11/21/22: Sacrificial George

My suggestion was quite simple: Put that needed code number in a little capsule, and then implant that capsule right next to the heart of a volunteer. The volunteer would carry with him a big, heavy butcher knife as he accompanied the President. If ever the President wanted to fire nuclear weapons, the only way he could do so would be for him first, with his own hands, to kill one human being. The President says, "George, I'm sorry but tens of millions must die." 

He has to look at someone and realize what death is—what an innocent death is. Blood on the White House carpet. It's reality brought home.

When I suggested this to friends in the Pentagon they said, "My God, that's terrible. Having to kill someone would distort the President's judgment. He might never push the button."

— Roger Fisher, Bulletin of the Atomic Scientists, March 1981

The volunteer was almost always someone the President was already close to. A cousin, or a god-daughter, or an old friend. It was designed this way so that the procurement of the codes and death of the carrier would have maximum emotional impact.

In the old days, it used to be placed by cardiothoracic surgery, by way of mini-thoractomy. After several decades, it became a minimally invasive procedure. An interventional cardiologist would access the right internal jugular and deploy the capsule in the pulmonary artery, in a manner reminiscent of a CardioMems. The recovery time was a few hours, rather than the original week as with the original George. 

Tina was selected as Sacrificial George the week before the new President was sworn in. “You’re his oldest friend, and closest advisor,” she was reminded. “Also of course, this is for the good of humanity.” She accepted the responsibility gladly. She had always been a proponent of disarmament, and had known that there was a strong possibility she would be chosen.

From that day onwards, she never left the President’s side. The black-handled butcher’s knife came to feel familiar at her waist, and she stopped noticing that it was there. 

Then, one day she became short of breath. She was rushed to Walter Reed, where she was put through a CT scanner and subsequently told by a steely-faced pulmonologist that she had a blood clot in the arteries that supplied her lungs.

“Many blood clots, actually. I suspect they’ve been embolizing into your pulmonary arteries for quite a long time. It looks like you have CTEPH.”

“C-what?”

“CTEPH. It’s a form of pulmonary hypertension caused by chronic blood clots that migrate to the lung.” 

He saw her expression.

“Yes, it’s as bad as it sounds,” he said. 

She was flown to a navy base in San Diego, where a trio of surgeons from UCSD came and saw her. 

“We’re not going to lie to you; the procedure is not straight forward,” one of them said. “We put you on bypass, harvest your lungs, clean out your lungs for blood clots, and stitch your lungs back into your chest.”

“Is that why there are three of you?”

“One is a trainee, and the other is a military-employed cardiothoracic surgeon who is here to supervise the retrieval of the codes. We will need to remove the capsule from your pulmonary artery during the procedure, and by law only dedicated military personnel are allowed to touch it.”

“And afterward…”

“Your body will have enough work on its plate just recuperating. The capsule will be implanted in another volunteer. I believe that a Mr. Reginald Lucille, a first cousin of the President, has volunteered to be the next Sacrificial George. Typically, these nuclear capsules are left in for life, so you will be the only living George to ever have it retrieved. Obviously, these are atypical circumstances.”

“Oh… okay,” she said in a faint voice. 

The three surgeons left the room. 

“Does she suspect, do you think?” one said to the other.

“She must. I certainly would, especially with the Venezuelan Crisis being what it is. And she knows the President better than anyone.”

“He’s doing this out of love, is what he said. He told me that he needed a clear head dealing with the situation, and that killing her would cloud his judgement.”

“Then she must know. And there must be something deep down in her, some preservation instinct, that is allowing her to go through with this. She must know he’s trying to spare her life?”

“Yes.”

“Poor Reginald Lucille.”

“Yeah.”

“That poor bastard.”

“The President must hate him.”

“Hate is a strong word.”

“I was told he chews with his mouth open. And that he’s a Democratic Libertarian.”

“Ah, that explains it then. Alright, gossip time is over. OR time is an hour from now. We carry the weight of the world in our hands.”

Note: Pulmonary Endarterectomy for CTEPH is a real procedure, so is implantation of medical devices in the pulmonary artery. Typically, these devices, once deployed, cannot be retrieved except by cardiothoracic surgery.