Read-along book ruining: Doomsday Book by Connie Willis
Time travel and infectious diseases, both past and present
I just started reading this book, and thought that maybe I’ll just talk about the infectious diseases it mentions as I go rather than doing a big review at the end. My copy of this book is over an inch thick, and since infectious disease is a theme throughout the whole thing, why not? Read on if that piques your interest.
Quick Goodreads summary:
For Kivrin, preparing an on-site study of one of the deadliest eras in humanity's history was as simple as receiving inoculations against the diseases of the fourteenth century and inventing an alibi for a woman traveling alone. For her instructors in the twenty-first century, it meant painstaking calculations and careful monitoring of the rendezvous location where Kivrin would be received.
But a crisis strangely linking past and future strands Kivrin in a bygone age as her fellows try desperately to rescue her. In a time of superstition and fear, Kivrin - barely of age herself - finds she has become an unlikely angel of hope during one of history's darkest hours.
Current Progress: Page 65 of 578
This book was written in 1996, so I expect a bit of what it talks about will be somewhat dated. For example, in 1996, people were still debating whether or not the Black Death was caused by the bubonic plague as caused by the bacterium Yersinia pestis. If you’ve listened to Season 1 Episode 4 about the Black Death, you’ll know that this wasn’t conclusively proven until 2010 when scientists looked at the dental pulp of known plague victims.
Set at some as-yet unspecified time in the future, this book dumps us right into the action scene and doesn’t waste time explaining the context.
We’re in a lab listening to two professors debate the foolhardiness of sending Kivrin into the past to the year 1320 to find out how people lived, what their day-to-day lives were like, how they ate, prayed, and dealt with death. Traveling to the Medieval era has been forbidden until now due to the high overall mortality and danger inherent in just existing back then.
From what I gather, things go horribly wrong and not only does Kivrin accidentally end up in a very wrong time period (I have a guess as to what year she lands in), almost immediately upon her leaving a disease epidemic breaks out in current-day Oxford as well, resulting in immediate quarantine.
Several times by now, a character has made casual reference to ‘the Pandemic’, as in ‘oh that was during the Pandemic, you know what it was like.’ Nothing more explicit has been mentioned, so I don’t know what the culprit disease was yet, but I think that the Pandemic ended anywhere from 5-10 years previously.
One of the professors talking is Dr. Mary Ahrens, and she’s telling the other, Dr. Dunworthy, how she’s tried to prepare Kivrin for her trip. She wanted to cauterize Kivrin’s nose against the smell (I’ve had one side of my nose cauterized, I strenuously recommend against it if you can avoid it, it sucks balls), but Kivrin declined and opted only for vaccines.
She calls out specifically cholera and typhoid, says she’s removed her appendix and strengthened her immune system, and given her “full spectrum anti-virals”.
Cholera and typhoid are both caused by bacteria, and we don’t have vaccines for them, so it’s impressive that this fictional future does. I would hope typhus was also vaccinated against, and was most certainly present in the poor and impoverished conditions of small hamlets and towns of medieval England.
More details on typhus and typhoid coming in Season 2 of the podcast, and Cholera is also slated for a future season!
Other bacterial diseases of concern would be dysentery (the flux, or the bloody flux), tuberculosis, diphtheria, scarlet fever (this bacteria also causes strep throat and flesh eating disease), and leprosy.
For broad-spectrum antivirals, this probably means smallpox as the main one, and probably measles, mumps, rubella, influenza, cold viruses, polio, and all the hepatitises (A through E, with E being probably more of a concern than it is today because it is found in pigs, and I imagine one would encounter a lot of those in medieval villages and farms).
There are also sexually transmitted diseases to worry about, like syphilis, gonorrhea, and chlamydia. HIV wasn’t a problem until the early 1900s, so there’s that, at least (details also coming in Season 2!). On a short trip, one wouldn’t think it prudent to have sex with the hotties of the past, but there is that trouble of all the rape that women were subjected to back then, and this book doesn’t shy away from mentioning that specifically. It makes me wonder if that’s going to be an event of the book, and lord I hope not.
So I think those are the main diseases that Kivrin will have to deal with, not to mention straight-up food poisoning or botulism from a lack of refrigeration.
The bit about removing Kivrin’s appendix and strengthening her immune system are a little contradictory. In 1996, the appendix was considered a vestigial organ, but nowadays we know it has important functions in keeping us healthy. Your gut bacteria are one of the most important things in your body. They protect you against diseases and help you digest your food. The appendix acts as a reservoir for these good bacteria, so taking it out, while it could prevent her from getting appendicitis in the past and dying of that, it could also put her at risk for other diseases.
There’s no known way to “strengthen” the immune system other than by making sure you have vitamins D and C, or by performing gene therapy to make sure that the pathogen-detecting genes you have are diverse and not common (this is a long topic that I’m not going to get into right now).
Where I am in the book, Kivrin is in the past, we know there’s something wrong with her trip and that she’s not where she should be, but, (in)conveniently, the only tech who can interpret the readings on exactly where she is has just collapsed with whatever current-day epidemic is starting to kick off.
He, Badri, is delirious, his blood pressure is dropping (but he’s not hemorrhaging), and he has an elevated pulse (“Pulse 110. BP 100 over 60”), a fever, chills, and a nasty headache. No congestion, coughing, or nausea, so maybe a flu, maybe not.
On the page I just read, 64, there’s some discussion of local quarantine laws because Oxford and surrounding areas have just been quarantined with alarming alacrity. But, keep in mind this is a recently post-pandemic world, where clearly untold numbers of people died and it’s entered the vernacular as a common event. One would imagine that after such an event, people would be quick to shut things down to prevent it, or other dangerous diseases, from spreading again.
One would have to imagine that, though [heavy dry sarcasm].
Lastly, we know that there are still some strict quarantine rules, because there’s a reference to Lassa Fever in Spain (which is not its usual stomping ground), and how things were quickly contained, and there was talk of increasing the strictness of the laws. So people are still worried about the Pandemic and willing to do what it takes to stop it.
Lassa Fever is a viral hemorrhagic fever similar to Ebola, but less deadly (only 1-15% mortality). It’s normally found in West Africa and is spread by the urine and feces of rats and rodents, or that of the humans who are infected. For it to be in Spain, when it’s not respiratory transmitted, is concerning. But, 80% of people who are infected with it are asymptomatic, perhaps it spread to Spain that way.
Anyways, that’s where I am. If you have a copy of this book and want to read along with me (or have already read it) we could have discussions in the comments, that’d be awesome! Or you don’t have to read it, you could just ask questions or make comments anyways :)