At least Ruby will be motivated. She wants this baby, and she has a nice boyfriend. Abby says he came in with her for the pregnancy test, a good-looking blond, a lineman for Mountaineer Electric. The two sat in the waiting room with their arms around each other, so excited they outshone the Christmas tree. Though the baby is less than a half-inch long, it already fills their hearts.
Winter Solstice
Winter has locked around us for sure now. As I leave from work, the storm begins. Snow coming in from the west. By the time I get to the freeway, the tops of the mountains are covered with white.
Despite a recent bout of melancholy, I’m excited. I always love the first good snow, and it’s winter solstice night. “Hello snow!” I greet the lacy clumps that whirl from the low gray clouds. It’s going to be a big one! They’re predicting eight inches.
Oh, the weather outside is frightful . . . I sing along with the radio.
On Turkey Run, the shortcut behind the University Agricultural Farm, the traffic slows and I find myself thinking of Ruby. I saw her in the clinic this afternoon for her first OB visit. Six weeks is early to start prenatal care, but that’s fine with me. I like to see the women as soon as they call, talk to them about how to have a healthy pregnancy, answer their questions, get lab work, and go over their history for risk factors. Despite her spotting, on the early ultrasound we could see the fetal heart flicker.
I hand Ruby a thick green folder with our Women’s Health Center logo printed on the front, a pine tree with the slogan, “Take care of yourself. Your health is a valuable resource.”
“What’s this?” Ruby asks.
“These are your OB handouts. You don’t have to read them all tonight.” I make a little joke of it.
There are hundreds of books on childbirth, but in our practice the patients’ educational and socioeconomic levels vary so much . . . some women have their PhDs . . . others never finished high school. Some have read Spiritual Midwifery and The Working Woman’s Pregnancy Book before they come for their first visit; others don’t read at all. For this reason, I like to start the educational process early.
I remove the flyer titled What to Eat for a Healthy Pregnancy out of the packet and place it in Ruby’s lap. “So what did you have for breakfast this morning?”
“I don’t usually eat breakfast. No appetite.” She shrugs as if that’s the end of it. But I don’t give up easy.
“I know what you mean. Me neither. But when you’re pregnant that has to change. So what could you eat? Do you like milk?”
Ruby and I problem-solve together on healthy food choices, things that are handy and not hard to cook. I have to be careful in my suggestions, because Ruby is on a medical card and doesn’t have much money. I tell her how to get signed up for WIC, the federal program that gives pregnant and nursing mothers coupons for free healthy food. Ruby still smokes a half-pack of cigarettes a day, has limited understanding of nutrition, is underweight, doesn’t exercise because of her chronic pain, is unmarried, with a lot of family problems, and is still on narcotics. This will be a challenge, but I like challenges, and I like Ruby.
Once I’m on the freeway the traffic thins out, but at the top of our steep drive, I stop singing. If the snow gets too deep, I won’t be able to get my Civic back up. I take a deep breath and drive down anyway. Let it snow. Let it snow. Let it snow . . .
Since returning from Moscow, I’ve been lonely for my boys and have had a hard time getting into the holiday spirit. I managed to get a tree up, a wreath on the door, and the manger scene laid out, but that was the end of it.
Inside, I toss my briefcase in my office and shake off the blues. Soon Zen will be home . . . we haven’t seen him for six months . . . and Orion and Ari and Lissie and baby Abraham will be here for Christmas.
Though it’s still afternoon, I put on an album of seasonal music and scurry around the house collecting candles for our solstice ceremony. This year, as last, it will be just the two of us. I glance out the window where snow now blows in at an angle, thankful that I made it home early. The gazebo is already covered, and six inches of fluff coats the porch rail. If the roads get too bad, it might be just me.
A blast of wind jolts the house and the lights go off. The microwave beeps. The stereo goes off. When I check the telephone, there’s no service. When I flip open my cell to call Tom, there’s no connection. No refrigerator sound, no fan from the heater. No heat, I remember. Even though we have a gas furnace and gas fireplace, electricity controls the pilot.
It’s nearly dark now and from the corner windows I can no longer see the oaks twenty feet in front of the house. I light one of our old kerosene lamps we brought from the farm. The wind slams the other side of the house and the whole building shudders. I’ve been in storms like this before, in Minnesota and at the commune. You’d think I’d be afraid, but I’m strangely excited.
“Whoo! Whoo!” Someone calls from out on the porch. I hurry to the front door. When I pull it open, white swirls in.
His arms are full of groceries. His L.L. Bean jacket and hair are plastered with snow.
“Happy solstice!” It’s Tom.
In twenty minutes, the two of us are seated at the dining room table. The room is dark except for the circle of yellow from the kerosene lamp. I can almost imagine the fragrance of wood smoke from a cast-iron cookstove and can see our little boys, Mica, Orion, and Zen, sitting with us.
Tom strikes a match to light the first taper. “This yellow one is for the sun, giver of life.” Then it’s my turn. “This gold candle is for family.” We take turns saying prayers.
“This pink one is for little kids.” I picture Rose, Abraham, and Lissie.
“The white one is for love.” I look in Tom’s eyes and am so grateful to be here with him as the blizzard rages around us.
I glance at the candlelight flickering on the ceiling. The wind still howls in the trees out front. “I love the house in this light. Wouldn’t you like to live with kerosene and candlelight always, maybe in a little log cabin?”
“We tried that before, Pats, remember?”
“Oh, yeah! How could I forget.” I laugh at myself and we keep lighting candles until they’re all gone.
“This one is for change, the only constant.”
“This one’s for the earth.”
“This one is for the yet unborn.” I think of Ruby and her baby.
Grace
Christmas morning, in the dim light before dawn, I lie in bed determined to appreciate my blessings. I miss Mica and his family but I must trust them to lead their own lives. For a few minutes, I lie in the dark, sending light and love their way and to my brother Darren and my mother, gone now to where mothers go when they lay their burdens down. Then I sneak out of bed to fill the stockings. Outside the corner window, the snow flies again.
Soon, we are opening presents. Orion and Zen look like true Soviets in the leather and sheepskin hats that Mica bargained for at the Moscow open-air market. Everyone tries hard to keep baby Abraham from ripping open all the packages, but it’s a losing battle. In the middle of everything Mica calls and we pass the phone around. “How you doing, man?” “What’s up, dude?” “Did you open your presents yet?” “How’d you like those caps?”
By eleven, the living room is an ocean of gift wrap and the sun comes out. Handel’s Messiah plays on the stereo. Every valley shall be exalted, and every mountain and hill made low; the crooked straight and the rough places plain . . .
In the kitchen, while I’m toasting bagels for brunch, I peek around the corner to watch Zen playing cards with Lissie, and Orion rocking little Abraham gently against his chest. What good and gentle men they are. Not perfect, but good . . . The only prayer we need is . . . thank you.
I remember when baby Abraham was born, I thought to myself, a new soul has entered the universe and everything must
shift over, the trees and the sky, the rocks and the stars. Even my heart must open wider, for one more joy, perhaps one more sorrow.
CHAPTER 11
Fall from Grace
“So, how was your day?” I ask as Tom settles himself in front of the fireplace.
“OK.”
He’s not too talkative, but I make up for that. We slouch on the sofa, sock feet up on the coffee table. It’s a chilly night, and the wind blasts the front windows.
“I saw Ruby again this afternoon,” I offer. “You know she’s expecting. I’m weaning her off the narcotics. She’s happy about being pregnant, and I think she’s going to be OK.” I glance at my husband, who stares blankly at his reflection in the dark windows. “You tired?”
“Yeah, I am. I did six surgeries at Community Hospital today, but it’s not that . . . Dr. Parsons took me aside in the doctor’s lounge. She told me that her husband, who’s an internist at the University Hospital, says the physicians over there are saying I’m the ‘go-to guy’ if a woman in town wants narcotics.”
I squint like hot water was thrown in my face. This is an insult to Tom, to our whole practice. We’ve tried so hard to run the chronic-pelvic-pain clinic professionally, providing a counselor for the support group at our own expense, Xeroxing each prescription so a patient is unable to alter it, insisting patients not get narcotic scripts from other medical providers. This is worse than when Linda heard the druggies talking about Dr. Harman in the women’s restroom. These physicians are Tom’s colleagues and peers.
“Why would they say that?” My voice goes up in outrage.
“I don’t know. They’re primary-care docs. They probably see our patients at the walk-in clinics or the ER and notice how many are on narcotics. They don’t know all that we do in the office to prevent misuse of the meds.”
My husband lets out a long sigh that reminds me of Zen . . . “What bothers me most,” he goes on, “is that the University Hospital has no chronic-pelvic-pain program at all. Well, the Anesthesia Department has the Pain Center, but all they want to do is teach residents how to do nerve blocks. I know what disdain they have for our patients. They think they’re all druggies, faking their ailments. But I’ve seen the insides of the women’s bodies during surgery; rarely is there a normal pelvis.”
My husband slides down farther on the sofa and I pull his head into my lap. Tom loves to be touched, probably more than anyone I know, but for some reason there’s not been much touching lately. I stroke his hair and his shoulders. He closes his eyes.
“Want to go to bed?” I mean more than sleep and I’m not usually so bold.
“I’m beat, Pats. It’s been a long day.” This is not like Tom. I offer sex and he turns it down?
“Can I just sleep here?” He looks up at me pitifully with a half smile that reminds me of that time long ago when he was so sick in the butterfly tent.
“You want me to just sit up here all night, holding your head?”
“Yeah,” my friend answers, almost in dreamland.
“Like that’s gonna happen!”
I run my fingers through his short silver hair and sing him a lullaby. My bed is too small for my tiredness . . . He is so weary from the cares of the world . . .
It has been fifteen years since we were part of the teaching faculty in the Department of Obstetrics and Gynecology. We came straight from Cleveland, where Tom did his residency at Case Western Reserve, full of natural-childbirth zeal. I was the first midwife in labor and delivery in recent memory and did my deliveries sitting on the side of the bed, without a mask. The women were allowed in the shower and were monitored only periodically. Tom was the only doc who let his patients use a squat bar and didn’t cut episiotomies. We started an OB teen clinic.
The trouble is, we were too successful. Soon, hundreds of women in town who wanted a natural birth were seeing us for prenatal care. Unable to sacrifice them to the roulette wheel of academic practice, we volunteered to come in for their deliveries.
“We’re working so hard, it’s like we’re in private practice,” Tom observed. “Maybe we should be.” The idea grew and in time we went out on our own to create the Women’s Health Center, the kind of medical environment in which we believed, where women were always treated with respect.
I continue to stroke my lover’s head, the best backup doc a midwife ever had . . . Wind, blow the moon out . . . please . . .
CHAPTER 12
RIVER
Light shining through ice. A cloudless blue sky. Snow under my feet. It’s been weeks since we’ve heard from the boys, and their silence worries me. Tom says quit fretting. Let it be.
Determined to do as he tells me, and singing under my breath, I pack a lunch of rice crackers and cheese. Let it be. Let it beeee. Seeking words of wisdom . . . I grab my parka and car keys and head for Swallow Falls State Park in the higher mountains.
As I wander the snow-packed trails, an announcement stapled to a worn wooden bulletin board attracts my attention. “Caution, Hikers: Bears have been observed in the park. Do not approach them. Do not feed them.” Bears again, I think, fingering my silver bear ornament. I wouldn’t mind seeing one. Hard to believe they would come into this busy recreation area.
At the fall’s edge, a man and a woman lean against a rail, arms around each other, staring at the cascade of frozen water. The yellows and blues glow from within like a rippled sheet of opal. They nuzzle each other, and I find myself wishing again that Tom were with me.
I miss my lover. I asked him to come, but he stayed at home to do pottery. Maybe it’s just as well. Being alone in nature always brings me peace, brings my shattered heart together.
“Hey, slow down there!” a father yells. Two little boys run ahead of their parents, skidding on the ice, just like Orion and Zen did when they were that age. I miss them too . . . It’s funny. I didn’t have empty nest when they first left home after high school. Tom and I were actually thrilled to have the house to ourselves. We were dancing around. “No more worrying about curfews or the boys getting in trouble!” It’s only now, when I realize they’re not coming back, that I long for them.
A group of young adults in colorful parkas, with lift tags attached to their zippers, cross my snowy path. These are not the bulky Appalachians I’m used to seeing at Shop ’n Save or Walmart. These are athletes who come to the mountains for rock climbing, whitewater rafting, hiking, and skiing. I wonder if, despite the beauty around us, they realize that Wild and Wonderful West Virginia is one of the most polluted states in the nation.
I stop to take photographs of hemlocks in the perfect slanting light, recalling Laurel’s e-mail of this morning. “Did you know that Forbes magazine ranks West Virginia fiftieth in terms of the greenest states? Number fifty, dead last and who else is at the bottom? The same states that are the worst in every other index of poverty and health.”
The article she attached contained a picture of a mud-swollen West Virginia stream. The caption said we have the fourth-worst scores in water cleanliness and more toxic waste to manage per capita than all but three other states, Mississippi, Louisiana, and Alabama.
I kneel in the snow next to a small ice-covered creek to take a shot of the shadows and light, wondering if it’s the industry in cities such as Charleston, Huntington, and Wheeling that cause the problems, or the coal-powered electric plants like the one on the outskirts of my town. Probably all of them.
Coal is King in West Virginia, and a hunger for commerce controls the decision makers at the capitol. Few people in the state, rich or poor, are concerned about global climate change or the carbon footprint that coal leaves. What they care about is their paycheck to put food on the table or their corporate profits. Need, greed, and shortsightedness leaves a beautiful region contaminated.
Listening to the water bubble under the ice, I follow the little creek down to the roaring
river. Two men in wetsuits and helmets carrying kayaks pass me, heading for a small icy beach. The shore is covered with glistening pebbles, and they slip and slide as they get to the water. “Having fun?” I ask, surprised to see them out in the cold.
“You bet,” the shorter guy, with a straight nose and a strong jaw, grins. Not a bad-looking man, with a little ponytail. He reminds me of Tom when we first started doing homebirths.
Before Tom went to medical school, he’d delivered only two babies, Orion and River. I can’t remember how he happened to get his hands involved in River’s birth.
Penny and Kevin, from the food co-op in Spencer, were our good friends. Maybe Tom wanted to practice doing another delivery, since he was a new EMT. Whatever the reason, Penny was easygoing, calm and in control. This was her third baby.
For the first time, our roles were reversed. I poured olive oil over Tom’s fingers and handed him warm compresses. Penny pushed, while Kev supported her back. In her own home, in her own bed, she gave birth to an eleven-pound baby, vaginally, without lacerations, the biggest infant that either of has delivered to this day. Tom still brags about it.
As I watch from the rocky ledge at the side of the trail, the men settle themselves in the low boats, one red, one blue. The breathtaking whitewater rages over boulders, catches the light in the spray. Where the spray hits the rocks it adds to the ice, but most of the water moves too fast to freeze.
The guys ready their paddles, then expertly maneuver their tiny boats into the current, catch the rapids, and race away. I laugh and clap my hands like my five-year-old granddaughter, Lissie. The men are so beautiful and brave. The kayaks get smaller and smaller, until they disappear where the majestic, possibly toxic, river turns north.
Games
Tom is quiet this Sunday, a cement pallor just under his skin. I haven’t seen him like this since three years ago when his patient, Dottie Teresi, a neurologist’s wife, suffered a post-op complication and was in the ICU for two months. The dime-sized patch of eczema on his cheek is the size of a quarter, and he plays a computer game on his laptop while he waits for a call from the hospital. Not a good sign. When Tom withdraws into computer games, you know he’s stressed out. Now and then he stops to chew his cuticles.
Arms Wide Open Page 25