Parasite Eve (6 page)

         “When people say nice
things to you, it makes you want to go on.” With that, she exited the ICU.

9

    Kiyomi remained in quiet
stasis until morning. Soon after the minute hand ticked past noon, her blood
pressure began to drop rapidly. By 1:00 pm it had fallen below 95 and, an hour
later, was below 80. The ICU soon became a swarm of doctors and nurses as they
bustled in and out, driving Toshiaki and his father-in-law into the corner of
the room. It was such a marked contrast to the quiet that followed the
brain-death examination.

    “The CCH transplant team will
be arriving at two thirty,” said one of the doctors, looking at his wrist
watch. “They’ll start by inserting a catheter. The extraction will begin once
she loses her pulse.”

    “May we be present when she
passes on?”

    The doctor nodded.

    “You’ll have five minutes to
say your farewells, after which Kiyomi will be brought to the OR.”

    The hissing of the respirator
was inaudible in all the commotion. Kiyomi’s blood pressure was now down to 75.

    Yoshizumi, accompanied by
Odagiri and two staff members, entered the university hospital. They brought
with them a minimal, but essential array of surgical equipment and perfusion
containers for Kiyomi’s kidneys. This being a university hospital, there was
plenty of technology at their disposal, but Yoshizumi never forgot to have his
own by his side for an extraction. Because speed was so imperative, it only
made sense to use his own familiar tools.

    After exchanging greetings
with the hospital staff, Yoshizumi left Odagiri in the waiting room and went
into the ICU to check on the donor. Her blood pressure was nearing 65 and her
heart rate was down to 30 beats per minute. Once her blood pressure fell below
50, circulation would no longer be complete, and cells in her extremities would
begin to decay. Since the donor’s family had consented to the procedure, the
catheter was going to be inserted into her femoral artery now so that they
would be ready when the pressure fell below 50. The head doctor showed the
donor’s data to Yoshizumi for confirmation. Odagiri was then informed via
intercom that the catheter was being inserted.

    Fifteen minutes later,
Yoshizumi and his assistants prepared the perfusion equipment. They spread the
donor’s legs slightly and placed the machinery between her feet. One of the
assistants soon began to adjust the equipment settings while another
disinfected the area around her thighs, whereupon a silicon double balloon-tip
catheter was readied. When sterilization was complete, Yoshizumi looked at the
donor, standing at her left side, and patiently confirmed that the femoral
artery and vein were well secured. After a quick glance to see that his team
was on full standby, he inserted the balloon-tip catheter into the donor.

    He carefully advanced the
catheter until the balloon arrived at the right spot. Yoshizumi indicated his
approval to the assistants with a single nod and told them exactly what to do.
They connected a perfusion pump to the end of the catheter. He then guided the
catheter into the femoral vein and had it connected as well. All preparatory
steps were now complete. Her blood pressure was at 62, and her heart rate had
fallen further.

    Yoshizumi and his crew
temporarily exited the ICU to wait it out. Noticing the family, he signaled for
them to be let in and headed to the doctor’s office. He hadn’t met the family
yet, and it was indeed his belief that he should keep a low profile with them.
For the bereaved, a transplant surgeon was no better than a hyena snatching
away the body of a relative. He did plan to meet with them just once, before
the actual operation, but it was the coordinator’s task to intermediate between
them. No need to risk upsetting the family. Yoshizumi sipped some coffee in the
office, reclined on the couch, and looked up at the ceiling.

    Mariko Anzai’s face came to
him.

    SHE sensed the change.

    Kiyomi Nagashima’s body was
crossing over to Death. After the accident, her metamorphosis had proceeded
slowly hut surely. Now it was accelerating. Kiyomi was dying; her body was
losing warmth, and it would stiffen first, and eventually dissolve. Her brain
had already begun its deterioration. Hormonal discharges would soon stop. Blood
flow was weakening. Cells were rupturing and crudely spewing their contents.

    Everything was proceeding
according to plan.

    Robbing Kiyomi of her vision
was the easy part. A little trick on her optical nerves was all it took. In
that small window of opportunity, She induced Kiyomi’s hands to turn the wheel
off course. Her primary concern was ensuring that the accident didn’t damage
Kiyomi’s body too much. It had to be brain death. If, by the minuscule chance,
she’d ruptured any internal organs by hitting her abdomen instead of her head,
there would be no talk of kidney transplants. At the moment of collision, She
gauged the most precise timing to apply the brakes. She held back Kiyomi’s
abdomen with all Her strength to prevent it from lurching forward, fixing both
of her hands on the steering wheel to protect against peripheral injury. Kiyomi’s
forehead struck the steering wheel. She could tell skull fragments had pierced
the brain. Every time She thought of that moment, She felt a shiver if
excitement. Kiyomi would die, but She would live. Forever.

    Kiyomi’s kidneys were to be
transplanted into two patients. Ideally, at least one of them would be female
and the process would be complete. Toshiaki would perform the primary culture
as planned. She’d already induced such thoughts in him without his knowing.

    Toshiaki.

    She imagined his figure and
Her body twisted slightly. It was almost time. Her entire being trembled. She
remembered Toshiaki’s voice, his expressions, the warmth of his body. She’d
been waiting for a man like him. He was the only human being who could
appreciate and understand who She truly was. She refused to let go of such
perfection.

    She would become one with
him.

    An acrid excitement sent Her
into convulsions. And as Kiyomi’s blood pressure made its rapid decline, She
surrendered Herself to the afterglow of Her bliss.

    When Yoshizumi and staff
received word that blood pressure had dropped to 50, they returned to the ICU
once again. An hour had lapsed since the catheter insertion. The assistants set
up a number of Ringer’s solution bottles, to which perista pumps were
connected. After ensuring that the catheter was in position, Yoshizumi inflated
its two balloons with clean air to intercept blood flow.

    At Yoshizumi’s signal, his
assistants ran the pump. Cold perfusate passed through the catheter at a
precisely calculated rate. Yoshizumi placed his hands on the side of the donor’s
chest to verify that it was flowing properly.

    The human body has a main
abdominal artery and vein through which a great amount of blood flows. The
arteries which supply blood to the kidneys extend from this main artery.
Similarly, the kidney veins are linked to the abdominal vein. The abdominal
artery and vein each fork out in the lower abdominal region and continue into
both legs. The balloon-tip catheter had been inserted up through this lower
arterial branch to reach the kidney extension, and the balloons then inflated
to interrupt blood flow in the abdominal artery. At this point, a coolant, or
perfusate, was sent through the catheter tube. There were minute holes in the
tube between the balloons so that the perfusate could seep through into the
abdominal artery. Since the artery was blocked above and below by the balloons,
the perfusate flowed directly into the kidneys. The donor’s kidneys were
swiftly cooled and simultaneously flushed of blood. After the perfusate passed
through, it traveled into the kidney veins and on to the lower abdominal vein,
where it was recovered by the perfusion device and sent back in.

    The fresher the kidney, the
better. Compared to kidneys extracted from brain-dead donors, heart-failure
donor’s organs were inevitably less viable given the period of blood
deprivation. To save the kidneys from such damage, it had become standard
procedure to introduce a perfusate through the artery to rapidly cool the
kidneys upon heart failure. Cooling them before they were extracted improved
their chance of staying alive in their recipients. With the donor’s family’s
consent, it was even possible to begin the procedure prior to heart failure.

    One of the assistants
reported the perfusion rate at regular intervals while another monitored the
donor’s heart rate. Her skin turned pale and cold from lack of blood flow. It
was forty minutes since the perfusion began. Her heart stuttered, reducing her
pulse to a hush.

    “Please call in the family,” Yoshizumi
said to the patient’s doctor and nurse. “This will be their last chance to see
her alive.”

    At twenty minutes past five,
the nurse came into the waiting room to call Toshiaki and Kiyomi’s parents. She
informed them of the situation and brought them back to the ICU.

    When they walked into the
room, Toshiaki was astonished at the dramatic change in Kiyomi. Unable to tear
his eyes away, he gazed steadily at her face and approached her slowly with the
doctor. With every step, her face grew more and more distinct. He looked around
and stopped at the left side of the stretcher. His mother-in-law was sobbing
behind him.

    “Kiyomi’s vital signs are
indicated here, but as it is now her pulse is erratic and nearly unverifiable,”
the doctor said as he pointed to the screen at Kiyomi’s bedside. “The
respirator is still running, but she barely has any heartbeat and her blood
pressure has fallen sharply. Her skin, as you can see, is getting very cold.”

    Kiyomi’s face was so white it
was nearly translucent, her lips like two flower petals glazed with frost. It
looked like a clear stream was flowing inside her body. Lashes extended from
closed eyelids like crystals, casting short, thin shadows upon her skin.
Without thinking, Toshiaki extended a hand towards her cheek. The moment his
fingertips made contact, a numb sensation shot through his arm to the back of
his head, not unlike the time he had accidentally touched dry ice: a pain that
flickered between coldness and heat. He gasped and his hand trembled. He
stroked Kiyomi’s cheek calmly with his index and middle fingers, continuing
down along her neck, then stopped at her white chest where the veins showed.
Though obscured by her garment, he could tell clearly that Kiyomi’s nipples
were erect. Toshiaki took his hand away and wrapped his fingertips in his other
hand to warm them. A cool sensation seemed to linger there.

    Toshiaki’s heart leapt with a
great
THUMP
that broke into its steady rhythm. Feeling as though he were
suffocating, he placed a hand upon his chest.
THUMP
. As if to mock his
nerves’ autonomy, his heart leapt again. He felt hot.

    “We will now stop the
respirator, if we may,” the doctor stated.

    Hand still clutching his
chest, Toshiaki gazed at Kiyomi and took a deep breath, his lungs swelling
unsteadily as they filled with air.
Kiyomi’s body is being destroyed
, he
thought. The doctor flipped the respirator switch. The machine, which until
then had been keeping rhythm like a metronome, stopped in an unfinished hiss,
and several seconds later, let out a languid
ssss
. The movement in
Kiyomi’s chest abated. The doctor glanced at his wristwatch and said quietly,
“Official time of death is 5:31 pm.”

    Kiyomi’s father inhaled
audibly.

   
THUMP
. Toshiaki’s
heart cried out yet again. It was such an enormous wave of sound, he wondered
why no one else in the room could hear it. Maybe Kiyomi was sending the last of
her life energy into him, almost as if he had caught her final heartbeat. She
seemed to be telling him:
I don’t want to die
.

    “After the extraction, she
will be transferred to the morgue for a post-mortem inspection,” said the
doctor before encouraging them to leave the room.

    Toshiaki and his in-laws
exited the ICU. Three men who looked to be doctors were standing in the hallway.
The coordinator was behind them, holding a large box and giving instructions.
One of the men, who looked to be the leader of the three, noticed Toshiaki and
Kiyomi’s parents and approached them. He looked to be about forty years of age,
but a certain pride in his face made him appear younger. He bowed his head
simply and stated his name.

    “I’m Takashi Yoshizumi, from
the transplantation staff at the City Central Hospital. I’ve been placed in
charge of both the kidney extraction and transplant. We’re about to begin the
surgery. Please forgive me for being so brief.”

    “I see. Good luck.”

    Toshiaki extended his right
hand and exchanged a handshake with this man called Yoshizumi, who was studying
Toshiaki’s face as if shocked at something.

    “What is it?”

    “Nothing... excuse me.”

    Yoshizumi bowed once again
and, seeming to shield his eyes, left together with the coordinator and the two
other men into the prep room.