By Terry Davis
Monday, March 3, 2036
The electronic voice coming from the car’s external speaker pierces through the early morning fog. Tom closes the door of his house behind him and pulls the front of his overcoat together against the drizzle and unusual chill for early March.
“Correct” Tom replies.
Climbing into the only seat, he places his brief case in the cargo space and closes the door. As the car leaves the driveway, he looks back at his darkened house, wondering if his wife, Claire, will get up any time before 11:00 this morning. He doesn’t know whether the fight they had last night will result in an earlier than usual start to her day.
As the car merges onto the Schuylkill Expressway on the way to his laboratory at the University of Pennsylvania, he pulls a cup of coffee from the dispenser. The smell of the coffee reminds him that this is his favorite time of day – quiet and completely alone. He reads the overnight news feeds on the screen in front of him. They make good time, quickly passing cars in the lane relegated to cars driven by people.
“Mornin’ Jenn” he says as he enters the laboratory, which is already humming with activity.
Dr. Jennifer Kim, his partner, is preparing herself and others for the day’s work. At 51 she is ten years Tom’s junior, but looks even younger than that. Her long, smooth black hair drops down to the shoulders of her crisp white lab coat. Her brown eyes and bright red lips are a contrast to Tom’s grey beard and light blue eyes. In addition to three laboratory assistants, two medical students from Penn Medical School are observing this crucial part of the experiment. At the center of the lab is a three-foot square, Plexiglas, fluid-filled container resting on a table. Suspended upside down in the clear fluid, hanging by its vessels, is the brain of a monkey. Tubing connects the brain’s vessels to a perfusion machine beside the chamber that is keeping the brain tissue alive by filling the vessels with a blood substitute – providing all the oxygen, nutrients, and other substances that keep it healthy and functioning.
“Hey Tom” Jennifer replies cheerfully. “I’ve increased the anesthesia all the way up for the drill this morning. We’re pretty much set to go”. She twists a knob on the anesthetic module which sits on the table beside the perfusion machine.
“Would this be painful to the brain?” a medical student asks, raising her hand.
“It’s not about pain” Jennifer responds. “The brain itself doesn’t possess pain fibers, even though the brain is where we experience pain. The reason for anesthesia is to blunt or eliminate awareness. To the degree the isolated brain is conscious, it’s experiencing total sensory deprivation – darkness, quiet, no touch, smell or taste coming into it. We imagine that would be quite frightening. So, anesthesia is to blunt consciousness, not pain.”
“Poor monkey!” the student blurts out.
“We’ve got a whole hour on that topic in your ethics course” she smiles. “For now, we need to put that aside – tight schedule. Everybody ready?” She asks. “Start the checklist.”
From the edge of the lab, one of the assistants calls out a list of a dozen items.
“Neurocap™ gel final prep completed.”
“Done” replies another assistant. Checklist completed.
Jennifer raises her hand. “Commence application.” The clear fluid in the brain chamber quickly turns dark black. At the end of one minute, just as quickly as the fluid had turned black, it becomes clear again. But the brain is now encased in an inky substance that looks like a gel, obscuring all the crevices on the surface of the brain – taking a shape closer to a sphere.
“Now we wait,” Jennifer says. “The gel will harden; in so doing, it breaks up into tiny shards, each one a light-emitting diode – over a hundred thousand of them. The frequency of the light emitted by each shard is a function of electrical activity in the underlying brain tissue. The final step will be to cover that surface with the cap we have perfected – the NeurocapTM, which captures those emissions and relays them to our computer. The result is a very high-definition version of what we used to call an “electroencephalogram, or EEG.
“Thank you, Mr. Preston. Next scheduled pickup is 0800 tomorrow morning, Tuesday March 4. Confirm?” the electronic voice says as Tom gets out of the car back at his home that evening.
“Confirmed,” Tom says as he exits the cool of the car into the 95-degree heat so typical these days for Philadelphia in early March. The sun is bright orange as it sets through the smog. It’s beginning to get dark, but no lights are on in the house that is also eerily quiet. As he approaches, the security system recognizes him and the door swings open. Tom knows where he will find Claire- asleep on the couch in the living room. “Hello, Sweetheart” he says with forced cheerfulness as he rubs her shoulder.
“Oh, Hi . . . what time’s it?”
“Almost six. Want me to pull up dinner?”
“No, I’ll get it,” she says rubbing her eyes as she sits up in her pajamas. “I’ll go put some clothes on.”
Tom knows better than to ask her about her day – why she hasn’t even gotten dressed. It seems to have gotten worse over the winter. He is hoping with the beginning of spring that her mood might improve but it’s only getting worse.
“Goddam Elaina!” Claire screeches. “We were supposed to have lunch today, but she cancelled at the last minute.” She punches “E14” into the MealMaster™ for her and “L21” for Tom. A minute later the upper door slides open on the large stainless-steel appliance. Her spaghetti with meatballs is presented steaming hot on a plate and Tom’s medium rare 5-ounce filet mignon is surrounded by hot mashed potatoes and green beans.
“She give you a reason?” he asks as he moves dinner to the table in the dining area. As he does, the kitchen lights dim, and low-level lighting comes up over the table. Quiet upbeat music begins in the background.
“Some phony excuse about a doctor’s appointment or something. I had half a mind to go get that gun of yours out of the drawer and teach her a lesson!”
“That’s not funny!” Tom fires back.
“I obviously wouldn’t . . . but the arrogant women in this town really annoy me. Or maybe it’s me . . . I really don’t have anything to offer; never add to the conversation”
As Tom pours them each a glass of wine, his mind briefly drifts away as he remembers their early days together – she was always surrounded by friends – in the thick of things. What’s happened to her? When did she get so depressed?
“We launched another isolated brain at the lab today,” Tom says, trying to change the subject. “We’re hoping to put information into the brain, not just get stuff out of it. We’re gonna put in an image of a leopard, and see if we can register a fear response.”
“Good for you”
“I hope to be able to report that next month at the meetings in Chicago. That would put us way ahead of the pack.”
“So you’re gonna be gone another week next month? Seems like you just got back from meetings in Houston!”
“ . . . part of the job. We have to publish papers and present at meetings. If I’m ever gonna make full Professor, I’ve got to. We’re getting a lot of attention now. If the monkey brain stuff continues to pan out, next it’ll be a human brain!”
In the silence that follows, they each turn on their individual monitors – hers – a collection of fictional offerings in various genres; his – news in the world of neurophysiology – summaries of recent papers, trending discussions, and several ethics channels.
“I’m headed up to bed. You clean up?” she says after nibbling at her food for a good half hour.
“Sure. Get some sleep” he says as he pours another glass of wine.
Kitchen cleaned up, he settles in for another quiet evening. He initiates a chat with Jennifer. “I’ve got some ideas about the Chicago meetings” he puts into the feed. Within five minutes Jennifer replies “whatcha thinking?”
3 ½ years later – Thursday, November 3, 2039
“Close the door, Jenn”, Tom says as she walks into his office.
His isn’t a typical academic office; no diplomas or licenses adorning the walls. Instead, pictures of him and his family; scenes from their summer home at the Jersey Shore and one of him sky diving. The furniture is more living room than office. He motions her to sit down beside him, a small end table and lamp between the chairs. He coughs quietly, and his recent weight loss is apparent – his open neck shirt revealing a newly defined waddle under his chin, and his belt buckle two notches in from its previous position.
They sit in silence for a few minutes, Jennifer fidgeting with the small notebook she always carries with her. “Well, it’s what I was afraid of, Jenn. Pancreatic. Pretty far along. Metastatic to liver, lungs.”
“No! When did you find out?”
“Yesterday. I was pretty sure that’s what it was; but hearing it spelled out so definitively hit me pretty hard. Pancreatic is one of the few they haven’t figured out yet.”
“What are you gonna do?” she said, trying to hold back tears.
“I’m not fightin’ it.”
“How’s Claire doing?”
“Not good. She’s mostly angry. Thinks I brought it on myself – too much stress – working too hard. Said I spend way more time with you and the lab than’s healthy.”
She reaches across the table and takes his cool hands in her warm ones and locks eyes with him as tears roll down her cheeks. His lip quivers slightly as he returns the gaze. Nothing is said until a very subtle mood change emerges in Tom as he takes a deep breath. “Ya know, Jenn, what this could mean? The only good that could come out of it?“
“I think I know where you’re going, but I don’t know if we can.”
“Jenn, we’ve talked this all through – worked out the plans and protocols in the event we ever got the chance. The toughest part will likely be the ethics committee; but I think we can deal with them. The whole thing about informed consent won’t be an issue if it’s my brain that’s being donated to the study. No one can know more of the risks and benefits than me. Of course, you’ll be the Principal Investigator and calling the shots. Hopefully I can convince Claire to be my surrogate, to make decisions on my behalf if need be. She would have the final say in go/no go situations where you might be considered to have a conflict of interest. I think that would help convince the committee to approve it.”
“How about the rest of the family?” Jennifer says as she has begun writing things in her notebook.
“I’ve thought a lot about that. This has to be absolute top secret. They, or anyone else can’t know this is going on. The media would go crazy. To have any chance of scientific integrity, the team has to be very limited, and abide by strict non-disclosure agreements. When the time comes, there’ll be a memorial service, I’ll be cremated, and allow all to move on in their own time. It can be known that I was an organ donor, but they can’t know that my brain was the organ.”
“Tom, this is so much . . . I need time to think it through” she says as she begins to get up from the chair.
“Understand. This can’t work if we’re not both 1000 percent committed.” They are facing each other, now, holding hands, which becomes a warm, prolonged embrace.
Five months later – Thursday April 5, 2040
The Mahoney Mortuary outside of Philadelphia is all set up as Tom indicated. Several hundred are expected – many from out of town. Local rooms are hard to find. The specified time is 3PM to 6PM and many have come early. Tom insisted that it be more of a party than a memorial, and the band is set up in the corner of the largest room in the facility. Stand-around tables are scattered throughout the room, and an open bar is in the corner. It is 5:15 PM and heavy hors d’oeuvres are being circulated by the young wait staff. Claire’s feet are beginning to swell and ache. She has been standing for over two hours greeting what seems an endless procession of people. She is beginning to understand how highly regarded he is by the comments made to her by his colleagues and admirers. It is hard for her to refer to him in the past tense, but the medication her therapist gave her is helping her cope.
“Can I get you a chair, Mom?” Kevin, standing beside her, asks.
At 32, he’s the oldest of their three children, and bears the most resemblance to Tom: medium height, slightly overweight, with thinning brown hair. Shawn and Becky, the other two, stand behind him.
“I think I’d like that. Thanks. And maybe another gin and tonic.”
Toward the end of the hours, as the crowd is beginning to thin, Jennifer approaches. She is casually dressed and waits her turn to pay her respects to Claire. She waits until the right time when the children are all involved in other conversations. “How’re you doing, Claire?” she asks, trying to be both empathetic and professional.
“As well as can be expected, Dr. Kim.” she replies coolly, scanning the room to ensure they were not being overheard. “How is . . . it . . . going at the lab?”
“Recovery was perfect. All looks good. No problems so far.”
“When am I due in for the required visit?” Claire whispers.
“Next Tuesday, 10:00AM. I’ll try to make it as quick and painless as possible.”
“Very well,” Claire concludes rather formally, pivoting to greet one of the stragglers, while most have left to return for the Service of Memory tomorrow.
The following week – Tuesday, April 10, 2040
Claire approaches the security checkpoint outside the laboratory on the seventh floor of the Harrison Research Building on the medical campus of the University of Pennsylvania. She shows her clearance papers to the armed guard, who scans it. “Ms. Preston? May I see a photo-ID?” He is unaware of the details of activities inside the laboratory, so the name does not ring a bell. But he does note that this individual has the highest level of security clearance: entrance to the lab at any time of the day or night – no restrictions. As she shows him her ID card – he waves her through, ignoring the beep of the metal detectors, giving her the courtesy of avoiding a search of her purse. At that moment, Jennifer appears, having asked to be notified of Claire’s arrival.
“Good morning, Claire. I’ll show you the way.”
”Thank you, Dr. Kim.”
It is an awkward few minutes, as they navigate several hallways on the way to the main laboratory. Jennifer is trying to think of something to say that won’t be inappropriate, or set Claire off. Claire is dreading going into the laboratory and seeing Tom’s brain on display two weeks after he died. Jennifer looks into the eye scanner which opens the door to the lab and she gestures Claire to enter. The room is bright; several technicians in their scrubs, caps and masks are attending to various monitors. A light smell of disinfectant gives the room a sterile feeling.
“It’s over here,” Jennifer says as she motions to the specimen area. At first, Claire is relieved that what she sees in that Plexiglas container doesn’t actually look like a brain – rather more like a black basketball suspended in clear fluid. Beside it and connected by tubes and wires are two pieces of apparatus. “This is the perfusion machine” Jennifer explains. “It’s providing the brain with artificial blood, keeping the tissue alive. And this. . .” – motioning to what looks like an intravenous infusion pump – “is the anesthesia module, set to a level of heavy sedation. Let’s go into the conference room so I can brief you on where we are right now.”
As Jennifer guides Claire away from the center of activity toward a quiet room with subdued lighting off to the side, Claire is beginning to churn. “ ‘It’ . . . she thinks to herself . . . ‘it’ . . . ‘the brain’ . . . that’s Tom in there; but Tom is dead . . . ashes in an urn, in a Columbarium outside the city . . . his body is dead and gone, yet he may still be thinking; and this woman is referring to that part of Tom as “it” and “the brain.”
Inside the conference room, the two are seated at a table, with slides showing up on a screen at the end of the table. “So far, everything has remained stable” Jennifer says calmly, as she begins the presentation required by the protocol. As Tom’s surrogate, Clair must be briefed every two weeks, to ensure she is current on what is happening, what they have been able to accomplish, and their plans for the next two weeks. “We’ve kept the brain heavily sedated, so only deep sleep patterns have been noted, and they have been normal and stable. We’ve been able to detect some visual images that would go along with dreaming – patterns not clearly identifiable, but different colors, and one brief image of a mountain that quickly distorted and disappeared.
”Dr. Kim! We need you in the lab right now!” the young technician shouts as he flings open the door and bursts into the room, filling it with light from the lab, and the sound of warning buzzers. Jennifer abruptly gets up and runs into the lab where several technicians are gathered around the anesthesia module.
“The tip snapped off, and I can’t make the syringe change work,” the anesthesia technician says – obviously flustered. “I was replacing the syringe, but the old one was screwed on really tight – tried to remove it – the tip snapped off – now I can’t get the new one to attach – brain’s waking up!”
“Consciousness level increasing rapidly!” shouts a technician monitoring the Neurocap™ output. Jennifer takes over the syringe changing operation, digging in to the emergency supply drawer, and retrieving a replacement anesthesia receptacle tip – using it to replace the damaged one. It takes her a couple of tries because she is shaking visibly, but at last she succeeds. “Back up the flow a bit to get rid of the air,” she orders.
Claire is now out in the lab, seeing all of this happening. Jennifer has completed the receptacle change and getting ready to attach a new anesthesia syringe. “I’m getting a visual from Sulcus 1512B” a voice shouts from the monitoring section. Having completed the repair, Jennifer quickly goes over to the monitors. When she sees the visual image emerging on the screen from Tom’s brain, she tries to put herself between it and Claire. The picture is fuzzy, but it is clearly of a female figure, dressed in white with long black hair. Claire turns away from the screen and abruptly sees herself out.
Tom is groggy as he awakes, assuming it is early morning – dark. Very dark. And quiet, very quiet. “Where am I? Why can’t I feel anything? What’s happening? Oh shit! I’m trapped! I’m in the lab. I’ve got to let Jenny know I’m waking up.” A huge wave of anxiety washes over him as he tries to picture Jennifer. Just as he does, the panic evaporates, a peaceful sensation washes over him – he goes back to sleep.
Later that same day – 5:05PM – The laboratory
Back again, Mrs. Preston?” the guard says as he scans her clearance papers which he recalls from earlier in the day.
“Yeah. A couple of things yet to do” she says as the guard signals back to the lab that she is here.
“I remember the way. . .” she says as the metal detector chirps on her way through. Half way back to the lab, Jennifer appears and walks her back the rest of the way.
“Claire, I’m so sorry about what happened this morning. It’s the only time we’ve had anything go wrong; but at least it was only for a few minutes . . .”
Claire, walking straight ahead, doesn’t respond. Jennifer opens the door and they enter the room together. “What can I do for you?” Jennifer askes. Claire heads straight to the brain chamber as everyone else freezes in their places.
Standing in front of the chamber she draws the gun out of her purse and shouts “everybody down on the floor.” As they scramble down, Claire pistol whips the anesthesia module, smashing it into many pieces. “Nobody move”
.Jennifer is terrified – frozen. She sees Claire’s dilated pupils and angry gaze, as the monitors begin alarming indicating increasing level of consciousness. Claire is in position to see the screen that had shown the picture of Jennifer during the episode in the morning. “Let’s see what he’s thinking” – she barks to the technician overseeing the screen.
“I need c- c- clearance to do that.”
“Go ahead,” says Jennifer, unable to think of anything else to do. As the screen fires up, there, once again, is a fuzzy image of a woman dressed in white with long black hair.
As that becomes obvious, Claire puts the barrel of the gun in her mouth and pulls the trigger, launching a 9mm bullet through her brain, out the back of her skull and smashing into the isolation chamber – totally shattering it. The chamber fluid pours out. The Neurocap™ containing Tom’s brain smashes onto the floor breaking into pieces. The room quiets into near-silence, except for the sound of the beeping monitors, announcing the flatlines, all that’s left to connect Tom and Claire, forever.
About the author: Terry Davis is a retired surgeon who enjoys writing fiction as a break from highly formulaic scientific articles. He has previously published short stories in Inwood Indiana and Cantaraville and an essay in The New England Journal of Medicine. He lives with his wife, two boys, their spouses and 7 grandchildren in Columbus, Ohio.
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