Five years ago, the science fiction writer Cory Doctorow published a short story whose plot might seem eerily similar to followers of the past few weeks’ news.
In Radicalized, one of four novellas comprising a science fiction novel of the same name, Doctorow charts the journey of a man who joins an online forum for fathers whose partners or children have been denied healthcare coverage by their insurers after his wife is diagnosed with breast cancer and denied coverage for an experimental treatment. Slowly, over the course of the story, the men of the forum become radicalized by their grief and begin plotting – and executing – murders of health insurance executives and politicians who vote against universal healthcare.
In the wake of the 4 December shooting of UnitedHealthcare CEO Brian Thompson, which unleashed a wave of outrage at the US health system, Doctorow’s novella has been called prescient. When the American Prospect magazine republished the story last week, it wrote: “It is being republished with permission for reasons that will become clear if you read it.” But Doctorow doesn’t think he was on to something that no one else in the US understood.
When he learned of the shooting, Doctorow’s first thought was one of horror (“I grew up in the anti-nuclear proliferation movement, I don’t want anyone to shoot anyone ever”) then of fear (“I hope he doesn’t have a copy of my book with him”). But from the alleged shooter’s Goodreads account, it appears that Luigi Mangione, who now faces charges of murder as an act of terrorism in New York, never read Doctorow. “I feel like the most important thing about that is that it tells you that this is not a unique insight,” Doctorow said, “that the question that I had is a question other people have had.”
When Doctorow started writing the short story in 2018, he was processing his own traumatic experience with the US healthcare system. The British Canadian author, who’s written more than two dozen fiction and nonfiction books, had only recently moved to the US when his parents flew down for a visit from his home town of Toronto. It was a fun trip until late one night his mother woke him up to say that his father was ill. The family raced to the nearest emergency room, where Doctorow’s father was treated for an infected kidney stone. After the stones were removed, Doctorow’s father crashed and spent the following days in a coma.
“My brother flew down from Toronto,” Doctorow recalled, “we thought he was going to die.”
As Doctorow’s family was waiting at his father’s bedside, he remembers someone from the hospital billing department coming to the room to ask his mother: “Who’s going to cover the bill?”
Fortunately, Doctorow’s father recovered – and, because he was a former teacher, Canada’s public service healthcare program footed the $176,000 bill. But Doctorow was left asking question after question about the country he’d decided to live in – especially as he noticed the abundance of firearms around him.
“How is it that there are so many Americans who own so many guns who are so indiscriminate about using them when someone makes them upset, and yet you’ve got four in 10 American adults carrying medical debt?” he said. He’d heard of people who wouldn’t approach someone who was texting at a movie theater or swerving across traffic because they might have a weapon. “How is it that people who fly off the handle under such trivial circumstances are so sober and responsible and even-keeled when it comes to these things that when I imagine them, all I can think is I would lose my mind?”
The incident – coupled with his daughter’s experience attending active shooter drills at her elementary school and Bernie Sanders’ campaign for the presidency in 2016, which called for Medicare for All – compelled Doctorow to start writing Radicalized.
In one part of the story, a man whose young daughter died after an insurance company refused to pay for brain surgery bombs the insurer’s headquarters. “It’s not vengeance. I don’t have a vengeful bone in my body. Nothing I do will bring Lisa back, so why would I want revenge? This is a public service. There’s another dad just like me,” he shares in a video message on the forum. “And right now, that dad is talking to someone at Cigna, or Humana, or BlueCross BlueShield, and the person on the phone is telling that dad that his little girl has. To. Die. Someone in that building made the decision to kill my little girl, and everyone else in that building went along with it. Not one of them is innocent, and not one of them is afraid. They’re going to be afraid, after this.”
“Because they must know in their hearts,” he goes on. “Them, their lobbyists, the men in Congress who enabled them. They’re parents. They know. Anyone who hurt their precious children, they’d hunt that person down like a dog. The only amazing thing about any of this is that no one has done it yet. I’m going to make a prediction right now, that even though I’m the first, I sure as hell will not be the last. There’s more to come.”
In the story, this was indeed only the beginning of the violence. But in real life, Doctorow imagines very different solutions to the crisis of American healthcare.
“We have historically done things about oppressive corporate systems that are destroying people’s lives, and we’ve done them, if not in living memory, at least not that long ago,” he says, speaking of the trust-busting movement to break up Standard Oil and other monopolies in the late 1800s and early 1900s. “Corporate power was significantly more dystopian than it is today, and we figured out how to deal with it, and it’s not like the political movements and the organizing that they undertook to get that done were the lost arts of a fallen civilization.”
The movement that brings single-payer healthcare to the US, Doctorow believes, will be a trust-busting one. “People don’t know that they’re all angry about the same stuff right now,” he says, noting higher costs at grocery stores and tech monopolies. “They’re actually all angry about the same thing. And when they figure it out the coalition will be unstoppable.”
