My five years as a medical student passed without my ever needing to see a patient in the flesh. My skills in anatomy and physiology were learned at the computer display terminal. Advanced techniques of diagnosis and surgery eliminated any need for direct contact with an organic illness. The probing camera, with its infra-red and X-ray scanners, its computerized diagnostic aids, revealed far more than any unaided human eye.
Perhaps I was especially adept at handling these complex keyboards and retrieval systems — a finger-tip sensitivity that was the modern equivalent of the classical surgeon’s operative skills — but by the age of thirty I had already established a thriving general practice. Freed from the need to visit my surgery in person, my patients would merely dial themselves on to my television screen. The selection of these incoming calls — how tactfully to fade out a menopausal housewife and cut to a dysenteric child, while remembering to cue in separately the anxious parents — required a considerable degree of skill, particularly as the patients themselves shared these talents. The more neurotic patients usually far exceeded them, presenting themselves with the disjointed cutting, aggressive zooms and split-screen techniques that went far beyond the worst excesses of experimental cinema.
My first meeting with Margaret took place when she called me during a busy morning surgery. As I glanced into what was still known nostalgically as ‘the waiting room’ — the visual display projecting brief filmic profiles of the day’s patients — I would customarily have postponed to the next day any patient calling without an appointment. But I was immediately struck, first by her age — she seemed to be in her late twenties — and then by the remarkable pallor of this young woman. Below close-cropped blonde hair her underlit eyes and slim mouth were set in a face that was almost ashen. I realized that, unlike myself and everyone else, she was wearing no make-up for the cameras. This accounted both for her arctic skin-tones and for her youthless appearance — on television, thanks to make-up, everyone of whatever age was 22, the cruel divisions of chronology banished for good.
It must have been this absence of make-up that first seeded the idea, to flower with such devastating consequences ten years later, of actually meeting Margaret in person. Intrigued by her unclassifiable appearance, I shelved my other patients and began our interview. She told me that she was a masseuse, and after a polite preamble came to the point. For some months she had been concerned that a small lump in her left breast might be cancerous.
I made some reassuring reply, and told her that I would examine her. At this point, without warning, she leaned forward, unbuttoned her shirt and exposed her breast.
Startled, I stared at this huge organ, some two feet in diameter, which filled my television screen. An almost Victorian code of visual ethics governed the doctor/patient relationship, as it did all social intercourse. No physician ever saw his patients undressed, and the location of any intimate ailments was always indicated by the patient by means of diagram slides. Even among married couples the partial exposure of their bodies was a comparative rarity, and the sexual organs usually remained veiled behind the most misty filters, or were coyly alluded to by the exchange of cartoon drawings. Of course, a clandestine pornographic channel operated, and prostitutes of both sexes plied their wares, but even the most expensive of these would never appear live, instead substituting a pre-recorded film-strip of themselves at the moment of climax.
These admirable conventions eliminated all the dangers of personal involvement, and this liberating affectlessness allowed those who so wished to explore the fullest range of sexual possibility and paved the way for the day when a truly guilt-free sexual perversity and, even, psychopathology might be enjoyed by all.
Staring at the vast breast and nipple, with their uncompromising geometries, I decided that my best way of dealing with this eccentrically frank young woman was to ignore any lapse from convention. After the infra-red examination confirmed that the suspected cancer nodule was in fact a benign cyst she buttoned her shirt and said: ‘That’s a relief. Do call me, doctor, if you ever need a course of massage. I’ll be delighted to repay you.’
Though still intrigued by her, I was about to roll the credits at the conclusion of this bizarre consultation when her casual offer lodged in my mind. Curious to see her again, I arranged an appointment for the following week.
