The neurologist-in-chief, Dr. Shea, has taken over my case, presumably because he wants to take the credit. I scarcely know him, but he acts as if I’ve been his patient for years.
He’s asked me into his office to have a talk. He interlaces his fingers and rests his elbows on his desk. ‘How do you feel about the increase in your intelligence?’ he asks.
What an inane question. ‘I’m very pleased about it.’
‘Good,’ says Dr. Shea. ‘So far, we’ve found no adverse effects of the hormone K therapy. You don’t require any further treatment for the brain damage from your accident.’ I nod. ‘However, we’re conducting a study to learn more about the hormone’s effect on intelligence. If you’re willing, we’d like to give you a further injection of the hormone, and then monitor the results.’
Suddenly he’s got my attention; finally, something worth listening to. ‘I’d be willing to do that.’
‘You understand that this is purely for investigational purposes, not therapeutic. You may benefit from it with further gains in your intelligence, but this is not medically necessary for your health.’
‘I understand. I suppose I have to sign a consent form.’
‘Yes. We can also offer you some compensation for participating in this study.’ He names a figure, but I’m barely listening.
‘That’ll be fine.’ I’m imagining where this might lead, what it might mean for me, and a thrill runs through me.
‘We’d also like you to sign a confidentiality agreement. Clearly this drug is enormously exciting, but we don’t want any announcements to be made prematurely.’
‘Certainly, Dr. Shea. Has anyone been given additional injections before?’
‘Of course; you’re not going to be a guinea pig. I can assure you, there haven’t been any harmful side effects.’
‘What sort of effects did they experience?’
‘It’s better if we don’t plant suggestions in your mind: you might imagine you were experiencing the symptoms I mention.’
Shea’s very comfortable with the doctor-knows-best routine. I keep pushing. ‘Can you at least tell me how much their intelligence increased?’
‘Every individual is different. You shouldn’t base your expectations on what’s happened to others.’
I conceal my frustration. ‘Very well, Doctor.’
If Shea doesn’t want to tell me about hormone K, I can find out about it on my own. From my terminal at home I log on to the datanet. I access the FDA’s public database, and start perusing their current INDs, the Investigational New Drug applications that must be approved before human trials can begin.
The application for hormone K was submitted by Sorensen Pharmaceutical, a company researching synthetic hormones that encourage neuron regeneration in the central nervous system. I skim the results of the drug tests on oxygen-deprived dogs, and then baboons: all the animals recovered completely. Toxicity was low, and long-term observation didn’t reveal any adverse effects.
The results of cortical samples are provocative. The brain-damaged animals grew replacement neurons with many more dendrites, but the healthy recipients of the drug remained unchanged. The conclusion of the researchers: hormone K replaces only damaged neurons, not healthy ones. In the brain-damaged animals, the new dendrites seemed harmless: PET scans didn’t reveal any change in brain metabolism, and the animals’ performance on intelligence tests didn’t change.
In their application for human clinical trials, the Sorensen researchers outlined protocols for testing the drug first on healthy subjects, and then on several types of patients: stroke victims, sufferers of Alzheimer’s, and persons – like me – in a persistent vegetative state. I can’t access the progress reports for those trials: even with patient anonymity, only participating doctors have clearance to examine those records.
The animal studies don’t shed any light on the increased intelligence in humans. It’s reasonable to assume that the effect on intelligence is proportional to the number of neurons replaced by the hormone, which in turn depends on the amount of initial damage. That means that the deep-coma patients would undergo the greatest improvements. Of course, I’d need to see the progress of the other patients to confirm this theory; that’ll have to wait.
The next question: Is there a plateau, or will additional dosages of the hormone cause further increases? I’ll know the answer to that sooner than the doctors.
I’m not nervous; in fact, I feel quite relaxed. I’m just lying on my stomach, breathing very slowly. My back is numb; they gave me a local anesthetic, and then injected the hormone K intraspinally. An intravenous wouldn’t work, since the hormone can’t get past the blood-brain barrier. This is the first such injection I can recall having, though I’m told that I’ve received two before: the first while still in the coma, the second when I had regained consciousness but no cognitive ability.
More nightmares. They’re not all actually violent, but they’re the most bizarre, mind-blowing dreams I’ve ever had, often with nothing in them that I recognize. I often wake up screaming, flailing around in bed. But this time, I know they’ll pass.
There are several psychologists at the hospital studying me now. It’s interesting to see how they analyze my intelligence. One doctor perceives my skills in terms of components, such as acquisition, retention, performance, and transfer. Another looks at me from the angles of mathematical and logical reasoning, linguistic communication, and spatial visualization.
I’m reminded of my college days when I watch these specialists, each with a pet theory, each contorting the evidence to fit. I’m even less convinced by them now than I was back then; they still have nothing to teach me. None of their categorizations are fruitful in analyzing my performance, since – there’s no point in denying it – I’m equally good at everything.
I could be studying a new class of equation, or the grammar of a foreign language, or the operation of an engine; in each case, everything fits together, all the elements cooperate beautifully. In each case, I don’t have to consciously memorize rules, and then apply them mechanically. I just perceive how the system behaves as a whole, as an entity. Of course, I’m aware of all the details and individual steps, but they require so little concentration that they almost feel intuitive.
Penetrating computer security is really quite dull; I can see how it might attract those who can’t resist a challenge to their cleverness, but it’s not intellectually aesthetic at all. It’s no different than tugging on the doors of a locked house until you find an improperly installed lock. A useful activity, but hardly interesting.
Getting into the FDA’s private database was easy. I played with one of the hospital wall terminals, running the visitor information program, which displays maps and a staff directory. I broke out of the program to the system level, and wrote a decoy program to mimic the opening screen for logging on. Then I simply left the terminal alone; eventually one of my doctors came by to check one of her files. The decoy rejected her password, and then restored the true opening screen. The doctor tried logging on again, and was successful this time, but her password was left with my decoy.
Using the doctor’s account, I had clearance to view the FDA patient-record database. In the Phase I trials, on healthy volunteers, the hormone had no effect. The ongoing Phase II clinical trials are a different matter. Here are weekly reports on eighty-two patients, each identified by a number, all treated with hormone K, most of them victims of a stroke or Alzheimer’s, some of them coma cases. The latest reports confirm my prediction: those with greater brain damage display greater increases in intelligence. PET scans reveal heightened brain metabolism.