Why No Plagues in Paksworld?

Posted: October 17th, 2014 under the writing life.
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With the Ebola situation that’s grabbed the attention of the country (not to mention those of us in Texas) for the past few weeks, some of you may be wondering why I didn’t throw some plagues into Paksworld. I did consider it, at one point, and as you recall there were illnesses, but a full-blown plague would have diverted the story to something else.

In the past few weeks, I’ve been writing some posts about the Ebola situation in Texas, in particular, because I have both some medical background and some knowledge of the many different kinds of Texas hospitals. If any of you are interested in those, they’re presently on my LiveJournal, and I’ve referenced some of them in Twitter. (If you want a list of links, I can provide it.) It was clear to us from the first report of Mr. Duncan’s experience at that Dallas hospital that a) it wasn’t a first-rate hospital (for more reasons than missing an Ebola diagnosis on his first visit) and b) that given its quality, additional cases were almost certainly going to show up.

We are from a generation when many of the modern immunizations weren’t available and the ones that were were absolutely required by the school systems. We had tetanus, diptheria, whooping cough, typhoid, and smallpox immunizations, all at a more frequent interval than they’re given now. Even so, there was sporadic smallpox across the river in Mexico, and there was a diptheria outbreak about 10 miles from where I lived. Children I knew died of polio and some survived with permanent disabilities. Nurses in my childhood had trained in the pre-antibiotic era; cross-contamination was a constant battle in hospitals; nurses and doctors both contracted TB and other diseases from their work. So sterile technique was paramount–the only defense against these and the other diseases.

We were quarantined when we had measles or mumps (not so much with chickenpox though we couldn’t attend school) and no school expected perfect attendance until at least junior high (by which time most of us had had measles, rubella, mumps, chickenpox and a host of less important diseases. Movie theaters and swimming pools were closed part of every summer, as polio outbreaks moved through the region. We had block quarantines (children not allowed to leave the block they lived on) for polio, and if someone you knew came down with it, the similar routine of daily checks of temperature and (different) neck suppleness. “Touch your chin to your chest!” because stiff necks were associated with polio attacking the spinal cord. A summer sniffle or cold was always a worry for parents, and for us by the time we were in school. When I was in first grade, one of the two second grade teachers came down with polio and I, like all the others who had been around her (she was a sweet young woman and we all liked her) had to get gamma globulin shots. Boy, did that hurt! But I didn’t get polio–which was lucky, because the year before (I think it was–I was still in Mrs. Jordan’s preschool) I had had encephalitis that nearly killed me. In a coma for 3-4 days with temperature (I was told later) over 106F. Packed in ice trying to get it down.

Anyway. The six years I spent as a rural ambulance volunteer took me to a variety of hospitals, from the excellent to the…very much not. I’ve put more medical things into other stories (SF more than fantasy) and may write more medical stuff in future…but these recent posts have been more analytical nonfiction than story. Will there be plagues in Paksworld stories in the future? Only if a character shows up in my head demanding that his/her story of a plague be told.

21 Comments »

  • Comment by Oz Ozzie — October 17, 2014 @ 10:54 pm

    1

    Lun? Rotengre?


  • Comment by elizabeth — October 18, 2014 @ 10:31 am

    2

    Well, yes, but those were different. I didn’t give them description, definition, onstage presence. And Lun was definitely enemy action, which I put in a different mental box from “because you let your sewage contamination your drinking water” or “see what killing cats as evil partners of Satan gets you? Rats with plague-carrying fleas.”


  • Comment by Justin — October 18, 2014 @ 1:40 pm

    3

    I wondered about this during the original trilogy, but mainly put the lack of disease down to better sanitation and less superstition than in our history combined with the availability of magical healing (clerical and otherwise).


  • Comment by elizabeth — October 18, 2014 @ 6:23 pm

    4

    Justin: Better sanitation certainly helps. And since there were societies a long time ago that had better sanitation without having a “germ theory” to focus sanitation on (“demons” do well enough) then better sanitation could exist in Paksworld. The history of public health shows that breaking the link between sewage and drinking water/food does more for general health and prevention of illness than medical treatment. (Yet providing clean water to drink and cook with, and managing sewage so it doesn’t contaminate drinking water sources, and handwashing are not glamorous. Hence, the failures still seen even in “developed” countries and the ubiquitous problems in the undeveloped.)


  • Comment by Eloise — October 18, 2014 @ 11:40 pm

    5

    Yet providing clean water to drink and cook with, and managing sewage so it doesn’t contaminate drinking water sources, and handwashing are not glamorous. Hence, the failures still seen even in “developed” countries and the ubiquitous problems in the undeveloped.

    Yes, yes, yes.
    To me this calls to mind the current issues around industrial meat production and fracking.

    My sister got polio the year before the vaccine.


  • Comment by GinnyW — October 19, 2014 @ 3:08 pm

    6

    The slow rate of travel (no airplanes crossing the world) and basically local food production can slow the spread of some diseases that we see dramatically. But as you point out, a plague would direct the story in a different direction. Perhaps a window on a whole different aspect of culture in Paksworld?


  • Comment by Jonathan Schor — October 19, 2014 @ 5:32 pm

    7

    I’m sure that if a plague was needed as part of the plot, Paks would get quite sick. It should be noted that in the Fox company the physicians were quite severe in promoting proper hygene. I suspect also that the code of Gird said something about personal cleanliness.

    For those who wanted Paks to fight plague, she also did not have a hangnail.

    Ms. moon makes a quite realistic world, but she also has to tell a good tale.


  • Comment by Suburbanbanshee — October 19, 2014 @ 7:53 pm

    8

    In the various Latin Vulgate/Old Latin translations of the Book of Baruch (don’t think it was in the Septuagint), it is noted that among other animals who are not afraid of idols, the cat will walk all over them. Like the animal names formerly translated as “unicorn” and “dragon,” the cat now receives a less fun name in Baruch. (And of course, Baruch’s not even in a lot of people’s Bibles.)

    But the whole witch/cat thing was always weird (unless you were in Nordic areas where witches were doing pagan Freya stuff), because plenty of medieval lawcodes assumed that everybody had cats. Maybe some people didn’t like housepets.


  • Comment by Sharidann — October 20, 2014 @ 1:27 am

    9

    Reading this post, I am thinking of friends of mine who do not want their child to get vaccinated at all….

    And I can’t help but call that behaviour both stupid and dangerous….


  • Comment by elizabeth — October 20, 2014 @ 7:07 am

    10

    Sharidann: It is, but as with many other mistaken notions people cling to it’s not easy to change their minds. Shots are unpleasant and they cost money (since universal free immunizations are no longer provided)–if there’s no epidemic around, it’s easier to skip them and believe the anti-immunization arguments.


  • Comment by patrick — October 20, 2014 @ 2:44 pm

    11

    Another interesting thing about plagues is that after they are over, people don’t talk about them. I never heard about the great Spanish flu of 1918 until long after I graduated from school. It was such a tragedy that it just wasn’t mentioned. I suspect similar behavior might occur in a culture like Paks world. Don’t talk about past hardships, we have plenty to deal with today. Instead, celebrate past successes to give us hope for the future.

    That would mean until a plague hit, there would be no natural mention of it in most character’s lives. Just as we see in the Paks stories. 🙂


  • Comment by Sharidann — October 20, 2014 @ 11:49 pm

    12

    @ Elizabeth: in Germany, where I live, and in France, where I come from, the costs are covered by the health insurance and more or less everybody got one (yes, including illegal Migrant workers, as apparently, it is cheaper to provide them with medical care than to handle the potential resurgence of epidemics). So it is not a question of costs, more a question of dangers associated with the shots.
    What those friends don’t seem to realize is that their Kid is mostly protected due to the other Kids getting the shots.
    Sure every shot can be potentially dangerous but we forgot that the diseases they protect us from are life-threatening or debilitatiing.

    Oh well, I could rant all day… What I find downright scary is that often People with a medical Background claim to be anti immunization…


  • Comment by Joyce — October 21, 2014 @ 5:49 am

    13

    Some years ago I had a conversation with a young woman who was vehemently anti-vacc. She had a ready supply of anecdotal “evidence” that vaccines are harmful and, she said, unnecessary. She couldn’t answer my questions:”How many people do you know who have had a family member die from whooping cough or diphtheria? How many people do you know who are unable to have children because they had mumps? How many disabled children do you know whose mothers were exposed to rubella during pregnancy?”
    If you have never seen the terrible effects of the diseases we vaccinate against it’s easy to discount them.


  • Comment by elizabeth — October 21, 2014 @ 7:54 am

    14

    Sharidann & Joyce: Back in the day when I first got on the internet (remember Usenet?) I discovered the anti-vaccine crowd online and particularly the vaccines-cause-autism crowd. I already knew there were people opposed to all immunizations–one such family came to our clinic.

    Interestingly, I got to the autism groups on Usenet before it was MMR that was supposed to be the problem, although I had read Wakefield’s papers in the medical literature because at that time we subscribed to multiple medical journals, including several from the UK. Anyway–the first vaccine under fire was of all things tetanus, but soon it was everything. Most of the people who were anti- were a lot younger, had never seen the diseases they were sure “weren’t really dangerous” or “wouldn’t happen if you ate organic” or “were vegan” or whatever other excuse they had. Being a data lover, and having the relevant figures to hand, I loaded my barrels with them and fired volley after volley but probably did not convince anyone–or maybe one or two but not the multitude. One person’s data v. lots of misinformation from lots of people doesn’t get very far.


  • Comment by patricia n — October 21, 2014 @ 3:23 pm

    15

    there were also other forms of illness in Paksworld, especially if you were a soldier. Paks gave Suli a right royal bolloking for not cleaning her sword and scabbard after they had rescued the Gnomes, pointing out that to nick yourself with a dirty sword taken from a dirty scabbard could have fatal results.Suli of course knew nothing of blood poisoning and ho,hum, it was too much trouble to go to.Why did she have to take the whole scabbard apart? Paks told her. Here endeth the first lesson


  • Comment by Lise — October 21, 2014 @ 3:31 pm

    16

    In Quebec, all the standard vaccines are free (and some are even given at school). Every child that is born gets a government issued booklet listing when to get each vaccine, and then the actual date is recorded. Vaccination isn’t mandatory, but the process is fairly automatic and quite public so there is significant pressure to get vaccinated. I don’t remember more than one or two people not getting vaccinated when I was at school, and most had some kind of medical problem blocking them.

    The only place people resist is when new vaccines get added to the list (like chicken pox a few years back), but then its mostly people who have had the disease wanting to allow a little time to see the effectiveness and safety of a new product, rather than anything against vaccines in general. I guess sometimes a slight language and cultural barrier works in our favor.


  • Comment by Genko — October 21, 2014 @ 5:02 pm

    17

    I remember being vaccinated against smallpox, and maybe TB in school, lined up in the gym. And it seems like the (then new) oral polio vaccine was also given at school at first. It makes a lot of sense, really, to make sure that almost all of the students get vaccinated (can’t remember what they did with students who were absent that day — maybe had a makeup day?). And I presume these were free — anyway, I don’t remember any discussion of payment for them.


  • Comment by Linda — October 21, 2014 @ 7:33 pm

    18

    This is something I feel really restless about. I am generally a believer in “shots” and lived thru the time when kids got polio and I had most of the childhood diseases then. As a result of chicken pox I had several attacks of shingles which were awful. I have a younger friend who will not vaccinate her daughter, and assumes that having chicken pox will not be a problem as it never harmed anybody she knows. She asked me about the outcome of my bout and has totally discounted my suffering from shingles, comparing it to poison ivy.

    I feel very sorry for her daughter, who may get any of these illnesses, especially as it seems fashionable to take kids to see others who are sick to expose them and to let them be sick to “develop natural immunity.”

    I wonder, can kids who have not had immunizations get them as adults once they have a say and still have them work? I still am unhappy about not having talked her mother out of foregoing them, but she is one of the most stubborn folks I know.


  • Comment by GinnyW — October 22, 2014 @ 5:44 am

    19

    I had measles, chicken pox, mumps and rubella as a young child. So did most of my classmates, and my younger brother and sister. The bout with measles threatened my eyesight. The bout with chicken pox was very serious for sister, who was under two years old, and was difficult to restrain from scratching. When I was in 6th grade, a serious flu went through the school. It was rare to have even have the kids in class during that January.

    People tend to forget. Then something like the enterovirus comes along, which killed a toddler near here, and they panic. Part of the problem is “scare reporting” – every serious case receives national attention – coupled with lack of solid education about symptoms and how to deal with them and the vectors of disease transmission.


  • Comment by Jazzlet — October 24, 2014 @ 4:23 pm

    20

    I too feel strongly about vaccinations. My mother had polio in the fifties which destroyed the nerves to her balance muscles and she had to learn to walk again from scratch. She couldn’t squat to lift us up when we were little or run after us. Or bend down to tie her shoelaces, which meant if they came undone when we were out I had to kneel and tie them for her which I found humiliating as a child. People stared, other children asked their mothers ‘What’s wrong with that lady?’.
    My oldest brother almost died from whooping cough and all the GP could suggest was that they try whiskey to cut the phlegm.
    I almost died from scarlet fever and in the process had terrifying hallucinations.
    And those were the worst bouts of illness, there were all the others common in the fifties for my older brothers and the sixties for me. One thing people don’t understand is that illness affects development, and that means it can affect your looks. One of the reasons we are wired to find symetry beautiful is that it suggests a disease free childhood and thus a good immune system. Of course different diseases can also have other long term effects, but they all requre energy to fight and in a child that is energy diverted from growth.


  • Comment by GinnyW — October 25, 2014 @ 8:43 am

    21

    Jazlel, You make a good point about long term effects, and self image.


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