Space Inc (anthology)

Suspended Lives by Alison Sinclair

Five facets of the icosahedral doctor’s lounge look up, or down, if you will, on Earth. The dayshift surgeon, Ygevney Barishenkov, slouches beneath the window, rumpled and bleached in the Earth light. I’d think he’d had a bad shift, but that Y’ always looks as though he hasn’t grown to fit his skin, never mind his scrubs.

I attach my coffee-sac to my belt and monkey along the perimeter struts in the approved manner. No microgravity aerobatics in the doctor’s lounge.

“I accepted two transfers from Franklin, Artemis? construction crew,” Y’ says, by way of evening greeting. “Both stable.”

“Tell me about them; I’m awake.” I suck on coffee, to ensure I can live up to the promise. I could ask the genie for the hand-over, since all the information is databased, but nobody comes up here to be a hermit.

“The first one’s Maria Jose Elliott, twenty-seven, closed-suit crush injury to right leg. Vascular repair was successful with recovery of good perfusion; some ischemic damage and rhabdomyolysis. No genetic risk factors for muscle breakdown, however, slightly increased risk of thrombosis. The gene-genii flagged two separate polymorphisms associated with mild thrombophilia.

“Second one is Li Shu Quen, thirty-four, decompression injury to left arm, sustained when she went to assist the first casualty. Transferred primarily for pain management; she’s a known hypo-responder to synthetic opioids and Franklin didn’t have the drugs to cover her.” I agree with his scowl; if they have a known hypo-responder, they should have the drugs to cover her.

“I thought Artemis’ argument for all-female work crews was that they had a better record in hazardous work environments?”

Out of the corner of my eye I see the nearest genie’s eye brighten. “Genii, cancel review request,” I get in, before the knowledge system starts to pontificate on the world literature on gender differences in safety practices. “When are they going to give us an upgrade that can recognize a rhetorical question?”

Y’ can recognize a rhetorical question. “Stephe Te Kawana has a hot gallbladder over at Sharman. The auditor-genii says she doesn’t have acceptable live experience, and so she wants to know whether she should transfer or whether you’ll operate from here.”

“How’d someone get up here with a hot gallbladder? They should have been screened out and treated Earthside.” Y’ produces another from his repertoire of shrugs. “What should I know about him?”

“Forty-eight-year-old male, Ellis Keene. Engineer with Faber. No known health problems.”

“I’ll review him, see whether we should transfer him here. What’s the lag between Sharman and here?”

“Seventy-one milliseconds,” supplies the genie, on cue.

Telesurgery is limited by, among other things, the signal round trip. Humans can only accommodate two, two fifty milliseconds delay between their movement within the operating station and the visual feedback from the OR suite. Much more than that, and the rhythm is broken, instruments get out of position, incisions are too shallow or too deep, sutures are ill-placed.

Then Y’ adds the joker to the pack. “We heard an hour ago that there is an IBDD shuttle due in at 2307 for Semmelweis.”

Another platter of dainties left over from the bioterrors. HIV-’flu, for instance, or Jerusalem hemorrhagic fever.

Although the last proven biowarfare release was seventeen years ago, and decommissioning of the former biowarfare labs is slowly proceeding worldwide, nobody quite wants to let go. Hence Semmelweis, another example of a small, not so bad idea that grew into a monster. We can see it from here, off to the right, a clutch of polyhedral pods, tube-linked, with solar collector deployed.

Unlike any other department of the IMS, there are no tubes linking it to the rest of the platform, only support struts. Semmelweis is entirely self-contained, shuttle and bubble-car being the only way to reach it. Initially, it was intended to be a temporary research and storage facility; now, because the IMS is the organization that all bodies and states distrust least, it has become the repository for all the ostensibly decommissioned pathogens… just in case.

“Genii, please confirm that all departments have been officially notified that ambulances are exempt from the standard security lockdown?” Two years ago a critical transfer was delayed by security, such that we nearly lost the patient. I might forgive and forget; space doesn’t.

Roll on the happy day when Semmelweis gets floated off on its own. Roll on the happier day when Semmelweis gets dropped into the sun.

“What else?”

What else is our current cadre of trauma inpatients, tucked away in the flare-shielded infirmary pods toward the center of the platform. Given the screening our crews undergo, they’re as near to perfect specimens as the human race produces: young or middle-aged adults selected for excellent health, low cancer risk, mental stability, intelligence, adaptability, and a variety of other assets.

Not that we are underemployed, since the five IMS platforms are effectively the tertiary care centers for the orbital population, the fifteen thousand or so inhabitants of everything from the great solar taps to long-term experiments in closed-environment living, with various materials manufacturing, materials research, and pharmaceutical research and manufacturing platforms in between. Trauma accounts for most of the surgical caseload. Platform construction crews are disproportionately represented, because of the number of new and short-term workers, then platform maintenance, particularly the outdoor monkeys, those whose work involves EVA. Inboard and teleconstruction crews are less likely to wind up in here, though we currently have two survivors from an explosive depressurization that killed one over on McAuliffe. One might be discharged back to McAuliffe today, assuming traffic control can clear the backlog created by the IBDD shuttle in time. The other is likely to be transferred Earthside if the anti-PTSD pharmacotherapy doesn’t take effect soon.

“G’ night,” I said to Ygevney, who waves an idle hand at me and monkeys toward the nearest hatch. I tuck myself into one of the lounge’s blebs—recessed communications alcoves—to look in the genii’s eye. I’m considered eccentric for my appetite for Earth news, but my family, like myself, incline toward dangerous places. My plant geneticist parents are currently working in the Christian States of America, whose attitude to gene-engineering is nothing if not ambivalent, even though climate change has so altered the Prairie and Southern landscape that no unengineered crop plants can survive. My marine-biologist sister, the radical conservationist, is campaigning against the expansion of the fish plantations in former New Zealand waters. Since a third of the world’s population is now dependent on the sea for food, the campaign has been, and will continue to be, violent. My peacekeeper brother is guarding a forensics team investigating accusations of bioagent release somewhere in Mid-Europe. And my ex-marital partners, a mobile group practice, have just been granted license to practice in a region of United Africa formerly closed to, and still very suspicious of, Western medicine.

I don’t want to be taken by surprise by the official message that begins with the words “We regret to inform you…” though I know I probably will be.

None of my spiders snag anything of interest, except for an item on the case before the World Court determming plat-formers’ rights to rear children in microgravity. A verdict is pending.

Pregnancy is both achievable and sustainable in a platform habitat, though there are challenges involving oxygenation and circulation. Study of mammals in microgravity suggests that the postnatal maturation of skeleton, muscle, and circulation under gravity is likely to be abnormal. Perhaps abnormal enough that any child raised purely or mostly in space would have serious difficulty readapting to Earth.

As far as those on the international and commercial platforms are concerned, the issue is academic. Our contracts stipulate contraceptive implants, and our benefits include gene-banking and IYF. But several platforms established by smaller governments, private foundations, and organizations explicitly promote procreation in space. Four infants have been born in the freehabs over the past three years, and the Earthside relatives of two have taken the argument over their well-being to court. The freehabber parents are refusing to take the children Earthside at all until their rights are upheld.

Personally, I regard our tenancy in space as entirely too precarious to think of colonization. But if the World Court rules the children have to be transferred Earthside, someone’s going to have to enforce the order. I can see the whole mess being recast as a child-health issue and dumped hot and quivering in the IMS’ jurisdiction. And that is something I want to see coming.

No verdict so far, and so to work.

I see no reason to transfer the patient from Sharman; indeed, knowing about the IBDD shuttle, I prefer to keep what grace we had for accidents and true emergencies. Hence at 2030, I’ve done rounds and am configuring the operating station Y and I both favor to my own preferences, fitting the headset, loading the VR interface, and adjusting the surgical gloves. For a small man, Ygeveny has big hands.

I study Keene’s anatomical reconstructions and lab results. He has a hot gallbladder, all right, taut and inflamed, with an impacted stone in the bladder neck. With the surgical expert system in simulation mode, I run through the procedure, a remote laparoscopy. In microgravity things flip and bounce far more than you’d expect, particularly a slippery bag of fluid on a stalk. But since the operating field is entirely reconstructed from 3D imaging data, when I nick the biliary artery, the gory cloud filling the abdominal cavity does not obscure the surgical field, as it might under camera Earthside. I spend about thirty minutes refining my approach so that won’t happen in vivo, all the time with a little clock ticking in my head. As though the arrival of medical emergencies is guided by any natural law—unless it’s the one that says the pager never goes off just before you go to sleep.

I’ve spoken to Ellis Keene before I start my setup, and I bundle up the result of the simulations with the expert system commentary and squirt them over to him, adding the information to the statistics on my record. If he’s unhappy with my experience and performance, we can prepare him for drop, but I gather from our talk that, like most people up here, he’d rather not drop out of turn. For someone who has been working on short-term contracts, he has accumulated a lot of hours.

While I’m waiting for a final conversation or a registered consent, I take a quick virtual trot around the ward and the parts and activities in the platform that experience has taught me are most accident-prone. The security lockdown helps, because nobody in the area is outside who does not absolutely need to be because something needs to be fixed now, and not in four hours. Who knows: it might be a quiet night. There’s a suspected atmosphere leak over in one of the seven bioreactor pods where these days we grow most of our pharmacopeia. The suit and implanted biosensors of the team outside are normal, not even one raised heartbeat. If they’ve got a problem, they don’t know it yet, and in any case, the duty internist will have them on his screen.

Lastly, I watch the IBDD shuttle emerging from Earth’s shadow, its trefoil symbol orange on shining white. Precious little information available on what it’s carrying—I, after all, will only have a need-to-know if something goes very wrong. Several IBDD teams have been visiting Serbiastan over the past months, so odds-on it’s fungi. While the Americans liked viruses, the Europeans were partial to fungi.

Ellis Keene calls me, with a question as to how serious my nicking the biliary artery would have been. He could get the answers from the genie, of course, and let the decision-assist software assist his interpretation, but I already sense he prides himself in making up his own mind. He’ll let me do this surgery if he decides to trust me. Which, in the end, he does, because, he informs me, I personally sent him my screwups and didn’t make him look them up.

The surgery itself is straightforward—hardly a drop of blood spilled. What is less so is the results of some of the blood work. PCR shows one of the more common leukemic chromosomal translocations. There’s a higher incidence of various cancers among space workers, and often a more rapid progression. I dislike the medical exemptions given for short-term contract workers, and the way companies like Faber take advantage of them. Those of us with long-term contracts have been screened for a low-risk genotype, as well as being fully dosed with the latest tumor suppressants. Ellis Keene’s predicted cancer risk was lower than average, but still below the standards of the IMS, and I don’t regard his tumor suppressant regimen as optimal. He’ll be medically discharged Earthside for a full workup and treatment. The leukemia is eminently curable, particularly at this early stage, but he won’t be back, not with a history of malignancy; no one would insure him.

Stephe Te Kawana seems as depressed as I am. We regard each other glumly across the virtual link, having agreed that she will be the one to tell our patient.

Like myself, Stephe is Unified Pacifican, though her ethnic blend is Asian Pacific, while mine is American Coast. Olive skin, light hazel eyes, black hair that she wears compressed under an elastic cap on duty and in baroque sculptures when not. She always looks slightly puffy-eyed, shifting fluids and the never-settling dust and dander even in our filtered air. Or that’s how she has always explained it. I brace myself when I ask, “How was your time Earthside? With your family.”

She smiles radiantly. “Hikaru’s moving them to Canberra was the best decision we ever made. The kids were being exposed to so much propaganda against space development,” the smile turns wry in acknowledgment that the big Space Centers are papered with their own propaganda, “never mind the relatives constantly dripping ‘poor little things’ into their ears and preaching about material goods being less important than family happiness. They’re not the ones with nearly half a million in pro-school debt.”

“To be honest, I wondered if you’d be back.”

“Yes,” she said. “You would. It’s hard, isn’t it? When it looks like it has to be a choice.”

I don’t talk about the divorce much: respect for my ex-partners and my own pride. I loved them, I honor their commitment to the ideals we once shared—still do, I believe, though we express them differently now. But their rejection still hurts, even after five years. “Not the same,” I tell Stephe. “No kids, for one thing. And there were five of us. The dynamics are different.”

“Where are your exes now?”

“They’ve moved the clinic down to the southern part of United Africa.”

“Isn’t that dangerous?”

“Less than it was; Africa is more stable and prosperous than it has been for a century.” United Africa has been an unexpected beneficiary of global climate change, with the transformation of large areas once-desert by rainfall; for the last decade, they have been exporting wheat and corn.

Stephe has just drawn bream when our entire surround breaks up in red bars. A beat later, the alarm sounds, a sequence I’ve never heard before.

Behind the pulsing red bars, Stephe’s lips move soundlessly. I’m seeing red myself. I never knew any platform system or alert could interrupt the visuals on a surgical link, even if we’re not engaged in surgery. “Genii! This is a surgical circuit A closed circuit. What’s the hell’s happening?”

Then I’m hanging over blue space, over the Earth. Looking down at the IBDD shuttle, pearl white on blue, gliding by an installation that twinkles coyly in the sunlight. I recognize it, one of our nearest neighbors, a quirky little bauble we all call the Desert Rose. It looks too decorative to be what it is, one of the most state-of-the-art experimental habitats.

I almost expect to hear music, Vaughn Williams, perhaps, or Elgar. But what I do hear, or rather, feel, is an irregular vibration through the pod, and then there’s a cascade of text down the side of the image, including the symbol we can all recognize in our sleep, the warning to get to the shielded areas, now. I never knew the thumping of bodies in the tunnels transmitted through the walls.

Shielded areas—including the infirmary and telesurgery stations—are reinforced against meteorites and solar flares. But this is neither. Now I can hear the pilot’s voice through my audio, speaking very fast, reciting what she’s seeing, what she’s doing, as though her instruments, her actions, were not being recorded and transmitted. And then she says, “Initiating cargo sterilization. Ejecting,” and the cabin-pod cracks away on a cleft of fire, cast into the shallowness of space.

Text screeds down both sides of my screen. At such moments I go word-blind, even as my visual perception expands and my time sense explodes. The pilot is still reciting what she’s doing as she rides the shuttle through the telelink, trying to turn it away from the platforms. She’s still talking when the whole side of the shuttle peels apart from an eruption that is for the briefest of moments brighter than the clouds of Earth. And then there’s a silence and murmured prayer.

Against the Earth light, the fragments are invisible, except for those large enough to contain their own shadow; they flicker, tumbling, Earthward, or obliquely past IMS-1. But we know the unseen ones by their passing: thin through the walls of the pod, the decompression alarms begin to squeal, and in the periphery of the display, as I have programmed it to do, the decompression warning icon blinks.

Faces bloom across my display, all the duty-docs, Julian Sutherland, space medicine; Tonia Sundralingham, radiation medicine; Nuria al-Hassam, psychiatry; and Y’, who must just have gotten to sleep. Medical emergency coordinator comes around in rotation, rather like the one shell in Russian roulette. Guess who is gazing into the little black eye of fate tonight?

“Load medical emergency coordinator expert system,” I… squeak. No, it’s not the atmosphere. Deep breathing.

Earth, clouds, the absent shuttle, are all replaced by a schematic of nodes, my preferred representation. Each node indicates a particular function or aspect of the disaster, color-coded according to priority for my attention. The colors dance as everyone except Y’ starts routing data toward it and me. The bioreads of scared and injured people. A map of the immediate vicinity, charting impacts, decompression reports. A report from Desert Rose’s duty-doc: They’ve been struck by debris, have lost solar panels, have four—five— perfed pods, one torn open to the point of explosive decompression, and can anyone kindly tell them what just came through their walls?

Luther Igorin, the EBDD specialist on Semmelweis, is trying to answer that question. No question about the need-to-know now, and he spreads out the shuttle’s manifest for us. It’s fungi. In the later years of the bioterrors, fungi in particular were bioengineered to withstand heat, desiccation, radiation, taking tips from Deinococcus radiodurans and other extremophiles. He’s highlighted two entries on the cargo manifest as radiation-resistants. The question is whether the radiation dose was adjusted to take account of that, whether the shuttle’s cargo got the full sterilization before the shuttle came apart. I’ve never seen Luther sweat the way he’s sweating now.

The shuttle crew announces their survival with a restrained, “I realize this may not be a good time, but we could use a pickup here.” Someone in the background is retching.

Luther withdraws from the team room temporarily to get more information from the shuttle pilot. He’s replaced by Jay McPhearson Leaphorn, responsible for rescue and retrieval. Jay traces descent from chiefs of clan and tribe, and his square, terra-cotta face reflects the stoicism of both traditions; nobody has ever sees him sweat.

Jay says, with his usual politeness, “My team have almost completed their hazard assessment. Do you have a casualty assessment, please?”

The expert system is crunching the biosensor readings, emergency calls, environmental readout, and other data, generating a list of urgent-attention cases in all the affected platforms. “I’m still waiting on a provisional list—”

“I’ll be back for your review. Excuse me,” and he blinks out.

The lit-up nodes now include: decompression, environmental compromise, radiation exposure, potential infectious agent exposure, psychological trauma.

Luther dumps the fingerprints of the shuttle’s manifest to the pathogen-sensors of all platforms above our horizon. I have a bad feeling that this means he is not satisfied that the cargo was sterilized. We should all be grateful for a man who appreciates priorities; some of his IBDD colleagues would still be trying to limit “exposure” of sensitive information. This doesn’t address the problem that, although there’s a minimum standard for platform atmospheric monitoring, not everyone has the grade of biosensors that we do, affinity sensors with a wide range of receptors associated with pathogenicity rather than specific to individual pathogens. But… I subclone the display again, in time to see one, two, three, four, five… potential positives.

I’ve gone cold, seeing the signal imposed on the familiar blueprint.

Now, the fingerprints Luther sent over have a strong bias for sensitivity over specificity: no surprise, since the consequences of failing to detect these spores are far worse than the consequences of getting excited over some innocuous mold.

Only my parents and I were in Montana in June 2034. Global warming coming atop sustained overuse and over-irrigation had cost the Prairies their place as the continent’s breadbasket; most of the Americas were dependent upon the sea, or imports from outside. I was on a student elective at a rural clinic and my parents were working on one of multiple drought-resistant engineering projects, efforts violently opposed by the Earth Redeemers. Since the Redeemers opposed genetic engineering of any organism, no one anticipated the anthrax bombing. My family had been vaccinated against all known strains ourselves, because of other areas my parents had worked; so we only got to watch other people die.

Transport of medicines and vaccines was delayed; the delay, it emerged, was because of concerns in Washington that further attacks might come, that the vaccines might be needed and better used elsewhere… in the important, economically valuable regions of the country, rather than in the depopulated, dust bowl Prairies.

Out of the outrage unslaked by the impeachment of the president, John Rand Brierly established his own Senate in Atlanta and built the New Secessionist movement. Four years after that, after an el Ninõ decimated the sea’s relied-upon harvest, Brierfy’s forces launched the first attack in what became the pan-American War. By then, I was in Africa, completing my training, falling in love with Luis and Michel, planning a future that had nothing to do with a continent half a world away splintering under environmental stress and political, religious, and racial extremities—Africa’s renaissance, after all, had come after decades of it.

“Helen,” says Nuria.

Almost unseen in all the clutter of texts and symbols is the warning signal of excessive stress on the surgical gloves. I unlock my hands and pull them out of the gloves. This is not the time to break equipment.

The other faces in the team room freeze. Only Nuria’s is animate. “I’ve locked them out for a moment,” she said. “I wanted to talk to you privately. Would you prefer to—”

“No.” And, more temperately, “The expert system will backstop my judgment. So will my colleagues and friends. We all lived through these times.”

She has a still, well-schooled face; even after five years in such proximity I cannot say I know her. Yet some shift of expression makes me wonder what she herself lived through, during the years the Islamic nations were isolated behind the “Iron Veil.”

Another flashing icon: the triage-list is complete, and Jay is waiting. We review the triage-list, stat, so Jay can start directing retrieval efforts. His job is not one I envy: besides IMS-1, four other platforms have been damaged by debris. All of those have lost one or more pods to total or severe decompression and have known casualties. Our size works for us: none of the holes were large enough to evacuate a standard IMS pod before they could be sealed. We now have four suspected sites of contamination. It was up to nine, but Luther has established by reanalysis of the sensor’s past recordings that, in five, the suspect signal actually preceded the shuttle’s destruction: false positive. Ours, unfortunately, is not one of those; the signal is new, persistent, and adjacent to one of the two pods that were penetrated. By quarantine protocols established thirty years ago, the signal, false or not, means that until we obtain IBDD clearance, we can neither send out rescue craft nor receive survivors, and until we obtain IBDD clearance, none of the staff from Semmelweis— enclosed in its own, inviolate, environment—can come aboard to do their own monitoring.

“I recommend,” says Nuria, “that someone else relieves Helen as coordinator of emergency medical response—” My mouth opens, though I’m not sure what would have emerged. “I recommend it,” Nuria leans on me, “because she’s the most experienced telesurgeon we have in the medical staff and we are likely to need that expertise, given that we cannot accept transfers for the foreseeable future.”

A private note flashes up, in green. “And that’s my only reason.”

Reassuringly, she does not say “believe me” or “trust me,” assertions anyone over thirteen knows to receive with skepticism.

Julian, as my successor by acclamation, squints at his suddenly cluttered work field. “Who’d have thought the old man had that many bits in him.”

That, no doubt is a literary allusion, but this is not the time to ask genie for enlightenment.

I slip my hands back into the gloves, and open synchs to the suites at the four priority platforms. All, fortunately, are within the lag-limit. Two have OR facilities; two have emergency medical stations. I squirt a message to Luther asking that priority consideration be given to lifting restrictions on transfers between one quarantined platform and the next. There’s a limit to what I can do with an EMS, which is de signed primarily for stabilization prior to transfer.

I’ve no sooner done that than the first casualty arrives in an EMS, a woman with blown-out lungs—pulmonary over-inflation syndrome—a newcomer who has never been through even a mild decompression and so never put into practice the prohibition against breath holding. Not a surgical case, but it quickly emerges that this platform’s paramedics were partners. She, sleeping in her cabin, is one of the two dead, and shock has him fumbling in microgravity as though he was only launched yesterday. So I find myself assisting with her intubation, assisting with placing lines, getting the expert support system up and running to backstop him. Her oxygen sats are lousy, her blood’s fizzy, she needs to go on bypass circulation both to get the oxygen in and to get the fizz out… And I’ve got another urgent from one of the OR stations, and Y’ is already involved with the most serious casualty from Desert Rose, decompression and chest trauma from the impact of a sizable chunk of shuttle that crushed the pod. A candidate for transfer if there ever was one. But the IBDD on the ground hasn’t changed its prohibitions: no transfers.

Julian drops in to my link, synching in Stephe from Sharman to take over. Guiltily, I wonder if Nuria wasn’t right to get me to pass this off to Julian: He’s the better manager. Doubt lasts all of three seconds, then I boot up the software which will aid me in coupling expertise in the form of the telesurgeons within lag limit to need in the form of the cases pending, reserving myself for those cases that need my experience. The urgent request gets passed to the duty surgeon on IMS-2, and I get a chance to think I shouldn’t have had that cup of coffee, before Y’ pages me.

Y’s patient on Desert Rose is unstable with a thoracic cavity full of blood, Y’s going to have to open the chest, and he’s having technical problems. His visuals are degrading, his imaging input is losing resolution, and even worse, beginning to stutter. Since he’s going to be working on breathing lungs and a beating heart, he needs the system to track the motion, stabilizing the images and synchronizing his instruments with the natural movement. I route his synch through my station temporarily and call on genie for a diagnostic. It turns out that Y’s OR suite contact-priorities haven’t been set high enough, and with the current state of emergency other links are poaching some of his bandwidth. Since only sysadmin, the genie-minders, get to meddle with those settings, I call them with a “fix, please, stat.”

I’ve no sooner reclaimed my bandwidth when Stephe pages me, wanting help with the bypass setup in her patient with the badly damaged lungs; with a nervous glance at the waiting casualty list—three of whom could get into trouble very quickly—I synch with her to assist as she establishes the jugular lines and watch until the woman’s oxygen saturation and her blood pressure finally begin to come up. Then the genie pages me over to the other EMS, aboard a material research platform, where the duty-doc and paramedic are running a code on a patient who has just arrested with an arterial blood embolism. There is nothing else I can do for them: they know what they’re doing, they have the expert system support, they’ve given the recommended drugs, and they have the hyperbaric chamber ready.

I freeze all links, giving myself a chance to breathe. When I pull my hands out of the gloves, sweat glitters in the creases of my palms. I check the other departments: The shuttle capsule has been retrieved and towed to Semmelweis, its original destination. Luther has issued another set of recommendations, this time for prophylactic treatments to begin immediately for all staff in all platforms with known penetration. That means turning over three of our bioreactors to the synthesis of his recommended mycostatins, and he has recommended that they be given by intramuscular bead implants, as well as aerosolized through the ventilation system; he’s going to be a popular man.

His prediction is that prophylaxis should be ninety percent effective in preventing infection; and immediate identification and aggressive treatment of the actual diseases should produce around an eighty-five percent cure rate, even for the bad actors. He adds, comfortingly, that additional information from Earthside suggests a better-than-even probability that the abbreviated sterilization will have been effective even on the radiation-resistants, in the presently incalculable event that one of the impact fragments was carrying infectious material. I don’t bother asking genie to try the arithmetic to tell me the probability that one of us will die of fungal sepsis within the month.

I review the operations in progress, the patients waiting, and unhook myself from the surgical station for a quick visit to the head. It’s a small triumph over circumstances that I actually make it there and back before Y’ pages me. His link’s stable, but the damage to his patient’s pulmonary veins is more extensive than the diagnostic imaging suggested; now he’s in there moving things around. I confer quickly with Julian, who accepts coordination of the surgical roster from me without even a literary quip, and drop into synch with Y’ and Desert Rose. Y’ has the Rose’s second paramedic suited and scrubbed to do fluid control and monitor the sterility of the field, while the duty anesthetist from ISM-2 is working anesthesia and life support, and an on-site technician is managing the mounting of transfusions and drags onto the operating assembly. It’s a brute of an operation. IMS-1’s communications system manager overloads and crashes, and the backup system comes up with the old settings, so Y’s bandwidth steal recurs and I have to take over clipping and gluing oozing vessels while he gets that corrected. Then Desert Rose starts having power problems, and while the engineers there are rejigging circuits to keep power going to the OR suite, we run out of SynthaHeme-M and have to go to an alternative blood substitute, and the patient’s blood pressure promptly bottoms out with an adverse reaction. But Y’ and I work as though our thoughts have synched as well, the anesthetist is sharp and solid, the patient is young, fit, and tough, and God, or whoever decides these things, toys with us all and then decides he doesn’t need another angel right now.

One for our side.

I check our status: Three ORs still going, two at quarantined platforms, one something that has nothing to do with the emergency—an incarcerated hernia. Julian looks like he has been squeezed through a fist-sized hole in the outer wall, very slowly. He gives me a precis: Final casualties, seven dead, including the patient with the arterial gas embolism, twelve injured, mostly decompression. The IBDD confirms the original estimates of radiation-resistance, so Luther’s numbers stand. Further analysis of the shuttle’s disintegration suggest that it really was a malfunction, enough by the sound of things to lead to heads rolling but not, we trust, to wars starting. The same analysis gives us some hope that the trajectory of the cargo carried it away from the platforms, toward Earth atmosphere—although there’s an understandable reluctance to disclose that reassuring tidbit Earthside, even though reentry would have charred it.

Julian and I review the rota. Y’ has already worked nearly two full shifts; I have worked one, and none of the people who would ordinarily cover have overdosed on sleep. So we decide I’ll continue through this next shift, Y’ will pick up the two after that, and then we’ll be righted; I’ll just owe Y’. We’d switch, only Y’ has a partner among the environmental engineers; their shifts are coordinated.

Julian orders me to find something to eat. I order him to do likewise. Besides, we’ve both been notified we’re due our first dose of antifungal prophylaxis. We make an appointment for the doctor’s lounge in ten.

I’m almost out of the chair before the page comes in, so I throw it up on the flat-screen. Stephe, hair unraveling in long plaits, like a handsome Polynesian medusa. No preamble: “The World Court just announced their decision. The freehabbers get to keep their kids.”

This is surely the last outcome I could have predicted, given the recent demonstration of the extraordinary dangers of our suspended lives.

Stephe is saying, “There’s a strong recommendation that the kids be taken down on the normal three-month rotation, and they’re requiring medical monitoring—but the research that we’re doing on bone and muscle protection and the development of rotating platforms decided the judges. And we knew that three of them were pro-space, but it was a five-four decision.”

“Some of that bone-protection research doesn’t stand up to critical review.” That’s not what I would have said; it is only the most accessible objection.

“But there are quality trials in there as well, two random controlled trials in the last year. We’re finally getting the numbers to up here to get grade 1 evidence. We’ve been accepting being tied to Earth all those years, with that three-month down rotation, and families staying downside—” She blinks at me, eyes suddenly a lighter green, and starry. “Wow!” she says. “That’s going to change things.”

“Stephe,” I say slowly, “your partner’s a physician. Did he pass the genotype tests?”

“Yeah,” she breathes. “We knew that before we married. But we decided that one of us should stay down with the kids. The kids should pass, too. I wonder if the freehabs need a couple of doctors. I expect it’ll be a while before the commercial stations come to terms with kids in space.”

“You need sleep,” I tell her, quellingly.

She laughs, hair flying. “I need to call Hikaru, before somebody wants me. Don’t say anything about this to anyone, will you?”

“Cross my heart,” I say, more than a little bemused. And she leaves me to think of the twelve hours we have just lived through, the hours we are going to live through, waiting for any contamination to declare itself.

If there’s news coming in, there must be bandwidth to spare. I settle back into the chair, fit the virtual array over my head again and request a channel to Earth.

It’s the middle of the night, but Luis is not asleep. Nor is he alone: I can hear movement around him, in the common area of the clinic’s living caravan.

Luis looks good, and that’s not only because I’ve been celibate too long. He has one of those faces that time only improves, since age reveals character. Though he was almost as light-skinned as Stephe when we met, Africa has darkened him, set squint-lines around his eyes, made him thoughtful in motion, careful of his energies. Like many of us, he’s a mongrel, born in a country that no longer exists, but unlike many of us, he has found his heart’s home. He was always the one I was closest to, my friend, my preferred lover; our intimacy at times made the others jealous. I’m not surprised at his greeting, “Helen, thank God. I’ve been trying to get through from this end. We heard the news—what’s been getting through the UA government filters. Are you all right?”

Terence, unseen behind him, says, “Ask her if it was sabotage, like the EEN said.”

A woman—Charmaine, probably—shushes him. Luis looks pained. This is certainly being monitored from my end, and probably from his, and Luis has always been cautious. Terence, on the other hand, thinks his radical credentials are imperiled if he’s not on some official shit list—and if the African governments are filtering the news, then quoting the Earth Ekumenical Network is a fine way to get there.

“How should I know what anyone on Earth is saying?” I parry. “I’ve had my head in the hood for the past nine hours. I’m all right, Luis. We weren’t one of the platforms with decompression emergencies. Needless to say, I’ve been busy assisting the ones that did.” That I judge safe to say. I will leave off mention of the contamination, lest that is not to be public knowledge where they are. “How is it with you?”

“We wanted to thank you for that last cash transfer.”

I flutter my hands. They look puffy and dry, with red pressure marks from hours in the gloves. His will be long, thin, weathered—I corral my vagrant thoughts. “You know I believe in the work, Luis, and it’s no hardship for me.”

After the pan-American War, support to the African restoration was cut, including support to our mobile clinic. With the cynicism of young, bruised idealists, we decided that those of us who could would find the highest salaried jobs until we had banked enough for five years’ self-sufficiency. I was the only one who qualified for space.

For my first three-month downtime, I joined Luis and Charmaine on the edge of the Sahara. After nine months in the confined, regulated, precarious environment of the space habs, I was utterly disoriented, starting at any shift of light, any change in the wind. I fainted when I stood up; I developed sunstroke; I had constant diarrhea, infectious and nonfectious. Luis was alarmed; Charmaine, contemptuous.

By the end of my third year, the others had reunited in the field, working in the Ganges delta. I was better at managing my readaptation, but Terence and I argued constantly. I saw how to expand our practice beyond the mobile clinic, using one or more telesurgery stations, but that would have required negotiation with local and regional governments, obtaining access to bandwidth and infrastructure—trusting and buying in; to Terrence, a deal with the devil.

One more year, I told us all. One more year, to give us more of a cash reserve, and then we’ll work it all out. Three months into that year there was an opening for a surgeon on IMS-1; I was invited to apply. And we all confronted how much I wanted that post, how much more satisfying I found the mastery of skills and technology required of this work, than the enervating struggle with Earth’s chronic afflictions.

Charmaine demanded a divorce; Terence called me a traitor; Michel withdrew. Luis alone gave me his blessing, and for him, alone, I would have stayed.

Luis is saying, “We were able to license some recombinants producing the proprietary antiparasitics, the ones effective against the super Plasmodium. Maybe now things have settled down politically, the WHO will get permission to release their new mosquito sterilization vector.”

I smile, despite myself. I’m sitting in a space platform under IBDD quarantine, after a decomissioning shuttle disintegrated in orbit. Half the world’s media is yelling screwup and the other half conspiracy; the IBDD has canceled all its inspections until further notice and three countries have issued statements declaring they’ve decided to review IBDD participation in their own decommissioning operations. But things are quiet in Africa.

After that long, slow moment of lag—well beyond operating distance—he returns my smile. “Any chance I could talk you into coming out into the field again, next time you’re down? We should still be here; we’ve got some excellent colleagues, including some I’m sure you’ll have heard about, in telesurgery.”

“Luis… let me think. That’s not an evasion, I do need to think.”

He nods. “You should go. I don’t want you spending all your salary on expensive calls—”

“When you’ve expensive drugs to spend it on. I’ll send you a vmail. Look after yourselves. All of you. Stay safe.”

His smile is sweetly ironic, and fades just as one hand be gins to reach out to me, as I, deceived by the virtual image of him, reach out in turn, into the unseen space beyond the virtual image. The surgery interface re-forms around me, a series of windows on the two ORs still running, the biosensor outputs from recovering patients, a reminder from Julian about our appointment in the doctor’s lounge, from Luther about the need to start antifungal prophylaxis, from the research coordinator about the necessity of registering our optouts if we object to the medical information gained from our exposure (putative exposure) and prophylaxis being distributed to the scientific community…

Five facets of the icosahedral doctor’s lounge look up, or down, if you will, on Earth. It’s dark now, though if we turned off all our lighting, we could see the civilizations of Earth sprinkled across the landmasses. Only the seas of Earth are dark. And the space above.

Y’ slouches beneath the window, rumpled and squinting. Even without the contrast, Nuria would look graceful, even in the knees-up astronaut tuck. Julian hangs beside her, tethered by one arm to a strut, sucking on a coffee-sac. The dayshift duty-docs orbit them gently, as though they are convalescents and their recovery, precarious.

Julian lifts an eyebrow to me. “And how was your night?”

Alison Sinclair is the author of Legacies, Blueheart, Cavalcade (nominated for the Arthur C. Clarke Award) and Throne Price (with Lynda Jane Williams). She has lived in Colchester (England), Edinburgh, Victoria (BC), Hamilton, Boston, Leeds (England), Calgary, and Ottawa. She has done basic and medical research. In 1999 she graduated from the University of Calgary with an MD and now works in Victoria as a medical writer. When not working or writing she sings, swims, dabbles in computers, and fantasizes about being perfectly organized. Her Web site is at http://www.sff.net/people/asinclair/.