Waterfall

The Death of Amy Long

 

I sat, hunched in the suffocating undergrowth, wondering about the eyes of lurking predators in the endless layers of green. How far off could those eyes be? And did they need to see me at all? I’d heard it said that animals knew the smell of fear, and that their keenest sense in pursuit of the hunt was the sense of smell.


The road was just below me, no more than a half mile down the hill. My skin was scratched and bloody from my frantic flight through the tangling jungle, and the mosquitoes continued their relentless assault. But to go back down to the road? Unthinkable. I’d seen a machete-wielding man cleave another man’s neck halfway through; now I too knew the smell of fear.


We separated in our retreat from the village. Everything happened so fast, and there was no way to know what they wanted, only that they had no compunction about killing another human being. It was the most shocking thing I’d ever seen—so unexpected. We all ran except Amy. To this day, I don’t know why she didn’t.


There was no network out here, and I was beyond the range of the others, so I had no idea whether they were safe. But Dr. Avery had her bag over her shoulder as we fled; my hope was that she had time to trigger a response via satellite. If I stayed hidden for a few hours, a rescue team would probably come from Jakarta, or perhaps even Guam. I kept my chips on for that reason, and Avery didn’t disappoint.


Buzzing from the mosquitoes; trills and shrieks from birds and other creatures; and the brief sound of raindrops in an afternoon shower had helped to quell the sense of terror from the attack. I’d kept as still as I could for those paralyzing few hours, listening for something. I heard nothing significant until that evening. The noise I heard then was the sound of a large animal, a man, or perhaps a jungle cat coming to finish the job a man had started. It was a frightening few moments.


“Dr. Early,” a voice came through the dark flora in the fading light. “I have you on infrared and have detected your signal. It’s safe to come out now.”


“Who are you?” I shouted back.


“I’m with a remote field infantry unit sent to rescue your party.”


“American?”


“Yes, sir,” the robot’s voice assured me. “Out of Guam. The village is secure and transport is waiting. I’m about thirty yards below you. I’ll lead you back to safety; just be careful coming down the hill.”


The sight of the robot’s defined metal outline in the untamed setting of that jungle was a staggering contrast. If ever a thing seemed more out of place, I certainly couldn’t name it. Still though, it was a comfort to see something so familiar, an American hero in a titanium shell. But that comfort was short lived.


“Is everyone else okay?” I asked as I approached the robot.


“It is my burden to inform you that one your colleagues has passed, Dr. Early. The terrorists killed Dr. Long before we had a chance to intervene.”


The bot offered to carry me back to the town after I slipped a few times. I decided to keep walking though, as it was only a few hundred yards to the road. It wasn’t that I couldn’t walk, but more that the walk required concentration I couldn’t give. It was difficult trudging through such terrain, and I’d never done anything like it: obstacles everywhere—slippery roots and rocks, leaves and branches brushing against my face. There were also the tears obscuring my vision, but most of all, there was the ponderous sense that I should have done more: I should have done something to save Amy.

 

The two-hour ride in the airship was the worst experience of my life. The continuous, dull whir of the rotors couldn’t stop the horrible silence we all felt in our hearts. Dr. Avery kept her head buried against the side of her seat, wrapped in her coat, weeping, only pulling her head out of her cocoon for brief moments to look down to the floor where Amy’s body was secured.


What a piteous sight it was—to see her face, pale and lifeless, her empty eyes fixed on the ceiling of the cabin. No matter that we all knew it to be real, it still seemed like it wasn’t happening, couldn’t be happening.


The robots tried to zip her up in a bag. It was their protocol, but Dr. Wei wouldn’t let them cover up her face. Instead she wrapped up Amy’s neck in her sweater, and once the gaping wound was beneath that shroud of clothing, it looked as though she could come back to life. Surely three of the best doctors in our fields should be able to do something. What was our purpose if we couldn’t even help our own?


None of us said a word until we landed in Jakarta. “Someone should stay with her until Davis gets here,” Dr. Koutos said. “It wouldn’t be right for her to be alone.”


“I’ll stay with her,” I said to my oldest colleague, and he nodded, offering to come and relieve me later that night.


There was quite a dispute between the embassy staff and our ambassadors at Doctors Without Borders. The military had orders to bring us survivors back to Guam, but the Indonesian government had laws about removing a body from their sovereign territory, especially before they had access to her for purposes of the investigation. We felt safe enough in Jakarta that we were willing to make a stand though. None of us was going to leave Amy alone. So after a few hours of diplomatic wrangling, it was determined that we would leave Jakarta together once Davis arrived to claim his wife’s body.


Davis and I went back over ten years. He was one of the most logical, least emotional minds I’d ever known, but I still didn’t want to be there when he arrived. I knew he’d never ask; I knew he’d understand; but I also knew he’d question in his heart what I was doing hiding in the jungle while those men were slaughtering his wife. I’d never known such shame. The only thing I could do was stay with Amy until he arrived. That was how I came to spend a long night in an empty Indonesian morgue.

 

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.

 

In the past decade alone, there had been numerous cases of violence against doctors volunteering in underserviced third-world areas. Some of the perpetrators believed that modern medicine conflicted with their religious beliefs; others were simply luddites who objected to the changes technology brought; some just hated westerners.


I kept remembering the conversations we’d had. Amy knew all of this—that they were out there, hiding among the people who would welcome us with open arms.


“We might not get a chance to reason with them,” I said. “They might just decide that they don’t want to hear a word we have to say. We could run into people who just want to kill us, Amy. What then?”


“You know what, Early,” Amy said, smiling at me as she shook her head. “The better we get at making our lives more comfortable and further removed from danger, the more we forget that sometimes changing things in the real world takes balls. You still got yours I presume?”


Despite my reservations, I stopped suggesting that we shouldn’t go, just that we should take all possible precautions to safeguard our wellbeing. Eventually though, Amy was right. You can never eliminate all risk. So I got on that plane to Jakarta, as did Drs. Koutos, Avery, Wei, and Dr. Long herself.


I fell asleep in the morgue’s waiting room again. I woke up alone, thinking about our visit with the Kombai of Papua on the first leg of our trip. I was thinking about how my memories of that village would be my last memories of Amy Long.


She’d made fast friends with one of the older men of the tribe with whom we’d visited for several days. He was high-ranking, but not quite a chief. I’m not sure that he had a title, but he seemed a sort of sage or medicine man. Maranjay was his name, and he treated us all very well, perhaps because he was old enough to remember the days when ‘the strange white people’, as he called us, came to visit the tribes often.


Amy was smart enough to bring a few pair of glasses and a repeater with a fairly decent range. After we’d spent a few days gaining the trust of the tribe, Amy took a chance by asking Maranjay if he would like to try something new. She went off with Dr. Avery and several of the tribal women to help them forage for food, leaving me, Koutos, and Wei with Maranjay and a few of the other Kombai. Then she called us.


I can’t express how difficult it was to explain the idea to Maranjay, but I have to say, he was far more open-minded than I ever would have imagined.


“Amy’s in here?” he asked through the local interpreter, holding up the glasses in disbelief.


“Not in there,” I tried to explain, “out in the jungle with the women, but you can see them and talk to them with this.”


I was a bit nervous. The Kombai still believed in witchcraft and magic; their tradition dictated that witches and sorcerers had to be killed. But Maranjay was amused when he saw Amy out in the jungle with the girls.


“You look like ghosts in there,” he told Amy as he reached his arms out as if to touch them. “It’s very funny. I know that spot in the forest.”


They talked for a few minutes, and though he smiled throughout and seemed to enjoy the experience, Maranjay declared, “You silly white people are just as strange as I remember.”


Later that evening, Amy asked Maranjay if he would like to meet her husband. Davis was just waking up back in Boston. I can’t imagine his surprise, speaking with a Kombai tribesman over breakfast.


Maranjay took it all in stride. “Davis, you must be a happy man with Amy for a wife, even though you live in a sad country with no trees or birds. Now I know why your people come to see our trees. We are happy to meet your wife and to speak with you.”


Amy was beaming.


After Davis signed off for work, she used the glasses to try and explain to Maranjay about our country, taking him on a few virtual tours—of Boston, of Yosemite, of the Grand Canyon, and one of Manhattan. He loved the parks, but the cities seemed a bit much for him. By the end, he was shaking his head in disbelief.


“How big is the world?” he asked Amy through the interpreter, and you didn’t need the interpreter to convey the sense of wonder with which he’d asked the question.


“It’s getting smaller,” Amy said, smiling in a joyous, reassuring way. “But it’s still big enough for all of us.”


He just smiled and nodded. And you could see it—Amy Long, bringing out the best in this Kombai tribesman, the same way she brought out the best in all of us.

 

Koutos woke me up as promised. It was almost morning by the time he got to the morgue. I spent the rest of my time in Jakarta sleeping in the hotel.


Avery came to wake me up several hours later. The staff at the U.S. embassy had arrived to escort us to the airport. Davis and Amy’s body were already on the private jet that MSF had chartered to bring us all home.


Davis got up to greet us when we boarded, but none of us could say anything. It was a sad, familiar feeling for us four old doctors, the dreaded end to a failed course of treatment. In the days before gene therapy, I used to say the same thing every time: ‘I’m sorry; we did everything we could.’ And then I said nothing else, because there were no words that could be of any comfort.


So we all sat down, the plane doors closed, and we all went back to America, carrying a body. And the world was less one monumental soul.