Dr. Garcia’s secret

We begin our story in New York City, where a grandmother gets bad medical news. Stoic as always, Mary has things left in life she still wishes to do, travels to faraway lands, making up fairy tales for her grandkids, and even leaving the world a little better than she found it. The first stranger she encounters is Dr. Manny Garcia:

One spring day in New York city, Mary spent the morning inside a hospital, having blood taken, and her fragile frame drawn through a scanner like a thread through a needle. Then Dr. Bains met her in the Cancer Center.

“I’m sorry,” he said, “There are new spots in the liver.”

They were alone in his small, windowless exam room. “What next?” she asked.

He referred her to a website for an experimental treatment. “Mary, for being in your 70s, you are exceptionally healthy, but time runs out for all of us,” he said. “The Chinese are at the frontiers of this war. I think this is one of their initiatives. I can’t officially recommend their approach, but I’ve been looking around.” 

She tried to smile, “To live for a few more years,” she said, “I’ll trust your suggestions, leave behind my pride, questions…”

Her voice trailed off. He was two decades younger than her. Keeping him as her doctor meant paying extra for health insurance and then waiting for hours to see him.  Every time she went to the Oncology clinic, they wanted her to see other “providers” instead. But those strangers knew little about her except what they gleaned from the computer. Then she refused to see anyone but Dr. Bains, and the medical staff grew impatient with her. But still she waited until she got her way. I guess I look easy to push around, she thought. At my age, I have all the time in the world to wait.

The oncologist scrolled through a blur of screens on the wall monitor.  “These treatments looks expensive,” he said.  “Your insurance will not cover any of it. I know you can afford it. OK, here it is, I’m sending you the link…”

He tapped away at another keyboard, adding, “But time is like land, they don’t make more of it, more valuable than money.”

He did not enter his “unofficial” recommendation into the work computer that was always there in front of them. Today, his scribe was also missing. In blueberry scrubs, some person was always there, intruding on their privacy, clicking everything into the computer, ringing up all the incomprehensible charges that would appear on her next medical bill. 

He saw her looking at his idling work touch board, then at his hands in his lap. He glanced at the closed door, “Mary, I don’t always put outside referrals into your file. When I send patients outside the system…” His voice trailed off as he looked down again.

When Mary said goodbye this time, Dr. Bains gently touched her hand with his blue-gloved one. “Good luck. Keep me in the loop about what happens?”

After clicking on the link Dr. Bains sent her, Mary enrolled in Soria International Clinics’ experimental trial. Then she wrote to the scientist designing her cancer vaccine.

Lying in bed at home, she slit open the Soria envelope that arrived a few days later. The letter inside was a reply from a Dr. Garcia, not a Chinese name, that welcomed her to the trial, “grateful for your participation.”

Brilliant sunlight flooded her room, reflecting off the snow draping Central Park. The winter season was melting into spring, and slush dropped from the branches of trees. Far below, merry pedestrians shielded themselves with their hoods. She told the masked nurse how she wanted to be outside, sharing not just this season but many more with her grandchildren, then went on about how instead her life was “melting like the kids’ March snowball piles, packed near the purple crocuses now blooming on my farm.”

The nurse propped up Mary’s pillows. “You really don’t want to be around all those people down there carrying germs like fleas.”

After the nurse left, Mary looked away from the windows and clicked the clinic’s link bookmarked on her laptop.  She typed her login and password. The image of a sun filled the screen, yellow halo with tie-dye kaleidoscopic edges radiating from a center. The next screen announced in black and white:

OUR SERVER IS DOWN

PLEASE CHECK BACK LATER

LEAVE YOUR MESSAGE HERE

It was always like that. She left her note. 

“MARY.”

Then they would call her.

Except for the Biblical Mary, her name was common. She was just another Mary in an infinite procession of Marys through time, past, present, and future. “BEELZEBUB” would have been a less boring account ID. She poured herself a glass of icy Chardonnay. They had told her not to mix chemotherapy with alcohol, one poison with another. Really?Unless the experimental treatment worked, her future was going to be just a quick fatal drink anyway. 

The wine bottle’s label was a watercolor of a castle beside a frozen ocean. Crumbling stones rippled the sand and water, specked with shards of ice. She had given Dr. Bains a case of the wine. He had thanked her later. “My wife likes the poem on the back: Always, those who love me will feel you, hear the song of our bond, until the roar of war and water breaks us down to ghosts and stones.”

The wine had a seawater tang. She inhaled it now, glass after glass, drowning, recalling herself as a young girl who loved pink hydrangea and red carnations, then a grown woman who had kissed the father of her children, before resting her cheek against his muscled shoulder. Bare branches had pierced the skies above their house the winter her husband had died. Forever young in her memories, she saw him again, echoed in their daughter and grandchildren, hearing his voice and even his quiet sense of humor. How do people die and not disappear? 

Mary’s eyes returned to her bedroom’s picture windows. She had paid a steep price to repurchase her childhood flat. Into the dimming city skies above, she murmured her remembrance: “In the whisper of the wind, listen. In a flash of color in the woods, I see you. In our songs, I am with you. You love me all over again when I dream of you…until l I fade away too.”

She fell asleep. The screen on her laptop turned off from inactivity. Dusk crept in, the windows glowing smoke and gold. She was dreaming again, traveling on the Silk Road to an Asian town of colored tents, flowering on desert sand under a crystal silver and blue sky. Since her treatments had first appeared to be from China, her dreams often carried her East. Dropping below the horizon’s sunrise — her body entered a half-floor in the kingdom of medicine, that of a modern alchemist who was her healer.

As Mary slept, her digital medical file travelled not East, but West, westward across the continental United States, not at the speed of Lewis and Clark in the 1800s, but at the velocity more than two centuries later of an electromagnetic wave, landing in an AI machine in Pandolf, California.

The machine’s human operator, Dr. Manny Garcia, broke the silence with a merry whoop as the file pinged its signal. Alone in his lab on a Saturday evening, he hummed G, C, A, and T, the nucleic acids of DNA, stringing them into long chains of letters, breaking with “A.”

“A” was in memory of his wife. In her 30s, Pia had passed from cancer.  She would have been forty this month and what a party he would have given her, fireworks, colored balloons, and kisses. The computer console before him flashed a spectrum of lights. Sounds spoke a language only a trained operator understood. His hands returned to the arcade style keyboard. He scanned across hundreds of streaming signals and occasionally tapped the screen. The machine suggested a break. To stretch, he walked to the window. Outside, he saw lights, nearby hospital buildings, and heard faint music from distant homes. After returning to the steel cockpit of the computer, like a priest inside a confessional, he opened Mary’s letter to read again.

Amid black Sharpie redacted lines, her blue ink strokes rippled and read:

March 15, 2025

“Hello, I am one of the patients in your cancer trial and a grandma who would like to have more time with my grandkids. My ticket arrived for Athens and then to go to a medical center in Africa. 

Thank you so much for your help! What can be more precious than hope?

Gratefully, Mary”

He hovered his phone to take a photo of the letter and stopped. His only record of this landmark document — the first volunteer for his project— would be a memory. He shredded the paper.

Next, he checked the home camera. Yesterday, it showed that someone had been inside his apartment, a masked shadow that flitted and disappeared through his door. Then there was his phone call to his 15-year-old son, Jorge. living with his sister and brother-in-law in Chicago, disconnecting, then rapid clicks before reconnecting.

He and Jorge always talked in Spanish. “Dad why do people not trust science?” Jorge asked. “This kid at school said that.”

“That’s unfortunate,” he said, pulling his hair away from his forehead.

How could he tell the boy that his father’s scientific world was crushing bureaucracy, bosses who only saw him as a tool, disappointment with himself, and self-doubt about breaking the rules. Why would the public trust science, he could not tell Jorge, when inside the system, his own father had lost faith?

Strictly speaking, Pandolf Medical Center had not authorized him to work on his secret side project. His contract specified that anything “an employee created with company time or resources was (their) intellectual property.” Still, what was the harm? During these off times like tonight, no one else was on the Drukker computer, and he was making tremendous progress using its latest AI, artificial intelligence, to run biological programs. Soria, an international clinic chain, had sent him terminally ill patient records, de-identified for privacy. For them, he was tallying treatment recommendations. Soria had not asked his employer for permission to use their equipment, and he had not pointed out their breach of normal protocol either.

It was time. Tap. A thin glass bar, the first disc ejected near his knee. Tap again. Another bar. Three more followed.

The computer asked, “Do you wish to run this file?”

Tap, yes.

“Your data will no longer be retrievable. Do you still wish to run this file?” A sympathetic synthetic woman’s voice.

Garcia hit the <Enter> key. Pages of code scrolled down the monitor, raining many colors before the screen went black. Then the bright Drukker sun dawned its 3-D security logo.

He scrawled in thick black marker on the five glass bars. He labeled “MARY” first. There were four other files, terminal cancer patients who were wealthy enough to pay but had not yet signed up for the trial. On their discs, he wrote: “MARK,” “MATTHEW,” “LUKE,” and “JOHN.” As for Soria’s choice of Biblical names, he figured that plenty of rich people with savior complexes dabbled in the medical field. His job, ignoring religious superstition, was to make recommendations to Soria’s machine learning and artificial intelligence team — to help the individual patient’s immune system combat the dynamic genetics of cancer. Feeding medical data into the computer, from blood and biopsy results to imaging, he sleuthed how each patient’s tumor evolved. 

The ingenious metamorphoses of cancer, from a single cell to its changing hide-and-seek organization of millions within the victim’s body, became targets for the Drukker’s AI in games, from micro to macro, that pitted the disease against vaccines. His aim: precision medicine for the terminally ill patient to have remission, even cure, and then die one day of something besides cancer.

Heart pounding, breathing shallow, he slipped the five glass bars into a case he dropped into his backpack. He was a scientist, not a thief, he told himself. But he had never bent the knee to anyone else’s moral code, had become an unbeliever in the church of American academic medicine and would pay the worldly price. To seize this chance to pursue his research ideas, after working all his life for other (dull) people on their projects, it was the right thing to do.

Next to the supercomputer housing, a frayed notebook swung like a hanged man from a nail. In it, his fellow scientists scribbled their times for reservations to use the Drukker. Their illegible writing often caused feuds about schedules, but no one wanted to use the machine in the graveyard hours he worked in. He scribbled his name into blank spaces for next week’s schedule.

His Soria phone showed a new notification from David Campbell. Campbell was also a scientist and was going to transport the data storage discs to the African desert state in North Africa, where Soria had built a new clinic. Garcia texted Campbell back that he would place the drives in a hiding place in the Pandolf hospital complex and leave him a hand-drawn paper map with directions to find them. 

“Look forward to going to Africa myself one day,” Garcia dictated into his phone.

“Saburia is fiery hot,” replied Campbell. “Nothing to do but work, you would like that. Buying the Drukker shows Soria is investing in your Terminator T-cells.” 

“Wish I could go now, away from little minds who rule my life here.”

“Can’t, your son is coming soon.  What about Jorge?”

“He wants to be called George now, I don’t understand.”

“When was the last time you saw him?”

“We video-chat all the time.”

“I mean in person?”

“Two weeks ago, in Chicago when I saw Michael,” said Garcia.

“Michael, yeah, he’s still in Saburia, waiting on us.”

Michael Kochanski was a husky Polish American businessman in his mid-40s, who had connected Garcia to Soria Clinics.  On a recent video-call, speaking accented hoarse English, he said, “Manny, I like the idea of cancer as a disease to live with, not fatal, so patients become regular customers. This is more glamorous than selling disposable razor blades.”

Garcia frowned.

Kochanski explained, “It’s a joke, Manny. You know the business principle; I lose money when I sell you the razor holder but make it back every time you buy more blades from me.”

“I know what you mean, Michael. But it isn’t that simple. A lot of work goes into proving scientific theories. And most of the time, they have no merit.”

“Time runs out for everyone,” retorted Kochanski. “Those dying patients have nothing to lose except for worthless relatives waiting for them to go, so they can inherit money. Soria Clinics makes sure patients understand that treatments may not be successful.”

“Thank you, Michael, for connecting me with Soria. Or my research ideas wouldn’t be going anywhere.” 

“Oh, don’t thank me too much,” said Kochanski.  “Soria pays me well for consulting, and your work so far is free for them. But I do think corporations are the future of science.”

“I meant,” said Garcia, “that being just a postdoc at Pandolf means I only work on other people’s ideas. But I must support myself and my son and keep slaving away on this plantation. What I really want to do is to help people like Mary whom conventional medicine sacrifices instead of pushing its limits. But doing this research on the side using Pandolf’s equipment without telling them? Not ideal.”

“Why would Pandolf care, Manny? The computer is not being used for anything else when you’re on it. You’re not hurting anyone or getting paid.”

“If they find out,” said Garcia, “there may be trouble. But then I have no loyalty to Pandolf or any respect for their authority. It’s not just the system. I also like people less and less as time goes by.”

But he had made one friend at Pandolf: Dr. Shelly Narayan. About thirty years old, she worked with him on research to strengthen her applications for advanced surgery fellowships, part of the army of resident doctors in Pandolf who floated through its labs. Narayan lived in her miniature world, like a mouse in a storybook, a happy young woman who spent hours pipetting placenta extract into endless wells in plates to slide into the analyzer. Back at Drukker headquarters, the Dock, they had robots to do that type of repetitive work. 

One evening, they discussed his idea for a new experiment for her over dinner. Walking to Palatine Hill, Pandolf’s Italian restaurant, he matched his long stride to her shorter steps. Palatine Hill overlooked an expanse of sloping lawn down to the central lake of the Medical Center. Inside, plaster walls displayed a painting of low Roman hills, the buildings half-ruined and half vegetated, reflecting a dawn sky, flushed red and streaked with gold.

“Palatine Hill in Rome actually looks a bit like this, just more dilapidated,” he told her as a waiter led them back outside to the patio, warmed by heat lamps and a firepit, past another panorama, this one of ancient gods and battles, framed by exposed brick.

At night, the silver lake mirrored the lights and traffic of the medical campus, glittering within the darkening valley. At dinner, he sipped Chianti and explained his idea. She jotted notes. The candle flickered in its glass globe, lighting her writing. A distant ambulance whined and threaded its flashing way into the hospital campus from the highway.

“Drukker has a pipetting robot so you can scale up your experiment,” he then said. “But Dr. Nepski says he wants to see preliminary results before he budgets it.”

After taking more notes, she put her phone away. Next, she rolled her fingertips on the table, back and forth, intensely looking at the scratches in the lower crescent of his glasses where the fine cracks formed a pattern. He removed his Drukker prototype glasses, wiped his eyes, and smiled at her. Her face was blurry now. She looked puzzled.

Perhaps she was wondering if she had been watching too many surgery videos? She had the sharp eyes of the surgeon she was training to become, he thought. Surgeons, originally butchers in the history of medicine, they see but don’t understand. Training to perform operations, she had the self-discipline and attention to detail that her path required. She had stamina and even ran marathons. Working with delicate lab equipment beside him, her long fingers had the dexterity that good surgeons possess. He would always remember the length of her fingers and how they moved?

She described how robots operated on patients. “The surgeon is at the controls with a video monitor for long-distance surgery.”

Their eyes met, hers a liquid brown with the candlelight flickering in their lucid centers. He reminded himself that he was her mentor, a duty that precluded romance — even if the god of love didn’t care about duty or trust. Anyway, any romantic spark within him was a distraction right now. The gap in their ages, pasts, and futures put a thick pane between them. 

Finally, they shared a tiramisu, a generous American portion with two forks. When Garcia’s wife was alive, they used to share dessert. “Like a kiss,” she would say. After one bite, his eyes grew wet, and his throat tightened. 

The Italian head waiter stopped by to visit. “Our tiramisu is a favorite.”

Garcia forced himself to keep eating it. He and the Italian discussed the Old World, before the pandemics and across oceans of water, time, and distance, anecdotes about opera, wine, and travels to remote “towns back in the day.” 

Garcia gestured to the fresco. “I wonder if they also had a god of olive oil?” The waiter smiled. 

After the Italian left, she commented, “I’ve never been to Europe. It’s fascinating to listen to both of you.” She expressed surprise that the stylish Italian, with his “cute” accent and tuxedo, did not mind their “casual dress.”

“You must mean me because you always look great,” he said.

They parted amid the lavender scent of jumbles of flowers in the restaurant’s lobby. He walked out into chilly breezes and night sky on the valley edge. 

He could not remember now when they had dinner. What is today? Time: its inexorable order in clocks, calendars, and schedules, then beeped an alarm on his watch. It was Saturday night and time to scramble that last record in the printer. Mary was his first and only patient so far. Her treatment files must arrive in Saburia on time.

But his task, to destroy the data on the computer, was detailed. With his toolbox, he laid back down on the floor and slid under the printer. Engrossed in delicate electronics by the light of his headlamp, he heard the laboratory door open and close. Who would be entering the lab now? He jerked his head out from under the printer and turned toward the sound of running footsteps. 

TO BE CONTINUED EVERY SUNDAY

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