I, Robot To Protect

by Mickey Zucker Reichert

  “I know that.”

  Susan thought she detected some defensive anger. This was not going to go well.

  “I’m a tool, created to perform a service, like an MRI scanner. My work is inside the hospital. I’m not comfortable outside; and, worse, people are not comfortable with me.”

  “I am.”

  Nate grinned. “And I’m so glad you are.”

  Susan intervened. It was easy to forget Nate had no actual training when it came to handling children or psychiatric cases. “Monterey, visiting Nate is a special reward you’ll get when you work hard at getting back to a normal life. We need to work on your relationship with your mother.”

  Monterey froze in place. Sharicka stared at her, as if hypnotized by what the older girl might do next. Susan suspected she might actually lapse back into silence or, perhaps, fling an explosive temper tantrum. It surprised Susan to realize that she preferred the latter. In Monterey’s case, it seemed the healthier response.

  But Monterey only turned Susan a partially suppressed smile. “I have to learn to sass her and slam doors?”

  Susan could not help laughing as the words of their first meeting came back to haunt her. “You were listening.” That boded well. If Monterey had not completely shut out the world during her extended silences, she might have matured mentally during her six years of self-imposed isolation.

  The girls spent the next hour romping with Nate and plying him with questions. The interaction amazed Susan, even though she knew how much like a normal human Nate generally acted. He could easily have passed for their uncle, tirelessly providing them with horseback rides, startling them with a sudden ankle-grab that sent them tumbling, or allowing them to catch their breath in the crook of his all-too-human lap. Had Susan not kept reminding herself, she would have forgotten he had no childhood of his own, that he never aged, that he had no precedent on which to base his play and answers other than what he had read or watched. According to her father, the programming for positronic brains was minimal, a language chip, the Three Laws, and a basic idea of primary function. All else came to Nate from personal learning.

  The hour ended too soon for everyone. Susan had a scheduled meeting with Goldman and Peters, and she wanted to make sure she handled any potential issues on the PIPU before she left. Better to address things that might never need her input than to leave them festering and risk getting called away. “All right. Fun time’s over. We need to get back to the unit.”

  The girls made loud, disappointed noises.

  Susan explained without apology. “Nate needs to go back to work, so he doesn’t get in trouble.” She suspected assisting a doctor with two psychiatric patients counted as part of his job, but the girls did not need to know that. An hour of playtime with two unrelated youngsters was enough for any adult. “And we need to get back to the unit before your nurses and parents start worrying I kidnapped you.”

  “No one will miss me,” Sharicka said, almost proudly. “I could stay all day.”

  Susan ushered the girls toward the door. “That won’t work for the rest of us.” She opened the door and gestured them through it, watching Sharicka closely, still worried the child might try to break for freedom. Without taking her eyes from the girl, she threw a friendly wave back over her shoulder toward Nate. She would get together with him later to compare notes; but, for now, she dared not remove her gaze from Sharicka.

  Monterey fairly skipped the whole way back, though she lapsed into silence. Sharicka took the same dense interest in everything she had on the way to Nate. She studied the details of the walls and floors, the locks and keys, with a fanaticism that bothered Susan, though she could not quite say why. In the end, both of the girls hugged and thanked her, then trotted off together to the television room.

  When the nurses pressed her, Susan had to admit the whole affair had gone off well.

  When Susan arrived at room 713 on the seventh floor of Hassenfeld Research Tower, she found Ari Goldman pacing furiously between the metal desks and his own, clutching a pencil in his hand, the eraser savagely chewed. The willowy Cody Peters sat in one of the chairs, head clamped beneath his long arms. They both looked up as Susan entered, and Ari stopped in his tracks. “He’s not here,” he grumped.

  Susan let the door spring closed behind her with a faint whoosh. Having no idea what Ari meant, she glanced at Cody, whose presence was obvious. “Who’s not here?” Alarm trickled through her. Is he upset about Nate? Was he supposed to be here instead of cavorting with my patients?

  Cody’s answer put her mind at ease for a moment. “Payton Flowers. Our first subject.”

  Discomfort flared anew. “The schizophrenic patient?” Susan remembered his parents’ anguish at losing their brilliant future attorney to madness. She knew every subject had a check-in routine, but she did not know all the details. Goldman and Peters involved her as much as possible but tried to accommodate her ward schedule as well.

  Cody explained, “He was supposed to be here an hour ago. We called his family. They don’t know where he’s gone, either. He took off during the night, apparently.”

  Susan could feel her heart hammering in her chest. A man with schizophrenia wandering off was not usually a frightening or terrifying event. People with psychoses who took their medicines as prescribed posed no threat, and even those who skipped doses or went undiagnosed rarely caused problems that required concern. The media played up those one-in-a-hundred-thousand cases where a patient with paranoid schizophrenia murdered someone he mistook for the devil.

  Ari explained, “If something bad happens to him, or anyone around him, we’ll have a hell of a time keeping the study quiet. And once it’s out, everyone will blame the nanorobots rather than the disease.”

  Susan could not argue. Once someone posted an accusation, no matter how false or corrupted, others with an agenda would cling to it even after its debunking. Cody shook his head, turned his gaze to Susan, and rolled his eyes. “Nothing bad is going to happen just because a man who happens to have schizophrenia decides to lose himself for a day or two.”

  Ari growled something wordless. He cleared his throat and spoke again. “Why did it have to be our man with schizophrenia? We should have admitted him for the week.”

  Cody heaved a deep sigh. “Were you planning to pay for weeklong hospital stays for all our study patients out of your own pocket? Or do you have some magic words to allow them to stay for free?” He shook his head. “And how many of our patients would willingly allow us to coop them up? Would you hold them against their will?”

  Ari had no answers. He continued to grumble to himself but did not speak aloud again.

  Uncertain what to say, Susan shuffled her feet. She could understand Ari’s concerns. Although Cody made sense and spoke the truth, she could not throw off a vague feeling of dread. Her thoughts went back to the protestor. He had known about the study and her role in it, which meant the study was not wholly secret. She could not imagine him snatching a grown man from his bed, but coincidences did not sit well in those circumstances. “Is there anything I can do?”

  Cody winced and glanced at Ari. He clearly did not want to speak of anything negative with his partner already in a snit. “We had another patient for you to inject, but he backed out. We’re scraping the bottom of the barrel for possible replacements. Do you have any suggestions?”

  Susan shrugged. “I’m the wrong person to ask. It’s my first rotation, and I’m on the PIPU. I’m only working with children.”

  Ari said softly, “We’re cleared for children.”

  That surprised Susan. She had little knowledge of research, but she had always heard safety and efficacy had to be proven on adults before the administration allowed children to participate.

  Cody nodded. “Special exemption for time and need.” He did not go into details, which relieved Susan. She did not need to hear a recitation of hundreds of rules governing medical research. These two knew them backward and forward. If they said children could pa
rticipate, it was the truth.

  “Hmm.” Susan considered the possibilities. “Let me think about it for a bit, and I’ll get back to you.”

  “Sooner is better than later,” Ari said. “The quicker we finish and get the data out there, the less chance the SFH has to interfere.”

  Susan would have liked to wait until she found Ari Goldman in a better mood, but she realized not speaking now would make it look as if she had hidden something later. “You should know I got accosted on the way into work this morning. Nothing violent or dangerous, but this man knew enough about the study to call it” — she tried to remember his exact words — “‘making cyborgs from mental patients.’ And he warned me to ‘get out.’ ”

  Now, even Cody’s smile vanished. “Did he say why? Did he threaten anything?”

  “No,” Susan said. “They trained us to ignore protestors, and I disengaged as quickly as I could.”

  “Good job,” Cody said, arousing a pang of guilt. Susan could not help remembering her first day and the conversation she had held with one of those protestors. She shook away the thought with the knowledge that the conversation had had nothing to do with robots or research. At the time, she did not even know the study existed.

  Ari’s frown deepened. It seemed to permanently score his aging features. “Making cyborgs from mental patients. Now I’ve heard everything.”

  “Oh, I’m sure I could say a few things you haven’t heard yet,” Cody teased his partner, running a hand through his unkempt hair and leaving it mostly standing on end.

  Ari ignored the taller, leaner man. “But wouldn’t it be cool if we had that technology?”

  Cody shrugged. “We do, depending on how you define ‘cyborg.’ There are people with functioning, robotic limbs with neural connections.”

  Ari dismissed him with a brusque wave. “I mean mental cyborgs. Positronic brains in human bodies. Toss out the old, malfunctioning head and replace it with working wire coils that can think and learn.”

  The thought seemed chilling to Susan, and Cody must have had a similar instinct. “Don’t say that where the Society for Humanity can hear you. They’d have a field day.” He rolled his gaze toward Susan again, indicating with a glance not to take certain musings of Dr. Ari Goldman seriously. “Isn’t it the intellect that makes the man? I mean, somewhere, there are freezers full of cryogenically frozen heads waiting for replacement bodies.”

  “Where?”

  “I don’t know. I thought I read that somewhere.”

  Ari defended his idea. “I’m not really suggesting we toss some human’s thinker into the garbage and put Nate’s in. I’m just saying we might replace a section of brain, say after an accident or stroke, with positronic circuitry. If we can map the brain down to the molecular level, perhaps we could replace a misfiring synapse or two and cure all mental illnesses.” He gave Cody a pointed look that probably passed for return humor. “Maybe even your arachnophobia.”

  “Hey! That’s a carefully guarded secret.”

  Both men looked at Susan, who made a zipper motion across her lips.

  The casual speculation convinced Susan her encounter with the protestor would neither get her banned from the study nor essentially killed, as Dr. Bainbridge had suggested in his initial lecture to all of the incoming residents. “If you don’t need me for anything today, I’m going back to the PIPU.”

  Ari waved a gruff good-bye. Cody shrugged. “Without Payton Flowers, or the newest patient, your schedule has completely opened. We’ll call you if anything else comes up.”

  That suited Susan just fine. She turned to leave.

  “Oh,” Ari added, “I’m serious about letting us know if you find another subject. Someone desperate with nothing to lose.”

  “Desperate with nothing to lose.” The phrase hung with Susan long after she left Hassenfeld Research Tower and headed back toward the unit. She could see how that phrase would make people worry about becoming a part of the study, but she also knew anything new and different required such a warning. In some ways, it harmed the research process, because medications and procedures that might help people in mild circumstances seldom got tested. In other ways, it helped, because it ensured that any new medication or procedure had to work on even the most extreme cases to get notice and approval.

  Susan realized if they had asked her the first day for patient suggestions, Monterey would probably have nanorobots circulating through her cerebrospinal fluid right now. The breakthrough with Nate had made even the controversial electroconvulsive therapy unnecessary. She wondered how the protestors would feel when the hospital and mother gave up the battle. Would they use Monterey’s improvement without ECT as an I-told-you-so victory for their agenda, or would the loss of a rallying point disappoint them? Would they savor their win and head for home, or would they channel their energy into a new cause, energized by their success?

  Susan shook those thoughts aside. She had no real interest in the political aspects of medicine, other than simple curiosity. Her job was to see the patients, diagnose them, and make them better, to ease the burden on the children and parents in her charge. The journalists, protestors, and politicians could go to hell for all she cared. They mostly just got in the way of the practice of competent, proper medicine.

  As Susan trotted down toward the bowels of the hospital, she studied her Vox to make certain she had not missed any pages or messages. Only one flashed up on the screen, a shorthand from her father wishing her a quiet, peaceful day. Susan smiled at the sentiment, touching the Kwik-key sequence to relay an “All’s well” in return. In fact, thus far, the powers that be seemed determined to keep her world quiet.

  By the time Susan arrived on the PIPU, however, her streak appeared to have ended. As Saranne keyed her through the first of the doors, she said softly, “The Ansons are here.”

  Susan did not know whether to smile or grimace, so she simply nodded. She appreciated that the Doctors Anson had not given up on their wayward daughter, or her caretakers; but the poor family had surely suffered enough. “Please tell me Shaden’s not pressuring them for discharge.”

  “Not discharge,” Saranne assured her. “Just a simple home visit.”

  Though it pained her to do so, Susan gave the suggestion serious consideration. When she had brought up the possibility of institutional care at rounds the previous week, the nurses, Stony and Clayton, and even Dr. Bainbridge had laughed. Few enough places accepted any patient for lifelong care, and none would consider a child, especially one so young, particularly a female. That had led to a discussion about inpatient psychiatry protocol, reasonable expectations, and ultimate objectives.

  Susan had always understood that the eventual goal for every patient was discharge to home as quickly as possible. No one wanted to stay in the hospital longer than necessary. The intrusiveness, exposure to superbugs, and 24/7 noise were bad enough; but most patients could envision their bank accounts emptying as the hours ticked past. Third-party payers, especially the government, allowed set amounts of hospitalization time for specific diagnoses. Keeping patients longer required a ream of paperwork that brought every administrator, from the charge nurse to the CEO, down on the doctors’ heads. Inquiries often seemed more like inquisitions. Denials occurred frequently, forcing the choice between premature discharge and personal payment, which few people could afford.

  Patients such as Sharicka made life especially difficult for physicians. Unlike most of the other PIPU patients, she had no evidence of psychosis or dementia. Personality disorders, even the antisocial type, were not justified diagnoses for inpatient therapy. Her youth further hampered them, as they could not even officially use the ASPD designation until she reached the age of majority.

  They had to settle for ADHD, ODD, and conduct disorder, none of which sufficed for inpatient care, especially long term. Sharicka had serious and permanent issues; weeks, months, even years on the PIPU could not change her underlying problem. The treatment for her, and other children on the c
onduct disorder spectrum, was to medicate them to some tolerable baseline of comportment, teach the parents behavioral modification techniques, and wait for the future. Concern for imminent criminal actions was not excuse enough to interfere with anyone’s freedom, especially a child’s, whether with prison, an institution, or long-standing hospitalization.

  Susan finally understood why the PIPU staff had discharged Sharicka to a therapeutic foster home after her first couple of weeks on the unit. Ultimately, everything the care team did had to bring, or at least attempt to bring, each patient one step nearer to discharge. So far, the Ansons’ insurance company had proven reasonable, but Sharicka only had to go a week or two without a violent incident for them to refuse further payment. It seemed inevitable given that Sharicka did seem truly determined to change this time. All too soon, Susan would have no choice but to discharge her, if not to her parents, then to another foster home.

  Susan realized that refusing any type of visitation, then dropping Sharicka on the Ansons the day of her discharge did not serve anyone’s best interests. The purpose of home visits was to ease the patient back into everyday life as well as prepare the family for the future in gradually increasing increments. A single overnight would also reward Sharicka for trying and, with any luck, rekindle the hope her family had all but lost. “Does Sharicka even want a home visit?”

  “She’s practically pleading.”

  Susan walked down the hallway with Saranne, pausing to glance in the open doorway where Sharicka snuggled on her mother’s lap, her father hovering like a guard dog. He looked up as doctor and nurse walked by and gestured silently to Susan.

  Susan held up a finger and nodded to indicate she would return shortly, then continued to the second massive iron door with Saranne. The nurse unlocked it, and they walked onto the unit and straight into the staffing area. Saranne could barely wait to ask, “What do you think?”

  Susan found herself nodding quietly for too long. From the corner of her eye, she saw Shaden coming to join the conversation. “I . . . think . . . ,” Susan started without a clue as to how she intended to complete the sentence, “. . . it might be . . . possible.”