The subject of the unusual experiment struggled to escape the restraint. With each movement pain coursed through its body. When the test subject escaped its restraints it moved to the edge of the table and thumped to the floor. A few moments later the researcher conducting the experiment noticed that the specially-bred animal had gone missing. He had no choice but to get down on his hands and knees to search for it. As he crawled down the aisle, he shined a penlight under each table and piece of equipment. At the end of the aisle he stood up and placed his hands on his hips. "Where the hell can that damn thing be?"
When he turned around he saw that his quarry had been behind him all the time. He ran toward it, but before he could get close, it disappeared under a large, immovable, metal examination table. Several attempts to grab it from under the table failed. The researcher realized that to capture the animal unharmed he would have to crawl under the table. He laid flat on his stomach on the cold tile floor and inched his large frame forward.
While the researcher continued his close-quarters pursuit in the claustrophobic space, a mustard-yellow taxicab, spewing a noxious cloud of oily smoke from its exhaust, came to an abrupt stop in front of the Weinstein-Cox Neuroscience Institute. The associate director of the institute's neural cell regeneration lab emerged from the taxi and walked to the building's main entrance. She pulled firmly on the handle of the ornately carved, brass and copper-inlaid door. "Damn. Why can't I remember this door is locked on weekends?"
Dr. Myumi Yukohara tapped a five-digit code into a wall-mounted key pad. A small metal door opened, revealing a palm print scanner. Similar biometric security systems had recently been installed in each of the research institutes affiliated with New York City's Midtown University Hospital. Five seconds after placing her right hand on the palm print facsimile, a blinking green light indicated admission to the institute had been granted. She needed two hands to pull the heavy door open. Once inside, she walked past the unoccupied security desk and took the nearest elevator to her laboratory.
At the door to the lab, Myumi entered the access code into an alphanumeric keypad and pushed it open. To her surprise, the lights were already on. That's unusual, she thought, no one is scheduled to work today. As she reached into the pocket of her jeans for the key to unlock her office door a sound startled her. Fearing someone had made an unauthorized entry into the lab, Myumi turned in the direction of the noise, took a deep breath, and walked quietly down an aisle. She stopped, seeing a pair of red, Converse high-top basketball shoes sticking out from under an examination table.
"Garrett. Is that you under there?"
Startled, Garrett Fielding, the neurosurgeon who had been appointed director of the lab, jerked his head up and hit the underside of the table's bottom shelf. "Ouch! Dammit!"
Myumi exhaled in relief. The voice belonged to Fielding. "I didn't mean to scare you. Did you hurt yourself?"
Fielding grunted, but didn't speak. He wiggled from under the table and stood up, rubbing the back of his head. "I didn't expect you here today. Would you see if I drew blood?" He bent over so she could inspect his scalp.
"It's not bleeding, but you'll probably have a good sized knot. I'll get some ice to reduce the swelling."
"That won't be necessary. I'll be fine." Fielding gingerly probed the throbbing lump.
Myumi shrugged her shoulders. "Okay, have it your way. What were you doing under there?"
"I'm trying to catch a goddamn mouse."
Myumi laughed as she recalled the confrontation he had with the director of lab animal procurement when he first began working at the institute. "Is Waxburn giving you trouble about getting lab animals again?"
Fielding didn't see the humor in the situation. "No, Myumi," he snapped, "the mouse slipped out of its restraint. He's under the table."
Without taking offense, Myumi laughed again. "Why don't you just offer it a piece of cheese? It works every time."
Fielding again touched the lump on his head. He chuckled, "I wish I thought of that."
"Too bad you didn't. Which group did the mouse come from?"
"The NC-Alpha group. It could be the big one you call Waldo."
"Well, if it is Waldo, we can't have him wandering around the lab. Let me get under there."
Before Fielding could say another word, Myumi got down on her hands and knees and crawled so far under the table that even her shoes disappeared. Then he heard her say, "Don't be difficult, Waldo. Come to Myumi." The mouse backed itself further into a corner. A moment later she exclaimed, "I've got him!"
Gripping her captive, Myumi wiggled out from under the table. She placed the albino mouse in the center of the table and saw that it had recently undergone surgery. Curious, she said, "What did you do to him?"
"I'll tell you in a moment. Let go of it so we can see what happens." As soon as she released the mouse, it moved toward the side of the table. Myumi caught it before it fell off. She placed the mouse in the center again, only to find it did the same thing.
"Garrett, what are you looking for? Except for dragging one hind leg, this animal is behaving normally."
Fielding didn't answer. He just stood next to the table grinning.
With her curiosity fully aroused and her patience growing thin, Myumi said, "Dammit, tell me what you did to him."
Fielding crossed his arms and leaned against the table. "Wednesday morning, while you were on your way to San Francisco to attend the conference, I combined an equal portion of your latest glial enzyme with the most recent variation of the neural cell growth factor I've been working on. I then severed this mouse's spinal cord near the base of the skull and applied the mixture to the nerve endings. I tried to perfectly align the spinal reattachment, but in the process I may have damaged the nerve fibers going to his hind leg. That could account for it not working properly."
"You can't be serious. You severed this animal's spine on Wednesday, and today he's able to move?"
"I'm dead serious," Fielding assured her.
Myumi knew that neural cell regeneration and tissue replacement had been reported in amphibians. She also knew that sensory hair cell regeneration had been detected in birds and other lower vertebrates, but similar phenomena had never been found to occur in mammals. Could it be that Fielding had succeeded where all others failed? "What prompted you to combine the enzyme with the growth factor?"
"I really don't know where I got the idea."
"I guess where it came from isn't important," Myumi concluded. "The fact that you severed this animal's spinal cord and three days later it's able to move is what we should be focusing on."
Fielding nodded his head in agreement. "Myumi, think about this. It could be that by combining the two factors, a beneficial synergistic reaction occurred. The ability of your enzyme to suppress the proliferation of the glial cells that would normally form where I severed the spinal cord appears to have been measurably improved. This can only mean one thing: the combination of the enzyme with the neural cell growth factor has resulted in an incredibly potent nerve cell generator."
"It would be a wonderful addition to the field of neural science if one or both of those suppositions proved to be true," Myumi said as she began to understand the implications of what Fielding had done. "Did you check each day to see if the reconnect had taken?"
"No. What with my Thursday surgical schedule, and three emergency operations on Friday, I didn't have time to check with the lab. That's why I came in today."
"Is there a possibility the nerve tissue reconnected on the first day?"
"It's possible, but I really don't know."
Myumi put Waldo back in the cage and sat down on a nearby chair to consider Fielding's information. Then, in a voice filled with excitement, she said, "Let's do another mouse now."
"Have you forgotten this is Saturday? This has been a busy week for both of us. We could use some time off."
"Yes, but he who hesitates..."
Fielding tugged on his ear as he considered his colleague's entreaty.
Impatient for an answer, she said, "Come on, Garrett, we're burning daylight."
Unable to think of another excuse, Fielding said, "Okay, let's do it."
The two researchers worked for more than five hours on their new patient, applying liberal amounts of the enzyme-growth factor to the severed nerve endings. The animal survived the spinal cord separation and meticulous reconnection and appeared to be sleeping soundly. It would be five or more hours before the anesthetic completely wore off.
Fielding's stomach growled. He hadn't anything but coffee since the late afternoon the day before. "Have you eaten today?"
"I had half of an energy bar and a glass of juice this morning. Why?"
"My stomach is telling me the time has come for me to feed it. Let's get out of here for a while. The mouse isn't going anywhere."
"Good idea. I could use something to eat also. Do you like sushi?"
Fielding and Myumi returned to the lab two hours later. The mouse had not moved. Myumi put on her lab coat. "I'll stay until the anesthetic wears off."
"There's no need for that. It could be many hours. Besides, I think we could both benefit from a good night's sleep."
Myumi reluctantly removed the coat. "Okay, I guess you're right. I'll see you in the morning."
Fielding had no intention of leaving. He wanted to be present when the mouse awakened. He understood why Myumi wanted to stay, but he felt uncomfortable about her spending her entire Saturday at the lab. He climbed onto the examination table, covered his torso with his lab coat, and tried to get some sleep. Fifteen uncomfortable minutes later, the lab door opened.
Fielding knew it could be only one person. He called out, "Did you forget something?"
"No. I want to be here when the mouse wakes up," Myumi said. "Besides, I thought you were leaving too."
"Sorry for the white lie. I guess I'm just as anxious as you to see what's going to happen. Are you sure Hirano is okay with you being here all weekend?"
"Yes, he's working a thirty-six. I called him a few minutes ago and told him what we were doing. He's all right with me staying until we know the mouse's condition. So tell me, is there any room in the inn?"
Myumi's husband of two years, Hirano Watanabe, the chief resident in pediatric oncology at Mt. Sinai, would most likely be away all weekend as well. "Sure, there's always room for one more," he laughed. "I'll get some blankets from the animal holding room. They might make this table top bearable."
As they lay side by side, Myumi told Fielding about the neurobiology conference and the response their paper on allogeneic transplant stem cells received. After a few minutes her voice trailed off and she fell fast asleep. While he waited for his own sleep to come, Fielding thought back to when they first met. It was his first day at the institute. Alexander Thornton, a renowned neurosurgeon and medical director of the Weinstein-Cox Neuroscience Institute, had introduced them. Thornton had great hopes that Fielding and Myumi, working in concert, could produce promising results in the field of regenerative medicine.
Fielding had already made a major step forward in neural cell regeneration during the sixth and seventh years of his neurosurgical residency at Hastings Medical Center in St. Louis. He continued the research while completing a two-year fellowship in cerebrovascular-skull base surgery at the New Mexico Neurological Institute in Albuquerque.
He came to Thornton's attention when the Journal of Neurosurgery published his research describing the development and effectiveness of a growth factor that stimulated neural cell regeneration in the corticospinal tracts of the cortex. He was so impressed with Fielding's work that he arranged a visit to New Mexico to discuss the status of his research and his plans for the future. Upon his return to New York, Thornton made the young neurosurgeon an unusually attractive offer to join the institute.
Myumi began her work at the institute five years earlier as a postdoctoral research associate. Intellectually gifted, she received her undergraduate degree at Princeton in molecular biology at the age of sixteen and immediately began a Master's in bioorganic chemistry. She then enrolled at Columbia where she earned her MD and, two weeks before her twenty-fifth birthday, a PhD in molecular biophysics. After completing her dissertation, Myumi decided to forego the practice of medicine and pursue a career in biomedical research. Recruited by Thornton, she had made significant contributions to the institute's enzymatic research agenda.
The long day, exacting surgery and satisfying meal eventually took its toll on Fielding and he fell asleep. Four hours later, he awoke refreshed. Careful not to wake Myumi, he got up to check on the mouse. He set the animal's cage on top of a lab table and adjusted the overhead light. Fielding bent over the cage for a closer look. His heartbeat quickened. Less than eight hours after its spinal cord had been severed the mouse was moving. Fielding opened the cage door and stroked the animal's head. He leaned close to the cage and whispered, "I'm sorry for the pain I caused you."
Myumi sat upright. "How's our patient doing?"
Fielding turned to his colleague. "Come and see for yourself. He's awake and moving." Any penitent feelings he may have had about the surgery were quickly displaced with amazement and relief. Waldo wasn't a fluke. The surgical results were reproducible.
Myumi joined Fielding at the table. Her eyes opened wide when she looked into the cage. "This is absolutely incredible, Garrett. I can't believe what I'm seeing."
For the next few minutes, the two researchers watched the animal attempt to get to its feet. When it succeeded in standing on all four feet, they joyfully hugged one another.
Over the course of the next twelve weeks, the research team performed more than twenty similar experiments on different species of lab animal. Thrilled with the results of their efforts, they co-authored several papers that were immediately accepted for publication. The combined enzyme/neural cell growth factor, which Fielding named N-CellGen, received widespread acclaim by the medical research community.
Despite their success, Myumi had questions about the work they were doing. She discussed the possible uses of N-CellGen with Fielding many times, but she continued to have the feeling that he may have a hidden agenda. Unable to contain her curiosity any further, she approached him for what she hoped would be clarification. "I can envision the use of N-CellGen if a portion of the brain or spinal cord is damaged, or in the case of a severed or severely damaged limb. But we seem to be focusing on what N-CellGen can do if the spinal cord is severed. Why would a surgeon ever intentionally sever the spinal cord in a human?"
The question surprised Fielding. He knew his answer had to be direct and to the point. "Because severing and reconnecting the spine is the critical element of a brain transplant."
Myumi reacted in stunned silence. She turned away to think. After what seemed like several minutes she said, "Good Lord, Garrett, are you seriously considering the possibility of a human brain transplant?"
"I am. Let me explain. My best friend, who had an IQ close to 200, died the night of our graduation from med school due to internal injuries he suffered in a car accident. The doctors did everything they could to save him, but to no avail. He lingered in a semi-conscious state for almost fifteen hours. Ever since then I've wondered if a brain transplant could have saved his extraordinary mind."
Another prolonged silence followed Fielding's explanation. He and Myumi looked blankly at one another until he said, "Look, Myumi, I'm not saying we're going to be doing brain transplants any time soon, but I think this is definitely the outcome we're headed toward. Think about it. Over the past half-century there have been thousands of heart, lung, liver and kidney transplants. In each instance, life is given to someone by another. Why can't the same thing be done with the brain?"
"But wouldn't the brain of the donor have to be alive at the time of the transplant?"
"Yes," Fielding said, "the brain of the donor and the recipient would both have to be alive."
"Taking the brain from a living person seems more like science fiction than science, Garrett. Have you considered the ethical and legal implications of such a surgery? And how would you prevent organ rejection?"
"I extensively researched those two questions while I did my fellowship at New Mexico. I found no legal, ethical or religious covenants that would prohibit the transplant itself. As for organ rejection, the research suggested the brain, unlike other organs, is immunologically privileged."
Myumi once again turned away. She brushed a few flecks of dust from her lab coat, and then removed and replaced the silver clip that held her ponytail in place. "What you've said almost makes a brain transplant seem plausible. Do you really think N-CellGen will work on humans?"
"Honestly, Myumi, I don't know. I haven't given that question any thought. But I do know that both our reputations will be at stake if we continue on our present course. The worst case scenario is that I'll be laughed out of medicine and you out of neuroscience research."
"If you're willing to accept that risk, then so am I."
"I'm really glad you feel that way," Fielding said. "What I envision will be unlike any other transplant ever performed. In the case of heart, lung, kidney or whatever, the one who benefits from the transplant is the recipient. With the brain transplant, the donor is the beneficiary."
Myumi nodded, immediately acknowledging the inescapable logic of Fielding's statement. "I agree, Garrett, but what you're proposing isn't just a brain transplant. It's also a...a body trade!"