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Overview
Nelson DeMille, author of The Gold Coast
When Dr. Anya Krim, the First Lady's fertility specialist, delivers a grossly deformed baby of undetermined sex, she tries to figure out how the child was conceived. But, before she is able to determine the baby's origin, she diagnoses a pregnancy in Megan, a Senator's daughter, who has been in a coma for two years. The question of who has impregnated Megan leads to a shocking suspicion based upon the FBI's DNA fingerprinting results.
At the same time, the First Lady's last-ditch attempt to have a child runs amok when the safety of her embryos is threatened. Anya not only has to secure the embryos she created. She must now prove that no one has altered them genetically.
Anya, herself, is desperate to have a child of her own, but her fears of having sex threaten to leave her childless. How far will she go to have a child? Unforeseen complications threaten her reputation, her career, and ultimately, her life.
Misconception takes the reader on a heart pounding and mysterious, yet intriguing journey, examining new reproductive and genetic technologies through Anya's eyes. Along the way, she must grapple with issues of passion and hate, conservative and liberal politics, morality and medicine and ultimately life and death.
Product Details
| ISBN-13: | 9781440183874 |
|---|---|
| Publisher: | iUniverse, Incorporated |
| Publication date: | 01/21/2010 |
| Pages: | 296 |
| Product dimensions: | 6.00(w) x 9.00(h) x 0.67(d) |
About the Author
Read an Excerpt
MISCONCEPTION
By Avner Hershlag
iUniverse, Inc.
Copyright © 2010 Avner HershlagAll right reserved.
ISBN: 978-1-4401-8387-4
Chapter One
Washington D.C., sixteen months laterSomething's wrong with this baby, thought Doctor Anya Krim.
Twenty hours in labor and the baby wasn't coming. What could be wrong? Was it the womb? She eyed the monitor. No. Contractions were regular, forceful. The baby was getting excited with each contraction, his heart rate accelerating. The muscle pouch that held the unborn child was working full force.
Was the canal too narrow? She felt the pelvic bones framing the head. There was plenty of room; this mother had big bones. Anya remembered her residency lingo: the kind of pelvis you could drive a truck through.
It had to be the baby, then. But why? She felt the sutures on the skull: presentation was perfect. And the baby was tiny, especially in relationship to mom. Bonnie Marshall should have been able to sneeze the little peanut out a long time ago.
Maybe the baby wasn't done nesting in the womb, holding on for dear life to its cradle, while the cradle continued its incessant, rhythmic attempts to eject it. The canal that lay ahead was wide open.
Maybe it's me. Maybe I'm out of practice.
She hadn't delivered a baby in eight years. And now what used to be routine for her seemed impossibly difficult. What was I thinking when I agreed to deliver this baby? I should've known better. How many patients I'd helped conceive had begged me to deliver them? It had to be hundreds. She'd told each of them the truth: they were better off in the hands of an obstetrician who'd been in the trenches day and night. How stupid was I to break my rule for Cody? What was I thinking, that I'd walk in, catch the baby, and walk out-end of story?
The cervix had been open for over two hours. Anya continued to stretch it to make more room for the baby's head.
She sat on a stool between the stirrups that supported Bonnie Marshall's long legs. Dysfunctional labor. Liz, the delivery room nurse, looked at the mother. "Something is wrong with this delivery."
Anya attempted a smile. "Brilliant. You must've been sick during bedside manners week in nursing school."
Bonnie's emotionless face gave no indication of whether she cared if the baby came out.
How unfair, Anya thought. For so many women, pregnancy was no more than an accident. A mishap.
"Maybe we should let the epidural wear off," Liz suggested.
"Maybe it's time for you to go on break," Anya offered. "This has been a long stretch."
"Thanks, Doctor Krim. But I'll stay. I wish you'd deliver babies all the time."
I wish, Anya thought. She wondered if Liz could read her mind. Did she sense that Anya felt out of place, an alien who had landed unexpectedly in the labor and delivery microcosm?
"Push, Bonnie, push," the delivery room choir recited. Liz, a large woman herself, was practically lying over Bonnie's upper belly.
Violent contractions were coming less than a minute apart. But Bonnie hardly flinched. Her face was lime-white, as if all the blood had gone up to her flaming red hair.
"Don't you worry, Bonnie, all babies come out in the end," Anya said. Her blue scrubs were drenched in a mix of sweat and the amniotic fluid that had broken more than three hours earlier. The nursing assistant wiped Anya's forehead with a wet sponge, removed Anya's foggy goggles, cleaned them with wet gauze, and fitted them back over her ears.
Anya had been up for over twenty-four hours. Now, with the repetitive gallop of the fetal monitor, the "push-push-push" from Liz, and that delivery room stench-a mix of Betadine, the patient's secretions, blood, and the sweat under her double layer of scrubs-assailing her, Anya's mind drifted.
It wasn't the stench that had driven her away from obstetrics. Not the bad hours. It wasn't even the bad babies she was terrified to deliver. It was any baby, every baby. She couldn't stand the thought that she'd never have her own.
Professor Feinberg thundered into the delivery room. "Doctor Krim, I've been looking for you."
Not him, Anya thought. Not here. And not now.
"Doctor Feinberg?" Anya said
"I wanted to congratulate you-"
The stout professor wore a small, blue, scrub top, his mammoth belly barely covered by green, extra-large bottoms.
"You've outperformed yourself. I thought you'd reached your peak when you cloned a human heart in a pig. But you keep coming up with new surprises. A human pancreas in the mouse! By God, this may be the first step to rid the world of diabetes. Are you ready for your testimony in the Senate?"
She kept her eyes fixed on Bonnie. "I haven't had time yet to prepare. But I'll be ready. Don't worry."
"Doctor Krim's going to testify as an expert witness in front of a Senate committee on the Embryonic Stem-Cell Bill. You know why?" he asked an audience of two nurses, a nursing assistant, an anesthesiologist, and a woman in labor. "She was able to grow a piece of human pancreas in a mouse. Now the little mouse makes insulin every day. Can you imagine? This woman is a genius. Once we transplant diabetics with a new pancreas, they'll never need to take insulin again."
Claustrophobia overwhelmed Anya. The professor had invaded her space.
"Professor, I'm busy. Push, Bonnie, push." Anya stretched the vagina. "I need some fundal pressure."
"My pleasure," said Feinberg. Anya heard the nurses gasp at this breach of protocol. "A double step stool," he ordered the nursing assistant, who hurried to stack one step stool on top of another, bowing for the king of the OB/Gyn to climb up to his throne. "I see a good one coming," he said, cheerfully leaning his stomach across Bonnie's.
"It's too much pressure, Professor, the baby doesn't like it," Anya said sharply. "Why don't you make an appointment if you want to talk to me? I'm really pretty busy-"
"Why are you here at all, Doctor Krim?" Feinberg's graying eyebrows tented upward. His right eye seemed narrow and mean, while his glass eye, painted dark brown, stayed wide open. With his cap and his face mask, he looked like a pirate who had just captured Bonnie's pregnant mound and declared it his.
"I don't understand," Anya said.
His good eye turned icy. "You know damn well what I mean. How long has it been since you've delivered a baby?"
"Push, Bonnie."
"I asked you a question."
"Eight years," Anya said faintly.
"Eight whole years," Feinberg enunciated slowly. "Eight years is like a lifetime in obstetrics. What on earth made you decide to do a delivery all of a sudden? Some kind of a divine inspiration?" He threw his arms in the air.
Feinberg was right. But there no way she'd tell him that. "This patient was sent by Cody. He was a resident here. Doctor Jeremy Coddington."
"Oh, I remember Cody! How can I forget? The first time I met him was right here, on the labor floor. He was struggling to pull a ten-pound baby from below on a five-foot even mom."
"Five-four."
"Size doesn't matter," he said. "By the time you sectioned the mom, the baby came out in severe distress, with two broken clavicles. And the rest of his residency got worse. Thank God he's not practicing OB anymore."
"This patient is from out of state, Professor. Cody asked that I deliver her."
"So Cody's deciding who should be delivering babies in my department? Well I'm still the chairman. And I say there will be no more babies for you after this one."
No more babies for me.
"Your place is in the lab."
"We'll finish this conversation later," Anya said. The baby's heartbeat had started to dip after each contraction.
"Hold it." He raised his hand. "Coddington never took initiative when he trained with me. Do you seriously think that he'd choose to send a patient to Lincoln Hospital on his own volition? Someone told him to do it. Someone who wanted you, and only you, to deliver this baby."
Feinberg was right again. Anya, too, had wondered about Cody's motive. He knew she wasn't practicing OB anymore. Since he was a follower, not a leader, whose orders did he take? Who told him Anya should deliver the baby? And why? She'd have to revisit this later. Right now, she had a job to finish.
"She's having 'lates.' Turn her to her side, Liz, and give her oxygen," Anya said. Her face white with rage, she whirled on Feinberg.
"You're getting in the way of this delivery. Please leave."
Feinberg stepped down from the double stool and crowded her again. "You were hired to work on stem-cell research and organ cloning. Instead, you've become the fertility guru to Capitol Hill and the White House. Don't think you've become untouchable just because the First Lady hired you as her fertility doctor. We'll finish this discussion later." He thundered out as he had thundered in.
The late decelerations of the baby's heartbeat did not recover with the change in position and oxygen. "We need to crash her," Anya said. "Open a c-section tray and call a resident to scrub in. Also, call the NICU."
"Doctor Gordon and the NICU team are on their way."
Anya sighed in relief. Having Alex Gordon around was reassuring. But she couldn't wait for him to arrive. The baby wasn't getting enough oxygen and needed to come out.
Within seconds, the delivery room transformed into an operating room. Liz handed Anya a fresh gown and a new set of gloves and then painted Bonnie's stomach with yellow Betadine solution. The resident stepped in, her hands dripping water; a nurse gowned and gloved her. Together they opened a large sterile paper drape and stretched it across Bonnie's body, leaving only a square window to expose the surgical site.
"Have you re-dosed the epidural?" Anya asked the anesthesiologist.
"She's ready."
"Incision time's ten past 5 am," Anya said. She took the scalpel and made a straight incision from the belly button down to the pubic bone. Skin, fascia, peritoneum-and the smooth purple uterus was exposed. She could feel the baby's head through the thin wall of the lower segment.
You're not out of practice. You'll never be.
She cut through the uterus, taking care not to cut the baby. Black curly hair, shampooed with a mix of blood and meconium-the baby's bowel movements during distress-emerged through the uterine incision.
Liz grabbed Anya's arm with her soaked gloved hand. "Free at last, free at last."
The ache at the pit of Anya's stomach was a reflex she'd always had at the sight of a new baby entering the world. In a matter of minutes, another woman will turn into a new mother. Pain shot from front to back, like an ulcer punching a hole in her stomach.
Bonnie remained expressionless. This baby would be better off in another home, Anya thought.
Alex Gordon stood behind her, looking at the baby. For a second, they made eye contact. She could tell his smile from under the face mask. A blanket was draped open over the arms of the NICU nurse Alex had brought with him, as if she expected the baby to parachute from the ceiling.
"Is there something wrong with this baby," Liz whispered, "or am I just beyond tired?"
"You might be right." Anya noted each facial feature as she drew the baby's head through the incision: each one seemed deformed: the eyes-slanted and drawn upwards, the ears-low-set, the nose-beaked, the palate-high-arched.
Ignoring her beeper's new vibe, Anya pulled the baby's head backward, allowing the front shoulder to come through the incision. She suppressed a sigh. Now the other shoulder. She kept a firm grip on the head with her left hand, while her right slid along the spine to grab the baby's feet.
Anya could see a huge hole in the baby's abdomen. The baby's gut protruded through the hole.
"Oh jeez," Liz cried softly. The neonatal team began barking orders. Anya heard Feinberg's clogs behind her. He's back. I'm going to kill him. I'm going to kill him now!
"You can thank your friend for this mess. Special delivery of a monster baby. Someone knew this baby would turn out this way, and they wanted you, and only you, to deliver it. I want to know why they chose you."
Don't you call this little baby a monster! Right there, right above that big stomach that I'm so dying to punch, there's a big hole. When did you lose your heart, Feinberg? Was callousness in your job description? "Professor, you've got to stop," she managed.
"I'm out of here," he turned toward the door. "But come see me in my office after the case. You've got some explaining to do."
Anya sighed with temporary relief. But not even a sigh came out of the newborn. Anya wiped its face. Mechanically, she completed the delivery. Cradling the baby securely in her left arm, she double-clamped the umbilical cord.
"Can you tell the sex?" she asked Alex.
"Absolutely not," he whispered. With a gloved hand, his fingers spread the two skin folds between the thighs, exposing an ill-defined bulge. "This could be either an underdeveloped penis or an overdeveloped clitoris."
"Ambiguous genitalia," she said. He nodded in agreement. They both knew what that meant. There was no way to tell Bonnie Marshall whether she'd just given birth to a boy or a girl. Indeed, they wouldn't know for days.
Anya handed the baby to the NICU nurse, who took it to an open warmer. Using a tiny preemie laryngoscope, Alex slipped a plastic tube into the baby's windpipe. The nurse started to pump oxygen-rich air while he worked on the IV.
Anya came over to Alex's side. "What can I tell the mom?"
"Not much, I'm afraid. I don't even know if the baby will live."
Anya approached the head of the delivery table, where Bonnie lay quietly. She squeezed Bonnie's shoulder. "They're taking care of the baby now."
"Thank you." The words were barely audible.
Anya saw a nurse take a footprint of the baby before the neonatal team wheeled it to the NICU. The nurse took the birth certificate to Bonnie for her signature.
"Jesus Christ!"
Anya rushed to her side. "Bonnie, what's wrong?"
"Look, Doctor, look!" Bonnie held the birth certificate out to Anya. "The baby has six toes. It has six-" She began sobbing.
"It's easy to fix" Anya said. "I know it's a shock, but we can remove the extra digits in a few days, and no one will ever know. Calm down." She stroked Bonnie's arm and sat with her. "Can you tell us if there's any way to contact the baby's father?"
"That's a problem," Bonnie whispered. "There is no father."
Chapter Two
In the locker room, Anya tried to imagine the look on the face of the midwife who had delivered her in St. Petersburg. In her case, too, there was no father. He had disappeared before he had a chance to find out his wife had died giving birth. Before he even knew whether he had a boy or a girl.Fatherless and motherless. That's how she grew up. Babushka, her maternal grandma, had given her all the love and warmth she could've wished for. She had filled all of Anya's childhood needs. Her street wisdom had always guided Anya as life became increasingly more complex. It made sense to her that Babushka had picked up where mom left, since her mother sacrificed her own life to have her.
But her dad was a different story. She never forgave him for running away. For not caring. He could've been the one to come home to with her report card during her first year in the United States, the only foreigner in middle school. He could've been there to hear her speech at her Harvard College commencement, the dean's praise on Harvard Medical School graduation, the good things Feinberg had to say about her when she finished her OB/Gyn residency at Lincoln.
The wound had never healed. She'd learned how to grow up without a father. Or had she? She'd never envied friends for their material possessions. Anya was never the jealous kind. But from childhood playdates and sleepovers, through parents' weekends in college, to Christmas breaks forever, that thin crust that had bridged over the hollow would always break open. The hurt was visceral. And now, in her adult life, trying to forge a meaningful relation with a man was like building a house in the air. The foundation wasn't there.
She spoke briefly to Sonia, the social worker on the floor. "It's going to be a nightmare to place this child in a home. We have a hard enough time with perfect babies that are 'hit and run' victims."
"You mean the mother isn't going to keep the baby?"
"She's already signed the papers. We'll give the father forty-eight hours to show up. And then it becomes a dispo problem. If this baby makes it."
"Dispo," was hospital slang for "disposition." At both ends, the just-born and the not-dead-yet, there were many lives no one wanted any part of. Baby Marshall was one of them.
She thought of the e-mail Cody had sent her:
Anya,
You have to help me. I'm sending Bonnie Marshall to Lincoln in labor. I know you don't do deliveries. But you've got to do this one for me.
Cody (Continues...)
Excerpted from MISCONCEPTION by Avner Hershlag Copyright © 2010 by Avner Hershlag. Excerpted by permission.
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