The Portable Veblen: Shortlisted for the Baileys Women’s Prize for Fiction 2016. Elizabeth McKenzie

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      “Dr. Vreeland, why don’t you ask a resident to take your cart?”

      He grinned, tossed off something about finding it difficult to delegate.

      Her eyes gleamed with the thrill of discovery. “My father says, ‘If you want something done, ask a busy man.’” She had just visited a dear friend, very ill, maybe she should have a coffee before hitting the road, would he like to come tell her about his work? She was with Hutmacher Pharmaceuticals, and loved to keep abreast of the latest developments. He stood taller. At the next floor he jettisoned the cart.

      “How long have you been here?” In the cafeteria they settled in plastic chairs.

      “My third year. Are you a rep or something?” he asked with a mischievous poke, because industry reps were no longer allowed to do their repping at the School of Medicine, and he’d signed his share of SIIPs (Stanford Industry Interactions Policy), which covered gifts from the industry, access of sales and marketing reps to the campus, and other strategies of coercion the industry was apt to deploy.

      “You could say that,” she responded. “You could say I’ve been repping for them since the day I was born.”

      Moments later, when he realized over his plain black coffee that he was actually speaking to a Hutmacher, namesake of one of the largest pharmaceutical companies in the world, a modern empire, she a virtual princess, he gulped and scalded his esophagus, and worse, felt his testes shrivel to the size of garbanzo beans. To his shame, he really believed the wealthy were superior. In a Darwinian sense, they had to be. He could read the story of past conquests and brutal takeovers in her bone structure, her long arms and legs, her narrow shoulders, her high cheekbones and forehead, her elegant hands. The marriages that had led to her creation had been of alpha males and glorious females, and you wouldn’t find the peasant’s short calf or hunched trunk among them.

      Meanwhile, he descended from a rough mix of Dutch farmers, Belgian carpet salesmen, Irish gamblers, and Presbyterian prigs, and he wondered what use she could possibly have for him.

      “But as I said, I’m not here on business. I was visiting a sick friend.”

      “I’m sorry,” Paul said.

      “Thank you. Now more about you.”

      “But—” He laughed at himself. “Shouldn’t you be skiing in Zermatt, or whatever heiresses are supposed to be doing?”

      “That’s next January. Tell me about your work!”

      Who had ever asked? The subject of his study was his gold reserve, burdening his heart. “Well, I’m working on traumatic brain injury. I’ve been developing a tool.”

      “A tool? Tell me more,” said Cloris, with such prosperous vitality he felt all underfunded and desperate and teenaged again.

      “To make it short: I’ve found a way medics on the line can take a proactive role in preventing permanent brain injury.”

      “That’s terrific,” said Cloris. “How?”

      “Well.” Was he pitching his tool? “You want me to tell you now?”

      “Please!”

      He nodded, and scalded another quadrant of his taste buds. “Let’s see. Where to start. The body’s response, you know, to just about any stimuli, is swelling—”

      “I’ve noticed.”

      His nostrils flared. “To injury. Like my burned tongue right now. The body swells.”

      “Yes, it does, doesn’t it?”

      “The blood rushes, it rushes to the—geez.” He laughed, looking down. “Okay. I have no idea what we’re talking about here.”

      “Don’t stop.”

      He cleared his throat. “So the brain. If the brain is injured and swells, the skull, I’m sure you know”—he made his hands look like a clamp—“holds it in, and—” His neck felt hot. “There’s pressure, lots of pressure.”

      “I understand,” said Cloris.

      “The pressure builds—”

      “—and builds—”

      “—cutting off circulation—”

      “Oh, my.”

      He bestowed a frank, open gaze upon her, and cleared his throat. “Anyway, the cells stop getting oxygen, which sets off a chain reaction called cell suicide, technically called apoptosis, but if a craniotomy—opening up the skull—can be performed immediately, releasing the pressure, to make room for the swelling”—Paul shifted in his seat—“then no more cell suicide, and under the right circumstances recovery is achievable, up to eighty, ninety percent.”

      “So how could this be done?”

      “Here’s the problem. Say you’re a medic in combat, and you need to get your injured troops to the closest field hospital, but for a thousand reasons, you can’t do it fast enough. This happens all the time. You’ve made your determination of brain injury—”

      “How is that done?”

      “Nonreactive pupils. Unconsciousness.”

      “Sounds like me every morning.”

      “Ah.” Paul felt a luxuriant warmth ripple down his thighs. “The point is, it’s not all that high-tech—craniotomies have been practiced for thousands of years. We see burr holes in the skulls of Egyptians, Sumerians, even the Neanderthals—”

      “That was for a snack,” she said.

      “The point being that long before there were hospital standards and antiseptics—”

      “It could be done.”

      “Right! And so in emergency situations, medics—”

      “Could do just as good a job as the Neanderthals!”

      Paul slapped his palms on the table. “Right. And here’s where my work comes in. I’ve devised an instrument that is safe, effective, essentially automatic, for the line medic to use right on the spot.”

      “The Swiss Army knife of brain injury?”

      “Yes.”

      “Something every medic would carry?” she grasped, eagerly.

      “That’s my hope.”

      “Simple, easy to use?”

      “Very.”

      “How big is it?”

      Paul held up his hands to indicate a tool of about eight inches.

      Cloris raised her eyebrows, then entered text in her phone. “What’s it like? Tell me there’s something like it but not as good.”

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