Axiomatic

by Greg Egan

  His tone was apologetic, but tenacious. I didn’t feel tenacious at all; I felt like I’d been struck all over with a rubber mallet. I didn’t trust myself to keep arguing without losing control—and anyway, it seemed like letting him say his piece would be the fastest way to get rid of him. If he snowed me under with details that I wasn’t ready to take in, then I’d just switch off, and make him repeat it all later.

  I said, ‘Go on.’

  ‘Of all the various options, the least costly doesn’t involve a life-support machine at all. There’s a technique called biological life support that’s recently been perfected in Europe. Over a two-year period, it’s more economical than other methods by a factor of about twenty. What’s more, the risk profile is extremely favourable.’

  ‘Biological life support? I’ve never even heard of it.’

  ‘Well, yes, it is quite new, but I assure you, it’s down to a fine art.’

  ‘Yes, but what is it? What does it actually entail?’

  ‘The brain is kept alive by sharing a second party’s blood supply.’

  I stared at him. ‘What? You mean… create some two-headed…?’

  After so long without sleep, my sense of reality was already thinly stretched. For a moment, I literally believed that I was dreaming—that I’d fallen asleep on the waiting room couch and dreamed of good news, and now my wish-fulfilling fantasy was decaying into a mocking black farce, to punish me for my ludicrous optimism.

  But Allenby didn’t whip out a glossy brochure, showing satisfied customers beaming cheek-to-cheek with their hosts. He said, ‘No, no, no. Of course not. The brain is removed from the skull completely, and encased in protective membranes, in a fluid-filled sac. And it’s sited internally.’

  ‘Internally? Where, internally?’

  He hesitated, and stole a glance at the white-coated woman, who was still hovering impatiently nearby. She seemed to take this as some kind of signal, and began to approach us. Allenby, I realised, hadn’t meant her to do so, and for a moment he was flustered—but he soon regained his composure, and made the best of the intrusion.

  He said, ‘Ms Perrini, this is Dr. Gail Sumner. Without a doubt, one of this hospital’s brightest young gynaecologists.’

  Dr. Sumner flashed him a gleaming that-will-be-all-thanks smile, then put one hand on my shoulder and started to steer me away.

  * * *

  I went—electronically—to every bank on the planet, but they all seemed to feed my financial parameters into the same equations, and even at the most punitive interest rates, no one was willing to loan me a tenth of the amount I needed to make up the difference. Biological life support was just so much cheaper than traditional methods.

  My younger sister, Debra, said, ‘Why not have a total hysterectomy? Slash and burn, yeah! That’d teach the bastards to try colonising your womb!’

  Everyone around me was going mad. ‘And then what? Chris ends up dead, and I end up mutilated. That’s not my idea of victory.’

  ‘You would have made a point.’

  ‘I don’t want to make a point.’

  ‘But you don’t want to be forced to carry him, do you? Listen: if you hired the right PR people—on a contingency basis—and made the right gestures, you could get seventy, eighty per cent of the public behind you. Organise a boycott. Give this insurance company enough bad publicity, and enough financial pain, and they’ll end up paying for whatever you want.’

  ‘No.’

  ‘You can’t just think of yourself, Carla. You have to think of all the other women who’ll be treated the same way, if you don’t put up a fight.’

  Maybe she was right—but I knew I couldn’t go through with it. I couldn’t turn myself into a cause célèbre and battle it out in the media; I just didn’t have that kind of strength, that kind of stamina. And I thought: why should I have to? Why should I have to mount some kind of national PR campaign, just to get a simple contract honoured fairly?

  I sought legal advice.

  ‘Of course, they can’t force you to do it. There are laws against slavery.’

  ‘Yes—but in practice, what’s the alternative? What else can I actually do?’

  ‘Let your husband die. Have them switch off the life-support machine he’s on at present. That’s not illegal. The hospital can, and will, do just that, with or without your consent, the moment they’re no longer being paid.’

  I’d already been told this half a dozen times, but I still couldn’t quite believe it. ‘How can it be legal to murder him? It’s not even euthanasia—he has every chance of recovering, every chance of leading a perfectly normal life.’

  The solicitor shook her head. ‘The technology exists to give just about anyone—however sick, however old, however badly injured—a perfectly normal life. But it all costs money. Resources are limited. Even if doctors and medical technicians were compelled to provide their services, free of charge, to whoever demanded them… and like I said, there are laws against slavery… well, someone, somehow, would still have to miss out. The present government sees the market as the best way of determining who that is.’

  ‘Well, I have no intention of letting him die. All I want to do is to keep him on a life-support machine, for two years—’

  ‘You may want it, but I’m afraid you simply can’t afford it. Have you thought of hiring someone else to carry him? You’re using a surrogate for his new body, why not use one for his brain? It would be expensive—but not as expensive as mechanical means. You might be able to scrape up the difference.’

  ‘There shouldn’t be any fucking difference! Surrogates get paid a fortune! What gives Global Assurance the right to use my body for free?’

  ‘Ah. There’s a clause in your policy…’ She tapped a few keys on her work station, and read from the screen: “…while in no way devaluing the contribution of the co-signatory as carer, he or she hereby expressly waives all entitlement to remuneration for any such services rendered; furthermore, in all calculations pursuant to paragraph 97 (b)…”

  ‘I thought that meant that neither of us could expect to get paid for nursing duties if the other spent a day in bed with the flu.’

  ‘I’m afraid the scope is much broader than that. I repeat, they do not have the right to compel you to do anything—but nor do they have any obligation to pay for a surrogate. When they compute the costs for the cheapest way of keeping your husband alive, this provision entitles them to do so on the basis that you could choose to provide him with life support.’

  ‘So ultimately, it’s all a matter of… accounting?’

  ‘Exactly.’

  For a moment, I could think of nothing more to say. I knew I was being screwed, but I seemed to have run out of ways to articulate the fact.

  Then it finally occurred to me to ask the most obvious question of all.

  ‘Suppose it had been the other way around. Suppose I’d been on that train, instead of Chris. Would they have paid for a surrogate then—or would they have expected him to carry my brain inside him for two years?’

  The solicitor said, poker-faced, ‘I really wouldn’t like to hazard a guess on that one.’

  * * *

  Chris was bandaged in places, but most of his body was covered by a myriad of small machines, clinging to his skin like beneficial parasites; feeding him, oxygenating and purifying his blood, dispensing drugs, perhaps even carrying out repairs on broken bones and damaged tissue, if only for the sake of staving off further deterioration. I could see part of his face, including one eye socket—sewn shut—and patches of bruised skin here and there. His right hand was entirely bare; they’d taken off his wedding ring. Both legs had been amputated just below the thighs.

  I couldn’t get too near; he was enclosed in a sterile plastic tent, about five metres square, a kind of room within a room. A three-clawed nurse stood in one corner, motionless but vigilant—although I couldn’t imagine the circumstances where its intervention would have been of more use than that of the smaller robots alre
ady in place.

  Visiting him was absurd, of course. He was deep in a coma, not even dreaming; I could give him no comfort. I sat there for hours, though, as if I needed to be constantly reminded that his body was injured beyond repair; that he really did need my help, or he would not survive.

  Sometimes my hesitancy struck me as so abhorrent that I couldn’t believe that I’d not yet signed the forms and begun the preparatory treatment. His life was at stake! How could I think twice? How could I be that selfish? And yet, this guilt itself made me almost as angry and resentful as everything else: the coercion that wasn’t quite coercion, the sexual politics that I couldn’t quite bring myself to confront.

  To refuse, to let him die, was unthinkable. And yet… would I have carried the brain of a total stranger?

  No. Letting a stranger die wasn’t unthinkable at all. Would I have done it for a casual acquaintance? No. A close friend? For some, perhaps—but not for others.

  So, just how much did I love him? Enough?

  Of course!

  Why ‘of course’?

  It was a matter of… loyalty? That wasn’t the word; it smacked too much of some kind of unwritten contractual obligation, some notion of ‘duty’, as pernicious and idiotic as patriotism. Well, ‘duty’ could go fuck itself; that wasn’t it at all.

  Why, then? Why was he special? What made him different from the closest friend?

  I had no answer, no right words—just a rush of emotion-charged images of Chris. So I told myself: now is not the time to analyse it, to dissect it. I don’t need an answer; I know what I feel.

  I lurched between despising myself, for entertaining—however theoretically—the possibility of letting him die, and despising the fact that I was being bullied into doing something with my body that I did not want to do. The solution, of course, would have been to do neither—but what did I expect? Some rich benefactor to step out from behind a curtain and make the dilemma vanish?

  I’d seen a documentary, a week before the crash, showing some of the hundreds of thousands of men and women in central Africa, who spent their whole lives nursing dying relatives, simply because they couldn’t afford the AIDS drugs that had virtually wiped out the disease in wealthier countries, twenty years before. If they could have saved the lives of their loved ones by the minuscule ‘sacrifice’ of carrying an extra kilogram and a half for two years…

  In the end, I gave up trying to reconcile all the contradictions. I had a right to feel angry and cheated and resentful—but the fact remained that I wanted Chris to live. If I wasn’t going to be manipulated, it had to work both ways; reacting blindly against the way I’d been treated would have been no less stupid and dishonest than the most supine cooperation.

  It occurred to me—belatedly—that Global Assurance might not have been entirely artless in the way they’d antagonised me. After all, if I let Chris die, they’d be spared not just the meagre cost of biological life support, with the womb thrown in rent-free, but the whole expensive business of the replacement body as well. A little calculated crassness, a little reverse psychology…

  The only way to keep my sanity was to transcend all this bullshit; to declare Global Assurance and their machinations irrelevant; to carry his brain—not because I’d been coerced; not because I felt guilty, or obliged; not to prove that I couldn’t be manipulated—but for the simple, reason that I loved him enough to want to save his life.

  * * *

  They injected me with a gene-tailed blastocyst, a cluster of cells which implanted in the uterine wall and fooled my body into thinking that I was pregnant.

  Fooled? My periods ceased. I suffered morning sickness, anaemia, immune suppression, hunger pangs. The pseudo-embryo grew at a literally dizzying rate, much faster than any child, rapidly forming the protective membranes and amniotic sac, and creating a placental blood supply that would eventually have the capacity to sustain an oxygen-hungry brain.

  I’d planned to work on as if nothing special was happening, but I soon discovered that I couldn’t; I was just too sick, and too exhausted, to function normally. In five weeks, the thing inside me would grow to the size that a foetus would have taken five months to reach. I swallowed a fistful of dietary supplement capsules with every meal, but I was still too lethargic to do much more than sit around the flat, making desultory attempts to stave off boredom with books and junk TV. I vomited once or twice a day, urinated three or four times a night. All of which was bad enough—but I’m sure I felt far more miserable than these symptoms alone could have made me.

  Perhaps half the problem was the lack of any simple way of thinking about what was happening to me. Apart from the actual structure of the ‘embryo’, I was pregnant—in every biochemical and physiological sense of the word—but I could hardly let myself go along with the deception. Even half pretending that the mass of amorphous tissue in my womb was a child would have been setting myself up for a complete emotional meltdown. But—what was it, then? A tumour? That was closer to the truth, but it wasn’t exactly the kind of substitute image I needed.

  Of course, intellectually, I knew precisely what was inside me, and precisely what would become of it. I was not pregnant with a child who was destined to be ripped out of my womb to make way for my husband’s brain. I did not have a vampiric tumour that would keep on growing until it drained so much blood from me that I’d be too weak to move. I was carrying a benign growth, a tool designed for a specific task—a task that I’d decided to accept.

  So why did I feel perpetually confused, and depressed—and at times, so desperate that I fantasised about suicide and miscarriage, about slashing myself open, or throwing myself down the stairs? I was tired, I was nauseous, I didn’t expect to be dancing for joy—but why was I so fucking unhappy that I couldn’t stop thinking of death?

  I could have recited some kind of explanatory mantra: I’m doing this for Chris. I’m doing this for Chris.

  I didn’t, though. I already resented him enough; I didn’t want to end up hating him.

  * * *

  Early in the sixth week, an ultrasound scan showed that the amniotic sac had reached the necessary size, and Doppler analysis of the blood flow confirmed that it, too, was on target. I went into hospital for the substitution.

  I could have paid Chris one final visit, but I stayed away. I didn’t want to dwell upon the mechanics of what lay ahead.

  Dr. Sumner said, ‘There’s nothing to worry about. Foetal surgery far more complex than this is routine.’

  I said, through gritted teeth, ‘This isn’t foetal surgery.’

  She said, ‘Well… no.’ As if the news were a revelation.

  When I woke after the operation, I felt sicker than ever. I rested one hand on my belly; the wound was clean and numb, the stitches hidden. I’d been told that there wouldn’t even be a scar.

  I thought: He’s inside me. They can’t hurt him now. I’ve won that much.

  I closed my eyes. I had no trouble imagining Chris, the way he’d been—the way he would be, again. I drifted halfway back to sleep, shamelessly dredging up images of all the happiest times we’d had. I’d never indulged in sentimental reveries before—it wasn’t my style, I hated living in the past—but any trick that sustained me was welcome now. I let myself hear his voice, see his face, feel his touch—

  His body, of course, was dead now. Irreversibly dead. I opened my eyes and looked down at the bulge in my abdomen, and pictured what it contained: a lump of meat from his corpse. A lump of grey meat, torn from the skull of his corpse.

  I’d fasted for surgery, my stomach was empty, I had nothing to throw up. I lay there for hours, wiping sweat off my face with a corner of the sheet, trying to stop shaking.

  * * *

  In terms of bulk, I was five months pregnant.

  In terms of weight, seven months.

  For two years.

  If Kafka had been a woman…

  I didn’t grow used to it, but I did learn to cope. There were ways to sleep, ways to si
t, ways to move that were easier than others. I was tired all day long, but there were times when I had enough energy to feel almost normal again, and I made good use of them. I worked hard, and I didn’t fall behind. The Department was launching a new blitz on corporate tax evasion; I threw myself into it with more zeal than I’d ever felt before. My enthusiasm was artificial, but that wasn’t the point; I needed the momentum to carry me through.

  On good days, I felt optimistic: weary, as always, but triumphantly persistent. On bad days, I thought: You bastards, you think this will make me hate him? It’s you I’ll resent, you I’ll despise. On bad days, I made plans for Global Assurance. I hadn’t been ready to fight them before, but when Chris was safe, and my strength had returned, I’d find a way to hurt them.

  The reactions of my colleagues were mixed. Some were admiring. Some thought I’d let myself be exploited. Some were simply revolted by the thought of a human brain floating in my womb—and to challenge my own squeamishness, I confronted these people as often as I could.

  ‘Go on, touch it,’ I said. ‘It won’t bite. It won’t even kick.’

  There was a brain in my womb, pale and convoluted. So what? I had an equally unappealing object in my own skull. In fact, my whole body was full of repulsive-looking offal—a fact which had never bothered me before.

  So I conquered my visceral reactions to the organ per se—but thinking about Chris himself remained a difficult balancing act.

  I resisted the insidious temptation to delude myself that I might be ‘in touch’ with him—by ‘telepathy’, through the bloodstream, by any means at all. Maybe pregnant mothers had some genuine empathy with their unborn children; I’d never been pregnant, it wasn’t for me to judge. Certainly, a child in the womb could hear its mother’s voice—but a comatose brain, devoid of sense organs, was a different matter entirely. At best—or worst—perhaps certain hormones in my blood crossed the placenta and had some limited effect on his condition.