The Waters & the Wild

by DeSales Harrison

  That night in my tent, I could make myself drink only enough to keep off the shakes. Did I think if I lay very still and waited in the darkness, the fact would pass me by? Did I think that by some inscrutable mercy I would be released, uncoupled from it? But suddenly there was a voice calling out in the campground. Then the voice was nearby. Someone was beating on the tent fly with his hand and shouting, Docteur! Docteur! Vous êtes là? Putain, il est où, le foutu médecin, le médecin américain?

  Yes, the fucking American doctor was here if he would shine that fucking flashlight somewhere else.

  The beam flashed up before he flicked it off, illuminating the gaunt face of the man who had expelled me from the squatters’ basement—though now he seemed a mere boy, gangly and rawboned. Panic cracked in his voice as he spoke. “Viens, Docteur, tout de suite! The girl, you must come, she is in trouble—”

  “She is in labor,” I said.

  “She is dying,” cracked the voice.

  “Then get her to a hospital, like you should have before.” I turned.

  “Pas d’hôpital! No time.” He clasped my arm and jerked me around. “She is dying. You come. Ma moto.” And then we were flying, my hands gripping his bony waist, the motorbike wailing over the bridge and up past the Porte de Paris, ricocheting through the twisted streets and then out through the housing projects, bumping over a curb into the unbuilt development, through the flung-open plywood door, and down the ramp, brakes shuddering, skidding to a stop in the abandoned basement.

  “She is dying. You see how she is dying,” he said, lifting the kerosene lantern over her body.

  “She is in labor,” I said. But the cast of her skin in the lantern’s glare looked livid and greased. Naked, she lay on her side, a lake of dark fluid pooled beneath her hip. A groan surfaced from the depths of her body. When I turned her onto her back, her head lolled to the side. Respiration labored, eyes half-open, carotid pulse weak and thready. The young man had been speaking. They’d thought her pains were just withdrawal cramps, so he’d gone out to cop. That had taken a couple of hours. When he came back, she was worse. She had shat or pissed or something all over the bed, and she was screaming. He hadn’t wanted to shoot her up, but she’d made him. She had stopped screaming then, maybe because of the hit, but she wasn’t better, she was worse. She’d turned a color. He’d had no idea what to do; maybe he shot her up again…But she was saying something, something about getting the doctor, the American doctor. Was she dying? She wasn’t going to die, was she?

  “She will surely die if you don’t get her to a hospital.”

  “But you can do something, no?”

  During his explanation, I had knelt and examined her. Though the cervix was effaced and fully dilated, her labor appeared to have ceased, with the baby’s head canted at a bad angle in the birth canal. I stood up.

  “You see she is not dying,” the young man repeated, shifting from foot to foot like a child needing to urinate.

  “No,” I said. “She is not dying. They are both dying, together, she and your baby. If you do not leave now, if you do not get an ambulance here now, they will die. Do you understand? Toutes les deux. Both of them.”

  Then, as though shot from a sling, he was gone, the echo of shrieking tires vibrating from the walls. An odor of scorched rubber and exhaust lingered, mingled with the odor of effluvia, ferric and excremental, pooled on the cardboard beneath her hips. I could neither look at the girl nor look away. The lantern hissed. Beside it in an ashtray, balanced across the bowl of a spoon, a loaded syringe rested, the needle-tip beaded with a clear droplet. The lantern light glowed scarlet in the needle’s chamber, suffused through the mixture of heroin and blood. The young man must have stopped or been stopped after he had found the vein.

  Another groan, weaker this time, rose from the girl. I had examined her at first without compunction, but now the thought of touching her appalled me. Standing there above her, I held my hands up, palms inward, as though I had just pushed my way through scrub-room doors into an operating room. My hands, however, were ungloved, and dark not with Betadine but with blood.

  What—I tried to make myself think—what what what were the likely complications? What was most urgent and what could be ignored? What could wait until the ambulance arrived? The heroin must have retarded or interrupted labor. It would have if he had given her enough. But something else could have interfered as well. There must be a dozen, a hundred possibilities. How long could it take for the young man to find a phone, flag down a policeman, summon the EMTs? I held my breath, listening for a siren, a motor…Nothing, only the hiss of the lantern and the girl’s breathing, irregular and stertorous.

  “Vous me permettez?” I asked absurdly, kneeling beside her. Perhaps if I shifted her hips, I could expand the pelvic basin, but when I lifted her thigh to push it up toward her chest, a horrid gasp leapt through her. The paroxysm seemed more a convulsion than a contraction. While it lasted the crumpled crown of the baby’s head emerged slightly from the birth canal, feathered with blood-matted hair, scalp waxen, blue black, and hypoxic. Leaning forward, my chin pressed into the back of her knee, I managed to pin her thigh against her chest, hoping to push the baby far enough back up the birth canal to turn it. It was during this blind and futile effort that I felt, at my fingertips, the hard, vein-ridged umbilical cord coiled in a double loop around the child’s neck, while the child’s shoulder remained wedged behind the cervical rim.

  Shoulder dystocia. Delivery arrested by shoulder dystocia. That would account for the bad angle of the head. Yes, there could be no doubt. But why was I so sure? Because shoulder dystocia was one of the few labor complications I could remember from my obstetrics rotation? During one of those deliveries, the attending physician, with a jerk of a forceps, had snapped a baby’s collarbone to deliver it, and for days I could not expel that sickening crunch from my head.

  If there was a name for that maneuver—the breaking of the clavicle to extract a distressed fetus—I didn’t remember it, and in any event I had no forceps but my ungloved hands. I struggled for a better purchase on the baby while cries surged through the girl with convulsive force. It was only after my hands had grown slick with vernix and blood, only after I had contrived a way to brace my elbows against my stomach while leaning over the girl, that I managed to force the baby back up enough to get a proper grip on its shoulders. At first the body felt like a greased piglet, but as I grasped harder, the tiny thorax seemed less slippery and more brittle, as though the pressure of my hands had melted away all insulating layers of fat and muscle, leaving only the frail cage of rib and collarbone. For an instant I hung paralyzed between the fear of losing my grip and the fear of killing the baby outright. I compressed the shoulder yoke with a desperate force: either the clavicle would refuse to break and the child would strangle in the canal or I would crush its thorax entirely. I was certain now I should give up, wait for someone to arrive, but the lantern hissed, I leaned harder, and it broke, the clavicle alone, with a wet snap.

  With the shoulder collapsed against its neck, the baby shot out, propelled on a wet gush, not of amniotic fluid but of blood, frank and opaque. I tilted the head back and with my mouth tried to suck the mucus plugs from its nose, the slurry of phlegm and meconium from its throat. I lifted the little body up by its ankles—as though whatever blackness had filled it, had darkened its face to bruise-bronze, would rush out of it. Only a brownish froth, however, no more than a teaspoon, drained down the cheek toward the sealed eye. Nothing happened. The child did not breathe.

  At last I replaced the small form alongside its mother, its rumpled feet bowed inward, the buttocks narrow. No afterbirth had followed the delivery, so the umbilical cord still disappeared in the mother’s vagina. Blundering through the shadows, I found an empty wine bottle and a plastic bag. I bit off the two handles of the bag, then knotted them to ligate the umbilicus. The bottle broken, a large shard serve
d to cut or rather crush through the gristled tissues, releasing a single spurt of blood when it breached the artery.

  It was then, for the first time, that I noticed: the child was a girl. The baby was a girl. But she had neither breathed nor cried, and she lay motionless where I had set her down, beside the mother now motionless too. An immense longing overcame me to leave them alone, to leave them in whatever impenetrable silence had claimed them for itself.

  I decided to place the child on the plateau of her mother’s sternum, near to the heart, but when I turned the baby so that she would not slide off, the clavicle ground and gave. It must have been the pain then that did it, stiffening the little body with a galvanic jolt. In a single spasm, it kicked and arched and spewed a plume of filth, followed by a squad of cries enraged but orderly, separated by short whooping gasps. The cries drove outward in every direction and echoed off the concrete walls, and the mother’s body heaved with an answering half rasp, half wail. Her eye, rolling to the side, caught mine and held it in blind, desperate appeal.

  If infection had taken hold, she could be disoriented, even delirious. Perhaps she had never been aware that I was there. The face, still waxen, tensed anew, but only briefly, as a final contraction ejected the afterbirth into the slick of effluent, and along with the afterbirth another surge of blood. I had put her hand up on the baby’s back, and for a moment she struggled to raise her head and look. The effort seemed to crush her and her head fell back, an enormous tear quivering in the hollow beside her nose.

  “Voilà votre enfant,” I said. “Une belle petite fille.”

  Had she heard me?

  “A girl,” I said again. “A beautiful baby girl.”

  But she said nothing. Her body shook, teeth chattering. Her lips had gone pewter blue. When I touched her, her skin scorched my fingers. The shaking had turned to shuddering, and the baby had begun to choke on its cries. I lay down on the pallet beside the mother and eased her onto her side, curling my legs beneath her backside to spoon myself around her. With my arm around them both, the baby resting in the hollow of her mother’s body, I could support the child against her mother’s breast. She had found the nipple herself and on her own had managed a shallow latch. Sucking, she was silent save for a little piping hoot released from time to time. How long we lay there like that, I cannot tell you. I cannot tell you because we slept.

  But who could believe such a thing? I myself cannot. And yet I swear to you, the three of us, together, sank into a dreamless, obliterating slumber. When I woke, everything was different. The surroundings had not changed. Every object was exactly as it had been, only a total clarity had descended, purifying the airless space, sharpening the edges of the lamplight. The mother’s breathing was regular and steady. The night, I knew, was far gone. I knew that no one would come to help us: no gendarmes, no police, no paramedics jogging down the ramp with trauma kits and stretcher boards. The young man had spurred his bike and fled. Our solitude, though shared, was absolute.

  * * *

  —

  Had you been there, Father, had you stood, say, at the top of the ramp, what would you have seen, looking down? The baby, sleeping, had fallen from the girl’s breast, the breast blue-veined, hard and pale in the hard glare of the lantern. Behind them both, the doctor: his eyes open now. The scene would seem frozen, fixed, a tableau, until you remarked the trembling of the doctor’s hand on the mother’s naked hip. At first you understand this to be a natural response, a discharge of adrenal tension after his urgent exertions. But then you see how the hand is not in fact trembling, not any longer, but shaking, and you understand that it is not the hand that is moving but the hip beneath it. The hand jerks as the mother’s body jerks, and you see now that her mouth has filled with a bloody spume. Her eyes rolling, erratically at first but then back in the direction of the doctor beside her, but they do not meet his own. He does not move to clear her throat, or to turn her so that she does not aspirate her own vomit. He only holds his hand against her hip, as though the hand were an instrument whose sole purpose was to register each twitch, each throe, within his own person, recording each spasm heaving now through her in waves, each one closer on the heels of the last until they have fused into a single convulsion, driving her chest forward, her spine arched. You would think this compounding paroxysm had lasted for many minutes, realizing only afterward that mere seconds had passed before it released her, a faint tremor flickering through her extremities, followed by a hoarse, scraping exhalation. The doctor’s hand is immobile now, as incapable of movement as the mother’s body, now perfectly still. So absolute is that stillness that when at last the doctor rises, slowly, as though taking all pains not to wake them, you think he must have risen out of his own body. You think when he bends over the baby and wraps it in his shirt, he has lifted the baby from out of its body as well, so that even after he has departed with his tiny burden, the three of them—the doctor, the mother, the child—would remain forever in that darkness, as though carved on a tomb lid or frozen in the shadows of a near-black photograph.

  FORTY-ONE

  During my rounds at the hospital, I must have fallen asleep in the chair at a patient’s bedside, next to the IV tree. Did no nurse think to wake me? I try to rise, but exhaustion like a great weight presses me down. And where is the patient? I wonder, aware now that I am the only person in the room—the only person, and yet not alone. Certain thoughts wait for me to regain consciousness. One, barely audibly, suggests that the chair I am sleeping in is not in fact a chair. Another indicates that I’m not sitting but lying in a bed. A third whispers that I have not been making rounds, that I have not made rounds in many years, not since I was a medical student. Another says, Listen: the voices in the hallway speak a foreign language. But it is not foreign; it is French. You have awakened in France. You took a wrong turn somewhere in the hospital, got out on the wrong floor, and now you are in France.

  Why was I there? How did I get there?

  * * *

  —

  If I shifted, the IV rack shook as though startled. The bags hanging on the rack drained into a converging tube, and the tube to an in-line catheter, the catheter to a needle, and the needle in a vein in the back of a hand. These elements hung together like segments of a syllogism. The hospital bed was my bed, the drip stood at my bedside, the hand was my hand. Nevers. Somehow I knew I was in Nevers. The reason, like a visiting bedside relative, had gone away but would come back later.

  * * *

  —

  There had been voices in the corridor, but the voices had disappeared. I thought: So this is what it feels like, the standard combination, Haldol and a benzodiazepine, lorazepam most likely. I’d ordered it often for my patients. The sedatives corralled my thoughts away from me, as though in a tank, submerged and distorted behind walls of heavy glass. They swam like huge fish, vanishing for a while and then bulging once more into view, their flat eyes tilting toward me slightly as they pass.

  * * *

  —

  At some point a nurse came in, took my temperature and blood pressure, looked at me but said nothing, and departed.

  * * *

  —

  It was only when the wall of sedation ruptured and my recollections flooded over me, all at once—the abandoned basement, the hissing lantern, the mother’s pinprick pupils, the baby’s orderly cries, the lake of blood—when I jerked upright, or tried to, only then did I discover I had been restrained, padded cuffs Velcroed around wrists and ankles, straps anchored to the bars of the bed.

  * * *

  —

  The nurse returned and a doctor followed. “He’s awake now,” she said. The doctor, young, put on a pair of fuchsia-rimmed spectacles and a bland smile. “Dr. Abend,” he said, “I trust you are feeling somewhat better now?” Without waiting for a response, he offered an apology for the restraints, his English betraying the slightest accent, almost British, barely Fre
nch at all. “You understand they are only a precaution.” He spoke as though we had already met: surely I could understand, a doctor myself and a psychiatrist—in cases of agitation—

  “The girl,” I said.

  “Yes,” said the smile, blank as a surgical mask.

  “The girl,” I said again. “How is the girl?” Even as I asked this question, I knew I had asked it before, more than once, many times.

  “Beautiful. She continues beautifully. Excellent progress, excellent vitals. She has gained another fifty grams.”

  “No—” I said.

  “I assure you, she tolerates the methadone well,” continued the smile, “though of course it is still early in the protocol. I believe I already mentioned she has begun to take the bottle.”

  “Not the girl,” I said. “The mother. How is the mother?”

  The doctor said nothing. He was taking my pulse. His lips moved as he counted the beats. The smile had disappeared. “I will be back, Dr. Abend,” he said, and left the room.

  * * *

  —

  As for what had happened between the birth in the abandoned garage and the moment I woke in the hospital, my memories are, you could say, secondhand recollections, furnished to me only later in the denatured French of the police reports.

  At approximately 4h15 an adult subject had approached a road crew for assistance, holding a newborn infant wrapped in a shirt. Police were notified and an ambulance dispatched 4h36. Subject informed responding officers of the location of the infant’s mother. Officers determined location to be a construction site at 19, rue Saint-Saturnin, and a second ambulance was dispatched. (See attached report, CZ090102.) Ambulance with subject and newborn arrived 5h11 at Hôpital Colbert, and both were taken in charge by hospital staff.