by Brian Stableford
There is no doubt that being required to sit in judgment over one’s peers is a profoundly uncomfortable business. A person thus appointed becomes gradually detached from the group; his former colleagues become suspicious of him, and he of them. Friendship gives way to paranoia. Nevertheless, the job has to be done, and somebody has to do it.
I never applied for the post of chairman of the Ethics Committee; I was asked to do it. They said, of course, that I was the person best qualified for the job, mainly because of my declared interest in the philosophy of medicine, although my “personal experience at the sharp end of ethical decision-making” was also mentioned—but all that was just soft soap and insensitivity. The simple fact was that my role was changing anyway, and the people in Admin took the opportunity to redefine it in a way that killed two birds with one stone.
My role was changing because the government’s policy of returning the mentally ill to what is euphemistically known as “the community” had inevitably wrought great changes in specialized hospitals like the Maudsley. We had been forced to undergo a virtual sea change in the mid-1990s. As the high priests of hi-tech moved in, eager to get on with the serious genetic engineering and the transplant surgery, old-fashioned psychotherapists were suddenly in surplus. Those who couldn’t find decent posts elsewhere and couldn’t be persuaded to take early retirement had to be found other duties. Not that being chairman of the Ethics Committee was a full-time job; I still had to offer what comfort and treatment I could to an ever-growing list of out-patients.
I never realized the extent to which I’d been marginalized within the hospital community until one of the nurses let slip that the DNA-cowboys—who’d never been colleagues, finding me already , in place when they arrived—had nicknamed me “Doctor Death”. I never knew for sure who coined the term, but I always suspected Dr. Gabriel. He was the real leader of the team, in terms of charisma if not rank, and he was the one whose ethical precepts were most definitely different from mine, he being a devout Catholic while I was an atheistic humanist. Maybe I over-reacted, but the nickname hurt. It was bad enough being the man who all-too-frequently had to take the final responsibility for life-or-death decisions—every one of them recalling to mind what had happened to Carol—without being mocked and insulted for doing it. No doubt Gabriel would have been a lot happier if the job had gone to a Jesuit, but that wasn’t any excuse for his attitude to me.
I suppose that if it hadn’t been Gabriel I saw with his arm around the heavily pregnant teenager, I probably wouldn’t have given them a second glance. I wouldn’t have followed them with my eyes as they moved through the reception area, I wouldn’t have craned my neck to look at the car she got into, and I certainly wouldn’t have gone to the desk to ask the secretary if she knew the patient’s name. On the other hand, once I’d begun the sequence, there was enough in the situation to keep my curiosity going.
For one thing, the girl was luminously beautiful, in a Latin sort of way, and she looked so incredibly happy. Gabriel was wearing a smile that was smug even by his standards while he escorted her to the door—and that in itself was odd, because he wasn’t in the habit of escorting patients to the door. He didn’t actually have patients, as such. He was no mere healer of the sick; he was a cutting-edge research scientist, and proud of it. Then again, the car the girl got into was a black limousine with darkened windows: the kind that high-powered diplomats and mafia bosses ride around in. I didn’t immediately decide to make a note of the number-plate, but I couldn’t help noticing it as it drew away because it looked like one of those “cherished plates” for which companies and individuals pay high prices, and was thus easy to remember. It was OD 111X.
The secretary gave me a funny look when I said “Do you know the name of the patient who was with Dr. Gabriel a moment ago?” but I am a senior consultant, so she could hardly refuse to tell me.
“That’s Ms. Innocente,” she said. “She’s a regular.”
“Oh yes, of course,” I replied—I don’t know why, because I’d never heard the name before, and there was no real reason to pretend that I had. “She must be nearly due now.”
“Under two weeks,” said the secretary, who liked to show that she was on the ball. “She’s booked in for the twenty-third.”
I was so intent on being blasé about it that I was halfway back to my office before it occurred to me that one of the things the comprehensively re-vamped Maudsley didn’t have was a maternity ward.
* * * *
It was after seven when I got home. Chris had been home from school for three hours, but he was well used to looking after himself. The last vestiges of a bacon and mushroom pizza were still hanging about in the kitchen; he wasn’t one for hasty washing up. He was in his room as usual, mesmerized by his computer-screen.
“Hi Dad,” he said, when I looked in to offer in him a cup of coffee. “Another bad day in Bedlam?” It was one of those stale jokes that become mere ritual. The Maudsley is also known as the Bethlehem Royal Hospital; it’s the direct descendant of the asylum that Simon Fitzgerald set up in 1247 for the Order of the Star of Bethlehem, which came to be popularly known as Bedlam.
“They all are,” I told him, wearily. “I hope that’s homework you’re doing.”
He sighed deeply. “It’s nothing nefarious,” he assured me, in a defensive fashion. More than a year had passed since the visit from the police and the official warning about accessing confidential data, and as far as I knew he’d been a little angel ever since. But how close an eye could a single father who worked the kind of hours I did be expected to keep on his teenage son?
I made the coffee, and took both cups up to Chris’s room, intending nothing more than to exchange a few polite words in lieu of what the Americans call “quality time”. I’d almost forgotten about Dr. Gabriel and the pregnant teenager, but when we’d both run out of platitudinous pleasantries and fell silent, something about the cryptic rows of data that were marching across the green-lit screen while Chris watched in total fascination tripped a switch in my memory.
“I don’t suppose you could trace a car number, could you?” I said, impulsively.
He looked up at me in frank astonishment. “You want me to hack into the police computer?” he said, incredulously.
I must have blushed crimson. “Well, no,” I said. “Isn’t there a legal way of doing it?”
“Sure,” he said. “Semi-legal, anyway. Every big commercial consultancy in the country has that sort of thing in their databanks. Mind you, there are some people who might be uneasy about the ethics of their trading in that kind of information. Do you want me to put it on your credit card, or are you actually asking me to pull a stroke and get it for free?”
There are times when being chairman of an Ethics Committee becomes positively oppressive, to the extent that one actually yearns to defy the rules. No one can be a saint all the time, especially someone who never had the appropriate training. I’d done my fair share of kicking over the traces when I was a teenager.
“I have to get a bite to eat,” I said. “I’ll come back later. If you happened to have found out by then who owns a car with the license-plate OD 111X, I certainly wouldn’t ask you how you knew.”
To my astonishment, he gave me the most incredible smile. It was as though real communication had been established between us for the very first time.
“O-kay,” he said. “Anything else you’d like to know?”
I blinked, and hesitated. His enthusiasm to help was so blatant that I felt obliged to follow up. I realized, belatedly, that this was probably the first time I’d ever asked him to do anything which I couldn’t have done for myself, and the fact that it was slightly shady made it all the more precious to him. I thought hard for a couple of moments, and then said: “If I gave you a couple of passwords, could you get into the hospital records—specifically the records of the DNA-research unit?”
“Your hospital?” he said, disbelievingly.
“That’s right,” I said. “I do have legitimate authority, you know, perhaps even a duty. It’s just that....”
“...You don’t understand how to play the system,” he finished for me. “What is it you want to know, Dad?”
“There’s a female patient named Innocente. I’d like a peek at her records—anything and everything you can get.”
“Why?” he asked.
“To tell you the truth,” I said, honestly, “I really don’t know. Simple curiosity.”
“Curiosity kills cats,” he observed. “And they have nine lives. Are you sure you want to risk it?”
I grinned. “At my time of life,” I told him, “you can begin to live dangerously.”
* * * *
When I’d finished eating I went back upstairs. Chris was pathetically eager to tell me what we’d learned. In all the years since Carol’s accident I’d never felt closer to him—nor he, apparently, to me.
“OD,” he said, “does not stand for overdose. Not in this instance.”
“What does it stand for?” I asked, easily following the line of argument.
“Opus Dei,” he said. “It’s Latin for...”
“The Work of God,” I finished, so quick to occupy the intellectual high ground that the import of the revelation didn’t sink in immediately. Several seconds passed before I said “You mean the limo belongs to Opus Dei? The secret society?”
“Hardly secret, Dad,” he countered, obviously having looked it up in the CD-ROM Encyclopedia. “Secret societies don’t use dedicated number plates. But yeah, it’s the Catholic organization that occasionally provokes silly season stories about its allegedly mysterious activities. Founded in 1928; very big in Spain under Franco. I didn’t know they were clients of the Maudsley.”
“Neither did I,” I said, wondering whether the conspicuously devout Dr. Gabriel might possibly be a member of the organization. “What about Ms. Innocente?”
“An appointments record. Just dates and times. Her first name’s Maria. There’s nothing else.” He handed me a strip of paper fresh of the printer.
“I thought you were supposed to be good at this,” I complained.
“I am good at this,” he retorted, in a martyred tone. “When I say there’s nothing else, I mean there is nothing else, not that I couldn’t find the rest.”
“There has to be more,” I told him. “Gabriel has to keep proper records of examinations and test results, and full medical notes. It’s obligatory.”
“In that case,” Chris said, “I think you’ve just uncovered a clear violation of procedure. The invincible Ethics Committee strikes again, hey?”
I looked at the list of dates on the printout. As the secretary had said, a bed had been booked for the twenty-third, for three nights; that was the last item on the list. The first item was also a three-day admission, way back in March. In between the two were a series of monthly out-patient visits, which had presumably included the usual amniocentesis tests and sonic scans. Gabriel had been monitoring the pregnancy all the way from the very beginning. If the dates were accurate, Maria Innocente’s first admission had corresponded with the time of conception.
It didn’t make sense. The girl hadn’t looked a day over seventeen, and seventeen year old girls weren’t candidates for any form of assisted conception. Good Catholic teenagers undoubtedly got pregnant all the time by accident, and good Catholic doctors like Gabriel undoubtedly did their level best to steer them safely through their pregnancies...except that Dr. Gabriel was a researcher at the cutting edge of progress, not a protector of wayward sheep, and a three day admission didn’t look like any kind of an accident.
Even then, I knew. I didn’t believe the conclusion to which I jumped, because it was incredible and absurd, but there were just too many dots to join up for the emergent picture to be coincidence. However ridiculous it might seem, there had to be something there.
“Find out anything you can about Maria Innocente,” I said to Chris, in a tone which was suddenly very sober. “Anything and everything. Date of birth, parents, siblings, all known addresses; everything. Use my credit card to buy data if you have to, bend the rules if you have to, but find out exactly who she is.”
Chris looked up at me with a different expression on his face. He knew that there was more to it than fun and games now, but he was still delighted to be involved, and to be needed. “It must have been a really bad day in Bedlam, hey?” he said, sympathetically. “Bad enough bringing your own work home, without having to load it on to me. Just coming up to Christmas, too.” He had started out jokingly, but the last sentence killed the levity.
“That’s right,” I said, humorlessly. “Just coming up to Christmas. Not to mention the new millennium.”
* * * *
“What is it that you want to see me about, Dr. Heath?” said Gabriel, as I eased myself down into the armchair in his office, glancing sideways at the silver crucifix which hung on the wall amongst his various degree certificates. “I’m afraid I have rather a busy schedule today.”
“I don’t doubt it,” I said, dryly. “It must be a stressful business, arranging the second coming.”
I wasn’t ashamed of the thrill of pure triumph I felt as I saw his jaw drop and his forehead crease up, surprise mingling with anxiety. By the time he recovered his scattered wits sufficiently to say “What on earth do you mean?” it was too late. He’d already blown it.
“Maria Innocente,” I said, succinctly. “Born St Mary’s Hospital Paddington in June 1983; her birth certificate records the father as ‘unknown’. Brought up and educated—if that’s the word I’m looking for—in a closed convent in Kent, supervised by the women’s branch of Opus Dei. Due to give birth on December 25th 2000, right here in Bethlehem Royal. You have a very peculiar sense of propriety, Dr. Gabriel. Is that name an accident, by the way, or were you also conceived with this particular role in mind? It can’t have been easy to contrive an immaculate conception, way back in ‘83, even if you could figure out what immaculate might signify in the present context—but then, you always have been at the forefront of the medical miracle business, despite your sins of omission in the matter of keeping proper records.”
He hesitated over a denial, but he must have realized that I had too much. However low his opinion of psychotherapists might be, he knew I was no fool.
“How did you get on to it?” he inquired, cautiously. He didn’t seem intimidated or shocked. His main priority now, I supposed, had to be to discover exactly how much I’d found out, and whether I had guessed the rest.
“OD 111X,” I said, contemptuously. “Why didn’t you just paint the name of the organization on the side of the car?”
“Ah,” he said, calmly enough. He’d recovered his composure by now. “My view is that it always pays not to advertise, but as a mere Supernumerary I have limited influence over my superiors. What are you accusing me of, Dr. Heath? Am I to be summoned before the Ethics Committee on a charge of not making full notes, or do you have something more drastic in mind? If you’ll pardon me for saying so, I don’t think this is a matter in which you’re qualified to take an interest.”
“We’ll have to disagree about matters of qualification,” I said, coldly. “As it happens, I do have more serious charges in mind than your failure to keep a proper record of your...experiment. There are, as I’m sure you’re aware, several other irregularities to be taken into consideration. The most important ones concern an implantation which was apparently carried out at this hospital in March, using an early embryo imported from abroad. That whole procedure was not merely irregular, Dr. Gabriel, but actually illegal on several counts. You could be up before the BMA even if the embryo was a perfectly ordinary one. If it was what I think it was, you could be all over the front page of every tabloid newspaper in the world.”
“And what, exactly, do you think it was?” he asked, equally coldly.
“I think it was a denucleated egg-cell replenished with DNA plundered from some Vatican reliquary. I think that you think it’s a clone of Jesus Christ.”
He knew that had to be a guess, but he didn’t try to deny it. He didn’t confirm it either, but I was no longer in any doubt. After a pause, he said: “I’m still not clear about what it is you want from me, Dr. Heath. A summons to appear before the Ethics Committee could have been put in the internal mail.”
It was my turn to be astonished. “Is that all you have to say?” I asked.
“I don’t have anything to say,” he told me, flatly. “In spite of your title, I don’t think I’m under any responsibility to explain or justify my actions to you. In any case, you’re the one who’s issuing the threats. If you want to mount an official investigation with a view to reporting me to the BMA, go ahead. If you want to ring the News of the World to offer them the scoop of the millennium, you’re perfectly free to do so, although I can’t imagine why you would. If they didn’t believe you, you’d look like a complete fool, and if they did...we’re perfectly well aware that the revelation has to be made eventually.”
He looked at me steadily, and I could see how wholehearted his confidence was: the confidence of faith. I realized that I hadn’t really thought the matter through; I hadn’t been able to imagine what it must be like for a man like Gabriel to believe that he was the instrument of an authentic miracle: the miracle.
“I have the power to stop Maria Innocente’s admission on the twenty-third,” I pointed out. It was an empty threat, but I didn’t like to appear so completely ineffectual
“No room at the inn, Dr. Heath?” he replied, in a softly mocking voice.
I shook my head, wonderingly. “Bethlehem,” I said, as sarcastically as I could. “Maria Innocente! Don’t you think it’s all far too contrived, if not plain downright silly?”
“Actually, no,” he replied, without embarrassment. “But I don’t expect you to understand that. Not that it matters what you think. As I say, you’re free to say what you please to whomever you please. You can’t make any difference at all to what will happen next week, or in the critical years of the next millennium. You’re an irrelevance, Dr. Heath, and so is your committee of sophists. The truth is about to be made manifest, and there’s nothing you can do except prepare your soul for judgment.”
And the sad truth was that whether he was crazy or inspired, unhinged or sane, he was quite right. Whatever I did or didn’t do, it would make no difference at all to him. All I could do was sit in retrospective judgment upon him, privately or publicly—and whatever judgment I made, he honestly and truly didn’t give a damn. The only responsibility he acknowledged was to a higher authority by far.
* * * *
I spent Christmas Day with Chris, alone in the flat. We exchanged our petty gifts, had an abundant meal and a good bottle of wine, and tried not to notice that the person we most wanted to be there wasn’t. We tried as hard as we could, in fact, to pretend that the universe was a place where justice and fairness meant something, even if the good and the innocent were being slaughtered by the score by careless drivers full to bursting with the Christmas spirit.
We tried to forget that for us Christmas was the anniversary of a death rather than a birth: a death whose grief was certainly no less easier to bear by virtue of the fact that in the end, I’d had to ask for the life-support systems to be switched off.
We failed, of course.
Chris was a real hero, and a real diplomat, but in the end he had to raise the other issue which was on our minds.
“I suppose it’ll be all over by now,” he said, meaning the birth.
“I dare say,” I said.
“I wonder if they fixed up a visiting roster—magi by appointment. Can you get frankincense and myrrh these days?”
“Harrods stocks everything,” I assured him, dully. I had no doubt that there would be wise men from the east. Dr. Gabriel and his friends were playing everything by the book. They’d have laid on a supernova directly overhead if only they’d had the means. All the symptoms of classic monomania were there, but even in my heyday I’d never have been able to treat it. If madmen don’t want to be brought back to sanity, they can’t be driven. All a psychotherapist can do is listen, offer suggestions, and be very careful not to pass too harsh a judgment on failure or confusion.
“Are you really not going to do anything? You’re just going to let them go ahead?”
“What could I do?” I asked.
“You could apply to have the child made a ward of court, on the grounds that its self-appointed guardians are round the twist.”
“Even if I could do that—which I doubt—what would it achieve?”
“Dad, they’re going to bring up that kid thinking it’s the messiah. They’re going to expect it to work miracles.”
“He’s a child, Chris, not an object. Do you think they’re going to treat him cruelly, or neglect him in any way? It’s not illegal to bring up a child to believe certain things, however wrong-headed the beliefs might be. It may be stupid, but it’s not criminal. I can make trouble for Gabriel, but what would that achieve? You do realize, I suppose, that if I went public with this, the principal consequence would be that a substantial proportion of the world’s population would start calling me the Anti-Christ. It’s bad enough being Dr. Death behind closed doors—and it wouldn’t do you any good, would it? Anyway, weren’t you the one who warned me that curiosity kills cats?”
“And weren’t you the one who said that a man of your age could afford to live dangerously?”
“I can also afford to live quietly—which, on the whole, I prefer.”
“So you think it’s okay to produce a mother, for the sole purpose of bearing a child who’s going to be taught that he’s the son of God? You’re the chairman of the hospital Ethics Committee, and you think that’s a responsible way to use the new biotechnology?” He hadn’t started out angry, but he was getting sharper now, and I could see the old bitterness surfacing again. It seemed a pity that we’d managed to get so close at long last, only to have it spoiled again.
“If they’d referred the matter to us in advance, we’d have refused permission,” I said, patiently, “and any other ethics committee would have done the same. But what we have now is a fait accompli, and a very delicate matter. If I tried to punish them retrospectively for breaking the rules I’d probably do far more harm than good.”
“So you’re going to let them get away with it. You’re even going to let them manage their own publicity. But then, you always were a non-directive therapist, weren’t you. Do you think they’ll announce the happy event right away, or will they wait until he’s old enough to get on with the task of putting an end to the world?”
“I don’t know,” I said, as professionally calm as ever. “They know that God moves in mysterious ways, and I suppose they’ll do their level best to imitate Him but it’s bound to leak out. Someone will let the cat out of the bag...and then it’ll all be down to the world’s lethal curiosity. But at the end of the day, it’ll all come to nothing, because the boy won’t be able to work miracles, and the world won’t end, and the day of judgment will keep right on happening the way it always has, in the hearts and voices of ordinary men.”
“Nice sermon,” he said, meanly—but then thought better of it, and changed his tone. “Whose DNA do you think it really was?” he asked. “I mean, could it really have come from some mummified relic that’s been sitting in a Church for centuries? And even if it did, whose body did the relic really come from? Aren’t they trying to have their cake and eat it too if they believe that Christ was resurrected and went to heaven, but that he conveniently left a sample of his DNA behind?”
I shrugged. “I believe that they believe it’s Christ’s DNA,” I said. “But I don’t think they’re the kind of people who’d find it to difficult to bolster their belief that any DNA they happened to use would fit the bill. After all, they’re the kind of people who believe that the body and blood of Christ can be routinely manufactured day by day, out of unleavened bread and cheap red wine. They’re looking for a miracle, remember? If they have to assume that one or two have already happened along the way, they’ll do it.”
“And you’ll let them. You won’t stand up for sanity and reason. You’ll let them do it their way, for the sake of a quiet life.” The anger was gone now, but there was something worse: the disappointment. He’d known for a long time now that it wasn’t cowardice or wrong-headedness that had made me ask for his mother’s life-support machines to be switched off, but there was still the disappointment, the heart-rending sense of the unfairness of it all. I wanted to answer that, too, if I could. I wanted to make him see that doing nothing when there was nothing to be done, letting events take their course when there was no productive way to interfere, not only wasn’t simply defeatism, but actually had a kind of courage in it.
“They’ve already done it,” I said, quietly, “and it can’t be undone. The whole point about Ethics Committees, Chris—in fact, the whole point about ethics—-is to try to decide in advance what should and shouldn’t be done for the best. What earthly use is the kind of judgment which only happens afterwards? What use is it to come along when all the damage is done and start handing down punishments to all the people who got it wrong, exacting savage vengeance from all the people who offended you? I’m supposed to be a healer, not a jailer; I look for progress in my patients, not perfection. I’m not in the business of retribution, Chris, and I won’t apologize for that. I’m content to leave decisions as to who goes to Heaven and who goes to Hell to the people who think the world is really like that, and to take what comfort I can from the knowledge that it isn’t. That really is the only way forward.”
He didn’t reply, because he’d said all he had to say, but he looked at me with what I thought—or, at least, hoped—was understanding.
* * * *
It wasn’t until nearly a week later, on New Year’s Eve, that I heard through the hospital grapevine that Maria Innocente had given birth to a boy who was outwardly perfect, but who didn’t respond to stimuli in a normal way. He was certainly blind, almost certainly deaf, and probably badly brain-damaged; only time would reveal the lull extent of his disability. Amniocentesis hadn’t thrown up any warning signs, but the DNA in the embryo had evidently been defective.
I shed some honest tears for the disappointed mother, because I understood only too well the sharpness and the bitterness of the grief that she must feel; but I couldn’t find it in my heart to weep for Dr. Gabriel, or for the dismal failure of the Work of God.