Can science fiction shape future reality? Some people think so. Take the retired military officers who have actually credited novels such as Doctor Strangelove, Fail-Safe, On the Beach, and War Games for helping them to avert accidental war. Recently, a Norwegian physiotherapy professor named Filip Maric, a futurist and professor of global cultural studies at the University of Oslo named Bodhisattva Chattopadhyay, and a Canadian health and ecosystems researcher named Jenna Webb got together to see how science fiction and speculative futurisms could be used to re-imagine healthcare. They call their approach “healthpunk,” and published a paper on the approach in Lancet Planet Health.
Today, human health is deeply intertwined with planetary health, and planetary health is in trouble, which means we need to find radical new solutions, they argue. The team of researchers trained students and healthcare professionals in the tools of science fiction and published several anthologies of the creative fictions their participants wrote. They believe that their healthpunk training program could be used to develop and implement new approaches to the health of people and the planet that address interconnections between global health and social and ecological issues.
I spoke with Maric about whether science-fiction approaches to health should be literal or allegorical, the potential ethical risks of relying on speculative storytelling for problem-solving, and how their approach draws on so-called CoFuturisms, which borrow from non-Western and Indigenous traditions.
What is healthpunk?
It’s a framework for trying to think about health in new ways, using different methods for thinking than we’ve used before, drawing specifically on science fiction and speculative fiction as a way to think through new healthcare challenges and new healthcare practices.
How does it relate to other forms of punk?
This notion that we need something considerably different from the status quo is the fundamental punk spirit. But beyond that, in this whole world of fiction genres and futurism, punk isn’t an uncommon suffix. There’s solarpunk, steampunk, all of these different punk genres, and all of them ultimately suggest that something different needs to go on, other than what’s happening at the moment.
You argue that deliberate training in science-fiction storytelling might help students and academics to use certain tropes more successfully, like zombie apocalypse, alien contact, or time travel. How could using these specific tropes be helpful in this context?
We’re not really saying that we need to use those tropes more effectively, but healthcare professionals like myself, living and working in public health or another medical or health profession, we’re not trained to think with science fiction, let alone write science fiction or speculative fiction. At best, we might be readers, some of us might be really into it by happenstance. If we’re given the task to suddenly write the science-fiction story without prior training, without expertise, potentially without being a fan or without having contact with science fiction that we perceive as meaningful, it’s been my impression over the last few years of us doing this, that you always end up hitting a certain limit of how far you can go. You don’t end up exploring the world-building that goes into science-fiction practice.
In the lens of planetary health, this little group of people that’s been working with this, we’ve been experimenting sort of playfully, throwing it around, trying a little bit of this, a little bit that, and thinking about it. But now we need to be more deliberate about bringing those worlds together—the world of planetary health and the world of science fiction and speculative fiction—to generate something more.
What inspired you to take this approach? Are you someone who reads a lot of science fiction?
No. But one of my colleagues, the second author on this paper, he’s from that world of reading and writing and research in science fiction. I came to it from the other end. Originally, before doing all of this work, my graduate work was at the intersections of healthcare and ethics, between philosophy and health, which generally involves a critical theoretical approach to health.
If you take a larger view to ethics, then maybe what we’re responsible for isn’t just an individual patient, but entire populations, and also the environment in some way because of its implications for health. From there, I started getting involved in this field that’s called planetary health, and its application to my original profession, which is physical therapy. I launched this notion of environmental physiotherapy or environmental physical therapy as it’s known in the U.S. I began asking, if healthcare is something that’s way bigger and way more complex than a single patient and single healthcare professional, then we need new ways of thinking about it.
I was developing a public-health module for our bachelor’s program in physical therapy, and we were presenting a lot of new stuff to our students in that module relatively quickly. Then essentially I told them, “This is a very new field for our profession so your exam is going to be to envision the future, and free yourself of the boundary of what’s pragmatic and what’s possible”—to go into a proper visionary space. I asked them to write a science-fiction story about the future in which the thing that physiotherapists do is work directly on social or ecological issues as a means to improve people’s health. This means having a different view of the roles and practices of healthcare professionals.
And then through my philosophical interests, I came across the environmental humanities a few years ago, which led me to all of this stuff that’s happening in fiction and these new genres at the moment, like eco fiction, climate fiction, and I thought, “Oh, maybe that’s something we could do.”
Read more: “Does Science Fiction Shape the Future?”
At Nautilus, we hosted a roundtable of science-fiction authors a few years ago where they talked about how science fiction can shape the future. One of the authors argued that the power of science fiction lies more in its allegorical nature than in literal solutions for things. Are you hoping for actual visions of a specific future, or trying to encourage a certain way of thinking?
I wouldn’t want to foreclose either possibility. I’m not necessarily inclined towards more literal results that might come out of it, but we also don’t want to stand in the way of that. As I said, I don’t come from a background of reading science fiction, but I don’t think you can grow up in general Western culture without some contact with science fiction, at the very least, through movies and through popular media and so forth. Star Wars and Star Trek showed people speaking to somebody in a totally different place while seeing them on a small screen in front of you. I don’t know how literal we can be about that being the precedent of the smartphone, but these kinds of things happen, right? Even in some of the stories people wrote for us, particularly the first volume that we put out—the physiopunk volume one, of student stories—there were some things that came to reality not as a result of the stories, but in a kind of parallel way.
One student wrote about how physiotherapists in the future would be going to the Arctic sea ice to do some multidisciplinary research and work on the ice and so forth. And about two months later, after the story was written, I was invited to go to the Arctic, alongside some researchers from Miami University, to do some stuff there. It wasn’t exactly the thing that was described in the story, but it carried the same spirit. There were a bunch of instances like that.
Those literal things can happen, and who am I to stand in their way? And allegory, that can sound a bit distant sometimes, too. It almost devalues what science fiction can do. For me, there’s a potential for cultural transformation that science fiction and speculative fiction can support. One simple example is my profession, which is physical therapy. Have you had physical therapy yourself, or do you have some kind of image of what physical therapy is?
Well, yes, because my parents both had it when they were in assisted-living communities. I imagine an encouraging, gentle person who’s extremely fit pushing someone to move their body in ways that will help them recover mobility or reduce pain.
Yes, there’s a lot of exercise focus. There’s occasionally some kind of manual treatment. And it’s been like that for about 200 years. For the most part, on the bigger scale, a lot of colleagues in my profession—including a lot of incoming students into our courses—find it very, very hard to think that this profession could be anything other than exactly that.
One of the functions of using science fiction and speculative fiction is also about can we break through this wall in our minds that’s preventing us from even imagining an alternative. The problems that we’re facing today, everything we’re thinking about in planetary health, including climate change, biodiversity loss, et cetera, I’m going to argue that most of those problems are actually cultural problems and that they’re based on certain ways of thinking and certain ways of doing. And fiction can be this space where we can explore new ways of thinking and new ways of doing in a relatively safe space, to just get our minds in the groove that, “Oh, yeah, maybe it could be different.”
I don’t know if that’s quite an allegorical use. It’s much more immediate on-the-ground cultural transformation kind of work. I think that that’s where a lot of its power really is.
Do you have an alternative vision for what physical therapy specifically should or could be?
We might need several hours or days to cover it, but the key point is that in order to think about one healthcare profession differently, we have to think about professional boundaries differently—and not just within healthcare. If we’re now saying, “Well, actually air pollution contributes to the development of neurological disorders, or pulmonary disorders,” then how am I going to work with somebody who’s involved in city planning where during the winter, a lot of the people use studs on their tires? When the snow and ice aren’t on the street, the studs scratch off the surface of the street, which leads to quite polluted air. So ultimately, I’d envision a future where healthcare professionals can co-collaborate with people who do planning and car development, and tire development—you name it—because it’s all connected together. And we’re coming to recognize that health is everywhere, so we need to work across all of those boundaries. That’s the baseline vision, the minimum.
Aside from the story you mentioned about the Arctic, were there any others that your participants wrote that really struck you in terms of their imaginative power?
I have a student who also published one of the stories in that original volume, who wrote in 2021 about a future where students would be studying physiotherapy in highly interdisciplinary programs where they’d be learning with people that studied tech and engineering, but also people that study biology, ecology, you name it. After she finished her bachelor’s degree, I didn’t hear from her until about half a year later when she made that future her reality by signing up to a master’s program in sustainable healthcare. Now she’s doing graduate studies and going further down that route. What she envisioned felt so important that she actually went and pursued it.
You draw on the idea of “CoFuturisms”—a framework that borrows from non-Western and Indigenous traditions of speculative thinking. Can you tell me more about this framework and how it informs your thinking?
It’s a look at science fiction and speculative futurism that’s not global North focused necessarily, but that takes science-fiction traditions from Asia, from Latin America, from Africa, and centers those, so going against the status quo of science fiction that always looks like Star Trek or Star Wars.
I started this in Norway, and for some Norwegian students, it’s much easier to express themselves in Norwegian, so we had them write in whatever language they wanted to, but then ended up publishing it bilingual for greater reach. Then, with volume two, we made it accessible to people from different countries that have different language backgrounds, so they could submit in whatever language they wanted to. We wanted to provide a space for different kinds of imaginations to ideally emerge because what we can say in one language is a bit different from things we can say in another language. How does that feed into that imagination around health futures? So that was one of the basic resonances. We were looking ultimately for a decolonized approach to engaging in science fiction.
You and your colleagues mention that there are certain ethical risks associated with speculative storytelling. What are they?
We need to make a clear effort to tease out what those risks might be as we bring the worlds of science fiction and health together more deliberately. I suspect there could be all kinds of things. We had some stories where certain things were imagined as a solution to one thing, but at the cost of considering what kind of consequences that might have on others.
When we envision these kinds of future scenarios, we need to keep our ethical radars up. It’s not just a matter of envisioning some kind of utopia for a small group of people. 
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Lead image by Tasnuva Elahi; with images by Rehman and knssr / Adobe Stock
