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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). <\/em><\/p>\n <\/p>\n A Spaceship in Trouble: Reflections on Harry Harrison\u2019s Spaceship Medic.<\/em><\/strong><\/p>\n Puffin books, 1976<\/em><\/p>\n Kindle version currently available<\/em><\/p>\n <\/p>\n Reviewed by Matthew Castleden<\/strong><\/p>\n <\/p>\n Lieutenant Donald Chase, a young medical officer serving on the interplanetary passenger liner Johannes Kepler<\/em>, is relaxing on a bunk in the sick bay\u2014 with a textbook describing the effects of low gravity on bone deterioration\u2014 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\u2014 including massive solar flares, mutiny, and a mysterious epidemic\u2014 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\u2014 where else\u2014 Mars.<\/p>\n The late Harry Harrison (1925-2012) clearly wrote the novella Spaceship Medic<\/em> 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 \u2018hard\u2019 science challenges, in a hierarchical space setting that any reader familiar with \u2018Golden Age\u2019 science fiction from the 1940s and 1950s would immediately recognise.<\/p>\n 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<\/em> 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\u2019s experiences as a newly qualified medical officer serving on board a Royal Navy frigate in the North Atlantic convoys. It certainly brought the boy\u2019s 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.<\/p>\n 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\u2019s Own derring-do in space, with the only obvious quirk being the professional background of the protagonist.<\/p>\n Re-reading the book nearly thirty years later, Spaceship Medic<\/em> is both less and more than I remember it from that afternoon in the school library. It is short\u2014 easily demolished in a couple of hours, then as now\u2014 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.<\/p>\n 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 \u2018black depression\u2019 when considering his situation. Chase\u2019s predicament appears to be an exaggerated version of the insecurity \u2014sometimes manifesting as fully-fledged \u2018impostor syndrome\u2019\u2014 that many doctors experience at various times in their career: often in its early stages, when starting new jobs or \u2018acting up\u2019 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.<\/p>\n It is significant that we first meet the young medic reading a textbook. Circumstances may force Harrison\u2019s 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\u2019s 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.<\/p>\n Chase\u2019s 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\u2019s 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.<\/p>\n The story also prompts broader consideration of the scope of health and healthcare. We can see how the death of the Johannes Kepler\u2019s<\/em> senior officers allows the reach of Chase\u2019s 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\u2019s 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 \u2018Spaceship Earth\u2019.<\/p>\n Harrison\u2019s choice of profession for his protagonist provides is itself telling\u2014 as is that of his mutinous antagonist, one of the ship\u2019s passengers named General Briggs. Briggs is pompous, hidebound, and has an overinflated opinion of his own self-worth: an embodiment of Harrison\u2019s distrust of the military dating from his time in the US Army. Harrison\u2019s 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.<\/p>\n Spaceship Medic<\/em> therefore sits squarely within the pacifist school of medical science fiction. Like James White\u2019s Sector General<\/em> 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\u2014 male-dominated, hierarchical, and heroic\u2014 elements of Harrison\u2019s 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 \u2018New Wave\u2019 sensibility lurking beneath.<\/p>\n 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: \u201cScience, and the facts of science, can be fun \u2013 because real things make a real world.\u201d [a]<\/sup><\/p>\n For one once young reader, it was and is an astounding success. Thank you, Harry Harrison.<\/p>\n <\/p>\n [a] https:\/\/harryharrison.wordpress.com\/2008\/01\/21\/lets-start-with-a-spaceship-in-trouble\/<\/a><\/p>\n <\/p>\n Related Reading – check out these Science Fiction titles online first at Medical Humanities:<\/strong><\/p>\n Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures\u00a0http:\/\/bmj.co\/2eOU0K0<\/a><\/span><\/p>\n The medical science<\/span> fiction<\/span> of James White: Inside and Outside Sector General\u00a0http:\/\/bmj.co\/2eiM5kA<\/a><\/span><\/p>\n Human life as digitised data assemblage: health, wealth and biopower in Gary Shteyngart’s Super Sad True Love Story\u00a0http:\/\/bmj.co\/2eOQijk<\/a><\/em><\/span><\/p>\n Zombie Tapeworms in Late Capitalism: Accelerating Clinical and Reproductive Labor in Mira Grant\u2019s Parasitology Trilogy\u00a0http:\/\/bmj.co\/2eUKenw<\/a><\/p>\n Rewinding Frankenstein and the Body-Machine: Organ Transplantation in the Dystopian Young Adult Fiction Series Unwind – Original Article\u00a0http:\/\/bmj.co\/2fnd0ji<\/a><\/p>\n Towards A Structure of Feeling: Abjection and Allegories of Disease in Science Fiction ‘Mutation’ Films\u00a0http:\/\/bmj.co\/2eUMdbA<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" 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\u2019s Spaceship Medic. Puffin books, 1976 Kindle version currently available Reviewed by Matthew Castleden Lieutenant Donald Chase, a […]<\/p>\n