For no reason at all, disease seems to be on a lot of authors’ minds right now. Whether you’re writing up a storm in self-quarantine or just thinking of new ideas during this difficult time, we’ve got all the disease-focused discussion you could possibly want. We talk about how actual diseases work, how speculative elements can be used as a parallel for disease, and how silly a lot of scifi medical dramas are. Get that cheese to sickbay!


Generously transcribed by Ursula. Volunteer to transcribe a podcast.

Chris: You’re listening to the Mythcreants podcast with your hosts Oren Ashkenazi, Wes Matlock and Chris Winkle.

Wes: Hello and welcome to another episode of the Mythcreants podcast. I’m your host Wes, and with me today is Oren and Chris. We’re talking about fictional diseases today, and it’s probably a good idea to let you all know that we’re based in Seattle and we’re all just fine. We record remotely and so really nothing much has changed since, I don’t know, years ago. Right, Oren?

Oren: Yeah, it’s been at least three years since we’ve recorded in a room together. I’m honestly not entirely sure any of you have faces anymore. It’s been a long time. Those were dark days.

Wes: Was editing more of a challenge back then, when you had to look at our faces while we were disagreeing about stuff?

Oren: Yes and no. Editing on the one hand was much faster back then, but it was because there was way less I could do. So if we were talking over each other, well, it’s all in one track. Too bad. And if there was a sound when someone was talking – too bad. It’s all on one track, so the amount that I could do was very limited, but now everything’s on different tracks, which means I have to spend about three times as long editing the podcast. It sounds way better though. It’s not like it’s a bad thing, exactly, it just takes more of my time. Although I do have a young protégé who may be training under me to edit some of the podcasts, so we’ll see. I’m sure they will do great, and then they’ll turn evil and then we will have a final confrontation. As this sort of thing goes.

Wes: Very exciting. We look forward to seeing this develop. So, yeah, with a lot of the Covid-19 talk, we thought that we would talk about fictional diseases as they’ve shown up in our media over time. Because stories about contagion plagues have been around since – I tracked down like an eighth century BCE poem about Erra, some Akkadian or Babylonian plague god. It turns out to be the god of mayhem, pestilence, and confusing political order. And so I feel like Erra has returned ,everybody. But then I was wondering, what sacrifices do you make to a plague god? I’m not sure if you can appease one so easily.

Oren: I mean, I feel like everyone who dies during a plague is a sacrifice to the plague god. That’s just efficiency.

Wes: I guess that makes sense. Yeah.

Chris: I think what we’re trying to do is stop sacrificing people to the plague.

Wes: But the plague god must be appeased somehow.

Chris: Maybe that’s not a best practice.

Wes: Yeah, we need to reevaluate our best practices during this time. So yeah, that’s a really old one. We can put a link to this poem in the show notes. A lot of people are familiar with the plagues from the Old Testament in the Bible and the Tanakh, and then of course The Walking Dead where we get zombie diseases and things like that.

Chris: It does feel like today fictional disease stories fall in two categories, zombie stories and not zombie stories.

Wes: Really true.

Oren: I also like how we went from eighth century BCE, to old Testament, to zombie stories. That’s quite a jump. We’ve gone from old Testament to 1967 in our timeline of diseases.

Wes: The fiction in between there is not super speculative. And you know, the ones about cholera are just not inspiring reads, because that is a horrible thing that happens to you. But then there’s a lot of tuberculosis ones, especially in like Victorian literature. And that has some very interesting associations. A lot of authors use that to try to convey spiritual meaning, because if you have tuberculosis, you get frail, blood gets drawn out of you. They kinda thought that it was like a wasting disease that made you sacrificial and angelic and holy because of it, and stuff like that. So – kind of weird. I’d rather talk about zombies.

Chris: Yeah, there are definitely some cultures where a woman being sickly is considered attractive, which is a little disturbing. But I think it’s the fact that women are supposed to be weak and fragile is part of femininity and they need rescuing or are in distress or something like that.

Wes: The zombie thing, Chris is right, it’s either zombies or, you know, not zombies. And I think we’ve kind of moved on to say, okay, we’re not necessarily talking about disease and plagues as something maybe related to some god punishing or blessing or however you want to look at it. And now it’s like, okay, there’s science here. But I think spec fic is still using disease to kind of comment on political and social realities, or to at least explore them, which is why in so many of them, the outbreak kind of happens before the plot. You don’t really see a lot of the disease in action.

Oren: Well, there’s a few reasons for that. So if we’re not talking about zombies – and someone may or may not have written an article about zombies on recently at the time of recording, we’ll never know if someone did that – but if we’re talking about not zombies as a rule, they are hard to make into stories. Not impossible. But diseases are kind of awkward from a storytelling perspective for a couple of reasons. They don’t tend to adhere very well to a narrative arc cause they’re viruses or bacteria or what have you, and they don’t care. And they’re kind of hard to fight.

You know, if you wanted a story about fighting a disease, you can do a medical drama. But medical drama is also really hard. Especially in spec fic. If you look at all science fiction, the medical drama gets even weirder, because you’re trying to do your research by talking to doctors and you’re like, “Okay, but like what if they had a magic scanner that could like tell if cancer existed?” And the doctors are like, “What are you talking about?” – “How would that change things?” – “I have no idea. I don’t know how to answer that question.”

Chris: I think the problem with having diseases and a lot of science-based problems in general is that. They don’t support the idea of a few unlikely heroes turning things around in a short period of time.

One of the funniest examples I’ve seen is in the movie outbreak, which I believe is from 1995. They do this thing at the end where it’s like, okay, we just need to get these antibodies from this one person and then we’ll mix it with this magic serum to create antiserum and then we’ll cure everyone. It’s ridiculous. Because they’re trying to make the science actually work for a story that has a climax and then has a neat resolution. It doesn’t work out so great.

Oren: Yeah. I mean, in this sort of scenario, the disease is essentially a disaster story. And disaster movies, I don’t know if you’ve noticed, but they tend to be pretty cheesy. You can’t fight a volcano. It’s possible to have a good story based on human drama around a disaster. There’s a lot of great drama there, but if the disaster itself is taking up center stage, it’s like, you know…  have you ever seen Twister? Where they act like the tornado is a villain? The tornado comes back for revenge at one point! It’s amazing, and most disaster movies are like that when they focus on the disaster itself as opposed to like how humans react to the disaster.

One advantage we do have as fantasy writers – this doesn’t work well in scifi in my opinion – but as fantasy writers, the scenario Chris just described of like, we need to get the antiserum, it could actually work if you wanted it to. If you set up properly that there’s a god of healing and they have a temple deep in the lost lands and you need to get there and get the thing that will cure all disease. Yeah. Okay. I guess that could exist in fantasy. Sure. Whereas if you tried to do that even in futuristic scifi, it would probably come off as very hokey.

Chris: So Star Trek has this ongoing thing that they do for a lot of their medical plotlines, whether it’s a disease or something else, where they have the technology to just look inside the body and know what’s wrong at a microscopic level, which is amazing. And we do not have that. But for some reason, despite having all of that knowledge, doctors always say they can’t do anything until they know the exact source of the disease, because otherwise there’s no conflict, right. They could just look at it like, okay, here’s a problem. I’ve come up with a solution.

But no, now that gives the characters a reason to go back and try to do some mystery solving and find out exactly what happened. And for that to work, the doctor has to be like, well, you know, I can see what’s happening in this person’s body at a microscopic level, but for some reason, my hands are just tied until I know the whole story of how this came to be.

Oren: In Star Trek in particular – and Star Trek isn’t the only scifi program to have this problem, but it does stand out as having a lot of medical dramas – the wild inconsistency of how their technology works. Because in some episodes they can completely de-transform you, like if you’ve turned into another species entirely, they can just be like, yeah, hang on, let me just undo that real quick.

And then in other episodes, they’re like, man, he has Space Alzheimer’s, it’s impossible. We just can’t. We can’t deal with it. Our technology is helpless before Space Alzheimer’s. And Alzheimer’s is a horrific disease in real life, but if you can change someone from a newt back into a person, I feel like maybe it’s not so indefeatable anymore. You know?

Wes: Doesn’t Worf turn into like a acid-spitting scorpion or something like that?

Oren: Yes. That does happen. There is a Star Trek episode where they de-evolve. That episodes is great because it misunderstands both how diseases work and how evolution works. It pushes the idea that we evolved from animals that are around today. So Riker turns into a Neanderthal, like we evolved from a Neanderthal, which are not around today, but you know what I mean. And Picard is turning into a lemur? No, we did not evolve from lemurs. Oh my God, what’s wrong with you?

Chris: Oh, what’s actually pretty good is the TNG episode Identity Crisis, which surprisingly good, despite its absurd premise where Geordi gets a parasite that turns him into an alien. The idea is this is how the aliens reproduce, which is probably completely unrealistic, but it’s a very creepy story because he just has medical problems that start happening and friends that start disappearing and he has to figure it out.

Oren: The mystery is really creepy, right? They do a really good job with his investigation. I love the part where he’s down on the holodeck and he notices there’s like a shadow he can’t account for in this recording, and he’s like, computer, based on these parameters that it’s reasonable for me to have, where would they be standing to cast this shadow? And it generates this really creepy-looking black blob and it’s like, oh my god, holodeck, whoa. But like once you find out what the actual problem is, it’s like, yeah, okay. I guess they’re going to retransform him with his DNA. That’s a thing DNA does, right? You can turn off the body and turn it back on and then the DNA will fix every problem.

Wes: That’s part of the season two Unnatural Selection episode, right? Where they just recombine Pulaski’s DNA structure to fix the aging problem that happens?

Oren: For that one, to be fair, they used the magic transporter,

Wes: Oh right. Good point.

Oren: Which they never do again because wow, it turns out the transporter being a resurrection device was a bad idea.

Chris: My favorite science snafu is still this Buffy episode where Buffy has the flu and she’s in the hospital. And the idea here is not that the flu is fictional, but that there’s a monster that in order to see it, she has to have a fever under the influence of this flu. She’s recovering and she can’t see the monster anymore, and so she breaks into this doctor’s office to grab a solution that has the flu in it. And when she grabs it, Willow objects: “No, that’s 100% concentration!” [laughs] Like – what, that liquid is 100% flu, it’s just nothing but flu particles all the way down?

Oren: Absolutely nothing else.

Chris: And then she just drinks what is supposedly pure flu and then just gets a fever again in a couple minutes. It’s amazing.

Wes: Oh, that’s great.

Oren: So in the scifi thing, I do think that if you want to have a scifi illness, you can do it. Because we discover new illnesses. It’s a thing that happens. But I do think you need to be a little more creative than taking a regular illness and giving it a space name. This happened in Mass Effect, where they make this big deal about how one of your companions is dying from a fancy space disease.

But when they explain it, it’s like – it’s cancer. He has space cancer. And it works exactly like cancer and has exactly the same symptoms as cancer, and they play all of the cancer tropes of this guy dying. Except for the part at the end where he beats up an assassin while dying of space cancer. I don’t think that’s in most cancer stories.

They would be improved by it though, just saying. But you could be a little more creative than that. I think you kind of have to be, otherwise it just feels very hokey. And you know, Mass Effect’s technology isn’t quite as advanced as Star Trek’s is, but it’s still advanced enough that it really feels like we should at least have made progress on the cancer front by then. By the time we have FTL drives, it seems like maybe we could have something that would be more effective against cancer. You know, we’re pretty good at developing treatments for disease when financial interests don’t get in the way. It’s not like we aren’t bad at that. We actually do a good job.

Chris: I would say that disease works much better as a threat that’s involved in the stakes than it is actually fighting it during the story. That’s how 12 Monkeys works. A main character in 12 Monkeys has gone back in time to stop a world-ending pandemic from starting. So we see the results of it, it doesn’t have to go into any of the biology of how this thing works, but we know it will work and then it’s about stopping it from happening in the first place. I think that’s definitely easier than trying to science your way out of it once it starts.

Oren: And you can use disease and illness as a powerful backdrop. There are several stories that do this. In The Train Job from Firefly, the premise of the episode is not “let’s fight the space disease”, but that they go to this town where everybody has this disease caused by industrial runoff, basically. And they’ve been tasked with stealing the medicine that these people need. And they’re like, “oh no, we’re the good guys, we can’t do that.” So they don’t. And that’s cool. And it helps for a few reasons.

One is that Firefly does a pretty good job establishing this divide between the future people who have the advanced technology and the future people who don’t. So you get the feeling that this probably wouldn’t be a big problem in a rich central core planet, but you know, out here in the rural boonies, it’s a lot more of an issue. That’s good. And then they also aren’t trying to fix it. It’s the backdrop of the conflict they’re having.

There’s also stories like Wanderers – which I don’t like, I don’t think it’s a good book. But it does portray disease quite well and uses it as an effective backdrop. Unfortunately, that’s the best part of the book. It doesn’t do anything else, but it has the disease.

Chris: I have to say though, a lot of the description of the disease in this book is really disgusting.

Oren: Yeah. There is that.

Chris: I had to stop when I was listening to some of the narration about this disease because it was just gross. So if you are easily grossed out or just don’t like body horror or anything like that, I would not recommend the disease parts of Wanderers – the actual disease parts of Wanderers as opposed to the pseudo disease parts of Wanderers.

Oren: Another cool way you can use disease and storytelling is as part of the politics of your setting. The Temeraire series does this quite well. I unfortunately don’t remember exactly which book this happens in. But they pick up a new disease that infects all of their dragons, because this is a Napoleonic-war-with-dragons setting. And they find out that this is a disease that is known about in another part of the world, and that part of the world has at least the potential to create a cure. So they go and try to get it, and that makes sense because this is Napoleonic-era transport, you can’t just call someone and have them fly it over to you the next day. It takes a while to get there. And then they have this interesting conflict of, well, we’ve got the cure, but the disease has started spreading to our enemy countries, so maybe we should just keep the cure for ourselves and let them deal with it.

And at that point, this causes the main characters to have a crisis of conscience. Because they’re like, “That’s evil. Letting people die of illness when you could prevent it is evil.” – “But those are the bad guys. And these are our orders. What do we do?” It’s a cool conflict and I liked it quite a bit. That’s not the only way to use disease, but it’s just a fun way of tying the disease into the human drama, which is what I think is compelling about that scenario.

Chris: One thing I’d really like to see is – apparently the most often used way of controlling a new epidemic that starts is by simply rigorously tracing people who’ve come in contact with it and isolating them, right? Some people have to do that work and to try to contain it best they can. And it doesn’t necessarily mean that they’re magically coming up with a cure, they’re just trying to keep it under wraps and keep it from getting too big. So I think you could probably have a fictional virus that, like Coronavirus, is contagious before symptoms start, but turns some people into monsters, so you can have that action component. And then have a team whose job it is to trace who could be infected and fight with the monsters that happen, but mostly contain it. They can never defeat it entirely because it’s always gotten ahead of them, but they can minimize its spread.

Oren: That is really cool and I’m way into that.

Chris: Somebody, if you’re listening, write me that story. I put in my order.

Wes: In general, if you are looking to write a story about diseases, the means of transmission, I think, is something that’s important to probably base on reality. I guess you could do some kind of auditory disease, maybe? You hear a contagion? I dunno. I’m just trying to think of anything besides the standards. But really, you know, there’s airborne diseases; Chris mentioned asymptomatic hosts who apparently are called reservoirs…

Chris: That’s creepy.

Wes: Touch, fluid transmission… parasites are a terrifying way for diseases to spread. And then, you’ve heard this one lately too in the news, it’s a little different from airborne and coughing and spittle, it’s called “aerosolized”. So if you cough, a little bit of it, like the water particles that come out of your mouth, can linger in the air for awhile. It’s different from a dry cough; with a wet cough, you can actually make a room full of the stuff for 10 minutes, up to that long. Just by having a really hard coughing fit. Really scary in its own. Adds some tension.

Oren: You said this as a joke, but I actually liked the idea of a disease that spreads via audio or via one of your senses. That’s creepy.

Wes: Yeah. I think it is creepy. The closest I’ve ever come to an idea like that was in Neil Stephenson’s Snow Crash, which is kind of a post-apocalyptic world and then there’s also this MMO kind of situation. And it’s an MMO, so if you’re in there, nothing bad can really happen to you in the real world. Except when somebody kind of gets their brain hacked by effectively looking at a snow crashed computer screen, you know, all white and stuff like that. It hacks and rewires the guy’s brain. But that person then could not spread the disease, but the software could be transmitted to spread it. It is interesting. I would have to reread the book before I could fully endorse it, but I remember that being a little compelling.

Oren: Well, making an illness that spreads via your senses is very unusual and I think very novel. It also has the potential to be difficult because, you know, we tend to rely on our senses to see things as it were and to understand the world around us. So if one of those is a vector for a disease, that creates some weird dynamics, which I think could be absolutely great to play with and have fun with. But if you’re not prepared for those, it can be kind of weird.

Chris: It reminds me of Bird Box, right? Also, I think it would start to feel really similar to a lot of the horror that we have out there that is sensory-based and purely magical, and there’s no premise that it’s specifically a disease. But there’s been a number of movies lately about trying to stay quiet because the monster can hear you, or, in the case of Bird Box, you can’t see the monster or you die.

Also The Ring, where you watch a video – that one is viral in a way, because the way that you live is by making a copy of the video. Now, granted, there’s no rule, or the movie doesn’t specify there’s a rule, that somebody has to watch your copy. So it does sound like you could just copy the video that gave you this curse and then throw both copies in a pit somewhere and it would be fine.

Oren: I mean, the real question is, why is anyone still watching VHS anymore? [all laugh] Boom. Gotcha.

Chris: I guess with a disease, if you can get it in a very surreal way by seeing or hearing it, I would wonder what makes it a disease and not, like, a curse.

Oren: I mean literally nothing. I would actually say that it in fact should be a curse, because at this point it’s not a traditional disease. It is a parallel for one. And I would say that that is potentially cool. I do see people talk about – I get there’s an analogy between the way memes spread and the way that a virus spreads, and in fact the term meme originally was used to refer to genetic material and not images – but sometimes I do see people take that a little far.

It’s like, “They’re going to infect us with their memes, and if I see this meme, I’ll become infected.” Again, it’s an analogy. It doesn’t quite work that way though. But if it’s a magic curse, it kind of could. I’m fine with it if it’s magic. I will accept a lot of things if they’re magic.

Wes: Another cool use for diseases in your stories is if you’re attempting to write a story that needs to be post-apocalyptic in some way, but you don’t want to necessarily destroy your planet to make that happen. Diseases are great for that. It’s kind of interesting right now in our current situation to see the ways in which nature is already rebounding. I saw some great pictures of how the channels in Venice are clear and fish came back because, you know, tourism has stopped.

So disease can give you an opportunity for your post-apocalyptic heroes, where society has probably broken down, to still be enjoying resplendent wooded forests and not a nuclear wasteland. Sure, there might be dilapidated cars and things like that, but you can more or less preserve a climate and an environment you may want to have in a story that you couldn’t otherwise, if we used devastating weapons to create our different type of reality.

Oren: That is definitely true. One thing that I will advise caution on – actually, two things. First, be careful when you’re using a disease to create a post apocalyptic world about what the conflict is going to be. There’s a british show called Survivors, where the premise is that something like 99% of the population gets wiped out by a disease, and there are these isolated groups of survivors and they fight. But the show doesn’t have anything for them to fight over, because there’s basically unlimited resources now.

They look into like, well, how long will canned food last? And it turns out it lasts several years. So, okay, at some point, maybe we might have to start fighting over the cornfield one of us started, but for right now, we basically have unlimited food and unlimited housing and unlimited building material. So why are we fighting? And the show didn’t have an answer, but it had them fight anyway.

So be careful of that. And the other thing to be careful of is – all right kids, it’s time to talk about ecofascism! Which is a thing where people say, “Oh, the earth would be better off without us. We should just kill all humans.” And this sounds like something that you would see on a bizarro episode of Captain Planet, but it’s a real thing. And the problem with it, the reason why it’s bad, is that it tends to get translated into, “what if we killed the poor people?”, and this idea that like, yeah, the world would be great if it was just a handful of privileged people and all of the poor people of color were gone.

I’m not saying that any story that uses a disease to create a post apocalyptic environment is supporting ecofascism. It is just kind of a hot button issue right now. So be aware of that when you’re writing your story. Maybe do a little research on it to make sure you don’t accidentally play into those tropes.

Wes: Also, just to piggyback off of Oren’s great point there, if you’re writing a disease into your story: Diseases affect humans. Do not make your diseases target a particular segment of a population, a certain race. Therein lies undesirable things. Your stories are better off saying humans share genetics and if it can infect me, it can infect Oren, it can infect everybody. Instead of trying to jump through loops, to piggyback, or remove… there’s colonialism in those stories.

Oren: And even something like Y: The Last Man is not great in that regard. The premise is that a virus killed all men and it has two problems. First, it’s just pretends that trans and intersex people don’t exist. It doesn’t know what they are and it doesn’t know what to do with them. So that’s a problem. But then the other problem is that the whole story basically like, “Oh man, what if this one beta male was the last man?” And it’s like, [in disillusioned voice] okay. I just… sure.

It’s sort of the premise of the story and I just didn’t like it. I thought it was kind of misogynist in some unusual ways that I was not expecting.

Wes: A good story to pick up on conflict in a post-apocalyptic disease world as opposed to Survivors, like you just mentioned, is Stephen King’s novel, The Stand, which you can read if you want, but it’s a beast, it’s like 1200 pages or something. Ungodly.

But his premise is that, in the first few chapters, the engineered super flu happens. And it just wipes out seven eighths of the American population or something like that. So the story is about the survivors who for whatever reasons survived and are trying to make their way to, I think it’s a city in Eastern Colorado. There’s supernatural elements in this where they’re getting visions and things of a person that’s setting up civilization again. But the larger conflict comes into scale with his villain, Randall Flagg, who with this super flu has basically also developed some kind of demonic power and is rallying tech workers and industrial strength, and basically trying to build a fascist state. And that kind of takes over this conflict of, why would these two groups who are rebuilding civilization come into conflict? Well, one of them is going to try to use weapons to oppress everybody else.

Oren: I mean, that’s perfectly reasonable. The issue with the show Survivors specifically was that it took place right after everyone was dead and the only people around were small isolated groups.

Wes: That makes no sense.

Oren: Yeah. It just didn’t really work.

Chris: Well, I can mention another one that’s funny. In the Voyager episode Learning Curve the ship gets a disease. They make a big deal on Voyager about how the ship is cutting-edge because it has these bio-neural gel packs. So one episode, the ship starts malfunctioning and it turns out they have gotten a disease from cheese that Neelix brought on board because of course, Neelix is the one who messes up everything.

Oren: That whole episode is basically built so that they can have the doctor say, “Get that cheese to sickbay.” [Wes laughs] Which is, incidentally, another example of how they have mega scanners that can scan everything, but for some reason they needed the original cheese. They couldn’t just scan the infected gel packs and be like, “Oh look, they’re infected with cheese.” They had to get the original block, which they’re fortunate no one had eaten. I don’t know what they were going to do if that had happened.

Wes: “This cheese is too delicious!”

Oren: Granted, it’s Neelix’s cheese, that was never going to happen, so they were at least safe from that problem.

Wes: We’re getting close to the end of our time here, but something else to maybe consider in your stories, is that diseases, viruses, these things don’t kill very fast. At least not highly contagious, pandemic-style ones. So that can continue as a background threat, where maybe it’s under containment. But the point is that a virus, for example, needs time to propagate. So if you wanted to make some kind of super deadly virus outbreak in your story, that just, it’s so dangerous, it will kill people in like 20 minutes.

Most people would read that with skepticism, because most sicknesses have a length of weeks or days because that’s just kind of the nature of how these things propagate. Even bacterial ones, like the black death, didn’t kill somebody in a few hours. It takes a little time for those kinds of things to set in, so that might be something to keep in mind if you want to write a story that’s trying to base your fictional disease on realistic ones.

Oren: Right, if you make your disease too lethal and too fast, then it’ll just burn out and it won’t spread.

Wes: Immediately. Yeah.

Oren: All right. Well, I think this is a good point to end the podcast. Before we go, I want to thank a few of our patrons. First, we have Kathy Ferguson who is a professor of political theory in Star Trek; next we have Ayman Jaber, who writes urban fantasy and knows all there is to know about Marvel. And finally we have Danita Rambo and she lives at

If anything we said piqued your interest, you can leave a comment on the website at and otherwise everyone please stay safe, if you can. We’ll talk to you next week.

P.S. Our bills are paid by our wonderful patrons. Could you chip in?

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