Into the New Millennium: Trailblazing Tales From Analog Science Fiction and Fact, 2000 - 2010 (49 page)

It had been exhilarating, knowing that he was in a place where he could really make a difference. Certainly there were telemedicine connections, even on Indigo, but this was not much use without a doctor to do the hands-on examination, to know the patient well enough to get a good history, to do the immediate work on emergencies such as poisonings or trauma. Samuel had thought it would be stressful, being the only doctor on Indigo, and it was at times, but he always had backup and support from the teledoctors, so he was never truly alone.

"You felt fulfilled in your work," Mrs. Garcia observed.

"Yes." Samuel tried to remember what it had felt like, back then. "There was little Maddie Harris; she swallowed a whole bottle of her mother's heart medication when she was two. Such a cute little toddler, and I've gotten to watch her grow up—she's six now. And Sean Davison, he was out cutting zebra trees when his blade slipped. He cut open his arm and lacerated an artery, but it's healed beautifully and there's hardly a scar now."

"It sounds as if they would have died, had you not been there."

"Yes," Samuel said. "Most likely they would have. Mrs. Garcia, the people on Indigo need me. They—they trust me."

"These hardly seem things one would wish to forget."

"But I do," Samuel whispered. "I can't bear that they trust me, not any more. They shouldn't."

"Why shouldn't they?" Mrs. Garcia looked at him quizzically.

"Jessica Miller." An image of Jessica shot into his mind. Thirteen years old, bright and happy, jet-black hair in a long ponytail that bounced behind her when she moved. And she was always moving, had been ever since Samuel first saw her, back when she was nine; the minute she was through with school and chores, she could be found running through the fields with her friends, jumping chasms, climbing zebra trees. Samuel had tended her inevitable lacerations and scrapes, had treated an allergic reaction to a zoombug sting. Another image of Jessica wiped away everything else in his mind: his hand on her arm, giving her the injection; the startled look on her face as she felt the drug enter her system. Samuel closed his eyes, but the image would not go away.

"Tell me about Jessica," Mrs. Garcia said.

"She was thirteen," Samuel said, and could not think of how to go on. "I've never told anyone," he said. "Not anyone at all."

Mrs. Garcia waited, silent. Samuel stared at the forget-me-nots on her desk, past them to a pair of framed photographs he had not noticed before. Children, a boy and a girl, smiling out at the camera. Jessica had smiled at him, and had asked how soon she would be able to go out climbing zebra trees again.

"She was in the fields," he said at last, "and she was bitten by an ariel. They're reptiles, quite pretty ones really. Brilliant blue, with translucent wings and frills down their backs. They're usually harmless, not aggressive at all, but the females hide their nests quite well, you see, and they burrow under the soil, and if a person stumbles into a nest, the female will bite. The ariels lay their eggs year round, and I usually see three or four cases a year. Jessica had been taught what to do in such a situation. She moved away from the nest, called for help on her link, and lay down to wait. It's important not to move around too much, you see. Movement causes the toxins to spread through the body much more quickly.

"Jessica's father picked her up in his floater and brought her to the clinic. No one was terribly concerned, because she'd gotten to the clinic in plenty of time, and we have an antitoxin that is quite effective. The original colonists had it manufactured on Topaz, and even when they had no access to any other medical care, most of the victims survived. With the supportive medical care I could provide, and with prompt treatment, well—everybody survived. I had seen a number of cases by this time, and the treatment had become routine to me. I calculated Jessica's dose, drew it up, and gave it to her."

It had not seemed important, at the time, that Jessica had looked startled, that her eyes had widened. But no patient liked receiving injections, and Samuel had thought nothing of Jessica's reaction.

"I was certain she would be fine. I told her she'd be back in the zebra trees in a week's time, and she wanted to know why she couldn't go tomorrow. I went back to seeing my regular patients, and came back to check on her an hour or so later. I was completely surprised to find out that she was worse. The bite was inflamed and painful, and the area around it was starting to go numb. I wasn't sure what was going on. I thought perhaps the bite had become infected, or that Jessica had had an allergic reaction to the antitoxin. I drew blood samples and set up a teleconference with the Saint Leona medical school, on Topaz. But they didn't know what was happening either. The ariel is unique to Indigo, and none of the doctors I consulted had ever seen a case. And Jessica was still getting worse."

Samuel fell silent, lost in memory. Mrs. Garcia stirred, and asked, "Could you not have given Jessica more of the antitoxin?"

"No," Samuel said. His heart began to pound so hard he could scarcely hear himself speak. "No, I couldn't—the consulting doctors concurred, more antitoxin was not an option. The dose window on the antitoxin is very small. Giving Jessica a second dose would almost certainly have been lethal. I was terrified for a moment that I had mistakenly given her an overdose—perhaps I had entered her body mass incorrectly—but the dose I had given, 4.7 cc, was correct. The consulting doctors confirmed this. And we all remained baffled.

"I put Jessica on supportive care, and treated her symptoms as best as I could. By now other medical schools and hospitals had come online, but none of them had an answer either. The Deep Verde medical school suggested a new treatment that had been shown to protect the liver from certain toxins, but on Indigo we did not have this drug. A packet was sent out in a priority shipment, but this was only a gesture, since it would take days to arrive.

"Jessica continued to deteriorate through the night. Her parents kept vigil over her, and I did the same on the net, sending messages to every medical site I could find. It was all useless. No one could help.

"Around noon the next day, Jessica seemed more comfortable, and she said that she felt a little better. She asked for water, and talked rationally to her parents and me. We all got terribly excited, because it seemed that the supportive care was going to work. Her blood levels stabilized. She asked for a vid,
The Legend of Black Star
. Her father hurried home to fetch the vid. I could see the hope, the relief, in her father's eyes, on her mother's face.

"But it didn't last. By the time her father returned, Jessica had crashed. Her blood values destabilized, and then went off the charts. But she was a fighter. She lived for two more days."

Two more terrible days, while part of Samuel knew things were hopeless and part of him refused to give up. Jessica drifted in and out of consciousness. When she was awake and aware, she described a growing numbness, emanating from the site of the bit and spreading all over her body. But soon she lost all awareness, even when she was conscious, and she did not seem to recognize her mother or father. Samuel could only hope that she did not feel much pain.

"After Jessica died, her parents thanked me for trying so hard, for not giving up. Her mother hugged me. They sent me a card, later."

Samuel stopped. He was coming close to it now, to the part that no one knew, that he had never told anyone. Mrs. Garcia said gently, "I understand why you wish to forget Jessica's death. But I do not think we can help you. There are extensive records, no doubt, that you would be bound to come across, and it seems that you will wish to continue to interact with Jessica's parents. We could make you forget, yes, but you would only learn of her death again, and you would not understand why you could not remember. The incongruity would likely be debilitating for you.

"We could, perhaps, cause you to forget the details of what the child went through. Then the memory of her death might not be so devastating to you. This technique has worked for others. But in your case I wonder if simple counseling might not be a better choice."

"Counseling?" Samuel said blankly.

"Yes," Mrs. Garcia said. "You feel more than simple grief and loss over this child's death, do you not? You feel guilt. A terrible guilt."

Samuel swallowed. "Yes."

"Yet you did all that could be done. You gave the proper treatment, consulted with experts; you were there for Jessica and her family in their time of need. Not everyone can be saved. You should not need to feel such guilt."

"I didn't, at first," Samuel said. He found himself staring at the forget-me-nots, unable to meet Mrs. Garcia's gaze. "The postmortem showed the characteristic effects of ariel toxin. The antitoxin had been ineffective in Jessica's case. The experts said it was an idiosyncratic reaction, something completely off the charts. These happen, sometimes. They can't be predicted, and sometimes they can't be controlled. I knew that; I accepted that. I grieved for Jessica, and the pain of losing her was terrible, but I did not blame myself.

"Four months later, a farmer, Jeremy Flynn, was rushed to the clinic with an ariel bite. Ariel bites had once been routine to me, but it was nerve-wracking this time. Jeremy knew what had happened to Jessica, and he was frightened. I did my job: I stayed calm, though I was just as nervous as he was. I explained Jessica's idiosyncratic reaction, and how incredibly rare such things are. I made sure I was projecting confidence. Of course while I was doing it I was calculating and double-checking the dose, which came to 10.4 cc. I got the bottle of antitoxin and began to draw up the dose.

"There are 20 cc in each vial of antitoxin. I had used 4.7 cc on Jessica; 3.5 cc on little Cinda O'Donnel the month before that. I drew up the 10.4 cc for Jeremy. There were 6.1 cc left in the bottle.
And there shouldn't have been
. There should have been 1.4 cc left. There was exactly 4.7 cc too much."

Samuel had stood still in shock, clutching the bottle, his mind turning to ice, his stomach turning to lead. Jessica's dose was still in the bottle. He had not given her the antitoxin. He had given her the wrong drug. In desperation he had checked his fingers again, twice more, three times, ten times. Every calculation had come out to the same, with 4.7 cc too much antitoxin in the bottle. Samuel's vision had blurred, and his hands had trembled so much he could barely hold on to his computer. Jeremy Flynn had watched him fearfully, had said, "It's going to happen to me too. Isn't it?"

"My reaction had scared Jeremy badly, but I somehow managed to pull myself together, to put on a false front. I tried to explain away my reaction by telling him I wasn't feeling well, that I was having stomach pains and nausea. Which I was, of course. He became concerned, and asked why I hadn't gone to Topaz for a checkup. I started talking about how difficult it was to find a doctor who would do relief on Indigo for even a few days, and I promised I'd go in for my checkup as soon as I found someone to cover for me. It was so strange listening to myself talk cheerfully to Jeremy, with some sort of automatic bedside manner. So strange, because I was dying inside."

Samuel fell silent, and Mrs. Garcia shared the silence for a time. Then she said, "Did Jeremy survive?"

"What? Oh, of course. Jeremy responded to the antitoxin very nicely, and was back working the fields within a week. He's completely recovered, now. As he should be, and not like Jessica. The look in her eyes—she jumped, she was startled, when I gave her the injection. As if the solution stung, or burned. The antitoxin doesn't burn. Doesn't sting. The injector is painless. If I had been paying attention I would have realized I had given the wrong medication. But I wasn't paying attention! I saw the look on Jessica's face, and I disregarded it, and now I can't stop seeing that look. The way she jumped, the way her eyes widened. I can't stop seeing it."

He met Mrs. Garcia's eyes at last. Reflectively, she said, "You didn't tell Jessica's parents."

"No, I didn't. I don't know for what reason. They had accepted Jessica's death. They were grieving, but they were coming to terms with their loss. I truly did think it would be better for them if I kept my secret, that if I told them the truth I would only upset them terribly to no good end. But there was another reason."

"And that was?"

"I couldn't bear to admit what I had done," Samuel said, ashamed. He sat with his head down, feeling sick and drained. He felt no relief that he had unburdened himself of his secret; he felt, if anything, worse than before.

He listened dully to the soft click of Mrs. Garcia's computer keys. After a moment she said, "How long has it been since Jessica died?"

"Sixteen months, standard," Samuel said. "And three days."

"The memory has not faded."

"No. It just keeps getting stronger. It haunts me, night and day. And it's affecting my work, very badly." He straightened up, and forced himself to meet Mrs. Garcia's eyes again. "I'm the only doctor in Indigo, and I've lost my ability to do the job. I've become so paranoid that I'm essentially paralyzed. I find myself reading drug labels fifteen times before I draw up injections, and as soon as I've drawn a dose and put the bottle back on the shelf, I'm terrified that it's the wrong drug. I end up discarding the dose and drawing it again, over and over, as each time I start having doubts about what it is. I can't bring myself to make the simplest diagnosis without getting outside confirmation. And it's hurting my patients. Last month Sarah Malone came in with an allergic reaction to a zoombug sting, which is a very easy thing to treat, and by the time I'd consulted online and drawn up her medication and discarded it several times, her symptoms had become severe. She nearly died while I was trying to decide what to do.

"I don't want to forget Jessica's death. I understand the limitations of your procedures, and besides, it wouldn't be fair to Jessica. How could I put her death out of my mind? What I want to forget is the moment I realized her death was my fault."