State of Wonder

by Ann Patchett

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

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

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

  Marina nodded.

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

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

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

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

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

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

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

  “With what?”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  “We don’t know,” Thomas said.

  “Who does know? Dr. Swenson knows.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  “I’m a pharmacologist.”

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

  “What’s wrong with his wife?”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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