I continue to struggle with the “NLH” distinction. It feels legalistic and rationalizing; it is not at all grounded in science OR religion. It is about moving forward, having some kind of plan, some response to the outbreak, except it really feels like moving backward. Things were barbaric enough before this plague. At least until now we’ve had our humanity. Now we have more narrowly defined even that.
Is someone born with a genetic malformation human? Their genes are different, and genes, or at least chromosomal counts, are how we’ve always defined species. But someone with abnormal chromosomal counts is still human. Those born without limbs, without speech, without the capacity to feel… someone born even without a brain is still one of us. You taught me that. We are all God’s creatures, all created in His image.
I have just accepted a position at the newly established UN bunkers in the South Pacific. This is a secret compound, but I am tired of secrets. I do not think this is premature for me to leave if I am to do any good, and if there were any way I could take you and all of the children of the village with me, I would. But then I couldn’t go, because they wouldn’t let me. And I’d stay here, along with you and everyone else, and we’d waste away, and change, and we’d feed. Would we still be human, Father? Would you? If we changed, would we still be able to receive His blessing?
So, I ask your pardon.
This note is like Confession. I can remember you when I was a child. You chuckled, and don’t think I didn’t hear you! You chuckled when I admitted to taking some candy from my brother. A “Hail Mary,” you gave me, and then you wished my family well and me. Isn’t that against the rules, to let me know so directly that you know me?
And you kissed me on both cheeks when I came back to our village after completing my studies. You praised my commitment to God’s miracles of life. You told me I would save many lives, and you told me you were proud. When Papa died, you said that also. How did you know, when I was so young, that I would always want to know more?
And now, I have had to make a choice that only the Devil himself could devise. I have created a protocol, a method, to stave off the disease, to slow the progression of the horrible madness, but in so doing I doom us all to die as humans, make martyrs of those who do nothing but breathe.
I have never felt this way before. I have always known of bad answers. But what to do when the questions themselves no longer suffice?
GUTIERREZ’S INITIAL DESCRIPTION OF ACID–BASE MANIPULATION TO DECREASE VIRULENCE OF THE PRION COMPONENT OF ANSD
A. Primary Known Facts:
1. There is a prion component to ANSD.
2. Prions in ANSD infect higher brain regions first.
3. Progression of prion infiltration into brain tissue increases stages of ANSD (i.e., increased prion infection within an individual brain causes progression from Stage II to Stage III and so forth…).
4. Prions are more virulent and damaging in low pH—more acidic—environments.
5. This is because prions bend into more actively infectious shapes with decreasing pH.
6. Infection from ANSD increases the normal immune response of the body, resulting in a lowering of pH—an increase in acidity—thus propelling the prion infection.
B. Primary Hypothesis:
1. Can internal pH be artificially raised to stop prion infectivity?
a. known fact—we CAN artificially raise pH
i. administer bicarbonate
ii. increase urination using medications
iii. this process is itself potentially toxic
• Toxicity from increased pH—seizures
• Toxicity from increased pH—tetanus
• Toxicity from increased pH—respiratory difficulties
• Toxicity from increased pH—confusion
• Toxicity from increased pH—dangerous heart rhythms
• Toxicity from increased pH—DEATH
b. known fact—we CAN reverse the effects of artificially raising the pH
i. administer acidic compounds
ii. alter respiratory status
iii. stop numbers i, ii, and iii from above
c. known fact—reversal of artificially raised pH will lead to progression of prion infection
C. Primary Confounders:
1. Death can result from artificially increased pH.
2. NLH status (“death”) can result from ongoing prion infection.
3. The symptoms of artificially increased pH are very similar to the symptoms of ANSD progression.
D. Necessary Components:
1. Must be able to measure internal pH in real time.
2. Must be able to alter internal pH in real time.
3. Must be able to monitor for abnormal heart rhythms in real time.
NOTE: The process will inevitably lead to “death” either via uncontrolled ANSD progression or fatal pH elevation.
APPENDIX VII
FLOW CHART FOR IMPLEMENTATION AND POSSIBLE OUTCOMES FOR TREATMENT OF ANSD
THERE HAVE BEEN QUESTIONS…
Here’s the thing. If you tell people that you’re going to write a Zombie book, that you have a major publisher like Grand Central Publishing willing to publish your Zombie book, that you will be attending—along with your usual set of work venues—gatherings with titles like “Scarefest” and “Spooky Empire,” and that all the while you intend to continue in your position as a somewhat respected (or at least competent) physician at a relatively well-known and august institution (like Harvard), you sort of shut the conversation down. It goes like this:
Mentor/Boss/Spouse/Colleague/Parent and so forth, hereafter referred to as
“Anyone”: Hey Steve, whatcha doing these days?
Me: Well, I’m working on a Zombie novel.
Anyone: Uh-huh.
(Mild smile from the Anyone who is addressing me. Steve, after all, has been working hard.)
Then there is The Pause.
Anyone tries again.
Anyone: So… seriously, whatcha been up to?
(Notice the feigned appearance of recognition that we are in fact just “shootin’ the shit.” But I’m a shrink. Subtle cues in language, changes in body posture… all this stuff matters to me. And Anyone isn’t being subtle here. Anyone in fact looks pretty worried about me. But I’m having fun, some of the most fun I’ve ever had.)
So I tell Anyone: I’m actually, really writing a Zombie novel.
There is, of course, another pause. Then there are the inquiries, the concerns for my health, for the health of my family, for whether or not I am eating well or getting enough sleep. But, inevitably, Anyone just can’t take it anymore.
Anyone: Really? A Zombie novel. You mean like in the movies? Like the ones that eat people?
Me: Yep… an honest-to-goodness Zombie novel.
Some of the Anyones then gather their strength and ask the really tough question.
Anyone: Are they real? Zombies, I mean? They don’t, you know, exist… do they?
And that is how it starts.
This is the beginning of the very long list of inquiries, ponderings, curious concerns—all quite reasonable given the circumstances.
I’ve kept track of these questions (I have a file on my desktop called “Zombie questions”), and I have saved pretty much every e-mail I’ve ever received about the creation of this book. For this paperback edition, I’d love to answer some of these questions to set the record straight.
Let’s start with the question that poor Anyone asks above.
QUESTION #1:
Are Zombies real?
I’ve learned to answer this question with the expectation that I will disappoint many people. Nevertheless, I respond truthfully, in part because I think I have an obligation to be truthful based on the oath I took as a physician, and in part because I am in general a crappy liar. Zombies, whether slow or fast, infected or contaminated, reanimated or never dead in the first place—ALL iterations of the cinematic wanderers who mindlessly crave human flesh—well, they
ain’t real. They don’t exist.
Yet.
“Booooo!!” That’s what I got at Comic-Con. “Hissssss,” they said. They were bummed. These folks, lots of folks, wanted Zombies to be real, wanted the Walking Dead to be waiting for them at Starbucks or in the classroom or just standing there in an otherwise serene riverbed.
“Are you people crazy?” another of the panelists retorted. “Have you not seen the movies I’ve seen? A Zombie outbreak would totally suck.”
But I get it, I think, or at least some of it. And I am always quick, therefore, to add that Zombies as we know them from guys like George Romero are brilliantly conceived ghouls that play to our worst and most iconic nightmares. Who hasn’t been frightened in the dream when the attacker is slow but never stops? Who hasn’t wanted to just end the madness of the pursuit of that slow attacker and blow its head off? And yet, there are always more attackers just around the corner.
Zombies are the feeling we get when we see a line out the door at the Department of Motor Vehicles. They’re the ten billion other people on hold with you when you wait on the phone to talk to your HMO about why your bill is so high. They are the ones who are maddeningly unmoved, or at least appear to be maddeningly unmoved, by the pervasive stench of Muzak in elevators and call centers. They neither hate nor love The Jersey Shore. They’re as mindless as the common cold virus that creeps back into your house at the start of every school year.
And in that sense, they exist, all right. Because Zombie stories aren’t about Zombies. They’re about people’s reactions to Zombies. And I know that my desire to declare Armageddon appears whenever I am told to stand in that bedraggled queue that the bored-looking airline employees direct me toward whenever the airline has lost my luggage. (But remember: It’s not about me. Hell, they lose everybody’s luggage). And if I decide to go all Hulk on the airline, glowing green and muscular with radioactive rage, it really won’t help at all. Raising any manner of Hell ain’t gonna move that line. My tantrum will get me at best a dirty look and at worst a pair of handcuffs.
We can’t all be Michael Douglas in Falling Down.
But, we could be Michael Douglas in Falling Down if there were Zombies.
So, just as Freud described dreams as forbidden wishes, perhaps the nightmare of the Zombie is the hidden verboten desire for societal permission to Totally. Go. Berserk.
Do Zombies exist? No. Do we act like they do? All the time. And therein lies the fun and the wisdom and the abiding caution of the Zombie trope. We don’t need Zombies as permission for violence. We need Zombies to get us to appreciate just how violent we can be.
This question passes, then, and I become aware that I have once again delivered a lecture where a sentence or two would have worked just fine (you’d understand this tendency if you grew up in my family). And we make our way to the next most common question.
QUESTION #2
“Could we make one? Could we make a real Zombie?”
And that question has come to me from physicians and teachers and screenwriters and authors and my own parents, bless their hearts.
Popular Science magazine asked me if we could make a Zombie. NPR asked me this on both Science Friday and On Point. The Boston Globe, The Boston Herald, and The Boston Phoenix asked. Hell, the Harvard Medical School Magazine wondered about this, and the Stanford Magazine made it a focal part of their article about my book. To be sure, no one wanted to know how to make a Zombie. That would be like telling the enemy in a war how to build something really awful. They just wanted to know if it could be done.
And, again, just as with the inquiry about the existence of Zombies, I’d say, “not really.” It is really, really hard to come up with a contagion or a brain lesion or a disease process that would produce the famous Hare Krishna Zombie in Dawn of the Dead. Weirdly, the behavior of the Zombie isn’t the hard part. There are lots of things that partially make people act like a modern horror Zombie. And I’m not talking about the more conventional and truthful Zombie of island and African religions. I’m talking staggering, flesh-eating, stupid as hell Zombies right out of the movies. We could get a human to look an awful lot like a Zombie, but that’s not the hard part.
The hard part? We can’t raise the dead. A true Zombie—and this comes to me from all sorts of reputable sources, including Mr. Romero himself—must first be dead and then come back to life. They must reanimate. And this just doesn’t happen all that often.
So, as anyone who has read this book knows, I decided that “death” was itself a construct. This idea is not at all outlandish. If you work in a hospital, then you’ve very likely openly and seriously struggled with this issue. When is the quality of life, the state of life itself, the same as being “as good as dead”? I’m not taking a stand on the answer here, largely because I don’t think there is a universal stand to be taken. These questions are uniquely and immensely individual inquiries. Culture, law, religion, science, and even existential philosophy all play a role. But, just as in the hospital, at a certain point we have to decide. For every case where this question emerges, we must find some consensus as a society. Otherwise, some argue, we mire ourselves in intolerable ambiguity.
If Zombies were out there and if every day we had more Zombies to fight, then we’d need to feel comfortable killing. As a rule, I don’t believe that most humans are entirely comfortable killing anyone.
But we also know from our shameful human history that once we legalize our classifications to include categories that call others something less than human, we get better and more comfortable with our nasty sides. So my guess, and it is I think an informed guess, is that we’d decide that Zombies do not live at all and therefore there is nothing to kill. We de-animate Zombies. We don’t annihilate them. Why?
First of all, we’d have pattern recognition. My book takes place in a world where Zombie movies are known and actually banned. We’d see those who are infected with ANSD and decide that they’re Zombies, and then we’d decide from that observation that Zombies are dead, which leads to the belief that we aren’t in fact killing anything at all when we bash in their heads as Shaun does with his cricket bat.
However, we have our pesky conscience to deal with. Neurobiologically, that conscience is some kind of epic battle fought with mirror neurons, frontal lobes, memories, and our primitive and competing desires to create and to destroy. If we take that internal battle away from our enemies (Zombies don’t have a conscience; Zombies don’t really have much of a brain at all), then we find our conscience resting substantially easier as we smash in a Zombie’s head with a fireplace tool.
But look at what happens to Pittman in this book. Look at how he screws it all up. It ain’t the Zombies that spread blood all over Gutierrez’s papers. It’s a still-functional human who brings us all down.
When it comes to Zombies, I’d say the biggest threat is ourselves. Give a man a gun and a slow-shambling Zombie, give that man a fifty-minute head start, and put that man near a bunker with food for a year. That man, nine times out of ten, is gonna shoot that Zombie. He doesn’t need to, but it’s a freebie. A one-way invitation to the dark side of all of us, and that lesson feels more real to me than any Zombie ever can be.
QUESTION #3
Are you more worried about the slow or the fast moving Zombies?
This came up for the first time at Spooky Empire, a wonderful annual gathering of horror enthusiasts in Orlando. I suggested there that we stage an Oxford-Style Debate in which I would resolve that “slow-moving Zombies are way more frightening than fast ones.”
My opponent in the debate was formidable. His qualifications were scary. Kevin A. Ranson, a well-known author and horror movie critic, was without reservation in his assertion that fast Zombies are way worse than slow ones.
And he might be right for some people. I think I lost the debate, though it was close judging from the response in the audience.
But I can’t escape my nightmare, just as I can’t escape a shambling corpse. A fa
st-moving Zombie has its sights set on me. On ME! It wants me, and that’s at least worth something, right? I mean, if it’s gonna tear out my viscera, I want it to specifically want MY viscera. At least then it’s personal. And if its personal I’m gonna have a much easier time blowing its head off.
But the slow ones? The ones that stare at me with dead eyes? The ones that would just as easily kill a complete stranger as me? The ones that find me entirely unremarkable but will always turn towards me if I so much as gasp? They scare the pants off me precisely because it ain’t personal. The slow Zombies are viruses incarnate, and viruses do not have preferences. That lack of awareness in the Zombie, that total blankness of life, gives me time to think. And time to think, for humans, is our best and worst enemy. In my book, time to think leads us to nuking half the planet. In my book, time to think leads folks to not believe a word about the spreading contagion until it’s too late. And in my nightmares, time to think buys me nothing but the chance to screw up. And if I screw up, God help me.
The Zombie Autopsies: Secret Notebooks from the Apocalypse Page 11