The Terminal Man

Tuesday, March 9, 1971: Asmission

They came down to the emergency ward at noon and sat on the bench just behind the swinging doors that led in from the ambulance parking slot. Ellis was nervous, preoccupied, distant. Morris was relaxed, eating a candy bar and crumpling the wrapper into the pocket of his white jacket.

From where they sat, they could look at the sunlight outside, falling across the big sign that said EMERGENCY WARD and the smaller sign that said NO PARKING AMBULANCES ONLY. In the distance they heard sirens.

"Is that him?" Morris asked.

Ellis checked his watch. "I doubt it. It's too early." They sat on the bench and listened to the sirens come closer. Ellis removed his glasses and wiped them with his tie. One of the emergency ward nurses, a girl Morris did not know by name, came over and said brightly, "Is this the welcoming committee?"

Ellis squinted at her. Morris said, "We'll be taking him straight through. Do you have his chart down here?"

The nurse said, "Yes, I think so, Doctor," and walked off looking irritated.

Ellis sighed. He replaced his glasses and frowned at the nurse.

Morris said, "She didn't mean anything."

"I suppose the whole damned hospital knows," Ellis said.

"It's a pretty big secret to keep."

The sirens were very close now; through the windows they saw an ambulance back into the slot. Two orderlies opened the door and pulled out the stretcher. A frail elderly woman lay on the stretcher, gasping for breath, making wet gurgling sounds. Severe pulmonary edema, Morris thought as he watched her taken into one of the treatment rooms.

"I hope he's in good shape," Ellis said.

"Who?"

"Benson."

"Why shouldn't he be?"

"They might have roughed him up." Ellis stared morosely out the windows. He really is in a bad mood; Morris thought. He knew that meant Ellis was excited; he had scrubbed in on enough cases with Ellis to recognize the pattern.

Irascibility under pressure while he waited - and then total, almost lazy calm when the operation began. "Where the hell is he?" Ellis said, looking at his watch again.

To change the subject, Morris said, "Are we all set for three-thirty?" At 3:30 that afternoon, Benson would be presented to the hospital staff at a special Neurosurgical Rounds.

"As far as I know," Ellis said. "Ross is making the presentation. I just hope Benson's in good shape."

Over the loudspeaker, a soft voice said, "Dr. Ellis, Dr. John Ellis, two-two-three-four. Dr. Ellis, two-two-three-four."

Ellis got up to answer the page. "Hell," he said.

Morris knew what he meant. Two-two-three-four was the extension for the animal laboratories. The call probably meant something had gone wrong with the monkeys. Ellis had been doing three monkeys a week for the past month, just to keep himself and his staff ready.

He watched as Ellis crossed the room and answered from a wall phone. Ellis walked with a slight limp, the result of a childhood injury that had cut the common peroneal nerve in his right leg. Morris always wondered if the injury had had something to do with Ellis's later decision to become a neurosurgeon. Certainly Ellis had the attitude of a man determined to correct defects, to fix things up. That was what he always said to his patients: "We can fix you up." And he seemed to have more than his share of defects himself - the limp, the premature near-baldness, the weak eyes, and the heavy thick glasses. It produced a vulnerability about him that made his irascibility more tolerable.

Or perhaps the irascibility was the result of all those years as a surgeon. Morris wasn't sure; he hadn't been a surgeon long enough. He stared out the window at the sunlight and the parking lot. Afternoon visiting hours were beginning; relatives were driving into the parking lot, getting out of their cars, glancing up at the high buildings of the hospital. The apprehension was clear in their faces; the hospital was a place people feared.

Morris noticed how many of them had sun tans. It had been a warm, sunny spring in Los Angeles, yet he was still as pale as the white jacket and trousers he wore every day. He had to get outside more often, he told himself. He should start eating lunch outside. He played tennis, of course, but that was usually in the evenings.

Ellis came back. "Shit," he said. "Ethel tore out her sutures."

"How did it happen?" Ethel was a juvenile rhesus monkey who had undergone brain surgery the day before. The operation had proceeded flawlessly. And Ethel was unusually docile, as rhesus monkeys went.

"I don't know," Ellis said. "Apparently she worked an arm loose from her restraints. Anyway, she's shrieking and the bone's exposed on one side.

"Did she tear out her wires?"

"I don't know. But I've got to go down and resew her now. Can you handle this?"

"I think so."

"Are you all right with the cops?" Ellis said. "I don't think they'll give you any trouble."

"No, I don't think so."

"Just get Benson up to seven as fast as you can," Ellis said. "Then call Ross. I'll be up as soon as possible." He checked his watch. "It'll probably take forty minutes to resew Ethel, if she behaves herself."

"Good luck with her," Morris said, and smiled.

Ellis looked sour and walked away.

After he had gone, the emergency ward nurse came back.

"What's the matter with him?" she asked.

"Just edgy," Morris said.

"He sure is," the nurse said. She paused and looked out the window, lingering.

Morris watched her with a kind of bemused detachment. He'd spent enough years in the hospital to recognize the subtle signs of status. He had begun as an intern, with no status at all. Most of the nurses knew more medicine than he did, and if they were tired they didn't bother to conceal it. ("I don't think you want to do that, Doctor.") As the years went by, he became a surgical resident, and the nurses became more deferential. When he was a senior resident, he was sufficiently assured in his work that a few of the nurses called him by his first name. And finally, when he transferred to the Neuropsychiatric Research Unit as a junior staff member, the formality returned as a new mark of status.

But this was something else: a nurse hanging around, just being near him, because he had a special aura of importance. Because everyone in the hospital knew what was going to happen.

Staring out the window, the nurse said, "Here he comes." Morris got up and looked out. A blue police van drove up toward the emergency ward, and turned around, backing into the ambulance slot. "All right," he said. "Notify the seventh floor, and tell them we're on our way."

"Yes, Doctor."

The nurse went off. Two ambulance orderlies opened the hospital doors. They knew nothing about Benson. One of them said to Morris, "You expecting this one?"

"Yes."

"EW case?"

"No, a direct admission."

The orderlies nodded, and watched as the police officer driving the van came around and unlocked the rear door. Two officers seated in the back emerged, blinking in the sunlight. Then Benson came out.

As always, Morris was struck by his appearance. Benson was a meek, pudgy, thirty-four-yearold man, with a sort of permanently bewildered air about him. He stood by the van, with his wrists handcuffed in front of him, and looked around. When he saw Morris, he said, "Hello," and then looked away, embarrassed.

One of the cops said, "You in charge here?"

"Yes. I'm Dr. Morris."

The cop gestured toward the interior of the hospital.

"Lead the way, Doctor."

Morris said, "Would you mind taking off his handcuffs?"

Benson's eyes flicked up at Morris, then back down.

"We don't have any orders about that." The cops exchanged glances. "I guess it's okay."

While they took the cuffs off, the driver brought Morris a form on a clipboard: "Transfer of Suspect to Institutional Care (Medical)." He signed it.

"And again here," the driver said.

As Morris signed again, he looked at Benson. Benson stood quietly, rubbing his wrists, staring straight ahead. The impersonality of the transaction, the forms and signatures, made Morris feel as if he were receiving a package from United Parcel. He wondered if Benson felt like a package.

"Okay," the driver said. "Thanks, Doc."

Morris led the other two policemen and Benson into the hospital. The orderlies shut the doors. A nurse came up with a wheelchair and Benson sat down in it. The cops looked confused.

"It's hospital policy," Morris said.

They all went to the elevators.

The elevator stopped at the lobby. A half-dozen relatives were waiting to go up to the higher floors, but they hesitated when they saw Morris, Benson in the wheelchair, and the two cops. "Please take the next car," Morris said smoothly. The doors closed. They continued up.

"Where is Dr. Ellis?" Benson asked. "I thought he was going to be here."

"He's in surgery. He'll be up shortly."

"And Dr. Ross?"

"You'll see her at the presentation."

"Oh, yes." Benson smiled. "The presentation."

The cops exchanged suspicious looks, but said nothing. The elevator arrived at the seventh floor, and they all got out.

Seven was the Special Surgical floor, where difficult and complex cases were treated. It was essentially a research floor. The most severe cardiac, kidney, and metabolic patients recuperated here. They went down to the nurses' station, a glass-walled area strategically located at the center of the X-shaped floor.

The nurse on duty at the station looked up. She was surprised to see the cops, but she said nothing. Morris said,

"This is Mr. Benson. Have we got seven-ten ready?"

"All set for him," the nurse said, and gave Benson a cheery smile. Benson smiled bleakly back, and glanced from the nurse to the computer console in the corner of the nursing station.

"You have a time-sharing station up here?"

"Yes," Morris said.

"Where's the main computer?"

"In the basement."

"Of this building?"

"Yes. It draws a lot of power, and the power lines come to this building."

Benson nodded. Morris was not surprised at the questions. Benson was trying to distract himself from the thought of surgery, and he was, after all, a computer expert.

The nurse handed Morris the chart on Benson. It had the usual blue plastic cover with the seal of University Hospital. But there was also a red tag, which meant neurosurgery, and a yellow tag, which meant intensive care, and a white tag, which Morris had almost never seen on a patient's chart. The white tag meant security precautions.

"Is that my record?" Benson asked as Morris wheeled him down the hall to 710. The cops followed along behind.

"Uh-huh."

"I always wondered what was in it."

"Lot of unreadable notes, mostly." Actually, Benson's chart was thick and very readable, with all the computer print-outs of different tests.

They came to 710. Before they entered the room, one of the cops went in and closed the door behind him. The second cop remained outside the door. "Just a precaution," he said.

Benson glanced up at Morris. "They're very careful about me," he said. "It's almost flattering."

The first cop came out. "It's okay," he said.

Morris wheeled Benson into the room. It was a large room, on the south side of the hospital, so that it was sunny in the afternoon. Benson looked around and nodded approvingly. Morris said, "This is one of the best rooms in the hospital."

"Can I get up now?"

"Of course."

Benson got out of the wheelchair and sat on the bed. He bounced on the mattress. He pressed the buttons that made the bed move up and down, then bent over to look at the motorized mechanism beneath the bed. Morris went to the window and drew the blinds, reducing the direct light. "Simple," Benson said.

"What's that?"

"This bed mechanism. Remarkably simple. You should really have a feedback unit so that body movements by the person in the bed are automatically compensated for…" His voice trailed off. He opened the closet doors, looked in, checked the bathroom, came back. Morris thought that he wasn't acting like an ordinary patient. Most patients were intimidated by the hospital, but Benson acted as if he were renting a hotel room.

"I'll take it," Benson said, and laughed. He sat down on the bed and looked at Morris, then at the cops. "Do they have to be here?"

"I think they can wait outside," Morris said.

The cops nodded and went out, closing the door behind them.

"I meant," Benson said, "do they have to be here at all?"

"Yes, they do."

"All the time?"

"Yes. Unless we can get charges dropped against you." Benson frowned. "Was it… I mean, did I… Was it bad?"

"You gave him a black eye and you fractured one rib."

"But he's all right?"

"Yes. He's all right."

"I don't remember any of it," Benson said. "All my memory cores are erased."

"I know that."

"But I'm glad he's all right."

Morris nodded. "Did you bring anything with you? Pajamas, anything like that?"

Benson said, "No. But I can arrange for it."

"All right. I'll get you some hospital clothing in the meantime. Are you all right for now?"

"Yes. Sure." And he grinned. "I could do with a quick shot, maybe."

"That," Morris said, grinning back, "is something you'll have to do without."

Benson sighed, Morris went out of the room.

The cops had brought a chair up to the door. One of them sat on it, the other stood alongside. Morris flipped open his notebook.

"You'll want to know the schedule," he said. "An admitting person will show up in the next half hour with financial waivers for Benson to sign. Then, at three-thirty he goes downstairs to the main amphitheater for Surgical Rounds. He comes back after about twenty minutes. His head will be shaved tonight. The operation is scheduled for six a.m. tomorrow morning. Do you have questions?"

"Can someone get us meals?" one of them asked.

"I'll have the nurse order extras. Will there be two of you, or just one?"

"Just one. We're working eight-hour shifts."

Morris said, "I'll tell the nurses. It'd help if you check in and out with them. They like to know who's on the floor."

The cops nodded. There was a moment of silence. Finally, one of them said, "What's wrong with him, anyway?"

"He has a form of epilepsy."

"I saw the guy he beat up," one of the cops said. "Big strong guy, looked like a truck driver. You'd never think a little guy like that" - he jerked his arm toward Benson's room - "could do it."

"When he has epileptic fits, he's violent."

They nodded vaguely. "What's this operation he's getting?"

"It's a kind of brain surgery we call a stage-three procedure," Morris said. He didn't bother to explain further. The policemen wouldn't understand. And, he thought, even if they understood, they wouldn't believe it.

Neurosurgical Grand Rounds, where unusual cases were presented and discussed by all the surgeons of the hospital, were normally scheduled for Thursdays at nine. Special rounds were hardly ever called; it was too difficult for the staff to get together. But now the amphitheater was packed, tier after tier of white jackets and pale faces staring down at Ellis, who pushed his glasses up on his nose and said, "As many of you know, tomorrow morning the Neuropsychiatric Research Unit will perform a limbic pacing procedure - what we call a stage three - on a human patient."

There was no sound, no movement, from the audience. Janet

Ross stood in the corner of the amphitheater near the doors and watched. She found it odd that there should be so little reaction. But then it was hardly a surprise. Everyone in the hospital knew that the NPS had been waiting for a good stage-three subject.

"I must ask you," Ellis said, "to restrain your questions when the patient is introduced. He is a sensitive man, and his disturbance is quite severe. We thought you should have the psychiatric background before we bring him in. The attending psychiatrist, Dr. Ross, will give you a summary." Ellis nodded to Ross. She came forward to the center of the room.

She stared up at the steeply banked rows of faces and felt a momentary hesitation. Janet Ross was tall and exceptionally good-looking in a lean, tanned, dark-blond way. She herself felt she was too bony and angular, and she often wished she were more softly feminine.

She clasped her hands behind her back, took a breath, and launched into the summary, delivering it in the rapid, stylized method that was standard for grand rounds.

"Harold Franklin Benson," she said, "is a thirty-four-year-old divorced computer scientist who was healthy until two years ago, when he was involved in an automobile accident on the Santa Monica Freeway. Following the accident, he was unconscious for an unknown period of time. He was taken to a local hospital for overnight observation and discharged the next day in good health. He was fine for six months, until he began to experience what he called 'blackouts.' "

The audience was silent, faces staring down at her, listening.

"These blackouts lasted several minutes, and occurred about once a month. They were often preceded by the sensation of peculiar, unpleasant odors. The blackouts frequently occurred after drinking alcohol. The patient consulted his local physician, who told him he was working too hard, and recommended he reduce his alcohol intake. Benson did this, but the blackouts continued.

"One year ago - a year after the accident - he realized that the blackouts were becoming more frequent and lasting longer. He often regained consciousness to find himself in unfamiliar surroundings. On several occasions, he had cuts and bruises or torn clothing which suggested that he had been fighting. However, he never remembered what occurred during the blackout periods."

Heads in the audience nodded. They understood what she was telling them; it was a straightforward history for a temporal-lobe epileptic. The hard part was coming.

"The patient's friends," she continued, "told him that he was acting differently, but he discounted their opinion. Gradually he has lost contact with most of his former friends. Around this time - one year ago - he also made what he called a monumental discovery in his work. Benson is a computer scientist specializing in artificial life, or machine intelligence. In the course of this work, he says he discovered that machines were competing with human beings, and that ultimately machines would take over the world."

Now there were whispers in the audience. This interested them, particularly the psychiatrists. She could see her old teacher Manon sitting in the top row holding his head in his hands. Manon knew.

"Benson communicated his discovery to his remaining friends. They suggested that he see a psychiatrist, which angered him. In the last year, he has become increasingly certain that machines are conspiring to take over the world.

"Then, six months ago, the patient was arrested by police on suspicion of beating up an airplane mechanic. Positive identification could not be made, and charges were dropped. But the episode unnerved Benson and led him to seek psychiatric help. He had the vague suspicion that somehow he had been the man who had beaten the mechanic to a bloody pulp. That was unthinkable to him, but the nagging suspicion remained.

"He was referred to the University Hospital

Neuropsychiatric Research Unit four months ago, in November, 1970. On the basis of his history- head injury, episodic violence preceded by strange smells - he was considered a probable psychomotor epileptic. As you know, the NPS now accepts only patients with organically treatable behavioral disturbances.

"A neurological examination was fully normal. An electroencephalogram was fully normal; brainwave activity showed no pathology. It was repeated after alcohol ingestion and an abnormal tracing was obtained. The EEG showed seizure activity in the right temporal lobe of the brain. Benson was therefore considered a stage-one patient - firm diagnosis of psychomotor epilepsy."

She paused to get her breath and let the audience absorb what she had told them. "The patient is an intelligent man," she said, "and his illness was explained to him. He was told he had injured his brain in the automobile accident and, as a result, had a form of epilepsy that produced 'thought seizures' - seizures of the mind, not the body, leading to violent acts. He was told that the disease was common and could be controlled. He was started on a series of drug trials.

"Three months ago, Benson was arrested on charges of assault and battery. The victim was a twenty-four-year-old topless dancer, who later dropped charges. The hospital intervened slightly on his behalf.

"One month ago, drug trials of morladone, p-amino benzadone, and triamiline were concluded. Benson showed no improvement on any drug or combination of drugs. He was therefore a stage two - drug-resistant psychomotor epilepsy. And he was scheduled for a stage-three surgical procedure, which we will discuss today."

She paused. "Before I bring him in," she said, "I think I should add that yesterday afternoon he attacked a gas-station attendant and beat the man rather badly. His operation is scheduled for tomorrow and we have persuaded the police to release him in our custody. But he is still technically awaiting arraignment on charges of assault and battery." The room was silent. She paused for a moment, then went to bring in Benson.

Benson was just outside the doors to the amphitheater, sitting in his wheelchair, wearing the blue-and-white striped bathrobe the hospital issued to its patients. When Janet Ross appeared, he smiled. "Hello, Dr. Ross."

"Hello, Harry." She smiled back. "How do you feel?"

It was a polite question. After years of psychiatric training, she could see clearly how he felt. Benson was nervous and threatened: there was sweat on his upper lip, his shoulders were drawn in, his hands clenched together in his lap.

"I feel fine," he said. "Just fine."

Behind Benson was Morris, pushing the wheelchair, and a cop. She said to Morris, "Does he come in with us?"

Before Morris could answer, Benson said lightly, "He goes anywhere I go."

The cop nodded and looked embarrassed.

"All right," she said.

She opened the doors, and Morris wheeled Benson into the amphitheater, over to Ellis. Ellis came forward to shake Benson's hand.

"Mr. Benson, good to see you."

"Dr. Ellis."

Morris turned him around so he was facing the amphitheater audience. Ross sat to one side and glanced at the cop, who remained by the door trying to look inconspicuous. Ellis stood alongside Benson, who was looking at a wall of frosted glass, against which a dozen X-rays had been clipped. He seemed to realize that they were his own skull films. Ellis noticed, and turned off the light behind the frosted glass. The X-rays became opaquely black.

"We've asked you to come here," Ellis said, "to answer some questions for these doctors." He gestured to the men sitting in the semicircular tiers. "They don't make you nervous, do they?"

Ellis asked it easily. Ross frowned. She'd attended hundreds of grand rounds in her life, and the patients were invariably asked if the doctors peering down at them made them nervous. In answer to a direct question, the patients always denied nervousness.

"Sure they make me nervous," Benson said. "They'd make anybody nervous."

Ross suppressed a smile. Good for you, she thought.

Then Benson said, "What if you were a machine and I brought you in front of a bunch of computer experts who were trying to decide what was wrong with you and how to fix it? How would you feel?"

Ellis was plainly flustered. He ran his hands through his thinning hair and glanced at Ross, and she shook her head fractionally no. This was the wrong place to explore Benson's psychopathology.

"I'd be nervous, too," Ellis said.

"Well, then," Benson said. "You see?"

Ellis swallowed.

He's being deliberately irritating, Ross thought. Don't take the bait.

"But, of course," Ellis said, "I'm not a machine, am I?"

Ross winced.

"That depends," Benson said. "Certain of your functions are repetitive and mechanical. From that standpoint, they are easily programmed and relatively straightforward, if you- "

"I think," Ross said, standing up, "that we might take questions from those present now."

Ellis clearly didn't like that, but he was silent, and Benson mercifully was quiet. She looked up at the audience, and after a moment a man in the back raised his hand and said, "Mr. Benson, can you tell us more about the smells you have before your blackouts?"

"Not really," Benson said. "They're strange, is all. They smell terrible, but they don't smell like anything, if you get what I mean. I mean, you can't identify the odor. Memory tapes cycle through blankly."

"Can you give us an approximation of the odor?

Benson shrugged. "Maybe… pig shit in turpentine." Another hand in the audience went up. "Mr. Benson, these blackouts have been getting more frequent. Have they also been getting longer?"

"Yes," Benson said. "They're several hours now."

"How do you feel when you recover from a blackout?"

"Sick to my stomach."

"Can you be more specific?"

"Sometimes I vomit. Is that specific enough?"

Ross frowned. She could see that Benson was becoming angry. "Are there other questions?" she asked, hoping there would not be. She looked up at the audience. There was a long silence.

"Well, then," Ellis said, "perhaps we can go on to discuss the details of stage-three surgery. Mr. Benson knows all this, so he can stay or leave, whichever he prefers."

Ross didn't approve. Ellis was showing off, the surgeon's instinct for demonstrating to everyone that his patient didn't mind being cut and mutilated. It was unfair to ask - to dare - Benson to stay in the room.

"I'll stay," Benson said.

"Fine," Ellis said. He went to the blackboard and drew a brain schematically. "Now," he said, "our understanding of the disease process is thata portion of the brain is damaged in epilepsy, and a scar forms. It's like a scar in other body organs - lots of fibrous tissue, lots of contraction and distortion. And it becomes a focus for abnormal electrical discharges. We see spreading waves moving outward from the focus, like ripples from a rock in a pond."

Ellis drew a point on the brain, then sketched concentric circles.

"These electrical ripples produce a seizure. In some parts of the brain, the discharge focus produces a shaking fit, frothing at the mouth, and so on. In other parts, there are other effects. If the focus is in the temporal lobe, as in Mr. Benson's case, you get what is called psychomotor epilepsy - convulsions of thought, not of body. Strange thoughts and frequently violent behavior, preceded by a characteristic aura which is often an odor."

Benson was watching, listening, nodding.

"Now, then," Ellis said, "we know from the work of many researchers that it is possible to abort a seizure by delivering an electrical shock to the correct portion of the brain substance. These seizures begin slowly. There are a few seconds - sometimes as much as half a minute - before the seizure takes effect. A shock at that moment prevents the seizure.'

He drew a large "X" through the concentric circles. Then he drew a new brain, and a head around it, and a neck. "We face two problems," he said. "First, what is the correct part of the brain to shock? Well, we know roughly that it's in the amygdala, an anterior area of the so-called limbic system. We don't know exactly where, but we solve that problem by implanting a number of electrodes in the brain. Mr. Benson will have forty electrodes implanted tomorrow morning."

He drew two lines into the brain.

"Now, our second problem is how do we know when an attack is starting? We must know when to deliver our aborting shock. Well, fortunately the same electrodes that we use to deliver the shock can also be used to 'read' the electrical activity of the brain. And there is a characteristic electrical pattern that precedes a seizure."

Ellis paused, glanced at Benson, then up at the audience.

"So we have a feedback system - the same electrodes are used to detect a new attack, and to deliver the aborting shock. A computer controls the feedback mechanism."

He drew a small square in the neck of his schematic figure.

"The NPS staff has developed a computer that will monitor electrical activity of the brain, and when it sees an attack starting, will transmit a shock to the correct brain area. This computer is about the size of a postage stamp and weighs a tenth of an ounce. It will be implanted beneath the skin of the patient's neck."

He then drew an oblong shape below the neck and attached wires to the computer square.

"We will power the computer with a Handler PP-J plutonium power pack, which will be implanted beneath the skin of the shoulder. This makes the patient completely self-sufficient. The power pack supplies energy continuously and reliably for twenty years."

With his chalk, he tapped the different parts of his diagram. "That's the complete feedback loop - brain, to electrodes, to computer, to power pack, back to brain. A total loop without any externalized portions."

He turned to Benson, who had watched the discussion with an expression of bland disinterest.

"Any comments? Mr. Benson?"

Ross groaned inwardly. Ellis was really letting him have it. It was flagrantly sadistic - even for a surgeon.

"No," Benson said. "I have nothing to say." And he yawned.

When Benson was wheeled out of the room, Ross went with him. It wasn't really necessary for her to accompany him, but she was concerned about his condition - and a little guilty about the way Ellis had treated him, She said, "How do you feel?"

"I thought it was interesting," he said.

"In what way?"

"'Well, the discussion was entirely medical. I would have expected a more philosophical approach."

"We're just practical people," she said lightly, "dealing with a practical problem."

Benson smiled. "So was Newton," he said. "What's more practical than the problem of why an apple falls to the ground?"

"Do you really see philosophical implications in all this?"

Benson nodded. His expression turned serious. "Yes," he said, "and so do you. You're just pretending that you don't."

She stopped then and stood in the corridor, watching as Benson was wheeled down to the elevator. Benson, Morris, and the cop waited in the corridor for the next car. Morris pushed the button repeatedly in that impatient, aggressive way of his. Then the elevator arrived and they got on. Benson waved one last time, and the doors closed.

She went back to the amphitheater.

"… has been under development for ten years," Ellis was saying. "It was first started for cardiac pacemakers, where changing batteries requires minor surgery every year or so. That's an annoyance to surgeon and patient. The atomic power pack is totally reliable and has a long lifespan. If Mr. Benson is still alive, we might have to change packs around 1990, but not before then."

Janet Ross slipped back into the room just as another question was asked: "How will you determine which of the forty electrodes will prevent a seizure?"

"We will implant them all," Ellis said, "and wire up the computer. But we will not lock in any electrodes for twenty-four hours. One day after surgery, we'll stimulate each of the electrodes by radio and determine which electrodes work best. Then we will lock those in by remote control."

High up in the amphitheater, a familiar voice coughed and said, "These technical details are interesting, but they seem to me to elude the point." Ross looked up and saw Manon speaking. Manon was nearly seventy-five, an emeritus professor of psychiatry who rarely came to the hospital any more. When he did, he was usually regarded as a cranky old man, far past his prime, out of touch with modern thinking.

"It seems to me," Manon continued, "that the patient is psychotic."

"That's putting it a little strongly," Ellis said.

"Perhaps," Manon said. "But, at the very least, he has a severe personality disorder. All this confusion about men and machines is worrisome to me."

"The personality disorder is part of his disease," Ellis said. "In a recent review, Harley and co-workers at Yale reported that fifty percent of temporal-lobe epileptics had an accompanying personality disorder which was independent of seizure activity per se."

"Quite so," Manon said, in a voice that had the slightest edge of impatience to it. "It is part of his disease, independent of seizures. But will your procedure cure it?"

Janet Ross found herself quietly pleased; Manon was reaching exactly her own conclusions.

"No," Ellis said. "Probably not."

"In other words, the operation will stop his seizures, but it won't stop his delusions."

"No," Ellis repeated. "Probably not.

"If I may make a small speech," Manon said, frowning down from the top row, "this kind of thinking is what I fear most from the NPS. I don't mean to single you out particularly. It's a general problem of the medical profession. For example, if we get a suicide attempt or a suicide gesture by drug overdose in the emergency ward, our approach is to pump the patient's stomach, give him a lecture, and send him home. That's a treatment - but it's hardly a cure. The patient will be back sooner or later. Stomach pumping doesn't treat depression. It only treats drug overdose."

"I see what you're saying, but…"

"I'd also remind you of the hospital's experience with Mr. L. Do you recall the case?"

"I don't think Mr. L. applies here," Ellis said. But his voice was stiff and exasperated.

"I'm not so sure," Manon said. Since several puzzled faces in the amphitheater were turned toward him, he explained.

"Mr. L. was a famous case here a few years ago. He was a thirty-nine-year-old man with bilateral end-stage kidney disease. Chronic glomerulonephritis. He was considered a candidate for renal transplant. Because our facilities for transplantation are limited, a hospital review board selects patients. The psychiatrists on that board strongly opposed Mr. L. as a transplantation candidate, because he was psychotic. He believed that the sun ruled the earth and he refused to go outside during the daylight hours. We felt he was too unstable to benefit from kidney surgery, but he ultimately received the operation. Six months later, he committed suicide. That's a tragedy. But the real question is couldn't someone else have benefited more from the thousands of dollars and many hours of specialized effort that went into the transplant?"

Ellis paced back and forth, the foot of his bad leg scraping slightly along the floor. Ross knew it meant he was feeling threatened, under attack. Normally Ellis was careful to minimize his disability, concealing it so that the limp was noticeable only to a trained eye. But if he was tired, or angry, or threatened, the flaw appeared. It was almost as if he unconsciously wanted sympathy: don't attack me, I'm a cripple. Consciously, of course, he was not aware of it.

"I understand your objection," Ellis said. "In the terms you present it, your argument is unanswerable. But I would like to consider the problem from a somewhat different viewpoint. It is perfectly true that Benson is disturbed, and that our operation probably won't change that. But what happens if we don't operate on him? Are we doing him a favor? I don't think so. We know that his seizures are life-threatening - to himself, to others. His seizures have already gotten him into trouble with the law, and his seizures are getting worse. The operation will prevent seizures, and we think that is an important benefit to the patient."

High up, Manon gave a little shrug. Janet Ross knew the gesture; it signaled irreconcilable differences, an impasse.

"Well, then," Ellis said, "are there other questions?"

There were no other questions.

"Jesus fucking Christ," Ellis said, wiping his forehead.

"He didn't let up, did he?"

Janet Ross walked with him across the parking lot toward the Langer research building. It was late afternoon; the sunlight was yellowing, turning pale and weak.

"His point was valid," she said mildly.

Ellis sighed. "I keep forgetting you're on his side."

"Why do you keep forgetting?" she asked. She smiled as she said it. As the psychiatrist on the NPS staff, she'd opposed Benson's operation from the beginning.

"Look," Ellis said. "We do what we can. It'd be great to cure him totally. But we can't do that. We can only help him. So we'll help him."

She walked alongside him in silence. There was nothing to say. She had told Ellis her opinion many times before. The operation might not help - it might, in fact, make Benson much worse. She was sure Ellis understood that possibility, but he was stubbornly ignoring it. Or so it seemed to her.

Actually, she liked Ellis, as much as she liked any surgeon. She regarded surgeons as flagrantly action-oriented, men (they were almost always men, which she found significant) desperate to do something, to take some physical action. In that sense, Ellis was better than most of them. He had wisely turned down several stage-three candidates before Benson, and she knew that was difficult for him to do, because a part of him was terribly eager to perform the new operation.

"I hate all this," Ellis said.

"Hate what?"

"The politics. That's the nice thing about operating on monkeys. No politics at all."

"But you want to do Benson…"

"I'm ready," Ellis said. "We're all ready. We have to take that first big step, and now is the time to take it." He glanced at her. "Why do you look so uncertain?"

"Because I am," she said.

They came to the Langer building. Ellis went off to an early dinner with McPherson - a political dinner, he said irritably - and she took the elevator to the fourth floor.

After ten years of steady expansion, the Neuropsychiatric Research Unit encompassed the entire fourth floor of the Langer research building. The other floors were painted a dead, cold white, but the NPS was bright with primary colors. The intention was to make patients feel optimistic and happy, but it always had the reverse effect on Ross. She found it falsely and artificially cheerful, like a nursery school for retarded children.

She got off the elevator and looked at the reception area, one wall a bright blue, the other red. Like almost everything else about the NPS, the colors had been McPherson's idea. It was strange, she thought, how much an organization reflected the personality of its leader. McPherson himself always seemed to have a bright kindergarten quality about him, and a boundless optimism.

Certainly you had to be optimistic if you planned to operate on Harry Benson.

The Unit was quiet now, most of the staff gone home for the night. She walked down the corridor past the colored doors with the stenciled labels: SONOENCEPHALOGRAPHY,

CORTICAL FUNCTION, EEG, RAS SCORING, PARIETAL T, and, at the far end of the hall, TELECOMP. The work done behind those doors was as complex as the labels - and this was just the patient-care wing, what McPherson called "Applications."

Applications was ordinary compared to Development, the research wing with its chemitrodes and compsims and elad scenarios. To say nothing of the big projects, like George and Martha, or Form Q. Development was ten years ahead of Applications - and Applications was very, very advanced.

A year ago, McPherson had asked her to take a group of newspaper science reporters through the NPS. He chose her, he said, "because she was such a piece of ass." It was funny to hear him say that, and shocking in a way. He was usually so courtly and fatherly.

But her shock was minor compared to the shock the reporters felt. She had planned to show them both Applications and Development, but after the reporters had seen Applications they were so agitated, so clearly overloaded, that she cut the tour short.

She worried a lot about it afterward. The reporters hadn't been naive and they hadn't been inexperienced. They were people who shuttled from one scientific arena to another all their lives. Yet they were rendered speechless by the implications of the work she had shown them. She herself had lost that insight, that perspective - she had been working in the NPS for three years, and she had gradually become accustomed to the things done there. The conjunction of men and machines, human brains and electronic brains, was no longer bizarre and provocative. It was just a way to take steps forward and get things done.

On the other hand, she opposed the stage-three operation on Benson. She had opposed it from the start. She thought

Benson was the wrong human subject, and she had just one last chance to prove it.

At the end of the corridor, she paused by the door to Telecomp, listening to the quiet hiss of the print-out units. She heard voices inside, and opened the door. Telecomp was really the heart of the Neuropsychiatric Research Unit; it was a large room, filled with electronic equipment. The walls and ceilings were soundproofed, a vestige of earlier days when the read-out consoles were clattering teletypes. Now they used either silent CRTs - cathode-ray tubes - or a print-out machine that sprayed the letters with a nozzle, rather than typed them mechanically. The hiss of the sprayer was the loudest sound in the room. McPherson had insisted on the change to quieter units because he felt the clattering disturbed patients who came to the NPS for treatment.

Gerhard was there, and his assistant Richards. The wizard twins, they were called: Gerhard was only twenty-four, and Richards even younger. They were the least professional people attached to the NPS; both men regarded Telecomp as a kind of permanent playground filled with complex toys. They worked long but erratic hours, frequently beginning in the late afternoon, quitting at dawn. They rarely showed up for group conferences and formal meetings, much to McPherson's annoyance. But they were undeniably good. Gerhard, who wore cowboy boots and dungarees and satiny shirts with pearl buttons, had gained some national attention at the age of thirteen when he built a twenty-foot solid-fuel rocket behind his house in Phoenix. The rocket possessed a remarkably sophisticated electronic guidance system and Gerhard felt he could fire it into orbit. His neighbors, who could see the nose of the finished rocket sticking up above the garage in the backyard, were disturbed enough to call the police, and ultimately the Army was notified.

The Army examined Gerhard's rocket and shipped it to White Sands for firing. As it happened, the second stage ignited before disengagement and the rocket exploded two miles up; but by that time Gerhard had four patents on his guidance mechanism and a number of scholarship offers from colleges and industrial firms. He turned them all down, let his uncle invest the patent royalties, and when he was old enough to drive, bought a Maserati. He went to work for Lockheed in Palmdale, California, but quit after a year because he was blocked from advancement by a lack of formal engineering degrees. It was also true that his colleagues resented a seventeen-year-old with a Maserati Ghibli and a propensity for working in the middle of the night; it was felt he had no "team spirit."

Then McPherson hired him to work at the Neuropsychiatric Research Unit, designing electronic components to be synergistic with the human brain. McPherson, as head of the NPS, had interviewed dozens of candidates who thought the job was "a challenge" or "an interesting systems application context." Gerhard said he thought it would be fun, and was hired immediately.

Richards's background was similar. He had finished high school and gone to college for six months before being drafted by the Army. He was about to be sent to Vietnam when he began to suggest improvements in the Army's electronic scanning devices. The improvements worked, and Richards never got closer to combat than a laboratory in Santa Monica. When he was discharged, he also joined the NPS.

The wizard twins: Ross smiled.

"Hi, Jan," Gerhard said.

"How's it going, Jan?" Richards said.

They were both offhand. They were the only people on the Staff who dared refer to McPherson as "Rog." And McPherson put up with it.

"Okay," she said. "We've got our stage three through grand rounds. I'm going to see him now."

"We're just finishing a check on the computer," Gerhard said. "It looks fine." He pointed to a table with a microscope surrounded by a tangle of electronic meters and dials.

"Where is it?"

"Under the stage."

She looked closer. A clear plastic packet the size of a postage stamp lay under the microscope lens. Through the plastic she could see a dense jumble of micro-miniaturized electronic components. Forty contact points protruded from the plastic. With the help of the microscope, the twins were testing the points sequentially, using fine probes.

"The logic circuits are the last to be checked," Richards said. "And we have a backup unit, just in case."

Janet went over to the file-card storage shelves and began looking through the test cards. After a moment, she said, "Haven't you got any more psychodex cards?"

"They're over here," Gerhard said. "You want five-space or n-space?"

"N-space," she said.

Gerhard opened a drawer and took out a cardboard sheet. He also took out a flat plastic clipboard. Attached to the clipboard by a metal chain was a pointed metal probe, something like a pencil.

"This isn't for the stage three, is it?"

"Yes," she said.

"But'you've run so many psychodexes on him before- "

"Just one more, for the records."

Gerhard handed her the card and clipboard. "Does your stage three know what's going on?"

"He knows most of it," she said.

Gerhard shook his head. "He must be out of his mind.

"He is," she said. "That's the problem."

At the seventh floor, she stopped at the nurses' station to ask for Benson's chart. A new nurse was there, who said,

"I'm sorry but relatives aren't allowed to look at medical records."

"I'm Dr. Ross."

The nurse was flustered. "I'm sorry, Doctor, I didn't see a name tag. Your patient is in seven-ohfour."

"What patient?"

"Little Jerry Peters."

Dr. Ross looked blank.

"Aren't you a pediatrician?" the nurse asked, finally.

"No," she said. "I'm a psychiatrist at the NPS." She heard the stridency in her own voice, and it upset her. But all those years growing up with people who said, "You don't really want to be a doctor, you want to be a nurse," or,

"Well, for a woman, pediatrics is best, I mean, the most natural thing…"

"Oh," the nurse said. "Then you want Mr. Benson in seven-ten. He's been prepped."

"Thank you," she said. She took the chart and walked down the hall to Benson's room. She knocked on Benson's door and heard gunshots. She opened the door and saw that the lights were dimmed, except for a small bedside lamp, but the room was bathed in an electric-blue glow from a TV. On the screen, a man was saying, "… dead before he hit the ground. Two bullets right through the heart."

"Hello?" she said, and swung the door wider.

Benson looked over. He smiled and pressed a button beside the bed, turning off the TV. His head was wrapped in a towel.

"How are you feeling?" she asked, coming into the room. She sat on a chair beside the bed.

"Naked," he said, and touched the towel. "It's funny. You don't realize how much hair you have until somebody cuts it all off." He touched the towel again. "It must be worse for a woman." Then he looked at her and became embarrassed.

"It's not much fun for anybody," she said.

"I guess not." He lay back against the pillow. "After they did it, I looked in the wastebasket, and I was amazed. So much hair. And my head was cold. It was the funniest thing, a cold head. They put a towel around it. I said I wanted to look at my head - see what I looked like bald - but they said it wasn't a good idea. So I waited until after they left, and then I got out of bed and went into the bathroom. But when I got there…"

"Yes?"

"I didn't take the towel off." He laughed. "I couldn't do it. What does that mean?"

"I don't know. What do you think it means?"

He laughed again. "Why is it that psychiatrists never give you a straight answer?" He lit a cigarette and looked at her defiantly. "They told me I shouldn't smoke, but I'm doing it anyway."

"I doubt that it matters," she said. She was watching him closely. He seemed in good spirits, and she didn't want to take that away from him. But on the other hand, it wasn't entirely appropriate to be jovial on the eve of brain surgery.

"Ellis was here a few minutes ago," he said, puffing on the cigarette. "He put some marks on me. Can you see?" He lifted up the right side of his towel slightly. exposing white pale flesh over the skull. Two blue "X" marks were positioned behind the ear. "How do I look?" he asked, grinning.

"You look fine," she said. "How do you feel?"

"Fine. I feel fine."

"Any worries?"

"No. I mean, what is there to worry about? Nothing I can do. For the next few hours, I'm in your hands, and Ellis's hands…"

"I think most people would be a little worried before an operation."

"There you go again, being a reasonable psychiatrist." He smiled, and then frowned. He bit his lip. "Of course I'm worried."

"What worries you?"

"Everything," he said. He sucked on the cigarette.

"Everything. I worry about how I'll sleep. How I'll feel tomorrow. How I'll be when it's all over. What if somebody makes a mistake? What if I get turned into a vegetable? What if it hurts? What if I…"

"Die?"

"Sure. That, too."

"It's really a minor procedure. It's hardly more complicated than an appendectomy."

"I bet you tell that to all your brain-surgery patients."

"No, really. It's a short, simple procedure. It'll take about an hour and a half."

He nodded vaguely. She couldn't tell if she had reassured him. "You know," he said, "I don't really think it will happen. I keep thinking tomorrow morning at the last minute they'll come in and say 'You're cured, Benson, you can go home now.' "

"We hope you'll be cured by the operation." She felt a twinge of guilt saying that, but it came out smoothly enough.

"You're so goddamned reasonable," he said. "There are times when I can't stand it."

"Like now?"

He touched the towel around his head again. "I mean, for Christ's sake, they're going to drill holes in my head, and stick wires in- "

"You've known about that for a long time."

"Sure," he said. "Sure. But this is the night before."

"Do you feel angry now?"

"No. Just scared."

"It's all right to be scared, it's perfectly normal. But don't let it make you angry."

He stubbed out the cigarette, and lit another immediately. Changing the subject, he pointed to the clipboard she carried under her arm. "What's that?"

"Another psychodex test. I want you to go through it."

"Now?"

"Yes. It's just for the record."

He shrugged indifferently. He had taken the psychodex several times before. She handed him the clipboard and he arranged the question card on the board, then began to answer the questions. He read them aloud:

"Would you rather be an elephant or a baboon? Baboon. Elephants live too long."

With the metal probe, he punched out the chosen answer on the card.

"If you were a color, would you rather be green or yellow? Yellow. I'm feeling very yellow right now." He laughed, and punched the answer.

She waited until he had done all thirty questions and punched his answers. He handed the clipboard back to her, and his mood seemed to shift again. "Are you going to be there? Tomorrow?"

"Yes."

"Will I be awake enough to recognize you?"

"I imagine so."

"And when will I come out of it?"

"Tomorrow afternoon or evening."

"That soon?"

"It's really a minor procedure," she said again. He nodded. She asked him if she could get him anything, and he said some ginger ale, and she replied that he was NPO, nothing per ora, for twelve hours before the operation. She said he'd be getting shots to help him sleep, and shots in the morning before he went to surgery. She said she hoped he'd sleep well.

As she left, she heard a hum as the television went back on, and a metallic voice said, "Look, Lieutenant, I've got a murderer out there, somewhere in a city of three million people…"

She closed the door.

Before leaving the floor, she put a brief note in the chart. She drew a red line around it, so that the nurses would be sure to see it:

ADMITTING PSYCHIATRIC SUMMARY:

This 34-year-old man has documented psychomotor epilepsy of 2 years' duration. The etiology is presumably traumatic, following an automobile accident. This patient has already tried to kill two people, and has been involved in fights with several others. Any statement by him to hospital staff that he "feels funny" or "smells something bad" should be respected as indicating the start of a seizure. Under such circumstances, notify the NPS and Hospital Security at once.

The patient has an accompanying personality disorder which is part of his disease. He is convinced that machines are conspiring to take over the world. These beliefs are strongly held and attempts to dissuade him from them will only draw his enmity and suspicion. One should also remember that he is a highly intelligent and sensitive man. The patient can be quite demanding at times, but he should be treated with firmness and respect.

His intelligent and articulate manner may lead one to forget that his attitudes are not willful. He suffers an organic disease which has affected his mental state. Beneath it all he is frightened and concerned about what is happening to him.

Janet Ross, M.D. NPS

"I don't understand," the PR man said.

Ellis sighed. McPherson smiled patiently. "This is an organic cause of violent behavior," he said. "That's the way to look at it."

The three of them were sitting in the Four Kings Restaurant, adjacent to the hospital. The early dinner had been McPherson's idea; McPherson said he wanted Ellis present, so Ellis was present. That was how Ellis thought about it.

Ellis raised his hand, beckoning the waiter for more coffee. As he did so, he thought it might keep him awake. But it didn't matter: he wouldn't sleep much tonight anyway. Not on the eve of his first stage three on a human subject. He knew he would toss and turn in bed, going over the operative procedure. Over and over again, reviewing the pattern he already knew so well. He'd done a lot of monkeys as stage-three procedures. One hundred and fifty-four monkeys, to be exact. Monkeys were difficult. They pulled out their stitches, they tugged at the wires, they screeched and fought you and bit you-

"Cognac?" McPherson asked.

"Fine," the PR man said.

McPherson glanced questioningly at Ellis. Ellis shook his head. He put cream in his coffee, and sat back suppressing a yawn. Actually, the PR man looked a little like a monkey. A juvenile rhesus: he had the same blocky lower jaw and thesame bright-eyed alertness.

The PR man's name was Ralph. Ellis didn't know the last name. No PR man ever gave his last name. Of course, at the hospital he wasn't referred to as a PR man; he was the Hospital Information Officer or News Officer or some damned thing.

He did look like a monkey. Ellis found himself staring at the area of the skull behind the ear, where the electrodes would be implanted.

"We don't know much about the causes of violence," McPherson said. "And there's a lot of crap theory floating around, written by sociologists and paid for by perfectly good taxpayer money. But we do know that one particular illness, psychomotor epilepsy, may lead to violence."

"Psychomotor epilepsy," Ralph repeated.

"Yes. Now, psychomotor epilepsy is as common as any other kind of epilepsy. There are some famous people. who have had it, like Dostoevski. At the NPS, we think that psychomotor epilepsy may be extremely common among those people who engage in repetitive violent acts - like certain policemen, gangsters, rioters, Hell's Angels. Nobody ever thinks of these people as physically ill. We just accept the idea that there are a lot of men in the world with bad tempers. We think that's normal. Perhaps it isn't."

"I see," Ralph said. And he did, indeed, seem to be seeing. McPherson should have been a grade-school teacher, Ellis thought. His great gift was teaching. Certainly he'd never been much of a researcher.

"And so," McPherson said, brushing his hand through his white hair, "we have no idea exactly how common psychomotor epilepsy is. But our guess is that as much as one or two percent of the population may suffer from it. That's two to four million Americans."

"Gosh," Ralph said.

Ellis sipped his coffee. Gosh, he thought. Good Christ. Gosh…

"For some reason," McPherson said, nodding to the waiter as the cognacs were brought, "psychomotor epileptics are predisposed to violent, aggressive behavior during their attacks. We don't know why, but it's true. The other things that go along with the syndrome are hypersexuality and pathological intoxication."

Ralph began to look unusually interested.

"We had the case of one woman with this disease," McPherson said, "who during a seizure state would have intercourse with twelve men a night and still be unsatisfied."

Ralph swallowed his cognac. Ellis noticed that Ralph wore a wide tie in a fashionable psychedelic pattern. A hip forty-year-old public-relations man gulping cognac at the thought of this woman.

"Pathological intoxication refers to the phenomenon of excessive, violent drunkenness brought on by minuscule amounts of liquor - just a sip or two. That much liquor will unleash a seizure."

Ellis thought of his first stage three. Benson: pudgy little Benson, the mild-mannered computer programmer who got drunk and beat up people - men, women, whoever happened to be present. The very idea of curing that with wires stuck in the brain seemed absurd.

Ralph seemed to think so, too. "And this operation will cure the violence?"

"Yes," McPherson said. "We believe so. But the operation has never been done before on a human subject. It will be done at the hospital tomorrow morning."

"I see," Ralph said, as if he suddenly understood the reason for the dinner.

"It's very sensitive, in terms of the press," McPherson said.

"Oh, yes, I can see that…"

There was a short pause. Finally, Ralph said, "Who's going to do the operation?"

"I am," Ellis said.

"Well," Ralph said, "I'll have to check our files. I want to make sure I have a recent picture of you, and a good bio for the releases." He frowned, thinking of the work ahead of him.

Ellis was astonished at the man's reaction. Was that all he thought? That he might need a recent photo? But McPherson took it smoothly in stride. "We'll get you whatever you need," he said, and the meeting broke up.

Robert Morris was sitting in the hospital cafeteria finishing some stale apple pie when his pagemaster went off. It produced a high electronic squeal, which persisted until he reached down to his belt and turned it off. He returned to his pie. After a few moments, the squeal came again. He swore, put down his fork, and went to the wall phone to answer his page.

There had been a time when he regarded the little gray box clipped to his belt as a wonderful thing. He relished those moments when he would be having lunch or dinner with a girl and his pagemaster would go off, requiring him to call in. That sound demonstrated that he was a busy, responsible person involved in life-and-death matters. When the pagemaster went off, he would excuse himself abruptly and answer the call, radiating a sense of duty before pleasure. The girls loved it.

But after several years it was no longer wonderful. The box was inhuman and implacable, and it had come to symbolize for him the fact that he was not his own man. He was perpetually on call to some higher authority, however whimsical - a nurse who wanted to confirm a medication order at 2 a.m.; a relative who was acting up, making trouble about Mama's post-operative treatment; a call to tell him a conference was being held when he was already there attending the damned conference.

Now the finest moments in his life were those when he went home and put the box away for a few hours. He became unreachable and free. And he liked that very much.

He stared across the cafeteria at the remainder of his apple pie as he dialed the switchboard. "Dr. Morris."

"Dr. Morris, two-four-seven-one."

"Thank you." That was the extension for the seventh floor nurses' station. It was odd how he had learned all these extensions. The telephone network of University Hospital was more complicated than human anatomy. But over the years, without any conscious attempt to learn it, he came to know it quite well. He dialed the floor. "Dr. Morris."

"Oh, yes," a female voice said. "We have a woman with an overnight bag for patient Harold Benson. She says it's personal things. Is it all right to give it to him?"

"I'll come up," he said.

"Thank you, Doctor."

He went back to his tray, picked it up, and carried it to the disposal area. As he did so, his beeper went off again. He went to answer it.

"Dr. Morris."

"Dr. Morris, one-three-five-seven."

That was the metabolic unit. He dialed. "Dr. Morris."

"This is Dr. Hanley," an unfamiliar voice said. "We wondered if you could take a look at a lady we think may have steroid psychosis. She's a hemolytic anemic up for splenectomy."

"I can't see her today," Morris said, "and tomorrow is tight." That, he thought, was the understatement of the year.

"Have you tried Peters?"

"No…"

"Peters has a lot of experience with steroid mentation. Try him."

"All right. Thanks."

Morris hung up. He got onto the elevator and pressed the button for the seventh floor. His beeper went off a third time. He checked his watch; it was 6:30 and he was supposedly off-duty by now. But he answered it anyway. It was Kelso, the pediatric resident.

"Want your ass whipped?" Kelso said.

"Okay. What time?"

"Say, about half an hour?"

"If you've got the balls."

"I've got them. They're in my car."

"See you on the court," Morris said. Then he added, "I may be a little late."

"Don't be too late," Kelso said. "It'll be dark soon."

Morris said he would hurry, and hung up.

The seventh floor was quiet. Most of the other hospital floors were noisy, jammed with relatives and visitors at this hour, but the seventh floor was always quiet. It had a sedate, calm quality that the nurses were careful to preserve.

The nurse at the station said, "There she is, Doctor," and nodded to a girl sitting on a couch. Morris went over to her. She was young and very pretty in a flashy, show-business sort of way. She had long legs.

"I'm Dr. Morris."

"Angela Black." She stood up and shook hands, very formally. "I brought this for Harry." She lifted a small blue overnight bag. "He asked me to bring it."

"All right." He took the bag from her. "I'll see that he gets it."

She hesitated, then said, "Can I see him?"

"I don't think it's a good idea." Benson would have been shaved by now; pre-op patients who had been shaved often didn't want to see people.

"Just for a few minutes?"

"He's heavily sedated," he said.

She was clearly disappointed. "Then would you give him a message?"

"Sure."

"Tell him I'm back in my old apartment. He'll understand."

"All right."

"You won't forget?"

"No. I'll tell him."

"Thank you." She smiled. It was a rather nice smile, despite the long false eyelashes and the heavy make-up. Why did young girls do that to their faces? "I guess I'll be going now." And she walked off, short skirt and very long legs, a briskly determined walk. He watched her go, then hefted the bag, which seemed heavy.

The cop sitting outside the door to 710 said, "How's it going?"

"Fine," Morris said.

The cop glanced at the overnight bag but said nothing as

Morris took it inside the room.

Harry Benson was watching a Western on television. Morris turned down the sound. "A very pretty girl brought you this."

"Angela?" Benson smiled. "Yes, she has a nice exterior. Not a very complicated internal mechanism, but a nice exterior." He extended his hand; Morris gave him the bag.

"Did she bring everything?"

Morris watched as Benson opened it, placing the contents on the bed. There were a pair of pajamas, an electric razor, some after-shave lotion, a paperback novel.

Then Benson brought out a black wig.

"What's that?" Morris asked.

Benson shrugged. "I knew I'd need it sooner or later," he said. Then he laughed. "You are letting me out of here, aren't you? Sooner or later?"

Morris laughed with him. Benson dropped the wig back into the bag, and removed a plastic packet. With a metallic clink, he unfolded it, and Morris saw it was a set of screwdrivers of various sizes, stored in a plastic package with pockets for each size.

"What's that for?" Morris asked.

Benson looked puzzled for a moment. Then he said, "I don't know if you'll understand…"

"Yes?"

"I always have them with me. For protection."

Benson placed the screwdrivers back into the overnighter. He handled them carefully, almost reverently. Morris knew that patients frequently brought odd things into the hospital, particularly if they were seriously ill. There was a kind of totemic feeling about these objects, as if they might have magical preservative powers. They were often connected with some hobby or favorite activity. He remembered a yachtsman with a metastatic brain tumor who had brought a kit to repair sails, and a woman with advanced heart disease who had brought a can of tennis balls. That kind of thing.

"I understand," Morris said.

Benson smiled.

Telecomp was empty when she came into the room; the consoles and teleprinters stood silently, the screens blinking up random sequences of numbers. She went to the corner and poured herself a cup of coffee, then fed the test card from Benson's latest psychodex into the computer.

The NPS had developed the psychodex test, along with several other computer-analyzed psychological tests. It was all part of what McPherson called "double-edged thinking." In this case, he meant that the idea of a brain being like a computer worked two ways, in two different directions. On the one hand, you could utilize the computer to probe the brain, to help you analyze its workings. At the same time, you could use your increased knowledge of the brain to help design better and more efficient computers. As McPherson said, "The brain is as much a model for the computer as the computer is a model for the brain."

At the NPS, computer scientists and neurobiologists had worked together for several years. From that association had come Form Q, and programs like George and Martha, and new psycho-surgical techniques, and psychodex.

Psychodex was relatively simple. It was a test that took straightforward answers to psychological questions and manipulated the answers according to complex mathematical formulations. As the data were fed into the computer, Ross watched the screen glow with row after row of calculations.

She ignored them; the numbers, she knew, were just the computer's scratch pad, the intermediate steps that it went through before arriving at a final answer. She smiled, thinking of how Gerhard would explain it - rotation of thirty by thirty matrices in space, deriving factors, making them orthogonal, then weighting them. It all sounded complicated and scientific, and she didn't really understand any of it.

She had discovered long ago that you could use a computer without understanding how it worked. Just as you could use an automobile, a vacuum cleaner - or your own brain.

The screen flashed "CALCULATIONS ENDED. CALL DISPLAY SEQUENCE."

She punched in the display sequence for three-space scoring. The computer informed her that three spaces accounted for eighty-one percent of variance. On the screen she saw a three-dimensional image of a mountain with a sharp peak. She stared at it a moment, then picked up the telephone and paged McPherson.

McPherson frowned at the screen. Ellis looked over his shoulder. Ross said, "Is it clear?"

"Perfectly," McPherson said. "When was it done?"

"Today," she said.

McPherson sighed. "You're not going to quit without a battle, are you?"

Instead of answering, she punched buttons and called up a second mountain peak, much lower. "Here's the last one previously."

"On this scoring, the elevation is- "

"Psychotic mentation," she said.

"So he's much more pronounced now," McPherson said. "Much more than even a month ago."

"Yes," she said.

"You think he was screwing around with the test?"

She shook her head. She punched in the four previous tests, in succession. The trend was clear: on each test the mountain peak got higher and sharper.

"Well, then," McPherson said, "he's definitely getting worse. I gather you still think we shouldn't operate."

"More than ever," she said. "He's unquestionably psychotic, and if you start putting wires in his head- "

"I know," McPherson said. "I know what you're saying."

"- he's going to feel that he's been turned into a machine," she said.

McPherson turned to Ellis. "Do you suppose we can knock this elevation down with thorazine?" Thorazine was a major tranquilizer. With some psychotics, it helped them to think more clearly.

"I think it's worth a try."

McPherson nodded. "I do, too. Janet?"

She stared at the screen and didn't reply. It was odd how these tests worked. The mountain peaks were an abstraction, a mathematical representation of an emotional state. They weren't a real characteristic of a person, like fingers or toes, or height or weight.

"Janet? What do you think?" McPherson repeated.

"I think," she said, "that you're both committed to this operation."

"And you still disapprove?"

"I don't 'disapprove.' I think it's unwise for Benson."

"What do you think about using thorazine?" McPherson persisted.

"It's a gamble."

"A gamble not worth taking."

"Maybe it's worth it, and maybe it's not. But it's a gamble."

McPherson nodded and turned to Ellis. "Do you still want to do him?"

"Yes," Ellis said, staring at the screen. "I still want to do him."

As always, Morris found it strange to play tennis on the hospital court. The hospital buildings looming high above him always made him feel slightly guilty - all those rows of windows, all those patients who could not do what he was doing. Then there was the sound. Or, rather, the absence of sound. The freeway ran near the hospital, and the reassuring thwock! of the tennis balls was completely obliterated by the steady, monotonous rush of passing cars.

It was getting dark now, and he was having trouble with his vision; the ball seemed to pop unexpectedly into his court. Kelso was much less hampered. Morris often joked that Kelso ate too many carrots, but whatever the explanation, it was humiliating to play late with Kelso. Darkness helped him. And Morris hated to lose.

He had long ago become comfortable with the fact of his own competitiveness. Morris never stopped competing. He competed in games, he competed in work, he competed with women. More than once Ross had pointed that out to him, and then dropped the subject in the sly way that psychiatrists raise a point, then drop it. Morris didn't mind. It was a fact of his life, and whatever the connotations - deep insecurity, a need to prove himself, a feeling of inferiority - he didn't worry about it. He drew pleasure from competition and satisfaction from winning. And so far in his life he had managed to win more often than not.

In part, he had joined the NPS because the challenges were very great and because the potential rewards were enormous. Privately, Morris expected to be a professor of surgery before he was forty. His past career had been outstanding- that was why Ellis had accepted him - and he was equally confident about his future. It wouldn't hurt to be associated with a major landmark in surgical practice.

All in all, he was in a good mood, and he played hard for half an hour, until he was tired and it was too dark to see. He signaled to Kelso - no point in calling above the freeway sounds - to end the game. They met at the net and shook hands. Morris was reassured to see that Kelso was sweating heavily.

"Good game," Kelso said. "Tomorrow, same time?"

"I'm not sure," Morris said.

Kelso paused. "Oh," he said. "That's right. You have a big day tomorrow."

"Big day," Morris nodded. Christ, had the news even reached the pediatric residents? For a moment he felt what Ellis must be feeling - the intense pressure, abstract, vague, that came from knowing that the entire University Hospital staff was watching this procedure.

"Well, good luck with it," Kelso said.

As the two men walked back to the hospital, Morris saw Ellis, a distant solitary figure, limping slightly as he crossed the parking lot and climbed into his car, and drove home.