Page 45 Review by Stephen
"What doesn't kill you makes you stronger.
"True for bacteria and people."
If you thought LOW's futuristic premise based on scientific certainty was pretty crushing, welcome to another far, far closer to the bleak hour at hand.
All too topical, this medical and medication-based conspiracy thriller addresses bacterial immunity to antibiotics - which is already reaching dangerous levels - and speculates on its repercussions for a society in a political climate currently lurching horrifyingly far to the right.
It's 2036, and the Conservatives have been eclipsed by the ultranationalist red-on-white Lionheart Party which is currently in power. I imagine they once had no members of Parliament whatsoever, but were given equal airtime by a feckless, controversy-cultivating and so complicit media. That's wild speculation of my part, obviously. It couldn't happen here.
In 2016 700,000 individuals died from antibiotic-resistant infections. By 2036 that annual figure has risen to 9 million. Tuberculosis, pneumonia, meningitis and most STDs have become untreatable. The condition is critical: you could now die of an infected paper cut.
This is far from a sensationalist prospect, I promise you.
"Alexander Fleming's messy lab led to the serendipitous discovery of penicillin. The very first class of antibiotic," we are told in a lecture by microbiologist Dr. Martha Scott. It saved hundreds of thousands of lives during WWII and "became the bedrock of modern medicine, curing once deadly diseases and infections".
That is all true, and so is this:
"By 2010, antibiotic use was rife in farming as well as medicine. And no new classes had been found since 1987. Some poor countries even sold them like sweets since it was cheaper than seeing a doctor. And so the resistance grew."
Bacteria adapt and evolve a great deal faster than we do: they multiply faster than we do.
"For decades, big pharma failed to invest in new antibiotics - not profitable. And governments didn't devote enough resources until it was too late. Hospitals have become breeding grounds for these deadly infections, and enforced home isolation is now the only option for the seriously ill."
Complacency is one of the things modern humans do best.
Featuring the finest (and unfortunately final) art of John Watkiss' career, printed on paper stock which make his deep and rich blacks glow alongside James Devlin's colours, this is a nightmare scenario so grippingly executed not because of its death toll (that is not what this is about) but because Kenney has concentrated on its ramifications for individuals under a regime which has decided - as a result of the limited resources and their efficaciousness - to ration the remaining antibiotics.
For a start, you will not receive treatment of any kind if you do not qualify for it under the stringent Productivity Contribution Index.
If you are deemed and dismissed as a waste of space by The Powers That Be - by being disabled and/or obese, for example - then you can probably fuck off and quite literally die.
The scenario has been so well thought through.
There are of course riots, for what else can one do when you are otherwise powerless and outright rejected by intransigent authorities? We begin with a bombing at a London mayoral election debate which injures both candidates and in attendance by accident is Dr. Martha Scott's sister, Rosa. Like her mother, Dr. Martha Scott is a microbiologist involved in education and active research; but, like her father, Dr Rosa Scott is a frontline surgeon. She works for the NHS. Under the Hippocratic Oath she has sworn to uphold certain ethical standards. She does not believe in the rationing, by governmental command, of antibiotics: these decisions she believes should be made by doctors. She believes all patients in need should be treated equally regardless of the PCI and that she must certainly do them no harm through her actions or inaction.
Yet faced with two political candidates in need she chooses to help the one whose policies are in accord with her own, and hesitates to help the other. There are... dramatic repercussions.
Two weeks earlier Dr Rosa Scott operated on a patient whose life was immediately at risk but who didn't qualify under the PCI and, threatened with disciplinary action, she quit the NHS. Instead she opened her own long-planned private surgery in the basement of her house. Unlike her father in the private medical sector, she is determined to operate on patients in need regardless of their financial resources. She is Surgeon X: underground and illegal. But she's going to find that those initially most in need are those closest to home.
And that's where the heart of this series lies: so close to home.
Far away from home was Rosa and Martha Scott's mother six weeks earlier, last seen on a refugee boat off the coast of Burma, injected with a paralysing drug then drowned in the sea. She was on the brink of discovering a new class of antibiotics but someone evidently didn't like what she'd found.
I know what you're thinking: this is packed!
And it is. I haven't even hinted at Rosa and Martha's half-brother Lewis, a schizophrenic desperately in need of maintaining his medication but who ditches it in order to feel liberated by its side-effects and suffocating restraint. If Sara Kenney hasn't had personal experience of a loved one in this condition then I would be stunned, for every element is perfectly played from Lewis' deluded decision that this time he will be fine (when he wasn't in the past) to the resultant suspicion and distrust of those once again closest to home and the wider, deep-rooted paranoia regarding authority and a conspiracy to constrain. The mind-set and language are both spot-on. I know: I've been there with two mates.
But what is brilliant is that it dove-tails into this scenario so well.
Also exceptional: the poetry when it's practised, the history lessons and the extrapolation of a credible future from where we are today (surgeons still only 15% female - long live the patriarchy, eh? - see Y - THE LAST MAN), with lovely little satirical side-swipes at Twitter ("Chatterblast") and cabbies who can't keep their predictable, opinionated gobs shut even when they're self-driven / automated:
"Welcome to London cabs. Would you like to know the predicted weather for this afternoon?"
"Would you like to discuss politics or a topic of your choosing?"
"Okay. How about King Charles' views on architecture, the environment or complementary medicine?"
"University College London - Cruciform Building. We've arrived at your destination. Have a nice day - and please don't slam the door...!"
My only complaint is that because this series is so rich in skulduggery that it does at times suffer from excessively expository dialogue. In this instance I can live with that: other than being released as an original graphic novel I'm not sure how it could have been avoided. It's just that we don't naturally remind each other in conversation of events that have dramatically impacted on our shared lives in the form of little memorandums or post-it notes.
I loved the bits out in orbit, the sunsets in Scotland, the flashbacks to Rosa's mistake working in the war-torn Libyan field, and the entire examination of how highly we regard surgeons when they are - like us all - individual, flawed human beings who cannot get everything right their first time. Institutional failings are unforgiveable but individual mistakes are inevitably made.
So tuberculosis, pneumonia, meningitis and most STDs have become untreatable and the condition is critical: you could die of an infected paper cut.
But what if an old-school epidemic reached our shores...? One with "prior", as they say.
It gets worse.