The Careful Ones — The Form
This is the first chapter of The Careful Ones, a five-part story about elective embryo selection. Story Index The form asked if they had a clinical indication. Owen ticked No and moved on.
"You don't have to do that so fast," Meera said.
"It's just a form."
She took it from him and read the question again. Do you have a diagnosed fertility condition or genetic risk factor requiring medical intervention? Below that, in smaller text: Elective profiling is available to all couples regardless of indication.
She handed it back. "Fine."
It wasn't dishonest. The clinic had been clear. The program was open. Elective genomic profiling, they called it — the language had shifted in the last few years, quietly, the way most language does. Elective implied choice. Choice implied agency. Agency implied responsibility. The logic ran downhill and you arrived somewhere sensible without noticing the gradient.
Meera was thirty-four. Owen was thirty-seven. They had conceived naturally once, miscarried at nine weeks, tried again without success for fourteen months. That was the clinical history. It was real, and it wasn't nothing, but it wasn't the reason they were here.
The reason they were here was Hugo Lau.
Hugo was their neighbour's son. Seven years old, violin on Tuesdays, swimming on Thursdays. Meera had asked about him once, over the fence. Joanna had mentioned the process in the same tone she mentioned the school. We looked at a few options. We wanted what was best. As if it were enrolment.
Owen hadn't thought much about it at the time. Later he found himself watching Hugo in the garden — the way the boy held his violin case, the particular seriousness of a child who had been given a lot to be serious about. He didn't seem different. He seemed like a child. But Owen kept noticing him, and the noticing had a quality to it he didn't like, something between curiosity and envy that he couldn't quite locate in himself and didn't want to.
Meera had found the clinic. She'd researched it for two weeks before mentioning it, which meant she'd already decided and was waiting for the right moment. Owen knew her well enough to recognise the pattern: the casual mention, the printed brochure left on the kitchen table, the question that was really a proposal. What do you think about this? What she meant was: I've thought about this. I need you to catch up.
He caught up.
• • •
The waiting room was designed to not feel like a waiting room. Plants. A water feature — one of those ones with stones that made a sound like a brook, or like what someone imagined a brook sounded like. The chairs were upholstered in a fabric meant to communicate warmth. Everything was meant to communicate something. Owen found himself reading the room the way you read a menu at a restaurant that's trying too hard: the effort was the message.
There were two other couples. One was young — mid-twenties, holding hands, the woman visibly pregnant. That confused him. The other couple was their age, maybe older, and sat with the practised silence of people who had been through this waiting room before.
Meera was filling out a second form. This one asked about family medical history. She wrote neatly, in the small boxes, and Owen watched her pen move through the generations. Her father's diabetes. Her mother's breast cancer scare, benign, but still. His own family: the high blood pressure that had taken his grandfather at sixty-eight, the depression his sister didn't talk about, the thing with his uncle that might have been early-onset dementia or might have just been drinking.
Written down like this, they looked like a family of risk factors. Everyone did, probably. That was the point. The information existed whether you collected it or not. This was just collecting it.
"Done," Meera said, and put the pen down.
• • •
Dr Kwan explained things with the patience of someone who had explained them many times. You could tell from the pauses — not searching for words, but letting them settle.
"We sequence each viable embryo," she said. "You receive a profile for each one. Disease risk, carrier status, polygenic scores for a range of traits. You choose which to transfer."
"What traits?" Meera asked.
"The science is more reliable for some than others. Disease risk is straightforward. Cognitive and physical traits involve larger uncertainty ranges." A beat. "But parents find the information useful."
Owen nodded. He had already read most of this on the clinic's website, and more on forums he wasn't proud of visiting — threads where parents discussed scores with the specificity of people comparing school league tables. The language was always careful. We just wanted the best chance. Nobody said we picked the smart one. They said we prioritised health outcomes. It meant the same thing, or it didn't, and the gap between those two interpretations was where everyone lived.
"What happens to the ones we don't choose?" Meera asked.
Dr Kwan's expression didn't change. "Embryos not selected for transfer can be cryopreserved for future use, donated to research with your consent, or discarded. The decision is yours."
Discarded. The word sat in the room for a moment.
"Most couples cryopreserve," Dr Kwan added, and the moment passed.
• • •
After, in the car, Meera sat for a moment without starting the engine.
"She said useful," she said.
"Is that a problem?"
"I don't know." She pulled out of the car park. "I keep thinking about what it means to look at a spreadsheet of your potential children and pick one."
"We'd be picking the healthiest one."
"We'd be picking the one that scored best."
"Those aren't different things."
She didn't answer. They drove home without the radio on, which they almost never did. The traffic was light. It was a Wednesday afternoon in early March, the sky white and close, and the city looked the way it always looked — people walking, buses turning corners, a man outside a newsagent's having a cigarette — and none of it had anything to do with what they were deciding, and Owen felt briefly and irrationally angry that the world could be so ordinary when they were in the middle of something that felt like it should change the weather.
"I want to do it," Meera said, as they turned onto their street. "I just want to know that we're doing it for the right reasons."
"Health," Owen said.
"Health," she agreed.
They both knew it wouldn't stop at health. They both knew they'd look at the other columns.
• • •
They received six profiles.
The document was clean, clinical, organised by confidence level. Disease risks at the top, flagged red, amber, green. Below that, the polygenic section — estimates, the header said, probabilistic, not determinative. IQ range. Height percentile. Cardiovascular health at sixty.
Owen looked at Embryo B for a long time. High confidence for disease-risk clearance. Estimated cognitive range: 112–129. Height: 75th percentile.
"This one," he said.
"You went straight to the cognition scores."
"I looked at the disease flags first."
"For about four seconds."
He set down the paper. "What would you have me do? Ignore the information? We paid for it."
"I know."
"We're not doing anything wrong. This is just — choosing the best outcome."
Meera looked at Embryo D. The scores were lower. There was a note about a cardiac variant: low penetrance, likely benign, monitoring recommended. She thought about what likely meant. She thought about what monitoring meant. She thought about being thirty-four, and the miscarriage, and the fourteen months.
She thought about Hugo Lau playing violin in the garden next door.
"B," she said. "Okay. B."
She said it the way you agree to something that you know you'll keep thinking about.
Owen put his arm around her. He meant it as comfort. It was comfort. But she felt something else in it too — relief — and she didn't know if the relief was his or hers, and she didn't ask.
That night she dreamed about a room full of children, all of them waiting, and she couldn't tell which one was hers. Next chapter: The Argument