The First Indigan
Chapter 20: The Birth
Brother Simon spent his time checking and rechecking the genetic changes. He felt a tremendous responsibility to make sure that his work was as near perfect as possible. He had always been a scientific "perfectionist". He approached the current project with an almost religious fervor. If it had not been for Captain Brezinski's specific orders, he would have worked himself to the point of exhaustion. When Captain Brezinski asked him why he was pushing himself so hard, Brother Simon responded, "I have this overwhelming feeling that this work represents the total meaning of my life. Everything that I have done and learned was in preparation for this task and satisfactory completion is essential. This work justifies the life that I have lived."
Captain Brezinski understood his sense of responsibility because she shared the feelings Brother Simon expressed. Her response was given very tenderly, "If a life is judged on the changes for the better that have been made in those with whom you interact, then your life is already a success. This mission is a shared responsibility and all we can do is our best." Captain Brezinski placed her hand on Brother Simon's arm and with a gentle squeeze said, "As your Captain and more importantly as your friend, I ask that you do your best, but that you share the load that you bare." In response Brother Simon placed his hand over Captain Brezinski's and for a short minute held it.
Eric-Peter and Doc Jules had been working together in order to prepare the nano machines. Two different approaches were available. A small unit, the size of a normal blood cell, was available that would react with predetermined antigens to denature them. These roving nano machines would hopefully destroy any antigens before Martha's own immune system could react to them. A very large number of units would be needed to compete with the billions of white blood cells circulating in Martha's system. A vascular filtering device was also available. It would be more efficient because the majority of the blood returning from the placenta would flow directly through the filtering device. Within this device fixed nano machines would perform their task of destroying the foreign antigens. This choice was complicated by the fact that the uterine veins enlarge by a factor of ten during pregnancy. A significant surgery would be required to install the device. After running many computer simulations the decision was made to combine both methods.
Doc Jules discussed with Martha the need for an additional surgery and she willingly accepted the risk. She did ask if the surgery could be performed with the telescopes so she could watch. Doc Jules said, "I'm sorry, this surgery actually involves opening you up so I can attach the filtering devices to your uterine veins." Martha in her typical fashion accepted this without hesitation and asked when the next surgery would be. Doc Jules told her that it would be about eight days before the auto supplier would complete the units and then they would perform surgery.
On the day of surgery Martha was greeted by Kate who said, "Doc Jules asked me to help him today and said that he would be a few minutes late." As Martha was changing into the hospital gown they visited about what it would be like to be the mother of the first Indigan. Kate admitted she and the rest of the female crew members were jealous of Martha's chance for motherhood. It had been a requirement that all crew members undergo voluntary sterilization prior to being accepted for the mission. Kate said, "I had never considered motherhood for myself because it would interfere with my profession and my lifestyle. Now that it is no longer an option I sometimes question my decision." Martha in reply said, "We all made similar decisions for our own reasons and I am reminded of something my grandmother used to say, ‘It takes a whole village to raise a child'. I may be the physical surrogate mother, but I think all of us will be required to raise our new people."
Kate sighed and said, "I know what you're saying is true, but I guess it is my hormones that make me jealous.
Martha laughed and said, "I am sure that Doc Jules has some magic mixtures he could inject you with to control your hormones."
Kate replied, "I think I have had enough of his injections, thank you anyway." They heard Doc Jules entering the building and changed their subject matter to a frivolous discussion. He asked them if they were ready and they both said, "Just waiting for you". He then showed them the small filtering structures that he had in the sterile packages. Kate asked him how they worked. Doc Jules explained that the lower portion was placed around the uterine vein and the nano machines inside would gradually enlarge the opening allowing more and more of the blood to filter through the device. The device would adapt to the increased blood flow of pregnancy, but not all of the blood could be filtered which is why they needed the free circulating machines. Kate shuddered and said, "I am not sure about having these machines inside of me".
Martha replied, "We do what we must."
Doc Jules had Martha lie on the operating table, started an IV, and placed the cardiac monitors. He told Martha, "I will be giving you some medicine that will make you fall asleep. When you awake the surgery will be over." Martha nodded in the affirmative and before she could have said much of anything she was asleep. Doc Jules inserted the breathing tube through her mouth and into her trachea. He connected this to the auto ventilator and had the computer program in the appropriate anesthesia gas mixture. He then washed Martha's abdomen with the sterilizing solution and covered her with the sterile drapes. He scrubbed his own hands for the required five minutes and donned his sterile gown. Doc Jules picked up the scalpel and quickly reviewed in his mind the exact procedure that he was about to perform. With a single deft movement he cut through the skin of Martha's abdomen exposing the thin layer of fat. The small bleeding vessels were sealed automatically with the energy of the laser. The vertical muscles in the midline were gently separated and the peritoneum exposed. Doc Jules made a very small incision into this layer and inserted his finger to protect Martha's intestinal tract. He then enlarged the incision and placed a retractor and sponges which allowed him good visualization. Using delicate surgical forceps he freed the uterine vein from the surrounding tissue. Taking the nano machine devices he opened the small flap door and inserted it under the uterine vein. As he was closing the door around the vein he mumbled something to himself and Kate said, "Pardon me."
Doc Jules apologized and said, "I was just talking to myself, saying that I hope these things work."
Kate was surprised and said, "What do you mean, you hope these things work?"
Doc Jules finished securing the base of the pyramidal filtering device to the uterine suspension ligaments before he replied. He said. "According to the computer these will work, but I prefer things that I can see and touch. At times I have trouble accepting computer simulations."
Kate finished his argument by saying, "We do place our trust in The Visitor and its computer much like Brother Simon does with his God."
Doc Jules response was a simple hmmm, and he continued his work moving to the opposite uterine vein. He methodically separated the vein from the artery and the surrounding tissues and again carefully inserted the vein into the filtering device. He secured the filter in the same fashion and began closing the surgical wound. Kate watched him meticulously turn the cut edges of the peritoneum outward and tightly sew them together with his sutures. He closed each successive layer with the same attention to detail using sutures which would absorb over the next six weeks. He closed the skin with staples and applied a simple dressing.
As the computer was reversing the anesthesia allowing Martha to awaken, Kate asked, "Why did you spend more time closing the inside layers than you did the skin?"
Doc Jules laughed and said, "Surgeons are often judged by the quality of the scar they leave, but proper closing of the inner layers is much more important to prevent complications from adhesions and other internal scarring." Together they moved Martha onto the bed and Kate sat with her while she recovered. Kate was envisioning these microscopic machines in Martha's body and shuddered at the thought. She decided she was no longer jealous of M
artha's selection as the surrogate mother.
Life slowed down slightly as they waited for Martha to fully recover from her surgery and for the hormonal preparation to take effect. Doc Jules used his increased free time to complete the fly rod that he had been working on. He made a date with Ann to meet at the garden pond for his first try at fishing. When they arrived at the pond, Doc Jules was so excited he did not even notice that the garden was empty of other crew members. Ann sat and watched quietly as Doc Jules joined the sections of his rod together and threaded his fly line through the guides. He then carefully tied a small ant pattern fly onto the end of the leader. Ann asked him, "How will the fish know they are supposed to eat ants if they had never seen any?"
Doc Jules explained, "I assume that they are genetically programmed and should instinctively recognize the ant as food. If this doesn't work I do have a secret weapon to try." He showed her a fly from his small box which looked amazingly like the food pellets they had been feeding the fish. Doc Jules began stripping out line and casting over the pond. He was able to cast half way across the pond. He allowed the fly to settle quietly on the water and his excitement became almost palpable when a trout rose next to the fly. His disappointment when the fish did not take the fly was transient and he simply lifted his rod and repeated the cast a few feet away. After a few cast one of the small trout took his fly and headed for the bottom of the pond. Doc Jules gently set the hook and reeled the fish in. He removed the hook almost reverently and released the fish telling it to continue growing. He turned to Ann and said, "It will be a few more months before these fish are large enough for the fish fry I promised you." He continued fishing and was thrilled to catch another small trout. The fish tired of his ant fly and after awhile Doc Jules gave up and sat on the bank with Ann. He was content to sit quietly and stare at the water with Ann nestled against his shoulder. Ann was studying his face and recognized that he appeared genuinely happy which was very satisfying for her. Doc Jules turned towards her and sincerely thanked her for her gift and completed his thanks with a soft kiss.
Brother Simon was walking about in deep thought and entered the garden not realizing he was invading their private time. He saw the fishing pole and asked Doc Jules if he had any luck. Doc Jules responded, "This has been one of my best fishing trips ever." Ann just melted with these words.
Doc Jules asked him what he was thinking about and he replied, "Do you know anything about the sugars on the cell surfaces?
Doc Jules replied, "Not much, seems they are involved in the autoimmune diseases. Why?"
"Well, all mammals except humans have both Neu5Gc and Neu5Ac forms but humans only have the latter. Seems my genetic modifications will cause our new beings to loose the Neu5Gc in order to allow brain growth. I’ve been considering the theological implications."
"Which are?"
Before he went on Brother Simon realized that he had forgotten Kate's admonition to avoid the garden area, he muttered something about needing to sort it out more and tried to excuse himself. Doc Jules accepted his excuse but began thanking him for helping Ann develop the garden pond and fish. The conversation continued despite his efforts to leave. Ann asked him if he was finished with the genetic development. He replied, "I know that my work is not perfect but I have done my best. I am ready to insert the new genetic code into the eggs Martha donated." Ann wanted to know where he got the genes that he had adapted from the human genome. He explained, "I felt that everyone on this mission was acting as earth's emissaries so I used genes from everyone on board, even from John Kotzebue." Ann commented on how they were all going to be the parents of their new Indigans. Brother Simon nodded acceptance of her statement and used that as his exit leaving them in the quiet of the garden.
Brother Simon began the final phase of his work by sorting through the genetic profiles of the frozen embryos that had arrived on the "Egg". He chose a male specimen that had a profile which lent itself to easy modification. The embryo was removed from the cryogenic chamber and allowed to return to normal temperature. He examined the embryo for signs of obvious damage from the period of freezing, and was happy to find no evidence of damage. He placed the embryo in a special solution to encourage growth and placed the container in the incubator. After six days the embryo had grown to the point that it had begun dissolving the tough shell-like structure called the zona pellucida, which had protected it. At this point Brother Simon placed the embryo in a solution which allowed the cells to separate into multiple potential identical twins. He was able to identify 12 complete cells which he placed in separate containers and cooled to prevent any further development. He used his instruments to examine each cell looking for the one closest to division where the chromosomes were tightly organized and therefore easier to work with.
His chosen cell was placed in the DNA auto analyzer and he began his genetic engineering. He had been working for months identifying the key genetic material which had been harvested and carefully stored. These individual genes were now spliced into the existing code one by one. Brother Simon had hundreds of individual genes to place in the appropriate chromosome to create their new Indigans. The machinery simplified the process immensely, but it was not until his fourth try that Brother Simon succeeded in producing an intact blueprint of his proposed genetic modifications. That night he slept well. The next task was simple in comparison. He took one of the eggs they had harvested from Martha and removed all of the nuclear genetic material. He then inserted his designed chromosomes into the cell. This human cell now contained the genetic code of the Indigans. The cell was carefully placed in the culture medium and allowed to begin growing.
Doc Jules was using this time to hormonally prepare Martha for the upcoming pregnancy. In addition she received an injection of the circulating nano-machines every few days. She was recovering nicely from the surgery despite her exposure to the very low oxygen levels. Captain Brezinski had arranged to meet with Martha and Doc Jules to review their progress and to assure herself that Martha was prepared to proceed both mentally and physically. It was an informal meeting to encourage frank discussion. Martha had asked if any testing of the filtering nano-machines was necessary.
Doc Jules had just shrugged his shoulders and said, "It appears you are the test and we're putting our faith in The Visitor that this will work."
Martha responded in her direct fashion. "It is more comforting to put my faith in Brother Simon, his God and in the rest of you. We accept the risk that we must in order to accomplish the mission we have accepted. For a reason that I do not understand I feel this task is what gives my life meaning."
Captain Brezinski was most interested in Martha's last comment and asked her for additional explanation of the feeling she had. Martha explained that her mother was a Buddhist and her father a Christian, but she had no significant religious beliefs prior to joining this mission. She then explained, "I had a dream about giving birth to a new and wondrous being and since then, I have felt an inner peace which I have never experienced before."
Captain Brezinski and Doc Jules again review the proposed protocols and the risk Martha was taking, but they knew that Martha was already content in her decision. At the end of the meeting Captain Brezinski gave her approval to proceed.
The next step was almost anticlimactic. Doc Jules had Martha present to the clinic and prepared her for a simple gynecological exam. He passed the slender glass tube through her vagina and cervix, injecting the developing embryo into her uterus which had been prepared with their hormonal therapy. The procedure was painless and took only a few moments. After Martha was dressed Doc Jules told her to rest quietly for a day and that they would know in ten days whether the pregnancy was established or not.
When Martha awoke on the tenth day, she had no sooner gotten out of bed than she felt a rush of nausea. She tried to tell herself that it was all psychological, but the nausea was too real to ignore. The decision to forego breakfast w
as all too easy to make. She presented to the clinic and when Doc Jules asked her how she was doing she explained that everything was fine until this morning when she became nauseated. Doc Jules smiled and said, "It would be a little early for morning sickness, but we will know pretty quick." He then drew her blood and placed the sample in the chemistry analyzer. Within minutes blood chemistry values began to show up on the computer monitor. They waited expectantly as the test results slowly scrolled down the screen. Suddenly Doc Jules broke into a big smile and pointed at a test results which had several red arrows pointing up. Martha looked at the results and saw the arrows were associated with a test called AHCG" and asked, "Is this the pregnancy test?" Doc Jules explained that the initials stood for human chorionic gonadotrophin and the elevated levels indicated that she was indeed pregnant.
Martha left the clinic with wondrous thoughts of the small blue baby which was growing inside her. These images of the baby developing within her progressed to the point where she was actually holding the newborn baby. Her reverie was unfortunately disrupted by another rush of nausea. She walked into the Long Branch and immediately went to the bathroom. Kate had seen her walk-in and when she came out of the bathroom noticed that Martha's normal brown complexion was pale and compromised by the bluish tinge to her lips.
Kate asked, "Martha, are you pregnant?"
Martha nodded in the affirmative and said, "The morning sickness was very evident this morning even before Doc Jules performed the pregnancy test. I do not like the nausea, but I am very willing to put up with it." Kate walked Martha over to a back table and made her sit down. She went to the kitchen to find some crackers and juice. She returned accompanied by Ann who had been working in the kitchen. Ann immediately gave Martha a hug. The three of them sat and visited about pregnancy and babies.
Kate remarked, "At least you do not have to put up with a mother-in-law's advice."
Ann interjected, "I am sure that you will be getting plenty of advice from the rest of us, who do not have any real experience. We will want to share vicariously in your pregnancy and will all have our own opinions on what his best for you and the baby."
Martha replied, "I would like to share this pregnancy with all of you because it is truly all of ours. I do miss having elders around, not so much for their advice, but for their sharing of their own experiences. Knowing that others have had the same feelings and concerns is very comforting. About all I have left from my family, following that horrible mountain climbing accident is my mother's diary. I cherish it because it is my link to who I am."
The conversation turned to methods of controlling the morning sickness. Martha admitted that Doc Jules had offered her medication, but that she preferred not using it if at all possible. Ann offered to search for specific foods that would help. Martha said, "I do recall that there is a portion of the diary that discussed what my mother did when she was pregnant with me on the mountain. Hopefully, a combination of certain foods and the traditional methods that my mother used will be enough to control the vomiting so that I will not need the medication."
The next eight months seemed to crawl by as Martha tolerated the misery of her pregnancy. Her intrinsic toughness kept her from complaining. The crew was like all expectant families, who fret about the mother-to-be and her baby. Instead of planning and working to complete the nursery in time the crew worked to complete the garden. As the pregnancy was coming to full development Doc Jules took increasing pains to document the fetal development and to prepare for the birth. Birth by cesarean section was necessary in order to limit the newborn baby's exposure to human bacteria and to limit Martha's exposure to the immunologic burden of increased placental leakage during the birthing process.
Doc Jules completed his exam of Martha and told her, "The baby appears to have reached full development. I think it is time to prepare for delivery."
Martha's smile revealed her excitement she asked, "It is early! Is everything okay?" Doc Jules explained that the testing had revealed full development of the baby and that the Indigans had a slightly shorter pregnancy. He then reviewed the procedure involved for the cesarean section and the need for sterility. As Doc Jules described the complex methods for maintaining a sterile environment for the baby, Martha was wondering how they were going to hold and cuddle this newborn infant. She finally interrupted Doc Jules by asking, "You do intend to let us hold the baby?"
Doc Jules was unable to answer at first because he had not considered the need. Looking at Martha's face which was so obviously pleading for an affirmative answer he knew that only one answer would be acceptable. He told Martha, "I will have to work with Mike to develop a flexible container for the baby which will isolate him from our environment, but still allow close contact."
Martha asked, "It will be ready when the baby is born so that he does not have to be alone won't it?"
All Doc Jules could do was promise to do his best. As soon as Martha left he called Captain Brezinski and reviewed the situation. After discussing the potential problems and benefits she approved the concept. Doc Jules called Mike with some hesitation because of their ongoing bickering with each other's priorities. When he explained the problem Mike responded, "Why do you wait until the last-minute and then expect me to bail you out." He continued without allowing Doc Jules to respond, "I can see where this is an important issue to all of the women aboard this ship and I am surprised that you did not see it as a problem until now. I will see what type of soft flexible material I can adapt so that they can hold this baby safely. I suppose it will need a clear hard plastic around the baby's face to prevent him from choking. We will also need a method of transferring the baby back to the sterile crib that you already had me design." He concluded, "I am not sure why all the sterile effort is needed anyway. It seems to me that since their germs did not harm us that our germs would not harm them."
Doc Jules had it admit that Mike could very well be right, but that he was unwilling to take the risk. He thanked Mike for his help and added one more request, "It would be nice if the unit was permeable to smells so that the baby and Martha could smell each other and bond faster."
Martha presented to the clinic a little early and was met by Kate who again was acting as the nurse. Martha's excitement was only partially hidden by her reserved Sherpa manners. Kate asked her if she had picked the name for the baby. Martha replied, "I think that the hardest part of this pregnancy may have been choosing the name. At the baby shower everybody had to bring a suggested name but I did not realize that you were going to make me choose the name. I felt that since it was everyone's baby we should have all voted on the name."
Kate was laughing as she recalled the most unusual baby shower. She said, "I am not sure what this baby is going to do with all of the toy cars, airplanes and horses that the men made for it. I do not think they really understood what a baby shower was for."
Martha had tears in her eyes as she recalled the excitement of Tom as she opened the small box and took out his handmade 1957 Chevrolet miniature car with bright red paint and doors that opened. The male crew members were like a bunch of little boys playing with the toys each of them had made. Doc Jules was the only one with a practical gift and had made a mobile using miniature fishing poles and brightly colored miniature fish. Martha finally answered Kate by quietly saying, "Indie." She then added, "If the new language we develop makes the name hard for them to say we can change it."
Kate's reply was a simple, "I like it."
When Doc Jules arrived he was all business. He asked Martha if she had any questions and hardly gave her anytime to respond before he began his review of the procedure for Kate. Kate listened again to her responsibilities and responded with a little uncertainty in her voice, "Okay." She continued, "I really think that we should have a real nurse rather than me with my three months of nursing cross training."
Doc Jules smiled at her and said, "You will do just fine and so far the decision of th
e powers to be to utilize you and Martha as nursing substitutes has worked." Doc Jules then completed his preparations for the spinal anesthetic and had Martha positioned on the table for the procedure. Martha had more difficulty bending forward because of the pregnancy, but Doc Jules had no trouble finding the proper vertebral space for his injection. After helping Martha lie on the table, with a pillow under her right side, he prepped her abdomen with the surgical scrub and drapes. Martha's very pregnant abdomen which was colored a golden brown from the scrub solution, protruded from the blue drapes like a golden icon. Before making his incision Doc Jules placed his hand reverently on the abdomen and said, "I have always found the pregnant abdomen to be not only beautiful, but also a wondrous thing. I suppose it is because it represents the essence of the difference between men and women."
Doc Jules positioned the table by tilting it slightly away from his side and picked up his scalpel. He looked at the scar from his previous surgery and commented, "Maybe I should have simply put in a zipper last time we were here." With that comment he made the vertical incision through the skin. The tissues were stretched thinly and dissected easily despite the previous surgical scar. Doc Jules carefully made a small opening in the peritoneum which he enlarged with scissors until the uterus began to protrude through the incision. The bladder had to be carefully dissected free from the uterus and protected with a retractor. He had Kate hold pressure against the lower uterus holding the baby up high. He then made the transverse incision low on the uterine surface below the baby. This incision released the amniotic fluid that the baby had been floating in. The fluid sloshed into the abdomen and out through the surgical opening onto Kate. She was startled by the sudden warm wet feeling that ran down her legs and into her shoes. Doc Jules apologized without looking up and said, "I learned my lesson as a first-year resident to always tilt the table away from myself when doing a C-section."
Doc Jules gently delivered the baby with the umbilical cord still attached. The baby was squirming vigorously obviously not enjoying his first exposure to the larger world. While Doc Jules concentrated on holding the baby, Kate clamped the cord with small plastic clamps and divided it. The baby was now forced to begin breathing on its own. The first few attempted breaths produced only the expelling of the amniotic fluid from its throat and lungs. The first real breath resulted in a strong cry which brought a cheer from everyone in the room. Doc Jules carefully cradled the very slippery baby against his body, supporting the head. He wrapped it in a sterile towel before placing him in the sterile heated crib.
Martha had been watching the surgery in the mirror and when the baby was delivered strained to count the fingers and toes. Counting the right number she broke down into tears of joy. Doc Jules did not notice her tears until after he had delivered the placenta and had saved the placental blood. He was surprised to see the stoic young lady crying and asked if she was having pain. Martha responded, "I am sorry I cannot help crying because I am so happy. He is so beautiful!"
Doc Jules responded, "My wife used to cry when she was happy and I never understood the logic of it. I suppose that is one of the feminine mysteries that will always puzzle men." Doc Jules then repaired the opening in the uterus and closed the abdominal wounds as he had done previously.
Martha was transferred to the small bed and positioned next to the baby so that she could watch it. The baby had quickly quieted down and found its right hand to suck on. Martha simply watched the sleeping baby without conscious thoughts being lost in the joy of the present. She desperately wanted to hold the infant to her breast but knew that Doc Jules had lots of scientific reasons why she should not. As a mother she knew differently. Kate expressed her concern that the baby was far too blue. Doc Jules assured her that the oxygen monitor revealed the baby to be breathing normally and that the name "Indie" was appropriate for their first Indigan.
The presence of their baby immediately changed life aboard their ship. The crew shared the responsibility for the feeding and holding of the baby. Amongst the supplies they had received from "The Egg" was a small supply of colostrum (the initial breast milk) which helps protect the baby during its first few days of life. Martha used a small breast pump to obtain milk for the baby which was first sterilized and then bottled. Doc Jules began vaccinating the infant almost immediately by selectively introducing the naturally occurring bacteria to the infant. Mike finished his "isolation bag" and everyone could actually hold their baby and smell it which further bonded them together. The baby was exposed to lullabies in several languages.
Mike and Captain Brezinski were sharing a "baby watch" and as Mike held the infant he remarked, "I never thought much about having children, but this is okay."
Captain Brezinski thought about her somewhat contentious engineer and his acceptance of the surrogate father role. She responded with, "You look good with the baby."
Mike was pleased with her comment but did not reply. As he handed the infant to Captain Brezinski for her turn at feeding he said, "Well, it looks like calm sailing from here on out."
Captain Brezinski sagged noticeably with his comment. She said, "The term is ‘smooth sailing' and it implies fair winds and following seas. Calm for a sailor is a dreaded condition. My first Captain used to say, 'The greater the calm, the worse the storm'."