In the author’s telling, the origins of this book lie in the middle of Donald Trump’s first term as president, when the United States was ‘busy building its border wall and the country’s right-wing media was in a state of absolute frenzy’. Arts journalist Oliver Basciano describes idly tuning into a hysterical television report about the southern border being ‘swamped’ by an ‘army’ of migrants. Just as he was about to change the channel in disgust, he was stopped in his tracks by a statement so bizarrely anachronistic that it stayed his hand. These migrants, a guest on the programme claimed, were bringing diseases like tuberculosis and leprosy to the United States. Tuberculosis, maybe, but surely leprosy doesn’t exist anymore, Basciano thought.

In the aftermath of that disorienting moment, Basciano became obsessed by leprosy, ‘the ur-stigma … the blueprint for other forms of discrimination’.
Ostracised, isolated, shunned and neglected, the figure of the leper struck him as the type specimen of the social outcast. Of course, we don’t say ‘leper’ anymore, not even on Fox News. Such is our fear of stigmatising labels, leprosy itself has been officially renamed ‘Hansen’s disease’, after the Norwegian physician who discovered the bacterium that causes it.

It turns out that the medieval image of the leprosy sufferer banging clappers to warn people of his advance is highly misleading. According to Basciano, leprosy bacteria are actually slow to reproduce and not terribly contagious. Ninety-five per cent of the population is naturally immune to the disease. Good hygiene