Chapter 4

Epidemiologies of state bioterror

In its report, Preventing Childhood Obesity: Health in the Balance, the US Institute of Medicine of the National Academies makes the following recommendation under the rubric of Federal Commitment': Just as broad-based approaches have been used to address other public health concerns including automobile safety and highway initiatives, efforts to curb youth smoking, and current efforts to defend against potential bioterrorist threats, the federal government should set forth obesity prevention as a national health priority - one that is acted upon through extensive and sustained funding and long-term commitment of resources.1 In reading this report, I was struck by the seeming incongruity of listing civic health initiatives such as youth smoking and automobile safety with potential bioterrorist threats all, furthermore, situated within the larger biopolitical frame of the childhood 'obesity epidemic.' In this chapter, I proceed to examine the complex biopolitical relations that suture national issues of obesity prevention to larger transnational frames of state terror, imprisonment and torture. Specifically, I examine the role of medical personnel in the conduct of torture in places such as Guantanamo and draw attention to the history of US medical science in advancing practices of state violence. In the course of my research, the above quotation worked as a type of incitement; a provocation to attempt to make sense of what, on the surface, seems like a non-sequitur in the sequence: the term 'bioterrorist' appears as a type of category error that seemingly violates the coherence of the lexical set concerned with civic health issues. In order to address this provocation, I will embark on a dilatory itinerary that works to trace a genealogy of historical relations that continues to inform a series of dispersed texts, locations and agents. My particular concern is to illuminate the complicit role of medical personnel in the administration and nuanced supervision of regimes of torture at Guantanamo.'-' I conclude, as an

end-point to this dilatory journey, by materializing the points of connection that biopolitically inscribe national concerns about obesity and terrorists.

US bioterrorism and medical experimentation at Guantanamo: the CIA's experimental laboratory

As I outlined in my Introduction, the Bybee Torture Memo effectively sanctioned a series of torture practices governed by carefully managed intensities and punctuated by levels of pain that could be inflicted as long they did not the push the victim over a fatal threshold. As I discuss below, assisting the torturer in keeping their victim from crossing the fatal threshold was an arsenal of medical personnel that effectively monitored the health of the victim in order to ensure that they could be kept alive for interminable torture sessions. Through its radical redefinition of torture, the Bybee Memo established the possibility for the CIA detainee prisons to become laboratories of torture shadowed by the tenuous limits between life and death. I term these CIA prisons laboratories of torture as the torturers proceeded to test a number of torture techniques on their captives. Guantanamo was, in fact, referred to by officials who worked there as a 'battle lab' because the torture that was conducted there encompassed a range of experimental practices: 'MG Dunleavy and later MG Miller referred to GTMO as a "Battle Lab" meaning that interrogations and other procedures there were to some degree experimental, and their lessons would benefit DoD [Department of Defense] in other places.'' Abu Zubaydah, whose case I discuss below, draws attention to the experimental practices of torture he endured: 'I was told during this period that I was one of the first to receive these interrogation techniques, so no rules applied. It felt like they were experimenting and trying out techniques to be used later on other people.'1 The experimental torture practices that Zubaydah was forced to endure were set in train under the direction of'The apparent leader of the CIA team ... a former military psychologist named James Mitchell, whom the intelligence agency had hired on contract.'Jane Mayer writes: 'Mitchell announced that the suspect had to be treated "like a dog in a cage," informed sources said. "He said it was like an experiment, when you apply electric shocks to a caged dog, after a while, he's so diminished, he can't resist." 'r> The biopolitics of speciesism at once enables the transmutation of human into animal and the attendant licence to 'diminish' Zubaydah through a range of experimental torture practices designed to produce a completely compliant and docile subject. The experimental status of the torture practices that Zubaydah experienced at Guantanamo was the result of the official sanctioning of a detainee experimentation program by the former Deputy Defense Secretary, Paul Wolfowitz. As Jason Leopold and Jeffrey Kaye note, 'Wolfowitz quietly loosened rules against human

experimentation' through the issuance of a directive titled 'Protection of Human Subjects and Adherence to Ethical Standards in DoD-Supported Research, 25 March 2002.' The Wolfowitz directive 'provided legal cover for a topsecret Special Access Program at the Guantanamo Bay prison, which experimented on ways to glean information from unwilling subjects and to achieve "deception detection."' Critically, the directive formally allowed the detainees to become subjects of medical experimentation without their informed consent: After the scandals over the CIA's MK-ULTRA program and the Tuskegee experiments on African-Americans suffering from syphilis, Congress passed legislation known as the Common Rule to provide protections to human subjects. The Common Rule 'requires a review of proposed research by an Institutional Review Board (IRB), the informed consent of research subjects, and institutional assurances of compliance with regulations.' 6 The Wolfowitz directive, however, includes a clause that enables the circumvention of a subject's informed consent with the authority of the Head of the DoD: 4.2.2. Consistent with 10 USC 980(b) (reference (b)), the requirement for prior informed consent under paragraph 4.2. or subparagraph 4.2.1. may be waived by the Head of a DoD Component with respect to a specific research project to advance the development of a medical product necessary to the Armed Forces if the research project may directly benefit the subject and is carried out in accordance with all other applicable laws and regulations, including 21 CFR 50.24 (reference (j)).7
Moreover, 'only (bur days before signing the new directive,' Wolfowitz had warned the public that, in relation to the detainees captured in the war on terror, 'We're dealing with a special breed of person here."1 The Wolfowitz directive illustrates the double logic of state violence and the manner in which its legal memoranda work to legitimate the very thing they appear to oppose: under the rubric of'Protection of Human Subjects and Adherence to Ethical Standards,' it provides, through its critical waiver of a detainee's right to informed consent, the abrogation of a detainee's human status and the consequent violation of ethical standards. The invocation of the descriptor 'special breed' locates the Wolfowitz directive in the domain of biopolitical war, a war in which, as I discussed in Chapter 1, racism is firmly imbricated with speciesism in order to position the target subject outside the legal frame of the human-rights-bearing person. Situated in a context that is fundamentally predicated by what Foucault terms 'the biological caesura,' 'the death of the bad race ... is something that will make life in general healthier and purer.'y As a 'special breed,' the detainee of the war on terror becomes subject to the state's regime of bio-regulation and 'medicine becomes a political intervention-technique with specific power effects.'"' The violent literality of medicine's political intervention into the very bodies of the detainees is evidenced by the testimonies of Shaficj Rasul, Asif Icjbal and Rhuhel Ahmed with regard to their experience of being forcibly injected witli unknown drugs while being held down by heavily armed guards. Rhuhel describes the violent medical interventions they experienced in Camp Delta: the ERF [Extreme Reaction Force] team would come into the cell, place us face down on the ground then putting our arms behind our backs and our legs bending backwards they would shackle us and hold us down restrained in that position whilst somebody from the medical corps pulled up my sleeve and injected me in the arm. They left the chains on me and then left. The injection seemed to have the effect of making me feel very drowsy. I was left like that for a few hours with my legs and arms shackled behind me. If I tried to move my legs to get into a more comfortable position it would hurt. Eventually the ERF team came back and simply removed the shackles. I have no idea why they were giving us these injections. It happened perhaps a dozen times altogether and I believe it still goes on at the camp. You are not allowed to refuse it and you don't know what it is for." In this scene, the body of the detainee becomes the site upon which militarized and medicalized violence intersect in order to further the biopolitical production of a docile body. The disciplinary violence of the ERF team weighs physically onto the body of the detainee and literally trusses his body with chains. The medical team deploys its disciplinary violence pharmacologically, reducing the detainee to a chemically pacified subject. What is evidenced here is the state's racialogical conceptualization of the Muslim detainee in terms of a 'biocriminal': 12 because his criminality is biologically (racially) innate, it can only be tamed and rendered governable through the application of a regime of double violence. The Muslim detainee emerges as the target of racio-speciesist relations of biopower that are advanced through the application of medico-militarized techniques designed to subjugate Wolfowitz's 'special breed.' Mamdouh Habib, a detainee tortured and imprisoned at Guantanamo for years before being released without charge, describes being injected with unknown drugs that 'disoriented me and made me feel that my blood was boiling; they gave me diarrhoea and splitting headaches.' 'I believe,' he concludes, 'that they used detainees as guinea pigs to test new treatments and drugs.' 11 These racio-speciesist techniques and applications of biopower are literally modelled on war and the state's medico-militarized concern to

immunize itself from the pathological virulence of its absolute other. The injections that the detainees are compelled to endure work to further some unknown experiment conducted by the state while also immunizing it from the contagions of its pathologized biocriminals. Perhaps the most disturbing aspect of this entire medico-militarized program concerns the fact that detainees were compelled to undergo interrogations and to give evidence while clearly under the influence of mind-altering drugs. A report by the Inspector General of the DoD confirms this: We noted in the medical records of some detainees, documentation of ongoing medication with psychoactive drugs which could impair an individual's ability to provide accurate information. We also observed that certain detainees diagnosed as having serious mental health conditions and being treated with psychoactive medications on a continuing basis were interrogated while under the influence of the medication." In other words, detainees whose mental state was affected by psychoactive drugs and who were in a state of mental instability continued to be interrogated and their statements were taken down as evidence that could be used against them. As one of the attorneys representing one of the detainees argues, 'under the system set up by the [US Court of Appeals for the District of Columbia], any statements detainees made during these interrogations would be presumed to be accurate even if the detainees took medication that could produce unreliable information.'1' Furthermore, the breach of medical ethics that was instantiated by such practices underscores the layered regimes of cruelty and torture that impacted on detainees. 'The problem,' notes Leonard Rubenstein, a medical ethicist, 'is not simply what the report implies, that good information is unlikely to be obtained when someone shows psychotic symptoms, but the continued use of highly abusive interrogation methods against men who are suffering from grave mental deterioration that may have been caused by those very same methods.'"' What emerges when one pieces together the various methods of torture and interrogation that were deployed on the detainees is a system of violence that is multi-dimensional in its scope and reach. Even the most vulnerable of all the detainees, those suffering acute mental illness, do not escape this comprehensive regime of violence; on the contrary, their illness and the psychoactive medications that they are administered are mobilized against them as they are compelled to endure sessions of interrogation that can only further undermine their fragile mental states even as they speak 'evidence' that is compromised at every level by both their illness and their psycho-active medications. The biopolitical regime of immunization-through-forced inoculations that I have drawn attention to is further evidenced by the involuntary administration of the anti-malarial drug mefloquine to detainees in Guantanamo. Jason Leopold and Jeffrey Kaye have drawn attention to the 'high dosage' of this 'controversial antimalarial drug that has been directly linked to suicide, hallucinations, seizures and other severe neuropsychological side effects.' They cite Major Remington Nevin, 'an Army public health physician, who formerly worked at the Armed Forces Health Surveillance Center and has written extensively about mefloquine.' Nevin condemns the use of the drug, 'even as a one-time treatment,' as 'at best, an egregious malpractice.' He adds that: ' "many dozens of detainees, possibly hundreds" likely experienced debilitating side effects "as severe as those intended through the application of enhanced interrogation techniques".' 17 Mefloquine operates, in other words, as a pharmacological technique of torture. Once again, it demonstrates the double logic of biopolitics at work: under the ruse of'immunization,' it is administered allegedly in order to protect the body of the detainee from a disease he does not necessarily have, while simultaneously rendering his body subject to a range of debilitating effects that amplify the regime of instru-mentalized torture to which he has already been subject. The biopolitical dimensions of 'immunization' in the service of medico-militarized interventions are further underscored by the duplicitous Hepatitis B vaccination program conducted by the CIA and its medical agents in Abbottabad, Pakistan, as a way of obtaining DNA from the compound in which they suspected Osama bin Laden was hiding. The CIA initiated this duplicitous vaccination campaign in 'a poorer part of town to make it look more authentic.'18 In other words, the subaltern subjects of Abbottabad were inoculated in order to further the US state's larger project of biopolitical immunization against the forces of al-Qaeda. Their subaltern status, as poor subjects, was expropriated through an act of medico-militarized extortion in order to provide a cover of 'authenticity' for a fake medical program. The poor of Abbottabad were thus ensnared within a transnational grid of US medico-militarized interventions that effectively instrumentalized them as a way of securing a statist end. The specific power effects of medicine that I have thus far outlined are precisely what detainees in Guantanamo were forced to endure for the benefit of the administering DoD doctors who conducted their torture experiments. David Hicks, one of the Guantanamo detainees, has given evidence of some of the experiments the detainees endured: A detainee with UK citizenship described being injected daily, resulting in one of his testicles becoming swollen and racked with pain. Along with these daily injections he was subjected to mind games by interrogators, medical personnel, and guards who worked as a team. Under these conditions they were able to extract written false confessions from him . . . There were pills and injections, plus constant blood tests over the years. Everybody regardless of their citizenship should

acknowledge that medical experimentation on human beings or animals is unacceptable. As with animals, we were held as prisoners when these procedures were forced upon us against our will and as with animals, we were voiceless. 19 Hicks names here the lived experience of the biopolitical caesura in the context of both imprisonment and involuntary medical experimentation, and the consequent rendering of the captive as Voiceless' animals in the face of violence. The 'mind games' Hicks refers to were the ensemble of physical and psychological torture techniques developed by the Behavioural Science Consultation Team (BSCT) personnel employed by the CIA. The Special Review of the CIA's Counterterrorism Detention and Interrogation Activities describes the complicity of BSCT personnel in the development of its torture program: Several months earlier, in late 2001, the CIA had tasked an independent contractor psychologist, who had [redacted] experience in the US Air Force's Survival, Evasion, Resistance, and Escape (SERE) training program, to research and write a paper on Al-Qaida's resistance to interrogation techniques. This psychologist collaborated with a Department of Defense (DoD) psychologist who had [redacted] SERE experience in the US Air Force and DoD to produce the paper, 'Recognizing and Developing Countermeasures to Al-Qaida Resistance to Interrogation Techniques: A Resistance Training Perspective.' Subsequently, the two psychologists developed a list of new and more aggressive EITs [Enhanced Interrogation Techniques] that they recommended for use in interrogations."0 The Special Review describes how 'psychologists/interrogators [redacted] led each interrogation of Abu Zubaydah and AlNashiri where EITs were used.'"'1 The SERE program was, in effect, 'reverse-engineered to develop the "enhanced" interrogation program.'a It was viewed as offering a legitimate range of techniques because it had been used on volunteer military personnel during training. However, it was obvious to those conducting the torture sessions that there was a critical difference between the SERE volunteer training program and what was used on the detainees: 'One of the psychologists/interrogators acknowledged that the Agency's use of the technique [of waterboarding] differed from that used in SERE training and explained that the Agency's technique is different because it is "for real" and is more poignant and convincing.'21 The enormity of the difference that divides the 'feigned' from the 'real' is underscored, as Abu Zubaydah's case evidences below, by the fact that the victims of the SERE torture techniques in the CIA prisons were brought to the very verge of death and back again. That the use of the SERE enhanced interrogation techniques was tantamount to torture, and thus in breach of the anti-torture laws, was evidenced by the request that was made by GTMO's Staff Judge Advocate LTC Diane Beaver, who 'found that some of the proposed tactics would constitute a "per se violation" of the Uniform Code of Military Justice (UCMJ) Article.' Consequently, Beaver said it would be 'advisable to have permission or immunity in advance from the convening authority for military members utilizing these methods.' al The call for 'immunity in advance,' as articulated by a number of military personnel who were called upon to authorize these torture practices, is raised time and again (see Chapter 5) across the corpus of torture memos correspondence. It evidences the fact that those implicated in the deployment of torture practices clearly knew that these techniques constituted forms of torture.

Shadow archives of US biowarfare and bioterrorism

As I remarked in Chapter 2 in the context of Abu Ghraib, the shadow archive is an historical repository of discursive practices that, although barely discernible because of its shadow status, continues to animate and shape the cultural intelligibility of contemporary practices. Haunting this contemporary use of medicine for biopolitical warfare, experimentation, and torture is a dense shadow archive of colonial and racist medicine that has been critical in shaping the biopolitical configuration of the US nation. The brutal literality of the power of colonial disease to determine who would live and who would die is clearly evidenced in the case of smallpox. The colonial settlers of North America deployed smallpox as a technique of biowarfare to advance the destruction of Native Americans in order to facilitate land clearing and white colonization. In their study of the destructive impact of the disease on Native American communities in colonial North America, Kristine Patterson and Thomas Runge note that: 'Smallpox ultimately killed more Native Americans in the early centuries than any other disease or conflict. It was not unusual for half a tribe to be wiped out; on some occasions, the entire tribe was lost.'25 Referring to the first documented account of the power of smallpox to effect mass extermination, the authors write that: 'The first epidemic occurred in 1616 along the Massachusetts coast, eliminating nearly 90% of the Massachusetts tribe of the Algonquin nation. This was later referred to as an act of Divine Providence to clear the land for settlers that landed at Plymouth in 1620.'"'*' The historical moment that marks the colonial foundation of the white nation is inscribed with an epidemiological case of ethnic cleansing that dovetails perfectly with a germinal form of that providential myth that will expand exponentially in its latter guise as Manifest Destiny - with its attendant massive campaign of genocidal expropriation of Native American lands. As a technique of biowarfare, smallpox operated as a 'Trojan Horse,' entering Native American communities through gifts of blankets and barrels inoculated with the disease. In

an effort to quash Native American resistance against the conquest of their lands, one military officer recommends that: 'You [Colonel Henry Bouquet] will do well to try and inoculate the Indians by means of blankets, as well as to try every other method tha[t] can serve to extirpate this execrable race.'27 This campaign of extirpation assumed many forms and continued well into the twentieth century, with the US state mobilizing medical personnel in the forced sterilization of Native American women. Native American women, Andrea Smith notes, are 'threatening because of their ability to reproduce the next generation of peoples who can resist colonization'; 211 consequently, their bodies become the target of biowarfare practices such as sterilization. Administered by the Bureau of Indian Affairs, sterilization rates as 'high as 80 percent' have been documented on some reservations.2'1 The practice of obtaining informed consent was either entirely disregarded or 'consent forms were signed while the patient was anesthetized or in the throes of labor. As a technique of biowarfare deployed in order to neuter and extinguish the state's designated enemies, the threat of sterilization reared its contemporary head in one of the US's transnational gulags: 'In January 2004 at a holding facility, an interrogator assigned to a SOF [Special Operations Forces] unit told two detainees that they would be sterilized, then poured the contents of a Chemlight onto one of the detainee's genitals.'31 In the annals of US colonial history, medicine has played a pivotal role in the racial typologizing and biopolitical governance of the nation's subjects. In Medical Afiartlieid, Harriet Washington tracks the involuntary use of African Americans for abusive medical experimentation from colonial times to the contemporary context. '[I]nvoluntary medical experimentation,' Washington writes, 'was the scientific personification of enslavement. Violence, pain, arid shame joined as the physicians forced the enslaved body into medical service, not for cure, but for profit.'*2 In the early twentieth century the eugenics movement, founded on the notion that personality traits and diseases were biologically innate and thus transferable across generations, established medically inflected programs of genetic engineering driven by concepts of race betterment and racial hygiene. These programs were oriented by biopolitical hierarchies that categorized subjects according to the intersecting categories of disability, race, gender and sexuality. As a biopolitical program driven by normative notions of what constituted acceptable life forms, eugenics set in train programs aimed at segregating, institutionalizing and sterilizing 'defective' population groups. These programs only stopped at the close of the Second World War, after the horrific disclosures of what had transpired in the Nazi camps and the way in which eugenics had been complicit in the extermination of those categorized as biologically inferior. 3' Regardless of the discreditation of such scientific disciplines as eugenics, the practice of using racially targeted population groups for medical experimentation continued well into the twentieth century. The infamous Tuskegee Experiments saw African Americans infected with syphilis, with white doctors denying their sick subjects treatment in order to study the often fatal effects of the disease." The Tuskegee Experiments stand as a landmark case of white bioterrorism against black bodies. This particular domestic program of medical experimentation conducted on people of color has been shown to have an international dimension: US researchers, led by the same doctor who conducted the Tuskegee Experiments, deliberately infected 'female Guatemalan commercial sex workers with gonorrhoea and syphilis and encouraged them to have unprotected sex with soldiers and prison inmates. The subjects were not told what the purpose of the research was nor warned of its potentially fatal consequences.'33 The US government, under the aegis of the CIA's MK-ULTRA scientifico-medical experimentation program, inflicted various diseases such as yellow fever and dengue fever on its African American citizens and 'mounted biological-warfare tests on oat crops in the (predominantly black) Virgin Islands.'31' Situated in both domestic and international contexts, medical experimentation on subjects designated by the US government as biopolitically expendable has worked as a crucial element in the conduct of state-sanctioned campaigns of bioterrorism and biowarfare.

Abu Zubaydah in Guantanamo's 'battle lab

In February 2007, the International Committee of the Red Cross (ICRC) produced a confidential report titled ICRC Report on the Treatment of Fourteen 'High Value Detainees' in CIA Custody. The ICRC Report was subsequently leaked to the public. The report was driven by the ICRC's grave concern over the humanitarian consequences and legal implications of the practice by the United States (US) authorities of holding persons in undisclosed detention in the context of the fight against terrorism. In particular, the ICRC has underscored the risk of ill-treatment, the lack of contact with the outside world as a result of being held incommunicado, the lack of legal framework, and the direct effects of such treatment and conditions on the persons held in undisclosed detention and on their families." The ICRC's Report was based on interviews that were conducted with fourteen detainees imprisoned at Guantanamo. In the course of the ICRC's interviews, the detainees document the range of torture practices that they have had to endure.

One of the detainees interviewed by the ICRC was Abu Zubaydah. The Bybee Memo on the interrogation of al-Qaeda operatives, 1 August 2002, constructs the legitimization of ten SERE torture techniques for CIA use on detainees around the notion that, in Bybee's words, 'Zubaydah is one of the highest ranking members of the al Qaeda terrorist organization.' Zubaydah is said to have 'been involved in every major terrorist operation carried out by al Qaeda' and he is identified as 'one of the planners of the September 11 attacks.'1" Framed as one of the 'worst of the worst' and subject to one of the most brutal and unrelenting regimes of torture deployed by the CIA post-9/11, including being waterboarded eighty-three times, the allegations made against Zubaydah have subsequently been proven to be false: The Justice Department has quietly recanted nearly every major claim the Bush administration has made about 'high value' detainee Abu Zubayadah, a Guantanamo prisoner who at one time was said to have planned the 9/11 attacks and was the No. 2 and 3 person in al-Qaeda . . . For the first time, the government now officially admits that Zubaydah did not have 'any direct role or advance knowledge of the terrorist attacks of September 11, 2011,' and was neither a 'member' of alQaeda nor 'formally' identified with the terrorist In a transcript of a Combat Status Review Tribunal held at Guantanamo, Zubaydah is quoted as saying: 'They told me, "Sorry, we discover that you are not Number 3, not a partner, not even a fighter." ' In Zubaydah's ICRC torture testimony, he describes how the torture sessions unfolded: Then the real torturing started. Two black wooden boxes were brought into the room outside my cell. One was tall, slightly higher than me and narrow. Measuring perhaps in area 1m x 0.75m and 2m in height. The other was shorter, perhaps only 1m in height. I was taken out of my cell and one of the interrogators wrapped a towel around my neck, they then used it to swing me around and smash me repeatedly against the hard walls of the room. I was also repeatedly slapped in the face. As I was still shackled, the pushing and pulling around meant that the shackles pulled painfully on my ankles." This first round of torture that is inflicted on Abu Zubaydah serves to 'soften up' the detainee. The bruises, welts and lacerations he receives in the course of this torture session will leave his body wracked with pain that, in the course of what follows, will be amplified by being encased within a coffin-like black box: After the beating I was then placed in the small box. They placed a cloth or cover over the box to cut out all light and restrict my air supply. As it was not high enough even to sit upright, I had to crouch down. It was very difficult because of my wounds. The stress on my legs held in this position meant my wounds both in the leg and in the stomach became very painful . . . The wound on my leg began to open and started to bleed. I don't know how long I remained in the small box, I think I may have slept or fainted.12 Confined within his coffin-like black box, Zubaydah's pain-wracked body is cut off from all external points of reference so that the only thing that continues to signify, in the context of his absolute isolation, is his pain. Immured within his black box, Zubaydah's wounds open up, bleed and proceed to amplify, without any assistance from the torturer, the pain inscribed by the initial torture session. This is the ultimate goal for the torturer: to make the body of the victim selfgenerate, through unbearable stress positions, its own torture regime of gratuitous violence. The incipient wounds and lacerations inflicted upon the body will now dilate, bleed and intensify the pain for the victim without the torturer lifting a finger. Evidenced here is the literality of 'no touch' torture. Operative in this regime of torture is an instrumentalizing coefficient that pivots on the production of maximum pain for the victim with minimal exertion of energy from the torturer. For a period of unknown duration, for Zubaydah there will be nothing but an intensity of pain that will destroy all other relations of his being-in-the-world: there will be for him no other ontology outside of a pain-wracked singularity. I juxtapose Zubaydah's testimony of his torture in the confinement boxes with the Bybee Memo's cool conclusion that these instruments of torture cause 'no profound disruption of the senses or personality' and that 'the use of confinement boxes does not constitute a procedure calculated to disrupt profoundly the senses or personality.'" Zubaydah documents the unrelenting sequence of torture sessions he is made to endure. They are sessions marked by no reprieve except for the moments when he loses consciousness: I was then dragged from the small box, unable to walk properly and put on what looked like a hospital bed, and strapped down very tightly with belts. A black cloth was then placed over my face and the interrogators used a mineral water bottle to pour water on the cloth so that I could not breathe. After a few minutes the cloth was removed and the bed was rotated into an upright position. The pressure of the straps on my wounds was very painful. I vomited." Zubaydah here identifies the deployment of medical apparatuses a hospital bed and straps - as instrumental in the regime of torture. I will presently discuss the medical dimensions of torture in some detail. But, for now, I want to focus

on the waterboarding torture Zubaydah is forced to endure. Strapped down tightly with belts, his face covered with a black cloth, Zubaydah's facial orifices become accomplices in the torture regime as water is forcefully poured into his mouth and nose, thereby severing his air supply. The closing in of the world upon Zubaydah, as he experienced in the confines of his coffin-like box, is here replicated by the violent binding of his limbs and the blanketing of his face. All external coordinates are obliterated. Once again, for Zubaydah there is no external point of reference outside of his pain. He is caught in the violent paradox of being strapped and anchored to his bed while being psychically severed from all moorings as he is plunged into a simulation of drowning. On the removal of the cloth, as he gasps for air, he vomits. The gagging victim upheaves the unbearable intensity of pain and suffocation through the visceral spasm of the vomit. Without reprieve, the torture regime resumes: The bed was then again lowered to a horizontal position and the same torture carried out again with the black cloth over my face and water poured on from a bottle. On this occasion my head was in a more backward, downwards position and the water was poured on for a longer time. I thought I was going to die. I lost control of my urine. Since then I still lose control of my urine when under stress. Zubaydah is here reduced to what Suvendrini Perera and I term, following Fanon, 'combat breathing.' Combat breathing, we contend, articulates the subject position of those 'at the receiving end of state violence . . . Combat breathing names the mobilization of the target subject's life energies merely in order to continue to live, to breathe and to survive the exercise of state violence.'1' In the fraught state of combat breathing, without a moment of reprieve, Zubaydah is compelled to endure yet another from of torture: I was then placed again in the tall box. While I was inside the box loud music was played again and somebody kept banging repeatedly on the box from the outside. I tried to sit down on the floor, but because of the small space the bucket with urine tipped over and spilt over me. I remained in the box for several hours, maybe overnight. I was then taken out and again a towel was wrapped around my neck and I was smashed into the wall with the plywood covering and repeatedly slapped in the face by the same two interrogators as before. 1" Zubaydah's testimony documents both the methodical nature of the torture regime and its brutal logic of repetition. Torture, in this testimony, is seen to unfold with a clinical precision in which all the moves have been carefully calculated: the precise tilt of the hospital bed in order to ensure maximum suffocation effect during the waterboarding sessions; the tightening of the straps so that they cut into the wounds of the victim and thereby contribute to a sensorial overload of pain that issues from multiple sites of the captive body. This methodical regime of torture is structured, in addition, by recursivities that ensure that the victim does not experience moments of reprieve and that the sites of pain are distributed across the entirety of his body. In this political economy of torture, virtually every area of the detainee's body is inscribed with a torture technique designed to produce pain of such intensity that the victim loses consciousness, only to be immediately revived in order to submit to a different modality of torture. The methodical and recursive nature of the violence that is administered in this torture session is augmented by both medical personnel and apparatuses. It is to the medical dimensions of the torture regime that I now turn.

Medically assisted torture

Documented throughout the testimonies of the Guantanamo torture victims in the ICRC Report is the presence of medical personnel supervising the CIA's torture sessions. Drawing on a range of medical technologies, the medical personnel complicit in the torture sessions are not employed to safeguard the health and safety of the detainees; rather, in direct violation of the avowed ethics of the medical profession, they are employed to make sure that the detainees never cross the fatal threshold of organ failure or fatal injury that would render them dead and useless as sources of information. If a detainee has been assaulted and battered by guards or interrogators, the question as to whether or not he receives medical attention is often predicated on whether or not he has been a compliant subject. Shaker Aamer, who has been imprisoned in Guantanamo for ten years even though he was cleared for release in 2007, has protested at the abuses that detainees have undergone in the prison. Consequently, on repeated occasions, he has been denied medical treatment. Shaker is held in Five Echo block, Camp Five, 'a maximum-security block modelled on the Miami Correctional Facility, a state prison in Bunker Hill, Indiana.' Camp Five holds among its range of detainees 'those who are regarded as "noncompliant." " 7 The carceral block is described by Shaker's lawyer, Ramzi Kassem, as 'decrepit, filthy and disgusting.' In the context of a maximum-security cell with 24-hour video surveillance, Shaker is not even allowed the dignity of having toilet paper: 'no toilet paper. Why?' he questions sardonically, 'In the name that I use it to cover the camera.'"1 Shaker has been subjected to

violent assaults by the guards due to his outspoken protests about the conditions in Guantanamo. He describes the violent practice of 'Forced Cell Extraction' that he had to endure for over two months:

I got beaten up on my knee and my finger almost broken. Swelled for few days . . . they refuse to give me any treatment not even knee brace. Bruises and swelling all over my body. Squeezing my neck so bad I could not breathe. Try to break my hand and fingers. Pressure on my back, stomach and chest, so much pressure. Tight, the plastic cuffs so tight the blood circulation stop. '9 The regimens of torture at Guantanamo produce disabled bodies that serve two biopolitical functions for the state: firstly, the disabilities produced by the violent assaults on the body of the detainee, once left untreated, will self-generate their own forms of gratuitous suffering and further amplify the pain that was directly produced by the trauma of torture; secondly, the pain generated by the disability is left untreated in order to produce a subject who can only qualify for medical treatment once he becomes compliant. The complicity of medical personnel in these torture regimens is clearly evidenced in the ICRC Report: 'Mr Khaled Shaik Mohammed alleged that, in his third place of detention, one of his interrogators stated that the greenlight had been received from Washington to give him a "hard time" and that, although they would not let him die, he would be brought to the "verge of death and back again." ' 'u The detainee is here shown to be set on a halting trajectory toward not-quite-death: he is tortured to the point that he almost, but not quite, veers over the edge of the abyss, only to be hauled back, revived and compelled to endure yet another session of torture. The ICRC testimonies of the CIA's torture victims repeatedly document the lived violence of this halting trajectory: Throughout the course of the initial phase of the detention, the ICRC received allegations that health personnel were directly involved in monitoring the health effects of ill-treatment. In some cases it was alleged that, based on their assessments, health personnel gave instructions to interrogators to continue, to adjust, or to stop particular methods . . . For certain methods, notably suffocation by water, the health personnel were allegedly directly participating in the infliction of the ill-treatment. In one case, it was alleged that health personnel actively monitored a detainee's oxygen saturation using what, from the description of the detainee of a device placed over the finger, appeared to a pulse oxymeter ... As well as the monitoring of specific methods of ill-treatment, other health personnel were alleged to have directly participated in the interrogation process.51 The direct participation of health personnel in the interrogation process also involved the direct exercise of physical violence on the detainee, as evidenced by Brandon Neely, a former Guantanamo guard: 'We were told there was no SOP [Standard Operating Procedure] and the book would be written as we went along. If detainees refused medication the IRF [Immediate Reaction Force] team came in and forced them to take their medication. I sat there and watched a medic punch a detainee in the face one time as the detainee was chained to the back of his cage in a Jesus Christ pose because the detainee didn't want to drink his Ensure.'02 The ICRC report describes how. in order to ensure that the detainee would be kept alive in the course of his risky shuttle between life and not-quite-death, medical personnel played key monitoring roles in the ensemble of torture agents. In the CIA laboratories of torture, the medical personnel clinically monitor all the relevant life-signs in order to keep the detainee alive so that he can continue to be tortured: 'Mr Bin Attash (the detainee has had a right-sided below the knee amputation) alleged that while being held in a form of stress standing position with his arms shackled above his head, and his feet touching the floor, he had his lower leg measured on a daily basis with a tape measure by a person assumed to be a doctor for signs of swelling."' The use of the tape measure to gauge the swelling of the victim's foot establishes a finely nuanced regime of torture calibrations: at what point does the swelling leg cross the irreversible line into necrosis? At what critical juncture will the blood oxygen level become so depleted as to risk organ failure? The attendant medical personnel will know. Operative here is the medicalized instrumentalization of torture, with its auxiliary weapons, including pulse oxymeter, tape measure and medical gauze, approved by General Geoffrey Miller 'to restrain the detainee's mouth to prevent him from becoming argumentative and verbally abusive."' In this torture laboratory, the detainee's body is firmly enmeshed within regimes of biopower. Biopower, Michel Foucault writes, is designed to bring 'life and its mechanisms into the realm of explicit calculations."" It deploys a battery of technologies of'infinitesimal surveillances' so that it can exercise micrological control over the body in order to 'qualify, measure, [and] appraise' the subject in question.' 1' The medical measuring of the swelling of the victim's leg with a tape measure will result in an appraisal that will determine whether or not the torture session can be productively continued - and not out of concern for the detainee's health or life: 'Mr Hambali alleged that, after a period of the same form of prolonged stress standing, a health person intervened to prevent further use of the method, but told him that "/ look after your body only because we need you for information.'" "7 Medical power is seen here to fold into a biopolitics of torture and extortion: the body of the torture victim is kept alive only in order to render it viable for the extortion of information. The subtext to this anonymous health personnel's veiled threat is that the detainee's life will only be sustained up until the moment that he is seen as 'useful.' Shadowing this veiled

threat is a long and harrowing US genealogy violently marked by the torsions of biopower that fold into explicitly fatal forms of necropolitical power. The connective biopolitical resonances between the Guantanamo detainee (who is only kept alive in the vestibularity of the torture laboratory because he has something of value to yield to his captors) and the conditions of Native Americans held sequestered within their own vestibular territories and spaces is brought into sharp focus in this meditation by Ward Churchill: The situation of Native North Americans thus remains much as it has been since the moment the Old World predator landed in the hemisphere. Liquidated to the extent deemed necessary or convenient by the invader in precisely the fashion, and at exactly the pace the invader's capacity to inflict liquidation has allowed - we are maintained alive at all primarily as a matter of utility by our colonizers, and then only in a form considered acceptable to them. 58 Churchill's apposite phrase, 'maintained alive,' vividly captures the manner in which the conditions minimal to keeping a subject alive set the operational parameters of the biopolitics of life and death within the different vestibular spaces of the nation. There are significant differences between the biopolitical violence inflicted on the detainees of Guantanamo and the genocidal violence Native Americans have been compelled to survive over the centuries. Yet, there can be discerned here a violent continuum of torture and biopolitical violence instrumental to the effective operation of the imperial state; this biopolitical continuum extends outwards from its homelands to its transnational gulags. In her profound and uncompromising mapping of captor and captive relations, Hortense Spillers writes: 'The world according to captives and their captors strikes the imagination as a grid of identities running at perpendicular angles to each other: things in serial and lateral array, beings in hierarchical and vertical array. On the serial grid, the captive chattel property - is the equivalent of inanimate and other things.'59 Spillers here materializes the hierarchies of life that are constitutive of the biopolitical state and that are principally organized around the category of race. These racialized hierarchies of life, as I discussed in Chapter 1, are critically inflected by the speciesism of the biopolitical caesura that cuts the human off from the animal and that, in turn, proceeds to categorize some humans as animals that can be enslaved, tortured and killed. The resultant biopolitical hierarchies of life determine the value of the subject situated along this vertical axis; an axis governed by the superordinate category of whiteness (and its tautological attributes: human, universal, rights-bearing subject), with all the racio-speciesist gradations following in a descending scale. At the terminal point of this vertical axis reside those subjects entirely beyond the pale. Situated at this fraught locus, the absolute other of the white subject is shown to inhabit the same category status as 'inanimate and other things': for example, the 'Pumpkin

Patch' Guantanamo detainee (see Chapter 3). As I discuss in some detail in Chapter 5, the vertical distribution of biopolitical power inscribes the captive in the order of objects that finds its necropolitical terminus in the assignation of 'carcass'; that is, the captive is finally transmuted into 'dead meat' that can be summarily dispatched with impunity. The serial nature of this biopolitical grid evidences the system of continuities that connect a cluster of disparate subaltern subjects reduced to object status: Native American, African American and Arab/Muslim detainee.

Dietary torture
Scoring the testimonies of the CIA's torture victims, as collected in the ICRC Report, are the accounts of the regime's use of dietary torture: Walid Bin Attash: During the first two weeks I did not receive any food. I was only given Ensure and water to drink. A guard would come and hold the bottle for me while I drank. Khaled Shaik Mohammed: During the first month I was not provided with any food apart from on two occasions for perceived cooperation. I was given 'Ensure' to drink every 4 hours ... I was weighed every day during the first month. This was done on a weekly basis later. At the time of my arrest I weighed 78 kg. After one month in detention I weighed 60 kg.1'" Ensure is a nutritional drink given to patients who cannot swallow solid food and it is also used to maintain minimum calorie intakes in weight-loss programs. 'Each bottle of #1 doctor recommended Ensure,' the official Ensure website proclaims, 'is a source of complete, balanced nutrition."'1 In the CIA dietary torture program, Ensure was used to deliver the baseline of life-support in the face of systematic starvation: no solid food, but just barely enough calorie intake via Ensure to keep the body alive so that it can endure more torture. Furthermore, in the

context of this torture program, the detainee was starved of solid food in order to weaken his resistance and to produce a compliant subject. At Guantanamo, this production of docile subjects who will be more amenable and compliant during interrogations is further supplemented by pharmacological regimes that included the administering of valium to detainees who had no diagnosed condition requiring the use of sedatives. 1'' In Guantanamo's corporeal economy of starvation and dietary torture, Ensure ensures that the victim is given a minimal calorie intake in order merely to be kept on the edge of life. Once situated in Guantanamo's torture laboratories, Ensure emerges as yet another instrumentality of torture within the CIA's arsenal of torture implements; located in this context, the slogan that advertises Ensure's Rich Dark Chocolate drink - 'Discover Nutrition's Dark Side' - has a sinister albeit unintended resonance. The hollowed-out body of the CIA dietary torture victim and the emaciated body of the Guantanamo hunger striker evoke spectres of the Muselmann. As I discussed in Chapter 3, in the Nazi camps the Muselmann embodied the anguished category of the living dead: starved, ostracized by all, they were killed without compunction and dispatched as so much refuse within the industrial killing machine of the Nazi camps. I transpose this figure of the Muselmann onto the Muslim inmates of Guantanamo in order to bring into focus certain genealogical migrations and discursive cross-hatchings that emerge from the locus of the camp. A number of hunger strikes have been staged at Guantanamo that, despite forced feeding, have resulted in the deaths of detainees. Facing the emaciated figures of the detainees on hunger strike, one of the prison guards is on record as saying to the detainee Shaker Aamer: 'They have lost hope in life. They have no hope in their eyes. They are ghosts, and they want to die. No food will keep them alive now."'* Ahmed Ghappour, one of the lawyers representing the detainees at Guantanamo, states that the hunger strikers were also force-fed 'laxatives that induced chronic diarrhea while they were strapped in their feeding chairs,"1' thereby exacerbating their dehydration and emaciation. As spectral reincarnations of Muselmdnner embodying the anguished category of the living dead, the Muslim inmates in Guantanamo are compelled to live the ontotautology of the Muslim as Muselmann. If, as Agamben argues, 'the camp is his [the Muselmann's] exemplary site,"'3 then the Muslim detainee in Guantanamo Bay emerges as the figure of exemplarity of the camp inmate as such: the 'as such' attests to the ineluctable status of his ontotautology. Traversing historical divides and politically unique trajectories, the one, through the instrumentalizing and serializing logic of the camp, fuses into the other even as this process of historical superimposition outlines those fundamental differences that cannot be homogenized or reconciled. The extensive dimensions of the regime of dietary torture, undergirded by the foundational biopolitical question of who shall live and who shall die,'1'' are made painfully manifest in the enforced administration of Ensure to the torture victims:
'If I refused [to drink Ensure],' Khaled Shaik Mohammed testifies, 'then my mouth was forced open by the guard and it was poured down my throat by force.'67 The violence of this regime of forced feeding is amplified by the use of 'riotcontrol soldiers to compel detainees to sit still while long plastic tubes were threaded down their nasal passages and into their stomachs.' According to the detainees, the personnel at Guantanamo used the medically inflected euphemism 'intensified assisted feeding' to describe the forced feeding they administered on their 'recalcitrant' captives."' The regime that Mohammed describes entailed the violence of guards 'strapping recalcitrant detainees into "restraint chairs," sometimes for hours a day, to feed them through tubes and prevent them from deliberately vomiting afterward. Detainees who refuse to eat have also been placed in isolation for extended periods in what the officials said was an effort to keep them from being encouraged by other hunger strikers."'"' This instrumentalized violence was further augmented by the gratuitous violence of the detainees 'strapped in restraint chairs having their feeding tubes inserted and removed so violently that some bled or vomited.'70 The hunger strikers at Guantanamo have repeatedly made clear that they have gone on strike because of the unliveable conditions which they are forced to endure, and yet, former Secretary of Defense, Donald Rumsfeld, flippantly referred to those on hunger strikes 'as a group of detainees going "on a diet" to get press attention.'71 We are here, once again, in the surreal domain of violent inversions where suicides are termed 'acts of asymmetrical warfare' and potentially fatal hunger strikes become PR-driven 'diets.' The medicalized torture practices described in the ICRC Report target the vulnerable orifices of the body in order to entrench the detainee's sense of utter violation and subjugation: 'On one occasion during the interrogation I was offered water to drink, when I refused I was again taken to another room where I was made to lie on the floor with three persons holding me down. A tube was inserted into my anus and water poured inside.' 72 The violation of the body's orifices is further evidenced by the forced insertion of suppositories into the victims in order to induce chronic diarrhoea and thus further debilitate and humiliate the detainees. The use of these suppositories emerges as a type of inverted program of

administering weight loss pills in order to insert the obese citizen-subject within biopolitical regimes of bodily normativity and disciplinarity.

Psychological torture
Across many of the detainees' testimonies of torture, the role of psychologists in monitoring and augmenting their torture is copiously documented.71 Their betrayal of medical ethics and protocols is clearly evidenced in a declassified email from an interrogator at Guantanamo: 'I've met with the BISC (Biscuit) people several times and found them to be a great resource. They know everything thats [sic] going on with each detainee, who they're talking to, who the leaders are, etc. I've encouraged the interview teams to meet with them prior to doing their interviews.'71 In other words, the interrogators would come primed to the interrogation sessions with information gleaned directly from the psychological personnel who were treating the detainees at Guantanamo. David Hicks, former Guantanamo detainee, articulates his view of the role psychologists played in the context of the prison: Apart from their contributions in interrogations they were always lurking in the background, waiting to 'help a detainee,' but to really act as another prong to the interrogation. If a detainee even whispered for such medical intervention a 'mental health expert' would appear with a pocket of unknown medication and a long list of probing questions. They were not there to help, but to harm. We knew this and so I always refused to speak with them . . . All they wanted was information, or to find new ways to defeat you.73 The role of behavioral scientists and other medical personnel at Guantanamo evidences the multiple modalities of'expertise' the state deploys in the biopolitical governance of its carceral subjects. Behavioral scientists and doctors work, in this context, in tandem with the larger repressive apparatuses of the state (for example, the military and the CIA). They provide techniques of subject constitution and subjugation that amplify, re-orient and/or underscore the work of their fellow state officials. They emerge as nodal points in the state's network of biopolitical power. As 'experts' they occupy positions that Foucault terms 'authorities of delimitation': their institutional accreditation establishes them as specialists who delimit, designate, establish and name their 'objects' of inquiry. 71' As such, they effectively transmute the detainee into a medicolegal object: the body. I emphasize 'body' as, in the Health Assessment reports of particular detainees, the symptomologies of the subject are recorded without reference to the detainee's lived traumatic history; rather, they signify autotelically, solely through their named diagnoses and in complete isolation from the detainee's history. The detainee under psychiatric analysis, then, becomes a 'site' for the reading of medical signs that emanate from a body disconnected from its lived history - a lived history that has effectively inscribed the body with its medical symptoms. The Health Assessment of the Guantariamo detainee Ahmad Bushir, for example, is recorded as follows: 'He has psychiatric diagnoses of Depression, Anxiety, and Personality disorders, to include Self Injurious Behavior and past Suicide Attempts.' Nowhere in the whole of Bushir's three-page medical assessment report is any reference made to the fact that he was a survivor of what Andy Worthington has termed the 'convoy of death.' After being captured in Afghanistan by Northern Alliance soldiers under the command of General Abdul Rashid Dostum, Bushir was transported to the city of Sherbegan, with hundreds of other captives, in shipping containers: According to one of the drivers, a few hours after the convoy set off from Qala Zeini, the prisoners started pounding on the sides of the containers, shouting, 'We're dying. Give us some water! We are human, not animals.' He said that he and the other drivers punctured holes in the walls and passed through bottles of water, but added that those who were caught doing this were punished. Even these gestures, however, were not enough to prevent large numbers of the prisoners from suffocating as the convoy crawled towards Sherbegan. When the first trucks pulled up at the prison and the doors of the containers were opened, most were disturbingly silent. One of the drivers recalled, 'They opened the doors and the dead bodies spilled out like fish.'78 The refrain across the testimonies of the detainees remains constant: 'We are human, not animals.' The cut of the biopolitical caesura, in this case, confines the detainees within the vestibularity of the shipping container where they are transported as livestock. At the terminus of their journey, most of the detainees have been transmuted into corpses that spill out like fish. Shafiq Rasul, Asif Iqbal and Rhuhel Ahmed were also transported in this convoy of death: According to information all three were given later, there were US forces present at the point they were packed into the containers together with almost 200 others. Asif became unconscious and awoke to find that in an attempt to allow air into the containers Dostum's forces had fired machine guns into the sides of the containers. Asif was struck in the arm by a bullet as a result. The journey to Sherbegan took nearly 18 hours and the containers were not opened until they reached the

prison. All three men remained in the containers amongst the dead and the dying throughout this time . . . On arrival at Sherbegan of the 200 originally in the container only 20 were alive, some of them seriously injured. 79 As I have discussed elsewhere, the divide between the Global North and Global South articulates itself across seemingly innocuous technologies and modes of transport.8" The geopolitics of life (where you're from) is inscribed by the biopolitics of life and death (who will live and who will be let to die) precisely in the context of these mundane, civil modes of trade, transport and communication. What is operative in the shipping of detainees in sealed containers is the geopolitical technologization and biopolitical instrumentalization of disposable bodies. Within this necropolitical economy, the detainees are instrumentalized into mere cargo; non-human objects that do not need to breathe, drink or excrete. They become 'high value,' but simultaneously disposable, commodities caught in the lethal circuits of intelligence commerce. The capillary reach of state power also works to resignify civic containers into sites of militarized violence and torture: the cells of Guantanamo's Camp Delta were constructed out of modified shipping containers designed, appositely, to warehouse the (human) 'packages' and 'property' of the US government. I have drawn attention to the critical absence of Ahmad Bushir's history of trauma from his medical assessment as it exemplifies the clinical 'grids of specification' that constitute Western medical practice."1 These grids of specification function, in Foucauldian terms, to break up, screen, inventory and classify the subject under the scientific gaze. As scientific grids, they determine the very limits of what may or may not be said; of what may or may not be relevant to the case. In this case, under the heading 'Detention Information,' Bushir's history is reductively noted in these terms: 'he received orders to surrender to Dostum's Northern Alliance forces in early November 2001. Once detainee surrendered, he was transported to Sherbegan Prison, AF for detention and later turned over to US Forces." 12 Excised from Bushir's case history is the horror of the death convoy that he managed to survive - an experience of such profound trauma that, one would assume, would be relevant to the 'psychiatric diagnoses of Depression, Anxiety . . . Self Injurious Behavior and past Suicide Attempts.' The absence of this lived history of trauma from Bushir's medical record presents him simply as a

dysfunctional subject prone to psychiatric disorders. The misrepresentations and elisions that score these official medical documents, and the consequent violence they sanction, are perhaps most graphically evidenced in Mohammed al-Qahtani's Interrogation Log. Al-Qahtani's subjugation to a range of violent 'enhanced interrogation' techniques began on 23 November 2002 and continued until 16 January 2003. His interrogation log depicts a regime of torture that runs the gamut of practices from puppet shows to waterboarding. As Larry Siems writes, al-Qahtani's interrogation sessions are conducted by a group of interrogators and medical personnel all working in concert: The interrogators are from military intelligence . . . The Major is from Joint Task Force Guantanamo's Behavioral Science Consultation Team. The 'Biscuits,' as they are known, are psychiatrists and psychologists whose job is to assess and assist interrogators in exploiting detainee's fears and vulnerabilities. The three and their interpreter form one of three teams that will work on Qahtani around the clock for the next fifty days. In the room throughout, unnoted except when called upon to subdue Qahtani, are masked MPs [Military Police]. Not in the room but never far away is a medic, and often a guard dog and its handler as well. On call at all times is a doctor.10 The relay of state biopower that inscribes the torture sessions is exemplified by this ensemble of figures constituted by official interrogators, psychiatrists, psychologists, doctors, MPs and guard dogs. The interrogators are enabled to deploy an inteqjlay of both symbolic and physical violence, as they see fit. The MPs are called in to exercise overt physical violence whenever the need arises. The psychiatrists and psychologists oiler expert advice as how best to extract information from the detainee by exposing fears and vulnerabilities that will render him into a docile and confessional subject. As Steven Miles has observed, The peculiar content and structure of this document [alQahtani's interrogation log] makes sense it it is the log of research on coercive interrogation. This would account for why it is focuses on the emotions and interactions of the prisoner, rather than on the questions asked and the information that was obtained."" Complicit in the very process of torture-driven interrogation, the medical personnel work to keep the subject alive as a prospective data-information resource in their ongoing research experiment: 24 December 2002 1800: Medical personnel checked vital signs and determined that detainee needed to be hydrated. 1810: Detainee was given two bags of fluids. Detainee stated that he did not want an IV and that he was in control of his body. SGT M asserted that he was in control and that detainee had no choice but to cooperate.

1845: Medical doctor arrives to evaluate detainee to ensure he is physically able to continue. Detainee stated he wanted to sign a form or a release stating that he did not want any medications. The doctor explained that no such form exists. Detainee was informed that we would not let him die."J In this account, it is late December and al-Qahtani has been subjected to over a month of torture and interrogation. He is at the stage where he prefers to die rather than to continue to endure this violent regime. And it must be made clear that al-Qahtani, prior to his undergoing this interrogation regime, had already been subjected to the most destructive form of isolationist torture and, by one account, had lapsed into psychosis: [I]n November 2002, FBI agents observed Detainee #63 [al-Qahtani] after he had been subjected to intense isolation for over three months. During that time period, #63 was totally isolated (with the exception of occasional interrogations) in a cell that was always flooded with light. By late November, the detainee was evidencing behavior consistent with extreme psychological trauma (talking to non-existent people, hearing voices, crouching in a corner of the cell covered with a sheet for hours on end). 1"1 After over a month of virtually uninterrupted interrogation, during which some of the interrogation sessions lasted up to twenty hours,87 al-Qahtani pleads to be able to write his will: 26 December 2002 1945: The doctor checked the detainee. The doctor looked at the detainee's back to ensure there were no abrasions from sitting in the metal chair for long periods of time. The doctor said everything was good. The next entry forty-five minutes later reads: 2030: Detainee stated that SGT L would be the cause of him committing suicide. He requested to write a will. His request was granted and he wrote a will with a crayon. Lead had will translated and it was a request that if he died here to have his body and passport sent back to his country quickly and to notify his mother. Lead entered booth with detainee's will and told detainee that since he had given the detainee this opportunity, what would the detainee give in return. The detainee said 'thank you' and lead stated that was not enough. Lead told detainee that a single truth would be enough and asked the detainee 'who recruited you into Al Qaida?' Detainee stated he was not Al Qaida and lead tore up the detainee's will in front of him."" By this stage of his interrogation, al-Qahtani has experienced dramatic weight loss; has suffered hypothermia, prolonged forced insomnia, sexual abuse, nudity, and an enforced enema; has been blasted with loud music and white noise; and has been so severely dehydrated that he is repeatedly forced to have intravenous fluids injected into him to keep him alive. Because of the unrelenting torture he has had to endure he is, in effect, asking to die and yet the administering doctor records that 'everything was good.' The complete dismissal of the detainee's harrowing mental and physical state by this doctor is echoed in the medical advice given by a Defense Department Behavioral Health Service clinician at Guantanamo: having documented a detainee's symptoms of nightmares, lapses in memory, decreased concentration and appetite, depressed mood, and suicidal thoughts, the detainee was 'treated with antidepressants and told, "[You] need to relax when the guards are being more aggressive." ' 9 The scientific model that undeqjins Behavioral Health Science's discursive practices is what enables this sort of clinically detached response to a subject in fear and pain. The scientistic schema that constitutes Behavioral Health Science practice is predicated on observational principles that exhort the deployment of a neutral and objective gaze in the analysis of their 'object' of inquiry. In its observation of behavior, the scientific gaze must, by definition, be detached, excising all affective responses that the 'object' under observation might elicit. The scientific gaze here operates under the ruse that the reflexive withholding of affect is actually coterminous with its actual absence. It is only by materializing the discursive conditions of the scientific gaze and its clinical excision of affect that one can begin to make sense of the following incident: a regional team leader interrogator at Guantanamo was sufficiently disturbed by the detainee abuse that he 'protested this abuse to a BSGT [Behavioral Science Consultation Team] person.' 9" The BSCT person's response was to assess the interrogator 'as having "Reverse Stockholm Syndrome." ' In other words, to have been moved and outraged at the detainee abuse that the interrogator had witnessed was tantamount to suffering from a psychiatric disorder caused by the anomaly of identifying with the victims of abuse.

Biopolitical wars
Khaled El-Masri, victim of extraordinary rendition and torture who was erroneously detained by US authorities in a number of black sites before being released without charge, describes the manner in which he was prepared, after capture, for shipment to one of the secret prisons. After having been blindfolded, his clothes were cut away, he said. He heard someone taking photographs. Then, he said, the blindfold was removed and the agents covered his eyes with cotton and tape, inserted a plug in his anus and put a disposable diaper on him before dressing him. He said they covered his ears, shackled his hands and feet and drove him to an airplane where they put him on the floor.91 El-Masri here documents the transmutation of the human into cargo. In the scale of the biopolitical hierarchy of life, scored vertically with its range of categorical caesurae, El-Masri is assigned a place below the live transport of animals as he is systematically converted by the military personnel into non-sentient freight. His bodily orifices are taped and plugged. His limbs are shackled and trussed. He is then dispatched as mere lading on the floor of the plane. El-Masri here exemplifies the state's absolute exercise of biopolitical power over life: he embodies the brutal literality of the aphorism: politics supposes (live)stock. The suspensive use of parentheses designates the tenuous border between the living and the dead that El-Masri is compelled to endure in the course of his violent transport. Omar Deghayes, who also underwent the profound trauma of this form of transport, describes how he felt he had been transmuted into inanimate stock: 'it was really, really like moving furniture.' In the course of that violent journey, he felt he had become 'a box of nothing.'92 What is documented in the description of El-Masri's extraordinary rendition is a violent negation of both his human sentience and his most basic biological needs. The key organs of his sensorium are blinded and muted, the very possibility to evacuate solid waste is staunched with a plug and he is thus refashioned into little more than a mechanical entity whose hydraulics could be blocked with little or no effect. The one concession to the fact that we are dealing with a biological human subject is evidenced by the use of a diaper. This use of diapers on the detainees that the US has rendered and detained is evidenced across multiple testimonies and reports. In his account of his harrowing journey of extraordinary rendition, Mohamed Bashmilah describes the humiliating use of diapers: 'Because my hands and legs were tied, I could not take off the diaper in which I had arrived. Instead, for the first fifteen days in Afghanistan, I was kept in the same diaper that had been put on me at the airport in Jordan. To go to the toilet, 1 would have to shuffle over the bucket, stand over it, lower the diaper down with tied hand, use the bucket and pull the diaper back up.'93 In his ICRC testimony. Walid Bin Attash documents the regime of torture he had to endure soon after his capture:
I was stripped naked and remained naked throughout the month ofjuly. Also during this time I was again kept for several days in a standing position with my arms above my head and fixed with handcuffs and a chain to a metal ring in the ceiling . . . During the standing I was made to wear a diaper. However, on some occasions the diaper was not replaced and so I had to urinate and defecate over myself.'" Abou Elkassim Britel, another victim of extraordinary rendition, testifies in his declaration as to how he was also stripped naked and was 'put in diaper like a baby.''1' These testimonies evidence the manner in which torture practices are often critically predicated on the infantilization of the prisoner. One of the detainees describes the manner in which he was administered mind-altering drugs under the ruse of being given candy: [Redacted] stated that during an interrogation at Bagram he was given pills; green and red ones. 'After I ate like three of them, my tongue started getting heavier. After that, I woke up and they (interrogators) said thank you very much, we've got what we need. After I ate the stuff, it was like a state of delusion.' He also said 'it took like three-four days (to feel normal again)' . . . During the interview, we asked [redacted] if he was told what the pills were. He stated: 'At the time they said it was some candy. And I was hungry so I ate it.' The admixture of lies, candy, mind-altering drugs, abuse of trust and breach of medical ethics works to reduce the detainee to a dependent child who will be duly rewarded for co-operating by being fed, in the words of two Bagram interrogators, 'cookies, Taffy's [sic], Jolly Ranchers, suckers and Fruit Loop cereal.'97 This violent process of infantilizing the detainee is also evidenced by the repeated shackling of detainees into fetal positions on the floor of the interrogation rooms: 'On a couple of occasions,' an FBI agent recounts, 'I entered the interview rooms to a find a detainee chained hand and foot in a fetal position to the floor, with no chair, food, or water. Most times they had urinated or defecated on themselves, and had

been left there for 18, 24 hours or more.'98 As a result of these torture practices, many detainees would actually regress to a type of psychotic infancy, shackled into 'fetal positions, crying in pain,' babbling gibberish while left to stew in their own waste.99 And it is precisely at this juncture, a juncture that intersects the terrorist and the child, that I want to stage a return to the opening quotations of this chapter, drawn from the US Institute of Medicine of the National Academies' report, Preventing Childhood Obesity: Health in the Balance, in which bioter-rorist threats are situated in the lexical set of civic health initiatives that include youth smoking, automobile safety and the childhood 'obesity epidemic.' The biopolitical state is fundamentally concerned with the regulation and governance of populations through the implementation of apparatuses of biopower concerned with issues of health, defence and securitization. Biopower is principally concerned with the body and its relation to structures of power. 'Bio-power,' writes Foucault, 'brought life and its mechanisms into the realm of explicit calculations and made knowledge/power an agent of transformation of human life.'10 Biopower, in other words, effectively colonizes the body, overlaying it with calcu-latory grids and inscribing it with formulae that will transform it into an object of knowledge and power. Biopower is 'the set of mechanisms through which basic biological features of the human species became the object of a political strategy.' lu Situated in this biopolitical context, I want to argue that there is an unsettling chiasmic relation that connects the subject of the obese child in the policy documents of US health authorities with the torture victim incarcerated in the US state's offshore prisons. The obese child is the target of a designated array of weight-loss health interventions designed to maximize the health and longevity of the subject under the state's tutelage. At the opposite end of this biopolitical spectrum is the state's absolute other: the infantilized detainee on an enforced weight-loss program of dietary torture who, as a type of adult-child, is compelled to endure nakedness and the wearing of diapers. The infantilization of the detainee, through sustained practices of torture, subjugation and humiliation, effectively works to render the detainee into a type of carceral doll, a Figuren at the mercy of its captors. The former Guantanamo detainee David Hicks describes the process: 'You become fully dependent with a childlike reliance on your captors. They pull you apart and put you back together, dismantling you into smaller pieces each time, until you are something different, their creation, when eventually reassembled.""2 If the biopolitical policies concerned with children and the so-called obesity epidemic pivot on maximizing the longevity of the citizen-subject through a series of health-promotion interventions, at die opposite end of this biopolitical continuum are located the adultchild detainees whose basic biological functions are manipulated, through an array of torture techniques that include weight-loss through starvation, in order to keep them on the cusp of living death. In the words of that anonymous health person operative at Guantanamo, 1 look after your body only because we need you for information.' For those at the opposite end of this biopolitical continuum, life is something that is sustained by the state only if the victim is seen to serve some useful puipose as data-information resource. What emerges, in the context of this chiasmic relation and biopolitical continuum, is a field marked by a number of intersecting vectors. This biopolitical Held is inscribed by two polarized coordinates: the medical maintenance of a normative notion of the optimally healthy body of the citizen-subject stripped of its pathogenic fat and, symmetrically, as a type of grotesque mirror image, the medical maintenance of the optimally starved body of the detainee on the border of life/death. The body of the torture victim is compelled to endure an enforced regime of dietary torture designed to strip it of its life-giving fat reserves in order to render it into a docile body-information-object that is compliant to extortionary confessions. What is being biopolitically 'treated' here is the pathogenic body of the 'terrorist' and, metonymically, its viral 'terror cells.' Operative across both the texts of the 'obesity epidemic' and the war on terror is the discourse of epidemiology. As that quintessentially biopolitical branch of medicine concerned with regulating and monitoring the health and illness of populations, epidemiology is mobilized by the biopolitical state in order to make interventions in the interests of public health and disease. The discourse of epidemiology at once frames the cultural panic of the 'obesity epidemic'"" and the war on terror. As with the obese subject, terrorists know no boundaries and, in their proclivities for violence, they show no restraint. As suicide bombers, their appetite for (self-)destruction breaches all civil codes and constraints. In keeping with biopolitical representations of the fat person, they are viral subjects who are out of control, wreaking havoc on the normative body politic of the nation. At work in this biopolitical economy that I am delineating is the mobilizing of war, understood in the broadest sense of the term, by the state in order to govern, regulate and discipline its target subjects. Once situated within this biopolitical schema, the seemingly incongruous series - war on crime, war on obesity and war on terror assumes politically intelligible dimensions. What connects this seemingly disparate series of wars are vectors of biopower that are spatiotemporally dispersed and yet relationally articulated across different sites and particular bodies: US domestic spaces and transnational gulags; the citizen-subject's fat body-at-risk; the racially profiled subject who is criminalized in advance of the fact; and the extra-national detainee's risk-provoking, racialized body that can be detained or killed because of the 'imminent threat' it poses. Operative across this biopolitical continuum is a system of relays that connects the civic governance of the health of the national population with the medico-militarized manipulation of the detainee's body through dietary regimens. The end goal of this regime of biopolitical intervention and governance is the immunization of the corpus of the state through the disciplinary correction and inoculation of the anomalous subject. These seemingly

bizarre relays and chiasmic relations of biopower are perhaps nowhere more evident than in the literal intertwining of US civic dietary concerns with the torture diets of detainees in the CIA's Office of Medical Services (OMS) Guidelines, which actually invoke 'commercial weight loss programs' in their establishing of viable benchmarks for the starvation diets of CIA detainees: Widely available commercial weight loss programs in the US employ diets of 1000 Kcal/day for sustained periods of weeks or longer without required medical supervision in persons voluntarily seeking to lose weight; these diets have proven safe and effective in inducing short term loss . . . Should the interrogation team choose to limit the detainee's food intake, OMS recommends a minimum intake of 1500 Kcalories/day.104 The CIA's use of dietary guidelines established by commercial weight loss programs is, however, immediately qualified by the following chilling warning: 'If enhanced interrogation methods are contemplated, a liquid diet is appropriate to minimize risk to the detainee of aspiration; a liquid diet is mandatory if the use of waterboarding is being contemplated. >1Uj Qualifying these civic dietary guidelines are the potentially lethal effects of a torture practice - waterboarding that can lead to the premature death of the detainee if they have been fed solids. Driving the relays of biopower that cross civic health programs with the dietary torture of detainees are mechanisms designed, on the one hand, to maximize the national population's health and life through the advocacy of dietary regimes and, on the other, to ensure the pacification and virtual destruction of the enemy through regimes of dietary torture that will be amplified through a variety of 'enhanced interrogation methods.'