State of Wonder

by Ann Patchett

  And Dr. Swenson said, she was very clear on this, that Marina was to wait. She was not to do the section without her.

  “Can you see anything down there?” asked the man in the suit.

  “No,” Marina said.

  “I don’t know how you can stand it. Me, I can’t do the window seat. If it’s all they’ve got I pull the blind. I tell myself we’re in a bus. I used to not be able to fly at all and I went to a class where they taught us to hypnotize ourselves into thinking we were on a bus. It works as long as I have a drink. Do you want a drink?”

  Marina shook her head.

  “Part of the paper?”

  Marina looked at him. He was pale with high red cheeks, a fellow traveler who wanted her to ask him why he was flying to Miami and if that was his final destination. He wanted her to tell him she was going on to South America so that he could be impressed and ask her what she planned on doing there, and she would do none of that. She would do nothing for him.

  She had done C-sections before but on that night she was told to wait and monitor and call back in one hour if there was no improvement. The fetal heart rate dropped and climbed, dropped and climbed, and still the patient wasn’t dilated. Marina paged Dr. Swenson the second time, and she waited and waited but there was no call back. When she looked at the clock she realized that only forty-five minutes had passed, not an hour. The rules were intractable. She had not followed the rules. It was exactly the thing Marina had always admired about Dr. Swenson until she was the one trying to get her on the phone. The patient was a talker, and they had time to talk. She said she was exhausted but that it wasn’t so much the labor. She said her two-year-old had kept her up all night the night before with an earache. Her husband had dropped her off in front of the hospital. He was driving their girls out to his mother’s and that was two hours away. Two hours out and two hours back but at the rate she was going he’d be there for the birth so she said she didn’t mind waiting. She wanted him there. He had missed the first two, circumstances, she said, not his fault. Her voice was strong, louder than it needed to be in the small room. “You always forget what childbirth is like,” she said, “but I don’t remember it being this hard.” Then she laughed a little and said, “That’s the whole point, right? You don’t remember, because if you did remember no one would ever have kids again and then what would happen? That would be the end of everything.” It was one thirty. It was two. It was three. No calls were returned. Marina delivered two other babies while the woman waited and both of the births were so easy they hadn’t needed a doctor at all. Women for the most part knew how to push out an infant. Even when they didn’t know there was no stopping them. Marina went back to check on the woman again. The doctor was terrified, the patient was patient. Back in the days when Marina played this film in her head every hour, waking and sleeping, this was the part she watched most carefully. She slowed down the tape to a crawl. She looked at every frame separately. She was not terrified that the patient would die or that she would lose the baby, she was terrified that she was doing something wrong in the eyes of Dr. Swenson. She was thinking that if she had followed instructions and waited another fifteen minutes to call the first time then none of this would be happening. Surely she had learned her lesson now. Surely Dr. Swenson was almost there. The nurses understood all of this. Even as they were prepping the patient for surgery and calling the anesthesiologist to wake him up they were saying, We’re just getting things ready for Dr. Swenson so she can walk right in. Marina should have called another doctor but she never even thought of it. She had stretched the time out too far trying to cover herself. If she hadn’t waited so long, if she hadn’t waited until everything was crashing and there was no other choice but to go ahead, she would have taken more time.

  The plane dropped sharply and then righted itself. It was an air pocket, a blip, but for a split second every person on the plane heard the same voice in their head, This is it. The man in the suit grabbed her wrist, but by the time his hand was on her arm it was over, forgotten, everything was fine. “Did you feel that?” he said.

  She hadn’t started in the right place. The deeper truth of the story was someplace years before this, at the beginning of her residency, or in medical school that first day of class when she saw Dr. Swenson down in the pit of the lecture hall. There were no words for how much she admired her, her intelligence, her abilities as a doctor. All of the students did. In every moment Dr. Swenson’s students were eager and anxious. She didn’t bother to learn their names and yet they lived their lives to the letter of her law. She was harder on the women in the group. She would tell them stories of her own days in medical school and how when she came along the men knit their arms together to keep her out. They made a human barricade against her, they kicked at her when she climbed over them, and now all the women were just walking through, no understanding or appreciation for the work that had been done for them. It wasn’t that Marina had ever wanted to be like her, it wasn’t in her. She had just wanted to see if she was capable of spending five years of her life living up to Dr. Swenson’s standards, and she wasn’t. All of a sudden she felt drunk. Somewhere very far away she could feel the presence of a man beside her. He had let her go. She could never have told this story to Anders, even if it would have put him on his guard, even if that might have been the thing to save his life. He had three sons of his own, after all. The skin of the patient’s belly was stretched to the point of startling thinness, like a balloon that had been blown up too far. Marina remembered there was a sheen to it. She cut the skin, dug through the fat for the fascia. She had thought there was no time left. Her hands were working at triple speed, and there was the uterus. She thought that she was saving the baby’s life because she was so fast, but the instant she realized he was occiput posterior, looking straight up, the blade had caught his head right of center at the hairline, cutting until she stopped in the middle of his cheek. It used to be that she could feel it in her own face, the straight incision, the scalpel slicing through the eye. The child’s father could feel it when he came back to the hospital that night to find his wife sedated and his son scarred and blinded in one eye. Marina met him in the hallway and told him what she had done. She saw him flinch in exactly the way she had flinched. He was not allowed to see the baby then. The specialists were already working but some things cannot be set to right.

  They did not terminate her residency. Marina remembered this with no small amount of wonder. When all of it was over and the lawsuit was settled, she was allowed to go back. The patient had liked her, that was the hell of it. They had spent the whole night together. She wanted the settlement money but she didn’t want Marina’s head on a pike. She said that other than that one mistake she’d done a good job. That one mistake. So Marina was left to mete out a punishment for herself. She could not touch a patient or face her classmates. She could not go back to Dr. Swenson, who had said in the deposition that the chief resident had been instructed not to proceed alone. Over the three hour period the fetal heart rate kept getting lower but every time it reversed. It kept coming up. Maybe in another hour or two she would have dilated. Maybe in another ten minutes the baby would have died. No one knew the answer to that. Marina was a sinking ship and from the safety of dry land Dr. Swenson turned her back and walked away. Marina suspected in the end Dr. Swenson had no idea who she was.

  Anders was never going to stay home. Not when there was a chance to leave in the winter and see the Amazon, to photograph the crested caracaras. And anyway, he had already left, he was already dead, she was flying to Brazil in hopes of finding out what had become of his body. She had been up all night with the patient, she had been up all night blinding the child, and now her eyes dropped, opened, dropped. This was the cost of going to find Dr. Swenson: remembering. She went to the lab at Vogel even though she had promised the man beside her on the plane that she would not. She went down the dark hall to their dark lab and there she picked up the pic
ture of the Eckman boys that sat on Anders’ desk, all three of them caught in a fit of hilarity that would hereafter be thought of as belonging to another lifetime. The picture, whose small subjects were so incandescent they seemed to throw off a little light of their own in the dark room, was in her hands when the door opened again. Anders had forgotten what this time? Wallet? Keys? It didn’t matter. She only wanted him back.

  “Come now, Mari,” her father said. “It’s time to go.”

  It was so perfect that Marina nearly laughed aloud. Of course he was there now, of course. There was a part of the dream that did not follow her into waking—this part—where her father comes into the room and says her name. The part when they are together for a while, the two of them, before things go wrong. The way things ended always obliterated the genuine happiness that had come before and that shouldn’t be the case. The truth was so much more complicated than that. It was made up of grief and great rewards and she needed to remember all of it. “I was looking at this picture,” she said, and held it out to him. “Aren’t these handsome boys?”

  Her father nodded. He looked good in his yellow kurta and pressed trousers. He looked fit and rested, a braided belt circling his trim waist. Marina hadn’t thought of it before but they were very nearly the same age now. She understood it was the business of time to move forward but she would have been glad to stay exactly in this moment.

  “So you’re ready?”

  “I’m ready,” she said.

  “Good, alright then, hold on to me.” And he opened the door and they stepped out together into the empty hallway of Vogel. For a moment there was a wondrous quiet and Marina tried to appreciate it while understanding that it couldn’t last. One by one the doors opened and her colleagues came out to meet her father and shake his hand and behind them came Indians, more and more of them, until it felt like all of Calcutta was pouring in beside them, raising their voices over the din of other people’s conversations.

  “I know where the staircase is,” Marina said into his ear. “We can get there.”

  Her father couldn’t hear her, it was simply too loud. They pressed ahead, holding on to each other for as long as was possible.

  Three

  The minute she stepped into the musty wind of the tropical air-conditioning, Marina smelled her own wooliness. She pulled off her light spring coat and then the zippered cardigan beneath it, stuffing them into her carry-on where they did not begin to fit, while every insect in the Amazon lifted its head from the leaf it was masticating and turned a slender antenna in her direction. She was a snack plate, a buffet line, a woman dressed for springtime in the North. Marina handed over her passport to the man at the desk whose shirt bore all the appropriate badges and tags of his office. He looked hard at her picture, her face. When asked, she said she was visiting Brazil on business. While her planned response to the question “How long will you stay?” was two weeks, she changed her mind just as she opened her mouth.

  “Three weeks,” she said, and the man stamped an empty page in a booklet filled with empty pages.

  Marina squeezed into place at the crowded baggage carousel and watched the river of bundled possessions flow past. Such enormous suitcases piled on top of one another like sandbags ready to stem a rising tide. Marina waited and watched for her own unassuming luggage, looking away only long enough to help a stranger drag a foot locker to the floor. She thought of Calcutta, the madness of the baggage claim that gave only the slightest preview to the madness of the streets outside. She and her mother and father were alone together among the thronging masses, her father shepherding them from the path of young men with roller carts. Sari-wrapped grandmothers guarded the family luggage by sitting on top of it, zippered soft-sides that strained to open against a series of exterior belts. Marina shook the image from her head, turning her full attention to the scene at hand. She tried to stay hopeful through the dwindling: the suitcases, the crowd, one by one they all left. A pair of child’s swim goggles remained on the belt and she watched them pass again and again. She made a mental list of the items a smarter person would have kept in a carry-on: the dictionary, the zippered bag with the phone, the Lariam, which was in a trash can in the Minneapolis–St. Paul airport.

  The unhappy people who crowded the office of lost luggage pressed against the stacks of unclaimed suitcases and together they raised the temperature in the little room some fifteen degrees beyond the heat in the vast cavern of baggage claim. A small black metal fan sat on the desk and stirred hopelessly at the air in a two foot radius. One by one they approached the girl at the desk, making fast conversation in Portuguese. When Marina’s turn came she handed over her ticket and the address of her hotel without a word, and the girl, who had had more than a little experience with these situations, pushed forward a laminated sheet of pictures of various bags. Marina touched the suitcase that most resembled hers. The printer churned out a piece of paper that the girl then handed back to Marina, circling a phone number and a claim number.

  Marina went past security and customs and stepped out into the lobby full of people who were looking behind her. Young girls stood on their toes and waved. Taxi drivers hustled for fares, cruise directors and Amazon adventure guides herded their charges into groups. An assortment of cheap shops and money changing stations vied for attention with bright colors and brighter lights, and right in the middle of everything stood a man in a dark suit holding a neatly lettered sign with two words:

  Marina Singh.

  So certain was Marina Singh that she was alone in this world that the sight of her own name written in a heavy black marker and properly spelled (how rarely anyone found the energy to include that final “h”) made her stop. The man holding the sign appeared to see everything, and though there were easily five hundred people to choose from, he very quickly turned to her. “Dr. Singh?” he said. He was quite far away. She did not hear her name as much as see it shaped by his lips and she nodded. He walked towards her and the sea of life parted easily around him. He held out his hand. “I am Milton.”

  “Milton,” she said. She had to remind herself that an embrace was not in order.

  “You are quite late. I was concerned.” And he looked concerned. His eyes peered into hers for any sign that things had not gone well.

  “My luggage was lost. I had to go to the claims office. To tell you the truth, I didn’t know that anyone would be here to meet me.”

  “You have no luggage?” Milton said.

  “I have an overcoat.” She patted at the coat and saw that one sleeve was almost to the floor. She pushed it back in the bag.

  On his face she saw a look of sorrow and responsibility. “You’ll come with me?” He took the small bag from her and put his hand very lightly on her upper arm, moving her a few steps backwards into

  the crowd.

  “I filled out all the forms,” she said.

  He shook his head. “We must go back.”

  “But we can’t go back through security.” To move backwards through a security door, a door clearly marked to indicate that all traffic flowed in one direction, was as likely as going back in time, but there was Milton, his hand now resting on the shoulder of the security guard. He leaned his body slightly forward and whispered something to the man with the gun and the man with the gun held up his hand to stop the people who were pouring ahead to let Milton and Marina through. They walked the wrong way through customs where a man in uniform had two hands deep inside a woman’s purse. He then held out one of those hands to Milton and Milton shook it as they passed.

  “I’ll need your paper,” Milton said to Marina, and she handed it to him. Already they were moving past the carousels. They stepped into the claims office which was now crowded with different people who had lost their luggage on later flights. They pushed against one another, angry and sad, thinking they had been the only ones.

  The girl working behind the desk saw them, or sense
d them, as soon as they stepped inside the door and she raised her head. “Milton,” she said, smiling, and then she was off on a tear of Portuguese. Marina put together the girl’s opening and then lost the thread—“Isso é um sonho.” The girl waved them up to the front where she and Milton began a conversation in passionate animation. When a man who had waited more than an hour for a word of recognition began to protest, the girl made a clucking sound with her tongue and silenced him. Milton gave her the computer printout and she read the report she had typed up herself as if it were a document of compelling mystery, then let out a long sigh. From his wallet Milton took a business card and quickly folded a bill around it, talking, talking. The girl took it from him and he kissed the tips of her fingers. She laughed and said something to Marina that may or may not have been lurid in nature. Marina looked back at her, dumb as a sock.

  The outside air was heavy enough to be bitten and chewed. Never had Marina’s lungs taken in so much oxygen, so much moisture. With every inhalation she felt she was introducing unseen particles of plant life into her body, tiny spores that bedded down in between her cilia and set about taking root. An insect flew against her ear, emitting a sound so piercing that her head snapped back as if struck. Another insect bit her cheek just as she raised her hand to drive the first one away. They were not in the jungle, they were in a parking lot. For an instant the heat lightning brightened up an ominous cloud bank miles to the south and just as quickly left them in darkness.