Miskatonic Medical


Summary: Dr. Lisa West is a postdoctoral researcher at Miskatonic University, continuing her infamous great-uncle's work in her own time. When her illicit job lands her in trouble, she learns the New England underworld can become very personal.

Dr. Lisa West never imagined her research career would take her to an illegal cage match beneath a dive bar. Despite completing both a PhD and a medical degree, the pecuniary pittance she earned from attending to the combatant's injuries was obviously far less than the utterly unique opportunities the position afforded to her. A decade in graduate and medical school had prepared her for many things, but she had always learned the rest on her own.

Lisa had always sought a chance to validate the laboratory notes of her late and infamous relative, Dr. Herbert West. Due to her uncle's work being luridly exaggerated in an infamous pulp story written by an overrated hack writer, she had learned it was best to keep her true interests and aspirations concealed beneath a veneer of scientific and technical buzzwords.

Despite the slings and arrows of her fellow researchers, Lisa West had found Dr. Herbert West was no hack. His research had directly inspired the early work on cardiopulmonary machines and organ transplantation, from Dr. Robert J. White's monkey head transplants to Dr. Canavero's proposed human surgery. What she noted with great interest was her uncle's work on reanimating concoctions had largely been abandoned, save for a handful of specialized preservatives and adrenaline substitutes.

It was that substance that Lisa West developed in her own free time, as few pharmaceutical companies or funding bodies desired to be associated with it. She had considered publishing some of the results of her reagent online, but she felt she still needed harder evidence to dispel the claims of her naysayers. Unfortunately for her, fresh corpses were hard to come by, and working with the brain-damaged was a legal quagmire she cared not to down herself in.

Fortunately for her, Lisa West was made aware of her position by a medical school dropout she had kept in contact with. The boorish young man was moving out of Arkham due to financial difficulties, and someone was needed to fill in for his absence at the pit-fitting ring beneath a local bar, Pickman's Model. The upper level was decorated decidedly strange for a dive bar, with grotesque creature portraits from an obscure Boston artist placed upon all the walls. Upon learning the position's responsibilities, she immediately signed on.

Lisa had observed her surroundings in erudite detail since her illicit employment had begun. The bar's foundation was a brick blockhouse that greatly predated the current tenants. Against one wall was were metal bleachers of the sort she had seen in public parks and sports fields. Against the opposite wall were a pair of halogen lights that bore down upon a chain-link cage in which the combatants entered. By the terminus of a round, the basement was rank and rancid with human sweat and fouler odors. By the end of a match, the arena floor was painted with a putrid arabesque of bodily fluids.

Lisa noted that each bout began with a series of ritualistic steps doubtlessly intended to increase the patrons' chances to consume alcohol in that fetid basement. She sat beside the arena in a hood, sunglasses, and bulky lab coat that gave her an androgynous appearance, trying to make herself as invisible as possible to the drunken and undoubtedly uninhibited audience. Whenever a combatant went down and did not get up on a count of ten, the beady-eyed and wretched little man that announced each match would let her into the cage to check for a pulse.

If Lisa detected signs of life, she'd administer first aid to the best of her abilities and then arrange for a bouncer to drop the patient off at a paid-off private clinic if necessary. If the downed loser was dead or close to it, she instead have the corpse stuffed into the specially modified trunk of her car. Noting the fight manager's alarmingly reptilian coldness to injury and death, Lisa was highly dis-incentivized to make any inquires.

Due to the discretion required, Lisa West never gave her real name, nor asked the names of her coworkers. It was much to her surprise when the bug-eyed dwarf addressed her by first name over the clamber of the crowd as an intense fight reached its bloody ending. She sat catatonically, wondering how the inhuman observer had acquired her personal information. Despite her mental unease, she nevertheless found herself responding to his gestures with a hypnotic obedience.

While Lisa tried to focus on her mental distress, she found herself focusing on the fight. A towering black man with a shaved head and sweat-glistened body delivered a kick to the chest of a white skinhead with Nazi symbols tattooed into him from head to toe. She felt an inexplicable schadenfreude, reveling in the grounded man's agony and uncharacteristically wishing she could deliver a harder blow to his head. A wet crunch that followed a second later sent the crowd erupting into cheers.

Over the din of the spectators, Lisa overheard the manager's soft-spoken voice as though it was divine revelation. "Doctor, the boss wishes to chat," he said in a voice that placed an unwavering emphasis on the first syllable in each word. "After you attend to your business."

Questions arose like in her fear-addled mind with the fecundity of swarming mosquitos, but Lisa found herself walking towards the cage entrance if only to avoid listening to the manager's disharmonious syntax. Sliding on latex gloves provided a tangible familiarity to her routine to temporarily steady her nerves. Her racing mind now settled on comfortable, macabre things, she unlocked the door and approached the man on the ground.

As the victor pranced excitedly towards the front of the cage, Lisa examined the downed opponent's bloodied and bruised face. She turned his head to the side, feeling both the neck and wrists. An unexpected rigidity in both caused her to watch the man's chest for a moment. The parts that weren't covered in blood or had the consistency of uncooked meat were elaborately tattooed with Norse runes, Nazi symbols, and gang symbols. Observing minute irregularities in the ink, she hypothesized the corpse-to-be had been an ex-convict, likely tattooed by some improvised, unsterilized apparatus.

The man's eyes, staring empty into the air, made contact with Lisa's sunglasses for a moment. A rare curiosity arose in her mind, which she mistook for an uncharacteristic empathy. She ruminated perhaps the man had been forced to take on the tattoos to survive in prison, or if he had no other alternative than to participate in bouts like this. She wondered if her earlier instinctual prejudice towards the dying man displayed the same callousness that she'd expect from an unrepentant racist.

Lisa dispelled those thoughts from her head as the manager's gaze fell upon her once more. She checked the man's torso, and with her clinician's instinct, she felt a patch of cooling skin upon his stomach. Suspecting internal bleeding, she realized the extent of the man's injuries was far greater than anything she, or the private surgeon, could deal with. Reaching into her first aid bag, she made her final decision.

Lisa sometimes felt squeamish personally administering a fatal dose to a patient, but far less than when she had first started. For those reasons and others, she withdrew a pneumatic dart pistol from her medical bag and trained the muzzle on the man. She placed a dart in his carotid artery with the reflexes of an expert marksman. The dying man's eyes rolled up in his head, and a final breath escaped his lips. She reflected it was one of the few peaceful deaths she seen in the arena. She knew that the fighter may have passed quietly, but his body would not know rest.

After retrieving her gear, Lisa reminded herself of the noisome manager and his peculiar speech. She expected one of the bouncers to carry the body back to her car, but the realization neither bouncer left the manager's sign implied something was amiss. Being addressed by her real name and title had been unnerving enough, but she had assumed the manager had the resources to determine who her identity. She briefly wondered if, if anything, the manager might not know about her.

Lisa had long feared being outed for her research, but she had always feared the authorities more than her underworld contacts. The manager had caused her to regret that assessment of threats in a pair of sentences. Before today, she had only heard him ever speak a few words before or after each bout, a fact which she had taken for granted. The greater implication of the manager's words were enough to get her consider leaving prematurely.

Lisa exited the arena just before the two bouncers reached the door. Instead of restraining her as she feared, they instead hoisted the victorious fighter and carried him upstairs. A throng of inebriated and half-sober fans followed them up the narrow stairs, like a retinue of servants behind an imperial palanquin. They left the mildew-tainted depths behind them, denying the primary escape venue that Lisa had considered.

Lisa recognized the two bouncers that flanked the manager as being undefeated pit fighters, heavy men with an emotional range only slightly broader than their employer. They tracked her with the dehumanized gaze of like a slavering dog following a steak. The predatory patterns of their movement and advance broadcast hostility as they advanced. The manager simply stood behind them, his silver eyes staring emptily at her.

Lisa had already loaded and fired the tranquilizer pistol when the bouncers stepped around the cage. The first clutched his neck and gasped for air as the dart's contents entered his bloodstream, but the second with an involuntary flinch that gave Lisa time to put a dart into his arm. Seeing his face twist into a mask of fury, she found herself sprinting as fast as her legs would carry her into the throng of people. Behind her, the bouncers pursued with a leisurely pace, as though apathetic towards and unaffected by the concoctions now coursing through their bloodstreams.

"Halt," came a single work from the manager. The two bouncers ceased their forward movement at once, not even stopping to removing the darts that protruded from their bodies. The crowd did not heed or hear the command, but instead seemed to stream out of the basement with a faster cadence than before. Lisa yearned to join them in emancipatory revelry, but some force of evil potency pulled at her dazed will. She walked towards the manager with no doubt the bouncers were unnecessary for his fell intentions.

"Follow," the manager said, his peculiar tone conveying a series of hypnotic compulsions in his single word. Lisa saw her hands sheath the dart gun in her bag and hand the backpack to one of the bouncers. The two bouncers simultaneously removed the darts from their bodies and slipped them into the bag. The manager walked towards a small door in the corner of the basement, with her own legs betraying her into following behind. The two bouncers blocked the door behind her. She briefly glanced at the corpse in the arena, wondering if she was soon to join her most recent patient.

Lisa saw the manager open the door for her and continue holding it, an almost gentlemanly action if it were performed under any other circumstance. The ancient, ten-paneled door bore a heavy lock and deadbolt on it, despite looking worm-eaten. She had never recalled seeing it open, let alone what lied behind it. The path beyond was well-illuminated, but she nevertheless could feel an impalpable aura of oppressive antiquity within. One of the bouncers now bore the corpse over his shoulders in a fireman's carry, while the other locked the door behind him.

Lisa only smelled mildew within the brick-walled passage, but the curious alcoves within the walls caused her imagination to think of morbid applications. A gnawing sensation of unwanted voyeurism struck her, as though she were examining the naked bones of the town itself. Like an superfluous medical examination on the sample patient, she confirmed her hypotheses with new data. Over the stale air, one particularly pungent odor defied classification.

The malodorous stench rose in intensity as Lisa approached the apparent terminus of the subterrene corridor. The shadows writhed and danced like a manic masquerade as the manager halted before the corner of the room. A trenchcoat-clad form stepped out of the blackest corner of the room, while the two bouncers blocked the way behind her. One of the bouncers laid down the corpse before the skulking abomination, as though paying deference to a forgotten god. Had she full command of her facilities, she doubtlessly thought she would have turned and in the opposite direction. Nevertheless, Lisa's attention was involuntarily fixated on the almost-human shadow as it spoke.

"A pleasure to finally meet you in person, Dr. West. I have returned from a very long trip, but I was familiar with your great-grand-uncle's work," said the figure in a high-pitched, discerningly jocose manner. "I would like to renew his deal."

Fearing she was still ensorcelled by the manager, Lisa did not speak for a tense and awkward eternity. Her muscles tightened, her heart raced, and her long-dormant reptile brain focused on the essentials of survival. Out of the corner of her eye, she saw the shaded figure squat upon all fours with a distinctively predatory stance. The misshapen, triangular head of the creature fell upon the manager. "Davis, release her."

"Respond," came the manager's compulsion. Lisa felt her mind being twisted and torqued once more, but felt her own thoughts verbalize with the bluntness of a sledgehammer. She was typically cognizant and apathetic about her utter lack of social decorum, but every word that left her lips felt like a taunt towards the skittering horror in the corner. She did not know if some fell enchantment compelled her to act as such, or she vainly tried to hide her insecurity. "What are you blathering about, freak?"

Lisa noted the first sign of emotion she saw on Davis' face since in a long time, a smarmy, coprophagic grin that stretched from ear to ear. A slow and uneasy chortle came from the corner, and she thought she saw the flash of obsidian eyes upon her body. "Young one, I know you are not happy with your currently arrangement. Your work at university is unappreciated by your undeserving peers, and your talents are clearly wasted as a ringside medic."

Her interest piqued beyond her sense of caution, Lisa listened to the creature's proposition. "Continue."

"Your work is marvelous, but you could afford to be more discrete. Remember that cadaver you dumped in the Miskatonic River under the covered bridge last month? It was fortunate for you that I have paid the police to look away."

Lisa did not respond, eerily aware the being chatting with her had preternatural senses or a wide network of informers. She did not wish to explore which possibility was more unnerving, but both caused her to involuntarily grit her teeth.

"Producing more corpses is in both of our interests. If you ensure this happens, I will raise your payments, keep the authorities away, and assist with disposal of unwanted remains."

Lisa blinked, as her tongue slipped between her jaws. The offer was obviously weighted in her favor, so she figured another would bears its external costs. From the distinct scowl on Davis' face, she had a good idea. She knew her work would save countless lives by its very nature. Those that fought in the arena, she thought, were already the unmissed dregs of society. She had considered cases where the few were sacrificed to save the many, but now she had a chance to put that theory into practice.

"Decline," said Davis in his irresistible, commanding tone. For the first time since she had met him, Lisa saw insecurity on the manager's face, an urge betrayed by his widening eyes and clenched teeth. She found solace in that discovery, as Davis displayed pitifully human weaknesses. She turned towards the hunched aberration in the corner, wondering about its response.

"Choose freely," replied the abomination in the corner, as it wagged a bony talon at Davis like a scalding finger. Its words reverberated in Lisa's head, dispelling the sorcerous compulsion from her mind. While the deepest parts of her mind uttered naught but the feeblest of protests, but a desire to spite Davis darted through her mind.

"Sounds good to me," Lisa said, as she found herself utterly unburdened by fear of the thing in the corner. "What do I do with the bodies?"

"Ah, good. We shall work that out later."

"Damn you, Pickman," Davis said, cursing under his breath. "Damn you."

Lisa saw Davis lose all shreds of deference towards the Pickman entity, uttering a stream of profanities as his eyes reddened.

"Lisa, you will survive," said Pickman in his croaking voice. "Survive."

When Davis charged at her, Lisa found herself fleeing back towards the basement arena as fast as her legs could carry her. The bouncers stood idly off to the side, vacantly staring towards Pickman's direction. She made a furtive glance over her shoulder, but could not see the full shape of her pursuer in the tenebrous tunnel behind her. A rapid gait and distinctly inhuman gallop echoed in the shunned corridor, both gaining upon her.

Lisa saw the light emanating from the basement door crack glow like sunbeams cleaving into oblivion. She redoubled her efforts to reach the door, only to recall it was locked. Struggling to turn the deadbolts that the bouncer had locked earlier, she heard the footfalls behind her grow louder. She found herself pleading to an uncaring universe to spare her, just as the door opened before her.

Lisa darted through, but was knocked over by the assailant sprinting behind her. She saw the uncleaned arena before her, and then the floor behind it. She tried to return to her feet, only for a powerful kick to strike her ribs. Sprawling backwards, she looked up to see Davis advancing on her like an enraged bull. His balled fists sat at his side as he moved forward to finish the downed doctor.

Lisa was momentarily unsure where the whistle came from, but she would later presume it was the same person that lobbed the dart gun onto the floor near her hand. She did not bother to think whom had loaded the weapon, but Davis' bug-like eyes widened. Seeing her only chance at survival, she reached for the gun as Davis sprinted towards her arm, bringing the impromptu weapon to bear on the manager. She pulled the trigger without the slightest hesitation, and the projectile struck Davis in the chest.

Lisa saw Davis extend his hands outward, as if pleading for help. He immediately ceased his advance, his seething aggression melting into his stoic stoniness. He turned towards the yawning portal to darkness behind him, and began to walk towards the tunnel. With each belabored step, Lisa noticed a cascade of grit tumble out of Davis' pant leg. His vigor and ability to stand erect diminished as he advanced, leaving naught but a shriveled frame decaying as though a disintegrating mummy. For the entire time, Lisa observed with a morbid curiosity. When Davis looked back at her a final time, she uncontrollably ran out of the basement as fast as she could.

The remainder of the night was a blur to Lisa. She remembered sprinted into the parking lot, fumbling with her keys, and speeding like a lead-foot back home. She crashed on her moth-eating sofa, not bothering to shower or change. Her night was a mercifully dreamless one of tranquility, but she awoke the following morning covered in cold sweat.

Lisa spent the following morning wondering if the events of the previous night were a nightmare or reality, until she resolved to distract herself by continuing a batch of experiments she had envisioned earlier. She moved through the unordered stacks of medical textbooks, the formaldehyde jars of preserved tissue, and notebooks of chemical formulae that she shared her rented house with. She descended the creaking flight of rotting wooden stairs, feeling as though something had changed.

When Lisa turned on the light, she saw her instinct vindicated. On her operating table was the corpse of the man with the distinctive Nazi tattoos, with her bag of medical supplies beside it. She gasped for a moment, scanning the shadows for nonexistent movement. As she sighed in relief, her curiosity overtook her fear, and she rifled through her bag of medical supplies. All of the items she recalled putting in were there, save for the addition of a small envelope.

Lisa opened it to find thrice the normal cash payment she typically received. She looked at the covered windows once more, fearful that an unwanted intruder would burst in to attack or arrest her. Her guilty conscience faded into measured breathing as her heart ceased pounding like a marching drum. At the bottom of the envelop, she found a note written upon a slip of paper. The writing was done with black pen, with each letter scribed by the graceful hand of a master calligrapher. It was archaic and elaborate, but perplexing.

"My apologies for any surprises. Keep up the good work. Here's to our future work," she read aloud.

Lisa slipped it back into the envelope and stared at the wall for a long time.