Exoteric

by Philip Hemplow

  At eleven o’clock, Galina went outside for a last cigarette before the surgery commenced. Arkady and her stepbrother waited for her, standing by the ice-smeared observation window, not talking. The corpse and the operating table were just about discernible on the other side, covered by a veil of feathery snow. Like a tray of meat shoved in a freezer, thought Arkady, suddenly glad that Ana had been cremated.

  “I will go in and wipe the cameras,” announced Arkady as Galina returned, blowing on her hands. “Are you both ready?”

  “Very good,” agreed Zapad. “Please put the screens in position also. We will test the equipment when you come out. It would not do to injure you with a careless scalpel swipe!”

  “One thing I dislike about telesurgery: it feels odd not scrubbing up,” complained Galina, resting her hands on a radiator to take the chill off them. “Hard to relax without the ritual.”

  Her voice betrayed no anxiety. In fact, she seemed an altogether different woman to the belligerent drunk of the night before. Her speech was brisk and clipped, her manner archly professional. Arkady found his doubts about her subsiding.

  He pulled on his coat, gloves, scarf, and snow boots, and braced himself for the cold of the calorimeter. Minus forty degrees, where Fahrenheit and centigrade became interchangeable: cold, even for Siberia, and as close to the temperature inside Molchanov’s cryostat as Arkady ever hoped to get. At least he would only be in there a few seconds.

  He buttoned the coat and pulled his woollen hat down as far as it would go, then signalled to Zapad that he was ready. The doctor mashed the green-lit button next to the door.

  It slid open with a sticky crackle from the airtight, rubber seals. Frozen air gushed out in a prolonged gasp, numbing Arkady’s face in an instant, and driving a convulsive shudder through his body. He stepped forward without giving himself time to think, and the door slid closed behind him.

  The room was dim, recessed ceiling lights providing only faint, ambient light. He could feel ice crystals forming in his nose when he inhaled, a crackle on his eyeballs as moisture there began to freeze. He blinked to clear them, and lurched forwards, towards the body on the table, wisps of breath trailing in mid-air behind him.

  The dead man’s raw ulcers had turned glassy in the cold. Tiny spikes of ice had formed on his bare skin, speckling his beard and hair with white. His eyelids were still dark, though, a sullen grey-red the same shade as the exposed muscle along his jawline. Someone—Galina or Zapad, presumably—had shaved his chest. Jesus, thought Arkady, what a way to go. What a waste. Suddenly he wanted to know more about the youngster: about how he had found his way to that place, that table. What had Zolin promised him for the right to plunder his remains? Money for his family? A pardon for some inmate relative or girlfriend, perhaps? Actually, Arkady decided, he didn’t want to know. There was no answer that could make it entirely right.

  The robot surgeon was already poised, ready to begin clawing and sawing. Four sturdy telescopic arms branched into clusters of gleaming instruments: blades, retractors, manipulators, suction tubes, and cauterising lasers—but mainly blades. The bulk of the thing, its arms and joints, were sheathed in white plastic and wrapped in transparent polythene to protect it from splatter. Only its weaponry protruded, ready to tear apart whatever was placed in front of it.

  A camera mast craned over the surgical equipment, like a rubbernecking spectator hoping for a better look. Spotlights and lenses of various apertures and focal lengths peered down, sparkling with ice. Arkady reached up and jabbed one of them with a shivering finger. Its delicate crust of frozen condensation shattered with a minute tinkle. A quick swipe around the perimeter and the lens was clear. He moved onto the next one, then the others, giving them all a final polish with the tip of his glove.

  He could already feel the saliva freezing on his lips. Breathing was painful, the air still well below zero when it reached his lungs. His eyes were drying out, the exposed skin around them raw and aching, and his lashes clung together when he blinked, making it difficult to see. He wasn’t properly dressed for such conditions. It was time to get out of there. Moving as quickly as he could, he pulled the wheeled screens into position around the table to contain any aerosolised tissue, and bolted for the door.

  By the time it opened again and he stumbled out, he’d been in the room for less than a minute. Even so, his teeth chattered uncontrollably, and his face and legs prickled and burned in the warmth. Next time, he promised himself, someone else could be on lens cleaning duty.

  Zapad called his thanks from the monitoring station around the corner, and pronounced the images stacked on-screen “crystal clear.” Arkady grunted an acknowledgement and went in search of a hot drink.

  “You must be a hot-blooded man, Colonel!” said Zapad, when he got back. “You have warmed up the room. It is not quite cold again yet. One degree left to go.”

  “Does it matter?” complained Arkady. “One degree doesn’t matter, surely? It’s getting late. Come on, let’s get this over with.”

  “The good news is that the equipment all works,” continued the doctor, as if Arkady hadn’t spoken. “Someone will need to take the heart in once we are ready to implant. It will be thoroughly suffused with ‘M22-plus’ by then, and able to remain viable in the operating chamber. We are lucky, in some ways: no need to worry about anaesthesia, and little chance of blood loss at these temperatures. Of course, the cutting will be harder than normal, but nothing the robotics can’t handle. Yes, there are definitely advantages to operating in these conditions.”

  He seemed to be talking mostly for his own benefit and reassurance. Arkady sipped his coffee and told himself to relax. The two doctors knew what they were doing—or at least had a better idea than he did. Besides, it was just the dress rehearsal. It didn’t matter if things went wrong. The man on the table couldn’t get any deader.

  Galina was sat at the monitoring station now. All the equipment had been installed on tables dragged through from the cafeteria, some of which looked to be sagging under the weight of electronics. Wiring piled up in huge coils on the floor, disappearing through the holes Votyakov’s men had drilled in the wall of the calorimeter. A central, hooded display was surrounded by other monitors of various sizes, displaying footage from inside the chamber. The surgeon herself was wearing a virtual reality headset that gave her a disconcertingly insectile appearance. In each hand she gripped a control-and-feedback yoke, as if preparing to wrestle for control of a kite.

  “Impressive, isn’t it?” she said, turning the bulbous, black goggles towards him.

  Arkady cleared his throat. “Yes, very. Looks expensive,” he said, wondering whether she could actually see him from behind the giant visor. Perhaps it had an external camera feed or something. He decided to assume it did.

  “Oh, very expensive,” she assured him. “State of the art. I’ve used the older model by this manufacturer, but this one is brand new this year; I assume the girl upstairs paid for it. I hope you’ll find it a good home once we’re done with it. Most hospitals cannot afford this kind of thing.”

  “I’m sure we will,” he assured her. “So, are you ready to begin?”

  She flicked a succession of fingertip controls in answer, and the mast-mounted lights in the calorimeter flared. More button presses, and the surgical array pitched forwards toward the cadaver, scalpels and saws extending like antennae. “Ready whenever you are. Where’s Roman?”

  “I’m here,” called her stepbrother, bustling back into the hub. “Sorry. I left my glasses in the bathroom. You have the protocol up? Okay, good. Well, it’s”—he checked his watch—“sixteen minutes past eleven. When you’re ready, we can proceed with the initial incision.”

  Galina shuffled in her seat, rolled her shoulders, and nodded. “Very well. Tracing median inline incision—cutting now.”

  In the next room, a scalpel darted into the base of the dead man’s throat and began ripping him open.

  *

  “Getting a lot of
feedback. This is a damned tough steak you’ve brought us, Agent.”

  There was no trace of humour in the surgeon’s voice. She controlled the operation with expert twitches of the two control yokes, sat hunched forwards as if that would bring her closer to the 3D image on her goggles. Zapad hovered nearby, fidgeting. Arkady could tell he was biting his tongue, fighting the temptation to keep up a running commentary on proceedings.

  Arkady half-sat on the back of a chair, wincing as his sciatica flared. His position against the opposite wall of the corridor enabled him to see both what the doctors were doing, and the ice-fogged windows of the calorimeter. The gory, mechanical mayhem beyond was silhouetted against the curtains round the operating table, a shadow play of plunging instruments and moving lights, suggestive and indistinct. Details could be seen on the monitors around Galina’s workstation: close-ups of the livid, purple incision running down the corpse’s chest; puffs of powdered bone as the electric sternotomy saw carved through exposed breastbone; the hooks which cradled and lifted the dead man’s ribs, exposing deflated lungs and a dull, triangular slab of pericardium.

  He looked away, perturbed by the efficiency with which their machinery rifled the corpse. There was no audio feed, which made the spectacle seem somehow eerier, and left him free to imagine his own soundtrack of buzzing blades and gnashing, mechanical teeth. He had seen worse—had inflicted worse—but the camera’s unflinching salacity gave the on-screen events a sense of deliberate desecration—of defilement.

  He turned back in time to see a five-fingered manipulator arm pull the dead boy’s heart from his chest.

  “We’ve got it,” declared Galina, rotating it slowly in front of the lenses. “Looks to be in good condition. Shame we can’t use it, really.”

  “Excellent work!” enthused her stepbrother. “You haven’t lost your touch!”

  “Well, you said yourself that working on a specimen is easier than dealing with a live patient. Still—so far, so good. Is someone going to take the replacement in?”

  Zapad turned and looked at Arkady, who gave a weary nod and began buttoning his coat again.

  “Thank you. There is room for it on the cart near his head. Just put it down there and open the box.”

  He opened a small, glass-fronted freezer plastered with chemical and biological warning decals, and from it retrieved a square, polystyrene box. Arkady tugged his coat straight, pulled down his hat, and took it. Something inside the box sloshed around, and he stood still, waiting for it to settle, and for Zapad to push the button which opened the calorimeter door.

  The door hissed open and cold enveloped him again. Squinting, Arkady stepped forward, holding the box in front of him like a votive offering. The icy air was rich with a heavy, offal aroma now, and when he inhaled he could feel his gorge rise. He tried to hold his breath as he crossed to the table and moved one of the screens aside.

  Beyond the curtains lay carnage. Surgical tools coated in black, jellified gore pointed at the cadaver’s ransacked chest like a firing squad. Rubber-tipped, steel fingers raised the excavated heart like a trophy, sticky with congealed blood which trailed back to the dark grotto between those jutting, gaping ribs.

  As Zapad had said, there was a small trolley-table next to the surgical apparatus by the dead man’s head. Arkady set the polystyrene box down on it and jiggled the lid until it came free. A puff of steam emerged when he lifted it, as the vapour trapped inside began instantly to condense.

  Within it, the pig’s heart, sterilised and rinsed clean of blood, lay steeping in a glossy, clear solution. It was a vivid, raw purple, marbled with fat, a spider’s web of frost already spreading across its surface where it protruded from the protectant liquor. It looked rubbery, its neatly severed veins and arteries gaping like a cluster of tubeworms. Arkady couldn’t help comparing it to the one sagging from the robot’s claw. It looked plumper, and was cleaner, but he failed to discern any obvious structural difference.

  The robot arm suddenly jerked to life with a high-pitched, mechanical whine, making him jump and inadvertently gulp the freezing, stinking air. It spun towards him, rotated, and deposited the old heart on the upturned lid of the polystyrene box. He heard Galina’s voice boom from a speaker hidden somewhere about the equipment’s base.

  “Bring that one back out, will you? Thanks.”

  The claw reached into the box itself and extricated the pig’s heart. With one smooth, whirring movement it swept it away, dripping preservative tears, and began orientating it above the vacant site in the corpse’s chest.

  Arkady eyed the lump of gristle it had left behind. Its valves were plugged by blood clots, exuding dark, slimy mucous that dribbled on the waxy polystyrene. Lifting the lid, he inclined it until the heart rolled back into the soup of ‘M22-plus’, then squeezed the two halves of the box back together. Trying to ignore the weight of the heart rolling around inside, he tucked it under his arm and moved the screens back into place.

  By the time he reached the door again, his eardrums and parotid glands ached with cold. Emerging, he stamped his feet, trying to encourage the blood back into his toes. He wanted to rinse his mouth and spit, to rid it of the lingering sense of contamination the air in the chamber had left him with.

  “I’m not going in there again,” he announced. “Someone else can go in next time. Here: his heart. Where do you want it?”

  “Thank you, Agent. There should be no need to go in again,” said Zapad, smiling and holding out his hands to receive the box. “I will take that.”

  “What happens to it now?” asked Arkady, pulling off his gloves and blowing on his fingers to warm them. “Do you incinerate it?”

  “We will keep it safe, so it can be interred with the rest of him. He has donated his body to science. We must respect that sacrifice. It will be handed to the undertaker or his next of kin, once we are finished here.”

  “I see.”

  If Zolin decided to put a lid on their activities, Arkady knew the dead man’s remains would vanish along with any other evidence of what had transpired. In the twilight world of parapolitics, medical ethics, indeed ethics in general, were very much a secondary consideration. There was no need to advise the doctor of that though; no point in encouraging him to ponder what else might be swept under the rug.

  “I’m going to begin by connecting the atrial and pulmonary trunks,” said Galina, flicking an array of fingertip switches. “I want to hook up as much as we can before fixing it in place. Going to have to improvise in a few places. It’s not ideal.”

  “Is something wrong?” Arkady forgot about his cold fingers and aching sinuses. He moved to stand behind her, staring at the glistening, overexposed images on the monitors as if he could tell what he was looking at.

  “What’s wrong is that we’re using a pig’s heart, Agent. Pigs aren’t people—though, with some people, that distinction isn’t as clear as it could be. Pigs spend their lives on all fours, and their hearts are orientated along that axis, not vertically. Their venous and arterial connections are laid out differently, so the plumbing doesn’t map exactly. Cardiac output and central venous pressure are about double those of a human, too.”

  “Right.”

  “Don’t worry; it won’t be an issue with the real thing. Tonight, we’re just playing with pork.”

  She tweaked her controls and laid hold of a pair of blood vessels with the suite’s micromanipulators, humming as she tugged them into conjunction.

  It was the most amiable and relaxed Arkady had seen her. Calm, professional, authoritative: she seemed to have little in common with the combative drunk of the night before, or the taciturn addict she at other times resembled. For a moment, he wondered if she had sneaked some opiates from the drug supply, but discarded the notion. There was nothing in her manner to suggest she was high—just oddly happy. Arkady had administered enough battlefield morphine to know the difference.

  “You enjoy surgery?” he asked her, watching the screens as a mechanical spinneret spra
yed thermomorphic polymer around the seam between human tissue and pig.

  She didn’t answer at once, and after a few seconds he assumed she wasn’t going to. Perhaps she was unwilling to examine her contentedness, and thereby risk destroying it.

  “I enjoy work,” she said at last. “It feels good to be doing something again, something I’m good at. It feels good to be the doctor again, instead of the patient. Is that wrong?”

  “Not at all. On the contrary, it’s good to see.”

  A tiny suturing tool machine-gunned stitches into the anastomosis, working with a speed and delicacy no human surgeon could match. Galina guided it with minute movements of her fingertip, tongue protruding slightly as she stared into the nowhere of her virtual reality display.

  “She is a fine surgeon,” said Zapad, his tone proud but slightly defensive as he moved to stand at her shoulder. “Wonderful hands. As a small girl, she used to produce the most exquisite embroidery. Didn’t you, Galina?”

  “Shut up, Roman,” said his stepsister, affably enough.

  It was past one a.m. by the time she finished working on the heart and began closing up the cadaver. The ribs were lowered back into place, and a helix of steel wire was threaded painstakingly between them, then drawn tight to hold the two halves together. The suturing tool repaired the initial incision, tattooing the dead man from navel to throat, and it was done.

  Galina removed the headset with an exaggerated sigh. Her hair, normally a mane-like nimbus of curls, failed to spring back into shape. She shook it with her fingers until it regained a semblance of its usual volume, and stood up.

  “You boys can finish up here. I’m having a drink.”

  “Of course. You go. Both of you, go.” Zapad started chivvying them toward the clinic’s exit. “I will switch off the equipment and refrigeration. Perhaps in the morning your men could help transfer the test materials to the mortuary, Agent.”