By: Mark J. Vaders, Counsel at Womble Carlyle Sandridge & Rice, LLP
Photo by DVIDS
Louis Wooten hadn’t always been a jealous man. He reflected on that fact as he sat, watching the steady trickle of foot traffic flowing through Jefferson Park. It was a gorgeous May morning, the first after an abnormally chilly spring, and the locals were out in force. One of the joggers huffed toward him, her lithe feet pounding a steady cadence in the crushed pea gravel. Louis watched her as she passed, admiring how each step slid fluidly into the next. Envy gnawed at him tentatively, but he pushed it away. He wasn’t going to feel sorry for himself today. He was here to make a decision, and he needed to clear his head.
Closing his eyes, Louis tilted his face back to catch the warmth of the morning sun. Its rays stroked his face, turned the world scarlet, and a breeze ruffled his already unkempt mop of salt-and-pepper hair. What would it feel like to really run again? Opening his eyes ever so slightly, he allowed them to drift over his left leg. Khaki jeans hid the transfemoral prosthesis he’d worn ever since the accident. The DAW Industries “Self Learning Knee” allowed him to walk, but not without pain and constant difficulty. He wasn’t sure how to feel. The prospect of feeling whole again seemed altogether impossible.
He’d come across an advertisement over the Christmas holiday, after sneaking away from the packed living room for a few minutes of restful solitude. A clinical study, located at the nearby Jefferson Institute for Living Technology, was seeking otherwise healthy individuals with missing or paralyzed limbs. The short blurb proffered therapy using some kind of new virtual reality technology. That had intrigued him. A quick call got him on the list, a few visits conveyed his entire medical history to ensure that he truly was “otherwise healthy,” and today the study was slated to begin.
Fear of disappointment sat heavily with him on the park bench.
Louis had allowed his hope to get the better of him in the past. The day the doctors fitted him with the bionic leg, he’d let his expectations far outpace the reality waiting for him. To be sure, the DAW Industries prosthetic was a wonder of modern technology. Its microprocessor constantly measured the movement of a small magnet in the kneecap, memorizing and reacting to every microscopic change in his gait. The leg would even let him run, if he wanted to. He seldom did. Running in a prosthetic hurt like the devil.
The problem with his prosthetic knee was that it was a prosthetic knee. No robotic technology, however advanced, was going to make him feel like he had his real leg back. He couldn’t scratch the itch he sometimes got on a leg that wasn’t there or squat while playing with his grandchildren. The prosthetic attached to his thigh with a terrifying suction that made Louis feel like he was being devoured alive. Most disappointing was that walking with the metal and plastic appendage simply didn’t feel like walking. It was a battle, and it left him exhausted. According to the literature, walking with the prosthetic took approximately eighty percent more energy than walking with a real leg. Louis was sure it took more than that.
Sighing, he made a decision and hauled himself up from the bench. He grimaced as the weight of his limb settled into the socket and the knee’s locking mechanism clicked into place. If the therapy could make him forget that his leg was missing, even for a few minutes, it would be worth the risk of disappointment. Hell, it would be worth just about anything.
. . . . . . . . . . . . . . .
“Good morning, Mr. Wooten! Have a seat along the wall, and we’ll call you when Dr. Heller is ready,” Jackie, the receptionist, called out. She was a perky twenty-something with bleached hair and too much red lipstick, but she was nice. And she remembered his name. Louis appreciated that.
“Sounds good, thanks,” Louis said as he lowered himself into one of the boxy chairs ringing the reception area.
Two other guinea pigs were already waiting, and they welcomed Louis warmly into their midst.
“Hugo Kardon,” said a rail-thin man perched in a wheelchair, extending a hand. He flashed a rakish smile, the white teeth a sharp contrast to his ebony skin. Hugo was missing both of his legs. Noticing Louis’s gaze, Hugo grinned wider. “Construction accident!” he said. “They dropped a damn I-beam on me. You ever hear of such a thing?”
The other man, seemingly of Japanese descent, nodded at Louis. “And my name is Akai Sansui.” He held up an obviously plastic hand but paused, seeming to consider the wisdom of saying more. He smiled, but did not speak again.
“Louis Wooten,” Louis said. He tapped his wedding ring against his knee, metal clinking against metal. “Car accident . . . drunk driver.”
Hugo whistled low. “They catch the bastard?”
“Yeah,” Louis said. “Big surprise, no insurance. Not a scratch on him, either. Apparently that’s pretty common.”
“I’ve heard that,” Hugo replied. “Alcohol makes ‘em like a great big rag doll—they just flop around.”
The door opened again, and a younger woman walked in. Thirty something, Louis guessed. She waved at the receptionist without smiling and plopped into a seat across from Louis. Her form was lean and muscled, and curls of dark brown hair framed her severe face. A white wife-beater hugged her torso. She had a swimmer’s body, Louis thought.
“Morning!” Hugo offered. “Hugo Kardon. Lost my legs to an errant I-beam. What’s your name?”
The woman gave them all a flat stare. “Ripley,” she finally muttered. “Ripley Weaver.” She crossed her legs, bringing up a piece of curved metal.
“Blade runner, eh?” Louis asked.
“Do you see me running?” Ripley asked, her voice acid. She picked up a magazine and began thumbing through the pages. Woman’s Day. Louis doubted she was actually reading the articles. She somehow didn’t seem the type.
Akai shrugged, turning back to their conversation, but did not get a chance to speak. The door to the waiting room swung open, and a nurse beamed at them from the doorway. “Please, everyone, come right this way. Dr. Heller is waiting for you.”
. . . . . . . . . . . . . . .
Dr. Daneeka Heller was not what Louis had imagined. When Louis thought about doctors, he almost always imagined older white men with bald heads or well-trimmed beards—nearly always with glasses. Not very politically correct, he supposed, but consistent with Louis’s experience. Dr. Heller did not fit Louis’s paradigm. He looked more like Justin Long from those “Hi, I’m a Mac” commercials Apple used to run. Definitely more hipster geek than the refined elderly gentleman Louis had expected, and he couldn’t be more than thirty years old. Must be smart, Louis thought.
“C’mon in, everyone!” Dr. Heller announced as they entered. “Before we can begin the experiment you’ll need to fill out some more paperwork, I’m afraid. I’ll talk you through the important bits to make sure everyone’s on the same page. If you have any questions at all, feel free to stop me.”
They stopped him frequently. Apparently they would all be on an IV drip containing something called “gamma-aminobutyric acid” during the simulation. “When you sleep, you lie still in your bed, even if you dream of moving, right?” said Dr. Heller. “If you got up and ambled about while you slept, you would hurt yourself. You don’t, because your body produces gamma-aminobutyric acid, or ‘GABA.’ GABA receptors trigger a flood of potassium into your neurons, which blocks sodium from entering and prevents the neurons from firing. Basically, your body paralyzes itself while you sleep. For your own safety.”
“So, you’re going to paralyze us?” Hugo asked. “That’s a bit scary . . . what if we stay that way?”
“There’s no identifiable risk of that,” Dr. Heller replied. “Your bodies will break down the GABA, so, once we stop the IVs, it’ll be just like waking up. You might experience a short moment of waking paralysis, but that’s pretty normal. Don’t panic, just wait for it to pass as your body gets rid of the GABA.”
“So we’re going to be asleep during the simulation? Is it going to feel like a dream?” Ripley asked, scowling. “I dream of . . . of running already, I don’t need your help for that.”
“You can think of it as a controlled dream, if that makes you comfortable, but you’re not really asleep,” Dr. Heller said. “But the simulation will feel real, and you will remember everything. We call the system ‘T.H.R.I.V.E.’ or the Therapeutic Haptic Relational Immersive Virtual Environment. Therapeutic because, obviously, this is therapy. Haptic because you will feel your environment as if you were actually there. Relational means you will all be in a shared simulation. You can interact with one another, just as in real life. Immersive because you will feel as if you are really there. The real world will not exist to you during the simulation. You will not ‘feel’ whole during the therapy. You will be whole.”
Fear of disappointment screamed in the back of Louis’s mind.
. . . . . . . . . . . . . . .
Louis rested on his back, trying not to rustle the sheet of paper between him and the table. His leg stood on the floor in one corner, next to his pile of clothes and belongings. Dr. Heller had not indicated that wearing the leg would interfere with the therapy, but Louis didn’t want to risk it. He was worried the physical sensation of the suction might carry over into the simulation. Better to do it this way.
“Alright, Mr. Wooten, now there’s going to be a slight pinch.” Louis watched as the nurse slid a needle into a vein on the back of his hand and taped it in place. Needles had never bothered him, but the IV port was a tad uncomfortable. He idly wondered why they didn’t use the inside of his elbow.
“Now Mr. Wooten, the GABA flow will start in just a few minutes. Just lie still, and don’t try to move—that way you won’t experience any discomfort or panic,” the nurse said. “We’ll get you fitted with the T.H.R.I.V.E. equipment in just a few moments, once everyone else is ready.”
She moved down the line, repeating the same procedure on Hugo, Akai, and Ripley. She then returned and smeared some conductive gel on Louis head. When the nurse turned to grab the T.H.R.I.V.E. equipment, Louis tried to shift his head and follow her movements. Nothing happened. Fighting back panic, Louis tried to ask the nurse if this was normal. His mouth didn’t move. He was totally paralyzed. A wild terror gripped him, sending his heart rate into high gear. The nurse returned, and whispered calmly into his ear. “Just try to relax,” she said. “The paralysis is completely normal, and everything is looking good. I know it’s scary the first few times, but you’re in good hands with Dr. Heller.” She slipped what looked like an all-black motorcycle helmet over Louis’s head, and the world winked out of existence.
Louis could hear nothing, see nothing, and smell nothing. The feeling of terror slowly receded, replaced by one of serene calm. Time stretched on, and Louis wondered when they would begin the therapy. Lying on the table, paralyzed, sensing nothing . . . he almost felt as if he didn’t exist.
Sunlight suddenly flashed through Louis’s eyelids, glaring and red. Extreme disorientation hit him like a wave. Had he fallen asleep in the park? Had he missed his appointment? He jerked upright, looking around, and froze. Louis, Hugo, Akai, Ripley, and Dr. Heller were lying in the middle of what looked like a university football stadium. He started to ask where they were, but then stopped as he noticed a foot sticking out his jeans. A left foot. His left foot. He wiggled it, and it moved. “Whoa,” Louis breathed.
“Welcome everyone!” Dr. Heller shouted. “Welcome to T.H.R.I.V.E.!”
. . . . . . . . . . . . . . .
For a few minutes, Louis closed his eyes and just experienced the sensation of being whole. He wiggled his toes, enjoying the warmth of sunlight on skin that shouldn’t be there. He reached down and scratched, finally getting to that place he could never reach. Louis wasn’t sure if he’d ever smiled so much in his entire life.
“Sweet Jesus! Look at me!” Hugo shouted. Louis opened his eyes and sat up, looking toward the exclamation. Hugo was running in circles, jumping and spinning around. Louis decided to join him, and slowly stood up. He tentatively put weight on his left leg and then stood on it, taking his right foot completely off the ground. It felt utterly normal. Joy filled him, and he sprang into motion, joining Hugo in his revelry. They hooked elbows and danced around, laughing until they collapsed on the ground in tears.
Ripley and Akai celebrated individually, in their own ways. Brown locks bouncing, the woman sprinted full-tilt around the track surrounding the football field. Her expression was intense as ever. Akai was meditating, his hands folded together in a complex gesture. After a few laps, Ripley veered back toward the group and loped over to Dr. Heller.
“Dr. Heller, will we ever get tired while we’re here?” she asked. “I feel like I could run forever.”
“Well, you’re not actually running, for starters,” the doctor replied. “Remember, this is a simulation. You are whole here, but nothing is real. Except the experience, that is.”
Louis pried himself up from the grass and ambled over. “I have a question too, doc. How come that GABA stuff paralyzes us, but we can still breathe? Why doesn’t it stop our hearts from beating?” he asked.
“Oh, that’s because the nervous system is divided into different functions,” the doctor answered. “Your conscious movements, your arms and legs and such, those are controlled by your somatic nervous system. That’s what GABA inhibits. Your heart, breathing, and even things like digestion, are controlled by the autonomic nervous system. Totally different ballgame.” Dr. Heller paused for a moment, then continued, “Speaking of ballgames, why don’t we put you all through your paces? Let’s play a little basketball. I’ll referee. Close your eyes while I alter our location . . . it can be very disorienting when T.H.R.I.V.E. shifts environments.”
. . . . . . . . . . . . . . .
Over the next few months, Louis and the rest of the participants regularly showed up for therapy sessions at the Jefferson Institute. They played more basketball, as well as other sports, in addition to engaging in activities that involved finer motor skills. Akai spent several sessions creating “shodo,” some kind of Japanese calligraphy. Moving brush over paper with a hand he didn’t have gave him intense pleasure, much the same as running seemed to provide for Ripley. She never smiled, though. Louis supposed she might need therapy for something other than the amputation, but kept that thought to himself.
The next week, Dr. Heller took them to the beach. “No need for sunscreen!” he proclaimed as they materialized in the hot white sand. The realism of the simulations was impossible to comprehend. “Dr. Heller, how does T.H.R.I.V.E. emulate these worlds in such detail? The computing power to do something like this . . .”
Louis scooped up handful of sand and allowed the silica to slip through his fingers.
“Do they even make computers powerful enough to do this?” Louis asked.
Dr. Heller laughed. “No, there’s only one computer powerful enough to do this.” He rested a long index finger on the side of his head. “The beauty of T.H.R.I.V.E. is that it doesn’t handle the heavy lifting. It provides the structure, links us all together, and makes sure that factually we all see the same thing. But the fine details . . . our brains are filling in all the gaps. Want to see something really cool?”
He fished a playing card out of his pocket. “What do you see?” he asked.
They each took turns looking at the card. “It’s an ace of spades,” Louis said. The others nodded.
“Right, but look at the back.” Dr. Heller flipped the card around. “What do you see?”
“It’s…” Louis’s eyes widened. “One of the cards my grandfather and I used to play with. I . . . I put that deck in the casket when they buried him.”
“Well, that’s morbid. Looks like a regular Bicycle brand card to me,” Hugo offered.
“Not to me,” Akai said. “It looks like an old Nintendo card.”
Louis frowned. “Nintendo?”
“Yes, before they made gaming systems they were a playing card company.” Akai said. “Though, they mostly made traditional hanafuda cards.”
“That’s pretty neat. I had no idea,” Louis said. “So Dr. Heller, why are we all seeing something different?”
“Because that detail doesn’t matter for the simulation,” Dr. Heller replied. “If we were to all sit down and play a game of poker right now, it wouldn’t work if the cards had different values for each player. But it doesn’t functionally matter what design is on the back of each card, does it?”
“But what if we wanted to play something other than poker? Something where the design on the back did matter?” Akai asked.
“Well, we’d have to get a different set of cards.” Dr. Heller said. “Once your brain selects details for an object, T.H.R.I.V.E. stabilizes that detail. Otherwise, stuff would be shifting all the time based on perceived need. Of course, it’s easy to accommodate any need here.” He put the card back in his pocket and pulled out another. “Anyone want to play UNO?”
. . . . . . . . . . . . . . .
Louis sat on his couch at home, idly flipping channels and nursing a half-empty bottle of Yuengling. His wife, Samantha, was curled up next to him reading a book. “How much more time do you have with Dr. Heller?” she asked, continuing to read. Louis frowned. They were nine months into the study. “Not enough. Only three months left,” he said.
She peered over the page at him, concern evident in her blue eyes. “What happens when the three months is up?”
“Don’t know,” Louis said. “It’s a clinical study so that means they’ll start offering T.H.R.I.V.E. to the public eventually, right?”
“I have no idea. I hope so. These past few months have been really good for you,” she replied. It was true. Louis felt so alive since starting the T.H.R.I.V.E. therapy. Despite spending the majority of his time in the real world still wearing his prosthetic, Louis’s outlook on life was decidedly improved. He didn’t mind so much the everyday aches and pains of his bionic leg when a therapy session was always on the horizon. The promise of another reality where his leg was whole again gave him strength. The idea of ending the therapy sessions was so painful that he purposefully avoided thinking about it. Louis was afraid it would be like losing his leg all over again.
“I’m worried about it,” he finally admitted. “This therapy . . . it’s great, but what if in the end it’s like becoming really addicted to a powerful drug? And then they take it away? What’s that withdrawal going to look like?” He frowned. “I might need therapy to recover from my therapy.”
Samantha closed her book and looked at Louis more seriously. “Do you think it will really come to that? Surely they intend to offer the T.H.R.I.V.E. therapy to the public at some point, or what would be the point of this research?” She slid across the couch and put a steady arm around Louis. “Didn’t they tell you anything when you signed up?” she asked.
“I’ll talk to Dr. Heller about it next time I go in,” he said.
. . . . . . . . . . . . . . .
Louis almost “forgot” to ask at the next session. He had something of a valid excuse, after all. When he arrived to sign in, the heated sounds of an argument were assaulting the waiting room from Dr. Heller’s office across the hall. “What’s all the ruckus about?” he asked.
“No idea,” Jackie replied, carefully cradling an enormous cup of Starbucks coffee. A cheerful ring of red lipstick was smeared around one side. “They’ve been going at it like this for a good fifteen minutes now. I wanted to call security, but Dr. Heller said he had it under control.” She winced as a few choice expletives made their way into earshot. “I’m not so sure.”
A door slammed in the hallway, and the waiting room door flew open. Ripley stalked into the room, her eyes rimmed with red. Throwing herself into a chair, she crossed her arms and scowled fiercely.
“You OK?” Louis asked. He didn’t really want to get involved, but he was admittedly curious about why anyone would have a bone to pick with Dr. Heller. Ripley gave him an incinerating glare, so Louis raised his hands defensively. “Sorry, sorry . . . forget I asked,” he muttered.
. . . . . . . . . . . . . . .
Ripley’s bad morning definitely got worse from there. The simulation that day was swimming, and the smell of chlorine permeated everything. Ripley went pale almost immediately, and stood transfixed by the edge of the water. After a few moments she rounded on Dr. Heller, eyes bulging. “I told you, I’m not ready for this!” she screamed. Noticing the pair of swim goggles that had materialized in her hand, she flung them at the doctor’s head. They missed, splashing briefly across the fifty-meter Olympic-size pool.
“We had this conversation already! You can’t make me get in there! Don’t even bother trying to explain again, I am not listening!” she shrieked at him, storming out of the pool area.
Louis looked around the group, gauging everyone’s reactions. Akai seemed horrified by the lack of self-control on display, while Hugo stared after her and chewed on his lower lip.
“Uh, Doc? Is she OK?” Hugo asked. “This is a new level of crazy, even for her.”
Dr. Heller sighed, tossing his towel onto a nearby chair. “Yes and no,” he replied. “Doctor-patient confidentiality and all, so I can’t tell you anything more. We’ll just have to wait here for a few minutes and give her some time to cool off.”
“Dr. Heller, can I check on her?” Louis asked. He didn’t really want to—Ripley freaked him out more than a little bit—but he felt it was the right thing to do.
“Sure, be my guest.” Dr. Heller replied. “Careful though, that tongue of hers is razor sharp.”
“Thanks Dr. Heller, way to boost my confidence,” said Louis as he pushed through the double doors and into the lobby of the T.H.R.I.V.E. SportsPlex.
. . . . . . . . . . . . . . .
Louis found Ripley curled into a ball on one of the black pleather sofas in the SportsPlex lobby. She held her knees tightly against her chest as she rocked back and forth, her face in a hard mask. Her expression did not soften as Louis approached.
“Ripley?” Louis said softly as he sat down across from her. “Are you OK? What was all that about?”
She looked at him through red-rimmed eyes. “Dr. Heller is a damn idiot, that’s what this is about,” she ground out through clenched teeth. “He can send whoever he wants out here, I am NOT getting in that pool.” Louis tried to put a hand on her back, but Ripley slapped it away. “Get OFF of me!” she snarled.
“Look,” Louis said, standing his ground, “Dr. Heller didn’t send me out here. I just wanted to see if you were OK. You’ve kept your distance from the group all this time, and I’m sure you have your reasons for that. I just wanted to say . . . we’re all in this together. If you ever want to talk, any of us will listen.” He stood up and turned to leave. “I’ll give you your space . . . but you don’t have to be totally alone.”
“Look, I’m . . . I’m sorry,” came a barely audible reply as Louis was halfway back to the double doors. He turned back to face Ripley, who was staring through the glass wall that made up the front of the SportsPlex. She didn’t turn to face him, but kept staring out at the trees and grass that weren’t really there. Her expression was vacant, and she just looked . . . sad, Louis thought.
“I shouldn’t have hit you,” she murmured. “I’m sorry.”
Louis put on a warm smile. “Hey, no worries,” he said. “You were upset. It happens.” He started walking back over, but Ripley put a hand up warning him away.
“That doesn’t mean I’m ready to be best friends,” she cautioned. “But, I will tell you this.” She paused, then looked him in the eye. “I was a swimmer, not a runner.”
“You have the build for it,” Louis replied. “I’m not surprised . . . competitive?”
“Yeah,” Ripley nodded slightly. “But . . . I messed up.” She turned to face outside again. “I hit my head during a practice session a few years ago. Lost consciousness under the water. They finally fished me out, but . . .,” she paused, clearly unsure whether she wanted to say more.
“Hey, look,” Louis said, putting up a hand, “you don’t have to do this, if . . .”
“It was the damn oxygen deprivation!” she spat, interrupting him and pounding her fist into the sofa so hard that it nearly turned over. “My legs . . . they were dead, and just hanging there. The doctors cut them off, and I had to give them permission! You, and Hugo, and Akai . . . you all have someone else to blame for your missing whatever. Me? It was my fault, Louis. And I am absolutely freaking terrified of water now! I don’t care if it’s real or not, and Dr. Heller can’t seem to get that through his hipster Harvard skull.”
Louis perched on the edge of the sofa across from Ripley’s, carefully keeping his distance. “Jesus,” he breathed, “I think you’re well within your right to be afraid of water after an experience like that.”
“You’re damn right,” she muttered, looking away.
“So Dr. Heller thinks you should be OK with this because the water isn’t real?” Louis asked.
“Dr. Heller says this is just like ‘Virtual Reality Exposure Therapy,’ which is apparently something they’ve been doing with socially inept people for years,” Ripley responded. “Putting people with social anxiety in virtual crowds. But I don’t have social anxiety.” She smiled bitterly. “Well, at least that’s not the problem right now.”
“Look,” Louis said, “I’m no expert, but even I can see that asking you to get in the pool is completely stupid. Do you want to sit in there and watch? I’ve got your back if Dr. Heller tries anything.”
“No way,” Ripley sighed. “I’m definitely staying out here.”
“Alright. Just remember that you’ve got a friend in there if you change your mind,” Louis said. He paused for effect, then continued. “I really appreciate you sharing all this with me. It means a lot.”
Ripley nodded and went back to staring outside. Louis shook his head as we walked back through the double doors to the pool. It amazed him how someone as smart as Dr. Heller could be such an idiot.
. . . . . . . . . . . . . . .
The rest of the pool session went by without incident. They swam laps, played some water polo, and made good use of the high-dive platform. Louis was pleasantly surprised to notice at one point that Ripley did appear in the room, though she kept her distance from the water. Her back was pressed hard up against the wall by the double doors. Dr. Heller started to call out to her at one point, but Louis put a hand on his shoulder and shook his head. “Not a good idea,” he said. Fortunately, Dr. Heller didn’t try to force the issue.
After several hours in the water, the group gathered by the double doors to towel off. Louis decided it was time to breach his own sensitive subject with the doctor. “So, Dr. Heller. I’ve been meaning to ask . . . what’s the plan for T.H.R.I.V.E. after we finish the study?” he said.
The doctor scratched the back of his head and winced, looking for all the world like a kid caught pinching cookies. “Well, that’s . . . complicated,” he began. The other participants started moving closer, equally intent on learning their fate. Apparently Louis wasn’t alone in wanting to know, but not wanting to ask. “No pun intended, but . . . what’s up, doc?” Louis asked.
Dr. Heller sighed and sat down on a pool chair, crossing his legs. “Have a seat,” he sighed. “Let’s talk about this. We might as well do it now.”
Everyone gathered around the doctor. Hugo’s smile was gone, and Akai was absently clutching the wrist of his right hand. Ripley didn’t sit, but instead stalked in a circle outside the group. She had to be on edge after watching them in the pool for so long.
“First of all, let me thank all of you for participating in the trial. We have two more months to go, but we’ve already collected some fantastic data that will help with the commercialization of T.H.R.I.V.E.”
“So what’s the problem?” Hugo asked.
“Well, it took several years to build the prototype T.H.R.I.V.E. that you’re using now. More are in the works, but this technology is almost prohibitively expensive. The Jefferson Institute for Living Technology has an Economic Division that holds the patents on the technology and makes decisions regarding how the machines will be commercialized. Right now their plan is to sell the T.H.R.I.V.E. units almost exclusively overseas.”
“What?!” Louis exclaimed. “Why won’t they sell them here, where the technology was developed?!” He felt completely numb.
“Like I said, it’s complicated,” said Dr. Heller, holding up a hand against their horrified stares. “The regulatory hurdles for bringing a device like T.H.R.I.V.E. to market in the United States are simply too complex. The FDA doesn’t have guidelines in place for VR therapy devices, and insurance providers aren’t going to cover treatment that doesn’t fit their limited category of ‘illness.’ If your leg is amputated, your insurance is going to cover a prosthetic. If you are depressed, your insurance is going to cover Zoloft. T.H.R.I.V.E. is a new kind of therapy, sort of a hybrid that addresses both physical and mental health. The U.S. healthcare infrastructure just isn’t ready, and probably won’t be ready for a long time.”
“Then why are we even here!?” Ripley growled from behind the doctor.
“This is clinical research,” Dr. Heller explained, “but not a clinical ‘trial.’ We’re not testing the safety of a new drug for a particular illness, and we’re not establishing substantial similarity of our device to any previous device. We can’t just fill out a 510(k) form. There’s nothing like T.H.R.I.V.E. available for comparison. What we’re doing here is just patient-oriented research to develop a new technology.”
“What if you didn’t claim to be treating disease with T.H.R.I.V.E.?” asked Akai. “Just market it as a virtual reality simulator, and let people use it as they will?”
“Oh, I’m sure the video game industry would love to get their hands on this technology,” Dr. Heller said with a wry smile. “The problem is, again, that it’s just too expensive. Not to mention the necessary medical supervision required for safety. Also, I’m pretty sure the FDA would see through that ruse pretty quickly.”
“What about the system here at Jefferson?” Hugo asked. “Can we keep using this system? Extend the trial?”
“I’m afraid not, Hugo.” Dr. Heller replied sympathetically. “I did request an extension, actually. I anticipated the disappointment you would all feel at the loss of these therapy sessions. The Institute . . . denied my request.”
Ripley was apoplectic, her hands clawing frantically at the air. “Disappointment?! This goes way beyond disappointment! Why the hell didn’t you tell us this before we started? Why the hell can’t we have an extension?!”
“Because this system has already been sold.” Dr. Heller said. “It’s going to Germany sometime in the next six months.”
At this news, Ripley deflated completely. She slumped, turned and walked away from the group, but Louis barely noticed.
“Yes, but why didn’t you tell us in advance, doctor?” Louis spoke through clenched teeth. “Why didn’t you let us know before the study that we would never get to have this therapy again?!”
“Because we were concerned you wouldn’t participate,” Dr. Heller said. He looked away, unable to meet Louis’s eyes.
“I would not have.” Akai spoke softly, still rubbing his wrist. “You wronged us, Dr. Heller.”
Suddenly, Hugo was on his feet. “Hey! HEY!!” he shouted, profound panic in his voice. “Ripley, what the hell are you doing!? STOP!!” The rest of them turned. They were just in time to see Ripley plunge headfirst off the wrong side of the high dive.
. . . . . . . . . . . . . . .
Louis’s eyes snapped open in absolute darkness. Muffled shouts full of panic reached his ears, unintelligible but quite clear in their character. He was still fully paralyzed.
Oh God, was Ripley dead?
The thought electrified him, and he felt his heart thumping in his chest. The beat pounded in his ears. What the hell happened? Could you die in the simulation? Louis didn’t know, and had no way to find out. Unable to move, call for help, or even blink voluntarily, Louis found himself in a state of utter helplessness.
This is Hell, he thought.
. . . . . . . . . . . . . . .
Fortunately, Ripley survived her simulated suicide attempt. Numerous T.H.R.I.V.E. safeguards kicked in just before she hit the ground, jolting them all back to full consciousness. The engineers who designed the system anticipated the possibility of serious injury or deadly events during simulations. This wasn’t surprising in retrospect. In the ensuing confusion, the staff worked double time to get Dr. Heller roused and Ripley sedated. Louis, Hugo, and Akai were left paralyzed and conscious for over an hour while the crisis was dealt with.
The remaining months of the trial were cancelled. Dr. Heller met briefly with the participants to relay the news, and apologized for the severe trauma of the final session. “The Jefferson Institute has graciously offered to provide free counseling to all of you out of consideration for your efforts on our behalf. We have an excellent team of mental health professionals and pastoral counselors, and I highly recommend that each of you seek them out. The Ripley incident and the loss of therapy . . . you shouldn’t try to deal with those alone.”
Louis didn’t want anything else to do with the Jefferson Institute. Fortunately, Hugo already had a counselor that he recommended to everyone. “Compassionate and smart as a damn whip,” Hugo told them all as they rode the elevator down to the Institute’s main lobby. “We should all go.”
. . . . . . . . . . . . . . .
They did all go to counseling, for a time. It helped a little, but not enough. Louis, Hugo, and Akai kept in touch, and their companionship helped more than anything else. “T.H.R.I.V.E. Survivors Anonymous,” Hugo jokingly called them. They met a few times every month, playing cards and going to Jefferson Park when the weather was warm. Samantha warmed to Hugo and Akai immediately, and the four of them often gathered for dinner at the Wooten home. It was a temporary solace, however. Late one evening, after the dishes were cleared, Akai broke the news that he was leaving the United States.
“I am so sorry, my friends,” he whispered while tears filled his eyes. “I have tried very hard to forget what we went through . . . but I cannot. It just isn’t possible. I also realize that . . . of all of us, I am perhaps the most physically . . . intact.”
“Don’t go there, man,” Hugo said, leaning forward in his wheelchair to cover Akai’s sole hand with his own. “We all deal with our losses in our own ways. We’re not talking about an equation here, there’s no less than or greater than with us.”
Louis grunted his assent, still surprised by Akai’s decision. He swirled his glass of scotch briefly, then slid it to one side. “So what’s your plan?” he asked. “We’re going to miss you, Akai. A lot. You sure about this?”
“I will miss you both as well,” said Akai, “but there is a private clinic in Singapore . . . they bought one of the new T.H.R.I.V.E. simulators. The regulations there are much less rigorous . . . and all of the staff were trained here in the United States. The facility is actually associated with Duke University. My family in Japan . . . they are willing to take me back in so that I can visit the clinic a few times each year. We can do it financially, so . . .”
Hugo whistled low. “That’s great news for you, Akai. Damn, though, it’s like being hurt by that machine all over again. Now it’s taking you away from us.”
“I know. I am very sorry,” Akai muttered, staring at the table.
“Don’t feel too bad, Akai,” Louis said, looking at Hugo, “and stop making him feel bad, Hugo! Damn, I’d go too if I could. Wouldn’t you?”
“Well, yeah. I guess. Suppose I’m just jealous, is all.” Hugo replied. “I mean, I’ve got some of the best insurance money can buy . . . but it’s not doing anything like that for me. I guess we just have to get used to the idea—all over again—that we’re just like this for life unless they figure out how to grow new limbs from stem cells or something in our lifetime. Not looking good though on that front.”
“Look Akai,” said Louis, “if you have the means, and a family or community that will support you in all this . . . you should go. Don’t let us give you a guilt complex.” He took his scotch back in hand and took a long swallow. “After all, there are a lot of suffering people in the world. We’re not even anywhere near the forefront of that pack. I don’t like my situation, but I’m not under any illusion that I’m some sort of martyr or special case. You’ve got to do what is right for you, and let us do the same. I don’t intend to give up. I’m sure better technologies and whatever will come along.” Louis reflected on the day in Jefferson Park when he made the decision to show up for the study. “I knew going in to the T.H.R.I.V.E. therapy that disappointment was likely waiting in the wings somewhere, just biding its time to come out. I just didn’t know when.”
“Man, my therapist is going to have a field day with this,” Hugo sighed. Looking at Akai, he added, “Seriously though . . . I’m happy for you. Louis is right, you need to go do what is best for you. I’m actually not sure I’d go even if I had the opportunity.”
“Really?” Louis pressed. “Why’s that?”
“Hell, I’ve always had a pretty good outlook on life. Even after the accident.” Hugo scratched his head absently. “There’s some things I’ve missed out on in life living in this chair, but some virtual reality isn’t going to get them for me. I can’t tell some pretty girl, ‘Hey, you should see what I look like in the computer.’ Talk about your creep alert.” His Cheshire grin returned. “Unless of course they’ll let you do that in the T.H.R.I.V.E. simulator! Talk about making the big bucks!”
“Jesus, Hugo, you’re making Akai uncomfortable!” Louis exclaimed, though he was grinning now as well. “I guess you’re right. I’d probably jump at the chance to do the therapy on occasion here in the States, but I’d lose too much moving.” Louis extended his hand. “Akai, it’s been an honor knowing you and being your friend. You will be missed.”
. . . . . . . . . . . . . . .
Ripley found Louis in Jefferson Park the following week. Louis was on his usual bench, enjoying the morning sunshine and sucking down a cup of dark roast. He was just working his way into a noir detective fantasy novel when a shadow fell across the page, making him look up.
“Hi Louis,” she said. Her exercise outfit was various shades of neon pink and green, making her look like a punk rocker from the 1980s. She actually looked healthier than any time Louis could remember at the Jefferson Institute. She also looked very uncertain. “I saw you sitting here and hoped we could talk a bit. Not sure if you’re interested after what happened, but . . .”
Louis moved over on the bench. “Please,” he said. Once she sat down, he continued. “I’m actually really glad to see you here. We were all pretty worried after what happened, but we didn’t have any way to contact you. No one at the Jefferson Institute would give us your information, which I understand—HIPAA and all—but still. How are you?”
She was quiet for a moment, staring out at the people in the park. “They put me away for a little while afterwards, Louis. Involuntary commitment. I think I needed it, though. They helped me deal with some of my anger issues . . . and I’m on some pills now. They seem to help.” She turned one of her blade prosthetics slightly, digging into the pea gravel. “I don’t bite the head off of every person I meet, at least.”
“It’s OK, Ripley.” Louis said. “God knows we’ve got some reasons to be angry from time to time. There’s more people than legs on this park bench, for one.”
“Thanks Louis, but you know what I mean. I was a monster during the T.H.R.I.V.E. therapy. I got us all kicked out early. I’m surprised you don’t hate me,” Ripley sighed.
“The therapy was going to end anyway,” Louis said. “I’m just glad you made it out alive. You look good. What are you up to these days?”
“Guess I’m going to be a runner after all. It hurts, but it beats sitting around. At least I can do it,” she replied.
“I . . . I tried to sue Dr. Heller,” she admitted. “I also looked into moving to Germany. Following the T.H.R.I.V.E. system.”
“I’m guessing neither of those worked out?” Louis asked.
Ripley shook her head in disgust. “Dr. Heller and the Jefferson Institute are bulletproof. No attorney wants to argue about the ‘standard of care’ for a completely experimental therapy. That, and they have an army of lawyers. No way to win.” After a few moments, she continued. “Germany was a no-go, too. The system is there, and I guess they’re using it . . . but I could never afford to get in. You’d have to be super rich.”
“Akai is apparently super rich,” Louis said. “He’s moving back to Japan and will be taking All Nippon flights to Singapore a few times a year.”
Ripley’s eyes widened. “Are you serious?! That must cost a fortune!”
“Yeah, no kidding. Hugo wasn’t happy about it.”
“Are you guys all still in touch?” Ripley asked.
“Yeah, we’ve been getting together a few times a month,” Louis said.
“Could . . . could I join you? I . . . I need all the help I can get right now. I know it’s a lot to ask, but . . .”
Louis stood up and held out a hand to Ripley. “Come with me,” he said. “Samantha, my wife, should be at the house right now. She can get us an ice-cold glass of something. We all need to learn how to thrive without T.H.R.I.V.E., right?”