To what extent is a person allowed to alter their body?

Medical ethics, mental illness and a physician's responsibilities to alleviate suffering are called into question in Anil Ananthaswamy's article for Matter Magazine, 'Do No Harm.'

Body Dysmorphic Disorder (BDD) is a mental illness commonly seen in adolescents and young adults with anorexia and bulimia, while in males it can cause excessive bodybuilding as well. The patient cannot reconcile his actual physique with the mental image he has of himself. This causes many young ladies who would be considered painfully thin to see themselves as bloated and disgusting, causing them to participate in risky behaviors to lose weight that isn't there to lose. In males, many see themselves as scrawny or weak, causing equally risky workout routines to 'bulk up' an already impressive physique. Mortality risk can be high in both instances, as the patient takes more and more extreme measures to achieve the unrealistic goals they've set for themselves. Once identified, psychiatric therapy and, in some cases, medication can be moderately effective in helping these individuals regain more healthy lifestyles.

Transgender individuals face some of the same problems. Their internal gender identity doesn't match up with their physical sex, and the social stigma of bringing their physical self in line with their mental and emotional self can cause years of depression, anxiety and other emotional problems. Unlike with BDD, transgender people do not respond to psychiatric treatment or medication, and generally are happiest when allowed to live as they wish, whether simply dressing and acting as their self-identified gender, or going farther with hormone therapy and surgery. These treatments are generally accepted to be medically valid, and a transgender person can have a reasonable expectation of treatment.

A much less well known phenomenon is starting to gain the attention of the medical community. Body Integrity Identity Disorder (BIID), on the ouside, seems fairly close to to BDD. These patients feel that their self, their internal body image doesn't include one of their limbs. These sufferers are the topic of Ananthaswamy's 'Do No Harm.'

Sufferers of BIID feel like the limb isn't theirs. They see that it's attached, it functions perfectly normally, but their mental image of themselves simply doesn't include it. It's a hunk of flesh that they don't want, but no amount of diet or exercise is going to get rid of it.

Unlike patients with BDD, neither therapy nor medication gets rid of the symptoms. There is no accepted physical cause, and in fact, if the limb is removed, the associated depression and anxiety go away. The patient is left perfectly happy, with a physical self that finally matches their self-image.

The problem that sufferers of BIID run into is that no medical practitioner is going to remove a perfectly healthy limb simply because the person in front of them says that they want it gone.This has caused many with this disorder to try life-threatening measures to damage said limb to the point where doctors have to amputate. Another path is to find a back-alley surgeon, or a doctor in a country where money talks more than medical licenses. Both paths have their own inherent risks, but after exhausting the medical establishment, there aren't many options left.

'Do No Harm' explores the medical ethics of the situation, as well as the desperation of those who suffer from BIID. No longer suffering alone, Ananthaswamy explores the support groups these people have formed online, interviews doctors who have come face-to-face with people with BIID, and challenges the reader to make her own decision regarding the question at the heart of this problem: does a person have the right to alter his own body as he sees fit?

Highs: Ananthaswamy does a wonderful job seeking out as many viewpoints as possible for this article, which gives it amazing depth.

Lows: Some of the people the author interviews aren't the most likable of people, but the perspectives they give are necessary to the narrative.

Verdict: A fascinating look at a mental illness that doesn't get much press, available for free at the Matter Magazine website.

Further Reading: 'Electric Shock!', The Immortal Life of Henrietta Lacks

Most preppers can only dream of being so ready for apocalypse

John Ringo, known for his military SF, fantasy and dark humor, tackles the Zombie Apocalypse in his new novel Under a Graveyard Sky.

Steven John "Professor" Smith isn't one to be caught with his pants down. His daughters know how to handle firearms, his wife encourages his having bug-out bags and burn phones, and he's got friends who would be some of the first to know when the shit hits the fan. So when his brother sends him a text that decodes to "Biological, viral, latent, wide-release, previously undetected, currently no vaccine, hostile activities parameter", it's time to go into bug-out mode.

Unlike many 'preppers,' Smith and his family actually know what they're doing. His two girls. Sophia (15) and Faith (13), while at the beginning skeptical about Uncle Tom's sources that the zombies are coming, nevertheless are mature enough to take direction from their father and help load the boat that was acquired under...questionable...means. Likewise, their mother Stacey jumps into her role as organizer, keeping stock of food supplies and making a rather suspicious run to Costco to buy them out of toilet paper and feminine hygiene projects.

For good reason: there's a virus out there that makes bath salts look tame. A strange, man-made combination of the flu and rabies, it's airborne in the respiratory phase and blood-borne as a neurological agent. Whoever created this, whether in a governmental lab somewhere or in a biohacker's basement, they've done their research. It's completely unaffected by any antivirals, and the neurological damage it does is almost certainly irreparable. The only hope would be a vaccine, but the world's resources are rather limited at the moment.

John Ringo is well known for his dark sense of humor, excellent characterization and attention to detail. Both girls react to and help with the crisis in their own way. The elder, with a calmer temperament and a mind for science, ends up initially helping her uncle work on the vaccine. The younger, a bit more reckless but good with a gun, stays behind with her parents to hold down the (floating) fort and search for survivors. Because in this situation, there's no hanging back and waiting for the government to save you. It's everyone for himself, and the more allies and shared resources you can discover, the better.

Under a Graveyard Sky is a Zombie Apocalypse story for the Libertarian at heart. The people who survive are the ones who take their own survival into their own hands. It's not pretty, and it's not always fair, but it's realistic, and a great read.

Highs: The way that Faith deals with the horrors of clearing boats in which the infected made it on board is heartbreaking.

Lows: The fact that we'll probably never find out how this all started is understandable, if frustrating.

Verdict: An addicting, quick read, and with the next book coming out in February, the reader won't have to wait long for his next hit.

Further Reading: To Sail a Darkling Sea, Princess of Wands, V-Wars

Sometimes it takes a little magic to save the scientists

There's magic and treason in the air, and it will take both a sorceress and a genius to resolve it in Lilith Saintcrow's The Iron Wyrm Affair.

Emma Bannon is a Prima Sorceress, able to control the magic that is infused into the world with each sunrise. With a focus on Black Magic, Bannon is in the service of Brittania. With her Shield by her side, Bannon is one of many Primes who take care of matters that need a certain magical touch.

Doctor Archibald Clare is a mentath. A genius of staggering proportions, he uses his powers of observation to make amazing connections and deductions. No longer in the service of the Crown, Clare has had very little to occupy his faculties, and has been suffering for it as of late.

Dr Clare is in trouble. Unregistered mentaths are being killed, and their bodies desecrated. In fact, Dr. Clare is the last remaining mentath who is not in the employ of the Crown. Now, Bannon and Clare must use their combined abilities to both discover why the mentaths are being killed, and protect Clare from the same fate.

Author Lilith Saintcrow has created an alternate Londinium full of clockwork-enhanced dock workers and a spirit of Brittania that is passed down from host to host. In fact, Saintcrow has packed so much universe into this book that at times it gets in the way of the story. I spent way too much time trying to figure out exactly how her magic, and the charter-charms, and the distraction took me away from the delightful characters and well plotted mystery. Usually, I think that a book should stand alone without an 'info-dump' intro, but perhaps this is one time where the reader would have benefited from an introduction to the world.

In the end, though, The Iron Wyrm Affair is an intriguing steampunk mystery with enjoyable characters and refreshingly little romance, that leaves the reader wanting the next book, if only to help clarify how the world works.

Highs: The mentath Clare is all the bumbling genius one comes to expect, but never seems to irritate the way that the stock character type can

Lows: Saintcrow needs to better define her world in the next book, or she'll surely lose readership

Verdict: There's better steampunk stories out there, but if one is running out of things to read, she could give this one a try

Further Reading: Soulless, Boneshaker, God Save the Queen

A dark prophecy may be coming true after all

Werewolves are male. Her twin brother is male. Her father, the Alpha of the northern section of North America is male. Her best friends in the pack are male. Werewolves have always been men, gaining their powers during puberty, for as far back as the Pack histories go.

Jessica McClain, in Amanda Carlson's Full Blooded, never really believed that she'd become a werewolf. Even with all the Cain Myth doomsday prophecy business surrounding her birth, everyone knows that the werewolf genes are on an extra Y-chromosome that is passed from father to son. Being female, with no Y-chromosome to draw from, it should simply be impossible for her to change. So as she got older, and her brother changed without her, Jessica eventually created a life for herself as a P.D., with coworkers and friends; rivals and nosy neighbors.

But one night, at age 26 and all alone in her apartment, she began to change. And as the wolf inside her took over for the first time, she managed to royally trash her apartment, take off into the countryside, and nearly get her leg shot off by a farmer. All hard to explain to her boss, her former coworkers on the police force, and her poor landlord.


Her personal issues have to take a back seat, though, to what her existence means to the Pack. Her father has already had some trouble with dissent, though he's tried to patch it up as best he can. There's also been rumor of some challenge from the South, and some of his pack members may have defected or gone rogue.

As Jessica tries to keep her personal, professional and family lives from crumbling around her, an offer of help comes from the oddest of places. Is it a trap, or perhaps her only chance at coming out of this alive?

Amanda Carlson does an admirable job at keeping straight all the story threads that she's started the story with. The characters are all very human (even when they're not), and the reader really wants Jessica and her friends and family to come out on top. With a bit of romance and a breakneck pace, Full Blooded is a great addition to the supernatural fantasy genre.


Highs: I love seeing kick-butt heroines in their mid-twenties, rather than simpering teenagers.


Lows: Rather than having the supernatural universe laid out clearly in the beginning, the reader is occasionally broadsided with new information.


Verdict: A supernatural fantasy in which romance, while present, isn't the main focus of the story, Full Blooded is an exciting page-turner.


Further Reading: Hot Blooded, God Save the Queen, Santa Olivia

A photographer's camera shows a bit more

A shadowy presence, and a string of deaths, may doom a young lady's portrait studio in Cindy Spencer Pape's second 'Gaslight Chronicles' story, 'Photographs and Phantoms.'

Note: 'Photographs and Phantoms' is the second story of the Gaslight Chronicles series. While the stories work well as stand-alones, there are inherent spoilers, especially where the romances are involved.