The theme for the next issue of Medical Humanities is Science Fiction. There are many online articles already available on the theme (see Related Reading below).
A Spaceship in Trouble: Reflections on Harry Harrison’s Spaceship Medic.
Puffin books, 1976
Kindle version currently available
Reviewed by Matthew Castleden
Lieutenant Donald Chase, a young medical officer serving on the interplanetary passenger liner Johannes Kepler, is relaxing on a bunk in the sick bay— with a textbook describing the effects of low gravity on bone deterioration— when he feels an impact shudder through the fabric of the ship, followed immediately by a cacophony of alarms. A meteorite has blasted through the bridge and killed all of the vessel’s senior officers, leaving Chase, as the highest-ranking remaining member of the crew, as captain. He must overcome a series of seemingly insurmountable crises— including massive solar flares, mutiny, and a mysterious epidemic— that threaten the survival of everyone on board. Drawing on a broad knowledge of astronomy, physics, and chemistry, whilst utilising a newly qualified doctor’s grasp of his own craft, and showing an impressive capacity for logical reasoning and quick decision-making, Chase struggles against the odds to bring his ship safely to— where else— Mars.
The late Harry Harrison (1925-2012) clearly wrote the novella Spaceship Medic with children, and more specifically boys, as his target readership. Published in 1970, the story must have appeared dated even then. The linear narrative describes a strong male character problem-solving his way through a series of ‘hard’ science challenges, in a hierarchical space setting that any reader familiar with ‘Golden Age’ science fiction from the 1940s and 1950s would immediately recognise.
Of course, none of this mattered to one young reader who stumbled upon the story one sunny afternoon sometime in the late 1980s. He picked up a well-thumbed Puffin edition of Spaceship Medic in his school library and was instantly hooked. Perhaps he linked the simple heroism described in the book to his sketchy knowledge of his grandfather’s experiences as a newly qualified medical officer serving on board a Royal Navy frigate in the North Atlantic convoys. It certainly brought the boy’s nascent interests in science, medicine, and storytelling together into one irresistible package. And it undoubtedly contributed to the development of two significant lifelong interests: medicine and science fiction.
It is a gripping tale. The thrills of a taut, tight plot are spilled with sparse, unpretentious language and near-faultless manipulation of dramatic tension. Much of the science, particularly with respect to orbital mechanics and spacecraft design, holds up well and the extrapolations remain plausible. The overall plot direction holds no big surprises: with the exception of one character, we are left in little doubt as to who are the good guys, and who the bad (and they are all guys). In many respects it is simple, straightforward science fiction: a tale of Boy’s Own derring-do in space, with the only obvious quirk being the professional background of the protagonist.
Re-reading the book nearly thirty years later, Spaceship Medic is both less and more than I remember it from that afternoon in the school library. It is short— easily demolished in a couple of hours, then as now— and the limitations of its language, structure and broader social and cultural perspective are sometimes painfully apparent. Yet there is more going on than the direct language, simple narrative form and Golden Age trappings might suggest, and much in the portrayal of the protagonist that remains relevant to the practice of medicine in the present day.
There is certainly more to the young Doctor Chase than first meets the eye. He spends most of his time competently dealing with one disaster after another, yet is constantly assailed by doubts regarding his capacity to succeed in his new role and, on occasion, sinks into ‘black depression’ when considering his situation. Chase’s predicament appears to be an exaggerated version of the insecurity —sometimes manifesting as fully-fledged ‘impostor syndrome’— that many doctors experience at various times in their career: often in its early stages, when starting new jobs or ‘acting up’ in a more senior role. Unexpectedly assuming command of a stricken spacecraft tumbling through the uncaring vacuum of space may not be too dissimilar, in terms of its emotional and psychological impact, from enduring a busy and chaotic acute hospital medical on-call shift for the first time as a junior doctor.
It is significant that we first meet the young medic reading a textbook. Circumstances may force Harrison’s reluctant protagonist into an active role, but he is first introduced to the reader as a thinking man. The tension between contemplation and action is a common thread running through much of Harry Harrison’s work: many of his protagonists are compelled to negotiate the difficult path between thinking and doing, which is, of course, a familiar one to most doctors.
Chase’s insecurity is unjustified; he overcomes his fears and delivers excellent outcomes to the population under his care, and does so in a manner that may seem familiar to modern medical readers. Despite working within the hierarchical environment of a spaceship the young doctor’s approach to problem solving is essentially collaborative, and he relies extensively on the knowledge and experience of the other members of his team. An early scene in which he evaluates the key skills and strengths of his remaining crew and delegates accordingly reads like an illustrative case study for a contemporary leadership and team-building exercise.
The story also prompts broader consideration of the scope of health and healthcare. We can see how the death of the Johannes Kepler’s senior officers allows the reach of Chase’s medical practice to suddenly expand to encompass the functional health and pathophysiology of the entire ship, not just the physical health of its human passengers and crew. Through Chase’s medical eyes, we start to view the spaceship as a body; a holistic socio-technical system comprising both physical hardware, and the lives and interactions of the people it carries. It is hard to read the story as an adult without constructing extended spaceship analogies: spaceship as hospital; spaceship as a microcosm of society; perhaps even ‘Spaceship Earth’.
Harrison’s choice of profession for his protagonist provides is itself telling— as is that of his mutinous antagonist, one of the ship’s passengers named General Briggs. Briggs is pompous, hidebound, and has an overinflated opinion of his own self-worth: an embodiment of Harrison’s distrust of the military dating from his time in the US Army. Harrison’s portrayal of Chase establishes the medical profession as an alternative, non-military ideal for young men: one that showcases qualities such as determination, hard work, and self-sacrifice without the need for violence or killing.
Spaceship Medic therefore sits squarely within the pacifist school of medical science fiction. Like James White’s Sector General series of novels, it paints a refreshingly positive picture of medicine within its fictional future. Although the world it describes is, in many respects, similar to the old-fashioned medicine of the nineteenth and early twentieth centuries— male-dominated, hierarchical, and heroic— elements of Harrison’s essentially liberal worldview are also evident, and there is much in his portrayal of Lieutenant Donald Chase that a contemporary doctor would recognise. In short, it is a curious and compelling mixture: while its dated setting and structure may reflect the Golden Age of science fiction, there are signs of a more open, experimental and progressive ‘New Wave’ sensibility lurking beneath.
But first and foremost it is a ripping yarn. The story was written to inspire interest in science in young people by engendering a sense of fun and excitement. As Harrison wrote: “Science, and the facts of science, can be fun – because real things make a real world.” [a]
For one once young reader, it was and is an astounding success. Thank you, Harry Harrison.
Related Reading – check out these Science Fiction titles online first at Medical Humanities:
Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures http://bmj.co/2eOU0K0
The medical science fiction of James White: Inside and Outside Sector General http://bmj.co/2eiM5kA
Human life as digitised data assemblage: health, wealth and biopower in Gary Shteyngart’s Super Sad True Love Story http://bmj.co/2eOQijk
Zombie Tapeworms in Late Capitalism: Accelerating Clinical and Reproductive Labor in Mira Grant’s Parasitology Trilogy http://bmj.co/2eUKenw
Rewinding Frankenstein and the Body-Machine: Organ Transplantation in the Dystopian Young Adult Fiction Series Unwind – Original Article http://bmj.co/2fnd0ji
Towards A Structure of Feeling: Abjection and Allegories of Disease in Science Fiction ‘Mutation’ Films http://bmj.co/2eUMdbA