MEDICINE

   Medical applications of TECHNOLOGY comprise one of the few areas where the cutting edge of scientific research impinges directly and intimately upon ordinary human life. New medicines are so rapidly brought into everyday use that it is easy to forget how rapid progress has been, and that barely 100 years separates us from the crucial CONCEPTUAL BREAKTHROUGHS associated with the development of organic chemistry and thegerm theory enunciated by Louis Pasteur (1822-1895). Even people who can find little else to say in favour of science and technology (ANTI-INTELLECTUALISM IN SF) are usually grateful for the benefits ofscientific medicine, although the rapid recent growth of "alternative medicine" has shown that even this gratitude has its limits. So urgent is the human need for better medicine that the field has always been home to legions of quacks and charlatans offering hopeful panaceas for all ills (PSEUDO-SCIENCE); the literary imagination has inevitably reflected andmagnified these hopes in fantasies of resurrection, rejuvenation and IMMORTALITY - usually couched, of course, as cautionary tales - and theideative apparatus of sf has been promiscuously deployed in stories of these types. Medical researchers and their endeavours have been objects of central concern in sf ever since Mary SHELLEY's Frankenstein, or The Modern Prometheus (1818; rev 1831). Because of the urgency with whichmedical matters concern us, plots involving new cures (and, of course, new diseases) have an inbuilt dramatic quality which readily recommends them to speculative writers inside and outside the genre. Thanks to writers like Robin COOK one can today recognize a subgenre of "medical thrillers" whose products very often stray over the sf borderline. Several notable sf writers have been MDs, including Michael BLUMLEIN, Miles J. BREUER, Michael CRICHTON, Arthur Conan DOYLE, David H. KELLER and Alan E. NOURSE.M.P. SHIEL and J.G. BALLARD both studied medicine for a while; although neither graduated, the influence of their studies is indelibly marked on much of their work.Early US sf is replete with what one might call, after the example of Oliver Wendell Holmes, "medicated novels", mostly dealing with mental aberration (PSYCHOLOGY) or the increasingly problematic question of the precise relationship between body and soul. Bizarre medical experiments are described in such early works as Nathaniel HAWTHORNE's "Rappaccini's Daughter" (1844) and Edgar Allan POE's "TheFacts in the Case of M. Valdemar" (1845). It was, however, UK writers who took up such themes more boldly in the latter half of the 19th century, in such novels as Robert Louis STEVENSON's Strange Case of Dr Jekyll and Mr Hyde (1886) and H.G. WELLS's The Island of Dr Moreau (1896). In keepingwith the traditions of the day, these experiments almost always go wrong, usually horribly. Even techniques which have since become realized, to the evident betterment of the human condition - organ transplantation, chemical contraception and medical cyborgization (CYBORGS) - were frequently deployed by early sf writers in vivid horror stories or contes cruels. Brain surgery offered considerable melodramatic scope to the writer of medical horror stories, exploited to the full in W.C. Morrow's "The Monster-Maker" (1887) and S. Fowler WRIGHT's "Brain" (1932), as didstories of radiation-treatment gone awry (MUTANTS). Even Sir Ronald Ross (1857-1932), who received the Nobel Prize for his work on malaria,deployed his expert knowledge thus in his only sf story, "The Vivisector Vivisected" (written c1889; 1932). One can also identify a small-scalesubgenre of "medical nightmare" stories involving hallucinations - usually vividly gruesome ones-suffered under anaesthetic; these run from Wells's "Under the Knife" (1897) to Neil BELL's Death Rocks the Cradle (1933 as byPaul Martens).Much modern sf continues this pessimistic tradition. C.M. KORNBLUTH's tale of the use and abuse of medical equipment timeslipped from the future, "The Little Black Bag" (1950), is one of the most famous sf contes cruels, and Daniel KEYES's classic FLOWERS FOR ALGERNON (1957; exp 1966) is a tragedy of unparalleled poignancy. Bernard WOLFE's LIMBO (1952) recruits medical technology to put an ironic twist on the idea ofdisarmament. Walter M. MILLER's "Blood Bank" (1952), William TENN's "Down Among the Dead Men" (1954), Cordwainer SMITH's "A Planet Named Shayol"(1961) and Larry NIVEN's "The Organleggers" (1969) are other stories in a vividly dark vein. Caduceus Wild (1959; 1978) by Ward MOORE and Robert Bradford, in which doctors run the world, is as DYSTOPIAN as othercontemporary stories in which some special-interest group has become dominant; James E. GUNN's The Immortals (1955-60; fixup 1962) is similarly but more thoughtfully downbeat, while such Alan E. Nourse novels as The Mercy Men (1968; rev from A Man Obsessed 1955) and The Bladerunner (1974)deploy dystopian imagery in a carefully ambivalent fashion. The tradition continues into recent times in such novels as Dr Adder (1984) by K.W. JETER, Resurrection, Inc. (1988) by Kevin J. ANDERSON, The Child Garden(1989) by Geoff RYMAN, Body Mortgage (1989) by Richard ENGLING and Crygender (1992) by Thomas T. THOMAS.Linked to the horror-story tradition of accounts of misfired medical experiments is a much less prolific comic tradition, in which things go wrong with rather less awful consequences; Wells' "The Stolen Bacillus" (1895) is an early example. The proposal bythe Russian physiologist Serge Voronoff (1866-1951) that testosterone generated by transplanted monkey-testicles might "rejuvenate" ageing men inspired some sf black comedies, including Bertram GAYTON's The Gland Stealers (1922); a farcical film on a similar theme was MONKEY BUSINESS(1952). A modern black comedy of medical chicanery is Joe HALDEMAN's Buying Time (1989; vt The Long Habit of Living 1989 UK). Like Raymond Hawkey's thriller Side-Effect (1979), the latter assumes that medical miracles might well be reserved by their creators for the favoured few, extrapolating the old medical adage that the best specialism is diseases of the very rich.The Great Plague Story, memorably featured in Mary Shelley's The Last Man (1826) and Jack LONDON's The Scarlet Plague (1912;1915), remains a melodramatic staple of the DISASTER story. Notable examples of stories whose main focus is on the medical effort to counter or control such plagues include Cry Plague! (1953 dos) by Theodore S. Drachman MD, The Darkest of Nights (1962; vt Survival Margin US) byCharles Eric MAINE, Plague from Space (1965; vt The Jupiter Legacy) by Harry HARRISON, The Andromeda Strain (1969) by Michael Crichton, Time of the Fourth Horseman (1976) by Chelsea Quinn YARBRO and Disposable People (1980) by Marshall Goldberg MD and Kenneth Kay. Interesting stories ofplagues which bring ambiguous benefits as well as posing threats include Walter M. Miller's "Dark Benediction" (1951), Octavia E. BUTLER's Clay'sArk (1984) and Greg BEAR's BLOOD MUSIC (1985). The newest real-world plague, AIDS, has called forth a rapid response in the sf field; Dan SIMMONS's Children of the Night (1992) features the notion that a curemight be found in vampires' blood. Extravagant stories of medical responses to AIDS include F.M. BUSBY's The Breeds of Man (1988), Thomas M. DISCH's The MD: A Horror Story (1991) and Norman SPINRAD's "Journals ofthe Plague Years" (1988).A much more positive image of medical science is seen in stories in which doctors struggle to understand and solve exotic problems which arise with respect to the interaction between humans and ALIENS. There are two particularly notable sf series of this kind: MurrayLEINSTER's Med Service series (1957-66) and James WHITE's ongoing Sector General series (begun 1957). L. Ron HUBBARD's earlier Ole Doc Methuselah series (1947-50; coll 1970) is unfortunately weakened by the eponymous hero's interest in eccentric theories. White's series is especially interesting by virtue of the warmly liberal humanism of its attitude towards aliens - gracefully making a point which is much more laboured in Piers ANTHONY's sitcom-like series about an interplanetary dentist,Prostho Plus (fixup 1971) - although White can also function effectively in the medical horror/thriller vein, as in Underkill (1979). Alan E. Nourse's Star Surgeon (1960) is a notable juvenile sf novel cast in theearnest and constructive mould. These stories of fairly ordinary people tackling localized problems tend to be more interesting than tales in which the discovery of a panacea promises an instant end to all ills, although some such stories can be effective; examples include S. Fowler Wright's "The Rat" (1929), Charles L. HARNESS's The Catalyst (1980) andKate WILHELM's rather ambivalent Welcome, Chaos (1983).A theme anthology is Great Science Fiction about Doctors (anth 1963) ed Groff CONKLIN and Noah D. Fabricant MD.

   BS/JSc