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by Charles Kaluza
When she awoke, sunshine was just creeping into her hospital room from the window. The glare transformed the framed picture on the opposite wall into a mirror. Molly recognized her own reflection. But the perspective was wrong, like the distorting mirrors at the carnival. She was much too short. She was a tall woman, yet her feet pushed the sheets up only two-thirds of the way down the bed. Something wasn't right. "If I am paralyzed, my back must have been broken," she thought. Could I have lost that much height from a broken back?" She knew that her reasoning was off. The answer evaded her, and she drifted off to sleep again.
* * *
Two months earlier, Jack and Molly had sat on their sofa watching the evening newscast. Molly's interview with the TV crew was to be the final segment. Her work had become public knowledge with the filing of an FDA application for the use of their genetically engineered organs in humans. The local TV station asked for an interview with Molly regarding her work. She was more than happy to share her excitement about increasing the supply of donor organs using her genetically engineered orangutans as donors. The interviewer seemed friendly enough while she was giving it -- even playing a bit with Molly's oldest donor-orangutan, Miss Lucy. She now sat stunned as the TV newscast replayed the much-edited version. There was no correlation between the interview she had given and the interview she was witnessing on TV. As the interview finished, Jack clicked the TV off, without saying anything.
Molly started to cry. "They make it sound like we are slaughtering orangutans for greed. They left out entirely my statement that sacrificing one of our orangutans will allow six humans to live. Why did they do that?"
Jack replied, "I suppose they need to generate controversy. It's much harder to sell good news than it is to sell conflict." He left unsaid the "I told you so" he had coming.
"I should've listened to you and refused the interview. What are we going to do now?" she asked, wiping her tears and trying to stifle her crying.
"What is done, is done."
"But Jack they're making us look like monsters."
"Molly, it would have happened sooner or later. We'll keep moving forward because we know we are right. I need to go to bed and get some sleep. We can deal with tomorrow when it gets here."
Molly usually had no trouble falling asleep, but tonight was different. She tried lying quietly by Jack's side to no avail. She finally got up and moved to the comfort of her study. She resumed working on the chemical structure of the neurotrophic growth factor for spinal cord regeneration. Concentrating on the complex chemical structure and the genetic code which would create it finally cleared her mind of the newscast. It was almost 4:00 A.M. when she slipped back into bed and fell asleep. Jack had been aware of Molly's absence from their bed. When he arose at 6:00 A.M., he knew better than to wake her. He prepared for the day and just before leaving gave her a kiss saying, "You had better sleep in this morning. I'll give you a call later."
When Jack arrived at the research facility, a small crowd of protesters had already gathered. They were chanting and carrying placards with statements about animal rights being violated. Jack tried to ignore them as he drove through the security gate.
He asked the security guard, "Have you called in reinforcements?" The security guard said he did not think the protesters would be a problem. Jack disagreed, "Call in all available security personnel and notify the police department of the protest. I want this gate secure for our employees. Molly will be coming in later, and I would prefer if this demonstration could be dispersed by then."
The protest grew in numbers and in emotion. Jack called Molly and tried to get her to stay home. She insisted on coming to work. Jack said he would send a car to pick her up. When Molly arrived, the several-hundred protesters were turning into an angry mob. The police secured an entry path to the security gate. The driver maneuvered slowly up to the gate. Molly slumped down in the back seat, trying to hide. Unfortunately, her nearly six-foot frame did not hide easily. When the protesters recognized her, their yelling increased in volume and vehemence. They surged forward against the police line toward her car. Molly's fear escalated when the crowd began throwing rocks at her car. By the time she made it through the security gate, it was all she could do to walk into her office. She just nodded to the other employees, afraid to speak, knowing she was close to breaking down and crying. She tried to work. First on her agenda were the forms she had requested to remove Miss Lucy from the donor program, due to a physical problem. But Molly was unable to even sign the papers. She got up and closed the door of her office and sat back at her desk, holding her head in her hands.
Jack finished the morning review and stopped by her office. She was still sitting with her head in her hands. He gently asked, "Are you okay?"
Molly replied without looking up, "Jack, all of these horrible things they're saying, maybe they're true."
Jack began rubbing her shoulders, silently supporting her. Molly let go and began to cry. Jack let her cry. As the sobbing moderated, he said, "Things will work out. We knew some people would object to our work. Some of them are sincere. Others are just looking for something to protest against. They have no trouble eating pork chops from hogs bred for meat production. If they wear leather or eat any meat, they're being hypocrites. Your work on the universal donor has the potential for saving thousands of lives each year. Saving lives is the essence of our effort."
Molly responded, "Maybe, if we show them how well we care for the animals, they will stop protesting."
"No, I do not think that is the issue. I think we should go away for a few days and let things settle down. Our PR department is working to counteract the distortions in the interview. Our security team is being beefed up. Things will be okay."
"Where will we go?"
"Let's go to Sun Valley. You can do some shopping and I can get in a little spring skiing."
* * *
Warren was having a tough time. His doctors wanted him to keep taking medicine and he was tired of taking medicine. His only remaining joy in life was sitting with his friend, Al. Al was one of the great apes at the city zoo. Warren would sit outside of his cage for hours talking to Al. Al seemed to enjoy Warren's company and Warren regarded Al as his only friend. When Warren saw the report on Molly's work, on his small black-and-white TV, he became incensed. He vowed to seek revenge for the wrong done to his friends. He methodically began collecting information on Molly. The Internet cafÈ provided him access to the information he needed. His goal was revenge. By phoning Molly's office and pretending to be a colleague, he discovered she would be in Sun Valley for the next two weeks. The next day he flew to the resort town and began stalking Molly.
Jack sat on the bench soaking up the warmth of the early spring sun while Molly shopped for the special trinket she wanted to buy for her mother. She liked the small tourist shops in the ski village. Watching Molly come out of one small shop only to begin immediately window shopping at the next shop, reminded him of the intensity at which she had pursued her idea of producing a universal donor species. She had overwhelmed him with her technical explanations of how it was possible to genetically engineer another species of primates to act as human organ donors. It was not the science but the business possibilities that had intrigued him. Their collaboration had grown from a business relationship into a wonderful marriage. She had the ideas. He had the ability to bring them to fruition.
Molly was studying something in the window and never saw the car veer off the road. Jack saw the car jump the curb, striking his wife like a giant battering ram. It pinned her against the building before bouncing back. Warren, dressed in an ape suit, jumped out of the car and began yelling, "Death to the killer of my cousins." Jack ignored him, crossing the courtyard in a few steps, he was at her side as she slumped to the ground. Her eyes were still alive. She was barely able to breathe and fear showed in her face. He cradled her and waited an eternity for the ambulance to arrive. Meanwhile, the police had arrived, and were now pushing Molly's handcuffed attacker, who was still shouting slogans, into a squad car. The paramedics pulled up and moved Molly quickly into the ambulance and began resuscitation efforts as they raced to the hospital.
Despite all of his power and money, Jack now felt helpless. He never had a chance to tell her that he loved her before she was rushed to surgery. Jack was left to wait. The waiting room had the blandness of most hospital waiting rooms. Sterile fluorescent lights distorted the color of the mauve carpeting and chairs. He paced the length and width of the room repeatedly. Jack recalled the day he realized he was in love with Molly. They were sharing lunch and she was trying to slow the mental dynamo of her mind enough for him to follow her thoughts. Her dark hair was, as always, a bit unruly and her face without makeup, sort of plain. But her eyes were so intensely full of life. He was starring into those eyes when she asked him what he thought. He responded, "I think I am in love with you." For once she didn't know what to say.
When the surgeon, a Dr. Lampert, finally came out from surgery, the grimness of his face told the story. He made Jack sit down and in a flat, professional tone said, "We have controlled the major bleeding, but the injuries are massive. I am afraid your wife is dying."
Jack's look of disbelief was quickly replaced by a look of anger, and he asked, "What injuries are so severe you cannot fix them?"
"The crush injury to the chest has produced a severe myocardial injury, and her lungs have so much internal bleeding that breathing is all but impossible. She is already developing renal shutdown, and I had to tie off the hepatic artery to control the bleeding of her ruptured liver. She would require a heart-lung transplant, a liver, and probably a kidney transplant if she were to have any hope of survival."
Jack listened to him, his mind already working on a plan. He told Dr. Lampert, "Prepare Molly for bypass. I will have the organs here in two hours!"
Dr. Lampert objected, "I can place her on bypass, but finding one organ much less all of them in two hours is impossible. I think placing her on bypass will just prolong her suffering." His voice softened as he continued, "It would be better if you could accept the reality of her death."
"You get Molly on bypass and I will have the organs and the transplant surgical team here in two hours," said Jack, taking control.
"We can't let you bring in a surgical team that hasn't been credentialed here, let alone utilize organs of an uncertain origin."
"Doctor, your job is to place her on bypass and keep her alive for the next couple of hours. Have your hospital administrator meet with me about the credentialing and organ source." Jack did not even wait for an answer, but immediately called his office and started giving orders. He told them to mobilize Harry's transplant team and a donor. They were to arrive in less than two hours and were authorized to procure jet transportation as needed. The coordinator asked him about the nature of the transplant. He responded, "Molly has been hurt and will need a multiple organ transplant. Bring the donor with the best antigen match."
The older hospital administrator arrived and was listening to the end of Jack's conversation. He presented a nice politically correct smile to Jack and offered his sympathies. He then proceeded to tell Jack, "Hospital rules were put in place to protect patients. Rules have to be followed."
"My wife is going to die unless she receives a multiple organ transplant. My company has developed a new species of primates to act as universal donors. I am prepared to make a grant of one million dollars to your institution, to use as you see fit, if you cooperate in this effort. My staff is forwarding the credentialing information to your office for my surgical team. I will take full responsibility for their efforts and will sign a release of liability for your hospital."
The offer of the grant made the administrator pause. He replied, "If the credentialing is in order and my chief of surgery agrees, we may be able to proceed." He continued speaking, but Jack was no longer listening. He was not a surgeon or a scientist but he knew how to get things done.
Time crawled by as he waited. When Jack finally heard the sound of an arriving helicopter, he moved to the doorway of the ER entry to watch it land. He could not bring himself to leave the walls of the hospital to meet the surgical team. It was these walls and what they contained that kept his Molly connected to life.
He was relieved to see Harry, the chief of the transplant team, disembark from the helicopter. It was amazing that a man so large could be so agile. He ran from the chopper in the stooped fashion of those who had served during the Vietnam War. Harry saw Jack in the doorway and asked how Molly was doing. Jack just shrugged his shoulders and the tears welled up in his eyes.
Harry said, "I have been on the phone with the surgery crew and Dr. Lampert, and I will look in on her while the rest of the team gets set up." Harry proceeded to the operating room and quickly changed into scrubs. His reputation had preceded him, and they were ready with an oversize gown and gloves for him. He finished donning his surgical attire and approached the operating table, joining Dr. Lampert. The description that Dr. Lampert had given him was pretty accurate. Things had unfortunately continued to go downhill. The traumatic aneurysm of Molly's aorta was much more evident and had produced vascular compromise of the intestinal tract. The crush injury of the chest had shattered her spine and destroyed her organs, making her life dependent upon the bypass machines. Harry finished his inspection and removed his gloves and gown to visit with Jack.
Jack could not tell if the news was going to be good or bad because Harry was thinking and talking to himself as he walked up. He wasted no words and said, "Jack, this is worse than I thought. Molly will not survive an attempt at a multiple organ transplant. We may be able to proceed with the new protocol she had us develop in the lab."
Jack knew that Harry was talking about the series of head transplants they had performed on dogs. The thought of transplanting his wife's head and essence, onto the body of a genetically engineered orangutan made him sit down. He wrestled with the vision of his wife as she was before the attack with the image of how she would be if the surgery worked. He realized this image paled in comparison to living life without Molly. He knew instinctively that Molly would not be opposed. Her love of life mandated trying anything possible. He looked up at Harry and said simply, "Go for it!"
Harry nodded and turned back to the operating room, he began barking orders as he entered the doorway. The donor orangutan had been deeply sedated for transport. She was placed on the operating table by the OR crew. The anesthesiologist was somewhat hesitant to begin working on the orangutan, but when Harry bellowed, "Put it to sleep so we can get going," he injected the intravenous anesthetic agent and placed the endotracheal breathing tube in without difficulty. The nurses began to scrub and shave the orangutan's upper body in preparation for the surgery.
When the orangutan was fully prepped and draped, Harry stepped up to the table and picked up the scalpel. He incised the anterior chest wall skin just below the collar bone and around below the arms. Harry had a surgeon's touch and made everything he did look easy. The surgical team controlled the bleeding as he proceeded. He quickly dissected the clavicles and the pectoralis muscle group free from the chest wall. Harry was careful to protect the muscle insertion points which would be used in the transplant. He then began exposing the vessels and nerves of the neck. He carefully identified and preserved the major anatomical structures. He cut through the trachea and reinserted the endotracheal tube. After dividing the esophagus and the anterior neck muscles he was to the level of the backbone. He checked his identification of the C7-T1 disk and separated the spinal column at that level. His dissection continued posteriorly freeing the muscle attachments. He then continued the skin incisions and the head and shoulders were free of the body. The surgical nurse passed the upper torso off without thinking about it, but the receiving nurse had all she could do to handle it. The company technicians took the torso to a back table and began the task of harvesting all usable tissue for further transplant use in other patients.
The donor was ready and Harry now turned his attention to Molly. He looked down at her shattered body and said, "Molly, I hope this is what you want, and I pray that you forgive me for what I am about to do." He picked up the scalpel with his huge hand and with the deftness of an artist incised through her skin. He again carefully freed the clavicle from the underlying rib cage and peeled the chest muscles free. He carefully freed the vena cava and the aortic arch from the surrounding tissue. He placed clamps between the bypass tubes and the heart itself. Molly's body was now dead and the bypass equipment was all that kept her essence alive. Harry worked rapidly, quickly freeing the rest of the tissues. He knew that she was already paralyzed, but cutting through Molly's spinal cord made him pause, he had never before done this on a human. The anesthesiologist started to ask what the problem was, but before he finished the question, Harry returned to work. He slipped the knife between her vertebrae and cut through her spinal cord. He completed his dissection quickly and had Molly's fractured body removed from the table.
The headless orangutan was now placed on the table below Molly's head and upper torso. The surgical team was working with such intensity that they did not react to the sight. Harry inserted a diffusion mesh between the severed ends of the spinal cords. Dr. Lampert asked, "What is that pad for?"
Harry responded, "Molly has been working on a method of stimulating regrowth of the spinal cord using a diffusion through this mesh. Nobody ever imagined that she would be the first patient to try her new system." They used surgical titanium plates to reattach Molly's cervical spine to the orangutan's thoracic spine. The pre-vertebral muscles were then repaired. With the two bodies now connected, Harry turned his attention to reconnecting the vascular system. He started with the brachiocephalic artery followed by the superior vena cava. When these major chest vessels were functional, he proceeded to the opposite side and connected the left carotid and subclavian arteries. He had been careful to protect the recurrent laryngeal nerves to preserve speech. He now connected the remaining portions of the vagus nerves together. The trachea and esophagus were closed using an auto-stapler. Harry took a minute to stretch and checked the EEG monitor. The anesthesiologist noted Harry's attention on the monitor and said, "She has been stable throughout." Harry just nodded and went back to work. He placed micro nerve stimulators on both phrenic nerves to stimulate the diaphragm for breathing, and carefully sewed them together. The remaining muscle tissues were repaired using the auto staplers.
It had been four hours of intense surgery and Harry needed a break. He excused himself telling his assistant surgeon, "Go ahead with finish fitting of the torso and closing the skin. I want at least six Penrose drains and as many suction drains."
After Harry left the room Dr. Lambert remarked, "I cannot believe how delicate of a surgeon he is considering his size and aggressiveness."
It took a few more hours to finish the surgery and insert all of the drains. The surgical crew was accustomed to seeing morbid things. Seeing Molly attached to the body of the orangutan all but overwhelmed their professionalism. As they transferred her to the intensive-care unit, they were careful to keep her covered so as not to shock other hospital personnel. They placed her in an isolation bed and carefully suspended her arms to prevent straining the new attachments. While the surgical nurse gave her report to the ICU nurses, a student decided to check Molly's heart and lungs. When she peeled the sheet back below the surgical dressing and realized she was looking at the body of an ape, she simply froze before passing out. The surgical nurse saw what was happening, but the student hit the floor before she could reach her. As they were reviving her the surgical nurse said, "This is why they want her in isolation, and we must respect her privacy."
Harry was sitting with Jack in the waiting room while the team finished their work. He told Jack, "Surgery went as well as we could expect, only time will tell if we were successful."
Jack thanked him saying, "Molly always said you were the best, Harry, and I appreciate your efforts."
They sat together silently. Harry finally interrupted the silence, "You know Jack, Molly's work on the universal donor and spinal cord regeneration are major advances in medicine. To think that a crazy terrorist could so easily take her from us is not right. I sure as hell hope we were in time to save the smartest person I ever worked with."
Jack responded softly, "So do I."
Molly received the anti-rejection drugs and was kept sedated on the ventilator. After 48 hours the sedation was gradually stopped. Jack sat at her bedside trying, for the first time in a long while, to pray. He stroked her gray-speckled hair and waited. Her long, thin face had the look of a stoic pioneer woman. It was the wonderful displays of excitement playing across her face that transformed it into a thing of beauty. Jack could still see this beauty even with the tubes and tape distorting her appearance. His silent watch was accompanied by the rhythmic air sounds of the ventilator. When she finally opened her eyes Jack saw only confusion and fear in them. She seemed to recognize his voice and touch. He tried to explain that she had been injured and had to have surgery. He told her that she would not be able to talk until she was strong enough to have the breathing tube removed. She seemed to calm with his voice but he could not tell if she understood him. She fell asleep again. When Molly awoke a while later she seemed a little stronger and was able to fix her vision on Jack. They tried to communicate by her answering with eye blinks and subtle head movements.
Harry stopped by to check on her. He asked, "Molly, I suppose you would like to get rid of this breathing tube?" There was no doubt in interpreting the look she gave him. Harry laughed his big laugh and said, "Well my dear friend, we'll test the phrenic nerve stimulators today, and if you can maintain your oxygen level the tube can come out tomorrow."
Jack left to get some needed rest. Molly was alone with her thoughts. Her thinking was clearing. She learned to not struggle because the nurses would inject her with medication and she would drift off to sleep. She needed to stay calm so that they would hold the medicine and she could think. She could feel her hands, and when she looked at them she could make them move. Her arms were supported by an apparatus which prevented any significant motion. She did not feel much pain. It was the lack of pain that made her aware that she could not sense the rest of her body. She tried to move her legs and nothing happened. She tried to wiggle her hips. Nothing. She checked her hands again and she could obviously move them. Now Harry's comment about the phrenic nerve stimulators made sense. She was obviously paralyzed from the shoulders down. How did this happen? She was an invalid. The thought made her cry and the anxiety raised her heart rate enough that the nurse came to check on her. She pretended she was asleep.
When the nurse left, Molly again tried to analyze her situation. She said to herself, "Well, like the philosopher said, 'I think, therefore I am'. If my arms still work I will be able to control a wheelchair and a computer. I can still work." She felt sorry for Jack. Just when they thought that they were going to spend more time enjoying life, she gets hurt. Jack deserved a healthy wife. She forced herself to leave this depressing line of reasoning and resumed analyzing her situation. She could read part of the label on the IV infusion and recognized one of the anti-tissue rejection drugs. "I must have had a transplant of some sort. I wonder if they used one of our organs? I kinda hope so." She dozed off.
When she awoke, sunshine was creeping into her room from the window. The glare transformed the picture on the opposite wall into a mirror. She recognized her reflection, but the perspective was wrong, like a funhouse mirror. She was a tall woman, yet her feet pushed the sheets up only two-thirds of the way down the bed. "If I am paralyzed, my back must have been broken. Could I have lost that much height from a broken back?" she wondered. She knew her reasoning was off, and the answer evaded her. She slept for awhile.
When Jack arrived, she tried to ask him. She could not formulate the question using their simple code system. Jack could sense her frustration and said, "You'll need to be patient for a little while longer. Harry said that he would be by this morning to remove the endotracheal tube and you will be able to talk then." Molly relaxed a bit. Waiting for Harry to show up and remove the damn tube irritated her. She wanted to know now.
Harry's booming voice preceded his arrival as he kibitzed with the nursing staff. When he walked into her room he completely filled the doorway. He announced, "It looks like the tube can come out," Molly actually smiled. He carefully loosened the tape which secured the tube and said, "This will make you cough a little and might hurt some." With that he broke the small pressure reservoir tube and deflated the endotracheal tube. He told her, "Take a deep breath." He slid the tube out. She coughed and tried to breathe. The spasm of her vocal cords made the breathing even harder. The phrenic nerve stimulators were working, but it was not like breathing naturally. After several minutes she had regained enough composure to try talking.
Her speech was limited to a few words per breath. She had only limited control of her breathing, which produced a very jerky uncoordinated speech pattern. She got her point across when she said, "I know-- that I am-- paralyzed-- from the-- arms down. I figured-- I had-- an organ transplant-- because Harry-- is here-- and I am-- receiving-- anti-rejection, drugs. How come-- I am-- so short?"
Harry and Jack looked at each other and both tried to talk at the same time. They deferred to each other without either talking. Molly waited with an impatient look.
Jack explained: "The local surgeon said you would need a multiple organ transplant. I called our office and mobilized Harry and his team. They brought a universal donor with them, the one you called Miss Lucy." Jack looked at Harry for help.
Harry continued, "Your body was so destroyed and your life was failing quickly, a multiple organ transplant would never have worked. We made the decision to utilize your new research protocol." He did not know how to continue.
Molly began nodding her head and said, "You combined-- Miss Lucy-- and me. We have-- become the-- first chimeric." Silence ensued for several moments. Molly continued in her broken rhythm, "Harry, I am glad-- you took-- the chance. Jack, I hope-- you can still-- love me-- this way."
Jack stroked the side of her face with the back of his fingers. He replied, "I will take you anyway I can. I was so afraid of losing you that I accepted the risk of surgery. I figured you would accept your new body."
Molly's thinking was still slow. She knew there was something special about Miss Lucy, but she could not remember what it was. She tried listening to Harry explaining about the surgery, but dozed off. When she awoke Harry was gone, but Jack was still there, he appeared to be napping in the chair. She started to think about how her mother would react, she then remembered what was special about Miss Lucy. She awoke Jack saying, "Jack, my love."
"Jack, I remembered what was special about Miss Lucy."
"She is -- or rather, we are -- pregnant."
Story copyright 2002 by Charles Kaluza email@example.com
Illustration copyright 2002 by Carl Goodman firstname.lastname@example.org
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