Alan E. Nourse’s The Blade Runner, The Novel That Ridley Scott’s Classic Film Stole It’s Title From

When you utter the words ‘blade runner’ in any conversation, the average person’s mind immediately jumps to Ridley Scott’s 1982 film, Blade Runner, especially in the wake of the release of Blade Runner 2049This iconic title originally belonged to a novel that bears almost no resemblance to the film that carries’s its namesake. That novel is Alan E. Nourse’s 1974 book, The Blade Runner, the story of a street doc and his trusty medical supply smuggler, also known as a blade runner for smuggling scalpels, that have to prevent a plague and reform a broken health care system in a dystopian future.

So Nourse’s The Blade Runner and Scott’s Blade Runner share the common thread of dystopia, and nothing more. The short version of how Blade Runner acquired its title from this unrelated source, is that William S. Burroughs, the often cited influence of many cyberpunk authors, was commissioned to write a screen-treatment of Nourse’s book. In 1979, when the screen-treatment hadn’t been produced, it was published under the title Blade Runner (a movie). Hampton Fancher, Blade Runner’s screenwriter, had a copy of the Burroughs’ adaptation and suggested the title. Shortly thereafter, the rights to the title Blade Runner were obtained for Scott’s film, and the rest is history.

The Blade Runner by Alan E. Nourse Cover

So what is The Blade Runner about? The two primary protagonists of the book are Billy Gimp, who has a club foot, and Dr. John Long, who is a doctor who runs an illegal medical practice in addition to his more legitimate medical work at Hospital No. 7. In the world that these characters inhabit, the price of medical treatment has become sterilization, which as you can imagine, has the side effect of making most people not want to get medical treatment from a hospital. The rationale behind this policy is to protect genetic worthiness and was created by the Eugenic Control laws.  This has created a thriving medical black market full of doctor’s moonlighting as illegal ‘street docs’, medical supply smugglers called blade runners, and organized crime bosses like Billy Gimp’s source, Parrot. All of this is of course enforced by a medical/police organization called Health Control. This practice resulted in the uprising of a movement called Naturism. The naturists follow in the footsteps of Randall Morganson, or Randall the Martyr. Randall decided that he would publically go without treatment for his severe diabetes, sparking the Health Care Riots. The symbol of the Naturist movement is to shave one side of one’s head, and the opposite side on one’s beard, because during the Health Care Riots, Randall had an accident while setting a hospital on fire and burned away his hair in this configuration.

Alan E. Nourse (ca. 1963)

Against this backdrop, Billy works with Doc to provide health care to citizens who don’t want to undergo sterilization, and even the occasional Naturist, even though their credo is to go without health care at all. In addition to acquiring supplies for Doc, Billy often assists with operations alongside Doc’s assistant Molly, who is a nurse at Hospital No. 7.  Billy discover’s that he is under surveillance by the Health Control, as are many blade runners, and this culminates in a police raid on one of Doc’s operations. Billy allows himself to be captured so that Doc and Molly can escape unharmed. This leads to Billy being unable to assist Doc, who besides tangling with other problems at work, comes to realize that a deadly epidemic is imminent. Health Control approaches him after he makes his concerns known to the hospital’s administrator, and he agrees to help prevent this epidemic by convincing illegal patients to come into clinics for treatment with the assurance that they won’t be sterilized and providing illegal treatment to those who won’t come in. They need Billy Gimp’s contacts to spread the word, and so Billy embarks on a journey to meet-up with his source, other blade runners, and others to spread the word in the underground, all while becoming sicker and sicker with the Shanghai Flu that he knows will eventually kill him unless he, himself, gets treatment. The book comes to a close with the entire health care system coming under necessary scrutiny.

There are three major themes in the book that I think are worth unpacking from a cyberpunk perspective. The first is the most obvious, the disenfranchisement of those without access to healthcare. When individuals and their families are denied health care it creates a separation that reinforces the existing class structure of the society. In reality, this takes the form of access to insurance in the US, but in The Blade Runner, this takes the form of people avoiding sterilization. If a citizen living under the Eugenic Control laws is sick, they won’t go to the doctor for fear of the consequences of doing so. This not only means people won’t go in for small ailments, such as the flu but also more crippling issues, such as fractured limbs or even surgeries if one can acquire medical treatment on the black market. In the US, this takes the form of people avoiding medical treatment because of the fear of having to pay the bill. If you don’t have good insurance and you don’t make much better than minimum wage, then going to the doctor can ruin your budget – or even mean falling further into inescapable debt. So instead, you risk it or you risk your children’s health. An impossible choice for many. Repo Men also does a good job of exploring this territory in a more action-oriented way, if that is your thing.

Repo Men Promotional Image

The second theme is surveillance. The Blade Runner opens with Billy Gimp discovering a surveillance camera in his room. This eventually leads to his capture by the police and Health Control, but we learn later, that many blade runners have been under surveillance for a long time without being brought in. Billy was brought in as part of Health Control’s plan, on their terms, not because of his illicit behavior per se. Then, we discover that Doc, Molly, and Billy have all been under surveillance for a very long time, as have many other members of the medical underground, and that the government has extensive records of their activities. It isn’t until the status quo of access to health care is threatened by an epidemic that the government can’t control due to their policies, that they finally leverage this knowledge to blackmail Doc and Billy into helping them. Our protagonists certainly would have worked to prevent this catastrophe with or without the government, but the government needed them to save face. This backfires, just as all governments secrets inevitably do when they reach the public eye. Governments all over the world use terrorism as an excuse for the mass surveillance of their own people. I don’t use the word ‘excuse’ lightly, to date there is no evidence that surveillance of an entire country’s population is an effective deterrent to terrorism. That information is awfully useful in discrediting inconvenient dissenters though. Psycho Pass is an excellent cyberpunk anime that also explores these themes.

Psycho Pass Promotional Image

Automation replacing human labor is the third theme that I’d like to look at. A major b-plot in The Blade Runner is Doc opposing the use of robotic surgeons to make up for the lack of medical professionals in the wake of the draconian laws that come out of Health Control. The way these robots are trained is by having the AI observe the behavior and brain patterns of a surgeon while they perform surgeries to teach the machine the nuances of the practice. Doc, ever rebellious, introduces minor mistakes into his surgeries to make the robots look bad, and uses this as an excuse to not allow them to take over. In reality, we are training AI’s to take over industries by having the humans in those industries use interfaces that are monitored by AI. Those AIs can then learn to do what the humans are doing. The goal is to eventually replace said humans and save money on wages while increasing profits for corporations. Some of this is inevitable, and perhaps even good, but in the short term, it is likely to lead to an increase in the wealth divide. 1988’s Appleseed is a good example of this within the cyberpunk canon, however, Kurzgesagt has a fantastic exploration of this concept in the real world.

It is also worth mentioning William S. Burrough’s contribution to Alan Nourse’s work, Blade Runner (a movie). The plot of Burroughs’ screen adaptation is essentially the same as Nourse’s; there are some major differences, however. The first is that Molly has been replaced with Roberts. The opening scene in Billy’s apartment focuses on the homosexual relationship between Billy and Roberts rather than the discovery of a surveillance camera, and it is quite explicit. This explicit nature can be seen in much of Burrough’s treatment. If you are easily offended, then perhaps reading this isn’t for you. The second major change is that the disease is no longer the Shanghai Flu, which is based on the Spanish Flu, but rather a disease analogous to AIDs/cancer. The third major change is that Burroughs spends a lot more time on the background than Nourse does, and in a much more info-dumpy sort of way. Had the film been made into a film though, the sense is that much of this would be told in the background through commercials, statue plates, etc. This reminds me a lot of the world building in Robocop. Burroughs’ also fleshes out some of the setting, making it feel more truly science fiction, rather than just dystopian. New York was sacked in the Health Care Riots of Burroughs’ vision, and this has led to a stratified society. The lower city is flooded, and there is Venice like transportation network that relies on boats. Above in the upper city, there are helicopters and zip-lines between derelict buildings. You can just imagine a Health Control police-copter coming in to capture Billy. I think a film based on Burroughs’ treatment would be phenomenal under the right director, someone like Paul Verhoeven.

Blade Runner (a movie) by William S. Burroughs Cover

The Blade Runner is not Blade Runner, nor would I say it is remotely in the same class, but it is an intriguing story in its own right. I enjoyed reading it, Burroughs’ treatment of it, and further exploring its relationship to the Blade Runner that we all know and love. If you want a good commentary on the ongoing health care crisis in the US, predicted all the way back in 1974, then The Blade Runner won’t do you wrong. If you want an inspiration for your next Street Doc character in Shadowrun or Cyberpunk 2020, then The Blade Runner can certainly help. If you want to delve into the details of a marginal part of Blade Runner‘s rich history, then at least it will be an interesting ride. Whatever the reason, The Blade Runner is worth a look.

The Blade Runner – 6/10

If you’d like to read The Blade Runner for yourself, you can find a copy here.

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Veritas is a cyberpunk and writer who enjoys all aspects of the cyberpunk genre and subculture. He also journeys deeply into the recesses of the dissonance exploring his nihilistic existence. If you'd like to contact Isaac L. Wheeler (Veritas), the founder and editor-in-chief of Neon Dystopia, you can do so here:
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  2. interesting…


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