MJ Skinner lives in northeast Ohio. He is married with a three-year-old daughter, and another daughter on the way. His history in the helping professions (law enforcement, counseling, and social work) has provided valuable insight into pain, pleasure, and complexities of the human condition. He currently writes speculative fiction, with a particular focus on horror, dystopian, and science fiction stories.
~~~
The door of the operating room swung open, and a nurse entered. Draped over her left shoulder was a large, black tote-style purse. She paused in the doorway, appearing startled as she looked at the surgical tech. The door swung back, bumping her off balance.
“Can I help you, nurse?” Ronan asked, his eyes narrowed. She was much earlier than she should have been.
“Oh, uh, yes, sorry, Dr. Mueller, I have the rest of the supplies you’ll need for the procedure.” The nurse unzipped the purse and reached in, pulling out the cloth-wrapped bundle. She gently placed it on the cold steel table and walked briskly from the operating room, pretending to type on her phone. Ronan gave a silent wave as she walked away, trying to play it cool.
“That’s the last one. Thank you for your help, Adeline. I’ll finish up.” Ronan nodded at the tech with a smile.
“Let me help you with these other supplies before I go,” Adeline said, walking towards the cloth bundle.
“No!” Ronan said with more urgency than intended, thanks to his surging adrenaline.
“Uh, are you sure, doctor? It’s no bother.”
“Getting that kidney to the transport drone is the priority. You focus on that, and I’ll finish up in here.” She nodded and walked towards the operating room doors. “Thank you, though,” Ronan said, releasing a deep exhale.
He pinched the thumb and ring finger of his left hand together and flexed the hand downward. The mechanical seat on his wheelchair slowly lowered from its elevated perch necessary for surgery, the hydraulics letting out a quiet hiss. This moment of pause, the same in every harvesting procedure, allowed Ronan to practice gratitude. He expressed his gratitude for the donor, whose death brought about life for the recipients of his organs. He also expressed gratitude for the gesture-controlled wheelchair that simplified his life. It had been specially developed for him by a sympathetic group of engineers during undergrad. Disability accommodations were a distant memory under the New Liberated Union party.
What came next in Ronan’s process was the direct result of one of the many gross overreaches of power by the members of the NLU. Ronan steered his wheelchair to the table, where he picked up the bundle and cradled it in his right arm. Ronan directed his wheelchair back to the operating table, where the splayed teen cadaver lay. Ronan had finished the scheduled harvesting of the teen’s organs for donation and now began the clandestine part of his process.
Ronan gestured for his wheelchair to rise to its surgical position. He tenderly placed the bundle into the now spacious abdomen of the cadaver, sliding it up into the chest cavity for added security. He paused. This was sloppy. This needed to be done with more decorum moving forward. The families deserved better.
He closed the incision on the donor’s torso, the delicate package safe inside, wrapped like a warm loaf of bread. Ronan bowed his head over the corpse in front of him. Organ donation was the ultimate act of giving – offering life and ending suffering for so many. This organ donor now unknowingly offering additional charity, serving as the vessel for an even more precious gift – the latest victim of the Birth Quality Act. As he always did, Ronan said a silent prayer over the sacred husk before releasing it to the local funeral home.
Exiting the operating room was a different challenge altogether. Freedom Hospital was a newer hospital and was not built to accommodate wheelchairs or other mobility devices. The doorways into the scrub areas and cleanup areas were narrow and required Ronan to approach at an angle and perform the equivalent of a five-point turn to enter or exit the rooms. Other spaces, including workstations which were outfitted for standing desks or seating with tall stools, were inaccessible as well, further necessitating his custom wheelchair.
* * *
Ronan sat outside his cottage next to an empty rocking chair, facing the long gravel driveway, and waiting for his closest friend, Dr. Ingrid Jacobsen, to arrive. The powder blue blanket he was currently knitting rested upon his slight, limp legs. Shadows from the tall pines lining his property fell over him, cooling his skin. The light grey newsboy hat hid his wavy, honey brown hair while the round black glasses sat on his wide, fleshy nose.
Ronan and Ingrid met in pre-med, in the large lecture hall that hosted their human anatomy course. Ingrid was seated in the end seat in the back row of the hall. Ronan had been uncharacteristically late to class that day and had parked his wheelchair next to Ingrid, hoping not to draw the attention of the full hall. Ingrid looked over at him, scrunched her lips to one side, and playfully accused him of cheating her out of the prized position that was both closest to the door and furthest from the professor. Ronan now held that position.
From that day on, their friendship grew. They registered for as many classes together as they could, enjoying the perks of a built-in study partner in each class and a close friend who understood the stresses of medical academia. Their close friendship was the subject of rumors in their cohort, and the plotting of friends who wanted them to be an item.
While there had been a single drunken hookup, Ronan and Ingrid never expressed any feelings for each other beyond the platonic. Early in their careers, they were too focused on work to consider romance. And for Ronan, intimate relationships required a level of emotional intimacy he struggled to achieve.
The grumbling sounds of an electric scooter plodding through gravel caught Ronan’s attention. Ingrid’s tall, slender, Dutch frame came into view. Her long blonde hair fluttered like sheer curtains, tamed only slightly by her purple knit beanie. Ronan loved that she wore it so often.
“I’ll never get used to a handsome young doctor spending his free time knitting,” Ingrid said, dismounting the scooter. She bent over to hug Ronan and then sat in the rocking chair next to him. Ronan had started knitting during med school to improve his fine motor skills and hand-eye coordination for surgery. Despite it earning him the nickname “Dr. Knitwit” by some of his more jockish peers, he found the hobby enjoyable.
“And I’ll never understand an attractive, refined doctor and biker chick spending time with a wheelchair-bound homebody who has the same hobbies as her grandmother.”
Ronan slid his glasses low on his nose, sucked in his lips, and smiled, feigning a toothless grin that looked more like a silent scream.
“You dork,” Ingrid said, laughing.
The two young doctors caught up, joking about current events, family dramas, and more, but it didn’t take long for their conversation to turn to work.
Ingrid worked as an OBGYN in the same hospital as Ronan. Freedom Hospital was the only operating hospital within fifty miles in any direction. While Ronan and Ingrid’s patients overlapped often, he rarely saw her within the walls of the hospital. It could be lonely work.
“I was talking to Janelle Ritter, and apparently the nurses in our merry little band of dissidents have started referring to us as the DDC,” Ingrid said with a smirk.
Ronan looked up from his yarn and needles and raised an eyebrow with curiosity. “DDC?”
“The Dignified Death Cooperative,” she said, with a straight back, puffed chest, and a lofty tone.
Ronan mulled the name over in his mind before letting out a dismissive “humph.” It was ridiculous. He turned his wheelchair to face Ingrid more directly. “Dignified?” He sighed. “It reminds me of how my dad buried my pet lizard, Bowser, when I was nine.”
Ingrid looked at Ronan quizzically.
“Dad wanted to throw him in the garbage, but I insisted he needed a funeral. So, my dad just dug a hole in the back yard, dropped Bowser in there, and filled the hole. No box or container of any kind, no prayer, nothing. Then he said, ‘Sorry, bud,’ patted me on the shoulder, and went inside to watch the game.” Ronan shrugged. “It just kind of feels like that’s what we’re doing with these BQA babies.”
Under the BQA, if mandatory testing revealed the parents to be carriers of certain “undesirable” conditions or if the child tested positive for certain genetic defects, the BQA mandated an abortion and medical disposal of the fetus. For Ronan, like Ingrid and many BQA detractors, his objection was not a matter of pro-life or pro-choice politics. It was about authoritarianism, parental agency, and thousands of fetuses arbitrarily being aborted.
“Rone, it may not be perfect, but it’s substantially better than them being lumped in with cancerous tumors, amputated limbs, and other medical waste and incinerated. By working with the team we’ve built to get the babies to you, at least they’re getting the burial we had hoped for.”
“I don’t disagree with you, Ing, but I just think there’s something more we could be doing. Something to honor their innocence and be more ceremonious, I s’pose.” Ronan’s voice echoed his passion. He’d sold Ingrid on this whole idea, in part, because of his passion for it.
“Rone, we have to be realistic about our limitations. You know if the wrong people found out about what we’re doing, we’d lose our medical licenses and go to jail. Execution wouldn’t even be out of the question.”
As Ingrid saw it, they were an underground railroad to the afterlife of sorts. It was a rudimentary service that offered something better.
“Believe me, I know. This wheelchair already puts me under the microscope anywhere I go.”
“What do you propose then, Rone?” Ingrid asked.
“That’s the problem, Ing. I’m not sure yet.”
* * *
Ingrid and a surgical nurse washed up after the late-term termination procedure. The nurse, in her fifties by Ingrid’s estimate, dried her hands and grasped the gold cross around her neck.
“It’s a good thing we’re doing, these abortions. It’s a real blessing,” the nurse said.
“Yeah?” Ingrid replied.
“Of course. My niece had spina bifida. It was horrible.” The nurse gently rubbed the gold cross with the pad of her thumb.
“What was her name?”
“Oh, uh, Shannon ... I don’t know if I ever saw my sister happy after that child was born. Poor Deb became a full-time caregiver for that child, helping her with the toilet, helping her shower and dress, the whole deal. Not to mention taxiing her around to all the specialists.” The nurse looked down and shook her head slowly. “Terrible.”
Ingrid sighed.
“What about Shannon? How did she feel about her condition?” Ingrid asked.
“Oh, she was mostly happy as a kid. As she got older, things got tougher. Bullying and the like. That child really struggled with depression and self-esteem.”
Ingrid frowned and turned towards the nurse.
“That’s awful. I’m sorry your niece and sister both had to go through that. Do you think Shannon knew her mom felt burdened by her condition? Could that have been part of the depression?”
Ingrid knew this line of questioning might not be received well. But the conversation framing a poor child as a burden and affliction to the child’s mother disgusted Ingrid. She stifled an eye roll when the nurse gasped.
“Goodness no! Deb loved that child. She dedicated her life to that child.”
Ingrid slammed the damp wad of paper towels into the trash can and marched towards the door.
“Well, I certainly hope for her sake that child doesn’t know her aunt thinks she would’ve been better off being aborted and thrown out with the medical waste.”
Once out of the scrub area, Ingrid grabbed her phone. Opening her conversation with Ronan, she began to type.
Ingrid: I really need to talk! Coffee?
Ingrid’s indignation propelled her at a rapid pace towards the elevator. She impatiently pressed the elevator call button repeatedly while staring at her phone, awaiting Ronan's reply. Ingrid’s thoughts raced as she entered the stuffy elevator and pressed the button labeled “B.” She was annoyed and discouraged. Partly from the flickering fluorescent that had been malfunctioning for weeks, but mostly by the conversation. Another BQA supporter prioritizing the challenge of supporting those with various chronic conditions. Prioritizing the inconvenience and expense over the preciousness of life, over the slippery slope of government interference in medical decisions, over the anguish of parents who will never get to meet their child, and who have no autonomy in their prenatal care.
She needed to talk to Ronan. He’d understand. She wouldn’t really need to say anything. He felt these things too.
Most people would be texting their spouse or partner, Ingrid thought, but she had none. She and Ronan both agreed that, given the severe consequences of their rebellion, it would be foolish to bring others into their personal lives. They would be putting innocent people at risk if they married or had children. Rebellion required sacrifice.
Ingrid knew that was the responsible decision, and the logical one, but damn if she didn’t need a partner these days. Her traditional work took a significant toll. Her subterfuge only intensified the stress, the loneliness, and the isolation.
As Ingrid paced in the elevator, her phone buzzed.
Ronan: Basement? Ten minutes?
Seeing the message brought immediate relief. She felt her nervous system resetting. The fury began to melt away, leaving a throbbing headache in its wake.
* * *
The multipurpose room of the Unitarian Universalist Church somehow felt dim and uninviting despite being awash in the glow of fluorescent tubes. The cold, bitter coffee shocked Ronan's taste buds; it tasted like an oil-stained mud puddle. Probably a forgotten leftover from yesterday’s Alcoholics Anonymous group. Ronan had parked his wheelchair near the entrance, requesting permission to observe as the participants entered. Hearing the experiences of grieving parents felt like a necessary perspective to have. The parents sat in a circle at the center of the room.
Ronan listened to the woman speaking. She had recently undergone the termination procedure required by BQA. Had he placed her unborn child into a cadaver?
Her eyes were red and puffy, and she had gone through an entire pocket-sized package of tissues. Her oversized hooded sweatshirt sported dried snot trails on the right sleeve. She white-knuckled another wad of tissue.
“I had miscarriages before … twice. The first one crushed me. The second time I hadn’t let myself get excited – my anxiety was too high, so that was easier, but still terrible.” She paused to dab her eyes with the tissue and took a deep breath. “Then we tried for a few more years to get pregnant, but we couldn’t. I thought we had missed our chance. I was so discouraged.”
Her husband lightly rubbed his hand in overlapping circles along her back.
“I used to hate when people would say ‘It’ll happen when you stop trying to make it happen,’ but that’s true, at least it was for us. It had been a decade since we stopped trying, and suddenly, we were pregnant again. We had very low expectations at first.”
The woman glanced over at her husband.
“Between the prior miscarriages and both of us nearing forty, we knew the odds were slim. But then both ours and the baby's genetic testing came back clear. We finally felt comfortable telling friends and family. And their joy and excitement... it felt so good.”
Ronan listened. His eyes teared up knowing where the story was going.
“And then we had our 20-week ultrasound.” Her trickle of tears surged into a waterfall, and her chest leapt with every sob. The words came predictably between sobs. “They… found… an… anomaly.” Her voice wavered. “Something about… his skull proportions.” She then described being brought into a small office. The doctor had explained the anomaly, but not what it might suggest about the diagnosis or prognosis of the child. He then informed them that, according to the BQA, a termination procedure would be scheduled for the next day.
Ronan had witnessed these consultations during his obstetrics and gynecology rotation, and his heart broke for her. They were often as cold and clinical as the woman described. Just chalk it up to another indignity of the process.
He thought back to the doctors and therapists he had worked with growing up, and the warm care and kindness they always showed him. They had inspired him to get into medicine.
“We weren’t given a choice. We barely had time to process everything. And next thing I knew, my baby was gone.” The woman looked into her husband’s eyes, who returned a compassionate gaze. “The worst part is,” she continued, “we have nowhere to mourn, nowhere to visit our angel baby. I just want to say goodbye.”
Ronan recognized her pain, her longing for closure, and a chance to say goodbye. How could she do that without a space, real or symbolic, to mourn? She was gutted.
As the meeting ended and folks dispersed, Ronan spotted a familiar face across the room, another observer he hadn’t noticed. The old man, forty years or so Ronan’s senior, shuffled towards him.
Frederick Adamle was the elder half of the local father-son run Adamle Funeral Services. As the only funeral home reasonably close to Freedom Hospital, Frederick often came to pick up the bodies of the donors after Ronan released them. One hospital, one funeral home, that’s how it was out in the sticks.
The men briefly discussed the practicalities of their work and Frederick’s shuttered crematorium services, thanks to the government’s newest “green initiative” banning cremation. Ronan subtly transitioned the conversation to inquiries about funeral home recordkeeping. Frederick shared the standard practice of maintaining records of where every customer was laid to rest. Ronan, relying on Frederick’s good nature, lamented many colleagues’ wishes to know where patients were buried, so the doctors and nurses could pay their respects. As expected, Frederick was more than willing to assist.
This was, in reality, a half-truth. While this had come up a time or two, Ronan was interested in the locations where the donor cadavers who hosted babies were buried. After hearing the woman’s devastation over having nowhere to visit their child, Ronan wanted to make this possible.
Ronan thanked Frederick and headed to his vehicle. A hand gesture triggered the wheelchair lift to emerge from the back of his old SUV. Ronan took the slow ride of the lift to relish what felt like a significant piece of the puzzle coming together. How to lay these babies to rest in a more dignified manner, and how to get this information to the parents, those were the remaining questions to be answered.
As he locked his wheelchair into place and buckled his seatbelt, he caught a glint of light out of the corner of his eye. Looking at the fence that stood a few feet in front of his vehicle, Ronan saw what looked to be two small pods suspended from the horizontal support frame of the fence. Activating the heads-up display on his windshield, Ronan used the magnification feature to zoom in on the fence.
Ronan examined the suspended capsules as they slowly undulated in the breeze. They shimmered a semi-translucent metallic gray with black and orange patches underneath. Monarchs? Not cocoons... chrysalides. Monarch butterfly chrysalides, that’s what they were.
Ronan watched the shells of hardened caterpillar skin, contemplating the metamorphosis that was underway inside the protective casings. A caterpillar, often considered a disgusting, creepy crawly, breaks down to a cellular level, no longer recognizable. After the caterpillar has wholly decomposed, the cells collectively reform into a Monarch Butterfly, a beautiful and beloved creature.
* * *
“Rone! You what?” From across her kitchen table, Ingrid chastised him. The long blonde braid that fell over her shoulder and onto her chest symbolized a playfulness that was currently unaccounted for.
Ronan focused on the photo collage on the wall behind her. Her glare was painful.
“That was incredibly risky. If anyone finds out what we’re doing… well, there go our jobs, medical licenses, and probably our freedom. You know this.” Ingrid crossed her arms, still staring at him.
He thought she’d be excited about his conversation with Frederick Adamle; clearly, he was wrong. “It’s okay, Ing,” Ronan said as he fidgeted in his chair. “Frederick keeps to himself. And s’pose he does mention it to someone; he still has no idea what we’re doing.”
“Still Ronan…” Ingrid said. The four-foot distance between them suddenly felt like a gulf.
“And even if he did somehow find out what I’m doing,” Ronan said, pointing at his chest. “I’ve never mentioned your name, or anyone else’s, nor would I. I hope you know that Ing … I’d never do anything to put you in danger.”
“So how do you plan to get this information to the parents without exposing yourself?” Ingrid asked.
The mint green walls seemed to be closing in around Ronan. Having anyone upset at him was genuinely a source of anxiety, but Ingrid’s disapproval caused a more intense anguish. Ronan felt the heat and redness in his ears.
“I still have to work out all the details. But I figured I’d send a typed letter so no one can identify any handwriting. I’ll say that I want them to know that their baby received a proper and dignified burial. I’ll share the location of their child’s grave – cemetery name and plot number only.”
Ingrid’s frustration seemed to be dissipating. Not gone but lessened.
Now able to take a full breath, Ronan’s lungs were relaxing. “I’ll send the letters in envelopes with no return address, and I could probably travel to various post offices around the state on my days off to mail them, so there are no consistent postmarks.”
Ingrid sighed and fidgeted with her braid. “You’re never gonna be satisfied, are you?”
“What do you mean?” Ronan asked.
“Rone, we’re already doing more for these families and their babies than most people are, and we’re risking our livelihood to do it. But that’s not enough for you; you need to do more. And when you start doing this part, you’ll only want to do more.” Ingrid inhaled deeply, releasing a prolonged sigh. “You’ve got a huge heart, and that’s one of the things I love about you, but I’m worried it’s going to get you—get us in trouble.”
Ronan leaned forward, reaching across the table and placing a hand on Ingrid’s arm. “I understand your worries, Ingrid, and I s’pose you’re right, in a way. I know this work is important to you, but this work we’re doing means something else entirely for me.” The lump in his throat demanded to be swallowed. “It’s not just about compassion or kindness. There’s a part of the BQA that nobody talks about… or maybe nobody sees.”
Ingrid slid her chair around the table closer to him. Her frustration seemed to dissolve, and her concern was now for him. They sat at a ninety-degree angle to each other. She placed her free hand on top of his, giving a gentle squeeze. “Tell me.”
Ronan hesitated for a moment, the dread rising over what he was about to say. “The BQA isn’t about ‘Healthy births for a healthy future union,’ it’s about eliminating people like me who the government sees as a drain on resources. It’s eugenics. The government hasn’t invested an additional dime in research to study these conditions targeted by the BQA or to identify genetic strategies to eliminate or treat them. They’re simply relying on forced abortions to eradicate those who can pass them on.”
Ingrid slid her chair closer still, butting it against Ronan’s. She placed an arm around him and pulled his head down to her shoulder. Ingrid leaned her head against his. Her natural scent was reassuring. Sharing this moment, this realization, was necessary. Vulnerability had often felt like a suit that was a size or two too small, but now it felt comfortable. With Ingrid, vulnerability made him feel lighter, finally feeling as if someone could help him carry this weight.
The friends sat together, weeping, bearing witness to Ronan’s pain. The only words exchanged came from Ingrid as they both ran out of tears.
“No matter what goes on out there, you belong, Ronan Mueller,” she whispered.
* * *
Ingrid walked into the O.R. and greeted Ronan with a soft smile, a bundle of “supplies” concealed in her backpack. Ingrid was making this delivery personally. After their raw heart-to-heart in Ingrid’s kitchen last week, Ronan had requested this. He requested that she, for the first time, witness his ritual. She was happy to oblige. It was important to her to support Ronan and honor his vulnerability.
Ingrid joined Ronan beside the still-open torso of the organ donor. She remembered how Ronan had described his process, but was eager to witness this new iteration, one that Ronan said felt more complete and more honorable. But being invited to witness also made her nervous. She felt like a tourist stumbling into a sacred ritual in a foreign land.
At Ronan’s instruction, she removed the backpack and gently set it on the floor beside her. The cloth bundle was soft on her arms as she lifted it from the bag. Peeling the cloth back a swath at a time, Ingrid held the tiny child reverently. It was so unfair.
Ronan reached into a satchel that was slung over his chair, pulling out a rolled-up knit pouch. The orange and black yarn was woven into a familiar pattern—one mimicking the Monarch Butterfly chrysalis. It was gorgeous.
Ronan held open the hand-knit chrysalis and watched as she slid the baby into the pouch. Ronan closed the chrysalis with a gentle pull of a string, which cinched the top corner. He tied a knot to secure the closure, and Ronan assisted her in placing the chrysalis into the donor vessel. Ronan fastened a small, stained-glass butterfly pin to the pouch.
At Ronan’s request, Ingrid closed the cadaver.
“I usually do a little prayer at this point,” Ronan said, staring at the cadaver. This was quite sacred to him. She knew Ronan well. He was still on the outside, but his mind was busy, like a duck on the water. What was he thinking? She hoped he found this as incredible as she did. Did he know what an amazing person he was, the magnitude of what he was doing for these babies?
Ingrid stood next to Ronan in his perched chair and placed her hand on his. The pair bowed their heads as Ronan began the prayer.
“Thank you, gracious donor, for your many gifts. Your death will not be in vain, and you now leave this world with a sacred passenger. Precious child, you were conceived in a world that was incapable of recognizing your true beauty. The world mistook you for a caterpillar, but you’ve always been a glorious butterfly. You will now transition to a new world, where you can spread your wings with grace. Travel well, angels.” She felt the tears coming. Was Ronan reflecting himself in this prayer? Did he believe the world saw him as a caterpillar?
Ronan’s chair settled into its lowered position. With wet streaks lining her face, she stepped behind his chair. She draped her arms around Ronan’s neck and bent down, giving a warm and gentle squeeze. She could feel his heart racing. She kissed his cheek gently; not a peck, but something deeper.
“Thank you for sharing this with me, Rone. You’ve always been a butterfly, even if the world is colorblind.”
* * *
If you were to visit Ronan’s cottage these days, you would see a simple, glossy granite slab centered in front of the house. On the left half, it reads: Ronan N Mueller 2023-2112. The right half reads: Ingrid A. Jacobsen-Mueller 2024-2115. Below this, a laser-engraved image of a butterfly is accompanied by a quote.
“We delight in the beauty of the butterfly but rarely admit
the changes it has gone through to achieve that beauty.”
– Maya Angelou
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