In honor of having the pestilence on my face named — it’s an adenovirus, related to a cold of all things, in one of its less common manifestations — I will spend a moment talking about all sorts of pestilence a writer can infect their characters with.

I’ll start with smallpox. Smallpox is a disease you don’t want to have. If the high fever doesn’t end your life, the chance of toxemia, or toxic reaction to the viral load, could. Only 30% of people who contract smallpox die, but what if someone genetically tinkered with it so that the fatal form, malignant smallpox, resulted 100% of the time? Smallpox doesn’t exist in the wild anymore, having been eradicated recently through vaccinations. There are, however, stores of the virus in government research labs throughout the world, who endeavor to create better vaccines using smallpox in case of biological warfare. Unless they’re planning biological warfare themselves. Hmmmm…..

If the book is set in an earlier time period, dysentery might be the disease the doctor ordered. Dysentery is an intestinal disease which causes bloody diarrhea, and it can be caused by bacteria, viruses, or amoebas. Malnutrition and dehydration are the causes of death. If death by diarrhea sounds strange, remember that it’s the largest cause of death in the world. For those of you who played Oregon Trail, this is the disease that killed you many times. If the writer wants a messy, smelly death carried by contaminated water, this or cholera will fit the bill.

Tuberculosis and leprosy (related diseases, as it turns out) aren’t what they used to be. In ways, these diseases functioned opposite to each other in literature. Leprosy spared the victim’s life but disfigured them due to numbness and subsequent injury, and made them a pariah. Tuberculosis drove romantic figures to an early coughing death while making them more attractive in their frailty and pallor. Nowadays, both are easily treated; we only see the dramatic forms of these diseases these days in Edwardian/Victorian romance (tuberculosis) and in travel/adventure novels (leprosy).

Influenza doesn’t seem to get written much about. Possibly because we usually get it and get better. But the flu killed a lot of people — and still kills people. People actually die from complications from the flu, such as immune system hyperactivity, an opportunistic disease, or organ failure. The only place this disease creates much drama is in the regret that one couldn’t talk to a loved one before they died an unexpected death.

Cancer, as a slower disease, usually allows characters to interact with the victim before they die. In fact, it’s often portrayed in literature as being a “pretty” death, much like tuberculosis used to be. In actuality, cancer is often a messy death, involving stages of dying from less talkativeness to coma to death rattle to death. Characters facing death by cancer also get portrayed as beings that have already ascended into the afterlife, only their bodies haven’t caught on. Gleefully pursuing their bucket lists from a wheelchair, they dispense truisms to their unlucky earthbound brethren.  There are people like this (watch Randy Pausch’s Last Lecture — he’s genuinely this enlightened by ensuing mortality), but there are also people who fight every step, there’s people who detail every pain they’re feeling, and there’s my mom — who demanded that the Catholic Church apologize for her abuse by nuns. (She only got as far as a chaplain, but he apologized).

Authors kill off characters. It’s one of the ugly realities of writing. My schtick, I guess, is that we should kill off characters as realistically as possible, to capture the humanity within humiliating, messy death.