Critique Technique Table of Contents

Here’s a Table of Contents of all of the Critique Technique posts to make it easier to go directly to the post you want to read.

Introductory Posts

Part 1: Critique, Technique, and Procedure

Part 2: Series Overview


Reader Response

Part 3: How Do You Feel?

Part 4: Authorial Intentions and Tracking Your Own Responses Updated!


Beginnings and Endings

Part 5: Weak or Missing Hook Updated!

Part 6: The Wrong Beginning Updated!

Part 7: Scene and Chapter Endings Updated!

Part 8: Story Endings Updated!



Part 9: Characters and Conflict Updated!

Part 10: Poor Characterization Updated!

Part 11: Lack of Character Development Updated!

Part 12: Showing and Telling in Character Development Updated!

Part 13: Timing the Reveal Updated!

Part 14: Out-of-Character Behavior

Part 15: Unclear Character Goals

Part 16: Unclear or Insufficient Obstacles

Part 17: Dialect, Foreign Languages, and Jargon



Part 18: Lost In Space

Part 19: Vague Setting

Part 20: Too Much Setting Detail



Part 21: Unclear Plot

Part 22: Overly Complex Plot

Part 23: Confused Storyline


Flashbacks, Flash-Forwards, and Backstory

Part 24: Unclear Transitions

Part 25: Misused Story or Flashback

Part 26: Tangents


Narrative and Dialogue

Part 23.5: Read-Out-Loud Tools

Part 27: Narrative and Dialog

Part 28: Awkward Dialog

Part 29: Writers’ Tics

Part 30: Too Many Words, or Too Few

Part 31: The Wrong Words

Part 32: %*@!$#^!!!! (Swearing)

Part 33: Contradictions

Part 34: Imbalance Between Narrative and Dialog

Part 36: Name-Calling

Part 37: As You Know, Bob



Part 38: The Pieces of Pace

Part 39: Pace: Speed It Up, Whoa It Up, or Change It Up



Part 40: The Gray Haze

Part 41: What Was That Again?

Part 42: The Dreaded Expository Lump

Part 43: Too Many Notes

Part 44: Telling, Not Showing


General Story-Telling Problems

Part 45: Pop Goes the Reader!

Part 46: No Story Arc

Part 47: Padding

Part 48: Danglers

Part 49: Stating the Obvious

Part 50: Head-Hopping

Part 51: Point of View Shifts


Mechanical Errors

Part 52: Spelling

Part 53: Punctuation

Part 54: Grammar Errors

Part 55: Manuscript Format


Positive Reinforcement

Part 56: Good Job!

Part 57: Great Start!

Part 58: Magic Middles

Part 59: Ending a Scene or Chapter Well:


Other Topics

Part 35: The Critiquer’s Mind

Part 60: The End

Bonus Material: Life on the Other Side of the Critique




The cover image for The Eternity PlagueI am thrilled to announce that The Eternity Plague has been published! Here’s the blurb:

In 2035, Dr. Janet Hogan makes a stunning discovery: infected by five species of naturally-mutated viruses, every one of earth’s nine billion inhabitants has become immortal.

Or have they? By the time Janet learns that this immortality is an illusion, it’s too late to change people’s beliefs. Some love her for creating this miracle and the coming paradise they long for. Others hate her for what they see ahead: immoral behavior without consequence, overpopulation, famine, and worse. Zealots demand that she save people’s souls, humanity, the earth… or the viruses. Or else.

Janet realizes this awful truth: no matter what she does, no matter what anyone else wants, sooner or later, billions will die and she’ll be blamed. Will she live long enough to figure a way out of this trap?

Meanwhile, the viruses are still mutating.

The paperback version is available from here for $12.99.

The ebook is available for $3.99 from these sources:

I’ll add links to more outlets as the book becomes available there. I expect that these will include the Apple iBook Store, Barnes & Noble (for the Nook), Kobo, Oyster Books (subscription service), and Scribd (subscription service).



Close Range Review



Close Range coverI came to this book with some unease. My first encounter with Annie Proulx’s collection subtitled “Wyoming Stories,” was the final one, “Brokeback Mountain,” in which a cowboy discovers, as an adult, that he’s gay. Uh, yeah, sure. The story was a “political” assignment by one of my English professors, and it set my expectations when, probably 15 years later, I finally picked up the book again.

Proulx starts “A Lonely Coast” late in the book this way:

“You ever see a house burning up in the night, way to hell and gone out there on the plains?… And you might think about the people in the burning house, see them trying for the stairs, but mostly you don’t give a damn.”

That seems like a fitting metaphor for the entire book. Every one of the people in these stories lives a life of nothing but tragedy, heartache, and loss. They never stop to admire a sunset or a field of wildflowers, or breathe deeply the scents of new-grown grass and the plants of the Wyoming plains. Any joy they have is fleeting, artificial, not to be trusted: it will only lead to more pain.

This sort of literary drive-by schadenfreude is not for me. It betrays a “life sucks and then you die” nihilism I simply don’t share. If this is Proulx’s world, I’m glad I don’t live in it. I don’t know why anyone would want to read about it, much less write about it.

Yes, Proulx is a master of the well-turned phrase, the concise and insightful description, but those masteries cannot overcome the miseries of these depressing and dismal stories.

The high plains of Wyoming can be a desolate place, to be sure, and ranching is a hard life. But not this desolate, and not this hard, not all the time.

Your time and money can be better spent on other books.

TusCon 45 Wrap-Up

My original plan was to give you a revised “thought experiment” this week in which I asked you what one device you would keep if you had to give up everything else, assuming that electrical power was still available. I’m going to hold that for next week, however, in favor of a quick summary of my participation in TusCon 45, the Tucson Science Fiction, Fantasy, and Horror Convention this past weekend. (The organizers are so organized, they’ve already updated their site for next year’s event!)

TusCon is a small and friendly convention (or “con,” in the lingo). While most of the participating authors come from Arizona or adjacent states, the staff has managed to score some big-name authors as the Author Guest of Honor, including George R. R. Martin (who happens to live in New Mexico) a couple years ago.

The con features not only the usual panel discussions and single-author presentations, book signings, and dealer room, but also an art room where all of the art is for sale, a game room for both board and online games, steampunk/Dr. Who/Star Trek/Star Wars “cosplay” (costume events), and a non-stop film festival of everything from horror to anime (an originally Japanese comic book/animated film style). With all that going on, you’d think there’d be a gazillion people, like there are at the various ComiCons around the nation.

You’d be wrong. Attendance is less than 200, and the event never feels crowded, the way ComiCons can.

This was my sixth or seventh year attending TusCon and for the first time, I was invited to be a panelist. I got to participate in panels on whether we (America, presumably) have lost our spirit of exploration, especially as it pertains to space exploration, critique groups, and telling stories from new angles. All good fun. Here’s a picture of my critique group panel.

L-R: Me, John Vornholt, Gemma Lauren Krebs, T. L. Smith

But I gave up my “panel virginity” with my first ever one: “Drake & McTrowell’s Hot Potato School of Writing.” What a way to start! At 10 PM on Friday night, two published authors—myself and David Lee Summers—were each paired up with a volunteer audience member. My partner was Jocelynne Simone, a.k.a. “Madam Askew” (pronounced a-SKEW), local steampunk celebrity and “tea aficionada.”

The ever-glamorous Madam Askew

“Dr. Sparky McTrowell” and “Chief Inspector Erasmus McTrowell” (their steampunk names, in case you hadn’t guessed) then inflicted upon the two teams—I MEAN, challenged us with—three plot points, selected by the audience from a list of twenty provided by our persecutors—I MEAN, our moderators. The first ones were:

  • Crazed herpetologists are breeding incendiary salamanders.
  • Pandemic chocolate craving.
  • Mud was everywhere!

Our task was then to improvise—out loud, and in real time—a story using these prompts, plus two “hot potatoes” that would be thrown at us during the event. David and his partner took the first one, and had two minutes to tell the first part of the story. (To be clear, there was no preparation time: they had to jump right into it.)

At the end of their two minutes, Madam Askew and I had to pick the story up, add the second plot point and the “hot potato” submitted by the audience and selected by Drake and McTrowell (“a love triangle develops”), and improvise the continuation of the story for two minutes.

Finally, David and his partner had to take the last plot point plus one more “hot potato,” (“Suddenly a DeLorean appeared, out of which stepped their love-child”), and complete the tale in another two minutes of madcap improvisation.


Then the partners were replaced and we did it all again. This time the prompts were:

  • Plot point 1: “They’ll never make fun of me again,” he exclaimed as he downed the entire vial of glowing green liquid.
  • Plot point 2: A mechanical squid plays the bagpipes beautifully.
  • Hot potato 1: The Tower of London makes a perfect nesting place.
  • Plot point 3: To make the task at hand easier, the Peregrine [a steampunk airship] is outfitted with a pumpkin launcher.
  • Hot potato 2: The giant snapping turtle crawled out of its tank with a menacing snap of its jaws.

This time my new partner David and I got to start and finish.

Do not adjust your eyes. The picture IS blurry.

Needless to say, much craziness and creativity were involved but not, surprisingly, adult beverages.

Madam Askew’s outfits are always quite dramatic, she puts a lot of effort into them. Here’s one more photo of her, David Lee, and an unidentified interloper that will give you a better idea. She wore a different one every day.

Madam Askew, David Lee Summers (right), and an unidentified interloper

The con wrapped up on Sunday afternoon, by which time I was ready to head home, but it was a grand time and I’m already signed up for next year.

Give It Up, Part 2

Last time I asked, “If you had to get rid of one piece of the technological stuff you use every day, what would it be?” This time the question is reversed and A LOT harder: you can only keep one thing.

This is a really sneaky and difficult question because technology, writ large, is so deeply embedded in our lives. Consider all of the things that are powered by electricity. The electrical grid that brings power to our homes is so critical that if you want to keep one electrically powered device, you have to either also keep the grid or replace it with some other technology that would generate electricity—and that violates the “rules” of this question.

So that means everything powered by electricity has to go: not just computers and smart phones, but refrigerators, washers and dryers, televisions, radios, light bulbs, heating and air conditioning systems (even those that use electricity only to light a pilot light or control a thermostat), any vehicle that uses electrical power in any way, battery-powered anything…. Yikes!

Photo by Sergey Khakimullin via

By the way, that means no water service, either, since the pumps are electrically powered. Even “doomsday preppers” might forget this: how are they going to get their water after any supplies they’ve laid in run out? A well? It better be hand-pumped. So, no water unless you’ve already got a hand-pumped well.

But how was that well dug? How were the pipes and pump made? No pump, just a bucket at the end of a rope? Fine. Again, what tools were used to dig the well? How were they made? Same for the bucket: the handle, the staves, any bands to hold the sides together. And the rope. Where did the fibers come from? How were they harvested, cut, and formed into the rope? With metal tools? Metal forging is a technology. Since you can’t use any of these things, you’d better live near a body of fresh water… and hope you can survive the bacteria living in it. Double yikes!

This is why people worry so much about a cyber attack taking down a national power grid. If the damage is bad enough and wide-spread enough, it becomes a threat not only to the existence of the nation but of the people living there. Even the loss of a regional power grid for more than a few days would be catastrophic. Take away the power people use for almost everything, especially water distribution, and things get really bad really fast.

For the sake of this blog post, how far do we take this definition of “technology?” Are stone tools “technology?” Sharpened sticks? Controlled fire? If yes, triple yikes!

If that’s the case, I’d keep control of fire. I can do things with fire.

Taken to its logical extreme of NO technology of ANY kind except for one thing, suddenly the options become very limited. Primitive in a major way. Pre-stone-age. It’s a scary thought.

Maybe next time I’ll back this off a little, let us keep electricity.

What do you think? Could you manage if EVERY kind of technology in your life suddenly went away, except for one thing?

Fortunately, the technology of the comment box is still working (so far as I know).

Give It Up, Part 1

Last time I asked what your least favorite piece of technology is. That’s a nice but sneakily misleading segue into this week’s topic. Here’s the question: If you had to give up one piece of technology, and you could choose which one, what would it be?

Actually, let me make that question a bit harder. If you had to give up one piece of technology that played an important role in your everyday life, and you had to choose which one, what would it be?

Woman talking on pay phone
Image courtesy of Sira Anamwong /

See the difference? It’s easy to give up, say, the battery-powered drill you only use once in a while, so that doesn’t count. About a year ago, I gave up the anti-lock braking system (ABS) on my car. The hydraulic actuator failed and my mechanic told me it was going to cost $3,500, parts and labor, to replace it. I’m not sure the car’s worth that much, and I’ve never actually had to use the ABS system, except at a couple of safety schools, so that was a pretty easy decision. And it doesn’t count, either.

But what about something you use and need—or think you need—every day? That’s a different animal. Would you give up your smart phone, and have to go back to using a landline, and a separate camera, and a Day-Timer®, etc.? Do you hate being tied to that electronic leash, yet find it indispensable now?

What about your broadband internet? Can you even imagine going back to dial-up? “File download will be complete in 3 days, 16 hours, 27 minutes.” Scary, huh? Well, today is Halloween.

How about your cable or satellite TV? We typically use only 10 or fewer channels of those 150 in the package anyway, and besides, there’s nothing on that’s worth watching. No more 4K Ultra-High Definition picture? Who’d even heard of that 10 years ago?

What about your computer? I mean all forms of them—laptop, desktop, tablet, phone—not just replacing a desktop with a laptop or tablet. No more e-mail, no more Facebook, no more blogs (Whoa! Wait a minute!), no more annoying banner ads, no more spam except the kind that comes in a can. Hmmm. That’s actually about 37 dozen technologies, though, so maybe it doesn’t count.

Sure, this is an arbitrary and artificial question, but I hope it’ll provoke a little thought. And it’s a great lead-in to next week’s post.

What would I give up? Probably the microwave oven. The things I use it for most—defrosting and/or reheating foods I’ve frozen—I could do other ways. I rarely cook in it, and I’ve got a cooktop and oven that could take its place. They’re just slower. I use the nuker just about every day but in truth it’s a convenience item. I could give it up.

What about you? Will you give up the technology of the comment box, or use it?

Damian and Mongoose Review

3-star rating



“Danny, if I find you’re a threat to my family, I’ll put a bullet between your eyes. Family is everything.”

“I understand that, Clyde. If I were in your position, I would say the same thing—and mean it.”

“You would; wouldn’t you?” He smiled as he studied me.


Those are the opening lines of Damian and Mongoose, Danny Williams’ memoir of his central role in taking down one of the most notorious spy rings ever to afflict the United States military. They promise a real-life spy thriller, better than anything John le Carré, Robert Ludlum, or Ken Follett could have dreamed up.

Unfortunately, the promise is not kept.

The reason is simple: Williams, who spent most of his Army career as a counter-intelligence agent, treats the memoir as if it were another debriefing with his superiors. He reports verbatim conversation after conversation, whether with Clyde Conrad, the leader of the spy ring, or any of Williams’ co-workers, superiors, or handlers. I understand that Williams wanted to use Conrad’s own words to reveal his motivations and personality, but when there’s so much dialogue, it can be hard for the average reader to process it all and separate out the important material.

The names in the title are significant, and self-assigned. Conrad’s code name, Damian, means “one who subdues or tames,” and he certainly did that to his recruits. Williams’ code-name, Mongoose, is, of course, the reference to the weasel-like animal that kills snakes.

Early on, Williams repeatedly says he considered Conrad a friend, and continued to feel that way even after he (Williams) had done the work that led to Conrad’s arrest by German authorities, his trial, conviction, and sentence to life in prison. Williams also states that he considered Conrad one of the most professional soldiers he’d ever known. For this military veteran, these statements are hard to square with what Conrad did. Williams eventually explains that while Conrad was in the Army, he did everything exactly right, and even went above and beyond what was required by regulation and procedure.

But those actions, it turned out, were so that Conrad could gain the confidence and trust of the people around him. That allowed him to later talk them into becoming spies, or at least sources of highly classified information for the Hungarian and ultimately the Soviet intelligence services. He did his work so well that NATO and German authorities later believed that if there had ever been war between NATO and the Warsaw Pact, NATO’s war plans would have been so compromised that the allies would have had to resort to nuclear weapons almost immediately.

Yet even after Conrad’s conviction, Williams considered him, a traitor to the United States, a friend. His explanation, that business is business and friendship is a separate thing, is unconvincing, to say the least.

Despite these flaws, this book’s look inside the worlds of espionage and counter-espionage are both fascinating and chilling. As a military officer, I was continuously cautioned against the kinds of behavior that could lead me to be compromised. The people who handled the classified documents Conrad eventually acquired and turned over—mostly relatively poorly paid enlisted personnel, it should be noted—surely received the same kinds of training and warnings, yet Conrad was so skilled he was able to overcome them.

Williams walked a fine line as he gathered the information needed to build the case against Conrad. On the one hand, he had to keep Conrad’s trust—to con the con-man, in other words—while at the same time not break any laws or do anything that would cause the investigation to fail, while retaining the confidence of his superiors, who doubted his non-standard methods of working with their target.

A more tightly woven and better-edited story would have made Damian and Mongoose a can’t-put-it-down read. I wish it had been.

What Is Your LEAST Favorite Technology?

Last time I wrote about all the technology that is part of our lives and how we’ve come not only to rely on so much of it, but to get pleasure out of some of it. But while there are some things we enjoy or at least appreciate having, there are others….

Love/Hate Relationship

I think it’s fair to say that there are at least some pieces of technology in our lives that we have a love/hate relationship with, or love/appreciate having it around when we or others can use it for our benefit, but hate it when we or others use it in ways we don’t like, or it behaves in unpredictable or even hostile ways.

Hit Any Key to ContinueA family friend used to call his computer his “disputer.” We can all relate to that. Remember this screen-saver image? (At least I’m not inflicting you with the animated one that never stops running!)

Many of us appreciate having a radio/sound system in our cars, particularly on long, boring road trips, but we’re not so appreciative when the teenager in the car next to ours has the volume on their system turned up so loud that the bass rattles both all the loose pieces on their car and our teeth too. Not that we ever did anything similar when we were that age.

Cell phones. Enough said.

But telephones generally: they’re great for staying connected with family and friends near or far, but not so great when the 27th telemarketer or robocaller of the day calls at dinnertime.

Embedded and Unavoidable

Last time I noted how deeply embedded technology is in our lives. While we tend to think of “technology” as electronic things, perhaps, it goes far deeper than that. That’ll be part of a topic for a later post, but that embedding is what can make technology so annoying: we can’t get away from it. Or if we can, it’s not easy to learn how to do.

Here’s an example. This morning I was reading an online article from the Washington Post’s web site. If you do this any at all, no matter what the news source, there are almost always ads on the site. (I can think of only one commercial site, Ars Technica, that is intentionally ad-free.) Yes, I have an ad-blocking app on my web browser, but many sites, when they detect that it’s working (yes, they can do that), whine about it and threaten to cut off my access if I don’t turn it off.

Maybe you’ve noticed that tiny blue triangle in the upper-right corner of these ads. If you click on it, you may be given the option from a company like Google to control which ads you’re shown. When I clicked it this morning, Google showed me all the categories they think, from tracking my web browsing (yes, they do that to all of us), I’d want to see ads about. There must have been over 60 categories. I have no idea how they associated some of them, like “Reality TV,” with me. Even after clicking off 27 of these categories (they counted them), there were easily that many left.

Now, I have no problem with web site owners trying to make some money off of their sites. They have to at least cover their costs of creating, maintaining, and putting “content” up on the site. That’s called “monetizing,” and I get it. Print newspapers and magazines are full of ads, after all, and we’re so accustomed to them we don’t really see them. While I don’t run ads on this site, I do have expenses and costs for having it: hosting fees and the time it takes me to write posts like this and to keep the site up to date, to name just a few.

What I DON’T like are a site’s blinking, flashing, attention-sucking ads that try to pull me away from the content I came to the site to see.

Least Favorite Things

But the ads are not my least favorite technological thing. It’s the tracking technology behind them, even though there are cases where I, in my own book marketing efforts, can benefit from it. There’s no way to be anonymous online; hasn’t been for a very long time. But there are so many ways in which the privacy we’d like to have is being eroded, even when we might benefit from that sacrifice. The sacrifice is not truly voluntary. (Have you ever actually read Google’s or Facebook’s “terms of use?” Yeah, me neither, and they know that we don’t.) And while they’ve provided ways to “control” some of that, who makes the time, or has the computer savvy, to find those controls?

So what’s your least favorite bit of technology? The technology of the comment box stands ready to accept your answer, and the technologies of the web site and e-mail will happily let me know that you’ve written something.

These Are a Few of My Favorite Things

Last time I started what will be a series on technology in our lives. I set the stage by equating so much of the technology we use without understanding how it works, and not being much worried about that in most cases, to magic.

So all right, we have these pieces of everyday magic all around us. Which ones are your favorites? When you think about it, there are so many to choose from. Here’s a list that isn’t even close to complete.

  • Desktop computers

    © Jossdim | Stock Free Images
  • Laptop computers
  • Tablet computers
  • Productivity programs for any of these (word processing, accounting, etc.)
  • Ordinary cell phones
  • Smartphones
  • Cable TV
  • Satellite TV
  • The internet generally
  • Other TV-like services (Hulu, Roku, etc.)
  • Digital video recorders
  • GoPro cameras
  • Video games and game consoles
  • Music streaming services
  • Video streaming services (Netflix, etc.)
  • Social media
  • Driving navigation aids/apps
  • Traffic advisory aids/apps
  • Safe-driving aids (lane-keeping, head-up displays, etc.)
  • Weather apps
  • Other smartphone apps
  • Microwave ovens
  • Other programmable kitchen appliances
  • Programmable thermostats/HVAC systems
  • Cell phone enabled home security systems (the Ring video doorbell)
  • Baby monitors
  • Pacemakers

…and the list goes on.

It’s pretty astonishing how much technology there is in our lives. This list is mostly just things that are in our homes and pockets. I haven’t even touched the kinds of things in the outside world, from power distribution systems to air traffic control to hospital and other medical technologies like CT scans to traffic light control systems to robots in manufacturing plants to… well, you get the idea.

When/if we stop to think about it—which we rarely do, technology being so deeply embedded in our lives—it’s enough to make our heads spin.


OK, so what’s your favorite piece of technology? Not which one makes you most productive, necessarily, or safer, or healthier. What gives you the most pleasure or satisfaction? Do any? Maybe none do.

That’s kind of where I am. I’ve been around long enough to have a reference point for how much things have changed over the decades. Long-distance phone calls used to be something special and expensive. Not anymore. That’s cool, but not, in and of itself, something that gives me pleasure. Same for other ways of communicating long distance, like Skype and the other video-conferencing systems I’ve used.

I don’t listen to music much, or watch movies, so streaming services don’t do anything for me. Sure, it’s nice to watch my favorite sports teams on TV (or on my computer or phone, if I used those services), no matter where they’re playing, but that’s not important to me.

My programmable coffee maker has a timer, so I could load it the night before and it would have coffee ready for me when I stumbled into the kitchen in the morning. That would be pleasant. Do I use it? No.

I could go on, but there’s not much point. About the only device I can think of that I’ve gotten pleasure out of is my (24 year old) car, but mostly when I’ve gone to performance driving events. Even though it’s that old, it’s got embedded technologies in it: power-assisted steering and computer-assisted braking, a computer-controlled engine, etc., but it’s the yee-hawing around the track or autocross course that’s fun, and any car could provide some degree of that.

Otherwise, all the technology around me just is. It helps me do things faster and better—sometimes, anyway.

But back to you. Are you like me, using but not getting any special pleasure out of the devices and technologies around you? Or is there something that gives you a special kind of joy?

In later posts, I’ll talk about our least favorite things, and the things we could give up, or things that we wouldn’t. Meanwhile, the comment box below is waiting to you to use it. And maybe even enjoy doing so.


It’s a Magical World

I’ll let you in on a little secret. I’m writing this post on a computer. No, that’s not the secret. The secret is, I really have no idea how it does what it does. I know that when I press a key on my keyboard, a letter appears on the screen. And it’s always the right letter, unless I pressed the wrong key.

Image by Monkey Business Images. Used by permission. (That’s not me, by the way.)

I roll the trackball around with my thumb and the pointer zips across the screen. I know there are sensors that detect the reflections of the laser lights shining on the trackball to reveal its movement, and somehow, what they detect gets translated into commands to move the pointer. But how?

My smartphone takes still and video pictures, helps me keep track of my expenses, tells me the time and the outside temperature wherever I happen to be, sends and receives e-mail, plays music and video. It even makes phone calls! OK, I know the phone is actually a two-way radio that (sometimes ) exchanges signals with antennas on a tower a few miles away, and those signals get turned into a phone call, or internet messages, or e-mails, or whatever. But how?

I know that the klystron tube in my microwave oven sends radio waves with micron (millionths of a meter) wavelengths into my food, where the water molecules absorb them, get all excited, and heat up the food. But how does it do that?

My car has an electronic ignition, electronic fuel injection, and several computers in it. I pretty much understand the basics of how an internal combustion engine works, but when mine stops working, can I fix it? HA. I’m mechanically reclined, not inclined.

I have an 8-day cuckoo clock. Doesn’t have a bit of electronics in it, it’s all mechanical. Do I know how it works, how the chimes and music box “know” when to chime or play? Not really.

We’re all like this, right? We’re surrounded by machinery big and small that we use every day, yet in many cases we have not the foggiest idea how it really works. Oh, sure, we can operate it, we know how to push the right buttons or turn the right knobs in the right order to (usually) get it to do what it’s supposed to do. But do we know how it does what it does?

No Luddites Allowed

People “of a certain age” hearken back to “the good old days” when they understood how machinery worked. I have friends who pine for the day when they could fix the cars they drove. Or they could fix a toaster that went on the fritz. Or they wish they could go back to a typewriter. But did they know how that toaster toasted or that typewriter smacked bits of type against the ribbon?

Since the dawn of the mechanical age, we’ve used things that worked but we didn’t know how they worked. I can argue that most of the folks who walked behind a plow being pulled by a couple of sturdy horses didn’t actually know how the blade split the earth. They just knew that it did, and that was good enough.

Need to Know

Truth is, we don’t need to know how something works most of the time.  We don’t need to know how the computer does its magic, or the microwave, or the phone, or the car, or even the cuckoo clock. We learn how to make it work the way we want it to—most of the time, anyway—how to operate it, in other words, and get on with our lives.

Arthur C. Clarke once said, “any sufficiently advanced technology is indistinguishable from magic.” To those who didn’t grow up with it, anyway.

There’s “magic” all around us every day and we don’t think a thing of it. We press a button, touch a screen, flip a switch, turn a knob, move a lever, and something happens. Most of the time it’s what we wanted and expected, and we’re happy.

It’s a magical world.

If Genetic Engineering Could Cure Your Child, Would You Use It?

Last time, I wrote about how gene therapy is being used to fix certain kinds of errors in DNA, and so cure or significantly reduce certain kinds of cancers. I asked whether you would accept such a treatment for yourself.

It’s one thing to accept the risks that are associated with these still new and experimental treatments, but would you make that decision for a sick child—one of your children?

Little boy in hospital
© Suthisa Kaewkajang |

Current Treatments

I didn’t make a point of it last time, but two of the diseases for which this kind of gene therapy is now available, B-cell acute lymphoblastic leukemia (ALL) and junctional epidermolysis bullosa (“butterfly skin”), are both childhood diseases. The children who received these treatments either were not responding to existing treatments anymore or there were no other treatments available. These kids’ parents were left with the choice of trying these experimental approaches or watching their children die. I think most parents wouldn’t consider that much of a choice.

The FDA has also approved a gene therapy for adults with non-Hodgkin lymphoma, another kind of cancer.

But what if the situation was not so dire? Doctors know, for example, that sickle cell disease is caused by a “single nucleotide polymorphism,” in plain English, an error in just one amino acid in one gene in a person’s DNA. The sickle cell mutation, which has to be inherited from both parents, is not usually fatal in children, although it can shorten the lifespan of someone who suffers from the disease. It’s treatable, but until now has only been curable by a bone marrow or blood stem cell transplant. Gene therapy might be able to change that. In fact, CNN has reported a complete cure in a very ill teenager in France.

Pre-Natal Therapy

But now things get more complicated. What if the therapy could be applied to a child before they were born? Pre-natal screenings can identify certain kinds of illnesses and conditions in the developing fetus. And there are some surgical procedures that are done in the uterus.

Could a gene therapy treatment even be done in this situation? Some current therapies use the subject’s own immune cells, tweaking them to recognize and attack cancerous cells, for example. However, a baby’s immune system is not fully developed at birth, so it seems like this kind of approach would be limited to certain diseases or conditions where the right kinds of cells were available enough and mature enough to be used.

Other gene therapies use special viruses to deliver their genetic payloads. Scientists have a pretty good idea how post-natal bodies, especially adult ones, respond to these viruses, but I wonder if anyone has much of an idea about how a fetus would react. And how would one ethically test such a therapy, or even how the fetus and the mother would react to the presence of the virus?

Post-Conception Therapy

For couples using in vitro fertilization, the egg and sperm cells, before fertilization, and the earliest forms of the fetus, such as the blastocyst, are available outside the mother’s body. It’s possible to test the genes of the blastocyst before implantation.

In the US and other Western countries, doctors agree that creating “designer babies,” that is, babies whose genes are modified to produce certain desired characteristics, is unethical.

But a designer baby is very different from one whose parents’ genes have destined that child for some kind of serious disease or condition before or after birth. Scientists in China and the UK have demonstrated that they can make genetic changes at this stage of development, but none of the fetuses so modified allowed to continue to develop beyond a very early stage, where they still look like just a ball of cells.

Big Decisions for Parents

In the future parents will face some big decisions if a genetic test reveals a fixable abnormality, beyond the decision of whether to abort the pregnancy or not. Every choice will entail risks and doctors may not be able to say exactly how much risk each option holds.

Good parents want to do what’s best for their children. What will they decide? How will they decide? What social pressures will they face to either agree to the treatment or refuse it?

If you’re a parent, or want to be someday, what would you do? Please leave your thoughts in the comments box below.