Copyright © 2016
by Nathan M. Hurst

Entry into the system had gone well. He was currently travelling slowly through the vein of his patients right arm, the flow lazy but constant as it pulsed its way back to the heart. Mr Emmerson's superior vena cava was his goal, just outside the heart. He had studied the images endlessly, each angle, every statistical data point, all the MRI sections and 3D renderings. He was very well informed on the insides of Mr Emmerson. The delivery method had been the intravenous cannula which was the standard method used to introduce controlling drugs, saline or blood, whichever was deemed necessary by him and his team in the moment. Right now, it was delivering the rest of the sedative which would calm the patient.

A couple of his team were with Mr Emmerson to ensure he stayed calm and relaxed. They also had the important task of subtly reading him and gaining feedback on any pain or discomfort he might be feeling. Anything out of the ordinary or alarming would be instantly relayed to him. It could be critical in the surgery he was performing. The patient would not be unconscious during the procedure, instead the sedative was enough to relax Mr Emmerson and keep him engaged but docile.

The remainder of his team were the technical team, they were with him in the adjoining room. The Hap Team took care of the most expensive piece of kit the hospital owned, an integrated haptic suit for surgical nano-devices. The haptic surgical suit or HSS was, as far as he was concerned, the pinnacle of modern surgical technology. His team were brilliant in their field, totally committed to their profession, saving and improving the lives of every one of those they treated. It was an amazing achievement to this point and one they were extremely proud of. The technology was wondrous to be a part of, pushing the frontiers of medicine like never before.

Working his way easily downstream along the arm and into the armpit he found the pressure build as he got closer to his target. Enclosed in the dark working capsule of the HSS the suit he wore translated his physical motion into that of the Grub, which was simply named as it looked like a grub with some level of core articulation enabling it to twist and bend through the body. It was also powered with a state of the art battery, powerful enough for up to six hours operation while driving a miniature laser which was fitted at the nose of the device along with a nano-camera. A small motor was also fitted to the grub which powered it forward through liquid substances or could propel it short distances through cavernous body sections. In addition, it was also covered in tiny stud legs which could be manipulated in sequence to move it along a surface with tiny pincers at the front and rear which could be applied in either a cutting or anchoring capacity.

He currently had the sensation of floating through the vein to his goal where the clot was wedged, caught just near the entrance of the heart. Being fully immersive, the feedback he received across his senses was a relative feedback pressure from the Grub, but there were some slight alterations, mainly in visibility. What he saw through the haptic goggles was a reconstruction of the view ahead, a composite layered from sonic data, live localised MRI which tracked the position of the device and transparent overlay of the Grub's nano-camera. It gave him most of the information he needed.

One thing they were still working on and gave him a real problem was the bodies own defence system. With the Grub being so small and clearly a foreign body within the patient's system it was quickly attacked by T cells, the bodies killer agents. It gave them a working window of about twenty minutes. For this operation, it may not be enough. As with all operations, time was money, if they had to come back another time that would be a problem, mainly for the accountants, but he didn't like having the argument. It wasn't something you could easily solve with numbers, it didn't matter how many Grubs you put in the system at once the clock started ticking from the moment they arrived, but equally with operations of this kind, there was only so much space available to work in. More than one Grub was generally counterproductive.

Flow and pressure was beginning to increase. All his instruments were indicating he was only minutes away from the target clot. As he travelled through Mr Emmerson's circulatory system lymphocytes were identified and catalogued with a target icon. He manoeuvred the Grub from their path for as long as possible, the last thing he wanted to do was to use the laser on them or get close enough to become tangled in their clutches. Once identified by the bodies countermeasures he would have about two minutes before the Grub became completely incapacitated. From his operational point of view it was annoying, but he could do little but marvel at the speed and design of the human body at this level.

The superior vena cava. He was almost fired into it. As he struggled to control the Grub and turning hard it brushed the vein wall causing it to begin to tumble in the flow. He shook his head in disgust at his own lack of concentration and flicked the controls in a practised fashion. His view stabilised and the vein before him opened out, the relative scale seeming vast.

His instruments fired an alert. 30 seconds from target. He began the grappling procedure and manoeuvred the Grub over to the far side of the vein, a heavy deep cotton wool darkness began to loom in the distance, like a spider had laced red cells into an amorphous ball. He centred on it then moved a little closer to the vein wall. As the clot began to take up more and more of his forward facing view he dropped the tail of the Grub towards the wall and fired the anchoring mechanism. He felt and heard the sound of the release as feedback through his suit, a dull percussive kick to his feet and lower legs. He shut down the main propulsion, but kept the thrusters in docking mode which fundamentally aimed them towards the direction of flow and countered any erratic surge in the stream keeping the laser platform steady as he put it to work.

Within moments he was knocking pieces of the clot apart, small and easily managed particles able to be absorbed and removed by the body as the cells passed through the spleen or lymph system. Each piece another life giving action, another few days added to Mr Emmerson's life.

At the half way point in the operation he found the blood pressure beginning to increase, it was a good sign. As the clot decreased in size more of the vein was open to pass blood into the heart, in turn the heart could pump more easily. He felt a smile break as he worked. There was something primal about helping and giving life to those in need.

“Er. Boss?” It was Gideon. He was the only one of the tech team who called him Boss. Everyone else managed to be professional using his proper title. It was a cheep point to be making, he well knew Gideon also had a PhD, not medical, but in Computational Haptic Interfaces. Offically he could be called Doctor, but he never used it. Damn it though, this was a hospital. Some traditions remained.

“What is it Gideon?” he said curtly.

“You've got company.”

“How many?”

“One, no two. Another will pass you by.”

“How long?”

“Fifteen seconds until contact.”

All he could do was work and work fast. He was committed. If he tried to relocate this close to the entrance of the heart with the increased blood flow he would be swept away. He could potentially escape by burrowing through the vein wall, but he needed longer than fifteen seconds, more than that it would not clear the clot.

He felt the touch of the T cell. Caressing his lower left leg softly, the guardian slowly but surely moved its way along his side checking him out, trying to identify what he was in relation to the cells it knew should be there.

More clot fragments where scattered into the stream and swept away. He worked with persistent haste, aiming, firing, aiming, firing into the reducing target mass. The second white cell made contact and latched on, this one far faster at deciding its intent. Immediately he felt the pressure on his right leg increase to an almost painful level, the feedback of the haptic suit geared to just below a level which would do him any harm, but enough to give him a real sense of urgency if the environment dictated. Within moments the T cells appeared to begin to work together, both now aiming to incapacitate the alien object within their grasp.

“Grub will be inactive in thirty seconds,” stated Gideon firmly.

Sweating under the tension and psychological sense of being engulfed by the attacking cells, he focussed on getting the job done. It was always the same though, at some base level this was the moment were realities blurred. The sensations mixing to work against his mind which was desperately trying to keep the observations separate from the feelings creeping up through his spine.

“Twenty seconds.”

Aim, fire, aim, fire. The biomass was almost gone, a couple more hits with the laser and it would be done.

There was a sudden tight pinch to his right foot and an alert started to blink in his status screen. A moment later his vision was swinging wildly. The right rear pincer had failed. With one anchor point gone he was now at the mercy of the current, the flow of blood throwing the Grub around like a kite in a storm.

“Fifteen seconds.”

The clot swung back into view momentarily. Taking his chance he fired, the aim was terrible, the laser only clipped a fine slither from the clot but scorched the inside of the vein wall. He estimated three or four more blasts, if he got the opportunity. Spinning and with the T cells engulfing him to his shoulders a sense of drowning worked its way into his mind. Only three shots, he thought to himself.

Sweeping across his view the clot took a full blast to its centre, bisecting it to a size a little bigger than he wanted, but he had little choice. One more clear shot should complete the job and dislodge the final piece of biomass.

A second alert and this time a pinch to his left foot. “Damnit!” he shouted. All hell broke loose. His view was completely incoherent, the targeting system unable to lock onto anything was flicking around his display like a spider on a hot plate. On top of that the two T cells were moving in for the kill. The sense of drowning was almost at an unbearable, mind numbing level. It didn't matter what Gideon reported now, he knew there was a handful of seconds remaining.

Manipulating the controls did nothing, the propulsion was gone, directional control also dead. A smudge of dark crimson blurred his view, but he was unsure whether it was his own sight fading due to the crushing force of his attackers or his target. His sight started to go dark, becoming obscured from the periphery, tunnelling to a point. He fired. The whole haptic cell powered down and went dark, releasing the pressure in the suit as he fell to his knees gasping.

“Did we get it?” he asked in the tense aftershock and darkness, ripping his goggles off he stared upwards waiting for some sort of confirmation from his team. Small LEDs flashed like coloured stars around him. Gideon keyed the mic, there was a short pause. Confirmation.

“Yeah. Yeah, we got it.”