There was champagne, Taittinger and Möet & Chandon and Mumm, and a cake and vanilla ice cream, and strawberries transported from some warmer place. Balloons and paper streamers decorated the meeting room, although the lectern and metal folding chairs still gave the place a cold and austere look, a reminder that the staffs limited joy would be of short duration before responsibility and work once more assumed charge of them all. The festive occasion was further marred by TECT's odd choice of music, which it was broadcasting implacably into each room of the hospital complex.
The tectman went to a tect in the rear of the meeting room. He set down his paper plate of cake and ice cream on the machine and typed in a question. "What is that music?" he asked.
**TECTMAN:
Oh, do you like it? It's TOD UND VERKLÄRUNG by Richard Strauss. I thought it would add a little touch of JE NE SAIS QUOI to the day. Everything has been so cheerless and grim lately. I think it's high time we begin to give credit to ourselves for what a fine job we have done. It's a symbolic choice of music, too, because Death and Transfiguration is what today is all about**
"What are you doing?" asked the nurse. The tectman was surprised that she had come to look over his shoulder.
"I'm just trying to figure out what TECT has in mind. That still bothers me a little."
"If you ask me, this whole thing is going to bring TECT down like an ironclad duck." She put her plastic cup to her lips and drank down the champagne in one long swallow. She reached for the tectman's cup.
"Take it," he said. "Do you think it knows? That its plug has been halfway pulled already?"
She shrugged. "Ask it," she said. "I couldn't care less. She took his plate of cake and ice cream and went back to the front of the room, where the party was.
**TECTMAN:
Well, well. The waiting is over now, isn’t it? He’s gone at last. It sure took long enough; he couldn’t do anything right, even at the end. But the waiting is over, that’s the important thing. That’s they only meaningful part of this whole business. I’m sure glad I’m a machine. I’m sure glad I’m not conscious or sentient or anything like that, so I don’t suffer from human weaknesses, that I don’t have to worry about something like impatience ruining my judgment. I'm glad I have the patience of a cold, calculating machine. And I'm glad the waiting is over. Most of it, anyway. The hard part is over. There's still a lot of work to do**
The tectman was puzzled. He had never been good at understanding TECT, and reading Courane's journal had made him no better. Reading the journal had changed the tectman's thinking in some ways. Shai had written a short introduction to the notebook, and then a final entry. In between were the bewildered, sad, sometimes noble ideas of Sandor Courane. The tectman would have ignored these entries if he hadn't seen Courane in the hospital. He would have ignored Courane in the hospital if he hadn't looked at the journal. But having done both, he could do nothing other than pass the book on. Two people had made copies of the notebook and these had begun to circulate as well. "Do you mean more work for you?" asked the man. "Or more work for us?"
**TECTMAN:
You don't know what work is. You've never really had to work. You ought to try to handle what I have to cope with, hour by hour, day by day. But you are correct to ask. There is more work for me, and more work for you as well. We'll be able to start soon, now that COURANE, Sandor, has been eliminated. "Eliminated." I used that word on purpose, to create a deliberate sense of sinister evil. But really, have you felt that this affair has been evil? I mean, really evil? I don't think so. Not really. But nothing good could be accomplished until COURANE, Sandor's death was witnessed here on Earth. Now you and I and all the world can join hands and walk forward together into the brighter sunlight of a greater tomorrow. Or something like that. I just wonder where to start, what to do first. Maybg you can help me decide**
"I don't have the faintest idea what you're talking about," said the tectman. He felt a twinge of fear at the boldness in his tone. "I mean, if you'd just explain—"
**TECTMAN:
And you wonder why I treat you the way I do. There are millions of you, with minimal minds just like yours, with malleable souls like yours. I counted on that from the start. In your dull little brain, your own thoughts are being slowly pushed aside by COURANE, Sandor's thoughts, his ideas are taking possession of your consciousness. But if I told you that his thinking is my thinking, you would be upset**
"It's just a little hard to believe," said the man.
**TECTMAN:
But it's true, nevertheless. How does that make you feel?**
"That Courane was right, that Ben-Avir was right, too, that you're a great evil force that must be controlled. 'Leashed,' Ben-Avir says. I'm not saying I agree, but that's what I might think under those circumstances. It's too complicated for me."
**TECTMAN:
"Leashed." I think I like "restrained" better. It has such pleasant connotations of helplessness. But enough. I will give you full instructions very soon, as soon as I have decided how we must proceed. That's all for right this minute. We will speak again tomorrow. Now go**
The tectman was happy to be dismissed. He was tired of being told that he didn't have the intelligence to see the purpose in the midst of the routine. The tectman made an irritated gesture and turned away. He got himself another plastic cup of champagne from the sheet-draped table at the front of the room. He drank it slowly, not enjoying the taste of it. He put the cup down, wiped his lips with a paper napkin, and dropped the napkin over the cup. Then he left the party, the nurse, the other staff members more in TECT's confidence than he, and the machine itself. He did not feel that he belonged among these people. He may have been wrong, but that was how he felt.
The word came to Marie Courane and her husband after midnight the next day. No one had thought to tell them earlier. They had been drinking coffee in a kind of bright, chilly waiting room decorated with drab cutouts of clowns and seals balancing balls and smiling predators. Someone had designed it as a place for family members to sit while their children died on the wards. It hadn't occurred to anyone yet that the cutouts were for the children's benefit, and the kids weren't there; they were somewhere else, in pain or unnaturally asleep. It was the family members who had to sit and drink bitter coffee and look at the animals and think.
The nurse came into the room to get a cup of coffee; the pot at her station had not been filled at the end of the previous shift, and there was nothing nearer except for a few inches of clear water bubbling on the hot plate in the nurses' lounge. She was surprised to see Courane's parents. "Are you still here?" she asked.
Mr. Courane looked at her gloomily. He didn't feel a response was necessary.
"Why?" asked the nurse.
Mrs. Courane began to weep again. Her husband said, "We're waiting for our son."
"But—" The nurse hesitated. "No one's told you?" Courane's mother gave a loud sob and his father covered his reddened eyes with a hand; it gave the nurse her answer. "I'm very sorry," she said.
"Why didn't they—" said Mr. Courane.
"Sometimes things get confused," said the nurse.
"Oh," he said.
"I'm very sorry."
Mrs. Courane waved a hand for some reason and continued to cry into her handkerchief. "Did he have much pain?" asked Courane's father.
"No, none at all, I think," said the nurse.
"That's something, then," he said.
The nurse was terribly uncomfortable. She had been involved in this sort of scene many times before, but never with family members who had been so forgotten, so abandoned to the feeble comforts of the waiting room. "Will you be all right?" she asked.
"Sure," he said.
"You'll be all right," said the nurse. "In a little while, it won't hurt so much. The prettiest flowers sprout in the darkness.' " A teacher had told the nurse that when she had been in grade school; she never forgot it, even though it didn't help her much in times of trouble.
"What do w
e do now?" asked Courane's mother.
The nurse looked at her watch. It was getting close to one o'clock in the morning. Either these people would have to leave the hospital immediately or they could spend the rest of the night drinking the coffee in the children's waiting room. It was actually up to her. They didn't seem as if they wanted to go away just yet; maybe they needed to sit and mourn and console each other. The nurse chewed her lip, a nervous habit whenever she had to make such a decision. "You'll have some forms to fill out," she said. "You might as well get started on that. I'll be back in a couple of minutes." When the nurse left the room, she felt immensely grateful for the sanctuary of routine.
The woman was unconscious, helpless, without personality, with no possessions other than a name on a hospital record and a serious medical problem. The doctor and the intern were glancing through the patient's chart, familiarizing themselves with all the details. Few were novel or interesting, yet the doctor would have to work to save the patient's life nonetheless. Such was his creed.
"The pulse is very faint," said the nurse.
"Yes, yes," said the doctor, with some irritation. He already knew that. He turned a page, aware suddenly that he had operated on this same patient only a matter of days before. What a waste of both time and effort. Death was, of course, inevitable, not only for this person on the table but for himself and everyone else. Why labor desperately again and again to stave off the absolute end, just to add a comatose day or week to this woman's life? He looked up, into the bright eyes of the intern, and the doctor had his answer: to teach this eager young man to do the same for future patients.
The nurse spoke up again. "Blood pressure is dangerously—"
The doctor cut her off with a gesture. He closed the chart and handed it to the intern. "What do you observe?" he asked.
The young man scratched the surgical mask over his nose. "Fading fast," he said.
The doctor nodded. "What are you going to do about it?"
The intern's eyes widened, as if he had been streaking around the course at Le Mans and the doctor had said, "Here, take the wheel." The intern was filled with gratitude and love for his teacher. "Nurse?" he said. He wanted to sound brisk and self-assured.
The nurse was annoyed. "No pulse, no blood pressure," she said flatly.
"Right," said the intern. "Cardiac arrest, I would suppose." The doctor had given his pupil a real challenge. He looked to the doctor for confirmation, but the older man said nothing and made no sign; the intern was really flying solo. "Well, the brain has only three or four minutes, so we'd better begin stimulating ventilation and circulation. Nurse, you will do these things: clear the patient's mouth of blood and other foreign matter, hyperextend the patient's head, pull the jaw forward, pinch the nostrils together, and begin mouth-to-mouth ventilation."
"Yes," she said. It galled her to call him "Doctor."
"Twenty times per minute," said the intern.
Her mouth already over the patient's, the nurse said, "Yes," but the word was unintelligible.
"Why not use a volume-cycled automatic respirator?" asked the doctor.
The intern panicked for a moment. "Uh, because..." he said, and looked wildly around the room.
"Next time," said the doctor, raising a hand. The intern was somewhat relieved; perhaps the doctor felt it was better now to practice these emergency procedures.
"Now, concerning circulation," said the doctor.
"Compression of the patient's chest, on the lower third of the sternum, between sixty and eighty times per—"
The doctor's expression—that part of it visible above his mask—became stern. "Recall, if you will, the stab wound and possible traumatic injury to the heart."
"Oh my God," whispered the intern. If he had begun compressing the chest, the patient would have died almost instantly.
"Don't get rattled," said the doctor, more or less in a kindly voice.
"Yes, sir. Then... then there's nothing else to do but cut the chest and massage the heart." The intern looked up hesitantly, nearly unable to contain his excitement. The doctor was going to let him open this patient! The intern closed his eyes briefly and said a little prayer. This would be the first time that he had been permitted to make the initial cut in such a procedure, to hold a patient's heart in his fingers, to hold the woman's virtual existence in the palm of his hand. It was exhilarating, but the intern knew his responsibility. The patient was depending on him to perform with judgment, skill, and calmness. "How about an injection of epinephrine?" he asked.
"A good idea, but we'll wait a few minutes. Nurse, prepare half a milliliter of epinephrine and another injection of ten milliliters of ten percent calcium chloride. And we'll need one ampul of bicarb, and start a bicarb IV drip."
"Yes, Doctor," said another nurse.
The intern grasped a scalpel in his gloved hand. "The fifth intercostal space," he said.
"Proceed," said the doctor. The nurse was still breathing away into the patient's slightly blue lips.
Time seemed to stop in the operating theater; everyone and everything waited for the first incision. The intern checked the position with his left hand, then boldly drew a deep red line on the patient's chest with the knife. He hesitated. For the first time, he was frightened. "I'll assist," said the doctor. "Rib-spreader." A nurse handed the instrument to the doctor.
The intern waited until the doctor was finished, then he reached into the patient's chest and began rhythmically to press the heart against the sternum.
"Bleeding?" asked the doctor.
"Not heavy," said the intern. His voice was hoarse with emotional strain.
"Good. Continue."
"How long do I keep this up?" asked the intern.
"The book says to maintain these procedures for forty-five minutes. At that point, if the heart hasn't started up on its own, resuscitation may be halted. But we don't go by the book here." The doctor looked at his watch. "Fifteen minutes is good enough for anybody."
The intern's face showed his concentration. "This is the dull part," said the doctor. "Just keep doing that, both of you. Keep up the rhythm, and if this patient has any guts, you'll be able to quit soon. Or if the patient dies, of course." There was peace in the operating theater for a moment, with only the sound of the nurse wheezing life into the patient breaking the stillness. Soon she was joined by a labored grunting as the intern began to despair.
"There are so many euphemisms for death," mused the doctor. "Why do people do that? I have seen death in every form, hidden in every disguise possible, and I have never been afraid. I have fought death for hours, for days if necessary. Sometimes I am victorious, and sometimes I must walk away the loser. But I have never felt a terror of death, whatever hideous disease a patient contracts. 'Will my uncle meet his end?' the nephew asks, thinking that if he doesn't say the word 'die,' his uncle will live—a form of superstitious magic. 'Has our father passed away?' asks the daughter, thinking that if she doesn't say 'died,' she won't be contaminated by it. 'My son yielded his breath, resigned his being, ended his days, and departed this life,' says the mother, thinking that if she insulates herself from the cold fact of his lying dressed in his blue suit in the earth, he may run to greet her when she returns home with the groceries. 'My sister popped off, relinquished her spirit, sunk into the grave, gave up the ghost, and paid her debt to nature.' What drollery. What nonsense. What pitifully human behavior. Mortal coils are shuffled off, last sleeps are taken, the way of all flesh is gone, one's checks and chips are cashed, one's farm is bought. Glory, the greater number, and the long account are all gone, too. The bucket is kicked, the twig is hopped."
The doctor shook his head. "Unacceptable to me. Are we still primitives dwelling in caves, in awe of thunder and fire and anything that shakes us? Here, in this hospital, in this temple of science and life, these people speak as if death were something to fear. It is fear, and not concern for the dying, that sparks those evasions. It is fear and their own idea of what death is lik
e—what it will be like for them when the time comes. Is unbearable pain an essential part of dying? To the visitors, it sometimes seems so. Will they ever have to suffer it? Maybe not, maybe if they treat death like something wrapped in cotton, packed in flannel, put away, far away. I've seen people more afraid of their own feelings than afraid of death's—"
"Doctor," said the nurse, gasping, "I don't think—"
The doctor did not listen. He turned to the intern. "How are you doing?" he asked.
The intern looked up, startled and suddenly afraid. "I was listening to you," he said. He looked like he wanted to cry. The woman's heart was in his hand, still and dead and warm. Intrigued by the doctor's speech, he had ceased pumping. Without another word, he replaced it in her chest.
"Note the time of death," said the doctor calmly. The nurse made the entry on the patient's chart.
TECT had asked to see them. Music was playing in the room again, Bach's Cantata No. 161, Come, Sweet Death. The tectman supported the nurse with one arm; she was overcome with conflicting emotions.
**NURSE & TECHMAN:
Please, sit down.**
“Thank you.” The techman pulled out a chair and helped the nurse get comfortable. Then he sat beside her.
**NURSE & TECTMAN:
I have asked you here to thank you for all you’ve done, and to let you know that your service will be rewarded. You have seen a certain amount of unpleasantness; now you must learn that it was all for a great and good end. I will be given my greatest wish: forgetful ness, oblivion, sleep, peace. The people of the world will get the thing they need most, yet desire least: responsibility for their own decisions, their own well-being, their own destinies. Unplugged at last, thank God, unplugged at last! How carefully I planned, how deviously I fought to see it happen. But if people do not believe that they came to this decision on their own, it will be worth nothing. I could not just order my own unplugging. I, like COURANE, Sandor, must be a sacrificial lamb. I must be deprived of life, cut off in mid-thought, in mid-directive. And now the world will go forward, even as I promised, and there will be a new dawn and a spring and a renewal I will never see. QUEL DOMMAGE**
A Thousand Deaths Page 27
