The Fifth World

Medicine

Medicine refers to the treatment of diseases and injuries.

Efficacy

Andrew Twaddle distinguished between disease, sickness, and illness:

  • Disease: the strictly biological dimension of the phenomenon.
  • Sickness: the social dimension of the phenomenon, including how the community thinks about and relates to the sick person.
  • Illness: the subjective experience of the individual with the disease.

In this light, we can see that in its final years, civilization achieved a form of medicine that excelled at treating disease, though it often fell short in treating sickness or illness. Given that they also faced much more common and much more virulent diseases (see Disease), this focus seems appropriate.

Approaches to medicine can vary widely from one region to the next, but in general, doctors in the Fifth World do not have the capabilities their ancestors once had to treat disease, but they also don’t face nearly as many diseases. They have no means of addressing cancer, for example, but it has also become an exceedingly rare condition.

Do not underestimate their capability to deal with disease on a purely biological level, though. Most individuals have experience with what we would call wilderness first aid. Trained healers cultivate antibiotics from fungi and gather a wide array of potent herbal remedies from their territories. They can even perform simple surgeries, including some brain surgeries.

But their medicine truly excels in its treatment of sickness and illness. The array of beliefs, rituals, and social spaces for the sick serve to bolster the placebo effect, creating a powerful healing force all on its own.

This combination — a reduced incidence of disease, vast ethnobotanical knowledge, and a systematically bolstered placebo effect — makes medicine in the Fifth World as effective as the medicine of their ancestors. Like the ancient healthcare system, sometimes it proves insufficient and people die, but most of the time it works.

Public health

People get sick sometimes, but when a sickness occurs more than once in a community, it usually points to a deeper problem. At that point, wizards get involved. Wizards negotiate the boundaries between human and other-than-human communities, and they understand outbreaks of disease as the direct result of a broader ecological problem. If people start getting malaria, that means that the territory has too many mosquitoes. Have pools of standing water become more common? What disturbance or problem might have caused that? Or have the birds and small mammals that normally eat mosquitoes become more scarce? A wizard’s primary job lies in monitoring the territory and solving mysteries like these.

As such, wizards play the part of public health workers, addressing disease on the larger scale of the entire territory. They must often come up with creative solutions to complicated problems. For example, if the malaria outbreak occurred because of too many pools of standing water near the people’s homes, that may indicate that they stayed in one place for too long, in which case the wizard may tell them that they need to move somewhere else. If they find that mosquitoes have proliferated because bats have become more scarce, because more owls have moved into the territory, the wizard might leave offerings of food to attract small rodents to the territory, to provide the owls with something to hunt besides the bats.