The First Heart in Space
Throwback Thursdays #1
Description: A satirical short story about the direction healthcare might be headed in a dystopian, ultra-capitalist future. Written circa August 2023.
Reading time: ~7 minutes
The GodPleaseFundMe campaign had been a wildly successful one. Even some celebrities had helped promote it on the socials once they’d gotten wind of my plight. All it took was a slickly produced video – thanks to my partner for that – with some emotive strings playing over the top and it just sort of, took off. Not that I was a huge fan of being stage centre in any of this. Having to come across as the kind of guy deserving of people’s help, smiling at the right time, looking bleak when the script deemed it appropriate. It was all a bit of a faff, but, needs must and all that.
The second great pandemic of my lifetime had unleashed a hideous little bastard of a virus that primarily attacked the heart. I was one of the sad sacks that was infected before the first round of vaccines made it to market, not that I’d have been front of the queue anyway, what with my credit score. Long story short, it left my heart severely weakened and I went from jogging 10k every other morning to, well, not. The chest pains were terrifying and the accompanying cold, slick sweat made me look like a weirdo who was overly excited in his short-shorts; the looks I got the first time I sat on a wall during a run, breathing heavily, sweat streaming down my face. I hadn’t realised, as I was hunched over at the start of that particular episode, that I was facing a group of OAPs in shellsuits doing their morning exercise aerobics while I panted, intensely wide-eyed, dripping sweat onto the concrete, grasping my thighs white-knuckled. You’d have thought that demographic would have recognised a heart problem when confronted with one. But no, what they saw was some pervert with an OAP fetish.
This happened a couple of more times – no, not the unsettling of paranoid elders – when performing fairly menial tasks around the flat, and after sustained pressure from my partner, and a forensic examination of our accounts and outgoings, I eventually booked an appointment with my GP. It wasn’t a lengthy visit, they knew almost immediately what was at fault.
“Your recent infection likely damaged your heart’s ability to beat effectively.”
Words more frightening I’d never heard uttered.
The long and short of it was that if I didn’t do something about it I might very well die an unceremonious death should I do something as mundane as take too strenuous a shit; the King has left the building, ah-thank you very much. Christ.
I was advised to book an appointment with a specialist ($1567.34) for confirmation and a treatment plan ($I’mFucked). This was going to ruin us.
I couldn’t see how this was financially feasible. I had almost resigned myself to the notion of giving up and just trying to live a more sedentary life. It wasn’t an entirely unappealing notion.
“I’m not having it,” my partner, red-faced, “I won’t be reduced to one of those tragi-comic paragraphs you read in some online tabloid where someone’s lover collapses on top of them dead in the throes of passion, pinning them until their wails of terror are heard by their fucking dickhead neighbour.”
“I’m not that big, you could just roll m...”
“I said ‘NO’, Eric.”
And that was that. We were on the road to financial ruin.
Don’t get me wrong, the subsequent fundraiser I mentioned was helpful, and I was grateful. It covered the initial expenses with the specialists, but, all-said-and-done there wasn't an awful lot left over for the recommended implant. People are people, and the celebrities inevitably moved on to the next shiny thing that caught their eye. And I couldn't expect my friends and family to donate indefinitely either, they had medical bills to pay and food to put on the table just like me. And well, yeah, that's reality isn't it?
#
I commuted to the medical centre in the city on the dilapidated overground train. I cringed when I tapped my travel card on the exit turnstile and saw the cost of the trip. Following the GPS directions squawking in my ear piece, I arrived in front of the monolithic corporate headquarters. I craned my neck and followed its receding form, past its iconic horn-shaped logo, into the sky above, a wave of vertigo crashing over me. One of the remaining two major car providers had diversified into medical technologies around the time their combustion engine vehicle sales tapered off. Charging people for the privilege of not dying is a lucrative industry, it turns out; there will always be people and each and every one of them will eventually be squarely in the demographic of the dying. Literally everyone that would ever be, would be a potential customer.
I didn’t want my partner with me. These things were basic, in-and-out-the-same-day, procedures. Nothing to make a fuss about. I was in somewhat of a daze as I was prepped by nurses and trainee doctors. I politely engaged with the routine, robotic small-talk that such interactions demanded. I mentioned in passing how the cost of the procedure was going to be life changing.
“But, so will the procedure too? Right?” said a young nurse sincerely.
“Sure, I don’t mean to sound ungrateful, but debt is a pretty stressful burden.”
We had apparently moved away from the mundane but familiar terrain of small-talk. The nurse smiled pityingly.
“You know, I might be able to help you with that.”
I gave her a confused look.
“Stay put, I’ll be right back.”
“I won’t be going anywhere.”
Another nurse joined me and instructed me to undress and put on a surgery gown. I’d forgotten about the young nurse from earlier until she returned with a pamphlet.
“There,” she said, handing it to me.
The shiny pamphlet had a psychotically happy looking middle-aged man with unnaturally white teeth, smiling like a maniac beneath the wording: Forget the heartache. Beat the future with Heartlet. I looked up at the nurse and raised an eyebrow.
“It’s a new pacemaker. They’re offering reduced fees to early adopters.”
“Oh,” I said looking back down at the pamphlet. “Is it safe?”
“Oh, of course. We’ve had 100% success in the pilot program.”
I flicked through the pamphlet and grew increasingly irritated by the overly-smooth-skinned middle-aged man in his various action poses, never not smiling.
“It’s about 75% cheaper,” added an older nurse who was taking my blood pressure.
“Huh.”
After, admittedly, little thought I informed the nurse I’d like to opt-in for the new pacemaker. Fuck, I’d be crazy to blow money on the older model. She took the pamphlet from me and disappeared between the curtains.
Not long afterwards I was handed a document on a clipboard with a pen while I sat in nothing but the surgery gown. Feeling the cold steel of the bench on my exposed ass-cheeks I wondered why the humble gown design had not been improved upon over the decades.
“It’s the usual legal gobbledygook, you know, there’s a risk of death, blah, blah, blah.”
A young, clean-shaven man stood before me in a neatly pressed suit.
“Sorry?”
He tapped the clipboard.
“It’s nothing to concern yourself with, just sign where the stickers point,” he said with a toothy smile.
“Oh, of course,” I said and scribbled my overly long signature that still looked the same as it did when I was twelve years old.
“Fabulous!” he said, snapping the clipboard from me and turning on his heal and leaving without another word.
A doctor in full scrubs came in almost immediately holding a glass jar before me. It was hard to keep track of all the faces.
“This is the little miracle of modern technology we’ll be attaching to your old ticker today.”
I looked at what she was holding. To my eye, it looked overly designed; it was a slick silver gadget about the size of a Zippo lighter with tendrils spiralling outwards.
“I thought it’d be smaller, you know, being a new model and all that.”
“It’s packed with all sorts of modern tech.”
“It’s a pacemaker.”
“Oh, it’s that and more.”
“Does it need to be more?”
The doctor smiled quizzically at me like I was some sort of fool. Maybe I was.
A nurse was ushered in shortly thereafter to help me onto a stretcher and to anaesthetise me and seconds later I didn’t exist. And then I did. I awoke in the recovery room, overhearing nurses talking about the paucity of decent options on the dating app du jour.
“I met my partner at work,” I slurred.
I heard a small giggle and the room faded to black again. I came-to in a different room, and a few hours later, after a saline drip was emptied into my tender, bruised arm, I was wheeled out of the building, still a little foggy. I was helped out of the chair and handed an instruction sheet and told not to remove the bandage and to only sponge-bath until after my follow-up appointment. In my foggy daze I made my way back to the train. I could feel my heart beating, and admittedly it felt strong, despite everything.
#
A few months passed, the bandages had been removed, the scarring was minimal and I had been getting increasingly stronger. I was even back on my old jogging route, albeit still taking it relatively easy. And then it happened.
Nausea, a cold sweat, difficulty catching my breath, irregular heartbeat. I found myself on that same wall from months before. I reached for my phone to contact my partner and, just as I scanned my face, a message from my banking app appeared.
INSUFFICIENT FUNDS – OVERDRAFT ACTIVATED – CHARGES WILL APPLY
I ignored it and brought up my partner’s number and... the nausea ceased. I caught my breath, heart beating as it should, and breathed deeply.
“What the hell was that?” I said to myself, got steady on my feet and started walking home.
#
“What do you mean monthly payments!?”
I had no idea if I was speaking to a human or an AI drone. The days of being able to tell were long gone and there was no point in asking since they were legally recognised as persons some years ago, and as such, could claim to be a “real person” without violating their programming. Corporations and AI; a marriage forged in white-hot greed.
“There was just a little hiccup in your accounting.”
“It didn’t feel like a hiccup. It felt like I was dying. And, no, you didn’t answer my question. What the hell did you mean by monthly payments?”
“I understand.”
“What?”
“I understand your frustration.”
“And?”
“And, what, sir?”
“You can’t end a conversation with a wishy-washy-wanky ‘I understand your frustration’ that provides precisely zero help.”
That did it. I gave them their out.
“Sir, I’m afraid I must discontinue the call. We have a zero tolerance policy for abusive language. Goodbye.”
The audio feed went dead. Definitely had to be a fucking drone.
My partner placed the next call, and, with their superhuman reserves of patience, got to the bottom of the mess.
“You signed a bunch of paperwork before the procedure, right?”
“Ah, yeah, the usual. Liability waivers, that kind of thing.”
“Well, apparently, the discounted model you signed-off on is a subscription based plan.”
“A what?”
“Subscription based. You pay monthly for them to keep providing the service,” my partner said this tapping my chest. “Hence the initial discount.”
“That’s...‘Service’?... That’s... that’s absurd.”
We stared at each other, saying nothing, but we knew she hadn’t gotten it wrong.
#
All that happened over forty years ago. To their credit, the pacemaker still ticks-over nicely. I’m in my late eighties, finding my way in an increasingly strange world. Everything hurts, apart from my heart, granted, I’ve had a few close calls over the years with the payments. I’d be in more debt if it wasn’t for what my partner had left me. In their typical contrarian way, they decided against getting any implants, and so I’m on my own. It’s all subscription-based now, of course; I was one of the pioneers on that front, like that dog or monkey shot into space way back in the Twentieth Century. I’m still working where I can, scraping together enough to cover that monthly fee. I had to give up the flat not long after my partner died, but it could be worse, I sleep on the bottom of a bunk in a fairly nice hostel, in a not-too shabby part of the city. It isn’t much but it doesn’t cost much either, so that’s something. The corporation monitors their pacemaker around-the-clock over the Internet, sending through software upgrades every now and then; I’m given twenty-four hours notice when that happens, can’t do anything too strenuous when its updating. Thankfully, the WiFi in the hostel is pretty decent and mercifully it’s covered by the rent.
On the occasional night the hostel is silent and my ear is pressed into my lumpy pillow, I can hear the pacemaker ticking-over, like an old-fashioned electric metre running down, gobbling up the slotted coins. I am inextricably part of the system now. I’ll work until I die, or I’ll die when I can no longer work. Either way, the destination is the same.
#