I yawned. Hours of staring at the charts and the 3-D anatomical scan of the boy on my screen had made my eyes heavy. My own reflection blinked back at me: the thin face in its late 30s, a steadily receding hairline, glasses that grew thicker with each year I put off surgery. I tilted the monitor and the reflection thankfully vanished. I got up from my desk, stretched my hands high to the ceiling, and yawned again.
Cruzen was alive, due to the care administered by good, modern hands. A medevac drone had airlifted him to the nearest hospital: here, Saint Almachius the Vulnerable Regional Medical Center and Wellness Waystation. The doctors had him in the operating room fourteen minutes after the anonymous emergency call. The O’Neill-Kane machine’s eight arachnid arms scanned his body, pinpointed the trauma, and cauterized the wounds. The burns were cryogenically cooled. Stem cells patched the gaps in his spine, and the surgeons mended the fractured bones within an hour of the paramedics pulling his smoking, broken body out of the burning car. They plied him with artificial cells grown in a lab in Japan. And in just a few hours, Cruzen was unhooked from most of the electronic monitors, and moved up to a quiet room in the Saint Almachius Intensive Care Unit. His bed faced a big bay window with a panorama of the streaming ultrahighway between his stirruped feet. The latest chemicals—drugs built from the atom up, designed to catalyze the healing process, to effect miracles—soon had him well on his way to recovery. The very next day some friends visited, slapping him on the shoulder and joking about the near-miss he’d had. Cruzen really was a lucky young man, though the little jerk would never know, or appreciate, it.
I strolled slowly to the doorway, toward this least favorite patient of mine, who had grown fond of making demands of me and my staff.
There was a reason for my grudge. On the third day of his stay, Cruzen started talking about a girl. It made no sense. The girl was from his Digital Philosophy class, the one who had the crush on him, he said, seeming to ramble. He couldn’t remember the name. The nurses thought he was delirious. But then he started hitting the red buzzer button next to his bed. I had rushed to his bedside. When I arrived, Cruzen was barking at the old nurse about someone named Esmeralda, whether she had been hurt, whether she was in the same hospital. The nurse just stared at him.
“Honey, you were alone in that car,” the nurse said. “You’re lucky they got you out before the natural gas exploded. It ended up taking out most of the state forest, sugar.”
“I was with a girl, you idiot,” he said. “I’m not hallucinating. Get me a doctor. Now.”
He hadn’t yet seen me, for the bandages covering his left eye. The nurse rolled her eyes at me, shook her head, then left. I turned and followed her. I double checked the brain scan for any brain trauma in young Cruzen—and whether the O.N.K. had missed something. It never overlooked anything, but if there’s one thing medical school had taught me, it’s to cover yourself. I always had to check. I could never leave the hospital in the evening without knowing I had tied up every last loose end.
But sure enough, the machine was right all along. There were no problems, I told him on this fourth day, as I arrived with the latest stem-cell booster injections. These were the very treatments that were keeping him alive and on the road to recovery.
“Dr. Barnes,” said the teenaged patient, staring with his one eye at his Atman screen, where he watched a rerun of How Low Can You Go.
I reviewed the electronic charts over my FocalSpecs. The teen pointed to the small test tube dangling from my neck.
“What is that?” the teen said, pointing.
“A memento from when I was your age,” I said. “It’s not important, James. My question is, how are you feeling?”
“Not good,” said the patient. “The stupid nurses keep bothering me. Why is this taking so long?”
“You know, you should be thankful,” I said. “Your recovery wouldn’t have been possible a hundred years ago. You would have died within an hour of the crash.”
No reply came from the bed—only more tapping into the device on the teenager’s thin wrist. I went to the cabinet and pulled out some supplies: two syringes, two cottonballs, and a bottle of rubbing alcohol. With the familiar clap of the closed cabinet, Cruzen glanced up. They always did—something about that snap of that cabinet door put them all on notice.
“No more shots, Doc,” he said. “Can’t we just skip them this time?”
“No, these are booster shots for the stem cells. If you don’t get them, you die,” I said, crossing my arms to emphasize my point.
“But I don’t want to.”
“I took an oath to heal my patients. I take that oath seriously, James. So you can take the treatments willingly, or I can call in the nurses to hold you down while we tap your spine.”
The teenager stared. With a snort, he leaned forward off the pillow. He winced when I jabbed the point into the nape of his neck.
“Dr. Barnes, don’t you think there should be some kind of home regimen for this? Is that too much to ask?”
“The Bureau of Wellness hasn’t approved them yet for home use,” I said, dabbing the spot of blood, affixing a bandage. “These things take time. And each of these shots is a half-million dollars. You should just be thankful your parents can afford them. Not all my patients are so lucky.”
I tossed the cotton balls and syringe in the hatch leading down to the basement incinerator. I sat in the bedside chair, setting aside my own Atman, this one handheld. I smiled.
“I’ve got to ask a few things,” I said. “You have no serious brain injuries—just a minor concussion, as far as the O’Neill-Kane can tell.”
The teenager rolled his eyes.
“But what I want to know,” I said, “is what you’re saying about a passenger in your car.”
“I’ve told all the nurses and the police a thousand times,” the teen said. “Esmeralda and I were driving back in time to catch the semifinals of How Low Can You Go, and we saw part of the forest on fire, these bugs started falling on the car and attacking us, and we crashed through the guard rail. That’s the last thing I remember.”
I nodded. Somehow, I kept a straight face. It was one of my best bedside-manner skills.
“James, have you ingested any hallucinogens in the last month?”
The teen brandished his middle finger at me. I smiled and shook my head.
“Just had to ask, James. It’s just a very—interesting—story,” I said. “And just who is this Esmeralda—your girlfriend?”
“No—just some fat girl who wanted to have some fun,” Cruzen said. “I barely knew her. We went to the diner, and she was going to come back to my house to watch the show, spend the night with me. She was sitting right there, in my passenger seat, when we crashed. After the bugs fell on the car.”
“Bugs. Okay,” I said, ignoring this brat’s vile comments about the girl. “Tell me about these bugs.”
“There were millions of them. They dropped from the sky,” the kid said. “They had pincers or something. Hurt like hell. Esmeralda was freaking out.”
“I’ll ask around if we have a patient by that name,” I said, patting his leg. “But a lot of what you’re telling me just doesn’t sound possible. Teenaged girls don’t just vanish out of car wrecks, James. Bugs don’t just fall out of the sky.”
“Believe what you want, Doc,” the teen said. “But that girl is still missing, isn’t she?”
I tapped his elbow, picked up my device, stood, and walked out the door, not even glancing back at that bratty child on the mend whose survival depended on me. A camera in the hallway audibly tracked and zoomed in on me as I left. I felt its electronic eye on the hairs on the back of my neck. I cringed away from the voyeuristic lens, as I always did.
As I walked the hallway back to my office, I recorded some notes into the case history for the overnight staff. I was convinced there was no patient named Esmeralda. There couldn’t be, since I’d been the doctor on call the night of the accident. The kid had suffered brain trauma, and h
e was probably still delusional. Hell, the toxicology screens hadn’t come back yet—any of the new synthetic ergolines or cannabinoids the kids took nowadays could explain the delusions. I tapped a button, requesting further scans from the O.N.K., something to explain why the kid was asking deliriously after a girl who didn’t exist. But I also made a note to triple-check the hospital census for anyone named Esmeralda. Just in case—and for my peace of mind. Always that peace of mind, that complete attention to detail that made me good at what I do.
That day, a Wednesday, seemed neverending. My sidekick, Nurse Betty Bathory, had come down with a summer cold, and I walked my rounds without her. But I was not totally alone. As I walked to each patient’s room I’d call her, and between great whooping hacks of phlegm, she updated me on vital signs, blood levels, dietary patterns. She had all the medical information at her fingertips on her own device, and she briefed me before each patient, preparing to give the news, good and bad. In truth, she was as much a part of any success as I was. Sometimes I even told her how important she was.
“What’s the prognosis, Betty?” I asked.
“Joe, it’s not good. Be gentle,” the nurse said, sneezing.
It went like that. After what seemed like days, the afternoon was almost over. I checked my Atman. The screen flashed—I was due for a five-minute break before briefing the night-shift nurses. So I turned right, walked down the hallway, and entered the doctors’ lounge. I sat down and pulled out one of my energy sticks. I cracked it, shoved it up my nose, snorted, then sat back in the plush chair under the TV. Last night’s episode of How Low Can You Go was on. My brain whirled, but with clarity, like it always did with the energy sticks. It kept me going.
I tried changing the channel, but the show was on five different stations. On the screen, a woman applied a red-hot poker to her sister’s arm in exchange for five-thousand dollars. The live audience roared with applause, which drowned out the screams of agony. The broadcast cut to a woman with surgically-plump lips, weeping with joy, reaching into darkness, whispering inaudibly into the camera, then kissing her wrist. It was very dramatic—an advertisement for the new Atman Gen Four, the implant that had already sold out weeks before the widely-anticipated release date.
“You know you want it,” cooed the breathless voice.
I groaned at the sheer stupidity of it. But I startled someone or something behind me, which jerked. My heart leapt up in my throat. The sound came from the couch in the dark corner nearest the locked drug cabinet. I squinted into the darkness. It was a man in the shadows—a man in navy-blue nurse’s scrubs. I had never seen him before. Our eyes met, and I approached with my hand extended in greeting.
“Joe Barnes,” I said. “And who are you?”
The nurse had a lopsided haircut over a misshapen head. He glanced in the direction of the door, and his shoulders slumped when he saw I had cut off his escape route. Only then did he reach out and shake my hand, with one limp pump. His fingers were cold and damp.
“Charles Culling,” said the man, pulling away quickly, as if I had bitten him. “I’m the new night-shift nurse.”
“I heard the Bureau was considering giving us more funding,” I said. “I just thought it would have covered fixes to the O’Neill-Kane. So where are you from?”
“Pennsylvania,” Culling said. “Spent a few years on a night shift over at Wessex Medical Center. Before that I was at Clara Maass.”
“Ah, Clara Maass. That’s our sister hospital. I know lots of people over there,” I said. “Do you know Dr. Danish or Dr. Michaelson? They pretty much run the geriatrics wing over there. We used to play in a weekly poker game.”
“I’ve heard the names,” Culling said, fidgeting in his pocket. “But they wouldn’t have heard mine. I’ve always been on the graveyard shift. I don’t really know anybody.”
The nurse’s jaw clenched in those sallow cheeks. His eyes were focused on the door. I smiled and stepped aside to make room to pass. The nurse shot past me, out into the hallway.
“Nice meeting you, Charles,” I called out. But the door clicked shut, without a response. They were hiring more and more weirdos around the hospital every day, it seemed.
I jammed twenty dollars in the machine, snorted another energy stick, and walked back through the lounge to my office. After the end of the long day of tending to the sick and agonized, it was time for my nightly routine. I hung the stethoscope on the brass statue of the wise man on my desk, dictated my notes, and sent the master file into the hospital database. Then I hung my white coat on the big worn hook on the door, next to the shelf with my stacked diplomas which I’d never gotten around to hanging. As I walked out to the parking lot I called my wife Mary to tell her I’d be a little late for dinner, but that she should still set out a NutriFast bag to defrost for me.
The hospital’s security cameras followed my car as it left the parking lot, then turned for the ultrahighway and disappeared behind the strip malls in the dusk.
Mary and I had a quiet dinner, talked a bit about the small things, and went to bed early. Just another end to another day, one among hundreds, and thousands.
* * *
I returned to the hospital at the break of dawn, as usual. Charging into the office, apple clenched in my teeth, I swept the coat off the door hook and onto my shoulders. I grabbed the stethoscope off the wise-man statue, checked the terminal, and started my rounds. The first three patients were sleeping, but the machines showed normal vitals, blipping along. I whistled as I marked them off on my Atman. I reached the fourth room down—the room of the bratty teenager with the snapped spine. I took a deep breath and went inside.
The wall monitors were all blank. No signs of life. The teen’s face and skin had turned gray. But no alarm had been activated. I rushed over, felt for a pulse, found none, and punched the emergency button. No other indications—no wounds, no swelling, no secretions. Within seconds a team of nurses and specialists appeared, pushing me out of the way, defibrillating the kid’s heart, infusing him with chemicals, then slamming with fists directly on his chest. Nothing worked. I hovered at the edge of the huddle. Minutes later, Cruzen was pronounced and hauled off to the basement morgue. The electronic filing of the teen’s death began as the O’Neill-Kane performed the autopsy.
After the commotion, the doctors and nurses scattered. I could not catch my breath, and my heart raced wildly. I was left with the empty bed, still imprinted with the impression of the body that had laid there. I walked over to the lounge. I stuck another twenty bucks in the machine, and got my morning energy stick, two hours ahead of schedule. I hadn’t lost a patient in three years. And this one was young, just a child. Even with a catastrophic injury, the speed of his death was baffling. There had been no alarm, no warning. As I snorted the last bit of the stick, my head light and airy, I found my feet taking me back to my dead patient’s room, step by step, down the hallway, snapping my fingers like I always did. I swiped my Atman and entered.
The room was lit brightly by the morning sun. The orderlies had removed most of the sheets, but the ghostly shape of the corpse remained imprinted in the fabrics.
The boy had meant nothing personally to me. But he had been under my care, and an unexplained death would haunt me forever. I needed some kind of an answer. I scanned the walls, the pastel landscapes in dark frames, the computer terminal, the wires leading to the monitors and oxygen hookups in the bedboard, the medicine cabinet. Something about it was all wrong. The standardized layout—everything square, in its right place—was off. These hospital rooms were so familiar to me, I could always pick out the slightest thing amiss. I rounded the other side of the bed. The sun streamed warm through the spotless window.
“Joe,” said a voice.
Betty was at the door. She was wearing her nurse’s scrubs, which hung loose around her petite body. Her dark hair was pulled back taut in her ponytail. The normal rouge of her lipstick wasn’t there that morning. Her nose looked raw, like a gin blossom, from her lingering c
old. But she smiled at me. She held out her wrist, pointing at the blinking screen there.
“Top of the morning,” she said, hacking up a bit of phlegm. She cocked her head down the hallway. “Let’s go. Other patients to keep alive. No time to dwell on one dead brat now.”
“Go ahead. I’ll catch up with you. I have to check one more thing.”
She shrugged at me and turned. The door clicked shut behind her. I glanced at the computer monitors on the wall, like an enormous scoreboard, and shook my head. I was imagining things. There was nothing strange about the room, the location of death. I was just rattled because there was no explanation. But I had to keep reminding myself—there had to be some reason. They’d drummed that into us in medical school. The answers really had always been there—if not from the O.N.K., then from the other scanners, monitors, and sensors. Even through the Blackout, we’d managed to keep a technological grip on Death, and make her behave in our antiseptic walls.
And yet, this was different, somehow. I turned to the door, carefully stepping around the wires splayed out over the floor.
Something bright and white at my feet caught my eye. It was halfway under the bed. I stooped to pick it up. A piece of crinkled paper. I shook my head. I hadn’t seen a loose piece of paper since the Blackout. It was much lighter than I remembered, almost as light as air. But adhesive coated one side—it was a sticker of some kind. I flipped it over, unfolded it carefully, trying not to rip it. It was a label with a lengthy serial number. Staring at it for a moment, I stuffed it in my pocket, and headed off after Betty. I had other patients to keep alive, and the dead would just have to wait.
ONCE, A PHILOSOPHER…
TWICE, A PERVERT
U.S.A., 2087
I watched the boiling pot on the stove. The deep heat roiled the tormented bubbles up to the surface, again and again. Mesmerized, I thought back on the long day behind me, and that shape of a dead teenager pressed into the empty hospital bed, and the unexplained death. I cycled through the same half-dozen diagnoses, without finding any satisfactory answer.
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