Poppy
Abstract:
This short story takes place a century in the future where exoskeletons, external frames that aid in the body’s mobility, are utilized to increase the average lifespan. People are still aging and losing mobility, but mechanical suits keep them alive and “walking” around. This results in a population where many people resemble mechanical “shells” who have lost their spirit and excitement for life, merely living to operate these machines that keep them alive. Shannon, the protagonist, visits an alternative care facility that specializes in palliative care and is shocked by their radical treatment of patients.
Throughout the story, I inserted images of a poppy flower. I chose the poppy flower because it is traditionally associated with death and peace, prominent themes in my story. I also included a repetitive time-lapse of drawing the poppy flower to mirror the circle of life process that Shannon encounters in this story.
I wrote this piece to discuss the implications of end-of-life care and ever-improving technology and medicine. After learning about the human aspects of medicine, I wanted other people to question the current structure of our healthcare system and how we treat patients.
This short story was inspired by Octavia Butler’s piece “The Evening and the Morning and the Night.” I found her use of the short story structure to communicate her opinions very interesting and compelling, so I followed suit with a short story of my own. I was also inspired by the novel Scythe by Neal Shusterman because it envisions a society where people only die at the hands of ordained killers.
I had never written a short story before, so I found this piece to be challenging as I struggled to determine the format of my story. Once I settled on my message and format, however, my words flowed freely.
Poppy
Shannon rolled her aching shoulders as she stepped away from the operating table and removed her hands from the Michelangelo machine’s controls. The unexpected opportunity to scrub in and work with Dr. Yusem, her attending surgeon, during today’s operation had been both a blessing and a curse; it gave her more hours to work on her technique with the unfamiliar technology, but took more hours of sleep away from her already questionable sleeping schedule.
Hiding a yawn behind her face mask and uttering another word of thanks to Dr. Yusem, she shuffled down the hallways of the hospital, taking care to stay on the right side to avoid the constant bustle of carebots and autocarts that took care of the patients’ basic needs. She passed many rooms containing patients encapsulated in clunky exoskeletons that served various functions. These days, just about everyone over the age of 80 had some sort of mechanical structure to help them stay active in the second half of their life. The extent of these life-aiding apparatuses varied from basic motor assistance to electrode-based robots that were used by patients who had been paralyzed or suffered a particularly harmful stroke.
After stripping off her used scrubs and gathering her personal belongings in her backpack, Shannon exited the hospital. Wearily looking up at the inky sky above, she clipped on her helmet and hopped onto her Zoome 600. Instead of heading towards her desolate apartment, the scooter followed the path it had been taking for the past few weeks, which took her towards a more residential part of town. Here, vehicles were programmed to run at a slower speed and the noise levels were regulated.
It was with heavy steps that Shannon climbed the front steps and let herself into her childhood home, pausing to remove her clunky sneakers before trudging down the hall toward her mother’s room. The sliver of golden light that escaped from beneath the door suggested consciousness, but when Shannon slipped inside the doorway she found her mother dozing in her favorite plush armchair. She gently awoke her mother and set aside the tablet in her lap whose screen had long since turned off. From there Shannon guided her to bed, taking care to help her take the plethora of pills that the doctors had prescribed her when they diagnosed her with Stage 4 pancreatic cancer.
Since that fateful day weeks ago, Shannon’s life had felt like it was in free-fall. Her father had long since abandoned them when he went off to start his second family, leaving Shannon as the sole caregiver for her mother. She should have had the help of an in-home automaton, but her mother had always opposed the medical use of exoskeletons and robots. Even though she was nearing her eighties and seemed to slim down every day, Shannon’s mom flat-out refused any pleas Shannon made to visit the hospital where she worked to get fitted for an exoskeleton. Instead, Shannon was left to take care of her mother on top of her already demanding residency hours at the hospital.
Hopefully, all of that would end tomorrow. Shannon’s mother had been researching a care facility that she liked, and tomorrow they were visiting it for the first time. They had agreed that if Shannon approved of the place, they would move her mother in during the upcoming weeks. With thoughts of a better future in her head, Shannon laid down on the spare bed and drifted off to sleep.
This had been a mistake. Shannon had not had the time to read the pamphlets about this hospital, for if she had she would have scrapped this whole trip. They had departed from the city this morning on one of the high-speed trains, her mother looking more cheerful than she had in weeks. Once they arrived at their destination, however, Shannon’s mom had adopted a more sheepish look as she noticed Shannon’s glower.
Instead of the high-tech, efficient-looking hospital that Shannon had been expecting, she was face to face with what looked like an old manor house. She doubted that the rooms had been updated with the latest technology or that they could carry out life-saving surgeries on the patients. To make matters worse, the patients milling around on the lawn and lounging beneath the broad tree branches all seemed to be about midway through their lives, yet none of them had been equipped with exoskeletons. This hospital was the opposite of what Shannon wanted: it seemed to encourage her mother’s rejection of technology and would not be able to provide her with the medical care that she so desperately needed.
Nevertheless, Shannon set her jaw and followed her mother into the antique structure. They were met by a woman with kind eyes and streaks of gray running through her dark hair. She introduced herself as Dr. Varghese, the head of this care facility. Despite her frustration with the facility, Shannon was impressed with the doctor’s calming presence and confidence-inspiring persona. As they proceeded with their scheduled tour of the building, Shannon was shocked to see no patients with exoskeletons. She also noticed many fewer carebots roaming the halls. Instead, nurses and doctors occasionally exited rooms where they had been caring for a patent individually.
During their walk, Dr. Varghese explained how the hospital had been designed as an alternative to federal hospitals like the one where Shannon worked. Rather than promoting the use of exoskeletons and robots, they specialized in what they called human-centered care. This approach utilized less-invasive techniques while aiming to maintain a better quality of life. This spiel only served to raise more questions in Shannon’s mind, so she stayed back with Dr. Varghese while her mother continued the tour with another doctor by heading outside to meet the patients.
Standing in one of the bright, homey patient rooms with the sunlight streaming in through the slightly opened windows, Shannon had to admit that she understood the appeal of the place. However, as she turned to face Dr. Varghese, she began to ask the questions that had plagued her throughout her visit. What was the patient-to-doctor ratio? Why did they not use more exoskeletons if they focused on the quality of life? And why were there no patients in their late hundreds here?
This last question particularly bothered Shannon; though she had seen many patients around the same age as her mother or a decade or two older, she had not seen any patients who looked to be at the end of their life. Was this not a terminal facility, but rather a temporary stop for these patients?
Dr. Varghese took these questions in stride and succinctly described their patient-to-doctor ratio, their nurse-to-patient ratio, and the tasks for which they used the carebots. She explained that exoskeletons served to preserve some mobility, but often led down the path to more and more invasive surgeries, eventually resulting in people solely living to operate the machines that kept them alive. Here at this hospital, the doctors focused less on extending the patients’ lives and more on preserving the quality of their life.
Shannon was shocked by Dr. Varghese’s candor. She was to believe that the doctors here ignored the most recent technological and medical advances in favor of letting their patients die at a young age? As a doctor, she was offended by the idea of not helping a patient and outraged that her mother could have been so careless as to choose such a dangerous facility. She said as much to Dr. Varghese, moving to chase her mother down and get them away from this place.
However, the doctor reached out a calming hand before Shannon had the chance to turn away. She asked Shannon to take some more time to consider the benefits of their hospital. Yes, it was very different from the way the other hospitals were run nowadays. But if she looked back into her history books, similar structures had existed for decades. Special centers had been developed to offer palliative care, and hospice centers had offered a comforting end-of-life environment. These measures had fallen to the wayside in recent decades as medicine improved and fewer afflictions became life-threatening, but the approach was still applicable to these patients who avoided exoskeletons and overly invasive surgery. Rather than push their bodies to stay alive for extra years simply to operate the exoskeletons that let them breathe, these individuals chose the quality of their lives over the quantity.
Throughout this impassioned speech, Shannon had remained stock-still and quiet. This world was so different from the one in which she grew up, yet it had its own set of rules that made sense. She thought of her mother and realized that she never wanted her mother to become like her patients at the hospital where she worked, full of medicine and technology yet empty of passion.
With a sigh of acceptance, Shannon admitted that she had initially reacted too harshly. Although she still needed time to come to terms with this concept, she was not opposed to the facility. Dr. Varghese smiled warmly before turning and leading Shannon to where her mother was conversing with a group of patients beneath a tree. Her mother was laughing at something that had been said, and her smile only grew when Shannon explained how she thought this place would be the perfect fit for her.
As they strolled back through the building and exited through the front doors, Dr. Varghese held Shannon back for a moment. She asked about her residency and suggested that Shannon apply for a position at their care facility. Shannon’s face cracked into a broad smile and she shook Dr. Varghese’s hand, promising to return soon.
Resources:
Collins, Steve. “Human Locomotion, Robotic Exoskeleton and Prostheses.” RoboticsTomorrow, Carnegie Mellon, 18 July 2017, 8:29 AM, www.roboticstomorrow.com/article/2017/07/human-locomotion-robotic-exoskeleton-and-prostheses/10325.
Ku, Bon, and Ellen Lupton. “What Is Human-Centered Health Care and Why Is It Important?” KevinMD.com, KevinMD.com, 11 Mar. 2020, www.kevinmd.com/blog/2020/03/what-is-human-centered-health-care-and-why-is-it-important.html.
Lee, David H. “Approach to end of life care.” The Ochsner journal vol. 4,2 (2002): 98-103.
Octavia E. Butler. “The Evening and the Morning and the Night.” Callaloo, vol. 24, no. 2, Johns Hopkins University Press, Apr. 2001, pp. 401–18, doi:10.1353/cal.2001.0082.
Shusterman, Neal. Scythe. Thorndike Press, 2016.
Zitter, Jessica Nutik. “How The Rise Of Medical Technology Is Worsening Death: Health Affairs Blog.” Health Affairs, 6 Nov. 2017, www.healthaffairs.org/do/10.1377/hblog20171101.612681/full/.