by Ted Chiang
I'm grabbing the down comforter with my fists, and I can feel myself trembling. I try to calm down, to breathe slowly, but sobs keep forcing their way out. It was so real I could feel it: feel what it was like to die.
I was in that water for nearly an hour; I was more vegetable than anything else by the time they brought me up. Am I recovered? It was the first time the hospital had ever tried their new drug on someone with so much brain damage. Did it work?
* * *
The same nightmare, again and again. After the third time, I know I'm not going to sleep again. I spend the remaining hours before dawn worrying. Is this the result? Am I losing my mind?
Tomorrow is my weekly checkup with the resident at the hospital. I hope he'll have some answers.
* * *
I drive into downtown Boston, and after half an hour Dr. Hooper can see me. I sit on a gurney in an examining room, behind a yellow curtain. Jutting out of the wall at waist height is a horizontal flatscreen, adjusted for tunnel vision so it appears blank from my angle. The doctor types at the keyboard, presumably calling up my file, and then starts examining me. As he's checking my pupils with a penlight, I tell him about my nightmares.
"Did you ever have any before the accident, Leon?" He gets out his little mallet and taps at my elbows, knees, and ankles.
"Never. Are these a side effect of the drug?"
"Not a side effect. The hormone K therapy regenerated a lot of damaged neurons, and that's an enormous change that your brain has to adjust to. The nightmares are probably just a sign of that."
"Is this permanent?"
"It's unlikely," he says. "Once your brain gets used to having all those pathways again, you'll be fine. Now touch your index finger to the tip of your nose, and then bring it to my finger here."
I do what he tells me. Next he has me tap each finger to my thumb, quickly. Then I have to walk a straight line, as if I'm taking a sobriety test. After that, he starts quizzing me.
"Name the parts of an ordinary shoe."
"There's the sole, the heel, the laces. Um, the holes that the laces go through are eyes, and then there's the tongue, underneath the laces…."
"Okay. Repeat this number: three nine one seven four—"
"— six two."
Dr. Hooper wasn't expecting that. "What?"
"Three nine one seven four six two. You used that number the first time you examined me, when I was still an inpatient. I guess it's a number you test patients with a lot."
"You weren't supposed to memorize it; it's meant to be a test of immediate recall."
"I didn't intentionally memorize it. I just happened to remember it."
"Do you remember the number from the second time I examined you?"
I pause for a moment. "Four zero eight one five nine two."
He's surprised. "Most people can't retain so many digits if they've only heard them once. Do you use mnemonic tricks?"
I shake my head. "No. I always keep phone numbers in the autodialer."
He goes to the terminal and taps at the numeric keypad. "Try this one." He reads a fourteen-digit number, and I repeat it back to him. "You think you can do it backwards?" I recite the digits in reverse order. He frowns, and starts typing something into my file.
* * *
I'm sitting in front of a terminal in one of the testing rooms in the psychiatric ward; it's the nearest place Dr. Hooper could get some intelligence tests. There's a small mirror set in one wall, probably with a video camera behind it. In case it's recording, I smile at it and wave briefly. I always do that to the hidden cameras in automatic cash machines.
Dr. Hooper comes in with a printout of my test results. "Well, Leon, you did… very well. On both tests you scored in the ninety-ninth percentile."
My jaw drops. "You're kidding."
"No, I'm not." He has trouble believing it himself. "Now that number doesn't indicate how many questions you got right; it means that relative to the general population—"
"I know what it means," I say absently. "I was in the seventieth percentile when they tested us in high school." Ninety-ninth percentile. Inwardly, I'm trying to find some sign of this. What should it feel like?
He sits down on the table, still looking at the printout. "You never attended college, did you?"
I return my attention to him. "I did, but I left before graduating. My ideas of education didn't mesh with the professors'."
"I see." He probably takes this to mean I flunked out. "Well, clearly you've improved tremendously. A little of that may have come about naturally as you grew older, but most of it must be a result of the hormone K therapy."
"This is one hell of a side effect."
"Well, don't get too excited. Test scores don't predict how well you can do things in the real world." I roll my eyes upward when Dr. Hooper isn't looking. Something amazing is going on, and all he can offer is a truism. "I'd like to follow up on this with some more tests. Can you come in tomorrow?"
* * *
I'm in the middle of retouching a holograph when the phone rings. I waver between the phone and the console, and reluctantly opt for the phone. I'd normally have the answering machine take any calls when I'm editing, but I need to let people know I'm working again. I lost a lot of business when I was in the hospital: one of the risks of being a freelancer. I touch the phone and say, "Greco Holographics, Leon Greco speaking."
"Hey Leon, it's Jerry."
"Hi Jerry. What's up?" I'm still studying the image on the screen: it's a pair of helical gears, intermeshed. A trite metaphor for cooperative action, but that's what the customer wanted for his ad.
"You interested in seeing a movie tonight? Me and Sue and Tori were going to see Metal Eyes."
"Tonight? Oh, I can't. Tonight's the last performance of the one-woman show at the Hanning Playhouse." The surfaces of the gear teeth are scratched and oily-looking. I highlight each surface using the cursor, and type in the parameters to be adjusted.
"What's that?"
"It's called Symplectic. It's a monologue in verse." Now I adjust the lighting, to remove some of the shadows from where the teeth mesh. "Want to come along?"
"Is this some kind of Shakespearean soliloquy?"
Too much: with that lighting, the outer edges will be too bright. I specify an upper limit for the reflected light's intensity. "No, it's a stream-of-consciousness piece, and it alternates between four different meters; iambic's only one of them. All the critics called it a tour de force."
"I didn't know you were such a fan of poetry."
After checking all the numbers once more, I let the computer recalculate the interference pattern. "Normally, I'm not, but this one seemed really interesting. How's it sound to you?"
"Thanks, but I think we'll stick with the movie."
"Okay, you guys have fun. Maybe we can get together next week." We say goodbye and hang up, and I wait for the recalc to finish.
Suddenly it occurs to me what's just happened. I've never been able to do any serious editing while talking on the phone. But this time I had no trouble keeping my mind on both things at once.
Will the surprises never end? Once the nightmares were gone and I could relax, the first thing I noticed was the increase in my reading speed and comprehension. I was actually able to read the books on my shelves that I'd always meant to get around to, but never had the time; even the more difficult, technical material. Back in college, I'd accepted the fact that I couldn't study everything that interested me. It's exhilarating to discover that maybe I can; I was positively gleeful when I bought an armload of books the other day.
And now I find I can concentrate on two things at once; something I never would have predicted. I stand up at my desk and shout out loud, as if my favorite baseball team had just surprised me with a triple play. That's what it feels like.
* * *
The neurologist-in-chief, Dr. Shea, has taken over my case, presumably because he wants to take the credit. I scarcely know him, but he acts as if I've bee
n his patient for years.
He's asked me into his office to have a talk. He interlaces his fingers and rests his elbows on his desk. "How do you feel about the increase in your intelligence?" he asks.
What an inane question. "I'm very pleased about it."
"Good," says Dr. Shea. "So far, we've found no adverse effects of the hormone K therapy. You don't require any further treatment for the brain damage from your accident." I nod. "However, we're conducting a study to learn more about the hormone's effect on intelligence. If you're willing, we'd like to give you a further injection of the hormone, and then monitor the results."
Suddenly he's got my attention; finally, something worth listening to. "I'd be willing to do that."
"You understand that this is purely for investigational purposes, not therapeutic. You may benefit from it with further gains in your intelligence, but this is not medically necessary for your health."
"I understand. I suppose I have to sign a consent form."
"Yes. We can also offer you some compensation for participating in this study." He names a figure, but I'm barely listening.
"That'll be fine." I'm imagining where this might lead, what it might mean for me, and a thrill runs through me.
"We'd also like you to sign a confidentiality agreement. Clearly this drug is enormously exciting, but we don't want any announcements to be made prematurely."
"Certainly, Dr. Shea. Has anyone been given additional injections before?"
"Of course; you're not going to be a guinea pig. I can assure you, there haven't been any harmful side effects."
"What sort of effects did they experience?"
"It's better if we don't plant suggestions in your mind: you might imagine you were experiencing the symptoms I mention."
Shea's very comfortable with the doctor-knows-best routine. I keep pushing. "Can you at least tell me how much their intelligence increased?"
"Every inp class="indent" idual is different. You shouldn't base your expectations on what's happened to others."
I conceal my frustration. "Very well, Doctor."
* * *
If Shea doesn't want to tell me about hormone K, I can find out about it on my own. From my terminal at home I log on to the datanet. I access the FDA's public database, and start perusing their current INDs, the Investigational New Drug applications that must be approved before human trials can begin.
The application for hormone K was submitted by Sorensen Pharmaceutical, a company researching synthetic hormones that encourage neuron regeneration in the central nervous system. I skim the results of the drug tests on oxygen-deprived dogs, and then baboons: all the animals recovered completely. Toxicity was low, and long-term observation didn't reveal any adverse effects.
The results of cortical samples are provocative. The brain-damaged animals grew replacement neurons with many more dendrites, but the healthy recipients of the drug remained unchanged. The conclusion of the researchers: hormone K replaces only damaged neurons, not healthy ones. In the brain-damaged animals, the new dendrites seemed harmless: PET scans didn't reveal any change in brain metabolism, and the animals' performance on intelligence tests didn't change.
In their application for human clinical trials, the Sorensen researchers outlined protocols for testing the drug first on healthy subjects, and then on several types of patients: stroke victims, sufferers of Alzheimer's, and persons— like me— in a persistent vegetative state. I can't access the progress reports for those trials: even with patient anonymity, only participating doctors have clearance to examine those records.
The animal studies don't shed any light on the increased intelligence in humans. It's reasonable to assume that the effect on intelligence is proportional to the number of neurons replaced by the hormone, which in turn depends on the amount of initial damage. That means that the deep-coma patients would undergo the greatest improvements. Of course, I'd need to see the progress of the other patients to confirm this theory; that'll have to wait.
The next question: Is there a plateau, or will additional dosages of the hormone cause further increases? I'll know the answer to that sooner than the doctors.
* * *
I'm not nervous; in fact, I feel quite relaxed. I'm just lying on my stomach, breathing very slowly. My back is numb; they gave me a local anesthetic, and then injected the hormone K intraspinally. An intravenous wouldn't work, since the hormone can't get past the blood-brain barrier. This is the first such injection I can recall having, though I'm told that I've received two before: the first while still in the coma, the second when I had regained consciousness but no cognitive ability.
* * *
More nightmares. They're not all actually violent, but they're the most bizarre, mind-blowing dreams I've ever had, often with nothing in them that I recognize. I often wake up screaming, flailing around in bed. But this time, I know they'll pass.
* * *
There are several psychologists at the hospital studying me now. It's interesting to see how they analyze my intelligence. One doctor perceives my skills in terms of components, such as acquisition, retention, performance, and transfer. Another looks at me from the angles of mathematical and logical reasoning, linguistic communication, and spatial visualization.
I'm reminded of my college days when I watch these specialists, each with a pet theory, each contorting the evidence to fit. I'm even less convinced by them now than I was back then; they still have nothing to teach me. None of their categorizations are fruitful in analyzing my performance, since— there's no point in denying it— I'm equally good at everything.
I could be studying a new class of equation, or the grammar of a foreign language, or the operation of an engine; in each case, everything fits together, all the elements cooperate beautifully. In each case, I don't have to consciously memorize rules, and then apply them mechanically. I just perceive how the system behaves as a whole, as an entity. Of course, I'm aware of all the details and inp class="indent" idual steps, but they require so little concentration that they almost feel intuitive.
* * *
Penetrating computer security is really quite dull; I can see how it might attract those who can't resist a challenge to their cleverness, but it's not intellectually aesthetic at all. It's no different than tugging on the doors of a locked house until you find an improperly installed lock. A useful activity, but hardly interesting.
Getting into the FDA's private database was easy. I played with one of the hospital wall terminals, running the visitor information program, which displays maps and a staff directory. I broke out of the program to the system level, and wrote a decoy program to mimic the opening screen for logging on. Then I simply left the terminal alone; eventually one of my doctors came by to check one of her files. The decoy rejected her password, and then restored the true opening screen. The doctor tried logging on again, and was successful this time, but her password was left with my decoy.
Using the doctor's account, I had clearance to view the FDA patient-record database. In the Phase I trials, on healthy volunteers, the hormone had no effect. The ongoing Phase II clinical trials are a different matter. Here are weekly reports on eighty-two patients, each identified by a number, all treated with hormone K, most of them victims of a stroke or Alzheimer's, some of them coma cases. The latest reports confirm my prediction: those with greater brain damage display greater increases in intelligence. PET scans reveal heightened brain metabolism.
Why didn't the animal studies provide a precedent for this? I think the concept of critical mass provides an analogy. Animals fall below some critical mass in terms of synapses; their brains support only minimal abstraction, and gain nothing from additional synapses. Humans exceed that critical mass. Their brains support full self-awareness, and— as these records indicate— they use any new synapses to the fullest possible extent.
The most exciting records are those of the newly begun investigational studies, using a few of the patients who volunteered. Additional injec
tions of the hormone do increase intelligence further, but again it depends on the degree of initial damage. The patients with minor strokes haven't even reached genius levels. Those with greater damage have gone further.
Of the patients originally in deep-coma states, I'm the only one thus far who's received a third injection. I've gained more new synapses than anyone previously studied; it's an open question as to how high my intelligence will go. I can feel my heart pounding when I think about it.
* * *
Playing with the doctors is becoming more and more tedious as the weeks go by. They treat me as if I were simply an idiot savant: a patient who exhibits certain signs of high intelligence, but still just a patient. As far as the neurologists are concerned, I'm just a source of PET scan images and an occasional vial of cerebrospinal fluid. The psychologists have the opportunity to gain some insight into my thinking through their interviews, but they can't shed their preconception of me as someone out of his depth, an ordinary man awarded gifts that he can't appreciate.
On the contrary, the doctors are the ones who don't appreciate what's happening. They're certain that real-world performance can't be enhanced by a drug, and that my ability exists only according to the artificial yardstick of intelligence tests, so they waste their time with those. But the yardstick is not only contrived, it's too short: my consistently perfect scores don't tell them anything, because they have no basis for comparison this far out on the bell curve.
Of course, the test scores merely capture a shadow of the real changes occurring. If only the doctors could feel what's going on in my head: how much I'm recognizing that I missed before, how many uses I can see for that information. Far from being a laboratory phenomenon, my intelligence is practical and effectual. With my near-total recall and my ability to correlate, I can assess a situation immediately, and choose the best course of action for my purposes; I'm never indecisive. Only theoretical topics pose a challenge.