Dear Lord, help us, she silently pleaded as she heard a groan turn into a cut-off scream from the room where Anna suffered in the midst of delivering her baby.
11
Water’s already broken,” Anna panted around a contraction.
“I know.” Astrid glanced at the man beside the bed, his wife’s hand strangling his. “Have you assisted before?”
He looked as if he were struggling with her words, then as understanding came he shook his head, fear widening his eyes. “At home the midwife sent me to the barn.”
“I see. Well, we do things differently here. If you do as I say, you can be a big help.” She laid her hands on the burgeoning belly, then placed her stethoscope on it. She could hear the baby’s heart racing. Her throat dried immediately. “Anna, can you hear me?”
She nodded.
“We are going to get you undressed and into a nightgown. This baby looks to be in a mighty big hurry. You’ve already had two children?” Another nod. “Both normal births?”
“She lost one once, our first,” the man explained. He knew his English, Astrid saw, but she would need to keep her words simple.
“Thank you. If you help me, this will go faster.”
He nodded and began unbuttoning his wife’s dress. Between the three of them, and in between contractions, they got Anna undressed and into a loose gown.
“Now, if you will take off your boots and sit with your back against the headboard, we’ll position Anna with her back against you.” Astrid used her hands to show him what she wanted him to do and then glanced up to see his eyes close. He sucked in a deep breath and bent to untie his boots.
While he did that, Astrid checked to see how far Anna was dilated. “How long have you been having the pains?” Astrid switched to Norwegian, making it easier for Anna to understand.
“They started during the night but got worse the nearer we come to Blessing.” She spoke a combination of Norwegian and English.
“Ja, well this baby wants to come pretty soon. So, Solem, you sit behind her like I showed you.” She glanced at the man’s face again, whiter than the sheets on which his wife lay. “You’re not going to faint on me now, are you?”
He shook his head, teeth clamped on his bottom lip.
“Ohhhhh.” Anna cut off what threatened to become another scream.
“Anna, if you need to scream, you go right ahead.”
“The children . . .”
“The children are fine. Don’t worry.”
“Signe, she’s been sick too.” He shook his head. “We were all sick. It was a terrible crossing. Even the sailors said so.”
“All right, we’ll keep the children here.” She caught herself almost praying. If only Pastor Solberg would show up. She wondered if anyone had sent for him. While God didn’t seem to regard her prayers, He listened when her mother and her pastor prayed. Another thought had crossed her mind, but she’d not pondered on it. Because there had to be a God. The Bible said so, and she’d seen too many prayers answered to doubt that part. He just didn’t seem to listen to her.
But right now she sure needed someone to help her. She studied her patient while keeping her eyes veiled. Anna lay collapsed against her husband, the last contraction having taken all her strength. As labors went, she’d not been at this one terribly long, but the time from when the water broke until the baby crowned had been hard labor, and with the last stretch of time, nothing more had happened.
“I’ll be right back.”
“Don’t leave us.” Her husband looked as if he might leap off the bed and go running out of the room.
“I need Dr. Elizabeth.”
Anna groaned as another massive contraction jerked her body upright in spite of her husband’s helping arms. Her groan escalated, rising to a scream that she muffled by clamping her teeth. The grimace sent a shiver up and down Astrid’s spine. She checked to see if the baby was crowning, and when nothing had happened, she tore out the door.
Taking a deep breath to calm herself lest she scare other patients, she knocked on the other bedroom door and peeked in.
“Don’t come in,” Elizabeth ordered. “This might be contagious.”
“But I need you.”
“Ingeborg, you keep cooling this woman. I’ll be right back.” Elizabeth motioned to Astrid to back up. “What is going on?”
“Nothing. Anna is in full labor and not dilating any further. The baby hasn’t crowned yet.”
“I see. You’ve checked for position?”
“You mean internally?” Astrid clamped her teeth on her bottom lip.
“Yes.” Elizabeth clipped the word.
Astrid shook her head. I can’t, her mind screamed.
“You’ve done it before.”
“I . . . I know. But . . .” Astrid looked down at her hands. Not since Vernon’s surgery. I touched him inside, and he died.
“It’s coming!” Solem shouted.
“See, you worried too soon.”
Astrid headed back into the delivery room. The baby had not only crowned, but one more push should free it. Astrid gasped at the blue skin. As the baby slithered out, she saw why. The pulsing cord was wrapped tightly around the baby’s neck.
Astrid reached for a scalpel to cut the cord, but what if the mother bled to death? Was the baby dead already or in extremis? Both Mor and Elizabeth were contaminated. She slid her fingers under the cord to take the pressure off the baby’s throat and pushed on his chest at the same time. Breathe, baby, breathe. God, help me. What do I do?
“What’s wrong?” Anna gasped.
Fingers flying, Astrid found two lengths of string and tied the cord in two places before cutting between them. Each moment seemed like an hour, as if she were standing up in the corner and watching rather than in blood to her elbows and a blue baby in her hands. With the infant freed, she tipped him upside down and smacked his feet. Then pushed again on his chest. Breathe! God, please make him breathe!
Regowned and scrubbed, Dr. Elizabeth entered the room, taking everything in at a glance. She called out the door, “Thelma, warm water—now!”
“The cord . . .”
“I can tell. We’ll swish him in warm water. Sometimes that works.
Breathe for him. Cover both his nose and mouth and force the air into his lungs.” While Astrid did that, Elizabeth massaged Anna’s now flaccid belly with one hand, and with the other she packed sterile cloths between her legs to staunch the blood flow.
When Thelma brought in a tub of warm water, Elizabeth said, “Take over here for me so I can help Astrid.”
Anna groaned again, and the afterbirth flowed out onto the soaked pads, along with too much blood.
“Swish him a couple times, then breathe for him again. See, his color is improving.”
No it’s not. He’s not responding at all. Tears streaming down her cheeks, Astrid did as she was told. Swish and breathe. One puff, two. Please, baby, breathe.
But he didn’t.
She held the little body to her chest, wishing she could fill him with her breath. Her tears dripped on his still face.
“Can I hold him?” Anna weakly raised her arms, her voice broken.
Astrid laid the little body on his mother’s chest. “I’m so sorry.”
Solem sniffed, his tears dropping down onto his wife’s head. He laid his hand on the baby, his other arm clutching Anna. “He’s so perfect. He can’t be dead.”
“Here, Astrid, keep packing and massaging while I go for some medications,” Elizabeth ordered.
“You want me to get them?”
“No, I better.”
Astrid took over while Thelma cleaned up the room, dumping the pail of soaked pads and bringing another stack of clean ones from the cupboard. It’s all my fault. I should have known. If I’ d done the internal exam, I would have known. Why, dear God, why did that baby have to die because of me?
Elizabeth came back in the room and held a cup to Anna’s mouth. “Drink this. I know it tastes terrible, but I had to hurr
y.”
Anna gagged but got the liquid down.
“Good, now you rest while we get this bleeding stopped. I think it is abating already.” Elizabeth put the cup beside the bed. “Mr. Brunderson, I think you can move now if you want to.”
“I’m fine. I help Anna. . . .” Solem’s eyes moistened, but no tears fell.
Anna leaned against her husband, and together they held their baby.
He looked up at Dr. Elizabeth. “We should not have come. That awful voyage killed our baby.”
“No, this could have happened anywhere. We don’t know why, but it just happens sometimes. You can’t blame yourselves or the circumstances.” She looked directly at Astrid. “This is no one’s fault. You could not have done anything differently to keep it from happening. I hesitate to say this, but we do know this baby has gone back to his heavenly home. You will see him again when you get there.”
“If we get there.” Solem shook his head. “You can’t be certain of that, you know. You just do your best and hope.”
Could that be true? Astrid paused, wanting to say something but unsure. What if Pastor Solberg was wrong? But what about the Bible verses she had memorized all these years? For God so loved the world, that he gave his only begotten son, that whosoever believeth in him should not perish, but have everlasting life. Others ran through her mind. The Bible never lied. God’s Word was truth. She’d said that at confirmation. “Is Pastor Solberg here?”
“Yes, I saw him in the hall.”
“Good.” Astrid stepped out the door. Sure enough, there he sat, his eyes closed but his lips moving. He wasn’t sleeping.
“Pastor Solberg?” she called softly.
He heard her and hurried to her.
The tears spurted again. “We . . . I . . . The baby died.”
Pastor Solberg gathered her in his arms and held her, his soft murmurs sounding much like her mother.
“Please.” She stepped back. “They need you.”
He nodded and entered the room.
It was all she could do to follow him through that door. All she wanted to do was run away, far away from the smell of blood and a silent baby held by two sobbing parents. She found the anger she had brought under control raging upward again.
* * *
THAT EVENING, WITH Anna sleeping in her room and Freda fighting against the fever in the room next to that, Astrid and Elizabeth sat out on the back porch, letting the evening breeze dry the perspiration that soaked their clothing and drained their spirits.
Once Elizabeth determined that there was no contagion, they sent the two brothers and Thor with Haakan. Signe was at last calm and asleep on a cot near Freda. She still had some fever but not as high as her grandmother’s. They all sighed with relief when Elizabeth determined the blood Ingeborg saw came from a cut in Signe’s inner lip and not from the chest.
“Astrid, there was nothing else you could have done.”
“I didn’t do an internal exam.” I put my hands in Vernon’s body, and he died. Now I couldn’t touch Anna, and her baby died.
“You would have felt the head and known that the baby was in the proper position for birth. He wasn’t breech. You wouldn’t have found this.”
Astrid heard the words Elizabeth spoke, but the ones in her head screamed louder and drowned out all reason.
The crickets picked up their evening melody, joined by the whine of mosquitoes. A dog barked off in the distance, probably singing at the haunting whistle of a freight train heading north and then west.
“Discuss this with your teachers at the hospital. They’ll have better answers than I do.”
Astrid heaved a sigh. “I think my going to Chicago would be a waste of money.”
“You let me decide that. After all, it is my money,” Elizabeth snapped and then sighed. “We are all very tired. I truly understand what you are going through, both with medicine and your faith.”
Astrid leaned forward to argue but then dropped her hands.
Elizabeth continued. “It’s always harder near the time of decision, but think about this. How can more training not help? It makes us better equipped to win more often. It’s only for six months, September through February. Take this opportunity, and if you are still struggling afterwards we’ll talk then.”
Too tired to argue, Astrid changed the subject. “Do you want first watch, or do you want me to take it?”
“Ingeborg said she’d stay until midnight. Then she’ll come and wake you. I’ll take the three o’clock.”
“She’s not going to die, is she?”
Elizabeth snorted. “Only God knows that, but I don’t think so. For a while I was afraid of cholera, but I talked with young Mr. Brunderson, and he said there was no mention of cholera on the ship, or they would not have been allowed to dock. Typhoid would have been handled the same.”
“Pneumonia?”
“Probably the results of dysentery of some type. The way the shipping companies treat their passengers in steerage is beyond reprehensible. Crammed together like they are, it’s a miracle more people don’t die in passage. Did your mother ever tell you about her voyage?”
Astrid shook her head and brushed away a blood-thirsty mosquito. If the breeze were a little stronger, it would drive the pests away. “I’ll ask her sometime. She doesn’t like to talk much about the hard times, you know. Just that God lived up to His word and brought them through.”
“Thorliff has shared all his memories with me. Your mor and Tante Kaaren are indomitable women. I don’t think I could have ever lived through all they did and on top of that be such godly women.”
“Mor says we are all becoming that.”
“Well, today was surely one of those dark valleys. But He brought us through.”
“But the baby died.” The words lay between them.
“You have to let it go, you know. This is God’s problem, not yours. No matter how learned we become and how hard we try, life and death are always His province. You do your best and leave the outcome in His hands. Your mother taught me that. She says God taught her.”
Astrid pushed herself to her feet. “I’m going to bed. Can I get you anything?”
“No, thank you. Good night. Make sure you come wake me at three.”
“Of course.”
“If the crisis comes earlier, ring the bell.”
Which crisis? Astrid wondered as she climbed the stairs. The patients’ battle or mine? And she couldn’t ask Mor—not now. She hadn’t seen that look on her mother’s face since they lost all the stock. As she tumbled across the bed, Elizabeth’s question ticked in her mind like the downstairs clock. Was it the medical training she didn’t want to go toward or the flashing dark eyes she didn’t want to say good-bye to again?
12
MID - AUGUST 1903
CHICAGO, ILLINOIS
The clacking train wheels hauled her closer and closer to Chicago.
“Supper is being served in the dining car.” The conductor paused beside her. “You are Dr. Bjorklund, are you not?”
Yes . . . no? What? “I am Miss Bjorklund, ja, er yes.” Elizabeth had warned her that to those outside of Blessing, she was not yet a doctor. Her certificate would come from Dr. Morganstein on the completion of her studies in Chicago. If she managed to complete her studies there, that is. Every day since Vernon Baxter died, she’d questioned whether becoming a doctor was the purpose of her life.
And then Anna’s baby died too.
“I have heard good things about you. The folks of Blessing are indeed fortunate to have two capable doctors in such a small town. Farther west doctors are few and far between.”
Please, not another mission field. The day before she left, she’d received a letter from Reverend Ted Schuman in Africa. He’d managed to include another plea for her to listen to God’s calling, and if He wanted her in Africa, there was need of her services. The stories he told. The thought of all the travel needed to get to his mission was scary enough, let alone the horrors of the medic
al needs there. She stared out the window to see shallow rolling hills planted in wheat or miles of tall green corn. For one used to pancake-flat land, this was some different. As were all the towns. Grain elevators dotted the land crisscrossed by railroad tracks and roads. Tall oak and elm trees shaded houses, while every barn had a silo to store the chopped corn.
The closer they drew to Chicago, the tighter grew her dread. She should have stayed home where she belonged. While Elizabeth had planned to come with her, she had two babies due any day, and one of the mothers was ensconced at the surgery to keep her off her feet. And since Mor was still nursing Freda and Anna, they decided that Elizabeth was needed more at Blessing. Which left Astrid with far too much time to think.
Astrid tried studying one of her textbooks—anything to keep away the dark monster that seemed to have taken up residence just on the periphery of her vision. She was sure that if she turned her head quickly enough, she would see it and would be devoured by its slathering jaws. She’d never known such fear and doubt, and the worst part was she’d not been able to tell anyone about it.
The black dots on the page danced before her eyes, making her feel nauseated.
She thought back on the going-away party her friends had organized to give her a happy send-off.
“After all,” Sophie reminded her, “you’ll only be gone a few months, and you’ll be so busy the time will fly by.” She dropped her voice to a whisper. “And I’ll make sure that no one tries flirting with Mr. Landsverk.”
Joshua Landsverk, the first man Astrid had hoped would be more than just a friend. After all, she had plenty of male friends, but this one was different. This time her heart picked up speed every time she saw him, and now she understood why Ellie had never considered anyone but Andrew and was willing to wait for him for years if necessary.
Surely the look in Joshua’s eyes when he smiled at her meant he felt the same way. The girls teased her about him, and even Thorliff mentioned what a good, dependable man he was.
She’d tried to insist she should stay and help Mor, but she said Freda only needed time to get strong again and Anna the same. Rest, North Dakota sunshine, and good food were all they needed to give God time to work the healing Mor was sure was happening.
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