Informed Consent - chapter 1 (free version) (Patreon)

Vicky's knees press into the mattress on either side of my hips. She leans forward and her hair falls across her collarbone in damp strands. The overhead light is off. The streetlamp outside comes through the blinds in thin orange strips across the sheets. The AC kicks on and the bedroom door drags on the rug underneath it, the same half-inch catch it's had for two years, and clicks against its frame.

She trails a hand down my chest, nails catching in the hair, and flattens her palm on my stomach.

"Stay flat," she says. Her voice drops into the register she uses when she runs the scenes. "I want my girl right where she is. Keep your legs open."

I let my pelvis drop back and spread my thighs wider. The night air cools the sweat on my skin. My knees ache the way they do the day after a long shift, except I haven't worked since Friday.

"That's a good girl." She leans down until her mouth is an inch from my ear. Her breath is warm on my earlobe. She smells like salt and grapefruit body wash.

Then she stops. Her nose comes up off my jaw an inch, and I feel her smell me.

"What," I say.

"Nothing. You smell different." She presses her face into my neck and breathes in again, considering. "Did they change the soap at the clinic?"

"I don't think so."

"Huh." She lets it go, and the moment closes over. "I'm making a mess of you. Tell me you're my girl."

"I'm your girl." My voice catches. The words scrape coming out.

Afterwards she rolls off onto the mattress beside me. Where she was, my skin goes cold. She pulls the sheet up over her waist and turns her face to me on the pillow, breathing ragged.

The room smells like sex and silicone and sweat. The streetlamp lays the same orange lines on the wall. The clock on the nightstand says 11:42. The nightstand is mine, a cheap IKEA thing I brought when I moved in, dwarfed next to her mid-century dresser. There's another of the same nightstand on her side of the bed.

I pull my hand off my stomach. I grab the towel off the floor and wipe my hand, then my belly. The terrycloth is rough on sensitized skin.

"You're amazing," Vicky murmurs, eyes half closed. She traces my jaw with one finger. "My favorite girl."

I lie still and stare at the ceiling.

Three days ago I did something I can't take back. It was deliberate. I planned it for weeks and it took less than a minute. Soon the fever will start, and after the fever, everything else. I don't say any of it.

I roll onto my side, away from her, and pull the sheet up. The springs compress under my ribs. I take up most of the bed. I always have. I sleep diagonally without meaning to, and Vicky has spent two years folded into the corner I leave her, and she doesn't complain about it, and I've never noticed until now that this is a thing a body does that another body has to answer for.

I trace my hip bone under the sheet, memorizing the density of the muscle over it.

I think about the window in the living room, the sash that sticks on the left track. Every spring I muscle it up with one arm. I think about the deadbolt on the front door, the one that sticks, the hip-check and twist I do without thinking, one hand, groceries in the other. I think I'll miss that, the raw utility of being the person who opens things. I'm probably wrong. I'll probably miss something smaller. The friction of denim on narrow thighs. Shoes that fit.

When I was nine or ten I used to close my bedroom door and walk a straight line from the window to the bed, one foot in front of the other, my arms held slightly away from my sides, hips swaying. I did it for about a year. I never told anybody, not because I was ashamed of it, but because there was no way to say it that would survive being said, and I'd already worked out at nine that a thing you can't explain isn't a thing you get to have.

Vicky drapes an arm over my waist and presses her face into my back. Her breathing deepens into sleep. I stay awake, listening to the sheets, waiting for the fever.

The thermometer beeps three times. I pull it from under my tongue and hand it to Vicky.

"A hundred and two." She squints at the screen. "You look terrible."

"I'm freezing." I pull the duvet to my chin. My teeth chatter. The thermostat reads seventy-two and my skin feels like it's in a draft.

Vicky sighs and sets the thermometer on the nightstand next to a half-empty glass of water. She's still in her scrubs, just off shift. She rubs the bridge of her nose. "It's that flu going around. I told you half your waiting room was coughing last week."

"Yeah," I say. My voice is thin, vibrating with the shiver. "Probably."

I let her believe it. I let her go to the kitchen for the ibuprofen. The tap runs. The fridge door opens and closes, and I hear the cactus magnet slide a quarter inch down the door and catch, the menu for the closed Thai place flapping once under it. I lie there timing my own chills and catch myself doing it and stop.

She comes back with two white pills and water in the Austin mug, the one with the price sticker still on the bottom. I swallow the pills dry and lie back.

"Try to sleep," she says, and turns off the lamp.

The first night is a crawl of sweating and shivering. The sheets saturate and turn heavy and cold. The air smells sour, metallic, sickness coming out of my pores. Tuesday and Wednesday dissolve into twelve-hour stretches of nothing.

Wednesday afternoon I try to get up to shower and my legs buckle before the hallway. Vicky finds me on the edge of the mattress, trembling, the wet sheet bunched in my fists. She doesn't panic. She assesses, brisk, a floor nurse at home.

She runs the bath. She comes back and gets my left arm over her shoulders. I'm dead weight, but she pivots my hips, takes my mass, and walks me into the steam.

She strips my soaked boxers off my legs and eases me onto the cold porcelain. The tub is apartment-standard, too short for me, and I have to pull my knees to my chest. She rolls her sleeves and runs the handheld over my shoulders, lukewarm. Her hands are firm. She works a bar of white soap over my chest, washing off the sick-sweat.

She pumps grapefruit shampoo into her palm and massages my scalp, nails scraping lightly. My shoulders are broad and heavy under her small hands. She rinses the lather away and talks the whole time in a low even voice about a difficult patient, grounding the room in complaint. She kisses my wet forehead. The tenderness of it forms a hard block in my throat. I sit in the shallow water and let her bathe a body that's dismantling itself.

She dries me, walks me back to a bed she's already stripped and remade, and I fall into the pillows.

The third night wakes me at two. The pain starts deep in the marrow of my pelvis and radiates out into the hip sockets.

I gasp, and it wakes Vicky. She rolls over.

"Marcus?"

"My back."

She turns on the light. I've pulled my knees to my chest to take pressure off my spine, but the movement grinds the head of the femur into the socket and the friction is excruciating.

"Do you need the heating pad?"

"No. Yes. I don't know."

She gets up and plugs in the gray heating pad and slides it under my lower back. The heat does nothing. The pain is in the bone itself, a deep, mechanical pressure.

"You're drenched." She wipes my forehead with the heel of her hand. "If this doesn't break by tomorrow, you need to call Dr. Yuen."

"No." Too fast. I slow my breathing. "It's just a bug. They can't do anything for a virus."

Dr. Yuen is the endocrinologist I work for. If I walk into her clinic she'll order a panel, and the lab will spin the tubes and see the viral load. I'm not walking into a clinic.

"You're stubborn," she mutters. She gets back in bed but keeps her distance from the heat of me.

Thursday afternoon the fever settles into a static, oppressive presence. Sunlight crawls across the floor. Dust motes drift in the AC current. I stare at the ceiling fan.

Vicky leaves for work. The apartment goes quiet.

My mind drifts to St. Luke's. Sonia Bhatt runs the lab and everything the lab touches, which at a clinic this size is most of us. She reconciles counts. I picture her monitor, a spreadsheet, a red cell. I'm stuck in this bed. I can't check anything.

I drag myself up and head for the bathroom. My legs shake. The muscle in my thighs is still there but the coordination is shot. I grip the doorframe.

I stand over the toilet. The anatomy is standard. The mechanics are unchanged. I flush, lean on the sink, and look at myself. Pale, slick. Dark circles like bruises. Three days of stubble on a heavy jaw.

I run my hands over my face. Thick knuckles. Large hands. Through the open door I can see the framed poster from the Austin trip, hanging slightly off-center above the bed, where she insists it goes.

I limp back. The joint pain migrates into my knees and ankles, hot sand in the synovial fluid. The closet door rattles on its broken track when I lean on the frame, a thing we both muscle past instead of fixing.

Vicky brings takeout Thursday night. She drags in the kitchen chair, the one with the short leg, and it rocks under her when she sits. She hands me a plastic container of broth. The smell is overwhelming, chicken fat and wet cardboard, and it turns my stomach, but I take it.

"Giorgio texted." She eats a salad out of a plastic bowl. "He wanted to know if you're making poker tomorrow."

"Tell him no." The broth burns the roof of my mouth.

"I did. Marty asked if they should bring the game here. I told him absolutely not, I'm not sanitizing this apartment after five guys."

"Thank you."

I set the soup on the nightstand and wipe my mouth. I can't eat.

"You're quiet," she says.

"Just tired."

"You've been sleeping for four days." She sets the salad down and looks at me closely, the annoyance softening into concern. She touches my cheek. Her fingers are cool. "I'm worried about you."

"Don't be. It's breaking soon."

She traces my jaw. "You feel hotter than yesterday."

I lean into her hand. She's sitting here taking care of me. I need the water and the ibuprofen and the illusion of normalcy.

"I'll be fine," I say.

The fifth night the fever goes past a hundred and three. The walls recede. I'm twelve, in the bathroom at my parents' house in Phoenix. A yellow towel wrapped around my chest, hiked up under my arms. The mirror shows the first dark hairs coming in on my sternum. I hold the towel where it is until my arms ache.

The memory folds back into the dark. The heavy weight in my hand is the corner of the pillow.

My pelvis feels like it's coming apart at the front. Not a break, a give, and it takes hours to do it. There's a stretch behind the ache, low, a slow pull toward the middle of me, and I can't tell if it's tissue or if it's the fever making things up. The sheets are sweat-soaked through to the pad. I can feel my own pulse in the bones of my hands.

I reach down between my legs and find everything still there.

I squeeze my eyes shut and breathe in jagged gasps. The pain in my lower back is blinding. I don't wake Vicky. I suffer through the last hours of it, pulse rapid, sweat pouring. I chose it.

The clock says 3:14. The dark stretches out. I grip the sheets.

The pillowcase is stiff against my right cheek. Yesterday's sweat evaporated overnight and left a crust of salt in the cotton that drags my jaw when I turn my head. The room feels normal. The chills are gone. The air from the ceiling fan is just air.

I lie still and notice the heavy structural ache in my pelvis is gone.

I slide my hand down my stomach.

The space between my thighs is empty. The familiar weight is gone.

I push the duvet back and the cool air hits my bare skin. I sit on the edge of the bed and plant my feet on the hardwood. When I stand, the shift is immediate. My center of gravity sits lower than it did yesterday. The widened pelvis pulls my weight down into my hips. I take three steps toward the bathroom and my thighs brush each other.

Vicky is asleep on the far side, her back rising and falling. I step onto the bathroom tile and push the door until the latch clicks.

The overhead light is blinding. I close my eyes until my retinas adjust, then look down.

The air along my thighs is cold, then warm low against me, and the smell of me rises, close and faintly sharp. There's a seam where the weight was. Pale skin, flushed pink at the edges, parted a little. Above it the dark line of hair down my belly stops where it has always stopped, and above that my chest is broad and flat, the shoulders I've had since I was nineteen. I reach down and touch it once, two fingers laid flat over the folds, and take my hand away. I put my right hand on the wall to steady the new balance.

I reach up for the hand towel on the bar near the toilet and my hand comes up short. Not by much. An inch, maybe two, the reach arriving where it used to arrive and finding nothing. I stand there with my arm extended at empty air. Then I rise onto the balls of my feet, and the motion tips me forward in a way it never has, my weight riding differently over my hips, and I catch the edge of the sink.

"Marcus?"

Vicky's voice comes through the door, thick with sleep but clear.

"Yeah." My voice is a male baritone.

"Are you out of bed?" The sheets rustle as she rolls over. "Did the fever break?"

"It broke."

"I knew it would." She yawns, long and loud. "Are you standing up in there making a mess, or are you sitting down like my good girl?"

I grip the edge of the sink. The porcelain is cold against my palms.

"I'm sitting down," I tell her.

"That's exactly where you belong." Her voice drops into the smooth commanding register. "Girls have to sit down. Go ahead. Sit on the cold seat and spread your legs for me."

I turn and look at the toilet. I sit, and I misjudge it, dropping the last two inches onto the seat harder than I meant to, the plastic biting the backs of my thighs. The body arrived overnight and I have no calibration for it. I spread my knees.

"Are you sitting?"

"Yes."

"Good." Her bare feet hit the floorboards. She walks over and stops right outside the door, leaning against the wood.

I reach down with my left hand.

"Tell me what you feel," Vicky says. She taps her nails on the door panel.

"I feel it." My breath catches.

"You sound so good. Now pee for me. Just relax and let it go. I want to hear my girl peeing."

I pull my hand away. My fingers are shaking. I relax the pelvic floor.

It comes faster than I expect, and not where I expect. It catches the front lip of the bowl before I shift back on the seat, and then it finds the water and stays there.

"Listen to that," Vicky says, dark amusement in it. "Sounding just like a girl. So pretty and neat. No standing up to pee, you have to sit down."

I pull three squares off the roll. The dry paper is abrasive against the sensitive tissue. I reach around behind me, which is the only way I've ever done this, and the angle is wrong before my hand gets anywhere. I come at it from the front instead. Front to back. I've said those three words to patients a hundred times and never had a use for them. I drop it in and flush. The water swirls and clears.

"Wash your hands and come back to bed." I hear her walk away. The mattress springs squeak.

I stand at the sink and run the hot tap. I pump soap and work it into a thick lather, scrubbing the clear fluid off my fingers. I rinse and dry on the gray hand towel. I look at my reflection. My face is unchanged. Heavy jaw and stubble.

I unlock the door and pull it open.

The bedroom is dim, the streetlight still doing what the sun hasn't started to do. Vicky is on her back, propped on two pillows, the duvet pushed to the foot of the bed. She's in a thin camisole, legs bare. She watches me cross the room.

I monitor every step. The dropped center of gravity makes my hips sway to keep momentum. I keep my arms close to my sides.

"You look exhausted," she says. The roleplay drops out of her voice for a second, genuine care coming through.

"I feel better. The joint pain is gone."

I sit on the edge of the bed and the mattress compresses under me, deeper on one side than I expect, and I catch myself with a hand behind me. I swing my legs up and slide under the flat sheet, leaving the duvet away. The thin fabric settles over my hips.

Vicky rolls toward me. Her heat crosses the space between us. She puts her hand flat on my chest. Her palm is warm.

"Your skin feels normal."

"I told you the fever broke."

She smiles. She slides her hand down my sternum, tracing the line of hair down my stomach. She leans in and kisses the side of my neck. Her lips are soft. She smells like salt and clean laundry.

"You were so good while you were sick," she whispers against my collarbone. "You just laid there and took it."

"I didn't have a lot of energy to fight it."

"I know. I like that." She bites the muscle of my shoulder lightly.

Her hand keeps going, fingers trailing over my navel, applying slight pressure, expecting the hard length of me.

Her hand slides between my thighs.

She grabs empty air.

Her fingers close on nothing. Her palm drops flush against my pubic bone.

She freezes.

The AC outside shuts off. I stop breathing. My hands stay flat on the mattress. My heart hammers the inside of my ribs.

Vicky's hand is pressed against me. She doesn't pull away.

She shifts her fingers. Drags her index finger down.

She recoils.

She yanks her hand back and scrambles backward across the mattress, up against the headboard. Her eyes are wide. She looks at her hand. She looks at the sheet over my hips.

"What," she says. A flat, breathless sound.

I pull the sheet down, folding it back over my thighs, exposing the lower half of my body.

Vicky stares at my pelvis. Her jaw drops. The muscles in her neck go rigid.

"What is that," she says, and her voice rises sharply. "Marcus. What the fuck is that. What is that?"

"It's a virus."

"What virus? What are you talking about?" She grabs a pillow and pulls it to her chest, a barrier. Her breath comes in short frantic gasps. "Where is it? Where did it go? Did it fall off?"

"The fever," I say. I keep my hands flat on the mattress. I don't reach for her. "The incubation period. This is what it does."

"You're insane. I'm hallucinating." She scrubs her face with her hands. She looks back down at my hips. The labia are slightly parted. The skin is real.

"It's called Expression," I tell her. "It alters the genetic sequence. It's irreversible."

"We need to go to the hospital." She drops the pillow and swings her legs off the bed, moving in frantic jerks. "Right now. Put your clothes on. Put your pants on, Marcus. We're going to the emergency room. Or we call Dr. Yuen. She's an endocrinologist, she'll know what to do."

"Vicky, stop."

"Don't tell me to stop!" She's on her feet. She points a trembling finger at the lamp instead of at me, her aim wild. "Look at the time, we have to go! It ate you! Whatever you caught at that clinic, it's rewriting your body. We have to get you antivirals right now before it does anything else."

"There aren't any antivirals for this."

She stops moving. She turns to face me.

"What do you mean?"

"It's completely new. They don't understand it yet. There's no treatment. Once the fever hits, the sequence is locked. It can't be stopped."

Vicky stares at me. The color drains out of her face. She looks at my broad chest, my heavy jaw, and then down at the smooth female anatomy between my thighs.

"You're a woman," she whispers.

"Yes."

"The virus turns you into a woman."

"Yes."

She covers her mouth with both hands. She takes a step back and her back hits the dresser.

Then she drops her hands and the fear in her face goes hard.

"You sat down," she says.

"What?"

"In the bathroom. Just now. You sat down to pee and you let me…" Her voice cracks upward. "You knew. Before you came out of that bathroom, you knew, and you let me run the whole thing. The good girl thing. You let me say it."

"Vicky."

"How long?" She's pacing now, a tight circle, her foot catching the edge of the woven rug. She kicks it flat. "How long have you known what it does? A day? A week? You laid there all night with the fever breaking and you didn't wake me. You just laid there and let it happen."

She stops. She looks at me again, and the question comes back around, the same one, like she can't keep hold of it.

"What is it," she says, quieter. "Marcus. What is that."

"I told you."

"Tell me again."

"It's a virus. It's called Expression. It's irreversible."

She stares at me for a long moment. Then she says, "I'm going to get my phone. I'm calling the clinic."

She walks out. I hear her bare feet on the hallway hardwood. Five seconds later she comes back. Her hands are empty.

"Lie back down," she orders. The panic makes her authoritative, reaching for protocol. "Lie down so I can look again."

I lean back on the pillows. She stares at the space between my legs. She grabs the flat sheet and throws it onto the floor.

"Why didn't you wake me up?" she yells. "You laid here all night and let this happen? The fever broke and you didn't wake me? You just laid there?"

She turns away, pacing again.

I sit on the bed and watch her. I don't try to stop her. The cold air settles over my skin. I put my hand flat against my lower stomach and feel the warmth of my skin under my palm.

The illustrated version of this chapter includes images of Marcus having sex with Vicky, in the bathtub and the bathroom, examining his vulva on the toilet and with Vicky in the bedroom after. The paid versions include significantly more explicit text content as well.