Now both R-2s stared at the receptionist.
Hazel shrugged and took another bite of cookie. “It’s the mid-stagers I feel sorry for, the ones on Unit 2. They still have bits and pieces of memory, individual pieces of a puzzle that no longer fits together. The world comes in and out of focus, but it’s a life without sense or logic. The struggle to remember the missing portions, to fill in the gaps, to come to grips with enough detail to make sense of the situation causes them to lash out in ways that suggest they’re in a constant state of agony. It’s only after those last bits of memory are extinguished that they finally find a weird bit of peace in a dementia-induced oblivion.”
Susan turned Kendall another look. This one, she hoped, conveyed anger and betrayal. She could have spent this painful month of renewal in a cushy outpatient clinic. Instead, in the depths of her own depression, she had to deal with the most hopeless creatures in existence. She wondered if she could ever crawl out of the deep black hole that circumstances and a poorly chosen rotation had created.
“Cheery,” Kendall said, popping his own cookie in his mouth and chewing thoughtfully. “These are delicious. I don’t suppose the patients made them.”
Hazel finished her own cookie and dusted the crumbs from her scrubs. “A family member brought them. Sweet, but totally impractical. Most of the end-stagers have forgotten how to swallow properly, and we’d have a run on aspiration pneumonia. We give the family the option of taking the cookies home or leaving them for the staff. Most choose to leave them. One of the few perks of working here.”
Susan brought an image of the unit to her mind’s eye. She supposed families could find a reasonable degree of privacy behind the sound-dampening curtains. “Do many people come and visit their relatives at…this stage?”
Hazel leaned back in her chair. “It varies a lot. Some people come every day, some never, and you see everything in between. It’s not always the ones you expect, either. The relatives who kept them home the longest are often the ones who disappear completely when they reach this stage.”
Susan found herself wondering how she would handle a similar situation if her father ever developed Alzheimer’s, then blocked her own considerations before they came to full fruition. Now did not feel like the time to grapple with additional weighty thoughts, no matter how appropriate to the situation. Not only would it borrow trouble at a time when she owned enough, but it was also rarely ever a good idea to judge the motives of patients and families, at least until she managed to get inside their heads. Once she had formed her own ideas of how she would handle a given situation, she could not help comparing it to others’.
Having finished her own cookie, Hazel looked expectantly at Kendall. Noting he had swallowed the last bite of his own, she gestured back toward the door. “Ready to move on to Unit 2?”
Susan doubted she would ever be fully prepared. However, she had never run from a challenge and did not intend to do so now. “Ready,” she said.
“Can’t wait,” Kendall added with a smile.
Susan rolled her eyes, but also forced a grin. She knew he was acting as much to keep her spirits up as his own. When they got off work that evening, they both knew she fully intended to kill him.
But by the time the day ended, Susan found herself with a pounding headache and a mood that would not make her polite company for any other human being, including her fellow resident. Worried that she might say something so heinous she permanently drove away the one person who could commiserate with her most times, she begged off the glide-bus ride that would take them closest to their respective homes. Instead, she went to the one place she thought she would want to avoid but that drew her inexorably: Manhattan Hasbro Hospital.
Susan arrived at 6:00 p.m., as most of the physicians left for the night and the on-call residents took over. She had come only to finish up a few charts from her last rotation, which she could do anywhere. However, she found herself heading straight for the little first-floor charting room, tucked between an insulated staircase and the central processing area for information storage, where she most often found Nate, the hospital’s resident robot.
Susan had gotten to know Nate in this room on her first night of call on her first rotation: the Pediatrics Inpatient Psychiatry Unit. As anyone would, she had mistaken him for a tall young man. He had not only set her straight, but had also told her more than she knew herself about her father and the company for which he worked: U.S. Robots and Mechanical Men, Inc. It was Nate who had led to her discovery that her father was not the simple bookkeeper he had claimed to be, but actually played an important role at USR.
Though well hidden and seldom visited by anyone but Nate, the area was known to a handful of staff and occasionally used as a quiet place for charting or private conversation. In fact, Susan’s senior resident on her first rotation, Stony Lipschitz, had mentioned it as his favorite on-call hideaway during the basement PIPU rotations. Last year’s R-3s had left for fellowships or to join private practices, except for Stony, who had decided to stay on as chief resident. As he now had a private office on the third floor, Susan doubted she would run into him here. Most of the other residents had not yet discovered it, considered it too far from their current assignments, or had found other places to disappear to between routine assignments and emergencies.
There was another reason, Susan knew, that might keep staff from this particular charting room—the very one that kept her returning to it. Nate and her father had both described the Frankenstein Complex, a surprisingly common fear of mechanical men, particularly android types, based on a concern promulgated and intensified by books and movies through the ages. An alarmingly large number of people worried about robots harming or replacing human beings. To Susan and her father, this fear seemed wholly irrational, although she could understand the logical basis for it. Nate was physically and intellectually superior to nearly all humans, in Susan’s experience, and the average person would find himself outmatched in a contest of strength, intelligence, speed, or stamina. She wondered if those same people also feared or despised human beings who were more competent than themselves. That would certainly explain some of the reactions she had experienced in her own life.
Reaching the charting room, Susan turned the knob and quietly pushed open the door. The room looked the same as it usually did, covered in modular shelving bulging with labeled opaque plastic boxes and a weird array of textbooks. To the right, the cozy nook with its odd assortment of couches and chairs beckoned, especially when she saw Nate sitting in a plush chair and leaning over a palm-pross on the central table. As she entered, he looked up. A smile spread across his features, as natural as any human expression. “Dr. Susan Calvin, what an unexpected pleasure. I heard you were on an outside rotation. Didn’t expect to see you for at least a month.” His hands moved from the keyboard to his sides.
“I couldn’t stay away from you, could I, N8-C?” Susan used his model number to remind him she preferred just plain Susan as much as he did Nate. “I’d suffer Nate withdrawal.”
Nate chuckled. “Well, I guess I thought you could go longer than a day without my handsome face.” He sobered suddenly. “What’s wrong, Susan?”
Susan flung herself down on a couch, her head resting against the armrest nearest Nate’s chair. “Wrong? What could possibly be wrong?” She knew better than to try to fool him. He recognized and expressed emotion better than many humans she knew. “It’s almost exactly a year since the best man in the world was killed in an explosion that left me critically injured. I’m a twenty-seven-year-old virgin. And, for the next month, I’m stuck in a freaking…garden.”
Nate narrowed his eyes. Since he had a perfect memory, it was rare someone used a term he did not know. “You’re stuck in a garden?”
Susan rolled her eyes toward him and explained the slang. “Treating a unit of vegetables. A garden.”
“Ah.” Nate figured out the rest based on previous conversations. “You’re working in the public dementia facil
ity.” His brow furrowed. “Isn’t it a wee bit unkind to refer to your patients as edibles?”
Not feeling in a particularly benevolent mood, Susan shrugged her shoulders nearly up to her ears. “Most medical slang has a nasty edge. That’s why we don’t share it with the patients.”
Nate made a thoughtful noise. “You’ve changed, Susan.”
Susan rolled her head toward Nate. “Of course I’ve changed. Everything we do, everything that happens in our lives changes us.” Susan considered her own words. “That’s why people who survive the same tragedy feel so drawn to one another and so isolated from everyone else. It’s probably the root cause of post-traumatic stress disorder, at least in layman’s terms.”
Nate made a thoughtful noise, the type of instinctive sound Susan expected only from a human. She had always found it difficult to think of Nate as anything other than a man. It surprised her more when he acted like a robot than when he did something characteristically human.
Susan tried to reassure him. “But I don’t think I’ve changed in any unexpected or unreasonable way. I mean, I never did have a lot of tolerance for prolonging undignified and hopeless life, even without clear suffering.” She remembered her pediatrics rotation in medical school. A child born anencephalic, missing most of its brain and skull, came onto the service because the parents insisted on aggressive resuscitation. It survived two weeks with nothing above its enormous blue eyes, a single fused nostril, and a relatively normal mouth.
Nate apparently caught the unspoken leap. “You’re not talking about your dementia patients. They had a conscious existence, at least at one time.”
Susan rewarded Nate with the truth. “You’re right. I’m thinking about rare and fatal birth defects, situations I saw in medical school that I guess the Dementia Unit reminds me of. There were parents who insisted on throwing away other people’s time and money to avoid making the difficult but necessary decision to let nature take its course and put the child out of its misery. When did we decide, as a species, that allowing people to die of lethal defects was ‘playing God,’ but jamming tubes and needles into soulless bodies was ‘natural’?” Susan rolled her eyes, head shaking. “When that’s clearly ass-backward.”
Nate sat back, crossing his legs. “I’d like to get back to your garden, Susan. Here we’re talking about once-normal people, with full lives and loved ones who’ve known their history, all their strengths and foibles. It’s not the same thing.”
Nate was right, of course, but it did not really matter. “Different, yes. Better, no.” Susan sat up. “It’s impossible not to think about what I would do in the same situation.” She drew a deep breath and let it out slowly before revealing thoughts she could not share with anyone else. “For the past year, I desperately wished Remy had survived the explosion. If he had sustained brain damage, I would have been with him every step of the way, would have helped him recover every bit of ability he possibly could. But…” She met Nate’s eyes, trying to read them to decide whether she should finish.
Susan found encouragement there, the same she might have found in Kendall’s, had she given him the opportunity. “If he…wound up like those patients, incapable of any worthwhile thought process”—she steeled herself and continued—“I hope I would have the strength and fortitude to kill him.”
“Kill him?” Nate’s brows flung upward. “Isn’t that a bit…active? I mean, withdrawing nutrition or fluids is one thing. Killing is…murder.”
Susan should have expected that reaction. It was the embodiment of the USR-patented First Law of Robotics: A robot may not injure a human being, or, through inaction, allow a human being to come to harm. Her father had made one thing abundantly clear: even the most rudimentary positronic brain could not exist without all three Laws present and intact. “A young, strong man like Remy”—she appreciated that she could now speak his name without tearing up—“could live for decades in a vegetative state. He would not have wanted that, and neither would I if it happened to me.”
Nate played devil’s advocate. “But how can you possibly know that other people and their loved ones feel the same way? From my research, the suicide rate for people with mental retardation is no higher than the general population. If you don’t understand the concept of normal, who’s to say you’re not content, that life’s not worth living? Admittedly, this is anecdotal evidence, but the patients with congenital intellectual disabilities I’ve met have always seemed quite happy.”
“Someone never read Flowers for Algernon.” Susan sighed and sank back into the couch. Nate raised an eyebrow in query, and suddenly she had an insight about positronic robots. Despite their amazing ability to retain every piece of information presented to them, they were wholly ignorant of anything else. Most of what Nate knew, he had gleaned from this room: the textbooks, the charts, his chats with visitors like her. There had never been any reason for anyone to give him a novel or take him to a movie.
She explained, “Flowers for Algernon was a story, and then a movie, about an experimental treatment that triples intelligence. It’s first performed on a mouse—that’s Algernon—then on an intellectually disabled human, Charlie. The reader gets to see the transformation and the problems it creates for Charlie. He’s at the peak at of his intelligence when he discovers a mistake in the experiment which invariably leads to Algernon’s intellectual deterioration and death. Once blissful in his ignorance, Charlie now knows the world of genius, where he no longer belongs, and it drives him into desperation and madness.”
Nate nodded thoughtfully. “So, you’re saying people with congenital mental retardation—”
Susan winced at the use of the term. Though medically technically correct, “mental retardation” wasn’t a phrase most people were comfortable using.
“—are usually happy because they don’t realize or understand they’re”—apparently noticing her discomfort, Nate softened his approach—“less than perfect.”
“Exactly.”
“But people with dementia are aware they’ve lost something precious and vitally important.”
Susan elaborated, “Even remembering bits and pieces of it, which they can’t quite fit together as a whole anymore. It’s torture of the worst kind. They’re miserable, degraded, humiliated. Given the opportunity, I know I’d want to die as swiftly and painlessly as possible.”
She added without thinking, “Wouldn’t you?”
Nate laughed. “Susan, it doesn’t apply to me. I’m just random human stem cells coaxed into a dermal and muscular system grown over a skeleton of porous silicon. If something happened to my body, USR could just make me another one.”
Susan did not agree. “You’ve just described your shell, not you. Nate is the positronic brain inside the skull portion of that framework, the network of neuron equivalents connecting thought to action.” Susan did not know the specifics of building a positronic robot, but she knew enough to realize Nate had made her point for her. “People aren’t that much different. Despite all the mushy poetry about what’s in our hearts, it’s only our brains that matter. You can remove the heart from our bodies and transplant one from an accident victim or even an animal, and we’re still the same person, for all intents and purposes. But if you remove the brain, assuming you could effectively transplant another, we become someone else entirely. The humanity, the intellect, the essence of everything we are is entirely in that one convoluted, double-fist-sized structure hidden in our craniums. Damage that one organ and we are—”
“Different?” Nate tried.
“Nothing,” Susan insisted.
Nate sat back, stroking his hairless chin like a stereotypical psychiatrist. For the first time ever, Susan wondered whether he had to shave. She could not think of a reason, other than to enable him to pass for human, to create such a feature. On the other hand, he did have real and growing hair on his head from the human dermal tissue comprising his scalp, so he probably had the same issues as any normal human male. “So, when someone surviv
es a brain injury—say, an accident or a stroke or the removal of a tumor—we should kill him?”
Susan snorted vigorously, blowing out her lips in a gentle raspberry of derision. “Please, Nate. Surely you’re above those kinds of extremes. Naturally, we have to stay within the boundaries of logical sense. I’m tired of the ‘where do we draw the line’ offense. We draw lines every day of our lives.”
Nate quirked an eyebrow, an all-too-human gesture to encourage her to speak her mind. Susan again found it difficult to believe he was a robot. Invented by the president and founder of U.S. Robots, Lawrence Robertson, the positronic brain was a miracle of science and technology. “Okay, let’s talk about the abortion argument. A lot of people on the antiabortion side won’t listen to anything, on the pretext we can’t be drawing lines. Yet they do draw the line, some would say randomly, at conception. Whereas, the abortion crowd draws the line, equally randomly, at viability outside the womb.”
Nate frowned, brows drawing downward again. “I’m not sure I would call either of those lines random.”
Susan clarified her thought. “I don’t mean random in a logical sense. I mean random in an intellectual sense. The nice thing about both lines is they’re solidly concrete, though wholly incompatible. But difficult individual decisions shouldn’t be made with a single brushstroke.”
“As opposed to laws,” Nate pointed out. “Which have to be.”
Susan nodded. “Which is why medicine should be bounded, not governed, by law. We need to stop legislating personal details without understanding the situation or the wishes of those involved.”
Nate studied Susan for several moments. “So, you’re promoting…anarchy?”
Susan slid back down on the couch, with her head propped against the armrest. “Certainly not. I’m a huge fan of lawful civilization. We need laws, and probably even leaders, to protect us from our own power, greed, stupidity, madness, immorality, and blind self-interest. Most things in life easily confine themselves to basic ethics and logical guidelines: Don’t murder other people, except in self-defense. Don’t take things that don’t belong to you. Don’t sell things to people that are addictive and deadly. Don’t do things that might incite masses to riot.”
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