Terminal Man (8 page)

Ellis picked up the first electrode array. From where Ross stood, it looked like a single slender wire. Actually, it was a bundle of twenty wires, with staggered contact points. Each wire was coated with Teflon except for the last millimeter, which was exposed. Each wire was a different length, so that under a magnifying glass, the staggered electrode tips looked like a miniature staircase.

Ellis checked the array under a large glass. He called for more light and turned the array, peering at all contact points. Then he had a scrub nurse plug it into a testing unit and test every contact. This had been done dozens of times before, but Ellis always checked again before insertion. And he always had four arrays sterilized, though he would need only two. Ellis was careful.

At length he was satisfied. “Are we ready to wire?” he asked the team. They nodded. He stepped up to the patient and said, “Let’s go through the dura.”

Up to this point in the operation, they had drilled through the skull, but had left intact the membrane of
dura mater
which covered the brain and enclosed the
spinal fluid. Ellis’s assistant used a probe to puncture the dura.

“I have fluid,” he said, and a thin trickle of clear liquid slid down the side of the shaved skull from the hole. A nurse sponged it away.

Ross always found it a source of wonder the way the brain was protected. Other vital body organs were well-protected, of course: the lungs and heart inside the bony cage of the ribs, the liver and spleen under the edge of the ribs, the kidneys packed in fat and secure against thick muscles of the lower back. Good protection, but nothing compared to the central nervous system, which was encased entirely in thick bone. Yet even this was not enough; inside the bone there were sac-like membranes which held cerebrospinal fluid. The fluid was under pressure, so that the brain sat in the middle of a pressurized liquid system that afforded its superb protection.

McPherson had compared it to a fetus in a water-filled womb. “The baby comes out of the womb,” McPherson said, “but the brain never comes out of its own special womb.”

“We will place now,” Ellis said.

Ross moved forward, joining the surgical team gathered around the head. She watched as Ellis slid the tip of the electrode array into the burr hole and then pressed slightly, entering the substance of the brain. The technician punched buttons on the computer console. The display screen read: “
ENTRY POINT LOCALIZED
.”

The patient did not move, made no sound. The brain could not feel pain; it lacked pain sensors. It was one of the freaks of evolution that the organ which sensed pain throughout the body could feel nothing itself.

Ross looked away from Ellis toward the X-ray screens. There, in harsh black and white, she saw the crisply outlined white electrode array begin its slow, steady movement into the brain. She looked from the anterior view to the lateral, and then to the computer-generated images.

The computer was interpreting the X-ray images by drawing a simplified brain, with the temporal-lobe target area in red and a flickering blue track showing the line the electrode must traverse from entry point to the target area. So far, Ellis was following the track perfectly.

“Very pretty,” Ross said.

The computer flashed up triple coordinates in rapid succession as the electrodes went deeper.

“Practice makes perfect,” Ellis said sourly. He was now using the scale-down apparatus attached to the stereotactic hat. The scaler reduced his crude finger movements to very small changes in electrode movements. If he moved his finger half an inch, the scaler converted that to half a millimeter. Very slowly the electrodes penetrated deeper into the brain.

From the screens, Ross could lift her eyes and watch the closed-circuit TV monitor showing Ellis at work. It was easier to watch on TV than to turn around and see the real thing. But she turned around when she heard Benson say, very distinctly, “Uh.”

Ellis stopped. “What was that?”

“Patient,” the anaesthetist said, gesturing toward Benson.

Ellis paused, bent over, to look at Benson’s face. “You all right, Mr. Benson?” He spoke loudly, distinctly.

“Yuh. Fine,” Benson said. His voice was deeply drugged.

“Any pain?”

“No.”

“Good. Just relax now.” And he returned to his work.

Ross sighed in relief. Somehow, all that had made her tense, even though she knew there was no reason for alarm. Benson could feel no pain, and she had known all along that his sedation was only that—a kind of deep, drugged semi-sleep, and not unconsciousness. There was no reason for him to be unconscious, no reason to risk general anaesthesia.

She turned back to the computer screen. The computer had now presented an inverted view of the brain, as seen from below, near the neck. The electrode track was visible end on, as a single blue point surrounded by concentric circles. Ellis was supposed to keep within one millimeter, one twenty-fifth of an inch, of the assigned track. He deviated half a millimeter.

“50
TRACK ERROR
,” warned the computer. Ross said, “You’re slipping off.”

The electrode array stopped in its path. Ellis glanced up at the screens. “Too high on beta plane?”

“Wide on gamma.”

“Okay.”

After a moment, the electrodes continued along the path. “40
TRACK ERROR
,” the computer flashed. It rotated its brain image slowly, bringing up an anterolateral view. “20
TRACK ERROR
,” it said.

“You’re correcting nicely,” Ross said.

Ellis hummed along with the Bach and nodded.

“
ZERO TRACK ERROR
,” the computer indicated, and
swung the brain view around to a full lateral. The second screen showed a full frontal view. After a few moments, the screen blinked “
APPROACHING TARGET
.” Ross conveyed the message.

Seconds later, the flashing word “
STRIKE
.”

“You’re on,” Ross said.

Ellis stepped back and folded his hands across his chest. “Let’s have a coordinate check,” he said. The elapsed-time clock showed that twenty-seven minutes had passed in the operation.

The programmer flicked the console buttons rapidly. On the TV screens, the placement of the electrode was simulated by the computer. The simulation ended, like the actual placement, with the word “
STRIKE
.”

“Now match it,” Ellis said.

The computer held its simulation on one screen and matched it to the X-ray image of the patient. The overlap was perfect; the computer reported “
MATCHED WITHIN ESTABLISHED LIMITS
.”

“That’s it,” Ellis said. He screwed on the little plastic button cap which held the electrodes tightly against the skull. Then he applied dental cement to fix it. He untangled the twenty fine wire leads that came off the electrode array and pushed them to one side.

“We can do the next one now,” he said.

At the end of the second placement, a thin, arcing cut was made with a knife along the scalp. To avoid important superficial vessels and nerves, the cut ran from the electrode entry points down the side of the ear to the base of the neck. There it deviated to the right shoulder. Using blunt dissection, Ellis opened a small
pocket beneath the skin of the right lateral chest, near the armpit.

“Have we got the charging unit?” he asked.

The charger was brought to him. It was smaller than a pack of cigarettes, and contained thirty-seven grams of the radioactive isotope plutonium-239 oxide. The radiation produced heat, which was converted directly by a thermionic unit to electric power. A Kenbeck solid-state DC/DC circuit transformed the output to the necessary voltage.

Ellis plugged the charger into the test pack and did a last-minute check of its power before implantation. As he held it in his hand, he said, “It’s cold. I can’t get used to that.” Ross knew layers of vacuum-foil insulation kept the exterior cool and that inside the packet the radiation capsule was producing heat at 500 degrees Fahrenheit—hot enough to cook a roast.

He checked radiation to be sure there would be no leakage. The meters all read in the low-normal range. There was a certain amount of leakage, naturally, but it was no more than that produced by a commercial color television set.

Finally he called for the dog tag. Benson would have to wear this dog tag for as long as he had the atomic charging unit in his body. The tag warned that the person had an atomic pacemaker, and gave a telephone number. Ross knew that the number was a listing which played a recorded message twenty-four hours a day. The recording gave detailed technical information about the charging unit, and warned that bullet wounds, automobile accidents, fires, and other damage could release the plutonium, which was a powerful alpha-particle emitter. It gave special instructions to physicians, coroners,
and morticians, and warned particularly against cremation of the body, unless the charger was first removed.

Ellis inserted the charging unit into the small subdermal pocket he had made in the chest wall. He sewed tissue layers around it to fix it in place. Then he turned his attention to the postage-stamp-sized electronic computer.

Ross looked up at the viewing gallery and saw the wizard twins, Gerhard and Richards, watching intently. Ellis checked the packet under the magnifying glass, then gave it to a scrubbed technician, who hooked the little computer into the main hospital computer.

To Ross, the computer was the most remarkable part of the entire system. Since she had joined the NPS three years before, she had seen the computer shrink from a prototype as large as a briefcase to the present tiny model, which looked small in the palm of a hand yet contained all the elements of the original bulky unit.

This tiny size made subdermal implantation possible. The patient was free to move about, take showers, do anything he wanted. Much better than the old units, where the charger was clipped to a patient’s belt and wires dangled down all over.

She looked at the computer screens which flashed “
OPERATIVE MONITORS INTERRUPTED FOR ELECTRONICS CHECK
.” On one screen, a blown-up circuit diagram appeared. The computer checked each pathway and component independently. It took four-millionths of a second for each check; the entire process was completed in two seconds. The computer flashed “
ELECTRONIC CHECK NEGATIVE
.” A moment later, brain views
reappeared. The computer had gone back to monitoring the operation.

“Well,” Ellis said, “let’s hook him up.” He painstakingly attached the forty fine wire leads from the two electrode arrays to the plastic unit. Then he fitted the wires down along the neck, tucked the plastic under the skin, and called for sutures. The elapsed-time clock read one hour and twelve minutes.

M
ORRIS WHEELED
B
ENSON INTO THE RECOVERY
room, a long, low-ceilinged room where patients were brought immediately after operation. The NPS had a special section of the rec room, as did cardiac patients and burns patients. But the NPS section, with its cluster of electronic equipment, had never been used before. Benson was the first case.

Benson looked pale but otherwise fine; his head and neck were heavily bandaged. Morris supervised his transfer from the rolling stretcher to the permanent bed. Across the room, Ellis was telephoning in his operative note. If you dialed extension 1104, you got a transcribing machine. The dictated message would later be typed up by a secretary and inserted in Benson’s record.

Ellis’s voice droned on in the background. “… centimeter
incisions were made over the right temporal region, and 2-millimeter burr holes drilled with a K-7 drill. Implantation of Briggs electrodes carried out with computer assistance on the
LIMBIC
Program. Honey, that’s spelled in capital letters,
L-I-M-B-I-C
. Program. X-ray placement of electrodes determined with computer review as within established limits. Electrodes sealed with Tyler fixation caps and seven-oh-grade dental sealer. Transmission wires—”

“What do you want on him?” the rec-room nurse asked.

“Vital signs Q five minutes for the first hour, Q fifteen for the second, Q thirty for the third, hourly thereafter. If he’s stable, you can move him up to the floor in six hours.”

The nurse nodded, making notes. Morris sat down by the bedside to write a short operative note:

As he finished the note, he heard Ross say to the nurse, “Start him on phenobarb as soon as he’s awake.” She sounded angry.

Morris looked up at her. She was frowning, her face tight. “Something the matter, Jan?”

“No,” she said. “Of course not.”

“Well, if there’s anything you want to—”

“Just make sure he gets his phenobarb. We want to keep him sedated until we can interface him.”

And she stormed out of the room. Morris watched her go, then glanced over at Ellis, who was still dictating but had been watching. Ellis shrugged.

Morris adjusted the monitoring equipment on the shelf above Benson’s head. He turned it on and waited until it warmed up. Then he placed the temporary induction unit around Benson’s taped shoulder.

During the operation, all the wires had been hooked up, but they were not working yet. First, Benson would have to be “interfaced.” This meant determining which of the forty electrodes would stop his seizures, and locking in the appropriate switches on the subdermal computer. Because the computer was under the skin, the locking in would be accomplished by an induction unit, which worked through the skin. But the interfacing couldn’t be done until tomorrow.