Robert Sawyer: The Terminal Experiment

The phone rang in Peter Hobson’s dorm room. “We’ve got an eater,” said Kofax’s voice. “You up for it?”

An eater. A dead person. Peter was trying to get used to Kofax’s callousness. He rubbed sleep from his eyes. “Y-yes.” He tried to sound more confident: “Sure,” he said. “Sure thing.”

“Mamikonian’s going to start the slice-and-dice,” said Kofax. “You can ride the EKG. That’ll take a good hunk out of your practicum requirements.”

Mamikonian. Stanford-trained transplant surgeon. Sixty-something, hands steady as a statue’s. Organ harvesting. Christ, yes, he wanted in on that. “How soon?”

“Couple of hours,” said Kofax. “Kid’s on full life support — keep the meat fresh. Mamikonian is out in Mississauga; it’ll take him that long to get here and prepped.”

Kid, he’d said. Some kid’s life cut short.

“What happened?” asked Peter.

“Motorcycle accident — kid was thrown through the air when a Buick sideswiped him.”

A teenaged boy. Peter shook his head. “I’m in,” he said.

“OR 3,” said Kofax. “Start prep in an hour.” He hung up. Peter hurried to get dressed.

He wasn’t supposed to do it, Peter knew, but he couldn’t help himself. On the way to the OR, he stopped at Emergency Admitting and checked the aluminum clipboards in the swivel-mounted rack. One guy being sewn up after going through a plate glass window. Another with a broken arm. Knife wound. Stomach cramps. Ah—

Enzo Bandello, seventeen.

Motorcycle accident, just as Kofax had said.

A nurse sidled up to Peter and looked over his shoulder. Her name badge said Sally Cohan. She frowned. “Poor kid. I’ve got a brother the same age.” A pause. “The parents are in the chapel.”

Peter nodded.

Enzo Bandello, he thought. Seventeen.

In trying to save the boy, the trauma team had given him dopamine and had deliberately dehydrated him, in hopes of reducing the brain swelling normally associated with a severe head wound. Too much dopamine, though, would damage the heart muscle. According to the chart, at 2:14 A.M., they’d begun flushing it from his body and fluids were being pumped in. Latest reading showed his blood pressure was still too high — an effect of the dopamine — but it should come down soon. Peter flipped pages. A serology report: Enzo was free of hepatitis and AIDS. Blood count and bleeding studies looked good, too.

A perfect donor, thought Peter. Tragedy or miracle? His parts would save the lives of a half dozen people. Mamikonian would take the heart out first, a thirty-minute operation. Then the liver — two hours’ work. Next, the renal team would remove the kidneys, another hour’s cutting. After that, the corneas. Then the bones and other tissues.

There wouldn’t be much left to bury.

“Heart’s going to Sudbury,” said Sally. “Crossmatching was excellent, they say.”

Peter put the clipboard back into the carousel and walked through the double doors that led to the rest of the hospital. There were two equally good routes to OR 3. He chose the one that went by the chapel.

He was not a religious person. His family, back in Saskatchewan, was white-bread Canadian Protestant. Last time Peter had been in church was for a wedding. Time before that, a funeral.

He could see the Bandellos from the hallway, seated in a middle pew. The mother was crying softly. The father had an arm around her shoulders. He was a deeply tanned man wearing a plaid work shirt with cement stains on it. A bricklayer, perhaps. A lot of Toronto’s Italians of his generation worked in construction. They’d come over after World War II, unable to speak English, and had taken hard-labor jobs to make a belter life for their kids.

And now this man’s kid was dead.

The chapel was denominationally neutral, but the father was looking up, as if he could see a crucifix on the wall, see his Jesus hanging there. He crossed himself.

Somewhere in Sudbury, Peter knew, there was a celebration going on. A heart was coming; a life would be saved. Somewhere there was joy.

But not here.

He continued on down the corridor.

Peter arrived at the scrub room. Through a large window, he could see into the operating theater. Most of the surgical team was already in place. Enzo’s body had been prepped: his torso shaved, two layers of rust-colored iodine painted on, clear plastic stretched over the surgical field.

Peter tried to get a look at that which the others had been trained to ignore: the face of the donor. Not much of it was visible; most of Enzo’s head was covered by a thin sheet, exposing only the ventilator tube. The transplant team was deliberately kept ignorant of the donor’s identity — made it easier, they said. Peter was probably the only one who knew the boy’s name.

There were two scrub sinks outside the OR. Peter began the regulation eight minutes of washing, a digital timer above the sink counting down the time.

After five minutes, Dr. Mamikonian himself arrived and began scrubbing at the second sink. He had steel-gray hair and a lantern jaw — more like an aging superhero than a surgeon.

“You are?” asked Mamikonian as he scrubbed.

“Peter Hobson, sir. I’m a grad student in biomedical engineering.”

Mamikonian smiled. “Good to meet you, Peter.” He continued to scrub. “Forgive me for not shaking hands,” he said, chuckling. “What’s your role today?”

“Well, for our course work we’re supposed to log forty hours of real-world experience with medical technology. Professor Kofax — he’s my thesis advisor — arranged for me to operate the EKG today.” He paused. “If that’s all right with you, sir.”

“That’s fine,” said Mamikonian. “Watch and learn.”

“I will, sir.”

The counter above Peter’s sink bleeped. He wasn’t used to this; his hands felt raw. He held his dripping arms out at chest height. A scrub nurse appeared with a towel. Peter took it, dried his hands, then stepped into the sterile green gown she was holding for him.

“Glove size?” she asked.

“Seven.”

She tore open a package, removed the latex gloves, and snapped them onto his hands.

Peter entered the OR. Overhead, a dozen people were watching through the glass ceiling from the observation gallery.

In the center of the room was a table holding up Enzo’s body. There were several tubes going into it: three volume lines, an arterial line to monitor blood pressure, a central venous line threaded into the heart to monitor hydration level. A young Asian woman sat on a stool, her eyes scanning the volume monitor, the CO2 monitor, and the volumetric infusion pump.

Until his arrival, the woman had also been watching the EKG oscilloscope mounted above Enzo’s head. Peter moved into position next to it and adjusted the contrast on the display. The pulse rate was normal, and there was no sign of damage to the heart muscle.

It chilled him. The guy was legally dead, and still he had a pulse.

“I’m Hwa,” said the Asian woman. “First time?”

Peter nodded. “I’ve been in on a few little things before, but nothing like this.”

Hwa’s mouth was covered by a face mask, but Peter could see her eyes crinkle in a smile. “You get used to it,” she said.

Across the room, an illuminated panel had Enzo’s chest X-ray clipped to it. The lungs hadn’t collapsed and the chest was clear. The heart, a silhouette in the center of the image, looked fine.

Mamikonian entered. All eyes turned to face him — the conductor for their orchestra. “Good morning, everyone,” he said. “Let’s go to work, shall we?” He moved in to stand over Enzo’s body.

“Blood pressure’s falling a bit,” said Hwa.

“Crystalloid fluid, please,” said Mamikonian, glancing at the readouts. “And let’s add a little dopamine back in.”