The grass feels cold and damp beneath my feet, and I shuffle closer to the edge, my nightie starting to freeze where the sweat has cooled.
The city looks so beautiful from up here. There’s a quietness that belies the hustle and bustle of nightlife going on down there, the twinkling lights a blanket of perfect stars, a gateway of opportunity. Somewhere couples are making their way home, hands intertwined as they huddle together against the cold. Young girls will be tottering arm-in-arm, carefully negotiating slippy pavements in perilous heels, shivering in clothes inappropriate for the weather, their hearts warm with Margaritas and camaraderie.
What do they know or care for me above them on Clare Point, gasping for air in my placeless place?
I thought I’d be frantic, rushing, desperate. After all, isn’t that how I spend my life these days? I can’t recall the last time I wondered at the intricacy of an orchid bloom, or got lost in the velvet indigo of a warm summer’s night sky, or sat beside a patient. How ironic that I have never felt so alive as in this moment.
I’d wanted to be a doctor for as long as I can remember. My father was the GP in our local surgery; he was an old-school physician, from an era when prescriptions were handwritten illegibly, and calculations were computed with a paper and pencil. He knew every patient by their first name – half the boys in Cloverfield were named after him for delivering them safely into this crazy world. On many a night I’d play quietly in the corner of his office watching him strain his eyes over volume after volume of medical journals, looking for that one entry which might be the missing piece in the puzzle of his latest case. When he retired they queued around the block for three hours to shake his hand. I mean, actually physically expended hours of their life to look someone in the eye and personally thank them.
Arm outstretched, I frame the three bright stars of Andromeda between my thumb and forefinger. Wrapped in a blanket on the porch, Daddy and I used to reach out and hold whole constellations in our hands, and I’d listen enthralled as he recounted stories from Greek mythology of how they got their names. The tale of Andromeda was my favourite – I never tired of hearing how she was chained to a rock to be eaten by a sea monster, only to be rescued by the brave and heroic Perseus.
“How come she ended up chained to the rock?” I’d always ask, and Daddy, frost kissing the edges of his moustache, would reply, “Her father sacrificed his daughter to save his kingdom, but Cassie, you are my kingdom and I will never let anyone hurt you. Especially not a sea monster.” And with that we’d giggle and snuggle up more closely.
I miss you so much, Daddy. We’ll be together soon.
Earlier that day
The brass barometer on my desk, a present from the parents of my first patient, showed signs of storms ahead, yet the weather outside was fine and still.
“Notification – appointment K54255 waiting in VCR 12. PC over.”
I sighed and took a last sip of tea before pulling on the visor. VCR 12… which virtual consulting room was that again? Ah - Dallas. I hadn’t been there for a few weeks. A chronic case of parental hypochondria if I remembered rightly.
I opened up the channel. “Good morning, Mr and Mrs Kingston. I am Dr Milner – how may I help you?”
Their avatars sprang to life, hers all doe eyes and cinched waist, his a sad parody of some intergalactic he-man. God, I miss working with real people.
“Doctor, we need your help. My wife is giving our daughter the very best of care, yet the child’s never done crying. She fusses at the breast, she won’t take to a bottle, and we’ve darn near worn a path in the rug pacing with her half the night. Not to put too fine a point on it, we were led to believe Dr Franklin’s IVF services are the best in the country. Quite frankly, this is not what we expected. I cannot effectively model statutory life insurance reserves on two hours of broken sleep per night.”
The antenatal notes downloaded and I scanned through them. The pregnancy was routine – in vitro genome screening, successful implantation of the first embryo in the gestation chamber, harvesting at term in week 20.
“OK, Mr Kingston – can you please place Amelia on the Nanolyser and we’ll run a molecular scan on her.” I opened the channel to the Nanolyser, and reviewed the scan results:
‘Unable to determine diagnosis based on symptoms A to E. Diagnosis based on symptoms A to D: infant colic.’
I sighed. 30 years of paediatrics, and my most critical case in 5 years has been a boil on the left buttock of an overweight 7 year old.
I reopened the channel to the VCR.
“Mr and Mrs Kingston, whilst foetal genome mapping and ante-chamber gestation has been hugely successful in eradicating the majority of childhood diseases, we have not yet managed to completely reengineer babies, thank the Lord. I can confirm that your daughter has been diagnosed with colic, and will request for 100ml of Colivac to be printed for you in the VCR lab now. Hopefully this should provide some immediate relief for her digestive problems. If you have any further problems please come back to me. Thank you and goodbye.”
I closed down the communication channel and was about to remove the visor when I thought back to the diagnosis summary. Diagnosis only made on symptoms A to D – so what was symptom E then? I pulled up the detailed symptom analysis. The hairs stood up on the back of my neck in a mixture of horror and excitement.
There were 76 avatars on-line in the Paediatric Virtuo Hub.
“Requesting secondary opinions on a three month old patient just analysed. Auto molecular system diagnosis of colic. Manual analysis of symptoms suggests an opposing diagnosis of Krabbe disease.”
A Lara Croft lookalike stepped forward. “Dr Milner – have you lost your mind? We haven’t had genetic disease in infants in the US since genome-mapped IVF became mandatory.”
“Look, I know how crazy this sounds, but she has all the markers – digestive impairment, excessive crying, pronounced limb stiffness, very low GALC enzyme levels. The Nanolyser didn’t suggest the diagnosis as it’s not programmed to scan for genetic diseases. If I’m right on this, our only option is to bring her in for an HSCT.”
Lara Croft was joined by a cartoon replica of a young Donny Osmond. “Dr Milner – this is Dr Hillgrove in Seattle. There is zero margin for error in embryonic genome screening. If you proceed with a hematopoietic stem cell transplantation there’s at least a 10% chance the treatment could kill the child. Your diagnosis is speculative, unproven, and completely unauthorised.”
“With all due respect, Dr Hillgrove, what if the wrong zygote was implanted into the gestation chamber? What if the algorithm that mapped the DNA is flawed? Without early HSCT this child has no chance of making her second birthday.”
“Now you’re questioning the accuracy of the entire Western world genome sequencing application? Dr Milner, may I remind you that your remit as a paediatric physician is to treat patients on the back of technological diagnosis. That’s it. Personal bias and guesswork no longer has a place in medicine, and quite frankly I’m more than a little disturbed that you’re even suggesting it.”
“So I’m defunct? I’m just supposed to perform some sort of ‘wipe disk’ operation on thirty years of medical experience? Jesus – since when did progress mean surrendering our integrity?”
I reviewed the stats – 74 ‘unlikes’ and counting. The nail that pops up is always hammered down.
I’m starting to shiver. I can see the expulsions of my breath quickening in the air around me. I’m frightened – I never imagined things would come to this, but there’s no going back. I’m sorry Amelia Kingston, but the system has failed you, and I’ve allowed myself to fail you too.
They say a frog doesn’t realise it’s going to die if placed in water that’s heated slowly. The water’s been heating up for years and I’m half dead already, but I’ve just enough breath left to jump out of the pan.
I’ve swum with the current of distinctive sameness for too long, stewing in the faint remains of my own self-identity. It’s time now. It’s time to fly. I unsubscribe.
The house is in darkness when I finally pull up, save for a faint light burning dimly in the porch. A small figure appears out of the shadows, his stoop more pronounced than before. Why have I left it so long?
He looks up to the night sky. “Andromeda is shining brightly tonight.”
I rush forward and wrap my arms around him. “She’s no longer chained to the rock, Daddy. She’s free.”