Teaching the Medical Humanities: Short Science Fiction

Previously I posted about designing my "Medical Humanties" course, which was themed around science fiction stories focusing on the future of medicine. Today, I want to talk about the sf stories I taught and what I did with them.

• 
  Daniel Keyes, "Flowers for Algeron" (1959). When I was prepping the class last summer, I also happened to read the 1966 novel Flowers for Algernon, which made me remember the original short story from 1959. About a low-IQ adult who goes through an experimental surgery to elevate his IQ, it is quite obviously all about the ethics of medicine! My first time teaching the class, I used it in my genetic engineering unit as a sort of metaphor for the issues of consent and identity raised by genetic engineering. But when I later read the papers by students who wrote about it, I felt I had really done the story a disservice by not actually meaningfully discussing disability! So I created a disability unit the following semester, and used the medical, social, and human rights models of disability as a way of discussing the story.
• 
  Sarah Pinsker, "Pay Attention" (2015). Expanding the disability unit meant I needed a second example of disability-focused piece of sf, otherwise I didn't have much of a unit! One thing I toyed with going from my first semester to my second was dropping Sinclair Lewis's Arrowsmith as my novel and replacing it with Sarah Pinsker's We Are Satellites (2021). This novel is about a brain implant called the "Pilot" that people can get to help them multitask more effectively; I decided not to make the change (I already had a bunch of Arrowsmith lesson plans, of course), but it did cause me to remember that Pinsker also wrote a couple short stories set in the world of We Are Satellites. "Pay Attention" is about a young woman with a mental disability whose Pilot enables her to obtain a military and medical career... but then one day it stops working. Like most of Pinsker's work, a great little story, and it let us talk about different aspects of disability than "Flowers."
• 
  Nancy Kress, "Invisible People" (2020). Moving "Flowers for Algernon" out of the genetic engineering unit meant I needed a second genetic engineering story as well. Looking backward through old blog posts, I found one I made about this story by Nancy Kress, where some parents who used a surrogate discover that their daughter was actually a victim of illegal genetic engineering. I think Kress's story is super clever, raising some interesting issues about less obvious uses of genetic engineering than "would you create a super-genius?", and focusing on some issues of identity and consent that were central to our class. The story ends in a debate that translated well to the classroom, and the story is thematically quite clever.
• Manjula Padmanabhan, "Essence of Gandhi" (1997). As soon as I knew I was doing genetic engineering, I knew I wanted to do this story, which is about Western corporations exploiting the DNA of colonized peoples—I had, after all, published an article on it! Neither semester did my students enjoy it; even though it's just four pages, they found it confusing and alienating. Their loss, I guess. I still think it's clever! (Probably they didn't like it because the story is almost totally unmentioned on the Internet, and thus ChatGPT can't summarize it.)
• 
  Channing Ren, "Resurrection" (2020). I will admit to cheating: this is the first of four short stories I recycled from my life-extension class. Hey, it gave me over a week's worth of lesson plans! What is technological immortality, arguably, other than medicine taken to its utmost? In my second iteration of the course, I moved this to be the first one we read, as it's a useful story for discussing the project of science fiction (it's very easy to get), and it has the most kneejerk negative depiction of immortality.
• Vanessa Fogg, "Traces of Us" (2018). This makes a good second immortality story, because like "Resurrection" it's about consciousness uploading, but it's much more positive, so it works against your assumptions. I will probably import this resequencing back into my immortality course. It also let me discuss "hard sf," of which I would argue it's the only example I taught in this course.
• Will McIntosh, "Bridesicle" (2009). This story is about issues relating to a different technology of immortality, cryonics. Students this semester got very into my explanation of what's really going on with cryonics.
• Paolo Bacigalupi, "Pop Squad" (2006). Lastly, we did genetic life extension. This semester, thanks to an episode of Radiolab I had coincidentally heard a week before teaching it, I leaned into some real issues of population explosion and decline; again, I'd like to import these concepts back into my immortality class. They really illuminated for me what I think Bacigalupi is up to in this story; it's about be estranged from the natural process of reproduction.
• Sarah Pinsker, "Escape from Caring Seasons" (2018). The first time I taught the class, a couple students brought up AI as the technology they were most interesting in when it comes to the future of medicine, which made me belatedly think of this story from Pinsker's book Lost Places, where algorithms supercede doctors in a nursing home... not because AI has gone horribly wrong, though, but because it's working exactly as intended. I added the story to my syllabus the second time around. Pinsker thus became my only repeat author.
• Cory Doctorow, "Radicalized" (2019). Right around the time I finished teaching the class for the first time, Luigi Mangione shot a health insurance executive; this caused someone to post on the printSF subreddit that "Cory Doctorow's story from Radicalized has come true," alerting me to the existence of this story, about how men whose loved ones have died because of denied insurance claims get radicalized in online forums and begin executing health insurance executives. I added it to the course pretty belatedly (after I had ordered my course packet!) for my second go run. It's a clever story, and let me talk about some important issues affecting American healthcare; students of course had lots of opinions about Luigi, so it taught well. Doctorow's blog post about the story is good reading.
• Samantha Mills, "Rabbit Test" (2022). This Hugo Award–winning story is about medical implants being used by the state to monitor if women are pregnant. Popular with my students, especially the women, and I like Mills's point that any technology that allows you to better understand your own body also allows others to better control your own body. She powerfully links her future technology to the history of birth control and abortion. I taught it as a good example of China Miéville's dictum that sf isn't really about the future but the present.
• Meg Elison, "The Pill" (2020). This is a disturbing novelette about a pill that makes you skinny... but has a 10% chance of killing you! Good for discussing if people's aversion to fatness is really about health; I paired it with concepts and background from Joan Jacobs Brumberg's The Body Project: An Intimate History of American Girls and Jeffrey Sobal's "The Medicalization and Demedicalization of Obesity" to discuss how obesity is viewed as either a medical issue one or an ethical one. (Thanks to my friend Christiana for her help.)

That's it! It was a fun class. I make the students take a survey ranking the stories, but thus far I've been too lazy to actually work up the data, so I'll be interested to see what they liked best when I get around to it all.

Technologies of Immortality: Reading List

This is a sequel to last week's post; I wanted to provide my reading list (with commentary) for my co-taught "Technologies of Immortality" course.

illustration by Galen Dara for Joe Haldeman's "Four Short Novels"

I divided the readings into two halves. The ones from the first half of the course focused on technologies of immortality being in their early stages, societies where they were just being invented or had only recently come into use. In the second half, I wanted societies much further on, where the technologies were commonplace and the long-term ramifications of the technologies on society could be explored. As I said in the previous post, we usually focused on three specific technologies: digital consciousness uploading, cryonics, and genetic modification to extend life.

If the stories are freely and legally available on the Internet, I've linked to them below. We did a reading ranking on the last day of class, where I had the students sort all of the stories they'd read from 1st (best) to 13th (worst); at the end of each paragraph, I've given how the story ranked by mean and median, and how many students ranked it first or last. Every story was some student's favorite... except two.

Prologue

• Will McIntosh, "Bridesicle" (2009). This is a disturbing story about both cryonics and consciousness uploading; it's about a woman named Mira who dies in a car accident and wakes up in a cryonics facility centuries later. The problem with cryonics has turned out to be that revival is expensive, so the dead don't have the money to be revived... but it turns out that men will pay to revive women who are frozen if the women will sign a marriage contract. The story also incorporates elements of consciousness uploading; people can have mental copies of loved ones called "hitchers" stored in their minds. I liked it a lot as a way to begin; it's a good story, well told, but also works well to grab the attention of students as to the purpose of the course. I think this was Professor Cragun's favorite, and it was something both we and the students referred back to a lot. The story was later expanded into a novel (Love Minus Eighty, 2013), and at first I was skeptical of this, but the students raised a lot of interesting questions about the world in class I'd like to see fleshed out. A student also told me they heard an interview with McIntosh where it was originally written about the man doing the revival; I am curious about this because the story would have nowhere near its power in that format! [ranked 1st by mean, 1st by median, 1st by 18 students, last by 1 student]
  

Part I

• Vanessa Fogg, "Traces of Us" (2018). We began part I of the course with this, because it's actually about the development process for consciousness uploading; it follows a pair of graduate students (later, postdocs) who are working on different aspects of consciousness uploading. It's very cute, a bit sad, and Fogg did some solid research on the science here; Professor Evans-Nguyen was impressed by the rigor and specificity. Fogg's blog post here gives good insight into her inspirations. [ranked 2nd by mean, 3rd by median, 1st by 1 student]
  
• José Pablo Iriarte, "Proof by Induction" (2021). This is also about a nascent version of consciousness uploading; a technology called the "coda" has just come into existence, which captures a digital snapshot of consciousness at the moment of death. This consciousness can't evolve or change, but you can interact with a deceased love one to obtain closure (or ask questions like, "where is the will?"). The main character is a math professor interacting with his father, another math professor, as they try to solve a proof together. The story explores the process of grief and dealing with the fact that your loved one will never change. [ranked 4th by mean, 4th by median, 1st by 1 student]
  
• Greg Egan, "Learning to Be Me" (1990). A very weird but very good story about a technology called the Ndoli jewel, an implant in your brain that records your neural processes with the eventual goal of taking over for them. The narrator has a series of existential freakouts over the fact that even if his jewel lives forever, it's not him living forever. [ranked 5th by mean, 6th by median, 1st by 2 students, last by 2 students]
  
• Channing Ren, "Resurrection" (2020). This is a Chinese sf story, again about consciousness uploading. A military engineer dies in battle, but his duplicated consciousness was copied into an artificial body, and then the body dumped on the doorstep of his grieving mother, who is now very confused—and only has a couple weeks with him before he gets sent back to the front. This one began to shift into looking at the social consequences of the technology; Cragun set up in an earlier class that one way sociologists like to look at situations is to as cui bono?—who benefits? And here we see that; it's not the resurrected who benefits from this technology, but those who already have political and economic power. [ranked 5th by mean, 6th by median, 1st by 1 student, last by 1 student]
  
• Ken Liu, "The Gods Will Not Be Chained" and "The Gods Will Not Be Slain" (2014). These are two linked short stories about a girl named Maddie, who (spoilers) discovers that her dead dad isn't actually dead, but that his consciousness has been uploaded to the Internet. I will admit to finding Liu a bit hit or miss, but it is a very accessible story, and again, we get a shift into the social implications of this technology, as Liu explores both who the actual beneficiaries of consciousness uploading would be, what they would use it for, and what the long term consequences would be. [ranked 8th by mean, 8th by median, 1st by 6 students, last by 4 students]
  

Interlude

• qntm [Sam Hughes], "Lena" (2021). This is a hermit-crab story, told in the form of a Wikipedia article about the first digital consciousness. The story explores the dark implications of such a technology, how it would lead to exploitation; the story is named for a famous test image, and HeLa cells are another inspiration. (I taught it in the middle of the course, alongside The Immortal Life of Henrietta Lacks.) What rights do we have to these products of ourselves—our images, our cells, our consciousnesses—that are not ourselves? The story explores these questions in a stripped back, kind of casually horrifying way. I think a couple students really liked it, but most struggled with the unusual conceit. One thing I really liked is this rant from the author: "'Lena' is a true story. You knew it was when you read it." [ranked last by mean, last by median, last by 7 students]
  

Part II

• Greg Egan, "Border Guards" (1999). I opened the "consequences" part of the course with a couple sequels to stories from the earlier parts of the class. This is a sequel to "Learning to Be Me"; it has no characters in common, but instead jumps centuries into the future to see what kind of society might result from the Ndoli jewel being commonplace. How would people treat relationships? What kind of problems would they have? It's a very optimistic story and too much detail about quantum soccer aside, has some beautiful imagery. It's easy to kneejerk reject these technologies, but I liked how this one not only challenges our preconceptions about the necessity of death, but explicitly calls out other fiction that argues for the necessity of death for being intellectually lazy. [ranked 11th by mean, 11th by median, last by 9 students]
  
• Ken Liu, "The Gods Have Not Died in Vain" (2015) and "Staying Behind" (2011). These two follow up the Liu stories from the first half. The first is the third Maddie story; the other takes place in the same world, looking at those people still living physical existences after the majority of humankind has been uploaded. The final Maddie story kind of fizzles out, but that's the point, I would argue: Maddie reaches no clear decision about whether it's better to live a physical existence or be uploaded, because Liu wants the reader to explore it for themselves. "Staying Behind" picks right up from the end of the previous story (despite being written first), and like Egan's "Border Guards," it pushes against our preconceptions—the story is told from the perspective of someone resisting this technology, and he's clearly wrong to do so. So... are we? I can find Liu a bit schmaltzy sometimes, but here he's at his best. Really well put together, clever connections, unsettling conclusion. ["Gods Have Not Died..." ranked 12th by mean, last by median, 1st by 1 student, last by 5 students; "Staying Behind" ranked 10th by mean, 9th by median, 1st by 1 student]
  
• Paolo Bacigalupi, "Pop Squad" (2006). In a world where everyone lives forever, wouldn't overpopulation be a problem? Especially if climate change continues unabated, and the amount of resources available to support humanity keeps dwindling. The story follows a police officer on the "pop squad"—he kills illegal babies and arrests their mothers. It's vividly, gruesomely told... but that's the point, as Bacigalupi is actually confronting you with something that happens everyday. Everyday the United States turns away immigrants with children, and those children suffer because we won't share our resources, and we want to continue to live in our current lifestyle, we do exactly what the characters in this story do, we just don't have to see it. [ranked 3rd by mean, 2nd by median, 1st by 8 students, last by 7 students]
  
• Orson Scott Card, "Skipping Stones" (1979). From the moment I knew I was teaching this class, I knew wanted to track this story down and read it, which I read in Card's collection The Worthing Saga. It's about a world where people can use a drug called somec to enter suspended animation; the rich get more than the poor, and it's about a rich boy and poor boy who start out friends but grow apart as one ages years while the other ages decades. Not a very complicated story, to be honest, but a good example of how social class dynamics will impact these kind of technologies. (A student pointed out that as technologies of immortality go, it was "stupid": you don't actually live longer. But as long as people have inequal access to the technology, there is a benefit. The inequality is the point.) [ranked 7th by mean, 5th by median, 1st by 3 students, last by 3 students]
  
• Joe Haldeman, "Four Short Novels" (2000). A weird story, but I knew I wanted to end on it: it's four sketches of "novels" about living forever, each with a different conceit: "Eventually it came to pass that no one ever had to die, unless they ran out of money" or "...unless they were so horrible that society had to dispose of them" or "...unless they wanted to, or could be talked into it," and so on. They are funny and have some neat ideas in them... but not really about immortality at all. It was important for me to end with a story that demonstrated China Miéville's claim that sf isn't actually about science or the future. But more on that next time! [ranked 9th by mean, 10th by median, 1st by 3 students, last by 6 students]
  

[Incidentally, "Pop Squad" had the highest standard deviation, and "Traces of Us" the lowest.]

Overall, I was really happy about the collection of stories we read. They were largely high quality tales, and not a single one of them was a dud in the classroom; I was able to get something interesting out of everyone of them. I do wish there were more stories that were more optimistic about these technologies, but I was limited by what sf authors are actually writing! (Later I should do a post on stories I rejected.)