For very obvious reasons, illness and disease are often on our minds these days, which means they’re bound to pop up in stories. Whether as a parallel for COVID-19 and other pandemics, or simply a single character getting sick, it’s important to understand how fictional diseases work and what effects they have on your story. This week, we talk about apocalyptic plagues, quests for a cure, and why you should get your bivalent booster. Seriously, please get that booster.


Generously transcribed by Paloma Palacios. Volunteer to transcribe a podcast.

Chris: You’re listening to the Mythcreant podcast with your hosts Oren Ashkenazi, Wes Matlock and Chris Winkle. [Opening Song]

Wes: You’re listening to the Mythcreant podcast, I’m your host, Wes, and with me today is-

Chris: Chris.

Wes: – and –

Oren: Oren.

Wes: Well, we feel like we’re farther along in the pandemic now to be able to discuss diseases in speculative fiction and not because the pandemic’s over, it is not, but because it’s been with us for so long now that for better or worse stories are just gonna feature pandemics and endemics and diseases, and it’s just gonna kind of be around for a whole long time. Kind of like how that little ice age from like 1600 to 1800 made all those stories back then kind of cold and broody, so that Lord Byron could really get his edge on.

Wes, Oren, Chris: Group Laughter

Wes: So that’s what we get to look forward to and there’s definitely ways to do it right and there’s ways that it’s done wrong, so we should probably warn you.

Oren: There is passionate discourse about whether or not we should be doing pandemic stories and if we’re going to, and whether or not this will take the route of the post 1918 flu pandemic, in which there was very little pop culture about it afterwards and people just wanted to pretend it never happened or “move on from it” is a better way of looking at that. That’s complicated, and I’m not even gonna try to get into that or predict what’ll happen.

Chris: I think we can agree that some portrayals of pandemics at this point are more sensitive and realistic than others.

Oren: Have any of you actually seen, like, a pandemic story that happened since Covid started? ‘Cause all the ones I’ve seen are from before.

Wes: Yeah. There’s Station 11 and that’s not really spec-fic and it’s much more, like, of an inspiring story in the sense that it’s post pandemic and it’s post-apocalyptic, but not like in a spec-fic sense, but it’s more about the community and rebuilding, and I can see how that story would make sense, but there’s really like the three types of stories are: It’s Happening (It’s Happening Right Now), and It’s Over and We’re Dealing With It, and maybe the It’s Over and We’re Dealing With It  stories are gonna be more because Spec-fic loves a good post-apocalyptic world where society is fragmented et cetera, et cetera.

Oren: Pandemics are difficult for fiction because as we have learned very harshly, there isn’t a lot of heroic action you can take against a pandemic. You can’t fight it with bullets or by driving your car real fast. Most of the things you do during a pandemic are not doing things, like don’t go out without a mask, and avoid large groups. You can remember to get your vaccine, but even that is only the most helpful if everyone does it.

Wes: Yeah. You can’t just shrink yourself and go punch the virus.

Oren: Right. This is why I maintain ‘till the day I die that zombie stories are not really good parallels for disease epidemics just because we can shoot zombies with guns and we are incredibly good at that. That comparison has always bothered me, but you know, maybe that’s just personal. I don’t know.

Wes: But you’re right. I mean, you’re really dealing with an environmental catastrophe. I mean, it’s akin to a massive earthquake or meteorite, cold weather – something like that, because you can prepare, but you kind of just have to deal with it. That’s not the realm of the heroic.

Oren: Which I’m not saying it can’t be featured or done or used, I’m just saying it is not an easy premise.

Wes: Yeah

Chris: Yeah. As far as an analogy goes, I actually thought, Don’t Look Up, which mainly was thought of as a climate change analogy, but also worked really well as a pandemic analogy, because the idea of an asteroid heading to earth, it requires the same sort of concerted public response and government resources that a pandemic requires. And so that worked much better because again, people can’t go out with guns and shoot the asteroid.

Oren: NASA did just smash a satellite into an asteroid, though. That was pretty cool.

Wes: That was pretty cool.

Oren: I like that experiment. 

Chris: Next, can NASA handle climate change?

Oren: I mean, maybe?  It should be noted that when you talk about disease in fiction, like obviously pandemics are on our mind for obvious reasons, but they don’t have to be pandemics to be a disease in fiction, right? Someone can just get sick, or even a small community can get sick, right? That can also be a perfectly useful part of your story. It doesn’t necessarily have to be a worldwide outbreak.

Chris: There’s also many stories where there’s a character who is a healer or needs to do something useful by healing somebody, so sometimes it’s less about the conflict of somebody getting sick and more about providing a useful role for a character.

Wes: It’s often good pointing out that you know your heroes are not completely foolproof, they can get sick. They are vulnerable, they are mortal by making them maybe have a brush with something that wants to give ’em really bad sinus infection or something like that.

Chris: They were traveling and they died of dysentery.

Wes: Yea, oh sad.

Oren: Wamp, Wamp.

Chris: Actually, cholera and dysentery are a couple of the ones that can actually be treated in a low-tech, because mostly antibiotics are often helpful, but in many cases, just lots and lots of water is really what’s necessary there. So, a knowledgeable character can pretty easily help somebody with those.

Oren: Right. The creating-a-cure-type problem is definitely something that writers like to try, but it’s also difficult just because what you’re basically doing there is you’re creating a scientific conflict where your character is trying to figure out the solution to something and you need to have a pretty firm grasp of what they’re doing to create something that both will have a turning point and will have like a mechanism that the audience can understand. ‘Cuz you don’t want it to just be: ‘And then we did a slow iterative process and over many, many iterations, we eventually found a cure,’. That’s good in real life. We love it when that happens, but there’s no turning point there, in fiction that’s kind of boring. You also don’t want it to be like, ‘And then I rerouted the plasma bacteria through the reverse polarity micro syringe,’. It’s like, what are you? What are you – what?

Wes: That’s why the best is just quests and then you go get cool sounding things like in Brian Jacques’ Salamandastron, the Dry Ditch fever is getting the mice at Red Wall and they have to go find the flowers of Icetor that are boiled in spring water, which is the only known cure. That sounds great. I want to go find those flowers.

Oren: That’s the search-for-the-cure or the quest-for-the-cure conflict, which is much easier than creating a cure in terms of writing, because usually this involves some kind of journey, which has more concrete dangers and obstacles you have to overcome to get the thing, and the fantasy version of the story is very popular. You can also do a small, isolated community, for example, you might have some kind of sled dog, I don’t know. Throwing out ideas here.

Chris: It’s good, but I wish Star Trek would stop doing it, because in Star Trek, somebody will get sick and they want to have a conflict that involves curing them, that people besides the doctor – we don’t want the doctor to just sit in the medical bay and reroute through the deflector dish. That would not be an interesting way to cure somebody. So, they always send people out to find the source or cause of the illness, and in most stories, this would be a great way to do it. The problem is that in Star Trek, their medical technology can basically see every single thing that’s happening in the human body, on a per molecule basis, so they don’t need any more information. They know exactly what’s happening in somebody’s body. There’s no reason they would need to figure out what the cause or the source, because they can see exactly what the problem is. Usually, the reason you need to go find the poison that poisoned this person is actually more of a diagnosis issue.

You know what the problem is, but if you have perfect medical scanning technology, you know exactly what the problem is. It always feels super contrived when they need to go and, for instance, find the exact venom that’s poisoning somebody.

Oren: But wait a minute, perfect lower decks episode concept! The doctor sends them out on one of these, like, go find the space snake that bit this guy and then they come back and they went through a difficult, harrowing adventure to get it and then they find out that the doctor didn’t need it. She just sent them on that so they wouldn’t be in the way. My new lower deck scripts, call me Paramount!

Chris: Turns out they could have just replicated the snake.

Oren: I mean, Star Trek is definitely a show that has the problem of ‘oops, our technology is too advanced’, so that makes it very hard to credibly create problems and the medical technology, in particular, is a huge problem and, partly, that’s because of the premise of the super advanced future, but also it’s because often writers want to have characters get murder-death, and then they want them to be fine later, so they just introduce a treatment for murder-death, and it’s like ‘you know this is gonna be a problem later, right?,’ And they’re, ‘No, it’s fine. Don’t worry about it.’

Chris: No, forget it.

Wes: I like how in season two, in Next Generation, they had ‘our medical knowledge is so advanced that we made the perfect human with the most aggressive immune system in the world’.

Oren: It’s like a person who just puts off clouds of horrible microbes.

Wes: You stand too close to them and, suddenly, you start rapidly aging.

Oren: Yeah, that is really gross. Now that I realize what’s happening. That’s also the episode where they establish that you can resurrect people with the transporter.

Wes: Do you remember the great conflict around that was like, ‘Oh, but no, Pulaski, she doesn’t use the transporter! Oh no, we’re doomed!,’ And they’re like, ‘Well, she probably brushes her hair, so let’s go find a hair, comb,’.

Oren: Hey, you find any nail clippings or something?

Chris: Maybe the computer’s just doing bio scans with people all the time?

Oren: I mean, in Voyager, we established that the computer is constantly monitoring everyone’s brain waves. That’s my favorite part about Star Trek, how it waffles dramatically between no personal privacy and we don’t know how to put a camera in our sensitive engineering areas.

Chris: In Enterprise, they have the discussion monitor that’s in the shower room.

Oren: Yeah. Though that was also Voyager.

Chris: So, somebody’s showering and then suddenly like a video comes on, ‘Hi, how’s it going?’

Oren: And they can activate it from their end, which is, you know, a dystopian nightmare. Also, in later episodes it’ll be like, Oh, hey, someone broke into engineering and blew up the warp core almost, but we have no idea who, and it’s like, are there security cameras around the warp core? You just think there would be. That was actually one of my favorite things about Murderbot was the argument over where to put security cameras and how many of them to have. I thought that was great, but that’s really far removed from disease.

Chris: Another trope that gets me is when you have a character in a historical setting, and in many cases, medicine was not great. People did not understand how medicine worked, and they often did more harm than good. Of course, if you have a hero who is dealing with a situation where somebody is hurt or has a disease, you don’t really wanna show them bleeding somebody or putting leeches on them. So, there’s just a lot of like, no, the hero just happens to be the one person who knows that bleeding somebody when they’re sick is not a good idea, or on the other side of it, if your hero is supposed to come up with solutions to historical problems, then they just happen to know that scurvy is caused by vitamin C deficiency and people need lemon. It just feels a little contrived that they just have this like advanced, anachronistic knowledge.

Oren: I wrote an article a while back about anachronisms that fantasy needs, and one of them was a relatively modern understanding of medicine. Just because you do not want your story to have a moment where you’re a protagonist is like; I’m going to treat my dying friend by bleeding them. You just don’t want that, even though that would be perfectly realistic for a lot of fantasy. That would just throw your readers right out of it and be very unpleasant.

Chris: If you’re in an otherworld fantasy, you just assume that medicine is better than it was in our world historically, and that everybody knows, so your hero doesn’t have to stand out. Everybody knows that bleeding is a bad idea, et cetera. It gets a little bit more awkward when you have a hero that’s in an Earth, historical setting, and then you kind of gloss over that a little bit. It’s just weird when everybody else in a setting believes bleeding is the way to go, but your hero, for some unexplained reason, is the one person who doesn’t.

Oren: If I was in that scenario, I would probably just pretend that the general level of medical knowledge is higher than it was and try not to call attention to it, unless my hero was like a John Snow type character, who does know something. It turns out John Snow, specifically, being a guy in England who was pretty sure that dysentery spread through water or it might have been cholera, but it was a waterborne illness that at the time most other medical professionals believed was airborne and it turned out it, he was right. It was waterborne. So, if you’re doing something like that, then sure you can have a character who, if you justify it, could know more about medicine than the people around them.

Chris: Right, or if your character is specifically on an assignment to figure out what the cause of scurvy is and test solutions or something.

Oren: Oh man. The history of trying to figure out what caused scurvy is super weird and to this day, very contentious. I did a bunch of research for this a while back, and there’s huge arguments about whether or not spruce beer prevents scurvy.

Wes: Pine needles in general have a lot of vitamin C, right?

Oren: Spruce has vitamin C in it, but there’s studies that show that the beer-making process destroys all the vitamin C, but there are historical claims that once they started drinking spruce beer, the scurvy went away and this is kind of a difficult thing to test cuz we don’t want to give people scurvy on purpose. Then there are arguments about people having been noticing the various things that stop scurvy for a long time. It’s very hard to test them, so there have been various attempts to test the idea that eating citrus fruit will prevent scurvy, but often those studies would fail for various reasons because they had the wrong kind of citrus fruit or they did something to it that messed up the vitamin C or something. Or they didn’t eat it for a while, but they were eating something else that cured their scurvy, and so they were like, well, obviously this citrus didn’t help. Unless you have a lot of resources and a lot of controls and trials, it’s often hard to tell where your result came from, which isn’t super relevant to most stories. I just found it fascinating.

Chris: Because now we think of it, it’s so simple. It’s like, oh, why couldn’t they get that it was just ‘need to eat citrus fruit’? Well, at the time, controlling all the different variables and also meeting the practical constraints of sailors was actually hard.

Oren: It was very difficult, so I figured we probably talk a little bit about the most dramatic or well-known use of disease, which is to explain the apocalypse. Like, why there’s no one else around or very few people around?

Wes: Should we just say we’re not gonna deal with zombies?

Oren: Well, I mean, zombies are a little different, right? But this is more like The Stand or the British show Survivors or the book Wanderers. You use a disease to explain why there are very few people in the world anymore.

Wes: That has the advantage of the setting is like this happened, and the book the story is in is after it’s happened. And so, the disease by far and large is not a threat anymore because the people that are still around, presumably, are immune unless you’re in utero, right? Isn’t that what happens in The Stand her baby? It’s like, oh no, we don’t know.

Chris: It’s very strange in The Stand because they establish that some rare people are immune, but we don’t know why and it seems like it doesn’t run in families at all. None of the characters that we see that survive, at least in the show (again, I haven’t read the book) none of their parents for instance, also live, so it doesn’t seem like it’s genetic ‘cuz otherwise you would expect them to have some family members that are also okay. But then we have one pregnant woman and then when the baby is born, they make a big deal about how this baby has half immunity, supposedly, because it has one immune parent and one not-immune parent and it gets the disease but lives. So, it’s just a strange inconsistent thing that hasn’t really been thought through.

Oren: And that was generally the same in the book. I read that a long time ago and it was like 1200 pages, but I do remember.

Wes: I think it was pretty inexplicable. It just wiped out eight, ninths of North America and the people who were left were just kind of random.

Oren: Well, The Stand is literally a deus ex machina story. I think the explanation is actually God gave a bunch of people the immunity gene for some reason cuz Steven King wanted him to, And that’s, that’s the explanation. One thing that I’ve noticed, I’m not even sure if this is something that writers should do or need to, but I have definitely noticed more now, is that a lot of post-apocalyptic stories assume that when there’s some kind of massive disease that kills everyone, that what’s gonna happen is that either you get it and die or you never get it and you’re totally fine. When it comes to actual illnesses, that level of dichotomy is very rare. You’re much more likely to get it and survive than you are to just never get it.

Wes: I mean, there are grounds in historical support for people that do have immunity or the closest thing to it for certain things. There’s a connection to where some people are far more resilient to HIV due to lineage connected to the Black Death basically removing one of the receptors on our cells so that HIV can’t quite plug in. And that’s across the world from small populations. There’s some people that allegedly the government’s researching are Covid dodgers. For whatever reason, living with people that got it, say they never got it, so they’re trying to get people to volunteer for blood sample studies. So maybe we’re witnessing the rise of the Xmen, I don’t know, if there’s some kind of gene mutation out there.

Chris: But in most of those cases, there’s a population that has semi resistance, especially if we’re talking about a gene that you could have two copies of it, so there’s always some people who can get it, but recover or have partial immunity. So just the idea that people are 100% resistant and never even contract a disease or they just die instantly there’s nothing in between, is weird.

Oren: There are some problems with the basic concept of disease wiped everyone out. And that’s the reason why there’s no people, authors like that because it allows them to just have empty civilization, I mean empty aside from all the bodies, but it allows them to have all of the mechanisms of civilization still be intact ‘cuz you don’t have to deal with a nuclear war or severe climate change or anything like that. But it does create some problems with things like, well, why is anyone fighting if this takes place shortly after everyone died? It’s like, well, there’s plenty of stuff for everyone. What are we fighting over, exactly? The show Survivors just kind of glosses over it and is like, don’t worry about it. And in The Stand adaptation that we watched; it’s everyone suddenly becomes a rapist. That’s the only thing that we could think of and neither of these are great outcomes.

Chris: It’s gross and it’s especially weird because in Stand, the survival rate is especially low and most people, when we actually get to characters, seem pretty eager to meet others who have survived and form communities, so then throwing that in with random rapists running around, it’s like, this is very weird.

Oren: Especially when it does it three times. This is a little much, guys.

Chris: The other thing that gets me about Sweet Tooth, which has that as a postapocalyptic, and The Stand is, at this point, I just have higher standards for how people would respond while a pandemic is happening. In The Stand it’s incredibly contagious and incredibly deadly. It’s really fast. People die right away, but it’s also obvious that they’re getting it ahead of time. They start coughing and sneezing and what have you, and there’s just nobody, despite all the people who are suddenly sick everywhere and possibly dying, nobody seems to be trying to prevent, isolate or prevent getting the illness. They’re all going out and there’s like no effort whatsoever to try to keep from getting it and in Sweet Tooth it almost gets even weirder, even though it sounds like the disease has a slower onset, there is a paranoid town that is actively killing people who are infected to try to protect themselves, but like isn’t afraid to go in their house and drink water with them. We care enough to murder people, but at the same time, we’re also okay exposing ourselves to the people we’re about to murder.

Oren: Obviously, the real pandemic has very starkly highlighted that lots of people, for various reasons will flout even the most basic of safety protocols, and will do absolutely absurd things that risks their own health and the health of people around them and will do it proudly because they’re not afraid of no virus or something. So that obviously exists, and I would probably argue that there would be way fewer of those if we were dealing with one of the fictional illnesses that make you bleed rocks out of your eyes or something. That’s a separate argument. But we’ve also seen that a lot of people do the opposite and will try very hard to stay safe.

So, it’s weird in fiction when you never see anyone doing that. I also just found Sweet Tooth, honestly, pretty hokey. Something I wondered during the pandemic and it is still going on, is that am I just gonna be too sensitive to pandemic media to enjoy it anymore? And I’m sure everyone has a different answer to that, but for me it’s not that I’m too sensitive by default, it’s that I get really sensitive to hokiness, and in Sweet Tooth it’s like we had the super flu that killed everyone and also made animal hybrids, and I’m like, okay, sure. That’s a theme break, and I think I probably would’ve been a little annoyed with it before Covid, but now after Covid, it’s just, I don’t know, it feels disrespectful to me now. If we had animal hybrids that would add some levity to this is all I’m saying.

Wes: A few other diseases that should have been in some stories that I think are interesting to mention. They don’t have to be fatal all the time. I’ve brought up Snow Crash on some recent podcasts, and the title of the book is The Titular Drug that is both a computer and a biological virus that can basically get you if you’re in the metaverse, which is basically like Second Life or something like that, but it can also get you in real life too.

Oren: Wait, if you get sick in the game, do you get sick for real?

Wes: Yes, and that’s like why? It’s like, Oh no. Like that’s why people start really getting messed up, uh, because that couldn’t happen, but it’s a mind-altering virus that doesn’t kill you, but it causes like glacialia. So, it sounds like you’re speaking a language, but it’s not coherent speech sounds that sound a lot like language, but nothing that’s coming out is in like a language proper. So, at the core of the book is figuring out how is the computer virus getting in into our brains. So, there’s a whole thing there with how language works, like hacking minds and stuff that’s kind of weird, but the transmission was novel for sure, because especially now we’re on the internet a lot. It’s like, oh no, I really don’t wanna go online and watch a video and have a computer virus go into my brain. But they did it in that book and it was done pretty well.

Oren: I think I’m already afraid of clicking on any video cause I’m worried I’ll be like going along and listening to something about cool historical weapons and then the YouTuber wanna tell me his views on feminism. Different kind of mind virus. A different kind. One thing that I wish writers would remember to keep in mind is if you are gonna have a situation where your characters are in the midst of a plague or an outbreak or something, is if you’re gonna have your characters not get whatever is going around, keep some attention to why. I’m not against magical reasons for them to be immune. If you have a fantasy setting, there are ways to do that, but I have just seen and read a bunch of stories where the characters just kind of act like they can’t get sick and they never do. I get it would be kind of inconvenient for the character to get sick cuz you need them to go somewhere, but give me some reason why they aren’t getting sick when other people are, whether it’s because they’re taking a lot of precautions or they happen to be immune or resistant or they already got sick a while back or something.

Chris: And it could be used for mystery solving like the TNG episode where nobody can sleep except for Troy, but when she sleeps, she gets these weird, repetitive nightmares and we figure out, oh, okay, it’s because she has psychic powers. So, somebody’s trying to communicate to the crew in their minds and it’s preventing most of the crew from sleeping.

Oren: And then we find out that another ship was trying to contact them and that that ship’s hailing frequency is the slowly-lose-your-mind-ray.

Chris: But that’s also an opportunity to be like, oh, that person has been drinking different water, or whatever you wanna do.

Oren: I had that in an RPG of mine actually. I had a bunch of townspeople getting sick and I had like one family that wasn’t, and eventually, my players eventually figured out that that family got their water from a well and the rest of the town got it from the river that comes through and they were like, it’s probably the river, and I was so proud of that.

Wes: So proud of them. Something else that we could mention is, as far as I’m aware, done some research, but I could be wrong, what is the most popular disease in fiction?

Oren: The most commonly used in fiction?

Wes: The most commonly used one.

Oren: Okay, this is actually interesting. I’m gonna bet the flu.

Wes: Okay. Chris, do you have a guess?

Chris: Um, Black Death?

Wes: So, the flu and the Black Death are, they’re contenders, but the one that I read about was actually consumption, aka tuberculosis.

Oren: Yeah, that makes sense.

Wes: And the reason why is because the symptoms are not super gross. You know, you’re not covered in snot, It’s not cholera or dysentery. You just kind of are wasting away quite literally, and you’re getting really pale. And so it showed up in so much Victorian literature. And often used by those guys more often than not guys to create pious, virtuous, wasting away people who are saints and whatnot.

Oren: Sexy Victorian wasting disease.

Chris: Another thing that you could use is anemia. Particularly for people who have periods cuz they lose iron. And that’s something that can actually, again, if you wanna character to cure something, you can give them things that have iron in them to help with that. But I think anemia is mostly like fatigue and stuff that is the symptoms, which is helpful when you don’t really want to describe black pustules…

Wes: Lots of gross stuff.

Oren: All right, well with that very pleasant image, we’re gonna go ahead and end the podcast. Also remind everyone listening that if you haven’t already you should definitely get the new I-Valent Covid Booster. There’s no reason not to get it. It’s just a very good thing to have.

Chris: And if Mythcreants has helped you with a creative project or reminded you to get a booster, you can support us on Patreon. Just go to

Oren: And before we go, I wanna thank a few of our patrons. First, we have Callie Macleod, then we have Kathy Ferguson, is a professor of political theory in Star Trek. After that, we have Amon Jabber, he’s an urban fantasy writer and a connoisseur of Marvel. And finally, we have Danita Rambo, she lives at the We’ll talk to you next week. [Outro Music]

Chris: This has been the Myth Grant Podcast opening and closing theme The Princess Who Saved Herself by Jonathan Colton.

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