by Jarrod Jones. If you’ve been looking at the press surrounding Image Comics’ latest series, Surgeon X, you’ll find that there is quite a bit of focus on the technical side of things.

That’s because writer Sara Kenney has done her homework. For her first-time comics project, Kenney went all out in constructing this near-future narrative, where antibiotic resistance and pandemics are commonplace. It’s pretty scary stuff when you get right down to it, and Kenney agrees completely. That’s why she went straight to the experts when it came time to conduct her research.

“[My research] was essential for several reasons,” Kenney told me earlier this September. “One, I think the storyworld is far more authentic because of my discussions with the experts. Two, the comic was funded by Wellcome Trust and this allowed me the time to research and speak with the experts. Three, I’m a geek and enjoy researching this stuff and speaking to experts – it’s just really bloody interesting to me.”

She’s certainly no stranger to social awareness. Born in East London, Kenney grew up to become a scientist for the UK’s Environment Agency, only to move into filmmaking as a writer, producer and director, working on topical subjects for documentaries and factual dramas. You have to check out Sara’s award-winning Angels and Ghosts, a short animated film about mental health and how it effects families across the world. (It’s narrated by Samantha Morton, and it’s really quite exquisite — you can find that here.)

Now Sara Kenney is bringing her heart and her talents to the world of comics. Teamed with none other than editor Karen Berger and illustrator John Watkiss, Kenney is primed to bring important issues to the fore with Surgeon X. While you would imply an incredible lack of free time on her part, Sara took a moment to talk with me about Surgeon X anyway.

1. One look at your credentials and it’s apparent that you have an unwavering dedication to public service, particularly in bringing vital issues to public awareness. Which issues are you looking to bring to the fore with ‘Surgeon X’?

Sara Kenney: When I first started thinking about the idea of Surgeon X (which was a long time ago, it’s been through a few evolutionary stages), I wasn’t thinking of it as an ‘issues based story’. I just really liked the idea of a female surgeon character that was amazing at what she did, but got twisted up and starts to make calls about who to save and who to leave by the roadside.

That said, I’ve always been a storyteller who wants to say something about the world – about the times we live in and to explore scientific and ethical dilemmas. I’d been thinking about the character for many years, but it was in 2014 that I started building the storyworld. I was on maternity leave during 2013/14 with my twin daughters and spent a lot of time reading the news on my phone day and night. My sleep deprived/addled brain was soaking up local and world news.

I started by exploring the future of medicine and how these amazing developments would be used. Did they make life better for certain groups? If so, who were these people? Could the NHS [National Heath Service] afford all these advancements? Clearly not. My starting point in terms of issues was the future of surgery and medicine and the impact, not just medically, but on a societal basis.

When I was looking for obstacles for the protagonist, Surgeon X, the more I read about the antibiotic crises the more I realised that this was about one of the worst things you could throw at a surgeon. What stunned me was how we’d slept walked into this crisis.

Finally, Surgeon X is a woman working in what is predominantly a man’s world – only 10% of surgeons in the UK are women, when over 50% of medical students are women. It’s something that’s changing, but I’m interested in Rosa Scott revealing the barriers and myths that exist in the world of surgery. If people like the comic, perhaps Surgeon X will inspire a few female medical students to take up surgery!

So there are a range of issues integral to the story, but they are not bolt on – they are the story.

2. The opening of ‘Surgeon X’ #1 features a… let’s call it a “motivational poster,” courtesy of the book’s fictional Lionheart Party. While the purpose of that poster shares the same purpose as the Ministry of Information’s “Keep Calm and Carry On” posters from 1939 — to create the illusion of stability during a crisis — the subtext is far more sinister, isn’t it?

SK: Yes, definitely. I’ve always been fascinated by public health campaigns, from the wartime adverts about syphilis to the AIDS ‘don’t die of ignorance’ campaign that ran in the 1980s and the ‘Just Say No’ drugs campaign of the 90s. There’s often subtext in these adverts and they reflect not only the government’s attitude to the issue, but also the culturally embedded views on these subjects.

The idea for the Lionheart Party public health campaign came from a real world situation I read about in early 2014. There’s an organisation in the UK called the National Institute for Healthcare Excellence, or NICE. They are the medicines watchdog who decide which drugs the NHS should pay for.

In 2013, the UK Government proposed to NICE that they should make judgements on the ‘wider societal benefit’ of medicines. The government were asking NICE to put a monetary value on the people who were likely to take the drugs, in terms of their contributions to society. So that would mean older people with less years to work would score lower, women who were mothers and didn’t work would score lower than their working husbands. Sound familiar? NICE rejected this proposal in 2014.

In Surgeon X a more extreme version of this proposal is put forward for antibiotics. Citizens are assigned a Personal Contribution Index, or P.C.I. score, which is based not just on health but on their contribution to society. In the story if you’re sick, disabled, an asylum seeker, elderly – your score will be affected. It’s pretty messed up, but after discussing with experts not as unlikely as you might imagine.

3. The credits to the first issue of ‘Surgeon X’ reveal that you have worked closely with specialists in Microbiology and Regenerative Medicine, with surgeons and historians. How vital is it to your story that you get the science and history right?

SK: It was essential for several reasons; One, I think the storyworld is far more authentic because of my discussions with the experts. Two, the comic was funded by Wellcome Trust and this allowed me the time to research and speak with the experts. Three, I’m a geek and enjoy researching this stuff and speaking to experts – it’s just really bloody interesting to me.

4. On that tack, how are you going about applying real-world science to your fiction? How much of your story is “sci-fi” and how much of it is “cautionary tale?”

SK: The story is definitely a ‘what if we do nothing’ story, it’s a thought experiment if you like. However, some of the experts, and in particular microbiologists I’ve spoken to, don’t have faith that we have what it takes to sort out this problem. If you check out the app with the documentary inserts you can see some of their views on this.

There’s no doubt that it’s going to get worse before it gets better, because we don’t have any decent antibiotics in the pipeline for gram negative diseases, which include salmonella, E. coli, meningitis, cholera and plague. Scientists are starting to get more worried about gram negative diseases rather than gram positive (such as MRSA), because we’ve found some potential new antibiotics for the gram positive diseases.

5. Quite a few Image books go without an editor, but ‘Surgeon X’ boasts the presence of legendary Vertigo founding editor Karen Berger. What has your experience been like, working with Karen?

SK: I’ve had an incredible experience working with Karen. She’s been an inspiration, and we have similar sensibilities when it comes to the sorts of stories and characters we like. I think since I managed to secure Karen’s involvement the ambition for the project has grown and grown – originally this was going to be a digital comic and there was no expectation of getting a print publisher. I wasn’t expecting to get Image to publish and to get so much interest from comics press. So the pressure to live up to expectations is immense, but I’ve given it my best shot! As a new writer you need to also be able to make mistakes, listen to others’ criticisms and build on what you have, so I’m interested in hearing and reading about what people think.   

6. Rosa Scott, the book’s main character, has a serious problem with unchecked authority. She has incredible willpower and, in context to the world around her, a sense of pragmatic morality. (“I now believe life is a privilege, not a right.”) How much of you can be found in Rosa?

SK: There’s probably a bit of me in Rosa — or the smarter, funnier, braver version of me anyway! There’s also a lot of the strong women I’ve met in Rosa – colleagues and friends. I think Rosa is one of those personalities who some people will adore and others would hate. You often get those characters at work that are a bit what I call ‘marmite’, you love them or hate them – but whatever side you take they’re bloody smart and interesting. I think Rosa is a bit like that.  

7. How closely are you working with artist John Watkiss in bringing the world of ‘Surgeon X’ to life?

SK: John and I are in constant contact via email and phone and we always meet and discuss every issue normally at rough pencil stage. John is an incredibly cerebral man with great instincts and I always enjoy our meetings and chats. He’s had to put up with me sending him medical references and detailing where people stand during surgery or adding gory references to surgeries. I’m sure that’s annoying, but I guess that’s my obsession with accuracy playing out! He’s very good-natured about it though and the artwork is stunning, so I think we’re a good team.

8. One of your characters, Lewis Scott, is a schizophrenic. Does Lewis’ condition underline that nothing is as it seems in ‘Surgeon X’, or does it enable you to provide some crucial representation to those who live with mental illness? Or both?

SK: Both. Firstly Lewis is Lewis – he’s the brother of Surgeon X and her wing-man. He’s helping her get to where she needs to be on many levels; one, in terms of the technology; two, in terms of preparing her for the criminal underworld; and three, in terms of encouraging her that this is a fight she needs to take up.

Like many people living with schizophrenia, they have lives, work, families and their illness doesn’t define them. It’s just something they might have to battle with from time to time. We sometimes have this view of schizophrenics as ‘lost souls’, but this isn’t always realistic.

With Lewis I do also want to play with the idea of reality. Our perception of the world as a dangerous or threatening place comes from what’s going on around us, the media, our friends and family’s views and also our own predisposition to paranoia or conspiracy. We’re all on a spectrum for those traits and also what goes on behind closed doors could be more or less extreme than we imagine. I want to play with the ideas of how we construct our reality in terms of real threats versus actual threats. In a world like Surgeon X it’s easy to get lost in terms of the range of threats to humanity that exist.

9. How much of the current political climate in the UK is informing the narrative trajectory of ‘Surgeon X’?

SK: I started writing Surgeon X back in 2014, so it’s informed by what I was seeing/experiencing around that time. The recession had increased inequality, the NHS struggling, the political landscape across Europe was changing. I was influenced by all of that, but since then things haven’t really got a whole lot better…

10. How far can we expect ‘Surgeon X’ to run? Could you give us a hint as to what dark detours Rosa’s path will take her next?

SK: I hope we go to a series 2; I have plenty more ideas to take us into the future. It all depends on how the audience responds and whether there is an appetite for more. Like the antibiotic apocalypse, I guess only time will tell…

‘Surgeon X’ #1 is in stores now.

Before: 10 THINGS CONCERNING Ryan Ferrier, Valentin Ramon, And ‘HOT DAMN’