by Nancy Kress
Esefeb cocked her head and looked quizzical. A worm crawled out of her hair.
Mia repeated, “Mia eb Esefeb etej Mia efef.”
Esefeb responded with a torrent of repetitious syllables, none of which meant anything to Mia except “Ej-es.” The girl spoke the word with such delight that it had to be a name. A lover? Maybe these people didn’t live as solitary as she’d assumed.
Mia took Esefeb’s hand and gently tugged her toward the door. Esefeb broke free and sat in the middle of the room, facing a blank wall of crumbling logs, and jabbered away to nothing at all, occasionally laughing and even reaching out to touch empty air. “Ej-es, Ej-es!” Mia watched, bemused, recording everything, making medical assessments. Esefeb wasn’t malnourished, for which the natural abundance of the planet was undoubtedly responsible. But she was crawling with parasites, filthy (with water easily available), and isolated. Maybe isolated.
“Lolimel,” Mia said softly into the wrister, “what’s the best dictionary guess for ‘alone’?”
Lolimel said, “The closest we’ve got is ‘one.’ There doesn’t seem to be a concept for ‘unaccompanied,’ or at least we haven’t found it yet. The word for ‘one’ is ‘eket.’ ”
When Esefeb finally sprang up happily, Mia said, “Esefeb eket?”
The girl look startled. “Ek, ek,” she said: no, no. Esefeb ek eket! Esefeb eb Ej-es!”
Esefeb and Ej-es. She was not alone. She had the hallucinatory Ej-es.
Again Mia took Esefeb’s hand and pulled her toward the door. This time Esefeb went with her. As they set off toward the city, the girl’s legs wobbled. Some parasite that had become active overnight in the leg muscles? Whatever the trouble was, Esefeb blithely ignored it as they traveled, much more slowly than yesterday, to Kenin’s makeshift lab in the ruined city. Along the way, Esefeb stopped to watch, laugh at, or talk to three different things that weren’t there.
“She’s beautiful, under all that neglect,” Lolimel said, staring down at the anesthetized girl on Kenin’s neuroimaging slab.
Kenin said mildly, “If the mutated virus is transmitted to a fetus, it could also be transmitted sexually.”
The young man said hotly, “I wasn’t implying—”
Mia said, “Oh, calm down. Lolimel. We’ve all done it, on numerous worlds.”
“Regs say—”
“Regs don’t always matter three hundred light years from anywhere else,” Kenin said, exchanging an amused glance with Mia. “Mia, let’s start.”
The girl’s limp body slid into the neuro-imager. Esefeb hadn’t objected to meeting the other medicians, to a minimal washing, to the sedative patch Mia had put on her arm. Thirty seconds later she slumped to the floor. By the time she came to, an incision ten cells thick would have been made into her brain and a sample removed. She would have been harvested, imaged, electroscanned, and mapped. She would never know it; there wouldn’t even be a headache.
Three hours later Esefeb sat on the ground with two of the guards, eating soysynth as if it were ambrosia. Mia, Kenin, Lolimel, and the three other medicians sat in a circle twenty yards away, staring at handhelds and analyzing results. It was late afternoon. Long shadows slanted across the gold-green grass, and a small breeze brought the sweet, heavy scent of some native flower.
Paradise, Mia thought. And then: Bonnet Syndrome.
She said it aloud, “Charles Bonnet Syndrome,” and five people raised their heads to stare at her, returned to their handhelds, and called up medical deebees.
“I think you’re right,” Kenin said slowly. “I never even heard of it before. Or if I did, I don’t remember.”
“That’s because nobody gets it anymore,” Mia said. “It was usually old people whose eye problems weren’t corrected. Now we routinely correct eye problems.”
Kenin frowned. “But that’s not all that’s going on with Esefeb.”
No, but it was one thing, and why couldn’t Kenin give her credit for thinking of it? The next moment she was ashamed of her petty pique. It was just fatigue, sleeping on that hard cold floor in Esefeb’s home. Esefeb efef. Mia concentrated on Charles Bonnet syndrome.
Patients with the syndrome, which was discovered in the eighteenth century, had damage somewhere in their optic pathway or brain. It could be lesions, macular degeneration, glaucoma, diabetic retinopathy, or even cataracts. Partially blind, people saw and sometimes heard instead things that weren’t there, often with startling clarity and realism. Feedback pathways in the brain were two-way information avenues. Visual data, memory, and imagination constantly flowed to and from each other, interacting so vividly that, for example, even a small child could visualize a cat in the absence of any actual cats. But in Bonnet syndrome, there was interruption of the baseline visual data about what was and was not real. So all imaginings and hallucinations were just as real as the ground beneath one’s feet.
“Look at the amygdala,” medician Berutha said. “Oh merciful gods!”
Both of Esefeb’s amygdalae were enlarged and deformed. The amygdalae, two almond-shaped structures behind the ears, specialized in recognizing the emotional significance of events in the external world. They weren’t involved in Charles Bonnet syndrome. Clearly, they were here.
Kenin said, “I think what’s happening here is a strengthening or alteration of some neural pathways at the extreme expense of others. Esefeb ‘sees’ her hallucinations, and she experiences them as just as ‘real’—maybe more real — than anything else in her world. And the pathways go down to the limbic, where seizures give some of them an intense emotional significance. Like… like orgasm, maybe.”
Ej-es.
“Phantoms in the brain,” Berutha said.
“A viral god,” Lolimel said, surprising Mia. His tone, almost reverential, suddenly irritated her.
“A god responsible for this people’s degradation, Lolimel. They’re so absorbed in their ‘phantoms’ that they don’t concentrate on the most basic care of themselves. Nor on building, farming, art, innovation… nothing. They’re prisoners of their pretty fantasies.”
Lolimel nodded reluctantly. “Yes, I see that.”
Berutha said to Kenin, “We need to find the secondary virus. Because if it is infectious through any other vector besides fetal or sexual…” He didn’t finish the thought.
“I know,” Kenin said, “but it isn’t going to be easy. We don’t have cadavers for the secondary. The analyzer is still working on the cerebral-spinal fluid. Meanwhile—” She began organizing assignments, efficient and clear. Mia stopped listening.
Esefeb had finished her meal and walked up to the circle of scientists. She tugged at Mia’s tunic.
“Mia… Esefeb etej efef.” Esefeb come home.
“Mia eb Esefeb etej Esefeb efef,” Mia said, and the girl gave her joyous smile.
“Mia—” Kenin said.
“I’m going with her, Kenin. We need more behavioral data. And maybe I can persuade another native or two to submit to examination,” Mia argued, feebly. She knew that scientific information was not really her motive. She wasn’t sure, however, what was. She just wanted to go with Esefeb.
“Why did you first enter the Corps?” Lolimel’s question stuck in Mia’s mind, a rhetorical fishbone in the throat, over the next few days. Mia had brought her medkit, and she administered broad-spectrum microbials to Esefeb, hoping something would hit. The parasites were trickier, needing life-cycle analysis or at least some structural knowledge, but she made a start on that, too. I entered the Corps to relieve suffering, Lolimel. Odd how naive the truest statements could sound. But that didn’t make them any less true.
Esefeb went along with all Mia’s pokings, patches, and procedures. She also carried out minimal food-gathering activities, with a haphazard disregard for safety or sanitation that appalled Mia. Mia had carried her own food from the ship. Esefeb ate it just as happily as her own.
But mostly Esefeb talked to Ej-es.
It made Mia feel like a voyeur. Esefeb was so unselfconscious — did
she even know she had a “self” apart from Ej-es? She spoke to, laughed at (with?), played beside, and slept with her phantom in the brain, and around her the hut disintegrated even more. Esefeb got diarrhea from something in her water and then the place smelled even more foul. Grimly, Mia cleaned it up. Esefeb didn’t seem to notice. Mia was eket. Alone in her futile endeavors at sanitation, at health, at civilization.
“Esefeb eb Mia etej efef—” How did you say “neighbors”? Mia consulted the computer’s lexicon, steadily growing as the translator program deciphered words from context. It had discovered no word for “neighbor.” Nor for “friend” nor “mate” nor any kinship relationships at all except “baby.”
Mia was reduced to pointing at the nearest hut. “Esefeb eb Mia etej efef” over there.
The neighboring hut had a baby. Both hut and child, a toddler who lay listlessly in one corner, were just as filthy and diseased as Esefeb’s house. At first the older woman didn’t seem to recognize Esefeb, but when Esefeb said her name, the two women spoke animatedly. The neighbor smiled at Mia. Mia reached for the child, was not prevented from picking him up, and settled the baby on her lap. Discreetly, she examined him.
Sudden rage boiled through her, as unexpected as it was frightening. This child was dying. Of parasites, of infection, of something. A preventable something? Maybe yes, maybe no. The child didn’t look neglected, but neither did the mother look concerned.
All at once, the child in her arms stiffened, shuddered, and began to babble. His listlessness vanished. His little dirty face lit up like sunrise and he laughed and reached out his arms toward something not there. His mother and Esefeb turned to watch, also smiling, as the toddler had an unknowable limbic seizure in his dying, ecstatic brain.
Mia set him down on the floor. She called up the dictionary, but before she could say anything, the mother, too, had a seizure and sat on the dirt floor, shuddering with joy. Esefeb watched her a moment before chattering to something Mia couldn’t see.
Mia couldn’t stand it any more. She left, walking as fast as she could back to Esefeb’s house, disgusted and frightened and… what?
Envious?
“Why did you first enter the Corps?” To serve humanity, to live purposefully, to find, as all men and women hope, happiness. And she had, sometimes, been happy.
But she had never known such joy as that.
Nonetheless, she argued with herself, the price was too high. These people were dying off because of their absorption in their rapturous phantoms. They lived isolated, degraded, sickly lives, which were undoubtedly shorter than necessary. It was obscene.
In her clenched hand was a greasy hair sample she’d unobtrusively cut from the toddler’s head as he sat on her lap. Hair, that dead tissue, was a person’s fossilized past. Mia intended a DNA scan.
Esefeb strolled in an hour later. She didn’t seem upset at Mia’s abrupt departure. With her was Lolimel.
“I met her on the path,” Lolimel said, although nothing as well-used as a path connected the huts. “She doesn’t seem to mind my coming here.”
“Or anything else,” Mia said. “What did you bring?” He had to have brought something tangible; Kenin would have used the wrister to convey information.
“Tentative prophylactic. We haven’t got a vaccine yet, and Kenin says it may be too difficult, better to go directly to a cure to hold in reserve in case any of us comes down with this.”
Mia caught the omission. “Any of us? What about them?”
Lolimel looked down at his feet. “It’s, um, a borderline case, Mia. The decision hasn’t been made yet.”
“‘Borderline’ how, Lolimel? It’s a virus infecting the brains of humans and degrading their functioning.”
He was embarrassed. “Section Six says that, um, some biological conditions, especially persistent ones, create cultural differences for which Corps policy is non-interference. Section Six mentions the religious dietary laws that grew out of inherited food intolerances on—”
“I know what Section Six says, Lolimel! But you don’t measure a culture’s degree of success by its degree of happiness!”
“I don’t think… that is, I don’t know… maybe ‘degree of success’ isn’t what Section Six means.” He looked away from her. The tips of his ears grew red.
Poor Lolimel. She and Kenin had as much as told him that out here regs didn’t matter. Except when they did. Mia stood. “You say the decision hasn’t been made yet?”
He looked surprised. “How could it be? You’re on the senior Corps board to make the decision.”
Of course she was. How could she forget… she forgot more things these days, momentary lapses symbolic of the greater lapses to come. No brain functioned forever.
“Mia, are you all—”
“I’m fine. And I’m glad you’re here. I want to go back to the city for a few days. You can stay with Esefeb and continue the surveillance. You can also extend to her neighbors the antibiotic, antiviral, and anti-parasite protocols I’ve worked through with Esefeb. Here, I’ll show you.”
“But I—”
“That’s an order.”
She felt bad about it later, of course. But Lolimel would get over it.
At base everything had the controlled frenzy of steady, unremitting work. Meek now, not a part of the working team, Mia ran a DNA scan on the baby’s hair. It showed what she expected. The child shared fifty percent DNA with Esefeb. He was her brother; the neighbor whom Esefeb clearly never saw, who had at first not recognized Esefeb, was her mother. For which there was still no word in the translator deebee.
“I think we’ve got it,” Kenin said, coming into Mia’s room. She collapsed on a stone bench, still beautiful after two and a half centuries. Kenin had the beatific serenity of a hard job well done.
“A cure?”
“Tentative. Radical. I wouldn’t want to use it on one of us unless we absolutely have to, but we can refine it more. At least it’s in reserve, so a part of the team can begin creating and disseminating medical help these people can actually use. Targeted microbials, an anti-parasite protocol.”
“I’ve already started on that,” Mia said, her stomach tightening. “Kenin, the board needs to meet.”
“Not tonight. I’m soooo sleepy.” Theatrically she stretched both arms; words and gesture were unlike her.
“Tonight,” Mia said. While Kenin was feeling so accomplished. Let Kenin feel the full contrast to what she could do with what Esefeb could.
Kenin dropped her arms and looked at Mia. Her whole demeanor changed, relaxation into fortress. “Mia… I’ve already polled everyone privately. And run the computer sims. We’ll meet, but the decision is going to be to extend no cure. The phantoms are a biologically based cultural difference.”
“The hell they are! These people are dying out!”
“No, they’re not. If they were heading for extinction, it’d be a different situation. But the satellite imagery and population equations, based on data left by the generation that had the plague, show they’re increasing. Slowly, but a definite population gain significant to the point-oh-one level of confidence.”
“Kenin—”
“I’m exhausted, Mia. Can we talk about it tomorrow?”
Plan on it, Mia thought grimly. She stored the data on the dying toddler’s matrilineage in her handheld.
A week in base, and Mia could convince no one, not separately nor in a group. Medicians typically had tolerant psychological profiles, with higher-than-average acceptance of the unusual, divergent, and eccentric. Otherwise, they wouldn’t have joined the Corps.
On the third day, to keep herself busy, Mia joined the junior medicians working on refining the cure for what was now verified as “limbic seizures with impaired sensory input causing Charles Bonnet syndrome.” Over the next few weeks it became clear to Mia what Kenin had meant; this treatment, if they had to use it, would be brutally hard on the brain. What was that old ditty? ”Cured last night of my disease, I died today
of my physician.” Well, it still happened enough in the Corps. Another reason behind the board’s decision.
She felt a curious reluctance to go back to Esefeb. Or, as the words kept running through her mind, Mia ek etej Esefeb efef. God, it was a tongue twister. These people didn’t just need help with parasites, they needed an infusion of new consonants. It was a relief to be back at base, to be working with her mind, solving technical problems alongside rational scientists. Still, she couldn’t shake a feeling of being alone, being lonely: Mia eket.
Or maybe the feeling was more like futility.
“Lolimel’s back,” Jamal said. He’d come up behind her as she sat at dusk on her favorite stone bench, facing the city. At this time of day the ruins looked romantic, infused with history. The sweet scents of that night-blooming flower, which Mia still hadn’t identified, wafted around her.
“I think you should come now,” Jamal said, and this time Mia heard his tone. She spun around. In the alien shadows Jamal’s face was set as ice.
“He’s contracted it,” Mia said, knowing beyond doubt that it was true. The virus wasn’t just fetally transmitted, it wasn’t a slow-acting retrovirus, and if Lolimel had slept with Esefeb… But he wouldn’t be that stupid. He was a medician, he’d been warned…
“We don’t really know anything solid about the goddamn thing!” Jamal burst out.
“We never do,” Mia said, and the words cracked her dry lips like salt.
Lolimel stood in the center of the ruined atrium, giggling at something only he could see. Kenin, who could have proceeded without Mia, nodded at her. Mia understood; Kenin acknowledged the special bond Mia had with the young medician. The cure was untested, probably brutal, no more really than dumping a selection of poisons in the right areas of the brain, in itself problematical with the blood-brain barrier.
Mia made herself walk calmly up to Lolimel. “What’s so funny, Lolimel?”
“All those sandwigs crawling in straight lines over the floor. I never saw blue ones before.”
Sandwigs. Lolimel, she remembered, had been born on New Carthage. Sandwigs were always red.
