Untreatable: A Dystopian Satire
If you had to trade someone else's life to save your own, who would you choose?
Now available via Kindle or Audible, narrated by me! Please enjoy the first of six chapters below. The audio version runs about 1hr and 16min.
Story Description (no spoilers)
It’s the year 2073 and Rowan Greenbaum is condemned to die of an easily cured form of cancer. The reason? His zip code is over its maximum population capacity — at least, according to recent legislation enshrined into law at the behest of the country’s largest health insurance company. This population cap disqualifies Rowan from lifesaving treatment but he discovers a loophole that allows him to trade another life for his own.
With the cancerous clock ticking, he sets off in search of his sacrificial savior, beginning a downward spiral of desperation and manipulation that will ensnare everyone around him, even those he loves most.
It's Catch-22 meets Black Mirror, a darkly funny and deeply depressing story about love, life, and death set against the cold, unfeeling machinery of corporate-captured bureaucracy.
NOTE TO NEW READERS: Much of my writing will appear on this website (and for FREE) but this is a special experiment in audio and ebook making, so it’s hosted offsite, and the price ranges are dictated by those platforms.
Chapter 1
So you’ve got a little cancer, big deal, Rowan Greenbaum thought to himself in the bathroom mirror of the Midtown Municipal Health Clinic. He instinctively picked at the misshapen mole on the back of his right hand, the subject of his recent diagnosis. It’s just a silly little melanoma. Hell, they cured pancreatic cancer back in 2032, so this should be no trouble at all.
He gave his reflection a reassuring grin, and noted the smile lines, barely visible on his still-youthful face, and the tiny wisps of gray hair streaked across his otherwise dark temples — the image of a man with many decades still ahead of him. Before exiting the bathroom, he washed his hands twice on the off chance the antiseptic soap might offer some small but crucial defense against the skin cancer, and then, after a deep exhale, walked out into the clinic’s drab, fluorescent-lit hallway, back to the little cubicle where Dr. Parkin was waiting with information about his treatment options.
His spirits were low but not so low he couldn’t fool himself into thinking they were high, as people often do when backed into a corner. He beamed a confident smile at Dr. Parkin as he took his seat opposite her. She responded with a toothy grin of her own and slid a tablet across the desk towards him. On the screen the words “Ending Life with Dignity” appeared in big yellow type overtop an image of an elderly man and woman on a beach in a vaguely tropical location.
“What’s this?” Rowan asked as he scrolled through the digital brochure. More photos of the elderly couple smiled back at him from sterile medical settings that were very unlike the tropical locale featured in the first image. “I think you pulled up the wrong brochure.”
“This details our most popular euthanasia program,” Dr. Parkin said with a cheerful sparkle in her voice, “but I do have some other options, if you’d like to see them.”
Rowan had never been treated by Dr. Parkin before today and was beginning to question her qualifications. She couldn’t have been more than thirty — thirty-five at most — but she carried herself with the weightless enthusiasm of someone who had all the answers and was delighted to supply them before you even knew to ask. Her jet-black hair was streaked with highlights and immaculately straightened, and her clear-rimmed augmented-reality glasses were technically still on-trend, since the new autumn styles had only just dropped a few days ago. A small calendar reminder appeared at the corner of her vision, reminding her to visit the optometrist later that day to obtain new frames. She dismissed it with a blink and smiled at Rowan. “End of life care is, of course, a matter of personal taste.”
“Wait a minute, wait a minute,” Rowan said, shoving the tablet back across the desk. “I thought I just had skin cancer.”
“Correct.”
“But skin cancer’s not a big deal, right?”
“Every cancer is a big deal, Mr. Greenbaum,” Dr. Parkin said with a sympathetic smile.
“Yeah, but it’s skin cancer,” he said with a dismissive snort. “It’s like cancer isn’t even trying. They had it beat back in the 1900s.”
Dr. Parkin nodded, still with that sad smile plastered to her face. “Yes, Mr. Greenbaum, we’ve brought many cancers to heel. In fact, that’s the whole problem.”
“Problem?”
“Too many people are surviving these days.”
“That’s a problem?”
She nodded again. “It really puts a strain on the population cap.”
“The what?” An icy trickle of fear began to seep into Rowan’s stomach as he realized this wasn’t simply a misunderstanding. “This is the first I’m hearing of a population cap.”
Dr. Parkin smiled knowingly. “We’ve been getting that a lot recently.” She picked up the tablet and tapped a query into its search bar. An instant later, a map of Midtown appeared on the screen, divided up by colored sectors. With her perfectly painted fingernail, she pointed to a sector overlayed in bright red. “This is your zip code, and as you can see, it’s at maximum population capacity.” The red overlay flashed to amplify her point. “Therefore, I’m not authorized to issue treatment to you at this time.”
Rowan grabbed the tablet from her and scanned it frantically. “How come I’ve never seen this before?” he asked. “Are you sure you’ve got the right map?” He pointed to the title of the map, located just above the graphic. “This says it’s something called the ‘Climate Sustainability Zones.’”
“Yes, that’s the official name,” Dr. Parkin said, “but we’ve found it’s easier to just call them population caps. People seem to get the idea quicker.” She chuckled. “Besides, ‘Climate Sustainability Zones’ is a pretty boring name, don’t you think?” She took his lack of laughter to mean that he was still confused. “So, basically, you live in an area that can’t sustain its current population.”
“Says who?” Rowan asked with indignity. “Surely, we would’ve voted on something so…so…insane.”
“Oh, there was no need for a vote,” Dr. Parkin said, as though this fact represented some kind of thoughtful courtesy. “It was simply added to the Healthcare and Human Rights Charter by the State Legislature last year. Can you imagine if the public was expected to vote on science-y stuff like that?” She chuckled again but noticed that instead of laughing along, Rowan was glaring at her with searing animosity. “But don’t worry,” she said, maintaining the pep in her voice, “it was all subjected to a very thorough review by ShieldCare’s Professional Oversight Committee.”
“ShieldCare, the health insurance company?” Rowan asked.
“Yes!” Dr. Parkin said, happy that he was still following. “Your insurance company. So you can rest easy knowing this was all handled by experts you trust.”
Rowan’s eyes crossed. “Sorry, I’m not sure I understand what ShieldCare has to do with the climate or sustainability or the number of people that are allowed to be alive.”
Some of the luster in Dr. Parkin’s smile faded. Clearly, she wasn’t getting through to him. “Maybe Randall Moore can explain it better than me.” She took the tablet back from Rowan and navigated to ShieldCare’s website. Once there, a hologram projection of ShieldCare CEO, Randall Moore, began playing in the middle of her desk. The chyron at the bottom of the projection indicated that it was a recording of a joint press conference he’d done with members of the State Legislature, and Rowan recognized two of the most popular representatives flanking him at the podium.
“As CEO of America’s largest health insurance company, it’s my job to prioritize the health of every citizen of this great nation,” said Moore, dressed like a rich person’s idea of a cowboy and reading from a teleprompter that had also been rendered into the hologram. “That means not turning a blind eye to the perils of climate instability, which affects all of us — particularly folks from communities who have currently or historically experienced conditions of underempowered systemic disprivilegement. Recent studies have shown that population regulation is one of the best ways we, as responsible stewards of the environment, can mitigate the devastating effects of climate instability and bring us more in harmony with Parent Nature. It will also allow us to provide a higher and more equitable standard of care to everyone. The establishment of these Climate Sustainability Zones is a great first step towards a new era of public/private partnership designed to ensure a healthier future for everyone, and we at ShieldCare are proud to take it with our good friends in the Legislature.” Mild applause followed, and then the hologram was replaced with ShieldCare’s logo, shimmering in the air above the desk along with an up-to-date readout of the company’s stock performance. A green arrow pointed upwards, and in small type, the words “a subsidiary of Drexel Energy Co.” could be read.
“How convenient for them,” Rowan said as he slumped in his chair. “I still have to pay my premiums, but they don’t have to do jack shit because it’s illegal to save my life.”
“Oh, it’s not illegal,” Dr. Parkin said, perking up again with pertinent information. “If your plan included an ayek, we would be obligated to treat you regardless.”
“An ayek?”
“A – E – C.”
“A – what?”
“Authorized Extension of Continuity. It’s available to Platinum Plus members. Maybe we can upgrade your plan!” Rowan sat up in his chair with interest as Dr. Parkin tapped on her tablet for more information. Once again, her bright smile dimmed a few shades. “Hmm. It looks like your credit score isn’t high enough.” She shrugged. “I guess I shouldn’t have brought it up.”
“So there’s nothing that can be done, huh?” Rowan said sardonically, trying to maintain a sort of calm infuriation in his demeanor, as one might during an actual negotiation where one had actual leverage, which, of course, he did not. In truth, most of his efforts were spent clamping down the trembles as awful thoughts began bombarding his mind. Of all the terrible images and ideas, what haunted him most was a question, How will I explain this to her? followed by images of his wife. His beautiful, wonderful wife. For a moment his own mortality faded and all he saw was her face, smiling and tranquil with a serene happiness that he would soon have to demolish. He saw her as he did that very first time, in a fit of glorious rapture with the urgent sensation that he must never, ever be without her, and then saw her again, cold and alone, after the inevitable moment when he would be the one to leave. How will I tell her how stupid this is? he wondered, and how stupid I am? Because he would have to be pretty stupid to die like this, right? Of a minor disease that could be cured in an afternoon? No, he couldn’t go home with that. He couldn’t do that to her — or himself for that matter. There had to be something else to try.
Across the desk, Dr. Parkin sat with her customer service smile waiting for him to come to grips with his fate, as she had with so many others recently. Her training insisted the friendly act was the most effective approach to such sensitive matters but a number of violent outbursts from patients had begun to shake her faith in this conclusion. She sized up Rowan and tried to determine what flavor of primal brutality he might try to inflict upon her, hiding the fear behind her sparkling eyes. As it happened, Rowan was looking at the mole on his hand and feeling the sudden urge to rip it off with his fingernails and stuff it down her throat. Luckily for both of them, inspiration diverted his rage. As he pondered the sight of his fist dilating her esophagus, blood pouring from the torn flesh of his hand, an idea struck him. “Wait! Mole removal can’t be too hard. It’s just a little bump, right?”
“Yes, the procedure would have been very quick,” she said, “if you’d been authorized.”
“You think I could DIY the surgery with…like…a kitchen knife or something?”
“I really couldn’t say,” Dr. Parkin said with a helpless shrug, her fear not exactly alleviated by thoughts of knives and carved-up flesh.
“But there’s a possibility it could work, right? Assuming the cancer hasn’t spread?”
“That’s not really my area of expertise.”
“You’re a doctor, aren’t you?”
“I’m your doctor,” she said, risking a hint of disapproval into her tone.
“Well, they must have taught you something about how skin cancer works in medical school.”
“My PhD is in Public Policy.”
Rowan’s eyes bulged. “Then what the fuck are you doing here?”
“I’m your doctor.”
“I need a medical doctor!”
“How about we leave it to the experts to decide what kind of doctor you need,” Dr. Parkin said in a chipper but firm tone to indicate that this particular discussion was over. “Now, I really must insist that we move on. We’ve got so much to go over, and we haven’t even started on your TIP —” She stopped herself, remembering that Rowan didn’t know all these acronyms that had become so mundane to her. “Termination Intake Procedure.”
“Whoa, whoa, hold on now, wait a minute,” Rowan said. “Isn’t there, like, some kind of appeals process or something?”
“ShieldCare had a generative chatbot anticipate every argument you might make, so there wouldn’t be much point,” Dr. Parkin said. “It’s actually quite convenient, when you think about it.”
Rowan seethed. “You know what would be even more convenient? Not dying!”
“Everybody dies, Mr. Greenbaum,” she said. “It’s the responsible thing to do.”
Rowan was about to have an aneurysm when suddenly her words took on a different meaning. “You know what, Doc? You’re right! Everybody does die. People do it all the time. I bet there’s someone out there right now just waiting to keel over. Tomorrow. Next week. All we have to do is wait them out, and then, when they die, I can take their spot in the population cap!”
“I’m afraid the algorithm already accounts for natural terminations.”
A smile began to creep across Rowan’s face as a new idea crept into his mind. “I guess that depends on what counts as a natural termination.”
“I’m not sure what you’re getting at,” Dr. Parkin said with a raised eyebrow as she slowly moved her hand towards the panic button just beneath her desk.
“A terminated pregnancy,” he shouted with a smile. “An abortion!” He laughed. “It’s perfect. My neighbor’s daughter got knocked up by a boy at her church not too long ago. Esther is her name. Esther Norton. She’s only 18. I just know I could convince her to get an abortion. Who wants a kid at 18? Or at all?” Dr. Parkin chuckled at that, which Rowan took as a sign to continue. “If she gets an abortion, that would up free a spot in the population cap for me, right?”
“Hmmm,” Dr. Parkin said, intrigued. “It depends on if her pregnancy has been registered in the population database yet.” She tapped around on her tablet some more and skimmed the information. “Ah, here it is,” she said with a smile. “13 weeks. Still well within the acceptable range.” She thought for a moment, nodding every now and then. “Yes…yes. Teen pregnancies are especially troublesome, particularly nearing adulthood. 18 is prime workforce age, after all, but we can expect to lose her for at least a month after the birth — if we’re lucky — and then her productivity will be stunted for at least a decade after that, even with state-mandated childcare.” Dr. Parkin exhaled as if existentially labored by such thoughts. “And, of course, with every new child, the state has to allocate an average of 72 years of resources. 74 if it’s a girl. It's a nightmare. Unfortunately, we don’t yet have the authority to order terminations,” Dr. Parkin looked up at Rowan with a smile, “but if you can convince your neighbor to end her pregnancy under her own volition, I’m confident the Board will be very grateful — grateful enough to approve your treatment.”
“That baby’s as good as dead!” Rowan said and sprung out of his seat before Dr. Parkin could change her mind or ask him to fill out any more ominous-sounding forms. “I’ll go see her today.”
Fresh with excitement, he yanked his gray jacket from the hook, nearly tearing it off the wall, and flung himself out of Dr. Parkin’s cubicle and down the hall, past dozens of identical cubicles filled with glum-looking citizens in various states of resigned defeat. But not Rowan. His future was once again in his grasp, and all he had to do was manipulate a frightened teenager into doing his bidding.
It would be a cinch.
Find out what happens next by downloading the ebook or audiobook. The story is six chapters in total and the audio version is 1 hour and 16 minutes long.