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Synopsis

Born of a crack-addicted mother in a charity ward in Washington, D.C., after the "crash," Job Napoleon Salk is destined to change the world.

Excerpt

Chapter One

Let the day perish wherein I was born,
and the night in which it was said,
there is a man-child conceived.

--The Book of Job, Chapter 3, Verse 3

Bed Nine. Infant pulse rate 139 and falling.

The charity delivery ward was on the lowest floor, a level where no modernization program would ever reach. Sweating walls and low ceiling softened and yellowed the reflection of overhead fluorescents. Light gleamed off racks of steel-cased equipment cabinets, battered by use, repair, and endless reuse.

Bed Nine. Infant blood pressure 48 over 20 and falling.

Eleven P.M. on December 31st, and the final minutes of the old year were fluttering away.

In the hour before midnight, the birthing urge moved towards its maximum. Down the middle of the long room, on a bank of screened table-beds, a dozen women lay in every stage of parturition. The loudest sounds were the hum of lights and the women's groans of pain and effort.

Bed Nine. Infant pulse rate arrhythmic, 112 and falling.

The soft mechanical voice of the in situ uterine sensors contained no suggestion of alarm, but it was insistent. As it spoke in her ear, one of the nurses moved to the head of the ninth bed. She glanced at the monitors, rolled her eyes above the white protective mask, and swore into her throat mike.

"Damnation! Doctor Brisbane! We're close to losing one."

"Coming." The throat mikes permitted the doctors and technicians to exchange information, no matter how ominous or final, without any patient hearing it. The physician moved to the bed and began to probe with delicate fingers between the supine woman's legs.

"Need to get the head showing, need to take a look at the cord. Not breech, position feels normal." He spoke as though to himself, but every word in the throat mikes formed part of the continuous medical record of the ward. "I don't think the umbilical is around the neck. Nurse Calder, tell her she has to do more work. She must push harder."

"Huh? Sure, I'll tell her to push. But how do I get her to listen?" An audible snort came from the other end of the table-bed. "Look at her. Think this one's been doing her Lamaze regularly?"

The doctor did not answer. He had seen enough as soon as he came to the bedside. Thin white quivering arms and legs, asymmetrically swollen belly, flushed face, far-off dreamy eyes, and a half-smile showing brown-stained teeth. The brief admitting report served only to confirm his immediate diagnosis: seventh month, alcoholic, malnourished, heavy smoker, crack addict.

One thing the admissions report did not say: the woman was high now. She must have jammed cocaine in the waiting room while she was being admitted, to mask the pain of contractions.

Bed Nine. Infant blood pressure 40 over 14 and falling.

"You're right." He made brief eye contact with the nurse at the other end of the bed. "We're going to lose this one unless we do something quick. Come give me a hand."

The long, curved forceps were a device from a medieval torture chamber. The nurse held them as the doctor adjusted their position within the expanded vaginal canal.

"Gently." He nodded. "Almost got it."

The woman on the bed gave a gasp.

Bed Nine. No pulse. Blood pressure indeterminate.

"Holy Mother of God. No time. That's as good as we'll get--give 'em to me."

He swept the uterine sensor out of the way, allowing it to fall to the floor. His right hand was probing, touching the malleable plates of the head and avoiding the soft fontanelle, while his left hand tightened the forceps and steadily applied tension.

"Hold her!"

A force stronger than drugs was at work in the woman's body. She grunted as shuddering contractions rippled bands of muscle across her belly.

"Come on, come on... " Brisbane's whisper sounded like a curse. "Come on--all right, here we go... right now."

Gripped at the sides of the soft-skulled head by the forceps, a tiny purple-red body was slithering free. It came fast, emerging completely in just a few seconds. The nurse grabbed and lifted it, assessing weight and condition.

"Stillborn male," she said into the mike. "Estimated body weight, three pounds. Anoxic. Nasty forceps marks, jaw appears abnormal. No other visible deformities."

Even as she spoke she was turning the shrunken body upside down, attaching sensor electrodes, slapping the fibrillator into position and massaging the little chest. Fluid began to drip from the open mouth, on past the eyes to the bulging and naked skull, and down to the floor.

"Don't waste your time. He's gone, we have to look to her." Doctor Brisbane bent over the mother. He grunted in surprise. She was asleep, sprawling splay-legged and slack-mouthed on the table-bed. After a quick inspection he turned back to the baby and the furiously active nurse. "Nothing to do here. Poor little bugger, he never had a chance with a mother like this. Lung damage for a certainty, probably liver, too, undersized even for seven and a half months. No wonder he didn't make it. If she'd bothered to look after herself one little bit, or if she'd just held him to full term, maybe we could have--well, I'll be damned."

His angry words had been interrupted by a weak, wavering cry.

Nurse Calder grinned behind her mask, and her eyes showed fierce triumph as she glared up at the doctor. Don't ever give up too soon. The long room had gone totally silent. It broke out now in excited chatter. Every woman had caught that faintest mewl of new birth.

"Got a pulse." The nurse had her finger at the baby's groin. "Faint, fast, maybe 150--little irregular."

"Need an incubator, ASAP." Brisbane took the baby and spoke rapidly into his throat mike. "First order service: high oxygen, liver stimulants, blood transfusion. Additional monitors. Bed Nine mother to recovery room. We're on the way up."

He severed and tied the umbilical as he spoke and handed the baby again to the nurse. She wiped slimy mucus from eyes and mouth, cleared the little blocked nostrils, and checked ears, caul, limbs, anus, and genitals. She gently wrapped the newborn in a swaddling cloth and held him out tentatively toward his mother.

"Don't bother. She's off and floating--still high." The doctor walked along the whole length of the row of beds, checking each monitor. The in situ uterine sensors were all silent. "That looks like our last one for tonight--thank God. Next delivery will probably be Bed Two, but that looks like an hour or two to go. Next shift's problem. Come on." He gathered up the patient records for the five deliveries they had made in the past ten hours, handed them to Nurse Calder in exchange for the baby, and headed for the exit.

The incubators were three floors up from the charity ward. By the time the baby had been installed there and the battery of monitors and telemetry units were hooked up, midnight was approaching. When the transparent plastic film was at last in position over the incubator unit Doctor Brisbane sighed, rubbed at his eyes, and removed his mask.

"Thanks, Nurse. You deserve all the credit for this one. That does me for the day. Just let me send word downstairs that the mother can visit as soon as she feels up to it, and we'll be off."

"Don't hold your breath." Nurse Calder removed her mask and was revealed as a plump-faced woman of fifty. Her expression had become angry, with no sign of her earlier euphoria. "Did you read these?" She held out the patient records.

"What about them?" He was removing his gown and surgical gloves, and he made no move to take the papers.

"The mother. Her name is Nina Salk. This is her fifth time in the charity ward. She's eighteen years old, unmarried, and the father of the child is unknown."

"So?" Brisbane had done enough pro bono work in the charity ward to recognize the pattern.

"So the last four times she was here for a delivery, she walked right out of the hospital as soon as she could stand. And she never came back. One child stillborn, one died at four days, two placed with foster parents. But I'll bet she doesn't know any of that. Damn her, she never even went to look at them, never came back to see if they were alive or dead."

"She's an addict, Eileen." With masks and gowns off, the formal relationship was replaced by familiarity. "A bad one, too--I'll be surprised if she sees twenty."

"I don't care what she is, or how long she lasts. She owes something to her kids--she didn't even stay long enough to give them names. I bet this one won't have a name."

"Then it's our job to name him if she won't do it. I'll name provisionally, just in case you're wrong and she does come here." He unclipped the ID card from the side of the incubator and took a pen from his shirt pocket. "Any ideas? John Salk? Not bad, and it's safe, but it sounds a bit too anonymous."

She was not listening. She had moved back to the incubator and was staring down into it. The monitors were doing their job, the status reports already appearing on the display screens.

"Little boy," she said softly. "You're so tiny, and so frail."

"That's not the worst." Brisbane waved his pen at the display. "See, that's what I was afraid of."

Weight at the fifth percentile for full-term delivery. The computer was integrating the reports made by the doctor with prior information on the mother and its own telemetry data of the child's condition. Length at the tenth percentile. X-rays reveal ribcage defects, malformation of jaw and dental structures, incomplete development of lungs. Liver, heart, and kidney abnormalities. Diminished retinal sensitivity. Prenatal cocaine addiction symptoms. Immediate postnatal survival probability, nine percent. Long-term survival probability, two percent. Mammal life expectancy, thirty-one years plus or minus three years.

"He's a total mess." The excitement of life snatched from death had died away. She was exhausted, reaction was setting in, and she was close to tears. A thousand healthy births could not take away the pain of a single sick baby. "You say you give me credit for this one--credit for what? He's ailing and weak, and doomed at birth. If everything went perfectly, he'd not live much past thirty."

"Christ was dead at thirty-three. So was Alexander the Great. How much more do you want him to do in the world?"

Still she was not listening. "Why do we do it?--drag the poor babies into the world, fight to save them, breathe life in them, operate on them--when even before we start we know they can't live a normal life, maybe can't live for an hour. Why do we bother?"

"You're tired out, Eileen." He took her gently by the arm. "We're not gods. Just medics. It's our job to save lives. That's all we can do, all we ought to do."

"We didn't save anyone. Look at him, and those displays. He's dying while we watch." But as she spoke, one miniature brown hand was raised in the air. The little head squirmed round on its negligible neck and the diminutive toothless mouth opened to deliver a cry of protest. One brown eye opened a slit.

"Oh, look at him." Eileen Calder gasped and leaned over the incubator crib. "See him, Doctor? He's looking at us." She smiled down and waved her fingers. "I'm sorry, baby. You heard me, didn't you? I shouldn't have said what I did--we wrote you off once tonight already, and we were wrong."

She turned to Brisbane. "He's a tough little thing, and he's a fighter, or he wouldn't be here now. I hope he makes it. But what sort of a life will he have? Poor little sweetheart, a few minutes old and already he's in trouble. He was born to trouble."

"Then we ought to call him Job, rather than John. 'Yet man is born unto trouble,' that's what the Book of Job says. If he's off to a bad start, he needs a better-than-average name, one with some weight to it. Job Salk." Doctor Brisbane was still holding the ID card, and now he wrote on it, his eyes blurring with fatigue. " 'Job Salk. No, that's not bad but it's not grand enough. Job Napoleon Salk. How about that? He was a little guy, too, and it didn't hold him back. Yes, I like it." He wrote again, and clipped the card back onto the incubator. "Come on, Eileen, let's go home. We've done all we can. I'm ready to drop."

The nurse took one last look at the squirming baby. "You keep right on fighting, babe, you hear me?" She blew a kiss through the scratched plastic cover of the incubator. "Good night, Job Napoleon Salk. I'll see you tomorrow."

She turned to the attendant who watched over the babies needing incubator care. "You look after this one really well. He's had a tough time."

Eileen Calder blew another kiss at the incubator and hurried out after the doctor, into the corridor and onto the elevator that would take them up past Administration to the hospital roof and the helicopter pad.

* * *

In the twelve hours since Brisbane and Calder had arrived for duty a weather front had been and gone, pushing high winds through the area. A balmy noon and low cloud had given way to cold, starlight, and crystal-clear air. When the two emerged onto the roof they found that the midday smog had vanished and the whole city lay spread out before them. The shuttle helicopter was already in take-off position. As they hurried to it they glanced to each side, out and down over the edge of the flat roof.

The area beyond the hospital's solid and windowless walls was poorly lit and gloomy. Most street lights had long since been smashed and never replaced. One mile to the southwest, in vivid contrast to the dark streets, the floodlights, landing pads, and flashing control beacons of the Mall Compound formed a bizarre blaze of red, white, yellow, and blue illumination. Brisbane and Calder were a little too far away to make out the barricades, wire, and watchtowers, but they could see the roaming beams of searchlights, sitting on their long poles and systematically scanning everything on the Compound's boundaries. While the doctor and nurse were climbing into the waiting helicopter, a sudden scream and a clatter of sirens, bells, and horns rang out below. It came from the Mall Compound and from all the darkened streets.

"What the hell. What sort of trouble is that?" Brisbane jerked to a halt and froze with one foot on the helicopter's bottom step.

Behind him, Eileen Calder laughed and waved her arm to take in the whole city. She poked him in the back. "You've seen too many emergencies, Doctor. It's midnight. Remember? Happy New Year!"

More sirens and klaxons were sounding. From all sides, church bells rang out through the chilly night. Brisbane stepped down from the helicopter, turned, and kissed Eileen Calder smack on the lips. "Happy New Year, Eileen."

He walked to the edge of the roof, leaned over, and shouted into the noise-filled night. "Happy New Year, everyone. Happy New Century!"

His cry vanished unanswered into the darkness. But in homes and bars and hotels and restaurants, in freezing log cabins and tall tents and stifling squat mud huts, in churches and chapels and synagogues, in hospitals and prisons and asylums and refuge shelters, on and under land and sea, in the air and out in the vacuum of space, with raised glasses and held hands and songs and cheers and prayers and tears, Brisbane's unheard words were echoed and reechoed. It was a night for jubilation, for reflection, for assessment, for rededication; a night for old memories and new commitments.

As midnight rolled on around the world, the people of Earth were celebrating the arrival of the Third Millennium.

Copyright © 1992 by Charles Sheffield

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