Secondly—and more seriously—it had become increasingly difficult to find people willing to volunteer for placebo trials. When you’re dying, you don’t give a shit about the scientific method. You want the maximum possible chance of surviving. Untested drugs will do, if there is no known, certain cure—but why accept a further halving of the odds, to satisfy some technocrat’s obsession with details?
Of course, in the good old days the medical profession could lay down the law to the unwashed masses: Take part in this double-blind trial, or crawl away and die. AIDS had changed all that, with black markets for the latest untried cures, straight from the labs to the streets, and intense politicization of the issues.
The solution to both flaws was obvious.
You lie to the patients.
No bill had been passed to explicitly declare that “triple-blind” trials were legal. If it had, people might have noticed, and made a fuss. Instead, as part of the “reforms” and “rationalization” that came in the wake of the disaster, all the laws that might have made them illegal had been removed or watered down. At least, it looked that way—no court had yet been given the opportunity to pass judgement.
“How could any doctor do that? Lie like that! How could they justify it, even to themselves?”
She shrugged. “How did they ever justify double-blind trials? A good medical researcher has to care more about the quality of the data than about any one person’s life. And if a double-blind trial is good, a triple-blind trial is better. The data is guaranteed to be better, you can see that, can’t you? And the more accurately a drug can be assessed, well, perhaps in the long run, the more lives can be saved.”
“Oh, crap! The placebo effect isn’t that powerful. It just isn’t that important! Who cares if it’s not precisely taken into account? Anyway, two potential cures could still be compared, one treatment against another. That would tell you which drug would save the most lives, without any need for placebos—”
“That is done sometimes, although the more prestigious journals look down on those studies; they’re less likely to be published—”
I stared at her. “How can you know all this and do nothing? The media could blow it wide open! If you let people know what’s going onh…”
She smiled thinly. “I could publicize the observation that these practices are now, theoretically, legal. Other people have done that, and it doesn’t exactly make headlines. But if I printed any specific facts about an actual triple-blind trial, I’d face a half-million-dollar fine, and twenty-five years in prison, for endangering public health. Not to mention what they’d do to my publisher. All the ‘emergency’ laws brought in to deal with the Monte Carlo leak are still active.”
“But that was twenty years ago!”
She drained her coffee and rose. “Don’t you recall what the experts said at the time?”
“No.”
“The effects will be with us for generations.”
* * *
It took me four months to penetrate the drug manufacturer’s network.
I eavesdropped on the data flow of several company executives who chose to work from home. It didn’t take long to identify the least computer-literate. A real bumbling fool, who used ten-thousand-dollar spreadsheet software to do what the average five-year-old could have done without fingers and toes. I watched his clumsy responses when the spreadsheet package gave him error messages. He was a gift from heaven; he simply didn’t have a clue.
And, best of all, he was forever running a tediously unimaginative pornographic video game.
If the computer said “Jump!” he’d say “Promise not to tell?”
I spent a fortnight minimizing what he had to do; it started out at seventy keystrokes, but I finally got it down to twenty-three.
I waited until his screen was at its most compromising, then I suspended his connection to the network, and took its place myself.
FATAL SYSTEM ERROR! TYPE THE FOLLOWING TO RECOVER:
He botched it the first time. I rang alarm bells, and repeated the request. The second time, he got it right.
The first multi-key combination I had him strike took the work station right out of its operating system into its processor’s microcode debugging routine. The hexadecimal that followed, gibberish to him, was a tiny program to dump all of the work station’s memory down the communications line, right into my lap.
If he told anyone with any sense what had happened, suspicion would be aroused at once—but would he risk being asked to explain just what he was running when the “bug” occurred? I doubted it.
I already had his passwords. Included in the work station’s memory was an algorithm which told me precisely how to respond to the network’s security challenges.
I was in.
* * *
The rest of their defences were trivial, at least so far as my aims were concerned. Data that might have been useful to their competitors was well-shielded, but I wasn’t interested in stealing the secrets of their latest haemor-rhoid cure.
I could have done a lot of damage. Arranged for their backups to be filled with garbage. Arranged for the gradual deviation of their accounts from reality, until reality suddenly intruded in the form of bankruptcy—or charges of tax fraud. I considered a thousand possibilities, from the crudest annihilation of data to the slowest, most insidious forms of corruption.
In the end, though, I restrained myself. I knew the fight would soon become a political one, and any act of petty vengeance on my part would be sure to be dredged up and used to discredit me, to undermine my cause.
So I did only what was absolutely necessary.
I located the files containing the names and addresses of everyone who had been unknowingly participating in triple-blind trials of the company’s products. I arranged for them all to be notified of what had been done to them. There were over two hundred thousand people, spread all around the world—but I found a swollen executive slush fund which easily covered the communications bill.
Soon, the whole world would know of our anger, would share in our outrage and grief. Half of us were sick or dying, though, and before the slightest whisper of protest was heard, my first objective had to be to save whoever I could.
I found the program that allocated medication or placebo. The program that had killed Paula, and thousands of others, for the sake of sound experimental technique.
I altered it. A very small change. I added one more lie.
All the reports it generated would continue to assert that half the patients involved in clinical trials were being given the placebo. Dozens of exhaustive, impressive files would continue to be created, containing data entirely consistent with this lie. Only one small file, never read by humans, would be different. The file controlling the assembly line robots would instruct them to put medication in every vial of every batch.
From triple-blind to quadruple-blind. One more lie, to cancel out the others, until the time for deception was finally over.
* * *
Martin came to see me.
“I heard about what you’re doing. T.I.M. Truth in Medicine.” He pulled a newspaper clipping from his pocket. “‘A vigorous new organization dedicated to the eradication of quackery, fraud and deception in both alternative and conventional medicine.’ Sounds like a great idea.”
“Thanks.”
He hesitated. “I heard you were looking for a few more volunteers. To help around the office.”
“That’s right.”
“I could manage four hours a week.”
I laughed. “Oh, could you really? Well, thanks very much, but I think we’ll cope without you.”
For a moment, I thought he was going to walk out, but then he said, not so much hurt as simply baffled, “Do you want volunteers, or not?”
“Yes, but—” But what? If he could swallow enough pride to offer, I could swallow enough pride to accept.
I signed him up for Wednesday afternoons.
* * *
I ha
ve nightmares about Paula, now and then. I wake smelling the ghost of a candle flame, certain that she’s standing in the dark beside my pillow, a solemn-eyed nine-year-old child again, mesmerized by our strange condition.
That child can’t haunt me, though. She never died. She grew up, and grew apart from me, and she fought for our separateness harder than I ever did. What if we had “died at the very same hour”? It would have signified nothing, changed nothing. Nothing could have reached back and robbed us of our separate lives, our separate achievements and failures.
I realize, now, that the blood oath that seemed so ominous to me was nothing but a joke to Paula, her way of mocking the very idea that our fates could be entwined. How could I have taken so long to see that?
It shouldn’t surprise me, though. The truth—and the measure of her triumph—is that I never really knew her.
THE DARK
Karen Joy Fowler
Karen Joy Fowler published her first story in 1985, and quickly established an impressive reputation, becoming a frequent contributor to Isaac Asimov’s Science Fiction Magazine and The Magazine of Fantasy and Science Fiction, among other markets. In 1986, she won the John W. Campbell Award as the year’s best new writer; 1986 also saw the appearance of her first book, the collection Artificial Things, which was released to an enthusiastic response and impressive reviews. Her first novel, Sarah Canary, was released this year, and greeted with even more enthusiasm. Fowler lives in Davis, California, has two children, did her graduate work in North Asian politics, and occasionally teaches ballet. Her story “The Lake Was Full of Artificial Things” was in our Third Annual Collection; her story “The Gate of Ghosts” was in our Fourth Annual Collection; and her story “The Faithful Companion at Forty” was in our Fifth Annual Collection.
The following story gives us a glimpse of the hidden connections between seemingly random events, and a scary look at some of the things that can be waiting for us in the dark.
In the summer of 1954, Anna and Richard Becker disappeared from Yosemite National Park along with Paul Becker, their three-year-old son. Their campsite was intact; two paper plates with half-eaten frankfurters remained on the picnic table, and a third frankfurter was in the trash. The rangers took several black-and-white photographs of the meal, which, when blown up to eight by ten, as part of the investigation, showed clearly the words love bites, carved into the wooden picnic table many years ago. There appeared to be some fresh scratches as well; the expert witness at the trial attributed them, with no great assurance, to raccoon.
The Beckers’ car was still backed into the campsite, a green DeSoto with a spare key under the right bumper and half a tank of gas. Inside the tent, two sleeping bags had been zipped together marital style and laid on a large tarp. A smaller flannel bag was spread over an inflated pool raft. Toiletries included three toothbrushes; Ipana toothpaste, squeezed in the middle; Ivory soap; three washcloths; and one towel. The newspapers discreetly made no mention of Anna’s diaphragm, which remained powdered with talc, inside its pink shell, or of the fact that Paul apparently still took a bottle to bed with him.
Their nearest neighbor had seen nothing. He had been in his hammock, he said, listening to the game. Of course, the reception in Yosemite was lousy. At home he had a shortwave set; he said he had once pulled in Dover, clear as a bell. “You had to really concentrate to hear the game,” he told the rangers. “You could’ve dropped the bomb. I wouldn’t have noticed.”
Anna Becker’s mother, Edna, received a postcard postmarked a day earlier. “Seen the firefall,” it said simply. “Home Wednesday. Love.” Edna identified the bottle. “Oh yes, that’s Paul’s bokkie,” she told the police. She dissolved into tears. “He never goes anywhere without it,” she said.
* * *
In the spring of 1960, Mark Cooper and Manuel Rodriguez went on a fishing expedition in Yosemite. They set up a base camp in Tuolumne Meadows and went off to pursue steelhead. They were gone from camp approximately six hours, leaving their food and a six-pack of beer zipped inside their backpacks zipped inside their tent. When they returned, both beer and food were gone. Canine footprints circled the tent, but a small and mysterious handprint remained on the tent flap. “Raccoon,” said the rangers who hadn’t seen it. The tent and packs were undamaged. Whatever had taken the food had worked the zippers. “Has to be raccoon.”
The last time Manuel had gone backpacking, he’d suspended his pack from a tree to protect it. A deer had stopped to investigate, and when Manuel shouted to warn it off, the deer hooked the pack over its antlers in a panic, tearing the pack loose from the branch and carrying it away. Pack and antlers were so entangled, Manuel imagined the deer must have worn his provisions and clean shirts until antler-shedding season. He reported that incident to the rangers, too, but what could anyone do? He was reminded of it, guiltily, every time he read Thidwick, the Big-Hearted Moose to his four-year-old son.
Manuel and Mark arrived home three days early. Manuel’s wife said she’d been expecting him.
She emptied his pack. “Where’s the can opener?” she asked.
“It’s there somewhere,” said Manuel.
“It’s not,” she said.
“Check the shirt pocket.”
“It’s not here.” Manuel’s wife held the pack upside down and shook it. Dead leaves fell out. “How were you going to drink the beer?” she asked.
* * *
In August of 1962, Caroline Crosby, a teenager from Palo Alto, accompanied her family on a forced march from Tuolumne Meadows to Vogelsang. She carried fourteen pounds in a pack with an aluminum frame—and her father said it was the lightest pack on the market, and she should be able to carry one-third her weight, so fourteen pounds was nothing, but her back stabbed her continuously in one coin-sized spot just below her right shoulder, and it still hurt the next morning. Her boots left a blister on her right heel, and her pack straps had rubbed. Her father had bought her a mummy bag with no zipper so as to minimize its weight; it was stiflingly hot, and she sweated all night. She missed an overnight at Ann Watson’s house, where Ann showed them her sister’s Mark Eden bust developer, and her sister retaliated by freezing all their bras behind the twin-pops. She missed “The Beverly Hillbillies.”
Caroline’s father had quit smoking just for the duration of the trip so as to spare himself the weight of cigarettes, and made continual comments about Nature, which were laudatory in content and increasingly abusive in tone. Caroline’s mother kept telling her to smile.
In the morning her father mixed half a cup of stream water into a packet of powdered eggs and cooked them over a Coleman stove. “Damn fine breakfast,” he told Caroline intimidatingly as she stared in horror at her plate. “Out here in God’s own country. What else could you ask for?” He turned to Caroline’s mother, who was still trying to get a pot of water to come to a boil. “Where’s the goddamn coffee?” he asked. He went to the stream to brush his teeth with a toothbrush he had sawed the handle from in order to save the weight. Her mother told her to please make a little effort to be cheerful and not spoil the trip for everyone.
One week later she was in Letterman Hospital in San Francisco. The diagnosis was septicemic plague.
* * *
Which is finally where I come into the story. My name is Keith Harmon. B.A. in history with a special emphasis on epidemics. I probably know as much as anyone about the plague of Athens. Typhus. Tarantism. Tsutsuga-mushi fever. It’s an odder historical specialty than it ought to be. More battles have been decided by disease than by generals—and if you don’t believe me, take a closer look at the Crusades or the fall of the Roman Empire or Napolean’s Russian campaign.
My M.A. is in public administration. Vietnam veteran, too, but in 1962 I worked for the state of California as part of the plague-monitoring team. When Letterman’s reported a plague victim, Sacramento sent me down to talk to her.
Caroline had been moved to a private room. “You’re going to be fine,” I told her. Of course,
she was. We still lose people to the pneumonic plague, but the slower form is easily cured. The only tricky part is making the diagnosis.
“I don’t feel well. I don’t like the food,” she said. She pointed out Letterman’s Tuesday menu. “Hawaiian Delight. You know what that is? Green Jell-O with a canned pineapple ring on top. What’s delightful about that?” She was feverish and lethargic. Her hair lay limply about her head, and she kept tangling it in her fingers as she talked. “I’m missing a lot of school.” Impossible to tell if this last was a complaint or a boast. She raised her bed to a sitting position and spent most of the rest of the interview looking out the window, making it clear that a view of the Letterman parking lot was more arresting than a conversation with an old man like me. She seemed younger than fifteen. Of course, everyone in the hospital bed feels young. Helpless. “Will you ask them to let me wash and set my hair?”
I pulled a chair over to the bed. “I need to know if you’ve been anywhere unusual recently. We know about Yosemite. Anywhere else. Hiking out around the airport, for instance.” The plague is endemic in the San Bruno Mountains by the San Francisco Airport. That particular species of flea doesn’t bite humans, though. Or so we’d always thought. “It’s kind of a romantic spot for some teenagers, isn’t it?”
I’ve seen some withering adolescent stares in my time, but this one was practiced. I still remember it. I may be sick, it said, but at least I’m not an idiot. “Out by the airport?” she said. “Oh, right. Real romantic. The radio playing and those 727s overhead. Give me a break.”
“Let’s talk about Yosemite, then.”
She softened a little. “In Palo Alto we go to the water temple,” she informed me. “And, no, I haven’t been there, either. My parents made me go to Yosemite. And now I’ve got bubonic plague.” Her tone was one of satisfaction. “I think it was the powdered eggs. They made me eat them. I’ve been sick ever since.”
The Year's Best SF 09 # 1991 Page 27
