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Sunday, 22 April 2012

Science Fiction and Medicine


William stared at his hand, curled his fingers, watched supple skin stretch taut over fresh knuckles. It felt so fragile after Q’Roth armoured flesh. His arms, however, still had the appearance of corrugated iron, blue-grey from shoulder to wrist, petering out into tan hands. Good enough. He held his breath as he pulled the sheet off to reveal his new legs. A metallic blue sheen glistened over powerful, hairless musculature, tailing off in sturdy feet with five toes, all of them prehensile.

The above is an excerpt from Eden’s Revenge, by no means the first (or last) science fiction book or film to consider the possibilities with medical advances. While few science fiction books are uniquely focused on health, many have this as a background thread, including how it affects society. So, why the obsession with medicine?

Science fiction explores our hopes and fears, and the possibilities in between. All of us sooner or later experience sickness or injury, and many of us lose loved ones or friends along the way; mortality is part of being human. So the idea that a particular disease could be cured, a prosthetic limb re-grown, or our life expectancy (and youthfulness) extended, is attractive. But usually science fiction imposes a personal or societal cost on such boons – like the proverbial deal with the Devil: you know that somewhere down the line, there’s going to be a cost.

My favourite SciFi medicine-related aliens are the Vidians from Star Trek Voyager, a race with a horrendous disease, whose only means of survival is to steal organs from other races, including humans. I was fascinated by their plight, wonderfully brought out in successive episodes of Voyager, where at first they are depicted as despicable criminals, and only later are their other attributes (e.g. incredible medical prowess) discovered.

In the (brilliant, if violent) SF book Altered Carbon (Richard Morgan) people can cheat death – if they can afford it – by having back-up copies of themselves inserted into new bodies (called 'sleeves'). Morgan explored the downsides of effectively living forever, with what he termed the Methuselah complex, where incredibly old but young-bodied people basically get bored, ever seeking new and more perverse thrills.

In Peter F. Hamilton’s equally compelling (and violent) Mindstar Rising, the hero can ‘gland’ substances at will to affect his capabilities. I borrowed this for my short story ‘Executive Decision’, wherein the heroine secretes various synthetic hormones whilst trying to mitigate the fall-out from an alien weapon (the cost for her is very high in the story).

Most science fiction, however, doesn’t delve too deeply into the medical science itself, just what it can do. Thus, futuristic hospitals are usually displayed in film and TV as swanky affairs, bright white or pastel shades with superb beds and definitely no needles (hypo-sprays being the Star Trek surgical implement of choice). In the book I’m currently writing, I wanted to do something a bit different in terms of ‘hospitals’, and make them more alien. Let’s return to William’s bedside for a moment, after his operation to make him human again…

He lay back on the pillow, inspecting the stars through windows on the domed roof. The vast hangar containing him and other alien patients was so strange that at first he thought his eye surgery had gone awry. Swathes of colour – violet, red, teal, and apple, swirled in the air as far as he could see, never mixing. Each layer was grainy, with fine particles that moved like sand beneath a wave, shifting and flowing, occasionally surging from one spot to another. The ‘air’ around him was teal. It had no taste or texture, and he had no idea of its function. The surgeons – squid-shaped creatures, transparent so that he could see all their organs and watch their two hearts twitch – drifted and surfed in the currents. When they had worked on him it had felt like a feather-touch, even when they had peeled back his armoured ribcage as if it were made of paper. He’d expected terrible pain when the anaesthetic wore off, but there was none at all, not even an itch.
One of the squids had gurgled to him in Largyl 6. “Sure want this? Q’Roth physiology beautiful design – human arrangement flimsy.”
            William told the squid it was necessary for political reasons. The surgeon made a strange gulping motion, then got back to work. Afterwards, the squid whispered that it understood, and had added some refinements to make life in a human body more bearable. William wondered what those might be, but no surgeons had approached him again since the operation, several hours ago.
He guessed the various coloured layers were for different patient species on the hospital ship, run by the Level Ten Ngankfshtra – he could no longer pronounce it properly with a human tongue – and that the swirling sediment had multiple purposes including bio-containment, regeneration, sterilisation, and monitoring of recovery progress and health parameters. Infinitely better than the last time he’d been in hospital, though he did miss having human nurses around.

Star Trek considered numerous medical angles and their attendant moral dilemmas, from episodes in the original series, which had, for example, a race without disease and a chronic over-population problem, so they used Captain Kirk to incubate a fatal disease. In Deep Space Nine the 'Dominion' inflicted an incurable and painful disease on a population as a control and punishment mechanism, and even the legendary Julian Bashir couldn’t cure it, the only solution being euthanasia in its final stages.

Another Scifi ‘trope’ is disease we might inflict on ourselves, due to accidental release of experimental medicinal substances that could kill tens of millions. This possibility is unfortunately closer to fact than science fiction, as some advanced medical labs do study highly virulent flu strains in order to try and create vaccines. This prospect has led to TV series such as BBC’s ‘Survivors’, where less than one per cent of the population survives such an outbreak. In my first book, The Eden Paradox, I assumed this will happen sometime in the next few decades, though I chose a nano-plague (via a release of invasive airborne nannites from a nanotech research lab) rather than a flu virus (and yes, nannites are currently being developed in certain labs around the world). Michael Crichton also explored this possibility in his book Prey, and of course his original smash hit book and film, The Andromeda Strain.

In my second book, Eden’s Trial, I had an alien race entirely bred to serve as the galaxy’s doctors. The Ossyrians have a Hippocratic oath but, given that the galaxy is also something of a jungle with predators wishing to use medicine as bio-weapons, they have to be capable of defending themselves and their technology. The following excerpt from Eden’s Trial shows how they react to such attempted theft while they are trying to purge the local population of a disease. The scene is seen through the eyes of two humans, Kat and Pierre, who are onboard one of a number of Ossyrian ships in orbit around the infected planet.


Kat watched from the viewport of their small pyramid that had detached from the mother ship. The huge silver ball shed pyramids like crystal snowflakes falling from orbit towards the yellow-green planet below. Despite herself, she was impressed by these Ossyrians, and relieved that compassion wasn’t a uniquely human trait. She felt Pierre’s hand touch hers, tentative, unsure. She took it, wrapped her fingers around his, and squeezed. She would lose him, sooner or later. Sooner, she decided. She let go.         

She stepped away from the portal and glanced at their upright dog-like Ossyrian minder Chahat-Me, who was maybe looking at them both, maybe not – it was impossible to tell with the Ossyrian’s quicksilver eyes. Kat sat cross-legged in front of the Hohash mirror. It displayed data on the progress of the medical mission as she’d requested. She’d studied epidemiology at University, and was interested to see how much more advanced this race was at dealing with pandemics.
            The Hohash entertained a number of vistas and displays with fuzzy maroon borders: some were actual pictures relayed from the surface. One showed the Ossyrians in golden encounter suits which she presumed served as protection against the plague, either for themselves or to prevent them from becoming carriers. They streamed out, administering equipment and drugs. Some Ossyrians were on foot, others on amber sleds that skimmed the surface as smoothly as an ice skater on a frozen lake.
Another vista showed Ossyrian pyramids, slowly spinning, traversing the landscape at low level, dispersing a colourless haze over the landscape. However, she was drawn to one particular data screen illustrating circular pictograms of the spread and density of the affected areas: concentric circles radiating out from an obvious epicentre. Three-dimensional graphs, like mountain ranges, showed intensity of the plague as a function of the region, and time since it had started. As she stared at it, she knew something wasn’t right.
It looked perfectly normal, exactly what she’d expect from her knowledge and understanding of epidemiological incursions; a textbook case. She studied it harder. It was a classic example. Too classic. She stood up and grabbed the Ossyrian’s shoulder.
“It’s a trap. It’s so perfect an example of plague radiation, so classic a mixture of randomness and single node origin that it has to be false. Someone has lured you here.”
Chahat-Me’s mercurial eyes danced.
“What’s she saying, Pierre?” Kat couldn’t yet interpret the Ossyrian ‘eye language.’
He moved side to side with her. “I don’t know, it’s too fast, too complex, or both. I think she’s communicating with the others, rather than us.”
Kat supposed he was right – their Ossyrian guardian had that look of being elsewhere, as far as she could tell. Abruptly, as Kat looked on, fascinated by the shapes in its eyes forming and collapsing at almost subliminal speeds, the eyes settled down, then appeared flat. But she wasn’t prepared for what happened next. Chahat-Me held out her two arms, and each one split into two thinner ones, peeling apart as if they had only been lightly stuck together, all the way to the armpits. Kat and Pierre both took a step backwards. One pair of the thinner arms swung back behind Chahat Me to a wall control panel, and blurred into action. The space they occupied went dark, just before their craft rocked heavily.
Kat tumbled into a corner, her head smacking hard against one of the benches. She tried to get up but a sudden burst of acceleration squeezed her into the soft fabric, her internal organs pressing against her back ribs. She realised they must be doing high-G manoeuvres, straining the inertial dampers to their limit. When it stopped she ended up rolling helplessly into the centre towards the other side, only to be stopped by one of Chahat-Me’s feet which stamped down on her chest, pinning her to the floor. The room spun a few times and then a sense of normality returned, leaving only a trace of nausea, reminding her of her space sickness training two years earlier.
The foot released her. She sat up, glaring at Chahat-Me, but she managed to growl a begrudging “Thanks, I think.” Pierre was already standing behind her, and helped her to her feet. “What –?” But she didn’t need to ask, as soon as her gaze reached the portal.  She saw the mother ship shattered into several large chunks, surrounded by myriad smaller fragments. Flames sputtered and winked out as soon as they formed, as the oxygen flashed into space. She glanced at the Hohash, still in view mode, giving ugly close-up shots of Ossyrians tumbling into space, jerking spasmodically for a few seconds before freezing into corpses that would shortly be cremated as they fell through the atmosphere. A number of Ossyrians on the planet lay prone on the ground, their encounter suit helmets smashed open, their muzzles gasping and bodies twitching, clearly unable to make any concerted movement. Nerve gas, she reckoned. The low-level pyramids were crashing, one by one, she presumed due to some kind of EM pulse or similar device disabling their engines or guidance systems, probably both. She watched the mother ship explode into even more fragments.
Only then did the other ships appear – black, spiked spheres reminding her of long-spined sea urchins. They approached the fragments and pricked their hulls. They’re boarding the mother ship, or what’s left of it.
“Why?” Pierre said.
Kat knew it was a pointless question. What he really meant was how could they? She reckoned it was probably technology capture by a lower level race. Then came a shock. The Hohash showed some of those boarding. They were wearing space suits and though she couldn’t see their heads inside the helmets, they definitely looked humanoid. She snuck a glance at Chahat-Me, to find that she was communicating with Pierre. She waited, trying not to look at the carnage.
“Mannekhi raiders,” he said, “Level 5.” He seemed about to speak, but stalled, staring at the Ossyrian. 
 “What?” Kat asked.
Pierre’s brow creased, and he looked from Chahat-Me to Kat, then out the portal. “We’re … we’re cloaked. So…”
Kat walked up to him and gripped him by his elbows. “Pierre, talk to me. What’s going on?”
He turned back to her, then sat down on the bench. “The Ossyrians have a vow to help people, a kind of Hippocratic oath.”
She folded her arms. “So, they’re going to stand by, while these Mannekhi bastards –”
“No. No, that’s just it. They have a higher oath, related to Galactic security. If the Mannekhi get the technology, the database from an Ossyrian mothership, well…” He waved a hand, listlessly.
She glanced through the portal again. Around thirty of the spike-ships festooned the collapsing hull fragments of the Ossyrian’s mighty vessel. “What can they do?’ What can we do? We’re just one tiny ship, maybe the only ones left alive right now.”
Without warning, Chahat-Me seized Kat’s shoulders and spun her around to face her, catching both her wrists and locking them in a vice-like grip. Kat’s eyes went wide. “Pierre!” But she sensed no movement behind her. Damnhe knows what she’s going to do to me! She watched as Chahat-Me’s second pair of aluminium-coloured arms transfigured at the ends into large syringes.
“Pierre! What’s going on?”
He stood up, laid a hand on her shoulder. “Chahat-Me is saving your life.”
With a blur, the first syringe stabbed into the left side of her neck, a fraction of a second before the second one punctured her belly.
“Christ!” she yelled, just as Chahat-Me released her. She took a swing at the dog-faced alien but hit nothing more than air, nearly falling over.
“Kat, don’t,” Pierre said quietly.
She regained her balance, and glared at the dispassionate Ossyrian, then turned to Pierre. “Wanna see if you can move that quickly too?”
He moved right in front of her, chin bared. “Go ahead. I won’t move.”
Her fist ached to connect with someone, or something; she realised how much she’d been holding in this past week. She thought about hitting the wall, but she’d given that up years ago. “Tell me what she just did to me.”
Pierre walked over to the portal. “Come and see.”
Reluctantly she joined him, just in time to catch a flash of emerald lightning. For a moment, as far as she could see, space turned an eerie green, then faded back to black. “Fireworks. So what?”
He nodded towards the vista. She watched. The bustle of activity slowed down. Ships still moved, but nothing changed course. One or two of the spike ships collided, bursting into flame for a second before snuffing out. Her anger subsided. Everything was stilling, silent – she tried to avoid the word which most aptly described the scene, but said it anyway. “Dead?” She tried to imagine how that could be.
He nodded.
“How?” So fast, she thought, so damned efficient.
“An Ossyrian weapon, like an electromagnetic pulse, but tuned only to organic signatures. Operates on what they call the epsilon spectrum: subatomic, penetrates hulls and shields.”
She felt light-headed, nauseous. “Then why aren’t we dead?”
“The weapon targets anything organic without Ossyrian DNA. The ship’s cloak transmits the DNA signature, and, I already have some Ossyrian DNA, and now … well, now you have some too.”
She sensed there was something else he wasn’t telling her, but it would wait. She moved back to see the Hohash, and was aghast. “The population! It’s wiping them out too!”
“I know. You were right about it all being too perfect. Most probable scenario is that the inhabitants, or at the least their government or factions of it, were in on the raid from the start. Probably they were promised advanced technology by the Mannekhi.”
She stared in disbelief. “But that’s all supposition. You don’t know that. Chahat-Me doesn’t know that for sure!”
Pierre faced her. “Kat, thanks to you they had a few seconds to take the appropriate precautions, or at least to set in motion their contingency protocol.”
“A few seconds! A few seconds to decide and execute genocide!” Her fists were ready for use again.
“The Ossyrians are Level Eight, Kat, compared to our Level Three. They think much faster than we do, and have considered all manner of scenarios before, including this one, and the appropriate response.”
“Stop talking like a diplomat, Pierre! It doesn’t give them the right –”
“But it does, Kat, that’s the whole point. That’s how this galaxy works.”
“Like the Q’Roth culling us. That okay with you too, Pierre?”
She saw his confidence falter, a crack in the façade. Too little, too late. But she had nothing more to say. She moved to where she could see neither the Hohash nor the portal, drew her knees up to her chest, and wrapped her arms around them. Pierre kept his distance, but the Ossyrian walked over towards her. It opened its mouth revealing the fibrous layers, like she’d seen once inside a dead whale’s jaws. A shrieking noise like a psychedelic choir emanated. Through the cacophony, Kat made out two distorted words: thank you.
Kat turned her head aside, unable to think of a suitable response.


The last provocative thought I’ll leave you with is that other alien races might consider us as a disease or virus, something to be contained as in Greg Egan’s masterful novel Quarantine, or eradicated (Greg Bear’s Forge of God series).

Let’s hope that idea remains science fiction.


The Eden Paradox is available in paperback and ebook from Amazon, Barnes & Noble, Waterstones and Ampichellis Ebooks
Eden's Trial is available as an ebook from Amazon, and in paperback Autumn 2012.
Eden's Revenge is due out for Xmas 2012

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