The Death of Amy Long

It was quiet and cold in the waiting room. We’d been outside in the humidity for so long that the air conditioning left me on the verge of shivering. I sat, waiting for the minutes tick away with nothing to do but think about the trip.

I was trying to remember how long it had been since I’d actually traveled in the real world. I couldn’t place it—twelve years was my best guess. As a young doctor, I vacationed, went to conferences, visited friends and colleagues, and flew to dozens of hospitals to harvest organs. But those days were gone so fast that no one had time to realize what was happening.

Neural adjunct technology had come so far since the early days of implants for Parkinson’s and epilepsy. It eliminated any need for travel. Now we didn’t even need to physically go to work anymore. Never would I have pictured a day when a doctor wasn’t needed at the hospital. But here I was, helping to bring that very thing to Indonesia.

And that was Amy’s doing—her vision.

From the time I’d first met her as a med student, Amy’s goal was to advance the logistics of automated medicine. She saw a widening gap, as wealthy urban populations benefitted from the vast gifts of modern technology, while the poorer, rural peoples were getting left behind by the rushing wave of technical advancement.

Amy feared a future where the human race diverged. Those with access to gene therapy and neural adjuncts would continue to grow and develop, creating a more integrated, more advanced society in a second-layer reality. But those without access to these miracles of modern technology would stagnate, becoming increasingly marginalized, and even relegated to second-class status by the majority urban populace.

She believed that remote automation of medicine could help bridge that gap. And recent advancements had made her vision more attainable. It was time to start bringing it to the rest of the world.

She asked me personally, as an old friend and long-standing member.

“Indonesia?” I said. “Have you gone mad, Amy? It’s dangerous in those rural areas. Not only am I not going, I don’t think you should go either. Does Davis know about this?”

“Davis is supportive of whatever I do, Earl.”

“So you haven’t told him yet, then?”

“Not specifically,” she said. “But that doesn’t matter. He’s always behind me.”

Amy was headstrong. She kept planning and persisting: years before the technology was there, she was scheduling deployment of it, struggling to find ways to get it into as many third-world areas as possible. She raised funding, built support networks, and recruited other doctors to help take up the cause.

I watched. I was too engrossed in my day-to-day routine in Boston to get involved with her campaign.

At times I had to remind her, “Amy, you have obligations here too. Look after your patients first, then you can devote time to your side projects.”

“It’s not a side project,” she would fire back at me. “People in Boston get the best care in the world, Earl. These people get none.”

That’s where her real interest was. And there’s no doubt her passion brought the field along faster than it would’ve moved without her. If anyone wanted to know about remote medicine, eventually they had to talk to Amy Long.

 She began her own foundation dedicated to directing medical research funding toward her goals—a bit like a pirate charity, consulting with other foundations, and convincing them to invest in certain types of research. She also published a media guide and held conferences.

Her work supported the proliferation of larger gene labs, so that the American model was already built around remote medicine. That way, the infrastructure was already proven. There wouldn’t be any need to design new infrastructure when the time came: it would just be a matter of copying the existing system.

Before we knew it, gene labs were taking swabs by courier and returning individualized gene-based nasal sprays within days. Amy had a huge hand in making all that happen.

When scanning and diagnostic tools became small enough, Amy was the first to develop methodologies for putting them into the hands of patients directly. The smaller and more user-friendly a device became, the easier it was to eliminate the need for patients to come to the hospital. At first, it was via video conference and glasses; then, it was the early virtual reality programming, which gave way to full-immersion second-layer programming. Her hand was there guiding the helm.

“The final piece,” she used to tell me, “will come when neural adjunct placement can be done remotely or robotically. Then we can get it to everyone.”

A year before we left for Indonesia, Amy started planning. She had outlines for a system that would encompass the entire island of Borneo.

“Cal Tech and Johns Hopkins both have robotic surgical systems producing comparable outcomes, Earl,” she said, when I asked her if she was jumping the gun a bit.

“But that’s under the direct scrutiny and supervision of some of the world’s best trained surgeons.”

“That’s the thing you’ve never seemed to understand,” Amy answered. “It doesn’t matter anymore whether the best trained surgeons are sitting outside the room pushing the buttons. They can be halfway around the world and be just as effective. And most of the time, they won’t even be needed. By the time we implement this, the robots are going to be better surgeons anyway. Our time is up.”

The more I looked at it, the more I came to understand just how right Amy was. I wasn’t sure whether it was Davis’s influence that allowed her to see things so clearly, but she always seemed to understand every nuance and every curve in the path toward medicine becoming a technological art.

She saw the next step just as clearly. “From here on out,” she said, “it gets political.”

That’s why she chose Indonesia. It was a massive country with huge gaps in wealth and technology; the logistical handicap of being geographically divided; and a long history of managing so many disparate groups of people under a system that had to work for everybody.

Medical infrastructure was so diverse that one scarcely knew where to begin. But Amy did. She started at the top, with the highest-ranking government ministers, laying out her vision for a sound medical infrastructure for every Indonesian citizen. She’d already done the math: the cost of bringing rural people into the system would be offset by the money they’d save treating urban populations remotely. And Amy was bringing most of the money from charitable contributions.

“How is the government going to say no when Doctors Without Borders offers to serve up a modern medical infrastructure on a silver platter, Earl? It’s essentially free to them, and they’ll look like heroes.”

The closer her vision came to reality, the harder it became to argue against it.

I still had reservations, though. “Some of these rural areas are going to have pockets of people who object to western medicine,” I said to Amy while we were planning the trip. “Even in America there are still groups of luddites who resist gene therapy and neural adjuncts. What makes you think rural tribesmen who live off the land are going to embrace these things?”

“People only fear technology until they embrace it, Earl,” she answered. “People in America only objected to implantation until it became obvious that it was safe and made their lives easier. Now people don’t have to leave the house to go to work; they don’t have to run errands; they don’t need to go out to socialize; and nobody wastes any time travelling any longer.

“Think about cancer,” she added. “A lot of people were wary of gene therapy and medical nanotechnology at first. People didn’t like the idea of having millions of tiny robots floating around their bloodstream. But as soon as the doctor came in with a diagnosis of brain cancer, attitudes changed.

“People had the option to cling to the old ways of fighting the disease—burning their insides with radiation, shrinking malignant growth with rounds of nauseous chemotherapy, only to die of cancer within a year anyway. How many people still choose that path? The option modern medicine has given us is to take a pill with a few million bots programmed to destroy cancer cells, and the disease is gone in an afternoon. Everyone takes the pill.

“It’s the same with villagers, Earl. They’re people like we are. Do you honestly think they’re going to let their mothers die if the other option is to take them to the clinic for an easy and full recovery? They don’t want to be sick, and they don’t want to die any more than we do.”

I tried my best to argue against her. “Some of these people though, Amy, they’re rural people with very little experience of modern technology. They shun outsiders and just want to be left alone. Are you seriously going to go to Papua to try to explain the benefits of neural adjuncts to an aboriginal with a bone in his nose?”

“Well, why not?” she said. “What’s a microscopic neural adjunct and a few nanobots to a person who’s willing to stick a bone through his nose?”

So she put Papua on our itinerary too. Borneo was the goal of the pilot project, but she thought it would be good to go to Papua to gather information—to see how the remotest of people would respond to the technology. Would they be hostile? Indifferent? Or, would they use it, as Amy suspected?

By the time we left for Indonesia, the pilot project had already taken on impressive shape. Borneo would have a central hub, connected to individual outlying clinics. Each clinic was the size of a small doctor’s office and was capable of serving a community of up to thirty-thousand people if scheduling was at peak efficiency.

They all had a macrorobotic surgical suite capable of almost any procedure imaginable, including neural implantation. Diagnostic tools and scanners were automated, and the genetic screening and treatment would be done remotely through one of the large gene labs in Jakarta. The only thing a community would need to provide was a staff to serve as ambassadors and educators, walking patients through the automated procedures. They didn’t even need to have medical training.

With proper communication and organization, Amy was going to bring modern medicine to millions who otherwise would’ve been left behind. I began to believe in her vision despite continuing concerns over our safety in those remote places. Concerns that so regrettably proved well founded.

My eyes were getting heavy sitting there in that dim little room. There was a young Indonesian man working in the cold room directly behind the morgue’s waiting area, but I hadn’t seen or heard him for hours.

I was starting to doze off when the hallway door opened, and a well-dressed woman walked in. She had a somber look on her wide face. I suppose she thought it was appropriate.

“You’re one of the American doctors?” she asked, extending her hand.

“I’m Dr. Terrence Earl,” I said, getting up to greet her. “But most people call me Early or Dr. Early.”

The woman introduced herself as Melati, an officer for the Indonesian National Police. “We have doctors coming to examine Dr. Long’s body,” she said. “I wanted to speak with you regarding what happened in the village.”

“Certainly,” I said. “Except I don’t really know what happened. Our group was visiting one of the proposed sites with the Bupati of Malinau. We were on our way back from a remote village and stopped to eat lunch in a small town. Everything was fine. After lunch, we approached our vehicle, and two other vehicles pulled up. Some heated words were exchanged between the men in the other vehicles and one of the Camats travelling with us. But what they were saying was too fast for the translation program, or in the wrong language. It wasn’t much of a discussion.

“The man shouted, then the Camat shouted back at him. The killer ran at the Camat with a machete. Then all hell broke loose.”

“Is this the man you saw with the machete?” Melati asked me, handing me her tablet.

“Yes, that’s him,” I answered, unable to forget the horrible anger in those eyes. I stared at him in silence for a few more seconds.

“Did you see him hit Camat Galang with the machete?”

“Yes, but I didn’t see if he was the one who killed Amy. Dr. Koutos was closer to her, and I was already running. We all were. I tried to make sure Avery and Wei got to the trees. Then when we got to the trees the guides advised us to separate so that we’d be harder for them to find. I walked with one of the guides for about fifteen minutes before he left me to go check on the others. He told me to be quiet but to keep walking.

“Will you be able to catch this man?” I asked, handing the tablet back to Melati.

She nodded, “We have him and four others in custody already. They are all under arrest for murder.”

“Do you know why they did this, Melati?”

“Umm, maybe I am not sure of the English word, but these men are against western technology in Indonesia.”

“We call them luddites,” I said.

“And they are very religious—fanatical. They knew you were coming, Dr. Early. They had planned this. They told us already when we arrested them.”

As she left, Melati told me that she would visit the hotel to speak with the others. Then it was quiet in the room again.