by Allen Wyler
Jon entered a spacious laboratory with temperature-controlled air carrying a hint of disinfectant. An impressive setup, lavishly outfitted with state-of-the art equipment, greeted him: spotless black soapstone work counters, gleaming chrome and stainless steel fixtures, six-foot-high freezers, centrifuges, microscopes, computers—all the toys a well-funded neuroscientist could ever ask for as well as a status symbol of Jin-Woo’s standing in Korean scientific circles.
Jin-Woo proudly showed Jon his supply of stem cells and the vials of various nerve growth factors to be combined to force the cells to eventually become neurons.
“I think you will find everything you need. You start. I will come for you at six, take you back to Walker Hill.” The plan was to work round the clock with one person always in the lab to prevent contact inhibition and perform the other routine chores that couldn’t be confined to the hours of a standard work day.
Jon watched his friend leave and heard the metallic snap of the lock, immediately encasing him in heavy silence. For a moment he stood still, absorbing the sleek impressive laboratory, savoring the milestone so long in coming. Along with this heady elation, fear began deep within his stomach. By nature, he wasn’t a gambler, preferring to be relatively conservative in just about everything that influenced his life. The person to always do the responsible thing, to start saving for retirement as soon as his training ended and his first real paycheck arrived. At this moment, all his career chips—the accumulated worth of a dedicated professional reputation—were being risked on the outcome of this trial. The gravity of the course he was about to take became almost paralyzing. Where to start?
25
AS YEONHEE LEE SAT in the speeding subway she felt a combination of anticipation and anxiety. Her excitement was pleasantly titillating, but it made her mouth unpleasantly dry and her palms tingle. The anticipation of working in the same lab with a world-class scientist was, in itself, exciting. Knowing she would be standing shoulder to shoulder with Jon gave her an extra layer of excitement. She knew what it would feel like and wondered if he felt the same. She thought about the way her heart beat faster when they accidently brushed against each other in the close laboratory quarters. Did he ever wonder what was beneath the shapeless white lab coat?
What would it be like to kiss him?
But she had to concentrate on her work. For the next four weeks she needed to devote one hundred percent of her energy to the laboratory project. Jin-Woo made that clear. And because he was her boss, she would do it. But she also knew how much this project meant to Jon. And that, more than anything, cemented her commitment. But already Jung-Kyo was acting like a spoiled little brat. Last night, within five minutes of walking into her apartment, her phone rang.
“Where have you been?” Jung-Kyo asks.
“I told you. I had to go to dinner with Dr. Lee and his American friend.”
“Had to? He said he’d fire you if you didn’t?”
“No, but it was expected of me.”
“Which restaurant?”
“Is that really important?”
“Oh, so you don’t want to tell me. Is there anything else that happened last night you don’t want to mention?”
“What are you implying?”
“Why so defensive? Are you hiding something?”
He was already jealous of the time she spent with Jin-Woo. They’d fought about it before.
“You fuck him, don’t you.”
“Believe what you want. I don’t care.”
“Why don’t you just tell me.”
“I need to hang up. I have a busy day tomorrow.”
Did he really expect a girl her age to be a virgin? Did she ask for a detailed list of every girl he’d ever slept with? Or the various things they’d done in bed? As long as it wasn’t her best friend, she couldn’t care less who he’d slept with.
The airbrakes hissed for the Medical Center stop. With her mind still caught up in personal issues, she flowed with the morning crowd onto the subway platform and then, in a clot of other workers, toward the escalators that would carry her up to the huge plate glass doors.
She pressed the button, spoke her name into the speaker, heard the metallic snap of the lock. A moment later she was inside, face to face with Jon.
JON WAS CHECKING email when the lock snapped and the door opened and Yeonhee entered. She smiled at him. “Morning, Jon.”
He responded with, “Morning,” and immediately felt awkward, like a teenager.
She let the door close and lock automatically, quickly exchanging her black raincoat for a white lab coat, then came over to where he was working, her hands in the coat pockets, face serious, ready to begin work. “You already started the cultures, I see.”
“Yes.”
She stood next to him, studying the flasks he just finished preparing, her familiar scent triggering memories. He studied the wisps of black hair loose around her right ear and resisted the urge to reach out and touch her. “Have you posted the schedule?” she asked.
He routinely posted a schedule on a clipboard near the counter for pipetting the cultures for the duration of the experiment. Whoever was responsible for the task on that particular shift initialed the sheet each time they completed it. He was impressed that she remembered such a little detail and took it as just one more indication of how meticulously she worked. “Over there,” pointing at it. Then, without thinking, asked the interrupted question from the other night. “When this is over and we have time, would you like to have dinner with me?”
She smiled broadly. “Yes. I would like that.”
26
JON PICKED UP THE square, black carbon fiber frame that looked like the skeleton of a box big enough to fit over a person’s head. He steadied it as Jin-Woo positioned the holes at the bottom corners over the patient’s head. An hour earlier they’d implanted the first of their four patients. The surgery sailed along, without a problem, increasing Jon’s confidence that the technique itself would not influence on the outcome of the trial. Jin-Woo marked a dot on the scalp directly under each of the four fixation points with a sterilized felt-tipped pen. Four blue dots, two on each side of the head just above the eyes, the other two just behind the ears. They worked in one of the medical center’s three MRI rooms, both surgeons in bright aqua blue scrubs, their watches, keys—anything metallic—locked securely in Jin-Woo’s desk drawer. Even their credit cards—with magnetic strips on the back side—were stored well away from the scanners’ strong magnetic fields.
The patient—the CEO’s mildly demented father, a bald man with buck teeth—was on the MRI table under general anesthesia, his head supported by a small pedestal to allow the two surgeons to bolt the carbon fiber frame to his skull. By acquiring a series of images with the frame rigidly attached to his head, the sides of the rectangular frame would be used to compute an XYZ trajectory to targets in the brain. Then, after drilling small holes through the skull, they would insert a small diameter probe to their target to deposit the stem cells that, hopefully, would become neurons. Theoretically this replacement brain tissue would resolve some of the Alzheimer’s symptoms.
“You can remove it now,” Jin-Woo said, reaching for a syringe of local anesthetic. With the frame clear of the patient’s head, Jin-Woo numbed the skin at each blue dot so the sharply pointed screws could be painlessly tightened into the man’s skull to hold the frame rigidly.
Jin-Woo picked up a scalpel, muttered something to the anesthesiologist, and made a tiny stab wound at each of the four numbed injection sites. Then to Jon: “Hold the frame, please.”
Jon held the frame in position while Jin-Woo used a torque wrench to seat the four screws into bone, rigidly securing it to the skull. Done, Jin-Woo muttered, “There. All set.” An MRI taken with this frame attached would then be used to plot the path to the injection site.
Jin-Woo inspected his work, nodded approvingly. “We will get an MRI now.”
Jon dropped into a chair to watch and wait. In a few mi
nutes the second patient would be injected, then two more the day after tomorrow. If this worked, thousands of people just like his grandmother might be spared slowly atrophying lives in disgusting nursing homes. The ultimate test of his career’s work was now underway. This realization almost overwhelmed him.
As he waited for the machine to crank through the images, his initial relief and awe began to be eroded by fear. What would happen if a strange, unforeseen side effect occurred, like the implanted cells turned rogue and became malignant tumors? Was that possible? Could he live with it if something so bizarre and unanticipated really happened? Fear blossomed into panic, stealing his breath. That doesn’t happen, that doesn’t happen . . . Still . . .
Jin-Woo did a double take. “You okay?”
Jon waved the remark away and tried to distract himself by watching the scanner on the other side of the control room window. “Yeah yeah, just . . . jet lag.”
Jin-Woo leaned closer, squinting in the dim room light. “You look pale.”
Another wave of anxiety swept over him. “No no, keep going.”
Jon watched the technician position the patient on the tray that slides into the tubular scanning gantry. Satisfied, the tech slowly moved the patient into the huge doughnut-shaped MRI machine. Once completely inside, the tech hung the IV bag on a plastic stand and the anesthesiologist did a final check of the settings on the non-metallic anesthesia machine. After the crew was convinced they were ready, everyone left the room to begin the imaging.
Minutes later pictures of the patient’s brain with attached frame began appearing on the control room monitor. Image quality was excellent, making the job of pinpointing the implant areas easy. Jin-Woo muttered something to the technician. Then to Jon: “We will go to surgery now.”
The MRI files, transferred from the scanner to the OR via a fiber-optic network, arrived before the two surgeons. Jon tapped the touch-sensitive control screen, moving from one “slice” of brain to the next, searching for the area to inject the cultured cells. Without a Korean medical license or hospital privileges Jon could not participate directly in the procedure, so they operated under a verbal understanding: Jin-Woo did the actual surgery while Jon “made suggestions” or answered critical questions. Hopefully, the other members of the operating room crew wouldn’t realize Jon was the mind behind Jin-Woo’s hands.
Jon flipped between the present image and the immediately preceding one, switching back and forth. Finally, he pointed at the screen. “Here’s your target. Might as well inject the remainder right here,” indicating a region just behind and above the roof of the eye sockets.
Jin-Woo muttered approval, typed a few characters on the keyboard, and magically a straight white line appeared, starting at the target site and continuing out through the top of the skull to intersect the carbon fiber frame, forming the X,Y,Z coordinates and trajectory. Jin-Woo called out the coordinates and angle in English along with the depth from the skull to the target site as Jon wrote them on paper. As a fail-safe to make certain no targeting error occurred, a third observer verified Jin-Woo’s figures matched those Jon transcribed. Jin-Woo drilled small holes in the skull through which the narrow cannula would be inserted into the brain.
Finished, Jin-Woo began suturing the small wounds, leaving Jon with nothing to do but sit in the chilly OR and watch—a role he hadn’t played since residency. As he waited, the earlier anxiety crept back . . . only this time not so much fear as premonition . . . of something bad about to happen, causing him to reconsider. . . . Wait a few more days before implanting the next two? Maybe even wait a couple months? See what happens to the first two before proceeding? Perhaps call Wayne to discuss it?
Heavy fatigue settled over him, seeping into his joints, sagging his shoulders. Maybe jet lag. Maybe the culmination of ten years of work. Maybe both, rolled up into one heavy shroud. Whatever the cause, he became incredibly weary.
Jin-Woo’s hands worked quickly, laying down double square knots, snipping off excess suture so that ends slipped below the surface of the scalp. He mumbled something to the anesthesiologist before turning to Jon and saying, “His vitals are perfect. We have no problems.”
A moment later Jin-Woo withdrew the black carbon-fiber frame from the patient’s head, officially completing the second surgery, half the study. He slipped the mask down off his nose and grinned at Jon.
Thirty minutes later the two stood at to Jin-Woo’s locker pulling the sweat-soaked scrub shirts over their heads. Jon wondered if he dare call Wayne with the good news that both patients were awake now and doing well, but decided not to. Years of practice taught him to wait hours before declaring a case out of the woods.
“It goes well, I think.” Jin-Woo smiled and tossed his wadded up scrub shirt at a laundry hamper. It sailed wide, landing on the floor a foot from the target, where it would remain until a janitor cleaned up. Every surgery locker room Jon ever saw began the day neat and tidy, only to end up looking like a disaster relief station. From his narrow metal locker Jin-Woo withdrew a white dress shirt with the loosened necktie still under the collar and began slipping an arm in. “We meet for dinner later?”
Jon hesitated, the fatigue and fear still smoldering inside. Somehow celebrating seemed . . . premature? Courting bad luck? He leaned against a locker, massaged the back of his neck, and once again mentally reviewed the surgeries. Everything seemed to go perfectly, yet . . . Probably best to lay low for the evening. Not that he was superstitious . . . but he needed some down time anyway. “Thanks, but I think I’ll just hang out at the hotel, go to bed early. These last couple weeks have been,” he stopped short of saying murder, “hell. . . . Want to catch up on some sleep, do some reading.”
Jin-Woo shrugged on his suit coat and shot his shirt cuffs. “You sure? We can make it short. Get you back early. No girls. Just us.”
Jon reconsidered. The cultures for the next two patients were scheduled to start first thing in the morning. Tonight would be devoted to relaxation and rest. “Naw. Thanks. Go ahead.”
27
NIGEL FEIST SLIPPED INTO the dimly lit room and moved quickly to the bedside. The patient lay flat on his back, snoring softly. Feist removed a syringe from his white lab coat, uncapped the needle and inserted it into the injection port of the IV line. One gram of potassium chloride. Enough to cause a cardiac arrest. And because KCl was a normal blood electrolyte, its presence would go unnoticed during a routine autopsy unless the concentration was specifically tested. Even then, it would be hard to detect. And since the IV was already in place, there would be no tell-tale needle mark. He injected the bolus as rapidly as possible. The patient groaned from the sting as the salt burned through his vein, but by then Feist had the needle capped and back in his pocket. He placed his hand over the patient’s mouth to stifle the groan. A few seconds later the old man was dead.
Then Feist was out of the room, across the hall, and into the second patient’s room.
JON BECAME VAGUELY aware of the phone ringing. He reached for it and slammed his knuckles on an unyielding surface. Another ring. Up on his right elbow now, he glanced around the dimly lit room. Faint city streetlight filtered through the gap in the drapes, reminding him that he was in a Sheraton in Seoul. A call? What the hell? He rolled onto the opposite side, checked the glowing digital clock. 1:57 a.m.
The phone rang again.
Shit! Middle of the night calls were never good news, especially with fresh post-ops in hospital. But they were Jin-Woo’s patients, so no one should call him. Unless, of course, it was Jin-Woo with bad news. Bolt upright, he stared at the bedside phone, too paranoid to lift the receiver. Only Jin-Woo, Yeonhee, Stillman, Wayne, and Fisher knew he was here. A call from any of them could mean bad news.
Another ring.
Could be a wrong number . . .
The premonition hit the moment his fingers touched the phone. “Hello.”
“Sleeping well, mate?”
What the fuck? A bolt of fear and panic struck. Can’t be.
Feist continued, “Your patients doing well, are they?”
Jon opened his mouth to answer but stopped. Was Feist just fucking with him or did he actually know?
“Don’t play dumb, mate. I’m talking about them geezers you and your little slant-eye mate did surgery on today. Hold on a moment, I reckon that’s an inexactitude and I should really be calling it yesterday seeings how it’s past midnight and all, right-right?”
Jon’s mind blanked with fear. Feist knew. He goddamn well knew. How? They’d been so careful . . . Then he remembered Fisher’s warning. And the GI at the airport.
“If I was you, I’d surely want to know how them patients of yours are doing. Indeed, I’d be right worried, I would. What with all you got riding on ’em.”
The phone went dead.
Gut churning, Jon cradled the phone. And realized he was holding his breath.
Now what? Call the hospital, check on them? That’s what he’d do if he were in Seattle, but Tyasami Medical Center, Seoul? Probably wouldn’t work. Most of the nurses didn’t speak English well enough to handle a surprise call from a doctor they didn’t know, especially this time of morning. Jin-Woo would know.
He flipped on the bedside light, reached for his wallet and pulled out the scrap of paper with his cell number, and dialed. Jin-Woo picked up with, “Jon?”
“Where are you?”
“Hospital called,” Jin-Woo spoke in gasps, his English choppy from stress and agitation. “I drive there now. The patients . . . something wrong. Bad, I think.”
“I’m on my way. Where should I meet you?”
“Don’t know. Patients’ room, I think.”
Jon threw on the same clothes as yesterday, flew out the door and down the hall, where he furiously punched the elevator call button over and over, as if repetition would make it arrive faster.