Remote Rural Surgery
Beep. Beep. Beep.
The heart monitor let out a periodic noise, letting Mabel Carter know she was still alive. Her breathing was ragged in a way that sounded like autumn leaves skittering across a street. Her attention was captured by busily pulling at a loose thread at the edge of her hospital blanket.
It was all she could do to keep her mind off the impersonal delivery in this clinical white room of her prognosis. End-stage cirrhosis.
“We can fix it, Mabel,” the young nurse insisted. Her name was Sarah, one of the few remaining staff at the Clay County Clinic. Her eyes were kind, but it was clear she was overworked. Her eyes were as wrinkled as Mabel’s own.
“Get Doc Allen,” Mabel rasped. “He’s been my doctor for years. He will know exactly what I should do.”
“Doc Allen? He retired eight years ago,” Sarah replied as she tapped on a tablet. “He lives in Flordia now and seems happy to be there. There aren’t any surgeons in the county anymore, Mabel. There haven’t been for a few years.”
“But... what is going to happen to me?” Mabel asked, her fingers picking at the blanket more frantically.
“We can schedule you with a surgeon in Philadelphia. Dr. Perro is the best in his field,” Sarah explained.
“Philadelphia? That’s a thousand miles away! I’m not going anywhere. Just find one in Charleston,” Mabel scoffed.
“You won’t need to travel. He will be connecting to our clinic remotely,” Sarah tried to explain calmly. “We have a Haptic Telepresence Surgical Unit, or HTSU.”
“Huh?” Mabel was obviously confused. “Can you speak English?”
“It’s basically a robot. We got it from a federal grant. Perro will connect to it from his office in Philadelphia. He will put on special gloves to feel what the robot feels and control it. It will be exactly like he was here in the room with us. There’ll be no need to worry. And I’ll be right at your side.”
It felt so impersonal, having a cold metal hand touch her body. She thought of some large, intimidating Terminator opening her up and pulling out her insides with mechanical claws.
“No,” she said adamantly. “I ain’t letting a machine cut into me. I have to have a real doctor.”
“He is a real doctor, Mabel, even if he isn’t personally here,” Sarah insisted. “You need a partial hepatectomy to remove the damaged part of your liver now. I am afraid without it, you won’t have much time left.”
“I’d rather die whole than have some city slicker’s toy slice and dice me,” she spat, her harsh voice masking a deeper fear. She thought of being buried next to Earl, how reassuring he had always been when she had trouble. What would he think of something this impersonal?
“I must insist you cooperate, Mabel,” Sarah affirmed.
The door opened at that moment. Two nurses wheeled in a large white tower. As it unfolded, Mabel could see long arms with multiple joints extending out. At the top was a large fluorescent light and a camera. A series of surgical instruments hung from the ends of the arms like an insect with sharp spikes lining its body.
“Get it out!” she shrieked as a primal panic overwhelmed her. It was so wrong. There was no way she could let that thing touch her, much less perform surgery on her.
The two nurses moved in quickly, grabbing her arms and keeping her from thrashing. Sarah’s face seemed to have a mask of sympathy even as behind it was a steely cruelty.
“Under the Federal Remote Healthcare Act, this is an Implied Consent for Vital Intervention. We have to do this,” Sarah explained.
“The hell you will!” Mabel yelled, throwing her body left and right despite the pain in her side. The heart monitor’s beeping became frantic.
Sarah placed a clear plastic mask over her nose and mouth. The hiss of gas was soon followed by her vision tunneling. She saw a small lens extend out from the machine. It stretched forward with a singular unblinking eye to watch her as the world faded to black.
Mabel awoke to the infrequent beeps from the heart monitor, steady and calm. Her head felt heavy. She slowly opened her eyes and they adjusted to the amber light of sunset coming in through the window. As she let out a loud yawn and stretched her arms, just starting to fight off the grogginess of anesthesia, she realized she felt different.
The pain in her side, which had been growing worse for months, was gone. In its place was a small ache that felt like a sore muscle. Her fingers reached down and touched her torso. She could feel the line of stitches from the incision. They felt neat and clean, like a zipper.
Outside, the sun was now hiding behind the familiar Appalachian mountains that had been there her whole life. She was safe now, but still felt a strange emptiness.
A man she had never met, from a city she never visited, had somehow reached inside of her with metal fingers. The feeling could be described as isolation, still being alive but disconnected from the interpersonal world she knew. She knew nothing about the doctor, couldn’t bake him cookies, couldn’t thank him. She was just a living entity in bigger system she would never be able to understand.