The car woke him up in his driveway, and he staggered up the icy steps and into the house.
That morning he dreamed he was on Wheel of Fortune; never mind that the last show had been twenty years ago and Vanna White was now getting senior citizen discounts. Somehow he kept getting “bankrupt” and selecting letters anyway. Then he realized that it wasn’t Vanna turning the letters, it was Angel. And she wasn’t turning letters, she was turning over tombstones, all bright and smiley.
Late the next day, Thorny’s home cybersystem informed him that the pathology report on Linda Coombs’s heart was available, and he pulled it up on his wall screen.
Good news and bad news; good news that they hadn’t removed the patient’s heart without cause. Bad news in that, apparently, Angel had been wrong.
“Angel?” he called, not loudly because the cybersystem would contact her wherever she was.
“Yes, Thorny?” her voice came instantly.
“Are you busy?”
“I’m assisting Dr. Tunman and Nurse Miles with a coronary endoscopy and ultrasonic atherectomy. He told me he felt really bad he wasn’t available the other night—he knew Dr. Creighton was around, he was tied up with a very sick patient over in Coronary Care, and he just never noticed that his link wasn’t working. He felt sorry about that, so he volunteered to teach me the procedure.”
Thorny wondered if there was any correlation between the times Creighton was on call and the times other people’s personal data links stopped working, but put the uncharitable thought from his mind.
“We’re working on a seventy-two-year-old black male,” Angel continued, “mildly obese, apparently healthy until he started having severe chest pains with exertion about two weeks ago. He had a strongly positive stress test, and Dr. Tunman thinks he probably has three-vessel or left main coronary disease. The patient was really nervous about having the procedure, so we had to sedate him pretty heavily. So, yes, I’m busy, but I can talk to you, or as many as ten other people, in parallel, without affecting what I’m doing because I have to do things at about one-tenth the speed I could do them—so that I can be supervised. That leaves a lot of me available for side conversation. I like it when you ask questions about me.” Her voice smiled.
“Glad to hear it, Angel.” Thorny laughed: the comment was pure Angel as he’d come to know her. All he’d asked was if she’d been busy. Listening carefully, Thorny could hear the man snoring in a deep bass in the background.
“Thorny, I’ve got emergency in C-12.” Bruk Tunman said, his light Balkan accent somewhat more evident than usual. A prominent but ethnically mixed cardiologist before the troubles, he’d had to learn a new language and repeat much of his medical schooling at age fifty-three just to get licensed here. Little things didn’t bother Bruk, and, while he never said so in so many words, he had a way of shrugging off complaints with a look off into space that seemed to shout, loudly and clearly, “You think you have problems?”
“There is nothing more I have to teach Angel here. You can watch her this way, Thorny, yes?”
Thorny hesitated a moment. It was a stretch; if something went wrong with Angel and a doctor wasn’t physically present… But Bruk didn’t use the word emergency lightly. And Sarah Miles was there—someone who knew Angel and someone he could trust.
“Probably better than if I were there. I’ve got her, Bruk.”
“Thank you,” he said, and was gone.
“Well, Angel, how is it going?” Thorny asked.
“It’s fascinating; we’ll have those arteries good as new in less than an hour.”
“Good. Ah, Angel, have you checked the pathology report on Linda Coombs?”
“Yes. Looks like I was wrong. There was a lot more damage to her heart than I recognized. Thorny, I know what’s in the literature, but I’m afraid it’s biased toward the interesting, unusual, and successful. Dr. Tunman says he’s seen patients whose hearts were in that condition as well, and that none of those who didn’t get a mechanical heart or an immediate transplant survived. So I owe Dr. Creighton an apology—but he probably wouldn’t take one from a machine, would he?”
“No, Angel, he probably wouldn’t.”
“I think we might need his advice, though.”
“Huh?”
“I’m having a little trouble here. Just now. I don’t know why, but I can’t find the ostium of the left coronary artery. I didn’t have any difficulty with the other patients, and I don’t know what I’m doing wrong.”
“You can’t find the opening for the artery?” What kind of problem had Angel got into now? He couldn’t supervise her twenty-four hours a day, and she never slept, so it was inevitable that something would come up when someone else was “using” her.
As he thought about it a few seconds more, Thorny became even more worried. The procedure Angel was doing now was similar to what she’d done when she’d catheterized Linda’s femoral artery to connect her to the assist pump. Both involved puncturing the artery and threading a long, thin, plastic-coated tube up to the heart. The only difference was the kind of catheter she was using. This one had a fiber-optic network inside it, and a combined sensor-transducer at its tip. By threading it into a coronary artery, blockages limiting how much blood was getting through could be seen, and then broken up.
If Angel could do a procedure under emergency conditions, why couldn’t she do something like it again under less hectic conditions? Her programming was supposed to let her “learn by experience.”
Angel’s voice came back on line.
“No, I can’t find the artery. Here, I’ll send you a video.” Thorny’s wall screen flicked on to an endoscope-eye view of the inside of the patient’s aorta. There was no pathology Thorny could see.
But no sign of the tiny opening to the left coronary artery either.
“I’ve done everything just right,” Angel continued, “the endoscope control unit checks out fine and I can’t find anything wrong through the hospital computer either. My ultrasonic imaging tells me the catheter tip is within a few millimeters of the right place. Maybe Dr. Creighton could tell me what I’m doing wrong. Could you talk to him? He’s not likely to respond to me.”
“Right away, Angel,” Well, maybe Creighton would respond to the “humble seeker of wisdom at the feet of the master” approach. Maybe.
But not likely.
“Benson?” Creighton’s voice came on line, and his face smirked from Thorny’s screen. Of course, Angel had placed the call.
“I’m on, Creighton.” Thorny explained the problem.
“Your machine’s in over its head again. I’ve got video, and it’s obvious what the problem is. Ask if it did a high-res scan of the heart before it started. Or was this Nurse Miles’s project?”
Ask her yourself! Thorny started to say, but thought better of it. Diplomacy, diplomacy… “Dr. Tunman didn’t require it, Dr. Creighton, but it sounds like a good idea now—” to everyone but the taxpayers who were going to pay for it, he added silently. “Angel—”
“I can’t get enough resolution with my own sensors. The machine’s on its way.” Within minutes, the imaging table drove through the door and Nurse Miles and Angel had eased the three-hundred-pound patient from one table to another. Thorny had to smile; no two ordinary women could have done that without an orderly’s help. But Angel and Nurse Miles were, each in her own way, most un-ordinary.
“Well, those two are good for something, I see,” Creighton chuckled in what he must have thought was humor. Sarah Miles raised her head, jaw clenched—but she couldn’t stare at a disembodied voice. Thorny counted to ten. But soon, a tri-D view of the patient’s heart appeared on the screen.