For the moment he was willing to be mightily impressed. The buggy attached itself to magnetic lines in the roadway and whizzed along a dedicated route. Llaving tapped in their destination, Lisa did not have to drive and could concentrate on their conversation. At intersections the buggy waited for some invisible signal, or sensed itself whether to proceed. Though the streets were crowded no buggies touched each other; a crash was virtually impossible.
All about him, Strether could see people both at their daily tasks and at leisure. He was struck by the physical similarity of many of those in dungarees, especially in the factories, the printing works, the sewage farm. Male and female, they were small, nimble, dark-skinned – with Cypriot blood, perhaps, or Arab. The majority wore eyeshades, except in dimly lit areas, of which there were many. There, they seemed to manage quite happily in the half-gloom where Strether could barely see his own feet.
‘They are colour-blind,’ Lisa explained. ‘They have a genetic condition that reduces the number of cones on the retina so that they’re ultra-sensitive to light. Obviously they’re much happier in low illumination. And as that’s cheaper, they’re welcome. They’re hard workers too, so they’re prized employees.’
‘Where does the colour blindness come from?’
‘It’s natural. It used to be found in isolated communities such as the Polynesian islands, but later it became widespread in Europe. Probably caused by the explosions. The mutation is linked to an increased flesh pigmentation – that’s why they’re so brown. Odd, that. They have increased protection against the sun as far as skin’s concerned, but are distressed by excess light. Most live down here permanently.’
‘Why wasn’t the defect cleaned up? Aren’t they entitled to gene therapy?’ Strether was not sure he would like the answer.
Lisa cast him a glance. ‘Because it’s useful. The gene bank is not immutable, you know. They’re well paid.’
They travelled on, Strether lost in his own thoughts. Then Lisa spoke again. ‘I’ll show you the hospital, then we can go for lunch. I’ve a particular reason for taking you to it. You should know why Porton Down still has to fight for its budgets. It has a lot to do with the demands posed by the numbers of elderly. Oh, I suppose I’ll be old some day, and grateful for the services. But the founding fathers believed that as people got healthier, their need for hospital treatment would diminish. That turned out to be rot.’
The buggy entered the sweeping grandeur of the hospital forecourt. The main construction component was a kind of lilac concrete, functional, though hardly endearing. So busy was it that they had to wait several minutes for a parking space in the multi-storey park. Strether experienced a slight feeling of vertigo as they came back up ten floors in the lift.
Lisa ignored the main entrance and led him round to the back. Here, the light was bright, the equivalent to a mid-morning sun. A gentle breeze blew from hidden vents. A garden had been created, complete with living plants and shrubs; the illusion of a summer sky with scudding clouds floated high above. ‘Hologram,’ Lisa answered his question. ‘Clever, isn’t it? The plants are completely fooled. Here we are.’
She pressed her palm on the door and waited. It admitted her and she pulled Strether in quickly. ‘I have access because sometimes I have to attend surgery on a newly discovered defect. They don’t invariably show up at birth. That way I can recommend the simplest method to correct it
in vitro
, whether via the bone, the marrow, or whatever. And this entrance has no camera.’ She halted suddenly. ‘You’re not squeamish, are you?’
‘I don’t think so. Seen many a disembowelled cow in my time. The main beneficiaries from those explosions in Colorado were the vultures – the modern variety are twice as big, twice as nasty.’
Lisa’s nose wrinkled. ‘Then I’ll take you into theatre. Don’t say a word, you might get us thrown out.’
In an anteroom she handed him a green gown, a hood, a surgical mask, and helped him cover his feet and dip his hands in sealing solution. As she did the same for herself she examined the surgery lists on the wall. Nobody was about, apart from a couple of orderlies; every theatre was busy, their exits and recovering patients unseen on the far side.
‘Let’s try number fourteen,’ she said. Strether followed her meekly as she slipped through sets of swing doors. Then he stopped dead.
Under the arc-lights a green-sheeted body lay prone. A bevy of staff surrounded the raised operating table. One glanced up as they entered. Lisa whispered, ‘Dr Pasteur,’ and the nurse turned back to her task. Machines and equipment pinged in rhythm: pulse 100,
blood-pressure
130 over 90, haemoglobin 12.6. A healthy body. The hands that peeped from under the sheet, plastic tubes in both wrists, were small and elegant though with wizened skin, the fingernails delicately manicured. A female. As Strether’s eyes roamed up the covered torso, he swallowed hard. He wished Lisa had prepared him better.
The face had disappeared. A bloody mess had taken its place, composed of oozing flesh, skin and silvery bone, the teeth grinning like a skull’s.
The surgeon was seated at the woman’s head, facing the feet, cradling the chin in one hand though the cranium was held rigid in a frame. The scalp had been cut just above the hairline and hung back down between his knees, dripping slightly in a retainer hairnet. The surgeon was humming to himself behind his mask; he did not look up. With an instrument shaped like a flat spoon he was scraping away between the skin and the bone. He had deflapped the entire forehead and started on the cheeks. As Strether watched, his gut tightening, the surgeon pushed too hard and the instrument came through the skin. ‘Darn it,’ muttered the surgeon, and switched the instrument to the other cheek. ‘Have to repair that later.’
It appeared that the eyes were to be avoided; Strether craned and saw that they must already have been attended to, for they were yellow with disinfectant and surrounded by crescent-shaped blood-encrusted scars. The surgeon was making his way down the jawbone, pushing hard as if he were skinning a bear. ‘Bit tough, this one,’ he muttered. ‘How old did you say she is? Eighty-six? Should have more sense.’
Strether was rooted to the spot. He was aware that Lisa was glancing in his direction. Perhaps this was her idea of a bizarre initiation rite he had to survive to win her confidence. If so, then he could do it. He forced himself upright, cleared his mouth of the bile that had risen unbidden, and made himself watch intently.
‘That’ll do,’ the surgeon announced. A nurse reached across and wiped the sweat from his brow. ‘Two hours, sir,’ she intoned. He wriggled his shoulders and set to again, this time using his hands to pull the flaps of skin hard away from the nose. Miraculously the face reappeared, its wrinkles gone. The lips were unpinned and pushed back over the teeth. Using clamps, he tried various shapes and tightnesses until some aesthetic standard was met. With a grunt, the doctor clicked the clamps shut and began to secure the ends under the ears with a gadget like a stapler. The edges were trimmed with bursts from a laser; spare triangles of skin dropped to the floor.
Lisa tugged at Strether’s arm. With enormous relief he stumbled out after her.
‘What the hell – ?’ he gasped, as he tore off the mask.
‘Completely pointless surgery, I agree,’ Lisa answered. ‘A full facelift. We are each entitled to two under the Health Service: the first at fifty, the second at sixty or over. I’ve no quarrel with that, not when so many men are on their third marriage by then. Why should men have only young women to choose from? What makes me
mad
is that this patient is on her
fourth
. And we’re paying for it. My attempts to eradicate muscular dystrophy for ever are frustrated by that lady, and people like her.’
‘She gets it free?’ Strether saw it would be useless to do other than follow Lisa’s train of thought.
‘
She
does, yes.’
‘Why?’
‘Because she’s Princess Io, that’s why. As upper caste as you can get. She could probably afford to pay for it, too.’ Strether cleared his throat. ‘I don’t think you should have told me that, Lisa. It’s a name I know, though I’ve never met the lady. Till now. She’s Prince Marius’s mother, isn’t she?’
Lisa was crestfallen. ‘Yes. You’re absolutely right. Forget what I said. But it’s just that people like her can hog the money, and there are so
many
of them. Yet my section struggles at the end of each financial year. Politicians like Prince Marius boast there are no waiting lists, and it’s true. But everything else takes a lower priority, and that’s not fair.’
Back in everyday clothes they walked slowly through the garden. Still feeling tense and nauseous, Strether eased himself on to the nearest bench while Lisa strolled about quietly. Above his head a purple hibiscus gracefully dropped scrolled buds; nearby a yucca was in full bloom, its creamy cups raised to the make-believe sky. Roses fluttered their petals in the breeze, their fragrance softening the air. He drew in deep breaths and held them until his stomach had stopped churning.
‘You wouldn’t deprive the elderly of health care, would you?’ he asked gently. ‘It’s been an agonised debate in America as long as anyone can remember. The rich pay, the poor get the basics. Everyone else insures or goes without. I had a sneaky feeling that European socialised medicine was a big improvement.’
‘No. I wouldn’t deprive them, but I’d ration them. If she pays to get her apartment redecorated she could pay to get her face rearranged.’
Lisa sat beside him and crossed her legs. She clasped her hands around her knees and stared into the middle distance. Again, Strether admired the shapely thighs and neat ankles.
‘The cult of the third age has gone too far,’ Lisa mused softly, a wary eye on a distant camera that had trained itself on them. ‘Age discrimination is banned, so it’s illegal to suggest someone’s too old for treatment. And the distinction between what’s cosmetic and what’s health-related gets blurred. For old people most interventions are both. What’s politically correct, as they used to say, is practically stupid.’
‘But surely, people refuse of their own accord? My wife did. Not everybody wants a fourth face-lift, Lisa.’
‘Well, the Princess does. Her doctor will have signed to the effect that without it, her psychological state would deteriorate or she’d lose her independence or some such. Not everything’s worth doing – yet where’s the doctor who’d stand up and say so?’
‘At home the fundamentalists are in charge. They rail against science, but they took against euthanasia too. They think suffering’s good for you. Europe seems ahead of us. Your codes outlaw excessive attempts to preserve life, don’t they?’
‘Sure. Euthanasia and living wills are perfectly legal. And cryogenics, though that’s now obsolete. But the pendulum’s swung too far the other way, Bill. Now whatever treatment a third-ager demands – provided he or she has connections – it’ll be done, and no refusals.’
‘Even if all that’s wrong is a few wrinkles?’
Lisa’s shoulders slumped. ‘You saw it. What can I say?’
‘Lisa.’ Strether waited until she gazed up at him. ‘I don’t get it. So much effort to make things perfect. Your work, and what’s going on inside that hospital. It’s as if nobody can cope with … well,
normality
. Mess. Disorder. Ageing. Defects. Disability, dammit. You say that cosmetic surgery is hostile to your work. Winston says your work is cosmetic. And –’
He stopped and pulled out a handkerchief to wipe his brow.
‘Look about us,’ he continued, exasperated. ‘Nothing is as it seems. The whole darn thing is a fake. I’m hot right now, like I’ve been in the blazing sun. But the sun’s kept at bay by fifty metres of rock over our heads. So much effort to create so much illusion. And I keep asking myself, what other illusions are there? What other guff am I being fed, where everything looks hunky-dory, and isn’t?’
She was silent, though her face was perturbed and she was biting her lip.
‘I heard a thing or two in Brussels that I didn’t like,’ he said heavily. ‘Those smooth world-weary Énarques – they give me the creeps. We have civil servants in America, but not an army of ’em, like here. And ours don’t all try to look alike, and don’t act as if everyone else is inferior.’
‘But they’re right on that,’ said Lisa, with sudden asperity. ‘That’s the trouble. The civil service and their friends have been bred to be ultra-smart for years. Throughout Europe. The programme is a success, Bill. I know – I make it so.’
He stared at her then, scrutinised the heart-shaped face, saw her distress and bewilderment.
‘Lisa, why are you telling me this? You sounded so worried on the vidphone. And why me?’
‘I don’t know the answer to that last question. Maybe because you have kind eyes, Bill. Or I fancy your accent. Put it down to instinct.’ She laughed shortly.
He took one of her hands in his. The skin was soft, the fingers slim. He touched the gold ring with the amber stone on her third finger, twiddled it gently round, once.
‘So what’s going on – at the lab, or here? What is it you’re trying to tell me?’
‘I don’t know that either. It may be I’m inventing conundrums. If not, then it could be something alarming. Before I could take any action I’d have to be sure – or closer than I am now.’
‘Those missing records are significant,’ Strether hazarded.
‘They could be. Combined with my Director’s off-hand response.’ Her voice became a whisper and she bowed her head, as if to ensure that the camera could not eavesdrop. ‘You see, they covered some repeat experiments I tried, which hadn’t worked first time either. The chromosome kept breaking. A weakness, somewhere – and at the crucial 21qll location.’
‘You’ve lost me. What does that imply?’
‘Personality. It’s where mongolism used to occur. I’ve never seen any examples, but Down syndrome children were supposed to have sweet, loving characters. If that bit’s missing we get instead a predisposition to violence. If my suspicions are correct, that’s seriously bad news. For everybody.’
The risks of talking in such an unguarded environment were too great. For her own sake, he had to stop her. ‘Then let’s hope you’re wrong.’ He rose, lifted her fingers to his lips and kissed them.