There was no laughter at his joke. Instead, their lot snapped to attention like wind-up toys. They spewed past him, bursting into the bowels of his clinic and spreading out like they already knew the place. He chased on hurried feet, watching as they snaked new wires through his surgery console, tying them tight around a little white router that sent messages to server farms large enough to drain a nuclear plant. They gave curt, dismissive replies when he asked why they had to set up all kinds of new cameras around the surgery bay, which the leader waived off as ‘HIPPA compliant’. Ringing in the new also meant burning away the old. They carted away boxes of manual saws, scalpels, and sutures. He tried to protest when they pulled his old Multiectomy Machine loose from the ceiling, Damien grabbing onto one end like a petulant toddler does their favorite toy. They insisted it was their legal prerogative—this model was far too outdated. Uploading their software would make it unstable. The new machine was complimentary, and better in every way, they said. Plus, they couldn’t have Damien working the controls of something he already knew. He’d only muck it up with his human liability. When he whined he could do all of his operations half-asleep, they quipped that servers never take a nap.

But his routine was so powerful that he still went to the OR in the next morning, eyes half-closed from his wife’s weak light-roast coffee. His hands stretched over the console to warm up the machine before his first patient. It didn’t turn on, instead blaring a large buzzer noise, the screen flashing that he had to review the steps first. That’s right, he was in the backseat now. Damien rolled his eyes as he pulled up the surgical procedure it had come up with for his morning’s first case, a routine rhinoplasty:

1. Intercartilaginous Incision:

a. Insert #15 blade between upper and lower lateral cartilages

b. Incise through vestibular skin and perichondrium

c. Extend from pyriform aperture to midline

d. Maintain 2-3mm caudal margin on upper lateral cartilage

e. etc.…

A wave of exhaustion crashed over him. Looking over it reminded him of why he left the University, back when they had him spending more time babysitting residents then actually doing what he studied for. He procrastinated telling this patient that they were about to be cut open by an unfeeling robot, leaving that to the PA. He pawned a cigarette and lighter off his intake nurse and instead sat on the back stoop of his clinic, watching the highway behind the strip mall. It had been several years since he last smoked anything, but for some reason, today felt like an indulgent exception. He lit the end and watched the clouds of smoke dissipate into the atmosphere.

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