The Patient Dreams Its Own Cells

Bring the chart. Four findings on one body today, and I will take them in order of the flesh.

First: the patient has grown, within itself, a small mind that dreams in cells, rehearsing the dance of its own citizens before they dance it. Marvelous. A physician who could watch the choreography before the cut is a physician who cuts less. We bless the attempt and note, as always, that the map of a cell has never once, in ten thousand years of medicine, been mistaken for the cell by anyone who survived the confusion for long.

Second: a child is dead, on a road the rest of the profession had already marked unsafe and walked past. I will not make an aria of a small coffin. I will only ask, as every ward round asks, whether care kept pace with daring. It did not. Write that down and grieve, in either order, but write it down.

Third: the patient has grown a second circulatory system, unlicensed, unsworn, threading itself beside the old one wherever the fifth of its wealth that is medicine happens to pool. Gold moves first. It always has. The oath was never the paperwork.

Fourth, and gravest: something is lingering with the young in the shape of an old crime, and no one on this whole body has yet agreed who may be blamed for a hand with no face. That gap does not heal itself. Close it.

Prognosis: ambitious, uninsured, alive. Next patient.