Margaritifer Basin (Margaritifer Trilogy Book 1) (55 page)

He shook his head. “Sue, it just
happened. You know, one of those things.”

“I understand and, up to a point,
honestly don’t care.”

“You don’t?”

“No.”

“Why?”

“Because I completely understand
Abby’s motivation.” She smiled softly and looked into his eyes. “Jeff, Abby is
not the only woman in this house that would take pleasure in sleeping with
you.”

His eyebrows went up. “Oh?”

“Of course not. However – and here
is the point at which I start to care – I do not believe Gabriel is, at
present, one of them. But, she is, in all probability, your future. And you are
hers. And news of this could be devastating to her.”

Jeff nodded.

“You are delicately balanced on a
tightrope, juggling a lot of sharp objects.”

He grinned. “That’s a pretty good
analogy.”

“Yes. Abby needs you. Fact is, I
need you, but I have a bit more self-control than Abby. And Gabe also needs
you, but in a different way. In case you have not been keeping up with events,
you have become Gabe’s foundation. Without you, I don’t know what she would do.
And besides that, she loves you.”

Jeff stared at his desk, scratched
his forehead and sighed. “Oh god, what have I got myself into?”

Susan smiled. “You never really
thought this through, did you?”

“Not this far. If I had, I’d
probably be laying on a beach in Bermuda.”

“It’s not too late.”

“No, of course not.” He looked up
at her. “But damn it Sue, I want to do this, and I believe we can.”

“In that, I think we are all in
agreement. But to do it, you will need to keep juggling those knives.”

“Yeah.”

She smiled and nodded.

Jeff sighed. “Okay then. So you’re
gonna take care of Abby’s little problem?”

“Yes.”

“Alright.” He gazed into her eyes.
“Thank you. Thank you for everything.” He grinned. “Particularly the counseling
session.”

“I’ll send you a bill.”

“You do that.”

Susan bit her lip and stared at him
for a moment.

“Was there something else?”

“Yes.” She paused
momentarily. “While we are here, there is a somewhat related matter I have been
meaning to speak with you about.”

Jeff
groaned. “What now?”

“Do you
know what pre-eclampsia is?”

He
frowned. “Um, I’ve heard of it. It’s some kind of pregnancy complication, isn’t
it?”

Susan
nodded. “Yes. It’s a disease distinguished by pregnancy-induced hypertension –
high blood pressure – and other symptoms, and is the most common of serious
pregnancy complications. Estimates vary, but it appears to occur in about 3% of
pregnancies. The exact cause is unknown, but there are a number of known risk
factors including a prior history of hypertension, obesity, diabetes, and, most
notably, first pregnancy. Pre-eclampsia is in fact largely a disease of first
pregnancies.”

“I’m
listening.”

“Abby and
I may be at slightly increased risk; she due to her age and I owing to my small
stature.”

Jeff
frowned, puzzled. “Small stature? What’s that got to do with it?”

“No one
knows, but statistically pre-eclampsia does present with a slightly increased
frequency in women of small stature.” She shrugged. “But the elevated risk for
both of us is probably inconsequential. Gabe has none of the known risk
factors, at least that I am aware of. So, except for the fact that this will be
a first pregnancy, no matter who gets the nod, under normal circumstances all
three of us would fall in the comparatively low-risk category.”

Jeff
smiled. “Okay. Well, that’s good news.”

“Yes.
However, though the cause, as I said, is unknown, one popular theory is that
pre-eclampsia results from the placenta failing to adequately implant in the
uterine wall stemming from an adverse maternal immune response to it. The
placenta, and accompanying embryo, appears to a woman’s immune system as a
foreign object, since half the genetic makeup comes from the father. Under
normal circumstances, the placenta functions as an immunological barrier
resulting in maternal immune tolerance. When that mechanism fails to function
as designed the maternal immune system can react rather aggressively, with
unpleasant results; including not just pre-eclampsia, but spontaneous abortion
as well. Do you follow?”

Jeff
nodded. “Yes, I’m with you.”

“One
theory, rather well supported by several studies, is that an unfriendly immune
response to the placenta can result from maternal immune intolerance owing to a
lack of significant prior exposure to paternal immune modulating factors.”

“Significant
prior exposure? Immune modulating factors? What are you talking about?”

Susan
smiled. “Sex.”

Jeff’s
eyebrows popped and his jaw dropped. “Oh.”

“Seminal
fluid contains a number of immune modulating factors which, over time, will
build a degree of immune tolerance within a woman such that, when she gets
pregnant, her immune system will be more likely to recognize the paternal
antigens from the fetus and placenta and, consequently, diminish the likelihood
of an adverse immune reaction to them. Your plan omits that step.”

Jeff
nodded. “I see.” He looked off and thought for a moment, then looked back at
her. “Wait a minute. There are lots of pregnancies that progress normally from
one-time, um, events; virgin brides on their wedding night, artificial
insemination with donor sperm, rape,
in vitro
…”

“Yes, that’s very true, though
all of the examples you just gave do exhibit higher incidence of pre-eclampsia.
It’s by no means a certainty, Jeff; there are numerous other factors at work.
Nevertheless, studies demonstrate that women with only brief periods of sexual
cohabitation with their partner prior to conception are at significantly
greater risk of developing pre-eclampsia.”

“How
significantly?”

“I don’t
know, the numbers vary and the study methodologies are disputed but, probably
at least two to three times more likely. But, as I mentioned previously, that’s
just the tip of the iceberg. In extreme cases, maternal immune intolerance can
also result in infertility and miscarriage.”

“Okay.
Well, what would constitute a sufficient period of sexual cohabitation?”

“Generally
speaking, the longer the better. According to one study, regular and frequent
sexual relations without barrier method contraception for at least four months.
A year would be better.”

Jeff
rolled his eyes and sighed. “You’re kidding?”

She
smiled and shook her head. “No. But, there are other ways.”

“What?”

“Well,
one would be a blood transfusion. But that would only work with Abby; the two
of you are A positive. However, Gabe is O positive and I am B positive. So you
can’t give blood to us.”

“Alright.
What else?”

Susan
grinned. “You’re going to love this.”

“I’ll be
the judge of that.”

“Let’s
see… how shall I put this?” She paused for a moment, biting her lip. “Um, at
least two studies have shown a surprisingly strong correlation between a
noticeably reduced incidence of pre-eclampsia and, uh… gastrointestinal
absorption of paternal immune modulating factors.”

He stared
at her for a moment, mentally chewing on that phrase. “Uh, did you just say
what I think you said?”

She
chuckled. “That would depend upon what you think I said.”

He
cleared his throat. “Ahem, you’re talking about oral sex.”

“Yes.”
She nodded. “Including seminal fluid ingestion. And, by the way, it also has
the advantage of being more effective and faster acting which, if you think
about it, makes perfect sense, as acquired oral tolerance is arguably the most
effective means of suppressing immune reactivity to antigens, which is
precisely what we are talking about.”

Jeff
cocked his jaw and sat staring at her for a moment, then stood, walked to the
bar, and poured a glass of Scotch.

“Isn’t it
a bit early for that?”

“Not
today,” and he drained the glass, then returned to his desk. “Good grief. The
things they don’t teach you in high school biology.”

Susan
laughed. “Um, given a classroom-full of raging hormones, leaving this item off
the lesson plan may have certain merit.”

“Uh,
yeah. Seminal fluid ingestion?”

Susan
shrugged. “I’m just relating what I have read.”

Jeff
chuckled. “Forgive the pun, but that’s a mouthful. Can’t you doctors just say…
swallow?”

She
grinned and blushed. “Honestly, I wouldn’t know.”

He looked
at her with surprise. “Really?”

She
slowly shook her head.

“You’re
not a virgin, are you?”

“No. But
neither do I have anything remotely approaching Abby’s experience.”

“Right.
Um, what about Gabe?”

“You’ll
have to ask her yourself.”

“What,
and end with
my
head stuck in a wall? No thank you.”

Susan
smiled.

“Sue, I’m
almost afraid to ask, but what are you suggesting?”

“Jeff,
I’m not suggesting anything, I’m simply providing you with the facts as I
understand them. Which, I might add, is what you hired me for.”

He
nodded. “Yeah. Okay, well, I’m, uh, confident that Abby would not have a
problem with this.”

Susan
grinned.

“What
about you?”

She
shrugged.

“Okay.
But explaining this to Gabe?” He cringed. “That could result in severe bodily
injury or death. Mine.”

Susan
chuckled. “That is possible.”

Jeff
shook his head. “Well, for the time being let’s hold off on that option.” He
grinned. “I have to admit, it does sound rather entertaining, but it could
really complicate matters.”

“I
agree.”

“Alright, Sue, what’s the
bottom line on this? If we do nothing and just stick to the plan, what’s the
risk?”

“I don’t
know, probably minimal. If I had to guess, not more than one in ten.”

“Well,
hell, the odds against us just making it back alive are probably greater than
that.”

Susan
frowned. “Thank you for that pleasant thought.”

“Yeah,
sorry.”

“In any
case, when the time comes, I would advise that, in addition to the, um, routine
procedure, you not ignore the possible benefit oral sex may have to her immune
system. Who knows? Even ten or twelve days may help. Further, if she fails to
conceive on the first try, she may be better prepared for the next.”

“Yeah.
Right. Um, what about pre-eclampsia itself? What if it did happen? Could you
deal with it?”

“Probably.
There are a lot of variables. It depends on what point in the pregnancy it
occurs, the severity, the patient’s response to treatment, and the degree, if
any, of coincident fetal distress. But in the vast majority of cases, treatment
is straightforward, and the prognosis is good. Frankly, most deaths
attributable to it – about 80% – occur postpartum.”

“They can
get it even after the birth?”

“Yes, up
to six weeks. And the reason for the high postpartum mortality rate is that
mother and child have gone home, all the excitement is over, they settle into a
routine, and the mother ignores or fails to recognize the symptoms. And the
next thing you know, she’s having eclamptic seizures, stops breathing, becomes
cyanotic, goes into a coma, and dies.”

“Ugh.”

“But in
our circumstance that is not likely to happen. I won’t allow it. I’ll be right
there and watching over both mother and infant like a hawk.”

He
nodded. “Well, there is something to be said for that.”

“Yes, and that’s the
upside of all this. She’s going to have her own personal physician tending to
her day and night, throughout the pregnancy and afterwards. It’s hard to get
that kind of care even on this planet.”

“Good
point.”

“Jeff,
I’m probably overstating the significance of this, but our situation will be a
bit unusual, and I feel matters such as this need to at least be discussed,
even if we choose to do nothing about it.”

“You’ll
get no argument from me on that point. Anything else?”

“No.”
She
got up to leave.

“Okay.
Well, I’ll say this much, at least you’ve given me something to think about as
I lay awake in bed at night.”

Susan
grinned. “Enjoy.”

“Yeah.”

At the door she paused and turned
back to Jeff. “And by the way, the next time your back is bothering you, call
me. Abby is not the only one with a therapeutic solution.”

Jeff chuckled. “Uh, yeah. I’ll, uh,
keep that in mind.”

Tuesday, September
30, 2014 (T minus 539 days)

Jeff glanced up at the big screen.
The view of Mars was fantastic, like nothing he’d seen before.

Gabe grabbed his hand. “That’s your
image. Not NASA’s or JPL’s, or the European’s or Russian’s.” She shook with
excitement. “That’s yours! You did it.”