Chapter 4 The Care Credit

Verdane General sat on the spine of the city, four towers connected by glass bridges, and at night the bridges lit up the way the city liked to be seen: continuous, generous, alive. Mireille took the long tram to the third tower and rode the lift to the renal floor and found her brother in the chair by the window, the one he always took, where the drip stand was close enough to the glass that the tube caught the city light and turned it red. Emre Corland was twenty-six and had been sick since he was nineteen. He had the thin, careful frame of a person who had learned to move less each year, and the face of a person who had decided early to be pleasant about it. He had a book open on his knee, which he was not reading. "You're early," he said. "Shift got cut short." She sat down. It was not true and he knew it and neither of them said so. "How's the arm?" "Same arm, same machine." He nodded at the catheter. "They moved my chair. Did you see? They said this window is reserved for higher care codes now, and then they left me here anyway, so I think someone was covering for me." He smiled, and it was the smile of a man rationing it. "Doctor Barrowman says I'm stable. Stable is his word for 'no change and no money to make one.'" She thought about lying better and could not manage it. Emre had learned to read her before either of them had a Standing number of their own, back when the household adviser came twice a year to the flat on Sixth Street and their mother stood behind the two of them with her hands folded and answered for the family. Their mother had carried a Standing of eight hundred and twelve until the year she died, and the flat they lived in now was the flat that number had earned them, and if Emre dropped below the activation floor the ward would reassign him and the flat would go with him. Mireille did not say any of this. Emre knew all of it. In Verdane, the things everyone knew were the things nobody said, because saying them was a kind of coding, and every code went into the roll. Mireille looked at the drip stand and the numbers on it and did the arithmetic she had done a hundred times. Emre needed a kidney. In Verdane, a citizen could be activated for scarce care at a Standing of seven hundred or above, which Emre did not have, or at a lower Standing with a household care credit, which their household did not have either, because a care credit was issued by the Bureau and a care credit went to households the Bureau considered net contributors to the roll. The Bureau considered Mireille's household net contributors last year. This year, with her number in the gray, it considered them something else. "You've been quiet all week," Emre said. "I'm fine." "You're a terrible liar and you've been the same terrible liar since we were children." He closed the book. "What's the number?" "How do you know there's a number." "Because you only come early when there's a number." He said it without accusation. "What's the number, Tal." "Six twelve." Emre looked at the drip stand for a while. Then he looked out at the bridges. "Okay," he said. "Okay. So we find points." "We don't find points. Points are not found, they're filed, and the filings are reviewed by a clerk, and the clerk has never met me." "Then we find something else." He turned his head. "There's a thing they do. At the ward office. I heard two women talking about it, about a credit broker. He moves care credits and he takes a cut." Mireille felt the floor of her day tilt. "That's a crime," she said. "It's not a crime against a person, it's a crime against the engine, and the engine doesn't forgive." "The engine doesn't know." He held her eyes. "Tal, I have four months of dialysis access left if I keep the current codes, and then they reprice me, and when they reprice me I drop below the activation floor and I lose the list entirely. Four months. Then twelve years of machines and waiting were for nothing. I'm not asking you to do anything illegal. I'm asking you to find out what the credit costs." The lift chimed in the corridor. Somewhere down the ward a monitor alarmed and was silenced by a nurse Mireille could not see. "I'll ask about it," she said. "Nothing more." "That's all I wanted." Emre opened his book again and did not read it. Doctor Barrowman met her in the corridor outside the renal bay, which he did when he wanted to say something he would not write in a chart. He was a compact man with the careful hands of a surgeon and the vocabulary of a clerk, and he had kept Emre alive through two infections and one failed access, which was the only credential Mireille cared about. "He asked you about the broker," Barrowman said. "He did." "Then you already know what I would tell you, and you already know it is true, and I will tell you anyway, because in this hospital a thing that is not said out loud is a thing that did not happen." He folded his arms. "The credit market is real. It is not a rumor. Every ward has one. A broker buys and sells care credits, which are transfers of household contribution from one file to another, and the transfer is illegal because the Bureau sets the price and the broker sets a different one. If you use him, your brother moves up the list and you move onto a different list, the one the wardens keep, and that list has no appeal process because officially it does not exist." "How many people use him?" "Enough that the dialysis chairs are never empty." Barrowman looked at the drip stands through the window. "I am not telling you yes. I am telling you that the floor of this hospital is built on people deciding something worse than yes." On the tram home, Mireille pulled up the ward notice board on her phone and searched the way a person searches when they do not want to be seen searching. She found the broker's name in the fourth comment of a thread about pharmacy queues, a single line that had survived three sweeps because it named no one: *ask the man at the laundry on Solvang.* She saved the thread. She told herself she was only gathering information, which was true, and that gathering information was not the same as acting on it, which was also true, and which was the kind of truth a person used to make a smaller truth out of a larger fear. Two days later, the review clerk struck two of the nine cohort flags and returned nineteen points to her Standing. She was six hundred and thirty-one. The gray line on the board still ran under her name. The notice said the variance sweep for Cohort Forty-One would begin the following week. ---