I guess I'll also use this blog to write about the process of fic writing for some fics. At least, the ones that have more interesting backstories.
So my most recent SKK fic,
Do No Harm is a pandemic AU. I say where I got the idea in the notes, but even further than that, this kind of topic of contagious diseases and pandemics is a huge interest to me. Pathology is actually also a huge interest to me. I'm not good at science and I don't know a lot of the science behind a lot of diseases, but I still find it really fascinating.
The disease in "Do No Harm" is a hemorrhagic fever (rather than the Spanish flu as originally suggested to me.) Hemorrhagic fevers are scary because of the bleeding they cause both inside and out. The most recent outbreak of hemorrhagic fever was Ebola in several countries in Africa, and I'd say that Ebola is the most well-known hemorrhagic fever that crops up.
There's an excellent book called The Hot Zone by Richard Preston that details incidents of outbreaks involving hemorrhagic fevers. I read this a few years ago (probably around 2012) and it became relevant around the time of the Ebola outbreaks. It provides a good look at what hemorrhagic fevers are and why their outbreaks are so devastating.
That said, a few liberties were taken for this fic. I based the virus in this fic off Marburg virus (which is very similar to Ebola, but had a major outbreak in Germany). Hemorrhagic fevers are extremely contagious, but they aren't actually easy to spread. These viruses spread through direct contact with bodily fluids, meaning that the bodily fluids of a sick person have to get into your bodily fluids for the virus to take. However, if you do happen to have end up with infected fluids inside of you, chances are you are going to get sick.
That method of transfer is different from, say, the flu, which is a lot more easy to transfer. Viruses like the flu can be transferred through the air, by coughing and sneezing and by inhaling particles of the virus. That means that being in the same room as someone with the flu can get you sick. Something like the flu is easier to spread, so a flu outbreak could more easily lead to a pandemic than something like Ebola could.
The flu also lasts longer. Severe hemorrhagic fevers tend to kill off their victims faster, which gives the virus less of a window to spread. People with those viruses are also less mobile once the severe symptoms kick in, which further hinders the virus' movement.
Hemorrhagic fever viruses can't be spread through air or aerosol (droplets in the air), but for the purposes of this fic I made it so that the virus can be spread via aerosol. Viruses that spread in this way can't travel on the air, and survive for short periods of time in droplets released into the air. It isn't as bad as the flu, but it's easier to spread than a standard hemorrhagic fever. Because the setting is Japan, which has high quality healthcare and medical facilities, I wanted the virus to be easier to spread. Even though I think something like a hemorrhagic fever would be able to spread a bit in Japan simply because they've never seen it before, which could result in delays of treatment and improper handling, I still thought the virus would have to have an easier method of spreading in order for it to have the impact on major urban areas that it did in the fic.
The title, "Do No Harm," has to do with the promise doctors make upon becoming doctors. It's also a reference to a memoir by Henry Marsh, a British neurosurgeon, which details the complex feelings and decisions and situations that come with being a doctor. I thought that sort of sentiment was relevant to the decisions Dazai and Yosano have to make in the fic. It's surprising how often there isn't a clear-cut right or wrong answer in medicine.
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