The Girl with All the Gifts

Caroline Caldwell is very skilled at separating brains from skulls. She does it quickly and methodically, and she gets the brain out in one piece, with minimal tissue damage. She’s reached the point now where she could almost do it in her sleep.

In fact, it’s been three nights since she slept, and there’s an itchiness behind her eyes that isn’t eased by rubbing them. But her mind is clear, with only the very slightest sense of a hallucinatory edge to that clarity. She knows what she’s doing. She watches herself do it, approving the virtuosity of her own technique.

The first cut is to the rear of the occipital bone–easing her slimmest bone-saw into the gap that Selkirk has opened up for her, through the peeled-back layers of flesh and between the nubs and buds of exposed muscle.

She extends that first cut out to either side, taking care to maintain a straight horizontal line corresponding to the widest part of the skull. It’s important to have enough room to work in, so she doesn’t squash the brain or leave part of it behind when she takes it out. She journeys on, the bone-saw flicking lightly back and forth like the bow of a violin, through the parietal and temporal bones, keeping the same straight line, until she comes at last to the superciliary ridges.

At that point, the straight line ceases to matter. Instead, X marks the spot; Dr Caldwell draws the saw down from top left to bottom right, then up again from bottom left to top right, making two slightly deeper incisions that cross at the midpoint between the subject’s eyes.

Which flicker in rapid saccades, focus and defocus in restless busy-work.

The subject is dead, but the pathogen that controls his nervous system isn’t even slightly deterred by the loss of a steering consciousness. It still knows what it wants, and it’s still the captain of this sinking ship.

Dr Caldwell deepens the intersecting cuts at the front of the skull, because the subject’s sinuses in effect create a double thickness of bone there.

Then she puts down the bone-saw and picks up a screwdriver–part of a set that her father received as a free gift from the Reader’s Digest publishing company when he subscribed to some of their products more than thirty years previously.

The next part is delicate, and difficult. She probes the cuts with the tip of the screwdriver, levering them further open where she can, but making sure that she never inserts the screwdriver’s business end deep enough to damage the brain beneath.

The subject sighs, although he has no need for oxygen any more. “Soon be done,” Dr Caldwell says, and feels foolish a half-second later. This is not a conversation, or a shared experience of any kind.

She sees Selkirk watching her, with a slightly guarded expression. Piqued, she snaps her fingers and points, making Selkirk pick up the bone-saw and hand it back to her.

Now she’s engaged in a ballet of infinitesimal increments–testing the skull with the tip of the screwdriver to see where it moves, going in with the saw again where there’s resistance, and gradually levering the whole top of the skull loose in one piece.

Which is the hardest part, now done.

Lifting the front of the calvarium, Caldwell snips loose cranial nerves and blood vessels with a number ten pencil-grip scalpel, lifting the brain gently from the front as it comes free. Once the spinal cord is exposed, she cuts that too.

But she doesn’t try to lift the brain all the way out. Now that it’s free, she hands the scalpel back to Selkirk and accepts a pair of snub-nosed pliers, with which she removes, very carefully, the few jagged edges of bone that stand proud from the rim of the hole she’s made in the skull. It’s all too easy to gouge troughs in the brain as you lift it through that makeshift trapdoor, and then it’s of such limited use you might as well throw it away.

Now she lifts it; with both hands, from underneath, teasing it up with the tips of her fingers through the opening in the skull without ever letting it touch the edge.

And sets it down, with great care, on the cutting board.

Subject number twenty-two, whose name was Liam if you accept the idea of giving these things a name, continues to stare at her, his eyes tracking her movements. It doesn’t mean he’s alive. Dr Caldwell takes the view that the moment of death is the moment when the pathogen crosses the blood–brain barrier. What’s left, though its heart may beat (some ten or twelve times per minute), and though it speaks and can even be christened with a boy’s name or a girl’s name, is not the host. It’s the parasite.

And the parasite, whose needs and tropisms are very different from human needs and human instincts, is a diligent steward. It continues to run a wide range of bodily systems and networks without reference to the brain, which is just as well seeing as the brain is about to be cut into thin slices and set between glass plates.

“Shall I take the rest of the spinal cord out?” Selkirk asks. She has that tentative, pleading tone in her voice that Caldwell despises. She’s like a beggar on a street corner, asking not for money or food but for mercy. Don’t make me do anything nasty or difficult.

Dr Caldwell, who is prepping the razor, doesn’t even look around. “Sure,” she says. “Go ahead.”

She’s brusque in her manner, even surly, because this part of the procedure, more than any other, hurts her professional pride. If anything were ever to make her shake her fist at the untenanted heavens, it would be this. She’s read about how brains were sliced and mounted in the good old days, before the Breakdown. There was a device called an ATLUM–an automated lathe ultramicrotome–which with its diamond blade could be calibrated to slice brains into perfect cross-sections of single-neuron thickness. Thirty thousand slices per millimetre, give or take.

The best that Dr Caldwell’s guillotine can manage, without smearing and crushing the fragile structures she wants to look at, is about ten slices per millimetre.

Mention Robert Edwards to Dr Caldwell. Mention Elizabeth Blackburn, Günter Blobel or Carol Greider, or any cellular biologist who ever got the Nobel prize, and see what she says.

More often than not she’ll say: I bet he (or she) had an automated lathe ultramicrotome. And a TEAM 0.5 transmission electron microscope, and a live-cell imaging system, and an army of grad students, interns and lab assistants to handle the dull routine of processing so the Nobel laureate would be free to waltz in the moonlight with his frigging muse.

Dr Caldwell is trying to save the world, and she feels like she’s wearing oven mitts instead of surgical gloves. She had her chance once to do it in style. But nothing came of it, and here she is. Alone, but complete unto herself. Still fighting.

Selkirk gives a bleat of dismay, jolting Caldwell out of her profitless reverie. “Spinal cord is severed, Doctor. Level with the twelfth vertebra.”

“Toss it,” Dr Caldwell mutters. She doesn’t even try to hide her contempt.

© 2013 by M.R. Carey