Expanded Universe

by Robert A. Heinlein

  "This is new. A few have already made the switch but all kidney victims can expect it soon. The suicide rate has dropped markedly—life is again worth living; hope has been restored.

  "Computerized-Axial Tomography, or CAT, or 'brain scan': They strap you to a table, fasten your skull firmly, duck behind a barrier, and punch a button—then an automatic x-ray machine takes endless pictures, a tiny slice at a time. A special computer synthesizes each series of slices into a picture; a couple of dozen such pictures show the brain in three-dimensional, fine detail, a layer at a time.

  "Doppler Ultrasound Stethoscope: another microminiaturization spinoff. This instrument is to an ordinary stethoscope as a Rolls- Royce is to a Model-T Ford."

  Witness stands up, turns from side to side. "Look at me, please! I'll never be Mr. America; I'll never take part in the Olympics. I've climbed my last mountain.

  "But I'm here, I'm alive, I'm functioning.

  "Fourteen months ago my brain was dull-normal and getting worse, slipping toward 'human vegetable.' I slept 16 hours a day and wasn't worth a hoot the other 8 hours.

  "Were it not for the skill of Dr. Norman Chater, plus certain spinoffs from the space program, today I would either be a human vegetable or, if lucky, dead of cerebral stroke.

  "My father was not lucky; from a similar disorder it took him years to die—miserable years. He died before the operation that saved me had been invented, long before there was medical spinoff from space technology.

  "Am I elderly? I'm 72. I suffered from a disorder typical of old age, almost never found in the young.

  "Am I handicapped? Yes, but my handicaps do not interfere with my work—or my joy in life. Over forty years ago the Navy handed me a piece of paper that pronounced me totally and permanently disabled. I never believed it. That piece of paper wore out; I did not.

  "Mrs. Heinlein and I spent 1976 and -77 on blood drives all over this nation. We crisscrossed the country so many times we lost track. It was worthwhile; we recruited several thousand new blood donors—but it was very strenuous. By the end of '77 we badly needed a rest, so we took a sea voyage. She and I were walking the beach on Moorea, Tahiti, when I turned my head to look at a mountain peak—and something happened.

  "I balanced on my left leg and said, 'Darling, I'm terribly sorry but I think I've had a stroke. Something happened inside my head and now I'm seeing double and my right side feels paralyzed.'

  "Mrs. Heinlein half carried me, half dragged me, back to the landing—got me back aboard.

  "A shipmate friend, Dr. Armando Fortuna, diagnosed what had happened: a transient ischemic attack, not a stroke. When we reached California, this was confirmed by tests. However a TIA is frequently a prelude to a stroke.

  "Remember that spinoff, computerized-axial tomography? That was done to me to rule out brain tumor. No tumor. The neurologist my physician had called in started me on medication to thin my blood as the clinical picture indicated constriction in blood flow to my brain. This treatment was to continue for six months.

  But in only two months I was failing so rapidly that I was shipped to the University of California Medical School at San Francisco for further diagnosis. Remember the image enhancer and that dog at the University of Arizona? I said that dog was not hurt. They did it to me, with no anesthesia; it did not hurt.

  "The catheter goes in down here"—witness points at his right groin—"and goes all the way up and into the aortal arch above the heart. There three very large arteries lead up toward the brain; the catheter was used to shoot x-ray-opaque dye into each, in succession. The procedure took over two hours . . . but I was never bored because the image enhancer included closed-circuit television of the fluoroscopy with the screen right up here"—witness indicates a spot just above and to the left of his head—"above me, where the radiologist and his team, and the patient—I—could see it.

  "How many people ever get a chance to watch their own hearts beat? Utterly fascinating! I could see my heart beating, see my diaphragm rise and fall, see my lungs expand and contract, see the dye go up into my brain . . . see the network of blood vessels in my brain suddenly spring into sharp relief. It was worth the trip!

  "They spotted what was wrong; my left internal carotid was totally blocked. So the left half of my brain was starved for oxygen, as it was receiving only what leaked over from the right side or from the vertebrals where the network interconnected, principally at the Circle of Willis under the brain.

  "But this is your speech center"—witness touches left side of skull above ear—"your word processor, the place where a writer does all his work. No wonder I was dopey—could not write, could not study, could not read anything difficult.

  "My left internal carotid is still blocked; the stoppage is too high up for surgery. So they sent me to Dr. Chater at Franklin Hospital, who moved my left superficial temporal artery to feed the left side of my brain. This operation is pictured on pages 62 and 63 of the April 1978 Scientific American, so I will omit grisly details; if surgery interests you, you can look them up there.

  "The procedure is this: Scalp the patient from the left eyebrow, going high and curving down to a spot behind the left ear back of the mastoid. Cut away from the scalp the temporal artery. Saw a circular hole in the skull above the ear. Go inside the brain into the Sylvian fissure, find its main artery, join the two arteries, end to side. The left anterior lobe of my brain is now served by the left external carotid via this roundabout bypass. Dr. Chater did the hookup under a microscope with sutures so fine the naked eye can't see them.

  "Check by Doppler ultrasound to make sure the bypass works, then close the hole in the skull with a plate that has a groove in it for the moved artery. Sew back the scalp—go to lunch. The surgeon has been operating for four hours; he's hungry. (The patient is not.)

  "They placed me in a cardiac intensive-care room. When I woke, I found in my room a big screen with dancing lights all over it. Those curves meant nothing to me but were clear as print to the I.C. nurses and to my doctors—such things as EKG, blood pressure, respiration, temperature, brain waves, I don't know what all. The thing was so sensitive that my slightest movement caused one of the curves to spike.

  "I mention this gadget because I was not wired to it.

  "Another space-technology spinoff: This is the way Dr. Berry monitored our astronauts whenever they were out in space.

  "Colonel Berry had to have remote monitoring for his astronaut patients. For me it may not have been utterly necessary. But it did mean that I was not cluttered with dozens of wires like a fly caught in a web; the microminiaturized sensors were so small and unobtrusive that I never noticed them—yet the nurses had the full picture every minute, every second.

  "Another advantage of telemetered remote monitoring is that more than one terminal can display the signals. My wife tells me that there was one at the nursing supervisor's station. Dr. Chater may have had a terminal in his offices—I don't know. But there can't be any difficulty in remoting a hundred yards or so when the technology was developed for remoting from Luna to Houston, almost a quarter of a million miles.

  "Space spinoff in postoperative care: a Doppler ultrasound stethoscope is an impressive example of microminiaturization. It is enormously more sensitive than an acoustic stethoscope; the gain can be controlled, and, because of its Doppler nature, fluid flow volume and direction can be inferred by a skilled operator. Being ultrasound at extremely high frequency, it is highly directional; an acoustic stethoscope is not.

  "It generates a tight beam of ultrasound beyond the range of the human ear. This beam strikes something and bounces back, causing interference beats in the audible range. It behaves much like Doppler radar save that the radiation is ultrasound rather than electromagnetic. Thus it is a noninvasive way to explore inside the body without the dangers of x-ray . . . and is able to 'see' soft tissues that x-ray can't see.

  "Both characteristics make it especially useful for protecting pregnant mothers and unborn babies. I am not
departing from the call; babies unborn and newly born, and mothers at term must be classed as 'temporarily but severely handicapped.'

  "Doppler ultrasound was used on me before, during, and after surgery.

  "After my convalescence I was again examined by computerized axial tomography. No abnormalities—other than the new plate in my skull.

  "This brain surgery is not itself a spinoff from space technology . . . but note how repeatedly space spinoffs were used on me before, during, and after surgery. This operation is very touchy; in the whole world only a handful of surgical teams dare attempt it. Of the thousand-odd of these operations to date, worldwide, Dr. Chater has performed more than 300. His mortality rate is far lower than that of any other team anywhere. This is a tribute to his skill but part of it comes from his attitude: he always uses the latest, most sophisticated tools available.

  "I was far gone; I needed every edge possible. Several things that tipped the odds in my favor are spinoffs from space technology.

  "Was it worthwhile? Yes, even if I had died at one of the four critical points—because sinking into senility while one is still bright enough to realize that one's mental powers are steadily failing is a miserable, no-good way to live. Early last year I was just smart enough to realize that I had nothing left to look forward to, nothing whatever. This caused me to be quite willing to 'Go-for-Broke'—get well or die.

  "Did it work? I have been out of convalescence about one year, during which I've caught up on two years of technical journals, resumed studying—I have long been convinced that life-long learning helps to keep one young and happy. True or not, both my wife and I do this. At present I am reviewing symbolic logic, going on into more advanced n-dimensional, non-Euclidean geometries, plus another subject quite new to me: Chinese history.

  "But I am working, too; I have completed writing a very long novel and am about halfway through another book.

  "I feel that I have proved one of two things: either I have fully recovered . . . or a hole in the head is no handicap to a science-fiction author.

  * * *

  "I must note one spinoff especially important to the aged and the handicapped: spiritual spinoff.

  "'Man does not live by bread alone.' Any physician will tell you that the most important factor in getting well is the will to live—contrariwise, a terminal patient dies when he gives up the fight.

  "I have been in death row three times. The unfailing support of my wife sustained my will to live . . . so here I am. In addition I have believed firmly in space flight for the past sixty-odd years; this has been a permanent incentive to hang on, hang on! My wife shares this; she decided years back to die on the Moon, not here in the smog and the crowds. Now that I am well again I intend to hang in there, lead a disciplined life, stay alive until we can buy commercial tickets to the Moon . . . and spend our last days in low-gravity comfort in the Luna Hilton, six levels down in Luna City.

  "Foolishness? Everyone in this room is old enough to know by direct experience that today's foolishness is tomorrow's wisdom. I can remember when 'Get a horse!' was considered the height of wit. As may be, anything that gives one a strong incentive to live can't be entirely foolish.

  "I get a flood of mail from my readers; a disproportionate part of it is from the very old and the handicapped. It is impossible to be a fan of my fiction and not be enthusiastic for space travel. Besides, they tell me so, explicitly, in writing.

  "Examples:

  "A college professor, blind from birth. He's never seen the the stars; he's never seen the Moon. The books he reads and rereads—has read to him by his secretary—are about space travel. He went to a lot of trouble to look me up . . . to discuss our space program.

  "A teenage boy, tied to a wheelchair, who wrote to ask me whether or not he could become an astronautical engineer—some 'friend' had told him that it was a silly ambition for a cripple. I assured him that an engineer did not need legs even on Earth's surface, advised him in what courses to take, and referred him to a story by Arthur C. Clarke in which a double amputee, both legs, commands a space station.

  "A housewife with epilepsy, grand mal, who doesn't expect ever to be able to go out into space . . . but finds her greatest interest in life, her major relief from the tedious routine she must follow, in our space program.

  "A very large number of elderly people who wrote to me immediately after the first landing on the Moon, all saying, in effect, that they thanked the Lord that they had been spared long enough to see this great day.

  "I could add examples endlessly. Just let me state flatly that my files hold proof that the aged retired, the shut-ins and the disabled of all ages get more spiritual lift out of space flight than does any other definable group of our citizens. For many of them the television screen is their only window on the world; something great and shining and wonderful went out of their lives when the Apollo Moon program ended.

  "Even if a space program had no other spinoff, isn't that sort worth 5¢ a day?"

  AFTERWORD

  Later: No, to most citizens of the United States the entire space program plus all its spinoffs is not worth even 5¢ per day; the polls (and letters to Congress) plainly show it. And they won't believe that 5¢ figure even if you do the arithmetic right in front of their eyes. They will still think of it as "all that money" being "wasted" on "a few rocks."

  It is easy to prove that the space program paid for itself several times over in terms of increased gross national product . . . and in new technology . . . and in saved lives. But they won't believe any of that, either.

  NASA has two remarkable records: first, a space program far more successful than anyone had dared hope; and, second, the most incredibly bumbling, stupid, inept public relations of any government agency.

  A Congressman's counsel pointed out to me that NASA and other government agencies were by law not permitted to advertise themselves. Oh, come off it!—it does not matter whether a man is called a "public information aide" or a flack; a press agent defines himself by what he does. The man who was NASA's boss flack all during the Moon program had the endearing manners of Dennis the Menace. He's gone now—but the damage he did lives on, while our space program is dying.

  Still . . . if you aren't willing to give up and start studying Mandarin or possibly Japanese, you can write to your congressman and to both your senators and tell them how you feel about it. If you do, send copies to Don Fuqua (Democrat, Lower House) and to Barry Goldwater, Sr. (Republican, Upper House). A strong space program has many friends in both parties and in both houses—but it is necessary to let them know that they have friends.

  THE HAPPY DAYS AHEAD

  FOREWORD

  One would think that a "prophet" unable to score higher than 66% after 30 years have elapsed on 50-year predictions would have the humility (or the caution) to refrain from repeating his folly. But I've never been very humble, and the motto of my prime vocation has always been: "L'audace! Toujours l'audace!"

  So the culprit returns to his crime. Or see Proverbs XXVI, 11. And hang on to your hats!

  "I shot an error into the air

  It's still going...everywhere."

  —L. Long

  "It does not pay a prophet to be too specific."

  —L. Sprague de Camp

  "You never get rich peddling gloom."

  —William Lindsay Gresham

  The late Bill Gresham was, before consumption forced him into fiction writing, a carnie mentalist of great skill. He could give a cold reading that would scare the pants off a marble statue. In six words he summarized the secret of success as a fortuneteller. Always tell the mark what he wants to hear. He will love you for it, happily pay you, then forgive and forget when your cheerful prediction fails to come true—and always come back for more.

  Stockbrokers stay in business this way; their tips are no better than guesses but they are not peddling dividends; they are peddling happiness. Millions of priests and preachers have used this formula, promising eternal b
liss in exchange for following, or at least giving lip service to, some short and tolerable rules, plus a variable cash fee not too steep for the customer's purse . . . and have continued to make this formula work without ever in all the years producing even one client who had actually received the promised prize.

  Then how do churches stay in business? Because, in talking about "Pie in the Sky, By and By," they offer happiness and peace of mind right here on Earth. When Karl Marx said, "Religion is the opium of the people," he was not being cynical or sarcastic; he was being correctly descriptive. In the middle nineteenth century opium was the only relief from intolerable pain; Karl Marx was stating that faith in a happy religion made the lives of the people of the abyss tolerable.

  Sprague de Camp is Grand Master of practically everything and probably the most learned of all living practitioners of science fiction and fantasy. I heard those words of wisdom from him before I wrote the 1950 version of "Pandora' Box." So why didn't I listen? Three reasons: 1) money; 2) money; and 3) I thought I could get away with it during my lifetime for predictions attributed to 2000 A.D. I never expected to live that long; I had strong reasons to expect to die young. But I seem to have more lives than a cat; it may be necessary to kill me by driving a steak through my heart (sirloin by choice), then bury me at a crossroads.

  Still, I could have gotten away with it if I had stuck to predictions that could not mature before 2000 A.D. Take the two where I really flopped, #5 and #16. In both cases I named a specific year short of 2000 A.D. Had I not ignored Mr. de Camp's warning, I could look bland and murmur, "Wait and see. Don't be impatient," on all in which the prediction does not look as promising in 1980 as it did in 1950.