Ann Patchett - State of Wonder

“There could certainly be a problem with bleeding, but Dr. Nkomo has offered himself for a transfusion if we need one. He’s A positive. That’s a stroke of luck.”

“Do you have a bag?” Marina asked. What they had and what they lacked was a source of great mystery.

“One line, two needles, gravity does the rest.”

“You must be kidding me.”

Dr. Swenson shook her head. “You would be amazed at all the things that are possible in a state of deprivation. It’s only a matter of thinking things through. Just take your time, Dr. Singh. There’s no reason to rush this. That was your downfall in Baltimore. Rushing is the greatest mistake.”

Marina sat up, a sound like a bell ringing in her head. “Baltimore?”

Dr. Swenson looked at her without bemusement or compassion, two of the things that Marina might have hoped to see, then she glanced back at her papers. “You thought I didn’t remember that.”

“Because you didn’t remember that. When I met you in Manaus at the opera you didn’t know me.”

“That’s true, I didn’t. It came to me later, not long after we were back, and by that point it didn’t make any difference.” She plucked a thick article out of the stack, scrawled a note across the top in illegible writing, and placed it in a blue cardboard file. “I only bring it up now because I don’t want it weighing on you going into surgery. That’s why I had you do that cesarean, you know, not just to see if you could do it. I wanted you to get your confidence up. You made a very common mistake that night at the General. You rushed, nothing more than that. Had it not been the eye you would have forgotten all about it in a week. Everyone at some point nicks a skull, nicks an ear. It was just your bad luck that the head wasn’t positioned another centimeter in either direction. In retrospect the real loss was your quitting the program. If I had known you better then I would have stepped in. At the time though,” she shrugged, “it was your decision. This will be easier for you. There isn’t the pressure of a baby to save.”

Marina sat down in a chair beside the desk, and there it went, the burden of her lifetime, taken. She wondered if she could have turned the Lakashi baby. She looked down at her hands. She wondered what they might have accomplished.

“It would have been remarkable if it had worked out, to have had a child at this age, to have had the chance to see myself in a child. I wouldn’t have ever thought about it except for the fact that we came very close.” She made another note, equally unreadable, and put it on the other side of the desk. “Be sure to freeze it, Dr. Singh. There are tests that I’ll want to do later. I’ll want to see what levels of the compound are in the tissues.”

Marina nodded. She would have liked to know what any of it meant, especially the part that concerned her, but she was lost. Mr. Fox was speeding down the river now and she wanted him to come back. She would tell him everything. She would start with her internship and bring the story right up to today.

Dr. Swenson looked at her watch, and then she took it off her swollen wrist and laid it on the desk. When she stood up from her chair she struggled, the great and looming failure of her pregnancy going before her. “We should get to work now, don’t you think? There’s nothing else here that I can do.”

Many hours after the surgery, and well after dark, Easter and Thomas took the mattress off the cot on the sleeping porch and carried it to Dr. Swenson’s hut. They had to take out the table and push the two chairs against the wall but in the end there was enough room for Easter and Marina to sleep. Not that Marina was sleeping, she was watching Dr. Swenson, watching the parade of every nocturnal creature in the Amazon as it wandered through the room. It seemed that they were all attracted to the light, which made her think of that first night in Manaus and Rodrigo’s store. The next day she sent Benoit over for the cot frame and the mosquito netting. Easter brought his strongbox with him. For a moment Dr. Swenson opened her eyes and watched while they rearranged the furniture again. “I don’t remember asking the two of you to move in,” she said, but before Marina could launch her explanation Dr. Swenson had fallen back to sleep.

Aside from her quick morning trips to the Martins, Marina stayed close to her patient, watching her pass in and out of fevers. In her lucidity Dr. Swenson was demanding, wanting to talk to Alan Saturn about mosquitoes, wanting briefings on the data that had been collected since her surgery, wanting Marina to take her blood pressure. Then just as quickly the fever came back and she cried in her sleep, great flooding tears. She would ask for ice and Marina would go and get the small block she kept in the freezer where they stored the blood samples, chipping it into shards with a knife. It was the same freezer where she kept the child with the curving tail. Sirenomelia. It was two days before Marina remembered the name for it. The only time she had ever heard of it was in a lecture on birth abnormalities Dr. Swenson had given at Johns Hopkins. It flashed by in a single slide, Sirenomelia, Mermaid Syndrome, the legs of the fetus are fused together into a single tail, no visible genitalia. It is nothing you’re likely to see . And there it went; with a click and a brief flash of blackness they were on to the next slide. The only person who ever stood to know what it would have been like to have Dr. Swenson for a mother had not lived to meet the experience. A life of such extraordinary beginnings had, in the end, amounted to little more than a science experiment. Marina had rested her hand on the tiny head for a moment when the whole thing was over, just before Budi covered it over to keep it from the insects and took it off to the lab.

In her fevered dreams, Dr. Swenson often gave bits and pieces of lectures, and sometimes it was a lecture Marina remembered, “Ectopic Pregnancy and the Damage to Fallopian Tubes.” She fell into another broken sleep, the blood of Thomas Nkomo making a slow loop through her veins. Marina gave her fluids and tinkered with the antibiotics. For all that they lacked in the jungle their assortment of antibiotics was as comprehensive as any hospital pharmacy. She checked the incision, watched for excessive swelling. She sat in the small room with the door open and read the copious notes on malaria. As the days went by, Dr. Swenson’s fevers would stop and then start again. Marina upped the dosages, beat them back. It was days before they could sit her up, and then stand her up. Marina worried about clots. With Easter on one side and Marina on the other, Dr. Swenson walked halfway down the path to the lab. When she was safely back in bed, too tired even to sleep, Marina read to her from Great Expectations . That became their new routine, and if the chapter was particularly good, or the day particularly dull, Dr. Swenson would ask Marina to read her some more. Easter sat on the floor with his paper and pad and practiced bending straight lines into the alphabet. Marina wrote out Dr. Swenson and put it on Dr. Swenson’s chest. She wrote the word Marina and put it in her lap.

“Did you think I’d forget?” Dr. Swenson said, looking at the piece of paper when she woke.

“I’m trying to give him a few new words,” Marina said.

Dr. Swenson put the piece of paper back on her chest and patted it there. “Good. Let him remember this. Dr. Eckman was always trying to teach him to write Minnesota . That was never going to do him any good.”

“You never know,” Marina said.

“I do know. I think about Dr. Eckman now. There is something very specific about having a fever in the tropics, very unlike having a fever at home. Here you feel the air burning into you, or you are burning into it. After a time one loses all parameters, even the parameter of skin. I think he couldn’t possibly have understood what was happening to him.”