Welcome back to a special Summer Edition of PILCROW. For this final week, we’ll finish serializing the remaining chapters of Martin van Cooper’s unpublished novel Don’t Disappoint (runner-up in our last contest back by popular demand). Stay tuned for submission deadlines for our next quarterly contest (in which each of two runners-up receive $500, and the ultimate winner - voted on by you, dear subscribers - receives $1,000).
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In Don’t Disappoint, amidst a flailing career, a displaced midwesterner in Los Angeles goes home to confront the complications of a mother with advancing dementia, only for a marital sucker punch to leave him questioning what’s left of his family to salvage.
Martin Van Cooper writes the Substack Don’t Read the Dust Jacket
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Tuesdays she was nonclinical and did cardio at the gym in the early morning and then went to her office to read or write. Action salve to the anxious mind. There was a plane to only be reached through extreme exertion. She was accustomed to the visual ransacking her body took from the men in the place. Black men had some discretion. White men either stutter or try to maul you. She nearly passed out on the bike that morning, edgewise glances from the rest of the 0500 class. Let me tell you, someone is saying, in saunas in the west valley you never hear English. Only Persian or Hebrew. One day I heard Mandarin and I nearly threw up.
She lingered by the mirror in the gym locker room. Jessica was not friendly with members of the class or in other communal spaces. He had to teach her, he had said once, to make small talk with other humans. Her phone on the sink pinged a notification: John Billiard Committee Meeting, 10:00am. Jason would be back that evening. The exhaustion of his inability to see her actions as anything other than a rebuke to him. He confused empathy with selflessness, when the former doesn’t require the latter. She dressed, packed her gym clothes in her bag and set the bag in the trunk and drove to the hospital.
There was an issue that had only recently begun to be appreciated with the percutaneous versus surgical repair of massive infarcts, that being of competing flows. If you performed coronary artery bypass graft surgery on a patient with hemodynamically significant flow in the left main despite stenosis, you ran the risk of bypass graft atresia, in which case you would be left with an unrectified left main stenosis while having blown the wad, so to speak, on the LIMA. This is a shitty situation. There was perhaps less overt animosity or competition amongst cardiothoracic surgeons—who are basically plumbers, at the end of the day, and many of whom remain skeptical about the efficacy of stents for revascularization—and cardiologists, and these days if a patient is young enough, with few comorbidities, and with a significant left main lesion, she and her colleagues almost always refer to CT surgery for CABG. If somehow the patient adamantly refuses to have his/her chest cracked open, or the surgeon refuses to operate (rare), recent double-blinds had showed that percutaneous coronary intervention (i.e. stenting) is a viable alternative, although the jury was really still out on this question because the post-PCI patient and the post-CABG patient will be on different cocktails of meds, which cannot be reconciled experimentally because of the fundamental difference between inserting a man-made anticoagulant-covered piece of chicken wire in the existing blocked artery and performing a thoracotomy to replace the artery with one from the breast. She still printed out papers. She needed to underline things and write in the margins and found it almost impossible to remember anything she had read off a screen.
When she had been inserting the aspiration catheter, Wilson had wondered aloud and absentmindedly whether when you entered another man’s wife’s vagina, it was like putting on his shoes, feeling the ridges he normally settles into, bumping over areas where your anatomy differs from his, leaving new impressions, however fleeting.
Her phone pinged another reminder for the meeting. 15min.
The contemporary iteration of doctoral committees in the life sciences consist of 4-6 faculty members (plus the mentor) selected based on familiarity with one or more aspects of the thesis work and familiarity with the mentor. You can get advice from anyone, her mentor had told her. You want people on your committee who will pass you. This kid’s committee included Wilson who was there because of his work on the microbiome, some guy named Singh who was an expert with glial cells, the mentor Pead (pronounced Paid) who was an expert with inflammatory signal transduction, and some other woman Zhou she didn’t know as well but who she thought was also a signaling or cytokine person, and her, because of her clinical work with neurocardiology. When Billiard arrived and before he gave his lecture, the mentor Pead asked Billiard to leave the room for a minute, standard practice to allow official confidential chit-chat about the student’s progress, strengths, weaknesses, readiness for graduation, likelihood of continuing in academic versus bailing to industry. There was some progress, Pead said, as you will see, but we still really don’t know what is going on with these new lines and I would like to see John finish up the mechanism before he defends. Beginning of his sixth, Pead said, in response to Singh. Zhou’s phone vibrated and she picked it up, and Singh then also picked his up although it hadn’t buzzed and they both scrolled for a few seconds and put them back on the table. He’s technically very good, there have been some personnel issues in the lab that we’ve had to address but these seem to have blown over. He’s got all ten alleles now, as we discussed in the last meeting, and he has done some initial phenotyping and we don’t have anything yet but I think we may have to do some more crosses. Wilson picked up his phone and put it down again. Shall I call him back in?
John Billiard was wearing a button-down cotton dress shirt tucked in too far to cotton dockers, with some type of Skechers-type dress shoes that looked brand new. His title slide had his name, Pead’s name, the department and the name of the graduate program and the university, and the title, which was Microbiome-Astrocyte Signaling in Early Onset Cardiomyopathies. Thank you all for being here today and for being on my committee he said, the last word interrupted by something that sounded like a hiccup. He advanced to the first introductory slide which was a cartoon illustration of the connection between the nerves of the heart and the support cells of the brain, called astrocytes. Everyone knows about the importance of neurons in the function of the body, he was saying, but we only recently have come to appreciate how astrocytes and glia contribute to normal and diseased function of not only the brain but other organs in the body. Wilson picked up his phone and put it down again. Billiard proceeded through another slide of cartoon background, the gut with microbes emanating from it and impinging on the various other organs of the body. Various molecular pathways represented as flow charts with genes’ names as lower case italicized acronyms.
He actually had the whole presentation prepared, 35 slides ready to go, loaded on his laptop, with notes and animations, according to the detective who interviewed her later that night.
Despite what you see in the movies, most people do not start screaming when someone takes out a gun, especially at close range and particularly if it is a .357 revolver, a drug dealer’s gun his father told him, not a practical weapon like a .45 automatic or a Beretta. He never told his Dad that he knew from several of his friends that graduated from pot to meth and percs that no real world drug dealers carried .357s, they wanted something reliable, lighter, quicker. But that if he wanted to purchase it with his own money and dislocate his thumb shooting it at old TV sets and pumpkins out behind what was then still the repair barn for the combines and tractors, then he should go right ahead and buy the thing, his father had said. After the third slide, Billiard advanced to a blank white screen, turned to his backpack on the chair next to where he was standing, unzipped it and removed the revolver. Instead of screaming—and this is due to a very strong sympathetic nervous system response which increases heart rate and vasoconstriction in the absence of physical exertion, raising blood pressure in a matter of seconds, leading to a massive parasympathetic surge which has the opposite effect, vasodilatation and a loosening of the bowels—witnesses either: (a) feel one or more of the following symptoms: light headedness and extreme anxiety, extreme perspiration, accompanied by a metallic taste in the mouth and a sort of singed feeling due to low O2 in the brain, a hollowness in your ankles and behind your sternum and maybe blurred vision; or (b) they faint.
Jason had told her she confused lack of empathy with the will to succeed.
Billiard himself started sweating profusely as the color drained from his face and he looked from one of the faculty to another down the length of the barrel. Jessica’s father had never wanted guns in the house although he shot them and took Jessica to shoot them when she was in high school. The human mind can be incredibly impulsive, he said, and then dropped the subject. The woman next to her on the bike that morning was wearing a shirt with what she understood to be a boob window, a design feature of women’s clothes, particularly athletic wear, along with a never-ending array of patterns showing some part of the leg through the yoga pants that were now almost ubiquitously worn by women across the gamut of daily activities. Jessica maintained eye contact with Billiard. Singh put his hand over his mouth and Pead said oh and grabbed the arm of his chair. Zhou didn’t move. She glanced at Wilson when Billiard trained the weapon on him—he sat unmoving, maintaining eye contact back over the muzzle. They waited for John Billiard to speak or act, the range of possible outcomes obvious but the specific one he would choose tantalizingly unknowable for the few seconds the whole affair lasted. He returned to pointing the weapon at Pead and Wilson and, evenly, John Billiard fired twice into the wall and then once into his own chin.
