“I’m very sleepy.”
“I appreciate that, but try to stay awake for just these few minutes. As I said, we need your help.”
“I’ll try.”
“That’s all we can ask,” Dr. Nawaz said. He lowered the drape, obscuring Ashley’s face. He turned and gave a thumbs-up to the group standing outside the window in the hall. Then, after flexing his latex-gloved fingers, he used the micromanipulator wheel on the guide holding the implantation needle. Slowly, millimeter by millimeter, he advanced the blunt implantation needle into the depths of Ashley’s brain. When the needle was halfway in, he again lifted the edge of the drape. He was pleased to see Ashley’s eyes still open, although barely. “Are you doing okay?” he asked the senator.
“Lovely,” Ashley said, with a trace of Southern accent. “As happy as a pig in a poke.”
“You are doing fine,” Dr. Nawaz said. “It won’t be much longer.”
“Take your time. The important thing is that it is done right.”
“There’s never a question about that,” Dr. Nawaz responded. He smiled beneath his surgical mask as he lowered the drape and returned to advancing the needle. He was impressed with Ashley’s courage and good humor. A few minutes later and with a final twist of the micromanipulator, he stopped at the exact measured depth. After a final check of Ashley’s status, he told Marjorie to ask Dr. Lowell to come into the room. Meanwhile, he readied the syringe that was to deliver the treatment cells.
“Everything going okay?” Daniel asked. He had donned a facemask as he entered. With his hands clasped behind his back, he bent over to look into the craniotomy hole with its imbedded needle.
“Very well,” Dr. Nawaz said. “But there is a problem I admit slipped my mind in the earlier fracas. At this stage, it is customary to take another corroborating X ray to be one hundred percent certain of the needle tip’s location. However, without X ray here in the OR, that is not possible. With the craniotomy open and the needle inserted, the patient cannot be safely moved.”
“Are you asking for my opinion whether to proceed?”
“Precisely. Ultimately, he is your patient. In this rather unique situation, I am, as you Americans say, only a hired gun.”
“How confident are you of your needle’s position?”
“Very confident. In all my experience with the stereotaxic frame, I have never not been where I targeted. There is also another reassuring factor in this case. We are adding cells, not doing ablative surgery, which is what I am usually doing with this procedure and which would cause far more problems if the needle were to be slightly off.”
“It is hard to argue with a one hundred percent record. I’m confident we’re in good hands. Let’s do it!”
“Right you are!” Dr. Nawaz said. He picked up the syringe, now loaded with the predetermined aliquot of treatment cells. After removing the trocar from the lumen of the imbedded implantation needle, he attached the syringe. “Dr. Newhouse, I’m ready to begin the implantation.”
“Thank you,” Dr. Newhouse said. He liked to be informed at critical stages of a procedure, and he quickly rechecked the vital signs. When he was done and had taken the stethoscope from his ears, he motioned for Dr. Nawaz to go ahead.
After raising the drape and having Dr. Newhouse give Ashley another nudge to wake him, Dr. Nawaz repeated the same instructions he’d given Ashley before inserting the needle. Only then did he start the implantation, utilizing another manual mechanical-assist device to depress the syringe’s plunger in a slow, even fashion.
Daniel felt a chill of excitement as he watched the implantation proceed. As the cloned dopamine-producing neurons augmented with genes from the blood on the Shroud of Turin were being slowly deposited in Ashley’s brain, he was confident medical history was in the making. In one fell swoop, the promise of stem cells, therapeutic cloning, and HTSR was being realized to cure a major human degenerative disease for the first time. With a sense of mounting exhilaration, he turned and flashed Stephanie a victory sign with his index and middle fingers. Self-consciously, Stephanie returned the gesture, with hardly the same alacrity. Daniel assumed it was because she was uncomfortable having to stand alongside Paul Saunders and Spencer Wingate and make small talk.
Midway through the implantation, Dr. Nawaz stopped as he’d done during the needle insertion. When he lifted the edge of the drape, he discovered that Ashley had fallen back asleep.
“Do you want me to wake him?” Dr. Newhouse questioned.
“Please,” Dr. Nawaz responded. “And maybe you could try to keep him awake for the next few minutes.”
Ashley’s eyes struggled open in response to being jostled. Dr. Newhouse’s hand was gripping his shoulder.
“Are you okay, Mr. Smith?” Dr. Nawaz asked.
“Delightful,” Ashley mumbled. “Are we finished?”
“Almost! Just a moment longer!” Dr. Nawaz said. After letting go of the drape, he looked at Dr. Newhouse. “Is everything stable?”
“Rock solid.”
Dr. Nawaz went back to depressing the syringe’s plunger. He continued at the same slow, controlled rate. At the moment he was about to give the mechanical-assist device the final twist, which would have delivered the last bit of treatment cells, Ashley mumbled something unintelligible beneath the drapes. Dr. Nawaz stopped, glanced at Dr. Newhouse, and asked if he’d understood what Ashley had said.
“I couldn’t hear it either,” Dr. Newhouse admitted.
“Is everything still stable?”
“There’s been no change,” Dr. Newhouse said. He put the earpieces of the stethoscope back in his ears to recheck the blood pressure. Meanwhile, Dr. Nawaz raised the edge of the drape and peered in at Ashley. The appearance of his face, which was visible only to the level of his eyebrows because of the frame, had changed rather dramatically. Curiously, the corners of his mouth were drawn up, and his nose was wrinkled in an expression that suggested disgust. This was even more surprising, because earlier his face had been demonstrably blank, a symptom of his disease.
“Is there something bothering you?” Dr. Nawaz asked.
“What is that awful stink?” Ashley questioned. He still sounded drunk, with his words running together.
“You tell us!” Dr. Nawaz said, with the stirrings of concern. “What does it smell like?”
“Pig shit, if I had to guess. What the hell are you people doing?”
An intuition of potential disaster spread through Dr. Nawaz like a faint, unpleasant electric current leaving a weak feeling in his stomach that only experienced surgeons know. He glanced at Daniel for consolation, but Daniel merely shrugged. With limited personal surgical experience, Daniel was only confused. “Pig manure? What’s that about?” he asked.
“Since there are no pigs in here, I’m afraid he’s having an olfactory hallucination,” Dr. Nawaz said, as if angry.
“Is that a problem?”
“Let’s put it this way,” Dr. Nawaz snapped. “It worries me. We can all hope it’s nothing, but I recommend we forego the last bit of implantation cells. Do you agree? We’ve given well over ninety percent.”
“If there is any question, absolutely,” Daniel said. He didn’t care about the last of the treatment cells. The amount he had decided on had been a mere educated guess, based on the mouse experiments. What bothered him was Dr. Nawaz’s reaction. He could tell the man was concerned, but he had no idea why a bad smell would be so worrisome. But the last thing Daniel needed was a complication of any sort, especially not when they were this close to success.
“I’m withdrawing the needle,” Dr. Nawaz said for Dr. Newhouse’s benefit, although there was no inhalation anesthesia to lighten up. With the same amount of care Dr. Nawaz had used for the insertion, he slowly extracted the implantation needle. Once its tip cleared the brain, Dr. Nawaz checked for any sign of bleeding from the site. Thankfully, there was none.