Precision Medicine in Chang-rae Lee’s On Such a Full Sea

• In Event: Between Emergence and Endurance: Racial Formations and Mutations

Abstract

This paper explores Asian American racial formation through an examination of “precision medicine” in Chang-rae Lee’s dystopian novel On Such a Full Sea (2014). Within the novel, racial triangulation (Claire Jean Kim, 1999) is disarticulated from individual bodies and instead established through three spaces—the Charters, the Facilities, and the Counties—that determine biopolitical citizenship. Drawing on Ulrich Beck’s theorization of risk society alongside recent critiques of the atomization of race in a genomic age, I argue On Such a Full Sea refracts contemporary dynamics of individual and collective health as well as a biopolitics of life itself that ensures, rather than challenges, the invisible endurance of race.

The vague “C-illness” that haunts the novel points to elisions in recent formulations of “precision medicine,” or “the tailoring of medical treatment to the individual characteristics of each patient.” The goal of precision medicine is “not the creation of drugs or medical devices that are unique to a patient, but rather the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease” (defined by the National Research Council; key funding for the Precision Medicine Initiative was provided by President Obama’s 2016 budget). Precision medicine’s definition is studiously free of reference to racial or socioeconomic inequality, yet one of its putative promises is postracialism: “Will Precision Medicine Move Us Beyond Race?” queries the September 2017 New England Journal of Medicine article on the topic. Against uncritical postracialism, I show that precision medicine’s focus on subpopulations and susceptibility, as well as its end goal of generating “preventive or therapeutic interventions [that] can then be concentrated on those who will benefit, sparing expense and side effects for those who will not,” is intrinsically premised on neoliberalism’s excesses, in producing biomedical futurities that further entrench racial inequality. (Significantly, one of the potential cures for the C-illness, developed by an Asian American doctor, is named “Asimil,” literalizing the false promise of assimilation as a cure for racial pathology). In a book with little explicit engagement with contemporary racial discourse, the search for purity, to be “C-free,” can be read as a nefarious parallel for postracial notions of health. Indeed, as the novel suggests, race itself has always been “precision medicine,” a heuristic finely calibrated to ensure life and death.

Author

• Michelle N Huang, Northwestern University