THE NEW YORKER, APRIL 13, 2020 3“deaths of despair,” as the economists
Anne Case and Angus Deaton call
them—overlooks a historical develop-
ment that supports his thesis (Books,
March 23rd). Gawande points out that
death rates across the world have been
falling for decades. This is generally
true, but, after the collapse of Com-
munism, in 1989, death rates in Russia
and much of the former Soviet Union
increased dramatically. While alcohol
consumption played a key role in this
surge, the underlying cause, as Case
and Deaton suggest, was social disin-
tegration. Throughout Russia, indus-
trial employment collapsed, just as it
has in the American Rust Belt. Income
inequality soared, with vulture capi-
talists snatching state resources and
becoming billionaires. Without the
centralized command economy, many
social and health services could no lon-
ger run. Non-state organizations that
might have offered some social stabil-
ity had been barred by the Soviet Union,
and religion provided solace for only a
portion of the population. For many
Russian workers, the future was bleak,
and deaths from violence, alcohol, and
heart disease escalated.
In short, we saw in Russia twenty
years ago what we see in America
today—deteriorating economic condi-
tions, ineffective social supports, and a
health-care system that cannot effec-
tively address self-destructive behavior
or chronic disease. We know what has
happened to Russian politics since the
nineteen-nineties. The conditions in
the U.S. that Gawande describes have
led to our own flirtation with a leader
who ignores the truth and manipulates
the media. I hope that our country will
not follow the path trod by Russia after
its decade of deaths from despair.
Frank Feeley
Concord, Mass.A SWIM IN THE SEA
Jill Lepore, in her chronicle of plague lit-
erature, reads Albert Camus’s 1947 novel,
“The Plague,” as a parable (“Don’t Come
Any Closer,” March 30th). The virus is
Fascism, and the inevitable return of
the disease is evidence of the failure of
human sympathy. “Men will always be-
come, again, rats,” Lepore writes. But
when I read “The Plague” with my ninth-
and tenth-grade students in the fall of
2017, we found that Camus’s text offered
not just the darkness that Lepore cites but
also a complex vision of resistance to it.
My students, in their essays, all wanted
to analyze the same scene: a moment in
which Bernard Rieux, a doctor and the
book’s narrator, escapes from the plague-
ridden town with his partner in resis-
tance, Jean Tarrou. They go for a swim
in the sea. Their strokes synch up, and
they find themselves in physical and
mental sympathy with each other, “per-
fectly at one.” Afterward, they must re-
turn to their plague-stricken patients.
My students were attracted to this scene
not only because it is a lyrical respite
from the horrors of the text but because
it offers the possibility of respite as a
form of resistance.
The physical leap that Rieux and Tar-
rou take into the sea is made possible by
an imaginative one: they free their minds,
if only for a moment, from the grip of
the plague. Lepore cites Rieux’s asser-
tion that “no one will ever be free so long
as there are pestilences.” But he and Tar-
rou do not naïvely assume themselves to
be free; they carve a form of freedom out
of a landscape inimical to it. To resist the
psychological effects of COVID-19, we
need to find a form of imaginative free-
dom that, like Rieux and Tarrou’s, does
not ignore the pestilence. Camus calls
this “a happiness that forgot nothing.”
Kyra G. Morris
Princeton, N.J.
1
LESSONS FROM RUSSIA
Atul Gawande, in his excellent article
about the rise in death rates among
less educated working-class whites—
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