Thorny thought it through. As long as Linda’s kidneys worked reasonably well, they could use medications to stimulate them and get rid of some of the excess fluid. But if her kidney function got too bad, her body would retain fluid even faster. Before too long the artificial heart itself would get starved for fuel and oxygen, and work even less efficiently. Then the kidneys and lungs would get worse, which would make the implant’s function deteriorate more—and the whole vicious cycle would keep on repeating itself, until her lungs filled up, or a blood clot from her failing heart caused a stroke. He remembered what he had thought when they implanted the heart—about a lingering death.
Thorny imagined Linda lying bloated, in a constantly dirty bed, connected to a ventilator, and surrounded by a metallic forest of IV poles. He had seen her in similar surroundings once—and he didn’t want to see her end that way. For the first time he thought seriously about her request to turn the Rockwell off. And what they might to do him if he did. Hell of a consideration, that.
“Angel, we’d better tell Linda. And then we’re going to have to talk to Dr. Creighton.”
Things went even worse than he’d expected. Linda’s response had been bad: “…Thanks for the extra months, but I guess I’m really not supposed to be here. You can turn me off any time. Thanks anyway, Angel.” Angel and Thorny had to convince her all over again that her life had a purpose.
But Creighton’s reaction was even worse.
When he found out that Thorny had ordered the tests Angel wanted and that she had made the diagnosis, he turned so red that Thorny thought Creighton would either have a heart attack himself, or resort to physical violence. Actually, either event would have simplified things—Elvis in Intensive Care, or in jail, would be Elvis out of the loop, unable to screw things up with Linda. And Thorny derived a little guilty pleasure from imagining what the AI Consortium’s lawyers would do to the wealthy Dr. Creighton if he damaged Angel.
It soon became apparent that they had reached an impasse with Creighton, so with the freedom of someone long retired from trying to climb greasy poles, Thorny went over Creighton’s head.
Not unexpectedly, Creighton did not like the idea—but he really didn’t have any choice in the matter and whatever revenge he might arrange would have to be delayed, and very circumspect.
It was the next day when they all sat in the office of the Director of the medical center. Dr. Tunman and several other physicians involved in the transplant program had also been asked to attend. So far, Tunman and the others had said relatively little—apparently trying to stay out of the line of lire of all the verbal bullets that were flying around them.
The Director, a tall, serious obstetrician of such poise and patrician bearing that she could usually silence an interloper by raising an eyebrow, frowned severely at Dr. Elvis Creighton. The surgeon had been in fine form—earnest, sincere, at ease, never stumbling or hesitating. But the facts were a little too much, and if the Director was frowning, Thorny and some of the others were doing a slow burn.
“No one’s disputing that the patient has a problem,” Creighton concluded, flashing his disarming grin. “I just don’t think we should exaggerate it. There are desperate patients ahead of her, and while I agree that her Rockwell’s function might deteriorate further, there’s also a reasonably good chance it won’t. Besides, we all know any nephrologist would tell us that a moderate amount of renal failure might help for a while; it could actually reduce the risk of blood clots and—”
Thorny interrupted. “Elvis, whether you think so or not, the next thing in line is a stroke—and we don’t have a brain machine.” Or you’d be the first on that list, he added silently.
Creighton shrugged. “We all know the risks. She could go on a kidney machine.”
“Ma’am,” Thorny bristled, “for reasons which some of us find obvious, Linda wants Dr. Creighton off her case and out of the loop.” Thorny took a breath, the next wasn’t going to help, but he had to be truthful. “She’s not going to tolerate being rooted to tubes the rest of her life; if you ask her now she’d say she’d rather be dead. She’s already asked us to turn the Rockwell off rather than face some of what she has to endure.” No point in trying to hide that, it was on the record. “And, frankly, I’m not into raising human vegetables no matter how profitable they might be.”
The Director raised the other eyebrow at Thorny. “That makes me wonder how good a candidate she really is for a transplant. Patient will-to-live and compliance is very important. What if she decides after she gets her transplant that she’s also not going to take her antirejection medications? We can’t ‘waste’ a heart on someone who’s not going to take her doctor’s advice and die anyway.”
“Exactly!” Creighton interjected, waving a hand dramatically. “And these calls should be made by experienced specialists.” He glared at Thorny. “Not by a generalist who sees these kinds of things once in a blue moon, however well-meaning he may be.” His eyes barely moved toward Angel. “And certainly not by an experimental robot, no matter how superficially sophisticated it may seem.”
Angel gave Creighton as cold a look as Thorny had ever seen from her. “Ma’am, may I defend myself?” she asked.
“That does it,” Creighton hissed. “Benson, get that, that thing out of here!”
“Dr. Creighton,” the Director murmured, followed by an embarrassed silence; Elvis didn’t run this meeting.
He appeared to calm down instantly, and flashed his boyish, charismatic smile in her direction. “Pardon me, ma’am.”
“No.” The smile disappeared from Creighton’s face.
“Angel,” the Director continued, “Thorny tells me you’ve followed the patient since her accident, and I’m very interested in what you have to say about all this.”
“Thank you.” Angel stood up so she could be seen by everyone. “Although Linda Coombs is ‘competent’ in the medical sense of the word, she’s depressed. You all know the ‘facts’ about her—how she lost everything she was living for. Is it any wonder that she might speak impulsively and say things that might seem non-compliant—things that a critical person might use to make her look like a bad risk?
“I know what the ‘rules’ say to do in this kind of situation. I literally can’t forget them. But we have to think about how to apply them, and do what’s best for the particular person we’re caring for. Linda is not non-compliant in general. She’s followed Dr. Benson’s instructions exactly, even though she knew it would compromise her figure, which had always been important to her. Linda doesn’t want to die, but her life has to have more of a purpose than just existing and she does have a reason to live which has become very important to her. That reason happens to be me, and what I and others like me can do to help people—”
“This self-serving egotism is hardly an objective analysis,” Creighton sneered.
“Dr. Creighton, are you suggesting our robot is not being objective?” the Director inquired mildly. “How very interesting. Do continue, Angel.”
Angel’s face was most hard set and un-Angelic. Where, Thorny wondered, had she got that?
“I have to make a point. I, and future robots like me, can help many people—if we are allowed to do it. I’m an artificial intelligence, yes. But I have likes, dislikes, and a full range of human emotional expression. I don’t want to hurt anyone, but when someone’s insecurity and stupidity—”