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Disease coverConsidered in its broadest definition, disease serves as the focus of all literature. The online Oxford Lexico defines the term as: “a particular quality, habit, or disposition regarded as adversely affecting a person or group of people.” The etymology of the term derives from “lying far from” an ideal state, and entering into one of inconvenience. What are stories without adversity, a protagonist without an antagonist? Stories are born from inconvenience, from characters flung far from their ideals, dealing with imperfections.

Sarah Tolmie’s writing has often addressed more specific themes of biological imperfection. At its most familiar, this might be illness; at its most extreme, mortality. A professor of English at the University of Waterloo in Ontario, Tolmie recently published a poetry collection entitled The Art of Dying. Disease, a volume of her unconventional short fiction—published by Aqueduct Press last year as Volume 76 of their Conversation Pieces series—now continues her exploration of how humans confront these bodily inconveniences.

The stories in Disease are written in a clinical style, without dialogue and focusing on the symptoms, etiology, and anecdotes of “contemporary” diseases. However, a quick glance at the table of contents reveals that the twenty diseases Tolmie writes of here are far from the typical infectious or inherited maladies that have infected humanity past or present. The stories are divided into sections entitled Alterity, Abandonment, Ubiquity, Information, Fecundity, and Displacement. One section stands apart: Hapax Legomena, featuring “idiopathies consisting, thus far, of a single case”—for example, a tale of a person who suffers from addiction to butterscotch pudding.

All the stories in Disease are built on a foundation of absurdity, with a bizarreness and humor that contrasts with the diagnostic textbook style of the prose.

There are actually people who will move in to others’ old houses. They are commonly known as scavengers […] Sometimes they will impersonate the previous owner of a house for a time, or even permanently; scavengers are amongst those most commonly prosecuted for identity theft.

The medical community is divided as to whether scavenging is a disorder or merely a colossal lack of delicacy. Consensus is clear, at least, that serial scavenging—moving from one left-over house to another, often at an accelerating rate, sometimes once or twice a year—is compulsive. The simple facts that houses are spun out of the blood and bodily fluids of other people, that they are the products of years of others’ labor and are the fundamental expressions of lives not their own make no natural impression on scavengers. Instead of respectfully allowing the regular processes of decay and reclamation that ought to overtake old homes once their makers have died or moved on, scavengers immediately move in and try to stop them.

The absurdity is a clue that the reader should not simply take the title of Disease at face value. A Publisher’s Weekly review that criticised her “shallow treatment of disease” in stories deemed “at worst, obliviously insensitive” has completely missed the point of Tolmie’s work. By no means should Disease be read as any sort of commentary on actual medical conditions. Nor does it serve to mock actual disabilities. Instead, Tolmie uses the structure and form of a clinical diagnostic text to artfully convey a variety of insight and expression. At times, Tolmie does draw connections to the literal realm of human health, but only in the universal sense that forms of illness and inconvenience are things we all have to face in one way or another—and that people can adapt to live and cope with this in myriad ways.

A standout story featuring this approach is “Carborundum”: a “disease” affecting a man who discovers that underneath his flesh is a body of pure glass. He goes through a gradual, and painful, process of removing the skin from his body, showing off the crystalline beauty of what lies beneath in acrobatic dance performances. Considering the possible fragility of his body, and the perhaps risky maneuvers he does with it, he simply concludes, “All people are breakable.”

About another disease, and in another story, Tolmie writes:

The medical literature refers to it as estrangement. In less enlightened ages it was viewed as a moral failing. Now we know it is caused by a virus. This does not prevent the estranged from being treated like pariahs much of the time.

This short passage serves as a reminder that no “moral failing” can explain away any type of biological disorder, but also that this fact does not stop humans and their societies from trying. Cancer to AIDS, the differences in classification usually lie—as Susan Sontag argued—wherever society chooses to draw the lines of personal culpability and reasonable control.

These uncertain or changing delineations are echoed later in the collection with a powerful story of a character named Jacob, who suffers from Misericord, an ability to associate numbers with people at a glance, specifically a number corresponding to misery:

Jacob is now the world’s foremost misery consultant … People need to balance the claims of misery… An underemployed American housewife and a 7-year-old Malaysian child laborer both score a 58. A surgeon in Tasmania who has botched an operation and killed someone is a 79. The survivor of a Bosnian internment camp is a 65. The commandant of the camp is a 60… The higher the number, the greater the toll it takes on [Jacob].

In other stories, Tolmie uses a “disease” to address the theme encapsulated by Aqueduct’s Conversation Pieces series, which “documents and facilitates” fiction and nonfiction that “celebrates the speculations and visions of the grand conversation of feminist SF”:

Privacy is a disease of men. Women throughout recorded history have been less subject to it, volitionally speaking, which explains the wide practices designed to enforce it externally or superficially by means of unrevealing dress.

For the diseases of “involuntary compassion,” meanwhile, Tolmie writes this in an anecdote of an afflicted woman named Aliyah:

She went to university, ignored the endless wailing about the need for women in STEM, and studied 20th-century history. She took political science. There are just as few women there, and nobody wails about it.

Aside from these direct instances, Disease only subtly touches upon the series’ theme of feminist SF, and its classification as science—or speculative—fiction will likely vary by reader. The one story that best fits the speculative mold for me was one of people who experienced “allergic hyperarousal” to “metabolized peanut nutrients in the bloodstream” of others. Though silly-sounding, the concept is not that absurd given known coevolution of species, such as Toxoplasma and mice, or arguably yeast and the humans who provide it food and cultivate it for the joy of getting ourselves drunk. In other words, this—almost uniquely here—is SF of the most essential variety, an outgrowth of a known scientific phenomenon.

This story with its potent peanuts also features the central theme that Tolmie frequently uses her examples of disease to explore: language. Her speculation of a “global vegetable conspiracy: the so-called peanut underground” plays with the Greek term for the legume, which Tolmie points out is hypogaea, meaning underground. Such playfulness with words serves as the entire focus for another story, about the disease of Polysemy—an allergy to words with more than one unique definition. Moreover, its severity in individuals becomes provoked by any considerations of etymology.

Divagation is a another of Tolmie’s diseases whose symptoms and progression seem to basically symbolize language as if it were a biological process. It is one of the Diseases of Fecundity in the collection, and bears mention as an illness not of humans, but of plants. Here, plants are propagated as if magically by “incantatory cultivation.” But then these cultivars fail to breed true, instead following a pathway of “connotational drift,” like an evolving culture of expression. Tongue-in-cheek, Tolmie advises: “If plants on your legal property are displaying cognate signs, you are advised to uproot them immediately.”

Through their unconventional style, then, the stories of Tolmie’s Disease are a splendid combination of serious, heart-breaking, and funny. Though the collection is short, it has an intelligence that benefits from careful reading. The absurdity of its anecdotes, its conversation with language, and its plot-free clinical format could, though, for some, quickly get old fast—adding to the perks of reading it in short fragments rather than straight through in a visual gulp.  Think of it, like any work of reference in the fields of pathology, as a volume to dip into in search of wisdom.

Daniel Haeusser ( is an assistant professor of biology at Canisius College, where his lab studies the effect of phage factors on bacterial cell division and shape. On the side, he writes and edits for Small Things Considered, and reviews books at Reading 1000 Lives and for the sci-fi/fantasy podcast/site Skiffy & Fanty. You can also find him on Facebook, Twitter, and Instagram.
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