Did the other five do the same? Did they have worn seat plans over which they pored in the dead of night? Did they silently reach for answers, wondering at the impossible reasoning of it all? In hotel lobbies. In boardrooms. Driving the freeway. Waiting to board a train. Did they all travel by train now? Had they sworn off flying, delaying meetings, putting everyone out of sorts, driving three hours to Seattle when a meeting with potential investors could not possibly be Skyped or avoided?
Two years later, two years into the downward spiral of what was supposed to be her recovery, her rebirth, Catherine Bach learned that at least one of them did. Sitting on her couch, stroking her old tabby cat Toby. And she thought: things happen for reasons. Effects are caused. And here comes a cause that she could have perhaps squinted her eyes and seen coming earlier, approaching her steadily all that time. A speck, then a shape, then a human form coming in across the waves, the beach and the dunes, through the sifting fronds of Irish beach grass. Only then a sound. Pinprick in the ear, a cascade of synthetic bells.
And now her phone ringing. Her personal cell. A number only a few people close to her knew and it wasn’t any of them calling.
It was 70F.
DIYagnosis
CATHERINE BACH WAS THIRTY-FIVE YEARS OLD when AF801 went down. In the year prior, she had managed to take a single week off, a poorly considered trip to Cabo San Lucas with a man she’d only been out with a couple of times. Liam. They shared a room, had sex once but went to sleep in separate beds. He hated the food. They broke up on the plane home, amicably enough, and she hadn’t heard from him since. Other than that, life was work. It had been a single frantic year since Catherine had stopped her practice at the clinic to plow all her still-meagre savings into DIYagnosis Personal Health Systems, a next-generation health-tracking wearable that monitored user vital signs and that would—assuming they succeeded in building and testing the various prototypes—feed back to the user a whole range of vital stats, from blood pressure to respiration rates, BMI, T-cell counts, liver enzymes.
Know your body. Change your world.
But even those weren’t the features that had insiders excited. (And they were excited. The DIY Warehouse out on Terminal Avenue behind the train station was buzzing and bouncing late into every evening: thirty-eight employees, three interns. They were all there weekends, hived off in team meetings at the whiteboard pods, playing ping-pong, huddled in twos and threes in the soundproof teepee that sat in the centre of the space.) What really had those on the inside excited were the features in development—skunkworks stuff, deep secret, need to know—that stood to completely reinvent the relationship people had with this business of their own health.
A health diagnostic wearable on steroids so you’ll never have to be.
Specifically: diagnostic modules in development that promised to read tumour markers, detect pre-cancerous tissue, early-alert risk factors for a range of disorders including diabetes, seasonal flu, malaria, meningitis, Crohn’s, hepatitis A through C, cirrhosis, encephalitis and most recently Alzheimer’s. There were molecular signatures for many of these. Ghostly geometric anomalies, mitochondrion tics and tells. And around the world physicists and molecular biologists were just now cracking these codes. Catherine’s big idea had been to bundle that knowledge, load it up directly into the body, then give the user a dashboard on which their own physiology might be monitored, read in graphics, animations and text.
Your body talks. We’ll help you listen.
“One subcutaneous chip and half these cases go away.” This was a long-time colleague back when Catherine was still working at the clinic on the Downtown Eastside. He was standing next to her behind the counter, looking out across a crowded reception area full of downcast faces, rounded shoulders—a roomful of slumped resignation, noting that the master-deficit in front of them was early information.
Catherine had just sent a patient away with abdominal pains and a referral to a GI specialist. Call it eight weeks and a cost of half a million dollars to the system by the time they were done. Prospects? Well, not great. By that point the man’s stomach was digesting itself, which was going to happen if you ate handfuls of ibuprofen morning and night—dialing down the pain from severe gout—such that you opened bleeders in your pylorus and duodenum. Catherine remembered it was a grey Vancouver day outside. There had been a freak October snowfall the night before that had melted off. The windows were steamed over. It was uncomfortably warm in the clinic but too cold outside to open the windows. Everything was humid and claustrophobically close, and Catherine saw something as clear as an actual vision in front of her: a warning light on a dashboard that that might have really helped had it lit up a few years prior.
“One chip,” the colleague continued. Harvey was his name. “Some computer somewhere. Gout isn’t exactly a stealth bomber. Uric acid. Urate crystals. Orange alert. Red alert. I mean, we’re not talking mesothelioma here. Gout pretty much announces itself. Someone should really invent something. You maybe. Weren’t you in engineering before med school?”
Of course, Harvey’s words alone hadn’t tipped the scale. There had been a sequence of steps and conversations that led to her changing first her mind and then her life. Her friend Phil, whom she’d known since university, hadn’t exactly been against it, but registered his caution when it came up. A start-up, really? Hadn’t medicine been her dream?
“Ever since your mother died,” he said.
They were sitting at a bar, as they sometimes did Thursdays after work.
“Ever since my mother died?” Catherine said, wondering if he was right. Twelve years since cancer had taken her far too early at the age of fifty-nine. Her mother’s death had been a deeper agony than Catherine could ever have imagined given the degree to which they had by that point drifted. Maybe that really had been the reason she went back to school. The motive for medicine. Saving lives. But if that was the case—and she had to acknowledge that Phil was generally right in these matters—then it motivated her now too. Knowing what the body already knows, building something that literally everybody on earth could use.
“I’m thinking big all of a sudden,” Catherine said. “I mean, what’s not to like about this idea?”
“Put it that way and I can’t think of anything,” Phil said, having listened to her speak with that wry and unflappable smile. Consigliere, she’d once called him. He’d nodded gravely, as if accepting a lifetime assignment. But the fact was he looked the part, handsome in a slightly lost way, with a round, boyish face and hair cut stubble-short to hide the male-pattern baldness. His father was Bahamian, mother English. He’d come to Vancouver to do his undergrad, then got into law school, got the articling position, got associate and then partner and never left. He said he liked Vancouver in part because people thought he was black.
“Or Libyan,” he’d once told her, early in their friendship. “I get that too.”
“Well we know you aren’t Libyan,” Catherine had said. “But wasn’t your father black?”
Sure, yeah. Maybe. Phil explained that his father had insisted until the moment of his untimely demise in a deep-sea powerboat racing accident that he was, in fact, Scottish. “That’s all he’d say,” Phil said with a characteristic shrug. “Plus he talked pretty much exactly like Sean Connery, so who was going to argue?”
Phil was, in any case, perfect for his role. He advised people. He made them aware of the legal landscapes just beyond their range of vision. He was superb at unpacking people and their problems, finding solutions that would never have occurred to clients previously. And so, as consigliere, with Catherine he had a tendency to probe, to ask his questions. How was she doing?
Oh fine. Of course she was fine. Busy as hell but wasn’t everybody? Catherine spoke with an airy nonchalance she was pretty sure Phil saw through. Of course she was nervous, but she was also excited. Phil didn’t really display either of those psychological states very often. He was himself so seemingly secure and settled with his thriving p
ractice, his big house in West Van, nearly empty since the divorce. But neither was he the sort to call her on it. That wasn’t Phil. Her consigliere segued seamlessly then, away from how she was doing and on to something he’d just read online that morning. He did this a lot. And she liked it. He curated the world for her. Articles from The Guardian, The Times, Buzzfeed Animals. Here was an interesting one. Something about how you could use the human body to make electrical power. Something about how you could turn a person’s stomach into a microbattery. It showed up on Digg.
Down in Gastown over beers. Irish pub. Ranks of colourful tap handles. Dead Frog. Four Winds. Steel and Oak. Red Arrow. Red Collar. Red Truck. Conversation roaring around them. Hops and barley in the air. Catherine was staring at Phil. Staring really hard.
“Cate,” he said. “What?”
“Battery how?” Catherine said to Phil. Her hand on his arm, nails just now biting into the silver-grey Paul Smith worsted.
How the pieces snapped together Catherine wasn’t sure she’d ever understand. All she knew for sure was that she’d mentally written her letter of resignation to the clinic by the time Phil dropped her home. Kiss on the cheek. She was so preoccupied she didn’t remember saying thanks, goodnight. However it had happened, it happened very fast. The answer to one of the questions that had been lingering since Harvey aired out his big idea about a recon drone launched into the body for the purposes of watching the shifting weather systems there.
The question was: what would the smart chip use for power?
“You swallow it.”
This was Catherine a week later talking to Yohai, a friend from her years in engineering. Yohai the wannabe rabbi-kibbutznik with his flowing beard and yarmulke, T-shirts and combat pants. Steel-framed glasses with scratched lenses. Catherine was pretty sure Yohai had never been to a synagogue, much less Israel. More crucially for her purposes, this old friend was under-plying his engineering and coding trade on a system to automate user payment on public transit. The only part of the job Yohai really seemed to enjoy was attracting attention from cranks who thought his system would be used to track people.
“Sorry, swallow what?”
It could not have pleased Catherine more to have snuck up on Yohai with this idea.
The sensor, the monitor. You could get it down to a quarter the size of an aspirin. And attached to it, at about the size of a grain of sand, a component made of copper and magnesium. “Copper, magnesium. Plus stomach acid. There’s your battery.”
Yohai thinking hard. “How do you stop it flushing out of the system?”
Exactly the right question, though here you had some highly proprietary information. The mooring technology, Catherine called it, which of course all still had to be developed and tested. But there were patents available for purchase that it seemed to Catherine had never quite been combined in the right way before.
Yohai looked dubious. “Subcutaneous would be more stable. And you could power it with a mini-cell easy, like a pacemaker.”
Sure, Catherine agreed. But then you had to cut people. Surgery would mean lower uptake. Here you had an almost invisible pill you could take with a glass of water.
Yohai staring. “Lifespan?”
Well, to be determined. But Catherine thought a year before the battery components failed and the device was naturally evacuated. Then you’d pop another pill and off you’d go.
She had him. His eyes were shining behind those glasses.
“So it gathers whatever data, then extracts.” Yohai was seeing it. He was imagining the future. “Like a wristwatch or pendant, some kind of wearable. Or a skin patch.”
Phone app, Catherine said. Device to phone. Phone uploads data to the cloud. Cloud automates reports and alerts back to users.
“Or maybe it downloads to the family doctor of record,” Yohai said. “Or to our own staff panel of experts. Customized health advice. Nano-scaled hyper-personalized health management. Grab that domain.”
He was already building the thing having heard about five minutes’ worth of the idea. And Catherine sat back and watched with real pleasure as his brain jumped gears.
A couple of months. Three maybe. To Catherine this was a blurry period, time accelerating with her thought processes. She had her meagre savings. She secured a bank line of credit and assembled patents, acquired in as stealthy and hasty a fashion as Phil could accommodate. And, most importantly, she had her team. Yohai. Designer Hapok, who’d just exited his last start-up, a nootropics play involving memory enhancement. Kalmar, fresh off the plane from San Francisco (Reykjavik before that), in Vancouver by his own account to snowboard, to mountain bike, to do the Grouse Grind and make his package.
“You say Reykjavik like that’s a qualification,” Catherine said to Yohai, when he showed her Kalmar’s CV. Who puts his picture on his CV? Like it was 1982. Brooding. Nice chin, admittedly. Something intense in the eyes. Twenty-nine years old. “And did he actually say package? He does realize nobody gets rich doing this kind of thing. He knows I’m in it for the ideals.”
“That’s not exactly motivating leadership,” Yohai said. “Just saying.”
More to the point, he noted, directing her attention down the page: database design, markets expert. Kalmar was a user-base and subscription ninja. He’d been at Hulu during the first phase of their explosive growth.
“Oooh,” Catherine said. “Why leave?”
“Videos are videos,” Yohai said. “A person’s health is on another level.”
—
Nootropics. Catherine wondered about that. Did those brain enhancements ever really work? Wasn’t gingko biloba basically a placebo?
Hapok laughed and shrugged his enormous shoulders when she asked him. He made a certain impression, this one. He brought a Vizsla named Cooper to work with him, who frequently sat in his lap during meetings. He also appeared to lift weights, and a considerable amount of them. With folded arms, his bald head and gold earring, he looked quite a bit like Mr. Clean.
“Yes and no,” Hapok said in response to the placebo question. Which seemed like the only fair answer. All four of them in the room together, finally. Her apartment on Ogden Avenue in Kitsilano. Her living room with its long view of Kitsilano Beach through the glass. A cobalt sea beyond, flecked with its countless licks of foam, soared over by screaming gulls. That was Vancouver’s English Bay, over which Catherine now briefly gazed, and on the far side of which, in the city’s West End, she’d long admired a single older apartment building, white and yellow and stately, far out of her price range but in which she imagined herself anyway. Kensington Place, it was called. It was right there on the waterfront on Beach Avenue. She could dream. And in one of those odd moments of utter stillness amid dense activity, Catherine’s eye was snagged there mid-conversation, wondering if it was herself she sketched into those wide rooms with their gleaming hardwood and carved columns, or if she merely glimpsed another version of herself, existing in parallel. Her but not her. A theoretical her, possible but only if time could be folded back onto itself, choices remade, consequences unwound, events respooled.
Yohai was pulling his beard, watching her.
She snapped back. “So…” she said. And then she was standing at the whiteboard squeezed in front of the counter in the kitchen. She’d drawn a Venn diagram with black marker, three overlapping circles, one each for Passion, Opportunity and Expertise. The little space where all three circles overlapped labelled in red: Sweet Spot.
No exaggeration. Those first months, that whole first year, they were in a zone where it seemed no new idea did not complete a straight flush. They bootstrapped a prototype for testing. They called it Red Pill 1.0. It didn’t do any of the diagnostics they were working on beyond blood type and blood pressure. No mooring tech, which was still a long way off. Call it a proto-prototype. But Yohai and Hapok mocked up an application that they loaded up on their phones. Then they all stood around in her living room and they popped those pills, they swallowed them down with tap
water. And they waited, staring at their devices. City sounds: sirens, a dog barking, a garbage truck reversing in the alley. Dumpster noise, crashing lids.
Your body is talking. Listen.
Here came the blinking lights, the alerts, phones held out in front of themselves, winking to life with a pulse of music, thrumming bass notes. “Spybreak!” From The Matrix. Nice touch.
“Okay, wow,” Catherine said, reading her screen. Blood type A positive. Pressure 135/90. High normal.
The boys were high-fiving. Kicking. Motherfucking. Ass.
“We could vencap you, like, now.” Kalmar talking, a mischievous smile flickering across his features.
She could have stopped it there. No venture capital. We bootstrap this thing. She could have turned to Kalmar and said what she’d always believed to be true and told anyone who’d listen. Investors are Plan Z.
But she didn’t say it because she enjoyed hearing the idea from her own in-house Icelandic metro-mystic. Vencap you. She would have been embarrassed for anyone to know the truth: that coming from Kalmar, the words made her proud. And he made it happen too. He knew people, it seemed. So within the month they were in front of their venture capitalist, a man out of Chicago named Morris Parmer. Wearable diagnostics, he said on that first occasion of their meeting, high over Randolph and Michigan, expansive views of the lakeshore, the Art Institute, the roll of the horizon where the city’s chilling winter winds originated. Wearable diagnostics is a hell of a growth vertical.
Catherine didn’t typically respond to praise. And she made the right reluctant noises then, gesturing to financials that proved they could see out the year, run version-two tests without additional funding, probably find their way to market with a beta and not need much help at all. During which protestations Morris listened to her alone, not even turning his head when Yohai addressed him, Hapok chiming in now too, each trying to make their separate impressions. Kalmar was silent, but every bit as much ignored.
The Rule of Stephens Page 2