"You"re very fortunate," a nurse whispered to him. He lay there, motionless, and he had an image of himself drifting upon a wide sea. The nurse was checking his blood pressure and intravenous tube. "Very lucky," she murmured.

He a.s.sumed that she meant that his injuries weren"t permanent, that he would walk again, that he wasn"t a quadriplegic. He had vague memories of conversations being held in the air above him, the voices of doctors undulating. Some function remained below the level of spinal injury, they"d told him. Early immobilization and treatment are the most important factors in achieving recovery, they said.

"Am I ...?" he said, and he thought he felt his fingers flex.

"They tell me that you"re Baby Rosalie"s father," the nurse said after a moment. Her face hovered briefly over him, her severe eyes and the pointed white nurse"s cap, and then she withdrew. Zach couldn"t turn his head far enough to maintain eye contact, so he wasn"t certain what her expression was like. No doubt there was a lot of gossip among the hospital staff about Rosalie. And there had been that short segment on a television news program that had focused-rather unsympathetically, he thought-on the fertility treatments that they"d undergone.

"Yes," he said, his voice parched. "Yes. That"s right. I"m Rosalie"s father."

"I"ve seen her," the nurse said. "Them." There was a pause and Zach flexed his fingers again. Something about her tone of voice disquieted him.

"You ... saw her?" he said. But the nurse was silent, busy with some task, and maybe she didn"t hear him. He could sense her presence, her movement at the periphery of his vision, the winged tip of her nurse"s hat. He didn"t know they still wore those.

"You know," the nurse said, after he had almost decided that she wasn"t going to answer him, "I"ve always believed that G.o.d puts every one of us on earth for a reason."

He cringed inwardly, but tried to smile. "Yes," he said. Ever since Rosalie"s birth, people had been quoting such homilies to him, and he had gotten used to accepting them-gracefully, he hoped. He was not a particular fan of religion.

"I think you"ve been blessed," the nurse continued, in her oddly singsong voice. "That"s just my opinion. Some people might tell you otherwise."

Zach felt the woman"s hand brush lightly across the lower part of his abdomen. "Thank you for your kind thoughts," he said. He wasn"t sure what else to say.

He rolled his eyes downward and he could vaguely see the white shape of her uniform. There was a tube that had been inserted into him, a catheter. Tape had been applied to his skin below his navel and he felt her fingers smoothing it down.

"Poor baby," the nurse said softly, almost musically. "Poor baby."

Of course no one was to blame for Rosalie"s condition.

Though he often felt guilty about it-it seemed as if, with some people, there was a kind of unspoken condemnation hovering in the air, his sister, Monica, for example, Monica and her two healthy children. He would be describing their struggles with conception, all the biological and scientific complexity, all the tests and methods-gamete intrafallopian transfer. Superovulation. Intracytoplasmic sperm injection. Gonadotropins. And then he would sense a very light film of judgment in her voice. What about adoption? Monica said. What about adopting a baby from China? They have such beautiful babies.

"We want to have a baby of our own," he said.

Was that wrong? he wondered, after Rosalie was born. Were they being punished?

When Zach woke again, Amber was sitting at his bedside. It was dark outside, and he could see the entire hospital room mirrored against the surface of the window. Here was Amber in the foreground, reading through a sheaf of papers. Here he was, in the bed nearby, posed like a statue in his various braces. Snow was falling through their translucent reflections.

It had been, he guessed, several days since he and Amber had actually spoken. In the months since the baby"s birth, their paths seemed to cross less and less. He would sometimes come into a room and it would surprise him to find her there and she, in turn, would seem to stiffen, alert and wary as he entered. It was like finding a deer or some other sort of woodland creature grazing in the backyard.

The two of them had been married for five years, and increasingly much of that time had been occupied by the issues of fertility. The process of conception, in all its arcane biological complexity. Long stretches of their married life together had been given over to such concerns-packets of materials arriving in the mail; hushed, endless waiting rooms and the subsequent conversations with condescending specialists and gently manipulative quacks; silent drives home afterward.

He could often sense Amber brooding as he drove. She was a lawyer by training, and she was bothered by the unfairness of it-by the simple fact that so many women had babies without even trying. They hadn"t had to struggle, as she was; they hadn"t even had to ask. Sometimes, in a supermarket or on the street they would encounter a mother who was not taking proper care of her baby. The mother would be swearing at it, or carrying it in the bright sunlight without a bonnet, or holding it carelessly against her hip, ignoring it, letting its nose run as she gossiped with another mother. At such times, Zach would watch Amber"s eyes settle on the woman. It would seem that the very molecules of the air vibrated with Amber"s disapproval, with her intense dislike.

Once they had heard on the radio a program about a woman who had drowned her two toddlers during some kind of postpartum depression and Amber"s hands had tightened against each other in her lap.

"I"d like to see that woman tortured," Amber had said quietly. "I"d like to see her burned alive."

Zach hadn"t said anything then, though the light in her eyes had disturbed him. They didn"t really argue about things, the way he imagined other couples did-though the ghosts of their disagreements would waft underneath their conversations, curling like the fingerlets of incense smoke that Amber would sometimes burn. RELAXATION, the incense said. GOOD FORTUNE, HAPPINESS.

He looked up at her face from his hospital bed and he was reminded of the grim look she would get as she lit her little incense sticks and candles. She had never expected to have so much hardship in her life.

Amber had looked up from her reading at last, and she"d noticed that his eyes were open. They regarded each other, and he could see her expression tighten. It felt as if her thoughts were withdrawing backward into the shadows so that he couldn"t see them.

"You"re awake," she said softly.

For a moment, he expected that Amber was going to tell him that their baby had died. That was, of course, what would happen eventually. Sooner or later, some member of the hospital staff would emerge from a closed room to speak to them in a hushed voice: Mr. and Mrs. Dixon. They both knew this was coming. I"m so sorry to tell you-there was nothing to be done. The doctors had more or less a.s.sured them of this, even as they prepared for the surgeries. There had never been a successful separation.

On the Internet, Zach had found one example of a craniopagus parasiticus baby who had survived into childhood. This was the so-called Two-Headed Boy of Bengal, who was born in 1783 in the village of Mundul Gait. He had apparently lived for four years without any special medical treatment, and had purportedly died of a cobra bite, rather than anything relating to his condition.

The skull of the Two-Headed Boy was still on display at the Hunterian Museum of the Royal College of Surgeons in London.

Zach would sit in front of the computer late at night after Rosalie was born, searching the Internet. He downloaded a photo of the Two-Headed Boy"s fused skull. He read various accounts.

He read that the parents of the Two-Headed Boy were poor farmers who soon realized that they could earn money by exhibiting their child. In Calcutta, they would cover him with sheets to prevent people who hadn"t paid from glimpsing him.

After the Two-Headed Boy died, he was buried near the Boopnorain River, outside of the city of Tumloch. The grave was later plundered by an agent of the British East India Company, who dissected the child"s decaying body and carried the fused skull away with him to England.

Sometimes Zach would fall asleep in front of the computer and wake up with his forehead pressed against the keyboard.

One morning after he"d been up nearly all night, he awoke and Amber was standing above him. "Zach," she was saying, her hand against his shoulder, and when he lifted his head he could feel the tooth marks of the keyboard impressed into the skin above his eyes. "Zach," Amber said, and she stared at the screen of his computer, at the photo of the Two-Headed Boy of Bengal"s skull in its gla.s.s museum case- "It"s seven-thirty," she said, and glanced at her cellphone. He didn"t know what she had been doing with her own night, while he had been following various branching trails of information, one Internet search leading to another and then another. Sometimes he would find her sitting in the television room, watching a sitcom; sometimes he would find her sleeping, curled up on the bed, on top of the covers with her shoes off, and he would lean over her, wishing that he had found a useful bit of information to give her, some kernel from his long foraging.

"I"ll see you at the hospital at six," she said. She touched the screen of her phone, used her thumb to scroll, furrowed her eyebrows, and he ran a hand through his hair.

"Even when a child"s death is imminent, the parent must forever carry the image of the child moving forward, alive, into the future." After Amber left, he had found this written in his own handwriting on a Post-it note on his desk. Was it a quote from something? Had he thought of it himself?

He was thinking about all of these things as Amber spoke to him. "You"re awake," she said and he opened his eyes and Amber"s face floated above him.

He was aware of specific thoughts, images, connections: the fused skull in the museum, the movement of Amber"s fingers against her phone, the little Post-it note. All of these things had been in the process of sliding into place, connections were being made, and then the links seemed to unfasten as his mind rose out of sleep. He lifted his hand and some kind of monitor was clipped to his index finger.

"I"m sorry," he said, and there were so many things that he didn"t even know what he meant. Was he sorry for the two-headed boy, exhibited by his parents; for all the time he"d spent reading such stories, staring at his computer while Amber moved through another part of the house; for falling asleep at the wheel and leaving her alone to deal with the terrible details of their child"s last days; for being yet another burden to worry about; for the life they had been thrust into, which was unexpectedly difficult and unexpectedly unexpected; for his hoa.r.s.e voice, which was a crackling of paper. I"m sorry, I"m sorry, I"m sorry.

"Zach," Amber said firmly, as if she hadn"t heard him. "Are you able to focus? Can you hear me talking to you?"

There was still a little paperwork to be done concerning Rosalie"s upcoming operation. Release forms and so on. These doc.u.ments needed to be signed immediately.

"Yes," he said. "I"m listening."

Meanwhile, upstairs, the babies had opened their eyes again as well.

Above them, a mobile was turning in a slow circle: blue giraffe, yellow duck, red doggy, bobbing on wires, turning slowly around an axle, and the babies followed the motion of the shapes as they wheeled by.

Rosalie moved her tongue inside her mouth and the other one"s brow furrowed. Rosalie"s hands waved gently in the air and the other shifted her eyes back and forth, searching. After a time, they could see the pointed cap of the nurse above them, a blurry white peak on the horizon. A hand emerged and lowered itself toward them and they felt the cold of the air as their diaper was undone. The legs gave bright, athletic kicks, a burst of energy or excitement, and the parasitic head smiled dreamily.

"There, there," the nurse murmured. "It"s all right, it"s all right." She began to hum, and the babies liked the music, the sound of a lullaby and the touch of the warm cloth as their body was cleansed.

The surgery would need to be performed immediately if there was to be any possibility of saving Rosalie"s life.

The parasitic head had begun to grow faster than Rosalie"s own, and the doctors feared that the pressure from the growth would start to hinder Rosalie"s brain development. Because the two brains shared common arteries that were dependent on Rosalie"s organs, Rosalie was now in constant danger of heart failure. The other head was getting nutrition from Rosalie"s body, blood from Rosalie"s heart, oxygen from Rosalie"s lungs. Keeping both heads alive was becoming a daily struggle for the body.

Zach listened as Amber repeated these things to him. She was reporting the information in a careful, formal voice, the way one might recite a lesson in a foreign-language cla.s.s. "Sagittal sinus," she said. "Venous drainage."

"Well," he said. He considered for a moment. He was a college graduate, but he had no idea what to say. No one had ever prepared him for such an occasion. After the head was removed, would they bury it? he wondered vaguely. Would it require a headstone?

"You don"t have to say anything," she said. Her expression flinched, and she looked at the hand he had lifted to hold out to her. She patted her palm against his knuckles, pressing his hand back down to the bed. "Just rest," she said.

When this is over, he thought. When it was over, there would have to be a way to repair their marriage. They would have to find their way back to the life they once had. Maybe a trip, he thought. They had once liked to travel. They had gone bird-watching in the cloud forests of Ecuador; they had walked through Roman ruins in the Dordogne of France, holding hands as they pa.s.sed through the archway of an ancient gladiatorial arena; they had driven recklessly on one-lane roads in the Scottish Highlands, singing. They were a happy childless couple once. They could be that again.

"Everything will be all right," he said.

"Yes," she said.

He lay there, waiting, awake. The operation would take many hours. He didn"t know how much time had pa.s.sed. It was now the middle of the night and he could see the snow was falling again onto the parking lot outside his window.

From time to time he would hear the clip-clop of someone"s hard-soled shoes against the floor of the hallway outside his room. The footsteps would gradually grow louder and then they would grow softer.

The doctors would need to separate Rosalie"s brain from the conjoined organ in small stages. Blood vessels and arteries were shared between the two heads. The doctors planned to slowly cut off the blood supply to the extra head. The doctors would clip the veins and arteries and finally close Rosalie"s skull, using a bone-and-skin graft from the second head.

If Rosalie died, he imagined that someone would come to tell him. Or-if the operation was successful, they would come and tell him that, too. He had called once and a nurse"s aide had come to a.s.sure him that he would be the first to know. Whatever happened, she said.

The television had been turned off for a while now, its gray face blank and neutral. If there was consciousness, he thought; if there was consciousness, even if there was some rudimentary consciousness, the head would be asleep, under anesthesia. It would not be aware of the moment in which the blood supply stopped, the oxygen cut off, the brain cells began to shut down.

The room was dark but he could see something trembling on the ceiling. A piece of light, a reflection, quivering like a leaf on the surface of a pond. He moved his fingers, then his toes. He could feel the screws that held the halo crown to his skull, and he knew that once his condition had stabilized he would have to begin rehabilitation; that would have to be discussed at some point, once the situation with Rosalie was resolved.

His life had started out pleasantly enough. He and his sister growing up uneventfully in a suburb of Chicago, moving dutifully through elementary school and middle school and high school and college and finding jobs not far from their parents, who had then died abruptly when Zach and Monica were in their early twenties. Their father, a heart attack in his car, in the parking lot outside of the little strip-mall office where he"d had a dentistry practice. Their mother, about six months later, in the same car, sitting in the garage of their old childhood house with the engine running.

It was not something he liked to think about. "You should get a little therapy," Monica had said. "I"ve found it very helpful, just to talk about my feelings, and sort of put everything in perspective," and he agreed that it sounded like it would be a good idea and he"d visited a mental-health professional who had given him some medication, temporary medication, which had basically been enough. Shortly thereafter he had met Amber and they had fallen in love and gotten married and his life had moved back onto the track; they had their honeymoon in Scotland and they"d bought a house and two cars, and they"d worked fastidiously to pay off their student loans and mortgage and tried to save a little for the future.

Even when our death is imminent, we carry the image of ourselves moving forward, alive, into the future. He had read that somewhere, but it came to him like a voice speaking from the back of his mind, and he shuddered. The t.i.tanium pins that held his halo traction in place, the pins that had been drilled into the skull above his ears, felt like they"d loosened a little. It was as if he could sense them twisting and untwisting.

He fingered a buzzer that would call a nurse to help him, but didn"t press it. What did he need help for? He could feel the nipple of the b.u.t.ton beneath his thumb.

He was remembering an article he had read on the Internet about the transplantation of heads. In 1970, Dr. Robert White first successfully transplanted the head of a rhesus monkey onto another monkey"s body. It lived for several days, paralyzed from the neck down but aware. Eating. Following people with its eyes. Sometimes trying to bite.

He came alert abruptly and the nurse was leaning over him. She looked surprised, drew back abruptly.

"Mr. Dixon," she said, and adjusted her nurse"s hat, which looked a little like a paper boat. "Mr. Dixon," she breathed, and he felt the pinch of an injection. "You shouldn"t be up at this hour," she murmured, and then she began to hum to him. An old lullaby he thought he remembered, the whispered words barely audible, coming as if from a great distance.

... while the moon ... drifts in the skies ... stay awake ... don"t close ... your ... eyes....

And then suddenly morning sun was streaming into the room. The morning, and Amber appeared, backlit against the window with a rind of light around her.

"Is-?" Zach heard himself whisper. "Dead?"

It was the first thing that he thought of, the first word that his lips formed. He couldn"t see her expression, but he felt fairly certain. "Dead?" he whispered, and she came forward and bent down and the features of her face came into focus.

"No," Amber said. Her face was pinched and her eyes were lit and fierce, in the way of a marathon runner, or an all-night gambler. Her lips drew back and she showed her teeth but it was too exhausted and intense to be a smile. "She"s alive," Amber said. "She made it through. She-"

He watched as her eyes scoped along the edges of his traction, the halo crown and the metal bars that ran past his ears and attached to the vest at his shoulders; the web of rope and pulleys that held his legs suspended-as if she had noticed for the first time.

"It"s not-as they expected," she said at last.

Rosalie"s condition was described as serious but stable.

After the surgery, she had been given barbiturates, which put her into a beneficial pharmacologically induced coma. Over the course of several days, she would be slowly weaned from the drugs, and this, it was hoped, would help to reestablish normal blood flow. Her heart was accustomed to beating faster to pump out more blood for the second head, and now it had to learn to pump more slowly. Otherwise, she was likely to have heart failure. In her ba.s.sinet in intensive care, you could see the scar that ran along the top of her head, the seam over which skin had been folded over and closed. Zach had not actually seen Rosalie since the operation, but Amber had brought photos for him to look at. One of the pictures had been taken by a photographer for the a.s.sociated Press, and had gone out over the wire service to news outlets across the world. It was probably the most flattering of the photographs. In it, Rosalie appeared to be sleeping blissfully, her eyelashes like little feathers.

The doctors were said to be cautiously optimistic. At the same time, they reported to the media, "Rosalie"s survival of the operation was a big achievement in itself."

"I"ll just have to take everything one step at a time," Amber told him as she sat there by his bedside. "Get through one thing and then worry about the next thing. Right? Isn"t that the way life goes?"

"Yes," he said. He was elevated into a sitting position, and Amber was spooning small cubes of gelatin into his mouth. Occasionally she would wipe his lip with a napkin. "That"s right," he said, though he didn"t like it that she said "I" instead of "we."

"We"ll get through it," he said. His voice croaky, tiny. "We"ll ..."

Behind Amber, the nurse poked her head into the room from the doorway and peered in. Checking, he guessed, to see if Amber was still there. He watched as the nurse paused and observed them for a moment, then withdrew.

"I know that it"s going to be touch-and-go for the next few months," Amber was saying. "For the next few years, probably. It might be premature to say anything, but I just feel like ..."

"I know," Zach said. "I know what you mean. I haven"t even had time to think much about my own situation. I imagine I"ll have to start rehab soon, and then I"ll eventually be able to help more, instead of just-"

"Mmm," Amber said. Her eyes rested distractedly upon his hand, and he made an effort to flex his fingers. "Mmm," she said. "Yes, well ..."

"-instead of just lying here."

"Everything will be fine," she said, and gave him a firm, noncommittal stare. "Why can"t it all be fine? I mean, it"s a miracle she lived through the surgery and we should just be grateful for that, and then whatever else happens ... we don"t have any control over that...."

"Right," Zach said. "Of course." He watched as she put the spoon down on the tray, next to the empty gelatin container.

They were silent. They were both looking forward-momentarily, looking forward very cautiously-thinking about the possibility of life together with a living child. Zach was aware that they were probably considering some of the same images in their minds.

For example, Rosalie walking for the first time. Rosalie"s uncertain feet, her arms held out, Rosalie wearing one of those bell-shaped dresses that little girls wear. Or, for example, Rosalie starting kindergarten. Her hair would be long enough to cover the scar on her scalp-it wouldn"t even be noticeable-and she would carry a lunch box and backpack and there would be certain cartoon characters that she liked, certain favorite books and songs. She would have her own personality at that point.

They were still silent. Of course it was bad luck to say any of these things, probably bad luck even to think about them.

Amber tapped her knuckle against the fibergla.s.s vest across his chest. It was a weary but gently playful gesture, Zach thought. Partly, it was meant to bring good luck, like knocking on wood. Partly it meant: I can"t really think of anything else to say at the moment. "Well," she said. "I guess-"

"Sure," he said. "You better get going."

They both tried out a smile, experimentally. But it felt a little dangerous to be smiling, and they stopped almost at once. As if their greedy sense of hope might be spotted-and punished?!-by some stern Higher Power.

After Amber left, Zach lay there for a long time, staring up at the ceiling. It will be okay, he thought. It was all going to be fine. He tried again to picture them-himself, Amber, baby Rosalie-in the future. Standing in the backyard, beside the tree with the old swing. All three of them smiling. He could see it as if someone had taken a photograph.

He would undergo rehabilitation, and eventually, after a struggle, he would walk again. Perhaps there would always be a limp, he thought.

And even if his body didn"t ever start to work again, at least his brain continued on. Right? He still had his mind, and really wasn"t the flesh just a container, a sh.e.l.l that you inhabited?

Back when he was spending his nights on the Internet, he had come across a long article about astral projection. According to some philosophies, the self existed outside of the physical body. There were many religions that believed the soul could lift away, a noncorporeal version of your mind could rise up from the tether of muscle and skin and bone and blood and float off on its own.

Its own journey.

People who experienced astral travel reported that it seemed to happen from a vantage point such as high in the sky looking down. Astral travel was frequently reported by people who had near-death experiences, in which they could view themselves from above, watching themselves as hospital staff worked on their bodies. Frederik van Eeden presented one of the first studies of out-of-body dreams to the Society of Psychical Research in 1913, and he described a "silver thread" that connected his projected self to his sleeping physical form.