What If and What Next? Speculative Fiction and the Erasure of Chronic Illness

There’s a quote hanging above my desk by author Tom Clancy: “Two questions form the foundation of all novels: ‘What if?’ and ‘What next?’.” While Clancy isn’t a speculative fiction writer, per se, I always felt that quote was particularly relevant to my particular brand of speculative fiction writing and reading.

It is also that question that I asked myself this week while working on my master’s thesis, which explores speculative fiction, chronic illness, and where the two intersect – or rather, where they historically don’t. As a part of writing this thesis, I was asked to examine my own relationship to this topic, and a few titles came to mind immediately. The more I thought about it, the more I realized that there had been many books I’d read throughout my childhood and adolescence that would have been – at least to me – so much more interesting if the characters in whom I found a slice of representation had been approached differently.

Don’t get me wrong, I’m not in the business of nitpicking other writers’ work on the basis of my own preferences. That’s just not cool. But I do want to offer up an alternate perspective because, historically, this particular perspective has been lacking.

So, if you’ll indulge me, what if…

…FEED’s Violet wasn’t reduced to her demise?

M.T. Anderson’s Feed is an early-2000s imagining of a far-off future where human beings exist within cyberspace. A huge computer network called the “feednet” is directly connected to the brains of almost three-quarters of American citizens by means of an implant device called a “feed.”

FEED / Penguin Random House

This was a fascinating concept for yours truly, who watched elderly relatives get pacemakers and benefit from other medical technology. But while this tech helped my relatives, the tech in Violet’s world was killing her slowly. The narrative centers around Violet’s slow death at the hands of the technology that kept her from accessing help for her health issues, and on her loved ones’ struggles to understand that.

I wondered this both in my youth and now: Isn’t there a better, less reductive story centered around Violet’s struggle to fit into a world that has, by virtue of technological advancements, shut her out and barred her from accessing what she needs to survive? That is a struggle to which I relate more than the experience of dying, but alas, Violet’s story centers around the pain her loved ones feel at her loss, reducing her suffering to something that’s more of a plot point than anything else.

Speaking of reducing a character’s terminal illness, what if…

…HARROW THE NINTH’s Dulcinea Septimus wasn’t infantilized by the fandom?

Harrow the Ninth’s Dulcinea is a necromancer who spent most of her life critically ill and knowing that her society glorifies her eminent demise as a thing of beauty. Despite the fact that her people expect her to die the “perfect death,” she is not known for her impending

Harrow the Ninth / Tor.com

demise among those who know her personally – she is remembered for her clever sense of humor, and a charming and personable demeanor.

It’s those personality traits that many people in the fandom choose to infantilize. While canonically she uses a wheelchair and a cane to get around, she exerts her own agency in a way that fanon tends to forget. Dulcinea’s strength comes from her desire to live on her own terms because she understands she won’t get to have her death to herself – and, because she won’t be alive to control the aftermath, she has accepted it.

Once again, Dulcinea’s approach to the limits her physical health imposes on her is reduced. Fandoms often play an active role in readers’ participation with the text, and while everyone is certainly welcome to interpret works in their own way, it grates against me that the fandom seems to have equated a combination of kindness, vivacity, and physical illness with license to infantilize a character in fanworks.

Which leads me to my last “what if…”

…authors chose to change their point of view?

Fiction impacts reality in many ways: perception, investigation, policy, the list goes on. Our world is shaped by the media we engage with, and storytellers are charged with reflecting the diversity of the world in which we live.

To return to the Clancy quote for a moment: We’ve talked about the “what if” plenty, and I’d like to leave you with the “what next.” From the #OwnVoices hashtag to this very column, it’s pretty obvious that chronically ill people want to see their stories represented in speculative fiction and have the ability to tell those stories accurately and fairly.

If speculative fiction is built upon the desire to imagine new, different worlds from our own, it’s time to examine what’s next in terms of representation and inclusion, especially when it comes to the worlds we imagine. If our what ifs and what’s nexts have nothing to do with chronically ill people, what does that say about who we as human beings plan on becoming?