The Moon and the Desert, page 6
“Ouch!”
“Oh, good, something works. Your facial nerves have regenerated just fine.” There was a dark note of sarcasm in Marty’s voice. “Makes sense, since you’re a touchy son of a bitch. Well, I have news for you, buddy. When I said one hundred percent, I meant it. Everything is turned on and functioning.”
“I can’t see anything! I can’t hear anything!”
“Whine, whine, whine. Tell me, flyboy, how do you tell the difference between a pilot and a jet engine? Well, they both whine, but at least the engine is going somewhere!” He put his hands on his hips and glared back. “So, what are you going to do about it?”
“I can’t walk! You assured me I’d be able to do this by now.”
“Are you really trying? I saw your legs move when you had your eyes closed and weren’t thinking so much.”
“I tried! Just like I took off the patch this morning and tried to see. Nothing! You failed.” Glenn broke down in sobs. “I failed.”
“Ah, so that’s what it is. The Mars mission.” Marty placed a hand on Glenn’s shoulder and let him take the time to work through the emotions.
“I asked them. They had two launch windows, now, and in six months. I petitioned to be allowed back on the team. In six months, I would have been ready.”
“I’m not so sure.”
Glenn looked back and glared at him again. Both eyes were focused, distinguishable only by the faintest reflection in the iris of the left eye. “I can do this.”
“Physically? Yes. Psychologically? You’ve got a massive chip on your shoulder. What’s that about?”
“Yvette.” He practically spat the name. “She stole my mission. By leaving now, they have to take her instead of waiting for me.”
“I’m not sure you’re being fair to her. She didn’t want the mission. I didn’t talk to her, but the Space Force general—Boatright—did, and he said she turned it down.”
“Oh, she’s always done this—didn’t want the emergency medicine fellowship, but the moment I applied for it, there she was, and got it. She said she didn’t want Chief Resident, but got that, too. Eventually we shared it, but she had better ratings from the attendings than I did despite the fact that I consistently outscored her. We always argued over patient care and cases. She even accused me of trying to push her aside and take over. She left the Force to be a civilian space contractor, and immediately broke up with me because I didn’t follow her.”
“Back up. You said you were fighting and she accused you of undermining her.”
“Yes, but lovers fight, and make up, and fight, and make up again. At the time we thought that was all it was. But she left the military, yet somehow ended up back on the Moon as Medical Officer.”
“Well, Moonbase is a civilian posting, these days.”
“Uh huh, sure. How many civilian CMOs have they had in the past ten years?”
“One. But then, they’ve only had two other CMOs, and you were one of them.”
“Sure. Okay, fine. She took the job, though. Probably jumped at it the moment it was offered.”
“Not quite. They asked her three times before she said yes.”
“Yeah, that’s her pattern. Anyway, that’s when I realized that her career has been driven by competition with me. And spite. So don’t tell me that wanting to turn off my ventilator was her way of wanting me to live.”
“I wouldn’t say that . . .”
“Don’t tell me she had my best interests at heart, either, Marty. She didn’t want to call you in. She didn’t want to stabilize me to get me back to Earth. Back when we were residents at Petersen AFB, a young airman came into the ER late on a Saturday night. He’d been in a car crash. The impact pulverized the bone in one leg. I argued for amputation of the leg due to the multiple fractures, bone fragments and damage to blood vessels. Yvette wanted to use hyperbaric therapy, and argued that they could save the leg if they could keep the tissues oxygenated. I countered that the shattered bones could not be adequately repaired and the young man would be confined to a wheelchair. With a prosthetic, he could return to work as an aircraft mechanic. She disagreed; the man’s military career was over. She sneered at me—was I recommending that they amputate the man’s fractured ribs and cracked jaw as well?”
“You can think what you want about her motivations, but she reacted instinctively and saved your life back then. She was conflicted. Her heart told her one thing, but her medical training told her another. Even that was in conflict—end your pain, or save your life? When I first saw you, I was amazed at how well she’d stabilized you for transport. She personally convinced Space Force to get that experimental SFX shuttle up there to get you back down to the ground in minimum time and no transfers. She wasn’t your personal physician anymore, but she cared enough to give you the best possible chance.”
“She’s going to Mars. In my place. Especially because it’s my place.”
“Yes, she is, because you’re not ready. Your time will come.”
“No. It won’t. Read this.”
Glenn handed the envelope over to Marty, and the doctor pulled the official stationery out and started to read. “. . . heroic rescue . . . risk of life . . . severe injuries . . . Purple Heart . . . Wow, you’ve been awarded a Silver Star!”
“Keep reading, Doc.”
“Coast Guard Gold Lifesaving Medal? Yeah, that fits. Morykwas was Guard, and he’s alive because of you.”
“Nope. That’s not it. Besides, that’s a civilian medal. It should be a clue.”
“. . . promotion to full colonel . . . needs of the service . . . potential contribution to the mission . . .” Marty looked up in shock. “They’re retiring you? General Boatright promised me that you would just be on standby reserve until you recovered. What is this?”
“It gets better . . . or . . . something.”
“Psychologically unfit for duty! What the hell? Is this Pillarisetty’s doing?”
“Actually, no. There was a medical competency hearing, and his was the lone dissenting voice. A board made up of headshrinkers and flight docs from the Space Force, Air Force, and Navy held a kangaroo court and drummed me out of the Service.”
“Why wasn’t I consulted?” Marty asked. “I’m the one who knows your whole progress, not a bunch of people who’ve never even met you.”
“They were all military docs. Nik was included only because he’s considered Veteran’s Administration hospital staff.” Glenn’s voice was filled with resignation. “Notice who else signed it. She’s back in uniform, at least as a reservist. It’s confirmation bias in action. We’re trying to make a point here, but their minds are—and in particular, her mind is—already made up.”
“I’m sorry, Shep.” Marty put the letter back in the envelope and put it on a bedside table. He walked over and put his hand on Glenn’s shoulder. “I know how much this meant to you, showing people that they shouldn’t be afraid of the risks inherent in space exploration. I admit that I thought going to Mars as anything other than a proof-of-concept demonstration was a long shot, but you’d think that after what’s been invested in you, they’d at least see it through.”
Marty sat down on the edge of the bed and stayed silent for a while in sympathy with his patient . . . and friend. A few moments later, he had a thought.
“Wait . . . does this mean they’re not going to pay for any of this?”
The anxiety on Marty’s face made Glenn snort. Laughter was still out of the question, but there was a small bit of humor in the doctor’s expression. “No, they’re still paying—at least the part my trust fund didn’t cover. General Boatright insisted on that part.”
“Oh, good, because you’re expensive, Shep.”
“Six million dollars?” It referred to a popular TV show from almost seventy years ago. It was also the amount he’d drawn from the trust fund account created from his father’s and mother’s insurance policies and supplemented over the years by his aunt and uncle, not to mention capable financial advisors.
“Oh, you are so, so far beyond that, my friend.”
They lapsed back into silence for several more minutes before Glenn spoke again. “Marty? Let’s prove them wrong.”
“Yes,” Dr. Martin Spruce replied. “Let’s do exactly that!”
CHAPTER 7:
The Doll Factory
Scott K @Kman549
Y’all already know I’m a neuro nerd, but did anyone else see the article in Rehabilitation Journal? The new neural control prosthetics are *amazing*!
DARPA @YesDARPA
@Kman549, if you think that’s amazing, wait until you see what’s coming next!
ChirpChat, March 2041
Despite numerous setbacks, and Glenn’s occasionally bleak attitude, the therapy had progressed well—he was walking, albeit with the assistance of a cane for stability, and could even use that cane with his artificial arm.
Dr. Pillarisetty thought the issues with vision and hearing were psychological, and had been working with him to train himself to see and hear again. Even though the interfaces were perfectly functional, they were not a perfect match to purely biological connections. The human brain could be trained to use the new inputs, but the patient had to want to do so. Many hours of counseling with Nik—one of the few people who would not be swayed by Glenn’s self-pity—were beginning to pay off.
“We’re going to have to put you under for the next one,” Marty had said. “We’re going to do an exploratory procedure to see why your vision and hearing aren’t working right. The engineers think it’s a power connection since that’s the only thing that would account for malfunctions in both. The power distribution built into your bionic processor is reading normal, but they want to check that, too.” Privately, Marty thought there was substance to the idea that the malfunction was all in Glenn’s mind, but the test instruments indicated that at least with the visual prosthetic, the signals were simply not reaching the brain.
“But that’s not what you think, is it? Nik thinks it’s a mental block.”
“I’m not sure what to think. Dr. Pillarisetty is not one hundred percent certain about the psychosomatic issues, and as I said, the bioengineers want us to check some things.”
Glenn sat quietly for a few minutes. “How will you be able to tell if it’s working and I’m just ignoring it?”
“Well, I wouldn’t say you’re ignoring the implants.” After a moment, Marty said “Wait, I have an idea,” and left the room. He returned a few minutes later with a portable EEG machine.
After fitting the electrode cap over Glenn’s head, the two of them watched the multiple horizontal lines trace from left to right on the screen. Marty had him put a patch on his left eye, and then flashed a light in his right eye multiple times.
“Okay, now see here, this is the point where the light flashes occurred.” Marty pointed to a spot at the left of the screen. “To the right is an average of all of the flashes. You can see the regular bumps to the left as the visual information passes through the various neural pathways to get to your visual cortex. Now the left eye.”
Glenn moved the patch to his right eye. All he could see was gray nothingness, not even the random flashes he normally got when his eyelids were closed.
“Okay, take the patch off and look. I flashed the light ten times and you never reacted.” Sure enough, the traces on the screen showed only random fluctuations instead of the regular peaks and troughs of the visual signal processing. “Now the hearing.”
He handed Glenn a set of headphones, and for the next few minutes he listened to clicks and beeps or different pitches. When they were finished, Marty showed him a screen comparing the signals recorded as each ear was tested.
“See, here with the right ear you have the clicks, the low and the high frequency beeps. You can tell the difference in the two frequencies by the spacing of the peaks. Now on the left you get some of the appropriate bumps for the clicks and beeps, but not the rest of the information. We think a signal’s getting in, but you’re just not decoding it properly.”
“This procedure will fix that?”
“If it’s connectivity, yes.”
“And if not?”
“We cross that bridge when we come to it.” Marty started coiling up the wires from the EEG machine. “Now let’s get this off of you. The nurse will be in here in a few minutes to shave your head for surgery.”
“Again.”
“Yes, again. I don’t know why you’re complaining, Shep. You have a full head of hair, yet you wear it in a buzz-cut, and run your hand through it like a brush all the time. Your left hand, I might remind you.” Marty cocked an eyebrow at him, then rapped a knuckle against his own bald head and ruffled the fringe of hair at the sides.
“Yeah, well, it feels funny now when it’s completely shaved.”
“Sucks to be you, doesn’t it?”
“Right there,” the surgeon said, pointing to the magnified view of Glenn’s left eye.
“Scar tissue?” asked Marty. The two stood off to the side while another surgeon and technologist worked on the auditory prosthetic.
“Not necessarily. It looks like gliosis—but that doesn’t usually happen in the eye. All neurons are surrounded by glial cells. They provide metabolic and structural support and even provide protection where they form the blood-brain barrier. It’s not uncommon to see glial cells encapsulate a recording electrode. However, this doesn’t look like encapsulation and I’m not seeing individual cells.” The surgeon spoke a command to the viewer and it zoomed in on the membrane covering the electrode grid resting on Glenn’s retina.
“That looks fibrous. Just like scar tissue. So, what’s the difference?”
“Yes, that’s what it looks like, but scar tissue like that doesn’t normally grow in a neural environment. Gliosis might occur if the cells grow too much, but what this looks like is the sort of posterior capsule opacity we sometimes see after a cataract lens replacement. This can’t be exactly the same, because we completely removed the lens and its capsule to implant the camera system. However, in those cases, cells just like the ones lining the interior of the eye itself start to grow in the capsule where the natural lens used to be. On the other hand, we certainly disturbed the interior of the ocular space enough to cause some sort of overgrowth.”
“Ok, I can understand that. It’s a natural body defense mechanism, then. What do we do about it, and why doesn’t this happen with other implant patients?”
“Well, we can burn the cells off with an ocular surgery laser. Out of deference to your electronics, we have to do it through an incision on the side instead of going in through the lens. As for why? How long did you wait to have him start using it?”
“He had an extensive rebuild, and the first time we turned everything on, he was overloaded. After that, I didn’t want him to have to adjust to everything at once. I waited for the incisions to heal, and then he was struggling with arm and legs, so we waited some more.”
“Two months? Three? Four?”
“Um . . . we tried it again at six months . . . and it’s been about a year since the last surgical procedure. Why?”
“We see gliosis and scarring around purely passive, record-only electrodes. The small amount of current going through a stimulating electrode usually works to minimize overgrowth. He wasn’t fully activating the system, and it allowed the membrane to grow.”
“So, long term, it should be okay as long as he uses the implant?”
“It should, and we can treat it if it does. That all presumes that he doesn’t actually have a psychological block, like the ear.”
“Actually, he doesn’t have a purely psychological block there, either,” came a voice from the other side of the surgical table.
Marty turned to address the other surgeon who was looking at a scan of Glenn’s brainstem. “What do you see?”
“This, right here.” He indicated a dark spot on the scan right where the spinal cord began to swell into the medulla oblongata. “There was a clot right here above the cochlear nucleus. Now don’t worry, it’s just a spot of necrotic tissue putting pressure on the nucleus and affecting the signals from the cochlea itself. I’m going to laser ablate the mass, hopefully that will relieve the pressure. Otherwise, you’re going to have to go with a surface electrode directly on the auditory cortex.”
“Okay, Dan. Go ahead, once Adrian finishes in the eye. Then we’ll see what Glenn can tell us after he wakes up.”
It wasn’t that simple or that fast. The technology team insisted on doing more tests while they had direct access to the implants, but after twelve hours in surgery and another four in recovery, Marty sat quietly in the darkened room as Glenn slowly opened his eyes.
“Damn, but that’s bright!” Glenn said, then flinched at the sound of his own voice.
Marty reached out and touched a control on his tablet. “I’ve turned down your low-light sensitivity for now,” he whispered.
“You don’t need to shout,” Glenn said in a quiet voice.
“Ah, I take it I can turn down the audio sensitivity as well.” He touched another control, and then commanded the room lights to return to normal illumination. “There, how’s that?”
“Wow,” was all Glenn said for a moment. After several minutes just looking around the room, he continued. “It seems to be getting less sensitive. The room was much too bright at first, but it’s better now. If I look at something for a few moments, it becomes clearer.”
“That’s the active feedback system in the visual sensors. Now that everything is working, the camera that replaced your iris activates electrodes that directly stimulate your retina. However, there’s a processing chip to help you sort through the light levels, distance vision and focus. That’s what you just experienced.”
“And my hearing?”
“More pre-processing there. Cochlear electrodes are ‘known tech’ but we gave you a lot more selective attention and filtering, and built all of that into the outer part of the ear when we rebuilt the cartilage and skin.”
“Oh, good, something works. Your facial nerves have regenerated just fine.” There was a dark note of sarcasm in Marty’s voice. “Makes sense, since you’re a touchy son of a bitch. Well, I have news for you, buddy. When I said one hundred percent, I meant it. Everything is turned on and functioning.”
“I can’t see anything! I can’t hear anything!”
“Whine, whine, whine. Tell me, flyboy, how do you tell the difference between a pilot and a jet engine? Well, they both whine, but at least the engine is going somewhere!” He put his hands on his hips and glared back. “So, what are you going to do about it?”
“I can’t walk! You assured me I’d be able to do this by now.”
“Are you really trying? I saw your legs move when you had your eyes closed and weren’t thinking so much.”
“I tried! Just like I took off the patch this morning and tried to see. Nothing! You failed.” Glenn broke down in sobs. “I failed.”
“Ah, so that’s what it is. The Mars mission.” Marty placed a hand on Glenn’s shoulder and let him take the time to work through the emotions.
“I asked them. They had two launch windows, now, and in six months. I petitioned to be allowed back on the team. In six months, I would have been ready.”
“I’m not so sure.”
Glenn looked back and glared at him again. Both eyes were focused, distinguishable only by the faintest reflection in the iris of the left eye. “I can do this.”
“Physically? Yes. Psychologically? You’ve got a massive chip on your shoulder. What’s that about?”
“Yvette.” He practically spat the name. “She stole my mission. By leaving now, they have to take her instead of waiting for me.”
“I’m not sure you’re being fair to her. She didn’t want the mission. I didn’t talk to her, but the Space Force general—Boatright—did, and he said she turned it down.”
“Oh, she’s always done this—didn’t want the emergency medicine fellowship, but the moment I applied for it, there she was, and got it. She said she didn’t want Chief Resident, but got that, too. Eventually we shared it, but she had better ratings from the attendings than I did despite the fact that I consistently outscored her. We always argued over patient care and cases. She even accused me of trying to push her aside and take over. She left the Force to be a civilian space contractor, and immediately broke up with me because I didn’t follow her.”
“Back up. You said you were fighting and she accused you of undermining her.”
“Yes, but lovers fight, and make up, and fight, and make up again. At the time we thought that was all it was. But she left the military, yet somehow ended up back on the Moon as Medical Officer.”
“Well, Moonbase is a civilian posting, these days.”
“Uh huh, sure. How many civilian CMOs have they had in the past ten years?”
“One. But then, they’ve only had two other CMOs, and you were one of them.”
“Sure. Okay, fine. She took the job, though. Probably jumped at it the moment it was offered.”
“Not quite. They asked her three times before she said yes.”
“Yeah, that’s her pattern. Anyway, that’s when I realized that her career has been driven by competition with me. And spite. So don’t tell me that wanting to turn off my ventilator was her way of wanting me to live.”
“I wouldn’t say that . . .”
“Don’t tell me she had my best interests at heart, either, Marty. She didn’t want to call you in. She didn’t want to stabilize me to get me back to Earth. Back when we were residents at Petersen AFB, a young airman came into the ER late on a Saturday night. He’d been in a car crash. The impact pulverized the bone in one leg. I argued for amputation of the leg due to the multiple fractures, bone fragments and damage to blood vessels. Yvette wanted to use hyperbaric therapy, and argued that they could save the leg if they could keep the tissues oxygenated. I countered that the shattered bones could not be adequately repaired and the young man would be confined to a wheelchair. With a prosthetic, he could return to work as an aircraft mechanic. She disagreed; the man’s military career was over. She sneered at me—was I recommending that they amputate the man’s fractured ribs and cracked jaw as well?”
“You can think what you want about her motivations, but she reacted instinctively and saved your life back then. She was conflicted. Her heart told her one thing, but her medical training told her another. Even that was in conflict—end your pain, or save your life? When I first saw you, I was amazed at how well she’d stabilized you for transport. She personally convinced Space Force to get that experimental SFX shuttle up there to get you back down to the ground in minimum time and no transfers. She wasn’t your personal physician anymore, but she cared enough to give you the best possible chance.”
“She’s going to Mars. In my place. Especially because it’s my place.”
“Yes, she is, because you’re not ready. Your time will come.”
“No. It won’t. Read this.”
Glenn handed the envelope over to Marty, and the doctor pulled the official stationery out and started to read. “. . . heroic rescue . . . risk of life . . . severe injuries . . . Purple Heart . . . Wow, you’ve been awarded a Silver Star!”
“Keep reading, Doc.”
“Coast Guard Gold Lifesaving Medal? Yeah, that fits. Morykwas was Guard, and he’s alive because of you.”
“Nope. That’s not it. Besides, that’s a civilian medal. It should be a clue.”
“. . . promotion to full colonel . . . needs of the service . . . potential contribution to the mission . . .” Marty looked up in shock. “They’re retiring you? General Boatright promised me that you would just be on standby reserve until you recovered. What is this?”
“It gets better . . . or . . . something.”
“Psychologically unfit for duty! What the hell? Is this Pillarisetty’s doing?”
“Actually, no. There was a medical competency hearing, and his was the lone dissenting voice. A board made up of headshrinkers and flight docs from the Space Force, Air Force, and Navy held a kangaroo court and drummed me out of the Service.”
“Why wasn’t I consulted?” Marty asked. “I’m the one who knows your whole progress, not a bunch of people who’ve never even met you.”
“They were all military docs. Nik was included only because he’s considered Veteran’s Administration hospital staff.” Glenn’s voice was filled with resignation. “Notice who else signed it. She’s back in uniform, at least as a reservist. It’s confirmation bias in action. We’re trying to make a point here, but their minds are—and in particular, her mind is—already made up.”
“I’m sorry, Shep.” Marty put the letter back in the envelope and put it on a bedside table. He walked over and put his hand on Glenn’s shoulder. “I know how much this meant to you, showing people that they shouldn’t be afraid of the risks inherent in space exploration. I admit that I thought going to Mars as anything other than a proof-of-concept demonstration was a long shot, but you’d think that after what’s been invested in you, they’d at least see it through.”
Marty sat down on the edge of the bed and stayed silent for a while in sympathy with his patient . . . and friend. A few moments later, he had a thought.
“Wait . . . does this mean they’re not going to pay for any of this?”
The anxiety on Marty’s face made Glenn snort. Laughter was still out of the question, but there was a small bit of humor in the doctor’s expression. “No, they’re still paying—at least the part my trust fund didn’t cover. General Boatright insisted on that part.”
“Oh, good, because you’re expensive, Shep.”
“Six million dollars?” It referred to a popular TV show from almost seventy years ago. It was also the amount he’d drawn from the trust fund account created from his father’s and mother’s insurance policies and supplemented over the years by his aunt and uncle, not to mention capable financial advisors.
“Oh, you are so, so far beyond that, my friend.”
They lapsed back into silence for several more minutes before Glenn spoke again. “Marty? Let’s prove them wrong.”
“Yes,” Dr. Martin Spruce replied. “Let’s do exactly that!”
CHAPTER 7:
The Doll Factory
Scott K @Kman549
Y’all already know I’m a neuro nerd, but did anyone else see the article in Rehabilitation Journal? The new neural control prosthetics are *amazing*!
DARPA @YesDARPA
@Kman549, if you think that’s amazing, wait until you see what’s coming next!
ChirpChat, March 2041
Despite numerous setbacks, and Glenn’s occasionally bleak attitude, the therapy had progressed well—he was walking, albeit with the assistance of a cane for stability, and could even use that cane with his artificial arm.
Dr. Pillarisetty thought the issues with vision and hearing were psychological, and had been working with him to train himself to see and hear again. Even though the interfaces were perfectly functional, they were not a perfect match to purely biological connections. The human brain could be trained to use the new inputs, but the patient had to want to do so. Many hours of counseling with Nik—one of the few people who would not be swayed by Glenn’s self-pity—were beginning to pay off.
“We’re going to have to put you under for the next one,” Marty had said. “We’re going to do an exploratory procedure to see why your vision and hearing aren’t working right. The engineers think it’s a power connection since that’s the only thing that would account for malfunctions in both. The power distribution built into your bionic processor is reading normal, but they want to check that, too.” Privately, Marty thought there was substance to the idea that the malfunction was all in Glenn’s mind, but the test instruments indicated that at least with the visual prosthetic, the signals were simply not reaching the brain.
“But that’s not what you think, is it? Nik thinks it’s a mental block.”
“I’m not sure what to think. Dr. Pillarisetty is not one hundred percent certain about the psychosomatic issues, and as I said, the bioengineers want us to check some things.”
Glenn sat quietly for a few minutes. “How will you be able to tell if it’s working and I’m just ignoring it?”
“Well, I wouldn’t say you’re ignoring the implants.” After a moment, Marty said “Wait, I have an idea,” and left the room. He returned a few minutes later with a portable EEG machine.
After fitting the electrode cap over Glenn’s head, the two of them watched the multiple horizontal lines trace from left to right on the screen. Marty had him put a patch on his left eye, and then flashed a light in his right eye multiple times.
“Okay, now see here, this is the point where the light flashes occurred.” Marty pointed to a spot at the left of the screen. “To the right is an average of all of the flashes. You can see the regular bumps to the left as the visual information passes through the various neural pathways to get to your visual cortex. Now the left eye.”
Glenn moved the patch to his right eye. All he could see was gray nothingness, not even the random flashes he normally got when his eyelids were closed.
“Okay, take the patch off and look. I flashed the light ten times and you never reacted.” Sure enough, the traces on the screen showed only random fluctuations instead of the regular peaks and troughs of the visual signal processing. “Now the hearing.”
He handed Glenn a set of headphones, and for the next few minutes he listened to clicks and beeps or different pitches. When they were finished, Marty showed him a screen comparing the signals recorded as each ear was tested.
“See, here with the right ear you have the clicks, the low and the high frequency beeps. You can tell the difference in the two frequencies by the spacing of the peaks. Now on the left you get some of the appropriate bumps for the clicks and beeps, but not the rest of the information. We think a signal’s getting in, but you’re just not decoding it properly.”
“This procedure will fix that?”
“If it’s connectivity, yes.”
“And if not?”
“We cross that bridge when we come to it.” Marty started coiling up the wires from the EEG machine. “Now let’s get this off of you. The nurse will be in here in a few minutes to shave your head for surgery.”
“Again.”
“Yes, again. I don’t know why you’re complaining, Shep. You have a full head of hair, yet you wear it in a buzz-cut, and run your hand through it like a brush all the time. Your left hand, I might remind you.” Marty cocked an eyebrow at him, then rapped a knuckle against his own bald head and ruffled the fringe of hair at the sides.
“Yeah, well, it feels funny now when it’s completely shaved.”
“Sucks to be you, doesn’t it?”
“Right there,” the surgeon said, pointing to the magnified view of Glenn’s left eye.
“Scar tissue?” asked Marty. The two stood off to the side while another surgeon and technologist worked on the auditory prosthetic.
“Not necessarily. It looks like gliosis—but that doesn’t usually happen in the eye. All neurons are surrounded by glial cells. They provide metabolic and structural support and even provide protection where they form the blood-brain barrier. It’s not uncommon to see glial cells encapsulate a recording electrode. However, this doesn’t look like encapsulation and I’m not seeing individual cells.” The surgeon spoke a command to the viewer and it zoomed in on the membrane covering the electrode grid resting on Glenn’s retina.
“That looks fibrous. Just like scar tissue. So, what’s the difference?”
“Yes, that’s what it looks like, but scar tissue like that doesn’t normally grow in a neural environment. Gliosis might occur if the cells grow too much, but what this looks like is the sort of posterior capsule opacity we sometimes see after a cataract lens replacement. This can’t be exactly the same, because we completely removed the lens and its capsule to implant the camera system. However, in those cases, cells just like the ones lining the interior of the eye itself start to grow in the capsule where the natural lens used to be. On the other hand, we certainly disturbed the interior of the ocular space enough to cause some sort of overgrowth.”
“Ok, I can understand that. It’s a natural body defense mechanism, then. What do we do about it, and why doesn’t this happen with other implant patients?”
“Well, we can burn the cells off with an ocular surgery laser. Out of deference to your electronics, we have to do it through an incision on the side instead of going in through the lens. As for why? How long did you wait to have him start using it?”
“He had an extensive rebuild, and the first time we turned everything on, he was overloaded. After that, I didn’t want him to have to adjust to everything at once. I waited for the incisions to heal, and then he was struggling with arm and legs, so we waited some more.”
“Two months? Three? Four?”
“Um . . . we tried it again at six months . . . and it’s been about a year since the last surgical procedure. Why?”
“We see gliosis and scarring around purely passive, record-only electrodes. The small amount of current going through a stimulating electrode usually works to minimize overgrowth. He wasn’t fully activating the system, and it allowed the membrane to grow.”
“So, long term, it should be okay as long as he uses the implant?”
“It should, and we can treat it if it does. That all presumes that he doesn’t actually have a psychological block, like the ear.”
“Actually, he doesn’t have a purely psychological block there, either,” came a voice from the other side of the surgical table.
Marty turned to address the other surgeon who was looking at a scan of Glenn’s brainstem. “What do you see?”
“This, right here.” He indicated a dark spot on the scan right where the spinal cord began to swell into the medulla oblongata. “There was a clot right here above the cochlear nucleus. Now don’t worry, it’s just a spot of necrotic tissue putting pressure on the nucleus and affecting the signals from the cochlea itself. I’m going to laser ablate the mass, hopefully that will relieve the pressure. Otherwise, you’re going to have to go with a surface electrode directly on the auditory cortex.”
“Okay, Dan. Go ahead, once Adrian finishes in the eye. Then we’ll see what Glenn can tell us after he wakes up.”
It wasn’t that simple or that fast. The technology team insisted on doing more tests while they had direct access to the implants, but after twelve hours in surgery and another four in recovery, Marty sat quietly in the darkened room as Glenn slowly opened his eyes.
“Damn, but that’s bright!” Glenn said, then flinched at the sound of his own voice.
Marty reached out and touched a control on his tablet. “I’ve turned down your low-light sensitivity for now,” he whispered.
“You don’t need to shout,” Glenn said in a quiet voice.
“Ah, I take it I can turn down the audio sensitivity as well.” He touched another control, and then commanded the room lights to return to normal illumination. “There, how’s that?”
“Wow,” was all Glenn said for a moment. After several minutes just looking around the room, he continued. “It seems to be getting less sensitive. The room was much too bright at first, but it’s better now. If I look at something for a few moments, it becomes clearer.”
“That’s the active feedback system in the visual sensors. Now that everything is working, the camera that replaced your iris activates electrodes that directly stimulate your retina. However, there’s a processing chip to help you sort through the light levels, distance vision and focus. That’s what you just experienced.”
“And my hearing?”
“More pre-processing there. Cochlear electrodes are ‘known tech’ but we gave you a lot more selective attention and filtering, and built all of that into the outer part of the ear when we rebuilt the cartilage and skin.”
