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Chapter 1 - Chapter 1: Baseline

The monitors made a sound like breathing. Not real breathing the approximation of it, the way a machine dreams of lungs. Twelve screens arranged in a soft arc, each one mapping a different brain at rest: delta waves scrolling thick and slow, the occasional flare of REM activity lighting up a temporal lobe like heat lightning over flat water. Dr. Maren Shaw sat in the center of the array and watched eight people sleep.

She'd been watching people sleep for fourteen years. First as a grad student at Johns Hopkins, hunched over polysomnography readouts in a basement lab that smelled of burnt coffee and carpet adhesive. Then as a postdoc in Zürich, where the lab was nicer and the insomnia was the same. Now here Sollen Pharmaceuticals, Seaport District, Boston where the funding was real and the sleep lab gleamed with the kind of sterile newness that made everything feel provisional, like a set that hadn't been struck yet.

The lab occupied a windowless sub-basement beneath the main building. Twelve beds behind pale blue curtains. Air that tasted of recycled nothing. The polysomnography machines hummed at a frequency just below hearing she'd measured it once, 42 hertz, a coincidence that amused her because 42 hertz was also the loneliest whale frequency, the one no other whale could hear. She'd told that to her intern, Tomás, who had smiled politely and gone back to his data entry.

It was 3:47 a.m.

Subject 031 rolled over in Bed 4, and her electrode leads shifted. The EEG trace stuttered, recovered. Maren made a note in the log movement artifact, channel Fp2, 03:47:12 and took a sip of cold green tea. The mug was white with a chip on the rim that she'd covered in clear nail polish so it wouldn't cut her lip. She'd had it since the Zürich days. There were people in her life she'd kept for less time than this mug.

She checked the drug-administration schedule on the tablet propped beside her keyboard. Each of the eight subjects currently sleeping had received their nightly dose of Somniplex-R at 10 p.m. the amber capsule, 200 milligrams, taken with eight ounces of water and a small carbohydrate snack. The protocol was exact. Maren had written it herself, tested it on three hundred simulations before the first human mouth opened. Eight months into Phase III, the results were, by any rigorous measure, extraordinary. Somniplex-R didn't just reduce sleep latency; it restructured sleep architecture itself, deepening slow-wave phases, regularizing REM cycles, producing patterns that Maren's models predicted should require years of cognitive behavioral therapy to achieve naturally.

The drug worked. It worked in a way that made her nervous, the way a bridge that never sways makes an engineer nervous. Perfection in biological systems was either miraculous or suspicious, and Maren had not survived graduate school by betting on miracles.

But the data was clean. She'd run it herself every variable, every control, every outlier flagged and explained. Clean.

At 4:15, Tomás arrived with two coffees and an apologetic expression. He was twenty-four, gangly, earnest in a way that made Maren feel both old and oddly protective. He'd been her research assistant for seven months and had learned two things about her: she did not take milk, and she did not want to hear about his girlfriend's pottery classes.

"Anything?" he asked, setting her coffee on the desk.

"031 moved at 3:47. Otherwise, eight brains doing exactly what the capsule told them to do."

"That's good, right?"

She took the coffee. "That's Tuesday."

He hovered. He always hovered when he wanted to ask something personal. She let him hover for eleven seconds she counted before saying, "What."

"You've been here since nine. You don't have to do the overnight shifts yourself anymore. We've got the monitoring techs "

"I know."

" and the automated flagging system you built "

"I built it, Tomás. I know what it misses."

He retreated to his station. The moment he looked away, Maren allowed herself a small yawn, buried in the crook of her elbow. She was tired. Not the good tired of satisfying work the gritty, mineral exhaustion of a body that had been lying to itself about sleep for months. She tracked her own sleep with a consumer-grade wrist sensor, a habit she found both ironic and impossible to stop. Last night: four hours, eleven minutes. The night before: three hours, forty-eight minutes. She could feel it in her eyes a dryness behind them, as though someone had scooped out the moisture with a small, precise spoon.

The irony was not lost on her. The woman running the most promising insomnia trial in a decade could not sleep.

• •

She left the lab at six, when the morning shift arrived with their lanyards and their matching water bottles. The elevator deposited her in the lobby glass, steel, the Sollen logo etched into the floor in a typeface that probably cost more than her first car. Outside, the Seaport morning hit her like a wet cloth: cold salt air off the harbor, diesel from the shuttle buses, the particular grey of a Boston November that seemed to come not from the sky but from the buildings themselves, as though the city were exhaling.

She walked to the Red Line. Took the train to Central Square. Walked four blocks to David's apartment, a second-floor unit in a yellow triple-decker that always smelled of whatever the downstairs neighbors were cooking, which at 6:40 a.m. was something involving cumin and regret.

David opened the door in sweatpants and a Tufts T-shirt that predated their marriage by three years and their divorce by one. He had the face of a man who'd been handsome before fatherhood exhausted his interest in the project good bones going soft, reading glasses perched on his forehead like a second set of eyes that couldn't quite focus either.

"She's almost ready," he said. "She insisted on picking out her own outfit and it's a choice."

"Bold?"

"Aggressively floral."

Maren stepped inside. The apartment was warm, cluttered in a way hers wasn't sneakers by the door, a half-finished jigsaw puzzle on the dining table, a plastic pterodactyl standing guard over a bowl of cereal. This was the house where Alma felt like Alma. Maren's apartment, the converted triple-decker in Somerville with the steam radiators that clanked at 3 a.m. and the hardwood floors that popped like knuckles, was where Alma felt like a guest who happened to share her mother's eyes.

She didn't think that. She noted it, filed it, moved on. It was what she did.

"Mama!"

Alma came down the hallway at full tilt seven years old, a velocity event in a sunflower-print dress and yellow rain boots with small penguins on them. She hit Maren at hip height and wrapped her arms around her waist with a force that suggested either profound affection or an attempt to topple a load-bearing column.

"Good morning, bug."

"I drew a whale. Do you want to see my whale?"

"Show me on the walk."

They left David's place and walked to school. Alma talked without pause the whale, her friend Noor's new dog, a theory about why pigeons don't get cold, a strong opinion about yogurt and Maren listened with the focused attention she brought to everything, which meant she was genuinely listening but also cataloguing: Alma's gait (slightly pigeon-toed on the left, same as hers), her mood (bright, elevated, no signs of the anxiety that sometimes surfaced on transition days), the sound of her rain boots on the wet pavement, a soft click-and-drag rhythm that Maren associated with everything good and simple in her life.

At the school entrance, Alma handed her a folded piece of paper. "My whale."

Maren unfolded it. Blue crayon, an oblong shape with a smiling face and a spout that looked more like a party hat. Underneath, in Alma's unsteady handwriting: MAMA'S WALE.

"It's beautiful."

"It's a beluga. They're the friendliest."

She kissed Alma's forehead and watched her disappear into the school building, the yellow boots flashing through the crowd of small bodies and oversized backpacks, and then she stood there for a moment longer than necessary, in the drizzle, holding a misspelled whale, feeling the particular ache of a parent who is about to return to the version of herself that does not include this.

• •

On the train back to Sollen, she reviewed the latest batch of trial data on her laptop, the screen angled away from the man beside her who smelled of wet wool and was trying not to look. The numbers continued to be excellent. Sleep efficiency across the treatment group had increased by 34 percent over placebo. Adverse events were minor and expected: headache, dry mouth, occasional vivid dreams. Nothing that would trouble the FDA. Nothing that troubled Maren, specifically. She'd designed this trial the way she designed everything with margins, with redundancy, with the paranoia of someone who believed that data was the only reliable narrator.

She ran a secondary analysis on the REM profiles a habit, not a requirement. The profiles were consistent. The drug was producing exactly the sleep architecture her models predicted, across all demographics, all dosage groups, all eight months of longitudinal data.

Too consistent.

She paused, her cursor hovering over the standard deviation column. The values were low. Not unusually low, not flag-worthy, not the kind of thing you'd mention in a meeting. But Maren had spent her career studying the one organ in the human body that resisted regularity the brain during sleep was a jazz musician, not a metronome, and these numbers had the evenness of a metronome.

She closed the laptop. Told herself she was tired. Told herself that if the data were too good, the correct response was not suspicion but celebration, because she had built something that worked, and the appropriate reaction to a thing working was not to stand over it with a magnifying glass waiting for it to catch fire.

She told herself several things on the train. By the time she reached the Sollen lobby, she believed most of them.

• •

Her office was a glass box on the fourth floor with a view of the harbor she never looked at. She kept the blinds half-drawn because she'd read a study linking excess natural light exposure in work environments to decision fatigue, a study she'd later discovered had been retracted, but by then the half-drawn blinds had become a habit and habits were the scaffolding of a controlled life.

She hung Alma's whale on the corkboard beside her whiteboard. It joined a drawing of a house (purple, triangular, floating in space), a stick figure labeled MAMA AT WORK (standing alone inside a rectangle Maren tried not to read into this), and a birthday card from March that said YOU ARE 38 WICH IS OLD BUT I STILL LOVE YOU.

She turned to her computer and opened the trial database. Clean data. Good numbers. A drug that worked.

She should have felt proud. She did feel proud, in the distant way she felt most emotions as information, not experience. Pride, like sleep, was something she understood better in theory than in practice.

She worked until seven. Drove to Somerville. Heated soup she'd made on Sunday butternut squash, because Alma liked the color. Ate standing at the counter, reading a journal article on her phone about hippocampal consolidation during non-REM sleep. Washed the bowl. Wiped the counter. Checked the lock on the front door twice, a compulsion she didn't examine.

She got into bed at ten-fifteen. Set her alarm for five. Closed her eyes and listened to the radiator clank its midnight Morse code, the old pipes speaking a language she'd never learned, and thought about sleep architecture and standard deviations and the sound of yellow boots on wet pavement.

She did not sleep for a long time.

When she finally did, she dreamed of a funeral she'd never attended a man in a grey suit being lowered into the ground in the rain, mourners holding black umbrellas, and somewhere a church bell ringing once, just once, as if the bell itself were tired and couldn't be asked to try again.

She would not remember this dream in the morning.

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