Excerpts

PROLOGUE March 6th 11:15 pm    It was a cold, raw, windy and heavily overcast March night on the lower east side of Manhattan, New York. Although the spring equinox was soon to arrive, winter had not given up. As evidence even a few wayward snowflakes swirled down out of the low cloud cover, which was churning like a witch's brew. With the temperature hovering in the mid-thirties these microscopically intricate and strikingly beautiful crystalline structures were immediately metamorphosed into mere droplets of water the instant they touched any terrestrial surface. In sharp contrast to this wanton destruction of nature's handiwork, the situation was the opposite inside a cozily decorated one-bedroom 4th floor walkup apartment on 23rd Street. Within the literal and figurative indoor warmth, a cascade of cellular events had begun that was ultimately the absolute opposite of the dissolution of the snowflakes. Here there was to be a progression of vastly increasing order and complexity initiated by the forcible ejection of more than a 100 million eager sperm into a vaginal vault.             The individuals involved in this amorous event were blissfully unaware of the miraculous drama they had initiated nor of its ultimate dire consequences for both of them. Thoroughly intoxicated by the passion of the moment and forsaking contraception, they had given no thought to the possibility there would be an almost simultaneous release of a receptive ovum from the female's right ovary. Nor did they consider how determined sperm are in fulfilling their singular desire to fuse with a receptive female equivalent.             Two and a half hours later when the woman was contentedly fast asleep and the man likewise in his own apartment, the fastest-swimming sperm, following a perilous and Herculean marathon from the depths of the vagina to the internal end of the right fallopian tube, collided head-on with the passively descending ovum. Powered by an irresistible reflex, this winning sperm rapidly burrowed between the cloud of cumulus cells surrounding the ovum to hit up against the ovum's tough covering. A moment later he injected his pronucleus into the ovum to allow his 23 chromosomes to pair with the ovum's 23, forming the normal human cell complement of 46. The ovum had now become a zygote.             Thus, on this nasty New York March 6th night, one of the most astounding miracles of the known universe had been initiated: human GENESIS. Although such episodes of fertilization currently occur in the staggering neighborhood of 350,000 times a day on a world-wide basis, which clouds peoples' appreciation by its repetition, it begins a process of  truly wonderous, dumbfounding complexity. As a single cell that can barely be seen by the naked eye, the human zygote contains all the data and instructions in its microscopic DNA library necessary to form and operate a human body.  That means without any additional informational input the single-celled zygote it is capable of orchestrating the origin of some 37 trillion cells of two hundred different varieties as well as several billion extraordinarily specific, large-molecule proteins that must be formed according to exacting standards at just the right time, in just the right amount, and at just the right location. The human brain alone with its 100 billion cells and more than 100 trillion synaptic connections might be the most complex structure in the universe.             By March 11th, five days after the lovemaking that initiated this particular ongoing miracle of human genesis, the rapidly developing conceptus reached the uterus to begin its implantation in the uterine wall. Soon it would make its presence known, proclaiming that a pregnancy had begun. From then on, all that was needed for the birth of a human infant in approximately nine months was basic nutrients, the removal of waste, and physical protection. Unfortunately, in a terribly tragic fashion these required needs were destined not to be maintained in this pregnancy even though everything else in the stunning process was right on track.       May 5th 10:05 pm             Taking a shower was a Zen experience for 28-year-old social worker Kera Jacobsen, especially after a tense weekend. Being careful not to fall since her bathtub's curved, porcelain coated bottom could be treacherously slippery, she stepped in, yanking the shower curtain closed in the process. She had already adjusted the water temperature to the near-scalding heat she preferred. After wetting her body thoroughly, she began to scrub herself with the help of a fragrant  gel and a long handle shower brush, washing away the stresses of the day and calming her general anxieties. She'd been experiencing more than her share of both lately.             Kera had been in New York City for just under six months. Coming to the Big Apple had been a rather sudden decision. She'd grown up in Los Angeles, obtained her master's degree at UCLA, and had held a position in social work at the UCLA Mattel Children's Hospital. Her specialty was working with children with complex needs and their families. It was demanding work and often emotionally draining although ultimately fulfilling. There was no doubt that her efforts made a big difference and were an important complement to the work of the doctors and nurses who were understandably focused on cure and alleviating immediate symptoms of the disease process rather than the bigger picture of how families and individuals coped. In this capacity she'd been content and professionally satisfied. What ended up rocking her world was the sudden and unexpected end the previous September of a long-term relationship with a medical student named Robert Barlow. Over the course of the two and a half years they had dated, they frequently spent the night at the other's abode. With similar interests, including a shared liberal political orientation, they were never at a loss for conversation, which occasionally included discussions of future plans with the standing assumption it would be together. His intention was to take a surgical residency at one of the well-known academic medical centers, preferably there in LA or, if not, possibly San Francisco. As a particularly dedicated student, he was hopeful he'd have his choice. Kera had assumed that she would follow if he were to head up to San Fran. With her sterling credentials she was confident she could get a job at any academic medical center.             But it wasn't to be, and Kera still had no idea of exactly what had happened, although she had heard through the UCLA Medical Center grapevine that Robert had been seen frequently in the company of one of the surgical department's first year female residents. Nonetheless and with zero warning whatsoever, Robert had informed her one hot, smoggy L.A. afternoon that their relationship was over. Having suffered a big blow to her self-esteem, Kera felt the urgent need to fly the coop. Mutual friends kept asking what had happened between her and Robert, pretending to be sympathetic but actually loving the drama and gossip. Besides, there were just too many chances of inadvertently running into Robert in and around the medical center. On top of all that, Kera always had had a soft spot for New York City, coupled with being tired of the monotony of Los Angeles weather, its uptick of annual forest fires, and the ever-present threat of San Andreas Fault activity. A few weeks after Robert's shocking news, she decided to turn an emotional whammy into something positive and made the cross-country move. After rinsing the soap off her body, Kera squeezed a dollop of shampoo into the palm of her hand and began to wash her hair. This was the part of the shower that she liked the best, and she used considerable force as she worked up copious suds to massage her scalp, trying to blank her mind. At first the move to New York had been positive in all respects except for the continued disappointment voiced by her mother and sister who claimed they missed her terribly. Kera had managed to get a commitment for a social work job at the NYU Langone Medical Center--specifically with the Hassenfield Children's Hospital--before leaving L.A., so employment hadn't been an issue. As for an apartment, she lucked out by responding to an ad on one of the Langone Medical Center's bulletin boards that had been posted by a nurse who had opted to join the Peace Corps. The listing was for the sublet of a furnished, rent-controlled one bedroom on 23rd Street just off Second Avenue. More importantly, from the standpoint of her self-image, Kera also found herself involved in a whirlwind affair with an attractive, highly accomplished, and older and more mature man than Robert, whom she met over the December holidays. Unfortunately, her life had taken another unexpected and unpleasant turn, and she had begun to question her judgement as well as her gullibility. Once again, she was experiencing disappointment and self-esteem issues--perhaps not as precipitously as with Robert, yet she was disturbed enough to have started seriously to consider returning to Southern California. As she expected, her mother and sister were absolutely thrilled with the possibility when she'd called them that evening to broach the subject, even though both had immediately questioned what seemed like a sudden change of heart. Only a month earlier in a similar group chat Kera had impressed them with how deliriously happy she was living in the Big Apple. Unprepared to share any details,  Kera merely carried on about having come to the realization of how important close family connections were to her. She felt a twinge of guilt at not having been forthright, but the truth was that she hadn't completely made up her mind. There was still a vestige of hope that things might improve, although the chances weren't good. Kera turned off the shower after making sure all the soap and shampoo had been completely rinsed. With her bath towel in hand, she stepped from the tub. Bending at the waist, she rapidly towel dried her thick, moderately long hair, which she considered the only contribution her emotionally unavailable father had provided her. As she straightened, she subconsciously glanced at her profile in the full-length mirror attached to the back of the bathroom door. When it occurred to her what she was doing, she laughed at herself. It was far too early to see any change. Finished with drying herself, Kera was about to hang up her bath towel when her buzzer sounded in the other room, announcing that someone was downstairs at the building's front door. The sudden raucous sound  cut through the quiet apartment like a hot knife through butter, shattering the peacefulness Kera had been experiencing. Tossing her towel over the edge of the bathtub and grabbing her robe from the clothes hook, Kera dashed out to the tiny kitchen where the ancient intercom was mounted on the wall. As she pressed the 'talk' button and asked who was there, she noticed the time on the microwave oven. It was 10:23. Since she hadn't ordered any take-out and there was only one person who would possibly ring her bell at such an hour, although never without a text or call, she was reasonably sure who it was. The possibility didn't thrill her. She'd been trying to calm herself prior to getting into bed. "It's me," the expected masculine voice said. "What are you doing?" Kera questioned. She leaned close to the speakerphone. She had to press the vintage device's 'talk' button each time she spoke and then let go to listen. "I'm sorry about the hour, but I need to talk with you." "I'm just getting out of the shower. How about tomorrow around lunchtime?" "I need to talk with you tonight. I've had a change of mind, and I want to share it with you. I need to share it with you." Kera paused even as her pulse quickened. After everything that had happened and everything that had been said over the previous month, there was no way she could be at all certain what he meant by 'a change of mind.' She could guess. But was it wishful thinking? After all, he had been painfully and consistently clear over a period of weeks. Still, if he meant what she thought he might, it would change everything. "What kind of change of mind?" Kera asked finally, lowering her guard. She didn't want to get her hopes up only to have them dashed on the proverbial rocks all over again. "I've realized you were right all along, and I was wrong. It just took me some time to figure it out. We need to celebrate!" "Celebrate?" Kera questioned to be sure she'd heard correctly. "Yes, celebrate. And I've brought the makings." Trying to contain her excitement, Kera hit the 'door open' button. Then she fled back to the bathroom, pulling on her robe in the process. She had been standing naked, clutching the robe to her chest the whole time she'd been on the intercom. Once in the bathroom she grabbed her hairbrush and tried to tame the wet mop on top of her head. It wasn't working. She felt she looked dreadful, but there was no time to do anything about it. Cinching the tie on her robe and with a final desperate pat to her hair, she was back out to the door to begin disengaging the panoply of locks and chains the renter of record had installed. Just as she'd finished, there was a furtive knock. With a final check through the peephole, Kera pulled open the door. Her visitor was wearing a dark fedora and a dark overcoat she'd never seen. Before she could greet him, he swooped into the room, closed the door, and enveloped her in an embrace that took her breath away. Only then did he put down the shopping bag he was carrying and remove his hat and coat, which he tossed onto the couch. "As I said, we have to celebrate," he announced with great fanfare. He then proceeded to take out several impressive cut crystal fluted Champagne glasses followed by a chilled bottle of rosé prosecco nestled in a thermal sleeve and finally, a small package of cocktail napkins. "Check this out!" he said, showing the bottle to Kera as if he were a sommelier. "Okay," Kera said while reading the striking black label. "Bortolomiol Finlanda Rosé. I've never heard of it." "It's fabulous," he said proudly, "and remarkably hard to find." "What exactly are we celebrating?" Kera asked hesitantly while he struggled with the wire securing the bottle's cork. This kind of response from him was what she'd hoped and had expected when she'd originally broken the news. She'd been crushed when it hadn't happened. "We're celebrating everything," he said triumphantly. "The fact is, you were right, and I was wrong. What's happened is truly a miracle that was meant to be. I just didn't see it in the heat of the moment." Kera could have pointed out that he'd taken far longer than a moment to come to the realization; in fact, there had been nearly a month of confrontation. But she didn't say anything for fear of breaking the spell his enthusiasm was creating. She heard a resounding pop when the cork came out of the bottle. A bit of foam with a pink blush appeared at the bottle's mouth. "As you said, life is too precious a miracle not to embrace." He poured two glasses of the bubbly wine. "What about your wife?" Kera struggled to question. "History," he said simply as he handed one of the glasses to Kera and then hoisted his and extended it toward her. A melodious clink resounded in the otherwise silent room as the glasses touched. Following his lead, she took a healthy swig of the prosecco, which tasted better than any other wine she had ever had. Almost a month earlier she'd decided to avoid alcohol, but this moment was special. They had had several unpleasant arguments about the future over the previous weeks, and she'd reconciled herself to their being hopelessly miles apart. His sudden 180 elated her. It was most definitely a time for celebration. "Let's sit and enjoy the wine," he suggested while gesturing toward the couch. He moved his coat and hat to a side chair. "This wine is from the Veneto part of Italy," he added as he tugged on the sleeve of her robe, urging her over to the couch and to sit. "It is tasty," Kera said. She had no idea where the Veneto was but assumed it was somewhere near Venice. She didn't ask for more of an explanation since she didn't care. As for the taste of the wine, she was being truthful. As she sat down, she took another healthy swig, enjoying the effervescence as well as the smooth and subtle taste. She'd never been particularly fond of Champagne and had always questioned the fuss and the cost, but this was different, making her wonder how much was from the wine and how much from her joyous mindset. Whatever it was, she was savoring the totality of the experience. Of course, she had a million questions, but for the moment they could wait. While he rambled on about prosecco and the Veneto of Italy with no appreciation of her lack of interest, she took another drink of the wine and held it in her mouth for a moment before swallowing. It was truly a delightful experience, and she luxuriated in the wonderfully relaxing feeling that spread over her, a far cry from the depressive thoughts she'd struggled with over the previous month. But then a dizziness intervened that wasn't so pleasant. Although he was still talking, his words stopped having any meaning. At the same time her vision blurred. Blinking repeatedly to clear her eyes, she put her glass down and tried to stand, but her legs wouldn't work. "Are you okay?" he asked while putting his own glass down. "I'm okay, I guess," she managed but her words were mumbled. "I'm just suddenly so tired..." Kera's voice trailed off as she slowly sank back with her head resting against the back of the couch. Her eyes had closed, and her mouth was agape, and her breathing slowed. Excerpted from Genesis by Robin Cook All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.