Less than a century after the Black Death descended into Europe and killed 75 million people—as much as 60 percent of the population (90% in some places) dead in the five years after 1347—an anonymous Alsatian engraver with the fantastic appellation of “Master of the Playing Cards” saw fit to depict St. Sebastian: the patron saint of plague victims. Making his name, literally, from the series of playing cards he produced at the moment when the pastime first became popular in Germany, the engraver decorated his suits with bears and wolves, lions and birds, flowers and woodwoses. The Master of Playing Cards’s largest engraving, however, was the aforementioned depiction of the unfortunate third-century martyr who suffered by order of the Emperor Diocletian. A violent image, but even several generations after the worst of the Black Death, and Sebastian still resonated with the populace, who remembered that “To many Europeans, the pestilence seemed to be the punishment of a wrathful Creator,” as John Kelly notes in The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of all Time.

The cult of Sebastian had grown in the years between the Black Death and the engraving, and during that interim the ancient martyr had become associated with plague victims. His suffering reminded people of their own lot—the sense that more hardship was inevitable, that the appearance of purpled buboes looked like arrows pulled from Sebastian’s eviscerated flesh after his attempted execution, and most of all the indiscrimination of which portion of bruised skin would be arrow-pierced seeming as random as who should die from plague. Produced roughly around 1440, when any direct memory of the greatest bubonic plague had long-since passed (even while smaller reoccurrences occurred for centuries), the Master of the Playing Cards presents a serene Sebastian, tied to a short tree while four archers pummel him with said arrows. Unlike more popular depictions of the saint, such as Andrea Mantegna’s painting made only four decades later, or El Greco and Peter Paul Reubens’s explicitly lithe and beautiful Sebastians made in respectively the 16th and 17th centuries, the engraver gives us a calm, almost bemused, martyr. He has an accepting smile on his face. Two arrows protrude from his puckered flesh. More are clearly coming. Sebastian didn’t just become associated with the plague as a means of saintly intercession, but also because in his narrative there was the possibility of metaphor to make sense of the senseless. Medical historian Roy Porter writes in Flesh in the Age of Reason: The Modern Foundations of Body and Soul that the “Black Death of the mid-fourteenth century and subsequent outbreaks…had, of course, cast a long, dark shadow, and their aftermath was the culture of the Dance of Death, the worm-corrupted cadaver, the skull and crossbones and the charnel house.” All of said accoutrement, which endures even today from the cackling skulls of Halloween to the pirates’ flag, serve to if not make pandemic comprehensible, then to at least tame it a bit. Faced with calamity, this is what the stories told and the images made were intended to do. Religion supplied the largest storehouse of ready-made narrative with which to tell stories, even while the death toll increasingly made traditional belief untenable. John Hatcher writes in The Black Death: A Personal History that many lost “faith in their religion and…[abandoned] themselves to fate,” where fatality is as unpredictable as where an arrow will land.

A different narrative, though not unrelated, was depicted 40 years later. Made by the Swedish painter Albertus Pictor, and applied to the white walls of the rustic Täby Church north of Stockholm, the mural presents what appears to be a wealthy merchant playing a (losing) game of chess against Death. Skeletal and grinning, Death appears with the same boney twisted smile that is underneath the mask of every human face, the embodiment and reminder of everyone’s ultimate destination. Famously the inspiration for director Ingmar Bergman’s 1957 film The Seventh Seal, Pictor’s picture is a haunting memento mori, a very human evocation of the desperate flailing against the inevitable. Both pictures tell stories about the plague, about the lengths we’ll go to survive. They convey how in pandemic predictability disappears; they are narratives about the failure of narratives themselves. What both of them court are Brother Fate and his twin Sister Despair. The wages of fortune are the subject of which cards you’re dealt and the tension of strategy and luck when you avoid having your bishop or rook taken. Life may be a game, but none of us are master players and sometimes we’re dealt a very bad hand.

There has always been literature of pandemic because there have always been pandemics. What marks the literature of plague, pestilence, and pandemic is a commitment to try and forge if not some sense of explanation, than at least a sense of meaning out of the raw experience of panic, horror, and despair. Narrative is an attempt to stave off meaninglessness, and in the void of the pandemic, literature serves the purpose of trying, however desperately, to stop the bleeding. It makes sense that the most famous literary work to come out of the plague is Giovani Boccaccio’s 1353 The Decameron, with its frame conceit of 100 bawdy, hilarious, and erotic stories told by seven women and three men over 10 days while they’re quarantined in a Tuscan villa outside Florence. As pandemic rages through northern Italy, Boccaccio’s characters distract themselves with funny, dirty stories, but the anxious intent from those young women and men self-exiled within cloistered walls is that “Every person born into this world has a natural right to sustain, preserve and defend” their own life, so that storytelling becomes its own palliative to drown out the howling of those dying on the other side of the ivy-covered stone walls.

Pandemic literature exists not just to analyze the reasons for the pestilence—that may not even be its primary purpose. Rather the telling of stories is a reminder that sense still exists somewhere, that if there is not meaning outside of the quarantine zone there’s at least meaning within our invented stories. Literature is a reclamation against that which illness represents—that the world is not our own. As the narrator of Albert Camus’s The Plague says as disease ravages the town of Oran in French Algeria, there is an “element of abstraction and unreality in misfortune. But when an abstraction starts to kill you, you have to get to work on it.” When confronted with the erraticism of etiology, the arbitrariness of infection, the randomness of illness, we must contend with the reality that we are not masters of this world. We have seemingly become such lords of nature that we’ve altered the very climate and geologists have named our epoch after humanity itself, and yet a cold virus can have more power than an army. Disease is not metaphor, symbol, or allegory, it is simply something that kills you without consideration. Story is a way of trying to impart a bit of that consideration that nature ignores.

The necessity of literature in the aftermath of pandemic is movingly illustrated in Emily St. John Mandel’s novel Station Eleven. Mostly taking place several years after the “Georgian Flu” has killed the vast majority of humans on the planet and civilization has collapsed, Mandel’s novel follows a troupe of Shakespearean actors as they travel by caravan across a scarred Great Lakes region on either side of the U.S.-Canadian border. “We bemoaned the impersonality of the modern world,” Mandel writes, “but that was a lie.” Station Eleven is, in some sense, a love letter to a lost world, which is to say the world (currently) of the reader. Our existence “had never been impersonal at all,” she writes, and the novel gives moving litanies of all that was lost in the narrative’s apocalypse, from chlorinated swimming pools to the mindlessness of the Internet. There is a tender love of every aspect of our stupid world, so that how the crisis happened can only be explained because of the fact that we were so interconnected: “There had always been a massive delicate infrastructure of people, all of them working unnoticed around us, and when people stop going to work, the entire operation grinds to a halt.” As survivors struggle to rebuild, it’s the job of narrative to supply meaning to that which disease has taken away, or as the motto painted on the wagon of the traveling caravan has it: “Survival is insufficient.” The need to tell stories, to use narrative to prove some continuity with a past obliterated by pandemic, is the motivating impulse of English professor James Smith, the main character in Jack London’s largely forgotten 1912 post-apocalyptic novel, The Scarlet Plague. With shades of Edgar Allan Poe, London imagines a 2013 outbreak of hemorrhagic fever called the “Red Death.” Infectious, fast-moving, and fatal, the plague wipes out the vast majority of the world’s population, so that some six decades after the pestilence first appears, Smith can scarcely believe that his memories of a once sophisticated civilization aren’t illusions. Still, the former teacher is compelled to tell his grandchildren about the world before the Red Death, even if he sometimes imagines that they are lies. “The fleeting systems lapse like foam,” writes London, “That’s it—foam, and fleeting. All man’s toil upon the planet was just so much foam.”

The Scarlet Plague ends in a distant 2073, the same year that Mary Shelley’s 1826 forerunner of the pandemic novel The Last Man was set. Far less famous than Shelley’s Frankenstein, her largely forgotten novel is arguably just as groundbreaking. As with Station Eleven, narrative and textuality are the central concerns of the novel; when the last man himself notes that “I have selected a few books; the principal are Homer and Shakespeare—But the libraries of the world are thrown open to me,” there is the sense that even in the finality of his position there is a way in which words can still define our reality, anemic though it may now be. Displaying the trademark uneasiness about the idea of fictionality that often marked 19th-century novels, Shelley’s conceit is that what you’re reading are transcriptions of parchment containing ancient oracular predictions that the author herself discovered while exploring caves outside of Naples that had once housed the temple of the Cumae Sibylline.

Her main character is a masculinized roman a clef for Shelley herself, an aristocrat named Lionel Verney who lives through the emergence of global pandemic in 2073 up through the beginning of the 22nd century when he earns the titular status of The Last Man. All of Shelley’s characters are stand-ins for her friends, the luminaries of the rapidly waning Romantic age, from Lord Byron who is transformed into Lord Randolph, a passionate if incompetent leader of England who bungles that nation’s response to the pandemic, to her own husband, Percy, who becomes Adrian, the son of the previous king who has chosen rather to embrace republicanism. By the time Verney begins his solitary pilgrimage across a desolated world, with only the ghosts of Homer and Shakespeare, and an Alpine sheepdog whom he adopts, he still speaks in a first person addressed to an audience of nobody. “Thus around the shores of deserted earth, while the sun is high, and the moon waxes or wanes, angels, the spirts of the dead, and the ever-open eye of the Supreme, will behold…the LAST MAN.” Thus, in a world devoid of people, Verney becomes the book and the inert world becomes the reader.

The Last Man’s first-person narration, ostensibly directed to a world absent of people who could actually read it, belies a deeper reason for the existence of language than mere communication—to construct a world upon the ruins, to bear a type of witness, even if it’s solitary. Language need not be for others; that it’s for ourselves is often good enough. Literature thus becomes affirmation; more than that it becomes rebellion, a means of saying within pandemic that we once existed, and that microbe and spirochete can’t abolish our voices, even if bodies should wither. That’s one of the most important formulations of Tony Kushner’s magisterial play Angels in America: A Gay Fantasia on National Themes. Arguably the most canonical text to emerge from the horror of the AIDS crisis, Kushner’s three-hour play appears in two parts, “Millennium Approaches” and “Perestroika,” and it weaves two narrative threads, the story of wealthy WASP scion Prior Walter’s HIV diagnosis and his subsequent abandonment by his scared lover, Louis Ironson, and the arrival to New York City of the closeted Mormon Republican Joe Pitt, who works as a law clerk and kindles an affair with Louis.

Angels in America combines subjects as varied as Jewish immigration in the early 20th century, Kabbalistic and Mormon cosmology (along with a baroque system of invented angels), the reprehensible record of the closeted red-baiting attorney and Joseph McCarthy-acolyte Roy Cohn, and the endurance of the gay community struggling against the AIDS epidemic and their activism opposing the quasi-genocidal non-policy of conservative politicians like Ronald Reagan. If all that sounds heady, Kushner’s play came from the estimably pragmatic issue of how a community survives a plague. Born from the pathbreaking work of activist groups like ACT UP, Angels in America has, because of its mythological concerns, an understanding that pandemics and politics are inextricably connected. In answering who deserves treatment and how such treatment will be allocated we’ve already departed from the realm of disinterested nature. “There are no gods here, no ghosts and spirits in America, no spiritual past,” says Louis, “there’s only the political, and the decoys and the ploys to maneuver around the inescapable battle of politics.” Throughout Angels in America there is an expression of the human tragedy of pandemic, the way that beautiful young people in the prime of life can be murdered by their own bodies. Even Cohn, that despicable quasi-fascist, who evidences so little of the human himself, is entitled to some tenderness when upon his death kaddish is recited for him—by the spirit of Ethel Rosenberg, the supposed Soviet spy whom the lawyer was instrumental in the execution of.

At the end of the play, Prior stands at Bethesda Fountain in Central Park, with all the attendant religious implications of that place’s name, and intones that “This disease will be the end of many of us, but not nearly all, and the dead will be commemorated and will struggle on with the living, and we are not going away. We won’t die secret deaths anymore… We will be citizens. The time has come.” In telling stories, there is not just a means of constructing meaning, or even endurance, but indeed of survival. Fiction is not the only means of expressing this, of course, or even necessarily the most appropriate. Journalist Randy Shilts accomplished something similar to Kushner in his classic account And the Band Played On: Politics, People, and the AIDS Epidemic, which soberly, clinically, and objectively chronicled the initial outbreaks of the disease among the San Francisco gay community.

In a manner not dissimilar to Daniel Defoe in his classic A Journal of the Plague Year (even while that book is fictionalized), Shilts gives an epidemiological account of the numbers, letting the horror speak through science more effectively than had it been rendered in poetry. Such staidness is its own requirement and can speak powerfully to the reality of the event, whereby “the unalterable tragedy at the heart of the AIDS epidemic…[was that] By the time America paid attention to the disease, it was too late to do anything about it,” the shame of a nation whereby Reagan’s press secretary Larry Speakes would actually publicly laugh at the idea of a “gay plague.” Shilts waited until he finished And the Band Played On to be tested for HIV himself, worried that a positive diagnosis would alter his journalistic objectivity. He would die of AIDS related complications in 1994, having borne witness to the initial years of the epidemic, abjuring the cruel inaction of government policy with the disinfectant of pure facts.

Most people who read about pandemics, however, turn to pulpier books: paperback airport novels like Michael Crichton’s clinical fictionalized report about an interstellar virus The Andromeda Strain, Robin Cook’s nightmare fuel about a California Ebola pandemic in Outbreak, and Stephen King’s magisterial post-apocalyptic epic The Stand, which I read in the summer of 1994 and remains the longest sustained narrative I think that I’ve ever engaged with. Because these books are printed on cheap paper and have the sorts of garish covers intended more for mass consumption than prestige, they’re dismissed as prurient or exploitative. Ever the boring distinctions between genre and literary fiction, for though the pace of suspense may distinguish entertainment as integral as aesthetics, they too have just as much to say about the fear and experience of illness as do any number of explicitly more “serious” works.

The Stand is an exemplary example of just what genre fiction is capable of, especially when it comes to elemental fears surrounding plague that seem to have been somehow encoded within our cultural DNA for more than seven centuries. Written as an American corollary to J.R.R. Tolkien’s Lord of the Rings trilogy, The Stand depicts a United States completely unraveled one summer after the containment loss of a government “Super-Flu” bioweapon nicknamed “Captain Trips.” In that aftermath, King presents a genuinely apocalyptic struggle between good and evil that’s worthy of Revelation, but intrinsic to this tale of pestilence is the initial worry that accompanies a scratchy throat, watery eyes, a sniffling nose, and a cough that seemingly won’t go away. If anything, King’s vision is resolutely in keeping with the medieval tradition of fortuna so expertly represented by the Master of the Playing Cards or Pictor, a wisdom that when it comes to disease “Life was such a wheel that no man could stand upon it for long. And it always, at the end, came round to the same place again,” as King writes.

Far from being exploitative, of only offering readers the exquisite pleasure of vicariously imagining all of society going to complete shit, there is a radical empathy at the core of much genre fiction. Readers of Robert Kirkman and Tony Moore’s graphic novels The Walking Dead (or the attendant television series) or viewers of George Romero’s brilliant zombie classics may assume that they’ll always be the ones to survive Armageddon, but those works can force us into a consideration of the profound contingency of our own lives. Cynics might say that the enjoyment derived from zombie narratives is that they provide a means of imagining that most potent of American fantasies—the ability to shoot your neighbor with no repercussions. More than that, however, and I think that they state a bit of the feebleness of our civilization.

This is what critic Susan Sontag notes in Illness as Metaphor about how pandemic supplies “evidence of a world in which nothing important is regional, local, limited; in which everything that can circulate does, and every problem is, or is destined to become, worldwide,” so that products and viruses alike can freely move in a globalized world. The latter can then disrupt the former, where plague proves the precariousness of the supply lines that keep food on grocery store shelves and electricity in the socket, the shockingly narrow band separating hot breakfast and cold beer from the nastiness, brutishness, and shortness of life anarchic. Such is the grim knowledge of Max Brook’s World War Z where “They teach you how to resist the enemy, how to protect your mind and spirit. They don’t teach you how to resist your own people.” If medieval art and literature embraced the idea of fate, whereby it’s impossible to know who shall be first and who shall be last once the plague rats have entered port, than contemporary genre fiction has a similar democratic vision, a knowledge that wealth, power, and prestige can mean little after you’ve been coughed on. When the Black Death came to Europe, no class was spared; it took the sculptor Andrea Pisano and the banker Giovanni Villani, the painter Ambrogio Lorenzetti and the poet Jeauan Gethin, the mystic Richard Rolle and the philosopher William of Ockham, and the father, mother, and friends of Boccaccio. Plague upended society more than any revolution could, and there was a strange egalitarianism to the paupers’ body-pit covered in lye. Sontag, again, writes that “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” Such equality motivated the greatest of medieval artistic themes to emerge from the Black Death, that of the Danse Macabre or “Dance of Death.” In such imagery, painters and engravers would depict paupers and princes, popes and peasants, all linking hands with grinning brown skeletons with hair clinging to mottled pates and cadaverous flesh hanging from bones, dancing in a circle across a bucolic countryside. In the anonymous Totentanz of 1460, the narrator writes “Emperor, your sword won’t help you out/Scepter and crown are worthless here/I’ve taken you by the hand/For you must come to my dance.” During the Black Death, the fearful and the deniers alike explained the disease as due to a confluence of astrological phenomenon or noxious miasma; they claimed it was punishment for sin or they blamed religious and ethnic minorities within their midst. To some, the plague was better understood as “hoax” than reality. The smiling skulls of the Danse Macabre laugh at that sort of cowardly narcissism, for they know that pestilence is a feature of our reality and reality has a way of collecting its debts.

Illness sees no social stratification—it comes for bishop and authoritarian theocrat, king and germaphobic president alike. The final theme of the literature of pandemic, born from the awareness that this world is not ours alone, is that we can’t avert our eyes from the truth, no matter how cankered and ugly it may be in the interim. Something can be both true and senseless. The presence of disease is evidence of that. When I was little, my grandma told me stories about when she was a girl during the 1918 Spanish Influenza epidemic that took 75 million people. She described how, in front of the courthouse of her small Pennsylvania town, wagons arrived carting coffins for those who perished. Such memories are recounted to create meaning, to bear witness, to make sense, to warn, to exclaim that we were here, that we’re still here. Narrative can preserve and remake the world as it falls apart. Such is the point of telling any story. Illness reminds us that the world isn’t ours; literature let’s us know that it is—sometimes. Now—take stock. Be safe. Most of all, take care of each other. And wash your hands.

Image Credit: Wikimedia Commons.