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 the germ theory enunciated by Louis Pasteur (1822-1895). Even people who can find little else to say in favour of science and technology (see Anti-Intellectualism in SF) are usually grateful for the benefits of scientific 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 (see Pseudoscience); the literary imagination has inevitably reflected and magnified these hopes in fantasies of resurrection, Regeneration, Rejuvenation and Immortality – usually couched, of course, as cautionary tales – and the ideative 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 which medical 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 T J Bass, 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 (see 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" (December 1844 United States Magazine and Democratic Review) and Edgar Allan Poe's "The Facts in the Case of M. Valdemar" (December 1845 American Whig Review). It was, however, UK writers who took up such themes more boldly in the latter half of the nineteenth 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 keeping with 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 (see Cyborgs) – were frequently deployed by early sf writers in vivid horror stories or contes cruels; an early quasi-cyborg example is Edgar Allan Poe's "The Man That Was Used Up" (August 1839 Burton's Gentleman's Magazine). Brain surgery offered considerable melodramatic scope to the writer of medical horror stories, exploited to the full in W C Morrow's "The Surgeon's Experiment" (15 October 1887 The Argonaut; vt "The Monster-Maker" December 1928 Weird Tales), S Fowler Wright's "Brain" (in The New Gods Lead, coll 1932), and a small subgenre of brain-transplant Identity Exchange stories. Also reliably gruesome were stories of radiation-treatment gone awry (see Monsters; Mutants); M John Harrison's "The New Rays" (Spring 1982 Interzone) is a more subtly disquieting addition to this canon. 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 circa 1889; in Strange Assembly, anth 1932, ed John Gawsworth). One can also identify a small-scale subgenre of "medical nightmare" stories involving hallucinations – usually vividly gruesome ones – suffered under anaesthetic; these run from H G Wells's "Under the Knife" (January 1896 The New Review as "Slip Under the Knife"; in The Plattner Story and Others, coll 1897) to Neil Bell's Death Rocks the Cradle (1933) as by Paul Martens.
Much later twentieth-century sf continued this pessimistic tradition. C M Kornbluth's tale of the use and abuse of medical equipment sent back from the future via Time Machine, "The Little Black Bag" (July 1950 Astounding), is one of the most famous sf contes cruels, and Daniel Keyes's classic Flowers for Algernon (April 1959 F&SF; exp 1966) is a tragedy of unparalleled poignancy. Bernard Wolfe's Limbo (1952) recruits medical technology to give an ironic and literal twist to the idea of disarmament. Walter M Miller Jr's "Blood Bank" (June 1952 Astounding), William Tenn's "Down Among the Dead Men" (June 1954 Galaxy), Cordwainer Smith's "A Planet Named Shayol" (October 1961 Galaxy) and Larry Niven's "The Organleggers" (January 1969 Galaxy; vt "Death by Ecstasy" in The Shape of Space, coll 1969) are other stories in a vividly dark vein; Niven's coined word Organlegging describes another small subgenre. Caduceus Wild (January-May 1959 Science Fiction Stories; rev 1978) by Ward Moore and Robert Bradford, in which doctors run the world, is as Dystopian as other contemporary stories in which some special-interest group has become dominant; James E Gunn's The Immortals (1955-1960 var mags; 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 continued to the end of the twentieth century and beyond 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. The dark tradition of The Island of Dr Moreau is revisited in Gwyneth Jones's thematically linked Dr Franklin's Island (2001) as by Ann Halam, and in the outright Sequel by Other Hands The Madman's Daughter (2013) by Megan Shepherd.
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; H G Wells's "The Stolen Bacillus" (21 June 1894 Pall Mall Budget) is an early example. The proposal by the Russian physiologist Serge Voronoff that testosterone generated by transplanted monkey-testicles might bring about the Rejuvenation of 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). 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 (June 1912 London Magazine; 1915), remains a melodramatic staple of the Disaster story; a later example is the long opening section of Stephen King's The Stand (1978; text restored rev 1990). 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) by Charles Eric Maine, Plague from Space (1965; vt The Jupiter Legacy 1970; rev vt The Jupiter Plague 1982) 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 of plagues which bring ambiguous benefits as well as posing threats include Walter M Miller's "Dark Benediction" (September 1951 Fantastic Adventures), Frank Herbert's The White Plague (1982) – featuring an artificial, gender-specific plague – Octavia E Butler's Clay's Ark (1984) and Greg Bear's Blood Music (June 1983 Analog; exp 1985). James Tiptree Jr's "The Last Flight of Doctor Ain" (March 1969 Galaxy; rev in SF: Authors' Choice 4, anth 1974, ed Harry Harrison) blackly suggests a positive benefit to Ecology and the well-being of Gaia in Doctor Ain's deliberate elimination by plague of the troublesome human race. In the late 1980s and through the 1990s the newest real-world plague, AIDS, called forth a rapid response in the sf field; Dan Simmons's Children of the Night (1992) features the notion that a cure might 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 of the Plague Years" (in Full Spectrum, anth 1988, ed Lou Aronica and Shawna McCarthy).
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: Murray Leinster's Med Service series (1957-1966) and James White's long-running Sector General series (1957-1999), largely set aboard the eponymous Space Habitat-cum-hospital which is equipped to provide the environmental needs – atmosphere, Gravity, nutrition – of every conceivable species. L Ron Hubbard's earlier Ole Doc Methuselah series, assembled as Ole Doc Methuselah (stories October 1947-January 1950 Astounding as by René Lafayette; coll of linked stories 1970), is unfortunately weakened by the eponymous hero's interest in eccentric theories. White's Sector General 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 (stories November 1967-October 1970 If and November 1967 Analog; fixup 1971) – although White can also function effectively in the medical horror/thriller vein, as in Underkill (1979). Though a singleton rather than a series, Alan E Nourse's Star Surgeon (1960) is a notable juvenile sf novel cast in the earnest and constructive mould, set against a background of galactic medical practice. Another singleton whose main focus is Politics, John Brunner's The Long Result (1965), features a miniature Sector General in the form of Earth's Alien Accommodation Centre (AAC or Ark), where a medical crisis duly arises. A later series somewhat in the Sector General vein though more varied in its settings is S L Viehl's StarDoc sequence, opening with Stardoc (2000). James White's influence can perhaps also be detected in the short-lived Television series Mercy Point (1998-1999), set aboard a Space Station hospital not unlike a smaller Sector General.
The Imaginary Science of Miniaturization offers future doctors the opportunity to confront humanity's internal problems personally, as in the joyously unscientific film Fantastic Voyage (1966) and in Barry N Malzberg's very much darker The Men Inside (1973). Perhaps more plausibly, Philip E High's These Savage Futurians (1967 dos) anticipates the dream of Nanotechnology with swarms of molecule-sized Robots which are injected to prowl the bloodstream, seeking and destroying undesirable micro-organisms.
In general, medical 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" (March 1929 Weird Tales; vt "Whom the Rat Bites" 1939 Fantasy), Charles L Harness's The Catalyst (1980) and Kate Wilhelm's rather ambivalent Welcome, Chaos (1983). In Theodore Sturgeon's "Slow Sculpture" (February 1970 Galaxy), a maverick Scientist has invented an electrical cure for cancer (distantly evocative of Nikola Tesla's devices) but keeps it dark because no one will believe such scientific heresy.
A theme anthology is Great Science Fiction about Doctors (anth 1963) edited by Groff Conklin and Noah D Fabricant MD. Games with medical themes include the Board Game Pandemic (2007), whose players must struggle to contain and defeat the titular Disaster, and the Videogame Plague, Inc. (2012), whose objective is to spread disease and wipe out humanity. [BS/JSc/DRL]
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