Then came the call. The call.
"I’m pleased to tell you, Miss Varda, that the tribunal has recommended you for eta-interferon treatment."
Sami shot to her feet. "I’ve been selected? Are you sure?"
There was no doubt.
"Oh, thank you, thank you." She was in luck, getting an appointment the next day. "Can you tell me why I was chosen?"
"It’s a clinical decision based on factors such as how likely your body is to respond to the drug, and also on the degree of benefit in terms of years of life gained. The fact that you’re young and that you work would count in your favor."
"So ... was the nature of my job considered at all?"
"No, that wasn’t a special factor, though it’s good that you are skilled."
"And ... did anyone else put in a good word for me that could have been important in the decision?"
"Anyone else?"
"I mean, other than the tribunal members or my family doctor, someone else who could have said something in my favor?"
"This was a medical decision, Miss Varda, as all such matters are. No one is allowed to make any representations on behalf of patients other than medical professionals. You have three senior doctors to thank for making a difficult decision in your favor. Other patients will therefore have been disappointed."
A purely medical decision. So had the Minister just strung her along the whole time to get her fixes? Or had she in fact made the critical intervention, which was in theory beyond her jurisdiction though not beyond her influence? If the latter were true, then the tribunal could hardly admit to such an obviously improper intervention. She spent some time rooted to the center of her lounge, phone still in hand, squealing with joy at the news and mulling over every detail of the conversation.
The next day she had the first infusion of eta-interferon. It felt like an infusion of hope, though with nausea and localized itchiness. During the next few months, Sami continued to help the government increase their mood stocks while her scans showed a steady reduction in the size of her tumor. Her energy levels picked up too.
One Thursday afternoon her webphone rang between donors as if the caller knew it was a good moment. Minister Vozd’s image appeared behind her infinite ministerial desk. Sami’s heart thumped briefly.
"Sami, you’re looking well. Could it be something to do with that new and grotesquely expensive eta-interferon you’ve been having?"
"The doctors are very pleased with my progress."
"So why do you look like you’ve been donating yourself? Was my intervention not wanted?"
"No, I’m very grateful, Minister," she replied, mustering some vigor.
Vozd shrugged her immense padded shoulders. "So?"
"Well, it’s just that ... they told me that I got it because of my age, because I’m so young and have a job and therefore have a lot of good years left ... and because of my type of tumor. They said it would be likely to respond to treatment better than other people’s, which it has, and that it was just a clinical decision." She looked up again at the minister in time to see those great eyebrows descend.
"Did you really expect them to admit I told them to break their precious rules that they spend so much of their time dreaming up? One word from me and you’ll soon see them change their minds."
"What do you mean, change their minds?"
"Well, let’s just say that the treatment you’re responding to so well, the treatment that costs this country’s taxpayers a veritable arm and a leg, the treatment that is denied to so many others in your situation, well, that treatment could easily be withdrawn and given to someone else. Someone else who is more grateful for it, for example." Vozd leaned still further forward in her chair, her image looming larger on screen as if trying to break through it.
"But I am grateful."
"I’m so glad to hear that, Sami. I’ve been following your progress and would hate to lose my favorite loader." She let the last word hang for a moment. "Talking of which, I wondered if I might pay you a visit today after the last donation? It’s been such a stressful time lately." She let out an exaggerated sigh. "The nurses’ unions are being so difficult. All I want is for the best to be rewarded and that those who are, shall we say, less able should be made to do better. Is that so wrong?"
"Today? But..."
"I’ll see you at seven. Same dose as last time? Show me that clever graph of the donations. My, the extendeds have been going well. You know, I really do think that another dose will give me just the edge I need to make those nurses see sense. My plan will improve patient care, I’m quite sure of it. Why ever can they not see it?" She sighed again.
Sami felt sick. She had naively assumed that her "loading" days had ended. Could Vozd really get the doctors to withdraw the interferon? Sami recalled how a year earlier she’d had a car accident. She’d had too much neocoke, and the court case had been made to disappear just a fortnight after she had obliged the minister with her first loading. Coincidence? Key medical notes showing the extent of her intoxication disappeared, a witness changed his mind about what he had seen, and the case collapsed. Now the same minister had moved from the justice department and was overseeing healthcare, and Sami had started a course of one of the most expensive drugs ever developed. Another coincidence?
Vozd arrived punctually at Sami’s desk. She stood with her gloved hands clasped together in readiness. Sami finished the preparations and looked up to see the minister beaming. She shuddered.
Vozd lay down and took out her portable music device. "I suppose," she said with a sigh, "that when you’re cured, I shall have to find another loader."
Sami said nothing.
"Well, I must make the most of this occasion, then, mustn’t I?"
Sami connected the minister’s scalp to the apparatus, applied the gel and began the outflow. This could be the last time she would have to do this, any of this. She sat erect in front of the monitor, not bearing to touch the minister’s bag and coat draped there once again, and followed the flow graphic. Just one more time.
Another citizen’s donation lost. Time passed slowly. Don’t think about Cecil. It’s him or your cancer.
Afterwards, Vozd blithely alighted from the bed, gathered her things and sighed, each emission of pleasure a further humiliation. Their eyes finally met as Vozd said simply, "Goodbye," and left without a word of thanks.
Sami flopped onto the chair. She spent a long time staring at the same floor tile. In the bathroom she spent even longer trying to scrub the disgust from her hands.
~~~~~
She was declared tumor-free by December — just in time for Christmas, as her doctor put it. During that time, Minister Vozd had made several appearances on screen. Sami would immediately dive for the remote control to change the channel. She should have known she could not escape that easily. One day, Vozd amazed her by webphoning the clinic room just after the day’s last donation.
"My dear Sami, how are the donations going?"
"We’re on target, Minister," Sami replied as blandly as she could, bringing up the relevant charts on screen.
"Excellent work," said Vozd, nodding. "Then you would still have a little to spare? Just a little?"
Sami put a hand to her mouth as if to hold back vomit. "Why, Minister?"
"Now don’t be like that. It’s nearly Christmas, and I’m rather short of Christmas cheer at the moment, what with the poor reception of the recent White Paper. Surely you wouldn’t begrudge me just one more load? It’s been such a stressful time, such a stressful time." She used her little-girl voice again that Sami never heard on television.
Sami hesitated and moved her lips without saying anything.
"You’re looking very well, Sami. I see that the eta-interferon did the trick, which is of course wonderful news. When something is that expensive, it is particularly heartening when it works, don’t you think?"
"Yes, it worked very well." She fixed her eyes on the minister’s desk.
"I’m so pl
eased. So let us consider this final load an expression of your gratitude. Usual time, usual dose? Just once more, I promise. Okay?"
There was a hint of uncertainty in her voice as if Sami had the option of saying no, which in truth she did. In a sense, she’d had the option all along, but hadn’t taken it. A final expression of gratitude.
But also an opportunity. She called Cecil’s mobile webphone. The poor man was nearly due for another donation.
"Oh, hello my dear. Don’t tell me I’m due already."
She felt relieved that he sounded his usual self. "Yes, in January, but that’s not why I’m calling."
"Oh?"
"How would you like to see the health minister make a donation? I mean, be there in the same room when it happens?"
"See the health minister make a donation? King Solomon and David! How?"
"Can you come to the Center this evening? I’ll need your help, Cecil."
"What do they say about wild horses?"
She had no idea, but smiled at the glee in his voice. Boosted by Cecil’s response, Sami’s mood was transformed as she reprogrammed the apparatus for an extended. When Cecil arrived after the last scheduled donation, she had only ten minutes to explain the hideous truth both of the minister’s abuse and of her own complicity and shame. As his face ran through the gamut of expressions, she couldn’t always bear to watch.
"You can say no, Cecil."
He set his jaw. "Just how low can you get her?"
"There are safety overrides, unfortunately, but if you can hold her down I may be able to do another extended straight after the first."
"Just you watch me try."
Sami felt already that she had made the right choice of assistant. She took him through the plan. "I felt so guilty about your reaction to the extended."
"And so you might," he said, before softening after a few seconds. "I know you’re just doing your job, my dear."
The minister arrived punctually as Sami fidgeted with paper files and pretended to check over the equipment.
"My dear Sami, you are looking even better than last time. I’m so pleased. I promise this will be the last one. I finally convinced the nurses to see sense, but now it’s the media who don’t understand the benefits of my plan. It’s just so draining. I expect that now you’re cured you’ll have a happy Christmas. Well, I just want to have one too. Is that so wrong?" She tossed her bag and coat onto Sami’s chair and took up her usual place on the bed.
The two minutes’ grace Sami had asked Cecil for had nearly passed. She hooked the minister up with slightly unsteady and moist hands.
"How about Wagner today?"
Sami mumbled, "Okay," made extra sure that the straps were secure and set the machine. Was Cecil counting the time? She looked across at the terrible grey skirt and then at the minister’s face to check for any sign that she had noticed something was amiss. The minister was still, eyes closed, humming quietly. Sami waited. Where was Cecil?
The door creaked slightly, and at last she saw him enter, tiptoeing in his none too gazelle-like manner. Vozd soon detected his presence. As she opened her mouth to protest, Cecil plonked himself on the edge of the bed, ready to grab any part of her that wriggled free. He grinned fiercely as if with pain.
"‘It is the duty of every citizen to help with the creation of a reserve of natural brain substances used for the greater happiness of all,’" Cecil quoted. "True or false, Minister Vozd?"
"Who are you? What’s going on? Get off me."
"I am a regular citizen who regularly donates my natural brain substances, whatever they are, at great personal cost to myself, I might add. I do my duty along with millions of others in this country. After my last extended, I was off work for six weeks. Would you like to see the souvenirs of that holiday?
He grasped her wrists and rotated his own to show her. "Today I find out that not only are our beloved appointed representatives in government exempt from donating, which I knew already, but the ministers are using our donations for kicks like common junkies. I think the Minister for Health should set an example and contribute too, don’t you?"
"What do you mean? You can’t do this to me."
"Oh yes we can. Just lie back, Minister. I would say that you’re due for an extended."
Vozd thrashed her legs, but after thirty seconds of struggling against the straps and Cecil’s might, she resigned herself to her situation.
"After this one, we’re going to make you do another," Cecil said. "And, if you don’t behave, we’re going to make you do another after that." Then Cecil explained in detail how it feels after a donation.
Sami watched him throughout, with the occasional glance at the monitor and the minister. At no time did she consider the consequences for her future as a result of this assault. Nothing mattered but yanking the last nanogram of happiness out of Vozd and sending her into catatonic oblivion.
At last it was time to stop.
"We can let her go."
Vozd just lay there. With some pushing from Cecil, she got up at last, half falling, and picked up her bag and coat without a murmur. Sami and Cecil stood an inch apart, not daring to touch. Together they watched the Minister for Health trudge through the clinic door on her way out into the weak winter moonlight.
By day Alex Bottle is an associate professor in medical statistics in London, UK, and he researches healthcare performance. He lives with his wife and cat in a small town famous for its forest.
(Back to Table of Contents)
Creativity Isn't About Ideas; It's About Execution
by Dan Hope; published March 6, 2013
Where does your creativity come from? Do you believe in a muse who touches your mind? It’s pretty easy to believe that our best ideas come straight out of the aether, especially the ones that seem to jump into our minds fully formed. The most creative people seem to have original ideas pop into their brains on a regular basis.
But that’s wrong.
I’ll make two very inflammatory remarks, and we’ll see if you stick around to hear the explanation.
#1 – There are no original ideas.
#2 – Every creator has stolen all their ideas.
Still with me?
I know that’s a big accusation, especially considering how much we all hate plagiarism (and have created legislation to prevent it, such as copyright, patent, and trademark law). No one likes a phony. Everyone likes to believe that their ideas are their own.
The truth is that they may be yours, but you cobbled them together from the pieces of other ideas.
Ideas from other people.
This is the concept of combinatorial creativity, and after you get over the shock of realizing that creativity doesn’t work the way we believe it does, it’s pretty liberating. I’ll explain the benefits more in a bit, but first, what is combinatorial creativity?
Start with this video. It’s a Derren Brown trick, but it’s also a quick primer on how the creative process works.
Derren has exploited the creative pattern to make a point, but this is still exactly how our minds work when we form ideas. Every cool new story, or song, or painting, or video, or yarnbombing you think up is inspired by bits and pieces of things you’ve experienced (though obviously not so directly as what Derren Brown did).
I talked about this over at LitReactor when I addressed some accusations that Orson Scott Card stole the idea for Ender’s Game. Whether you read that article or not, there is one concept that I want you to remember from it:
Creativity isn’t about ideas; it’s about execution.
In other words, there are no original ideas because every new "creative" idea is built from the bits and pieces of the creator’s experience. That’s why creators are always consumers, too. They consume the things they love, and it inspires them to create things they love.
So the thing that makes people truly creative isn’t how previously unfathomable an idea was, but how the creator put those inspirations together. For instance, when an au
thor does this right, the book feels fresh and new, even though the technical plot points and character attributes have all been seen before in various combinations in other books.
Say it again: Creativity isn’t about ideas; it’s about execution.
This is what makes parody, homage, mashups, metaphor, and allusions possible, but it’s also what made every piece of art and media possible. The creator’s work is a conglomeration of their experiences, not the manifestation of their wholly new ideas.
It’s pretty easy to take the concept of combinatorial creativity as tacit permission to steal things wholesale. But it’s not an excuse for plagiarism. Taking ideas directly, with the intent to pass someone else’s work off as your own is still wrong. Very wrong. But it also means that every similarity between products isn’t automatically plagiarism. It’s likely that some complete stranger somewhere has had the same idea for a flying timecop TV pilot that you have, and they didn’t steal it. Their brain simply combined some of the same ideas that your brain did.
Austin Kleon is a proponent of combinatorial creativity, and this video tells the story of how he discovered his brain was combining similar ideas that other people had thought of, and there was no plagiarism whatsoever. I highly recommend watching it.
The best part is that combinatorial creativity doesn’t make you or the other person more or less creative. It means that creativity is more egalitarian than we previously thought.
So why do some people still seem more creative? Two reasons: They’ve seeded their mind with more potential combinatorial elements (either by quantity or quality), and they have actually done something about it.
Remember the part about creativity not being about ideas, but about execution?
The creative people aren’t the only ones who have ideas, they’re just the ones who did something about it. How many times have you heard someone claim to have sixteen great novel ideas written down somewhere; they’re just waiting for the right moment to turn one into a book? How many times have you said that?
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