On the Pulse of Tomorrow

“You can check by gripping my wrist, you know.” 

The doctor looks at me like I’m something quaint, like a moth-eaten teddy; something that one used to hug, but now needs consigning to storage. 

“To measure the pulse,” I circle my papery wrist, pressing my thumb to the blood flowing, tapping an almost imperceptible stream. 

“Ah yes, of course.” He nods like he’s remembering something he was once told, perhaps as a joke, on his first day at med. school.

“Well no need for that now. I’ve got all your essential stats right here, courtesy of the graft.” He waves a hand in the direction of my right bicep. The Smart Patch they fitted nearly a month ago is invisible; a secret and silent doctor, monitoring me 24/7. He smiles broadly, in what is presumably supposed to be a reassuring way.

“No, I wouldn't want to interfere with your privacy; your physical space. These days we try to keep hands-on contact to an absolute minimum. It’s better for doctors and of course patients this way.”

I remember the doctor at the care home, gently closing your eyes, the practised hand stroking the lids shut for their long final sleep and blink the memory away. 

“Do you have any questions about the procedure? It’s really nothing to be worried about. The Smart Surgeons will ensure it all runs, what was the saying, with those old timepieces?”

“Like clockwork.” 

“Yes, exactly! Although didn’t those old watches always run down?” He lets out a burst of laughter which echoes around the empty ward, stripped of everything but him, me, and the one screen. 

“Well no worries about that today! Chief surgeon AI-da will be overseeing the procedure. As soon as it’s complete, the Smart Patch will fully activate, commencing operations formally completed by the redundant,” he looks briefly lost for words, shifting from one foot to the other, “er, the redundant part.” He finally manages. 

“Now, you take it nice and easy David, and when your Smart Patch and AI-da are ready to begin, your Hear-Speak will let you know.” He gestures to the implant lodged in my right ear. 

The screen, previously dark, flashes to colour. Lines of text appear: Elevated levels of Cortisol detected; attendant spike in blood glucose. Recommended medical intervention: tranquilliser and insulin administered in 3 minutes, should levels fail to stabilise. 

“Doctor, no!” I blurt out, gripping the rails at the side of my bed. “I can manage this; I’ve learnt breathing exercises to deal with stress. I don’t need a tranquiliser!” 

“Of course,” he soothes, making for the door. “The nanobots will only deliver the drugs if there is a medical need. Now do try to relax. If you like, I can check in on you one more time.” And he closes the door quietly behind him. 

It’s only when he’s gone that I realise I forgot to ask any questions. But I can’t let that trouble me now. I have less than two minutes to try and lower my stress levels, or the nanobots will deliver the drug and I’ll only know the dark when it slips about me, pulling me under. Breathe David, I tell myself: long, deep breaths. In: one, two, three, four, five; and out: one, two, three, four, five. In through the nose: one, two, three, four, five; and out through the mouth: one, two, three, four, five. Again. And it helps: my breath, that old familiar; a rhythm that has rocked me throughout my life. Here, in this alien place, it is the comfort of the known, still performing the daily miracle of turning air into breath, breath into life, deep in my lungs. 

I’ve managed it. The screen closes its beady eye; the lines of text vanish into reassuring nothingness and I silently thank those relaxation classes I stumbled into months ago at the care home. They didn’t seem to bring much respite at the time, unless you count staring vacantly at my feet while others did the breathing exercises a help, but perhaps they’ve finally come in handy now. Yes, my hand’s not shaking. I look at it swiping over the imperceptible Smart Patch. It's supposed to be seamless, and I certainly can’t see a crease or a wrinkle of skin, let alone a scar. But I know it’s there; I can almost sense it pulsating with my data. Soundless blips are instantaneously zipped to the screen with its invisible eye trained on me; to my smart fridge: door now locked, barring me from all my lovely creamy, fatty, artery-clogging favourites. And of course, inevitably, my health insurance has been automatically updated with my vital stats: my premiums will go up, again. And for tomorrow, my Smart Car has the schedule in place: pick up at 8am, when I’ll be ready to check out, this one final procedure complete, finally having crossed the finishing line; my destination: brand new me. 

I remember other finishing lines. A water-logged playing field. A school sports day in March. The other boys all lined up, hands on scabby knees, waiting for the whistle. And from the sidelines, the blast ripped across the grass, a summons to run- and we did. Elbows out like mug handles, shoes claggy with mud. Each stride was exhilarating pain. I forgot to breathe, forgot to pace myself; I only knew I was the closest to the finishing line, was upon the finishing line, was over the line- I’d won! Heart thumping, blood in my ears, whole body shaking with the effort; I’d gulped down air feeling, for the first time, with every fibre of my small being, the thrill of a win, yes, but also the thrill of being alive. 

I’d sat down afterwards, head between my knees, a little sponge, letting the rain-soaked earth seep into me. I was dizzy, with elation or exertion, I couldn’t tell- probably both; but I knew I needed to rest. Clear signals: body to mind. Blood a speeding messenger, delivering its missive: sit!- to my befuddled brain. That was then; this is now. Which signals will Smart Patch or AI-da send me? Will they bother at all? Perhaps the nanobots will just release the anaesthetic when they’re ready to go. No need for a countdown, an old-fashioned: 3-2-1. It’s not like I didn’t sign up for this; my Insurance made the stipulation and my digital fingerprint is on all the forms. If they want darkness to descend in the swirl of a Smart magician’s cloak, well they’re the conjurors now, not me. 

It didn’t use to be like this. It used to be me with magic at my fingertips, for I’d touch you and you’d quiver, a string stroked by a bow. And oh what music we made. Those nights, under the stars; me, a poor boy, wishing for the diamond necklaces strung on night's throat; wishing I could reach up and pluck one down, clasp it about your lovely neck, and see how you outshone the lights of heaven. Not that you needed jewels; we didn’t even need the stars. I would have found your lips, drank your breath, even if the earth had heaved and we two had fallen into an abyss. 

That first kiss: where the bee sucks, there suck I; heart hammering like it wanted to knock down every door I’d ever shut; blood roaring like an orchestra in my ears. The sounds of love: hammering, roaring, music on full blast. I look about the ward and can only wonder, at the clear digital silence. It is like someone has come with a big bag, opened it up and put all the sounds inside, snapped it shut and left. There’s no hum of machines, no shuffle of shoes; if AI-da is here, she is as silent as the grave

No, I lie, there is a noise: the click of the door opening; the doctor is back again, just as he promised. He begins to parrot a spiel; perhaps this is his role, although he seems pretty redundant, if truth be told, given Chief Surgeon AI- da will be running the show with her team: Smart Patch and the nanobots. Perhaps he’s part of the package, paid for by my monthly premiums: a salute to the bygone days, offering a comforting patter, even if he won’t take my pulse or listen to my chest. I struggle to focus on what he is saying, trying to keep the rhythm of my breathing while I glance at the screen behind him. 

“So there’s no need to feel anxious at all, David. This is the last procedure: the final great overhaul.”

I nod, his words setting me adrift, not hauling me in at all.

“And after this, the Smart Patch and nanobots will be able to fully navigate this old ship of a body.” He nods, as if appraising my paper-thin skin and silver hairs and deducing an old steamer, long since destined for harbour. 

He seems to be building up to a grand oration and I wonder if he is just voicing the Hear-Speak in his ear. I seem to remember this speech from the Insurance blurb I had to read and sign weeks ago. When the rep. explained that as I now no longer had someone to care for me, and as I was of an age where I would place more demands on my Insurance than supply could possibly meet, I would have to, please, press my fingerprint to the screen, agreeing to the procedures listed: a Hear- Speak implant; a Smart Patch graft, an infusion of nanobots…the list went on. I’d closed my eyes and pressed. 

Here, in this ward, the doctor’s still droning on. I grip the rails, feeling the bed rock beneath me.

“This great storm of life: age, disease; it is over. Ours will be smarter sailing, on the high-wi wave of the future.”

I remember other waves. 

Our last holiday, pushing your wheelchair, well pulling it in reality, across the beach. You were so light, but still we stuck in every ripple of sand. Right down to the shore where the little waves lapped over the wheels and I half thought we should just keep going. It was easier here, the sand compacted from the tide; the chair picking up speed of its own accord. The thought crossed my mind: I could push right on, let the waves cover me and you. Yes, we could have stepped into the tide, and accepted that there was no wave, no medical miracle, which would break in time for you. Better to let the surf pound and render us back to the particles we came from; to mingle with the sand. 

Instead we stopped, watching the boats far out on the horizon, specks which seemed stationary and devoid of purpose compared to us: watching, holding hands, feeling the twitch of your pulse, your life force, trembling, but insistent still. 

I collected your Death Certificate two weeks later and to the wider world you are gone. We are steeped in surveillance, but your presence goes unnoticed by all but me. For what can detect an invisible shadow, cast by no light, possessing no form? But I sense you; you’re the daylight moon, an improbable miracle, but one right there to see, if we only just glance up. 

As I do now, looking at the parroting doctor like I’m seeing for the first time after months of floundering in the dark. And the questions pound relentlessly: what am I doing here? Yes, I’m signed up to the Three R programme: Renew, Regenerate, Revive but what is it exactly that I want to revive? There is nothing dormant, slumbering or passed-on. I know what I’ve felt since I first took you in my arms under that jewel-studded sky, all those years ago. You don’t need to revive something that never died.

Yes, I signed the paper. It stated it was just an organ, like any other: blood, tissue, muscle. It’s a medical procedure, not much more than a bypass, fitting a pacemaker, or having a transplant. Except it’s not. 

I’m no medical man, no anatomist; I’ve been telling myself these last months. What do I know of this beat in my chest? Enough to know it now for what it is: the drum of my life which I could never, ever, let someone silence, substituting in its place a silent, staring patch. 

One hand clutching my chest, I begin to rise from the hospital bed. I grasp at my heart, my one and only treasure chest, storing every bit of gold I ever had: a bounty of pleasure and pain. I glare at the doctor, this thief with his band of AI robbers. 

I can’t give it up and I won’t. I open my mouth to tell him, only to rebound from the words he has let fly.

“Ah, I’m getting a message that AI-da is ready now. Don’t worry David, you won’t miss your heart at all. It’s packing up; time for the Smart Patch to take over. 

My chest tightens, it feels like a boulder is squeezing the air out of me. The invisible patch burns under my skin like a brand and unseen I feel the nanobots speed through my veins like dark lightning, scorching my senses.

“I-”

He smiles broadly, "yes, I know, we’re so lucky to be living on the pulse of tomorrow.”