[FIRST][LAST]
After Action Report - Venlil Colonial Defense Force
Subject : Captain Farva
A gentle giggle rose from the foot of my bed. I curl up in my blankets at first not willing to be woken by the kids; Whatever they were up to; my mind still foggy from morning dreariness. I heard chief Donu exchanging excitedly with someone not far away in engineering speak, my tired brain could not parse. The tones of synthetic beeps, and electrical humming slowly entered my awareness. I raised my paw to wipe the morning dew from my eyes but I felt some kind of resistance to my paw. I sit up confused, I am not in my bedroom, or my quarters aboard my ship.
I am on a soft bed, with a soft blanket made of a finely woven material draped off my form. Around me is a curtain wall hung off of a curved metal pole which encompasses the entire bed, and I am flanked on both sides by medical equipment. Boxy screens display what I assume to be my vital signs accompanied by a strange blocky alien script. Inspecting my arm I notice an IV drip is inserted into the vein. Feeling a fading headache I reach up to my forehead where I feel a bandage covering a tender wound. Where Did I….
A sharp meep escapes my mouth. I am on the predator ship!
I quickly begin to tear at the IV line, not wanting whatever poisons the predators are feeding me to further enter my body. The room goes quiet, the curtain wall is disturbed, I focus on tearing away the bandage, panicking my coordination falters but I almost have it out when a paw reaches out to stop me. A cream colored venlil has rushed to my bed frantically batting at my arms in an attempt to stop me from saving myself.
“Captain, please let me help. I don't want you to hurt yourself!”
Not thinking, in full stampede mode I back hand the interloper with my paw.
A startle meep escapes her lips.
The IV is ripped out with the sudden motion.
Orange Blood begins to drip from the improperly removed IV.
This site further raises my heart rate.
The Venlil Recovers and I recognize her.
“Nurse Fila, What are you doing? what's going on?!”
“Farva you need to calm down, your going to be alright let me look at that arm”
“NO!”
I pulled my injured arm away. Jumping up to stand on the bed. Why was Fila working with the predators? What had they injected into my body?
“What are they holding over you! Why are you working with the predators! Where's Nyan?!”
“Captain Farva please calm down, These predators are different, they don't want to hurt us, you need to believe me”
It must have been some mind altering drug, these predators clearly have her under their spell! I needed to get out of here. I couldn't force her to come with me. I needed to escape and regroup, and pray to whatever gods will listen that I could get off this ship somehow.
I bolted from the bed crashing through the curtains, they did not move out of the way fast enough and my mass caused the curtain rods to be hoisted from their housings. I collapsed upon the floor, my movement hindered by the tangled mass of predatory linens. I struggled against the vile curtain entrapment. I had to use my claws to tear my way free of them. I looked up, predatory growls of surprise, and startled meeps echoed out from all around me.
My peripheral vision was filled with images of both predator and prey alike, I was surrounded on all sides. Nurse Fila was behind me stunned by my sudden actions. Donu looked towards me with concern, and I looked to the far end of the room to see Nyan, In the clutches of a blond haired predator. Digging her claws into his young flesh.
Donu gets up gesturing with her tail in a placating motion. “Easy now Farva, don’t do anything rash!” Donu speaks.
They have her too!
I bolt past her and the massive predator standing next to her. I go to grab Nyan, but he is pulled from my reach! The large predator turns her body to shield me from her catch.
“Hey easy now!” It barks, holding Nyan away from me.
Nyan reaches his paw out past the predator. A horrified look in his eyes.
With only the frantic strength a mother could conjure, I grasp his outstretched paw and pull him from the predator's grasp. With him once again in my arms I see the door to the pen we are in begin to open. Wasting no time, I bolt full sprint from the door. Only to be met by a large black mass. A tall impenetrable wall of muscle, cloaked in foot to shoulder black artificial pelts. Holding a colorful pink box, no doubt gaining that color from being caked in the blood of innocent prey animals. I raise my paw not holding Nyan to swipe at him, to rip my way past him. But before I can make contact my arm is grabbed by the predator's meaty digits. It holds me tight just below the paw where the wound from the ripped out IV sits. Blood dripped from the wound, no doubt triggering its bloodlust. I drop Nyan to free my other paw, I go to swipe the predator to free my arm but again I am stopped. I look to my right to see Donu restraining my arm.
“Donu let go!” I scream. “You're not of your own mind!”
“My mind is fine thank you!” She replies.
I turn to kick her away, striking her twice with quick kicks. Desperately trying to free myself from her deranged clutches. I wind up to kick a third time only for Nyan to wrap his whole body around my legs.
“Nyan Stop” I cry, my heart beating at a million light years per hour.
“Please…Don't hurt Teal’c and Donu” Nyan pleads.
I frantically wiggle my body desperately trying to regain autonomy from my traitorous captors.
“Im going to sedate her” proclaims my former ship nurse Fila.
Grabbing a Needle she stalks towards me, eager and willing to deliver me into the jaws of her captors.
“That will not be necessary” says the large predator holding my arm. He sets his package upon a nearby bed, and grabs my other arm from Donu, and then easily flips me around. And holds my arms behind my head, he then proceeds to kick my legs out from under me and forces me to the ground in a vice-like headlock.
“BE CALM CAPTAIN FARVA” It bellows “Further resistance will only cause more harm to yourself, and more worry from your crew, listen to them”
“Captain please just relax your safe, if they wanted to hurt you they could have a long time ago” Donu almost seems to try and trick me to the predator's side. But I see her glancing nervously towards the cut on my arms. Deep down I think she knows what that means. Nyan also pleads with me to listen. It's at this I begin to tear up at the hopelessness of it all. I wail out in despair frantically thrashing to free myself from the predator's death grip but to no avail.
I sit here once again, bested by predators, having failed those I love, but instead of rotting in a cattle pen or in the belly of an Arxurs stomach. They lie in a different kind of pen, their minds’ no longer theirs, as they fall victim to the predator's spell. Brainwashed to serve as the perfect compliant cattle.
Nurse Fila approaches a needle in her hand.
“I'm going to sedate her I need to look at that wound”
“Hold up a second” speaks the blond predator, she seems to be calming down.
The truth is I have no will left to fight, I have been bested time and again, there is only sorrow left and self pity. I only wish for a swift end now. I don't wish to live with the weight of this long string of failures weighing on my mind any longer. I go limp in the predator's arms.
“Please just… make it quick predator” I manage to say, sobbing making it hard to talk as I get out the words between snuffling breaths.
“It's okay Farva, please don't be sad” Nyan pleads as he clings tightly to my waist.
The predator holding me growls quietly into my ear. “I am going to release you now, do not attempt to harm nurse Fila as she is trying to help you now, do you understand?”. I tilt my ears in the affirmative, nothing happens for a moment until Donu signals to the predator who I guess whose name is Teal’c that I responded in the affirmative. My arms are slowly brought to my side. My left arm is released but not the wounded right one. Teal’c displaying some knowledge in medical etiquette seems to be intentionally applying pressure to the wound to prevent bleeding, I am led back to the bed.
Nurse Fila is about to attempt to fix my wound but is stopped by the blond predator.
“Allow me, this should go a lot more smoothly with this.” The blond predator produces a strange golden metal device, it appears like a strange wiry gauntlet, with metal claws and a strange crystal in the center. It emits a strange pulsing sound that I cringe at, but I am held firm by nurse fila, I can't look away as the strange glow it emits passes over my arms. The curtain of despair lifts for a moment, replaced by incredulousness as before my eyes the wounded artery in my arms miraculously seals itself, as elegantly as a flight suit being zipped up. My arm is left feeling slightly warm which soon fades, any sign of the wound is gone.
Fila speaks in an incredulous tone.
“It is endlessly baffling how your medical bay is stocked with simple alcohol based disinfectants and primitive bandages and sutures. Like something I'd see in a primitive yotul field hospital, while simultaneously containing healing tools so advanced they would make the finest Zurulian theoretical medical engineers sell their own tail.”
The blond predator lets out a high pitched broken chortle, which my translator pings as laughter. “I don’t know what a Zurulian is but compared to what we've seen this is nothing, this is a miniature version of the same technology used in a Goa'uld sarcophagus, which can reanimate dead tissue, bringing people back to life even after complete brain death.”
“Fascinating” Donu replied “what is the nature of this radiation”
“That technology itself is actually derivative of an ancient healing device created by our distant primordial ancestors the Alterans, which emitted subspace based healing radiation. We currently have the original device back in our home dimension being reverse engineered back in area 51” Spoke a third predator, who was standing up against the far wall.
He seemed to be holding onto himself quite fiercely, perhaps he struggled to hold in his bloodlust, unlike the two predators currently at my side.
“For predators they have such wondrous technology Farva” Donu says as she takes my paw and massages it gently in an attempt to ease my anxiety. “I almost wouldn't believe it if not for what they have shown us so far. Tell me, do you know how they got us off of our ship?”
A wave of realization washed over me as I sat dumbfounded in the bed. How did they get us off this ship? My brain had been in nonstop flight mode since the battle. I had been so occupied with survival I never stopped to contextualize my mere presence, on this ship, in one piece, why had we all seemingly awoken in this ship's hangar bay. No wait we didn't awaken, most of us were standing. Maybe we were drugged and removed, with no memory of the lost time. But that couldn’t be right. I was looking at the countdown to the core explosion. It had hit zero. I saw the flash myself.
“I was on the bridge holding Nyan in my arms, but after that I remember being in that hangar bay, with Nyan, in the exact same position.”
“The humans have a technology that allows them to break down matter at the atomic level, transfer it via an electromagnetic molecular confinement beam, and reassemble it at a different location completely remotely!” Donu excitedly proclaimed.
“You were teleported directly from the bridge to our ships hangar bay with your crew, and Donu to our infirmary due to her severe radiation poisoning.” Commented the blond predator.
Nyan finished crawling up the bed and snuggled into my side. “They fixed Donu, Samantha fixed her with her healing glove!” Nyan excitedly brayed, his tail wagging uncontrollably.
My stomach dropped, how had I forgotten, how did I let that slip my mind, Donu was subjected to at least 3.6 standard units of gamma radiation. Her presence here was a miracle. I hugged her tightly, my guilt for my actions only increased, how could I neglect the damage done to one of my oldest friends. Was I so predator diseased that I forgot to think of my herd?
The predator whose name was Samantha spoke ”Yeh sorry it took us so long, we cut it a lot closer than we wanted, but we had to adjust our transporter lock to account for the radiation flooding the ship, the levels experienced were harmless for the most part, but enough to cause problems.”
The fear chemicals were slowly draining from my mind, my head became clearer as I started to consider the actions of these predators so far. They had offered to help my ship while risking their own vessel, they had tried for peace before throwing themselves into battle, they had little reason to help us and little reason to try and take our technology as their capabilities seem to surpass ours in many ways so far.
I looked towards the blond haired predator, towards Samantha.
“Why did you help us? What do you hope to gain?”
She responded ”Well now we would like to maybe get some intel about this local region of space, we are not from around here and frankly we could do with some help securing some parts. But with that in mind we didn't really expect anything out of you when we first got your hail. We helped because you were in trouble, and your situation sounded dire.”
“And I'm just supposed to believe that! Prey ships would be waging pros and cons before even thinking about helping another ship under attack, especially with not knowing anything at all about the other ships capabilities”
Donu squeezed my paw and interjected. "These humans aren’t like normal predators, they are pack predators, they are very social, and even appear to feel genuine empathy, they even eat plants, they have been feeding us from their own reserves!”
“How is that possible?” I ask, having never heard of such a thing.
“Well where we come from” Samantah responded ”Omnivorous life is extremely common, not just on our home planet but nearly every one of the thousands of habitable planets we have visited contain omnivorous life in some form or another, It is an incredibly beneficial evolutionary trait.”
“Thousands! How can that be, our scientist have never encountered such a thing”
“That's the thing, they're not from this galaxy Farva, they're not even from this dimension!”
Donu gets into explaining the technical aspects of the Daedalus's faithful journey to our dimension, while Nyan, an always hungry growing boy, runs off during her explanation, to approach the large predator known as Teal’c.
“Can I have another donut?” he asks, pointing to the box that I now realize is not covered in blood but instead merely painted a gaudy pink.
“You may, but only after you have completed your grooming rituals, it is important for little ones such as yourself to learn and maintain proper hygiene practices” Teal’c spoke, his growls almost seeming to take up a fatherly aura.
He looks disappointed slightly but then his ears and tail perks up as he runs behind Samantha and out of sight, he remerges with a hairbrush and plops himself down on the predator's lap. To which she responds by snarling at him intensely.
“Donu” I shriek, interrupting the third predator's speech on the volatile nature of fourth dimensional space. Shocked at how quickly the predator could go from civility to volatility so rapidly. I was quickly calmed by Donu and Fila assuring me that this was merely an odd habit of the humans. The upturned teeth baring signaled happiness to them. Samantha made it clear to me that since her jaw was not clenched it did not indicate aggression. Her explanation sounded dubious, but after further observation, her following actions did not seem to indicate she wanted to harm the boy. Nyan offers her the brush once he sees that I am finished panicking.
She gives and odd closed mouth smile. "You have an almost PHD level knowledge of physics! don't tell me you don't know how to brush your own fur”
His tail gives a meek wag. ”I like when you do it, you have such nice flat nails and warm fingers!”
He makes his eyes go wide like a pup pleading for attention. The predator’s resolve immediately falters. ”Awh how could I say no to such a cute little angel”.
Samantha begins to help the boy detangle his fur, running her long grasping appendages through his fur in combination with the brush to gently pull apart the knots. He’s already clean from the grime that was present on him from when we were back on the heavily damaged ship, speaking of which I gesture to nurse Kila.
“Kila, how is the crew? How are they holding up? why aren't they here?”
“17 survivors including yourself, the humans have set up a triage center in their hangar bay, keeping the crew together and trying to give them some space, their stable but many of them are bedridden. They're quite scared naturally but,“ nurse Kila gives a look towards the humans “but I think we are going to be alright.”
“So what happens now?” I asked, “you aren't from this dimension and you said you were having drive problems, can you fix those? What are your plans for this dimension?”
The third predator stalked out from his isolated corner to address the room in a posture that emphasized the obvious restraint that was required to contain his instincts around us. “Hi ummm.. My name is Doctor Rodney Mckay, I think I can help with that question, simply put, our drive system uses a specialized quantum subspace field generator to warp 4th dimensional space in a way that allows us to track and catalog dimensional eddies as we call them, and track their specific frequencies which allow us to…….”
------- one long boring explanation later ------
“Ah So I see, you came to this dimension by mistake and need a replacement part that you cannot manufacture yourself to return home, but you think we might be able to manufacture a replacement with our industry?” I asked for clarification from Rodney.
“I discussed with your chief engineer earlier, we should be able to reproduce the part we need at what Donu described as a hyper fabricator, the meta materials available in your dimension you use for warp travel should be sufficient to recreate the part we need”
“In exchange I believe we can help you with your little arxur problem.” Spoke Samantha, running her grasping appendages through the fur of a contented Nyan, who was happily munching away at the strange circular Staryu-like treat the human Teal'c had presented him. Samantha proclaiming it to be sourced from his personal stash.
I was taken back by the revelation that they wanted to offer further assistance, when the predators first mentioned their damaged drive system, I thought they might try to leverage our place as rescued survivors as a means to get access to the part they needed to repair their damaged vessel. But now they were offering further assistance in exchange?
“I don’t understand, you've already done so much? Why would you help us more and risk more damage to your vessel?”
“Well if you want the reason we are going to put on paper, “Samantha said, ”it's to gather intel about a potential threat, and to ensure trust and cooperation of the locals to better expedite the procurement of mission critical drive components. If you want our real reason, its that no one deserves what has been done to you, we can't stay because we have responsibilities in our home dimension, but we don't see why we can’t help you while we are here.”
“So wait, are you proposing what I think you're proposing?”
“I am, from what we learned from your crew the arxur take a large portion of their abductees as cattle, we can track your subspace trails quite quickly and we think we have a good chance of hunting down the arxur transport ships.”
Nyan angled his head to look at both me and the human. Hope in his eyes, the idea of getting my family back would normally seem like an impossible dream, but here I was being comforted by predators, offering to risk their lives for a very lopsided trade in our favor. An ember of hope for the first time in many claws went alight in my chest.
I looked to Donu, who while trying to hide it, looked forlornly in Nyans direction. He was so happy to hear about a rescue plan and excited by all the predators' incredible technology, but while my family was young and fertile enough to be taken as cattle and potentially rescued. I had little doubt that if his family wasn't eaten, or killed in the bombing of the colony, the arxur would have no reason to hold a couple of such advanced age as cattle.
While I myself was a meek prey and a hopeless failure of a military officer, these Humans, despite obviously being fierce predators, had shown off an odd compassion. If anyone could; stand up to the arxur, and hunt them in return it was them.
I would help them anyway I could, they were unfamiliar with our foe, but they have shown themselves to be quite adaptable so far. Working together, we just maybe had a chance at making up for my failures. To set things right, and to save innocent prey from a fate worse than death.
“I think I may have to take you up on your offer kind predator”
Officer Report - Captain Caldwell
CLEARANCE LEVEL 5
Our interim chief engineer Dr.Mckay has successfully clamped open the 4th dimensional hole in space ; as he calls it; so we are clear to jump through this dimension freely without losing our path back to our home dimension. While my first impulse would be to jump to Earth, Unfortunately it seems that this dimension’s earth cold war went hot and it is currently a bombed out waste land. That being said carter and Mckay have struck a deal with the captain of the destroyed venlil defense frigate, in exchange for aiding in the rescue of captured civilians, they are willing to grant us access to the advanced manufacturing equipment needed to repair our Quantum drive.
While the antagonistic cannibalistic arxur are certainly an intimidating foe, they are not invincible and our ship stacks up favorably against theirs when specialized techniques are employed. The problem they cause for us is more unique. Carnivores are rare in this dimension and seemingly more so are omnivores. The Herbivore species known as the venlil are quite afraid of us, having dealt with these arxur for so long, and also due to a seemingly quite intense biological fear response, have been very wary to deal with us. Fortunately due to our admittedly unusually charismatic crew, and their admirable diplomatic efforts, we seem to have gotten them to calm down a lot since we initially transported them onto our ship. I am going to check up on the venlil crew and captain in the Medbay now, as they will be the most essential venlil to our efforts going forward.
As I walk in it seems that captain Farva is fast asleep, while Rodney appears to be using a Donut to explain the workings of a stargate to the aliens engineers.
“Okay so the stargate, you see this donut, imagine it's about 10 venlil tall, and made of metal” Rodney picks up another donut and hands it to the Child named Nyan. ”Okay first off don't eat that, secondly imagine you are a ancient alien race, and you want to get to point A to point B as fast as possible. Ftl isn’t quite fast enough so what if you could instead skip the trip and skip to the end. The stargate network allowed the ancient alternans to simply walk from planet to planet” Rodney used his finger to gesture from donut to donut in his explanation of the stargates, speaking about their functions as well as their dangers, mentioning some notable accidents associated with their use, like unwanted time travel, stellar poisoning and dimension hopping, the ladder being a large part of why we were here in this dimension to begin with. Most concerningly however, the venlil Nyan took a bite out of the donut when rodney finished his explanation.
Samantha was working quietly with nurse Fila and looked up from some chemical diagrams when she noticed I had entered the room. I asked if I could have a word, and took Her, Rodney, and Teal'c aside to have a meeting with them. We left the room due to the venlil’s exceptional hearing, as we had previously discovered when various medics made some inappropriate comments on how the venlil were “cute enough to eat '' thinking they were out of earshot.
Having taken them aside I spoke up. “I have already told this to Shepard and our medical staff in the hangar bay, and I would like to congratulate you on your remarkable progress on bridging the gap with the venlil. Going from shoot on sight in the hangar bay to literally eating out of your hands in a matter of hours represents some major diplomatic prowess.”
“Thank you captain” Samantha Said.
“There behavior is indeed most unusual” followed Teal’c
“But seemingly quite understandable given what they have been through with the wraith, Sorry! Arxur, Freudian slip.” chimed rodney.
“I would love to look at the biosphere of one of their planets, their ecology seems preposterous judging by the way they describe it. But they are a space faring species so they presumably know what they are talking about.” added Samantha.
“I myself am curious based on what you reported general, their dimension is quite odd but I suppose ours would be weird to them as well, but we have responsibilities back home.” I responded curtly. “I do have a question for you all though, The Venlil are a herbivorous species with intense emotional reactions and societal values pertaining to the consumption of meat, including animal products correct?”
Samantha answered ”We have been avoiding the subject of meat consumption as much as possible, focusing on our plant based foods for the venlil’s comfort, and they have been happy to keep that topic to a minimum after the initial introductions, but I don't believe they would respond well to the idea of consumption of…..” Samantha trails off with a worried look. “Oh god wait, please don’t tell me”
Teal’c looks confused, Rodney facepalms.
“You do know that donuts have eggs in them? Don't you.”

Grey’s Anatomy Narration
Season Three
Episode One: Time Has Come Today
Meredith Grey
In the O.R., time loses all meaning. In the midst of sutures and saving lives, the clock ceases to matter. 15 minutes, 15 hours…inside the O.R., the best surgeons make time fly. Outside the O.R., however, time takes pleasure in kicking our asses. For even the strongest of us, it seems to play tricks - slowing down, hovering…until it freezes…leaving us stuck in a moment, unable to move in one direction or the other.
Time flies. Time waits for no man. Time heals all wounds. All any of us wants is more time…time to stand up…time to grow up…time to let go…time.
Episode Two: I Am a Tree
Meredith Grey
At any given moment, the brain has 14 billion neurons firing at a speed of 450 miles per hour. We don’t have control over most of them. When we get a chill - goose bumps, when we get excited - adrenaline. The body naturally follows its impulses, which I think is part of what makes it so hard to control ours. Of course, sometimes we have impulses we would rather not control…that we later wish we had.
The body is a slave to its impulses. But the thing that makes us human…is what we can control. After the storm…after the rush…after the heat of the moment has passed…we can cool off and clean up the messes we’ve made. We can try to let go of what was…and then again…
Episode Three: Sometimes a Fantasy
Meredith Grey
Surgeons usually fantasize about wild and improbable surgeries - someone collapses in a restaurant, we slice them open with a butter knife, replace a valve with a hollowed-out stick of carrot. But every now and then, some other kind of fantasy slips in. Most of our fantasies dissolve when we wake, banished to the back of our mind. But sometimes, we’re sure…if we try hard enough…we can live the dream.
The fantasy is simple…pleasure is good…and twice as much pleasure is better…that pain is bad…and no pain is better.
But the reality is different. The reality is that pain is there to tell us something. And there’s only so much pleasure we can take without getting a stomachache. And maybe that’s okay. Maybe some fantasies are only supposed to live in our dreams.
Episode Four: What I am
Meredith Grey
At some point during surgical residency, most interns get a sense of who they are as doctors and the kinds of surgeons they’re going to become. If you ask them, they’ll tell you - they’re going to be general surgeons…orthopedic surgeons…neurosurgeons…distinctions which do more than describe their areas of expertise. They help define who they are. Because outside the operating room, not only do most surgeons have no idea who they are, they’re afraid to find out.
Episode Five: Oh, the Guilt
Meredith Grey
First do no harm - as doctors, we pledge to live by this oath. But harm happens…and then guilt happens. And there’s no oath for how to deal with that.
Guilt never goes anywhere on its own. It bring its friends doubt and insecurity.
First do no harm - easier said than done. We can take all the oaths in the world, but the fact is…most of us do harm all the time.
Sometimes even when we’re trying to help…we do more harm than good…and the guilt rears its ugly head. What you do with that guilt is up to you.
We’re left with a choice…either let the guilt throw you back into the behavior that got you into trouble in the first place or…learn from the guilt and do your best to move on.
Episode Six: Let the Angels Commit
Meredith Grey
To make it…really make it…as a surgeon…it takes major commitment. We have to be willing to pick up that scalpel and make a cut that may or may not do more damage than good. It’s all about being committed…because if we’re not…we have no business picking up that scalpel in the first place.
There are times when even the best of us have trouble with commitment. And we may be surprised by the commitments we’re willing to let slip out of our grasp. Commitments are complicated. We may surprise ourselves by the commitments we’re willing to make. True commitment takes effort…and sacrifice. Which is why sometimes…we have to learn the hard way to choose out commitments very carefully.
Episode Seven: Where the Boys Are
Meredith Grey
As surgeons, we’re trained to look for disease. Sometimes the problem’s easily detected. Most of the time, you need to go step-by-step, first probing the surface, looking for any sign of trouble…a mole or a lesion or an unwelcome lump.
Most of the time, we can’t tell what’s wrong with somebody by just looking at them. After all, they can look perfectly fine on the outside while their insides tell us a whole other story.
Not all wounds are superficial. Most wounds run deeper than we can imagine. You can’t see them with the naked eye. And then there are the wounds that take us by surprise.
The trick with any kind of wound or disease is to dig down and find the real source of the injury. And once you’ve found it…try like hell to heal that sucker.
Episode Eight: Staring at the Sun
Meredith Grey
Many people don’t know that the human eye has a blind spot in its field of vision. Theres a part of the world that we are literally blind to. The problem is, sometimes our blind spots shield us from things that really shouldn’t be ignored. Sometimes our blind spots keep our life bright and shiny.
Episode Nine: From a Whisper to a Scream
Cristina Yang
As doctors…we know everybody’s secrets - their medical histories…sexual histories…confidential information that is as essential to a surgeon as a 10-blade…and every bit as dangerous. We keep secrets. We have to. But not all secrets can be kept.
In some ways, betrayal is inevitable. When our bodies betray us, surgery is often the key to recovery. When we betray each other…when we betray each other, the path to recovery is less clear.
We do whatever it takes to rebuild the trust that was lost. And then there are some wounds, some betrayals that are so deep, so profound…that there’s no way to repair what was lost. And when that happens…there’s nothing left to do but wait.
Episode Ten: Don’t Stand So Close to Me
Meredith Grey
At the end of the day, when it comes down to it, all we really want is to be close to somebody…so this thing where we all keep our distance and pretend not to care about each other - it’s usually a load of bull.
So we pick and choose who we want to remain close to. And once we’ve chosen those people…we tend to stick close by…no matter how much we hurt them.
The people that are still with you at the end of the day…those are the ones worth keeping. And sure, sometimes close can be too close…but sometimes that invasion of personal space…it can be exactly what you need.
Episode Eleven: Six Days: Part 1
[No narration]
Episode Twelve: Six Days: Part 2
[No narration]
Episode Thirteen: Great Expectations
Meredith Grey
No one believes their life will turn out just kind of okay. We all think we’re going to be great. And from the day we decide to be surgeons, we are filled with expectation - expectations of the trails we will blaze, the people we will help, the difference we will make…great expectations of who we will be, where we will go. And then we get there.
We all think we’re going to be great. And we feel a little bit robbed when our expectations aren’t met. But sometimes, our expectations sell us short. Sometimes the expected simply pales in comparison to the unexpected. You gotta wonder why we cling to our expectations because the expected is just what keeps us steady, standing…still. The expected’s just the beginning. The unexpected…is what changes our lives.
Episode Fourteen: Wishin’ and Hopin’
Meredith Grey
As surgeons, we live in a world of worst-case scenarios. We cut ourselves off from hoping for the best because too many times, the best doesn’t happen. But every now and then, something extraordinary occurs…and suddenly…best-case scenarios seem possible. And every now and then, something amazing happens…and against our better judgement…we start to have hope.
As doctors, we’re trained to give our patients just the facts. But what our patients really want to know is, will the pain ever go away? Will I feel better? Am I cured? What our patients really want to know is…is there hope? But inevitably, there are times when you find yourself in the worst-case scenario…when the patient’s body has betrayed them and all the science we have to offer has failed them. When the worst-case scenario comes true, clinging to hope is all we’ve got left.
Episode Fifteen: Walk on Water
Meredith Grey
Disappearances happen in science - disease can suddenly fade away, tumors go missing. We open someone up to discover the cancer is gone. It’s unexplained, it’s rare, but it happens. We call it misdiagnosis…say we never saw it in the first place…any explanation but the truth…that life is full of vanishing acts. If something that we didn’t know we had disappears, do we miss it?
Episode Sixteen: Drowning on Dry Land
Meredith Grey
Like I said…disappearances happen - pains go phantom…blood stops running…and people - people fade away.
There’s more I have to say…so much more. But…I’ve disappeared.
Episode Seventeen: Some Kind of Miracle
Meredith Grey
There are medical miracles. Being worshippers at the altar of science, we don’t like to believe miracles exist. But they do. Things happen. We can’t explain them, we can’t control them…but they do happen.
Miracles do happen in medicine. They happen every day. Just not always when we need them to happen.
At the end of a day like this, a day when so many prayers are answered and so many aren’t…we take our miracles where we find them. We reach across the gap…and sometimes…against all odds…against all logic…we touch.
Episode Eighteen: Scars and Souvenirs
Meredith Grey
People have scars in all sorts of unexpected places, like secret road maps of their personal histories, diagrams of all their old wounds. Most our wounds heal, leaving nothing behind but a scar. But some of them don’t.
Some wounds we carry with us everywhere, and though the cut’s long gone…the pain still lingers.
What’s worse, new wounds, which are so horribly painful…or old wounds that should’ve healed years ago and never did?
Maybe our old wounds teach us something. They remind us of where we’ve been and what we’ve overcome. They teach us lessons about what to avoid in the future. That’s what we like to think. But that’s not the way it is, is it? Some things we just have to learn over, and over, and over again.
Episode Nineteen: My Favorite Mistake
Meredith Grey
Surgeons always have a plan…where to cut, where to clamp, where to stitch. But even with the best plans…complications can arise, things can go wrong…and suddenly you’re caught with your pants down.
The thing about plans is, they don’t take into account the unexpected. So when we’re thrown a curveball whether it’s in the O.R. or in life…we have to improvise. Of course, some of us are better at it than others. Some of us just have to move on to plan B…and make the best of it.
And sometimes…what we want…is exactly what we need. But sometimes…sometimes what we need is a new plan.
Episode Twenty: Time After Time
Meredith Grey
A patient’s history is as important as their symptoms. It’s what helps us decide if heartburn’s a heart attack, if a headache’s a tumor. Sometimes patients will try to rewrite their own histories. They’ll claim they don’t smoke or forget to mention certain drugs, which, in surgery can be the kiss of death. We can ignore it all we want…but our history…eventually always comes back to haunt us.
Some people believe that without history, our lives amount to nothing. At some point, we all have to choose. Do we fall back on what we know? Or do we step forward to something new? It’s hard not to be haunted by our past. Our history is what shapes us, what guides us.
Our history resurfaces time after time after time. So we have to remember…sometimes the most important history is the history we’re making today.
Episode Twenty-One: Desire
Meredith Grey
As interns, we know what we want - to become surgeons…and we’ll do anything to get there. Suffer through killer exams, endure 100-hour weeks, stand for hours on end in operating rooms…you name it, we’ll do it. The tough part, though, is reconciling this huge thing we want - to be surgeons - with everything else we want.
Too often, the thing you want most is the one thing you can’t have. Desire leaves us heartbroken…it wears us out. Desire can wreck your life. But as tough as wanting something can be…the people who suffer the most…are those who don’t know what they want.
Episode Twenty-Two: The Other Side of This Life: Part 1
Meredith Grey
The dream is this - that we’ll finally be happy when we reach our goals. Find the guy, finish our internship - that’s the dream. Then we get there. And if we’re human, we immediately start dreaming of something else. Because if this is the dream…then we’d like to wake up…now, please.
Episode Twenty-Three: The Other Side of This Life: Part 2
Meredith Grey
At some point, maybe we accept the dream has become a nightmare. We tell ourselves the reality is better. We convince ourselves it’s better that we never dream at all. But the strongest of us, the most determine of us, we hold on to the dream. Or we find ourselves faced with a fresh dream we never considered. We awake to find ourselves…against all odds…feeling hopeful. And if we’re lucky, we realize…in the face of everything, in the face of life…the true dream…is being able to dream at all.
Episode Twenty-Four: Testing 1-2-3
Meredith Grey
A surgeon’s education never ends. Every patient, every symptom, every operation…is a test, a chance for us to demonstrate how much we know…and how much more we have to learn.
Episode Twenty-Five: Didn’t We Almost Have it All?
Richard Webber
Being chief is about responsibility. Every single surgical patient in the hospital is your patient, whether you’re the one who cut them open or not. The scalpel stops with you. You need to be able to look at a family…and tell them your team did everything they could to save someone’s child…their husband…their wife. You get caught up…taking care of other people’s families. And responsibility, it makes you…you take care of other people’s families…and you sacrifice your own.

26 M, 5’10”, 140 lbs. Reasonably active, healthy lifestyle. No other symptoms, non-smoker. I found a small, bony lump in the back of my head on Thursday. It's pea sized or smaller. It's just as hard as the skull around it, smooth, and immovable.
It's located pretty far to the right, and low on the ridge of my skull, right where the skull gives away to soft tissue. Behind and near the very top of the mastoid process where it joins the temporal bone. Near or on the occipitomastoid suture if I’m reading anatomy diagrams correctly. I'm worried because I can't find a similar structure on the opposing side.
It was very mildly painful on Saturday, especially when I would roll my neck in that direction. It's still a little tender to the touch today (Monday). But, it wasn't painful at first since I found it by touching it, not from any pain. So, I'm thinking any pain was just from me touching it repeatedly over the past few days. I suppose it's possible that it's something I've always had, or that I've had long term at least, but I feel like I would have noticed it earlier.
Would appreciate any thoughts about what my next steps should be and when/if I should visit my GP. Thank you!

DAY: APRIL 9 2024
​

• 4-9-2024MANY FACTORS STOP U.S. WOMEN FROM GETTING MAMMOGRAMSHealth care cost and access are not the only barriers women face in getting lifesaving mammograms, a new government report finds. Food insecurity, lack of transportation, less hours at work and feelings of isolation also can keep women from getting screened for breast cancer, researchers from the U.S. Centers for Disease Control and Prevention discovered. […] Read More
• 4-9-2024EPA CRACKS DOWN ON TOXINS THREATENING THOSE LIVING NEAR CHEMICAL PLANTSAre you one of the estimated 104,000 Americans who lives within six miles of factories that spew organic chemicals into the air? New rules issued Tuesday by the Environmental Protection Agency might make your life healthier, agency officials said. The new rules “will significantly reduce toxic air pollution from chemical plants, including ethylene oxide [EtO] […] Read More
• 4-9-2024MORPHINE TOLERANCE FOUND TO RESULT FROM TIAM1-MEDIATED MALADAPTIVE PLASTICITY IN SPINAL NEURONS Morphine and other opioids are vital to treat severe and chronic pain. However, they have two problems—prolonged use creates morphine tolerance, where ever-increasing doses are needed for the same pain relief, and paradoxically, prolonged use also can create an extreme sensitivity to pain, called hyperalgesia. Researchers at the University of Alabama at […] Read More
• 4-9-2024THE ROLE OF BROKEN CHROMOSOMESScientists have unraveled the mechanisms of the cyclic guanosine monophosphate-adenosine monophosphate synthase-stimulator of interferon genes (cGAS-STING) signaling pathway activated by micronuclei, as well as its significant effects on tumor immunity. This study illuminates how chromosomal instability, marked by micronuclei formation, plays a critical role in controlling the capacity of the innate immune system to regulate […] Read More
• 4-9-2024COGNITIVE DECLINE MAY BE DETECTED USING NETWORK ANALYSIS, ACCORDING TO RESEARCHERSWe all lose our car keys or our glasses from time to time. Most people would be correct to laugh it off as a normal part of aging. But for others, cognitive decline may start as a worrying but clinically unnoticeable step toward cognitive impairment, be it relatively mild or as severe as Alzheimer’s disease. […] Read More
• 4-9-2024HOW CELLULAR PLASTICITY DRIVES CANCER METASTASISAbout 90% of deaths from cancer are a result of metastasis—that is, from cancer’s ability to spread from an initial primary tumor to seed new tumors throughout the body, often in the lungs, liver, and brain. Metastasis relies on cancer cells’ ability to adapt to different tissue environments throughout the body by gaining improper access […] Read More
• 4-9-2024RESEARCHERS CALL FOR FOCUS ON HIGHER STROKE RISK IN WOMENWhile stroke is the fifth-leading cause of death for men, it’s the third-leading cause of death for women in the United States. Someone’s risk of stroke increases as they age, and since women continue to live longer than men, they have more strokes over their lifetimes. However, a review article in the Journal of Stroke […] Read More
• 4-9-2024MYTHS ABOUT PSA TESTS AND PROSTATE CANCER SCREENINGThe understanding of prostate cancer has significantly evolved in the past 15 years. However, many people—including primary care providers—may not be aware of the current guidelines for prostate cancer screening, says Andrew Vickers, Ph.D., of Memorial Sloan Kettering Cancer Center (MSK). The main screening tool for prostate cancer is the PSA test, which measures levels […]
• 4-9-2024TRANSDIFFERENTIATION WITH RNA SEQUENCING AIDS DIAGNOSIS OF GENETIC DISORDERSResearchers at Baylor College of Medicine have tested the feasibility of using human cell transdifferentiation with RNA sequencing to facilitate diagnoses of Mendelian disorders. The approach generated an overall diagnostic yield of 25.4% in a cohort of Undiagnosed Diseases Network cases. The findings are published in The American Journal of Human Genetics. Functional experiments such […] Read More
• 4-9-2024STUDY REVEALS MECHANISM LINKING HEART DISEASE TO CANCER DEVELOPMENTResearchers have found a mechanism responsible for increasing the risk of developing cancer among patients with heart disease: Small extracellular bubbles, or vesicles (sEVs), secreted from the sick heart to heal itself, are released into the bloodstream and […] Read More

​

• 4-9-2024SCIENTISTS SAY BLOOD PROTEIN COULD HELP DETECT DELAYED CONCUSSION RECOVERY IN CHILDRENResearchers have discovered a blood protein that could help detect which children will experience ongoing concussion symptoms more than two weeks after an injury. The research, led by Murdoch Children’s Research Institute (MCRI) and published in the Journal of Neurotrauma, found the protein was a potential biomarker for delayed recovery from concussion in children. For […] Read More
• 4-9-2024VIDEO EDUCATES AND CONNECTS MEN TO PROSTATE CANCER SCREENING OPTIONSAs part of a comprehensive effort to improve cancer screenings among diverse communities, Penn Medicine’s Abramson Cancer Center (ACC) Community Outreach and Engagement team developed a culturally sensitive educational video to address prostate cancer screening disparities. In findings shared today at the American Association for Cancer Research (AACR) Annual Meeting 2024, the team showed that […] Read More
• 4-9-2024‘BE PREPARED,’ CDC TELLS STATE LEADERS AFTER BIRD FLU FOUND IN TEXAS DAIRY WORKERThe Centers for Disease Control and Prevention officials said Monday they have met with state health leaders in Georgia and around the country, telling them to be prepared for more human cases of bird flu after a dairy worker in Texas was being treated for the virus. While stating the risk to the public is […] Read More
• 4-9-2024CLINICAL TRIAL FINDS NASAL SPRAY SAFELY TREATS RECURRENT ABNORMAL HEART RHYTHMSA clinical trial led by Weill Cornell Medicine investigators showed that a nasal spray that patients administer at home, without a physician, successfully and safely treated recurrent episodes of a condition that causes rapid abnormal heart rhythms. The study, published in the Journal of the American College of Cardiology, provides real-world evidence that a wide […] Read More
• 4-9-2024PERIOSTIN SHOWS PROMISE TO HELP FIGHT A COMMON FORM OF ESOPHAGEAL CANCERSchematic diagram of roles of periostin (POSTN) in the esophageal squamous cell carcinoma (ESCC) microenvironment. Direct contact with ESCC cells leads mesenchymal stem cells (MSCs) to become cancer-associated fibroblast (CAF)-like cells, which secrete periostin and activate the Akt and extracellular signal-regulated kinase (Erk) pathways via integrin subunit beta 4 (ITGB4) in ESCC cells, promoting their […] Read More
• 4-9-2024MOUSE STUDY UNCOVERS HOW ALTERED GENE EXPRESSION CAN INDUCE AUTISMGenes involved in chromatin modification and gene transcription are associated with the progression of neurodevelopmental disorders. Researchers from Japan have developed a new mouse model to study the molecular mechanism behind the ability of KMT2C to cause autism spectrum disorder. They also showed that vafidemstat has a rescuing effect by normalizing disrupted gene expression. Credit: […] Read More
• 4-9-2024MORE SYNCHRONY BETWEEN PARENTS AND CHILDREN NOT ALWAYS BETTER, SAYS STUDYMore synchrony between parents and children may not always be better, new research has revealed. For the first time, a new University of Essex study looked at behavioral and brain-to-brain synchrony in 140 families with a special focus on attachment. It looked at how they feel and think about emotional bonds while measuring brain activity […] Read More
• 4-9-2024ADVANCES IN AGING BONE REGENERATION MATERIAL DEVELOPMENTThe new development process for aging bone regeneration materials focuses on in-depth research of dysfunctional mechanisms, the development of a biomaterial ‘toolbox’, AI-assisted material design, and high-throughput in vitro manufacturing and evaluation of materials. Credit: Science China Press In the elderly, a multitude of factors contribute to diminished bone regeneration capabilities, including a reduction in […] Read More
• 4-9-2024STUDY FINDS THAT EFFORTS TO HELP LOW-INCOME AMERICANS BY BUYING UP THEIR MEDICAL DEBT AREN’T GOING AS PLANNEDWhen it comes to helping Americans manage rising health care costs, one increasingly popular policy stands out for both its simplicity and potential payoff: Buy up vast amounts of medical debt for pennies on the dollar and cancel it, thereby giving struggling families a break from one major stressor. Over the last two years, 15 […] Read More
• 4-9-2024EXPERTS GIVE RECOMMENDATIONS FOR LONGER AND BETTER LIVES FOR PATIENTS WITH ATRIAL FIBRILLATION An international panel of experts published recommendations to improve management of atrial fibrillation (AF). The position paper summarizes the results of the 9th AFNET/EHRA consensus conference—a two-day expert meeting which was jointly organized by the German Atrial Fibrillation Network (AFNET) and […] Read More
• 4-9-2024PATIENT IMAGES ARE MISSING IN STUDIES ON ATOPIC DERMATITIS
• 4-9-2024NOVEL MECHANISM SUPPORTS ANTITUMOR RESPONSE AND T-CELL SURVIVAL
• 4-9-2024CMS121 MITIGATES AGING-RELATED OBESITY AND METABOLIC DYSFUNCTION:
• 4-9-2024DUBIN-JOHNSON SYNDROME IN TWINS LINKED TO NOVEL GENETIC MUTATIONS
• 4-9-2024SOME PROTEOGENOMIC SIGNATURES LINKED TO PROSTATE CANCER PROGRESSION IN PATIENTS WITH AFRICAN AND EUROPEAN ANCESTRIES
• 4-9-2024AZD1390 WITH RADIOTHERAPY SHOWS MANAGEABLE SAFETY PROFILE AND PRELIMINARY EFFICACY FOR PATIENTS WITH GLIOBLASTOMA
• 4-9-2024ARTIFICIAL INTELLIGENCE ANALYSIS OF DNA FRAGMENTOMES AND PROTEIN BIOMARKERS NONINVASIVELY DETECTS OVARIAN CANCER
• 4-9-2024SURVIVORSHIP PORTAL BRINGS CANCER RESEARCHERS ONE CLICK AWAY FROM DISCOVERY
• 4-9-2024INVESTIGATIONAL PERSONALIZED VACCINE PROVIDES CLINICAL BENEFIT FOR SOME PATIENTS WITH RESECTED HEAD AND NECK CANCERS
• 4-9-2024SURVIVAL RATES AFTER HIP OR SPINE FRACTURE WORSE THAN FOR MANY CANCERS
• 4-9-2024CARING FOR CHILD WITH CANCER INCREASES MENTAL HEALTH CARE UTILIZATION FOR PARENTS
• 4-9-2024SCIENTISTS DISCOVER THAT DIABETES DRUG IS PARTIALLY EFFECTIVE AS A BITTER BLOCKER
• 4-9-2024RESEARCHERS DEVELOP STATISTICAL METHOD FOR GENETIC MAPPING OF AUTOIMMUNE DISEASES
• 4-9-2024RESEARCH SHOWS ART THERAPY BRINGS BENEFITS FOR MENTAL HEALTH
• 4-9-2024RESEARCH TIES GUT MICROBIAL TMAO PATHWAY TO CHRONIC KIDNEY DISEASE
• 4-9-2024JOB INSECURITY IN EARLY ADULTHOOD LINKED TO HEIGHTENED RISK OF SERIOUS ALCOHOL-RELATED ILLNESS IN LATER LIFE
• 4-9-2024SWAPPING RED MEAT FOR HERRING/SARDINES COULD SAVE UP TO 750,000 LIVES/YEAR IN 2050
• 4-9-2024NEW ATLAS OF MRNA VARIANTS CAPTURES INNER WORKINGS OF THE BRAIN
• 4-9-2024LONELY CHILDREN MORE LIKELY TO EXPERIENCE PSYCHOSIS, NEW STUDY FINDS
• 4-9-2024ELECTROCONVULSIVE THERAPY FOUND TO REDUCE SEVERITY OF CERTAIN MENTAL ILLNESSES
• 4-9-2024TACKLING SOCIAL ISOLATION COULD BE MORE EFFECTIVE THAN HEALTHY EATING FOR OBESITY
• 4-9-2024DIETARY FIBER CRITICAL IN MANAGING HYPERTENSION, INTERNATIONAL STUDY FINDS
• 4-9-2024PATIENTS WITH DEVICE-DETECTED ATRIAL FIBRILLATION AND MULTIPLE COMORBIDITIES DO NOT BENEFIT FROM ANTICOAGULATION: STUDY
• 4-9-2024COULD CAR-T CELL THERAPY IMPROVE KIDNEY TRANSPLANTS?
• 4-9-2024STUDY IDENTIFIES NOVEL MECHANISM OF GLUCOSE SENSING BY ADIPOCYTES IN REGULATING THERMOGENESIS AND ENERGY METABOLISM
• 4-9-2024NEUROBLASTOMA STUDY IDENTIFIES NEW SUBGROUPS WITH DISTINCT PROGNOSES AND POTENTIAL VULNERABILITIES TO THERAPIES
• 4-9-2024MORE MENTAL HEALTH SUPPORT IN SCHOOLS MAKES SENSE—BUT SOME CHILDREN MAY FALL THROUGH GAPS
• 4-9-2024NEW CONSENSUS STATEMENT AIMS TO IMPROVE ENDOMETRIOSIS EVALUATION
• 4-9-2024CARDIOLOGY TEAM PERFORMS NOVEL HEART ARTERY REPAIR WITH NEWLY APPROVED DEVICE
• 4-9-2024BRAIN VESICLES FOUND TO CONTAIN SELECTIVELY PACKAGED, FULL-LENGTH MRNA
• 4-9-2024TARGETING RAS PROTEINS MAY PREVENT RELAPSE IN ACUTE MYELOID LEUKEMIA
• 4-9-2024STUDY UNCOVERS MULTIPLE LINEAGES OF STEM CELLS CONTRIBUTING TO NEURON PRODUCTION
• 4-9-2024PEOPLE WITH HYPOTHYROIDISM AND TYPE D PERSONALITY MAY BE MORE LIKELY TO EXPERIENCE POOR TREATMENT OUTCOMES
• 4-9-2024SALT SUBSTITUTION MAY REDUCE ALL-CAUSE, CARDIOVASCULAR MORTALITY
• 4-9-2024RESEARCHERS SAY PROGRESSIVE RESISTANCE TRAINING NOT SUPERIOR FOR HIP OSTEOARTHRITIS
• 4-9-20242020 TO 2022 SAW INCREASE IN ENROLLMENT IN MEDICAL CANNABIS PROGRAMS
• 4-9-2024ADDING VACCINE TO IMMUNOTHERAPY FOR LIVER CANCER SHOWS PROMISE IN EARLY TRIAL
• 4-9-2024MEASLES IS A HUMANITARIAN ISSUE, AND ITS UNWELCOME REAPPEARANCE IN CANADA IS A REMINDER OF ITS IMPORTANCE
• 4-9-2024STUDY SUGGESTS WEGOVY HELPS THOSE WITH BOTH DIABETES, HEART FAILURE
• 4-9-2024COVID-19 SHOWED THE IMPORTANCE OF COMMUNITY-ENGAGED RESEARCH
• 4-9-2024STUDY SUGGESTS LIGHT PHYSICAL ACTIVITY AS A CHILD IS KEY TO REDUCING RISK OF TYPE 2 DIABETES
• 4-9-2024FEDS JOIN RANKS OF EMPLOYERS WITH GENEROUS FERTILITY BENEFITS
• 4-9-2024MEDICAL DEBT AFFECTS MUCH OF AMERICA, BUT COLORADO IMMIGRANTS ARE HIT ESPECIALLY HARD
• 4-9-2024MORE FRUITS, VEGGIES, GRAINS WILL GET TO KIDS UNDER NEW WIC RULE
• 4-9-2024HOW CHILDHOOD STRESS INFLUENCES GENE ACTIVITY AND INCREASES THE RISK OF MENTAL ILLNESS
• 4-9-2024KNOW YOUR SPRING ALLERGENS AND THE MEDS THAT CAN HELP
• 4-9-2024RESEARCHERS COMPILE DETAILED CATALOG OF BACTERIA LIVING IN CANCER METASTASES
• 4-9-2024NURSES CITE EMPLOYER FAILURES AS THEIR TOP REASON FOR LEAVING
• 4-9-2024NO LINK BETWEEN ACETAMINOPHEN USE DURING PREGNANCY AND COGNITIVE RISKS, SAYS LARGE SIBLING STUDY
• 4-9-2024PROMOTING HEALTHY MOVEMENT BEHAVIORS IN CHILDREN UNDER FIVE IN EUROPE
• 4-9-2024FDA APPROVES NEW ANTIBIOTIC FOR THREE INDICATIONS
• 4-9-2024MORE PATIENTS ARE LOSING THEIR DOCTORS—AND TRUST IN THE PRIMARY CARE SYSTEM
• 4-9-2024RETHINKING HOW RESEARCHERS UNDERSTAND BRAIN ACTIVITY
• 4-9-2024EXPLORING ETHICAL AND LEGAL RAMIFICATIONS OF GROWING BRAIN ORGANOIDS FROM HUMAN FETAL BRAIN TISSUE
• 4-9-2024GLOBAL RESEARCH TEAM FINDS NO CLEAR LINK BETWEEN MATERNAL DIABETES DURING PREGNANCY AND ADHD IN CHILDREN
• 4-9-2024NEW INSIGHTS INTO CHOLESTEROL DYNAMICS SHED LIGHT ON NEURODEGENERATIVE DISEASE
• 4-9-2024A POTENTIAL THERAPY FOR PEOPLE WITH A RARE GENETIC CONDITION
• 4-9-2024HEPATITIS VIRUSES KILL 3,500 PEOPLE A DAY: WHO
• 4-9-2024RESEARCH CONFIRMS A SIMPLE METHOD FOR REDUCING ANGER
• 4-9-2024EVERYDAY SOCIAL INTERACTIONS PREDICT LANGUAGE DEVELOPMENT IN INFANTS
• 4-9-2024UK WORK POLICIES NOT FIT FOR PEOPLE LIVING WITH LONG COVID, SAYS STUDY
• 4-9-2024BIOMEDICAL ENGINEERS USE AI TO BUILD NEW TOOL FOR STUDYING AND DIAGNOSING HEART FUNCTION
• 4-9-2024INTRAVASCULAR ULTRASOUND OUTPERFORMS ANGIOGRAPHY FOR PERIPHERAL ARTERY DISEASE TREATMENT
• 4-9-2024IS XYLITOL FOR YOUR TEETH A SWEET TREND OR A TRUE CAVITY BLOCKER?
• 4-9-2024INTERMITTENT FASTING MAY HELP PRESERVE INTESTINAL HEALTH AS WE AGE
• 4-9-2024HEART-ON-A-CHIP MODEL USED TO GLEAN INSIGHTS INTO COVID-19-INDUCED HEART INFLAMMATION
• 4-9-2024OPIOIDS KILL, ESPECIALLY IF YOU’RE ALONE: STUDY
• 4-9-2024PREVENTIVE PERCUTANEOUS CORONARY INTERVENTION FOR HIGH-RISK CORONARY PLAQUES FOUND TO REDUCE CARDIAC EVENTS
• 4-9-2024BARBIE MAY HELP PHYSICIANS, PATIENTS HAVE MORE PRODUCTIVE TELEHEALTH VISITS
• 4-9-2024LONG COVID LEAVES TELLTALE TRACES IN THE BLOOD, FINDS NEW STUDY
• 4-9-2024INDUCING LABOR WITH DRUG VAGINALLY SHOWS BENEFITS IN STUDY
• 4-9-2024NEW STUDY EXPLORES VIDEO GAME ADDICTION RATES
• 4-9-2024NEW REVIEW PROVIDES INSIGHTS INTO THE IMPACT OF OSTEOPOROSIS AND RELATED MEDICATIONS ON FRACTURE HEALING
• 4-9-2024ACCESS TO GENOMIC MEDICINE ILLUSTRATES PRECISION MEDICINE’S DELICATE FUTURE
• 4-9-2024LOW CARDIORESPIRATORY FITNESS IN YOUTH ASSOCIATED WITH DECREASED WORK ABILITY THROUGHOUT ADULTHOOD, FINDS 45-YEAR STUDY
• 4-9-2024LOW CARDIORESPIRATORY FITNESS IN YOUTH ASSOCIATED WITH DECREASED WORK ABILITY THROUGHOUT ADULTHOOD, FINDS 45-YEAR STUDY
• 4-9-2024LOW CARDIORESPIRATORY FITNESS IN YOUTH ASSOCIATED WITH DECREASED WORK ABILITY THROUGHOUT ADULTHOOD, FINDS 45-YEAR STUDY
• 4-9-2024SOCIALLY VULNERABLE CHILDREN IMPROVE HEALTH KNOWLEDGE, WELL-BEING AFTER RESIDENTIAL HEALTH EDUCATION PROGRAM
• 4-9-2024A FRIENDLY PAT ON THE BACK CAN IMPROVE PERFORMANCE IN BASKETBALL
• 4-9-2024SINGLE-CELL PROFILE REVEALS THE LANDSCAPE OF CARDIAC IMMUNITY AND IDENTIFIES A CARDIO-PROTECTIVE YM-1HI NEUTROPHIL
• 4-9-2024LANDSCAPE OF GLOBAL URBAN ENVIRONMENTAL RESISTOME AND ITS ASSOCIATION WITH LOCAL SOCIOECONOMIC AND MEDICAL STATUS
• 4-9-2024SHORTER SCAN TO DIAGNOSE PROSTATE CANCER COULD INCREASE AVAILABILITY AND REDUCE COST
• 4-9-2024MORE PREMATURE BABIES BORN FOLLOWING SWEDISH PARENTAL LEAVE POLICY
• 4-9-2024HEART DISEASE AND DEPRESSION MAY BE GENETICALLY LINKED BY INFLAMMATION
• 4-9-2024NEW STUDY HIGHLIGHTS THE BENEFIT OF TOUCH ON MENTAL AND PHYSICAL HEALTH
• 4-9-2024TARGETING VULNERABILITY IN B-CELL DEVELOPMENT LEADS TO NOVEL DRUG COMBINATION FOR LEUKEMIA
• 4-9-2024CANNABIS USE DURING PREGNANCY LINKED TO INCREASED RISK OF ADHD, AUTISM AND INTELLECTUAL DISABILITY IN CHILDREN
• 4-9-2024ONTARIO’S PROPOSED PLAN TO BROADEN ALCOHOL SALES WILL HARM PEOPLE, SAY PUBLIC HEALTH OFFICIALS
• 4-9-2024UNDERSTANDING THE LINK BETWEEN FAMILY PHYSICIAN CHARACTERISTICS AND COVID-19 VACCINATION GAPS
• 4-9-2024RESEARCHERS IDENTIFY AN ECONOMIC SOLUTION TO CANADA’S OPIOID CRISIS
• 4-9-2024VIRTUAL REALITY SESSIONS LESSEN CANCER PAIN IN CLINICAL TRIAL
• 4-9-2024IS A SLEEP AID SUPPLEMENT SAFE?
• 4-9-2024DIABETES DRUG FOUND TO IMPROVE CARDIOVASCULAR OUTCOMES ACROSS A RANGE OF HEART AND KIDNEY CONDITIONS
• 4-9-2024APP-BASED THERAPY CAN HELP MEN WITH FREQUENT URGES TO URINATE, FINDS RESEARCH
• 4-9-2024NEUROSCIENTISTS RELEASE STATE-OF-THE-ART SPIKE-SORTING SOFTWARE
• 4-9-2024‘MINI KIDNEYS’ REVEAL NEW INSIGHTS INTO METABOLIC DEFECTS IN POLYCYSTIC KIDNEY DISEASE
• 4-9-2024WILL INTRODUCING INDEPENDENT DOCTORS AT GAMES HELP THE AFL TACKLE ITS CONCUSSION PROBLEM?
• 4-9-2024THE FIVE-STEP WELLNESS MODEL THAT REALLY WORKS—AND THE PSYCHOLOGY BEHIND IT
• 4-9-2024COULD MY GLASSES BE MAKING MY EYESIGHT WORSE?
• 4-9-2024STUDY UNCOVERS CONSEQUENCES OF MOLNUPIRAVIR USE TO TREAT COVID-19
• 4-9-20243 MARKETING MYTHS THE SUPPLEMENT INDUSTRY WANTS YOU TO SWALLOW
• 4-9-2024ACETAMINOPHEN MAY BE LESS HEART-SAFE THAN PREVIOUSLY THOUGHT
• 4-9-2024STUDY SHOWS ONE INJECTION OF NOVEL DRUG CUTS SYSTOLIC BLOOD PRESSURE BY UP TO 12 MMHG
• 4-9-2024ACCELERATED AGING MAY INCREASE RISK OF EARLY-ONSET CANCERS IN YOUNGER GENERATIONS
• 4-9-2024BIOLOGIC DRUG-DEVICE COMBINATION IMMUNOTHERAPY FOR METASTATIC PROSTATE CANCER PATIENTS
• 4-9-2024RESEARCH FINDS PREVENTIVE ANGIOPLASTY DOES NOT IMPROVE PROGNOSIS
• 4-9-2024MEDICARE PAYS FOR MESSAGE-BASED E-VISITS. ARE OLDER ADULTS USING THEM?
• 4-9-2024HAVE YOU EVER SUFFERED INTIMATE PARTNER ABUSE? WE ASKED GIRLS IN MALAWI AND 40% SAID YES
• 4-9-2024RESEARCH FINDS PRETZEL SIZE AFFECTS INTAKE BY GOVERNING HOW QUICKLY A PERSON EATS AND HOW BIG THEIR BITES ARE
• 4-9-2024PUPIL CONTRACTION INDICATES HIDDEN COGNITIVE FATIGUE IN PROLONGED ESPORTS PLAY ACROSS VARIOUS SKILL LEVELS
• 4-9-2024CALL TO REDUCE REPEAT ‘WITHIN-EPISODE’ ANTIBIOTIC PRESCRIPTIONS FOR RESPIRATORY TRACT INFECTIONS IN PRIMARY CARE
• 4-9-20247 WAYS TO USE THEM MORE SAFELY
• 4-9-2024DIFFICULTIES OF SETTING EFFICACY ENDPOINTS IN EARLY-STAGE CLINICAL TRIALS OF BRAIN TUMOR DRUGS
• 4-9-2024BISPECIFIC IMMUNE CHECKPOINT INHIBITOR IMPROVES SURVIVAL IN GASTRIC CANCER PATIENTS REGARDLESS OF PD-L1 STATUS
• 4-9-2024SCIENTISTS EXPLAIN HOW THE COVID STATES PROJECT ANALYZED THE PANDEMIC WITH OBJECTIVITY
• 4-9-2024PREOPERATIVE GLP-1 AGONIST USE DOES NOT INCREASE ASPIRATION

​
​

Hey! DGG orthodontist here, vumby in chat. DGGer since 2017. With Destiny's latest journey into the world of Invisalign a lot of tooth/face/jaw discussion has come up (VOD) in the past few months and I thought I could explain and debunk a few things while upping the Oral Health education of the community!
​
Dentist vs Orthodontist, Invisalign vs. Braces
Some discussion has been had about going to a dentist versus an orthodontist for tooth movement. It is my opinion that most dentist's are not knowledgeable enough to do orthodontics. Historically, most dentist's did not do orthodontics due to the large barrier of entry including supply, knowledge and skill required to bond braces to patients. With the invention of Invisalign, now nearly all dentist's offer some form of tooth movement because it eliminated those issues.
Invisalign has done an incredible job marketing to promote its product as faster and better than braces with easier to accomplish results (the downstream effect being the DIY companies like smiledirect). In my specialized opinion, this is not the case (source). In reality, it has only made highly specific situations easier to correct. In fact, many tooth movements are fairly inaccurate (source). The trick is that you have to actually be knowledgeable enough to be selective on the cases you treat with aligners. When aligners don't work they slip off of the teeth instead of moving them.
Unfortunately, Invisalign education for dentists is essentially non-existent. Some dental schools including my own did not require any clinical orthodontic care on a patient to graduate. Buffalo and Harvard have students just observe orthodontic residents (Harvard, Buffalo). Finding time in dental school to treat orthodontic patients when most dentists need to learn crowns, root canals, fillings and dentures is difficult.
In contrast, ortho residency requires 3700 hours of ortho lecture and patient care to graduate. Unfortunately, 95% of that education is in braces, not aligner therapy. The principles of biomechanics are the same, but the tool is quite different. I've personally found it necessary to take additional CE courses for me to feel comfortable treating these patients and have just recently gained a strong understanding of the ability and limitations of Invisalign. The best thing about being an orthodontist is that I always have braces as a backup, which the dentist does not.
When I'm selective.. Invisalign works just as well as braces.
How do teeth move?, Root resorption, & Diet vs Genetics
Teeth are really cool. Teeth do not have enamel-to-bone contact. We do not need to break the roots or jaw to move them. Teeth sit in the alveolar bone in a socket, but are connected to the bone by the periodontal ligaments. These are like little fibers all around the root of the tooth. When teeth are pushed, the ligaments get stretched on one side of the tooth and compressed on the other. The compression of the ligament promotes resorption (subtraction) of bone and the stretching promotes osteoblastic deposition (addition) of new bone (pic). You can actually create bone by moving teeth. Neat.
To stretch those fibers and move teeth only 50-250 grams of force is needed (source). Excess forces and increased duration of tooth movement can lead to a phenomenon called root resorption (pic) (source). Many teeth show mild, clinically insignificant root resorption after treatment. 14.8% of patients show severe root resorption (greater than 1/3 of root resorbed) (source). Other research shows its as low as 1-5% (source), which is closer to my clinical experience.
Our final tooth position is determined by the equilibrium of all of the small forces around our mouth contributed by our face, tongue, cheeks, food and habits. These forces change while we develop and continue to change while we age. Orthodontic tooth movement actually disrupts natural equilibrium to establish improved function and esthetics which is why retainers are especially important.
There is a lot of conjecture about why human skulls are smaller than our ancestors and why we can't fit in wisdom teeth. The truth is that there is not strong evidence, but like most human things - it's probably a combination of genetics AND environment. My best guess is that most people have a range of predetermined jaw sizes available to them which is then modulated by their environment during the growth phases especially while the skull is soft (wiki)%20(colloquially%2C%20soft%20spot)%20is%20an%20anatomical%20feature%20of%20the%20infant%20human%20skull%20comprising%20soft%20membranous%20gaps%20(sutures)%20between%20the%20cranial%20bones%20that%20make%20up%20the%20calvaria%20of%20a%20fetus%20or%20an%20infant). Hard foods and breast feeding initiated and terminated at proper times is linked to improved tooth position (pilot study). In contrast, we know bad habits like thumb-sucking beyond appropriate ages will negatively impact the position of jaws and teeth (pic).
What is mewing? Is it real?
Mewing is a fad, fueled by the pseudoscience “orthotropics”. Like all pseudoscience it hinges on just enough truth to make it believable. The figurehead, Mike Mew is currently being taken to court) for false claims and patient damages.
The truth is that as children the bones of our skull grow at aspects called “sutures”. Pressure at the sutures allows our skull to adapt to changes in size of our muscles and organs. If sutures didn't exist or don't work this happens: (wiki)). One such muscle that influences bone growth at a suture (pic) (pic) is the tongue. With proper tongue posture the tongue should sit at the roof of the mouth and hold its width. If not, the counter-pressure from the cheeks will collapse the width. Children with typical tongues tend to also breathe nasally and the passage of air actually helps develop the face as well (source) (pic). After the age of 12, sutures are mostly fused bone-to-bone contact (source) and tongue pressure alone will not widen the maxilla (upper jaw). As the skeleton matures and growth is completed there is nothing left to modulate. The theory of Mewing relies on a misunderstanding of growth and development combined with deceptive photography as evidence. (pics: temporary changes in posture, lighting, weight loss + exercise > reddit comment where he claims he lost 8% bodyfat)
Now that we understand more about bones, teeth and growth; here are Mike Mew's radical claims on facial changes you can expect in an adult with mewing: Video, 6M views, 3 months
If you have issues with speech, or don't like the way your face or teeth look find an orthodontist :)
This was longer than I expected it to be, but let me know if you want to know about anything else. Also I've been trying to get that sweet health professional flair in chat... drvumby out.

This is a strong article that gives an overview of different RPG culture and some brief history. I wouldn't organize mine in quite the same way, but I think a lot of people on this sub would do well by engaging with wider RPG design and history.

In this post I am going to present the taxonomy of the six main play cultures as well as a few notes about their historical origins. I am doing this to help people from different play cultures both understand their own values better as well as to encourage stronger and more productive cross-cultural discussion.
There are at least six main cultures of play that have emerged over the course of the roleplaying game hobby. There may be more: my analysis is mainly restricted to English-language RPG cultures, tho' at least three of them have significant non-English presences as well. In addition to these six cultures, there's a proto-culture that existed from 1970-1976 before organisation into cultures really began.
A culture of play is a set of shared norms (goals, values, taboos, etc.), considerations, and techniques that inform a group of people who are large enough that they are not all in direct contact with one another (let's call that a "community"). These cultures of play are transmitted through a variety of media, ranging from books and adventures to individuals teaching one another to magazine articles to online streaming shows. A culture of play is broadly similar to a "network of practice" if you're familiar with that jargon.
Individuals in the hobby, having been aligned to and trained in one or more of these cultures, then develop individual styles. I want to point out that I think talking about specific games as inherently part of some culture is misleading, because games can be played in multiple different styles in line with the values of different cultures. But, many games contain text that advocates for them to be played in a way that is in line with a particular culture, or they contain elements that express the creator's adoption of a particular culture's set of values.
The Six Cultures
1) Classic
Classic play is oriented around the linked progressive development of challenges and PC power, with the rules existing to help keep those in rough proportion to one another and adjudicate the interactions of the two "fairly". This is explicit in the AD&D 1e DMG's advice to dungeon masters, but recurs in a number of other places, perhaps most obviously in tournament modules, especially the R-series put out by the RPGA in its first three years of operation, which emphasize periodic resets between sections of the adventure to create a "fair" experience for players as they cycle around from tournament table to tournament table playing the sections.
The focus on challenge-based play means lots of overland adventure and sprawling labyrinths and it recycles the same notation to describe towns, which are also treated as sites of challenge. At some point, PCs become powerful enough to command domains, and this opens up the scope of challenges further, by allowing mass hordes to engage in wargame-style clashes. The point of playing the game in classic play is not to tell a story (tho' it's fine if you do), but rather the focus of play is coping with challenges and threats that smoothly escalate in scope and power as the PCs rise in level. The idea of longer campaigns with slow but steady progression in PC power interrupted only by the occasional death is a game play ideal for classic culture.
This comes into being sometime between 1976-1977, when Gygax shifts from his early idea that OD&D is a "non-game" into trying to stabilise the play experience. It starts with him denouncing "Dungeons and Beavers" and other deviations from his own style in the April 1976 Strategic Review, but this turns into a larger shift in TSR's publishing schedule from 1977 onwards. Specifically, they begin providing concrete play examples - sample dungeons and scenarios, including modules - and specific advice about proper play procedures and values to consumers.
This shift begins with the publication of Holmes Basic (1977) and Lost Caverns of Tsojcanth (1977), before eventually culminating in AD&D (1977-1979) and the Mentzer-written BECMI (1983-1986) line. Judges Guild, the RPGA, Dragon Magazine, and even other publishers (e.g. Mayfair Games) get on board with this and spread Classic norms around before Gygax and Mentzer leave TSR in late 1985 / early 1986. Judges Guild loses its license to print D&D material in 1985, and the RPGA's tournaments have shifted away from classic play by about 1983. Most of the other creators at TSR have shifted to "trad" (see below) by the mid-1980s, and so the institutional support for this style starts dries up, even tho' people continue to run and play in "classic" games.
Classic is revived in the early 2000s when the holdouts who've continued to play in that style use the internet to come together on forums like Dragonsfoot, Knights and Knaves Alehouse, and others, and this revival is part of what motivates OSRIC (2006) to be released. NB: This is the only name in this essay where it's not an autonym used by the practitioners themselves, tho' Gus L. of All Dead Generations is interested in many of their ideas and does call his own style "Classic".
One weird quirk of history is that people who were trying to revive classic in the early 2000s are often lumped into the OSR, despite the two groups really having distinct norms and values. Some of the confusion is because a few key notable individuals (e.g. Matt Finch) actually did shift from being classic revivalists to being early founders of the OSR. Because both groups are interested in challenge-based play, even if they have different takes on challenge's meaning, there are moment of productive overlap and interaction (and also lots of silly disputes and sneering; such is life).
This intermingling of people from different play cultures who initially appear to be part of the same movement but turn out to be interested in different things is pretty common - story games and Nordic LARP go through a similar intermingling before they split off into different things (more on that in a sec).
2) Trad (short for "traditional")
Its own adherents and advocates call it "trad", but we shouldn't think of it as the oldest way of roleplaying (it is not). Trad is not what Gary and co. did (that's "classic"), but rather is the reaction to what they were doing.
Trad holds that the primary goal of a game is to tell an emotionally satisfying narrative, and the DM is the primary creative agent in making that happen - building the world, establishing all the details of the story, playing all the antagonists, and doing so mostly in line with their personal tastes and vision. The PCs can contribute, but their contributions are secondary in value and authority to the DM's. If you ever hear people complain about (or exalt!) games that feel like going through a fantasy novel, that's trad. Trad prizes gaming that produces experiences comparable to other media, like movies, novels, television, myths, etc., and its values often encourage adapting techniques from those media.
Trad emerges in the late 1970s, with an early intellectually hub in the Dungeons and Beavers crew at Caltech, but also in Tracy and Laura Hickman's gaming circle in Utah. The defining incident for Tracy was evidently running into a vampire in a dungeon and thinking that it really needed a story to explain what it was doing down there wandering around. Hickman wrote a series of adventures in 1980 (the Night Verse series) that tried to bring in more narrative elements, but the company that was supposed to publish them went bust. So he decided to sell them to TSR instead, and they would only buy them if he came to work for them. So in 1982, he went to work at TSR and within a few years, his ideas would spread throughout the company and become its dominant vision of "roleplaying".
Trad gets its first major publication articulating its vision of play outside of TSR in Sandy Petersen's Call of Cthulhu (1981), which tells readers that the goal of play is to create an experience like a horror story, and provides specific advice (the "onion layer" model) for creating that. The values of trad crystallise as a major and distinct culture of play in D&D with the Ravenloft (1983) and Dragonlance (1984) modules written by Hickman. TSR published Ravenloft in response to Call of Cthulhu's critical and commercial success, and then won a fistful of awards and sold tons of copies themselves.
Within a few years, the idea of "roleplaying, not rollplaying" and the importance of a Dungeon Master creating an elaborate, emotionally-satisfying narrative had taken over. I think probably the ability to import terms and ideas from other art forms probably helped a great deal as well, since understanding trad could be done by anyone who'd gone through a few humanities classes in university.
Trad is the hegemonic culture of play from at least the mid-1980s to the early 2000s, and it's still a fairly common style of play. For an example of a fairly well-thought through style of trad by someone who's been influential on the last 15 or so years, check out S. John Ross's RPG Lexicon.
Both of the next two styles emerge out of problems with trad, especially the experience of playing Vampire (a tradder-than-trad game in its authors' aspirations), but the details of that are larger than this essay can contain so I'm just going to mention it and leave it for another time.
3) Nordic Larp
This is again an autonym. The "Nordic" part is more about origins and mass of the player base than a true regional limitation of any sort. The "Larp" designation is part of the name for reasons that are unclear to me, even tho' its ideas started in tabletop roleplaying, and its philosophy and aspirations are realisable in tabletop games just as much as in dress-up games. (Edit: Spelling it as if it wasn't an acronym is a shibboleth of Nordic Larp, so in keeping with the autonym principle I've edited it to follow that convention when referring to the culture, but kept the activity as LARP)
Nordic Larp is built around the idea that the primary goal of a roleplaying game is immersion in an experience. Usually in a specific character's experiences, but sometimes in another kind of experience where player and character are not sharply distinguished - the experimental Jeep group often uses abstract games to affect the player directly. The more "bleed" you can create between a player and the role they occupy within the game, the better. Nordic Larps often feature quite long "sessions" (like weekend excursions) followed by long debriefs in which one processes the experiences one had as the character.
Embedding the player's character within a larger story can be one way of producing vivid, absorbing experiences, but it's not necessary and may even interfere with pulling it off (especially when done badly). Nordic Larp players emphasise their collaborative aspects, but when you drill into this, it's a rejection of trad's idea of a single DM-auteur crafting an experience, and the collaboration is there in service of improving immersion by blending player and character agency more thoroughly.
I think LARP conjures up images of people doing fantasy cosplay, and there are sometimes elements of that in some Nordic Larps, but I actually think the trend has been away from fantastical games to scenarios and set-ups that are closer to real life since it allows the incorporation of modern architecture, technology, and other details from the real world to facilitate immersion.
Nordic Larp's first major publication that I know of is the very self-conscious Manifesto of the Turku School by Mike Pohjola in 2000, and I think the early community is in dialogue with the Forge crew, tho' the two groups have very different ideals of play. By 2005 you have specific groups like Jeep developing these ideas, and in 2010 you get the publication of the Nordic Larp book. Nowadays there's also a wiki and an official website.
Nordic Larp is the part of roleplaying that seems to receive the most grants and funding for academic study. I'm never sure why, tho' I suspect some of it has to do with the interest in commodifying LARP ideas to create immersive entertainment experiences for tourists at mega-resorts in the Gulf Cooperation Council countries. I'm not going to link to any specific individuals connected to Nordic Larp who have jobs there to avoid doxing private individuals, but they exist (please don't dox anyone in the comments, either).
4) Story Games
Again, an autonym. Most people who dislike them call them stuff like "Forge games" or "post-Forge indies" after the Forge indie RPG forums. "Indie RPGs" was a term for these at one point as well, but I don't think it was particularly distinctive or edifying, and evidently neither did the adherents to this culture since they mostly abandoned it. Here's a post discussing the origin of the term "story game" from Across the Table.
The Big Model is notoriously obtuse and post-Forge theory has a lot of ideas I strongly disagree with, but I think a fair characterisation of their position that doesn't use their own terminology is that the ideal play experience minimises ludonarrative dissonance. A good game has a strong consonance between the desires of the people playing it, the rules themselves, and the dynamics of the those things interacting. Together, these things allow the people to achieve their desires, whatever they may be. "Incoherence" is to be avoided as creating "zilch play" or "brain damage" as Ron Edwards once called it.
The story games crowd, to their credit, is willing to be very radical in terms of techniques towards that end - both the mechanics proper and the development of positions (story gamers often call them "Creative Agendas") like "narrativism" are meant to produce consonance and avoid dissonance on as many levels as they can picture it happening.
Story games starts with Ron Edwards in 1999, when he writes System Does Matter and sets up the Forge. By 2004 you have the Provisional Glossary and the Big Model, and one million arguments on the internet about what is or isn't "narrativist" and how much brain damage RPGs are causing, etc. The Story games forums themselves are founded in 2006 as a successor to the Forge. For the past decade, the big cluster of story game design has tended to orient itself around "Powered by the Apocalypse" games patterned after or building on Apocalypse World by Vincent Baker.
BTW, if you want a great example of someone applying the cultural norms of story games to a game that was written to be played in a trad way, The Sacrament of Death by Eero Tuovinen describes his experiences doing just that.
5) The OSR ("Old School Renaissance / Revival")
Yes, it's this late in this chronological listing. And yes, the OSR is not "classic" play. It's a romantic reinvention, not an unbroken chain of tradition.
The OSR draws on the challenge-based gameplay from the proto-culture of D&D and combines it with an interest in PC agency, particularly in the form of decision-making. The goal is a game where PC decision-making, especially diegetic decision-making, is the driver of play. I think you can see this in a very pure form in the advice Chris McDowall gives out on his blog for running Into the Odd and Electric Bastionland.
An important note I will make here is to distinguish the progressive challenge-based play of the "classic" culture from the more variable challenge-based play of the OSR. The OSR mostly doesn't care about "fairness" in the context of "game balance" (Gygax did). The variation in player agency across a series of decisions is far more interesting to most OSR players than it is to classic players.
The OSR specifically refuses the authoritative mediation of a pre-existing rules structure in order to encourage diegetic interactions using what S. John Ross would call "ephemeral resources" and "invisible rulebooks", and that the OSR calls "playing the world" and "player skill", respectively. Basically, by not being bound by the rules, you can play with a wider space of resources that contribute to framing differences in PC agency in potentially very precise and finely graded ways, and this allows you to throw a wider variety of challenges at players for them to overcome. I could write an entire post on just what random tables are meant to do, but they tie into the variance in agency and introduce surprise and unpredictability, ensuring that agency does vary over time.
I tend to date the start of the OSR from shortly after the publication of OSRIC (2006), which blew open the ability to use the OGL to republish the mechanics of old, pre-3.x D&D. With this new option, you had people who mainly wanted to revive AD&D 1e as a living game, and people who wanted to use old rule-sets as a springboard for their own creations. 2007 brought Labyrinth Lord, and the avalanche followed thereafter. The early OSR had Grognardia to provide it with a reconstructed vision of the past to position itself as the inheritors of, it had distinct intellectual developments like "Melan diagrams" of dungeons and Chris Kutalik's pointcrawls, and I would say it spent the time between 2006 and roughly 2012 forming its norms into a relatively self-consistent body of ideas about proper play.
6) OC / Neo-trad
This is the only one of the terms that isn't fully an autonym, tho' "OC" can be appended to a "looking for game" post online to recruit people from this culture consistently, so it's closer. I also call it "neo-trad", firstly because the OC RPG culture shares a lot of the same norms as trad, secondly because I think people who belong to this culture believe they are part of trad. You also see this style sometimes called "the modern style" when being contrasted to the OSR. Here's an example of someone who calls it "neo-trad" elaborating a very pure vision of the style (tho' I disagree with the list of games provided as examples of neo-trad at the end of the article). On Reddit, "OC" is often called "modern" as in "the modern way to play" or "modern games".
OC basically agrees with trad that the goal of the game is to tell a story, but it deprioritises the authority of the DM as the creator of that story and elevates the players' roles as contributors and creators. The DM becomes a curator and facilitator who primarily works with material derived from other sources - publishers and players, in practice. OC culture has a different sense of what a "story" is, one that focuses on player aspirations and interests and their realisation as the best way to produce "fun" for the players.
This focus on realising player aspirations is what allows both the Wizard 20 casting Meteor Swarm to annihilate a foe and the people who are using D&D 5e to play out running their own restaurant to be part of a shared culture of play. This culture is sometimes pejoratively called the "Tyranny of Fun" (a term coined in the OSR) because of its focus on relatively rapid gratification compared to other styles.
The term "OC" means "original character" and comes from online freeform fandom roleplaying that was popular on Livejournal and similar platforms back in the early 2000s. "OC" is when you bring an original character into a roleplaying game set in the Harry Potter universe, rather than playing as Harold the Cop himself. Despite being "freeform" (meaning no die rolls and no Dungeon Master) these games often had extensive rulesets around the kinds of statements one could introduce to play, with players appealing to the ruleset itself against one another to settle disputes. For the younger generations of roleplayers, these kinds of games were often their introduction to the hobby.
I think OC RPG emerges during the 3.x era (2000-2008), probably with the growth of Living Greyhawk Core Adventures and the apparatus of "organised play" and online play with strangers more generally. Organised play ended up diminishing the power of the DM to shift authority onto rules texts, publishers, administrators, and really, to players. Since DMs may change from adventure to adventure but player characters endure, they become more important, with standard rules texts providing compatibility between game. DM discretion and invention become things that interfere with this intercompatibility, and thus depreciated. This is where the emphases on "RAW" and using only official material (but also the idea that if it's published it must be available at the table) come from - it undermines DM power and places that power in the hands of the PCs.
These norms were reinforced and spread by "character optimization" forums that relied solely on text and rhetorically deprecated "DM fiat", and by official character builders in D&D and other games. Modules, which importantly limit the DM's discretion to provide a consistent set of conditions for players, are another important textual support for this style. OC styles are also particularly popular with online streaming games like Critical Role since when done well they produce games that are fairly easy to watch as television shows. The characters in the stream become aspirational figures that a fanbase develops parasocial relationships with and cheers on as they realise their "arcs".
No Quizzes, No Buckets When I first presented these on a forum, someone joked that I ought to create a quiz for people to determine which culture they belonged to, but I'd rather not. Truthfully, I think most individual gamers and groups are a blend of cultures, with that blend realised as an individual style. The play cultures are more like paradigms - they cohere at the level of value and reflection on what "excellent play" could mean (put more formally, they share teloi of play). To be a part of a play culture is in some sense the capacity to recognise when someone else is playing in accord with a set of values you share with them.
My main purpose in the above taxonomy is to help people better understand that there are distinct paradigms of play that esteem different things, tho' they can be sutured together (with all sorts of fun results) in concrete situations. I doubt this list is exhaustive, and there are probably cultures I've left out as well as ones that are yet to emerge. The purpose of the list is mainly to briefly illustrate that there are many different values of play, and to discuss the logic animating some of the more well-known ones.
The original purpose of this essay was to talk about OC roleplaying, since I think it's the least well-characterised out in the wild, and most characterisations are relatively pejorative (see the above "tyranny of fun"). There also tends to be a lot of confusion between people working within the paradigm of OC and trad, since they often use the same terms to refer to very different things.
Also, without wanting to be a jerk, OC roleplaying tends to be the default paradigm of new players coming to the hobby through streaming, and thus has the largest group of people who are low-skill and ignorant of the history of roleplaying. I'm hopeful that articulating their values and relation to the larger hobby will encourage them to develop OC roleplaying culture in interesting and robust ways, while also steering them away from arrogance about the universality of their vision.
I am hopeful that the above taxonomy will help people to apprehend and navigate the differences between cultures and styles rather than constantly running into dead-ends as it turns out that the baseline assumptions about play that one is working from simply aren't shared with one's interlocutor(s).
I unfortunately can't respond to comments on the blog directly, so if people leave comments or questions about the above taxonomy, I will collect them up and respond in a blog post.

I’m scared and confused why no one is worried and leave me to wait for 6m to follow up? Given margin came back positive and cin3 extending to the endocervical area? Had my first abnormal pap result with hpv 16 & 18 - cin1 that jumped to cin3 in the space of 1 year, had leap for that and now they found cin3 in the endocervical area in my understanding?
CLINICAL HISTORY LEEP for TI TZ HSIL on Bx. cervix. Histology MACROSCOPY
ILETZ stitch 12 oclock: An oriented cervical excision 20 × 18 × 10 mm (3-9 oclock by 12-6 oclock by depth), oriented with a suture marking 12 oclock. Ectocervical mucosa is gray and smooth, with an incomplete os 10 x 6 mm. Macroscopic photo taken and available. Inking 12 oclock blue, 6 oclock black. The specimen is serially sectioned from 3-9 oclock and all processed into 6 blocks.
MICROSCOPY Sections of cervical LET biopsy include ectocervix and endocervix. The squamous epithelium of the transformation zone, in a span of at least 1 mm (block 1B2), shows atypical cells with high nuciear to cytoplasmic ratios, occupying more than two thirds of the total canning thickness of the epithelium. The cells have 111-defined boundaries and scanty cytoplasm, resulting in loss of polarity and nuclear crowding.
The nuclei are large, irregular and hyperchromatic and show clumping of chromatin. There is minimal flattening of the surface layers where there are focal koilocytic changes. Mitotic figures are present at all levels with a few asymmetric forms. The endocervix appears 'shredding unremarkable.
There is no evidence of stromal invasion The high-grade p16+ dysplastic epithelium extends to the endocervila) margin (of the 12 oclock half) and measures more than 8 mm from the corresponding ectocervical squamous margin.
CONCLUSION LLET?, cervix: High-grade squamous intraepithelial lesion (CIN III/HPV), extending to the endocervical margin

Note: I am finishing up 37 as we speak. Should be posted within 12 hours.
Edit: ALSO!!! Thank you to u/tulpacat1 and u/cruisingNW and u/JulianSkies for their comments and suggestions and so on. Always glad to have help ironing out the kinks.
Patreon / Kofi/ Paypal
[Prev][First][Next]
Memory transcription subject: Andes Savulescu-Ruiz, Human Director at the Venlil Rehabilitation and Reintegration Facility. Patient ignoring care recommendations.
Date [standardized human time]: December 10, 2136
I woke up to a couple dozen venlil eyes intently watching me. It nearly gave me a heart attack. My whole body tensed up, and that's when I felt that I was not the only person on the couch. Lihla had curled up against me, and was hugging one of my arms.
When did she get here? How long was I out? I could, of course, not use changes in the sunlight as a guide, because VP’s star just hung stationary in the sky making you question your life choices. It took me a moment to spot one of the human clocks. It was three in the morning for me.
“Ah. Um… Hm…” I felt around for my pad and activated its external translator. “Hi, kids. Want your couch back?” I asked with a yawn. The questions began to pour in the second I gave signs of life.
“How did you get hurt?”
“Will there be a new savageness?”
“Did you save us from the old bosses?”
My brain could not handle the cuteness, or existential anxiety, that early in the morning.
“...The old bosses weren't the ones that attacked,” I said, addressing them in order of most recent. I didn’t actually know the Arxur hadn’t attacked, but it seemed like the safest possible bet if they were out of the bunkers and asking questions. “I’m still the Director, even if I’m hurt. And I got hurt trying to save a kid like you from a car.”
They broke out into whispers. Lihla stayed curled up against me, making it infinitely harder for me to leave the comfort of the couch and the warm blanket that–Who put this blanket on me?
I closed my eyes as my head tried to catch up to the situation. I still felt a little like there was a thought-action delay, as if the connection between my body and my brain was suddenly operating on less bandwidth. I opened my eyes again, then leaned in closer to Lihla.
“Hey… Little lamb…” I whispered. “I have to get up…”
She let out a little groan, then turned to me and pressed her head against my chest, looking up at me with those big, adorable eyes.
“Are you going to kill them?”
What the fuck? My heart rate skyrocketed. It took me a moment to realize what she was actually asking. Her sisters. The ones who snuck out. Right. She was being cute on purpose, to try to earn mercy for her sisters.
“No, Lihla,” I told her, trying to keep my voice soft and gentle. “I’m not going to kill anyone.”
She clung more tightly to my arm. “I knew you were a good boss…”
It took a moment for her to let go. Then she groggily rubbed her eyes and got off the couch, allowing me to maneuver myself over to the wheelchair. It was annoying. At least I was getting an arm workout out of all of this. Even with smooth sliding and unfolding, the act of getting off a couch with only one functional leg and getting onto a wheelchair had a thousand little failure points—wrong angle for the wrist, remember to put on the brakes or it’ll slide back—immediately frustrating me.
Lihla stayed there, watching me the whole time. “What will you do?”
I finished fiddling with the wheelchair’s armrests and took a long deep breath. “I am going to find them. And then I am going to bring them back here.”
“Did they break you?” Lihla asked, pointing at the temporary brace on my leg.
“...No. This was from a car, like I said. But look, now we can be brace-buddies for a little bit,” I said with a chuckle, gesturing at her own leg brace.
“Brace buddies…” she echoed, like I had bestowed upon her some great arcane knowledge. Looking at her leg, she probably wouldn't need it for much longer. She just wandered around like normal at this point, barely favouring the injured leg.
“I need to go get a different brace now,” I told her. "One that can help me move more, like yours."
She nodded quickly and scurried away before I could ask her if she wanted to come with me. Well, okay then. Once I was finally wheeled up, I rolled over to the “emergency room” which now seemed to have been converted back into a lobby, and headed to the medical treatment rooms.

Memory transcription subject: Larzo, Yotul geneticist at the Venlil Rehabilitation and Reintegration Facility.
Date [standardized human time]: December 10, 2136
I had just finished returning some supplies to a storage-room when I spotted Andes in a wheelchair, propelling himself forward with his long, veiny human arms. He looked like the arena where death had been in a violent altercation with medicine, and while it had ultimately lost, it got in quite a few good kicks.
“Hey, how are you doing?” he asked. I scoffed and stared at him in disbelief.
“How am I–Andes! You are in recovery! What are you doing?” I asked back, gesturing at his wheelchair-bound situation, and his presence in the clinical area of the facility. Not to mention the fact that he was conscious. Do I need to sedate him?
“Looking for my custom leg brace, it should be ready by now, right?” he said, with the voice of a man who had not at all been run over by a car six hours earlier. It was absurd. I simply blinked in startled befuddlement.
“...Well, yes, I can assemble it, but–it was my understanding humans need eight hours of sleep for optimal functioning. And more when injured. You have had four at most. Likely less than three. There have been no new developments. You should be resting.” My arms tensed up and my paws tightened into fists at the frustration. You would think someone who monitors his health so closely would care about it when it was in its greatest jeopardy.
He frowned, tilting his head a few degrees and looking at me like a curious hensa. “How much do Yotul sleep?”
This is what you want to discuss? “It varies. I tend to do best with short bursts on a daily basis, and the occasional very long sleeping period. But never as much as eight human hours.”
That seemed to satisfy some other question he had in his mind. I wound around to the back of his chair to drive him to one of the clinic rooms. Better make the best of this situation. “You’re awake now, so let’s get your custom brace on you. It should make sleep come easier.”
Once inside the room, he had to limp his way to the bed awkwardly. He moved his right arm in a strange fashion when leaning down. Probably damage to the elbow, there was visible bruising but he might have damaged a ligament as well. I’d have to get the scanner later to check, the leg took precedence. Once he was lying down, I put up some cushions to elevate his leg, and started to remove the brace.
“How are you feeling?” I asked, as officially and respectably as I was able. Perhaps some vague impression of authority would get him to cooperate? He groaned.
“Tired.”
“To be expected. You did not sleep enough,” I told him with a stern glare. “You are healing. It requires rest.”
“I know, I know…”
I finished taking off the brace and looked over his incisions. With a clearer head and imminent death no longer on the horizon, I could appreciate that the suture-aids had done a fantastic job. He had minimal bruising and no tearing of any sort. A couple of afternoons’ laser treatments would ensure there was not even a scar to show for it.
“Do you have any lingering pain?” I asked, tracing up and down the incision with the round face of my claw. He said nothing, simply hissed in pain when I approached the injection ports. As expected, of course. The nerves should distribute more evenly over the coming weeks with use and physical therapy, perhaps with some additional electrical stimulation if he wanted optimal results. “Can you check your mobility and internal sensory feedback?”
He sighed, then took a long deep breath in preparation. A moment later, he was wiggling those ridiculous tiny human toes. They look vestigial! In strong contrast to human hands, their feet’s digits were rather amusing little nubs. I successfully did not laugh at them.
“Enough to tell the nerves are doing well,” he said with a wince, then allowed his foot to relax.
“I’ll be back with the brace, do not leave,” I told him in my most severe tone, pointing an accusatory digit at his sternum. I was quite certain that, were he left to his own devices without the reminder, he was liable to go hopping on one leg over to the cafeteria for some of his protein sludge.
I took as little time as possible fetching the brace. Once Clarice told me Andes had fallen asleep, I’d taken the liberty of choosing a more time-consuming design, and as luck would have it, it was freshly finished printing and coating. Knowing him, the more athletic model would ensure he used it regularly.
When I got back, he had changed his entire posture, twisting up and putting unnecessary tension on his hamstrings for absolutely no reason but impatience. I nearly harrumphed in indignation and thought back to Rodriguez’s words. Doctors make the worst patients, indeed.
“I barely moved,” he spat defensively, gesturing vaguely towards the bed. “I just had to check my implant’s diagnostics. Between the bleeding and the adrenaline and… the painkillers, and so on, I need to make sure everything is good.”
“I see…” I said. I walked closer to him and craned my neck up to look at his pad. I could read nothing, for it was all in English, but I was impressed by the number of things being measured. Everything was shown in colourful little charts, and he flipped through them with ease. I could imagine some obvious variables–blood sugar, cortisol, perhaps something with his immune system?–but others left me befuddled. The main menu he returned to a few times was a whole-body model of him, divided by sections, which could in turn be divided by organs. “Astonishing… So many measurements… And this implant, how large is it?”
“Oh, it’s tiny,” he said, holding out his fingers apart at a distance a little thicker than his thumb. “It’s a little ball with a pretty elastic skeleton and a way to get material from the body through blood and interstitial fluid. Folds up into a tube going in, thankfully, but once it’s inside it stretches out and adapts to its… uh… environment.”
I tilted my head a little, and gave him an ear-flick. “I see…”
The way he said that made me want to ask more about the implant’s environment. According to that diagram, it was located somewhere in his abdomen, though he was now looking over some radial charts instead. I decided not to ask. I had already stepped too much into the position of “doctor” and away from “friend”. As Andes’ friend, I should not pry; and as his colleague, I trusted him to volunteer relevant medical information should it be necessary. Still, a gentle prod couldn’t hurt…
“You’ll have to show it to me in more detail at some point,” I said. Even as a matter of idle curiosity, I might want one of my own.
He shrugged and leaned back once he was satisfied with his evaluation of the implant’s information. “Alright, everything looks… Not okay, but on its way there.”
“I’m glad to hear it,” I said, as I repositioned his leg on the pillows. Assembling the brace was easy enough. The material was cleverly designed to function largely like cloth until its ‘bones’ were activated. I hooked one end under his heel and handed him the other to loop up over his hip. It was designed to shift a lot of effort to its mechanical structures, or to his thigh, keeping the knee joint from receiving a lot of strain while providing pressure on around the lower leg to ensure a good environment for the bone paste.
I activated the bones and adjusted the pressure gradient. “Let it adjust for a moment and we will test mobility. I have painkillers for you to choose from, along with their profiles, give me a moment…”
Given how little I knew about human endocrinology, I was infinitely glad that Andes understood a great deal of it, and so could make an informed decision about pain management. He discarded all those that would impair his judgement (perhaps prematurely, I thought, as that would enable him to rest). He also discarded all those that were known to be habit-forming, and those that would impair his motor control. We eventually settled on a refillable dermal patch, based on it being “slow,steady and local” and proceeded to test his capacity to walk on crutches. He could–barely–and I insisted he use the chair as much as possible over the coming days.
“You should not be working at all,” I added, driving him towards the cafeteria for his first meal in at least six hours, potentially twelve.
“It’s just a leg–”
I waved my paws in outrage. “Just a region of major blood vessels, he says! While working with a hodge-podge of emergency blood! Not to mention a new bone, impairment from the surgical anaesthetics, a concussion–”
“Look, the first couple of days after someone goes missing are the most important, and Karim has neither the time nor the skillset,” he said, standing up on his crutches to use the blender for his daily protein sludge. “I don’t even know if he’s here right now. And anyway, I’m pumped full of neurogenic agents, it wasn’t a bad concussion. There was no vomiting, vision was unaffected–”
“Make Rodriguez do it!” I spat. She could organize a search party. She was capable, steady, and not in recovery from being hit by a car.
He scoffed. “She’s already got her hands full between the kids, and the nurses, and handling the bunker situation, and making sure there isn’t another stampede.”
I crossed my arms, emulating a human gesture of disapproval. “Why are you qualified to do this, anyhow? The UN should send someone.”
“The UN’s someones are also busy. We should get one soon, though. Chiaka’s on it, ”he said, showing at least a modicum of sense. He served the protein shake in a tall glass with a straw. The turning motion hitched because of his bruised elbow, and he completely ignored it. “There was a stampede yesterday, Larzo. They still haven't found all the dead.”
I took a deep breath and let it out slowly. He was right, but they were not my responsibility. He was my patient, and so he was. “Very well. But as your current doctor I insist that you delegate as much as you possibly can.”
“I will delegate,” he said with a groan. He was probably finding my demands tiresome, but as he could hardly stand and was placing nearly all of his weight on his left arm, I believed my concerns were entirely justified.
Once he was back on the wheelchair with his daily sludge I wheeled him over to the table before getting my own meal. We ate mostly in silence, a stark contrast to how talkative Andes tended to be. I was busy enough carefully observing his movements for new impairments that it didn’t bother me, but it did bode ill. Despite the callous way with which he was treating his need for recovery, some part of him clearly understood that he had a limited amount of energy, and sought to conserve it.
Whatever part of him knew, though, it had little hold on his higher faculties. He insisted on working, taking calls and checking his pad, all the while continuing to sip his sludge “on the go” as I drove him to his office.

Memory transcription subject: Andes Savulescu-Ruiz, Human Director at the Venlil Rehabilitation and Reintegration Facility. Patient ignoring care recommendations.
Date [standardized human time]: December 10, 2136
Larzo continued to push me around. It was kind of annoying how he kept just kind of wheeling me places before we’d actually hashed out where I wanted to go, but he was right that I wanted to go to my office, so I tried to ignore it. It gave me a chance to check on Security’s search-party with my pad, anyway. They were updating a map of places they’d looked; but other than that, there wasn’t really any news. On the way to my office we passed by Karim’s. He was sitting at his desk looking more exhausted and frazzled than I’d ever seen a venlil, and I’d seen some pretty exhausted nurses by that point. Then I realized I probably looked worse. I hadn’t really paid attention to any reflective surfaces to check either way. He perked up when we moved past his window, and rushed after us just as I was opening my door.
“Andes! Thank goodness you’re awake!” he bleated, his whole body sagging down as if he’d just let go of a very heavy weight. “That madwoman, the one you called, with the predator-trackers–”
My heart skipped a beat and I stared at him in horror. What did you do?
“–she said she’d be here in a quarter-claw.”
…Was Karim… Helping?
“She did?” I asked, more shocked that he was the one delivering the news than anything else.
“Yes,” he said. “Told me to greet her if you weren’t conscious. I understand desperate times call for desperate measures, but I have my limits. You’ll have to greet her, or tell someone else to.”
“...Yeah… Um, of course,” I said, briefly wondering if I was still unconscious on the couch and was about to wake up any second now.
“Clarice gave me this list,” he said, pulling up his pad. “The camera drone is supposed to arrive soon with the UN envoy, and the security search party hasn’t found anyone yet.”
“Yeah I saw—did she find anyone who can fly a camera drone?”
“Yes, Jilsi’s waiting for their arrival.”
I blinked. “...Jilsi?”
He flicked an ear at me. “Of course. She’s in the top fifteen percent of players on the planet, Andes. It’s one of the reasons I hired her, that kind of thing shows dedication. Patience.”
“...I’m still awake, right?” I asked Larzo. Everything felt just fuzzy enough that the dream hypothesis was too plausible for my liking.
“I’ll get you some electrolyte water and an acetylcholine antagonist,” he said in response, pointing at my sternum with an accusatory digit and as he flashed me a glare. “Do not move.”
Karim glanced at him approvingly as he went by. “You know, your Yotul pet did incredibly well in your absence.”
There it is. “Larzo always does well. And… Don’t call him that.”
He gave me some gesture with his tail that could have been an apology or a middle finger and I wouldn’t have known the difference.
“No matter. Please tell me that, despite your heroics, you will be able to take over the search for the girls, Andes. The venlil are not persistence predators, I need to go home; or at least sleep.”
I gave a tentative nod. “...Yeah, I um… It should be fine. Thanks for holding down the fort, talking to Chiaka.”
“...You’re welcome,” he said, and trudged back into his office.
I called Chiaka and she picked up immediately.
“Hey did you–”
“I am almost at the facility. The UN is actually in favour of this, as a controlled field-test. I have your drones. We’ve set up our three oldest, best-behaved dogs. They’re still very young, but they’ll be under control. Good news? They’ve been letting people out of the bunkers in waves to avoid another stampede, and told me they’re slowing down your area of the city to avoid a panic.”
It took a moment for me to process everything. “...Good news? Is there bad news?”
“Yeah, you owe Olivier a favour now. I owe him three.”
The chuckle came out of me entirely by surprise. “What? That—that’s fine. I’ll wine and dine Chief Hunter Isif for him, if Olivier’s contacts are the reason we can get the girls safe and sound.”
“I figured. We’re literally pulling up into the parking lot right now.”
“I’ll be right down,” I told her, hung up, and started to roll over to the elevators. Larzo spotted me halfway there and rushed to block my path.
“What part of ‘do not move’ do you not understand?! Is there a translator error?”
“Chiaka’s here with the dogs. They need to track the girls. I need their pillowcases and to head down so–”
“Right, well, I’ll leave you with her. The nurse brought the pillowcases to the lobby,” he said, taking over the driving yet again. I did my best to take deep breaths, and drank the whole bottle of electrolyte water in the ride down the elevator, along with the little alien-caffeine pills. The colours around me suddenly seemed brighter, and my head stopped hurting, which alerted me to the fact that it had been hurting since I woke up. A lot. Okay, I was definitely dehydrated. Good call, Larzo.
We arrived at the lobby, where he parked me in front of Chiaka. “You need to keep an eye on him, he keeps wandering off like a toddler.”
She snorted. “That sounds about right.”
My jaw dropped, and I sputtered indignantly for a moment, then shook my head and sighed. “Thank you for coming, Chiaka. He’ll get the pillowcases.”
Larzo gave me an ear-flick and jogged off.
“Alright... How are you doing?” she asked, her face had an expression that I couldn’t quite decipher. Like she was feeling bad for me involuntarily, and also trying to hide it.
I didn’t know how to explain “how I was doing”. Thankfully, I didn’t have to. Jilsi came into the lobby, and stood frozen for a moment. I realized suddenly that Chiaka wasn’t wearing a visor. Nor was I, for that matter.
“Jilsi? Are you ready?” I asked, my voice as gentle as I could manage. Chiaka looked immediately annoyed. “You were going to help us by flying one of the drones, right?”
That snapped her out of it and she rushed up to me, her paw in an official UN Salute.
“Yes, sir, I–that is Director Karim said–I can–”
“He told me you’re in the top fifteen percent of players on the planet, Jilsi,” I said, trying to look as much like an impressed authority figure as I could. It seemed to work, and her eyes lit up, her tail suddenly wagging happily.
“Yes, sir,” she said.
“Then I think you’ll do a great job,” I told her. “I’m so glad Karim hired you.”
Tears started to well up in her eyes. Shit. What did I do wrong now?
“I won’t let you down, sir!” she squeaked, and threw herself at me, nearly tipping the wheelchair to give me a hug. Oh, good. I patted her gently on the back.
Chiaka rolled her eyes. “Drones are in the back of the truck, stay clear of the dogs.”
Jilsi flicked an ear at us and rushed outside, where a UN peacekeeper was waiting with a couple of drones.
Chiaka, for her part, carefully took the dogs out of their impressively luxurious kennels. Once they were out, they all sat down at attention right next to their respective seats, and she began to put little helmets on them. They seemed to work like little muzzles, with snowboarding-style goggles and a shine all over the helmet to make it harder to see which parts were goggles vs which parts were “just the helmet”. I struggled not to laugh when I noticed the fake peripheral-vision eyes protruding over where the dogs’ temples would be.
Once the little helmets were on, Chiaka hooked up a leash to each of their little harnesses.
“What do you think?” she asked.
I couldn't keep a straight face, but I managed to mostly quell the laughter that wanted to erupt out of me. “They’re very cute.”
She rolled her eyes, but still smiled. “They look ridiculous, but if this is what it takes to get venlil-approved dogs…”
Larzo came back with the pillowcases. There was a whole song and dance about moving the dogs to the girls’ last known location before Chiaka took the pillowcases out carefully and chose one for each dog one to smell. Immediately, they were sniffing around, trying to get a lead. Chiaka had one, the trainer had another, and some UN peacekeeper had the third.
“We’re off,” she said, “We’ll keep you updated.”
The three of them left, and there was a quiet moment when Larzo and I just kind of stood around by the door, the UN truck sitting idly in the parking lot.
“...We should probably send nurses after them,” I said, feeling stupid I hadn’t thought of it before they left. “Venlil nurses.”
Larzo’s eyes grew and he flicked an ear in agreement. “Yes. I’ll arrange it. You–”
“Stay here?” I asked flatly. He nodded and jogged off again. He’d been doing that a lot. Would probably need another nap soon too. Once I was alone, the driver of the UN truck stepped out. He was in full UN Peacekeeper uniform, with a whole-face visor and gloves, so I had no idea who he was until he talked.
“You have seen better days, my friend,” he said in French. Quebecois French.
“Olivier?” I tried to confirm. Despite how annoying Larzo was being, he had a point. My brain was not the greatest at that moment.
He laughed “Yes. I had to take this up very high, Andes. I will be expecting some help in return.”
“Yeah, I know,” I said with a yawn. “How’s CSIS?”
He swapped over to English. “Busy, like the rest of Five-Eyes. You know how Americans are, they declare themselves in charge and make the rest of us clean up their messes.”
I chuckled. “Well, I’m sorry to add to the messes you have to clean up.”
“Don’t be. It is a good opportunity to test them,” he said. I couldn’t tell if he was referring to the dogs, the UN, Americans or some fourth party not immediately cognitively available to me.
Larzo was back with three venlil nurses, each equipped with a pad. We spent a little too long fiddling with all the information-sharing settings, but each dog had a tracker and Olivier had access to all of them, so eventually each nurse had the tracker’s information. They all also had their own car, so they could make their own way to each search team.
With everything set up… It was just time to wait.

[Prev][First][Next]
Patreon / Kofi/ Paypal

I'm a 69 year old man in reasonably good health. I had a TURP in 2014 and since then I had been having off and on problems with blood in my urine. I pretty much blew it off until last year on June 22nd when it became a virtual Niagara Falls. I contacted my Urologist and he had me come in for the first of 3 cystoscopies and one concurrent TURBT.
So, I have a somewhat unusual bladder. I have a diverticulum and that is where the tumors were found. My regular urologist hadn't seen squamous cell carcinoma in a bladder so he sent me to this urological oncologist. I was just going to blow it off because I figured my regular guy already got the tumors and it wasn't in the muscle so it was just one of those things. The surgeon called me at home and said he absolutely needed to see me. It took a while to get in to see him and that's when he told me about all the different things that could happen. We could just remove the diverticulum or we could do a radical cystectomy. And of course if it was the latter I could opt for a neo bladder(which my wonderful wife was leaning towards) or go with the stoma. As it turns out, with a little pushing from me, we decided to do the partial cystectomy, removing the diverticulum and some margin around it. He also removed my lymph nodes. I still don't have the pathology back from the lymph node dissection, but I'm not anticipating anything serious regarding that.
Here's where stuff got interesting though. I developed an ileus which is essentially just my bowels shutting down and not digesting anything. So they had to put me on a nasogastric tube and start pumping stuff out of my gut. They were able to pump over 3 liters of stuff out of me before I started feeling better. While all of this was happening I was npo - nothing by mouth. All of my regular meds had to be crushed and administered by the nasogastric tube. So I had stuff going in and stuff going out. I was only supposed to be in the hospital for about 5 days and with the ileus, I'm at 10 days and counting. My anxiety was out of control so I was prescribed some benzos and that helped tremendously. Of course it didn't help with anything but the anxiety, but anxiety can put the brakes on sleep and sleep is paramount for recovery and mental health.
Today, my NG tube has been taken out. I've been passing gas which means that my gut is starting to function again. I spoke with my surgeon and he said that I would be put on a clear liquid diet tomorrow and solid food the day after. If all goes well with the ileus, they will do a dye study to make sure that the bladder sutures aren't leaking. If that goes well, my Foley catheter will come out and my JP drain will be removed. And of course all of this is contingent on the fact that some other crazy thing doesn't happen.
But I'm hopeful.
I'm sure they are details that I've missed. I'm sure that there are some holes in my narrative. If anyone has any questions: ask. Remember this is just one man's experience. It may not be similar to what you went through. It may not describe what you might go through. But you will never advance your knowledge if you don't ask the questions.
Best of luck, friends.
Edit: we took out a bunch of non-relevant stuff.

Karim Sarhane, MD
ABSTRACT
The present invention is directed to a device and method for a nanofiber wrap to minimize inflation and scarring of nerve tissue and maximize the nutrient transport. More particularly, the present invention is directed to a novel semi-permeable nanofiber construct prepared from biocompatible materials. The nanofiber construct is applied around a nerve repair site following end-to-end anastomosis. The nanofiber construct is porous and composed of randomly oriented nanofibers prepare using an electrospinning method. The nanofiber construct has a wall that is approximately 50-100 μm thick with pores smaller than 25 μm. The nanofiber construct prevents inflammatory cells from migrating into the nerve coaption site, while still permitting the diffusion of growth factors and essential nutrients. The nanofiber construct allows for enhanced neuroregeneration and optimal function outcomes.
FIELD OF THE INVENTION
The present invention relates generally to medical devices. More particularly, the present invention relates to a device and method for a nanofiber wrap to minimize inflammation and scarring of nerve and other tissues as well as any other tubular structure or as a layered constituent of a biologic or synthetic mesh.
BACKGROUND OF THE INVENTION
Peripheral nerve injuries constitute a frequent and disabling condition, with an estimated incidence of 23 out of every 100,000 persons per year in developed countries. This statistic does not account for non-traumatic cases (i.e. nerve damage secondary to abdominal or pelvic surgeries) and for lesions not treated at health facilities. Despite great advances in microsurgical techniques, nerve repair continues to be suboptimal, and full functional recovery is seldom achieved. There is thus an imminent need to develop novel strategies to enhance neuroregeneration and optimize return of function.
Research in peripheral nerve injuries has shown that the formation of scar and fibrosis at the site of nerve coaptation impedes axonal regeneration. Furthermore, a negative correlation between the degree of functional recovery and the amount of scar formation at the repair site is a well-established phenomenon. Although nerve regeneration normally occurs at the rate of 1 to 3 mm per day, regenerating axons may require up to 20 to 40 days to traverse the scar at the site of nerve repair. Reduction in scar formation at a site of nerve repair is associated with better recovery. Mechanistically, scarring at the nerve repair site is due to invasion of inflammatory cells, with subsequent upregulation of fibrogenic cytokines.
It would therefore be beneficial to provide an inert barrier around the coaptation site that prevents inflammatory cells infiltration while still allowing diffusion of nutrients and other growth factors to promoting nerve regeneration.
SUMMARY OF THE INVENTION
The foregoing needs are met, to a great extent, by the present invention, which provides a device for promoting healing at a connection site between tubular biologic structures including a construct of nanofibers. The nanofibers are spun from a biocompatible material in a sheet configured and sized for wrapping around the connection site tubular biologic structures. The sheet is configured to have a pore size to prevent the infiltration of inflammatory cells to the connection site.
In accordance with an aspect of the present invention, the sheet is approximately 50 μm to 500 μm thick. More particularly the sheet can have a thickness of approximately 100 μm. The device can have pore size of approximately 0.5-25 μm. The biocompatible material can be polyester, such as polycaprolactone, polylactide, or polyglycolide. The biocompatible material can also be a blend of synthetic polyester such as polycaprolactone and a natural macromolecule such as collagen. Each one of the nanofibers can have a diameter of approximately 100 nm to 25 μm. The nanofibers are formed using a system comprising a syringe, a source of voltage, and a copper plate. While a copper plate is described herein with respect to the preferred embodiment any sort of conductive plate or rod known to or conceivable by one of skill in the art could also be used. A needle of the syringe has a gauge of approximately 27, a distance between the source of voltage and the copper plate of approximately 6 cm, an applied voltage from the source of voltage of approximately 7.5 kV, and a flow rate of solution from the syringe of approximately 0.75 mL/h.
In accordance with an aspect of the present invention, a method for forming a device for promoting healing at a connection site between tubular biologic structures includes filling a syringe with a solution containing a biocompatible material for forming the nanofibers. The method includes applying an electrical current to the solution containing the biocompatible material, such that the solution extends out into a fiber. Additionally, the method includes extruding the solution onto a grounded plate in an electrospinning process until a predetermined thickness of a sheet of the fiber, such that the sheet has a pore size of less than 10 μm.
In accordance with yet another aspect of the present invention, the method further includes using the solution comprising an 8 wt % PCL (MW=80,000) solution in a 9:1 (by wt) ratio of dichloromethane:N, N-dimethylformamide. The method includes using the biocompatible material taking the form of a polyester. Additionally, the method includes using one selected from a group consisting of a polycaprolactone, polylactide, and polyglycolide. The method includes using the biocompatible material formed from a blend of synthetic polyester such as polycaprolactone and a natural macromolecule such as collagen. The method also includes using the grounded plate comprising a conductive material.
In accordance with still another aspect of the present invention, the method includes using a grounded plate with dimensions of approximately 11 cm×11 cm×0.3 cm. The method includes using a power supply for applying the electrical current to the solution. The method includes forming the fiber having a diameter of approximately 100 nm to 10 μm and forming the sheet with a thickness of approximately 50 μm to approximately 500 μm. The method includes forming the sheet using a flow rate of 0.75 mL/h; a distance between applied voltage and the grounded plate of 6 cm; an applied voltage of 7.5 kV; and a needle gauge of 27. Additionally, the method includes applying the method for one consisting of a group of repairing one selected from a group consisting of crushed, compressed, and injured peripheral and cranial nerves and protecting one selected from a group consisting of autologous and allogeneic nerve grafts. The method also includes repairing injured or inflamed tendons.
BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying drawings provide visual representations, which will be used to more fully describe the representative embodiments disclosed herein and can be used by those skilled in the art to better understand them and their inherent advantages. In these drawings, like reference numerals identify corresponding elements and:
FIG. 1 illustrates an exemplary setup for fabricating an electrospun nanofiber wrap according to an embodiment of the present invention.
FIGS. 2A-2D illustrate images of an exemplary nanofiber wrap according to an embodiment of the present invention.
FIGS. 3A-3C illustrate schematic diagrams of a nanofiber wrap according to an embodiment of the present invention.
FIGS. 4A and 4B illustrate an exemplary rat arm or leg nerve to be wrapped with the nanofiber construct for Groups 1 and 3 and an exemplary rat arm nerve to be wrapped with the nanofiber construct for Groups 2 and 4, respectively.
FIG. 5 illustrates a summary of the Groups, the intervention used, and the endpoint.
FIGS. 6A-6D illustrate images and graphical views of the percent of collagen at the repair site and the macrophage counts at the repair site.
FIG. 7 illustrates a graphical view of up-regulation of the anti-inflammatory cytokine IL-10 and down-regulation of the pro-inflammatory cytokine TNF-α that were detected at the nerve repair site in the experimental group.
FIGS. 8A and 8B illustrate images of nerve cross sections for the control and experimental groups as well as a graphical view of regenerated myelinated axons in the experimental and control groups.
FIG. 9 illustrates a graphical view of serial electrophysiological measurements showing improved functional recovery in the experimental group.
FIGS. 10A and 10B illustrate images of neuromuscular junction and a graphical view of neuromuscular junction re-innervation quantification. Increased reinnervation in the experimental group was accompanied by decreased gastrocnemius muscle atrophy, as assessed by a higher muscle weight and higher single muscle fiber cross sectional area.
FIGS. 11A-11D illustrate image and graphical views of gastrocnemius muscle weight and laminin staining analysis.
DETAILED DESCRIPTION
The presently disclosed subject matter now will be described more fully hereinafter with reference to the accompanying Drawings, in which some, but not all embodiments of the inventions are shown. Like numbers refer to like elements throughout. The presently disclosed subject matter may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Indeed, many modifications and other embodiments of the presently disclosed subject matter set forth herein will come to mind to one skilled in the art to which the presently disclosed subject matter pertains having the benefit of the teachings presented in the foregoing descriptions and the associated Drawings. Therefore, it is to be understood that the presently disclosed subject matter is not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims.
The present invention is directed to a device and method for a nanofiber wrap to minimize inflation and scarring of nerve tissue as well as any other cylindrical structures, such as a tendon, a ligament, or a vessel, or as a layered constituent of a biologic or synthetic mesh to cover a wound repair site. More particularly, the present invention is directed to a novel-semi permeable nanofiber construct prepared from biocompatible materials. The nanofiber construct is wrapped around a nerve repair site. The nanofiber construct is porous and composed of randomly oriented nanofibers prepared using an electrospinning technique. The nanofiber construct has a wall that is approximately 100 μm thick with pores smaller than 25 μm. The nanofiber construct prevents inflammatory cells from migrating into the nerve coaption site, while still permitting the diffusion of growth factors and essential nutrients. The nanofiber construct allows for enhanced neuroregeneration and optimal function outcomes.
FIG. 1 illustrates an exemplary setup for fabricating an electrospun nanofiber construct wrap according to an embodiment of the present invention. The exemplary setup 10 for fabricating the electrospun nanofiber construct wrap includes a syringe 12 containing a solution containing a biocompatible material for forming the nanofibers. In a preferred embodiment, the solution can take the form of an 8 wt % PCL (MW=80,000) solution in a 9:1 (by wt) ratio of dichloromethane:N, N-dimethylformamide. The biocompatible material can take the form of a polyester, such as polycaprolactone, polylactide, or polyglycolide. The biocompatible material can also be a blend of synthetic polyester such as polycaprolactone and a natural macromolecule such as collagen. It should be noted that these examples are not meant to be considered limiting and any suitable material known to or conceivable by one of skill in the art can be used. The exemplary setup also includes a power supply 14 and a square, grounded copper plate 16. While a copper plate is described herein with respect to a preferred embodiment any sort of conductive plate or rod known to or conceivable by one of skill in the art could also be used. It can also be a rod or other curved surface for giving the nanofiber wrap some initial curl. The copper plate 16 can be in any suitable size known to or conceivable by one of skill in the art for this purpose. However, in an exemplary embodiment the plate is approximately 11 cm×11 cm×0.3 cm. The solution is extruded from the syringe onto the copper plate and nanofibers are formed through the process of electrospinning and applying a current to the solution, which causes it to stretch out into a fiber shape. The exemplary setup includes several variable elements including, but not limited to, flow rate (Q), distance between applied voltage and the copper plate (d), applied voltage (V), and needle gauge (n). These variables can be adjusted to change the properties of the nanofibers produced by the exemplary setup 10. For instance, according to an embodiment of the invention the nanofibers can be produced under the following conditions: Q=0.75 mL/h; d=6 cm; V=7.5 kV; and n=27. With this exemplary setup constructs of 100 μm thick with pores smaller than 10 μm are obtained. The thickness of the nanofiber wrap can range from 50 to 500 μm. While this exemplary setup is described herein, any suitable setup known to or conceivable by one of skill in the art could also be used. Generally, the nanofibers produced using the exemplary setup have a diameter of approximately 100 nm to 10 μm. However, any suitable length or diameter known to or conceivable by one of skill in the art could also be used.
FIGS. 2A-2D illustrate images of an exemplary nanofiber wrap according to an embodiment of the present invention. As illustrated in FIGS. 2A-2D the nanofiber wrap has a thickness of 100 μm and a pore size of less than 10 μm. FIG. 2A illustrates a cross section of a nanofiber wrap according to the present invention. FIG. 2B illustrates a side view of a nanofiber wrap according to an embodiment of the present invention. FIG. 2C illustrates a cross section of a wall of the nanofiber wrap and FIG. 2D illustrates porosity of the nanofiber wrap.
FIGS. 3A-3C illustrate schematic diagrams of a nanofiber wrap according to an embodiment of the present invention. FIG. 3A illustrates a nanofiber wrap according to the present invention, as placed in an arm of a patient. FIG. 3B illustrates a schematic diagram of a nanofiber wrap according to the present invention being wrapped around a nerve repair site. As illustrated in FIG. 3B, the wrap is placed at the nerve repair site, and more particularly at a joint of the host nerve and the donor nerve. The wrap is placed around the joint and secured with a fixative, such as a drop of fibronectin glue or sutures. FIG. 3C illustrates a sectional schematic view of the wrap placed around the joint of the nerve repair site. The macroporous nanofiber mesh restricts the infiltration of macrophages and fibroblasts to the nerve repair site, while the access of nutrients, growth factors, and oxygen, in general are enabled. The trapped macrophages can also be tuned from an inflammatory phenotype to a pro-healing phenotype (more indicative of M2 phenotype than M1 phenotype), thus rendering the local environment pro-regenerative.
EXAMPLE
An exemplary implementation is described herein. This description is merely illustrative and is not meant to be considered limiting. Thy-1 GFP transgenic rats, whose axons constitutively express GFP, were used for the example. Four groups in total were used; 2 for short-term assessment of nerve regeneration measures (Groups 1 and 2) and 2 others for long-term assessment (Groups 3 and 4).
In Group 1 (control short-term group), a sciatic nerve transection and epineureal repair was performed; in Group 2 (experimental short-term group), in addition to sciatic transection and epineureal repair, the repair site was wrapped with the nanofiber construct. Groups 1 and 2 were harvested at 5 weeks for assessment of nerve inflammation/fibrosis. Groups 3 and 4, consisting of control and experimental long-term groups, respectively, were harvested at 16 weeks for assessment of nerve and muscle functional recovery. FIGS. 4A and 4B illustrate an exemplary rat arm nerve to be wrapped with the nanofiber construct for Groups 1 and 3 and an exemplary rat arm nerve to be wrapped with the nanofiber construct for Groups 2 and 4, respectively. FIG. 5, illustrates a summary of the Groups, the intervention used, and the endpoint.
Early measures of nerve regeneration (at 5 weeks following implantation) consisted of inflammation/scarring quantification at the repair site; collagen deposition was assessed by Masson's Trichrome staining; macrophage invasion was evaluated by co-immunofluorescent staining (CD68/TUJ1 staining); and inflammatory cytokine gene expression was assessed by qRT-PCR. Additionally, the number of regenerated myelinated axons was quantified at this early time point by analyzing the histomorphometric measures of nerve cross sections taken 5 mm distal.
Late measures of nerve regeneration (16 weeks) consisted of neuromuscular junction (Sciatic nerve—Soleus muscle) re-innervation quantification (α-Bungarotoxin/GFP staining), muscle histology assessment (gastrocnemius muscle weight and laminin staining), as well as serial electrophysiological measurements starting week 8 (every 2 weeks until week 16). The compound motor action potentials (CMAPs) were measured in the re-innervated intrinsic foot muscles in the plantar surface using subdermal needle electrodes. Stimulation was accomplished by subdermal needle electrodes placed near the sciatic nerve at the sciatic notch.
Masson's Trichrome and double immunofluorescence staining (ED1+TUJ1) of nerve longitudinal sections 5 weeks following repair showed a significantly decreased level of intraneural scarring and inflammation in the nanofiber nerve wrap group, as determined by collagen quantification (7.4%±1.3 vs. 3.2%±1.3, p<0.05) and macrophage counting (32.2±2.4 cells/mm2 vs. 14.6±1.8 cells/mm2, p<0.05) in the repair site (n=5/group). Collagen was trapped outside the nerve wrap in the experimental group, as illustrated in FIGS. 6A and 6B). FIGS. 6A-6D illustrate images and graphical views of the percent of collagen at the repair site and the macrophage counts at the repair site. As illustrated in FIGS. 6A and 6B, the percentage area of Masson's Trichrome blue staining for collagen was quantified at the coaptation site. As illustrated in FIGS. 6C and 6D, intraneural macrophage (positive for ED-1) were counted at the coaptation site, and results are expressed as cells/mm2 (10 μm sections, 40× mag). ED-1 (CD68): Macrophage marker TUJ1 (Neuronal Class III β-Tubulin): Neurofilament marker.
Mechanistically, these outcomes were correlated to an up-regulation of the anti-inflammatory cytokine (IL-10) and down-regulation of the pro-inflammatory cytokine (TNF-α). FIG. 7 illustrates a graphical view of up-regulation of the anti-inflammatory cytokine IL-10 and down-regulation of the pro-inflammatory cytokine TNF-α were detected at the nerve repair site in the experimental group. Furthermore, nerve cross sections taken 5 mm distal to the coaptation site demonstrated a significantly increased number of myelinated axons in the experimental group (n=8 per group) (FIGS. 6A-6D).
FIGS. 8A and 8 B illustrate images of nerve cross sections for the control and experimental groups as well as a graphical view of regenerated myelinated axons in the experimental and control groups. As illustrated in FIGS. 8A-8B, numbers of regenerated myelinated axons were counted at 5 mm distal to the repair site (ultra-thin sections, 1000× mag).
Electrophysiological measurements showed return of function at week 8 with significantly higher CMAPs in the experimental group. This trend persisted throughout week 16. Furthermore, the number of re-innervated neuromuscular junctions was significantly higher in the experimental group. FIG. 9 illustrates a graphical view of serial electrophysiological measurements showing improved functional recovery in the experimental group.
FIGS. 10A and 10B illustrate images of neuromuscular joints and a graphical view of neuromuscular junction re-innervation quantification. Increased reinnervation in the experimental group was accompanied by decreased gastrocnemius muscle atrophy, as assessed by a higher muscle weight and higher single muscle fiber cross sectional area. FIGS. 11A-11C illustrate image and graphical views of gastrocnemius muscle weight and laminin staining analysis.
These results effectively demonstrated decrease inflammatory response and connective tissue proliferation at the site of neurorrhaphy and improved nerve regeneration with optimal functional outcomes. While the invention is described above with respect to nerve tissue, the invention can also be applied to vessels or any other generally tubular structure. Therefore, the nanofiber wrap design is optimized for minimizing scarring at a connection site between two tubular structures such as nerves or vessels. It can also potentially prevent pain from neuroma formation. The construct can also be applied to blood vessel anastomosis by preventing leakage of blood cells at connection sites.
The many features and advantages of the invention are apparent from the detailed specification, and thus, it is intended by the appended claims to cover all such features and advantages of the invention, which fall within the true spirit and scope of the invention. Further, since numerous modifications and variations will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation illustrated and described, and accordingly, all suitable modifications and equivalents may be resorted to, falling within the scope of the invention.
https://link.springer.com/article/10.1007/s00238-012-0735-x

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.

Bill Meags was nothing if not a giving man.
He’d give you the shirt off his back, even if it was sewn right onto him!
This was a lifelong trait of his. In childhood, he stopped eating lunch once his mom stopped packing one for him and he had to start buying it at school. All it took was throwing a certain kinda look Bill’s way, or just making at him like you were going to ask him for his money, before he’d hand it over, not wanting to get in the way, he’d say, and he’d say it like he was apologizing, too.
That character never went away from Bill, no sirree. He was always real considerate, a sweetheart, especially to his parents – even though his dad saw him as a pushover (and another p word that doesn’t feel all that Christian for me to be repeating). I lived real close to him growing up, down the same block on Copperfield Drive, so we got all acquainted like kids that live close to each other at that age will do a lot of the time.
My bad, friend. I’m getting a bit lost in the weeds here, aren’t I? What I’m getting at is the generosity of Bill Meags, and why it is that you and I find ourselves in our situation at the present moment. You must be wondering about it, aren’t you? You seem like the curious type.
A few more things about Bill in those early years, first. Bill, you see, was always sharing his toys with his brothers back in those days. Not a birthday would go by – Bill’s birthday, I mean – where his brothers wouldn’t make out with at least half of his new toys stuffed in their greedy little pockets. Far as I know, this went on as long as he still had birthdays at home.
He was never real popular with the ladies either, when we got to that age where liking girls and their nice legs and nice smells went from gross to sweet. Bill was not a bad looking guy, but he was not a good looking one either. He was just there most of the time, as much as it pains me to say. He was just about decent at school, not an ivy league contender or anything like that, but better than you woulda expected out of a guy who was like Bill – a guy that was just there, who looks kinda like he’d fit better standing next to a potted plant or the wallpaper than around other people. I think him doing well in school made sense. He got the reps in. As in, he had been doing everyone’s homework for them. No one had threatened him, there was never anything like that.
The rumor that was floating around certain circles at our school was that if you asked Bill if he wouldn’t mind helping you with your homework, and you made it seem like it would be just the biggest fuss for you if you had to do any of it, he would tell you not to worry, that he would get it done, and he’d say it like he felt guilty that it wasn’t already done even though he just had it handed to him. Didn’t matter the subject, he’d do it. He always denied the rumor when I’d ask him about it, but I was pretty sure it was true, and I think he wouldn’t tell me because he didn’t wanna break up my peace of mind. So, yeah, I think he was alright at school because he was doing homework for classes he wasn’t even taking.
Me? I think it ended up being his helping his classmates with homework that led him to meeting Ana, a girl that took a real liking to Bill. Or maybe her name was Ava… it was something like that. Strange how time fades the clearness of your memories like they’re in a heavy fog, isn’t it? Well, in any case, Ava or Ana was a nice girl, and pretty, too, and she made her intentions real clear to Bill Meags, and that was unusual at the time, you see, for a girl to be that forward with a guy in the romantic sense. That was lucky for Bill, because I don’t think they woulda gone out if it wasn’t for her...
And they did go out. For a time, anyway. Until Brad Something-or-Other had come up to Bill one day and told him he thought Bill was such a nice guy, one of those real generous types, and Brad was acting all like he didn’t know that Ana (or maybe it was Ari?) was going steady with Bill, and he was really hamming it up and saying how it would be just swell to have the chance to go on a date with that cute girl from third period math. Brad was one of those guys, you’d know the type if you saw him, that made you wanna question the Creator when all your knowledge of what it meant to suffer was that you were stuck at home again with your parents on Saturday night. He was a complete jackass – there’s just no other word that works here – but he was also gifted by God and genetics and growth hormone to be a good-looking jackass. He was tall, a jock, and had a jawline that angled his face in a way that seemed to slide the looks that girls would give him into the rest of his face. What I’m getting at is that Brad could go on a date with anyone he wanted, and had gone one dates with anyone he wanted, “gotten down” with girls in higher social brackets compared to Bill’s girl. And he was too plugged into the social jungle that is high school to not have known they’d been going steady.
This is important, you see, because even though I can’t prove it, I believe deep down that Brad was pulling a prank on Bill. But Bill didn’t see it as a prank, and Bill agreed with Brad, telling him of course, you and Ana/Ava/Ari would make such a cute couple, you should go for it. Bill didn’t wanna impose on Brad, and he didn’t wanna get in the way of their potential future relationship, he told me later. Wouldn’t it just be awful, he said, if I were the reason they weren’t happy together? I can’t get in their way, I just can’t do that. That’d be just plain selfish of me.
Thing is, this was 8 months into their relationship, and he was as into her as one got at that age. But he didn’t want to be a bother, didn’t want to burden Brad-the-Tall-and-Chiseled-Jackass, didn’t want to get in the way or be an obstacle, so he stepped back, and Brad and Ava/Ana/Ari/Ash had gone on 3 dates before he forgot to wear a rubber on the third and knocked her up, and Bill was real outta their way when they both dropped out of school together to raise it. But Bill was heartbroken, he was, even though he’d never say it.
Ah, you don’t need to say anything for me to know what you’re thinking. I can see it in your face. I’ve been at it again. Rambling, haven’t I?
There is a point, I promise; a reason I’m telling you this and telling it to you the way I am. But we should fast forward a bit, shouldn’t we? Time is ticking, and midnight is getting closer, and I would like you to know why we’re here, hard as that might be from your perspective to believe.
So, fast forward some decades, and Bill’s married. His wife’s a presence of a woman named Martha. Now, lemme tell you, that Martha, she’s a force – both her and her mother.
Only reason Bill and Martha got married was because she asked him directly if he was planning to propose to her. Some 5 years into their relationship, that was. And Bill sure wasn’t going to tell her no, was he? That wasn’t in Bill’s nature. It was about that time, he told me after he broke the news of their nuptial plans, that I got myself good and married. Then, almost like it was just an afterthought, he added how he didn’t wanna annoy her, or make her feel all negative because he had struck the idea down, even if the answer woulda probably been not right now. So instead of saying not right now or let’s talk more about it he said yes, both right then and right there. She made him propose all formal with a ring, of course, but she was happy. Martha’s version of happy, anyways.
Now here come the newlyweds, and not 10 months later, out of Mrs. Martha Meags comes their first and their only, a boy they named Artimus. Bill had wanted to name him David, but Martha wanted to name him Artimus, so Bill and Martha named him Artimus. The child was adored, I can tell you that. Even after he started getting hard to be around since he was turning into one of those mopey teens with one of those mopey faces who always talks about how no one could ever understand them. Martha told Artimus he could do no wrong, and she told him that even after he started coming home in the back of a police cruiser. He started with shoplifting, getting caught wearing expensive shirts and sweaters under the oversized hoodie he’d always wear. But because he was underage, and since Martha had settled into one of those clerk jobs at the precinct office (and because she had come to know some of the fellas on the force), the young and troubled Artimus would often come back home after getting caught, at least in the beginning. You best believe I prayed for that kid every morning and every night. But God helps those who help themselves, my momma always used to say, God rest her.
Bill, at this point, had raised the idea of sending Artimus to a disciplinary school over the summer break. The way Martha reacted you’da thought you told her she needed to sacrifice Artimus in some pagan ritual. She would hear none of it. She said her son was one of those boys that came into his own a bit rougher and a bit later than the other boys, but it was because he was sensitive, and sensitive boys need extra coddling. Bill had thought about how he had been as a kid and felt his son woulda been one of the ones to ask him to do his homework if they’d been kids together. I guess this thought musta sparked something in him, because Bill didn’t back down off the jump and he raised the issue again with Martha. Or at least that’s how he told it to me. In any case, he said to her that he was concerned that one day Artimus wouldn’t come home in the back of a police car, that he wouldn’t come home at all, that instead the police officer would come to their home without Artimus and tell them that their son was dead or dying alone in some cold hospital bed. She went into hysterics, said that Bill was completely exaggerating, there would be no way that she would let her son go off canoodling with delinquents and murderers and rapists and thugs. And so off to the disciplinary school their dear Arty did not go, and into trouble their dear Arty stayed.
You can see I’m shaking now. I can tell it from the way you’re looking at me. It’s because he’s getting closer. But I think we’re still making good time, we should wrap up just as midnight comes. But no more dilly dallying – because he is getting closer. I can feel him, and I think you can too.
I think it started happening right around the time Bill had been in the running for a promotion. The guy right above him had been dropped by a heart attack at the ripe young age of 40. He survived it, but he was starting to take a good hard look at his priorities, as some men get to doing when they remember that the Almighty calls them back eventually. He decided he wasn’t spending enough time with his kids and wife and quit his job the day before his heart decided to permanently quit on him. So the position – Bill’s boss’s position – was open, and it paid pretty well, at least compared to what Bill was getting paid at the time, which was little more than peanuts. Didn’t matter how many times I told him, but Bill just wouldn’t ask for a raise. He didn’t want wanna offend his boss, or his boss’s boss, or make either think that Bill was ungrateful for his salary. That could hurt one of their feelings, maybe even both of their feelings, and the idea made Bill feel uncomfortable.
Right around the time Bill was in the running for the promotion, his boss’s boss got real sick. I heard it was something with his diabetes, but the short of it was that he needed a new kidney or he’d die. Estranged from his immediate family, as it happens, which is not the spot you wanna be in if you’re in the market for a new kidney. He was looking for donors in all the ways he could: taking out ads in the paper, putting up a billboard you’d see taking the ramp off the highway into downtown, hanging up flyers on the streets, all that.
Bill read the ad in the paper, and it just so happened that he has a compatible type of blood and kidney, and he knows this fact about himself. Martha knows it about him too, and she also knows that Bill has been up for that promotion. Martha asked Bill to donate his kidney to his boss’s boss, that Martha did. Bill didn’t wanna give away his kidney. But Martha wanted Bill to do just that, and after she contacted Bill’s boss’s boss, the man who paid Bill’s salary had wanted Bill to do just that, and Bill was not going to disappoint Martha or his boss’s boss, so just that was what Bill did.
That was just the beginning. It wasn’t long after they did the kidney removal – the scar was like a big smile that ran from his middle belly to his right hip like a real big gun holster – that Martha’s dear mom was the one who got real sick.
Ah, don’t move. You’re starting to slip a bit, let me tighten that for you.
Looks about right and good. Well, anyway, Martha’s mom was heavy handed with the bottle, that woman, and eventually consequences caught up with her actions as the good Lord makes right sure of, and she found herself looking down the barrel of life-threatening liver failure with the trigger half-pulled.
She would die if she didn’t get a new liver, or at least part of one. The doctor had explained to Bill and Martha near her mother’s room that livers were “adept” at regrowing themselves. Live liver transplants were becoming more common, he told them. You see where this is going, I think.
Martha had wanted Bill to give away a piece of his liver. Bill had not wanted to. But Martha had, and so had Martha’s mother, and so (I think) had the young doctor who wanted to impress the more senior doctor. And so Bill did.
The liver procedure was a bit more complicated than the kidney one. Bill was far from spring chicken territory, but he wasn’t that old – so they felt he would be safe to get a hunk of his liver taken out so soon after having the kidney removed. But he lost a lotta blood, Bill did, and the wound wasn’t healing as quick as they wanted. Eventually, not enough blood was making it to his kidney, the only one he had left, and so his left and only kidney died. The doctor recommended they remove it before it got infected and caused him more problems. They assured him that his kidney would be used for research, so they could help prevent this from happening in the future. To other patients, of course. Bill would be on dialysis for the rest of his life.
I went to visit Bill lots when he was in the hospital during that time. I was always the only familiar face to him around there. That would be the case until Artimus was a patient in the room next to him.
Artimus Meags, dear Arty to his mother Martha, had been drag racing in a car that did not belong to him. He told his mother dearest that he was going to study at his friend’s house, and Martha had believed Arty because Arty could do no wrong. Blood alcohol was twice the legal limit, and he was not the legal age, but he could do no wrong. He had crashed into a park tree, and they estimated he had been going about 98 miles per hour, give or take. The car was hugging the tree, and the picture they showed us made it look like one of those abstract metal art exhibits.
How he survived at all was a mystery to us. They found him pinned under the spear of a tree branch that jabbed into the driver’s side window, with his legs folded backwards and over his head at all these odd angles, and the jagged edges of the crumpled car door were drilled through both his arms like rows of nails through drywall. One of the doctors in the hallway had said loud enough for me to hear: Artimus’s legs came in mangled strips, tendon and bone and muscle all mushed together… indistinguishable, each one from the other. They counted the one blessing that Artimus had passed out early – either from the pain or the booze – and wouldn’t wake up until after the amputations. Amputations, more than one.
Artimus, dear Arty to his mother, no longer existed below the waist, beyond the left shoulder, above the right elbow.
At first, they were trying to save the left arm and the right upper arm if they could. The left arm, the doctors said, had some potential to recover, it was still getting blood and they might be able to salvage it. They said that on the first day. On the second day, the doctor had said pretty much everything except for what he was thinking, which was well, let’s just wait and see, that’s all we can do right now. On the third day, Jesus rose from the dead and Bill and Martha were told that surgery was the “mainstay of treatment for a gangrenous limb,” but please try not to worry too much because they were making big advancements in fake limbs, in prosthetics, and the quality of life for quadriplegics was getting better, they’re even doing trials on limb donations! Of course, these trials were in the early stages, but they were so grateful for their generous donors who gave so much so they could do such vital research. They said it was all above board, but when I got the chance some time later to actually look it up myself, I could find nothing at all about it online. When I called the hospital to ask them how the trials had gone, they acted like I was crazy. Can you believe that?
Anyway, as you can imagine, Martha jumped on that real quick, oh yes she did. Limb donations? Do y’all do them here? Bill had been so generous already, and, now turning her attention to Bill and cooing in a way that always made my skin crawl, oh, Bill, wouldn’t it be so wonderful if you could give the gift of walking to our son, to our baby boy, so that he could move his arms again, and grab at things again, and live his life again, like it’s all normal and this never happened. Oh, he was so young, wasn’t he? And you’ve lived a life, Bill, with those arms and those legs. Our Arty hasn’t.
Martha wanted Bill, the man with two less kidneys than you and me and a large chunk taken out of his liver, to donate his arms and his legs to their son. To Artimus, the boy who had moved only when he began to seize in his bed, who made no noise on purpose and whose breathing was being done by a machine that shoved oxygen through a tube down his throat, and whose eyes had to be taped down so they would not stay open and dry out because the part of his brain that gave his eyes the command to blink was asleep or dead.
Yes, Martha had wanted Bill to do this. Bill did not want to, but Bill smiled at Martha and said yes, Martha, because he just couldn’t tell her no. It’s the right thing to do, was his reason this time, which he gave me right before the operation when they were getting him ready (I was the only visitor; Martha was at Artimus’s bed). Besides, he added before they wheeled him away, I don’t want to make Martha feel sad, or make her feel like I don’t love our son. I would hate to let her down… I don’t want to let him down, either. I can handle living without my arms and my legs. I’ll adapt, and better I adapt to it than he does. I tried. I couldn’t get through to him, but I did try. So, then, he went with the folks in the scrubs, and that was the last time he was whole.
He was now without limbs, any of the four. His head sat atop his torso, and his torso atop his bed, and everything else had been sealed with some foam and some surgical duct tape. It was gonna be two surgeries, so they didn’t sew him back up on the first go. I was able to see through some of the foam packing they put on his stumps (the nurse didn’t do such a good job changing it, and Bill stayed silent because he was sure she was busy, even though he started leaking onto the bed), and I could see the sawed-off edge of bone splintered in uneven edges. I looked away right quick after that.
The next request came to Bill’s room pretty soon after that. It was sometime after Bill’s boss’s boss had decided to let Bill go from his position since he had taken off one too many days since he was in the hospital, and he thanked Bill for his years of service to the company. The requester was a lady who had overheard one of the nurses in the hallways talking about the remarkable and generous gift that the father had given the son. The mother of a young blind girl had come to Bill to ask him if he would be willing to donate his eyes and optic nerve, to give the gift of sight to the sightless, and she showed him a picture of her daughter, a young girl with blank sheets of snow for her eyes where the color shoulda been, and Martha had started weeping and saying that of course Bill could, and the doctor at the door who had overheard was saying that he had never seen such generosity from one man and Bill did not wanna give off the impression that he didn’t care about the girl like he was an uncaring type of person, and he didn’t want them to think that he wasn’t open to their thoughts on the best use of his eyes and optic nerve – and, he said to me before the operation, is it really all that fair for me to have my eyes and the nerve that lets me see if that girl can’t? Do I deserve them any more than she does? That’s what he told me, anyway. But I knew better, I knew Bill said yes because Martha wanted it, and the girl’s Mom wanted it, and the doctor wanted it, and it no longer mattered what Bill wanted, or maybe it hadn’t mattered for a while now, maybe ever, so Bill’s eyes had been scooped out, the space around his optic nerve taken out to remove it in one full piece, and the girl saw out of Bill’s eyes, and Bill saw out of no one’s.
By then, news had traveled quick. Local news first picked the story up, and larger media outlets megaphoned it out, and now there were hundreds of people showing up to Bill’s room in a single day, Bill unable to talk to them all but unable to get up and leave either. The hospital set up official lines and rules for these visitors – they gotta line up in this line or the other, fill out the official appeals form, circle on the diagram which part of the body they are in need of and from which body system, and give a response to: In 200 words or less, explain why Mr. Bill Meags, the always generous Mr. Bill Meags, should donate his organ/tissue to you or your loved one? Bill, unable to read and write because he didn’t have the eyes to read or the arms to write, gave complete medical decision-making power to Martha and the doctors. He hadn’t wanted to, but he had been asked – Martha the one doing the asking – and it seemed to him it would really ruffle her feathers, maybe even cross into inconvenient, if he said no, so he said yes.
His skin was given to a 44-year-old firefighter who had saved a child from a burning building. His skin had melted clean off, several layers of it.
Burn pains hurt. One of the worst pains you can experience, did you know that? All touch becomes real painful, a light breeze sets your nerves on fire, the cloth of your bedsheets feels like fire ants marching and you can’t shake them off because they’re a part of you.
But once the firefighter started wearing his new skin – the skin that they had cut off Bill like the pelt of an animal – he no longer felt the fire on his nerve endings or the ants crawling around anymore. They were Bill’s now, and for Bill, every second was agony. He never said so to anyone, and he never screamed, but he did tell me once when he was floating on a cloud made of morphine that he felt like screaming a lot of the time but didn’t wanna make too much noise. That could disturb the other folks here. I don’t wanna stop anyone from healing.
His right lung came out next, this one given to one of our state’s senators. The politician, one of those folks who make a real career out of politics and campaigning, got cancer in his lungs after smoking like a chimney his whole life, but he was running for a fourth term and he wasn’t ready to meet his Creator, so they took out his bad lungs and gave him one of Bill’s good ones. The senator was 75 years old, two full decades Bill’s senior, but that didn’t matter, of course. The senator’s third wife had pleaded to Martha, and Martha had said yes and of course and Bill was a patriot and Bill always followed their campaigns the most close out of anyone and so that was that and Bill’s chest had been opened and out came his lung. They took out the lung all the way to the place it forked into his throat, and I know that because they left his chest opened, they didn’t sew him back up, so it would make the next operation easier to do, the doctors told us. I sat by the bed afterwards – it happened too quick this time, and there wasn’t enough time between the agreement and the operation for me to see him off – and he told me, in between real deep gasps he had to take even with the tubes forcing oxygen into his nose and only lung, that even though it was ‘an adjustment’ to breathe now, he woulda felt like just the worst if he went ahead and said ‘no, I’d like to keep my lung, thank you.’ But he couldn’t do that to Martha, he said, or to the senator or to the senator’s third wife (who the senator had ended up divorcing not two months later after he was caught in bed with a different woman. He won his fourth term). Besides, what right do I really have to my lung? At least I have the other one.
Until he didn’t, of course. But by then I had started losing track of which parts were being given to which people, especially with Martha doing all the approvals herself. Next to go was Bill’s mouth, which made conversations much more one-sided. They had gone ahead and removed both the top and the bottom rows of teeth in Bill’s mouth. The bottom row of teeth was removed with the jawbone, all in one piece, but I’m not real sure what they needed his jaw for. But they musta decided to take out the tongue while they were in there too, maybe so it wouldn’t just be hanging out of his face all the time like he was a dog dying of thirst. They sliced the tongue out, and when Bill would try and talk you could see the little sutures tied in the back of what was left of his tongue and it looked like barbed wire that was waving at you.
Much of those days were foggy, and it wasn’t long after that when I stopped going to visit Bill for a while, for which I hope to be forgiven when I get to the Pearly Gates. I couldn’t right stand it, see? It was becoming more and more difficult to see less and less of him. But Bill, silent and unmoving, was becoming an eyesore. They had started removing his muscles and some of the other bones in his face by the time I stopped coming to see him most days. One by one, his face started missing features, and that’s why Bill started to look less human and more like a slab of raw meat that got stuck in the gears of a slaughterhouse grinder. His head had become a skull with some of the muscles still attached in spots, muscles that would move like a pulley and lever system when he’d react to something because you could see them shrinking and contracting against each other. That was the only way you could tell he could still hear you because his eyes were scooped out of his head like they were two spoonfuls of ice cream, and his teeth and tongue were missing and his jaw was missing and the entire base of his head was missing except for the part that was attached to his torso, and the head was the only thing attached to that torso, it was. Not a pretty sight. I couldn’t right stand it.
Sorry, friend, guess I didn’t ask if you were the squeamish type. But… I’m getting used to the idea that it won’t matter if you are for too long, and that all this is for real and it’s happening. You woulda thought it gets easier the more times you do it, but it doesn’t.
Bill’s nose, the tissue that made up the full thickness of it, had been lopped off, and he now had no eyes and two almond-shaped holes where his nose used to be. His mouth – which was now a hole in the middle of a lake of exposed muscle – looked so little like a mouth, but it sometimes moved when he tried to mime out words that would come out as grunts instead. But that didn’t matter all too long, because he stopped the grunting and the miming when his vocal cords were out.
Bill, the man, the generous man with emptying insides and with no eyes, no nose, no mouth, who could not scream; who had no skin but the island of it on top of his head which made up the scalp that his hair grew out of like sprouting weeds; that man, Bill, existed here and there on the hospital bed, in pieces, pieces that were getting smaller, pieces made of tissue and organs that were going to be removed soon because some of it was starting to die while it was still on him, decaying and rotting like spoiled meat. Or at least that was what the doctors told him. But by then he couldn’t say or ask much.
I am not sure he woulda asked much of anything anyway.
Once, though, while he still had neck muscles and could still shake his head or nod it, this young lady, some girl from one of the colleges around here, had come and asked him if he really agreed to all of these donations – as in out of his own free will. Willful consent she had called it, or something like that. She was one of those activist types, looking for a cause, and Martha wouldn’t’ve let it happen if she’d been paying attention, but she had been spending a lot of time talking to the doctor about how Artimus was doing. Since it was just Bill and I and the lady and cause his neck muscles were still attached and working at the time, he would nod in agreement to whatever questions she asked.
Martha did find out later, and she was real pissed, you can bet on that. Pretty soon after that, Martha had the fortune of coming across the perfect candidate for the muscles in his neck, and Bill could nod and shake his head no more.
It was maybe 2 months when I saw him next, because I had the occasion to be in the hospital myself. Made it through, God bless, and I knew it had been a while since I had seen Bill, and… well, anyways, I had decided I better find myself paying my dues to make things even and all that. When I entered the room, it took me a good long minute to realize that there hadn’t been a mistake, and that I was in the right one.
Bill wasn’t there, you see.
Well, he was, but he wasn’t.
The bed had been removed from the room, the bed he had spent the large part of a year not moving from. A table, like one of those you’d see in a high school chemistry class, had been put where the bed was before. And on the table were a couple of large devices and a small transparent tub with some water, the tub with a brain sitting at the bottom of it like dead weight. And then I realized it’s not water in that tub, it’s one of those preserving solutions with nutrients and electrolytes and all that, one of those solutions meant to keep the brain alive, to keep the cells in there from dying like they’re supposed to when the brain isn’t connected to the rest of you. The nurse told me in a hushed and awed kinda voice that the rest of Bill had been donated, so generously, and wasn’t he just the most giving person you’ve met? and I couldn’t do that myself, but I have so much respect for him and for the people that do. I asked the nurse if Bill could think and if he would be able to tell that I came to visit, and she looked at me the same way the hospital lady sounded when I called her asked about the trials. No, I don’t think he can.
I stayed in the room a bit, kinda just looking at what was left of Bill. He was just a pink blob, with what looked like a maze carved into its surface. Bill was that blob (or he was in it somewhere) but either way he was an anchor at the bottom of the tub, kept alive by bathing in a liquid and being stimulated with electricity which came from a device on a timer to shock the cells so they wouldn’t die off from not being used, a blob whose body was everywhere and nowhere, a blob which was Bill’s or just Bill and who would stay sunk in this transparent solution until Kingdom Come.
Well, I turned out to be wrong about that last thing. I read in the Times later that week that he had given (with such generosity) the two halves of his brains, the “hemispheres” – like Bill’s brain was a globe, and I guess in a way it was – to the children.
Apparently – and maybe you know more about this than I do, given how folks your age are much more on the internet compared to folks my own – some kids can be born with half their brain missing. And most of the time, those kids – being younger than me and you both – have the ability to regenerate their brain since they’re so young. So the half of their brain that did develop is able to do the tasks that the missing part woulda done normally. You wouldn’t even be able to tell they were missing anything.
But sometimes, the kids aren’t alright, the one hemisphere can’t pick up the missing one’s slack, and those kids with half a brain act like you’d expect a half-brained kid to act. They’re in beds, on life support, and often bleeding their parents’ dry of their savings. Of course, the money isn’t the priority, but you gotta consider it anyway. Bill’s hemispheres, both the left and the right, were separated and placed in the skulls of two young girls who belonged to the second of the two groups and had been on life support since babies, and each of Bill’s hemispheres had been attached to the half of their brain that the young girls were born. Each operation had taken 36 hours and I read they had neurosurgeon on top of neurosurgeon, all wanting a hand in the girls’ heads and their names in their paper and their egos inflated. ‘The Times’ sat down with Martha Meags, the late wife of the generous Bill Meags. She describes the difficult decision Bill Meags had voiced to her in his final days: to donate the rest of his body to those who needed it most. ‘I had to come to peace with it,’ she told us, holding back tears. The picture on the paper showed a black and white Martha with a real solemn look on her face, like she was trynna be brave for everyone.
I can see you’re shaking real bad now. You can feel him, too, can’t you? This part is the worst part – the waiting, especially when he gets close. And he’s terribly close now, no more than a few minutes, but I think I got the time to piece it altogether for you, God willing.