Distracted now by heavy oozing from Sister Mary Joseph Praise's soggy, friable uterus, Hema turned back from infants to the mother.
“What is her BP?” Hema asked, peering over the drapes, first at Nurse Asqual, and then at Sister Mary Joseph Praise's face. The anesthetist, the whites of her eyes showing like saucers, shook her head. Beautiful Sister Mary Joseph Praise's face now looked bloated and lifeless. “More blood! For God's sake. Pour it in!” Hema shouted.
As she toiled in the now deflated cavity of the belly, Hemlatha remembered that when she'd handed over the second baby to the probationer, she had been surprised to find the probationer still standing there, holding the first, a blank look on her face. But Hema had no time to worry about that. Once the babies were out, her duty as an obstetrician was to turn completely to Sister Mary Joseph Praise; her duty was to the mother.
CHAPTER 10
Dance of Shiva
WE TWO UNNAMED BABIES, newly arrived, were without breath. If most newborns meet life outside the womb with a V V shrill, piercing wail, ours was the saddest of all songs: the still-born's song of silence. Our arms weren't clamped to our breasts; our hands did not make fists. Instead, we were limp and floppy like two wounded flounders.
The legend of our birth is this: identical twins born of a nun who died in childbirth, father unknown, possibly yet inconceivably Thomas Stone. The legend grew, ripened with age, and, in the retelling, new details came to light. But looking back after fifty years, I see that there are still particulars missing.
After labor stalled, I dragged my brother back into the womb and out of harm's way as lances and spears came at him through our only natural exit. The attack ceased. Then I remember—and I believe I do—the muffled voices, the tugging and sawing outside. As the rescuers neared us, I recall the blinding glare and strong fingers pulling at me. The shattering of the darkness and the silence, the deafening racket outside was so great that I almost missed the moment when we were physically separated, when the cord connecting my head to Shiva's fell away. The shock of that parting lingers. Even now, what I think about the most isn't that I lay there without breathing, immobile in the copper basin, born to the world, yet not alive—instead, I recall only the parting from Shiva. But, to return to the legend:
The probationer unloaded the two stillborns into a copper basin used to hold placentas. She carried the basin to the window. She made a notation in the delivery chart: Japanese twins connected by the head but now disconnected. In her eagerness to be useful, she completely forgot her ABC's: Airway, Breathing, and Circulation. Instead, she thought of what she had read the previous night about jaundice of the newborn and the helpful role of sunlight. Shed memorized that passage. She wished she had read about Japanese twins (the word “Siamese” eluded her) or asphyxiated babies, but the fact was she hadn't; shed read about jaundice. But then, as she set the basin down, she realized that for sunlight to work, the babies had to be alive, which these weren't. Her sorrow and shame made her confusion worse. She turned away.
The twins lay face-to-face, feeling the basin's galvanic touch against their skin. In the chart the probationer used the words “white asphyxia” to describe their deathly pallor.
The sun, which had stage-lit the room moments before, now honed in on the basin.
The copper glowed orange. Its molecules became agitated. Its prana rose into the infants’ translucent skin and passed into their doughy flesh.
HEMLATHA DISSECTED the broad ligaments, then clamped the uter ine arteries, praying that she wouldn't accidentally clamp the ureters and shut down the kidneys in that bloody mess. “Quick, quick, quick!” She was tempted to smack Stone on the forehead instead of on the knuckles. “Retract properly, man!”
She followed his gaze to Sister Mary Joseph Praise's head, which bobbed like a rag doll's as the anesthetist tugged at her arm to find another vein. Matron, teary and lost in her grief, stroked Sister Mary Joseph Praise's other hand.
When Hema finally delivered the uterus, clamps and all, into a basin, she saw no pulsations in the abdominal aorta. Her hands, steady till now, shook as she loaded a syringe with Adrenalin and attached a three-and-a-half-inch needle to it. She lifted Sister Mary Joseph Praise's left breast, hesitated for a moment, invoked God's name again, then plunged the needle between the ribs and into the heart. She pulled the plunger back, and a mushroom of heart blood appeared in the syringe. Whenever I've had to resort to adrenaline to the heart it has never worked, Hema said to herself. Not once. Maybe I do it as a way to signal to myself that the patient is dead. But surely it must have worked, somewhere, with someone. Why else was it taught to us?
Hemlatha prided herself on being methodical in an emergency, keeping her cool. But she stifled a sob now as she waited, her right hand buried in Sister Mary Joseph Praise's abdomen, palm down, just over the spine, waiting for a throb in the aorta, a slap to register in her fingers. She couldn't forget that this was dear Sister's heart she was trying to jump-start, and whose life was slipping away. They'd shared the bond of two Indian women in a foreign land. The bond extended back to the Government General Hospital in Madras, India, even though they hadn't known each other there. To share a geography and a landscape of memory made them sisters, a family. And Hema could see her sister's hands turning blue, the nail beds dusky, and the skin turning dull. It was the hand of a corpse, and holding it was Matron, her head bowed as if she were asleep.
Hema waited longer than she might have under normal circumstances. It was some time before she could bring herself to say, her voice breaking, “No more. We have lost her.”
IT WAS DURING this hiatus of activity in the room that the firstborn, the one who'd been spared a skull puncture, signaled its presence. It rapped its hands on the copper basin. It brought its left heel down to produce a muffled gong. Now that it had come wholly forth from a dying womb, it reached both arms skyward and then to its right, to its brother. Here I be, it announced. Forget the shoulds and coulds and might haves and hows and whys. I am sympathetic to the situation, the circumstance, and in due course we can explore the details, and, in any case, Birth and Copulation, and Death—that's all the facts when you come down to brass tacks … I've been born, and once is enough. Help my brother. Look! Here! Come at once! Help him.
Hemlatha ran over at this summons, saying “Shiva, Shiva,” invoking the name of her personal deity, the God whom others thought of as the Destroyer, but who she believed was also the Transformer, the one who could make something good come out of something terrible. Later she would say that she'd assumed the worst about the twins. One of them had his head bloodied, and then there was the matter of her dividing the fleshy tube that connected them, and God knows how much distress they'd been in before she cut them free of the womb. But she'd also assumed that Matron or the probationer or both would be reviving the infants while she worked on the mother, though she recalled seeing Matron seated and immobile.
The probationer was mortified at the sound of a baby that had come alive right behind her back, confounding her most basic clinical assumptions. The child was no longer white, but pink, and not jaundiced. The other infant was a robin's egg blue, and it was still and unmoving as if it were the discarded chrysalis from which the crying baby had emerged. Matron, hearing that newborn cry, jumped off her stool. Her glance let the probationer know she was a hopeless case. Hemlatha went to work on the twin that was unmoving while Matron hastened to clean up the living one.
THE BREATHING TWIN gazed out from the copper vessel. Its puffy newborn eyes surveyed the room, trying to make sense of its surroundings.
There stood the man everyone took to be the father, a tall, sinewy white man, looking lost in his own theater. The father's hands were preternaturally pale from the talc that lingered on them after he'd stripped off his gloves. His fingers were clasped together in a posture shared by surgeons, priests, and penitents. His blue eyes were set deep in the orbits under a ledge of a brow which could make him look intense, but on this day made him l
ook dull. From the shadows sprung the great ax blade of a nose, a nose that was sharp, in keeping with his profession. His lips were thin and straight as if drawn with a ruler. Indeed, the face was all straight lines and sharp angles, coming to a point in a lancet shaped chin, as if it had all been carved out of a single square of granite. His hair was parted on the right, a furrow that originated in boyhood with every follicle tamed by the comb to know exactly which direction it was to tilt. The top was cut unevenly, as if after saying, “A short back and sides,” he'd risen from the chair when that was accomplished, despite the barber's protests. It was the kind of obstinate, determined face that with a spyglass held to the eye and a ponytail wouldn't have been out of place on the deck of an English man-of-war. Except, of course, for the tears rolling freely down the cheeks.
And from that tear-stained face, a voice emerged: “What about Mary?” startling everyone because it had been silent for so long. The measured syllables had the quality of a slow fuse.
“I'm sorry, Thomas. It is too late,” said Hemlatha as she suctioned the infant's pharynx, then pushed air into the baby's lungs, her movements speedy and almost frantic. The irritation with Stone was gone from her voice, and pity had taken its place. She stole a glance at him over her shoulder.
A wrenching noise emerged from Stone's mouth, the cry of an unsound mind. Hed been a passive observer and a worthless assistant ever since Hema's arrival. Now he leaped forward and grabbed a scalpel from the tray. He placed a hand on Sister Mary Joseph Praise's chest. Hemlatha thought of restraining him and then decided it wasn't prudent to approach a man wielding a knife.
Stone lifted Sister Mary Joseph Praise's breast. The motto of those pioneers of resuscitation, the Royal Humane Society, resounded in his ears: Lateat scintillula forsan—a small spark may perhaps be hidden.
He pushed the breast up and out of the way, and under his knife a red gash appeared between the fourth and fifth ribs. He drew the knife over the wound again, and yet again till he was through muscle. If he was clumsy earlier, his movements now were those of a man incapable of tentative strokes. He cut the cartilages that connected the two ribs to the breastbone. He spread the ribs and watched in disbelief as his ungloved hand slid out of sight and into the still warm cavity of her chest. The spongy lung he pushed away. And there, under his fingers like a dead fish in a wicker basket, was Sister Mary Joseph Praise's heart. He squeezed, surprised at its size, barely able to encircle it. Meanwhile, he exhorted the nurse anesthetist to keep pushing air into her lungs, not to stop.
His right hand was buried within her thorax, but his eyes were on Sister Mary's engorged left breast, which he held out of the way with his left hand. The breast felt firm, unlike the slippery, soft heart. He saw blotchy blue shadows creep into her face, a hue that her brown skin shouldn't have been capable of. Her abdomen had collapsed, its surface crinkled like an airless balloon, its two halves splayed open like a book whose spine had given way.
“God? God? God?” Stone cried with every squeeze, calling on a God he had renounced once and didn't believe in. But Sister Mary believed, rising before dawn to pray, and lingering in prayer at night before she slept. Every beat of her life and each day of her calendar had been filled with God events, and no morsel of food entered her mouth without God's blessing. Make your life something beautiful for God. If Thomas Stone never understood it, he respected it, because it was the same quality she brought to the operating theater, and to the textbook she'd helped him with. That was why he called out God's name now, because if there was a God, God bloody well owed His devoted servant, Sister Mary Joseph Praise, a miracle. Otherwise, God was the shameless fraud Stone had always found Him to be. “If you want me to believe, God, I'll give you another chance.”
The theater doors swung open.
All eyes turned to the figure that entered.
But it was only wide-eyed Gebrew, priest, servant of God, and watchman. The covered bowl he carried held the injera and wot, and their scent was added to that of placenta, blood, amniotic fluid, and meco-nium. Gebrew had hesitated to come into this sanctum sanctorum. He held the food container in front of him, unsure if it were the ingredient that might save the day. His eyes almost popped out of their sockets when he saw, on the altar of this hallowed place, Sister Mary Joseph Praise opened like a sacrificial lamb with Stone's hand in her chest. He started to shake. He put the food on the floor, squatted down against a wall, pulled out his beads, and swayed in prayer.
Stone redoubled his efforts. “I demand a miracle and I want it right now,” he said, his body rocking back and forth. He kept it up even when the heart had turned mushy in his hand, and he was shouting now. “The bloody loaves and fishes … Lazarus … the lepers … Moses and the Red Sea …” Gebrew's chanting in ancient Geez matched Stone, call and response, as if Gebrew were translating because in this hemisphere God didn't know English.
Stone looked up to the ceiling, prepared for the tiles to part and for an angel to intercede where surgeons and priests had failed. All he saw was a black spider hanging down from its web, with its compound eyes taking in the scene of human misery below. Stone's shoulders slumped, and though his hand was still in Sister Mary's thorax, he was now merely caressing her heart, no longer squeezing. His chest heaved, tears falling onto the body of Sister Mary Joseph Praise. His head fell forward so it rested on his arms, which rested on Sister's chest. No one dared approach. They were transfixed by the sight of their surgeon so defeated, so destroyed.
AT LONG LAST he looked up, seeing as if for the first time the green tile going halfway up the wall, the swinging green door to the autoclave room, the glass instrument case, the bloody uterus with its necklace of hemostats lying in the green towel, the blue-black placenta right next to it on the specimen table, and the jade-colored ground-glass windows through which sunlight filtered. How did these things dare to exist if Mary did not?
That was when his eyes fell on the twins, no longer in their copper throne; that was when he saw the orange halo of light that surrounded the two boys. Somehow both children were alive, bright-eyed, one of them seeming to study him, the second one now as pink as the first.
“Oh no, no, no,” he said in a pitiful voice. “No. That was not the miracle I asked for!” When he withdrew his hand from Mary's body it made a gurgling sound. He left the theater.
He came back with a long broom. He brushed the spider off the ceiling, and then, with his heel, he ground it into the tile.
Matron understood he was intent on blasphemy; in case the arachnid was God, he was killing God.
“Thomas,” Hemlatha said, using his first name, which sounded strange on her tongue in Operating Theater 3, because they were always formal here. By this time both babies were in Hema's arms, wiped off and suctioned and swaddled in receiving blankets. The one in whose skull Stone had tried to drill a hole had aspirated some amniotic fluid but now seemed recovered; there was a big pressure dressing in place over the head wound. The other child showed only the stump of the flesh-bridge that had connected him to his brother, a stump now tied off with umbilical cord suture.
Hemlatha had established that the boys could move their limbs, neither of them was cockeyed, and they seemed to hear and to see. “Thomas,” she said, approaching, but he cringed. He turned away. He would not look.
This man she thought she knew well, seven years a colleague, now stood bent as if hed been gutted.
That, she said to herself, is visceral pain. As angry as shed been with him, the depth of his grief and his shame moved her. All these years, she thought, it should have been clear to us that he and Sister were a perfect match; maybe if wed encouraged them it could have been something more. How often did I see Sister assisting him in surgery, working on his manuscripts, taking notes for him in the outpatient department? Why did I assume that was all there was to it? I should have reached over and smacked him at my dinner table. I should have shouted at him, Don't be blind. See what you have in this woman! See how she loves you. Propose to
her! Marry her. Get her to discard her habit, renege on her vows. It's clear her first vow is to you. But no, Thomas, I didn't do it because we all assumed that you were incapable of anything more. Who knew that this much feeling was hidden in your heart? I see it now. Yes, now we have these two as proof of what was in your hearts.
The two bundles in her arms propelled her forward, because they were, after all, his, and even as she thought that, she was still fighting her own disbelief. Surely he wouldn't try to deny that fact. She couldn't back away from this moment; she had to force the issue—who else could speak for these children? Stone was a fool who lost the one woman in the world fated for him. But now he had gained two sons. And Missing would rally round these infants. He'd have lots of help.
She moved closer.
“What shall we name these babies?” She could sense the uncertainty in her voice.
He appeared not to hear. After a pause, she repeated the question.
Stone thrust his chin at her, as if to say she could name them whatever she wanted. “Please get them out of my sight,” he said very softly.
He kept his back turned on the infants to gaze once more at Sister Mary Joseph Praise. Which was why he missed the way his words fell on Hema like hot oil; he didn't see the flames of anger shooting out of her eyes. Hema would misread his intentions, and he hers.
Stone wanted to run away, but not from the children or from responsibility. It was the mystery, the impossibility of their existence that made him turn his back on the infants. He could only think of Sister Mary Joseph Praise. He could only think of how she'd concealed this pregnancy, waiting, who knows for what. In response to Hema's question, it would have been a simple thing for Stone to say, Why ask me? I know no more than you do about this. Except for the certainty that sat like a spike in his gut that it was somehow his doing, even though he had no recollection how or where or when.
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