"Shit," snapped the doctor, tossing the plastic gloves in the biohazard bin and storming out of the operating room. The patient on the table was dead. The cheaper implant had failed and turned septic before they could do anything. His health assistant, NRSE, following close behind him down the hall.
"Dr. Padua, please confirm Patient 26's Death Certificate."
NRSE displayed the necessary documents that ensured the patient's death was properly recorded. He viewed the Death Pronouncement ensuring the time of death and other details was accurate and linked to the proper patient's Progress Notes. He pressed his thumb to the screen, signing the Death Certificate. This prompted more screens to appear.
"Coroner Notification and Hospital Discharge Summary have been completed. Patient 26's Personal Belongings Inventory is included in the Next of Kin Notification. Final Hospital Billing Statements are ready for the insurance company. Would you like to proceed with these filings?"
"Yes." He sighed, taking a moment in the hall to compose himself.
Just like that a person's life was over. All that was left was for the next of kin to collect whatever personal effects were left and the body to be released to a morgue. So efficient and devoid of personal attachment.
Dr. Padua had been in the medical field for nearly two decades. A lot had changed since being a young doctor. Nurses, the life blood of hospitals, running around assisting doctors with patients and bogged down with hospital administrative duties were increasingly being replaced by machines. There were no more spontaneous birthday celebrations in the break room, words of comfort after the loss of a patient, or the pleasant sound of laugher offering that healing touch in an increasingly sterile environment filled with beeps, buzzing, and whirls of medical machines.
NRSE urged him to finish his rounds. There were still so many patients to see. He approached another doctor in the otherwise empty hall fighting with her NRSE about billing. She slammed an open hand against the wall, demanding an explanation, but Dr. Padua heard only the other doctor's side of the argument as he passed by. Doctors were fitted with an implant that connected them to their personalized NRSE. The implant allowed them to view augmented images and auditory stimulation from their NRSE, ensuring patient privacy.
Before the hour was over, he finished attending to three additional patients, but still felt the lingering impact of the death of his patient from earlier.
"Patient 49 in room 305 is next, Dr." NRSE relayed the patient's medical results while they headed towards the room. He wiped the scowl off his face before entering. Patient 49 was resting, but only lightly, as she stirred before he reached her bedside.
"Ms. LaFleur, the antibiotics appear to be effective. However, I have some concerns. In most patients, we expected to see a positive response within about two days. It's concerning to me that the antibiotics are less effective for you."
He wanted to take another blood sample and run a few more tests. She consented but speaking had caused another bout of coughing. He heard a rattle in her lungs that was worrying and asked Ms. LaFleur if she was able to sit up, moving behind her to listen to the lungs. Her hospital gown drooped around her shoulders. Already quite petite, her lack of appetite had led to additional weight loss since her arrival. He pulled aside the neck of the gown to listen to her lungs, revealing a raised white scar below her shoulder. He asked her to breathe and prescribed additional medication.
"I apologise, Ms. LaFleur," Dr. Padua began. "I noticed an old scar just now on your shoulder. May I ask how you got it?"
The woman tensed, scowled, and pressed her lips together as if distressed by the question. She shrugged and said it had happened so long ago she couldn't remember. Her mother had told her it had just been some accident. The doctor asked if there was anyway to get in touch with her mother to find out more details.
With a pained look in her eyes, Ms. LaFleur replied. "She died six years ago. My son is the only family I have left."
"I'm sorry, Ms. LaFleur."
She smiled in response to his condolences but the pain was still very evident. "Me too. She was a good mother." Her tone was soft and it was clear they had been close.
He cleared his throat. "It's likely nothing. Just a habit borne from years of training to take accurate medical histories. There wasn't anything in your record even though it appears to have been severe." She assured him it caused her no pain, and given its placement, she had forgotten about its existence.
Dr. Padua asked NRSE to pull up the images of her lungs and display it for Ms. LaFleur to view. He pointed to the shadows and indicated that the images were recent from the ones taken upon her admittance to the hospital. He noted the improvement, though slow, and informed her that, given the trajectory, she may be able to return home in a few weeks. She sighed, relieved, and thanked him for his care.
Dr. Padua remained troubled however and the scowl from before had reappeared on his brow. His patient noticed and asked what was wrong.
"Your medical insurance called. It seems they have unilaterally determined that due to your improved condition, continuing your stay in the hospital would no longer be mandatory. Therefore, as of tomorrow, additional hospital care will no longer be covered under your insurance plan."
Ms. LaFleur was silent. She stared at the image of her lungs, the shadows still speckled throughout, and processed what the doctor was telling her.
"I see. Then let's continue the treatment from home." A little laugh escaped her lips, but it lacked the spark of real humor. She tried to put a positive spin on the news.
"It will be nice to sleep in my own bed again."
When Chez opened the door, he saw the doctor and his AI health assistant beside his mother's bed. An augmented scan of her lungs was displayed above the bed between them. The doctor's expression looked displeased.
"I would advise against it, Ms. LaFleur," he said, cautioning her that leaving the hospital could cause her condition to worsen. Ms. LaFleur looked frail and tired. The neck of her hospital gown drooped low revealing her collarbone and pale skin. Until that moment, Chez hadn't noticed how much weight she had lost.
"There's no helping it," Ms. LaFleur insisted. She noticed Chez standing by the door and her appearance suddenly shifted. She smiled brightly and waved him closer, pulling the blankets up around her as if trying to hide herself from him.
The doctor excused himself and closed the door behind him. Chez approached the bed, asking what she and the doctor had been talking about. Ms. LaFleur reclined and brushed off the question saying it was just the regular doctor-patient conversation. Before Chez could press her further, she asked what he had brought for her. Every day, Chez stopped by the hospital, bringing her flowers or a book or anything he thought might help her feel more at ease away from home.
From his backpack, Chez revealed what looked like a robotic spider the size of a tennis ball. He placed it on her lap and explained it was the project he and Kevin had been working on for the robotics competition. It utilized machine learning and had a programming component that would generate code automatically to keep it upright and stable should its center of balance be disrupted.
He tipped the spider on its back to demonstrate and explained that it would gather information from its environment to generate code telling it how to stand up again independent of specific instructions from an operator. As he spoke, the spider started moving its limbs, pushing and gripping the surface of the blankets on her lap until it had righted itself.
Ms. LaFleur clapped her hands enthusiastically, praising both his intelligence and its design. She said the robot was just like him in its resilience no matter the challenge. Handling the spider with care, she gave it back and assured him that they would win.
She then told him she had her own good news. Tomorrow she would be coming home. Chez asked if the doctor had cleared her to do that.
"Of course," Ms. LaFleur said sighing and asked Chez to read a little from the book on the table beside them. After his mother drifted to sleep, he slipped out and found the doctor.
The doctor shook his head. "She isn't being discharged," he corrected. "Her insurance company called to say that they wouldn't be covering her stay at the hospital anymore." He pressed his finger to NRSE's touch screen and asked it to locate Alice LaFleur's insurance case. Several redacted documents flashed up on the AI health assistant's screen. The doctor gave NRSE permission to share the screen allowing Chez to see the redacted information. Highlighted in bold letters, Chez noticed the text "Non-essential Care".
"They claimed your mother's hospital care is 'non-essential', so it won't be covered anymore. We appealed but it was denied earlier this morning." His lips pressed, but before he managed to school his features, Chez noticed the look of disdain when he mentioned the denied appeal.
"In my medical opinion she shouldn't leave, but like so many, she can't afford to stay without insurance covering the cost." He shook his head, appearing worn down. "These companies are always shortchanging patients," he sighed, revealing his own sense of helplessness. Before parting ways, the doctor suddenly stopped him, as if remembering something.
"There's a quarter-sized scar on the back of your mother's left shoulder," he said, demonstrating its placement on NRSE with his hand. "Your mother said it was from a childhood accident." Chez remembered noticing it a few times when he was young, but his mother dressed conservatively, and the scar was often covered.
"Has she ever mentioned the circumstances around the accident?"
Chez considered a moment but shook his head. The doctor assured him that it was nothing to worry about, simply that it was a deep scar that likely would have left a vivid memory of the incident, but his mother seemed unable to recall any of the details surrounding it.
Like many questions, Ms. LaFleur was adept at brushing them aside with vague answers and shifts in topic. Chez reflected on the response she'd given him when he'd asked if the doctor had cleared her for discharge. It had been the first time she had outright lied to him, or at least, it had been the first time Chez had noticed. What else was she keeping from him?
The next day, Ms. LaFleur walked out of the hospital, gripping her discharge papers. She told Chez and the staff that recovery would come easier in her own bed, away from the suffocating sterility of the hospital. But a few days after leaving, her condition took a turn for the worse and Ms. LaFleur returned to the hospital – not in an autoCAB, but on a stretcher, with the wail of an ambulance echoing in the distance.
That night Chez refused to leave her side, oblivious to the world outside the hospital walls. He lowered his head into his hands as the cold, rhythmic beeping of the monitors became a cruel symphony to his heartache. Her labored breaths came in uneven gasps beneath the oxygen mask, and it couldn't hide the ghastly yellow hue of her skin. Her kidneys had shut down. She was slipping away, and there was nothing he could do. The torturous sound of her lungs struggling for air was the sound of his world unraveling.
"I wish you had kept the umbrella," he muttered without thinking. He looked up at the sudden touch of a hand on his head, harkening back to how she use to check his temperature when he was young. His eyes were red and hot with unshed tears. Alice LaFleur smiled with the same grace as always and lowered the mask.
"Looking out for your child is just what mothers do," she told him. Her voice was weak and raspy, but there was a gravitas to it that Chez never forgot.
It was just what mothers do.