Synecdoche

One of the unanticipated consequences of a family member being diagnosed with an undesirable genetic condition is a greater understanding of science-fiction. In combination with a professional research degree, one gets a crash-course on how fascinating reproductive technology is for people whose options unexpectedly turn out to be various shades of terrible. One learns all manner of thrilling acronyms for procedures ranging from the mildly to the painfully invasive. One hears tell of many doctors, all of them extremely knowledgable, each of whose takes on each procedure seems to be just different-yet-nuanced enough to raise new questions without quite answering others. Each visit is a tragic reminder that one still doesn’t know whether having a (nominally) 100% chance of having a 50% chance of having a healthy child is better or worse than having a 30% chance of having a (nominally) 100% chance of having a healthy child (or children), with all its attendant emotional and interpersonal stresses.¹ And that one probably never will.

Enter, curiously, Orson Scott Card. I have long celebrated science-fiction as a medium for re-presenting real, present problems in an unfamiliar context (a thought recently echoed on NPR in an interview that I cannot seem to find). Card made a name for himself upon publishing the phenomenally successful Ender’s Game, the story of a genius child who is selected to attend the prestigious “Battle School” and, ultimately, to lead a team of other children into battle against the Earth’s alien invaders. After spinning Ender’s Game out into a quartet of novels, the latter three of which follow the details of Ender’s life in space thousands of years after the battle is over, Card produced another quartet —the Ender’s Shadow quartet— which follows the life of Bean, one of the graduates of Ender’s army, on Earth in the years immediately following Ender’s victory.²

As blurbs on back covers would have it, the three latter books in the Bean quartet tell the story of the ascent of Peter, Ender’s brother, as the “Hegemon” who will unite a fractured world populated by battle-trained genius children. Bean comes to his aid, along with a number of other Battle School graduates, by taking command of Peter’s army. Together these characters work to eliminate those who profit from the uncertainty that threatens to splinter the nations of the world into warring factions, to take on those who would unseat Peter as Hegemon (or nullify his influence), to predict what will happen as events unfold, and to do their best to steer and alter the course of world events. And this, essentially, is what the books are about.

That and, you know, sex.

But wait! Not the kind of hot, steamy, consequence-free sex we have come to expect from books that labor under the (often unfortunate) epithet “fantasy/sci-fi.” Indeed, at bottom, the latter three books of the Ender’s Shadow quartet detail the shockingly prosaic story of two people trying, despite all odds, to have babies.

Granted, these people are geniuses who spent their childhoods playing war games in a desperate attempt to save the Earth from alien invasion, only to return to the Earth they saved and spend their adolescence trying to avoid being drafted or forced into military service at the behest of whatever country claims to be their “home.” Granted also, the human-engineered genetic illness that they are laboring to eliminate causes Bean to grow disproportionately quickly, acquire disproportionate intelligence at a disproportionately young age, and die disproportionately early. Granted, finally, that of the ten viable blastocysts created by Bean’s mad scientist endocrinologist and embryologist are stolen by an evil genius trying to take over the world.

But let’s back up for a moment, because the story that underlies these extraordinary circumstances is profoundly ordinary. Upon returning to Earth, Bean is convinced, against his better judgment, to reconsider his decision not to have children. What he does not reconsider —and what most poignantly parallels the situation I am familiar with— is his unwillingness to pass his genetic condition on to his progeny. In order to have his way, he enlists a battery of medical techniques that seem like science-fiction, but which (I assure you) are very real. They all fall under the umbrella of Assisted Reproductive Technology (ART), but we prefer to call it, affectionately, “having babies the hard way.” First, Bean and Petra must find a reproductive endocrinologist and infertility (REI) specialist who can harvest a number of Petra’s eggs. The is the first step of the more well-known process of in-vitro fertilization (IVF). Because they are not dealing with infertility, but rather are trying to screen out a genetic condition, each egg must be fertilized with a single sperm injected directly inside its cellular wall. Genetic screening is a precise science, and one cannot run the risk that another, less successful sperm cell gets accidentally tested and throws off the results. This process of direct injection is called intracytoplasmic sperm injection (ICSI). Some three days after fertilization, allowing enough time for the blastocysts to divide up to three or four times (for a total of 8 or 16 cells), one cell is carefully extracted, and run through any requisite genetic testing, a process called pre-implantation genetic diagnosis (PGD) or pre-implantation genetic screening (PGS). Statistically speaking, 50% of the fertilized eggs will carry the genetic condition and will be discarded. The remaining few will either be injected into the would-be mother’s uterus, or frozen for potential future use. After all that, the chances that the egg will implant and be carried to term are approximately 30%.³

Bean and Petra have literary necessity and science-fiction on their side. Upon realizing that their REI doctor is in fact an evil madman, they escape with all 10 fertilized eggs, but no idea which ones carry the genetic condition and which don’t. Petra, nonplussed, has one injected into her before the remaining nine are kidnapped and injected into other women. Miraculously, all ten implant and are carried to term.⁴ The remainder of the quartet, on some level, is about Bean and Petra struggling to recover their nine missing children, determine which ones carry the genetic mutation, and figure how to keep them alive until a cure can be manufactured.

Broken people saving a broken world, trying to keep each other whole. We should all be so lucky.

Footnotes

1. Forget about all the other terrifying conditions that one isn’t testing for. ↩
2. The first book of the quartet, Ender’s Shadow, is a brilliant narration of Ender’s Game as it unfolds from the perspective of Bean. ↩
3. Realistically, the process of viable egg attrition is much harsher. Many extracted eggs will not be mature enough to fertilize. A certain percentage of the remaining fertilized eggs will not survive to day 3. Of those that do, some will not survive the cell extraction process. Of those that do, some will not survive the extra 1-2 days it takes to perform the tests. Most couples are lucky to be left with a mere one or two viable, healthy fertilized eggs by the time the process is over. ↩
4. Parenthetically, Petra never considered one other procedure that could have alerted her as to whether the fetus she carried was affected by Bean’s genetic condition. The procedure, called chorionic villus sampling (CVS), involves extracting a cell from the placenta after 11-12 weeks of gestation. Since the DNA of the placenta are genetically identical to the DNA of the fetus, this allows one to test for genetic irregularities while posing minimal risk to the fetus. ↩

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