Kate Bush was a small person in a small town: meek, delicate and, in the recollections of her classmates, annoyingly passive, as reported by Fred Vermorel in his “Secret History of Kate Bush: And the Strange Art of Pop.”

“She was so nice it was ridiculous,” said one.

Another said: “I was jealous of her. So petite and so pretty. A perfect little goody-goody.”

Vermorel quotes Bush saying, “School was a very cruel environment and I was a loner. But I learnt to get hurt and I learnt to cope with it.” One way she coped was by coming home from school and making up songs at the piano. Loner songs. She went inward early on and never came out again.

When Bush was 16, she produced a demo tape with the help of her two musician brothers, Paddy and John Carder, who managed to get the tape, through friends, to Pink Floyd guitarist David Gilmour. Gilmour liked it and passed it on to EMI, which promptly came back to Bush with a remarkable deal: The record company wanted her but didn’t think she was ready yet. So they gave Bush money and three years to “grow up with.” Bankrolled, she dropped out of school and played local shows as the KT Bush Band, with her brothers as backup. She took mime classes and dance, both of which would always be a part of her work; then in 1977 she gave EMI a gigantic hit.

There are probably few things more galling for an established musician than reviewers who hover lovingly around work you did 25 years ago, ignoring or glossing over anything more recent. This has always been Kate Bush’s problem. “The Kick Inside,” her first album, went to the top of the British charts almost immediately, largely based on the success of “Wuthering Heights,” her first No. 1 single and the most commercially successful of her career.

“Wuthering Heights” sounded like nothing else. It seemed to come out of some raging tornado inside her; it growled and screeched and pitched, as Bush/Cathy begs her lover Heathcliff to come join her in death.

Ooh, it gets dark! It gets lonely
On the other side from you …
How could you leave me
when I needed to possess you
I hated you
I loved you too.

Bush has always teetered dangerously at the edge of sentimentality and cliché, and her early songs (what one reviewer called her “soft-focus Victorian melodramas”) could have gone all wrong had her bizarre phrasing not somehow let us know how serious she was.

Bush sang melodramas, but she meant them like truth; those “oohs” aren’t filler. The conviction in her voice, the baldness and great crushing desperation of it, is overpowering. It’s the kind of music that grabs your innards and you turn it up, squint your eyes with the strain of it. Kate Bush was younger than 20 when she wrote “Wuthering Heights.” She couldn’t (and still can’t) read or write music, but she knew how to make a song true, how to up the tension with a key change, repeat the chorus with a hardness in her voice.

She was a prodigy, an 18-year-old who looked 35, with an ethereal voice and a knack for inventive songwriting. She looks, in photos of the time, simultaneously naive and defiant, like someone who doesn’t need other people. Much later in life, when she was asked in an interview with Rolling Stone why she toured so infrequently, Bush replied: “The more I got into presenting things to the world, the further it was taking me away from what I was, which was someone who just used to sit quietly at a piano and sing and play. It became very important to me not to lose sight of that.”

In other words, Bush decided early on that our approval didn’t matter. She was doing this from herself and largely for herself and if people didn’t like her, or if they didn’t understand her, well then, screw them.

She did everything herself, and it shows in the absolute precision of her songs. There’s nothing spontaneous about Bush’s elaborately produced arrangements, from the way she weaves her voice around the Trio Bulgarka, in “Rocket’s Tail” on the sixth album, “The Sensual World” (1989), to the way she mixes in sound effects — street sounds, bird sounds, artillery shots, wind, conversations — in stereo, sometimes barely audibly. There’s a decisiveness here, and more than a touch of the perfectionist. Bush was only 21 when she said to an interviewer from England’s Newcastle Journal: “I’ll always be tough on myself. But I find the strength in being alone, fighting a battle and emerging satisfied that I’ve done my best. Perhaps that’s what is strange about me.”

Kate Bush fan sites commonly and adoringly refer to her “getting her way” about everything from the production of an album to the amount of time she has to produce it, from the look of a video to the image on her album jackets. She’s stingy with interviews (and is said to demand veto power over which photos will accompany the magazine articles) and as a result of this and her insistent aloofness, the interviews that do get published inevitably come off a little dull. One Rolling Stone interviewer described the frustration of trying to get Bush to speak about her personal life: “Try to pin her down on a matter of emotional substance and her expression goes blank, a shutter descends — clunk! — and that’s the end of that.”

Kate Bush wants fame the way Greta Garbo wanted it. She pours her guts out in her music and dance and belts out her words with barely a trace of self-consciousness, but the edges of her private life — her relationship with bass player Del Palmer, with her brothers, the recent birth of her son Bertie — have been airbrushed out to a maddening obscurity. It took Paddy Bush, Kate’s brother and longtime musical collaborator (he’s responsible for bringing world music — the didgeridoo, Bulgarian choruses, Irish jigs — to Bush’s music), to explain her reclusiveness so plainly that you almost like her for it.

“I know this may give her a mystique and make the press all the more curious about her, but that’s not the intention; it’s not a ploy to get her more attention. She genuinely doesn’t see why people should be interested in her personal life and she certainly doesn’t like going out to clubs or trendy restaurants. It’s just not her.”

“It’s the music that says it; it says it eloquently enough,” Kate Bush said in an interview with the Toronto Star. Clunk!

“The Kick Inside” was followed quickly by “Lionheart” in 1978, the cover of which features Bush, her penchant for leotards and bodysuits firmly established, on all fours in a furry catsuit, her hair crimped into a mane. “Lionheart” was followed by “Never Forever” in 1980. If “The Kick Inside” offered Victorian novels and Feminism 101 (“No we never die/We keep bouncing back/Because we’re woman!” she exulted), “Never Forever” went dark, winning Bush her goth audience. She was getting weirder too: On this album cover she’s dressed up as a bat, black lace wings outstretched, tongue way out.

She was still young when she made “Never Forever,” and some of her songs gush with a naive exuberance that’s endearing when it works and saccharine when it doesn’t. She’s crazy for Egypt (“Oh, I’m in love with Egypt!”), the violin (“Get the bow going, let it scream to me!”). But it’s the last song on the album, one called “Breathing,” that really brings out Bush at her hugest, most theatrical, over-the-top best.

On “Breathing” she pulls no punches. Her telling of nuclear holocaust starts right at the moment of death, at the last gasp. “Chips of plutonium are twinkling in every lung,” she sings with so much anguish that it works. It’s one of the only truly scary songs I know.

What are we going to do without
Ooh, please, let me breathe
Quick, breathe in deep
Leave us something to breathe
We are all going to die

The drastic scale of this song, the way it ends — a single synthesized thud signaling some kind of global death knell — would be a little, well, silly if it weren’t so convincing. Possessed of a confidence so strong, and a sense of self-importance so grave, Bush attacks that song like it’s the last one she’ll ever sing. You could laugh at her, but it would be like laughing at a monk; how do you argue with someone whose conviction is that strong? Can you help finding yourself just a little converted?

It wasn’t until “Hounds of Love” (1985), Bush’s fifth album, that she finally became well known in the United States. Even with the success of that album, she’s better known here as an influence for a generation of young female singer-songwriters such as Jewel, Tori Amos and k.d. lang. “Hounds of Love” was big, but Bush’s U.S. fame never matched what she’d had in England.

It may be that by the time Americans became aware of Kate Bush we’d already decided we liked our women tough. Patti Smith bared her armpit hair on the cover of “Easter” and wore her androgyny like a badge. Debbie Harry pouted and strutted, and Pat Benatar scowled. When Kate Bush looked at us, if she looked at us, she did so blankly, without insult or invitation. She didn’t bother to provoke.

When female American pop stars weren’t tough, they were languid and sexy, two things Kate Bush could never be, and she sounded forced whenever she tried. The early EMI photos do their damnedest to crank up the sex appeal, but there’s something a little cold about them, as if she’s holding back. Kate Bush is beautiful, but at heart, you sense, she never stopped being that overeager girl in drama class, the one with the guitar and the black turtlenecks.

Bush was never funny enough, either. Describing her youth, she once recalled, “I was aware of a lot of my friends being into things I wasn’t into. Like sarcasm. It had never been a part of my family — they still don’t use sarcasm.” That kind of sobriety is what allows Bush to pull off songs like “Breathing,” but sometimes, particularly in her recent work, you want her to take herself a little less seriously.

Bush’s latest album is not very recent; it came out in 1993. “The Red Shoes” was based on the Hans Christian Andersen story about the girl who puts on a magic pair of slippers and finds herself unable to stop dancing. Like “Wuthering Heights,” this is perfect Kate Bush material. It’s got magic and dancing and tragedy, and the vaguely sinister mood that permeates so much of her music.

Bush could have toured “The Red Shoes.” Fans are still awaiting a follow-up to her only tour, in 1979 — an elaborately choreographed costume extravaganza that necessitated the invention of the first microphone headset. But she chose to make a movie instead, opting for the contained and controllable over the interactive, and called it “The Line, the Cross and the Curve.” Like her albums, the video was a Bush-only affair, with Kate singing, dancing, acting (along with Miranda Richardson and others), directing and presiding over the production.

It wasn’t disastrous: Bush’s fans are tuned in to the Kate Bush sensibility, and the thick symbolism of it fits an aesthetic she’s been developing all along. She made a film that’s as laden with emotion and meaning as anything else she’s done, but she’s like someone remembering a dream she had the night before; Bush gets so lost in the story that she forgets whom she’s talking to. She leaves her audience behind.

“It’s not important to me that people understand me,” Bush said in an interview after the film’s release. And thank God for that. Bush may have lost us with “The Red Shoes” and “The Line, the Cross and the Curve,” but it wasn’t the first time she’d taken the chance. She took us to the apocalypse, after all, and if she’d been too concerned with what we’d think of her for that, she never would have made the trip.

Some of the deletions were accidental but others were not, says Dori Allman, a Lycos spokesperson. “We were in the process of removing sites that were in clear violation of our terms of service and, inadvertently, there were other sites which were also removed and should not have been.” Allman wouldn’t be specific about why Lycos had shuttered the sites, saying only that “the sites that were removed on purpose were in some way in violation of our terms of service.”

Aggrieved Tripod community members say, however, that the real problem isn’t Tripod’s technical glitch — it’s Tripod’s terms of service. As one fan site manager who calls herself Nestra says, “The problem is that the terms of service agreements are intentionally worded very broadly to allow Tripod/Lycos to delete anything they feel like.” Add to that the site’s policy of giving no advance notice to managers of violating sites, and the result is not quite the egalitarian community that companies like Lycos and Geocities boast of.

Writers of fan fiction — the practice of penning unofficial scripts and stories based on commercially copyrighted characters — have had to deal with accusations of intellectual property violations before. One fan site manager, Bridget O’Donohue, says that the deletion of fan sites is a huge problem. “The Web is where a lot of us get together to display and share our love for particular fandoms. When [the sites] are unceremoniously destroyed, well, it leads to large amounts of resentment and makes it difficult to share our mutual admiration for a fandom.”

Copyright violations are probably the explanation for some of the fan site deletions. But what to make of the sudden demise of the Malaysian opposition sites? While Allman did say that Tripod has had no direct communication with the Malaysian government on the issue, she refused comment on whether the political sites were shut down intentionally.

Malaysian site readers have been lobbying Lycos executive chairman Joachim Agut for an explanation since Saturday, and still don’t know what’s going on. “It is believed that the government will be communicating with many more Web site operators or hosts in an attempt to close down all the anti-government Web sites,” read one letter from an opposition group to Agut. “We write this letter to appeal to you not to buckle under the Malaysian government’s pressure.”

One Malaysian protest site frequenter, Anoop Krishnan, says that the Malaysian government has long been critical of these sites. “The government had made it clear in the official government-owned newspapers that these Web sites — which were the only source of real news — were the work of ‘subversive’ elements and had to be shut down.”

But at Lycos, mum continues to be the word. All Allman would say is that the managers of sites that were deleted as a result of the company’s “technical difficulty” will get a personal e-mail from the company by the end of the week, and their sites will be reinstated soon.

But Wyeth-Ayerst dropped out of the market, leaving the medical community with a situation one doctor described as “a real problem” and another as “frightening.” A vaccination required by law in 47 states is now in the hands of only one major company — Aventis. And for the next 11 months, the amount of time it’ll take Aventis to get up to speed, there’s a good chance that if you ask your doctor for a booster shot, you’ll be told to wait until next year.

American schoolchildren receive vaccines for tetanus, as well as measles, mumps, rubella, polio, meningitis and chicken pox. Getting your shots is a ritual as basic to American childhood as the Sunday comics. And most Americans, if they think about these medicines at all, probably assume that the government manufactures them or controls their supply. But the government got out of the business long ago, turning it over to more efficient private companies. The problem is that the vaccine business offers very low profit margins — in large part because of well-meaning but hopelessly outdated price controls — and if private manufacturers decide they’re not making enough money and decide to get out, there’s nothing to stop them.

The result is a looming public health crisis — the first manifestation of which appeared last month, when the four companies producing a strain of flu vaccine all fell victim to manufacturing problems, causing widespread shortages. Like the flu vaccine shortage, the Wyeth-Ayerst affair is a case study of what can go wrong — and will continue to go wrong — in the vaccine industry.

Wyeth-Ayerst, which has already faced major embarrassment in the marketing of the diet drug fen-phen and other drugs, abandoned its tetanus vaccine production not long after the Food and Drug Administration slapped a major fine on it and asked it to improve conditions in its manufacturing plants. Wyeth, answering to its stockholders like any other private company, said good riddance — and as a result, lockjaw may be poised for a comeback.

“Every 10 years we need boosters because immunity begins to wane,” says Dr. Larry Pickering, a pediatrician with the Centers for Disease Control and Prevention’s vaccine program. “The organism is still in the environment and if you don’t get those boosters, [and if you] are exposed to it, like in a cut, without a proper inoculant, people will begin to develop it, and we will start to see more cases.”

About 45 people develop tetanus each year, with older patients, who are less likely to be up to date on their booster shots, making up the bulk of the cases. On Jan. 5, an Associated Press story described the case of an 80-year-old woman named Fern Turner who developed tetanus from an infected spider bite. Turner spent 53 days in an intensive care unit with muscle spasms and a locked jaw, but she lived. The mortality rate for elderly tetanus suffers is over 50 percent.

Pickering can’t say how many cases of tetanus we can expect to see as a result of the shortage; no one can, which makes it hard to find an impending public health disaster to rally around. Dr. Yvonne Maldonado, a member of the National Vaccine Advisory Committee, comes a little closer, but not much: “We’re pretty sure that we would have all these diseases if we didn’t vaccinate, but we can’t prove it. Science doesn’t prove negatives.”

Doctors can’t say how much of a danger the tetanus vaccine shortage could be, but they can tell you that it points to a larger problem: The fewer sources we have for these crucial drugs, the more vulnerable the supply becomes and the more we put ourselves at risk for diseases most of us forgot existed.

Tetanus is one of those diseases whose onset is marked by symptoms so mild they’re almost sinister: fatigue, soreness, irritability. A few days later, when the patient notices a stiffness around the jaw, and a labored breathing, it’s often too late. As swallowing becomes difficult, the mouth fuses shut while the rest of the body is racked with muscle spasms so severe that a patient can break his or her bones.

You don’t quickly forget photos of tetanus patients, their faces frozen into something that would look like a smirk — eyebrows raised, the corners of the mouth turned up into a smile — if it didn’t give off the distinct impression of a physical prison; tetanus patients look, literally, trapped in their own faces. Later, their bodies become fortresses too; tetanus stiffens the entire body into positions you wouldn’t want to spend five minutes in. One photo shows a man bent backward into a crescent moon shape; another has a child’s arms bent up at the elbows, like a boxer getting ready to punch, but immobile. The people in these photos look scared.

Dr. William Muraskin, author of “The Politics of International Health” and assistant chairman of graduate studies at Queens College, says, “If you have tetanus, you die.” He’s exaggerating, but not by a lot: In developed nations, about two-thirds of those infected with tetanus die, with those who catch the illness quickly more likely to survive. Recovery for tetanus can take months, during which time the patient is treated with a medical arsenal that’s almost as scary as the disease itself: muscle relaxants, or medically induced temporary paralysis, weeks spent isolated in dark, silent rooms intended to reduce stimulation to the nervous system.

Tetanus is scary, but when you’re a pharmaceutical company, it’s the vaccine business that causes nightmares. In 1999, Wyeth-Ayerst caused a stir when it had to withdraw its rotavirus vaccine from the market, after an intense ad campaign and widespread usage. Rotavirus, a diarrhea-like sickness common among young children, is potentially deadly, but so, it turned out, was the vaccine, which caused bowel obstructions in dozens of children. The incident was particularly embarrassing to the FDA, which had approved the drug only a year before, officially recommended it to all children in the United States and then proceeded to vaccinate (according to a New York Times article on the withdrawal) 1 million 2-, 4- and 6-month-olds. Add to that the well-publicized recall of Wyeth-Ayerst’s notorious diet drug, fen-phen (which was found to cause heart problems and cost the company $3.7 billion in damages), and you have a company justifiably wary of vaccine scandals.

The company doesn’t cite earlier problems with its decision to drop the tetanus vaccine. Wyeth-Ayerst spokesman Doug Petkus won’t say much beyond “We periodically evaluate our portfolio to see how we can better and more efficiently allocate our resources.”

But Wyeth-Ayerst’s announcement of its decision came just seven months after Justice Department officials entered the Wyeth-Ayerst warehouse in Venore, Tenn., on orders from the FDA to seize thousands of wrapped, ready-to-go syringes of tetanus/diphtheria vaccine and other drugs.

Such seizures are not uncommon, and in this case, the move came after a series of FDA warnings to Wyeth-Ayerst regarding the company’s production of tetanus vaccines and other drugs. The paperwork around this event is a fax-machine hazard — blurry, 25-page documents blotted with ink spots to cover classified information — but it’s possible to make out the FDA’s charge. It wasn’t Wyeth-Ayerst’s vaccines that were found to be at fault, it was the packaging.

“Vials [found at Wyeth-Ayerst's manufacturing plant in Marietta, Pa.] had defects ranging from a slight ‘nicking’ to a complete ‘chipping’ around vial rim surfaces that present a potentially critical defect which cannot be unsuspected out following filling and capping.”

FDA documents suggest that the company had been warned in the past about possible sanitation issues. However, Petkus, who spoke on behalf of the company at the time of the seizure, says that the FDA’s complaints “referred in many cases to paperwork” and that beyond that, well, we’ll have to ask the FDA. “Seizure is a process the FDA has at its disposal,” he said, three times, “to indicate FDA is serious about its inspections.” When asked about this seizure, and about the charges that vials containing the tetanus vaccine weren’t meeting FDA standards, Petkus said, “That’s not my recollection.” Possibly, he suggested, the FDA seizures were a “symbolic gesture” of the agency’s determination to be stringent with recently upgraded regulations.

Whether the FDA got what it came for is another question.

The FDA’s seizure of tetanus vaccine from the Venore warehouse was reported in a handful of periodicals (some of which quoted Petkus as the company spokesman) and initial phone conversations with the FDA confirmed it — which is why it came as something of a surprise when an FDA spokesperson (who declined to be named in this piece) called to say that, in fact, she’d been wrong about the seizure of tetanus vaccines from the warehouse; the FDA never seized any tetanus vaccine at all, she said.

“The FDA did not find [the tetanus vaccine] at the warehouse. They only seized products that were there and there was no tetanus toxoid in the warehouse. Intending to [seize the tetanus vaccine] — if it was there — and doing it are two different things.”

Wyeth-Ayerst has a different account. “The seizure took place on June 15 and involved several injectable products,” reads Petkus from Wyeth-Ayerst’s report on the seizure. “The products involved were phenergan [a muscle relaxant], diphenhydramine and dimenhydrinate [both antihistamines] and tetanus/diphtheria vaccine”

In the FDA’s telling, the vials of tetanus vaccines were presumably released into the marketplace; according to Wyeth-Ayerst, they never got that far. Both make a point of saying that the vaccines — released or not — were never a risk to public health. But the seizure, and the inspections that preceded it, were enough to convince the FDA that Wyeth-Ayerst would have to make some changes in its manufacturing process.

In October, the FDA and Wyeth-Ayerst hammered out a consent decree detailing Wyeth-Ayerst’s agreement to bring its plant up to FDA standards and, importantly, levying a $30 million fine on the company. Three months later, Wyeth-Ayerst announced that it was getting out of the tetanus business altogether.

Wyeth-Ayerst won’t explain why the company halted tetanus production, except to note, again, the process of portfolio review. But it’s easy to come to at least one conclusion: Wyeth-Ayerst dropped out of the tetanus business, leaving a shortage, because making tetanus was bad business for it. The FDA demanded changes, and levied a fine, and presumably, that didn’t bode well for Wyeth-Ayerst’s profit margin. As a public company, it answered to the only people to whom it is obligated: stockholders.

According to Bob Snyder, a public health advisor for the CDC, there’s a conflict of interest at the heart of the tetanus shortage, and the vaccine industry in general, that keeps vaccines in short supply. “They’re a private company; they’re not a philanthropy. Can we really force them to stay in business for products they don’t feel confident about producing? Do we really want to use a product from a company we’re forcing to make it?”

But why is the vaccine business so unprofitable?

For starters, old-fashioned vaccines like tetanus have traditionally sold cheap.

“Vaccines are expensive to make, expensive to do research and development on, and yet the return is very low, and the stringency of monitoring vaccine production is very expensive,” says Stanford’s Yvonne Maldonado, who sits on Wyeth-Ayerst’s advisory board.

Vaccine manufacturing is one of the few industries in which having a monopoly on a product doesn’t guarantee limitless price inflation. Sixty percent of the tetanus vaccine is bought by a single client: the CDC, which in turn supplies the vaccine to low-income and Native American children, Medicaid patients and the uninsured. The CDC needs the vaccine, but in a perfect example of well-meaning legislation gone all wrong, it is forbidden by law to pay market price.

Says Snyder, “When I put the bid out on the street for this product, nobody came. Nobody sent a bid in. They said, ‘You’ve got to raise your price.’ And my problem is, I’ve got legislation which says I can’t raise the price.”

The legislation at fault is the Vaccines for Children Program, which was established in 1994 to help the CDC distribute vaccines to families that otherwise couldn’t afford them. The program met an important need, but it also stipulated that the price on those vaccines could only rise in accordance with the Consumer Price Index. When vaccine producers started raising prices (in response, in part, to tightening FDA regulations) the cost of the tetanus vaccine went up and the CDC found itself unable to afford it. That same year the agency exhausted its tetanus stockpile.

Changing the price cap would mean bringing the Vaccines for Children Program back to Congress, something the CDC is loathe to do. “Congress has to change the law,” says Snyder, “and that’s fraught with other problems. Once you open a law up, anything can happen. So we’re in a quandary: Do we go back and risk having them appeal the whole program?”

From a dollars-and-cents point of view, vaccines are losers: People who take them don’t get sick. People who suffer from heart trouble will continue to medicate five or six times a day, and a diabetes patient, says Maldonado, “will be on drugs for the rest of his life.” But most of us will only come back for tetanus vaccines a couple of times before we die. The vaccine seems to be working, so — to the dismay of the vaccine producers, and to our own minor health risk — we forget about it.

Another disincentive for vaccine manufacturers is the anti-vaccine lobby. Thanks, in part, to a powerful campaign linking childhood tetanus vaccinations and autism, vaccine opponents have succeeded in raising the price of those vaccines to consumers, via the Vaccine Compensation Program.

Established in 1988, the program imposes, for every dose of vaccine bought, a preemptive payment for potential damages caused by that vaccine. Pay $7.50 for a dose of tetanus vaccine, and you’re putting $1.50 into the Vaccine Compensation Program Fund, which doles out money to those claiming adverse reaction to the vaccines (required by law for children). The goal is to give the producers a little breathing room and to encourage the production of vaccines with a diminished threat of lawsuits. But, in effect, what the program does is raise the prices of vaccines, forcing manufacturers to charge more for them. Again, what’s intended to help is only exacerbating the problem.

Those who are trying to provide tetanus vaccine are, in Snyder’s words, caught “between the devil and the deep blue sea.”

The CDC can’t force a company to stay in the vaccine market, but in the event of a public health crisis (which tetanus is unlikely to pose), they could step in and offer to subsidize production of an unprofitable product. Indeed, those kind of subsidies may be in the works — an arrangement the CDC’s Larry Pickering hints at when he says “We have to work together to ensure a safe, effective vaccine supply.” Still, that kind of cooperation between a private company and a government agency raises prickly issues: How much profit, for instance, should the CDC guarantee private companies from the sale of legally mandated vaccines?

The sentiment among many doctors and public health officials is that until we face a major outbreak of something preventable, like tetanus or measles, we aren’t going to see any meaningful changes in how the drugs get made and sold. “The bottom line is this is gonna have to fail,” says Dr. Maldonado. “There’ll have to be some cracks in the dike before we can fix this.” It may be that before we can secure the supply of vaccines against the diseases that threaten us, we’ll have to start getting sick first.

For reasons that are clear, and others that aren’t, life makes us want to empty ourselves and be filled up with something we cannot see.

We’re sophisticated and busy. We make movies, fly in airplanes, build microscopes. We work, invent, play, mingle, become inspired; we have love affairs, heartbreaks, families and friends. Yet, we suffer from the lurking sensation that something is missing. Americans labor hard and long to fulfill dreams of acquisition, comfort, material success, and then, once a week or more, a full 44 percent of us turn away from all we’ve amassed and toward something whose existence we take on faith alone.

Americans are religious people. According to U.S. News & World Report, 96 percent of us believe in God. Fifty-four percent attend church at least once a week — more than in any other industrialized country. And though common wisdom holds that poor nations tend to be more God-fearing than rich ones, the correlation between wealth and religion does not hold true in the U.S.: College-educated Americans are as likely to participate in organized religion as those without a high school diploma; and there’s only a one percentage point variation between those who earn less than $10,000 a year and those whose salaries exceed $60,000. American churches may be segregated, their dogmas incompatible, but Americans’ eagerness to take a leap of faith is something the vast majority have in common.

And so we keep hearing about religion. This month’s presidential election, like nearly every one in recent decades, brought us two candidates determined to win our faithful hearts, and in the process, our votes. Tiptoeing across America’s love/hate relationship with the intersection of religion and politics, George W. Bush and Al Gore struggled to paint themselves as among the faithful, without having to offer too many details about what, exactly, that means. And, for the most part, no one asked.

Apparently, abstraction works — the less precise candidates are about the nature of their faith, the easier it is for us to count them among our own. According to a 1996 Gallup poll, 82 percent of Americans think that, despite their religious differences, Jews and Christians share the same basic moral values. So what’s the other part that makes up religion? Why do so few people talk about it, and how much does it matter to us?

If religion is the pursuit of God or of some greater meaning beyond our everyday selves, do we ever find what we’re looking for?

All over the world, people continue to seek this higher understanding — God, enlightenment — through diverse means, including the oldest route to transcendence, monasticism. Christianity — the faith claimed by 85 percent of Americans — has its own surviving austerities. Carmelite nuns take vows of prayer, penance, abstinence and seclusion. They renounce ownership, as well as contact with the outside world, and divide their day between prayer and manual labor. Discomfort, the theory goes, forces us to look beyond ourselves and rewards some with enlightenment.

But monastic traditions have long been on the decline. According to a 1997 Los Angeles Times survey, only 3 percent of American nuns are less than 40 years old, and enrollment in seminaries dropped from 45,000 in 1965 to 7,000 in 1990. In some places, Eastern religious traditions — Buddhism, in particular — have provided contemplative order for those who might have sought cloistered lives in Catholic institutions 40 years ago, but overall, Americans are turning down whatever offers exist to give up worldly concerns in search of direct experience of their faith.

We may not have it in us anymore — or at least fewer of us may be willing to make the sacrifice. Ours, after all, is a national myth based on the acquisition of comfort and material success; what surer way to avoid the American Dream than joining a monastery? So, Americans bring religion down to earth. If there’s a common theme to be found among American religious traditions, it’s an emphasis on family, community and ethics. Suddenly, we have more in common than we thought: So what if you take communion while I turn toward Mecca — we both agree it’s wrong to commit adultery, right?

Religion is, among other things, a rule book that people show their children. While statistically, wealth and education count little in determining who among us believes in God, what does matter is family. Single, childless adults are more than twice as likely to describe themselves as religiously indifferent than are married adults with children. For many, religion is less a solitary pursuit than a guidance system for family life and, in turn, a template for social responsibility.

The religion of values may provide a useful lingua franca, but it feels incomplete. Take, for example, Americans’ reaction to the prospect of an Orthodox Jew for vice president. Sen. Joseph Lieberman’s faith struck many as mysterious at first; it began winning favor only once it was translated into a set of values. At a pre-election press conference at the University of Notre Dame, Lieberman bemoaned the fact that religious indifference in America has made it more difficult for us to find our way out of such seemingly intractable ethical quagmires as “Why is it wrong to lie or cheat or steal?”

Is that really what his religion is for? Does he — does anyone — need religious doctrine to answer those questions? If so, religion is considerably less complex than we might have thought. Lieberman’s faith, translated into campaign speak, lulls us right back to the Christian values espoused by Presidents Clinton, Reagan and Carter and generations of American politicians.

Religion in America, for the most part, seems neither mystical nor remote. It has to do with notions of how a society should behave. And, in doing so, it contains a germ of something momentous: If religious Americans made from their faiths a movement of volunteerism, community activism and greater kindness, ours would be a very different country.

Mormons are, in number and in popular opinion, a religious minority, but of the American religious groups, theirs may come closest to such a commitment. By obligating every young member to undertake two years of missionary service, the Church of Jesus Christ of Latter-day Saints builds the duty of working for the community (in this case, the church) into the meaning of being a Mormon. But the value of that time hinges on your view of the goal of evangelizing the world. Americans sing the praises of those whose religious beliefs are made manifest in altruism, but only a minority follow their lead. Still, the groundwork is laid.

Religion, in the best American sense, gives us a way to treat one another, to behave during our time on Earth. The gray area where Americans religions overlap — the values that have come to symbolize religion itself for so many people — could, if we let them, provide a blueprint for altruism. And even if that’s as close to transcendence as religious Americans get, faith alone can still hold the promise of the otherworldly, of hope, of an answer.

Now a psychologist at Southwest Missouri State University, Cox recently conducted a study of 203 women in an effort to get to the bottom of that enduring mystery of her youth: Are women who suppress their anger more likely to feel ineffective, powerless — less “instrumental,” in her words — than those who don’t?

The results surprised her, and they also pointed to a puzzling discrepancy between women’s health and happiness: Many women who withhold anger nevertheless described themselves as effective, successful and assertive.

At a recent Congress on Women’s Health in San Francisco, Cox and six other women gathered to present their findings from recent studies on women and anger. The presentations began with the results of another, broader study on anger, led by psychologist Sandra Thomas of the University of Tennessee. A few years ago, Thomas polled 535 women in an effort to determine what those of the gentle sex do when they’re mad. And, like the women from Cox’s hometown, it turns out that most of us hold it in.

Said one 21-year-old female in the Thomas study: “I don’t think that a lot of us feel worthy of being angry. We want peace more than we want to actually express our anger and have somebody have to deal with it. It’s a lot easier just to suppress it and not make anybody unhappy.”

In psychologist-speak, this means that most women fit an “Anger/In” profile. Many studies on anger (including Cox’s and Thomas’, although both also used focus group discussions) draw heavily from a multiple-choice test designed to deliver “Anger/In, Anger/Out” scores. Responses to these questions place subjects along a continuum between, as you’d expect, those who display their anger and those who suppress it. Loosely speaking, this boils down to something like the venters and the martyrs, those who don’t hesitate to let the world know when they’re displeased and those who say “I’m fine, really” while they fume silently inside. A final group of questions identifies the physical manifestations of an anger behavior that isn’t working.

Most women will buck at the characterization, but statistics bear it out. Women are more likely to deny their rage than men are. And really, this should come as little surprise. There are words for an angry woman — bitch, shrew, nag — and acting the part of Anger/In is in keeping with traditional notions of femininity. As Thomas points out, “Women’s anger does not conform to the feminine ideal of the selfless, ever-nurturing, perfect mother.”

In Cox’s and Thomas’ surveys, many female subjects described feeling embarrassed and debilitated by their fury. In one conversation Cox quotes in “Women’s Anger,” a book she co-wrote, a researcher asks a group of girls: “What do you look like when you’re angry?” “Ugly,” the girls reply. Another subject ignores her anger like bad advice: “I keep everything to myself because I know that when I explode, I say things I regret later. I just keep everything to myself.”

But if women have been socialized to suppress anger, is doing so keeping them from getting what they want?

It’s here that Cox steps in, sealed envelope with her results in hand, and awaits her cue. If all women fit the mold of those Southern women of her youth, Cox would expect to find a correlation between Anger/In women and those who felt ineffective, unlikely to succeed.

Cox’s results tell a different story. Though most women fit the Anger/In profile, many of them also described a strong sense of instrumentality. Here she found a clear distinction along gender lines. Men who fit the Anger/In profile typically felt ineffective; they lacked assertion. Among men, anger fueled action. In contrast, the Anger/In women often anticipated success in their lives. Given the limited scope and size of the study, Cox’s results must be considered tentative. Still, it appears that the Anger/In women felt that their voices were heard just as often as the Anger/Out women.

One shortcoming of Anger/In, Anger/Out questionnaires is that they don’t give respondents much of an opportunity to explain what, exactly, they do with their anger. For example, a woman who both “takes it out on others” and “talks to a friend or relative” would be described as an Anger/Out/Discussion personality, even though she may never direct her anger to its source. As a result, speculation about how women deal with their anger is just that. In Cox’s educated guess, “Maybe they tell someone else besides the target of their anger, maybe they just chomp down on it, keep quiet and find an indirect way to make some kind of change.”

But is giving your husband the silent treatment — even if it works — really a healthy way to effect change in a marriage? Earlier research shows that keeping it all inside can put women at a health risk.

From a scientific perspective, anger is just one way that people experience stress. In order to test the physiological strains of stress, researchers subjected participants to (among other things) a series of timed math problems. Bombarded by 7s and 13s, the subjects unconsciously readied themselves for escape, releasing a dose of adrenaline, which in turn caused blood vessels to constrict as their heart rate and blood pressure increased.

Now this may be just the jolt that saved ancient man from the woolly mammoth attack, but over time, that kind of repeated physiological call to action takes its toll. In 1998, a 10-year study led by Dr. Karen Matthews at the University of Pittsburgh School of Medicine found that women who scored high on Anger/In tests were more likely to exhibit early signs of heart disease.

One can’t help wondering whether these are the same kinds of women we met in Cox’s study, the women who — despite their tendency to suppress anger — felt they were doing pretty well in the world. Considered jointly, the two studies leave us with incongruous notions of mental and physical health: What works for one can be disastrous for the other. So what’s a woman to do?

For vast numbers of women, the answer lies not within scientific discourse, but in the abundance of therapist-written self-help books that address the subject of women and anger. After all, the selling premise of self-help books is that they provide answers, not questions. And for the women who continue to struggle with their anger, this is surely a comfort.

It may also be a comfort that self-help advice on the subject of anger is not exactly revolutionary. Harriet Lerner, author of one of the most popular of these books, “The Dance of Anger,” cautions women to temper their anger with reason, to “strike while the iron is not hot” and to “get creative in problem-solving.” Like most common wisdom, there’s truth in it.

In fact, this is just the kind of advice that you’ll hear from researchers, once they turn their attention away from statistical analysis and multiple-choice questions. Despite the contradiction in their findings, both Cox and Matthews conclude (to quote Matthews): “It may be best to express negative feelings in a constructive fashion [rather] than to hold them in.” Women will find solace and physical health neither in Anger/In nor in Anger/Out but through direct, honest communication with the target of their frustration.

When statistics leave us scratching our heads, common sense provides the answer. Reflecting back upon her findings, Cox’s words take on a tone that’s more therapeutic than scientific.

“We hear women so often talking about not wanting to make a decision when they’re angry. And I have some serious doubts about anger diminishing our ability to think, if being really angry doesn’t help us get very clear about what we need. The more angry we are, I think sometimes, the more we see.”