The Blue Cotton Gown

by Patricia Harman

  “We hardly ever understand why this happens,” I answer carefully. “Something just wasn’t forming right. There’s nothing you or anyone did to cause the miscarriage and there’s nothing we can do to make it stop. It’s just nature’s way of insuring that most of the babies that are born are perfect.”

  Heather nods and wipes her eyes again.

  “So nothing could have been done, even if we’d come to see you earlier? No medicine or anything? There’s nothing you could have done?” Mrs. Gresko asks.

  I shake my head no. “Nothing but wait and hope.”

  The grandmother raises her eyebrows and lets out a long tired breath.

  Reprieve

  Lying in bed tonight, I feel a sense of relief, despite everything. Outside, through the open screen door, a rare loon laughs on Hope Lake. Maybe Gorham isn’t so bad. When I’d gone up to Pittsburgh to explain there was no way we could pay the IRS in a lump sum, she’d looked up from her desk, which was cluttered with papers, books, and pencils, twisted a strand of her red hair, the gold bangles on her wrists catching the light, and suggested we get another bank loan.

  “It’s done all the time,” she told me. “They use the assets of the practice as collateral. Your ultrasound machine would cover the loan.” This evening after work, Tom and I’d signed the promissory note for twenty-one thousand dollars and mailed the check to our accountant.

  How long ago was it that we had no debts? I calculate back. On the communal farm, we paid cash for everything. We didn’t need much, just gas for the truck, peanut butter, rice, whole wheat flour, canola oil, and beans. We grew all the rest.

  When we went back to nursing and medical school, we got student loans, then a few credit cards. When Tom got out of residency and joined the faculty at the university hospital, we took out a loan for our first house, and a few years later borrowed more for the cottage on the island in Lake Erie. I picture the two-story yellow farmhouse that sits on the rocky waterfront, the expanse of lawn and the willow trees, the red-roofed barn. It was worth it.

  We started our private practice at Community Hospital with a loan from the bank; then we borrowed for the ultrasound machine, got money to set up our new partner, Dr. Burrows, in practice, took a loan for the laser equipment, and now this, another twenty-one thousand. I grimace. It adds up. But by the end of the week, the sword of the IRS will no longer hang over our heads, and we can make payroll. Tonight, the waters of Lake Hope lie quiet, lapping the shore.

  TRISH

  I haven’t seen Trish for days, I’ve been so preoccupied with our own financial problems, and then I spot her trudging across the employee parking lot after work. “Trish!” I call out. “Hey, wait up.” She turns slowly, tucking her sandy blond hair behind her ear.

  “How are things?”

  “Oh, up and down. You know. My life’s such a drama.” Trish laughs at herself.

  “What’s happening? I haven’t seen Aran since we transferred her to the teen OB clinic at the university hospital. She doin’ okay?” We walk across the blacktop together.

  “Jimmy got laid off after he had a fight with one of the other workers but found a new job doing landscaping. Then he didn’t like his boss and quit. Aran moved home again this weekend. It’s the third time she’s come back. She says she’s through with him now. To tell you the truth, I hope so. This stress is killing me.”

  I groan sympathetically. Sometimes I don’t know how Trish stands these ups and downs, ins and outs.

  “How’s Dan doing?”

  “Oh, you can guess. He’s just withdrawing from the situation, trying to maintain. He’s getting stomachaches and has started smoking again. I’m getting stomachaches too, right here.” She puts the palm of her hand below her heart. “Acid maybe, something cold and bitter like rust. I don’t know. A premonition, mother’s intuition, maybe. I feel like I should be doing something to help Aran, but she won’t let me.” Trish stops to unlock her car. “Sorry—I have to hurry. I have an appointment. I’m going to have my hair highlighted. It’s the first time.” She laughs again. “The gray’s coming in fast and I’m only thirty-five!”

  Twenty minutes later I’m at the Veterans Memorial Park in bike shorts. Tom hands me my helmet and gloves, and without more than a few words we hit the trail. We pedal along the Jefferson River, past the dam, where the water churns gray and a few logs bob up and down in the foam. Here Asian men fish for bass and the occasional trout. These are university students from China, I imagine, enjoying the sunshine and a social pastime that reminds them of home. We pass the kids’ jungle gyms and slides, where I nearly always see a mother with a child I’d delivered, now a toddler in a stroller. Sometimes I stop to talk, but today I pedal on.

  We roll through successive waves of fragrance where honeysuckle vines grow along the riverbank. Pink phlox and blue chicory bend in the wind. Tom stops and points out an indigo bunting on a low sumac bush.

  Trish’s hair is turning gray, and mine is more than half silver, but on the bike trail I’m still twenty-five.

  Harvest Song

  The radishes and sugar peas are ready to harvest. Today I’m picking the peas by the handful and throwing them into a basket, grabbing the thin pods, my back bent over, then pulling the radishes up by their veined green leaves and washing them under the hose. This could take hours, and I’m not in the mood. I love planting and seeing things grow, but I plant too much and then have to tend it. When we lived on the farm, we preserved hundreds of jars of produce, but harvesting in those days was fun.

  Six or eight of us and Mica would gather in the big log house, the men mostly bearded and sweaty, the women in shorts or long skirts with no bras. We’d sit on homemade oak benches around a long wooden table, chopping tomatoes or stringing beans. Sometimes we’d sing while we worked. Spirituals would ring out through the open windows in perfect four-part harmony. Now I pick peas alone, not as enjoyable, but still good … good to grow your own food. Roscoe, our trusty basset-beagle, follows me along the rows, thinking I might find something she can eat. Despite the name, Roscoe’s a female. Zen got her when he was fourteen. Our youngest son had always wanted a dog named after Rosco P. Coltrane, the sheriff in the old TV show The Dukes of Hazzard. He didn’t care if it was a female.

  The dry clots of dirt hurt my bare feet, and the sun warms my back. Nearly everyone in West Virginia has a vegetable plot. The garden might be only one or two tomato plants out on the porch, or acres of potatoes and corn. If they don’t have their own, they get produce from the brothers who still live on the family places in Big Sulphur Springs or Clover Gap.

  Homegrown vegetables, deer meat, and trout are the soul food of Appalachia. It’s the Little Debbie Devil Cremes at the 7-Eleven, the fried chicken, and the bacon grease on the green beans that give us one of the highest rates of obesity in the nation.

  On the commune we did everything by Rodale’s Encyclopedia of Organic Gardening. “Rotate your crops from year to year to renew the nitrogen.” “Never place zucchini next to yellow squash; they’ll cross-pollinate.” “Don’t weed beans when they’re wet, you’ll spread leaf wilt.” Lately, I just garden when I have the time and plunk the plants where there’s space. What I put in the ground doesn’t always flourish. I tend my plants like I tended my kids. The boys got abundant love, but maybe not the pruning and direction they needed. I fear my children are ill prepared for this world. They grew up like wildflowers, sometimes like weeds.

  I stand up from my labors in the garden and stretch my back, looking out across the clearing to the gazebo. Let’s face it: Tom and I, too, are ill prepared for this world.

  CHAPTER 6

  HEATHER

  “Dr. Harman,” Tom says, flipping open the cell phone he keeps on the small bedside table. I elbow myself up in the dark to squint at the red numerals on the alarm clock. Shit. I might have slept through the night if he hadn’t been paged. It’s 3:00 a.m.

  “How much is she bleeding?” my husband asks. I turn on the green and white stain
ed-glass dresser lamp.

  “I’ll be right in. Will you call the nursing supervisor, alert the OR, and have her typed and crossed for two units?” He’s already on his way to the closet, where a pile of blue scrubs are stacked on a shelf.

  “What’s up?”

  “Patient hemorrhaging. Miscarriage.” He’s a man of few words.

  “Heather?” I know the answer.

  “Yeah, the girl with twins.” He’s tying his running shoes. “See you in a few hours.” Tom flicks off the light, then closes the door. I lie awake, flooded with adrenaline, as I always am when the phone rings at night.

  Throwing back the covers, I pad through the house. On the porch, I pull up a deck chair, take a sip of my bitter sleep medicine, and rest my chin on the rail. In three hours my alarm will go off. There’s no sound but the rain and the trucks on the highway a mile away.

  Tom will be driving fast. In the middle of the night, it’s thirteen minutes to Community Hospital, longer during the day. We know exactly how fast we can get there after all the years of doing obstetrics.

  He streaks through the traffic light near the Mountain Plaza and avoids the Torrington business district, where the winding streets that lead to the Jefferson River slow you down. Now he pulls into the ER parking lot and clicks his remote lock at the Toyota. He steps calmly out of the elevator into the harsh light of the fifth-floor pre-op bay. I see Heather’s white face, wet with tears, when she sees him.

  Calling

  Some people are born to be midwives. I think about that. Going back to school took work, sacrifice, and student loans, but I decided to go after my first delivery, which I did by accident.

  Laura, dressed in denim coveralls and about seven months pregnant, seeks me out at the Growing Tree Whole Foods Co-op. “I want to have my baby naturally, can you help me with the breathing?” she says, swinging her long blond braid back over her shoulder. “I heard you had Mica that way. Will you help me?”

  We meet four times in the back room of the natural-food store that our commune started; it’s located across the street from the courthouse in Spencer. Sitting behind a row of five-gallon buckets of peanut butter, barrels of whole wheat flour, and sacks of oats and pinto beans, we go over deep breathing, shallow breathing, staying centered, and trusting your body. I had taught Lamaze classes and read a few books. I’d attended two hospital deliveries as a labor coach, and I’d had one baby myself. That was the extent of my knowledge. It made me a local expert.

  “The breathing doesn’t really take away the pain. It just gives you something to do when you want to run away, which you can’t do anyway, so why even try!” I tell her. Laura laughs.

  “You can hum or count backward. It all works the same.” I show her some tricks of positioning, some techniques for massage.

  Three weeks before her due date, Laura and her husband, Lou, ask Tom and me to come over for dinner and one last childbirth class. They live in a large converted barn in relative luxury, four couples and three kids under seven.

  On Saturday we drive down the rutted dirt road into their hollow. On either side of the narrow lane, redbud and dogwood are blooming, everything’s alive and expanding. The barn, a huge, sturdy, insulated two-story structure, comes into view. I’m impressed when Lou gives us a tour. Each family has its own space in the loft. The common areas are downstairs: kitchen, living room, and library. The commune even boasts an indoor commode and hot running water. After dark, when a spring snowstorm comes up, we decide to sleep over rather than get the jeep stuck in the mud. Tom, Mica, and I are shown to an empty bedroom, and after a luxurious hot shower, we settle down for the night.

  Around three I hear rustling, low voices, and footsteps back and forth to the john. Maybe one of the commune’s toddlers is sick … Tom sleeps through it all. At four in the morning, Star comes to our door. “Can you come, Patsy? Please! Something is happening.”

  I pull on my jeans and turtleneck and follow the woman up wooden stairs. Star wears a long paisley skirt and has disheveled golden hair down to her waist. She looks as if she’s been up all night. “At first it just seemed like a backache,” she whispers. “But it’s got to be more than that. I’ve never had a kid, so what do I know? Laura’s been up most of the night. Now she’s started to puke and there’s blood down her legs.”

  The small woman pads down the hall on her calloused bare feet and leads me up narrow wooden steps. We stop at the door to a bedroom illuminated by dozens of candles. Pachelbel’s Canon plays low on the stereo. On a mattress on the floor, Laura crawls naked, moaning and swinging her head.

  Lou kneels beside her in shorts and a tie-dyed shirt, massaging her back. His long ponytail droops over his shoulder. “It’s coming, Patsy! I don’t know what to do. We planned a home birth and I was supposed to catch but I can’t. I just can’t …” His face is as white as the bedsheets. “You have to do it,” he says to me.

  I go very still. Pregnant woman … almost full term … moaning … blood … muddy roads … hospital two hours away. That’s what I’m thinking. Then there’s a pop, Laura groans, and a gush of clear fluid squirts out of her vagina. “Go get Tom, Star, he’s hard to wake up. You’ll have to shake him—and get the birth kit. You have something prepared, don’t you, Lou, some supplies?” The man looks around wildly.

  “Top drawer—bureau,” Laura snaps between moans. “My back hurts so bad. Damn! I have to push, but when I do it only hurts worse.” She lets out a wail and starts shaking. So much for childbirth breathing. “Get a grip, Laura,” I tell her. “Yelling is not gonna help, and it scares the baby.” I don’t know where I came up with that line, but it works. I’ve used it a hundred times with women in labor since then. She shuts up.

  Then Tom steps into the room with Star and takes in the situation at a glance. “Where’s the birth stuff?”

  “Inside the chest. I need some gloves. She’s gotta push.”

  Something is bulging between Laura’s legs as she wags her butt back and forth, and I haven’t even washed my hands. Tom pulls a paper sack out of the drawer and finds a box of exam gloves. They aren’t sterile, but neither is anything else, and they’ll have to do.

  “It’s almost over, Laura. I’m going to touch you. Don’t move around.” I part her labia and am startled to find a head covered with dark wet hair, about the size of a large apple.

  Laura moans again. “I got to get this fucking baby out of there. It’s killing me.” She growls like something coming out of the earth, and the head moves a quarter inch into my hands.

  “What’s in the bag besides gloves, Tom? Shoe strings, scissors?” Tom isn’t a paramedic or a doc. He hasn’t even thought of being one yet. He’s a bearded hippie beekeeper with the shoulders and arms of a carpenter and the soul of a string bass player.

  “Scissors in a plastic baggie with shoelaces. Some gauze and a blue infant suction thing. There are some worry beads, a baby blanket, and a laminated picture of Krishna.” He drops the beads in the drawer and hands Lou the picture of Krishna. The medical supplies he lays out on a pink flannel baby blanket, and then he puts on gloves himself.

  “I don’t suppose you could roll over?” I ask Laura between her contractions. She’s still rocking back and forth on her knees. “Lay on your back?”

  “Oh, shit,” she says, and she’s right. As the baby slides down the birth canal, some BM moves through the rectum and out of the way. Tom takes some gauze and wipes it up. Everything is moving fast now, but the baby’s head doesn’t flex. I know from the drawings in the emergency-childbirth manual that you should keep the head flexed, but this baby’s upside down with its chin tucked under the pubic bone, and I haven’t a clue what to do so I just hold on and put my hands around the head like a crown.

  “Breathe it out now,” I say with authority. “Breathe it out slowly.” Laura breathes. “Now pant!” A baby’s face is emerging from between Laura’s legs, scrunched and blue, looking up at the ceiling.

  Tom reaches over and suctions the mouth lik
e he’s done this before. “It’s trying to suck on the bulb,” he says, laughing. “Good sign.” Then the whole wet mass swivels and shoots out onto the bed. I scoop it up. The infant’s still dangling from the umbilical cord.

  “A baby!” the father yells, then slumps into the fetal position. The newborn screams.

  Laura laughs. “That wasn’t so bad!” Women always say that when it’s all over. I look between the infant’s wet legs.

  “It’s a girl.”

  “I told you!” says Lou, raising his head.

  After we tie off the cord and dry the infant, I hand the baby to her mother. The placenta slips out easily a minute later. Lou pulls himself together, and the three of them squirm to the head of the bed, where it’s still dry. I throw a blanket across them, and the candlelight shines on their faces.

  Behind Star, in the doorway, stands the rest of the commune. Three men and two women in various states of dress or undress, two sleepy toddlers, and one baby, who’s being held by his mother and sucking on a breast. Mica sleeps through it all.

  No one says anything, not even the kids, not a word. Pachelbel still plays on the stereo, music of holiness … Tom and I just kneel on the bed in the wet amniotic fluid.

  Baptized.

  SHIANA

  “I think I might have herpes,” the young coffee-skinned woman bursts out and then begins to sob. She doesn’t just leak tears. She floods. There’s no way to ask what’s going on, or why she thinks she has an infection. “The son of a bitch, I’ll never forgive him.”

  When a woman says she has herpes, it’s usually fifty-fifty; half the time it’s herpes, half the time it’s something else. Sometimes it’s a painful yeast infection, a boil, or an abrasion after sex. Sometimes it’s a bump in the mucosa that’s been there all along but the patient has just noticed it … and sometimes it’s herpes.