The Mountain Midwife

by Laurie Alice Eakes

  “But that’s why I’m putting in long days, so I can stay home after the baby is born, at least for a while.” The kitchen door creaked open. Stephanie rose, hugged Ashley, and gathered up her designer handbag and matching briefcase. “See you in a week.”

  “Unless you have a problem or your fatigue grows worse.” Ashley tried to sound stern.

  Stephanie laughed, waved, and exited the exam room via the direct outside door rather than through the kitchen.

  Ashley popped her head into the kitchen. A young woman with straight dark hair and big brown eyes stood in the center of the room holding the lapels of her coat together with fisted hands. “Rachel?”

  The girl nodded.

  “Hey, I’m Ashley. Have a seat. I’ll be with you in a minute.”

  The girl nodded again but didn’t move.

  Figuring the faster she cleaned up the exam room, the faster she would be able to make her patient comfortable, Ashley proceeded to sterilize her instruments, change the sheet on the bed, and pull out a new patient chart to go with the sketchy information she had gathered when making the appointment. Rachel Neff was nineteen, was not married, and had had another baby a year and a half ago. She had no known diseases or allergies and didn’t take medication or illegal drugs. Occasionally she had a drink, despite the legal age for her being two years off. Making a mental note to remind Rachel not to drink alcohol now, Ashley opened the door wide to invite Rachel into the room.

  She still stood in the middle of the floor clutching her coat.

  “Are you cold?” Ashley asked.

  Rachel shook her head.

  “Are you scared of me?”

  Though Ashley was a little above average in height, Rachel stood at least a head taller and outweighed her by twenty pounds or more, none of it looking like fat.

  The question brought out a hint of a smile on the girl’s full lips. “I’m never scared of nobody.”

  “You don’t look like you need to be.” Ashley stepped back. “Come on in and sit down so we can talk.”

  Slowly, the low heels of her boots clomping on the tile floor, Rachel crossed the kitchen to enter the exam room. “Where do I sit?”

  “Here.” Ashley perched on the edge of the daybed and patted it in invitation.

  Rachel sat. “My sister told me I should come to you, but my boyfriend says as how his baby shouldn’t be borne by no wise woman.”

  If he was so quick at directives about his baby, he should consider marrying the mother.

  “He gives me a compliment. I don’t much think of myself as being wise.” Ashley kept her tone light, though she wanted to grind her teeth. “But I am pretty educated, with a master’s degree in nurse-midwifery. See?” She indicated her diplomas on the wall.

  Rachel shrugged. “I don’t care about that. I just don’t want to go back to no hospital.”

  “Didn’t like it the last time?”

  Rachel began to unbutton her coat, releasing a hint of cigarette smoke.

  Ashley worked not to wrinkle her nose. Rachel hadn’t mentioned smoking, and she could be getting the smell secondhand, but it was something Ashley needed to address immediately—after some trust was established.

  “I hated it. They took my baby away as soon as he was born and they cut me.”

  “A cesarean?” Ashley frowned.

  Although a vaginal birth after a cesarean was possible with a midwife, it held risks.

  But Rachel shook her head. “I mean . . . below.”

  “Ah, an episiotomy.” Ashley nodded. “Those are too often done in hospitals and aren’t usually necessary.”

  “The doctor was late for dinner with his wife or something.” The girl grimaced. “I felt like a chicken in a factory because I’m on medical assistance.”

  “It’s not just your medical insurance type that is the issue.” Ashley rested her hand on Rachel’s arm. “They do that to rich women too.”

  “My sister says they should let you nurse right away, so she sent me to you.”

  “Good for her. Do you have any questions before we get started with the exam?”

  Rachel shook her head.

  “All right then.”

  Ashley began to take the mother’s vital signs, then the baby’s vital signs. The mother’s were good. The baby seemed small for the five months along Rachel said she was, a typical complication of a smoking mother.

  Heaving an inward sigh, Ashley turned to the questions about diet and vitamin intake, and where did Rachel want the birth to take place—there or at home? Did she have a family doctor?

  “I don’t have no particular doctor,” Rachel said. “Just whoever is at the clinic.”

  “That’s all right. I have a physician I can refer you to.”

  “Refer me to?” Panic widened Rachel’s eyes. “Miz Tolliver, I don’t want no doctor.”

  “Then you need to stop smoking right now. Your baby might be undersized, though it is early to tell for sure, but it is more than likely for a smoker.”

  “But I did quit months ago.” Rachel wrapped her arms across her slight mound of a belly. “Promise.”

  “You smell like smoke.” Ashley settled on the bed and leaned toward her patient, meeting and holding her gaze. “I don’t work with smokers, and I don’t work with people who don’t tell me the truth. If you aren’t smoking, someone is in your car smoking enough that you brought it in with you. Either way, it’s not going to work. I simply do not work with smokers.”

  Or drinkers or those who used illegal drugs. As much as she wanted to help all women, she had to protect her reputation and license and take appropriate steps to get them the care their circumstances needed, care beyond her scope of practice.

  Unless she got her medical degree, when she would have far more power to help women with more serious medical conditions yet wanted to have babies. No, not unless—until.

  Rachel bit her lip.

  “You have to stop—now.” Ashley was firm, but gentle. “For your sake and for the sake of your baby.”

  Rachel nodded. “I’ll try.”

  Ashley gave her a stern look.

  “Okay. Okay. I’ll stop.” Rachel yanked a pack of menthol cigarettes from her handbag and tossed them onto the floor. “I hate them anyway. But when everyone around you smokes, it’s so hard to stop. They hand you a cigarette and you take it without thinking.”

  “And the next thing you know, you need it when no one is offering it.”

  Rachel’s eyes widened. “Exactly. How do you know?”

  “I work with a lot of patients who struggle with stopping those things not good for them like cigarettes or caffeine. I’ll work with you if you are truly trying to stop. And maybe you can persuade your family to quit too.”

  “Maybe.” Rachel caught up her coat. “Do I gotta pay you a copayment or something?”

  “Let me file the paperwork before we worry about that.” Ashley offered Rachel a hand to rise from the daybed, then walked her to the door. “Are you all right coming here, or would you prefer I come visit you?”

  “Maybe you can come out to me. We’re living with my sister, and she leaves her brats for me to watch.”

  “I can do that. Does she work?”

  Rachel snorted. “When her husband makes her, but she says I gotta earn our keep. I don’t like it, but I can’t afford any place on my own.”

  WITH RACHEL GONE and another two hours before she needed to start out for her home-visit patients, Ashley cleaned the exam room, entered Rachel’s information into the computer, then glanced to the basement door standing ajar for the cats, an invitation for her to descend to the climate-controlled room in which all the family midwife records were kept. Thirty-two years ago. October. Finding a record of that birth should be easy.

  One of the cats peeked through the door, then sprinted across the kitchen to land on Ashley’s lap as light as thistledown. Her rumbling purr filled the room. Her furry warmth seeped through Ashley’s jeans. Moving now seemed unkind to the proffered
affections of the feline. So she began to look up articles online—articles about one Hunter McDermott.

  He built tunnels. Such an odd profession. She never thought about what engineering went into digging tunnels, but of course it did or whole cities and mountains would crash down. Hadn’t a tunnel collapsed in Boston a few years earlier? Not one of his, but someone had interviewed him about it. The video was on YouTube. He looked great in a suit, and his voice . . .

  She closed the window, dislodged the cat, and began to make herself some soup for lunch. She also packed a bag with bottles of water and energy bars, as her afternoon appointments took her climbing into the mountains, over the Ridge, and down into the New River Valley. The first house was a log cabin straight out of a Daniel Boone imagining. Fifty years earlier, Rita would have been called a hippie with her living-off-the-land behavior and the way she supported herself with her weaving, wearing her Birkenstocks even in the cold autumn air, and tattoos of fanciful woodland creatures. Who the baby’s father was she didn’t say, and Ashley didn’t ask. She was there to give her good pregnancy health care and help her deliver a healthy baby, not judge her lifestyle.

  “I wish all my patients were so fit.” She eyed Rita’s buff arms with envy. Even lugging around her fifty pounds of birthing kit—monitors and oxygen and all the other equipment she might need—didn’t make her that fit. “You might want to introduce a little more protein into your diet, though.”

  “I have.” Rita smiled, showing perfect, white teeth. “I put in a pond and stocked it with trout. Want to see it?”

  “That’s all right.” Ashley read the blood pressure. “Perfect, of course.”

  If only Mary Kate’s was half so good.

  “You and the baby are doing great, but I am concerned about you being here alone.” Ashley began to pack up her equipment. “With you due in January, we can’t count on the roads back here to be clear enough for me to get here on time. Can you move closer to town, or maybe have someone stay with you to help, just in case?”

  “Can’t come into town. No one to take care of the animals.” Rita gestured to the half dozen dogs of all sorts of mixed breeds taking up half the floor space of her cabin. “And I don’t have anyone to come.”

  Not a hint of sadness or bitterness tinged Rita’s voice with this pronouncement. She simply stated a fact as that.

  Ashley’s heart still contracted at the idea of having no one to be with her during birth and to help afterward.

  She set down her case and took Rita’s hands in hers. “You are welcome to come stay with me. We have ten acres and a house far too big for my parents and me, so you can bring every dog with you.”

  Rita’s eyes widened. “Are you serious?”

  “Completely.”

  “I—well, I—” Her mouth worked. Her eyes grew glassy. “Thank you. I-I’ll think about it.”

  “Please do. I’ll feel better.”

  Ashley gathered up her equipment again and headed for her Tahoe. Over the Ridge again, she looked in on a patient only three months along and with the opposite problem of Rita’s—too many people around her. Her husband, four children, and mother lived in a three-bedroom ranch-style house tucked between two hills and surrounded by the timber her husband cut to support them. Janet was tired and sick and complained with each inhalation of breath, about either her pregnancy or one of the children. With every other breath, she broke off to yell at one of those children about some minor infraction like speaking above a whisper or taking two crackers spread with peanut butter instead of just one. Janet was Ashley’s least favorite kind of patient, but she gave her as much attention as she did her other patients, listening to the discomforts of morning sickness, the fatigue, how no one would help her. Ashley examined her, found all normal, and packed up to go. Janet would do just fine, as she had with her other pregnancies, two of which Ashley had assisted with and two Momma had seen through. When her labor came, Janet would be surrounded by a husband, mother, and a dozen aunts and cousins and shouting them all away from her.

  All her energy gone, Ashley climbed into her Tahoe and headed over the Ridge to home. With the Bluetooth connection on her cell phone, she listened to her messages. Heather had called wanting to get together, her elder brother called to see how she was doing and to tell her about operating on a pregnant woman, and then Hunter McDermott’s voice poured through her vehicle like hot chocolate with half-melted marshmallows—smooth and rich and a little dark.

  “I’m sorry to bother you, Miss Tolliver, but there’s been another development in my search for Sheila Brooks.”

  Knowing a series of hairpin turns were coming up, Ashley pulled into a lay-by to listen to the rest of the message.

  “She told me where she lives, so you don’t need to search your records, but her directions make no sense to me, and I thought perhaps you could help.”

  Ashley smiled at that. She could only imagine the directions: “Turn left at the lightning-struck tree, then right where that horse barn used to be . . .”

  “I know this is a huge imposition, considering you don’t know me, and I am uncertain as to whom else I can ask. With the way you travel through these hills . . .” His voice faltered for the first time. “Call me anytime you are free—or not.” The call ended.

  For several moments, Ashley sat drumming her fingers on the steering wheel and stared at the eastern sky growing dark beyond the peaks ahead of her. She owed him nothing. She had more than enough work to keep her busy without wandering around Brooks Ridge and the New River Valley in search of some elusive woman who claimed to be this man’s mother, while some woman in a mansion in northern Virginia laid claim to be his mother. And yet somewhere back in their family tree a half dozen generations ago, they were probably cousins a gazillion times removed, and blood meant everything to the Tollivers.

  “All right, Mr. McDermott, I’ll help you.” She spoke to the inside of her SUV, with its windshield fogging up from the heater going inside and the air temperature dropping outside. “But first I am going to find Gramma’s records on your birth.”

  CHAPTER 9

  HUNTER WENT FOR a run. The mountain made his legs burn with the effort of climbing up and up and up. The cold air seared his lungs and stung his face. Nothing cleared his head from the echoing words, Too late . . . Too late . . .

  He had failed to help a sister he hadn’t even known existed three days ago. He still didn’t know if all this was true or an elaborate hoax against a man who had “enjoyed” fifteen seconds of fame. His parents, the McDermotts, claimed it was entirely possible. Their texts and e-mails, at least one an hour since he’d walked out of their Great Falls house, warned him to be careful.

  He had been careful. He contacted the midwife, or as close to her as he could, considering the original one was deceased. He tried to research in the local library. As Ashley Tolliver had claimed, the mountains were riddled with Brookses. Sheila might have been one of them, but her name and address didn’t show up in any records he could find. Yet Virginia McDermott, Mom, said she did exist. The voice on his message in-box said she existed, or someone calling herself that did. Directions to her house, however, were strange, the worst he had ever received, even in some of the remote countries in which he had worked over the past dozen years.

  “Go up Brooks Ridge Road until it turns to gravel, then make a left and go until the cliff drops off to the river. Make another left and go until the cliff rises before you . . .” And so they went. He wrote them down as he heard them, but he wasn’t about to attempt the drive that night after dark, and the next day rain fell so heavily the gravel part of Brooks Ridge Road was more like mud, and his tires spun until he got stuck. He managed to work the powerful German SUV out of its wallow, but decided to wait for drier weather—and the midwife. No one, the clerk at the motel assured him, knew the Ridge like Miss Ashley, except for maybe her momma, who was off saving the world.

  In Hunter’s book, churches came down here to save the mountain people from their
ignorance and poverty. Mountain people didn’t go to other parts of the world to do the same. He was apparently wrong.

  He was wrong about a lot of things. Brooksburg, though small, was a pretty village with little shops along the main street and a few decent restaurants scattered beyond the chain establishments near the highway. Churches outnumbered all but houses, seemingly one for each of the major denominations. What it didn’t have was a movie theater, playhouse, or anywhere for live music except for a band shell in a minuscule park. Anyone wanting live entertainment or a movie drove the hour-plus route up I-81 to Christiansburg, or farther to Roanoke, or south to Bristol. From the number of satellite dishes Hunter passed during his run, he suspected most people simply watched TV.

  He wasn’t much for TV and hadn’t thought to bring a book with him, so he ran up one hill and down another, his shoes squeaking on wet concrete or sucking into mud on the side of the road. Few cars passed him, and no pedestrians. If not for lights in the houses he passed every quarter mile or so, he would have felt more isolated than he already did.

  Not until he returned to his motel room did he fully comprehend the reason for his sense of isolation—he was without a true family. Despite their protestations that nothing had changed, he no longer felt as though he had a right to say he belonged to the McDermotts, and Sheila Brooks was a mother who had given him up. And he mustn’t forget the sister he was too late to save—from what or whom, he didn’t know.

  Thirty-two years of being sure of who and what he was had vanished in less than a day.

  Mist began to swirl around his legs. Not sure how far he had run, he decided to turn back and retrace his route to the motel. This was not a place to get lost in the dark and wet. Most of the time his cell phone showed zero bars of service. The majority of the route back was downhill. It made the running easier. None of the physical exertion had done anything for altering his mood or alleviating his frustrations. If the next day wasn’t clear enough for him to attempt a ride through the mountains in search of Sheila Brooks, then he would give up and go back home.