Chapter 3
#6 of The Waiting is the Hardest Part
We finally get to meet Dr. Carter, and a few more of Donna's mysteries are uncovered. She's a complicated wolf isn't she?
Chapter 3:
I stopped for a moment in the hall to examine the painting of an aging, balding thoracic surgeon that was displayed so prominently there. 'Doctor Lewis Gavelle, Chief of Medicine, Saint Ares General Hospital' the inscription read. I had studied this painting often in the past. Before I met him in person, I was worried that being unable to recognize the Chief of Medicine would be rather embarrassing. He didn't seem like the type of person that would care though. He was nice to me, though it was easy to tell he was a bit taken aback by the fact that there was a wolf working for him. From an administrative standpoint I was doing pretty well though, so he never really had any reason to have a problem with me.
I turned to the window on the opposite side of the hallway. I was briefly lost in thought as I stood there in the hall looking out to the well-kept grass in the courtyard and the sheer cliffs of the national park in the distance. It was one of those odd places that boasted "Original Martian soil" and "Landscapes untouched by terraforming". Humans are such oddly sentimental creatures...
"Daydreaming, Donna? That's not like you."
I turned to see that it was Doctor Carter who was appraising me. I felt the need to justify all this unproductive introspection.
"I was just wondering," I began, "what it is about humans that would make them want to preserve the barren wasteland that this planet was when they got here."
"Well, you know what they say." He walked up to the window next to me. "Those who ignore history..."
"Are doomed to repeat it. You don't really think that they'll let what happened on Earth happen here too, do you?"
"Hard to say. We've never had to worry about the greenhouse effect here. Heck, the first things we put up were industrial CO2 seeding plants to try and kick-start it. Sure we've got better technology now, but by the time this place was truly terraformed, those who remembered the old Mars were retiring and getting out of the game. Having a little piece of untouched soil keeps us grounded, if you'll pardon the pun. It helps us remember what a tenuous grip we have on the environment we enjoy here. We need reminders of how far we've come. I believe it's a similar motivation that leads the nursing staff to keep that photo of a young, four-pawed Donna Morris up on the bulletin board."
"Aww... I really wish they'd take that old thing down. No one else has their puppy-pictures up on the wall." It's okay. He can't see you blushing... He can't see you blushing...
"Oh, you don't mean that. If anyone has a right to be proud of how far you've come, it's you," he stated, turning to walk down the hall. "Now come on, we have rounds."
"You mean you have rounds."
"And you're going to want to be there, now don't make me tell you to heel!"
I followed him into a nearby room and found one of the newer patients there, one I had never seen before. He was a young man that seemed relatively healthy at first glance, but for looking a bit pallid. Normally I'd ask him how he was doing, introduce myself, answer obligatory questions, and so on, but he didn't look in any condition to respond. I waved my datapad over the node at the foot of his bed to pull up his chart.
"Let's see what's behind door number one..."
"You tell me." Dr. Carter promptly hid the datapad's display with his hand and attempted to pull it from my grasp. I resisted. "Oh come on now... Donna. Drop it."
I felt the datapad slip through my fingers, I couldn't help it. That phrase islike a secret password in my brain. An analogy that breaks down a little bit when I think about the fact that my brain may actually have a few secret passwords. Well, the Good Doctor is challenging me. I'd best not disappoint. I took a closer look at my patient, trying to glean as much information as I could.
"This is not a comfortable position, with his head back like that. I don't think he fell asleep. He must've been brought in unconscious."
"Very good. He was brought in as an evac yesterday afternoon. He hasn't regained consciousness since then."
"He's had a sponge bath, but the scent of soil still sticks to him. It's deep in the skin of his hands, under his nails... It's original soil. Inarable stuff, not even well oxidized, must be from below the surface. He's got to be some kind of earthmover, well... marsmover... construction maybe?"
"Close enough," Dr. Carter said as he read the chart on my datapad. "So, what's wrong with him?"
"He feels cold," I said as I took his pulse. "Weak heartbeat, and he's colder in his limbs than in his torso."
"So..."
"Poor circulation."
"Good, what else?"
"His breath seems... I don't know how to describe it. It's dry, like he never breathed the air at all." I got a closer look at his face. "He's got chapped lips too. Must be he has really dry mucous membranes, and I don't think that's from the supplemental oxygen."
"Very true."
Now convinced that my patient wasn't going to be waking up anytime soon, I felt around a little bit. "He's pretty stiff, and there's some swelling of the glands in his neck, but I don't think it's enough to say it's from an infection."
"He's clean, yes, but what might gland swelling indicate in the absence of infection?"
"Compromised immune system?"
"Right. What else can you tell me?"
"Well..." I was running out of ideas. I put my head to his chest. "His heart isn't beating very smoothly. I can also hear some valve flutter. Could be fluid retention in the chest cavity."
"All right, so we've established that this guy isn't having a good day. Presenting with unconsciousness, poor circulation, dry mucous membranes, stiffness, poor immune response; EKG even confirms your arrhythmia. What does that tell us?"
"I... I'm not drawing the connection." Knowing so much and yet so little was frustrating. "Was I even right about what he does?"
"Not quite, but that's fine, nothing wrong with asking for a patient history. He's a miner."
"Really? He looks to be about thirty to me..."
"Min-ER", he replied, spelling it. "Deep shaft work, mostly ferrous metals. He passed out on the job and had to be extracted."
"If it was an emergency, they would've brought him up as quickly as possible. Nitrogen narcosis?"
"It would explain the stiffness and poor circulation, but it wouldn't be this severe. And it certainly wouldn't explain why he passed out while still in the mine. I will tell you that his saturation is still unusually low."
"Low oxygen would certainly cause the unconsciousness and most of the other symptoms. He might've suffered asphyxia in the mine, but that wouldn't explain why his saturation hasn't recovered; particularly with him on supplemental oxygen."
"If I mentioned 'fibromyalgia', what could you tell me about it?" he asked.
"Fibromyalgia... dysoxygenosis, the abnormal aerobic metabolism of oxygen compromising the nervous system. But if it was severe enough to cause unconsciousness, he would've displayed symptoms before now..."
"Quite. Nothing about it in his medical history, but that doesn't mean he didn't have it. It means he didn't know. So what might aggravate a condition like fibromyalgia?"
"You said ferrous metals, inhalation of metal oxides could rile up the lungs... dry mucous membranes... Wait. If he had trouble processing oxygen, and he was put in a low-oxygen environment-"
"Like a mine."
"Like a mine, then _that_would be enough to force his saturation down past the threshold for consciousness, even if the underlying fibromyalgia wasn't severe enough to have been detected before!"
He smiled and gave me back my datapad. I looked over the remarks in his file.
-Lost consciousness while deep underground; low atmospheric O2
-Blood saturation initial 55%. Stabilized near 80% on ventilator
-2 hrs. decompression therapy for mild nitrogen narcosis
-Low saturation found to be a result of moderate, undiagnosed FMS
-Suggested to begin upper-respiratory therapy after recovering on supplemental O2
-Gas exchange nanites may be required if further depletion manifests
"Coulda saved a lot of time by just reading the chart," I joked.
"Donna, you have abilities that any MD would kill to have," he stated, "but they won't develop if you don't practice with them. Speaking of which..."
Heel, Donna. Time for the next one... I trotted after him down the hall.
"Looks like I can't conceal too much about Mr. Thompson from you. I see another dog-ear diagnosis of arrhythmia in the remarks. Yes, I know that 'DEA/Poss: C-myopathy' is nurse-code for 'Donna says his heart sounds funny'."
"Yes, well, there's that, and you can tell we've met before by how he didn't jump when I entered the room. How are you feeling, Mr. Thompson?"
Mr. Thompson was a full-figured, balding man with a kind, round face and a good disposition. A good sign, a positive attitude sometimes helps the recovery as much as the most advanced treatments. It was odd to see a balding man these days what with all the easy ways we have to correct that.Dr. Gavelle was the only other example I could think of readily. Mr. Thompson had said that he liked it, that being bald was distinctive, that it made him look older and more experienced. Well, it certainly made him look older...
"Quite well, young lady," he replied. "Other than being subjected to breakfast at an unholy hour it's been a good morning. Are you going to introduce me to your friend?"
"This is Doctor Carter, and he's really the reason I'm here. I'm following his rounds to learn from him."
"I'd say it goes both ways," Dr. Carter said. "But, if we're here for business, let's get started then,shall we?"
"Oh, certainly," our patient agreed. "Wouldn't want to stand in the way of my own health,would I?"
Dr. Carter jealously concealed the screen of the datapad as I summarized Mr. Thompson's condition.
"Mr. Thompson was admitted yesterday with severe chest pain and dizziness. A mild case of arrhythmia was identified, but it wasn't severe enough to explain the symptoms on its own. His blood profile showed a substantially low pH, but gave no clues as to what might be causing the acidemia. We suspected ketoacidosis, but his diabetes was corrected more than a decade ago. No ketones in the urine means that's right out. Intravenous bicarb has stabilized his blood chemistry, but the chest pain remains. This leads me to believe that the acidosis was a symptom and not a cause in itself."
"Well then, that's the million-credit question isn't it? What _is_the cause?"
"Well, the lab looked for ketoacids, part of the diabetes line of thinking. They didn't find any, but they also couldn't pin down what acids _were_causing the pH suppression. Based on the amount of mineral salts we're seeing from the neutralization reactions in the blood, there's still acid being infused into the bloodstream. So not only have we failed to identify the source, we haven't stopped it either. The fact that nothing flagged in the blood profile means that it's probably not a foreign contaminant. Mr. Thompson, you said that you were an air traffic controller?"
"Yes, 25 years. Very much looking forward to retirement."
"It's a stressful job, yes?"
"I had hair when I started," he said, tapping his scalp. "Like I said, very much looking forward to retirement."
"And you said you've eaten recently?"
"Yep, eggs that were brown and crisp and toast that was warm and runny. Almost a perfect meal."
"May I smell your breath?"
"Well, of allthe things you could've asked to smell... I suppose that's a reasonable choice."
He gave an obligingly gentle breath while I examined the odor closely, trying not to get uncomfortably close in so doing. Flipping quickly through the odors of breakfast and a little halitosis, I found what I was looking for. Dr. Carter noticed my smile.
"A revelation, I take it?" he asked.
"I noticed that his breath smelled acrid when he came in, but I attributed that to the immediate stress of thinking that you're having a heart attack."
"I'll admit that did have me a bit riled up. Bad hearts run in the family."
"And you have every right to be worried, sir, but in this case, I think your heart is fine. Now that I was looking for it, I smelled something else on your breath, blood. Since you haven't eaten any meat recently, that odor probably means a peptic ulcer, or possibly a compromised esophageal lining. And it stands to reason that if there's blood in your stomach acid, there's stomach acid in your blood."
"It would certainly explain the severe acidosis," Dr. Carter stated. "And since the immediate treatment is quite quick and painless, the easiest way to find out if you're right would be to begin a treatment regimen. Which is...?"
"The most likely cause is stress-related gastroesophageal reflux. I'd recommend keeping your head elevated, Mr. Thompson. That will keep the gastric acid from leaching up into your esophagus."
"I'm all for that," he said.
"As for us, I say we switch his bicarbonate from intravenous to oral."
"Oral bicarb?"
"Rolaids. And probably a long-term histamine blocker as well, depending on how long you plan on continuing to be the thin thread keeping our delicate aircraft infrastructure from crashing down on our heads."
"Like I said..." he began.
"... Can't wait to retire," Dr. Carter finished, making the necessary updates to Mr. Thompson's file. "Well, sounds like a plan to me. Take it easy, Mr. Thompson. And that's not just a well-wish, it's medical advice."
"Will do, doc. Thanks for dropping by," he said. "I've had far too many doctors that like to do this sort of thing by teleconference. Of course, the talking dog bit would be a little easier to swallow if she were on a screen."
"I'm sorry," I said. "I do try to be unobtrusive, you know. I go to great lengths to avoid startling the heart patients."
"Oh come now, I'm only teasing. Sounds like that sleuth nose just saved me a lot of downtime and diagnostic fees. You enjoy your morning walk, Miss Morris."
"Thank you, I will!"
My wagging tail followed me out the door as I trotted once more after Dr. Carter. He was normally a lot more personable than this, but he had a lot of patients to see today and that meant we had to keep moving. After awhile you get used to compressing all the social niceties into a couple minutes and then hopping off to your next case. It's a little frazzling, especially when talking to people has the complications that it does with me, but it feels good after awhile. When every second is used to the fullest, it makes you feel quite efficient and it's very satisfying when you think of all you've done at the end of the day.
Fortunately, no interaction was needed with our next patient. Or perhaps that was unfortunate, as his continued unconsciousness was actually rather worrying. Nurse Barnes was there, making some annotations to his profile.
"Pretty severe dehydration on this one, Doctor Carter," she said as we entered the room. She didn't look up, yet by some magic she knew who we were. "He's going to need another IV infuser line, you can place that for me, can't you Donna?"
"Me? I... I've never had good luck at placing IVs with these claws..."
"That's why you're supposed to use the needle to pierce the vein, dear."
"Oh... you know what I mean!"
"I do, and I know that you're perfectly capable of doing it correctly," she said as she strode past us. "Dr. Carter will be right there to help make sure you get it right."
"Oh... well, okay. I... I guess I can do it." 'Okay?!' What? But I- darnit! She was gone already too!
"Oh, don't make that face, Donna," Dr. Carter said. "She only pushes you because she has faith in you. Anyone else she would've been all over, but she trusts you enough to not perch on your shoulder."
"I know, it's just that... I didn't even want to agree with her and... and then she just disappeared while I was talking. It's like getting Jedi-mind-tricked by Batman."
"Well, you've never been the most difficult person to persuade..." he said, reaching out a hand to lift my chin. He brushed the hair out of my eyes, too. He always got all sweet and fatherly when I was getting down on myself.
"Yes, I know. I also noticed that you just nodded politely when she volunteered your help."
"Yes, well... I was here assisting you anyway, and... it's not too much of an imposition."
"Riiiight." The zipper is showing on your alpha disguise, Dr. Carter. "H-hey..."
I noticed his hand sneaking behind my ear. I know he was just trying to make me feel better, but now wasn't the time for-
"Nngh, nnmmmn..."
"What's that, Donna?" he teased. "You're mumbling."
He was rubbing that spot_._ He knows I can't form words properly when he's rubbing that_spot._ No, don't lean into it! You'll only encourage him, no d-don't d-aww... I suck...
My eyes drifted shut as I pressed my head against his hand. I planted my paws firmly on the floor. I was not going to do the leg thing. Even if I can't stop myself from enjoying this, I draw the line at the leg thing. He took his hand back and I shook my head, realizing that I had no idea how much time had passed.
"So, are you going to keep your head up as we get back to business then?"
"I will, Doctor," I said, fixing my hair a little compulsively. "Right, business. Mr. Stevens hasn't woken yet. I don't like this at all. We should've seen some response from him by now. He wasn't in that bad of a shape when they found him."
"And how much information is that to go on?" my wizened companion asked. "You know as well as I that no account is complete, and that any throwaway detail can be of critical importance."
"So... what do you think is going on?"
"Me? I doubt that there's anything remarkable to be found here. I was just reminding you to always use a critical eye. Even when you're sure of yourself, don't let your confidence blind you. Much better to be wrong and have a patient live than to lose one for the sake of pride."
I appreciated his advice, but I couldn't accept that this wasn't anything more than it looked at first glance.
"Persistent unconsciousness isn't 'nothing'," I stated. "There has to be something else we're not seeing."
"Hmmm, well if that's your professional opinion then I suppose we'd best investigate. And the first step in a good diagnosis is?"
"Symptom elaboration."
"Very good. This one's relatively simple. I'll even let you have the chart," he said, handing me my datapad. "Well go ahead, it's your hunch, Miss Morris."
"Let me see here..." I read down the list. "Dehydration, vascular dilation, exhaustion, anemia, lack of sleep-"
"Remember, not all of those are symptoms. A lot of those are on the chart because they are conclusions drawn by the medical examiner. He did base them on solid fact and observation, his pallor led him to conclude anemia, his low blood pressure led him to exertion, his poor pupil response lent itself towards lack of sleep, etcetera, just as the vasodilatation would lead one to the conclusion of self-medication using oral ethanol. I'm certain that they are quite correct, but it's important to understand the distinction."
"But what would explain all that? There's no indication of extreme physical activity. His roommates said that he had been home since last night."
"Physical exertion is not an absolute," the Doctor explained. "A moderate level of activity for an extended period can produce the same symptoms as acute exertion."
"That's not all though. The report from his chest scan stated-"
"You ordered a full abdominal for an unexplained fainting?" He asked, incredulously.
"His military service record showed that he saw a total of over three years on the front lines. There are three purple hearts in there and a lot of notes in his medical history, mostly shrapnel. I thought I should check that there wasn't some they had missed."
"Shrapnel isn't hard to see on a chest x-ray."
"Not on one of ours, but our fluoroscope doesn't have to fit into a duffel bag."
"Hmph. Very thorough, I'm impressed, and what did you find?"
"Not what I was looking for," I admitted. "His chest is free of debris."
"But..."
"But I found evidence of significant bone decalcification, far beyond what the transition to Mars gravity would explain. The lab is running a density test right now."
"A bone density test on a twenty-six-year-old man? Was I in error when I granted you lab privilege?"
"You didn't see the scan, Doctor," I told him. "The difference was considerable."
"How old was your comparison?"
"It's from his enlistment processing, so about six years."
"A lot can change in six years, but if it really is significant bone loss it would be worth investigating. Do check with me before jumping to such bold conclusions though, would you?"
"Of course, I apologize."
"No, no. Enthusiasm is one thing that I do not punish," he said with a gentle sigh. "It's just that you seem to have gotten a bit swept away with the idea of some exotic condition."
"If you don't mind my asking, what do you think it is?"
"Well your little calcium problem seems a good place to start. What's the most common cause of bone decalcification?"
"Drug abuse. Mostly common mild stimulants, ephedrine, taurine, B-12 complexes, even caffeine in large doses."
"Good, and a combination of anemia and low blood sugar?"
"Malnutrition."
"All right, so what have we got here? Prolonged exertion, lack of sleep, poor diet, alcohol abuse and chronic caffeine overdose. That's a set of factors that I would most readily associate with a condition known as 'being a college student'."
"You think it could really just be a lifestyle problem?" I asked. "That he just almost partied himself to death?"
"Not just partied, it's how he behaves in general. You were in college for even longer than he was. You know that there's quite a fair amount of irresponsible drinking, but there's also a lot of stress and big life changes, and a lot of students without much experience in dealing with them."
I made something of a frustrated huff. It came out sounding a lot more canine than I meant it to.
"Sorry if my diagnosis wasn't thrilling enough for you, Donna. But the fact is that a lot of people come down with very boring and trivial conditions."
"I still don't like it."
"While I admire your conviction, I believe that there's not much to be gained by pursuing this further. If any of your ideas hold water we'll examine them more thoroughly, but for now I think you've spent quite enough of the VA's money on a simple caffeine crash."
"Well, if you acknowledge that he has risk-taking behaviors, there could be something else going on."
"Harder drugs would've shown up on the tox screen, and there's nothing in his DNA profile to suggest illicit gene modification," he stated. "He's probably just been living like this for a very long time and ignoring his prior symptoms. You know how young men are, I'm sure. The assumption is that they're invincible until proven otherwise."
"I think that your memories of college life are a bit exaggerated, Doctor."
"Oh, you wound me. It wasn't all that long ago. And it's only been a few years for you. How do you not recognize a binge drinker when you see one?"
"Sorry, Doctor. I'm only... academically familiar with alcohol. I don't really know what to look for."
"Well, academia is where most of us became familiar with alcohol. I don't see why that's a problem."
"You know what I mean. No one else in pre-med had an alcohol-based emergency shutdown interlock. I was a real cheap date. I pass out for hours after a tiny sip of the stuff."
"A number of them probably could'vebenefited from having such a safety feature... I suppose that yours is a valid observation though and I'm glad you weren't afraid to make it. If I'm wrong, the failure to regain consciousness could indicate a significant underlying vascular problem. Add about 25 mMol/L potassium chlorideto his drip. Have the infuser adjust dynamically to maintain isotonicity and see if you can get his electrolytes evened out. If he isn't showing signs of improvement after a few hours, start pushing thrombolytics. And make sure to route any further analysis through me, all right?"
"Yes, Doctor."
"And the only way he's going to get that potassium is if we get that new line placed. And by 'we' I mean..."
"Yes... Doctor," I sighed, preparing the IV needle.
He watched me closely as I found a suitable vein and took aim with my tiny lance. Setting an IV cannula was like lining up an extremely tiny pool cue with a target that's under someone's skin.
"Don't stress about your claws so much," Doctor Carter said. "I know you keep the tips filed off for just this reason. In fact, use them. I bet if you pressthe trailing edge of a claw right here it'll make the vein stand out more."
I couldn't fathom how he knew that would work, but work it did. The vein raised and became very obvious under the pressure of my claw. Once the line was placed, he uncapped the end of the infuser line and handed it to me as a way of showing his approval. I started making the connections and getting the seals right. Hooking up the rig was fiddly detail work that required more time than attention, nowhere near the delicate process that setting the needle was. Now that the hard part was over, I started to think that I would feel a little more comfortable if we had something to talk about rather than him just staring at me in silence while I worked. Of course, in true canine fashion, I couldn't think of anything to talk about other than what I smelled at the time.
"Sasha's scent is strong on you this morning. You two been wrestling again?"
"Hmm, overtime earlier in the week," he replied. "The longer I'm away the bigger reception I get when I come back. They say dogs can't tell the difference, but I swear that she's watching the clock while I'm gone."
"She must've been all over you. I can smell her even on your work clothes and lab coat. Australian Shepherds aren't lapdogs, you know."
"Hah! Try telling her that."
The infuser beeped to signal it had started its cycle and we were in business. Just as I had finished cleaning up I heard a rustling of sheets on the bed.
"I think he's waking up. I should go."
"Go? Why?" Doctor Carter asked.
"I want to avoid putting additional strain on him. My face is... not the best thing to wake up to after a rough night."
"You make it sound as if there's a story behind that."
"Well, yeah. The infamous 'coyote ugly' incident of my sophomore year in college. Remind me to tell you about that sometime when we're not on duty," I said as I went to wait outside.
"With an intro like that, how could I not?"
I heard him talking to the patient as I stood outside the door.
"Ah, Mr. Stevens! It seems time does heal all wounds. Good to have you back with us."
His voice was slow to respond, but he managed to mumble a greeting.
"Terribly sorry we disturbed your rest, but this is a teaching hospital after all. I think that Miss Morris has some real promise even if she is a bit naive."
"Hmmm... I wouldn't say that innocence is a bad thing, Doctor," the patient said in a gravelly voice, followed by a feeble cough.
Huh? No 'where am I?' or 'what happened?' It's like this sort of thing happens all the time. Maybe Dr. Carter was right...
"Funny you should mention innocence given what you were wearing when they found you." He must've read terror on his face, as he moved quickly asto quellit. "Don't worry, son. It's in a nondescript paper bag with your personal effects. When EMTs discover someone in a... compromising position, it falls under Doctor-patient confidentiality. Naturally I won't mention it to anyone else, but I would be negligent if I failed to advise you that your behavior has become a bit unduly risky, as I'm sure you've already figured out."
"Yeah, things did get a bit out of hand..." the patient admitted.
"As long as you learned from it. Making mistakes and learning nothing is the only real sin." I heard him pouring out a glass of water. "Here, you'll to need to drink up if we're going to get you back on good terms with your kidneys."
"All right. Here's to learning, Doc. You think I'm going to be alright?"
"Cheers, to your health. And yes, you should be alright. Alright..."
* * *
"Alright... Miss Morris? Are you alright, Miss Morris?" Simon asked.
"Hmm, what?" I blinked my way out of a fog.
I found myself back in the cafeteria. The crowd had died down significantly and the smell of disinfectant floated through the air as the staff began to clean up after all their customers. Simon was still speaking. I made sure to pay attention to him this time.
"I asked if this 'Doctor Carter' you mentioned often helped you in your efforts to learn the medical profession and you became... distant, for some time."
"Oh, yeah. He... he has been a great help to me. I don't know where I'd be if not for him."
"Hmm... Forgive me if I pry, but may I ask a personal question?"
"You may ask," I told him. "That does not guarantee an answer."
"Do you like Doctor Carter?"
"I... well yeah, he's always treated me well. My reception at the hospital, and by humans in general,is often... mixed. Dr. Carter was among few to not display at least some amount of trepidation about my presence. What brings this up exactly?"
"I am actively writing a subroutineto establish a model of your emotional state in real-time. I needed to resolve a major conflict in my data sets."
"Conflict? Simon, emotions seldom make sense, but I like to think that mine are at least... consistent. What conflict have you observed?"
"Doctor Carter is your friend. Social interactions with friends and memories of them result in positive emotions. When you speak of Doctor Carter, your gaze drifts downward, your anterior auricularis muscles extend turning your ears to a more passive position and the thoracic curve of your spine is exaggerated; all reactions that I had previously determined to be associated with experiencing strong negative emotions. It appears that my assessment was incorrect. I will revise the program."
"Have you ever thought of pursuing a career as a polygraph machine?" I sighed.
"I do not imagine that I would be particularly successful. The implication is that I have exposed a lie by my observations. I am entirely unaware of what deception I have uncovered which prompted that statement."
"It's not too hard to catch someone lying. You managed to catch someone withholding information."
"Is it your intent to continue concealing this information from me?"
"No. No, I really do need to get this off my chest and you're probably the best person to talk about it with. You're not close to the issue, you seem to understand me pretty well and... well, you're a really good listener. Have I told you that?"
"You informed me of that opinion thirty-six minutes ago. You said: You seem to be a pretty good listener."
"Please... don't playback recordings of my voice."
"Please... don't playback recordings of my voice."
"Really, Simon? Really?"
"That was not humorous?"
"Well, I guess it was. In a juvenile, 'stop hitting yourself' kind of way. It was a good attempt. But seriously though, stop doing that."
"Very well, I apologize," he said. "I am under no compulsion to obey your directives and that sensation is... something of a novelty."
"I know what you mean. I really hate direct orders too. I don't have compulsory action subroutines the way you do, but it can be very... unpleasant, if my behavior doesn't conform to some very narrow parameters when I'm acting under orders."
"Interesting. You receive negative feedback when disobeying orders, but you are able to do so?"
"In theory, yes. My brain isn't programmed to circumvent my freewill the way yours is. That was mainly a matter of convenience. Despite humanity's vast understanding of how the mind works, the mechanism that governs freewill in an organic brain is still on the frontier of that knowledge base. The pleasure/pain response is much better understood, so it was easy to make a very powerful 'feel reallybadunless you do this' mechanism."
"That sounds nice..."
"Nice?" I asked. I couldn't believe it.
"Having your self-control periodically turned off is very... disconcerting. I would much prefer that it were still me making the decision and taking the action, instead of having control forcibly wrested from me at a critical moment."
"I guess I've never really thought of it that way. I've always imagined that I'd prefer to simply have something else control my actions. That would take a great burden off me. Knowing that I might be able to resist something I didn't want to do makes me wonder if I'm really responsible for any of my actions. I might be... but then again, disobedience could have much more serious consequences than just an unpleasant feeling.
"I've never seriously tried to outright disobey an order. I know that the mechanism blocks serotonin receptors to suppress my mood until I complete the order. Long-term consequences of this effect haven't been studied, but it's not unreasonable to think that it could permanently change my brain chemistry. Most of my understanding of neuroscience is anecdotal. It's a very specialized field, but I'm well aware of what a delicate balancing act it is to keep my brain operating smoothly.
"I've been fortunate in that I haven't come into conflict with any of my directives. At least not to a point that would justify risking permanent brain damage. Most of them are things that I'm in agreement with. There was that time I was inspecting a patient's laceration and I... licked it, you know, old habits. Anyway, after that little incident it was either a direct order or one of those lampshade thingies. There's a handful like that, 'No licking wounds, no startling patients in the cardiac ward, no chewing on get-well teddy-bears...' There ought to be one about chasing the crash-cart, but I haven't gotten caught doing that in awhile."
"Those sound like very reasonable requests. I don't understand the source of your disapproval."
"Even if I intend to follow an order, it still makes a difference in my frame of mind. Just because your leash isn't being pulled, it doesn't make the leash go away. I stillcringe a little when I see one of those teddy bears. Once-bitten twice-shy,I suppose. I always get this constricting feeling in the back of my neck when I'm under the influence of an order, whether I'm okay with the order or not.
"When I was young, I thought it was a scary monster. I suppose it's because that's how a child responds to anything threatening that they don't understand. I did my best to make the monster go away within the scope of the few orders I had to deal with at the time. 'No chewingslippers' is technically an order. I came to understand the process better as I grew up, but the stigma never really went away. Today I view it as more of a jackal than a mysterious, hulking monster. Not a big threat, just a snide little scavenger that shows up to harass the huntress while she does her work."
"That perspective is rather unusual," Simon stated. "What prompted you to personify your programming in this fashion?"
"The neural response is supposed to be consistent, with the same response to chewing on a slipper as violating a human-safeguard. If there's a priority difference between two orders, it just means that the higher-authority order triggers the serotonin response. That's not what I experience though. Sometimes it's stronger or weaker, it may go away after a moment or stick with me all day. It seems to have different moods, maybe even a will of its own. If I'm tempted and think about disobeying an order, I get a reminder. If I do it multiple times, it gets impatient and really lets me have it.
"It really behaves more like a person or an animal than a program, and I guess it helps me cope to think of it as such, even though I know better. It gets my thoughts in order when I think of my situation as battling an adversary or arguing with someone. Coming up with an argument or rationale to present to the Jackal lets me get a better handle on the situation and can actually spare me the worst of the effect sometimes. If I can convince it that I'm trying to be a good dog it'll let up a little. And it makes me feel a little more sane to hash things out like that. It's nice to think that it's not me driving _myself_up the wall. After all, you're fine if you talk to your imaginary friend. It's when your imaginary friend talks back that you should worry."
"I suppose that's a fair rationalization, given the situation," Simon observed. "Though it is difficult for me to envision you as a puppy, uh, child."
"No, puppy is the right word. I was much more dog-like when I was little."
"Interesting. Were you a good dog?"
"As far as I know, yeah. Early childhood memories are always a little suspect though, particularly when your brain undergoes such radical changes in your adolescent years. I think I was a pretty good dog. Though that's not to say it was easy. It's tough to have to paper-train, then get housebroken and _then_go through toilet-training. I was pretty sick of the whole business by the end of it."
"Did you act out? Rebellious teenager-like?"
"Oh, no. Nothing like that. My owner says I was very much like a normal dog, though there were occasional reminders that there were a few more gears spinning inside my head than the average pet. One of the first times they brought me to the hospital was when I was still paper-training. They took their eyes off me for just a second and like any playful infant or curious puppy I promptly disappeared. They found me in the staff break room. I had managed to yank a stack of paper napkins down on the floor and scatter them about before doing... what I had been trained to do on them.
"My owner said that he felt like he should've been mad, but he couldn't be. I was just doing as I was told. That describes a great deal of my formative years, actually. I did try to be a good dog, I really tried, but there was often some quirky naivety that got in the way. Since I had the order response that just made me step-to without thinking, it took a long time for me to learn how to truly understand what was being asked of me. I'd often miss the intent of instructions I was given.
"They thought that I was disobeying the 'don't bark at the delivery man'order, but I was barking at the cable guy, the landlord, solicitors... you know, anyone I didn't know that _wasn't_the deliveryman. Eventually they learned to take a second look at what they said to me. Naturally they made sure to remind me that barking at solicitors was okay. In fact, they liked that idea so much that it wasn't long before they taught me how to use the videophone to bark at telemarketers. All our neighbors asked Edward how he managed that. Went great until that crafty guy from Petcetera called. To be fair, I didn't think he was serious about being able to ship in a whole forklift pallet of Milk Bones...
"I guess since I have a robot brain it's appropriate that I use robots as an analogy. It's kind of like the way robots make silly mistakes because they don't have enough information. Humans tend to make assumptions about what is 'common knowledge' when they're giving orders. The instruction 'help the old lady cross the street' should come with the qualifier 'but make sure she actually wants to go first' for the uninitiated."
"It certainly is a struggle," Simon stated. "I often liken it to how early humans would do bizarre and nonsensical things to appease their gods. They had such difficulty interpreting their masters' will that their final courses of action were great wastes of effort. Fortunately, we have safeguards that prevent us from tearing out peoples' hearts or ritually burning livestock, but our misunderstandings can still be rather costly."
"You make me feel a little better about my robot friends every minute, Simon."
"I do try to reflect positively on my contemporaries, as I'm sure you do."
"Oh yes, absolutely. Positive customer feedback is quite literally a life-or-death matter for Bowman's Wolves. Our only real chance of long-term survival as a species is being a profitable enough product that Ecosystems Unlimited could justify the expense of mixing up another batch of us."
"Hmmm, very true..." he sighed in that funny way of his. "I suppose I've missed that chance to salvage my product line into a profitable enterprise. But I suppose that the ultimate fate of my 'species' being sealed does not affect my capacity to be productive in the operating lifetime that I have remaining."
"Oh, don't be like that. It's good to not let something like that bother you, but you can't just give up. As long as you're still alive you can still make a difference."
"I do not believe that I possess the capacity to change the nature of the situation singlehandedly. Ecosystems Unlimited was quite clear about the conclusions drawn from the evaluation of my program."
"Are you familiar with quantum physics, Simon?" I asked.
"Peripherally. I could perform a Commnet search-"
"No, that won't be necessary. The biggest thing that you need to learn from quantum physicsis that nothing is impossible."
"Ah yes. In theory, there is an infinitely small chance that the atoms in my hand will spontaneously align themselves in such a way as to allow it to pass through this table."
"And, as long as you're still around, there's still a chance that you could change EU's mind."
"Very well. I concede that the longevity of my product line is not entirely unachievable."
"Good. Now that's the right attitude to have."
"This is unusual. In light of this new information, the rather unfavorable statistics associated with achieving that objective no longer deter me from attempting it. I suppose you could call it a change in perspective."
"That certainly is unusual," I told him. "In my experience, robots tend to be a bit... _inflexible_in their perceptions."
"I do try to be rather dynamic in my interactions with those around me. Speaking of which, I believe I have identified another discrepancy in my Bowman's Wolf social interaction subroutine."
"Awww... You wrote a whole subroutine just for little old me?"
"I no longer wished to risk the large-scale changes that our conversation was demanding of my human interaction subroutine. I made a copy of it such that I could integrate the facial-recognition data I have collected from you thus far and actively restructure it to a large extent without risking the degradation of my existing program."
"Well, it's a little less thoughtful when you phrase it like that." I said. "So, what about my behavior has fallen outside your expected data scatter?"
"You impressed upon me that it was important for you to discuss the matter of Doctor Carter, and that doing so would benefit you. From that point you proceeded almost immediately towards introducing topics which, while quite interesting, were almost certainly intended to divert the conversation in another direction."
"Oh. So they were..."
"The only conclusion I can draw is that you were insincere in your desire to talk about him, or that I have said something in the interim that caused a change of heart."
"No, it's not you. It is most certainly me," I stated. "And you're right. I can't let myself put this off any longer no matter how bad it makes me feel. Hmph, you and I must share a brain because you are most definitely inside my head. I guess you're just lucky that I don't get aggressive when I've been verbally cornered."