EXCERPT FROM: Correspondence: in Response to Letters to the Editor from Issues 1-3, Volume 65

  The review article "A One-Year Retrospective: Apparatus-Incorporated Prostheses and the Future of Maladous Implants" [Tao and Tao, 1641], published late last year, has touched off a spirited discussion among academics, drawing opinions from outside the medical field and even those from foreign hubs. As the authors of said article, we have been humbled by the interest shown by our esteemed colleagues while also attentive to the questions and criticism that have been raised. Here, we would like to address some of those comments. Given the nature of the topics at hand, we beseech your forbearance if some of our discussions veer into the personal rather than the purely academic.

  It has been more than a year and a half since the seminal procedure of Barong Apparatus implantation as a bridging device to leg prosthesis, first conducted at Sembawang General Hospital [Singh et al, 1640] (equipment provided by PARAGON BIOMEDICAL ENGINEERING, 14 Boon Lay Way, Jurong East). Since then, the subject of the procedure has achieved full return of function and has re-commenced employment as an adventurer with minimal residual effects of the inciting injury or the operation.

  Those of you following the literature or partaking in the practice yourselves are well-aware that this field has since expanded. We ourselves have since reported on another successful implantation on a leg amputee performed at Central Temasek Hospital [Tao et al, 1640]. The collaborative efforts of doctors, adventurers, and engineers across Temasek have produced no less than twelve completed cases of Maladous implantation, by no means limited to the Barong Apparatus or the lower limb.

  With that in mind, we also acknowledge and value the voices of concern and dissent. Some have been of a straightforward clinical nature, pointing to the uncertainty regarding the potential long-term effects and complications of Maladous implantation. To this, we would reiterate that all of our recipients at Central Temasek are monitored closely via regular follow-up in a multi-disciplinary setting. Should any significant complication arise, we deem it would be of the utmost academic urgency to report and disseminate the information in every case. Indeed, we refer our readers to several reports of this nature already published in the last year [Tupuola and Tao, 1640; Zhou, 1641]

  We would also stress that all of the Maladous implantation procedures performed at our centre thus far have been the result of careful collaborative consideration as well as thorough discussion with the recipients themselves. Invariably in all cases, every party involved agreed that the clinical and scientific benefits outweighed the potential risks.

  A second point of concern that was expressed by multiple sources relate to the ethics of introducing a Maladous component as a surgical implement. It goes without saying that mankind has had an extensive and contentious history with Maladies. Ancient records tell us that there had been a time when our species stood on the precipice of an extinction event. Our way of life today had been carved out from that initial struggle and passed down over centuries of devastating setbacks and bloody victories. So it is eminently understandable that some would feel a natural aversion to the very idea that we are effectively fusing man and Malady.

  The tale has been illicitly lifted; should you spot it on Amazon, report the violation.

  However, we would encourage our readers to take pause and consider what is around you. How many of you keep spices in ivory cups derived from Oliphant tusks? Use parasols stretched from Frogmouth wings to stay cool on sunny days? Did your lunch contain produce grown in fields fertilized by Aurochs dung? If we were to then include all of our drugs and medical supplies that count Maladous products among their ingredients, this list would grow exponentially.

  Let us also harken back to the earliest days of Magic and Medicine, to the time when Imhotep performed the first Maladous dissection in history to learn the secrets to their powers. Nearly everything we have built since and continue to build on today, and indeed the very survival of our species, depended on the intimate knowledge and judicious utilization of Maladies. We sincerely believe that the use of Maladous Apparatus to overcome individual functional deficits is a logical progression of our existing way of life.

  Finally, we would give recognition to one particular observation, sent to us by a reader outside the medical profession. This was a thought that, frankly, had not previously occurred to us or anyone we worked closely with. Even now, we struggle to compose a response that would satisfy even ourselves. But in the writing of this missive, this specific question proved to be the point of the liveliest debate among the authors. As such, we would be remiss not to at least attempt to address it.

  To paraphrase our reader, a question was put to us regarding the societal implications of technological advancement in the area of overcoming disability and enhancing physical capabilities beyond what was once considered to be the limits of biology. This reader also rightly emphasized the context for this question, which was that this technology, at least for now, distinctively favours the attuned over the non-attuned. In a society that already and unequivocally stratifies those with Magical talents from those without, what does the future hold if we continue on this path that seemingly bolsters this apparent advantage?

  We certainly do not claim to be experts in economics or in the social sciences, and as such, it is not our place to offer unfounded opinions within those realms. What we can and will try to express is what we feel and experience every day as members of an attuned profession, or as family and friends to such.

  It can be said that there are none more privileged than those of us in the medical profession. We possessed the foundation for and were able to develop a moderate level of attunement which, combined with our scholastic training, gave us access to a comfortable living and a unique standing within our community. Further, it may not be a real stretch to say that we have been more fortunate than those that awakened to the most robust and refined of attunements, as those members of our society are, almost without exception, pushed into adventuring, thus fulfilling vital yet dangerous roles both within and without our city.

  These sentiments are borne by our lived experience, and we believe the same can be said for our esteemed readers and colleagues. For every time we learn of our adventurers braving the wilds to protect outreach workers, to bring back much-needed supplies, to explore and expand our horizons, indeed to perform their sacred duty—every time we think on this, we are filled with awe, pride, admiration, but we are also filled with dread. We have sleepless nights. For these adventurers are our brothers and sisters, our fathers and mothers, our sons and daughters, our loved ones and dear friends.

  We are doctors. Since the time of Imhotep, we have been at the forefront of learning whatever we can about Maladies and supporting those in the front lines. If this wave of Maladous implantations and continued advancement in the field mean that we manage to tip the balance, away from dread and sleepless nights, and toward the assured triumph and safe return of our adventurers, then we feel that we would have done our job. This, in the view of the authors, is our highest calling and our greatest privilege.