Causes: A story from Infectious Futures

25 Jun 2018

Written by Lydia Nicholas

In 2015, we commissioned six stories about a future facing up to the challenge of antibiotic resistance called Infectious Futures: Stories of the post-antibiotic apocalypse as part of a much larger effort to publicise, educate, and enrich the conversation around the subject. These stories, originally in print form, will be uploaded as blogs into an online collection. Enjoy!

cover of a story called "Cause", black squared image on faded pink background


CORRIDORS FALL into the distance, to the left and to the right of you. Smooth white floors curve into smooth white walls curve into bright white ceilings and unbroken strips of white light, dimmed in mockery of the night. The strip-lit hall leaves no dark angles for any dirt to stick to or exhausted gaze to rest on. By about four a.m., your aching brain can’t hold on any longer to the corridor’s shape. It splits into polygons of white-greys and greywhites that spin and morph in bland, repeating patterns, like a middle-manager’s kaleidoscope. The pieces spin and come together into other forms, other corridors.

Fighting nausea, you slump back in your smooth, white chair. There’s no grip or give in the wipe-clean white plastic ice-cream scoop of a seat. Your bum shoots forward and the back of your skull slams against the rim of the backrest. Ow. Dig your heels in and push yourself back up before you’re seen slumped like a fool. A great image this would be to get out. Nationalist and Progressive extremists finally unite in common cause against the idiot woman left watching hospital halls for them who can’t even use a chair. You could be a meme. You peer around for photographers, spy drones, anything.


Looking over your shoulder, through the soundproofed, frosted glass wall, you see the blurred, incomprehensible bustling of white coats and medical equipment. Keeping an eye out: that’s your only job tonight. And it’s a job rendered irrelevant by the security staff on every hospital entrance, the scanners and beepers on every person and system throughout the palace complex. All the other comms staff will be on the net where they are actually useful, monitoring and manipulating rumours. Who did this? Why? Was it Nationalist terrorists shrieking for closed borders and quarantines, raging against the prince’s foreign wife? Was it Progressives demanding the opening of everything for all, never mind the cost and contagion? Or foreign agents, religious extremists, corporate interests, individual attention-seekers? Who slipped a contagion past the palace quarantine? Comms will be playing the news-wires like a string band. That is where you belong. You can’t even get Twitter here.

But an heir to the throne, even an unconscious one, must have his attendants. This long night must surely be a hazing thing – a dull, head pounding, hallucinatory threshold to your new life. Maybe your new colleagues each have their own nightmares of twenty-hour stints spent in these corridors. Hours left clueless about how serious this particular attack on His Highnesses’ body might be. Hours spent wondering how many rounds of what exhausting, speculative treatments, how many hours or days of waiting, how much chopping and cauterising the royal flesh will take before the crisis is passed. You remember another long wait in another long, white corridor. For an instant those crowds – the screaming children and the shouting, shoving queues – smear the wipe-clean halls with old terror. You hear the ghost of a quiet, ceaseless cough.

Blink. Breathe. There is only silence here.

The first thing they do, once they’ve shown you the toilets and cafeteria and living quarters – which comes after the shaving and dousing and burning, which comes after the month-long quarantine with its endless swabs and petri-dish smears, which comes after the interviews, the background searches, the Q&A sessions spent in EEGs and MRIs and fitted with GSR bands – the first thing they do once you’ve reached your desk, and it’s all become actually, really, real, is they hand you a fresh new phone that’s already ringing.

You answer. “Hello,” you say, pitched carefully for the mentor in front of you, and any interested new cubicle-mates. You use an accent your mother would have sneered at – a recognisable regional tint to the vowels to indicate pride and sincerity; consonants clear as crystal. K-lear, K-rys-tal, to hint at years in the right schools. They can tell it’s a cover, of course, of course. But perhaps they don’t know you know they know.

He answers. Actually him. Him himself. “Good afternoon and welcome to the palace. I trust the introduction processes passed without complication, and your accommodation is satisfactory.”

Your turn. You feel every molecule of breeze flowing over your freshly buzz-cut scalp. “Yes, everything is great”. No, that isn’t right. You can’t speak to the third-in-line-to-the-throne in monosyllables. “Exceptional. The accommodation is exceptional. I am of course most excited about those facilities which will permit me to use and develop my skills in order to meet the challenges of this new role.”

It ends soon. An invitation to the new starters’ tea on the lawns. The family will be there. The. Family. Him. Her. Them.

A colleague lets you know that you can take out a loan against your first pay to purchase suitable attire. “Attire”, wow, you’ve only ever owned “clothes” before.

Them, though. Him. Her: the brilliant Indonesian human-rights-lawyer wife, and the children whose mixed ethnicity features in about half the death threats you had to sort and tag in the early rounds of interviews. You think it will be strange to meet people in the flesh after you’ve read so many descriptions of the ways they’ll die.

When you work, you feel like a surgeon, palpating the swollen mass of social media’s rage. With sensitive algorithms, you test and categorise the swelling, and identify those pustules just about to burst. You’re there to trace the root cause of the trauma.

This cluster of interconnections looks like private-clinic profiteers are engineering a “grass-roots” protest to the opening of a new hospital. That surge, related to an outbreak of gastroenteritis in Liverpool – the families’ howls of grief and rage echo each other a little too closely. So: triangulate the location of relatives’ deaths, the threateners’ addresses and social networks. Identify the locations the activist most likely used to hand out the pamphlet. Reconstruct elements of its likely contents. Recommend which camera-feeds to pull. They’d been impressed with that one. A thousand applicants for every opening here and you made it. You actually made it.

Those first few days, you thrilled at the work, grappling with models and tools better than any you got to play with outside. Your cubicle neighbour made obscure jokes about structuring database queries and you laughed, you really laughed, and no one glared or snarled for an explanation. You leant back from your second-floor desk, sipping the best coffee of your life, and watched through a real open window, feeling the unfiltered breeze, as staff flowed past below.

Of course there are patterns to see there, too. The old guard press in close, valuing privacy, flaunting their confidence in the palace’s clean system with touches and whispers. Newer staff back away, unconsciously attempting to maintain the wider personal space they learned to acquire outside – the cough’s distance enforced in all nurseries. Old and new staff attempting conversation slide backwards in an unconscious comedy of mismatched manners. Lean in, step back, lean in, step back… and pirouette, and – tap.

You sipped extraordinary espresso and watched the strange palace dance. You are the very newest of the staff here, but you are skilled at spotting and following subtle rules. You are used to mimicry, observing the flow from the outside. “Little changeling”, your mother called you, from childhood, for the dark hair and eyes which set you apart from your sisters. The name stuck, though the tone she used changed over the years.


Someone is running up the right-hand corridor. You’ve been awake over twenty hours and the wipe-clean corridor is so featureless that, for a long moment, you have the horrendous sensation that the white-coated man with a suitcase handcuffed to his wrist is running on the spot and growing, bulging in spurts, filling your field of vision. This image is familiar. You think you know the message he is bringing and you don’t want to hear it, you don’t, you don’t.

But then you are standing up and have got yourself together: “ID?” He rolls his eyes and fumbles one-handed to a lanyard. The ID card dances with fraud-resistant holograms. His hand is shaking as he holds it out to scan. Exhausted.

You smile. “Any clues as to who’s behind it?”

“You think they’d tell me?”

“I haven’t seen anyone or heard any news in hours. Come on, I’m a comms tech. Radio silence is killing me. What are they saying?”

The glass wall is slowly sliding back to reveal an airlock. He steps through as soon as the crack is wide enough. “Official line is still exhaustion. Outside, I don’t know. There’s a lot of noise. I’m not much of a news person.”

This is impossible for you to understand, as though the man had denied he breathed oxygen. He sees it in your face.

“So there’s a whole thing about it being an inside job, he’s getting too political, the princess treading on too many important toes. The Progs are acting outrage—”

The glass screen slides back into place; the silence is instant. You see a helpless, exaggerated shrug through the frosted glass. Inside job? Damn it, comms must be on fire. The urge to swipe open your news feeds is physically painful. The filters you would run! Oh, the material you could scrape concerning, the factions’ accusations, categorised by place, affiliation… Those are publishable papers, right there, and all of it slipping away while you sit here, helpless.

You lean back in your seat – cautiously – and stare at the ceiling lights until their white spots dance in your eyes.

Blink. Breathe.

You’ve had only a week to enjoy your new living quarters. A small, single room. A bathroom with the strict washing routine and symptom-reporting regulations printed directly onto one smooth wall. On the other hand, there are those bright prints you chose, fabrics and rugs, and a window looking onto the complex’s private park where children play. If you do well, there are larger rooms, apartments, secondments in other comms teams and other complexes. You will do well.

A small set of trinkets on your desk. The wobbly clay elephant your younger sister made for you when you first left the city to study. Its four feet refuse to touch the ground together, and it trembles at the slightest disturbance – your movement, the building’s, the city’s. Sometimes you hover your hand over it and feel it thrum with something like life. A mechanical clock from your mother; its tick is a comfort, its cautiously classic design a reminder of the gulf across which the two of you tried to connect. A fluffy bear from your older sister feels strange to the touch after its cavity search on the way through quarantine. The last photo of you and your sisters as a three, together.

Your mother smashed the frame of the copy you gave her when you said you were leaving. Why don’t you think about anyone else? Why don’t you think about what she’s already lost? (Your older sister fed her son in silence.) You explained – what? That you really believed in the royal couple’s campaigns for more and better hospitals; for better care, even in losing battles? That you wanted an end to those isolation ‘wards’ – the cells stacked three-high in long rooms they won’t let you see, even if you’re family, even if you push past the doctors, howling, and get a glimpse of endless honeycomb doors before the floor turns beneath you and you fall into security’s arms.

Your mother curled her lip at the idea. That you, of all people, would accept as truth a story that made some sense of it all! A romantic story of a quiet prince courting a brilliant, radical lawyer across a political carousel of fundraisers and awards and debates, and on into the centre of these burning, populist causes! That you, of all people, had found a place for yourself in that story!

Or did you explain that you were good at what you did? That you could do good with that story, do good in that story, spin though it might be? Or did you just say that you’re ambitious? What is wrong with being ambitious? Yes you wanted more, what on Earth is wrong with that? Don’t come back, she said. I don’t intend to, you said.

Blink. Breathe.

You stare at the ceiling. Nothing so complete as an idea emerges. Half-made theories. Factions and motives and means go spinning through your mind. Pointless.

Your nephew – you’ll send him something from the elegant palace complex shops when this is over. An educational toy your mother and sister won’t deny him, even coming from you. Or you could set up an emergency medical fund for him. They can’t object to that. Maybe they’ll let him send you a note.

The frosted glass wall slides back. You jump to your feet. A woman pops out of the crack, a cork from champagne, fleeing down the hall.


She keeps running. You barely saw her face – were those tears?

“Let her go.” You see a man in the airlock. “We buzzed head office the details, but they always want direct confirmation.”

“You identified it? You know who did it?” You’ve been thinking. “Was it Progs framing Nationalists? They know there’s enough sympathy for the family right now that any attack will come over as crude, and they’ve got some skilled tacticians in the youth wing. I can see them going for that angle.” He looks at you strangely: you’ve misread something. “Not a big player? Some lone nutter got slow-acting spores on a gift for the five-year old’s birthday party? Awful, but it’ll play well.” You are so tired. You can’t parse his silence. “Just tell me, why they—”

“You don’t understand. That doesn’t matter.”

“Of course it matters.” The man explodes. “You think you have a job chasing conspiracies any more, you idiot? He’s dead.”

The world slips gently out of its orbit; a slipped digit, a shift in weight. The taut equation that held it on course for so long degrades into an inexorable death spiral.

“Just a stubbed toe, and staph cellulitis, and then sepsis. We can’t even find the break in the skin. Under the nail, we think. If there is a break. We don’t know.” He looks around, as if he can see what you can: that the corridor is flying apart in bright white shards, falling into the sky. Quieter, staring at his hands: “We don’t know.”

Someone is sobbing. Something is broken. You wrench at the space, try to force it back into the right place, the right time. When you bring the pieces together, you find that it is you.

Lydia Nicholas is an anthropologist focused on biotechnology, medical and digital culture who draws on narratives and design as research methods. She worked in Nesta’s Collective Intelligence team.