The Patient

by Michael Palmer

  Thanks to a med school rotation riding on the ambulances, she had little trouble working the radio. In just seconds, the C-Med operator had patched her through to the Maine State Police.

  “We’ve got an awful lot of people looking for you,” the officer said. “One in particular. Wait a minute.”

  There was some static, then Alex’s voice.

  “Jessie?”

  “Alex, where are you?”

  “In the sky, headed your way.”

  “They’ve got Emily.”

  “Not anymore, they don’t. She’s okay. So is Gilbride. The pilot of the helicopter told us where they were headed in Maine, so we’ve been looking for you along the way. Where’s Malloche?”

  “Right here, Alex. He and Arlette are right here, but they can’t come to the phone.”

  “How did—?”

  “I’ll tell you when I see you. Can you find me?”

  “We think so. Listen, turn on the headlights and every other light and flasher you can find. It shouldn’t be long.”

  “Were many people killed by the soman?”

  “It was bad, but it could have been much worse. Hang on, we’ll be there soon. I’ll tell you about it then.”

  “It’s almost over, Alex.”

  Jessie switched on the ambulance lights and flashers. Then she checked on her prisoners and walked across the road to a small field. The night air was chilly and sweet. Overhead, the pitch black rural Maine sky was radiant with stars. Exhausted and drained, she sank onto the cool unmown grass and waited.

  Ten silent minutes later, she realized that one of the thousands of stars was growing larger and moving steadily in her direction.

  AUTHOR’S NOTE

  While a flexible robot such as ARTIE remains a thing of our future, many of the neurosurgical innovations described in this novel, including intraoperative MRI, are available today. The remarkable evolution of computer technology that has revolutionized much of our world over the last three decades has advanced our surgical capabilities beyond what even the visionaries of medicine could have predicted. High-speed graphic computers are radically changing the face of surgery and information exchange. Virtual reality, the assembly of realistic realms within the computer environment, now enables a surgeon to see and experience in advance the intricate, physiological relationships and anatomical problems he or she will encounter during an operation.

  Minimally invasive surgery using thin, flexible endoscopes is being applied to more and more clinical disorders, and the use of lasers and precisely guided radiation as alternatives to the scalpel is growing daily. Telesurgery, with the surgeon operating through robotic hands that may be hundreds of miles away, is being pioneered by the United States military. In the not-too-distant future, a surgeon may be able to perform simultaneous operations on patients in locations across the globe from one another, or even in outer space.

  In fact, ARTIE’s day may not be that far off. Currently, the use of robotic arms for performing tumor biopsies and placing counterstimulating electrodes in the brains of epileptics is nearly routine. And one team of neurosurgeons is experimenting with a small, intraoperative robot that is steered through the brain to its target using strong magnetic fields.

  Michael Palmer, M.D.

  References

  Grimson, W. E. L., Kikinis, R., Jolesz, F. A., Black, P. M. “Image-guided surgery.” Scientific American, June 1999; pp. 62–69.

  MIT Medical Vision Group. http://www.ai.mit.edu/projects/medicalvision/surgery/surgical_navigation.html.

  Textbook on computer workstation—guided neurosurgery. Alexander, E., III, and Maciunas, R. J. Advanced Neurosurgical Navigation. Stuttgart, New York: Thieme Medical Publishers, Inc., 1999. (See http://www.thieme.com/onGJHFFAEHKIEFM/display/590.)

  ABOUT THE AUTHOR

  MICHAEL PALMER, M.D., is the author of Miracle Cure, Critical Judgment, Silent Treatment, Natural Causes, Extreme Measures, Flashback, Side Effects, and The Sisterhood. His books have been translated into thirty languages. He trained in internal medicine at Boston City and Massachusetts General Hospitals, spent twenty years as a full-time practitioner of internal and emergency medicine, and is now an associate director of the Massachusetts Medical Society’s physician health program.

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