James Gunn - The Immortals

There is a kinship in old age, just as there is a kinship in infancy. Between the two, men differ, but at the extremes they are much the same.

Pearce had seen old men in the nursing units, Medicaid patients most of them, picked up on the North Side when they didn’t wake up in their cardboard boxes or Dumpsters, filthy, alcohol or drug addicts many of them. The only differences with this man were a little care and a few billion dollars. Where this man’s hair was groomed and snow-white, the other’s was yellowish-gray, long, scraggly on seamed, thin necks. Where this man’s skin was scrubbed and immaculate, the other’s had dirt in the wrinkles, sores in the crevices.

Gently Pearce laid the arm down beside the body and slowly stripped back the sheet. The differences were minor. In dying, people are much the same. Once this old man had been tall, strong, vital. Now the thin body was emaciated; the rib cage struggled through the skin, fluttered. The old veins stood out, knotted, ropy, blue, varicose, on the sticklike legs.

“Pneumonia?” Dr. Easter asked with professional interest. He was an older man, his hair gray at the temples, his appearance distinguished, calm.

“Not yet. Malnutrition. You’d think he’d eat more, get better care. Money is supposed to take care of itself.”

“It doesn’t follow. As his personal physician, I’ve learned that you don’t order around a billion dollars.”

“Anemia,” Pearce went on. “Bleeding from a duodenal ulcer, I’d guess. We could operate, but I’m not sure he’d survive. Pulse weak, rapid. Blood pressure low. Arteriosclerosis and all the damage that entails.”

Beside him a nurse made marks on a chart. Her face was smooth and young; the skin glowed with health.

“Let’s have a blood count,” Pearce said to her briskly. “Urinalysis. Type and cross-match two units of blood, packed RBCs if you can get them, and administer one unit when available.”

“Transfusion?” Easter asked.

“It may provide temporary help. If it helps enough, we’ll give him more, maybe strengthen him enough for the operation.”

“But he’s dying.” It was almost a question.

“Sure. We all are.” Pearce smiled grimly. “Our business is to postpone it as long as we can.”

A few moments later, when Pearce opened the door and stepped into the hall, Dr. Easter was talking earnestly to a tall, blond, broad-shouldered man in an expensively cut business suit. The man was about Easter’s age, somewhere between forty-five and fifty. The face was strange: It didn’t match the body. There was a thin, predatory look to its slate-gray eyes.

The man’s name was Carl Jansen. He was personal secretary to the old man who was dying inside the room. Dr. Easter performed the introductions, and the men shook hands. Pearce reflected that the term personal secretary might cover a multitude of duties.

“Doctor Pearce, I’ll only ask you one question,” Jansen said in a voice as flat and cold as his eyes. “Is Mister Weaver going to die?”

“Of course he is,” Pearce answered. “None of us escapes. If you mean is he going to die within the next few days, I’d say yes—if I had to answer yes or no.”

“What’s wrong with him?” Jansen asked. His tone sounded suspicious, but that was true of everything he said.

“He’s outlived his body. Like a machine, it’s worn out, falling to pieces, one part failing after another.”

“His father lived to be ninety-one, his mother ninety-six.”

Pearce looked at Jansen steadily, unblinking. “They didn’t accumulate several billion dollars. We live in an age that has almost conquered disease, but its pace has inflicted a price. The stress and strain of modern life tear us apart. Every billion Weaver made cost him five years of living.”

“What are you going to do—just let him die?”

Pearce’s eyes were just as cold as Jansen’s. “As soon as possible we’ll give him a transfusion. Does he have any relatives, close friends?”

“There’s no one closer than me.”

“We’ll need two pints of blood for every pint we give Weaver. Arrange it.”

“Mister Weaver will pay for whatever he uses.”

“He’ll replace it if possible. That’s the hospital rule.”

Jansen’s eyes dropped. “There’ll be plenty of volunteers from the office.”

When Pearce was beyond the range of his low, penetrating voice, Jansen said, “Can’t we get somebody else? I don’t like him.”

“That’s because he’s harder than you are,” Easter said. “He’d be a good match for the old man when he was in his prime.”

“He’s too young.”

“That’s why he’s good. The best geriatrician in the Middle West. He can be detached, objective. All doctors need a touch of ruthlessness. Pearce needs more than most; he loses every patient sooner or later. He’s got it.” Easter looked at Jansen and smiled ruthfully. “When men reach our age, they start getting soft. They start getting subjective about death.”

The requisition for one unit of blood arrived at the blood bank. The hospital routine began. A laboratory technician, crisp in a starched white uniform, came from the blood bank on the basement floor. From one of the old man’s ropy veins she drew five cubic centimeters of blood, almost purple inside the slim barrel of the syringe.

The old man didn’t stir. In the silence his breathing was a raucous noise.

Back at the workbench, she dabbed three blood samples onto two glass slides, one divided into sections marked A and B. She slipped the slides onto a light-box with a translucent glass top; to one sample she added a drop of clear serum from a green bottle marked “Anti-A” in a commercial rack. “Anti-B” came from a brown bottle; “Anti-Rho” from a clear one. She rocked the box back and forth on its pivots. Sixty seconds later the red cells of the samples marked A and B were still evenly suspended. In the third sample the cells had clumped together visibly.

She entered the results on her computer: patient’s name, date, room, doctor… Type: O. Rh: neg.

She pushed another key. A list of blood available wrote itself across the screen, grouped by types. The technician opened the right-hand door of the refrigerator and inspected the labels of the plastic bags on the second shelf from the top. She selected one and put samples of the donor’s and patient’s blood into two small test tubes.

A drop of donor’s serum in a sample of the patient’s blood provided the major crossmatch: the red cells did not clump, and even under the microscope, after centrifuging, the cells were perfect, even, suspended circles. A drop or two of the patient’s serum in a sample of the donor’s blood and the minor crossmatch was done.

On the label she wrote:

FOR

LEROY WEAVER 9–4

ICU DR. PEARCE

She telephoned the nurse in charge that the blood was ready when needed. The nurse came for the blood in a few minutes. She and the lab tech checked the name of the recipient, the blood type, and the identifying numbers of the blood unit and initialed the tag that hung from the bag. The lab tech stripped one copy for her file, and the nurse carried the bag away. At the nurses’ station she removed another copy and filed it in a drawer. Then, with a second nurse, she went to ICU and attached a copy of the tag to the patient’s chart before both reviewed the doctor’s orders and the patient’s identity, and compared the numbers on the patient’s identification bracelet with those on the unit of blood and on the tag.

Dr. Pearce studied the charts labeled “Leroy Weaver.” He picked up the report from the hematology laboratory. Red cell count: 2,360,000/cmm. Anemia, all right. Worse than he’d even suspected. That duodenal ulcer was losing a lot of blood.