It was a different operating room entirely now.
Jensen was as stable as he'd get in the foreseeable future, and the augmentations Vera had helped install were whirring away in his chest and head keeping him there. From here, it would be a different job from the quick, desperate, and dirty work of keeping Jensen alive long enough to augment him: It could go slower, be more measured and calculated. There were still risks, certainly, and still significant dangers to his health that needed to be dealt with one by one, but their damage was subtler and slower. They had time, now. Time that would be spent consolidating their progress and ensuring their patient's stability. Time spent on Sarif's dollar, a part of her thought with what might have been bitterness.
The OR was filled with techs, nurses, and doctors. They moved between each other like well-choreographed dancers, plugging prostheses and support equipment, ventilators and blood-maintenance machines into wall mounts near Jensen and almost on top of one another. A seemingly endless cascade of wires and tubes flowed down from the autosurgeon and into Jensen, into his flesh and into the prosthesis maintenance plugs that now dotted the ridges of his chest like scars. In the eye of the storm, augmented mechanically and psychologically into a tightly-wired centredness of calm, stood Dr Yan with his arms folded behind his back. Vera moved through the crowd as gracefully as she could, and came up beside him with a quick nod.
"David says this 'Typhoon' is a failed military-grade prototype," said Vera, her face a steady mask. "He scavenged the power supply for Jensen, but the remainder of the augmentation was not deployed."
Yan thought it over for a moment, and then nodded. "Certainly plausible. Do you believe him?"
Vera took in a breath and chose her words carefully, clamping down hard on the mix of anger and guilt as it boiled upwards. "I believe him, yes. I have known him long enough to know when he was lying. He was not."
Yan eyed her. "I see." He cleared his throat. "Well, in any case, if we were to remove that device at this stage it could kill him. It will have to wait. We need to determine the treatment of his remaining wounds, and conduct a triage."
Vera paused to take stock of the progress report data streaming out of Jensen's prostheses. "Jensen's nervous system is interfacing quite well with the augmentations. Basic communications test results from the abdominal implants show no anomalies beyond those characteristic of the injuries sustained and some mild inflammation around the implants. Jensen's mind is, by all indications, still in a comatose state and there is evidence of significant damage. However, cognitive testing performed by the augments and MRI were able to identify the extent and neuropsychological functions affected, and his brain is in the early stages of offloading those processes into the RET1 chips we implanted."
"We can assume Jensen is sufficiently stable neurologically, then?"
"Yes," said Vera. "In addition, the abdominal implants are ready to regulate cardiovascular function. At the moment, a ventilator is regulating oxygen intake for safety reasons."
"You can confirm, then, Dr Marcovic, that the class IV augmentations are apparently capable of functioning normally and that there is no outstanding risk to the patient's cardiovascular or central nervous system?" The phrase was practically textbook, possibly with a shade of deadpan humor to it. There was certainly some smug relief radiating off of Yan at their success in stabilizing their patient.
"Yes."
Yan looked satisfied. "Good." She could practically see him looking up Jensen's chart through his iris HUD. He pointed out the various regions of Jensen's body he was referring to with his organic hands as he spoke; Vera couldn't tell whether he was still jacked into the autosurgeon or not. "Jensen's remaining abdominal injuries can heal themselves. Several cracked ribs, simple fractures; they'll heal themselves. Numerous soft tissue injuries not worth mentioning. I am concerned about damage to his digestive system and several glands, but there is no indication any of those need replacement." Yan cracked a thin smile in one corner of his mouth and glanced at Vera. "Unless our new engineering overlord disagrees?"
"Not at all, Yan," said David Sarif, as he walked in. Vera tensed, but said nothing. Yan jumped; he'd been looking away from the OR doors and hadn't realized David was there over the commotion from everyone else in the room. David looked around the room, evaluating, then put his hands on his hips and nodded once in impressed approval before he turned back to them. "Please go on, Doctor," he said.
Yan cleared his throat. The surgeons Vera had known were generally so unshakably calm that they could make it look like a psychosis, but he almost looked embarrassed. Vera chalked it up to stress. "As I was telling Doctor Marcovic, Jensen's major injuries have been dealt with for now. We do not believe there is any likelihood of further complications with his heart, lungs, or nervous system. I am vaguely concerned with potential internal bleeding and with damage to his remaining organs, although the smart clotting system in the synthetic blood we're giving him should be capable of handling that."
"We can regulate that with the augmentations, too," said David. "Part of the abdominal package was a system designed to regulate and enhance normal healing rates by managing the adrenal and lymphatic tissues."
Vera's eyes narrowed. "David. Are you telling us that in addition to the augments meant to replace cardiovascular and nervous function in Adam's abdomen, there are other augmentations which you implanted without our knowledge? Ones designed to have direct effect on his healing process?"
David made an acknowledgement gesture at her. "In one, Vera. It's codenamed Sentinel. It's a-"
The slap was so hard, Vera fancied her palm might have a bruise. David stumbled back, jaw hanging open in surprise. Despite what many of his devices could do, David himself was very unused to physical violence. "You do not," said Vera, enunciating every syllable with razor-sharp precision, "augment one of my patients with such a thing without informing me first."
David rubbed his jaw, and she could practically see the gears in his mind turning, re-evaluating, re-calculating. As discreetly as she could, Vera tried to shake some of the pain out of her hand. She became aware that most of the OR, including Yan, were staring at her.
"It's not active, obviously," growled David. "And it doesn't contain any potential biohazards. Just a choice mix of biomolecules and micro-electric shocks to regulate the healing process."
"I still want a brief on such devices before they are implanted. And I certainly want them added to my HUD. I can hardly do my job without that."
"There was hardly time before, Vera," said Yan. "This case hasn't been typical, and has certainly been the most frantic case of human augmentation that I have ever worked on. I doubt seriously that David could have briefed you quickly enough."
"What he said." David straightened his back and stretched his shoulders slightly. "Vera, I'm sorry that there hasn't been time for you to interface properly with these augmentations. They aren't on your HUD yet because I've got the power cut to everything but the bare essentials. They aren't even logging data or interfacing yet, not until you've had the chance to get acquainted with the software and what these things do. They won't affect Jensen until you say they will. "
"Well, David, we certainly have time now. Why don't you add them into my HUD before we go any further? I need to be able to observe all of the patient's augments to do my job, and we finally have time to do this properly."
"Fair enough, Vera. Give us a second, Yan." Without another word, David turned on his heel and headed out of the OR. Vera, presuming David needed a discreet conversation, followed him.
She was right about the conversation, but she hadn't realized there'd be so many forms to sign as well. David made a beeline for the pile of prosthesis boxes and interface systems and pulled a demure black briefcase from somewhere near the middle of the pile. He slid his thumb across the access catch and the case arched open on well-oiled hydraulic rails. Vera folded her arms and waited while he sorted through the paperwork he'd brought.
David found a moment to motion to the cheek where she'd hit him, hand filled with non-disclosure agreements. "Bit much, Vera. You mind keeping your hands to yourself?"
She shrugged. "I merely reacted as I normally would to engineering negligence. I have lost too many patients in experimental trials to... 'let things slide'?. You should know this. Yan knows this. I had thought you would want me to act normally, yes? Or perhaps imply some measure of hostility between us? Now that you have included me in your conspiracy, I mean. If Yan were to discover the extent to which I presume you have augmented Mr Jensen, he may react... badly."
David snorted. "Understatement." If he noticed the veiled threat he didn't react. He fished a pen out of a suitcase pocket and handed her the whole mess of legalese so that she could sign it. Vera flicked through it experimentally and then signed page after page of it. It wasn't really like she had much other choice, rather than walking out of the hospital right then and there.
When she handed the documents back to David, he looked up at her suddenly with a sly grin. "Felt good though, right?"
She couldn't hide her snort of laughter. David allowed the grin to dissolve into a small smile, and then his face drifted back into what was now his normal impassive mask. "Vera, there's a lot of technology in there. Those NDAs are serious things, all right? You can't unring this bell."
Vera just sighed. "Get on with it, David."
She could already feel the effects, though. David had been enabling the wireless feeds to her even as she spoke. A couple of mental switches flipped, and then it began.
It felt like a digital river pouring down into her, and for a moment she almost felt tugged away by the current. She stood there, eyes half closed, as the stream poured into her, earthing itself in the hard memory of her grey matter. Processor handles and header files near the surface stood out and glowed like phosphorescence to her conscious mind. The names flowed past her.
Sentinel RX.
Icarus.
Typhoon.
And those were just the big names. Beneath them, in the subsystem layers, lay an endless number of intricate augs that gleamed in the data stream like smoothly polished river stones. Vera could sense a power system far more intricate than anything she'd seen before, and countless pieces of interface and bus hardware meant to connect to future augmentations. They'd even reinforced sections of Jensen's ribcage, spine and pelvis in anticipation for prosthetic hardpoints.
Vera opened her eyes. David looked back with something caught between watchful caution and pride.
"Mother of God," whispered Vera, "David, what have you done?"
David regarded her a moment longer, then just turned on his heel and walked back into the OR. Vera followed, still trying to process the data coming in. Most of it was well beyond her engineering acumen, and there was simply no way she could understand the full function of Jensen's augmentations. That might even have been by design. She would be spending the project interfacing with them at the most abstracted level. Regrettable, but an increasingly common outcome as augmentation technology outraced the understanding of everyone but its creators.
Yan nodded at them both, and his eyes slid to Vera. "Are you satisfied, Doctor?"
Vera just nodded once.
"Good," said Yan. "As I was saying, I believe the next most urgent topic is the patient's left arm. The first responders used a tourniquet until he entered the hospital, and we had higher priorities for the last several hours. The risk of blood loss was far too high while he was being stabilized and I requested that it be kept tight enough to fully restrict blood flow."
Vera swore out a few taut syllables in Polish.
Yan's mouth tightened into a grimace. "Quite. There is already necrosis of the tissue near his fingers. As well, there is a significant number of fractures, and I suspect there is substantial arterial injury. The high risk of infection, even in here, from a superbug, could lead to severe consequences the amount of stress the patient is already under and the amount of tissue we have already removed."
"If we loosen that tourniquet," translated David, "he'll probably bleed out. And even if he doesn't, his body trying to heal it just might. But if we want to save the limb, we'd better do something."
"I suspect," said Yan, "that we are already out of time. I recommend we remove the limb entirely."
"That, we can do," said David. "I've got a replacement arm warmed up and waiting. All we have to do is remove the arm and install a hard point."
Yan tilted his head. "Which in turn is bolted onto the composite/ceramic reinforcements we added to his skeleton in the previous operation. Yes. I see how that could work."
Vera cleared her throat. "You already had this arm ready?"
David nodded once. "Couldn't be sure how much of Jensen would need replacing, in the end," he said. "I've got parts ready for pretty much everything."
Yan frowned. "So, if necessary, we can replace all of Jensen with a machine. How comforting. Tell me, Sarif, haven't you lost enough people today?"
"Replacements for his body, not his mind, not him," said David, a bit harshly. "Like I said, if you're ready for the operation then so am I."
"I am not," said Yan. "I had a long day in surgery before you called me in here, and as we've discussed, Jensen is now relatively stable. The nurses and the machines can do the rest, even bring us back in if anything changes. If we have the time, I think we could all benefit from four to five hours' sleep. It's 2 am now. I think we should begin again at 8 am tomorrow. There are some cots meant for nursing staff if any of you live more than several minutes away."
"Works for me," said David. He nodded once in friendly goodbye to Vera and then headed out. Vera had to check over the augs one last time, and Yan needed to check over Jensen's chart before he handed it over to the night shift.
It was a few minutes before Yan asked her, "Vera, tell me again, how is Jensen's body responding to the implants?"
It took her a moment to switch gears enough to communicate verbally. "Mild inflammation at most. It's lessening now."
Yan grunted. "Not typical."
"No."
Yan leaned over the table at Jensen's prone form. "We've been doing this for about a hundred years, now. The human body's response to implants and augmentations is consistently poor. It treats synthetic components as foreign bodies. It ramps up immune responses to the point that many implants can no longer function at all. We can barely manage the process with drugs. Even neuropozyne, with its endless list of side effects, is hailed as a miracle drug."
"It's certainly a strange response," said Vera, "but not entirely unheard of."
Yan almost seemed to ignore her. "How is Jensen even still alive? This procedure should have killed him. Did Sarif know this would happen? Was it just a desperate gamble?"
Vera stared at Yan, pondering. She'd worked with him once or twice before, and he had a reputation for calm and effective functionality that even amongst surgeons was impressive. He lived on the edge, to an extent; many of his operations were high-risk and on patients with effectively terminal conditions. It was why she'd picked him. But she knew about him more as a professional than as a person.
"And here I thought you weren't getting on so well with David Sarif."
Yan shrugged. "I don't like anyone who thinks they can buy me with money," he said. "Or my operating rooms. I assumed Sarif was just a rich desperate man who would fail. I assumed Jensen would perish. I was completely wrong."
Yan was silent a little longer, contemplating. "It's a remarkable result, frankly," he said finally. "This is a truly remarkable experiment."
"It is not an experiment."
"A lot of novel medical procedure is experiment, in my experience," said Yan. "We never know enough about how a patient will respond to any treatment to have any real certainty about what will happen. Often, in our desperation, we resort to potentially dangerous action. Drugs and surgical procedures untested beyond animal stock. But we must conduct such experiments if we are to find new ways that do work. Even if Sarif's motivations were not pure, his results will be. And collaboration always requires...compromise."
He turned to look at her, saw her expression. "But I ramble. My apologies. See you in the morning, Doctor Marcovic."
One of the nurses led her to a small room stuff with cots. Vera got into one almost entirely devoid of thought. Yan, her and David Sarif all flew back and forth through her head like devils around Jensen's body until they blended together and she drifted into sleep.
