The Masters of Triage by Evan Appelman	Table of Contents Part 2 appears in this issue.
part 1 of 5

Brightest and best of the sons of the morning,
Dawn on our darkness and lend us thine aid.

“It would have been different if the baby had lived.”

“That’s when things started to go bad?”

“Yes. That’s when he started withdrawing. He talked less and less, until now we are hardly communicating at all. I think he feels that I’m somehow blaming him for the baby’s death.”

“Are you?”

“No, of course not. It was an accident. SIDS. The doctor said it could have happened to anyone.” She pauses.

“But?”

Indignantly, “I didn’t say ‘but’!”

“No, but might you have thought it? It happened on his watch, didn’t it?”

“Well, yes. But I swear I’ve never reproached him for it. Never!”

The man behind the desk rubs his forehead wearily and studies the young woman seated opposite him. She is in her early thirties, brown hair and eyes, carefully dressed, with an olive complexion suggestive of a Mediterranean background. She is by no means a beauty, he thinks, but she is quite attractive in an intelligent sort of way. And she clearly wants this relationship to succeed.

“No, I’m sure you haven’t,” he says. “But you must realize that body language can be as significant as anything that is actually said.”

He pauses for a moment and then continues. “You also need to recognize that grief itself is not an isolated phenomenon. It is an essential part of life.”

“I know, I know. ‘Without a hurt the heart is hollow.’ Isn’t that how the old song goes? But that doesn’t make it hurt any less!”

“No, of course it doesn’t. But my point is that it doesn’t help to sequester your grief as if it were your private property. You should be sharing it with those you love and who love you. If you don’t, not only do you make it harder for yourself, but your partner may start to question your commitment to the relationship.”

“I hear what you’re saying. But putting it into practice may not be so easy.”

“No, it never is. You both wanted the baby?”

She nods. “Yes. We were planning to get married soon after the birth. But when the baby died, everything got put on hold, and then things just started falling apart.” She gropes in her purse for a handkerchief and dabs at her eyes.

The man writes briefly in the notebook in front of him. “It would be helpful if I could meet with your fiancé, and also talk to the two of you together.”

The woman shakes her head. Her tone reflects a sense of hopelessness. “No, he’ll never come. Oh, God, it’s so unfair!” She dabs at her eyes again. “I’m sorry. That was a pretty naive thing to say, wasn’t it? Fairness doesn’t have much to do with the real world, does it?”

The man is silent, his expression impenetrable. “No,” he says at last, “I’m afraid it doesn’t. But I would be the last person to call you naive for expecting it.” He makes a few more notes and then stands up. He is tall, with craggy features — almost Lincolnesque. “Well, Ms. Malantis, I would really urge you to try to persuade your fiancé to come see me. You obviously need to work toward restoring communication if you’re to have any chance of getting this relationship back on track.”

She rises also. “Thank you, Dr. Orr, for taking the time to listen to my story. I’ll do the best I can. But...” Her voice falters. “But it all just seems to be going down the drain.”

“I know,” he says gently, “And I’m sorry. But there’s always the chance that with enough effort it can be turned around.”

“I’ll try,” she says, without conviction. “I will try.” Then, almost to herself, “‘And how am I to face the odds of man’s bedevilment and God’s?’”

He finishes the verse for her. “‘I, a stranger, and afraid, in a world I never made’.”

“I guess it’s hard to disabuse oneself of the notion that the fact of our existence ought to create some sense of obligation on the part of the universe.”

He looks at her sharply, his interest piqued. Maybe there is more depth to this woman than he had realized. “Well, yes,” he smiles ruefully, “but unfortunately the universe has never acquiesced in that conceit. And as to the odds, I know it sounds trite, but all we can really do is play the hands we’re dealt.”

“Yes, I suppose so.”

“Can we go ahead and schedule a follow-up appointment now? I’d like to see you again, even if you can’t get your fiancé to come with you.”

“No, I think I’d rather wait. I’ll call for an appointment if it looks as though I’ll have anything constructive to talk about. Goodbye, Dr. Orr, and thank you again for all your help.”

She extends her hand; he takes it gently and holds it for a moment. To his surprise, he finds himself resisting an urge to raise it to his lips. He releases her hand almost abruptly. “Goodbye, Ms. Malantis, and good luck.” He watches expressionlessly as she turns and walks out of the office.

* * *

Lucien Orr, Ph.D., Licensed Marriage and Family Therapist, turned to the computer at the side of his desk and began transcribing his notes. Finishing, he clicked on an icon in the form of a large question mark. The screen went blank, and after a moment the words “Loading probability matrix” began flashing. A long list of descriptive sentences appeared.

He scrolled down and clicked on “Relationship successfully reestablished.” The screen flashed “Calculating” and then settled to the message “Relationship successfully reestablished: probability 32%.” Lucien’s eyebrows lifted quizzically, and he shrugged. “It could be worse,” he whispered to himself.

He started to get up, then turned back to the keyboard, hesitating. Why look at this again, he thought. What’s the point? He shrugged again and clicked on an icon that looked like a miniature picture frame. “Review current scenario? OK? Cancel?” He hit “OK” and sat back in his chair, watching the screen.

A small room, dimly lit by a night-light. In the center, a crib with a sleeping baby. Above the crib, a colorful mobile. A young man enters the room quietly, approaches the crib, and looks down at the baby with a tender smile. Gradually the smile fades, replaced by a look of concern. He touches the baby’s forehead; there is no response. Frantic, he picks up the baby, brushing the mobile and setting it gyrating wildly. Carrying the baby, he rushes out of the room.

Sirens. A pounding on the door. The room fills with people: policemen, firemen, paramedics. A continuous din of questions and barked instructions. The door opens again, and an attractive, brown-haired young woman enters. As if on cue, the room falls silent. The woman looks about, for a moment uncomprehending. Her eyes meet those of the young man. They stare at each other. Her hand goes to her mouth, and a long, low moan fills the room.

Lucien hit a key, and the scene faded. She was right, he thought, she never did reproach her partner. She didn’t need to. He was feeling enough self-reproach to last a lifetime. And she was so wrapped up in her own grief that it hardly occurred to her that he, too, might need comforting. Little wonder the relationship was on the rocks.

There remained one more thing to look at. Once more Lucien hesitated. He knew it all; why did he insist on looking again? But he had to. He clicked again on the picture frame icon and scrolled until he found the choice he wanted: “Return to branch point.” A bright yellow triangle containing a black exclamation point appeared on the screen. Below it in bold letters:

“WARNING! This branch point has been passed. You may review alternatives, but you cannot alter the scenario. Abort? Continue?”

He hit “Continue.”

The scene progresses as had the previous one. But this time, as the young woman enters the room, a piercing wail of indignation arises from an invisible point in the midst of the bustling paramedics. The woman rushes forward and is soon holding and soothing a much put-upon infant.

I don’t need this, Lucien thought. Then he hit a key. The words “fast forward” flashed. The screen image became blurred, with a series of rapidly advancing numbers superimposed on it. He hit another key, and the image stabilized.

The young woman is driving along a suburban street, her three-year-old daughter strapped into a car seat in back. They approach an intersection with a green traffic light. The mother doesn’t notice another car rapidly approaching the intersection from the left. As the woman’s car enters the intersection, the other car surges through the red light, and the two vehicles collide.

The mother is thrown out of her car. Dazed and bleeding, she gets up and looks around confusedly, as bystanders rush to help. Suddenly the car is enveloped in flames. The mother starts toward it, but many hands grab her and hold her back. “No,” she shouts, “Oh, no!” And then she screams, and the scream goes on and on...

Lucien hit “Exit,” and the screen faded. But the scream continued to echo in his head. At least we avoided that, he thought grimly. I guess you can say we’re doing some good.

C’mon Luce, get hold of yourself. You know how this damned game is played. Anyhow, you’ve got real work to do. Although he had been thinking of taking off for a cup of coffee, he decided now that he no longer had time and returned to the keyboard. A few keystrokes, and the screen was filled with the face of a middle-aged man. “Hi, Boss,” the face said.

“Hi, BZ. What have you got to make my day today?”

“Not much that you’ll like, I’m afraid. If you want, we can start with the earthquake in Japan.”

“Might as well. What’s the story?”

“Well, we were able to work the matrices and get a lot of people out-of-doors and away from the epicenter. Doing that held the casualties down to around 7K.”

“Seven thousand! You call that a success?”

“Dammit, Boss, we’re doing everything we can. Molly and Mam and Belial have been working nonstop on the matrices for the past week. There’s only so much we can do with a catastrophe of that magnitude. You know we can’t risk altering the geological features. And the alternatives would have killed off 15K at least.”

“I know, I know. The best of all possible worlds. But that doesn’t mean we have to like it. I’m sorry, BZ, I guess I’m a little stressed out today. I know all of you all are doing your best. So what’s next?”

“Well, there’s the mess in Sudan. Call it what you like: ‘genocide,’ ‘ethnic cleansing,’ whatever.”

“So what are you doing about it?”

“Hold on a minute, Boss, I’m just getting to it. We were able to anticipate the movements of the gangs of thugs and arrange for several of the villages to be empty when the hoods arrived. Probably reduced casualties by several thou at least.”

“Big deal. But this is no natural disaster. You should be able to tackle some root causes.”

“I know, and we’re trying. But it’s not as simple as you might think. It wouldn’t be too hard to engineer a regime change — just a few key people who happened to have heart attacks. But when we study the branchings, it’s not at all clear that the alternatives are going to be any great improvement. I think the hip word these days is ‘blowback.’ But we’re working on it.”

“OK. Keep me posted. What about the Middle East?”

“You mean Israel and Palestine?”

“That’s exactly what I mean. What are you doing down there?”

A pained look came over the face on the screen. “I don’t know, Boss. It’s kind of got us stumped. Of course we can keep on with the palliative stuff — minimize the number of people around when a suicide bomber sets himself off, keep the Palestinian kids away from the windows when the scared Israeli soldiers start shooting the place up, all that kind of thing.

“But when it comes to trying to deal with root causes, it’s just a godawful mess. The branchings are spread out in so many directions you can’t even count them. The main players don’t know quite what they want, but they’re both ready to fight to the death for it. And the outside interference is simply horrific. There is never an obvious intervention that we can count on to yield a favorable result. The bottom line is that we’re just about at our wits’ end.”

Lucien scowled. “I don’t have to remind you how long this has been going on. You know as well as I do that the Chief has a special interest in the region. He’s been cutting us a lot of slack on this, but sooner or later he’s going to want to see some results. I find it hard to believe that any man-made crisis can be so persistently intractable.” He paused thoughtfully. “Maybe I should come out and take charge of things myself.”

The face showed surprise. “Well, sure, Boss. We can always use your insights. But you must have a lot to tend to there in the back office, and...”

“I know, it’s been a long time since I was last in the field. But I don’t think I’ve entirely lost my touch.” He wondered if that were really true.

“Of course you haven’t, Boss. Whatever you want. But why don’t you give us a little more time. Maybe we can come up with something.”

“OK, but see that I get regular updates. We can’t let this go on indefinitely.”

“Right, Boss. Talk to you later.” The screen faded.

BZ was right, Lucien thought. He did have a lot of back office work to do. Keeping track of the fieldwork was only a small part of what had to be attended to. The hyperlinks to the home office were always fraying and in need of maintenance. And even the matrices themselves had a tendency to tangle, making forecasting and probability analysis dicey at best and impossible at worst.

And those were problems that only he could take care of. If he disappeared out into the field for any length of time, all hell was bound to break loose back here at home. And he at least had to maintain the appearance of running this family counseling service, even if the Council did think it was one big joke.

Anyway, despite his grumbling, he knew that BZ and his crew were first-class professionals. If they couldn’t solve a problem, there was a good chance that there wasn’t a solution. All his intervention would accomplish would be to make BZ and his team resentful.

But the mess in the Middle East had been going on for most of a century now. Not so long by cosmic standards, but longer than it should. He supposed he could take the whole matter before the Council, but the idea was repugnant to him. He could just see Mike and the others smirking and whispering to one another, “Old Luce has lost his magic touch.” Anyhow, he’d never had to do it before; he and BZ and the crew had always found a way out. This time, too, something was bound to turn up.

But root causes had always been the bugaboo. How much had they ever really been able to accomplish? A little palliative work here and there. A few lives saved, maybe even a lot of lives saved, but no real attack on the underlying causes. They couldn’t be expected to do much with natural catastrophes. As BZ said, they couldn’t reorganize the geology of the whole damned planet. But the man-made disasters! After all these years they still hadn’t found a way to crack human nature.

He decided to let the whole thing simmer and get on with his other business. He shut down the computer, leaned back in his chair, and closed his eyes. For a moment he thought again about his last client. He found himself hoping that she really would call for another appointment.

Then the room vanished. In its place, a vast grey expanse permeated with gnarled, root-like structures leading off in all directions. These were not static, but were continually writhing and twisting, like so many giant serpents. From time to time one would break apart and become entangled with the others. With a sigh, Lucien settled down to his maintenance work.

* * *

Proceed to part 2...

Copyright © 2007 by Evan Appelman