That pushy guest, Real Life
Two months since I last posted here, because real life has decided to intrude on my curated existence. This intrusion was in the form of illness – my wife Kim (learn all about her at string-or-nothing) was diagnosed with a rare cancer, chordoma, that affects the bones of the spine. Now, by rare I mean a literal one-in-a-million chance; there’s about 300 cases per year in the USA.
This is not the time to do a lot of world-building, so I’ll jump right to the end of the chapter. The surgery to remove the tumor was successful and Kim is on the road to recovery. Things are going slow, today is the 4-week anniversary of Kim’s stay in hospital, and she will probably have anywhere from 1 to 2 more weeks in a rehab facility. Then after the return home there will be more to do, regaining mobility, navigating stairs, simple around-the-house tasks and so on. That’s all because the surgery she had was truly major and recovery can’t happen overnight. When I think of my own surgeries – replacements of knee and hip for example – those were like Dunkin Donuts drive-throughs in comparison to Kim’s.
Over this month my own mind has bounced back and forth between different states: Early on I was frozen a lot of the time, waiting for results and answers and trying not to dwell on possibilities. Then came a lot of boredom, as for about 3 weeks I’ve been doing frequent drives to Providence, RI (about 55 miles) and Newport, RI (about 85 miles). And there have been episodes of comfort and, dare I say, happiness, like when Kim and I shared lunch a few weeks back, she with a grilled cheese sandwich – the first solid food after the surgery – and me with a ham sandwich from home.
Lastly, I find I have been just plain ‘ol thinking a lot. Herewith some of my musings …
We live in a Sci-Fi world
Science fiction has for a long time conditioned us to think of the future as having magical technology improvements. In the golden age that was mostly about spaceships, space stations, rayguns, etc. Towards the end of the 20th century, the Star Trek replicator was the signature tech idea that defined the SF future. Nowadays, sci-fi tech tends to concentrate on AI and/or virtual worlds as the hallmarks of conceived futures.
But if you look at medicine, as my up-top picture suggests, the future is here already. Chordoma as a disease was first identified in the 19th century, but for over 150 years nothing could be done to treat it. Since these tumors attack the spine or the base of the skull, removing them without destroying or damaging important nerves is extremely difficult. In the early 1980s the first radiation treatments were performed. Success was marginal, as chordoma is a kind of tumor resistant to radiation. In the late 1990’s the surgical removal of these tumors was being explored. Kim’s surgeon Dr. Ziya Gokaslan authored one of the first papers on this technique, available from NIH here. Since then the state of the art has been improving year by year. In my layman’s view that is not just a matter of surgical skill improving, but comes from improvements in imaging, analysis and neuro-physiology. Before Kim’s procedure she had a high-resolution MRI that showed in 3D the shape and extent of the tumor, and the affected nerves, at millimeter resolution. That became the “map” Dr. Gokaslan used to perform the surgery. In the end stage of the surgery, Kim’s spinal nerves received treatment to promote nerve healing. And there’s also biomechanical advances, like the system of screws and struts that now secures Kim’s spine to the two halves of her pelvis.
While I’d welcome Dr. Crusher’s dermal regenerator – BTW something like it is being prototyped – I think what we already have is pretty sci-fi.
Hospitals can’t help but be chaotic
Even just by visiting the hospital – let alone being the inmate – it doesn’t take long to see that things do not exactly go like clockwork. Something that is expected to happen at 9 gets pushed to 11, then to 3, then the next day. Expected people don’t show up, while unexpected people do. Despite endless pages of digital medical records, people often don’t know the plan or what has already been done. Food services send the wrong thing, or sometimes forget you altogether.
I imagine the typical American finds this uncomfortable, if not downright infuriating. Imagine if you took your car for a 1-hour oil change and it ended up taking a week. Probably a lot of people can’t help but view their healthcare services the same way, expecting Jiffy-Lube promptness for all their medical interactions. Popular culture shows this in the MAX show The Pitt, where an impatient man waiting for hours in the ER begins to show violent tendencies.
Now I have no behind-the-scenes experiences for how hospitals work, but I do have guesses on why things perform the way they do. I think the core reason is in our own unpredictability as organisms. Despite all the technical advances I mentioned, no doctor or nurse can predict your future. Something that happened to Kim was about 12-13 days after the surgery, she developed a high fever. The cause was found to be a blood infection, an E. Coli bacteriemia. Dealing with this needed consults from multiple doctors, her original surgeons and an infectious disease specialist. New diagnostics needed to be done, and a special antibiotic, currently in short supply was required. At least 4 people had to drop what they were doing in order to respond to this event. Multiply this by hundreds or thousands of patients and it makes total sense (to me) that hospital sailing won’t always be smooth.
Even though you’re not typing you can still be writing
Last year at this time I was well over 50,000 words into the 1st draft of STONE BY STONE, my 2024 writing project. For this year’s project, FORLORN TOYS, I’m at about the 30K mark – not discreditable but definitely a slower build. A lot is just mental distraction over Kim’s health, as well as days spent visiting down south in RI. Of course I wouldn’t change anything, in a way writing is a luxury.
But I find that even while I have less time doing scenes and chapters, I still can review and think. Like most genre fiction, FORLORN TOYS has a layered story. There’s an immediate plot line that goes like this:
Alien-tech archaeologist Galena Craft made the most important find ever of extinct alien technology – then three people she considered friends betrayed her, handing over the tech to the unscrupulous Dross Corporation and sending Galena to ten years in prison. Now Galena, taking the name Irá Norlander and in a regenerated body of a 10-year-old, is on a quest for vengeance against her three betrayers.
A classic premise, if I may say, with similarities to The Count of Monte Cristo and Vance’ The Demon Princes. If I can’t make something entertaining out of that idea, it won’t be because the premise is weak.
But there’s also a bigger story, a mystery about the future world that Irá lives in: Why did all these alien races, with such cool technology, all go extinct? The answer to that will unfold over 3 books – one for each betrayer, got it? But, you have to know the answer to the mystery before you can write it.
That’s one of the things I’ve been thinking about. I feel I’ve achieved a milestone: I have figured out the mechanism for these large-scale backstory events. I won’t give spoilers, but this “mechanism” is pretty epic in scope and has lots of potential to say things about the world. Now I need to work through scenarios using the mechanism, to satisfy myself they make sense for the narrative. The scenarios need to be credible to readers, not too complicated that they get in the way of the story, yet be rich enough that they offer a spectrum of possibilities.
Here’s an example of what I’m talking about. In the Star Wars universe The Force is the magic macguffin: the writer needs something, the force will do it. For some reason, George Lucas decided in The Phantom Menace he needed to explain the mechanism of the force: midichlorians, kind of like magic bacteria. The only reason for this bizarre invention was to give an objective measurement to the potential force-power in the child Anakin Skywalker. Once we learn “his midichlorians are off the scale!” we never hear about these magic microbes ever again. This is an example of a bad narrative mechanism: shallow, unadaptable, unconvincing.
I’ll leave you all with some lines from FORLORN TOYS. Irá has been traveling with JUDD MADDOX, a former COM-MED trooper and now an amiable but nihilistic spaceship captain. Judd’s ship is named The Perpetually Unimpressed Bystander, Perp or sometimes PUB for short. They are about to visit the surface of Earth, a first-time for Judd:
The rest of the burn Irá rested. There was nothing for Judd or PUB to do for the final dock with the shuttle station, all was handled by a Sol System nav-management satellite. They waited in silence outside the airlock a few minutes for the dock to complete. Judd seemed limp as he floated, looking down at his feet.
“All clear,” PUB announced. “See you in a few days, or a week, or I suppose whenever it suits you. Have a good time.”
The airlock opened. Irá squeezed Judd’s massive hand with her tiny one.
“What’s the matter, Judd?” she asked.
His reply was a mumble.
“It’s a great folly to appear in the marketplace.”
Irá laughed at that, and Judd turned, confused.
“I’m in the mood for folly – let’s go!”
I find I’m more and more of Irá’s mood – I hope next time to tell you of some folly I have committed. Till then …

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