System Update Read online

  “Ian, please stand and remove your clothes for the scan.”

  The doctor’s voice startled him, and Ian sneezed. A thick wad of phlegm scraped by his dry lips and smacked the interior of the capsule with a dull thud. Ian had never heard anything strike the capsule before, but had wrongfully assumed it would make a hollow, tin can-type noise. He grunted, swore, then quickly grabbed his shirt and wiped the phlegm away.

  Why can’t they make one of these things that cleans itself?

  To his surprise, despite its thick and yellowish appearance, the phlegm wiped away clean. The sneeze had also squeezed more fluid from his eyes, and he brought a dry corner of his pajama top to his face to dab them clean. He removed his bottoms next, and then commanded his naked, wrinkled body to the middle of the capsule. After the scan, he felt even more lightheaded than before and quickly sat down on the bench for fear of falling.

  “All right, Ian,” the doctor began.

  Ian, who realized that he had been staring at and thinking of nothing, brought his attention back to the center monitor.

  “Bloodwork is fine, save for slightly elevated neutrophil levels. Do you have any pets, Ian?”

  Ian looked skyward.

  Yes, he felt like saying, I have nineteen cats and seven dogs. I tie them all to a massive leash and we go for long walks on the beach.

  “No, doc,” he said with a sigh, “I don’t have any pets.”

  The doctor nodded, and Ian turned to the monitor at his left and started to process the information. The data from his blood was listed in a simple table with three columns: protein, value, and normal range. Ian had asked the doctor several times what was meant by ‘normal range’—Normal for me? Normal for my condition? Normal for the population?—but when he had repeatedly failed to receive a satisfactory answer—one that he could actually understand—he had eventually stopped asking. Indeed, all of the important values—AST, ALT, and GGT, the ‘Ts’ as he had branded them—all fell within this ‘normal range’. Neutrophils, as the doctor had already indicated, were slightly elevated, but only a few hundred units higher than the upper limit of normal.

  Ian sniffed, feeling more mucus enter his throat, but he swallowed quickly before it reached his tongue. He pulled his bottoms on, but didn’t bother with his shirt for fear of the vertigo returning.

  “Doc, I feel terrible,” Ian began. “I—I—I think it’s my liver.”

  “Your liver is fine, Ian; I checked your liver function and everything is normal.”

  Ian grunted.

  Normal. Everything is always normal.

  “Well look at the damn green dots! They’re spreading!”

  He turned to look at his body outline, and while he had made the comment without looking at the image first, it really did appear as if the green flecks in his abdomen were growing.

  “Ian, the dots are not spreading. The spectral data indicates that—”

  Ian cut him off mid-sentence.

  “Normal! Everything is normal! Well I don’t care about your normal; I’m sick! The cancer is back!”

  He hadn’t meant to shout, but his head was suddenly hot and he was sweating, which compounded the leakiness of his face and set him on edge. He wiped at it once more with his shirt, careful to avoid the thick wad of phlegm that clung to the wadded cotton.

  “The cancer’s not back, Ian,” the doctor responded calmly.

  Clearly this was not his first rodeo, either.

  “But I can take a closer look, if you would like.”

  “No!” Ian shouted, again more forcibly than he had intended. “I want a second opinion!”

  “You always do,” the doctor said, and the face on the screen changed.

  THURSDAY

  Ian could barely get out of bed. His entire body felt heavy and laden with ache. His previously runny face had seized, and now congestion made his head feel like a block of cement. He couldn’t remember the last time he had showered, and his beard had grown beyond stubble. He was also subtly aware of a slight funk that surrounded him like an unpleasant cologne.

  “I think, doc…” Ian began hesitantly. He paused for nearly a minute, his arthritic fingers picking at a button on his dirty pajama top. “I think I need you to take a closer look,” he finally conceded, forcing the words out with stale breath.

  Ian averted his eyes as he spoke, almost immediately regretting his decision.

  “Okay, Ian. I have been expecting this.”

  Ian frowned.

  What was that in his voice? Vindication? Reproach?

  “Please step forward and put the mask over your mouth and breathe deeply when I instruct you to do so.”

  As the doctor finished speaking, a panel opened beneath the center monitor. A mask slowly began extending from the opening. The first time the doctor had taken a closer look at Ian’s condition, when the cancer had started to spread, he had expected something more dramatic—a team of doctors, nurses, men in hazmat suits, anything—but the benign mask that jutted out before him then, the same one that was looking up at him now like a plastic snake, was just a simple oxygen mask. If nothing else, it was disappointing.

  Ian stood, and after taking a moment to muster some courage, he slowly moved towards the mask. He coughed once, a dry, thick sound, and then brought the mask to his nose and mouth, closing his eyes as he did. As usual, the tube holding the mask pulled easily from the panel, offering negligible friction or resistance.

  “Okay, Ian. Now I want you to count to three and draw a deep breath in through your mouth,” he heard the doctor say.

  Ian counted and then inhaled deeply. Like everything else in the capsule, what happened next was unexpectedly silent. Ian felt a slight coldness in his throat, followed by a mild tingling sensation, as if he had inhaled a thousand microscopic pebbles. He opened his eyes then, and saw the tail end of a grey particulate cloud exit the tube and enter his mouth. Then the tube was clear again.

  “Ian, we can do the scan now. The images should be uploaded in a few seconds.”

  Ian looked up at the doctor and was unsurprised by his apathetic expression. He breathed deeply in through his nose and shuddered; his flesh tingled slightly as if there were an electrical charge in the air. These foreign sensations passed quickly, however, and he soon felt the same as before: thick and swollen and heavy.

  “You can sit down now, Ian,” the doctor told him after the scan finished.

  Ian dressed and sat, his eyes remaining trained on the monitor on the left. After an excruciating thirty seconds, the darkness faded and his usual body outline appeared, only this time there were definitely more green flecks in his abdomen.

  “There appear to be some abnormalities on the heat map, Ian. Your liver appears more metabolically active compared to your global averages.”

  Ian swallowed, his throat so constricted now that his saliva only made it halfway down before it hit a dead end and was forced back into his mouth.

  “Relax, Ian,” the doctor began, sensing his apprehension. “Keep looking at the monitor on the left; the computer has stitched together video from the DiagNanos.”

  The DiagNanos, Ian knew, were the cloud that he had inhaled only moments ago. The first time that Ian had given the doctor a ‘closer look’, he had been terrified to learn that the cloud he had inhaled was in fact thousands of nanocameras that entered his blood stream through his alveoli.

  ‘This is the least invasive way we can image your biological processes,’ the doctor had told him in a failed attempt at comforting. ‘Each nanocamera records a video of its passage through your body and wirelessly transmits that information in real-time to the capsule. The computer then takes all of these video streams that each individual nanocamera recorded and stitches them together into one seamless video of their collective passage.’

  Ian had found the doctor’s matter-of-fact explanation, like all of his explanations, annoying and condescending.

  ‘But how do they get out?’ Ian had asked, eyes wide.

  The
idea of a foreign body—so many foreign bodies—in his lungs, blood, and organs had made him squirm. His mind kept returning to the urban legend of the spider that rested on a man’s face while he was asleep. When the man awoke, there was a boil in the area where the spider had lain. Only, in his version, Ian imagined thousands of small robots tearing through his skin and crawling over his wrinkled face instead of hundreds of tiny baby spiders.

  ‘Don’t look so worried, Ian. They are powered by something called multi-coil telemetry generated by the capsule. This energy is extremely short-range, so when you leave the capsule, the DiagNanos become inert.’

  ‘But how do they get out?’ he had repeated.

  ‘Once they are inert, they basically leave your body the same as anything else: either in your urine or in your feces.’

  This did nothing to ease Ian’s anxiety; instead of erupting from a boil on his cheek, now he envisioned miniature robots tearing themselves out of his urethra and rectum.

  The image on the screen flicked suddenly from the heat map of his body to what looked like the interior of a moist pink sock, and Ian was drawn from his reverie.

  “Okay, Ian. The video is ready; we can observe what the DiagNanos have discovered.”

  Ian apprehensively turned his attention to the center screen, which started playing the video of the DiagNanos’ passage down his trachea and into his lungs. Even though he had seen DiagNanos videos several times before, he was amazed at how seamlessly the video had been constructed; only occasionally, at small bifurcations in his bronchioles or blood vessels, did the image distort slightly.

  “As you can see, there is quite a bit of mucus buildup on the lining of your throat,” the doctor said.

  No shit.

  “I’m going to fast-forward here a bit, Ian. The computer has detected an anomaly downstream.”

  Ian’s heartrate increased as the video suddenly sped up.

  Anomaly? What happened to everything looks normal?

  “What kind of anomaly?”

  His words came out in short bursts, his heart beating so fast now that he was starting to feel lightheaded.

  The doctor didn’t look up from his monitor.

  “Ah, here we are.”

  Ian tried swallowing again, but was met with the same result as before. His mouth was full of spit now, and regardless of who had to clean the damn thing, he was going to have to spit on the floor if his throat didn’t loosen soon.

  “Here we are in your liver,” the doctor continued, and the video skipped forward.

  “This here”—the image on the screen jogged back and forth between a handful of frames as the doctor repeatedly rewound and fast-forwarded a second of video—“is unusual. You see how tortuous this vessel is?”

  Ian nodded, but the doctor didn’t appear to notice; the man’s hazel eyes were fixated on another screen, one that was just out of frame for Ian.

  “I isolated just a handful of DiagNanos that extravasated out of the bloodstream at this location,” he said.

  The onscreen picture magnified, and now instead of being surrounded by a reddish light, the image looked strangely like a soft pink forest, filled with long, leafless pines.

  “We are now in the extracellular matrix just outside the tortuous vessel,” the doctor informed him, and the video started again.

  The words were incomprehensible to Ian, but he continued to watch, rapt with interest. The video skipped forward another few frames, and after a fraction of a second of darkness, the image cleared and they were in a new area.

  “And here,” the doctor said, stopping the video for a second, “the DiagNanos are endocytosed by cells near the vessel.”

  Enodcytosed, extravasated, extracellular matrix. Gibberish. All of it.

  The video continued forward again, but now there were occasional black squares—missing data—on the screen, and the image suddenly began to look more two-dimensional than three.

  “The image quality suffers a bit because there are but a few DiagNanos in this particular cell, but the resolution is—” The camera rotated slightly. “Ah, here we are in the nucleus of one of the cells.”

  Even though it had been many, many years—decades—since Ian had taken Biology, he could still recall some of the basics, and he found it difficult to believe that he was seeing a video from inside a living cell; one of his living cells. He forced himself to look away from the screen to see if the doctor’s expression matched his own, which he suspected was a mixture of wonder, incredulity, and horror. But the doctor had the same bored, somehow placating expression on his face, and he was still looking down at what Ian presumed was his own monitor.

  “Here,” the doctor began without looking up, “is the DNA of this particular cell.”

  To Ian, the image on screen looked like a horrible tangle of hair, occasionally interspersed with strange, jelly-like globs that appeared to hold the strands together.

  This can’t be real, Ian thought, and was about to say something to this effect when the doctor spoke before he could muster words out of his dry throat.

  “Now, the DiagNanos will take images of the DNA sequence—thousands per second—and the computer will look for sequence irregularities by comparing them against your normal genetic code from your previous scan and with known malignant sequences.”

  The video on the screen sped up again, this time whipping around the individual hair-like strands of DNA like the corkscrew portion of a rollercoaster. Ian could only look at the monitor for a few moments before he felt nauseated and had to avert his eyes. He squeezed them closed tightly and held his breath in order to avoid vomiting. After the sensation passed, he looked at the doctor instead of the video. To his surprise, the doctor was staring back at him now.

  “Ian,” he began slowly, “the metastases are back.”

  Ian stared at the doctor in disbelief. His head felt so thick and heavy that it was difficult to even blink.

  Again?

  He coughed into his hand, wiping the green expectoration on his pajama bottoms without a second thought.

  They’re back.

  His heart, which moments ago had been pounding away in his chest, seemed to seize.

  They’re back. And I’m going to die.

  Ian blinked tears from his eyes and stared up at the doctor’s face. Something flickered on the screen to his right, but he couldn’t seem to look away from the doctor. Staring into those dull, almost lifeless hazel eyes, Ian’s fear suddenly started to abate. And then the fear was replaced by something else.

  Normal! You fucking said everything looked normal. How many days now have I been saying there is something wrong, and how many days have you told me that everything looks normal?

  Somewhere, someone was speaking.

  “Ian! You still with me, Ian? I want you to relax. You are not going to die.”

  Was I saying that out loud? I am going to die.

  Ian looked up, eyes rheumy.

  “There is good news,” the doctor continued.

  Fury flashed across Ian’s face.

  Normal! Everything is normal! Everything is fine!

  Again he wished that the doctor were here with him, in person, face-to-face—but this time it was for a different reason. Ian quickly glanced down at his balled fists, examining the swollen, arthritic knuckles.

  I could still wring your little fucking neck.

  Either the doctor was oblivious to Ian’s mood change or chose to ignore it, as he continued to prattle on.

  “The computer only identified a few nodules in the liver, and the rest of your body is clean. Also, the tumor cell mutations are the same as before—K-ras and p53—so we can use the same SanaraNanos to eradicate the malignant cells.”

  Ian pushed the anger aside and tried to understand the implications of what the doctor was saying, but it was all too foreign, too confusing.

  SanaraNanos? DiagNanos? K-ras? What the hell does it all mean?

  Even though he had been through all this before, it seemed f
oreign again as if his neurons had since reassembled in a way that turned these letters into alphabet soup.

  He felt the urge to bury his head in his hands again, but resisted and coughed instead. This time, he couldn’t stop coughing for almost a full minute, and when it was finally over he was left gasping for air. The spit that he had so desperately been trying to swallow for the last few minutes now dripped from his trembling lower lip and he did nothing to stop it.

  “It will only take a little while to produce more of the SanaraNanos to attack the specific mutations in your liver metastases, seeing as they are already designed.” The doctor paused, examining Ian’s face. “Remember last time? The nanobots sought out and destroyed the diseased cells in your body, using the specific sequence mutations as their guide. Ian, we should be able to eradicate the tumor tomorrow.”

  Although Ian knew that the doctor expected him to show some exalted relief, everything was too sudden, too overwhelming.

  And how long until it comes back? How many days of being normal before you find an abnormality again?

  “What about my throat?” he demanded, focusing on the only thing that made any sense to him. “My stomach? And my head… it… it… it feels huge.”

  “I have prescribed something for the pain. I will see you again tomorrow, Ian.”

  A panel opened below the center monitor just to the left of where the breathing tube had protruded. Ian struggled to his feet and slowly made his way to the panel.

  “These fast-acting sublingual tabs will have you feeling better in no time. I also added something to help you sleep.”

  There was another pause, and something in the doctor’s face changed.

  Was he smiling?

  It was an odd, tight expression, but Ian thought it could be a smile.

  Smiling. This fucking quack is smiling.

  “Ian, you are well shy of the century mark, young and otherwise healthy. There is no need to worry.”