Communion Of Dreams


It’s the End of the Year as we know it…

So, the WordPress Machine informs me that I’ve had a fairly busy year blogging here.

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As I mentioned a while ago, earlier this month I had fallen prey to the nasty bit of cold virus going around.  Turned out that the damn thing was even more stubborn for my wife, who is still struggling with a hacking cough and various other annoying symptoms.  We’ve been keeping a close eye on it, watching for signs of secondary pneumonia, which would call for antibiotic intervention, but I think she’ll get past this on her own.

Which is good, because there really isn’t much we can do to fight a virus. In this sense, medical science is at about the same place in viral treatments as we were in dealing with bacterial infection 70 years ago:

In 1941, a rose killed a policeman.

Albert Alexander, a 43-year-old policeman in Oxford, England, was pruning his roses one fall day when a thorn scratched him at the corner of his mouth. The slight crevice it opened allowed harmless skin bacteria to slip into his body. At first, the scratch grew pink and tender. Over the course of several weeks, it slowly swelled. The bacteria turned from harmless to vicious, proliferating through his flesh. Alexander eventually had to be admitted to Radcliffe Hospital, the bacteria spreading across his face and into his lungs.

Alexander’s doctors tried treating him with sulfa drugs, the only treatment available at the time. The medicine failed, and as the infection worsened, they had to cut out one of his eyes. The bacteria started to infiltrate his bones. Death seemed inevitable.

* * * * * * *

You may not have heard much about it here, but the norovirus is causing all kinds of grief in the UK. Cases are up 83% over last year, and are estimated to have hit over a million people already. In the UK the norovirus is commonly called the “winter vomiting bug” whereas here we tend to call it “stomach flu”.  As miserable as it makes people feel, it’s usually not a life-threatening disease for otherwise healthy people, and the best thing to do is just ride it out.

Of course, public health authorities have taken steps to try and limit the spread of the disease into populations where the virus could be life-threatening, and a lot of hospitals have curtailed or eliminated visiting hours. Furthermore, appeals have been made to the public to not to go see their doctors or go to emergency rooms for routine cases of the norovirus, since there is little that can be done to treat the virus and this just contributes to the spread of the disease.

Still, people get scared when they get sick, even when they know that it is a fairly common bug that’s going around — and one that most people have had before and gotten over just fine. So they tend to swamp available medical services, overwhelming the health care system.

Just think about what would happen if it was a disease which wasn’t known. And one which was killing people so quickly that they’d drop over in the street on the way home from work.

* * * * * * *

I’ve been thinking about that a lot, since it is an integral plot point to St. Cybi’s Well.  This isn’t a spoiler, since the advent of the fire-flu is part of the ‘history’ of Communion of Dreams.

But it is something which has had me in a bit of a quandary this fall, as I’ve been working on writing St. Cybi’s Well.

Howso? Well, because I kept going back and forth on making one final decision: where to end the book.

See, I know how the *story* plays out — I’ve had that all sorted since I first worked up the background for Communion of Dreams. But in going to write St. Cybi’s Well, I needed to decide exactly where in the story that book would end. Which is to say, I needed to decide how much, if any, of the onset of the fire-flu would be included. Because I could set everything up and have the book actually finish at the onset of the fire-flu — after all, the reader would know what was about to happen. Why drag the reader through that horror?

* * * * * * *

A week or so ago I made my decision, and I’ve been chewing it over since then as I’ve been busy with other things, making sure that I was comfortable with what I have decided, and why. I’m not going to give you the details, but you can safely assume from what I’ve said in this post that at least some of the pandemic will be portrayed.

I decided this not because I have a desire to write about the horror (in spite of what I may have said previously) but rather because it is critical for character development of the main character.

Poor Darnell.

* * * * * * *

So, the WordPress Machine informs me that I’ve had a fairly busy year blogging here. 293 posts (this makes 294), which is a faster pace than in some years. Of course, I’ve had a lot of promotional stuff do to with the launch of Communion of Dreams last January and everything to support that through the year, not to mention the Kickstarter for St. Cybi’s Well.

And while I’ve cautioned that I won’t be writing quite as much here on the blog as I’m working on St. Cybi’s Well, well, it does make for a nice change of pace.

So thanks for being along for the ride this year. Together we can see how things go in 2013.

 

Jim Downey

 

 



The other 90% of you.

Your body has something on the order of 10 trillion individual cells. But surprisingly, it has nine or ten times that number of microorganisms which it hosts in some capacity or another, many of which we have co-evolved with and which seem to be critical to our long health. While these microorganisms are typically much smaller than human body cells, in one very real sense, “you” is actually only about 10% “you.”

These microorganisms have a substantial impact on how your body digests food. On whether you can resist various kinds of infection or develop any of a range of auto-immune diseases. Perhaps even on your mood and risk assessment.

Would it therefore be any kind of a surprise at all if doing something to change the “mix” of these microorganisms had an impact on you?

Hell, it’d be a surprise if it didn’t.

Almost all of us know what happens when you have to take a broad-spectrum antibiotic: usually some degree of diarrhea and intestinal discomfort. And in the last decade or two it has become commonplace for people to seek out some variety of probiotics, frequently in the form of live yogurt, as a way to replenish gut flora following antibiotic treatment. I do it myself.

So, extending that idea a bit, researchers are now investigating whether part of the slow-moving plague of obesity can be due to the changes created in the human-hosted microorganisms:

Early use of antibiotics linked to obesity, research finds

The use of antibiotics in young children might lead to a higher risk of obesity, and two new studies, one on mice and one on humans, conclude that changes of the intestinal bacteria caused by antibiotics could be responsible.

Taken together, the New York University researchers conclude that it might be necessary to broaden our concept of the causes of obesity and urge more caution in using antibiotics. Both studies focus on the early age, because that is when obesity begins, the scientists say.

As I’ve noted previously:

In Communion I have a post-pandemic society, one which is recovering from a massive disruption caused by a flu virus which caused rapid death in a large percentage of the population. But the reality of what we’re dealing with might be even more insidious.

More insidious in this case because we have done it to ourselves.

And perhaps not even with direct antibiotic treatment to deal with some kind of life-threatening infection. Consider that it is still a widespread practice to boost livestock weight gain through the use of antibiotics, and that leaves a residue of antibiotics in the meat. If it boosts weight gain in feed animals, why wouldn’t it do the same to us?

I’ve said before that there has been some kind of change to the way our bodies absorb nutrients in the last 40 or 50 years, and that that is behind the global rise in obesity. Previously there were indications that it might be due to some kind of virus. Or an immune response to the germaphobia of the 20th century. But maybe it is more directly our own damned fault, and we’ve traded the ability to defeat infections for a different kind of health risk.

Jim Downey



Extinction in the news.

Yeah, I know I said I’d try and get a nice cheery travelogue up next.  Oh well. This has more relevance to Communion of Dreams, which is ostensibly the focus for this blog, anyway, right?

Right.  So, here: seems that researchers have for the first time clearly determined the extinction of a mammal to have been caused by disease.

In 1899, an English ship stopped at Christmas Island, near Australia. Within nine years, the island’s entire native rat population had gone extinct, and scientists have wondered ever since what exactly happened.Now, researchers led by an Old Dominion University scientist think they have unraveled the mystery – and, they say, the lessons of Christmas Island apply today to issues such as disease, invasive species and the law of unintended consequenceTurns out, says ODU biology professor Alex Greenwood, that a British black rat had stowed away on the ship in a bale of hay. Upon reaching the island, the rat – or several rats – escaped on land and spread a “hyperdisease” among the native population.

“Anyone who has ever tried to kill a rat – let alone a whole population – knows how hard that can be,” Greenwood said in an interview Monday. “That’s what made Christmas Island so fascinating for so long. Imagine, a whole species – especially one as tough as a rat – gone within 10 years of exposure!”

OK, for those of us who are non-biologists, this may be something of a surprise: why wouldn’t extinction occur due to disease?  But the prevailing theory has long been that it was virtually impossible that a disease would wipe out all members of a species – and that any survivors would pass on their immunity to their descendants, thus continuing the Darwinian arms race.  To determine that this has happened – and to a robust and fast-reproducing species such as a rat – is real news.

Which touches on an older item I came across recently:

Reducing the Risk of Human Extinction
Jason G. Matheny

Abstract: In this century a number of events could extinguish humanity. The probability of these events may be very low, but the expected value of preventing them could be high, as it represents the value of all future human lives. We review the challenges to studying human extinction risks and, by way of example, estimate the cost effectiveness of preventing extinction-level asteroid impacts.

* * *

3. Estimating the Near-Term Probability of Extinction

It is possible for humanity (or its descendents) to survive a million years or more, but we could succumb to extinction as soon as this century. During the Cuban Missile Crisis, U.S. President Kennedy estimated the probability of a nuclear holocaust as “somewhere between one out of three and even” (Kennedy, 1969, p. 110). John von Neumann, as Chairman of the U.S. Air Force Strategic Missiles Evaluation Committee, predicted that it was “absolutely certain (1) that there would be a nuclear war; and (2) that everyone would die in it” (Leslie, 1996, p. 26).

More recent predictions of human extinction are little more optimistic. In their catalogs of extinction risks, Britain’s Astronomer Royal, Sir Martin Rees (2003), gives humanity 50-50 odds on surviving the 21st century; philosopher Nick Bostrom argues that it would be “misguided” to assume that the probability of extinction is less than 25%; and philosopher John Leslie (1996) assigns a 30% probability to extinction during the next five centuries. The “Stern Review” for the U.K. Treasury (2006) assumes that the probability of human extinction during the next century is 10%. And some explanations of the “Fermi Paradox” imply a high probability (close to100%)of extinction among technological civilizations (Pisani, 2006).4

I haven’t spent the time to look up the entire paper and read it, though I have followed this topic in the (popular) scientific news for most of my adult life. It is, in fact, one of the reasons why I decided to write Communion of Dreams – to explore the idea of humanity on the brink of extinction (as well as to examine Fermi’s Paradox, as I have written about previously).  Just as most people seem to prefer ignoring their own mortality, we as a species seem to prefer ignoring the possibility of our own extinction.  Even the vast majority of Science Fiction (including my own) written with humankind facing the possibility of extinction is resolved with some kind of salvation – it’d just be too bleak for most readers, otherwise.

And that doesn’t sell.

Jim Downey



Heinlein was right.

Via BoingBoing, an interesting discussion over on Tor.com: The Dystopic Earths of Heinlein’s Juveniles. An excerpt:

It’s funny how it’s overpopulation and political unpleasantness that cause the problems, never ecological disaster. Maybe that wasn’t on the horizon at all in the fifties and early sixties? I suppose every age has its own disaster story. It’s nice how little they worry about nuclear war too, except in Space Cadet which is all nuclear threat, Venusians and pancakes. They don’t make them like that any more. Come to think it’s probably just as well.

* * *
No individual one of these would be particularly noticeable, especially as they’re just background, but sitting here adding them up doesn’t make a pretty picture. What’s with all these dystopias? How is it that we don’t see them that way? Is it really that the message is all about “Earth sucks, better get into space fast”? And if so, is that really a sensible message to be giving young people? Did Heinlein really mean it? And did we really buy into it?

Yeah, he meant it. And further, he was right.

No, I’m not really calling into question the premise of the piece – that Heinlein had something of a bias about population and governmental control. And I’m not saying that he was entirely correct in either his politics or his vision of the future.

But consider the biggest threat facing us: No, not Paris Hilton’s involvement in the presidential election, though a legitimate case can be made that this is indeed an indication of the end of the world. Rather, I mean global warming.

And why do we have global warming? Because of the environmental impact of human civilization. And why is this impact significant? Because of the size of the human population on this planet.

And what is the likely response to the coming changes? Increased governmental control.

[Mild spoilers ahead.]

For Communion of Dreams I killed off a significant portion of the human race as part of the ‘back story’. Why? Well, it served my purposes for the story. But also because I think that one way or another, we need to understand and accept that the size of our population is a major factor in all the other problems we face. Whether it is limitations caused by peak oil or some other resource running out, or the impact of ‘carbon footprints’, or urban sprawl, or food shortages, all of these problems have one common element: population pressure. We have too many people consuming too many resources and generating too much pollution. In fact, when I once again turn my writing the prequel to Communion, I may very well make this connection more explicit, and have the motivation of the people responsible for the fireflu based on this understanding.

So yeah, Heinlein was right. He may not have spelled out the end result (ecological disaster) per se, but he understood the dynamic at work, and what it would lead to. Just because things haven’t gotten as bad as they can get doesn’t mean that we’re not headed that direction. Our technology can only compensate for so long – already we see things breaking down at the margins, and the long term problems are very real. You can call it ‘dystopic’, but I’ll just call it our future.

Jim Downey



All you need to know . . .

. . . about human nature is summed up very nicely in one little comment I came across on MeFi, in a discussion about news of some potential life-extending medical breakthroughs.  Here it is:

people dying isn’t a bad thing

(boggle)

Yes. Yes it is. If you don’t think so, you’re welcome to accept it with equanimity. I, on the other hand, would club little old ladies to be first in line for some biotech that would prolong a healthy lifespan.

[Mild spoilers ahead.]

Part of the crucial history of Communion of Dreams revolves around what people would do when they think they have been denied life-saving treatment during a pandemic.  When I was thinking this through, I had to stop and wonder just how cynical I was going to be – there are, after all, plenty of instances of people making sacrifices to save others during a crisis.  But I decided that given the timing of the pandemic (in our near future), and given how I was going to ‘set up’ that history, the likely response would be much uglier.

Sometimes I hate being right.

Jim Downey



“If we have a pandemic, pray hard.”

One of the ‘front page’ writers at Daily Kos is very much concerned about public health issues, and preparations for a pandemic or other public health emergency.  He’s also one of the people responsible for the Flu Wiki.  He had a good post up today at dKos about how this issue is playing out in the current presidential election.  In the discussion of that post, there was one comment in which the author said this:

Our Emergency Rooms are in Chaos Now …

…without a pandemic.

We are in no way prepared for anything out of the normal. Republican misrule has mazimized corporate profits in medicine while minimizing social welfare benefits. Unprofitable activities like emergency preparedness have gone wanting.

If we have a pandemic, pray hard.

I am not a person of faith.  I don’t write about that much here, though if you follow any of my links over to UTI, you’ll certainly see what I have to say about religion there.  So the thought of praying for help in a pandemic would never occur to me – I would much rather do something practical to prepare for such an emergency, like getting our hospitals ready.

And I don’t think that the author of that comment is saying that we should only rely on prayer – just expressing some exasperation with the current situation, the current mindset about what role hospitals play in our society.  Daily Kos is, after all, a blog devoted to electing progressive democrats and pushing liberal values like a good universal health system.

Anyway, first consider how prepared you are for a possible pandemic, earthquake, whatever.  Personally.  You have to take responsibility for yourself and your family.  As I have written before, there are a lot of good resources with excellent information on what steps you can take to insure your own survival in an emergency.  And then investigate what steps you can take to help your local government, your community, to better prepare.  It is a very complex problem, and they will likely welcome your help.  This will be a step I will likely be looking into in the future, now that our care-giving responsibilities are done and I am recovering.

If prayer is important to you, then by all means, pray.  But that shouldn’t stop you from doing what you can to also prepare in more tangible ways.

Jim Downey



Who will die?

Well, we all will, unless there’s some sort of miracle breakthrough in medicine or technology. But that’s not what I’m talking about. Rather, I’m talking about something anyone who has thought about it much has probably already assumed is true: that in the event of a large-scale pandemic, procedures will be put into effect by medical authorities to determine who will be treated and who will be allowed to die.

This is called triage. And to the best of my knowledge, for the first time such procedures are being publicly put forth as being applicable for all hospitals in the US, in recognition that it is better to have consistent and uniform criteria already in place before a disaster hits. The May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), today carried a supplement titled Definitive Care for the Critically Ill During a Disaster. From the press release on the ACCP website:

(NORTHBROOK, IL, May 5, 2008)—In an unprecedented initiative, US and Canadian experts have developed a comprehensive framework to optimize and manage critical care resources during times of pandemic outbreaks or other mass critical care disasters. The new proposal suggests legally protecting clinicians who follow accepted protocols for the allocation of scarce resources when providing care during mass critical care events. The framework represents a major step forward to uniformly deliver sufficient critical care during catastrophes and maximize the number of victims who have access to potential life-saving interventions.

“Most countries, including the United States, have insufficient critical care resources to provide timely, usual care for a surge of critically ill and injured victims,” said Asha Devereaux, MD, FCCP, Task Force for Mass Critical Care. “If a mass casualty critical care event occurred tomorrow, many people with clinical conditions that are survivable under usual health-care system circumstances may have to forgo life-sustaining interventions due to deficiencies in supply, staffing, or space.” As a result, the Task Force for Mass Critical Care developed an emergency mass critical care (EMCC) framework for hospitals and public health authorities aimed to maximize effective critical care surge capacity.

So, is this just good public health planning? Well, yes. But it is also very sobering to read the following:

The proposed guidelines are designed to be a blueprint for hospitals “so that everybody will be thinking in the same way” when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

“When”. Emphasis mine. Not “if”. The news report goes further:

Bentley said it’s not the first time this type of approach has been recommended for a catastrophic pandemic, but that “this is the most detailed one I have seen from a professional group.”

While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.

Devereaux said compiling the list “was emotionally difficult for everyone.”

That’s partly because members believe it’s just a matter of time before such a health care disaster hits, she said.

“You never know,” Devereaux said. “SARS took a lot of folks by surprise. We didn’t even know it existed.”

Again, emphasis mine.

I’ve written many times about the possibility of widespread flu or some other kind of pandemic. Partly this is just because such a catastrophe sets the stage for Communion of Dreams. But more importantly – and this is even part of the reason *why* I wrote Communion of Dreams – is that I don’t think that people give this matter nearly enough thought.

It is good to see that the public health authorities are taking this step. And I was heartened to hear about it on NPR as I started to compose this post. Maybe it will prompt people to stop and think for a moment about what they themselves should be doing to prepare for some kind of pandemic or other disruption. Because I bet that almost no one you know is actually ready to ride out such an event – and by the time you hear of a pandemic starting, it will be too late to get everything you will need to increase the chances of you and your loved ones surviving. This is not fear-mongering; this is taking some reasonable precautions – the same sorts of precautions that have lead to the development of this new triage plan. If you want to know more, check out the Flu Wiki (where they also link to this resource).

Yeah, we’re all gonna die. And I can easily imagine disaster scenarios where I would not want to live. But I sure as hell don’t want to die needlessly from something I can avoid, or ride out with a little advance prep.

Jim Downey




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