If you were responsible in your own daily health-care practices, the polity appreciated the way in which you eased the general strain on medical resources. You had objectively demonstrated your firm will to live. Your serious-minded, meticulous approach to longevity was easily verified by anyone, through your public medical records. You had discipline and forethought. You could be kept alive fairly cheaply, because you had been well maintained. You deserved to live.
Some people destroyed their health, yet they rarely did this through deliberate intention. They did it because they lacked foresight, because they were careless, impatient, and irresponsible. There were enormous numbers of medically careless people in the world. There had once been titanic, earth-shattering numbers of such people, but hygienically careless people had died in their billions during the plagues of the 2030s and 2040s. The survivors were a permanently cautious and foresightful lot. Careless people had become a declining interest group with a shrinking demographic share.
Once upon a time, having money had almost guaranteed good health, or at least good health care. Nowadays mere wealth guaranteed very little. People who publicly destroyed their own health had a rather hard time staying wealthy—not because it took good health to become wealthy, but because it took other people’s confidence to make and keep money. If you were on a conspicuously public metabolic bender, then you weren’t the kind of person that people trusted nowadays. You were a credit risk and a bad business partner. You had points demerits and got cheap medical care.
Even the cheap treatments were improving radically, so you were almost sure to do very well by historical standards. But those who destroyed their health still died young, by comparison with the elite. If you wanted to destroy your health, that was your individual prerogative. Once you were thoroughly wrecked, the polity would encourage you to die.
It was a ruthless system, but it had been invented by people who had survived two decades of devastating general plagues. After the plagues everything had become different, in much the way that everything was different after a world war. The experience of massive dieback, of septic terror and emptied cities, had permanently removed the culture’s squeamishness. Some people died and some didn’t. Those who took steps to fight death would be methodically rewarded, and those who acted like fools would be buried with the rest.
There were, of course, some people who morally disagreed with the entire idea of technologized life extension. Their moral decision was respected and they were perfectly free to drop dead.
Mia’s choice of upgrade was known as Neo-Telomeric Dissipative Cellular Detoxification, or NTDCD. It was a very radical treatment that was very little tried and very expensive. Mia knew a great deal about NTDCD, because she was a professional medical economist. She qualified for it because she had been very careful. She chose to take it because it promised her the world, and she was in a mood to gamble.
Mia put 90 percent of her entire financial worth into a thirty-year hock to support continued research development and maintenance in NTDCD.
NTDCD was considered a particularly promising avenue of development. Medically speaking it was extremely difficult to perform. In medical upgrades, the promise and the difficulty were almost always tightly linked. Qualifying for such a lavish upgrade required an intimidating level of personal sacrifice. Patients qualifying for this treatment would have all their funds reinvested in maintenance and R&D. The funds would be returned handsomely if the avenue of upgrade paid off. If it didn’t pay off, then the donor would probably be dead before the funds came back into liquidity.
Losing years of control over one’s money was a very stiff price, but it was not the worst of it. The loss of money did not sting the way it once had stung. Money was no longer what money once had been. The polity had never been a free-market society. People dying of plague were not much impressed by free markets. The polity was a plague-panicked allocation society in which the whip hand of coercive power was held by smiling and stouthearted medical rescue personnel. And by social workers. And by very nice old people.
Mia’s forthcoming ordeal had been plotted in meticulous detail.
The first major trick was to stop eating. Her entire digestive tract would be clogged with a sterilizing putty.
The second trick was to stop breathing. Her lungs would be filled with a sterilizing oxygenating silicone fluid. These two processes would immediately kill off most of the body’s internal bacteria.
The third trick was to stop thinking. The blood-brain barrier would be scrubbed free from the capillaries of her skull and the cerebrospinal fluid would be replaced with a sterilizing saline fluid. Profound unconsciousness resulted.
The next trick, quite an advanced one, was to stop being quite so rigorously multicellular. Mia would be fetally submerged in a gelatinous tank of support fluids. Her internal metabolic needs would be supplied through a newly attached umbilical. The hair and the skin had to go. The bloodstream and lymphatic system would be opened to the support vat for the remaining course of the treatment. Red blood cell production would be shut down and the plasma replaced by a straw-colored fluid toxic to any cell which was not mammalian. All commensal organisms in the human body had to be destroyed.
Once the bacteria were thoroughly and utterly annihilated, the hunt would commence for the viruses and prions. It would take about a week to tag and destroy the genetic menagerie of imbedded human viruses. It would take about three weeks to destroy the vast metabolic cosmos of once-unsuspected human prions. These rogue proteins would mostly be shivered apart through magnetic resonance techniques.
Once this much had been accomplished, Mia would become an entirely antiseptic organism, a floating amniotic gel culture.
The DNA treatments could then commence. Intercellular repair required a radical loosening of the intracellular bonds so as to facilitate medical access through the cell surfaces of the corpus as a whole. The skinless body would partially melt into the permeating substance of the support gel. The fluidized body would puff up to two and a half times its original volume.
At this point, flexible plastic tubing could worm its way into the corpus. The skinless, bloated, and neotenically fetalized patient, riddled with piercings, would resemble an ivory Chinese doll depicting acupuncture sites.
Specific procedures would take place in the marrow of the femurs, the spine, the ventricles of the brain, the sinuses, and other deeply interiorized spaces. Toxic buildups and precipitated mineralized bodies in the arteries, gall bladder, and lymphatic system—especially the metabolically crucial coacervate deposits in the pineal gland—would be reduced or eliminated.
On a genetic level, Mia’s cells would be studied for cumulative replication errors. Precancerous and/ or junk-burdened cells would be tagged with artificial antibodies and made the targets for programmed apoptosis. Some 15 percent of the body’s cells would be killed during this period and removed by migratory artificial phagocytes. This process alone would require over a month.
The surviving cells would then be treated to a neotelomeric extension. The telomeric ends of the chromosomes were a genetic clock, wearing thin as the human cell approached its Hayflick limit of allowable replications. New telomeric material would be spliced onto the chromosomes, tricking the aging cells into believing in the fiction of their own youth. The cells would then begin replicating furiously in the nutrient broth, and the wasted body would regain its 15 percent of lost body mass.
The extremely rapid growth within a buoyant support vat was closely akin to fetal growth. It was to be expected that there would be certain developmental abnormalities, especially in the adult joints and musculature. This was an expected price for marination in a fountain of youth.
The recovery process posed its own difficulties. The skin had to be regrown, commensal bacteria had to be gently reintroduced, the interior fluids had to be painstakingly replaced with natural substances. It was not entirely certain when the patient would regain consciousness, or what that state of consciousness m
ight entail in the way of somatic sensation.
“I believe what you’re trying to say is that this will be extremely painful,” said Mia.
Her counselor was Dr. Rosenfeld, a sharp-faced, brilliantly preserved clinician with two dark wings of hair. Dr. Rosenfeld was a man of her own age. He had taken pains to inform Mia that he still considered himself fully bound by the Hippocratic oath he had taken some seventy years previously. In Dr. Rosenfeld’s opinion, there were a few hundred million Johnny-come-lately medical technicians, and then there were actual doctors. Dr. Rosenfeld was a traditional, actual doctor. He would never allow any patient in his clinical charge to enter such a profoundly transformative state without a great deal of previous bedside manner.
“The term ‘pain,’ ” said Dr. Rosenfeld, “is a relic of folk models of mental function. We have to draw a distinction between the higher-level subjective experience of pain, and the basal-level sequence of somatic nerve transmissions. All of these practices in NTDCD would be extremely painful to a fully operational brain, but your brain is going to be considerably less than operational. Have you heard of Korsakoff’s syndrome?”
“Yes, I have.”
“Of course, in modern practice we recognize thirty-one distinct substates of Korsakoff’s.… You will be placed into one of those amnesiac modes during the procedure. It’s like a virtuality, but it’s a profound healing space. Extreme states of so-called pain may flash through certain preconscious processing centers involved in working memory, but those experiences will simply not be recorded through any normal channels. We’ll be doing constant emission scanning, and I can guarantee you that whatever preconscious events may occur will never be consciously accessible, either during the time of treatment or afterward.”
“So I’ll feel it, but I won’t feel it.”
“That’s semantics again. ‘Feel’ is a very broad and inexact folk term. So is the term ‘I,’ for that matter. Maybe we can say that there will be feelings, but there won’t be any ‘I’ to have them.” Dr. Rosenfeld smiled. “Ontology is fascinating, isn’t it? I hope we can work through this discussion without invoking René Descartes.”
“I’ve read René Descartes.”
“The old fellow was remarkably prescient about the pineal gland.” Dr. Rosenfeld spread his long-fingered, tapered, well-kept hands. “NTDCD is no mere maintenance procedure. This is the closest that humankind has yet come to genuine rejuvenation. This might be a treatment program that could put our patients on the path to immortality.”
Mia only smiled. It was a claim that she had heard and read many times before. Medical entrepreneurs loved to claim that their particular line of life extension would carry patients all the way to a future transcendant medical breakthrough.
“It’s a public-relations tactic that’s been rather overblown,” Dr. Rosenfeld admitted. “Still, look at the figures and trends. It’s very clear that the speed of improvement in life extension is itself improving. Sooner or later we will hit the plateau. We’ll reach a rate of life-span improvement of one year per year. At that point, the patients will become effectively immortal.”
“Some patients,” Mia said. “Maybe.”
“I’m not saying that we’re there yet, or even that we can see it. Obviously there are many hard decades of research ahead. But with NTDCD, some of our patients may, possibly, live to see that day.”
“I didn’t ask you for any such promises, Doctor. Anyway, I’ll believe in immortality when I see it done for rats and dogs.”
“We’ve done it already for fruit flies and nematodes,” said Dr. Rosenfeld.
“I’m not a fruit fly,” Mia said.
“Too true,” said Dr. Rosenfeld. “I take your point. But you are a very special woman in a privileged position. Only forty human beings have gone through this treatment to date. Furthermore, none of them have had the exact clinical experience that you’ll be undergoing. This treatment in its present form is only two years old. There is very little postoperational experience with patients. And that is a matter that concerns us both.”
Mia nodded helpfully.
“Once you’re out of the tank, you’ll be consciously experiencing the end results of a very profound metabolic change. Once you enter your convalescence, you’re not going to be the same woman who’s sitting here in front of me right now. You’ll discover that you’re not even the mistress of your own body. You’ll have lost a lot of nervous and muscular coordination.”
Dr. Rosenfeld opened a notebook. “You’re ninety-four years old. Your records tell me that you’ve lost about 12 percent of the neuronal and glial tissue that you had when you were, say, twenty. That’s perfectly normal and natural, but NTDCD is very, very far from normal and natural. You’re going to get all that tissue back—not the original tissue, mind you, but a new infiltration of fresh brain tissue that is essentially unimprinted. And brain tissue is not something you can turn on and turn off, plug in or plug out. It’s going to be part of you. The new you.”
“How dangerous is that?”
“Let’s just say you’re going to require a lot of surveillance and counseling during the integrative process.”
“What’s the worst I can expect?”
“Very well … As you know, in the early days we had two fatalities. Catastrophic neural failure, cessation of higher functions, euthanasia. The customary ethical procedure—tragic, but customary. You could die in this treatment. That has happened.”
“And?”
“And profound dissociation. What they used to call schizoid behavior, in the old days. Some preepileptic manifestations. We understand these mental processes fairly well these days, on a cellular level. Unless there is gross physical damage, strokes, infarcts, amyloid degeneration, then we simply don’t allow our patients to enter states of dementia. We can interfere and avert most gross neuronal misbehavior.”
He leaned back in the chair. “But there are other and subtler disturbances: culture shock, anomie, postoperation letdown, a few hints of bipolar disorder. Plus good old-fashioned human mulish impatience … Human consciousness is the highest and most complex metabolic function in all of nature. We can throw medical terms at the soul, but we can’t box it up. We simply can’t give people their identity the way we might give an injection; in the end, people have to find their own souls.”
“Are you religious, Doctor?”
“Yes, I am, actually. I’m a Catholic lay brother.”
“Really. How interesting.”
“I wouldn’t advise any use of entheogens under your medical circumstances, Mia. If you want to see your Savior face-to-face, then He will wait for you. You’ll have plenty of time.” Dr. Rosenfeld smiled.
Mia nodded and wisely said nothing.
Dr. Rosenfeld hesitated. “May I ask something? When was the last time you had an orgasm?”
Mia thought it over. “I’d have to say about twenty years.”
“Very wise. I’m sure that has helped your metabolism. But you’re going to become a sexual person again, with something very close to the full complement of metabolic drives. I won’t say that’s unpleasant, because of course sexuality is very pleasant, but it won’t be easy for you. In fact, sexuality is generally the worst recuperative problem that our patients face.”
“Really. How odd.”
“People of our advanced years come to terms with a loss of libido. Our elderly patients often think they can repress sexual urges through a simple act of will. That’s a canard. If human beings could control sexuality, the human race would have ceased to exist during the Pleistocene.” He paused reflectively. “You’re postmenopausal, of course. There’s not much we can do about egg-cell lines. We wouldn’t want to do egg-cell restoration anyway, because the ethicists don’t approve. So you won’t become fertile again.”
Mia smiled. “Well, Doctor, I’ve been a young woman before. I’ve been married, I had a child. When I was young, people died from sexual diseases. Even contraception was troublesome. I’ve always been
rather careful about that aspect of my life.”
“Ah, but back then you had years to get accustomed to puberty. You didn’t have a subjectively sudden dusting and cleaning of your entire limbic and hormonal systems. We’re redoing your brain, and most of the brain doesn’t think or reason. The human brain is a gland, it’s not a computer.”
Dr. Rosenfeld drummed his shining fingertips against the desktop. “People don’t live because life is a rational decision. People don’t get out of bed in the morning because of cost-benefit analysis. People don’t get into bed together because they’ve decided on that course of action through logical deduction. Sexuality is an aspect of being, and you cannot stop your being through any mental act of will. You’re going to be a ninety-four-year-old woman who can look, act, and feel like a twenty-year-old girl. Of course there will be complications.”
“Can’t I just take libido suppressants?”
“That’s an option. Libido suppressants are very popular nowadays, but I wouldn’t advise that you use them. Hormones have a strong function in physical development. Young people have a lot of hormones because young people really need those hormones, and you also need your hormones for the sake of proper development in your new brain tissue. My advice to you as your physician is that you are better off putting up with the troubles. Think of them as growing pains.”
Mia smiled. “Are you advising me to take lovers?”
“Mia …” He patiently steepled his fingers. “Even if you can find lovers, and that’s no small matter under your circumstances, taking lovers doesn’t seem to help. It’s not a simple matter. Our patients are elderly people, they’ve been through marriage, they’ve had children. They don’t want to start flirting or courting. They don’t want to commit to life partners, or start new families. They’ve already been through that aspect of human experience, they learned by it and they put it behind them. It’s not that they’re incapable of loving other people, but they’ve reached a state of deep maturity, of posthuman self-actualization. They just don’t have it in themselves to maintain a committed and passionate sexual relationship. And yet after the treatment, the drives are very strong. Our patients tend to find it distressing. It’s demeaning, and very difficult to integrate.”
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