by Greg Egan
Thirty-five vehicles arrived between ten and eleven – none I’d seen before – and then the flow tapered off abruptly. I scanned the entertainment channels on my notepad, satisfied by anything with colour and movement; I’d had enough of Ariadne’s bad news.
Just before midnight, a blue Ford campervan rolled up and parked in the corner opposite me. A young man and a young woman got out; they seemed excited, but a little wary, as if they couldn’t quite believe that their parents weren’t watching from the shadows.
As they crossed the car park, I realised that the guy was the blond kid who’d spoken to me in Pliny.
I waited five minutes, then went and checked their licence plate; it was a Massachusetts registration. I hadn’t recorded it on Saturday night, so I would have missed the fact that they were following the Trail, if one of them hadn’t—
Hadn’t what?
I stood there frozen behind the van, trying to stay calm, replaying the incident in my mind. I knew I hadn’t let him paw me for long, but how long would it have taken?
I glanced up at the disinterested stars, trying to savour the irony because it tasted much better than the fear. I’d always known there’d be a risk, and the odds were still heavily in my favour. I could put myself into quarantine in Nashville in the morning; nothing I did right now would make the slightest difference …
But I wasn’t thinking straight. If they’d travelled together all the way from Massachusetts, or even from Greensboro, one should have infected the other long ago. The probability of the two of them sharing the same freakish resistance to the virus was negligible, even if they were brother and sister.
They couldn’t both be unwitting, asymptomatic carriers. So either they had nothing to do with the outbreaks—
—or they were transporting the virus outside their bodies, and handling it with great care.
A bumper sticker boasted: STATE-OF-THE-ART SECURITY! I placed a hand against the rear door experimentally; the van didn’t emit so much as a warning beep. I tried shaking the handle aggressively; still nothing. If the system was calling a security firm in Nashville for an armed response, I had all the time I needed. If it was trying to call its owners, it wouldn’t have much luck getting a signal through the aluminium frame of the village hall.
There was no one in sight. I went back to my car, and fetched the toolkit.
I knew I had no legal right. There were emergency powers I could have invoked, but I had no intention of calling Maryland and spending half the night fighting my way through the correct procedures. And I knew I was putting the prosecution case at risk, by tainting everything with illegal search and seizure.
I didn’t care. They weren’t going to have the chance to send one more person down the Trail of Happiness, even if I had to burn the van to the ground.
I levered a small, tinted fixed window out of its rubber frame in the door. Still no wailing siren. I reached in, groped around, and unlocked the door.
I’d thought they must have been half-educated biochemists who’d learnt enough cytology to duplicate the published fibroblast-culturing techniques.
I was wrong. They were medical students, and they’d half learnt other skills entirely.
They had their friend cushioned in polymer gel, contained in something like a huge tropical fish tank. They had oxygen set up, a urethral catheter, and half a dozen drips. I played my torch beam over the inverted bottles, checking the various drugs and their concentrations. I went through them all twice, hoping I’d missed one – but I hadn’t.
I shone the beam down onto the girl’s skinless white face, peering through the delicate streamers of red rising up through the gel. She was in an opiate haze deep enough to keep her motionless and silent, but she was still conscious. Her mouth was frozen in a rictus of pain.
And she’d been like this for sixteen days.
I staggered back out of the van, my heart pounding, my vision going black. I collided with the blond kid; the girl was with him, and they had another couple in tow.
I turned on him and started punching him, screaming incoherently; I don’t remember what I said. He put up his hands to shield his face, and the others came to his aid: pinning me gently against the van, holding me still without striking a single blow.
I was crying now. The campervan girl said, ‘Sssh. It’s all right. No one’s going to hurt you.’
I pleaded with her. ‘Don’t you understand? She’s in pain! All this time, she’s been in pain! What did you think she was doing? Smiling?’
‘Of course she’s smiling. This is what she always wanted. She made us promise that if she ever caught Silver Fire, she’d walk the Trail.’
I rested my head against the cool metal, closed my eyes for a moment, and tried to think of a way to get through to them.
But I didn’t know how.
When I opened my eyes, the boy was standing in front of me. He had the most gentle, compassionate face imaginable. He wasn’t a torturer, or a bigot, or even a fool. He’d just swallowed some beautiful lies.
He said, ‘Don’t you understand? All you see in there is a woman dying in pain, but we all have to learn to see more. The time has come to regain the lost skills of our ancestors: the power to see visions, demons and angels. The power to see the spirits of the wind and the rain. The power to walk the Trail of Happiness.’
REASONS TO BE CHEERFUL
1
In September 2004, not long after my twelfth birthday, I entered a state of almost constant happiness. It never occurred to me to ask why. Though school included the usual quota of tedious lessons, I was doing well enough academically to be able to escape into daydreams whenever it suited me. At home, I was free to read books and web pages about molecular biology and particle physics, quaternions and galactic evolution, and to write my own Byzantine computer games and convoluted abstract animations. And though I was a skinny, uncoordinated child, and every elaborate, pointless organised sport left me comatose with boredom, I was comfortable enough with my body on my own terms. Whenever I ran – and I ran everywhere – it felt good.
I had food, shelter, safety, loving parents, encouragement, stimulation. Why shouldn’t I have been happy? And though I can’t have entirely forgotten how oppressive and monotonous classwork and schoolyard politics could be, or how easily my usual bouts of enthusiasm were derailed by the most trivial problems, when things were actually going well for me I wasn’t in the habit of counting down the days until it all turned sour. Happiness always brought with it the belief that it would last, and though I must have seen this optimistic forecast disproved a thousand times before, I wasn’t old and cynical enough to be surprised when it finally showed signs of coming true.
When I started vomiting repeatedly, Dr Ash, our GP, gave me a course of antibiotics and a week off school. I doubt it was a great shock to my parents when this unscheduled holiday seemed to cheer me up rather more than any mere bacterium could bring me down, and if they were puzzled that I didn’t even bother feigning misery it would have been redundant for me to moan constantly about my aching stomach when I was throwing up authentically three or four times a day.
The antibiotics made no difference. I began losing my balance, stumbling when I walked. Back in Dr Ash’s surgery, I squinted at the eye chart. She sent me to a neurologist at Westmead Hospital, who ordered an immediate MRI scan. Later the same day, I was admitted as an in-patient. My parents learnt the diagnosis straight away, but it took me three more days to make them spit out the whole truth.
I had a tumour, a medulloblastoma, blocking one of the fluid-filled ventricles in my brain, raising the pressure in my skull. Medulloblastomas were potentially fatal, though with surgery, followed by aggressive radiation treatment and chemotherapy, two out of three patients diagnosed at this stage lived five more years.
I pictured myself on a railway bridge riddled with rotten sleepers, with no choice but to keep moving, trusting my weight to each suspect plank in turn. I understood the danger ahead, very clearly …
and yet I felt no real panic, no real fear. The closest thing to terror I could summon up was an almost exhilarating rush of vertigo, as if I were facing nothing more than an audaciously harrowing fairground ride.
There was a reason for this.
The pressure in my skull explained most of my symptoms, but tests on my cerebrospinal fluid had also revealed a greatly elevated level of a substance called Leu-enkephalin – an endorphin, a neuropeptide which bound to some of the same receptors as opiates like morphine and heroin. Somewhere along the road to malignancy, the same mutant transcription factor that had switched on the genes enabling the tumour cells to divide unchecked had apparently also switched on the genes needed to produce Leu-enkephalin.
This was a freakish accident, not a routine side-effect. I didn’t know much about endorphins then, but my parents repeated what the neurologist had told them, and later I looked it all up. Leu-enkephalin wasn’t an analgesic, to be secreted in emergencies when pain threatened survival, and it had no stupefying narcotic effects to immobilise a creature while injuries healed. Rather, it was the primary means of signalling happiness, released whenever behaviour or circumstances warranted pleasure. Countless other brain activities modulated that simple message, creating an almost limitless palette of positive emotions, and the binding of Leu-enkephalin to its target neurons was just the first link in a long chain of events mediated by other neurotransmitters. But for all these subtleties, I could attest to one simple, unambiguous fact: Leu-enkephalin made you feel good.
My parents broke down as they told me the news, and I was the one who comforted them, beaming placidly like a beatific little child martyr from some tear-jerking oncological miniseries. It wasn’t a matter of hidden reserves of strength or maturity; I was physically incapable of feeling bad about my fate. And because the effects of the Leu-enkephalin were so specific, I could gaze unflinchingly at the truth in a way that would not have been possible if I’d been doped up to the eyeballs with crude pharmaceutical opiates. I was clear-headed but emotionally indomitable, positively radiant with courage.
* * *
I had a ventricular shunt installed, a slender tube inserted deep into my skull to relieve the pressure, pending the more invasive and risky procedure of removing the primary tumour; that operation was scheduled for the end of the week. Dr Maitland, the oncologist, had explained in detail how my treatment would proceed, and warned me of the danger and discomfort I faced in the months ahead. Now I was strapped in for the ride and ready to go.
Once the shock wore off, though, my un-blissed-out parents decided that they had no intention of sitting back and accepting mere two-to-one odds that I’d make it to adulthood. They phoned around Sydney, then further afield, hunting for second opinions.
My mother found a private hospital on the Gold Coast – the only Australian franchise of the Nevada-based ‘Health Palace’ chain – where the oncology unit was offering a new treatment for medulloblastomas. A genetically engineered herpes virus introduced into the cerebrospinal fluid would infect only the replicating tumour cells, and then a powerful cytotoxic drug, activated only by the virus, would kill the infected cells. The treatment had an 80 per cent five-year survival rate, without the risks of surgery. I looked up the cost myself, in the hospital’s web brochure. They were offering a package deal: three months’ meals and accommodation, all pathology and radiology services, and all pharmaceuticals, for sixty thousand dollars.
My father was an electrician, working on building sites. My mother was a sales assistant in a department store. I was their only child, so we were far from poverty-stricken, but they must have taken out a second mortgage to raise the fee, saddling themselves with a further fifteen or twenty years’ debt. The two survival rates were not that different, and I heard Dr Maitland warn them that the figures couldn’t really be compared, because the viral treatment was so new. They would have been perfectly justified in taking her advice and sticking to the traditional regime.
Maybe my Leu-enkephalin sainthood spurred them on somehow. Maybe they wouldn’t have made such a great sacrifice if I’d been my usual sullen and difficult self, or even if I’d been nakedly terrified rather than preternaturally brave. I’ll never know for sure, and, either way, it wouldn’t make me think any less of them. But just because the molecule wasn’t saturating their skulls, that’s no reason to expect them to have been immune to its influence.
On the flight north, I held my father’s hand all the way. We’d always been a little distant, a little mutually disappointed in each other. I knew he would have preferred a tougher, more athletic, more extroverted son, while to me he’d always seemed lazily conformist, with a world view built on unexamined platitudes and slogans. But on that trip, with barely a word exchanged, I could feel his disappointment being transmuted into a kind of fierce, protective, defiant love, and I grew ashamed of my own lack of respect for him. I let the Leuenkephalin convince me that, once this was over, everything between us would change for the better.
* * *
From the street, the Gold Coast Health Palace could have passed for one more high-rise beach-front hotel – and even from the inside, it wasn’t much different from the hotels I’d seen on video fiction. I had a room to myself, with a television wider than the bed, complete with network computer and cable modem. If the aim was to distract me, it worked. After a week of tests, they hooked a drip into my ventricular shunt and infused first the virus and then, three days later, the drug.
The tumour began shrinking almost immediately; they showed me the scans. My parents seemed happy but dazed, as if they’d never quite trusted a place where millionaire property developers came for scrotal tucks to do much more than relieve them of their money and offer first-class double-talk while I continued to decline. But the tumour kept on shrinking, and when it hesitated for two days in a row the oncologist swiftly repeated the whole procedure, and then the tendrils and blobs on the MRI screen grew skinnier and fainter even more rapidly than before.
I had every reason to feel unconditional joy now, but when I suffered a growing sense of unease instead I assumed it was just Leu-enkephalin withdrawal. It was even possible that the tumour had been releasing such a high dose of the stuff that literally nothing could have made me feel better: if I’d been lofted to the pinnacle of happiness, there’d be nowhere left to go but down. But in that case, any chink of darkness in my sunny disposition could only confirm the good news of the scans.
One morning I woke from a nightmare – my first in months – with visions of the tumour as a clawed parasite thrashing around inside my skull. I could still hear the click of carapace on bone, like the rattle of a scorpion trapped in a jam jar. I was terrified, drenched in sweat … liberated. My fear soon gave way to a white-hot rage: the thing had drugged me into compliance, but now I was free to stand up to it, to bellow obscenities inside my head, to exorcise the demon with self-righteous anger.
I did feel slightly cheated by the sense of anticlimax that came from chasing my already-fleeing nemesis downhill, and I couldn’t entirely ignore the fact that imagining my anger to be driving out the cancer was a complete reversal of true cause and effect – a bit like watching a forklift shift a boulder from my chest, then pretending to have moved it myself by a mighty act of inhalation. But I made what sense I could of my belated emotions, and left it at that.
Six weeks after I was admitted, all my scans were clear, and my blood, CSF and lymphatic fluid were free of the signature proteins of metastasising cells. But there was still a risk that a few resistant tumour cells remained, so they gave me a short, sharp course of entirely different drugs, no longer linked to the herpes infection. I had a testicular biopsy first – under local anaesthetic, more embarrassing than painful – and a sample of bone marrow taken from my hip, so my potential for sperm production and my supply of new blood cells could both be restored if the drugs wiped them out at the source. I lost hair and stomach lining, temporarily, and I vomited more often, and far more wretchedly, than whe
n I’d first been diagnosed. But when I started to emit self-pitying noises, one of the nurses steelily explained that children half my age put up with the same treatment for months.
These conventional drugs alone could never have cured me, but as a mopping-up operation they greatly diminished the chance of a relapse. I discovered a beautiful word: apoptosis – cellular suicide, programmed death – and repeated it to myself again and again. I ended up almost relishing the nausea and fatigue; the more miserable I felt, the easier it was to imagine the fate of the tumour cells, membranes popping and shrivelling like balloons as the drugs commanded them to take their own lives. Die in pain, zombie scum! Maybe I’d write a game about it, or even a whole series, culminating in the spectacular Chemotherapy III: Battle for the Brain. I’d be rich and famous, I could pay back my parents, and life would be as perfect in reality as the tumour had merely made it seem to be.
* * *
I was discharged early in December, free of any trace of disease. My parents were wary and jubilant in turn, as if slowly casting off the fear that any premature optimism would be punished. The side-effects of the chemotherapy were gone; my hair was growing back, except for a tiny bald patch where the shunt had been, and I had no trouble keeping down food. There was no point returning to school now, two weeks before the year’s end, so my summer holidays began immediately. The whole class sent me a tacky, insincere, teacher-orchestrated get-well e-mail, but my friends visited me at home, only slightly embarrassed and intimidated, to welcome me back from the brink of death.
