The next few scenes are quite long, [apologies Metan!] and pretty sci-fi so some of you may find them boring, but I had to do quite a lot of research, and a fair bit of head-scratching extrapolation to write them, so consider these a down payment on the fun scenes later on. 😀
* * *
The emaciated woman with the shaven head kept her eyes on Kenneth Wu as she counted backwards from 99.
As her eyes rolled up into their sockets, the voice of the AI filled the narrow corridor.
“Patient is anaesthetized. All vital signs are within normal parameters. Stage 1 can begin. Please step away from the guerney Dr. Wu.”
Kenneth did as he was told, but kept his eyes on the guerney as it trundled into the outer airlock. Only when the door irised shut did he turn and walk away.
For the next forty-five minutes the automated systems would sterilize the patient inside and out. The sealed operating theatre in which Stage 2 would take place was sterilized already.
Even though no human hand would touch the patient from now on, Kenneth liked to keep his reflexes sharp, that was why he always used this waiting time to centre himself with yoga.
It was rare for the surgical AI to encounter something outside the parameters of its programming, but it did happen, and when it did, the supervising team were required to make the life or death decisions the AI could not.
The patient was much younger than the majority of people who came to Innerscape, so the team did not expect anything to go seriously wrong. Nonetheless, the cancers riddling her body were quite advanced, so they had to be prepared for any eventuality. Preparing her body for Innerscape was such a lengthy and delicate process that even a tiny mistake could prove fatal in the long run.
They had not lost a patient yet, and Kenneth had no intention of allowing Miira Tahn to be the first.
* * *
“Patient is ready for Stage 2.”
In the teleoperating room, the eight member surgical team lay in an eliptical circle around an empty space, waiting for the signal to begin. The bio suits they wore made them look like astronauts having a nap, however the suits were far more sophisticated than any EVA suits could ever hope to be. The bio suits would not only support their bodies, inside and out, to minimize fatigue, they would also act as VR portals during the gruelling eight hour operation that lay ahead of them.
Lying at the ‘head’ end of the ellipse, Kenneth Woo was relaxed and calm as he said, “Ready to begin. Initiating Stage 2… now.”
In the sterile operating theatre twenty feet away, the multiple appendages of the surgical AI remained still, but the mirror foam on which the patient lay began to bubble as it slowly encased her body.
“Beginning induced hypothermia,” the AI said.
Inside his VR faceplate, Kenneth Wu watched the readouts as Miira’s core body temperature began to slowly drop. This was the crucial first step to ensuring her brain suffered no permanent trauma.
“Induced hypothermia stable at 32 °C,” the voice of the AI intoned. “Continuing to cardiopulmonary bypass.”
Miira’s heart was quite strong, but her lungs were riddled with cancer and would have to be removed completely. In normal circumstances they would be replaced with bio-identical lungs grown from her own cell tissue, but this had been done once already and the cancer had grown back, so this time she would be connected to artificial lungs to make sure the blood supply to her brain remained optimum for as long as possible. While her heart was still they would also perform a few minor repairs to make sure it too continued to function efficiently.
Two hours later Miira’s heart and new, artificial lungs were ready to be switched back on, however the bypass remained in effect while the AI tackled the cancer that had metastized to her spine. Moving with microscopic precision it removed one vertebra at a time, before spray painting each exposed section of her spinal cord with a solution of fast acting nanoparticles. Seconds after being activated the invisible sheath of particles was already protecting her nerves from damage. Within two days, the sheath would be almost as thick, and ten times as strong as the original vertebra protecting her spinal cord, but it would be inflexible.
The procedure to replace the spinal column was relatively simple and could have been done before Miira entered Innerscape, but she had not wanted to be paralyzed while she was still conscious. Now it would not matter.
Four and a half hours into the surgery the AI had repaired the worst of the damage caused by the cancers but there were still two important organs that would have to be fixed if Miira was to have a relatively long and happy life in Innerscape : her failing kidneys would have to be replaced by a state-of-the-art, artifical kidney and her bowel would have to be removed completely.
Removing the bowel was a necessary precaution for all Innerscape patients as the bowel was a major source of infection and infection could kill patients faster than any disease. In Miira’s case it was also necessary because her bowel too was riddled with cancer.
It was during the removal of the bowel that the scans revealed a tiny, but malignant cancer in one of the regional lymph nodes. The tumour was only small and had been masked by the growths in her bowel. Only once the bowel was removed had it shown up as a tumour in its own right.
While the AI finished off the bowel, Kenneth Wu and the rest of the team held a hurried teleconference. The thing that worried them was that a malignancy in one lymph node could well signal the presence of cancerous tissue in other nodes. A simple procedure could check whether this was the case, however it took time for the results to come back and Stage 2 was already nearing the seven hour mark. Every minute past eight hours increased the risk of complications and death.
Some of the team were in favour of removing adjacent nodes in the hope that this would catch as much of the cancer as possible, but Kenneth Woo knew such a shotgun approach would not work in Miira’s favour, long term.
“No, “ he argued. “We should just remove this one node and then wait for the tests to come back. If other nodes are affected we will know exactly which ones are involved and can remove them during Stage 3.”
“That’s very irregular!” Charles McGrath said. “Stage 3 is delicate enough without adding to it.”
“That is true, Dr McGrath,” Kenneth said without inflection, “but the nodes can be removed manually without taking any resources from the AI.”
“Manually?” McGrath sputtered. “That’s archaic! You’re not seriously proposing to remove the nodes yourself?”
“Why not?” Kenneth asked. “We are all surgeons are we not?”
“Of course we are,” McGrath growled, “but none of us can match the precision of the AI!”
“That is true, but the removal of a few nodes is very simple in comparison to most other procedures, and besides, all of us have to be skilled enough to step in if anything untoward happens during the course of a procedure, do we not?”
Kenneth’s words caused a long, and rather uncomfortable silence as many of the surgeons present secretly wondered how skillful they would be in a real emergency. As accredited surgeons they were all required to practise their surgical skills on a regular basis but in reality those practice sessions were all just simulations. Very good, very realistic simulations, but simulations nonetheless, and few had touched a real, live body since medical school.
“I suggest we let the team decide,” Charles McGrath said, his voice hard.
When the vote was taken, the shotgun method won by a margin of five to three.
As Kenneth directed the AI to remove the suspected lymph nodes, he prayed that his colleagues were right, and that they had removed the right ones.
* * *
p.s. I’d really appreciate any and all feedback on the medical procedures. I know it’s all make-believe, but I’d like it to be as realistic as possible. Thanks in advance!