standards. But those who destroyed their health still died young, by comparison with the elite. If you wanted to destroy your health, that was your individual prerogative. Once you were thoroughly wrecked, the polity would encourage you to die.
It was a ruthless system, but it had been invented by people who had survived two decades of devastating general plagues. After the plagues everything had become different, in much the way that everything was different after a world war. The experience of massive dieback, of septic terror and emptied cities, had permanently removed the culture’s squeamishness. Some people died and some didn’t. Those who took steps to fight death would be methodically rewarded, and those who acted like fools would be buried with the rest.
There were, of course, some people who morally disagreed with the entire idea of technologized life extension. Their moral decision was respected and they were perfectly free to drop dead.
Mia’s choice of upgrade was known as Neo-Telomeric Dissipative Cellular Detoxification, or NTDCD. It was a very radical treatment that was very little tried and very expensive. Mia knew a great deal about NTDCD, because she was a professional medical economist. She qualified for it because she had been very careful. She chose to take it because it promised her the world, and she was in a mood to gamble.
Mia put 90 percent of her entire financial worth into a thirty-year hock to support continued research development and maintenance in NTDCD.
NTDCD was considered a particularly promising avenue of development. Medically speaking it was extremely difficult to perform. In medical upgrades, the promise and the difficulty were almost always tightly linked. Qualifying for such a lavish upgrade required an intimidating level of personal sacrifice. Patients qualifying for this treatment would have all their funds reinvested in maintenance and R&D. The funds would be returned handsomely if the avenue of upgrade paid off. If it didn’t pay off, then the donor would probably be dead before the funds came back into liquidity.
Losing years of control over one’s money was a very stiff price, but it was not the worst of it. The loss of money did not sting the way it once had stung. Money was no longer what money once had been. The polity had never been a free-market society. People dying of plague were not much impressed by free markets. The polity was a plague-panicked allocation society in which the whip hand of coercive power was held by smiling and stouthearted medical rescue personnel. And by social workers. And by very nice old people.
Mia’s forthcoming ordeal had been plotted in meticulous detail.
The first major trick was to stop eating. Her entire digestive tract would be clogged with a sterilizing putty.
The second trick was to stop breathing. Her lungs would be filled with a sterilizing oxygenating silicone fluid. These two processes would immediately kill off most of the body’s internal bacteria.
The third trick was to stop thinking. The blood-brain barrier would be scrubbed free from the capillaries of her skull and the cerebrospinal fluid would be replaced with a sterilizing saline fluid. Profound unconsciousness resulted.
The next trick, quite an advanced one, was to stop being quite so rigorously multicellular. Mia would be fetally submerged in a gelatinous tank of support fluids. Her internal metabolic needs would be supplied through a newly attached umbilical. The hair and the skin had to go. The bloodstream and lymphatic system would be opened to the support vat for the remaining course of the treatment. Red blood cell production would be shut down and the plasma replaced by a straw-colored fluid toxic to any cell which was not mammalian. All commensal organisms in the human body had to be destroyed.
Once the bacteria were thoroughly and utterly annihilated, the hunt would commence for the viruses and prions. It would take about a week to tag and destroy the genetic menagerie of imbedded human viruses. It would take about three weeks to destroy the vast metabolic cosmos of once-unsuspected human prions. These rogue proteins would mostly be shivered apart through magnetic resonance techniques.
Once this much had been accomplished, Mia would become an entirely antiseptic organism, a floating amniotic gel culture.
The DNA treatments could then commence. Intercellular repair required a radical loosening of the intracellular bonds so as to facilitate medical access through the cell surfaces of the corpus as a whole. The skinless body would partially melt into the permeating substance of the support gel. The fluidized body would puff up to two and a half times its original volume.
At this point, flexible plastic tubing could worm its way into the corpus. The skinless, bloated, and neotenically fetalized patient, riddled with piercings, would resemble an ivory Chinese doll depicting acupuncture sites.
Specific procedures would take place in the marrow of the femurs, the spine, the ventricles of the brain, the sinuses, and other deeply interiorized spaces. Toxic buildups and precipitated mineralized bodies in the arteries, gall bladder, and lymphatic system—especially the metabolically crucial coacervate deposits in the pineal gland—would be reduced or eliminated.
On a genetic level, Mia’s cells would be studied for cumulative replication errors. Precancerous and/ or junk- burdened cells would be tagged with artificial antibodies and made the targets for programmed apoptosis. Some 15 percent of the body’s cells would be killed during this period and removed by migratory artificial phagocytes. This process alone would require over a month.
The surviving cells would then be treated to a neotelomeric extension. The telomeric ends of the chromosomes were a genetic clock, wearing thin as the human cell approached its Hayflick limit of allowable replications. New telomeric material would be spliced onto the chromosomes, tricking the aging cells into believing in the fiction of their own youth. The cells would then begin replicating furiously in the nutrient broth, and the wasted body would regain its 15 percent of lost body mass.
The extremely rapid growth within a buoyant support vat was closely akin to fetal growth. It was to be expected that there would be certain developmental abnormalities, especially in the adult joints and musculature. This was an expected price for marination in a fountain of youth.
The recovery process posed its own difficulties. The skin had to be regrown, commensal bacteria had to be gently reintroduced, the interior fluids had to be painstakingly replaced with natural substances. It was not entirely certain when the patient would regain consciousness, or what that state of consciousness might entail in the way of somatic sensation.
“I believe what you’re trying to say is that this will be extremely painful,” said Mia.
Her counselor was Dr. Rosenfeld, a sharp-faced, brilliantly preserved clinician with two dark wings of hair. Dr. Rosenfeld was a man of her own age. He had taken pains to inform Mia that he still considered himself fully bound by the Hippocratic oath he had taken some seventy years previously. In Dr. Rosenfeld’s opinion, there were a few hundred million Johnny-come-lately medical technicians, and then there were actual doctors. Dr. Rosenfeld was a traditional, actual doctor. He would never allow any patient in his clinical charge to enter such a profoundly transformative state without a great deal of previous bedside manner.
“The term ‘pain,’ ” said Dr. Rosenfeld, “is a relic of folk models of mental function. We have to draw a distinction between the higher-level subjective experience of pain, and the basal-level sequence of somatic nerve transmissions. All of these practices in NTDCD would be extremely painful to a fully operational brain, but your brain is going to be considerably less than operational. Have you heard of Korsakoff’s syndrome?”
“Yes, I have.”
“Of course, in modern practice we recognize thirty-one distinct substates of Korsakoff’s.… You will be placed into one of those amnesiac modes during the procedure. It’s like a virtuality, but it’s a profound healing space. Extreme states of so-called pain may flash through certain preconscious processing centers involved in working memory, but those experiences will simply not be recorded through any normal channels. We’ll be doing constant emission scanning, and I can guarantee you that whatever preconscious events may occur will never be consciously accessible, either during the time of treatment or afterward.”
“So I’ll feel it, but I won’t feel it.”
“That’s semantics again. ‘Feel’ is a very broad and inexact folk term. So is the term ‘I,’ for that matter. Maybe we can say that there will be feelings, but there won’t be any ‘I’ to have them.” Dr. Rosenfeld smiled. “Ontology is fascinating, isn’t it? I hope we can work through this discussion without invoking Rene Descartes.”
“I’ve read Rene Descartes.”
“The old fellow was remarkably prescient about the pineal gland.” Dr. Rosenfeld spread his long-fingered, tapered, well-kept hands. “NTDCD is no mere maintenance procedure. This is the closest that humankind has yet
