Neal Stephenson - Interface

"That is the name of the football team associated with this institution," Dr. Radhakrishnan said.

"Ah, yes, football," Salvador said, his memory jogged. He was showing all the signs of a man who had just flown in from some other hemisphere and who was trying to get cued into the local culture. "That's right, this must be high football territory. The pilot told me that we are on mountain time here. Is that correct?" "Yes. Two hours behind New York, one ahead of L.A." "I didn't know that such a time zone existed until this morning." "Neither did I, until I came here."

Salvador took a sip of coffee and sat forward, all business. "Well, I would love to indulge my weakness for endless small talk, but it would be wrong to waste your time, and it is rude for me to sit here being mysterious. I understand that you are the world's best brain surgeon."

"That is flattering but not exactly true. I could not even aspire to that tide unless I devoted myself to doing procedures."

"But instead you have chosen to devote your career to research."

"Yes."

"It is a common career choice among the very finest medical minds. There's more of a challenge in trying something new, isn't there?"

"In general, yes."

"Now, it is my understanding - and please correct me if I say something stupid - that you are developing a process to help persons who have suffered brain damage."

"Certain types of brain damage only," Dr. Radhakrishnan said, trying to be discouragingly cautious; but Mr. Salvador was not even slightly deterred.

"As I understand it you implant some kind of device in the damaged part of the brain. It connects itself to the brain on one side and to the nerves on the other, taking the place of damaged tissue."

"That is correct."

"Does it work with aphasia?"

"Pardon me?"

"A speech impediment - caused, say, by a stroke?"

Dr. Radhakrishnan was badly thrown off stride. "I know what aphasia is," he said, "but we do our work on baboons. Baboons can't talk."

"Suppose they could?"

"Speculatively, it would depend on the extent and the type of the damage."

"Dr. Radhakrishnan, I would appreciate it very much if you would listen to a tape for me," Salvador said, pulling a microcassette recorder out of his pocket.

"A tape of what?"

"Of a friend of mine who recently became ill. He suffered a stroke in his office. Now, as luck would have it, this took place while he was dictating a letter on a tape machine."

"Mr. Salvador, excuse me, but what are you getting at here?" Dr. Radhakrishnan said.

"Nothing really," Salvador said, good-humored and unruffled as if this were an entirely normal procedure.

"Are you about to ask me for some kind of a medical opinion?" "Yes."

Radhakrishnan had a canned speech cued up, about how the doctor/patient relationship was extremely solemn and how he could not even dream of diagnosing a patient without hours of examination and the all-important paperwork. But something stopped him from saying it.

It might have been Mr. Salvador's unpretentious and offhand manner. It might have been his personal elegance, his obvious status as a member of the upper class, which made it painful to bring up such banal issues. And it might have been the fact that he had been escorted here personally by Jackman, who would not have bothered to do so unless Mr. Salvador were very important. Mr. Salvador took Dr. Radhakrishnan's silence as permission. "The first voice you will hear will be that of my friend's secretary, who discovered him after the stroke." And he started the tape rolling. The sound quality was poor but the words were clear enough.

"Willy? Willy, are you all right?" The secretary sounded hushed, almost awed.

"Call." This command did not sound finished; the man wanted to say, "Call someone," but he could not summon forth the name. "Call whom?"

"Goddamn it, call her!" The man's voice was deep, his enunciation flawless. "Call whom?"

"The three-alarm lamp scooter." "Mary Catherine?" "Yes, goddamn it!"

"That's all there is," Mr. Salvador said, switching off the machine. Dr. Radhakrishnan raised his eyebrows and took a deep breath. "Well, based on this kind of evidence, it's difficult-"

"Yes, yes, yes," Mr. Salvador said, now sounding a bit annoyed, "it's hard for you to speculate and you can't say anything on the record and all that. I understand your position, doctor. But I attempting to engage you in a purely abstract discussion. Perhaps it would have been better if we had met over dinner, rather than in such a formal setting. We could arrange that, if it would help to get you in the right frame of mind."

Radhakrishnan felt miserably stupid. "That would be difficult to arrange in Elton," he said, "unless you are very fond of chili."

Mr. Salvador laughed. It sounded forced. But it was nice to make the effort.

"Speaking very abstractly, then," Dr. Radhakrishnan said, "if the stroke hit his frontal lobes, he may very well have personality changes, which my therapy could not fix. If that part of his brain was spared, then the cursing probably reflects frustration. Your friend, I would wager, is a successful and powerful man, and you imagine how such a man would feel if he could not even say simple sentences."

"Yes, that puts it in a new light."

"But I can't say much more than that without more data."

"Understood." Then, offhandedly, as if asking for directions to the men's room, Salvador said: "Can you fix the aphasia, then? Assuming your off-the-cuff diagnosis is correct."

"Mr. Salvador, I hardly know where to begin."

Mr. Salvador took out a cigar, a mahogany baseball bat of a thing, and scalped it with a tiny pocket guillotine. "Begin at the beginning," he suggested. "Care for a cigar?"

"To begin with," Dr. Radhakrishnan said, accepting the cigar, "there are ethical questions that entirely rule our performing an experimental procedure on a human subject. So far we've only done this on baboons."

"Let us do a little thought experiment in which we set aside, for the time being, the ethical dimension," Mr. Salvador said. "Then what?"

"Well, if a doctor were willing to do this, and the patient fully understood what he was getting into, we would first have to build the biochips. In order to do this we would have to take a biopsy a few weeks ahead of time, that is, take an actual sample of the patient's brain tissue, then genetically reengineer the nerve cells - in and of itself, hardly a trivial operation - and grow them in vitro until we had enough."

"You do that here?"

"We have an arrangement with a biotech firm in Seattle."

"Which one, Cytech or Genomics?"

"Genomics."

"What is their role?"

"They implant the desired chromosome and then culture the cells in vitro."

"They grow them in a tank," Mr. Salvador translated.

"Yes."

"How long does that phase last?"

"A couple of weeks usually. Cell culture is dodgy. Once we had gotten the cultured cells back from Seattle, we would fabricate the biochips."

"How long does that take?" Mr. Salvador was obsessed with time.

"A few days. Then we would proceed to the implantation."

"The actual operation."

"Yes."

"Tell me about that."

"We identify the dead portions of the brain and remove them cryosurgically. It's rather like a dentist drilling out a cavity, cutting away damaged material until he hits a sound part of the tooth."

Mr. Salvador winced exquisitely.

"When we do this on baboons, we do it in a specially con­structed operating room here that is not sterile. It is not even minimally fit for humans. So in order to do this operation on a human, it would be necessary to build a specially designed operating theater from scratch. The operating room would prob­ably cost more than this entire building in which we are sitting."