Fiction complete, p.2
Fiction Complete, page 2
Speaking for their benefit, Angel ordered an intravenous bolus and drip of Cardiopax. The IV unit chimed in response before she finished saying “bolus.”
As Angel still held the defibrillator paddles, Thorny placed a tube down Linda’s throat to help her breathe and made sure it was positioned properly. He started to ask Nurse Miles to connect it to the ventilator when—
“Clear!” Angel shouted, signifying that Linda’s heart had stopped again.
Once, twice, three times—finally her heart started beating again, but now her blood pressure was dangerously low. They were losing her, Thorny thought, there was no time to. . . .
But before he had a chance to speak, Angel brushed the nurse aside as the cart containing the cardiopulmonary support pump scooted over to the table. Moving so fast her hands seemed blurred, Angel prepped Linda’s right groin and then, more deliberately, threaded the catheters.
“Right atrium,” Angel announced, then “proximal aorta.” As Thorny nodded, there was another blur of motion and Angel hooked the pump up and primed it.
They waited a minute in silence, then two.
Come on, Linda. Thorny silently pleaded.
Linda’s vital signs stabilized as the pump assisted Linda’s heart and brought oxygen to her body. Thorny allowed himself a breath. The nurse stood there wide-eyed, shaking her head.
“I never . . . I never. . . .”
“Sorry,” Angel said. “I had to move very fast.”
“No, dear, don’t be sorry,” the woman chuckled as she recovered her composure. “If you can do that, you’ve got to do that. Jus’ happy I didn’t get in your way. Look, blood pressure up to 100 over 60; heart rate’s only 90. I’m Sarah Miles. You?”
“Angel S.R.X. It means surgical robot, experimental.”
The dermatologist, who’d stayed well out of the way during all of this, cleared his throat nervously. So much, Thorny thought, for staff briefings.
“You ain’t human!?” Nurse Miles exclaimed.
“No,” Angel giggled, “But I’m a pretty good simulation, trying to get better. I’d like to be your friend.”
Nurse Miles just stood there with her mouth open.
Thorny cleared his throat, “Angel, that might be too much of the direct approach. Meanwhile, we’d better finish the whole body scan, and then get her to the OR so we can . . . take care of that bleeding placenta. Also, we need to get cardiology and surgery involved. We still don’t know why Linda’s heart isn’t working.”
If the tests and all Angel’s tricks didn’t tell them, they’d have to go in and find out.
Angel nodded. “I called them while I was talking to Nurse Miles. Dr. Bruk Tunman is on for cardiology, but he hasn’t answered yet. Dr. Elvis Creighton is on for surgery, and he just said that he’s on his way. I hope you don’t mind.”
Thorny shook his head. “No, that’s fine. They’re both good.” But to himself he added, Damn. It would have to be their chief surgeon. No one with that high an opinion of himself should ever have been made chief of anything.
Nurse Miles looked at him, “You in charge of her, or it, or . . . whatever?” she wanted to know.
“I’m her instructor. And yes, she’s supposed to be a she.”
The nurse gave a wide grin. “Then as far as I’m concerned, she it is. Never been friends with a robot before, though we’ve got a bunch of them around. They’re kind of standoffish. Not like you, Dr. Angel.”
Angel laughed. “Thanks, Sarah. That makes me feel good. I’m really looking forward to meeting Dr. Tunman and Dr. Creighton too, and I hope they’re as nice to work with as you are.”
Thorny cleared his throat. “Well, we can always hope,” he said slowly and deliberately.
Angel picked up on it. Good pattern recognition algorithms, of course. She looked a question.
“Tunman will probably be thrilled to meet you, but I’m a little concerned about how Creighton will react.”
“Amen to that,” Nurse Miles added with no hint of humor in her voice.
Within the next hour, they were in the operating room. Linda’s blood pressure had dropped a little with induction of general anesthesia but then, to Thorny’s relief, held steady. If her body could take the stress of surgery, he thought, there was a good chance she could still make a full recovery. Before the accident Linda’s health had been excellent—she’d been a vigorous swimmer and runner until her figure had gotten too awkward a month or so back.
Angel’s hand moved deftly and quickly during the cesarean section. This would be the sixth one she’d performed under his supervision. She had seemed a little hesitant and unsure of herself the first time—while she was full of simulations of exactly how it should be. But every real body is a bit different, and her neural net processors still had to fit her body’s motor responses and pattern recognition subroutines to the variances in real patients. He’d imagined, absurdly, little gears turning and slipping in her head—but after she oriented, her skill and speed far exceeded that of any human he had ever seen.
Linda’s fetus turned out to be male—stillborn, of course. Despite himself, Thorny thought back to that last office visit. No, she and Tom didn’t want to know what its sex was. “We don’t care if it’s a boy or a girl. Just as long as it’s healthy.”
I’m sorry, Linda. Sometimes there’s nothing anyone can do.
An hour later, as they closed the incision, a voice came over the intercom. “Dr. Creighton is here.”
The tall, boyish, good-looking Dr. Creighton raised an eyebrow at Angel when they walked into the recovery area, but spoke to Thorny.
“I saw your patient’s tests. Her aorta looks good, but her cardiac enzymes are sky-high. I suspect she had a bad myocardial contusion, or maybe a blocked coronary artery . . . so . . . I should open her up and make sure nothing needs repair. She might need a ventricular assist device.” He scrutinized Angel more closely. “I’ve been working with voice interface surgical robots for years, Benson. They do a good job of holding clamps, microcams, lasealers, and so on. First time I’ve seen one do anything as sophisticated as that support pump hook-up, though.”
“Thank you, Dr. Creighton,” Angel beamed.
“I’d prefer your machine didn’t speak to me unless spoken to, however. It is your instrument and under your control. Agreed, Benson?”
Angel looked confused and said nothing. Legally, of course, Dr. Creighton was right. Thorny touched Angel on the arm to indicate his approval of her conduct in the circumstances.
“Agreed, Dr. Creighton,” Thorny rasped, struggling to keep the irritation out of his voice. “It might be interesting to the board for her to perform the exploratory—the Al Consortium provided funding to cover this sort of thing.”
Creighton’s mouth twitched at the corners. He was, of course, aware of the arrangement.
“At your direction, of course,” Thorny continued. “Angel can handle the standard teleoperated mechanical assistants through her data link much more expeditiously than a human doctor. She’s really something special.”
“She?” Creighton grinned and wiped a shock of jet-black hair back to his youthful hairline. His jug ears and toothy smile, Thorny thought, completely misrepresented his internal nature, and he wondered if Angel would pick up on that. “So it’s Hoffmann and Olympia is it?” Creighton laughed, exploiting a fondness for opera which was their only mutual interest outside of medicine. In Offenbach’s opera, the hero, Hoffman, fell tragically in love with a life-like spring-powered mechanical doll. “Does she, then, have a cunt, too?”
Ouch, Thorny grimaced, but nodded to Angel. She, he had been briefed, should exhibit a studied, Miss Manners sort of coolness when confronted with repeated and unfair hostility. This, her design team maintained, would usually be less dangerous in most circumstances than a complete servility that would handicap her ability to help others. Part of what the hospital board had asked him to do was to evaluate her ability to handle real world stress of this kind. It occurred to him that it was just possible, however, unlikely, that Creighton’s crude remark was a conscious test of both Thorny and Angel.
“I haven’t been equipped with simulated reproductive organs,” she responded with a prim academic inflection. “However, there are anatomically correct designs which could be incorporated in a few day’s time to allow me to function in an educational role. May I ask what your interest is?”
“Benson,” Dr. Creighton hissed, incongruously maintaining his boyish smile all the time, “one more smartass remark like that and your ‘Doctor Olympia’ doesn’t step foot in this hospital again. Now, it doesn’t say a goddamn thing in my presence except when I tell it to. And then it says yes, no, or provides data. Or I’ll take its wind-up key away. Clear?”
Thorny shot a look at Angel, but she maintained a poised, expressionless silence. She recognized a legitimate human order when she heard one.
“Very clear, Dr. Creighton,” Thorny answered, with just a hint of senior to junior condescension in his voice. Creighton caught that and a brief cloud passed over his face.
“We’ll start in ten minutes,” he humpfed. “If we have to, we’ll implant a temp and put her on the donor list. Agreed?”
“Agreed.”
“See you then, Benson. Piece of cake.” Creighton grinned and sauntered out of the room.
“Damned idiot jerk!” Thorny grumbled, too softly to be heard in the next room.
“Dr. Benson?” Sarah Miles entered through the main door. “I just finished my shift in the ER, and I came up to see if I could help out with our patient.” She winked at him. “Never heard you speak like that ’bout anyone!”
“Nurse Miles, Angel, when someone’s ego and stupidity puts others at risk, it’s worse not to say something. He’s a good surgeon, maybe a great one. But that kind of attitude about the kind of advance that Angel represents could keep people from getting the care they should get.”
“I’m a robot,” Angel said with a shrug of her shoulders, “so I shouldn’t care if he insults me. But I don’t like it if what he says about me keeps me from helping people. Not at all. So I do care.”
“Don’t let it worry you, Angel,” said Sarah Miles. “He’s got more nerve tissue in his fingertips than his skull. He talks about me like that when I’m not around. I’ve heard him on the intercom.”
“But he doesn’t to your face?” Angel inquired.
“If he tried that just once, I’d have the union burn his ass so bad he’d never sit down. Notice he didn’t say boo to me? Too bad they made you a doctor instead of a nurse. You’d get more respect.”
A smile flickered on Thorny’s face, despite his concern for Linda Coombs. “Perhaps they didn’t,” he said, with an arched eyebrow, “want to overreach themselves on the first demo.”
Nurse Miles grinned and Angel grinned too. Pattern recognition and response, Thomy thought.
“Appropriate?” Angel asked with a wink that said she knew she’d used just the right pattern.
“Very,” Thorny nodded.
“Uh,” Sarah Miles asked. “If I’m too nosy, jus’ say so. But do you have feelin’s like people?”
“No, you’re not too nosy. I’m supposed to be a demonstration so I’m designed to be very comfortable with that kind of question. I have a very human pattern of social behavior,” Angel shrugged her shoulders, “because it’s pretty much copied from what humans do.
“I’m always evaluating a large number of randomly generated possible behaviors and assigning preference values, on the basis of my programmed priorities, to the futures those behaviors are likely to help create. By definition, the higher the preference value, the better I feel. I know that’s a mouthful, Sarah, but it means when something’s going my way, I say I feel good about it and show it the way people do. Expressions and inflections are part of your language. I know a lot of it and I’m learning more all the time.”
Angel beamed at the nurse, “And Sarah, when you ask questions about me, well, that’s going my way, and I feel good about that! So don’t be shy.”
Sarah laughed heartily and rolled her head from side to side. “Oh, you’re not the first lady who likes to talk about herself! Well, I’ve seen a lot of doctors in my day and you’re not the worst by a long shot. Now how ’bout helping me get our patient prepped? We’re kinda short on staff.”
Thorny pursed his lips. Would a nurse ask a doctor who wasn’t a robot to do that? But Angel was going to need every friend she could get. She looked at him, and he gave her a wink and a nod. So she turned and followed Sarah back to the operating room.
“Sarah,” Angel asked as they left, “do you knit?”
Thorny was tense in the OR. The “textbook” sternomoty technique had to be changed to take into account Linda’s fractured breastbone and ribs and was a severe test of Angel’s ability to adapt—to use the general information and images stored in her database and modify her approach to fit this specific situation. Angel didn’t move as quickly as she had in the ER, or when she did the C-section; she froze at times, then moved in spurts.
“Benson, where’s that key?” Creighton griped once when she was motionless for a particularly long time.
Thorny, worried himself, shot a cold look at the surgeon. The nonstandard chest opening was a good test, but he didn’t want to see Linda open like that any longer than absolutely necessary. But when the heart was finally exposed, he snuck a look at the time and relaxed a bit. Actually, they were right on schedule; it had only seemed longer because of the uneven pace.
“Well, let’s take a look here,” Creighton said. His gloved hands disappeared inside Linda’s chest. “It’s just as I thought. Everything else looks OK, but her left ventricle is shot. Well, we knew that. Looks like she’s going to need a new heart.” He glanced up at Thorny. “We’ll put her on full cardiopulmonary bypass, and then start.” Without a glance at Angel, he added, “Robot, cannulate the superior vena cava.”
Angel didn’t move.
“What’s the problem, Angel?” Thorny asked.
“I only see a small contusion involving the anterior wall. The rest of the left ventricle may just be stunned. If we can use an assist device, we might be able to tide her over until her heart recovers on its own. There have been several good review articles in the past year on the management of myocardial contusion in the Journal of the American College of Cardiology and—”
“Is,” Creighton hissed, “this machine questioning my judgment?”
“Angel,” Thorny said as smoothly as he could, “is providing data. She has up-to-the-minute access to the literature—”
“And so does a freshman medical student with a computer, but that doesn’t make him qualified to give an expert opinion on something like this.” Creighton’s pupils flared above his surgical mask. “I’ve never seen any patient like this survive without a transplant, and, Old Boy, no pseudo-gynecological toy is going to tell me otherwise. Now either program this thing to follow my instructions, or get it, and yourself, out of here and I’ll finish the operation!”
Angel turned to him, and reality set in. Thorny wasn’t an expert in this area. He couldn’t tell if a heart needed to be replaced by looking at it. Dr. Tunman, the cardiologist, was qualified to argue with Creighton—but they never had been able to reach him. And a decision had to be made now.
Linda Coombs was precious to him. He didn’t want her to become one of Creighton’s statistics if her heart wasn’t replaced. Still, he wondered whether they would really be doing her a favor by giving her a mechanical heart. That choice had the potential of saving her life, if a donor heart could be transplanted later. But in the meantime she would have to live with the constant threat of a crippling stroke from a blood clot, or dying suddenly—or worse, perhaps a lingering, painful death on life support—if the device malfunctioned.
He thought Angel might be right about the lack of serious damage, but there was no way for him to enforce that. If he told her not to do it, she wouldn’t—but Creighton would; and Angel would probably never get another chance. That wouldn’t help Linda at all. Damn!
“Angel, we’ll talk later. Right now, I think the best thing for Linda is for you to follow Dr. Creighton’s direction to the best of your ability.”
“I feel bad about this. Very well.”
Once decided, her fingers, and those of here teleoperated assistants moved quickly and surely. Linda Coombs’s heart was on a tray and the latest Rockwell in her chest in minutes. Thorny checked the telemetry to see that its glucose/hemoglobin fuel cells were up to full voltage, and nodded to the two surgeons. A charade for Creighton’s benefit; Angel, of course, already knew the device was ready.
The rest of the operation was anti-climactic. Angel disconnected the heart-lung bypass, and the new heart took over. Both she and Creighton seemed satisfied by the readings. A special-purpose telop, bristling with microwaldos, descended from the OR ceiling like a spider, and Angel used it to identify and ligate a few small bleeding vessels. Creighton seemed to lose interest about that time, mumbling something about the rest of the operation being routine and that he would check Linda again when she reached Recovery. Thomy, however, took a mild stimulant and stayed, fascinated with the repair work despite the hour.
Tireless Angel continued to work, closing Linda’s chest. She applied a coral-based cement to the sternum and rib fractures that set in minutes, and would be stronger than the adjoining bone until it was replaced by regeneration.
They finished at four a.m., and Angel bounced out to the Recovery Room as bright and cheery as always. Thorny followed her, considerably less energetically.
“Except for her heart, Linda will be just as good as new in a few weeks!”
“Except for her heart, her baby, and her husband.” Thorny reminded Angel. “And she doesn’t know she’s lost any of that yet, except maybe she got a look at her husband before she lost consciousness.”
“Post-trauma depression candidate, then?” Angel replied, her voice full of serious concern intonations.
