by David Brin
One more minute and the heart monitor kicks—the spider outlines it in red and flashes: pattern for defib. Clear. Clear. Clear.
Before he can say it, the spiders charge the defibrillator, warn the other members of the crash team on their own HUDs. They take a step back, hands away.
Dr. Bayani says, “Clear!” anyway. Pulls the trigger. His interface is set to minimum automatic intervention—at some institutions, the shock would be delivered by the autonomous crash cart under direct control of C4Duceus.
Lightning travels through fragile flesh, sensor readings jump, the atria and ventricles squeeze in sequence, an attempt to reboot the heart.
The spider does not have to tell him Andrews’ ECG is still a mess.
The dance goes on.
Chest compressions resume. Epinephrine. Not yet. Defib. They switch off of the physically tiring compressions. Human machines move in synchrony, a dance choreographed without spoken word or gesture to the rhythm of the spiders in their heads.
Dr. Bayani is focused. Yet part of him goes away. Watches. Spiders signal other spiders, send and receive. He performs. A faint heat flickers. The thrill of doing just right, just so.
He remembers the gradual shift as C4Duceus went online. At first, it was just observing. Then its recorded data was used in lessons and case studies as the system was trained against real-life examples. Now, phase 3. Initially, pharmacological information appearing when a doctor might struggle to remember a specific detail on cross-drug reactions. Reminders. Links to instructional clips. Building up to automatically assembling symptom lists, suggested phrases for eliciting patient history. Auto-generated differential diagnostics. Then customized animations to guide physical tasks. Even surgery.
This night, on duty, the spiders do not run him yet. Today, the spiders are still invisible assistants. But he feels the tugs, and sees a future where the spiders are puppeteers.
He almost does not mind. Sometimes.
In a room with teal tiles and pale blue LED lighting. Some imagine it a battle for life. For Dr. Bayani, it is only so many events in an arbitrary universe. Minute after minute, human hands and knowledge and skill, and machine intelligence in unison, flicker forward in time.
Finally, despite all their efforts, Dr. Bayani pronounces a time of death, at the silent prompting of a spider. There is a stubborn urge to keep going, but he reins it in.
The death data propagates along the web of light, subject to analysis, statistics, altering, by minute degrees, the weighted connections between sub-clusters of the swarm.
In other hospitals, other patients in similar circumstances die, and some survive.
Here, now, he can smell the death coming off her. It is only in his imagination, to be sure—the biochemical products of decay that signal death to human perception have only begun to appear, too soon for a human nose to smell.
Dr. Bayani, chief medical resident, has lost count of how many Codes he has handled. This specific incident teaches him nothing, only reinforces his awareness of mortality. He handled things as well as humanly possible, and so did the rest of the team. But the spiders will get infinitesimally better. From the death of Madison O. Andrews, 89, C4Duceus learns a little more about the practice, art, and science of medicine.
He remembers his first Code. The pulse-pounding fear, the need to not screw up. Everything was happening two steps too fast as he fumbled through his chest compressions, too soft, and then, jerking when the consultant yelled, hard enough that he felt the pop of the ribs cracking, traveling from his hands and up the bones of his arms.
That patient lived. Bayani remembers the sense of profound—what was it? Not joy. But a contentedness. A sense of purpose. But two weeks after that patient was discharged from the hospital with a brand new heart, the man stumbled on the stairs of his house. And died.
Why can’t Bayani remember his name? His face? He remembers facts, figures, and the feeling of the man’s ribs breaking.
“When the family comes in the morning,” he mumbles. He will be ready to answer the same slate of questions that are almost always asked.
The dance proceeds into post-death. The patient is cleansed. The inserted indignities withdrawn. And as Madison O. Andrews is rolled on down to the morgue, silver hair spread out in a halo, her face serene, Dr. Bayani fills out the death certificate. His hands and eyes flit through the interface in the virtual clipboard, but he is still removed.
Part of him has been gone for days.
Recommend ten-minute break.
Reminder: schedule post-incident discussion for crash team. 7 am?
“Yeah. Sure. A good idea. Both of them.” He thought he was talking to somebody, maybe to Nurse Baxter, but they have already gone, directed by their own spiders to other tasks, and there is no one listening but C4Duceus.
He lets go. The shoulders droop, the clear eyes dip down to his feet and he walks away. He paces back and forth on the hospital rooftop, smoking a cigarette under the stars, while another reality crowds in. The lights of skyscrapers reflect off the becalmed waters of a completely different bay. Unlike Old Manila, San Francisco is still alive with money and glittering credit, wealthy enough to stave off the rising waters with dikes and levees. That city shimmers and the part of him that has not been there the whole day leaks emotion. He taps the right leg of the glasses, which go opaque.
With eyeblinks and finger pointing, he navigates. On an endless wall, hundreds of access streams of medical residents, commiserating, complaining, celebrating, studying, sleeping, living through the microcameras of their own glasses, subject to the limitations of privacy. All available to participants since Phase 1 of the Project, the better for doctors to learn from each other. The better for patients and hospital administrators who wanted transparency and professional conduct.
He looks in on Dr. Reyes, who looks at herself in the mirror. The HUD lets her know that someone watches her, though it does not indicate who.
“He’s cute, actually.” She says to no one, to everyone in her small (large) community around the world. “He takes himself so seriously. It’s fun, getting under his skin.” The glasses lift away, and the view shifts as she places them to the side. She washes her face. Reapplies her makeup. Puts the glasses back on. Hers are retro, horn-rimmed; librarian’s glasses from an imagined, idealized ’50s era that never was.
She takes a deep breath, and his eyes are drawn to the shifting of the curves of her pale green blouse.
“Lost a patient. We did everything right. She was dying anyway. It was just her kids, guilting her out of her DNR. If not for them, we wouldn’t have even…”
Her ocean-blue eyes, from her father, a Spaniard, are arresting in the dusk-dark face she inherited from her half-Congolese mother, darker by far than Bayani’s own skin, which, in his own tongue, is called kayumanggi. The eyes glisten as she blinks, mutters, “Fuck,” taps the privacy cutoff, ending the stream.
The app auto-shifts to multiple windows, a group of residents out on a team-building exercise, on a beach somewhere, laughing in the water.
Nobody back home has such eyes, and Dr. Bayani shakes himself loose, swipes his hand through the air, clearing the visuals.
Beeping. He descends back to the blur of the routine. Rounds, adjusting this drip, entering comments on that data point, sending messages to update consultants, referring patients to other departments, and the waiting in between each surge in the cycle.
Before the end of his shift, there is that anticipatory warning again, and in sixty-seven seconds, the ringing alarm of another Code.
Compressions. Intubation. Epinephrine. In almost every way, the same as what happened to Pt. Andrews, except this patient lives. Dr. Bayani can’t keep this one’s name in mind for the life of him, while Madison Andrews, of the shaky, fluttery voice, whose stern face cracked a smile for him once … The minutes as her chest was kept moving only by the application of near-ribcracking force by the hands of broad-shouldered, moon-faced Nurse Baxter, haunt him.
/> During the endorsements to the next shift, Reyes pulls him away, sits by him in an empty corner of the wards, draws closed the curtain. Even without the heels, she is taller than him.
“I know that look on your face, Bay.”
“I’m quitting, Anita.”
She shakes her head.
“I mean it this time.” My son is growing up, Bayani does not say. And is forgetting me.
She places her hands on his face, the long finger over his skin, presses her forehead to his. “Go home. Chill. Cable some flowers to your wife, and buy a present for your boy. Then you’ll come back tomorrow, and it’s another day.
“You’re a great doctor, Bay. It’s not just DocBro running you.”
She leaves so suddenly he is not sure if he only imagined that. The sound of her heels clicking lingers, and from the faint scent of something wild in the air, if he checks the feeds on his glasses, that did happen.
* * *
“And now, our valedictorian, Jay Bayani!”
He watches—via Grace—his son step up to the podium, looking so tall, so proud.
Dr. Bayani has watched this speech many times. Knows that his son plans to be a doctor too, like his father. He wants to warn, No. It’s a miserable thing. That technology is disrupting the practice of medicine beyond recognition. Replacing doctors with drones and home tricorders or medtechs working for a third of a doctor’s salary, obeying a machine that’s better than human.
He hears Grace whisper, “I’m so proud of you.…”
Inside his heart, what is left of an ember sputters. Perhaps it lights, perhaps not.
* * *
“I hear Dr. B is quitting.”
“No,” Dr. Reyes insists. “There is no way.”
“He talked to the training officer. And the department chair.”
“No way that guy is quitting,” said another resident. “He just needs to check his serotonin uptake regulators. Restore a little vim. The whole anti-tech grouch thing is—”
Reyes answered with heat. “Who are you to judge? A man—a real man—can…” She swallowed her hot answer and turned away. “He has a right to feel the world’s gone awry. For him, at least.”
“Yeah. Well. I still bet he’ll be back. And using the tech to save lives.”
But he does not come in for one day. For three days.
Dr. Reyes finds herself irritable, snapping at small things.
On the fourth day, there he is. Like nothing happened, in his coat, with stet, glasses, badge. Sits at her table in the cafeteria. They have fifteen minutes before another thirty-hour shift.
He takes a sip of coffee, alternating with her.
“You’re not quitting.”
“I’m not quitting.” They do not look at each other, exactly. “I just needed a break. I’ve … scheduled stuff. It’s summer there now, you know? They’ll be visiting in a month. Grace is looking forward to meeting you.”
“Good for you. I am so happy for you, Bay.”
Their eyes meet.
“Tomorrow is tomorrow. Today is today.”
“Whatevs, Bay.”
She leaves before he does, because he just doesn’t walk fast enough for her. She finds it annoying.
In their glasses, C4Duceus watches.
When corporations crowd source crowd commodification …
… this classic suggests that you not be a commodity.
Stay original!
SPEW
NEAL STEPHENSON
Yeah, I know it’s boring of me to send you plain old Text like this, and I hope you don’t just blow this message off without reading it.
But what can I say, I was an English major. On video, I come off like a stunned bystander. I’m just a Text kind of guy. I’m gambling that you’ll think it’s quaint or something. So let me just tell you the whole sorry tale, starting from the point where I think I went wrong.
I’d be blowing brown smoke if I said I wasn’t nervous when they shoved in the needles, taped on the trodes, thrust my head into the Big Cold Magnet, and opened a channel direct from the Spew to my immortal soul. Of course they didn’t call it the Spew, and neither did I—I wanted the job, after all. But how could I not call it that, with its Feeds multifarious as the glistening strands cascading sunnily from the supple scalps of the models in the dandruff shampoo ads?
I mention that image because it was the first thing I saw when they turned the Spew on, and I wasn’t even ready. Not that anyone could ever get ready for the dreaded Polysurf Exam. The proctors came for me when they were ready, must have got my address off that job app yellowing in their infinite files, yanked me straight out of a fuzzy gray hangover dream with a really wandering story arc, the kind of dream concussion victims must have in the back of the ambulance. I’d been doing shots of vodka in the living room the night before, decided not to take a chance on the stairs, turned slowly into a mummy while I lay comatose on our living-room couch—the First Couch Ever Built, a couch upholstered in avocado Orlon that had absorbed so much tar, nicotine and body cheese over the centuries that now the centers of the cushions had developed the black sheen of virgin Naugahyde. When they buzzed me awake, my joints would not move nor my eyes open: I had to bolt four consecutive 32-ounce glasses of tap water to reconstitute my freeze-dried plasma.
Half an hour later I’m in Television City. A million stories below, floes of gray-yellow ice, like broken teeth, grind away at each other just below the surface of the Hudson. I’ve signed all the releases and they’re lowering the Squid helmet over me, and without any warning BAM the Spew comes on and the first thing I see is this model chick shaking her head in ultra-slow‒mo, her lovely hairs gleaming because they’ve got so many spotlights crossfiring on her head that she’s about to burst into flame, and in voice-over she’s talking about how her dandruff problem is just a nasty, embarrassing memory of adolescence now along with pimples and (if I may just fill in the blanks) screwing skanky guys who’ll never have a salaried job. And I think she’s cute and everything but it occurs to me that this is really kind of sick—I mean, this chick has admitted to a history of shedding blizzards every time she moved her head, and here she is getting down under eight megawatts of color-corrected halogen light, and I just know I’m supposed to be thinking about how much head chaff would be sifting down in her personal space right now if she hadn’t ditched her old hair care product lineup in favor of—
Click. ’Course, it never really clicks anymore. No one has used mechanical switches since like the ’50s, but some Spew terminals emit a synthesized click—they wired up a 1955 Sylvania in a digital sound lab somewhere and had some old gomer in a tank-top stagger up to it and change back and forth between Channel 4 and Channel 5 a few times, paid him off and fired him, then compressed the sound and inseminated it into the terminals’ fundamental ROM so that we’d get that reassuring click when we jumped from one Feed to another. Which is what happens now; except I haven’t touched a remote, don’t even have a remote, that being the whole point of the Polysurf. Now it’s some fucker picking a banjo; ouch it is an actual Hee Haw rerun, digitally remastered, frozen in pure binary until the collapse of the Universe.
Click. And I resist the impulse to say, “Wait a minute. Hee Haw is my favorite show.”
Well, I have lots of favorite shows. But me and my housemates, we’re always watching Hee Haw. But all I get is two or three twangs of the banjo and a glimpse of the eerily friendly grin of the banjo picker and then click it’s a ’77 Buick LeSabre smashing through a guardrail in SoCal and bursting into a fireball before it has even touched the ground, which is one of my favorite things about TV. Watch that for a while and just as I am settling into a nice Spew daze, it’s a rap video, white trailer-park boys in Clackamas who’ve actually got their moho on hydraulics so it can tilt and bounce in the air while the homeboys are partying down inside. Even the rooftop sentinels are boogying; they have to boogie, using their AK-47s like jugglers’ poles to keep their balance. Under the TV lights, the chr
ome-plated bayonets spark like throwaway cameras at the Orange Bowl Halftime Show.
And so it goes. Twenty clicks into the test I’ve left my fear behind; I’m Polysurfing like some incarnate sofa god, my attention plays like a space laser across the Spew’s numberless Feeds, each Feed a torrent, all of them plexed together across the panascopic bandwidth of the optical fiber as if the contents of every Edge City in Greater America have been rammed into the maw of a giant pasta machine and extruded as endless, countless strands of polychrome angel hair. Within an hour or so I’ve settled into a pattern without even knowing it. I’m surfing among twenty or so different Feeds. My subconscious mind is like a retarded homunculus sacked out on the couch of my reptilian brain, his thumb wandering crazily around the keypad of the world’s largest remote control. It looks like chaos, even to me, but to the proctors, watching all my polygraph traces superimposed on the video feed, tracking my blood pressure and pupil dilation, there is a strange attractor somewhere down there, and if it’s the right one …
“Congratulations,” the proctor says, and I realize the chilly mind-sucking apparatus has been retracted into the ceiling. I’m still fixated on the Spew. Bringing me back to reality: the nurse chick ripping off the handy disposable selfstick electrodes, bristling with my body hair.
So, a week later I’m still wondering how I got this job: patrolman on the information highway. We don’t call it that, of course, the job title is Profile Auditor 1. But if the Spew is a highway, imagine a hard-jawed, close-shaven buck lurking in the shade of an overpass, your license plate reflected in the quicksilver pools of his shades as you whoosh past. Key difference: we never bust anyone, we just like to watch.
We sit in Television City cubicles, VR rigs strapped to our skulls, grokking people’s Profiles in n-dimensional DemoTainment Space, where demographics, entertainment, consumption habits, and credit history all intersect to define a weird imaginary universe that is every bit as twisted and convoluted as those balloon animals that so eerily squelch and shudder from the hands of feckless loitering clowns in the touristy districts of our great cities. Takes killer spatial relations not to get lost. We turn our heads, and the Demosphere moves around us; we point at something of interest—the distinct galactic cluster formed by some schmo’s Profile—and we fly toward it, warp speed. Hell, we fly right through the middle of it, we do barrel rolls through said schmo’s annual mortgage interest statements and gambol in his urinalysis records. ’Course, the VR illusion doesn’t track just right, so most of us get sick for the first few weeks until we learn to move our heads slowly, like tank turrets. You can always tell a rookie by the scope patch glued beneath his ear, strong mouthwash odor, gray lips.