Second Nature
The Restorationists

Episode 27 / 50

The possibility of rebuilding Rina’s human lungs was raised when the waterway had twenty-eight hours of storage left.

City Three physician Asha Bell did not use the word restoration.

“Staged reconstruction of nonsymbiotic respiration.”

Daniel asked, “You mean she could live without the culture tank?”

“If it succeeds.”

“Could she return to her original body?”

Asha’s throat turned yellow, the color of uncertainty.

“The original lungs no longer remain. Less than half of the bronchi can be separated from the symbiotic tissue. We would grow new tissue and connect it.”

Rina watched them through the middle wing’s transparent membrane.

“Talk to me first about my body.”

Asha turned.

“I’m sorry. I didn’t check whether you could hear.”

“I can.”

“We can reduce the symbiotic membrane around your lungs and implant small pieces of lung tissue grown from your cells in four stages.”

“Four?”

“Your blood flow and immune system couldn’t withstand a single replacement. Preparation takes eleven days. Surgery and recovery take at least seven weeks.”

“Could I die?”

“Of nineteen people who had similar procedures here, three died. Five could not leave culture support. Six learned to breathe independently. The rest are still in treatment or stopped.”

Daniel asked only about the six successes.

“Where are they now?”

“Four in the dry wing, two in the mixed wing.”

“Can we meet them?”

Rina said, “I didn’t say I wanted to.”

Daniel approached the glass, saw the contact line on the floor, and stopped.

“You need information to decide.”

“You want information so you can decide.”

“I can’t let you spend your entire life in a culture tank.”

“Who knows whether it will be my entire life?”

“That’s why we should look when there’s a way.”

Rina’s heart rate rose from eighty-one to ninety-six. Auxiliary circulation held at 72 percent.

Asha raised the back of her hand.

Stop.

“The explanation continues only if Rina chooses to hear it.”

Daniel said, “I’m her guardian.”

Rina answered, “City Seven took that away.”

“Aegis took it.”

“If they give it back here, does it belong to me?”

Daniel had no words.

Rina asked Asha, “If I don’t do it now, can I do it later?”

“Yes. But if the black external tissue connects farther inside your bronchi, more must be removed. With current readings, starting suppressants within fourteen hours causes the least loss.”

“What happens if I take them?”

“The white stalk cooling the tank may die. The spots on your wrist may disappear. Some sensation may dull.”

“The forest sound too?”

“We have no way to measure what you call the forest sound.”

“Could it disappear with my voice?”

“I can’t assign a number to that possibility.”

Rina looked at the blackened tip of the biological line.

“No.”

Daniel answered at once.

“Don’t decide now.”

“You said to do it now.”

“I’m asking you to be examined.”

“If I’m examined, the fourteen hours keep running down.”

“They run down whether you’re examined or not.”

Rina did not answer.

Wet herbs and salt drifted in from outside the middle wing. City Three’s residents were requesting that the treatment proposal be made public.

Asha explained.

“Your treatment would use 4,600 liters of water and one immune-culture room for seven weeks. With the waterway as it is, surgery for four others may be delayed. So this is not only an individual decision.”

“Who are the four?”

“Transitionals waiting for reconstruction.”

Daniel said, “Shouldn’t the child go first?”

Asha’s throat turned red.

“That statement is a warning here. Age does not automatically put another person’s pain later.”

Rina said she would meet the four.

The first was Soren Vale, thirty-two. Thin respiratory folds along both sides of his neck absorbed supplemental oxygen in humid air. In the dry wing, they cracked and bled after twenty minutes.

“I’m going to have the surgery,” Soren said.

“Because you hate this body?” Rina asked.

“My child lives in the dry wing. We have to meet through transparent membrane.”

“What if your child comes to the wet wing?”

“They’re allergic to mold.”

“If the surgery works, can you live together?”

“Yes.”

“And if it fails?”

Soren’s skin could no longer change color after the respiratory-fold implant.

“At least I can tell my child I chose.”

The second was Hima Rez. Fungal tissue had fused with the muscles of one leg. Amputation could cost her the pelvis as well. She was on the reconstruction list but had postponed surgery three times.

“Why?”

“I can feel beneath the waterway with this leg. On painful days I want it cut off. On days I find a leak first, I want to keep it.”

“Which is how you really feel?”

“Both.”

The third candidate could not meet them because an infection had been discovered during testing. The fourth refused an interview.

The restorationists were not a group seeking one kind of body. They included people trying to end pain, people wanting to breathe the same air as family, and people who wanted reversal because they had not chosen the change.

Asha opened the operating-room observation window. Inside, the nineteenth patient, Toma Allen, was undergoing his second-stage procedure. A new lobe had been implanted on one side of his chest. The symbiotic membrane remained on the other.

“They don’t remove it all?” Rina asked.

“Not until the first lobe can breathe alone.”

“What if both stay?”

“The immune system may attack the two different tissues.”

Toma’s blood pressure fell. The medical team clamped flow to the new lung and increased circulation through the symbiotic membrane.

Asha stopped explaining and focused on the alarms.

Oxygen saturation: 71 percent.

67.

The symbiotic membrane expanded. Red lines spread between Toma’s ribs. Tissue suppressed to save the new lung took over his breathing again.

The team removed a clot.

Oxygen saturation: 73.

81.

His blood pressure returned.

Rina asked, “Did he fail?”

“Not yet.”

“Did he succeed?”

“Not yet either.”

Toma woke after surgery but could not speak. He wrote one sentence on the communication board.

CONTINUE.

The team asked whether he meant continue recovering from this surgery or continue the entire course. Toma selected CONTINUE ALL SURGERY.

Daniel looked at Rina.

“He knew the risk and chose.”

“Does that mean I have to choose the same?”

“I want you to see that you have a choice.”

“You’re only looking at one side.”

Asha closed Toma’s record.

“To be fair, she should meet someone who chose not to reconstruct.”

They met Orel Kass in the mixed wing. A broad green membrane covered his back. In bright light it produced sugar. Indoors, it consumed Orel’s blood glucose. He had to lie under light at least four hours a day.

“At first, I asked them to cut it off,” Orel said.

“Why didn’t they?”

“They said excision would cost half the muscles in my back.”

“So you learned to love it?”

“No. I still hate it many days.”

“Then why keep it?”

“I learned I could live in a body I hated. You don’t have to love a body to protect it.”

Rina looked at the spots on her wrist.

“What if you want it removed later?”

“I’ll remove what can be removed then. It will be riskier than now.”

“Don’t you regret it?”

“I do.”

“Then didn’t you choose wrong?”

Orel turned his back toward the light.

“If I had waited for a choice without regret, I would still be standing outside the operating-room door.”

Rina asked permission to record his words. Orel agreed.

Back in the middle wing, Rina accepted only noninvasive tests.

“No cutting. No suppressants. Only look.”

Asha confirmed the scope one item at a time.

Low-output ultrasound.

Blood-flow imaging.

Culture-fluid analysis.

External biological-line conductivity test excluded.

Store in personal record first.

No research-network transmission.

Rina added the last two conditions herself.

Daniel wanted to enter the examination room.

“Watch from outside.”

“What if you get scared?”

“I’ll call you.”

The exam took forty-eight minutes. When the ultrasound crossed Rina’s chest, the symbiotic membrane contracted with the machine’s vibration. The image shook. They repeated it three times.

Right human-lung tissue remaining: 19 percent.

Left human-lung tissue remaining: 7 percent.

Symbiotic respiratory-membrane contribution to blood flow: 64 percent.

Culture-fluid oxygen exchange: 28 percent.

The rest was error.

Implanting new lungs required reducing symbiotic-membrane blood flow from 64 percent to below 20, in stages. Rina might lose her low-frequency hearing, part of her temperature sense, and her cooling connection with the white tissue outside the tank.

If left as it was, the membrane would probably wrap farther around the bronchial nerves.

Expected operable range after 14 hours: 58–83 percent.

After 7 days: 31–69 percent.

The ranges were wide because the sensors could not determine where the symbiotic tissue ended.

“Probability of success?” Daniel asked from outside.

Asha looked at Rina for permission.

Rina nodded.

“Independent breathing without the culture tank: 32 percent. Nighttime support only: 29 percent. Continued dependence on the tank: 23 percent. Death or surgical termination: 16 percent.”

“You said three people died. That’s lower than 16 percent.”

“The sample is small. Rina’s tissue also differs from those nineteen cases.”

“If she does nothing?”

“Six-month survival in the current culture state: 61–88 percent. Independent breathing outside the tank cannot be calculated.”

“The range is too wide.”

“That is why it must be used only as data, not as a decision.”

Rina saved the images to her own display. Asha asked whether to delete the original from the medical network.

“Wouldn’t they need it for emergency treatment?”

“You can define who may open it if you lose consciousness.”

Rina set it to open only with the joint approval of Daniel, Sarah, and Asha. Neither Daniel nor Sarah could view it alone.

Daniel agreed, but he was not happy.

Families of reconstruction candidates and the waterway repair team attended the medical-allocation meeting. If Rina chose surgery, the other four start dates would each be delayed at least nine days.

Soren said, “I oppose saying the child should go first. But Rina’s tissue is more urgent.”

Hima raised a yellow band.

“Urgency must not turn refusal into something temporary.”

Dry-wing residents opposed tying up 4,600 liters in medical treatment. Some wet-wing residents supported surgery because Rina’s black tissue might provide data on reactions with the city membrane.

Rina said, “Getting city data while fixing my body is not a reason to treat me.”

The research-benefit item was removed from the meeting record.

Daniel did not object. Instead, he requested that preparation water be secured first.

“Rina may change her mind within fourteen hours.”

The repair team asked, “Do you know how much removing 4,600 liters reduces storage time?”

“Three hours, forty minutes.”

“What if the channel blocks again?”

“Return it if it isn’t used.”

Asha said, “Water used to begin immune culture cannot be returned.”

Without asking Rina to decide, Daniel submitted the proposal to reserve it.

Rina opposed it.

The proposal failed.

Daniel wanted his daughter to have surgery, but he could not take another patient’s water for her. He sat like a defeated man.

Watching him, Mira did not think she was different. This time, procedure had stopped the hand.

Symbiosis keepers gathered across the middle wing. They too tried to persuade Rina.

“If they excise it, the senses you lose can never be restored.”

Nami raised the back of her hand.

“As the restorationists choose their bodies, Rina chooses hers. Do not present fear as information.”

One of the keepers objected.

“The medical team shows only the chance of success.”

Asha disclosed the surgical mortality and discontinuation records.

“We showed everything.”

“You didn’t measure sensory loss.”

“There is no method.”

“Then you treat it as no loss.”

Rina tapped the glass.

“Both of you leave.”

Everyone stopped speaking.

“Only the people explaining things stay. Come when I call.”

Nami released the wet-stone scent of consent. Restorationists and keepers withdrew from the middle wing.

Daniel remained.

“Dad too.”

“I’m family.”

“That’s why.”

Daniel’s face hardened.

“I came all this way to be beside you.”

“I decide where beside me is.”

He did not cross the contact line. After a long time, he went outside.

Mira found him sitting at the dry-wing entrance with a surgical-information panel in his hands.

“Did you make a reservation?”

“I checked open times.”

“Rina said no.”

“She’s eleven.”

“So you get to decide?”

“You shouldn’t be the one saying that.”

Daniel looked up.

“You substituted my daughter for your son. You talk like someone who has learned consent now, but if your child’s body had become that, do you really think you would have waited?”

Mira could not answer.

“I don’t know.”

“Don’t escape with that.”

“I’m not. I mean I can’t promise I would have.”

Daniel folded the panel.

“I want Rina back the way she was.”

“The Rina from before is gone.”

“Are you saying she died?”

“No. I’m saying Rina now isn’t the same as Rina before.”

“She’s the same child.”

“Then listen to the child who is here.”

Daniel stood.

“You have no right to listen.”

He was right.

The waterway repair alarm sounded.

Flow through the grafted water membrane plunged.

437 liters per hour.

281.

196.

Estimated storage: 19 hours.

Nami and the repair team ran to the waterway. The graft had not torn again. Living membrane had grown too far into the metal pipe and blocked the channel.

“The sulfide changed its growth direction,” Mateo said. “It bound the nickel but made the membrane seek iron.”

The water membrane kept the city alive while eating its pipes.

Rao looked at his wrapped hand.

“It’s still hot.”

Nami said, “We won’t use it.”

“Nineteen hours.”

“Even so.”

“I’ll look.”

“The sensory membrane hasn’t recovered.”

“Then I’ll look with the machines.”

Rao’s condition was that he would not put his hand in the water. They laid a wet cloth over the soil and he rested his hand on it. It carried less information than direct contact, but absorbed less nickel.

Ian did not try to hear the city’s low frequencies beside him. He read the pressure-probe numbers instead.

“Left, 0.8. Right, 0.3.”

Rao said, “The right is sweet, but cold.”

Mateo measured the outside of the pipe. The right side was 1.7 degrees colder. The growth membrane was evaporating water.

Without cutting the pipe, Mira passed a weak current across its exterior. She tested whether the iron-seeking tissue would turn toward a closer sacrificial electrode.

The electrode was corroded metal brought from Reclamation Factory Two.

Three minutes later, the tip bent toward it.

“It works,” Sarah said. “Long term, it may consume the electrode and return to the pipe.”

“Scrape the membrane inside while it’s diverted.”

The repair team opened the pipe. Instead of removing all the living membrane, they cleared only the center of the channel. They placed removed tissue in a separate tank instead of discarding it, to observe the sulfide reaction.

Flow: 213.

328.

401 liters.

Estimated storage: 27 hours.

Not a complete recovery.

When Rao removed his hand, dizziness dropped him to the ground. Sarah gave him three hundred milliliters of electrolyte water.

“My allocation?”

“Public repair cost.”

Mateo did not object this time.

Rina watched the repair from the middle wing. One white stalk beneath her tank moved toward the sacrificial electrode. Its blackened tip reacted like the water membrane.

Asha said, “Suppressants would probably stop that growth.”

Daniel opened the surgical panel again.

“Rina, will you still leave it after seeing this?”

“You don’t know whether it’s bad.”

“It blocked a city pipe.”

“My stalk didn’t.”

“It reacted the same way.”

“If your hand moves the same way as someone else’s, are you the same person?”

“This isn’t wordplay.”

Rina’s heart rate rose again.

Asha raised the back of her hand.

Daniel did not stop.

“After fourteen hours, they’ll have to remove more.”

“I know.”

“You may want it later and be unable to.”

“I still don’t want it now.”

“You’re saying that because you’re afraid.”

“So are you.”

Daniel’s mouth closed.

Rina said, “I may choose wrong.”

“That’s why—”

“The right to choose wrong is mine too.”

Daniel reached toward the glass. He stopped before the contact line.

“May I hold you?”

Rina shook her head.

Daniel lowered his hand.

The medical-allocation meeting convened. Preparing for Rina’s surgery required moving 4,600 liters from waterway storage to the medical reservoir. Soren and the other candidates would be delayed.

Rina refused surgery.

The official record stated refusal by the person concerned.

Daniel stared at the guardian-appeal field.

Under City Three’s rules, the guardian of a child under twelve could request review if danger to life was imminent. Rina was eleven by the record.

Her current danger was not classified as imminent.

But Asha’s fourteen-hour limit might qualify as substantial loss of recoverability.

Daniel placed his finger above the review button.

Mira watched from a distance and did not approach.

Rina watched too.

“If you press it,” she said, “I won’t share a room with you.”

Daniel withdrew his hand.

“I didn’t press it.”

“You were going to.”

“I was afraid you’d regret it.”

“You’re afraid you’ll regret it.”

Rina made the culture tank’s inner membrane opaque.

For the first time, something thicker than glass closed between father and daughter.

The window of highest surgical probability had 13 hours, 22 minutes left.

Behind the opaque membrane, Rina’s black biological line moved alone. The cut tip reached toward the model of a new lung at the bottom of the tank, then stopped just before touching it.

Rina saw it and did not call her father.

She wanted first to know whether the movement was her choice or her body’s response.

She still could not separate the two.