Morphology by Alexis Clements

The winner of the Subtle Science Short Story Challenge, Alexis Clements, has been writing for print and for the stage for just over five years and is currently working towards a masters in philosophy and history of science at the London School of Economics. In her story, the actions of the unnamed narrator and her partner in the field of research science are given ominous resonance through the fact that they are never fully disclosed

I suppose you would call me a conwoman, a huckster, a fraud. You would say that what we do is reprehensible, unforgivable, an abomination. I've been accused of worse.

You probably think there should be laws against people like me. You probably thought there already are. You would be only partly right. What we're doing is not entirely legal, but it isn't entirely illegal either, and it's completely fine as far as the officials who we've encouraged to support us are concerned.

I admit to all this. I have nothing to hide. And if you ask me how I sleep at night I'll tell you, very well. I'm not ashamed of what I do.

I'm only here because I'm tired. Because the travel is wearing me down, because making all the arrangements, sending all those packages, placing all those follow-up calls, making sure it all goes as it should, and then dealing with it all when it doesn't go to plan (because it never does), is making me tired.

I'm only here to take a rest, a kind of vacation.

* * *

When my brother found out what I was doing with Ron he didn't say anything at all. He changed the subject and then we never spoke about it, or anything else, ever again. But that wasn't so unusual. We've barely spoken at all since the last time I went home. We've never been very close, David and I. We've just had separate lives. We played together when we were children, we did all the things that siblings do, but we just went our own ways at the age of 10 or 11 and never really reconnected. I don't really think that fault or blame are really relevant, it's just the way it was. Our family was like that. We each had our own things to do, we kept ourselves amused.

* * *

With Ron I'm closer to anyone than I've ever been. We know each other well enough to know our limits, we know pretty much exactly what the other person is and isn't capable of. We've been with each other long enough now to have stopped fighting about it, we just accept it. We had reached that point a couple of years before we started this business together.

He's the first person that I've ever been completely honest with. My first husband and I, we played a lot of games with each other. I suppose I can't really say for sure if Ron is completely honest with me. There are limits to that, there have to be. But I can say with some certainty that we know more about each other than anyone else knows about either one of us, maybe more than anyone would care to know. We keep each other company, we live separately from most other people. We both seem to prefer it that way.

* * *

You probably think that all of this makes me a cruel person. I can imagine you think it's even worse because I'm a woman, that it's even worse that I do what I do because of that. No matter how much progress there's been, we're still the nurturing ones, right? And I suppose if I told you that I don't have any children you would draw some further conclusion from that - she's not even a real woman, she's selfish and cold, and she doesn't even have the excuse of a great career to fall back on, she's only a secretary, a childless secretary.

Would it make any difference if I told you I've miscarried twice? Or that my first child died after only three months? Perhaps with what you know you would find a way to blame me for that, maybe you imagine I'm such a monster that I'm even capable of killing my own child.

* * *

When I was growing up my father made my brother and I attend church with him. Afterwards David and I would have to go to catechism classes. One day the teacher of my class tried to tell us about our conscience, to explain why it was that sometimes we got the feeling that what we were doing is wrong. He told us that our conscience was a triangular blade inside of our stomachs and each time we did something bad the blade would twist, it would give us three little cuts inside of our bellies. He said that was the reason why we felt funny when we committed a sin. But, he said, if we kept doing bad things, if we kept on committing sins, and the blade kept turning, eventually the corners would wear down until it was just a circle spinning out of control and we would stop feeling anything at all.

I figured then that I must have already worn the corners of my conscience down to smooth curves, I couldn't remember feeling pain like that for a long time.

* * *

If I have to tell the truth, it's the expression on their faces that bothers me. That's the only thing - the earnestness.

You probably think they're all idiots for going along with it, for paying all that money. How could they believe any of that stuff we send them, right? How could they possibly think that any of this stuff is true, with all those studies against it, with all those warnings posted on the internet and articles printed in the papers.

I think you'd be surprised how much they do know about what's going on. And by that I'm not just talking about the science of it, I mean the whole thing - the science, Ron and I, the likelihood that there will be any effect at all, the likelihood that they are just wasting all that money.

They go along with it because one in a billion is better than one in a trillion. They go along with it because they want a possibility where someone else has told them there's none. They go along with it, most of them, knowing full well what the whole thing is about, somewhere inside of them, but they tell themselves what everyone tells themselves - it's better to try and fail than not to try at all, right?

What we do is not going to kill them. I've always tried to make sure of that. The rest is up to chance.

* * *

Most of the time they bring their families with them. As many as they can afford to bring. Someone willing to spend $30,000 on a treatment that may or may not work can probably find a couple of extra thousand to bring someone else along.

We've got an arrangement with one of the resorts on the island. We send clients over to them and the resort gives us a cut of the costs. It's a nice resort. I've been there myself a couple of times. Their motto is, The Complete Package.

I go there to meet all of the clients and bring them back to the clinic. We could arrange a driver, but personal contact is important. I can have a long chat with them, find out what it is they really want, why they really came all that way. It makes the treatment process much easier, for them and for Ron and me.

We encourage them to treat it like a vacation. We tell them that a bit of sun and sea air are good for the treatment, for the recovery process.

Maybe in the end it's just a placebo effect. But that's some improvement, right?

* * *

Like I said before, I've tried to make sure that none of it will cause them any harm. Ron has all the contacts to actually get the cells, but I'm the one who follows up, who tries to make sure the women didn't have any diseases, drug habits. I'm terrified that one of our clients will pick something up - hepatitis, AIDS. I suppose we could just move the clinic, close up for a little while and reopen later, but I don't want that on my hands. It's just so difficult to know if they're telling the truth down there, if they're actually doing the tests I tell them have to be done. There's just no regulation in place down there.

* * *

I once wrote to one of the doctor's who does work with stem cells in a real lab, in the UK. He was impressed by how much I knew. I read everything that comes out. I read more than Ron does.

I'm the one who compiles all the papers, the articles, the notes and references, I'm the one who puts together the packages to send to the people who are interested. I regularly talk to the clients about it, answer their questions. In the end, they always want to talk to Ron, the real doctor, they want to hear his reassuring voice, hear him read off the lists of references that I prepare for him.

It is true that science doesn't support what we do. It's also true that most of them think we are decades away from even knowing what would happen if they tried to do what we're claiming stem cells can do already. It's not that they can't do it, only a tiny number say that, it's just that we don't know how to go about it, how to start to process on the right track and then stop it once it's done, how to handle what might happen afterwards.

He studies stem cells and cancer, the doctor that I wrote to - he started off as an oncologist, like Ron, a practicing physician, and then moved into research science. I don't think they ever knew each other.

I wanted to ask him about a paper he had published a couple of weeks before in the Journal of Pathology. He had written about how stem cells in the body try to repair stomach ulcers, how they leave the bloodstream and go to the stomach and try to rebuild healthy cells, but because they're programmed to just keep going and going they go too far and what starts off as healthy tissue then turns into cancer.

The body is funny that way. It thinks it's doing one thing, a good thing, and then it turns out that too much of a good thing is even worse than what was there before.

* * *

The papers and articles that I send to the clients are excerpts and references from hundreds of other papers. I change it about once a month, update it, tweak it a bit, change the order of things depending on the clients.

Some of them come because they think it will make them healthier, smarter. They think it will make them live longer. Those ones are mostly CEO-types. They come down with their wives and girlfriends and get an injection on one day and fly back home the next. But there aren't so many of those.

The others come because something is wrong, usually something is very wrong: leukemia, cancer, kidney failure, liver disease, Parkinson's, multiple sclerosis, just about anything really.

We don't make specific claims, just general statements. We only say it will help, we don't ever say that it will cure.

There have been complaints lodged against Ron. A few former colleagues, other doctors, scientists. They are trying to get his license taken away, trying to have him investigated, but none of it has had much effect on business.

People want what they want.

* * *

There are problems sometimes. Calls from angry family members. A fair number of our clients have to borrow money to undergo treatment. Many of them come for more than one treatment. They sometimes spend everything they have in savings and then more. They come back because they feel it has done something positive for them, because they felt better after the first treatment, because they want to feel it again. It's a very simple impulse, very understandable.

The families yell and scream, say horrible things into the phone, threaten us with everything they can think of. I've had one death threat. Ron has had more.

I'm not immune to that. Who would be? But I've learned to deal with it. I've learned not to try to talk to them, to just let them say what they have to say, to get it out. I think more often than not it's that they're sad that their relative is dying, they're scared and angry, and we become an easy target, someone to blame, when before there was no one. I've learned not to take it personally.

The only time it really bothered me was the time the sister of one of our clients came in to talk to me. The parents were inside the treatment room but she didn't want to be there, didn't want to see what was happening. She found my office, at the back of the clinic and sat down opposite my desk. She told me that she knew that what we were doing was a scam, that she had done her own research, that she had copies of all the complaints against us, copies of some of the police reports. She said that she had spoken with Dr. Obamwe, Ron's old colleague, the one who started the investigations. She wasn't angry or loud, she wasn't emotional at all. She looked quite calm, she was very well-dressed. She told me that she'd flown all the way from Germany to meet her parents and her sister there, at the resort. She told me that she'd even paid for the treatment herself, even though her parents didn't know it yet, that she had transferred the money into their account the day before. She told me all of these things quietly, as if we were talking about the weather, both of us sitting there in my office, the fan blowing the humid air between us. And then she asked me to tell her why she had done all that. Tell me why someone who knows all that would ever go along with all this?

Because you love your sister, I told her. Because you love your family.

You think that's it, she said. I couldn't tell if she was agreeing or if she wanted a different answer. Was it just a rhetorical question?

Or maybe it was guilt, I offered, thinking maybe she felt in some way responsible for her sister's condition.

I wanted her to leave but I also wanted to know why she was there, why she was sitting across from me, telling me all those things she knew.

She leaned her head back against the wall behind her and closed her eyes. I wondered if she was going to stay there forever, to never leave. I wondered what she did for a living, if she was trying to escape from that, somehow. But I barely knew anything about her. Her parents had come from small suburban town outside of Seattle. Her sister lived with them, able to function in part, to move around, to walk and eat, though she had to be fed, and she couldn't speak, couldn't communicate at all. The brain damage was the result of a car accident. I didn't know anything more than that. I didn't know anything about this woman sitting in front of me.

Guilt makes people do funny things, she answered after a little while. But that's not why I'm here.

I'm sorry, I said. I don't know.

She kept her head back, her eyes closed.

I asked her if she thought I should feel guilty for what I do.

She shook her head, no. It's the choice you've made. We're all human.

She stayed there, sitting, quiet.

I offered to get her some water, a drink. I kept a bottle of the local rum in the storeroom.

Part of me hopes this thing will kill her, she said.

We stayed silent for a moment.

What about the other parts, I asked. Once you've made a choice it's hard to remember all the reasons why you made it, you just keep going, you have to follow it through.

The treatment finished not long after that. She left the next morning.

* * *

I've got to leave here in two days. Ron expects me back for the next week's trip down there. He's been trying to get an article published in one of the medical journals for the past few months on his treatments, but none of them will even read the thing. He told me he would see if he could get one of his old colleagues to publish it for him. I don't imagine he's going to have any success. I can't see why anyone would want to support him. But he still wants his notoriety back, he still wants to be a part of something. I think he's growing bored with the treatments, but he has to continue, he has no other choice. He'll never get work anywhere else again.

A few more years and we'll be able to retire.

I'm not entirely sure what we'll do then. I don't have any desire to travel, and I don't think Ron does either. I think we're both feeling a bit tired. I'm sure we'll find something to keep ourselves busy.

· Alexis Clements' play, The Interview, is playing at the Pleasance Dome from August 2-28 at this year's Edinburgh Festival. Another of her short stories, Aubrey, is forthcoming in the next issue of online magazine Route.