by Paolo Bacigalupi
Readouts glow blue on driplines where they burrow into Maya Ong's spine. She lies on the
birthing table, her dark eyes focused on her husband while I sit on a stool between her legs and
wait for her baby.
There are two halves of Maya. Above the blue natal sheet, she holds her husband's hand and sips
water and smiles tiredly at his encouragement. Below it, hidden from view and hidden from
sensation by steady surges of Sifusoft, her body lies nude, her legs strapped into birthing stirrups.
Purnate hits her belly in rhythmic bursts, pressing the fetus down her birth canal, and toward my
I wonder if God forgives me for my part in her prenatal care. Forgives me for encouraging the
full course of treatment.
I touch my belt remote and thumb up another 50ml of Purnate. The readouts flicker and display
the new dose as it hisses into Maya's spine and works its way around to her womb. Maya inhales
sharply, then lies back and relaxes, breathing deeply as I muffle her pain response in swaddling
layers of Sifusoft. Ghostly data flickers and scrolls at the perimeter of my vision: heart rate,
blood pressure, oxygenation, fetal heart rate, all piped directly to my optic nerve by my
Maya cranes her neck around to see me. "Dr. Mendoza? Lily?" Her words slur under the drugs,
come out slow and dreamy.
"I can feel it kicking."
My neck prickles. I force a smile "They're natal phantasms. Illusions generated by the gestation
"No." Maya shakes her head, emphatic. "I feel it. It's kicking." She touches her belly. "I feel it
I come around the natal sheet and touch her hand. "It's all right, Maya. Let's just relax. I'll see
what we can do to keep you comfortable."
Ben leans down and kisses his wife's cheek. "You're doing great, honey, just a little longer."
I give her hand a reassuring pat. "You're doing a wonderful thing for your baby. Let's just relax
now and let nature take its course."
Maya smiles dreamily in agreement and her head rolls back. I let out a breath I hadn't known I
was holding and start to turn away. Maya lurches upright. She stares at me, suddenly alert, as if
all the birthing drugs have been lifted off her like a blanket, leaving her cold and awake and
Her dark eyes narrow with madness. "You're going to kill it."
Uh-oh. I thumb my belt unit for the orderlies.
She grabs Ben by the shoulder. "Don't let her take it. It's alive, honey. Alive!"
She yanks him close. "Don't let her take our baby!" She turns and snarls at me. "Get out. Get
out!" She lunges for a water glass on her bedside table. "Get out!" She flings it at me. I duck and
it shatters against the wall. Glass shards pepper my neck. I get ready to dodge another attack but
instead Maya grabs the natal sheet and yanks it down, exposing her nude lower half splayed for
birth. She claws at her birth stirrups like a wolf in a trap.
I spin the dials on my belt remote, jam up her Purnate and shut off her Sifusoft as she throws
herself against the stirrups again. The birthing table tilts alarmingly. I lunge to catch it. She flails
at me and her nails gouge my face. I jerk away, clutching my cheek. I wave to her husband, who
is standing dumbly on the opposite side of the birth table, staring. "Help me hold her!"
He snaps out of his paralysis; together we wrestle her back onto the table and then a new
contraction hits and she sobs and curls in on herself. Without Sifusoft, there is nothing to hide the
birth's intensity. She rocks against the pain, shaking her head and moaning, small and beaten. I
feel like a bully. But I don't restart the pain killers.
She moans, "Oh God. Oh, God. Oh. God."
Benjamin puts his head down beside her, strokes her face. "It's okay, honey. It's going to be
fine." He looks up at me, hoping for confirmation. I make myself nod.
Another Purnate-induced contraction hits. They're coming fast now, her body completely in the
grip of the overdose I've flushed into her. She pulls her husband close and whispers, "I don't
want this, honey. Please, it's a sin." Another contraction hits. Less than twenty seconds apart.
Two thick-armed female orderlies draped in friendly pink blouses finally come thumping through
the door and move to restrain her. The cavalry always arrives too late. Maya brushes at them
weakly until another contraction hits. Her naked body arches as the baby begins its final passage
into our world.
"The pretty queen of the hypocritic oath arrives."
Dmitri sits amongst his brood, my sin and my redemption bound in one gaunt and sickly man.
His shoulders rise and fall with labored asthmatic breathing. His cynical blue eyes bore into me.
I touch my face, come away with wet fingers. "A patient went natal."
All around us, Dmitri's test subjects scamper, shrieking and warring, an entire tribe of
miscalibrated humanity, all gathered together under Dmitri's care. If I key in patient numbers on
my belt unit, I get MedAssist laundry lists of pituitary misfires, adrenal tumors, sexual
malformations, attention and learning disorders, thyroid malfunctions, IQ fall-offs, hyperactivity
and aggression. An entire ward full of poster-children for chemical legislation that never finds its
way out of government committee.
"Your patient went natal." Dmitri's chuckle comes as a low wheeze. Even in this triple-filtered
air of the hospital's chemical intervention ward, he barely takes enough oxygen to stay alive.
"What a surprise. Emotion trumps science once again." His fingers drum compulsively on the
bed of an inert child beside him: a five-year-old girl with the breasts of a grown woman. His eyes
flick to the body and back to me. "No one seems to want prenatal care these days, do they?"
Against my will, I blush; Dmitri's mocking laughter rises briefly before dissolving into coughing
spasms that leave him keeled over and gasping. He wipes his mouth on his lab coat's sleeve and
studies the resulting bloody smear. "You should have sent her to me. I could have convinced
Beside us, the girl lies like a wax dummy, staring at the ceiling. Some bizarre cocktail of
endocrine disruptors has rendered her completely catatonic. The sight of her gives me courage
"Do you have any more squeegees?"
Dmitri laughs, sly and insinuating. His eyes flick to my damaged cheek. "And what would your
sharp-nailed patient say, if she found out?"
"Please, Dmitri. Don't. I hate myself enough already."
"I'm sure. Caught between your religion and your profession. I'm surprised your husband even
tolerates your work."
I look away. "He prays for me."
"God solves everything, I understand."
Dmitri smiles. "It's probably what I've missed in my research. We should all just beg God to
keep babies from absorbing their mother's chemical sludge. With a little Sunday prayer, Lily, you
can go back to pushing folate and vitamins. Problem solved." He stands abruptly, coming to his
full six-and-a-half feet like a spider unfolding. "Come, let us consummate your hypocrisy before
you change your mind. I couldn't bear it if you decided to rely on your faith."
Inside Dmitri's lab, fluorescent lights glare down on stainless steel countertops and test
Dmitri rustles through drawers one after another, searching. On the countertop before him, a
gobbet of flesh lies marooned, wet and incongruous on the sterile gleaming surface. He catches
me staring at it.
"You will not recognize it. You must imagine it smaller."
One portion is larger than an eyeball. The rest is slender, a dangling subsection off the main
mass. Meat and veiny fatty gunk. Dmitri rustles through another drawer. Without looking up, he
answers his own riddle. "A pituitary gland. From an eight-year-old female. She had terrible
I suck in my breath. Even for Chem-Int, it's a freak of nature.
Dmitri smiles at my reaction. "Ten times oversized. Not from a vulnerable population, either:
excellent prenatal care, good filter-mask practices, low-pesticide food sources." He shrugs. "We
are losing our battle, I think." He opens another drawer. "Ah. Here." He pulls out a foil-wrapped
square the size of a condom, stamped in black and yellow, and offers it to me. "My trials have
already recorded the dose as dispensed. It shouldn't affect the statistics." He nods at the flesh
gobbet. "And certainly, she will not miss it."
The foil is stamped "NOT FOR SALE" along with a tracking number and the intertwined DNA
and microscope icon of the FDA Human Trials Division. I reach for it, but Dmitri pulls it away.
"Put it on before you leave. It has a new backing: cellular foil. Trackable. You can only wear it in
the hospital." He tosses me the packet, shrugs apologetically. "Our sponsors think too many
doses are walking away."
"How long do I need to wear it before I can leave?"
"Three hours will give you most of the dose."
"Who knows? Who cares? Already you avoid the best treatment. You will reap what you sow."
I don't have a retort. Dmitri knows me too well to feed him the stories I tell myself, the ones that
comfort me at 3 a.m. when Justin's asleep and I'm staring at the ceiling listening to his steady
honest breathing: It's for our marriage . . . It's for our future . . . It's for our baby.
I strip off the backing, untuck my blouse and unbutton my slacks. I slip the derm down under the
waistband of my panties. As it attaches to my skin, I imagine cleansing medicine flowing into
me. For all his taunts, Dmitri has given me salvation and, suddenly, I'm overwhelmed with
gratitude. "We owe you, Dmitri. Really. We couldn't have waited until the trials finished."
Dmitri grunts acknowledgment. He is busy prodding the dead girl's bloated pituitary. "You could
never have afforded it, anyway. It is too good for everyone to have."
The squeegee hits me on the El.
One minute, I'm sitting and smiling at the kids across the aisle, with their Hello Kitty and their
Burn Girl filter masks, and the next minute, I'm doubled over, ripping off my own mask, and
gagging. The girls stare at me like I'm a junkie. Another wave of nausea hits and I stop caring
what they think. I sit doubled over on my seat, trying to keep my hair out of my face and
vomiting on the floor between my shoes.
By the time I reach my stop, I can barely stand. I vomit again on the platform, going down on
hands and knees. I have to force myself not to crawl down from the El. Even in the winter cold,
I'm sweating. The crowds part around me, boots and coats and scarves and filter masks.
Glittering news chips in men's sideburns and women with braided microfilament glo-strands
stepping around me, laughing with silver lipsticks. Kaleidoscope streets: lights and traffic and
dust and coal diesel exhaust. Muddy and wet. My face is wet and I can't remember if I've fallen
in the murk of a curb or if this is my vomit.
I find my apartment by luck, manage to stand until the elevator comes. My wrist implant radios
open the apartment's locks.
Justin jumps up as I shove open the door. "Lily?"
I retch again, but I've left my stomach on the street. I wave him away and stumble for the
shower, stripping off my coat and blouse as I go. I curl into a ball on the cold white tiles while
the shower warms. I fumble with the straps on my bra, but I can't work the catch. I gag again,
shuddering as the squeegee rips through me.
Justin's socks are standing beside me: the black pair with the hole in the toe. He kneels; his hand
touches my bare back. "What's wrong?"
I turn away, afraid to let him see my filthy face. "What do you think?"
Sweat covers me. I'm shivering. Steam has started pouring up from the tiles. I push aside the
cotton shower curtain and crawl in, letting the water soak my remaining clothes. Hot water pours
over me. I finally drag off my bra, let it drop on the puddled tiles.
"This can't be right." He reaches in to touch me, but pulls away when I start gagging again.
The retching passes. I can breathe. "It's normal." My words whisper out. My throat is raw with
vomit. I don't know if he hears me or not. I pry off my soggy slacks and underwear. Sit on the
tiles, let the water pour over me, let my face press against one tiled wall. "Dmitri says it's
normal. Half the subjects experience nausea. Doesn't affect efficacy."
I start retching again but it's not as bad now. The wall feels wonderfully cool.
"You don't have to do this, Lily."
I roll my head around, try to see him. "You want a baby, don't you?"
"Yeah, but . . ."
"Yeah." I let my face press against tile again. "If we're not doing prenatal, I don't have a choice."
The squeegee's next wave is hitting me. I'm sweating. I'm suddenly so hot I can't breathe. Every
time is worse than the last. I should tell Dmitri, for his trial data.
Justin tries again. "Not all natural babies turn out bad. We don't even know what these drugs are
doing to you."
I force myself to stand. Lean against the wall and turn up the cold water. I fumble for the soap . . .
drop it. Leave it lying by the drain. "Clinicals in Bangladesh . . . were good. Better than before.
FDA could approve now . . . if they wanted." I'm panting with the heat. I open my mouth and
drink unfiltered water from the shower head. It doesn't matter. I can almost feel PCBs and
dioxins and phthalates gushing out of my pores and running off my body. Good-bye hormone
mimics. Hello healthy baby.
"You're insane." Justin lets the shower curtain fall into place.
I shove my face back into the cool spray. He won't admit it, but he wants me to keep doing this;
he loves that I'm doing this for him. For our kids. Our kids will be able to spell and to draw a
stick figure, and I'm the only one who gets dirty. I can live with that. I swallow more water. I'm
Fueled by the overdose of Purnate, the baby arrives in minutes. The mucky hair of a newborn
shows and recedes. I touch the head as it crowns. "You're almost there, Maya."
Again, a contraction. The head emerges into my hands: a pinched old man's face, protruding
from Maya's body like a golem from the earth. Another two pushes and it spills from her. I
clutch the slick body to me as an orderly snips the umbilical cord.
The MedAssist data on its heart rate flickers red at the corner of my vision, flatlines.
Maya is staring at me. The natal screen is down; she can see everything we wish prenatal patients
would never see. Her skin is flushed. Her black hair clings sweaty to her face. "Is it boy or a
girl?" she slurs.
I am frozen, crucified by her gaze. I duck my head. "It's neither."
I turn and let the bloody wet mass slip out of my hands and into the trash. Perfume hides the iron
scent that has blossomed in the air. Down in the canister, the baby is curled in on itself,
"Is it a boy or a girl?"
Ben's eyes are so wide, he looks like he'll never blink again. "It's okay honey. It wasn't either.
That's for the next one. You know that."
Maya looks stricken. "But I felt it kick."
The blue placental sack spills out of her. I dump it in the canister with the baby and shut down
Maya's Purnate. Pitocin has already cut off what little bleeding she has. The orderlies cover
Maya with a fresh sheet. "I felt it," she says. "It wasn't dead at all. It was alive. A boy. I felt
I thumb up a round of Delonol. She falls silent. One of the orderlies wheels her out as the other
begins straightening the room. She resets the natal screen in the sockets over the bed. Ready for
the next patient. I sit beside the biohazard bin with my head between my legs and breathe. Just
breathe. My face burns with the slashes of Maya's nails.
Eventually I make myself stand and carry the bio-bin over to the waste chute, and crack it open.
The body lies curled inside. They always seem so large when they pour from their mothers, but
now, in its biohazard can, it's tiny.
It's nothing, I tell myself. Even with its miniature hands and squinched face and little penis, it's
nothing. Just a vessel for contaminants. I killed it within weeks of conception with a steady low
dose of neurotoxins to burn out its brain and paralyze its movements while it developed in the
womb. It's nothing. Just something to scour the fat cells of a woman who sits at the top of a
poisoned food chain, and who wants to have a baby. It's nothing.
I lift the canister and pour the body into suction. It disappears, carrying the chemical load of its
mother down to incineration. An offering. A floppy sacrifice of blood and cells and humanity so
that the next child will have a future.