R&R Fiction Chapter 2: Dr. Juan Carlos Hernandez and Jane
Cardiopulmonary Transplant Surgery
Juan Carlos stood over his anesthetized patient, a female in her mid 90s. Her issues were essentially a gradually occurring inability to exercise despite appearing mostly fit, and her annual check-up history showed a clear but gradual decline in lung and heart function. Treatment history included mitochondrial transplants, senolytics, and some other standard treatments for an old cardiovascular system. However, these were losing effectiveness as they sometimes tended to do around this age, and rather than opting for a complex cardiomyocyte cell therapy the patient wanted an all in-one solution. A full artificial heart-lung transplant.
It was really a very common procedure, which Juan Carlos had done hundreds of time, but it was one of his favorites. Pre-fit the device for the patients chest based on MRI, open the chest and put them on a life-support machine briefly, and attach the aorta and superior vena cava to the new artificial heart-lung device. Boom, totally new cardiovascular system. Even for those who weren’t so enthused about getting “Borged out” (as Dr. Juan Carlos the sci-fi nerd called it) it mostly seemed worth it as the new device ended up just sitting hidden in their chest, not affecting their personalities or appearances as some other non-biological implants might. And most patients were running again in a week.
One med student on rotations sat near him as he readied for the surgery. Two generic humanoid robot techs stood adjacent to monitor blood leakage, hand him instruments as needed, etc. And, a multi-armed robot very much specifically designed for this surgery sat overhead to help with certain parts. Juan Carlos preferred to do most of it himself as long as there were no factors preventing him from doing so, though.
“Jane, do you know for like a solid 200 years around 2/3 of people died from issues relating to these two organs? Crazy right?” Juan Carlos said exhuberently.
“Yes Dr. Juan. Glad we went from the era of heart attacks to the era of space lasers and not back to the era of cholera”.
“Eyy, that’s Dr. Hernandez to you!” He said in mock accusation.
“Okay Dr. Juan”.
He rolled his eyes and gave her a side smile, and looked back to his patient. Her face and body revealed a mix of youth and age, speckled with some things artificial which could not easily be dated. She was born in the early (19) 90’s to a white-American father and a mother of east-African descent. She had sharp and prominent features and slightly sunken eyes which were far from youthful yet carried a kind of piercing attractiveness unique to gen-Xers and millennials in this day and age, highlighted by largely youthful looking light brown skin and framed by short curly hair styled in a pixie-like cut that maintained patches of gray. One of her eyes was clearly artificial when inspected closely (though was not visible at the moment as she was unconscious), and a section of her eyebrow above was cut out with a vertically streaking scar perhaps 2 inches in length. Less obvious upon inspection was the neural-linked hearing aid, only noticeable by a faint shine of metal that could be observed from the reflection of a flashlight while peering deep into her ear. She was tall at 5’10” and her body was slender and muscular in a somewhat taut looking manner, with some highly faded tattoos including one on her clavicle with the name “Tommy” that looks like it may have more recently been touched-up. A surgical scar was visible on her abdomen, and a layer of artificial skin encircled her neck. Most noticeably, her arm was fully artificial, visibly metallic with no real overlay.
The assisting robots rubbed iodine gently on the woman’s chest near where her sternum would soon be opened as Juan Carlos pulled his face mask down and stretched on his gloves. “Okay Dr. Jane. Or soon-to-be-doctor Jane, anyways. Let’s go through her medical history highlight reel one more time to make sure there’s nothing else essential to consider before digging in.”
“Sure. Patient’s name is Gloria Thompson. Current medications include valproic acid for epilepsy as well as mixed Estrogen-Progesterone HRT, low-dose androgens and T3. That’s actually it for actives – impressive. I’d have guessed 3 or 4 at her age just by probability”.
“Also nice for us Jane. Less complicated. What about treatments in the last 10 years?”
“Overnights with senolytic CAR T-cells 2 and 7 years ago and a week in the hospital for a partial immune system replacement with allogenic modified HSCs 6 years ago in which she caught a small infection and needed monitoring. And dopamine neuron addition surgery last year. Otherwise mostly outpatient. Combo mitochondria therapy (mitochondrial transplant and mitophagy enhancers combined) also 2 and 7 years ago. VEGF/endothelial cell combination therapy 5 years ago. Cyclodextrin based oxidized cholesterol removal bi-annually as well as a more in-depth surgical removal of plaques 9 years ago. Other cardio treatments like AGE removers and calcified elastin rejuvenation here and there. Fairly typical of someone who is 95 I would say. Oh and she takes an anti-cataract eyedrop for her...umm..eye.”
“She still has a natural lens! Dayum I want what this lady is smoking.”
“Hmm yes well that would be marijuana periodically, according to her records.”
“Alright that’ll do, though might have to wait until after work eh? What about big events before that? Take a guess on how she became Gloria Silverhand? Maybe for slamming a guitar harder?”
“Sorry sir, I read my medical textbooks, not your weird retro sci-fi comics.”
“Hey! You oughta get into sci-fi if you want to prepare for life and medicine in 2187! Worked for me, worlds still spinnin and still changin.”
“I’ll just read my updated medical textbooks sir. Anyways, she had artificial kidney addition 12 years ago also, and the hearing implants was in 2071. Other than that, it appears the eye, scar and arm are all linked – explosive injury in, um, 2032. Wow, hit by a drone, ooph. Covered her face with her arm, lost the upper half of the arm to the blast and her eye to shrapnel, plus a pretty bad concussion and 3 years on disability. Current replacement arm came in 2037 from a donor, she never got an upgrade to something more natural looking. Got some cuts to her neck too, was lucky there, that explains the replacement skin.”
“I told you Jane, our lady here is tough as nails. You didn’t mention 50 pushups and 5 miles a day either. And I wonder who “Tommy” is. I’ll just have to ask her later.”
“Sir is that ethical? Seems kind of invasive.”
“Jane, I’m literally giving her a new heart. She’s not going to be too annoyed when I ask her how she got the scars on her old one. Trust me.”
“Okay Dr. Juan. Whatever you say. Looks like the robots are done prepping. Skin fully washed and disinfected, negative air pressure in-place, finger blood drip for active vital monitoring applied. ECMO machine ready to go and extra blood on the ready as needed.”
He began lowering the massive robot from above. “All right Jane. We’re missing one more thing. Hey Siri, play “Synthpop Oldies” playlist.”
“Oh my god. Dr. Juan, please just play some Beethoven or something like a normal surgeon.”
“For the sake of your education, Jane, okay. But just this one time.” The lights switched off and he moved to the control screen for the surgery robot as Jane diligently took notes.
...
Three hours later, the surgery was complete, and Gloria had woken up, just now fully weaned off of anesthesia. Though a bit dazed, she was more or less fully lucid, appearing effectively just hungover – one more thing impressive for her age. Juan Carlos walked back into the room, having left to attend to other duties while Jane kept an eye on her and her vitals as the anesthesia wore off.
Gloria winced thrice and smiled brightly, her eyes droopy but looking appreciatively into Juan Carlos’. “Hey doc, you work faster than my damn tattoo artist. I appreciate you.”
“Gloria, I appreciate you coming to our clinic here today and entrusting us with your care. Want to hear your new heart?”
“Well how can I say no to that, huh doc? Give it here”.
Juan Carlos handed her his stethoscope. A faint humming sound came rather than a beat, going in and out once a second to simulate a heart rhythym.
“Oh my lord, am I zombie now doc? Or a ghost perhaps?”
“No Gloria, don’t worry. You’re just a cyborg.” Juan Carlos winked.
“Hmm well I’ve got years of that under my belt. What’s one more step?”
“Yes Gloria, I was curious about that. Your arm is a 50 year old General Cybernetics model, from the very early days of neurological implant controlled robotic arms. Clearly working well from good upkeep but also why would you not trade it in for an upgraded model?”
“You don’t get rid of gifts, doc. Specially not deathbed ones.”
“Okay well, now you’ve got to tell me this story Gloria. I hate to be nosy but it sounds like you’ve lived quite a life and I could use some sage-like wisdom right now.”
“Well doc, hmm, Dr. Hernandez. It was in the 2032 war, I was working as part of a drone operation team. We meaning, um, my partner and I.”
“I did see a little bit about this in your file. Partner like on your team?”
“Yes but also a little...more. Regardless, we got hit hard one day, got a taste of our own medicine from the other team I guess. Gave me a whole bunch of issues you probably just rattled off before this surgery. But Tommy got hit harder, lost his arm too but also a bit of his marbles. He qualified for clinical trial on the general cybernetic arms, but I didn’t cuz of a host of other things going on. Regardless, I was with him for 5 years everyday and we helped each other out.”
“My god. So that’s the tattoo. Then you...he…”
“Yes, like I said, he’d lost his marbles. Spiraled, never made it out. But he left me part of himself at least. Sometimes I feel my own arm and I feel him…”
Juan Carlos, uncharacteristically, was welling up with tears. He turned to Jane, shaking his head to indicate that maybe she shouldn’t record all of this.
“Wow. That’s...something else. Well, I guess it’s not your style, but the heart and lungs are fresh off the shelf and designed just for you. They’ll last you quite awhile.”
“Doc, you know, that’s nice to hear. I hope so, you know the more I live the more I remember how Tommy would have wanted me to keep living. But if one day the Reaper comes for me too, well, maybe I can give someone a heart at least now.”
Juan Carlos was speechless, and Gloria was serene (and still a little high from the anesthesia wearing off). Jane, however, interrupted.
“Dr. Juan, I think maybe I’m interested in being a surgeon.”