Recombination Blues
A short story about medical apartheid and biohacking
Alejandro
"Is that a six with six zeroes?"
"That's what I said. It will be six million dollars."
"American dollars?"
"American dollars."
Alejandro shifted in his seat, a lump forming in his throat. He wanted to scream, he wanted to throw the doctor out the fucking window. He wanted to do something, but he said, "Is there a possibility to make the payment in parts?"
The doctor grimaced, then remembered himself. "I'm sorry it's just... It wouldn't be possible."
The weight of the diagnosis left his shoulders for a moment, and Alejandro could only feel rage. But he knew that neither of them could do anything.
The doctor glanced up at the camera in the corner of his office. A glass eye stared down on him, ensuring he didn't say anything off-brand.
"I'm very sorry Alejandro but if you can't pay or won't sign on to an approved payment plan, there's nothing I can do." The doctor opened a drawer in his desk and pulled out a pad of fluorescent pink sticky notes. He scribbled on the note and as he did the air conditioning kicked on, allowing in blessed cool air. Alejandro pulled at his shirt collar to let some of the air in. Dust motes danced around in the sunlight as the doctor slipped Alejandro the sticky note.
"What I would recommend is talking with your bank. Or there are companies who manage medical debt too. Sometimes if you contact the bank before the debt is sold they provide coupons."
"Coupons?" Alejandro didn't even look at the note, he folded it with two fingers and slipped it into his breast pocket. The doctor's eyes followed the note.
"For food and necessities. But they're very rarely given out."
"I see," Alejandro said, catching the doctor's message. Alejandro patted the sticky note in his pocket and the doctor gave him a slight nod. Imperceptible. Almost not a nod at all but like when a film skips a frame, and his chin moved a micrometer up and down.
"Again. I'm sorry."
"It's okay. I understand. Have a good day doctor." Alejandro stood and walked out of the little office. Blue check linoleum squeaked under his feet.
Alejandro walked down Fifth Avenue (fifty cents pulled from his bank account for the use of the road), took an auto-cab back to their apartment (surcharge of ten dollars for use of a non-solar vehicle on top of the fifteen for the three-mile journey), and fell into Theo's arms.
"What's going on babe?" Theo said, running his fingers through Alejandro's hair.
"Cancer," was all Alejandro could say through the tears.
Avis
The stink of plastic filled Avis's nose. The whirr of the fan pushing air into her mask hummed in her ear, vibrating up from its fanny pack. The device provided positive pressure, forcing any contaminants out. Most important though, the fan pushed out the smell. She was glad that she couldn't smell the isolation ward. Glad for the stink of plastic instead of the stink of vomit and feces.
Under all her gear she didn't even notice the eyes staring down at her: cameras watching her every move, every injection, every wiped mouth, every changed bedpan. Oh, but they were there. They were always there. But in her plague getup, she could forget for a while, if only because her mind was occupied with more pressing things.
An elderly woman who two days ago presented to the ER with intestinal distress let loose a waterfall of vomit. Hunks of red Jell-O and kale salad came up through her mouth and out her nose like she heard a good joke.
"Hey, honey. You're alright," Avis knelt and wiped the woman's chin. She wretched again but nothing came up. Avis handed her a tissue and the old woman blew out a leaf of kale with bloody snot, she laid a hand on Avis's plastic-covered arm in thanks.
Avis moved on to the next patient. A middle-aged man who presented to the ER that morning with a sore back and a knock-you-on-your-ass headache. He was sleeping the pain away, veins full of morphine. She checked his chart and his vitals on the screen and moved on.
Another patient, a little girl of six, with stomachache and everything coming out both ends. She huddled over a bucket shivering. When she saw Avis approach she lit up, then barfed up her chicken soup and wiped her mouth with her sleeve.
"When can I see my mommies?"
"We can set up another video chat, they're right outside in the lobby they–"
"I want to see them. Please."
"I'm sorry," Avis said sitting on the girl's bed and replacing her bucket with a fresh one. "I'm sorry."
Making her rounds Avis tried to detach herself from all the suffering, from all the fear, and grief, and faces of scared people who she couldn't comfort. She couldn't say everything will be alright because she didn't know if it would. Nobody did.
At last, six thirty AM came, and Avis finished her shift. She dropped off the nasal and oral swabs she’d collected that day in the “to be tested” box and stepped into the decontamination tent. The plastic hallway sprayed her down first with disinfectant, and then when she’d stripped out of her plastic suit down to her underwear, with soap and water.
The world's least luxurious shower.
Avis flapped her arms, shaking the water away, feeling the droplets slide down her skin and fly off. She grabbed a freshly autoclaved towel from the cabinet, ripping through the plastic and hugging close to the blessed warmth of the fabric. Soft against her skin. She dried her hair and moved the towel down her back like she was flossing then pulled on her civilian clothes.
It was odd looking forward to the bleach smell of the hospital, but Avis did. She took a lungful of fresh air and walked to the door, hoping to God that nobody stopped her and asked if they could have her cover them while they ate lunch, or while they picked their kid up from daycare. Avis needed to get home, to collapse onto her sofa with a bottle of wine and something brainless on TV. But a hand fell on her shoulder. Avis tried to put on a brave face when she turned to meet Greta's, but she couldn't help but scowl.
"What's up?"
"They figured it out."
"What?" Avis shifted on her feet, her back complaining from the hours of standing.
"They figured out what's wrong with them."
Avis's mouth hinged open. "Holy shit."
Alejandro
Alejandro rolled over in bed and ran his fingers through Theo's hair. In that bliss and confusion of the first few minutes of wakefulness, they lay next to each other without focusing on the fact that Alejandro was dying. Theo opened his eyes to a squint and smiled, kissed Alejandro then pulled him in close, flipping him over so they could snuggle like spoons in a drawer.
"You going into work today?" Theo said, his morning dog breath wafting over Alejandro, but he didn't mind.
"No."
"Good. You need to relax."
Slowly the world trickled back in, and it wasn't just Theo and Alejandro in bed anymore. It was lung cancer and medical bills, and parking subscriptions, and rent, and work, and side gigs, and his mother and her hatred of Alejandro's "lifestyle". It all came back, and Alejandro sat up in bed.
"I think I'm gonna bake some bread."
"That sounds like a good idea. Baking always makes you feel better." Theo's hand ran up Alejandro's back, scratching it in long strokes, leaving red marks behind on his brown skin. “And I don’t exactly mind getting to stuff myself with fresh bread.”
Alejandro craned around and kissed Theo then ran to the kitchen in underwear and stocking feet, made coffee and toast, hacked off a chunk of Jarlsberg cheese, and put it on a plate. Alejandro sat at the kitchen table in their tiny one-bedroom and sipped the coffee waiting for Theo to take his shower and get dressed in work clothes.
Theo at last came out, hair still wet and a curly mess, tie loose around his neck, and his top button undone.
"What'da you got planned for today?"
"Gotta go over the equations for the Auto-Magic contract. They're wanting to ship on Friday, and we need to confirm the AI are doin their thing before I'll feel comfortable letting them."
Alejandro knew that they would let the contract ship even if the data confirmers told them it wasn't ready. Last month another autonomous bus killed all the passengers. The AI's algorithms were all wrong when it came to bridges, but they rushed it and didn't listen to their data confirmers, and when that bus hit water, all the doors automatically locked. But still, "Machine learning is the way of the future!" and all that.
Alejandro was happy he didn't work in cars. They were a lot more careful with planes, so he actually had some power in his work confirming the robot's numbers.
"I keep telling you, you gotta give them an ultimatum."
"You know I can't do that," Theo took a bite of cheese and a sip of coffee. "Anyway, I need to head in early." He picked up his slice of toast and took a few glugs of coffee. "I love you."
"Love you too."
And with a kiss, Theo was out the door.
Alejandro sat at the table for a long time, watching his coffee cool, staring, before he got up and fished out the sticky note his doctor had given him.
An address written in careful print; not the doctor's usual unreadable scrawl. This was important.
"Go here," said the note with a phone number at the bottom.
Nadia
Nadia fell into her mind as she passed the supernatant from her small flask to an Eppendorf tube. Her hands moved of their own volition, she didn't have to think about the protocol, she'd done it a thousand times. That was a precious thing, her protocol.
It was the same protocol they used at Rosebud and at Prudence, it had taken a lot of time and a lot of money for Nadia to get her hands on it.
When all was said and done one dose, the only dose that was needed to stop the growth of cancer, cost nineteen dollars not including labor costs. This wasn't a cure for just one type of cancer either. This was a targeted genetic approach, and depending on the tag you put in it, the enzyme could cut out any cancer gene you gave it.
Cancer is not one disease, but dozens of different ones doing the same thing. That's why usually when people talk about a cure for cancer, they're misguided, there would be no ONE cure. But science was marching on and now they had the right technology to do just that. To make a singular treatment—infinitely maliable—to treat any type of cancer. What Nadia had was the real deal. It could be the ONE depending on how you edited it.
Rosebud and Prudence, the pharmaceutical companies that patented the treatment, they were selling it for over five million dollars a pop. It might be worth it if you're a billionaire but for everyone else...
Nadia stuck a few tubes in a centrifuge and waited, then popped them out and separated the supernatant from the pellet, then ran the supernatant through an affinity chromatography column and let it drip, pouring buffer, then wash, then elution buffer and collecting the flow through. What she was left with was a miracle. She popped the plastic tube in the fridge in her makeshift lab.
She opened up an incubator and pulled out a flask stinking with mutant E. Coli. doing their thing, making her enzyme cocktail. Making the cure. Then she started all over again. The next order was for a young guy, mid-twenties, with lung cancer who’d just called not a day before.
The patient’s genetic analysis showed point mutations in a few cell proliferation genes, likely the origin of the malignancy. The tumor itself mutated further and was well on its way down the molecular path toward metastasis. All of this--the patient’s full genetic makeup, tumor genome, and proteome, phylogeny of tumor mutations, and spatial analysis of the tumor microenvironment—sat unused on the hospital’s servers. It’s easier and cheaper to run every tumor through the same diagnostic pipeline, even if the data is never used (i.e. the patient can’t afford to access it).
With all of that data, this lung cancer patient’s tumor would be relatively easy to treat with modern techniques, even putting aside a targeted genetic approach. But traditional methods… On chemo and radiation, he maybe had six months.
After another protocol finished, another cure made, and three chapters in an audiobook down, Nadia peeled off her gloves and went into the dry lab, which was little more than a broom closet with a desk and a computer, and a secure server ran through VPNs and TOR network and an extra encryptor Nadia whipped up herself.
She sent a message to the lucky soul who had their cure now. All free. None of them believed it at first but she assured them, this was the real deal. Her grandmother's money paid for it all. Fracking money, blood money, now spent to cure the sick.
It would be funny if it wasn't so sad.
There was one thing that kept her up at night though. There was one thing she was missing, that was important. All her teachers and mentors and professors and PIs knew it and lectured Nadia about it.
Peer review.
Obsessive double-checking.
She didn't have any tech, or fancy algorithms to sequence and ensure that what she thought was in the vial was really it. Nor did she have anyone who could act as a peer reviewer without doubling—tripling–her chances of getting caught. She used test plates and tried tagging the protein with a fluorescent residue so it glowed when she did it right, but it never worked right when she did it that way. So, she was going in blind, hoping that she made the right protein, the right enzyme, to make the right cut, the right insertion. That was the only thing Rosebud and Prudence had over her: billions of dollars of equipment and personnel.
That and no souls.
But if Nadia didn't do it, who would? Rosebud and Prudence wouldn't lower their prices out of the kindness of their hearts. Until some action was taken (governmental or of the Molotov cocktail variety), Nadia was fine compromising certainty for saved lives.
She hoped that that was the right thing to do.
Alejandro
It was a nervous period of waiting. He didn’t sleep that night and then spent his morning waiting until he was sure that Theo was gone and would not be back until the end of the day. Alejandro sat at the kitchen table for no more than twenty minutes but of course, the little pink sticky note screamed at him. He checked in on Theo using their tracking app, and yep, Theo was at work, at his desk, and would likely not move for 14 hours.
But what if it was a hoax? Some kind of sting set up by med companies–Rosebud and Prudence perhaps–to catch those that would dare infringe on their copyright. What if he arrived at the address and was met with a black bag?
And worse, what if it was real? What then? That presented the largest dilemma. Alejandro would have to trust in this stranger, albeit a stranger whom his doctor of some years had vouched for, as much as he could anyway.
Dr. Rusch was a good man so far as Alejandro could tell, a good doctor if that meant anything towards the man’s character. But what of this stranger? This rogue agent; a biohacker. Alejandro was not one to forget what biohackers were capable of–and of course–were not capable of as was so often the case. Most biohackers were not terrorists of the South Dakota Six type but were chop-shoppers willing to tweak some genes for a quick buck, usually leading either to a cure or to a painful growth or a painful death as the case may be.
Biohacking was not something to trifle with.
Yet, there was no other choice. It was do or die for Alejandro. Chemo was an option sure, but at stage four there was only so much that could be done. And in any case, Alejandro preferred that, if he must die, he do it in Theo's arms and not hugging a toilet in a hospital room, ass flapping in the wind out the back of a scratchy gown.
Alejandro dipped a finger into his coffee. Cold and still almost full. He'd only taken one bite out of his little hunk of cheese.
He stood, collected his dishes, washed them, showered, dressed, and stood looking at the door. A breeze caught the back of his damp head, bristling the short hairs on the nape of his neck. The AC flipped on and blew its winter air over Alejandro. At the sudden loss of heat, Alejandro gasped, hiccupped, and coughed. One cough led into another until Alejandro could not control his lungs. They fought to expel the mass growing inside of him, desperately blow-blow-blowing as if the wind would erode the tumor and allow Alejandro to cough it up like so much lung butter, as pappa would call it. The tumor did not come up, however, and the coughing kicked Alejandro to the floor and left him in a winded slump. His throat ached, vocal cords scratching one another as guitar strings do when too loosely tuned. It felt as though he might cough up more blood, a little coppery taste lilted up into his mouth, but there was no blood that day. A good day as far as they went. A weakening definition after months of coughing and lethargy and blood in the Kleenex.
Alejandro collected himself from the floor, took a few ragged breaths to steady himself, then took the pink sticky note and left the apartment in search of his biohacker.
Avis
"He's not explaining it right. I mean he's correct, he's just not good at explaining it." Greta took a bite from her sandwich, a rogue pickle falling to the plastic bag beneath it on the cafeteria table, gesturing up to the TV.
So many weeks ago, it was only a few patients presenting to the ER with gene-hack flu. No big deal. A few meetings with corporate investigators, some paperwork, nothing abnormal. Then Herb, bless him. Herb Vasquez a nurse of thirty years contracted lymphoma, a specific lymphoma, a rare one, a lymphoma one of his main gene-hack flu patients just happened to also have.
Herb was dead, and so were a few more patients. Nobody on staff got as unlucky as Herb though. Now it was all isolation wards, dealing with anti-science protesters outside, evacuating nonessential staff for a bomb threat, everyone wondering what was causing it; though no one seemed to know for sure, except for the media, of course. The entire media apparatus had decided who was at fault: The likes of South Dakota Sixers and if not Sixers or neosixers, it was some rogue ideologue who just wanted to force good hard-working job creators to give away free stuff.
Every TV in the hospital was playing it on a loop, 24-hour news networks salivating over all the blood in the water. The NIH spokesman stood on a stage trying to tell the nation what was killing so many people, and Greta was right: he was doing a terrible job.
"The Prudence and Rosebud mix is an enzymatic therapy," Greta bit her sandwich, moved the lump of ham and swiss to one cheek. "They found an enzyme that makes a cut on a specific portion of DNA. They put this in a vector, usually a virus, a nerfed one that can't do anything but pass along genes. Then they 'infect' the patient with the viral vector, and it spreads throughout the body duplicating the enzyme which goes on inserting the normal DNA sequence, cutting out the cancerous one." Greta swallowed. "What probably happened is some biohacker fucked up their protocol, inserted the wrong gene, and now the virus mutated. It fixed their cancer but it uptook the cancerous gene and became virulent. Now you've got airborne cancer. That is to say, if the patients survive long enough to spread it. The bad gene therapies also turned cytotoxic. Which makes sense."
"But that doesn't make sense. No, not the virus stuff. The biohacker theory."
"Hypothesis," Greta said.
"Whatever. Look," Avis pushed a chart across the table. This was her specialty. Epidemiology. Avis got into medicine for the people, mapping outbreaks, and helping folks. Greta was a lab rat, only in it for scientific curiosity.
Greta looked the chart over and shrugged. "Doesn't mean anything."
"How do you figure? She got the legit cure, from Prudence and Rosebud, and still got the cytotoxicity."
Greta didn't look convinced. "Could be cross-contamination. Real cure mixing with fucked cure," she said it with nonchalance as if airborne cancer wasn't something to worry oneself over. Greta took another bite of her sandwich, mustard dripping to the table.
Alejandro
"When did you find out?" the woman said. Nadia. She said her name was Nadia, but Alejandro figured that wasn't her real name.
"Yesterday. I went to see my doctor about my cough, to get my test results."
The place wasn't what Alejandro pictured when he thought of "illegal black-market cancer clinic". It was a small office space, maybe big enough to hold ten cubicles, but it was full of fold-out tables with fancy lab equipment, cords running everywhere.
"That's good. Moving fast makes it easier. Dr. Rush? He's your doctor, right?"
"Yes. He's been my primary care for... huh. Shit. Years. Since college."
"He's a good man," Nadia shifted in her chair and scribbled something down on her notepad. They were sitting in fold-out chairs away from the lab equipment. Nadia sat with her back to a small room filled with a desk with a desktop computer hooked up to routers and a server.
“And… Well. About the– gene-hack flu going around…”
Nadia laughed. “I understand your concern and appreciate your hedging, but no. That is not me.”
Alejandro laughed with her. Of course. That was something… Something else. Maybe a gene-hack gone wrong or maybe a new virus. Who knew at that point? It was too early to tell.
"So... How much will this all cost?" Alejandro said. He could feel the spot in his chest, where the tumor was. He suppressed a cough and steeled his nerves. He was here because he could barely afford rent most months, let alone six million dollars. If she said anything higher than a thousand Alejandro would have to go home empty-handed. And what if she sent someone after him, worried he'd squeal? She was a criminal after all. But she was sweet. Had an honest smile and she wasn't a criminal criminal.
Nadia smiled. Her teeth glowed, perfect and straight. She had good dental work. Must have been rich growing up. "Alejandro, do you know the name Iglesias?"
Alejandro was quiet for a moment. "I went to high school with a guy named Iglesias."
Nadia crossed her legs. "No. THE Iglesias, of Iglesias Technologies."
"The fracking company? That's you?"
"That was my grandmother. She's dead now and I have more money than I could spend in my life. So..." she gestured to the lab. "Alejandro," Nadia said. "The cure is free. I'm giving it to anyone who asks."
Alejandro wanted to cry but he said, "Free?"
Nadia smiled wider. "Totalmente gratis."
Nothing was free. Roads weren't free, housing wasn't free, food wasn't free, hell even air wasn't free. Every citizen had to pay monthly fees to keep the smog cyclers going.
Smog'b'Gone! A breath of fresh air for the world!
"Your cure is ready too," she proffered a paper bag to him.
"I… I don't know how to…"
"You don't have to thank me."
"But I want to. Thank you."
Nadia just smiled, set down her notebook, and said "Well, let’s just say, Alejandro Pérez, who lives on 10th Ave with your partner. Yes, Theodore Dreyfus. You both work as data confirmers: you for an airline, he for an auto manufacturer.”
Alejandro’s blood went cold, he felt a shit come up to the exit and scream to get out. He had to squeeze every muscle in his body, not to run, not to hit her, not to mess himself.
Nadia smiled and said, “You can pay me back, by not ratting me out. And I’ll do the same.” Nadia stood, said “Thank you.”
Alejandro rose and turned to leave without her having to say it.
“And Alejandro?” Nadia said. “Good luck.”
Greta
What amazed Greta was how calm Dr. Rusch was. Perhaps it was the years of surveillance training that cooled his nerves, or maybe like a lot of men Greta knew, he suppressed his emotions, only for them to rise again and come all at once on some unlucky day in the future.
"Have you spoke to Nadia?" Rusch said running his finger around the rim of his mug.
They were seated in a coffee shop, not one of Greta's coffee shops, but one of Rusch's. Serious-looking baristas went at the coffee as a scientist to an experiment. Exact, precise movements, practiced thousands of times, all just to attain the perfect overpriced cup of coffee.
"Not since she needed help finding proprietary reagents."
Rusch nodded. "Knowing her, she's probably somewhere having an existential crisis."
"Don't patronize her mental health."
"That's not... Look I didn't—"
"You did."
"Okay. I'm sorry."
"Don't apologize to me, apologize to her."
"If we see her again."
That about did it, summed it all up. It would be a miracle if they all got out of this without visiting the inside of an overfull prison.
"What's your plan?"
"Is there anything else to do?" Rusch sipped a steaming cappuccino.
"Dude. Rusch. Of fucking course there is. Try and figure out how to reverse it."
"Good luck. It took Nadia years just to get her hands on PR's protocol."
"But now she has years of notes."
"Well if you think you can make magic happen be my guest, shit, I'll even be a guinea pig." Rusch held out his arm as if to offer a vein. "Good luck."
"Fucking pessimist."
Rusch blew air through his nose. "I'm not a pessimist. I'm a realist."
"What's the difference? Both are just an excuse to feel good about doing nothing." Greta had had about enough of Rusch today. Yeah, he was good help in college, yeah he was a good friend, a good doctor, and he was risking his free life to help a few people. What a great plan that turned out to be. Regardless, he was good people, only... insufferable. Greta rubbed at her eyebrows where after a long shift, they cramped up.
"If only I could sustain my anger like you…"
"Oh, fuck you," Greta said. She wanted to leave, to just leave him there and never come back until the next time she somehow missed his company.
"No! I mean that as a compliment," Rusch said. "You never stop being angry. It drives you. It keeps you going. I admire it. I just... can't. Too many years of practicing under lock and key, under corporate surveillance... We think, are constantly told, that only the big corps can do real science, that everything else, all the little lab techs and idealists in university labs are just as bad as biohackers… I believed that for a long time. That’s why I’m here now. Because I was angry… But now I’m just… tired.”
Rusch downed his cappuccino, stood, pulled on his coat, threw a temporary bank code on the table. "I got it this time."
Greta picked up the little slip of paper, a few numbers and letters written on it in scrawling scratches.
"But Greta, please stay angry. You remind me that this all means something. Whatever. I hope you know what you're doing."
Rusch left and disappeared into foot traffic.
For maybe too long, Greta sat there sipping coffee, staring at nothing, getting angry. She stood and at last, paid for the coffee with Rusch's temp note, a good thing too. She wouldn't be able to pay for both the coffees and the walk home without overdrafting her account.
Greta stepped out into the street, felt her phone buzz, fifty cents gone, leaving her with a little under nothing. She imagined opening her bank app and flies buzzing out. Walking and thinking, she got angrier. Then her anger hit, what she thought was a crescendo, when she felt a second buzz from her pocket.
Another charge. Innovation Road Services took another fifty cents. This happened before, a mistake. She might even get angry enough to call customer service this time. But when Greta pulled her phone from her pocket, she saw that the second buzz was not an accidental charge, but a news article. Greta tapped it. Another bank notice covered the headline for a second: a dollar flying from her account to pay for the article. She dismissed the bank charges, and then read the headline.
"Fuck. Girl, what did you do?"
It was Nadia.
Alejandro
Alejandro held the needle against his skin trying to work up the courage to stick it in and depress the plunger. He was so close to the cure. He was so close to having everything go back to normal.
He already had it planned out. After a week or so he would go back to the doctor and request another test, a second opinion. When it came up negative, they would apologize for the false positive and treat him like royalty, worried he'd sue their asses off. Then he'd tell Theo, and everything would be happily ever after. But Alejandro faltered.
Theo knocked on the bathroom door.
"You okay in there?"
"Fine. I'll be out in a minute."
"Kay."
Alejandro looked at himself in the mirror and he thought he could feel the cancer in his chest again, slowly moving its way around his body, like a crab. The root word for cancer is carcinos: the Greek word for crab. He imagined black-red crab legs coming out from his lungs, sharp, tearing his insides. Alejandro thought of Theo crying over his casket, his mother wailing a prayer to the virgin, his father scowling in shame, and him, dead at twenty-five in a coffin holding flowers or some shit like that.
It took all the will and resolve that Alejandro had to push the needle into his arm, willing his hand to move, his arm to flex making the skin taught. The needle pinched his arm and then slid in, he pushed down on the plunger and prayed. He prayed for the first time since he was that twelve-year-old boy, confused and scared at those odd feelings. He prayed as if he believed someone was listening, he prayed, and he hoped.
Alejandro capped the needle and wrapped the contraband in a plastic sack then stuffed it in his pants. After Theo and he ate dinner Alejandro threw it in the kitchen garbage and took the bag to the trash chute.
Alejandro was ready to start again.
Nadia
Nadia's grandmother always told her, "If you're going to do something, do it right." It was an old aphorism, reused from old episodes of Leave It to Beaver and The Andy Griffith Show. It was, however, good advice, if overplayed. But Nadia never listened to her grandmother. If the old crone had anything resembling a soul or wisdom, Nadia wanted no part of whatever it contained.
Yet, like the legal battle over her grandmother's will, old words from that cruel woman came back to haunt Nadia.
"Do it right."
She hadn't. She'd fucked up so royally she just might have ended the world.
In the bathtub, that's where she was now, in the throes of a bracing panic attack. She'd gotten to the point of submerging her head underwater, just to hear the silence beneath the water. Over and over, she submerged, then surfaced, like a hyperventilating dolphin.
She dunked her head. All the sound in the bathroom went away: the fan escorting steam from the surface of the water to outside, the chirps of her water heater telling her she'd used more than her allotted amount, crackling of a long unused Jesus-candle her tía insisted on getting her. Nadia stopped breathing for just a few seconds, taking away the last sound in her aquatic world.
For a moment, it was all okay. She hadn't screwed anything up. In fact, in her little world under the waves of gray water, Nadia couldn’t see that there was a global panic about airborne cancer, there was no mystery disease, and there had not even been the need for her to create her cure illicitly. In that underwater world, things made sense, and everyone got any and all medicine they needed.
Then, she surfaced.
And of course, it was all a fantasy, but it crystalized a new image of what she would do. A plan.
So often, in her early days, she would have... not visions precisely, as they were merely musings on Nadia's future, that when brought into her notional mind, produced vivid images. Dreams, goals, whatever you want to call them, on occasion Nadia saw with perfect clarity what she was to do.
After that first big “vision”, she made the cure happen, with grandma's money and determination and reams of biochemistry textbooks. Her musings never ceased to come true. But perhaps it was simply a matter of being filthy rich off fracking money that made what to some, might be an impossible fancy, into reality.
Whether it was providence or wealth, it hardly mattered. She had luck and cash on her side. And now, Nadia had an image, an idea of what to do, an idea of how to fix this.
Alejandro
That morning Alejandro woke with a twist in his stomach. Perhaps, it was the sandwiches he and Theo ordered last night—thick steak piled high and dripping with american cheese— or maybe it was knowing what was going to happen when he logged into the video meeting.
Alejandro put on his best button-up Oxford shirt that morning. He even had Theo iron it for him and wore an old, over-tight, pair of slacks. There was still a stain on the seat of the pants from when he took a spill into an hors d’oeuvre table at his tía's wedding. What? Three—four years ago? But they were his sole pair of good pants, and he’d only put them on just in case, and at any rate, his managers would only be seeing the front of the pants if at all.
Theo retreated to his downtown office, leaving Alejandro with a kiss and a plate of toast and cheese. Alejandro never touched the plate of food. As it got closer and closer to the meeting, Alejandro felt that if he put so much as a crumb of bread to his lips he'd vomit all over his computer.
A harsh growl pushed out of Alejandro's mouth, his stomach speaking for him. He pushed down the nausea, willing it to go away, just for a little bit, just long enough to get this over with.
A few faces popped up on Alejandro's computer screen, then a few more. Alejandro waited until they all arrived, then he turned on his camera.
"Hello," Alejandro said in a sing-song tone.
"Good morning," the central face said, Alejandro's big boss. The boss of everyone else in the video call, and to show it, his box was the biggest.
A smaller face said, "So. To move right along, we are here to speak on the matter of employee number 664's absence. An unplanned absence needs I remind you all. This absence lasted two working days and resulted in the loss of a quarter percent of his team’s daily Capital."
"Yes," Alejandro said, swallowing a renewed wave of nausea. He knew it was stupid, that this would happen, but he had no more time off for the year, and he had to get his cure. He would not die, not now.
The same smaller face said, "We are required by the board to read out and remind everyone of–"
"Oh, will you just get on with it?" the big boss said.
"Very well," the smaller face took it in stride. "We will not be pursuing interference of capital charges, but it has been decided by the board that we cut the pay of employee number 664 to the tune of one percent until the loss in capital is paid off."
Alejandro wanted to yip, wanted to scream "Fuck yes!", he wanted to celebrate, but he could only unclench his jaw and wait. Even if he could have celebrated, another, harsher wave of nausea hit shore which made him feel like doing anything but jump around and yell. And it was hot, so hot, that even when he opened his shirt for the AC he felt like he’d pop with all the blood rushing to his face.
"That's settled then," the big boss said. "Well, do we have the–ah of course. We’ll send the paperwork off and 664 please file the paperwork accordingly."
"Yes sir," Alejandro said.
"Meeting adjourned," the big boss said.
The screen went blank, and back to the homepage of the video call. Alejandro could see his reflection in the screen. He could see the way his eyes sagged, the way his mouth hung open just a smidge. He breathed in heavy air to try and quell the battle going on in his stomach, but each breath tasted like paper carton scrambled eggs.
If he could just get to the bathroom if he could only...
How did he… He was on the floor. All around him: a pile of vomit. His stomach churned, like a stand mixer set to high with a sticky dough, all rocking and banging and grinding and... Alejandro vomited all over the front of his shirt and he wouldn't have even been able to tell the old vomit from the new if it hadn't been for the blood.
News stories flashed in his mind. Airborne cancer, dead people, gene-hack flu. He’d tried to tell himself that this wasn’t it. That he wasn’t the next victim of the ongoing outbreak.
Alejandro attempted to stay upright. He tried.
He felt his mind going, slipping away, and even though there was nothing he could do, even though he was doubly dying (what else could it be?) he couldn't help but think, "I'm supposed to be at work right now."
That was the last thought that went through his mind before he collapsed into unconciousness.
Greta
When Greta got home, she found a thick manila envelope stuffed in her mailbox.
Of course.
Nadia.
She spent fifteen episodes of a YouTube cooking show, researching, hunched over her laptop sitting on her couch.
It wasn't a surprise then when an hour into Greta's literature search, Nadia's face appeared everywhere.
“Miss Nadia Iglesias, the biohacker responsible for the outbreak that has claimed seven lives so far has been sentenced to life in prison today after a swift trial. Miss Iglesias confessed to creating the outbreak on accident while attempting to replicate the gene cure patented by Rosebud and Prudence pharmaceutical, stating that "no cure is worth having if nobody can have access to it." Both Rosebud and Prudence Pharmaceutical refused to be questioned on the matter. Scientists at the NIH are hopeful that the information that Miss Iglesias provided will help them develop…”
The medical news got first rights to publish, and right to first views but now, the moratorium passed and all the news networks and internet personalities were heralding Nadia as the harbinger of this plague. A rogue biohacker. A dangerous criminal. A stupid little girl.
If they only knew.
It took Greta only two YouTube cooking shows to realize that Nadia's work had been flawless. Prudence and Rosebud on the other hand... And Nadia, oh sweet Nadia, had been so blinded by the thought of being a hero that she missed the glaring flaw in the pharmaceutacal giant’s work.
An annealing temperature set too high. The protein wouldn't fold properly, at least not all the time. That must be how there were so many Prudence and Rosebud trial patients who didn't experience the cytotoxicity, why the viral vector had never turned virulent until now. Prudence and Rosebud had gotten oh so lucky.
How Rosebud and Prudence had missed it Greta didn't know. Perhaps they were too blinded by dollar signs to catch it.
The rest of Greta's research then, was trying to find a way to make the cure correctly and undetected. After a long time running through every scenario she could think of, Greta accepted that there wasn't a way. Not if she wanted to remain undetected.
The only lab she had access to was the hospital's and it was filled with cameras. Nadia's lab was no doubt overflowing with police by now. It would take months, years even, to replicate Nadia's setup. Not to mention money. Money Greta did not have.
"Fuck it."
Greta rose, changed into fresh scrubs, dawned her most comfortable non-slip shoes, dismissed the bank notification from Innovation Road Services, and walked back to the hospital.
If there was one scenario in which Greta was A-Okay going to prison, this was it. She'd taken the Hippocratic fucking oath, hadn't she?
As she walked, Greta contemplated the end of her free life.
Alejandro
Nothing made sense anymore. Fog all around him. Voices coming in and out. Theo. Mamma. Papa. Voices he didn't recognize. Then the clouds cleared, and Alejandro snapped up, and he was in a hospital ward, sick people all around him.
He vomited, feeling his stomach leap and his throat corrode with acid and a sweet voice told him it would be alright and then it was fog again. In and out of dreams that made no sense. More voices, voices of the damned, voices of angels, voices of God, and Alejandro was sorry. Sorry for thinking that he could find his way to salvation without going through the proper channels. He wished he could take it back; he would pay any amount. He would pay a billion and die in poverty, stuck in a debtor's shelter. Anything as long as he could see Theo again. As long as he could get through this.
Slowly, he began to wake. Though he wished he could go back to the confusing world of fog and vague voices from far away. The real world in which Alejandro found himself was biblical. The kingdom of the damned. A special circle of hell for all the lost souls who tried to cheat the medical gods on high.
All around him, Alejandro saw suffering, pain, horror, in the faces of the damned. A little girl, skin and bones wretched into a bucket. Nothing came up but blood and bile. She cried the little sobs of someone who had cried too much to let it interfere with their normal goings-on.
A man limped to the bathroom only to mess himself when he collapsed to the floor and a doctor in a plastic suit had to clean him up. Alejandro would feel humiliated for the man, but the man didn't seem embarrassed. There was no room for that here.
"How are we doing today?" the doctor asked, and Alejandro replied by filling his bucket full of hospital cafeteria fried chicken and mashed potatoes. "Here," she said. She took his face and wiped it with a pure white towel that scratched his skin. "Now say ahhhh."
Whether Alejandro had the wherewithal to oblige the request he did not know. Perhaps she had to prop his mouth open, perhaps he did it himself, it was hard to focus on anything. The doctor stuck a swab in his mouth, jangled it around, then stuck it in a little plastic tube. She left him before he could embarrass himself. Before he could say, "Please hold me. I don't want to die alone."
It was worse than any flu he'd ever had, worse than any chemo he could imagine. His only solace was the quiet nights when everyone, high on painkillers, at last, collapsed into sleep. Yet Alejandro fought his falling eyelids and researched in his scant hours of lucidity.
He was a mathematician and a computer scientist; he didn't know jack about biology, but he tried to learn. He searched databases and compilations of medical literature. Paper after paper told him there was no hope for any of them.
What was happening to them was that their cure was killing them from the inside out. An erroneous sequence change turned cytotoxic. The only hope was the real deal. The drug that came out of that cooperation between Rosebud Pharmaceutical and Prudence Pharmaceutical.
How much does a human life cost?
To Prudence and Rosebud, the answer was six million dollars. And all the people in this ward were there because they couldn't pay up, weren't they? So even if they identified the sequence causing the cytotoxicity, even if they successfully gave the wonder drug to all of them. Even if it worked and they survived, all they'd have to show for it would be debt. Unfixable, unpayable debt. In this world that was worse than death.
Alejandro turned off his phone and fell into a dreamless sleep.
The next morning, they took a little girl out in a bag. Alejandro didn't cry, just as he didn't cry when they took out the old woman. Genie, who shared stories with him. She must have been ninety, but she fought dammit she fought. And when she lost, Alejandro was too tired and horrified by it all to shed a tear.
He missed Theo, he missed Mama, he missed Papa, he missed the world, but more than all of them he missed having hope.
When he got that syringe full of the cure, he had hope. When he thought he could pull one over on the big corpos, he'd had hope. But now there was no hope. He imagined himself as Dante encountering the sign at the gates of hell.
"Abandon all hope y'all who enter," the sign said. Or at least that's what Alejandro remembered it saying.
"How are we feeling today?" the doctor asked but she knew the answer.
"Horrible."
"Is there anything I can get you?"
"A bullet."
"I'll get you some more morphine and ondansetron then. Does that sound okay?"
Alejandro shrugged and vomited some more. "Water?"
"I can get you water."
They were making him comfortable, that much was clear, they had given up hope too.
Alejandro didn't even manage to stay awake until the doctor got back.
Avis
The way Greta was talking, pushing all her words together, a pileup of verbiage, trying to speak through reams of information in the amount of time it took for a shift to change, scared Avis. She hadn't seen Greta this frazzled since med school.
Avis slipped her moon suit over her head, the smell of plastic greeting her the moment she unzipped it to slip her legs inside.
Greta held Avis's mask out. "I need samples. Get me some."
Avis, after one long and confusing conversation, just now felt her palms go balmy, her heart go into palpitations, her lungs catch fire, her throat close up. "How–were… I..." She stopped and caught her breath. "Why can't you just make it? I'll give them the dose once you do I just... It's too many facets, too many-"
"I need to know."
Avis stopped.
"I have to be sure."
"Greta, it wasn't Nadia, you said so."
"I need to be certain Avis or... Please. This is going to work. Just... Trust me. Fuck."
The way the cameras saw it, a lab tech was helping a friend suit up for a shift in the isolation ward. Not an odd occurrence. The only place in the entire hospital where the cameras could not both see and hear one talk was in the entrance and exit to the isolation ward. All their words would be muffled to incomprehension by the plastic wall between the camera and them.
"Get a swab from one of the ones without records of a real deal cure, and one from someone who got the Prudence and Rosebud cure. Put it in the to-be-tested box. I'll come and pick the sample up like normal. When I know. When I'm sure, I'll start."
"How long will it take to print?"
"Not long." In the hospital, Greta didn't have to rely on mutant E. Coli to make the cure for her. She had a Mol-Printer. Though it was very off-brand to use it in the way Greta intended. Illegal even. But, Avis knew that Greta didn't plan to come out of this a free person.
"Will you... Will you still be here... after?"
"Avis," Greta plopped the mask in Avis's hands. "I don't want you to worry about me. I'll be fine. Now go."
Greta left Avis standing in the plastic room, half-dressed up like an astronaut. Avis sealed herself in, ran through a sanitation cycle, a dry cycle, then entered the isolation ward.
Nadia
Nadia’s cell was a square cement room with not even a window to the outside. Her greatest form of entertainment was staring out through the bars to the other prisoners held in solitary. They didn’t put her in one of the true isolation rooms. She was a high profile case, but not a problem child so she got a full door to look out of and not just a food flap. Nadia took her imprisonment with grace and for what it was worth, the guards were more gentile with her than they were during intake.
There was a media blackout at the prison, which was probably because of her. If the other prisoners got word that the biohacker who’d just casued an international crisis was amongst them, there was no telling what they might try. Biohackers were both loved and hated for good reason. For some they were the only hope for living a longer life, for others they were dumb-shit anarchists playing scientist like a kid with their dad’s gun. Nadia liked to pretend she was the former, but all outward evidence said that she was amongst the latter.
Weeks passed and the rhythms of incarcerated life became second nature to Nadia. She had no clock to mark the passing of time, but her internal clock got quite tuned. She could feel it in her guts when feeding time was about to come, right before lights out, before they’d come and allow her a weekly shower. But that day Nadia’s stomach growled and she was certain that breakfast was late.
The sun passed overhead and laid its rays down through the skylights beyond her prison bars. The sunbeams shifted and moved, changed orientation, and then went away entirely. They had still not brought her any food even when she was damn certain that it was nighttime, the sun rays completely absent, replaced by a dull blue light coming through the skylights.
She looked out through the bars and saw that in other single-cells the lights were already off, but her chittering fluorescent bulbs still glowed above her. She sat and waited, nothing else she could do, and anxiety tried to take her. Though the anxiety tried, it could not pierce her, not like it used to. She’d already been caught, what else was there to be anxious over?
But soon a guard came, somewhere around midnight from Nadia’s best guess.
“¿Que pasa?” she said.
“Ni idea,” the guard said. Her only source of human contact, unlocked the door and pulled the bars aside. “Tienes que hablar con el jefe.”
“What does he want?”
The guard just shrugged, held out some handcuffs.
“Fucking for real?” Nadia said but she put her hands behind her back and let the guard truss her up.
The guard led her down a spiral staircase and through the endless hallways of white and stainless steel. They went through a half a dozen airlocks before they made it to the interrogation room she’d been so familiar with near the beginning of her incarceration.
The guard pushed her inside and shut the door behind her. Nadia turned and almost yelped when she saw the steel table girded by two men and three chairs. It wasn’t just the warden but her lawyer stood behind a chair as well.
“Nadia,” the warden said. “Sorry for the delay there was… A considerable amount of paperwork to get through. Are you hungry?”
“No,” Nadia said and sat at the head of the steel table, hands still behind her back.
“Here,” the warden said, fumbling for his massive key ring. He produced a small key and took Nadia’s cuffs off which only made her more nervous.
Nadia rubbed at her wrists and before she could ask what in the hell is going on? Her lawyer spoke.
“Well Nadia, it appears that you managed to put Prudence and Rosebud over a barrel.”
Nadia sat there, blank, uncomprehending.
“‘Member we’ve been on media blackout,” the warden said to the lawyer.
The lawyer rubbed his temples, set his palms flat on the table. “Right… So, some explanation is in order then.” The lawyer tapped his fingers then pulled his palms from the table and clapped once. “Okay. So. Nadia, in short, you were found to not be responsible for the outbreak. It happened this morning, a federal judge made the ruling, so that means you’ll be released, effective immidiately.”
Nadia felt her heart burst to life, pounding on the cage of her ribs, so loud she thought the two men must have been able to hear it. Her eyes felt like they were going dry but she could not close them, nor control their size: big as deer’s eyes.
“What the man’s trying to say,” the warden said. “Is it wasn’t your fault all those folks got sick. It was Prudence and Rosebud.”
“That’s not proven in court yet and Nadia’ll still be on the hook for practicing without a liscence…”
The warden stared the lawyer down.
“But… Well… Oh fuck it. Yes. That’s more or less true. All you did is reveal to the public sector, exactly how Prudence and Rosebud did it. Now… Well there’s been a few dozen papers published already, noting everywhere where Prudence and Rosebud screwed up. Apparently their internal peer review leaves something to be desired. And what that means for you now, Nadia, is that you’re a free woman.”
“What about my friends?” Nadia said, the first thing she could get past her throat which felt like it was closing up.
“Your accomplices have already been released on bail,” the lawyer said.
“They’re waiting to tell them until the announcement goes out tomorrow,” the warden said. “I imagine all their cases will be dismissed without condition.”
“Well you don’t really know that yet, there’s still the appeals court in—”
“Shut up,” Nadia said. “Shut the fuck up, both of you.” The news swirled and consumed her. A wave of panic washed over her, but then she felt where the handcuffs had bitten into her skin and she realized that this must be real. It could not be a dream, but it may as well have been. Nadia began to cry, tears now ripping out of her unbidden.
“My patients!” she managed. “What about my patients?”
Alejandro
When Alejandro woke, he was in a different room, in a different robe, and Theo was asleep, his head on Mama's shoulder. Papa stood looking out the window.
"We thought you would die," he said.
"I thought I would die."
His father turned around and for the second time in his life, Alejandro saw him cry. "I was so scared mijo."
Alejandro felt the tears before he realized he was crying too. "So was I."
His father said nothing more but to walk over and hug him tight. Alejandro felt the whiskers on his chin from days without a shave and he imagined them all watching over his sleeping body, waiting.
"I love you mijo."
"I love you too."
The next morning Alejandro woke to just Theo in the room and he was thankful.
"Morning you," Theo said.
"I love you."
"I love you too." Theo was calm, an odd calm.
"Are you mad?"
"Of course I'm not mad. You're alive. That's all that matters."
Theo sat on Alejandro's bed, pulling the blankets tight over his legs with his weight.
"How much did this cost?"
Theo laughed. "You just survived a fucking plague and all you can think about is the cost?" They both laughed. "It cost nothing at all."
"How long was I out?"
"Long enough for me to miss you like crazy."
Theo leaned in close and kissed Alejandro and that sensation was better than any morphine drip in the world.