by Kira Peikoff
“Zoe Kincaid.”
The girl typed a few words, paused, and then looked Zoe full in the face. The corners of her mouth twitched down, though it was hard to read her expression. Was it pity? Fear?
“What’s wrong?” Zoe asked.
The girl’s face smoothed into a professional smile. “Dr. Carlyle will be right with you, sweetie. Come this way.” She walked around to the front of the desk, towering in her heels above Zoe, and extended a hand out to her.
“It’s okay, I’m not a kid,” she said wearily. “I’m probably older than you are.”
The girl drew back her hand with a frown, looking her up and down. Zoe could only shrug.
They walked down an antiseptic hallway to a tiny room, where she soon found herself alone under the glare of fluorescent tube lights. She climbed onto the examining table and kicked her heels against the strip of translucent paper stretched across it.
She had lied to the receptionist out of grown-up duty, but to herself she could admit the truth—she did want a hand to hold. As the doctor’s knock loomed, all she could focus on was the emptiness of the chair in the corner. Its white plastic sheen radiated loneliness like heat. She closed her eyes and pictured Gramps sitting there, inevitably distracting her with an off-color joke—Maybe he’ll help you fill out. Better late than never, right? She looked around the room at its starchy white walls and desk covered by an array of plastic gloves, tubes, cotton balls, and the harsh orange soap that carried an aroma of despair. The one photograph on the wall showed a sepia image of Half Dome, the gigantic rock at Yosemite. Zoe was reminded of her favorite ride at Disneyland, Indiana Jones, where in its climactic finale, the car lurches toward an oncoming massive boulder. Trapped inside a cave with no apparent exit, all seems lost—and even on second and third rides, this hopelessness had overcome her—when at the last moment, the bottom of the cave drops out to reveal the road to safety.
Stuck inside this room now, with no apparent trapdoor in the ground, Zoe knew that this time, she really was about to be steamrolled. Was it too late to slip out unnoticed? To cling to the safe notion that she was simply an obsessive hypochondriac? Rather than gravely ill, perhaps fatally—
A loud rap on the door startled her. She stiffened, bracing for Dr. Carlyle’s face. His expression would tell her everything. The door pushed open and he walked in, carrying a hefty file under his arm. Reserved, serious, he briefly made eye contact and nodded hello. His lips formed a curt smile, without showing teeth. The permanent wrinkle between his gray eyes looked deeper than ever. This was all wrong. She waited—hope dropping off by the second—for his cheerful welcome or buoyant handshake, but his earlier confidence that had so reassured her was gone. He turned around to face his computer and spoke with his back to her.
“Zoe, how are you?”
In her mind, fire engines blared a five-alarm emergency through every neuron. I’m dying. It’s over. She wondered if she could find her voice, but then reminded herself that she had chosen this route. Reality. After so many years in hiding, she was going to claim it.
“I’m here,” she said.
Dr. Carlyle turned to face her and sat down on his black swivel chair. He glanced down at her encyclopedic file, licking his lips.
“Please, just tell me now if it’s curable,” she pleaded. “Whatever it is.”
“I—I’m afraid not.” His apologetic tone was a death sentence. “Not that we know of, but—”
She felt her jaw sag, saw his image blur like a fun-house hologram. All that registered was skin-prickling horror—her body’s blanket of dread ignited with an acid torch. His next words barely penetrated.
He touched her arm. “Zoe, did you hear me?”
“What?”
“It’s not what you think,” he said.
“I have a brain tumor, don’t I?” she choked out. “I knew it.”
“Your brain is perfectly healthy. It’s not what anyone thought.”
She wiped the tears from her eyes. “What does that even matter now? How long do I have?”
“Let’s back up a second.” His tone was firm, but not unkind. “I want to go over your test results. Are you with me?”
“Can’t you just give it to me straight?”
“There’s no name for your condition, Zoe. Not yet. That’s why I want to go over everything with you very carefully, so you understand what we’re dealing with.”
“Huh?” This was so far afield of her expectations that she almost laughed. “What are you talking about?”
“Let’s go over your tests one by one. The MRI of your brain showed that your corpus callosum is not perfectly formed, lacking some of the posterior body and splenium that we would expect in a twenty-year-old woman, but your cognitive functions have remarkably continued to develop, if a bit slower than normal, due to the plasticity of the neurons and neuronal circuits.”
She let his words hang in the air, struck by the bizarreness of using her frazzled brain to process news about her brain. Her head began to throb. “So? What does that mean?”
“In an otherwise normal adult, it could be meaningless. Statistical deviations from the general population happen all the time. But”—he shuffled his notes to a new page—“your full-body X-ray shows that your growth plates never closed.”
“Growth plates?”
“The soft parts at the end of each of our bones that help contribute length to the bones as we grow. In females, the plates usually close after puberty, around age fourteen to seventeen.”
She shifted on the examining table, her feet twitching with a desire to run, run away as fast as she could. “But I never really hit puberty.”
“Right. The question these results all boil down to is, Why not? You’ve been the same height and weight for years and you’ve never menstruated. We also analyzed your recent radiographic dental scans and compared them with similar tests that Dr. Harrington performed when you went to see him for the growth hormone treatment. When you were fourteen.”
“I remember,” she said. “It did nothing.”
“No one could have guessed at the truth then, but now enough time has passed so that the results are quite shocking.” Dr. Carlyle looked bewildered, but also strangely hyper. She noticed that his hands were trembling.
“Your teeth,” he went on, “normally change from childhood through adolescence. But yours haven’t changed since you were fourteen.”
“I’m . . . I’m not sure I get it.”
“One final result,” he said. He leaned back and crossed his legs in an imitation of composure, though his knuckles were white around his pen. “Anthropometric measurements show that your weight, height, and body mass index are less than the second percentile for a typical twenty-year-old woman. So now you see what I’m getting at.”
“No.” Her fingertips tingled with anxiety. “What?”
“Zoe.” He stared at her in open awe. “You stopped aging six years ago. You’re physiologically fourteen years old.”
CHAPTER 4
New York City
9:25 A.M.
Zoe didn’t know how much time passed before she spoke again.
“That’s ridiculous,” she breathed. “I’m twenty.” Though instantly, she knew he was right. She closed her eyes as nausea bloomed in the pit of her stomach, spreading upward.
I’m still a kid.
She looked down at her arms and legs, touched her face. Her skin felt cold. She dug her nails into her cheeks to see if they were still hers. Pain bit. She pulled back her hands in surprise, staring at her rounded nails. Child-sized nails. Finally she looked up at Dr. Carlyle, speechless. He reached for her hand, pressing it between his own. The unexpected kindness hastened fresh tears. She clutched him like a lifeline, letting go of all propriety. He squeezed back.
“But how?” she managed to choke out. “Why?”
“We just don’t know. My hypothesis is that it might stem from a disruption of the master regulator gene, which no one’s identified yet, bu
t which is thought to exist.”
“What?” It was hard to comprehend anything outside of her shock.
“It’s an idea that was first proposed in 1932 by a British marine biologist, who proposed that there’s a master gene that guides organisms through development, aging, and eventually death. But if this gene were disrupted, a chain reaction would occur throughout the body—which could explain your failed growth and seizures. Needless to say, this is only a guess. It merits much closer study, of course.”
An astonishing thought swept through her with such force that she sagged against the wall. “Wait, am I not about to die?”
“I was just getting to that.” A smile crept onto his lips. “I see no evidence that your body is breaking down. In fact, quite the opposite. Your heart, lungs, and bones are in peak condition.”
“My God.” She closed her eyes again. “I was about to . . . I don’t know what . . .”
“I understand. This is all very overwhelming.” He paused. “But once things settle down, I hope you’ll realize how valuable a contribution you could help make. You’re nearly unprecedented, Zoe.”
She withdrew her hand from his and wiped her tear-stained face. “Nearly?”
“There’s only one other case in the literature that comes close. A girl, Victoria Janzen, born in 1980 in Australia, whose growth stopped completely at around nine months old. She lived eighteen years as a baby, and no one could figure out why. Just like you, the only things that grew were her hair and nails. They called it Syndrome X. Unfortunately she passed away after a sudden seizure in 1998, about two years before the first human genome was sequenced. They didn’t have the antiepileptic medication then that you’re taking today. But many of my colleagues today believe she was the one and only recorded case of a disruption of the master regulator gene.”
Zoe exhaled a deep breath she didn’t know she was holding. Dr. Carlyle watched her, allowing her to absorb the full weight of his words.
“Why did Victoria stop aging as a baby, and I stopped at fourteen?”
He shrugged. “It’s a good question. I would guess that the idiopathic metabolic disorder that prevented you from reaching puberty somehow partially turned off your master gene.”
“Only partially?”
“Your cognitive growth has not been severely affected, so whatever mutation you have, it’s pretty much just compromised the physiological part of the gene’s expression. In other words, your mental age has been able to advance somewhat beyond your physical age.”
“But not Victoria’s?”
“Right. I’m guessing she had a mutation that turned off the entire gene. But I can’t say for sure.”
A more pressing concern was already spilling out of her lips. “If they had the medicine, could Victoria have lived forever?”
“Forever is a very long time,” he said, rubbing his chin. “What we do know is that there’s no known upper limit of human longevity. Every generation pushes the boundary. There’s nothing in nature that says we have to age.”
She balked. “So you’re saying I might live to be a thousand?”
“I wouldn’t necessarily go that far. Even if you’re not susceptible to aging, there’s still a million other ways to die—sicknesses, injuries, et cetera. It’s not as if you’re immortal. And anyway, we don’t know what effect this condition will have on your organs long-term”—Zoe opened her mouth to interrupt, but he beat her to it—“though how long is long-term, I really can’t say.”
“How could I be only fourteen?” She squeezed her throbbing temples with the heels of her hands. “I have a driver’s license, a high school diploma. I just babysat a girl that age last week!”
Dr. Carlyle tilted his head, eyes widening. “What was that like?”
The girl, Bethany, was the daughter of her parents’ friends, and Zoe had been doing them a favor by staying the evening while they went out. But it had felt less like a chore than a get-together—watching Harry Potter on Blu-ray, baking brownies, and paging through a titillating copy of Seventeen magazine. Zoe had felt so comfortable that night, never once feeling self-conscious about her lack of alcoholic tolerance, political interests, or a boyfriend—the triple threat of grief in college—but thought little of it afterward.
“It was fun,” she admitted. “But . . . still . . . this is crazy. I can’t wrap my head around it.”
“Take your time,” he said gently. “I have a psychologist on staff who would be happy to see you whenever you’d like . . .”
“What am I supposed to do with my life now?” she blurted out. “What about college?”
“That can be sorted out later. First, go home, talk to your family, spend some time taking this in.”
“All I want to do is grow up,” she whispered. “That’s all I’ve ever wanted.”
Dr. Carlyle faltered for a moment. “I’d be happy to schedule your first session with—”
She shook her head. “Do you think, if you study me, you could figure out a way to make me age?”
He smiled as if at a child’s amusing remark. “You know, most people would ask the opposite.”
She was in no mood for irony. “Could you?”
“Well, if we can first learn what’s stopping it in you, the goal would then be to manipulate the genes to turn them on or off at will. So it’s possible, but it could take a long time, a very long time.”
“Centuries?”
“Maybe not that long. Could be decades, unless some genius gets us there faster.”
“Aren’t you a genius?”
He smiled. “I don’t specialize in aging research, but I have brilliant colleagues who do. They would want to sequence your entire genome.”
“Will it hurt?”
“Not much. It’s only drawing blood.”
“And a genome is like all my genes together?”
“Sorry, I should have explained.” He leaned back in his chair and folded his hands over his knee. “Yes, your genome is the entirety of all the information you’ve inherited, encoded in your DNA. At Columbia, I teach my students to think of a genome like a book. It has twenty-three chapters, which are your chromosomes, and in each chapter there are roughly forty-eight to two hundred fifty million letters. Those letters spell out all your genes, which determine your characteristics. The whole book fits into a cell nucleus the size of a pinpoint, and there’s a copy of it in pretty much every cell in our bodies. So when we sequence a genome, we examine about ninety-eight percent of those three billion letters to see if we can find any unusual spellings—any clues unique to your body at the molecular level.”
She took a deep breath. “I see,” she said. Though she didn’t, not really. The scale was impossible to grasp. How could billions of letters fit into a single cell that you couldn’t even see? Even though she’d taken biology as a one-semester requirement in high school, the subject had never felt real or urgent until now. “So,” she said, wanting desperately to understand, “you think I have misspellings, right?”
“Exactly, called mutations.”
“And—and how would those affect your overall hypothesis? About the master gene?”
“The master regulator gene,” he said, smiling. “Well, today, we think of genes as ripples in a pond, not as isolated entities. So if the master regulator gene was disrupted, it could set off mutations in other genes that affect aging, which could cause other mutations, and so forth. They can also just happen randomly. So finding mutations in you wouldn’t necessarily prove my hypothesis. The key is to locate mutations that lead to the master regulator gene itself.”
“Okay,” she said. “I think that makes sense.”
He reached into his briefcase at the foot of the desk, pulled out a well-worn hardcover book, and handed it to her. On the bright blue cover were the swirly letters A, T, G, and C, and a title: The Genomics Age: How DNA Technology Is Transforming the Way We Live and Who We Are.
“It’s a primer I assign undergrads in Intro to Genetics,” he explained. �
�You’re quite precocious, Zoe. Listen to me, don’t underestimate yourself because of a number. Read this book and you’ll get a better idea of what I’m talking about. I can tell you want to.”
She hugged the book to her chest gratefully. “ ‘Why’ was my first word,” she said. “My grandpa is forever proud of that.”
Gramps. She couldn’t wait to go home and collapse into his arms. He would be the air above water.
“I should go,” she said, sliding off the examining table. Her feet dropped to the floor with a shaky thud.
“Call me when you’re ready to go forward, or if you need anything at all,” Dr. Carlyle said, handing her a card emblazoned in black with his personal contact information, including his cell phone number. “I’m going to recommend your case to my colleagues at NIH. The Undiagnosed Diseases Program—you might have heard of it.”
She smiled. “That’s how I found you. I did my research, too.”
“Then we’re a good team.” He patted her shoulder as she walked to the door. “I’m looking forward to hearing from you,” he said. “Assuming you do want to proceed,” he added. “You do, don’t you?”
She turned around to face him, but he held up a hand.
“Don’t feel pressured to answer just yet,” he said. “What you choose to do with your body is obviously up to you.”
“Is it?” she asked. “If I’m really only fourteen?” Every time she spoke the number felt like an aftershock.
His frown deepened. “That’s a good point. There’s no legal precedent . . . I suppose your parents would need to sign off going forward . . .”
“Forget that,” she declared, straightening her spine. “I’ll set the precedent. I’m still my own person and I’ll make my own decisions.”
Dr. Carlyle raised his white eyebrows. “Well then . . .”
She grabbed the doorknob, still facing him. His eyes shone with worry as his mouth opened, then closed.
“My whole teenage life,” she said, “I’ve wanted nothing more than to get to the bottom of this. You think I’m going to stop now?”
He exhaled. “Even if your family . . . ?”