Women had no other choice. They birthed their babes on rush mats laid on the maliciously gleaming floor, the floor that could be easily swept, the dirt floor made shiny and smooth by multiple coats of varnish concocted from water and cow manure. The floor that guaranteed a fifty-fifty chance that either mother or child—or both—would contract deadly infections.
These were the women for whom Dorothy had come to do battle. These were the women she’d found in this remote outpost, this place that had no hospital beds, no instrument sterilizers, no bassinets or x-ray equipment in those early years.
And for that matter, no electricity or running water at the time.
She’d labored here for a mere month by then, with none of the tools of the trade her American associates enjoyed. No sterile operating room, no well-trained nurses to tend the patients on whom she performed surgery.
She had her skill. Her intellect. Her ingenuity. And a small staff with a tenacious will to support her.
The rest she had figured out on the fly.
Within seconds of encountering the young woman, a sour gorge had risen in Dorothy’s throat and left its bitter sting on her tongue. In order to examine the woman, she had to kneel—or squat—in the middle of the mess that had so recently been vacated by a rat. But Dorothy had abandoned all thought of the filth through which her shoes were sliding and tucked her dress beneath her knees as she knelt beside the woman to confirm the midwife’s assessment. The rigid cervix and hardened tissue surrounding it validated her fears.
“Tetanus,” she whispered, and her aging associate nodded.
In no time at all it had become clear to both women that neither the mother nor the child would survive without radical measures. The woman’s cervix, completely paralyzed from the tetanus she had already contracted, could never accomplish its work of expanding to allow the delivery of the child. And yet the child had begun its journey. It had descended into the birth canal, its head pressing on the frozen cervix harder and harder with each contraction.
“What would you do?” Dorothy had asked, searching the midwife’s eyes for evidence of a solution.
The woman sighed and rocked back on her heels. “Nothing to be done. She’s too far into labor and no way to open the gate.”
Dorothy bit back an astonished reply and swallowed to restore her clinical control. “But we must. It could be days before they both succumb. You know the agony that would entail.” She waited until her weary associate raised her head to look at her. “For both of them.”
The midwife turned away. “I’m well aware, Dr. Kinney. I wager I’ve seen it more times than you, and it will never be something I can stomach. But I say again, there is nothing to be done.” She wiped her instruments and sighed. “I’ll speak to the headwoman.”
Dorothy lifted the young mother’s limp wrist to take her pulse, and started as the woman wiggled her hand free and clutched Dorothy’s. She looked at Dorothy, her eyes pleading as her other hand fluttered spastically to her abdomen. Lying in squalor as she was, it seemed the most eloquent supplication Dorothy had ever witnessed. There was no doubt what she meant to communicate.
Save my child.
The sound of mourning began quietly in a corner of the hut. The midwife was telling them—this woman’s friends—what to expect. It would be horrific. It would be so hellish that they would all abandon her and she would die here. Alone. Cradling her dying child within her womb.
Dorothy studied the looks that passed from woman to woman. Disappointment turned to resignation in an instant. One gave a small nod to another. It seemed to be an instruction, or perhaps a granting of permission. Permission to begin mourning?
Understanding crawled to the pit of Dorothy’s stomach. It was not permission to begin mourning. It was permission of a far more terminal sort.
They knew how to end the suffering. They would administer some kind of merciful end as soon as she and the midwife left.
That’s how it was done. That’s what was expected.
“Wait.”
Dorothy smiled at the women.
The murmuring stopped.
“What?” The midwife frowned.
“I said wait. We’ll take her to the hospital.”
“Dorothy, no, you can’t. She’ll die. It’s too far. They’ll die anyway. The babe’s too far into the canal for a Caeserean.”
Dorothy turned to her friend, the old woman who had performed her share of medical wonders. “But I’m not going to deliver the babe by Caeserean,” she smiled.
“Then...how...”
Dorothy inhaled, the long, steady breath affirming her belief that she had made the right decision.
“I’m going to remove her cervix.”
. . . .
It had been bold. It had been daring. It had been rife with risk.
And it had been enough. A young American doctor’s skill, her courage, and God’s good grace had won the night, and twenty-four hours later the new mother lay recovering in the Gauhati hospital in the most sterile environment Dorothy’s primitive circumstances could muster in those early days.
Death had been near, and the Great Physician nearer. It felt good. It felt...powerful. And it frightened her more than any other thing in her life. The woman should have died, and Dorothy could have let her. Because it was what they expected.
The fledgling doctor had sat at the end of her own bed at dusk the next day, weary to the bone, shaking like a leaf, and praying like she’d never prayed before.
It was You, Father, I know that it was, who guided my thoughts and willed my hands to save those two dear lives. Forgive my hesitation. Please! Forgive me that I very nearly did not take the risk!
A tear slipped down her cheek. She was in this remote outpost because she’d known better than the medical school staff what work she was best meant to do. She was here because she’d known better than every mentor in her life who tried to steer her away from her chosen medical specialty.
Strong-willed as she was, she’d always believed she knew best what course her life was meant to take. But they had sown a seed of doubt, and it had nearly made her ignore God’s quiet prompt to save a mother and her child.
It would never happen again, she’d promised. And with God as her witness, she knew now—a full seven years later—that she’d been keeping her promise.
In Dorothy’s Own Words
I taught myself surgery skills by correspondence study, and performed surgery under those primitive conditions. I allowed God to perform miracles through my surgeries. I often felt a divine power just beyond my fingertips as I performed some of the most difficult surgeries under many hardships. I also learned to do cataract surgery which was a big help to the people.
One day I was awakened at 2:00 A.M. A native midwife had been unable to deliver a baby at home although she had followed her usual procedure of having the woman lie on the dirt floor—because a bed or anything else touched during childbirth would have to be burned. The hard mixture of mud and dung which coated the floor was filled with tetanus and other bacteria which often caused illness in both mother and baby. This woman’s cervix, covered with mud and dung, was inflexible, and both mother and baby would have died without something being done immediately. So, I removed the cervix so the baby could be born. Six months later the mother came back to the hospital, healed and happy, to express her thanks!
Let me follow up with an interesting little story! Later when I returned home on furlough and wished to pursue some special obstetrics training (which was still NOT a profession for women), one of my medical school professors asked, in a very condescending tone, what kind of cases I’d had out there. I related that case to him. His reply was, “What a radical thing to do!” I calmly asked what he would have done in such a case; he had to admit he’d never had such a case! I could honestly tell him that my cases had included every possible health problem, multiplied by cultural traditions, lack of sanitation, and the social situation.
CHAPTER THIRTEEN
SINGLE–BLESSEDNESS
Seven years. When she let herself think about it, the whole of it quite overwhelmed her. And now that she had met Fred, it overwhelmed her nearly every day. Finding Fred cast a lovely glow over every facet of her life. It lightened her heart in a way that made everything seem new and perfect.
It promised that she might come to know a joy that she had never thought possible for herself. And yet all the while she knew that opening her heart to that joy could also mean monumental loss. No matter how much the missionary board might value her service, would they ever entertain the idea of keeping a married woman working in the field?
Fred’s letters came almost daily, and each one inched closer and closer to suggesting that somehow their individual futures were becoming entangled, though neither dared to voice just how that might come to pass, or even what it might look like. Would he come to Gauhati? Would she become a housewife or could she break the mold of her ilk and continue to work in medicine? Would she move to Jorhat, find herself forced to leave her practice and abandon her career, to assume the role of contented lady of the house? Sometimes trying to work it all out simply tied her heart in knots.
She chased that idea hastily from her mind.
She wanted to write giddy letters home, to tell her parents she’d met the most wonderful man, a man her father had actually met ten years earlier and didn’t even know it, a man who had graduated on the same Colorado stage with her and they’d never known the other existed. If she had read it in a storybook she wouldn’t have believed it. Yet it was true. She was living it herself.
And so was he.
He’d somehow turned the page and found her, this man who made her heart sing and her face light with joy at the prospect of another letter from him.
But nothing about Fred fit into the future that her parents understood she had carved out for herself. In fact, her father had often declared that his firstborn daughter was destined for single-blessedness, so sure was he that she would live out her days as a spinster missionary.
Each time she sat down at her typewriter, the ruthless chains of single-blessedness twined so heavily about her fingers that she wrote only of the most mundane things and never dared breathe a word to them that she might be, may be, very possibly could be falling in love.
NOVEMBER 1935
The Dawali Puja was celebrated on Monday night. It is sort of a puja done in order that the harvest may be plenteous. It is just about the time to harvest the rice. It is really a pretty festival and it is characterized by thousands and thousands of little lights. They make tiny shallow clay saucers, put some oil in them and a wick and light them. These are set around everywhere—lines and lines of them. It made me think a bit of the lights at Christmastime.
You should have been here the other day when the husband of a patient came to see his wife. He arrived on a huge elephant, and left the elephant parked under the portico of the hospital. It is the first time that we have ever had an elephant parked in such close proximity to the hospital. Later, Marian took some snaps—I didn’t have any on hand, and then got up on its back and rode over to the bungalow where she was joined by Ethel, and then they rode back to the hospital again. Ethel said she had to hang on for dear life to keep her seat.
In the afternoon I had a queer case. A child of three came in just about wild. They said she had not slept for three days, and had eaten scarcely anything, and had been going about in circles. She was bleeding from one ear. Got one look in her ear, and then Alice gave her some Chloroform. In the next two or three minutes we removed eight nice big fat maggots, each very, very much alive, and each about ½ inch in length. One never knows what will come in next.
February 1936
It would be hard to convince anyone that the British Raj (rule) was not held in admiration had they been here on Tuesday. King George had requested that the mourning for him should not interfere with the regular work as he knew the hardship that it might put upon wage earners. However, there was scarcely a shop open in Gauhati all day Tuesday, and the ones that were open refused to sell even a penny’s worth. The papers have been full of the details of the Lying-in-State, the funeral, etc. The Queen Mother’s letter of appreciation to the Empire was published the other day and was beautiful.
We are going to have to get some more babies’ beds soon as yesterday we had one more baby than we had tiny beds for, and at that, both of the twins were in one basket. The hospital continues to run pretty full. We have simply got to have more money for running expenses somehow as we get only about $91 a month for all the running expenses, drugs, helpers, repairs on the compound, bungalow and hospital, and it just will not jury (cover it all). We are getting more and more cases, but we can’t count on what we get from the pay cases (have had many more of them lately, and we are at a place where we can’t refuse cases if we want the hospital to grow and the people who can pay to come in). With the increase in patients we have increased our income, but not in the same proportion that the overhead has been necessarily increased. If only we didn’t have to think about money in connection with a hospital of this sort.
The words flowed like gibberish, all intending to sound like life as usual, but they were mere camouflage for her true feelings. She wanted desperately to tell Wink about Fred, but that would be absolutely disastrous, unless she wanted the whole world to know about him.
But that didn’t keep thoughts of Fred and what he meant in her life from joining a maelstrom of thoughts that cluttered her mind one late afternoon as Dorothy walked back to the Satribari Compound from the village ghat (market) with her canvas bag smacking rhythmically against her knee.
Klunk.
How could she manage the rising hospital costs?
Ka-klunk.
Would there be a letter from Fred?
Klunk.
Where could she get more beds for the overflow of patients?
Ka-klunk.
Would Fred really be able to come down for a visit in two weeks?
Klunk.
Where in the world would they put all the newborn babies?
Ka-Klunk.
If she only had a husband, he’d build her some new bassinets.
Klunk.
How soon might she manage a trip to Jorhat?
Ka-Klunk.
What would—
“Memsahib! Memsahib!”
A male voice broke her concentration, shouting with alarm from just inches away. His urgent tone cut through her distraction, banishing thoughts of patients and babies and a certain handsome headmaster.
Dorothy stopped abruptly, startled. Her eyes fell immediately upon the reason for the man’s urgent warning. Just inches from her toes sat a small pile of brick atop which sat a crude box of carpenter’s tools. One more step and she would have taken a nasty fall across the jagged bricks.
And she would have ruined his tidy pile in the process.
“Oh! I...Thank you, sir!”
Her heart thudded once in relief as she looked toward the craftsman who had stopped her in her tracks. His gaunt face showed his own relief as he rubbed his hands across his makeshift apron. Tattered pants hung below, falling far too short of his muddy brown ankles and crusted feet.
She recognized the tatters immediately.
He was wearing a pair of the men’s pajamas that had been gifted to the hospital! She remembered having given several pair to Monglu before tearing the rest into bandages. And in the way these things happen, they must have found their way onto the muddied legs of the man who stood before her wringing his hands.
February 1936
Our panniwalla or water carrier is a busy hard-working little fellow. The other day we were surprised to see him come to work in a new suit of clothes. The funny part was that it was a suit of blue and white pajamas which had come out with the White Cross charity things, and as we do not take boys over 12 at the hospital and the women don’t wear them, we
were unable to use them.
We finally gave them to our derzie which is the tailor and told him to sell them for us. One pair had gone to the paniwalla and he was wearing them as though they were the latest style from Paris. The legs were rolled up above the knees.
We have the matroni sweep the floors and do the bathroom work. We could get along with fewer servants if it were not for the fact that Cook will not as a rule do bearer’s work and bearers will not do paniwalla’s work and none of them will do the matroni’s work and so it goes.
“Missahib, you must please to be careful,” he chattered as he motioned for her to walk around the obstruction. The man might easily have reached for her elbow to stop her, rather than screaming in her ear, but that would have required him to touch her. And that was something he would never do.
He was low caste. Touching a high born Indian woman was a sin that could easily get him hanged, and from the habit of a lifetime, he ascribed to Dorothy that same deference.
“Thank you, kind sir, thank you!” She smiled as she daintily stepped around the man’s building materials.
Once she had skirted the obstacle, Dorothy could see that the man’s project was nearly finished. And it was indeed marvelous.
Three newly constructed half-walls formed an open-air verandah to one of the bunglas on the hospital compound. Unlike other similar structures, this bungalow had decorative teakwood lintels which—judging from the tools in his hands—the man had carved. The artful additions gave an unexpected grace to the little home.
Its lines were clean and plumb, its construction carefully planned and executed, unlike much of the rustic work she regularly saw about the community.
The man was a carpenter! With that realization, Dorothy whirled and nearly bumped into the poor man who seemed to be following to ensure she successfully navigated his workspace.
His distress instantly elevated as he gasped and jumped aside, so as not to touch her with his unclean, low caste hand—and promptly fell over the malicious little pile of brick.
Courage in a White Coat Page 9