To Obey

by Mickey Zucker Reichert

  “May I?” Susan asked, pulling out her reflex hammer. Jessica did not resist as Susan tested several deep-tendon reflexes, including the biceps, brachioradialis, and patellar, all of which were notably brisk but equal from side to side. In contrast, the tendocalcaneal reflex at the ankles was absent. The primitive Babinski and Rossolimo reflexes in response to specific stimulation of the feet were both abnormally, if only slightly, positive.

  Susan exchanged her reflex hammer for a tuning fork. Blind testing demonstrated that Jessica had almost no vibratory sensation awareness, and her proprioception, the ability to mentally locate a body part in space, was severely impaired. Her responses as to whether Susan had raised or lowered her big toe were little better than random guessing. When asked if touches to various parts of her body felt normal, Jessica always answered that they did.

  A light touch to her right arm was perceived the same as a similar one to the left. However, Susan did elicit a vast difference in the response to stimuli applied to Jessica’s hands or feet and those applied to her face and torso. A pinprick to her shoulder resulted in a yelp of pain and a request that it not be repeated, while she acknowledged a sharp poke to the top of any toe as a touch.

  It soon became clear to Susan that Jessica had distal neuropathy of both hands from the tips of her fingers to just past her elbows and from her toes to her ankles. Most people would define what Jessica called normal as a pins-and-needles tingling or burning sensation of the hands and feet with decreased sensation overall, as if they were wearing gloves and socks. Apparently, Jessica had suffered the problem since childhood, because she considered the neuropathy completely normal. That alone could explain her lifelong clumsiness. It might also explain why the neuropathy had escaped the notice of doctors for so long. Unless a physician had strong suspicions, as Susan did, the diagnosis of neuropathy depended on patient complaint and description. Few doctors, other than neurology specialists, bothered to check routinely for vibratory sensation and proprioception anymore; they saw little cause for wasting time on such a low-yielding and time-consuming test in otherwise normal patients.

  Making sure the door was closed and curtains pulled, Susan performed a complete physical examination. The relatively subtle findings on neurological testing turned out to be the most striking problems found on examination. Jessica’s hair was a bit brittle and thin for Susan’s taste, but she had seen no other genetic family members for comparison. The woman’s breath was unwelcoming, and her dental hygiene marginal at best. Closer inspection revealed multiple crowns, implants, and veneers. She was still confused, though far less so than on admission. Prodded to walk, Jessica stumbled about dizzily, quickly became short of breath, and masked her discomfort beneath a sudden and intense irritability that sent doctor and nurse scuttling from the room.

  Once outside, the door shut, Farrah rounded on Susan. “What do you think, Doc?”

  Susan forced a weak smile. “I think a couple of lean-beef burgers, a glass of whole milk, and two or three hard-boiled eggs would perk her right up.”

  Farrah looked horrified. “You’ll never get the family to agree to that, Susan. They’re on God’s Ideal Diet. It’s vegan and a hundred percent raw.”

  Susan headed toward the privacy of the charting room. “Well, God’s Ideal Diet may work for angels, but it’s destroying Jessica Aberdeen’s neurological system.” Remembering a promise she made to herself that morning, Susan disengaged without further denunciation and headed more firmly toward the charting room.

  Before she got there, Kendall hurried up, hooked her sleeve with a finger, and hauled her toward the staffing area. “Good morning, Susan. How’s tricks?”

  “Tricks?” Susan repeated, mock scandalized. “So now I’m a hooker to you?”

  “Sailors,” Kendall pointed out, “also call their shifts tricks.” He unhooked his finger briskly, propelling Susan toward a chair while he spun one directly in front of himself. “And I think you know the expression really just means ‘How’s life treating you?’”

  Susan took the proffered seat. “Well, as you know, life is spitting all over me. But you’re not going to see me mooning over that anymore.”

  “Oh?” Kendall’s gaze was so absolute he clearly, genuinely wanted to know the reason.

  Susan looked for a way to word her new decision. “From now on, you might want to call me Su.”

  “Sue?” Kendall gave her a sideways glance. “Short for Susan, obviously; but I’ve never heard anyone call you that. Not even your father.”

  Susan elaborated. “Not Sue. S-U 2.”

  Kendall straightened suddenly. “What?”

  The reaction was not what Susan had expected. “S-U 2. As in the second unit in the Susan update line. S-U, Su. Like N8-C is Nate.”

  “So,” Kendall guessed, “you’re a robot now?”

  “Think of the advantages of living life by the Three Laws of Robotics.” Susan had considered it the entire way into work, which gave her an enormous benefit over Kendall, who had the idea dropped on him cold and without context.

  Kendall gave her a bemused look. “You mean, emotionless, apathetic, and calculating? Calvin, I’ve heard of maintaining professional distance, but isn’t that overdoing it a bit?”

  Susan was seized by a sudden urge to slug him. “After all we’ve been through, that’s your take on robots? Apathetic? Calculating?”

  “Well,” Kendall started slowly, but he had to know he was treading on thin ice. “I admit Nate’s absolutely amazing, but I’m not to the point where I’m ready to trade in my human brain for coils and wires.”

  Susan did not bother to correct his misconception of the makeup of the positronic brain, especially since she had only a superficial understanding herself. “I think we could exchange half the existing human brains for positronic ones, and it would only improve the world. We’d have fewer people believing in spirits and ghosts and a lot more trusting in proven science.”

  Kendall added, “That may be so, but yours isn’t one of the brains we should be replacing, Calvin.”

  Susan continued as if he had not spoken, “We’d double the average IQ, halve the rate of illness, and people would treat one another a lot better.”

  Kendall did not seem as enamored of the idea as Susan. “What’s the point? It’s not as if those features would be passed on to future generations. Only the actual humans could procreate. All our faults would survive, and you’ll have to convince me that’s a bad thing. Art, music, poetry all arise from our flawed human minds. We may be stupider than our robotic counterparts, but it took our imperfect minds to conceive of and create them.”

  It was an undeniable point, one Susan had not previously considered. “I’m not suggesting we replace humans entirely. I just think there’s some advantage to my taking on a robotic persona for the remainder of this particular rotation.”

  Kendall nodded stiffly, clearly in agreement at last. “If you were forced to observe the First Law, it would probably rescue our attending from slow disemboweling.” He chuckled. “Though I’d love to see you try to follow the Second Law. I don’t think you could obey orders given by human beings, even if you agreed with them. You have too much faith in your own competence and too little in that of most other people.” He added quickly, “With good reason, of course. But even if the order was sound, you’d question it. You’re a contrarian by nature.”

  “I am not!” Susan retorted, while Kendall laughed so hard, he nearly cried.

  She had just proven his point, and Kendall had no need to speak a word in explanation. He merely turned on his heel and headed out of the charting room, leaving Susan alone to contemplate her mistake.

  I am not a contrarian. Susan rolled her eyes at her own reply, then managed a laugh of her own. My father and Nate are right about one thing: Kendall gets me. And, at the moment, he’s exactly what I need. She tried to imagine herself dating Kendall Stevens. He was not stunningly handsome in a Remington Hawthorn sort of way, but neither was he wholly unattrac
tive. He was a bit ginger for her taste, but that was not a deal breaker. The idea of kissing him did not repulse her. He did have a great sense of humor, if over the top on more than one occasion. Intellectually, he had graduated medical school in the middle of his class, which made him nearly enough her equal. He embarrassed her sometimes, but he always had her best interests at heart, even when she did not realize it. They had a great working relationship, and, after her father, she considered him her closest human friend.

  Susan opened the palm-pross and checked Chuck Tripler’s information. Transferred to the neurosurgery service at Manhattan Hasbro Hospital, he had undergone resection of a large cauda equina neurinoma, a benign spinal tumor of nerve-cell origin. Time would tell how much permanent damage had been done by the long-term compression of brain tissue by his dilated ventricles, but she felt certain he would have a far better future than what he had suffered the past few years. At least he had a reasonable chance for a partial or near-full recovery.

  Susan wondered about Thomas Heaton and Barbara Callahan, but she did not want to interfere with Kendall’s patients. So many times he had watched her succeed beyond expectations. She wanted him to experience the delight and excitement of having cured someone who seemed hopeless. He did not seem to mind sharing the credit with her, even looked to her for guidance, but she suspected he would appreciate it more if he managed a few triumphs on his own. He’s more than capable, but strangely insecure. His near-constant need to resort to humor proved the thought. Susan wondered if she would ever elicit the root cause of his self-doubt.

  While Susan looked over Chuck’s recent history, Hazel Atkinson approached her. Susan would never forget the CNA receptionist, the first person she had met at Winter Wine Dementia Facility. Hazel handed Susan a manila envelope containing something hard, flat, and square.

  Susan accepted it, curious. “What’s this?”

  Hazel pressed wrinkles from her scrubs with her hands. “Thomas Heaton’s wife said you’d asked for it. It’s some of the music he conducted.”

  Susan remembered. She had mentioned the possibility the first day she had met the addled conductor. “Thanks. This is great.” She leapt to her feet and went searching for Kendall, and found him almost immediately in Barbara Callahan’s room. The elderly woman sat up in bed, a stupid grin plastered on her features. She wore a pair of stretch jeans and a T-shirt displaying a basket full of Chihuahua puppies. She bobbed from side to side with a sinuous movement that started in her head and moved down her neck to her shoulders.

  “Interesting,” Susan said.

  Barbara’s gaze found Susan, but Kendall was the one who replied. “Positive urine test for cannabis. Negative for everything else.” He glanced at his patient. “She’s actually a bit better today. She’s in the right century, anyway.”

  Barbara continued to study Susan. “Caden, introduce me to your girlfriend.”

  Kendall rolled his eyes toward Susan but nodded indulgently. “I’m not Caden, Barbara. Remember? I’m Dr. Kendall Stevens, and this is my fellow doctor, Susan Calvin.”

  Barbara bobbed her head. “Caden, Kendall—what’s the difference?”

  Susan chuckled. “Nice to meet you, Barbara. I’ve talked to your children.”

  Barbara stopped her odd movements and put both hands over her face. “Oh, I embarrass them.”

  Susan continued to smile. “All parents do. I’d worry if you didn’t.”

  Barbara lowered her hands. “Really? Oh, I’m so glad you understand. You’re like that nice neighbor of mine. Do you know Emma?”

  Kendall looked moderately pleased. “Earlier, she’d have assumed you were Emma.”

  Barbara turned to him curiously, “Emma who, Caden?”

  As Barbara seemed less confused when speaking with females, Susan perched on the edge of the bed. “Tell us about Emma.”

  “Emma?” Barbara repeated in evident confusion. She tipped her head in consideration, then her features brightened. “Oh, Emma, my neighbor. Sweet girl, isn’t she?”

  “I don’t know her,” Susan reminded gently. “Tell us about Emma.”

  “Emma’s my downstairs neighbor. I just adore her. Anything I need, she gets for me, sometimes even before I know I need it.” A beatific smile crossed her face. “She got me a kitten, gray tabby, looks just like my Mr. Tibbs. I didn’t realize how much I missed the old fellow.” The grin left her features suddenly, and she turned to Kendall again. “You did feed Tibbs. Didn’t you, Caden?”

  Barbara seemed so concerned, Kendall simply answered, “The cat has been fed.”

  Susan appreciated that the straightforward reply, though possibly untrue, forestalled a long discussion about a kitten that might or might not exist. She made a mental note to make certain an animal had not been forgotten in the old woman’s apartment.

  Kendall made a desperate attempt at an answer. “Barbara, does Emma ever bring you any…brownies?”

  Barbara rocked her head in a noncommittal fashion. “She comes for tea every day. I usually supply the pastries.” She added happily, “I like apple tarts best.”

  Kendall and Susan exchanged looks. The obvious avenue had not panned out. At least, not yet. It seemed unlikely they would get any useful information that day, and prudent to wait until Barbara had regained more of her senses.

  Susan rose from the bed, displaying the envelope for Kendall. “I’ve got something for you.”

  Apparently thinking Susan had addressed her, Barbara clapped her hands with delight. “Thank you, Emma. Do you have some more of those wonderful cigs?”

  Susan froze in midmovement. Kendall’s double take could have graced the most primitive cartoon. “Cigs?” Susan repeated. “Do you smoke, Barbara?”

  “Smoke?” Barbara made a pained face. “Heavens, no. Nasty, dangerous habit. No one does that anymore.” She turned Kendall a severe look. “And I’d better not find out you’ve started smoking, young man.”

  “Never,” Kendall promised. “I’m more concerned about you. Has Emma been bringing you”—he used Barbara’s own words—“wonderful cigs?”

  “Emma who?” The confused expression crossed Barbara’s face again, and her eyes went limpid. She closed them, rolled onto her side, and appeared to drift off to sleep in an instant.

  The residents tiptoed from the room, Susan still carrying the envelope and her palm-pross. As the door shut behind them, Kendall exclaimed, “I think we have a pretty good idea what’s going on here. But why would someone take tea with an elderly woman just to poison her with wacky tobaccy?”

  Susan saw the situation differently. “I don’t think there’s any deliberate attempt to harm anyone. The way Barbara and Bambi describe it, Emma’s a good friend. She just has a certain way of…of relaxing, let’s say. I’m betting Emma has no idea her wacky tobaccy is the cause of Barbara’s dementia. In fact, I’m betting she thinks what she’s supplying is medicinal.”

  Kendall groaned. “What I am supposed to tell Bambi and Caden?” He made a broad gesture, as if gathering kindergarten students into a huddle. “Kids, I’m afraid your mum’s a bent-A stoner.”

  “No,” Susan said. “Definitely not.”

  Kendall continued to pay attention to Susan’s response, which she interpreted as a request for real help.

  “THC is known to compete with acetylcholinesterase and helps prevent amyloid beta-peptide aggregation. In the early part of the century, it was considered and discarded as a possible treatment or preventative for Alzheimer’s.” Susan shrugged. “Emma probably read that somewhere and thought she was helping Barbara stay young and focused.”

  “Or,” Kendall suggested, “Emma has an addiction and thought she’d share it.”

  Susan could not deny the possibility. “I think we’re better off taking the first approach. Marijuana as a cause of dementialike symptoms in the elderly is well documented, but, used sparingly, there’s no indication it actually causes long-term dementia. If we make it clear to Barbara, her family, and Emma that Barbara is havi
ng acute, toxic reactions to the stuff and needs to completely avoid it, I think we can keep all the friendships intact and our patient permanently out of harm’s way.”

  Kendall nodded vigorously. “I like that. If the kids believe Emma meant well, they’re unlikely to uproot Barbara or ruin a treasured friendship.”

  “Unless it happens again,” Susan pointed out.

  “In which case, she should be uprooted and the relationship ended. There’s no real danger to her having another episode. Correct?”

  Susan managed a lopsided grin. “Correct. As long as Barbara hasn’t become pathologically attached to her wonderful cigs.”

  Kendall added, “Or doesn’t replace them with some wonderful pills or snorts.”

  Susan rolled her eyes. She doubted Barbara Callahan would discover the joys of hallucinogens at the ripe old age of seventy-six. “I’m pretty sure this will solve the problem, but you’re welcome to lecture Grandma Barbara on the dangers of home baking methamphetamine for the grandchildren.”

  Kendall put his hand out, palm up. “So, are you ever going to give me that thing you promised? Or are you holding out for money?”

  “What?” Confused, Susan stared at Kendall, watching his gaze fall to the arm at her side. Noticing the manila envelope still clutched in her fingers, she put it into his waiting hand. “Sorry about that. I forgot that’s why I came in.”

  Kendall shook out the tiny disc. “What’s on this?” He examined it closer, reading the miniscule print on the label. His eyes widened, his mouth curled upward, and a light crossed his features. “This is great!” He glanced around, finally noticing that Susan clutched a palm-pross as well. “Bring that. We’re going to visit Thomas Heaton next.” He swept away.

  Caught up in Kendall’s excitement, Susan followed. She passed the palm-pross to Kendall, tuning her Vox to catch the audio signal. In tandem, they trotted down the hall, followed by the gazes of curious inpatients and staff, and burst into the conductor’s room. He sat up in a chair, covered in a hospital-issue blanket, headphones over his ears, his arms weaving in staccato patterns.