The Interprovincial Medical Institute is the sole provider of medicine in a post-apocalyptic world. But unbeknownst to anyone, the Institute is a hive mind, a parasite living within, controlling and training the world’s doctors. When one of the Institute’s bodies dies, it sends a new doctor to investigate—and discovers it isn’t the only parasite interested in the human race. We talked to Ennes about fusing gothic literature with sci-fi and the terrifying scientific theory that keeps them up at night.
Parasites aren’t new to speculative fiction and horror, but your choice to tell this story from the perspective of the Institute, a hive mind that is both a medical professional and a parasite, is extremely original. What did writing from that point of view allow you to do as an author?
Building a narrator out of a many-minded parasite was not easy, but it let me take advantage of a sort of pseudo-omniscience, which was such a boon for world building. Writing from the Institute’s point of view was also an opportunity to delve into the threat a microscopic antagonist might pose. We all get it, parasites are spooky. That isn’t saying much at all. Where the true intrigue lies, I think, is in the mechanism of infection and the cellular changes that take place in a host. A protagonist needs to be proficient in microscopy to see the terrifying devil in those details.
The Institute harks back to classics like Invasion of the Body Snatchers. Were there any particular stories that informed your creation of the doctor?
At the moment I can’t think of any fiction that influenced me as much as the stories science can tell us about our own cells. I was particularly taken by the theory of endosymbiosis: Deep in our mitochondria lives a strand of DNA separate from our nuclear chromosomes, an essential piece of our cellular network without which we would die. This strand is circular, like a bacterium’s, leading scientists to propose it is the genome of a foreign organism that hitched a ride inside us back when we were single-celled. It’s been sitting there ever since, perpetuating itself through the maternal line and providing the basis of a fun mind game I like to call “Am I even me?” Is that DNA truly mine? Am I being parasitized by my own genome? Does it care about me, or does it only care about my reproductive success? Is everything I do and think at the behest of a little self-interested string of nucleotides living inside me? You stay awake so many nights thinking about stuff like that, and eventually you write Leech.
Bodily autonomy is always going to be a ripe subject for horror, but it is something particularly terrifying for many people right now. What drew you to writing a book that delved so deeply into body horror and questions of bodily and mental autonomy?
I knew autonomy would end up being one of several themes, as a consequence of writing about parasitism, but the narrative quickly shoved autonomy to the forefront seemingly of its own volition. Leech was a demanding animal. It wouldn’t let me stop at the microscopic ecosystems parasites use to commandeer behavior but demanded I touch on the equally parasitic structures of hierarchy, power, abuse and some of the ways these structures rob us of our own bodies.
Despite the fact that Leech epitomizes a gothic novel, it’s also set in a post-apocalyptic world. What led you to marry these two genres?
To put it simply, I think they work well together. Gothic literature is usually predicated on the exploration of some sordid past, whether of an individual, a family, an old house or an isolated township—often all of the above. If a single dead child can make for a terrifying poltergeist, what hauntings might manifest from the cruel impulses of a dead society? In what ways will human cycles of exploitation, bigotry and imperialism haunt the future? What monstrous forms might their resurrections take?
There’s a definite shift in the language the doctor uses to talk about humans throughout the book, moving from a clinical analysis, to becoming more familiar, to a sort of horror. Can you talk about this shift in language? Was this a conscious decision, or did it develop organically?
The shift in language was a conscious development, and an excruciating one. I can’t count the hours I spent going back and forth, micromanaging colloquialisms, contractions, turns of phrase and intrusive thoughts. At the extreme ends of the story, the narration styles are pretty distinct, but it gets muddy enough in the middle that I’m fairly sure I underwent some sort of ego death while writing it.
There are hints as to what happened to society that caused everything to go wrong. Can you tell us what plunged your world into this dark age and how humanity survived?
I don’t think there is any one thing that plunged this world into ruin. The collapse of a society is a slow, mundane and brutal process (a process we are currently witnessing in real time). I don’t know how the world ended, or how many times it ended, but I do know humanity survived by virtue of resilience, ingenuity, mutual aid and cooperation. And trains. I suspect the resurgence of the locomotive was vital to the resurgence of human society. I don’t know why. I just feel it in my heart.
How did your background in medicine inform the writing of Leech? Is there anything that you’ve learned in your studies that you wish you could have included that didn’t quite fit?
To be honest, my background when I started Leech was in physics. My background when I finished it was in medicine, which definitely informed some of the details but not the core of the story. There are a few aspects of doctoring I might’ve incorporated if I’d had a more solid grasp of the realities of clinical practice—namely, a deeper exploration of the unique and sometimes mystifying relationships people have to their own bodies. I think I touched on this with Hélene’s (perceived) hypochondria, but I have seen some truly fascinating disconnects between internal and external experiences of disease: Munchausen’s syndrome, functional disorders and one case of a lovely, cheerful patient whose stated history painted a picture of health and who, almost as an afterthought, lifted her sweater to show me a massive open wound she had been nursing for nearly a year.
In gothic literature, deformity and physical differences are often cast as physical manifestations of sin, which is a theme now understood to be ableist at best. You manage to incorporate these bodily differences without that baggage. What drew you to including these elements of the gothic, and how did you navigate including them while avoiding the negative connotations that they usually hold?
I won’t claim that Leech is free of ableist baggage; after all, ableism is one of the many flavors in that soup of oppression in which we all grow up swimming. That said, I did consciously set out to subvert traditional, moralistic depictions of deformity. I wanted pretty much every “normal” patient to have some unconventional physical attribute. In a world where everyone has a mechanical limb or a migratory birthmark or a literal doppelganger, it’s hard to view these things as anything but variations of the norm. This allowed the narrative to focus more on the unique roles these attributes play in the characters’ lives and how they might be admired, celebrated, exploited or fetishized on an interpersonal, rather than societal, level.
A few characters speculate about where they think the monstrous, mysterious ventigeaux that stalk the woods near Verdira came from.Do you have an answer, or are they mysterious to you as well?
The ventigeaux are a mystery even to me. In the future, if there is an opportunity to dissect them, I might uncover their origins. For now, I share the Institute’s suspicions that they are orphans of biotechnology, but I can’t guess what sort of misguided endeavors led to their creation.
One of your characters tries to make sure that humans don’t regain the ability to make flying machines, believing that they are what caused the apocalypse in the first place. If the denizens of this world recovered lost technologies, do you think they would be doomed to the same self-destruction as their forebears?
I’m a utopian at heart, so I genuinely hope not. But I believe that without significantly, consciously dismantling institutions of power, people will end up re-creating the oppressive structures that haunt our past. Not as any function of “human nature” or some such evolutionary psychology nonsense, but by dint of centuries of vicious cultural selection. People tend to emulate their forebears, and the world of Leech is no exception. Fortunately, in that world, as in ours, there are those working to demolish monopolies of power, technology and capital. And in that world, as in ours, there will be monumental successes and devastating failures. Let us hope the former is more frequent than the latter.
Picture of Hiron Ennes courtesy of the author.