We associate with science and fiction the extrapolation of scientific trends into some futuristic settings. The most striking examples of science fiction in novels or video use some scientific findings (dinosaurs, genetic engineering) and project this knowledge into another fictional setting. The usual personal relationships follow rather predictable plots of romance, deception, violence or war.
The novel “Wellness” (Hill 2024) is also a kind of science fiction as it is based on social science evidence and builds its fictional plot firmly embedded into the social and psychological research. The attachment of references (and defending the print of those in translation) underlines the commitment to write a new type of “social science fiction”.
In this innovative style the scientific basis of psychology and sociology is then extrapolated into a fictional arrangement. Research on subjective well-being with the U-shaped form over the life course and the extrapolation of the placebo effect, which is instrumentalized for a business, derive from key topics in the social sciences. In fact, the novel and the background scientific literature in the bibliography could well figure in a social science course at university entry level. These readings constitute a 360-degree-view on personal development and social structures. Of course, social sciences move on and add new evidence on an almost daily basis, but the selection and arrangement of the characters create an innovative social science fiction, without some unrealistic technological extrapolation.
It strangely feels like we are already part of this social science fiction (compare “Klara and the sun” by Ishiguro) as politicians advocate and campaign with placebo topics in elections and project us into some more happy past or future.
The social science fiction of Nathan Hill resembles for me the great utopian novel by George Orwell “1984” published in 1948. A title “2032” instead of “Wellness” could have worked quite well, as the first edition of Nathan Hill’s social science fiction was published already in 2023. (Image: Extract of: Lo Spagnolo, 1665-1747, Hecuba makes Polymnestor blind, MRBAB).
Patient Empowerment
The empowerment of patients is a well-established practice in the treatment of diabetes. Measuring your own blood sugar and adjusting your medication to the self-monitored data is common practice. For patients with high blood pressure this patient empowerment is less prevalent. A medical study carried out in Valencia (Spain) by Martínez-Ibáñez et al. (2024) has tested the effects of such a self-monitoring and self-medication experiment.
The results publishes in (JAMA) gave rise to considerable attention in the profession as the empowerment of patients is one way out of the likely increasing shortage of medical professionals in aging societies. Whereas other studies found that total costs to the medical system might increase, the study in Spain provides evidence of the cost-reduction effect of such an empowerment. 24 months after the beginning of the trial. After the establishment of a “medication based on an individualized prearranged plan used in primary care” the self-administering participants achieved a significant decrease in their blood pressure that lasted until the end of the study after 2 years. The drop-outs of the study seem to follow a random pattern.
The conclusion gives support to the potential of patient empowerment in the widespread treatment of higher blood pressure beyond the regular visits of medical doctors. The monitoring of changes in lifestyle add to this to keep the costs of health care under control in aging societies. 