State of Wonder

Nine

It was on the fourth morning after the trip to the trading post that Marina saw Dr. Budi and the second Dr. Saturn walking through the jungle. It was very early, much earlier than she normally would be out, but something had crawled beneath the net above her bed and bitten her near the elbow and the bite, now swollen and hot, had prevented her from going back to sleep. She used what scant morning light was available to inspect the snake’s long-lasting tattoo that had deepened the color of Easter’s bruises to eggplant and spread from his armpits to his groin. When she had assured herself yet again that these bruises were merely horrible and not a sign of some underlying medical catastrophe, she dislodged herself from the sleeping child and went in search of the coffee that Dr. Budi, always working, was sure to have made. It was still fifteen minutes short of full daylight when she saw her colleagues on the other side of a giant termite mound, the ground between them trembling with industry. She waved and called good morning and they stopped abruptly, looking at her as if she were the last person they had ever expected to see in the Amazon. After a pause, Dr. Saturn leaned down to whisper something in Dr. Budi’s ear and Dr. Budi, after what appeared to be consideration, nodded her approval. The two doctors then made their way towards her, cutting a wide berth around the termites.

“How’s Easter?” Nancy Saturn said.

Marina gave Nancy the credit for saving Easter’s life, for having the presence of mind to say the word knife when Marina was still attempting to win a wrestling match with a snake. It was Nancy Saturn who had set their salvation in motion. “He was sleeping when I left. Dr. Swenson gives him half an Ambien at night now, otherwise the pain wakes him up.”

“Blessings from Allah on that,” Dr. Budi said, nodding.

“We’re going out to the trees,” Nancy said casually, laying her hand on the bag of notebooks that hung across her chest. “Why don’t you come along?”

Before Easter’s accident, if pulling a snake into a boat can be called an accident, Marina had asked several times to see the trees, but her requests had been met by a vague evasiveness — they had already been or this wasn’t the week to go. Since the anaconda, she had frankly forgotten about them. Her notions of what was important had shifted. The jungle was not short on trees and she had seen many of them. It was difficult to imagine that some would be so substantially different from the others. Still, now that the invitation had been extended she accepted with pleasure, feeling that her patience had been noticed and rewarded.

In fact, she had written just such a sentiment last night to Mr. Fox, sitting on the floor of the sleeping porch and using the chair as a desk because Easter had already gone to bed. (Since the snake, his hammock had hung empty until a marmoset took it up for afternoon naps. It was a filthy little creature.) I find myself following your advice now that I have no direct way of reaching you. You would tell me to wait and observe. You would tell me there is more to this situation than I could immediately understand and you would be right, just as you were right to tell me to come here and right to tell me (I know this is what you would say) to stay. Look how agreeable I’ve become since I’ve been gone! I can hardly believe how close I came to getting on the next flight home. I would have suffered through Manaus only to miss the very thing I had come for.

Far to the west, Budi and Nancy and Marina heard a rustling of branches as two young women laughing and talking in what Marina still considered to be an impenetrable language passed at a distance, nodding their heads with disinterest when they spotted the doctors. One of the older women was walking from the direction of the river holding the hand of a young girl. Three more suddenly appeared from behind a large, dead stump. “You would think they all had alarm clocks,” Nancy said as more and more women stepped from the underbrush and headed in the same direction. They were on a path Marina didn’t think she had been on before although she couldn’t be sure. Paths opened up when she studied the undergrowth carefully and then disappeared as soon as she turned her head. She had a mortal fear of following one path into the jungle and then being unable to find it again when she was ready to go out. If Marina had it all to do over again she would have brought sacks of red yarn with her so she could tie one end of the ball to the foot of her bed every time she entered the labyrinth.

“It is the Lakashi biological clock,” Dr. Budi said, and Nancy and Marina laughed. Dr. Budi smiled shyly, having made so few successful jokes in her life.

It wasn’t often that Marina dwelled on the contents of either of her lost suitcases but there were moments, and this was such a moment, when she would have liked a real pair of shoes instead of the rubber flip-flops. She would have liked a long sleeved shirt that would have saved her arms at least from the smaller thorns, and a pair of pants to protect her from those random blades of grass which when brushed past at exactly the right angle could slice the shin like a razor. The small amount of blood that beaded and then seeped from her leg was an advertisement for all she had to offer. It felt as if they were going a very long way, but distances, like directions, were hard to measure. It could have been that this particular path (were they on a path?) had more fallen trees lying across it that required clambering over, more mysterious sinkholes of standing water heralded only by a sudden sponginess underfoot. It could be that they were only two or three straight city blocks away from their destination but that distance was meaningless given the obstacles they had still to overcome. Marina brushed her hand across the back of her neck and dislodged something with a hard shell. She had learned in time to brush instead of slap as slapping only served to pump the entire contents of the insect, which was doubtlessly already burrowed into the skin with some entomological protuberance, straight into the bloodstream.

The Lakashi women were singing now. No, they weren’t singing. It was just that so many of them were talking at once and when their voices came together it sounded vaguely like a section of Torah as sung by a group of bar mitzvah boys whose voices had yet to change. “Do you know what they’re saying?” Marina asked.

Nancy shook her head. “I catch a word every now and then, or I think I do. We had a linguist with us for a while. He had been a student of Noam Chomsky’s. He said the language wasn’t particularly difficult or even interesting, that all the languages in this region of the Amazon came from a single grammatical base with variations in vocabulary which meant at one point the tribes must have been connected and then split apart. It made me wish we had a language that was a little bit more obscure so we might have kept him. He made us some charts with phonetics so we can put together some basic phrases.”

“Thomas is very good at it,” Dr. Budi said. She held up her arm and the other two women stopped and waited while a very large, low slung lizard dragged itself across their path, its loose green skin hanging over the rib cage like chain mail. “I don’t know that one,” Dr. Budi said, watching it carefully.

Nancy leaned over to peer at the lizard as if it were someone she could almost place, then she shook her head. “Neither do I.”

It was another twenty minutes past the lizard before they came to a clearing, or, if not a clearing, a place where fewer, thinner trees stood farther apart from one another, and all the trees were the same. There was no thick coat of undergrowth covering the ground, just a light wash of grass, there were no hairy ropes of vines strangling the trees, only the smooth, straight expanse of bark. Sunlight fell easily between the pale oval leaves and hit the ground in wide patches. “It’s beautiful,” Marina said, dropping her head back. Such sunlight, such pretty little leaves. “My God, why don’t they live here?”

“Too far from the water,” Dr. Budi said, looking at her watch and making a note of the time.

A dozen Lakashi women were already there. Marina knew most of them by sight even if she couldn’t properly reproduce the series of tones that made up their names. Over the next few minutes two dozen more arrived and took their places against the trunks that were a buttery yellow color and ranged from ten to twenty inches around. Without ritual or fanfare, with no apparent consideration, the women went for bigger trees, the ones already bitten, and left the saplings alone. Pressing in like a partner for a slow dance, they opened their mouths and began immediately to scrape their teeth down the bark. The jungle on this morning was particularly quiet and so it was possible to hear them, a small sound amplified by so many women making it at the same time.

A few stragglers wandered in and stopped to greet the women at the trees around them who stopped their biting and chewing long enough to receive the greeting and return it. Two of the women who had a great deal to say to each other took opposite sides of the same tree and from a distance they appeared to be kissing. Women who had brought their children left them in a pile in the center of the trees and the older children herded the younger ones back when they tried to crawl away. One of the older women went into the group of children and led a girl of twelve or thirteen to a tree and the others stopped all at once, turning their heads from their trees to watch her. When the girl tilted her face to the side, looking uncertain of how she should approach it, the others hooted lightly and slapped their trees to make a kind of tree-plus-human applause. The thin branches trembled and shook the delicate leaves from side to side. The girl, whose hair was unbraided and disheveled by sleep, looked embarrassed to be the center of so much attention. She then began to nibble at the bark. After the others felt certain she was performing this primal act correctly they all went back to their work. From the nubile to the beldame they scraped and chewed without pleasure or distaste. They had turned the fairly exotic act of biting a tree into nothing more than factory work.

“This is important,” Dr. Budi said to Marina. “The girl has just completed her first menstrual cycle. The Lakashi rituals are very brief, unsentimental. You are lucky to see such a thing on your first day.”

Nancy Saturn turned some pages in her notebook. “I didn’t realize Mara was menstruating.”

Dr. Budi held up her book. “I have it.”

There were more than enough trees for everyone, maybe two hundred of them spread over two acres of land. The tallest climbed to a height of sixty or seventy feet, but there were plenty of new trees coming up as well. In the places where a tree had been recently eaten, the absence of bark left a mark that was soft and white; growing back, it was the palest of yellows and then darkened over time so that most of the trees at the height of a Lakashi’s head appeared to have been banded by decoupage.

It was easier to breathe in this place, and so easy to see! In every direction the vista was open. No more wondering what might be tearing through the jungle with its wet jaws hinged open. “I never thought there would be so many trees,” Marina said. “I didn’t picture it like this.”

“It’s actually just one tree,” Nancy said. She was counting the women and marking them present by name in her notebook. “They’re Populas, like Aspens, a very rare phenomenon. It’s a single root system. The tree is cloning itself.”

“Very delicate,” Dr. Budi said, nodding to herself.

“The root system changes the acidity level in the soil so that nothing much will grow here except for the trees and a little bit of grass. In a sense you could say the tree poisons the area it inhabits to make sure that nothing else will survive in its space and take the nutrients out of the soil or grow taller and block out the sunlight.”

“Except the Rapps,” Dr. Budi said. “The Rapps thrive right where they are.” She pointed the tip of her pen towards the clusters of mushrooms that grew near the base of the trees, each cap a perfect golf ball on a tall, slender stem. The Rapps were a most unearthly shade of pale blue. They came so close to glowing in the light of day that she wanted to come back with a flashlight and see them in the dark. Marina couldn’t imagine how she had missed them.

“Psilocybe livoris rappinis,” Nancy said. “They are considered to be the greatest single discovery in mycology. There has never been any evidence that this ecosystem is duplicated anywhere else in the rain forest, anywhere in the world. These trees you’re looking at here, these mushrooms, this is it. As far as we know, these are the only Rapps in the world. Your passport to spiritual enlightenment.”

“You’ve tried them?”

Nancy Saturn closed her eyes and nodded slightly, holding up one finger.

“Very sick,” Dr. Budi said. “Interesting, everything you see, but too sick.”

“So if the mushrooms are Rapps, are the trees called Swensons?” Marina asked. There was an inordinate number of lavender moths the size of quarters bobbing through the sunlight. Marina didn’t remember seeing them before but then it would be difficult to notice such a small moth in the workaday tangle of vines that suffocated the rest of the jungle.

“The trees are called Martins,” Dr. Budi said. “Tabebuia martinii.”

“It’s actually the Rapps we’re protecting,” Nancy said. “All the secrecy about the work and the location, it’s so no one can find the Rapps. Scientifically, it’s the Martins that have presented such remarkable potential. The Martins really may prove to be one of the great botanical discoveries of our age. But people have been trying to get their hands on the Rapps ever since Dr. Rapp started writing about them. If the greater world knew where they were—”

Dr. Budi covered her eyes with her hand and shook her head.

“Exactly. This place would be overrun, drug dealers, the Brazilian government, other tribes, German tourists, there’s no telling who would get here first and what sort of a war would ensue. The only thing I know for sure is that the Lakashi would be destroyed. Their entire existence is built around Rapps and while they have easily a hundred times more mushrooms than they need for their rituals they have no interest in drying and storing them. The Rapps present three hundred and sixty-five days a year and so the Lakashi just assume they’re always going to be right here under the trees. I’ve been trying to grow Martins and, subsequently, Rapps, for three years now, and I’m not talking about growing them back in Michigan, I’m talking about growing them in the lab from root dissections, the same soil, the same water, and I can’t do it.”

“You will,” Dr. Budi said.

Nancy Saturn shook her head. “It’s too soon to say.”

Dr. Saturn and Dr. Budi announced that they were talking too much and the window of time for work would not stay open indefinitely. They excused themselves and began going tree to tree asking the women questions that involved the use of four or five words of Lakashi. Nancy took a cuff out of her bag and was checking Mara’s blood pressure. Marina took the opportunity to look at the trees: a small plastic placard, numbered and dated, had been staked in front of each one. She ran her hands over the scarred bark, sniffed at the wood. Had she seen them by a lake in Minnesota she wouldn’t have given them a second look, or maybe one glance back, just because she had no memory of seeing such yellow bark. The Rapps she would have noticed, looking down at the small clump near her feet. They were like a cluster of exotic sea creatures that had washed up a thousand miles inland. How in the world had Dr. Rapp found this place? How had he known to look past the fire waving tribe on the shore and go a mile into the jungle? Marina cut a path between the trees. What a pleasure it was to walk! What a pleasure to take a large step and be able to see where her foot was landing. She raised her arms above her head and stretched. One by one the women stepped back from the trees and began scratching out whatever splinter of bark had lodged between their teeth with their fingernails. Budi picked a handful of women out of the crowd and wiped down their fingers with alcohol swabs and then pricked them to draw the small pipettes of blood. After making notes she carefully pressed the tubes into a small metal case. On the other side of the stand, Dr. Saturn went through a more challenging interaction as she handed three of the women long cotton swabs and waited while they reached beneath their dresses, made a quick flick with the wrist, and handed the swab back to her. Dr. Saturn then tapped the swab on a slide and on a piece of litmus paper.

“What in the world are you doing?” Marina asked.

“Checking the levels of estrogen in cervical mucus.” Dr. Saturn’s carrying case was a more complicated affair and she sat down on the ground to make her notations on the test tube where she deposited her swabs. “The slides are for ferning.”

“No one does ferning anymore,” Marina said. It was the slightly arcane process of watching estrogen grow into intricate fern patterns on slides. No ferns, no fertility.

Dr. Saturn shrugged. “It’s very effective for the Lakashi. Their estrogen levels are quite sensitive to the intake of bark.”

“How in the world did you convince them to—” She wasn’t sure of the appropriate word. Self-swab?

“That,” Dr. Saturn said, “is Dr. Swenson’s genius. The training was in place a long time before I arrived. I cannot imagine how terrified of her they must have been to have gone along with it. These days it doesn’t even seem to register as an invasion of privacy.” The third Lakashi woman handed over her Q-tip without fanfare and Nancy bowed her head as she accepted it.

When the Lakashi had finished what had been asked of them, they walked off in groups of two and three and four, not looking back at the trees or acknowledging the scientists. They picked up the children who were too small to walk reliably and let the others trail behind as best they could. They were done.

“Do they come every day?” Marina watched as the entire lot of them receded into the thickening woods as if a school bell had been rung. They left without so much as a glance back to the doctors or the trees. Their work was done.

“They chew the bark every five days, though the entire female sector of the tribe doesn’t come on the same day. Their visits are regular. How they figure the five days is beyond us as they have no apparent system for marking time. I can only assume that it has at this point become a biological craving. They don’t come when they’re pregnant. In fact the bark repulses them from what seems to be the moment of conception. Dr. Swenson confirms this. Because of this pregnancies seem especially long out here. We know about them for a full thirty-nine weeks. They also don’t come when they’re menstruating, though conveniently they’re pretty much on the same cycle so we get a few days off every month.”

“All of them?”

Nancy nodded. “It takes the new girls a while to get it straightened out and no one is perfectly regular after giving birth, but other than that.”

Dr. Budi walked over to a tree near her and looked to find a place where the bark was darkest yellow and dry, then she leaned towards it and bit, her teeth making that same scraping sound. “You’ll try it?” she said, looking back at Marina.

“I should take her vitals,” Nancy said, pulling out the blood-pressure cuff again. “Budi, take her temperature.”

“Why would I?” Marina said.

“We need people to test. People who aren’t Lakashi. We do it.”

“But I’m not going to get pregnant.”

Nancy Velcroed a cuff around Marina’s arm and began to pump it tighter and tighter. Dr. Budi held up a flat plastic thermometer and Marina, sure of nothing, opened her mouth.

“You would not be alone in that,” Dr. Budi said.

“Believe me, there are plenty of things to test you for. You don’t have to get pregnant.”

“Thomas will tell you,” Dr. Budi said, and then as if on cue, Dr. Nkomo broke through the thicket outside the stand of Martins and was walking towards them.

“I see I am sufficiently late,” he said, bowing his head to the three women.

“Men and women don’t come to the stand at the same time,” Nancy told Marina. “The women chew the trees and the men gather the Rapps.”

“Division of labor,” Dr. Budi said. Nancy removed the blood-pressure cuff and pressed two fingers to the side of Marina’s wrist to find her pulse.

“First time, yes?” Thomas said.

Marina nodded, keeping her mouth fixed to the thermometer.

“Ah, very good. Just remember to keep your tongue pushed down. Otherwise you can get splinters.”

“Although we’re geniuses at taking them out,” Nancy said. “Pulse sixty-four. Well done, Dr. Singh.”

Thomas brought his mouth to the tree beside him and, far above the band of scarring, began to scrape down the bark. Marina took the thermometer out of her mouth. “Wait a minute,” she said.

“The Martins have many purposes,” Nancy said. “For years Dr. Rapp thought that part of the hallucinogenic qualities in the mushrooms must come from the root system of the tree, that it must in some way be leached from the trees themselves, so he assumed that by chewing bark the women were, in essence, giving themselves a little bump. It was Annick who made the connection between the trees and extended fertility. Apparently he never noticed that they kept getting pregnant.”

“She still is always giving Dr. Rapp the credit,” Dr. Budi said, not as a correction, simply as a statement.

“If you look at their notes from that time it’s quite clear.” Thomas took a handkerchief out of his pocket and touched it to the corners of his mouth.

“It wasn’t until 1990 that she made the connection between the Martins and malaria,” Nancy said. “And that was definitely her discovery. Dr. Rapp was barely in the field by the nineties.”

“She still gives him credit,” Dr. Budi said. “Says he had mentioned it before.”

Thomas Nkomo shook his head by way of acknowledging the sadness of a woman who was so quick to assign her achievements to a man. “This is the greatest discovery to be made in relation to the Lakashi tribe. Not the Rapps or the fertility but the malaria.”

“I don’t understand,” Marina said, and she didn’t, not any of it.

“Lakashi women do not contract malaria,” Dr. Budi said. “They have been inoculated.”

“There is no inoculation for malaria,” Marina said, and the other three smiled at her, and Thomas bit the tree again.

Nancy Saturn pointed out the small purple moth resting on the white inner bark of the tree. It was the spot that Dr. Budi had recently chewed and there was still the slightest glimmer of saliva on the surrounding outer bark. “The Martin is a soft bark tree. Once the bark is broken the Lakashi have no trouble scraping through the inner bark and down into the cambium where the living cells are. This creates an opening, as you can see, a sort of wound in the tree, and into that wound comes this moth, the purple martinet.”

“You can’t be serious,” Marina said, leaning in for a better look. “Is there anything he didn’t name for himself?”

“The Lakashi tribe was not a Martin Rapp discovery. If it had been, this place would surely have been Rapptown.” Nancy put a finger just beneath the moth which, like the Lakashi, seemed impervious to the invasions of its privacy. “Agruis purpurea martinet. It takes liquid from the pulp of the Martin, not the sap, which is deeper inside the tree. The insect subsists on the moisture in the wood itself. It ingests and excretes almost simultaneously, processing the proteins from the pulp. Once a year it lays its eggs.”

“In the bark?” Marina asked. When the moth opened its wings it showed two bright yellow dots like eyes, one on either side, then it folded back up again. A butterfly rests with its wings open and a moth rests with its wings closed, she had read that somewhere years ago.

Nancy nodded. “Like the Martins and the Rapps, the purple martinets seem to exist right here. You’ll see one in camp from time to time. They’ll go as far as the river, but we have no record of it feeding outside this area. The key to fertility is found in the combination of the Martin tree and the purple martinet, although we haven’t isolated the moths’ excretions from the proteins in its larval casing. What we know is that it works.”

Dr. Budi wiped an alcohol swab over her own finger and then pricked it herself.

“What about the blood samples?” Marina asked. “Can you actually read hormone levels on such a small amount of blood?”

“Nanotechnology,” Budi said. “Brave new world.”

Marina nodded.

“We’ve isolated the molecules as they are metabolized in the bark of the tree,” Budi continued, “but we’re still charting the impact of the Lakashi saliva, their gastric juices, plasma. What we don’t know is what combination of factors is also giving the women protection against malaria.”

Marina asked if the men in the tribe were susceptible to malaria and Thomas nodded. “After they have completed breast-feeding, the male babies are as likely as any member of comparable tribes to contract malaria, as are female children between the ages when they cease to be breast-fed and the onset of their own first menses, when they begin chewing the trees.”

“So they aren’t actually inoculated. The tree and the moth act as a preventative, like quinine.”

Dr. Budi shook her head. “Preventative while breast-feeding, inoculated when eating the bark. The question is why the entire tribe hasn’t evolved to eat the bark in their youth, but considering how many children die of malaria, there could be a terrible population explosion among the Lakashi were they all to live.”

“But how do you know?” Marina asked. Her head was swimming with this. Had they convinced some men to eat the bark? How had they tested the children? “Could you get some of the women to stop eating the bark?” She looked up again at the trees. She could see now far away against the ceiling of sky the clusters of pink flowers that hung as heavy as grapes.

“There have been a few cases of women who were unable to conceive who after a while stopped participating in the group visits to the Martins,” Nancy said. “But because they had already eaten the bark they were inoculated.”

“Mostly we have experimented on ourselves,” Thomas said.

“With what?”

Dr. Budi looked at her, blinked. “Mosquitoes.”

“So what drug is being developed exactly?” Marina asked. A purple martinet dipped past her and then landed on the front of her dress, its purple wings opening and closing twice before flying off again.

“There is enormous overlap,” Thomas told her. “In exploring one we learn about the other. They cannot be separated out.”

Nancy Saturn was a botanist. She could be playing for either team. But Dr. Budi and Thomas and Alan Saturn all seemed to be on the side of malaria. “Is Dr. Swenson the only one working on the fertility drug?”

“That is certainly her primary project,” Thomas said. “But we believe the answer to one is the answer to the other.”

“It’s a lot to take in,” Nancy said. “We understand that. Just give the bark a try, see what you think. You probably won’t be here long enough to be part of the tests but you should at least give it a go. The number of non-Lakashi who have had the chance to chew the Martins is very small.”

“It is an honor,” Dr. Budi said, leaning forward to take another bite herself.

What was it Anders had said to her? “Pretend for a moment that you are a clinical pharmacologist working for a major drug development firm. Imagine someone offering you the equivalent of Lost Horizon for American ovaries.” Marina closed her eyes, pressed down her tongue, and opened her mouth. It was not as natural as it appeared. It was more like milking a cow, easy as long as someone else was doing it. The secret seemed to be in the angle of the head, not coming at the tree straight on. In truth the bark was nearly soft, yielding. It offered up the slightest amount of pulpy liquid that tasted of fennel and rosemary with a slightly peppered undertone that she could only imagine had to do with the excrement of the purple martinet. It wasn’t bad, but then it couldn’t be bad. Generations of Lakashi women and a handful of scientists would not persist in chewing a foul tasting tree. How had that first Lakashi woman thought to break the bark with her teeth, and how did that first moth, who must have been eating something somewhere before this, flutter in behind her? Marina pressed in somewhat harder and felt a sharp stab in her upper gum line but she was not deterred. She was not seventy-three. She was not so old at all, and there were plenty of women who had children at her age, women who certainly never went as far as this. As ambivalent as she was regarding her own ability to reproduce, she was not the least bit ambivalent about the science of the experiment. Now she wanted that global satellite phone. She would have called Mr. Fox from where she stood and told him what was possible.

Dr. Budi tapped her shoulder. “Enough now,” she said. “Too much at first affects the bowels.”

Nancy handed her a swab sealed inside a test tube. “For later,” she said. “You could just drop it off on my desk.”

Marina touched her fingers to her lips and nodded. “Did Anders come here? Did he try this?”

There was a look that passed between the other three, a very brief flash of discomfort. “He was interested in our work,” Thomas said. “From the beginning. He was with us here for as long as he could be.”

“I want to see where he’s buried,” Marina said, hoping it was here in the field of Martins. She hadn’t asked before because she wasn’t sure she would be able to bear the sight of it, looking down at all the ungodly growth and knowing that Anders was beneath that weight forever. But it would be easier to remember him in a beautiful place. She could describe all of this to Karen. She could explain the openness. Even if he wasn’t here, this is what she would tell her.

“Ah,” Nancy Saturn said, pressing the toe of her tennis shoe against the root of a Martin.

“We don’t know,” Thomas said.

“Who does know? Dr. Swenson knows.”

After a period of silence it was Dr. Budi who spoke up. She was not one to leave a difficult job to someone else. “The Lakashi bury people during a ritual. They take the body away, they take the Rapps. It is a private matter for them.”

“But he wasn’t one of them,” Marina said. She saw him laid out on a makeshift bier being carted off into the very trees he hated, Gulliver dead and dragged away by Lilliputians. “It makes a difference. It makes an enormous difference.” She said it knowing full well it made no difference whatsoever. He was dead and that was all that mattered.

“They were very fond of Anders,” Thomas said, patting her shoulder. “They would have given him every care.”

“It was raining hard that week,” Dr. Budi said. “It was very hot. The Lakashi would not bury him where we asked and we could not bury him ourselves.”

“So you gave him up.” She saw Karen so clearly in her mind, sliding down to her kitchen floor, taking the dog in her arms. Karen had felt it fully even then, never having seen this place. “It was the only thing Dr. Swenson said in her letter, that he had been buried in keeping with his Christian traditions. I don’t even know if he had any Christian traditions but I doubt he planned to be buried in a jungle by a group of people eating mushrooms.”

“She said it to comfort you,” Dr. Budi said.

“Let’s go back,” Nancy said, and put an arm around Marina.

There was no one clear point of loss. It happened over and over again in a thousand small ways and the only truth there was to learn was that there was no getting used to it. Karen Eckman had wanted Marina to go to Brazil to find out what had happened to her husband, but now that she was here she understood what Dr. Swenson had told her in the restaurant that first night after the opera: it could have been anything, any fever, any bite. It never was remarkable that Anders had died; the remarkable thing was that the rest of them were managing to live in a place for which they were so fundamentally unsuited. Karen had wanted to believe that knowing what Anders had died of and where he was buried would make a difference, but it wouldn’t and it didn’t. At some point Marina would have to figure out a way to tell her that.

Marina went back to the porch with the taste of Martins still on her tongue and found that Easter was up and gone. She looked through the sheets to see if there was a letter from Anders but there was nothing. Easter was no doubt showing off his bruises to the other children. She had already seen him laying two sticks in the mud very far apart to show them how long the snake had been. She wondered at what point he had lost his hearing and if he understood enough about language to miss it when there was so great a story to tell. She would have loved to know how the snake had lodged itself in his memory, if he thought of it as the terror it was or as a great adventure, or maybe he didn’t think of it at all except as the source of the dull ache in his chest. Marina had to admit she really didn’t know what Easter thought about anything. His nightmares had abated since the snake, he no longer cried out in the night, though that could have been the Ambien or the comfort of sleeping the entire night in her bed. It could have been that once an anaconda had squeezed him half to death there really wasn’t anything left to be afraid of.

Outside, Marina heard Dr. Swenson calling her name, and she went and leaned over the porch railing.

“You’ve been gone half the morning, Dr. Singh,” Dr. Swenson said. She was with a Lakashi man wearing shorts and a gray T-shirt that he had sweated through. The men wore T-shirts as a means of dressing up, certainly anyone coming early in the morning to seek an audience with Dr. Swenson would find a shirt to put on. He was holding a small red canvas duffel bag with both hands. From this particular angle, looking down on the two of them from a height of eight or ten feet, she couldn’t imagine that she had ever missed Dr. Swenson’s pregnancy. She was nothing but belly.

“There was a lot to talk about,” Marina said, and she had every intention of talking to Dr. Swenson about it as well: Anders’ burial, and who was funding the research for the malaria vaccine. But the man standing next to Dr. Swenson was bobbing up and down on the balls of his feet and twisting his hands back and forth against the straps of the bag and it was difficult to concentrate on anything but him. He twitched like he was trying unsuccessfully to conceal the fact he was crawling with ants.

“Talk we will, Dr. Singh. It’s not a short walk. There’s plenty of time to catch up, but I need you to come with me now.”

“What’s the problem?” Obviously there was a problem. The man was moaning. She could hear him now above the din of the insects though he seemed to be making a concerted effort to be quiet in the same way he was trying his best, she could tell, despite all his movement, to stay still. It wasn’t just that Dr. Swenson had convinced the Lakashi to submit to her tests, they were as afraid of her as any group of first-year interns. The clear accomplishment of the man in the gray T-shirt was that he wasn’t screaming.

“You’ll like this,” Dr. Swenson said, and turned back to the path they had come down. “This will be right up your alley.”

Marina was out the door and down the steps. Dr. Swenson did not wait for her and had continued to carry on their conversation alone. “I know how much you’ve been looking forward to practicing medicine while you’re here. I think we’ve found you an opportunity.”

Even with Dr. Swenson six or seven months pregnant Marina had to rush to keep up with them. The man was setting the pace and the pace was quick. She kept a close eye on the ground. Marina had a particular fear of breaking her ankle. “I didn’t say that.”

Dr. Swenson stopped and turned to Marina. The man now looked petrified. It was imperative they continue their forward motion. He raised up the bag in case she had forgotten it and began a quick monologue in Lakashi, but Dr. Swenson held up her hand. “You did. You remember, on the boat. We were discussing the girl with the machete in her head.”

“I do remember,” Marina said, marveling at how the panic rising up in her was obliterating all of her questions: Why did you give Anders over to them and why did you lie about it and there was something else after that but now she couldn’t remember. “I thought it was right for you to attend to the cases that presented themselves.”

“That presented themselves to me as a doctor, or you as a doctor. Either way, you waved the Hippocratic oath above our heads like a flag so now you’ll have the chance to bask in its glory.”

“I’m a pharmacologist.”

To the man’s great relief Dr. Swenson started walking again. The sun was high and bright and very hot. “Yes, well, I can’t get on the floor and in this village things happen on the floor, and if you’re planning to tell me that they should bring his wife to the lab, I’ve already suggested that. She can’t go down the ladder. As much as I am opposed to hosting a medical clinic in my office, I am considerably more opposed to house calls.”

“What’s wrong with his wife?”

Dr. Swenson passed a dead log covered in bright red butterflies and the breeze that she made caused them to startle and disperse upwards into a bright red cloud. “It has something to do with the birth of a child. If you are ever betting on the nature of a local tragedy you’ll never go broke putting your money on that one. For the most part they do it remarkably well but the sheer volume in which they reproduce brings forth a certain number of errors.”

“Do you know what this error is?” Marina was walking faster and faster when everything in her was saying she should stop.

Dr. Swenson shook her head. “No idea.”

“But you said you didn’t want to interfere.” Interference in the medical needs of an indigenous people suddenly struck Marina as the worst possible idea. She could see now the virtue in leaving them alone, of observing without imposition. “You distinctly said there was someone—”

“The county witch doctor, yes. His malaria has flared again. He’s running such a fever we’ve been asked to go by and check on him later. There is also, you will be pleased to know, a midwife, who is presently in labor herself. She is being attended by the midwife-in-training, who is her daughter. The daughter would feel much more comfortable if we stopped in.”

“Who told you this? It isn’t possible.”

“The messages are collected by Benoit, who brings them to Dr. Nancy Saturn. Benoit and Dr. Saturn can stumble along together in Portuguese. Frankly, the chain of communication is so weak that we might arrive and find out none of this is true. I do a better job communicating with Easter than I do most members of the tribe.”

In the jungle they passed the stilted huts of several families who leaned against the railings and waved. An enormous fallen branch blocked the path for a moment but their scout dragged it away before they had the chance to wonder how they might crawl through. Marina began again. “Dr. Swenson, you have to listen to me. I am not the person for this job. There are other doctors here and any one of them, I promise you, is better qualified.”

“Shall we ask the botanist?” Dr. Swenson said sharply. “Or one of the other three? I doubt they have ever been out of a lab in their lives. You forget I have worked with these doctors for several years now. They have a real talent for breeding mosquitoes and that is all the credit I will give them. You may be a pharmacologist, Dr. Singh, but before that you were a student of mine. You know how to do this, and if you don’t I will be standing there reminding you. I cannot get down on the floor anymore. My leg won’t allow it. I will not go to the trouble of telling you that you can turn back now and leave this woman to her fate because it would be a waste of my time and yours. You will do this regardless of how you feel about it. That much I know about you now.”

Marina felt such a sudden weight in her feet that she looked down at them, sure she must have stepped in something.

“Cheer up, Dr. Singh. It’s your chance to do good in the world.”

Marina’s scalp was wet with sweat and it ran down the sides of her face and the back of her neck. She was going over notes in her mind and finding that entire pages of them were missing. Of course there was a chance that everything was fine, that they would arrive to find nothing but a long labor and a nervous husband. If it were only a matter of delivering the child because everyone else was indisposed, well, she could do that. Anyone could do that. She was only hoping there would be no cutting involved. Where was the bladder exactly? When she walked away from her last C-section it had never occurred to her that this was a skill she might someday be called to use again. Why should she have stayed current, attended the conferences, read the journals? She wasn’t even boarded in obstetrics. Any fireman or taxi driver could be called on for a vaginal delivery, but the unqualified were never asked to cut. Somehow this thought calmed her, and for a moment she allowed herself the pleasant picture of a baby slipping easily into her hands while her teacher watched. There was no reason to think this wasn’t the way it would go.

“You’re very quiet,” Dr. Swenson said. “I thought you would have so much to talk about while we walked. Everyone back at the lab this morning was anxious to discuss your feelings.”

“I’m trying to remember how to deliver a baby,” Marina said.

“The brain is a storage shed. You put experience in there and it waits for you. Don’t worry. You’ll find it in time.” With these nearly encouraging words they reached their destination. Had the Lakashi lived in a city, this particular hut would have been located in the outskirts of the farthest suburb. It was for the native who wanted privacy, who wanted a view of the river without a view of his neighbors. They knew it was the right house by the pitifully weak screaming that emanated from it. The man and the duffel bag bounded up the ladder ahead of them and was gone.

Dr. Swenson looked behind him, gauging the logistics. “When I think of finishing this project and going back to the States the thing I picture is a staircase. I suppose if I were more ambitious in my daydreams I would think of elevators and escalators, but I don’t. All I want is a nice set of stairs with a banister. You are my witness, Dr. Singh. If I make it out of this country alive I will never climb another ladder again.”

At seventy-three it was hardly a shocking oath to swear. Marina considered the length of Dr. Swenson’s arms and legs against the width of her circumference. It did not seem possible. “Is there any way for me to help?”

“Not unless you strap me to your back. I believe I can go up but the coming down concerns me. I don’t want to get stuck up there and wind up having to give birth in this hut myself.”

“No,” Marina said, though the thought of going up there alone was not without problems.

Dr. Swenson rubbed at her temples. “What do we know for certain, Dr. Singh? I am a seventy-three-year-old woman who is pregnant and short. But women who are older and shorter and more pregnant than I have made it up and down these ladders every day of their lives, including the day of their delivery.”

The T-shirted man leaned over the floor and looked at them with expectation. “Vir! Vir!” he said.

“Oh good,” Dr. Swenson said. “He has a little Portuguese. He says we should come.” She looked up again. “I suppose we should.”

“We also know for certain that none of those women was having her first child at seventy-three,” Marina said. “They had a lifetime of experience in climbing the ladders, pregnant or not. They were used to it.”

Dr. Swenson turned to her and nodded her approval. “Well said, and I admire your willingness to argue against your own best interests. Now stay one step behind me and prepare yourself to be an ox. You are very strong, aren’t you?”

“Very,” she said. And so they climbed, Marina stretching her long arms around her professor, her hands just beneath Dr. Swenson’s hands, her strong thighs beneath Dr. Swenson’s thighs, and up they went towards the wretched weeping and the husband’s calls of “Agora.” Now!

Benoit had been sent ahead with instructions that the family should have waiting a large quantity of water that had been twice boiled and twice strained, and the first thing they saw were the buckets, which were not clean themselves, sitting in a row. Benoit, who had avoided Marina since the incident with the snake, was nowhere in evidence. The woman lay on the floor in a pile of blankets and both the woman and the blankets were so wet they looked like they’d been dredged up from the river. Spreading across the floorboards beneath her was a dark, soaking stain. Their guide was kneeling beside his wife, holding her hand, rearranging her wet hair with his fingers while the other members of the household went about their business. An elderly man with no shirt stretched out in a hammock while two small children, a boy and a girl, pushed him back and forth, laughing ecstatically every time he swung away. Three women, one with a baby on her breast, were tying strings of red peppers together while a man in the corner sharpened a knife. When Dr. Swenson arrived at the top of the ladder she was panting and they all snapped up their heads in attention. She pointed to a wooden crate and one of the younger women ran to bring it to her. She sat down and was offered a gourd full of water which she accepted. Even the woman on the blankets quieted herself to acknowledge the honor she had been shown. To think that Dr. Swenson had come to her house!

Marina didn’t know if she should first attend to the patient or the doctor, when in fact she wasn’t sure she had the skills to help either one of them. “There’s the bag,” Dr. Swenson said, and gave a nod towards the floor. “You’ll find what you need. I’ll tell you, I’m impressed to have managed this.” She covered her heart with her hand. “I haven’t gone up a ladder since this whole ordeal began.”

Marina unzipped the bag and ran her hand in circles inside, heartsick to see how little she had to work with. There was a bar of soap in a box, no scrub brush, some packaged, disinfected towels, packaged gloves, a prepackaged surgical kit, some various medications that rolled around the bottom of the case looking paltry. There were two silver shoehorns with their ends bent back. Marina held them up. “What are these?”

“Shoehorns!” Dr. Swenson reported happily. “Rodrigo got a whole box of them once years ago. They make brilliant retractors.”

Marina put the shoehorns in her lap and bowed her head. “How can I sterilize them?”

“How can you sterilize anything? You can’t, Dr. Singh. This is what it is. Go ahead and wash up in the first bucket,” Dr. Swenson said. “I’m catching my breath.”

The water in the first bucket was tepid and Marina ground the soap into her skin over and over again, wondering how it was possible that she was where she was, that what was about to happen was in fact happening. Surely she had participated fully in every step it took to get to this place, agreeing whenever she had meant to decline, but still, it wasn’t such a long time ago that she was back at Vogel charting lipids and Anders was alive. She was trying to dig out the dirt from underneath her fingernails when the woman on the blanket let out such a cry she jumped. What Marina needed was to deputize a nurse, someone had to open the packages. She called to one of the three women, jerking her head until the woman reluctantly laid down her peppers and came over. Marina handed her the soap and did a pantomime of washing and opening the packages while the woman stared at her as if Marina had lost her mind. She wondered if she would have to act out every stage of the surgery, but now she was getting ahead of herself. No one had said there would be a surgery. Dr. Swenson had situated her crate next to the woman on the blankets. Marina came over with her nurse who continued to scowl at the bother of it all until Dr. Swenson made eye contact with her and the eye contact settled her at once.

Marina pulled on her gloves, got down on her knees. When the woman on the blankets looked at her, Marina pointed to herself, “Marina,” she said. The woman gave her a weak nod in return and said a name no one could hear. Having made the introductions, Marina soaped the woman’s genitals and thighs, bent up her knees and showed the nurse how to hold them. “It would be nice to have a clean blanket to put her on.”

“If you had a clean blanket you would want a sterile one, and a sterile blanket makes you think you can’t do anything without a table and a light, and from the table and the light it is a very short step to needing a fetal heart monitor. I know this. Check and see how dilated she is.”

Again, Marina looked at the woman as she slid in her hand to check the cervix. There was enough room for a well placed baby of normal size to make an easy exit and Marina felt a great wave of relief come over her. “She’s wide open.” She moved her hand around, feeling for the baby. As it happened, the basic construction of the female body had not changed since she had done this last. Having the patient on the floor made no difference: there was the baby, though she was quite certain that was not the baby’s head she was feeling. “It’s breech,” she said. It wouldn’t have been her first choice but she could manage it. “I’m going to have to try and turn it.”

Dr. Swenson shook her head. “That takes forever, causes a great deal of pain, and half the time it doesn’t work anyway. We’ll do a section.”

Marina removed her hand from the woman. “What do you mean it takes forever? Where do we have to go?”

From her perch on the wooden box Dr. Swenson dismissed the suggestion out of hand. “There’s no point in putting her through all of that if in the end you’ll have to do the section anyway.”

Marina sat back on her heels. “The point is we don’t have anything approaching sterile conditions. The chance of her dying from a postoperative infection is enough to indicate that turning the baby is worth a try. I don’t have a nurse to help me with a surgery, I don’t have an anesthesiologist.”

“Do you think we keep an anesthesiologist around here?”

“What do you have?” Marina pulled off a glove and poked through the bag.

“Ketamine. And don’t go throwing gloves away. This isn’t Johns Hopkins.”

“Ketamine? Are we planning on sending her out to a disco later? Who in the world uses Ketamine?”

“Here’s the news, Dr. Singh, you get what you get, and I was lucky to get that.”

“I’m going to try and turn the baby,” Marina said.

“You’re not,” Dr. Swenson said. “It is enough that I had to go up that godforsaken ladder. I would appreciate it if you did not make me get down on the floor as well. Even if it were possible to take my leg out of the equation, I have edema in my hands.” Dr. Swenson held up her hands for exhibition. Her fingers were swollen out straight and the skin was pulled tight. Ten little sausages.

“Dear God, when did that happen?” Marina reached up for a hand and Dr. Swenson jerked it away.

“I would have a difficult time with the scalpel. I have a difficult time with a pencil. All that said, either you are going to do the cesarean or I am. Those are the choices.”

“What is your blood pressure?” Marina asked.

“I am not your patient,” Dr. Swenson said. “You would do well to keep your attention on what is in front of you.”

The man in the gray T-shirt looked from Dr. Swenson to Dr. Singh, holding his wife’s hand. Clearly, their disagreement concerned him. It did not concern his wife, who took the opportunity to close her eyes for the two minutes she had between contractions. Had someone asked Marina whose opinion was more valuable on the question of whether or not to proceed with a cesarean — the former head of obstetrics and gynecological surgery at Johns Hopkins who had not touched the patient, or the obstetrics and gynecological surgery dropout who was touching her first patient in thirteen years — Marina would cast her lot with the former. Still, being the latter, she was sure she was right, and equally sure she wasn’t about to physically prevent her mentor from taking over the case. That left her one option. “Tell me how to use the Ketamine,” she said.

The Ketamine was put in a syringe, which, once the needle had been inserted into the vein, was taped to the inner arm so that it could be slowly tapped in as needed, and with that tapping the patient ceased to whimper. Marina washed and dried the woman’s belly, straightened out her legs, and, putting on clean gloves, showed her nurse how to hold the skin taut. She had her nurse’s attention now. The woman was wide-eyed and still while Marina slid the scalpel into the skin. Once she felt the knife insert, it occurred to her that this was not her first surgery after so many years. It wasn’t a week ago she had cut through the snake. The subcutaneous fat welled up through the line of the incision like clotted cream dotted with the first bright beads of blood.

That cut, which passed without a sound save a small gasp from the husband, drew the sudden attention of everyone in the hut. Even the old man pulled himself out of the hammock and brought the two children over to see. The other two women, and the man with the knife, all gathered round for the show, leaning forward and pushing a little to get the best view. Marina felt someone’s knees against her back. “This isn’t helping,” she said.

Her nurse, hands steady on either side of the incision, barked out an order, and the circle immediately took one big step back.

“Now we’re looking for the fascia,” Dr. Swenson said. “I didn’t bring my glasses. Do you see it there, under the fat?”

“I’ve got it,” Marina said. She took the nurse’s hands and put a shoehorn in each one. She dug the horns into the incision and showed the woman how to pull. There was the uterus. Despite the drowning flood of adrenaline she recognized it all — bowel and bladder, it was perfectly familiar. Why was that so surprising? She had given up her profession, not her knowledge. Marina, half blinded by her own sweat, turned her face to Dr. Swenson who picked a shirt up off the floor and wiped her down. Dr. Swenson then leaned forward and blotted off the face of the nurse, who was wrestling mightily to keep the cavity open wide with her shoehorns.

“Now take the bladder down,” Dr. Swenson said. “Don’t nick it. You see the bladder, don’t you?”

“I do,” Marina said. It was a miracle to see anything without direct light. She cut into the uterus carefully, avoiding everything that was not meant to be cut, and the blood boiled up into the cistern of the belly. Blood, combined with the great slosh of amniotic fluid, made a dark and raging ocean Marina could not get past. The hot liquid broke over the floor and pooled beneath the doctor and her patient. “How in the hell do you do this without suction?”

“There’s a bulb in the bag,” Dr. Swenson said.

“I need another set of hands.”

“You don’t have them. Make do.”

Marina grabbed at the bulb which shot out of her bloody glove and skidded across the floor where it was caught, like all balls, by a five-year-old boy loitering nearby. “Christ!” Marina said. “At least get somebody to wash it off.”

And Dr. Swenson, without a word, motioned for the bulb to be run through the bucket with soap and water and so it was returned to Marina who used it to pull up a half pint of liquid that she then shot onto the floor beside her. She did it again. There, beneath so many layers, she could see the baby face down, feet to the head, bottom lodged firmly in the pelvis. Marina tried to sit the baby up but it was stuck.

“Lift the breech,” Dr. Swenson said.

“I’m trying,” Marina said, irritated.

“Just tug it up.”

Marina moved the shoehorns to the inside of the uterus and motioned for the nurse to pull, to really pull, which this woman who was herself doomed to a lifetime of constant reproduction did with all her might while Marina reached in and tried to pry the baby out. It was wedged into the mother like a child who had shoved himself into the tiniest cabinet during a childish game and could then not be coaxed out. The muscles in Marina’s shoulders and neck strained, her back pulled. It was a physical test of strength, 142 pounds of Marina Singh against six pounds of baby, and then with a great sucking sound the baby dislodged. The man with the knife put his hand on Marina’s back to keep her from falling over. Red and white and shining, one entire boy flipped over on the mother’s chest.

“Look at that. Could that have been easier?” Dr. Swenson gave a single, decisive clap. “Give the baby to them now. They know all about this.” No sooner were the words spoken than the slippery child was out of her hands, the thick liver of placenta going with him. The entire crowd bore him away, the old and the young made off with the astonishingly new. They had proof of something spectacular happening now. As many births as there had been no one was completely inured to the charms of infants. “Do you remember the rest of it? Massage the uterus now. This is the part I always liked, reconstruction, restoring order to the chaos.” Dr. Swenson leaned forward for a better look. “The baby is gone, he’s someone else’s problem, and you can pay more attention to the details. There isn’t the same sense of urgency.”

From the other side of the room the baby was crying now and the husband, still fixed to his wife’s hand, craned his head towards the sound. “Tap the Ketamine,” Dr. Swenson said. “There’s no point in her waking up now.” Marina suctioned out the belly again and set to work on the heavy stitches, a procedure as delicate as closing a Thanksgiving turkey with kitchen twine. The nurse, so much braver than one would have imagined, moved her shoehorns back knowledgeably while Marina reassembled everything she had taken apart: the uterus sewn, the bladder placed back on top.

“This is a good man,” Dr. Swenson said, nodding to the husband. “He stayed right with her. You don’t see that. They like to go fishing. Sometimes when they hear it was a son they’ll come in for a look, but that’s about it.”

“Maybe it’s their first,” Marina said.

Dr. Swenson shook her head. “I should know that. I can’t remember.”

Marina was making her last knot when the baby was returned. She slid the Ketamine out of the woman’s arm and lay the baby there in its place, though the mother, who was just barely flicking her eyelids, did nothing to hold it. It was a good looking baby, two furry eyebrows and a rounded mouth, swaddled in striped yellow cloth. He gave half a cry and half a yawn and everyone seemed to find this charming.

Marina was stiff coming up off her knees. “See?” Dr. Swenson said, pointing. “It’s hard enough for you.”

Marina nodded, taking off her gloves, and looked at the blood on her arms, the blood on her dress, the tidal pool of blood in which she had been sitting. “Good Lord,” she said. She looked in the bag for a blood-pressure cuff.

Dr. Swenson shook her head. “You don’t realize how much blood there is when you have all those other people waiting there to sop it up for you. This is a perfectly reasonable amount. You wait and see, she’ll be fine. They’ll both be fine.”

The nurse came over and covered the woman with another blanket. “It would be good if we could just move her to someplace that was dry,” Marina said. “I can’t leave her lying in all of that.”

“There are certain things we cannot expect the Lakashi to do,” Dr. Swenson said. “They cannot perform cesarean sections. That is a matter of training and equipment. They do know that a sick woman should not be left to lie on a sodden blanket, and they know perfectly well how to clean up. You will come back tonight and check on your patients, Dr. Singh, and come back again to check on them tomorrow. You’ll see how well they manage without you.”

The woman who had been nursing a baby when they arrived had handed that one off and was now nursing the new one while his mother slept on the floor. The father came to Marina, who was putting the contents of the used surgical kit back in her bag, and very lightly slapped her back and arms with his open hands. Then the others came over, all except the woman nursing and the woman sleeping, and did the same. The two children hit her legs and the old man reached to slap her ears. Marina in turn pounded the back of her nurse who had never flinched or turned her head during the surgery and in return the woman gently slapped Marina’s face with the back of her hand.

“Come now,” Dr. Swenson said. “Once you get started with this it can go on for hours. You’ll come home with more bruises than Easter.”

It took some navigation to get Dr. Swenson down the ladder but there were so many Lakashi waiting for her at the bottom with their arms stretched up that they would have simply caught her had she fallen and borne her aloft all the way back to the lab. She gave herself a few minutes to catch her breath and while they waited a crowd assembled. Clearly the news of their success had spread. The natives made a thick ring around Marina and Dr. Swenson, chattering and clapping their hands together once Dr. Swenson made it clear they were to keep their hands to themselves.

“Everyone is admiring you,” Dr. Swenson told Marina in a raised voice.

Marina laughed. There was a woman behind her holding on to her braid, staking out the territory as her own. “You’re just projecting. You have no idea what they’re saying.”

“I know their happiness. I may not know the details of every sentence but believe me, there are many ways to listen and I’ve been listening to these people for a long time.” The crowd was moving forward and the two doctors moved with them. “They think you will replace me,” Dr. Swenson said to her, “the way I replaced Dr. Rapp. Benoit told them you were the one who killed the snake to save Easter and that you brought the snake back for them. Now they’ve seen you cut out a child and keep the mother alive. That’s a heady business around here.”

“They didn’t see that,” Marina said.

“They most certainly did,” Dr. Swenson said, and lifted up her hand towards the sky. “They were in the trees. The entire surgical theater was full.”

Marina looked around at the faces of all the beaming Lakashi. What would have happened if the woman hadn’t lived? If the child were dead? “I didn’t look up,” she said.

“Just as well, too much pressure. You did a fine job. I could tell you were a student of mine. You made a classic T-incision. You kept the opening in the uterus small. You have very steady hands, Dr. Singh. You are exactly the person I want when I deliver.”

What a thought, delivering the child of the person who taught her to deliver children. “I won’t be here when you deliver,” Marina said, and took comfort in the knowledge. “How far along are you?”

“Just over twenty-six weeks.”

“No, no,” she said. “That’s not even possible. Who were you planning on delivering the baby?”

“The midwife. I’ll be honest, I had envisioned an experience as close to the Lakashi’s as possible, but as time goes by I’m thinking more about the need for a section. I’m doubting that my pelvis will spread. Chewing the Martins does nothing to reverse the aging of one’s bones. I’m going to need a section and there’s no one else here I’d trust for that.”

“Then you’ll go to Manaus.”

“A woman my age can’t go to the hospital to have a baby. There would be too many questions.”

“I would have to think a woman your age couldn’t avoid going to the hospital.” Marina looked at Dr. Swenson and seeing that she wasn’t listening began again. “Even if I was going to be here, and trust me, I’m not, you don’t know what kind of complications you might have. You’re breaking ground here, you can’t just expect to have the baby on your desk. You just saw me perform my first surgery in over thirteen years. That hardly qualifies me to deal with anything that could come up.”

“But you could. I saw you work. At some point I realized I should have made better plans for this inevitability but now you’re here. You’re a surgeon, Dr. Singh, and all the pharmacology in the world isn’t going to change that.” She shook her head. “Pharmacology should be reserved for doctors who have no interpersonal skills or doctors with uncontrolled tremors who are prone to making mistakes. You never did tell me why you changed your course of study.”

Some members of the crowd around them had begun to sing and some others to tap their tongues against their palates, making a noise of cheerful wailing. The children cleared the path ahead like a pack of hungry goats, snatching up every leaf and twig, ripping out vines, knocking down spider webs with a stick, until the trail was as neat as anything found in a national park. “You never told me why you changed yours,” Marina said.

“I had no choice. I saw the work that needed to be done and I had to do it myself. You can’t draw the world a map to this place and have everyone come running in, trampling the Rapps, killing off the martinets, displacing the tribe. By the time they understood what they were doing, it would all be dead. The conditions for this particular ecosystem have yet to be replicated. Eventually, yes, but for the time being if it is going to happen it’s going to happen here. For years my study was strictly academic. I wanted to record the role of Martins in fertility. I had no desire to synthesize a compound. I’ve never believed the women of the world are entitled to leave every one of their options open for a lifetime. I believe it less now that I am pregnant. Give me your hand, Dr. Singh, this leg is killing me. Yes. We can walk a little slower than the rest of them.” With that the Lakashi, who had at times an uncanny ability to understand English, cut their pace in half. “But when I discovered the link to malaria all of that changed. No scientist could be on the threshold of a vaccination for malaria and not make an attempt at it. I’ve been very careful about the people I’ve brought here. They are all extremely committed, respectful. I wouldn’t have any of them take out my appendix, but as far as the drug’s development is concerned they have made remarkable progress.”

“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.