Black Diamond Fall

by Joseph Olshan

  Mañalac turned and followed his glance to stare at the unconscious girl, unable to beg for her own life. He sighed softly. Julien knew he’d won when the nurse nodded tapped his device to look for a free theater, then carefully waited for a response. But instead of triumph, all Julien felt was a sudden wave of gratitude—and hope.

  Soon they were wheeling her through back corridors to an outpatient surgery wing in the basement, where all the day’s scheduled procedures had been canceled because of the unexpected shortage of staff. Julien hoped the rest of them would be too overwhelmed to notice what he and his team were up to.

  Two surgery assistants appeared like ghosts in their gray surgical scrubs, the same color as Mañalac’s uniform. The first, Ram, prepped Julien, while the other, George, hooked up Sabine to the monitors and put an oxygen tube into her nose. He quickly removed her clothes and wiped her stomach clean with antiseptic, then raised her legs.

  Julien, waiting, glanced around at the intricate machines, the high ceiling, the observation panel—all empty now. How intimidating he’d found it as a medical student during his surgery rotation. Now he was a captain commanding a ship, Mañalac and the two assistants his able seamen, and the ill young woman his passenger. He was determined to bring them all to safe shores. He closed his eyes for a moment and was astonished to find himself asking an unknown force for help, for steady hands, for success. Doctors weren’t their own gods, after all.

  Julien

  Mañalac had been keeping an eye on the cardiac monitor as it tracked her heartbeat and blood pressure. Ram and George pushed IVs into her arms, administering saline in one and keeping the other free for anesthesia. Shock could claim a patient faster than any other malady; they had to stabilize her quickly so that her body could cope with the surgery ahead.

  “I need her blood count, please.” Julien said. “Give me her serum lactate levels, the metabolic panel, type and cross-match, Rh factor, everything. Oh, and be gentle with her. Treat her as if she were your sister,” he added. George’s eyes narrowed quizzically above the surgical mask over his nose. Even Julien was surprised at himself. Something had truly taken him hostage, making him say and do the unthinkable. Was it her femaleness or the fact that he held her life in his hands?

  All Green City citizens had blood taken from their heels at birth, dried and stored on special filter papers. Digital microfluidics could be used to make a quick analysis on the sample, if a citizen was ever in a medical emergency. Julien had been thrilled to learn how all was hidden in that tiny drop of blood, a ruby-red treasure that revealed its secrets only to those who knew how to read its arcane code. And he was one of those few code-breakers to whom drops of blood and strands of DNA and cells and atoms could actually speak.

  Ram quickly took a drop of blood from her finger, put it onto a digital blood chip and waited thirty seconds for a quick reading. The sample wasn’t matched to an official Green City ID, but it revealed that she was twenty-one, young and strong, never pregnant before. Julien listened as Mañalac rattled off the woman’s blood type, hormone levels, genetic history, previous diseases.

  “Drugs?”

  “There’s something, but I can’t tell right now. We’d need to do more tests. Still, yes, I think she ingested some kind of chemical in the last twenty-four hours.”

  “Any abortifacients?”

  “I don’t think so.”

  “Do you think she’s had a reaction to it? Is that why she collapsed?”

  “Could be, but it’s not anaphylactic.”

  “All right, let’s have twenty units of O positive ready. She’s going to need them soon.”

  George removed the bags of serum from the blood safe, while Mañalac quickly performed more scans. She was roughly five weeks pregnant, but the fetus had implanted itself in the fallopian tube, which was ruptured. An ectopic pregnancy, and now blood was just beginning to pool inside her abdominal cavity. Julien was both vindicated and horrified when he realized that if they didn’t operate now, she’d die.

  Her blood pressure was back up just enough for Julien to start. Mañalac handed Julien the laser scalpel, and they all watched him intently as he readied for the first cut. Their eyes were anxious but trusting. George and Ram held their instruments poised to follow his lead. Mañalac held Sabine’s hand and whispered words of reassurance to her, as if she could hear him, in whatever realm she was in, halfway between life and death. ‘You’ll be all right, just hold on. Dr. Julien will take care of you. Don’t worry.”

  Julien had already ruled out a laparoscopy; radical surgery was the only option. All his medical texts and lectures in Kolachi came rushing into his mind. Nothing, however, had prepared him for the reality of this woman on the table in front of him, This was not the way he’d imagined a real woman laid out before him for the first time.

  Julien aimed the laser scalpel at the woman’s smooth, pale skin. He was aware, at the far edges of his focus, of the roundness of her belly, the light hairs below her navel. With a delicate touch, almost a lover’s caress, he traced the beam of light down her abdomen, three inches in length. The blood swirled around the incision; Ram quickly suctioned it away.

  Deeper and deeper, past thin layers of tissue, then thicker layers of muscle, until he penetrated the layer that enveloped all the vital organs. A few deft strokes opened up the cavity. While George kept suctioning away the blood, Julien quickly found what he was looking for with the help of the scanner: the internal reproductive organs, uterus, fallopian tubes, and ovaries. “You’ll recognize them because they look like the scales of justice,” his professor had said in the lecture hall, then quipped, “Although there’s no justice as far as a woman is concerned.” They’d laughed then, but Julien remembered his words now and winced. They were operating on her without her consent, without informing her next of kin. Would she wake grateful or violated? He’d had no choice when her life was at stake. He put his thoughts aside and concentrated hard, examining the ovaries. “Small and white, of healthy size and color, they look completely normal—no pathology, no injury here,” he said out loud. “The uterus, too, is healthy pink—that’s very good.”

  “Hypovolemic shock?” said Mañalac.

  “I don’t think so, we’re lucky, but let’s keep an eye on her blood pressure now. If it surges, we might have a bleed, and that’d be a disaster.”

  Next, he had to find the damage. The scanner grew smarter with each procedure, but it had definitely not been programmed to identify this kind of problem in the female body. Julien put the scanner aside and tried to spot the ruptured tube with his naked eyes. He wondered aloud: “Which one? Left or right?”

  Then he spied a small rending apart of tissues, like fine frayed threads, in the lateral wall of the left fallopian tube. He caught his breath: he’d have to widen the space and tease the fetus out, bit by bit. Could he save the tube, rather than removing it completely? He couldn’t stand the idea of making this woman anything less than perfect and whole.

  He used tweezer-thin robotic forceps and clamps to lift the tube up and away from the surrounding organs. The tube came up easily in his grasp, the small curved funnel a place of transition, too narrow to bear the burden of a growing embryo. Normally the fertilized egg would drop into the uterus, ready to catch the small clump and hide it deep within its protective folds. Nature had made a mistake this time, and he would have to work fast to rectify it. At least now the end was in sight....

  He nudged the tear further apart. A tiny lump no bigger than the end of his finger slipped out from the tube, accompanied by a fresh spurt of blood. It had not yet assumed the curled shape of a fetus, with rudimentary hands and feet, dark spots for eyes, a small hump where the brain was growing larger than the rest of the body. But it still was the earliest stages of a living being, and its miniature size threw them all off balance.

  “My god,” breathed Ram.

  “God has nothing to
do with this,” said Mañalac testily.

  “Oh my god,” echoed George, provoking another glare from Mañalac.

  “Quiet, please.” Julien kept his gaze steady on the tube. As soon as the entire sac was out, he judged that the tube couldn’t be saved after all. The rupture was too extensive, damaging too much of the tube, as well as the artery that supplied it with blood. He quickly removed what was the rest of the fallopian tube, incising and cauterizing once again, precisely and efficiently.

  “Well done, Dr. Julien,” said Ram, when it was finally over.

  “What are her vitals now?” he murmured, listening to George rattle them off. But Julien felt little joy at the success of the operation. He’d ignored all the rules of the hospital, as well as the Perpetuation Bureau’s directives on the immediate reporting of endangered pregnancies. The adrenaline was fading away, leaving him afraid once more. He had succeeded as a doctor in Green City by obeying the rules so far. In a single morning this woman had made him break every rule in the book.

  “Thank you, good work. Clean her up, please. Let’s get her... Ram, can you check the rooms, please?”

  “You’re going to put her in a room?” said Mañalac.

  “I’ll have to talk to Dr. Bouthain, figure out how to enter her into the system,” Julien hedged. The clarity he’d known during the surgery was fading fast. He should have reported her presence, the emergency, to the Bureau immediately. Why hadn’t he done that? Surely they’d understand that he’d acted as a doctor; saving a life first, filing the necessary reports later.

  George and Ram were bustling around the table, unhooking the woman from the oxygen and anesthesia lines, settling her limbs and cleaning her up. Soft beeps from the machines punctuated the distant, tinny voices on the announcement system that signaled the end of the early morning shift and the beginning of the next one. Julien would have to return to work soon.

  Mañalac bent his head to his device, pressing buttons again and again and shaking his head. The device chirped. Mañalac read the new information and whistled. “Dr. Julien, look at this!”

  “What is it?”

  “There’s a private room showing up, on the thirty-second floor. Instructions say post-operative. VIP, Do Not Disturb. And there’s no name on the room, nor a Green City ID. It just says, Patient X, female, 21.”

  Julien’s eyes narrowed and his teeth bit hard against the inside of his lip. Someone was making deliberate changes in real time to the hospital records to accommodate her. Whoever had brought her to Shifana was monitoring exactly what was happening to her. And sending out a message that she was under that someone’s protection. But whose? Julien’s stomach clenched at the idea that her protector was watching their every move.

  Julien studied her face closely for the first time. Her dark hair, smooth olive skin, and full lips denoted youth and good health. She had a slight scar under her lip. Her narrow jaw and small ears were almost elfin to look at. Her fragility was deceptive: even though she was still unconscious, now she had power, because there was a nameless, faceless someone pulling all their strings like puppets, directing them to save her life.

  “What are you going to do?” said Mañalac, with a slight emphasis on the word you. No matter what his complicity in Dr. Julien’s actions, people like Mañalac survived by never questioning their role. Dr. Julien would take the blame for whatever had already happened, and whatever would come next.

  Julien wiped the sweat off his forehead, then raked back his hair with his fingers, tugging on his hair until his scalp tingled. “Let’s get her in that room, quickly. I don’t want anyone to see her.” He scrubbed his hands clean, peeled off his surgical suit and dropped it into the incinerator.

  Mañalac’s shoulders slumped. Dr. Julien should have said he would report to Dr. Bouthain first, before deciding to move the woman into the room. But look at how he’d acted to save the girl, not even thinking of the rules and regulations. It was what every good doctor should do, but in Green City, flouting the protocols was classified as rebellion, and everyone sooner or later paid for the crime. There was already someone watching them, the person changing the records.

  Everyone at Shifana knew the young doctor had a golden future ahead of him; he wouldn’t stay a junior for long. Already word of his talent was reaching the ears of the Bureau, the Agency, the leaders, and higher-ups. They’d pluck him away from the hospital one day and put him in a position where he would make decisions concerning all of their lives. Mañalac hoped that Dr. Julien would remember him for his loyalty and dedication when that time came. Maybe Dr. Julien would even take him with him, as an assistant or right-hand man. In Green City you survived when you learned how to control others, bend them to your will, make them think that your subtle manipulation was for their own good. Mañalac hoped Dr. Julien was his bridge from one class to another, which most men of Mañalac’s background could never hope to achieve.

  There was only one thing that stood between Julien and his destiny: Julien himself. Dr. Julien mistakenly thought that each person’s individuality mattered as much as the collective duties the authority figures had assigned them according to their station. Nor did Dr. Julien sacrifice his own autonomy for the greater good of society. It would not serve him well once they took notice.

  Mañalac had spent hours observing the young doctor, attending to him during the long work days and nights at Shifana. While Julien was correct in his interactions with the senior doctors and the hospital administration, he lacked the deferential manner that his position demanded and his seniors expected. He ventured his own opinions without fear or embarrassment; he never indulged in the obsequious bowing and scraping that a junior doctor was expected to show. He remained quiet throughout floor meetings, listening calmly, usually not saying a word among other juniors too eager to impress the seniors.

  Mañalac knew that Dr. Julien’s patients always recovered quicker than the others, that he was requested again and again whenever former patients returned to the hospital. He delivered results that nobody else could match, and there was talk of him winning the Green City Doctor’s Award this year, although it usually always went to someone far more senior than he was.

  Mañalac admired and feared for Dr. Julien in equal measure. As he watched Julien’s eyes move all over the girl’s face, a painful sorrow came over him. He could see, with dangerous prescience, where this would lead: they would both be caught, Dr. Julien and the girl, and punished by the Agency for rebellion, if not revolt.

  “Ram, you’ll stay here and clean up?” said Julien.

  “Don’t worry, Dr. Julien,” Ram said, busy with trays and instruments. “It’ll look like nobody’s been in here for a week when I’m done with it.”

  Julien stayed behind George and Mañalac as they maneuvered the young woman onto a stretcher. They wheeled her away from the main areas, again using private corridors and elevator. The elevator sped up to the thirty-second floor in a matter of seconds, blocking their ears up with pressure and making Julien slightly dizzy in the ascent. He kept wondering what was at work here other than the usual authority. Clearly it was someone with the access to the hospital system, someone who was, obviously, incredibly powerful.

  When they reached the preassigned room, Julien spoke his name quietly to the electronic lock, “Dr. Julien Asfour.”

  The door recognized his voice and immediately unlocked itself, revealing a luxurious room usually reserved for only the most important patients: Leaders and their families. The walls sparkled with fresh leaf-green paint, the air maintained at ambient temperatures, and the lighting in the room changed color depending on the time of day. Right now the lights were pulsing a gentle blue, to match the powder-light sky of the early morning just beyond the walls of glass. Julien shook his head, amazed. He’d lost all track of time in these past hours, and was astonished to realize that the world was going on as normal, while he was plunged in this unfolding, co
mplicated situation.

  The small entourage paused before entering, even though the hermetic seal was already broken. But once they crossed the threshold, there was no going back. The scent of lemons wafted out from the room as they stood there, hesitating and shuffling.

  “Look,” said George, pointing at the display on the inside of the door. “There’s a name. And an ID number.”

  Julien stared. Faro, Female. GCID 9301102-2 read the display. Faro. Faro... where had he heard that name before?

  Currents of fear buzzed through his body. Who was this woman?

  As Mañalac and George eased the woman into the bed, Julien strode to the window and looked out at the sea, close enough to surround the hospital on three sides, like a protective moat. He was worried about the medical supplies they’d used in the operating room. Everything from the oxygen and drugs down to the last strip of gauze was automatically recorded on the hospital’s internal databases. Everything—the IVs, the monitors, the syringes, even the doors opening and closing—talked to the network to tell it how much was being used and what for. The hospital could be resupplied, expenditures tracked, and performance of the staff monitored, a system that eliminated wastage and stealing from every hospital in Green City. How could he have forgotten the precision of the system? It would betray him, even if nobody else in this room did.

  George suddenly laughed “Wow. Unbelievable. The records don’t show anything. Look. I’ve never seen anything like it.” Julien looked at George’s device, followed his finger pointing to the rows and columns on the sheet: all the supplies for the operating room they’d just vacated were at full levels, at least according to the device. On the record, it looked as though the operating theater hadn’t been used since the day before. The benefactor again, resetting the system so that nobody would know they’d been in there.

  “What the... ?” muttered Julien. The continuing mystery was fraying his nerves, but he didn’t want them to know that. “All right, let’s get Mrs. Faro comfortable.”