A Brain

by Robin Cook

  “Now, listen,” said Michaels. “I know it’s shocking when you first see it. But this scientific breakthrough is so big that it is inconceivable to contemplate the immediate benefits. In medicine alone, it will revolutionize every field. You’ve already seen what our very preliminary program will do with a skull X ray. Philips, I don’t want you to make any snap decisions, you understand?”

  They’d finished the trip around the room, which was a marriage between a hospital and a computer installation. In the corner was what appeared to be a complicated lifesupport setup, like an intensive-care unit. Sitting in front of the monitors was a man in a long white coat. Michaels’ and Philips’ arrival had not disturbed his concentration.

  Standing again in front of Katherine Collins, Philips found words for the first time: “What is going into this subject’s brain?” His voice was flat, unemotional.

  “Those are sensory nerves,” said Michaels eagerly. “Since the brain is ironically insensitive to its own state, we’ve joined Katherine’s peripheral sensory nerves up to electrodes so that she can tell us which sections of her brain are functioning at any given moment. We’ve constructed a feedback system for the brain.”

  “You mean this preparation communicates with you?” Philips was genuinely surprised.

  “Of course. That’s the beauty of this whole setup. We’ve used the human brain to study itself. I’ll show you.”

  Outside of Katherine Collins’ cylinder but in line with her eyes was a unit that resembled a computer terminal. It had a large upright screen and a keyboard, which was electrically attached to a unit within the cylinder as well as to a central computer on the side of the room. Michaels keyed a question into the unit and it flashed onto the screen. How are you feeling, Katherine?

  The question vanished and in its place came: Fine, I’m eager to start work. Please stimulate me.

  Michaels smiled and looked at Martin. “This girl can’t get enough. That’s why she’s been so good.”

  “What did she mean, ‘stimulate me’?”

  “We planted an electrode in her pleasure center. That’s how we reward her and encourage her to cooperate. When we stimulate her she has the sensation of one hundred orgasms. It must be sensational because she wants it constantly.”

  Michaels typed into the unit: “Only once, Katherine. You must be patient.” Then he pushed a red button on the side of the keyboard. Philips could see Katherine’s body arch slightly and shudder.

  “You know,” said Michaels, “it’s been shown now that the reward system of the brain is the most powerful motivating force, even greater than self-preservation. We’ve even found a way to incorporate that principle in our newest processor. It makes the machines function more efficiently.”

  “Who ever conceived of all this?” asked Philips not sure he believed everything he was seeing.

  “No one person can take credit or blame,” said Michaels. “It all happened in stages. One thing led to another. But the two people most responsible are you and I.”

  “Me,” said Martin. He looked like he’d been slapped.

  “Yes,” said Michaels. “You know I’ve always been interested in artificial intelligence; that’s why I was interested in working with you initially. The problems you presented about reading X rays crystallized the whole central issue called ‘pattern recognition.’ Humans could recognize patterns, but the most sophisticated computers had inordinate difficulty. By your careful analysis of the methodology you used to evaluate X rays, you and I isolated the logical steps that had to be solved electronically if we were to duplicate your function. It sounds complicated, but it isn’t. We needed to know certain things about how a human brain recognizes familiar objects. I teamed up with some physiologists interested in neuroscience and we initiated a very modest study using radioactive deoxy-glucose, which could be injected into patients who were then subjected to a specific pattern. We used the E charts frequently used by Ophthalmology. The radioactive glucose analog then made microscopic lesions in the subjects’ brains by killing the cells that had been involved in recognizing and associating the E pattern. Then it was just a matter of mapping those lesions to determine how the brain functioned. The technique of selective destruction had been used for research on animal brains for years. The difference was that, using it on humans, we learned so much so quickly that it spurred us on to greater efforts.”

  “Why young women?” asked Martin. The nightmare was becoming a reality.

  “Purely because of ease. We needed a population of healthy subjects who we could call back whenever we needed them. The Gynecology population suited our purpose. They ask very little about what’s being done to them, and by merely altering the Pap smear report, we could get them to return as often as necessary. My wife has been in charge of the university’s GYN clinic for years. She selected the patients and then injected the radioactive material in their bloodstream when she drew blood for their routine laboratory work. It was very easy.” Martin had a sudden vision of the severe, black-haired woman in the GYN clinic. He had trouble associating her with Michaels, but then he realized that was far more believable than everything else he’d seen.

  The screen in front of Katherine Collins came alive again: Stimulate me, please.

  Michaels typed into the keyboard: “You know the rules. Later, when the experiments begin.”

  Turning to Martin, he said: “The program was so easy and so successful that it encouraged us to expand the goals of the research. But this happened gradually, over several years. We were encouraged to give huge doses of radiation to delineate the final associative areas of the brain. Unfortunately this caused some symptomology in a few of the patients, especially when we began work on the temporal lobe connections. This part of the work became very tricky because we had to balance the destruction we were causing with the level of tolerable symptoms for the subjects. If the subject got too many symptoms we had to bring them in, which initiated this stage of the research.” Michaels gestured toward the row of glass cylinders. “And it’s been here in this room that all the major discoveries have been made. But of course we never envisioned this when we started.”

  “What about these recent patients, like Marino and Lucas and Lindquist?”

  “Ah, yes. They did cause a bit of a stir. They were the patients receiving the highest dose of radioactivity, and their symptoms came on so fast that some of them went to physicians before we could get to them. But the physicians never came close to a diagnosis, especially Mannerheim.”

  “You mean he’s not involved?” asked Martin with surprise.

  “Mannerheim? Are you joking? You can’t have egotistical bastards like that involved in a project of this magnitude. He’d want credit for every little breakthrough.”

  Philips looked around the room. He was horrified and overwhelmed. It didn’t seem possible that it could happen, especially right smack in the center of a university’s medical center. “The thing that amazes me most,” said Martin, “is that you could get away with this. I mean some poor bastard up in pharmacology mistreats a rat and the animal league is on his back.”

  “We’ve had a lot of help. You might have noticed those men out there are FBI agents.”

  Philips looked at Michaels. “You don’t have to remind me of that. They tried to kill me.”

  “I’m sorry about that. I had no idea what was going on until you called me. You’ve been under surveillance for over a year. But they told me it was for your protection.”

  “I’ve been under surveillance?” Martin was incredulous.

  “We all have. Philips, let me tell you something. The results of this research are going to change the entire complexion of society. I’m not being dramatic. When we first started, it was a small project, but we had some very early results, which we patented. That caused the big computer companies to shower us with research money and help. They didn’t care how we were making our discoveries. All they wanted was the results, and they competed with one another in giving u
s favors. But then the inevitable happened. The first major application for our fourth-generation computer was the Defense Department. It has revolutionized the whole concept of weaponry. Using a small artificial intelligence unit combined with a holographic molecular memory-storage system, we designed and built the first truly intelligent missile-guidance system. The army now has a prototype ‘intelligent missile.’ It is the biggest defense breakthrough since the discovery of atomic power. And the government is even less interested in the origin of our discoveries than were the computer companies. Whether we liked it or not, they blanketed us with the highest level of security they’ve ever amassed, even more than the Manhattan Project back when the atomic bomb was being created. Even the President couldn’t have walked in here. So we’ve all been under surveillance. And those guys are a paranoid lot. Every day they thought that the Russians were about to storm the place. And last night they said you went berserk and were a security risk. But I can control them, to a point. A lot depends on you. You’re going to have to make a decision.”

  “What kind of decision?” Martin said tiredly.

  “You’re going to have to decide if you can live with this whole affair. I know it is a shock. I confess I was not going to tell you how we were making our breakthroughs. But since you learned enough to nearly be liquidated, you had to know. Listen, Martin. I am aware that the technique of experimenting on humans without their consent, especially when they must be sacrificed, is against any traditional concept of medical ethics. But I believe the results justify the methods. Seventeen young women have unknowingly sacrificed their lives. That is true. But it has been for the betterment of society and the future guarantee of the defense superiority of the United States. From the point of view of each subject, it is a great sacrifice. From the point of view of two hundred million Americans, it is a very small one. Think of how many young women willfully take their lives each year, or how many people kill themselves on the highways, and to what end? Here these seventeen women have added something to society, and they have been treated with compassion. They have been well cared for and have experienced no pain. On the contrary they have experienced pure pleasure.”

  “I can’t accept this. Why didn’t you just let them kill me?” said Philips in a tired voice. “Then you wouldn’t have had to worry about my decision.”

  “I like you, Philips. We’ve worked together for four years. You’re an intelligent man. Your contribution to the development of artificial intelligence was and can be enormous. The medical application, especially in the field of radiology, is the cover for this whole operation. We need you, Philips. It doesn’t mean we can’t do without you. None of us is indispensable, but we need you.”

  “You don’t need me,” said Philips.

  “I’m not going to argue with you. The fact is, we do need you. Let me emphasize one other point. No more human subjects are needed. In fact this biological aspect of the project is soon to be closed down. We have obtained the information we needed and now it’s time to refine the concepts electronically. The human experimentation is over.”

  “How many researchers have been involved?” asked Philips.

  “That,” said Michaels proudly, “is one of the beauties of the whole program. In relation to the magnitude of the protocol, the number of personnel has been very small. We have a team of physiologists, a team of computer people and several nurse practitioners.”

  “No physicians?” asked Philips.

  “No,” said Michaels with a smile. “Wait! That’s not entirely correct. One of the neuroscience physiologists is an M.D.-Ph.D.”

  There was a silence for a few moments as the two men eyed each other.

  “One other thing,” said Michaels. “You, obviously and deservedly, will take full credit for the medical advances that will be instantly realized with the application of this new computer technology.”

  “Is that a bribe?” asked Philips.

  “No. It’s a fact. But it will make you one of the most celebrated medical researchers in the United States. You will be able to program the entire field of Radiology so that the computers will be able to do all the diagnostic work with one-hundred percent efficiency. That will be an enormous benefit to mankind. You yourself told me once that radiologists, even good ones, only function around seventy-five percent. And one last thing . . .” Michaels looked down and shifted his feet as if he was somewhat embarrassed. “As I said, I can only control the agents to a degree. If they think someone is a security risk, it’s out of my hands. Unfortunately Denise Sanger is now involved. She doesn’t know the specifics about this research, but she knows enough to jeopardize the project. In other words, if you choose not to accept this program, not only you, but Denise too, will be liquidated. I have no control over that.”

  At the mention of a threat against Denise, another emotion overwhelmed Philips’ sense of moral outrage. Hatred welled up inside of him. Only with great difficulty did he hold himself back from striking out in a fit of blind fury. He was exhausted and every nerve was drawn to its breaking point. It took every ounce of strength to force his mind back to rational thought. When he did, he was overcome by a feeling of futility in the face of the sheer power and momentum behind the project. Philips might have been able to sacrifice himself but he could not sacrifice Denise. A sad feeling of resignation settled over him like a smothering blanket.

  Michaels put his hand on Philips’ shoulder. “Well, Martin? I think I’ve told you everything. What do you say?”

  “I don’t think I have a choice,” said Martin slowly.

  “Yes you do,” said Michaels. “But it’s a narrow one. Obviously both you and Denise will stay under close surveillance. You will be given no chance to give the story to either Congress or the press. There are contingency plans for any eventuality. Your choice is merely between life for you and Denise or purposeless instant death. I hate to be so blunt. If you decide the way I hope you will, Denise will only be told that our research has had Defense Department application that you did not know about and that you became a mistaken security risk. She will be sworn to secrecy and that will be the end of it. It will be your responsibility to keep her from knowing the biological origins.”

  Philips took a deep breath, turning himself away from the row of glass cylinders. “Where is Denise?”

  Michaels smiled. “Follow me.”

  Retracing their steps back through the double vault-like doors and past the amphitheaters, the two men walked down the rubble strewn corridor, turning into the old medical-school administrative office.

  “Martin!” shouted Denise. She jumped up from a folding chair and rushed between two agents. Throwing her arms around Philips she burst into tears. “What has been happening?” she sobbed.

  Martin couldn’t speak. His pent-up emotions overflowed with joy at seeing Denise. She was alive and safe! How could he take responsibility for her death?

  “The FBI tried to convince me you had become a dangerous traitor,” said Denise. “I didn’t believe it for an instant, but tell me it isn’t true. Tell me this is all a bad dream.”

  Philips closed his eyes. When he opened them he found his voice. He spoke slowly, choosing his words with great care, because he knew Denise’s life was in his hands; they had him shackled for the moment, but he would find a way to break their hold someday, even if it took years. “Yes,” said Philips. “It’s all a bad dream. It’s all a terrible mistake. But it’s over now.”

  Martin tilted Denise’s face up and kissed her mouth. She kissed him back, secure that her feeling about him had been correct, that as long as she trusted him she would be safe. For a moment he buried his face in her hair. If individual life was important, then so was hers. For him more than anyone.

  “It’s over now,” she repeated.

  Philips glanced at Michaels over Denise’s shoulder and the computer expert nodded approval. But Martin knew it could never be over . . .

  THE NEW YORK TIMES

  * * *

  SC
IENTIST SHOCKS

  SCIENTIFIC

  COMMUNITY; SEEKS

  POLITICAL ASYLUM

  IN SWEDEN

  * * *

  STOCKHOLM (AP)—

  Dr. Martin Philips, the physician whose research has recently propelled him into international celebrity status, disappeared yesterday afternoon under mysterious circumstances in Sweden. Scheduled for a lecture at 1 P.M. at the famed Carolinska Institute, the neuroradiologist failed to appear in front of a packed audience. Along with the celebrated scientist, his wife of four months, Dr. Denise Sanger, also disappeared.

  Initial speculation suggested the couple sought seclusion from the attention that has been showered on them since Dr. Philips began unveiling his series of startling medical discoveries and innovations six months ago. That idea was abandoned, however, when it was learned that the couple had had surprisingly massive Secret Service protection and that their disappearance definitely depended on Swedish authorities’ cooperation.

  Inquiries to the State Department have been met with strained silence, which has been made more curious when it was learned that the affair had unleashed feverish activity on many U.S. government levels, seemingly out of proportion to the event. International curiosity, already peaked, was honed to a razor’s edge by the following prepared statement released late last night by the Swedish authorities:

  Dr. Martin Philips has asked for and has been granted political asylum in Sweden. He and his wife have been placed in political seclusion. Within twenty-four hours a document written by Dr. Philips will be released for the international community outlining a gross abrogation of human rights perpetrated under the aegis of medical experimentation. Until now, Dr. Martin Philips has been constrained from voicing his opinions by a consortium of vested interests including the United States government. After the document has been released, Dr. Philips will hold a press conference by video under the auspices of Swedish TV.