I expected her to begin to ask me questions with that look on her face all doctors hate—but she didn’t. I put my hand on her shoulder and told her we had done everything we knew how to do for Jean but that we really didn’t know what, finally, was killing her. The woman didn’t make any sign of hearing me. Just sat there looking in between the bars of the crib. So after a moment watching the poor kid beside her, I turned to the infant in the next crib to go on with my rounds. There was an older woman there looking in at that baby also—no better off than Jean, surely. I spoke to her, thinking she was the mother of this one, but she wasn’t.
Before I could say anything, she told me she was the older sister of Jean’s mother and that she knew that Jean was dying and that it was a good thing. That gave me an idea—I hated to talk to Jean’s mother herself—so I beckoned the woman to come out into the hall with me.
I’m glad she’s going to die, she said. She’s got two others home, older, and her husband has run off with another woman. It’s better off dead—never was any good anyway. You know her husband came down from Canada about a year and a half ago. She seen him and asked him to come back and live with her and the children. He come back just long enough to get her pregnant with this one then he left her again and went back to the other woman. And I suppose knowing she was pregnant, and suffering, and having no money and nowhere to get it, she was worrying and this one never was formed right. I seen it as soon as it was born. I guess the condition she was in was the cause. She’s got enough to worry about now without this one. The husband’s gone to Canada again and we can’t get a thing out of him. I been keeping them, but we can’t do much more. She’d work if she could find anything but what can you do with three kids in times like this? She’s got a boy nine years old but her mother-in-law sneaked it away from her and now he’s with his father in Canada. She worries about him too, but that don’t do no good.
Listen, I said, I want to ask you something. Do you think she’d let us do an autopsy on Jean if she dies? I hate to speak to her of such a thing now but to tell you the truth, we’ve worked hard on that poor child and we don’t exactly know what is the trouble. We know that she’s had pneumonia but that’s been getting well. Would you take it up with her for me, if—of course—she dies.
Oh, she’s gonna die all right, said the woman. Sure, I will. If you can learn anything, it’s only right. I’ll see that you get the chance. She won’t make any kick, I’ll tell her.
Thanks, I said.
The infant died about five in the afternoon. The pathologist was dog-tired from a lot of extra work he’d had to do due to the absence of his assistant on her vacation so he put off the autopsy till next morning. They packed the body in ice in one of the service hoppers. It worked perfectly.
Next morning they did the postmortem. I couldn’t get the nurse to go down to it. I may be a sap, she said, but I can’t do it, that’s all. I can’t. Not when I’ve taken care of them. I feel as if they’re my own.
I was amazed to see how completely the lungs had cleared up. They were almost normal except for a very small patch of residual pneumonia here and there which really amounted to nothing. Chest and abdomen were in excellent shape, otherwise, throughout—not a thing aside from the negligible pneumonia. Then he opened the head.
It seemed to me the poor kid’s convolutions were unusually well developed. I kept thinking it’s incredible that that complicated mechanism of the brain has come into being just for this. I never can quite get used to an autopsy.
The first evidence of the real trouble—for there had been no gross evidence of meningitis—was when the pathologist took the brain in his hand and made the long steady cut which opened up the left lateral ventricle. There was just a faint color of pus on the bulb of the choroid plexus there. Then the diagnosis all cleared up quickly. The left lateral sinus was completely thrombosed and on going into the left temporal bone from the inside the mastoid process was all broken down.
I called up the ear man and he came down at once. A clear miss, he said. I think if we’d gone in there earlier, we’d have saved her.
For what? said I. Vote the straight Communist ticket.
Would it make us any dumber? said the ear man.
A Face of Stone
HE WAS one of these fresh Jewish types you want to kill at sight, the presuming poor whose looks change the minute cash is mentioned. But they’re insistent, trying to force attention, taking advantage of good nature at the first crack. You come when I call you, that type. He got me into a bad mood before he opened his mouth just by the half smiling, half insolent look in his eyes, a small, stoutish individual in a greasy black suit, a man in his middle twenties I should imagine.
She, on the other hand looked Italian, a goaty slant to her eyes, a face often seen among Italian immigrants. She had a small baby tight in her arms. She stood beside her smiling husband and looked at me with no expression at all on her pointed face, unless no expression is an expression. A face of stone. It was an animal distrust, not shyness. She wasn’t shy but seemed as if sensing danger, as though she were on her guard against it. She looked dirty. So did he. Her hands were definitely grimy, with black nails. And she smelled, that usual smell of sweat and dirt you find among any people who habitually do not wash or bathe.
The infant was asleep when they came into the office, a child of about five months perhaps, not more.
People like that belong in clinics, I thought to myself. I wasn’t putting myself out for them, not that day anyhow. Just dumb oxen. Why the hell do they let them into the country. Half idiots at best. Look at them.
My brother told us to bring the baby here, the man said. We’ve had a doctor but he’s no good.
How do you know he’s no good. You probably never gave him a chance. Did you pay him?
Sure we paid him.
Well what do you want me to do? To hell with you, I thought to myself. Get sore and get the hell out of here. I got to go home to lunch.
I want you to fix up the baby, Doc. My brother says you’re the best baby doctor around here. And this kid’s sick.
Well, put it up there on the table and take its clothes off then. Why didn’t you come earlier instead of waiting here till the end of the hour. I got to live too.
The man turned to his wife. Gimme the baby, he said.
No. She wouldn’t. Her face just took on an even stupider expression of obstinacy but she clung to the child.
Come on, come on, I said. I can’t wait here all day.
Give him to me, he said to her again. He only wants to examine it.
I hold her, the woman said keeping the child firmly in her arms.
Listen here, I spoke to her. Do you want me to examine the child or don’t you. If you don’t, then take it somewhere.
Wait a minute, wait a minute, Doc, the man said smiling ingratiatingly.
You look at throat, the mother suggested.
You put the baby up there on the table and take its clothes off, I told her. The woman shook her head. But as she did so she gradually relented, looking furtively at me with distrustful glances her nostrils moving slightly.
Now what is it.
She’s getting thin, Doc ’think somethink’s the matter with her.
What do you mean, thin?
I asked her age, the kind of labor she had had. How they were feeding the baby. Vomiting, sleeping, hunger. It was the first child and the mother was new at nursing it. It was four and a half months old and weighed thirteen and a half pounds. Not bad.
I think my milk no good, said the woman, still clinging to the baby whose clothes she had only begun to open.
As I approached them the infant took one look at me and let out a wild scream. In alarm the mother clutched it to her breast and started for the door.
I burst out laughing. The husband got red in the face but forced a smile. Don’t be so scared, he said to his wife. He, nodding toward me, ain’t gonna hurt you. You know she hasn’t been in this country long, Doc. She’s sca
red you’re gonna hurt the baby. Bring it over here, he said to her and take off his clothes. Here, give ’im to me. And he took the infant into his own hands, screaming lustily, and carried it to the table to undress it. The mother, in an agony of apprehension kept interfering from behind at every move.
What a time! I couldn’t find much the matter and told them so. Just the results of irregular, foolish routine and probably insufficient breast milk. I gave them a complemental formula. He chiseled a dollar off the fee and—just as he was going out—said, Doc, if we need you any time I want you to come out to the house to see it. You gotta watch this kid.
Where do you live, I asked.
He told me where it was, way out near the dumps. I’ll come if you give me a decent warning, I told him. If you want me call me in the morning. Now get that. You can’t expect me to go running out there for nothing every time the kid gets a belly ache. Or just because she thinks it’s dying. If you call me around supper time or in the middle of a snow storm or at two o’clock in the morning maybe I won’t do it. I’m telling you now so you’ll know. I got too much to do already.
O.K., Doc, he said smiling. But you come.
I’ll come on those conditions.
O.K., Doc.
And sure enough, on a Sunday night, about nine o’clock, with the thermometer at six below and the roads like a skating rink, they would call me.
Nothing doing, I said.
But Doc, you said you’d come.
I’m not going there tonight, I insisted. I won’t do it. I’ll ask my associate to make the call or some good younger man that lives in that neighborhood but I won’t go over there tonight.
But we need you Doc, the baby’s very sick.
Can’t help it. I tell you I’m not going. And I slammed up the receiver.
Who in the world are you talking to like that, said my wife who had put down her book as my voice rose higher. You mustn’t do that.
Leave me alone, I know what I’m doing.
But my dear!
Four months later, after three months of miserable practice, the first warm day in April, about twenty women with babies came to my office. I started at one P.M. and by three I was still going strong. I hadn’t loafed. Anybody left out there? I asked the last woman, as I thought, who had been waiting for me. Oh yes, there’s a couple with a baby. Oh Lord, I groaned. It was half past three by then and a number of calls still to be made about the town.
There they were. The same fresh mug and the same face of stone, still holding the baby which had grown, however, to twice its former size.
Hello Doc, said the man smiling.
For a moment I couldn’t place them. Hello, I said. Then I remembered. What can I do for you—at this time of day. Make it snappy cause I’ve got to get out.
Just want you to look the baby over, Doc.
Oh yeah.
Listen Doc, we’ve been waiting out there two hours.
Good night! That finishes me for the afternoon, I said to myself. All right, put it up on the table. As I said this, feeling at the same time a sense of helpless irritation and anger, I noticed a cluster of red pimples in the region of the man’s right eyebrow and reaching to the bridge of his nose. Like bed-bug bites I thought to myself. He’ll want me to do something for them too before I get through I suppose. Well, what’s the matter now? I asked them.
It’s the baby again, Doc, the man said.
What’s the matter with the baby. It looks all right to me. And it did. A child of about ten months, I estimated, with a perfectly happy, round face.
Yes, but his body isn’t so good.
I want you should examine him all over, said the mother.
You would, I said. Do you realize what time it is?
Shall she take his clothes off? the man broke in.
Suit yourself, I answered, hoping she wouldn’t do it. But she put the infant on the table and began carefully to undress it.
No use. I sat down and took out a card for the usual notes. How old is it?
How old is it? he asked his wife.
Ten months. Next Tuesday ten months, she said with the same face on her as always.
Are you still nursing it.
Sure, she said. Him won’t take bottle.
Do you mean to say that after what I told you last time, you haven’t weaned the baby?
What can she do, Doc. She tried to but he won’t let go of the breast. You can’t make him take a bottle.
Does he eat?
Yeah, he eats a little, but he won’t take much.
Cod liver oil?
He takes it all right but spits it up half an hour later. She stopped giving it to him.
Orange juice.
Sure. Most of the time.
So, as a matter of fact, she’s been nursing him and giving him a little cereal and that’s all.
Sure, that’s about right.
How often does she nurse him?
Whenever he wants it, the man grinned. Sometimes every two hours. Sometimes he sleeps. Like that.
But didn’t I tell you, didn’t I tell her to feed it regularly.
She can’t do that, Doc. The baby cries and she gives it to him.
Why don’t you put it in a crib?
She won’t give it up. You know, that’s the way she is, Doc. You can’t make her do different. She wants the baby next to her so she can feel it.
Have you got it undressed? I turned to the mother who was standing with her back to me.
You want shoe off? she answered me.
Getting up I went to the infant and pulled the shoes and stockings off together, picked the thing up by its feet and the back of the neck and carried it to the scales. She was right after me, her arms half extended watching the child at every movement I made. Fortunately the child grinned and sagged back unresisting in my grasp. I looked at it more carefully then, a smart looking little thing and a perfectly happy, fresh mug on him that amused me in spite of myself.
Twenty pounds and four ounces, I said. What do you want for a ten month old baby? There’s nothing the matter with him. Get his clothes on.
I want you should examine him first, said the mother.
The blood went to my face in anger but she paid no attention to me. He too thin, she said. Look him body.
To quiet my nerves I took my stethoscope and went rapidly over the child’s chest, saw that everything was all right there, that there was no rickets and told them so—and to step on it. Get him dressed. I got to get out of here.
Him all right? the woman questioned me with her stony pale green eyes. I stopped to look at them, they were very curious, almost at right angles to each other—in a way of speaking—like the eyes of some female figure I had seen somewhere—Mantegna—Botticelli—I couldn’t remember.
Yes, only for God’s sake, take him off the breast. Feed him the way I told you to.
No will take bottle.
Fine. I don’t give a damn about the bottle. Feed him from a cup, with a spoon, anyway at all. But feed him regularly. That’s all.
As I turned to wash my hands, preparatory to leaving the office the man stopped me. Doc, he said, I want you to examine my wife.
He got red in the face as I turned on him. What the hell do you think I am anyhow. You got a hell of a nerve. Don’t you know …
We waited two hours and ten minutes for you, Doc, he replied smiling. Just look her over and see what the matter with her is.
I could hardly trust myself to speak for a moment but, instead turned to look at her again standing beside the baby which she had finished dressing and which was sitting on the table looking at me. What a creature. What a face. And what a body. I looked her coldly up and down from head to toe. There was a rip in her dress, a triangular tear just above the left knee.
Well—No use getting excited with people such as these—or with anyone, for that matter, I said in despair. No one can do two things at the same time, especially when they’re in two different places. I simply gave up and return
ed to my desk chair.
Go ahead. What’s the matter with her?
She gets pains in her legs, especially at night. And she’s got a spot near her right knee. It came last week, a big blue looking sort of spot.
Did she ever have rheumatism? You know, go to bed with swollen joints—for six weeks—or like that.
She simply shrugged her shoulders.
Did you have rheumatism? he turned to her.
She don’t know, he said, interpreting and turning red in the face again. I particularly noticed it this time and remembered that it had occurred two or three times before while we were talking.
Tell her to open up her dress.
Open up your dress, he said.
Sit down, I told her and let me see your legs.
As she did so I noticed again the triangular rip in the skirt over her left thigh, dirty silk, and that her skin was directly under it. She untied some white rags above her knees and let down her black stockings. The left one first, I said.
Her lower legs were peculiarly bowed, really like Turkish scimitars, flattened and somewhat rotated on themselves in an odd way that could not have come from anything but severe rickets rather late in her childhood. The whole leg while not exactly weak was as ugly and misshapen as a useful leg well could be in so young a woman. Near the knee was a large discolored area where in all probability a varicose vein had ruptured.
That spot, I told her husband, comes from a broken varicose vein.
Yeah, I thought so, she’s got them all up both legs.
That’s from carrying a child.
No. She had them before that. They’ve always been that way since I’ve known her. Is that what makes her have the pains there?
The Doctor Stories Page 9