aFirst time, yes?a Thomas said.
Marina nodded, keeping her mouth fixed to the thermometer.
aAh, very good. Just remember to keep your tongue pushed down. Otherwise you can get splinters.a aAlthough weare geniuses at taking them out,a Nancy said. aPulse sixty-four. Well done, Dr. Singh.a 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. aWait a minute,a she said.
aThe Martins have many purposes,a Nancy said. aFor 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.a aShe still is always giving Dr. Rapp the credit,a Dr. Budi said, not as a correction, simply as a statement.
aIf you look at their notes from that time itas quite clear.a Thomas took a handkerchief out of his pocket and touched it to the corners of his mouth.
aIt wasnat until 1990 that she made the connection between the Martins and malaria,a Nancy said. aAnd that was definitely her discovery. Dr. Rapp was barely in the field by the nineties.a aShe still gives him credit,a Dr. Budi said. aSays he had mentioned it before.a 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. aThis is the greatest discovery to be made in relation to the Lakashi tribe. Not the Rapps or the fertility but the malaria.a aI donat understand,a Marina said, and she didnat, not any of it.
aLakashi women do not contract malaria,a Dr. Budi said. aThey have been inoculated.a aThere is no inoculation for malaria,a 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. aThe 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.a aYou canat be serious,a Marina said, leaning in for a better look. aIs there anything he didnat name for himself?a aThe Lakashi tribe was not a Martin Rapp discovery. If it had been, this place would surely have been Rapptown.a Nancy put a finger just beneath the moth which, like the Lakashi, seemed impervious to the invasions of its privacy. aAgruis 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.a aIn the bark?a 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. aLike the Martins and the Rapps, the purple martinets seem to exist right here. Youall see one in camp from time to time. Theyall 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 havenat isolated the mothsa excretions from the proteins in its larval casing. What we know is that it works.a Dr. Budi wiped an alcohol swab over her own finger and then pricked it herself.
aWhat about the blood samples?a Marina asked. aCan you actually read hormone levels on such a small amount of blood?a aNanotechnology,a Budi said. aBrave new world.a Marina nodded.
aWeave isolated the molecules as they are metabolized in the bark of the tree,a Budi continued, abut weare still charting the impact of the Lakashi saliva, their gastric juices, plasma. What we donat know is what combination of factors is also giving the women protection against malaria.a Marina asked if the men in the tribe were susceptible to malaria and Thomas nodded. aAfter 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.a aSo they arenat actually inoculated. The tree and the moth act as a preventative, like quinine.a Dr. Budi shook her head. aPreventative while breast-feeding, inoculated when eating the bark. The question is why the entire tribe hasnat 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.a aBut how do you know?a Marina asked. Her head was swimming with this. Had they convinced some men to eat the bark? How had they tested the children? aCould you get some of the women to stop eating the bark?a 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.
aThere 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,a Nancy said. aBut because they had already eaten the bark they were inoculated.a aMostly we have experimented on ourselves,a Thomas said.
aWith what?a Dr. Budi looked at her, blinked. aMosquitoes.a aSo what drug is being developed exactly?a 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.
aThere is enormous overlap,a Thomas told her. aIn exploring one we learn about the other. They cannot be separated out.a 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. aIs Dr. Swenson the only one working on the fertility drug?a aThat is certainly her primary project,a Thomas said. aBut we believe the answer to one is the answer to the other.a aItas a lot to take in,a Nancy said. aWe understand that. Just give the bark a try, see what you think. You probably wonat 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.a aIt is an honor,a Dr. Budi said, leaning forward to take another bite herself.
What was it Anders had said to her? aPretend 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.a 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 wasnat bad, but then it couldnat 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. aEnough now,a she said. aToo much at first affects the bowels.a Nancy handed her a swab sealed inside a test tube. aFor later,a she said. aYou could just drop it off on my desk.a Marina touched her fingers to her lips and nodded. aDid Anders come here? Did he try this?a There was a look that passed between the other three, a very brief flash of discomfort. aHe was interested in our work,a Thomas said. aFrom the beginning. He was with us here for as long as he could be.a aI want to see where heas buried,a Marina said, hoping it was here in the field of Martins. She hadnat asked before because she wasnat 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 wasnat here, this is what she would tell her.
aAh,a Nancy Saturn said, pressing the toe of her tennis shoe against the root of a Martin.
aWe donat know,a Thomas said.
aWho does know? Dr. Swenson knows.a After a period of silence it was Dr. Budi who spoke up. She was not one to leave a difficult job to someone else. aThe Lakashi bury people during a ritual. They take the body away, they take the Rapps. It is a private matter for them.a aBut he wasnat one of them,a 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. aIt makes a difference. It makes an enormous difference.a She said it knowing full well it made no difference whatsoever. He was dead and that was all that mattered.
aThey were very fond of Anders,a Thomas said, patting her shoulder. aThey would have given him every care.a aIt was raining hard that week,a Dr. Budi said. aIt was very hot. The Lakashi would not bury him where we asked and we could not bury him ourselves.a aSo you gave him up.a 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. aIt was the only thing Dr. Swenson said in her letter, that he had been buried in keeping with his Christian traditions. I donat 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.a aShe said it to comfort you,a Dr. Budi said.
aLetas go back,a 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 wouldnat and it didnat. 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 didnat think of it at all except as the source of the dull ache in his chest. Marina had to admit she really didnat 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 wasnat anything left to be afraid of.
Outside, Marina heard Dr. Swenson calling her name, and she went and leaned over the porch railing.
aYouave been gone half the morning, Dr. Singh,a 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 couldnat imagine that she had ever missed Dr. Swensonas pregnancy. She was nothing but belly.
aThere was a lot to talk about,a Marina said, and she had every intention of talking to Dr. Swenson about it as well: Andersa 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.
aTalk we will, Dr. Singh. Itas not a short walk. Thereas plenty of time to catch up, but I need you to come with me now.a aWhatas the problem?a 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 wasnat 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 wasnat screaming.
aYouall like this,a Dr. Swenson said, and turned back to the path they had come down. aThis will be right up your alley.a 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. aI know how much youave been looking forward to practicing medicine while youare here. I think weave found you an opportunity.a 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. aI didnat say that.a 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. aYou did. You remember, on the boat. We were discussing the girl with the machete in her head.a aI do remember,a 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 couldnat remember. aI thought it was right for you to attend to the cases that presented themselves.a aThat 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 youall have the chance to bask in its glory.a aIam a pharmacologist.a To the manas great relief Dr. Swenson started walking again. The sun was high and bright and very hot. aYes, well, I canat get on the floor and in this village things happen on the floor, and if youare planning to tell me that they should bring his wife to the lab, Iave already suggested that. She canat 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.a aWhatas wrong with his wife?a 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. aIt has something to do with the birth of a child. If you are ever betting on the nature of a local tragedy youall 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.a aDo you know what this error is?a Marina was walking faster and faster when everything in her was saying she should stop.
Dr. Swenson shook her head. aNo idea.a aBut you said you didnat want to interfere.a 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. aYou distinctly said there was someonea"a aThe county witch doctor, yes. His malaria has flared again. Heas running such a fever weave 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.a aWho told you this? It isnat possible.a aThe 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.a 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. aDr. 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.a aShall we ask the botanist?a Dr. Swenson said sharply. aOr 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 donat I will be standing there reminding you. I cannot get down on the floor anymore. My leg wonat 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.a Marina felt such a sudden weight in her feet that she looked down at them, sure she must have stepped in something.
aCheer up, Dr. Singh. Itas your chance to do good in the world.a Marinaas 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 wasnat 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 wasnat the way it would go.
aYouare very quiet,a Dr. Swenson said. aI 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.a aIam trying to remember how to deliver a baby,a Marina said.
aThe brain is a storage shed. You put experience in there and it waits for you. Donat worry. Youall find it in time.a 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. aWhen 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 donat. 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.a At seventy-three it was hardly a shocking oath to swear. Marina considered the length of Dr. Swensonas arms and legs against the width of her circumference. It did not seem possible. aIs there any way for me to help?a aNot unless you strap me to your back. I believe I can go up but the coming down concerns me. I donat want to get stuck up there and wind up having to give birth in this hut myself.a aNo,a Marina said, though the thought of going up there alone was not without problems.
Dr. Swenson rubbed at her temples. aWhat 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.a The T-shirted man leaned over the floor and looked at them with expectation. aVir! Vir!a he said.
aOh good,a Dr. Swenson said. aHe has a little Portuguese. He says we should come.a She looked up again. aI suppose we should.a aWe also know for certain that none of those women was having her first child at seventy-three,a Marina said. aThey had a lifetime of experience in climbing the ladders, pregnant or not. They were used to it.a Dr. Swenson turned to her and nodded her approval. aWell 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, arenat you?a aVery,a she said. And so they climbed, Marina stretching her long arms around her professor, her hands just beneath Dr. Swensonas hands, her strong thighs beneath Dr. Swensonas thighs, and up they went towards the wretched weeping and the husbandas calls of aAgora.a 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 theyad 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 didnat know if she should first attend to the patient or the doctor, when in fact she wasnat sure she had the skills to help either one of them. aThereas the bag,a Dr. Swenson said, and gave a nod towards the floor. aYouall find what you need. Iall tell you, Iam impressed to have managed this.a She covered her heart with her hand. aI havenat gone up a ladder since this whole ordeal began.a 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. aWhat are these?a aShoehorns!a Dr. Swenson reported happily. aRodrigo got a whole box of them once years ago. They make brilliant retractors.a Marina put the shoehorns in her lap and bowed her head. aHow can I sterilize them?a aHow can you sterilize anything? You canat, Dr. Singh. This is what it is. Go ahead and wash up in the first bucket,a Dr. Swenson said. aIam catching my breath.a 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 wasnat 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, aMarina,a 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 womanas genitals and thighs, bent up her knees and showed the nurse how to hold them. aIt would be nice to have a clean blanket to put her on.a aIf you had a clean blanket you would want a sterile one, and a sterile blanket makes you think you canat 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.a 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. aSheas wide open.a 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 babyas head she was feeling. aItas breech,a she said. It wouldnat have been her first choice but she could manage it. aIam going to have to try and turn it.a Dr. Swenson shook her head. aThat takes forever, causes a great deal of pain, and half the time it doesnat work anyway. Weall do a section.a Marina removed her hand from the woman. aWhat do you mean it takes forever? Where do we have to go?a From her perch on the wooden box Dr. Swenson dismissed the suggestion out of hand. aThereas no point in putting her through all of that if in the end youall have to do the section anyway.a Marina sat back on her heels. aThe point is we donat 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 donat have a nurse to help me with a surgery, I donat have an anesthesiologist.a aDo you think we keep an anesthesiologist around here?a aWhat do you have?a Marina pulled off a glove and poked through the bag.
aKetamine. And donat go throwing gloves away. This isnat Johns Hopkins.a aKetamine? Are we planning on sending her out to a disco later? Who in the world uses Ketamine?a aHereas the news, Dr. Singh, you get what you get, and I was lucky to get that.a aIam going to try and turn the baby,a Marina said.
aYouare not,a Dr. Swenson said. aIt 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.a Dr. Swenson held up her hands for exhibition. Her fingers were swollen out straight and the skin was pulled tight. Ten little sausages.
aDear God, when did that happen?a Marina reached up for a hand and Dr. Swenson jerked it away.
aI 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.a aWhat is your blood pressure?a Marina asked.
aI am not your patient,a Dr. Swenson said. aYou would do well to keep your attention on what is in front of you.a The man in the gray T-shirt looked from Dr. Swenson to Dr. Singh, holding his wifeas 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 cesareana"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 yearsa"Marina would cast her lot with the former. Still, being the latter, she was sure she was right, and equally sure she wasnat about to physically prevent her mentor from taking over the case. That left her one option. aTell me how to use the Ketamine,a 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 womanas belly, straightened out her legs, and, putting on clean gloves, showed her nurse how to hold the skin taut. She had her nurseas 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 wasnat 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 someoneas knees against her back. aThis isnat helping,a 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.
aNow weare looking for the fascia,a Dr. Swenson said. aI didnat bring my glasses. Do you see it there, under the fat?a aIave got it,a Marina said. She took the nurseas 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 alla"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.
aNow take the bladder down,a Dr. Swenson said. aDonat nick it. You see the bladder, donat you?a aI do,a 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. aHow in the hell do you do this without suction?a aThereas a bulb in the bag,a Dr. Swenson said.
aI need another set of hands.a aYou donat have them. Make do.a 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. aChrist!a Marina said. aAt least get somebody to wash it off.a 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.
aLift the breech,a Dr. Swenson said.
aIam trying,a Marina said, irritated.
aJust tug it up.a 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 Marinaas 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 Marinaas back to keep her from falling over. Red and white and shining, one entire boy flipped over on the motheras chest.
aLook at that. Could that have been easier?a Dr. Swenson gave a single, decisive clap. aGive the baby to them now. They know all about this.a 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. aDo you remember the rest of it? Massage the uterus now. This is the part I always liked, reconstruction, restoring order to the chaos.a Dr. Swenson leaned forward for a better look. aThe baby is gone, heas someone elseas problem, and you can pay more attention to the details. There isnat the same sense of urgency.a From the other side of the room the baby was crying now and the husband, still fixed to his wifeas hand, craned his head towards the sound. aTap the Ketamine,a Dr. Swenson said. aThereas no point in her waking up now.a 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.
aThis is a good man,a Dr. Swenson said, nodding to the husband. aHe stayed right with her. You donat see that. They like to go fishing. Sometimes when they hear it was a son theyall come in for a look, but thatas about it.a aMaybe itas their first,a Marina said.
Dr. Swenson shook her head. aI should know that. I canat remember.a Marina was making her last knot when the baby was returned. She slid the Ketamine out of the womanas 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. aSee?a Dr. Swenson said, pointing. aItas hard enough for you.a 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. aGood Lord,a she said. She looked in the bag for a blood-pressure cuff.
Dr. Swenson shook her head. aYou donat 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, sheall be fine. Theyall both be fine.a The nurse came over and covered the woman with another blanket. aIt would be good if we could just move her to someplace that was dry,a Marina said. aI canat leave her lying in all of that.a aThere are certain things we cannot expect the Lakashi to do,a Dr. Swenson said. aThey 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. Youall see how well they manage without you.a 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 Marinaas face with the back of her hand.
aCome now,a Dr. Swenson said. aOnce you get started with this it can go on for hours. Youall come home with more bruises than Easter.a 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.
aEveryone is admiring you,a 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. aYouare just projecting. You have no idea what theyare saying.a aI know their happiness. I may not know the details of every sentence but believe me, there are many ways to listen and Iave been listening to these people for a long time.a The crowd was moving forward and the two doctors moved with them. aThey think you will replace me,a Dr. Swenson said to her, athe 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 theyave seen you cut out a child and keep the mother alive. Thatas a heady business around here.a aThey didnat see that,a Marina said.
aThey most certainly did,a Dr. Swenson said, and lifted up her hand towards the sky. aThey were in the trees. The entire surgical theater was full.a Marina looked around at the faces of all the beaming Lakashi. What would have happened if the woman hadnat lived? If the child were dead? aI didnat look up,a she said.
aJust 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.a What a thought, delivering the child of the person who taught her to deliver children. aI wonat be here when you deliver,a Marina said, and took comfort in the knowledge. aHow far along are you?a aJust over twenty-six weeks.a aNo, no,a she said. aThatas not even possible. Who were you planning on delivering the baby?a aThe midwife. Iall be honest, I had envisioned an experience as close to the Lakashias as possible, but as time goes by Iam thinking more about the need for a section. Iam doubting that my pelvis will spread. Chewing the Martins does nothing to reverse the aging of oneas bones. Iam going to need a section and thereas no one else here Iad trust for that.a aThen youall go to Manaus.a aA woman my age canat go to the hospital to have a baby. There would be too many questions.a aI would have to think a woman your age couldnat avoid going to the hospital.a Marina looked at Dr. Swenson and seeing that she wasnat listening began again. aEven if I was going to be here, and trust me, Iam not, you donat know what kind of complications you might have. Youare breaking ground here, you canat 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.a aBut you could. I saw you work. At some point I realized I should have made better plans for this inevitability but now youare here. Youare a surgeon, Dr. Singh, and all the pharmacology in the world isnat going to change that.a She shook her head. aPharmacology 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.a 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. aYou never told me why you changed yours,a Marina said.
aI had no choice. I saw the work that needed to be done and I had to do it myself. You canat 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 itas 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. Iave 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.a With that the Lakashi, who had at times an uncanny ability to understand English, cut their pace in half. aBut 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. Iave been very careful about the people Iave brought here. They are all extremely committed, respectful. I wouldnat have any of them take out my appendix, but as far as the drugas development is concerned they have made remarkable progress.a aHow do you know it works?a Dr. Swenson used her free hand to pat her stomach. aIn the same way I know the fertility aspects work. I test them. Iave been regularly exposing myself to malaria for more than thirty years now and Iave never had it. Dr. Nkomo, Dr. Budi, both of the Saturns, we all have regular exposures. Iave exposed the Lakashi. I can show you all the data. Itas the combination of the Martin bark and the purple martinets. We know it now. Itas just a matter of replicating it.a aAnd what about Vogel?a Marina asked.
aVogel 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 isnat interested in what can be accomplished. He only wants to see where the moneyas 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 Iave 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 Iave fought the intrusion I can see you have a place here. You get along well with everyone, your health seems excellent, and I think youall be able to soothe Mr. Fox, convince him that things are progressing nicely and weall just need a little more time.a aBut why would I do that? I work for Vogel. Theyare paying out enormous sums to develop the drug that you brought to them, that you proposed. You havenat even told them about the malaria vaccine and that seems to be all youare working on. Why would I want to cover for you?a Marina balanced the weight of Dr. Swenson on her arm. The farther they went the more Dr. Swenson leaned against her.
aIt isnat a matter of covering anything. This isnat 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 Iam interested in personally really doesnat matter when either way we end up in the same place. When we get one drug weall have the other, and I donat 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. Isnat 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.a Marina, as usual, felt that she was five steps behind in the conversation. aIt seems you should give Vogel a chance. You may find theyare as interested in the vaccine as you are.a aYour trust would be charming if it werenat so simplistic,a Dr. Swenson said without a trace of rancor in her voice. aBecause if youare 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.a 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.
aCome to the lab,a Dr. Swenson said, patting the arm that she held with her other hand. aDr. Nkomo will show you our mosquitoes.a aLet me take a swim first,a Marina said. aGet the blood off.a Dr. Swenson shook her head. aUse a basin. Iall 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.a aI went into the river when I had half an anaconda on me,a Marina said, looking down at her dress which had stiffened as it dried.
Dr. Swenson nodded her head. aWeare being more careful with you now.a 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 didnat want to touch anything until shead 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.
Ten.
Every morning Marina extricated herself from the sleeping limbs of the lightly drugged child and took the path to the field of Martins. She didnat 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 hadnat eaten in the past and anticipate the bark she would never eat in the future. This was her moment, the perfect now. She didnat mind making the trip deep into the jungle by herself anymore, though there was never a morning when she didnat 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 theyad 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 wasnat 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 monkeyas 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. Swensonas repeated references to aoura 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.
Marina had never seen the rooms where the other doctors lived. There was a small circle of huts behind the lab but the lab was where they worked and ate and stayed to talk in the evenings. She had known for some time that one of the huts contained the mice that were forced into repeated pregnancies, their heavy bellies bumping against their exercise wheels, and now she knew that another hut was full of mosquitoes. Their larvae grew in tepid water inside of plastic trays that stacked into a tall rack of metal shelving. When they were ready to hatch they were transferred into large plastic buckets with a piece of pantyhose stretched across the top that was held in place by a rubber band. From there the mosquitoes were infected with malaria. It might have been because everyone felt so confident in the success of their vaccinations that they could afford to be so sloppy in their protocol, but when Alan Saturn first showed them to Marina she did not feel comfortable with the hundreds of flying insects per bucket banging their minuscule weight against a web of nylon.
aFeeding time at the zoo,a Alan said, and soaked a large wad of cotton in a cup of sugar syrup. aGo on and give them a taste of what they really want. Breathe on them. Just lean over and exhale.a And so she did, and they flung themselves upward in one ineffectual black fist. Marina stepped back.
aMammalian breath, thatas what draws them. Itas only the females that bite, you know. The males neither contract nor spread the protozoa.a He dropped the cotton onto the hosiery and the mosquitoes went in like sharks for bloody chum. He watched them for a minute. aThey always hold up their end of the bargain.a There were two plastic flyswatters tacked to the wall, their wire handles rusted. aHow do you test yourself?a she asked, not entirely certain she wanted to know.
aWe take five mosquitoes out of the infected bucket,a he said, tapping the lip of the bucket shead just breathed into. aWhen I first came here you should have seen what we went through. Wead put on hazmat suits, seriously, face masks, gloves. As if every tenth mosquito outside isnat carrying anyway. Now I just stick a net in there. I know what Iam doing. I put those five in a cup with a piece of nylon over the top, then I hold the cup on my arm, on my leg, it doesnat matter. When I have five bites I kill the mosquitoes and run them under the microscope on a slide to make sure they were all infected. Thatas pretty much it.a aThatas it?a aWell, then you wait. The malaria will present in ten days. But it doesnat present. It hasnat for any of us.a aSo how can you be certain your mosquitoes are good?a aThe microscope tells us that, and then from time to time we infect one of the men in the tribe from the same batch. Ten days later, clockwork, he has malaria. We bring in some of the women and the same group of mosquitoes can bite them all day long and itas nothing.a Alan was leaning over another bucket. He blew in before giving them the cotton.
aAnd this man who contracts malaria, how does he agree to this?a He stood up and shrugged. aI suppose if this man had a lawyer it could be said that he hadnat agreed, or that he hadnat been made fully aware of what he was agreeing to. Iave got some Cokes in here, I donat tell Annick that. They love them.a aYou give them a Coke for getting malaria?a aDonat make this out to be the Tuskegee Institute. Chances are excellent that these men have had malaria before, or that they would have had malaria eventually. The difference is that when they get it in this room weare also going to cure it. Curing malaria isnat the problem, youall remember; the problem is figuring out a way to vaccinate against it. If they get sick for a couple of days in the name of developing a drug that could protect the entire tribe, the entire world, then I say so be it.a aYes,a Marina said, feeling a little uncomfortable with the argument. aBut they donat say so be it.a Alan Saturn picked up his buckets and began to arrange them on the counter. aItas good to get out of the American medical system from time to time, Marina. It frees a person up, makes them think about whatas possible.a He took an empty plastic cup off the table and held it out in her direction. aDo you feel like trying it? At least you can count yourself as fully informed to all the risks, and you will have saved one unfortunate native from standing in your place. The best part is, all youall wind up with in the end is five itchy bumps.a Marina considered her Lariam, long gone. She considered her father. She looked inside the cup and shook her head. aI think Iall wait.a aResearch doesnat happen in a Petri dish, you know, and mice only go so far. Itas the human trials that make the difference. Sometimes you have to be the one to roll up your sleeve.a But Marina didnat stay. She wanted more bark before she became part of the experiment.
Dear Jim, I see how this could take years, how no amount of time would ever be enough to figure out everything thatas going on here, but Iam going to begin the business of trying to get home. The first thing Iall have to figure out is the boat. Given Dr. Swensonas investment in keeping me I doubt sheall be quick to offer hers. But boats do go by and I know the direction of Manaus. Some days I think Iall see one and swim out to it, and if Easter swims with me then who would stop us?
Marina wrote more letters now. She wrote them every day. Dr. Budi left her pack of stationery open on her desk and Nancy Saturn was generous with her stamps. She would take Easter with her to the river and they would skip rocks from the shore or go for a swim. Boats did go bya"a child in a canoe, a rare river taxi on its way to the Jintaa"but then two or three days would pass with nothing. She made Easter keep watch when she was working, leaving him alone with the letters. It would never have occurred to her that it was possible for the system to work, except that it had worked, Anders had mailed letters, who knew how many letters, and some of them found their way to Karen. Yet as often as she wrote to Mr. Fox she hadnat really told him anything. She hadnat told him about the malaria or Dr. Swensonas pregnancy or Andersa burial. Those things she needed to say to him herself.
Easter and Marina liked the river best at six oaclock when the sun was spreading out long across the water and the birds had just begun to make their way home for the night. They sat on the damp banks, as far away as they could from the heat of the Lakashias fire. It was too early to eat and still she wanted to leave the lab for a while, stretch her legs and roll her neck. Sometimes she would sit for twenty minutes, thirty minutes, and other nights she would stay until it was dark. She had never seen a boat go by once it was dark but it was such a pleasure to sit and watch the hot red ball of the sun sink fully down into the jungle that she made the excuse that one might come. Easter pointed out every fish that broke the riveras surface and she pointed out the bats swimming through the purple evening sky. She had gotten very used to spending her time with someone who said nothing at all. She found that watching the coming on of night without feeling any need to comment on it brought about a sense of tranquility that she had rarely known.
It was in that tranquility a boat was spotted in the distance.
She heard it before she saw it, the sound of a well-maintained engine pushing effortlessly ahead. That was in itself worthy of notice as the boats she was familiar with here came in two varieties: the completely silent canoe/raft/floating bundle of logs, and anything with a grinding motor. She got to her feet with four letters in her hand, one for her mother and one for Karen and two for Mr. Fox. The boat was coming on fast, a small round dot of light fixed to the front that was pointing up river, and Easter, ever the thinker, jumped up and grabbed two long branches from the edge of the fire, one for Marina and one for himself, and they stepped into the water until it was up to their knees and they waved the branches overhead. A boat that fast was surely headed to Manaus eventually, even though it was going in the wrong direction for now. She wanted that boat. She swung the fire over her head and let out a high, bright sound, a sound she never would have guessed she had in her. She hoped it would encompass every language in which the words Stop the boat could be spoken. Whether the people on the boat heard her it would be impossible to say, sitting as they were just on the cusp between near and far, but the Lakashi heard her, and they ran through the jungle faster than any boat could travel and picked the fire apart and lit sticks from one anotheras sticks and then let out a giant howl, their own particular shibboleth, and all of this so Marina could send off her mail. Bless the Lakashi, and for this one night bless them for watching her too closely, because suddenly their shoreline was ablaze and the noise they made was deafening and the boat, which was almost on them now was certainly slowing out on the dark river though it wasnat slowing enough to give the impression of stopping, and Marina, buoyed up on the energy of the people, called out with the lungs of a soprano, aStop the boat!a All sound stopped, the Lakashi startled into a brief silence by the intensity in Marinaas voice, even the frogs and insects for an instant held their breath. She wasnat used to it herself, the power of her own voice, and so in the new silence she called again, aStop the boat!a And the boat, which was past them now, stopped. It turned and slowly came towards the dock, its spotlight sweeping the crowd on the shore slowly, left to right.
aCorrespondncia!a Marina called. She had been reading a Portuguese dictionary at night along with the Dickens. aObrigado, obrigado.a She came out of the water and ran down the planks of the dock, the letters in one hand, the burning branch in the other, and the light from the boat leapt across her and then returned. It hit her squarely in the face and froze her in mid-step. In her own defense she closed her eyes.
aMarina?a a voice asked.
aYes?a she said. Why did this not seem strange, someone calling her name? It was because of the light she could not make sense of what was happening.
aMarina!a The voice was happy now. She did not know the voice, and then she did. The second it came to her he spoke his name. aItas Milton!a The enormity of Marinaas happiness was caught in that light. Of all the tributaries in all of the Amazon he had wandered onto hers. Milton her protector, Milton who would know exactly how to set everything to right. She threw her branch into the water and let out a scream of joy which took the shape of his name, aMilton!a But the scream that met hers was high and entirely female and there bounding over the edge of the boat and into her arms came Barbara Bovender wearing a short khaki colored dress with a stunning number of pockets. Milton was driving the boat for Barbara Bovender! The light of every Lakashi torch was caught in the reflective sheet of her wind-tangled hair. Marina embraced the narrow back of her friend who clung to her neck and whispered in her ear too softly to be heard above the cries of the Lakashi. She smelled of lime blossom perfume.
aHow are you here?a Marina said. There was no sensible way to say ita"how did you find us and why did you come and how long can you stay and will you take me with you when you leave? Easter bounded down the dock on a wave of childlike glee and straight into Barbaraas arms, burying his face in her hair. Marina felt the smallest ping of somethinga"jealousy? That couldnat be right. It was so much to take in and it was all too wonderful and confusing. The Lakashi were continuing to sing and the smoke from all the fires was as blinding as the spotlight from the boat. Marina was climbing over the edge of the boat to throw her arms around Milton, her feet bare, her dress torn at the left side seam, her hair neatly combed and braided because she had been sitting for a long time watching the sunset. She put out her arms to Milton and he took her hands, his arms out straight, and turned her entire body so that she could see there was in fact a third person there, and because that person was not catching the light it took her a moment to understand. It should have been Jackie and it was not Jackie.
aMarina,a said Mr. Fox.
It was just that one word, her name, and suddenly she was certain of nothing. Could she embrace him? Did they kiss? In the torch light she could make out that all three of the visitors wore a similar expression, a look that was hollowed out and exhausted, possibly terrified, a look that Marina no doubt must have had on her own face that first night she came down the river to see the burning Lakashi torches. The other doctors would be walking down from the lab by now. They would have heard all the ruckus and come to see why this night was different from all other nights. Could she kiss Mr. Fox in front of Dr. Swenson? In front of Barbara Bovender? She had never mentioned that part to any of them, that Mr. Fox was the person in all the world she kissed. aIave been writing to you,a she said, and held out the letters to him like a defense. He was wearing a white cotton shirt like Miltonas and she wondered if he had come down in a wool suit. Had Milton taken him to Rodrigoas late at night to buy him clothes? aI was flagging down the boat to see if it would take my letters to you.a He took the letters. He took her hand.
aI havenat had any letters,a he said. His voice was hoarse. aI havenat heard from you.a The time she had been gone had aged him, the boat trip had aged him. How long had he been in Brazil? How long had it taken him to wear the Bovenders down? aI didnat know what had happened to you. Are you hurt?a aIam fine,a Marina said.
aThereas blood all over your dress.a Marina looked down and sure enough there was, but she couldnat remember who it once belonged to or how much of it was just a stain she hadnat been able to scrub out. The Lakashi were coming on board now and they grinned as they slapped Mr. Fox who flinched at first and then raised his hand in what appeared to be self-defense. Marina pulled him back. They were slapping Milton and Barbara Bovender, pounding out their particular and aggressive form of welcome. Already two women had their hands deep in the white gold of Barbaraas hair and she struggled hopelessly to get away. A suitcase was held aloft and then passed overhead and Marina leapt up to grab it. aMilton!a she called out, adonat let them take the bags!a Milton managed to wrestle the remaining duffels and totes away from the natives. He waved to Easter, who came on board and gave Milton a hearty slap at the waist and then began to loop his arms through the various handles of bags.
Marina took Mr. Foxas hand and held it tightly. aWe have to keep an eye on Barbara. She wonat be able to manage this.a aI wouldnat worry about Mrs. Bovender,a he said in a flat voice. This was not the reunion they were supposed to have. She wished he would have waited in the Minneapolis airport for her to come back. It wouldnat have been too much longer. Once they were on the dock he let go of her hand. Maybe it wasnat a good thing the boat had come at all. There was no aligning Minnesota to Amazonia. There was no explaining one world to the other. Dr. Swenson was walking towards them.
aEnough of that,a she said, clapping her hands. aLeave her alone now.a The two Lakashi women who fought over Barbaraas hair had settled their differences, leaving her in under a minute with two long braids already tied off at the ends with pieces of thread pulled from their own dresses. Dr. Swenson walked by Barbara with barely a glance. aWeall be talking about this,a she said as she passed, and Barbara dropped her head. When she got to the end of the dock her full attention turned to Milton. aWhose boat is this?a aIt belongs to a friend of Rodrigoas,a Milton said.
aRodrigoas friends donat have money like this.a aOne of them does,a Milton said. aThe man who bottles Inca Cola. Rodrigo sells it in the store.a Dr. Swenson nodded. aDid you bring supplies or only guests?a aRodrigo put together a list of what you must need by now, plus some things youall like. He had just gotten in a full case of oranges and he sent them all to you. I think he did a very good job.a Having dealt with two of the travelers, she turned to the third. aYou no doubt moved heaven and earth for this, Mr. Fox.a Mr. Fox stood on the dock and stared at Dr. Swenson and stared at the entire flaming tableau that spread behind her. A bat spun down perilously close to the top of his head and he did not flinch. aWe have had a difficult trip. There is clearly a great deal to discuss, including the heaven and earth I have moved, but for now you should tell us where we will be sleeping.a aI donat know where youall be sleeping,a Dr. Swenson said, making no concessions to civility. aWe are working here, not running a Hyatt.a The Lakashi, sensing there was no further call for celebration, began stacking their burning sticks into a single raging bonfire that threatened to spread to the dock they were standing on. Thomas Nkomo stepped forward, waving his hand and bowing quickly to the guests. aLet us work this out away from the fire,a he said calmly. aWe will make sure everyone is accommodated.a Once he had herded them gently to shore he told Barbara Bovender that she would follow Marina, and Mr. Fox would bunk with him, and Miltona"
aI can sleep in the boat,a Milton said.
Thomas shook his head. aThere is a cot in the lab near Dr. Swensonas station. She will be happy to have you sleep there for tonight.a aLetas leave your assumptions of my happiness out of this,a Dr. Swenson said. As she turned and walked back up the dock, Marina could see that Dr. Swenson was limping badly and wanted to go to her and lend her an arm, and she wanted to go with Mr. Fox because Thomas of all people would give them a moment together without asking questions, but instead she took Barbara Bovenderas hand and led her through the jungle towards the storage shed.
aDo you know where weare going?a Barbara asked.
aI do,a Marina said.
Jackie had left for Lima five days before, this being the season when the surf rose along the Peruvian coast with such ferocity that it cleared the lesser surfers from the beaches and brought forth the greater ones from other continents. The Bovenders had talked it over at length and decided this would be a good time for both of them. Barbara could work on her novel and he could spend a couple of weeks curled in the lip of a giant wave. aWe went over everything that could possibly happen and decided there was nothing that I couldnat handle myself.a She was sitting in the chair on top of Marinaas extra dress. She closed her eyes and shook her head. aWe didnat take Mr. Fox into account. I told him I didnat know where Annick was. That lasted about three minutes.a aHeas better at it than I was.a Mrs. Bovenderas blue eyes went round at the thought of it. aHeas better at it than anyone. Vogel holds the lease on the apartment. He said I would be on the curb in an hour. He got Milton, Milton got the boat. I said, fine, good luck, and then he said I was coming with them. Miltonas never been out here before and Iad only come with Jackie. Half the time I came with him I was asleep. Jackie gets seasick unless heas the one driving the boat. I was supposed to tell them how to get here? Oh God, it was awful, wead pass one river and then Iad start to think a half an hour later that that was the river we were supposed to turn on.a aBut you got them here,a Marina said. She wasnat sure she could have done it.