Thread by @TheRealDoctorT

There once was an oath that all doctors had to take. Something about doing the right thing, and trying not to hurt anyone.

That was long ago, in the 21st century, before the machines. My great-grandfather took that oath.

Machines don’t need oaths.

But I’m still human. 1/

The first thing that hits me is the smell. Coming to the Reach is always a stark reminder of just how impoverished some of us are.

Progress always leaves people behind. The question is who gets to choose who gets left behind and who rises.

I’m here to make a house call. 2/

I’m a physician, although in the 22nd century that phrase has lost most of its meaning.

We always thought people would want the human touch in healing.

But once machines were hitting 100% in their diagnostic accuracy and gene splicing and nanotech were viable, it was over. 3/

MD now stands for “Medical Device,” and refers to any of the hundreds of cyborg Med-Techs on the market.

Immortality is in your grasp if you can afford it.

Human physicians never see patients now. They just sit in control rooms, overseeing armies of Med-Techs.

Except me. 4/

Me, and a few others like me, are the last of a dying breed.

We offer medicine to those who can’t afford an MD. Our society corporatized medicine long ago, except for us few, making our last stand.

Derisively, our colleagues in the rich cities call us “hand-holders.” 5/

“Hand-holders” because we don’t have the tech to fix most problems. Not like they do.

But we still have skills, from a time long before the first machines performed their first solo surgeries.

So here I am, in the sprawling slums on the edge of the City, known as the Reach. 6/

My nano-mask is filtering the air I breath, invisible over my face, and yet it can’t get rid of the stench.

The smell of rot and decay hits me like a sledgehammer. The synthetic and sanitized City doesn’t have smells like these.

I walk alone, except for Bernie beside me. 7/

MD-BRN1E786, or “Bernie” for short, is a decommissioned second generation Med-Tech cyborg, virtually obsolete.

I got him on the black market. He provides some medical help, and more importantly, security.

There are many anti-medicine cults out there, and most are violent. 8/

We walk together, in silence, Bernie’s motors whir quietly as he takes one plodding step after another beside me.

He’s painted white and red, with “MEDTECH” stenciled helpfully across his chest.

“Almost there,” I say out loud.

“Yes, 132 meters,” Bernie’s voice is chirpy. 9/

The dwelling we enter is a ramshackle affair, typical of the Reach. With flimsy walls leaning against each other and a dingy bulb swaying, lighting everything in a sickly glow.

The patient is a young girl, dressed in rags stitched together, lying motionless on the floor. 10/

Her father is kneeling beside her, and looks up at me with a hollow gaze, bereft of hope.

I know better than to ask where the mother is. This is the Reach, after all. If you aren’t present, you’re in the past.

I kneel down and touch the girl’s forehead. She’s burning up. 11/

A quick glance at the floor next to her reveals empty bottles of “medicine.” Most of them are scams, or diluted so much they’re practically useless. Snake oil salesmen are rampant in the Reach, preying on the vulnerable.

This girl is dying.

I take out my instruments. 12/

My great-grandfather was a physician, a long time ago. When medicine was still practiced by humans. He was a kidney doctor, an idea that seems quaint now.

I don’t really know much about him, but I have his stethoscope, passed down to me. A relic.

I press it to the girl. 13/

Through the earpieces, I hear the crackling of fluid in the lungs. The thundering of her heart driven to a fury by her fevers and dilating vasculature.

A raging storm.

Bernie leans over her, next to me, his voice unreasonably cheerful, “Alert! Impending systems collapse!” 14/

My options are limited (I’m a hand-holder, after all). But I retrofitted Bernie a few months ago. It’s risky, but I think he’s the only chance the girl has.

I take her father aside and explain.

His face shows no emotion.

I understand.

How much more can one heart break? 15/

I enter the authorization codes on Bernie’s interface, and leave the dwelling with the father, to give the cyborg space to initiate his “OR Protocol.”

There’s a brief flash of flickering blue light as Bernie sterilizes the room.

As he leans over the girl, I close the door. 16/

I stand outside the dwelling with the girl’s father, breathing in the heavy smog, saying nothing.

He looks down at his feet, silent.

I want to ask him his story. How did he end up here? Was he born into this, like most of us, the end result of an unbalanced equation? 17/

As I’m lost in my thoughts, I feel a small tug on my heavy traveling cloak.

Glancing down I see a child squatting in the dust by my feet. He says nothing, but holds his hands up, cupped together.

I have nothing to give him.

With his each breath I see his emaciated ribs. 18/

I know in the City, everyone has healthcare, and everyone has food.

I could try to take him to the City, beg for help. But those gates were closed to him the day he was born a “natural” birth, without the genetic coding that would gift him entrance.

“I’m sorry,” I say. 19/

The child looks up at me one last time, then vanishes into the dark night.

To join the many faces I haven’t helped, that gaze upon me in silent condemnation every time I close my eyes.

Hand-holder, they say, why didn’t you hold our hands?

“I’m sorry,” I say, over and over. 20/

The hours pass. Finally the father speaks, “Is she gonna make it?”

I sigh, “She’s in better hands with the Med-Tech than with me.”

He nods, then gestures to a tiny disc I wear as a pendant around my neck.

“What’s that?”

“It’s a Codex. It’s called the Hippocratic Oath.” 21/

“What’s the Hippocratic Oath?”

“I don’t know, it belonged to my great-grandfather. The file’s damaged, I can’t read it.”

“So why do you keep it?”

“Good luck, I guess.”

Bernie emerges from the house. Cheerful as always, he chirps “Procedure success! Patient resting.” 22/

A light enters the father’s eyes, for the first time, he smiles, “Thank you. I don’t have much to pay you. But I can fix that Codex.”

I smile in return, taking off the pendant and handing it to him, “Thank you.”

The truth is no hand-holder ever gets paid, not with money. 23/

The father disappears into his home, and I’m left running Bernie’s post-op analytics.

After a few minutes, the father steps out again, handing me my Codex back.

“It wasn’t broken, just scratched.”

I nod, “Thanks.”

Then I read it for the first time.

The Hippocratic Oath. 24/

There once was an oath that all doctors had to take.

An oath, reaching across the centuries, reminding me.

Kindling a fire.

Why we go to those who suffer, and why we hold their hands.

I walk with Bernie, away from the Reach, and into the lonely darkness of the endless night.