Will I stay? Will I flee? Will I go to court? Time's running out. My call is sure to come up in another few weeks. I feel a tickling sensation in my back, now and then, as though somebody's quietly sawing at my kidneys.
Cannibalism. At Chou-kou-tien, Dragon Bone Hill, twenty-five miles southwest of Peking, paleontologists excavating a cave early in the twentieth century discovered the fossil skulls of Peking Man, Pithecanthropus pekinensis. The skulls had been broken away at the base, which led Franz Weidenreich, the director of the Dragon Bone Hill digs, to speculate that Peking Man was a cannibal who had killed his own kind, extracted the brains of his victims through openings in the base of their skulls, cooked and feasted on the cerebral meat — there were hearths and fragments of charcoal at the site — and left the skulls behind in the cave as trophies. To eat your enemy's flesh: to absorb his skills, his strengths, his knowledge, his achievements, his virtues. It took mankind five hundred thousand years to struggle upward from cannibalism. But we never lost the old craving, did we? there's still easy comfort to gain by devouring those who are younger, stronger, more agile than you. We've improved the techniques, is all. And so now they eat us raw, the old ones, they gobble us up, organ by throbbing organ. Is that really an improvement? At least Peking Man cooked his meat.
Our brave new society, where all share equally in the triumphs of medicine, and the deserving senior citizens need not feel that their merits and prestige will be rewarded only by a cold grave — we sing its praises all the time. How pleased everyone is about the organ draft! Except, of course, a few disgruntled draftees.
The ticklish question of priorities. Who gets the stockpiled organs? they have an elaborate system by which hierarchies are defined. Supposedly a big computer drew it up, thus assuring absolute godlike impartiality. You earn salvation through good works: accomplishments in career and benevolence in daily life win you points that nudge you up the ladder until you reach one of the high-priority classifications, 4-G or better. No doubt the classification system is impartial and is administered justly. But is it rational? Whose needs does it serve? In 1943, during World War II, there was a shortage of the newly discovered drug penicillin among the American military forces in North Africa. Two groups of soldiers were most in need of its benefits: those who were suffering from infected battle wounds and those who had contracted venereal disease. A junior medical officer, working from self-evident moral principles, ruled that the wounded heroes were more deserving of treatment than the self-indulgent syphilitics. He was overruled by the medical officer in charge, who observed that the VD cases could be restored to active duty more quickly, if treated; besides, if they remained untreated they served as vectors of further infection. Therefore he gave them the penicillin and left the wounded groaning on their beds of pain. The logic of the battlefield, incontrovertible, unassailable.
The great chain of life. Little creatures in the plankton are eaten by larger ones, and the greater plankton falls prey to little fishes, and little fishes to bigger fishes, and so on up to the tuna and the dolphin and the shark. I eat the flesh of the tuna and I thrive and flourish and grow fat, and store up energy in my vital organs. And am eaten in turn by the shriveled wizened seniors. All life is linked. I see my destiny.
In the early days, rejection of the transplanted organ was the big problem. Such a waste! the body failed to distinguish between a beneficial though alien organ and an intrusive, hostile microorganism. The mechanism known as the immune response was mobilized to drive out the invader. At the point of invasion, enzymes came into play, a brush-fire war designed to rip down and dissolve the foreign substances. White corpuscles poured in via the circulatory system, vigilant phagocytes on the march. Through the lymphatic network came antibodies, high-powered protein missiles. Before any technology of organ grafts could be developed, methods had to be devised to suppress the immune response. Drugs, radiation treatment, metabolic shock — one way or another, the organ-rejection problem was long ago conquered. I can't conquer my draft-rejection problem. Aged and rapacious legislators, I reject you and your legislation.
My call notice came today. They'll need one of my kidneys. The usual request. "You're lucky," somebody said at lunchtime. "They might have wanted a lung. "
Kate and I walk into the green glistening hills and stand among the blossoming oleanders and corianders and frangipani and whatever. How good it is to be alive, to breathe this fragrance, to show our bodies to the bright sun! Her skin is tawny and glowing. Her beauty makes me weep. She will not be spared. None of us will be spared. I go first, then she, or is it she ahead of me? Where will they make the incision? Here, on her smooth rounded back? Here, on the flat taut belly? I can see the high priest standing over the altar. At the first blaze of dawn his shadow falls across her. The obsidian knife that is clutched in his upraised hand has a terrible fiery sparkle. The choir offers up a discordant hymn to the god of blood. The knife descends.
My last chance to escape across the border. I've been up all night, weighing the options. There's no hope of appeal. Running away leaves a bad taste in my mouth. Father, friends, even Kate, all say stay, stay, stay, face the music. The hour of decision. Do I really have a choice? I have no choice. When the time comes, I'll surrender peacefully.
I report to Transplant House for conscriptive donative surgery in three hours.
After all, he said coolly, what's a kidney? I'll still have another one, you know. And if that one malfunctions, I can always get a replacement. I'll have Preferred Recipient status, 6-A, for what that's worth. But I won't settle for my automatic 6-A. I know what's going to happen to the priority system; I'd better protect myself. I'll go into politics. I'll climb. I'll attain upward mobility out of enlightened self-interest, right? Right. I'll become so important that society will owe me a thousand transplants. And one of these years I'll get that kidney back. Three or four kidneys, fifty kidneys, as many as I need. A heart or two. A few lungs. A pancreas, a spleen, a liver. They won't be able to refuse me anything. I'll show them. I'll show them. I'll out-senior the seniors. There's your Bodily Sanctity activist for you, eh? I suppose I'll have to resign from the League. Good-bye, idealism. Good-bye, moral superiority. Good-bye, kidney. Good-bye, good-bye, good-bye.
It's done. I've paid my debt to society. I've given up unto the powers that be my humble pound of flesh. When I leave the hospital in a couple of days, I'll carry a card testifying to my new 6-A status.
Top priority for the rest of my life.
Why, I might live for a thousand years.
Geriatric Ward
by ORSON SCOTT CARD
Orson Scott Card is the best-selling author of more than forty novels, including Ender's Game, which was a winner of both the Hugo and Nebula Awards. The sequel, Speaker for the Dead, also won both awards, making Card the only author to have captured science fiction's two most coveted prizes in consecutive years. Card is also the winner of the World Fantasy Award, eight Locus Awards, and a slew of other honors. He has also published more than eighty short stories, which have been collected in several volumes, most notably in Maps in the Mirror and Keeper of Dreams. His most recent book is a young adult novel called Pathfinder.