Connie Willis - Passage

It developed, on Joanna’s close questioning of her, that she had nodded off for a moment and “awoke” to feel Tish’s hand on her wrist, taking her pulse. “I’m so sorry,” she said. “I’ll try to stay awake next time.”

“Do you remember the point at which you feel asleep?” Joanna asked.

“No, I was lying there, and it was so quiet and dark…” she said, clearly making an effort to remember. “I don’t know what came over me. I don’t usually doze off like that.”

“Did the quality of the silence or the dark change at any point?” Joanna pressed. “Did something wake you up? A sound?” But it was no use. Mrs. Troudtheim had told her everything she remembered.

“I’ll be happy to try it again, and this time I promise to stay awake,” she said.

Richard explained to her that they couldn’t send her under again so soon. “This doesn’t disqualify me, does it?” she said worriedly.

“Not at all,” Richard said. “There’s usually some trouble getting the dosage right at first. I’d like to schedule you for another session this week. Can you come in day after tomorrow?” That would give him time to look at the scans and the data and see what the problem was. It was probably simply that Mrs. Troudtheim required a higher dosage to achieve an NDE-state. It was too bad, though. He could have used another set of scans for comparing the endorphin sites.

“I just thought of something,” Joanna said after Mrs. Troudtheim left. “She had oral surgery the day before yesterday. Could the anesthetic she’s getting for her oral surgery be interfering with the dithetamine?”

“It shouldn’t be,” he said, but he had Joanna call and ask her what she was getting, which turned out to be short-term novocaine and nitrous oxide, neither of which should have stayed in her system for more than a few hours, but he checked her neurotransmitter analysis anyway and then called up Mr. Wojakowski’s, and then Mr. O’Reirdon’s.

He spent the rest of the day analyzing them for endorphins. Both showed the presence of beta-endorphins. Alpha-endorphins were present in Mr. Wojakowski’s, but not Mr. O’Reirdon’s. Tish came back at five to collect a scarf she’d forgotten and to ask him if he wanted to go to dinner at Conrad’s, “a bunch of us are going,” but he wanted to go over the rest of the analyses before Amelia’s session, so he told her no.

“All work and no play,” Tish said, and then, coming closer to look at the screens, “What do you see in those things anyway?”

Good question. There was no NPK in Mr. O’Reirdon’s analysis either, and when he checked Mr. Sage’s, he didn’t show any, and no alpha-endorphins. He did, however, show the presence of dimorphine. And high levels of beta-endorphins, which must be the key.

He did some research. In laboratory experiments, beta-endorphins had been shown to produce feelings of warmth and euphoria and sensations of light and floating. He called up the scan of Amelia’s third session again, the one after she had uttered the famous “oh, no,” and looked at the beta-endorphin receptor sites. As he’d expected, they showed lower levels of activity. The majority of the sites registered yellow rather than red, and two were yellow-green. In addition, several receptor sites for cortisol, a fear-producing neurochemical, were lit.

Could Mrs. Troudtheim need a higher dosage of dithetamine to generate those endorphins? He went over her analysis, but her waking and non-REM sleep endorphin levels were within the normal range and her scans on entering non-REM sleep looked identical to both Amelia Tanaka’s and Mr. Wojakowski’s. When Joanna asked him the next day if he’d found out what had gone wrong, he said, “Not a clue.”

“I still haven’t been able to get in touch with Mrs. Haighton,” Joanna reported. “She was at the Women’s Networking Seminar or the Women’s Investment Club, I forget which. And there’s a problem with Mr. Pearsall. He couldn’t come in tomorrow or Thursday, so I scheduled him for today after Amelia.”

“Good,” he said. If Mr. Pearsall’s NDE showed the same beta-endorphin levels—

“Sorry I’m late,” Tish said, coming in. “I was at Happy Hour till after midnight. You should’ve been there, Dr. Wright.”

“Umm,” Richard said, and to Joanna, “Have any of your subjects used the word floating to describe the out-of-body experience?”

“Nearly all of them,” she said. “Or hovering.”

“Do you know if there’s a correlation between out-of-body experiences and a blindingly bright light?”

“No, I can check.”

“Hi, Dr. Wright,” Amelia said, coming in. She shrugged out of her backpack. “I’m sorry I’m late. Again.”

Tish handed her a folded gown. “I’m Tish,” she said. “I’m going to be prepping you today.”

Amelia ignored her. “I got a B-plus on that biochem exam, Dr. Wright!” she said. “And an A on my enzyme analysis.”

“Great,” Richard said. “Why don’t you go get dressed, and we’ll get this show on the road,” and went over to the console to look at the scans again while Tish prepped Amelia and started the IV, and then went over to the examining table.

“All set?” he asked Amelia.

She nodded. “Can I have a blanket first, though? I’m always so cold afterward.”

“Were you just as cold both times?” Joanna asked. “Or were you colder one time than the other?”

Amelia considered that. “I was colder last time, I think.”

Which might mean that was an effect of lower endorphin levels, too, rather than lowered body temp. He had the nurse start the feed and then went back over to the console to watch Amelia’s NDE. Both the intensity of activity and the number of sites were greater this time, so the variation must not be due to a developed resistance.

He looked over at the examining table. Joanna, who had looked anxious at the beginning of the session, had relaxed, and Amelia’s face had the same Mona Lisa smile as during previous sessions.

Richard kept her under for four minutes. When she came out, there were no frightened murmurs, and, as he had expected, Amelia described the light as being brighter and “sort of shining out,” spreading her hands in a feathering motion to indicate rays. Definitely endorphin-generated.

“Did you have a warm, safe feeling?” he asked, and felt a sharp kick to his ankle.

“Can you describe the feelings you had during the NDE?” Joanna asked, her face impassive.

“I felt warm and safe just like Dr. Wright said,” Amelia said, smiling at him, and he knew Joanna would accuse him of leading, but Amelia mentioned the warmth and the light several more times as she recounted what she’d seen, and when Joanna asked her, poker-faced, if she’d experienced anything that frightened her, her answer was a definite no.

What she had seen was a long, dark room “like a hallway,” with an open door at the end of it, and people standing behind the door. “Did you recognize the people?” Joanna asked, and there was a pause before Amelia shook her head. “They were dressed in white,” she offered.

“What happened then?” Joanna asked.

Amelia pulled the blanket closer around her shoulders. “They just stood there,” she said.

Joanna wasn’t able to get much more out of her except that she had heard a sound (which she couldn’t identify) as she entered the hallway, and that just before that, she had had a momentary sensation of floating.

Definitely the beta-endorphins, Richard thought. He needed to look at the neurotransmitter analysis and the bloodwork, but if they were both higher than Amelia’s two previous sessions, then possibly all the core elements were endorphin-generated. Which would mean that the NDE might be what Noyes and Linden had thought—a protective mechanism to shield the brain from the traumatic emotions of dying and not a survival mechanism after all.