This story was written for the MSc Science Communication course at Imperial College London, for assessment as part of the Narrative module.
By Sascha Pare
Posted April 2022
The foreign object prodded me again, tentatively. I could feel its sharp tip and immediately knew what was coming. Below me everything throbbed with anticipation. In the next instant, I was pulled tight by a large body somewhere deep down, my delicate envelope taut and stretched around the bulging mass. The tip found a sweet spot, halting for a few seconds as if to take a breath. In the expiration that followed, its stinging point pierced through my layers with practised ease and the tense mass relaxed. My elastic fibres bounced back to close around the intruder, chemical fingers extending to assess the damage. The tip had punctured a clean hole – half a millimetre across, half an inch deep – almost satisfying. The object remained curiously motionless, like it was weighing up its options.
Then the throbbing resumed, more vigorous this time, more urgent. The tissue below me seemed to swell and surge in grotesque trepidation, my protective film straining against the pressure. The spasms quickened and reached a frenzied climax, every cell electrified. Suddenly, the mass fell limp and seemed to recoil, my fibres retracting to bury the wound. Then, the familiar suction caused by the retreating object. As it withdrew, layer by layer, its sharp edges chafed me, igniting a hundred nerve endings. A warm liquid seeped through me, flushing to the surface of the wound where it formed perfect little red beads. I busied myself with tidying up the mess of cells, organelles and protein fragments. There was another substance in this biochemical cocktail, something unexpectedly acidic. It pooled between the hair follicles and sweat glands, permeating ruptured cell membranes and dissolving their innards. It too, trickled up to the surface of the wound. Blood mingled with the reddish-brown nectar in the crater left by the needle.
The woman reclined against the brick wall, exhaling until she could feel her abdominal muscles tense and her throat burn. Her shoulder blades softened down her back and her left hand dropped onto the cold asphalt. One of her freshly painted acrylic nails cracked and broke off. A jewel that had been stuck on for extra sparkle bounced and tumbled across the pavement, into the gutter. She rested her left temple against the wall and felt the crown of tiny hairs above her forehead stand on end. Her limbs grew unbearably heavy and she wished she could be rid of them. Please someone take them away. As she pictured herself limbless, a faint smile tugged at the corners of her lips. How exquisitely hideous. The smile faded and she closed her eyes.
There was a small rupture in the network, down near the cephalic vein – nothing major. I was always quick to react when these things happened. Tears and ruptures triggered a meticulously rehearsed choreography where I inexorably took on the role of prima ballerina. I flowed down to the breached vein, effortlessly, backup dancers following in my crimson trail. Erythrocytes, leucocytes, platelets – all the acts were summoned. Down the subclavian artery we rushed, down the brachial and radial, and back up the median antebrachial vein. Twisting and twirling in and out of these narrow corridors to arrive centre stage. The vessel was constricted and we gathered in a slow vortex at the entrance of the funnel. Once inside, the platelets veered right and locked arms with the exposed collagen in the gash. One by one, they joined this tight embrace. As I drifted past and more platelets waltzed off, an impenetrable seal formed where the tear had been. Like the pieces of a completed puzzle, each cell fragment played its part in filling the holes – an outstanding performance. As the curtain closed over this insignificant incident, the vein expanded again and I flowed on with renewed gusto.
As I was making my way up the cephalic vein, alarm bells sounded throughout the network. A surplus of hydrogen ions had entered the bloodstream and was making its way around the circuit unchecked. Arterial receptors had done a preliminary reading of the invading substance: pH 3.45. Dangerously acidic. Then came signals of abnormally high body temperature. I was running along the deltoid muscle when the vessels expanded once more, creating a momentary backflow. This was soon corrected and I flowed on at a leisurely pace. My services were needed in the lungs; the entire network was on high gas exchange alert. The kidneys were always slow to respond to acidity problems and I regularly had to step in. I didn’t mind; the lungs were an obligatory detour. It took me longer than it should have to get there. Obstructions and delays were rare and usually minor, but I could tell this was different. The propulsions were irregular, half-hearted, lethargic. When I finally completed the loop, the pace hadn’t picked back up and the oxygen delivery was unusually light. Unfortunately, there was nothing I could do to help.
The paramedics spilled out of the van onto the strip, weaving in and out of the tents and plastic bags that littered the pavement. There was still time but they had to be quick. The man on the phone had given them rough directions but the landscape was constantly shifting out here, mutating from one moment to the next like a mirage. Who knew what might have changed, someone could have dragged her halfway down the strip by now. No, no, there she was and there was the syringe. The plunger was gone, the lead paramedic noted, a dozen possible scenarios wrestling in her mind. She crouched down and recorded the woman’s vital signs, her movements precise and practised many times over. Body temperature, high. Blood pressure, heart rate, too low. Breathing rate, zero. The assistant paramedic yanked the oxygen mask out of the kit, adjusted it around the nose and mouth, and pulled the straps. Come on, come on, breathe. They had taken the opioid kit as was routine when you were called to these streets. Even when the emergency wasn’t an overdose, you could turn a corner and find a case.
Lola hated gambling. There was always an element of it in this job and that was the worst part. Her assistant had injected the reversal agent – they had found an intact vein immediately, thank God – and they were waiting for the woman to come to. Kneeling on the cold pavement, the paramedics both stared blankly at her nails. Lola had always thought that you could gauge a person by the look of their nails. This woman was compensating for something, detracting attention from a gross flaw. Three minutes and still no sign of consciousness. The Naloxone should have kicked in by now, the woman should have woken up or at the very least stirred. Here was a fatal gamble, a life on the line, and Lola couldn’t think straight. Sometimes, when she came home in the early hours of the morning after a long shift, she couldn’t help but think that these people were a waste of space and resources. Terrible and unfair thoughts, which she chased away and replaced with the knowledge that she was saving human lives. She was a real-life heroine, so different from those silly girls you read about or watch on screen. This was too severe a case to deal with on the street. Her colleagues made the decision for her. They hurried over with a stretcher and raced back to the ambulance carrying the woman. Lola ran after them, praying that they would be in time.
The morphine substrate unlocked my opioid receptors at a dizzying rate, usurping the pathway from duller substances. The endorphins could wait in line as far as I was concerned. Now that the neuronal breaks were off, the dopamine ebbed and flowed, tickling the most sensitive corners of my reward centre. Each wave delivered a rush of delicious satisfaction. The synapses screamed euphoria in a chorus of chemical voices.
Other sensory stimuli dissipated in a hollow and distant echo. I was free of all burden, little clouds of worry lifting off and sailing away to some faraway destination. I was falling apart, dissolving into shreds of grey and white matter. The molecular phantoms that usually haunted my sinuous tunnels suddenly became irrelevant and ridiculous. The pain too, became laughable and faded into the background. Imaginary soap bubbles swallowed my inescapable thoughts and anxieties, drifting away on the current of a gentle breeze. Their delicate membranes reflected a thousand particles of light and scattered them in a shower of ecstasy. I had entered a hologram world that I wished never to leave.
But the molecular keys were numbered: the morphine ran out and the blissful feeling slowly dissipated. Instead of floating away, the little clouds now became a dense fog with ghostly tentacles. They wrapped around me and held me in a suffocating grip. Long vaporous fingers curled around my receptors and smothered them. I became numb to the onslaught of information traveling up from the rest of the body. Shortage of oxygen in the lower limbs. Dehydration and reduced salivary flow. Thirty-eight point four degrees Celsius. Inflammatory marker levels through the roof. What did I care? Every cell was gasping for oxygen and I was starving too.
The ambulance tore down the avenue to the hospital, sirens wailing. Inside, Lola was hooking up the ventilator while her assistant held the mask in place with a shaky hand. They didn’t say a word to each other, it was easier to pretend that this was just another inevitable casualty. Deep down, Lola knew, they both felt defeated. Frantically, she reached for the reversal agent and gave the woman a double dose. It was more to keep her hands busy than anything else, and she was infinitely grateful that her assistant remained silent. They both jerked up as a sudden burst of peaks appeared on the electrocardiograph monitor, spelling out the possibility of a miracle. The ambulance was suspended in tense expectation as they held their breaths. The peaks died back down to irregular bumps and Lola let out a moan of surrender. Then, the bumps withered and perished into a continuous horizontal line. The drawn-out beep rang like a distant church bell in her ears. The irony! She couldn’t bear it. She had saved many lives but now she felt like her indecision had taken one. Which heroine had killed this woman? The drug or the fraud?
Sascha Pare is an online features editor and sub-editor at I, Science. She is enrolled on the MSc Science Communication course at Imperial College London and writes whenever she can. While she enjoys creative writing, her keen interest is in science journalism and non-fiction writing.