by Vincent Lam
“You’re sure about the cord,” said Janice.
“The cord is pulsing on my finger, and I’m pushing up against the head…it’s coming down.”
Brrr. Brrr.
The telephone next to the bed.
Brrr. Brrr.
It was an old style of telephone, with a heavy C-shaped handset. Janice picked it up and held the handset in one palm and the phone in the other.
“Janice.”
“Hi, Oliver.” Janice spoke through her oxygen mask.
“I can’t believe it. I got a flat. I’m waiting for triple A. I tried to change it, but you know I’m not good with these things. I cut my finger. How is it going?”
“Dr. Ming is just giving me an update.”
“Did you bring the camcorder to the hospital?”
“You know what? I forgot.”
“Jan, I bought fresh tapes for this.”
“I’m sorry, Oliver. I just forgot.” A contraction began to well up inside her, and Janice felt Dr. Ming’s hand firm, insistent, pressing up against the baby’s head.
“Should I stop at home and get it? I’m a couple hours from the border. Or just come to the hospital?”
“If you really want the video…”
“Okay, honey. Oops. There’s the triple A truck. I’ll be there soon. By the way, I got the deal in New York wrapped up. Love you.”
Janice hung up the phone and placed it squarely, symmetrically, on the side table. The scalp monitor flashed a new number every two seconds.
126
130
123
“Can you turn up the volume?” said Janice. “I’d like to hear the beats.”
“Sure,” said Dr. Ming, leaning her torso and left arm toward the box on its rolling stand, while careful to not move her right hand from where it was the placeholder for Janice’s umbilical cord. “I can’t reach.”
“I’m having a contraction,” said Janice. She felt it tighten and grow in strength as if these muscles expanded their sinews each time they were exercised. It was like strong hands circling her pelvis, and the end was like a slow exhalation.
She saw that Dr. Ming watched the monitor.
80
85
83
90
“Too slow?” asked Janice.
“Well, it’s not just the number,” said Dr. Ming. The twist of her eyebrows made Janice suspect that a simple answer was being obscured. “It’s the pattern, the timing.” Janice looked over Dr. Ming’s shoulder, out the door into the empty hallway. There was a second overhead page for anaesthesia.
“It’s not good if I have contractions now, is it?” said Janice.
“The nurses are setting up for the section. The anaesthetist is coming.”
“And the head is pressing on the cord.”
“Yes.”
She could not will her womb to stop, now that it had begun its crescendo dance of muscle movements. It was awakening into its final purpose. The birth of a baby, the death of pregnancy. Months ago, Janice had been amazed that it grew, that it claimed a mass which had never before been occupied in her body. Now, the fleshy cradle had become aware of the being formed within it and was trying to thrust it into the world. It was faithful to its program of bearing down, of pushing the head through thinning muscles of the pelvis. Is my uterus so stupid? she thought. But it wasn’t its fault. It didn’t know that the head was crushing the thread of oxygen that allowed the fetal heart to beat, staunching the trickle of blood that fed this new brain just as it began to wonder if it existed.
“Dr. Ming,” said Ronai, running into the room in her clogs, “section room’s ready.”
Then there were more nurses. They took the intravenous bags off poles, attached them to the hospital bed, unhooked certain wires, attached other ones, everyone telling Janice not to move. They put a hairnet on her and repeatedly told her that everything would be fine, like an urgent mantra. One nurse turned up the volume of the scalp monitor.
“Get up on the bed,” said Ronai to Dr. Ming. “We’ll push it down the hall.”
Dr. Ming was crouched, now leaning on her elbow with her fingers still pushed up inside Janice. Ronai put a sheet over them. With Dr. Ming crouched between Janice’s legs like a monstrous emerging newborn covered by a hospital sheet, the nurses released the brakes on the bed and with a hollow clang set off down the hallway. Past the pastel-painted nursing station. Past the other rooms, where women laboured and in one room a man yelled “Push! Push!” as a woman gave a long wailing grunt. Past a room where Janice heard the coughing cry of a baby, to the C-section room. Hands on each side of her pushed buttons, raised the bed so that it was level with the operating table, unplugged wires, plugged in wires, ripped down empty intravenous bags, hung fresh bulging ones, and repeated to Janice the dual mantras: “Don’t move” and “It’ll be fine.” In a series of manoeuvres during which all around her seemed to stretch themselves into contortionists, while urging her to be as still as possible, Janice was lifted onto the surgical table and Dr. Ming’s hands were replaced by those of Ronai, who slid her fingers in alongside Dr. Ming, allowing the doctor to free herself.
They began to wheel the bed away. “Can I have my pillow?” said Janice to a nurse who was masked but did not wear a surgical gown.
“I’ll have to put our pillowcase on it.”
It smelled like hot sand.
“Where is anaesthesia?” said Dr. Ming.
“Paged three times now,” said a nurse who was gowned and masked in green.
“Page them again,” said Dr. Ming.
“I’m feeling a contraction,” said Janice. She looked at the monitor. They all looked.
“Three minutes apart,” said Dr. Ming.
60
65
60
80
“Have them page any anaesthetist in the hospital,” said Dr. Ming. “I’m going to scrub. Call pediatrics.”
It took a long minute for the numbers to rise again, for them to reach 100. Then it hovered at 82, then up again to 95.
From where she lay on the operating room table, Janice could see the clock. A minute. Ninety seconds. The contractions are closer together. My womb is doing exactly what it is supposed to do, pushing the head down.
Two minutes.
Dr. Ming backed into the room, opening the door with her shoulder. The back of one hand was clasped in the palm of the other, held in front of her as if about to catch her own heart leaping from the centre of her green V-neck surgical scrubs. Her arms were white-clean and dripping to the elbows.
Two minutes thirty seconds.
“Another contraction,” said Janice.
“The head’s coming down,” said Ronai. She sat at the side of the operating table on a black-covered stool, pushing up against the head that surged slowly forward.
Janice no longer found it strange to have a hand pressed up inside her like a finger in a dam. In the birth videos, she had seen that sometimes labouring mothers would touch the head as it came out, to feel that there was a living globe there to push against. A hand connected the pushing. Now, feeling Ronai’s fingers inside her made her want desperately to relax. It was a reminder, a scolding that the squeezing of her body had become dangerous.
67
75
80
69
A nurse opened a crack in the door. “Got a phone call.”
“Anaesthesia?” said Dr. Ming.
“Husband. Wants to know if Janice needs her foot massager.”
“Tell him to drive safely,” said Janice.
The monitor was one in which the pitch of the beeping changed with the rate. As it fell slower, it beeped in a sad, low note.
Dr. Ming stepped into a gown offered by a nurse who stood, in sterile gloves, by the operating table next to an open tray of steel blades, clamps, handles, scissors, and spreaders. Janice saw Dr. Ming plunge her arms into the fabric, saw that she kept her hands hidden in the cuffs. Then, the nurse offered a pape
r-wrapped cord from the gown, which Dr. Ming accepted. The nurse held another cord in place as Dr. Ming spun fully around in front of her. This dance unfurled the gown and wrapped Dr. Ming in a membrane that made her shine green like the tiled walls.
Another contraction.
The nurse tied the two bands at Dr. Ming’s waist, then held out gloves. She spread their opening wide so that Dr. Ming inserted her right hand into one, and it became a live thing of latex. Dr. Ming made a fist and released it, to fully animate the pearly synthetic skin. Then the left hand.
66
66
70
75
This contraction was longer, and urgent. Janice realized that her uterus asked no questions, did not wonder whether the baby was doing well, whether the umbilical cord was safely tucked away.
80
85
80
Dr. Ming painted Janice’s belly with a red-ochre liquid. It was cold, and ran down to her thighs. Neither of them spoke. Quickly, Dr. Ming taped drapes over Janice’s skin, leaving only a rectangle of tight stretch marks tinged the colour of sunburn.
“Chart the time,” said Dr. Ming to the nurse who was not gowned. “Chart the time, that we are at twenty-two fifty-five fully ready to perform an emergency Caesarean section but have had no response from the anaesthetist on call.”
The monitor beeped a slow, low note.
Why are all these people here? thought Janice. I’m cold. I’m dissolving into this table. There’s the contraction. Maybe if I focus hard enough, I can hold it off. I read about Tibetan monks who can make their hearts stop, and then start again.
It’s stronger, squeezing at me. It has its own force, but stop! Stop! Why don’t they turn down that monitor—that noise is like mourning.
60
50
NO VALUE
NO VALUE
50
60
My womb is choking my baby. Dr. Ming, why is she standing there?
“You don’t need the anaesthetist,” said Janice.
She looks at me like I’m crazy, but like I’ve saved her.
“Do you?” she continued. “To cut me open?”
I’ll pretend I’m not here. I’ll just pretend that it’s over already. That I only exist in the future.
“Get any of them,” said Dr. Ming. “Someone run and find an anaesthetist.”
“Just give me the laughing gas. There’s no time, is there?” said Janice.
“You need more than that. There’s no time for a spinal, we need them to knock you out.”
“The actual operation—you can do it even if I’m awake, right?”
Why do I feel calm, having said that? It’s me asking, that’s why. No—not asking, I’ve made my offer.
No one moved.
“They call it a Caesarean section,” said Dr. Ming, “because it comes from the time of the Caesars in Rome. They used to tie the woman down.”
So simple, that this doctor will cut me open and pull out my baby, who will cry. Then she will stitch me up again like a universe that has exploded from a dense star and then billions of years later condenses into a black hole.
“Get the nitrous,” said Dr. Ming. Her eyes did not meet Janice’s. “And six of morphine. Give me a fifty-mil syringe of lidocaine.” She looked at Janice and said, “Breathe the gas deeply. I’ll freeze the skin. We can’t stop once we start.”
Who is that nodding? It’s me.
Dr. Ming ran the long heavy needle under the skin at the incision line, made it swell with lidocaine like a sausage.
The laughing gas, which smells like clouds. A rush of warmth with the morphine injection. It’s like a blanket through the intravenous. That jab in my skin—freezing. Why do they call it freezing when it burns, when it’s hot like a brand on my stomach? Dr. Ming is picking up a knife. They call them scalpels, to make it official. I’m glad it’s her. Why? Because she felt the cord—she knows it’s there. She’s cutting, I can see her stroking the blade into me.
It’s true, the skin is frozen.
Oh.
It doesn’t freeze deep, does it?
She’s cutting muscle, the blade deep inside me now.
My mouth dry, throat too tight to yell.
Breathe the gas.
Where is the clock?
How long? I can’t see the time.
The ring of operating lights is like suns, and moons, and stars, blinding me.
Dr. Ming operated quickly, methodically, as if she were alone in the room. A nurse assisted, pulled on spreaders, pushed on the belly as they slipped instruments through the layers of a woman. Dr. Ming directed the operation in short, tight phrases, and silence roared through the operating room. Her movements were fluid, and violent in the speed of cutting the uterus itself.
I need to let go, I may be close to evaporating, vanishing.
What is that noise?
Ripped open.
Myself screaming.
That’s what it is—to hear my voice truly for the first time.
But, strangely, as if it’s someone else.
The room black and swirling, where are the lights?
The strange beach.
The waves are going to crash over me, drown me. Why can’t I move?
Foamed tops of breakers swirled high in front of Janice. The water rushed around her head, which lay heavy and aching on the wet beach. The sea pushed forward—hissing along the beach—and as the water fell back in a desperate clamber into the ocean, it dug a trench in the shape of her body around her, into the sand. Deeper, her shoulder blades seemed to settle like broken wings in the warm slurry. Her buttocks were heavy. Water ran around their edges to hollow out bowls for her flesh. She felt as if her balance had shifted, as if there were gravity lower within her that had been removed, lightened, now replaced by a searing torn-open pain. She tried to feel her belly, but found that she could not move her arms. Now the water fell over her, lifted her into a wave free and churning, and threw her tumbling into its froth of bubbles.
Janice saw hands flutter and whirl in the hard sun of operating lamps that shone on her belly. The soft, flat white of the gloves was streaked with red, and the fingers themselves beat like wings. One of the hands held a metal claw that descended into her belly with a needle, stung it, and then flew upward to pull the thread tight. The other hand flew around this thread to tie it, the fingers grasping and tying the thread like the movement of a bird’s nest-building.
“I’m closing you,” said Dr. Ming.
Janice heard a sputtering, protesting cry. She turned, and glimpsed the exultant blood-smeared child between the green-mantled shoulders of those around the baby-warmer. As Dr. Ming began the last layer of closure, Janice no longer felt pain, because this outermost skin was frozen.
NIGHT FLIGHT
December 9, 17:45 EST—Toronto
My phone rings at home, waking me from sleep. It’s dispatch in Calgary.
“Dr. Fitzgerald speaking.” I clear my throat.
“Dr. F? Be at the hangar at six-thirty. I’m faxing you the flight plan.”
As we talk, it spools out of my fax machine: 19:00—depart Toronto, 22:45—Tampa for fuel, 1:50—St. Therese, Guatemala. Local ambulance to the hospital, rapid assessment, grab the patient and go. 3:20—takeoff from St. Therese. Tampa fuel stop, then the hop to Toronto.
“What’s the rush? Ninety minutes ground time?”
“The St. Therese airport closes at 3:30 EST, 2:30 local.”
“Can’t fly tomorrow, huh? I just got in from Thailand a few hours ago.” I had a little nip this morning to settle my nerves, then slept through the day. Now I am jittery and dazed, both from sleep disruption and from needing an eye-opener.
“Flight’s booked, Dr. F.”
I have given up trying to understand the scheduling of flights. Sometimes we need to fly sooner than a competitor, sometimes it is a rush to get the plane back for another job, sometimes it is an insurance company’s whim. I rummage for fresh und
erwear and socks and pull on my uniform, which is stale and crumpled over the chair where I left it this morning. In the blue flight suit is my passport, stethoscope, PDA, wallet, sunglasses, and my folded wad of emergency U.S. dollars, which I keep cellophane-wrapped in the inside zippered pocket. With a small funnel, I fill my hip flask with vodka. I pocket a fresh package of strong mint chewing gum. I close the vodka bottle.
I reopen the bottle, take a sip before putting it away, feel a bit better already. Just another little sip. Better not overdo it before driving, even if the flight doctor uniform carries some pull with the highway cops.
19:10 EST
I’m in the four-foot-wide back seat of the Lear 35. Our planes are kept in a side hangar attached to Pearson International, three highway exits west of the passenger terminals.
“We’re supposed to be wheels-up at nineteen hundred,” says Niki, fidgeting. We often fly together, and I like Niki because she watches the details. “Already ten minutes behind schedule, Dr. Fitz,” she says. She’s in the forward seat, next to the stretcher. Behind me, the cargo bay is tight with flight and medical bags. The plane jitters and bounces out of the hangar, ungainly as it turns onto the taxiway. I slip out the flask and take a real slug. It’s a good warmth, and I’ll be dry by the time we get to Guatemala. The other thing I like is that Niki’s not one to say anything.
In front, the pilots activate switches and speak into their headset microphones. Their hands slip back and forth across the glowing instrument panels. The jets’ vibration soothes and surrounds the plane, and frozen rain shatters the black of night. A storm’s coming—this sleet that blows in from Lake Ontario. I stuff a pillow under the small of my back, a smooth miniature airplane pillow. I belt myself in snugly, the secure feeling of pulling the strap tight. I close my eyes as the plane comes to life at the end of the runway. I’m tired. I slept four hours after getting back from Chiang Mai this morning. Open my eyes again. Another little sip, I deserve it.