Seeking some medical expertise!

[Sydnie]

Context: The early portion of a story I'm working on centers on two characters, Robin (the protagonist) and Tobias (her elderly adoptive father). Tobias is taking medication for an as-yet unspecified condition that he's keeping a secret so as not to worry Robin. However, recently, the price of that medication has been sharply increased, to the point that he can no longer afford it. Some event causes his health to take a sudden downturn (or at least make it impossible for him to keep soldiering on), and Robin takes over his duties as a librarian while he rests. Over the course of a few weeks, his condition steadily worsens due to his inability to medicate. Finally, he passes in his sleep. However, right up to his final night, he's still in his right mind. It's only his body that's failing him.

What I'm looking for are some ideas for ailments that can fit that description (requires regular medication for the rest of the sufferer's life, and failure to medicate will cause them to slowly die over the course of a few weeks, though they'll maintain their usual mental capabilities). I'd like to base Tobias' condition on a real one because a lot of the conflicts in the story are based pretty blatantly on real-world matters. (For example, this initial arc is kind of commentary on capitalistic health care.) In other words, I want readers to maybe be able to look at the symptoms Tobias deals with and say, "Oh, yep, I know exactly what he's dying from".

I don't necessarily need super detailed explanations of all the symptoms and treatments or anything! It's just that I wanna find something that realistically aligns with how Tobias' health deteriorates. I can handle the research portion on my own as long as I have a more concise starting point than...well, the description I put up above~

Thanks in advance!

 

[Finchbearer]

No medical expertise over here, but there is another forum user I have in mind to answer your question…perhaps they will see the thread.

From my view you’re inclining about the pharma industry particular in the US where insulin is simply unaffordable and those unfortunate enough to have diabetes as an auto immune condition are left in a heart wrenching situation. Insulin and other types of medication such as thyroid medication are free on the NHS over in the UK for example, and made accessible to all residents.

Anyway, I digress…things that come to my mind are diabetes, motor neurone disease, multiple sclerosis and various cancers.

 

[pmmg]

Diabetes and Cancer come to mind for me, but I am wondering at the time period? Cause I am not sure what would cound as medicine the further back in time we go. Maybe pneumonia or tuberculosis but that would be hard to hide.

(and nothing is really free.)

 

[Sydnie]

In fact, I was specifically thinking about diabetes since it'd be pretty on the nose from a real-world commentary approach, that is, "something people are needlessly dying from because the medication to treat it is made prohibitively expensive for profit". But a little light Googling suggested that failing to get insulin entirely can lead to death within a few days, which I saw as much too short a time frame for Tobias' collapse.

Although...I was originally planning on Robin not finding out about his problem until after he died. But it might serve the story better if she has to go to the pharmacy on his behalf. She needs to be familiar with it anyway for what she intends to do in response to his death, and it could also serve as an opportunity to force her to interact with the world. Hm, hmm, hmmm, I'll have to think on that one!

For the time period...I guess it's like "anime-style medieval fantasy". Like, at first it looks archaic by modern standards, city guards all using swords, people getting about on foot or sometimes by carriage, that kinda thing. Except then you realize that, through the power of ~magic~, most of the modern conveniences are readily available. Even though I've kinda been leaning more in a low fantasy direction, I'd still say that kind of touches on the sort of setting I'm going with. So as it pertains to this discussion, I think it's safe to say "modern"~

 

[Finchbearer]

Sounds interesting! As long as you’re ok with the fact that insulin wasn’t invented that long ago. I assume that would cause fatigue and eventually coma and death, whereas MND would be more gradual, and cannot be treated and managed like diabetes can as far as my understanding goes.

 

[pmmg]

With diabetes, I suspect if you drop sugar from your diet, you can manage it well without insulin. So, lack of insulin could be managed for a while without it.

 

[Finchbearer]

With diabetes, I suspect if you drop sugar from your diet, you can manage it well without insulin. So, lack of insulin could be managed for a while without it.

I’m not a diabetes expert, but I don’t believe that would necessarily be the case. It’s the blood sugar in the body that your pancreas naturally makes insulin to manage, and in a diabetic person, the pancreas either doesn’t make enough insulin or doesn’t make any at all, which would be fatal for anyone if not artificially managed by injecting insulin. Carbohydrates also turn into sugar, so it is easily done where a diabetic person does not understand why their blood sugar levels are going haywire, when they’ve eaten a stodgy sandwich and end up having a hypo.

You also have different types of diabetes, type A, which to my understanding is the auto immune type of diabetes that you may be born with, and type B is typically diet and lifestyle induced, but there are many genetic factors too. In pregnancy, gestational diabetes is also a risk. You can also be pre-diabetic, and yes (only type B) diabetes can potentially be ‘reversed’ by watching sugar and carbohydrate intake, and probably the amount of exercise done.

No one diabetic over here lol?

 

[Finchbearer]

Medication on the NHS for British residents is entirely free…if you’ve never worked a day in your life that is! Obviously for the disabled and vulnerable that’s what the system is there for, and the taxpayer helps with that, it’s not a perfect system, but it’s pretty amazing.

 

[pmmg]

It may seem that way, but someone pays for it, and secretly, it is still you. You may like the system, but what you dont see is the other system where you did not do that to compare it to.

 

[pmmg]

I’m not a diabetes expert, but I don’t believe that would necessarily be the case. It’s the blood sugar in the body that your pancreas naturally makes insulin to manage, and in a diabetic person, the pancreas either doesn’t make enough insulin or doesn’t make any at all, which would be fatal for anyone if not artificially managed by injecting insulin. Carbohydrates also turn into sugar, so it is easily done where a diabetic person does not understand why their blood sugar levels are going haywire, when they’ve eaten a stodgy sandwich and end up having a hypo.

You also have different types of diabetes, type A, which to my understanding is the auto immune type of diabetes that you may be born with, and type B is typically diet and lifestyle induced, but there are many genetic factors too. In pregnancy, gestational diabetes is also a risk. You can also be pre-diabetic, and yes (only type B) diabetes can potentially be ‘reversed’ by watching sugar and carbohydrate intake, and probably the amount of exercise done.

No one diabetic over here lol?

Well, we are hoping he will still end up dead.... So if he believes something is true, but its not, that wont hurt too much.

 

[Demesnedenoir]

"Ayurvedic physicians (5th/6th century BC) first noted the sweet taste of diabetic urine, and called the condition madhumeha ("honey urine").

And we thought our physicians were dedicated! Tasting pee! That's why they made the big bucks even back then, heh heh.

An early treatment: "A measuring glass filled with Water from the Bird pond, Elderberry, Fibres of the asit plant, Fresh Milk, Beer-Swill, Flower of the Cucumber, and Green Dates". Urinary troubles in the adult were also corrected with "rectal injections of olive oil, honey, sweet beer, sea salt, and seeds of the wonderfruit".

Yoah! Rectal injections! That better be free.

 

[pmmg]

Somethings are not worth knowing

I thought starvation might do this as well. If the character had stomach cancer, he might not be able to eat or digest. So he could hide the fact that he's not eating, and slowly waste away.

 

[Queshire]

The history of the discovery & manufacture of insulin is interesting and what those who suffered from it before the discovery is horrifying.

Spoiler

Spoiler

It's a shame to hear about them going to all that effort only for people to still die to naked greed.

As for the actual story... Hm... well, I suppose it doesn't fit a thread asking in the research forum, but something magic based could be interesting. Mana poisoning or something?

 

[Finchbearer]

It may seem that way, but someone pays for it, and secretly, it is still you. You may like the system, but what you dont see is the other system where you did not do that to compare it to.

I do pay for NHS services in the form of something called National Insurance which taken like a tax out of peoples wages. I also pay for my individual prescriptions.

 

[Queshire]

Yeah, that was weird? Is the argument supposed to be that people are only okay with nationalized healthcare because they don't know any better??? We're already talking across the pond as it is. Hard to argue that people don't know better when they can pretty easily see how other countries handle healthcare by just asking someone from that country.

 

[Finchbearer]

Not sure lol just Google the NHS if you want to learn about socialist healthcare. I have an American side to the family who pay for their healthcare so I’m fairly familiar with how that works. No system is perfect, there is always a cost to it.

 

[Rexenm]

I just got my driver’s licence photo today. It cost 100 bucks. However my medication, is subsidised. To put clearly, in a fantasy based environment, one needn’t call someone fat or unhealthy, they could be cursed, or psycho. Drugs can do a lot for suicide, or any form of death, so it could be that.

Health is a slow deterioration. Someone may be insistent on going to sleep, or passing through to the other side. They may question their gender, feel disingenuous. I had an operation, and needed antibiotics, so it could be that.

Without knowing the plot, I cannot judge what I feel personally about it, but a pearl of wisdom is to question the skeleton, not the choice of words, as a pearl before swine. I think the state of fantasy today is fairly bland, so some poisonous personality could give it the stink it needs.

Also, a side note, some medications cause diabetes, as a side effect. Cocktail of pee, wheatgrass, sprinkled with sugar, doused in vodka and, pink sauce. Served hot and cold.

 

[pmmg]

Yeah, that was weird?

What was weird? What I said? I was just saying nothing was free, even it appears to be. That was counter a comment saying it was free.

I did not wish to dredge deeper cause it would drift into politics. I just dont like blanket statements that gloss over something untrue to stand.

 

[Sydnie]

Hum, I was almost sold on sticking to diabetes, but I don't imagine Tobias as the kind of person who would be prone to the behaviors that typically lead to diabetes, and if it was the genetic sort, I don't think it'd be something he would try to keep secret. I did look a little bit into MND and MS based on Finchbearer's suggestions, and either of those might work. (My initial draft of this segment involved Tobias generally losing motor function, so I could still incorporate that.)

Anyway, I think I've at least got enough to start really poking around for ideas on my own now. Thanks a bunch for the helpful discussion, everyone!

 

[Prince of Spires]

There are plenty more diseases other than diabetes that require lots of medication. Both HIV and MS (is it Multiple Sclerosis in English as well?) fit the bill where if you don't take your medication on time you will die at some point. Though I think depending on the stage of the disease it will take a fair while. You could take a look at the list of Degenerative disease - Wikipedia on wikipedia for ideas.

Two issues I think are the time-path, and the technology level. You need pretty advanced technology to make most types of medication. Since you're going to fix it with magic you might as well go with a magical disease. And most of these diseases aren't killing you on the indicated time-path. An issue which again can be solved by making your own disease.