Dr. Natalia Arlofskaya found Alfred F. Jones sitting on the ground, attempting to throw a chair at one of the nurses. She ignored the man for a moment, eyes flicking to the cane that was abandoned by the doorway, the x-rays on the desk.
"Mr. Jones," Natalia said.
It actually sounded quite reasonable when Alfred explained the situation later—then again, Alfred made everything he did sound rational. It was a story that Natalia hadn't heard before, but she knew the ending. Car crash, intense physical therapy, the cane was new, it's been over ten years.
Natalia listened, nodding when it was appropriate, but her attention was focused on the x-rays. The disease had taken a different pattern than she was used to; instead of growing out, the metal had chosen to grown along the bone. It was one of the better growth patterns, and it didn't surprise her that Alfred took a couple of weeks to make an appointment.
Alfred leaned back in the chair he had been attempting to throw earlier, taking off his glasses and massaging his eyes. Natalia raised an eyebrow.
"But they checked for the…" He waved his free hand. "Thing. I shouldn't have to lose my leg. It's not fair." Alfred looked up, head tilted slightly. "I was in a baseball league last year."
"It's an unusual pattern. The metal usually tries to adjust itself to the tissue around it, mimic it. Had your doctor caught this earlier, we might have been able to remove the effected bone. Your leg has to go." Natalia watched Alfred's face contort. "We have to check your other implants."
It was standard procedure to check on patients before their surgeries. Natalia watched from the doorway as Alfred fidgeted in his bed, playing with the marker. The gown kept slipping down his shoulder; she could see the necrosis despite the gloom.
Left collar bone, right shoulder—
Alfred uncapped the marker, writing and underlining NOT THIS LEG.
—Right knee implant.
Natalia entered the room, but Alfred barely spared her a look.
"Jees, you're really creepy and quiet, did you know that?" He reached up and absently itched at his neck. "What're you ripping out? Matt looked over the paperwork because he said I would throw someone out the window."
"Everything," Natalia answered.
"Great," Alfred muttered, leaning back on the pillows, "Three years until I could walk in a straight line. Another six months till I could write my name. And now you're going to rip everything out."
Natalia nearly rolled her eyes. "Yes. Either that or you figure out how to walk with a metal foot." The pouting made her lip curl. "You're lucky; it's usually the elderly. They can't survive the surgeries. You have a chance."
"It spread."
"I've seen the x-rays."
Resentful silence on Alfred's part. Natalia missed the elderly, who at least had the decency to thank her for the help. Few people under sixty crossed her path; the young were given extensive tests for bacteria.
Maybe Alfred should be upset. It was like a heart attack, something he should have only had to distantly worry about.
"We're doing the best we can. There are new drugs out that are too volatile for the usual age group. They might work."
Alfred sighed, wiggling the toes on his right foot. "I've Googled about it."
Natalia didn't answer.
Alfred looked at her. "I've Googled you, too." He grinned lopsidedly. "What's it like, having half a brain?"
"I can see. I have an IQ nearly twice that of the average person. I can function." Natalia resisted the urge to touch the back of her head. "The growth shouldn't restart if I'm lucky. I have as much brain as you do, Jones."
Later, Alfred sloppily wrote her notes. Natalia only worked the night shift, and Alfred was too busy sleeping. But there were the notes, about Matthew, and Alfred's dog, and how long it had taken him to make a fist when he was still a teenager.
Sometimes, if Alfred couldn't sleep and was picking at the metallic spirals in his arm, they would sit together. Already, his neck was a mess of wires and cord. His voice box was intact, somehow, and so they talked.
"What colors can you see?" He asked, picking at his right arm with his left.
"All of them."
Alfred tested his fingers. "They showed me the x-rays. All up to," He made a slicing motion on his forearm. "Here is metal. Something about a corkscrew pattern, destroys bone n' shit down and then grows out."
Natalia had seen the x-rays, too. She poured over them, talking with Toris and her brother for surgical options. Rip out the metal, cut off his arm, destroy his neck, cut more of his leg off. Pray, Ivan had suggested. Toris had pushed more of his drugs.
But the pattern was the same. Alfred stopped wheeling around the hospital, restricted to his bed. They hadn't cut enough of the leg off. His right arm disintegrated to thin metal spires. The metal burrowed into his jaw bone, and he couldn't speak.
He couldn't write notes. He couldn't walk. He wouldn't get better.
Natalia watched, as she always did, from the doorway. At night, the only thing she could see was the light glinting off of the metal. The rasp of air through the metal in Alfred's neck. The necrosis made the nurses scurry in and out of the room as fast as possible, door shut.
It was a twenty-six year old needing a heart replacement.
"I'm moving you to hospice," Natalia said, back to the wide-open windows.
A note, the same one as always: Not fair, not fair, not fair.