The Migration, page 19
Most of the parking lot is taken up with massive inflatable structures—body storage. The deadpan murmur of portable generators spills out in a close radius. Mom waits impatiently while blue-clad staff wheel twenty-foot-long racks by us, then clutches my hand while we cross the pavement toward the entrance. A blast of cold air raises goose bumps all over my skin.
* * *
—
When we get to Dr. Varghese’s office I see Nate Peverill from class coming out.
“Hey, Perella,” he says, but his voice is quiet and he doesn’t really look at me. He keeps scratching awkwardly at a rash that’s begun to crawl up his arm. He’s wearing a medical ID bracelet now.
“Did you hear about what happened to Lilee?”
He nods sharply but it doesn’t look like he wants to talk. As he wanders down the hallway there’s a moment when I almost feel good about the fact he’s one of us now. He could be such a prick, always going along with whatever Evie Chudwell and that lot wanted! But mostly I just feel sorry for him.
A minute or two later Dr. Varghese greets us. I’ve never seen her so worn down, so removed. A partially rubbed-out jitterbug has been drawn on her door with permanent marker. I wonder who did that, how they got in.
Before she enters I tell Mom, “I want to do this by myself.” There are things I need to know, things I won’t be able to ask if she’s around. She starts to protest but I hold up my hands. “This is how it’s been since I was diagnosed.” That seems to do the trick.
She lingers, a hurt look on her face, but there’s no back-up from Dr. Varghese. “If this is what Sophie wants,” she says, drawing it out into a question. I nod and slip inside.
“Tell me what you know about what’s happening to us,” I demand as soon as the door is closed behind us. Dr. Varghese shrinks away from my anger behind her desk. And I realize this must be her life right now, these same questions, over and over and over again.
“Please, Sophie, sit down. I’ll try to answer whatever questions I can—but first, there are things you need to know.” I hate the vaguely rehearsed feeling of this. Whatever pronouncement Dr. Varghese’s about to make, she’s made it before. She must have just made it to Nate. “This concerns you. And it’s serious.”
I swallow a thick bolus of fear.
“You know our assumption has always been that the hormone will dissipate past a certain point.” Her fingers touch the edge of her desk, trembling. She sounds as if she’s pleading with me now but I don’t want to give her my sympathy. “That people like you, Sophie, will grow out of the condition if you pass a certain threshold. Our research suggested that your body eventually loses…” she pauses again here, searching for words, “a certain plasticity. The same plasticity that allows your body to change during puberty.”
“I don’t know what that means.”
“Over the last week we’ve discovered a change in the progression of the symptoms of people like you,” she says. “An escalation.”
“What kind of escalation?”
“Your symptoms could get worse—much worse. All the threats to your immune system we’ve been tracking. We were able to diagnose you because your body had begun to produce a hormone, which rewired the way your body works. Do you remember what I said about Toxoplasma gondii?”
“The parasite?”
She licks her lips, trying to judge my response, how much to tell me. “Suicidal thoughts, emotional swings, all designed to put you in harm’s way, making you more vulnerable. It’s happening faster, all of it. Your body is actively seeking the right conditions to—”
“Change,” I finish and she nods. My fingers tap out a nervous tattoo against my leg. “But why? Why is it happening now?”
“We don’t know, Sophie, only that the situation is different than it was before. We’ve never seen anything like this.”
“How is it different?”
“It’s like an inherited condition, something hardwired into your system. When a patient dies under certain conditions—when enough of the body is left intact—then the hormone activates new developmental processes. We think…the potential for this was always present. In everyone, your mother, your aunt, me. But it doesn’t affect adults, not in the same way.” She sighs. “Your body isn’t changing because you’re sick, Sophie. You manifest as sick because your body has already begun to change, because certain genes have already been activated by the hormone.”
“They’re waking up,” I whisper. “You said things are getting worse. How much worse will they get?”
“Some patients have fallen into trance states. They’re completely immobile and unresponsive now. Others have shown signs of increased anxiety and aggression. Spontaneous hemorrhaging resulting in death. We don’t know the full extent of it yet. But we’re trying.” She swallows. “We’re trying to figure it out as quickly as possible. In the meantime we’ve been in talks with government officials and the World Health Organization. We’re investigating the possibility of alternate means of care. A long-term care facility for people like you.”
“You mean they’ll lock me up.” My voice is tinged with desperation. It’s like Redmond said, exactly what he was afraid of.
“It isn’t as bad as it sounds.” A muscle twitches beneath her eye. “We’re working on a treatment. But right now you’re at risk and we have to take care of you. A long-term care facility will be able to monitor you much more closely. They’ll be able to understand your sensitivities, to control your total environment. There will be medical staff on hand at all times. They will have better resources. They’ll be able to protect you.”
“Until the hormone dissipates, until we’re older like you are.”
“We think—yes.”
“But you don’t know?”
“You need to understand about the numbers. It’s just—”
“Not many of us will live that long.”
She says nothing but her eyes are wide, resigned. I know it’s true.
I feel light-headed but oddly calm, as if something important has been cut away from me, some fragile grasping after hope. What’s left is…propulsion, maybe that’s the best word for it. I should be frightened but instead I feel weightless. The sense that time is speeding up, running away from me.
“What will happen if I die? Will I be cremated?”
Her mouth trembles as a look close to sickness passes across her face. “Sophie, we need to focus on your health, on your options.”
“This isn’t about my options, don’t you understand that? You told me that there was nothing that comes after. When Kira died, you said it would be easier on my family if we handed her over to you. You wanted me to trust you—but how can I now?”
“Please.” Her voice is rising, taking on a higher pitch.
“I’ve seen them myself. It’s clear they’re alive. You had to know that—maybe not everything but some of it. You had to know they were changing, yet you still told us we should cremate Kira.” My hands have bunched into fists and I can feel the adrenaline soaring, the sweet pulse of it in my veins—even as I try to stay in control. “What I don’t understand is—why would you do that? Why would you ask us to do that?”
She won’t look at me. Instead she stares out the window that overlooks the parking lot, those vast beehive structures barely visible from my angle. Over the sound of my breathing I can hear a faint susurrus. Chanting, I think, from the protestors. No more lies! No more lies! The whine of a siren cutting through the white noise of their voices. She has to listen to this every day.
“Sophie…”
“Just tell me the truth, Dr. Varghese. You owe me that, don’t you?”
When she turns back to me there’s a bright shimmer of tears in her eyes. She wipes them away with the back of her hand.
“When the crisis first started I thought I could help. But this? It’s…” Her voice breaks. “I’m just trying to do the best I can for you.”
“Then tell me. I was there when Martin Paisley died—he was this close to me. I—I couldn’t help him. So please—enough about my symptoms, I know the danger. What I need to know is what happens next.”
Her voice hitches: “Martin? You knew him?”
I nod slowly.
She closes her eyes for a moment. “I was his clinician too.” She opens a drawer, pulls out a file and drops it on her desk. I wait for her to acknowledge it but she doesn’t.
“What is that?” I ask her but she doesn’t answer. The folder is unmarked. I pick it up gingerly and lift the cover.
The folder contains a chart, diagrams, pages of notes—an autopsy report.
The clinical death of Martin Paisley was recorded at 1:27 am on March 11. Cause of death: blunt force trauma causing abrasions of the forehead. The skull casing was found to be fractured leading to hemorrhaging in the brain. Transition initiated upon cessation of vital functions.
“Take it,” she says. Her gaze has wandered to the picture of the Lakhaniya Dari waterfall on her desk. She’s smiling in that picture, young, elated with what she’s accomplished. A completely different person. I remember telling her I wanted to go there. When I was older, when it was safe to travel.
“I’m sorry about your sister. And I’m sorry about Martin too. When Director Ballard said there were no alternatives, I believed him. That the severity of the crisis didn’t leave us with any choice. But I became a doctor to relieve the pain and suffering of others. I promised to do nothing that might harm a patient.”
A wave of anger rises up in me when she says that. I don’t want to acknowledge the pain in her eyes, the genuine regret. I don’t want to have to forgive her anything.
She sees the atom of rage in my eyes and her gaze flicks down to the folder. “Leak it to the papers if you want. Maybe you’re right. Maybe everyone should know.”
* * *
—
When Mom sees the look on my face she lets me be. For a while anyway. We drive in silence, the sky lead-coloured and roiling above us. “What did she tell you?” she asks eventually.
“She said they’re looking at long-term care options.” My voice is flat.
“That’s a good sign, isn’t it?”
“They want to send us to a facility. All of the people like me.” Her knuckles whiten around the steering wheel. “You don’t have to do that, Feef. They can’t make you.”
“Yet.”
“I’m serious. I don’t trust them. I don’t care if they’re the best doctors and scientists. They didn’t tell us what was going on and they should have.” Her voice rises. “They should have let us choose for ourselves.”
I stare at her, surprised by her vociferousness.
Suddenly the urge to tell her the truth about Kira is so strong, but I don’t know how to put the story together. And if I’m honest I’m scared too. Ever since the night of the riots I’ve been scanning the skyline, searching for her.
Am I doing the right thing by keeping this all from her? Or am I as bad as Dr. Varghese?
Soon, I think. I’ll tell her when I know for sure.
Above us a growl of thunder sounds, rain pebbling the windshield. Something is coming, it seems to say to me and my body thrums in agreement, my blood thick in my veins, my pulse hammering in reply.
Soon.
30
NAME: PAISLEY, MARTIN
Clinician: Dr. Anil Varghese
Martin Paisley, a 17-year-old male with JI2, presented unconscious on March 11, in critical condition due to acute cranial trauma caused by blunt injury to the head. Following cessation of vital signs and pronouncement of clinical death, activation of JI2 “post-mortem” changes began and Martin was recruited to the M-Plagge trial by Dr. Lane Ballard.
General observations
Martin was seventeen years old when first diagnosed with JI2 on January 3 and regular check-ups confirmed the continued presence of the juvenile hormone. He was a student at the Faculty of History at the University of Oxford where by all accounts he was flourishing. His sister Catherine Davis had been named his guardian, and encouraged him to defer for a year after his condition was reported to her, but he resisted.
Initial progression of JI2
13 MARCH. The first stage of the transition has proceeded along anticipated trajectory although much faster than previous observations have indicated. Muscle tremors have ceased. The epidermis has begun to develop a thick layer of keratin forcing rigidity but only briefly. Internally, there is a catastrophic destruction of the prior form’s tissues, as lungs, kidney, spleen are being broken down into an autodigestible “mush” but only a limited period of stasis, much shorter than before. A needle biopsy has revealed that clusters of individual cells have returned to an embryonic state, embarking upon a secondary developmental path.
Research thus far has suggested that the fertilised human egg contains the hereditary programming for two very different and specialised patterns of body development. Humans have typically developed upon a singular path as witnessed by the standard phases (zygote, blastocyst, fetus, neonate, pre-adolescence, etc.) but this transition indicates a possible “branching” during puberty in which the secondary form might be triggered if certain conditions are fulfilled. But there are still questions I can’t answer: What are they? Why is this happening now?
14 MARCH. Sac-like epithelial clusters detected, which will develop into the “wing-buds” over time. Already, bones have lightened considerably, faster than we’ve observed previously. Multiple air sacs established, extending into the humerus, the femur, the vertebrae and the skull. The external layer of keratin has begun to resolve itself into the first layer of the nymph’s plumage (dark brown). Rigidity of the body form is substantially reduced now that the initial interior re-organization has taken place. The new organs (heart, lungs, stomach, liver) have been established and are functioning smoothly. Martin blinks frequently during marked cycles of alertness and motor activity.
15 MARCH. At the request of Dr. Lane Ballard, Martin has been started on the M-Plagge trial.
Course on M-Plagge
The secondary instar—or growth stage—has been inhibited, as suspected. M-Plagge appears to be functioning successfully as a blocking agent, reducing substantially the effects of the juvenile hormone. If these tests bear out over time, then M-Plagge might offer some hope of stalling the development of early symptoms in JI2 patients and reducing the possibility of transformation.
16 MARCH. Martin shows striking changes. His expression is alert, and his rigidity is distinctly reduced. Small interactions include bouts of staring in which his eyes appear to track—or focus intensely—upon anyone who enters the room. But I can’t dismiss the feeling that he recognizes me. Dr. Ballard insists this is sentimentalizing but there is evidence that suggests otherwise. He has shown renewed signs of awareness, including frequent openings of the mouth as if to yawn or speak. It should be noted that the anatomy of the vocal cords has been significantly altered. All that remains of its previous function is a high chirruping sound.
17 MARCH. On a higher dosage, Martin shows improved posture. Despite the limitations of his body, he has begun to move. Gestures of the truncated metacarpus, something like little waves? His behaviour is remarkable. No prior patients have demonstrated anything like this responsivity. But what does it mean? The rapidity of metamorphosis in other patients means our tests are now of vital concern. Might there be a way to communicate with Martin? I think so.
First test shows a limited range of responses, but a basic method of communication (one blink for no, two blinks for yes) has been established. fMRI scans indicate that perhaps more of the language centres of the brain (Broca’s area) have remained intact, or perhaps their function has been amalgamated into processes directed by an enlarged hippocampus? When questioned as to whether the subject could understand me, subject blinked twice.
If the subject’s identity remains intact at any level, this raises serious concerns about current regulations re: cremation. Previous subjects showed no signs of awareness but the speed of the instar development prior to M-Plagge is astonishing. Dr. Ballard has expressed unease with this line of questioning, fearing that evidence of subject identity may raise concerns with the Medical Research Council, which could jeopardize our primary trials. I have argued repeatedly that establishing the full nature of the condition is the only way to develop an appropriate treatment.
18 MARCH: M-Plagge dosage increased to 5 gm. daily. Initially Martin responded well, but over the course of several hours his movements became increasingly frenetic. Metacarpal gestures resumed but with some urgency. When restrained, he went through a series of muscular convulsions. Concerns over a possible seizure forced us to reduce the dosage.
(transcription taken from 18 March video record)
Dr. Varghese: Martin, can you understand me? (Two blinks.)
Dr. Varghese: Are you in pain?
(One blink. A long pause. A second blink.)
Martin looked at me directly when I asked him that question. I could track his eye movements.
19 MARCH: A reduced dosage of M-Plagge has allowed us to reach a better balance with Martin. Responsiveness returned to previous levels. He seems to experience minor convulsions when I leave, followed by a series of flexing gestures, increasingly urgent. Martin becomes quiescent when I return.
I have commissioned an Eye-gaze Response Interface Computer Aid (ERICA), which will allow a camera and infrared light to track Martin’s gaze on a computer screen as it focuses upon key icons, words and in some cases letters. Communication should be much more rapid and efficient.
The success of the ERICA unit has now allowed for a number of long conversations to be recorded. Martin has been able to identify images of members of his family: his living sister as well as his deceased parents. His memory, however, is not perfect, as at times he is unable to distinguish between past and present, imagining his parents still to be alive. When questioned about this, he indicated, “They are dead, I know they are dead, but sometimes I seem to remember clearly that they are not dead. My mind is lying to me.” This sense of confusion has recurred throughout subsequent sessions. “I feel pulled by something,” he indicated. “Like someone is in the room next to me, shouting for me. Sometimes it is very loud. They are impatient.”
