Filed under: BoingBoing, Climate Change, Cory Doctorow, Emergency, Flu, General Musings, Global Warming, Government, Heinlein, Pandemic, Plague, Predictions, Robert A. Heinlein, Science Fiction, Society, Space, tech, Tor.com, Weather, Writing stuff
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
Filed under: Daily Kos, Emergency, Flu, Flu Wiki, Government, Health, Pandemic, Plague, Preparedness, Religion, Society, Survival
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
Filed under: Emergency, Flu, Flu Wiki, General Musings, Government, Health, NPR, Pandemic, Plague, Predictions, Preparedness, Science, Science Fiction, Society, Survival, Writing stuff
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
Filed under: Flu, General Musings, Pandemic, Predictions, Preparedness, Press, Science, Society, Writing stuff
Communion of Dreams is set in a post-pandemic world, some 40 years after a new flu strain has caused massive death and global disruption.
For the most part, people never really think about the flu or any other virus presenting much of a threat. Partially, this is due to not wanting to think about such things as death. Partially, it is because there really isn’t much in the way of treatment for most viral diseases. As a result, sometimes it is difficult to get much information in the news, unless you really work at it. A good example of this is the recent outbreak of EV71 in China – my wife caught a brief mention of it on the BBC news, told me. I had to really hunt around to find this:
Mass intestinal virus infection up to 1,520, kills 20
HEFEI — A lethal outbreak of intestinal virus in Fuyang City in east China’s Anhui Province has killed 20 children and befallen 1,500 others, the provincial health department said on Tuesday.
Du Changzhi, Anhui Provincial Health Department deputy chief, said the virus, known as enterovirus 71, or EV71, had altogether sickened 1,520 children, claiming 20 lives by Tuesday morning.
Of the sick, 585 had recovered thus far. At present, 412 sick children have remained in hospital for further medical observation. Of the total, 26 are seriously ill.
The Wall Street Journal did have this:
China Suffers HFMD Outbreak
Common Illness Catches Attention Of Global Officials
HONG KONG — A deadly outbreak in eastern China of a common childhood illness that rarely kills people has caught the attention of international health officials.
The outbreak of hand, foot and mouth disease, or HFMD, has killed 20 children in Fuyang, a city in eastern Anhui province, and has affected some 1,200 children altogether, according to the Anhui provincial health department. Of those cases, 341 children are still in the hospital.
A report by the state-run Xinhua news agency late Sunday evening said the outbreak began in early March and cited the city’s health department as confirming that the disease was caused by enterovirus-71, one of several viruses that can cause HFMD.
* * *
China’s Health Minister Chen Zhu visited Fuyang on Saturday, according to the Xinhua report. Chinese health officials at the local level in the past have sometimes played down disease outbreaks early on, only to be caught off guard later.
Indeed. There have been a number of such problems with reporting outbreaks in China, as we saw with the SARS virus in 2003. What this means is that a new virus can get established before anyone really knows what is going on. And that could be really catastrophic in terms of implementing public-health plans to limit the spread of any major new disease.
[Major Spoilers Ahead.]
At the end of Communion, I reveal that the new engineered flu virus which has been released comes from China. I did this for this reason – to draw attention to this very real problem. It’s bad enough that some virus could pop up just about anywhere where there is very little public health infrastructure, and so be missed. That a threat could come, and be intentionally ignored, is really dangerous. You really gotta wonder just what people are thinking when they do this.
Just as you really gotta wonder why such things are not covered in the news, rather than the latest celebrity gossip or outrage.
Jim Downey
Filed under: Feedback, Flu, Heinlein, movies, Pandemic, Religion, Robert A. Heinlein, Science Fiction, Society, Survival, Writing stuff
A discussion over on UTI about a post I made there took a bit of an odd turn, engendering some interesting discussion about polygamy. This morning I made a comment that I thought I would share here, since it does relate directly to some of the things I do in Communion of Dreams. You’ll see what I mean.
Heinlein’s use . . . of non-standard family structures got me thinking about many of these issues when I was very young, and helped me form my opinions intellectually before getting into emotional commitments.
I tend to think that the serial monogamy that we see as a default in Western countries reflects the differences between societal conventions and evolutionary inclinations, with a big helping of “we live a whole lot longer now than early humans did” thrown in for good measure. It is rare to see a marriage last more than ten or fifteen years these days, and I think that makes a lot of sense – when most humans lived until 30 or so, it would make sense that pair-bonding would be a good strategy to raising and protecting children into early adulthood. That would mean a “marriage” of about the length I mention above.
But we live a lot longer now, and people grow and change throughout their lives. So it is unsurprising to me that divorce is common (something like half of all marriages end in divorce) as a way of dealing with these changes. Some people find a way to grow in tandem with their partner, and some find ways of allowing a certain freedom of definition for each partner within the structure of an ostensibly conventional marriage (some, of course, do both). Different cultures have found different strategies to accommodate these stresses – some allow for polygamy of the ‘conventional’ sort (think the Mormon or Islamic variety), some make divorce easy, some de-emphasize marriage itself, some ‘look the other way’ when one or the other partner in a marriage cheats or has a formal concubine system.
A fairly recent development in all of this has come to be known as polyamory – defining relationships as being more open and less “possessive”. There are some fairly well-known practices and practitioners, such as Penn Jillette. This attitude pretty well covers most of Heinlein’s alternative marriage structures and can work for some people, though it would understandably require a different sort of approach and mindset than what is commonly considered about marriage/love/relationships. In an homage to Heinlein I had originally used alternative family structures as the “norm” in my SF novel set about 50 years from now (a survival-strategy response to environmental conditions), but early readers of the book got too hung up on that so I changed it. Perhaps if/when I am an established author I can get away with it, as RAH did.
Children? I dunno – don’t have any, by choice. Not an issue for me, in several senses of the term.
[Mild spoilers ahead.]
To me, the novel actually does work better the way I had the family relationships defined before, with a group marriage built around a small number of adults who have just a couple of fertile people at the core. This would allow for those precious few who are able to have children (remember, the fire-flu plague had not just killed vast numbers – it also left most people who survived it sterile) to do so with minimal stress, the rest of the family caring for them and the children born into the family. Think how it would be otherwise: the few fertile couples trying to have and raise children in a society desperate for kids, maybe even willing to steal them or force child-baring couple to give their children to others.
But this change was just too hard for some people to wrap their heads around comfortably – they wanted to turn it into something about sex rather than about children. Maybe they felt threatened by the idea, since the time-frame of the novel was so close to our own. I dunno – my head doesn’t work that way. So I made the change, and tried to work in enough explanation for the type of ‘family’ that exists in the book, while removing the polyamory element. So far no one has commented on the current version as being a problem for them, and that is likely how it will stay.
Jim Downey
(Again, if you didn’t recognize the quote used in the title, shame on you. It’s from this.)
Filed under: Alzheimer's, Book Conservation, Firefly, Flu, Health, Hospice, Joss Whedon, movies, Predictions, Science Fiction, Serenity, Sleep, Society, Writing stuff
Last night we settled down with some dinner to watch a bit of Firefly, settling on Serenity (the episode, not the movie). At one point fairly early on, when plans have gone south at several junctures, the captain of the ship (Mal) is considering options, trying to make the best of a not-great situation. There’s this little bit of dialog:
MAL: We don’t get paid for this, we won’t have enough money to fuel the ship,
let alone keep her in repair. She’ll be dead in the water anyhow.
(Mal turns to the others)
We just gotta keep our heads down and do the job. Pray there ain’t no more surprises.
I looked at my wife, and we just nodded to one another.
* * * * * * *
We did a hard thing. And we did it well.
Caring for my MIL for years somewhat warped my perspective. First and foremost in our consideration was always what her needs were and how best to meet them. I’ve often talked about what that meant in terms of rewards and sacrifices, and I don’t intend to rehash that now.
But a couple of things have changed with her passing. First off, is the odd sense of disorientation. I’ve compared it in discussion with friends with almost having a sense of agoraphobia – a nervousness when out in the world I’ve never felt before. It’s really just a conditioned reflex, and will fade as I adjust to the lack of need to always being worried about Martha Sr.
Another thing which has changed is the need to return to something resembling a ‘normal’ life, with the usual requirements of work. I don’t mind work, never have. My life has never been easy (though it certainly could have been harder), and I’ve never expected it to be otherwise.
But sometimes you wonder if maybe it couldn’t be just a little bit easier.
Caring for Martha Sr those last weeks was more demanding, and lasted longer than anyone expected. Getting hit with the flu so hard following seemed a bit gratuitous, in the sense of the universe having fun at our expense. Both my wife and I are behind on our work, and while our clients understand, that doesn’t help the cash flow situation. I knew these days would come, and things would be a little rough for a while until we got settled again. But we’ll manage.
* * * * * * *
We did a hard thing, and we did it well.
What has come of a bit of surprise has been how some people have responded to that. There’s been some discord in the family about the disposition of Martha Sr’s possessions, borne mostly out of a misguided sense of guilt, from what I can tell. It’s really unfortunate, but everyone has their own way of reacting to death. If we’re lucky, with time the matter will sort itself out with a minimal amount of damage.
I’ve also seen others in different forums who have almost felt like they had to defend their own decisions regarding a loved one who has Alzheimer’s or some other debilitating illness leading to hospice care. I’ve witnessed those who almost seem resentful that we did what we did, because it somehow implies that they did less – that they cared less.
No. We were able to make this work out. Barely. Everyone has a different situation, and each family, each person, must come to their own conclusions, their own solutions. None is better or worse than another. Because my wife and I don’t have kids, we didn’t have to juggle that aspect of life at the same time. Because we live here in the same town as Martha Sr, and have professions which allow a considerable flexibility in terms of work hours, we were better able to adapt to providing care at home than most. Our solution worked for our situation – barely. Those final months were very demanding, and I will admit that I was pushed further than I would have thought was possible, and failed and succeeded in ways I never expected.
I will not judge another – this experience has taught me humility.
Jim Downey
Communion Of Dreams 