MONDAY 08 OCTOBER 2035
7:15 AM

PRIMA, Prognostic Intelligent Medical Algorithms
Main Campus, Seattle

Dr. Hope Kestrel was the only person who knew the patient in Room 132 wasn’t responding to the algorithm-selected treatment.

She shuffled forward in the hospital security line, wanting to get her day started already yet dreading how she’d tell her patient the unexpected and devastating news. The straps from her work bag dug into her right shoulder as she shifted the trays of coffee and scones in her arms, her usual Monday morning offering to the staff. From PRIMA’s lofty location at the top of “Pill Hill,” the floor-to-ceiling windows framed downtown Seattle’s skyline, lit up by the early morning sun—its first appearance in over a week. In the distance, a ribbon of pink sky silhouetted the Space Needle, the tip poking out of the murky blue of the cloud bank. She frowned down at her pale hands, unable to recall the last time her skin had seen the sun. Even her freckles were fading.

Her heart lifted when she spotted Bear, the Security Force service dog, rounding the corner. The German shepherd dashed for her, pulling Kyle, his Security Force guard, with him. The people next to her in line stepped back.

Bear nosed at her lab coat, and she lifted the pastry box in one hand higher while shielding the cardboard carrier of coffee in the other. Hot liquid sloshed onto her wrist, the sting on her skin not far off from the burn in her chest that had been present all morning, triggered by the impending meeting in Room 132. One where she’d need to engage on an interpersonal level without the usual buffering layer of technology.

Her gaze shifted from Bear to the familiar logo on the wall behind Kyle’s head—Prognostic Intelligent Medical Algorithms—and she shut out the searing pain in her chest. They were so close to the breakthrough to enhance the artificial intelligence even further. To render tumors like her mom’s curable. Because to rely on only hopefulness promised everything and got you nothing. No matter her damn name.

She had to focus on the big picture. All she needed was to maintain her top ranking for a few more months. Then the coveted post-residency position at PRIMA would be hers—complete with her own research lab. Soon, she’d work side-by-side with her mentor Cecilia, no longer an underling.

Bear gave a muffled woof and sat down obediently at her feet. Although Kyle would probably deny it if asked, she strongly suspected the guard went out of his way each morning to find her, knowing how much she loved Bear. It had been their unofficial routine for five years now.

Hope gestured with her elbow. “Kyle, could you take this for a sec?”

The burly, middle-aged man accepted the breakfast offerings with a flash of white teeth gleaming in contrast to his warm brown skin. “You got it, High Resident Kestrel.”

“For the millionth time, you can call me Hope.”

His eyes twinkled. “Whatever you say, oh most High One.”

Heat flamed Hope’s cheeks, and she tried to cover it with an eye roll. Three months into her final year, she still wasn’t used to her lofty title. She’d be called the Chief Resident—not the High Resident—at any other program, but PRIMA had its own language.

The loyal dog emitted another stifled woof from his barely contained seated position.

Hope fished in the front pocket of her white scrubs for one of the dog biscuits she always carried and tossed the treat to Bear, who snapped it up.

Kyle returned the pastries, then spoke in the deep, rumbling voice that Hope had come to learn only masked his kindly nature. “He sure loves you, Dr. K. He’d follow you anywhere. Have you reconsidered about one of the puppies?”

She shifted her grip and gave a wistful shake of her head. “It wouldn’t be fair. I’m never home.”

“So? You’d figure it out. Hire a dog walking service—and doggie daycare, too. You don’t have to do it on your own.”

“I’d be nothing more than a familiar stranger who provides shelter and food.”

Kyle bent down to rub Bear behind his ears, only to glance up and hastily straighten into a military posture, shoulders back. He tugged Bear to heel, his gaze fixed over Hope’s head.

The dog sensed his handler’s shift in mood, the fur on his neck bristling upward.

Hope swiveled, following the direction of Kyle’s eyes. More coffee dribbled on her hand, but she barely felt it this time. A man and woman in matching black suits and pressed white shirts were staring in their direction. Hope couldn’t help but stare back. The man was tall and broad-shouldered, mid-thirties, with angular cheekbones and deep-set eyes, his striking features set off by his onyx black hair. The woman appeared to be of similar age and height, equally imposing, with skin paler than Hope’s, commanding eyebrows, and white-blonde hair in an identical short haircut to her partner.

Hope’s eyes darted to Kyle, who flashed another smile, but it didn’t reach his eyes.

“Are those two—?”

“Not regular Security Forces. They’ll notice me deviating from my route.” Kyle grimaced. “And letting Bear interact with civilians.”

“But—”

Kyle dropped his voice. “Last week, another disgruntled non-responder tried to get in.”

A non-responder. A patient the algorithm had identified as refractory—resistant to all known therapeutics—and therefore wouldn’t be offered treatment at PRIMA. Or shouldn’t, at least.

Hope went cold all over. All patient volunteers agreed to abide by the algorithm’s determinations in exchange for free healthcare. What would the guards do if they discovered another non-responder already here, admitted by mistake? On Hope’s service, no less.

But that wasn’t her fault—

“You’re a busy doctor, and we shouldn’t be holding you up.” Kyle tugged Bear away before she could ask him anything more. “We’ll see you again soon, Dr. K.”

Before the dog was out of reach, Hope hurried to transfer the pastry box to the crook of her elbow, bracing it against her side enough to allow her to extend a hand to trail her fingers in Bear’s soft fur. The brief comfort the touch provided would have to last until tomorrow. She re-joined the line to watch the man and woman cut through the security checkpoint.

Her muscles tightened, and she forced them to relax. She needed to focus. At least medical training had made her a champion at putting extraneous thoughts out of her mind. Compartmentalization for the win.

A few moments later, she passed through the checkpoint and stepped onto OASIS—the Oncologic and Surgical Intervention Success Unit—and its familiar buzz of activity.

Patients strolled the oval hallway in the sunshine-yellow robes and plush slippers allocated upon admission. If not for the slim IV poles, they might be in a luxury hotel. The hidden panels in the walls and ceiling secured all medical equipment out of sight.

Abbie Fuentes, the charge nurse on OASIS for as long as Hope or anyone else could remember, spotted her arrival and trailed her into the break room. Hope wordlessly handed her one of the coffees, and she took a noisy sip while scanning Hope up and down, her impeccably bobbed hair not moving an inch. “What’s going on with you today? You’re late.”

Hope shrugged. The nurses hadn’t yet seen her patient’s latest test results, and the part of Hope that feared being perceived a failure planned to wait until the last possible moment to tell them. “Line at security. You know, it’s getting slower every day.”

***

Excerpt from The Algorithm Will See You Now by JL Lycette. Copyright 2023 by JL Lycette. Reproduced with permission from JL Lycette. All rights reserved.