by Joseph Xand
Jennifer led Thad to the NUCI, which opened up into a large, rectangular room where normally babies born premature or with other serious health issues would lay in incubators situated so a few nurses could see them all at a glance. But the incubators had been removed, replaced by flat, stainless-steel slabs sectioned off by thin curtains on hastily-installed curtain rods.
The room now was nothing more than a makeshift coroner's office where forensic pathologists contracted with the CDC performed autopsies that were anything but routine.
The first cubicle they came to housed a patient strapped down completely. Its eyes were also covered with a blindfold and its mouth muzzled with some sort of grated mask that looked like something out of Silence of the Lambs.
A medical examiner, sans biohazard suit, hovered over the body, scalpel in hand, preparing to make the first slice required for an autopsy. The overhead recording system he would likely have been used to wasn't available here, and his notes were logged by a small, digital recorder on a rollaway, stainless-steel table next to him.
"Dr. Montgomery, I'm sorry to interrupt," Jennifer said.
Montgomery turned and seemed briefly confused when he first saw Jennifer. Then he recovered when he saw Thad next to her. Montgomery obviously wasn't used to seeing her dressed in the rubber suit.
"No problem at all," he said.
"Dr. Montgomery, I'd like you to meet Dr. Thaddeus Palmer, who we've brought in as a consult."
"Dr. Palmer, yes. It's an honor. I've seen you on TV, and might have stumbled onto one of your articles somewhere." Montgomery extended a gloved hand and Thad shook it. "Rumor has it you had a bit of excitement this morning after you arrived."
Thad ignored that. Instead, he smiled, gave Montgomery's hand one last shake, then dropped it. "It's a pleasure to meet you, doctor." Thad looked at Jennifer, then back to Montgomery. "I see you've opted to lose the biohazard suit. I've been noticing a lot of people have done the same."
"More and more of us are, since we realized they appear useless."
Before Thad could respond, Montgomery turned to Jennifer. "What can I do for the two of you?"
"Well, I wonder if Dr. Palmer and I might have a moment alone with your subject here before you get started. There are a few details of our situation here that Dr. Palmer is having a hard time accepting."
"Oh, I imagine so!" He began snapping off his latex gloves. "Sure, I'll leave you with this for a few. I could use a break." He then clicked off the digital recorder and moved towards the gap in the curtain.
"Doctor, may I borrow your stethoscope?" Jennifer asked before he stepped out.
"Oh, sure." Montgomery lifted the stethoscope from his shoulders and handed them to her as he left.
Setting the stethoscope on the table next to the recorder, Jennifer grabbed the chart attached to the end of the slab and flipped it open. As she studied them, Thad watched the patient, a man, fighting against his restraints.
"A Mr. Douglas Lyle," Jennifer said. "Caucasian male, born 1963. Time of death, 2:43 a.m. this morning." Thad raised an eyebrow as she looked up from the chart. "Tell me, Dr. Palmer, is he dead?"
Douglas Lyle's hands groped the air. His head moved side to side in spite of the straps.
"Of course not," Thad answered assuredly while he looked directly at Jennifer.
She retrieved the stethoscope from the table and held them out to Thad. "Prove it."
Determining whether or not someone's dead, oddly enough, is easier said than done, and even in modern times, the definition of dead is still a controversial issue. Throughout most of human history, it has been nearly impossible to determine for sure if a person is truly dead, and many people have been buried prematurely as a result. Doctors had known for hundreds of years that living people had beating hearts and breathed, but still occasionally misdiagnosed patients whose pulses were slowed or weak or whose breathing was so shallow as to be practically non-existent, for any number of reasons—drug or alcohol use, dehydration, or excessive bleeding, to name a few.
Physicians began creating other methods of determining death. They inserted red hot, metal objects into body orifices, designed devices to yank nipples and tongues for long periods of time, performed crude enemas using tobacco smoke, all in hopes of eliciting a response from the patient. Even with all these methods, doctors still pronounced people dead who were not.
At one point doctors decided to simply wait for the bodies to start smelling, knowing that the living don't decay, establishing "waiting mortuaries," as they came to be called.
Thad knew all of that. And he knew something else.
Dead people don't need to be strapped down.
He told Jennifer as much, but still, she held the stethoscope out to him, not saying anything.
Finally, he snatched it out of her hand. He couldn't get the earpieces directly into his ears with the bio suit's hood on his head. He placed one of the earpieces against his ear with the plastic between them. He did his best to block out noise with his shoulder against his other ear, then placed the diaphragm over his own heart. Even with the burdensome bio-suit, he detected a faint drumming.
He then put the diaphragm over the patient's heart.
Nothing.
Again Thad put the stethoscope to his own heart to make sure nothing had changed. The faint heart beat was there again.
He moved to the patient's heart again, and this time held the stethoscope in place for a long minute to be sure the pulse hadn't simply slowed so much as to escape detection. Still nothing.
Then he scrutinized each of the patient's lungs. In a patient this overwhelmed with bacterial infection, Thad should have easily been able to ascertain respiratory distress, but other than the collateral noise from the patient's movement on the metal table and its moorings, he heard nothing at all.
He sat the stethoscope aside and felt directly for a pulse in spite of his thick gloves and the wrist straps. Then he checked the neck area for the patient's carotid artery. He couldn't find a pulse anywhere.
Thad looked around for a mirror to check for breath, but then realized he wouldn't be able to get it near the patient's mouth with the face guard in the way. He grabbed up the discarded scalpel and carefully worked it between the metal grates of the guard and leaned close, trying to position the mirror-like surface in front of the patient's nose. He looked for the scalpel to steam up as the patient breathed, but the patient's head moved from side to side, making it impossible for Thad to decide anything conclusively.
Thad removed the scalpel from the mask and looked at the patient's flexing fingers. He considered holding down a finger and shoving the scalpel beneath a fingernail to see if the patient yelped in pain, but simply dropped the scalpel back on the tray and leaned against the exposed metal on the slab, staring down at the decaying man in front of him.
"Well, Dr. Palmer?" Jennifer asked after giving Thad time to digest his findings.
The whole Dr. Palmer-thing was beginning to grate on his nerves. "It's impossible to make a proper determination with all…all this," he said, never looking up at her, but waved a hand at his bio-hazard suit and the equipment in the room.
"Thad…"
Now he looked at her. "He's moving, Jen! What do you expect me to say?"
Jennifer sighed and moved past the curtain into the corridor. Thad followed her out. A younger CDC employee, probably an intern, was walking by and Jennifer caught her arm.
"Are there any more autopsies going on right now?"
The intern pointed further down the hall. "Dr. Young is just finishing up in Five."
"Thank you." Then to Thad: "Come on."
They both walked down two cubes where a small, rotund female physician with a loupe perched on her brow was bagging and cataloging recently removed organs. "Afternoon, Dr. Laramie," Dr. Young said to Jennifer when she and Thad came in. "You need the room? I'm just about done here."
Jennifer looked at the corpse on the slab, another male, but younger than the last, and shook
her head. It had already been quieted. Its brain hadn't been logged yet. It sat on a small, rollaway table next to the corpse.
The top of the corpse's skull had been removed, and so had a large portion of one side of its face, which didn't register at first as peculiar. So many people came in mangled, a torn-up face was hardly uncommon.
"No, no. Dr. Young, this is Thaddeus Palmer. I was hoping to show him an autopsy in progress."
"Dr. Montgomery will be starting one soon. There are no shortage of them lately." Young turned to Palmer. "Nice to make your acquaintance, Dr. Palmer. I'd shake your hand, but…" She held up the lung she was cradling.
Thad smiled at her, then looked back at Jennifer. She seemed to be studying the corpse. Then her eyes landed on something and she quickly moved to the other side of the body, to the table on which the brain rested.
"What made you remove this?" Jennifer asked, indicating a small, chalk-colored object that resembled miniature tree branches, or maybe veins of a leaf if the leaf were stripped of everything else and then wrapped around an invisible ball. It sat next to the brain.
"Oh, Peters stuck his head in a while ago and asked if I'd remove a specimen from somewhere. I was working on the brain at the time, so I took it from the face." Dr. Young had bagged the lung while she spoke and was busy logging it in.
Jennifer nodded. "Dr. Palmer, come look at this."
Thad moved around the corpse, past Young, and looked at the veinal, milky ball.
"What do you see?" Jennifer asked him.
"Nerve fibers," he returned quickly.
"The ophthalmic nerve, to be precise," Young interjected. "Just before it branches out into the frontal and nasociliary."
Thad looked at her. "If you say so."
Jennifer put a hand on his arm. "But what do you see? Give me some details."
Thad eyed her for a moment, then turned back to the steel table and gingerly picked up the small display of nerves. He looked at Dr. Young and gestured towards the loupe still on her forehead. "May I?"
"Oh, sure, sure." The doctor removed the loupe and handed it to Thad.
Thad handled the loupe, looked at Jennifer, and tapped against his plastic hood with it, as if to say, "Now what?"
Jennifer took the loupe from him and loosened the strap so that it fit on a much larger head. Then, with Dr. Young's help, she managed to push down the hood so that it molded somewhat to his skull while Young wrapped the loupe around it.
It took a minute to adjust the eyepieces so they were over Thad's eyes, but soon he gave a thumbs up. But the plastic face of the hood was pressed tightly near Thad's nose and mouth.
"Can you breathe?" Dr. Young asked.
"It'll probably disappoint your colleague," Thad poked a thumb Jennifer's direction, "but, yes, I can."
Jennifer smiled quickly. Thad moved the nerve fibers within view of the loupe's eyepieces and studied it, first the exterior, then the largest cross-section where it had been surgically severed.
It had been a while since he'd been in school and memorized the names of the different pieces that made up the nerves. "The…" he looked at Young, "epineurious?"
"Epineurium," she corrected him.
"The epineurium seems intact. Undamaged. The para—"
"Peri-"
"The perineurium also appears fine. The nerves look perfectly healthy."
"Exactly," Jennifer said. "And how long would you guess our autopsy patient has been dead? Roughly, judging from the rate of putrefaction."
Thad tried to remove the loupe on his own, but Jennifer and Dr. Young had to help him. Setting the nerve fibers back down, he turned his attention to the corpse in front of him. The skin had marbled to a greenish-black color. The skin was also blistered in places and the abdomen swollen. Purge fluid had recently been draining from the patient's nose and mouth, and as a result, the tissue around the corpse's fingernails had retracted.
Of course, it would be impossible to precisely estimate a time of death without knowing the environmental conditions in which the body was subjected to after death. But he'd only been told to render a guess based on what he saw.
"Three days, maybe four, under normal conditions."
"Doctor?"
"Four days is about right," Dr. Young confirmed.
"Okay," Jennifer said, "now these nerve fibers were taken from this body. If you had looked at only the nerve fibers, what would you have guessed the age of the body to be that they'd come from?"
Thad looked back down at the nerves but didn't pick them up again. He didn't need to. "Very recently deceased. Minutes old. An hour tops." He turned to Young. "Doctor, you can confirm these nerves did, indeed, come from this body?"
Young nodded. "Not long before you came in."
Thad walked across the small, curtained cubicle and studied the specimen bags containing the extracted organs. It was what he expected from a four-day-old corpse, some organs predictably more decayed than others with the stomach and intestines being the most putrefied. But all of them definitely showed significant signs of decomposition. For the nerve fibers to show no decay at all was impossible.
Finally, Thad looked back to Jennifer.
"That's why they are dead, but still moving," Jennifer explained. "Because the nerves throughout the body are protected from putrefaction. We don't know why."
"But…that's not possible. Intact nerves can't activate tissues or other muscles if the tissues themselves are decayed and inoperable. How—"
"We don't know that either. We think that the bacteria, maybe using some sort of bio-film, are receiving the signals from the nerves. Bypassing the tissue, somehow. The bacteria plays a role in the tissue's response to stimulation. It's just a theory, but we have some research to support it."
"So, when did the body stop moving?"
"When the brain stem was severed," Young answered.
Thad nodded. That made sense. That is if any of this actually made any sense.
"And all the nerves throughout the body are as equally preserved and healthy?"
"Well, no." It was Jennifer who spoke up this time. "The sensory nerves decompose. Which is why—"
"Which is why they don't feel pain," Thad finished. He thought about Dr. Amata. He thought about the sounds of his ribs snapping as he reached for them.
* * * * *
They thanked Dr. Young and left her to finish her work. Thad still wasn't sold. He still held firm to the idea that dead people can't move. Sure, living people usually don't decompose either, but there was still such a thing as gangrene. Perhaps they were dealing with an advanced form of that. The fact the bodies moved proved the brain was still sending signals through the nerves, which meant brain death had not occurred. And wasn't brain death the most acceptable definition of death?
He mentioned as much to Jennifer as they left the former NICU.
"Well, you saw the brain. Was it decomposed?"
"Yes, I suppose it was."
"But actually, you're right. You saw it, but you never picked it up. If you had…if you'd turned it over, you'd have realized the bottom part of the brain, around the brain stem, had miraculously escaped the putrefaction process. It's as pristine as the nerve fibers."
"You mean, the hypothalamus."
"Precisely."
"And the hypothalamus controls many basic body functions." Thad held up a hand as they walked and began ticking them off with his fingers. "It secretes neurohormones, it regulates body temperature, controls how we sleep, our moods, our sex drive—"
"Hunger," Jennifer added flatly.
"Hunger?"
"Yes. And that's what these things are trying to do. It's why they attack people. Attack anything that moves, really. They think they're hungry, and they want to eat."
Thad decided to ignore the fact she'd just referred to patients as things. "But if their bodies are decaying…if their organs are decomposing, their digestive systems would be the first to go. How are they eating? How are they satisfying a hunger that can't ex
ist?"
"Their hunger never gets satisfied."
They stopped walking. Thad eyed her disbelievingly.
Jennifer leaned against the wall and looked down the corridor.
"A few days ago we had a specimen we were studying locked in a room on Four. It was an operating room we'd cleared out with a viewing room above it, so it gave us a chance to observe it safely. This was one of the original passengers of the cruise ship, by the way, so it was already well decomposed, but still walking around.
"Anyway, someone, I don't remember who, got the idea to dangle something down from the gallery to see what it would do. So we raided the cafeteria freezer and found a whole chicken. We thawed it out and dropped it down on a thick string. We moved it around to get the creature's—"
"The patient's…"
Jennifer sighed. "The patient's attention. When he saw it, he moved to it immediately and started eating it. And he kept on, chewing bone and all, until there was practically nothing left. We got another chicken and another, each time with the same result. He just kept eating and kept eating.
"Eventually, his stomach ruptured and bursts, but he kept eating. His abdomen split open and the chicken he'd eaten spilled all over the floor, undigested, of course. But he kept eating. Some people wanted to keep the test going, and I admit I was fascinated, but I put a stop to it. Shortly after that, I had the specimen autopsied so we could learn what we could from it…him. But then I had him quieted."
"Quieted?"
"That's what we're calling it when we damage the brain stem enough to put them down permanently."
"Quieted." Thad looked at the floor. Mulled the word over.
"Thad, I know you still don't believe they're dead. I get that. I didn't want to believe it either. None of us did. But stick around. You'll become convinced."
Thad looked at her again. His entire body was sweating under the bio-hazard suit. He wanted out of it soon.
"What's next?" he asked.
