“I must know more about this,” Benicoff said. “Is there any chance you will let me observe the operation?”
“Every chance in the world — I have had up to five residents in the O.R. breathing down my neck at one time. It’s fine with me as long as you stay out of my way. What’s this sudden interest?”
“More than morbid curiosity, I assure you. You’ve described the machines you use and what they do. I want to see them in operation. I need to know more about them if I am going to ever know anything about AI.”
“Understood. Come along, then.”
3
February 10, 202
Benicoff, gowned and masked, stretchable boots pulled over his shoes, pressed his back to the green tiles of the wall of the operating room and tried to make himself invisible. There were two large lights on ceiling tracks that one of the nurses moved about and focused until the resident surgeon approved their positioning. On the table sterile blue sheets had been draped tentlike over Brian’s still figure. Only his head was exposed, projecting beyond the end of the table and held immovably by the pointed steel spokes of the head holder. There were three of them, screwed through the skin of his scalp and anchored firmly in the bone below. The bandages that covered the two bullet wounds were stark white in contrast to his orange skull, shaved smooth and painted with disinfectant.
Snaresbrook looked relaxed, efficient. Discussing the approaching operation with the anesthesiologist and the nurses, then supervising the careful placement of the projector. “Here is where I am going to work,” she said, tapping the hologram screen. “And this is where you are going to cut.”
She touched the outlined area that she had hiked onto the plate, checking once again that the opening would be large enough to reveal the entire area of injury, large enough for her to work within. Nodding with satisfaction, she projected the holograph onto Brian’s skull and watched while the resident painted the lines on the skin, following those of the image, matching it exactly. When he was finished more drapes were attached to the surrounding skin until only the area of the operation remained. Snaresbrook went out to scrub: the resident began the hour-long procedure to open the skull.
Luckily Benicoff had seen enough other surgical procedures not to be put off. He was still amazed at all the force that is needed to penetrate the tough skin, muscle and bone that armor the brain. First a scalpel was used to cut through to the bone; the scalp, spreading apart as it was severed, was then sewn to the surrounding cloth. After the bleeding arteries were sealed shut with an electric cautery it was time to penetrate the bone.
The resident drilled holes by hand, with a polished metal brace and bit. Bits of skull, like wood shavings, were cleared away by the nurse. It was hard work and the surgeon was sweating, had to lean back so that the perspiration could be dabbed from his forehead. Once the holes were through the bone he enlarged them with a different tool. The final step was to use the motorized craniotome, fitted with a bone-cutting extension, to connect the holes. After this had been done he worked the flat metal flap elevator between skull and brain to slowly pry up and free the piece of skull; a nurse wrapped the piece of bone in cloth and put it into an antibiotic solution.
Now Snaresbrook could begin. She entered the O.R., her scrubbed-clean hands held up at eye level, poked her arms through the sleeves of the sterile gown, slipped on the rubber gloves. The instrument table was rolled into position, the tools on it carefully laid out by the scrub nurse. The scalpels, retractors, needles, nerve hook, dozens of scissors and tweezers, all the battery of equipment needed for the penetration of the brain itself.
“Dural scissors,” Snaresbrook said, holding out her hand, then bent to cut open the outer covering of the brain. Once it had been exposed to the air, automatic sprays kept it moist.
Benicoff, standing against the wall, could not see the details now; was just as glad. It was the final stage that mattered, when they rolled over the odd-looking machine that was now pushed back against the wall. A metal box, with a screen, controls and a keyboard, as well as two shining arms that rose from the top. These ended in multibranching fingers that grew smaller and smaller in diameter, each tipped with a glistening fuzziness. This was caused by the fact that the sixteen thousand microscopic fingertips at the branching ends of the instrument were actually too small to be seen by the human eye. The multibranching manipulator had been developing for only a decade. Unpowered now, the fingers hung in limp bundles like a metallic weeping willow.
It took the surgeon two hours, working with the large microscope, scalpels and cautery, to clean the track of destruction, a slow and precise debridement of the lesion left by the bullet.
“Now we repair,” she said, straightening up and pointing to the manipulator. Like everything else in the O.R. it was on wheels; it was pushed into position. When it was switched on, the fingers stirred and rose, descended again under her control into the brain of its designer.
Snaresbrook’s skin was gray and there were black smears of fatigue under her eyes. She sipped her coffee and sighed.
“I admire your stamina, Doctor,” Benicoff said. “My feet hurt just from standing there and watching. Do all brain operations last that long?”
“Most of them. But this one was particularly difficult because I had to insert and fix those microchips into place. It was like combining surgery with solving a jigsaw puzzle, since every one of those PNEPs had a different shape in order to perfectly contact the surface of brain.”
“I saw that. What do they do?”
“They are PNEP film chips — programmable neural electron pathway devices. I have applied them to every injured surface of his brain. They will make connections to the cutoff nerve fibers that end at those surfaces, that control the regrowth of Brian’s nerves. They have been under development for years and have been thoroughly tested in animals. These chips have also been wonderfully effective in repairing human spinal injuries. But until now they have never been used inside human brains, except in a few small experiments. I would certainly not be using them if there were any good alternative.”
“What will happen next?”
“The chips are coated with living embryonic human nerve cells. What they should do is grow and provide physical connections from the end of each of the severed nerves to at least one of the quantum transistor gates on the surface of the PNEP. That process of growth should already have started, and will continue for the next few days.”
“As soon as those new nerve fibers grow in, I’ll start to program the PNEP chips. Each chip has enough switching capacity to take every nerve signal that comes in from any part of the brain and route it out along an appropriate nerve fiber that goes to another location in the brain.”
“But how could you know exactly where to send it?”
“That is precisely the problem. We will be dealing with several hundred million different nerves — and we don’t know now where any of them should go. The first stage will be to follow Brian’s brain’s anatomy. This should give us a crudely approximate map of where most of those fibers should go. Not enough to support fine-grained thought but enough, I hope, to restore a minimal level of functional recovery, despite all the errors in wiring. For example, if the motor area of his brain sends a signal to move, then some muscle should move, if not the right one. So we’ll have a response that later could be relearned or retrained. I have implanted a connector in Brian’s skin, just about here.” Erin touched the back of her neck just above her collar. “The computer communicates by inserting the microscopic ends of fiber-optic cables that communicate with each of the PNEP chips inside. Then we can use the external computer to do the search — to find opposite areas relating to the same memories or concepts. Once these are found, the computer can send signals to establish electronic pathways inside, between the appropriate PNEPs. Each separate chip is like an old-fashioned telephone exchange where one phone was plugged through a board to another phone. I’ll start using the neural telephone exchange inside Brian’s brain to reestablish the severed connections.”