by Gina Bright
All six eyes fixed on him after he turned on the lights. They trusted him in spite of his masked face.
“Good morning, little cancer fighters.”
Ned was excited because the doctors, not the non-human primate ones he was more comfortable working with, believed they might have found a cure for cancer this time, or at least something like they had for AIDS. Death would be rare.
After a few years of assisting with dog and cat exams, blood draws, and vaccinations, Ned had joined the research team at this start-up pharmaceutical company. That was after his father died from lymphoma. That was before anyone really knew how to use the body’s own immune system to fight disease.
Ned was honored when the scientists selected him to be the animal health technician for these special cynos who would receive SIM001, the first ever “super immune modifier.” Killer T cells would multiply and crush cancer cells while B cells would halt them in their desperate desire to proliferate into infinity. That was how Ned understood it.
He just knew today’s infusion would annihilate the lymphoma cells he injected into his three patients weeks ago. If only Dad was still here.
He needed to feed them before the treatments began. Sassy was his favorite, Subject AF1, the first female monkey who would receive this drug. She had arrived here months ago from the big breeding facility in the Philippines. That long and dark trip did nothing to deter her from biting Ned when he lifted her out of the filthy box she could barely turn around in.
It took him weeks to train her not to go after him every time he opened her cage. He learned mangos were her favorite. Today he hoped a plum would remind her of the lipotes back home and allow him extra leeway with the infusion.
He handed her the mango. Sassy devoured it and then held out her arm. She knew the routine for blood draws, but now Ned needed to leave in the needle. He secured the needle with some tape and gave her the plum. Success.
Ned changed his gloves and unlocked Subject AM1’s cage, the first male in the study.
“Hey, hey, Slick,” Ned said as he placed a large amount of monkey chow in his bowl. Slick learned a few days after his arrival how to unfasten his cage door from the inside. He was usually found wading in the pool in the next room after one of these great escapes. Ned found a little padlock with a key only he carried while on duty.
Slick was not a big fruit eater, unusual for a cynomolgus monkey, but he sure did like the fruit loops Ned gave him every time he needed to draw his blood.
“You’re a good one, my little Houdini,” Ned said as Slick extended his arm in exchange for a Kong toy filled with the sweet, round delights.
The third subject, AM2, was next in line for Ned’s needle. When Ned unpacked this little monkey from his shipment box, his eyes had a longing for comfort so deep Ned had no choice but to just hug him. There was no fight or escape in this one.
Sad Eyes, as Ned named him, was not a big eater; a little chow here and there and the occasional mango was it for him. He always extended his arm without a special treat, but Ned thought a papaya today would lift his spirits. Sad Eyes seemed to enjoy the fruit after the big stick. He even licked his fingers long after it was gone.
All three of them sat still in their cages for the hour it took to receive SIM001. Nate noted, “No adverse events observed during or after the infusion” in each of their charts.
Ned only recorded his observations on the days required by the study doctors, even though he cared for the monkeys the rest of the time. He knew the human doctors were only interested in their responses to the drug at key time points.
Today labs and EKGs were scheduled. It did not take Ned very long to collect a tube of blood from Sassy, but when Ned applied the little pads with wires to her chest to measure her heart’s function she showed him some teeth. Another plum allowed him to complete the procedure.
Ned entered “No adverse events observed” in each of their charts.
Ned was relieved his patients were doing well and he took all of them to the pool. The veterinarians encouraged activities for the monkeys that they would normally engage in in their natural habitats. Ned knew cynos loved the water. He read about the rivers they occupied deep in the forests. The water saved them from the high temperatures and unbearable humidity.
The sauna-like poolroom mimicked their native land and all of them seemed to love it. Slick groomed Sassy as they basked in the cool water. Sad Eyes was not too far away but did not participate. It had been that way since their second time at the pool a few months ago.
Ned knew, the vets had told him, Sassy, Slick, and Sad Eyes were perfect subjects for this study because of their youth, really their sexual immaturity. The males were only two and Sassy was just a year and a half—too young to mate or to have any other illnesses. Nevertheless, Ned was warned to watch Sassy for any sign of estrus, just in case the breeding facility was not completely accurate about their ages.
They stayed at the pool for hours. The cynos succumbed to sleep as soon as Ned placed them back in their cages.
No EKGs today but more blood work. Ned knew they had one more week left before the second infusion. He hoped they would not experience anything too severe so the study could continue and no one close to him would have to die from cancer again.
Ned remembered his father’s awful abdominal pain near the end as he turned on the lights in the cyno room. His Dad spent most of his time in the only chair in his workshop that provided any comfort. At least he was surrounded by the scent of the wood he once crafted into cabinets and bookshelves.
Sassy was still sleeping when Ned approached her cage. Slick was all too happy to receive some fruit loops in exchange for his arm. Sad Eyes expected his papaya now on blood draw days.
Sassy was sitting up in her cage when Ned returned to her. Her eyes were a little glassy. Ned removed the sheath from the needle. She did not demand a mango. Strange.
“My good Sassy girl, enjoy,” Ned said as he handed her the mango when he was done.
She set the fruit on the floor and then rubbed her tummy.
“Subject AF1 appears to have some fatigue, loss of appetite, and maybe nausea or stomach pain,” Ned wrote in her chart.
Ned did not expect to record any observations today, but he had no choice. Before he even turned on the lights, he heard the terrible “Kra, Kra, Kra” from Slick who then rattled his cage as soon as he saw Ned. Sad Eyes had plucked so much hair from the top of his head it looked like he was wearing a little white hat.
Ned ran to the middle cage. Sassy was far away from the opening and her back faced Ned. She was bent over and seemed frozen in that position. He placed his right hand on the front of her neck and his left one on her lower torso to support her as he tried to straighten her out.
The scream was excruciating. More “Kras” came from Slick and now Sad Eyes joined in on the commotion. Ned turned her around. He almost dropped her. Sassy’s greenish-brown eyes were filled with blood.
Ned set her down and ran to the wall to sound the alarm. It was still early but he knew some doctor would be in the building. Thankfully, the veterinarian Dr. Walker arrived first. He took one look at Sassy and asked Ned to get a stretcher.
Next came Dr. Becker. “What has happened?” she said. And then she asked Ned, “Have you not been monitoring her since Day 15?”
He told the doctor Sassy had no new symptoms since then. Yesterday she seemed slightly more tired but she even ate two mangos in addition to some chow. Dr. Becker rushed along with them as they wheeled Sassy to the sick bay. She asked with concern in her voice, “What will I do without Subject AF1?” But Ned knew she really meant, “How can my study continue with one of the three cynos unable to receive the next infusion?”
Dr. Becker examined Sassy in order to observe all of the side effects from SIM001, or what Ned knew she would term “dose-limiting toxicities” if the study ever made it into humans.
Dr. Walker covered Sassy’s eyes so the ceiling lights did not hurt her. Ned started an IV in her right arm and infused the fluids ordered by Dr. Walker. Dr. Becker offered an explanation for Sassy’s condition, “It seems the ‘super immune modifier’ was a bit too ‘super.’ The drug might have attacked more than the lymphoma cells she received. Her central nervous system was a victim of T cell fire.”
Sassy’s face was clenched. Dr. Walker gave her some Demerol and her pain subsided after a few minutes. Dr. Walker also started steroids, Dr. Becker’s suggestion before she left. They might help dull the extreme immune response and even the pain coming from her spine. Usually the doctors would put the animal out of her misery at this point, but Dr. Becker wanted to see if the steroids would reverse this severe adverse event. Not for Sassy’s sake, Ned knew, but for the unfortunate human in the future.
By now Ned was two hours into overtime, but he did not care. He wanted to see Sassy turn around, and he did not have anything better waiting for him at home. He removed the cloth from her eyes. A little snippet of her irises started to peep through the bleeding. Maybe the steroids were working.
After another hour, Sassy seemed relaxed and Ned thought it was safe to go home. But then she started to shake. When Ned tried to stop her writhing he noticed she was burning up. He reached for the thermometer on the table next to her head. He removed it from her rectum when the reading started to pass 106 degrees.
He ran over to Dr. Walker’s office next door. Dr. Walker ran back to the sick bay with Ned. “She’s probably septic. Let’s try some antibiotics through the night.” Then Dr. Walker told Ned to go home. “Sally came on duty hours ago, Ned. Sassy will be her only patient tonight.”
Ned read the night notes in Sassy’s chart as soon as he arrived before dawn. Dr. Walker stayed the night. Sassy’s temperature came down around 4 AM but by 6 AM she was unresponsive. Ned knew euthanasia was inevitable now.
She did not require the propofol usually given for sedation before the barbiturate committed the final act. Ned handed the pentobarbital to Dr. Walker and Sassy was no more.
Ned tried to have a normal workday after Sassy’s death and so he went to take care of Slick and Sad Eyes.
“Good morning, gentlemen,” he said with a somber tone as he turned on the lights.
Slick had now joined Sad Eyes in plucking out his own hair. Sad Eyes had now resorted to biting his arms throughout the night. They were stressed, indeed.
Ned did not have any fruit for Sad Eyes but he knew there were plenty of fruit loops to be had in the cabinet. Sad Eyes joined Slick in a good-sized helping on the floor. Ned felt good letting them out of their cages for some breakfast together.
A few hours later, Dr. Walker came into the cyno room to ask Ned if he would like to assist with Sassy’s necropsy. Ned always hated that term. Why isn’t the dissection of the dead monkey, or dog or cat for that matter, called an autopsy? They’re individuals too.
Ned was the one with sad eyes now when he saw Sassy’s body lying so still on the table. Dr. Walker inserted the knife in her upper chest and moved it until it reached her bottom end. It was just a matter of seconds. Sassy was only 16 inches long.
“Oh Lord!” Dr. Walker exclaimed when he opened her lower abdominal cavity. And then he lifted a tiny, black cyno from Sassy’s uterus. “Just two more months and Sassy would have had her first. Well, probably not with that SIM001 in her system.”
Ned remembered the first day he took all of them to the pool about three months ago after they completed their required quarantine. Ned watched them so closely for any shenanigans as they sat in the water for hours after displaying their talent for splashing. Ned got soaked.
How could it have happened? That was the day though of the last emergency before this one. He was the only tech on duty and he had to run to Dr. Walker’s aide when the alarm sounded. A cyno in an Alzheimer’s study was having unstoppable seizures and Ned had to get Valium for the doctor from the locked cabinet.
He might have been gone ten minutes, fifteen tops, but it was long enough. Now he understood why Slick groomed Sassy every time they went to the pool after that. He knew she would be the mother of his firstborn.
Dr. Walker determined the cause of death was encephalitis due to the study drug.
“You know, Ned, they want me to euthanize Slick and Sad Eyes now. Dr. Becker said the study is too unsafe to continue.”
“I can’t do it.”
Ned could not bring himself to say goodbye to the two males on his way out of the cinder block building. The mid-day air was thick. It’s no wonder they spend so much time in the water back home.
Ned looked up at the cyno floor as he unlocked his car door. He would not return tomorrow. He never would.
Gina M. Bright has a doctorate in medieval English literature and is a registered nurse. She is the author of Plague-Making and the AIDS Epidemic: A Story of Discrimination (Palgrave Macmillan, 2012), and the short story, “The Poet’s Wife; The Mistress’ Sister” (The Copperfield Review, July 24, 2017).