by Cliff Hedley
Eventually the van turned in and climbed a rise, up a driveway to a large brick building. The driver helped Chase and another couple of passengers out and they were shown into the reception area by a nurse who was waiting for them outside. Inside the building was every bit as busy as New York itself. To Chase, it seemed to be a microcosm of the city outside. There were medical staff hustling everywhere, patients arriving and waiting to be seen, and the same colour scheme of green, grey and white he had seen a lot of at Bagram. Despite the level of activity, it seemed to be running efficiently, like a carefully wound piece of clockwork. Every fast-moving person seemed to be carrying out a role — coming to retrieve patients, ebbing and flowing from the reception desk and waiting area in busy synchronicity. He had barely sat down in a comfy armchair when he heard his name being called.
“Master Sergeant Chase?”
The woman standing beside him was short, dark-haired and maybe in her late thirties or early forties. She was also in very good shape. Chase figured her for a fitness fanatic, or at least someone who took good care of herself. Her face looked sun-weathered but not old and her green eyes showed both empathy and strength. He figured her for a senior nurse based on her uniform, and she exuded the calm confidence that is gained only by experience. He took an instant liking to her.
“That’s me.”
“I’m Nurse Harris. Please come with me.” She was all efficiency, like everyone else moving around him.
He rocked forward and swung up from his seat, using his usual technique. He wondered for a moment if his abs and core muscles would be getting stronger as a result of all the rocking out of chairs he had done lately. He had certainly gotten the hang of it. Harris was watching him, seeming unsure whether she should be helping him up. She hovered close, ready to assist. It took her only a moment to realise he had it under control.
She led him out of the hustle and bustle of the main reception area into a quieter corridor. He could sense the activity all around but it was definitely turned down a notch: there were medical staff coming in and out of rooms further up the corridor, the odd cough from patients, and various trolleys and pieces of medical kit sitting against the walls, ready for use. They reached an examination room and she went first, holding the door open for him.
“Please take a seat.” She motioned to a padded chair. As Chase eased himself down, she went about pulling over a trolley with various pieces of basic equipment on it and sat next to him.
“I’ll be running some tests on you before Doctor Carlton arrives. Nothing too serious, just making sure your blood pressure and heart rate are OK — the usual physical stuff. Then we’ll take a look at your wounds and change those bandages.”
“OK,” Chase smiled.
He watched in silence as she went about her work. She was obviously well practised, and took a few notes on a chart which was on the trolley.
“How was the flight over? Any pain or discomfort?”
“Nothing out of the ordinary. I was well looked after, thanks.”
“So the painkillers are doing OK?”
“Yeah. It hurts a bit less every day. Kind of down to a dull throb rather than screaming agony now.”
She slowly and carefully unwrapped the bandages from his arms, gently rolling his arms over one at a time, so as to inspect them thoroughly. She gave him a smile. “Good. You seem to be healing pretty well.” She caught his eye to make sure she got her point across. “This won’t be a fast process. Your body needs time to heal but rest assured that we will make you as comfortable as we can. Eventually we should be able to do without the pain relief altogether, though you might get the odd phantom pain as your body tries to adjust to the changes in your nervous system.”
“Yeah, I get the phantom sensations. I can still feel my hands sometimes.”
She nodded. “That’s probably not a bad thing. Weird, yes. But useful. Your tests to date suggest you still have some pretty good wiring available to use, which is where Doctor Carlton comes in. I’ll finish up here and go and find him. Just relax for a minute.”
With that she was gone, bustling her way out of the room. Chase slumped back in the chair and looked down at his arms. She had left them without the bandages and he took time to do his own check, slowly lifting and rotating each arm so he could check on his healing progress for himself. He had been watching every time the nurses had changed his bandages but he hadn’t been left for too long without them. He appreciated having time to himself to look them over. The mess of scars were getting less angry and the swelling had reduced further but still it wasn’t the prettiest of sights.
He felt oddly exposed. His arms were now bared for the world to see. He was naturally self-conscious, perhaps more so around a woman like Harris where he felt a tinge of attraction. It was more frustrating still that like this, she would only see him as a patient.
Five or ten minutes passed and the door swung open. Harris held the door open and was followed moments later by a youngish-looking doctor in a wheelchair. Chase felt a moment of relief at not being the only physically challenged man in the room, then guilty at the thought. The man was every bit as energetic as the rest of the hospital staff and clamped one hand down on his left wheel to turn himself abruptly, before coming to a full stop in front of Chase. He wore a white lab coat and must have been in his late thirties but had an almost boyish, nerd-like quality about him. He reminded Chase of a fresh-faced teenage computer coder.
“Hello, Master Sergeant Chase. I’m Doctor Carlton.”
“Will you need me for now, Doctor?” Harris was hovering near the doorway.
“No, thank you, Nurse Harris. Please check back in around twenty minutes so we can get the Master Sergeant some new bandages and settled into a room.”
She nodded and whirled out into the corridor.
“So, Master Sergeant,” Carlton began. “I assume that Doctor Renfrew spoke to you about why you’re here?”
“Chase is fine, Doc. Or Will. I guess I’m a civilian now, like it or not. I’m not used to hearing my first name, so maybe Chase is best.”
“You earned your rank, Chase, but I’m happy to keep things informal. All things going to plan, we might be spending a fair bit of time together. How much did Renfrew show you?”
“Not a lot. He said you were working on some next-generation prosthetics and needed a guinea pig. I figured if I can end up with something useful, I can try to keep some semblance of independence and you get the guinea pig you need. I also don’t seem to have a lot of other options.” Chase grinned on that last point.
“How about I give you the full overview, then later we can arrange a tour?” Carlton rolled around the far side of the desk to a computer monitor on an extendable arm. He tapped away at the keyboard to log in, then swung the monitor around so that Chase could see it from his side.
“What do you know about robotic prostheses?”
“I’ve seen them before. One size fits all, kind of clunky but better than the old piano-wire and claw option. I think they use some kind of sensors, hence you wanting a guinea pig with good nerves?”
“That’s pretty much it.” Carlton clicked onto some photos, which showed examples of the kind of robotic arms Chase had seen before, then various shots of the sensors attached to the skin of their wearers. “These are the sensors that have traditionally been used to operate our artificial prosthetics. They rely on having a group of nerves near to the surface of the skin, where we can attach electrodes, or sensors, to pick up impulse signals that your brain is sending.”
Chase nodded to show that he was following.
“These were a massive jump on the old wire systems, which hadn’t changed in over a hundred years. I think those were invented during the Victorian era. The problem with the robotics, though, is that they’re still pretty clunky. The arms are a basic robot arm, and look like it. Fully rotating wrist joint, basic elbow joint, bas
ic pincer hands. We can have individual finger articulation but that takes some doing. The harder part, still, is placing the electrodes.”
He brought up a picture showing a man with a cluster of small round electrodes on his chest, with a wire coming out of each one.
“As you can see, this approach is pretty messy. We aren’t limited so much by the nerves available in the human body as we are by being able to map uniquely to each one and recognise the signals that they are producing. The old electrodes are too big, which means we can only send so many basic commands, because they take up a lot of real estate. Therefore the arms we can offer have been just as basic. We have some pretty clever software which maps nerve location and commands for each individual user. We have chipsets that keep getting smaller and faster for processing the commands but until now the input has been the biggest factor holding us back”
Carlton was building up to something and there was an excited sparkle in his eyes. Chase’s estimation of him being like a stereotypical nerd were so far bang on. He clearly enjoyed talking technology.
“So, what I’ve come up with is a new way to receive those nerve impulses.” He was beaming now.
Chase did his best to present an impressed look. “And what’s that?”
“Instead of placing electrodes next to each other, we place a fabric wrap over as much of the skin as we need and map our impulses to that. All of a sudden, our bottleneck is gone. We are less restricted by space taken up by the electrodes and we pick up more impulses. Add to that, it’s more comfortable for the user and you can put it on yourself instead of having to get someone to stick the electrodes to you each time. Suddenly, you get to be independent.”
Chase was beginning to understand how important the advancement was and nodded in appreciation. Carlton clicked his mouse and the picture changed between someone having a bunch of electrodes attached, to one of a fabric, showing a metallic weave through it.
“Here’s what it would look like for you. Each prosthetic arm is moulded to fit you exactly, so every one of these is custom-made. It’s comfortable too — hard plastic where you have soft flesh and a memory foam where you have bone, so that nothing rubs or chafes and it all fits snugly. Then we insert the weave so it forms a layer next to your skin, by sticking it to the inside of the prosthetic. That picks up the signals and maps them via the software we run on board. There is a bit of a process to go through initially, to get your nerves mapped. Once your nerve locations are mapped to specific commands, you’ll be able to take the arms off and put them on again, without having much hassle other than charging the batteries.”
Chase sat and stared at the diagram of the weave for a moment. “Wow. That’s impressive.” After a moment, the idea occurred to him that plugging in a flat battery without the arms might be difficult. “How do they charge? Would I need to plug in the battery — like a phone, for example?”
“Yes and no.” Carlton’s twinkle in the eye remained. He was clearly pleased with himself. “You see, all we’ve done is borrow technology that already exists for mobile phones and other devices. Proximity charging. All you would need to do is rest the arms on a sensor pad, which you could have wherever you like — say, on the armrests of your favourite chair while you watch TV. The batteries will recharge without you having to do anything and there’s an LED indicator showing you the level of charge.”
Chase nodded as he thought it through. He was highly trained in electronics himself, so a lot of the technology made sense. It was damned impressive in his estimation.
“So I don’t need to wear a separate battery pack?”
“No. The batteries are embedded in the arm. You can thank the technology from advancements in smartphone batteries once again for that, as well as Tesla and Panasonic. They have a joint venture which is advancing batteries rapidly.”
“What stops the arms falling off? How do I fasten them myself?”
“We’ve got that covered too.” Carlton raised his arm. “In your case, you have a mid-forearm amputation — well, times two. To make sure the prosthetic stays secure, we would fasten it above the elbow, on your upper arm, with self-tightening straps above and below your bicep. All you would need to do is thread your arms through a pair of loops, which are loosened when the prosthetics are not active. Once your arm is in place, the loops automatically adjust. There’s also a gentle pressure applied by the prosthetics themselves to make sure your arms stay inside the mouldings. In the end, they should be pretty difficult to knock off you.”
“I have to see these things.”
“Excellent. I was hoping you’d say that. So, you’re still interested in being my guinea pig?”
“Absolutely! When do I start?”
Carlton knitted his fingers together and rested his elbows on the desk. “Here’s where I need you to be a little patient. First off, we’ll get you checked in and you’ll need a few more weeks to heal before we can start working with you. Your swelling needs to subside and those scars need to be healed, or you’ll just inflict damage to yourself and add scar tissue, which will block our weave receptors from working. Good, clean skin is the name of the game. Yours should heal pretty well and give us a good bit of real estate to work with. We might need to operate as well to bring your nerves close to the surface, which will make the weave work better.”
“Yeah, Doc Renfrew told me about the extra surgery. I’m OK with that.” Chase sank visibly as he said it, his shoulders slumping slightly. It was all so exciting, yet he faced several more weeks of being stuck in a hospital and relying on help for everything, before he could even start the work.
Carlton obviously picked up on his change in mood. “Don’t worry. Yes, there’s a long road ahead. And there are no guarantees that this will work for you. You will get sick of hanging out in a hospital room and watching bad TV. I’d like to assure you however that I am as excited as you are to see this work. In the interim, you’ll be seeing a lot of the nurses who will look after you. It may take up to a year for your arms to settle fully in terms of the swelling, which means we’ll need to adjust periodically to make sure everything still fits and works properly as well. You will also have work to do. I’ll arrange for a therapist to come and show you some exercises to keep your arms as healthy as possible.” He paused. “And you will be seeing a counsellor.”
“A shrink?”
“Yes. You’ve been through a lot and they will help you both come to terms with your amputation and adjust to life without the use of your hands. We have specialists who help amputees, so it’s not just about you getting over the shock of the injury but adjusting back to life.”
Chase hadn’t considered having a psychiatrist of any kind. He had pretty much expected it but he also didn’t really think he needed it. He was used to pressure and finding ways to deal with it, though it occurred to him that now he was back in the real world, it wouldn’t hurt to get some help with decompressing.
“Do you have any other questions for me?” Carlton asked.
“Not now but I’m sure I’ll think of some. I’m looking forward to doing this.”
“Great. Well, I’ll be back to check on your progress from time to time. Right now the nurse will come back to look at your dressings and show you to a room. We’ll get your therapists to stop by once you’re settled in. I’ll also arrange for a prosthetic for one arm that you can use in the interim, when you’ve healed enough. It will be the basic strap-on wire-and-hook thing for starters but it’ll help you a little before we can try the tech.”
“So I get my pirate-hook hands after all.” It wasn’t a question from Chase, more of a comment to himself.
“Just for now. See you in a bit.” Carlton wheeled his way to the door and he was off again at high speed.
Harris soon returned. She changed Chase’s bandages and led him to his new room. There was a TV playing and once she was satisfied that he would be OK, she left him to it. He w
aited for her to hustle her way back out of the room, and once he was alone he began practising some basic footwork and balance again. There was a small amount of room next to the bed and he was happy to note that his balance was getting better. All his life and through his martial arts career, Chase had been used to balancing with his arms when he was on one foot. Now, the loss of weight in his arms meant that he had to adjust years’ worth of well-established patterns. He was still moving from one foot to the other and sweeping through different stances when the door swung open again.
It was one of the physiotherapists, to help him through his rehabilitation routine. She took his arms one by one and asked him to flex each elbow. She held her hand gently but firmly against his forearm to provide some resistance. She was wearing a subtle fruity perfume. He was sure that he didn’t smell as good after all the travel and looked forward to a shower.
She went on to show him a few other exercises, making him rotate his arms and lift them to the side and front. All in all, he could see that she was trying to keep his arms as strong as possible. It was pretty similar to programmes he had done for years in the gym, just adapted to suit him.
“Once you’re ready,” she said, “we can start using more resistance in the gym.”
Chase lit up at the thought of having somewhere proper to work out and a chance to get out of the room. “You have a gym?”
She picked up on his sudden enthusiasm. “Would you like to go there now? Just for a tour?”
She led him down a corridor and towards an elevator, which took them down to the ground floor. They stepped out into another corridor and after thirty paces or so reached a set of double swing doors. Through the safety-glass windows Chase could see another injured veteran on a treadmill. He was missing one arm but it didn’t seem to be affecting his jog. Across the room was another man supporting himself between two parallel horizontal bars, learning how to walk on his new prosthetic leg.