Open Heart

The story below is a short exercise I completed for the writing group I attend. It draws on some of my hospital experiences from last year.

Open Heart

Two masked and gowned figures stood over the prone form, peering into the open chest cavity. The heart within showed obvious stitches where silvery, artificial tissue had replaced old, diseased muscle.

"Maintaining the open incision gives us easy access to the heart, but the risks are severe,” Dr. Davey broke the silence.

“Nonsense,” Lanscomb replied, “We simply administer a nano-pantibiotic and the risk is limited.”

“But we have no idea how the nanos will respond to the convergent tissue. If it isn’t close enough to the subject’s, they could react…” Davey began to counter.

“Davey, if the convergent tissue isn’t a close enough match, the nanites will be the least of our worries.”

“No shit. I would have never have guessed that. I just think that there are risks.”

“There are always risks…but, in this case, I am willing to live with them.”

Davey shook his head. “Of course you can live with them, Lanscomb. I just hope the patient can.”

“Bite my ass! I’ve been a surgeon for a lot longer than you have. We still used bypass machines when I started.”

Davey held up his hands. “Look, I’m not saying it isn’t they way to go. But this gent has enough issues to deal with. Adding another variable to the equation might not be in his best interests.”

Lanscomb sighed, seeming mollified by Davey’s explanation.

“The patient had no prospects before the surgery. You know the procedure was very experimental to begin with. What good is the experiment if we can’t closely observe the results? Anyway, I’m satisfied that the nanos will take care of any infection.”

* * *

Tiny, molecular machines swam through freshly oxygenated blood, plucking small bits of O2 from the red cells’ treasure trove. Individually, the nanos were dumb, like ants, but collectively their purpose emerged.

Analyze, Synthesize, Rebuild

Analyze, Synthesize, Rebuild

Analyze, Synthesize, Rebuild

Analyze, Anomaly Detected, Analyze, Anomaly Confirmed

Working…Working…Working

Synthesizing New Pattern, Rebuild

Analyze, Synthesize, Rebuild

Analyze, Synthesize, Rebuild

Analyze, Synthesize, Rebuild

***

Doctor Davey rubbed his goatee, feeling each bristle brush against his wired nerve endings. He peered over at Lanscomb in the room, also wearing a doctor’s smock.

“So, Lanscomb, any idea how to proceed?” He asked. “As you can see, the nanos have interacted with the Myolon[1] in a very unanticipated way.”

Lanscomb’s eyes flashed. “You love this, don’t you?”

“Uh, I love the concept of you being wrong.” Davey pointed at the man on it table. “But it sucks for him. The nanos have gone berserk and are replacing his normal muscle tissue with Myolon. We have no idea how far they will go.” Davey looked up from the monitor, a strange expression in his eyes.

Lanscombe’s voice betrayed his growing concern. “There is no way I could have predicted this.”

“I agree. There is no way you could have predicted this…because it would have required you to take your head out of your ass. Did anyone die the last time you came up for air?”

“Shut up! All we have to do is inject him with the nanos’ disabling agent and they’ll stop. They haven’t gotten very far. Besides, his heart still appears to be pumping fine.”

“You’re brilliant, Lanscomb. That was the first thing we tried, but the nanos are not responding. Whatever caused them to malfunction is interfering with the agent and we haven’t figured out how to shut them off yet. They’ve replaced nearly all of the normal heart tissue with Myolon.”

“Well, um…” Lanscomb sputtered. “What do you suggest we do?” Some of the anger in his voice, replaced by concern.

Davey’s brows knitted. “I had my databot find out what agents are used to deactivate Myolon producing nanos. The lab is synthesizing a non-toxic variant. The original compound is very nasty.”

“How long does the lab think that will take?”

“The lab rats assured me it will be done in a few hours. I pray it is not too late by then. If it stops the nanos I guess we close him up and hope for the best.” He sighed and stepped back from the table. He met Lanscombe’s eyes. “If not…”

***

Ignorant of the torrent of activity singing through his vascular system, Duncan Wilbury slept; senses dulled by narcotics, his thoughts swimming in murky, addled dreams. Dream after dream came; dreams that seemed backed by a chorus of harmonizing voices. They washed over him, drowning him in sensations. Duncan’s mind, struggling to make sense of it all, crafted intricate explanations of what it all meant. Each crumbled with the slightest breath of logic.

Slowly, painfully slowly, his conscious mind began to emerge from the fog. At first, all he caught were identifiable sounds, snippets of the nurses’ conversations, the sound of a squeaky wheel on the food tray, the wet slopping of the janitor’s mop. The pieces began to fit together again. After a time Duncan began to test himself, prodding at the edges of awareness.

The mental fog burned off revealing a clear mind with no active thoughts. Like a scene from some cliched movie, Duncan could hear his own voice in his head asking the question.

“Where the hell am I?”

His eyes shot open.

In a torrent, reality gushed back in: the diagnosis of an aortic aneurysm, getting his affairs in order, his wife’s worries, the surgical prep. In less than a week, Duncan’s life transformed from ‘blah’ to ‘holy shit?’ Again, it sounded like some movie tugging at the heartstrings about discovering what was truly important. He smiled, or thought he did. He’d have to reassess his classification of movies. He planned to do that as soon as he got out of the hospital.

Hospital? Of course, a hospital, but this didn’t look like any recovery room he had been in before, and with plenty of sick relatives, he knew what to expect.

Luck favored him in the form of a smiling nurse. “Oh, good morning. It’s nice to see you awake.”

Duncan tried to respond, but no voice came out. The nurse’s smile widened.

“That’s okay, child, you’re fine. Don’t try to talk. You won’t be able to for a while until they take you off the ventilator.”

Duncan’s eye widened No words came out of his mouth, only a groan.

The nurse nodded. “Yes, Mr. Wilbury, you are on a ventilator.” The nurse’s soft hand stroked his cheek lightly, radiating calm from the point it touched. “Relax, child. You’re going to be fine. Just rest now.”

With a smile, she strolled from the room, flipping the light switch off as she passed. Darkness enfolded Duncan. Sleep arrived next. He passed out.

***

Analyze, Synthesize, Rebuild

Analyze, Synthesize, Rebuild

Analyze, Synthesize, Rebuild

Analyze, Reactive Compound Detected, Analyze, Power Down

A single nano, heeding the commands of its programming, sent out the chemical signal heralding the end of its existence. The power down signal spread through billions of the tiny machines, causing each to cease its meticulous task and commit robotic suicide, breaking down into component molecules. Each nano passed its chemical death sentence to the next in a chain of quiet destruction.

***

“Mr. Wilbury? Mr. Wilbury, wake up.” An unfamiliar voice raised Duncan from the depths of sleep but lacked the strength to bring him to full consciousness.

“Child?” A more familiar voice beckoned. “Please wake up. The doctor needs to talk to you.” The voice was accompanied by a gentle touch on his shoulder.

Duncan’s eye flickered open, then slammed shut against the bright fluorescent glare from the overhead fixture.

“Hold on, darlin. I’ll turn the lights down.” The glow penetrating his tightly-shut lids dimmed. “That should be better.”

Duncan diffidently lifted his eyelids, relaxing his furrowed brow. While still bright, the light was now at least tolerable. His eyes couldn’t quite seem to focus on a largish fuzzy shape floating above him.

“Good morning, Mr. Wilbury,” the fuzzball said. “I am one of your surgeons, Dr. Davey.”

“Mornin,” Duncan croaked. His eyes widened in panic as he recalled the earlier talk of a ventilator. His hand feebly reached toward his mouth.

“Don’t worry; we took you off the ventilator. You can talk now.”

Duncan sighed. That single uttered word left his throat sore and dry. Avoiding another attempt at a painful verbalization, he simply shrugged and gave the doctor a pleading look.

“Just rest for now, Mr. Wilbury. You have a long recovery in front of you.”

Duncan shrugged again. A question in his eyes.

Davey nodded. “Yes, there were some complications…but your vital signs are stable. The initial procedure went just as we planned, but we had some trouble getting your heart restarted. After inserting a temporary micro pump through your leg, to aid your heart, we administered some nanos to prevent infection. There was an unexpected reaction from the nanos.”

Doctor Davey watched as a cloud of confusion passed over Duncan’s face.

“Congratulations, you are now the owner of an unbreakable heart.”