Music Therapy

Dr. Kira Murphy conducted all her treatment sessions standing up. It helped her focus. It also gave her a full, unobstructed view of the treatment bed in the center of the room—and of her patient lying on it.

Presently, she looked up from her 64-channel vibroacoustic mixer and frowned.

In his eighties, his head as bald as an egg, Adam Ostrovsky sported a neatly trimmed goatee, and a cotton shirt and pants. Two rows of slender needles stuck out of his leathery left foot, from his crooked big toe all the way across his instep to his ankle.

Mr. Ostrovsky, a retired lawyer, was a new patient on Kira's roster. Incredibly, given his age, he was also a stranger to music therapy—or vibroacoustic retuning, as the treatment was properly called, VART for short. Apparently, his health had been as sound as a bell.

Until two days ago, when he'd been diagnosed with liver cancer.

The man hadn't even blinked when the slender robotic arm swiftly inserted a dozen electro-acupuncture needles into his foot, each needle digitally mapped onto his meridians and ending in a wireless tip that would both relay the stimulation from the mixer and transmit the response data. Not as much as a wince when Kira had delivered the test pulse, which most people found unpleasant, on a par with the sting of an angry wasp.

Instead, Mr. Ostrovsky smirked the whole time, as if the whole procedure—the bed, the needles, the vibroacoustic protocol rigorously computed to save his life—rather amused him. As if everything was fine.

But it wasn't.

With an eye on the data that streamed across the holo-screens over her mixer, Kira checked and rechecked the parameters of the musical selections and the locations of the acu-points. She reviewed the patient's diagnosis and his genomic and proteomic profile. She even located and plotted the time-course data from three similar cases for comparison.

All this information told Kira that Mr. Ostrovsky should be responding to the treatment beautifully.

Instead, he was hardly responding at all.

In fact, his estimated De-Qi values barely reached five percent, which was alarmingly close to zero and the lowest response Kira had ever seen.

A chill ran up Kira's spine. If the treatment didn't work …

But she smoothed her white coat and pushed the thought away.

On the treatment bed, Mr. Ostrovsky twisted his wrinkled neck in her direction. "Say, Doc. I asked about Maggie Liu when I checked in, but they told me she's not taking patients anymore. How come?"

For a moment, Kira drew a blank. Maggie Liu? Who was Maggie Liu? Then the name snapped into place. "You mean Margaret Liu?"

Her boss.

Mr. Ostrovsky chuckled. "She goes by Margaret now? She used to hate that name." He rose on his elbows. "She once clipped me with her mike for calling her that!"

"Please lie still," Kira admonished. Margaret did what to him with what? And how on earth did he know her at all? "Dr. Liu is the Chief of the VART Research Division," she explained. "She hasn't been treating patients in years." Not in Kira's seven years with the Center, for sure, and probably not for decades before that.

Mr. Ostrovsky dropped back on the bed. "Shacks. I'm off beat again."

The odd comment barely registered. Kira's attention was on the holo-screen and the jittery line running through it—the De-Qi estimates, plotted in real time and still frighteningly low.

"We're almost done."

What was going on? There were documented cases of VART non-responders in the literature, but they were incredibly rare. One in a million. Kira had never expected to run into one.

The VART protocol ended, and the robotic arm once more danced over the patient, swiftly removing the needles and spraying the contact sites with a disinfectant and cell-regeneration mist.

With the last needle out, Mr. Ostrovsky sat up and swung his legs over the edge of the bed. "Hey, Doc. Is the music any good?"

Kira was only half listening, still checking the data. "I'm sorry?"

"My treatment. The music, you know?" The man went on cheerfully. "What does it sound like?"

That registered. Kira blinked and looked up. "Sound like?"

She was aware, of course, that people used to play music out loud to feel better, but she never really understood it. Auditory experiences were so chaotic and inefficient in comparison to the silent, computerized delivery of vibroacoustic stimuli directly to the patient's body. Not to mention dangerous. Which is why all audible music had been illegal for decades.

On the other hand, despite its enormous clinical success—better than drugs, radiation, and surgery combined—VART was still relatively new. It hadn't been around for most of Mr. Ostrovsky's life.

"Oh, come on, Doc." Excitement shone in the old man's eyes. "I know all music is kept under a tight lid these days. But can you hum a few notes for me?" He put his hand over his heart and grinned. "It would do me a world of good."

"You want me to hum the music?" The suggestion was so strange that Kira actually laughed. "I couldn't possibly do that. I've never heard it!"

Music had never entered her ears in her life. Her parents were law-abiding citizens. And why would she risk her career by breaking the law?

"Never heard it?" Mr. Ostrovsky's eyebrows went up. "Then how do you choose the music for the treatment?"

Kira narrowed her eyes. Was he joking? How could hearing the music help her in any way? The human brain could never process the complexity.

But the man's face was creased with puzzlement. He stayed perched on the edge of the treatment bed, his bare feet dangling as he waited for an answer.

Fine. Kira pointed at the mixer. "I use a specialized AI to search and analyze the VART database. All the files are tagged with specific diagnoses and cross-linked with data from clinical trials as well as whole-genome and protein sequencing." She cleared her throat. "The AI suggests the possible options, and I make the final selection and optimize the parameters."

Mr. Ostrovsky's mouth twisted as if he bit into a lemon. "Optimize the parameters? What does that mean, Doc?"

He slid from the bed, his feet landing in a pair of flip-flops. Now he walked over to the mixer, eyeing it with suspicion, the backs of his shoes slapping the floor.

Kira cringed at the sound.

"Well, it depends," she said. "In some cases, a slightly different pitch or harmonic structure may be more effective. But in other cases, I need to alter the entire texture of the piece to maximize the therapeutic benefit. Every protocol is unique and tailored to the patient."

She bristled at herself. Why did she sound so defensive? VART was the single most important accomplishment in medical history. A rigorous, evidence-based, computer-assisted medical specialty that within a decade delivered a safe and effective treatment for any known human ailment, from acne to heart disease. Nothing to apologize for.

Still, Mr. Ostrovsky shook his bald head with disapproval. "That's not how we talked about music in my days." He circled the mixer, inspecting it warily. He poked his fingernail into the holo-screen with wireless transmission specs. Then he heaved a sigh. "And now you won't let the old man listen to one lousy song to save his life."

Kira glanced at the low De-Qi values and, absurdly, guilt slashed through her. "I'm sorry," she said. "But the effects of audible music are too unpredictable. They might interfere with the treatment. I cannot risk that. Otherwise I would gladly let you listen—"

"You would?" The old man's face lit up, and he drummed his palms against his thighs. "Excellent. I look forward to it!"

Kira blinked, caught off guard. "Mr. Ostrovsky, surely you understand that—"

But the old man didn't let her finish. "Don't you worry about me, Doc. I feel better already. See you tomorrow." And, still grinning, he hurried out the door.

Kira didn't have the heart to correct him. She returned her focus to the worrisome data.

Could it be the new cloud server? The VART predictive models ran on huge volumes of patient data pulled from a network of cloud repositories. If the connection was glitchy, no wonder the De-Qi estimates made no sense.

Darcy would know.

A Research Associate in Neuroimmunology, her wife was a serious IT geek. Kira would ask her first thing when she got home.

Kira bent over the mixer.

What did the music sound like?

She'd always thought of music as something you pumped into a patient's body to fight disease, stop an infection, or heal a broken bone. What would it be like to play it out loud and hear it instead?

An intense curiosity gripped her, and her finger hovered over the key that would feed the music to the room's audio system.

The Center's parent corporation owned all the music. It held medical patents on all existing treatment protocols, including the original musical pieces they contained plus any modifications. But Mr. Ostrovsky's treatment had just began, so technically there was no patent yet.

Kira snatched her hand back, dismayed at herself. What got into her?

She closed her eyes and took a deep breath. Exhaled. Inhaled again.

She let the thoughts pass through her mind like water while she focused on her breath, on the air entering her lungs, the oxygen carried in her bloodstream to nourish her body. She imagined her Qi—the life force-flowing through her meridians, tuning each organ and tissue it passed through, smoothing out tension and restoring balance.

Her mind clear and her professional values reaffirmed, Kira opened her eyes and bent over her mixer once more.

Her next patient was arriving soon, and she would heal them with music the proper, safe and effective way—without ever playing a chord of it aloud.

*

Kira's home was a condo in a high-rise five blocks away from the Great Lakes Medical Research Center multiplex. A network of glass skywalks connected the buildings.

As she walked home, her echoing footsteps reminded her of Mr.Ostrovsky's flip-flops. Of his dismally low De-Qi values.

VART—or music therapy—had its roots in ancient Chinese acupuncture, and De-Qi was a key concept from the beginning. For centuries, skeptics in the Western world dismissed De-Qi as laughable hogwash not worthy of scientific study: patients would report a dull, needling sensation after an acu-needle was inserted and the stimulation began, and the acupuncturists noticed an extra resistance when manipulating the needles, like "a fish taking bait." Both purely subjective and hopelessly vague self-reports. But then clinical data started pouring in, and in one regression model after another, in thousands and thousands of patients, the result was the same.

De-Qi was a scarily accurate predictor of treatment efficacy.

What did it mean for Adam Ostrovsky if his De-Qi was truly so low?

Kira picked up her pace.

*

The moment she entered the apartment, the savory smell of cooking made Kira's stomach clench with hunger.

Darcy stood in the kitchen, still in the shirt and slacks she wore under her own white coat at work, frowning at the holo-tablet in her hand. On seeing Kira, she hastily tucked the tablet under her arm and peered inside the oven. "Dinner is ready. Vegetable lasagna. Could you set the table?"

"I had a new patient today, in his eighties," Kira said when they sat down to eat. "He wanted to know what his treatment music sounds like, and if I could hum it for him. Like he really missed it—missed listening to music. Isn't that strange?"

Darcy's face tightened. The holo-tablet stayed at her elbow, and she kept glancing at the dark screen, something clearly on her mind. "Does he miss all the diseases too? Being sick or in pain all the time because there is no effective treatment?"

"Of course not. Nobody would miss that." Kira thought back to her very first year in med school, to the weekly Medicine & Society seminar they'd all had to attend—and where she'd met Darcy. "But maybe he still doesn't understand how powerful music is. Or doesn't believe the research. I'm not sure."

"It doesn't matter if he believes it or not, Kira. This research will save his life. And it doesn't stay still either—it moves forward." Darcy tapped her tablet and pushed it toward her. "I bet you haven't seen this yet."

One glance, and Kira's pulse was racing. "No …"

She snatched the tablet and read greedily, her eyes snagging on the key information.

A Rapid Communication in Nature. Out of the New Beijing Medical School.

The first ever evidence that neuroimmune signaling was necessary for De-Qi in the musical treatment of leukemia.

Kira's head spun.

It was a breakthrough. Out in the world for more than six hours. How had she missed it?

Not to mention—they'd been scooped. Big time.

"Darcy, this is … this is …" But she had no words.

Her wife threw her a withering look. "Yeah. I know." She reached for Kira's plate. "I'll do the dishes. You read."

*

Hours later, long after her wife had gone to bed, Kira was still wide awake. She sat in the oversized reading chair, her legs folded under her and the tablet in her lap. Not reading anymore—she'd read the De-Qi article back to back three times—but mulling over the discovery.

The sample size in the study was small, and the pharmacological agent used to block the neuroimmune signal and abolish the De-Qi—thus demonstrating the necessity of the former for the latter—not one she would have chosen.

But the results still gave her goosebumps.

Music therapy was spectacularly successful—in a great majority of patients. But the biophysical mechanism remained a mystery, and the prospects for non-responders were grim.

The ability to manipulate the De-Qi would mean that every single patient—every human being now alive or yet to be born—could reap the full therapeutic benefits of music. It would mean the end of pain and disease as we knew it!

Kira's mind churned through the article.

The involvement of inflammatory pathways in acupuncture effects had been documented decades ago, creating much excitement and setting a foundation for a modern theory of how acupuncture—and later the vibroacoustic retuning—worked. On a very basic level, the acu-needles were unwelcome foreign bodies that induced local micro-trauma at the site of the needle insertion, and this simple alarm signal then got boosted and relayed up all the way to the brain, triggering a whole host of the body's natural self-healing capabilities. At least that was the theory, since the neural mechanisms of such built-in resiliency were unknown.

Still, Kira had always found the underlying message incredibly hopeful: That human beings had a secret, as yet untapped capacity, at will and completely on their own, to crush any disease and heal any injury that afflicted their bodies—if science only showed them how to go about it. Was there anything more thrilling?

Kira certainly found it so, even if it meant she'd be out of a job. But some of her colleagues might not share the sentiment—starting with her boss and the Chief of the VART Research Division, Dr. Margaret Liu.

A chill went through Kira's body.

Mr. Ostrovsky .

Non-responders to music therapy had always been hard to find and therefore valuable to the medical research establishment. Never more so than now, with the New Beijing group's article out there, a clear and loud challenge to Margaret Liu and all VART research divisions around the planet. Behold our awesome accomplishment. We've transformed the field overnight. Your turn. What have you got? Anything?

If Kira's boss knew Adam Ostrovsky's low De-Qi values, he was done for.

Kira's thought raced like an electric current, but her head was getting heavy. She leaned back in her chair and closed her eyes.

The next thing she knew, Darcy was bending over her and gently shaking her arm. "Kira. Sweetie. Wake up. I have to be in lab early. I made coffee."

Sunlight stung Kira's retinas, cutting through her foggy brain and plucking out a lingering question. "The cloud server. Is the migration still going on?"

Darcy blinked. "What? No. It's done. Finished last week. Why?"

Kira's heart sank. An urge to spill her worries gripped her, but there was no time. Darcy was already heading out. "Nothing. I'll tell you later. Did you say there is coffee?"

Her story would have to wait.

*

As soon as Kira stepped into her treatment room and shrugged on her lab coat, her hair still wet from the last-minute shower, the holo-communication unit on the wall beeped and a message blinked on.

An emergency division meeting in five minutes. Margaret Liu needed to speak to everyone.

Oh no .

Skipping the meeting wasn't an option, and neither was arriving late. Kira rushed out the door.

The conference room was ten floors up. She slipped in through the back door, apparently the last one to arrive.

The other fifty or so physicians and researchers in the division were already gazing at the wall-sized holo-screen at the opposite end of the room, their faces alive with emotions Kira had never witnessed in her colleagues before—awe and envy and unabashed longing.

And no wonder. The interactive data holographs from the Rapid Communications paper sparkled like priceless, exotic jewels.

Kira had just caught sight of Darcy, when a hush fell over the room.

A tall, thin woman with short hair the color of steel stepped in front of the screen.

In her eighties but radiating authority, her white coat blindingly bright, Margaret Liu nodded curtly to her audience. She spoke in a deep, resonant voice that made Kira shiver.

"I trust you all heard the news from our friends in New Beijing. We are humbled by their accomplishment, and in their debt for advancing the field forward. In the span of ten pages, they made half of our most innovative research look pathetic, and completely obviated the usefulness of the other half. Needless to say, we need to fix that—and fast."

Margaret Liu looked from person to person as she spoke, her gaze laser-sharp and blazing with resolve that allowed no excuses.

"How do we fix it? Data. Make it your priority. I've already set up an umbrella protocol, and I'll be meeting with each of you individually about how you will contribute. But the first thing I want you to do is check the data you already have. If you find anything of use, anything at all, you report it to me immediately."

The old woman's eyes lingered on Kira. Or did Kira imagine it?

"Are there any questions?"

There were none.

"Very well. Then let me leave you with this." Margaret Liu's voice deepened until it made the holo-screen vibrate and glitch behind her, one formidable source of energy clashing with and cancelling out the lesser one. " We are the leaders in the field, and the next big paper will come from us. Whatever it takes." Another curt nod, this time dismissing them. "That's all. Thank you. Let's get back to work."

The room emptied, but Kira stood frozen.

Whatever it takes .

"Are you okay?"

It was Darcy.

"Yes," Kira said. Then, "No. I need to talk to you. It's about my patient."

*

Adam Ostrovsky arrived for his second VART appointment with hands in his pockets and a sly smile on his lips, oblivious and nonchalant. "How are you, Doc? Ready for me?" Without waiting for Kira's reply, he kicked off his flip-flops, climbed on the treatment bed, and stretched flat on his back. "Bring on the music!"

"All right, Mr. Ostrovsky. We're going to switch to your other foot today." Kira masked her nervousness by keeping her voice and her bedside manner more detached than usual. She programmed the robotic arm with barely a glance at her patient. "Please hold still for the insertion."

"Okie-dokie," came a cheerful reply.

Her gaze glued to the array of holo-screens above her mixer, Kira swiftly checked the music parameters and the location of the acu-points. Good. Vitals? Everything was in order.

She took a deep breath, fingers poised over the controls, eyes fixed on the blinking cursor that would graph the De-Qi estimates as soon as the treatment began.

It would work this time. It had to work . The music would heal this man and the data would bear witness—right now, right here, in all its silent, computerized, patent-pending glory. HisDe-Qi would be at least 70 percent, maybe 80 percent, maybe even 90. Yes.

She initiated the VART protocol.

The De-Qi trace rose from zero to 4 percent, then 5. But at 6 percent it flatlined.

Kira glared at it, willing the values to ascend. An octagenerian or not, Mr. Ostrovsky was bursting with life. There was no reason why the therapeutic vibrations of music shouldn't blast down his meridian like a river, clearing the way for the healing Qi and mobilizing his immune system to crush the renegade cancer cells that were turning his liver to Swiss cheese.

Suddenly, the De-Qi line trembled and soared.

Kira held her breath.

Ten percent … Fifteen percent … Eighteen percent … The line trembled again, then edged across the 20 percent threshold …

Kira didn't dare move a muscle.

But Mr. Ostrovsky's De-Qi kept climbing … The line brushed 25 percent and leapt over it … It reached 40 percent and kept going … Then 50 percent … Then 70 …

Kira laughed in relief, her whole body warmed. Her worst fear was over.

Relucantly, not wanting to miss a second of the auspicious data, she glanced at her patient. "You're doing grea—"

The words died on her lips.

Adam Ostrovsky lay flat on his back, the rows of acu-needles in his foot undisturbed, at first glance a perfectly behaved patient.

But his bald head rocked from side to side, and a bulky device stuck out of his ear.

Kira blinked. Then shuddered. Could it be—?

She had a vision of the old man convulsing, his bones snapping and organs exploding, blood soaking his cotton shirt and pants, helpless against the violent, deadly force.

She got to the treatment bed in three long leaps, almost knocking down her vibroacoustic mixer in her hurry.

"Mr. Ostrovsky." She extended her hand, struggling to keep calm. "I need you to … to remove it and … and hand it over right now."

The old rascal grinned at her, unrepentant. "All right, Doc. You got me. But let me tell you—there's nothing like music."

He plucked the device from his ear.

Kira snatched it away, gripping it between her thumb and index finger—and froze, realizing too late the danger to herself.

The device vibrated in her fingers, the VART protocol still in progress. Caught by surprise, she'd been careless and didn't stop it. What would a direct exposure do to her? But she had no choice. Her patient's life was at stake.

She glanced frantically around the room. God! Where to put it? It was like holding a bomb. Nowhere was safe.

"It was Adele, just now. A voice to melt your heart. Certainly brings back memories." Mr. Ostrovsky spoke with a maddening cheer. "And before that, Chopin, and a Celtic song, and Nigerian drums. You certainly like to mix it up, Doc. Not that I'm complaining."

Kira felt lightheaded, the vibrating device threatening to slip from her fingers. "How … how do I turn it off?"

"Oh." The old man lifted his bald head and wiggled a bony finger. "There is a little switch on the side, right there. See it? Cuts off the wireless signal. I have proper headphones at home, you know. Much better sound. But they didn't fit in my pocket. Too big to smuggle in." He grinned.

Kita lifted the offending ear piece to her eyes. It was like holding a furious wasp. Her fingertips burned from the relentless throbbing, and a rivulet of sweat iced her spine. Better not to think about the dose she'd already absorbed.

There. She pushed the tiny switch.

The vibrations stopped.

Kira's knees went weak with relief. She turned, momentarily unsure of where she was. Wasn't she about to do something? Something urgent?

"You're okay there, Doc?"

"What? I'm fine. Thank you." She dropped the device in the pocket of her coat. No time to worry about it now. She needed to focus on her patient. "How are you feeling, Mr. Ostrovsky? Are you in any pain?"

"Nope. Feeling better than—"

"The protocol!"

It was still running, still pumping the music through this man's body.

Kira rushed to the mixer, her finger ready to hit the emergency stop key. But one glance at the holo-screen stayed her hand.

She'd expected a disaster: flashing warnings about crashing vitals and severe trauma.

But the readings were fine, showing only a slightly elevated heart rate and a minor bump in corticosteroids, as if her patient took a brisk walk. Apparently, the audible music did the man no harm.

Only one metric was plummeting right before Kira's eyes: Mr. Ostrovsky's De-Qi values.

Incredibly, just a minute ago, they had traced a firm, resolute line at 72 percent—a perfectly healthy response. Now they'd fallen back to the dismal single digits. The non-responder levels.

But how was it possible? Unless it was the audible music …

*

Before Kira knew it, the session was over. From the door of her office, she watched her patient depart down the hallway, his flip-flops smacking the floor, when she saw another figure approaching.

Kira's stomach clenched.

What was her boss doing here?

The moment they saw each other, Margaret Liu and Adam Ostrovsky both came to a halt—a sharp, precisely timed step of two fencers ready to duel.

They faced off across six feet of space for a few beats, their bodies frozen, backs straight and shoulders squared.

Then Mr. Ostrovsky bowed gallantly.

Margaret's eyes widened in surprise, then narrowed in warning. She broke eye contact and marched right past him, the tails of her white coat slicing the air like knives.

Panic licked Kira's spine.

Her boss was heading straight for her.

Did Margaret somehow already know about her transgression? But how?

And worse—did she know Adam Ostrovsky was a rare non-responder?

Kira had an impulse to slam the door and lock it. She couldn't flee the consequences of what she'd done, but maybe she could delay them a bit. Long enough to warn Darcy.

But Margaret was already there. "How was the session?"

Kira blanched under the piercing gaze. "Well—"

A complicated emotion twisted Margaret's stern features. "Make sure you back up the files," she ordered. "I want to look at the data first thing tomorrow."

And, without waiting for an answer, she swept past Kira's door and into an office down the hallway, her white coat slicing the air behind her.

Moving as in a dream, Kira closed the door and did something she hadn't done in years. She climbed on top of the treatment bed, leaned back, and stretched flat on it. She closed her eyes and focused on her breath, badly wishing for some semblance of balance.

But it was useless, what with her heart drumming, her thoughts racing, and icy chills shooting through her.

Her hand went into her coat pocket, fingers closing on a bulky shape. She yanked it free.

Mr. Ostrovsky's ear piece!

She sat up, clutching the device.

Her knowledge of history was shaky. But she knew the main beats.

All personal music players had been banned in the U.S., China, and lots of other countries for decades, since before she was born. A response to a health crisis caused by overexposure to unregulated music, as she learned in med school. But something else happened when they were just starting to pass the laws. A virus struck, corrupting all audio files on millions of devices. Including music files that, in the U.S., couldn't be legally replaced due to new FDA and CDC regulations and medical patents. The U.S. and Chinese governments also did something about music businesses and private musical instruments—some kind of national buyout program—but she didn't remember the details. Anyway, the acute health threat of audible music was contained pretty quickly, although protests and resistance from some diehard fans went on for much longer.

Apparently, some of those diehards were still around and kicking.

Kira turned the ear piece in her fingers.

Mr. Ostrovsky must have tuned it to the transmission frequency of her mixer. Easy enough to do—and totally illegal.

Now the question was: What should Kira do about it?

*

Kira was still mulling it over as she and Darcy headed home together at the end of the day. The Center's hallways and lobbies, elevators and escalators had always reminded her of a giant circulatory system. Today, by an unspoken agreement, she and Darcy traversed it in silence. But when they entered the skywalk, Darcy turned to her.

"Kira, what's going on?"

Kira hesitated. Maybe the less Darcy knew, the better. But she couldn't keep it from her either.

"Today his De-Qi improved."

Darcy blinked. "It did? But that's good news, isn't it?"

Kira bit her lip. "I'm not sure."

"What do you mean? His De-Qi wouldn't just go up overnight. It's a stable trait. You thought it was some technical glitch the first time. Sounds like it was to me."

Kira shook her head. "I wish it was a glitch. But it wasn't. He did it on purpose."

"He? Who—your patient? You mean he somehow messed with your protocol yesterday?"

"More like … enhanced it today."

Darcy caught Kira's arm and pulled her to a stop. "Wait. I don't understand."

Kira sighed. Then she reached into her pocket and produced the ear piece. "He used this to … listen to the music."

"What!" Darcy snatched the device and glared at it. Then turned her fierce gaze on Kira. "I don't care how old or fragile this man is. He's a criminal—"

"Actually, a lawyer."

"—and he's putting you in danger. If I get my hands on him, I swear—!"

It was too much for Kira. A laugh burst from her throat.

Darcy paled. "Sweetie?"

"I'm sorry. I'm fine, really." Kira was still laughing. She couldn't help it. "The thing is … I know it sounds crazy. I still can't believe it myself. But it worked, Darcy. The audible music worked!"

Darcy stared at her. "You mean … he wasn't hurt?"

"Not at all!" Kira's enthusiasm did strange things to her voice, illegal things, making it soar and leap, slide up and down. "And his De-Qi went through the roof. Hit 72 percent, and stayed there for … well … until I took the ear piece from him. Darce, I wish you could've seen it!"

"Kira!"

"I know you're worried about me—"

"Worried about you?" Darcy exclaimed. "I'm not worried—I'm terrified! You could be arrested tomorrow. Not to mention putting your life at risk!" She shuddered.

"I know," Kira said gently. "But this isn't about me, Darce. It's so much bigger … I have an idea, but I need your help. Will you hear me out?"

Darcy sighed. "Why do you ask if you already know the answer?" She opened her palm and examined the ear piece for the first time. "I'm guessing your idea hinges on this illegal and potentially lethal device."

A wordless emotion rolled over Kira. "It does."

*

By dawn, Kira and Darcy had, if not a plan, then a solid pitch. One that had a fifty-fifty chance of persuading their boss not to fire them on the spot.

At least Kira hoped so as she walked shoulder to shoulder with her wife down the skywalk. From now on, their every action was fraught with risk. Including that they had no appointment. A complete breach of protocol, and bound to tick Margaret off. But what choice did they have?

This early in the day, the sprawling Research Center stood unnervingly still, the silence thick in the air. More like a tomb than a medical facility.

A bad sign.

But that wasn't true. Kira sharpened her hearing. There were plenty of sounds if she listened closely. There! The low, distant roll of the air filtration pumps … The sharp clicks and buzzing of extra lights turning on overhead … The harmonized hum of electronics inside the offices …

And what about the music files? Thousands of them lay silent and trapped on the Center's computers; hundreds of thousands more on the upgraded cloud servers.

What if she could press a key to release them and make them all burst into sound?

The ridiculous thought was blasted from Kira's head when a door flew open and a stern voice commanded, "Come in. Both of you."

Far from surprised to see them, Margaret Liu radiated impatience as she waved the two women into her office and flung the door shut behind them. As if they were not just expected—but late.

Something was wrong.

Margaret knew.

A quick scan of her boss's computer station confirmed Kira's suspicion.

The familiar time-course graph of Mr. Ostrovsky's De-Qi data stood frozen on the main holo-screen like an impossible rock formation—the rapid stepwise climb, the high but narrow peak, and finally the precipitous drop into the long, grimly flat valley. On another holo-screen, an array of analytics flickered.

The Chief of the VART Research Division had been busy. And judging by the output, Adam Ostrovsky's data held no secrets to her by now.

Kira met Darcy's eyes, and caught a look of alarm there.

But her own reaction was an odd relief. Now they could skip the excuses and get straight to the point.

Her gaze strayed to the only artwork in the otherwise austere room—a perfectly orderly arrangement of four square, grainy black-and-white prints on the wall. All close-ups of … medical equipment? She squinted at the first print. Two slender acu-needles with rounded points hovered over a reflective disk.

Wait . Were they acu-needles?

"I have never seen this pattern of data," Margaret said, her piercing gaze locked on Kira. "But I will venture a guess that the peak De-Qi values correspond to … an auditory experience of music."

There was a sharp intake of air from Darcy. But all Kira felt was a strange calm. "You guess correctly," she admitted.

The Division Chief raised an eyebrow. "Very well. So please help me understand. How does a patient talk a certified medical professional into breaking the law?"

Darcy rushed forward, her shoe squeaking on the hard floor. "He didn't talk her into anything! He used this." She slapped the ear piece onto the desk in front of Margaret.

Margaret poked the ear piece with her fingernail. "I should have known."

Kira sensed an opportunity. "We believe the effect is real!"

"I beg your pardon?"

"The improvement in De-Qi values tracks the auditory experience precisely. Of course, it's only a correlation at this point." Kira waved her hand toward the analytics on the holo-screen. "But the patient tolerated the exposure very well. No adverse effects. Actually, he—"

"You mean no immediate adverse effects," the Division Chief corrected. "We would need a comprehensive battery of tests and longitudinal data before we can conclude—"

"He doesn't have time!"

Kira's heart pounded. Had she just interrupted Margaret Liu in mid-sentence? She felt Darcy tense next to her. But she couldn't stop now.

"Adam Ostrovsky is a non-responder." She swallowed. "Audible music may be his only chance."

Margaret studied Kira. She'd turned pale in shock, but now regained her composure. "What exactly are you suggesting, Dr. Murphy?"

Kira's body turned cold. It was now or never. She glanced at her wife.

Darcy didn't look happy but she nodded. Go on. I'm with you.

Kira took a deep breath and plunged in.

"We," she said, indicating herself and Darcy, "want to test the effectiveness of adding audible music to the standard VART treatment."

Margaret's eyes flashed with warning. "And your rationale?"

Kira had expected the question. She and Darcy had spent hours pouring over the literature. "One: auditory suggestion in placebo analgesia. Decades of research show endogenous opioid release as measured with PET and radioactive tracers. Two: auditory processing in operant conditioning, including pitch- and tempo-dependent immune responses. There is functional MRI evidence—"

Margaret raised her hand. "Fine. So how would you do it?"

Kira mentally backtracked. "A case study. That is, if … Mr. Ostrovsky consents to participating."

Margaret Liu clicked her tongue. "Oh, he better! If he has any common sense left. He's old enough to remember what cancer does to people." She closed her eyes for a moment. Then opened them again, and regarded the two women in her office. "But the two of you … Music is a highly political subject. Your careers will be on the line. Are you certain you want to take the risk just to save an old man?"

Did that mean their boss approved? Kira opened her mouth to speak but emotion choked her and no sound came out.

Strong fingers laced with hers, and a firm voice answered. "Yes, we are."

Darcy.

Kira squeezed her wife's fingers, and the familiar wordless force burst inside her, flooding her veins, warming her skin, and nearly lifting her off the floor.

"All right." Margaret's voice reverberated like a gong. Standing behind her tall desk, her coat blazing white and her head high, their Division Chief looked like a commander ordering her ship to change course. "We will use the umbrella protocol and begin immediately." Margaret paused, thinking. "But … no audible music. We could never get away with it."

Kira and Darcy spoke with one voice. "What?"

Margaret picked up the ear piece, frowning as she mulled something over. Then she looked up, a spark in her eyes. "Bone conduction." She lifted the ear piece to her own ear, then moved it an inch behind. "The skull will do just fine."

Darcy perked up. "Like the old hearing aids."

Margaret nodded. "Exactly. We can avoid at least some of the lawsuits that way." She handed the ear piece back to Darcy. "I bet you can figure it out, Dr. Stevens."

Darcy pocketed the device. "I'll get right on it."

Kira's heart fluttered.

This was their cue. Their meeting was over.

Darcy gave Kira's hand a tug, and they both turned to leave.

But Kira paused at the door. "Dr. Liu. I'm curious about your art prints. Where did you get them?"

The Division Chief glanced at the wall. "Oh, these? They were a gift. Ages ago. Now they just … fill an empty space." She straightened. "Well, I'm afraid we're out of time."

"Of course," Kira said. "Thank you." Two words that were vastly inadequate for the occasion.

Margaret smiled, her whole face transformed by it. "No. Thank you. And keep me posted on your progress."

It was only after the door closed behind them that the sheer enormity of their undertaking hit Kira.

They did it. She and Darcy.

Now Mr. Ostrovsky's life depended on them.

*

The next time Adam Ostrovsky entered Kira's treatment room it was as a research participant—a new and higher status that, judging from his swagger, he enjoyed immensely.

After their meeting with Margaret, Kira and Darcy had thrown themselves into the task like two deep-water divers, never coming up for air until they had what they needed.

Darcy had spent ten hours straight pouring over old medical blueprints and tinkering with the confiscated earpiece. At the end of it, bleary-eyed but triumphant, she'd presented Kira with a functional prototype that would deliver vibroacoustic stimulation via direct contact with the patient's skull. Another hour of safety testing and calibration, and they had the tech ready to go.

Meanwhile, Kira had composed a brand new VART protocol, drawing on the musical traditions that had evoked a beneficial spike in her patient's De-Qi during his brief and unauthorized auditory exposure. At least she never had to worry about her participant. Adam Ostrovsky was all in. Apparently, Margaret had conducted the informed consent interview herself.

Now, back in the treatment room in his new role and thrilled about it, the old man bowed his bald head to Kira, then to Darcy.

"Doc. Doc. Where do you want me? On the bed?" He saw Darcy frown, unused to his antics, and he grinned. "Pardon me. That came out wrong. It's an honor to be here, like landing on a new continent. I won't give you any trouble."

Kira bit her lip. The man already knew the research protocol. But, boy, did he love showing off for an audience. "Yes, Mr. Ostrovsky," she said. "We will use the bed like we did before, and follow roughly the same procedure." His De-Qi values would indicate the effectiveness of the new bone-conduction treatment. "But first I need you to put this on."

Darcy handed her the new device, and Kira passed it to the man.

He snatched it from her fingers and examined it, not hiding his amusement. "Ha! Look at that."

"It fits right over your ear," Kira instructed. "The disk should press against the scalp behind your pinna or the fleshy part. Not in front of it."

Mr. Ostrovsky chuckled. "Right. We couldn't have that." Then, with nimble fingers, he slipped the device in place and offered his ear for inspection. "Like this?"

Kira and Darcy both leaned in to check.

Darcy wiggled the device in place. It fit snugly. She nodded her approval. "Good," she told the man. "You can go ahead and lie down."

The man grinned. "You bet, Doc."

Kira stepped behind her mixer, her pulse quickening.

It was really happening. If only the participant could treat it a tad more seriously.

"Okay. Mr. Ostrovsly. We will do a short run of the experimental protocol today—just three minutes."

Adam Ostrovsky had kicked off his flip-flops and stretched on the bed in two seconds flat. Now his bald head popped up. "Just three minutes? Oh, come on, Doc. That's not even a whole song!"

Kira sighed. "Just three minutes today, Mr. Ostrovsky. But the goal is to extend the duration over the next five sessions, until it's the length of your regular VART treatment and we can run them together." She took a deep breath. "I will closely monitor your responses. If you experience any pain or discomfort, any at all, let me know immediately. Are you ready?"

"Hit it, Doc!"

And Adam Ostrovsky lightly drummed his palms on his thighs, not concerned in the least.

In contrast, Kira's heart hammered in her chest. What they were attempting was daring and ground-breaking, and a mistake could be catastrophic, whether the research participant appreciated the danger or not.

"All right. Please hold still for insertion."

She touched the controls and the robotic arm sprang to life.

But when the acu-needles were in place—two rows of them sticking out of the man's leathery foot—and it was time to send the music to the device clipped behind his ear, she froze.

Just because the man was reckless with his life, didn't mean that she, a trained physician, had to be. What if the other day was a fluke? What if today, when they used the music, he suffered an epileptic seizure, or his organs burst open and his bones shuttered in his body, right here on her treatment table? How would she live with that?

Darcy stepped next to her and touched her hand.

She didn't say anything. She didn't have to. It was all there in her gaze.

I'm here. I believe in you.

Kira inhaled. Exhaled. Inhaled again.

Focus. Find your center. You can do this .

"All right, Mr. Ostrovsky," she said. "Three minutes. Try to keep as still as you can. Here we go."

Kira hit a key, and her mixer wirelessly fed the VART protocol to the device over the man's ear, the precise patterns of vibrations transferred directly to the bone.

Standing side by side, their hands clasped together and eyes locked on the holo-screen streaming the data, she and Darcy watched breathlessly as the man's De-Qi values shivered, inched higher, stalled for a few moments … and then shot upwards.

Kira bit down a whoop of joy.

A wince answered her, followed by a laugh. She'd squeezed her wife's fingers hard enough to crack her knuckles.

Adam Ostrovsky's De-Qi values reached a smug 94 percent and stayed there.

Kira couldn't believe it.

It worked. Their bone-conduction treatment worked.

Before they knew it, the three minutes were up. The robotic arm swooped down to retrieve the needles. Mr. Ostrovsky sat up on the bed, kicking his bare legs and turning the earpiece around his finger.

Not only was he still in one piece, no broken bones and no blood pooling underneath him, but he was in an even better mood than before, visibly tickled by something.

Kira couldn't help herself. "How do you feel? Anything to report?"

The man snorted. "Well, since you asked, the sound quality could be better. But we do what we can. Slow progress is better than none, right?" Then he cocked his head. "Say, Doc. What are you calling this new treatment? I'm curious."

Kira smiled stiffly. They'd had to come up with a name on short notice, all of their creative energy exhausted by the planning and troubleshooting that took priority.

"Well, mechanically speaking, we hypothesize that the resistance of the bone will enhance the VART response. So we went with resistance-enhanced vibroacoustic retuning."

"Resistance … enhanced … vibro … acoustic … re … tuning." Mr. Ostrovsky let the words roll off his tongue, a skeptical look on his face. "Resistance-enhanced VART." Then his eyes widened, and he clapped his hands on his thighs. "You mean,re-VART!" Now he was laughing. "Re-VART! That's rich. It re-VARTs, all right. I tell you, Doc, you hit the nail on the head with this one!"

Kira pursed her lips, trying to hold on to a professional composure and already regretting she'd said anything. If the man insisted on poking fun at serious science, she couldn't stop him. But she didn't have to engage either. Although she had to admit it was funny.

Then she glanced at Darcy and saw her wife's shoulders shaking with laughter.

That did it. Kira's own hilarity bubbled up her throat and burst from her mouth, her voice joining the joyful chorus.

And why shouldn't they laugh? Irreverent or not, De-Qi in the ninety percent range boded well for a full remission. They had every reason to celebrate!

"Okay. Re-VART. We've reverted. I get it. I get it."

She was still smiling when she extended her hand. "Now, Mr. Ostrovsky, can I have the device back? It'll be here when you come back tomorrow."

*

The next five days flew by Kira and Darcy in a blur of activity, with the duration of Mr. Ostrovsky's reVART treatment gradually extending to a full hour, and his De-Qi values sticking solidly at 95 percent. And the three weeks after that were busier still, with both VART and reVART administered to the patient at once, a brand new therapeutic synergy.

The tip of Adam Ostrovsky's goatee was now artfully shaped into a loop, his bald head smooth like a polished marble, and his wardrobe a rotation of well-worn graphic t-shirts with odd, vaguely familiar designs. Not only did he tolerate the dual treatment without a hitch, but he genuinely enjoyed himself.

By the end of week 4, Kira and Darcy had all the data they needed. The only task left was to analyze it.

It was 9 p.m. on Friday, and they were in Darcy's office, finally ready to head home.

"We could come back tomorrow," Kira offered.

The dark circles only brought out the fire in Darcy's eyes. "Or we could do it now."

"What if it didn't work?"

"Then we've tried. And we'll try again."

Kira smiled. "I love you."

Darcy smiled back. "I love you too."

They kissed, the agreement reached.

Darcy's computer station was large enough for two. Kira took her place next to her wife. "Load the data," she said. And Darcy did.

They worked in silence, effortlessly mashing their workflows, passing files back and forth, elaborating on each other's steps. Integrating all the data and treatment parameters into one harmonious time progression and fitting them into a series of analytic models. They could already glean the answers, but they had to be sure.

And then, suddenly, it was midnight and the work was done.

They gazed in awe at the results—all of them statistically significant and better than their wildest hopes.

Their final model of the clinical data, carefully time-locked to each VART/reVART session, was a symphony of success. No matter what marker they picked—the lymphocyte expression levels, the activity index of the glymphatic system, or any other—the results were the same.

When hit with the beneficial double-whammy of music, Adam Ostrovsky's neuroimmune system kicked into overdrive that bordered on superhuman—and not just obliterated the cancer altogether, but left him with the healthiest and best-performing liver on record.

Dreams were made of data like that. Dreams—and published papers.

Kira and Darcy's paper (with Margaret as the senior author) practically wrote itself: a brief introduction, the key methods and results, a concise discussion to wrap it up.

The first rejection was swift, only hours after their submission. They had aimed high—at the top medical journal, widely read and madly competitive—so the rejection wasn't a surprise. But the comments from the hastily assembled team of experts still stung.

Misguided and self-indulgent , was how one anonymous reviewer summed it up. Shows reckless disregard for both the human life and the medical standards , decried another. The third reviewer opted for brevity: Criminal.

As time passed and the rejections mounted, Kira tried to keep things in perspective. All they needed was for one journal to say yes. Just one. That was all.

One morning, Kira had just walked into her office and powered on her mixer and the holo-screens when the message arrived.

Excitement surged through her. This wasn't another rejection. She could feel it.

Her hand shook when she opened the message. She read the first line and gasped.

It was different all right—an official legal notice and court summons.

They were being sued.

*

Kira was on the move, walking and then running through the empty northern wing of the Great Lakes Medical Research Center before she consciously decided where she was going.

If convicted, the punishment for musical patent infringement was merciless. Several years in prison and exorbitant penalty fees. No offender would ever see patients or do clinical research again.

She couldn't let that happen to Darcy.

Darcy—who had always been there for her, ready to risk her neck for Kira, no questions asked. And who, thankfully, was still asleep right now, having worked long past midnight, and so hadn't yet seen the legal notice.

Which was a good thing—it bought Kira time.

She raced down the curved hallway to Margaret Liu's office.

But the door was locked. The Division Chief wasn't in yet.

Kira was about to bang on the door in frustration when a distant voice made her turn.

"Of course I'm mad! What do you think? You left without a word!"

The voice was hollow, as if reaching her across time, and it rang with reproach.

Kira froze. Darcy?

But … how did she know? Kira hadn't done it yet. Had she?

"There was no other way," a second voice answered. "You'd never let me go. But I had to do it. You deserved so much better. I did it for you!"

It all fit. These could be her words. Kira stared down the curved hallway, transfixed.

"It wasn't your decision to make, Adam!"

Adam?

Now Kira heard footsteps down the hallway. Two people walking toward her.

"I know, Maggie, and I'm sorry." Sure enough, the voice was Adam Ostrovsky's.

The footsteps stopped, the couple still out of sight, hidden behind the curved wall.

"You're sorry? What good is that to me?" Margaret Liu's voice snapped.

Kira shook herself, as if waking from a dream. The unease lingered, but she pushed it down. She'd made her decision, and she would stick by it.

"I thought I was doing the right thing by you, Maggie," Adam Ostrovsky continued. "Dammit! You think it was easy? Your voice … From the first time I heard you sing, all I wanted was to make music with you, believe me. But it just … wasn't fair to you. You had so many other talents. Brilliant in everything you did. It was pretty annoying, really. I didn't want to hold you back. Medicine was a better career for you than music."

Margaret sighed, anger gone from her voice. "I could have done both."

Kira shivered. A variation on that thought had crossed her mind too. Why couldn't they have both: music to cure disease, and music to enjoy? Would that be so bad?

"Then let me make it up to you," Adam Ostrovsky said.

"How?"

"I'll take you dancing!"

Margaret laughed, a deep, rich laugh that filled the hallway. "Oh, hush, you old fool! You haven't changed a bit."

"Nope. I was crazy about you then, and I'm still crazy about you now. What do you say?"

Another laugh. "Haven't you heard it's dangerous to mix business and pleasure?"

"Doesn't apply here. It's all pleasure for me. You know how I love a good fight."

The footsteps resumed, getting closer. Kira had an impulse to flee, but she braced herself and stood her ground.

For Darcy.

But Adam Ostrovsky, sporting another ancient graphic t-shirt, only beamed at her, unperturbed. "How are you, Doc?"

Margaret only raised an eyebrow. "Another early morning for you, I see." She unlocked the door. "Come in."

The three of them stepped inside the office. Adam Ostrovsky spotted the art prints on the wall and chuckled. Margaret clicked her tongue at him, then faced Kira. "What can I do for you? Anything to report?"

"I want to keep Darcy out of it," Kira said.

"Keep Darcy out of what?"

"The lawsuit!"

"Ha!" Adam Ostrovsky spun around and drummed his palms on his thighs.

Margaret frowned. "They really should have cc'ed me. It's a simple courtesy. I'm the senior author on the paper. In any case"—she waved her hand in Adam's direction for Kira's benefit—"meet Adam Ostrovsky, our new legal counsel. He generously offered to exit his retirement for us and to work pro bono."

The old man gave a solemn bow. "At your service."

Kira glanced from Adam Ostrovsky's t-shirt to the wall behind him, momentarily distracted. No wonder the design had seemed familiar. It matched one of Margaret's art prints exactly. The two slender acu-needles… except they weren't that at all.

"What's on your t-shirt?" she blurted out.

"Ah!" The man grinned at her. "Our very first album cover. I designed several. A shame we only recorded one." He winked at Margaret.

Margaret shook her head at him. Then turned back to Kira. "Don't mind him. I will make sure to keep him busy. So about Darcy—"

"I'll do anything." Kira's heart was pounding. "Just tell me what to do. But it has to be just me."

Margaret regarded her for a moment. "There is something I want you to do. I was hoping for a better outcome, but now it may be our only option. However, I'm afraid we cannot leave Dr. Stevens out. You and she are in this together."

"But—"

"For now, do not submit the paper anywhere else. Do not answer any inquiries or make any statements for the press. I will be in touch with the details."

Kira wanted to argue, to protest, to refuse. But something stopped her.

Was it Kira's imagination—or did Margaret Liu just wink at her?

*

It was late August. The sun hung low over the horizon like a golden coin. The air, luxuriously warm, was fragrant with pines and wildflowers.

Kira and Darcy relaxed on a hotel balcony overlooking the green expanse of the Great Smoky Mountains. They had pushed their chairs together and kicked off their shoes, and now sat sipping red wine.

The conference was over, and so was their research presentation: The Safety and Effectiveness of a Novel VART Add-On Utilizing Bone Conduction: A Case Study in a Non-Responder . Given the preliminary nature of their reVART findings, the audience had been justifiably skeptical. But there had been some cautious supporters as well, and a lively discussion over dinner. Not to mention that she and Darcy were the first wife-and-wife research team to ever present at the event. Darcy got a kick out of that.

Now all the other conference attendees had departed, and a soothing quiet enveloped the hotel. Kira and Darcy were staying an extra night. Their first vacation in a long time.

An electronic preprint of their paper lay on the table between them. Accepted for publication by a small but reputable open access journal just two days ago.

A flat square plastic box sat on top of it.

Kira picked up the box. The cover design brought a smile to her face. She turned to Darcy.

"Shall we?"

Two powerful forces had converged to bring her and her wife to this point.

Margaret Liu, their boss and mentor. First using all her power and authority to protect them and clear any obstacles from their path, and now tirelessly fighting to secure funding for their next and larger project.

And Adam Ostrovsky, their research participant and now legal counsel, valiantly defending them in seven lawsuits and counting. He swiftly crushed the accusation that reVART was like listening to music. What nonsense! He was old enough to remember the experience, and was even rumored to have been a drummer half a century ago—an allegation he neither confirmed nor denied—so he should know.

Incredibly, Margaret Liu and Adam Ostrovsky shared a musical past.

The box on top of Kira and Darcy's preprint was their gift. It held a rare music disk—the single album they'd ever recorded.

Darcy's eyes brightened. "I'll be right back."

She returned a moment later with an ancient, jury rigged wireless music player, and two reVART earpieces to go with it, one for herself and one for Kira. They slipped the devices on, the disks fitting snugly behind their ears.

Kira popped the plastic box open and handed Darcy the disk. Darcy slipped it inside the player.

"Ready?"

The familiar nameless emotion slammed into Kira with full force. "Not quite yet."

She reached for her brilliant, brave, beautiful wife and kissed her mouth. She poured all of herself into that kiss, everything she had to give, too much of it overdue. When they moved apart, both breathless, she grasped Darcy's hand.

"Now I'm ready."

The music gripped Kira, split her open, and filled her up to her very core—a slow, soulful melody riding on a strong, steady beat. And she knew her wife felt it too.

The experience was breathtaking—like ten thousand acu-needles singing inside her at once. Every cell, tissue, and organ restored to perfect balance with the same glorious, resistance-enhanced and barely audible vibrations.

Medical progress was a hell of a thing when experienced first-hand.

THE END

Bio: Vera Brook is a neuroscientist turned science fiction and fantasy writer, with three indie published novels, a handful of short stories, and lots more fiction in progress. To learn more about her writing, visit her website at verabrook.com or follow her on Twitter at @VeraBrook1.

E-mail: Vera Brook

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