by Kira Peikoff
To my parents, with love and thanks for always believing in me
And to Matt, whose passion gives me courage
CONTENTS
Title Page
Dedication
Part 1
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Part 2
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Acknowledgments
Copyright
PART ONE
ONE
One number flashed in Arianna’s mind: 464. She didn’t have much time.
Dr. Arianna Drake stepped into the deserted hallway, listening.
It was 7:30 A.M.—still too early for the man to arrive. No matter her dread, their appointment could not be adjusted or canceled, even if a patient went into labor before her eyes.
In the silence, Arianna could hear her own pulse drumming in her ears. She hurried toward the locked door at the opposite end of the hall, her heels clicking across the linoleum floor. The corridor was narrow and painted an antiseptic white, made starker by the fluorescent lights overhead. Nothing about the place stood out from any other private clinic in Manhattan; Arianna had made sure of it.
She stopped at the end of the hall, thumbed through her keys, and inserted one into the lock. Pushing the handle down, she leaned into the door and slipped inside.
The lab was neither hot nor cold, and breathing suddenly seemed easier, like stepping into an oxygen tank. On the left side of the room, a black floor-to-ceiling freezer spanned about ten feet wide, with multiple doors opening to different compartments inside. A green digital display across the front read -78°C. It hummed quietly next to a liquid nitrogen supply tank. Along the back of the room was a row of electron microscopes hooked up to computer monitors. Facing the freezer, on the right side of the room, was an incubator set at 37 degrees Celsius.
She yanked one of the freezer doors open. Cool air billowed out. Inside, several hundred slender glass tubes lined the shelves in rows, appearing to contain a hardened red liquid. Murmuring numbers under her breath, Arianna shivered as she counted the tubes, her finger hopping up and down the rows.
A pins-and-needles sensation suddenly surged in her right ankle. The tingling slid into her foot, tickling her veins from the inside out. Afraid of losing count, Arianna pressed on, stressing every fifth number aloud like a musician keeping time. When she at last reached the final tube—number 464—she shut the freezer door and sat down in place, breathing hot air onto her frozen hand. For a moment, she closed her eyes, appreciating her aloneness in the lab and the way everything in it functioned. But her foot was waking from slumber, twitching with little stabs of pain. She pointed her toes and traced a few circles in the air, wincing as the pain dispersed. Was the numbness starting to last longer, she wondered, or was she just more aware of it?
It was quiet enough to hear the seconds tick on her watch: 7:50 A.M. Ten minutes to showtime. She swallowed uneasily, considering whether she had time to count the tubes once more, just in case. But there was no need; she had counted them last night, after hours, and arrived at the same magic number. Better to be sitting at her desk, composed and ready. She breathed in and stood up slowly, avoiding a rush of blood to her head. Before letting herself out, she threw a loving glance at the incubator. Sometimes she wondered if she was capable of forgetting what preciousness lay inside—or whether that knowledge stood like a pillar in her mind, with every other thought swerving around it just to get by.
The hallway was still empty, but she heard the low rumble of Dr. Gavin Ericson’s voice in the office next to hers. It was a comforting sound, the reminder of an ally. She paused at his door and knocked.
“Arianna?” he called.
She opened his door a crack and peered inside, seeing he was on the phone. Gavin and his wife, Emily, who together constituted the rest of the clinic’s staff, were among her closest friends, dating to medical school a decade back.
Everything okay? he mouthed, one hand cupping the phone.
She smiled and nodded. “Good to go,” she whispered, and pulled the door closed.
Inside her own office, she sat down at her desk, straining to hear any sounds from the clinic’s front door. Nothing. She turned to her computer and pressed her index finger to the middle of the screen. After two seconds, the screen lit up and unlocked. A floating message in a box read, WELCOME, ARIANNA. NOVEMBER 1, 2027. 7:57 A.M.
It was impossible to concentrate on real work, and Arianna knew better than to try. She wondered who the man would be this month—but there was no way to know ahead of time. She looked up at her wall, which was covered with pictures of newborns swathed in blue and pink, next to a bulletin board of cards from grateful parents. In the middle of all the pictures hung a flat screen that streamed live video of the entrance to her clinic. Now it showed an empty sidewalk, occasionally a passerby, and a tree-lined street littered with yellow leaves.
For a few tense minutes, she watched—and then, just as she turned back to her computer, she heard it: the creak of the front door. She felt her body stiffen.
Neon red light burst from the screen on the wall, followed by an earsplitting whistle. She swiveled fast to face the screen. Between flashes of red, she could make out a man in a suit. Shielding her eyes, she grabbed a remote from her desk drawer. As she clicked off the alarm, the high-pitched whistle faded, leaving a ringing in her ears.
She stared at the screen, which preserved a snapshot of the intruder. This one was a stout older man with a raised knee, captured the moment he entered the clinic’s waiting room. He wore a black suit and a stern expression, also a gun at his waist. Arianna’s stomach clenched as she recognized him. He was the most senior inspector at the New York Department of Embryo Preservation.
Even though each month it happened the same way—the creak, the alarm, the snapshot—Arianna still felt jolted. She felt even worse for patients who happened to be in the waiting room when a man with a gun swaggered in. But DEP inspectors, as Arianna would explain, had magnetic passes that let them swipe into any fertility clinic whenever they wanted, which set the alarm off every time.
With a sigh, Arianna walked to the waiting room to greet the man. He was standing in the center of the room, looking starkly out of place next to the bright yellow couches and Babytalk magazines. His gaze steadied on Arianna, revealing no emotion as she stepped forward to shake his hand. Pinned to the lapel of his suit was a thin gold cross.
She forced a cheerful smile. “Good morning, Inspector Banks.”
He shook her hand firmly, saying nothing. The man was a professional judger, she thought: too shrewd to show his contempt. So they had one thing in common.
“Follow me,” she said, turning on her heel back to the hallway.
In the narrow corridor, they walked uncomfortably close to each other. His breathing was slightly strained, as if the bulk of his extra weight sat on his lungs. She slowed down so as not to outpace him, keeping her arms crossed over her chest. They passed the five examining rooms that made up her modest clinic, along with the three offices that belonged to her, Dr. Ericson, and Emily, the clinic’s embryologist and nurse. At the end of the hallway, they stopped at the locked white door. Banks still had not said a word.
He took a printed form from his br
iefcase.
“It was a busy month here for in vitro, wasn’t it,” Arianna said as she put a key into the lock.
“Yes, it was,” he responded, clearing his throat and looking down at the sheet. “Unusually busy. According to the department’s tally, you should have four hundred sixty-four unused embryos this month from thirty-one couples.”
“That’s exactly right,” she said. The state-run Department of Embryo Preservation mandated that all fertility clinics “preserve the soul of every embryo.” In keeping with the law, the department required that clinics report, once a month, the number of embryos left over from every patient’s attempt at in vitro fertilization—a number the inspectors verified with their visits. To ensure accurate reporting, the department periodically conducted random audits, during which it obtained access to a year of the clinic’s original records, complete with all patients’ contact information. Women could always be counted on to remember exactly how many eggs were taken out of their bodies, and how many embryos were later put back in—so their memories often proved to be the department’s greatest resource in corroborating a clinic’s reporting. If even a single unaccounted embryo came to light, it meant serious consequences for the clinic: probation and heavy fines.
But if a destroyed embryo were discovered, then the clinic would be shut down and the doctor charged with first-degree murder.
Six weeks prior, the department had questioned dozens of her own patients in a random audit, but all the women had reported the correct numbers. The clinic passed easily, as Arianna had known it would; her real patients knew nothing.
“Something about fall this year,” she said as she swung open the door to the lab. “It feels like spring, so everybody wants to have babies.” She laughed shrilly. Don’t make small talk, she thought. You don’t know how.
The inspector grunted as he stepped past her into the lab. She followed and closed the door, leaning against it. The oxygenated air filled her lungs like a calming agent as the inspector pulled on a pair of gloves.
“Let’s see here,” he said, opening one of the freezer doors labeled OCTOBER 2027. After the whoosh of cold air dissipated, Banks surveyed the rows of tubes inside and looked over his shoulder at Arianna. “That’s quite a lot you got here.”
Arianna felt her heartbeat do a drum roll. “I know, right?”
Banks turned back to the tubes and painstakingly lifted each one, examining its label as he counted. The label on each tube disclosed several facts: the names of the couple whose egg and sperm had joined in a dish; the date that embryo had been frozen; and its place in the couple’s leftover batch, such as ANNE AND MIKE SMITH, OCT. 10, NUMBER 5/16.
For the in vitro procedure, Arianna would surgically remove about eighteen eggs from a woman’s lifetime supply of three hundred thousand. Then Emily would mix the extracted eggs with sperm, and after five days of growth in the incubator, Arianna would implant only two or three of the strongest embryos back into the woman’s uterus, to lower the chance of multiple births. This routinely left about fifteen excess embryos per couple to be frozen, suspended in the first stages of growth forever.
Arianna waited as Banks counted the October flasks; he paused after each one to mark another tally on his sheet. The minutes dragged on. When he finally reached number 464, she had to keep herself from noticeably exhaling.
“Perfect,” she said, gripping the door’s handle behind her.
“Let me count those one more time to make sure.”
Her stomach dropped; she didn’t know how much longer she could stand to be trapped there, watching him.
“Of course,” she managed. “Take your time.”
Monotonous counting ensued. She stood by, willing herself not to fiddle or twitch. At least his rounded back was turned. What was he thinking, she wondered, when he cradled the flasks in his hands? As the embryos’ legal guardian, was he overcome with a desire to protect them? Or did he enjoy the power he held over helpless lives, including her own?
“And that, again, makes four sixty-four,” he said at last, turning around to face her. “Now let’s make sure you’re preserving them properly.”
She smiled. “Which ones would you like to see?”
“I would like to see all of them. But unfortunately, I only have time for a sample. Let’s see these.”
He turned to the flasks and randomly pointed to several dozen of them. Arianna placed each one carefully on a tray and carried it to the electron microscopes in the back of the room. One by one, she put the flasks under a microscope, and a camera underneath captured and transferred the images to the adjacent computer screen. Almost immediately, pictures showed up of circles with vague clumps of cells inside. The inspector squinted at the images, nodding after each one.
“Fine,” he announced after scrutinizing all the images. “You can put them back now.”
He scribbled his signature on the form as she eagerly replaced all the tubes in the freezer. Sweat dribbled onto her upper lip, salty and warm. She licked it away before he could notice any sign of nervousness.
She thought he was walking back to the door when he paused next to the incubator, grabbed the chrome handle, and pulled it open. Arianna sucked in a silent breath; that wasn’t part of the protocol.
Banks peered at tiny petri dishes carefully spaced on the shelves under heat lamps. On the bottom shelf, a cluster of dishes was pushed to one side, under a label marked only with a sad face.
“How are they doing so far?” he asked with a general wave toward the dishes.
“It varies,” she said. “They’re still less than four days old. We don’t know which of them we’ll use yet.”
“Then what about those?” He frowned, pointing to the cluster of dishes under the sad face.
“Oh, those.” She winced. “Those just aren’t doing well. They’ll likely be frozen. We need to differentiate the strong ones from the weak.”
Banks nodded. “I assume those will count for November’s EUEs, then.”
Extra-uterine embryos—the politically correct term for “leftovers.”
“Yes.” Don’t flinch, she willed herself.
He eyed her for a moment. Indifference glazed across her face.
He looked down at his form. “Well, none are missing. They look to be properly preserved. Sign here.”
She took the paper from him that was headed in bold, NEW YORK DEPARTMENT OF EMBRYO PRESERVATION, and signed under her clinic’s name—WASHINGTON SQUARE CENTER FOR REPRODUCTIVE MEDICINE—next to the number 464.
“Good, so we’ll see you next month,” she said, turning to open the door. She stepped out into the hallway and exhaled shakily, as if she had just stumbled off a carnival ride.
“Me or one of my colleagues,” he replied.
“I’ll show you out,” she said, not wanting to leave him alone in her clinic for a second. She walked briskly back to the waiting room as he trailed a step behind. Saying good-bye always felt like an awkward moment to her. Was she supposed to thank him? Act gracious for the interruption that threatened to undermine her life’s biggest project?
In the waiting room, a slender woman with auburn curls was sitting on the couch, drumming her fingers on her lap. She grew still when she saw the inspector enter the room with Arianna.
“Hello!” Arianna exclaimed, and then, remembering, evened her tone. “I’ll be with you in a moment, ma’am.”
Turning back to the inspector, she nodded and casually extended her arm toward the front door. “Have a good day,” she said.
He muttered, “Same to you,” striding to the door. She watched it swing open and slam. And just like that, she thought, they were safe for another month.
With a giant grin, she turned to the woman on the couch, who sprang up and embraced her.
Arianna hugged her tightly. “Thank you so much, Meg.”
“Of course,” Megan said, stepping back. “But first I want to know: How the hell do you stand that guy?”
Arianna shook her head. “
It’s easier if I pretend he’s just a handyman coming around for a checkup.”
“With a gun?”
Arianna shrugged.
“So how are the good souls doing?”
“Pretty nippy,” Arianna said with a smile. “But they’re not lonely, that’s for sure.”
Back in her office with the door shut, Arianna thought how much they resembled each other. Both were tall, thin, and pale, thanks to their grandfather’s side of the family. They shared thick hair, though Arianna’s was nearly black. And unusual dark blue eyes. As kids, they used to pretend to be sisters—each wanting a sibling that never came. But it didn’t matter: to be cousins, growing up side by side, was enough to give each the companionship she craved, without the rivalry. Still, being part of a small family had its downsides: With Arianna’s parents dead, Megan’s living far away, and neither woman yet married, they were each other’s Thanksgiving gatherings, Christmas mornings, and faithful standbys through every difficult time when family was indispensable—like now.
As soon as they sat down, Megan’s face contorted with worry, as if she suddenly remembered why she was there. She stared at Arianna with the same determined hope as any other woman about to undergo ovary stimulation. “I want to think my eggs will help.”
Arianna reached across the desk and took her hand. “They will.”
“But what if they don’t? What if they just turn into more failed attempts?”
Arianna shook her head. “Whatever happens, it won’t be a complete failure. The whole thing is trial and error, so we need all those errors to get us closer to the answer.”
Megan sat back with a frown. “Do you—do you think they’re getting closer?”
Arianna looked away. “You know I would tell you.”
“And there’s nothing else I can do?”
“Meg, you’re doing plenty. More than I could ever ask for.” Arianna picked up a chart that lay next to her computer, feeling the steeliness of her professional training cut through her own fear. “All your vitals look good. We can get started if you’re ready.”
Megan grimaced, running her hands through her hair the way she often did when she was nervous. “You know how I get around needles. It’s so embarrassing.”
