Sunday, July 28, 2013

The Quantum Transfiguration of Sensory Input

“Do you feel this?”

I felt a squeeze on my bicep.

“Yes, on my arm.”

“Which arm?”


“Okay,” said the voice, what about this?”

“Yes. Back of my hand,” I said. “Very light.”

“Excellent, and this?”

A warm hand clasped mine.

I smiled. “Doctor, your hands are softer than I expected.”

“Excellent, George. You can open your eyes now.”

Ginny, the SQuID tech, was holding my hand. Forest green eyes under short-cut auburn hair, with a smile that lit up a room like a cliché.

Dr. Monet sat slightly forward on his doctor stool. Under a gray comb-over a big grin was plastered on his jowly face. I reluctantly let go of Ginny’s hand, slid my palms along the arms of the chair. Smooth leather, just a hint of wear.

Four weeks ago the touch of this chair on my skin was a blistering sunburn. Today I was wearing jeans, what I used to call “hot tar pants”. Today I sat comfortably in a chair in a doctor’s office, just like normal people did everywhere, all the time. Complete absence of pain. Complete absence of scraping, slicing, burning, freezing, stinging, abrasive, gnashing pain. I had thought I’d forgotten comfort. Sensory inundation for so many years.

And today I was just sitting in a chair.

“Well, George, I think we’re done here then,” Dr. Monet said. “We’ll want to do weeklies on the SQuID to make sure everything stays in sync, and if all goes well we can stretch those out to monthly in a few weeks, and basically then get you out to quarterly.”

I dropped my head, rubbed my eyes.

“George, this is why I went down this rabbit hole,” Monet said, just above a whisper, “to help people like you. You’re one of my best patients yet.” He stood up and walked over to me. I lifted my head, then stood as well. My body unfolded, rose, stood. Just like that. “Get back to living,” he ordered.

I shook hands with him. Everything that placing your hand into boiling water was, this was not. Ginny, too, shook my hand, then gave me a hug. Her eyes were getting a little moist. “We’ll see you next week, George, good luck,” she whispered. Simple, plain, human contact. Just a handshake and a hug, but just...everything.

* * *

Many years ago I watched Morgan Freeman on the Late Late Show. Morgan was talking about the science show he was hosting, and for some reason the topic of pain came up. He said that while our hand may be what’s hurting, it’s the brain that actually makes the pain. Or something like that. So all pain is actually just in your head. And when Morgan Freeman tells you it’s all in your head, you know it’s all in your head. I realized then that I was very upset with my brain, since it was at that time, and had for half a decade prior to that time, been telling me that my whole body was in torment, when in reality it was all just a cubic inch or so of brain matter. The thalamus was at the root of this. I hated my thalamus.

Some pain pills worked, some of the time, for a while. They also left me addicted, every time. That had to stop, and there is nothing like breaking pain pill addiction while experiencing the resurgence of the pain that was being suppressed. I’m proud to say that I never seriously considered suicide, but if I’d gotten hit by a truck, I wouldn’t have really minded.

I met Dr. Christian Monet at the Chronic Pain Research Center that he had opened up adjacent to the UA hospital. After two weeks of near-daily visits and hours of variously acronymed scanner tests he told me that there was nothing current medicine could do for me. However, an experimental research project at the Center might offer some hope. They were gearing up for human trials, would I like to participate?

This was a no-brainer for me. The chronic pain started in my hands twelve years ago--I thought it was just carpal tunnel--and within two years my entire body felt like it was experiencing a permanent sunburn, interspersed with bouts of acid-tipped lashing thorns-of-Satan’s-tail agony. Clothing was awful, and so was anything I sat or laid on. Sheets of vinyl were about the only thing I could tolerate for any length of time. Whenever I had to go out in public, the only material that could touch my skin was coarse silk. Mostly I sat at home, naked, on my vinyl wrapped furniture. After about a year I got used to that.

Monet told me about the thalamus, and nociceptors, and the antics of my shivving, pitchforking brain. But I also learned about tantalum wires, self-guiding neuronal sensors, and the hottest thing in materials science: “super high temperature superconductors”. His research center, collaborating with the university, had developed what was effectively a brain pacemaker. It was now being reengineered to utilize these new superconductor materials to be faster, smaller, and--when implanted--requiring no external power source. They were going to call it a “Super High Temperature Superconducting Quantum Illation Device”, or SHTSQuID, but then someone noticed the acronym, and it was decided to drop the Temperature reference, so it was now just a SQuID. The name fit, because the tantalum wires tugged out by the neuronal seekers ended up looking a lot like an array of tentacles reaching deep into a patient’s brain. In the case of “Patient Me” that brain was mine, and the tentacular target was my hated thalamus and a few other brain bits.

* * *

It’s fairly common knowledge that the brain itself cannot feel pain, which of course I found just hilarious. Brain surgeons, therefore, really like to do their operations with the patient wide awake. Just a little local anesthesia to numb the incision, and then drills, saws, chisels, etc. You don’t feel the pain, but you can certainly feel the grinding. In my case, though, they pretty much had to put my body to sleep from the neck down, as a choice between operating table and bed of hot coals would’ve been a toss-up.

Dr. Monet had a good operating table-side manner. He kept up a running commentary for the medical transcription, a lot of which I could follow, and checked in with me from time to time to see if I’m okay and whether there were changes in my perception of what was going on around me. After inserting the socket and the tantalum microspools the last piece of hardware to go into my brain was the SQuID. As he slid it in the socket, I distinctly heard, “Sploop!”  Minutes later the skull plug was back in place and they’d stapled the incision.

This was now the point where I was knocked out, after the surgery. I would be out for two weeks, in a state the medical profession calls “conscious sedation”. I could still hear and respond to speech, but would have absolutely no recollection of anything I experienced. Two week amnesia. For the first week the neuronal seekers would be unspooling about six feet altogether of wire threads from the SQuID socket over to the thalamus, limbic system, and a few other places. Apparently experiencing this can be extremely hallucinatory, so it’s been found best to leave the patient unconscious. The unspooling takes about a week. The second week is where the SQuID undergoes its “training regime”. My body, from head to toe, is incrementally stimulated to train the SQuID to nullify the thalamus and other neurons that are causing the pain, but leaving sufficient sensitivity such that I can still feel “normal” sensations. I was warned of a long-term risk in all this, that if something happens that ought to cause me serious pain, like breaking a rib, it won’t, and so I won’t feel it like a normal person would. I would likely end up being injured worse than would otherwise have occurred.

I’ll take my chances.

Two weeks after the operation I awoke in a hospital bed, laying between cotton sheets, with my arms resting on a micro-fiber polyester blanket. My whole body was tingling, though slowly fading, like an arm or leg that went to sleep but was now almost fully restored. The sun was shining through the window, I could feel warmth on my face. My body was...silent. Like one day you’re in downtown Manhattan at rush hour, and the next you’re on the side of an Alabama mountain, watching fireflies and listening to katydids and crickets. Not actually silent, just...quiet.

Then Dr. Monet checked me out of the Center.

* * *

The date with Ginny went really well. No, I mean really well. I hadn’t been out socially, much less dated, for years. (Flaming skin really dampened one’s ardor for the company of others.) Ginny ran the SQuID monitors on each of my visits with Dr. Monet at the Pain Center. Oh that smile. That’s what always stuck with me after each checkup.

I’d done six weekly visits for checkups and then shifted to monthlies. Ginny was the tech for these, and we always chatted about what I’d been doing since being released from the Center. After my fourth monthly visit, I waited around at the reception desk, and then caught her attention and asked her out. She grinned. I pretty much melted onto the floor right there at the desk when she said “Sure!” and flashed her eyes at me.

This was our fourth date. We had a really nice dinner, and then went retro cinema to see a superhero blockbuster, and I was relieved that the superheroes had reverted to heroic and uplifting rather than the dark brooders dominating the genre when I’d last gone to a movie years and years ago.

On the walk back to the car she asked if I wanted to come over to her place for breakfast.

This time the grin was on my face.

So when a texting driver ran their SUV through a red light and slammed into the rear of my car, spinning it into a light pole--direct hit on the passenger side--I really, really minded.

* * *

My eyelids fluttered.

There was a scraping noise, chairs being pushed back.

“Mr. McKnight. Mr. McKnight. Can you hear me?” A woman’s quiet voice.

Now a man’s. “George. This is Dr. Monet. Can you hear me George?”

“Unh,” I said.

Groggy. Very, very groggy. I slowly opened my eyes. Dr. Monet was on my left, looking at me, more worry on his face than I’d ever seen. In fact, I’d never seen worry on his face at all before now. On the other side, a nurse’s head atop a butterfly infested scrub top. Worry lines all up the forehead above blue-gray eyes. Not Ginny. I just stared up. Didn’t respond to my name.

They kept talking to me, trying to get an acknowledgement.

Finally, I blinked and tilted my eyes towards the doctor.

“I’m so sorry, George, I’m so very, very sorry. But there was nothing we could do. The crash cracked the socket and snapped half the wires. We had to pull the SQuID out. We’ve been suppressing the pain for as long as we could. We need to get an idea of where you are now, though, so we can figure out what to do next.”

I rolled my head towards the nurse. In the corner of my eye I glimpsed something on my arm. I went to twist my neck down to see what it was. A hard surface contacted my jaw and prevented any further motion. I was able to  raise my arm just a bit. There was a cast on it. And the thing poking into my jaw was a neck brace.

I managed to croak, “I feel...fine?”

* * *

My inventory: broken right forearm (both bones), two broken ribs (numbers five and six on the right side), whiplash, severe concussion, widespread bruising.

I got off lucky.

Ginny was in the hospital’s ICU, stable for now. Her right arm had been virtually severed in the accident and had to be amputated above the elbow. Six broken ribs, internal bleeding, collapsed lung, skull fracture, facial lacerations. Most of her right ear was missing. Damage to her right eye, but she would probably keep it. She was comatose, and they had no idea when she might come out of it.

A couple days after I woke up they wheeled me over to see her in ICU. Twenty minutes, I held her hand the whole time. Still soft and warm. I didn’t say a word.

I was subjected to an endless round of CT scans, PET scans, and NET scans, plus some even more esoteric brain and spinal tests. The SQuID was gone, so I should’ve been in agony, but not only was I mercifully free of the chronic pain I’d lived with for over a decade, I literally felt no pain from the accident injuries. Whatever had taken over suppressing the pain was now doing a more than adequate job on its own. The wires were still in my head, some in place and some detached, along with the cracked socket. Dr. Monet wasn’t ready to remove anything yet, and was in fact quite perplexed over my whole not-feeling-pain state.

Over the next week a theory came together. Dozens of scans, including live monitoring of brain activity while I was being brushed, poked, prodded, and pushed began to reveal something the doctor had not expected or seen before. The SQuID, with its inferencing and interfering with my neuron activations, appeared to have “trained” the brain’s neural network to itself suppress pain. And as Dr. Monet had cautioned when the device was first installed, my pain management neural network was now overdoing it, suppressing even “normal” pain, like the kind that accompanies the healing of broken bones.

* * *

The neck brace came off, it would be another six weeks for the arm cast, and I had to consciously be careful about the ribs, since I couldn’t feel what is normally the stabbing pain that happens when one tries too quickly to get back to normal movement.

I went to see Ginny every day, the bandages began coming off her face, but she never woke. All I did was hold her hand, it was as soft and warm as always.

* * *

I began stumbling when I walked. I couldn’t tell where my feet were, so I wouldn’t know if they had gotten properly set before putting my weight on them. My hands were getting numb. I began to lose the awareness of where the parts of my body were. I could command my arm to rise, and it would, but I didn’t feel it.

More NET scanning. The pain suppression neural network, Dr. Monet told me, seemed to be invading other parts of my brain, suppressing bodily sensations and body self-awareness. I looked it up on the Internet while I was still able to visually direct my arms and hands. I was losing “proprioception”, the self-awareness of my body’s whereabouts.

My hearing started to fade. And then vision. Not like going black around the edges, and leaving a tunnel or anything, but just everything getting hazy, fuzzing into a gray smear.

I lost the sense of the passage of time. I would sleep, and wake, and sleep again, but I had no idea of what my body was doing. I went completely deaf. I tried counting one one thousand, two one thousand, three one thousand, but I didn’t know if my brain was operating ten times faster than normal, ten times slower, or just at the regular speed. There was nothing external against which to judge the passage of time. One day (maybe it was a day) I counted up to three thousand, but all that told me was that I’d spent enough time to count up to three thousand. This was sensory deprivation on steroids, which can cause serious hallucinations and psychosis. But after ten years of flaming sensory inundation, this was a vacation.

I assumed I was being fed somehow, since I was still alive. But I had no idea how. Was I getting fed through a tube? An IV? Or where they putting hospital food in front of me and telling me to eat it, and I was?

I believe I’m still alive, but how would I know? I just have nothing to judge against, it’s all silent and gray, and without sensation. Did I slip into death and not realize it? Heaven, hell, some pan-universal state of consciousness?

I don’t know.

Am I alive?

* * *

The mouse pointer clicked an icon, cutting out the audio-visualization. Ginny wiped a tear. She winced as she worked her way up onto the crutches. Looked into George’s hospital room, then slowly approached, the gentle knives of healing ribs slowing her pace. George lay almost flat on the bed, most of his head encased in the real-time NETscan array. His mouth was just visible, caught with a small smile.

She reached down and took his hand.

Inputs from haptic sensors raced up the fiber optic network in her new arm, converging in the shoulder-implanted SQuID, mechanical electronics transfigured into nerve electronics.

Inputs to the thalamus.

Soft and warm.


Copyright 2013, Marc A. Criley

1 comment:

Cloud said...

That's amazing! I love your writing, all the more exciting since I wasn't really focused at the beginning, so I didn't realize it was fiction until after the first few paragraphs!