Copper engraving by Paul Fürst called “Dr. Schnabel von Rom”, depicting a “Doctor Schnabel” (meaning Dr. Beak), who treated victims of the bubonic plague in 17th century Rome, circa 1656.

Staying at home and feeling trapped or bored? Not in the mood for your usual type of book? Have a look at this shortlist of unusual horror novels with the themes or settings of epidemics and pandemics. They were not written as Horror Fiction, but they make you react the same way that Horror Fiction does – they make your skin crawl. That fear and revulsion you feel releases a rush of adrenaline and a sense of relief – and also provides a little bit of Schadenfreude. Haven’t you ever finished a scary novel and thought to yourself; “Gosh, I’m so glad that’s not me! I’m much smarter than those stupids. I’ll never go into a creepy house that has a knuckle-dragging, knife-wielding owner in the middle of the night, and leave my phone in the car.” Yeah, right.

Often the central menace of a horror story is a metaphor for the larger fears of a society. Today, Horror Fiction is not only about creepy killers, zombies, madness, torture, etc., as metaphors for whatever frightens people. It can also be about a disease taking over the world, not as a metaphor for an existentialist threat but as a plain theme, because that is something that many people are afraid of at this time.

There have been many pandemics throughout history, which provides more than enough material for really scary novels. Here’s a horrible list: bubonic plague (Black Death), whooping cough (pertussis), cholera, influenza (Spanish Flu), typhus/typhoid fever, smallpox, measles (rubella), tuberculosis, leprosy, malaria, yellow fever, diphtheria, HIV/AIDS, and more. Current pandemics include HIV/AIDS and COVID-19. Epidemics, restricted to specific geographical areas but no less dangerous, have included Zika, SARS and Ebola. For most – not all – of these illnesses, treatments have been developed as well as vaccines to control their spread.

The novels discussed here feature three of these killer diseases – typhoid, diphtheria, and HIV/AIDS. And while none of them were written as Horror Fiction, reading them today makes them newly relevant. Just shows you how times change.

Love in the Time of Cholera, by Gabriel García Márquez – Not thát kind of cholera

Just to set the record straight: Love in the Time of Cholera by Gabriel García Márquez is not about cholera, or an epidemic. I’m including it because many people make the mistake of thinking it is a novel about cholera due to the book’s title. (Márquez himself warns against making easy assumptions about the novel due to the title.) When I read it the first time I was puzzled that there were no mentions of hospital wards full of patients and streets full of corpses. In the novel Márquez depicts love as an infectious disease, cholera, that drives people mad and causes them to do violent, insane things from passion. He makes the term “love-sick” into an extended metaphor.

Why should you read it?

Well, it’s Márquez. No more reason needed.

Love in the Time of Cholera, by Gabriel García Márquez, 1985 (Paperback; publisher, Vintage; reprint edition, Oct. 5, 2007; 368 pages)

The term “cholera” has a long history in medicine and psychology. In early proto-psychology, before the 17th century, people believed that human temperament was divided into four types: sanguine, choleric, melancholic, and phlegmatic, and that these types had their origins in different internal organs and fluids. Having a “choleric temperament” meant that someone was extroverted, ambitious, dominant, violent, vengeful, and short-tempered. They believed that a “choleric” temperament originated in the liver and gallbladder. As for the real disease, by the time Márquez wrote this, the world knew exactly what it was.

Márquez uses the term to describe the furious passion between the characters, not to refer to a historic period blighted by a cholera epidemic. This title is actually a double entendre, since in Spanish, the language in which he originally wrote the book, the word “cólera” in the title, El amor en los tiempos del cólera, literally means the disease, but also, figuratively, wrath or anger.

Horror Fiction for today

The Sheltering Sky, by Paul Bowles – Typhoid Fever

Paul Bowles’ 1948 novel is about badly behaved, aimless people on a pointless trip into Morocco, mindlessly and cynically putting themselves in harm’s way until they die or go mad. “Kit” and “Port” have been travelling for 12 years when they reach a small, filthy Moroccan village called Ain Krorfa. They make no attempt to get away to a more habitable place. They have practically no money but because they are visitors from America they think they are untouchable. Then bad things happen. As they would.

Why should you read it?

To have another good reason not to go travelling.

The Sheltering Sky, by Paul Bowles; originally published in 1949; publisher: John Lehmann; United States)

“Port”, the man, does not bother to get vaccinated. They sink lower and lower into the dregs of this already poverty-stricken society. While growing increasingly sick from what turns out to be typhoid fever, Port and “Kit”, his wife, continue their journey into the interior of the country.

Acclaimed and prolific writer and musicologist Paul Bowles wrote this in Tangier, Morocco, where he lived for most of his life. For about 25 years he says he smoked huge quantities of the local “kif” (cannabis), ate a lot of “majoun” (cannabis edibles), and used many stronger drugs. When he wrote about decadence and being out of your mind, he knew what he was talking about.

Port and Kit are definitely decadent and do not think of themselves as common “tourists” but as sophisticated “travellers.” When Port’s passport is stolen and they are stuck in the back of beyond, he says;

“I don’t have to justify my existence by any such primitive means. The fact that I breathe is my justification. If humanity doesn’t consider that a justification, it can do what it likes to me. I’m not going to carry a passport to existence around with me, to prove I have a right to be here! I’m here! I’m in the world!” (pp. 88 – 89)

Port thinks of himself as a “global citizen” – does that sound familiar? Despite his high-minded attitude his condition drastically worsens but Kit has no idea what to do or how to do it. The situation becomes critical; “…We realize that the risk is very real – humanity will do whatever it likes with those who demand global citizenship.” (Datema, J. and Krumrey, D., eds., Wretched Refuge: Immigrants and Itinerants in the Postmodern, Cambridge Scholars Publishing, U.K. 2010, pp. 63 – 64)

Read the novel for extremely stupid, careless people putting themselves in harm’s way, and find out how the tragedy ends. Remember these idiots when you’re tempted to leave the house to travel somewhere.

The First Four Years, by Laura Ingalls Wilder – Diphtheria

This novel is definitely about the effects of an epidemic. The First Four Years is the 9th of Laura Ingalls Wilder’s Little House books for children, with this one being an exception since it is meant for adults. The book is the first in which Wilder’s writing tone is not cheerful, happy and well pleased with the world, perhaps because the manuscript was discovered in draft form and did not have the usual “softening” edits by her daughter. It is about the first four years of Laura Ingalls’ marriage in August 1885 to Almanzo Wilder, and in it, Almanzo (then 28 years old) and Laura (aged 18) fall victim to an epidemic of diphtheria, also known as the “Plague Among Children”. They were living in a small cabin on a remote homestead, with no vaccine, no cure.

Why should you read it?

You might not have read it before.
And it’s pretty sobering.

The First Four Years, by Laura Ingalls Wilder, written in about 1940

Wilder’s stories are tales of the pioneers in mid and west America in the 19th century, and,  underneath the surface of descriptions of a happy family life there lie the facts about what was really happening historically. In February 1888, Laura and Almanzo (Manly) became very ill with diphtheria, which is caused by the bacterium Corynebacterium diphtheriae. If you look up diphtheria, you’ll see it is a really gross, horrible disease.

“But in spite of the warm day Laura caught a severe cold and had a touch of fever so that she must stay in bed. Ma came over to see how she was and took Rose home with her for a few days. Instead of getting better, the cold got worse and settled in Laura’s throat. The doctor when he came said it was not a cold at all but a bad case of diphtheria. But then Manly came down with it, and on his morning visit, the doctor ordered him to bed with strict orders to stay there. […] So both in the same room, with the crudest of care, Manly and Laura spent the miserable, feverish days. (pp. 87 – 88)

To put their nightmare situation into perspective: Until the early 20th century, diphtheria was a killer disease and outbreaks around the world were frequent and devastating. For instance, in 1735 a diphtheria epidemic had swept through New England, killing entire families. In one New Hampshire town, 32% of children under 10 died of diphtheria. The case-fatality ratio was almost 40%. Noah Webster (1758-1843) later wrote: “It was literally the plague among children. Many families lost three of four children—many lost all.” Treatments were largely ineffective and the disease was greatly feared. Finally, in 1890, almost 60 years after it was named, Shibasaburo Kitasato and Emil von Behring developed an antitoxin and serum therapy. (Source:, rtrvd. 25-03-2020. Note that this award-winning, WHO-certified website is produced by the College of Physicians of Philadelphia.)

By then, of course it was too late for the Wilder family. Reading it makes you grateful for the development of vaccines.

The Year of the Flood, by Margaret Atwood – A fictional viral pandemic

In the first part of the MaddAdam Trilogy, called Oryx and Crake, Atwood writes about the drug called “BlyssPluss” developed by “Crake”, which is supposed to be an aphrodisiac but actually causes a viral pandemic that wipes out most of the humans on earth. It results in the uninfected elite holing up in the protected “Rejoov” compound, while outside all hell breaks loose. In part 2 of the trilogy, The Year of the Flood, the flood does not refer to a water flood – it is the pandemic, the human species-ending disaster caused by BlyssPluss, which the cult, “God’s Gardeners”, call “The Waterless Flood”. Their prediction about the end of the world comes true when Crake’s viral pandemic destroys human civilization.

Why should you read it?

It shows what happens to society when you have infected people in one camp, and uninfected people in another.

The Year of the Flood by Margaret Atwood, 2009

The story is told through flashbacks with the two main characters separately surviving the apocalypse described in the previous novel. Atwood, in her typical detail-focused style, describes the branding, systems, products, naming, etc. related to the infection, and the way it divides society and leads to extremism. While I wasn’t crazy about the series, it now seems that when she wrote the novel more than ten years ago, she was prescient about the range of people’s responses to a pandemic. Sad really, when you think about it.

The Facts Behind the Helsinki Roccamatios, by Yann Martel – HIV/AIDS

This was one of Martel early works, first published in 1993, and was an early indication of the superb novels that he would subsequently write, like Life of Pi and The High Mountains of Portugal. It is so well-written that I’ve treasured my copy ever since I bought it in 1993. It is a collection of four short stories and the title story, The Facts Behind the Helsinki Roccamatios, depicts a first-person narrator who takes care of his boyfriend, “Paul”, who is dying of AIDS. To help pass the time and give them something to look forward to (and put their situation into different perspectives), they make up stories about an imaginary family of Italian immigrants living in Helsinki, Finland.

Why should you read it?

It’s beautifully written and a sobering reminder.

The Facts Behind the Helsinki Roccamatios, by Yann Martel, 1993

To organize the plot of their story they use Encyclopædia Britannica extracts dating from 1901 until the year in which the story is set, 1986. Just to clear up one thing, “Roccamatios” is not some church ritual, legal document or medical term. It is the surname they invent for the fictional Italian family.

“I asked him about the name of the family. He pouted his lips and narrowed his eyes and thought for a moment. Then he expelled a sound: ‘Roccamatio’. What? ‘The Roccamatios – Rok-kah-MAH-tee-ohs.’ I wasn’t keen on that one. Not very realistic. Something more Nordic-sounding would be better, no? But Paul insisted…” (p. 22)

As the story progresses, and it isn’t long – less than 25,000 words, which makes a novella – Paul gets sicker and sicker. Martel pulls no punches when he describes the progress of the disease and the toll it takes. I have to confess, it made me cry. It still makes me tear up decades later as I’m writing this post and rereading the book:

“He’s too weak to move or speak. He just lies there, his eyes blinking once in a while. He’s had his morphine three hours before. ‘Paul? Paul, it’s me.’ His eyes blink. Since my eyes are level with it, I touch his ear. I rub the lobe with my thumb and forefinger. He seems to like it. I get some cotton swabs and I clean Paul’s ear, first the outer ear, then, very gently, the inner; a little yellow wax comes out. Paul’s mouth trembles into an approximation of a smile. ‘Don’t worry,’ I whisper. ‘It won’t be long.’ His lips move to make a word. There is no breath to create it. He struggles.” (p. 97)

Nowadays people say “AIDS” as if it is just a word, and they mix it up “aids” meaning helping someone. If, like me, you grew up in a country where HIV/AIDS infection levels are high, and the threat was serious, real and close, you never, ever say or think the words without shuddering.

Human Immunodeficiency Virus infection (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are now established facts. People think that with antiretroviral medication, the HIV/AIDS “death sentence” has been lifted. It hasn’t. There is no vaccine for HIV or AIDS. HIV/AIDS is considered a pandemic—a disease outbreak which is present over a large area and is actively spreading. The global statistics on HIV/AIDS are scary – it’s millions, not thousands: between 32.7 million and 44.0 million people globally were living with HIV by the end of 2018. Since the start of the epidemic to the end of 2018, about 74.9 million people have become infected with HIV. Worse, about 32.0 million people have died from AIDS-related illnesses. (Source: UNAIDS organization, rtrvd. 25-03-2020)

The Facts Behind the Helsinki Roccamatios takes place in 1986, long before treatment was possible. Imagine the horror of watching someone you love die slowly, horribly, “melting” – as Martel describes it in the story – and not knowing why and not being able to help. The story is hard to read, but it’s worth it.

About the header

Engraving by Paul Fürst called “Dr. Schnabel von Rom”. The figure with the bird mask is my interpretation of the copper engraving depicting a “Doctor Schnabel” (meaning Dr. Beak), who treated victims of the bubonic plague in 17th century Rome, circa 1656. Plague doctors wore the beak-like mask, which was filled with aromatic substances, to protect them from putrid air which they believed was the cause of sickness. (Source: Wikipedia) The street is in downtown Vancouver, BC.

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