Modern Medicine

Jack sat in the waiting room.  He pulled absently at his fingers, cracking each knuckle in turn – a habit he thought he’d given up as a teenager.  He wore his florescent works uniform – they’d allowed him an hour’s compassionate leave and he was already well past that.  It would take the transport nearly twenty minutes to get him back to South America.

He was a tall muscular man, a tattoo ran the length of his left arm, it read: “Carrie”.  His right arm was lacerated in an intricate criss-cross pattern down its entire length – evidence of how he made his living.

Looking around the cold, white room again, he saw an electronic sign that told patients the expected waiting time – now showing ten minutes for anyone with an Advantage card. 

He rubbed his hand over his shaved head and cracked his knuckles again.  He should have gone for the advantage card – he could have cut back on the beer a little, or worked a few extra hours.

A glance at the receptionist prompted a retaliatory glare back and then, remembering herself, painfully bent her mouth into a smile.

“Shouldn’t be too long now,” offered the receptionist, pre-empting his question.

It had been an hour since they’d taken Vicky in.  In his head he visited every possible nightmare scenario again and again.  There was a new virus on the news that affected young children, although he couldn’t remember what it was called – just a string of meaningless letters.

She was constantly tired – the slightest thing was suddenly a massive chore.  He’d dismissed it at first – but she was constantly falling.  Even climbing the stairs was a massive undertaking for her.

The doctors seemed clueless.

He wanted a name for the illness.  He wanted them to say that she had Virus A, or Disease B, and then to give him a bottle of small blue tablets with instructions for her to take them twice a day.  That’s how hospitals should work – not all this vague guesswork and blank looks.

“Mr. Altamon!”

Jack looked around to see a short nurse wearing a forced smile and carrying a clip-pad; her hair was tied tightly in a bow, and she repeatedly touched it – as though trying to balance it on her head.  She was a round woman with a flushed face and a distracted look.

Rather than looking at him – he was the only person waiting – she stared at her clip-pad, it’s bright glow bathing her face and, if it was possible, making her look even more flushed.  Jack stood, and she began walking through a door behind her, obviously expecting him to follow.

The nurse set a fast pace, considering her size.  She navigated a complex labyrinth of corridors and doors, never letting up the pace, and never looking back to see if Jack was following.

“Is she okay?” Jack asked.

They entered a long, empty corridor that seemed to stretch as far as he could see into the distance.

“I’m sorry, Mr…” she checked her clip-pad briefly, without breaking step, “Altamon.  You’ll have to discuss that with the Doctor,”

After walking along the seemingly endless corridor for a hundred yards or so, the nurse abruptly turned into a doorway.  He almost walked straight past her.

“Sir,” she called, impatiently.

He turned to see that she was stood at the entrance to a lift.  She waved her hand over a scanner and the door opened.  They entered and it slid shut behind. 

They stood inside a perfect cube.  Each wall was white, illuminated by the harsh lights in the ceiling panel.  The wall to Jack’s left as he faced the door was covered with room numbers.  The nurse leaned past him and pressed one.  Jack’s stomach lurched as the lift accelerated at speed.

The nurse saw his face and smiled, “Ever seen Omen II?” she asked.

Jack’s mouth dropped open, “Err… Sorry?”

“Never mind,” she replied, resuming her previous detached officiousness.

A pleasant female voice announced that they had arrived at floor ninety-two and the doors slid open.  Jack stepped out, and wondered if they had left the previous floor.  In front of, and behind them, bright white corridors stretched for as far as he could see, in exactly the same configuration as he’d seen before he’d entered the lift.

“Do these corridors ever end?”

“No,” replied the nurse.  Jack thought she would probably leave it at that, but she glanced at his face and obviously thought better of it. “They form the circumference of the building, which is a perfect circle.”

“You wouldn’t tell to look at them,”

“It’s a big building,”

The nurse walked across the corridor and entered a door directly facing the lift.  She stopped suddenly, and Jack nearly walked into her.

They had entered a large, empty, white room. 

“Your daughter is in that room, with the doctor,” said the nurse, pointing to Jack’s right.

He stared at the door for a minute.  The nurse seemed to fade away, and Jack knocked lightly on the clean, white door.  At the behest of a male voice he entered the room.

“Mr. Altamon?” said the Doctor, holding out his hand. “I’m Doctor Graham,”

Doctor Graham was a tall man; wisps of stray hair seemed to spill from somewhere on his head – although there was no obvious origin.

Jack shook the man’s hand.  The doctor glanced at the cut’s along Jack’s arm.

“You’re a lumberjack?”

“Yeah, I run the Nine Thousands,”

The Lumberjack 9000 was a new invention that could cut trees perfectly cleanly, chewing up the entire tree and grind it down to dust in thirty seconds.  But they needed people like him to operate it.  It worked fine most of the time, but occasionally a branch or animal would get caught in it.  It needed a team of strong, agile men and women to keep the machines running.  Every so often, one of the bigger animals would still be alive when they got wedged.

Jack looked around for his daughter.

“Your daughter is in the next room, Mr. Altamon.  I wanted to speak with you, privately, first,”

Jack suddenly felt weak.  Blood flowed from his head, his arms, his legs – his energy drained.  This evidently showed on his face, because the doctor gestured towards a chair close by.  He sat down, staring at the other man.

“Mr. Altamon, your daughter is very ill,”

“You know what it is?”

The doctor broke eye contact, casting around the room.

“Yes. Yes, we do,”

Jack waited, but the doctor didn’t seem to want to continue.

“Well?”

“Your daughter is showing early signs of an illness that I personally have never encountered before.  We had to send the test results off to the foundation for confirmation.  We thought that with the clinical screening before birth, and especially as you have Gold cover…” the Doctor paused, struggling for words that would not over commit him, “We’re surprised about the results,”

“What is wrong with her?” asked Jack, weakly. 

“She has an illness called Duchenne Muscular Dystrophy” replied the doctor.  “Mr. Altamon, I’m pleased to say that after the foundation brought in screening for all children with Gold cover and above, we were able to detect and filter out the specific genes and would cause this condition.  There hasn’t been a case in over sixty years.”

Jack gaped, “You’re pleased?”

“What I mean to say is that this is an illness of the past,” replied the doctor.

“So why wasn’t this picked up with Vicky then?” asked Jack, still unsure what he was being told.

“We…” the doctor took a very deep, steadying breath, “We don’t know.”

“And you’re pleased about that?”

“Sorry, I’ve phrased this very badly. What I’m trying to say, Sir, is that this illness in eradicated.  You’re daughter is the exception.”

“Your screening system doesn’t work then?” Jack said.

“We’re investigating,” The Doctor paused, “We suspect that it does in all but a very specific handful of cases,”

“I’m sorry, I don’t understand.”

“The condition is genetic.  For a female to inherit this condition was rare even before screening was introduced.  You and your wife may both be …” he trailed off as he saw Jack’s face.

“Is there a cure, can you do anything?”

“Yes, we can.  We can cure your daughter.  It’s a relatively simple procedure, as well.”

The doctor smiled broadly, evidentially back on familiar ground.

Jack breathed out a long slow sigh of relief.  “Thank God for that!” he smiled, “I thought you were going to tell me something terrible then!”

The Doctor smiled, indulgently again in response.

“Okay, what is it?  Is it painful?”

“Not at all.  What we do is take Vicky’s DNA and filter the offending gene from the sample.  We then perform a memory scan and upload the data to a clone,”

“Clone?”  Jack’s expression narrowed in a mixture of suspicion and confusion.

“Yes.  Effectively, your daughter will be transferred over to the new, clean, body,”

Jack’s head swam.  He wished that Carrie was here.  She’d always been the one to deal with these decisions – to make the difficult choices.  She’d have stayed calm and asked every single question that would later occur to him.  But Carrie wasn’t here any more, and he just said nothing.

“The procedure is totally painless, and Vicky will not even be aware it has happened.  As far as she’s concerned, the procedure will simply be to fall asleep in one place and wake up in another,”

“You said that you’re not even sure your filtering system works properly – what makes you think it’ll work this time,” Jack asked.

The doctor smiled broadly, “Mr. Altamon, while there may, or may not, have been an error in the automated screening process, we can be totally confident that the manual process to filter this will be completely successful,”

What would Carrie have asked?

“What if you don’t do it?”

“The disease could lead to your daughter being unable to work.  It will drastically shorten her life expectancy and she will probably be unable to walk within a couple of years,”

Jack went cold.  He thought about Carrie again.  She’d been nearly thirty when they’d asked her to volunteer for a labour camp, because she couldn’t work.  Since the screening program had been introduced, anybody of working age that was not working was encouraged to join government funded work camps. 

He’d heard rumours about what went on there – there was never any proof, just rumours and untimely deaths.  Carrie had spent three years in a camp before she had died.  They told him that she’d suffered a heart attack, brought on by her illness.  Jack has asked to see the body and his request had been refused.

Just after Carrie’s death he’d been approached by a group calling itself “Right to Freedom”.  They gave him a leaflet with some gut wrenching claims about how the weak and disabled were used for experimentation.  He’d dismissed it at the time – the government wouldn’t be allowed to do something like that. 

The memory of Carrie prodded him, “What if some of it were true, Jack?  Would you want Vicky to go through what I did?”

Jack stood up unsteadily, “Okay, do it then.”

The Doctor smiled and made some notes.  He swivelled the paper round and proffered the pen to Jack, “Just sign there, please.”

Vicky had been allowed home.  The doctor had suggested starting the procedure the following week, as the symptoms weren’t critical.  They sat in an auto-cab, travelling along the slow lane.  Auto-cabs always used the slow lane, because the fare was by the hour, not by the mile.  Through the glass roof they could see the traffic in the middle lane whizzing past.  Vicky liked to count them.

“How many is that, Vicks?” Jack asked.

Vicky held up her hands; they were fists, and she uncurled the fingers slowly and clumsily, counting each one.

“Whoh, twoo, three, five, sheveh, nine, sisteen!” she looked triumphantly at Jack, “Daddy!  Sisteen!”

“Sixteen – do you have that many fingers?”

“Confirm destination: 856 Block 3, Section 9,” demanded the auto-cab.

“Confirm,” Jack replied, then he looked at Vicky, “Wait – cancel,”

“Destination cancelled, please state new destination,”

“New destination: 98 Block 6, Section 1,”

“That destination is a food complex.  Do you wish to accept direct marketing?” intoned the auto-cab.

“How much?” Jack asked.

“Eight credits will be deducted from the fare,”

“Okay,”

The cab filled with light and sound as the jingles for each of the restaurants in the food hall took turns in persuading them to eat there.

– COME TO JILLY’S BURGERS AND KEBABS –

– AT RANDOLF’S, THE FOOD’S GOOD AND THE ENTERTAINMENT’S BETTER –

– YETI’S ICECREAM.  YOU HAVEN’T TASTED ANYTHING LIKE IT…  YETI –

“Daddy, do we have to go back to the hospital?”

“Yes, we have to go back next week.  When we go back they’ll make you better again,”

“Will it hurt?” she asked.

Jack pulled her onto his knee.

“Would I let anything hurt you?”

She smiled and waited patiently for her favourite advert.  When it came on she began singing along.  He just stared out of the window.  He’d made the same promise to her mother, but hadn’t kept it – he’d been too scared to challenge the authorities.  He vowed silently that he would never let it happen again.


“Mr. Altamon!” said a small man with bulging eyes and a bright red waistcoat, peeking out from his crisp white doctor’s coat.

“Yes, hello,”

“Could you wait here please, Sir?”

The doctor looked down at Vicky and proffered his chubby hand.  “Would you like to come with me, please?”

Vicky just stared at him.

“Little Girl,” he said, in a way that suggested he was convinced the reason she hadn’t answered was that she didn’t realise he was speaking to her.

Vicky gripped Jack’s hand.

“Daddy?” she said, nervously.

“It’s okay, Vicks,” Jack replied, “You go with this man, and I’ll be waiting for you when you’re done,”

“Come with me!” she begged.

Jack looked down at her pleading eyes.

“Is it okay?” he asked the small man.

“I’m afraid we don’t allow that, Sir,” he looked again at Vicky, “Come with me, please, Little Girl.”

Jack thought that they must not get very many children in here.

“Her name’s Vicky,” Jack offered.

“Is it,” replied the Doctor.

“Go on, Vicks,” Jack gently pushed her towards the man.  She wondered off after him, looking back to check Jack hadn’t left.

It was two hours later when Jack approached the receptionist.  It was the same woman that he had seen the first time.

“Can you give me an idea of how much longer this might take?”

The woman looked up from her screen.  She stared at Jack for two or three seconds before responding.

“Usually finished in half an hour or so,” she replied, curtly.

She stared at Jack for a few seconds more, a look of distaste crossing her features, then shook her head and returned to the screen.

“I’m sorry, have I offended you in some way?”

“No,” she replied, in a tone that clearly meant the opposite.

“What is it?”

“Okay, I shouldn’t say this – I might even get the sack – I don’t care any more – but people like you sicken me,” she answered.

Jack stood there for a few seconds, mouth agape.

“I think you’ve confused me with someone else.  I’m just here with my daughter.” He paused, then added, “She’s having an operation,”

The nurse smiled. “Operation – is that what you call it?”

“I don’t understand.  You work here.  Why would you object to my daughter having an operation that will save her life?”

“Save her life?” asked the nurse, incredulously, “More like euthanasia for the imperfect!”

Jack felt numb.

“I don’t understand – what are you saying?”

“You do know what this ‘operation’ entails, don’t you?” the nurse asked, locking Jack’s gaze.

Jack thought: did he know what the operation entailed?  Very roughly he did, but not in any kind of detail; not in as much detail as he should have.

“It’s some kind of filtering process on the genes in the body to remove the illness,” he replied, half as a question.

“That’s right, it’s some kind of filtering process,” she looked again at Jack, here eyes softening now, “You really don’t know, do you?”

Something about the way she asked sent a wave of ice washing across the back of his head and through his spine.  He felt like he was Wile E Coyote and had run off a cliff about thirty yards back – now he realised there was nothing beneath him.

“Please, just tell me what it is that you’re getting at,” his voice broke, “It’s my daughter in there,”

Her voice lowered slightly and she talked quickly.

“Okay, you’re correct about the filtering process.  They scan every molecule in the body and run it through a filter to remove the imperfections.  The filtered molecules are then copied and constructed without the imperfections.  The reconstruction is, to all intents and purposes, the same as the original,”

Jack looked puzzled, “So what’s the problem?”

“The original,”

As he heard the word, jack suddenly realised what he’d agreed to.

“Where is she?”

Jack ran from the waiting room, his heart pounding, his head numb.  The nurse had said to turn right and follow the corridor as far as it went; the operating room was one floor below.

Jack burst out of the stairwell and pushed the door to the operating room.  The room was locked.  He stepped back and kicked at the door, but it wouldn’t move.

The handle rattled and the door swung away.  In front of Jack stood a tall man, wearing ill-fitting glasses, and a white coat that was too short for him.

“Can I help you, Sir?” asked the man, completely ignoring the pounding on the door.

“You have my daughter in there!”

“You’re Victoria Altamon’s father?”

“Yes,”

“We’re in the middle of a procedure here.  You will be able to see you daughter when we are finished.  I’m sure all of this has been explained to –”

“I want to see her now,”

“I don’t think that’s wise, Sir,” answered the Doctor, looking a little flustered now.

“I don’t care!”

“As I said, we’re in the middle – “

“…Of a procedure.  Yes – I heard you!” snapped Jack.

“Of an irreversible procedure,” finished the doctor.

“Let me in!”

The Doctor stood back, nervously and Jack brushed past him into a crisp, wide and bright room.  Two other people were in the room, operating computer terminals; they didn’t look around.  Jack could see that one of them was the Doctor that had collected Vicky earlier.

In the centre of the room was a bed.  Vicky was laid on the bed, asleep; Jack exhaled. 

Jack looked round to the Doctor, “I’m so sorry, I thought – “

“Daddy!”

Jack swung round, looking at the sleeping Vicky, and she was still asleep.

“That’s okay, Mr. Altamon, now if you could – “

“Daddy!”

Jack looked at Vicky again – she was still sleeping soundly.  Then he noticed a tent-like structure at the far corner of the room.

“Daddy!”

The voice was coming from there.

“What’s in that tent?”

“Mr. Altamon, you really must leave now,”  the Doctor took Jack’s arms and began guiding him towards the door.

“What’s in the tent?” Jack shouted, pulling away from the doctor.

He headed to the tent.

“Daddy!” Vicky shouted as he approached.

He looked back and the sleeping figure, and then into the tent; the two were identical.

“Vicks!” Jack said, feeling dizzy.

Jack looked at the Doctor, “What have you done?”

“Mr. Altamon, this procedure was explained to you beforehand, and you agreed to it,” offered the Doctor.

“No!  No it wasn’t.  You never said anything about two of her!  Why is she in a tent?”

“Mr. Altamon, you’ve come in half way through the procedure.  The process to filter out the bad genes involves copying all the existing molecules in the body and filtering the bad ones out.  Once that is done, we must destroy the original,”

“Destroy!”  Jack’s eyes were wild, “You mean you are going to kill her?”

“No, it’s very humane.  We simply remove the oxygen from the tent.  She will just feel sleepy,”

“You’d better let her out of there.  Now!” Jack said slowly, squaring up to the doctor and challenging him.  The memory of what had happened to Carrie, and how he’d stood by and watched, welled up.

“Mr. Altamon, I’m afraid we can’t do that.  At this stage in the procedure we have two subjects that are identical,”

“Okay – well I’ll take them both home!”

“You don’t understand.  They aren’t identical in the way that you understand identical.  They are not simply alike, they are the same person,”

“What’s the difference?” Shouted Jack, “This is obscene!  You should never have been allowed to do this!”

“Look, Mr. Altamon, I understand your distress.  If you’ll calm down for a second then I’ll try to explain,”

“You’re killing my daughter, if you don’t get her out of there, I’ll rip your fucking head off!”

Jack was now stood fully square to the doctor, and was within inches of his face.  Suddenly the door behind Jack opened and two large security men came through.  Realising the situation, they immediately took hold of Jack and held him.

There was a scuffle and, although Jack was a big man, he couldn’t free himself from the two men.

“Mr. Altamon,” continued the doctor, looking very relieved, “What I was trying to explain is that your daughter’s memories and personality will exist in the sleeping version over in the corner.  As soon as she wakes up, she’ll be your daughter,”

“What’s in this tent then?”

“This is the defective version of your daughter,”

“I didn’t agree to you killing her!  I want to take her home – both of them!”

“I’m trying to tell you that you can’t!  They are the same person,”

“So you keep saying, but they won’t be for long, they’ll have different experiences, which will make them different.  The one in the corner won’t have the memory of being in this gas chamber, for example!”

“Yes, she will!” answered the doctor.  “That’s what I’m trying to tell you.  Look, there are parts of this procedure that even we don’t understand yet, but we know that once every molecule in the body is duplicated, the two subjects are the same.  We have done experiments showing that they both experience the same things, even when one of them is not present.  Consistently, they react in the same way to events.  Having them both would be unthinkable!”

“I’ll find you!” 

The doctor looked taken aback, and Jack seized his chance, “I’ll find you and kill you.”

“Get him out!” shouted the doctor.

The two men dragged Jack from the room.

“What happened?” asked the receptionist after the security guards had deposited Jack back in the waiting room.

“I threatened to kill them and they threw me out.”

“I might be able to do something,” she replied, picking up the phone.

“Hi, is that Amy? … Jane … Yeah … Listen, do you want an exclusive?”

The receptionist – Jane, replaced the receiver, and then picked it up again and dialed a much shorter number.

“I’ve just called the press – they’ll be here shortly to speak to Mr. Altamon… yes… I understand.”

Jane replaced the receiver, stood up calmly and unhooked her coat from where it hung at the side of the room. As she walked away from her desk, she turned briefly to Jack: “Your daughter will be out in a minute.” She walked a few more paced and turned again, “Thankyou!”

Jack looked up as the Doctor entered the waiting room.

“Well?” asked Jack, now resigned.

“You got your wish, Mr. Altamon,” replied the Doctor.

“What do you mean?”

“We were advised that you may have a legal case if we continued with the procedure, and so we stopped it.”

Jack sat back and took a long breath out, “Thank you!”

“Mr. Altamon, I feel very strongly that this was the wrong course of action, and I believe you will concur once you appreciate exactly what the consequences are.  We have never had this situation with humans before,”

“I don’t want to argue the case any more, Doctor.  I just want to take my daughter – my daughters – home.”

From behind the Doctor, a young nurse escorted two small girls into the room.  They were completely identical versions of Vicky.

“Vicks!” he shouted.  The two girls began running, but something was wrong.  They were running like they couldn’t see straight.

Jack looked at the Doctor, “What’s wrong with them?”

“Nothing is wrong with them, they are just struggling to orient themselves,”

“What do you mean, orient themselves?” asked Jack, as the girls finally managed to locate him, and hugged him at the same time.

“Daddy,” they said at exactly the same time.

“Okay, let’s go,” said Jack, standing up and starting the walk out.

“Mr. Altamon!” called the Doctor.

Jack turned.

“This is your last chance.  Once you leave the hospital, we will not be able to correct this, should you change your mind,” he added, “That would be murder.”

“What you were about to do was murder!”

“Please reconsider,”

“Don’t worry about us,”

As he moved again towards the door, the girls turned and walked directly into one another.

“What’s wrong with them!” Jack asked again.

“I’ve explained to you.  They can not orient themselves.  So far, they’ve only ever seen the world from a single pair of eyes, but now, they see it from two detached pairs,”

“You mean that they can both see out of each others eyes?” replied Jack, confused.

“No, Mr. Altamon, that’s not what I mean.  As I tried to explain to you earlier, these are not two separate children.  They are a single child with two separate bodies,”

Jack looked confused.  “I don’t understand,”

“Allow me to demonstrate, if it will convince you to change your mind,” the Doctor walked across and took one of the girls by her arm, leading her across the reception area and through a door.

The other Vicky tried to follow, but Jack held her back.  Suddenly, she said, “A big square!”

The Doctor opened the door and beckoned Jack.  As Jack passed through to door, the second Vicky handed him a card with a large square drawn on it, as the did so, the child next to him make the same hand gesture.

“Mr. Altamon, legally, these are two separate children.  While they both live, they will have to live together, to go everywhere together.  They will behave exactly the same in every conceivable situation.  If you try to separate them, it would have the same effect as one of your eyes suddenly being on the back of your head.

“She is young, so she will adapt to this, but she will never be able to hold a job, never be able to have any form of relationship.  Also, one of these girls may die in several years of the original disease she was brought in for.  At that point, the other will be old enough to be permanently affected by the experience.  The survivor will die, but will still live.

“We don’t know what the effect of this will be!”


The grey mist settled over the cemetery.  It was a cold Tuesday morning, and the tiny grave was surrounded by a large crowd.  Photographers and journalists vied for positions close to Jack and Vicky.  Jack was quietly crying.

“Who’s died, Daddy?” Vicky asked, holding Jack’s hand and looking towards him with concern.  “Did we know them?”

“I don’t know,” he replied, holding her tightly.


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