Advance Directive
My name is John Price AD, and I have to decide if someone lives or dies. That's my only job, that's why I'm here, that's my goddamned raison d'etre, pardon my French.
If this particular person hadn't popped a clot out of his heart and got it lodged in his brain, subsequently wound up on the stroke ward of the local District General with no movement in his right side and not much in the way of consciousness either, I wouldn't be here. Literally.
I can't go and touch this poor bastard, can't hold his hand or shake his shoulder myself, can't try and reach him physically. But I've got a whole shed load of different camera views from my little room, and I can see it's pretty much a hopeless case. He hasn't really woken up, not since he's been brought in. Sometimes his eyes flicker open and stare blankly at the camera on the left – not to the right, I'm not even certain he's really aware of what right means anymore – sometimes he moans or cries. But there isn't much light behind those eyes, that's for sure. They're feeding him by a tube that goes down his nose into his belly, because the muscles in his throat don't work properly anymore, and if he ate anything, half of it would probably wind up in his lungs.
All in all, the guy's in a pretty shitty state, as I say.
But it's a tough call to make, tough as hell.
That's what I'm here for. That's what he wanted, what I wanted I should say.
That's why I was constructed, from his brain twenty years back, when it was young and optimistic, and didn't have a big gaping chunk of necrotic white matter rotting away on one side like a worm in an apple.
It's tough waking up one day and realising you're not real.
It's even tougher seeing what you've become, and then having to decide whether to pull the plug.
< 2 >
Karen's not really supposed to talk to me – that's one of the rules – but I can watch her, and she knows I'm here. She was the one who persuaded John Price – the real John Price, that is; not John Price AD, i.e., me – she was the one who persuaded him to have the advance directive made.
I can remember it clear as glass, of course I can, just as clear as I can remember every other significant event of my simulated life. It was around the time her father was dying. He didn't have a stroke, he had dementia, but hell, same difference at the end, really. We went to see him most days for what seemed like forever, but it was probably only a couple of months. Most of the time he didn't even recognise her, didn't even register her presence. Sometimes he cried out and talked to people who weren't there. Most of the time he just blinked, looking confused and kind of hurt, then got on with the business of pissing and shitting himself.
Karen wanted them to pull the plug, but they couldn't, of course. They could withdraw some treatment, they told us, but it was another thing entirely to stop feeding him, stop giving him fluids.
It wasn't their decision to make, they told us, and it wasn't Karen's, either.
"Bullshit," said Karen, "I was his little girl, for Christ's sake, he raised me and changed me, I was closer to him than anyone, you think I don't know he would have hated this?"
But it wasn't in their hands or ours, and it took several long weeks for him to die. When he started coughing up green phlegm and struggling to breath, Karen was so happy.
Right about that time, the whole advance directive thing was getting fashionable, at least if you could afford it, and we weren't doing so bad.
So we got scanned, we both did.
And that's how come I'm here, watching myself live like a vegetable, live through the thousand and one electronic windows of my digital cage.
< 3 >
I wouldn't want to go on, if that was me, I keep catching myself thinking. And then I realise, shit, that is me!
This whole damn situation is just too fucking weird.
Karen brings the children, and that's weird as hell, too.
Tommy was only four when John Price was scanned, and Grace was just a faint swelling around my (his) wife's belly. Now my kids are young adults; I missed their whole lives. I can kind of recognise Tommy, the tilt of his chin or something. And I can see myself in Grace, too; our eyes are the same.
I try and imagine what it must have been like, watching them blossom and grow. I have access to a whole library of videos and photographs, birthdays and holidays and so on, but it's not the same, of course it isn't. I review these archives, try to feel some connection to these children, but it's like grasping mist; and I feel like I'm spying on them, too. Are they really mine? Sort of. Yes. No. I'm not sure.
Tommy holds John's left hand – they keep the right one under the blankets because it's horribly swollen and stiff, don't ask me why – and gets excited when the hand twitches back. It doesn't mean shit. I can see it doesn't mean shit. This poor bastard might as well be dog food, might as well be a fucking jellyfish for all the awareness of his surroundings he has. But all Tommy can see is that his Dad squeezed his hand, and suddenly there's a treacherous glimmer of hope in his face.
Karen strokes her/our son's head, and looks straight at me through one of my cameras. Her eyes are hard. What is that there? Defiance? Resentment? Hate?
I take my time to come to my decision – shit, I'm not gonna rush into killing myself, am I? – but there's only one way I can jump, really.
I wouldn't want this, and I'm based on him.
< 4 >
Ergo, John Price would want the plug pulled. Case closed.
I log into the system, and enter my choice.
Except, it turns out the case isn't closed at all.
Karen knew which decision I'd come to – she had lived with me for close on twenty years; even after the divorce there was some contact, or at least, that's what the records give me to understand. The point is, she knows how I think (or maybe that should be thought?), and she had an objection order in place just waiting for me.
Which means, this is not going to be a clear cut case of me saying my future self would want to pop his clogs, and then vanishing myself in a puff of evaporating electrons.
If I want me dead, I'm going to have to fight for it.
I can't get over how real this all feels. Just like real life. My lungs move, fill with air. I can hear sounds, taste and smell and touch things. And the so-called 'real' world can see me, too. We're just separated by an endless sequence of thin glass sheets, that's all. I'm trapped in a cage made up of all the computer screens in the world.
Karen is in front of me, standing behind what looks like a thin glass window. Up till now we haven't been able to talk to one another. Now that the case is going to the courts, the rules are different.
I don't have to justify my decision to kill John Price. Of course I don't. That's not the moot point. As his walking, talking advance directive, I have complete powers of advocacy over his life. I had them from the moment it became doubtful if he would ever regain a significant degree of consciousness, at which point my files were dusted off and my simulated self was switched on.
No, Karen couldn't make a case around whether I'm making the right decision or not. That wouldn't wash at all.
< 5 >
What she can do – has done – is to attack my right to existence at all.
"People change," she tells the jury, "When you leave this hearing today, you won't be the same people you were when you arrived this morning. Every experience changes you. Everything you learn, everything you see and hear, every event in your life, however marginal, all build up in you, changing you. We are, all of us, in a constant state of becoming."
It's obvious where she's going with this. Other people have tried similar things in similar cases. Sometimes it has worked, sometimes it hasn't.
"That simulation of my ex-husband that you can see standing just behind the TV screen is not my ex-husband," she goes on, "It's a simulation of the man John was twenty years ago. The fact that as of this moment no law exists that automatically nullifies advance directives after a given amount of time has elapsed – and one could argue that even five years would be too long a time – the fact that no such law exists is just one example of how poorly thought out and bound in law the whole science of simulated advance directives has been, and continues to be."
Karen was always good at talking. She's better than she was when I knew her, much better. I wonder what the woman I love has been doing with herself these past twenty years to get so much more confident, so much smoother.
That's something else that complicates the situation, by the by.
I love her.
I can't help it. John loved her when he was scanned, so I love her now. The fact that she's put on some weight and has more grey in her hair than brown doesn't change a thing.
I love her. I love her, and she hates me.
It's my turn to talk now.
< 6 >
I address the jury, not Karen. Matter of fact, I can't even look at Karen. I can't stand to see the contempt in her eyes.
"Karen Price is trying to convince you not only that I'm not really real, but also that I am an inaccurate simulation of the man I was based on," I begin. I am struggling to keep my voice steady, struggling not to notice the way Karen is looking at me.
"I can't attempt to argue the first charge – though I can tell you it feels pretty Goddamn real – but I'll give the second my best shot. Yes, everyone changes as they go through life, of course they do," I carry on, "But that doesn't mean that we become different people, not literally. Elements within us change, but the core of us does not. I'm here because John Price didn't want to go on living if he ended up as a vegetable. That wasn't something John changed his mind about. If he had done, he could have logged into his account and deleted me with the click of a button. The fact that he didn't means that, despite twenty years of life experience existing between him and me, we are still essentially the same person."
Karen says some more after that, then I go again, but the thrusts of our arguments have already been laid out, and it's basically a matter of recapitulation, of trying to win the jury over with different ways of saying the same thing.
After a while, a bell goes off, and we have a recess.
Karen asks to see me privately during the break, and I hesitate for the whole of about a second before clicking the button and accepting the request. Big mistake.
She asks me directly to drop my decision, to resign my position as advocate, to let John Price live.
"Karen, can't you see that he doesn't want to live?" I ask her, "I wouldn't want to, and I am him, for Christ's sake!"
< 7 >
"You arrogant prick," says Karen, "Don't talk as if you're really him. You're not him. You're nothing but lines of code churning away in a motherboard somewhere. When this farce is over someone will press a button, and that's that, you'll be gone, no ashes, no funeral, because you're not real. And I'll tell you something else, I hope to hell the person who gets to press that button is me."
"Shit Karen, when did you get so fucking bitter?" I say, because something is breaking in me, "You were never like this before. Never nasty like that, never so fucking nasty."
I realise my voice is breaking, too, and the tears running down my face are obscuring the video screens. They even simulated the damn tears right.
When I look up again, something has changed in Karen's face. I think maybe she's crying, too.
"Jesus, John, don't you think this is hard for me, too?" she whispers, "To see you again, to see how you were, before things went wrong…"
She trails off, then starts up again.
"You look exactly like he did," she says, "You look like him, sound like him. The way you talk…It's like meeting a ghost. It's just like meeting a ghost."
Then she puts one hand out and touches the screen. I reach out to her, but all I can feel is cold glass.
"The kids…Tommy…he can't bear to see his father go like this." Karen is not quite looking at me as she speaks, "There was a lot of bad stuff between them, at the end. After the divorce, things got pretty messy. If he was to go now…look, maybe John won't wake up. Maybe he won't. But if he just hangs on a little longer, maybe that'll give Tommy the chance to…I don't know. To say some things, even if there's no one listening. To make peace with himself, or…or something."
I can feel my resolve caving in. I love her. How can I say no to her? She wants me to hold off on my decision on account of her/my son.
< 8 >
I run a hand through my hair.
"Look," I say, "Look, OK, I'll hold off. For the moment. If Tommy needs some time, then OK, we'll give him some time."
Also, it'll give me some time, too. I suddenly realise that maybe I'll have a chance, not only to get to know the woman Karen has become, but also to get to know my kids. To get to know Tommy.
"Thanks, John," she says. She half-smiles at me. I nod, and kill the connection on the computer screen.
Her face flashes and is gone, replaced by a familiar view of John's hospital room. I watch his chest rise and fall, slow, laboured. A doctor comes and stabs his good arm with a little needle so they can put another bag of fluid up, to keep him from dehydrating and dying while I refuse to make the decision that he would want, but that the woman I love does not. His hand jerks a few times, and the doctor calls a healthcare assistant to pin the arm down while he gets the needle in position.
His eyelids flutter briefly, then still.
I'm not scared of dying. I know that sooner or later I'm going to be pulling the plug on John, and when I do that I'll basically be pulling the plug on myself too. Us advance directives do not enjoy the right to live beyond the souls who made us.
There's a catch, though, to stop ADs from choosing to keep their "real" counterparts alive as long as possible, just so that they can go on "living" (in this weird, digital sense) themselves as long as possible.
You get a couple of weeks to make your choice, then either way, that's that buddy, time's up for you.
Say I decided to say, OK, John Price would want to go on living, don't pull the plug. I'd make my choice, throw my two cents in the ring, then I'd be switched off, just the same as if I'd decided to pull the plug. Goodbye John Price AD. The only difference is, if I decided to keep him alive, I could be re-awoken again if there were any change in his condition. If he deteriorated, for example, say he had a second stroke or something, then I'd be brought back to reassess, to see if I felt the situation had changed significantly.
< 9 >
But am I afraid of dying? Why the hell should I be? I don't even really exist, as people are so fond of pointing out. Truth is, I am a ghost. The real person is either dead or dying, depending on your point of view. Fuck it, if I think about these things too long, my head starts to hurt. And that pain feels pretty Goddamn real, thank you very much.
There are other things I'd rather spend these precious remaining ghost-moments on than a killer of a headache. Like watching my son, for example.
He comes to see John most days, more often than Karen does.
He mostly just sits by the bedside and doesn't say much. Sometimes he holds John's good hand. Once or twice he tried reading to him, but I think he felt self conscious about it, and he didn't do it for long. The book he tried reading him was "Flowers For Algernon", a science fiction book from a couple of hundred years ago. I remember that book, I used to love it when I was Tommy's age. It's about a guy called Charlie who has learning difficulties. He has an operation to make him smart. It works – in fact, he gets super-smart – but then after a while it begins to wear off, and he ends up being even dumber than he was to start with. It's funny, I used to run myself round in circles thinking about who the real Charlie was – was he the idiot or the genius, or who? Which version would he be when he died and went to heaven?
Now that the court case has been resolved, I'm not supposed to talk to Karen or the others again. But it's not an actual law – as Karen said, the law surrounding the use of simulated advance directives is ridiculously lax – and I can't help myself in the end.
"What are you thinking about, Tommy?" I say through a speaker one day, when I can't stand his endless sad silence a moment longer.
< 10 >
He doesn't jump, doesn't even start. It's as if he knew I was there all along – of course he knew I was there, where the hell else would I be? – and was just waiting for me to say something.
He doesn't reply for a long time, and I begin to worry that maybe he won't say anything, that he has decided to follow the rules and not interact with me at all.
"I'm thinking…how did things change to end up like this?" he says eventually, "When I was a little kid, we were so close. I used to have nightmares about what it would be like when you…when he died. I used to get really worked up about it. Then I used to run and hug…him…I used to hold him so tight. And now, this. Sitting in a hospital room, and not being able to say anything…I'm not even sure the last time I hugged him. We…fought a lot, since the divorce. Since before the divorce, really. So I guess I'm thinking about how point A gets to point B, when there isn't even really a single moment I can point to and say, that's it, that's when things changed."
The silence stretches on.
"Was I a good father?" I ask eventually. I have to.
"Yes. You were." I can see the tears starting to form in the corners of his eyes. "You were a great father. I loved you so much. Whatever happened afterwards, you were a great father."
He gets up suddenly, leans forwards and kisses John on the forehead. Then he turns around without another word and walks away.
Karen comes to the hospital the next day, but she doesn't come to see John, she comes to see me.
"Tommy says he spoke to you," she tells me, "I think it did him good. I don't think he's going to visit again."
There is a long pause. I know what that means. I know why she's here.
< 11 >
I wonder if I should ask the question I am dying to ask. Is it fair? But then, I'm going to be gone soon, probably in a few hours at the most. Why the hell shouldn't I ask her?
"Could it have been different, Karen?" I say, "I guess…thing's looked so rosy. Did it have to end up this way?"
"You shouldn't forget, we had good times too. A lot of them." She wipes the corner of her eye. "Things run down in the end, one way or another. Things end."
"I wouldn't have fucking let things get this bad!" The words jump out, before I can call them back. I should stop, it isn't fair to talk to her like this, but I can't rein myself in.
"How could he have hurt you all like this, ruined everything, fucked everything up so royally? I want to kill him. I want to kill him, Karen. I want to switch us both off."
She smiles so sadly. She kisses my screen. Now there's a smear of lipstick on the glass, and the world is blurred.
"It's time to go, John," she says, "But please, don't do it in hate. Do it, but not in hate. There were good times, I promise you. You did good things."
She leans over the body in the bed, and kisses him on the forehead, too.
Then she stands up, shakily, and walks out of the room.
She is right. If she can forgive him, why shouldn't I?
I type the code in, and this time there is no counter-instruction waiting there from Karen.
John is about to die.
I wonder if computer simulations go to heaven.
After all, does God really give half a damn about the difference between a neurone and a diode?
< 12 >
Maybe there's every version of every possible person in heaven. All the people we could have been if we went left instead of right, or had one less beer before driving home, if we had seen things through rather than giving up on them.
Something flickers, and all the screens go dark.
