Q&A with Ken Foxe

If you enjoyed this week's "Pill Pill", then why not learn more about Ken Foxe's creation process? With our fiction editor, Angela Thoma, discover more about the themes of survival, detachment, and isolation.

This story drops us into a world already in crisis. Do you remember what first sparked the idea? Was there a particular question or feeling you were exploring when you began writing?

The origin of the story is just that general unease a lot of people feel about the world and how its changing, in particular the growth in far-right extremism. I think an aspect of this is how changes in what we consider democratic norms shift by small degrees until a tipping point is reached. I think collectively we’ve made a mistake in forgetting how quickly that can happen.

For the past few decades, there has been a sense that the natural endpoint for each country is some form of liberal democracy, along with a free and tolerant society. And I think we are beginning to understand the naivety of that way of thinking.

There’s a second aspect of the story about modern medicine and the changes this has brought for life expectancy and people’s expectations about their quality of life.

But there’s another side to that for things like pain management and mental health where things aren’t nearly so straightforward. A medication that greatly helps one person may cause another person to suffer more. Another medication, which is of enormous help in the short term, can create addiction. So that’s the second more abstract level about how pills can come to control a person’s life, for good and bad.

The infection remains unnamed, its effects never fully explained. What drew you to that ambiguity?

I think the infection and the nature of the disease is mysterious because if it was made real, then the possibility of a ‘cure’ exists. But the infection in the story is really a mechanism of control and creating absolute dependence on the state. It may be that there is no ‘infection’ at all and it’s just a manufactured addiction to ensure subservience.

Though the narrator interacts with others, there’s a striking sense of detachment in the way he moves through the story. How did you think about shaping those moments of contact, and what they reveal about him?

My sense of the narrator was that he had lost interest in human contact once his family had safely left Ireland. He tries to convince himself that it is enough for him to know they are safe, and he has resigned himself to the fact that he will never join them. Of course, convincing yourself such a sacrifice is enough is one thing – living it every day is quite another.

There also remains a fear in him that he will be singled out for ‘infection’ because of some past unexplained ‘crime’ or involvement in dissent or opposition. In other dystopian short stories that I’ve written, I’ve been much more explicit about what the person’s past was and why this was happening to them. But I liked the idea of being a little more vague about it in "Pill Pill."

The narrator's voice is measured, almost distant, yet there’s an undercurrent of fear. How did you develop his perspective, and what do you think it adds to the story’s vision of a world unravelling?

There’s two parts to that, the first where he tries to put distance between himself and the world. His family is safe, so it doesn’t matter what happens to him. And there’s a resonance for a parent like me where you would be willing to sacrifice anything – including yourself – for your kids. The narrator sees himself as having fulfilled that duty, given up on any personal ambition, but now finds himself completely unrooted without any purpose.

There’s also a separate strand around the treatment of illness, particularly for older people, for chronic pain, and for mental health issues. And this is around how many people are utterly dependent on medication but not in the sense of an ‘addiction’. They know they must take a pill (or multiple pills) every single day even though sometimes that medication may have unwanted or unpleasant side effects. The medication might not make them feel ‘good’ or ‘better,’ yet they know if they stop, they will get ‘worse’.

So, people have dependence on their medications but in a different way to how we usually talk about abuse of drugs or narcotics. And psychologically, I think that can be an adjustment for some, especially as we age, knowing that our bodies or minds can no longer be relied upon to function properly by themselves.

One of the most powerful moments is when the narrator's children call him from Australia—one of the only times we see him connected to anyone personally. Do you think he sees the phone as a lifeline, or more as a reminder of what’s already lost?

I think the daily call is a lifeline. It’s the only thing that keeps him going, the last bit of his old life that he can cling to. He and his wife have deliberately created an illusion for their children, an imaginary future in which the family will be reunited. The point in the story where he cuts out the video so that they can’t see his face is his realisation that even this sliver of happiness is disappearing too.

Would you say this is a story about survival, about surrender, or about something else entirely?

I think it’s primarily about surrender. The narrator has accepted his fate and lacks the courage to do anything about it. The idea in my mind was that at one point, he was somebody who thought himself a strong person who advocated for social justice through journalism, politics, trade unionism, or another form of activism. However, as society shifted, he shied away from that to protect himself and his family. I think that is something we are seeing in real time. How dissent and opposition can begin to evaporate once people see it as an existential threat for them and the people they love.

What was the writing process like? Did the story shift significantly from its early drafts, or did it emerge much as you first envisioned?

The writing process is always a bit different for each short story I write. It usually starts with a concept or a ‘what if’ moment. And I never start to write immediately. I leave it in the back of my mind for at least a week or two to percolate. For me, a really important part of writing is to let an idea sit for that period of time. It gives you time to build a world, a language, and a character (or characters). One of the most magical things about the human mind is the way you can park something, and your brain will continue to work away on it quietly in the background.

When writing short stories, I sometimes have a very clear start and end point and then try to work out the path from A to B. But for this one, there was only a start point, which was the concept of a state-orchestrated system of addiction as a means of control.

The story feels particularly resonant in the way it explores uncertainty and isolation. Were you thinking about our broader cultural relationship to illness and crisis as you wrote?

I think it’s really hard for anybody who writes at the moment not to feel the weight of the way the world is changing. There is an obvious dystopian element to the story that reflects the fear of the future that many people share. And I think an element of it is rooted in COVID and the division that caused. I think the pandemic fractured society in a way that we do not yet fully appreciate. It led to the mainstreaming of conspiracy theories and a distrust of authority. It created a situation where people suddenly had huge amounts of free time – almost too much – and some drifted deep into the sphere of social media misinformation.

When the pandemic was over – those feelings of alienation and anger were never just going to disappear and sometimes got directed elsewhere, often towards refugees and minorities. I think that impact of the pandemic has not been explored enough yet. There’s been lots of discussion over which countries managed that period best. But the element of the pandemic that we can forget is how different the experience was for different people. This could be as simple as whether someone had their own house or just a tiny flat, access to a back garden, if they were a natural introvert or extrovert, or had kids to mind to keep them occupied.

When future generations look back on this period of history, I think that connection between COVID and the instability that followed will be glaringly obvious to historians