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If I'm off by a couple of years it could have been early 1990s, but not later than that.

I don't clearly recall the structure of the story; I believe there is a present-time framing story with a flashback in the middle.

In the present a man with a broken arm gets off his sailboat and goes into town to get medical attention. There may be a scene at a bar where there is a machine that people can use to get instant STD tests from a small drop of blood. (Shades of Theranos!) He goes to a medical clinic where an orderly escorts him into some kind of autodoc. He asks to see the doctor first, which takes a bit of arguing, but finally he gets to see the doctor who is nominally supervising the machines. The protagonist finds the doctor a bitter, disheartened alcoholic who has no meaningful value in his work because the machines know more than he can.

(In theory the doctor could step in if there is a condition that the general-purpose autodocs can't handle; in practice they will simply connect to a more specialized system at a major medical center and either follow their instructions or arrange to transfer the patient.)

In the flashback we find out that the protagonist is actually the inventor of these devices. He created them, in a way, as revenge against the medical community because he was unable to become a doctor. The devices are in the process of being approved, and he is fighting to avoid a restriction that they only be used under supervision of a licensed MD. His partner is more pragmatic and is willing to accept the restriction to get their autodocs into use. His partner tricks the inventor into assigning her an extra ownership share, so that she can outvote him. He feels betrayed, and walks away from the business. He buys a boat.

Back in the present, he finally realizes that his partner was correct to accept the supervision condition because ultimately the outcome was the same. He goes to apologize to her. (He may also have finally gotten over his anger at the medical profession, having witnessed the human cost of having their ability to help people taken away.)

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    Was it in an anthology? A magazine? A collection by a single author? – Stormblessed Jun 28 '19 at 17:01
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    @Stormblessed Analog – DavidW Jun 28 '19 at 17:12
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    I thought you meant it was analog, as in physically printed :P – Stormblessed Jun 28 '19 at 17:21
10

"Trauma", a novelette by Eric Vinicoff, first published in Analog Science Fiction/Science Fact, May 1988.

In the present a man with a broken arm gets off his sailboat and goes into town to get medical attention.

It's not the beginning of the story, and his arm isn't broken, but here it is:

Bill was standing at the bow rail as the Trauma eased into its slip at the San Francisco Yacht Club.

[. . . .]

His left arm still ached where the boom had slammed into it. The bruise was almost gone, and the injury didn't seem any worse than a dozen others he had shrugged off. But it was an excuse to give in to the desire that had been growing since he set his homeward course.

"May I see the yellow pages?" he asked the bartender.

"Certainly, sir." Moments later the fat book was set in front of him.

He flipped to the P's to find a doctor. For his arm, and for information. The Auto-Med was his brainchild no matter what. He wanted to know how it had turned out, to see it in action if possible.

There may be a scene at a bar where there is a machine that people can use to get instant STD tests from a small drop of blood.

That's at the beginning of the story:

Bill glanced at the back of the tavern, where a Littlejohn Test-O-Matic stood next to the cigarette machine. It looked like a modest jukebox; the straightforward brushed steel and plastic design was intended to inspire user confidence. "I see you traded in your old model for a Mark Three."

[. . . .]

"Uh . . . would it be nosy to ask how your magic box works?

"Not at all. As you know, the Test-O-Matic performs a quick, accurate blood test for the major sexually transmitted diseases—gonorrhea, syphilis, hepatitis, herpes, chlamydia, and of course AIDS. The machine takes a drop of blood from the testee, separates out the serum, splits it several ways, then uses advanced laser nephelometry and flow cytometry techniques to identify the antibodies for those diseases."

He goes to a medical clinic where an orderly escorts him into some kind of autodoc.

She touched a button on the hatchcover, and it swung open. As the gleaming aluminum and plastic latticework of a manipulator couch extended into the room, he realized that the hatchcover was actually the entry end of an Auto-Med behind the wall. "Let me help you up," the nurse offered. "It can be a bit tricky."

She was right. Soon he was lying face-up on the dozens of plastic supports. It wasn't very comfortable, but he knew he wouldn't be awake long to feel anything. The cool electro-sleep contacts attached themselves to his scalp.

He asks to see the doctor first, which takes a bit of arguing,

Not first, but after he's been through the Auto-Med:

"Excuse me," he said to the nurse, "but isn't the Auto-Med supposed to be used under a doctor's supervision?"

She looked puzzled. "Of course. Doctor Thomas is on duty now, I believe. He's very good. He reviewed your case—that's his signature at the bottom of your record."

"May I see him?"

Her face showed the irritation of a busy person whose routine is being unreasonably disrupted. "If you wish. This way, please."

but finally he gets to see the doctor who is nominally supervising the machines. The protagonist finds the doctor a bitter, disheartened alcoholic who has no meaningful value in his work because the machines know more than he can.

Bill sat in a chair across the desk from Doctor Thomas. He was close enough to see the doctor's unfocused eyes, and smell the sourness of alcohol on his breath.

[. . . .]

Doctor Thomas was looking down at his hands. He paused for a moment, then went on mostly to himself. "I was a doctor once. A good one. Medical school, internship, residency—so many long, hard years to learn how to be a healer. Eighteen years in private practice. How many people did I help? Hundreds? Thousands?

"Now I sit here and watch machines do the work that I dedicated my life to. You can't practice medicine without patients. I'm supposed to be fortunate to have any job at all—doctors are a glut on the market. I receive the same salary as the receptionist. A fine joke, no?"

In the flashback we find out that the protagonist is actually the inventor of these devices. He created them, in a way, as revenge against the medical community because he was unable to become a doctor.

Somewhere in his childhood, for reasons he no longer remembered, he had decided to be a doctor when he grew up. He worked hard to make his dream happen. But the medical schools he applied to said, "Not good enough." So he became a medical technologist instead. He spent a few years at San Francisco Metropolitan Hospital, and learned two very important things.

One was contempt for doctors. At close range he recognized the healing heroes he had once so admired for what they really were. He saw bad medicine practiced by underskilled doctors, doctors on drugs, doctors who were too old, unstable doctors, doctors who worked too fast or too slowly, and doctors who just didn't care enough. [. . .]

The other was that he had a natural gift for understanding and improving medical machinery. At first he just daydreamed. They he put his ideas on paper. They were impressive enough to attract some venture capital. He quit his job, and the Littlejohn Company was born in an Emeryville warehouse.

The devices are in the process of being approved, and he is fighting to avoid a restriction that they only be used under supervision of a licensed MD. His partner is more pragmatic and is willing to accept the restriction to get their autodocs into use.

She paused. "We can get the AMA on our side instead of fighting us. All we have to do is change our FDA application so the Auto-Med can only be used under a doctor's supervision. Then—"

"No!" The sharp word came from too deep inside him to be controlled. "No doctor is going to make money off of my Auto-Med."

His partner tricks the inventor into assigning her an extra ownership share, so that she can outvote him.

"What the hell do you think you're doing, making deals behind my back? Well, it won't work. We're equal partners. You can't change the FDA application without my agreement."

She reached into a drawer, brought out a piece of paper, and pushed it across the desktop. "I suggest you have your personal attorney review this. It's a copy of a contract we both signed last week, authorizing the sale of an additional ownership share. I bought that share. I'm now the company's majority owner, and under the bylaws I can set policy unilaterally."

He snatched up the paper, stared at it. His signature under hers looked genuine. He regularly signed business papers she sent over without trying to decipher the legalese, because he trusted her.

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  • Wow. Comprehensively and unarguably correct (as usual)! Thanks! – DavidW Jun 29 '19 at 11:51
  • I hate to say it, but sometimes I wish there were fewer plot details in the question! – user14111 Jun 29 '19 at 12:51
  • Just for you, next time I post a question I'll just put in 3 lines about the story. :) – DavidW Jun 29 '19 at 12:58
2

I think this is a "Little Black Bag" by Cyril Kornbluth. It was originally published in Analog, but much earlier, in the 50s. Wikipedia summarized the plot thusly:

A "physicist" goads his minder into giving him specifications for a time machine. The faux physicist builds it, and uses it to send a "doctor" friend's highly automated medical kit into the past (our present), where it is found by Dr. Full, a physician who has succumbed to alcoholism and fallen to the bottom level of society. At first attributing its advanced properties and unfamiliar components to medical advances made since he last practiced, he uses it to heal a seriously injured young child. The patient's cynical eighteen-year-old sister, Angie, discovers the patent application date on one of the instruments (2450) and is quick to grasp the financial opportunities. She blackmails Full into taking her on as a partner.

The responsibility helps Full recover from his alcoholism, and he is soon running a respectable clinic curing mankind's ills with amazing success, although Angie wants to specialize in the more lucrative plastic surgery. When Angie learns that Full intends to turn the bag over to the medical establishment for the good of humanity, she grabs it and tries to leave. In the ensuing scuffle, the instruments spill out. Without thinking, Angie stabs Full with a scalpel, killing him. Initially shocked, she quickly recovers and disposes of the body using a small incinerating device used for tumors. Full had taught her how to use the kit, so she sees no obstacle to continuing to treat rich patients.

Her first patient sees the sharp instruments and balks at another treatment. To reassure her, Angie demonstrates their safety by running a scalpel through her arm without harm. Still unconvinced, the client requests another test. Back in the future, a technician notes the bag has been used for murder and deactivates its advanced functions. Angie runs what has just become an ordinary scalpel across her own throat, with fatal results.

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    Interesting story, but no, that doesn't match. Thanks. – DavidW Jun 28 '19 at 17:27
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    It's a very good story, with a nice twist ending -- but clearly not the one about the autodoc inventor. That one, as described in the question, seems older, maybe 1970s or even earlier. – Zeiss Ikon Jun 28 '19 at 17:32
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    The Little Black Bag flashed near-instantaneously through my mind too, and I yearned to suggest it too, but knew it wasn't a match, however delightfully ripping good it is. .... Because I, you know, want to share this great story with the world. – Occam Shave Jul 1 '19 at 20:51

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