We don't tend to write about disease in fiction – not just teen novels but all American novels – because it doesn't fit in with our idea of the heroic romantic epic. There is room only for sacrifice heroism war politics and family struggle.
American influence in the world is certainly considerable but the United States does not control directly or indirectly the politics and economics of other societies as empires have always done save for a few special cases that turn out to be the exceptions that prove the rule.
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The thing about American politics as I've learned is there is no choice.
