State of Wonder (34 page)

“You don’t have them. Make do.”

Marina grabbed at the bulb which shot out of her bloody glove and skidded across the floor where it was caught, like all balls, by a five-year-old boy loitering nearby. “Christ!” Marina said. “At least get somebody to wash it off.”

And Dr. Swenson, without a word, motioned for the bulb to be run through the bucket with soap and water and so it was returned to Marina who used it to pull up a half pint of liquid that she then shot onto the floor beside her. She did it again. There, beneath so many layers, she could see the baby face down, feet to the head, bottom lodged firmly in the pelvis. Marina tried to sit the baby up but it was stuck.

“Lift the breech,” Dr. Swenson said.

“I’m trying,” Marina said, irritated.

“Just tug it up.”

Marina moved the shoehorns to the inside of the uterus and motioned for the nurse to pull, to really pull, which this woman who was herself doomed to a lifetime of constant reproduction did with all her might while Marina reached in and tried to pry the baby out. It was wedged into the mother like a child who had shoved himself into the tiniest cabinet during a childish game and could then not be coaxed out. The muscles in Marina’s shoulders and neck strained, her back pulled. It was a physical test of strength, 142 pounds of Marina Singh against six pounds of baby, and then with a great sucking sound the baby dislodged. The man with the knife put his hand on Marina’s back to keep her from falling over. Red and white and shining, one entire boy flipped over on the mother’s chest.

“Look at that. Could that have been easier?” Dr. Swenson gave a single, decisive clap. “Give the baby to them now. They know all about this.” No sooner were the words spoken than the slippery child was out of her hands, the thick liver of placenta going with him. The entire crowd bore him away, the old and the young made off with the astonishingly new. They had proof of something spectacular happening now. As many births as there had been no one was completely inured to the charms of infants. “Do you remember the rest of it? Massage the uterus now. This is the part I always liked, reconstruction, restoring order to the chaos.” Dr. Swenson leaned forward for a better look. “The baby is gone, he’s someone else’s problem, and you can pay more attention to the details. There isn’t the same sense of urgency.”

From the other side of the room the baby was crying now and the husband, still fixed to his wife’s hand, craned his head towards the sound. “Tap the Ketamine,” Dr. Swenson said. “There’s no point in her waking up now.” Marina suctioned out the belly again and set to work on the heavy stitches, a procedure as delicate as closing a Thanksgiving turkey with kitchen twine. The nurse, so much braver than one would have imagined, moved her shoehorns back knowledgeably while Marina reassembled everything she had taken apart: the uterus sewn, the bladder placed back on top.

“This is a good man,” Dr. Swenson said, nodding to the husband. “He stayed right with her. You don’t see that. They like to go fishing. Sometimes when they hear it was a son they’ll come in for a look, but that’s about it.”

“Maybe it’s their first,” Marina said.

Dr. Swenson shook her head. “I should know that. I can’t remember.”

Marina was making her last knot when the baby was returned. She slid the Ketamine out of the woman’s arm and lay the baby there in its place, though the mother, who was just barely flicking her eyelids, did nothing to hold it. It was a good looking baby, two furry eyebrows and a rounded mouth, swaddled in striped yellow cloth. He gave half a cry and half a yawn and everyone seemed to find this charming.

Marina was stiff coming up off her knees. “See?” Dr. Swenson said, pointing. “It’s hard enough for you.”

Marina nodded, taking off her gloves, and looked at the blood on her arms, the blood on her dress, the tidal pool of blood in which she had been sitting. “Good Lord,” she said. She looked in the bag for a blood-pressure cuff.

Dr. Swenson shook her head. “You don’t realize how much blood there is when you have all those other people waiting there to sop it up for you. This is a perfectly reasonable amount. You wait and see, she’ll be fine. They’ll both be fine.”

The nurse came over and covered the woman with another blanket. “It would be good if we could just move her to someplace that was dry,” Marina said. “I can’t leave her lying in all of that.”

“There are certain things we cannot expect the Lakashi to do,” Dr. Swenson said. “They cannot perform cesarean sections. That is a matter of training and equipment. They do know that a sick woman should not be left to lie on a sodden blanket, and they know perfectly well how to clean up. You will come back tonight and check on your patients, Dr. Singh, and come back again to check on them tomorrow. You’ll see how well they manage without you.”

The woman who had been nursing a baby when they arrived had handed that one off and was now nursing the new one while his mother slept on the floor. The father came to Marina, who was putting the contents of the used surgical kit back in her bag, and very lightly slapped her back and arms with his open hands. Then the others came over, all except the woman nursing and the woman sleeping, and did the same. The two children hit her legs and the old man reached to slap her ears. Marina in turn pounded the back of her nurse who had never flinched or turned her head during the surgery and in return the woman gently slapped Marina’s face with the back of her hand.

“Come now,” Dr. Swenson said. “Once you get started with this it can go on for hours. You’ll come home with more bruises than Easter.”

It took some navigation to get Dr. Swenson down the ladder but there were so many Lakashi waiting for her at the bottom with their arms stretched up that they would have simply caught her had she fallen and borne her aloft all the way back to the lab. She gave herself a few minutes to catch her breath and while they waited a crowd assembled. Clearly the news of their success had spread. The natives made a thick ring around Marina and Dr. Swenson, chattering and clapping their hands together once Dr. Swenson made it clear they were to keep their hands to themselves.

“Everyone is admiring you,” Dr. Swenson told Marina in a raised voice.

Marina laughed. There was a woman behind her holding on to her braid, staking out the territory as her own. “You’re just projecting. You have no idea what they’re saying.”

“I know their happiness. I may not know the details of every sentence but believe me, there are many ways to listen and I’ve been listening to these people for a long time.” The crowd was moving forward and the two doctors moved with them. “They think you will replace me,” Dr. Swenson said to her, “the way I replaced Dr. Rapp. Benoit told them you were the one who killed the snake to save Easter and that you brought the snake back for them. Now they’ve seen you cut out a child and keep the mother alive. That’s a heady business around here.”

“They didn’t see that,” Marina said.

“They most certainly did,” Dr. Swenson said, and lifted up her hand towards the sky. “They were in the trees. The entire surgical theater was full.”

Marina looked around at the faces of all the beaming Lakashi. What would have happened if the woman hadn’t lived? If the child were dead? “I didn’t look up,” she said.

“Just as well, too much pressure. You did a fine job. I could tell you were a student of mine. You made a classic T-incision. You kept the opening in the uterus small. You have very steady hands, Dr. Singh. You are exactly the person I want when I deliver.”

What a thought, delivering the child of the person who taught her to deliver children. “I won’t be here when you deliver,” Marina said, and took comfort in the knowledge. “How far along are you?”

“Just over twenty-six weeks.”

“No, no,” she said. “That’s not even possible. Who were you planning on delivering the baby?”

“The midwife. I’ll be honest, I had envisioned an experience as close to the Lakashi’s as possible, but as time goes by I’m thinking more about the need for a section. I’m doubting that my pelvis will spread. Chewing the Martins does nothing to reverse the aging of one’s bones. I’m going to need a section and there’s no one else here I’d trust for that.”

“Then you’ll go to Manaus.”

“A woman my age can’t go to the hospital to have a baby. There would be too many questions.”

“I would have to think a woman your age couldn’t avoid going to the hospital.” Marina looked at Dr. Swenson and seeing that she wasn’t listening began again. “Even if I was going to be here, and trust me, I’m not, you don’t know what kind of complications you might have. You’re breaking ground here, you can’t just expect to have the baby on your desk. You just saw me perform my first surgery in over thirteen years. That hardly qualifies me to deal with anything that could come up.”

“But you could. I saw you work. At some point I realized I should have made better plans for this inevitability but now you’re here. You’re a surgeon, Dr. Singh, and all the pharmacology in the world isn’t going to change that.” She shook her head. “Pharmacology should be reserved for doctors who have no interpersonal skills or doctors with uncontrolled tremors who are prone to making mistakes. You never did tell me why you changed your course of study.”

Some members of the crowd around them had begun to sing and some others to tap their tongues against their palates, making a noise of cheerful wailing. The children cleared the path ahead like a pack of hungry goats, snatching up every leaf and twig, ripping out vines, knocking down spider webs with a stick, until the trail was as neat as anything found in a national park. “You never told me why you changed yours,” Marina said.

“I had no choice. I saw the work that needed to be done and I had to do it myself. You can’t draw the world a map to this place and have everyone come running in, trampling the Rapps, killing off the martinets, displacing the tribe. By the time they understood what they were doing, it would all be dead. The conditions for this particular ecosystem have yet to be replicated. Eventually, yes, but for the time being if it is going to happen it’s going to happen here. For years my study was strictly academic. I wanted to record the role of Martins in fertility. I had no desire to synthesize a compound. I’ve never believed the women of the world are entitled to leave every one of their options open for a lifetime. I believe it less now that I am pregnant. Give me your hand, Dr. Singh, this leg is killing me. Yes. We can walk a little slower than the rest of them.” With that the Lakashi, who had at times an uncanny ability to understand English, cut their pace in half. “But when I discovered the link to malaria all of that changed. No scientist could be on the threshold of a vaccination for malaria and not make an attempt at it. I’ve been very careful about the people I’ve brought here. They are all extremely committed, respectful. I wouldn’t have any of them take out my appendix, but as far as the drug’s development is concerned they have made remarkable progress.”

“How do you know it works?”

Dr. Swenson used her free hand to pat her stomach. “In the same way I know the fertility aspects work. I test them. I’ve been regularly exposing myself to malaria for more than thirty years now and I’ve never had it. Dr. Nkomo, Dr. Budi, both of the Saturns, we all have regular exposures. I’ve exposed the Lakashi. I can show you all the data. It’s the combination of the Martin bark and the purple martinets. We know it now. It’s just a matter of replicating it.”

“And what about Vogel?” Marina asked.

“Vogel pays for it. I would have said I had been careful in choosing Vogel as well, but Mr. Fox has grown too restless for me. He isn’t interested in what can be accomplished. He only wants to see where the money’s gone. Not that I think some other company would have been better. They all claim to support science without any real understanding of what science entails. Dr. Rapp spent half of his life down here, he did the most important work in the history of his field and he only scratched the surface of the mycology that was available to him. These things take an extraordinary amount of time. They can take lifetimes. You would think they would be grateful that I’ve given them my life, but someone like Jim Fox would be incapable of understanding that. Sending Dr. Eckman here was a disaster for all of us. His death was very bad for morale. For a week or two I thought I might lose all of them. But then you came, Dr. Singh, and as much as I’ve fought the intrusion I can see you have a place here. You get along well with everyone, your health seems excellent, and I think you’ll be able to soothe Mr. Fox, convince him that things are progressing nicely and we’ll just need a little more time.”

“But why would I do that? I work for Vogel. They’re paying out enormous sums to develop the drug that you brought to them, that you proposed. You haven’t even told them about the malaria vaccine and that seems to be all you’re working on. Why would I want to cover for you?” Marina balanced the weight of Dr. Swenson on her arm. The farther they went the more Dr. Swenson leaned against her.

“It isn’t a matter of covering anything. This isn’t a lie told in school. The drugs are intertwined. We have not been able to separate them out. Look at me. I am clearly pursuing my work in fertility even if my interests lie in how it relates to malaria. What I’m interested in personally really doesn’t matter when either way we end up in the same place. When we get one drug we’ll have the other, and I don’t see the harm in making an American pharmaceutical company pay for a vaccination that will have enormous benefits to world health and no financial benefits for company shareholders. The people who need a malarial vaccine will never have the means to pay for it. At the same time I will give them a drug that will, if anything, undermine the health of women and make them a truly obscene fortune. Isn’t that a reasonable exchange? Eight hundred thousand children die every year of malaria. Imagine an extra eight hundred thousand children running around the planet once this vaccine is in place. Perhaps instead of trying to reproduce themselves, these postmenopausal women who want to be mothers could adopt up some of the excess that will surely be available.”