Rather than drive myself into ever-tighter spirals of madness and dismay, I decided to throw myself back into my new daily grind, hoping to shove the nagging questions out of my thoughts and lose myself in the jagged rhythms of my work. For once, I appreciated working myself to the bone. I think the most surprising aspect of it was the unexpected monotony. On a good day, I might have resented that, but here and now, it was perhaps the closest thing I could get to a blessing. From my earliest years at medical school, I’d been privy to horror stories from all quarters of the healthcare profession, especially nurses, surgeons, and anyone acquainted with them. I’d gotten the impression of drudgery mixed with the freshest bits of Hell, sprinkled with more variety than anyone would ever want. Bedpan troubles were like snowflakes: no two were exactly like. That’s what I’d been expecting, but instead, I got monotony. Or, perhaps, it was just human nature to turn to soothing, narrow-eyed monotony when faced with horror in numbers that defied the imagination.
As morning turned to afternoon, the constant influx of patients hour after hour monopolized my thoughts, leaving me in a kind of blissful mental exhaustion, too worried about making it from one moment to the next to bother with the supernatural implications of what was happening to me. And, just as importantly, there was genuine comfort to be found in the work, harrowing though it was. Knowing that I could make a meaningful difference in other people’s lives made me feel like less of a failure for being so bumbling and hapless when it came to my own travails. However evanescent they might have been, the smiles I got from those I helped helped keep me going.
It was something that made sense, and in that regard, it was a life-line: a bridge over troubled waters. A gateway through a wall. “Wall” really was the perfect comparison. There was a wall here, and in the hallway, and everywhere else. The barrier was both invisible yet clear as day. It ran through the middle of every man, woman, and child.
And there was nothing I could do about it.
The wall had many names. Wealth. Class. Privilege. Call it whatever you want. I’d been born closer to the wrong side of that fence, not all the way on the other side, but at some unsafe midpoint. I eventually made it to the right side, but more so from my marriage and a spoonful of dumb luck. Hard work kept me on the “right” side of the wall, but only because I’d consciously refused to let my wife’s inheritance snatch that capacity out of my hands. The benefit was a sense of continued purpose for me; the side-effects were stress, tension in the family, and the constant fear that I was somehow both working too much, yet not enough.
Only time would tell how all these stories would play out.
There was one bright spot, however: a message on my console direct from Dr. Arbond. Merritt’s exploratory surgery was scheduled for tomorrow evening. I had the news forwarded to the console at Merritt’s bedside.
It was in this state of mind, in the middle of doing rounds—and still getting used to it—when a hand grabbed my shoulder, out of the blue.
I couldn’t have known where it was going to lead me.
“Please, are you a doctor?” a man asked.
Turning brought me face to face with a man standing smack-dab in the middle of the hall. He was probably no more than a few years younger than me, wearing a white shirt colored pale red on the sleeves, collar, and buttons, and a tattered belt that barely kept his slacks up. There was a thin scar across the bridge of his nose, half-hidden beneath the edge of his translucent turquoise face-mask, clearly labeled F-99.
He cradled an infant in his arms, swaddled in a pink blanket.
The baby had to be at most a couple of months old; brown hair had just begun to dust the top of the little girl’s head. A lumpy mass rudely protruded from the baby’s throat, right below the jaw. And she was crying—but not a strong cry.
You didn’t need to be a pediatrician to recognize it wasn’t a good sign.
“Yes,” I said, “I’m a doctor.” But I worried it was a lie.
What could I possibly do for them?
For a moment, I felt like I was back with Bethany in Room 268, but then I squeezed my fists, shook myself out, put on the most encouraging smile I could muster.
It was my attempt to perk myself up.
“What’s the matter?” I asked, looking the man straight in the eye.
Tears pooled in the corners of his eyes. He inhaled sharply, rearing his head with a shudder while trying to comfort the infant in his arms.
Stolen story; please report.
“My wife is sick,” he said, his head drooping over the child. He sniffled. His cheeks were inflamed. “I’m pretty sure she has it… the Green Death, I mean.” The man looked down the corridor. “She’s waiting back in the lobby, but…” Shaking his head, he glanced down at his daughter. “Please… we thought the lump would just go away after a day or two, but it didn’t.” Gently, he ran his finger down her head. “I think it’s gotten bigger. And… I think she’s having trouble breathing. I don’t know what to do.”
Oh God…
“What’s her name?” I asked.
He looked up at me, eyes glinting in the light. “Julia.” He tried to smile, but it backfired and he bit his lip. “You can call me Jack,” he added.
Nodding, I stepped forward and leaned in, to get a closer look at Julia. That was what general practitioners did, right?
No, I have to tell him.
I tried my best to look Jack in his eyes. “Just so you know, my specialties are neurology and psychiatry,” I said. “I’m not used to doing rounds like this, but, if I had to take a guess,” I glanced at the mass once more, “I’d say it’s some kind of tumor.”
After a moment’s hesitation, I decided to draw on my actual expertise—even if it might have been horribly wrong.
I pursed my lips.
“There’s a chance it’s a neuroblastoma,” I said.
Jack was already pale, but that didn’t stop him from paling even more. “-oma? That means cancer, right?” He stepped back and bent his head forward in a moan. “Oh God. Cancer… that was our worst nightmare when we first saw it.”
“Yes,” I said, quickly, “it is a cancer—it originates from the cells that develop into our nerves while we’re in the womb—but, they’re one of the most common causes of tumors in infants, and are usually very treatable… if they’re caught early enough.” I put a great deal of emphasis on the but, going so far as to shake my hand at him, just to get my point across.
Now, technically, all of that was perfectly plausible. However, for all I knew, the mass in little Julia’s throat could have been lymph nodes that had swollen up because of leukemia, in which case—
—Clearing my throat, I smiled nervously, trying not to show my macabre thoughts. But then I blinked.
“Wait…”
In my haste to help Julia and her father, I’d failed to notice something very, very important.
“Why are you coming to me for this?” I asked. I gave Jack a second good look over, from his scuffed, suede shoes to his spriggy brown hair. “If you thought your daughter had cancer, you should be in the oncology department. They would take a biopsy to get an official diagnosis, and that would be far more definitive and reliable than anything I could tell you.”
Somehow, that comment struck him harder than the news his newborn daughter likely had cancer. Jack reacted as if I’d just slapped him in the face. He stepped back, curling his arms even more protectively around the pink blanket swaddling his daughter. But then his posture went slack. Shame weighed on his head as he shook it in defeat.
“We don’t have health insurance,” he explained. “I was between jobs, and then the car got wrecked, and—”
“—What SPN did you get?” I asked.
The Trenton healthcare system was fiscal occultism by any other name, a den of dark arcana and healthcare heresy so odious that it almost made me wish the Third Collegium hadn’t reformed the Inquisition and its sacramental institutions. Yes, before the Angelic Doctors met in the Collegium and implemented the doctrinal “refinements” that Resurrected the Church after the expulsion of the Munine colonists, the inquisition had a nasty habit of going around killing people in cold blood who refused to adhere to orthodox Lassedicy and the political systems it helped to uphold, but at least they kept usury at bay. I’d like to think the inquisitors of old would have been clear-sighted enough to see Service Priority Numbers for the devilry that they were. And, really, it was devilishly simple.
SPNs had been implemented to curtail the horror stories of patients without health insurance having to sell their homes or their organs in order to keep the debt collectors off their backs after hospitals charged them exorbitant, illogical, and completely arbitrary fees for services rendered. This got especially bad after the Prelatory fell and the economy went nuts as a result. People could lose their homes and life-savings because of the cost of an ambulance ride and an epi-pen for a first time victim of anaphylactic shock. Insurance lobbyists got the National Diet to pass the SPNs laws, claiming they would solve the problems. SPNs would take care of the doling out of healthcare cost coverage for people who either weren’t lucky enough or rich enough to have a health insurance plan—or, worse, a health sharing plan—which provided adequate coverage for whatever sucker-punches fate had in store for them. By prioritizing patients according to their ability to pay for treatments, healthcare providers no longer had to worry about bankrupting people who couldn’t afford treatment. Instead, those people got SPNs high enough so that no one would give them treatment. It was like monetary credit, but worse. It literally reduced people’s lives to matters of numbers.
“My SPN?” Jack said. He sighed in defeat. “4444.” He whispered it like it was a dark secret.
“Fiddlesticks!” I swore, swinging my fist in outrage.
Anything lower than 1000 was great. 1000 to 2000 was okay. Anything over than 2000, though, and your best bet was to buy some sugar pills and pray that the placebo effect would have mercy on you.
Then, Jack and I heard the sound no father ever wanted to hear. The child gasped for breath, and then went limp once breath failed to come.
“Julie? Julie? Julie!?”
Frantic, the man shook his baby girl. I had to grab Jack by the arms to get him to stop. And just as I felt the situation was about to explode into a million pieces, Dr. Ani Lokanok swept down the hall like a hawk with the flag in its beak and the sun in its tailwind. I only noticed her when I flinched and turned at the sound of a PortaCon hitting the floor with a thud.
“Come with me, quickly!” Ani said, with a hushed voice and a stare.
We followed.