AN
My other stories are the priority still so this will likely get sporadic updates, but this is the start to a Hazbin Hotel fic!
Genesis 3:22-24
And the LORD God said, Behold, the man is become as one of us, to know good and evil: and now, lest he put forth his hand, and take also of the tree of life, and eat, and live for ever: Therefore the LORD God sent him forth from the garden of Eden, to till the ground from whence he was taken. So he drove out the man; and he placed at the east of the garden of Eden Cherubims, and a flaming sword which turned every way, to keep the way of the tree of life.
The CBC comes back at oh-four-twelve.
Nick is at the bench in the analyzer's small light, the rest of the lab dark behind him, and the printout slides out of the machine with the same patient mechanical sigh it has been making for three days. He doesn't look at it immediately. He's halfway through a sip of coffee and the coffee has gone cold enough that he has to commit to swallowing it now or spit it back into the cup, and the work — the real work, the only work that matters in this lab right now — is supposed to be at the boring part. The every-six-hours check that confirms nothing is happening. He has read fifty of these printouts in the last seventy-two hours. They have all said nothing is happening, in the precise mechanical language that means the protocol is working.
The lab smells of ethanol and cold coffee and three days of nobody opening a door.
He swallows the coffee. Sets the cup down and pulls the printout toward him.
LDH 437.
He blinks.
Reference range is one hundred to two hundred and forty.
For a single full second Nick reads it as something else — a transcription error, a stray decimal, a value from the wrong patient as if there were another patient — and then his hand is already moving for the next thing, because that is what the hand does in this lab when something doesn't make sense. The hand goes for the next thing. Re-run. Check the reagents. Check the calibration. The machine has been a little cranky on the alkaline phosphatase channel this week, that's not nothing, that could be —
Equipment error, he thinks. That's equipment error.
He runs it again.
—
The second run is at oh-four-twenty-eight.
He uses a different aliquot from the same draw. Different cuvette. Recalibrates the channel by hand before he starts. He stands in the analyzer's light with his arms folded and watches the machine cycle through its sequence, the centrifuge whirring into the wall behind him, the faint mechanical rhythm of a place that is doing exactly what it was built to do.
LDH 441.
The CBC differential — and now he is reading the rest of the printout, which he should have read the first time and didn't because he was looking at one number — shows a left shift. Elevated WBC. Reticulocytes off. Platelets sliding low. The picture is wrong everywhere he looks.
He stands very still.
Sampling artifact.
Contamination.
Equipment.
He doesn't think the word.
He runs it again at oh-four-forty-six with a fresh draw from a fresh stick — Dylan asleep through it, scrubs cool under Nick's gloved hand at the wrist, the pulse beneath his skin even and slow and fine.
The CBC comes back at oh-five-oh-three.
The same.
—
There is no oncologist on-call. The trial protocol calls for one to be available within four hours; Nick has the contact list pinned above the bench. He looks at it for a long moment and does not pick up the phone. He will call. He is not going to call until he is certain, because once that call is made the trial is over, and he is not ending twenty years of work on the strength of three blood draws.
He orders the X-rays.
The films can be read in an hour. The radiologist who keeps the imaging suite running won't be in for another four. Nick has read more chest films in undergrad and grad school than the average GP reads in a year. He can read them himself.
He sends Dylan a text through the test-wing intercom system — need imaging series, no caffeine first, twenty minutes — because he doesn't want to wake him in person yet. He doesn't trust his own face.
The reply comes back in under a minute.
on it.
Nick puts the phone down.
He sits at the bench with his hands flat on the surface and waits.
— — —
The corridor to the imaging suite is one hundred and forty meters.
Nick walks it in clean scrubs — not the orange ones Dylan has been complaining about for a week, the standard staff blue Nick has barely registered as clothing in three years of running this lab. The fluorescents above him are the same fluorescents that have been there since the lab opened. He has never noticed before how they hum.
He stops at the observation window of the animal wing for a count he does not consciously decide on.
The rats are in their enclosures. All forty-two of them. Fourteen months past administration. Five months past the age at which the control cohort started dying. They are eating. They are grooming. One of them — Number Seventeen, his favorite, though he’s not supposed to have favorites and has never said so out loud — is asleep in the corner with her tail curled neatly around her. Her fur is glossy. Her body is healthy. She is going to outlive everyone in this building.
Nick stands at the window for longer than he means to.
Then he keeps walking.
—
Dylan goes into the imaging suite at oh-five-thirty-two and comes out at oh-five-fifty-one. The films process for forty-three minutes — the suite has a digital developer Nick has been meaning to upgrade for two years and now never will — and Nick stands in the dark room with his hands in his pockets and waits for them to come up. The room still smells faintly of developer chemistry the digital system replaced years ago.
He could go sit with Dylan. He doesn't. Dylan is on the other side of the airlock, back in the residence, probably back in bed. The text he sent after the imaging said back in bed, lmk what you find.
Nick has not replied.
The films come up on the lightbox at oh-six-thirty-four.
He looks at them for a long time.
There is a special kind of quality to the silence that happens when the brain is doing something complicated and the body has not caught up to it yet. Nick's body is standing in front of the lightbox. His hands are still in his pockets. His shoulders are relaxed. His face is doing nothing in particular. Inside his head a differential is running like a sequence — not hepatitis, the LFTs were normal at twenty-four hours; not HIV, the dose protocol is closed-system and there is no plausible route of exposure; insufficient ionizing radiation exposure in his history to be radiogenic; no family history; no known carcinogenic exposure inside the lab —
The differential runs out.
There is only one option left.
The phrase that comes to him is not the word. It is the longer version, the one a clinician writes in a chart when the chart is going to be reviewed.
Uncontrolled cell growth consistent with a malignant neoplasm.
He thinks the phrase. He thinks it again. He stands in front of the lightbox and lets the phrase do what it is designed to do, which is hold the thing he cannot yet hold himself.
He looks at the films.
The mediastinum is wrong. The hila are wrong. There is mass effect in the lower lobes. There is something — and this is the thing he does not have the training to name, because he is not a cancer pathologist, he is a biologist who has spent his whole adult life working on a different problem entirely — in the periphery of the right lung that should not be there and that he cannot place because it does not match the patterns he has read about for general study. It is too aggressive. Too diffuse. The cells in Dylan's body are not following the rules they are supposed to follow.
Twenty years.
He thinks the phrase.
He thinks it again.
He sits down on the stool in front of the lightbox and stares at the films of his best friend's chest while the words malignant and neoplasm and hyper-aggressive arrange themselves into a sentence in his head that he cannot say yet.
The animals are still alive in the next wing.
Dylan is in bed in the test wing.
Nick is alone in the imaging suite, and he has a chart he has to write, and a phone he has to pick up, and a man he has to tell.
— — —
The walk to the test wing is one hundred and forty meters in the other direction.
He could walk it in his sleep. This morning he counts the steps. He counts them because counting is something a brain can do when it does not want to do anything else, and his brain does not want to do anything else.
He stops at the airlock.
Protocol calls for full clean entry — boot covers, gown, mask, hood. Protocol calls for it because Dylan is a Phase I subject in a closed-system trial and clothing is a variable, Nick told him three weeks ago when Dylan was grumbling about the orange scrubs. Clothing is a variable, and there can be no variables in this trial that I have not accounted for, so the scrubs go on and stay on until we hit the ninety-day clearance.
There is no ninety-day clearance. There is no trial.
He puts the boot covers on. He puts the gown on. He puts the mask on. He puts the hood on. He does it because he does not know what else to do with his hands, and because protocol is the only thing in this building that still works the way it is supposed to.
He scans his badge.
The airlock cycles.
The air on the residence side smells of nothing — three weeks of HVAC scrubbing it clean of anything personal.
—
Through the observation port, Dylan is at the small table in the residence. He is in the orange scrubs Nick made him wear. His hair is washed. His beard is kept. He is reading something — a paperback, Nick cannot see the cover — and he has his hand wrapped around a mug of coffee that has probably gone cold.
He looks fine.
He looks like a man at the start of being immortal.
The Mjölnir pendant is out over the scrubs. Dylan cast it himself, years ago. Bronze. Nick has sterilized it twice in the early weeks of the trial. Both times Dylan had it back around his neck inside the hour. His gods have not protected him.
Nick stands at the port for a count of three.
Then he opens the door.
—
Dylan looks up.
His face moves through three expressions in a second and a half. The first is hi. The second is what's wrong. The third is oh.
Nick stands inside the door in his full clean kit and tries to find his professional tone, the version of his voice that he uses when he tells someone something clinical.
"I got the panel back."
Dylan sets the paperback down. Closes it carefully. Marks his place with a finger and then takes the finger out and lets the book close on its own.
"Okay."
Nick stays standing. He does not know why. There is a chair across the table from Dylan. He does not sit in it. He has a clipboard he doesn't remember picking up. He looks down at it and looks back up.
"LDH is elevated. Four hundred and forty-one. Reference range tops at two-forty. CBC differential is showing a left shift, reticulocyte count is off, platelets are sliding. I confirmed on a fresh draw. I ran a chest series at oh-five-thirty and developed the films myself. There's mediastinal involvement. Hilar involvement. Mass effect in the lower lobes. There's a peripheral lesion in the right lung."
He stops.
He has not said the word.
Dylan watches him.
The mug is between Dylan's hands. He has not picked it up.
"Nick."
Nick keeps looking at the clipboard.
"Nick."
He says it gently. The way you say it to someone who is about to break.
"Tell me what it is."
Nick looks back at Dylan.
"Uncontrolled cell growth consistent with a malignant neoplasm."
The phrase comes out flat. The way it would read in a chart.
Dylan's face does not move.
Nick watches him very carefully and Dylan's face does not move at all.
A long second. Two. Three. Dylan looks down at the mug. He picks it up. He takes a sip. He sets it down.
"How aggressive."
"Hyper. Hyper aggressive. The differential is unusual. The cells aren't presenting in a pattern I recognize. I think — I think the mutagen is interacting with —"
"How long."
Nick closes his mouth.
He has been rehearsing the answer to that question for three hours and has not landed on a version of it that he can deliver without it being a sentence.
"I don't know yet. Days. Weeks at the outside. I'm not a cancer pathologist."
Dylan exhales through his nose.
"Don't hedge."
Nick looks at him.
"Days. Maybe a week. Maybe less."
Dylan nods. Slowly. Once.
He picks up the mug. Takes another sip. Sets it down.
"Okay."
That's it. That's the reaction. Nick stands at the door in his full clean kit and watches his best friend absorb a death sentence with a sip of coffee and an okay, and the thing he has been holding in his chest since the second LDH at oh-four-twenty-eight starts to crack along a line he didn't know was there.
"I want to start radiation today," Nick says.
Dylan looks up.
For the first time since Nick walked in, Dylan looks at him like a person and not like a doctor.
"Sure."
The word lands in the room like something dropped.
Nick's mouth goes dry.
He has known Dylan for twenty-three years. He knows what Dylan said about radiation. If I'm gonna die, Dylan has said, more than once, may as well just go.
Sure, Dylan says now. At oh-six-fifty-eight on a Tuesday in October. In orange scrubs. With his hand around a mug of cold coffee.
Nick stands in the door and feels the floor go out from under him.
—
"I'll set up," Nick says. "Give me an hour to prep the suite."
"Take your time."
Nick turns to the door. He does not let his face do anything. He keeps his hands at his sides. The airlock cycles slowly enough for him to feel every second of it. On the other side, in the corridor, he pulls the mask down and pulls the hood back and walks to the imaging suite at a pace just slightly under a run.
He does not cry.
No.
You are not right about this.
You do not get to be right about this.
I am going to be right and you are going to be wrong, and the way I am going to be right is by working until these goddamned numbers move, and the numbers are going to move because I am going to make them move, and that is what is going to happen.
He does not cry.
He sets up the radiation suite.
— — —
What follows is the work.
The work is a thing Nick has done before. He has done it in undergrad, in grad school, in the long months at the bench in his postdoc when the gel didn't show what it was supposed to show and he had eighteen hours to figure out why before the lab meeting. The work has a shape. You do not stop. You drink coffee until your hands shake and then you drink more coffee. You write in a notebook even when you are not sure what you are writing. You sleep in twenty-minute increments at the bench with your forehead on your forearm and you wake up and you keep going. You do not eat properly. You do not call anyone who is not relevant to the problem. You do not look at yourself in a mirror because the mirror is not relevant to the problem.
He starts at oh-eight-hundred on day one.
He does not stop.
—
The radiation runs on the first day at fourteen-hundred. Dylan is calm through them. He makes a small joke about being microwaved that Nick does not laugh at because he is not in the room — he is two corridors away monitoring through the screen — and Dylan looks up at the camera afterward and says you should have laughed, that was a good one, and Nick presses the button on the intercom and says next time and goes back to the bench.
The markers do not move.
He runs another panel at oh-two-hundred. The LDH is four-eighty.
—
He calls his thesis advisor at oh-four-twelve on day two. The man is seventy-one years old and has not been awake at four in the morning for thirty years. He picks up on the second ring.
Nick describes the case. Not by name. Not by identifier. He describes it like a paper he is writing.
His advisor is quiet for a long time.
Then his advisor says, Nick. Is this a real case?
Nick says, no.
His advisor says, if it were a real case, what would you want me to tell you.
Nick says, I don't know.
His advisor says, go to sleep, Nick.
Nick hangs up. He does not go to sleep. He goes back to the bench.
—
The counter-mutation protocol takes nine hours to design. He pulls the corrective sequence from the original mutagen architecture and reverses the orientation. The theory is that if the original mutagen induced a runaway in cell-cycle regulation — and the histology is consistent with that, the films are consistent with that, the markers are consistent with that — then a reversed sequence might compete for the same binding sites and slow the cascade.
The theory is shit. He knows the theory is shit. The corrective sequence has never been tested even in vitro and the math is suspect at best. He has nine hours of work and a single best guess and a friend who is dying down the corridor.
He runs it anyway.
The dose goes in at twenty-one hundred on day two. Dylan asks what it is. Nick tells him. Dylan listens to the explanation with the polite attention of a man being told about something that is not going to work, and when Nick is done Dylan says okay, let's try it, and rolls up the sleeve of the orange scrubs himself.
—
The markers do not move.
—
Twenty-three hundred on day two. Nick is at the bench with the latest panel in his hand. The LDH is five-fifty. He looks at the number. He looks at the printout. He thinks about the corrective sequence binding to the wrong site. He thinks about the rats in the next wing. He thinks about twenty years of work.
He picks up the phone again.
This time the call is to a guy he went to grad school with who now runs an oncology lab in Boston. The conversation goes longer. Nick is more honest. He still does not say my best friend. He says the patient. The guy in Boston listens. Asks questions. Asks more questions. Eventually the questions stop and there is a silence on the line that Nick recognizes.
The guy in Boston says, Nick. There's nothing.
Nick says, there has to be something.
The guy in Boston says, I'm sorry, man.
Nick hangs up.
He sits at the bench for a while.
Then he gets up and goes to the bathroom and is sick into the sink.
He rinses his mouth out. He goes back to the bench.
—
Day three. Dylan comes by the lab at oh-six-hundred. He is in the orange scrubs. He brings Nick a mug of coffee.
He does not say anything. He puts the mug down next to the keyboard. He puts his hand on Nick's shoulder for a count of two. He leaves.
Nick does not look up.
—
The markers do not move.
The markers do not move.
The markers do not move.
— — —
It happens at fourteen-twenty-seven on day three.
Nick is at the bench. The latest panel is on the screen in front of him. The LDH is seven-twelve. The platelets are critical. The differential is something he does not have a word for. He has been awake for seventy-six hours and the coffee is in a mug at his elbow that has gone cold for the fourth time and he is looking at the screen.
He is looking at the screen.
He has a pen in his hand. He was going to write something in the notebook. He does not remember what.
The hand stops moving.
The pen falls out of it. It lands on the notebook page. It rolls. It stops.
Nick looks at the pen.
Pick it up.
He does not pick it up.
He puts his hands on the bench to push himself up.
His legs do not carry him.
He stays in the chair.
He sits in the chair and his hands are on the bench and the pen is on the notebook and the screen in front of him is showing him a number he cannot make smaller, and the thing in him that has been doing all of this for three days — the thing that has been answering the phone and running the panels and writing the protocol and pretending the protocol was going to work — that thing stops.
Some piece of him just gives way.
He does not know what it is. He does not have a name for it. He sits in the chair at the bench in his three-day-old clothes with the pen on the notebook and the cold coffee at his elbow, and he understands — physically, not intellectually, the understanding lives in his ribs and his shoulders and the place behind his eyes — that he is done.
The thing that was doing this before — the part of him that believed the work would yield, the part of him that walked into this lab twenty years ago and started building toward a single moment that was supposed to be three days ago and was instead this — that part is gone.
Nick reaches up and pulls the mask down.
He has been wearing the mask for three days. There is nothing left in this lab to contaminate anymore.
He sits there for a long time.
[End Act 1]