Alan E. Nourse - The Bladerunner by Alan E. Nourse, Karl Swanson Page B
Authors: Alan E. Nourse, Karl Swanson
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manufactured response there, a subtly incorrect clinical summary from one hospital visit, a totally erroneous electrocardiograph interpretation from another visit—in short, a craftily designed patchwork of misinformation and half truths about the patient's clinical course, all concocted for the sole purpose of misleading the computer into a slightly erroneous diagnosis, prognosis, and plan for treatment.
And it had worked. As a result of his efforts, Mabel Turner had been identified by the computer as a high-risk, desperately ill cardiac case, candidate for an immediate heart transplant—precisely the kind of case that Dr. Katie Durham and the other medical directors of the hospital so eagerly wanted him to perform with a full neuropantograph hookup, a case involving multiple difficult, perhaps even life-and-death, surgical decisions to be made from opening to closing. Now Doc smiled to himself in satisfaction. With the case finally scheduled, despite his formal, almost ritual, objection to the neuropantograph hookup filed with Dr. Durham, there could be no backing out without extreme embarrassment in high places. For all their claims and contentions, Health Control authorities were really not all that certain of the reliability of their computerized diagnosis and prognosis systems, so that the error could as well have arisen in their system as in Doc's machinations, and only a time-consuming and costly retrospective analysis would spot the difference. And now that they were boxed in, the case would give him a splendid opportunity to play hob with the neuropantograph, first confusing it thoroughly at the discrepancy between the procedure scheduled and the procedure he intended to do, and then almost certainly sending it into a paralyzing feedback crisis when he, as surgeon-in-charge, changed the projected procedure entirely.
And change the case he would, for he had no intention of performing a cardiac transplant on Mabel Turner this morning or any other time. He had never intended to.
Walking down the corridor from his office, Doc nodded to the occasional intern or resident who hurried by, then paused to wait at the northside elevator bank. Moments later the elevator dropped him off on the ninth floor, devoted exclusively to pre- and postoperative patients, and he hopped a jitney moving briskly down the main central corridor, passing wing after wing of perpendicular ward corridors. Hospital No. 7 was loudly acclaimed by Health Control authorities as one of the most modern and best designed of all the new federal Hospitals built in the last decade, with each patient bed within comfortable view of an outside window, with holo-TV stages with multiple projectors in each room so that each of four different patients could watch a different program projected on the same holography stage at the same time without any overlapping or interference of the images. With its thirty-eight stories, and thirty-six wings branching from the main central corridor, the hospital housed four thousand patient beds and, as usual, was filled to within 10 percent of capacity at all times. What was more, internal hospital transit was so efficient that a doctor could, if necessary, travel from the main lobby to the farthest end of the top-floor main corridor in no more than fifteen minutes of travel time, a significant improvement over some of the earlier pentagonal and hexagonal hospital designs in which just finding a patient's bed might well consume an hour of a doctor's time.
Mabel Turner had already received the first stage of her preoperative medication and when Doc finally reached her room, the small, chipper middle-aged woman was relaxed and a little drowsy, but still alert. Doc greeted her like an old friend, which indeed she was, a patient that Doc had been following closely in the outpatient clinics for nearly three years before the decision for surgery had to be taken. Now he rolled the bed into an upright position and carefully checked
And it had worked. As a result of his efforts, Mabel Turner had been identified by the computer as a high-risk, desperately ill cardiac case, candidate for an immediate heart transplant—precisely the kind of case that Dr. Katie Durham and the other medical directors of the hospital so eagerly wanted him to perform with a full neuropantograph hookup, a case involving multiple difficult, perhaps even life-and-death, surgical decisions to be made from opening to closing. Now Doc smiled to himself in satisfaction. With the case finally scheduled, despite his formal, almost ritual, objection to the neuropantograph hookup filed with Dr. Durham, there could be no backing out without extreme embarrassment in high places. For all their claims and contentions, Health Control authorities were really not all that certain of the reliability of their computerized diagnosis and prognosis systems, so that the error could as well have arisen in their system as in Doc's machinations, and only a time-consuming and costly retrospective analysis would spot the difference. And now that they were boxed in, the case would give him a splendid opportunity to play hob with the neuropantograph, first confusing it thoroughly at the discrepancy between the procedure scheduled and the procedure he intended to do, and then almost certainly sending it into a paralyzing feedback crisis when he, as surgeon-in-charge, changed the projected procedure entirely.
And change the case he would, for he had no intention of performing a cardiac transplant on Mabel Turner this morning or any other time. He had never intended to.
Walking down the corridor from his office, Doc nodded to the occasional intern or resident who hurried by, then paused to wait at the northside elevator bank. Moments later the elevator dropped him off on the ninth floor, devoted exclusively to pre- and postoperative patients, and he hopped a jitney moving briskly down the main central corridor, passing wing after wing of perpendicular ward corridors. Hospital No. 7 was loudly acclaimed by Health Control authorities as one of the most modern and best designed of all the new federal Hospitals built in the last decade, with each patient bed within comfortable view of an outside window, with holo-TV stages with multiple projectors in each room so that each of four different patients could watch a different program projected on the same holography stage at the same time without any overlapping or interference of the images. With its thirty-eight stories, and thirty-six wings branching from the main central corridor, the hospital housed four thousand patient beds and, as usual, was filled to within 10 percent of capacity at all times. What was more, internal hospital transit was so efficient that a doctor could, if necessary, travel from the main lobby to the farthest end of the top-floor main corridor in no more than fifteen minutes of travel time, a significant improvement over some of the earlier pentagonal and hexagonal hospital designs in which just finding a patient's bed might well consume an hour of a doctor's time.
Mabel Turner had already received the first stage of her preoperative medication and when Doc finally reached her room, the small, chipper middle-aged woman was relaxed and a little drowsy, but still alert. Doc greeted her like an old friend, which indeed she was, a patient that Doc had been following closely in the outpatient clinics for nearly three years before the decision for surgery had to be taken. Now he rolled the bed into an upright position and carefully checked
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