JR Gerow

The Clinical Trial

By J.R. Gerow

When she prompts you, you will provide her with all of your information, medical, legal, social, psychological, public and private, sacred and un-, until you are nearly naked before her, dissected on the intake form, splayed across the table and not unhappily so. But rather as though, maybe for the first time, you might see yourself clearly, through her eyes. And through all the others: outside the room there was an army of nurses, doctors, lawyers, pharmaceutical researchers prepared to take your body and make it into their instrument, you had passed them all in suits or rubber gloves through the recruitment process and orientation. You would be a commodity to them. If there was a defect at the heart of you, they would find it. They would name it, give it externality, permit it rise to consciousness. You were almost grateful.

“Are you on any prescription medications?” she queries, her fingers drilling the previous answer into the keyboard. Her eyes remain on the screen at all times, ignoring the projection of you in favor of the real account compiling on her display.

“No,” you respond.

“Do you smoke?”

“No.”

“Drink.”

“Yes.”

“How often,” she prompts, and you reflect for a deliberately natural amount of time, arms crossed, eyes skittering like a fly searching for a window, nursing your exposure. You could’ve done this on paper, you think, but they like to put you in front of a person, to make you lie with that hardened intent. You could always tell her the truth. Your spine twists inchingly.

“Once or twice a week,” you lie.

“Do you have high blood pressure, asthma, or colitis?” she responds without missing a beat.

“No,” you reply.

“Any history of heart issues in your family?”

You pause here momentarily. “Not on the side I know of,” you hedge. It’s a loaded answer, but she takes it without regard. She is attractive and indifferent, the worst kind. College girl. Eyes bright and beautiful and utterly disinterested in you. You begin to feel irritated at her. You note that she is dressed conservatively, a dark blouse of shapeless material, buttoned over the majority of the juicy stuff. Her fingers are long, competent, and they go on so quickly over your responses that it’s like they’re scolding you for dawdling. You start tapping the eraser end of your pencil softly on the corner of her desk, time-keeping.

“How much time do you spend on the internet?”

You cough.

“I’m sorry?”

“Do you have access to the internet?”

You don’t like this question. You are not sure why. You instinctively feel ashamed without being aware of what there is to be ashamed of.

“Yes.”

“How much time do you spend online?”

You’ve never thought to put it exactly into time before, as if the internet were a discrete activity, the world of information segregable from a world without it. “A few hours a day,” you say to be safe.

“How many,” she insists.

“Maybe eight,” you wriggle.

“Have you ever been diagnosed with depression?”

“Is that how you flag people?” you reply glibly, forcing a chuckle, but you were expecting the question from the start. Again, she does not return your smile.

The trial is for an aggressive opioid-based antidepressant, you have been told. They gave you the long spiel in an auditorium-scale waiting room, among an audience of prospective subjects. Your cohorts were a cross-section of urban poverty, almost exclusively black and Hispanic except for you, basically the East side of town. Mostly middle-aged, with an accustomed look of fear in their eyes. As volunteers for a six-week inpatient study, apparently there was nobody who might miss them too badly. The room was glazed eyes and phone scrolling as they walked the candidates through the details of the drug. A seven-syllable name that ended in two numbers and a letter. Gone through three rounds of study among other test groups in the Pacific Northwest without incident. The effects on disordered populations had shown positive mental health effects, but you were there to test the risks of overdosage, and so non-disordered profiles were desirable. This was to be the fourth clinical trial.

A balding, contentedly plump Doctor Choudry explained the scope in generous monotone – the risks of cardiac hypertension, liver failure, blindness, and nausea would all be measured over six weeks. On-site activities would be provided. Moderate exercise encouraged to regulate the rate of metabolic absorption, although limited to one hour per day, at the outside. The subjects would not leave the clinic, although they might accept visitors during prescribed hours. They would eat a fixed caloric intake daily from a prepared menu, adjusted for weight and gender. They would provide regular blood and urine samples. Their time would otherwise be their own. They would have access to a television, books, personal electronics. They would be paid seven thousand dollars.

You didn’t like him already, this Doctor Choudry. But a little piece of you responded cathartically at the sound of the dollar figure. You needed the money like air. Seven thousand dollars, no tax deducted, without rent or expenses for six weeks -- enough for a car, a room in another city, for maybe six months. You felt overwhelmed at the promise. Your eyes felt hot suddenly. Your throat felt thick.

And all just for presenting the body, free to inspection, absorbing the chemical record of some corporation’s research and development process into your bloodstream. You accepted their terms by signing six times throughout a long legal form that no one reads.

And now the room around you leaches its function: clinical. The color scheme of the intake room -- a series of clearly demarcated black, white, eggshell, bone and cream blocked within disciplined borders, the angles all ninety degrees or perfectly annular corners. Nary a freckle or unhygienic blemish seeps between the cascade tiles, calendar, clock, court pad, keyboard, console displaying blood pressure and oxygen level, carrier case for fifty 10mL vacutainers, six of which now contain your blood, the rich purple froth a disjointed blush of color in the otherwise blanched cocoon. There is no posturing at welcome here. No corporately-selected music in the background, no sound at all but the rifling of the nurse’s keyboard and a mysterious, sourceless medical beep saturating the halls, an imperative metronome tracking the circulations of some ambient heart.

The young nurse wears her glasses low on her nose and purses her lips prudishly. Her dark hair is pulled back tight enough to read the ridges in her skull. Her efficient questions suffocate any potential small talk.

“No. No history of depression,” you answer.

She ticks away at her keyboard, as though she knows all of your responses before you open your mouth. You crawl a little in your compromised skin, curling to one side over the armrest, wrapping an arm around your ribcage, the other hand picking at the purple cohesive-wrap bandage they’ve placed around the needle site, over your elbow. You try to smile for emphasis and are aware of every wrinkle that forms at the edges of your lips and under your eyes, wincing. You feel the A/C circulating from a fan in the back wall and how its current subtly exposes your receding hairline, and turn a degree to give yourself a more flattering profile. Your ankles cross, cotton socks rubbing over bone. You feel a little lengthening hangnail working to expose itself at the edge of your thumb, and a second later, as you pick at it, a dimple of blood puckers from underneath.

“Good. Now I’m going to need a urine sample,” and her gaze is empty the first time she looks you in the eye, holding the screwtop plastic jar out to you at arm’s length over the desk.

The first dose is administered intravenously on an exam table. You are half-naked, the chill metal gloss goosing your skin, stomach turning when the needle enters you. You feel it go in, warmly, stretching the fluid capacity of the arm, and wonder when it will hit you, that giddy feeling it ought to induce. It’s just the completion of your intake physical, you dressed in a partial gown, passed between six sets of hands you will not see again, that do not register you mentally as there in front of them, that read you as a specimen. Rejecting the theory of mind implied when you say I think so to their questions, marking an affirmative in the space available on their forms, inquiring into your most recent bowel movement, the last time you had food, water, medicine, intercourse.

A different nurse takes you to your room, a shorter Hispanic woman with blonde streaks in her hair and a round face that strikes you as friendly, if in a professional, overpracticed way. She’s passable, but not pretty. Good enough for gimpy fantasy, perhaps, in the unenviable eventuality that she should the most presentable woman you see here for a while. Lucky you, she says when you arrive at a private room, number five-thirteen, where you will spend your next six weeks. The others are all sharing.

The room is bare expect for a dresser where your clothes have already been deposited, folded. A hospital bed, four-inch-thin mattress and guardrails running the sides. A television bolted to the ceiling with a corresponding remote chained to the bedside. Between the pale yellow, flowering curtains, the windows look out on a long, mostly empty parking lot. A tree is visible overhanging the pavement at its far end, the branches almost wilting in the thermal updraft. A highway overpasses in the distance, past a strip mall the other side of a six-lane empty road and rows of stubby, ranch-style housing creeping in around the edges.

The door is never to be closed, she admonishes, although it is not clear to you why. A sliding curtain may shield you visually from the hallway, you note, but you imagine that you will have to masturbate, when you do, in the bathroom. A half-squat, inglorious.

You step outside when she is gone, and regard the milieu. The room sits at the corner of two hallways. To the left, eleven patient rooms for twenty-two subjects line the hall on either side, most with their curtains drawn already. A utility room for the cleaning staff, you gather, is at the end, beside which there is a freight elevator, key-controlled. Straight ahead there is one more patient’s quarters to the right and then a nurse’s station. Past these, a side of double-wide metal doors to an administration office are bolted under key code. The obscure glass block windows in either door give just the impression of their administrative shadows moving somewhere behind, no sound. To the left of those doors, a large common area opens up with televisions, tables, chairs, old magazines of no interest with their pages wrinkled and stuck together. On the far side of the common area, an exercise room, and a door that actually closes.

About seven other participants are there when you walk into the common room that first day. They sit each in their own territory, save for two who have claimed the television and appear to be connecting a gaming system. One, a thin, mustached man with a square face, square haircut, square eyes, square frown, Mexican, is pacing like a bored animal in a cage already. Some are still in their nursing gowns from the physical, whose shamelessness feels aggressive to you, confronting with their state of half-undress. No one looks you in the eye, although you do sense that they look.

Bad weather is gathering outside. A standing fan blows by the window, though none of the windows are open. Voices down the hall mesh with their muted cable stations and the sounds of rolling carts and beeps. The immediate television plays an empty blue screen and hum and the halogen ceiling lights reflect brightly off dark skin.

They orbit you distemperedly, the other subjects. Distractedly, on their phones or practicing hygiene openly or listening to something bass-heavy through headphones and nodding and clicking their jaws. And you feel surprised by how natural you seem here, among them. That they take no notice, perhaps because they know who you are already. As though there were always a place reserved for you here, the white one, the one who fell from outside their world and became poverty.

You will be the best subject in the study, you think. You will excel them all easily.

When no one approaches you over the next minute, you file back to your room.

The first day, you are aware of searching for the feeling of giddiness that is promised by the drug. You are cautious to avoid overinvesting in placebo effects. But all it feels like to you, through the first few hours, is maybe a rush of caffeine and a slight headache. Or that could just be dehydration, perhaps. Everything seems a little louder, too, you think, but that could also be the environment. Throughout the day, as more of the subjects start passing your room, you become very aware of your position at the hallway juncture, funneling all of the noise throughout the floor onto you. Either they’re all loud or the drug is worsening your noise sensitivity. They know each other, some of them, from past studies, you gather as they regale each other out in the hall in broken English with horrific anecdotes about vomiting and migraine and being rushed to the hospital before eventually being readmitted and completing the study, laughing all the while, and part of you is quietly horrified.

You had wanted to read, really, but it was almost impossible. You had brought a small library with you. Things that had sat untouched on your shelf for years, that’s what you had looked forward to most during the study: using this period as a kind of mental recuperation. The presence of books always made you feel calm, a little wealthy. You had wanted to feel equally rich in attention. Had wanted to, but find it almost impossible now – manage to turn only five pages before the noise displaces you, and you begin fingering the remote, just because it is there in the otherwise tactile desert of the room, the humid rubber kiss of button to fingerpad milked neurotically, repeated like a mantra. Until you finally press down, turn it on just for competing background noise, so that the chatter of infomercials for inane kitchen products mixes with the subjects outside. And then foreground noise, and then shut the book altogether just as you are realizing that you need to turn two pages back to reassociate yourself with whoever the narrator is speaking to anyways, and instead you commit to returning to the text later, with clearer attention.

The sun sets early. The quality of the light in the room shifts from natural to halogen. Daytime television turns to primetime television and you still haven’t registered an appreciable difference in mood, attention, physiology. The cackles quiet in the hall, everyone back to their rooms now, the dim hushes of other televisions weaving interference patterns into white noise, and the white noise owns you. You listen to the sound of your breath, magnified. Cycling now through the same four news channels in circulation. Same reports on each, migrants on the Turkish border, riots in Germany and Oakland. Timeless stories, you think, the same things you have been watching all of your life.

It grows a bit later and the patter of noise from down the hall has winnowed down to a distant phone conversation, whispered at intervals from some nearer subject’s room. And the constellation of arrhythmic harmonies of medical beeps, harsher and then more attenuated like scattered starlight, and the whirring of industrial floor-scrubbers. There is no reason to sleep here, you realize. No one is waiting for you to be anywhere else in the morning. You could completely invert your sleep schedule, no problem, who would care. You have been idly comparing coverage between the major news agencies online and don’t remember when you started. Your fingers instinctively begin to type in a URL and then stop, recognizing that it is the same site you are already on, with no memory of seeing it before. You feel unnerved.

Around two-thirty AM, you pull back the bedside curtain, cautiously wheel your IV to the door, and peer out into the hall. It stretches longer than you remembered, and every door is dark. You don’t hear the sound of the medical trackers. From the darkened rooms, there are muffled sounds like the soft growling of animals.

Doctor Choudry visits you twice daily. A fastidiously scheduled man, he keeps you to seven and a half minutes precisely, every time, without looking at a watch. You wonder if this is a neurotic tic or simply an unconscious rhythm for him, the same script repeated in room after room until it is muscle memory. The doctor is a warm, impersonal man. Eyes flat with contentment, impenetrable in the sense of there being nothing under the surface. Wide lips pulled back into a pleasant resting smile. There is no doubt in your mind that he is married to a beautiful woman, five years younger than he is. That they have two children, ages twelve and nine, that he enjoys wine with dinner but never without moderation. Golfs with his white colleagues out of social obligation, never performing better than their average, maybe on purpose.

“How have you been sleeping,” he inquires in a fat baritone that does not inflect as a question, that begs only affirmation.

“Good,” you collude. You are shivering slightly in the aggressive air conditioning, wearing a thin t-shirt, elbows tucked into the stretched-out arm-holes. It is the sixth time you have seen him, the third day.

“Appetite.”

“Fine.”

“And your bowel movements.”

“Same as usual,” you offer, although you actually haven’t defecated more than once since intake. You wonder if they have ways of knowing this, like inferring from your physicals. You feel guilty and protective about the fact of your own shit.

“No abnormal heart,” he drawls, scrolling through your chart. “Normal blood pressure. No bad dreams?” he asks, and looks at you with such a mild grin that you can’t be sure if he’s making a little joke or not. You shake your head cooperatively. “Good,” he pans, and in the ensuing lull he writes something that feels suspiciously responsive to your silence. The doctor looks up then with a sharpened, scrutinizing gaze. You feel uncomfortable, dissected without even knowing what information you have given up.

“You, uh, this friendly with all of them in here?” you ask, grinning. By Choudry’s response, this seems neither to land well as joke or accusation.

“Do you find yourself craving any particular diet?” he asks.

He is gone within another three and a half minutes. Later you distract yourself with futzing on YouTube until you can’t remember the feeling of embarrassment. Play stupid little flash games with playtimes under a minute, repetitively until the optimal move sequences all become tics. Click swerve jostle click straight up, again. Down the hall, a distressed subject is arguing with their nurse about how many calories they may be allowed. Another being sick loudly, unpleasantly, moaning like an exorcism. You hear some babbling about needing to get out of here, Just for ten minutes, just for goddamn ten minutes, don’t take my damn money, I just need outside, man, won’t go no farther than the corner, repeated inanely, mindlessly, and you pull the bedside curtain closed, reducing all noise to the same level of dissociation as television.

Whenever you close the door, it slips open again within five minutes, with the next nurse to round the hall.

Outside, in the crook of tree branches overhanging the parking lot, you can see two bluebirds returning to a nest, chickless. They preen for each other stupidly, happily, nothing on their minds.

At night, it starts as a memory. The moon is a rippling circle on still water, flat beside the lawn’s waveform, in back of the gallery. You’ve drunk enough for two of you, for probably three of you – stumbling from the long marble steps and then off the path, into the wet grass, laughing at nothing. Her stupid little dance careening off into the trees, heedless, and so you are after her, always. She falls down on purpose, you think, maybe, and so you lay beside her. Doing what, you wonder, what’s the plan here. Still within sight of the path, still near enough to be seen by anyone wandering through at three in the morning. You don’t even understand what’s happening yet, you haven’t made a move, haven’t been the man yet when she starts undressing for you herself, before the sense of her can even resolve in your gaze, and then she’s in panties and her breasts are exposed and alarming, bared for you. Stunning. Not quite how you imagined them, the nipples tiny and pert, but nothing is really trustworthy in your swimming vision, and she is laying back down into the grass, flawlessly feminine, chin bowed, inviting you over her. She makes a soft, stunned little noise for you, like all of the wind rushing out of a house.

And you, without will or deliberation, are suddenly the quivering hood bowed convexly over her, almost afraid to touch. One hand shaking where it is supposed to go, breath uneven. She looks up at you like something is wrong, like you are suddenly not who she thought you were. She had been made for you, you think, and yet here you were, conditioned to believe that you didn’t deserve her. Petrified of your inadequacy, before you can even try. And isn’t it awful, the insinking realization that you don’t think you can perform, the drugged dick hanging deaf and limp in your shorts no matter how consequential your brain tells it the moment is. Not being able to cease your hands from shaking, unable to speak, to know what to say if you could even say it. How to casually dismiss the trauma of it, a thousand deaths of self-disappointment, and so you just smile in the most pathetic, apologetic kind of way.

But she is turning one thousand degrees Fahrenheit, in your dream. She is burning a hole in the grass and within a minute you are alone in the charred crater where her body was, where it had wanted you for just a moment, and she is gone, gone like an overwritten memory, gone like a golden age, gone like something that never even was. Your skin is burnt numb and tingling by the sense of her, but not numb enough, not yet. That moment, that half-memory curdling into nightmare, the only time you almost had her.

The next day you wake up by degrees, turning between the rising noise in the halls and the insistence of your dreams for what might be hours before you are fully awake, and feel sensitive, through your reddened skin, to the end of every soft hair.

There is nothing on the television and you hate it. You spend an hour or so fighting with this reality. Then another half an hour in the bathroom touching yourself hopefully until your morning constitutional with Dr. Choudry interrupts for seven and a half minutes, and then by eleven you dress in running shorts and a white undershirt and go to the exercise room just to self-segregate, the only room with a door you can fucking use. You pass through the common room where the subjects are all out at play, with three different strains of competing music, Spanish and half-English, all pitted against each other, as someone is tearing up wet magazines several pages thick at a stroke with a disturbed expression, one woman with her breasts half hanging out of her smock is just sitting still and laughing to no one, really just on quite a chemical vacation, and a pack of them surrounds the installed gaming console grunting at each other, or half-giggling, who can tell. You reach the door to the exercise room without making eye contact, and find it brightly empty inside, and feel a slight relief, instantly, when the door opens as though the volume dissipates into the new space.

It is two stationary bikes, a limited set of free weights and exercise balls, no television. You step in and hear the latch hit the doorframe behind you like a benediction, the satisfying click that feels good, that feels respectful, that feels like control.

The more energy you burn, as you recall from orientation, the better you will be able to absorb the drug, and you still believe in being the best subject. If you must be a subject at all, you should win at it. You are on the bike without pause and pedaling, the onboard computer loading an automatic workout belatedly and beginning to record your heart rate through the handlebars, a blinking red one-thirty, one-thirty-four, and climbing. You are falling into a comfortable rhythm, adjusting the resistance to where you can hit sixty revolutions a minute without too much strain, straightening your arms and letting your shoulders hunch back, your head drop meditatively as the sweat begins to dampen your forehead, your hair begins to hang wet, a little satisfying taste of salt on your upper lip. You listen to the sound of your breath, accelerating, magnified.

You feel well, for just a moment. A happy relief from a tension that you cannot locate, somewhere in your body. The muscles and rhythm and breath and damp and gathering body odors, it’s all welcome to you. You almost forget where you are. Until the door opens a second time, and he leaves it that way: a pair of tight black calves passing, in what look like your sneakers, in front of you to the second bike, and the music from the common room is now louder than your breath again and the second man is on the bike just as automatically, and falling into a rhythm that picks up instantly, climbs to a hair faster than yours.

You speed up to match him. He accelerates subtly.

You do not look at your counterpart. To look at him would give him power. You stare straight ahead, or close your eyes. The uncoupled rhythm is maddening, the way he catches more speed at just the moment you match him. Each revolution of the pedal is an audible cycle, a whirr-whump, whirr-whump of an internal weight shifting inside the bike, and you are almost in sync, or you are barely in sync for a half a rotation, and then he is faster than you again, or you are slowing down involuntarily and don’t even realize it, can’t maintain pace. Your breath wants to accelerate out of proportion with the pedaling, but you won’t let it, it would not do. You must keep your breath steady, even, even if it’s not enough oxygen. Even if it hurts, even if it hurts in your calves and your chest, you must keep proportion and rhythm and time and balance and control until suddenly you are coughing – so quickly, startlingly, before you even realize you’ve pushed yourself too far – so that you hardly realize it before your feet have slipped off the pedals, and the pedals spin and slam into the back of your calf and you lurch forward, and then you’re swinging your body unsteadily off the bike, and reaching for the door, until you cannot get a breath in suddenly for the coughing and you see just a quick frame of black cut into your vision for an instant, and then hit the floor – and then looking up suddenly you’re fine, you’re fine, no, you’re perfectly alright, but your counterpart is standing over you as if to help, hands on his knees, looking down, but he is not extending a hand to you.

“Who do you think you’re looking at?” he says, and grins.

And you are not ready to die yet, no, you are not ready to be replaced, usurped, or rendered useless in this world. When you look up at him, his face is a black mirror of yours.

They switched the drug on you, you’re certain. At least two days ago. It used to be a blue tablet, and now it is a green one. You’re not sure when they did it first, not exactly. Didn’t note the pill carefully at every instance. But it feels different now. It feels harder, stronger, more right.

And then comes a day when you wake up humming with chemical focus, as though the high has finally hit you while you were still asleep. You don’t feel the needle entering the vein. You dream of racing so fast your feet lift off onto the tangent plane to the earth, angled into heaven. You dreamt of pressing her there, and then of idle flash sequences of the game, instinctive repetition, thrusting buttons to completion. There is a pulse twitching in your lower eyelid and your breath is long and even, meditative. Early yet, the other subjects haven’t even begun to stir, the long halls silent but for the ambient beep. What light is there is bare and dark blue on the windowsill. Parking lot empty, most of the nursing staff still at home, a-bed. Your television playing on mute and you shut it off.

You open your texts. You are ready to read now. You are finally ready to read.

Finally comes this day when you can read everything you have ever thought to, everything you brought with you into the lab in one sitting, inhaling the text defenselessly. All the greats, the luminaries, the lights of civilization. The reasons the species was worth preserving, really, and they could be held in your palms, possessed, so that you were almost redeemed by them. They were named, of course, Pynchon, Wallace, Nabokov, Miller, Joyce, Faulkner, Campbell. Your mind an immediate mirror of the page, and then you were laughing with them, and moaning softly, and reeling in the rapidfire swell of hilarity and anguish and, above all, self-awareness. These were men, truly. Men who understood things, who saw the culture’s spiritual tapering against a century of moral destablization and made a bulwark of genius to stand in its way. The world outside was going crazy, all the time, and still, just past the still end of the parking lot, and there was no natural order. There were massive movements on the Turkish border, riots in German city squares. No invisible hand holding it all together, no word of God in the secular age, but at least we had the canon. And we knew who fucking wrote it.

The drug has finally infested your brainstem and unlocked some latent competency, righted some relation between shuttered neural regions and the body long estranged from them, and you are delighted to discover you have what feel like a hundred eyes swiveling, and a hundred hands to turn a hundred pages, and a hundred toes to tap the crackling rhythm of concatenated thought tripping down the page, and only haven’t been able to command them until this moment. They pore over the shapes of paragraphs bodied gorgeously down the page, the tactile quality of touching them with your eyes, feeling the roll of unjustified text stipple into your senses, and all of this just from staring at that first page. How have you not known before the pain and pleasure of such fluid thought – knowing you can follow its trail for happy days and nights and never even blink. Knowing that you have wasted forty years standing outside its door, unable to walk inside. And all narrative, and all books you have ever read, all thoughts you have ever experienced come inrushing like floodwater through open windows in a house dropped undersea, though it seems you are still on that first page, twitching, caught before the idea of an ecstasy you could not stand to experience.

And outside, it is raining, a dull, fertile rain that brings life out of the dead earth, and a cool wind against which birds shiver in their nests, and you shiver, too. Doctor Choudry calls your name four, five times. You are aware of it but unable to respond.

The drug is imbued. You watch it make curls of pink smoke when you exhale. You feel short of memory but the past is irrelevant anyways.

You walk the empty halls that night, dragging behind you the unplugged monitor. You are an order of magnitude more muscular, lithe, dangerous to everyone here. Prickles of spine project from your skin and your breath leaves a trail of smoke coiled to the ceiling. You glance in every room but they are all void of people. You listen close, for a sound like all the wind rushing out of a house.

And then you hear them, at the outskirts of audible frequency, always coming from just past the next room. Taunting you, step by step. You don’t see me, they say. You don’t see me, motherfucker, but I see you.

“The patient is not dilating,” says Doctor Choudry, shining a white light in your eyes, drawn open by a rubber thumb pressed up into the left eye socket.

“He is looking very sick?” replies the nurse, peering over his shoulder.

“It’s normal,” Choudry replies, switching the light to your other eye, which does not respond, but gazes into the senseless brightness curiously, as one tries to see just past a horizon.

“Should we lower his dosage?”

“No, these are great numbers. I need to call up the company.”

“Mister?” the nurse prods you with the end of her pen. “Mister? You are feeling okay?”

You are aware that she is asking you for narrative. You are aware that she requires you to tell the story of a physical condition that is nowhere more honestly represented than corporeally, already in evidence. It does not do, does not compute. You respond, “Nummm.”

“Oh boy,” the nurse says, biting her lip.

“Don’t worry,” Doctor Choudry says in that same flat baritone, that commanding tone insufferably assured of its own authority. “Put it on the IV, keep him at 100 milligrams an hour and let me know if he loses consciousness again.”

“Maybe we should let him rehydrate for a little while?”

And the nurse looks at you protectively. She looks at you like you are too weak for self-reliance, your petty star damp at the ember. She’s not the pretty one, the college girl – no, this one is still the Hispanic. Just okay. So eager to clean up after you, helpless. This one is not indifferent, but it’s almost worse, in a way. The way she looks at you, how she will lower you that final rung, into dependence.

“No, no, no,” and Choudry turns on his heel at the door, at what must be the 7:29 mark. “I want him sucking down blood the whole entire time. I like his color very much.”

Weeks pass. The nuclear century. You are still here, you think. Or were. Or some part of you is.

There is no sensible noise from up and down the hall. The other subjects are all gone, you think, quite gone. They have no speech, no means to communicate with the nurses who idle through their rooms dutifully, making one-sided conversation, chattering with machines. It starts at night, and then leeches into the day, the sound of them moaning, beastly tunes. Not so different from how they came here, you think. More self-realized. You hear the sound gurgling up inside of you, too, but you need not give in to it.

Stories, all day, just stories. The pile of books grows larger the longer you wade through it. How does the idea of being human rely on such a story. Compiling like a mausoleum around you, walls rising out of the linoleum coordinate plane, enshrining you for future generations to examine. Words repeating backwards in an upflowing waterfall, sucking back into their pooled source.

Source: that pliant mental space, once pregnant with potential and splayed open out of evolutionary fluke. That first neural concatenation arranged in man receptive to language, inviting a word to fill it.

“You are not doing so good today?” the nurse asks you, again with a real note of concern in her tone, a real irritating motherishness about her.

“I’m fine,” you try to tell her, but this is not true and you both know it. You are so damp with a cold sweat that it wrinkles your fingers. You are burning up and then freezing and you can’t hold down water, haven’t been able to for days. So they have put the IV in the other arm to fill you with some nutritional paste and fluids. You can feel the nerves in your teeth, you think. You can feel them start to move.

“Doctor Choudry says two more days on this dosage, then they maybe lower you, okay?”

“It’s fine,” you growl and turn back to your book, but there is no book in your hands, truthfully. Nothing to read but the scratch of black bristles over your palms, held at prayer in the posture of reading. You’re not sure there ever was.

“You want to use the bathroom? You need help to go?”

“I don’t need to go.”

And she leans insistently into your field of vision, head cocked in skeptical appraisal. Smirks.

“You like what it do to you?”

You look outside mournfully. The bluebirds have departed their nest. The nest deteriorates like a scab, lonely and whitening. You have not seen them in days.

Probably got eaten, you think, by some vagrant.

You dream of being inside of her, finally, four weeks into your stay.

Your night erections, more powerful than any during the day, pressed firm between your stomach and the mattress, through which you can feel the steel bars of the bedframe like the bone under her flesh. Her body is infinitely passive, infinitely compliant, needful of you. Finally, your cock gliding like a key against the tumblers of a lock, resetting her machinery. And she is so, so sorry. So penitent for all the years she has made you wait for her.

Your muscles are full of blood, your lips flush. Your brain is pounding like a second heart inside your skull, and your teeth go back for miles into the receding corners of your mouth in glittering rows, jangling. Your hundred arms close around her all up and down her body like a cocoon, controlling every ebb and thrust of her pelvis up into you, fluidly, servile.

You will consume her this way. There is no cumming, because she is bound to you this way, voicelessly.

And then there are four white men in buttoned lab coats, black ties, with scattered grey hair, thin lips, all staring down at you from either side of the table through opaque glasses, reflective with the operating room light.

You turn this way and that against the restraints. You spittle and swear, and they are amused by it. You do not recognize them, but you are only half-present yourself. They are looking down at only the invisible part of you, the part you could not name, that you have come, you realize now, for them to reveal.

“He’s gonna make us a fucking fortune,” one says at right, with a pinched expression framed by moist gray stubble. “Give him the girl again.”

You see it one night, finally, in the basement. After the noise is all squelched, the doctors and their researchers gone back to their wives, and the suburbs hum with rot. It’s that Hispanic nurse, the one always worried about you. She comes to your room alone. Asks you if you want to see it, down below, where the medicine is made.

Unplugs the IV from your arm, wraps it in gauze. Draws you out of the bed gingerly, letting you lean against her, cradling your palm between hers. “Follow, hurry,” she says, taking you by the hand down the empty hall, her two footsteps echoed by your several.

There is no sound from the dozen curtained doors. There is only the smell of decay, and the hoarseness of your breathing, labored, trying to sustain the new body growing out of you, heavy. She turns a key and the freight elevator lurches with a bass rumble through the shaft. When it arrives, the hunch of your hard skeleton presses into the top corners of the hold, and you can taste the chemical clean glossing the steel sheeting.

Ding, the door closes, and then a long ride below the surface of the earth, into sweltering temperatures, until ding it opens again onto a phantasmagoric scene: an expansive lab with an enormous vaulted ceiling, extending backwards as far as a football field and lit with only black light.

The room is filled with metal tables, holding tanks, inscrutable machines bolted to the floor with pressure gauges and steam outlets chuffing away, and between them all, scattering the ceiling at a great height and projected out of every empty corner of the room, the tables, the edges of the tanks, are thousands of naked bulbs shining pure black, a burning dark that almost hurts when it hits you. The holding tanks slosh with a burgundy liquid, running through some intermediate apparatus before pipetting into long, lean vials, which are collected mechanically, shuttled into what appear to be dumb waiters at the edges of the room.

“What is it?” you ask, though the sound is sticky and unclear on your tongue.

The lights dim and brighten with fluctuating current, cast slow shadows through the churning tanks, shifting.

“Blood,” she tells you. “Tainted, first. And compost, too, all diluted together.”

Bubbling lonely, it sloshes and a light film sticks to the glass as the chamber evacuates, backfilled from another pipe, roiling and mingling with the intake gas. It makes little noises as it settles, bubbles forming and trickling upward, popping. Reducing into hot, darker tanks of condensed medicine.

“That’s the drug?” you ask.

She doesn’t respond.

You see, drifting through the liquid of one of the near tanks, a form gliding up weightlessly against the pane. The fur matted. The single wide eye turned towards the glass, impassive. Like a cow, you think maybe, although you can’t be sure. Twisted, one leg turned at an impossible angle, suspended and drifting in almost balletic slow-motion. The tank evacuates suddenly, and the figure is taken by gravity, hits the floor in a soft crumple, hollow. More like empty clothes than a body.

She takes your hand then, and presses it to the evacuated glass. You can feel the heat still through the pane, cooling. You feel something lurch inside of you, feel the muscle responding. You are turning sweaty and nervous without knowing why. Your body is not its own.

You shake her hand off and scuttle forward between the tanks, your ragged claws clicking under the thousand dark bulbs, penetrating from every angle and colonizing, to let it wash over you, the impossible scale of it all. One tank after another, and all of them holding something inhuman. Some kind of animal, squid, insect, you can’t be sure, the forms are all muted, shifting shadows in the froth.

You are starting to hyperventilate. The plates where your chest was slide apart and back together quickly as you inhale, exposing the little, embryonically-sensitive hairs underneath. Your pulse rises.

This is what the drug wants: that you should hold just one thought in your brain, isolate it down and let the mind rarify back to its minimalist design. You can hear the narrative of blood deconstructing narrative.

You are afraid of your body suddenly, and your body is afraid of your thinking. Of the idea that subjugates urge.

“You still like it?” she asks you softly, but as though ashamed, and you can hear her clear as a bell across the room.

One more tank, you see. One more glass enclosure, its black milk or medicine churning and buffeting a lonely figure within. The form floats softly from deep in the pool to nearly touch the surface of the glass before you, almost as if drawn by your gravity.

“They didn’t make it,” she says, as if anticipating the question. “No, they found it, way down in the sewers.”

It is not an animal, you think. Not yet. As its face resolves through the fluid, it looks human. Like you, you think. Or a version of you, as you were, looking back at you clearly now, gauzy eyes fixed open. Lips hanging, teeth bright. Nude and hairless as a baby. Brilliantly white, practically shining in the dark, as if you had never been touched by sun. The double, long hidden from you, as you were seen. As they accounted you here.

Instinct overwhelms. You crack the glass with your head and watch the figure slip to the floor and across the tile in the rush of fluid. She screams, calls for help suddenly. You spread your wings and leap at the nurse before she can reach the elevator, enveloping her. Consume her there efficiently. Consume her and then consume the double slipped down beside her, licking until there is nothing left but wet bone.

“Please, a definition,” the administrator reads to you in a patient, fatherly voice. “A hibernation is a covert preparation for a more overt action. Besides, the drug destroys one's sense of time completely. If that happened, I might forget to dodge some bright morning and some cluck would run me down with an orange-and-yellow streetcar, or a bilious bus! Or I might forget to leave my hole when the moment for action presents itself.”

The man in the buttoned lab coat, opaque glasses, moist stubble is sitting beside the bed, in the late afternoon light from the window overlooking the empty parking lot. There is no other noise on the floor. The halls are all empty, the nurses all furloughed or sacked by this point. He is reading from a book, which you could not make out the title of. Not one of yours, you think. But lovely, almost as though it could be.

“Later I would try to find my way out, but now I could only lie on the floor, reliving the dream. All their faces were so vivid that they seemed to stand before me beneath a spotlight. They were all up there somewhere, making a mess of the world. Well, let them. I was through and, in spite of the dream, I was whole. And now I realized that I couldn't return to Mary's, or to any part of my old life. I could approach it only from the outside, and I had been as invisible to Mary as I had been to the Brotherhood.”

He looks down at you every now and then, as if to see if you were still listening, and at one point he nudges his glasses forward on his nose so you can see, finally, into the whites of his eyes. They are kind and attentive, bloodshot with exhaustion, ringed with age and worry. For you, perhaps, you think – or the idea of you, as you were now. For what you meant to this world.

“You go along for years knowing something is wrong, then suddenly you discover that you're as transparent as air. At first you tell yourself that it's all a dirty joke, or that it's due to the ‘political situation.’ But deep down you come to suspect that you're yourself to blame, and you stand naked and shivering before the millions of eyes who look through you unseeingly. That is the real soul-sickness, the spear in the side, the drag by the neck through the mob-angry town, the Grand Inquisition.”

You want to speak to him but find that you cannot speak. You want to ask him how you came to be here, and how it was that he had known. How he saw your need even before you did, and brought you where you needed to be. How he had made you worthy, when you had thought that you were nothing at all.

“Nevertheless, the very disarmament has brought me to a decision. The hibernation is over. I must shake off the old skin and come up for breath. There's a stench in the air, which, from this distance underground, might be the smell either of death or of spring -- I hope of spring. But don't let me trick you, there is a death in the smell of spring and in the smell of thee as in the smell of me.”

He purses his thin little lips, grimacing like he is in pain. Like he is struggling just to say the words.

“And it is this which frightens me: Who knows but that, on the lower frequencies, I speak for you?”

You wake up in the charred pit, the place in your dream. Lithe and potent, claws dug into the soil. Your scales glisten with the early morning sun. The scent of her body still freckles the pit, and you writhe hungrily in response. All chemical, pheromone reaction. Your body unwinds from where it stiffened for two decades, the bones clacking into their sockets. Many eyes blinking eagerly, suckling in the light. You have never been sure that you belonged in this place before, but now you are. You are exactly where you are meant to be.

Tracking her body across town, you skulk behind trees, under sewer grates, through the undercarriage of cars. Sometimes losing the scent for moments at a time, sometimes following it at an attenuated distance. Greasing your abdomen along drainage channels, through gravel and litter, hearing the pulse of the city’s underground distribution. You grow faster, more fluent, moment by moment, as the sun just creeps into its angle, gaining speed between your many coordinated legs as quickly as newborn prey. Like a giraffe, learning to run within minutes of birth. Emptied of all neural baggage unrelated to survival.

You find her in the suburbs, of course, at the rounded end of a quiet court. Young families kind of neighborhood, new cars in all the driveways, kids pulling wagons down the sidewalk. A white stone house with fiberglass columns, wide driveway leading to two-car garage. Two stories, casement windows, light pink trim. Pretty. Wind chimes that sound a seventh chord down the block, mixing with the morning routines of daddies out to cars, kids waiting for the bus. Her scent is so powerful here you can almost lick it out of the air.

Your claws splinter the window open and you hear the chairs pull back in alarm from the next room. The clatter of dishes, a man’s voice lowing, What was that.

Afraid, almost pitiable. You come upon them in the next room.

She looks up at you, lips parted, staggering with fear or awe or what could almost be hunger, recognizing you for what you are. Just starting now to descend into middle age, she is somehow all the more perfectly realized for you – what she has always been, drawn into sharper relief by these subtle changes: the furrows around the hanging mouth, the hair pulled back so hard as to reveal the ridges in her skull, the eyes just beginning to dim, mute themselves, out of possibilities, the edge of some frontier. That fraction distorted, you can see more clearly what you loved in her first. The version of the girl who was soft, impressionable. An infinite territory begging your colony. Who was spacious and empty and she opened herself to you freely, so that you might find yourself rich in her uncontested center. Under the moonlight, staring up at you, her amber eyes, purple lips, fruited breast.

And him, beside her: a dark, thick-lipped man. Impostering, searching for his pistol.

You destroy them both with a kind of beautiful efficiency that conveys how fully right you are in this body. How unrepentant, perfect, well-become.

There is a noise, then. Rattling of pans and infant gasp. You scuttle. A child in the kitchen, huddled under the sink. You press into her view. About two years old, back pressed into the cabinets, eyes wide, unable to move, knees drawn up into her little red dress. Miscegenation.

Her lips apart, wet. Creaseless face, dark eyebrows. His lips, hers. You consider her. She does not cry at you, just stares with wonder. No story yet. Nothing to tell you. She does not even know to resist.

You are still for a very long time, regarding that child.

At the end of your six-week contract, a legion of handlers in body armor and latex gloves and lawyers with clipboards and executives peeking curiously from behind their wall of bodyguards and bouncers crowding out media descend upon the ward, and the blinds are all closed, and your bed is hoisted upright, and they begin loosening the straps for transfer, and you are read a series of legal disclaimers and terms of release and they sign for you in several places by virtue of incapacity, and you let them.

In truth, you could overpower them all, and they know it. But you are a benevolent creature, and you understand what they are here to do without necessarily recognizing the words. You allow them to make their overtures to process, escorting you down to street level on a comically-undersized gurney and then loading you into the back of an armored vehicle, where you are surrounded by six men with automatic rifles and combat helmets as the truck rumbles down the expressway at lunch hour, until you hear a shout and feel the front tires jump the curb as the vehicle screeches to a stop, and the doors pop open, and your guards cut the straps and dash out of the way, clearing a perimeter. Letting you free upon the curious traffic at the center of the business district.

You lumber slowly into view, stepping down onto the curb. Feel a wind you have not felt in weeks. A wind you have never felt before, actually, in this skin. Crackle your finger joints, loosen your jaw. Begin to rear slowly, noisily, to your full height.

Their eyes widen in stereo. The cars slow and then come to a stop. An office page drops his files in the street. Escorted children in their neon security vests fall dumb, their ice cream scoops hitting the pavement in plop plop plop sequence. The traffic signal turns, no one moves. A woman in a navy suit whispers My God, and they can all hear her softly chilled voice up and down the block in the fallen silence.

You are a tower, swelling over them, needle legs clicking in syncopated rhythm, breath rasping through the long, wet cage of your throat. Your eyes are mechanical, merciless.

You know that they are unworthy of you, and so do they. They regret themselves the moment they see you, recognizing the truth. That society is built on hierarchy, after all, and it is only that order which holds us back from violence. They have denied you for a long time, a long, painful avoidance, like Peter of his King. They have denied even knowing how to speak your name. But you are here, at long last, and you are, after the final no, that yes on which the future world depends, and so you will give them permission, where they were held unworthy, to speak their own power, and give them back themselves.

Your limbs crackle with the sound of their hearts snapping back into place, and they begin to cry, some of them, and it is only in their overwhelming awe and hope and terror that they all miss a little girl in a red dress, slipping her leash and dropping her neon vest in the gutter, scuttling out of the frame.

Stories tall, you bend your neck to let them look on your face. For miles, miles around, they fall kneeling.

Born in Buffalo, NY, J.R. Gerow has studied literature, economics, and law, spent a decade in NYC, and worked in the environmental think tank world. His short fiction has been featured in journals, including The Yale Review and Hypertext Magazine. He now lives in Montreal. You can follow him online at JRGerow.com.