In the teleoperating room, the eight member surgical team lay in a circle around an empty space, waiting for the signal to begin.
The bio suits they wore made them look like astronauts having a nap, however the suits were far more sophisticated than any EVA suit could ever hope to be. Not only would they support the team's bodies to minimize fatigue, they would also act as VR portals during the gruelling eight hour operation that lay ahead of them.
Lying at the 'head' end of the circle, Charles McGragh cleared his throat. "Ladies and gentlemen, we are ready to begin. Initiating Stage 2... now."
In the sterile operating theatre twenty feet away, the multiple appendages of the surgical AI remained still, but the mirror foam on which the patient lay began to bubble as it slowly encased her body.
"Beginning induced hypothermia," the AI said.
* * *
Inside his VR faceplate, Kenneth Wu watched the readouts as Miira's core body temperature began to slowly drop. This was the crucial first step to ensuring her brain suffered no permanent trauma.
"Induced hypothermia stable at 32 °C," the voice of the AI intoned. "Continuing to cardiopulmonary bypass."
Miira's heart was quite strong, but her lungs were riddled with cancer and would have to be removed completely.
In normal circumstances her lungs would be replaced with bio-identical organs grown from her own cell tissue, but this had been done once already and the cancer had grown back. This time, she would be permanently connected to artificial lungs, to ensure the blood supply to her brain remained optimum for as long as possible.
While her heart was still, they would also perform a few minor repairs to make sure it too continued to function efficiently.
Two hours later Miira's heart and new, artificial lungs were ready to be switched back on, however the bypass remained in effect while the AI tackled the cancer that had metastized to her spine.
Moving with microscopic precision, the instruments of the surgical AI removed one vertebra at a time, spray painting each exposed section of her spinal cord with a solution of fast acting biocrete before moving on to the next section.
Seconds after being activated, the sheath of biocrete would begin protecting her nerves from damage.
Within two days, the sheath would be almost as thick, and ten times as strong, as the original vertebra protecting her spinal cord, but it would be inflexible.
The procedure to replace the spinal column was relatively simple, and could have been done before Miira entered Innerscape, but she had not wanted to be paralyzed while she was still conscious. Now it would not matter.
Four and a half hours into the surgery, the AI had repaired the worst of the damage caused by the cancers, but there were still two important organs that would have to be fixed if Miira was to have a relatively long and happy life in Innerscape : her failing kidneys would have to be removed, replaced by state-of-the-art dialysis machinery, and her bowel would have to be removed completely.
Removing the bowel was a necessary precaution for all Innerscape patients as the bowel was a major source of infection, and infection could kill patients far faster than any disease.
In Miira's case, removing the bowel was also necessary because it was riddled with cancer.
It was during the removal of the bowel that the scans revealed a tiny, but malignant cancer in one of the regional lymph nodes. The tumour was only small and had been masked by the far larger growths in her bowel. Only once the bowel was removed had it shown up as a tumour in its own right.
While the AI finished off the bowel, Kenneth Wu and the rest of the team held a hurried teleconference.
The thing that worried them was that a malignancy in one lymph node could well signal the presence of cancerous tissue in others.
A simple procedure could check whether this was the case, however it took time for the results to come back, and Stage 2 was already nearing the seven hour mark. Every minute past eight hours increased the risk of complications and death.
Some of the team were in favour of removing adjacent nodes in the hope that this would catch as much of the cancer as possible, but Kenneth Wu knew such a shotgun approach might not work in Miira's favour long term.
"No, " he argued. "We should just remove this one node, and then wait for the tests to come back. If other nodes are affected we'll know exactly which ones are involved, and can remove them during Stage 3."
"That's very irregular!" Charles said. "Stage 3 is delicate enough without adding to it."
"That is true, Dr McGragh," Kenneth said without inflection, "but the nodes can be removed manually without taking any resources from the AI."
"Manually?" Charles sputtered. "That's archaic! You're not seriously proposing to remove the nodes yourself?"
"Why not?" Kenneth asked. "We are all surgeons aren't we?"
"Of course we are," Charles growled, "but none of us can match the precision of the AI!"
"That's true, but the removal of a few nodes is very simple in comparison to most other procedures," Kenneth began in a reasonable tone.
"Besides, all of us have to be skilled enough to step in if anything untoward happens, don't we?"
Kenneth's words caused a long, and rather uncomfortable silence as the seven other surgeons present secretly wondered how skilful they would be in a real emergency.
As accredited surgeons they were all required to practise their surgical skills on a regular basis. In reality, however, those practice sessions were all just simulations. Very good, very realistic simulations, but simulations nonetheless. Few had touched a real, live body since medical school.
"I suggest we let the team decide," Charles said, his voice hard.
When the vote was taken, the shotgun method won by a margin of five to three.
As Kenneth Wu directed the AI to remove the suspected lymph nodes, he prayed his colleauges were right, and that they had removed the right ones.
* * *
Two days later the surgical team were ready to begin the most delicate part of the whole procedure.
Exposing the brain was both the simplest, and most invasive of all the procedures performed on Innerscape patients, involving as it did, the removal of the entire skull, including the bones of the face.
Once the procedure was complete, Miira's naked brain would be encased in a sealed container filled with a bath of proprietary biofluids.
In keeping with the morbid humour that had named the contaiment capsules the Catacombs, most of the medical staff referred to the biofluid as the 'embalming fluid'. Yet in reality nothing could have been further from the truth.
The self-replicating nanoparticles of the biofluid did not just preserve the brain, they invaded it. No nook or cranny was exempt. The centres for sight, sound, touch, taste, smell, gross and fine motor skills, and the finer senses like spatial awareness, all were invaded.
Some of the embalming fluid even made its way to the amygdala because the ability to fear was an integral part of being human.
As the nanoparticles slowly grew, they would organize themselves into a network of artificial neural pathways, pathways capable of connecting the organic brain to the AI interface.
Once those pathways were complete, the patient would experience the most minute digital feedback as if it came from the real world.
Kenneth Wu had been instrumental in creating the AI-neural interface, and few people alive knew more about it than he did.
Stage 3 was quite literally his baby, and even Charles McGragh deferred to him in this area.
"The team is ready to begin Stage 3 Dr. Wu," Charles said evenly.
"My instruments are ready to begin as well," the surgical AI added.
Kenneth Wu stared up at the image of Miira's face in his faceplate, but superimposed over that image was the memory of her frightened brown eyes staring up at him as the anaesthetic took effect.
She had been scared, very scared, but her last look had held nothing but trust. She trusted him. He would not let her down.
"Begin."
"Sealing external carotid arteries now," the AI said as its tools cut through the skin with lightning speed. "External carotid arteries sealed. Initiating removal of skin."
Even before the AI finished speaking, a fine mist began to form around Miira's features. As the seconds ticked by it became progressively thicker until her whole head seemed to be encased in a swirling ball of white.
As Kenneth and the rest of the team watched, the mist gradually changed colour from white to a dirty pink.
When the mist was sucked away a few minutes later, all the soft tissue of Miira's face was gone, leaving her head looking like a halloween mask. Her eye sockets gaped empty, her nose was gone, and her slightly crooked teeth sagged open, exposing the emptyness where her tongue had been.
It was not a pretty sight, but the team had watched this transformation many times before, and were inured to its ugliness.
All of them had grown up with the wonders of nanotechnology, and if they felt any awe at its power they did not voice their feelings.
"Phase 2 of Stage 3 complete," the AI said. "Commencing removal of skull."
Once again, a ball of liquid nanoparticles encased Miira's head, but this time their function was to eat away at the bone protecting her brain.
Bone was much denser than skin and cartilage, and the process took a full 30 minutes. At the end of that time, the ball of liquid bore a rather disturbing resemblance to oatmeal porridge.
As the team watched, one of the tools hovering outside the ball released three drops of pale blue liquid onto the surface.
The outside of the ball quickly began to look more like dirty concrete than porridge. A few minutes later still, the concrete hardened and began to crack.
As the process accelerated, the cracks turned into shards, and the shards turned into even smaller fragments that lifted from the surface, and were drawn away like iron filings captured by a magnet.
Once the hard crust was removed, the ball of liquid held in place by electromagnetic currents was perfectly clear once more. And nestled in the centre of it was Miira's brain.
"Phase 3 of Stage 3 complete," said the emotionless voice of the AI. "Commencing diagnostics."
This was the moment when Kenneth always held his breath.
A great deal of computing power had gone into calculating the composition, and number of nanoparticles to use, but there was always a slight element of uncertainty. If even a thin layer of unwanted cells remained around the patient's brain, the embalming fluid would not work properly, and the team would have to take remedial action.
It could be done, and had been done in the past, but the results were not always optimal. The patients often suffered some small damage to the outer surface of the brain, or to one of the exposed blood vessels...
"Results are optimal," the AI said.
Kenneth did not cheer like the rest of the team, but he did exhale on a very relieved sigh.
"Preparing to initiate Phase 4."
This time the AI inserted an array of needles into the ball of liquid cradling Miira's brain. Each hollow needle was as fine as a human hair, and drippped a measured dose of embalming fluid into the liquid.
Over the course of the next two days, the nanoparticles in the embalming fluid would grow to fill the entire ball.
Once that happened, the semi-solid surface of the ball would be sprayed with a different cocktail of nanoparticles which would grow into the interface connecting Miira's mind to the digital world that awaited her.
"Phase 4 completed successfully."
Now all we can do is wait, Kenneth thought with a familiar thrill of excitement mixed with trepidation. If he had done his job properly, the next time he saw Miira, it would be in Innerscape.
* * *
"Miira. Miira wake up!"
Miira did not want to wake up, but the voice was so insistent it drew her from the warm, dark depths like a siren song.
When she finally opened her eyes it was to a cascade of colours.
She blinked, and blinked again, until the chaotic colours finally resolved into the shape of a head. The head was bald, and floated in space like an oval soccer ball, but it was definitely a head.
Working out who the head belonged to took a little longer, but then the dark, almond shaped eyes and high cheekbones triggered a memory.
"W-oo?"
Miira was surprised at how odd her voice sounded, but assumed she had been sick. Or...
"Wha' wong?" she asked, an edge of panic in her voice.
"Nothing Miira!" the soft, full lips said with a big smile. "We're just calibrating your responses. Can you tell me what you see? Take your time, there's no rush."
What I see? Miira wondered, her thoughts slow and sluggish.
"Ah-I, I ssseeee yuuu."
The garbled sounds coming from Miira's mouth made her angry, and her brain sped up a little more.
"I... see...you!" she articulated with painful concentration.
"Good girl," the lips said, and this time the eyes seemed to crinkle in a smile too.
"You're doing so well. So very well! Now tell me, do I look strange to you?"
"Yur baldd," Miira said, wondering why he would ask the obvious.
"Yes I am! Well done. Would you like to see me with hair again?"
"Yess?" Miira replied, her confusion evident.
"Watch carefully."
As Miira watched, hair began to sprout from Kenneth scalp. It looked just like the time lapse photography of grass she had seen as a child...
"Oh!" she cried as understanding dawned. "Ish thish in-innashkapp?"
"Almost," the avatar of Kenneth Wu said with another big smile.
"We're still running tests, so you'll have to be patient a little longer. But the next time you wake up you'll be in the Presidential suite of the Ritz!"
"Ha! Funi maan," Miira replied.
She thought she might be smiling too, but wasn't quite sure.
"Can you raise your hand for me Miira?"
For one awful moment Miira could feel nothing where she thought her hand should be. But then an odd tingling came from somewhere else in her 'body' and she concentrated hard on the sensation, willing it to form into something recognizable.
"Gently! Gently!" Kenneth laughed. "Just let the feeling form."
...just let it form, he says...
"Ezi fo yu to-...Oh!"
The angry retort died stillborn as Miira stared at the hand pointing at Kenneth Wu's face. Her hand, and yet not. The fine bones were hers, but the flesh was soft and plump, the skin creamy and elastic.
It was how her hand had looked twenty years before. When she had still been healthy...
"Take my hand Miira."
Blinking in astonishment, Miira looked away from the wonder of her own fingers, and saw that a strong, tanned hand had now joined the head floating in mid air. There was still no body connecting the two, but she knew it was Kenneth's hand.
Could she reach it?
As she pushed her own hand through the intervening space, her wrist and part of her forearm came into view. And they were just as young and unlined as her hand!
She was still staring at her arm in delight when she felt warmth envelope her fingers. Pressure followed as tanned fingers intertwinned with her own.
"Look at me Miira."
Miira looked up into the attractive face smiling back at her, and was astounded by the warmth she saw there.
"Do you realise you have just leap-frogged three whole testing sessions?" the face said. "I'm so proud of you!"
The avatar of Miira Tahn was still trying to squeeze her Doctor's hand when sleep crept over her like a warm blanket.