The Genesis Machine: Our Quest to Rewrite Life in the Age of Synthetic Biology

Book Preface

AMY—THE FIRST TIME I FELT THE SHARP TWINGE IN MY BELLY WAS during an important client meeting. Seated around the table were senior executives from a multinational information-technology company. We were developing the company’s long-term strategy when the twinge hit me again. I quickly handed the meeting off to one of my colleagues and ran to the bathroom. By then, a layer of sticky, dark blood had soaked through my black tights and adhered to my inner thighs. I couldn’t breathe. I couldn’t physically take in air. I slumped over on the toilet and finally allowed myself to sob, silently, so no one could hear.

I’d been eight weeks along. I was scheduled the following week for an early ultrasound. I’d already started thinking of names: Zev if the baby was a boy, Sacha if she was a girl. As I cleaned up the blood on my legs and the floor, I searched for answers, but kept arriving at the same place of anger and self-blame. It was my fault. I must have done something wrong.

The third time I felt that twinge, I already knew what to expect: blood loss and a humiliating trip to the drugstore for extra-large pads, followed by deep depression, insomnia, and a stream of questions with no answers. My husband and I saw the best fertility specialists in Manhattan and Baltimore, and we subjected ourselves to every test offered: blood tests to evaluate my hormones, tests to make sure I had enough eggs in reserve, and tests to determine whether I had any benign growths or cysts that might be causing problems. These were high-tech guesstimates, not answers.

We kept trying, and in a subsequent pregnancy I made it past the four-month mark, a milestone, and we finally allowed ourselves to feel excited. We arrived at the OB-GYN for a routine checkup. I was at eighteen weeks now, and my belly was starting to protrude. I laid on the exam table, and a technician squirted cold jelly onto my midsection, smearing it around with a sonogram wand. She punched a few keys on her keyboard, zooming in on a grainy, mostly black video. She apologized, mumbled something about her old equipment, and left the exam room, returning with another machine and my doctor. Again, she squirted cold jelly onto me, and again smeared it around, clicking her keyboard to zoom in as she glanced at my doctor, and then, reluctantly, back at me.

I don’t remember exactly what they said, but I remember my doctor taking my hand and the sound of my husband crying. I would be admitted for surgery to remove the fetal tissue. In the end, I was told that nothing was medically wrong with either of us. We were in our early thirties. We were healthy. We could get pregnant. The problem seemed to be my ability to stay that way.

One in six women will miscarry during her lifetime, and there isn’t a singular reason. Most often, the cause is a chromosomal abnormality—something goes haywire as the embryo divides—that has nothing to do with the health or age of the parents. It wasn’t my fault, I was told. My body just wasn’t cooperating.1

ANDREW—SINCE AGE TEN, I had been resolute in my intention to never have children of my own. We’d lived on a rural farm property on the outskirts of Montreal. My parents struggled with each other, and as a result, with me and my two siblings. The three of us had been born in quick succession: my brother was a year younger than me, my sister a year older. When my parents told us they were separating, I wasn’t upset, but I do remember thinking that my mom would have been happier as a nun. Instead, she became a single mother and a nurse working the night shift.

She slept during the day while we were at school. It helped that we were all independent, capable kids. I often escaped to the library—my second home, where I lived in the stacks. I’d bring home armfuls of books and see her off to work at 10 p.m., and I would keep watch over my siblings, often reading to them until dawn, when my mom returned home. Stories about traditional nuclear families felt foreign to me. I couldn’t relate. What made sense was the dependable logic of engineering, the wonders of biology, and the visions of science fiction. Sometimes, when my brother and sister drifted off to sleep, I stayed awake reading and thinking about life: where creatures both enormous and microscopic came from, how they evolved, and the promise of what they might become.

By the time I was eighteen, I wanted to study the fundamentals of life—genetics, cell biology, microbiology—but I had no intention of making children of my own. At that point, I was writing software and databases, thinking in both genetic and computer code, and I had a lifetime of research ahead of me. Sex was compelling, kids were not. The only forms of male birth control were mechanical, not medical, and they were hardly reliable. The guaranteed solution was vasectomy, so I sought out my doctor and asked for one. At first, he protested—at age eighteen, I was barely an adult, and certainly in no position to make such a drastic choice. Vasectomies were reversible, I countered, and I could bank sperm if I had doubts, but I didn’t. My conviction won his approval and referrals to urologists, but it would ultimately take six years to turn off the taps. Most of the specialists thought I was being rash and immature. I argued that I was just trying to be responsible. Still, once I got the vasectomy, there was no guarantee I’d be able to have children in the future.

Thirty years later, I connected with a beautiful woman at a conference who lit up when I talked about cells and who indulged my long-winded diatribes on DNA as software. Lying next to her one morning in her Manhattan apartment, I was overcome with a terrifying new feeling: I wanted children. I wanted that family, with her by my side. But I was now in my late forties, and I knew exactly what to expect medically and biologically.

When we decided to get pregnant, we were both hopeful, but realistic. On the day of my reversal, I fixed my eyes on the ceiling as the attendants pushed me into a surgical suite. The lights blurred past in a rhythmic pattern, and with each burst of light I cycled back to the doctor’s warning so long ago, and thought about how life paths can suddenly change. The tubes connecting my testicles to my urethra, which would have enabled sperm to leave my body, hadn’t been clamped or tied off—making a reversal easy. Instead, the surgeon had severed them entirely and cauterized them to make sure I didn’t leak internally. It would take a delicate microsurgery and general anesthesia to reconnect them.

We tried, and failed, to get pregnant for eighteen months. I knew what was wrong—and how little I could do now to change things. The surgery had been successful, but my body’s system had been shuttered for too long. Mechanically, there was nothing wrong with me. My body just wasn’t cooperating.