Creative Writing Honourable Mention – “The Caretaker” by William Upjohn

“The Caretaker” by William Upjohn received an Honourable Mention in the Creative Writing division of the 2022 MIPS x The Auricle Creative Writing and Visual Art Competition. William says, ‘I wrote a short science fiction/horror story, set on a deep-space satellite in the distant future. It is titled “The Caretaker”.’ This piece featured in The Auricle‘s October-December Edition in 2022.


Caretaker’s Log:

02/08/54,675 C.E  (Estimated Earth Date)

This is likely to be my final statement. I have not made many other entries to this log, a decision that I now regret. I am not sure who, if anyone, will read this. I seek only to explain what happened on my satellite, and to enlighten those who would otherwise not understand what lead me to undertake what I did. I do not seek forgiveness, because I know I have not done anything wrong. This is not a confession.

I am not sure how long until my satellite will be found, or by whom. In case this part of our history is forgotten by those who discover it, I shall provide a brief amount of context. In the year 54,345 C.E, our sun began expanding at a rate far, far greater rate than our scientists had anticipated. This gave us around 50 years to escape our planet and retreat to a safer distance, before life on earth became unviable. The decision was made to place as much of the population as possible into a hibernation-like stasis or “cryo-sleep”, and put them safely on millions of satellites in orbit, far away from the now malignant sun. Most, including mine, were placed in orbit at a distance similar to that of the former planet Pluto. The plan was for other, exploratory spacecraft to search deep space for a new planet with conditions favourable for colonisation. Once this new planet was found, the cryo-sleep satellites would be brought over and reawakened. 

Using almost light-speed travel, the estimated time for this mission was between 60 and 80 Earth years. This timeframe has come and went, without transmission or signal from any of the thousands of exploratory craft. It seems overwhelmingly likely that all missions have ended in failure.

My satellite is one of the smaller models placed into orbit. It initially housed 100 individuals in cryo-sleep. It is almost entirely run algorithmically by AI; however, the decision was made to include a single human overseer to ensure the smooth running of all the ship’s functions. This overseer, or “caretaker” as we came to be colloquially known before launch, could override any direction from the ship’s AI, to prevent computer glitches or malfunctions from jeopardising the survival of the satellites’ occupants. 

Being a healthy young male with a favourable genetic profile, I was chosen to be the caretaker of my vessel, a position I was honoured to accept. While the position was demanding, and the prospect of decades of isolation not very attractive, I was assured that personalised neurotropic medications would be administered to ensure my mental wellness was preserved. The fact that I was unlikely to secure a position on a satellite otherwise, and be left on the soon-to-be uninhabitable Earth also contributed greatly to my decision to accept.

The first few decades of orbit were largely unremarkable. I developed a routine of monitoring the sleeping passengers and certifying all vitals were in the desired range soon after waking. I then spent my time confirming our orbital path was optimal, supervising any maintenance activities, and generally ensuring that the satellites processes ran smoothly. In order to preserve power, communication with other satellites was completely ceased after the first year. As a result, I had no contact with other humans, only being able to communicate with the satellites’ AI. While this might have been emotionally detrimental to a normal person, the medications I took daily ensured that my mental state remained favourable.

 Though the 24 hour cycle of days was now arbitrary, I kept to a pattern of 8 hours sleep followed by 16 hours of waking, trying to avoid the cognitive disturbances found in disrupting the normal circadian rhythm. I ate three times per day, and bathed regularly. The temperature of the satellite’s internal spaces, where I lived and worked day-to-day, was kept to around 14 degrees Celsius. This low temperature was maintained in order to slow metabolic activity and decrease the rate of aging.  This meant I was permanently slightly cold – though this is a small price to pay for the supposed increase in longevity.

It wasn’t until my 35th year in orbit that the first complication occurred. During my annual health scan by the satellite’s medical AI, a sizeable adenocarcinoma was found in the hilum of my right lung. This most likely due to exposure to radon, an inert gas that can leak from small nuclear reactors such as the one powering my satellite. While I was not yet experiencing symptoms, it was still a threat to my wellbeing, and I elected to have it surgically removed. The satellite had multiple automated surgical robots, capable of performing almost any surgical procedure at a standard far exceeding human surgeons. Multiple passengers in cryo-sleep had already had procedures performed on them by the machines. They were not even awakened from their stasis – part of the contract for being placed into cryo-sleep involved consent to any procedure the ship’s medical AI deemed necessary.

The operation was a success, at least initially. The tumour was resected completely – however, 4 years later, I developed more tumours, this time spread throughout both lungs. Breathing was becoming increasingly difficult, and I experienced haemoptysis on a daily basis. This presented a clear and present threat to my life, and subsequently to the functioning of my satellite, and to the lives of all those under my care. The only possible treatment was a lung transplant.

While my subsequent actions may appear unethical, it must be kept in mind that my death would certainly jeopardise the lives of all those on my satellite. I could not allow this to happen. It was a difficult decision to make, but ultimately, it is a decision that I stand behind. I took no pleasure in making this choice, and to this day I find the whole process distasteful. I detail my decision here not out of pride, but simply to allow future readers to understand what happened.

I elected to take the lungs of one of the passengers. It was a very grim choice to make, but I eventually settled on those of a 55-year-old man, whose name I will not mention out of respect for the dead. He was a healthy adult male who didn’t smoke, and the medical AI suggested that his organs made the most favourable match. This wasn’t truly necessary – the immunosuppressive medications I would take made virtually any donation viable, although matching did reduce the risk of complications. I cannot detail all the factors that went into my decision, but after 2 weeks of deliberation, accompanied by increasingly severe symptoms, I finally made the decision to go ahead with the procedure. I had to manually override the medical AI, but the surgery went off without issue. The donor was not brought out of cryostasis during the procedure. He did not suffer.

The new lungs were completely successful, and it was almost a full decade before I needed another organ donation. Perhaps due to my constant use of neurotrophic medications, my renal function had deteriorated to a dangerously low level. I required a transplant. Selecting a donor was far less ethically difficult this time, as transplanting a kidney would not result in the donor’s death. For the sake of brevity, I will not give the details of this donation, nor for any of the subsequent ones. Again the procedure went by without issue. The donor was in cryo-sleep for the entire surgery, and was successfully returned to her cryo-pod afterwards, without ever knowing such a procedure took place.

I will not give unnecessary detail about all the subsequent transplants. Initially, at least, I held out as long as possible without using any more organs. However, as the length of my mission extended longer and longer past the expected end point, the aging process resulted in the inevitable deterioration of my body. The successful running of the ship was paramount, and this success was dependent on my input. As such, any and all actions I undertook were necessary, and in my opinion ethically sound. While it appears increasingly likely that I will not have to explain my actions to any individual in my lifetime, I would like to emphasize that I stand by the decisions I made.

Over the almost 280 years that I have now been caretaker of this ship, I have had to extend my lifespan much, much further than would be natural. I have considered bringing a passenger out of cryo-sleep and training them to be a new caretaker, allowing me to finally give up my position, but this is not a viable alternative for many reasons. The most important one, in my opinion, is that the neurotropic medications, which allow me to function under enormous psychological strain, are personalised to my neurological profile. They would not be effective in any other individual. It seems overwhelmingly likely that another person in my situation, faced with the cold, claustrophobic, completely isolated conditions that I live in, would be made insane. I think of myself as something like a deep sea fish, one that inhabits unimaginable pressures without issue. Any normal organism, however, would be crushed.

In order to prolong my life, I have received new transplants of almost every viable organ in my body, as well as various tissues and vessels. I have been through 48 sets of lungs, 40 hearts, and 44 pancreases, as well as countless skin, marrow and vessel grafts, just to name a few. I am not wasteful – I do my best to maximise the number of organs I can use from every donor, and try my best to prolong the use of every organ that I receive. It is difficult, however; as my age increases, the amount of use I get from each transplant lessens. While my first new heart lasted me over 30 years, currently, a new heart will only last me four. This has meant that I am requiring new donations more and more frequently, a situation that is as regrettable as it is inevitable. It brings me great emotional pain to accept organs from those I am supposed to take care of, and were it not for my medications I likely would not be able to cope. These actions must be undertaken to fulfil my duty as caretaker.  

I have all but given up hope of rescue – I have not received any transmission, from another satellite or any other craft, since the silence descended all those years ago. I have considered the possibility that my equipment is faulty, and all the other ships have been rescued while I remain here alone, unable to receive the signal. These idle speculations serve no purpose but to heighten my distress, so I avoid them as much as I can. 

 I imagine that my story is not unique, and that every other living caretaker has had to make the difficult decision that I have. My supplies are dwindling: I have only 20 more untouched donors to use, and my needs are increasing with every year. I do not know what I will do when I have run out, when my satellite has no more passengers and I am left truly alone, orbiting a dying star. According to my ship’s navigational system, we have almost finished our first complete orbit around the sun. I only wish my satellite had windows, that would let me look outside and see the stars. It has been far, far too long.

That concludes all that I wish to say. This is not a confession.

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Humans of Medicine: MedRevue’s Ruby Doherty and Jess McKie

In the July-September Edition instalment of Humans of Medicine, we spoke to Ruby Doherty and Jess McKie. The brains behind the 2022 MedRevue, these two possess a creative and humourous side that shone through in two extremely successful and well-received shows in August. We hope you enjoy their insights into the process of creating such a stunning performance.


Ruby (left) and Jess (right)

First of all, congratulations on two magnificent shows! The reaction from audiences was hugely positive. You must be relieved that everything went so well?

Yes, we are very relieved! Especially after having 2 years without a show, we did feel some pressure to really come back with a bang. The audiences were fantastic, we’ve been so lucky to have had so much positive feedback about the show and we are really grateful to everyone who supported us throughout the year and came to the show. Everyone has been so kind and supportive! We want to give a big shoutout to the members of faculty that came and have reached out since, we really appreciate that they take it all in such good humour and continue to stand behind MedRevue. Their support means a lot! The entire team at every point in the process did such an amazing job and the whole committee is just so proud of the show we were able to put on.

The theme for this year’s MedRevue was “The InMEDibles”. What was the inspiration for this theme?

Every year at the MedRevue AGM (which everyone should come to this year if they are keen to get involved), we have a brainstorming session for the theme for the following year’s show. We discuss many different theme options and consider possible plot lines and then everyone at the AGM gets to cast their vote. The Incredibles was a particularly appealing theme as it was a story that lent itself to a more ensemble cast, which means that we are able to create a wider range of opportunities for more people to be involved.

Can you take us through the process of designing a show?

The very first step is our AGM. This happens at the end of every year after the show. Our AGMs have an open-door policy and everyone is welcome. At this meeting, we recap the show from that year, do all the boring committee things, elect the new committee and select a theme for the following year’s production. The incumbent committee then gets to work over the summer and early the following year planning the script, looking for a venue for a show, sorting out costumes, budget and all the behind-the-scenes stuff.

Next, the creative holds auditions and then once we have our cast, dancers and band we set to work with rehearsals throughout the year where our creative, vocal, and musical directors as well as choreographers coordinate cast, dancers and band to bring the show to life. Meanwhile, our technical team and production team organise the theatre, ticketing, costumes, sets, marketing, promo, lighting/sound design, etc. After about a week of tech/dress rehearsals in August/September time, we then have finally put on a show. It really is a huge team effort and is so much fun to be a part of.

The InMEDibles was really, really funny. What’s the secret to writing such an entertaining script?

The secret of a good script is having a strong cohesive scripting team right from the brainstorming period. Then once it’s on paper it is important to allow time in rehearsals for the cast and creative director to work together to ensure that the jokes and storyline work on stage. A big part of the comedy of MedRevue is also developed throughout this time, as the actors put their own spin on the jokes and the physical comedy is also added. This rehearsal period also allows us to get feedback from cast and crew members in all the year levels about what has happened in their year what they want to joke about and incorporating these things into the script.

Overall, we aim to make sure that the jokes are funny, understandable to a large audience, but also that the jokes are never personal or mean spirited. We focus on incorporating issues relevant to each year level, incorporating jokes that are both med and non-med related so that friends and family can also laugh even if they’re not medically inclined and we love a gentle jab at faculty every now and then.

The MedRevue band, dressed to theme!

There are so many moving parts to putting together a show like MedRevue. The script, singers, dancers, band, promotion, venue hire and all the rest! How on earth did you coordinate it all?

This would not be possible without our amazingly dedicated committee who worked very hard to put this show together. It was also helped greatly by a very strong partnership, trust and great communication between us as creative director and producer. Having worked together as co-creative directors last year, we had already had a chance to develop a strong working relationship which we were able to build on further this year. As creative director, Ruby was responsible for coordinating the cast, band, dancers throughout the rehearsal process, collaborating with other creative committee members and all that was necessary to bring the show to the stage. Jess as our producer was responsible for coordinating the committee and making sure everything was happening behind-the-scenes in order to ensure a production could on stage with an audience. Overall, the most important thing was teamwork between all members of the production and especially our incredible committee.

Both of you were responsible for creating last year’s MedRevue as well, which unfortunately couldn’t go ahead. What was it like to put so much effort into a show that didn’t come to pass?

It was very disappointing as we were so close to our performances, with less than 2 weeks from showtime. Tickets had been sold, the show was finished and everyone had put in an incredible amount of effort. It was a great show that we were all really proud of. It was disappointing that it couldn’t go ahead and that we couldn’t reschedule for later in the year but it just became impossible due to the lockdowns, graduations, exams, etc.

However, we had discussions with the cast and crew it was felt that we had all had the experience of doing MedRevue. Although audiences didn’t get to see it and this was disappointing, we all still had the experience of getting to know and work with one another and really engage in that creative outlet. As much as MedRevue is a performance, it is also so much more than just a 2 night event, it’s a 12 month long process between a large team of people you become close with and have a lot of fun with along with the way.

Why should people get involved in MedRevue?

There really is something for everyone! Whether you’re someone who prefers to be on stage, offstage, play an instrument, or work behind the scenes in tech or backstage, there’s something in MedRevue for you. You don’t have to sing, dance or act or have any experience, it’s all about enthusiasm, having fun, making friends and doing something a bit creative. All we ask is that you bring yourself and your sense of humour. It’s also a really great way to meet and become friends with people in other year levels and you can learn a lot from those people. You really get to know the people you do MedRevue with and we are not sure there is another subcommittee that fosters connection and relationships in the same way MedRevue does, purely due to the amount of time spent working together towards a very fun common goal.

MedRevue is a welcoming space for everyone. Our community is very diverse and you don’t have to be massively into musical theatre to be involved, we have a very wide range of people who come to MedRevue and are involved in MedRevue and all are welcome. As it’s not academic focussed, it is a more light-hearted subcommittee experience, people have a lots of fun and look back on their MedRevue experience very fondly.

If you are keen to know more or want to get involved please like, comment, and subscribe and stay tuned for notice about the 2023 show. Follow Monash MedRevue on social media, all updates with be announced on Facebook primarily.