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Chapter 10: Gift of Twins

  Peter and Eric were completing the inspection of the aft starboard storage compartment when Eric saw the beam which held the upper shelves give way. Before he could yell a warning the beam struck his brother and then, in slow motion, pinned him against the wall. He felt the vibration of breaking bones, but did not have enough time to sense the pain before he blacked out. Their small health monitors began broadcasting the distress signal simultaneously. They were quickly moved the short distance to the sick bay. Doc Jules had received an update from the computer, and was already pulling supplies out of the cabinets when they arrived. By the time the nursing assistants Kate and Martha had arrived he had already performed his initial triage.

  His quick inspection had revealed a fatal head injury to Peter and severe chest injuries to Eric. He told Kate to start an IV and oxygen on Peter mostly to assuage her feelings. He had Martha help him move Eric onto the operating table. Martha was unable to find a vein for an IV because Eric was already slipping into shock. Doc Jules responded by placing a large needle into Eric's jugular vein and sliding a venous catheter through it. They began to rapidly administer fluids to maintain Eric's blood pressure. The MRI scanner which was built into the operating table revealed that Eric's mediastinum was filling with blood. Doc Jules inserted a needle and removed a large amount of blood, but the improvement was only temporary. He made the decision to open Eric's chest. He was not a cardiovascular surgeon, but knew that without control of the mediastinal bleeding Eric would not have more than a few minutes to live. He inserted the endotracheal tube into Eric's trachea and connected him to the auto ventilator. The computer sensors immediately adjusted the gas mixture to increase the available oxygen, and the pressure was increased in an attempt to compensate for the damaged lung tissue.

  He used the laser scalpel to cut through the skin and expose the bone of the sternum. He used a small ultrasonic bone saw to quickly cut through the sternum. The sight of Doc Jules reaching in and pulling the sternum apart was more than Kate could tolerate. She tried to sit down, but passed out slumping to the floor. Doc Jules had seen her fall, but he was much too busy to help. When Martha turned to help Kate he gently reprimanded her saying, "She’ll be all right, I need your help here."

  He placed the retractor in the sternum and exposed the mediastinum. The pericardium which is a thin bag that holds the heart was stretched tightly limiting the ability of the heart to pump blood. He made a small incision and began sucking the blood out. He was able to restore a reasonable heartbeat, but his inspection had shown a severe crush injury to the heart with partial avulsion of the aorta. Cardiopulmonary bypass was necessary and he began preparing for the bypass without even considering his limited training or the probable futility of the effort. As a surgeon Doc Jules was a risk taker; he knew that if he did not try Eric would most certainly die. It was preferable to have a patient die despite your efforts rather than from failing to have acted. It is this willingness to accept the risk and responsibility that separate surgeons from other physicians and normal people.

  Doc Jules knew that once he clamped the vena cava, the main vein that returned blood to the heart, that he had only seconds to place the tubes and insert them into the bypass ports that were built into the ventilator. He took a deep breath and placed the clamp across the vena cava, stopping all blood to the heart, to the brain, and to the rest of the body. He then used scissors to open the torn aorta and placed the bypass tube into the aorta and the other end into the ventilator. He was working with such intensity that he noted the large size of the aorta in a sort of "out of body" way. Doc Jules then took the second tube and inserted it into the vena cava. The relatively thin tissue of the vena cava made clamping and thereby sealing this tube much more difficult. He noticed himself swearing only when Martha asked, "I'm sorry. Could you repeat that."

  Doc Jules mumbled an apology and kept working. When the vena cava was finally sealed around the bypass tube and the tube inserted into the ventilator, Doc Jules relaxed enough to become aware of the time. He asked the computer about elapsed time and felt like a failure when he learned that he had taken almost two minutes to complete the bypass. The computer seemed to sense his state of mind and added that it had taken the liberty of hyper oxygenating Eric and this actually allowed for a full two minutes of bypass insertion time.

  The sigh that came from Doc Jules was felt by everyone else as much as it was heard. Eric's vital signs improved immediately with the completion of the bypass and Doc Jules now took the time to complete his evaluation. He used the laser scalpel to make a small incision into the abdomen carefully opening the last layer in order to protect the intestines. Blood again gushed out. Doc Jules attempted to use a scope to inspect the abdomen but the bleeding blocked his view. He then used the laser scalpel to open up the entire abdomen. He washed out the cavity and began cauterizing the torn liver. The damage was so severe that in order to control the bleeding he had to clamp the main artery to the liver. This reduced the bleeding enough that he could see that the spleen was also ruptured; rather than trying to remove the spleen he just clamped off the artery to it also. The major bleeding was now controlled and eminent death had been averted but Doc Jules knew that survival was still unlikely. Doc Jules straightened his back and took a deep breath and only then did he notice that Peter was still waiting for treatment. He asked the computer if Eric was stable and the computer replied, "Compensation for the blood loss was adequate, but that the liver would fail within the next 30 minutes if the blood supply was not reconnected."

  Doc Jules examined Peter more carefully. The crush injury to the head was severe with a portion of the skull and at least one-third of the brain actually missing. He was maintaining a reasonable blood pressure despite the severe neurologic injury. He decided to stop all efforts and discontinue life support, but when he looked at Martha and Kate he knew that this was not acceptable. Instead he asked the computer to perform a tissue match for a possible transplant. He told Kate who still appeared a little shaky, "I want you to keep the IV going and keep the dressings over the wound." She nodded her head in the affirmative.

  The Captain now spoke through the monitor and apologized for interrupting Doc Jules, but asked him if it would be possible to have a command conference. Doc Jules was startled, and replied that he did not think it was an appropriate time for administrative duties. The Captain asserted command and asked the computer if Eric would remain stable if Doc Jules was absent for 10-15 minutes. The computer replied that he was stable but that the damaged liver would begin to fail after that period of time. The Captain then ordered Doc Jules to report to the sick- bay office at once. Doc Jules tore off his gloves and withdrew to the office mumbling under his breath.

  Assembled in the small office were the Captain, Brother Simon and Mike. The Captain apologized to Doc Jules and opened the conference officially by invoking the power of the crisis protocols. Doc Jules asked why the injuries to two crew members was sufficient to declare a crises. The Captain explained that Peter and Eric represented the primary and backup billets, or positions, for both nuclear propulsion and guidance. They were chosen because of their cross training in both of these essential fields. The loss of either would be serious but the loss of both would severely compromise their mission and potentially cast them adrift among the stars. Hearing this caused Doc Jules to sit down and turn pale. The Captain asked him for his report.

  He reported, "Peter is almost certainly brain dead and Eric's injuries are probably fatal."

  The Captain asked about doing organ transplants and Doc Jules replied that he would need a liver, heart and probably a lung transplant and that it looked like Eric's back was also crushed so that even if he lived he would be paralyzed. The Captain asked what the chances of success would be for survival with a retained intellect? Doc Jules said that with a team of transplant surgeons and a good tissue match that maybe Eric had one chance in a hundred. With onl
y him and an unknown tissue match the odds would be 1 in a million. The Captain said, "That is not good enough." She asked for comments from the command team.

  Mike asked if there was any way to do a brain transplant from Eric's damaged body to Peter's damaged head? Doc Jules just groaned and said no way. Mike asked why not and Doc Jules started to explain that nerves could not just be reattached like wires in a machine, but he did not finish. Instead he asked the computer if it had finished the tissue match. The computer said that it had and it appeared that Eric and Peter were identical twins with a perfect match. Doc Jules said, "A brain transplant is not possible but that maybe a head transplant would be."

  The Captain asked if he could do a head transplant and Doc Jules said it would be easier than attempting a multiple organ transplant. The Captain than ordered him to proceed, but Doc Jules objected stating that the attempt would kill one or both of the twins. The Captain reminded him, "You already told us that Peter was brain dead."

  Doc Jules responded, "Ethically it is one thing to stop mechanical life support and quite another to actively kill one patient so that the other would have a chance to live."

  Mike asked, "If Peter were pronounced dead would it be permissible to proceed?"

  Doc Jules said he would proceed if the command group would act as his ethics committee and declare Peter to be legally dead. The Captain asked Doc Jules what was involved in declaring someone dead. He told her, "Lack of organized electrical activity in the brain is usually sufficient." The computer reported that Peter's EEG pattern did in fact have such minimal activity that it could qualify for certifying brain death.

  Brother Simon objected, "Since Peter is surviving with such minimal life support and is still breathing, I feel that Peter is obviously still alive."

  The Captain then asked the command conference to vote on the ethical issue of certifying the death of Peter. She instructed them that the decision had to be based on the well-being of the individual not on the mission requirements. Mike objected, stating that the survival of the group and the mission should take precedence over the rights of the individual, but the Captain stuck by her decision. The vote was called and the decision made to proceed with the transplant attempt.

  Doc Jules was excused and told to return to his work. He began speaking to the computer as he left the room, asking for anatomical evaluations of the proposed transplant. The computer began to show the normal anatomy superimposed on the MRI films of Eric's shattered body. Doc Jules asked that the muscle attachments and the nerves to the arms and shoulders be highlighted. These structures were above the area of spinal crushing and appeared to be intact. Doc Jules made the decision to do the transplant at the C7-T1 level. By removing Eric's arms and shoulders at the junction of the neck and back Doc Jules felt that if Eric did survive that he would then have the use of his arms in addition to his voice and the senses of his head. Once the decision had been made as to the extent of the transplant, the mechanics of the actual surgery became Doc Jules's concern. The computer was told to review the mechanism of attaching the transplanted neck vertebrae onto Peter's chest vertebrae. The monitor revealed a plate technique which would stabilize the vertebrae rigidly, using opposed titanium plates. The collarbone would be reattached to the sternum with a flexible plate that would allow a little motion so that the arm function would be better. Doc Jules told the computer to have the auto supplier fabricate the plates and asked for a time estimate. The computer said that fabrication and sterilization would take about 1 hour. This delay concerned Doc Jules because he was already approaching the 30 minute time limit that had been put in place in an attempt to save Eric's liver. The computer responded that by limiting life support to just Eric' head and neck that the auto-ventilator would be able to detoxify and maintain the life of Eric's head for about 2 hours. This became Doc Jules's primary concern.

  Protecting the survivability of Eric's head was crucial so Doc Jules made the decision to sacrifice the rest of Eric's battered body. The chest cavity was reopened, moderate bleeding persisted, but the cellsaver transfusion system was reusing the majority of the blood. With the protocols displayed graphically on the monitor Doc Jules began dissecting out the arch of the aorta and the superior vena cava. The aorta was clamped off as it made its turn inferiorly and the blood supply to the lower body was completely cut off. The inferior vena cava was then clamped to prevent any toxins, from the damaged organs, from reaching the remaining circulation. The point of no return had been crossed; Eric's body was now dead. Doc Jules dissected the clavicles from the sternum, pealing the shoulder tissues off of the rib cage. Bleeding was controlled with the laser scalpel which was adjusted automatically for the vessel size. Only a few of the larger veins and arteries had to be clamped and tied. The muscles were gradually dissected off the sides of the rib cage and onto the back. The computer was using the real-time MRI images to assist Doc Jules in the dissection by controlling the energy of the laser in order to protect those nerves and muscles that the protocols meant to protect. The freeing of the shoulder and neck muscles proceeded rapidly, but Doc Jules was basically unaware of time. It was not until the dissection was complete that he even asked for a time progress report and he was heartened to hear that he was on schedule.

  The next step was to severe Eric's backbone and spinal column. Doc Jules hesitated as he began cutting through the vertebral disk that separated the last cervical vertebra and the first thoracic vertebra. Martha noted the hesitation and asked, "Is something wrong with the equipment?"

  Doc Jules replied, "The equipment is fine, but I think that the surgeon may be marginal." He then continued the dissection completely severing the head, neck and shoulders from the rest of the body. Eric's life was now in the hands of the computer and the auto-ventilator. The monitor showed that the brain function remained intact and that the blood flow and balance were satisfactory. Doc Jules had the rest of Eric's body removed from the OR table and had Peter moved on to the table. The breathing tube was placed into the trachea of Peter and connected to the pulmonary side of the auto-ventilator. This machine was designed to support only one life at a time and the computer had to continuously monitor the auto-ventilator in order for the life of Eric's head and Peter's body to be simultaneously maintained.

  Doc Jules again had a momentary pause as he looked at Peter's shattered head lying just below the torso of his brother. Both were alive only because of the technical ability of the computer and the auto-ventilator. The dissection of Peter's upper torso proceeded even more rapidly than Eric's dissection. The computer again automatically assisted Doc Jules by controlling the strength of the laser, but this time the actual attachment points of the muscles were being protected at the expense of the muscles which were to be discarded. The vertebra were separated at the same level as Eric's and the spinal cord sealed with the laser scalpel. The major vessels were them clamped and cut depriving the remaining part of Peter's brain of all blood and ending its life. The trachea and esophagus were then divided at a point slightly higher than Eric's to allow an easier closure of the transplant organs. The phrenic nerve to the diaphragm and the vagus nerve were tagged on each side to allow for re-anastomosis with Eric's's nerves. The now-dead upper torso of Peter was then removed from the table. The unconnected body of Peter and the upper torso of Eric now lay before Doc Jules, awaiting the joining that would hopefully allow the combined parts the life that would have been impossible for the separate individuals.

  Doc Jules stretched, took a deep breath, and asked for an update on the vital signs and the time. He felt good to know that he was on schedule as per the protocols. The first step in joining the twins was to stabilize the backbone. Doc Jules took the custom made vertebral plates and attached them to Peter's vertebra with the titanium screws, the fit was nearly perfect with the bends in the plate following the natural curves of the vertebra. Eric's torso was then slid down until the cervical vertebra of Eric was resting on the
top of Peter's thoracic vertebra. Doc Jules then completed the union by attaching the plates to Eric's vertebra. The protocols called for the insertion of a small tube and pad between the severed portions of the spinal column. Doc Jules performed this portion of the operation without even wondering why. He knew that regeneration of the spinal column was impossible and had already accepted the fact that the new Eric-Peter would be paralyzed from the shoulders down. Working against the clock Doc Jules now began reconnecting the arteries and veins. The auto-supplier had provided an absorbable tube that fit into the ends of both Peter's and Eric's arteries. The tube acted as a stent to help keep the arteries open and acted as a glue and sealant that relieved Doc Jules of the very tedious chore of sewing the ends of the vessels together. As soon as the major arteries were connected and the fresh blood from Peter began to flow into Eric's head, the brain wave pattern began to improve and Doc Jules felt genuine hope for the first time. After the remaining vessels were connected, the phrenic and vagus nerves were connected by inserting the cut ends into a small tube which again held the nerves together and sealed them to encourage regrowth. A small nerve stimulator was attached to the phrenic nerves of Peter and a small sensor was attached to the phrenic nerves of Eric. This would allow the diaphragm to respond in a normal fashion until nerve regrowth made the artificial stimulation unnecessary.

  Doc Jules felt relieved to be performing the re-anastomosis of first the esophagus and then the trachea. Working on these large non-bleeding tubes seemed easy compared to the intense concentration of the vascular and nerve anastomosis. Doc Jules inserted a trach tube into Eric-Peter's trachea and plugged the ventilator circuits into it. Repair of the muscle attachments and the skin incisions were accomplished almost mechanically due to the extreme fatigue Doc Jules was beginning to feel. In the last three hours he had worked harder than he had ever worked before and performed a surgery that had not even been described before. The fact that the surgery may even turn out to be successful was beyond Doc Jules ability to comprehend at this time.

  Doc Jules removed his gown and gloves and told Martha to administer antibiotics and narcotics to Eric-Peter as needed. The enormity of what he, his limited staff and the computer had accomplished was settling in. As Doc Jules walked into his office he was surprised to see the Captain and Brother Simon still at his desk watching the monitor. The Captain extended her hand and offered her thanks and congratulations for the effort that Doc Jules had put forth. She said, "You’ve done your best and all we can do now is hope that it was good enough."

  Brother Simon also offered his hand as a friend and offered to get Doc Jules refreshments. Doc Jules asked for some chocolate and fluids to help with the fatigue and hypoglycemia he always seemed to develop after stressful surgery. The Captain asked what the chances of Eric-Peter (which is what everyone immediately started calling the now-joined twins) surviving the ordeal with his mental abilities intact, were. Doc Jules admitted, "We will not know for a few days because Eric-Peter will be kept sedated to decrease the chances of cerebral edema (brain swelling) from developing. I am confident that the computer will be able to maintain Eric-Peter's metabolic status and if infection or tissue rejection can be avoided, then Eric-Peter will have a good chance of making it."

  Captain Brezinski told Brother Simon, "Inform the rest of the crew of Eric-Peter's status and develop a plan to help the crew deal with the loss of the individual crew members, Eric and Peter." The task of incorporating Eric-Peter into the crew would be dealt with a little later. Brother Simon volunteered to make funeral arrangements, but Doc Jules asked him to wait on any final plans until the survival of Eric-Peter was assured. If Eric-Peter died a separate funeral just did not seem right to Doc Jules.

  After 48 hours Doc Jules allowed the computer to decrease the medication that Eric-Peter was receiving and Eric-Peter gradually regained consciousness. Eric-Peter's first awareness of himself was a dreamlike sensation. He visualized the beam striking his brother and tried to call out. The struggling increased his blood pressure and the computer automatically medicated him. He slipped back into unconsciousness. When he awoke again he was slightly more aware of his surroundings and realized that he was in a hospital bed. When he tried to call out the computer again medicated him and he lost his grasp on reality. He learned that any struggle brought on a return to unconsciousness. He needed to think. If he avoided any attempts at calling out or moving he was allowed to stay awake.

  The room was dimly lit and he could see the monitors above him. No one was around. He figured that it must be nighttime. He could move his mouth and face but no sound came out when he tried to talk. His hands and arms were supported by an apparatus. He could feel his fingers and see them move. He had almost no pain. The memory of the beam striking him became more vivid. He wondered why he was not having much pain. It was then that he noticed he could not feel his feet or legs. He tried to move them, nothing happened. He tried to shift his hips and nothing happened. He realized that he was paralyzed. His analytical nature allowed him to take stock of his situation. He could think so he was still alive. His hands worked which meant that he would be able to use a wheelchair and his computer. He could continue his work. That was enough. His thoughts turned back to Peter. The vivid memory of the beam striking his brother caused his blood pressure to rise and the computer medicated him. He again lost his connection with reality.

  Doc Jules was with Eric-Peter when he regained consciousness the next morning. He spent time explaining what had happen and what they had done in order to save Eric-Peter's life. Eric-Peter's status continued to improve and the trach tube was removed on the 5th day after surgery. Breathing was a little difficult for Eric-Peter, but the chance to talk made removal of the tube worthwhile. Brother Simon came by and spent time discussing the philosophy of existence and trying to help Eric-Peter come to grips with who he was. Eric and Peter no longer existed as separate entities. Acceptance of this loss by Eric-Peter happened in a way only twins could accomplish. Eric and Peter had started life as a single embryo which had split creating two genetically identical individuals. This allowed Eric-Peter to accept the fact that the twins had again been rejoined sharing each other's heart and mind.

  The Captain waited only until Eric-Peter's status had been elevated to "good condition" to ask Brother Simon to complete the funeral arrangements for Peter-Eric. Eric-Peter agreed with the Captain that a "sea burial" was indicated. Peter-Eric's body was encased in a tomb of ice which had the effect of a crystal casket. The funeral was a formal military affair attended in military dress and protocol. Brother Simon presented the eulogy which discussed the need for man to contribute to the greater good in order to fulfill life's meaning. At the completion of the ceremony the casket was taken by robot to the propulsion unit. The casket was loaded and with the help of a small explosion it was ejected from the ship, its mass and inertia used to help propel the remainder of the crew forward towards the completion of their mission. Eric-Peter attended the ceremony in a motorized chair, his arm motion was still restricted by his braces but the hand controls allowed him complete control of the chair. The pacing of his diaphragm allowed for fairly natural breathing and speaking. Special sensors and stimulators helped him control his bladder and other body functions. The crew seemed to accept Eric-Peter as a combination of the twins and the loss of Peter-Eric was tempered by the survival of Eric-Peter.

  The rehabilitation of Eric-Peter was begun in earnest. The muscle attachments were not yet healed and the use of the arms had to be restricted. The small pad that had been inserted into the space between the joined spinal cords was now being infused with small amounts of a nerve growth hormone that Brother Simon had synthesized from the recommendations of the computer. An artificial circulation of white blood cells was begun, bathing the severed ends of the spinal cord. Doc Jules doubted that regeneration of the severed cord was possible, but Brother Simon was adamant that the computer data gave
hope for recovery of significant function. The white blood cells cleaned the nerve endings and secreted chemicals which encouraged nerve regrowth. Normally the spinal column was completely isolated from the white blood cells so that the helpful chemicals never reached the severed nerves. It was this hope for recovery that allowed Eric-Peter to put up with the torture that Doc Jules prescribed for maintaining the strength of his legs and trunk muscles. Rehabilitation is the most grueling aspect of recovery.

  Captain Brezinski added her own efforts to the rehab effort by asking Eric-Peter to resume work on the propulsion and guidance problems. The acceleration that they had obtained from their sling shot around Jupiter had produced a velocity that was faster that any human had previously traveled. They still required continuous acceleration of almost a full gee as they fled their home planet. Exponentially larger quantities of energy were required to maintain this acceleration. Eric-Peter now had the dual responsibility of both guidance and propulsion. The computer had the data and the computational ability but not the comprehension to make use of it's abilities without the human interface. Eric-Peter's survival had kept the mission alive.

  Brother Simon spent a considerable amount of time with Eric-Peter and Doc Jules discussing the meaning of personal loss. Eric-Peter accepted his loss reasonably well, but was very interested in the ongoing debate between Doc Jules and Brother Simon regarding the issue of "why do bad things happen to good people." Doc Jules explained his viewpoint with a story from his past. During his second year of surgical residency he was working in a ghetto hospital in Detroit. The hospital had a cancer ward which always had several children as patients.

  "I was taking care of a four-year old girl with leukemia who had severe nose bleeds. Almost every day I had to cauterize or pack her nose. I felt as if I was torturing her and she would cry during the procedure but would always give me a hug when I was done. Watching this beautiful girl suffer made me question my concept of goodness. This blameless child had done nothing to deserve the suffering which she was enduring. Why did God let this child suffer? Why do "bad" things happen to good people? I was very troubled by the unfairness of the situation. The fear for my own children's health was obviously contributing to the emotional load that I was carrying. If this terrible thing called "leukemia" could happen to this wonderful child that I was taking care of, what prevented it from happening to my children? Was it the grace of God that protected my children, but if so why did he allow this other girl to suffer? This dilemma bothered me until one morning when I was driving through the ghetto, to reach the hospital; I saw a bumper sticker on a car. This car was a rust-bucket of a wreck which was spewing out a plume of smoke from the exhaust pipe. It had a single bumper sticker on the back bumper which said "Shit Happens." At first I just laughed at the vulgarity of the language, but then I started to think about what it meant. If things just happen it means that a person who is suffering did not do anything to deserve the suffering, it just happened. There was no divine reason for illness, God did not cause or prevent illness. Life became much more logical if I just denied the existence of a God."

  Brother Simon listened intently to the story as did Eric-Peter. They both agreed that Doc Jules had reached a logical conclusion, but Brother Simon added, "Just because a conclusion is logical does not make it correct."

  Doc Jules asked him "What other conclusion could be reached based on the evidence I presented?"

  Brother Simon responded, "The dilemma of why God lets bad things happen to good people has been a theological and philosophical issue for at least 4,000 years. Despite my years of study I am not sure that I have the correct answer. During my search for an answer to this question, I began to wonder if maybe my concept of "bad" was what was at fault. For instance, when a cougar is successful in the hunt and drags home a deer for its young so that they do not starve, I would think that this is a good thing. When I think of it from the deer's perspective, I arrived at a very different conclusion. Being killed by a cougar can be nothing but "bad." How can the same thing be both good and bad. I began to think that maybe I was being presumptuous in defining what was "good and bad." In my narrow perspective I could be either the cougar or the deer but not both. I realized that I was limiting God by expecting that my viewpoint was the same as God's. I cannot define what God thinks. Maybe indeed things just happen, but I am convinced that our perception of things as being bad is a reflection of our limitations in understanding. The question is not whether God allows bad things to happen to good people, but rather, has God given us the strength to deal with things that just happen. In the story you presented, the young girl was always able to respond to your medical efforts in a positive manner by giving you a hug. I would say that she was most certainly blessed by God with the strength to deal with her illness."

  Eric-Peter ended their philosophical discussion by reminding them, "Remember, gentlemen, I am still connected to your instruments of torture."

  Doc Jules laughed heartily and said "I suppose we have been ignoring you but the computer says that you have a few more minutes of torture yet today."

  Eric-Peter replied, "I suppose that I can survive a few more minutes, but can we change the conversation to a more light-hearted subject?" When Brother Simon asked him which topic he would rather discuss. Eric-Peter replied, "Let’s discuss something simple like the question of whether there is enough dark matter in the universe to prevent it from expanding forever." Doc Jules and Brother Simon both rolled their eyes up and began to laugh.