It’s two in the morning. I’m sitting in the staff room of the hospital’s emergency department and reading a paper by a professor in Saskatchewan about allergic reactions to medical implants. The paper is badly written, the theory seems unlikely and, if the emergency bell on the wall hadn’t started pinging, I might have dozed off. But it has and the duty surgeon, Alexa Standish, puts her head around the door.
“Hey, John Medinerd! I need you in the operating theatre. Middle-aged man got a CancBit implant two weeks ago and he’s just collapsed. He’ll be here in ten minutes.”
The surgeons and operating nurses don’t like us IT medics. We get called “circuit freaks” or “medinerds” all the time. They’re worried we’re taking over more and more of their work.
The first time we became necessary was 20 years ago, when neurolinks appeared. Patients have a small, coin-sized microchip implanted in their brain. It sends electrical impulses to the neural network and means paralysed people walk again and blind people see again. And that’s just the start. But the problem is finding medical staff to make sure these things work: people to do the coding and patching and to take care of cybersecurity. Most doctors like doctoring, not IT, and so the IT medic was born. We have the standard doctor training and then IT on top.
The man is unconscious when he arrives. While the nurses prep him, Alexa and I talk to the paramedic. The patient had complained of a headache before going to bed that evening. When he started screaming, his wife called the ambulance.
“Looks like anaphylactic shock,” says the paramedic. “Heart rate’s all over the place, temperature is 42 °C and he has breathing trouble. We’ve given him adrenaline, so he’s stable for the moment.”
“What’s he eaten?”
“Sushi.”
“At his age, he should know he’s got a seafood allergy,” says Alexa, tying on her mask.
“Do you need me then?” I ask.
“With that CancBit chip inside? Sure! Anything goes wrong with it, you can take the blame.”
That is the problem. The CancBit chip is super expensive. It’s a beta version, but it could revolutionize cancer treatment. The chip is placed in the brain, it constantly searches for DNA released by cancers in the body and, if necessary, orders the release of drugs placed in other parts of the body to deal with it. If successful, CancBit will be worth a fortune. I’ve even bought shares in the company myself.
We go into the operating theatre, but nothing works. His immune system goes into overdrive and attacks all his organs. We get blood clots and haemorrhaging, and by 3 a.m., he’s dead. We can do nothing.
The surgeon is in pieces, which is unusual. She’s tough, but she’s never had something like this. I tell the wife that her husband is dead as we sit in the empty foyer of the hospital, each of us holding a cup of cold coffee.
“I have to ask,” I say, “did your husband have a seafood allergy?”
She’s crying her eyes out but tells me no, they eat — ate — sushi about once a month and it’s never been a problem. Her brother comes to take her away and I do the necessary reports before I go home to my wife and family.
When I wake, there are three messages from someone I don’t know on my phone. He has my name from the hospital, the man says. He needs to talk to me. I shower, eat, go to work and find him waiting. He’s a tall, distinguished-looking man in a grey suit. He looks exactly how you want a medical expert to look.
“Dr John Malloy?” he asks. “I’m from CancBit Technologies. We need to talk about the report you filed earlier this morning.”
“Who are you? And how have you even read it?”
He laughs. “That’s not important. Can we go somewhere private?”
The next 20 minutes are a shock. He doesn’t like my report’s hypothesis: that the reaction might have been caused by the CancBit implant.
“You can’t be certain about that. Your colleague Dr Standish says it was a shellfish allergy.”
I explain what the patient’s wife told me, but he dismisses it with a wave of his hand. “People are weak. They like something, so they carry on consuming it, even though they know it’s dangerous. Like cigarettes. And there’s something else,” he adds. “Your management is concerned about the things you read online.”
“What things?”
“You read a lot of what I call science-fiction reports and blogs about medical implants written by conspiracy theorists in places like Saskatchewan. Now, how can this hospital be taken seriously if staff read such nonsense? And you know,” he pauses and looks me straight in the eye, “it would be a bad decision to write negatively about a treatment that could help us win the war on cancer. Remember Dr Nightly?”
I do remember Jane Nightly. She made a lot of fuss about another CancBit product, until, one day, the police searched the lockers of all the hospital staff, found stolen morphine in hers and she was fired. Is this a threat? And how can CancBit know about my online reading? He guesses my thoughts.
“Oh, we know a lot about you, Dr Malloy. We know about your charming wife, your lovely children, your expensive mortgage…”
Now, I’m really scared.
“What do you want?” I ask.
“A little revision,” he says. “Just change your report to say the cause of death is unclear — which is true, after all.”
I sit still after he’s gone, thinking about what to do and about my values and priorities. Then, feeling sick, I open the report and make the revisions he wants, knowing this decision will haunt me forever.
But before judging me, do you know what you would do?