Ann Patchett - State of Wonder

“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.”

Marina, as usual, felt that she was five steps behind in the conversation. “It seems you should give Vogel a chance. You may find they’re as interested in the vaccine as you are.”

“Your trust would be charming if it weren’t so simplistic,” Dr. Swenson said without a trace of rancor in her voice. “Because if you’re wrong, and I am fairly certain you are wrong about an American pharmaceutical company wishing to foot the bill for Third World do-gooding, then we lose everything. That is not a risk you are allowed to take when the outcome of an incorrect assumption amounts to such a significant annual loss of lives.”

They were back in the village, having picked up a great many more Lakashi on the way. It looked to Marina like almost the entire tribe was assembled.

“Come to the lab,” Dr. Swenson said, patting the arm that she held with her other hand. “Dr. Nkomo will show you our mosquitoes.”

“Let me take a swim first,” Marina said. “Get the blood off.”

Dr. Swenson shook her head. “Use a basin. I’ll have some men bring some buckets of water over for you. No sense getting into the river all covered in blood. You never know who might mistake you for dinner.”

“I went into the river when I had half an anaconda on me,” Marina said, looking down at her dress which had stiffened as it dried.

Dr. Swenson nodded her head. “We’re being more careful with you now.”

When Marina went back to the sleeping porch the sheets on the bed had been straightened and there was a letter lying on top of the pillow. She reached carefully into the netting and took it out. She didn’t want to touch anything until she’d had a bath and still she slid a finger around the edges of the envelope, turning it back into a sheet of paper. All that was there was her name, Karen Eckman, Karen Ellen Eckman, Mrs. Anders Eckman, Karen Smithson, Karen Eckman. The letters were scrawled and uneven. A few times the pen had torn the paper. He had printed the words but his hand was shaking. Maybe he had folded this one up and kept it with him in the bed. Maybe this one he had never even thought to mail.

Every morning Marina extricated herself from the sleeping limbs of the lightly drugged child and took the path to the field of Martins. She didn’t follow the native example and wait for five days to pass. She was thinking it was possible that five days from now she would be out of this place and so she wanted to stuff herself with the bark, to turn herself into medical evidence before she went home. Her goal was to make up for all the bark she hadn’t eaten in the past and anticipate the bark she would never eat in the future. This was her moment, the perfect now. She didn’t mind making the trip deep into the jungle by herself anymore, though there was never a morning when she didn’t run into other women eventually, both Lakashi and the doctors. Dr. Budi said there was scientific precedent for going to chew the trees so often at the beginning. They said they’d had a loading dose as well. Maybe it was just the excitement of the discovery, or maybe it was something the body had been starved for all along. Dr. Budi told Marina that even at this early stage she would be inoculated against malaria and that her window for monthly fertility would be extended from three days to thirteen. Beyond that, Marina had begun to wonder if there wasn’t something mildly addictive in the fenneled bark, something that kept the Lakashi women trudging back to the trees long after they were sick to death of babies, something that kept the doctors at their desks for years after they were ready to go home. Maybe Dr. Rapp had been correct in his original assessment that there was some mild connection between the mushrooms and trees, the smallest touch of narcotic in the bark that kept the women leashed to the forest.

As for herself, Marina dreamed of Martins. They were there, slim and stately, in front of her eyes before she opened them in the morning, and when she drifted off at night she was walking towards them. It was the thought that she could become addicted to anything in this place that first made her realize it was time to leave the Amazon, though everything was pointing towards departure. In one week she had sewn together the eyelid of a girl who had been bitten by the very monkey she had worn around her neck. It took both of her parents to hold the child down while Marina worked with too heavy a needle and too thick a thread to reassemble the delicate tissue. When she asked Dr. Swenson about getting some human rabies immunoglobulin, Dr. Swenson said she would first need to see a slide of the monkey’s brain. She had removed a six-inch wedge of wood from between the third and fourth toes of a man who was cutting down trees to make boats to ride to Manaus. Three men had dragged him down to the lab without so much as a tourniquet, leaving Marina to do her best to piece together muscles and bones whose names she could no longer remember. The terror of the jungle was now redefined by the work it could dream up for her. While the other doctors, no doubt relieved that they had not been asked to perform the task themselves, praised her to the point of ridiculousness, the Lakashi peered over her porch railing at night and raised up on their toes to sniff her neck whenever they were close. It was clear to Marina that no good was going to come of this. She was tired of her two dresses, tired of waking up in the middle of the night trying to figure out how she could take Easter with her when she left. She was unnerved both by Dr. Swenson’s repeated references to “our” delivery date and by the letters from her dead friend that she found waiting in her bed at night. She wanted out of all of it, but still, it was just now light in this beautiful, singular stand of trees and she cupped her hand around the slender trunk of one of them and leaned in.