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"What if We Do Nothing?" Talking To Surgeon X's Sara Kenney About The Antibiotic Apocalypse

Sara Kenney is a TV and film producer with a new comic book out. Drawn by John Watkiss and edited by ex-Vertigo EIC Karen Berger, Surgeon X is a nightmarish vision of the near future where the antibiotics have stopped working and Britain is in political turmoil. I read the first two issues and had the chance to put a few questions to Kenney.

Bleeding Cool: I read the first two issues of Surgeon X with an infected foot, waiting to go and get antibiotics. So thanks for that Sara. Now I'm a careful medical subject, I don't push for antibiotics within reason, I always finish the course as prescribed, I never dispose of antibiotics without care, I buy organic meat and dairy, but am I still part of the problem? Do you see an inevitability to the future, specifically on medical grounds, that Surgeon X presents?

Sara Kenney: Firstly I'm sorry to hear about your foot and in this instance you don't appear to be part of the problem. I don't see this future as inevitable at all, which is partly why I wanted to tell this story. The medical aspects are based on my conversations with scientists and those from the medical humanities and while some of them don't have any faith in us being able to stop the antibiotic apocalypse, many of them do. All of them say it will get worse before it gets better and that's because we have very few new antibiotics in the pipeline.

The story of Surgeon X is a 'what if we do nothing' story. It's a thought experiment if you like on what we could face if we aren't able to organise ourselves.

Bleeding Cool: The job of all good science fiction is not so much to predict the future but to comment on the present. Surgeon X repeatedly grounds itself as the result of our own times. We have a left wing hardly present or dissolved into protest, the political ground being taken by the Conservatives and the Alt-Right in conflict. Is this modern Britain you have in mind, or the American Presidential Election? Do you value a one nation Conservatism over the other alternatives?

Sara Kenney: Interesting question. I started building the storyworld for Surgeon X back in 2014 and so much has been bubbling away since the recession that I wanted to weave this into the story. Across Europe we've seen the rise of the far-right and I wondered what would happen if this rise were to gather momentum and take hold here in the UK. I know it's a cliché but scared people are easier to control. An antibiotic apocalypse would play into all those fears particularly as people travelling or migrating could spread antibiotic resistance and disease.

But I don't think I really believed, when I started writing this, that a far-right government would hold power in Britain in 20-years time. Then came Trump and Brexit and I started to think about what it takes to trigger these monumental political shifts. It's not just about racism or socialism or a protest vote – there's a disenfranchisement that's been ignored for far too long.

Now, I'm not an expert in politics, but I definitely do not value a one nation conservatism. I think the paternalism is at best patronising and at worst perpetuating the view that old white men should be in charge of everything. My good friend a journalist, Joe Muggs, had an excellent description for one nation conservatism as being 'a sort of Downtown Abbey view of Britain', knowing what's good for the poor and wanting to do the right thing, protecting the status quo, without actually doing much for the rights of people who are struggling.

On reflection I think our character Surgeon X's Dad, John Scott, is a one nation conservative – yes that suits him quite well, so thanks for that Richard! He'd probably argue that one nation Tories put a break on free-market right wing policy and are therefore still relevant.

Bleeding Cool: Britain continues to have debate and change to the services the NHS offers, but you posit a completely broken system with a health service that picks and chooses seemingly on the lines of eugenics being pushed by a UKIP/Trump soundalike political figure. While there are issues, even in Britain, regarding the equitable distribution of healthcare, is there anything more than fearmongering here? Do you see this as a possibility, or regard the current system in these terms?

Sara Kenney: If this was a documentary then yes it could be fearmongering – well the part where a far-right government such as the Lionheart Party, is rationing antibiotics based on your 'economic benefit to society', rather than just supplying antibiotics based on medical need.

However, this is a drama in what I call a 'hyperreal' comic book world, so I don't think it's fearmongering. It's also worth noting that I didn't pluck this idea from thin air. You probably know there's an organisation in the UK called the National Institute for Healthcare Excellence or NICE. They are the medicines watchdog who decide which drugs the NHS should pay for.

In 2013, the UK Government proposed to NICE that they should make judgements on the 'wider societal benefit' of medicines. The government were asking NICE to put a monetary value on the people who were likely to take the drugs, in terms of their contributions to society. So that would mean older people with less years to work would score lower, women who were mothers and didn't work would score lower than their working husbands. Sound familiar?? NICE rejected this proposal in 2014.

In Surgeon X a more extreme version of this proposal is put forward, but not for all medicines, just for antibiotics. The current system does not work like this, but if a Conservative government can propose something along those lines in 2013, what's to say a far-right government wouldn't go that route in 20-years time in the midst of an antibiotic apocalypse?

Bleeding Cool: You also show the power of doctors here, taking on both political and guerilla activist roles, and demonstrating the power of life and death held in their hands. Britain had its first doctor's strike just the other month over Conservative government plans. Would you trust doctors with greater powers than they have now? I was very much reminded of John Wyndham's Consider Her Ways – noting the Douglas Adams mention, was this an intentional parallel or an extrapolation of the now?

Sara Kenney: This is definitely an extrapolation of the now and inspired by the amazing doctors and surgeons I've been talking to. I haven't read Consider Her Ways, but I will add it to my reading list. I think doctors have had to become more political in order to protect the NHS that they love. For various reasons I've spent more time in hospitals than I'd care to and my view of our doctors and nurses is that they are incredibly dedicated and selfless people. They are also smart, so they are obviously going to question the system they work in.

I think if more doctors and nurses went into management or even politics it would help immensely, because they have the lived experience of this world, of how things work on the front line. Our protagonist Rosa Scott has worked for the NHS for over 15-years, she has weathered the storms, but when prescribing of antibiotics is taken out of her hands that's the last straw for her. She has no option but to become Surgeon X. She's pissed off and powerless to help the people who really need it. While Surgeon X is extreme who's to say what people will be prepared to do, when they are fighting for survival.

So yes I'd trust doctors with greater powers than they had now. It's not going to happen though because politicians are scared of them. They're too fucking smart!

Bleeding Cool: You use medicine and the availability as such as an allegory for class structure, the idea of the haves and the have nots, as well as tying in fear of immigration, here more about the diseases they may bring rather than the jobs they may take. Do you believe people are this divided, is it getting worse?

Sara Kenney: According to research, in very crude terms since the recession the rich have got richer and the poor are poorer. That's an incredibly divisive situation for our society. I think Brexit further shone a bright light on the divisions. Not just class divisions, but age too. Is it getting worse? I don't know – I'm hoping we've just hit rock bottom and the only way is up…

However, in the future world of Surgeon X, the NHS is collapsing because the antibiotic apocalypse will also cause further financial turmoil – the recent AMR report illustrated this. In Surgeon X that's when I have the private and blackmarket sectors burgeoning and this will be divisive. I made this bit up, who knows if that would happen, but it feels like it could!

Sara Kenney: Your production company is called Wowbagger – I presume a reference to Life The Universe And Everything – what does Douglas Adams mean to you? 

My Dad brought me up on a diet of science fiction and science fact books. Douglas Adams was available on tap. I loved his work from a young age and always will – the way he blends incredible storyworlds, with sharp, funny writing and brilliant characters. He makes it seem so easy – it's not of course.

I was struggling to find a name for my production company, they all just sounded so wanky, so I thought 'Don't Panic' and turned to the Hitchhikers Guide. I then contacted the Douglas Adams Estate to get permission to use the name. They kindly said yes. Most people probably think it's a stupid name, but I don't care, it means a lot to me!

Bleeding Cool: You're a first time comic book writer with this project and have been working with experienced creators. And while the whole of the production seems polished there were a few jarring moments. While the use of a lecture given to students as a way of delivering exposition for this future world, and the history that this let us learn worked well, some of the dialogue about the same felt like Basil Exposition in Austin Powers. And while much of the comic felt smooth, there was one point, featuring a young man leaping up and shouting that, on a left-to-right panel read seemed to have his parents reacting to that action before he's actually done so. How hard have you found the switch to comic book storytelling and what traps did you fall foul of?

Sara Kenney: Harsh, but fair. Yes, it's been an incredible learning curve moving from documentaries to comics. Getting the logic, pacing, dialogue working together and crafting a compelling story in a small number of panels and pages, is no easy thing. I know this experience will make me a better writer in other mediums I work in. So to run through the main traps I fell foul of, although there are more:

– In docs it's all about explaining. Explain, explain and then repeat that explanation – particularly if you're writing for US TV (which I did a lot). I'm still working on the best ways to turn exposition into drama and I guess as you've highlighted that will just take me more practice and time!

– Working in film I'm used to being able to tell a story using frames and frames of footage. I think sometimes I've packed too much into a panel or a scene and I need to let the story breathe more.

– On the nose dialogue, again in the medium I come from you 'say what you see'. Still working on this.

When I started working on Surgeon X, it was supposed to be a digital comic, with a small UK audience. I didn't expect to get someone like Karen Berger on-board who has been so gracious and inspiring in terms of getting me to where I need to be. Then came the brilliant John Watkiss who is a genius in terms of the art and takes Surgeon X to another level. I certainly didn't believe Image Comics would publish it. The ambition for the project has grown beyond my expectations.

In addition I'm acutely aware everyone is excited to see what Karen does next and that's some crazy pressure there. I know my limits, I couldn't get close to writing like a Gaiman or a Moore, I don't have that sort of command over the English language and that beautiful and lyrical style. But I think there's room for different types or writers and more diverse voices.

I think I have good instincts when it comes to story and characters and I love bringing humour/ satire into storytelling. I really hope Surgeon X goes ok, so I can continue to write comics and hone my writing style and find my comics writing voice, if that makes sense! Like the possibility of an antibiotic apocalypse only time will tell…

Ps – if your foot infection gets worse and you need an amputation I now know some bloody good surgeons who could help! 

Bleeding Cool: Thank you Sara – turned out not to be an infection at all, but gout! So, I may be in touch…

 Surgeon X #1, an over-sized first issue for $3.99, will be published on September 28th by Image Comics.

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