To Run Again
“Thank you so much for your time; we’ll let you know if you’re chosen by the end of the week.”
The hunched man in the wheelchair was escorted out on squeaking wheels. As the chair’s rattle receded down the hall, Dr. Laura Brandie was left with a few moments to collect her thoughts. She tapped her pencil against her clipboard as she reviewed her notes: age was around what she’d wanted, but the two decades of smoking left the general constitution weaker than was ideal. The patient presented with clear-cut, complete diplegia brought on by spinal injury, and as Laura leafed through the medical reports of that accident, she reasoned that the cut was likely clean enough for treatment to have a chance at meaningful impact.
All in all, a promising-enough candidate; his paperwork was placed in the finalists’ pile, joining three others from earlier that morning.
“Next volunteer can enter,” Laura called, rifling through her notepad for a blank page. From the door behind her, she heard a scuffling, a shuffle, a drag… and again: scuffle, shuffle, drag. It was a sound that brought with it a wave of goosebumps, a wave of memories. That was a sound that brought to mind the way Mom used to stumble around the creaky wooden floorboards of the Pennsylvania house—or, at least, the gait she’d borne for the few years between diagnosis and the end. Laura’s tenth birthday had also been the funeral, and all Laura could remember of the thing was hating the fact that it had rained.
Laura turned to face the shuffling footsteps, and, of course, the newcomer was not Regina Brandy; ALS had set her to peace nearly three decades prior. But the newcomer walked with that same flailing footstep that bespoke the poor coordination of significant nerve damage. The hobbling woman leaned on a cooked cane that wobbled nearly as much as its owner did; Laura immediately rose to her feet to assist.
“Please, let me,” Laura started, but the woman dismissed her with a proud wave.
“This old stick’s never failed me yet,” she said, setting herself down heavily in the chair.
“Are you comfortable?” Laura asked.
The woman nodded through huffing breaths. “Good enough to start,” she wheezed, but already her breathing became less heavy, less strained.
Laura’s eyes began her preliminary assessment: the woman’s palsy seemed to affect the legs and torso, but arms were more stable—the woman’s leaning on the cane proved as much. Laura’s eyes next found the deep, smoothed scars across the woman’s face and neck, vanishing into the neckline of her blouse. Not genetic then, Laura thought. Something brought on by acute injury, likely. Only then did her eyes settle on the crow’s feet that wrinkled the eyes, the nasolabial folds, the whisps of grey that accented her frazzled hair. Laura frowned.
“My name is Dr. Brandie; thanks for volunteering to talk with us. Please speak as clearly into the microphone as you’re able,” Laura said, reciting the first line of her script. She then reached for the stack of submitted paperwork, grabbing the stapled corners to flip packet-by-packet.
“What’s your name?” Laura asked.
“Alexandra Harmon,” the woman answered, finding her breath again.
“And how old are you, Ms. Harmon?” Laura asked, flipping for the paperwork filed under Harmon.
“Sixty-three last month.”
Laura pursed her lips. “I can see you have nerve damage, sure, but the sign-up forms should have made our desired candidate’s age range quite clear—"
“It’s not for me,” Alexandra said. “It’s for my son.”
Laura peered up from the paperwork. “Well, then, if he’s of age, we’d need him to volunteer himself, as a procedure this… invasive of course requires express consent.”
“I’m his court-appointed full guardian, as he’s deemed unable to make his own medical decisions.”
Laura’s mind rattled through possible conclusions. Incompetency, nerve damage… stroke? TBI? “As you may know, our procedure is no ‘miracle cure.’ The KSE serves as a new neuromuscular system, in a way, but we still need a functional, competent brain to direct it. What’s the nature of your son’s condition?”
Alexandra Harmon leaned forward on her cane, a grave expression on her face. “The first doctors called it a pseudocoma,” she said. Laura, too, suddenly leaned in, and a satisfied smile twitched the corner of Alexandra’s scarred lips as she noted the change in demeanor. “Ah, so you’ve heard of it, Dr. Brandie?”
“You don’t mean to imply…” Laura began. Alexandra merely nodded.
“Locked-in syndrome.”
Laura reeled. LIS had, what, a handful of cases per year? “Patient’s age?” she asked dazedly.
“Twenty-nine.” The perfect age range—brain no longer developing, but still young enough to adapt.
“Etiology of his condition? Uh, I mean, how he got it?”
“Car wreck,” Alexandra said. “Same as, well…” She gestured to herself, her cane, her scars on her neck. “’Bridge ices before road,’ as the signs always say.”
Laura set down her pencil and clipboard—she hadn’t needed it since the moment Ms. Harmon said locked-in. She steepled her fingers and considered the woman anew.
“Is it true, what the paperwork said?” Emotion cracked Alexandra’s voice, her face twisting with pain. Laura wondered if that pain was physical or remembered. “You’d be able to help my Brett walk again?”
Laura reached across the table and clasped Alexandra’s clammy hands, as knobby and cold as the head of her wooden cane.
“Far more than that, Ms. Harmon… we’ll help him run again.”
* * *
Dr. Brandie imagined the vibrance of a springtime meadow, wind whipping through her hair and bringing the unmistakable scents of life. It was a pleasant image to hold while walking through a place that was every part its opposite. At the Carlile Medical Complex, the air was unmoving and dull, stale and heavy—as though weighed down by envy for the vitality it should have carried.
In the long-term-care wing of the facility, Dr. Brandie was escorted to a private room on the sixth floor. As she entered, the first thing she noticed was the floor-to-ceiling windows, and she was heartened to see them. Such good for the spirits, natural light can be. Her eyes next traced downward—one could tell a lot about a medical facility by the condition of its floors. These were clean, polished white, and the rounded corners were neatly swept of dust and debris—impeccable, nearly, though Laura noted a strange olive-colored scuffing on the floor next to a sagging bedside chair. Multi-layered, vaguely circular pattern… could it be—
“His view’s impressive, isn’t it?” Alexandra’s scratching voice sounded from the doorway, and Laura heard the woman’s shuffling gait as she, too, made her way into the room. She clutched a bag of crackers from the hall’s vending machines under her arm. “View’s better than mine at least,” she huffed as she stumbled her way through the room, and then, with a sigh of gratitude, she set herself down into the sagging chair. As she sat, she clutched her cane, and Laura noted that its base sat at the center of the smattering of scuffmarks; its olive-colored rubber tip was the final puzzle piece.
“You’re here often, aren’t you?” Dr. Brandie asked.
“Every damn hour I can be,” she said, and the warmth in her voice made Laura hear mother more than matron.
It was enough to pull Laura’s gaze at last to the form wrapped in the bed’s white blankets. His eyes were closed, but as Laura well knew, that didn’t necessarily mean that he was asleep. Locked-in syndrome went leagues beyond merely quadriplegic. In Brett Harmon’s case, his paralysis was essentially complete: he could open and close his eyes, he could look up and down, and he could voluntarily move not a single muscle more. And perhaps most troubling of all, his mind was otherwise intact: he was a statue that could live, could breathe, could think, but he could never speak, could never smile, could never even so much as turn his head. At war within Laura were two contradictory feelings. Here was a life-sentenced prisoner in a cell made of flesh… it was enough to bring an empathetic shudder and a ripple of goosebumps. And yet, at the same time, here was a man who stood to gain more from the KSE than perhaps anyone else; Laura’s stomach burned with anticipation as she imagined making such a profound difference in Brett’s quality of life.
“Is he awake?” Laura asked.
Alexandra nodded. “You can tell by the breathing—it’s slower when he’s resting.”
Laura nodded and leaned in toward Brett, taking his hand in hers. His eyes fluttered open, but they didn’t search for Laura’s; they held flatly on the window across the room.
“Hey there Brett, my name is Dr. Laura Brandie. Did your mother tell you anything about me?”
Laura waited expectantly for the man’s eyes to move, for some acknowledgement of the question or new presence in the room, but his gaze never shifted… his eyes stayed locked on the window, perhaps staring towards the distant forest at the edge of the city.
“He stopped answering questions a few months ago, which is why the state appointed me his decisionmaker. Brain scans confirmed he’s still here—just quiet these days.”
Dr. Brandie nodded gravely. People normally wore their emotions on their faces—the raised eyebrows of elation, the sagging eyes of depression. But in a patient with full facial paralysis, that expressiveness was gone. Brett’s face was a placid neutral, if tired. There was no heavy set to the shoulders, no deep wrinkles of a frown, not even so much as a glimmer in the watery eyes to betray the despondency or despair he must feel.
“We’re gonna get you better again,” Dr. Brandie promised, releasing the man’s hand as she stood. And then, as though on cue, the quiet stillness of the wing was replaced with a rising commotion of murmured conversation and screeching wheels, and then the two women turned toward the echoing footsteps of Dr. Brandie’s approaching entourage.
Eight they were, men and women both, wearing white coats and wheeling delicate machinery on carts. The terminals and casings, all of a sleek, white metal, were unloaded; keyboards, instrument panels, and electrodes were unfolded on hinges from the undersides of desks; the overhead lights flickered as a thick-grade extension cable was plugged in, and then snaking wires were passed and connected as machinery whirred to life.
“Y’all brought the whole damn laboratory,” remarked Alexandra Harmon, scooting her chair into the corner by the bedside to make more space.
“Brett seemed in little condition to visit us,” Dr. Brandie said.
“So… now? You’re doing it now?” She balked.
Dr. Brandie pursed her lips. No matter how in-detail the consent forms went, no matter how significant the stakes, patients (and their caretakers) would often scratch their signatures on the line without so much as reading 10 words. It was the legal equivalent of crossing the street without looking both ways, but in the world of medical science, that street was more like a highway. There was science to be done, real, life-changing science, and Alexandra Harmon apparently could hardly be bothered to read the entire volunteer agreement. Dr. Brandie tried to not let her frustration color her reply.
“As the paperwork outlined, we start with this, well, calibration visit.” She gestured with her neck toward a technician holding what might have seemed a price scanner at a grocery store. “We start with taking full-body measurements—not merely height and weight, but specific dimensions for things like the arms, legs, torso, and more. Ensuring the proper amount of KSE to install is something of an exact science.”
A bottle of viscous gel squirted into a gloved hand, and then the clear gel was rubbed unceremoniously into Brett’s thinning hair. “We scan brain activity, of course, to better understand the health of the control centers atop the nervous system.” A series of electrodes were adhered to Brett’s scalp, and then a cap with dozens more was placed atop it. Meanwhile, technicians touched pointed probes with needle-like tips to Brett’s arms, staring at readings at their base. “We test nerve conductivity—really a measure of body hydration more than anything else. Don’t worry, it’s painless to the paralyzed. We use them to look for any unexpected breaks in nerve conduction—full-body paralysis happens in the brainstem, which would make it hard to see if there were a nerve severed in an arm or leg.”
The technician with the needle-point probe raised a thumbs up, and Dr. Brandie smiled. “All clear, at that. Our technician there is performing something akin to an allergist’s scratch test—the KSE is a foreign substance entering the body, so we’d like to make sure Brett doesn’t react poorly.”
“What is it, exactly?”
“Think of it like a thousand tiny machines that work together to move Brett’s muscles—a single network, directed by his brain. Speaking of,” Dr. Brandie said, gesturing towards a silvery metal case. A technician popped it open with reverence, raising the lid slowly.
Alexandra rose to better see the case’s contents. Inside, on a bed of sleek, velvety black packing foam, sat a strange square of burnished rose-gold-colored metal that glistened as though rubbed with oil. Etchings and gridlines of laser-cut circuitry formed arcane patterns across its face, and a tangle of fine fibers like mechanical dreads extended out the object’s base. The technician at the case lifted the device with exaggeratedly slow movements—as though the thing might explode if mishandled. All of the bustling pin-pricks and measurements and electrodes seemed to pause as everyone in their room—save for Brett—craned their necks to look at the small square. It was no larger than a slice of cheese, but Alexandra suspected it would cost more than a whole hamburger franchise.
“What is that?” she asked, whispering now, as though the sound of her voice might crack its polished face.
“That, there, is the Nexus… the swarm controller, the system’s own brain. The braid of fibers at the base, that will be grafted to Brett’s nerve system—directly to his brain. The pinkish square—we call it the ‘black box’—that will read Brett’s nerve signals and translate it, so-to-speak, into a language that the KSE can understand. Do you know much about neural networks—the machine learning types, not the biologic type?”
Alexandra mutely shook her head.
“Me neither, to be honest, before I started this project… seemed like esoterica for the computer scientists. But the human brain is a complicated thing: we’ve got something like 85 billion neurons, each of us. That’s billion with a B. If you wanted to lift your arm, the right neurons in the right places fire off, sending signals to the muscles—in Brett’s case, that signal never goes anywhere, given that things are cut where the brain plugs into the nervous system. But imagine that we had real-time, perfect knowledge of which neurons are firing. Suppose I gave you a list of which neurons specifically are firing, in which clusters, at what intensities, and at what time… how do we tell which limb Brett is trying to lift?”
Alexandra shrugged her shoulders. “Enlighten me, doc.”
“Hell if I know myself,” Dr. Brandie said. “But that type of question—turning a massively large and complex input to a single, actionable output—that is exactly the type of thing neural networks are good at.”
“So, what, is that thing artificial intelligence?”
Dr. Brandie shook her head. “Not quite—it’s not awake, not thinking in the traditional sense. Maybe it’s more like a subconscious mind at best. It can decide things, sure, but a calculator can ‘decide’ whether to show a number as a fraction or a decimal based on the operations used. It’s clever, and it’s complex, but it’s nothing more than a wild tangle of interlocking rules, hard coded into sophisticated chipware.”
“A calculator,” Alexandra repeated. She watched, breath held, as a group of technicians crowded around Brett, fussing over machine readings. One whispered to Brett’s ear and then nodded to a counterpart with a syringe. Brett’s IV bag was injected with something clear, and, in moments, Brett’s watery eyes flicked shut.
“A sedative?”
Dr. Brandie nodded. “What comes next shouldn’t hurt him—his nerves transmit no pain—but we need a sample of cerebrospinal fluid. You switch off the engine before you go rummaging in the gas tank.”
Alexandra watched as Brett was gently rolled to his stomach, his gown pulled open, and then a nurse produced a new syringe; this one was larger, with a needle that nearly resembled a drinking straw. Alexandra stammered. “That looks much too—”
“No sense in watching, Mrs. Harmon, and remember that he feels no pain. Do you trust me?”
Alexandra nodded, and Dr. Brandie smiled with a practiced warmth.
“Then look up at the ceiling with me, count of four, and it’ll be done. Just like that, Mrs. Harmon. One, two, three… four. All good now.”
The two women turned back to the bed in time to see one of the nurses taping a gauze pad over a blooming dot of red. The large syringe, formerly empty, was now filled with a clear liquid that might have been water, but Alexandra knew it was anything but. The syringe was taken to the rose-gold-colored square and injected into a small reservoir at the device’s center. The liquid flowed through channels carved into the device, and if the square had appeared slick with oil before, now it looked as though it were properly lathered in petroleum jelly.
“The brain and spinal networks have their own immune system—and microglia are notoriously sensitive to invaders, be they stray bacteria or sophisticated KSE machinery. Normally, we’d use immunosuppressant medication, but the blood-brain-barrier poses, well, a difficult barrier. To combat that, we’ve just draped the Nexus in a thick layer of biologic camouflage. When his cells scan the Nexus, they’ll see his body’s own signature, and things should be left alone.” The Nexus was gingerly placed in a plastic sac filled with a thick clear liquid. “To preserve things until surgery,” Dr. Brandie noted.
“When is that supposed to be?” Alexandra asked.
“We’ll be getting the samples collected just now to our printers tonight—we need to print KSE substrate with the correct biomarkers. Based on averaged printing rates, we should have enough for the first round of injections in fifteen working days. To give time for Brett to acclimate post-surgery before that first substrate dose, how about a week from today?”
Alexandra pursed her lips, swallowed. Dr. Brandie noted that her knuckles were balled white on the head of her wobbling cane. Gone was the easy smile of an affectionate mother, replaced by the wariness of a woman who was stranded far outside of her element. “You don’t have to let me know right now—you can mull it over with Brett here.” Dr. Brandie placed a business card on the bedside table, near to a mug of coffee that sat on a stacked collage of hundreds of coffee rings—yet more proof of this mother’s tireless dedication. “Call my number directly when you’re ready to schedule.”
Alexandra nodded, grateful for the reprieve. “It’s all, you know, a lot to consider all at once. I’ll talk with him tonight and try to get him to agree,” Alexandra murmured, watching as the technicians began to collect their sophisticated equipment. With how quickly they’d come, the whirlwind of their prodding, and now how quickly it all was packed back onto their screeching carts, Alexandra felt like she’d just survived a tornado more than a medical visit.
When the swarm of footsteps retreated down the echoing halls, Alexandra’s knees began to wobble, and she fell roughly into her sagging chair. She was midway through taming her breathing when a final nurse entered the room with a knock.
“Courtesy of Doctor Brandie,” he said, gesturing to a fresh mug of coffee on a metal tray. “She said it looked like yours had gone cold.”
The nurse collected the old mug and left Alexandra with the new one. Alexandra lifted it to her mouth and took a lengthy pull of the dark liquid, a frown immediately blooming on her face. Dr. Brandie acted like a woman in control of every detail, entire teams of medical experts marching to her softly-spoken commands… but despite the unquestioned authority and meticulous oversight, despite the fact that Dr. Brandie herself must have poured in half-and-half until the coffee turned to the exact same shade of fallow brown she remembered from the mug by the business card, the woman wasn’t infallible: Alexandra preferred her coffee with no sugar, but Dr. Brandie had added two packets at least.
Alexandra winced at the saccharine taste and set down the mug. It wasn’t that Dr. Brandie had failed to read her mind and learn an unspoken preference… what rubbed Alexandra the wrong way was the casual way Dr. Brandie assumed she knew everything, the way that she hadn’t even bothered to ask.
* * *
Camera shutters crackled like volleys of gunfire, and a strobing flash left afterimages swirling in Dr. Brandie’s view. As the floating, green spot started to fade, she let her eyes wander from figure to figure in the first few rows of seats. Hands scribbled furiously at notes on small notepads, while others tapped with impressive speed on laptop keyboards. They were all hunched forward, practically squirming on their seats.
“Any moment now,” she said into the podium microphone. It whined with feedback, the mic apparently as uneasy as the attending press felt, as uneasy as she herself felt. She was grateful that the podium obscured her feet, lest the whole of the press conference see her left foot’s nervous tapping.
She glanced at her phone: still 0 new messages.
She took a sip of her water, trying not to listen to the rising murmurs from the back of the room. After an uncomfortable span of heavy silence that felt like hours but might have only been a minute, of anticipatory breathing and jittering legs, her phone at long last buzzed in her hands.
DR. JORDAN, 12:07 P.M.: success
Dr. Brandie let out a puff of air that might have been a laugh, might have been a sigh, but whichever it was, it expelled her stress and apprehensions with it.
“Ladies and gentlemen, I am pleased to announce the first successful installation of the KSE system—one small step for the paralyzed, and one giant leap for mankind.”
The room broke out into sudden chatter. Reporters stood, arms and notebooks waving in the air to catch Dr. Brandie’s attention.
“Yes, you, here in the front.”
“Damian Barrow, Seattle Daily News. How long before you know if the patient can walk again?”
“That’s the thing we love about our system, Mr. Barrow. That’s already known, already a certainty. KSE stands for Kinetic Semi-autonomous Endoskeleton. Unpacking those words, we’ve got ‘kinetic,’ which obviously describes the movement it enables. There’s ‘endoskeleton,’ the KSE supporting the patient from within. And there’s ‘semi-autonomous,’ which means that the system can run itself.
“Right now, the substrate has bound to his musculoskeletal system and is confirmed to be receiving signals from the Nexus processing unit. It’s not a matter of ‘if his body can use it’ or ‘if he can take to it.’ Think of it like… we’ve implanted a flashlight into his body, and you’ve asked me ‘when will we know if the light can turn on?’ We knew that from the moment we implanted the thing, and the answer is just as obvious—right away, needing only the signal to start.”
More hands shot up, notebooks wagging in the air. Camera strobes fired again, leaving a new wave of green afterimages drifting across Dr. Brandie’s view.
“Yes, you, woman with the auburn blouse.”
“Sharon Wallace, New Metro Times. Is it true that implanting the KSE led to the direct death of over 400 rodent recipients due to muscle hyperextension?”
Dr. Brandie let her face fall, knowing that it was the expected reaction to animal deaths. If she were being honest with herself, she was long past feeling remorse for the death of a mere lab rat, but she respected their steady contributions. When endoskeletons went awry, when the wrong muscle commands were executed, things got messy: images of the tiny creatures twisted into small tumbleweeds of fur and bone hadn’t caused her to lose any sleep, but she did feel disappointed that she hadn’t quite managed to configure the KSE right on her first animal trial, or even her fortieth. Their deaths were no tragedy, but they were consequences of Dr. Brandie’s own mistakes, and that, more than anything else, drew the frown to her face.
“No medical advancement worth its research grant is without a pet cemetery’s worth of lost test subjects. Insulin to treat modern diabetes only came about thanks to trials on dogs; polio vaccines were only developed after intentionally injecting monkeys with the disease and trying out different curatives. While it’s true that the KSE—”
“But Dr. Brandie, what are the risks of your John Doe patient succumbing to a similar fate?” the same reporter interrupted.
“Mathematically zero,” Dr. Brandie assured. “The Nexus unit was added as an essential intermediary controller to moderate and regulate muscle commands. That component itself is the heart of the ‘semi-autonomous’ component of the KSE, and it keeps all of its substrate behaving properly. Malfunctions like those early trails are provably impossible under the new system.”
The reporters could sense the end of an answer, and so their hands shot up just as Dr. Brandie’s previous sentence wound down. Dr. Brandie glanced from reporter to reporter, settling on a mustachioed old man with a worn cap. “Yes, you with the hat.”
“Paul Creighton, Tacoma Enquirer. If the KSE-what-have-you uses nanobots, like they say, has your team done enough to prevent ‘grey goo’ scenarios? I’m no science fiction author, but—”
“The KSE cannot self-replicate. Grey goo concerns are thus moot. Next question.”
“Theodora Roush, Medicinal Globe—there are those who consider research into wildly expensive treatments like the KSE to be academic frivolity. What would you say to critics who believe the KSE’s price point makes it impractical for public treatment?”
“While speaking of finances—the Medicinal Globe, your publication, receives over 90% of its operating funding from Fitzpatrick Pharmaceuticals, does it not? The very same company pouring billions of dollars into its own nerve therapies?”
“I’m not aware,” said the reporter.
“Well, I am,” Dr. Brandie admonished, with all the stern firmness of a mother correcting a wayward child. “I invite you to ask that same question of your sponsor’s Project Cordell—despite being years from a workable prototype, their per-treatment cost is already looking to be double that of the KSE, if not more.”
“Can you offer a direct response instead of a deflection?”
Dr. Brandie glared at the woman—a look that normally sent lab techs scurrying away—but the reporter stood firm. “Then to answer your question, my team and I believe that there is no price too high for good health. To take someone with effectively no quality of life and give them their freedom back? The ability to walk around, care for themselves, feed themselves, hell, even wipe themselves? That’s damn worth any price if you ask me. Let the insurance providers and hospital systems figure out the finances—my team’s work is improving lives, not wasting time with economics.”
A new volley of hands shot up with a cacophony of dozens of overlapping follow-up questions. Skeletal failures, grey goo, financial considerations… these weren’t the topics Dr. Brandie had imagined the questions might focus on. She was no publicist, but she was socially attuned enough to read a room, and she could tell the tone here was falling to skepticism, negativity. It would take a miracle to make believers of them; fortunately for Dr. Brandie, allowing the paralyzed to walk again was one such biblical miracle.
“I believe the results of the KSE will speak for themselves,” she said to the reporters, “and so I’ll answer no more questions for today. I need to go visit the patient and ensure everything is in order… our media portal will contain updates to patient John Doe’s recovery, and we will remain responsive to selected email questions. Thank you all for your time and attention.”
* * *
“KSE clinical trial, day 15 post-surgery,” Dr. Brandie spoke softly into the handheld microphone unit. Her tone was clinically neutral, the auditory equivalent of the eggshell-white walls of the laboratory she sat in. That placid neutrality was a practiced, hard-to-maintain thing; it was all she could do to sit still and quell her giddiness just looking up at the figure seated across from her. “Patient name, Brett Harmon,” she said, looking at his seated posture—upright and unsupported by external assistance devices. The overhead fluorescent lights were sleepy and buzzing, casting tired shadows over Brett’s sunken and atrophied face, but Dr. Brandie’s eyes sparkled as though she stared at gold—not a man but a Nobel Prize, unlimited grant funding, whatever ends her professional heart desired.
“Following successful surgical implanting of the KSE Nexus, Brett received his first injection of KSE substrate on day 0, a second on day 8, and his final just this morning—day 15. No adverse reactions were observed.”
Aside from the steady rising and falling of his chest, Brett sat as still as a mannequin. The effect was somewhat unnerving, so Dr. Brandie moved to start with the tests.
“On day 8, we began testing of physical capabilities for Brett’s arms and torso, finding hand and arm function to be fully restored.” Dr. Brandie’s face was colored by wistful recollection, watching again as the man passed his arm back and forth in front of his face in shock and amazement. His face was still mostly paralyzed—that degree of fine muscle control was still beyond this iteration of the KSE—but Dr. Brandie could see the way his eyes lit up with wonder at his recovered capability. She’d promised him more wonder, and today, she made good on that promise.
“With this morning’s final substrate dose administered, we begin trials now for Brett’s lower body—legs, balance, and coordination." She stood, and, to her continued delight, Brett stood as well. The two walked over to a treadmill where technicians stood at the ready with wires and electrodes, always wires and electrodes. As they were fitted to Brett’s arms, chest, and neck, Dr. Brandie walked toward the treadmill’s controls.
“We’re starting our first trial with sustained walking speed of 1 meter per second,” the technician said. “Just south of average walking speeds.”
Dr. Brandie shook her head. “Were this some patient recovering with traditional muscle therapy, that might make sense… giving the withered muscles time to find their proper paths of motion. But remember that the KSE is doing the lifting now, and it doesn’t need to be babied… you don’t have to drive your new car at a turtle’s pace until the engine gets used to driving. No, I think we’ll start with a run. Configure for 3.5 meters per second.” The technician swallowed, but she complied, both knowing that arguing the point would get her nowhere.
Dr. Brandie next reached for a thick print of foamboard propped up on a nearby lab counter. Its surface was covered in ovals, and each oval featured a word or phrase written inside. The largest two ovals were at the bottom left and right corners, containing the words Yes and No respectively. Words were clustered based on semantic meaning: near to the Yes oval was one that said Please, and to that oval’s right was one that said Thank you. As was the case with facial expressions, the fine motor control of speaking was beyond the KSE, but Brett could communicate by way of pointing at this board… there would be time to learn sign language later.
Dr. Brandie watched with satisfaction as the final electrodes were fitted to Brett’s chest and his gown was drawn back closed.
“Are you ready, Brett?” she asked. She held up the communication board, and Brett tapped the oval for Yes.
Technicians stood to either side, clipboards in hand. Brett climbed atop the machine and gripped the handrails—his hold was relaxed, easy. No muscles quavered, there was no clumsiness of newfound mobility Dr. Brandie had seen in so many physical recovery trials… Brett looked like any other runner climbing onto a treadmill, ready to begin today’s workout.
“Begin trial,” Dr. Brandie commanded, and the treadmill was toggled on. Its track rolled slowly at first, and Brett shuffled forward to keep up with its leisurely pace. In seconds, that steady slow roll became a trot, and Brett’s posture changed to adapt. His arms drew in, and his steps jostled him easily up and down as he kept up. By the rising whir of the electric motor, Dr. Brandie could tell that the belt was still accelerating—perhaps accelerating too much. A voice in the back of her mind told her to stop it there, to consider this trial a success at even this speed, but a louder voice wondered just how far the KSE could go.
“Doctor, should we, well…” started the technician nearest, but she let her question trail off. She, like Dr. Brandie, was totally captivated by the smooth, easy run of the man on the treadmill—a man who hadn’t even been able to turn his head mere weeks ago.
“Heart rate data?” asked Dr. Brandie.
“Elevated, but stable, and not all that far from baseline for a non-athlete running.”
“Substrate muscle readings?”
“Contractions are stable, sustained.”
Dr. Brandie let out a laugh of delight. “Push the treadmill up by 1… 4.5 meters per second.”
The engine whirred high-pitched chords, and Brett’s stable thumping steps matched the new tempo. Dr. Brandie’s eyebrows raised… she herself would certainly struggle to keep up now.
“Substrate exertion readings?”
“40% channel capacity,” answered a man at a computer terminal.
“Far better than I’d have imagined—push to 6.5 meters per second.”
The machine’s base rattled as it whipped its belt by at dizzying speed. This was no longer a mere run… this was a sprint. Dr. Brandie watched in amazement as Brett released the handles, his arms tucking in and pumping with each footfall. A sheen of sweet blossomed across his body. His footfalls thundered in the quiet laboratory. He was racing for Olympic—no, medical—gold, and it seemed he had so much more—
“Ma’am, isn’t that enough to prove his mobility?” asked the woman again, interrupting Dr. Brandie’s wandering thoughts.
“If he wanted to stop, he’d—” Dr. Brandie’s eyes widened. He’d tell us, she had been about to say, but non-vocal Brett could hardly point to a communication board while sprinting.
“Right, yes. Of course. Stop the test.”
The humming of the engine cycled down. Brett gripped to the handles as the frantic sprinting pace downgraded to spirited running to brisk jogging to steady walking and then, at long last, stillness. His breathing was shallow, and his heartrate readings were nearing the red zone.
“Push to media outlets that patient John Doe’s peak running speed was 15 miles per hour,” Dr. Brandie said to her communications manager. Only then did she think to grab the foamboard and approach her star runner.
“I can see your eyes are wide… you’re as impressed as we are, aren’t you?” She proffered the board, and Brett tapped the Yes oval. His finger left a small damp trail as it slid towards the Thank You oval.
“Are you alright?”
Yes, Brett tapped. Good. From the final word, his arm fell loosely, exhaustion evident.
“Given what your life was like only a month ago, I’d bet you never expected you’d be sprinting today, or perhaps ever again. Has the KSE been everything you wanted it to be?”
Dr. Brandie smiled warmly as Brett tapped the Yes oval, followed by Tired.
“Of course,” she said, giving Brett a gentle clap on the shoulder. “We’ll give you a half-hour to rest before bothering with the balance beam and soccer ball. For now, Manny over there will get you an iced drink of your choice… doctor’s orders.”
He walked in the indicated direction to find Manny, and as he did, Dr. Brandie watched his posture, his bearing. Already, his legs and muscles carried him as though he hadn’t been sprinting. There was no trembling, no lagging. His breathing and heartrate would need to recover, but his endoskeleton and new musculature was entirely unperturbed, was ready to sprint immediately again should he have willed it.
Last, her eyes traced to the top of Brett’s back, where she noted a small blossom of red dabbing Brett’s hospital gown. His sprint must have torn at his stitches, she reasoned. That part didn’t need to make it into the press release.
Mom, this trial was for you, Dr. Brandie thought. For everyone who thought what the nerves lost was lost for good, let today’s run prove you wrong. No more kids left alone in the world, no more loved ones wasting away in wheelchairs…
Her mind was once again wandering her Pennsylvania childhood home, traipsing after mom’s stumbling footsteps, imagining the way mom’s face would’ve lit up if then-eight-year-old Laura had given mom the gift of walking again.
“Oh, Laura, it’s a wonderful thing you’ve done,” she imagined her mom saying, in that always-formal way she had. “A truly wonderful thing you’ve done.”
Dr. Brandie’s hand closed to a fist in her lab-coat pocket, pulling out the small hand-held recorder. “Locomotion test: success,” she intoned, eyes wet, but not quite crying. She was a professional in her laboratory, and such positions required emotional control. With a tone as flat as her mother’s once had been, after the illness had stolen all vocal affect and joy from her voice, Dr. Brandie finished her trial log: “Sustained sprinting speed of 6.5 meters per second achieved; plan to push for faster running in future trials.”
