“Zulus”, “Clays Ark”, “Zone One,” and “Medical Apartheid” all share a similar theme of the conflict that comes with being externally rather than internally defined. That is, being told what you are rather than willing your self to be itself. In “Zulus,” we can see this clearly from people’s attitudes towards Alice Acitophel; she’s fat and judged very negatively as a result; she’s fat in a context where being fat is far from the norm and implies wrongdoing—eating too much food in a food-starved world. She is further defined later as a cow, as an animal to be milked for the benefits that others will partake in at Alice’s expense. In “Clay’s Ark”, Eli and the other infected individuals meet with the negative knee-jerk reactions of Rane and her father Blake, who look with disgust and self-interested worry at the infected. Even more powerfully, Eli has to wrestle internal with defining himself as an external force enters Eli’s body and begins affecting his inward definition of himself. In Eli’s case, it is not merely himself against an external thing—like another person’s judgment—rather, it is Eli against an external thing (the organism) that has entered him and has begun changing him from within. In “Zone One”, as with “Clay’s Ark”, the infected, as far as can be seen in the story, are exclusively defined from without by the uninfected survivors of the plague. So it is with the history in “Medical Apartheid”, where blacks are frequently defined from without, typically by whites and typically by whites that possess a great degree of power, e.g. doctors, and value is placed upon these external judgments of the victim’s worth. In other words, external forces define an other’s worth.
The pain that comes along with this—with the self being defined from without—can be clearly seen in the aforementioned works, as well as in other literature such as Du Bois’ “The Souls of Black Folk” and Langston Hughes’ “The Negro Artist and the Racial Mountain.” One is, according to Du Bois, and borne out by some studies, placed behind a great veil in which they are separated from another world through no action of their own. Rather, an external force has deemed, consciously or implicitly, that separate spheres must, and therefore do, exist. From behind this veil one becomes ever aware of one’s twoness; that one is both who they will to be internal, and who they are determined to be by external things. One is conscious of himself as he defines himself, but is also conscious of how other define him, and he must always navigate these two worlds. There comes to be a lack of concord in one’s heart: I am that I am, but the world sees and treats me differently from how I am internally. With Alice Acitophel, we can see that she possesses a naturally kind heart (albeit she is very naïve), yet she is treated poorly by others on account of her physical appearance, which they have deemed to be a serious crime. Shen she becomes thin, however, she becomes more like the perfect Lucinda Knotes and is generally treated better by the people she subsequently meets. Eli in “Clay’s Ark” has to cope with the natural internal problem of defining oneself, a natural external defining him (i.e. other people’s perceptions of him), and an external that enters him and changes him from within. The individuals in Medical Apartheid, likewise, are defined from without in contradiction with their presumed internal definitions of themselves. (No one wills to be victim of non-consensual medical exploitation that leads to so much suffering.) The common theme of being defined externally found in these works is clearly displayed as a source of significant trauma and suffering in the victims’ lives.