I like the small things in fantasy, by which I mean I like germs and figuring out if the characters know about them. People in the real world didn’t know about germs for a long time, either (though many people put forth theories about spores, contagions, and small bodies and how to prevent their spread). Our previous theories and treatments made sense given what we could observe, and many fantasies draw from the centuries before we put names to the things that cause and spread illness.
There’s a terrifying tinge of dramatic irony to injuries in fantasy, especially when the reader knows the limits of the world’s medicine and magic. It is easy to cast aside the scientific history of a fantasy world when the focus of the story isn’t medical in nature, but good books still hint at their world’s medical knowledge. This part of world building can be so small that it’s nearly imperceptible, but as in medicine, small things can make all the difference.
Here are a few incredible fantasies where magic and medicine combine.
Briar’s Book (Circle of Magic #4) by Tamora Pierce
“No one asks to live in squalor, Tris. It is just that squalor is all that is left to them by those who have money.”
Forgive me for leading with the fourth book in a series, but this was one of the first fantasy books I ever read. Briar Moss, a mostly reformed thief, is a plant mage who grew up on the streets and remembers how difficult and dangerous it was. When a mysterious illness begins to affect Briar’s friends, he struggles to get them the help they need and eventually joins the team of mages and non-magical healers struggling to contain and cure the disease.
In Emelan, magic has its limits and costs, and the reader is made very aware of what is possible and what the consequences of attempting to do the impossible are. This book not only deals with the slow, dangerous work of developing a cure but the social structures that contribute to who epidemics kill and how they spread.
Witchmark (The Kingston Cycle #1) by C.L. Polk
The patient’s face rolled toward me, and my heart kicked against my chest. Not just sick; by the waxy look of his skin, this man was dying. He lifted his trembling hand to claw at my coat lapels.
Miles Singer is a doctor and a mage, and in his world, these two identities are at odds. To reveal his magic and himself would doom him to a life serving his sister or locked away, so he cures his patients in secret. When one dies before him, Miles is caught up in a medically-tangential murder mystery and forced to work with a mysterious man with secrets of his own. Magic in this world could gently be considered a cure-all, but it is hindered by the same thing that hinders medicine in our world: our own limitations. Miles’s magic depends upon what he knows and figures out. While the book isn’t focused solely on medicine, the ways in which his profession influences Miles and his world feels exceptionally deliberate, and the book deals heavily in how medicine functions as an institution.
Rosemarked (Rosemarked #1) by Livia Blackburne
The hotter the ziko gets, the stronger its protective properties—but only up to a point. A perfect potion is brought to boiling and then immediately cooled, but letting it boil a few moments longer ruins it all.
Zivah, a carrier for the deadly rose plague, travels behind enemy lines as a spy with a soldier in search of a way to overthrow their nations’ oppressor. The rose plague is largely a backdrop to the story, but Zivah’s training as a healer influences her characterization in lovely ways. Zivah’s internal struggles over whether or not she should use her training to fight back make her nuanced and relatable. Once she does commit to it, her usage of medical knowledge is a breath of fresh air in a genre so often crowded with heroes who prefer swords, bows, or fists.
Despite the fantastical elements in this novel, there is no magic. Because the world is built so well and so consistently with Zivah’s understanding, it’s easy to believe that Zivah can do what she does without blatant magical powers.
City of Lies (Poison Wars #1) by Sam Hawke
The symptoms had begun at his mouth; likely whatever had triggered the attack did, too. “Eat, drink, breathe, kiss,” I murmured.
This isn’t a book about medicine so much as it’s a book about reverse-medicine—poisons. Sometimes you just have to murder someone. Jovan is a proofer: a taster who tests everything the Chancellor eats and drinks for poisons. When the Chancellor and Etan, Jovan’s uncle and teacher, are fatally poisoned, Jovan and his sister must uncover who was behind it and why while staying one step ahead of the complicated politics of their city. This book is part murder mystery and part political thriller, and the poisons and how the characters’ lives are intwined with them are fantastic.
Give the Dark My Love (Give the Dark My Love #1) by Beth Revis
A few months ago, I would have thrown this book down in disgust and walked away—maybe even returned home, where the only books I knew reminded me of my father. But now…
My fingers wrapped around the spine of the book.
Now I was willing to try anything.
Nedra, a scholarship student at an elite school, studies medicinal alchemy, which transfers a patient’s pain into another creature. However, when the Wasting Death begins to sweep across the country, killing hundreds of impoverished people, it makes the world’s already precarious politics more so. Like many of the other books here, it deals heavily in privilege and health care. Nedra’s journey from desperate healer to furious necromancer driven by good intentions is made more real by how intricately linked medicine and magic are in this world. Though dark, Nedra’s story is timely and her choices relatable.
Originally published in February 2020
A wayward biologist from Arkansas, Linsey Miller previously worked as a crime lab intern, neuroscience lab assistant, and pharmacy technician. She can be found writing about science and magic anywhere there’s coffee. She is the author of the Mask of Shadows duology, Belle Revolte, and the upcoming What We Devour. Visit her online at her website.