Exoteric

by Philip Hemplow

  “We have it,” said Zapad, repeating it more clearly so everyone could hear. “We have it! We have a rhythm!” He reached around Sophia and took control of the mouse, clicking icons, and watching information flicker on the laptop’s screen. “The implant is cardioverting…we have a sinus rhythm! It is working! The heart is working!”

  He turned round, flushed with triumph. “It works! We have proved that vitrification of human organs is a viable strategy for transplantation! Galina, give him oxygen! And turn the temperature up to maximum! We must not lose him now!”

  Arkady and Sophia stood back out of the way as the two doctors busied themselves about their patient. Galina intubated him, tilting his head back so she could drive a laryngoscope down his throat with practiced ease. Her stepbrother applied a stethoscope to Molchanov’s chest, dabbing it here and there, listening intently. The skin on Arkady’s neck and scalp tingled with apprehension as he watched them. Had they really done it? Was it really possible?

  “Weak pulse,” confirmed Galina, snapping a pulse oximeter onto the patient’s finger. “About sixteen BPM and a bit variable, but getting stronger. Still nothing on the capnograph.”

  “Increase the O2 flow. He’s still cold, its solubility won’t be good. Saturation?”

  “Keeps changing—twenty-five, thirty-five…trending upwards, but I wouldn’t trust these readings yet.”

  “Push atropine, point five milligrams.”

  They spoke rapidly but calmly, sharing information with none of the noisy theatrics that typically accompanied such scenes on television. To Arkady’s eye, Molchanov still looked stone dead: flesh mottled and sallow, mouth slightly agape, like some albino cave fish desiccating on a specimen table.

  He told himself he was witnessing an event of transcendent historical importance, but it was difficult to believe. Perhaps this was how real breakthroughs were always made though—Fleming and his mould, Röntgen and his X-rays—away from bright lights and committees, and the reach of conventional wisdom. Maybe they were always accompanied by a feeling of dreamlike disconnectedness and a surreal thrill of horror.

  “Look at that QRS deflection.”

  “He’s got a partial right bundle branch block. T-wave discordance looks fine, but let’s keep an eye on it. Not seeing much reaction to the atropine. Let’s give epinephrine, please: one milligram.”

  “Pushing one milligram epinephrine.”

  “Thank you. That’s got a response. Pulse strengthening, O2 sat’s up to 55 and climbing. Still no respiratory activity. Are you getting a blood pressure?”

  “Eighty over fifty, or in that region.”

  “It’s working! Everything is heading in the right direction!”

  “We have traces of CO2.”

  “I’m going to attach the EEG. Let’s see if there’s anything happening upstairs.”

  Arkady felt a hand brush his, and looked down. The tips of Sophia’s fingers squirmed their way under his thumb, into his palm, until he relaxed and let her hold his hand. Her skin felt cold and smooth. He gave her digits a reassuring squeeze.

  Zapad was fitting an electrode cap to Molchanov’s head. His eyes blazed with feverish excitement. Arkady had seen that look before, but only in the eyes of men serving on a front line.

  “Respiration,” confirmed Galina. “It’s shallow, and I don’t like the sounds coming from his lungs, but he’s trying.”

  “Really? Let me hear—yes, bilateral rales. What does the oximeter say?”

  “68 percent saturation.”

  “Reduce the oxygen flow. We don’t want to cause any toxic damage. It could be that preservation caused some trauma at the alveolar interface. Hopefully it will recover with time, if so. Still, he is trying to breathe! This man, who a few moments ago was dead, is attempting, spontaneously, to respire!”

  “I know. I’m proud of you, Roman.”

  Zapad flushed with pleasure. “Take the tape off his eyes. I must check his pupillary reflex.”

  “What’s happening?” asked Sophia, looking up at Arkady, unable to follow the stream of medical jargon. “Is there a problem?”

  “I don’t think so,” he replied in a tentative whisper. “They say he’s breathing, a bit at least.”

  “Oh, my God!”

  He could feel her hand trembling in his, and held it tighter.

  “Eyes equal and reactive,” declared Zapad, holding up Molchanov’s eyelids with the fingers of one hand, flicking the beam of a penlight over them with the other. “No indications of oculomotor damage. This is fantastic! We are observing normal physiological reactions!”

  “What does that mean?” asked Sophia, her voice quiet and tremulous, like a child’s. “Are they saying he’s alive?”

  Arkady wasn’t sure how to answer. To him, Molchanov’s blindly-staring brown eyes looked no more alive than a pair of boiled sweets, but the doctors sounded positive. Fortunately, Zapad replied for him, clicking off the penlight as he straightened and swivelled to face them, his own eyes gleaming with good-natured excitement.

  “That is, perhaps, a question for the philosophers. However, from a medical point of view, he has circulation—albeit mediated by his new pacemaker—and he has respiration, though it is at a low level and he will require external oxygen for the present. As you can see, he is not yet conscious and his brain remains inactive, but he is perhaps equivalent to a coma patient now—not a dead one. Be in no doubt, this is a moment the world will remember for a very long time!”

  Slowly and carefully, he closed Molchanov’s eyes again.

  “Will he wake up?” Sophia wanted to know.

  Zapad winced slightly, and his tone became less assured. “I, ah…I cannot say for sure—not just yet—but there is no reason to assume he will not, with appropriate treatment. It is best if we allow him to recuperate for now though; allow him time to stabilise. Rest assured, the indications are very positive. We will formally assess the depth of his coma later, but there is no sign of decerebrate or decorticate response, and the fact his respiratory centre began to respond as soon as circulation was restored is very encouraging. It means that, at the very least, his medulla oblongata is intact and functioning. That being so, we may be optimistic activity will resume elsewhere in the brain in due course. Tomorrow, if we are confident it is safe, we may attempt to return him to full sentience. It might take some time.”

  Sophia nodded, and chewed her lip.

  “Roman—we have spikes,” said Galina quietly, her tone apologetic. “On the EEG.”

  Her stepbrother’s eyes widened in disbelief, and he span to face the display. “No! Show me!”

  “Right here: 1.2 millivolts at 120 millisecond intervals, give or take. What is that? It’s too regular to be burst suppression…cardiac contamination from the pacemaker, maybe?”

  “No, it can’t be; it’s out of synch. Besides, this equipment compensates for signal contamination. This is fascinating! I have heard of this before, but never seen it! I think we’re looking at nu-complex pattern activity. Look at the timings: it’s propagating from his hippocampus. That, also, is consistent.”

  “Well, I’ve never heard of it,” complained Galina. “What the hell are you talking about?”

  “So far as I know, nu-complex signals have only been observed in a single human test subject, but they have been well-characterised in laboratory animals. They occur beyond the isoelectric baseline: beyond what we typically think of as ‘brain death.’”

  “What? What do you mean?”

  “Well, patients in the deepest irreversible comas exhibit a flat line on the EEG—correct? They are electrically silent. However, if that coma is intentionally deepened even further, say by administration of thiopental, nu-complex activity may appear. We do not know why. It is not clear what it indicates—a very strange phenomenon! It does at least tell us this patient’s brain can generate impulses, and that these can propagate successfully—but clearly he is a long way from consciousness! Make sure that data stream is recording! We must
make sure it is preserved!”

  Sophia emitted an involuntary half-sob, half-whimper, and turned her face away, finally overwhelmed. A stab of pity penetrated Arkady’s bewilderment and sense of surreal detachment.

  “Come on,” he said, resting a hand on her shoulder. “Let’s get you out of here. Dr Zapad will let us know if there are any developments, won’t you, Doctor?”

  “Uh—assuredly, I will. For now, we will just give him some saline and continue to monitor his condition. I must check his electrolytes, too, and collect some samples for future analysis, monitor his temperature…but, yes: I will tell you if there is any significant change in his condition.”

  Looking unhappy, the girl allowed herself to be led towards the door. Truth be told, Arkady was looking forward to getting out of the room himself, away from Zapad’s grotesque pronouncements and the stench of melting excrement. A growing sense of foreboding made it hard for him to concentrate: a haunting and inexplicable feeling of general unease, which he could not trace to any specific cause.

  “You must have seen dead bodies before,” said Sophia quietly when the door closed behind them, wiping her eyes with her sleeve. “Do they always look like that?”

  “After a decade? No: usually they look much worse.” Arkady realised he sounded unintendedly derisive, and softened his tone. “Anyway, you heard the doctor: he’s not dead. He’s comatose, but he’s breathing and his heart is beating. Does that sound like a dead body to you?”

  “No,” admitted Sophia. “That sounds more like…” Her voice trailed off.

  “More like what?”

  “A zombie?”

  Arkady forced an unconvincing chuckle and started walking down the corridor, as much to avoid her being able to read his expression as from any sense of purpose. “Come on,” he called over his shoulder. “I think I know what you need. Let’s brew some of that chaga we found in the woods. I’ll teach you how to make chaga tea. That will make you feel better; you’ll see.”

  Sophia mustered a weak, unhappy laugh. “That’s your answer: mushroom tea?” She traipsed after him anyway, shoulders hunched, hands in pockets. “I brought a bottle of champagne. I thought we could open it if the operation was a success, but it doesn’t feel like the right time. I mean, he’s not awake. He might never be awake. None of it’s how I imagined it was going to be.”

  Arkady nodded in understanding. “I’m afraid you’ll learn the big moments in life, the ones which really matter, seldom are,” he told her.

  *

  Sophia didn’t like the tea—not that he’d expected her to—but it had the desired effect of giving her something else to think about for a while. After half an hour of gentle conversation in the darkened canteen, she seemed to have recovered something of her equanimity, and Arkady felt able to suggest she go to bed. Even the mention of the word was enough to trigger a series of expansive yawns, and reluctantly, she agreed.

  Arkady cleared away the samovar and cups, then returned to the clinic to check on the doctors before turning in himself. In the calorimeter, Zapad was reciting his thoughts and observations to a handheld dictation machine. Molchanov had been transferred from the operating table to an adjustable hospital bed, and Galina was catheterising him, a procedure Arkady tried to avoid watching. He warned them to make sure they got some rest, and left them to it.

  As soon as the door of his room was closed and he was alone, he was overcome by sudden weariness. It had been a long, emotionally draining day, and he just wanted to sleep. He’d only managed three hours in bed the previous night, and it was already half past two in the morning again. Twenty years ago, that would have been nothing. Even ten years ago, he could have taken it in his stride. Now, it left him aching, exhausted, and unable to focus his eyes or mind.

  He was older now than his father had been when he died, writhing and sweating as his organs failed in sequence. It was a thought he tried not to dwell on, but one which often found him when his defences were down.

  You’re older than I was, too, whispered Ana.

  “I was always older than you though,” sighed Arkady. He sat down on the edge of the bed, reached down with a grunt of exertion, and began to unfasten his shoes.

  You could just leave this place. How many times did I tell you it was time to retire?

  “Too many.” He kicked off his shoes and sat up straight again, hands braced on knees while he waited for a sudden attack of dizziness to pass.

  Should I have frozen your body? He asked the question silently this time. Do you wish you were in a tank in Zapad’s crypt, waiting to come back?

  “Come back without you? No, darling. I don’t think I would like that.”

  Maybe if we had children…descendants…

  “Tchuh! Always you bring it back to children! Death is just death; it happens to everyone.”

  Not these days, apparently.

  The bathroom door was open. From where he sat he could see her reflected in the mirror, bustling about, tidying up his toiletries. He tried not to blink, knowing that when he did so she would be gone—then realised she already was. There was no image in the mirror anymore, no lost voice echoing off the porcelain: just him, the rumble of the wind outside, and a muted, threshold whine of tinnitus. He was alone.

  It was the first time he’d seen Ana since embarking on the Zubgorai project, he realised. In the first weeks after her death, she’d been everywhere: in the corner of his eye, leaving rooms as he walked into them, disappearing into crowds. He knew hallucinations were a common symptom of bereavement, and while her voice still addressed him in his mind, she had soon stopped appearing before his eyes. He had adjusted, found a new equilibrium—until now.

  It was exhaustion, clearly: exhaustion and the resort’s morbid atmosphere, picking at his emotional scars. He had been going without sleep, and the stress of the project had been eating away at him—nothing more.

  He undressed and climbed into bed, sighing with relief as the mattress took his weight and allowed the muscles in his back to relax. The shivering roar of the wind outside was muted by double-glazing, becoming white noise and whispers in the room, more comfortable than total silence. Too tired even to roll over and turn out the light, he closed his eyes and tried to direct his imagination away from the thing in the clinic, downstairs.

  It didn’t take long for encroaching sleep to disorder his thoughts, and send him tumbling through long, dark galleries of night.

  *

  He started awake with a mighty, apnoeic gasp, his dreams instantly fracturing into a jumble of cryptic, half-remembered images: Chechen men lying in a trench; the accusing eyes of bomb victims; a body bag which trembled, sat up, and turned towards him. Looking down, he saw one of his hands clutching a fistful of bedsheet, and forced himself to release it.

  The LED bulbs recessed in the ceiling still glowed, feeble now by contrast with the light leaking through the curtains. Arkady reached for the switch and turned them off, then swung his legs out of bed, waiting to see if a jolt of sciatica would follow. To his relief, it didn’t.

  In the bathroom, he forced himself to shave for the first time in days, then lingered in the shower until hot water had steamed away the worst of his fatigue. There was nothing to be done about the dark rings under his eyes, but by the time he left his room, wearing clean clothes and antiperspirant, he at least looked and smelled better than he felt.

  The outside world was screened from view again, not by fog this time, but falling snow. Fat, pirouetting flakes of it filled the air, whirling down from a white-out sky to be seized by the gales sweeping the plateau. The treeline was no longer visible from the resort’s windows, everything more than a few metres distant dissolved in static. As he crossed the reception area, Arkady could see Votyakov’s men through the front doors, working to dig their vehicles out of deep drifts which had accumulated against them. It seemed like a waste of time while the stuff was still falling: a make-work task the Ogre had set them out of sheer malice.

  The air i
n the restaurant was gritty with burnt toast when he entered. A pall of black smoke hung over the breakfast bar, where Sophia was prodding at a slice of carbonised bread that was too hot to pick up. Galina and Votyakov were there too, with their backs to him, staring at the wall-mounted television. It was showing the morning news, and the banner headline scrolling across the bottom of the screen was large enough for Arkady to read from across the room:

  EXPLOSION STRIKES PRESIDENTIAL VEHICLE…MASLOK: ‘WE FEAR THE WORST…GUNFIRE REPORTED INSIDE SUB BASE…

  “What’s happened?” demanded Arkady, tiredness immediately behind him. He sprang down the two steps separating the halves of the split-level room with an alacrity which surprised even him, and advanced on the television.

  “Sophia burnt her toast,” said Votyakov without turning round. “Oh, yes, and the President has been assassinated.”

  “How? Is that Murmansk? What in the damned hell was he doing there?” Arkady gestured at the screen, which was replaying footage of a burning car. The president’s NAMI-built armoured limo by the look of it, turned inside-out by some catastrophic explosion. “An IED?” he guessed.

  “No, a missile,” said Votyakov. “He flew up there last night to demand the base commander’s surrender and reclaim the Minister of Defence. He had an entire armoured battalion behind him and Spetznaz in front. It should have been safe, but as his convoy reached the local command post an ATGM was fired from the base perimeter. You can see the results.”

  “What were they thinking, letting him within line-of-sight of a hostile position?” spat Arkady, exasperated by the sheer, public incompetence of the president’s security detail.

  “That’s a fair question,” allowed Votyakov. “You might as well ask what a Kornet anti-tank missile was doing on a naval base.” He waited for Arkady to meet his eye. “They aren’t subtle, are they?”

  Arkady glared at him, warning him to say no more in front of the others. “That’s true,” he growled, “but perhaps we should be.”