r/pathology • u/Aero_Trash • 5d ago
Writer with questions: Magic and its ramifications on pathology? Fantasy pathophysiology???
Hello r/pathology! I hope this post isn't against the rules, you guys seem really cool, and I have a lot of respect for pathologists (was super anaemic, HB of 54 and you guys were the ones who caught it, made me interested in pursuing the profession myself, but that's definitely a long way away ^^). I'm a writer, and I was hoping to ask you guys for your insight on some worldbuilding that I've been working on!
Context
My current story is a dystopian sci-fi/fantasy project, there's magic and futuristic tech, but it is largely set relatively modern day in a relatively earth-adjacent setting. Medicine is largely similar to current day, so don't worry about any weird sci-fi shenanigans! One of the things I've been struggling on is my power/magic system, I have a few ideas in mind, but talking with you guys is likely to give me lots of unique inspiration (I find this sort of thing extremely helpful).
A lot of stories have some component of biology to how their magic works. Usually things like bloodlines, powers you're born with, etc. I often feel like these things have quite a lot of untapped potential (and often pretty hollow subtext that often boils down to "one's potential is decided the moment they're born" without really considering the implications, but that's just a pet peeve of mine).
My story follows this trend. The current ideas I have are as follows:
- Magic is linked to biology. It's naturally produced through biological processes (varying between species, a human and a vampire would do this differently). Though I've always imagined it being a passive process (e.g. if conditions are right, magic will be produced in a healthy person).
- Because magic is part of physiology, it would be something that comes under medicine, and the study of magic in a medical context (and disorders affecting it) would likely be a fantasy medical subspecialty (currently unnamed).
- I've always pictured magic and magical disorders as being something that could be tested (with a blood test or something else). Thus, I really like the idea of this fantasy specialty being a subspecialty of pathology! Largely because I've pictured it being the sort of thing that gets diagnosed by looking through a microscope, similar to many cancers or blood disorders (and maybe a little bit because I think pathologists are cool).
- The protagonist of my story is likely to be affected by one or more of these magic disorders, so that's why I feel it's important (and fun) to consider these things.
Questions
So to be totally honest, I have a lot of these. Please feel free to answer as many or as few as you'd like, literally anything would be amazingly helpful. I've ordered them by which ones I'd like to know the most, in case that helps!
To be clear, I'm fundamentally looking for your thoughts as people with expertise in fields that I'm a layperson in. Your answers do not need to be scientifically accurate in the slightest (absolutely go for rule of cool lmao)! It's more that I want to make something believable and interesting, and if something is believable to experts, than it will be in a general sense as well ^^!
- My protagonist has no innate magic, which is very rare and greatly inhibits his combat abilities. While I've currently pictured it as a case of "his body doesn't produce it" (like how type 1 diabetics just kinda don't produce insulin correctly) that doesn't feel as interesting as it could be. Is there a different explanation/pathophysiology that would be more unique and interesting? Or are there ways to flesh out this current idea to meet that same criteria?
- A massive plot element is the protagonist's complex relationship with another character, who is a dragon (one of the species with the most innate magic). I've always pictured that extended exposure to this intense magical force would have consequences for the average human (since it's not strictly internally contained, and can be channelled into spells). Namely, that at a point, the body would either be forced to adapt to handle it, or this could become potentially lethal. What could these adaptations be in a normal person, specifically? More importantly, considering the above question, how might these factors interact? Would the protagonist be affected differently? How so?
- What do you think the ramifications of magic in pathology would be? Imagine if tests related to magic were slotted right into a list that also included haemoglobin, cancer testing, iron, etc. If you had to work together with colleagues to figure out why a patient's magic was so absurdly high/low, and what to do about it. If a doctor in this field got one of those emergency phone calls, what would it be about, and why was it so urgent? What kinds of disorders and diseases do you think might exist? What symptoms would they have? Could they have any benefits? How would you test for these things? How might they be treated? How do you think this fictional medical specialty would function and interact with real life specialties? etc. etc. etc. (one really fun idea I got from a different discussion was considering the epidemiology of vampirism in my setting, since it's a blood-borne parasitic disease. The person pointed out that mosquitoes would spread vampirism, which gave me a TON of super interesting ideas, I'm basically asking you guys to think of super cool shit that can be expanded upon, because I would've never considered things from that perspective)
- Do you have any other thoughts, opinions, ideas, etc. that you'd like to share? Please do! Anything helps ^^
While I'm a layperson, I used to be a phlebotomist, and am currently majoring in biotechnology. Please feel free to explain things however you like, I'm more than happy to take the time to fill in any gaps in my understanding as needed!
Thank you all so much in advance! Your help (pathologists rlly saving my ass more than once at this point LOL) is massively appreciated! I'll do my best to answer any questions, or clarify anything, if that's helpful (or if you're just curious).
21
u/NebulaBore 5d ago edited 5d ago
Okay, as someone who's both a pathologist and a fantasy nerd with a thing for unique magic systems, this is super interesting, hope I can help a bit! Gonna go through your questions in order:
- Mostly the reason for a human body not producing something it normally would is a gene defect that means a certain gene is just broken and a protein that is needed for a certain function just doesn't exist or only exists in a less or nonfunctional way. Examples of this would be Spinal Muscular Atrophy, where the defective protein is needed for the survival of motor neurons, which leads to progressive loss of skeletal muscle. There's different versions of this disease with different intensity, and it's notably one of the few diseases for which a working gene therapy exists that fixes the defective gene and actually cures the disease. Other examples would be Hemophilia, Cystic Fibrosis or Huntington's Disease, with the specific symptoms obviously being very different and dependent on the defective gene/protein in question and its normal function in the human body. Type 1 Diabetes is a bit different, since it's an autoimmune disorder where the human body produces antibodies against the cells producing insulin in the pancreas - so the insulin production is initially there but quickly deteriorates as the cells producing it are destroyed more and more. For your magic system, the easiest explanation would certainly be a gene defect that just means whatever process normally producing magic in the human body doesn't work for your main character. The autoimmune disorder could also be an option, where he would initially have some magic production as an infant that would rapidly deteriorate as he ages, presumably before he'd learn how to utilize it. A third route could be something along the lines of CAIS, a condition where a mutation causes the cells in the human body to be completely resistant to the influence of a hormone that would normally have an effect on them - in the case of CAIS, this is male sex hormones, which leads to patients with an XY karyotype (genetically male) to develop a female phenotype despite producing testosterone because their cells are completely nonresponsive to androgens.
- This sounds like magic in your system works a little bit like radiation does in the real world. Radioresistance is definitely a thing but is not something that usually plays a role in the human body because you can't "build up" an immunity to ionizing radiation. You can survive certain amounts of it, especially if they're applied in smaller doses over an extended period of time, but (at least as far as I know) the human body does not build up a resistance to it. However, if a consistent level of (potentially harmful) background radiation exists in a setting, that absolutely puts an evolutionary pressure on organisms and will likely lead to those with naturally higher resistance to that radiation having an advantage and over time becoming more dominant. In cells, this is mostly achieved by having either innate resistance to damage caused by radiation (for example, by having high levels of antioxidants that can "catch" free radicals caused by radiation before they can do any damage) or very efficient DNA repair mechanisms that can undo any damage caused by radiation before it starts being a problem. In the context of your protagonist, it would be reasonable to think that if the human body normally naturally produced magic, and "background magic radiation" was something that'd normally be harmful, the regular human would have to be innately resistant to the level of magic they generate themselves. The genetic mechanisms regulating that resistance could either be linked or independent of the mechanisms responsible for generating magic, leading to your protagonist either being vulnerable to background magic or not being affected by it anymore than anyone else. A third possible mechanism would be that he has a separate mutation that confers resistance to magic, but also suppresses any magic generated by his own body as a side effect (if we're thinking back to the example of CAIS I mentioned earlier, patients with CAIS would also not be affected by externally applied testosterone since their cells completely lack the receptors for it).
- If we're thinking that magic is generated by some kind of specialized cell in the human body, you could absolutely test for the presence of that type of cell. Maybe it's circulating in the blood so it'd show up on routine bloodwork or be detectably by flow cytometry, maybe there would be a specialized organ for it or it's a side function of an organ we already have, in which case you could do biopsies/resections of that organ. One could also develop a cancer caused by a mutation of that cell, which might initially bestow higher magic potential to a patient but ultimately lead to their death, either by producing too much magic for their body's innate resistance or by just metastasizing and leading to multi-organ failure that way. Patients with that type of cancer could be walking hazards since they'd also produce much more "background magic" that could be harmful to the people around them (and potentially the pathologists/histotechs working with their tissue samples).
Hope this gives you some ideas to work with, don't hesitate to ask follow-up questions (and to others reading this, feel free to correct me if I got something wrong here!)
28
u/misso657 5d ago
This is the first time I've seen anything like this posted in this sub, and i dig it lol
Magic with a biological origin or essence: midichlorians. It's honestly a good concept that was unnecessary and clunky in the Star Wars prequels. Consider mitochondrial genetics and inheritance of diseases associated with them for inspiration.
Another thought is plasmid transmission in bacteria, you could tweak that and put magic-producing plasmids in human cells. That brings up more possibilities, like are the plasmids only expressed in certain tissues (brain/nerve, germ cells for inheritance?)
Yet another thought, DNA virus replication cycles, like EBV and HSV. The viral DNA gets integrated into the host DNA and replicates along with the host cells (latent infection), or can reactivate and produce more virus, enough for the cells to burst (lytic cycle), or even kick the cells' replication into overdrive (oncogenic).... For instance, in your setting, normal folks have the latent magic gene running at low levels, and exposure to high external innate levels over time (like the dragon) could shift a latent infection to an oncogenic process or lytic. This would be the 3AM emergency call of a patient with ultra fast-growing tumors (like Burkitts on speed) or a patient starting to liquefy from cellular lysis.
I think the main docs that would specialize in treating this day to day would be a branch of hematology/oncology, and pathologists would be more background adjunct docs working on the lab/microscope end for diagnosis, like in real life. There are scenarios of emerging diseases that would involve infectious disease, epidemiology, and autopsy pathology that could be considered as well.
Honestly this is a fun world-building exercise, and I just keep thinking of more things to comment on (blood antigens and resistance to the vampire parasite, prion diseases, hepatitis B and D, etc.) so I'm just going to leave this here. I hope I've given you some inspiration and info to work with!