Subject A arrived at the Centre for Tropical Diseases approximately two hours too late. A prospector for an agricultural development consultancy, she had returned a week earlier from surveying the Amazon, complaining of acute pains behind her eye. A rare lepidoptera had infected her right ear canal with a form of myiasis. Initially the parasite was identified as a subspecies of Dermatobia hominis. Judging by the size of the larvae and the milky skin of the chrysalises, I believe it is a new variety of Saturniidae.
A’s husband-to-be brought her to the university hospital’s emergency unit. The couple had been dining at home with his parents when the headaches magnified in intensity, followed by the first of the hallucinations. According to the fiancé’s account (from the case file):
“She jumped up from the table and pointed at the divan, saying, ‘Who’s he?’ Well, we looked over and saw the cat, sleeping in its basket. Then she shouted, more a kind of scream, like she was being strangled, and she dug her nails into her cheeks and I jumped up to hold her. She said she could see a shadow, a dark shape. When I tried to calm her she screamed, grabbed the carving knife out of the roast and fell over her chair trying to get away, waving the knife like there was something flying around her.”
In hospital her descriptions of the shadow grew more precise, slowly solidifying in her imagination. Equally troubling, the shadow’s movements suggested it frequently manifested behind the patient, discounting the possibility that the hallucinations were caused by retinal damage from the larvae. Other instances in the hospital records suggest the movement of the shadow was inconsistent with that of the eyeball, remaining fixed in Subject A’s physical environs.
It was unfortunate the hospital was slow to refer her to us. I would have liked to have witnessed these early stages myself. I have not completely discredited the fiancé’s belief that these visions were a form of malignant visitation, although colleagues are quicker to dismiss the notion. Yes, A’s mental and visual functions were damaged enough to project neural misfires onto the distorted visual sensors. Equally, the larvae may have excreted hallucinogenic chemicals to aid ingestion, but the level of botulinum used to try and kill the parasites makes it impossible to measure chemical levels in her brain. Fortunately, several of the larva survived, now in the pupal stage. I am hopeful we will have a mating pair.
A’s death was fascinating. By the end she had the strength of a psychotic, despite her anorexic frame. Four nurses tied her to the bed while she thrashed and screamed, impervious to anaesthetics and pacifiers, but not as if in pain, more like a hysterical fit. She reached out as far as the restraints allowed and contorted her shoulders as if trying to stretch invisible wings.
I extracted her right eyeball, to try and save what remained of her brain. Her violent movements, complicated by the swollen, fleshy bulge of her face made it difficult to insert the scoop. Inevitably I tore the optic nerve as I pulled her eyeball free of the pulpy socket. As I examined the ruined optical tissue in my palm, her unintelligible screaming clarified into garbled sentences, describing her visions.
I paraphrase here, but you can verify the accuracy with the theatre’s audiovisual records. The shadow before her spread its black wings and extended huge talons from the wing tips. Nebulous clouds of near-mammalian breath gusted in the thin air of her mind. Beyond it, blurring with the real of the operating theatre, extended the otherworld of jagged ice, as if an ocean of violent waves froze in roll and rush. She described a broken collage of black butterfly-angels, flying and hunting, their shadows splaying the white tundra; in the distance an ice palace-pyramid as huge and steep as a mountain, crawled with thousands of these humanoid lepidoptera; and above, in what should have been the sky, a bleak crag of white light poured as if through a hole torn in a cave’s roof. In the last seconds she begged for her life, tossing her head and spilling maggots from the cavity of her eye-socket, then arched sharply as if she had been stabbed below the ribs.
The extent of the damage to her brain was impossible, her frontal lobes mostly destroyed along with a substantial portion of the meninges. As we extracted the larvae, they were strung with capillaries and protein. I speculate that they had substituted parts of her neural network, merged with the pathways and flowers of her thoughts in rudimentary symbiosis, keeping her functioning. Lesions revealed by autopsy confirm that the eggs hatched in the cochlea. The larvae crawled through the osseous labyrinth and burrowed into the flesh of the optic nerve, spreading into the lateral geniculate to feed on neural proteins and retinal fluids.
I stood with the fiancé afterwards, in front of the specimen tank. A strip of willow from the centre’s internal garden now holds the pale chrysalises. Who knows how long they will take to burst? I explained to him that her case was the first of its type. Yet he was desperate to know what she had experienced. Our conversation was brief, but fruitful. I expect to begin notes on Subject B shortly, once they have hatched and begun to mate.
WRITTEN BY GEORGE TTOOULI
ILLUSTRATED BY ROBERT ELROD
George Ttoouli is an Honorary Teaching Fellow for the Warwick Writing Programme and a freelance editor. His articles, reviews, poems and short fiction have been published round and about. He co-edits Gists and Piths with Simon Turner, an experiment in poetry e-zining. His debut collection of poetry, Static Exile, was published in November 2009 by Penned in the Margins.
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