Desperate Remedies

Community Hospital – Cardiology Department 

Diagnostic & Treatment Confidential Conference Room  

RE: Case #00411325, Name redacted, Age 20 (DOB redacted)    

Diagnosis: Cardiomyopathy

Medications: ACE inhibitors (prescription details redacted)  

Proposed Treatment: Heart transplant from out-of-bounds donor

Notes: Patient currently is on list of above medications and extra dosage of Community-issued suppressants. Patient responds well to medication but shows no improvement in heart function. Still awaiting donor heart availability. Potential donor heart arrived from outside the Community this morning, appears to be match to patient. 

Status: Transplant pending Committee approval.

In Attendance: Dr. Ken Whinston MD, Dr. Sal Ferrucci MD, Dr. Rebecca Averies MD, Paige Brewer RN, Dr. Spencer Morrow MD

Security Clearances: Dr. Spencer Morrow MD (by invitation)

Under the fluorescent blue lights illuminating the sterile, stainless-steel furnishings of the hospital’s confidential pathology lab turned conference room, Dr. Ken Whinston reads through the case file with a disapproving frown.                                                                                                                          

“We do realize the risks associated with this procedure?” he casts a dubious glance around the table at his colleagues – and Dr. Morrow. 

“I think you should wonder instead about the risks of not doing the procedure,” Dr. Morrow counters, which makes Dr. Whinston bristle – he’s the chief of surgery in the Community and does very much not like being undermined by a shaggy, twangy young doctor from outside the Community borders who looks like he’s just to start medical school. Still, he signed off on the security clearance, seeing the value of having him on this case, and bites his tongue, letting Dr. Morrow continue,

“The patient has shown virtually no improvement on the ACE inhibitors. Looks like she’s had several medications in the past, and the ACE inhibitors were supposed to finally be effective. Since they haven’t helped, it proves that medication is obviously not helping this patient. Her next best option is surgery.”

“We could do a septal myectomy instead of a transplant though,” Dr. Averies suggests, but Dr. Morrow shakes his head, his ash blonde hair longer than Community protocol allows for its residents falling into his sky blue eyes.

“Have you taken a good look at these imaging results?” he hands her a copy of the scans. “The muscle wall is too thick for that to work. If you remove too much of it, you risk the patient’s life on the table, but if you leave too much of it, she’ll need multiple follow-up surgeries. I don’t see how that’s a better option than the transplant to begin with.”

“It does seem we’re out of other options,” Dr. Ferrucci quietly says to Dr. Whinston. “All other treatment plans have failed to produce any good results.”

“Is the patient eligible for the transplant?” Nurse Brewer asks. “Dr. Morrow, as you can see, we don’t have many cases of serious illness in the Community,” she says proudly. “So we may not be able to fully appreciate the risks and benefits of this procedure for our patient, who is an anomaly in the health of our general population.” Dr. Morrow raises his eyebrows – since when is a sick patient called an anomaly? – but doesn’t interrupt yet. “Therefore, we are counting on your expertise to best judge this case,” Nurse Brewer sweetly says.

“In my professional opinion,” Dr. Morrow says, intentionally giving Dr. Whinston – he doesn’t trust that high and mighty chief of surgery – a composed look, “the patient is the ideal candidate for transplant. She’s young, able to respond positively to donor tissue, lungs clear, no infections. She gets the green light from me.” The Community doctors look at him strangely. “Sorry, that means I approve,” Dr. Morrow clarifies the metaphor.

“We know what ‘green light’ means here, Dr. Morrow,” Dr. Whinston snaps. 

“Just sayin’ because you don’t have typical transportation systems like we do,” Dr. Morrow causally leans back in his chair, shoe squeaking on the shiny tile floor. 

“Anyway, I’m still not convinced,” Dr. Whinston protests. “I still believe the transplant is too much of a risk to take.”

“Then when will it feel right to you, Doctor?” Dr. Morrow nearly spits the word out, angry. If he had a patient like this back home, no one – no one – on their medical team would spend time arguing if they should go through with the transplant or not on a patient who clearly needs it desperately and when the donor heart is available right now. He became a doctor to help people, to try to do something for them when their life is literally in his hands, and he can’t believe these doctors would let this case go so easily because it’s uncharted territory in their Community’s protocol. “Your patient is dying. Okay, maybe in your optimized-Community you don’t realize what that actually means when it doesn’t fit your algorithm or is an anomaly,” he shoots Nurse Brewer a vicious look, “but the human body isn’t an algorithm, no matter how many vaccines or pills or whatever is in these suppressants of yours you stuff into someone. This girl,” he drops the file on the table for dramatic emphasis, “she’s not going to make it another year without this heart. It’s a perfect match, and she’s a perfect candidate. I don’t know what we’re doing wasting time in here when we should be prepping her for surgery to save her life!”

The Community doctors fall silent, trying to preserve their dignity. 

“Nurse Brewer, please notify the patient of the procedure,” Dr. Whinston eventually says calmly, as if it were all his idea. “Everyone else, report to OR 2. Dr. Morrow, please scrub in as well – I am sure we will need your assistance in the procedure as you are most familiar with it. Nurse Brewer will show you were everything is.” He gives Brewer a small nod that she immediately understands, and she escorts Dr. Morrow to the OR, who follows with a relieved sigh – he doesn’t understand this Community or their protocols, but he does know a patient in need when he sees one, and he’ll personally see to it that she gets the best care under his hands. He’ll protect her from any side effects and complications of the transplant – and of the Community doctors. 

When the door hisses securely shut behind them, Dr. Whinston turns to the rest of his colleagues – he never counted Morrow as a colleague, just a nuisance. But the higher-ups in the Committee took personal interest that Amorie Reeves’s case receive all due care so the Community couldn’t be found negligent in not providing her optimal care based on her defect. They also had another concern they needed Ken Whinston to monitor very carefully. 

“We do realize the risks of this procedure?” Ken asks again, knowing his fellow doctors understand what he means now that Morrow is out of the way. 

“Why is Morrow here again?” Sal complains with a groan.

“Apparently, he’s one of the best cardiologists in his region, where the heart is from.”

“Him?” Rebecca says in surprise and shakes her head. “He looks like someone who would mess up a simple blood draw.”

“Apparently he is,” Ken confirms. “And the Committee thought they should bring in a specialist not only in cardio but about this specific heart itself.”

“Because a donor heart from outside of the Community boundaries is dangerous,” Sal scoffs.

None of them was concerned that the heart contained diseases – the Community is the gold standard of public health in the world, best-immunized, with all diseases and illnesses eradicated. Amorie Reeve’s cardiomyopathy was a fluke, a condition born out of poor gene screening too susceptible to the adverse environment and climate. An infinitesimal chance, but one they need to rectify now. Even though the rest of the globe’s medicine lags far behind theirs, the donor heart was screened intensively and deemed to be safe from any and all specimens. 

The donor heart was safe of all diseases. But not of memories. And that is what the Committee and Ken Whinston feared. Despite the hard science and refuted claims of its possibility, all the Community doctors were aware of the risk of the transfer of cellular memory. Studies of people claiming their personalities or their habits or their likes and dislikes changed after receiving a transplant. Maybe Ken Whinston and the higher-ups wouldn’t be so concerned if they didn’t have something to hide. Because what if the donor heart remembers that grass is still green, not the wilted brown the Committee claims to have preserved from the worst of the climate crisis? What if it remembers flowers that never bloom here? What if it remembers that it can cook instead of the individualized meals delivered to Community residents’ houses like clockwork? What if it remembers it can paint and write and be creative, additional fluff their efficient Community does not need? 

Worse – 

What if it remembers how to feel? What if Amorie Reeves will learn what emotions are, and no dosage of suppressants will ever be enough to forget and nullify them? 

“We’ll have to keep a very close eye on her – and him,” Ken Whinston says. “Get those files digitized to show the patient; she doesn’t need to know everything here. And let’s get going to the OR before Morrow gets suspicious of our intentions and motivations.”

 In the OR, Amorie Reeves is already out cold from the anesthesia. Spencer had just learned her name. This was the person behind #00411325, although the number is printed on a barcode on the strap on her wrist. So, Spencer takes her hand instead – it is cold and her fingertips are blueish from poor circulation, and Spencer makes a mental promise to take care of her so that they can become rosy and pink again. He’s done two heart transplants before, but he already knows this procedure will be the one to most tug at his heartstrings.

“I still can’t believe the Committee approved this – and him,” Rebecca glances warily at Morrow appearing to check the patient’s pulse.

Ken Whinston sighs. “Desperate times call for desperate measures – and desperate remedies.”