Coming of Age: Volume 1: Eternal Life (29 page)

6. The Next Generation

John Praxis lay in bed with Antigone, cuddling after a bout of lovemaking. Her head rested against his shoulder and her hand played across his chest. Slowly he shifted to one side and lowered her into the pillows, lifted himself up and stared down at her with a long, thoughtful look. “I wish there was more than this,” he said. It was a lack he had been feeling lately, a sense of purpose left unfulfilled.

“What we have is good,” she said. “What more do you want?”

“I want to have a child with you, someone who shares the best of us both.”

“Then you should have met me thirty years ago—twenty, even.”

“It wouldn’t have mattered then,” he said. “I was still married. Adele was my partner, my wife, ‘to have and to hold.’ We took those vows seriously back then.”

“Do you want to get married again?” she asked.

“We can do that,” he said, almost dismissing it. “But a child would join us—”

She wrinkled her nose at him. “You may still be able to get it up, sir. But I’m afraid my uterus is no longer fit for the task.”

“Many people these days use
in vitro
techniques and surrogate carriers. That takes the work out of it—except for the first part.”

“Maybe for you. But after sixty-odd years, my eggs are long past their sell-by date.”

“That shouldn’t be a problem, either,” he said. “We still have usable bits of DNA all over our bodies. If they can rebuild my heart and your kidneys with the stuff, they ought to be able to find a few good chromosomes to build a fertilized egg. The rest is just chemistry … plus paying the bills for someone to bring it—him, her—to term.”

“And then the sleepless nights begin,” Antigone said.

“We can pay someone for that, too.”

* * *

Melissa Willbrot was a mouse—a powerful mouse, to be sure, because she was assigned counsel to the City of Los Angeles Board of Public Works—but still a mousy little person. She stood an inch shorter than Mariene Kunstler, but there the resemblance ended. Willbrot was thin and twitchy, nervous, with strangely yellow-brown eyes that darted side to side every couple of seconds as they talked, as if she suspected an attack from either direction. She wore her dark hair in a cloud of ringlets, each one carefully permed, and they jittered around her forehead and ears like tiny, silent bells. It made Mariene tired just to spend five minutes with her.

But all that aside, from Mariene’s researches Willbrot was shown to be the woman to know in the bidding process on county work. And the subject today was the project for renovating the Long Beach Freeway, the old Interstate 710, which linked the glamorous downtown area and the distant harbor through fifteen miles of sandy lots, dry riverbed, and industrial wasteland. Although the actual construction work would be funded by the F.R. Department of Transportation and the state’s own Caltrans, both of those agencies had been cut back by war and reunification until they could only offer minimal planning and accounting services. The real decisions were made at the local level.

Also from Mariene’s researches—although not explicit in any database, more to be read between the lines and inferred from the stub-ends of various special committee reports—Willbrot was bent. The whiff of corruption was strong, like the scent of cheese in a pantry, but nothing had ever been proven. Time and again, the finger of justice had tapped others—planning commissioners, city council members, accountants and budget analysts—but never Willbrot herself.

And now that Mariene was face to face with the woman in her office, she could sense that Willbrot was bent in another way. It was nothing overt and suggestive, nothing communicated through words, glances, or gestures. But the woman was definitely interested in Mariene. Not in any dominating way, like a predator, nothing butch and obvious. Willbrot was more like docile, willing prey. In the past, certain people had attributed to Mariene a catlike grace and quickness, a tendency to slash first and ask questions later, and an ability to make surprising leaps to save her life. But now, like a mouse fearing the danger yet hypnotically drawn to it, Willbrot was playing up to Mariene’s inner cat. Timidly at first, surreptitiously, but with growing confidence.

All of this was useful information.

“You understand that we have a statutory preference for local contractors,” the woman was saying.

“Praxis Engineering is a California company,” Mariene said, giving her best smile with plenty of teeth.

“Yes, but you’re relatively new and small, with experience limited to Northern California.” Willbrot made a little grimace, as if the cheese wasn’t ripe yet.

“Our principals have a great deal of experience, going back to the prewar firm, which was an international giant in the construction field.”

“Oh yes—the firm that failed.” Willbrot shook her head.

“I think you would be honored to work with them.”

The woman shrugged. “How honored would I be?”

Aha!
The first little kink in their conversation!

“This is a major project,” Mariene said in her silkiest voice. “The costs will be huge, eight figures? Probably nine! We haven’t even begun to estimate it yet.”

“I know! We’re still putting together all the elements of the bid package.”

“I’m sure there will be many considerations,” Mariene said. “With many peripheral expenses to be calculated.”

“Of course, I don’t make the final decisions. I just help the process along.”

“But I’ll bet you can be very helpful—very
persuasive.
”

“I just do my job,” Willbrot cooed, then glanced down at her watch. “Oh, dear! Is that the time? I’d love to discuss the bid process further with you, but I have another appointment. …”

“Such a pity!” Mariene said. She knew exactly what was going on. Only a fool would say anything definitive inside an office in a public building. Oblique suggestions and polite overtures, the first steps of the dance, to test the waters, as it were, all couched in language that would fool listeners at keyholes and microphones—that much was permissible. Specifics and the basics of haggling—those were for later, outside, on neutral ground of the haggler’s choosing.

“Perhaps we could meet later for drinks?” Mariene suggested.

“That would be lovely!” Willbrot agreed, naming a time and place.

Drinks would become dinner, Mariene knew, and then the evening would progress along now-predictable lines. The things she was expected to do for the family!

* * *

Antigone Wells still wasn’t sure she wanted a child. After all, she had lived her whole life without becoming totally responsible for another person—let alone for that hypothetical person’s genetic inception, birth, growth, intellectual and emotional development, and ultimate presentation as a human being. She had never kept so much as a cat in her apartment. Orchids were as much personal commitment as she felt she could make.

But John was gently insistent, even though he already had three grown children of his own—well, two now, and one of them estranged. He still felt the hunger of fatherhood. And so, for his sake, as well as for their future together, she was willing to give
in vitro
fertilization and all the rest a try.

The trouble was, she didn’t know where to begin looking for such services. In the old days, before the world fell apart, she would have gone to her primary care physician, the internist or general practitioner who was her medical insurance plan’s gatekeeper to the universe of specialists. Together they would have discussed the problem, what services were available within her preferred provider network, and how much her insurance would pay. But then, did designing a child out of two adult human genomes come under the heading of “elective surgery” or “reproductive therapy”?

Wells could remember when a huge bureaucracy had tried to run the business of health care across the entire country. It had started with the insurance companies and their health maintenance organizations, or HMOs—or perhaps it began with the federal government itself, back in the nineteen-sixties, when it introduced Medicare and Medicaid. In either case, the bureaucracy established huge buying structures, leveraged volume purchases into advantageous price schedules, and forced the development and consolidation of doctors’ associations, hospital corporations, and pharmaceutical manufacturers. People who were signed up with the system could get medical appointments, hospital and laboratory services, and drugs for next to nothing, or for just a few dollars per visit—called “copays”—so long as they stayed within that circle of preferred providers. Those outside the system, individual buyers without such leverage, paid much more than the market rate. In fact, there was no market, no matchup of producer and consumer, since everything passed through an impersonal middle man. Consumers got what the bureaucracy could negotiate or they suffered the consequences.

But the business of medicine in California had changed since the end of the war and reunification, although seeds of the old pricing structure’s dissolution had been sown long before. For one thing, what was now on offer was no longer “health care,” implying some overall responsibility for the human body, human life, and its well-being, served through the primary care physician and designated specialists. The business was back to passing out “medicine”—not a lifetime commitment to the individual but a marketplace for separate ills, procedures, pills, and surgeries. If you wanted holism or top-to-toe health, you went to a spiritual guru or a yoga teacher.

The biggest change was that the government was no longer in the medical business. The economic collapse that had preceded the civil war had taken care of that. Not that the old United States, as practiced on both coasts, didn’t try to continue offering some form of government-funded health care—a wheezing steam calliope with a bunch of broken and missing pipes. The Federated Republic had dumped that monstrous obligation in the first year after secession.

Without a national bureaucracy of accountants, working either for the insurance companies or for the Department of Health and Human Services, to support a multi-tiered pricing system, with good deals for the volume buyers and sticker shock for everyone else, the whole system eventually collapsed. Hospitals, doctors, laboratories, and drug makers had no incentive to maintain such a monster. Even with computerized billing to keep track of what they might charge through different accounts, they simply could not explain the fee structures and choices to their patients, and they got tired of the haggling. Consumers—forced for the first time to think about what they were paying—became conscious of price and quality. Prices flattened and then began to fluctuate according to the local supply and quality of service. Competition between providers held prices and service offerings in line with consumer expectations.

After a hundred years of being the country’s wealthiest class of professionals, the
nouveau riche
of every community, with pricing expectations to match, the doctors returned to being just fee-for-service working stiffs—the same as any accountant or attorney. After fifty years of being cash cows, hospitals and drug companies went back to being just service providers. Standards slipped for a while, as charlatans and snake oil salesmen practiced their range of gimmicks, and scandals ensued. Finally, the medical fraternity reimposed serious review and licensing, and let their members compete and advertise on the basis of quality, skills, and experience.

Without government support and volume deals, patients suffered for a while. Then they wised up and began paying for their medical expenses in the same way they paid for educating their children or putting a roof over their heads: they planned and they saved. To guard themselves against the unexpected—the original purpose of “health insurance”—people joined mutual funding associations that grew up among neighborhoods, professional groups, social clubs, churches, and even some extended families. Variations included market rating associations for individuals with particular diseases or conditions, and limited liability pools for patients who were more risk conscious. Each association was structured, funded, and paid out a little differently. Since most of these organizations never grew beyond the local community or county level—although some of the professional associations might attain statewide status—they never established the kind of national buying power wielded by the old federal government, and so prices and expectations remained relatively flat.

When Antigone Wells went to explore her and John’s options for
in vitro
fertilization and surrogate hosting, she found a number of providers, some offering package deals with genetic analysts and cloning services thrown in, some offering the best low prices on single procedures. Medicine had rejoined the disorganized world of buying and selling that had all along pertained to car dealerships, oil changers, and auto body shops. Medicine had become a commodity once again, like carpentry or house painting—although perhaps with a higher sense of humanitarian purpose.

Wells did most of her shopping online because, along with the advertising of providers and their services, a secondary market had grown up on the internet, modeled off the original Angie’s Doc
^®
listing. It was an automated, area-wide, word-of-mouth service that provided reviews and testimonials on quality of care and pricing. But still Wells had to get out her sharp pencil, take notes, figure costs, decide what she actually wanted in terms of service and how much she could afford, and then make her own decisions. It was both daunting and exhilarating.

At first, she thought she should look into cloning services, because that seemed to be the nature of her quest—to copy one person out of two genomes. Since it had become technically feasible, cloning had enjoyed a varied history, filled with social taboos and local restrictions. The biggest disincentive, however, was a popular perception of buyer’s remorse. You might want to recreate a favorite cat or dog, or even a deceased loved one, but you soon discovered that genetic material was just the starting point of any organism, and about as important as the yeast in bread dough. Original genes might exist in an embryo, but their expression in the body’s different tissue types was controlled by a variety of chemical factors present in the environment. This was the enigmatic realm of “epigenomics.” It was why even identical twins grew apart over the years. And, in the case of human beings, nurture and the accidents of life, experience, education, and acquaintance had more to do with the essence of personality than the original genes.