—You don’t understand. I can’t salvage any of the bones—not me, not anyone else. It’s not a matter of will, and threatening me won’t change anything. I can’t “wish” his bones back together. And I can’t just make him new legs out of thin air.
—Sure you can. You wrote several papers on titanium implants and you have the highest success rate in titanium total hip replacements. You may or may not lack some of the mechanical engineering skills to create implants of this size, but we can remedy the situation with one phone call. I believe you already have all the equipment you need, but if you require anything else, I will have it flown here within the hour.
You will enjoy unlimited funding, and you may use any and all of the resources of the United States Army, the NIH, the NSF, NASA, as well as those of agencies you have never heard of. If you require anything, simply call this number and mention your name. Someone will make sure that you get all that you need. It is vital that you realize the colossal amount of resources at your disposal. I would not want this experiment to fail because you assumed certain technologies did not exist, or that certain materials were unobtainable. Right now, at this very moment, you are the most powerful person in the medical field on the planet.
—We’d have to replace every single bone in his legs. Basically, we’d be inserting whole mechanical legs inside his tissue. It’s never been done, there’s a reason for that. The human body is hostile to foreign objects. I’m not even sure we could salvage enough muscle for them to be functional, but his body would absolutely reject such a large implant. I can guarantee it. We’ll just end up killing him.
—That is precisely what I was talking about. You need to understand how much you do not know, and you need to understand it very quickly. In about twenty minutes, you will receive a call from someone at the US Army Medical Research and Materiel Command. They will provide you with a new immunosuppressive agent they have been working on. That should help him accept his new legs. They will also send a muscle-building agent that…
—I can’t inject a patient with something I know nothing about.
—It is a myostatin inhibitor, much more efficient than anything else you may have read about. I am confident it will come with some sort of label. They tell me it works wonders on mice. Do not waste precious time pretending. We both know you are as curious as I am to see it work. You will get to use experimental drugs the FDA will not even hear about for another decade.
—You obviously don’t care about my opinion, but I want to make sure you understand. He could live a very productive life with prosthetics if we amputate now.
—He will live an astoundingly productive life after you build him new legs.
—I need to think about this.
—You do not. You made up your mind about twenty seconds ago. You see, Dr. Haas, our jobs are not that different. We analyze the situation, we gather as much data as we can before we take action, and we try to anticipate every possible outcome. I did my job as thoroughly as I hope you will do yours. You gained a tremendous amount of the knowledge we are now asking you to use during two extensive studies funded with corporate money, one on tapered titanium cementless total hip replacement, and the other on tissue response in failed titanium implants. In 2006, two of the patients participating in your hip replacement study rejected their implants, one of them died of complications. Interestingly, there is absolutely no trace of these two patients in any of your grant proposals, or in any of your publications. Somehow, however, their data show up in a tissue-response study they never took part in. You switched the patients from one study to the next, as if nothing ever happened. No harm, no foul, except for a dead patient.
—That woman had a heart condition she didn’t tell me about. I would never have chosen her for this study had she not lied in her application.
—I have no doubt. Putting her in your report would not have saved her. You just made the preliminary results look this much better to the people paying for it.
More to the point, when you immigrated to this country, you also neglected to declare that you were arrested for driving under the influence. I realize it is only a misdemeanor in the United States, but it is a criminal offence where you come from.
You are egotistic enough to believe that the rules do not really apply to you, that these little white lies served a greater good, and that you were actually helping others. It is not uncommon with people of your background.
—My background?
—Raised in precarious conditions by a poor family with traditional values. First one in the family to get a college education. First to rise out of poverty. It sounds cliché, I know, but we have become very proficient at this sort of profiling. One thing is certain: you are a survivor, Dr. Haas. You are definitely not one to throw away your life, your family, and your career for something as petty as principles.
When you leave this room, you will make sure that enough of the remaining living tissue in Mr. Couture’s legs is preserved while you construct his new bones.
—If we do this, and by some miracle it works, I can guarantee he’ll wish he had died on the operating table. He’ll beg for us to end his life. You simply can’t imagine the amount of pain he’ll have to suffer. Every minute of every day will be the worst of his life. Will you be the one to tell him that?
—I would rather not. That is a horrible thing to tell anyone, especially before life-threatening reconstructive surgery. Will he suffer any less if we tell him that he will?
—No. He’ll go through hell no matter what; if he doesn’t die first.
—Then I see no reason to tell. I want him in as good a mental state as humanly possible. I want you to tell him everything will be fine.
—I want the record to show that this procedure is being done against medical advice and that I am participating under duress.
—I am recording this conversation so anything we have said so far is on the recording. You may call this a record, if you wish. If you were referring to the hospital records, then no. This is your idea and yours alone. You are performing this surgery because you firmly believe this is the best solution for your patient and you have every confidence in its success. There will be no reference to this conversation, in any form, whatsoever. Let me be abundantly clear on this. Any mention of my presence, of my very existence, to anyone, will have dire consequences for both you and your loved ones.
—What kind of consequences?
—I have not yet had time to ponder an appropriate response, but I can guarantee that you will never see your children again, even if the operation is successful.
—What if it isn’t?
—Then you will almost certainly lose your medical license.
—No. I won’t say anything. But what if the patient doesn’t survive? What are you threatening me with?
—Why would I threaten you if you do exactly as I ask? I am not evil, Dr. Haas. That said, you will most likely lose your medical license, along with your house, your car, and everything you own. I would expect some jail time. You are about to perform absurdly complex, insanely risky, and completely unnecessary experimental surgery on a stable patient without his knowledge or consent. What do you think will happen if he dies?
Before you go, I also want you to take a look at these designs. You will need to integrate them into your leg structure.
—What are they?
—Knees.
—I’m not a mechanical engineer, but it looks like they…
—Yes, Dr. Haas. They do.
FILE NO. 126
INTERVIEW WITH ALYSSA PAPANTONIOU, PH.D., GENETICIST
Location: Denver Public Library, Civic Center Park, Denver, CO
—It is an interesting accent you have, Ms. Papantoniou. Is that from the Balkans?
—Yes, most of Greece is in the Balkans.
—You must be from a region I have not visited. It is very unique.
—Thank you. I’m curious to know why we’re meeting at the p…public library. I’m sor
ry. I get nervous when I t…talk to people.
—There is no need to apologize. I did not want us to be disturbed. It is a pleasure to make your acquaintance.
—The pleasure is mine. What did you want to di…discuss?
—It has come to my attention that you disapprove of the direction this project is taking. I would be remiss if I did not take such complaint seriously, especially coming from someone of your intelligence.
—Thank you very much. I didn’t mean to go over your h…head.
—So it was an accident?
—I…
—It does not matter. Now, tell me, what is it that you find so objectionable in the way that Dr. Franklin is leading her team?
—I have all the respect in the world for Dr. Franklin. She is a very good physicist.
—But?
—But she does make mistakes. She’s not as…she’s not as brilliant as you think she is. I often find it necessary to d…double-check her calculations.
—I am certain she appreciates.
—More than anything, Dr. Franklin is too…fragile. She lets her feelings for the members of her team cloud her judgment. She treats Kara and Vincent as if they were her ch…children. Kara is a stubborn, unyielding person, and I feel it is…irresponsible to rely entirely on her good will for this project to move f…forward. I have requested, on several occasions, that she submit to a series of tests to determine why the helmet will only activate for her, and Dr. Franklin has systematically refused.
—Is that statement really accurate? I was told that Ms. Resnik submitted a saliva sample and that you performed an analysis of that sample. In fact, I remember seeing a report in which you conclude that there is nothing out of the ordinary about her genetics.
—I did perform some genetic and biochemical tests and found no chromosomal anomalies, nor any obvious mutation. But there are a lot more tests, mitochondrial analysis. I haven’t even done a full genome sequencing. I could study her brain structure, her eyes might also be the answer.
—Dr. Franklin also performed a retina scan if I am not mistaken.
—I meant that I could study a sample of her eye, not a picture of it.
—Could these other procedures wait until we have recovered all the pieces from the robot, and solved our more immediate problems?
—You don’t understand. It’s not just Kara. We can’t…we can’t move forward without Vincent now. What if he doesn’t survive? What if he can’t w…walk again? Understanding why the helmet worked for Kara might be the key to replacing Vincent as well.
With all due respect, there is too much at stake here to worry about personal feelings, or some mild dis…comfort while I insert a needle into someone’s eye. I thought you of all people…
—You thought I of all people?
—I thought you were…pragmatic, that you understood what needed to be done. Maybe you’ve also become emotionally attached.
—Are you questioning my judgment?
—Let me ask you this. If we needed dogs, and not humans, to control this machine, would we not already have a dozen pu…puppies to spare?
—Puppies…I find the question is a lot more interesting than any answer I could provide. But I thank you for shedding new light on the situation. I have found your comments both insightful and interesting and, I promise you, I will take everything you said under advisement.
—Thank you. That’s all I ask.
—Good day, Ms. Papantoniou.
FILE NO. 129
INTERVIEW WITH ROBERT WOODHULL, ASSISTANT TO THE PRESIDENT FOR NATIONAL SECURITY AFFAIRS
Location: White House, Washington, DC
—What can I do for you, Robert?
—SecDef has moved us to DEFCON 3.
—The Russians?
—Amongst others. The Chinese spotted us leaving their territory. They’ve lodged a formal complaint with the UN.
—Since when do you care about the UN?
—I couldn’t care less about the UN, but the Russians were all ears. They put two and two together very quickly. They still don’t know what we’re after, but they know it’s not just some ancient artifact, if we’re willing to enter every country uninvited to get it. The Turkish government also made your little visit known to the Russians, which didn’t do anything to help.
They are now blaming us, officially that is, for the death of their soldiers in Siberia. They are calling our little incursion a deliberate act of provocation. The Russian ambassador left for Moscow about an hour ago. They’re cleaning out the embassy as we speak. You can almost hear the shredders all the way down here. It’s only a matter of time before China follows suit.
—Have they increased their military readiness?
—You could call it that. In the past three hours, we’ve seen more naval activity out of Russia than we have since the Cuban Missile Crisis. The entire Northern Fleet is on alert, so is most of the Pacific Fleet from what we can tell. There are over one hundred ships operating in the North Atlantic alone.
—Submarines?
—The Severodvinsk set to sea this morning along with two Borei-class subs. The White Sea Base looks like it was abandoned. There are five Delta-IVs roaming around, just as many Delta-IIIs, even their big old Typhoon. Basically, everything with a nuke that is seaworthy is now out there. We haven’t seen any unusual action on the Chinese side, but I wouldn’t be surprised if they sent out part of their fleet as well.
—They are bluffing. You know that.
—So are we. Bluffing doesn’t mean what it used to. No one wants an all-out war, and everyone knows it. Both sides know the other doesn’t want a fight, so we push each other against the wall, a tiny bit further every time. It’s all about saving face but, basically, we’re playing chicken, and both sides think that they can do whatever they want because the other guy will never use its nuclear arsenal. It probably won’t be today, but someday…someday one of us is gonna be terribly wrong.
We’ve deployed our attack subs, of course. If China steps in, we’ll send even more ships to go against their ships. Our aircraft carriers are already on full alert. If we send them out anywhere in the general direction of Asia, they’re gonna launch everything they have and send it our way. You can see where this is going.
Nothing good has ever come of a naval standoff. I know it looks big on the map, but an ocean can get crowded real fast, and I sure as hell don’t like putting my fate in the hands of a dozen half-blind sub captains trying not to bump into anything.
—Do we really need to always respond in kind? Could we not simply do nothing and let the Russians posture for a few days? I never understood the merits of proportional response.
—I’m not sure there are any. It’s just what we call human nature for people with too much firepower in their hands. Ever been in a bar fight?
—I assume this is a rhetorical question.
—Well, that’s how it starts. You bump into someone, make them spill their drink. They yell at you and push you away. You pretend that you apologized while you poke at their chest. Everybody “proportionally responds” until someone gets their teeth knocked out. No one really wants to fight, but no one wants to be the one to back off either. It’s a hundred times worse with military men, and a hundred times more so with politicians.
So we’re gonna do our thing, they’re gonna do their thing, and if we’re really lucky we won’t send twenty million people to their deaths in the process.
—We were all aware of the risks when we agreed on this course of action.
—That’s a bit…That’s a pretty distorted way of looking at the situation, don’t you think?
—How so?
—We didn’t exactly agree on anything. You presented us with a fait accoupli. You told us what you were doing after the fact and you threatened…
—Accompli.
—What?
—The expression is: a fait accompli. It means done deed. Accoupli is not even a word. I never understood why people use words they
do not understand.
I made my intentions abundantly clear when I asked for your assistance. You chose to help. You did not have to supply troops. You could have said no. You also had the means to stop me at any time. You could, at any point, have had me and every member of my team arrested, imprisoned, or even killed. Had you said nothing, it would have been the perfect example of a tacit agreement, but you went farther and you set out certain conditions, under which I would have “the full support of this administration.” I can understand your desire to distance yourself from this decision, given the current state of affairs, but you did make a choice. That choice will not cease to be yours because a lot of people might die as a result.
—What about you? You’re fine with that? The end justifies the means, is that it?
—You make it sound as if I were irrational. Yes. I do think this particular end justifies considerable means. I draw the line somewhere, like everyone else. I just draw it based on reason and not emotions.
—So you’d let a few hundred people die? Would you stop for a thousand? How many lives are you willing to sacrifice for this? A million?
—Certainly not. But a thousand seems like a reasonable figure.
—You’re an asshole, you know that? Isn’t that just a bit arbitrary?
—Of course it is. Most things are. Eight people died while we raced the Soviets to the moon. Another fourteen lost their lives in the Challenger and Columbia accidents, and yet the space program is still around. Space exploration is important enough to justify the death of twenty-two people. Had 22,000 people died, things might have been different.
We lost about three hundred soldiers liberating Kuwait. Most would think that was reasonable. Over four thousand Americans died in Iraq. Some might say it was too high a price to get rid of Saddam Hussein, some might not. Obviously, the Administration thought that it was worth it at the time.
Over twenty million soldiers died during World War II. Twenty million, in the military alone. There had to be a lot of people who believed that their particular end justified some unfathomable means.
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