Am I Still There?, Page 2
James R. Hall
nodded, so Letzmiller continued. "Replacive surgery is actuallyquite old. Old as medicine itself, I suppose. Very early attempts atdentures were tried, though with little success. And, of course, peglegs and hooks for persons who had lost their hands might be calledreplacive surgery, though they were very crude. Later on came morerefined dentures, artificial limbs, corrective lenses, skull plates,hearing aids, plastic or cosmetic surgery, blood transfusions, alltypes of skin grafts, et cetera.
"The 1950s saw the beginning of bone and corneal transplants, use ofplastics in arteries, those huge heart-lung and kidney machines,implantation of electrodes in the heart to steady its beat--manythings which were mostly emergency or stop-gap measures. All throughthe late 1900s refinements continued to be made, but it wasn't until1988 that the fathers of replacive surgery, Doctors Mills, Levinsonand McCarty made the breakthrough that revolutionized the wholeconcept. In very simplified language they unlocked the key toproducing specialized living tissue through a bombardment of anextremely complex carbon compound with amino acids and electricity,then making it selective in function by a fantastically intricateapplication of radiation.
"That pulmonary replacement you received in 1991 was undoubtedly oneof the first successes. You were quite lucky, you know. Up until 2017,only about five per cent of their synthesized hearts lasted more thanthirty days. At any rate, the principle was established, and it wasproven that it could work. Most of our work from then till a few yearsago has been in improving and refining the work those three gooddoctors did over three hundred years ago."
Letzmiller's cigar had gone out, and he discarded it in favor of acigarette. "That would be the end of my history lecture, if it werenot for the nature of your trouble."
Lee looked at him closely. "Why's that?"
"Well, Mr. Lee, the big thing missing in that summation is theseemingly impossible task of synthesizing nerve tissue, especiallythat of the cerebral cortex. It's been approximated, at any rateclosely enough to give us good enough results to allow an artificialtissue to respond to brain signals about ninety-eight per cent as wellas the original would. But actual duplication? No. At least not untilabout three years ago. To tell you the truth, it is barely out of theexperimental stage."
"Experimental!"
* * * * *
"Yes, this will be the first complete replacement of a human brain.Oh, of course it has been done with animals, and it has beensuccessful with partial replacements on humans. But you will have thehonor of being the first human with a complete substitution."
Lee could not contain himself. "Doc, that's just it! There won't be asingle atom of me except what you fellows have conjured up--"
Letzmiller broke in mildly. "I think 'conjured' is hardly the properword, Mr. Lee."
"Well, of course, I didn't mean that. But don't you see what I'mdriving at? You could just as well start from scratch and duplicate mewithout bothering about going about it piecemeal. And what does thatmake me?"
The doctor had been looking at Lee intently, studying him through thisoutburst. "I think I see what you mean. And I can't answer you. Thequestion you raise may be philosophical, or metaphysical, but itcertainly isn't medical. And from a doctor's point of view completesubstitution is the only course open, risky as it may seem."
Lee mulled this over. Of course he knew surgery was the only solutionto his decaying mentality, actually the only alternative to hisbecoming a virtual idiot, and, shortly after that, dead. And he didnot want to die. He had lived a long time, but thanks to the methodsof Letzmiller, Gorss, and all their predecessors, he was as full ofjuice as he had been at thirty-five. But the question that keptplaguing him Letzmiller seemed determined to avoid. He didn'tunderstand very much about replacive surgery, really didn't care to.If Letzmiller said it could work, then he wasn't worried about that.Well, he guessed he really didn't have much choice. With thisrealization, he had only one more question for Letzmiller.
"Doc, if I'm not me when this is over, do you think I'll know it?"
Letzmiller looked at Lee's troubled face. "Do you think that you wouldwant to?"
Lee answered slowly. "No, no I guess not."
Letzmiller rose from his chair. "I'll talk to you again after theoperation. Do you think you're ready to go to your room now?"
Lee nodded and obediently followed the doctor.
* * * * *
Lee was asleep when the nurse came, but with the efficiency of allgood nurses since time immemorial, she woke him to give him thesedative to prepare him for surgery. She chattered brightly as sheprepared the hypodermic.
"You know, you have all the nurses speculating, Mr. Lee. I mean we'rewondering just what Dr. Lakin, he's the anesthesiologist, is going touse for you when you won't have any brain for the anesthesia to workon." She stopped, the needle poised above Lee's arm, realizing theinaptness of her remark. "Oh. I shouldn't have said that."
"No, that's all right," said Lee. "I've already reconciled myself tobeing the headless horseman for a while." He had, too, although it waswonderfully strange to think of himself lying on the operating tablewith a cavity where he right now thought, felt, knew that he was aperson.
* * * * *
Lee didn't actually lie on the table in the literal sense. The tablewas inclined to about forty-five degrees, with his head exposed andsupported by a clamp on the cheek and jaw bones. This arrangement wasnecessary to allow the waiting machinery access to the area where itwould perform.
Physicians, surgeons, biologists and the like were gathered in theamphitheater to see a bit of medical history. Actually there wasn'tmuch to see. A team of technicians, radiologists and surgeons wereworking around Lee. Some were attaching electrodes to parts of Lee'sbody to maintain the electrical impulses necessary to keep his vitalprocesses in motion while the main switchboard was out of commission.Others were sensitizing the exposed brain, from which the skull hadalready been removed, to guide the delicate fingers of the hugeautomatic Operating, Recording and Calculating Complex through itsprecisely programmed steps.
Letzmiller was among those in the amphitheater, as a spectator, drawnboth by professional curiosity and a desire to know the answer toLee's question, "Doc, what will there be left of me?" Of course hecouldn't find out even part of the answer for some weeks. Even the ORCcomplex, now being fitted to Lee's unconscious brain, adjusted andactivated, would not finish with its job for something like thirty-twohours.
The synthesizer would reconvert the data, translate it into countlesschemical and electrical formulae, and apply it to the raw material ofcarbons, amino acids, proteins, and other components. When the basicorgan had been reconstructed, a process requiring another week and ahalf in the synthesizer, it would be grafted back. The nerve lead-inswould then be reconnected, one by one, spaced at intervals to avoidshock. Lee would be unconscious the whole time, of course. Or ratherLee would be unconscious part of the time. Most of the time hewouldn't have the capacity for either consciousness or the lack of it.
Dr. Letzmiller observed the huge ORC complex for a time, but therewasn't anything to see. It simply sat over Lee, doing its job.Unwanted, the thought came to Letzmiller that the machine looked likea frog with a long worm dangling from its mouth. Lee was the worm.
* * * * *
"You can talk to him now, doctor." Oldenreid, Surgeon in Charge,addressed Letzmiller outside Lee's room where he had just finished hisexamination. "Personally, I think things went exactly as they should.All physical and mental responses check out. I guess here's where I'mfinished and you go to work."
Lee was sitting up in bed as Letzmiller entered. He looked just likehe had in Letzmiller's office before the operation, except for thesmall white bandages around his head to protect his healing skull."Well," the doctor said, "how do you feel? Your head hurt?"
* * * * *
Letzmiller checked at Oldenreid's office, and was admitted to give his
report, as had been planned.
"Well?" asked Oldenreid.
Letzmiller lit the end of his cigar before answering. "I wholly agreewith you. Everything seems to have worked out exactly according toplan. I found him essentially the same as he appeared to me during hispre-operative interview. Of course he's a little foggy yet, but Isuppose that's just the post-operative shock."
"Yes, that will clear up in a few days."
"He seems alert, responsive, full memory. I don't think there will beany difficulty with my part of his post-operative treatment. Except--
"Doctor, have you ever listened to a group of violins and sensed,
"The 1950s saw the beginning of bone and corneal transplants, use ofplastics in arteries, those huge heart-lung and kidney machines,implantation of electrodes in the heart to steady its beat--manythings which were mostly emergency or stop-gap measures. All throughthe late 1900s refinements continued to be made, but it wasn't until1988 that the fathers of replacive surgery, Doctors Mills, Levinsonand McCarty made the breakthrough that revolutionized the wholeconcept. In very simplified language they unlocked the key toproducing specialized living tissue through a bombardment of anextremely complex carbon compound with amino acids and electricity,then making it selective in function by a fantastically intricateapplication of radiation.
"That pulmonary replacement you received in 1991 was undoubtedly oneof the first successes. You were quite lucky, you know. Up until 2017,only about five per cent of their synthesized hearts lasted more thanthirty days. At any rate, the principle was established, and it wasproven that it could work. Most of our work from then till a few yearsago has been in improving and refining the work those three gooddoctors did over three hundred years ago."
Letzmiller's cigar had gone out, and he discarded it in favor of acigarette. "That would be the end of my history lecture, if it werenot for the nature of your trouble."
Lee looked at him closely. "Why's that?"
"Well, Mr. Lee, the big thing missing in that summation is theseemingly impossible task of synthesizing nerve tissue, especiallythat of the cerebral cortex. It's been approximated, at any rateclosely enough to give us good enough results to allow an artificialtissue to respond to brain signals about ninety-eight per cent as wellas the original would. But actual duplication? No. At least not untilabout three years ago. To tell you the truth, it is barely out of theexperimental stage."
"Experimental!"
* * * * *
"Yes, this will be the first complete replacement of a human brain.Oh, of course it has been done with animals, and it has beensuccessful with partial replacements on humans. But you will have thehonor of being the first human with a complete substitution."
Lee could not contain himself. "Doc, that's just it! There won't be asingle atom of me except what you fellows have conjured up--"
Letzmiller broke in mildly. "I think 'conjured' is hardly the properword, Mr. Lee."
"Well, of course, I didn't mean that. But don't you see what I'mdriving at? You could just as well start from scratch and duplicate mewithout bothering about going about it piecemeal. And what does thatmake me?"
The doctor had been looking at Lee intently, studying him through thisoutburst. "I think I see what you mean. And I can't answer you. Thequestion you raise may be philosophical, or metaphysical, but itcertainly isn't medical. And from a doctor's point of view completesubstitution is the only course open, risky as it may seem."
Lee mulled this over. Of course he knew surgery was the only solutionto his decaying mentality, actually the only alternative to hisbecoming a virtual idiot, and, shortly after that, dead. And he didnot want to die. He had lived a long time, but thanks to the methodsof Letzmiller, Gorss, and all their predecessors, he was as full ofjuice as he had been at thirty-five. But the question that keptplaguing him Letzmiller seemed determined to avoid. He didn'tunderstand very much about replacive surgery, really didn't care to.If Letzmiller said it could work, then he wasn't worried about that.Well, he guessed he really didn't have much choice. With thisrealization, he had only one more question for Letzmiller.
"Doc, if I'm not me when this is over, do you think I'll know it?"
Letzmiller looked at Lee's troubled face. "Do you think that you wouldwant to?"
Lee answered slowly. "No, no I guess not."
Letzmiller rose from his chair. "I'll talk to you again after theoperation. Do you think you're ready to go to your room now?"
Lee nodded and obediently followed the doctor.
* * * * *
Lee was asleep when the nurse came, but with the efficiency of allgood nurses since time immemorial, she woke him to give him thesedative to prepare him for surgery. She chattered brightly as sheprepared the hypodermic.
"You know, you have all the nurses speculating, Mr. Lee. I mean we'rewondering just what Dr. Lakin, he's the anesthesiologist, is going touse for you when you won't have any brain for the anesthesia to workon." She stopped, the needle poised above Lee's arm, realizing theinaptness of her remark. "Oh. I shouldn't have said that."
"No, that's all right," said Lee. "I've already reconciled myself tobeing the headless horseman for a while." He had, too, although it waswonderfully strange to think of himself lying on the operating tablewith a cavity where he right now thought, felt, knew that he was aperson.
* * * * *
Lee didn't actually lie on the table in the literal sense. The tablewas inclined to about forty-five degrees, with his head exposed andsupported by a clamp on the cheek and jaw bones. This arrangement wasnecessary to allow the waiting machinery access to the area where itwould perform.
Physicians, surgeons, biologists and the like were gathered in theamphitheater to see a bit of medical history. Actually there wasn'tmuch to see. A team of technicians, radiologists and surgeons wereworking around Lee. Some were attaching electrodes to parts of Lee'sbody to maintain the electrical impulses necessary to keep his vitalprocesses in motion while the main switchboard was out of commission.Others were sensitizing the exposed brain, from which the skull hadalready been removed, to guide the delicate fingers of the hugeautomatic Operating, Recording and Calculating Complex through itsprecisely programmed steps.
Letzmiller was among those in the amphitheater, as a spectator, drawnboth by professional curiosity and a desire to know the answer toLee's question, "Doc, what will there be left of me?" Of course hecouldn't find out even part of the answer for some weeks. Even the ORCcomplex, now being fitted to Lee's unconscious brain, adjusted andactivated, would not finish with its job for something like thirty-twohours.
The synthesizer would reconvert the data, translate it into countlesschemical and electrical formulae, and apply it to the raw material ofcarbons, amino acids, proteins, and other components. When the basicorgan had been reconstructed, a process requiring another week and ahalf in the synthesizer, it would be grafted back. The nerve lead-inswould then be reconnected, one by one, spaced at intervals to avoidshock. Lee would be unconscious the whole time, of course. Or ratherLee would be unconscious part of the time. Most of the time hewouldn't have the capacity for either consciousness or the lack of it.
Dr. Letzmiller observed the huge ORC complex for a time, but therewasn't anything to see. It simply sat over Lee, doing its job.Unwanted, the thought came to Letzmiller that the machine looked likea frog with a long worm dangling from its mouth. Lee was the worm.
* * * * *
"You can talk to him now, doctor." Oldenreid, Surgeon in Charge,addressed Letzmiller outside Lee's room where he had just finished hisexamination. "Personally, I think things went exactly as they should.All physical and mental responses check out. I guess here's where I'mfinished and you go to work."
Lee was sitting up in bed as Letzmiller entered. He looked just likehe had in Letzmiller's office before the operation, except for thesmall white bandages around his head to protect his healing skull."Well," the doctor said, "how do you feel? Your head hurt?"
* * * * *
Letzmiller checked at Oldenreid's office, and was admitted to give his
report, as had been planned.
"Well?" asked Oldenreid.
Letzmiller lit the end of his cigar before answering. "I wholly agreewith you. Everything seems to have worked out exactly according toplan. I found him essentially the same as he appeared to me during hispre-operative interview. Of course he's a little foggy yet, but Isuppose that's just the post-operative shock."
"Yes, that will clear up in a few days."
"He seems alert, responsive, full memory. I don't think there will beany difficulty with my part of his post-operative treatment. Except--
"Doctor, have you ever listened to a group of violins and sensed,
