“That then we’ll be lying to them,” Maggie concluded. “It’s such a sleazy way to deal with people.”
Beckie nodded. “I agree. Maggie, it’s sleazy. It’s also known as politics, and I hate it as much as you do. But the thing to keep in mind is that it’s a political victory that we’re after now. Enough political victories, and we’ll have your philosophical victory. But I’m afraid that’s going to be a long time in the coming.”
Maggie’s frown continued. “Some of those women get me so mad—they’re as bad as the obstetricians were. They just can’t let a woman have her child. They have to get in there and do it for her.”
* * *
The meeting was at the home of Amy Belever, a classmate of Maggie at the San Francisco School of Midwifery. Amy lived in the old Haight-Ashbury section of the city, just a few blocks from Golden Gate Park. The neighborhood was a mix of recently renovated three-story flats and curvilinear plastihomes. Amy, who stood a mere five foot one, tended to win arguments by sheer force of will. Fortunately, she was solidly behind Beckie and Maggie.
“There is absolutely nothing wishy-washy about the motion,” she insisted. The meeting was running late over the issue. “The motion states, ‘The Medical Practices Committee proposes that the California Midwives Association recommend that its members refrain from the use of intrauterine fetal monitors, except in circumstances where the member believes that either the mother or child is at risk.’ The only part that could be the least bit unclear is the meaning of ‘at risk.’ Since the resolution doesn’t define it, the midwife would have to use her discretion in deciding whether mother or child were at risk. And if she can’t, for God’s sake, she could look up the indicators in any obstetrics text. Frankly. I don’t think there have been any rational objections presented to the proposal, and if there were, I’d like someone to repeat them for me!” Glaring from one face to another in the room, she thunked into her chair.
Maggie looked around the room silently. We’re arguing just like men—angrily, personally, even violently. Everyone knows that we’re arguing philosophy and not just about the fetal monitor. Beckie was wrong to think that it could be left out. Hesitantly, she raised her hand and was recognized by the chair.
“I think that there’s an issue here that we’ve all been thinking about but hiding in the background. Maybe it would be easier to talk about the fetal-monitor issue if somehow we could talk about the other one separately. So I’d like to suggest—I know it’s getting late—but I’d like to suggest that maybe we take some time here just to discuss our feelings about the use of technologies like the fetal monitor, and others too, like anesthesia and analgesia. Because . . . because I think that the general issue is what all the anger we’re seeing here is about.” She looked around and saw despair in Beckie’s face.
When Maggie turned back to the chair, she was confronted by Susan Glanvil, who stood with an almost terrifyingly smug smile on her face. She was one of the leaders of what Maggie had come to think of as “The Opposition.”
“Well! I must admit I’m surprised that one of you finally had the guts to come out and admit it!”
Maggie felt herself turning red under the unexpectedly violent attack. The woman suddenly turned sharply away from Maggie, dismissing her, and spoke in an almost inaudible voice.
“Because this truly is the issue before us.” She paused, for emphasis, and then continued. “I must confess that when midwifery was legalized, my fellow R.N.s and I had mixed feelings on the proposition. Not that I worried so much about the capability of those women who were obstetrical nurses and who would now become midwives, but rather I worried that women who had not had the opportunity to work with trained obstetricians, who had not worked in good obstetrical wards in hospitals, that those women might not have the training in some of the less common techniques involved in delivering children.” Her voice slowly grew louder. “But not once did I consider the possibility that those women, rather than frantically seeking to gain this necessary expertise, would renounce invaluable techniques, that they would renounce the gains of obstetrics during the last twenty years, that they would rather return to the devastatingly crude nostrums of the past, when midwives earned their bad reputations through their ignorance of medicine and their dabbling in witchcraft!
“But the sponsors of this motion want us to vote that midwifery return to the dismal state it occupied in the 1600s. I think we have no choice but to reject this proposal overwhelmingly.” By the end, her voice was soft again. She turned to Maggie briefly, her face a mixture of pity and hatred, then sat.
There was a shocked silence in the room. Before Maggie fully realized it, Beckie had risen to her feet and begun to speak.
“. . . doesn’t seem reasonable at this late hour. It is, however, two weeks until the general meeting, and I would like to suggest that we table this until next meeting, and that we finish with it then.”
Glanvil leaped back to her feet, ready to continue her attack, but was stopped by the chair.
“Beckie, you’re suggesting that we adjourn. If we do that, we will meet again in two weeks as scheduled, and this issue will still be on the floor when we come back. If you want to so move, you still have the floor. A motion to adjourn is not debatable.”
A wave of relief swept over Maggie. Thank God the chair, in addition to being on her side, knew what she was doing. Glanvil hadn’t had a chance.
In a calm, strong voice, Beckie said, “I so move.”
In another half-minute the meeting was over, much to the relief of most everyone except Susan Glanvil.
* * *
As they left Amy’s house, Maggie and Beckie said nothing. The drive out of the city was slow as fog sometimes completely obscured the road. They headed inland to avoid it, following Highway 101 down the western edge of San Francisco Bay.
Finally, as they neared the airport turnoff, Maggie commented, “I guess I messed things up, bringing up the technology issue. I’m sorry.”
Beckie shrugged a shoulder and drove on.
“You’re mad at me,” Maggie said, more as a statement than a question.
“Oh, hell, I don’t know if I’m mad at you or not. I think I’m just so damn annoyed with Glanvil that you’re getting some of it. But we’re going to have to go over it all this week sometime and figure out how to play it from here. I think with a couple weeks’ perspective, Glanvil is going to look rather hysterical to people.” She drove on for a few minutes in silence. “Anyhow, now you know why I wanted us to stick just to the fetal-monitor question.”
“I’m sorry, what did you say?” Maggie had missed the last statement.
Beckie laughed and looked at her watch. It was almost midnight, and they were still an hour from home. “It was nothing. Go back to sleep.”
Maggie looked across at Beckie in surprise. “I wasn’t sleeping.” She paused a moment. “I was thinking about my mother.”
“Oh.” Beckie gave her a sympathetic smile. “How’s she doing?”
Maggie shrugged. “Not well. The pain is almost to the point Where she has to be kept heavily drugged to deal with it, and then she’s so out of it that she can hardly keep track of where she is.” There were tears in her eyes. “Carol’s taking it pretty hard, too. She’s never seen anyone dying before. She feels guilty, that we’re not doing all we can for Mother.”
Beckie nodded. “That’s the hardest part, I think, facing up to the realization that there’s nothing you can do.”
“I think that’s why I said what I did back at the meeting, about the whole issue of technology, because I suddenly realized very clearly how much of what we do in medical practice is for our consciences rather than for the patient’s health and comfort.”
Beckie nodded in agreement.
“But then,” Maggie continued, “I feel the exact opposite, that the reason I’m not doing more for Mother is because I want to accept that she’s dying and have it over with. Then I feel that Carol’s right, I should be doing more.”<
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Beckie shrugged. “But if the hospitals can’t do any more, what could you hope to do, except make her more comfortable?”
“Oh, I don’t know,” Maggie admitted “but—well, you know we don’t usually hold the opinions of the medical establishment in such high regard. Doesn’t it seem that if we’re so sure that they’re doing a terrible job on childbirth that maybe they’re doing equally poorly in something like cancer treatment?”
“Except,” Beckie argued, “they tend to overtreat patients, rather than undertreat them. That’s certainly our objection regarding childbirth—that they treat a normal, healthy process as a terrible illness. I think that in regard to serious illnesses, like cancer, they do as well as anyone could.”
Maggie didn’t reply; her thoughts had wandered back to her mother and to her own youth.
“Mommy?”
“Yes, Maggie?”
“Tell me about all the Margarets again.”
“Okay, I’ll tell you, but then it’s straight to bed.”
“I promise.”
“Fine. Then you climb up on my lap, and I’ll tell you. There. Okay. A long time ago, before you or I were born, or my mommy, or even my gramma, there lived a woman whose name was Margaret.”
“Just like me?”
“Yes, her name was like yours, but, except for that, she was very different. Because, first of all, she was all grown up, and you’re just a child still, and she lived so long ago that they didn’t have cars, or electric lights.”
“Or books.”
“Well, not many books, And Margaret was like a doctor, and she went around to people who were sick and made them better, and to people who were going to have babies and helped them have the babies.”
“And she had her own baby too, didn’t she?”
“Yes, she did, except her baby was already a big girl, and sometimes she would help her mommy, who was Margaret—”
“What was her daughter’s name?”
“Now that I don’t know, but when she got bigger she had a daughter—”
“And she was called Margaret too, like her gramma.”
“That’s right, and—”
“And then there were more babies, and more babies, and whenever there was a baby and her gramma’s name was Margaret, then she was named Margaret, and then there was me, and I have a Gramma Margaret, and that’s why my name is Margaret, too.”
“Yes, that’s right, and that’s the end of the story, and it’s time for you to go to bed.”
“Mommy?”
“To bed now.”
“When I grow up, I’m going to fix sick people, too.”
“That would be very nice.”
“And if you ever get sick, I’ll take care of you, too.”
“I’d like that.”
“And I’d make you better, too. I promise.”
“That would make me very happy. And do you know what else would make me very happy?”
“What?”
“If you went to bed now with no more fuss.”
Beckie nursed the car up the hills between San Jose and Santa Cruz. Their speed was down to seventy, and the engine of the small car would occasionally protest with a harsh cough. Beckie peered anxiously into the rearview for any sign of smoke; the car was too important to her work for her to risk having it impounded for a pollution violation. Maggie stared out the window at the continuous wall of rook at the roads edge, as they slowly spiraled along the hills.
She thought about that promise, made so many long years ago, and suddenly felt an overwhelming need to—she didn’t know what—to at least try to do something for her mother. She turned to Beckie, unsure of herself. “Beckie, do you believe in folk remedies?”
“Like what?” Beckie hadn’t been expecting the question; in fact, she had thought Maggie asleep.
Maggie’s confusion spread. “I don’t know. Like people used to use hundreds of years ago.”
“Oh, to an extent, I guess I do. I think medical practitioners, whether they were witch doctors in Africa, or doctors and midwives in England and the U.S., I think they all practiced a kind of empirical medicine, where they just kept mental records of what seemed to work and what didn’t.”
“You don’t think it was just—you know, silly quack things, like patent medicines?”
Beckie thought a minute, absentmindedly falling in line behind a slower car. “I don’t think they all worked all the time, and I suspect that some folk medicines had rather bad side effects, but I know that ergot, belladonna, and digitalis—drugs still used today—were used by witch healers even back in the 1600s, and they were used appropriately. And since 1980 the Chinese have decreased the incidence of angina by using herbal remedies the West refuses to try. In fact Chinese herbalists discovered ephedrine and used it to treat asthma successfully centuries ago.
“Oh, Maggie . . .” She said it sympathetically, realizing what Maggie must be thinking.
“No, listen, Beckie.” Maggie turned full around in her seat to face Beckie, pulling her feet up under her. “Why not? They used to cure warts and things like that all the time, and warts are—well, they’ve got characteristics in common with cancers, and the pharmaceutical houses would never mess with anything less than a pure substance. Look, it really makes sense!”
Beckie let out a long sigh, then, suddenly, pulled out and passed the car in front of her. “Maggie . . .” She didn’t know what to say.
“Well, why not try it?” Maggie demanded.
“Because the search will just cause you endless pain and grief, because in the end it won’t work. Even if there is a one-in-a-million chance, it’s still only one in a million, and you would just be punishing yourself to try something like that on your own mother.”
Maggie smiled gently and turned back to face forward. “In other words, because my peace of mind is more important than my mother’s life?”
She had decided.
Chapter Four
TUESDAY morning brought a cold rain to the Santa Cruz area, and as Maggie came down to breakfast the sky was dark and depressing. Carol sat sleepily in a chair while eggs fried on the stove. Her exhaustion brought a gentle smile to Maggie’s lips.
“How’re you doing, Carol? You look like you could use more sleep.”
“No. I’m okay.” She said it grudgingly, without looking up from the table.
The smile left Maggie’s face as she sat across from her daughter. She sat patiently, waiting for Carol to continue.
When she did look up, there was something in her face that Maggie could not identify. “Gramma was calling for you last night. Didn’t you bear her?”
“No, I didn’t . . . When was it?”
“Around two. I’m not sure exactly when, I was asleep too.” Then, “What difference does it make when?”
Maggie was puzzled. “I don’t know, I’m just confused about why I didn’t wake up, too. Did she just call out once, or—”
“First, just once, but then a couple of minutes later, again, and then—I don’t know how soon, I fell back asleep and then woke up again—then she called twice more.”
“Why didn’t you come get me then?” She still couldn’t identify what was strange in Carol’s manner.
Suddenly, Carol was close to tears. “Because I was afraid to get up!” she shouted without realizing it. “Because what if she was dying, what could you have done? Because even if she wasn’t dying what could you have done? Because”—she began to cry—“because I don’t want her staying here, crying out to you, needing you, needing something that you can’t give her, and taking from you and leaving you so exhausted and depressed, and I don’t know what else. Mommy, everything’s been so terrible around here since she came, I can’t even bring my friends over here anymore . . .” She leapt from the chair and ran to the sink. Strong, warm arms encircled her, calming her with their touch.
“Carol, darling, I’m sorry,” Maggie paused, not wanting to make what followed a qualifier of that sorrow “I didn’t re
alize how much you were being hurt by it, too. I guess, I guess that I was so tied up in my own hurt that I couldn’t see how you were hurting, too.”
“I don’t want her here!” It came out as a whisper, almost a hiss, partly a plea and partly a demand.
Maggie hugged her close. “Would you put her out?” she asked. “Send her back to a cancer ward, with her only comfort being that those around her were dying, too?”
Carol shook herself free of her mother’s embrace and turned to face her. “But what were you doing for her? You’re not even here most of the time, you just leave her by herself. In a hospital at least there would be nurses all the time if she needed them.”
Maggie frowned at her. “You do know that it was Gramma who asked to come here?”
“But you said yourself that she wasn’t thinking right now. She said that she would rather die than keep having the pain. Well, if you’re just going to do whatever she says . . .” She stopped in midsentence, horrified by what she was about to say. Almost hysterical, she threw-herself into her mother’s arms. “No, I didn’t mean that, Mommy, I didn’t!”
“I know, darling,” she whispered. “I know you didn’t.”
“It hurts so much to see her so unhappy, so much in pain.”
“I know. Death doesn’t always come easily, but I can’t let her go through it alone, in isolation, surrounded only by people who don’t have the time, or the energy, or the concern to care about her. I guess you’re still too young to have any feel for what death is like—but its important to know, to be reminded constantly that there are those who will remember you after you’re dead, and who will cherish that memory always in their hearts. And she is my mother.”
For a long time, neither of them spoke. Finally, Carol looked up to her mother’s tear-streaked face. “I’m sorry, Mommy. I’m sorry.” She wiped her face on her mothers shirt. “I just keep thinking that we should be doing something, and then realizing that we can’t, and then I feel like—I feel just terrible!”
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