I lay on a stretcher, unable to avert my gaze from the brilliant light of the procedure suite in the vascular institute, and listened as the interventional radiologist explained the procedure to his resident in vivid detail. My skin was now foreign to me, but I could feel the catheter as it was threaded up through the femoral artery, aorta, and then into the basilar artery, that tiny little bastard that cut me off from the world.
"There. Got it!” Dr. Siteu gloated. “Hooked it like the cork on a bottle of fine Merlot."
The radiology resident was impressed. “Man, look of the size of that sucker."
"Second biggest I've ever seen,” Siteu said with pride as he pulled the clot from the artery at the base of my brain, threaded it back out through my body, and deposited it on the instrument tray next to the table. I caught a glimpse of it on the LCD monitor to the right of the procedure table.
Siteu saw me straining to look and turned my head to help the cause. “So what do you think of that?"
It looked like a juicy purple earthworm.
"That's the sucker that was clogging up the works,” he said. “Feel any different?"
One blink for yes, two for no, they had told me. I blinked twice.
"It may take a while. Let's see how we did."
I felt a warm flush as he injected dye into the artery he'd just pulled the clot from. A streak of white puffed out of the tip of the catheter on the wall monitor. I wasn't sure what it meant, but the doctor seemed very pleased with himself.
"Perfect.” He turned to leave the room.
All that night I lay in the hospital bed staring at the ceiling. Dr. Siteu's words were encouraging, but I couldn't feel a damn thing. The procedure was a success, but I was not.
* * * *
Every time I closed my eyes, I saw her face. It was an image I had tried so hard to erase, but never with more than fleeting success. If I'd only left the party when she pleaded with me, if only for once in my life I had let business take a back seat to what I couldn't see was the most important thing in my world, maybe I wouldn't have been so tired, maybe I would have seen it coming in time to stop.
I had regained consciousness just long enough to see her sitting beside me, that beautiful face all bloodied, just inches from my own as she took one last breath before I lapsed back into coma knowing it would be the last breath I'd ever see her take. That look has haunted me for almost eleven years.
Morning was a welcome relief. Nurses and doctors started filtering in. Hell, I was even glad to have my blood drawn. But it wasn't until the neurologist gave me the once-over that I realized I could move my right thumb an eighth of an inch; the procedure had indeed been a rousing success.
And so I lay there twitching my thumb. The day was interspersed with visits from therapists and brief depressing hellos from a parade of business associates who felt obliged to pay their respects, but could rarely stomach looking at me for more than a few seconds. Tanner would sit and bring me up to speed on the goings on at the office, but it was hard for him; he didn't know how much was getting through to me, and even he showed the restlessness of a discomfited sickbed visitor.
The days were interminable.
And then came the nights.
And Linda.
I'd learned to live with the pain, to banish the terrors by filling my head with other images, any images besides that battered lifeless face. She was the best thing that ever happened to me, and all I wanted was to forget her.
But now there was nothing else. No conversation, no books, no mindless escorts to stimulate my senses into pleasure divorced from joy. I couldn't even turn on the damn boob tube. Even in the worst of times, there had always been the promise of tomorrow, a hectic office, a roost to rule.
Tomorrow ... well, work was out of the equation now. There would only be more time to think.
And in between those unbearable moments came a parade of physical therapists, or as I came to know them, physical terrorists, who would take turns marching into my room every morning and again in the afternoon, stretching every joint in my body until tears ran from my eyes. It was their only signal that I could take no more. They tried to convince me that it was critical to maintain my range of motion to keep me from turning into a pretzel that would be in constant agony and begin to rot at every convoluted crevice that would harbor bacteria and fungi; a delightful picture that made the torture of therapy no easier to bear.
It was two weeks to the day after my stroke that the rehab doctor gave me the first glimmer of hope.
"Mr. Adams, we haven't gotten too far with your therapy."
Thanks for the insight, I said inside my head, as I lay motionless in bed. I never could have figured that out without you. Is that what eight years of med school and residency get you? I looked away and tried to tune him out. Asshole.
"But there is another option."
Wait. What? I looked into the eyes of Dr. Benson Burgess. Empathy. There's been a lot of that since I landed on the Rehab Unit, but I need more than that this time.
"A computer-brain interface."
I stared blankly.
"Have you heard of it?"
I blinked twice.
"It was developed around the turn of the century at Duke. First on monkeys, then later on humans with spinal cord injuries. It's a way of getting your brain to send signals to a computer that's programmed to control a robotic arm, a powered wheelchair, even a voice generator. It's not easy to master, but results have been pretty good in some cases."
Great. I'm a case now. What the hell; at least it's a chance.
"It takes a lot of money and a lot of work. It also involves cutting your head open and implanting a series of microchips on the surface of your brain. We haven't seen many complications, but it could cause a brain infection, seizures, even death if things go wrong. You still interested?"
Like I've got a lot of options. I blinked once.
The surgery took place one day later. I awakened in my room feeling no different than I had before the procedure; couldn't even get a look at myself or grope my skull.
Dr. Burgess entered with a wide grin. “It went great,” he said. “Wanna see?"
I blinked once.
He held up a mirror he'd carried in with him. The left side of my head was shaved and had a u-shaped incision that was stapled shut. I looked like a baseball with hair growing out one side.
"Your hair will cover all that in a few weeks,” he said. “The neurosurgeon placed seven chips along your pre-central motor strip."
My face was obviously blank, but somehow he caught my confusion.
"Uh ... the surface of your brain: the part that controls your right arm, your right foot and your speech. The chips will pick up the brain activity, send it through the wire he tunneled down to your belly...” He showed me the faint bulge under the skin on my neck and chest, and the small incision in my abdomen. “...and trigger the IR transmitter here.” He pointed to the incision. You'll wear a belt that will pick up the IR impulses and turn them into RF waves that are then sent to the computer, which will turn your thoughts into actions."
I hadn't thought it possible, but yes, the grin had gotten wider.
"Got it?"
I blinked once. At least I got the gist of it.
"Good. The first goal is to get you talking. Once we do that, the rest will go a lot faster.” He positioned the computer monitor in front of my face. “Now say hi."
Hi.
Nothing. So far, I was not impressed.
"No, no. Don't think hi, say hi. You've got to use the same part of your brain you would if you were talking. I know you're out of practice, but it's like riding a bike ... Okay, bad example, but you get my drift."
I did. Hi, I said again, and the voice came out of the computer almost as I said it. Shit, it sounds just like me. That last part just came out as garbled nothingness.
Burgess grinned. “Pretty cool, huh? The speech therapist programmed it with recordings we had from your office. It sounds just
like you."
He understood me?
"Well, not that last part; that sounded like mush. The computer's got to learn what the signals coming from your brain mean. I programmed it to say hi in response to the first signal you sent, so hopefully you weren't screwing with me, because whatever you said first is going to come out as hi every time you say it from now on. Was it hi?"
I blinked once.
"Good. We'll do yes and no next, then if all goes well, I'll have the speech therapist get started with some vocabulary."
I spent the better part of the next month with a brunette named Marta teaching me how to talk through the voice synthesizer. She was deceptively demure, unrelentingly tenacious, and worked me to exhaustion; the verbal equivalent to my physical terrorists. One by one, she flashed pictures up on the monitor, I named the objects I saw, and the computer learned which signals from my brain corresponded to which words. Tedious, but very cool. I grew to look forward to these sessions. No doubt I would soon become little more than a memory to Marta, another patient in her files, but her daily visits came to bring a familiarity that I treasured in this chaotic abyss I'd fallen into.
And when I was not in therapy, my mind had time to play with my sanity. The harder I tried to forget, the more I remembered.
But in forcing me to confront all I had suppressed for the better part of a decade, my mind began to let me remember the woman I had loved. Memories of all the years before the accident began to wash over me. Our wedding, the briefcase she surprised me with as I left for my first day on the job, vacations and endless conversations about life, about kids. We both wanted them, the time was just never quite right. And then one day there was no more time.
So alone.
* * * *
Burgess had just returned from a trip to Israel to meet with some robotic engineers who were working on a new type of wheelchair for me. “So,” he said, “how's my favorite patient?"
"Tired of lying in this damn bed staring at the ceiling."
He smiled. “I see Marta's gotten around to the practical stuff. Good."
"Sweet kid, Marta, but enough's enough. When are you going to get me out of here?"
"Funny you should ask."
He walked out and a few seconds later there was a thump as the door burst open and The Monster—his words, not mine—whirred into the room with Dr. Burgess close behind. It was a wheelchair with a big black metal box on the back, which I assumed held the battery and computer, and a robotic arm tucked in along the right side.
"My new jail cell?"
"Your freedom. You're going to learn how to maneuver the chair with your thoughts and control this arm as if it were your own."
My own ... it looked like the detached arm from the terminator robot in the 3D remake of that old Schwarzenegger flick, a shiny mass of metal and cables in the form of a human limb without the skin. Only instead of being attached to a torso, it protruded from the end of a telescoping titanium rod emerging from the right side of the chair, where it pivoted on a ball joint of a shoulder. The dexterous fingers were going through a demo mode that made it look like they were the metallic equivalent of a disembodied magician's hand practicing the motions of a well-ingrained card trick.
I wasn't sure whether to be impressed or to vomit.
"Will I be able to play the piano?"
He laughed. “Ah, the age-old joke. Glad to see you've got your sense of humor back."
"I was a concert pianist before I went back to business school,” I said.
"Oh ... I, uh ... sorry.” Burgess turned beet red.
It felt good to be able to make someone squirm again. “So let's get to it. I'm going buggy here."
The next month was almost as tedious as the last. I was assigned a new team of therapists to show me how to use all the gadgets I'd need to function at home. My latest physical therapist, a brute of a guy named Bill, turned out to be a lot less intimidating than he looked. He taught me how to activate the automated transfer sequence that slid my body from the bed into the chair and back. Once I mastered that, the rest seemed easy by comparison, almost intuitive.
I learned a lot more than I ever wanted to know about being disabled, and even more about the recovery process. In spite of all the cool technology, it took a crap load of work to accomplish even the most mundane things I'd always taken for granted: feeding myself, brushing my hair, that kind of stuff. Other things like getting dressed, washing, even wiping myself ... forget it, the robots aren't that advanced yet. Not sure I'd really trust a robot to wipe my butt anyway. Your definition of vanity changes, to say the least.
An occupational therapist, as it turns out, has nothing to do with occupations of any kind, except their own, of course. It was Laura Feibelman's task to make me more independent in activities of daily living, which in my case boiled down to figuring out how to use the robotic arm. All I had to do was think about moving my own arm, and the thing mimicked my thoughts—not as easy as it might sound. Manipulating a soupspoon with a seventy-three-pound hunk of machinery strong enough to bend metal can be a little nerve-wracking. But practice makes perfect, and what else did I have to do?
The Monster's drive mechanism was a blast to learn. I could steer it with my new arm using a joystick, and to accelerate, all I had to do was push down on the pedal. My foot didn't actually move, of course, but my brain didn't know that unless I was looking down; the computer did all the work, but the end result was the same. It only took a few minutes to learn how to accelerate and brake, just like driving a car.
Eleven weeks to the day after my stroke, I was ready to return to my world.
Going home was the hard part. I'd grown so accustomed to everyone at the Rehab Center, it felt like my training wheels were being taken off and I was being pushed into oncoming traffic. Of course, it wasn't nearly that bad. Two nurse's aides had been working with me and the rehab staff for the past week, learning how to do whatever I'd need to have done at home. And the house was equipped with full environmental controls that let me manipulate everything through my computer-brain interface by tapping into the home automation system. Lights, heat, TV, telephone, and of course the pager that my aide wore on her wrist were all at my beck and call.
It's nice to have money.
Still, it didn't feel like home. Linda should have been there.
My newly appointed driver picked me up the next morning. Very tacky. I made a note to have them build me a van I could drive myself.
He unloaded me at the main entrance. It felt odd to be wheeling into the atrium at Nucleic Innovations through the same doors I'd walked through a thousand times before.
Tanner had been keeping me abreast of the boardroom battles going on in my absence. I whirred into his office in The Monster, bruising the polished wood as I entered.
Tanner started at the cacophonous intrusion.
My brain smiled, but I knew all Tanner could see was a blank face. “Guess I'll have to get some kick plates on those doors before I punch holes in them."
"Or you could wait for somebody to open it,” Tanner said, surveying the damage.
I ignored him. “So what's happening with the Shower Heads?” Shower Heads ... we always managed to come up with some innocuous name for each of our brutal inventions; in this case, missiles carrying a head of nuclear waste that would burst three hundred yards over its target and shower the area with its venom.
"We vote on Thursday,” Tanner said. “The Defense Department's pressuring us to come up with the goods or they're going to release it to another contractor."
I tried without success to bite my lower lip. “You know I'm not one to shy away from a new weapon system. Hell, we built this place on nuclear applications for war, but up till now it's all been miniature explosives like the Pea Shooter Grenades or nucleic power cells to run the tanks and planes. But this ... how will history judge us, Tanner?"
"Hell,” Tanner said, “how will we judge ourselves?"
"It would certainly end the argument about
whether we crossed the line in letting the ethics of war justify what we do."
"So how do we stop it? The board's split dead even on this one."
"In which case, my vote decides the victor,” I said. “It's good to be king."
"I was afraid you wouldn't cash in that chip,” Tanner said.
I had never had any problems impressing my will on others, winning by conversion rather than coercion. A press of the hand, a gleam in the eye, a nod so subtle it only registered in the direction it was aimed. I could sway any vote my way and everyone would walk out thinking I was a nice guy; depends how you define nice, I guess. I ruled with an iron fist that no one noticed, but life would be different now; no time for nuance.
"I've been saving it for the right occasion."
When Thursday morning came I was ready to do battle. God, it felt good to mean something again. In spite of a crowded lobby, I had the elevator to myself; The Monster can be pretty intimidating. The bell dinged and when the doors slid open I rode out with purpose, right past the gawking secretaries and through the newly installed automatic door to my office.
Tanner appeared at the doorway a few minutes later. “Ready?"
"Let's get the bastards,” I said.
Tanner led the way and held the boardroom door for me as I rolled in. We were the last to arrive. My customary spot at the head of the table had been cleared to make room for the new mechanical me.
Dave Dunnster stood. “First on the agenda is the financials from the fourth..."
"We're not blind, Dave,” I sputtered. The agenda was up on our monitors plain as day.
"But it's protocol, Troy."
"Screw protocol. Let's get to the meat, shall we, gentlemen?"
The buzz around the table was comical. I had always placated these turkeys, and it was fun watching them adjust to my change in attitude; some experiences can affect your priorities. It was tedious using my new brain toys and I had to get business done before I collapsed from exhaustion.
Analog SFF, March 2010 Page 12