Sixty Days and Counting sitc-3

by Kim Stanley Robinson

  ———

  All the various scans that Frank’s doctors had ordered had been taken, at an increasing pace as they seemed to find things calling for some speed; and now it was time to meet with the brain guy.

  This was an M.D. who did neurology, also brain and face surgery. So just in ordinary terms a very imposing figure, and in paleolithic terms, a shaman healer of the rarest kind, being one who actually accomplished cures. Awesome: scarier than any witch doctor. Whenever the technological sublime was obvious, the fear in it came to the fore.

  The doctor’s office was ordinary enough, and him too. He was about Frank’s age, balding, scrubbed very clean, ultra-close-shaven, hands perfectly manicured. Used to the sight of the bros’ hands, and Rudra’s hands, Frank could scarcely believe how perfect this man’s hands were. Very important tools. They gave him a faintly wax-figurish look.

  “Have a seat,” he said, gesturing at the chair across his desk from him.

  When Frank was seated, he described what he had found in Frank’s data. “We’re seeing a chronic subdural hematoma,” he said, pointing to a light spot in an array of spots that roughly made the shape of a brain section—Frank’s brain. The CT scan and the MRI both showed evidence of this hematoma, the doctor went on, and pretty clearly it was a result of the trauma Frank had suffered. “Lots of blood vessels were broken. Most were outside the dura. That’s the sack that holds your brain.”

  Frank nodded.

  “But there are veins called bridging veins, between the dura and the surface of the brain. Some of them broke, and appear to be leaking blood.”

  “But when I taste it?”

  “That must be from encapsulated blood in scar tissue on the outside of the dura, here.” He pointed at the MRI. “Your immune system is trying to chip away at that over time, and sometimes when you swing your head hard, or raise your pulse, there might be leaking from that encapsulation into the sinus, and then down the back of your throat. That’s what you’re tasting. But the subdural hematoma is inside the dura, here. It may be putting a bit of pressure on your frontal cortex, on the right side. Have you been noticing any differences in what you think or feel?”

  “Well, yes,” Frank said, thankful and fearful all at once. “That’s really what brought me in. I can’t make decisions.”

  “Ah. That’s interesting. How bad is it?”

  “It varies. Sometimes any decision seems really hard, even trivial ones. Occasionally they seem impossible. Other times it’s no big deal.”

  “Any depression about that? Are you depressed?”

  “No. I mean, I have a lot going on right now. But I often feel pretty great. But—confused. And concerned. Worried about being indecisive. And—afraid I’ll do something—I don’t know. Stupid, or—dangerous. Wrong, or dangerous. I don’t trust my judgment.” And I have reasons not to.

  “Uh huh,” the doctor was writing all this down on Frank’s chart. Oh great. Confessing to his health insurance company. Not a good idea. Perhaps a bad decision right here and now, in this room. A sample of what he was capable of.

  “Any changes in your sense of taste?”

  “No. I can’t say I’ve noticed any.”

  “And when you taste that blood taste, does it correlate with periods of decisiveness or indecisiveness?”

  “I don’t know. That’s an interesting thought, though.”

  “You should keep a symptom calendar. Dedicate a calendar to just that, put it by your bed and rate your day for decisiveness. From one to ten is the typical scale. Then also, mark any unusual tastes or other phenomena—dizziness, headaches, strange thoughts or moods, that kind of thing. Moods can be typified and scaled too.”

  Frank was beginning to like this guy. Now he would become his own experiment, an experiment in consciousness. He would observe his own thoughts, in a quantified meditation. Rudra would get a kick out of that; Frank could hear his deep laugh already. “Good idea,” he said to the doctor, hearing the way Rudra would say it. “I’ll try that. Oh, I’ve forgotten to mention this—I still can’t feel anything right under my nose, and kind of behind it. It’s numb. It feels like a nerve must have been, I don’t know.”

  “Oh yeah? Well—” Looking at the scans. “Maybe something off the nine nerve. The glossopharyngeal nerve is back there where we’re seeing the encapsulation.”

  “Will I get the feeling back?”

  “You either will or you won’t,” the doctor said. All of them had said that; it must be the standard line on nerve damage, like the line about the president having so much on his plate. People liked to say the same things.

  “And the hematoma?”

  “Well, it’s been a while since your injury, so it’s probably pretty stable. It’s hypodense. We could follow it with serial scans, and it’s possible it could resolve itself.”

  “And if it doesn’t?”

  “We could drain it. It’s not a big operation, because of the location. I can go in through the nose. It looks like it would be straightforward,” checking out the images again. “Of course, there’s always some risk with neurosurgery. We’d have to go into that in detail, if you wanted to move forward with it.”

  “Sure. But do you think I should?”

  He shrugged. “It’s up to you. The cognitive problems you’re reporting are fairly common for pressure on that part of the brain. It seems that some components of decision making are located in those sulci. They have to do with the emotional components of risk assessment and the like.”

  “I’ve read some of the literature,” Frank said.

  “Oh yes? Well, then, you know what can happen. There are some pretty unusual cases. It can be debilitating, as you know. Some cases of very bad decision making, accompanied by little or no affect. But your hematoma is not so big. It would be pretty straightforward to drain it, and get rid of the encapsulated clot too.”

  “And would I then experience changes in my thinking?”

  “Yes, it’s possible. Usually that’s the point, so patients like it, or are relieved. Some get agitated by the perception of difference.”

  “Does it go away, or do they get used to it?”

  “Well, either, or both. Or neither. I don’t really know about that part of it. We focus on draining the hematoma and removing that pressure.”

  It will or it won’t. “So if I’m not in too much distress, maybe I ought not to mess with it?” Frank said. He did not want to be looking forward to brain surgery; even clearing out his sinuses sounded pretty dire to him.

  The doctor smiled ever so slightly, understanding him perfectly. “You certainly don’t want to take it lightly. However, there is a mass of blood in there, and often the first sign of it swelling more is a change in thinking or feeling, or a bad headache. Some people don’t want to risk that. And problems in decision making can be pretty debilitating. So, some people preempt any problems and choose to have the surgery.”

  “Jeez,” Frank said, “this is just the kind of decision I can’t make anymore!”

  The doctor laughed briefly, but his look was sympathetic. “It would be a hard call no matter what. Why don’t you give it a set period of time and see how you feel about it? Make some lists of pros and cons, mark on your symptom calendar how you feel about it for ten days running, stuff like that. See if one course of action is consistently supported over time.”

  Frank sighed. Possibly he could construct an algorithm that would make this decision for him, by indicating the most robust course of action. Some kind of aid. Because it was a decision that he could not avoid; it was his call only. And doing nothing was a decision too. But possibly the wrong one. So he had to decide, he had to consciously decide. Possibly it was the most important decision he had before him right now.

  “Okay,” he said. “I’ll try that.”

  -

  BACK AT WORK, FRANK TRIED to concentrate. He simply couldn’t do it. Or he concentrated, but it was on the word hematoma. Chronic subdural hematoma. There’s pressure on my bra
in. He thought, I can concentrate just fine, I can do it for hours at a time. I just can’t decide.

  He closed his eyes, poked at his Things To Do list with a pen. That was what it had come to. Well, actually he had bundled three things to do in a military category, and now he realized he should have poked the GO TO THE PENTAGON item on the list, because Diane had told him to and he had made appointments, and today was the day. So there hadn’t been any choice to be made. Check the calendar first to avoid such tortures.

  1) Navy, 2) Air Force, 3) Army Corps of Engineers, the list said. Secretary of the Navy’s office first: chief nuclear officer, happy to meet with the president’s science advisor’s advisor, Diane had said. Lunch at the Pentagon.

  The Pentagon had its own Metro stop, just west of the Potomac. Frank came up out of the ground and walked the short distance to the steps leading up to the big doors of the place. These faced the river. From them it was impossible to see how big the Pentagon was; it looked like any plain concrete building, wide but not tall.

  Inside there was a waiting room. He went through a metal detector, as at an airport, was nodded onward by a military policeman. At the desk beyond another MP took his driver’s license and checked his name against a list on his computer, then used a little spherical camera on top of the computer to take a picture of him. The MP took the photo from a printer and affixed it to a new ID badge, under a bar code, Frank’s name, and his host’s name. Frank took the badge from the man and clipped it to his shirt, waited in the waiting room. There was a table with promotional brochures, touting each of the services and its missions, also the last two wars.

  The Navy’s chief nuclear officer was a Captain Ernest Gamble. He had been a physics professor at Annapolis. Cool and professional in style.

  They walked down a very long hallway. Gamble took him up some stairs to an interior window, where the pentagonal inner park stood in the sunlight. Then it was onward, down another very long hallway. “They used to have little golf carts for the halls,” Gamble explained, “but people kept running them into things. It takes a long time to get repairs done here. The joke is, it took eighteen months to build the Pentagon, and ten years to remodel it.”

  They passed a small shopping mall, which Frank was surprised to see there inside the Pentagon itself, and finally came to a restaurant, likewise deep inside the building. Sat down, ordered, went to a salad bar and loaded up. As they ate, they discussed the Navy’s nuclear energy capabilities. Ever since Admiral Hyman Rickover had taken over the nuclear fleet in the 1950s, the Navy’s nuclear program had been held to the highest possible safety standards, and had a spotless record, with not a single (unclassified) accident releasing more than fifty rads.

  “What about classified accidents?”

  “I wouldn’t know about those,” Gamble deadpanned.

  In any case, the Navy had had no reactor accidents, and a half-century’s experience with design and operation. They discussed whether the Navy could lead the way in designing, maybe even overseeing, a number of federally funded “National Security Nuclear Plants.” That might avoid the cost-cutting disasters that free-market nuclear energy inevitably led to. It would also excuse the new power plants from those environmental regulations the military already had exemptions from. Overall those exemptions were a bad idea, but in this case, maybe not.

  In effect, pursuing this plan would nationalize part of the country’s energy supply, Gamble pointed out. A bit of a Hugo Chavez move, he suggested, which would enrage the Wall Street Journal editorial page and its ilk. Between that and the environmental objections, there would be no lack of opponents to such a plan.

  But the Navy, Frank suggested, had no reason to fear critics of any stripe. They did what Congress and the president asked them to do.

  Gamble concurred. Then, without saying so outright, he conveyed to Frank the impression that the Navy brain trust might be happy to be tasked with some of the nation’s energy security. These days, global military strategy and technology had combined in a way that made navies indispensable but unglamorous; they functioned like giant water taxis for the other services. Ambition to do more was common in the secretary’s office, and over at Annapolis.

  “Great,” Frank said. While listening to this artful description, vague but suggestive, something had occurred to him: “When there are blackouts, could the nuclear fleet serve as emergency generators?”

  “Well, yes, if I understand you. They’ve done things like that before, doing emergency relief in Africa and Southeast Asia. Hook into the grid and power a town or a district.”

  “How big a town?”

  “The ships range from a few to several megawatt range. I think a Roosevelt-class aircraft carrier could power a town of a hundred thousand, maybe more.”

  “I’d like to get the totals on that.”

  Then lunch was over and it was time for 2) Air Force. A new aide appeared and escorted him around two bends of the Pentagon, to the Air Force hall. The walls here were decorated with giant oil paintings of various kinds of aircraft. Many of the gleaming planes were portrayed engaged in aerial dogfights, the enemy planes going down under curved pillars of smoke and flames. It was like being in a war-crazed teenager’s bedroom.

  The Air Force’s chief scientist was an academic, appointed for a two-year stint. Frank asked him about the possibility of the Air Force getting involved in space-based solar power, and the rapid deployment thereof. The chief scientist was optimistic about this. Solar collectors doing photovoltaic in orbit, beaming the power down in microwaves to Earth, there to be captured by power plants, which became capture-and-transfer centers, rather than generating plants per se. Have to avoid frying too many birds and bees with the microwaves, not unlike the wind turbine problem in that regard, otherwise pretty straightforward, technically, and with the potential to be exceptionally, almost amazingly, clean.

  But?

  “You would need a big honking booster to lift all that hardware into space,” the chief scientist said. Maybe something that had horizontal takeoffs and landings both, some kind of ramjet thing. In any case a major new booster, like the old Saturn rocket, so foolishly canceled at the end of Apollo, but modernized by all that a half-century’s improvements in materials and design could give it. A good booster could make the shuttle look like the weird and dangerous contraption it had always been.

  “Much progress on that, then?” Frank asked.

  The matter had been studied, and some starts made, but it could not be said to be going full speed yet. Even though it was a crucial part of a full clean energy solution.

  “What have people been thinking this last decade or two?” Frank wondered once. “Why not do the obvious things?”

  The chief scientist shrugged; a rhetorical question, obviously. Only Edgardo would bother to shout out Because we are stupid!

  Frank said, “Could the Air Force itself commission a big booster, as a defense priority?”

  “Well, it’s supposed to be NASA’s thing. And there’s lots of people nervous about what they call militarizing space.”

  “Can NASA do it?”

  Another shrug, very expressive. NASA was tricky, small, often very messed up. Maybe the Air Force could partner with them, try to help without being too intrusive.

  “Even fund it,” Frank suggested.

  But of course that brought up the problem of “reprogrammed funds,” as General Wracke had described to him the year before. Really something like that could only be Congress’s call. Again. But the Air Force would be willing to advocate such a thing to Congress, sure. They would serve as called on.

  So. Frank thanked the man and was escorted around to the Army hall, for his 3) Army Corps of Engineers meeting.

  But here it turned out General Wracke had been called away unexpectedly, so his escort led him back to the waiting room, the only place where he could exit the building.

  Back onto the Metro (and who had built that?), he tried to work it out. Navy helps Energy, Air Force h
elps NASA, Army Corps of Engineers helps all the land-based infrastructure, including carbon sequestration and shoreline stabilization. Together with all the other mitigation efforts, they would be terraforming the Earth. It was, after all, a matter of national defense. Defense of all the nations, but never mind. Republic in danger; the military should be involved. Especially given their budget. A military as big as all the other militaries on the planet, working for a country that had explicitly renounced any imperial ambitions or world police responsibilities, which it wanted to cede over to the UN as a globalized world project. That meant there was now a gigantic budget and productive capacity, extending into the private sector in the form of the military’s many contractors, that did not have all that much to do. It was an instantaneous investment overhang. Maybe it could be devoted to the mitigation project. The Swiss Army did work like that. Frank wondered if the FCCSET program could be used to coordinate all these federal efforts, perhaps out of the OMB. Construct an overarching mission architecture.

  He wondered if the FBI could be sicced on black-black programs that had taken off on their own and hidden within the greater intelligence and security morass.

  It was hard to imagine how all this would work, but Frank felt that here he was baffled not by his own cognitive problems, but by the sheer size and complexity of the federal government, and of the problem. In any case one thing was clear: there was serious money being disbursed out of the Pentagon. If they were interested in trying to help with this, it could be an incredible resource.

  In the private sphere, meanwhile, it was time to find and talk to big pools of accumulated capital. As, for instance, the reinsurance companies, with total assets in the ten-trillion-dollar range. Next item on the list. If he could only keep this busy, there would be no need to decide anything. Or to wonder where Caroline was and why she hadn’t contacted him yet.