The Book of Apex: Volume 1 of Apex Magazine Read online

  Father Raymond Cleary, St. Cecilia’s Church, Lowell: I’m generally wary of medical professionals declaring things to be miracles. That’s the church’s job. But in the case of Nell Gabrielli, I find it hard to argue. And like most miracles, it comes at a high cost for the grantor.

  Nell Gabrielli: When was the last time I left the hospital? (Looks out window.) Maybe six years?

  Dr. Neil Steffensen, Minneapolis School of Medicine: Any doctor who accepts a transplant from Nell Gabrielli is playing Russian roulette with his patient. We have no idea what’s going to happen to these people down the line.

  Mick Coombs, Transplant Recipient: I’ve gotten two years of life that I wouldn’t have had without this replacement kidney. They wouldn’t even put me on the regular transplant list because I was so old. I don’t care if I start sprouting horns or turn green tomorrow—I would never have lived to see my first great-grandchild without this kidney.

  Megan Ferretti, Medical Reporter for NBS: It all began at Lowell Memorial Hospital, a public hospital twenty-five miles north of Boston. Lowell Memorial serves predominantly low-income patients, many of whom get free or low-cost insurance coverage from the state. The hospital was suffering a staffing crisis, and its president started asking his friends in the local medical community for help. One of the doctors who answered the call was Dr. Sylvia Burbage, a professor and researcher at New England Medical College, who started volunteering her services on weekends. One of her first patients was Nell Gabrielli, an unemployed twenty-six-year-old woman.

  Dr. Burbage: Nell came to me presenting with a small fleshy sac, growing from the surface of her stomach. Her chart indicated that she’d been treated all her life for benign, mature teratomas. Teratomas are tumors that mimic other body tissues, most commonly teeth or hair, but sometimes more complex organs as well. Now, it was unusual enough that she produced so many of them, but to make her case even more unusual, the teratomas didn’t grow inside her body, but on the surface. I decided to perform a biopsy and an ultrasound before excising it, just to be safe, and was astounded by the results. Her body had grown a tiny, functioning kidney. So I asked her to please come back with me to New England Medical for further tests. My research team was already working on genetic regulation of organ formation, so it wasn’t hard for us to adjust our focus from growing new organs in mice to working with Nell.

  Nell Gabrielli: I just wanted the thing removed. I was so sick of growing those stupid skin bags all over my body. Especially the ones with teeth in them. If I had to hear one more guy ask if I had teeth in my hoo-hah... (Trails off.) I guess I was hoping Dr. Burbage could cure me.

  Richard Forrest: Oh, they could completely cure Ms. Gabrielli. But they’ve convinced this poor woman that her life’s purpose is saving other people. I hope she some day realizes that her own life is just as worth saving.

  Dr. Burbage: We were able to accelerate the organ’s growth by essentially performing chemotherapy on it, which seems contradictory, but teratomas don’t behave like a typical tumor. The results were amazing. Within a month, we had an adult-sized kidney that could be removed through a simple outpatient procedure. Better yet, with Nell being blood-type O negative, we had a kidney that could be transplanted into a wide range of recipients.

  Megan Ferretti, NBS: As news leaked out about Nell’s abilities, colleagues of Dr. Burbage dubbed her “Organ Nell.”

  Random on-the-street interviewee #1: I’m glad she exists, but man, would I hate to be her. Her body’s freaky. Freak-show freaky.

  Dr. Burbage: Of course, we then had to deal with changing the way Nell’s major histocompatibility antigens were expressed so we could help minimize the possibility of rejection among potential recipients. That took some time and experimentation, but Nell was amazingly good-spirited about it.

  Nell Gabrielli: I hadn’t had the money to pay the rent in months, so I was about to be evicted. No one wants to hire someone who’s in the hospital every month or two to get stuff removed. And the lumps freaked people out. It was nice to have a roof over my head, even if it was a hospital roof.

  Dr. Steffensen: I can’t even begin to list all the rules of medical ethics that Dr. Burbage and her team have broken. You don’t experiment like that on a human being without first spending years working out computer models, then more years experimenting on mice, then primates, before moving up to experimenting on actual sick people. Ms. Gabrielli was a healthy human being with an unfortunate and unusual predilection toward sprouting benign but disfiguring teratomas before Dr. Burbage and her team got their hands on her.

  Ted Ousterhout, AIDS Action Committee, Massachusetts: A person can live decades with HIV nowadays, but if they suffer organ failure, even if it’s completely unrelated to their HIV status, that’s it. Lights out. End of show. Our clients’ only options used to be to accept organs from high-risk donors. Now, we’ve got Nell.

  Megan Ferretti, NBS: The organs and tissues grown by Nell’s body are only being transplanted into patients who otherwise wouldn’t be considered for the surgery. This has prompted many people on the official transplant lists to question why they’re being left to die while those who have been deemed medically unfit for new organs get new leases on life. It’s also led others to wonder if Nell’s doctors are preying on the desperate to further their research.

  Dr. Steffensen: There is no guarantee that these transplanted organs won’t start sprouting teratomas of their own. True, none have yet, but we’ve hardly had enough time to observe how these organs will behave in the long run. Plus, if they do, I’d say there’ll be zero chance that they’ll be nice, easy-to-remove surface teratomas like Ms. Gabrielli’s. Now, I ask you, do you think it sounds like a good idea to put a transplant recipient—especially one who was sick enough that they couldn’t get on the official transplant list—through additional major surgery?

  Richard Forrest: As you know, it’s illegal to pay money for an organ, so Ms. Gabrielli isn’t getting any compensation for what she’s going through. New England Medical provides free room and board, but that’s it. She doesn’t even earn a salary. That’s just one of the many tricks they’re pulling to keep the government from shutting them down. So if Ms. Gabrielli decided to walk out the door tomorrow, she’d be destitute.

  Nell Gabrielli: Oh, the staff here are really nice. Dr. Burbage buys me things. (Holds up computer gaming system.) This plays movies and music too. And some of the people I grow organs for buy me gifts. The people from the AIDS group make sure I always have flowers. They tried buying me books, but I don’t really read, so they get me movies instead, which I play on this. (Scratches lump on neck and winces.) Forgot about this one. I’m not supposed to poke it. It’s an eyeball, so it’s real sensitive. I wish they wouldn’t grow stuff on my neck. I make them take stuff off of my face before it can turn into anything, but they won’t take stuff off of my neck.

  Dr. Burbage: Never in our wildest dreams did we think we’d be able to develop her abilities to safely produce so many functional organs all at the same time. We really got lucky with that. I won’t bore you with the medical details, but needless to say, we’re thrilled. We just wish we could predict what her body was about to grow, or even direct it, but it doesn’t matter. There’s always at least fifty people waiting who can use whatever her body chooses to produce.

  Dr. Steffensen: We’re all waiting for the details on that particular development, but New England Medical isn’t sharing them. Frankly, many of us in the medical community are skeptical about this one. Not that Ms. Gabrielli’s body has this ability. There’s no denying that. What we’re skeptical about is the means they used to encourage her body to produce organs so fruitfully. If they’re not talking, then that means they’ve got something to hide.

  Random on-the-street interviewee #2: I think I’d rather die than put a part of that woman into my body. Aren’t teratomas tumors? Why would I want to get a tumor transplant?

  Vandana Vidyarthi: Nell gave me a new pair of corneas, so I went to the hospita
l to thank her when I was healthy again. I...I don’t think I’ll ever forget her. (Puts shaky hand over mouth.) My god, what it must be like to look like that. She’s a saint for doing it. I don’t think I could live that way.

  Nell Gabrielli: What else am I growing? Um, right now, I’ve got the eyeball. It’s my first eye. I’ve grown eye parts before, but never a full eye. Uh, there’s a couple of kidneys on my back, some liver bits, a bunch of teeth, a thyroid, a little tiny lung that they don’t think they’ll be able to use, and a heart. The, um, ventricles, they say they look kinda messed-up. But they say they can put little mechanical ventricles in it and make it work.

  Dr. Burbage: We’re very excited about the possibilities for hearts and lungs. Obviously, we won’t be able to leave them to grow to their full size on Nell. That would be too much of a strain on her body. Our plan is to remove them once they’re well-formed, but still small, and then attempt to complete their growth in the lab.

  Dr. Steffensen: I find it interesting that they draw the line at letting hearts and lungs grow to full size on Ms. Gabrielli’s body. How is it not a strain on one’s system to have a dozen maturing organs of other types growing from one’s skin?

  Unidentified Transplant Recipient, presented in silhouette, voice altered: My body had rejected two liver transplants already, and my doctor told me that he couldn’t get me on the list for a third. Then we heard about Nell, and I have to admit, I was afraid. I wasn’t sure I wanted a piece of her inside of me. What if it made me become just like her? But in the end, I accepted it. It’s been difficult, though. I can’t stop thinking about what might happen if it... I... (Fist goes up to mouth.) I’ve started drinking again.

  Megan Ferretti, NBS: The issue of how best to manage the national transplant list has become a political hot potato, and not surprisingly, there’s been no official word from Washington on the Nell Gabrielli situation. During this mid-term election cycle, no one wants to risk alienating potential voters on either side of the issue. The Commonwealth of Massachusetts assures us that they are monitoring the situation, but refused to have an official connected to the case comment on-camera.

  Nell Gabrielli: Oh yeah, someone from the state checks in on me every month to make sure I’m still okay with volunteering. I’m still the only person who can do this, right? So I gotta keep doing it. If I don’t, people will die, right? It’d be nice if they found someone else who could do it, though. Then maybe I wouldn’t have to grow so much all at once.

  Father Cleary: I pray to God every day to give Ms. Gabrielli strength. And I pray to God every day that He not give any other person the same gift. What a heavy burden it must be. God chooses our trials for us, and there are times that I wish He wouldn’t impose such difficult ones on such innocent people.

  Richard Forrest: There are plenty of people out there who like to say, “Look, it’s not like the woman was doing anything important before this happened. At least her life has meaning now.” They may be right, but I’d still challenge them to imagine themselves in her shoes. Perhaps we should see this as an indictment of the society that left Ms. Gabrielli with so few options in life that she was willing to become a one-woman organ farm. Ask yourself: could you see the president’s son in Ms. Gabrielli’s place? He’s not doing anything important with his life either. Well, unless you think becoming the poster boy for DUI is important work.

  Dr. Steffensen: How convenient was it for them to find this ability in a lower-class, unemployed, undereducated woman with no children and no strong family ties. I wonder how many other people have this ability and are having it kept quiet by their family doctors? I certainly wouldn’t let any of my family be used this way.

  Dr. Burbage: Of course, our goal is to find a way to isolate the specific genes in Nell’s body that cause her to produce these tissues and organs.

  Megan Ferretti, NBS: There is real fear in the medical community that, if these genes are isolated, gene therapy could be created to turn other people into organ farms. Hospitals might pressure families of coma patients to allow them to use their bodies this way in exchange for lowering the cost of their hospitalization. And, of course, there are whispers of nightmare scenarios, such as the homeless being given this treatment in exchange for room and board, or prisoners in countries with poor human rights records being forced to grow organs against their will.

  Dr. Burbage: No, of course we’re not interested in asking anyone else to volunteer to grow organs and tissues. It’s wonderful that Nell is so willing, but we’d never deliberately do this to another human being. What we’re instead hoping to do is to find a way to use her genes to grow organs in a laboratory setting. Unfortunately, that day is still at least a decade away, if not more.

  Dr. Steffensen: They’ll never make this work in the lab. They’re just saying that to string their patient along. If they have their way, she’ll be there for the rest of her life.

  Nell Gabrielli: If this all stopped tomorrow, what would I do? (Stares into space without answering.)

  Jarel Padovano: They say she’s started growing hearts. I’ve been waiting for one for years, but they keep passing me by. They say it’s because other people are sicker than me, but I know it’s because of all the time I spent in prison. I know it. If I can just get a new heart, I’ll make a clean start of it. Just you watch. That woman is my only hope.

  Dr. Burbage: I’m so grateful to Nell. We all are. She’s a living miracle, and I am so honored to have been able to help her give this gift of hers to the world.

  Nell Gabrielli: It’s...it’s tough. Yeah. Every day, I wish it had happened to someone else and not me. (Sighs and prods lump under her shirt.) But it did. And it’s important. So I guess it’s good that I’m here. Isn’t it?

  A Night at the Empire

  Joy Marchand

  Between nightmares about mail sorters that reeked of brimstone, Len dreamed of his workstation at the Salem post office. In his dream, the computer had become part of his thigh, and the proximity of its motherboard to his groin had given him erectile dysfunction and prostate cancer.

  It wasn’t hard to guess what that was about.

  Len walked to work in a snowstorm, feeling older, balder, and lonelier than ever. He couldn’t work up the energy to hate Lizzie for leaving, so he hated her cyber-age Don Juan instead—the high-speed internet connection, the Teflon chin implants, the LoveMatch.com tagline:

  Net-savvy Senior Seeks Virtual Goddess With Webcam.

  The hate boiled his brain. He dreamed stop-motion silent films, mailroom mayhem made dramatic with the wailing of oboes, the tinkling of a player piano.

  As always, Len felt his mood lift as he passed the Empire Theater. He yearned for an evening in its dusty black and white paradise, sitting among like-minded strangers in the fluttering darkness, undeniably alone and yet buoyed by anonymous trembles of laughter, gratified by gasps of fright and moans of sympathy. He craned his neck at the brick theater front, but the marquee still read C-O-M-I-N-G S-O-O-N, so he trudged on, the wind whipping away his body heat. No one went to the movies any more; they stayed home and flipped cable channels, cruised chat rooms where they lost themselves in anonymous venom.

  The poor bastards. The browsing dead.

  People lined the steps of the post office, shielding their bundles from the blowing snow. A disturbed rumbling centered on a woman in a green chenille scarf, who was fighting to keep her fluttering newspaper open against a flurry. “Third one this week already,” she announced to the huddled masses. “Dead from heart failure, and his TV gone. They say someone’s waiting for people to die, then stealing their televisions and laptops and cellular phones.” She snatched Len’s arm as he passed. “You think they could let us in early? Page five says they found someone frozen to death on Washington Street.”

  Len disengaged his arm from the woman’s grip and slipped past the bulb-nosed Irishman guarding the door. As usual, Len said, “Hey, Sully, why don’t we let ‘em in,” and, as usual, Sully glared at Len around his cell
phone and mouthed, “Shut the fuck up,” and it was settled, although not to Len’s satisfaction.

  The computerized workstation felt like the visitor’s window of a federal prison. Len’s neighboring inmate, Keith The Mouth-Breather, had a habit of sharing little gems of philanthropy as he polished his view screen. “Any one of dose people out there could be the TV thief. Ya think of that?” Keith slapped a box of sanitary wipes beside his register, his fingers wet and pink inside latex gloves. When he got no response from Len beyond a look of disgust, Keith wriggled a gloved finger into his ear to touch a forbidden cell phone ear bud. Keith wore the ear piece constantly, and stroked a handheld e-mail whatsit on every smoke break as if it were the girlfriend he’d never have. When asked what he found so interesting coming in over the wireless, Keith just gave a look that said the answer was fucking obvious.

  Len wondered if Lizzie still lived that way, shielded from reality behind a curtain of constant input. He wondered if she still had sex with her geriatric lover in antiseptic keystrokes. He wondered if she’d strayed because he hadn’t given her enough of whatever it was she had needed. Whatever it was that Keith got out of his e-mail device.

  Goddamned mystifying, that’s what it was.

  Sully let the customers in, and Len chewed over the Lizzie dilemma in the mind-numbing void of metering mail and dispensing stamps until right before noon, when the bastardly computerized workstation went toes-up. Red-faced, Sully shoved a Polaroid at Len. “Old fuck wants a passport photo. Make sure he can pay.”

  An old man had come to the counter, his face an aggravated pucker between a navy beret and the prodigious coils of a scarf. “I can pay for the photograph.” The accent was French, the hot breath like compost in summer. Tucked under the man’s arm was a squishy garbage bag that burped a miasma of stale beer even less pleasant than the stink of its owner’s tooth decay. “These pig never think I can pay, but I can pay.”