal Isolation brings to life the roles that health statistics, public health institutions, and even urban form play in public acts of remembering and forgetting...[it is] a rare and sought-after type of book: it is of interest to scholarly readers across multiple disciplines and will also provide a good choice to introduce undergraduates to a number of fields, ranging from public health to history, anthropology, and French studies."

— Andrew Newman, Technology and Culture

Introduction - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0006
This chapter is available at:
https://academic.oup.com/chica...

1. Stories, Suffering, and the State: The Heat Wave and Narratives of Disaster - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0001
[media, death toll, catastrophe, politics of disaster, political dysfunction]
Chapter 1 relates a chronology of the disaster. Drawing on media accounts and the reports of a number of state agencies as well as hearings in the French National Assembly, it discusses the heat wave's meteorological origins and effects, describes its impact on the French population, and presents an outline of individual and government responses to the crisis. Its scope includes the seven weeks between the onset of the heat wave and the publication of the official report of the death tally, which established the disaster's excess mortality at 14,802 victims. It uncovers the day-to-day conditions of the heat wave, and emphasize the gradual realization of a catastrophe in the making. The chapter has several goals. One is to orient the reader to the disaster's scale and its wider political and social context. Another is to detail the dysfunction that characterized the state's response to the disaster. And a final goal is to indicate the ways in which media, political, and scientific accounts of the disaster—as it unfolded and in its immediate aftermath—portrayed the heat wave's victims in a light that exacerbated their vulnerability through a relentless emphasis on their marginality. (pages 25 - 56)
This chapter is available at:
https://academic.oup.com/chica...

2. Anecdotal Life: Isolation, Vulnerability, and Social Marginalization - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0002
[anonymous death, social isolation, ethnography, anecdotes, social memory, marginalization, abandonment]
Chapter 2 delves into the story of the hundred bodies abandoned to public burial in the aftermath of the heat wave. It describes the demographic characteristics of the group, and highlights the ways in which these forgotten victims are both representative of and an important departure from the aggregate portrait of the “typical” heat wave victim as presented in state reports. The chapter tells the story of the “forgotten” from a media and political perspective, interpreting closely the dozens of stories produced about the group in the daily press, magazines, television news, documentary film, and books. It travels from a public cemetery to nearly every section of Paris, from luxurious buildings in the city center to the sidewalks of decaying neighborhoods, detailing the methods used to track down the individual stories of those who frame this book. But it also highlights the powerful intersection of invisibility and vulnerability, of forgetting and marginalization, that the disaster revealed. The stories of the heat wave's forgotten victims provide an indication of how public memory of the disaster has contributed to a public imagination of those who died as social isolates who had made their own vulnerability and predetermined their own fates. (pages 57 - 86)
This chapter is available at:
https://academic.oup.com/chica...

3. Place Matters: Mortality, Space, and Urban Form - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0003
[urban environment, geography, vulnerability, urbanism, Paris, poverty, inequality]
Chapter 3 investigates how place shaped the disaster's outcomes, showing how the urban built environment is a technological system capable of breaking down in its own right. It explores the forms of vulnerability built into individual buildings, neighborhoods, and the layout of the city. There is a long history of Parisian urbanism and the evolution of ideas about the city as a site of sickness and health, beginning with the first medical geographies of Paris in the mid-nineteenth century. Drawing on this rich history, the chapter explores the spatial dimensions of vulnerability by investigating patterns of mortality throughout the city both in normal periods and during the heat wave; but it also notes a vertical dimension of risk, through the cases of those among the forgotten who died in tiny quarters (sometimes of less than 100 square feet) directly under zinc roofs on the top floors of sometimes luxurious and sometimes decrepit buildings. There are pockets of desperate poverty even in the city's most chic quarters, and official efforts to rectify an illegal housing market that perpetuates inequality and vulnerability for the city's poorest residents have fallen far short of protecting those residents from the vicissitudes of the market. (pages 87 - 114)
This chapter is available at:
https://academic.oup.com/chica...

4. Vulnerability and the Political Imagination: Constructing Old Age in Postwar France - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0004
[aging, vulnerability, biopolitics, dehumanization, demography, history of aging, welfare state]
Of the heat wave's fifteen thousand victims in France, some eighty percent were over seventy-five years old. Chapter 4 explores the transformation of ideas about aging in the past century. Based on interviews of those who lived alongside the elderly victims of the heat wave and a range of archival sources, it develops a historical context for their lives and deaths. There are both real and imagined connections among aging, disability, and poverty, and the ways in which those intersections have shaped political and social discourses about the elderly in the postwar era reveal a history of the biopolitics of aging. Offering a meditation on the relationship between health and citizenship, this chapter charts a course that has led to the systematic social and political marginalization and dehumanization of the elderly in contemporary France. The heat wave represents a culmination of these processes in two ways. On the one hand, it has forced a collective realization of the social impact of aging in France. On the other, the marginalization of the elderly that so dramatically skewed mortality in their direction is itself an end result of the conceptualization of aging as a social burden and a political problem. (pages 115 - 149)
This chapter is available at:
https://academic.oup.com/chica...

5. Counting the Dead: Risk and the Limits of Epidemiology - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0005
[demography, epidemiology, risk groups, aggregation, disaster victims, death toll, qualitative research, uncertainty, vital statistics]
Chapter 5 investigates cases of the heat wave's abandoned victims to explore vulnerability in groups other than the elderly. Calling on the examples of a suicide, a homeless heroin addict, an alcoholic man, an AIDS patient, and others, it asks the question, who is a disaster victim? These victims open a discussion on three issues. The first is an engagement with the science of epidemiology and the amassing of vital statistics. The counting of the dead and the attribution of causality are practices that are fraught with uncertainty. While the forgotten victims all figure in the global mortality statistics of the disaster, a closer examination raises questions about the cause of their deaths. Second, the deaths of these figures draw the focus away from the elderly as the heat wave's principal victims. Policy initiatives focusing on enhancing resilience among the elderly during heat waves have little effect on victims like these, yet they remain at high risk. Finally, it examines how aggregate pictures of vulnerability stereotype victimhood. In the aftermath of the heat wave, it became easy to associate vulnerability with advanced age and poverty, but increasingly difficult to ascribe the deaths of non-typical victims to the disaster itself. (pages 150 - 180)
This chapter is available at:
https://academic.oup.com/chica...

Epilogue - Richard C. Keller
DOI: 10.7208/chicago/9780226256436.003.0007
[Thierry Jonquet, welfare state, climate change, policy, qualitative research]
The epilogue focuses on tensions between ethical dilemmas that the heat wave forced on the French public and the continued invisibility of vulnerable populations. It begins with a reading of a 2005 novel set during the heat wave, Thierry Jonquet's Mon Vieux, which asks the question, should a society invest in the old, or in its young? The epilogue summarizes the ways that city and national officials attempted to come to terms with the 2003 heat wave and to prevent its recurrence. Many publicity campaigns have sought to generate awareness of the vulnerability of the elderly in order to mitigate the effects of future heat waves. When the heat struck in July 2006, a far lower death toll convinced authorities of their methods' success. Yet there are important limitations to the state's programs that are revealed by the experiences of many of the forgotten: the homeless, the mentally ill, the figures discerned in the cityscape but who defy easy intervention. The book concludes with a discussion of the rising concern with climate change in France—a phenomenon hardly mentioned in political and social life before 2003, but a regular fixture in the aftermath of the heat wave. (pages 181 - 192)
This chapter is available at:
https://academic.oup.com/chica...

Acknowledgments

Notes

Bibliography

Index