McFarlane didn’t respond right away. He sat back in the chair, crossed his legs, and closed his eyes. For a long moment he made no movement. And then he said, without opening his eyes: “Think of the existential horror of it. A brain with no body, no life, no interactions, no sensory input. Just endless existence. No wonder it wants to die. And no wonder, as Prothero reported, the communication ended so abruptly, both times: the Baobab silenced the alien brain, kept it from continuing the conversation.”
Gideon let that thought sink in. If McFarlane was right, that meant Alex, effectively, was still alive: her memories, her personality, everything she was. But trapped, disembodied, in the creature, to be used as a vehicle for its procreation. The horror of it was almost beyond imagining.
He opened his eyes.
“Are you all right?” McFarlane asked.
“No. Because you know the biggest irony of all? That thing had harvested four brains from the Rolvaag, probably when it first sank—yet it remained quiescent. Now it has two more—and it’s suddenly growing active. I think by coming down here, we provided it with just enough additional brains for it to move to the next stage of development. Instead of killing it, we’ve helped it to propagate.”
“Maybe so.” McFarlane waved his hand. “But you know what? I think you’ve just figured out how to kill it. By destroying all seven of those brains.”
49
PATRICK BRAMBELL HAD done six months of a general surgery residency, which was how he discovered that he was not cut out to be a surgeon. He was not a team player, which made for bad OR etiquette, and he did not enjoy working with his hands like a mechanic.
And now here he was, performing emergency brain surgery.
The patient, the exobiology lab assistant named Reece, lay anesthetized on the operating table, under bright lights. His head had been shaved and the surgery area cleaned and scrubbed with betadine. Reece’s cranium had been placed in a three-pin Mayfield skull clamp, which held it rigidly in place. A testament to EES thoroughness that such a device happened to be in the surgical cabinets on board.
He had already gone through a stressful procedure—guided in real time by a neurosurgeon in Australia, via Skype—in which he had fixed a lumbar drain in the patient’s lower back to remove some cerebrospinal fluid; this, the Australian neurosurgeon explained, was to “loosen” the brain and make it easier to operate on.
Standing at his side and assisting was Dr. Sax. This was little comfort; Sax was, indeed, an MD, but she had gone on to get a PhD and had never practiced medicine, let alone surgery. She was, if anything, more nervous than he was. As for his own assistant, Rogelio, after Glinn’s crew-wide announcement about the parasitic worms, the man had locked himself in his stateroom, refusing to come out under any circumstances.
On a large monitor in front of him was Dr. Susanna Rios of Sydney, standing over a detailed plastic model of the head and shoulders of a human patient, lying facedown. Next to it was a real human cranium. These were the props she was going to use to guide him through the surgery.
This felt not unlike the nightmare that Brambell sometimes had: of finding himself in the cockpit of a plane, flying it after the pilot had suffered a heart attack, listening to the instructions of an air traffic controller on how to bring the plane in for a safe landing. The dream never ended well.
“The craniotomy will proceed like this,” Rios was saying. “We’re going to remove most of the suboccipital bone in what we call a skull-base surgical procedure. We’re taking out an unusually large bone flap because, while we know the parasite is in the vicinity, we don’t know exactly where it is. You’re sure it’s in between the dura mater and the brain itself?”
“Yes.”
“And the parasite itself is of a rare variety, about which little is known?”
“Quite rare.”
“Very well. I’m going to draw a line on this model, where you’ll make the initial incision.” She drew a line with a Magic Marker, just behind the hairline. “Now you copy it on the patient.”
“Yes, Doctor.” He drew the same line on his patient with a sterile pen.
“Dr. Brambell, your hand appears unsteady.”
Brambell held it up. It was indeed trembling.
“Please close your eyes, take a deep breath, focus, and get that tremor under control.” Rios spoke sternly yet calmly.
Brambell did as she instructed. The trembling steadied.
“Good. Make the incision, like this.” She demonstrated with the scalpel on the plastic model.
He followed suit, the scalpel running lightly along the bone. Guided by the Australian surgeon, Sax followed the incision with an electrical cauterizing tweezers, zapping any bleeders. In between she used a sponge to keep the area wiped clear of blood.
“Now the skin and muscles are to be lifted off the bone and folded back, like this. Clip the edges of the incision with clamps and let the weight of the clamps hang down to keep the incision open.”
She demonstrated with the plastic pieces of the model. Brambell followed suit.
“Very good. Now you’re going to make four small burr holes in the skull with the perforator drill. Like this.”
She drew four black dots on the real skull model and demonstrated. Brambell watched as, ever so gently and deftly, she cut a small hole in the cranium with the drill.
“Go slow. The perforator must be held perpendicular to the bone. Do not stop or pull back until the drill stops itself—which it will automatically just before it penetrates all the way through the bone. Ready?”
Brambell nodded. Sweat was running into his eyes, threatening to blind him. “Dr. Sax, please mop my brow,” he murmured.
He drew four black dots on the cranium, as indicated. He started the air-powered drill, which came up to speed with a soft whine. Then, taking another deep breath, he hovered over the bone with it.
“Do not use downward pressure,” Rios said.
He lowered the drill until it bit into the skull with a high-pitched rasp. He immediately smelled the bone and blood atomized by the device even through his surgical mask.
“Slow…easy…that’s it.”
The drill stopped.
“Pull out and do the next hole. Your assistant needs to be ready with a little bit of saline in there to cool it.”
Brambell eased off and raised the drill, following her directions. In a few minutes he was done with the four holes.
“The perforator,” Rios said, “leaves a very thin layer of bone at the bottom of each burr hole. It has to be taken out, like this.” She demonstrated with a funny-looking tool. Brambell did not have the tool.
“Use a small forceps instead,” Rios said.
He used the small forceps to remove the wafer-thin pieces of bone. He could now see the whitish-bluish-gray membrane, the dura, peeping through the holes.
“Good. Now you’re going to cut from hole to hole using the craniotome. You will cut along the lines, while your assistant uses the suction tube to draw up the saline solution and also gently push down the dura, keeping it away from the saw tip. She should be dribbling the saline into the cutting edge to keep it lubricated and cool.”
Once again she demonstrated. “Ready? Both of you?”
Brambell nodded.
“Turn on the craniotome. Go slow. And steady: there’s no hurrying anything in brain surgery.”
He turned on the saw and it whispered up at a high pitch, like a mosquito. He began to cut along the line. Again that smell came.
As he eased it along the line, Dr. Rios talked him through the procedure, gently correcting him as he went. It took a long time, but was finally done. He expelled air. Sax mopped his brow again.