State of Wonder

“Mr. Fox was not a doctor. He had been the first CEO to come from the manufacturing side. When she spoke of him to other people she spoke of Mr. Fox. When she spoke to him in front of other people she addressed him as Mr. Fox. The problem was calling him Jim when they were alone”

This quote sheds light on both Mr. Fox’s career background and the nature of his relationship with Marina. It is noteworthy that his background is in production and not medicine, which prefigures his obsession with the Martin based fertility drug, a drug that has very little value in terms of public health, but a lot of value financially. Beyond this, Marina’s difficulty in separating “Jim” from “Mr. Fox” shows how difficult she finds loving a man whose personal and corporate identities seem so inextricably linked. 

“Mr. Fox didn’t know Karen Eckman. He had met her at company parties but he told Marina he could not remember her face, a fact that seemed unforgivable now in light of what had happened” 

The fact that Mr. Fox does not know Karen, even after meeting her at several company parties, does seem damning. This is particularly true given the fact that he personally dispatched her husband—against the advice of his board—thus risking his life on a company mission that he was ill-equipped to tackle. This detail is a brush stroke in a larger portrait of the CEO, portraying a cold man largely interested in his business, but disengaged from the human beings that help drive it.  

“It strikes Marina as odd that all these years later she still remembers Dr. Swenson in the lecture hall. In her mind’s eye she never sees her in surgery or on the floor making rounds, but at a safe, physical distance” 

Marina’s memory of Dr. Swenson from her time at Johns Hopkins suggests a woman who is unapproachable, unknowable, forever distanced and emotionally disengaged from the vast majority of her students and colleagues. She is a public figure with a large platform, but beyond that public image is an inscrutable women intent on being heard, on being respected, but not on being personally known.

“This was the moment for Mr. Fox to tell the story, to explain it in a way Marina herself did not fully understand, but nothing came” 

When Marina and Mr. Fox visit Karen Eckman to break the news of her husband’s death, Mr. Fox leaves it up to Marina, his subordinate, to deliver the message. Even though he should be the messenger, since he is responsible for sending Anders to his death in the Amazon, Mr. Fox is unwilling or unable, to perform the task, content to make Marina to deliver the emotionally charged news instead.  

“It wasn’t until the third night after she took the first tablet of Lariam that Marina’s thoughts swung sharply in the direction of India and her father. In the process of leaving for the Amazon, she had inadvertently solved a mystery that at present was the farthest thing from her mind: What had been wrong with her childhood?...And then the unexpected answer: these pills” 

Marina, preparing for her journey to Brazil to track down the truth about Anders’ death and to hasten the progress of Dr. Swenson’s research, is forced to take the anti-malarial drug Lariam. This drug has a number of side-effects, including depression, which are particularly devastating for Marina. The drug triggers recurring nightmares that force her to relive her childhood separation from her father. Furthermore, she realizes that it was Lariam, proscribed during her childhood trips to see her father in India, which initially triggered these nightmares. In taking Lariam again for her trip to Brazil, Marina is forced to relive and re-experience her traumatic nightmares.

“Being the child of a white mother and foreign graduate student father who took his doctoral degree but not his family back to his country of origin after he was finished had become the stuff of presidential history, but when Marina was growing up there was no example that could easily explain her situation” 

Marina’s childhood was not only traumatic as a result of her father’s abandonment, but because she grew up during a time when there was no model or well-known point of comparison for explaining or making sense of her complex family situation. Beyond the abandonment, her white mother and her Indian father made the question of her identity a particularly difficult one.

“She calls for him, Papi! Papi! But the ringing of bells, the calling and crying of beggars, has taken the sound from her mouth. She doesn’t know if he even realizes she’s gone” 

In Chapter 2, the narrative describes the recurring nightmare that haunts Marina. The dream features the teeming crowds of Calcutta, her father’s native city, swallowing her father up and permanently separating him from his daughter. It is symbolic of her father’s abandonment, and the lingering damage it caused to her self-esteem.

“She thought that she was saving the baby’s life because she was so fast, but the instant she realized he was occiput posterior, looking straight up, the blade had caught his head right of center at the hairline, cutting until she stopped in the middle of his cheek…The child’s father could feel it when he came back to the hospital that night to find his wife sedated and his son scarred and blinded in one eye” 

The passage highlights the thin line between life and death that doctors have to navigate in their profession. Marina, during a flashback to her days as a resident in Baltimore, remembers one of her life’s grave “accidents.” Faced with an infant who might not survive a delayed C-Section, Marina plows ahead without her resident advisor, Dr. Swenson. In her haste, and ignoring protocol, she slices through the middle of the infant’s face during the initial incision of the womb, leaving a permanent scar and blinding the baby in one eye. This “accident” ended her career as an obstetrician and continues to haunt her. It serves as a harsh reminder that even the noblest impulse must be accompanied by sound practice. 

“She spent a great deal of time looking at the water, which was the color of milky tea and completely opaque even when she walked down a dock, squatted on her heels, and stared directly into it. She did this often. She couldn’t see a quarter of an inch below the surface. She was waiting for Dr. Swenson” 

Marina’s first few weeks in Manaus are a sort of Limbo; she is forced to wait for Dr. Swenson, without any clues about the journey that lies ahead. Like the surface of the Amazon, Marina’s path is clouded and uncertain. She has nothing to do but wait. 

“A thirty-five-year period of study? That would mean that while Dr. Swenson was, to the best of her knowledge, teaching a full load at Hopkins she was also studying the Lakashi in Brazil?” 

During Marina’s time in Manaus she learns more about Dr. Swenson’s expeditions to the Amazon. Her discovery that Dr. Swenson balanced both the demands of a full teaching load while simultaneously organizing research expeditions into the deep Amazon is one of many clues pointing to the fact that Dr. Swenson is a relentless, willful, resilient, and tirelessly ambitious individual.  

“She’s such a force of nature. Her work is thrilling, but really, it’s almost beside the point. She’s what’s so amazing, the person herself, don’t you think? I try to imagine what it would have been like to have a mother like that, a grandmother, a woman who was completely fearless, someone who saw the world without limitations” 

While Barbara Bovender, one of Dr. Swenson’s “gatekeepers”, whom Marina meets during the Manaus chapters, is largely known for her skimpy outfits and superficial concerns, this is one of her rare bursts of insight. Dr. Swenson, like many other people we admire, represents those who refuse to be bound by the limitations of the world. This quality is particularly attractive to the young and idealistic Barbara. Barbara’s words also help to illustrate the change from Marina’s youthful admiration for Dr. Swenson, to her mature skepticism about her former mentor. 

“She was Orfeo, and there was no question that Anders was Eurydice, dead from a snake bite” 

In Chapter 5, Marina attends a performance of Gluck’s opera, Orfeo and Eurydice at the Teatras Amazonas. The opera, a reimagining of the Greek myth, where Orfeo braves Hades to bring his lover back to mortal earth, has many parallels with the trajectory and purpose of Marina’s own journey up the Amazon. She, like Orfeo, wants to bring someone—Anders—back from death and the hellish heat and disease of the jungle.

“I was a student of Dr. Rapp’s, and the location of his classroom was unpredictable. I followed him through Africa and Indonesia, but the Amazon was the source of his most important work. He studied botany, and I was free to study the workings of a true scientific mind. As an undergraduate at Radcliffe I wasn’t allowed to take his class at Harvard. Harvard couldn’t have stood for anything as radical as that, but Dr. Rapp let me travel on the expeditions. He was the first teacher I encountered who saw no limitations for women. As it turned out he was the only one” 

During their long boat trip up the Amazon River, Dr. Swenson reveals the first major clue about the nature of her relationship with the legendary ethnobotanist, Dr. Martin Rapp. While we later learn about their romantic involvement, this passage sheds light on what attracted her to Dr. Rapp. He was a man who “saw no limitations for women,” a quality that echoes Barbara’s earlier statement about Dr. Swenson.

“‘Open your eyes, Dr. Singh,’ Dr. Swenson said. ‘Look at the stars’”

While this is a short, imperative statement, delivered in a terse manner, Dr. Swenson’s message moments before their arrival at the Amazon research station has much broader implications. During much of her journey up the Amazon, Marina has been so disoriented by this alien landscape, so caught up in her own confusion about how to reconcile this new experience with her previous mental models, that she fails to live in the moment and see the world around her. By telling her to look at the stars, Dr. Swenson allows her to see and experience this world while living in the present. 

“It was a dozen fires, and then the fires tripled, and then Marina could no longer count them. What had been a line had spread into layers, and in those layers the circles of light lifted and fell. Was the fire in the tops of trees? Was it somehow burning in the water? Easter turned the lights of the boat back on and instantly the fire began to leap. An ululation of voices exploded the night, the ringing sound of countless tongues hitting the roofs of countless mouths. It filled the entire jungle and poured up the river in a wave…There were people on the banks of the river”

This passage describes Marina’s first encounter with and image of the Lakashi tribe. From the elemental confusion of fire and water, to the sensory overload of flame, jungle, and ululating voices, the entire passage illuminates “a state of wonder,” where one’s prior experiences cannot account for or fully describe a mesmerizing encounter.  

“When she sat down on the edge of her bed, Marina realized that in her concern about fire and snakes and the wandering hands of the natives she had walked off and left her suitcase on the boat” 

“The older woman now got up stiffly from the floor and began to unbutton Marina’s shirt. Marina caught the woman’s fingers and shook her head but the woman simply waited until Marina let her hands go and then she started again…The woman’s belly was high and hard and suddenly Marina saw the woman’s arms were thin, her face and legs were thin. Only her stomach protruded…Marina stopped, considering the ways to extricate herself while the woman resumed the work with the buttons, her stomach pressed against her, and then she felt the baby kick”

Marina’s initial experiences with the Lakashi are full of disorienting encounters and moments of culture-shock. This passage describes her first experience in a Lakashi family platform hut, and her first time coming face to face with the potency of the Lakashi fertility compound. The scene is not only intensely uncomfortable—she must directly confront very different cultural values governing personal space and boundaries—but also shocking, as Marina comes face to face with an elderly woman in the midst of pregnancy.

“In this group Marina danced with the people who were not white while the white people watched them. It would never have been her preference to be part of a tourist attraction” 

While the Amazon wilderness may seem far removed from the influences of Western civilization, we learn that this is not the case during Marina’s visit to the Jinta Trading Civilization. Unlike the Lakashi, the Jinta have much more direct exposure to the outside world, and have already been corrupted by it, turning their ceremonial dances into tourist attractions, and performing for the white tourists. 

“Benoit wants to be a tour guide and the stock and trade of an Amazon tour guide is the ability to pick things up—tarantulas, Caiman lizards, all sorts of ridiculous things. Pulling an anaconda into a boat is an extraordinary accomplishment…Had it ended better he probably would have asked you to write a letter to the National Board of Tourism” 

During their return voyage from the Jinta Trading Post, Benoit shows another example of Western civilization’s corrupting influence on the Amazon tribal cultures. Benoit, like many young men, hopes to make good money in the booming Amazon River tourist trade. Intent on making a name for himself, he makes an extremely misguided and nearly fatal decision when he pulls an Anaconda out of the river and onto the boat. Like the motorcycle stuntmen who leap over ever widening gorges, the tour guides feel compelled to compete for notoriety and acclaim through spectacle.

“There has never been any evidence that this ecosystem is duplicated anywhere else in the rain forest, anywhere in the world. These trees you’re looking at here, these mushrooms, this is it. As far as we know, these are the only Rapps in the world. Your passport to spiritual enlightenment” 

The scene in the Martin grove exposes Marina to an ecosystem that has no parallel in the world. The trees and mushrooms are not only dazzling sights, but have rare medicinal properties. While Dr. Nancy Saturn’s comment about a “passport to spiritual enlightenment” is delivered in a tongue-in-cheek manner, there is a truth to her irony. The Lakashi not only use the hallucinogenic properties of the Rapp mushrooms in their “vision quest” ceremonies, but the rare vision offered by the Martin grove, a rare picture of pure symbiosis, offers a startling epiphany; that “state of wonder” often associated with deep and direct religious experiences.

“If the greater world knew where they were…this place would be overrun, drug dealers, the Brazilian government, other tribes, German tourists, there’s no telling who would get here first and what sort of a war would ensue” 

Nancy’s words shed light on the vulnerability of this rare environment. It explains Dr. Swenson’s intense and deliberate secrecy about her station, and it touches on a difficult truth about the human tendency to corrupt, exploit, and destroy in the relentless drive for money and power.

“The key to fertility is found in the combination of the Martin tree and the purple martinet” 

Nancy reveals the secret of Lakashi fertility, explaining that all the rare elements of this unique environment—the martinet moth and the Martin tree—must work together to create the potent medicine. This passage not only underscores this fascinating symbiotic relationship, but also illuminates the fragility of a process that requires a delicate balance between multiple organisms. 

“The people who need a malarial vaccine will never have the means to pay for it. At the same time I will give them a drug that will, if anything, undermine the health of women and make them a truly obscene fortune. Isn’t that a reasonable exchange?” 

In two sentences, Dr. Swenson outlines the troubling dichotomy, and ethical conundrum that is at the heart of modern medicine—those who make medicine to aid greater public health are often thwarted in their efforts by those who make medicine to aid their stock shares and financial portfolios. While she willfully lies to her corporate sponsor, Mr. Fox and Vogel, her question forces us to consider the realities of her position within the larger framework of publicly traded, for-profit pharmaceutical corporations. Her lies are an attempt to leverage a malaria vaccine that no corporation would ever pay for—because malaria afflicts mostly the third world poor and is therefore unprofitable—in exchange for a relatively worthless fertility drug that will be extremely profitable. Her ethical dilemma underscores the difficult position of many researchers who must balance personal idealism with the realities of modern big-money medicine.