Body Models and Metaphors

I was talking recently with a friend about illness - we both have kids, so we do this quite a lot. We were discussing how to "read" a cold, to tell when we should take one of the kids to the doctor rather than just waiting for them to get better. During this discussion I realized that though she and I were trying to do the same thing, we were using different metrics for how to decide when we needed to worry.

My friend's model of assessing whether to go to the doctor was based on the passage of time. A cold that needed attention was one that had been going on for a long time. My model of assessing whether to go to the doctor was based on trends of change. If the cold had been slowly improving and then appeared suddenly to get worse, I figured it was time to get attention.

I think if you were to ask around, you'd discover that almost everyone has a slightly different model of assessment that they're using. In fact, I'd be curious to discover whether medical practitioners are taught to use precisely the same models, and whether that results in them applying the same models and metaphors to what they see, or different ones.

One of my kids' books talks about early health beliefs. These are things like the belief in the existence of miasmas - evil drafts of air that carry disease - or an understanding of the body based on the influence of the liver, or the influence of the spleen, etc. I think we're all familiar with the idea that the heart is the source of love in the body, but I didn't know, for example, that some people believed that function was performed by the liver. Or that the gall bladder was seen by some as the seat of courage. Or that others believed that Saturn rules the right ear and Jupiter rules the feet.

Different levels of technology have some influence on body models, because they give people the ability to observe how the body operates. On the other hand, it's good to remember that people have an enormously strong tendency to create metaphors for the operation of aspects of life and the universe. Rulii in "Cold Words" used his hunt metaphors and had quite accurate knowledge of body parts and their operation (as a result of his hunting experience), but couldn't conceive of the idea that it would be possible to look into blood and see things.

The aliens we create can similarly have different models and metaphors for the body and its operation, and if you use those things to your advantage, they can influence characters' behavior and judgments, and possibly even the plot of a story. If a character were injured for example, why would or wouldn't he/she decide to get treatment? How would that influence the course of the story? Would two people from different countries in a fantasy world have different ideas of how the body worked and what kind of treatment would be good for it? Might one believe that washing with soap was dangerous (as we used to), while the other believed it was necessary for sanitary treatment?

Actually, it occurs to me that a wonderful example of an elaborated health concept is in Janice Hardy's book The Shifter. Given that it centers on a form of magical healing, that shouldn't perhaps come as a surprise - but it makes for a very interesting example. The healers have precise terms for talking about injuries - "breaks," "bleeds," etc. and a very extensive sense of the body and its parts. But when they heal they literally pull the pain out of the person and into themselves, and then have to get rid of it into a type of magical metal that is a finite resource. You can imagine this changes everything about the healing process... and what Janice does with it is create an entire society with a pain economy alongside (and linked to) its monetary economy. She's taking the concept to a fully elaborated extreme that influences everything about her story - worldbuilding, characters, plot, etc. And while I'm not suggesting that every author do the same, I think it's worth taking the time to consider how the people in your story think about health and the body. The example of me and my friend should make it clear that this is true even if you aren't working with fantasy and science fiction.

It's something to think about.

Diseases, and the lack thereof

People don't tend to get colds a lot in SF/F. Unless you count that story of the man waking up in a future that has eliminated all disease, only to be euthanized when he says he has a cold. (It's been so long since I read it that I can't remember the author. Help me out, anyone?)

Probably colds seldom appear because the turning point of a plot doesn't tend to rest on whether Captain Whoever has the sniffles at the time. Most often in my reading I see plagues - serious ones - like the one in Anne McCaffrey's Moreta where the entire Pernese population comes under threat. Now that's a disease worthy of attention in a story!

This is not a bad thing. I've only read one series where people got colds, and were hurt every time they were hit by a rock or had a bad fall, a serious battle, etc. By the time I was 100 pages in it was so appalling that I was ready to laugh (or put the book down).

On the other hand, I do get concerned when I see people portrayed in abject poverty, having no visible means of health care or benefits of plumbing in their lives of squalor, yet who seem to have no illnesses. Parasites, anyone? Fevers, or malnutrition? And if not, why not?

I've actually spent a good deal of time agonizing over whether the poor in my Varin world should have good teeth. Cosmetic dentistry? Absolutely not. Orthodontia? Another no. But what about cavities and decay? Varin isn't a possible future earth, so tooth decay isn't exactly required. On the other hand, I don't think of Varin as a fantasy world, where it would be somewhat easier to imagine that mouth bacteria don't exist. And if it's science fiction, well... The jury's still out, but my current thought is that their technological level is high enough - the repressive government has probably fluoridated the water. Plausible, yet unobtrusive. With a high enough level of general societal technology, it's not too far out to imagine their medical profession is up to the task of getting that done.

As far as medical technology goes, there is a lot of room for flexibility. For low technology, you can look at the history of medicine in our world and vary it according to your needs. For high technology, you can extrapolate, which is always fun. Personalized medicine based on DNA is something people are already aiming at now, so I like to think it would be possible in the future.

Then there's medical culture. Who is the doctor? Is his or her role spiritual, scientific, both, neither? What of bedside manners? Is the doctor or the patient considered to know more about the nature of the complaint?

The last thing I want to mention is something I've been working with in a recent novel revision: How do you portray a population with weak immune systems, high incidence of mental illness, and high rate of infant mortality if none of your protagonists are currently sick? Yes, of course you can always say, "this population is inbred and has weak immune systems etc., etc." ...

How to describe the feeling I get from an explanation like that? Clunky, I could say. Or I could brandish my "show not tell" sword. But I think the best word for me is "external," or perhaps "distant." The explanation is something the author knows, but people living inside such a society would probably not be inclined to step back and talk about themselves that way (unless they were doctors making reports to the government, or something).

So instead I try to create a culture of health in the group I'm working with. I have them place labels on the sufferers - people "closeted" with deformities or chronic illness, or spoken of in whispers as "weak in the head." I make an increase in birth rate and infant health the stuff of public propaganda announcements. And I lace every slightest sign of ill health with a sense of fear in those who witness it. I have people make defensive statements about illness, always knowing internally that the diseases that cause minor affliction in others would likely kill them.

This actually forms a nice lead into my next topic, "worldbuilding in foreground vs. background." It's essentially "show not tell" - but I'm hoping to make it somewhat easier to think through, and to implement...

Upcoming posts at TTYU: worldbuilding in foreground vs. background; metaphor