The Thackery T. Lambshead Pocket Guide to Eccentric & Discredited Diseases

Edited by Dr. Jeff VanderMeer & Dr. Mark Roberts

Night Shade Books, 2003, ISBN 1-892389-54-1; 298 Pages, Hardcover $24.00. [Browse/Purchase]

Review by Andrew F. “Likes to Play Doctor” Duncan

Naturally, it was raining the night everything started. And not the usual steady pattering of soft drops; a heavy downpour was beating the entire world into submission. I remember thunder, but not lightning. The insects were silent, as were the reptiles.
This was a Tuesday evening; I don’t remember how many weeks ago. I was in the midst of watching my weekly dose of the delightful Mama’s Family when I heard a heavy “thump” on my doorstep. The noise startled me, and I muted the television. My life paused momentarily. Those familiar with the lives of book reviewers will know we hardly ever entertain visitors. Any human sound near a critic’s doorway is a rare occurrence indeed! I slugged down the rest of my White Zinfandel, and strode cautiously to the door half expecting company, half expecting an unwanted visitor – perhaps my neighbor looking for his lost chemicals.
Happily, what I found was much more predictable. Yes, a book wrapped in plain brown paper lay atop my ribald Yosemite Sam “Wipe Your Paws, Varmint!” doormat.
After carefully opening the mundane, if somewhat damp, package – addressed to me in Cibolian Sanskrit – it was hardly with surprise that I found myself staring at a recently published edition (the 83rd, to be exact) of the legendary Thackery T. Lambshead Guide to Eccentric & Discredited Diseases. What other book would arrive amidst such mysterious circumstances? I quickly shut my door, excited at what wonders Lambshead’s Guide had in store.
I stopped for a moment. From outside, just on the edge of my range of hearing, there came a strange noise: the squish-splash of footsteps running across wet earth. I paused for a moment, straining my eyes to catch a glimpse of something; but there was nothing. As the sound faded away into the darkness, I opened my door and retreated to my study.
Astute readers will by now have noticed the series of particularly melodramatic portents characterizing that night. These same people may also have already predicted my doom. Well, perhaps it was my loneliness... perhaps it was my willingness to escape into the giddy amusements of television... or perhaps it was the insidious catchiness of that latest Beyoncé single; however you look at the situation, attention was unfortunately not paid. I immediately cracked open the spine of the Lambshead Guide, ready to forget the apocalyptic events of the evening by swimming amidst the familiar and comforting seas of “literature.”
Fortunately, before the eventual effects of the book began to take hold, I was able to record my thoughts on the Guide. I then unceremoniously ate my notebook in a fit of inanity. With the addition of salt, ketchup, and pudding, the papers went down quite easily.
Days later, I decided to attempt another review of the Guide. After I finished writing, I realized that I had merely duplicated my previous judgment – verbatim. I was struck numb. Was this more proof of Lambshead’s spell, or was it the early stages of Menard’s Disease? Difficult for one in such a state as myself to say.
Looking back at my initial critique, I realize how foolish and naive I was. Although my opinions have since radically changed, I offer my original thoughts as a document of a happier time:

Upon opening the Lambshead Guide, one will find themselves staring at the names of the somewhat suspicious editors of this strange endeavor: one Jeff VanderMeer, and his equally shifty cohort, Mark Roberts.

I’ve come across VanderMeer’s work in the past. An award-winning writer and editor of some note who has tendencies towards dark fantasy, he is the author of the science fiction novel Veniss Underground, and a well-received collection of short stories, City of Saints and Madmen.

The highly imaginative VanderMeer and Roberts have assembled a motley but talented crew of modern masters of the fantastic – Neil Gaiman, Alan Moore, Michael Moorcock, Rachel Pollack, China Miéville, and Jeffrey Ford among many others – to accomplish something of a clever and elaborate joke. And make no mistake; The Thackery T. Lambshead Guide to Eccentric & Discredited Diseases is extraordinarily elaborate and fiendishly clever. Thanks to an attention to detail that borders on the obsessive-compulsive, the Guide feels as genuine as it is exhaustive. To polish this shellac of realism, VanderMeer and Roberts include many witty touches. A full history of the editors’ tenure with Lambshead has been devised, as have detailed reminiscences of the mysterious doctor by a host of different “colleagues.” Excerpts from the incarnations of the Guide throughout the 20th century match the tone and temperament of their time, and there’s even an excerpt – in Spanish and English – from an Argentinean spin-off of the Guide, purportedly edited by the great Jorge Luis Borges himself.

Much of the Guide’s incredible attention to detail can be attributed to the book’s designer and artist, John Coulthart. His unnerving cover certainly sets the tone for the book, but it’s in the interior where his painstaking care and abundant talent become obvious. Each disease is accompanied by evocative illustrations, and spot medical collages perpetuate the strange aura of the work, which hovers along the fine, provocative line between funny and creepy. Coulthart also designed the covers for previous permutations of the Guide, each one carefully matching the design aesthetic of its time. Apparently not satisfied with these artistic embellishments, he even manages to contribute his very own disease: “Printer’s Evil”...naturally.

Of course, the heart of the Guide resides in its fifty-odd essays on “imaginary” diseases, each a short but detailed treatise with a description and history of the disease, a list of symptoms, directions for treatment, and index of endnotes and cross-references. The maladies range across a broad variety of types, including gleefully disgusting, Monty Pythonesque splatter (Michael Barry’s “Ballistic Organ Syndrome”), intelligent satires of the modern age (Cory Doctorow’s “Pathological Instrumentation Disorder”), wry literary homage (Martin Wesley Newell’s “Poetic Lassitude”), and just plain bizarre (Stepan Chapman’s “Motile Snarcoma”). Like many anthologies, the Guide tends to be a hit-or-miss affair; although the worst that can be said about the lesser contributions is that they are only mildly amusing. The best pieces are smart, enjoyable, and inventive small fictions in their own right, exploring the effects of diseases on history, society, and culture; and peppered with loving allusions to H.P. Lovecraft and the aforementioned Borges – without whom playful subversions of literature like the Guide would be entirely impossible, and perhaps, implausible.

After filing my notes away for future revision, I returned to my moribund, mild-mannered existence, which consisted mainly of imbibing food, drinking water, absorbing culture, and researching my extensive survey of mid-19th-century Eskimo porn, One Hundred Words for Fucking. The Guide merely existed as one of many recent memories fighting for prominence within my addled brain, somewhere between the untimely demise of my Sea Monkey colony and the unceremonious exit of Julianne from my life. In time, I forgot about the Guide entirely.
Or so it seemed. One night while sitting on the toilet – where I do some of my best thinking – I felt a nagging at the back of my mind. I didn’t think much of it, and attributed the oddity to a lack of sleep or dearth of the recently FDA-approved Vitamin X. That night, I woke up with a start around 2 am. My hair was damp with sweat, and my mouth dry. My body was quaking with fear – but at what, I had no idea. All I knew was that I was deathly afraid. I lay awake until the sun rose, sweating and anxious – but not in a sexually aroused way.
That morning, I; not to mention more paranoid than usual. While in the shower, I found myself examining all parts of my body, and paying closer attention to my physicality and demeanor. It occurred to me over my customary morning bowl of Cinnamon Toast Crunch that I was coming down with something that was not a cold, nor the flu, but some other kind of sickness.
All day I tried in vain to work. I couldn’t get my own anatomy out of my head. What sickness was attacking my being? What could my white blood cells not defend against? Was I ever going to feel better? Was I about to get sicker? Questions were rattling around my brain like so many Lotto balls.
Four-fifths of Maker’s Mark later, my brain was calm, and I began the inevitable experiments. Unfortunately, a round of trepanning and various phrenology tests turned up nothing. I sank back into a chair and stared into space, lost. My eyes roamed wearily to the ceiling, the walls, my bookshelves, the melancholy ruins of Julianne’s gingerbread house...and eventually fell upon an unassuming tome sitting on an unassuming end table in the unassuming corner of the circular room. There was no heavenly halo shining upon the object; no light bulb that suddenly came on over my head as if I had a brilliant idea. Yet I rushed over to the book, inherently knowing that it was the cause of all my problems. I did not hesitate in greeting my tormentor: The Thackery T. Lambshead Pocket Guide to Eccentric & Discredited Diseases.
It suddenly occurred to me that my symptoms vaguely called to mind a malady I had discovered in the Guide. But which ailment was it?!? Was my disease fatal? Were there more fearful symptoms to come?
I studied each entry closely, trying to discern anything that resembled my condition. Was I about to experience the hideous disfigurations – but lovely tonal qualities – of Dr. Michael Cisco’s “Ledru’s Disease?” The extreme intestinal discomfort of Dr. Jay Lake’s “Mongolian Death Worm Infestation?” The reality bending effects of Dr. Brian Evenson’s “Worsley’s Supplement?” Or, most terrifying of all, the beautiful, obsessive violence of Dr. Liz Williams’ “Spontaneous Self-Flaying Sarcoma?” The possibilities were endless, as was my fear. I could barely contain my panic. The book slid out of my hands, and I fainted to the floor.
I don’t know how many days passed before I woke up. Underneath the mail slot, a healthy pile of letters sat untouched. Stubble covered my sunken face. I slowly rose from the floor, and made my way towards the kitchen. If I was to discover what was ailing me, I needed sustenance – meaning alcohol, mixed with a crude form of PCP made from liquid soap, bleach, and packets of Jell-O. I returned to the library. Steeling myself for the discovery I must make, I opened the book once again.
And that is where I am today. I do not go out. I rarely rise from my chair. I have the blinds pulled. When I am not looking at the book, I am sleeping. I sanitize my body three times daily. I wear surgical gloves, a condom, and have my navel filled with construction putty at all times. I have plenty of suction tubes at hand. I hide when the cleaners come...if they do come anymore, I’m not sure. Although I do not know what disease I have, the book knows, and I must learn what it is – and what to do – before my time runs out. I’d rather know before dying – I would rather not succumb to something like Bufondic Cephalitis without knowing what it is.
What I do know is this: these are the last words I will ever write. And whether this is just my stated opinion or a warning, I can’t tell. Enter the world of Thackery T. Lambshead at your own risk. I pray my fate does not befall you.

“When I opened the book, it laughed at me. I then closed the book. For three days I wandered the monastery’s halls, haunted by the literary derision. It was only on the fourth day that I realized the author’s genius, and I flogged myself incessantly for a month. These were days of unimaginable bliss. I returned to the library and opened the book again.”
–Unknown flagellant monk, 13th century

–Andrew F. Duncan
15 November 2003

Additional Information

The Lambshead Guide’s Official Page – Contains images, excerpts, and various unreliable diagnoses.

Night Shade Books – The publisher’s homepage.

“How I became one of Dr. Lambshead’s assistants” – A piece on the Guide by VanderMeer; online at BookSense.


Email get-well cards to Andrew F. Duncan at:

Aleph, alpha: nought, nought, one.