We’ve long been thinking about health, well-being, illness, sickness, and disease, in relation to risk. That things might not be maintained at their present levels, either individually, among our cared-for, or socially, is not something new, even if we’ve entered a period of intensification, with calls to ‘repeal and replace’ the Affordable Care Act, and the slow, often subtle chipping away at social safety net policies in the United States and throughout the North Atlantic in the spirit of austerity and for the sake of freedom. What might have been primarily personal and interpersonal concerns about health and disease have also expanded to include the environment and the species, as we continue to think through the Anthropocene and its consequences for exposures to environmental dangers – toxins and radiation foremost among them – and the spread of once localized diseases to the global stage, as the recent zika outbreak raised, and Ebola recurrently threatens. The intensification and generalization of risk may very well entail the intensification and generalization of speculation; what are our individual and collective possible futures? And what better way to confront our possible futures than through media that explicitly engages with the future, speculative and science fiction?

Is speculation fundamental to life itself? That’s the question that Steve Shaviro seeks to answer in his recent Discognition. Shaviro argues that sentience itself – which we might see operating in computer programs, plants, slime mold, and emergent technologies – is founded on the existence of the ability to speculate, to anticipate and plan. We may not be able to infer how speculation works for a sentient computer program or a slime mold, yet, they depend upon an ability to forecast, to imagine what may come next, so as to act appropriately in advance. In this sense, science fiction and speculative fiction help us exercise our speculative capacities, they allow us to think through a set of possibilities and a set of potential solutions. In doing so, they make life’s continuance possible, for individuals, communities, and the species – or, at least, they lay the foundation for enacting a variety of solutions in the face of looming disaster. Whether or not speculative futures are taken seriously – and whether or not a set of responses to their reality seem possible – is potentially an outcome of their presentation in media, and the popularity of those representations.

Across the pieces collected in this series on speculative health, contributors point to the need for scholars to engage critically and appreciatively with a variety of media and popular genres of fiction. From the recent popularity of ‘weird fiction’ to the ongoing presence of the Star Trek franchise, from the post-WWII generation of science fiction writers – like Octavia Butler and Ursula Le Guin – to more contemporary writers engaged with the implications of social media and internet connectivity, contributors point to a long-standing interest in representations of the human body, health and disease, and concerns about communicability and contagion in speculative literature. Engaging with these media may lead scholars to think critically about how their own media consumption shapes their views about viable research projects, empirical observation, and the futures we participate in making. Engaging with genres like speculative and science fiction may also inspire experiments in the presentation of social scientific research data, encouraging writers and readers to conceptualize new modes of ethnographic mediatization in an effort to engage the speculative capacities of readers.

In this respect, it’s worth thinking through Charles Briggs’ concept of biocommunicability, the process through which media comes to infect individuals and communities with ideas and categories. Speculative fictions have the potential to be contagious, to create ways of seeing the world that infect a broad swath of media consumers, both directly through the consumption of a given media, but also more broadly, as those readers shape their practices based on speculative futures. Science fiction scholars enjoy pointing to these very quirks of history, like Robert Heinlein’s speculative ‘waldo’ technology, which would come to be realized in ubiquitous smart phones and tablets, Aldous Huxley’s ‘soma’ seems to have been realized in widespread antidepressant pharmaceuticals, and Hugo Gernsback’s televised communication has become realized in video chat technologies (to name just three). Ideas spread through fiction, literature and lies, and inspire people to act in ways that might realize those ideas or forestall them. That speculative and science fiction have become wildly popular genres in recent decades might lead us to consider just how infectious these ideas are as well as the paths that they help carve through the world.

I’ve long been taken with Thomas Disch’s The Stuff Our Dreams are Made of, his survey of the history of science fiction and its popularity. Like so many science fiction scholars, Disch has an argument to make about what was the first science fiction story – his unconventional choice is Edgar Allan Poe’s ‘The Balloon-Hoax.’ It wasn’t called ‘The Balloon-Hoax’ at the time: Poe published a short piece in New York’s The Sun in 1844, claiming that a man had traversed the Atlantic Ocean in three days under the power of a gas balloon. Readers were apparently so taken with the idea that they believed it could be real and swarmed the offices of The Sun in an effort to get copies of the historic newspaper. But it was all a lie, and the newspaper was forced to issue a retraction, explaining that the story had been a work of fiction. It’s this line between reality and fiction that speculation so often treads – at its most deceptive, it convinces us of its truth, it makes us want to believe in its veracity, and appeals to our speculative reason to make sense of a lie, lies which are sometimes massive deceptions.

Because of this increasing popularity – and even mainstreaming – of speculative and science fiction, it’s also worth thinking about the relationship these genres have to capitalism and financialization, processes which rely on their own forms of speculation – to create profit and avoid crisis. Or maybe, to create crises and therein produce profit. In making emergent technologies desirable, if not entirely plausible, speculation compels investments, social and capital. Now a lesson in speculation gone awry, Theranos convinced investors that its emergent technologies could perform futuristic-seeming feats: with small amounts of blood, a wide variety of medical testing could be efficiently conducted. What seemed too good to be true turned out to be just that. But what is important here is how a speculative promise inspired investment – and a host of lies, fraudulent reporting, and shady practices, all to maintain the speculation. As playful and fun as speculation can be, it can also be corrupting and horrific – especially when it comes to the species-threat that the Anthropocene is increasingly taken to be.

Thinking through speculation and health asks us to think through scale – from individuals, to communities, to species, to planet – maybe even to the cosmos. In considering our individual and collective futures and their potential outcomes, speculation encourages scalar imaginations that might inspire action. The challenge in the present is thinking through the ethical implications of these actions and their possible future repercussions. Many futures are possible, but how do we adjudicate which are the right futures to bring into being? If we forego utilitarian attempts at creating the best health for the most humans and non-humans, what are we left with? Can we even hold onto a concept like ‘health’ in the long term? Let’s see.

Matthew Wolf-Meyer is Associate Professor of Anthropology at Binghamton University. His work focuses on medicine, science and media in the United States to make sense of major modern-era shifts in the expert practices of science and medicine and popular representations of health. His book The Slumbering Masses: Sleep, Medicine and Modern American Life was the first book-length social scientific study of sleep in the United States. It offers insights into the complex lived realities of disorderly sleepers, the long history of sleep science, and the global impacts of the exportation of American sleep. He is currently finishing a book manuscript on the alternative histories of American neuroscience, seen through the lens of neurological disorders, tentatively titled Unraveling. He is in the beginning stages of a project entitled The Colony Within on the history and contemporary medicalization of digestion and excretion in the U.S.