Restructuring

A total overhaul, but for the human body instead of a machine...

Cryostatic biomechanical restructuring - or 'restructuring' for short - is a complex, interdisciplinary medical procedure in which an otherwise unsaveable patient undergoes a combination of traditional surgery, cybernetic implantation, and gene therapy while under the effects of cryostasis to prevent a fatal condition from progressing. The term is most often applied to fetal and neonatal variants of the procedure, where congenital conditions what would usually be incompatible with life are painstakingly corrected within an artificial womb, though restructuring can take place well into adulthood as well. Restructuring is by far the most advanced medical treatment available in the Cobalt Protectorate short of full neurological transcorporealization, representing the latest stride in the Protectorate's long march towards the conquest of natural death.

Treatment

Part of the reason that restructuring is so rare is that it requires an unusual confluence of events. First, a prospective restructuring patient must either have already undergone cryoprotectant therapy at some point or be a fetus still early enough in development to survive a cryogenic freeze. The gene therapy may applied to a fetus in an artificial womb in preparation for restructuring - a process greatly hastened by the small volume of the developing child - but this also means that a problem must be detected promptly to be corrected in this manner. Second, a condition incompatible with life must be detected before the patient succumbs, meaning that exigent circumstances generally do not call for restructuring. Third, the patient's conditions must be amenable to surgical, cybernetic, and/or genetic treatment; restructuring buys time and a greater margin for error, but some conditions remain untreatable despite the advanced state of Protectorate medical technology.
Throughout the restructuring process, the patient's life processes are suspended through cryogenic freezing. This means that (non-radiological) diseases stop progressing, infection is inhibited, bleeding stops, the patient is unconscious and insensate of pain, and the patient doesn't grow or age. While freezing a patient to exend their lives or inhibit the progression of fatal conditions is not unusual in Protectorate medical practice, restructuring is distinct in its long duration and in that it involves widespread, systemic alterations to the body in the process of treatment. Restructuring can involve changes as extreme as adding or removing chromosomes, replacing or rebuilding limbs with full natural enervation and function, restoring brain tissue after up to 70% of it is lost, excising metastatic cancer, replacing or transplanting an entire organ system, and more.

Prognosis

In addition to the risks inherent in a cryogenic freeze (see Cryoprotectant Therapy), restructuring involves heightened risks owing to the fact that it necessarily involves widespread trauma to the patient's body. This increases the risks already inherent with a surgical proceedure based on the patient's other risk factors (i.e. age). Should the patient survive, the process of recovering from restructuring is long and pain management is difficult. Restructuring does, however, present a patient with the chance that they may live a full, somewhat comfortable life when previously there was none.
A restructuring leaves the patient irrevocably altered, both physically and (likely) mentally. It is common for restructured patients to undergo a radical shift in philosophy in response to cheating their otherwise inevitable death. Those who were restructured before their births might face stigma associated with their status similar to the stigma one might face for congenital defects; this state of affairs is helped little by the ethical questions that still swirl around the proceedure (see sidebar). Because of both the invasiveness involved with the proceedure and the fact that Protectorate doctors are loathe to engage in germline genetic alterations, restructured individuals are often infertile and are encouraged to get genetic counselling should they prove otherwise.

Cultural Reception

Restructured individuals occasionally find it difficult to reintegrate into society after undergoing the treatment. While the Protectorate is famous for its laissez-faire attitude toward cybernetic alterations of all kinds, the patient's newly restructured body and personality may render them unrecognizable to loved ones. The unfortunate circumstances and painful recovery of restructuring evoke sympathy for the patient, but there is also an element of body horror to the procedure that onlookers find difficult to shake.
Restructuring seldom appears in Cobaltic media, but when it does, it is usually associated with themes of renewal, identity, and growth through trauma. Restructuring was used as a way of disguising the identity of an antagonist so many times that the trope is considered cliche in modern storytelling. Some stories use restructuring and the personality changes that often accompany it as a means of marking a sharp shift in a character's story arc. For example, a restructured individual's pain in recovery might make them seethe for revenge against the people who caused the condition the character was treated for. Alternatively, a restructuring patient might develop a god complex in response to denying death its prize, turning to increasingly dangerous and bizarre exploits in the false belief that they are now invincible.
The extranet video drama Chiralities is well-regarded in part for its nuanced, philosophical portrayal of a long-distance romance between two restructuring patients. One half of the duotagonist is a Cobalt Knight pilot built into his spacecraft after a bout of aggressive metastatic cancer led to him being restructured as an Elegy. The other half is a scientist on Planet Evermorn whose brain was almost entirely replaced by cybernetic hardware after her exposure to teratogenic chemicals in the womb. The scientist later arranges passage aboard the pilot's ship-body and the pair go on a journey together to the outer asteroid belt, where they interact with Lepidosians who aren't aware of the fact that restructuring is possible, and misunderstandings ensue. Eventually, the couple face off against Aniki Labs pirates and must work together to make it back to Evermorn alive.

Type

Nanite / Mechanical

Parent

Cryoprotectant Therapy

Origin

Engineered

Rarity

Rare

Affected Species

• human

Ethical Considerations

Restructuring is expensive, time-consuming, and difficult for all involved, leading many to ask if its downsides are worth the rewards. Many who undergo restructuring would have, in previous eras, been placed into palliative care to live the remainder of their lives in relative comfort or otherwise allowed to die on their own terms. Restructuring offers the potential for a greatly extended life, but at the cost of pain, disfigurement, or stigma. It is up to the patient to decide if this trade-off is worth it.

Restructuring allows those who would otherwise die or suffer greatly to survive long enough to potentially reproduce. While eugenics has long been a dead idea in the Protectorate, restructuring undeniably interferes with the role of natural selection in preventing mutations otherwise incompatible with survival from entering the gene pool. Culture-wide genetic screening and advanced medical treatments can ameliorate many effects of these mutations, but these treatments are often not available in the isolation of far-flung colonies far from the core region's industrial base. This puts restructuring at odds with the goals of organizations like the Evermorn Strategic Colony Initiative, who intend to spread human and near-human life as far into the galaxy as possible - potentially requiring colonists to do things the 'old-fashioned way' once isolated from the resources of the Protectorate core.

Restructuring is expensive and resource-intensive, meaning that those on the lower socio-economic strata are unlikely to recieve it. This stands in contrast to the Protectorate's belief (as enshrined in the Code of Evermorn) that all human, human-like, or human-related intelligence should be accorded certain rights, including the right to life.

Restructuring fundamentally alters the nature of the person affected. The most extreme alterations can involve near total replacement of the brain with cybernetic hardware. In contrast, restructuring might involve almost everything but the central nervous system being replaced with cybernetic components. In these cases, restructuring presents questions of personal identity akin to those presented by the creation of human-like artificial intelligences. While the patient will still recieve rights and consideration under the Code of Evermorn, they may have to reassess what makes them themselves.

Challenge Submission

Catoblepon's Unofficial Condition Challenge