Tin Angel

Illustration by Alan M. Clark

They both heard the sirens.

Angel’s eyes went wide. “Automobile accident, drunk driver uninjured in custody, man dead at the scene, pregnant woman, coming here, possible internal injuries, unconscious.”

Dr. C. Thornhart Benson looked sharply at his new protegee, momentarily surprised. She grinned and pointed a finger to her eyes. He smiled in spite of himself. Her eyes were infrared as well as optical receivers, and she was, of course, linked into every digital device in the hospital, including the comm net. He wouldn’t have to wait for the call. Too bad about whoever it was, but this was an opportunity to see what Angel could do.

“Let’s do it,” he said. They had been about to leave his stuffy, cluttered third-floor office at the medical center after a few minutes of paperwork and decompression following evening rounds on his patients. Instead, he put down his journal, Angel put down a half-finished stocking cap she was knitting, and they headed toward the emergency room.

He wanted to be there when the patient came in, not only to do what he could to help, but also to see how Angel would handle the situation. If the experiment called Angel was to work, she’d have to learn this side of the business.

The wail of sirens faded as the ambulance approached the hospital. Why, he wondered, did they still let people drive precybernetic cars? Inevitably, some of them did it drunk.

“That ambulance knows its business, Angel,” he remarked as they left the elevator for the first subfloor. “No need to wake everyone; the siren’s done its job once the ambulance hits the emergency room driveway.”

Angel nodded with such a human look of concern on her face that he had to remind himself that she wasn’t even alive in the usual sense. Her repertoire of appropriate verbal and nonverbal patterns of communication was extensive but, he knew, required only an insignificant part of the optical core memory stored in her chest.

Approximately where her heart would be, he realized.

They could “can” diagnostics, anatomy, and pharmacology in a database and drop it into her brain, but experience was something else; a collection of someone else’s anecdotes just wasn’t good enough; too much missing. So the Artificial Intelligence Consortium that made her decided she should have an internship just like any other doctor. Of course, one of his long-time patients was part of the consortium, and when they’d needed an advisor to teach their creation the human side of medicine, they’d talked him into it.

They’d made her bright, cheerful, tireless, and innocent. He was a childless widower. It had been pretty much a case of love at first sight. Hell, he thought, he’d fallen in love with cars, an airplane, even the great old oak desk his grandfather had left him. So, his attachment to Angel had been completely predictable.

They reached the entrance to the emergency room, and he held one of the heavy swinging doors open for her.

“Well, let’s go.”

“I’ll follow you, Dr. Benson.” She winked and tossed her head, sun-touched platinum polymer threads cascading around perfect shoulders. “Age before beauty.”

“Hrrmph!” He went through the door first, grinning in spite of himself.

He nodded to the ER physician, a moonlighting dermatology resident who’d been only too happy to let Benson take over a major trauma case as he and Angel charged into the prep room, stripped to shorts and T-shirts, and shrugged into scrub suits. Then it was out to the ambulance entrance to wait for the stretcher. The woman’s vitals were already displayed on the high-res overhead. Shock.

“Probably hypovolemic,” Angel said, her voice full of concern. “Nearly two liters of Ringer’s lactate in her… starting to stabilize.” She frowned. “Thorny, I’d better tell you this now. It’s Linda Coombs.”

“Oh, God!” Thorny winced and shut his eyes. He’d saved her life once before, twenty-five years ago, when she’d almost strangled on her own umbilical cord in one of the more difficult deliveries a G.P. ever got to do these days—by virtue of his being in her parents’ living room when she made her somewhat early entrance into this world. This meant Terry was dead, he realized. He’d been at their wedding just last year. Good kid, ran his own security service…

Angel’s hand was on his arm. “Are you…?”

“I’ll be fine. Thanks for telling me now. Better than recognizing her on the stretcher.”

As he spoke the doors slid open and things became a blur. He and Angel followed behind as the stretcher drove itself into the trauma room with its silent burden, and paramedics hovering around like ghostly bees around a red flower. Linda’s nose and mouth were covered by an oxygen mask, and a cervical collar encircled her neck. A blood-stained white sheet partially covered her limp body, which was connected at multiple puncture sites to bags of intravenous fluids hung on tall poles. The portable heart monitor, connected by multicolored wires to electrode patches stuck onto her exposed chest, beeped in a disturbingly fast and irregular rhythm. Thorny motioned to the scanning table, and they slid her onto it, tubes and poles following in an orderly ritual that only looked like mass confusion.

Thorny still found it hard to believe this was the same exuberant, vivacious young woman he’d last seen in his office not quite a week ago.

Forcing himself into objectivity, he watched Angel do a quick visual examination for external injuries. Linda’s chest was bruised, with some swelling above her left breast, and she had a golf-ball sized lump in the middle of her forehead.

“Beginning scan.” Angel said, and the bistatic resonance sensor head beneath the table glided to the top of Linda’s head and began to move slowly down the length of her body. As the imager started its examination, Angel resumed hers.

“Pupils equal, round, and reactive. No blood in the ears or nose.” She continued while one of the ER nurses—Sarah Miles, a robust, almost angrily competent black woman who Thorny knew slightly—drew blood for the analyzer.

“Type AB negative,” Angel announced. “The blood bank has it—it’s on its way.”

The nurse shot a quick look at Thorny as she prepared to do a twelve-lead electrocardiogram, and her eyes widened a bit when he nodded. “How the—?”

Thorny held up a hand. “Later. Let’s get those electrodes on.” He’d been assured that the medical center staff had been briefed about Angel, but seeing her in action was, it seemed, something else.

The imaging camera stopped abruptly at the level of Linda’s shoulders. “No fractures or bleeding,” Angel declared. “We can take off the collar.”

Now it was Thorny’s turn to stare. Angel smiled and the holoscreen monitor above the table snapped on. Thorny noted the image was blue tinged—probably the blue laser power setting, since the ultra-high res screen with the interference patterns was digital. The unit was a bargain when the center got it ten years ago, although it was bulky and hard to maintain by current standards, but it beat the hell out of what he’d had when he started in practice. In rapid sequence standard views of the skull and cervical spine appeared, rotated 360 degrees, and were replaced by images of the brain. Of course, he realized, Angel controlled its operation through her optical interface. For that matter, the images she showed would be strictly for the benefit of the human staff.

The imager resumed its slow path down Linda’s body and Angel moved her hands quickly over Linda’s pregnancy. The tiny sensors and transducers in her fingers and palms could, Thorny remembered, sense pressure through ultrasound and electrical fields through microwaves.

“No fractures or bleeding,” she repeated, “except—” Her hands caressed the abdomen once more. “The placenta has partially separated, and there’s some intrauterine bleeding. The size of the fetus is consistent with a gestation period of 34 weeks.” She paused, then looked at Thorny. “I’m sorry. No fetal heart beat or cerebral activity.”

Thorny felt a brief pressure in his own chest. Even though they were too late to save her baby, Linda still had a chance. Needing to do something to restore his clinical detachment, he glanced up at the overhead monitor. “Her blood pressure is—”

“—Eighty-five over fifty.” Angel completed his sentence without looking up. Thorny winced; he’d forgotten.

Angel’s fingers brushed across Linda’s chest. “No pneumothorax or any significant bleeding—mildly depressed sternal fracture—the left fifth, sixth, and seventh ribs are broken. The aorta seems intact. Her heart—” Suddenly Angel froze; utterly, inhumanly, motionless.

For a heart-rending second, Thorny thought she had malfunctioned, and realized that he might have to lift her out of the way, somehow, and take over.

But she started speaking again, her mouth moving while the rest of her body remained eerily rigid. “Her left ventricular function is very poor. I’m not sure how to explain that.” Thorny sighed in relief, and remembered how often he’d told her; “When in doubt, don’t just do something, stand there.” Apparently, she’d taken that literally. He shook his head, pushed his attention back to the patient, and wrinkled his forehead.

“I’m not sure either. Her grandmother died of heart failure at sixty, and her mother at forty-two, though that was complicated by smoking. But Linda never had any signs of a heart problem. I—”

Suddenly, Angel was a blur of motion.

“She’s in v-fib!” Nurse Miles shouted. “No pulse!”

Even before the sentence was completed Angel had grabbed the defibrillator paddles, and charged the machine.

“Clear!” Angel ordered, and everyone obeyed instantly. Chalk one up for a humanoid robot, Thorny thought; people might have hesitated if something that was obviously a machine had issued that order.

Angel delivered the electrical shock to Linda’s chest. Thorny peered anxiously at the heart monitor—and exhaled thankfully as it started beeping again. Nurse Miles pressed her index and middle fingers against Linda’s neck, and smiled slightly. “Good pulse.”

Speaking for their benefit, Angel ordered an intravenous bolus and drip of Cardiopax. The IV unit chimed in response before she finished saying “bolus.”

As Angel still held the defibrillator paddles, Thorny placed a tube down Linda’s throat to help her breathe and made sure it was positioned properly. He started to ask Nurse Miles to connect it to the ventilator when—

“Clear!” Angel shouted, signifying that Linda’s heart had stopped again.

Once, twice, three times—finally her heart started beating again, but now her blood pressure was dangerously low. They were losing her, Thorny thought, there was no time to…

But before he had a chance to speak, Angel brushed the nurse aside as the cart containing the cardiopulmonary support pump scooted over to the table. Moving so fast her hands seemed blurred, Angel prepped Linda’s right groin and then, more deliberately, threaded the catheters.

“Right atrium,” Angel announced, then “proximal aorta.” As Thorny nodded, there was another blur of motion and Angel hooked the pump up and primed it.

They waited a minute in silence, then two.

Come on, Linda. Thorny silently pleaded.

Linda’s vital signs stabilized as the pump assisted Linda’s heart and brought oxygen to her body. Thorny allowed himself a breath. The nurse stood there wide-eyed, shaking her head.

“I never… I never…”

“Sorry,” Angel said. “I had to move very fast.”

“No, dear, don’t be sorry,” the woman chuckled as she recovered her composure. “If you can do that, you’ve got to do that. Jus’ happy I didn’t get in your way. Look, blood pressure up to 100 over 60; heart rate’s only 90. I’m Sarah Miles. You?”

“Angel S.R.X. It means surgical robot, experimental.”

The dermatologist, who’d stayed well out of the way during all of this, cleared his throat nervously. So much, Thorny thought, for staff briefings.

“You ain’t human!?” Nurse Miles exclaimed.

“No,” Angel giggled, “But I’m a pretty good simulation, trying to get better. I’d like to be your friend.”

Nurse Miles just stood there with her mouth open.

Thorny cleared his throat, “Angel, that might be too much of the direct approach. Meanwhile, we’d better finish the whole body scan, and then get her to the OR so we can… take care of that bleeding placenta. Also, we need to get cardiology and surgery involved. We still don’t know why Linda’s heart isn’t working.”

If the tests and all Angel’s tricks didn’t tell them, they’d have to go in and find out.

Angel nodded. “I called them while I was talking to Nurse Miies. Dr. Bruk Tunman is on for cardiology, but he hasn’t answered yet. Dr. Elvis Creighton is on for surgery, and he just said that he’s on his way. I hope you don’t mind.”

Thorny shook his head. “No, that’s fine. They’re both good.” But to himself he added, Damn. It would have to be their chief surgeon. No one with that high an opinion of himself should ever have been made chief of anything.

Nurse Miles looked at him, “You in charge of her, or it, or… whatever?” she wanted to know.

“I’m her instructor. And yes, she’s supposed to be a she.”

The nurse gave a wide grin. “Then as far as I’m concerned, she it is. Never been friends with a robot before, though we’ve got a bunch of them around. They’re kind of standoffish. Not like you, Dr. Angel.”

Angel laughed. “Thanks, Sarah. That makes me feel good. I’m really looking forward to meeting Dr. Tunman and Dr. Creighton too, and I hope they’re as nice to work with as you are.”

Thorny cleared his throat. “Well, we can always hope,” he said slowly and deliberately.

Angel picked up on it. Good pattern recognition algorithms, of course. She looked a question.

“Tunman will probably be thrilled to meet you, but I’m a little concerned about how Creighton will react.”

“Amen to that,” Nurse Miles added with no hint of humor in her voice.

Within the next hour, they were in the operating room. Linda’s blood pressure had dropped a little with induction of general anesthesia but then, to Thorny’s relief, held steady. If her body could take the stress of surgery, he thought, there was a good chance she could still make a full recovery. Before the accident Linda’s health had been excellent—she’d been a vigorous swimmer and runner until her figure had gotten too awkward a month or so back.

Angel’s hand moved deftly and quickly during the cesarean section. This would be the sixth one she’d performed under his supervision. She had seemed a little hesitant and unsure of herself the first time—while she was full of simulations of exactly how it should be. But every real body is a bit different, and her neural net processors still had to fit her body’s motor responses and pattern recognition subroutines to the variances in real patients. He’d imagined, absurdly, little gears turning and slipping in her head—but after she oriented, her skill and speed far exceeded that of any human he had ever seen.

Linda’s fetus turned out to be male—stillborn, of course. Despite himself, Thorny thought back to that last office visit. No, she and Tom didn’t want to know what its sex was. “We don’t care if it’s a boy or a girl. Just as long as it’s healthy.”

I’m sorry, Linda. Sometimes there’s nothing anyone can do.

An hour later, as they closed the incision, a voice came over the intercom. “Dr. Creighton is here.”

The tall, boyish, good-looking Dr. Creighton raised an eyebrow at Angel when they walked into the recovery area, but spoke to Thorny.

“I saw your patient’s tests. Her aorta looks good, but her cardiac enzymes are sky-high. I suspect she had a bad myocardial contusion, or maybe a blocked coronary artery… so… I should open her up and make sure nothing needs repair. She might need a ventricular assist device.” He scrutinized Angel more closely. “I’ve been working with voice interface surgical robots for years, Benson. They do a good job of holding clamps, microcams, lasealers, and so on. First time I’ve seen one do anything as sophisticated as that support pump hook-up, though.”

“Thank you, Dr. Creighton,” Angel beamed.

“I’d prefer your machine didn’t speak to me unless spoken to, however. It is your instrument and under your control. Agreed, Benson?”

Angel looked confused and said nothing. Legally, of course, Dr. Creighton was right. Thorny touched Angel on the arm to indicate his approval of her conduct in the circumstances.

“Agreed, Dr. Creighton,” Thorny rasped, struggling to keep the irritation out of his voice. “It might be interesting to the board for her to perform the exploratory—the AI Consortium provided funding to cover this sort of thing.”

Creighton’s mouth twitched at the corners. He was, of course, aware of the arrangement.

“At your direction, of course,” Thorny continued. “Angel can handle the standard teleoperated mechanical assistants through her data link much more expeditiously than a human doctor. She’s really something special.”

“She?” Creighton grinned and wiped a shock of jet-black hair back to his youthful hairline. His jug ears and toothy smile, Thorny thought, completely misrepresented his internal nature, and he wondered if Angel would pick up on that. “So it’s Hoffmann and Olympia is it?” Creighton laughed, exploiting a fondness for opera which was their only mutual interest outside of medicine. In Offenbach’s opera, the hero, Hoffman, fell tragically in love with a life-like spring-powered mechanical doll. “Does she, then, have a cunt, too?”

Ouch, Thorny grimaced, but nodded to Angel. She, he had been briefed, should exhibit a studied, Miss Manners sort of coolness when confronted with repeated and unfair hostility. This, her design team maintained, would usually be less dangerous in most circumstances than a complete servility that would handicap her ability to help others. Part of what the hospital board had asked him to do was to evaluate her ability to handle real world stress of this kind. It occurred to him that it was just possible, however, unlikely, that Creighton’s crude remark was a conscious test of both Thorny and Angel.

“I haven’t been equipped with simulated reproductive organs,” she responded with a prim academic inflection. “However, there are anatomically correct designs which could be incorporated in a few day’s time to allow me to function in an educational role. May I ask what your interest is?”

“Benson,” Dr. Creighton hissed, incongruously maintaining his boyish smile all the time, “one more smartass remark like that and your ‘Doctor Olympia’ doesn’t step foot in this hospital again. Now, it doesn’t say a goddamn thing in my presence except when I tell it to. And then it says yes, no, or provides data. Or I’ll take its wind-up key away. Clear?”

Thorny shot a look at Angel, but she maintained a poised, expressionless silence. She recognized a legitimate human order when she heard one.

“Very clear, Dr. Creighton,” Thorny answered, with just a hint of senior to junior condescension in his voice. Creighton caught that and a brief cloud passed over his face.

“We’ll start in ten minutes,” he humpfed. “If we have to, we’ll implant a temp and put her on the donor list. Agreed?”

“Agreed.”

“See you then, Benson. Piece of cake.” Creighton grinned and sauntered out of the room.

“Damned idiot jerk!” Thorny grumbled, too softly to be heard in the next room.

“Dr. Benson?” Sarah Miles entered through the main door. “I just finished my shift in the ER, and I came up to see if I could help out with our patient.” She winked at him. “Never heard you speak like that ’bout anyone!”

“Nurse Miles, Angel, when someone’s ego and stupidity puts others at risk, it’s worse not to say something. He’s a good surgeon, maybe a great one. But that kind of attitude about the kind of advance that Angel represents could keep people from getting the care they should get.”

“I’m a robot,” Angel said with a shrug of her shoulders, “so I shouldn’t care if he insults me. But I don’t like it if what he says about me keeps me from helping people. Not at all. So I do care.”

“Don’t let it worry you, Angel,” said Sarah Miles. “He’s got more nerve tissue in his fingertips than his skull. He talks about me like that when I’m not around. I’ve heard him on the intercom.”

“But he doesn’t to your face?” Angel inquired.

“If he tried that just once, I’d have the union burn his ass so bad he’d never sit down. Notice he didn’t say boo to me? Too bad they made you a doctor instead of a nurse. You’d get more respect.”

A smile flickered on Thorny’s face, despite his concern for Linda Coombs. “Perhaps they didn’t,” he said, with an arched eyebrow, “want to overreach themselves on the first demo.”

Nurse Miles grinned and Angel grinned too. Pattern recognition and response, Thorny thought.

“Appropriate?” Angel asked with a wink that said she knew she’d used just the right pattern.

“Very,” Thorny nodded.

“Uh,” Sarah Miles asked. “If I’m too nosy, jus’ say so. But do you have feelin’s like people?”

“No, you’re not too nosy. I’m supposed to be a demonstration so I’m designed to be very comfortable with that kind of question. I have a very human pattern of social behavior,” Angel shrugged her shoulders, “because it’s pretty much copied from what humans do.”

“I’m always evaluating a large number of randomly generated possible behaviors and assigning preference values, on the basis of my programmed priorities, to the futures those behaviors are likely to help create. By definition, the higher the preference value, the better I feel. I know that’s a mouthful, Sarah, but it means when something’s going my way, I say I feel good about it and show it the way people do. Expressions and inflections are part of your language. I know a lot of it and I’m learning more all the time.”

Angel beamed at the nurse, “And Sarah, when you ask questions about me, well, that’s going my way, and I feel good about that! So don’t be shy.”

Sarah laughed heartily and rolled her head from side to side. “Oh, you’re not the first lady who likes to talk about herself! Well, I’ve seen a lot of doctors in my day and you’re not the worst by a long shot. Now how ’bout helping me get our patient prepped? We’re kinda short on staff.”

Thorny pursed his lips. Would a nurse ask a doctor who wasn’t a robot to do that? But Angel was going to need every friend she could get. She looked at him, and he gave her a wink and a nod. So she turned and followed Sarah back to the operating room.

“Sarah,” Angel asked as they left, “do you knit?”

Thorny was tense in the OR. The “textbook” sternomoty technique had to be changed to take into account Linda’s fractured breastbone and ribs and was a severe test of Angel’s ability to adapt—to use the general information and images stored in her database and modify her approach to fit this specific situation. Angel didn’t move as quickly as she had in the ER, or when she did the C-section; she froze at times, then moved in spurts.

“Benson, where’s that key?” Creighton griped once when she was motionless for a particularly long time.

Thorny, worried himself, shot a cold look at the surgeon. The nonstandard chest opening was a good test, but he didn’t want to see Linda open like that any longer than absolutely necessary. But when the heart was finally exposed, he snuck a look at the time and relaxed a bit. Actually, they were right on schedule; it had only seemed longer because of the uneven pace.

“Well, let’s take a look here,” Creighton said. His gloved hands disappeared inside Linda’s chest. “It’s just as I thought. Everything else looks OK, but her left ventricle is shot. Well, we knew that. Looks like she’s going to need a new heart.” He glanced up at Thorny. “We’ll put her on full cardiopulmonary bypass, and then start.” Without a glance at Angel, he added, “Robot, cannulate the superior vena cava.”

Angel didn’t move.

“What’s the problem, Angel?” Thorny asked.

“I only see a small contusion involving the anterior wall. The rest of the left ventricle may just be stunned. If we can use an assist device, we might be able to tide her over until her heart recovers on its own. There have been several good review articles in the past year on the management of myocardial contusion in the Journal of the American College of Cardiology and—”

“Is,” Creighton hissed, “this machine questioning my judgment?”

“Angel,” Thorny said as smoothly as he could, “is providing data. She has up-to-the-minute access to the literature—”

“And so does a freshman medical student with a computer, but that doesn’t make him qualified to give an expert opinion on something like this.” Creighton’s pupils flared above his surgical mask. “I’ve never seen any patient like this survive without a transplant, and, Old Boy, no pseudo-gynecological toy is going to tell me otherwise. Now either program this thing to follow my instructions, or get it, and yourself, out of here and I’ll finish the operation!”

Angel turned to him, and reality set in. Thorny wasn’t an expert in this area. He couldn’t tell if a heart needed to be replaced by looking at it. Dr. Tunman, the cardiologist, was qualified to argue with Creighton—but they never had been able to reach him. And a decision had to be made now.

Linda Coombs was precious to him. He didn’t want her to become one of Creighton’s statistics if her heart wasn’t replaced. Still, he wondered whether they would really be doing her a favor by giving her a mechanical heart. That choice had the potential of saving her life, if a donor heart could be transplanted later. But in the meantime she would have to live with the constant threat of a crippling stroke from a blood clot, or dying suddenly—or worse, perhaps a lingering, painful death on life support—if the device malfunctioned.

He thought Angel might be right about the lack of serious damage, but there was no way for him to enforce that. If he told her not to do it, she wouldn’t—but Creighton would; and Angel would probably never get another chance. That wouldn’t help Linda at all. Damn!

“Angel, we’ll talk later. Right now, I think the best thing for Linda is for you to follow Dr. Creighton’s direction to the best of your ability.”

“I feel bad about this. Very well.”

Once decided, her fingers, and those of here teleoperated assistants moved quickly and surely. Linda Coombs’s heart was on a tray and the latest Rockwell in her chest in minutes. Thorny checked the telemetry to see that its glucose/hemoglobin fuel cells were up to full voltage, and nodded to the two surgeons. A charade for Creighton’s benefit; Angel, of course, already knew the device was ready.

The rest of the operation was anti-climactic. Angel disconnected the heart-lung bypass, and the new heart took over. Both she and Creighton seemed satisfied by the readings. A special-purpose telop, bristling with microwaldos, descended from the OR ceiling like a spider, and Angel used it to identify and ligate a few small bleeding vessels. Creighton seemed to lose interest about that time, mumbling something about the rest of the operation being routine and that he would check Linda again when she reached Recovery. Thorny, however, took a mild stimulant and stayed, fascinated with the repair work despite the hour.

Tireless Angel continued to work, closing Linda’s chest. She applied a coral-based cement to the sternum and rib fractures that set in minutes, and would be stronger than the adjoining bone until it was replaced by regeneration.

They finished at four A.M., and Angel bounced out to the Recovery Room as bright and cheery as always. Thorny followed her, considerably less energetically.

“Except for her heart, Linda will be just as good as new in a few weeks!”

“Except for her heart, her baby, and her husband.” Thorny reminded Angel. “And she doesn’t know she’s lost any of that yet, except maybe she got a look at her husband before she lost consciousness.”

“Post-trauma depression candidate, then?” Angel replied, her voice full of serious concern intonations.

“Angel, I’ve known Linda all her life. She’s sensitive, passionate, drives herself hard and takes things hard. I’m not sure how she’s going to take all this; everything she was living for is gone.”

“That could be serious.” Angel agreed. “The reason isn’t known, but depression has been associated with an increased risk of implant clotting. We could reduce that risk by 50 percent with a tetracyclic antidepressant. At least, that’s what Withers, Yung, and Zegrov reported in last month’s Archives of—”

Thorny held up a hand. “First, it’s too late for me to think like that. Let’s just get her to the ICU and keep her asleep for another twenty-four hours at least so we, I mean I, will be ready for her. Second, antidepressants can have some nasty side effects, like dropping her blood pressure. Her Rockwell won’t help very much with that.”

“You’re right. Why didn’t I think of that? The data’s there. I just don’t always create the right question.”

“You can’t anticipate everything, Angel. Look, Creighton’s right about some things. There’s a hell of a lot more to practicing medicine than just quoting articles. Every patient is unique. ‘Cookbook’ medicine works most of the time, but it takes judgment and experience to know when the usual rules don’t apply—and those are the kinds of things you can’t program. That’s why you’re doing this residency.” Thorny winced at what he had to say next, but he had to be fair. “And we can’t judge Creighton on his phony personality. Many people actually like that style, and he really is an outstanding surgeon.” He was trying to convince himself as much as Angel.

She nodded, seriously.

“I’m awfully tired.” Thorny sighed. “These are late hours for a sixty-seven-year-old. I’ll be back in the office about eleven, I suspect. I hope you don’t mind answering phones.”

“Not at all, Thorny.” This time he got a hug that was a little scary in its intensity. “I never forget a message. Good night.”

“Yeah. Night.”

He left the recovery room and called his car, which met him by the time he’d walked down the stairs and out of the lobby. The east was already gray. Talk about the lullaby of Broadway! Looked like another snowstorm on its way, too. Suited his mood.

Angel’s performance, he thought as he dozed off on the freeway, was the only saving grace in a very bad day, but it had only gotten her a fifty-fifty acceptance with the hospital staff, in his estimation. And that was equating Nurse Miles with the chief of surgery. And God help Linda Coombs when she finally woke up. And what would pathology say about her heart in the clear light of twenty-twenty hindsight?

The car woke him up in his driveway, and he staggered up the icy steps and into the house.

That morning he dreamed he was on Wheel of Fortune; never mind that the last show had been twenty years ago and Vanna White was now getting senior citizen discounts. Somehow he kept getting “bankrupt” and selecting letters anyway. Then he realized that it wasn’t Vanna turning the letters, it was Angel. And she wasn’t turning letters, she was turning over tombstones, all bright and smiley.

Late the next day, Thorny’s home cybersystem informed him that the pathology report on Linda Coombs’s heart was available, and he pulled it up on his wall screen.

Good news and bad news; good news that they hadn’t removed the patient’s heart without cause. Bad news in that, apparently, Angel had been wrong.

“Angel?” he called, not loudly because the cybersystem would contact her wherever she was.

“Yes, Thorny?” her voice came instantly.

“Are you busy?”

“I’m assisting Dr. Tunman and Nurse Miles with a coronary endoscopy and ultrasonic atherectomy. He told me he felt really bad he wasn’t available the other night—he knew Dr. Creighton was around, he was tied up with a very sick patient over in Coronary Care, and he just never noticed that his link wasn’t working. He felt sorry about that, so he volunteered to teach me the procedure.”

Thorny wondered if there was any correlation between the times Creighton was on call and the times other people’s personal data links stopped working, but put the uncharitable thought from his mind.

“We’re working on a seventy-two-year-old black male,” Angel continued, “mildly obese, apparently healthy until he started having severe chest pains with exertion about two weeks ago. He had a strongly positive stress test, and Dr. Tunman thinks he probably has three-vessel or left main coronary disease. The patient was really nervous about having the procedure, so we had to sedate him pretty heavily. So, yes, I’m busy, but I can talk to you, or as many as ten other people, in parallel, without affecting what I’m doing because I have to do things at about one-tenth the speed I could do them—so that I can be supervised. That leaves a lot of me available for side conversation. I like it when you ask questions about me.” Her voice smiled.

“Glad to hear it, Angel.” Thorny laughed: the comment was pure Angel as he’d come to know her. All he’d asked was if she’d been busy. Listening carefully, Thorny could hear the man snoring in a deep bass in the background.

“Thorny, I’ve got emergency in C-12.” Bruk Tunman said, his light Balkan accent somewhat more evident than usual. A prominent but ethnically mixed cardiologist before the troubles, he’d had to learn a new language and repeat much of his medical schooling at age fifty-three just to get licensed here. Little things didn’t bother Bruk, and, while he never said so in so many words, he had a way of shrugging off complaints with a look off into space that seemed to shout, loudly and clearly, “You think you have problems?”

“There is nothing more I have to teach Angel here. You can watch her this way, Thorny, yes?”

Thorny hesitated a moment. It was a stretch; if something went wrong with Angel and a doctor wasn’t physically present… But Bruk didn’t use the word emergency lightly. And Sarah Miles was there—someone who knew Angel and someone he could trust.

“Probably better than if I were there. I’ve got her, Bruk.”

“Thank you,” he said, and was gone.

“Well, Angel, how is it going?” Thorny asked.

“It’s fascinating; we’ll have those arteries good as new in less than an hour.”

“Good. Ah, Angel, have you checked the pathology report on Linda Coombs?”

“Yes. Looks like I was wrong. There was a lot more damage to her heart than I recognized. Thorny, I know what’s in the literature, but I’m afraid it’s biased toward the interesting, unusual, and successful. Dr. Tunman says he’s seen patients whose hearts were in that condition as well, and that none of those who didn’t get a mechanical heart or an immediate transplant survived. So I owe Dr. Creighton an apology—but he probably wouldn’t take one from a machine, would he?”

“No, Angel, he probably wouldn’t.”

“I think we might need his advice, though.”

“Huh?”

“I’m having a little trouble here. Just now. I don’t know why, but I can’t find the ostium of the left coronary artery. I didn’t have any difficulty with the other patients, and I don’t know what I’m doing wrong.”

“You can’t find the opening for the artery?” What kind of problem had Angel got into now? He couldn’t supervise her twenty-four hours a day, and she never slept, so it was inevitable that something would come up when someone else was “using” her.

As he thought about it a few seconds more, Thorny became even more worried. The procedure Angel was doing now was similar to what she’d done when she’d catheterized Linda’s femoral artery to connect her to the assist pump. Both involved puncturing the artery and threading a long, thin, plastic-coated tube up to the heart. The only difference was the kind of catheter she was using. This one had a fiber-optic network inside it, and a combined sensor-transducer at its tip. By threading it into a coronary artery, blockages limiting how much blood was getting through could be seen, and then broken up.

If Angel could do a procedure under emergency conditions, why couldn’t she do something like it again under less hectic conditions? Her programming was supposed to let her “learn by experience.”

Angel’s voice came back on line.

“No, I can’t find the artery. Here, I’ll send you a video.” Thorny’s wall screen flicked on to an endoscope-eye view of the inside of the patient’s aorta. There was no pathology Thorny could see.

But no sign of the tiny opening to the left coronary artery either.

“I’ve done everything just right,” Angel continued, “the endoscope control unit checks out fine and I can’t find anything wrong through the hospital computer either. My ultrasonic imaging tells me the catheter tip is within a few millimeters of the right place. Maybe Dr. Creighton could tell me what I’m doing wrong. Could you talk to him? He’s not likely to respond to me.”

“Right away, Angel,” Well, maybe Creighton would respond to the “humble seeker of wisdom at the feet of the master” approach. Maybe.

But not likely.

“Benson?” Creighton’s voice came on line, and his face smirked from Thorny’s screen. Of course, Angel had placed the call.

“I’m on, Creighton.” Thorny explained the problem.

“Your machine’s in over its head again. I’ve got video, and it’s obvious what the problem is. Ask if it did a high-res scan of the heart before it started. Or was this Nurse Miles’s project?”

Ask her yourself! Thorny started to say, but thought better of it. Diplomacy, diplomacy… “Dr. Tunman didn’t require it, Dr. Creighton, but it sounds like a good idea now—” to everyone but the taxpayers who were going to pay for it, he added silently. “Angel—”

“I can’t get enough resolution with my own sensors. The machine’s on its way.” Within minutes, the imaging table drove through the door and Nurse Miles and Angel had eased the three-hundred-pound patient from one table to another. Thorny had to smile; no two ordinary women could have done that without an orderly’s help. But Angel and Nurse Miles were, each in her own way, most un-ordinary.

“Well, those two are good for something, I see,” Creighton chuckled in what he must have thought was humor. Sarah Miles raised her head, jaw clenched—but she couldn’t stare at a disembodied voice. Thorny counted to ten. But soon, a tri-D view of the patient’s heart appeared on the screen.

“You see?” Creighton said triumphantly. “This patient only has a single large coronary artery, coming off the right aortic sinus. That’s why your machine couldn’t find the left coronary—there isn’t one! Any experienced cardiologist would have recognized what was going on and done a scan right away, without freezing up! It makes you wonder what else they left out of its programming.”

Angel’s voice returned. “I was focused on the procedure, and it didn’t occur to me that his heart might just be different. I won’t make that mistake again. But I do know about coronary anomalies. They occur in I percent of the population—”

“Benson—” Creighton started, ice in his voice.

“Angel, let’s try to get Dr. Tunman back on the line as soon as he’s free.” Thorny interrupted. This was turning into another confrontation, and not reinforcing Angel’s social matrix at all. “Until then, just do what Dr. Creighton says.” Silently, Angel completed the procedure flawlessly at Creighton’s direction, ignoring a sarcastic comment now and then with a robotic ease that Thorny envied.

“Benson,” Creighton drawled as Angel was removing the last catheter, “I hope you’re going to be honest to the hospital board about how dangerous a robot like that is.”

“Dangerous, Elvis?” Thorny used the younger man’s first name. He’d been in practice twenty years longer than Elvis Creighton, and in what most people now acknowledged to be a more demanding practice than any specialist’s. “Elvis, whatever mistakes Angel has made are minor compared to the mistakes any intern makes, and she learns from them. She never forgets. And she has skills neither you nor I can ever hope to duplicate.”

“Duplicate? Interesting choice of words, Benson. We can duplicate the skills without the bogus personality. This fraud of yours looks and acts too much like a person—so much so that someone can forget at times that it isn’t a person. It doesn’t have a person’s judgment; it freezes up and consults when a real doctor would make a decision. Instead of doing what you tell it, it argues with you! I’ll bet when Tunman finds out how your little wind-up toy endangered his patient, he’ll be so mad we’ll all learn some Croatian they don’t put in dictionaries!

“Benson, we can have the useful parts of her, of it, duplicated as we need them. We don’t have to anthropomorphize it, and shouldn’t.”

“But I think,” Thorny replied evenly, “that human simulation was the general idea. The AI Consortium hoped that packaging their technology as a compassionate young woman would lessen patient’s psychological fear of advanced medical technology—”

“Patients! What about the doctors that have to use it? That thing is high end technology; it doesn’t get used until the patients are unconscious or sedated! Has any patient even ‘met’ your machine yet? Have any of them known they were being worked on by some out-of-control robot?”

Thorny stared at him. The plan had been to get staff acceptance first, then start easing Angel into patient relations. But maybe that was all wrong.

“No, Angel hadn’t interacted with patients, not yet. The trial still has months to go.”

“Not if I have my way about it! Good day, Benson.” He faded from the screen.

“Angel?”

“I heard. Maybe I should try harder to be friends with Dr. Creighton. Could he use a stocking cap? I know you don’t think this is a good idea, but I’ve tried it twice, you and Sarah Miles, and it worked both times. No one else has wanted to be my friend.”

Thorny shook his head. “Now you’re questioning my judgment.”

“Angel,” Dr. Tunman’s voice finally came on line. Thorny wondered how long he’d been monitoring them. “I would be your friend as well. Elvis is correct that I am upset. He is not correct concerning the reason for my displeasure. Instead of trying to impress you about how much he knows and you don’t, he should be trying to help you learn. That is perhaps all I should say, other than I’m happy to work with you. I’m done here, not successfully I regret, but there is nothing more to do. We have another patient on the schedule in half an hour. I’ll meet you in the viewing room in about ten minutes and we go over the chart. This is OK?”

“Just fine, Dr. Tunman. I’m sorry. I’ll be there.”

The link counter indicated that Angel was the only one left on the line. Thorny shook his head, “Angel, your ‘I want to be your friend’ line is corny as hell. But maybe you’re right. I don’t see what harm it would do. You have my permission to try.”

“Should I get the reproductive education package installed first? He seems to be interested in that.”

Thorny opened his mouth, but words wouldn’t come. It would serve Creighton right, but the repercussions… Finally, he choked out: “No, Angel. Bad idea. Very bad idea.”

Two days later under a bright Sun in a crisp blue sky, the snow along the roads was dirty again and puddles were breaking out of their icy prisons. It was time, Thorny decided, influenced as much by the bright springy feeling of the day as much as anything else, for Linda Coombs to wake up. Creighton, busy, had given a perfunctory concurrence and excused himself, but with Angel and her instant knowledge, Thorny felt he could handle any technical questions. Those weren’t the ones that worried him.

Linda’s injuries were healing well and she had been weaned off all the external hardware except for a pair of IV’s, but she remained in a sedative-induced sleep. Now, all her body needed was some exercise. And a donor.

Angel turned off the IV line containing the sedative. The Rockwell heart responded to the change in chemical environment and increased its pumping rate. After a few minutes, Linda’s eyes opened.

“Dr. Benson?”

“Good afternoon, young lady. How are you feeling?”

She squirmed and smiled. “Comfy… fuzzy…” She yawned, then her eyes went wide. “Ouch… I’m sore all over. Where am I? Where’s Terry?”

“Linda, there was an accident. Do you remember?”

“Accident? I’m in a hospital!… What happened?… What day is it?”

A tone signaled that the Rockwell had reached its peak pumping rate, unable to keep up with the demands her system was trying to put on it.

“Please try to calm down,” Thorny told her. “I know this is a big shock, but it’s very, very, important that you try to remain calm and not work yourself up. You and Terry were on your way to his folks’ place and a drunk driver hit you. It happened very quickly and Terry didn’t suffer. I’m sorry.” Thorny couldn’t think of anything to say, so didn’t, as a chaos of expressions raced across Linda’s face. Finally it occurred to him to fill the void by simply answering her question.

“Today is Wednesday, the twenty-fifth, and we’re very happy you’re back with us.”

Suddenly Linda’s hands jerked up toward her nearly flat, empty belly.

“The baby—” It was partly a question, and partly a scream.

“I’m sorry.”

“Terry?…” Tears began to form on Linda’s face, and Thorny placed his hand on hers. Angel looked concerned, but, following Thomy’s instructions, didn’t try to say anything.

“We were going to… it’s all gone.” Sobbing, Linda shook her head. “Just like that, everything, all gone? This isn’t happening! Dr. Thorny, no! No!”

“Linda, Linda,” he shook his head. “It’s awful, I know. I was a basket case for a week when my wife died, and I still miss her. But there will be a lot of people to help you, and don’t worry about the time. You just take all you need. You’ll just have to go on, now, and concentrate on getting well. That’s what Terry would have wanted.”

She sobbed and nodded, uncertainly. He gave her hand a slight squeeze.

“There’s something more you have to know, then we’ll leave you alone if you want. Your heart was badly damaged in the accident. We had to give you an artificial heart.”

She looked at her chest, confused, then horrified. “I don’t feel different.”

“It’s a good one, but you’ll have to be careful with it. The first rule is to try not to let yourself get too emotional, or exercise too strenuously. It can follow you a little way, but not what you were used to. The second rule is that you’ll need to eat a fair amount of sugar. It isn’t like the old ones, with wires and batteries; it pretty much runs off the same fuel the rest of your body uses. But it’s not as efficient as a real one, so you’ll need to eat and drink more. Except for salt—that’s a no-no. The third rule is that you’ll have to be very careful about cuts and things. You’ll need to take a blood thinning medication as long as you have it, because clots tend to form and break off inside it, and they can block the flow of blood to your brain.

“But that’s the worst. Otherwise, you should be able to lead a fairly normal life until we find a donor. Then you’ll get a brand new heart that will work just as well as your old one.” He smiled reassuringly, but wondered how much of this was really getting through to her.

“After you get it, you’ll have to take medicine for the rest of your life, but there’s no reason you shouldn’t live as long as you would have if this hadn’t happened. Back in the Dark Ages, when I was a medical student, the only drugs they had to prevent the body from rejecting a new heart didn’t work all the time, and weakened a person’s resistance so much that a lot of them died from terrible infections even though the heart itself was still OK. The medicines we use now are ‘customized’ for each person’s new heart. They’re nearly perfect at fooling the body into thinking that you still have your original one, and they don’t have any of the bad side effects like infections that the old ones…” He trailed off. He was babbling like an old fool, he realized, and Linda’s mind was somewhere else.

Linda’s eyes suddenly got wider. “I remember it now. We were coming home from his parents’ place. Someone crossed over the median. I screamed, Terry hit the brakes, then we skidded and hit the rail and the airbags went off. We skidded around and around, it seemed like forever. Then the other car just slammed right into Terry’s door. I slammed into the door and bounced into the steering wheel. Terry’s head… I…” She was sobbing again. “It’s all over. Everything’s gone.”

Thorny put a hand on her shoulder, like he had when she was twelve and had to convince her that acne was not the end of her life, either. “Not for you, Linda. With luck, you’ll have a long full life ahead of you.”

“Life? It’s all gone.” Linda’s tear-streaked face hardened, and she took a breath and looked at her chest. “Doctor Thorny?”

“Yes?”

“Can you just turn it oil? Please?”

No! he thought, Linda, don’t do that to me.

“Please. I want to be with Terry and my baby. Not be some kind of ghoul or cyborg. I’m sorry to have been all this expense and trouble but I don’t want to live this way. I shouldn’t have survived. It’s not fair. I don’t want to have to deal with this. Please don’t do this to me, Dr. Thorny, just put me back to sleep, forever.” Linda shut her eyes, turned her head on the pillow, and sobbed.

“Linda… Linda, I can’t do that. You can go on. Everyone does, even though they feel like there’s no point. And then they find something else. You’ll do that. You have to.” He motioned to Angel, and she restarted the intravenous sedative at its lowest dose.

Linda shook her head and didn’t say anything. Thorny, you old idiot, he told himself, you’ve been down this road one way or another, often a dozen times a year, for forty years of practice. If you can’t make it better, at least stop screwing it up!

“Look, Linda, I need to talk to the nurses taking care of you. Could you put off any drastic decisions until I get back? Give old Dr. Thorny that much?”

Linda nodded her head on the pillow. He blinked and she looked like she was five, not twenty-five, when he’d helped her get through an earache and she’d told him he was called Thorny because he was always sticking people. He and Ellie had never had any children of their own; too poor, then too busy, then too old. But he’d had a thousand little girls and boys come through his offices. He patted her on the shoulder again, possibly as much for his own comfort as for hers.

“I’d like you to meet someone. This is Angel. She’s a doctor, and a robot. The first. I’m her teacher. She knows just about everything, and she’s been working with me. We were in the hospital when you came to the Emergency Room after the accident, and as part of her training she helped to treat you. I wish to God it hadn’t been you, but we can’t do anything about that now.”

Linda’s eyes opened and she turned to Angel as if looking at her for the first time.

“Hi.” Angel said.

“Hello.” Linda’s voice was lifeless, but her eyes held a spark of wonder. “You’re a robot?”

“Uh, huh. They finished me five weeks ago and I’ve—”

“Excuse me ladies,” Thorny interrupted. “I should be back in a little while.”

As he left the room, he heard Angel say; “I’d like to be your friend. Do you knit?”

He smiled. The folks at the consortium said they’d been going for independent judgment.

“Well, how are we this morning!” Dr. Creighton beamed at Linda, throwing his not inconsiderable charisma at Thomy’s patient, in for her bi-weekly. They stood amid the light wood of Dr. Creighton’s spacious ninth floor Danish Revival anteroom, looking out over the fresh and flowered spring green of the medical center’s spacious suburban grounds. Linda seemed to be reasonably cheerful for an outpatient waiting on a heart transplant, but Thorny felt rumpled, out of place, and out of sorts. He had asked Creighton if Angel could be present, but after the third sarcastically condescending demurral couched in elegantly gross innuendo concerning his relationship with Angel, Thorny got the point. Further argument would have only upset Linda.

“Oh, hmmm. That looks good!” Dr. Creighton continued, grinning at Linda.

“What looks good?” She asked, smiling back.

“I see you’ve been sticking to that high energy diet, maybe even a little too well? Heh, heh.”

Linda blushed. She had, Thorny realized, put on a few pounds.

“Feeling good?”

Linda nodded, then hesitated. “I’ve been getting a little stomach ache every now and then. And I’m a little out of shape—.”

“Oh? Probably too much rich food. And according to the tests we did just before you left the hospital, your circulation’s fine. Rockwell’s making a good product these days, not to worry. But we can’t keep it forever, can we? Well, no rush. You’re moving up the donor list; I’d say in a month.”

“If this heart’s doing so well, why can’t I keep it?”

“Oh, everything wears out eventually. We’ll see you in another week. See that she gets some exercise, Thorny. I want her fit for the transplant. Speaking of exercise, I’m due for some of my own; a quick nine at Bellewood. Make yourselves at home!” With that, Creighton breezed out.

Thorny had to deliberately unclench his teeth before he could talk.

“Where’s Angel?” Linda asked.

“Children’s wing, probably,” he replied. “They aren’t as prejudiced—a robot doctor doesn’t bother them at all.”

A cloud passed over Linda’s face at the mention of children. She hadn’t been able to keep up with her old job at the newspaper, but Thorny had been able to find a lot of free-lancing editing work at the hospital and word of mouth had gotten her even more business. She could do that at home; that and the insurance settlement had given her an adequate, though not generous, income. But it seemed to him that she’d been a little morose and out of sorts lately. Maybe she could use a challenge.

“Linda, would you mind putting up with another little experiment?”

She sighed. “What now, Dr. Thorny?” Then she brightened. “Maybe you have an artificial ear for me that works off a remote control so I can turn off my hearing when certain people are talking at me!”

“Ha. I won’t mention any names,” he chuckled a bit, then sprung his idea. “Linda, what I’d like to try is to have Angel talk with you, as if she were going to do the surgery instead of Dr. Creighton. I’ll just sit in a corner and watch. You don’t mind me letting her practice on you, do you?”

“No. Angel and I are good friends. She’s teaching me how to knit; I’m up to moss stitch now. I tell everyone she’s the robot that cut my heart out, and they get this awful look on their faces, and we laugh and laugh. Yesterday, I asked how they made her look and act so human and she almost took herself apart in front of me. Said it was only fair since she’d seen most of my innards.”

Thorny laughed. “I guess that’s fair. Now, I’ve been too polite to ask that kind of question.”

“She doesn’t mind at all. She likes to show you everything. Her skin is thick and flexible, like ours. Her skeleton is just like yours or mine everywhere that counts for surface appearance, except it’s plastic. Everything underneath is in some kind of padded composite. She has muscles that swell and contract just like ours when they get electricity, but they can do it a lot faster. She’s got silicone implants for breasts—she says they’re the same kind they used to use in flesh-and-blood women before fat cultures. But they didn’t give her any nipples.”

Thorny wondered how difficult it would be to have the programmers tone down Angel’s cheerful exhibitionism; it wasn’t always appropriate. But how small a cage does one make for a butterfly?

“Well, she’s not likely to use them, is she now?” he said.

“Why not? She’d make a great nanny. I bet someone clever could figure out the plumbing. Then she’d look right in a T-shirt. And it would make her happier because she’d be able to make more people happy.”

“Linda, she was designed to be that way, it’s not like she was a human being—”

“Hey, Dr. Thorny, she is what she is. Who cares how she got to be that way? And I can think of at least one person who could learn a lot about being a real human being from her: your great Dr. Creighton. That pompous, lecherous phony can go take a flying you-know-what.”

“Hey, yourself,” Thorny chuckled—but it really wasn’t funny. So Creighton had been up to his old tricks with Linda, just this side of doing anything that would generate a formal complaint. One couldn’t really blame him; so many female patients went gaga over his looks and his natural charisma, the poor man probably thought that making a pass was a failsafe way to cheer someone up.

“Linda, just because somebody has an ‘M.D.’ behind their name, doesn’t mean they automatically qualify for a ‘Saint’ too. I’ll grant his bedside manner stinks, but he’s an outstanding surgeon, and by his own lights, a good person.” Aren’t we all? Thorny wondered. “He’s still responsible for you, and when the time comes he’s the one who’s going to give you your new heart.”

“I’m not going to let him cut me again. Or let him see me naked again.”

“Linda, you have to have the transplant.”

“Angel can do it.”

“Maybe she will. But it has to be under a specialist’s direction. As human as she seems, she’s legally just a tool. Like a scalpel, or a stethoscope. She doesn’t have her own malpractice insurance.” Or her own anything. She wasn’t a legal person, Thorny thought. Angel was a slave; property pure and simple. Maybe that had something to do with how protective Sarah Miles had been with her.

“Nuts. I want her to do it all alone.”

“Linda, that’s not possible.”

Linda shrugged and looked him in the eye. “Then no operation and I die. I’m ready. Doesn’t bother me at all. I shouldn’t have survived in the first place. Just turn me off and save the trouble.”

Thorny shook his head and tried to smile. “Please don’t talk like that. I’ve got too much work invested in you. What if we talk to one of the other surgeons?”

“That’s better, but not what I want. I want people to treat Angel like a real doctor. I’ve been trying to figure out why I didn’t die with Terry and my baby, and maybe this is it. So I can help her. You keep saying you want me to live, Dr. Thorny. Give me something to live for. Make them let Angel do my transplant.”

“Linda…” Thorny threw up his hands, then he thought of a way that she might accept. “I’ll work on it. But I want something from you, too.”

“Anything, Dr. Thorny, as long as Angel does the operation.”

“Leave yourself a little room for compromise, OK? Even if Angel were a human doctor, she wouldn’t be doing this alone.”

“OK I understand there have to be others around. But I want Angel giving the orders, I want her cutting me, and I don’t want Dr. Creighton anywhere near that operating room!”

“I’ll do what I can,” Thorny temporized.

“Please. My life depends on it.”

Thorny shook his head. “Well, then, I guess you should talk to your other doctor too. Let’s go find her.” They left the opulence of Dr. Creighton’s office for the elevator to the basement, the bustling lower floor corridors, and the children’s ward with its bright painted anthropoid ducks and chickens shedding feathery chips of paint here and there. They found Angel helping a hairless young girl in a red stocking cap build a castle from red foam blocks.

“Hi, Linda.” Angel beamed at them. “How are you doing today?” One wall of the castle started to collapse. Still smiling, Angel’s hands moved in a blur, catching the foam blocks in midair and setting them back in place. The girl giggled.

“Oh, OK Dr. Thorny thought I should talk to you.”

“I’d really be happy to talk to you.” Angel turned to the little girl. “Tippy, I have to go now.”

The girl’s forehead wrinkled. “Will you come back and play with me?”

“Sure. We’re friends, aren’t we?”

The girl giggled and turned to Thorny. “She can take her whole arm off!”

“Angel…” Thorny groaned.

Angel smiled and shrugged. “Bye, bye.”

“Bye,” Tippy said.

A few minutes later, they were in the cramped examining room of Thorny’s office. Its narrow crack of a window looked out over a shaded parking lot filled with dirty snow left over from winter. True to his word, Thorny positioned himself in a corner and tried to make himself invisible, almost knocking his ancient analog scale over in the process.

“Are you comfortable?” Angel asked her patient, after she and Linda had sat down.

“Yes.”

“How have you been feeling?”

“Oh, OK. Well, like I told Dr. Creighton, I’ve been getting a little stomach ache every now and then. And I’m a little out of shape. Terry’s gone, but still—”

“You’d like to feel good about yourself, I understand. Why do you think you’re out of shape?”

Linda shrugged, “I’ve put on some weight, so I guess that’s why I get tired going up stairs. And if I try to do any work around the house, I have to stop and rest after a few minutes. I can’t seem to swim full out for more than a couple of laps. Sometimes I wake up short of breath, like I had a bad dream or something. Maybe about the accident. But I’ll sit up and read for a half hour or so, then get tired again and go back to sleep. Do you sleep?”

“Sometimes I shut down for a few milliseconds and reorganize my files. That’s kind of what people do when they sleep, but I do it a lot faster. Hmm, Linda, have you had any swelling in your feet or ankles?”

“Sure, after I’ve been sitting in a chair or standing for a while. Isn’t that normal? Maybe my body still thinks I’m pregnant?” There was more than a note of sadness in her voice, Thorny thought.

“Hmm, I wouldn’t think so, those hormones should be out of your system by now. You said something about a stomach ache?”

“Yes, sometimes after I eat.”

“Oh. Thank goodness I don’t have to eat the food here!” Angel joked and they all laughed.

“Can you show me where it hurts?” Angel continued to ask questions for the next five minutes. Finally, she finished with “Any other problems, anything else you want to tell me?”

Linda squinted for a second. “Nothing that I can think of.”

“If you do think of anything else, let me know. Right now, I’d like to do a physical examination. Is that OK?”

“Sure.”

Thorny rose out of his chair. “Let me step out so you can put on a gown—”

Linda laughed. “That’s OK Dr. Thorny, you’ve seen everything before anyway.”

Thorny watched Angel do a brief but thorough examination—one that was far more thorough, he reflected, with her built-in sensors than he could have done with only a stethoscope and the few basic instruments in the room. They fed a blood sample into the office wall terminal, ran a saliva slide under its microscope, and had Linda step up and down Thorny’s battered old kiddie steps wearing a cellular cuff.

After Angel finished, she spoke to Linda.

“Linda, do you mind if we have you sit outside in the waiting area for a few minutes? I need to talk to Dr. Benson while we wait for the lab results.”

For a second Thorny was afraid Linda was going to ask, “Why? What did you find wrong?” But instead she smiled back and said, “Sure.” He walked her out and she settled down with a smile to a coverless magazine that looked like a relic from the twentieth century, and probably was.

Back in the examining room, Thorny asked. “What do you think?”

“I’m worried. Her symptoms suggested at least mild congestive heart failure, and my examination confirmed it. She’s definitely retaining too much fluid—in her lungs, liver—everywhere. So I did a complete diagnostic check on her implant.

“Fortunately, there were no large blood clots inside the chambers, or on its valves. But it’s still not working as well as it should. The Model 4 Rockwell is rated for a peak cardiac output of 4.9 liters per minute, but hers is down to 2.8. There have been some reports in the past few months that smaller units like the Models 4 and 5 may lose efficiency much sooner than they’re supposed to owing to problems in the semipermeable membranes used for oxygen transfer. The recent article in—”

“I’ll take your word for it, Angel.”

They sat silently for a few minutes. Angel’s programmed knowledge of the pathophysiology of congestive heart failure, Thorny knew, was more exhaustive than his—but the basic points were simple. When a human heart began to fail, the body retained water. With a little extra fluid, the heart’s reflexes made it beat more forcefully, and for a while the person did better.

But if the body kept too much of it, the excess fluid actually made the heart work less efficiently. Then fluid leaked out into the lungs, replacing the air that was supposed to be there—and the person very gradually began to drown. When not enough blood and oxygen got to the rest of the body, the kidneys and other organs eventually failed too.

Linda’s mechanical heart had none of a human one’s reflexes. In her any extra fluid was “too much”—and, if it got worse, could kill her.

Angel’s face became very serious and professional. “What did Dr. Creighton think?”

Thorny grunted. “Dr. Creighton thought everything was ‘fine.’ ”

Angel looked puzzled. “But what about her symptoms and—”

“Angel,” Thorny snorted, “Dr. Creighton doesn’t even know that there are any symptoms because he didn’t listen to Linda. So he didn’t bother to examine her, didn’t check her unit, or even order blood tests. Why go to all that expense if everything’s fine?

“I don’t understand. Why didn’t Dr. Creighton listen? Why didn’t he want me to see her?”

Thorny sighed. “I don’t know, Angel. For the first, you have to have a lot of self-confidence to do what Elvis does; it’s hard to absorb contrary data if you think you already know everything. Nor does it help to need to impress people so much that you can’t admit you need any other input. For the second,” Thorny shrugged, “maybe he sees himself as John Henry racing the steam hammer.

“Hell, I’m the one who should feel threatened. You’d make a great G.P., Angel. I may call myself a G.P., but really there’s been no such thing as a general practitioner for almost two centuries.” Actually, to be technical about it, he really hadn’t been a “G.P.” for a long time himself; he’d gone back and completed a family practice residency five years after he’d finished his internship, even done an extra two years of obstetrics—and a year with the army in Zaire back in oh seven had left him with a lot of surgical experience he’d rather not have had. But, as a slightly pugnacious “badge of honor”—especially around some of his more snobbish colleagues—Thorny still liked to call himself a “G.P.”

“Back then, if a physician knew how to saw off a limb and deliver a baby—if they had a supply of morphine, calomel, foxglove, and maybe a few anemic leeches—they could do just about everything that could be done for patients. But as the ‘science’ part of medicine grew, no one doctor could know or do everything anymore—so some, and nowadays most, became ‘specialists.’ ”

Thorny exhaled deeply. “And now we’ve come full circle. With your programming, and a little more experience, you can be a ‘general practitioner,’ in the literal sense. Potentially, not only will you be able to do everything I can, or Creighton can, or any other specialist can—but you’ll be able to do it better. Someday, instead of you being my assistant, we poor human doctors will be assisting you!”

Angel looked concerned. “I don’t want to threaten anyone. I just want to be their friend.”

“Progress, Angel. As long as I’ve been around, there’s been a kind of de facto hierarchy among doctors, with ‘specialists’ like Creighton at the top of the pyramid, and ‘generalists’ like me a lot closer to the base. I think Creighton knows that if you succeed, his prestige is going to suffer. The bottom line, though, is that the kind of advance you represent is going to help patients—and that’s a lot more important than bruised egos.”

“Don’t worry, Dr. Benson. As long as I’m around, you’ll always have a job with me.”

“That,” he laughed, “makes me feel so much better.”

Angel started to laugh too, then froze for a second. “Linda’s test results are in the hospital computer.” She recited a long list of lab values.

“Well?” Thorny knew all too well what they meant, and it wasn’t good. But he wanted to hear Angel’s interpretation; diagnostics were one of the first and most successful uses of cybernetics in medicine, providing everything was in the database.

“The low serum sodium and elevated liver enzymes are worrisome, but her BUN of 83 and her creatinine of 4.1 are very alarming. They were only 20 and 1.2 when she was discharged from the hospital.” Angel paused. “If this goes on, she’s going to lose her kidneys—and that won’t help her implant either. I think she’s going to need a real heart much sooner than we expected.”

Thorny thought it through. As long as Linda’s kidneys worked reasonably well, they could use medications to stimulate them and get rid of some of the excess fluid. But if her kidney function got too bad, her body would retain fluid even faster. Before too long the artificial heart itself would get starved for fuel and oxygen, and work even less efficiently. Then the kidneys and lungs would get worse, which would make the implant’s function deteriorate more—and the whole vicious cycle would keep on repeating itself, until her lungs filled up, or a blood clot from her failing heart caused a stroke. He remembered what he had thought when they implanted the heart—about a lingering death.

Thorny imagined Linda lying bloated, in a constantly dirty bed, connected to a ventilator, and surrounded by a metallic forest of IV poles. He had seen her in similar surroundings once—and he didn’t want to see her end that way. For the first time he thought seriously about her request to turn the Rockwell off. And what they might to do him if he did. Hell of a consideration, that.

“Angel, we’d better tell Linda. And then we’re going to have to talk to Dr. Creighton.”

Things went even worse than he’d expected. Linda’s response had been bad: “…Thanks for the extra months, but I guess I’m really not supposed to be here. You can turn me off any time. Thanks anyway, Angel.” Angel and Thorny had to convince her all over again that her life had a purpose.

But Creighton’s reaction was even worse.

When he found out that Thorny had ordered the tests Angel wanted and that she had made the diagnosis, he turned so red that Thorny thought Creighton would either have a heart attack himself, or resort to physical violence. Actually, either event would have simplified things—Elvis in Intensive Care, or in jail, would be Elvis out of the loop, unable to screw things up with Linda. And Thorny derived a little guilty pleasure from imagining what the AI Consortium’s lawyers would do to the wealthy Dr. Creighton if he damaged Angel.

It soon became apparent that they had reached an impasse with Creighton, so with the freedom of someone long retired from trying to climb greasy poles, Thorny went over Creighton’s head.

Not unexpectedly, Creighton did not like the idea—but he really didn’t have any choice in the matter and whatever revenge he might arrange would have to be delayed, and very circumspect.

It was the next day when they all sat in the office of the Director of the medical center. Dr. Tunman and several other physicians involved in the transplant program had also been asked to attend. So far, Tunman and the others had said relatively little—apparently trying to stay out of the line of lire of all the verbal bullets that were flying around them.

The Director, a tall, serious obstetrician of such poise and patrician bearing that she could usually silence an interloper by raising an eyebrow, frowned severely at Dr. Elvis Creighton. The surgeon had been in fine form—earnest, sincere, at ease, never stumbling or hesitating. But the facts were a little too much, and if the Director was frowning, Thorny and some of the others were doing a slow burn.

“No one’s disputing that the patient has a problem,” Creighton concluded, flashing his disarming grin. “I just don’t think we should exaggerate it. There are desperate patients ahead of her, and while I agree that her Rockwell’s function might deteriorate further, there’s also a reasonably good chance it won’t. Besides, we all know any nephrologist would tell us that a moderate amount of renal failure might help for a while; it could actually reduce the risk of blood clots and—”

Thorny interrupted. “Elvis, whether you think so or not, the next thing in line is a stroke—and we don’t have a brain machine.” Or you’d be the first on that list, he added silently.

Creighton shrugged. “We all know the risks. She could go on a kidney machine.”

“Ma’am,” Thorny bristled, “for reasons which some of us find obvious, Linda wants Dr. Creighton off her case and out of the loop.” Thorny took a breath, the next wasn’t going to help, but he had to be truthful. “She’s not going to tolerate being rooted to tubes the rest of her life; if you ask her now she’d say she’d rather be dead. She’s already asked us to turn the Rockwell off rather than face some of what she has to endure.” No point in trying to hide that, it was on the record. “And, frankly, I’m not into raising human vegetables no matter how profitable they might be.”

The Director raised the other eyebrow at Thorny. “That makes me wonder how good a candidate she really is for a transplant. Patient will-to-live and compliance is very important. What if she decides after she gets her transplant that she’s also not going to take her antirejection medications? We can’t ‘waste’ a heart on someone who’s not going to take her doctor’s advice and die anyway.”

“Exactly!” Creighton interjected, waving a hand dramatically. “And these calls should be made by experienced specialists.” He glared at Thorny. “Not by a generalist who sees these kinds of things once in a blue moon, however well-meaning he may be.” His eyes barely moved toward Angel. “And certainly not by an experimental robot, no matter how superficially sophisticated it may seem.”

Angel gave Creighton as cold a look as Thorny had ever seen from her. “Ma’am, may I defend myself?” she asked.

“That does it,” Creighton hissed. “Benson, get that, that thing out of here!”

“Dr. Creighton,” the Director murmured, followed by an embarrassed silence; Elvis didn’t run this meeting.

He appeared to calm down instantly, and flashed his boyish, charismatic smile in her direction. “Pardon me, ma’am.”

“No.” The smile disappeared from Creighton’s face.

“Angel,” the Director continued, “Thorny tells me you’ve followed the patient since her accident, and I’m very interested in what you have to say about all this.”

“Thank you.” Angel stood up so she could be seen by everyone. “Although Linda Coombs is ‘competent’ in the medical sense of the word, she’s depressed. You all know the ‘facts’ about her—how she lost everything she was living for. Is it any wonder that she might speak impulsively and say things that might seem non-compliant—things that a critical person might use to make her look like a bad risk?

“I know what the ‘rules’ say to do in this kind of situation. I literally can’t forget them. But we have to think about how to apply them, and do what’s best for the particular person we’re caring for. Linda is not non-compliant in general. She’s followed Dr. Benson’s instructions exactly, even though she knew it would compromise her figure, which had always been important to her. Linda doesn’t want to die, but her life has to have more of a purpose than just existing and she does have a reason to live which has become very important to her. That reason happens to be me, and what I and others like me can do to help people—”

“This self-serving egotism is hardly an objective analysis,” Creighton sneered.

“Dr. Creighton, are you suggesting our robot is not being objective?” the Director inquired mildly. “How very interesting. Do continue, Angel.”

Angel’s face was most hard set and un-Angelic. Where, Thorny wondered, had she got that?

“I have to make a point. I, and future robots like me, can help many people—if we are allowed to do it. I’m an artificial intelligence, yes. But I have likes, dislikes, and a full range of human emotional expression. I don’t want to hurt anyone, but when someone’s insecurity and stupidity—”

“Damn it!” Creighton growled. “Put a lid on that machine, Benson! Or I—”

“Stuff it, Creighton!” Angel snapped back in a voice that dripped with authority, at a volume that surprised the hell out of Thorny.

A shocked silence gripped the room. Creighton appealed to the Director with a look of gaping-mouthed outrage, and got a stony stare in response.

“When,” Angel continued sharply, “someone’s insecurity and stupidity puts other people at risk, I think it’s better to say the situation and the idiot responsible stink to high hell than not. I won’t risk peoples lives just to be nice!”

The Director gave her a ghost of a tight-lipped smile. “We do have to keep priorities clear. But, Angel, the language of a crusty old family practitioner doesn’t quite fit you.” She looked at Thorny, who coughed in embarrassment. There was a scattering of soft laughter around the room as other people realized just whose language had inspired Angel.

“Ma’am, the words fit. Not only has Dr. Creighton’s behavior threatened to deny Linda Coombs and others the benefit of the speed and accuracy with which I can perform surgery, but the patient has asked that I, specifically, perform the surgery. I regret hurting Dr. Creighton’s feelings but those must be secondary considerations…”

There was more laughter, including from Angel. Thorny realized that one way of interpreting the laughter around the room was that the other doctors had reached a conclusion similar to Angel’s. Creighton, for once, sat in shocked silence.

“Ma’am,” Angel added, “Linda happened to latch on to me, but someday she’ll latch on to other things, and other people. Another husband, a child. She’s young, she’s a fighter and a very determined person. She’s not going to forget her medicine, sit around, mope, give up and die if we let her have a reason to live. And with respect to objectivity, one has to ask how much Dr. Creighton’s dislike of what I represent has affected his treatment of Linda.”

“I only suggest,” Creighton huffed, “that putting one willful, non-compliant patient ahead of others on the priority list not be dictated by the advertising needs, if you can call them that, of a robot.”

“My patient, Dr. Creighton,” Thorny interjected, “has not been non-compliant. And I don’t make any claims to objective detachment here, I’m too old for that charade. I brought Linda into this world. I don’t want her to rot waiting for a heart just because you don’t put her into the right category’ for reasons that I don’t think have a gnat’s ass to do with her suitability!”

“Doctors.” the Director interjected, at a volume and with an inflection that brought instant silence. “We were listening to Angel.”

“Thank you, Ma’am. Physically, Linda’s a good candidate for a transplant, and if I do it, she’ll be an excellent candidate psychologically. And I can help those unnamed other patients if I can help Linda. She’s a real person, who needs help. Please let me help her.”

A deep hush filled the office. Corny, but effective. Thorny reflected. On second thought, maybe it wasn’t so corny.

The Director leaned back and laced her fingers together. “I’ll have Dr. Tunman do a thorough review of the case and discuss it with all of you”—she nodded to the other transplant people, pointedly ignoring the fuming Creighton, “and we’ll follow your recommendations.”

She paused. “Angel, Nurse Miles told me about Linda’s feelings, and that she would be comfortable with you as lead surgeon on the transplant. From what I’ve seen today, you are a responsible, independently-thinking being, and highly motivated to help your patient—whether by feelings or programming doesn’t seem to matter. But… you aren’t a doctor and you aren’t even a legally responsible person.”

“I know, Ma’am. Dr. Benson could still supervise me, and a surgeon would have to be technically in charge of the operation. Whatever I may think about him as a person, I don’t want to deprive Linda of Dr. Creighton’s experience. Dr. Tunman has already agreed to help us from the cardiology side when the new heart is in, and I know I can do a very good job with the surgery itself. If Nurse Miles will take charge of support, I think that would make a very good team.”

Creighton’s face was now a stoic stone mask “I have no current objection to, uh, her performing the surgery with whatever assistance is suitable. A heart transplant is, after all, fairly straightforward from a technical standpoint. I can concentrate on donor selection and postoperative care, and monitor the operation itself from my office. But since I will be legally responsible for the patient, I reserve the right to have the final say as to how the operation is done. I assure all of you that I am as committed to this patient’s survival as anyone. And, well, I’ll try to be a good sport about it.” He gave Thorny a wintry grin. “Then have your dance, Thorny.”

But he’ll call the tune, Thorny finished the line silently. Creighton saw himself as Figaro? Despite himself, he felt some sympathy for the humiliated man. Modified sympathy. Angel looked concerned as well. Perhaps, he thought, there was a greater distinction to be made between biological emotion and her emulated anger than her other emotions; it was more copied, more phony.

The Director looked around the room for any other comments, but there weren’t any. “Very well. It’s a risk, but clearly one the patient wants to take, and arguably one that will help her morale and increase her chance of survival. Dr. Benson, Angel is your project and… Linda is your patient. I’ll look to you to organize everything. See me if you have problems; a lot is riding on this.”

“That’s fine with me, ma’am,” Thorny declared, forcibly putting aside any second thoughts.

“And with me.” Angel added.

The Director nodded curtly, and the meeting was over.

At his home office the next evening, Thorny watched Angel handle one of his young football patients with a badly dislocated thumb. She had his forearm and hand strapped to a conformal imaging plate, so he could watch what was happening as she maneuvered the joint back into place.

Thorny’s mind wandered to the advances he’d seen in four decades of practice. He remembered having to send patients to a hospital for a long wait to get a two-dimensional still photograph taken with radiation so hard it might cause cancer in its own right. And then waiting more hours, or sometimes a day or more for an “official” interpretation by an underworked, overpaid, “no weekends, 8-to-4 and off to the golf course” radiologist.

Nowadays, a three-hundred-dollar flat plate array of nanosensors could use the few photons of monochromatic light that made it through soft tissue to reconstruct a realtime three dimensional image of anything thinner than a man’s arm. Anyone who’d covered a bright flashlight with their hand could see that something like that was possible, and, about a decade ago someone had finally done it. In five years the price had dropped to the point where Thorny could afford one. Best of all, he didn’t need an “expert” anymore—his eye and the computer’s interpretation were just as good, if not better.

The young man, however, seemed to take it all for granted. He was clearly more interested in Angel’s sculpted anatomy than his own—something which pleased Angel no end but, he worried, might be sending the wrong message to her patient. Young men these days, he thought testily, had to learn to suppress any outward evidence of such natural interests to protect themselves from harassment charges, so Angel wasn’t doing the boy any long-term favor. Another thing to mention to her.

“I can’t believe, uh, you’re a robot,” the boy said, manfully ignoring what must have been a fairly painful twist and pull from Angel. “You’re so pretty. And you act so, so natural like.”

“The people who made me had a lot of fun doing that, and I’m really happy that I please people. But most of that is just following examples. The hard part was my imaging processor and my future-modeling functions. The stuff that lets me predict what will happen when I do something like this.”

“Ouch! Oh, that feels better now.”

“It’s back in place, so it should,” Angel declared with what seemed motherly authority.

“See how the proximal phalanx—that’s the short bone—fits on the metacarpal bone—that’s the longer one—there now? That’s how it’s supposed to be. Your tendons—these ropy things here, and here—are going to be sore for a while and you might experience a little tenderness in the joint here, off and on for a few weeks. Don’t worry about it—just take it as a warning to take it easy in that area. Keep wearing this brace until the pain and swelling are pretty much gone. Call me in a couple of days, and let me look at it over the phone. Remember, the longer you can keep from reinjuring it the better. I’ll give you some exercises to do, too.”

“For my fingers?”

Angel laughed. “Just like any other part of you that plays football. The stronger and bigger your finger muscles are, the less likely that something like this will happen again.”

“You don’t have to exercise, do you?”

“Actually, I do. I have to move to pump lubricant to my joints; otherwise they’ll dry out and get hard to move. So I knit for my finger joints and have some other exercises that make sure I move everything. I’m programmed to feel good when I do it, so I do it whenever I don’t have anything better to do with my body and isn’t likely to bother anyone. My joints are really sophisticated; they can move in ways that yours can’t so that all my fingers are opposable. I can take my skin off and show you what it looks like inside. Want to see?”

The boy shook his head, embarrassed, “Uh, no, that’s OK.”

“Angel,” Thorny interrupted, “Our patient’s mother is probably holding dinner for him.”

“Oh, yeah.” The boy said. “I’d better get going.” He gathered up his things clumsily, with the thumb in its brace. Angel helped him. “See you, Doc, Angel.”

The boy was out the door, and Angel turned to him, displaying joy at what must have been near the top of her scale. Not quite appropriate for her last patient, Thorny thought, so something else must be going on. “Well?” he asked.

“We did it!” Angel gushed. “They decided to move Linda up on the waiting list, and she could get a new heart as soon as they find a match! The hospital cybersystem just got the decision, and now it’s going out on the national transplant network.”

Thorny smiled. Angel’s learned repertory of emotional display had grown over the last month to the point of near histrionics, and he’d had to caution her to tone it down a bit for some audiences because some people would react against that style of communication. But at home, she could let herself go. One of her programmed purposes in life was to display her abilities, and she got internal rewards for doing so. Was this, Thorny wondered, so very different from what went on inside his own biochemical machine?

“May I tell Linda?” Angel asked, with standard hopeful intonations.

“Sure,” Thorny agreed.

The operation started out uneventfully. Everything went by the book: quickly, smoothly, efficiently. Thorny glanced at Tunman, who stood silently in a corner of the operating suite, poised to take over when the new heart was in. Until the operation was completed, Creighton was officially in charge, and Tunman’s authority was as limited as Thomy’s. They all knew Elvis was on the line, monitoring everything from his office. But he said nothing.

Angel moved smoothly, accurately, tirelessly. She never paused, except to wait for one of her human assistants. They were ready for the donor heart in half the usual time.

The Rockwell unit came out and the connecting large blood vessels were trimmed carefully—too much and they would be stretched to reach the new heart, requiring a graft; not enough, and there would be tissue weakened by its prolonged contact with the prosthetic.

The new heart was that of a thirty-year-old woman from Alabama, brain-dead of a gunshot wound inflicted by a husband who’d complained of her laziness. It was the twenty-first century, thought Thorny, but some things never change. The one saving grace was that the murderer would probably also wind up on the donor list—as soon as his appeals ran out. Dr. Creighton, in a rare display of personal concern, had personally flown to Montgomery to examine the potential donor, and brought the organ back in his own private jet. Perhaps, Thorny thought, the man had learned a lesson.

An overhead waldo descended to the carrier, cradled the new heart out in a basket of arms, and set it in place as Angel held the chest cavity open. The microwalds began connecting blood vessels immediately, gluing the small ones, adding a few stitches for the main arteries.

“Any problems?” Angel asked. Everyone said no, so she started the heart, sending a slight current through one of the waldos. The heart began beating, and Thorny sighed with relief. Angel touched it gently, almost lovingly, and then let it take over fully from the heart-lung bypass. Nurse Miles shot a look at him.

“She can hear through her fingers. She’s listening.”

Angel froze. “Thorny, the heart’s defective. Listen, I’ll send it through the cybersystem.”

Thorny heard the rhythmic swish of blood coursing through the heart from a nearby speaker. A few seconds later a tri-D view of the heart with animated false-color blood flow appeared on a monitor.

“Damn,” he said. He wasn’t entirely sure what he was seeing, but he knew it wasn’t good.

Angel spoke, “This heart has a flail anterior leaflet and wide-open mitral regurgitation.”

Tunman nodded in agreement, but Thorny didn’t see him. Even a nonspecialist like himself knew what “wide-open mitral regurgitation” meant—with every heart beat, much of her blood spurted back through the leaking mitral valve into her left atrium and lungs, and not enough went to the rest of her body. How could that happen? Every donor heart was supposed to be thoroughly checked before it was harvested!

Linda was as good as dead. She was weak already, and this heart would never sustain her. It wasn’t Angel’s fault, nor his, but there was no question in his mind where the blame would fall.

“I see it, too.” Creighton’s disembodied voice broke in, very quickly. “The heart will have to be removed and a new Rockwell implanted. And I don’t want any argument from you, Benson! Stabilize her and I’ll be in with the new unit in ten minutes.” His link went off line.

“No, her kidneys won’t take another wait on the donor list.” Angel declared, “Let’s fix the valve.”

You can’t do that, Thorny almost said. Angel “knew” the standard techniques—but she’d never actually done that kind of operation, and not even the best, most experienced human surgeons were always successful. If she ignored Creighton’s order, and Linda died…

It was bad enough that Linda’s life was at stake—but, potentially, the lives of so many other people that Angel and her successors could help were also.

She looked questioningly up at Thorny.

“Bruk?” he asked.

“You have ten minutes, I think,” the cardiologist coolly replied.

Thorny’s throat felt like it was on fire, and the pressure building in the center of his chest made him wonder if he might need a new heart soon, too. But… heart, kidneys, the patient’s mind, the whole patient. It was a “general practice” decision if there ever was one. He nodded.

He could imagine Angel smiling through her surgical mask.

“Miles?” she said.

“I dunno…”

“Please…”

“If it were anyone else but you and her, I wouldn’t. OK, Angel, my ass is on the line now too. Do it good, lady.”

Angel glanced back at Thorny. “Looks like all our rears are uncovered,” he said.

“OK I’m going to reestablish cardiopulmonary bypass and cardioplegia.”

What happened next was a blur, like watching the operation on a fast forward. Unhindered by human reaction time, Angel showed her full range of talents. Much more now, Thorny realized, than what the consortium had built into her. Tools seemed to fly into her hands as she plucked them off their trays unerringly. Microwaldos buzzed like hummingbirds. Thorny could follow only the large-scale details in real time. The heart was stopped and laid open, the valve repaired, and the entry closed in a matter of minutes. Angel restarted the heart as the doors to the OR flew open.

“You can’t do that, Angel! Benson, make her stop!” Creighton shouted as he caught on to what was in progress. A first, Thorny realized—Creighton had addressed Angel directly, admitting, essentially, her personhood. However, Thorny thought grimly, it was too late, and he would choose to ignore Creighton’s accidental trip to reality.

“No,” Thorny responded, “Angel and I can do it. With Angel, I can do more than any specialist, and be a friend to my patients as well. You should consider retraining in family practice, Elvis—you might learn to like it.”

“Do you want to close, Dr. Creighton?” Angel asked, surgically.

Angel’s next appearance before the Director was at a meeting of the full medical staff in the ground floor auditorium. Winter was in full cold bore again outside, and the coat racks were full of greatcoats and stocking caps, not a few of which were hand-knit white with big red hearts on them; Thorny’s yarn bill was beginning to get significant.

Linda Coombs was accounting for some of that; Thorny was helping her finance her boutique by buying the raw material. Last he heard, she was getting friendly with a skier who’d bought a sweater from her. She was writing a book about her experience, with Angel’s memory to help, of course.

The atmosphere in the meeting was much more friendly this time, now that Elvis Creighton no longer sat as department head. The “official” line was that Creighton had resigned from the staff to pursue a better employment opportunity in another state. But word travels fast in a hospital, and everyone was talking of how the Director had invited him to review, in her presence, a huge folder filled with formal complaints filed against him by patients and staff—the last few from Linda and Nurse Miles.

When he was done, the story went, she had smiled thinly and raised both eyebrows.

Thorny’s report and recommendations concerning Angel had been accepted, unconditionally.

“Angel,” the Director called. “Would you come up here?”

Angel smiled and walked up to the dais. The Director first handed her a frame wrapped in brown paper, which Angel unwrapped. She read what was in the frame and gave a squeal of delight.

“What is it?” Nurse Miles called out.

“It says I’ve completed my internship!” Angel gushed. “Thank you! But how did you manage that without my being a person?”

There was a bit of a gleam in the Director’s eyes as she answered, and a twitch upward at the corners of her normally severely straight, thin, lips. “Forgive me if I found an obstetrician’s solution to that little problem. This,” she produced a simple vanilla envelope and read it, “is for you, Dr. C. Thornhart Benson. Congratulations.”

He went forward and accepted the envelope. Angel looked at them in confusion.

Thorny opened it and then laughed hard and long. “Well, assuming this holds up in court—”

An eyebrow went up and Thorny coughed a retreat. “Ahem. Angel, it appears I’ve finally become a father. It’s a birth certificate. Yours.”