Her hospital room was crowded—unusually so, for a woman standing in death’s doorway, but her doctor had hoped that by bringing her family to see her, he could better plead his case for taking her off life support. The damage from the accident had been too great. Tests had shown that Sally herself—the thinking, acting girl they remembered—was gone. “Clinical brain death” was the term he used, over and over again, trying to make them understand. Sally was gone. Sally was not coming back. And if they kept her on artificial life support for much longer, more of her organs would begin to shut down, until there was nothing left. If her family approved the procedures to harvest her organs now, her death could mean life for others. By pairing her organs with splices taken from her SymboGen implant, the risks of rejection could be reduced to virtually nothing. Dozens of lives could be saved, and all her family had to do was approve. All her family had to do was let her go.

All they had to do was admit that she was never waking up.

Sally Mitchell opened her eyes.

The ceiling was so white it burned, making her eyes begin to water in a parody of tears. She stared up at it for almost a minute, unable to process the message she was getting from her nerves. The message wanted her to close her eyes. Another part of her brain awakened, explaining what the burning sensation in her retinas meant.

Sally closed her eyes.

The doctor was still pleading with her family, cajoling and comforting them in turn as he explained what would happen next if they agreed to have Sally declared legally dead. His voice was no more or less compelling than the buzz of the machines around her. None of his words meant anything to her, and so she dismissed them as unimportant stimuli in a world that was suddenly full of unimportant stimuli. She focused instead on getting her eyes to open again. She wanted to see the white ceiling. It was… interesting.

The second time Sally opened her eyes, it was easier. Blinking came after that, and then the realization that she could breathe—her body reminded her of breathing, of the movement that it required, the pulling in of air through the nose, the expelling of air through the mouth. The respirator that was supposed to be handling the breathing process began beeping shrilly, confused in its mechanical way by her sudden involvement. The stimulus from the man in the ceiling-colored coat became more important as it grew louder, hurting her ears.

Sally sat up.

More machines started to beep. Sally winced, and then blinked, surprised by her own automatic reaction. She winced again, this time on purpose. The man in the ceiling-colored coat stared at her and said something she didn’t understand. She looked blankly back at him. Then the other people in the room started making noise, as shrill and confused as the machines around her, and one of them flung herself onto the bed, putting her arms around Sally and making a strange sound in her throat, like she was choking.

More people came into the room. The machines stopped making noise, but the people kept on doing it, making sounds she would learn were called “words,” asking questions she didn’t have answers for, and meanwhile, the body lived. The cells began to heal as the organs, one by one, resumed the jobs they had tried to abandon.

Sally Mitchell was going to live. Everything else was secondary.

STAGE 0: EXPOSURE

Your health is too important to trust to just anyone. Choose SymboGen. Choose freedom.

—EARLY SYMBOGEN ADVERTISING SLOGAN

Where am I?

—SALLY MITCHELL

When the hygiene hypothesis was proposed in the late 1980s, most people laughed it off as fringe science. It was based around the idea that more people were developing life-threatening allergies and autoimmune conditions because they weren’t getting enough early-life exposure to infectious agents. Not just viruses—everyone gets exposed to viruses, unless they live inside a bubble—but allergens, bacteria, even parasites. We weren’t living in literal bubbles, but we were sterilizing our environments more every year, and we were starting to see the effects. Children were getting sick because we refused to let them play in the dirt. It was a ludicrous idea. Pure scientific comedy.

Except that by the beginning of the 21st century, no one was laughing. More and more, the human race was being faced with a choice: find a way to keep our systems in the equilibrium they had evolved to maintain, or accept a future of chronic illness, increasing biological and neurological disorder, and potentially, eventually, extinction.

That’s where we came in.

—FROM “KING OF THE WORMS,” AN INTERVIEW WITH DR. STEVEN BANKS, CO-FOUNDER OF SYMBOGEN. ORIGINALLY PUBLISHED IN ROLLING STONE, FEBRUARY 2027.

… traffic cameras captured images of the driver’s hands beginning to shake uncontrollably in the middle of the intersection before she apparently experienced a massive seizure, losing control of her vehicle and causing a dramatic sheer to the right. Witnesses reported that Sally Mitchell, age 20, appeared unaware of her surroundings as she drove straight into the path of an oncoming crosstown bus.

In his deposition, the bus driver (David Alexander, 37) claimed he had been unable to either hit the brakes or swerve to avoid Mitchell’s car. The two vehicles collided without slowing, sending Mitchell slamming into the wall of a nearby bank. One pedestrian was hit, Anthony Thomas, 28. Mr. Thomas was hospitalized for a broken leg and several minor contusions, and was released two days later. At the time of this writing, Sally Mitchell remains under hospital care, and has not yet regained consciousness…

—FROM THE CONTRA COSTA TIMES, JUNE 13, 2021.

Chapter 1