The Janus Legacy

by Lisa von Biela

  She took a quick look at Johnnie in his playpen and shut off the stove. Then she followed him. “Not this time. We’re going to talk.”

  He continued up the stairs to their bedroom, hoping to shake her from his tail. “Katie, I mean it. I’m way too tired to talk right now.” He reached the bedroom, sat heavily on the bed and slipped off his shoes.

  Katie stood in the doorway, wearing her most stubborn look. “Not till we talk.”

  He groaned and hung his head. He’d seen her like this before. She would not back off until she was satisfied. He had to tell her something, or she would stand there until hell froze. He weighed his response before starting. “I can’t give you specifics, but I’m involved in a new project at SomaGene. Ivan started it before he died, and Glen and I have been working on it since, according to his wishes. It’s very leading edge, never been done before. The work is…difficult, and Glen and I are not seeing eye to eye on some aspects of it.”

  Her eyes widened with curiosity. “What sort of project?”

  He raised his head with an effort and looked up at her. “That’s what I can’t talk about. It’s crucial it remain under wraps. But I can tell you, it is what’s been stressing me. The work itself, as well as the conflict with Glen over certain aspects. That’s really all I can say, but I hope you understand.”

  “Well, all right. You know I’d keep quiet if you did tell me.” She looked at him imploringly.

  “Maybe someday I can tell you more. But not now.” He leaned back. “Can I please just go to bed now? I’m sorry about dinner. I just really need to sleep.”

  “All right. I’ll get Johnnie’s bath, too.” Katie started to back out of the room.

  “Thank you.” Tim didn’t bother to change clothes. He just closed his eyes and fell asleep within minutes.

  CHAPTER 52

  Jeremy stood staring out of his office window. He wouldn’t have believed it possible, but time had flown by while he recuperated from his second surgery. The leaves in the trees now had that mature sort of green about them, looking tired and ready for the transition to fall in a few weeks. Such a stark contrast with how he felt now.

  His recovery had gone remarkably well for such an extensive procedure. He was back on a normal diet after being initially restricted to only the most easily digested foods while his new intestines established themselves in his body.

  Amanda had been with him every step of the way—and they had somehow managed to avoid the topic that lurked beneath his miraculous return to health. For that he was grateful. It had taken all his strength and concentration to convalesce as rapidly as he had. He couldn’t have handled such discussions—and besides, what point was there? The procedure was done, and the Subject was being nutritionally supported. It’s not like there was any turning back. So there was no sense in draining his energy constantly revisiting the opportunity to feel guilty.

  And now, he was off the meds, pain-free, and feeling even better than after the first procedure. Life was certainly good now. But he had to wonder how long this respite would last. He still had Crohn’s, and the disease would want to lay waste to his digestive tract. And it would—it just had new tissues to work on that would stave off the worst of it for a while. For how long? He had no idea, and neither did Tim or Glen.

  What if it only worked for a couple of years—or less? How many more times over his lifetime would he need a transplant? He didn’t want to think about this, but eventually he’d have to face it. Would he need an indefinite supply of new Subjects to keep him healthy? Maybe there was some medication that he could take that would at least slow the process down.

  A knock on his office door interrupted his thoughts.

  “Come in.”

  Glen stepped in. “You have a few minutes?”

  “Yeah.” Jeremy returned to his desk and motioned Glen to sit. “What’s up?”

  “We need to talk about next steps. You gave me the go-ahead to start a new Subject from Ivan’s tissues, and I did so.”

  “OK.” Jeremy had to admit that this news gave him a feeling of relief. It also made him feel like a parasite.

  Glen leaned forward in his chair with a rather enthusiastic expression on his face. “We anticipate it will be several years before it’s ready to harvest from. We need to look at what drug regimen will have the least side effects for you, yet still retard Crohn’s effects on the new intestines. That might be easier than before since you now have new, undamaged intestines. Personally, I suspect there may be something of a vicious cycle involved with Crohn’s—once it gets some headway in damaging the tissue, there is more inflammation and it can attack more viciously. This is just a hunch, of course, since no one’s ever observed a situation where it gets to start over in the same patient on an entirely new intestinal tract.”

  “I’d prefer to be off the drugs entirely, but what you say makes sense.”

  “We also need to look into whether we can get to harvestability any sooner than the first time. Could we, for example, increase some of the growth hormones and nutrients in the second Subject’s diet to get there sooner? Worth a shot.”

  “Is there any risk inherent in speeding it up, though? Could it lead to anomalies?”

  Glen paused. “That is something to consider, of course. We should probably only incrementally increase the nutrients and growth hormones over what we used with the first Subject. You know, I wish we could find a way to regenerate the digestive tract right within the original Subject. I just haven’t figured out yet how to avoid some of the same pitfalls we encountered in trying to develop digestive tracts in vitro. The walls would adhere and seal the lumen shut, and we weren’t able to generate the complex supporting structure that naturally develops in utero.” He stood. “Well, that’s all I have for now. I’ll let you get back to what you were doing.” He strode from the room and shut the door behind him.

  Jeremy realized his new life came with a price. The Subject wasn’t the only guinea pig at SomaGene.

  CHAPTER 53

  He lay on his thin mattress and gazed at the ever-present tube that led from just below his collarbone to the bottle suspended high above him. He rarely felt like moving around in his enclosure any more. Instead, he spent most of his day just staring at the bottle, watching as a bubble occasionally formed and the level of the liquid within slowly lowered throughout the day.

  It was always sore where the tube connected to his body. Always. He didn’t want to look at it, didn’t want to touch it for fear of making it hurt worse. It made him want to draw into himself to escape it, but there was no escape.

  The White Coats never brought him anything to eat any more. He heard the animals in the room next to him shout and screech every day still, and his stomach made noises and hurt. But no one brought him food. He didn’t understand it. Even though the food had tasted bad since the last time the White Coats had taken him into that special room, he missed eating.

  His body didn’t even feel right ever since that day the White Coats came in and pinned him down. He couldn’t remember what happened after they came in. His next memory was waking up and having pain in his stomach again. So much pain. He’d very tentatively reached his hand down and touched his stomach. Again, it had some large pad taped to it for some days.

  Then one day the White Coats took the pad off and left it off. When they left him alone again, he reached down and touched the area. He felt a long, painful ridge that went halfway up him. And he felt something else. When he lay on his back, his stomach sunk right into him. And it hurt. Not just on the skin where the line was, but all through him inside hurt if he shifted position.

  And that’s why he hardly moved these days.

  He tried to think, to find a connection. The only thing he could think of was when both White Coats came in, something always happened. And when that something happened, he would forget what it was, but would remember having pain afterwards. The first time was bad, but this time was so much worse.

  What if they came in tog
ether again? Would it happen again? How much worse could he hurt? He couldn’t quite fathom it.

  He watched as another bubble made its way to the surface of the fluid, and the level in the bottle went down just a little bit more.

  He turned quickly when he heard the door open. It was one person, Not White Coat. The one who always acted strangely when he came in, but at least he had never hurt him. He watched him approach his enclosure. He didn’t feel sufficiently threatened to bother moving.

  Jeremy’s stomach clenched when he took his first look at the Subject since the procedure. He lay draped on his pathetic little shelf of a bed. He looked listless, pale, and…hollow. Even beneath his hospital gown, the concavity of his abdomen was apparent. Jeremy wondered what sort of sensation the Subject experienced, if he realized that his abdomen was devoid of any intestines.

  A permanent IV drip had been installed into his subclavian artery. The bottle held an off-white fluid that provided total parenteral nutrition. The Subject could never be allowed to have solid food ever again. It would simply hit a dead end just below the stomach and turn into an indigestible bolus that would have to be removed one way or the other.

  Jeremy stood rooted in place, staring. What kind of life did the Subject have? He couldn’t imagine never being able to eat again; of course, he was able to eat whatever he wanted now. Food represented both sustenance and pleasure for him. The Subject had been fed lab rations all his life, had never experienced anything more than utilitarian meals meant to deliver nutrition, not enjoyment. But still, to never be able to eat, and to be hooked up to that IV for the rest of his life. It had to be its own sort of unique prison for him.

  The door behind him opened. “Oh, I didn’t realize you were in here.” Tim entered, carrying another bottle of the fluid.

  “Oh, um, yeah. I—”

  “It’s your first time in here since the procedure, isn’t it?” Tim’s eyes took on a weary, yet sympathetic, look.

  “Yeah. I felt I should see how he’s…doing.”

  Tim gazed at the Subject as he answered. “Well, he’s doing as well as can be expected, I suppose. He appears to be absorbing the nutrients from the fluid reasonably well. We’ve managed to keep the needle site from getting infected, and we’ve been lucky he doesn’t seem interested in pulling at it. In fact, he doesn’t even touch it. It must hurt.” He sighed. “Maybe that’s just as well. I can’t imagine what we’d do if he did actively interfere with it. Like it or not, it’s his lifeline now.”

  Jeremy’s mouth turned dry as cotton as he forced out the question that plagued him. “What do you think he’s feeling? What must it be like for him, beyond not being able to eat solid food? What does it feel like to be missing his entire digestive tract?”

  Tim glanced at the level in the current IV bottle, then quietly entered the enclosure and swapped it out for the new bottle before answering. He closed the enclosure door behind him and stared down at the nearly empty bottle in his hands as he answered. “I honestly don’t know, Jeremy.”

  He turned the bottle over and over in his hands, appearing focused on the remnants of whitish fluid that sloshed within. “You know, he arrested during the procedure. I had just removed his intestines and set them aside for Glen. I was ligating blood vessels, and he started to go tachy, then he seized. I got the paddles and zapped him back. All the while, Glen was yelling at me to not bother, to keep focused on you and the rest of the procedure.” He stopped, glanced at the Subject once more, then said, “Now I wish I’d done as Glen said. Excuse me.” And he exited the room without another word.

  CHAPTER 54

  “Jeremy—what’s the matter?” Amanda dropped her purse on the counter and hurried to the kitchen table where he sat.

  Jeremy looked at her through eyes that stubbornly refused to focus. He didn’t generally drink the hard stuff, but it seemed like a good day for it. He raised his half-full glass of whiskey in greeting. “I paid a little visit to my…benefactor today.”

  “What?” Amanda frowned in confusion.

  “The Subject. First time I’ve seen him since he so generously gave up his entire intestinal tract so that I can have a good life.” Jeremy took another sip.

  Amanda stared down at her hands. “Oh. I thought you’d made some sort of peace with yourself on that.”

  “Yep, out of sight, out of mind was working pretty well for me. Then I made the mistake of actually looking.” Jeremy put down his glass and pressed his face into his hands. “Oh, my God, Amanda.”

  “I thought they said they would come up with some alternate feeding method—”

  Jeremy slammed his palms onto the table and glared at her. “They sure did.” He waved his hand as if the Subject were in the room just off to his right. “Yeah, it’s great. He’s hooked up to IV nutrition for every minute of the rest of his goddamned life. There it is, nice bottle of white crap flowing into his veins all day every day.” He pointed to a spot just under his collarbone. “Needle goes in here. And that’s where it’s going to stay. Forever.” He paused, stared off into the distance and continued in a lower tone. “No solid food again. Ever. Unimaginable.”

  Amanda reached out and put her hand on his arm. “Probably wasn’t the best idea to go see him.”

  He glared at her again. “Well, too late now. The image is burned in my brain forever.” He sat back in his chair, crossed his legs. “Tim doesn’t feel too good about now either. Apparently, the Subject arrested during the surgery and would have died a peaceful death but for Tim’s heroic acts with the defibrillator. He sure seems to have second thoughts about it now himself. We can only guess at the pain and discomfort the Subject’s enduring.” He shook his head. “My God.”

  “I’m sure they’re making him as comfortable as possible. Jeremy, you had no choice. You know how bad you were getting. Something had to be done.”

  “No, they’re not making him as comfortable as possible. There’s an advantage to the needle site remaining sore—to keep him from trying to tamper with it. Isn’t that great?”

  Amanda opened her mouth, then shut it and stared down at the table. Tears began to stream down her face. She wiped them away, put her face in her hands, and began to sob.

  Jeremy felt filled with poison, and wanted to try to drain himself of it in any way possible. “And I already gave Glen permission to go ahead and generate another Subject—because some day Crohn’s will degrade this set of intestines and I’ll be ready for a retread. I can inflict this pain on another Subject so that I can live.” He took another gulp of whiskey. “Wonder how many times this little cycle will play out, how many Subjects I will leave in this condition and how long they’ll live.”

  Amanda looked up, her face red and puffy. “You can’t think of it that way, you just can’t.”

  “What other way would you suggest?”

  CHAPTER 55

  Tim had closed his office door and set his phone to go straight to voicemail. Now he sat at his desk, his eyes fixed on his med school diploma on the far wall. He’d been staring at it for the last twenty minutes as he sat absolutely motionless.

  He thought back to why he’d wanted to become a doctor in the first place. Unlike some of his classmates, who seemed driven by the prestige and money at the end of the rainbow, he’d gone to med school simply because he really liked the idea of learning the necessary skills to heal.

  He remembered the day he completed his very first operation. He was so pumped that he was unable to sleep that entire night. He sat in his apartment alone, amazed at what he had done and grateful he had the knowledge and manual dexterity to do it well.

  He’d gone into research because he wanted to be on the front line of developing new ways to improve people’s health and lives. And for a number of years, that is precisely what he had done at SomaGene. He had been there in the early days with Glen and Ivan, developing the various protocols needed to cultivate and harvest the organs successfully, and refining the surgical procedures and physical environment to ne
arly guarantee a successful outcome. Of that he was proud, and always would be.

  But now, thanks to Ivan’s desperate desire to find a way to save Jeremy—as well as Glen’s and his own hubris—he’d succeeded in reclaiming Jeremy’s health at the terrible price paid by the Subject.

  Ashamed, he turned away from his diploma, then stood and walked to the window. Several inches of fresh snow carpeted the ground and stuck to the branches of the pine trees on the wooded SomaGene campus. He usually liked the look of fresh snow. Today it just looked as cold and bleak as he felt in his heart.

  He reflected on his encounter with Jeremy in the Subject’s room several weeks ago. Even Jeremy, beneficiary of the procedure, could see it was wrong. Tim wondered how he lived with that knowledge—that his nearly normal health was completely due to an involuntary sacrifice on the part of the Subject. And the Subject—how much pain must he be in every single day of his life? What does he know or understand about what happened? Does he have a concept of time? Even if he did, he probably did not understand that his condition will never, ever improve.

  Tim held his hands before his eyes and stared at them. Healing hands. And he’d participated in the procedure. He had removed vital organs from a living human being, sentencing him to a life of pain and continual dependence on his nutrition flowing through his veins and being processed by his kidneys.

  He felt a stone settling in the pit of his stomach as he realized he truly meant what he said to Jeremy—that he shouldn’t have intervened when the Subject arrested. He who only wanted to heal patients had admitted to another—and now to himself—that he would have preferred to let the Subject die.

  If the Subject could truly comprehend his situation, what would he want for himself? Tim returned to his desk and pressed his face into his hands. He chided himself for thinking he could play God. But then…he already had, hadn’t he? He’d played God, and he’d cooperated in putting a human being into a severely degraded physical condition.