Patient Read Free Page A

one of the magnets. Jessie understood nearly every aspect of the apparatus, but that knowledge never kept her from marveling at it.
    “Let’s do it,” she said, crouching a bit to peer under the video screen and make brief eye contact with her friend. “Everyone ready?”
    The scrub and circulating nurses acknowledged that they were, as did the radiology imaging fellow and the team working the console outside the OR. Through the glass viewing window, Jessie could see radiologist Hans Pfeffer—Ichabod Crane with a stethoscope in one pocket, a calculator in the other, and an IQ that had to be off the charts. The imaging system was as much his baby as ARTIE was hers. He had been watching, motionless, for every minute of the three hours. Now, as their eyes met, he simply nodded.
    “Come on, ARTIE,” Emily said. “Do that thing that you do.”
    The flexible robotic surgeon, three-quarters of an inch long and a third of that in width, was packed with microelectronics and gears. The guidance console by Jessie’s right hand was connected by microcable to six pods—tiny sets of pincers—three to a side. The pods enabled ARTIE to move along—and, where necessary, even through—the brain with minimal damage to the structures it passed. In addition to the guidance cable, ARTIE carried two other fine tubes, one capable of delivering ultrasonic waves powerful enough to liquefy tumor cells, and the other, a hollow suction catheter, designed to remove debris or to implant slivers of radioactive isotopes. Not counting the tubes and cable, the remarkable little robot weighed less than two ounces.
    Jessie stretched some of the tension from her neck and began the meticulous process of liquefying and removing the large glioblastoma. She had inserted ARTIE up through the patient’s nose and into the cranial cavity, and then guided it to the diseased tissue. The tumor would have been virtually inoperable by conventional methods because of the normal brain tissue that would have been destroyed in the process of simply reaching the spot. ARTIE had made it with only minimal damage to healthy brain. Test one, passed with honors.
    “He’s working perfectly, Jess,” Emily said. “Just don’t let him forget for a moment that’s brain he’s sucking on.”
    “To do that I’ll have to change his program. I have him thinking he’s operating on kidney. I thought he’d be less nervous that way.”
    The two women communicated with each other directly, while overhead cameras recorded the operation. They spoke over their shoulders to the nurses and technician, and by microphone to the team managing the console. Although neither of them was large, gowned as they were, surgeon and assistant virtually filled the spaces between the huge MRI tori. As long as neither of them keyed the microphone, by keeping their voices low they could conduct a conversation in virtual privacy. But at the moment, there was no need to speak. It was time to begin the actual operation. For a silent, motionless minute, they shared the appreciation that for the next three to ten hours, a narrow, twenty-six-inch space would be their world.
    Bit by bit, Jessie began the dissection of the cancer, dissolving the cells with ultrasound and removing the resulting debris. As the procedure progressed, Emily monitored the various parameters within ARTIE and occasionally broke the viselike tension with small talk about the latest examples of Carl Gilbride’s florid egomania, about her two teenage sons, or about Jessie’s life—especially her mother, Paulette, whose shameless determination to do something about her forty-one-year-old daughter’s single status was a cartoon that never failed to amuse them. From here on, Emily was the supporting player, but she handled her role well. The two of them had spent so many hours together in the operating room that they functioned essentially as one. But today a third player had been added—a tiny robot that might, with time,