This is a preview of my forthcoming novel, which will be released on October 7th. It will be available in hardcover, paperback, and Kindle from Amazon here.
1
“You are not pregnant.”
Words any woman would be ecstatic to hear. Unless, of course, for some reason she had been hoping desperately to hear the opposite.
The woman sitting across from Dr. Seth Michaud in his office at the Home Harmonix clinic just so happened to fall on the latter end of the spectrum, so that even before he had uttered these four simple words, a single stream of tears departed her left eye, traveling swiftly over the still landscape of her face. She must have already divined what Seth was going to say, either through intuition or by reading the involuntary microexpressions that had manifested on his face in preparation to deliver the news: those tense, twitching signifiers of reluctance, sympathy, and duty. (Had he drawn too heavy a breath before his delivery? Blinked too slowly, leaving the lids closed for a fraction of a second too long? Failed to smile as she entered his office, or touched her too furtively on the shoulder while guiding her to her seat? Waited too long to speak?) She had come straight to his office from the gynecology wing down the hall, where a post-insemination ultrasound scan had revealed all. Her name was Olivia Witten, and no, despite all the money, time, and hope she had invested in a medically assisted pregnancy—to say nothing of the rather astronomical added cost of fine-tuning the genetic makeup of the embryo—she was most definitely not pregnant.
Or “no longer pregnant” is what he should have said. She had been pregnant, and yet now she was not. A mystery, insofar as she claimed not to have experienced a miscarriage: no sudden spasm of abdominal cramping, no bloody knickers or bedsheets. Where could her child have gone, then? Had it somehow been reabsorbed into her body—or could it have sublimated into thin air? Her questions were a ruse, part of her denial; no pregnancy as advanced as hers misfires without acute trauma. She was lying, Seth knew. She must have miscarried. And yet a cursory examination had revealed no clear cause: no uterine scarring, no sign of infection. Miscarriages had long been a rare occurrence, although still a statistical inevitability. The possible factors involved were staggeringly multivariate, from diet and sleeping patterns to disease and hereditary defects; sometimes the cause was beyond the ken of even the most invasive tests. Seth could tell Mrs. Witten what had happened—but they would probably never know why. Her tears, then, were more than justified.
Tears or no tears, a miscarriage is a miscarriage, there is nothing to be done about it, no popping the bun back in the oven. Home Harmonix had upheld their end of the bargain: The in vitro procedure had produced a viable zygote. That is, the controlled petri-dish fertilization of one of Mrs. Witten’s ova in a solution rich with her husband’s sperm had finally, against unknown odds, produced life—a life that her body had rejected in the seventh week. Given that she was otherwise as healthy as could be, deeper insight into the tragedy would best be obtained by following up with the clinic’s chief genetic engineer, Dr. Maria Greenberg—or, if Mrs. Witten was a woman of faith, with God. As the clinic’s resident psychologist, Seth really understood only the broad strokes of assisted reproductive technology and genetics, he played no technical role in any of the fertility or gene-editing treatments, it merely fell to him to guide his clients through the ethical quandaries and emotional oscillations resulting from whichever one of the wide range of Home Harmonix services they had purchased. He liked to think that he had been selected to interface with the clinic’s clientele on the strength of his PhD from Stanford alone, but he was no fool: He was a blue-eyed, blond-haired Adonis to whom the entire staff of various geniuses and technicians had offloaded all customer contact just as soon as he’d assumed the role.
He removed a package of tissues from a drawer, pushed it toward Mrs. Witten. She took one and carelessly wiped her cheek. No more tears followed. She looked down at the tissue crumpled in her hand. He noticed she was straining to avoid looking at the picture of his daughter on his desk, upon which she had commented favorably on previous sessions; he had placed it there not so much as a reminder to himself why he bothered to go on living but as a conspicuous signal to clients that he had skin in the game.
The picture only mocked Mrs. Witten now. She tried to speak. “What else . . . ?” Her voice cracked, the words catching in her parched throat. Seth removed a small plastic bottle of water from another drawer, twisted off the cap, and set it before her. She sipped timidly and, with a thankful glance, tried again: “What else can we do?”
The question merited careful circumspection. Some of her husband’s sperm sample remained. The first problem, as Dr. Greenberg had expressed it, was that the diminished sample carried diminished odds of success. Which would not have been much of a problem at all if not for the second problem: Mrs. Witten’s husband was dead. He had died in an auto accident, killed by a drunk driver, hardly a month after their first visit to the clinic and mere days after they’d placed their order. The legality of using the man’s sperm in absentia was a bit on the gray side—but who would dare prohibit it? Surely the man’s surviving kin would not wish to see his line ended on a petty technicality.
Given the decreased probability that another simple IVF would succeed, the obvious next step, Seth explained, was a procedure called intracytoplasmic sperm injection, in which a single one of Mr. Witten’s sperm would be injected directly into one of Mrs. Witten’s eggs. “If and when you feel ready to try again,” he added.
A redoubled flood of tears and snot seemed imminent. But no, she held it in, sighed instead. “I’m ready now,” she said.
“You’ll take some time, of course,” Seth urged. “To process, to grieve.”
Her face contorted with fright at the prospect. “How long?”
“We’ll see what your ob-gyn thinks about it.”
“And if this . . . intravenous sperm whatever—”
“Intracytoplasmic sperm injection. ICSI for short.”
“Right. If it doesn’t work . . . ?”
Glancing at her file once more, Seth reminded himself that she was thirty-eight—that is, well into the twilight of her fertility, a handful of years out from the ethical event horizon, beyond which only increasingly outlandish perversions of the natural order could hope to give her a healthy child. If an ICSI were to fail—due, for example, to some undetected problem with her gametes on a chromosomal level—she might prove eligible for in vitro gametogenesis, a procedure by which somatic stem cells harvested from her bone marrow could be reprogrammed into healthy egg cells. Even so, the procedure was prohibitively expensive, and it would not come with a guarantee; there was no reason to believe blindly that her body would accept this high-tech embryo where it had rejected others. (Seven others, Seth reminded himself with a glance at his notes.) Plainly put, this woman’s options were dwindling.
She took another tissue, dabbed at her nose. “I’m running out of time,” she said. “And money.”
“Those are factors,” Seth conceded, “but there’s still plenty of cause for hope.”
“Is there?”
“You mentioned that your husband was an only child, and that his parents are willing to spare no expense to produce an heir.”
Mrs. Witten sniffed, squeezing her eyes shut. “I can’t ask them for money. Not again.”
“There’s no shame in it,” Seth said. “Asking for help is difficult. We’re prideful creatures. But you have to remember that our capacity to lend help is one of the only things that makes us human.”
She looked up at him with a fragile smile. Because he was handsome (add to the fine blond hair and pale blue eyes a bold and lightly stubbled jaw), his assertion landed with extra gravity, like a benediction from a priest. At last, another stream of tears went gliding down her left cheek. (A woman who cried with only one eye while still smiling; how peculiar.) As Seth nudged the tissue box yet closer to her, he noticed that only her lips moved to produce the smile while the rest of her face remained taut, frozen, like the eerie visage of an alien world glimpsed from orbit. In temperament, she did not strike him as a likely habitual abuser of Botox; then again, it was a common practice among the women (and some men) who could afford even the base tier in the pyramid of Home Harmonix services. It was not even unthinkable that within a few years, the clinic would diversify to offer Botox as an in-house supplement to the premium tier, alongside deep tissue massage, stem-cell injections, and pre-implantation yoga. With the success of the inaugural Home Harmonix clinic, the proof of concept, its Phase B was all but set to roll out in several other cities, trading in the standard fertility clinic model for the concept of the spa. In his additional role of liaison to the out-of-house marketing firm, Seth had already seen some early proofs of the brochures.
Balance. Harmony. Family Now.
There was nothing more he could do for this woman today. Which didn’t always prevent him from trying. “Do you have a good support network?” he asked.
“I do,” she said. Her gaze became suddenly intense. She told him that she attended an infertility support group. They met every week in the basement of the Providence Center for the Visual Arts, formerly the Cathedral of Saints Peter and Paul. They would meet that night, in fact, at five. With a strange lilt of reverence in her voice, as if indeed she were appealing to a higher authority, she asked Seth if he would come and speak.
His immediate inclination was to scoff. But why? Probably because he tended not to think of himself as especially helpful—more as a superfluous cog in a preposterous machine. Which, of course, he could never say to her—nor, for that matter, to anyone else.
She could see that he needed a push, and she rose to the challenge. “I just think that if the group could hear about the work you do here . . . the work you’ve done with me . . . it might give them some hope.”
“I’ll talk it over with my wife,” he said.
She gave a little start, as if jolted by the news that he was married, as if she had never noticed his silver wedding band. To be fair, there was no picture of his wife on his desk, only his daughter, which might have led Mrs. Witten to assume they were divorced, or at least separated. She looked at the ring, at the picture, at the floor. “Please do,” she said.
He rose from his chair and, guiding her to the door, reminded her in a gentle tone that an IVF failure was not a defeat—“Just a bump on the road.” He kept his next thought to himself: that she should prepare for the very substantial possibility that the medical and genetic sciences alike would fail her, that soon it might happen that her only recourse to becoming pregnant would be prayer. Was she already a woman of faith? Or would she convert in her darkest hour? It hardly mattered. Whether she prayed several times a day on her knees or never gave a single thought to the mysteries of Creation, she was in for a long winter.