It describes the political intrigue surrounding a mid-twenty-first century physics conference, at which is to be presented a unified Theory of Everything. In the background of the story is an epidemic mental illness, related in some way to the imminent discovery of the TOE. The action takes place on an artificial island called "Stateless", which has earned the wrath of the world's large biotech companies for its pilfering of their intellectual property. The novel contains a great deal of satirical commentary on gender identities, multinational capitalism, and postmodern thought. It also features Egan's usual playful exploration of physical, metaphysical, and epistemological theories.
Egan uses his hypothetical future to postulate the existence of not just one but five new genders, and introduces a set of new pronouns to designate each one. One of the central characters of the novel, Akili Kuwale, provides a demonstration of this change and its implications. As an asexual human, Akili has had all reproductive organs removed entirely. Within the scope of the novel, Egan uses the pronouns 've', 'ver', and 'vis' to represent Akili's definitive gender neutrality.
Egan also uses the hypothetical technological advances in Distress to explore ideas about anarchism, especially when its protagonist, Andrew Worth, a journalist, travels to the anarchistic man-made island named Stateless. Andrew meets some small characters on Stateless who explain to him the relationship between anarchistic principles and various ideas such as quantum physics, information theory and independent spirituality.
Worth also meets a painter, Munroe, who attempts to explain how anarchy work on Stateless functions.
Munroe is an Australian as is Andrew Worth and Greg Egan himself. Egan uses Munroe to deliver a critique of Australian culture.
Don't you ever get sick of living in a society which talks about itself, relentlessly - and usually lies? Which defines everything worthwhile - tolerance, honesty, loyalty, fairness - as 'uniquely Australian'?"
A major theme running through Egan's presentation of a futuristic anarchism is something called 'Technolibération', which is to do with the liberation of technology and information from corporate control as well as the idea of using advanced technology to enable liberatory social movements.
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