She stared again at all the machinery, and momentarily wondered why it had ever been invented.
Why couldn"t they just let people die?
And yet, she realized with sudden clarity, even though she understood the reality of Alex"s situation, she would never simply let him die.
If she were going to, she would have done it already. During the last two hours there had been plenty of opportunities. All she would have had to do was turn off the respirator. Alarms would have gone off, but she could have dealt with that. And it wouldn"t have taken long-only a minute or two.
But she hadn"t done it. Instead, she"d simply sat there battling her feelings of despair, strengthening her resolve not to let him die, and whispering encouraging words to Alex as she held his hand.
And even though part of her still insisted that Alex was already dead, the other part of her, the part that was determined that he should live, was growing stronger by the hour.
Suddenly the door opened, and Barbara Fannon stepped into the room, closing the door behind her.
"Ellen? It"s eight o"clock-you"ve been here all night."
Ellen turned her head. "I know."
"Marsh is in Frank"s office. They have the test results. They"re waiting for you."
Ellen thought about it for a moment, then slowly shook her head. "No," she said at last. "I"ll stay here with Alex. Marsh will tell me what I need to know."
Barbara hesitated, then nodded. "I"ll tell them," she said, then let herself out of the room, leaving Ellen alone with her son.
"It"s bad," Frank Mallory said. "About as bad as it can get, I"m afraid."
"Let"s see." Marsh"s whole body felt drained from the shock and exhaustion of the last hours, but for some reason his mind was perfectly clear. Slowly and deliberately he began going over the results of all the tests and examinations that had been administered to Alex during the long night.
Mallory was right-it was very bad.
The damage to Alex"s brain was extensive. Bone fragments seemed to be everywhere, driven deep into the cortex. The cerebrum showed the heaviest damage, much of it apparently centered in the temporal lobe. But nothing seemed to have escaped injury-the parietal and frontal lobes showed extensive injury as well.
"I"m not an expert at this," Marsh said, though both he and Mallory were well aware that many of the ramifications of Alex"s injuries were obvious.
Mallory decided to take the direct approach. "If he lives at all, he won"t be able to walk or talk, and it"s doubtful that he"ll be able to hear. He may be able to see-the occipital lobe seems to have suffered the least amount of damage. But all that"s almost beside the point. It"s highly doubtful if he"ll be aware of anything going on around him, or even be aware of himself. And that"s if he wakes up."
"I don"t believe that," Marsh replied, fixing Mallory with cold eyes.
"Don"t, or won"t?" Mallory countered gently.
"It doesn"t make any difference," Marsh replied. "Everything"s going to be done for Alex that is humanly possible."
"That goes without saying, Marsh," Frank Mallory said, his voice, reflecting the pain Marsh"s words had caused. "You know there isn"t anyone here who wouldn"t do his best for Alex."
If Marshall heard him, he ignored him. "I want you to start by getting hold of Torres, down in Palo Alto."
"Torres?" Mallory repeated. "Raymond Torres?"
"Is there anyone else who can help Alex?"
Mallory fell silent as he thought about the man to whom Marsh was considering turning over his son.
Raymond Torres had grown up in La Paloma, and though there was little question in anyone"s mind of the man"s brilliance, there were, and always had been, many questions about the man himself. He had left La Paloma long ago, remaining in Palo Alto after medical school, returning to La Paloma only to see his mother-old Maria Torres. And even his visits visits to her were rare. There was a feeling in La Paloma that Torres resented his mother, that she was little more to him than a constant reminder of his past, and that, if there was one thing Torres would like to ignore, it was his past. In La Paloma he was primarily regarded as a curiosity: the boy from behind the mission who had somehow made good. to her were rare. There was a feeling in La Paloma that Torres resented his mother, that she was little more to him than a constant reminder of his past, and that, if there was one thing Torres would like to ignore, it was his past. In La Paloma he was primarily regarded as a curiosity: the boy from behind the mission who had somehow made good.
Beyond La Paloma, he had become, over the years, something of an enigma within the medical community. To his supporters, his aloofness was a result only of the fact that he devoted nearly every waking hour to his research into the functioning of the human brain, while his detractors attributed that same aloofness to intellectual arrogance.
But for all the questions about him, Raymond Torres had succeeded in becoming one of the country"s foremost authorities on the structure and functioning of the human brain. In recent years, the thrust of his research had changed slightly, and his primary interest had become reconstuctive brain surgery.
"But isn"t most of his work experimental?" Mallory asked now. "I don"t think a lot of it has even been tried on human beings yet."
Marshall Lonsdale"s desperation was reflected in his eyes. "Raymond Torres knows more about the human brain than anybody else alive. And some of the reconstruction work he"s done is just this side of incredible. I"d say it was was incredible if I hadn"t seen the results myself. I want him to work on Alex." incredible if I hadn"t seen the results myself. I want him to work on Alex."
"Marsh-"
But Marsh was on his feet, his eyes fixed on the pile of X rays, CAT scans, lab results, graphs, and other doc.u.mentation pertaining to the damage his son"s brain had sustained. "He"s still alive, Frank," he said. "And as long as he"s alive, I have to try to help him. I can"t just leave him alone-you can see what he"ll be like as well as I can. He"ll be a vegetable, Frank. My G.o.d, you told me so yourself just now. Nothing can hurt him anymore, Frank. All Torres can do is help. Call him for me. Tell him what"s happened, and that I want to talk to him. Just talk to him, that"s all. Just get me in to see him."
When Frank Mallory still hesitated, Marshall Lonsdale spoke once more. "Alex is all I have, Frank. I can"t just let him die."
When he was alone, Frank Mallory picked up the phone and dialed the number of Raymond Torres"s office in Palo Alto, twenty miles away. After talking to him for thirty minutes, he finally convinced Torres to see Marsh Lonsdale and look at Alex"s case.
The doctor made no promises, but he agreed to talk, and to look.
Privately, Frank half-hoped Torres would turn Marsh down.
CHAPTER FIVE.
Exhaustion was overtaking Marsh, and he was beginning to feel that the situation was hopeless. He"d been in Raymond Torres"s offices for most of the day, and for most of the day he"d been by himself. Not that it hadn"t been interesting; it had, despite the overriding fear for his son"s life that had never left his consciousness since the moment he had arrived that morning.
He"d stared at the Inst.i.tute through bleary eyes. The building itself was a b.a.s.t.a.r.d-it had obviously started out as a home, and an imposing one. But from the central core of the mansion-for a mansion it had been-two wings had spread, and no attempt had been made to make them architecturally compatible with the original structure. Instead, they were sleekly functional, in stark contrast with the Georgian ma.s.siveness of the core. The buildings were surrounded by a sprawling lawn dotted with trees, and only a neat bra.s.s plaque mounted on the face of a large rock near the street identified the structure: INSt.i.tUTE FOR THE HUMAN BRAIN INSt.i.tUTE FOR THE HUMAN BRAIN.
Inside, a receptionist had led him immediately to Raymond Torres"s office, where he"d turned all of Alex"s records over to the surgeon himself, who, without so much as glancing at them, had given them to an a.s.sistant. When the a.s.sistant had disappeared, Torres had offered him a chair, then spent what Marsh thought was an unnecessarily long time lighting his pipe.
It took Marsh only a few seconds to decide that there was nothing of Torres"s scientific reputation in either his manner or his bearing. He was tall, and his chiseled features were carefully framed by prematurely graying hair in a manner that seemed to Marsh more suitable for a movie star than a scientist. The star image was further enhanced by the perfectly cut tan silk suit Torres wore, and the cool casualness of his posture. For all his fine credentials, the first impression Raymond Torres gave his visitor was that of a society doctor more interested in the practice of golf than in the practice of medicine.
Nor was Marsh"s instinctive dislike of the man alleviated by the fact that once the pipe was lit, the meeting had lasted only long enough for Torres to tell him that there would be no decision made until his staff had been able to a.n.a.lyze Alex"s case, and that the a.n.a.lysis would take most of the day.
"I"ll wait," Marsh had said. From behind his desk, Raymond Torres had shrugged with apparent disinterest. "As you wish, but I could just as easily call you when I"ve come to a decision."
Marsh had shaken his head. "No. I have to be here. Alex is my only child. There"s...well, there"s just nowhere else for me to go."
Torres had risen from his chair in a manner that Marsh found almost offensively dismissive. "As I said, as you wish. But you"ll have to excuse me-I have a great deal to do this morning."
Marsh had stared at the man in stunned disbelief. "You"re not even interested in hearing about the case?"
"It"s all in the records, isn"t it?" Torres had countered.
"Alex isn"t in the records, Dr. Torres," Marsh had replied, his voice trembling with the effort to control his anger. Torres seemed to consider his words for a moment, but didn"t reseat himself, and when he finally replied, his voice was cool. isn"t in the records, Dr. Torres," Marsh had replied, his voice trembling with the effort to control his anger. Torres seemed to consider his words for a moment, but didn"t reseat himself, and when he finally replied, his voice was cool.
"I"m a research man, Dr. Lonsdale. I"m a research man because, as I discovered long ago, I don"t have much of a bedside manner. There are those, I know, who don"t think I relate to people very well. Frankly, I don"t care. I"m interested in helping people, not in coddling them. And I don"t have to know the details of your son"s life in order to help him. I don"t care who he is, or what he"s like, or what the details of his accident were. All I care about are the details of his injuries, so that I can make a reasonable judgment about whether or not I can help him. In other words, everything I need to know about your boy should be in his records. If there is anything missing, I-or someone on my staff-will know, and do whatever has to be done to rectify the matter. If you want to spend the rest of the day here, just in case we need you, I have no objection. Frankly, I doubt we"ll need you. If we need anybody, it will be the patient"s attending physician."
"Frank Mallory."
"Whoever." Torres shrugged disinterestedly. "But feel free to stay. We have a comfortable lounge, and you"ll certainly find plenty to read." Suddenly he smiled. "All of it, of course, having to do with our work. One thing I insist on is that the lounge be well stocked with every article and monograph I"ve ever written."
Offended as he was by the man"s open pride in himself, Marsh managed to keep silent, for without Torres, he knew there was no hope for Alex at all. And by two o"clock that afternoon he"d become totally convinced that whatever Raymond Torres lacked in personal warmth, he more than made up for in professional expertise.
The articles he"d read-and he"d read at least thirty of them, forcing himself to maintain his concentration through the interminable hours-covered a wide field of interest. Torres had not only made himself an expert on the structure of the brain, but he had also become a leading theorist on the functioning of the brain as well. In dozens of articles, Torres had described cases in which he"d found methods with which to circ.u.mvent damaged areas of a brain, and utilize other, healthy areas to take over the functions of the traumatized tissue. And through it all ran one constant theme-that the mysteries of the human brain were, indeed, solvable, but that the potentialities of the brain were only just being discovered. Indeed, he"d summed it up in a few sentences that had particularly intrigued Marsh: The backup systems of the brain appear to me to be almost limitless. Long ago, we discovered that if a portion of the brain fails, another portion of the same brain can sometimes take over the function of the failed portion. It is almost as if each area of the brain not only knows what every other area does, but can perform that work itself if it really has to. The problem, then, seems to be one of convincing a damaged brain not to give up, and, further, of making it aware of its own problems so that it may redistribute its work load among its healthy components.
Marsh had read and reread that article several times when the receptionist suddenly appeared, smiling warmly at him.
"Dr. Lonsdale? Dr. Torres will see you now." He put the journal aside and followed the neat young woman back to Torres"s office. Nodding a greeting, Torres beckoned him to a chair near his desk. In another chair, already seated, was Frank Mallory.
"Frank? What are you doing here?"
"I asked him to come," Torres replied. "There are some things I have to review with him."
"But Alex-"
"He"s stable, Marsh," Frank told him. "There haven"t been any changes in his condition for several hours. Benny"s there, and a nurse is always in the room."
"If we may proceed," Torres interrupted. He turned toward a television screen on a table next to his desk. The screen displayed a high-resolution photograph of a human brain.
"It"s not what you think it is," Torres said. Startled, both Marsh Lonsdale and Frank Mallory glanced toward Torres.
"I beg your pardon?" Frank asked.
"It"s not a photograph. It"s a computer-generated graphic representation of Alexander Lonsdale"s brain." He paused a beat; then: "Before the accident."
Mallory"s gaze shifted back to the screen. "Here"s what happened," he heard Torres"s voice say. "Or, more exactly, here"s a reconstruction of what happened." He typed some instructions into the keyboard in front of him, and suddenly the image on the monitor began to move, turning upside down. Then, at the bottom of the screen, another shape came into view. As the three of them watched, the image of the brain came into contact with the other object, and suddenly began to distort. It was, Marsh realized, just like watching a movie of someone"s head being smashed against a sharp rock.
In slow motion, he could see the skull crack, then splinter and begin to cave in.
Beneath the skull, brain tissue gave way, part of it crushed, part of it torn. Fragments of skull broke away, lacerating the brain further. Frank Mallory and Raymond Torres watched in silence, but Marsh was unable to stifle a groan of empathic pain. Suddenly it was over, and the brain was once again right-side-up. And then, as Torres tapped more instructions into the computer, the image changed again.
"Christ," Mallory whispered. "That"s not possible."
"What is it?" Torres demanded.
"It"s Alex"s head," Mallory breathed. Marsh, his face ashen, gazed at Mallory, but the other man"s eyes remained fixed on the screen. "It"s his head," Mallory breathed. "And it looks just the way it did when they brought him into the hospital. But...how?"
"We"ll get to that," Torres replied. Then: "Dr. Mallory, I want you to concentrate on that image very hard. This is very important. How close is that picture to what you saw when they brought the patient in?" He held up a cautioning hand. "Don"t answer right away, please. Examine it carefully. If you need me to, I can rotate the image so you can see it from other angles. But I need to know how exact it is."
For two long minutes, as Marsh looked on in agonized silence, Mallory examined the image, asking Torres to turn it first in one direction, then in another. At last he nodded. "As far as I can tell, it"s perfect. If there are any flaws, I can"t see them."
"All right. Now, the next part should be easier for you. Don"t say anything, just watch, and if there"s anything that doesn"t look as you remember it, tell me."
As they watched, the image came to life once more. A forceps appeared and began removing fragments of bone from the brain. Then the forceps was gone, and a probe appeared. The probe moved, and a small bit of brain tissue tore loose. Mallory winced.
It went on and on, in agonizing detail. For each fragment of bone that was removed from the wound, a new wound was inflicted on Alex"s brain. And then, after what seemed an aeon, it was over.
Frank Mallory was staring at an exact image of Alex"s brain after he"d finished cleaning his wounds.
"Well?" Torres"s voice asked.
Mallory heard his own voice shake as he spoke. "Why did you show me that? Just to prove my incompetence?"
"Don"t be ridiculous," Torres snapped. "Aside from the fact that I don"t need to waste my time with such a thing, you"re not an incompetent. In fact, you did as good a job under the circ.u.mstances as could have been expected. What I need to know is whether that reconstruction was accurate."
Mallory chewed his lip, then nodded. "I"m afraid so. I"m sorry-I was doing my best."
"Don"t be sorry," Torres remarked coldly. "Just think about it."
"It"s accurate," Mallory a.s.sured him. "Now, can you tell us how you did it?"
"I didn"t do it," Torres replied. "A computer did it all. For the last"-he glanced at the clock on his desk-"six hours, we"ve been feeding the computer information. Much of it the results of the CAT scan your lab did in La Paloma. Fortunately, that was a good job too. But our computer goes a lot further than yours. Your machinery can display any aspect of the brain, from any angle, in two dimensions. Ours is much more sophisticated," he went on, and suddenly his eyes, so cool and aloof until now, took on a glowing intensity. "Once it had all the data, it was able to reconstruct everything that happened to Alexander Lonsdale"s brain from the first impact to the time of the CAT scan. For ourselves, an educated guess would have been the best we could do. We would have been able to extrapolate the approximate shape of the traumatizing instrument, and the probable angle from which it struck. And that would have been about all. But the wounds are extensive, and the computer is designed to handle a great many variables simultaneously. According to the computer, what you just saw is 99.624 percent accurate, given that the input was accurate. That"s why I wanted you to look at the reconstruction. If there were any basic errors in the data, they would have been magnified by the extrapolation process to the point where you"d have seen something significantly in error. But you didn"t, so we can a.s.sume that what we saw is what happened." didn"t do it," Torres replied. "A computer did it all. For the last"-he glanced at the clock on his desk-"six hours, we"ve been feeding the computer information. Much of it the results of the CAT scan your lab did in La Paloma. Fortunately, that was a good job too. But our computer goes a lot further than yours. Your machinery can display any aspect of the brain, from any angle, in two dimensions. Ours is much more sophisticated," he went on, and suddenly his eyes, so cool and aloof until now, took on a glowing intensity. "Once it had all the data, it was able to reconstruct everything that happened to Alexander Lonsdale"s brain from the first impact to the time of the CAT scan. For ourselves, an educated guess would have been the best we could do. We would have been able to extrapolate the approximate shape of the traumatizing instrument, and the probable angle from which it struck. And that would have been about all. But the wounds are extensive, and the computer is designed to handle a great many variables simultaneously. According to the computer, what you just saw is 99.624 percent accurate, given that the input was accurate. That"s why I wanted you to look at the reconstruction. If there were any basic errors in the data, they would have been magnified by the extrapolation process to the point where you"d have seen something significantly in error. But you didn"t, so we can a.s.sume that what we saw is what happened."
While Mallory sat in silence, Marsh voiced the question that was in both their minds. "Why is that important? It seems to me that what comes next is what we should be concerned with."
"Exactly," Torres agreed. "Now, watch carefully. What you"re about to see is going to be at high speed, but it"s what we think we can do for Alexander."
"Everyone calls him Alex," Marsh interjected.
Torres"s brows arched slightly. "Very well. Alex. It makes no difference what we call him." He ignored the flash of anger in Marsh"s eyes, and his fingers once more flew over the keyboard. The picture began to change again. As the two doctors from La Paloma watched in fascination, layers of brain tissue were peeled back. Certain tissue was removed entirely; some was simply maneuvered back into place. The chaos of the wound began to take on a semblance of order, and then, slowly, the mending process began, beginning deep within the medulla and proceeding outward through the various lobes of the brain. At last it was over, and the image on the screen was once again filled with the recognizable shape of a human brain. Certain areas, however, had taken on various shades of red, and Marsh"s frown reflected his puzzlement.
"Those are the areas that are no longer functional," Torres told him before he could ask his question. "The pale pink ones are deep within the brain, the bright red ones on the surface. The gradations, I think, are obvious."
Mallory glanced at Marsh, whose attention seemed totally absorbed by the image on the screen. Finally he turned to Torres, his fingers interlaced beneath his chin. "What you"ve shown us is pure science fiction, Dr. Torres," he said. "You can"t cut that deep, and make repairs that extensive, without killing the patient. Beyond that, it appears to me that what you"re proposing to do is to reconstruct Alex"s brain, even to the extent of repairing nerve cells. Frankly, I don"t believe you or anyone else can do that."
Torres chuckled. "And, of course, you"re right. I can"t do that, nor can anybody else. Unfortunately, I"m much too large, and my hands are much too clumsy. Which is why Alexan-Alex," he corrected himself, "is going to have to be brought here." He switched off the monitor and rose from his chair. "Come with me. I want to show you something." he corrected himself, "is going to have to be brought here." He switched off the monitor and rose from his chair. "Come with me. I want to show you something."
They left Torres"s office and walked down a corridor that led to the west wing of the building. A security guard looked up at them as they pa.s.sed, then, recognizing Torres, went back to gazing at the television monitor at his desk. Finally they turned into a scrub room, beyond which was an operating room. Wordlessly Torres stood aside and let the two others precede him through the double doors.
In the center of the room was an operating table, and against one wall was the customary array of O.R. equipment-all the support systems and monitors that both Marsh and Frank Mallory were used to. The rest of the room was taken up with an array of equipment the likes of which neither of them had ever seen before.
"It"s a computerized microsurgical robot," Torres explained. "In the simplest terms possible, all it does is reduce the actions of the surgeon-in this case, me-down from increments of millimeters into increments of millimicrons. It incorporates an electron microscope, and a computer program that makes the program you just saw look like simple addition in comparison to advanced calculus. In a way," he went on, the pride in his voice belying his words, "with the development of this machine, I"ve reduced myself from being a brain surgeon to being little more than a technician. The microscope looks at the problems, and then the computer a.n.a.lyzes them and determines the solutions. Finally it tells me what to attach to what, and I make the movements relative to an enlarged model of the tissue. The robot reduces my motions and performs the procedures on the real tissue. And it works. Physically, that machine and I can repair much of the damage done to Alex Lonsdale"s brain."
Marsh studied the equipment for several minutes, then turned to face Torres once again. When he spoke, his voice clearly reflected the uncertainty he was feeling. "What are the chances of Alex surviving the operation?"
Torres"s expression turned grim. "Let"s go back to my office. The computer can tell us that, too."
No one spoke again until they were back in the old core building, with the door to Torres"s office closed behind them. Marsh and Frank Mallory took their seats, and Torres switched the computer back on. Quickly he began entering a series of instructions, and then the monitor flashed into life: .