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    • In Memoriam - Linda Lea

transition

Transition       
        This was a special day, almost a week before the eerie actions of the children described above. And I would have admitted even as the day began that I was filled with elation at the possibilities, elation that barely concealed a core of terror.
        Failure held unknown and fearful results, but even success held possibilities that might not be as I had imagined. What would it be like to live for thousands of years, or even for hundreds? As someone who craved certainty and control, I now found myself without either. I would prefer the future known, all guilt expunged in either death or a future life.
        The route to the hospital, only a short distance from my academic quarters, was lined several people deep. Most were focused on the possibilities of a prolonged life, perhaps even victory over death. Of course, like any spectator sport, this event held by its very nature the possibility of loss. Perhaps this was the same sentiment that had always drawn the public to executions.
        A few brave souls went against what was called the common good. They called out for me not to undergo the therapy. I am sure that even these diehards knew the inevitability of human genetic modification. The modification of my own genes was to be a leap forward into the future.
        Indeed, other gene transplants had been done multiple times to counter specific diseases. There had always been a specific abnormal gene to overcome, but my transplant aimed for a greater goal: the elimination of genetic pathways leading to death.
        Previous somatic gene transplants had focused on small, isolated functions. These had been successful on the whole, but side effects and the current high cost had undermined the widespread use of this therapy.
        This would change.

        Years of planning had gone into this day. Our company had the lead over two other competing companies (which happened also to be in competing countries) with the same goal but different approaches. We needed to move quickly, and we were confident that we had anticipated the possible negative reactions of my body.
        We, the circle that had worked so tirelessly on this exciting technology, had debated how to select a test subject.
        There had been a great deal of discussion on qualifications, but a remark by our company’s owner on the dangers of being the test subject struck a chord with me. He said, “Moving forward in science has often involved great danger. Some sacrifices must be made.”
        I resolved that if there must be a sacrifice, I would be the one.
        I suggested that one of our own should be the first recipient. With no other volunteers, there was only one contestant for the guinea pig role, so I won the rigged lottery.
        In retrospect, the admonition to be careful for what you wish seems more appropriate than my joy at the opportunity. I honestly thought the odds of success were reasonably good, but failure and the death of another person would have been devastating for me at this point in life.
        Besides, to be the first is to be remembered in history. Again, be careful what you desire. Being first, or last for that matter, in history may be either good or bad.

        The colleagues not assisting in the operation greeted me at the entrance to the campus hospital. A smaller group, those with whom I had worked most closely, accompanied me past the receptionist’s desk toward the elevators. There was light banter as we walked the familiar halls to the operating room, but we were much more subdued than what would have characterized us a year earlier.
        This was not much of an operation actually. Samples of the genomes of several pathways had been taken from me some weeks ago. That small operation had generated little interest. The removed genes were tweaked at our lab and prepared for return into my body.
        Now, Dr. Cliff Kane would insert these altered genes into their appropriate pathways to begin replacement of all cells in those pathways. The process of replacing all the old cells would range from weeks to months depending on the nature of the particular pathway, and then systems would stabilize based on the new genetic structure.
        Details are not necessary, but an overview might help the reader to understand why things did not go as planned.
        Note that experiments on mice with altered genes in these pathways had been honed to the point of complete repeatable success. Side effects had been minimal to non-existent on the latest rounds. We could not afford to wait and see how much longer they actually lived. But with no observable negative effects, we had been given permission to proceed to a test on primates
        Several genetic pathways had to be changed.
        One pathway governs protein synthesis. Part of this pathway acts as an energy sensor, monitoring energy intake of food. By altering this pathway to report no or minimal intake, the person appears to the controlling mechanism of the body to have no impact on external food supplies, thus marking the body as very efficient.
        Based on the current understanding of natural evolution, the least disruptive impact on the environment grants permission for longer life. Many experiments had shown a significantly longer lifespan in the mice with these altered genes. Other experiments had shown over-activation of this pathway reduced the mouse lifespan.
        All was good up to a point, although it does pain me as I write this to think back on that phrase, “current understanding.”

        Another altered pathway involves the death of old cells and replacement with new cells. The process of cell death was slowed almost to zero. Confirming the theory that there is a limited number of times that cells will die and be replaced, the decreased turnover of cells should lengthen lifespan greatly.
        The combination of these two genetic changes required some important changes in other pathways to remedy known interactions with those systems. These were accounted for with other slight tweaks. The multitude of other interactions were relatively minor, and we had good scientific reason to believe that the body would adjust other pathways in a short period of time.
        This combination of genetic changes appeared to offer the opportunity to experience a much longer lifespan. This was the first step toward the ultimate goal of unlimited lifespan.
        Testing on a primate preceding a human trial was necessary with all new pharmaceuticals. We were confident even as we gave lip service to the possibilities for failure in what we did not know that we did not know. The early successes and the pressures to be first to market so that we could recoup our large investments could have overruled this step, but fortunately that decision was not up to our company but to the regulating authority.
        Yes, we were fooling Mother Nature. Or attempting to fool her.
        If that causes you concern, consider how effective we had become at doing just that in so many areas. We had overcome nature in so many areas through the sheer force of our scientific knowledge: electrical and magnetic power to overcome darkness, cold, and gravity, among others; chemical agriculture augmented by genetic modification; pharmaceuticals and nutraceuticals to override symptoms; and so much more!
        As industrialists became technologists, and then evolved into scientists over the course of the centuries, the practicality of our knowledge increased exponentially. Harnessing the power of computers, nothing seemed beyond our grasp. The only limiting factor was time. Significantly longer lifespans would greatly reduce even that limit as knowledge within single individuals would accumulate and be better utilized.
        The possibilities of our knowledge seemed endless, and the possible pitfalls appeared merely as low speed bumps!
 
        Shortly after waking in my hospital room several hours later, Dr. Kane greeted me with a thumbs up: “The operation was a success, Evan! You were an excellent patient.”
        A bit groggy, I still had the presence of mind to rejoin, “And your bedside manner during the operation was very reassuring. I loved your jokes, especially the one about the two little boys waiting outside their respective operating rooms. Let me see if I remember it.
        ”The first boy asks, ‘What are you here for?’
        “The other boy responds, “They are going to remove my tonsils. I am pretty scared.”
        The first boy grunts. “Don’t worry about it. I had it done when I was 4 and it was a breeze. After I woke up, I got to eat Jell-O and ice cream for days.”
        “Thanks. What are you here for?”
        “A circumcision.”
        “Oh, no! I had that done when I was born and couldn’t walk for a year.”
        Cliff had grown more and more concerned as I retold his joke. He was clearly at a loss and stuttered, “What…, how…., were you awake?”
        I laughed as much as my drugged condition would allow. “No, the nurse who was here when I regained consciousness retold your joke to help me feel better. She said laughter was the best medicine.”
        Still groggy, I gave a goofy grin. “I got two laughs out of that one.”
        He smiled back, though perhaps it was a bit forced. “Let me warn you that you are testing my bedside manner.” To get the last laugh, he added, “I may have to order a regimen of enemas to purge you.”
        He reverted to his normal serious demeanor. “If you remain on good behavior, we will keep you for only a week. Then we’ll see about a very gradual resumption of normal activities. You need to ease into your new prolonged life so that it goes well and we can follow in your footsteps.
        “We will monitor you here overnight, and move you into an extended care room for monitoring over the next few days.”
        This was as we had discussed. I was tired and nodded, my eyes closed as I was ready for a nap.

        Recovery was normal for such a minimal operation. The incisions had been small and the primary negative effects came from the anesthesia.
        I became bored during the first full day in the extended care room. There was nothing expected in the ways of observable effects, so the precaution of being monitored 24 hours a day for seven days seemed overkill.
        And the first day confirmed this. I felt well and all readings were normal.
        The second and third days were much the same, and all readings were in range. Normal was boring, but believe me, I soon wished for normal.
        The fourth day, some blood test readings were definitely out of range. Cholesterol had dropped precipitously. Other readings pointed in the direction of pernicious anemia and muscle breakdown. All of these indicated that my body was not utilizing the balanced but bland meals I had been given.
        Dr. Kane came to me with the tests in his hand and let me look through them.
        Only a few minutes were necessary to see that things were not headed in the right direction.
        “How are you feeling?” The question was more in the tone of friend to friend than doctor to patient. I sensed his concern and understood it.
        “I feel great! A bit tired, but I think boredom will do that to you. Maybe I need to be allowed out to the sea or even put to work in the gardens! Any outside activity would be good.”
        He looked back at the numbers. “I would not suggest much activity based on these numbers. My prescription would be for digestive aids and plenty of nutritious food.” He looked on the second page. “You have lost weight quickly for such a short time.”
        “I do not care what the numbers say. I feel good. I could lose a few pounds!”
        “You don’t have that much extra weight. And according to this,” as he held up the pages, “you are losing muscle mass. You know as well as I that this is not normal.”
        His expression matched the concern in his voice. I had been feeling pretty good when he entered the room. Now I was beginning to feel tiredness almost to the point of exhaustion.
        Was this a matter of what we think affecting the body? I felt great until the bad news came, and now I didn’t feel so good.
        He was glancing over the pages of the report again. “Numbers don’t lie, Evan. You know that. You have been psyched up for this for a long time. Your mind is telling you what you want to hear.”
        He held up the pages again. “Is your body lying to us?”
        OK. Perhaps it was the other way around. I wanted to feel great but exposure to the numbers reported by my body now allowed me to feel my true condition.
        Dr. Kane was good, and he was a practicing physician while I was an academic doctor. I resigned myself to patient status.
        “OK, Doc. What do you recommend?”
        “I know you are bored and have walked all the halls. Perhaps a little fresh air will do you good. But do not, I repeat, do not become overly strenuous. And at the first sign of fatigue, get your butt back in the bed.”
        He smiled and added, “We do not want anything to negatively affect your longevity. If you die, it will set the program back months, maybe years!”
        I smiled and nodded. “Will do. I would hate to have a negative effect on the program.”
        “Good. I have an open spot this afternoon at 4:00. Are you up for a game of pool at the rec center?”
        The hospital had a physical therapy wing complete with a gym and Olympic size swimming pool. Somehow, a pool table had been classified as a “therapy device” and given its own place.
        “Sure, that would be great.” Already I felt great again.”

        The morning passed slowly even though I did take a stroll through the gardens outside and on around the complex. I was tired afterward, but I attributed that to the days that I had been “out of service.”
        Lunch was not very exciting and I felt like a little nap. I lay down and the next thing I knew it was 4:15 and Cliff was shaking me awake.
        My eyes were open but it took a moment to come out of the sleep. Cliff was talking.
        “Are you OK? When you didn’t show at the rec center, I came here. It gave me quite a scare to see you so soundly asleep that you did not answer. At least, I hoped you were asleep.”
        “Yeah, yeah, I’m fine.” I tried to sit up but fell backward before I reached a sitting position.
        “Wow, I feel like I’ve been drugged.” I smiled, “Whatever that feels like. Did you have them put something in my lunch?”
        Cliff wasn’t smiling. “Of course not. And the chart said you hardly ate any of your lunch. What is going on with you, Evan?”
        I didn’t feel like trying to sit up again. “I honestly don’t know. But I am tired and I could go back to sleep.” I closed my eyes. That felt good, but the next thing I knew, Cliff was shaking me again.
        He pulled up my eyelid, and then took my pulse. He put a finger on the intercom button. “I need some assistance in Room 202. I need a blood draw and a sugary soft drink.”
        Without opening my eyes, I said, “What?” Even to me my voice sounded like I had slurred my speech.
        “Evan, you’re sinking on me. Here, let me help you sit up. I think your blood sugar has dropped very low and we need to get something in your system quickly.”
        He let the bed automatically crank upwards to a sitting position since it was clear I did not have the energy to sit up unsupported.
        The nurse arrived with the drink and Evan got me to take several swallows.
        The nurse began the blood draw and I began to revive a little with the rush of glucose from the drink into my system.
        “Eight hours ago I felt ready for a return to normal. Right now, I feel like the energy has drained out of me. This little pool,” I held up the bottle, “won’t last but a few minutes.”
        I do not know where those words of wisdom came from but they were on target. Within about 15 minutes I was ready to lay down and sleep.
        Cliff and I had been having a conversation, but the talking was increasingly on Cliff’s side as I began to fade. I fell asleep and that is the last moment that I remember that day.

        The fifth day started with me waking mid-morning sometime. Whether I had been sleeping or comatose with no memory of waking during that time I do not know. The length of time that I was in that unconscious state was definitely not natural. There was no reason for such an extended period of sleep.
        I was kept on a glucose drip, and given stimulating intravenous solutions in addition to parenteral nutrition (intravenous feeding).    There is no doubt that this gave sufficient energy for living, but did not seem to build any reserves. The tubes were necessary 24 hours a day, apparently, as they were left in me.
        My waking was barely that, having hardly enough energy to open my eyes and process where I was and what was happening to me.
        When Dr. Kane arrived shortly after the nurse noticed that I was awake and conscious, his expression was not encouraging.
        “How are you feeling, Evan?”
        “From your expression, I would agree that I feel about that bad.” I could not even generate a smile. “You tell me, doc.”
        I was ready to fall asleep again. Cliff was now at the bedside with a hand on my shoulder.
        “Frankly, Evan, your body is shutting down. Every system is in decline and we cannot seem to find a trigger, assuming there is one cause.”
        This provoked me enough to summon the energy to speak. “What do you mean, ‘we cannot seem to find a trigger?’ It has to be the new genes. What are they doing?”
        Cliff was silent, his hand still on my shoulder. Finally, he said, “We seem to have triggered a shutdown of the body. Some feedback loop we have not found is passing along the information that you are receiving no food. The body has gone into a severely restricted mode of operation to conserve energy.”
        This made sense. It was sort of like going on a diet after a long period of more food than needed. When the body sensed the lower caloric intake, it downsized the rate of metabolism, essentially conserving the lower caloric intake until the “famine” ended. This had always been a good survival strategy, but hard as hell on dieters.
        Now I was feeling the negative effects, as well, apparently.
        Cliff continued. “I mean we have not found the particular feedback loop that is involved. We assumed there must be something related to the thyroid, but we cannot find it. Your ghrelin and leptin are in perfect balance between hunger and satiation, but they are so low as to be almost zero.”
        He paused. “At the rate that the situation is deteriorating and considering our lack of understanding on these events, your time is short.”
        I tried a smile as I weakly imitated some movie actor’s voice: “OK, doc. Give it to me straight. How long have I got?”
        “No more than 24 hours unless something changes.”
        His hand on my shoulder gave a gentle squeeze, and his voice was as soft and compassionate as I have ever heard him speak. That only added to the feeling of hopelessness.
        “Is there anything that you can suggest to help us, Evan?”
        My mind was a blank. Increasingly, that statement was a fact. A thought was like lifting the maximum barbell weight possible for me. A second thought was as impossible as immediately lifting that weight again. I needed time between thoughts to recharge.
        My eyes had closed during his short speech, and my response was a silent “No,” mouthing the word more than saying it aloud.

        I do not remember anything else until the next morning, the morning of the sixth day.
        Surely someone (“Shirley Someone” I said in my mind, imitating Leslie Nielsen) had checked on me during the night, but I had been unaware. A nurse arrived about 5:00 A.M.
        As she entered, I thought I was sitting in one of the visitors’ chairs, but she started toward the bedside, stopping abruptly when she saw the machine readings.
        “Hey, I am over here,” I said with a smile.
        She ignored me, leaning over the bed. I could not see what she was doing as she was between me up above and the bed below.
        She pressed the intercom and requested someone to come to the room. I could not hear the name she requested.
        “Wait, I said,” reaching for her arm. “I’m right here.”
        I had continued speaking even as my hand passed through her arm. The nurse was oblivious to my presence. Neither touch nor speech reached her senses.
        The head physician of the night shift arrived.
        Looking at the bed, he said, “Have we lost Mr. Yellen, nurse?”
        Between the time she stepped back and he leaned over, I caught a glimpse of my body on the bed.
        “Quite right,” he confirmed after a quick check.
        Straightening his posture a bit, he spoke in his more authoritative medical voice, “I will notify Dr. Kane. I didn’t like being a part of this experiment and this just confirms my instincts. There is serious work to do in this hospital and here he is playing God. Immortality! What insolence!”
         The nurse had begun leaving after his initial command, so his last words were to what he considered to be an empty room. There was obvious disdain in his voice.
        Just checking, I had passed my arm through him several times as he spoke.
        I tried to make noise but found I could not move anything. Indeed, the “hand” that had passed through the nurse and the doctor was something I could see but had no substance. My feet were now on the floor, but they had no feeling.
Indeed, the sense of feeling, like my speech, was non-existent. I could see and hear. Could I taste? There was no way to test that since         I could not bring the apple on my (“my?”) bedside table to my mouth. I assumed that taste was out.
        Checking my sense of feeling again, I did not feel anything. That my feet were “on the floor” was purely the result of my mind believing that this was where they were supposed to be. I smiled at the reassuring thought that I still had a mind.
        I found that wanting to sit on the bed resulted in my actually moving onto the bed.

        Over the next few hours, I made several other discoveries about my new state of being, but there is no need to bore you with the many discoveries, both favorable and unfavorable, that I experienced in this new state of being. They are irrelevant to the story, distractions, and they were only temporary. (Please do keep in mind the larger perspective of endless time when I say “temporary.”)
        As the nurse continued her duties, I decided to explore my surroundings in this new state of partial being. By habit, I walked through the door. It happened to be open, but I knew it would not have been a barrier. I moved down the hall to the nurses’ station.
        As I moved in that direction, it occurred to me that I could have no impact on my surroundings, nor could the people or things around me have an impact on me. Well, that was true in a physical sense. But when I saw the images on the television monitor, I realized that events in my old world could have an impact on me.

        By this time, news reports of the children lining the island’s banks had reached the internet. Visuals from a 7-24 news channel were streaming across the silent monitor on the wall in a small sitting area. The open curtains of a visitors’ room revealed the same images on that screen.
        I could read the closed caption beneath the images, getting the gist of the story.
        Were the children connected to what had happened to me? That did not seem likely since they were visible and solid even if they did not communicate. But coincidences are often events that are tied together in ways we cannot see. Perhaps that was true now, as well.
        Unable to communicate or relate in any way with the people and things around me may seem like a situation ripe with some combination of panic and fear. But as the situation became clearer to me, a sort of peace quickly replaced all feelings of fear or loss.
        This state of existence was straightforward, perhaps like falling off a ship and finding oneself alone on a deserted island. Not needing food or water or shelter, this deserted island on which I found myself was quite peaceful.
        But the overriding issue of a deserted island is that it is deserted and one is alone.
        After only a few minutes of beginning to understand my new state of being, I recognized that the greatest drawback would be the lack of interaction with people. Observation, a view through a one way mirror, was all that was possible. I was no more real to those around me than they were to the commentators on the screen.
        A hope sprang from this realization: perhaps there were others like me. This is not something I would have wished on anyone, but the thought of their possible existence gave me hope. Somehow, a shared limitation at least meant that I was not alone.
        Of course, I had just been involved in a unique experiment, and my present state was probably just as unique. But what of those silent children gathering for no apparent reason on the island’s shores? I wanted to believe I was connected with that in some way.
        This hope drove me to the nearest access to the sea, not far from the hospital. Could just thinking of being there get me to the shore? I did not want to know just then. In spite of my desire to learn what was happening with those children, perhaps fear that there was no connection to my situation kept me from rushing to them.

        I walked in that way that imitated life, one foot in front of the other. I convinced myself that I could feel the pleasant warmth of the sunshine, but the breeze evident in the limbs of the trees touched me not.
        I covered the distance quickly, arriving at one of the points where a large crowd had gathered. The spectacle had attracted a collection of various media, reporters for all kinds of news outlets moving among the spectators while cameras alternating between the spectators and the children.
        I literally walked through the crowd of spectators toward the children and the sea. Their humming washed over me like the breeze that should have been caressing my skin. The notes struck chords within me so that the sound seemed to come back out as if I were joined to their choral group.
        Only the backs of their heads were visible to me. There was a fear that they would not see me, either. So I stayed in place, absorbing the waves of sound and sending them back out again.
        Time no longer seemed relevant, so how long before the boy turned to me I cannot say. All sight had become oblivious to me as the harmony had become my sole focus.
        But when the boy directly in front of me turned, my attention went to him.
        “You did come,” he said with a smile.
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