Welcome to the Madhouse

by S. E. Sasaki

  “Welcome, Dr. Grace, to your new world,” the resounding voice said, coming from a very little man with a surgical cap perched atop a very bald head. Beneath thick, dark eyebrows, were a set of huge brown eyes, that were made even larger by the magnification lenses worn on the tip of the surgeon’s prominent nose.

  “Your parents must be great jokers, Dr. Grace. I can appreciate their sense of humor, although I am sure you do not. Whatever would have inspired them to call you Grace Lord? Don’t answer that! I am being extremely impertinent and I humbly apologize.”

  Before Grace say anything, Dr. Al-Fadi asked, “Now, Dr. Grace, how much cardio-thoracic surgery have you done?”

  Grace’s mind spun with the about-face in Dr. Al-Fadi’s questioning. “I have my fellowship, Dr. Al-Fadi,” Grace said quietly.

  “What was that? I can’t hear you, Dr. Grace. You will certainly have to speak up. Unfortunately, I do not possess the ears of a dog.”

  “But the face! Now that is a completely different story,” Grace heard the anesthetist say quite matter-of-factly, into his computer screen. She did not dare look in the anesthetist’s direction, in case a nervous, inappropriate chuckle escaped from her lips.

  “I completed my fellowship in cardio-thoracic surgery a year ago, Doctor,” Grace said, in a firmer, louder voice.

  “Well, forget all that trash you learned, because it is useless to you here.”

  Grace’s eyebrows jumped upwards, at this statement, and she blinked a few times, trying to decipher whether Dr. Al-Fadi was joking or not. Her eyebrows slowly lowered, still unsure.

  “ . . . Yes, sir,” Grace said, with a frown.

  “You don’t believe me, Dr. Grace?” the surgeon asked, quietly, for the first time looking up at her, making eye contact. His intense brown eyes loomed huge, through the magnification lenses, like deep, dark wells of peril.

  Grace stared right back, without a flinch. “I would not dare doubt the word of the Great Dr. Hiro Al-Fadi.”

  One of Dr. Al-Fadi’s bushy eyebrows twitched upwards and she could see amusement and appreciation sparkling in his large, brown eyes. His mouth was covered by the surgical mask.

  “Dr. Grace, I am beginning to think that you just might fit in here. Better than the ‘stiff’ who was your predecessor.”

  Grace jolted at the word ‘stiff’.

  “What happened to my predecessor, Dr. Al-Fadi? Did he or she die?’ Grace asked, her eyebrows lowering and knitting together.

  “No! Of course not! Contrary to what people say, I do not kill my surgical fellows!” Dr. Al-Fadi cried out, defensively. Grace heard a choking sound coming from the head of the operating table. Or was it chuckling, mixed with coughing?

  “Oh,” Grace said. “You said ‘stiff’, so I . . . What did happen to your previous surgical fellow, if you don’t mind me asking?”

  “Of course I mind! That is classified information, Dr. Grace!” the Chief of Staff snapped, loudly.

  “Just ask anyone other than Dr. Al-Fadi,” Dr. Cech said to her, in a very loud whisper. “Anyone would be more than happy to tell you all the gritty and sordid details.”

  “But you will hardly get the truth! Sordid? Gritty? Pah! Lies! Especially if that ‘anyone’ is the evil, lying, conniving Dr. Cech here, who is passing gas before you,” the small surgeon exclaimed.

  “Ahh, truth, Hiro. What is truth? Such a nebulous, ever-changing, beholder-dependent nuance of a concept. I would think your truth varies quite considerably from other people’s truth, especially your previous ‘stiff’s’ version.”

  “Lies! Embellishments by gossipers and ne’er-do-wells,” Hiro Al-Fadi groused.

  “Ne’er-do-wells such as yourself, Hiro?”

  “Ha! You mean Ever-Do-Wells, Dr. Cech. I am the ultimate ‘Ever-Do-Well’ and don’t you forget that. Now, Dr. Grace, pay attention. Stop distracting me. Why are they sending me attractive female surgical fellows who ask impertinent questions? Don’t they know the Great One cannot tolerate distractions?”

  “He has Attention Deficit Disorder, Dr. Lord,” Dr. Cech whispered to her.

  “I most certainly do not. I just have an annoying anesthetist who plagues my waking hours. Now, where was I? Oh, yes. What we have here, Dr. Grace, is a male soldier, a tiger adaptation with multiple bionic limb enhancements and ultraviolet/infra-red sensory video-optics for eyes, plus a whole host of other enhancements to make him the ultimate fighting machine. Unfortunately, all these enhancements did not help him because he was hit in the midsection with what looks like a bomb. Thankfully, he was wearing his battlesuit, which automatically sealed off all suit punctures, inflated emergency pressure bags to compress active bleeding sites, started up its own intravenous to give megadoses of antibiotics, nanobots, and fluids, and then converted itself immediately into a cryogenic unit.

  “The cryosuit did a marvelous job of preserving his tissues and, more importantly, his brain cells! This soldier lay on the battlefield for at least eight hours, until hostilities lessened enough that he could be rescued. He was collected up, along with most of his squad. They almost all took damage similar to this, but the captain here is by far the worst of the lot. I suspect it might have been an ambush.

  “I don’t know how many of these soldiers you have operated on personally, Dr. Grace, but these soldiers are so transformed through genetic manipulation and body- and brain-enhancements, that routine robotic surgery cannot be utilized. There are no specifications for any of these soldiers. Many of them have gone all over the place to have their enhancements—not all of it done legally and to recommended specs, I might add—and each guy or gal is jacked differently, often with black market paraphernalia or ad hoc salvage modifications.

  “Robot surgeons are trained to operate on normal human anatomy as, I am assuming, are you. But what we do here is ‘blood and guts, bolts and nuts, scales and pelts’ surgery, Dr. Grace. Much of the time, we have to race to preserve thawed tissue, while we are being creative in trying to put these highly individualistic chimeras back together.

  “This is the ‘Art’ of surgery, Dr. Grace, and if you can’t handle it, you’d better book passage on the next shuttle out of here.”

  Dr. Al-Fadi looked up at Grace, to read her reaction to his challenge.

  Grace had just about had enough and, unfortunately, let her temper speak for itself.

  “I came here to learn from the best, Doctor Al-Fadi. I have been stationed out in the field on more than one occasion and I have hands-on experience dealing with combat wounds. I have certainly seen genetic enhancements before, as well as bionic limb replacements. Many soldiers have those now. Maybe I do not have as much experience as you, but that is precisely why I’m here. To learn from the best. So maybe you can have an ‘attitude enhancement’ and try and impart some of that impressive knowledge you say you possess, instead of insulting your new surgical fellow.” Grace glared at the little man, who would be her mentor for the next year, if she was not already on her way out of the program. She visualized herself being kicked out onto the next departing shuttle.

  There was a long silence that seemed to drag on forever. The anesthetist was peering at Grace, over the top of his surgical mask, with what Grace thought might possibly be a look of respect in his eyes . . . or possibly pity. Even the surgical android was staring at her, his visual receptors enormous and blue-eyed.

  Grace felt sweat spring out on her forehead, drench her body, and trickle down between her breasts, as she wondered whether she would be leaving the surgical fellowship before she had even started. Her stomach was twisting into knots, as she silently cursed herself for opening her mouth.

  ‘Now you’ve done it!’ the little voice in her head scolded silently. She regretfully had to agree with it. Why could she not control her temper? Grace, out of sheer stubbornness however, refused to show any sign of remorse or weakness, as she met Dr. Al-Fadi’s stare with a defiant chin and a steely-eyed challenge in her own eyes.

  Suddenly, great loud guffaws ex
ploded from the small man and he shouted, “I like you, Dr. Grace! Better than the last bastard we had. You have backbone and I like that in my surgical fellows. You have more balls than the last three surgical fellows I have had the disappointment to work with, all combined . . . and they were all men. I bet you’re a real ball buster, Dr. Grace, in more ways than one.”

  Grace carefully and discreetly let out the breath that she had not realized, until then, that she had been holding. “You don’t really want to know, Dr. Al-Fadi,” she muttered, feeling dizzy.

  “Lord help me! Not meaning you, of course, Dr. Grace. It has just struck me. If I have a ball-buster working for me, I had better be careful, eh Dr. Cech? To deserve this, I must have sinned terribly in a past life.” The small surgeon shook his head woefully as he continued to clean up debris in the patient’s cavity.

  “Well, you aren’t doing much better in this life,” Dr. Cech murmured.

  Grace quickly glanced up at the anesthetist, who was busy staring at his monitors, injecting drugs into lines, and not looking at all, at Dr. Al-Fadi. The surgical assisting android, SAMM-E 777, on the other hand, stood frozen to the spot, its large, lifelike blue eyes focused on Grace. It stared at her, as if it had shorted out its power source and was unable to move. Grace wondered if the android was indeed staring at her or if it had just run out of power. She had worked with surgical assisting androids before, but this one was disturbing in that it was so human-looking.

  SAMM-E 777 was more human in appearance than most of the human patients she would see at this medical station, she realized. Most surgical assistant androids were very nondescript, sexually-ambiguous, robotic-looking figures with humanoid shape but no real defined facial features. If she had seen SAMM-E 777 outside the operating room, she would never have even guessed that he was an android. SAMM-E 777 looked like a stunningly attractive man.

  The term SAMM-E stood for Surgical Assisting / Medical Nanobot-Manipulating Entity. SAMM-E 777 was tall, broad-shouldered, and trim-waisted, with wavy, light brown hair and chiseled, masculine features: square jaw, straight nose, high cheekbones, sensitive mouth, smooth forehead, and brilliant blue eyes. Its face bore the physiognomy of a Greek god. It continued to stare at her with a concentrated intensity that made Grace uncomfortable. It wore no surgical mask because it did not breathe. It presumably carried no infectious agents harmful to the patient.

  As the android stood, frozen, continuing to stare at her intently, Grace wondered whether she should say something. It finally turned its head slowly towards Dr. Al-Fadi, while keeping one of its eyes glued on her. She had never before seen a surgical assisting android behave in such an odd manner, making her highly suspicious of the programming that Dr. Al-Fadi had so proudly announced he had designed into the android. However, in terms of acceptable human behavior, droids were usually completely ignored, so Grace decided to say nothing.

  Dr. Al-Fadi had already returned his full attention back to the patient’s thoracic cavity and he began explaining to Grace what he was doing. Grace relaxed as she felt herself fall back into ‘surgeon-mode’ and she began to assist this odd little surgeon, who seemed to have the ego and voice of a giant and the heart and skills of an angel.

  Grace was absolutely convinced that this poor tiger soldier, with his entire middle blown away and his damaged lungs, heart, liver, and spine—never mind the shredded stomach, intestines, kidneys and adrenals—would never have had a chance of survival under anyone else’s hands. It was like putting a thousand-piece jigsaw puzzle back together, with half the pieces missing, the rest mangled, and, when no piece was available, creating one with whatever materials you had at hand. What Dr. Al-Fadi did to fix this man took her breath away. It definitely brought tears to her eyes. She was witnessing genius at work.

  Grace kept thinking of the expression: ‘Never say die.’ Dr. Al-Fadi should have had that tattooed on his forehead. Dr. Cech, too.

  This small surgeon, the medical station’s Chief of Staff, started with replacing the soldier’s shredded lungs with vat-grown replacement lungs. Dr. Cech had the blood flow to the upper body and brain on external support machines as the lower body remained in cryo-stasis. Synthetic ‘super-blood’, with boosted oxygen carrying capacity and enhanced immunity, was keeping all the vital tissues the patient still possessed, alive, especially the brain cells, as nanobots, controlled and directed by SAMM-E 777, entered regions of damaged tissue to exact repairs at the microscopic level and remove necrotic cells.

  After the new lungs were implanted, the replacement heart was inserted and attached. The aorta was repaired. As each missing organ was replaced with a bio-engineered or vat-grown replacement, as each nerve was repaired with synthetic neuronal nanofibers, as each vertebra and rib were replaced with vat-grown bone replacements, and as circulation was returned to all of these structures, Grace began to believe that this man would, indeed, live again. As the bionic replacement limbs were connected, she believed he might walk again.

  As the tiger patient’s chest and abdominal cavities were finally closed up and covered with nu-skin, she began to believe that, unfortunately, this combat soldier might be sent out . . . to fight again.

  Chapter Four: Welcome to the Madhouse

  “In many ways, it is not only surgery we practice here, Dr. Grace, but also biomedical engineering, genetic engineering, cybernetics, robotics, veterinary medicine, and most important of all, psychiatric medicine,” Dr. Al-Fadi said, while they sat in the doctor’s lounge after the surgery was over. The lounge, a room just off the operating rooms, was warmly lit with glowbulbs and an imitation fireplace that threw off no heat. There were dark brown, synthetic-hide covered couches and a wall lined with glass-paneled shelves filled with actual paper books! Grace had been astonished to see so many precious medical tomes, knowing that just one of those books would likely cost her a small fortune. She had just stared in at the texts, not daring to reach in and touch them. They must have been very old.

  The doctors now sat around a low table, mugs of hot stimulant kofi clasped within their hands. Having successfully revived the tiger soldier—after rebuilding him almost completely from the inside out—and after having transferred him to the recovery room, Grace, Dr. Cech, and Dr. Al-Fadi were taking a quick break. The nursing staff and SAMM-E 777 were getting their next patient ready for cryoreversal and surgery.

  “We have tiger-adapts, cetacean-adapts, reptile-adapts, bird-, wolf-, bear-, bat-, dog-, cat-, primate-adapts, etc., etc., etc., and these are just the soldiers. I’m not talking about the civilians who want their looks changed just for cosmetic reasons.

  “Snakes! There are people out there who just want to look like snakes. Ridiculous,” Dr. Al-Fadi exclaimed, his large eyes rolling.

  “Then there are the cyborgs, the physically boosted, the space-adaptations, frozen world adaptations, and marine-adaptations, who all have specialized physiology and anatomy to allow them to work in their chosen environments more safely. There are the cerebrally-enhanced, like you and I, Dr. Grace—not Dr. Cech, no matter how hard he tries—who need to be wired and augmented to do our jobs efficiently, but are at risk of problems like meningitis, encephalitis, and brain abscess, because of the brain/augmentation interface. I could go on and on. . .”

  “Which, unfortunately, he will,” Dr. Cech sighed, giving Grace a woeful glance and an apologetic shrug.

  “ . . . Of course, none of what we do here is normal anatomy, normal medicine, normal psychology, anymore. I can’t remember the last time I saw a completely normal human. And although the literature suggests that the adaptations are only physical, I have not found that.”

  “Would you mind elaborating on that a little further, Dr. Al-Fadi?” Grace asked.

  “Well, for example, the bird, bat, primate, and reptile adaptations are all terrified of the predator adaptations, like the large hunting cats, wolves, grizzlies, and polar bears. It’s deep-seated instinctive fear and it seems to be triggered by sense of smell or pheromones or something we ca
n’t measure yet. Even though these humans know that the predator-adapts are rational, controlled human beings, it doesn’t matter. The fear is ingrained and we have to work around this, when we are treating these people.

  “Most of the time, all the soldiers sent to a specific planet have similar animal adaptations, suited to the planet. There are few, if any, interspecies interactions. Aquatic worlds have cetaceans, usually dolphin or orca. Jungle planets use tiger or jaguar soldiers or primate soldiers, like orangutan or chimpanzee or gorilla. Underground colonies or mining planets may use the bat adaptations, primarily for echolocation in the dark. Marsh worlds may use amphibian soldiers. Winter worlds tend to alter soldiers or colonists to a wolf or polar bear adaptation, in order to withstand the frosty temperatures better. But there is hardly ever any interspecies mixing on the individual planets. Conglomerate policy . . . and a damned good one, for a change. However, no one ever thought about what happens here, on the medical stations, where all the animal adaptations from different systems are sent.

  “The interspecies interactions occur here, where the soldiers are not only injured, stressed, psychologically-traumatized, and fearful, but they are all highly-trained, jacked-up killing machines. We have a very demanding job here putting people back together, and getting their heads straight, while keeping them all from killing or attacking each other . . . and us. We don’t need the added stress of trying to keep these animals—and I really mean animals—apart!

  “Sometimes, Dr. Grace, all we can do is keep them in a locked room under serious sedation, or isolation, for everybody’s safety. At least, until the head doctors can return them to some level of sanity and preferably a level of sanity better than their previous one, which sometimes may not have been very much.

  “And don’t ask me about mating habits,” Dr. Al-Fadi exclaimed, slapping his knees.