by Victor Koman
"Fine."
"Nurse Dyer will assist me tonight. I think you've met."
Valerie nodded. The nurse gazed back with cool efficiency.
"While we're getting ready here," the doctor said, "could you please climb onto the table?" Valerie sat up on the paper-covered cushion, leaned back, and lifted her legs up to the stirrups with Nurse Dyer's guid-ance. While Dr. Fletcher pulled on a pair of latex gloves, then slipped another pair over them, Nurse Dyer stepped over to the far side of the room to unlock a closet. There, on small rubber wheels, stood a white and gleaming object the size of a small refrigerator. On one side was a control panel with switches, dials, lights, and a small video screen. On the other side was a long, white, flexible plastic tube terminating in a stiff, clear segment with a small opaque ridge on one side. Nurse Dyer wheeled the device into position a few feet back from where Valerie's legs spread. She hooked a foot to slide a chair under Fletcher as the doctor slipped a mask over her mouth and nose. Dyer pulled a light down from the ceiling, switched its brilliant lamp on, and positioned the beam directly between Valerie's legs. The rays warmed Valerie like the sun. It brought to her an old memory of a camping trip with her first boyfriend in high school. They had biked up to Flagstaff from Grand Junction. Below them spread the town of Boulder and the endless plains of eastern Colorado. They both disrobed and lay in the sun, its heat tickling parts of them that seldom basked in its radiance.
Valerie let out a startled gasp. The cold touch of a thermom-eter entering her brought her back to the present.
"Okay," the doctor said, sliding on a pair of goggles. "Hold that in there for a moment." Nurse Dyer donned two sets of gloves and her own goggles. Silent, well rehearsed, she performed her duties with a prac-ticed efficiency that wasted no motions of her shapely frame. She switched on the machine. It hummed and gurgled. The end of it made a sucking sound for a moment.
"Dulbeco's medium ready," the nurse said. "Pump on. Ham's F-10 warming."
"Buminate?" asked Fletcher.
"Five percent."
Dr. Fletcher turned her attention to Valerie. "Since you're only about seven weeks, Valerie, we're going to use the suc-tion method. This is the latest equipment, and it's very gentle."
"Will it hurt much?" She craned her neck to see what was going on. She saw Dr. Fletcher lubricating the tube with K-Y jelly.
Fletcher withdrew the thermometer. "Thirty-seven point five." The nurse took it from her hand. She grasped the suc-tion tube, bent the hysteroscope into position, and peered into an eyepiece on the end.
"Well," she said, "the uterus itself doesn't have too many nerve endings, but it'll feel a little uncomfortable when we dilate your cervix." She grasped the syringe Dyer pressed into her hand. "We're going to give you a pericervical block. It'll numb you up like Novocain at the dentist's so it won't hurt as much." Using the fingers of a speculum to open the way, Fletcher guided the needle to its destination and pushed gently. The sharp sensation caused Valerie to twitch.
"Easy," Fletcher said, emptying the syringe into Valerie's flesh. "There. All done." The hypo withdrew. She reached next for the suction tube.
"What makes this device better than the older models is that I can see what I'm doing through this hysteroscope. Here we go."
Valerie felt the cool intrusion of the tube as it slid into her. There was a pause, then she felt a blunt pressure against her cervix. The end of the tube moved slowly around, Fletcher peering head down into the scope like a submarine commander seeking an enemy ship.
"Just relax, Valerie," her soothing voice entreated. "I'm get-ting it lined up." A slow, insistent pressure gave way to the pain of numbed tissues and muscle being stretched. Valerie clenched her teeth. If it hurt this much under the painkiller for just a little tube, what must childbirth feel like? In that instant, she experienced an agonizing relief at her choice.
"Relax. Loosen up. We're almost there."
A pain like a fiery knife stab pierced her as a final, firm push drove the tube home.
"Transcervical," Nurse Dyer noted, watching the image on the video screen.
"Now we look around a bit," the doctor said in her most con-versational tone. "The uterine walls-I don't know if you've ever seen a picture of one-look like an ocean filled with drift-ing fronds of seaweed. Nestled in there somewhere is the embryo."
"Go back," Dyer interjected.
"Saw it," Fletcher murmured, gently maneuvering the probe. She continued to speak soothingly to her patient.
"Now what we're going to do, Valerie, is turn on the suction. It's not noisy, and you won't feel any pressure. What we'll do is dislodge the embryo and remove it. This is a very gentle method that doesn't damage much tissue. You'll have a little bit of spot-ting when we're done but virtually no scarring." Valerie nodded. She didn't know what else to do. She lay back and stared at the soft green color of the ceiling. A fire sprinkler head hung directly over her, right next to the smoke detector. There was a little brown spatter on the ceiling. She wondered what it was. Could it possibly be blood? How? Maybe it was a water stain. Rust.
She felt something indistinct rip within her. Deep and far away, like a plant being uprooted in the distance.
"Lavage," the doctor called out.
"Cycling," replied the nurse.
"Hold it." She moved the tube around slightly, then with-drew it an inch. "All right. Suction." Her hands held the tube rock steady.
"This is the slow part," Fletcher said in a pleasant voice. "It takes a minute or two to get everything out." She peered and probed gently. "We don't want to leave any foreign tissue in there where it could cause problems."
"Transoptus nominal," Nurse Dyer said, flicking some switches and turning a dial or two. "Capture."
"Okay" was the doctor's terse reply. "Cleaning up."
"Tanking out lavage."
Dr. Fletcher slowly pulled the tube back. "While I have you here, Valerie, would you want me to fix this so it doesn't hap-pen again?"
Valerie looked between her knees at the woman's masked face.
"What? You mean tie me off?"
The doctor nodded. "I can do a laproscopic sterilization when we're done here."
"Oh, no. I still want to be a mother. Just not right now. Maybe later." She grunted at the sensation of the suction tube's with-drawal. Her cervix throbbed; her vaginal walls ached.
"Then we're done." Fletcher placed the instrument in a small tray on the side of the machine. It was coated with smears of bright red blood. Blood covered the fingertips that reached for cotton gauze. Valerie did not feel as if she was bleeding. She felt nothing at all now but a dull ache in her abdomen and an impression of finality. There was no going back now. No chance to change her mind. The gauze rubbed roughly against her tender flesh. Dr. Fletcher removed her goggles, then stripped off her outer set of gloves and threw them in a metal waste can.
Nurse Dyer wheeled the suction device out of the room, switches still on, lights still glowing, a faint hum still emanat-ing from its interior. She used a door that led to a short hall-way with another door at the end. Closing the door from the other side, she left Dr. Fletcher to finish up with Valerie. The doctor lifted her patient's legs out of the stirrups and rotated her to a sitting position.
"That's all there is to it," Dr. Fletcher said cheerfully, strip-ping the second pair of gloves off. "Expect some cramping and spotting. Use pads rather than tampons until your next pe-riod. No vaginal intercourse for six weeks." She handed Valerie three sample packets and a prescription slip. "This is an anti-biotic. This one's to control the bleeding. And this one's for the pain. Fill the prescription, take all the medication, and get plenty of rest. Then see us in ten days or so for a follow-up." She turned to follow Nurse Dyer's path out of the room, unty-ing her paper gown and removing her hat to throw both into a can by the door.
"Someone will be by when you're dressed to walk you back."
With that, she closed the door behind her. Valerie stared at the emptiness and listened to
the silence. She hurt inside. Pull-ing on her light yellow panties, she was aware of a growing regret. Without deliberately thinking about it, she pulled a Maxi-Pad from her purse and slipped it into place. She was free. Free but hollowed. Free of obligation, but bur-dened with a sudden doubt. The outer door opened. Ron stuck his head in.
"Val?"
She turned toward him, buttoning her shirt. He smiled with soothing warmth.
"Hi, babe. Miss Tact out there told me I could come take you home. Need a hug and a ride?" She nodded sadly.
His arms wrapped around her like the warm folds of a thick wooly sweater. Gently, he lifted her from the table to lower her to the ground. She leaned against him, woozy at the change in position.
"I'm starving," she said.
"What should you eat?"
"I don't know. I just don't want anything that bleeds."
V
Nurse Dyer rolled the cart into the short hallway, stopped to close the door, then quickly stripped off her gloves and re-moved her gown. These went into a receptacle on the side of the cart. Opening the opposite door, she wheeled the cart into another operating room. This one possessed far more electronic equipment and medical implements than the other. On the table, swathed in a paper gown, feet dangling over the edge between the stirrups, lay a brunette with an expectant smile and steely grey eyes staring up at the nurse.
"The doctor will join us in a moment," Dyer said, handing the woman a small plastic probe wired to a computer console. "Hold that under your tongue for a minute." She dressed again for surgery, slipped on a pair of surgical gloves, added another pair, and reached for a second probe.
"Please put your feet up. I'll be taking your vaginal tempera-ture, too."
"I know," the patient said around her oral thermometer, a smile forming like that of a child's around a lollipop stick. "I've been doing this for long enough."
Nurse Dyer smiled. "Right. And tonight's the big night."
Just then, the door opened to admit a smiling Evelyn Fletcher.
"Well, Karen, it's taken us a while, but I think we have a baby for you." Opening a cabinet on the wall, she dressed for surgery.
Nurse Dyer carefully removed a white cylinder about the size of a two-liter soft drink bottle from the suction instru-ment. She hefted it as if it were filled with a dense liquid.
"This is the most wonderful moment of my life," Karen Chan-dler said.
"It won't feel like that when I start," Dr. Fletcher said. "We've loosened you up with the appropriate hormones, but I've got to insert a hysteroscope and microsurgical instruments into your uterus." She snapped on the second pair of gloves. "This will give you a little preview of what to expect in seven or eight months."
"I'm ready." Karen Chandler watched Nurse Dyer carry the white cylinder from one machine to another, similar-looking unit. Sliding the small object into a receiver on the top, the nurse punched a few buttons on the console, switched on the video screen, gazed at dials, and said, "Adding serum to Ham's F-10, seventy percent."
"Check," said the doctor, pulling an instrument tray toward her with one foot. She administered the pericervical block, then picked a sterile tube from an assortment of various di-ameters and lengths on the tray, lubricated it lightly, and slowly inserted it into Karen.
"Right out of the fridge," Karen murmured. "Can I get frost-bite from that?" Fletcher smiled without distraction. When she reached the cervical area, she slid the hysteroscope into the tube, locked it in place, and gently sought her way into Karen's uterus. Karen grunted as the probe spread apart her flesh. In a mo-ment, the shock of entry had subsided to a dull, throbbing ache.
"How's that?" Fletcher asked.
"Fine," Karen moaned, taking a deep breath.
"Don't strain," the doctor said urgently. "Just relax. We've got lots of work to do." Nurse Dyer stared intently at the video monitor. She moved a tube on the machine's side with slow, deliberate motions. A soft sucking noise grew and subsided in concert with the mo-tion of her wrist and the touch of her fingers on the controls. "In place," she said, quickly pressing a button and grasping the tube.
In a blur of rehearsed speed, Dr. Fletcher unlocked and with-drew the hysteroscope, leaving the hollow tube inside Karen. The nurse slid the other tube out of the machine and gently pressed it into Fletcher's hand. With a fluid motion, the doctor inserted the opaque rob deep into Karen's womb.
"Transfer," Fletcher said in a sharp voice.
"Pump on," Dyer replied.
A fluid warmth filled Karen. Liquid pressure swelled in her belly, pleasant and comforting amidst the ache of the instru-ments.
"It's in."
Another jolt as Fletcher removed the device and inserted a combination hysteroscope and laser microsurgical instrument.
Karen Chandler gazed at the doctor's head as she worked intently and silently between her legs. She thought there should be a sign around that read Caution: Baby Being Installed. She wondered who the donor was. Part of the privacy ar-rangement, according to her contract, was that the identity of the mother would not be revealed until the child was eighteen years old, and only if he or she asked to know. She hoped her child would someday ask. She wanted the chance to thank the nameless, faceless woman who so generously offered her baby to someone who couldn't produce one naturally.
Nurse Dyer stepped away from watching the work on her monitor to dab sweat from her doctor's brow. Fletcher re-mained bent over the eyepiece of the hysteroscope, maneu-vering the remote scalpel and laser microsuture with intense concentration. "
Thirty-five minutes passed during which Dr. Fletcher never shifted from her crouched position, never said a word. Nurse Dyer, watching the progress on the monitor, took over the re-sponsibility of reassuring Karen that all was well.
"The embryo knows what to do," she told Karen. "It's al-ready manufacturing the hormones that will tell your body you're pregnant. But since it's been detached from one uter-ine wall, we've got to reattach it surgically so that it won't bounce around." She smiled warmly. "You wouldn't want a child that young running around loose, would you?"
Karen tried her best to smile, but the length of the operation was getting to her. She simply stared at the ceiling. Someone had stuck a smiling yellow sun directly over the table. She focused on it, thinking of sunrises and waking up to mother and father and brothers when she was a child. She'd have a chance, now, to see it from a parent's point of view. If all went well this time. If their terrible past didn't repeat itself.
At long last, Dr. Fletcher said, "There. Transoption complete. Looks good inside." She let go a tense, deep breath. "I took a snip of chorionic villi for genetic testing. That way we can skip the risk of an amniocentesis. We're going to keep you here a few days for observation just to make sure the little one in there is settling in and on the job."
Karen groaned as the tube slid out of her. She raised her head to look at the doctor. "I'm pregnant?"
"That's what you paid for."
She lay back to stare at the bright and silly paper sun over-head. Tears brimmed her eyes. "Thank you, Doctor, thank you. I don't know how I can ever pay you enough for-"
"Just make sure you take every precaution with this preg-nancy. I've done all that I can surgically. The rest is up to you and that baby." The doctor remembered something. "Oh-will you want to know what sex it is?"
"No. David and I want to be surprised." She murmured a few more thank yous amid her assurances that she would fol-low every guideline. Then she allowed Nurse Dyer to unstrap her from the stirrups and help her onto a gurney.
As she wheeled the patient out, Dyer turned to look inquir-ingly at the doctor. She tilted her head slightly toward the medical equipment.
Dr. Fletcher shook her head imperceptibly. "You take the CV sample to the lab. I'll clean up." The gurney wheeled out of the room. The doors slammed shut with a muted thunk. Dr. Fletcher, alone in the silence of the empty operating room, locked the doors, took several deep breaths, and leaned against a counter. After a m
oment, she stepped over to the surgical machinery, switched everything off, and pressed a button near the monitor. A videocassette popped out into her waiting hand. She took a case from one of the drawers, slipped the cassette in, and wrote a few notes on the outside. Then she quietly set to the task of cleaning the device.
Cleanup was usually a job left for nurses or surgical techni-cians. Dr. Fletcher, though, guarded her new machine jeal-ously. No one else besides Nurse Dyer even knew about this night's operation. What was known throughout the hospital was that Dr. Fletcher considered the Reproductive Endocri-nology department to be her own private stomping ground. Her success with the fertility clinic gave her the freedom to call the shots.
Even so, she had to be cautious this time. Trust no one. Do all the dirty work. Leave everything spotless. She had finally crossed the line.
She quietly emptied the holding tank into a container marked with the curving red biohazard trefoil. Out poured a transpar-ent, thickish carnelian liquid. Here and there, suspended in the mixture, floated little deep-red clumps of tissue and clot-ted blood. She washed out the container with powerful detergents, rinsed it with methanol, and placed it in the autoclave for sterilization. The hysteroscope and microsurgical gear re-ceived meticulous cleaning, followed by treatment in a steril-izing bath-they were too delicate for the autoclave.
The customized tubing, probes, and suction hoses were all disposable. She placed them in a receptacle after making note of the specific design she had created on the spot. Each pa-tient would require unique combinations of hardware-notes now could save her time in the future. A future she saw as bold, bright, and terrifying.
The cleanup took twice as long as the operation.
When everything had been returned to orderly cleanliness, Dr. Fletcher glanced at her watch. Nine forty-five.
She could be in bed by ten-thirty if she hurried.
"
Even in sleep, Evelyn could not escape the consequences of her decision. A dream grabbed her and would not let go. In it she lay-once again nineteen-upon a stiff white table, feel-ing a young life drain out of her. She was alone, all alone. Not even the abortionist was present. The room became a vast plain that she raced over, flying in her blood-drenched hospital gown. Covered with the sectioned remains of the dead, the plain stretched for unthinkable miles in all directions.