In a country where advanced medical services were rarer than gold his family had been wealthy enough or at least desperate enough to hire specialists to try every possible remedy. Mostly they ran endless tests and rated him on various scales'the DRS, the Rancho los Amigos Index, the Glasgow Coma Scale. They tried to get him to blink his eyes, to wiggle his toes. They stuck him with pins, made him smell unpleasant odors; a nurse moved his hand around on a computer keyboard and helped his fingers twitch and spell out nonsense words.
Eventually the doctors presented their findings. The boy was not in a coma, they assured his parents. Coma victims could not react to unpleasant stimuli. He was not in that darkest of closed-off places, the persistent vegetative state, because his brain was undamaged, at least physically. He was not in a stupor, nor had he suffered cataplexy, or narcolepsy, or any of a hundred other things.
He was, the doctors whispered, 'locked in.' For whatever reason his brain continued to function and his body lived but they weren't on speaking terms any more.
'To myself,' the Tsarevich explained, 'is not so bad. I had dreams, nice dreams. An angel stood in my corner and showed me pictures of world. This was in actual a television set, ha ha. Every day beautiful nymphs they came and washed my body, was quite stimulating. Were nurses, of course. I lived in fairytale land, where I am Prince Ivan, yes? You know the story of Prince Ivan? He is taken away by the grey wolf, to fabulous and magic land, and has great adventure. He even fights Koschei the Deathless, and he wins! No one ever told tale of Prince Ivan grows up to turn to Koschei. Never before.'
The causes of 'Locked In' Syndrome had always eluded the medical profession. There was no real treatment, the doctors told his parents, only therapies with little hope of any real amelioration of his condition. There was very little hope of his just coming out of it on his own, though here the doctors split. Some suggested it could happen, that children were resilient, that there was always room for a miracle. Most of the doctors suggested quietly removing the boy's feeding tube and ending what promised to be a short and extremely unpleasant life.
American consultants and Russian Orthodox priests were contacted and their advice sought. Decisions were made. The machines that kept his body going were paid for. His room was kept sterile and safe and free of intruders. Everything was kept on battery power because the local electrical grid was unreliable. All of his supplies'liquid food, replacement parts for the oxygen supply, pain medication'were ordered in bulk and fed into automatic delivery systems. When the Epidemic came the nurses deserted the hospital but the boy's life hardly changed.
At least, until the food in the automated feeding machine ran out. For days he languished, his body quietly devouring itself. Death and life combined, tried on each others' mantles. In that bad place, the Tsarevich said, 'my angel he closed his eye, yes. I saw no more.'
In darkness he was blind and alone. His world collapsed to become a narrow space, between a blanket and a mattress, a softly respiring universe no larger than a bed. And then, without warning, he wasn't alone.
'Lad,' someone said, calling from very far away, 'lad, you've known so little of life. Yet now it's time you learned of the other thing.'
In the darkness the voice spoke to him of what had happened. It pulled no punches and spared no pains explaining things in minute detail. The boy had never learned so many basic concepts'to him death had been a true abstract, to him, perhaps alone in Russia, hunger was a complete blank.
He had not known, for instance, that he was created to oversee the destruction of the entire world. He had not know that God had ordained him the angel of death.