It’s not too late, she thought. Do it. I have to do it.
“I need to show you something,” Serena told the nurse behind the desk. She set down the e-pad containing the scans, the medical history file, all of the information that no longer mattered now. She slipped out a package from the pocket of her lab coat. It was a sterile scalpel. She kept it low, behind the desk, out of the nurse’s sight. She opened the package and snapped the protective plastic off the blade. She let the packaging fall to the ground.
Serena raised her left hand. Then she raised the scalpel and the nurse gasped and held up her own hands. Serena dragged the scalpel from the base of her left thumb across the bottom of her palm, slicing open her hand, not too shallow, not too deep.
Sharp, burning pain followed. Pain was still a thing. She pushed her left hand forward so the nurse could see. But the nurse’s gaze followed the scalpel still in Serena’s right hand.
“Look at my hand! My left hand.” Drops of blood fell on the counter.
The nurse flinched, but she looked Serena in the eye. She was a brave one, like so many nurses. “Just calm down, okay.” Her voice was calm and steady.
“Look at my hand.”
The nurse did as she asked. Serena didn’t need to see what the nurse was seeing. Serena wanted to keep her eye on the nurse and make sure she didn’t call security.
Blood was dripping and trickling down her wrist, soaking the cuff of the white lab coat. The pain began to fade right away, replaced by a tingling sensation, like the one that normally happened when the circulation was returning to a limb that she’d fallen asleep on. Then, she felt the itching.
The nurse’s eyes widened.
Serena felt itching and a touch of tightness. She knew what the nurse was seeing. She set the scalpel down on the counter. With her right hand, she wiped enough blood from her left that the nurse could see that the wound was gone. Not healed. Vanished.
“The thing that’s growing in Walter right now,” Serena said, “it’s not disease. It’s not a tumor.”
THIRTY MINUTES AGO
Breathe, she told herself. And don’t sweat!
She smiled at the guard as she passed him and he nodded in return. She breathed in as she passed the gift shop and out as she entered the elevator. The surgery suite was on the fourth floor and so was the small conference room where the meeting would be held. She lifted her left hand up a little to check the time and exhaled impatiently as she realized she would be cutting it very, very close. The meeting was in ten minutes.
She inhaled as she stepped out of the elevator onto the fourth floor. It was moderately busy. Nurses, doctors, orderlies, a few people in business attire who may have been hospital administrators strolled the corridors. She had spent enough time in hospitals to know that she could find a quiet moment when no one was around. She might not even have to bluff her way into the meeting to discuss the surgery she was trying to stop. If there was no nurse at the desk, she might be able to walk right into the conference room.
She didn’t know hospital procedures, despite her desperate and distracted attempt to research over the past few days. But she had evidence. The evidence had not convinced the patient. She hoped it would convince his doctors. If all else failed, she had an idea for a dramatic demonstration. She hoped it wouldn’t come to that. She hoped she could convince them. But when Serena found a quiet corridor and slipped on the white laboratory coat and clipped on the fake ID badge, she wasn’t sure if she would be able to fool anyone into stopping the surgery that was sure to end Walter Win’s life.
They had found a mass in his belly. They had biopsied it. It was growing. And Walter wanted it out of his body. He was weaker than she was when it happened to her. Much weaker. His prognosis, even with the kidney transplant he had received, was only fair. And his doctors were more cautious and less curious than her own had been.
She heard her own doctor’s voice in her mind.
I call it the regenerative system.
Such awe in his voice. Such excitement. Such hope. Hope. An emotion she had not felt in so long that she did not recognize it until she heard it in her doctor’s voice. She had felt fear too, that all-too-familiar fear of dying and new fear of surviving. She had braced herself to be disappointed, for disappointment too was an old and unwelcome friend-enemy.
But disappointment never came. Instead there came strength and health. And healing.
No, not healing…regeneration.
That’s what livers are supposed to do, regenerate. But Serena’s liver was too sick, too damaged, ruined and rotted by disease. Until someone died unexpectedly. Someone whose tissue signatures were a match for her. Someone who had a healthy liver.
Someone who had more than just a healthy liver.
Serena inhaled an exhaled. She walked into the corridor.
Confidence, she told herself.
She approached the nurse’s station. The nurse didn’t look up from the computer monitor before her as she asked, “What can I do for you, doctor?”
“I’m Doctor Miles. I came in for a special surgery consult for a patient with a metastatic abdominal tumor that presented with some abnormalities.” Serena took a quick breath, hoping she sounded like she knew what she was talking about.
The nurse looked up suddenly, her brows raised. “Oh doc, you’re late.”
“There’s a surgery in progress right now for a metastatic abdominal.”
Serena pretended to consult the e-pad in her hand. “Patient 24179? A Walter Win?”
“Yeah, they bumped him up because he started deteriorating last night. Wait! You can’t go in there!”
Serena had rushed past the desk. But she couldn’t pass the security doors. She was no spy. And she hadn’t really thought it out. She had a fake ID. But she didn’t have a scan card. She hadn’t hacked the hospital computers to add her fingerprint on their approved access list.
She ran back to the nurse’s station.
“You’ve got to stop the surgery,” she said. “I looked at the patient’s scans. It’s not a tumor.”
The nurse shook her head. “They’ve been at it for two hours—“
“Why wasn’t I contacted? I was supposed to be on the surgical team.”
“They probably tried and couldn’t reach you.” The nurse frowned.
“Can we call the operating room?”
And now there was a spark of suspicion in the nurse’s eyes. “Let me call Doctor Jenkins in administration.”
“Can you let me into the viewing room at least?”
The nurse was already dialing. And Serena’s bluff was done. They would remove the so-called tumor. And with it any chance that Walter Win would develop a regenerative system. His transplanted organ, the origin of the growth in his belly, was a kidney. A healthy kidney. And more than just a healthy kidney.
What have I done? Serena thought. I’ve killed him.
She was supposed to have saved him. He hadn’t believed her. When she spoke to him, told him what they had in common, told him not to worry about that mass in his belly. He hadn’t believed her, but he would have believed a doctor.
I should have told Dr. Stanler. I should have asked for his help.
She hadn’t wanted to involve her doctor because she wasn’t supposed to know who the other organ recipients were and who the organ donor was. She had yet to track down the donor. But she had found the recipients, all of them. And of the dozen or so people who had received organs from the one donor, only three seemed to have received that something extra. Serena was one. Molly Mendez was another. And the last was Walter Win.
Serena had gotten to Molly. But it seemed she was too late for Walter.
SEVENTEEN DAYS AGO
“One more left,” Serena said. “All I know for now is that it was a male and he got a kidney.” I just hope I’m not too late, she thought. He might already be gone. If he was taking his anti-rejection drugs, if his body was weak but slowly recovering, she might have a chance to find him and talk to him.
Molly smiled. “That’s good, Rena,” she said in a quiet but steady voice. “Find him. Help him, too.” She had breathing tubes coming out of her nostrils. And her eyes looked droopy, slightly bloodshot, and slightly baggy from not enough sleep.
Not enough sleep, as opposed to no sleep. She had color in her face now, a pale olive color, far more attractive and welcome a sight than the ghastly yellow she had been when Serena first met her. Molly had on a bright yellow t-shirt her sister had given her that said “Banana Betty.” She said it was some joke nickname based on the slang doctor’s used for patients with jaundice and diabetes.
A nervous spasm passed through Serena’s gut. A remnant of guilt and fear and doubt. Even with the evidence of Molly’s recovery, Serena still wondered if she had done the right thing. She had convinced this sick young woman to opt out of a surgery that would save her life. Because she was convinced that the tumor growing in Molly’s abdomen was not her cancer returning, not disease tissue, but healthy tissue.
Molly was just nineteen. She had developed pancreatic cancer and had been receiving chemotherapy and radiation treatments to shrink her tumor down enough so that doctors could operate and remove the diseased part of her pancreas. But when the doctors went in, they found that her pancreas had been too ravaged to resect. They left it as is and continued her treatments as a stopgap in the hopes that a new organ could be found.
And it was found.
When Serena first met her two months prior, Molly was jaundiced, in pain, diabetic, starting to lose her vision, starting to lose the feeling in her extremities. The disease and the treatments and the surgeries had taken their toll. But she was young, and she had been strong and athletic before the cancer overtook her body. And the organ was a match. She had a good chance of recovery if her body accepted the organ. And it did. And she struggled, but she seemed to be doing well. There was cautious optimism all around. Until the doctors scanned her one day and found a small mass behind her new pancreas. A mass that grew a little the next day, and the next. Miraculously, or so it seemed to all at the time, Molly did not deteriorate. She was in pain, constant pain, and she complained of strange tingling sensations. But she lived. And she seemed to be getting stronger. And so they waited until she would be strong enough for them to cut out of the mass and begin a new round of cancer treatments.
And that’s when Serena told her. She told Molly her own story, and convinced the girl to forego the surgery to remove the mass, to trust Serena.
Serena’s gamble had paid off. The tumor had grown larger in the days after the surgery was cancelled. Molly had wandered into and out of consciousness. Her family had begged the doctors to go ahead with the surgery. Molly had forbidden it. And she had already signed the papers and proven her state of mind. If she had died, her blood would have been on Serena’s hands. Her family’s wrath would have fallen on Serena’s head.
But she didn’t die.
The tumor started shrinking, melting away, the cells using existing pathways and trails to guide themselves to their proper places. A small mass remained, the size of a walnut, lodged between Molly’s new pancreas, her liver, and one of her kidneys.
The first noticeable sign of her recovery was the disappearance of the constant dry cough. It grew phlegmy for a few days, then dry again, then it was gone. Her wheezing breath became deep and silent and strong. Nurses found her flexing her fingers, her arms, then her legs. They found her reading fantasy novels, flipping through travel magazines, doing Sudoku puzzles.
And one day, they found her standing by the window, having rolled all of her assisting machinery along with her.
The assisting machines. One by one, they disappeared. Her blood sugar normalized. The numbers in her other test panels shifted closer and closer into the ranges marked “normal.”
Serena had warned her it would hurt, not like sharp pain, but aching and itching and tingling everywhere. All that was gone now, Molly reported, save a remnant of tingling. Serena wanted to wait a little longer, until Molly was fully recovered. And then they planned to go see Dr. Stanler…
THREE MONTHS AGO
“I’m calling it the regenerative system,” Dr. Stanler said.
Serena raised her brows and gave an uncertain smile in return to the beaming smile on the good doctor’s face. They were in a conference room in the research institute that was a ten-minute walk away from the hospital proper. This was where Dr. Stanler kept his office. It was where he had performed several rounds of whole-body scans on her using some new non-invasive advanced scanning technology. He had brought his laptop into the conference room and was searching through a folder labeled with her patient number. He pointed to the white screen at the head of the room. He clicked a button that projected an image on the screen. An outline of the upper half of a genderless human.
Dr. Stanler clicked again and a network of red lines of varying thicknesses appeared within the outline.
“The circulatory system,” he explained. “One of the body’s highways. The other being…” He clicked again and another network of lines appeared, yellow this time. “…the lymphatic system.”
“That’s…the immune system?” Serena asked.
“Well, it’s part of the immune system. Our bodies have a layered defense system, starting with our skin actually, a physical barrier. But yes, the lymphatic system represents a sophisticated cellular-level response to foreign objects or organisms that get inside your body.
“The immune system is like the body’s military,” Dr. Stanler said. “It will fight off invading forces, but depending on the length of that fight and the severity of the illness or injury, what remains of the body may be so damaged that there is no recovery. And even when the body can recover, it isn’t always the same. After the ‘war,’ the debris must be swept clean, rebuilding and restoration must occur, those who were displaced must return, in order for the place to thrive again. The body can’t do that. It can heal, given enough time. But generally it can’t rebuild. It can often just replace what was lost with a poor substitute, non-functional scar tissue. But imagine if your body could rebuild itself.”
He clicked the button again and another network appeared, blue lines.
“I think it used the existing circulatory and lymphatic systems as guideposts to lay down its own vessels and establish its own nodes. Only unlike lymph nodes, these regenerative nodes are everywhere, and they are tiny by comparison.”
Serena gulped. “I have that, inside me?”
“Yes, a whole new organ system. And there’s more.” He walked up to the screen and pointed to a structure in the center of the figure’s abdomen. “I had to scrutinize every scan we had, but I found the little guy, crammed between your liver, pancreas, and right kidney. It’s an organ—I think—about the size of a walnut. I believe it is the brain of the system. The headquarters. The immune system has something like this in the organ called the thymus, but that’s mostly active during youth. This entire system arose in a mature adult.” He paused for a moment, staring at the screen.
Then he turned to Serena again, his eyes bright. “I’m calling it the argilla. It’s the Latin word meaning ‘potters’ clay.’ It sounds nuts, but I believe it’s a stem cell organ. I think it produces stem cells that then travel to the regenerative nodes.” His gaze shifted downward. “Maybe partial differentiation occurs along the way to a given node,” he said to himself. Serena was used to it. He would address her, then get side-tracked by a specific thought that he spoke aloud, something she didn’t understand.
He glanced up at her again. “If you have an injury, the system’s function is to detect that injury and then deploy stem cells to the site or sites of injury. Those cells then go through a process called differentiation, meaning they sense what they need to become, and they become it. You break a blood vessel, the cells become blood vessel cells. If you have damaged heart tissue, they will become cardiac cells.”
“Have you…?” Serena gulped. “Have you ever met anyone else with this organ?” She already knew the answer. She already knew the implications. She had done so much reading when she’d been sick about state-of-the-art technologies, cutting edge research in gene therapy, limb and organ regeneration. Scientists were studying salamanders and starfish. They were making mice live twice their normal life spans. She even read about one group’s promising but failed effort to make an artificial heart. But there was nothing, nothing that could save her. She was helpless unless another human being died and left a healthy organ for her to scavenge.
Dr. Stanler shook his head. “Serena…I have so many questions.”
So do I, Serena thought.
What was this organ, this argilla? An experiment? An old organ that evolution got rid of? A new organ that somehow developed in a full-grown adult? Was the donor an alien or an advanced human or an angel or a demon or a fairy or a god? Was it chance that brought the argilla to her? Was it design? If so, whose design? If it was design, it was a sinister force that did it—to kill the donor. Were there any others like her? There had to be. And what now was her responsibility? To science and medicine. To humanity.
Serena didn’t tell her doctor that she was looking for the donor. And for all the other recipients.
FOUR MONTHS AGO
“It’s remarkable,” the nurse who was changing her intravenous line said.
“I really don’t need that anymore,” Serena said, smiling. “I’ll be leaving soon and I’ll be able to feed my hungry body some real food.” She was so hungry now. Healing was hungry work, she supposed.
The nurse, her name was Clara, smiled her eyes glistening. “I’ll miss you.”
FIVE MONTHS AGO
“Miss Desai, you understand that if we don’t perform this surgery, the tumor will get larger and larger. And it has metastasized. It has spread and it’s still spreading.”
Serena’s whole body was tingling and itching and aching. But the aching had faded and was still fading. She pushed herself up in bed and glanced over at the doctor who was sitting before her. It wasn’t Dr. Stanler. She hadn’t seen him in days, not since he told her that he agreed with her about not removing whatever it was that was growing in her belly. She could feel it. Maybe it was just her imagination, but she swore that she could feel it, a gentle heat, like a burning ember.
They had shown her the scans. They had shown her their serious expressions.
After the doctor left, Clara came to change her bedpan, check her monitors, change her intravenous line, and so forth.
“I know you’re tired, honey,” Clara said. “But don’t give up. I’ve seen your scans. The tumor has pretty clear margins. And you were doing well with the transplant. Just help us fight a little longer and you’ll be out of here in no time.”
Serena was tired, but feeling stronger each day, unbeknownst to her caretakers. She smiled. “I’m not giving up.” She had been recovering. But since the tumor began growing, she’d felt better and better. Even the doctors couldn’t explain how her surgery wounds had healed so quickly. Not only had they healed, but they hadn’t left any scars. There was no evidence that anyone had ever cut into her flesh, removed her diseased liver, and replaced it with another. And now, something was growing near that liver, something that was making her stronger still. And she didn’t want them to take it away.
She looked up at Clara with eyes that could now see clearly without glasses. “I’ll be okay. Who knows? I may be out of here soon. And not in a body bag, like you’re thinking.”
Clara had sniffed then, and turned away so Serena couldn’t see if the nurse had shed a tear. Clara was younger than Serena, but they’d become bedside buddies. She had only been a nurse for a year or so. Serena wondered how many patients Clara had lost to death.
“Will you miss me?” Serena asked, trying to lighten the mood. But Clara didn’t answer.
EIGHT MONTHS AGO
She knew it was inadvisable. It had only been a month since the surgery, but she felt good. Everyone said she was recovering well and quickly, and she wanted to do more than just run mundane errands and courageously go to coffee shops with friends. It was bad enough that she was considered legally blind and couldn’t drive anymore. She should have checked with Dr. Stanler. But she didn’t.
Serena began exercising. Lightly at first. Her surgery wounds felt tight. They were still healing, and they ached and itched, but nothing she couldn’t bear.
NINE MONTHS AGO
It was the middle of the night. And for once, she’d been able to doze off for a bit. But she woke to the sounds of low voices.
“What time was her last meal?”
“Did you get a hold of him yet?”
“Miss Desai? Serena?”
She came awake then and someone clicked on her bedside light. “I’ve got amazing news for you. We found a donor match for your liver. It’s being transported here as I speak. And we are getting ready for transplant surgery. I know it’s a lot to take in, but we warned you things would move fast if we found one.”
Serena frowned. False hope again. Why wouldn’t they just let her be? She had fought hard enough. Was it too much to ask for a night of sweet sleep? For the refuge of good dreams? She nodded her head. She didn’t need to do anything anyway. She would just be lying there. If she’d been more awake, she might have said something. Maybe she would have stopped them and told them to give the liver to someone who was more likely to survive than she was. She didn’t feel as strong as they said her body was.
“You’re a lucky young woman,” a voice said as she drifted back into sleep.
NINE MONTHS AND ONE DAY AGO
An emergency room nurse strolls out through the receiving doors into a misty night. It was raining hard earlier and the world was still dripping and fresh. He sees what he thinks is a pile of clothing lying in one of the spots where the ambulances park. He approaches and his eyes widen when he realizes that what he is seeing is not a pile of clothes. Instinct kicks in. He rushes to the body and drops to his knees, not noticing the rainwater soaking into his scrubs. He checks for a pulse. She is wearing a button-down shirt that was some other color and now is red, soaked through with blood. She has a faint pulse. And faint puffs of mist rise from nose into the frosty air.
He calls for help and they bring her inside. And they get her on a gurney and cut away clothing and call for doctors. She is in an operating room in minutes. There seem to be several wounds in her chest and abdomen. They look like bullet wounds, but they’re not. She is still bleeding. They do their best. They do everything right. They even notice that the organs in her abdomen are intact as if they had miraculously healed. They notice unfamiliar vessels and knots of tissue. Despite the confusion, they do everything right. But they are losing her.
An orderly picks up the belongings that the nurses had left in the ambulance bay as they’d quickly and carefully assessed the injured woman. A pair of short black boots. A long black pea coat. He lifts the coat and from a pocket fall a bunch of keys and a small green wallet. There is blood on both. The orderly picks up the wallet. There is a clear pocket on the outside containing a driver’s license. The orderly looks at the smiling—almost smirking—woman in the picture, and he silently wishes her luck.
On the bottom center of the license, there is a small pink dot with a word written within.
Copyright © 2014 by Nila L. Patel.