“Daniel!”
“I’ve killed her.” He stops for a moment and then starts pacing again, up and down the shallow, dry ditch.
“Who? What? A cow? A horse?”
I know bad things happen in medicine. Dr. Blum has lost patients, and veterinarians must lose patients too, but what terrible mishap could have brought the man to this state?
“Daniel, I insist you sit down. You’re upset, but whatever has happened cannot be that bad.” I use my nurse voice, the voice I would use if I were still on the wards and had to deal with a soldier having a breakdown, but he doesn’t respond, and when I reach out to touch him, he pulls away. “Daniel? Daniel, what’s wrong? Is it someone’s dog?”
“It’s Patience. She’s pregnant.”
“I didn’t know. She didn’t tell me, but surely this is not all that bad.” The vet’s hysteria surprises me. I thought he was a level-headed man.
“She doesn’t like to tell anyone because she’s lost babies before, but now she’s bleeding. This is the way it always happens to her . . . except for little Danny.
“I took her into Torrington this morning and Dr. Seymour, the specialist, said she’s going to lose the baby. He told us it’s inevitable and recommends an abortion before she hemorrhages, but Patience refuses. She’s lost two babies like this before, one when she was sixteen, then another, our first together, the year you left Union County. Little Danny is the only one who’s survived.
“The placenta is separating, that’s what Seymour says, but Patience won’t give up. She had all but stopped bleeding a few days ago, but now it’s started again.”
“How far along is she?”
“The physician thinks twenty weeks, but her cycle’s irregular. He’s just going by her uterine size. That means four long months in bed. That’s if the bleeding slows down. As strong as Patience is, she’s not immortal. I should never have gotten her pregnant, and l should never have . . .” Here he starts the pacing back and forth again, as if he were chased by demons.
I am so shocked that I don’t even notice Dr. Blum get out of the car. He doesn’t rush over, just moves in his slow, measured pace as if sleepwalking, then sits on the ground. When Daniel marches past him Blum sticks out his foot.
“What the hell!” The vet falls in the doctor’s arms and sits up again, but at least he’s stopped the interminable tromping.
“Oh, God. Oh, God,” Daniel moans, shaking his head.
My stomach goes cold. To lose Patience, to lose the Midwife of Hope River! It’s unthinkable. I sit down in the grass with the two men and try to imagine what Dr. Blum would advise.
Bed rest, of course. If the placenta is only separating along the edge and Patience doesn’t move around for the next fourteen to sixteen weeks, the baby and mother might survive, but if it breaks loose completely both mother and baby will die.
Daniel now rocks back and forth, his arms around his legs. The doc sits next to him like a tree stump. In the tall reeds, a small brown bird with an orange beak and very wise black eyes watches us.
“Where’s Patience now?” I ask.
“At home in bed. Little Danny was napping.”
I pull myself together. “Let’s go to your house. Let’s go see Patience. You can’t stay with her every minute, but we have to work out a plan. For all we know she could be hemorrhaging . . . or out splitting wood, either one.” Hester looks at me wildly and I bite my tongue.
Feel of the Earth
A few minutes later, we bump across the wooden bridge that spans the creek and into the drive. At the open door to the kitchen, Daniel raises his hand. “I’ll go up first. Maybe she’s sleeping.”
“Honey? Patience?” he calls softly.
There’s no answer.
“Patience?” he calls again louder and I hear his footsteps upstairs, clunking around, moving from room to room, opening and closing doors, getting more frantic. Then he stops.
“Daniel!” I rush up, imagining he’s discovered the worst, his pregnant wife in a pool of blood, her drained body with the dead baby still in her, but when I get to their bedroom there’s no blood on the sheets and no Patience either.
“Well, where the hell is she?” Daniel growls. “While, I’m mourning her possible demise and the devastating loss of another baby, she’s outside picking posies?”
“Calm down, Daniel. You’re distraught. Maybe she just went to the outhouse.”
“No, look, the potty is right there. I brought it up before I left.” A blue-and-white chamber pot, with a white lid, sits in the corner.
Dr. Blum now stands with us, looking out the window. I push in front of him to see what he’s staring at and discover Patience Murphy lying on the green lawn below, her arms outstretched like a cross. Little Danny sits at her side playing with his red metal tractor.
“Oh my God!” Daniel rushes down the stairs.
“Slow down, Daniel. Get yourself under control,” I yell, running after him. “She’s alive and moving. I just saw her roll over. There’s no blood on her dress.”
I grab his shirt as he bolts toward the door and pull him back. “Take a few deep breaths. Don’t make Patience more upset. Just go out there and sit at her side. We’re going to talk. It may not be hopeless.”
The man wipes his eyes and runs his hands through his ragged hair. He returns to the kitchen, pumps water in a tin pan, washes his face, and then steps out in the sun.
“Patience, honey. I’ve been looking for you. Whatcha doing out here?”
“Lying down like you told me.” The midwife’s shoulder-length brown hair is fanned out in the grass and she adjusts her wire-rimmed glasses.
I follow with Blum and we sit in a circle in the grass around her.
“I meant lying down in bed. I thought you would lie down in bed.”
“It feels better out here,” Patience says in a quiet voice. “I like to be in the sun and the wind, with the smell of growing things and the feel of the earth under my body. I think it might heal me.”
Here I raise my eyebrows. Patience seems an intelligent woman, but she’s so naïve. Surely, she doesn’t imagine a placenta that’s separating can knit back together just from sunshine and the touch of the sweet earth, yet I see peace in her face.
I decide to head things off, before Daniel starts to get hysterical again. Moving in close, I check Patience’s pulse. It’s rapid but not thready, indicating she’s holding her own. Her skin is warm and dry. Respirations twenty-four. No acute distress.
“How much blood is there?” I ask. She pulls a blue cloth from under her skirt without embarrassment, and though it’s covered with blood, I know, from my days as Dr. Blum’s surgical assistant, it’s only about a quarter cup.
“How are you feeling? Any pain? Any contractions? Are you light-headed when you stand?
“No pain yet. No contractions. Just the bleeding.” She sounds so matter-of-fact, but looking into her eyes, I see the fear. If you’ve already lost two babies, you know the pain, the everlasting pain.
Commune
“Is there any hope, Becky?” Daniel asks, his eyes wide and sad.
“There’s always hope,” I answer, sounding more positive than I am. I look at Patience and continue. “This bleeding and your previous OB history make the prognosis for the pregnancy poor, but we should try to save it. It will be hard and you’ll need to stay in bed for as long as it takes.”
“It’s probably due in March, the month of heavy, wet snow, one of the worst times for getting over the mountains and into Torrington,” Daniel observes.
“But there’s no way I can stay in bed that long!” Patience moans. “Who will deliver the babies? I have five women due in the next four months, and how can I take care of Danny? You have to work, Daniel. We live from hand to mouth just like everyone else. If you don’t go on house calls, we can’t eat . . . and then there are the payments for electricity, the telephone and the mortgage. . . .” She raises both hands, signaling her despair.
“We can’t
eat?” asks little Danny, looking over at us. The child didn’t appear to be listening, just playing with his little red tractor, but he got that part.
“No, honey,” Daniel reassures him. “We will always eat. We have food in the root cellar. Don’t worry. Mommy and I will take care of you.”
“Is there a woman you could get to move in with you?” I ask.
Patience frowns. “I can’t imagine who. . . . We can’t afford help.”
“How about a girl from Hazel Patch or Liberty? You could provide room and board.”
Out of the blue, Dr. Blum breaks his silence. “Isaac and Becky.” We all turn with mouths open, shocked at the sound of his voice, as if a rock spoke or a tree.
“Us?”
“Oh, would you?” Patience pleads. “Could you come stay here? Just help us get through the fall and winter?”
Patience goes on as if “Isaac and Becky” were a normal suggestion from a normal individual. “We have the extra room downstairs and we have Moonlight, our cow, and a few chickens, plenty of milk and eggs and vegetables. We could all live together.”
It sounds like it’s almost decided, but I inwardly cringe. There’s no way I am going to share a room with Dr. Blum!
“Please . . .” Patience pleads.
“It could work out well.” That’s Daniel, more muted.
“A commune, like Peter Kropotkin, the anarchist who advocated intentional communities in the twenties!” the midwife exclaims. She has told me a little about her radical days but I don’t even know who Peter Kropotkin is.
Daniel rolls his eyes. “Don’t get carried away, hon,” he cautions, knowing his wife’s idealistic tendencies.
I finally come out with my strongest objection. “I’m sorry. It isn’t possible. Dr. Blum and I . . . We can’t share a room.”
There’s dead silence and I notice that Isaac has wandered away past the outhouse, where he has stopped at the rail fence.
“Well then, he could bunk with Danny,” decides Daniel. “We could bring one of the iron beds over from the house on Wild Rose. It’s a big room at the top of the stairs.”
Patience is looking at Hester. Hester is looking at me. I am looking at Danny. Better Dr. Blum with the little boy than Nurse Becky, I think. It’s bad enough that I’m with Isaac almost every day, all day. I have to have some privacy, at least at night.
Across the yard the doctor leans his forearms on the cedar rail and stares out across the fields toward Spruce Mountain, where a few yellowing oak stand out against the green spruce.
“Please . . .” Patience asks again.
How can I say no? There’s a life at stake. Maybe two.
Sleepwalker
It’s a hot night and tomorrow we move from the house with the blue door that I’ve come to love to the Hesters’ farm. I toss and turn, thinking about Blum and how he has been uttering a word or phrase now and then, wondering if eventually he will talk, but fearing he will never be normal. Finally, I tiptoe downstairs in my nightdress to get some air.
No moon yet. There’s the Big Dipper, Orion’s Belt, and the Seven Sisters. Those are the only constellations I know in an infinite universe with stars that go on forever. The wind in the big oak rattles dry leaves, and I forget about the chiggers and lie down in the grass.
I have always been humbled when I look up at the heavens. We think our problems are so big, but the universe is so much bigger and everyone on this planet has problems; it’s part of being alive.
A few minutes later, I hear the creak of the screen door and watch as Dr. Blum, wearing only his long johns, steps out of the house. Maybe he’s come out to pee . . . but no, he’s sleepwalking and I’m only thirty feet away.
They tell you in nursing school, never wake a sleepwalker. The patient can get violent if disturbed. (David Myers, my late husband, would be a case in point. When I woke him, he nearly killed me.)
Like a ghost, the doctor shuffles right toward me, his head tilted back, looking up at the sky. Is he conscious enough to wonder about the stars, like I do? When he’s only a few feet away, I shrink into the ground, pretending to be a log, afraid he will step on me, but somehow he senses my presence. The ghost plunks down next to me, but if Dr. Blum knows I am here he shows no sign.
I’m wondering what I should do, lie still or try to creep away, when he reaches both arms straight up toward the sky and opens his hands, like he’s harvesting stars, plucking them from the black night. Stranger yet, he cups the stars and washes his face with them. Three times he splashes the starlight on his face and runs his hands through his hair. Then he takes a deep breath and, still in his sleep, holds the stars out to me. “Yours,” he says.
We lie in the dark for a long time, maybe hours, until a sliver of moon rises over the mountains. Finally, Isaac begins to snore and I make my move. I tiptoe inside, retrieve the green quilt and come back to sit on the steps in the dark, a sentry guarding a man, who seems dead . . . but may only be hiding.
20
The Midwife’s Instructions
“Just tell me,” I insist, sounding braver than I really feel, “what I’m supposed to do when I go to a birth. I’ll write it all down and memorize each step.”
We’ve been installed in the Hesters’ house for more than a week and Patience is staying in bed, as she should. Dr. Blum is downstairs at the kitchen table silently drawing pictures for Danny in a sketchbook that Daniel gave him.
“Okay, let’s get to it,” Patience says, becoming serious. “Mrs. Kelly always told me that most mothers could deliver their own babies if they had to, so try not to worry so much. The midwife is there for the two out of ten that might have trouble.”
“Two out of ten!”
“Well, roughly. So, here’s what you do. First thing, check the baby’s heartbeat. After that, make sure of the baby’s position. I always keep the woman up as long as she can stand it. The pain will be less and the contractions stronger. Do vaginal exams only if you have to. Maybe one at the beginning if you aren’t sure about the presenting part and maybe another if the labor seems stalled. Of course, all your supplies and gloves should be sterile, but you know that.”
“Okay, okay,” I interject. “Let me catch up. I’m writing as fast as I can. . . . So after I assess that everything is normal, what happens next? Do I just sit in the corner and wait? Do I boil water? Do I go to sleep?” I say this as a joke, knowing Patience would never go to sleep.
“No. You give her support. Walk with her, be sure she is well hydrated and has nourishment to keep up her strength, nothing heavy like bread or pork and beans, but fruit, broth, tea with honey, things like that. And get your instruments laid out well in advance. Sometimes women will surprise you.”
“I learned that with Dahlila.”
“And while you’re waiting, be calm, tell her she’s doing great and try to get her to laugh.”
“Make her laugh?”
“Yeah. Laughter is good for everyone. I didn’t used to know that. . . . Oh, yeah, every hour or so check the baby’s heartbeat again.”
“Yes. Yes. Dr. Blum insisted on that.” I am scribbling fast. I’ll make an outline later.
Patience goes on to tell me how to support the perineum, how to check for a cord around the neck, how to deliver the shoulders without a tear, and how to get the baby to breathe if it has trouble. Then she describes what I do in the third stage of labor, the most dangerous time for the mother. She instructs me to be vigilant, watch for a show of blood, never pull on the cord, and so on.
“And I have a suction bulb in my birth kit.” She tilts her head. “Which will be your birth kit for a while, Becky . . . if you are willing. . . . I know you’re reluctant, but that’s what makes you brave. Even when you are scared you do what needs to be done. . . . These are the women who are due in the next six months.” She hands me a short list.
Brave! I think as I stare at the names and break out in a sweat. Am I really going to be able to do this? The first name on the list is Lilly Bittman.
“Childbirth is such an intense experience,” the midwife acknowledges, putting a hand on my arm and looking into my eyes to encourage me. “Think of it. The moment a new person enters the world, everything changes. Everyone must move over to make room, every person, every rock, every tree, every star, and the midwife is privileged to witness the miracle.”
Lilly
I’m driving too fast, I know I am, but if I don’t speed up, Lilly is going to deliver without me. I run the one stop sign in Liberty, make a U-turn in the middle of Main, and pull up in front of Bittman’s Grocery, trying to remember all the instructions I wrote down.
It’s three A.M., and no one’s around, so the U-turn doesn’t matter, but I had forgotten that the grocery store would be closed at night and the way into the young couple’s apartment is up the back stairs.
I make another U and cut down the alley, where I have to decide which stairs are the Bittmans’. I hadn’t realized that all of the storefronts on Main have stairs in the back, but I finally decide the one with the lights on must be it and, grabbing Patience’s birth satchel, I take the steps two at a time.
At the landing, I stop for a few moments to compose myself, pull back my hair, and straighten my top. If I had time to take my own pulse, I’m sure it would be one hundred and twenty! Breathe, I tell myself, like I was the one in labor. Breathe.
Then I knock twice on the back door. “ ’Bout time you got here!” B.K. laughs. (He sure is calm!) Maybe Lilly’s not in hard labor after all, though on the telephone he certainly sounded like he thought she was.
“I came as soon as I could. You only called me forty minutes ago. How’s Lilly?”
“Come in. You’ll see.” He leads me back to their small bedroom where I find the mother holding her newborn infant with her little boy in his pajamas sitting next to her on the bed.
“See how soft he is,” the sightless woman says, showing her five-year-old, her face calm and radiant. “Oh, Miss Becky! I’m sorry I couldn’t wait. The baby was coming about the same time you did that U-turn on Main, not more than five minutes ago. How does he look? I can tell he’s healthy because he cried right away. Does he have all his parts? I mean, I know he has his boy parts, but everything else. . . .”
The Reluctant Midwife Page 16