Pluripotent
Amanda Niehaus
Part I.
In 1911, J. F. Gudernatsch conducted an experiment on tadpoles, fed them pieces of organs—including thyroid, liver, adrenal gland, pituitary gland, muscle, thymus, testicle, or ovary—from horses, calves, cats, dogs, pigs, or rabbits. He described the food as “ravenously taken by the animals.” Gudernatsch found that thyroid suppressed growth in the tadpoles but caused their immediate metamorphosis. They became frogs.
***
Cells proliferate in my uterus, forming cerebral cortex, salivary glands, blood, nipples. She curls into herself; she twitches involuntarily. She is a germinated mung bean, pale tail pushing into my spaces, all these astonishing spaces. If only I could see her, imagine her, dream her. Could I love her any more?
***
Fetal skin is like tadpole skin, thin and simple. Wounds heal rapidly, may leave no traces.
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A newt can regenerate a lost limb in only five months. The newt is extraordinary: most amphibians do not retain this ability after metamorphosis.
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Janet Lane-Claypon (1877–1967) was one of the founders of epidemiology, the study and analysis of public health and disease. She earned a BSc and DSc from University College in London, an MD and MB BS from the London School of Medicine for Women, and was the first woman to be awarded a research fellowship from the British Medical Society. In the first study of its kind, Lane-Claypon discovered that the risk of developing breast cancer is associated with age at menarche, age at first pregnancy, age at menopause, number of children, and duration of breastfeeding.
***
When she is made: my breast in his palm, nipple on tongue, rain pelts the tent so hard I can’t hear his breath or his grunt or the squeak of my skin on the mat. We are enough for each other, more than, but still we need more; we need her, we want her, and after he comes, I tip my pelvis up, angle in the sperm.
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Stem cells retain the ability to self-renew or to differentiate into other types of cells during development and growth or to repair tissue damage. The more cell types a stem cell can become, the greater its potency.
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Potency (n.): the power to influence; also, a male’s ability to achieve orgasm.
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When she is real: in the clinic, I see her on a screen, all profile, seeming to look up toward my center, and the ultrasound tech captures her, prints her out. In the rainforest, I wander too close to cassowary chicks, and their fathers—birds the size of men, with stony crests and sharp hooked claws—puff up and hiss. They are frugivorous. Peaceable. Deadly. In the lab, tadpoles transform into numbers, data, words and words and words; their bodies pile up in my thesis, in my dreams. I dissect them. I lie in bed, and the fan spins, pushing hot air around. I have never known such tiredness.
Inside, she begins to yawn.
***
I raise the tadpoles, each in its own sawed-off soda bottle filled with filtered water. The bottles are grouped by temperature—hot or cool or cycling between the two—and twice a day, I drop a pinch of frozen spinach into each container. It floats on the surface of the water, and the tadpole swims up, nibbles it, piece by piece, until it is gone. Vegetation becomes flesh and feces, tadpoles become small striped frogs, and though reared apart, animals in the same treatment emerge much the same.
The environment is everything.
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When Lane-Claypon married in her fifties, she retired due to restrictions on the employment of married women.
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Inside my breasts, multi-potent stem cells create new capacities. Ducts extend and multiply; fat pads expand with epithelial tissue; alveolar bulbs enlarge and become secretory—as in secrete, not secret. (Should not be secret.) I buy practical, rose-shaded bras with front clips for feeding.
***
On Friday, I must print out my thesis and carry it across campus to the Research Office, where they will stamp the time on it and prepare to send it to the reviewers. I have written the chapters, inserted the figures, formulated the conclusions; all that’s left is to format, fit the words to the template.
But then she is here. Fifteen days early. On Thursday.
The day before Friday.
I want to be an academic, a scientist, a woman, a mother, her mother. But I don’t know how to do this, all of it, at once. This push off from land into water, where I can’t see the bottom. I have to swim, I can’t swim. I’m ready, not ready.
***
Parity, or childbirth, is associated with cancer risk. Women having their first child at an “advanced age” are significantly more likely to develop hormone-receptive breast cancer, which grows more rapidly in response to estrogen or progesterone. In most studies, advanced age is defined as twenty-four years.
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When she is born: I am thirty-one.
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Part II.
Dear Amanda, Please be aware that the last day to submit your thesis so you are not incurring any fee penalty is tomorrow. If this is not possible, then the only way to avoid paying fees is to take an interruption to your candidature. This will need to be done URGENTLY. Could you please advise whether you will submit by tomorrow? Kind regards.
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Human breast milk contains four hundred different proteins and two hundred different lipids; numerous factors that reduce inflammation and promote antibody production, protecting the developing infant; bacteria from more than two hundred genera that colonize the intestine; and pluripotent stem cells, which are thought to move throughout the infant’s body, boosting growth and development.
***
When she is hungry: her face flushes, clenches; she screams and twists; she grapples for my nipple but does not latch, will not seal, cannot be filled by what I give her. She is too much and
I am not enough.
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Social psychology tells us there are four ways to respond to philosophical contradictions in the formation or maintenance of relationships: a) select one option, and ignore or deny the other; b) separate options into discrete contexts; c) attempt both options but without full realization of either; d) construct a reality where the options are no longer perceived as contradictory.
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Reality (n): the true situation as it exists, rather than how it is imagined or appears to be.
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I am not going to give her a dummy, a pacifier, a silicone plastic plug. She is not that kind of child; I am not that kind of mother. But my choices are no longer mine to make, and when my skin and nerves are raw and I press the thing into her mouth, she eases.
***
Parity, or functional equality, remains an issue in the STEM fields—science, technology, engineering, mathematics—where women are paid less, promoted more slowly, and awarded fewer honors and leadership roles than male colleagues. Though 50 percent of Australian undergraduates, PhD students, and Level A academics in the sciences are women, only 10 to 15 percent of Level E (professorial) academics are. Marriage and childbirth account for the greatest losses of women in academia after obtaining their PhD.
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In Australia, 91.5 percent of surgeons are male.
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I used to jut into the world. Jut. Now I slump, gap, sag; my belly hangs, does not return to what it was before, could not—even if I wanted it to.
Even if I didn’t.
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In 1811, novelist Frances (Fanny) Burney was given a wine cordial, a stack of old mattresses to lie upon, and a mastectomy. Anaesthesia had not yet been invented. “You must expect to suffer,” the doctor said. “I do not want to deceive you.” He removed her breast and scraped her clean, and she survived.
***
Every chapter of my thesis begins the same way, with heterogeneity, variation, change. And yet, I am not ready when change comes.
***
When she is seven months old: a hard ball in my upper chest, near the armpit. I run my hand over it in the shower. I run. My hand. I pause. The physician says lactation, blocked duct, come back in a couple of weeks, have a scan in seven. Nothing to worry about.
I don’t believe her.
***
I picture it black, bulbous, dense. I want to feel it outside my body—hold it, consider then crush it in my hands, through my fingers. But I am given a general anesthetic. I do not see when the surgeon cuts it out and sets it on a steel tray or plops it into a specimen container to be examined by the pathologist, who will characterize it and set out my life before me, however much is left.
I wake; I gasp for words.
***
Gregor Samsa wakes, and he is a beetle.
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I graduate in July. I have a PhD. I have a prognosis, a surgeon (male), an oncologist (female). I have a dip in my breast, a long puckered scar. I have no hair. My daughter wears pink for the photos.
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When it is over: it is never over.
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Part III.
One cell, two cells, cells in the lining of the lobule, cells transform, cells become immortal, cells become more cells, acidify adjacent cells, spread, invade, overcome; cells amass, vascularize; cells pass into the lymph or the blood; cells move, cluster; cells colonize distal tissues; cells replicate again and again and again and again.
***
My cancer is confined to the breast. The right breast.
There is never a right breast.
But I survive.
***
In 1940, scientist and philosopher C. H. Waddington described embryonic development as an “epigenetic landscape,” later represented as a ball (cell) perched at the top of a ridged slope, ready to roll down, specialize, differentiate, slip into one gully or another, become this or that kind of tissue, nudged onto a trajectory by genes and communication among cells. To a point, each cell can be anything.
***
When I was a girl: I wanted to be Miss America. A detective. An otter. A writer. I ran through the yard with invisible wolves, weaving between the apple tree and the cherry, the metal swing set, the pill-shaped propane tank, under the clothesline. Sometimes, they cornered me; sometimes, I escaped. Inside the house, I pressed stories through black ink ribbons and scrawled them in notebooks with spiral binds—stories about fairies and unicorns, ponies, children, getting lost, finding the way back.
***
A dead heart can be erased, washed with special detergents to remove cardiac cells, leaving only the structure behind: the matrix of proteins and fibres and vessels that held the cells in place. The heart becomes translucent.
And then, it can be remade. Pluripotent stem cells, embryonic or induced, are cultured and seeded into the empty organ, and they repopulate it, grow into its scaffolding, mature. Begin to function and communicate.
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No, she is the only one. The one. And only. No brothers or sisters. I will never have another child. But she is beautiful; she is enough. She has to be enough. I couldn’t want for anything more.
Could I?
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When she starts school: I make carrot muffins, or zucchini, or sweet potato (no nuts), and tuck them into the steel lunchbox in the insulated bag in her too-big backpack. Her uniform is blue and white plaid, leaf-crisp. I walk her up the stairs to her classroom, and she sets her bag outside the door and says, I love you, mummy, and kisses me, and gives me a hug and another kiss and another hug and turns to go in. I stand and watch because I can’t leave, not yet, in case she needs me.
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According to the website, the objectives of the Discovery Early Career Researcher Award (DECRA) scheme are to: support excellent basic and applied research by early career researchers, advance promising early career researchers and promote enhanced opportunities for diverse career pathways, enable research and research training in high quality and supportive environments, expand Australia’s knowledge base and research capability, and enhance the scale and focus of research in the Science and Research Priorities.
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I win the award, study sex and death. And I write.
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The body’s stem cells maintain their ability to regenerate, differentiate; accumulate mutations over time; become cancer; evade the immune system; resist chemotherapy and radiation; move through the body; persist.
I watch, on television, a tumor being taken from a woman’s breast, and it shocks me: the mass is enclosed in adipose, flesh, fatty meat. I cannot make out the darkness inside.
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And if I only have five years left?
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Evocation, according to Waddington, is “[the adoption] of one or the other of the alternative paths of development open to it.”
Originally published in Creative Nonfiction