Noble Vision (27 page)

“When the patient later regained consciousness, she, of course, exhibited total bilateral loss of vision. You know as well as I do, Father, that without my intervention, the trauma to those nerves would have rapidly resulted in total atrophy and permanent, irreversible blindness.”

“So you took matters into your own hands.”

“I explained the surgical procedure, its experimental nature, and risks. The patient gave me her informed consent. Then I called Randy.” David leaned forward in his seat, his eyes intense. “I told Randy I had your permission to operate. He believed me. Neither he nor the OR staff nor anyone else knew the surgery was illegal. I lied to everyone. Is that clear?”

“What happened in the OR?”

“I performed a pterional craniotomy. I reanastomized the nerve ends. Then I implanted at the lesion site of each nerve an embryonic growth protein, a substance I had discovered in lower mammals that’s active prenatally but absent from the body after birth. I found that the embryonic growth protein plays a critical role in the formation of the central nervous system.” David paused to sip the orange juice. “When I treated injured nerve with this new protein, it imparted to that tissue the most remarkable powers of regeneration.”

If only
I
hadn’t been so weak
, the father said silently to the figure that still possessed the slim lines and wavy tangle of hair from his boyhood.
But, no, I let you have your way in matters where you were wrong. I taught you science, all right, but I was too lenient in another area.

“I encased the nerve ends in a silicon sheath to fix the alignment and focus the medication. Then I placed my embryonic growth protein in a timed-release capsule that will dispense the medication directly to the lesion site of each nerve for three months.”

You had no right to do what you did to my patient, Bob Martin,
Warren scolded the slender boy of ten in his thoughts.
Even though Bob bought an extravagant new sports car a month after his surgery and didn’t pay me my fee, and even though he blasted me to the local newspaper for sending a collection agency to get my money, the majority of people in Oak Hills took Bob’s side, David.

“The operation went smoothly, and the patient exhibited no neurological deficit after surgery.”

I felt the disapproving stares of the entire community whenever I walked down the streets,
Warren silently said to a face resembling his own.
I couldn’t stand it, David. So I gave up trying to collect my fee from Bob. I learned my lesson from incidents like that, but I failed to teach you yours.

“Now the second procedure involves the scar. I discovered a substance that inhibits scar tissue from forming at the lesion site. Unfortunately, the substance inhibits nerve growth as well, so it can’t be introduced until the nerve has been completely regenerated.” David looked calmer, the fascination with his subject overpowering his anger.

When you slashed the four tires on Bob’s new car, I was shocked at the anger inside you, David. When you refused to pay for the tires with money you had saved from your odd jobs, when you hid that money so I wouldn’t be able to find it, when you defied my order to pay Bob and told me I could beat you instead—what did I do? How could I beat you when you were the only one who had defended me? So I paid for the slashed tires myself, and you didn’t learn your lesson about social responsibility.

“In the second operation, after I surgically remove the scar tissue that has formed, I aim to prevent any more scar from growing by injection of the scar inhibitor.”

And you had no right to do what you did to Charles Fox,
Warren silently admonished a boy of twelve with eyes too large for his small face.
When Charles Fox and his Earthlings for a Simple Planet vandalized my lab because they said my work polluted the environment, I was angry, too. I sued him, didn’t I? But what was I to do after they publicly smeared me? What did it matter that their accusations were false? People believed I was wrong, and they made me feel guilty. The Simple Earthlings were entitled to their opinion, too, weren’t they? How could I bring suit against people working for the good of the planet?

“If everything goes well in the second surgery, I will free the regenerated optic nerves from scar interference and permit the permanent restoration of function.”

The day I dropped the lawsuit against the Earthlings, you were supposed to be in school, David, not outside the courtroom waiting for Charles Fox. At twelve, you were too old to punch him in the stomach and kick him in the shins not once, but five times, before I could tear you away. Even though I reprimanded you, grounded you, and took away your allowance when you refused to apologize to Charles, I didn’t force you to do it. How could I, David, when you were the only one who had taken my side? I was much too soft on you. And that’s why you never learned about social obligations.

“However, if the scar tissue isn’t removed and prevented from re-forming, it’ll impede nerve function and the nerve repair will be futile. Therefore, I must impress on you the
absolute necessity
of the second surgery.” David sat back in his chair. “So, that’s the story, Father. You know that an injury of this nature had to be dealt with quickly and couldn’t wait for committees or certifications. You also know that the people granting the approvals—your staff—are incompetent to evaluate my surgery, and the thought of them telling me what to do in the OR is ludicrous. If you really want to do something noble, you’ll leave me and my patient free to handle this matter without interference.”

David studied Warren’s face. It looked as immovable as Nicole’s pupils.

Finally, the secretary spoke: “Medically, you are right.”

“The first word is superfluous.”

“There are considerations beyond medicine in determining right and wrong.”

“Like what?”

“Like this agency’s obligation to protect the patient.”

“From me?”

“From unscrupulous doctors. If you can do whatever you please, that means all doctors can do the same. Then how will the public be protected from unprincipled physicians?”

“How will substituting your edicts for our judgment improve our performance?”

“Even if I wanted to, I couldn’t spend public funds on an unrecognized procedure.”

“Because the procedure is experimental, I insist on waiving my fee and personally paying the hospital bills.”

“You can’t pay for anything! That’s illegal.”

“You mean charity is now outlawed?”

“Your charity would have the self-serving motive of advancing your pet project. The press would see that.”

“Would I do better work if I had no interest in my projects and couldn’t care less whether Nicole lived or died?”

“You’d do better work if you could hold on to your license!”

“If I’m not permitted to finance my own experiment, then my patient will gladly pay her own medical bills to keep the surgery out of the purview of CareFree.”

“She can’t pay! That’s against the law. If we let patients pay with their own money, then we’ll be back to the old corrupt system where only those who can afford it get treatment.”

“You mean it’s corrupt to pay for the services of others but right to expect them for nothing?”

“Your patient must not pay a single medical bill. CareFree
guarantees
care to her for free.”

“But she doesn’t want the care you’re guaranteeing.”

“Even if you could waive your charges, Randall’s hospital couldn’t take private money for its fees. Our charter would drop the hospital as a CareFree provider, and it would go out of business. So your patient’s treatment
is
publicly funded—and has to be. That’s the glory of CareFree. It sets people free from having to pay for their medical care.”

“How is my patient set free if she no longer can decide for herself?”

“Did you let your brother decide for himself when you performed the surgery at his hospital?” Warren saw a break in the marble face. “When Randall loses his job, as he will if he’s foolish enough to defend you, are you prepared to bankroll the development of his children’s talents?”

“Don’t blackmail me with threats against the innocent!” Lines of pain twisted a face that could not conceal them.

“And Marie told me you’ve been paying hefty fines to this agency. Because I insist that no staff member is to bend the rules for my family, I was never told about your fines, nor would I have intervened had I known. Because you would apparently be strapped to help Randall out, and he wouldn’t accept money from you anyway, are you prepared to explain to his children why they will lose their futures?”

“Are
you
prepared to explain to your grandchildren why their futures are being jeopardized to further your own?”

“But David, I’m not acting for myself. I’m acting for the
people
!”

“What gives them the right to stop a treatment that I want to do and that my patient wants to have?”

“It’s
you
who had no right to perform an operation against the interests of your brother and the hospital.”

“Why would a hospital disapprove of a new procedure that could skyrocket its caseload? I could bring a lot of money into that hospital—if it was free to make money. You know what’s behind the clash between me and the hospital”—his voice became low—“and between me and my brother.”

“And what about your wife’s feelings? She and I dined alone last night. Did you know that Marie had invited me to join you two for dinner? She thought you’d want to reconcile your differences with me. Instead, look what you’ve done.”

“I never agreed to dine with a man who wants to poison me.”

The color drained from Warren’s face. “You know, when you were two years old, you used to cry every morning when I left for work. You gave your mother a terrible time because you wanted to be with only me. Now you show not the slightest remorse at the pain you’re causing me and the rest of the family.”

“Is that what I’m supposed to tell my patient, Father? That she has to grope in darkness for the rest of her life because members of my family are personally offended by her surgery?”

Warren’s face grew taut. He leaned forward in his chair, pointing an accusing finger at David. “There are severe penalties for what you did. So choose: Either you give up this case, apologize to the governor and the public, and hope to hell I can save you even then, or keep up this brash defiance and get yourself kicked out of medicine and possibly thrown in jail. Those are the penalties. I have not only the power but also the moral obligation to enforce them.”

“If you have a moral obligation to throw me in jail, then who’s allowed to roam free? If science is outlawed, then what’s legal?”

“Choose, David.”

“A new discovery lands me in jail, but blind obedience to the whims of this institution sets me free. Is that the choice you’re giving me?”

“I’m acutely aware of the value of your research. If you would only have patience and go through the proper channels, in time we would make allowances for you to conduct your experiments and test your procedure. I’m giving you a choice between professional suicide, public disgrace, and a possible prison sentence versus your research, your career, your success, and your freedom.”

“Doing my work at a time determined by you, with your funds, in your labs, under your rules, with your inspectors breathing down my neck? Is that what you call my freedom? Let’s drop the pretense, Father. What you really mean is that if I do what you want, then you might become the next lieutenant governor. Isn’t that true? Everybody knows that the governor’s reelection rests on the voters’ confidence in CareFree. And everyone also knows that CareFree is a colossal failure. The governor needed a scapegoat to explain why just a few years of CareFree has wreaked havoc with medicine. That’s why you made your budget cuts, blamed the doctors for the mess, and issued your threats. Now you have to make good on those threats. So you’re ordering me to ignore the whole of my medical knowledge and chose a treatment that’s best for you and your boss to win an election. And in some perverted attempt to delude yourself or me or both of us, you claim you’re doing something noble. I call it an unspeakable corruption!”

“Your mother warned me that you would become antisocial, but I never listened. You were so bright, David, and the things you did gave you such immense pleasure that I couldn’t force you to change your ways. I let you think only of yourself and your interests while you ignored the opinions others had about you. That’s why today you can think only in the narrow terms of one doctor, one patient, and one case and you don’t consider the effects of your actions on society as a whole.”

“And how am I to know what effects my actions would have on society? That’s where you come in, isn’t it, Father? You’ve got us all strung out on some cosmic necklace threaded by you and your boss, so that slack for some of us means gagging for the rest. What effect could Nicole’s surgery have on a man with a broken ankle in Saratoga Springs if she paid for the treatment with her own money? Why would he care if she bought a mink coat or an operation if her treatment didn’t result in the curtailment of his own?”

But David realized that his argument, like rays deflected off an impenetrable surface, did not reach Warren.