I, Robot To Protect

vocabulary, it was apparent he did not lack for attention, money, or education.

“If I ever threw up, I think I’d be hungry doing it.”

“Gross.” Susan managed to chat even as she mulled the pertinent.

“You’ve never thrown up?”

“I once broke into the freezer and ate three boxes of Popsicles, two things of ice cream, a cake, a loaf of French bread, and a package of shredded cheese in less than five minutes. They said I should be puking all over the place, but they couldn’t even make me.” Diesel seemed almost proud of the accomplishment. “I don’t throw up.”

Susan suspected if she had eaten all that, she would be in a coma. “Wow.” She could think of nothing else to say.

Diesel loosed a raw, honest belly laugh so fun and contagious Susan could not help joining him.

She finally managed, “I’ll bet you could eat Tokyo.”

Diesel laughed again, and Susan realized she loved that sound. She bet people did silly things just to elicit it.

Having stopped his nosebleed, Diesel turned to wiping blood, snot, and tears from his face.

Susan could not help wondering if someone took pleasure in Diesel’s overeating. Perhaps he or she encouraged it, either intentionally or subconsciously. More than one person might be to blame. Maybe even me. She felt a sudden pang of guilt at having slipped him a candy. She wondered how many people had tried to win his trust that way and vowed she would never do so again. “So, how’d you get the nickname Diesel?”

Diesel actually smiled. “Football. I plow through the other line like an old-fashioned diesel truck or train.”

“You’re a lineman?” Susan guessed. She hoped her ignorance of football did not show too much. When she took her pediatrics rotation, she remembered one of the residents telling her the smartest thing a pediatrician could do was to keep up with the trends in gaming, music, and play. Nothing impressed a child more than a doctor who knew the hip shows, the names of the newest characters, or could keep up with him in a game of I-Star.

“Nose guard,” Diesel said. “And center on offense. Right smack dab in the middle of the line.”

Susan looked him over. Though notably short for his age, he was built like a tank. “So, I bet you love the Giants.”

Diesel wrinkled his nose. “I like college. Longhorns.”

“Texas?” Susan asked.

Diesel looked at her as if she had gone mad. “No, the Pennsylvania Longhorns.”

“Pennsylvania?” Susan realized he was teasing her. “Funny.” Of course Texas, you moron. “What do you like about them?”

“For one thing, they’re good. Ten and oh last season. For another, they send a lot of guys to the pros. Especially quarterbacks.”

Susan made a mental note to study up on football, especially the Longhorns. “You think you’re calm enough to go back out there?”

Diesel sighed. “And apologize. Yeah, yeah. I know the drill.”

“Good, because I have to get back to rounds.” Susan looked around the room at the blood-splashed, padded walls. “And someone is going to have to clean up in here.”

Diesel followed Susan’s gaze as if noticing the mess for the first time. Only then, he studied himself. He looked as if he had gone ten rounds in an ultimate fighting ring.

Susan rose, walked to the door, and knocked politely.

It swung open immediately.

“We’re ready to come out,” she announced to the waiting nurse, who gave her a gaze that spoke volumes. Susan had a feeling she was about to face a punishment worse than Diesel’s own.

To her surprise, she did not care.

Chapter 5

When rounds restarted, they naturally focused on Diesel. More confident after their conversation, Susan started again. “Dallas ‘Diesel’ Moore is a ten-year-old black male who has been diagnosed with ADHD, oppositional defiant disorder, severe depression, obsessive-compulsive tendencies, and morbid obesity.” As Susan glanced around the office, she could see the other residents looked more relaxed than they previously did. The hour off had given them more time to meet their patients and review the charts, while she had entombed herself with Diesel. Stony had changed into the blue corridor scrubs that served two purposes. First, they announced their lack of sterility, that the wearer was not headed for the operating room. Second, their bright color was a reminder not to wear them outside of the hospital.

Dr. Bainbridge studied Susan with a bemused expression. “You’re about to tell us you don’t agree with those diagnoses, aren’t you, Susan?” He already had her pegged from her presentation of Starling Woodruff. Worse, he was right.

“Well, actually, sir . . .” Susan paused, uncertain how to continue. She had not expected to get to this point so quickly and had not fully organized her thoughts on the matter. “I think it’s possible he has an undiagnosed syndrome, yes.”

Stony leaned toward her. “What are you thinking?” Less jaded than Bainbridge, he actually seemed eager to hear her theories.

“Well . . .” Susan tried to work through her thoughts as she presented them. A well-reasoned argument would speak volumes over an educated guess. “Obesity has three main causes: familial, psychiatric, and physiological. The first one is the most common, and also the most treatable. The first and second types cover some ninety-eight percent of all cases of obesity.”

“You think Diesel has the third,” Bainbridge said predictably.

Susan did not wish to couch her ideas as speculation or intuition. Those would not fly in a scientific institution like Manhattan Hasbro. “I think there’s a reasonable amount of evidence to come to that conclusion.”

“Evidence.” Bainbridge made a “come here” motion Susan took to mean he wanted more information, not for her to stand beside him.

“Neither his parents nor his siblings are obese. While there is some history of a maternal uncle who was, that’s not strong evidence for familial obesity.” Susan supposed she had not needed to present those details. That Diesel resided in the PIPU proved his previous physicians believed in a psychiatric basis for his problems, not familial or physiological. “Diesel hasn’t responded to any of the standard antiobesity drugs.” A plethora of those had emerged in the early part of the current decade, when medical research dollars had been restored after nearly two decades of attempts to balance the national and state budgets by channeling that money into medical care for the indigent. The antiobesity drugs worked for anyone with even a modicum of self-control and the desire to attain a healthy weight.

Bainbridge made a more severe gesture, as if to get across to Susan they had a limited amount of time.

“Diesel was underweight until about age two and a half, when he developed hyperphagia and put on enormous amounts of weight quite suddenly. That’s remarkably early for nearly all the psychiatric causes. He packed on the weight despite having ADHD, with an emphasis on the hyperactivity part in his case. He started walking very late. Intelligence testing reveals an enormous backward split between performance and verbal aptitude. Most children with learning problems do worse on the verbal parts, but Diesel has a profound vocabulary and the ability to use it. He has much more trouble with dexterity: drawing, writing, shoe tying. Also, he’s short for both his age and his family history, with surprisingly long arms.”

Monk Peterson blurted out, “Prader-Willi syndrome.”

It was the obvious diagnosis. Though rare, it was still the most common obesity syndrome. Even at the turn of the twenty-first century, most children with Prader-Willi died before they reached adulthood. Driven to eat, they would choke to death, poison themselves with spoiled or uncooked foods, or rupture their stomachs. Those who