I, Robot To Protect

places in between.” He glanced around at each of them in turn, as if reading their futures. “You will wind up working with examples of each type of physician, and most of them will be excellent doctors in their own way. Despite protocols and studies, no two doctors approach a patient exactly the same way, and that’s not a bad thing.”

Stony leaned backward, against the desk again. “All of you will develop a style, and it might change over time. Some of the R-3s, and most of the attendings, believe their way is the only right way. I’m not one of them. I’m more of a hands-off leader. You can’t learn responsibility, or to think for yourselves, if I’m always telling you what to do. These are your patients. If you want to try something different, go ahead. If it’s outlandish, stupid, or dangerous, I guarantee the nurses will run to me before implementing it.”

Susan saw her peers’ heads bobbing in agreement and found herself doing the same thing. With long-term patients, especially children, nurses often became every bit as attached and protective as the parents.

“You’ve probably heard the pediatric inpatient unit is the hardest psych unit, and it is. But it’s also a great place to try new approaches. It takes a serious situation to land a child here, and conventional medicine has already failed them. You’re unlikely to make things worse, and who knows? You might have a brilliant breakthrough that doctors with more rigid ideas have missed.”

Stony looked around the group. “If you’re uncomfortable with the sink-or-swim approach, Clamhead and I are here to help you with any problems or questions. Any. You’re here to treat the patients. We’re here to keep you, and the hospital, out of trouble. So, if you feel you need some backup, or just some advice from someone more experienced, come to Clammy or me.”

Stony reached into a cubby and removed a baseball cap, which he held upside down by the bill. “He called me your peerless leader, but I’m just a resident, like you. Every day, we will round with the real man in charge, our attending physician. He will want to hear about your patients and their progress, and he’s the one you have to impress. Tomorrow, he’ll expect you to give a detailed presentation of each of your patients, so read your charts. After that, he’ll just want to hear what’s new and different. We were lucky enough to get assigned the head of Psychiatry himself, Dr. Kevin Bainbridge.”

Susan’s blood ran cold.

Monk spoke their realization aloud. “Isn’t he the older man who talked to us in the auditorium?”

Kendall hauled out his gravelly old man Bainbridge imitation. “And by working only twelve-hour days, we missed half the good cases.”

The R-1s snickered, and even Stony smiled broadly. “That’s the one. He’s a bit intense, but he’s an excellent diagnostician.” He tapped the Vox on his wrist. “He’s not a fan of devices, though. He prefers you try to memorize every bit of medical knowledge and have it on the tip of your tongue when he asks a question. But he’s also slow enough, you can usually sneak the answer off Vox with a bit of distraction. Just be on time, don’t try to slip out early, look busy even when you’re not, and you’re fine. He growls sometimes, but there’s not a mean bone in the old coot’s body.”

Stony shook the cap, then held it out toward Nevaeh. “I’ve separated patients into reasonably balanced groups of four. Whichever bunch you pick is yours.”

Each of the R-1s took out a torn sheet of paper with Stony’s sloppy writing on it. Susan read hers:

1. Monterey Zdrazil: 12-yo white female:

traumatic mute

x 6 years

2. Dallas “Diesel” Moore: 10-yo black male:

psychotic depression

,

attention deficit hyperactivity

,

oppositional defiant disorder

3. Sharicka Anson: 4-yo mixed female:

juvenile conduct disorder

4. Starling Woodruff: 13-yo white female:

dementia

status post aneurysm repair

Susan stared at the paper, a strange mixture of emotions washing over her: excitement, fear, and uncertainty blending into a cacophonous mix that held her spellbound. My patients, my patients. The awesome responsibility for those children lay in her inexperienced hands. They deserved the best treatment she could devise, the wisest decisions; yet Susan wondered what she could add that previous doctors, more veteran and capable clinicians, had not already considered, discarded, or tried.

Doubts descended upon Susan an instant later. What if I make a mistake? What if I say the wrong thing and further damage their delicate psyches? What if I take away the only medication allowing them to function or add one that causes permanent harm? What if I kill someone?

Susan glanced at her companions. All of them stared at their own small pieces of paper, their expressions sober; and she imagined the same painful insecurities bombarded each of them. Doctors throughout history had contemplated their place in the world, had worried about these same issues, had realized the delicate balance of life, health, and sanity in those they served. Unlike those in other professions, doctors could not afford to have a bad day. A physician who got lazy might make a fatal mistake. Vox and other fast, portable computer-links helped; but the human behind it still had to know enough to put the pieces together, to calculate the direction of thought, and to access the proper information.

No wonder John Calvin considered his work boring. No matter how skillfully a robot performed its job, no matter how magnificent its shape or precise its “fingers,” no matter how much information filled its electronic circuitry, it was only as smart as the person who programmed it. At least, that was how Susan Calvin figured it. A computer might spit out the facts, but only a human could read the subtle signs that altered the course of consideration. One word, one small detail, one momentary thought could change what she chose to research and, therefore, the course of a human life forever.

Apparently recalling the overwhelming grandeur of that “first patient” moment, Stony waited a long time before speaking again. He held out his cap once more, this time with fresh pieces of torn paper. Wrapped in her thoughts, Susan had not even noticed him preparing them. “One of you has to take in-house call tonight,” the R-3 said. “I’ve numbered the papers. Whoever gets ‘one’ is on tonight, ‘two’ tomorrow, et cetera. Clamhead gets night six by default.”

Each of the R-1s drew a new piece of paper. Susan opened hers carefully to display the number one.

Chapter 3

Head whirling with the details of the unit and her on-call duties, Susan Calvin sought out a private corner to review patient charts and explore diagnoses and data. All of the residents on the Pediatric Inpatient Psychiatry Unit had stayed late preparing for the next morning’s rounds. They had eaten dinner as a group, where Stony Lipschitz and Clayton Slaubaugh discussed helpful tips, tricks, and ideas for surviving the R-1 year. When the conversation turned to on-call suggestions, given that she had drawn the first night, Susan paid close attention.

And now, palm-pross in hand, she searched for the hidden charting room on the first floor that Stony had mentioned as a favorite on-call hideaway. She found it tucked away between an insulated staircase and the central processing area for information storage. She pushed open the door to reveal a room larger than she had expected. Modular shelving stood in rows, covered with labeled, opaque plastic boxes and well-worn textbooks that seemed to encompass every specialty. To her right, the area opened up into a cozy nook, with two overstuffed couches, three unmatched chairs, and a central table set at perfect height for palm-prosses. Apparently alone, Susan flopped down on one of the couches and placed her little portable on the table.

From her pocket, Susan pulled out the piece of paper with her patients’ information. What next? She considered meeting the children first, before the information in their charts prejudiced her; but the idea seemed foolish. The children had lives and diagnoses that long preceded Susan’s drawing their names from Stony’s baseball cap. They did not just appear from thin air because she needed patients. Though children,