From the author: Nurse Anjee knows that bio-nanites are the cutting edge of personalized medicine: they can kill cancerous cells, keep down inflammation, keep insulin receptors functional, and keep waistlines trim. But if they can be programmed, then they can be hacked--and to her hospital comes the most terrifying, cutting-edge hack of all.
In the notes box, Dr. Dasgupta had scrawled a single bleak word: “lungs.”
No other explanation was needed. Each of her breaths a forced, asthmatic rasp, fighting to find a channel through all those crystals. Every five or ten seconds, she’d cough, making the crystals crack, and she’d try to spit them out. Spittle oozed endlessly down her chin, glittering with crystals, a lethal matrix of quicksand.
Anjee replaced her chart. “She’s on her way,” Dr. Dasgupta had said.
Bed 3 had a little longer, but he’d been put into an induced coma months ago. “Bones,” said his notes box, because his skeleton was thickening with crystal, fattening within his flesh like so many plump maggots, slowly popping joints and ligaments apart from within. And you didn’t want to be conscious for that.
Anjee would take “bones” over “lungs,” if she had to pick. That way, she’d at least have narcotics and pleasant dreams at the end. Nisha always said she’d pick “blood” — “You can survive that one for a while and, honey, I’d rather have three extra years of misery than no extra years at all.” Claire liked to pick “eyes” but that didn’t count. If the hack affected your retinal maintenance, it probably just left you blind, dissolving your eyes from inside your head. Which was horrible, to be sure, but not fatal. Just look at the homeless guy by Broadway and St. Nicholas. Eye sockets like frozen craters, but there he sat on the sidewalk every morning, his musical can-I-get-spare CHANGE fully intact.
They never asked Dr. Dasgupta what she’d pick. Her daughter had died back in 2089 from “hair” — spreading over her skin like wildfire, covering her in an otter-sleek pelt. Needle-hard crystals growing in the place of hair. And when they entered her ears (piercing sound), her nose (piercing breath), the tear ducts of her eyes, her lips and gums and tongue and throat, and down and deeper — well.
Anjee’s uncle had died from “arteries.” At first they’d thought it was a run-of-the-mill heart attack, caused by run-of-the-mill atherosclerosis. But then they did the autopsy.
His aorta was a geode.
Bed 17 was Anjee’s least favorite.
They’d admitted him on his nineteenth birthday. He was in a coma, too, because his notes read “brain.” That small word haunted Anjee in the afternoons, riding the A train in from Bed-Stuy for the second shift, when she had too much time to stare at the stony faces of New York and think, Which one of you is doing this? Early last year, Dr. Dasgupta had called them all into a staff meeting. They’re getting more sophisticated, she said. Over at Beth Israel, they’re seeing fewer incidents of other tissue- or region-specific attacks, and a rise in targeted attacks on people’s brains.
It’s the End Times, Jamal had blurted.
No, Dr. Dasgupta had said. It’s human nature. Hacking the bio-nanites to breach the blood-brain barrier is next to impossible, but hackers are lured by the biggest and baddest challenges. That’s how it’s always been.
Washing her hands, Anjee glanced in the bathroom mirror and noticed that her right earring was missing.
The earring, she never found. The backing she found by Bed 17. When she stood up from her inspection of the linoleum, Bed 17 was sitting up and looking at her.
They locked eyes.
“Muh-aaaahhhnn,” said Bed 17. The moan was guttural, deep in the throat, struggling to navigate the barrier of soft palate and tongue. His jaw flopped, brokenly. “Maaahhhh muhhhhhhh maaaaahhh.”
“Hello,” said Anjee, her own throat suddenly dry. The ones with “brain” never woke up from their comas.
“Maaaaa uuuuhhhhh aaahh.”
“Do you know where you are?”
Bed 17’s eyes rolled. His head dropped to the left and drool dribbled onto his shoulder. “Ong ongong onggggaaaaaaa.” His hand flung up and dropped down, the arm of an infant who cannot control himself.
Breath shallow, Anjee backed out of the room.
She ran to Dr. Dasgupta’s office — it’s Bed 17 — and they ran back together.
Bed 17 lay peacefully, eyes closed and unresponsive. Anjee stuttered. “He was awake,” she said. “Sitting up and trying to talk. I swear.”
Dr. Dasgupta’s eyebrows pulled together in concern.
Dr. Dasgupta approached his bedside. “Steven,” she said. “Can you hear me?”
“If you can hear me, open your eyes …. If you can hear me, squeeze my hand …. If you can hear me ….”
Anjee’s gaze drifted to the floor. No sign of her missing earring, still, and no sign Bed 17 had ever been otherwise.
Sitting at the right-hand side of Bed 8, as if in vigil for another terminal stranger, Anjee hugged herself and shivered.
It won’t be like that, she promised herself. That won’t be how you die. Not if she could help it. Everyone else on the floor got a partial bio-nanite panel from their physician every six months, like any responsible adult, but Anjee insisted on a full one every quarter. It was how she was raised.
You mark my words, her grandmother had said, when Anjee was nine. That was the year they began clinical trials in humans. This is how we will die off as a species. Not nuclear war, not overpopulation, and not climate change, thank-you-very-much you good-for-nothing Kyoto Protocol. But bio-nanites. Hey, I’ve got a great idea — let’s inject microscopic machines into the blood of every man, woman, and child in the developed world! Nothing can go wrong! They’ll kill our cancerous cells, keep down inflammation, keep our insulin receptors functional, and keep our waistlines trim! Well, guess what, kids? If they can be programmed, then they can be hacked. Christ, let’s all just forget modern medicine and go back to the Dark Ages. At least dying of the plague was honest.
Not five years later, the first crystals appeared. Like Louis Pasteur’s worst nightmare. Kidney stones everywhere, appearing from nowhere, eating muscle and liver and bone.
The bio-nanite diagnostic panels had gotten better since then. And you could do virus scans at home now with a mouth swab. And Anjee was even more careful than most — she never had unprotected sex, she never kissed strangers, she always washed her hands, and every time she cut herself, it meant a virus scan. No exceptions. All it took was a single bio-nanite, suspended in normoxic, pH-balanced, body-temperature fluid, to spread an unrecognized piece of malware amongst its hive-minded kin. And all it took was one sick fuck on the subway to place an infected tack on your seat before you sat down.
”You’re being paranoid,” Anjee’s friends said.
Next to Bed 26, Dr. Kriegstein was saying, “Of course, if you’ve changed your mind and you’d rather be at home, we can make arrangements to discharge you.”
Bed 26 was “global.” She could go at any time, from anything, but everyone had seen her latest MRI, and Bed 26 herself had looked at the mass by her brainstem and guessed that she’d probably just forget how to breathe one day. “I’ll think about it,” she said. “My daughter keeps insisting that she’d rather I be with her and her husband, even though I know it kills her to see me like this.” She coughed. Flakes of crystal stuck to her lips. “Always knew I shoulda had more kids. Poor girl. She’s gotta feel so alone.” Bed 26 noticed Anjee waiting. “Hi there. Coming to join the party?”
It was worse, somehow, when they still had enough life left to be human. “Dr. Kriegstein? When you’re through here, can I talk to you for a minute?”
She led him to the room with Beds 9 and 10, empty for now, and shut the door. She told him about Bed 17.
“Is that so,” said Dr. Kriegstein.
“Do you think …” Anjee started. “I mean … the way he was moving his arm. Like … a puppet. Being controlled by someone.” Anjee shivered again. “Do you think a hacker could — I mean, would it be feasible, in theory, to create a —”
Dr. Kriegstein regarded her impassively, in silence.
“… a supplemental neural network …” Anjee stumbled. “… out of bio-nanites that could … if the hacker knew enough about neural circuitry … that is, hijacking it could be …”
In her pocket, Anjee’s computer emitted a distinctive pattern of beeps. She pulled it out to check. Bed 1 was coding.
“Shit,” said Anjee. “Sorry, that’s mine.” She ran out, leaving unreadable Dr. Kriegstein in the dark, as if they had any hope of buying Bed 1 another few minutes of life.
Dawn came. Another small chapter of the nightmare, complete. Anjee was waving goodbye to everyone at the desk when Jamal, who’d just come on duty for first shift, said, “Yo. Dr. Dasgupta is looking for you.”
Anjee found her by Bed 17, looking down and frowning, hands behind her back.
“Oh,” said Anjee. “You saw him do something?”
“Dr. Kriegstein said you had an interesting question for me,” said Dr. Dasgupta.
Anjee blushed. “Did I?”
Dr. Dasgupta’s face stayed down, but her eyes darted up to Anjee’s. “Did you?”
Anjee’s blush deepened.
“Listen,” said Dr. Dasgupta. She circled the bed until she stood at Anjee’s side. “I understand that you’re frightened, but we can’t have misinformation and speculation floating around, especially here of all places.”
Anjee squirmed. “I’m sorry. I just — you have to admit — I mean, you said …”
“In that meeting we had once. That hackers always go for the biggest and baddest challenges.” Anjee scrutinized Bed 17, so she wouldn’t have to look at Dr. Dasgupta’s hard, narrow face. “If you were a bio-nanite hacker, wouldn’t that be your ultimate goal? To hack not only a person’s nanites to breach the blood-brain barrier, but to actually hack the person’s brain — the person themselves?”
In an act of surprising tenderness, Dr. Dasgupta pulled one of Anjee’s hands into hers.
“There’s no need to be frightened by this,” said Dr. Dasgupta, nodding to Bed 17. “The human brain is an incredibly complicated, sophisticated system. Bed 17 here is the work of an amateur.”
Anjee felt herself relaxing into the older woman’s confidence and touch. Funny how such a small amount of compassion, timed just right, could go such a long way.
Then Dr. Dasgupta squeezed and Anjee felt the needle prick her hand.
Anjee looked down. Dr. Dasgupta pulled away, revealing a dark, fattening drop of blood on Anjee’s skin. Dr. Dasgupta’s smile was sharp as crystal.
“There are already masters walking among us,” she said.
This story originally appeared in AE: The Canadian Science Fiction Review.