by Juliette Fay
* * *
Deirdre met him at the bus station in Framingham. She was waiting in the drop-off/pickup area, idling Aunt Vivvy’s ancient but meticulously maintained Chevy Caprice Classic. He heaved his backpack into the back, got into the front seat, and took a deep breath, hoping the oxygenated blood would soothe his still-constricted veins.
Deirdre watched him for a moment, and then reached over to give him a brief hug. He responded a second late, as she was beginning to release him, making the gesture even more awkward than it normally would have been. Six years, he thought. I barely know her anymore.
“So, um . . .” She glanced around and spied his pack behind him. “That’s all you’ve got?”
“Yeah, that’s it.”
“Looks like the one you had in high school.”
“It is.” He sucked in another oxygen load and glanced over at her as she backed out of the waiting area. Her pale skin was sprinkled with freckles—Irish fairy dust, their mother used to call it. And fanning out from the corner of her eye was a tiny thread of a line. Crow’s-feet? How did his baby sister already have crow’s-feet? But she was thirty-two now, he remembered. She’d only been twenty-six the last time he’d seen her, after their brother Hugh died.
“Who’s at the house?” he asked.
“Viv’s there. Who knows where Kevin is—probably in the woods somewhere. School’s out next week, so there isn’t much homework going on.” She glanced at him, dropping her chin so her eyes peeked out over the tops of her sunglasses. Drama, he thought, here it comes. . . .
“And there’s George.” Her gaze returned to the road.
Would he take the bait? Hell, why not. “Who’s George?”
“Oh, you’ll see. Can’t miss her,” Deirdre said dryly. “Especially when she sniffs your crotch.”
He smiled—he couldn’t help it. Deirdre knew how to deliver a line.
“Good,” he countered. “Haven’t had a good crotch sniff in some time.”
“She’s thorough. You’ll be set for years to come.”
* * *
When they pulled into the driveway, he noticed the grass was long. And was that a dandelion? Was Viv laying off the chemicals? She usually spent the entire spring with a spray bottle of Roundup in hand, ready to spritz even the most delicate weed to kingdom come.
“What happened to Stevie?” he asked.
“She fired him. She said he was cutting it too long so he could come back more often.”
“Stevie? The guy would’ve cut it with nose hair trimmers if she’d asked him.”
“Yeah, I don’t know. Kevin cuts it now, but he can’t always get the mower started.”
When they walked up the wide steps to the front porch, a loud bark startled Sean. Deirdre didn’t flinch. “Shut your pie hole, you damn dog!” she yelled, turning the knob and shoving her shoulder against the door. The barking intensified. Deirdre heaved her shoulder against the door again and it popped open. The dog (if it could be called that—in the dim foyer, Sean could’ve sworn he was looking at a Shetland pony) stood on high alert, barking as if it were the last defense against masked intruders.
“Cripes, enough already!” Deirdre said, and the dog reduced its clamor to an annoyed growl. She turned to Sean. “Just stand there a minute till she decides if she’s going to take a chunk out of you.” The dog stalked forward and stretched its long black nose toward Sean’s hand. Then the nose jammed between Sean’s thighs so hard he yelped, swatting the dog away. The dog stepped back, apparently satisfied that Sean—or his crotch, at least—posed no immediate threat.
The swinging door from the kitchen let out its muted little screech, an ee-EEE sound that Sean would’ve recognized in any state of consciousness. It soon revealed Aunt Vivian, her wizened arm pressed against it as if she were pushing back the stone from a tomb. Once she’d gotten through, the dog lowered its tail and murmured a low whining plea for her attention.
“Shh, now,” she told the dog, her hand running over its back as it slid up beside her. “Deirdre, did you forget to feed this poor creature?”
“Auntie Vivvy,” she said, feigning patience. “Sean’s home.”
His aunt glanced over to him, and for a moment there was no look on her face at all, as if she were seeing a shrub or a bookshelf. Aunt Vivian wasn’t given to grand gestures of warmth, even by an orphan’s standards, but this seemed colder than usual. Then her eyes sharpened to reveal the relentless intelligence behind them. “Sean Patrick,” she said. “Has war broken out here in Belham? Some horrific act of God, perhaps? I must have missed it on the news.”
Sean smiled. “Thanks for sending the airfare, and your driver here to round me up.”
Aunt Vivvy’s gaze dropped to the worn backpack on the floor beside him. “Take that up to your room, please,” she said. “And I’d like you to cut the grass. Kevin has yet to prevail over the mower this week.”
* * *
The oak stairway rose to a landing halfway up the back wall of the house, then did a tidy about-face and continued in the opposite direction toward the front. At the top was an alcove with a cushioned window seat. A circular window looked out over the front yard; Sean remembered imagining that it was really a ship’s hatch. On the ship was his father, giving orders, bravely securing lines in a storm, or keeping a lookout for pirates. Sean knew the kind of pirates his father spoke of didn’t wear eye patches and striped shirts, but he’d often found it hard to adjust the picture in his mind. Once an imaginary pirate had a striped shirt, it was pretty hard to make him change his clothes.
To the right was Aunt Vivvy’s room, and no one but her ever went in that direction. Sean hauled the backpack down the hallway to the left, back aching with the effort. The first bedroom was Deirdre’s, the walls plastered with theater posters. Aunt Vivian had often chastised her about the wallboard being shot with thumbtack holes and said that “when the time came,” Deirdre herself would be the one to spackle all those marks. Apparently, in the thirty-one years she’d inhabited the room, the time had yet to come.
At the end of the hallway was the room that Hugh and Sean had shared until Sean left for college. It had bunk beds, but these had been un-bunked and placed next to each other when Hugh brought his pregnant girlfriend home to live. Her strict Filipino Catholic parents had disowned her, but as Hugh mentioned to Sean in that offhand way he had, “It really isn’t that big of a deal. They’ve been disowning her since she started smoking weed in the ninth grade. This just made it official.”
On the right side of the hallway was his parents’ room. It also had twin beds, because their mother couldn’t always remember that the man who tried to climb into bed with her at night was actually her husband. “Lila,” Sean could remember hearing his father plead when they lived in their old house, just the five of them. “It’s me. Jesussufferingchrist, it’s me!”
Now it appeared that Sean would occupy his parents’ former quarters. There was clearly a boy living in his and Hugh’s old room. Sean peeked in and saw the strewn clothes, the bed piled high with mismatched blankets, and the odd collection of items on the desk: an old cassette tape, a scratched compass, a short pair of scissors, and a blue plastic whistle.
Sean set his pack on the floor in his parents’ room and lay back on one of the beds, but his body didn’t seem to remember how to relax. What was he thinking, coming here? That static feeling he’d been having off and on for months came over him again. There was no guidance anymore, no reassurance that he was on the right path. In fact, he was pretty sure he was currently on no path at all. Maybe this had been the case all along.
He had the sensation of being observed, and for a moment it calmed him. This used to happen often—a feeling that there was a presence watching over him as he disinfected a wailing child’s suppurating gash or held a baby while his mother’s rape wounds were examined. Yes, this p
resence seemed to say, this is where you should be, doing exactly what you are doing.
That hadn’t happened to him in over a year, though, and after a moment he realized it didn’t feel as if he were being gazed upon lovingly. It felt like surveillance. He snapped his head up and looked around quickly. There in the doorway stood the dog, just staring at him.
CHAPTER 2
After twenty-four hours of travel, at least it felt good to lie flat. His back had been hurting for months, maybe longer, though he couldn’t really be certain. His days at the small hospital near Bukavu, Democratic Republic of Congo, had been filled with patients whose bodies were so battered that paying attention to his own discomfort seemed absurdly weak. Most of them were victims of brutal tribal warfare, women and children who were relatively lucky enough to have made it to the hospital before their wounds prevented them from walking.
Sean’s pain came and went. Sometimes he thought it was improving, and then a simple action—bending to lift an emaciated patient from her cot, perhaps—would bring it on with a vengeance. The sensation was like an unhitching of something that surely ought to have stayed connected, and then the compensatory clenching of the surrounding muscles to keep the unhitched pieces from separating altogether. He should have been able to evaluate exactly what was going wrong. But all he could do when it came over him was squeeze his eyes shut and mutter, “Jesussufferingchrist,” against clenched teeth.
It had gotten pretty bad toward the end of his time in Bukavu. It was a wonder he’d stayed so long. He supposed he’d been waiting for that time-to-move-on feeling that settled on him reliably every several years or so, but it never came.
Usually he would hear of something—military attacks on native Indians in Guatemala, for instance. He had gone there right out of nursing school and stayed for a few years, learning the dialect and suturing wounds, staying far enough away from the politics to be ignored.
And then he’d heard of a clinic in the Dominican Republic tending to the slaves of the sugar industry, with an infant mortality rate that rivaled that of the Dark Ages. From there he’d gone to Kenya. In 2001 there had been a devastating earthquake in India, and he had thought to go for a month or two and help out, but stayed for several years. Then the tsunami in the Indian Ocean hit, and there was such widespread need for medical care, it took him a few days to figure out which country to head for and which relief agency to offer himself to. He wrote Aunt Vivvy for travel funds to Sri Lanka. She never said no. She never said yes, either. She just wired the money without a word of interest in his plans or news from home.
Bukavu hadn’t been his first stint in Africa. The first had been in a little clinic outside of Bomete, Kenya. He’d loved it there. The staff had been great—hardworking and friendly—almost like a family. It was fourteen years ago, now, but Sean could still see it clearly. Lying there in his long-gone father’s bed, it was a relief to focus on the unambiguous past rather than on his throbbing back and undefined future. . . .
* * *
He’d only been in Kenya a month, so his Swahili was just slightly better than that of Dr. Yasmin Chaudhry, a newly arrived OB/GYN he was working with.
“She says she feels . . . full of air?” Sean struggled to translate.
“Does that mean she’s breathing well, or having trouble?” asked Dr. Chaudhry.
“Imevimba,” insisted the girl, and blew her cheeks up like small, coffee-colored balloons.
“Swollen!” said Sean.
“Bloody hell,” muttered Dr. Chaudhry. “Of course, she’s swollen. She looks about ten months pregnant.”
Slowly, Sean reached out and took the girl’s hand. In the six years since graduating from nursing school, he’d learned that no matter how good his intentions, a tall freckled white man was an oddity in developing countries, and sudden moves didn’t do anything to instill trust. He gently pressed his forefinger onto the back of her hand, creating a depression that took several moments to disappear. It was a sign of preeclampsia, a potentially deadly pregnancy complication that could only be remedied by delivery of the baby.
Dr. Chaudhry met his gaze. “Ah,” she said, nodding. “Check her blood pressure.”
It wasn’t only his patients Sean had to prove himself to. He stifled a smile, secretly enjoying the challenge of establishing credibility with a new medical team. It always made coming to a new place just that much more interesting.
The girl’s name was Amali, and she was kumi na sita, which was either sixteen or seventeen—the two numbers sounded alike, and Sean couldn’t remember which was which. It was enough to know she was quite young, though he’d treated pregnant twelve-year-olds in Guatemala and the Dominican Republic. This was Amali’s third pregnancy. She and her husband had traveled more than forty miles to the hospital on foot—she wearing a pair of battered bedroom slippers, the soles all but worn through, and he with no shoes at all.
“Your children?” said Sean. “Watoto?”
She shook her head and looked away.
Stillborn, he guessed. Sean had delivered as many dead babies as live ones. Most women didn’t come to a hospital unless something had gone terribly wrong, and by then it was often too late. Any small complication—even something as common as a breech birth—could trap the baby in the birth canal, causing death. Cervical necrosis could set in, sterilizing or even killing the bereaved mother. Sometimes Sean wondered which was worse. Children were often the only joy desperately poor women had—and the only thing they could offer a prospective husband, without which they lived in the double jeopardy of being female and having no protector.
Amali’s preeclampsia was confirmed by high blood pressure and a dipstick urine test indicating an overabundance of protein. Dr. Chaudhry ordered an induction, instructing Sean to manually strip Amali’s cervical membrane, and if that didn’t kick-start labor, to break the amniotic sac. She hurried off to see another patient, whose terrified screams reverberated throughout the curtained labor and delivery area. Amali’s eyes went wide with fear.
Oh, great, thought Sean. And now a white guy’s going to stick his hand in your vagina. Not quite the day you bargained for.
In halting Swahili, liberally mixed with English and an entire ballet of interpretive gesturing, Sean explained the plan to Amali. Her expressive face changed with every new piece of successfully transmitted information. Skepticism, mild disgust, deep concern as her eyes flicked toward the direction of the ward door, beyond which her husband waited.
He doesn’t have to know, Sean wanted to say. He’ll just be happy you’re alive.
Amali looked at him, her face pinched in anxiety. You really have to do this? she seemed to be saying with those enormous dark eyes. Seriously?
Sean took her hand and pressed his thumb into the bloated skin, showing her the dimple it made. “Mbaya,” he said. “Bad for you,” pointing to her, “and for the baby,” indicating her belly.
She gave the tiniest of nods, turned her head away, and parted her knees. Sean averted his own gaze to give the illusion of some small bit of privacy. As he slid gloved fingers toward her cervix he prayed silently, a habit he’d gotten into back in nursing school. For women he usually said a Hail Mary, but today he heard the Gloria in his head. Glory to God in the highest, and peace to His people on earth. He began the painful procedure of irritating her cervix into dilation. Lord God, heavenly King, almighty God and Father, we worship You, we give You thanks, we praise You for Your glory. . . . When he’d finished, he pulled the sheet back over her legs and left without a word, knowing eye contact would only compound her embarrassment.
He came back later to check on her and there were no contractions, so he talk-mimed the need to break the amniotic sac. This time he used what looked like his sister Deirdre’s plastic crochet hook. During his brief visit home a month before, she’d been crocheting a 1960s-era vest as a costume. He slid the amnio hook in
to Amali’s vagina. The image of Deirdre, whose main worry was whether she’d get the lead in her high school play, was weirdly incongruous as he broke the water of a girl of approximately the same age, who’d already buried two children. Lord God, Lamb of God, You take away the sin of the world: have mercy on us. . . .
* * *
The induction failed. Amali’s contractions were weak, and the hospital carried no Pitocin to chemically force them. Dr. Chaudhry looked tired, and Sean felt himself in that crystallized state of sleep deprivation where objects take on an added glimmer when they move. As they began the Cesarean section, the doctor’s face went into a fixed blank state, suggesting intense concentration . . . or that her mind had wandered far away from the understaffed, underequipped hospital on the outskirts of a small Kenyan town.
After anesthesia had been successfully applied, and just before the incision, Amali’s blood pressure skyrocketed, and she began to hyperventilate.
“Hold her still,” commanded Dr. Chaudhry.
Sean threw himself across the young girl’s heaving body and the scalpel was applied. He waited for the duckling squawk of a newborn and felt his own pulse race, adrenaline rushing into all the cracks of his fear. Two young lives would be lost or saved in these moments. And though he knew the final outcome was in God’s hands, he felt the rightness of his being there to help. In moments like these, Sean experienced a surge of gratitude for having been guided so clearly to his life’s work. And despite everything, he felt immensely lucky.
A baby girl was soon released from the confines of her mother’s body. After tending to the baby, Sean went out to tell the father, who had waited all night at the hospital door. The young man shook his hand vigorously and came in to see the baby while his wife was being stitched up in recovery. Slipping his newborn daughter into his shirt to keep her extra warm, he sang quietly to her. Sean had never seen an African father take such an active role in a baby’s care. Generally this was considered the sole province of women. He felt an unexpected hopefulness for the future of a baby with such a devoted father, despite their profound poverty.
