The Ingram Clinic
The Ingram Clinic
Dr. John Ingram M.D. PhD. arrived as usual at 8 AM sharp. And, as he had planned, the first major crisis had happened at about 7:43.
A nurse came running up to him. "John!" he called.
The orange tabby turned to look at the intern, a fox half his age with a stain swiped across the front of his scrubs.
"James threw up for the first time. I told him it was to be expected, but he didn't like it. He wants an alternative, and demands to see you."
John sighed; new patients were always the hardest. "Send Barbara," he answerd calmly. "If he really insists on seeing me, then I will come around later."
The emergency dealt with, he walked through the foyer of the most expensive clinic on the face of Giaya, ignoring the decore, and headed straight for the elevator. His rounds weren't until 10, and he wanted to keep his clinic moving before seeing any more patients.
A good omen was presented as the doors opened on the third floor of offices in the three floor building, and Karen was changing the sign. They had apparently just admitted patient 513.
It made Dr. Ingram smile to see her writing the 3 after erasing the 2. "Good morning, Karen," he said with a genuine smile.
"Isn't it great, John?" she asked excitedly, "half of our capacity, at last!"
"We need the money, believe me," he replied, walking briskly to his office. One more comment, and he might have to lie to her.
"It was stupid of them to overbuild this place, anyway," she added.
He pretended not to hear, for silence was the best defense.
Into his office he walked, at the very end of the hall, but with a large pair of oak doors instead of one; like a fancy operating room entrance. He just liked the swinging doors, and thanks to a few dedicated donors wanting to make children more affordable, he got them on his office at last.
He pulled on the gold handles, dropped his medical bag on his glass desk -- which contained a checkbook instead of tools -- and took out of it the first item of the day. Setting the piece of paper down, a full-page advertisement, he dialed the phone and tried to relax.
The other end answered, "Predat Magazine, Advertising."
"Hello, my name is Dr. John Ingram, and I would like to place a full-page ad in next month's issue."
After failing to describe it, he agreed to have it sent electronically.
Next, he reviewed all the paperwork from the buying department, and signed invoices with his pen. Everything was fairly typical for a maternity hospital, except to his frustration, the cost of genetic analysis and gamete cloning. Not only were they high, in spite of modern technology, but they kept going up.
He put it on his to do list to fix this with several phone calls, and in preparation, spent the next hour trying to sign and skim everything else that was paper on his desk. He only got through a third before Karen came in.
"It's 10 o'clock," she reminded.
He got up slowly. "Thank you Karen," he said without emotion, "and please have this sent to Predat Magazine." He walked to the elevator and pushed the button.
"Why Predat?"
"Because most of our patients like males," he answered, "I see it in their rooms all the time. I would have thought half of them would like females, but it doesn't look that way."
She shrugged, and he went down to floor two for his rounds.
***
When he was planning to go out to lunch, the floor nurse reminded him they had admitted a new patient, and he, -- or she, depending -- had to be examined. And that examiner had to not only be an M.D., but an expert in genetics, and what he called "imaginative biology." Dr. Ingram considered only one doctor to fit the bill: himself.
Into the examination room he went, only to find a rather thin-looking terrier in jeans and a T-shirt. The eyes were brown, as were all of his patients, and other than that, the only clue to the gender was a pink necklace and an earring. As always, therefore, Ingram looked at the form first.
"Cindy, is it?" he asked, the name only confirming the female gender checkbox next to it.
The dog nodded, but did not speak.
"You seem to be in good health," he continued, "would you consent to an exam?"
"I suppose," replied a surprisingly deep voice for a female -- another characteristic shared by all of his patients.
"Alright, take off your shirt."
Checking off another morphotypical feature, he noted that neither the mammaries nor chest muscles were very well developed. From the chest up, his patient looked fairly male, except for the name. But John knew, as he checked breathing and heartbeat, that would change in the next step.
"Okay, good," he murmured as he finished these, and checked the mouth and tongue, "now, strip off please."
The dog hung the jeans around the ankles, and allowed Dr. Ingram to inspect everything. He checked for testicular cancer first, like a normal male patient, but did an extra step. Pulling back the skin of the modestly small penis, and rubbing a little bit, he asked, "feel that?"
"Yes," the dog answered.
He stopped immediately. "Alright, now turn around."
It was a shock that Ingram never got over. The dog turned, and there was a clitoris. John was glad that the patient's back was turned; otherwise, the sudden feeling of visceral fear that went through John from head to toe was unmistakeable. This was why they were here, he told himself, as he focused on a female examination.
He also asked if rubbing the lips gave sensation, and it did. Despite his detached professionalism, every time he contemplated such a well-equipped nervous system, he felt a small pang of envy mixed with his disgust.
"Okay, now for the difficult part of the exam," he said, professionalism turning somewhat grave as he grabbed a rubber glove from the box. "I'll try to make this quick. Please bend over."
The legs bent, and the tail moved, allowing access. "It's important that we know where your prostate has moved to," he explained as his finger penetrated, "because I presume you urinate like a male?"
The answer was only a grunt and a nod. He felt it had moved forward, making this one of the difficult 20 percent.
After removing his finger, and letting Cindy recover, he gave her the bad news. "It looks like your prostate has moved forward, to accomodate the ovaries, rather than upward. So you may have trouble urinating."
"I -- catheterize myself now," she answered.
"But this may be different. The ureter may be closed off in the last 3 or 4 months completely. This would mean, probably about month 5 or 6, putting in an indwelling catheter to keep the flow. Other than that, you seem in good health. All we need is an egg sam--"
Just then, his pager went off. He switched it off, and started leaving.
"An egg sample," he repeated, "and then we can implant it, and pay you the upfront fee. Doctor Foster will be in shortly if you have any questions."
Leaving Cindy with a question on her lips, he left; and, after he got out, sighed before going to get her.
***
The next day, when he walked in, there was no emergency. He made sure that on surgical days, those were routed to Barbara. He wished he could do paperwork, but instead began focusing his mind on his hands.
The chart was shown to him as he was gowned, scrubbed, and masked. First up was the final step in another patient's contract, the step that made this place worthwhile in Ingram's mind. While he only supervised the deliveries, he was present for all of their complications. And those complications were quite frequent -- more frequent than anyone but him knew.
He walked into one of the two operating rooms at the end of the hall, with all of the equipment and technicians waiting.
"I'm Doctor Ingram," he said, sice the mask would make it impossible to tell. "For verification, could you give your name, please?"
"Raymond Goersch."
"And what are you having done today, Raymond?" John smiled when he said it.
"Cesarian section, uterus removal, and then, getting the big payday." He said it without a smile.
"Everyone concurr?" There was one "concurr" per technician.
After Raymond was put under, Dr. Lisa Bennett began first with the cesarian section. The only difference was the ultrasound in the beginning, resulting in a cut that was much lower on the abdomen than normal. It took half an hour to slowly remve the child, who was promptly put on life support; it was 2 weeks before it was due, just like those born with the standard method for troublesome parents, artificial wombs.
John stared at the tiny body, laying the the chamber of pure oxygen, kept at body temperature. Blood was exchanged witht an imaginary mother via IV, who provided only neutrients, and a few dozen basic antibodies. This was the reason Dr. Ingram's accidental discovery was worth all of his time, effort, and personal difficulty, he thought. This moment, where the impossible has come to life.
After only a moment of watching, the life support chamber was taken to a darker room. Dr. Ingram then took over, performing what he considered his most important fuction: bringing sex and gender into line in the body of poor Raymond.
***
This and three more operations -- including quite a change, an emergency appendix removal -- took up the rest of his day. He at least managed to get a 20 minute nap in the office before the last big thing today: he was scheduled to speak.
"We all know where we stand," annouced the lupine MC into the microphone on the small stage, "but today, I have brought in someone who knows where he stands too. He assures me that we should agree with his work, even though I am skeptical. But there is only one way to find out, so please at least listen, to the distinguished Doctor of the Herms, Dr. John Ingram!"
Rather than applause, was murmuring. Looking out over the small audience of about 50, some of them looked like they were afraid of the tiny bi-gendered minority, and others more like they would beat one up for fun. These were his sharpest, and stupidest, critics. As the only friend he had in the room, the MC Stanley, watched from off stage, he planned to win an impossible bet he had made: that these hooligans would invest in his hospital.
"Gentlemen -- and Ladies," he added, as he saw a group of six females in the back of the room. "I am not here tonight to sing the praises of equality as forced upon you by our government. --"
"Let 'em try it!" shouted a large rottweiler.
This got a brief bit of laughter, making John take a deep breath to relax again, but when he spoke, they went silent.
"I am here to talk about economics, pure and simple. Now, let me ask you: how do you have a child? I'm sure all of us know one very easy way..." He paused for a chuckle, but there was none, so continued.
"...invented by nature about 350,000 years ago, and practiced by our progenetors for about 345,000 of those years. But that method is rife with problems, not the least of which is, none of us would be here!" At least, scanning the crowd, he had their attention.
"The cost of our existence, however, grows by the day. The method developed by biology has never been so easy for us. There are errors that affect three in twenty of us; horrible diseases like Andrews' Syndrome, Rajdahl's disease, and worst of all, a heredetary form of Impotence, probably held by some of you in this very room!
The audience looked sour; several crossed their arms. So, he tried to move on. "Do you know what it costs your government, paid in your taxes, to own a machine capable of developing a child for parents who cannot have one? One tenth of my entire hospital! For one machine! And they will make that back over the course of the machine's life by raising your taxes and charging you!
"Instead, all I propose is a solution: cheapen it. Cheapen the cost of having a child. Don't make the government spend so much on something so simple." The ambiguity of the audience, however, had not gone away.
"What about the herms!?" someone shouted.
Obviously, they weren't going to let him make the speech the way he wanted to. They were not amenable to rational argument, or reason. Deciding he had to play to their base instincts, he took another deep breath, and let his inner rage take over.
"You wanna talk about the Herms? Fine! They are the scum of Giaya!" he suddenly shouted, making everyone in the room jump. "Aren't they!?" he repeated when no one responded.
There were a few nods; he presumed the rest suspected a trap.
"They are the most perverted creatures alive! Natural nature does not tolerate them! They had to be invented!! And you know who did it!? One human company! They came up with a genetic sequence, which could be inserted into the DNA of any of us, for who knows what reason! Now isn't that sick!?"
Invoking the most feared ghosts in the culture was working. There was one "yes!" in the background.
"And if any of your children sleep with one, they wish they were one! They become objects of envy, not of disgust! They are slithering their way into the hearts of the next generation like snakes!!
"And so you know what I do!? I collect them! They are not wandering the streets, they are in prision! It's in my contract, they cannot leave once they are admitted! They cannot wander around the schools, or neighborhoods, and talk to your children! They are tied to hospital beds for 8 months, and kept away for another 6! You should thank me!"
The answer, however, was silence.
"This is a no-brainer, gentlemen!" he inisted, ignoring the six females for the sea of males. "Keeping them off the streets, making them be productive, having the children parents so desperately want! No more flaunting, or taunting! C'mon, isn't that just what you want!?"
"They'll never stop!" someone shouted.
"Oh really? I have 513 patients out of 1,026 registered Hermaphrodites! That's half of all in existence! And I am pursuing the other half relentlessly! We have the capacity! We have the building! We have the contracts! And we have them signing up!" he emphasized, stamping his foot.
"And when they fulfill their purpose, they are reverted to one gender! They are so stupid, they are buying into their own demise! Isn't that fantastic!?"
This time, even the strongest opponent, one he looked at the entire time, started the applause. And it was long.
"So gentlemen, that is why I am here tonight. To tell you what I really think! To tell only you my secret plan, that no one will tolerate hearing! And now, that I have revealed myself to you, I need your help. Under your chairs are some envelopes. Please open them." He glanced briefly to Stanley, the one to place the envelopes, and was pleased to see a look of shock on his face.
"In there, are bonds. You don't have to be a bond trader to understand what an option is: it's the right to buy something at a different price. You send me that piece of paper tonight, you can buy a bond to help me with my hospital, and at 10 percent below par. You believe in identity politics? You want a good investment when you see one? Then I ask you gentlemen, in public or private, talk to Stanley and put your money where your mouth is."
Without another word, he walked off the stage.
Stanley struggled to clean up the mess. Everyone was rowdy, despite a lack of conensus. John wondered, as he walked home, whether his bet would be won. But the next day, he got ten pieces of paper back, with nine checks, and one bundle of cash.
***
The next morning, as he began his rounds, Barbara told him that James still wanted to see him. So, he went up to the second floor, to the private rooms, and knocked on 214.
Fortunately, it was not James who answered the door, but Lance, his mate.
"May I come in?" he asked in his professional calm voice.
The door was silently opened for him. He immediately walked past the living room, plain white walls offset with a large green sofa, into the small bedroom considered to be the master. There was James. His jaw was lulled open in weakness, and his eyes were angry.
"How are you feeling?" he asked, since signs seemed to indicate good health in spite of the nurse's report.
"Not good, doc," he growled weakly.
"Any pain?"
"Just nausea, which has ruined my life."
"We can get rid of the nausea," offered the Doctor as he put his stethoscope under the blanket, "if you will do blood tests twice a day."
The large dog laying in bed looked a little smaller as he exhaled during Ingram's checks. "Fine," he answered.
After checking the pulse, he decided now was the time to issue the standard bad news. He stood back up, took a deep breath to steady himself, and said it.
"Since you are having nausea, in some sense, that is good. It means your body is adjusting to the idea that you will become a mother. In fact, we are probably going to start estrogen injections next week. I have warned you about the side effects originally, but there is something I would like to clarify."
The way he said words so simple as that made the black fox behind him start glaring, and the dog before him become worried.
"After you give birth, your body will have been at a completely different hormonal balance for months. One of two things happens, depending on your adrenaline and androgen levels prior to the surgery. Either they will just drift back to normal over several weeks, or the new levels -- and their physical side effects -- will become permanent. Your masculinity will recede completely."
James' jaw clenched; apparently he didn't like the thought.
"Is there anything you can do about this, doc?" Lance's sharp question wasn't asked two seconds after the Doctor had finished speaking.
"The only way," he answered, still talking to James, "is to remove the vagina after the child is born, inject cortisol, and then slowly return your levels to normal. The surgery carries considerable risk, but it is requested often enough that we will do it."
Nothing changed between the face of James or the breathing of Lance behind him.
After the silence hung a moment, he reassured, "I would suggest you think about it. If you opt for surgery instead of seeing what your body will do, we need to know in 3 months ahead we can plan it out."
"I have a question," asked Lance, voice still pointed, "how likely is it that he -- won't lose his masculinity? I love him the way he is."
The doctor stood, and looked him right in the eye sympathetically. "I don't know. All my research tells me that androgyny is a very precarious state. Nature doesn't like it in mammals, because fertility is so complex. His testosterone levels were pretty weak when we saw him, but I don't know if they cycle. I wish I could be more sure, but I can't."
"Well -- what will he -- what will he be like if the -- masculinity goes away?"
"Just -- a girl, with an oddly placed vagina, and a little on the bucth side."
"If I took the surgery," asked James at this point, "would you still love me?"
No answer from Lance; another question instead. "Doc, can I ask you something outside?"
He briefly turned to see if James had anything else to say, and then walked back out to the living room.
"Doc, after we start him on a regular estrogen regimen, then what will he be able to do?"
The question was netural, but the tone was pointed. He apparently had something in mind.
"He should be quite fit, as long as he doesn't undergo too much stress. Walking is okay, running is not. We have a pool he can swim in, if he doesn't do laps. You know, all the general pregnancy advice."
"Yes, but -- if he might take the surgery, then this would be my last chance --"
Dr. Ingram nodded. "I see. You want to know about sex. It depends on the size of the uterus. The male organs usually work fine for about the next 5 or 6 months, and the vulva is fine. But you might not want to penetrate him after about 4 months or so."
Lance nodded, and held the door for the doctor. "Thanks, Doc," he said, his voice still a little cold.
John, once in the hallway, sighed and smiled in relief. Another one converted.
***
The banquet he attended at the end of the week was much different from the last group he spoke to. And it was a good thing, because having worked through lunch that day, he was quite hungry. He insited on speaking at the top, so that he could eat right away, and then have the most possible time to persuade this crowd with money to give some of it to him.
His speaking slot was simple: repeat his discovery: his discovery of the genetic "patch", its government clearance, his later discovery of its purpose, and the tension it created between free individuals and the social good of creating children efficiently by those unable. He pleaded that his clinic was the solution, and it should be funded.
But after the polite round of applause finished, and he took to starting on a large plate of chicken, he was interrupted when a lanky vixen, who was slightly sloppy, sat down at his table.
"Pardon me, Doctor Ingram," she said in a sharp voice, "but what are you doing here?"
"Raising money, of course," he replied with a full mouth, hoping to brush her off.
"That's not what I meant," she continued, "your work is well and good doctor, but I am curious as to your opinon on these individuals."
The Doctor was mildly surpised to see such an attitude here -- if that is what it was. "What do you mean?" he asked, strengtening his gravitas.
"I've heard a diffegent side of you, Doctor, a few days ago. You stirred up a sentiment that they were unworthy of existing."
He did not remember seeing her in the back of the room, but presumed she must have been there. "Oh that," he smiled, "I have to talk to people without compassion like that. Otherwise, one of them would probably kill me. They need appeasement periodically, nothing more."
She nodded, and said nothing more, but didn't leave his table.
After the current speaker finished another paragrah opining about the birth rate, and Doctor Ingram was starting to become uncomfortable with her not leaving, she made her next statement. "You know they'll shut you down," she said cryptically.
Dr. Ingram knew that was wrong. "A group of a hundred angry ingrates? They'll never --"
"Not them," she corrected, "the government. They are rethinking their approval of androgyny in light of your discovery. They see it as in the same category as parents choosing their child to have 12 fingers."
Dr. Ingram, however, didn't want to think about that. "Obviously, you haven't been listening," he chastized, taking a brief pause to applaud at the same time as the audience. But it was long enough to let her get a word in when the noise died down.
"No one gives to a hospital that is about to lose," she whispered, "you'll have a hard time of it." Then, she finally left.
It gave him resolve to prove her wrong; to get at least enough of an operating budget for a year. When he finished his chicken, which was dry but adequate, he began those rounds.
He started with the speaker most emphatic about the birth rate. "We have a common cause," he explained. "It's clear that the humans were trying to solve the same problem we were. That is why they created this: to allow the regular birth of clones when they had no stable method for creating them."
"I agree, I agree," was his hesitant answer, "but very few others do. They think cloning is almost automatic by now. As if this were just making a building or something. but let me introduce you..."
The new acquaintence turned out to be government bioethicist with a radical proposal. "As you know, we take a very dim view of androgyny, but we see your work as valuable in benefiting society," he explained. "If you will turn your hospital from focusing on androgynous births into one which helps more ordinary parents with genetic difficulties, --"
"But most of my equipment is not suited for that. Too much of it is a hospital, too little a genetics lab."
"I'm sure that parents who presently pay you for a child would be glad to have you give it a shot with their own bodies. If you stop contracting out births to other parents, and we will give you a sizable grant for rennovation -- say, twice your operating budget last year?"
The proposal was quite a strain; maintaining his purpose was now put up for money. As much as he hated to admit it, the geneticist was right, at least in the long run. And if he said no, that would mean his true purpose -- keeping those Herms in his hospital beds -- would be revealed.
"How fast do I have to decide?" he asked cautiously.
"We'd send a timeline for your final approval, along with the usual laundry list of steps. I merely wish to know if we should even consider it."
The Doctor grit his teeth, and faked a smile. "Consider it," he said.
"Glad to hear it. We'll call you." The hyena walked way.
It was enough to almost make him sick. He stumbled out, with a sense that his life's work since those doors opened -- and his personal quest -- was a failure. He kept telling himself that he would try to find a loophole, as he made his way home.
***
The last agenda item on his list before he went to bed was a return to the office. It was the phone call that, he hoped, would at least make him feel good in the face of a blow like this. He drew himself slowly to his office, the night shift nurse giving him a nodd of familiarity on the way by, and fumbled for the key to his desk drawer in his pocket.
When he was sure no one was listening, he made his first call. "Hello?" asked the other end of the phone.
"Mr. Ynnot," guessed Dr. Ingram, "my name is Dr. John Ingram. Am I disturbing you?"
"Yes you are," growled the canine voice on the other end.
"The I'll get straight to the point: I run a clinic which pays the few androgyn--"
"I know all about your clinic," he replied sharply, "because your people have called me four times already! Any more, and I will consider it harassment!" The sound of the hangup had a distinct bang to it.
When the next three calls ended in roughly the same way, and the Doctor had put an X next to all of their names, he called Stanley, blood starting to boil.
"I've got a few new addresses for you," he grumbled.
"Same instructions as always?"
"Right." The addresses were given, and the instructions were known. They proved the fact that Dr. Ingram and the extremists both knew: androgyny was, in fact, a sexual draw. Otherwise, why were his instructions always followed, to getting clients when nothing else would?
"By the way, Stanley," he added, "it was true: over half have passed through my doors since I opened."
"But, as I am sure they would ask, how many have had their gender resolved?"
"You mean their sex," he corrected, mood not improved. "A fairly large number, probably over 200."
"That's under half!"
"Yes, it is. I won't do anything illegal," he snapped.
Stanley laughed wryly. "And giving my friends their addresses isn't illegal?"
"I don't know what they are going there to do," he said, drawing back against a mock prosecutor, "they could be going to pay their condolences."
Stanley laughed, but Dr. Ingram didn't even smile. There was nothing else to talk about, so he hung up.
In order to prevent suspicion for getting rooms ready without reason, he did nothing but mark the sheet on the secratary's desk, indicating that two vacant rooms needed to be cleaned -- a clerical error. He was at least satisfied, even if he still felt black as the night he stepped into.
But that night got even worst in an instant. Two big males grabbed him, and started beat him to a pulp. It was obvious, he reflected, they didn't get his message. They must have been in his audience earlier that week, and not believed him.
The pain focused his thoughts: the game was up. His injury at the hands of these extremists would start an investigation, and that would surely uncover his lies, if not his plans. The same thing would happen if he were dead, except he wouldn't be there to see the world that the evil Herms would create without their extinction or enslavement.
And so, when the larger of the two dragged him up, and growled, "what do you say now, Doc?" the response was not fear, but resignation.
"Kill me," he moaned. Immediately after, a knife began draining his arteries onto the street. The Doctor got his wish.
The End.