Richard Powers - Operation Wandering Soul

He feels his muscles initiating the shove-off, biceps starting to reverse-curl the thousand-pound receiver back onto its cradle when he hears her ask, "Sleep any better last night?" Her words shine with confused, hurt highlights, a banished me-neither tone — can't you guess? Hearing it, he can no longer help himself. He needs her otherness. He hangs on her every distraction the moment work stops. Addicted already, and following the viscous, familiar path of habituation, he will soon need her even during daylight hours. A fix, a whiff, just to start moving in the mornings.

He loves her absurdly, immaturely. His blood hops up with the high schooler's full panoply of anticipation and dread. He would tell her now, but for Kean working in the next cubicle to his. And yet: he will not say so, even in their next night-long privacy. How else except by silence can he hope to keep her all along his length, always, and when the hour comes, still a permanent stranger?

She does not ask, as her voice hints, Are you on call tonight? Instead, her words assume the courage neither of them has. "There's nothing to be afraid of, you know."

But there is. Is everything. All the world must be run from. Little girls stump for miles on severed stems across a wasted city to come ambush him in the dark. Old golden-agers a lifetime beyond his roam the pediatrics ward, dying on him in the prime of childhood. How can he tell her, and not drive her hastening away?

He knows no more about progeria than he can afford to learn. And he can afford to learn no more than he needs to string along and pass the next certification. What's it to ya, buddy? Absolutely nothing.

Nobody, it appears, has even a game show's clue about the thing's etiology. Without a shred of supporting evidence, a little one-room school of thought lays suspicion on a hereditary cause. Sure, why not? Throw it on top of the "congenital" heap, the fuck-ups in the master switches twisting the body this way and that like hideously abused Raggedy Anns and Andys. The intermediary gaps between "Ann" and "and," and "and" and "Andy" fill with any number of permutations on battered puppethood: microcephaly (pinheadedness in less polite circles), protrusion of the meninges and neural elements out the rear of the little baby back ribs, the whole salad bar of androgynies and cretinisms, endocrine leaks and overflows, organs on fire or attacking themselves, hips and limbs and skeletal connectors pointed every which way but useful. Or simply missing. Stolen. Never delivered.

Genetic disorder is Kraft's absolute first nightmare category. It is corruption at the source, at the point of manufacture. Obscenity nuzzles up close to molecular innocence, suckling its infantile teat the way flies lap at a running sore. If purpose can be scattered akeady, even here, then what's the point? The morning's first shadow casts itself over his ward. And worst of all, all these specific charts — the No-Face, the Nephrosis, the Septal Defect — they have all been born just hours before the breakthroughs that might have saved them.

They are, perhaps, the last generation to be struck down before the arrival of the ultimate gene-weaponry. Cures are coming, just around the corner, all but here. Fantasy treatments, fictive fairy diagnostics, complete in-the-womb screenings, packets of substitute chromosome segments to replace the defective instructions. His successor physicians will have every intervention imaginable, thought-designed curative texts placed into action simply by specifying the right combination of magic words. Kraft and the rest of the last graduating class of witch doctors have only their blundering surgical corrections, bulling about with knives, helping sometimes but always at crippling expense, buying the necessary patch job at ruinous rates the day before a massive, half-price giveaway.

No firm evidence proves that Hutchinson-Gilford is, in fact, a twist in the master narrative. And yet, lumping it with congenital disorders beats the pathological alternatives. Bald, diminutive, withered twelve-year-old kid, his skin yellowed like ancient newspaper, his whole circulatory system corroding to worthlessness. We're clearly not dealing with infectious disease here, not even one of the truly exotic. And if it were a contagion? Kids passing progeria around, picking up communicative old age as easily as croup. Whole playgrounds turned to pensioners in a matter of weeks. Lawrence Welk hastily recast to include Saturday morning cartoons. Now there would be a real plague, one worthy of Kraft's day and age.

An environmental cause is at least conceivable. Some erratic, unidentified toxin accumulating in secret tissue. But it has no geographical outbreaks, no stricken communities like the ones becoming mundanely familiar even to those, like Kraft, who studiously avoid the nightly scoop operas. Nutrition, perhaps. God and the social workers only know what specialty dishes they're feeding youngsters in the town's eastern marches this season. But if age were ingestible, Southern California — the whole holistic concept —would be awash in juvenile octogenarians.

Perhaps cause lies somewhere on the far, sinister end of the spectrum. Chance micro-hit. Physical injury. Damage incurred through the placenta or sustained at birth. Regulatory mechanism wiped out in one systemic shock. A blow to the head, deliberate or — always that ludicrous euphemism — accidental. Accidents do happen, but the stats don't jibe. Ten American children are killed each day by handguns alone. Yet only fifty of these little old men have appeared in the entire historical record. If it is injury, then strange, reticent, internal, even molecular — not one of the more expedient violences of this increasingly adept twilight culture.

Etiology cannot help Kraft, as is so often the case. How this freak, this Nico happened to put on six decades in as many years is of less interest than what to do about it. Thank the bureaucrats that be that Kraft doesn't have to deal with the case. How can anyone hope to treat the kid? He's brittle, beaked, dry. Dermis like phyllo. Only, it's not old age. No senility, no wasting of the CNS. Half his organs are untouched. The kid's got spring in his legs yet, even if he looks more third-base coach than runner.

Jesus, the kid's a kid. Whatever else it may or may not be, freakish aging is a childhood condition. And there, precisely, is the whole hopeless situation in a handbag. The would-be Department of Pediatrics, Dr. Joseph "It's Under Control" Milstein presiding, is about as mythically monolithic as that twenty-five-language empire on the other side of the globe, at this very minute breaking into a caldron of contentious turfs. Their service is no more than a Jack-and-the-bean-curve, a wide-load Gaussian with Infancy on one end and Adolescence on the other, with a class of cases fat in the mode-peaked middle for which English has no good word.

Pediatrics is not a discipline. It's a default, a catchall. Kraft cannot connect even its two main provinces. The bins themselves are hopelessly coarse: from birth to vertical, and from vertical to near voting age. What, pray tell, is the common denominator between pyelonephritis and Munchausen syndrome by proxy? In one, the kidneys drive the parents crazy; in the other, the parents drive the kidneys insane. The specialty is designed by one of those guys who go into bookstores and order a yard and a half of red hardbacks no taller than eight inches. As Dr. Brache once told him (and irony lies outside the bounds of Miss Peach's rhetorical modes), if you can crack a fourteen-month-old's chest, than you can wean a fourteen-year-old off crack.

The international community, from Kraft's third-hand vantage, is currently engaged in some intensive R & D, smoking up several delicious monster scenarios for the coming collective blowout. Things are definitely on the march. Nightly news lays out its attendant horrors in a series of thought-eradicating, three-minute music videos. Ice caps melt. Fuel reserves push toward asymptote, with nothing anyone can do about it. Debt amasses faster than global capital. IRS computers threaten to trigger the long-teetering global financial shutdown by issuing checks and debits essentially at random. The president's astrologer joins the Secretary of Defense in clicking off the Patmos checklist of critical warning signals. And Angel City, an incredible place to live for Those About to Die, has about a decade and a half s jump on all other up-and-comers.