I started to imagine an outbreak of a totally drug-resistant form of TB, not in the emerging world, but in the towns and cities of present-day America. I wondered what would happen if people fell ill with a long-term, contagious illness that modern medicine had no ability to treat. And then I wondered how a teenager would be transformed by the experience of moving from the institution of a school to the institution of a medical facility. TB is a disease of the young, after all. I began to invent a sanatorium for teens, borrowing elements from the open-air schools and from the private, spa-like sanatorium depicted in Mann’s The Magic Mountain, but adding in technology and a fear of contagion. Just like that, I had a setting for a novel.
What in Extraordinary Means is fact, and what is fiction? The name Latham House is borrowed from Dr. Arthur Latham, a prominent English physician who published manuals for the treatment of TB at the beginning of the twentieth century. The school-like atmosphere of Latham House owes a debt of gratitude to Hailsham from Kazuo Ishiguro’s Never Let Me Go, another novel about an alternate medical timeline and the institutions it creates. TDR-TB, which I invented, is a worst-case scenario conjured from the increasingly worried headlines and new stories about swine flu, bird flu, whooping cough, and Ebola. TDR-TB’s negative response to the MDR- and XDR-TB medications is borrowed from an article I came across in a medical journal that detailed the increased mortality rate in MDR-TB patients when given a new, second-line medication. Protocillin, of course, is a made-up cure for a made-up illness. But the idea of access to care, where wealthy, insured patients at private sanatoriums like Latham House are given the medicine first, is very real. And the concept of an extraordinary means of preserving life, or a risky, optional treatment that doctors don’t recommend, is one I studied in graduate school, and one that fascinates me to this day. It’s the idea that the patient ultimately controls their own fate, and that sometimes deciding for yourself is the greatest freedom you can have within a system that sees patients as their diagnosis rather than as people.
Lane and Sadie are both characters who struggle with the question of what exactly counts as living one’s life. For each of them, their TB symbolizes a deeper issue. Lane arrives at Latham House so exhausted from his rigorous course of studies that he has become literally consumed by it. Sadie has internalized all her fears and, instead of taking action, has become afraid of living. The story in this book is not a story of what it means to be sick so much as a story of how it feels to be an outsider. But most important, Extraordinary Means is a story of second chances, and what it means to have hope that you’ll figure out your place in the world, and that you’ll be strong enough to get there.
Robyn Schneider, MBE
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ABOUT THE AUTHOR
PHOTO COURTESY ROBYN SCHNEIDER
ROBYN SCHNEIDER is a writer, actor, and online personality. She is a graduate of Columbia University, where she studied creative writing, and the University of Pennsylvania School of Medicine, where she studied medical ethics. She lives in Los Angeles, California, but also on the internet. You can watch her vlogs at youtube.com/robynisrarelyfunny.
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BOOKS BY ROBYN SCHNEIDER
The Beginning of Everything
Extraordinary Means
COPYRIGHT
Katherine Tegen Books is an imprint of HarperCollins Publishers.
EXTRAORDINARY MEANS. Copyright © 2015 by Robyn Schneider. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, nontransferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse-engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereafter invented, without the express written permission of HarperCollins e-books.
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Library of Congress Cataloging-in-Publication Data
Schneider, Robyn.
Extraordinary means / Robyn Schneider. — First edition.
pages cm
Summary: Two teenagers with a deadly disease fall in love on the brink of a cure.
ISBN 978-0-06-221716-5 (trade bdg) — ISBN 978-0-06-239255-8 (int’l ed.)
EPub Edition © May 2015 ISBN 9780062217189
[1. Diseases—Fiction. 2. Terminally ill—Fiction. 3. Love—Fiction.]
PZ7.S36426Ex 2015 2014038817
[Fic]—dc23 CIP
AC
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15 16 17 18 19 PC/RRDH 10 9 8 7 6 5 4 3 2 1
FIRST EDITION
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