State of Wonder

by Ann Patchett

  “You’re okay,” Marina said. “You found me. Milton got you out.”

  She nodded but her fingers could not get far enough ahead of the tears to wipe them all away, there were simply too many of them. “He did. He was so fast. Milton deserves some sort of medal. He’d never driven that boat before and he slammed it around so fast we nearly went over. When I looked back the air was full of arrows. Arrows! How can that be possible? And then I saw something. I thought I saw something.”

  “What?” Marina said.

  She shook her head. “It was worse than anything, worse than Mr. Fox or us getting lost or those people shooting at us.” She looked up at Marina and blinked her eyes and for a moment the crying stopped and a look of utter seriousness crossed her pretty face. She took Marina’s hands. “I saw my father running through the trees,” she whispered. “I don’t know what you’d call it, a vision, a visitation? He was coming straight towards me, coming down to the water, and I threw myself on the bottom of the boat. There were arrows in the boat and Milton said not to touch them. I tried to look back for him but Milton said to keep down. Marina, my father is dead. He died in Australia when I was ten years old. I think about him all the time, I dream about him, but I’ve never seen him. He came there for me because he knew I was going to die.”

  “Did Milton see him, or Mr. Fox?”

  She shook her head. “Mr. Fox was on the deck and Milton was driving. I don’t think they would have been able to see him anyway. I think he was only there for me.”

  “Who would have known you were missing?” Dr. Swenson was saying to Mr. Fox when Barbara and Marina walked into the lab. Dr. Budi could not stop shaking her head and the two Drs. Saturn stayed very close together. The misery that comes from having a good imagination was writ large on Thomas Nkomo. “I suppose the Inca Cola man would have wanted his boat back at some point. When Jackie Bovender came home from his surfing expedition in two or three weeks they would have come here together. Don’t you think so, Barbara? He would have come looking for you then.”

  Barbara Bovender, now the center of everyone’s nervous attention, made the slightest gesture towards a nod.

  Dr. Swenson held out a hand towards this confirmation. “One man missing a boat, one man missing a wife. What do you think I should have told them when they arrived? I wouldn’t have had any idea where you were.”

  “If you had a telephone no one would have to risk their lives to find you,” Mr. Fox said. How was it possible that Marina could not go to him? Why didn’t he come to her now having survived a rain of poison arrows? How could he not take her in his arms regardless of who was in the room? He looked so out of place in his lightly embroidered white shirt and khaki pants, as if he had dressed up for a party whose theme was the Amazon.

  “This is about my not having a telephone? Do you think Dr. Rapp came to the Amazon with a telephone? I am trying to finish my work. First you send a man down here who dies and when you decide to follow him it seems you are determined to die yourself and take two of my people with you. It is disruptive, Mr. Fox, can you understand that? You do not advance your own case by continuing to throw these tragedies in my path.”

  “I was looking for Dr. Singh,” he said, tapping his glasses up the bridge of his nose with his index finger, a nervous tic Marina knew to be the slightest outward manifestation of simmering fury. “I hadn’t had any word from her. I couldn’t take the chance that another one of my employees was sick or in danger.”

  Another one of your employees, Marina thought. Well, there you have it.

  “But you endanger them yourself!” Dr. Swenson said. “You throw a person in the river and then make a spectacle of jumping in to save them.”

  Before Mr. Fox had a chance to answer, Dr. Budi stepped between them. “I must ask that you stop this now,” she said, her voice unexpectedly strong. “Dr. Swenson, this is not right for you. This argument has ended. You must sit.”

  The room fell suddenly silent and in the silence they could hear the unexpected sound of Dr. Swenson struggling to catch her breath. There was no ignoring Budi’s advice. Dr. Swenson sunk down heavily in her chair and put her swollen feet up on a box in front of her. Nancy Saturn came over with a glass of water and Dr. Swenson waved her away. When she spoke again her voice was calmer. “Look at as much data as you need to reassure yourself, Mr. Fox. The two Drs. Saturn will help you. Tomorrow when it’s light, Dr. Budi will take you to see the Martins, and after that you will get back on the Inca Cola and go to Manaus. That is all the hospitality I am capable of extending.”

  “Dr. Singh is coming with us.” Mr. Fox said. It was not a romantic gesture but the first counteroffer in an ongoing negotiation.

  Dr. Swenson shook her head. “That will not be possible. Dr. Singh has agreed to stay until I deliver my child.” She put her swollen hands on either side of her belly. “The big reveal, Mr. Fox. Seventy-three years old and I am pregnant. If you trouble yourself to look around in the morning you will see that I am not alone in my condition. We are very close to being able to bring you what you want if you could only control your impulse for disruption. I’m keeping up my end of the bargain. I expect you to start keeping yours.”

  For a moment Mr. Fox was too far behind. He had missed the rodent trials, the studies in higher mammals. He had no knowledge of a first efficacious dose or the multidose safety studies. He had seen no reports on the probability of technical success, and then suddenly he was six months into the first human dose. First in Man, that’s what it would always be no matter how inherently sexist the implications. Given all there was to absorb it took a moment for the news to settle in, but when it did the look on Mr. Fox’s face was as tender and pleased and surprised as it had been on a night thirty-five years before when his own wife Mary had made a similar announcement. He took a few tentative steps towards Dr. Swenson. He softened his voice. “How far along?”

  “Nearly seven months.”

  “I’m not qualified to do the section,” Marina said to her. “I’ve told you that. You need to go to a hospital.”

  “I would feel more comfortable with Dr. Singh,” Dr. Swenson said. “We can’t afford any breaches in security at this point. I can’t go to the city to have a child. I’ve seen her operate several times now. She does a brilliant job. I have no questions as to her complete competence.”

  While Marina had come far enough to contradict Dr. Swenson when they were alone, she still lacked the skills to do so publicly. There was no way to point out that these compliments were her road to perdition.

  “We could bring in an obstetrician from Rio,” Mr. Fox said. “We could bring one in from Johns Hopkins if you’d like.” He had already forgotten about the trip from Manaus, about Mrs. Bovender, about the Hummocca. The drug worked, that was all he had ever needed to know. He didn’t care about the paperwork, the trees, he didn’t need to see Marina. He could get back on the boat tonight.

  “What I would like is what I have already said. I trained Dr. Singh myself. You can spare her for a little while longer.”

  “I can,” Mr. Fox said.

  Marina started to say something but Dr. Swenson cut her off. “Dr. Budi is right, I am tired. Walk with me back to the hut now, Dr. Singh. I’ve done enough for tonight.” She held up her hand and Marina took it. The skin between Dr. Swenson’s fingers was cracked and bleeding. Mr. Fox touched Dr. Swenson’s shoulder before they left the room and she nodded at him in return.

  Once they were safely under the cover of darkness, the stars spreading their foam over the night sky, Marina started in. “I told you I wasn’t going to stay,” she whispered sharply over the grind of insects’ wings, over the endless repetition of frogs croaking. “Did you think you could just lease me out from my employer?”

  “Hold on to yourself for two more minutes,” Dr. Swenson said.

  Dr. Swenson’s hut was the one closest to the lab. It was a small room with a si
ngle bed and a dresser, a folding table with two chairs. Dr. Swenson struggled up the four stairs, leaning her weight against Marina, and when she came inside she sat down heavily on the bed. “I’m going to have to lie down,” she said, and with that she stretched over the bed, her stomach pointing up. She sent forth a low moan, though whether it was pain or the relief from pain Marina could not be sure. “Be a friend and pull off my sandals, Dr. Singh.”

  Marina struggled with the Birkenstocks but managed to get them loose. Dr. Swenson’s toes were sunk halfway into her swollen feet which had an unnatural purple cast. “Don’t make me feel sorry for you,” Marina said. “The more I worry about you the more certain I am that you need to go to a hospital with doctors who know what they’re doing.”

  “You know what you’re doing,” Dr. Swenson said, “and you will feel sorry for me because that is your nature. There’s nothing I could do to prevent that.”

  Marina sat down on the edge of the single mattress. “Who’s the man in the picture?” She took Dr. Swenson’s wrist between her fingers. Her pulse was almost too rapid to count.

  Dr. Swenson turned and looked at the frame on her bedside table. It was a black-and-white photograph of a tall, thin man with a very fine nose standing in the jungle. He was wearing a white shirt and seemed to be looking over the shoulder of whoever was holding the camera. “Never ask a question if you already know the answer. I find that the most irritating habit.”

  “He’s very handsome,” Marina said.

  “He was,” she said, closing her eyes.

  “Where’s the blood-pressure cuff?”

  She pointed down to the red bag on the floor and Marina got the cuff and a stethoscope. “The baby is dead, Dr. Singh. It died yesterday, maybe the day before. I was going to tell you tonight but then the company arrived. You can go on and try to listen but nothing has moved. I’m not certain when it moved last. I haven’t been able to find a heartbeat.”

  Marina put her hand on her teacher’s arm but Dr. Swenson shook her off. “Go on,” Dr. Swenson said. “Try.”

  Marina put the scope in her ears, ran the drum across Dr. Swenson’s belly, trying one spot and then another and then another.

  “There’s nothing there,” Dr. Swenson said.

  “No,” Marina said. She took her blood pressure then and then took it again to make sure her reading was correct. “One seventy-two over one fifteen.”

  Dr. Swenson nodded. “I have preeclampsia. There is no Pitocin. There is a syrup the locals use to bring about labor in these circumstances, a boiled-down extract of crickets or some such thing but for the time being I am finished with my own human experimentation. I don’t think I’d survive labor anyway. So the bad news is you will have to do the section and the good news is you won’t have to wait two months to do it. Mr. Fox will leave tomorrow with the proof he needs that the drug is viable, and that in itself will buy us a great deal of time. If you could stay here just a little while after the surgery to make sure there are no complications I would appreciate it. Later I’ll have Easter and the Saturns take you back to Manaus in the pontoon. Can you do that?”

  “I can put you on that boat in the morning and we can go to a real hospital with real medicine and a sterile surgical room and an anesthesiologist. I’m not going to operate on you with a syringe full of Ketamine.”

  Dr. Swenson waved her hand. “Don’t be ridiculous. We have bags of Versed for special occasions.”

  There were things to say about that but Marina let them go. “These are serious circumstances. I know it isn’t what you want but you have got to think like a medical doctor and not an ethnobotanist. If you go with Milton and Mr. Fox you’ll be there in half the time. You could be there tonight, which, considering your blood pressure, is what you should be doing anyway. You’d never put this off if it were someone else.”

  “Listen to what I’m saying the first time, Dr. Singh. I don’t have the energy to keep repeating myself. I’m not going anywhere tonight, so if I die before you have the chance to save me the onus will be completely my own. You can’t have Mr. Fox take me to the hospital. Then all of his dreams will be shattered and subsequently my dreams will be shattered as well. I will not sacrifice a potential malaria vaccine for a hospital bed in Manaus. I am asking you to do this surgery as a way of saving myself from having Alan Saturn do it. I don’t know that I have asked you for so much in the past that you would find this single request something you are unable to grant.”

  Marina waited, considering the horror of it all. In the end she could do no better than a nod of the head.

  “There is of course every reason to think that this will kill me in the end.” She opened her eyes and looked at Marina. “It’s difficult to say if this is an outcome of the drug or the circumstances of age. Whether or not I am finished remains to be seen, but I want you to know that the drug is finished, at least the fertility aspect. Mr. Fox can go and cry in his cups. With a little luck we’ll be able to keep that news from him for a few more years while he finances a malaria vaccine.”

  Marina shook her head. She wrote it off to the circumstances. In a couple of months when all of this was behind her Dr. Swenson would feel differently. “You shouldn’t say that. You’ve worked on it for too many years to let it go.”

  “And how shall we test it further? I’ve been eating this bark for years. I’ve seen my own menstruation return at sixty. I’ve lived through the pimples and the cramps and I will tell you there was nothing there to enjoy. I did not need to see that aspect of my youth again.”

  “That’s why they have NHV, normal healthy volunteers. No one expects that you should do all of this yourself.”

  “We would have to find a great many childless seventy-three-year-old women who were willing to be impregnated in order to evaluate safety. Chances are we would kill the lion’s share of them in the course of the drug trials.”

  “Chances are,” Marina said. She brushed down the insane wires of Dr. Swenson’s hair with her hand.

  “Don’t be tender, Dr. Singh. We’re fine the way we are. I only tell you this because I want you to know that if anything happens to me now, anything, it is not your fault. I’ve brought this on myself in the interest of science and I don’t regret any of it. Do you understand that? This has all been to the positive. We are very close to securing a vaccine, and in addition to that we know what the body has told us all along, postmenopausal women aren’t meant to be pregnant. That is what we had to learn.”

  “It might not work at seventy-three. That doesn’t mean it couldn’t work at fifty. This isn’t the time to throw everything away.”

  “Let the fifty-year-olds console themselves with in vitro as they have in the past. I have no intention of unleashing this misery on the world because I trust women to stop trying at a sensible age.” She shook her head. “So it’s good then,” she said, “it’s good. I’m going to go to sleep now. I want you to get some sleep, too. We’ll do this tomorrow in the afternoon when everyone has left and there’s plenty of light. Do your best to get them off early. Milton and Barbara would swim out of here, I feel sure of it, but Mr. Fox may try to linger. Once you get them on the boat, go and ask Dr. Budi to assist you. There’s no sense in telling her tonight.”

  “Alright,” Marina said. She pulled the mosquito netting down over the bed. She turned down the flame in the lantern but she couldn’t seem to make herself go.

  “You’re still here,” Dr. Swenson said finally.

  “I thought I’d wait until you fell asleep.”

  “I know how to sleep, Dr. Singh. I don’t need you to watch me unless it is something you are trying to learn to do yourself.”

  When Marina got back to the lab, Dr. Nancy Saturn was explaining the relationship between the Martin trees and the purple martinets to Mr. Fox, and Thomas Nkomo was showing him the charts of pregnancies, birth weights, live births, and they were all lying to him in eve
rything they chose not to tell. Milton and Barbara made sandwiches out of the store-bought bread they had brought with them. Everyone was helpful. Everyone was getting along.

  “Have you seen all of this?” Mr. Fox said to Marina when she came over to them.

  “I have,” she said. “I’ve been here a long time.”

  “It’s remarkable work. Truly remarkable work.” He was smiling at her now without the slightest trace of collusion. He was simply happy. The drug would soon be in hand, the stock would exceed expectations, his risk would be lauded by generations of board members to come.

  Dr. Budi handed her a sandwich on a plate, potted chicken after so many weeks of potted ham. “Dr. Swenson?” she asked.

  “Her blood pressure is high,” Marina said.

  Mr. Fox looked up and Marina shook her head. “She’s tired. She just needs rest, that’s all. There should be as little stress as possible.” It was a line of dialogue she remembered from meeting with patients years ago. It always comforted them. Anyone could embrace the idea that the answer was rest.

  “We’ll leave in the morning,” Milton said.

  “After we’ve seen the trees,” Mr. Fox said.

  Marina waited another minute for old time’s sake. Mr. Fox bent back over the data and she wanted very much to put her hand on the crown of his head. It was probably better that he didn’t look at her, that he didn’t take her aside and whisper his true plan in her ear. If he loved her now, it would only be sadder later on when he realized that she had lied to him along with all the others. He would leave her once the whole thing fell apart. It might be years, but once he understood that he was holding a malaria vaccine instead of a drug for fertility and that she had known it and done nothing to stop it, nothing to save him, he would break with her in every possible way. That loss would be infinitely harder to take if he had ever loved her. “Let’s go to bed now,” she said quietly. Then he did raise his head, looking at her as if to say that surely he misunderstood.