By the Numbers

Another character study, this time of Gabe. Somewhat disjointed to match its subject, with a shout-out to his first in-game scene.

In med school, surgical rotations aren't just an integral part of the curriculum. They set delineating boundaries for the class, a kind of rubric for the aspiring doctors to sort themselves out by. Without fail, there's always three groups: Group A, the "I've wanted to do surgery since I was six years old" group, Group B, the "maybe I'll consider it, possibly" group, and Group C, the "oh no way in hell am I ever going to be a surgeon" group.

For as long as he can remember, Gabriel Cunningham's been the poster child for Group C.

It isn't just his childhood fear of blood, although he's overcome that for some time- he's had to, as a doctor. It's not his poor hand-eye coordination, although he can't deny that that's been a factor. Once, there'd been a carotid endarectomy on the vascular rotation, and so, while the attending physician grafted a length of saphenous vein to the patient's carotid artery, she'd casually invited Gabe to sew up the incision on the leg where they'd harvested the vein.

He'd actually thought he was doing pretty well, methodically tying and threading each stitch with careful precision (before they'd invented those damn instantaneous suturing machines), until halfway throughout the stitches, he'd noticed an odd, almost reverent silence, and then he suddenly realized the attending physician had finished her job fifteen minutes ago and was now waiting, along with everyone else, for him to finish suturing the harvesting site.

The instructor's tone capped the whole fiasco off. "Don't worry," she'd said, almost kindly. "The patient will be too concerned with the small scar on his neck to notice the large one on his leg."

The resulting sniggers, sotto voce, only cemented Gabriel's convictions. Group C material for sure.

Not like that first-year brown-nose Derek Stiles, trying to muscle his way onto every rotation whether his schedule and the laws of space-time allowed it or not. More than once, Gabriel awoke to the sound of Derek's frenzied footsteps striking a rapid tachycardia against the linoleum floors of the student dorms, rushing to yet another god-forsaken surgery seminar; before long, few people on their floor even bothered to set alarm clocks anymore. Derek was a Group A fanatic if there ever was one.

By contrast, Gabriel's always felt more comfortable in the cut-and-dried world of academic medicine: of dictionaries as thick as a Bible, with dated, labeled anatomical diagrams that the less mature would snicker over during their lunch hours. He'd much rather list the symptoms of an intracranial aneurysm than be the surgeon opening up the guy's head, poking at tangles of blood vessels like a bloody game of pick-up-sticks.

Surgery is a task that requires confidence, commitment, and communication- things Gabe's rarely excelled at. Even the simplest, most routine operation requires a tightly choreographed sequence between the doctor and several other parties; the assistants, the nurses, even, to some extent, the vital machines and the patient on the table. The doctor must work with his units as a team, ready not only to execute a perfect procedure for the hundredth time but also to improvise instantaneously, flawlessly, when something doesn't go as planned. In such a situation, there's no room for hesitation or error.

The truth is that Gabriel's never been a so-called 'people person'. He's never quite been able to build enough rapport with anyone to maintain a conversation, let alone a meaningful relationship.

Instead, he's always preferred to remain detached; he'd rather be in the background, piecing together causes and vectors in the serenity of his own solitude, instead of fighting battles under the scrutiny of the surgical lamp. He might have questioned a career choice that required face-to-face contact and meaningful interaction with people every day, but the way he figures it, it's still preferable to being a surgeon.

After all, he's thought, there's no situation that calls for greater mutual understanding and trust than letting somebody slit you open and peek at your insides, and Gabriel doesn't want to risk anyone turning that responsibility over to him- which is, he realizes, after Joshua's surgery is over, the reason he'd been all too happy to shift the burden of his son's operation to a convicted mass murderer.

He knows Joshua may have gained his trust as a doctor, but he also knows that his son isn't yet ready to trust him as a father.

The first thing they tell you in any semi-decent medical school is to respect your patients: to see them for the people they are, and not as the symptoms and ailments their bodies are suffering from. Being a successful doctor isn't merely knowing where to check and what pills to prescribe; it's a job rooted in empathy, in recognizing that behind every clinical exam and analysis are actual people, with their own emotions, memories, and lives.

Gabriel's rarely been very good at remembering that tenet. It's not that he flouts it on purpose; it's just easier for him to see things in terms of numbers and statistics, concrete variables that he can assign values to and tabulate in his head.

As a doctor, he's lived his whole life by the numbers; his job is largely cross-checking matching discrete symptoms across other cases while checking for statistical deviation in accepted values. He likes it that way; he can be a doctor without ever having to worry about blood on his scrubs, or apologizing to widows outside an operating room. For Gabriel, a diagnosis is nothing more than a kind of equation where multiple variables and symptoms add up to a final, unifying solution. That people are cured by his answers is icing on the cake.

To Gabriel, numbers possess a certain finite finality that people don't have. Numbers don't grumble and complain about smoke or consultation fees; numbers can present a truth more stark and unvarnished than any babbling patient's testimony. Hell, he's even learned to tolerate RONI; RONI may have had a voice and a personality algorithm that made him want to slap her programmer (no, RONI was more understanding of him in its own way than any woman- why did he refer to RONI as a female, anyway?), but in the end, he knows RONI's still a spool of circuitry wrapped around commands and numbers; easily understood, easily readable to the core. He can empathize more with white blood cell counts and fibrinogen levels, than Mrs. Mary White from across the street with the two kids and the recent mortgage. The one whose stomachaches and husband just can't stop bothering her.

He skims through her charts (rotoviral gastroenteritis) and conversation ("…he never listens to me, it's like I don't even exist to him anymore…"), then prescribes rehydration solution and a divorce lawyer. The lawyer's a bit of a jerk, frankly, but he's good at what he does; Gabriel can vouch personally for that.

Next.

He's never been able to figure out what Lisa first saw in him that day, though heaven knows he's made a few guesses- maybe it was the fact he'd just got back from his stint in the military, and she was attracted to the soldier-type; or maybe it was his medical degree, or hell, maybe he was just unusually handsome back then. It could have been anything, a multitude of possible causes scattered amongst a foregone conclusion.

Gabriel sighs, leaning into the couch cushion. He doesn't remember- to be honest, he doesn't remember much at all about the period between the day they'd first met and the day he was trapped in now, waiting for her to phone about what last things of hers she'd left in his house.

He's always had a good memory, but he's never seemed to remember things equally. He's good at remembering differences between MRI images, and he's committed the exact stages of the Glasgow Coma Scale to memory, and yet he can't remember anything about his own life to save it.

When he tries, dredging his brain, he comes up with fragments: a kiss, a promise, a child, an argument, scattered across the nebulous void of his own past, all converging to a future clouded by ashen haze.

Had his life really come to this?

Had he really driven himself to this, as Lisa always said?

For a moment, Gabriel wants to revisit the 'unusually handsome' theory, but then he remembers (distantly) that Lisa took the picture album with her when she left.

Over the years, Gabriel's realized- or rationalized, rather- that it's unhealthy to get attached. He's a professional, and he can't let anything get in the way of his doing his job to the highest standard, even if his job involves the lives of other people.

Especially since his job involves the lives of other people.

Seeing someone in person is different from reading charts with a picture paperclipped to the manila cover, as Gabriel knows all too well. From a lab chart, you can learn the most intimate details about a patient's body- their age, their weight, their blood type, even the precise schedule and composition of their bowel movements- and yet when they come in and start opening their mouths you'll find you knew nothing at all, and if there's one thing Gabe's learned throughout his life so far, it's that seeing the whole picture isn't always a good thing. Transparency's an overrated characteristic; the truth might set you free, but not without digging its talons into your shoulders first.

As a diagnostician, Gabriel's careful to toe the line between the patient's stats and the patient as much as his job will allow him to. He asks questions only when he has to. He's no shrink. He isn't so much a doctor as he is a car mechanic, tinkering around the machine until he finally figures out what the hell's wrong and then sticks out a fat, unsympathetic bill for his trouble.

The truth is, Gabriel never wants to pass the point where he starts seeing a patient as a person rather than a list of symptoms and numbers. He can understand symptoms and numbers.

He just can't understand people, and Gabriel Cunningham's never been able to trust what he can't quantify with a formula or a textbook definition.

It just never ends.

He's lying on the bile-colored couch in his office at Resurgam, watching the wispy remains of his first love spiral upwards.

The cigarettes were a habit he'd picked up in the military, like a symptom that refused to go away. The first time he'd had one, it was like sucking the ash from a furnace; hot, dry, disgusting. He remembered thinking of the slides of lung cancer patients they'd shown in the oncology classes, the pockmarked carcinomas glaring up at him with their thousands of blackened eyes through the microscope. His tongue had throbbed with the acid taste, a flagrant bitterness seeping over his mouth.

Then, a stray mortar from a long-range battery had landed near the medical compound, and suddenly it didn't taste so horrible anymore.

Being a doctor or a soldier is supposed to embody you with a newfound respect for life; Gabe's been both, and as he flicks the latest smoldering stump into the overflowing ash tray, he reflects that all that's done is to make him disregard his own health even more.

Lisa had always used to pick on him for the cigarettes for a variety of reasons. She hated the black smears they made him leave on the walls and floor. She'd said they made his kisses taste burnt. She complained that they left scorch marks on the bedsheets and that those weren't the easiest things in the world to replace, stop it, Gabe, it's not good for the baby, are you even listening to me when I talk to y-

The office phone rings, loudly. Gabe sits up.

…look, look, Gabe, it's positive, it says it's positive-

He grunts, accidentally chewing down too hard on his cigarette. A caustic sear races across his tongue. "Must've dozed off."

…we're going to be parents, Gabe, parents, I can't believe it…!

The ringing stops, abruptly. Gabriel leans back, waiting for the answering machine to do its job.

"It's Lisa." Her machine-distorted voice blends seamlessly with the fragmented memories racing in his head, until he can no longer distinguish between the two.

A pause. "I thought it'd be useless calling the house."

…what are we going to call the baby, if it's a boy…Gabe?

"I wanna get Joshua's things next Sunday."

...Honey…are you listening? I said…

"…I'm sure you won't be there anyhow."

…you're never here anymore, Gabriel. Even for Joshua's sake…Gabriel, I've tried, God knows I've tried so much, but I can't keep going any more. If your job's so important to you that- that you have to turn your back on us- then stay. Stay in that goddamned hospital, Dr. Cunningham. Stay as long as you want-

"…I'll drop the keys in the mailbox."

I'm leaving.

Click.

Gabriel's always lived his life by the numbers, finding and unraveling problems through cold, logical analysis. But as he closes the door behind him, he reflects that some things can't be solved that way, no matter how hard he tries.