The Janus Legacy

by Lisa von Biela

  “He seems all right. He’s been dozing on and off.”

  “Good. I put a sedative in his IV to help ease things for him as he came out of the anesthesia. I didn’t want the post-op pain to hit him all at once.” Glen took a look at the monitors. “I think he’s progressing well, all things considered.”

  “So what’s next?”

  “I’d like to keep him here a little longer than last time, since he went into the procedure in a more weakened state. It must have been pretty uncomfortable for you sitting there like that all this time. I could wheel another bed in and you could stay here with him if you like.” He absently ran a hand through his hair. “Actually, if you would do that, I’d be rather grateful. We could both keep an eye on him, since there is no one else to do it.”

  “Neither of you could convince Tim to at least assist through this operation before leaving?”

  “No. He was determined to cut ties—immediately. He didn’t even pack up his office. Just marched in and told Jeremy he was resigning, and never looked back.”

  Amanda gazed at Jeremy’s sleeping face as she spoke. “I can understand it, actually. We’ve had many discussions about this, and grateful as we are for the chance this gives Jeremy, I’d be lying if I didn’t admit there is a dark side to it.”

  “Well, this is probably not the time to discuss it, but I’ve never seen it that way. The Subject is a mere product of a process that involved some tissue that Ivan donated—donated to help save his son from a terrible fate.”

  Amanda shook her head and sighed. “You’re right. I’m not up to discussing the ethical aspects right now. I’m ashamed to admit it, but I’ve tried hard to avoid dwelling on that. Given we’ve gone ahead and taken advantage of it, it seems disingenuous to look the gift horse in the mouth.”

  “Sorry. I know this must be difficult for you, especially after what you both have been through in the last year. I’m tired and not being very diplomatic.” He tried to smile.

  “Thanks. I understand. We’re all pretty tired about now, I suppose.”

  “Yeah. Well, I’ll check back in later. Remember to buzz me if you notice anything that concerns you.”

  “Will do.” She smiled, then turned back to gaze at Jeremy.

  Glen shut the door behind him. Jeremy did look like he’d weathered the procedure in decent shape. That much was a relief. He decided to go lie down on the couch in his office and take a real nap for a while. He desperately needed the rest, and figured he should take advantage of a quiet point to grab some before Jeremy needed further post-op attention.

  CHAPTER 63

  He awoke to even worse pain than before. Only the small lights were on now in his enclosure. The darkness didn’t usually frighten him, but this time he felt so cold and alone and he hurt so very badly.

  How could he get the pain to stop? He wanted to curl up in a ball in the darkness, to shield his belly from the terrible, searing pain. He squirmed, tried to get onto his side. Another pain—worse than all the rest—shot through his stomach when he moved. He flinched, accidentally kicking his feet against the wall and toppling himself over the edge of the narrow bed and onto the cold cement floor.

  He heard a loud crash when he fell. He wasn’t sure what it was. He reflexively clapped his hands to his upper chest as he experienced a new, tearing pain there. It was warm and wet where his hands were.

  There was even more pain in his stomach. He reached down to his belly. The pads there were wet, sticky, and warm. He lay there, uncomprehending, as his vision grew dimmer and dimmer in the dark. The pain became mercifully hazier along with his vision. He was too tired to get back up on the bed, so he just curled up on the floor as the darkness came.

  Glen flung his forearm over his face as a ray of early morning sunlight attempted to penetrate his eyelids. He rolled over to settle back into sleep, then realized where he was and why. His eyes snapped open and he took in his surroundings. He was all crunched up on his office couch, and sunrise was creeping through his window already. He’d slept there the better part of the night and still felt completely drained.

  He groaned as he forced himself to a sitting position. His back still ached from the long surgery and his limbs were stiff from sleeping on his couch in such an awkward position. He tried to stretch out the kinks as he planned his day.

  Maybe he should check in on the Subject first and replenish his IV bottle, then take the time to give Jeremy a more thorough exam. That sounded like a good plan. Jeremy had looked pretty good when he last saw him, and he would have heard the buzzer had Amanda tried to reach him. He wasn’t quite up to dealing with her yet anyway. After she voiced her ethical concerns, he realized he walked a fine line with her that could lead to a confrontation he didn’t need right now. He wanted to get Jeremy stable enough to leave his immediate care, so he could get some real rest.

  He headed for the restroom down the hall to splash some water on his face and make himself presentable. He looked in the mirror and decided the night’s rest on the couch hadn’t done him nearly as much good as he had hoped. Dark circles lay beneath his bloodshot eyes and made him look ten years older overnight. He sighed and resolved to try to sneak in another nap later. He smoothed his hair and left the bathroom to go check on the Subject.

  Planning only a brief visit, Glen entered the Subject’s room, only to discover he’d fallen to the floor with his back to the door. The IV rack had toppled and the bottle had shattered on the hard cement floor. He groaned at the prospect of having to heave the Subject back up onto the bed and clean up the mess.

  Annoyed more than anything, Glen stomped over to the enclosure and let himself in. Only then did he notice the blood. Two large pools of it lay on the other side of the Subject.

  He scooped the Subject up to get him back up onto the bed, doing his best to lift with his legs to avoid wrenching his already aching back. Glen didn’t like his color, especially the blue tinge on his lips. He reached down and checked for a pulse. Barely there. He took a closer look at the damage.

  The needle apparently ripped out when the Subject fell and tugged the IV down, leaving a tear in the subclavian artery that had flowed pretty freely before partially clotting. Though it had mostly stopped bleeding, he didn’t dare touch it and risk getting it flowing again before he had the materials on hand to try to suture it shut.

  But the needle tear was the least of it. Blood soaked the hospital gown where it lay over the abdomen. Glen lifted the gown and peered beneath the bloody bandages. His shoulders slumped as he realized what had happened. The fall onto the cement floor had been hard enough to rip open some of the fresh external stitches. He wiped aside some of the blood with the edge of one of the bandages and confirmed his even greater fear—not only was the incision bleeding, but the fall must also have reopened at least one other blood vessel internally. Blood seeped both from the edges of the wound and from within the abdominal cavity.

  Glen sat on the bed next to the unconscious Subject and wearily weighed his options. He could drag him back into surgery and try to stem the flow of blood and repair the damage. But why? He’d hoped to try to develop a new set of intestines in vivo using the Subject, but that was a long shot and he was far too tired to try to perform another singlehanded surgery now. Given the amount of blood loss, any such attempt would probably be a waste of time and energy anyway.

  He checked the pulse again at the carotid artery. Very weak and thready. He was nearly gone. Screw it. He’d deal with the mess later. Glen decided to let it go, and just focus on Jeremy’s care.

  Jeremy suddenly awoke screaming in pain. His color was terrible, and he clutched at his abdomen.

  Amanda looked at him, wide-eyed. “What’s wrong?”

  Jeremy screamed and moaned, “Not again!”

  Amanda grabbed the call button and frantically pressed it.

  Glen shut the door to the Subject’s enclosure and tried to think of when he was going to get the time—let alone the energy—to get back in there and clea
n up the mess. He would have to park the body in the freezer with the first Subject and deal with them both later. He shook his head. He was just way too tired to deal with these complications now.

  He was already on his way to check on Jeremy when his buzzer went off. “Shit!” Forgetting his exhaustion in a surge of adrenaline, he sprinted down the hall to the recovery room.

  He burst through the door and ran to Jeremy’s bedside. One look at his patient triggered a panicked déjà vu. He could draw blood for tests, but feared he already knew what it would tell him.

  “What’s going on?” Amanda stood near the bed, pale and taut, her hands pressed to the sides of her face. She appeared right on the edge of hysteria.

  Glen decided not to share his suspicion with her until he verified it. He hoped he was wrong, though in his gut, he knew he wasn’t.

  “I need to take some blood. I’ll let you know as soon as I get the results.” He hastily drew the blood, administered some additional painkillers through Jeremy’s IV port, and left the room before he could get into a discussion with her.

  He ran to the Subject’s room and hurried to the enclosure. He pressed a trembling finger to the Subject’s carotid, knowing and fearing what he would find. Death.

  And now he had his answer. He now knew why Jeremy’s first transplanted intestines had failed. The donor Subject had to be kept alive at all costs. But that didn’t do him any good now.

  He slumped from exhaustion, exhaustion that was magnified because he knew what he would have to do, how long it would take, and that he would have to do it all unassisted.

  CHAPTER 64

  It’s the same damned thing. I know it. Jeremy’s blood chemistry profiles matched the ones run when the first transplanted intestines began to die inside of him. Glen rubbed his eyes and groaned. To be perfectly, professionally certain, he should confirm with a laparoscopic exploratory, but neither he nor Jeremy could spare the energy.

  He knew what the problem was, and now he knew the cause. If only he hadn’t been so cavalier about letting the Subject bleed out. Even if he’d just done some minimal patching, rather than extensive surgery, it might have been enough. It’s not like he cared about brain damage. He just needed to keep the Subject alive, however minimally. Too late now.

  “God damn it!” He slammed his fist onto the desk. To have brought the project this far, only to come to this. Again. And this time without any assistance whatsoever to do what needed to be done.

  And now he had to go deliver the news—if Jeremy hadn’t already figured it out on his own. He might have, if he wasn’t too drugged to realize it.

  He cursed Tim again. Not just for leaving at such a critical point, but for actually causing the critical point. If he hadn’t let his emotions drive him—rather than his brain—he wouldn’t have killed the original Subject and none of this would have happened. Jeremy would have continued to enjoy good health until his Crohn’s eventually made its move—and who gave a damn about the Subject? Tim never did get it through his head that the Subject was a piece of tissue created to serve a purpose. Nothing more.

  Glen gritted his teeth. No matter how stupid and misguided, what was done was done. Now he had to go face Jeremy and Amanda, and have a very hard conversation.

  Amanda didn’t like the way Jeremy was breathing. It was labored, and there was a noticeable hitch in it now and again. She was grateful for his sake that Glen had sedated him—the pain he experienced appeared to be far worse than any pain she’d ever witnessed and she couldn’t bear the sight of him enduring it. But on the other hand, she didn’t like that he was out of it and unable to communicate his wishes to her. The situation seemed serious enough that it was important for her to know what he wanted. Or what he would not want.

  Almost superstitiously, they’d diligently avoided the topic before this latest procedure, as if somehow that would shield them from having to face such a situation. But now she wished they’d discussed what he might want if something went badly and he couldn’t speak for himself. At what point and under what conditions would he want to be allowed to…? She couldn’t even think the word to herself, despite her previous reflections on the quality of his life and whether he was really happy living it.

  She took his hand in hers. It was damp with perspiration. He must be feverish, by the feel of it. She pressed it to the side of her face. Where the hell was Glen? When was he going to come back and explain what was going on? Did she even want to hear what he would have to say? Despite her high talk about ethics, she knew she’d do anything to have Jeremy well again. Anything.

  A knock sounded at the door. She quickly wiped away her tears. “Come in.”

  Glen stepped in, a notepad in his hand. “Hi, Amanda. How’s he been?” He approached the bedside opposite of her.

  “His breathing worries me. It sounds terrible.” She looked up at Glen, her eyes burning with tears. “What is it?” she asked in a small voice.

  Glen glanced at the monitors and made a show of taking Jeremy’s pulse and giving him a visual onceover before answering. He pulled a rolling stool to Jeremy’s bedside and sat down on it heavily. “It is serious, Amanda. I won’t kid you.”

  Amanda’s stomach felt hollow. She didn’t know what was coming, but she already knew it would be dismal.

  “Remember the last time, when he’d healed and the transplanted organs failed and began to die? Well, that’s exactly what’s happening again. So not only have the organs ceased to function, but he’s being hit with toxicity from tissue death and infection.”

  Amanda remembered all too well. Jeremy had been rushed into emergency surgery, only to emerge tied to the IV full-time until he could get another transplant. And it was all happening again. “Why?”

  Glen hesitated before answering. “You’re going to find this a little difficult to believe, but best I can tell, there appears to be a clear correlation. Last time, this happened right after Tim terminated the Subject. This time, it happened right after the Subject expired due to a hemorrhage. It happened in the same way, with the same timing.”

  She tried to grasp what he had said. The Subject had to stay alive for Jeremy to stay alive. She knew of no precedent for such a connection in normal organ transplants. All she knew was that Jeremy had lapsed into a very precarious situation because of it. “Couldn’t you stop the bleeding? Couldn’t you have taken more care?”

  Glen waved his hands as if to ward off her rising anger. “I didn’t realize the correlation until this time, or I would have tried to do more, believe me. It still seems preposterous to me, but it’s too tightly coupled to ignore.”

  “So what the hell do we do now, watch Jeremy die?” Anger began to overtake her fear. She’d been through so much with Jeremy—he’d lived to taste good health, only to have it snatched away. Again. She wanted him back, and healthy. It wasn’t fair to go through all he’d been through, only to end up like this. She glanced at him. His breathing was no better. Worse, if anything.

  Glen looked like he’d been physically beaten by some invisible entity. He spoke in a soft, defeated tone. “The intestines are dying inside of him right now. If nothing is done, gangrene will set in, shock will ensue. He’s in the early stages right now.” He stared down at the floor, as if trying to find his next words there. “There isn’t a lot of time. He needs to have the dying organs removed. Just like last time. Or they will certainly kill him. Then he needs to go back on the IV as before, until a new Subject can be developed.”

  “What are you waiting for? You can’t just let him die!”

  “Amanda, it’s complex surgery. I’m completely exhausted, and Tim is gone. I’m not sure I can handle it.”

  “You have to try. If you don’t, you already said what would happen, right?” Amanda wished she could will energy directly into Glen to get him to do what Jeremy needed done.

  “It’s tricky surgery. I just can’t do it alone.” Glen looked at her. “Can you assist? I don’t know who else I can ask.”

  “
Me? I’m a research scientist, not a surgeon. I don’t know about instruments or anything. I might do more harm than good.”

  Glen dropped his head into his hands. “I can’t let anyone else here in on it, and I sure as hell can’t do it alone, not after the long procedure yesterday. I can about guarantee I’ll miss something—and the end result will be the same as doing nothing.”

  Amanda stood and began pacing the room. “I can’t accept that. There has to be a way. We can’t just give up on him and leave him like this.” She stopped pacing as an idea struck her. It wasn’t without its problems, but it was probably Jeremy’s only hope. “I have an idea.”

  “What?”

  “I know—or knew—a surgeon who could handle this.”

  “No one outside these walls can know about this project.”

  “At the cost of Jeremy’s life? I’m not willing to make that trade.”

  “Don’t you understand what it would mean if this got out? The scandal would bring down SomaGene. This wasn’t meant to be a public project, not as it was originally designed. Maybe someday, we could redesign the approach to raise fewer ethical hackles. But not now.”

  “I don’t give a shit about SomaGene. I only care about Jeremy. Besides, there might be a way to convince this person to keep quiet. It would be a small price to pay to save Jeremy—and protect your precious SomaGene.” She stepped back over to Jeremy’s bedside and folded her arms. “Jeremy owns the company. I’m going to contact this person and offer him whatever I need to—on Jeremy’s behalf.”

  She suspected she was on thin legal ground, but didn’t care. She saw only one way to save Jeremy, and she’d do whatever she had to do. She figured if he were able to speak for himself, and knew of the person she spoke of, that he would do the same.

  CHAPTER 65

  Amanda adjusted Jeremy’s bed sheet and gazed at his sleeping face for a moment. He still looked deathly pale and fragile, despite the heavy antibiotics. If anything, he was starting to look worse and time would soon be running out.