Arms Wide Open

by Patricia Harman

  “Thank you for reminding us,” Shona says. “When you aren’t here, it doesn’t feel the same.” This surprises me. Why wouldn’t it feel the same? Is it possible I bring something special to the group, something from the days when talking to trees and prayer were what you needed to get by?

  We rise and I send love through my hands . . . into these other hands . . . that will touch women . . . that will comfort . . . that will birth joy.

  Step by Step

  One wrong turn and twenty minutes circumnavigating in a wide circle and we’re back on 68, heading straight into the setting sun, toward central West Virginia. The Great Sleeping Bear of the Appalachians rises before us, then the mountains close around.

  Shona, Nicki, and I are each thinking our own thoughts as we come down the Allegheny Ridge, past the lights of the Hazelton federal prison, that place of heartache that reminds me of a fairy castle. A CD of women’s music plays low on the stereo and I’m trying to pick out the lyrics. Step by step we’re heading in the right direction, the vocalist sings. You can take this line in more than one way.

  I think of myself as a person of faith, but I sometimes wonder. So many things seem to be going wrong . . . First there’s the state of obstetrics. Somehow, in my simple mind, the warping of childbirth seems connected to what we’ve done to the earth.

  Then there’s the death of Ruby.

  And finally my marriage. Tom seems so far away. Fog closes around me.

  Step by step . . . the woman sings in her clear soprano. Step by step, the chorus repeats. Are we? Are we headed in the right direction?

  Renunciation

  It takes four to six weeks to get the results of an autopsy back. Four to six weeks if you’re lucky, sometimes lots longer. Not that there’s anything lucky about an autopsy . . .

  Tom and I are on our way home from Hueston Woods State Park, in Ohio, where we rented a cabin and spent a long-planned pre-Easter weekend with Orion and his family. We dyed eggs and had an Easter egg hunt with the grandkids. We fed tame deer, played on the swings, and went swimming in the indoor lodge pool. We tried to act normal but the gold of daffodils and the yellow of the forsythia meant nothing. Ruby’s death hangs over us.

  I’m almost asleep when Tom clears his throat and says into the dark car, “I got the autopsy report back Friday.”

  “You got it.” I sit straight up. “Why didn’t you say so?”

  “I didn’t want to spoil your weekend. I know how you get.”

  I’m not sure I’m grateful, but maybe he’s right. “Well . . .”

  “Ruby’s death was a clear overdose of narcotics. All the drugs in her body were meds I prescribed for her. She must have been stockpiling them. She had methadone and Lorcet in her bloodstream, two Duragesic patches on her arm and one in her mouth.”

  “In her mouth?” Somehow this shocks me more than the rest. “Why would she do that? Was she trying to kill herself?”

  “The pathologist doesn’t think so. There’s no suicide note and he says that it’s a method druggies use to get high. He’s seen it a lot in the tri-state area.”

  I reach over and put my hand on Tom’s leg. “Do you think it was because I wouldn’t give her more meds? . . . No, that doesn’t make sense . . . She had meds or got them somewhere . . . But she was five months pregnant! She had a tiny baby inside her and a nice boyfriend. He seemed nice, anyway. Maybe he partied with drugs, too.”

  I blink back my tears as we pass the gas refinery, the chimney belching blue flame. Ruby Tuesday wasn’t my friend. Sometimes I didn’t even like her. She was stubborn, childish, and self-centered, but she was also full of life. Now she’s gone.

  “I don’t understand . . . why would she do that?”

  “We’ll never know. Most likely an accident. She was probably using her meds to get high all along. Maybe she had pain too; I know when I did her surgeries she was full of endometriosis . . . You think a patient’s legit. You listen to her symptoms, respect her, try to help her, and this happens . . .” We drive in silence as we take the new bypass around Ohio University in Athens, then Tom speaks again.

  “I just can’t do it anymore, Pats. It’s been eating away at me until nothing’s left but a deep hole that I’m about to drop through. I’ve given all I can to the chronic-pelvic-pain patients. There are other women who need me. If I keep this up, I’ll leave medicine altogether.

  “At any rate, I’ve made a decision; I’m going to write all the doctors in town that I won’t give narcotics to patients anymore except right after their surgeries. I can’t be responsible for shit like this. People say I’m the go-to guy for narcotics? Well, the patients can find other go-to physicians, drive two hours to Pittsburgh or pester the ER docs, but it can’t be me.”

  Helping women with pelvic pain has been Tom’s specialty for the last fifteen years. Maybe he was naive when he started. Perhaps the physicians who refuse to give care to chronic-pain patients are right. You step into that role and something dark pulls you down. Narcotics are a tricky business, a godsend for many, a chain around the neck for others. Tom’s been concerned about the patients’ misuse of narcotics in the past, but I’ve never heard him talk like this before.

  “And next week, I’m also going to send all the chronic-pelvic-pain patients a registered letter saying that they should begin weaning off their narcotics or find another care provider who will prescribe them. I’ll see them all for another few months to give them time to get settled, but that’s it.”

  “You could do that?”

  “I will do that. They can come to us for routine gyn and other problems, but no more methadone or Oxycontin, Duragesic patches or Percocet. The women I feel worst about are the people like Cindy Carlton, the teacher. I feel bad for her and women like her who always use their meds as prescribed, never ask for more. It doesn’t seem fair, but if I’m going to get out of narcotic supervision, I can’t pick and choose. Let’s face it; we’ve been fooled before.”

  We ride the rest of the way in silence, down Route 50, across the bridge at Parkersburg, and then across Route 68.

  The moon is just setting when we pull down the drive. Four deer stand near the pear trees, now covered with blossoms. Tom stops the car, rolls down the window, and whistles once. “I could train these deer, I bet, if I whistled and threw them a pear.” He grins and his eyes crinkle at the corners. For a minute, I think I see my old friend again, but maybe not.

  Encounter

  It’s Saturday morning and Tom and I are biking up the trail along Ten Mile Creek. We don’t talk much about Ruby Tuesday. We’re both trying hard to get over her death, and the letters have gone out to the pelvic-pain patients. Below us, in the wooded ravine, the creek roars downhill over boulders as big as Rachel’s old cabin. As usual Tom rides on ahead, pedaling hard.

  Three vultures, circling low, catch my eye in a gap between the trees. Their wide fringed wings curl up at the ends, and they’re so close I can see the individual feathers. There are vultures over Hope Lake, too, not just a few as in other years but scores at any time, circling, floating on air currents.

  And it’s rained every day for a month. Sun in the morning, by afternoon the sky is full of towering thunderheads, puffy dark clouds that extend from the horizon halfway up the sky. I’ve never seen anything like them. It’s been so wet, I’ve had to replant the beans in the garden, twice. The seeds rot in the wet soil.

  My mind wanders to climate change, again. Global warming isn’t something we anticipated in the 1970s. We knew the black smoke bellowing out of the power plant down by Lake Superior was bad for our lungs, but never dreamed it could destroy our whole ecosystem.

  I pedal on, admiring the pink and white phlox that fringe the gravel bike path. This world of ours is so beautiful. I’m in love with the flowers, the cascading water, the infinite variety of insects and animals and birds. Each sea
son that comes and goes, I’m more aware of the colors, the light. I’m attached to every living thing and don’t want to lose them, the clouds too, even the ominous, magnificent, towering thunderheads.

  Movement catches my eye on the uphill side of the path and I stop my bike. Tom is long gone, halfway up the mountain, and it’s fine with me. I thought once he’d made the decision to give up the chronic-pelvic-pain program he might be his old self again, but most of the time silence stretches between us, and we’re just going through the motions of marriage. I step off my bike, stand very still, and crane my neck, expecting to see a fox or maybe a raccoon.

  On the rocky slope, between the dark trunks of trees, mostly fir and hemlocks with a few maple and oak, I focus on a shadow. Did it move? As my pupils adjust, I see two black eyes, close set and surrounded by very black fur, looking back at me. A bear stands on her hind legs not forty feet off the trail. What’s a bear doing here? They are usually far up in the mountains.

  “Hello,” I say in a shaky voice, trying to sound friendly. You don’t want to show fear at a time like this.

  The bear snuffs and scrapes her paw in the leaves. Is that a baby bear in the rocks behind her? The huge animal wags its head and snuffs again.

  I’m not sure if the snuff is a greeting or warning, but I can’t stay around to find out. Bears can run 30 to 40 mph when enraged. Cautiously, keeping my eyes on hers, I swing my leg over the bike.

  The bear wags its head then drops to all fours, poised to pursue. I put my right foot up on the pedal. The bear makes a whoosh noise . . . I step down, my legs shaking, and move out with my head low over the handlebars, hoping to catch up with Tom. I don’t look back, just push as hard as I can. It isn’t until I’m a mile up the hill that I stop to rest. When I turn around, my lungs burning, there’s no dark beast chasing after me, no friendly bear, or curious bear, or angry bear, just my fear.

  CHAPTER 15

  AKILAH

  “You don’t remember me, do you?”

  The auditorium of the convention center in Boston is filled with nurse-midwives, several thousand, I estimate. Like songbirds, they come in all varieties. Peacocks, dressed in expensive summer suits with peep-toe wedges. Cardinals, in long paisley skirts and Birkenstocks. Wrens, in jeans and running shoes. One woman sitting in front of me wears a pink T-shirt that reads on the back, WE HAVE A SECRET. IT’S NOT THAT BIRTH IS PAINFUL, BUT THAT WOMEN ARE STRONG.

  I sit toward the back of the huge hall, alone, at the annual conference of the American College of Nurse-Midwives. I wanted Tom to come, just for the experience, but he wasn’t up for it. None of the other midwives from West Virginia came either. They’re probably too busy delivering babies.

  The woman sitting next to me, who looks to be in her late thirties, dressed in slacks, with an embroidered wool vest and long dangling beaded earrings, smiles and asks again, “You don’t remember me do you? It’s been a long time. You delivered my first baby when I was fifteen. I’m Serena. Serena Holt.”

  I study the coffee-colored face and brown eyes. “Was this in Cleveland?” My first official paying job as a midwife was at Case Western University Hospital, where Tom did his ob-gyn residency.

  The session has ended and the auditorium empties. “Yes, at Case. I was a single fifteen-year-old mother and you took care of me in labor and then helped me give birth naturally. I have two kids now. The one you delivered just started college. The other is still in high school.”

  “I’m trying to remember. There have been thousands of births. Tell me something about your labor.”

  “Well, it was a long one. My water broke at 3:00 a.m. and I came to the hospital with my grandmother. My folks had all but disowned me. Kicked me out when I told them I was pregnant, called me a tramp. I was living with Gram, but she had to work. She’d just gotten on with the Board of Ed and couldn’t afford a day off. My water was leaking, but I wasn’t having hard contractions yet, still in latent phase.

  “You sat with me all day, a scared kid, all alone. You entertained me with stories of the hippie days and how you became a midwife. You told me about other young girls like me, who’d gone on to college and made something of themselves. I’ve always remembered this one thing you said . . . I often use the same words with my patients:

  “Labor is like playing cards. You don’t get to choose the hand you’re dealt. You just play the game the best you can . . . Life’s like that, too.

  “Anyway, once the contractions finally kicked in, I went fast. My grandmother made it back to the hospital and then my parents showed up. You wouldn’t let them in the birthing room until after the baby was born, said it would distract me, that I had to concentrate on getting my job done. The baby was posterior and my back hurt like hell, but you got me through.

  “That day changed my life. I named my little boy Akilah. It means ‘wise.’ You believed in me when no one else did, and here I am.” She dips her head and passes her hands in front of her body as if introducing someone rare and beautiful.

  “I finished high school, started community college, went into nursing, got my master’s degree, and became a nurse-midwife because of you. When I was an RN in labor and delivery at Case Western University Hospital, we nurses used to tell stories about you after you left, funny things you did with the patients. We called you the wisewoman.”

  “The wisewoman?” I almost choke. In many countries the title midwife means wisewoman, but I am a child staggering through life. I wipe the corner of my eye and give my fellow midwife a hug. Life is a journey and you never know whose life you may touch.

  Sacrament

  A crow calls from the top of a maple. I lie on my back feeling the moss on the huge flat boulder under my palms. I have been lost before, and come into these woods . . . I remember the song I wrote on the commune such a long time ago . . . to lay my burdens down.

  Tom and I are picnicking in the woods, in an empty campground, on the huge slab of sandstone surrounded by trillium at the state park. I open my eyes and catch my husband’s profile as he eats his cheese sandwich. Good appetite I see . . .

  He stares into the forest of hemlock spruce and a few hardwoods. The pink buds of mountain laurel are poised to unfold, and the forest smells of dirt and new growing things, but there is no celebration. We’ve been so estranged lately.

  Sadness festers like a purple bruise just below my breastbone. Ours was a shining, forever love; in my heart a holy golden circle of light . . . and now . . . the candle flickers, about to go out.

  I take a big breath . . . “Tom, what’s wrong? I thought maybe once you gave up the chronic-pelvic-pain program you’d feel better . . . but nothing’s really changed. There’s dead space between us . . .” I roll over and tentatively put my hand on his leg. He continues to wolf down his sandwich and then swigs from a bottle of water. It’s so quiet; I notice the wind in the top of the spruce trees.

  Finally he answers. “I’ve been really down. It’s everything. You want me to be the optimist, always cheerful and confident. You want me to buoy you up. When anything goes wrong, you expect me to hold it together . . . But I get tired of it.” He turns and pushes my long bangs off my forehead.

  I shake his fingers away. It’s true. I need him to tell me that all is well with the universe. That’s his job! I rely on him . . .

  “It started after I got a letter from a law firm in Charleston about Bobbie Boyd; remember her, the bleeder I had to take back to the OR and her husband was pissed? I had a feeling the family would sue. Now they’re saying she has lasting pain after surgery and the husband’s lost the comfort of ‘conjugal relations.’ It’s bullshit; she had pain when she first saw me, but the lawsuit isn’t going to disappear.”

  “Another medical-malpractice claim?” A ripple of dread goes through me. This isn’t the first time, but that only makes it worse.

  “I didn’t tell you about it bec
ause you get so freaked out. Anyway, it may have been anger about the lawsuit; I get so tired of this crap. You try your best to take care of patients and this is what you get . . . Or it could have been grief after losing my mom or hearing the other docs say I was the ‘go-to guy’ for narcotics, but I couldn’t shake a feeling of gloom, such a weight I could hardly push myself out of bed in the morning. And then there was Ruby . . .”

  I stare at my husband, a stranger despite his familiar face. He looks past me into the sky, where high cumulus clouds ride the wind.

  “It was easier to deal with my depression alone than to have my problems compounded by your anxiety . . .”

  I am stunned. Is this the same man I fell in love with, the same easygoing hippie bass player? And is this me he describes? The hyper, fearful, unsupportive wife, once a brave flower child?

  “I’m better now,” he goes on in a quiet, thoughtful voice. “Little by little . . . I never thought of myself as a person who could be so knocked off-kilter. I thought I was stronger. I thought I was immune . . .” He snorts a short laugh, “Shows you no one is . . .”

  I throw my arms around him, hold on tight, and bury my face in his shoulder. “Tom, don’t go away again.” My lover presses his forehead against mine and kisses me, his lips warm and familiar, then my tears come for real. “You are my touchstone, even when you’re unhappy. I don’t want to drive you away by being so anxious.”

  When he rolls on my body, there’s a buzzing in my abdomen, a buzzing like bees getting ready to swarm. The ground rises up, and we find a place far away from our troubles. The months of hurt roll back, like thunderclouds passing over the mountains. Storms will come again, I know this, but for now the sky clears and we are back under the Trillium Stone, skin to skin, heart to heart. In this place there is comfort and, in the end, light.

  Hold On

  A huge V of geese flies low over the water and lands on the bay. We’re in the side yard of our house on Pelee Island, our first trip of the season, to ready the cottage for renters. The tall lilac bushes along the property line are blooming, and their scent fills the air. No moon yet. One by one, stars come out in the violet sky, and Tom and I vie with each other to see the next one. We’ve been singing old peace songs around a campfire. Will every man ’neath his vine and fig tree live in peace and unafraid . . .