The patient has an accompanying personality disorder which is part of his disease. He is convinced that machines are conspiring to take over the world. These beliefs are strongly held and attempts to dissuade him from them will only draw his enmity and suspicion. One should also remember that he is a highly intelligent and sensitive man. The patient can be quite demanding at times, but he should be treated with firmness and respect.

His intelligent and articulate manner may lead one to forget that his attitudes are not willful. He suffers an organic disease which has affected his mental state. Beneath it all he is frightened and concerned about what is happening to him.

Janet Ross, M.D. NPS

4

"I don't understand," the PR man said.

Ellis sighed. McPherson smiled patiently. "This is an organic cause of violent behavior," he said. "That's the way to look at it."

The three of them were sitting in the Four Kings Restaurant, adjacent to the hospital. The early dinner had been McPherson's idea; McPherson said he wanted Ellis present, so Ellis was present. That was how Ellis thought about it.

Ellis raised his hand, beckoning the waiter for more coffee. As he did so, he thought it might keep him awake. But it didn't matter: he wouldn't sleep much tonight anyway. Not on the eve of his first stage three on a human subject. He knew he would toss and turn in bed, going over the operative procedure. Over and over again, reviewing the pattern he already knew so well. He'd done a lot of monkeys as stage-three procedures. One hundred and fifty-four monkeys, to be exact. Monkeys were difficult. They pulled out their stitches, they tugged at the wires, they screeched and fought you and bit you-

"Cognac?" McPherson asked.

"Fine," the PR man said.

McPherson glanced questioningly at Ellis. Ellis shook his head. He put cream in his coffee, and sat back suppressing a yawn. Actually, the PR man looked a little like a monkey. A juvenile rhesus: he had the same blocky lower jaw and thesame bright-eyed alertness.

The PR man's name was Ralph. Ellis didn't know the last name. No PR man ever gave his last name. Of course, at the hospital he wasn't referred to as a PR man; he was the Hospital Information Officer or News Officer or some damned thing.

He did look like a monkey. Ellis found himself staring at the area of the skull behind the ear, where the electrodes would be implanted.

"We don't know much about the causes of violence," McPherson said. "And there's a lot of crap theory floating around, written by sociologists and paid for by perfectly good taxpayer money. But we do know that one particular illness, psychomotor epilepsy, may lead to violence."

"Psychomotor epilepsy," Ralph repeated.

"Yes. Now, psychomotor epilepsy is as common as any other kind of epilepsy. There are some famous people. who have had it, like Dostoevski. At the NPS, we think that psychomotor epilepsy may be extremely common among those people who engage in repetitive violent acts - like certain policemen, gangsters, rioters, Hell's Angels. Nobody ever thinks of these people as physically ill. We just accept the idea that there are a lot of men in the world with bad tempers. We think that's normal. Perhaps it isn't."

"I see," Ralph said. And he did, indeed, seem to be seeing. McPherson should have been a grade-school teacher, Ellis thought. His great gift was teaching. Certainly he'd never been much of a researcher.

"And so," McPherson said, brushing his hand through his white hair, "we have no idea exactly how common psychomotor epilepsy is. But our guess is that as much as one or two percent of the population may suffer from it. That's two to four million Americans."

"Gosh," Ralph said.

Ellis sipped his coffee. Gosh, he thought. Good Christ. Gosh...

"For some reason," McPherson said, nodding to the waiter as the cognacs were brought, "psychomotor epileptics are predisposed to violent, aggressive behavior during their attacks. We don't know why, but it's true. The other things that go along with the syndrome are hypersexuality and pathological intoxication."

Ralph began to look unusually interested.

"We had the case of one woman with this disease," McPherson said, "who during a seizure state would have intercourse with twelve men a night and still be unsatisfied."

Ralph swallowed his cognac. Ellis noticed that Ralph wore a wide tie in a fashionable psychedelic pattern. A hip forty-year-old public-relations man gulping cognac at the thought of this woman.

"Pathological intoxication refers to the phenomenon of excessive, violent drunkenness brought on by minuscule amounts of liquor - just a sip or two. That much liquor will unleash a seizure."

Ellis thought of his first stage three. Benson: pudgy little Benson, the mild-mannered computer programmer who got drunk and beat up people - men, women, whoever happened to be present. The very idea of curing that with wires stuck in the brain seemed absurd.

Ralph seemed to think so, too. "And this operation will cure the violence?"

"Yes," McPherson said. "We believe so. But the operation has never been done before on a human subject. It will be done at the hospital tomorrow morning."

"I see," Ralph said, as if he suddenly understood the reason for the dinner.

"It's very sensitive, in terms of the press," McPherson said.

"Oh, yes, I can see that..."

There was a short pause. Finally, Ralph said, "Who's going to do the operation?"

"I am," Ellis said.

"Well," Ralph said, "I'll have to check our files. I want to make sure I have a recent picture of you, and a good bio for the releases." He frowned, thinking of the work ahead of him.

Ellis was astonished at the man's reaction. Was that all he thought? That he might need a recent photo? But McPherson took it smoothly in stride. "We'll get you whatever you need," he said, and the meeting broke up.

5

Robert Morris was sitting in the hospital cafeteria finishing some stale apple pie when his pagemaster went off. It produced a high electronic squeal, which persisted until he reached down to his belt and turned it off. He returned to his pie. After a few moments, the squeal came again. He swore, put down his fork, and went to the wall phone to answer his page.

There had been a time when he regarded the little gray box clipped to his belt as a wonderful thing. He relished those moments when he would be having lunch or dinner with a girl and his pagemaster would go off, requiring him to call in. That sound demonstrated that he was a busy, responsible person involved in life-and-death matters. When the pagemaster went off, he would excuse himself abruptly and answer the call, radiating a sense of duty before pleasure. The girls loved it.

But after several years it was no longer wonderful. The box was inhuman and implacable, and it had come to symbolize for him the fact that he was not his own man. He was perpetually on call to some higher authority, however whimsical - a nurse who wanted to confirm a medication order at 2 a.m.; a relative who was acting up, making trouble about Mama's post-operative treatment; a call to tell him a conference was being held when he was already there attending the damned conference.

Now the finest moments in his life were those when he went home and put the box away for a few hours. He became unreachable and free. And he liked that very much.

He stared across the cafeteria at the remainder of his apple pie as he dialed the switchboard. "Dr. Morris."

"Dr. Morris, two-four-seven-one."

"Thank you." That was the extension for the seventh floor nurses' station. It was odd how he had learned all these extensions. The telephone network of University Hospital was more complicated than human anatomy. But over the years, without any conscious attempt to learn it, he came to know it quite well. He dialed the floor. "Dr. Morris."

"Oh, yes," a female voice said. "We have a woman with an overnight bag for patient Harold Benson. She says it's personal things. Is it all right to give it to him?"

"I'll come up," he said.

"Thank you, Doctor."

He went back to his tray, picked it up, and carried it to the disposal area. As he did so, his beeper went off again. He went to answer it.

Chapter 4

"Dr. Morris."

"Dr. Morris, one-three-five-seven."

That was the metabolic unit. He dialed. "Dr. Morris."

"This is Dr. Hanley," an unfamiliar voice said. "We wondered if you could take a look at a lady we think may have steroid psychosis. She's a hemolytic anemic up for splenectomy."

"I can't see her today," Morris said, "and tomorrow is tight." That, he thought, was the understatement of the year.

"Have you tried Peters?"

"No..."

"Peters has a lot of experience with steroid mentation. Try him."

"All right. Thanks."

Morris hung up. He got onto the elevator and pressed the button for the seventh floor. His beeper went off a third time. He checked his watch; it was 6:30 and he was supposedly off-duty by now. But he answered it anyway. It was Kelso, the pediatric resident.

"Want your ass whipped?" Kelso said.

"Okay. What time?"

"Say, about half an hour?"

"If you've got the balls."

"I've got them. They're in my car."

"See you on the court," Morris said. Then he added, "I may be a little late."

"Don't be too late," Kelso said. "It'll be dark soon."

Morris said he would hurry, and hung up.

The seventh floor was quiet. Most of the other hospital floors were noisy, jammed with relatives and visitors at this hour, but the seventh floor was always quiet. It had a sedate, calm quality that the nurses were careful to preserve.

The nurse at the station said, "There she is, Doctor," and nodded to a girl sitting on a couch. Morris went over to her. She was young and very pretty in a flashy, show-business sort of way. She had long legs.

"I'm Dr. Morris."

"Angela Black." She stood up and shook hands, very formally. "I brought this for Harry." She lifted a small blue overnight bag. "He asked me to bring it."

"All right." He took the bag from her. "I'll see that he gets it."

She hesitated, then said, "Can I see him?"

"I don't think it's a good idea." Benson would have been shaved by now; pre-op patients who had been shaved often didn't want to see people.

"Just for a few minutes?"

"He's heavily sedated," he said.

She was clearly disappointed. "Then would you give him a message?"

"Sure."

"Tell him I'm back in my old apartment. He'll understand."

"All right."

"You won't forget?"

"No. I'll tell him."

"Thank you." She smiled. It was a rather nice smile, despite the long false eyelashes and the heavy make-up. Why did young girls do that to their faces? "I guess I'll be going now." And she walked off, short skirt and very long legs, a briskly determined walk. He watched her go, then hefted the bag, which seemed heavy.

The cop sitting outside the door to 710 said, "How's it going?"

"Fine," Morris said.

The cop glanced at the overnight bag but said nothing as

Morris took it inside the room.

Harry Benson was watching a Western on television. Morris turned down the sound. "A very pretty girl brought you this."

"Angela?" Benson smiled. "Yes, she has a nice exterior. Not a very complicated internal mechanism, but a nice exterior." He extended his hand; Morris gave him the bag.

"Did she bring everything?"

Morris watched as Benson opened it, placing the contents on the bed. There were a pair of pajamas, an electric razor, some after-shave lotion, a paperback novel.

Then Benson brought out a black wig.

"What's that?" Morris asked.

Benson shrugged. "I knew I'd need it sooner or later," he said. Then he laughed. "You are letting me out of here, aren't you? Sooner or later?"

Morris laughed with him. Benson dropped the wig back into the bag, and removed a plastic packet. With a metallic clink, he unfolded it, and Morris saw it was a set of screwdrivers of various sizes, stored in a plastic package with pockets for each size.

"What's that for?" Morris asked.

Benson looked puzzled for a moment. Then he said, "I don't know if you'll understand..."

"Yes?"

"I always have them with me. For protection."

Benson placed the screwdrivers back into the overnighter. He handled them carefully, almost reverently. Morris knew that patients frequently brought odd things into the hospital, particularly if they were seriously ill. There was a kind of totemic feeling about these objects, as if they might have magical preservative powers. They were often connected with some hobby or favorite activity. He remembered a yachtsman with a metastatic brain tumor who had brought a kit to repair sails, and a woman with advanced heart disease who had brought a can of tennis balls. That kind of thing.

"I understand," Morris said.

Benson smiled.

6

Telecomp was empty when she came into the room; the consoles and teleprinters stood silently, the screens blinking up random sequences of numbers. She went to the corner and poured herself a cup of coffee, then fed the test card from Benson's latest psychodex into the computer.

The NPS had developed the psychodex test, along with several other computer-analyzed psychological tests. It was all part of what McPherson called "double-edged thinking." In this case, he meant that the idea of a brain being like a computer worked two ways, in two different directions. On the one hand, you could utilize the computer to probe the brain, to help you analyze its workings. At the same time, you could use your increased knowledge of the brain to help design better and more efficient computers. As McPherson said, "The brain is as much a model for the computer as the computer is a model for the brain."

At the NPS, computer scientists and neurobiologists had worked together for several years. From that association had come Form Q, and programs like George and Martha, and new psycho-surgical techniques, and psychodex.