After he’d scrubbed his hands, he performed the exam, noticing that Dora barely winced as he did so.
“The infant is too far up in the abdomen and isn’t descending,” he said. “When we have a case like this, there are a few options, none of which are ideal. The first is to use a pair of forceps to grab hold of the head and pull the child out. Miss Peterson, if you’ll look in the top of my bag, you’ll see the forceps there.”
She peered inside. “Are these what you mean?” she asked, holding them up.
“Exactly. That method is the least of the three evils, but it often means internal damage to the mother, and sometimes the child is injured as well.” Phillip used his forearm to scratch his nose, which had started to itch. Perhaps he was just delaying the next part of his unpleasant task, which was to tell Miss Peterson their two remaining options.
“If the baby were to become stuck in the birth canal, we would be forced to perform a craniotomy.”
“And what does that entail?”
He pressed his lips together. “Crushing the skull to enable it to be removed. This is necessary if the skull won’t pass through on its own or with forceps.”
Miss Peterson’s face became a shade paler, but she did not react in any other way. “You mentioned another alternative.”
“Yes. That’s to perform a surgery known as a Cesarean section, where the abdomen is cut open and the child removed. This procedure is risky because of the high likelihood of infection. I have no way to verify this information, but I have heard that in Paris over the last one hundred years, not one woman who has had this operation has survived, most dying from infection, but many from loss of blood.”
“But this isn’t Paris, and you’ve studied Dr. Lister’s techniques,” Miss Peterson reminded him. “Surely your process is more advanced.”
Phillip was impressed. “You remember the things we discussed while treating Tom White.”
She gave him an incredulous look. “Of course I remember. Assisting you with Tom’s care is what made me decide to become a nurse. So, Doctor, tell me. Can you treat Dora the same as you did Tom?”
Phillip shook his head. “I can apply the carbolic acid, certainly, but it’s not the same as using it on Tom’s leg. Putting it inside a woman’s body in such a way could cause devastating tissue damage from the inner layers to the outer layers of her organs and skin, and I don’t know enough about it at this point to make that kind of decision.”
“Then the forceps it is.” Miss Peterson handed him the instruments without any further discussion.
Phillip blinked at her rapid assessment. “How did you arrive at this course of action, Miss Peterson?”
She lifted one shoulder. “Both the craniotomy and the Cesarean section would be performed only as a last resort, and we haven’t tried everything else yet. The forceps are the least destructive, as far as I can tell from your description, so they would be the first thing to try.” She paused. “Come, Doctor, there’s no need to stare at me like that. I simply followed your own trail of logic and arrived at the proper conclusion. Now, I do believe we’re wasting time.”
Phillip was jolted back into motion by the quickness of her words. He took the forceps from her, then directed her to pull a bottle of ether and a handkerchief from his bag.
“Dora seems to be drifting in and out of consciousness, but we’ll use some anesthesia just in case. There’s no need for her to suffer if we can prevent it. Dribble some of the ether onto the handkerchief, then hold it over her nose and mouth. Don’t inhale any yourself, and be sure to hold it loosely so she can still breathe.”
Miss Peterson did as she was asked quickly and efficiently. Phillip waited a moment for Dora’s breathing to become more regular, then said, “Goody, would you please take Miss Peterson’s place at Dora’s head? I’d like to demonstrate the use of forceps to her.”
Goody moved into position, and Miss Peterson came to his side. “The trick is to place the forceps on either side of the baby’s head and to pull gently downward. The head is far enough up in the body that this will be a difficult task—first, I have to determine where the head is. I must tell you, Miss Peterson, that I generally only use the forceps when the head is farther down, but your logic prevailed, and I must try this first.”
She gave him a slight smile. “What happens next?”
Phillip took a deep breath. At moments like this, he wished he was more of a praying man and had some sort of understanding with the Almighty. Then, when the moment passed and he had moved on to another task, that desire faded. He supposed he was only a fair weather friend to God, and would have to give it more sincere effort for it to really count.
He felt for the baby’s head again, then inserted the forceps. If the child hadn’t shifted, he should be able to grasp it. Using only his sense of touch and his intuition, he guided the tool into place. It felt right, but he had no way of knowing for sure.
“Now, using a gentle but steady pressure, we bring the forceps down,” he said, hoping the professional tone of his voice hid the nerves he felt. He hoped beyond hope that Miss Peterson was right and this was the best choice. If it didn’t work, he would most likely have to perform a Cesarean, which could save the baby, but would most surely kill the mother.
Goody held her position, a stalwart anchor in the midst of this tense moment. Miss Peterson stood next to him, a towel in her hands, ready to take the baby as soon as it was withdrawn. Phillip pulled, and a moment later, out came the head. He released it from the forceps and delivered the baby with his hands, quickly examining the skull for any damage before handing the child over to Miss Peterson. He tied and snipped the umbilical cord, then turned his attention back to Dora. She hadn’t moved or made a sound. Perhaps the ether was doing its job, or perhaps she was slipping away.
“Remove the ether, please,” he asked, and Goody laid the handkerchief aside. The bleeding had increased, and he pushed another towel beneath his patient. If he couldn’t save this woman, he’d be leaving several children without a mother.
***
Jeanette wrapped the baby in the towel she held and then used the corner to wipe the little eyes. “It’s a girl,” she said because she’d heard no one else make the pronouncement.
“Dora mentioned that she liked the name Alice, if this was a daughter,” Goody said.
“I think Alice is a lovely name.” Jeanette carried the baby over by the window, where she could study her tiny features more closely. “Hello, Alice,” she crooned, admiring the pert nose and impossibly small fingers. She hated to think of the damage the forceps might have caused, but she could see no injury to the head aside from a little bit of scraping on the sides, but it was mild, and should soon heal. The baby was a nice pink color, and seemed to be breathing regularly. Of far greater concern was the mother.
Dr. Wayment worked feverishly for several minutes while Jeanette and Goody stood by. There didn’t seem to be anything they could do but offer their support, and so they waited vigil for whatever the outcome was to be. The bleeding continued to get worse and worse, and finally, he stepped back and let out a long breath. “She’s gone.”
Jeanette held the baby a little closer to her chest. “What do you suppose will happen to Alice?” she asked softly.
“I imagine her mother’s sister will take her,” Goody said. “Do you want to speak with the husband, Doctor, or would you rather I do it?”
Dr. Wayment didn’t answer. His eyes were fixed on Dora’s face, and Jeanette couldn’t even imagine what was going through his head. “I’ll do it,” he said after a long moment. “I’m the one who couldn’t save her. It’s my responsibility.”
“That’s ridiculous,” Goody said, placing both hands on her hips. “I watched you just now. There was no more to be done, not by you or anyone, and believe me, I’ve observed a great many doctors over the years. You’re not to hold yourself to blame for this.”
Dr. Wayment didn’t reply, but turned to the bucket of water that stood nearby a
nd washed as best as he could. Jeanette noticed that he had some blood on his cuffs. She supposed it couldn’t be helped, but it made everything so much more real. Then he stepped through the door, leaving it open. Jeanette was grateful for that. It had become unbearably hot in the house.
“Doctor, how is she?” She heard the husband’s voice drift in from outside. He must have been waiting just in the yard.
“Mr. Green, I never caught your first name,” Dr. Wayment replied. Jeanette moved over a little so she could see what was going on without obviously eavesdropping, even though that’s exactly what she was doing. She rocked back and forth with the baby, detesting this outcome, but so grateful Alice had survived.
“I’m Peter. Now please, Doc, tell me how she is.”
Dr. Wayment reached out and placed a hand on the man’s shoulder. “I’m sorry to tell you this, Peter, but she didn’t make it.”
Peter took a stumbling step, but caught himself. “And . . . and the baby?”
“You have a beautiful daughter. I’ll perform a more thorough exam in a moment, but from my first look, she seems to be healthy and strong.”
Peter shook his head, rocking back and forth much like Jeanette was doing with the baby. He seemed completely bewildered. “Dora’s gone?”
“She is, Peter. I’m sorry. She was bleeding internally, which made her weak, and her body just couldn’t go any further. Then the bleeding increased, and I did everything I could, but she couldn’t be saved.”
“I see.”
Dr. Wayment waited for a minute, but Peter said nothing else. “Would you like to see your daughter?”
“What? Oh, yes. My daughter. Please.”
Dr. Wayment took Peter by the elbow and supported him as he walked across the yard. Jeanette met them in the doorway and handed the father his child. He stared down at her with eyes that seemed vacant, but then he blinked and focused. Jeanette saw the moment when he realized and became aware. “Hello,” he whispered, a tear rolling down his cheek. “I’m your pa.”
Jeanette stepped back and allowed him a moment of privacy with his baby. Dr. Wayment was gathering up his instruments, and Goody had already tidied up Dora’s body as much as she could and was making a bundle of the linens that had been used.
“What will happen now?” Jeanette asked Goody in an undertone.
“I’ll go next door and speak with Dora’s sister. The undertaker will be sent for, and I’ll stop in to check on the baby a time or two.”
“That’s it? We’re finished?” Jeanette was surprised that there wasn’t more to be done. She felt useless, as though they hadn’t done any good here at all.
“We’re finished. There’s nothing more to do.” Goody tilted her head to the side and gave Jeanette a kind look. “You’ve got a good heart, young lady. But we can’t solve the ills of all the world—it’s impossible. We’ve done our part, and now family and friends will step in and do theirs. Meanwhile, we’ll go help someone else. This is how it’s meant to be. Now, why don’t you go assist Dr. Wayment while he examines the baby?” She nodded to the corner of the room.
Jeanette turned to see that the doctor had taken Alice and laid her on the bed. “Of course.”
“I’ll be back in a moment after I speak to the family.” Goody left, bustling through the doorway with a waddle that reminded Jeanette of a goose.
Dr. Wayment’s hands were gentle as he lifted the baby’s arms and then her legs, flexing them. “Her limbs seem to be well formed—I detect no abnormalities in her skeleton,” he said as Jeanette came up beside him. “Her reflexes also seem to be good—notice how she curls away when I tickle certain points along her body. I won’t be able to assess her vision or hearing today—those are tests I’ll perform in a couple of weeks, when she’s more reactive to the world around her. But for right now, she appears to be in perfect health.”
“Oh, I’m so glad.” Jeanette leaned over and stroked the baby’s soft head.
“Goody will give her a bath before she leaves, and it looks like Dora was well prepared with clothing.” Dr. Wayment nodded to a basket near the rocking chair, where some little nightclothes were draped over the top. Jeanette had never seen clothes so tiny. It almost seemed impossible that they would fit on any living creature.
Twenty minutes later, they climbed into the buggy and drove away. Dora’s sister had come straight over, and the baby had been bathed and dressed. Dr. Wayment held his shoulders straight and strong until they were out of sight of the home, and then he dropped them, and Jeanette wondered just how tired he was after the ordeal. A moment later, he guided the buggy down by the river, where he brought it to a stop in the shade of some leafy trees. They sat there for a long moment, staring at the water.
“You’ve just seen the ugly side of the medical profession,” Dr. Wayment said, his hoarse voice breaking the silence. “There are times when there’s nothing that can be done, even after you’ve tried everything you’ve done in the past or even just read about.”
“I also saw the beautiful side,” Jeanette said softly. “I saw a new life come into the world.”
“Thank God for that.” Dr. Wayment didn’t turn to look at her, but kept his eyes trained on the water. “Sometimes I dream of what the future will be like. Will there ever come a day when we’ll be able to see inside the human body and know what’s wrong with it? Will we have a broader assortment of medications? Will we have more precise instruments? When I look at all we’ve learned just in the last twenty years, I have to believe that we’ll only continue to make new discoveries and refine our techniques, but I confess, I’ve grown impatient with the wait. I want to know everything now.”
“Is it even possible to know everything now?” Jeanette asked, keeping her voice light. She sensed a great despair coming from the doctor, and wanted to help lift it. “I rather think the brain couldn’t hold it all.”
“Perhaps it can’t, but I’d certainly like to try.” Dr. Wayment finally turned and met her gaze. “What a dreadful first day this has been for you.”
“Parts of it, yes,” she answered honestly. “But I wouldn’t have missed it. You’ve no idea how much I’ve learned by watching you.”
“I haven’t done much,” he protested.
“You’ve done a great deal. You’ve demonstrated quality of character, and a depth of caring and commitment to your patients. I believe those are traits I should learn before I undertake any other sort of study, don’t you?”
“But you already have them in spades! You’re one of the most compassionate people I’ve ever met.” He seemed genuinely surprised. “You have nothing to learn from me on that score.”
“Then I suppose I am ready for my next lesson.” She smiled, and to her relief, he smiled in return. Perhaps he could be brought out of this melancholy after all. “I think you’d best change your clothes before you do anything else, though.” She nodded at his cuffs.
He looked at them as though seeing them for the first time. “You’re right. Let me take you back to the hotel, and I’ll go home and clean up. With any luck, no one else will need us for a while, and we’ll get some rest.”
As the horse trotted toward the Brody, Jeanette felt exhaustion take over her body. She had missed her dinner and her supper, and the emotions of the day were taking their toll. She stood on the porch and watched the buggy drive away, then turned and went inside. All she wanted was a quick bite of supper and her bed.
Abigail met her just inside the door. “You look worn clear through,” she said, wrapping her arm around her sister’s shoulders. “How did it go today?”
Jeanette tried to think of a word or a sentence that would sum up everything she’d seen and experienced. Telling Abigail everything would have to wait—her head was buzzing, and she knew she wouldn’t remember half the details. “It was more than I could have imagined,” she said at last. “Is there any food left?”
Abigail laughed. “Yes, I made sure to save you a plate. Come on.” She guided Jeanette into the kitchen,
which was a blessing—even though Jeanette knew every inch of this hotel by heart, at that moment, she most likely wouldn’t have been able to locate it. After eating, she climbed into her bed, her eyelids so heavy, she wondered if they had anvils tied to them.
Chapter Seven
Despite his exhaustion, Phillip woke at dawn the next day, his mind churning with thoughts. He took an hour before breakfast to update his patient charts, and then after eating, he pulled out his stationery and penned a letter to Frank Russell, a friend who worked at Woman’s Hospital in New York under Dr. J. Marion Sims. He began with the standard greetings, then launched into the reason for his letter.
I’ve just begun working with a bright young woman who wishes to train as a nurse. Yesterday was her first experience in the medical profession, and I believe she handled herself with grace and maturity. She has great potential. However, I find myself lacking as her teacher. I’ve never taken on a student before, and I know you have trained many. What advice could you offer me?
After folding the letter, Phillip leaned back in his chair and steepled his fingers. He was deep in thought when Mrs. Hadley came bustling in, carrying a tray. “I wondered if you could use more coffee,” she said. “You had such a trying day yesterday.”
“Thank you, Mrs. Hadley.” He took a sip. “What do you think of Miss Peterson?”
“I like her quite a lot. How did she do her first time out?”
“Remarkably well, considering the circumstances.” He took another sip and then set down his cup. “I find myself confused by her, though. She won’t say anything about her family or where she lived before she came here. Whenever I ask a question, she gives me a vague answer and then changes the subject as quickly as she can. I feel she’s hiding something.”
“You don’t mean she’s escaping the law, do you?” Mrs. Hadley’s eyes grew wide. “She’s rather young to be a criminal, isn’t she?”
Phillip smiled and shook his head. “Mrs. Hadley, you’ve been reading too many exciting stories lately. I only mean that she has secrets, things she doesn’t want me to know. She doesn’t strike me as a bad sort—in fact, far from it. I’m just not sure why she won’t answer my questions. I haven’t asked anything too personal or inappropriate—at least, I don’t think I have.”
The Dark and the Dawn (Kansas Crossroads Book 3) Page 7
