Sisters

by Laurence Dahners

  Oh, she thought, when she shifted position. The painful spots in my back hurt worse too. Marissa looked up into the fond eyes of her sister. “You already did it?”

  Eva produced a nod that somehow combined itself with a shrug. “A lot of it. Not all.”

  “Why not?”

  “You bled some when Daussie took the tumors out. Tarc cauterized the vessels that were bleeding to stop you from losing too much. Daussie ported some saline into you to help replace what you’d lost but I was afraid you were too weak to tolerate much more blood loss. Also, we think you have too much cancer for Tarc to heat so much of it at once. The tumor he kills with heat has to be reabsorbed by your body. You’ll get sick if you resorb too much at one time.” She gave Marissa a look, as if trying to decide whether Marissa was following all that. Apparently deciding she understood, Eva continued, “That’s the reason we had Daussie remove big chunks of your cancer rather than just having Tarc heat all of it—all of it would’ve been a massive quantity for you to resorb.”

  “Oh,” Marissa said, beginning to grasp just how much of a problem her disease represented, even for these healers and their odd abilities. Deciding to bear her cross joyfully, she smiled and said, “How about if I get up and cook you guys some food then?”

  Eva pursed her lips and looked concerned. “I… don’t think that’s a great idea. The cancer’s destroyed a big piece of one of the bones in your spine. It was pretty weak and now it’s even worse because Daussie removed a big chunk of the tumor. We’re trying to come up with some ideas for what to do about that, but we’re worried that if you get up now the weakened bone might just crush down to nothing.”

  Marissa frowned, “Is it going to get stronger?”

  Eva looked unhappy, “Bone gets stronger when it carries your weight. Kind of like muscle gets stronger when it’s exercised. So, we’re kind of between a rock and a hard place. If you get up, your bone might crush. If you don’t get up, it won’t get stronger. In fact, it’ll get weaker. We’re trying to come up with some way to reinforce your bone, but we left almost all our medical books back in Clancy Vail.”

  “Books? Books from the ancients?” Marissa asked uncertainly, not sure whether she was appalled or not.

  Eva nodded solemnly. “Books that’ve helped us understand diseases like cancer well enough to have a chance at curing you.”

  “A chance? You’re not promising to cure me like all the other healers did?”

  Eva slowly shook her head. “Can’t promise anything. All we can do is the best we can do.”

  “Okay… agreed,” Marissa said, not sure whether she was glad to be talking to a healer who didn’t make promises she couldn’t keep, or apprehensive to have a healer with as little confidence as Eva seemed to be displaying.

  “Besides,” Eva said brightly, “people say I’m a pretty good cook, so let me see what I can make for us.”

  ~~~

  When they’d figured out Marissa’s kitchen and evaluated the pantry, Eva sent Tarc to the market for supplies. She and Daussie started rustling up a meal with what George had on hand. Once they had something cooking, Eva turned to Daussie, “Any ideas for how we could strengthen Marissa’s spine? The body of her second lumbar vertebrae would probably be stronger if it were made of lace.”

  Daussie spoke slowly, “I saw in one of the books that the ancients had ways to surgically shore up vertebral bodies, but I didn’t read it very carefully.”

  Eva sighed, “I should’ve brought more books.”

  “We couldn’t bring them all, Mom. Besides, traveling isn’t very good for them.”

  “Do you remember anything about how they did it?”

  Daussie’s look was doubtful. “I think in one section they talked about injecting stuff called ‘bone cement’ into the bad bone. But I’m not sure the bone was bad because of cancer. It might’ve just been bone weakened by osteoporosis.” She shrugged, “Even if we knew what ‘bone cement’ was, I’ll bet it isn’t something we could buy.”

  Offhandedly Eva said, “They called it an ‘acrylic.’ Which I think was some kind of plastic. But you’re right, I’ll bet even the Gellers would have a hard time making it for us. Do you remember any other treatments?”

  “They also put in rods that went in the back of the spine. They hooked into the laminae of the vertebrae several bones above and several bones below the bad vertebra and kind of stretched and straightened the spine. That way they were supposed to keep the load off the weak vertebral body in the front.” Daussie gave Eva an inquisitive look. “I don’t understand how that could work though. If the vertebral body in the front of the spine’s rotten with cancer, it seems like the lamina in the back would be in bad shape too.”

  Eva spoke thoughtfully. “Cancer seems to have a predilection for the vertebral body. I think it doesn’t usually affect the posterior parts of the spine until late in the disease. So if we could get some rods made with hooks on them…” She gave Daussie an intent look, “Can you draw me pictures?”

  Daussie stared at her. “And just how are you thinking we’d put these rods in?”

  Eva gave her a surprised look, then said as if it were obvious. “You’d port them in.”

  “Mom! To do that I’d have to port out some bone of the neighboring lamina to make a place for the hook. If I port a hook into a slightly incorrect position, I’ll wind up porting out a piece of the lamina it’s hooking into. The hook could wind up seated into a big laminar defect instead of around the lamina like it’s supposed to be! The hook would probably just rip out of the weakened bone!”

  Eva frowned, “How did the ancients put them in?”

  “I don’t know!” Daussie said, sounding frustrated. “If the book had pictures of it being done, I don’t remember them. I don’t even think the written description was very good.”

  Eva gave her a doubtful look, “Come on, you port glass lenses into the eye all the time. That’s got to be a lot more exacting than putting rods in the spine. You don’t worry about whether you’ll put those in the right place.”

  “But, when I do that I’m taking out a simple geometrical form and, in one pass, replacing it with one that I shape to be very similar! With this, you’re asking me to implant an existing complex shape into a location it might not quite fit. During open surgery, they would’ve been able to position the hooks correctly between the laminae, then insert the rod into the hooks. After everything was in place, they could adjust the tension on the hooks to put a little stretch on the spine. That’s not something we’d be able to do.”

  “I thought there wasn’t a good description of how it was done?”

  “There wasn’t,” Daussie said exasperatedly, “I’m just imagining how it could be done if you had the spine exposed.”

  “Well, keep thinking about it,” Eva said, “I’m going to go check on Marissa.”

  ~~~

  The next morning, Daussie and Eva were sitting at Marissa’s kitchen table. Daussie was trying to make a drawing that showed hooked rods seated into the posterior elements of the spine so she could better explain how they kept the pressure off of the anterior vertebral bodies. When Tarc came through, Daussie looked up, “Hey, can you help me do a better drawing of the spine? I’m trying to explain what I read about the rods the ancients used to protect spines weakened by metastases like Aunt Marissa’s.”

  Tarc sat down and looked at what Daussie’d drawn. He asked a lot of questions about what anatomic structures were supposed to be represented by the various lines in her drawing. She felt frustrated that he didn’t seem to get what she’d meant by the different elements in her diagram, but, after all, that’s why she’d asked him to help—her mother hadn’t understood her drawing either.

  Once he thought he’d grasped what she’d drawn, he said, “What if we drew it this way…” With a few strokes of the charcoal, he sketched out a simple yet clear representation of the lumbar spine as seen from the side. As she gazed admiringly at that, he said, “… and then we could
show your hooks like this…” The hooks magically appeared in place on the drawing of the laminae. “And then your rods would go… like this, right…? Is this something like the drawing they had in the book?”

  Better than the one in the book, Daussie thought admiringly. She nodded, saying, “That’s pretty good brother. Can you see how it’d be hard to teleport the rods into place? I think the ancients had something like threads and nuts on the rods… so you could put the hooks into position, then put in the rod, then stretch the spine. We’d have to have the spine already stretched, then put the rods in. Since we couldn’t adjust them once they were in place we could wind up putting them in too loose. Or, while trying to put them in tight enough, we could wind up porting them into the laminar bone a little out of position. The porting event might cut away enough bone that it’d be too weak to hold.”

  Tarc studied his drawing for a moment, then said slowly, “Even if we could get threads and nuts for the rod, the nuts would be really hard to tighten telekinetically. But…” he trailed off.

  “But what?

  Tarc looked up at her. “Have you come across ‘Sutton’s law’ in your reading?”

  Daussie shook her head.

  “It says you shouldn’t try to correct a problem in one part of the patient’s anatomy by working somewhere else in the body. If your ankle has a problem, you shouldn’t work on the knee.”

  “Okaay,” Daussie said slowly, thinking that calling something so blindingly obvious a “law” was ridiculous. “What’s that have to do with Aunt Marissa’s spine?”

  “I think you’re trying to fix a problem in the front of her spine by working on the back of her spine. You’re violating Sutton’s law.”

  “Um… and you know of a way to fix the front of her spine? The bone’s no good there, you know. That’s why she needs to be fixed in the first place.”

  Tarc looked down at their drawings, “Aren’t your rods going from the hooks at the eleventh thoracic vertebrae, across the laminae of T12 and L1, past the lamina of the sick L2, then across the laminae of L3 and L4 to hook into the lamina of the fifth lumbar vertebra?”

  Daussie nodded.

  “You’re going all that distance because you have to span a big distance so the bending stress isn’t focused in a small area. If, instead, you held the front of the spine out to length you’d be able to get away with just spanning L2.”

  “But L2’s diseased and weak.”

  “Yeah, you’d have to go from L1 to L3 so the ends would be in good bone, but that’d be a lot less than T11 to L5.”

  Eva asked, “How are you going to hook into the fronts of L1 and L3? There aren’t any laminae in the front like there are in the back.”

  Tarc had a look of concentration on his face. Not, Daussie thought, because he didn’t know the answer to Eva’s question, but because he was trying to figure out how to explain it to them. He said, “In the front, it’ll be loaded almost entirely in compression like a post holding up a roof. It’ll be squeezed from the top to the bottom… as opposed to in the back where it’s loaded in bending and needs to be hooked into place. In compression, it’ll only have to hold L1 and L3 apart. It can essentially just be wedged into place. You could put some teeth on each end to keep it from slipping out of place. Or…” he paused, looking thoughtful.

  “Or what?”

  “You could make it out of titanium. I read somewhere that bone likes to attach itself to porous titanium. Once the bone attaches to the post, you wouldn’t have to worry about it coming loose.” He started drawing. In a couple of minutes, he’d drawn the posterior elements of L1 through L3 and the anterior vertebral bodies of L1 and L3 with L2 missing. Somehow he managed to also draw in something that looked like a meshwork pipe spanning from the bottom of the L1 vertebral body to the top of the L3 body.

  Daussie studied Tarc’s new drawing, trying to think of some reason it wouldn’t work. It’d take a while for her to teleport something that large but she’d done bigger objects, it just took a while for them to jump to their new location. She said, “Titanium? That’s one of the elements, isn’t it?”

  Tarc nodded, “A metal. It’s light and strong and most importantly, ‘biocompatible.’”

  “Where’re you going to get titanium?”

  Tarc shrugged, “I guess I’ll have to ask some blacksmiths.”

  “And if they don’t have any?”

  “Then we’d have to make it out of stainless steel.”

  They all sat looking at Tarc’s drawing for a while, then Eva said, “See if any of the blacksmiths here in Cooperstown have titanium. If they don’t, get some stainless steel.”

  Tarc said slowly, “The ancients used a lot of different kinds of stainless steel. Some were a lot more biocompatible than others but I’m not sure we can tell which was which. I think it’d be a lot better if we could find titanium.”

  “Okay,” Eva said, “try hard to get titanium, but, don’t look forever, we need to get her out of bed… Daussie could always replace the stainless one later if we can’t find titanium now.”

  Tarc shook his head, “That assumes we’d be able to find a titanium tube with the same diameter and wall thickness as the stainless steel tube we used this time.” He got a thoughtful look, “Or I guess if we were able to find one a little bigger and thicker so the new titanium one would fit tighter than the stainless steel one it replaced. It’d be a disaster if we put one in that was loose.”

  ***

  Seri sat with her right leg crossed over the left—so her right ankle lay on top of her left knee. Her ghirit was deep in the gastrocnemius muscle of her right calf. She’d telekinetically smacked the muscle a couple of times—“smacking” being what she’d called using her talent to hit Mr. Milner’s heart muscle after his heart attack. Smacking the muscle made it contract alright.

  Unfortunately, it hurt about the same as if she’d slapped her calf with her hand. After the first two times, she’d decided she didn’t want to keep smacking it.

  Instead, she was trying to make the muscle contract as if she’d smacked it. So far she wasn’t having any luck. She zoomed in on the muscle, trying tiny smacks on just a few muscle fibers. She still felt pain, but only a little, like an insect bite. The fibers twitched in response. This felt tolerable so she started trying what she thought of as hitting just a few fibers of the muscle at different speeds.

  Then one of the little smacks caused a big part of the muscle to twitch. She hadn’t been as focused as she should’ve been on what she was doing, so she couldn’t remember exactly what she’d done. Try as she might, she couldn’t replicate it no matter the speed of the strike.

  She went back to what she thought were the same fibers. Suddenly she got a major activation again. The same type of smack didn’t work elsewhere. She focused in on that area with her ghirit. As she zoomed in, she found a strand of different tissue there. She traced the tissue distally where it seemed to split into smaller and smaller fibers. When she followed it proximally it conglomerated with other fibers and strands, collecting branches and getting bigger. Oh, it’s a nerve, she realized.

  She tried smacking the nerve up where it was bigger. This produced a contraction of a large segment of the gastrocnemius.

  A big twitch that hurt!

  Seri sent her ghirit into her own heart, thinking there must be a nerve that was controlling the muscle there as well. An icicle shot down her spine as she realized she’d been contemplating an attempt to get that nerve to fire when she found it. You freaking idiot! she thought. You do not want to mess with your heart!

  As it turned out, she couldn’t find such a nerve anyway. When she looked it up in the books, she found that the heart had a “bundle branch” that seemed to serve a function something like a nerve in coordinating the contractions of the heart.

  Deciding that messing around with the bundle branch was far too dangerous, she decided to try to learn about electricity instead. Vyrda’d taught her how to focus in on tiny areas. She focused in
so far that the area seemed to be made up of tiny vibrating particles. Vyrda had told her that Tarc had been the first one to zoom in so far and that he wondered whether those particles might actually be the atoms or molecules the ancients talked about. She said they just didn’t know whether they were actually zoomed in that far or not. Vyrda’d been showing Seri how to make those tiny particles vibrate faster to create heat or hold them still to produce coldness. The way Vyrda’d been doing when she’d welded the retinal detachment.

  From the limited amount Seri’d been able to learn about it so far, electricity was something that flowed in metals, copper and silver being two metals that were particularly good for conducting its flow. She pulled a copper out of her pocket and focused in on it, zooming deeply enough that she could see particles vibrating in the coin.

  She lifted the copper up and held it against her forehead. As she’d hoped, with it so close, she could zoom in farther and farther. Now she perceived many tiny points, arranged in a somewhat regular pattern and surrounded by an amorphous fuzziness. Do the points flow when electricity moves through a wire? she wondered. She wished she had a wire instead of a coin but decided to try to move the points with her ghirit anyway.

  When she did so, the coin twitched in her fingers. That seems kind of obvious, she thought. If the coin’s made up of atoms and I’m moving the atoms, then the coin’s going to move too. She stared at the coin, thinking, Water flows and air blows, but solids like copper or wood don’t flow. How in all the hells can electricity flow through copper?!

  Seri spent some time searching through their books for something that would explain electricity to her, but the books they had in their little clinic library were focused on medicine. They only dealt with electrical currents in peripheral ways, as when they described the effects electricity had on muscles and nerves. One of the more basic books did talk about making muscle twitch by using copper wires to hook a muscle up to a battery. But it didn’t explain batteries, treating them as everyday objects anyone would have access to.