Robert Sawyer - Mindscan

I stood behind my seated mother, with a hand on her shoulder.

“What is it?” Mom asked. “A stroke? For God’s sake, Cliff is only thirty-nine. He’s too young for a stroke.”

“A stroke can happen at any age,” said Dr. Thanh. “But, although technically this w as a form of stroke, it’s not what you’re thinking of.”

“What then?”

“Your husband has a kind of congenital lesion we call an AVM: an arteriovenous malformation. It’s a tangle of arteries and veins with no interposing capillaries—normally, capillaries provide resistance, slowing down the blood-flow rate. In cases like this, the vessels have very thin walls, and so are prone to bursting. And when they do, blood pours through the brain in a torrent. In the form of AVM your husband has—called Katerinsky’s syndrome—the vessels can rupture in a cascade sequence, going off like fire hoses.”

“But Cliff never mentioned…”

“No, no. He probably didn’t know. An MRI would have shown it, but most people don’t have routine MRIs until they turn forty.”

“Damn it,” said my mother—who almost never swore. “We would have paid for the test! We—”

Dr. Thanh glanced up at me, then looked into my mother’s eyes. “Mrs. Sullivan, believe me, it wouldn’t have made any difference. Your husband’s condition is inoperable. AVMs in general affect only one in a thousand people, and Katerinsky’s affects only one in a thousand of those with AVMs. The sad truth is that the principal form of diagnosis for Katerinsky’s is autopsy. Your husband is actually one of the lucky ones.”

I looked over at my father, in the bed, a tube up his nose, another in his arm, his hair matted, his mouth hanging open.

“So, he’s going to be okay, then?” said my mother. “He’s going to get better?”

Dr. Thanh sounded truly sad. “No, he’s not. When the blood vessels ruptured, the adjacent parts of his brain were destroyed by the jet of blood pounding into the tissue. He’s…”

“He’s what?” demanded my mother, her voice full of panic. “He’s not going to be a vegetable, is he? Oh, God—my poor Cliff. Oh, Jesus God…”

I looked at my father, and I did something I hadn’t done for five years. I started to cry. My vision began to blur, and so did my mind. As the doctor continued to talk to my mother, I heard the words “severe retardation,” “total aphasia,” and “institutionalize.”

He wasn’t coming back. He wasn’t leaving, but he wasn’t coming back. And the last words of mine that ever would have registered on his consciousness were—

“Jake.” Dr. Thanh was calling my name. I wiped my eyes. She had risen and was looking at me. “Jake, how old are you?”

I’m old enough, I thought. I’m old enough to be the man of the house. I’ll take care of this, take care of my mother. “Seventeen.”

She nodded. “You should have an MRI, too, Jake.”

“What?” I said, my heart suddenly pounding. “Why?”

Dr. Thanh lifted her delicate eyebrows, and spoke very, very softly. “Katerinsky’s is hereditary.”

I felt myself starting to panic again. “You—you mean I might end up like Dad?”

“Just get the scan done,” she said. “You don’t necessarily have Katerinsky’s, but you might.”

I couldn’t take it, I thought. I couldn’t take living as a vegetable. Or maybe I did more than think it; the woman smiled kindly, wisely, as if she’d heard me say those words aloud.

“Don’t worry,” Dr. Thanh said.

“Don’t worry?” My mouth was bone dry. “You said this—this disease is incurable.”

“That’s true; Katerinsky’s involves defects so deep in the brain that they can’t be repaired surgically—yet. But you’re only seventeen, and medical science is galloping ahead—why, the progress we’ve made since I started practicing! Who knows what they’ll be able to do in another twenty or thirty years?”

There were perhaps a hundred people in the ballroom of Toronto’s Fairmont Royal York Hotel, and at least half of them had only a short time left to live.

Of course, being rich, those who were near death had mostly availed themselves of the best cosmetic treatments: face-lifts, physiognomic rebuilds, even a few facial transplants. I found it unsettling to see twenty-year-old visages attached to stooped bodies, but at least the transplants looked better than the ghastly tautness of one face-lift too many.

Still, I reminded myself, these were indeed cosmetic treatments. The faux -youthful faces were attached to old, decaying bodies—bodies thoroughly worn out. Of the elderly who were present, most were standing, a few were in motorized wheelchairs, some had walkers, and one had his legs encased in powered armatures while another wore a full-body exoskeleton.

Being old isn’t what it used to be, I thought, shaking my head. Not that I was old myself: I was just forty-four. Sadly, though, I’d used up my fifteen minutes of fame right at the beginning, without even being aware of it. I’d been the first baby born in Toronto on 1 January 2001—the first child of the new millennium. A much bigger fuss had been made over the girl who had popped out just after midnight on 1 January 2000, a year that had no significance save for ending in three zeros. But that was okay: the last thing I wanted to be was a year older, because a year from now, I might very well be dead. The old joke ran through my mind again:

“I’m afraid I’ve got some bad news,” said the doctor. “You don’t have long to live.”

The young man swallowed. “How much time have I got left?”

The doctor shook his head sadly. “Ten.”

“Ten what? Ten years? Ten months? Ten—?”

“Nine … Eight…”

I shook my head to dispel the thought and looked around some more. The Fairmont Royal York was a grand hotel, dating from the first glory days of rail travel, and it was enjoying a revival now that magnetic-levitation trains were flying along the old tracks. The hotel was across the street from Union Station, just north of Toronto’s lakeshore—and a good twenty-five kilometers east of where my parents’ house still stood. Chandeliers hung from the ballroom ceiling, and original oil paintings adorned the flock-papered walls. Tuxedoed servers were milling about offering glasses of wine. I went to the open bar and ordered a tomato juice heavily spiked with Worcestershire; I wanted a clear head this evening.

When I stepped away from the bar with my drink, I found myself standing next to an honest-to-goodness old lady: wrinkled face, white hair. Amid the surrounding denial and fakery, she was quite refreshing.

The woman smiled at me, although it was a lopsided smile—she’d clearly suffered a stroke at some point. “Here alone?” she asked. Her pleasant voice was attenuated into a Southern drawl, and it was also tinged by the quaver often found in the elderly.

I nodded.

“Me, too,” she said. She was wearing a dark jacket over a lighter blouse, and matching dark slacks. “My son refused to bring me.” Most of the other old folks had companions with them: middle-aged children, or lawyers, or paid caregivers. I glanced down, noted that she was wearing a wedding band. She apparently followed my gaze. “I’m a widow,” she said.

“Ah.”

“So,” she said, “are you checking out the process for a loved one?”

I felt my face quirk. “You might say that.”

She looked at me with an odd expression; I sensed that she’d seen through my comment, but, although curious, was too polite to press further. After a moment, she said, “My name’s Karen.” She held out her hand.