‘Only a man would simplify it like that.’ I couldn’t hide the disdain.
‘I disagree. Even you would concede that by the time a woman reaches term, she’s pretty much prepared for the inevitable. Nature is an amazing force; it would have been getting her ready emotionally and physically for the entirety of the pregnancy for the very moment of birth.’
‘And what if the baby presents in the breech position, or the umbilical cord is looped around its neck, or the —’
‘Any number of complications, yes, yes,’ he said, waving my protest away as though it were academic. ‘And that’s when you and your midwives play their role, but if saving lives is what you’re after, Dr Fenwick, I doubt you can find a more worthwhile wing than mine. I simply can’t get enough help. Even the nurses are scared of TB. I doubt you are.’
‘I’m not,’ I assured. ‘But I have a job to do in maternity. The dangers of childbirth aside, I learned yesterday that there are pregnant women and babies dying who are not allowed to come to the clinic because of family pressure.’
He didn’t look surprised. ‘And why does that affect you? Be assured that the Muslim families will not change on this; husbands will not permit their women to undress, not even unveil, anywhere where men might be.’
‘But —’
‘Dr Fenwick, one of the first important wisdoms of working here successfully is respecting the rules of the local people. I do hope someone has explained the caste system to you too. That’s vital if you’re —’
‘Would you stop lecturing me, please?’
He laughed as I bristled. ‘There are so many do-gooders here in India, all trying to change the poor savages and show them how to live like proper Westerners.’ The sarcasm struck like poison. I knew he was right. Just on the journey alone I’d listened to the dismissive way that the English spoke about their hosts but I wasn’t going to admit that to him.
‘Well, I’m not one of them,’ I responded lamely.
‘You are, you know. Actually, you’re worse. They might be rich with impressive titles and important connections, but they’re nonetheless ignorant, believing everyone but their own kind is inferior. You’re far from ignorant but you’ve come on a selfish mission – a grandiose daydream to change the world, to somehow reverse time, show your adoring Daddy that darling Mummy didn’t die in vain. You want to return home triumphant that you not only solved crises in midwifery but can bend someone’s faith to suit your clinics . . . and maybe even cure TB as you pass us by . . . all in a matter of months, of course! Meanwhile, all the other memsahibs are just too self-centred and impressed with themselves to notice there is any other way than their —’
I didn’t put much of a swing into it; I suppose because I’ve never taken to raising my hand to anyone previously. The sound of the slap died quickly against his cheek, so the effect was really more of a thud but it achieved the desired outcome and his tirade ended immediately.
The professor nodded. ‘Congratulations, Dr Fenwick, your communication skills are succinctly honed. Matron might feel we haven’t made much progress today but I think we understand each other perfectly.’
I took a ragged breath, genuinely appalled at my behaviour and angry that I was the aggressor. ‘Professor Vickery. I’m really rather hoping our paths don’t cross in the coming months. Can we both try to achieve that please?’
‘I can’t promise, but I shall avoid you if that makes it easier on your tendency towards histrionic behaviour. Drink your tea, Doctor; you should know that chai has immeasurable soothing properties. It will help to keep those female emotions of yours under control.’
I don’t think I could have been angrier in that moment. If I’d even tried to hurl back a rebuke, it would have come out as an explosive stutter and I prided myself on having the presence of mind as white anger flashed through me to stay still, stay silent.
I stood, desperate to be the one to walk away this time.
‘Before you go,’ he said.
I halted, only out of a sense of shock at the full realisation that I had just hit someone, but I didn’t turn to look at him.
‘Take one piece of well-aimed caution and do not interfere with the ways of the locals.’
It was time to leave and I was going to have to tell Matron our little chat over tea did nothing but worsen my opinion of the professor and brought on violence that I had never thought a part of me. Breaking my hope that I could walk away without so much as sharing another word, I swung around on my heels.
‘You have no jurisdiction over me, Professor.’
‘I’m not claiming to have any. What I am doing is giving you solid counsel.’
‘I didn’t ask for it.’ I sounded breathless from the exertion of not raising my voice.
‘Yes, but you need to hear it, Dr Fenwick. You need to understand that you’re dealing with faith now. And faith is far stronger to these people than our medicine or any of your clinics. And when it comes to caste that provokes terrible repercussions if the rules are flouted. Don’t risk it.’
‘Women and babies are dying unnecessarily,’ I repeated and could see how it prompted only fresh disdain in that gaze I wanted to escape. ‘I can and will save them . . . or have you forgotten the oath you took as a doctor?’
‘No, but I’m rational enough to know when to exercise that oath. You will not save a woman from her family’s wrath if she contravenes the tenets of her religion. Husbands would rather kill their wives than break with their faithful traditions. Do not come between them and their ways. It is a pathway to danger and you’re here but for a blink in their time.’ He stood, eyes glittering with the passion of this warning but also something else . . . I couldn’t tease it out in the moment our gazes met angrily. ‘When you’ve calmed down and can see reason about what I say – even if you do despise me – maybe you’ll visit the TB ward. You are most welcome, and be assured, Dr Fenwick, I’ve said that to so few people, I could count them on one hand. Good day to you.’ He placed his cup into my hand and strode away.
I was so livid that he not only had the last word in such a superior, calm manner but that he’d stolen the march and stomped away before I could. I helplessly watched him, mouth open in astonishment at his nerve to treat me like one of his staff . . . worse, like one of his cringing servants. I looked down at his empty cup and it was only my upbringing that prevented me from hurling it against the tree we’d been sitting beneath.
9
The following day I was still fuming but the rage had dulled to fury at myself for being so easy to manipulate. I was a doctor, supposed to be objective, able to guard my emotions, and yet I’d acted precisely how he’d accused – a woman with a histrionic personality. My morning lecture walk around the ward – as the nurses liked to call it – lacked its usual humour. It was fortunate that Parni had given them so much to be in awe over and to discuss in great detail.
‘Hold that memory, ladies, because perhaps none of us will ever witness such a birth again.’
They gushed on, one admitting she kept a tiny piece of the linen that had cleaned away the infant’s caul.
‘My husband is away at sea. I want him home safe,’ she explained. The others laughed and I didn’t have the heart to tell her that the luck was supposedly passed on to the sailor, not his wife, so he was the one who needed the linen.
We moved through our rounds, pausing while the midwives went through their checks of each mother in the ward.
‘Up until even as recently as the Great War, your role was known collectively as “handywomen” and you did everything from attending births to laying out the dead in a local community. But we’ve come ahead in great leaps since then, and especially since the turn of the century, when it was made illegal for anyone uncertified to attend a woman giving birth.’
I could hear how stilted I sounded. There were nine pairs of eyes watching me, their mostly Anglo-Indian owners supposed to be hanging on my words, learning from each wise sentence I spoke, and here I was giving
them a history lesson that had no bearing on their role today in India. I glanced at the frowning Lily and tried to shake myself out of my distraction. It didn’t help that even though so many hours had passed I swore I could still feel precisely where my hand had connected with Professor Vickery’s face. At the point where my fingers connected to my palm I had touched jawbone, hard and unyielding. My skin had scraped against a darkly golden beard, where he’d not shaved since the previous day. It was surprisingly abrasive for such a fair man. Now I came to think of it, his hair was blond but his skin had that olive, Scandinavian tone that tanned easily.
‘Dr Fenwick?’ It was Lily. My words must have petered out as I became lost once again in the spell of Saxon Vickery. This realisation only served to vex me further and I stopped myself just in time from snapping at my loyal head midwife.
‘Er . . . sorry, everyone.’ I gathered my scattered thoughts. ‘What I’m trying to say is that you now own a measure of respect that has been well and truly earned. By the time you help a mother to deliver a child alone, you will be fully certified, well experienced in all aspects of delivery, including en caul.’ They murmured a collective chuckle. ‘You’ll know when to get the doctor or when to simply hold your nerve, remain patient and guide your mothers-to-be through what is the most natural of processes.’ I dared myself to say it. ‘After all, Mother Nature has prepared her women well for the inevitable journey that is giving birth. She’s been readying them for nearly ten months. And should something go wrong, I mean to ensure you’re well equipped to lead your mothers through other procedures that may well involve the doctor, surgery, special care for their babies after delivery and so on.’
I dismissed thoughts of touching Saxon Vickery’s face and found my rhythm.
‘So, today, I want to concentrate on being able to judge the position of the baby simply by gentle touch on the mother’s belly. Hello again,’ I said, nodding at a heavily pregnant woman who was sitting up in the bed we’d all begun to cluster around. ‘It’s Gamini, isn’t it?’
She smiled shyly and looked towards Dipali, who nodded. Gamini gave me the gesture I learned as the Anjali mudra – a special and polite greeting. Dip had explained in my first week that because I was a teacher, the mudra would be offered at chest height from students and probably from patients too. I gathered that if Gamini, for instance, were to give greetings to a god in her local temple, then she would make that identical gesture of palms placed flat against each other, fingers neatly pointing upwards, above her head out of fearful respect. It occurred to me to wonder whether Professor Vickery instructed his staff to make the mudra above their heads whenever addressing him. I bit my lip to force my thoughts back to where they were relevant; I was allowing Vickery far too much playtime in my head.
This time I succeeded and was able to lead my group through a helpful, valuable session that had begun to cover fundal massage, which would help them enormously for reducing bleeding and cramping of their mothers post-birth. ‘You all need to be able to do this and we’ll have a practical demonstration tomorrow if we have a birth and I suspect we shall,’ I said, grinning towards Gamini. ‘Any questions about what we’ve talked about this morning?’
One of the women raised a hand and I nodded.
‘Dr Fenwick, can you give us some guidance on how to talk a mother through the delivery? I mean, there’s a lot of pain clearly,’ she said, looking around embarrassed, and I presumed this was because she’d not had a child of her own. ‘I’m gathering it’s up to us to get them through sometimes. What troubles me is that the women want to squat, not lie down.’
‘This is true, Jennifer. A most valid point too.’ I took them through the modern-day mild sedative pain relief we offered and about the new idea to use gas and air – not that it was available in India – but then moved step by step across what might be plausible for this ward, with mothers used to letting Nature take her own course. ‘Warm and cold flannels, back rubbing and good old moral support remain our best weapons against pain that simply can’t be avoided. Anyway, with Gamini due, we can tackle the topic more practically through her labour. Although it’s not a mathematical equation – her baby will come when it and her body decide it’s time.’
Jennifer nodded with enthusiasm.
‘I have to tell you that today’s preference – certainly in Britain – is to give birth in bed, to ensure ease of access to the mother and of course a presumed safer delivery of the child.’ My students didn’t look entirely convinced. ‘And I agree with your dubious looks. While we don’t have them here yet, I’ll explain the use of stirrups on tomorrow’s round. For the medical team it’s a wondrous boon, especially if we need to use forceps, or turn the child – that sort of thing. However, I’m not sure the mothers would agree. Several mothers we delivered for in London who had laboured in wards for their first child chose home births for subsequent births so they could allow gravity to be their greatest assistance, rather than being urged into a bed, legs wide apart, feet in stirrups and expected to push out a child.’ They nodded their agreement. ‘Please do not repeat this but I remain convinced that what is essentially pushing “uphill” can lead to lumbar strains, perineal tears and surgical involvement. But my instincts fly in the face of today’s general practices that doctors – male doctors,’ I qualified, and won smiles, ‘seem determined to follow. I have expressed my concern at the highest levels that the pressure of the full uterus during labour might present problems for the mother’s blood circulation. If the uterus presses on that all-important blood vessel, the vena cava – which permits what?’
‘Vital blood flow to the placenta,’ Yvonne answered.
‘Yes. If that flow is constricted I believe there could be a risk of compromising oxygen to the baby with the mother on her back and pushing so hard. Make that homework. Think on it. We’ll discuss tomorrow. Thank you all. Back to duties. Lily, can I have a word please?’
She followed me into my small office.
‘I’ve been thinking,’ I began, pouring a drink from the jug of regularly replenished safe water, ‘about the women who aren’t allowed to come to our outpatient clinic, or be confined in the hospital.’ I gave her the glass, which she accepted and turned to pour another. ‘Why don’t we go to them?’
Lily coughed as she swallowed from her first sip, smiling as she patted her chest. ‘Sorry.’ I’d startled her obviously and I drank, watching her.
‘Run a clinic outside the hospital?’
I put my glass down. ‘Why not? Me, you, Dip, a couple of the others . . . once a week? Husbands and male family members couldn’t possibly complain about an all-female team offering genuine medical help for their pregnant wives, sisters, nieces . . . surely? They could accompany them, and be sure it is only women who will see them undressed and in a fully enclosed tent.’
She drank some more; I knew it was to stall for time while she thought this through, so as I sat down and sighed, she sat opposite and turned her face upwards to the fan that stirred hot air around us, feigning a breeze but it felt more like hot breath. ‘You mean just for the Muslim community?’
‘I mean for every woman who needs our help. But if their faith demands all and only women, we’re ready for them.’
‘Well, over the last few years there have been lots of uprisings between Muslims and Hindus.’ She shook her head in the Indian way that had so many meanings I’d come to learn. ‘It was never like this. Suddenly, even the most trivial of quarrels can lead to riots and I know I’m generalising, Dr Fenwick, but it always seems to happen at festival time when passions are aroused. We have to be careful.’
‘But we’re not interested in any of that. We don’t take sides.’
She wobbled her head again, pondering the idea. ‘Of course it could work but they wouldn’t just come with questions regarding pregnancy, as you’d imagine. Once they know we’re available they’d ask us to look at their sores and boils, their broken limbs and twisted ankles, their running bellies or constipated bowels .
. . ’
I nodded, knowing instantly she was right in this presumption. ‘All right. Two choices, then. We either make it a general clinic and have to extend the service we offer, or —’ I paused as Lily shook her head.
‘The only other female, Dr Powers, is going home next month. I heard on the jungle telegraph that they’re replacing her with a male doctor, ex-military.’
I made a face of suffering. ‘How reliable is that information?’
She shrugged. ‘He knows Calcutta well; I think it’s going to happen.’
‘Right . . . ’ I bit my lip. ‘Then we stick to gynaecological issues and obstetrics. We have all the right people and we can save some lives, perhaps get some better practices happening in the villages.’
‘I suppose even if some of the other doctors offered a general clinic for the poor in the south of the city, you’d have more than enough work and could justify the special obstetrics clinic.’
‘So do you think the women of the Muslim faith will be allowed to see us?’
Lily looked uncertain but smiled. ‘We can only try and it’s a wonderful effort to help if you can get the idea off the ground. I’m all for it but we have to be very careful, Dr Fenwick. Forgive me for the caution but this is an extremely tricky area because we’re encroaching on faith.’
I rolled my eyes at her and felt badly about deriding a comment that was meant with the kindest of intentions.
‘I’m sorry. I’ve had that advice rammed at me so many times but it feels more like an excuse, as though it negates all responsibility towards these women.’
She looked immediately concerned. ‘Who else mentioned this, Dr Fenwick?’
I gave a groan. ‘Among others, the intolerable Professor Vickery.’
The Tea Gardens Page 14