by Brad Watson
“Well, the rest of you figure out the order amongst yourselves.”
He wasn’t tired anymore when he was done with them all, so he went into town and sent a telegraph to his friend from medical school, Ellis Adams, now a urological surgeon at Johns Hopkins. Then waited an hour and called him, long-distance. Described the Chisolm baby from his notes and drawings, asked some questions. Then went home again. No patients waiting this time, thank God.
His wife, Lett, was in the parlor drinking coffee. He sat down and she brought him a cup, sat with him. She was tall, like him, with long brown hair she kept pinned up nicely. A locket cameo beauty carved from ivory, come miraculously to life. But she looked tired. Beautifully so, but tired. And so was he, now. Exhausted.
“I guess you didn’t sleep much last night, either,” he said.
“No.” She set her coffee cup down and tapped on her wedding ring, a habit she had when bothered. “Ed, have you thought anymore about setting up a clinic in town? Or joining someone? Not everyone makes house calls anymore, you know.”
He sipped his coffee. It entered his blood as what it was, some powerful drug.
“I don’t know what to say, Lett. I’ve told you it seems unethical to abandon a practice, especially this kind.”
“Well, find someone to take it, then. As I have suggested before.”
“And, as I have explained, the youngest doctors—the ones who don’t like house calls—don’t want this kind of practice anymore. And the older ones are already settled.”
“Well. Ed.”
“Yes.”
“If you come home from a late-night call and I’m not here, you can figure I’ve gone to Mother’s for the night. I don’t like being here on the edge of town in this big house by myself when you go out. It didn’t bother me so much for a while, but it’s begun to. I wake up, find you gone, and can’t get back to sleep.”
“How is getting up, getting dressed, and driving or taking a buggy into town, waking up your mother—just how is that going to help you sleep, Lett?”
“It’s not all about not being able to sleep, Ed. It’s feeling left alone.”
He noticed her hands were shaking just the slightest bit. She saw him notice, clasped one over the other, and went to the window, facing out.
“Did you sleep at all last night, Lett?”
He was gazing at her tall slim figure there, her lovely neck exposed and half in shadow of diagonal light, and suddenly he felt a fear for her.
“I’m scarcely ever gone more than a few hours, often less.”
She gestured with one hand, as if helpless against her frustration.
“I could give you something to help you sleep,” he said.
She turned then, looking so on the verge of tears he was startled.
“Laudanum, are you saying? No, thank you.”
“No, Lett. There are herbs.”
“They don’t work for me.” She looked at the floor, shook her head.
“Come along with me, then. At least sometimes.”
She turned back to the window and seemed to stiffen.
“You know I don’t like being around sick people. I’m ashamed of it but it’s true. I guess I shouldn’t have married a doctor,” she said, trying to laugh it off. But her laughter was momentary, false, and he could only gaze at her as tenderly as possible, knowing that her feelings for him had been weakening for some time. Detecting the loss of love from one he’d hoped would always give it.
HE DROVE BACK to the Chisolm place the next afternoon, in his Model T Ford. Went inside the house and examined the child, asked Mrs. Chisolm a few questions, then went out to his car, gathered up a douche apparatus, and went back inside. Ida Chisolm seemed to recoil from it.
“Do you have one of these?” he said to her. She shook her head, like a horse pestered by a fly. “Well, you can have this one. She must be kept very clean—inside, I mean. You want to try to keep her fecal matter—her poop—from getting into her other parts. It’s all kind of together in there, with this child. Let me show you.” She didn’t move. “Come on over, now. This is important. And when she’s old enough, she must be taught to do it herself, and frequently. Otherwise she will have frequent problems for sure.”
“What kind of problems?”
“What I believe, from what I can tell and what I’ve been told, is that without it she could have frequent infections, and you don’t want me over here every other day having to treat that.”
Warily, the woman approached and watched, listened to what he said. When he looked up at her for a moment, he saw her blinking back tears.
“It will be all right,” he said.
“So you say,” she said.
“All right,” he said after peering at her, trying to figure her state of mind. “Now, listen. I know we normally don’t let infants sleep on their backs, if we can help it. But it would be good if she could sleep with her hips slightly elevated. It might mean checking on her more often, I know. But it will help avoid the possibility of the kind of thing that would lead to infections. And during the day, when she’s in the crib, same thing. And when she’s upright, being held or whatnot, not a problem.”
She said nothing, looking blankly at the child lying there in her crib, at the little diaper the doctor had folded and placed beneath her bottom.
“You understand, Ida?” He said her first name to get her attention.
She only nodded. And he went out.
CHISOLM WAS in the work shed sharpening edges on a disc harrow. He stepped out and the doctor met him there just outside the shed, in the shade of its eave. The doctor removed his hat, ran a hand through his hair, inspected the hat as if for flaws, then put it back on.
“Child seems all right,” he said to Chisolm. “Seems healthy, to me. Doesn’t have everything she ought to have, but there does not appear to be an obstruction and as long as she’s able to eliminate waste and y’all keep her clean, she should be all right.” He looked at the man. “I’ve explained that to your wife.” Chisolm looked back at him curiously. “We’ll see how she comes along in time, but I believe she’ll be all right. She’s nursing well.”
“She, then.”
“Yes.”
Chisolm looked at him a long moment, studying him the way he did, taking the words in.
“Doesn’t need anything special, then?” he said. “No medicine or special food?”
The doctor shook his head.
“I’ll be honest with you, though,” he said.
Chisolm said nothing, waiting.
“The truth of the matter is that if something is going to go wrong, it will likely go wrong in these first weeks or even first few months. If she doesn’t soil her diaper often as any child ought, or especially if she goes even a day without that, as I said, you send for me quick. Keep an eye out for any swelling in her lower tummy. Or something kind of poking the skin out in an odd way. You can expect me to be checking in pretty often for a while. I won’t charge you for it. Let’s just call it a learning experience for everyone, but especially me, as a doctor I mean.”
Chisolm just nodded, his eyes on the doctor’s as if expecting more. Then he looked away.
The doctor yawned and rubbed his face with his hands.
“Blame me if it doesn’t seem I’ve treated half the county in the last few days. I had a passel waiting on me when I got home this morning, then went to town to call a friend who knows more about this kind of business here than I do. Went home hoping for a nap but I’d hardly lain down before a boy rode up hollering his father cut himself bad at the sawmill. Had me a bit of a nap under a sweet gum beside the road between there and here. I thank you for that gift of spiritual aid in that regard.”
Chisolm nodded, managed a grim smile.
“You need another?”
“I’m plenty good for now, thank you. Sir, I believe your product is as good as anything bottled in Kentucky. You are an artist.”
Chisolm almost grinned. “Anytime you’re in the n
eighborhood, Doc, just help yourself.” Then he said, “I guess I got one question.”
“Shoot.”
“How is it a child comes out like this’n?”
The doctor shrugged his shoulders inside his jacket, like he’d got a chill. He was overtired.
“The way I see it, most everybody’s lucky nothing goes wrong during a pregnancy. I sometimes can’t believe how often nature gets it just right. I’ve seen some things you wouldn’t believe. Most that come out wrong or odd die soon after birth. Sometimes I can be pretty sure, when I come back to check on them, that what happened was not a natural death.”
Chisolm looked at him for a long minute, but the doctor kept looking out over the field.
“Anyhow,” Chisolm said, “you figure this one’s a girl just because, I reckon, it’s clear she ain’t a boy.”
“Best I can tell,” the doctor said, “she’s just a girl who did not fully develop. Something stopped that in the womb, for whatever reason. It happens. No one’s fault. It’s rare, but at this point I do not think it’s life-threatening.” He paused. “There’s many a case of a child being both, to one degree or another, but that’s not the case here. I’m told this is most likely a condition you see only in female children, anyway, and not boys.”
Chisolm looked at him.
“Both, you say.”
The doctor raised his eyebrows and gave a nod, took his hat off to look it over again, brows furrowing down.
“Can’t be a nothing,” he said. “Come out able to be one or the other, and you have to wait and see which one wins out. Sometimes it just stays both.”
Chisolm looked at him, taking that in.
“Well, I reckon if a thing like that can happen to a child, we got damn lucky.”
“All things considered,” the doctor said, “I’d have to agree.”
“And nothing to do about it.”
“I don’t believe so, no. But, in time, who knows? If you can, you might put a little away toward it whenever you can, just in case.”
They stood there another long minute. Then the doctor gave Chisolm a light pat on the shoulder. “She’ll be a little treasure for you and Mrs., I don’t doubt it,” he said.
Chisolm nodded, and went back into his shed and began filing at the disc blade again. The doctor left and made a couple of house calls in the general area. The afternoon grew chilly, late November coming on. When he returned home at last light the house was empty, but a small fire flickered in the hearth, and there was a tin plate on the stove’s warmer, covered by a clean cloth. A note from his wife on the kitchen table. She’d gone into town to visit her mother, might stay overnight, not to worry.
He went into his study, where he’d left the jug from Chisolm, poured himself a measure into an empty coffee cup, lit a small lamp on his desk, and wrote in his journal. A tree frog sang out its loud, long, piercing song just outside the window on the porch, and even its near-deafening note, coming from an inch-long operatic amphibian soprano, somehow brought up a corresponding silent note of melancholy.
AS SOON AS the child got a little strength in her neck, her mother enlisted the older daughter, Grace, who carried the infant around like a broken third arm in a makeshift sling. She brought her to her mother when she was hungry and would step outside and walk fast, then run to someplace on the farm she could hunker down, hide out, curse or weep as the mood might fit her. Occasionally she would take a little homemade corncob vine-stem pipe she’d fashioned with a paring knife and puff on a bit of tobacco she’d snitched from her father. It was a small rebellion but there was a measure of satisfaction in it.
Later on, when winter had passed and the baby was able to crawl around like a quick little hobbled dog, Grace got her out of the house as often as possible. They wandered as far as the child’s ability and bobbling curiosity would take them, Grace only picking her up when she veered too close to an animal or machine and turning her like a windup toy in another direction. She grew out a full head of fine dark brown hair that Grace pulled up into a tiny little bow on top of her head. Quite cute, her older sister had to admit.
But she never lost her conviction that this motherhood business wasn’t ever going to be for her.
She stepped from the privy into the gray-blue light of a windy March afternoon, gusts buffeting the wooden door she held on to, kicking up dust in the yard, rattling the leafing, bony limbs in the trees, and rippling the surface of the cattle pond down in the pasture. The door to the house opened and her mother’s arm swung out, tossing a wadded diaper over the edge of the porch and into the yard. Grace looked at her duty lying there, steam rising like scant smoke from its folds.
The doctor’s Ford pulled to a clattering stop in front of it, as if it were a traffic sign of the oddest sort. He was in the habit now of stopping by at least once a week. She watched him get out, step around the car on his long, just slightly bowed legs, look down at the steaming bundle, then over at Grace standing in the open door to the privy. He was hatless, hank of carelessly debonair hair on his forehead, hands in pockets as if studying something worthy of thought. She just looked at him. His casual relationship with the world, his bookishly handsome, relative ease, infuriated her. He had the audacity to give her what looked like the faintest smile, as if he were amused. Grace was not.
She followed him inside the house and stood in the doorway to the living room as he examined the baby, pinned her fresh diaper, then followed him as far as the kitchen doorway to listen while he spoke to her mother.
“Four months now,” he was saying as they sat at the table. “If anything serious were going to develop, I believe we would have seen signs of it already.”
She looked at the doctor sitting there, his oddly aristocratic features, no gray in his hair. It struck her he might be younger than she’d thought.
“Grace, mind your manners and put on a pot of coffee,” her mother said.
She slumped over and got the pot, rinsed it at the pump out back, put in new water, and brought it back inside. Loaded some coffee in it and set it on top of the stove. Threw another chunk of wood in the stove furnace. At one point a lull in the conversation caused her to glance at the doctor. She started when she saw he was looking at her, a quizzical if bemused look on his face. She frowned and went back to the doorway and stood just outside it, as if not listening.
He went on to say that Mrs. Chisolm should continue to make sure there was no odd swelling, and that he would continue checking in regularly if she wouldn’t mind.
“I thank you,” her mother said, though her tone held something of suspicion and a trace of resentment as well, no doubt at having to feel beholden.
Grace went back in when the coffee was done and poured the doctor a cup. He smiled up at her.
“Thank you, Miss Grace.”
“Welcome,” she mumbled, furious at herself for blushing.
He said he thought he would take a little stroll into the woods behind their house and then be on his way, if they wouldn’t mind. Her mother gave herself a wry smile and said of course, to make himself at home. The doctor smiled in an odd way back at her, a bit of mischief in his eye, then took up his coffee cup and went out the kitchen door.
“What’s that all about, then?” Grace said.
“He’s one likes to walk in the woods, I guess.”
“Oh, I thought maybe he just needs a little sweetener in his coffee.”
“Don’t be impertinent,” her mother said. “He’s not charging us for any of this, whatever it’s worth.”
“Why not?”
“I don’t ask.”
Leaving, later, when the doctor rounded the corner of their long drive toward the road, she was standing just off it in the shadow of a ragged pine tree, watching him pass. Without looking her way he lifted a finger from the steering wheel in a little acknowledgment or wave, to which she responded by lifting her middle finger toward his car as it raised the dust on its way down the drive.
Ellison Adams, M.D.
Johns Hopkins University School of Medicine
Baltimore, Maryland
Dear Ellis,
A busy winter it was here with ague and the results of physical violence bred and borne by folks cooped up a bit too much with their chosen enemies. I’m sure you would find it all most amusing.
Since there have been no complications (and I have to say I expected there to be some, but it seems you were right so I must have described it well enough), it has been some time since I’ve written to you concerning my young patient with her interesting if apparently manageable urological condition. As you expected, there’s been no apparent danger arising from blockages, fistulas, or other developments in that direction, etc. An interesting case, and a very fine and otherwise normal child in the making as it turns out.
The mother seems to have found her ways to cope. Her older daughter takes on most of the child caring duties whenever she’s not away in school. Curious girl, never says much. I get the feeling she’s like some wildcat tethered to that family and her duties as if to a tree by a pulled-taut chain. Only question is will she give more trouble than she gets.
Speaking of coping, my Lett seems to spend more time in town with her family than here, these days. Not really but it seems so. Feels like I see our housekeeper young Hattie more than I do my own wife. I had not considered how difficult (and unamusing) it might be for a refined city girl to be married to a man who for some reason ends up an old-time country doctor. I suppose she expected me to end up in research, like you, or at least some sophisticated urban practice, coming and going like a banker, instead of mending the cracked limbs and skulls of simple farm folks who often enough show up at the door bloody and smelling of animals and dirt. I believe she is profoundly disheartened by the sight of a man or woman with the dental apparatus of a jack-o’-lantern.
Of course do please keep your more refined and intelligent ears open whenever possible to any research developments that would apply and let me know posthaste should something relevant be in the works. If such a case/condition as I have on my hands here is indeed as rare as you suspect, then I wonder if Young et al. would be interested in some kind of pro bono examination, for the purposes of advancing science, as we say. If you should manage to get anyone’s attention on the matter, please let me know directly. Your colleague Dr. Young will, I believe, continue to make great strides in this field, in time. Please maintain your friendship with this man and do not let the horse’s ass in you come out at some kind of social gathering or whatnot, as we know this Dr. Young is a bit of a prude and campaigned against prostitution when he served in the war, etc. etc., as if contracting a case of the clap could somehow be worse than having one’s entire apparatus blown off or to pieces by a German artillery shell—but, pardon, I stray afield. In other words also be discreet as possible concerning your other habits, if you will, oh Great One. My regards to Mary Kate and the children, by the way.