I’d never left the country; I hadn’t even moved house in a decade.
She came home only now and then, on her way between continents, but we’d stayed in touch electronically, circumstances permitting. (They take away your SatPhone in Bolivian prisons.)
The telecommunications multinationals all offer their own expensive services for contacting someone when you don’t know in advance what country they’re in. The advertising suggests that it’s an immensely difficult task; the fact is, every SatPhone’s location is listed in a central database, which is kept up to date by pooling information from all the regional satellites. Since I happened to have “acquired” the access codes to consult that database, I could phone Paula directly, wherever she was, without paying the ludicrous surcharge. It was more a matter of nostalgia than miserliness; this minuscule bit of hacking was a token gesture, proof that in spite of impending middle age, I wasn’t yet terminally law-abiding, conservative and dull.
I’d automated the whole procedure long ago. The database said she was in Gabon; my program calculated local time, judged ten twenty-three p.m. to be civilized enough, and made the call. Seconds later, she was on the screen.
“Karen! How are you? You look like shit. I thought you were going to call last week—what happened?”
The image was perfectly clear, the sound clean and undistorted (fibre-optic cables might be scarce in central Africa, but geosynchronous satellites are directly overhead). As soon as I set eyes on her, I felt sure she didn’t have the virus. She was right—I looked half-dead—whereas she was as animated as ever. Half a lifetime spent outdoors meant her skin had aged much faster than mine—but there was always a glow of energy, of purpose, about her that more than compensated.
She was close to the lens, so I couldn’t see much of the background, but it looked like a fibreglass hut, lit by a couple of hurricane lamps; a step up from the usual tent.
“I’m sorry, I didn’t get around to it. Gabon? Weren’t you in Ecuador—?”
“Yes, but I met Mohammed. He’s a botanist. From Indonesia. Actually, we met in Bogota; he was on his way to a conference in Mexico—”
“But—”
“Why Gabon? This is where he was going next, that’s all. There’s a fungus here, attacking the crops, and I couldn’t resist coming along…”
I nodded, bemused, through ten minutes of convoluted explanations, not paying too much attention; in three months’ time it would all be ancient history. Paula survived as a freelance pop-science journalist, darting around the globe writing articles for magazines, and scripts for TV programmes, on the latest ecological troublespots. To be honest, I had severe doubts that this kind of predigested eco-babble did the planet any good, but it certainly made her happy. I envied her that. I could not have lived her life—in no sense was she the woman I “might have been”—but nonetheless it hurt me, at times, to see in her eyes the kind of sheer excitement that I hadn’t felt, myself, for a decade.
My mind wandered while she spoke. Suddenly, she was saying, “Karen? Are you going to tell me what’s wrong?”
I hesitated. I had originally planned to tell no one, not even her, and now my reason for calling her seemed absurd—she couldn’t have leukaemia, it was unthinkable. Then, without even realizing that I’d made the decision, I found myself recounting everything in a dull, flat voice. I watched with a strange feeling of detachment the changing expression on her face; shock, pity, then a burst of fear when she realized—far sooner than I would have done—exactly what my predicament meant for her.
What followed was even more awkward and painful than I could have imagined. Her concern for me was genuine—but she would not have been human if the uncertainty of her own position had not begun to prey on her at once, and knowing that made all her fussing seem contrived and false.
“Do you have a good doctor? Someone you can trust?”
I nodded.
“Do you have someone to look after you? Do you want me to come home?”
I shook my head, irritated. “No, I’m all right. I’m being looked after, I’m being treated. But you have to get tested as soon as possible.” I glared at her, exasperated. I no longer believed that she could have the virus, but I wanted to stress the fact that I’d called her to warn her, not to fish for sympathy—and somehow, that finally struck home. She said, quietly, “I’ll get tested today. I’ll go straight into town. Okay?”
I nodded. I felt exhausted, but relieved; for a moment, all the awkwardness between us melted away.
“You’ll let me know the results?”
She rolled her eyes. “Of course I will.”
I nodded again. “Okay.”
“Karen. Be careful. Look after yourself.”
“I will. You too.” I hit the ESCAPE key.
Half an hour later, I took the first of the capsules, and climbed into bed. A few minutes later, a bitter taste crept up into my throat.
* * *
Telling Paula was essential. Telling Martin was insane. I’d only known him six months, but I should have guessed exactly how he’d take it.
“Move in with me. I’ll look after you.”
“I don’t need to be looked after.”
He hesitated, but only slightly. “Marry me.”
“Marry you? Why? Do you think I have some desperate need to be married before I die?”
He scowled. “Don’t talk like that. I love you. Don’t you understand that?”
I laughed. “I don’t mind being pitied—people always say it’s degrading, but I think it’s a perfectly normal response—but I don’t want to have to live with it twenty-four hours a day.” I kissed him, but he kept on scowling. At least I’d waited until after we’d had sex before breaking the news; if not, he probably would have treated me like porcelain.
He turned to face me. “Why are you being so hard on yourself? What are you trying to prove? That you’re super-human? That you don’t need anyone?”
“Listen. You’ve known from the very start that I need independence and privacy. What do you want me to say? That I’m terrified? Okay. I am. But I’m still the same person. I still need the same things.” I slid one hand across his chest, and said as gently as I could, “So thanks for the offer, but no thanks.”
“I don’t mean very much to you, do I?”
I groaned, and pulled a pillow over my face. I thought: Wake me when you’re ready to fuck me again. Does that answer your question? I didn’t say it out loud, though.
* * *
A week later, Paula phoned me. She had the virus. Her white cell count was up, her red cell count was down—the numbers she quoted sounded just like my own from the month before. They’d even put her on the very same drug. That was hardly surprising, but it gave me an unpleasant, claustrophobic feeling, when I thought about what it meant:
We would both live, or we would both die.
In the days that followed, this realization began to obsess me. It was like voodoo, like some curse out of a fairy tale—or the fulfilment of the words she’d uttered, the night we became “blood sisters.” We had never dreamed the same dreams, we’d certainly never loved the same men, but now … it was as if we were being punished, for failing to respect the forces that bound us together.
Part of me knew this was bullshit. Forces that bound us together! It was mental static, the product of stress, nothing more. The truth, though, was just as oppressive: the biochemical machinery would grind out its identical verdict on both of us, for all the thousands of kilometres between us, for all that we had forged separate lives in defiance of our genetic unity.
I tried to bury myself in my work. To some degree, I succeeded—if the grey stupor produced by eighteen-hour days in front of a terminal could really be considered a success.
I began to avoid Martin; his puppy-dog concern was just too much to bear. Perhaps he meant well, but I didn’t have the energy to justify myself to him, over and over again. Perversely, at the very same time, I missed our arguments terribly;
resisting his excessive mothering had at least made me feel strong, if only in contrast to the helplessness he seemed to expect of me.
I phoned Paula every week at first, but then gradually less and less often. We ought to have been ideal confidantes; in fact, nothing could have been less true. Our conversations were redundant; we already knew what the other was thinking, far too well. There was no sense of unburdening, just a suffocating, monotonous feeling of recognition. We took to trying to outdo each other in affecting a veneer of optimism, but it was a depressingly transparent effort. Eventually, I thought: when—if—I get the good news, I’ll call her; until then, what’s the point? Apparently, she came to the same conclusion.
All through childhood, we were forced together. We loved each other, I suppose, but … we were always in the same classes at school, bought the same clothes, given the same Christmas and birthday presents—and we were always sick at the same time, with the same ailment, for the same reason. When she left home, I was envious, and horribly lonely for a while, but then I felt a surge of joy, of liberation, because I knew that I had no real wish to follow her, and I knew that from then on, our lives could only grow further apart.
Now, it seemed that had all been an illusion. We would live or die together, and all our efforts to break the bonds had been in vain.
* * *
About four months after the start of treatment, my blood counts began to turn around. I was more terrified than ever of my hopes being dashed, and I spent all my time battling to keep myself from premature optimism. I didn’t dare ring Paula; I could think of nothing worse than leading her to think that we were cured, and then turning out to have been mistaken. Even when Dr Packard—cautiously, almost begrudgingly—admitted that things were looking up, I told myself that she might have relented from her policy of unflinching honesty and decided to offer me some palliative lies.
One morning I woke, not yet convinced that I was cured, but sick of feeling I had to drown myself in gloom for fear of being disappointed. If I wanted absolute certainty, I’d be miserable all my life; a relapse would always be possible, or a whole new virus could come along.
It was a cold, dark morning, pouring with rain outside, but as I climbed, shivering, out of bed, I felt more cheerful than I had since the whole thing had begun.
There was a message in my work station mailbox, tagged CONFIDENTIAL. It took me thirty seconds to recall the password I needed, and all the while my shivering grew worse.
The message was from the Chief Administrator of the Libreville People’s Hospital, offering his or her condolences on the death of my sister, and requesting instructions for the disposal of the body.
I don’t know what I felt first. Disbelief. Guilt. Confusion. Fear. How could she have died, when I was so close to recovery? How could she have died without a word to me? How could I have let her die alone? I walked away from the terminal, and slumped against the cold brick wall.
The worst of it was, I suddenly knew why she’d stayed silent. She must have thought that I was dying, too, and that was the one thing we’d both feared most of all: dying together. In spite of everything, dying together, as if we were one.
How could the drug have failed her, and worked for me? Had it worked for me? For a moment of sheer paranoia, I wondered if the hospital had been faking my test results, if in fact I was on the verge of death, myself. That was ludicrous, though.
Why, then, had Paula died? There was only one possible answer. She should have come home—I should have made her come home. How could I have let her stay there, in a tropical, Third World country, with her immune system weakened, living in a fibreglass hut, without proper sanitation, probably malnourished? I should have sent her the money, I should have sent her the ticket, I should have flown out there in person and dragged her hack home.
Instead, I’d kept her at a distance. Afraid of us dying together, afraid of the curse of our sameness, I’d let her die alone.
I tried to cry, but something stopped me. I sat in the kitchen, sobbing drily. I was worthless. I’d killed her with my superstition and cowardice. I had no right to be alive.
I spent the next fortnight grappling with the legal and administrative complexities of death in a foreign land. Paula’s will requested cremation, but said nothing about where it was to take place, so I arranged for her body and belongings to be flown home. The service was all but deserted; our parents had died a decade before, in a car crash, and although Paula had had friends all over the world, few were able to make the trip.
Martin came, though. When he put an arm around me, I turned and whispered to him angrily, “You didn’t even know her. What the hell are you doing here?” He stared at me for a moment, hurt and baffled, then walked off without a word.
I can’t pretend I wasn’t grateful, when Packard announced that I was cured, but my failure to rejoice out loud must have puzzled even her. I might have told her about Paula, but I didn’t want to be fed cheap cliches about how irrational it was of me to feel guilty for surviving.
She was dead. I was growing stronger by the day; often sick with guilt and depression, but more often simply numb. That might easily have been the end of it.
* * *
Following the instructions in the will, I sent most of her belongings—notebooks, disks, audio and video tapes—to her agent, to be passed on to the appropriate editors and producers, to whom some of it might be of use. All that remained was clothing, a minute quantity of jewellery and cosmetics, and a handful of odds and ends. Including a small glass vial of red-and-black capsules.
I don’t know what possessed me to take one of the capsules. I had half a dozen left of my own, and Packard had shrugged when I’d asked if I should finish them, and said that it couldn’t do me any harm.
There was no aftertaste. Every time I’d swallowed my own, within minutes there’d been a bitter aftertaste.
I broke open a second capsule and put some of the white powder on my tongue. It was entirely without flavour. I ran and grabbed my own supply, and sampled one the same way; it tasted so vile it made my eyes water.
I tried, very hard, not to leap to any conclusions. I knew perfectly well that pharmaceuticals were often mixed with inert substances, and perhaps not necessarily the same ones all the time—but why would something bitter be used for that purpose? The taste had to come from the drug itself. The two vials bore the same manufacturer’s name and logo. The same brand name. The same generic name. The same formal chemical name for the active ingredient. The same product code, down to the very last digit. Only the batch numbers were different.
The first explanation that came to mind was corruption. Although I couldn’t recall the details, I was sure that I’d read about dozens of cases of officials in the health care systems of developing countries diverting pharmaceuticals for resale on the black market. What better way to cover up such a theft than to replace the stolen product with something else—something cheap, harmless, and absolutely useless? The gelatin capsules themselves bore nothing but the manufacturer’s logo, and since the company probably made at least a thousand different drugs, it would not have been too hard to find something cheaper, with the same size and colouration.
I had no idea what to do with this theory. Anonymous bureaucrats in a distant country had killed my sister, but the prospect of finding out who they were, let alone seeing them brought to justice, were infinitesimally small. Even if I’d had real, damning evidence, what was the most I could hope for? A meekly phrased protest from one diplomat to another.
I had one of Paula’s capsules analysed. It cost me a fortune, but I was already so deeply in debt that I didn’t much care.
It was full of a mixture of soluble inorganic compounds. There was no trace of the substance described on the label, nor of anything else with the slightest biological activity. It wasn’t a cheap substitute drug, chosen at random.
It was a placebo.
I stood with the print-out in my hand for several minutes, trying to come to ter
ms with what it meant. Simple greed I could have understood, but there was an utterly inhuman coldness here that I couldn’t bring myself to swallow. Someone must have made an honest mistake. Nobody could be so callous.
Then Packard’s words came back to me. “Just look after yourself as you normally would. Don’t do anything out of the ordinary.”
Oh no, Doctor. Of course not, Doctor. Wouldn’t want to go spoiling the experiment with any messy, extraneous, uncontrolled factors …
* * *
I contacted an investigative journalist, one of the best in the country. I arranged a meeting in a small café on the edge of town.
I drove out there—terrified, angry, triumphant—thinking I had the scoop of the decade, thinking I had dynamite, thinking I was Meryl Streep playing Karen Silkwood. I was dizzy with sweet thoughts of revenge. Heads were going to roll.
Nobody tried to run me off the road. The café was deserted, and the waiter barely listened to our orders, let alone our conversation.
The journalist was very kind. She calmly explained the facts of life.
In the aftermath of the Monte Carlo disaster, a lot of legislation had been passed to help deal with the emergency—and a lot of legislation had been repealed. As a matter of urgency, new drugs to treat the new diseases had to be developed and assessed, and the best way to ensure that was to remove the cumbersome regulations that had made clinical trials so difficult and expensive.
In the old “double-blind” trials, neither the patients nor the investigators knew who was getting the drug and who was getting a placebo; the information was kept secret by a third party (or a computer). Any improvement observed in the patients who were given the placebo could then be taken into account, and the drug’s true efficacy measured.
There were two small problems with this traditional approach. Firstly, telling a patient that there’s only a fifty-fifty chance that they’ve been given a potentially life-saving drug subjects them to a lot of stress. Of course, the treatment and control groups were affected equally, but in terms of predicting what would happen when the drug was finally put out on the market, it introduced a lot of noise into the data. Which side-effects were real, and which were artifacts of the patients’ uncertainty?
The Year's Best SF 09 # 1991 Page 26