Horror & Dark Fantasy

Best American Science Fiction and Fantasy 2017



The H Word: Following the Symptoms

You may recall that the last time I was invited to write for “The H Word,” I mentioned my passion for the Black Death, a disease which swept through Europe for centuries, beginning in 1347, when it first appeared in Messina, Italy. At the time, I said that the hemorrhagic fever theory of the disease would be a topic for an entirely separate column, and now here we are.

Some background: My interest in this particular pandemic began with a book called Return of the Black Death: The World’s Greatest Serial Killer, by Susan Scott and Christopher Duncan. I had heard of the Black Death before that — as someone with a great fondness for epidemics, it would have been impossible for me to have missed it — but I had never considered how little we actually know for sure about what the disease was and how it worked. Which brings us to how this relates to the use of viruses in horror, and why a little research can turn something distantly frightening into something to be truly afraid of.

Have you heard of the Black Death? I’d be willing to wager that you have, since it’s taught as a major part of European history, and European history is one of those subjects that’s virtually impossible to avoid (although the Black Death did enormous amounts of damage in Asia and the Middle East as well as in Europe; this was not a disease which respected borders). Most people know it as another name for the bubonic plague, that flea-borne disease that still haunts the West Coast of the United States, where it’s been endemic in our small ground mammals since prior to the 1906 earthquake. This is the Big Mama pandemic, the one that set the stage for some of the earliest tales of man versus disease. “The Masque of the Red Death”? This is where it comes from.

Like most people, I had never really thought critically about the Black Death. It was something that had happened, and hence something that could potentially happen again, but it didn’t have anything to do with me. Then I read a book about it. And then I read another and another, until I realized that the Black Death was a giant, beautiful mystery that we all thought we understood.

Therein lies the opportunity for horror.

Consider this: I tell you that millions of people have died, and we think we know what the disease is. We think that it’s bubonic plague, which is spread primarily by infected fleas. Person-to-person transmission is possible, but rare. Symptoms include swelling of the glands, gangrene, chills, seizures, and extreme pain. Also death. Fortunately for us, all of these people died a long time ago. Unfortunately for us, their bodies were buried all over several continents, and there’s a chance that someone will go and dig them up, which could result in a new outbreak. But don’t worry! We have lots of treatment options for bubonic plague. So as long as our mystery disease was, in fact, bubonic, we’ll be able to keep that second plague from being as bad as the first.

It’s just that we can’t be sure. We’re basing our diagnosis, after all, on a bunch of old records and anecdotal statements; we have no samples of the disease and no living witnesses. And we’re basing our diagnosis on the symptoms we like thinking about — the ones that fit our idea of what we’re dealing with. Cats have tails; this creature has a tail; this creature is a cat, because quite frankly, when the other option is a Utahraptor, we’d much rather have the cat. So let’s look at all the symptoms.

The Black Death — whatever it was — did, in fact, come with swelling of the glands. It also came with fever, hallucinations, occasional violent outbursts, and an odd rash on the torso, back, and legs, which formed hard, scaly patches sometimes referred to in writings of the time as “God’s tokens.” Autopsies of plague victims revealed advanced internal necrosis, which also explains why so many plague victims commented on the sweetness of the air before they succumbed. (Fun fact: when your vital organs are rotting inside your still-living form, the gases they produce will often cause an impression of sweetness. Because sometimes, your body tries to trick you into thinking that the things it’s going through are not, in fact, horrible.)

The Black Death in Europe happened during a period known as “the Little Ice Age,” during which temperatures plummeted to record lows, disrupting farming, trade, and animal migration routes. Some places which historically had rats — like Iceland — had no rats during the Little Ice Age, because the temperatures were so low that the animals said “screw this,” and went elsewhere. Great for the grain supplies in Iceland, not so great for the spread of the bubonic plague, which depends on rats and their relations to spread it around. Yet somehow, the Black Death was able to make the jump to Iceland and kill a lot of people while it was there.

One of my favorite bits of contradictory evidence relating to the Black Death — which is to say, evidence that is generally ignored because we’d rather have a cat than a Utahraptor — is about the dovecotes. Dovecotes are houses for doves. Prior to the arrival of the black rat, an invasive species generally credited with the spread of the Black Death through Europe, the dovecotes of England were built flush to the ground. This is because the native brown rat is a lazy thing, and didn’t consider climbing into dovecotes and fighting pissed-off doves for their eggs to be a valid use of its time. The black rat, on the other hand, is a much more enthusiastic and opportunistic feeder, and will happily climb into a dovecote. So once the black rat started spreading through England, people started raising their dovecotes off the ground.

Fun fact about English architecture: for some reason, the people there just loved putting dates on things. Every house and building seems to have the date it was constructed worked somewhere into the foundation. That even includes things like the dovecotes, which were — in some cases — so well constructed that they’ve endured into the modern era, or at least their foundations have. So we have dates on when the dovecotes were raised, which means we have dates documenting the spread of the black rat through England. The black rat spread through England more than ten years after the Black Death spread through England.

Now, it is entirely possible that while people were busy dying of the Black Death, they didn’t exactly feel like running out and building themselves new dovecotes. It’s possible that it took a few years to figure out that the solution to rats eating everything that wasn’t nailed down was picking the dovecotes up off the ground. But a decade seems a bit extreme, especially considering the speed with which the black rat can mow through a dovecote. There might not have been any doves left if they had actually waited that long after the black rat showed up. So now we have some concrete, if anecdotal, data that puts the Black Death in England several years before the black rat.

There’s lots of other fun evidence to undermine the bubonic plague theory of the disease. Quarantine rarely works with insect-borne diseases, since quarantining fleas or mosquitoes is sort of like interviewing fungus: it doesn’t work, and you feel sort of silly for having tried it. Nonetheless, we have strong evidence that quarantine worked in the case of the Black Death. The Black Death spread too fast to have been zoonotic (spread by animals); it had person-to-person transmission. And so on and so on for hundreds of years, until the disease finally tapered out.

Am I saying that the Black Death absolutely wasn’t the bubonic plague? No. I don’t have a time machine. I can’t say what caused the pandemic with any more assurance than anyone else. But by focusing on the evidence that I find interesting, rather than the evidence that is commonly associated with the outbreak, I can paint a very different picture of the disease. Either one is terrifying. Bubonic plague, however, is something we know how to treat, prevent, and deal with. About my mystery virus . . . we know nothing. Just that it killed a lot of people over the course of a lot of years, and could still be out there somewhere, lurking. Waiting for a construction project to break into the wrong plague pit and let it out for another chance at destroying the human race.

But what does all this have to do with writing horror?


People who don’t know what measles can do treat it as a form of “super chickenpox,” ignoring the fact that it can have permanent, dangerous consequences — and the two viruses look very similar when they’re just getting started. Part of the slowdown on diagnosing West Nile was the fact that it looked like a lot of different, less dangerous, less novel things. (The rest of the delay had to do with the fact that many of the organizations responsible for public health did not, at the time, like to share information with each other. They still don’t do the best job of that, which is why it can take a while to figure out what’s making people sick.)

Novel viruses crop up more frequently than most of us would like to think, and they can do a great deal of damage before they’re properly identified. You want to get mileage out of a disease? Look at an outbreak and start digging for the pieces that weren’t included in the original. The pieces that turn it from a manageable bacterial threat into a terrifying hemorrhagic nightmare. Look at speed of spread. Consider your options. Zoonotic diseases are harder to defeat with quarantine, but they also move more slowly through the population.

What clues can you scatter? What is your version of the dovecote? There will always be something that dedicated virologists — and dedicated readers — can follow back to the source of the disease, and there’s a lot of ground to be gained by making people question their assumptions about the outbreak. Maybe the Black Death was the bubonic plague; maybe all the material I’ve presented here was just coincidental.

But maybe it wasn’t. And let’s be serious for a moment: isn’t my way a lot more fun?

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Seanan McGuire

Seanan McGuire

Seanan McGuire was born and raised in Northern California, resulting in a love of rattlesnakes and an absolute terror of weather. She shares a crumbling old farmhouse with a variety of cats, far too many books, and enough horror movies to be considered a problem. Seanan publishes about three books a year, and is widely rumored not to actually sleep. When bored, Seanan tends to wander into swamps and cornfields, which has not yet managed to get her killed (although not for lack of trying). She also writes as Mira Grant, filling the role of her own evil twin, and tends to talk about horrible diseases at the dinner table.