A Simple Charity

by Rosalind Lauer

  Meg leaned closer to the young mother and nodded with sympathy, though she didn’t speak. She believed Dr. Walters’s threat that he would throw her out of his OR if she uttered one more word, and at this point, she figured Terri was better off with a silent companion here during her cesarean than no friend at all.

  Four months ago, Terri and her husband, Blake, had come to Meg with a very specific birth plan. When her first child was born, the attending physician had insisted that Terri undergo an emergency C-section, and this time, for their second birth, the couple wanted to avoid a cesarean.

  “They call me a VBAC at the doctor’s office. As if I don’t even have a name. I’m just a problem to them because I don’t want a C-section,” Terri had told Meg when she had first met with the couple. “I don’t want the drugs or the incision. I don’t want to be incapacitated for days. I want our baby’s birth to be a beautiful experience for all of us.”

  Although many doctors would have insisted on a scheduled C-section for Terri, Dr. Taylor had reviewed her records and given his approval for her to try a home delivery with Meg as midwife.

  “Of course, there are risks,” Meg had told the couple. She had wanted them to know the facts and possibilities. But Terri and Blake had done their research, and they were passionate about making the birth process as natural as possible this time.

  Most of Terri’s pregnancy had gone well. She’d been two weeks away from her due date when she went into labor while her husband was away on a business trip.

  When Meg had arrived at Terri’s house, there had been a mood of joy and celebration that included Terri’s mother and young daughter.

  “Mom’s going to take care of Patsy, and Blake is getting on the next flight out of Denver,” Terri had told Meg. “Do you think you can convince this baby to stay put until her daddy gets back in town?”

  “I have many skills, but that’s not one of them,” Meg said with a smile.

  There was no stalling the delivery, and unfortunately, as Terri’s labor progressed, complications arose that made it necessary to transport her to the hospital. “I don’t think you’re going to need a C-section,” Meg had assured the young mother. “But we want to access the other technology that’s available—for your safety and the baby’s.”

  Although Terri had been disappointed, she had agreed. They had made the quick trip to the hospital, where the skilled maternity nurses had helped Meg get Terri settled in with everything she needed. Dr. Taylor was on his way, and Meg sent him a text with an updated status for their patient.

  For two hours, Terri’s room was a sea of calm in the storm of the busy Pittsburgh hospital. And then, Dr. Walters had penetrated the safe harbor, strutting into the room like an angry peacock.

  “Where’s her doctor?” he had demanded.

  “Dr. Taylor is on his way. But I’m a licensed midwife.”

  Walters scowled at her as if her credentials and experience were a ludicrous insult. “As chief resident on the floor, I am now responsible for this woman. Where’s her chart?”

  “Everything is under control,” Meg had said, keeping her voice low. She didn’t want to disturb Terri, who was breathing through a contraction.

  But Dr. Walters didn’t care. He demanded the notes, which Meg offered to let him review out in the hall. That seemed to infuriate him all the more. Then, when he saw that they were doing a vaginal delivery after cesarean, the doctor pushed past Meg and, without a word of introduction, began to examine Terri.

  “What’s going on?” Terri cried, peering at the doctor through eyes puffy with exhaustion.

  “Dr. Walters, please. Dr. Taylor is on his way, and until he arrives, we’re monitoring mother’s and baby’s heartbeats. It’s under control.”

  “Under whose control?” The edges of the doctor’s mouth turned down in a sneer. “Aren’t you the midwife who lost her license?”

  She opened her mouth to tell him that she had been cleared of all charges, that her license had never been revoked, simply suspended. That she was damned good at what she did. But any response right now would take precious peace and attention away from the laboring mother.

  “This woman needs a C-section now,” he insisted. He peeled off his gloves and crossed to the door. “Get her to the OR stat.”

  “Wait.” Meg held up her hands, keeping calm but firm. “That’s not what she wants, and I’m—”

  “You are not a physician with privileges here,” Walters interrupted. “And patients do not call the shots in this hospital.”

  “But patients have rights, and I’ve been working with Terri throughout her pregnancy.”

  The doctor made a note on Terri’s chart and strode out the door.

  Meg followed him. “Dr. Walters, please. We can give Terri what she wants … what she deserves … without risk to her or her baby.”

  “There are always risks,” he insisted. “It’s my job to minimize them.”

  “But—”

  “Why are you out here arguing with me when you should be with your patient? Go. Be a midwife. I’ll even let you in my OR if you promise to keep quiet.”

  Meg fought him politely, and when that didn’t work she asserted herself, stepping out of her comfort zone. But the doctor wouldn’t budge.

  Regrouping with Terri, Meg put in a desperate call to Dr. Taylor, who had scrubbed in for an emergency procedure across town. She tried to talk to another doctor in his practice and looked for support from the maternity nurses in the ward, but no one dared to cross Dr. Walters’s path. As one nurse put it, “When Walters is on duty, we walk on eggshells around here. One wrong step and you’re out.”

  When the aids came to wheel Terri into the OR, Meg had exhausted every resource. She and Terri were both crying, but Meg dashed away her tears, determined to remain calm and provide support to her patient, her friend.

  “I’m so cold,” Terri whimpered. She was shivering, maybe even a little bit in shock.

  Fortunately the anesthesiologist, a silver-haired woman whose kind eyes shone over her mask, seemed sympathetic. She leaned over Terri and took her temperature with the wand. “It’s almost over, honey,” she whispered. “You’ll forget all this and put it behind you.”

  That’s the problem, Meg thought. A forced cesarean was a trauma that was best dismissed, unlike the natural birth experience that could empower a mother. Western medicine had a long way to go to embrace the art of birth.

  Later, when Meg was alone in her apartment, she stepped into a hot shower and bawled like a baby. She cried for Terri, who had been robbed of a beautiful experience. She cried for Terri’s baby daughter, whose mother would not be allowed to hold her for the first forty-eight hours because she was on a morphine drip to alleviate the pain from her incisions. She cried for every mother giving birth at that hospital, being pushed through like widgets on a factory conveyor belt. There was a better way, and she knew it. Why wouldn’t the hospital administrators respect the organic stages and patterns of human birth?

  And she cried for herself … her own failures and disappointments. Her time with Jack had underlined the fact that she was alone here in Pittsburgh, alone and often lonely. How had her daily schedule devolved into a string of battles with hospital administrators? Right now she felt miles away from her purpose in life.

  When she stepped out of the shower and bundled up in a towel, her cell phone was buzzing on the bathroom counter. It was a text message from Jack, who knew what she was going through.

  No one is strong enough to bear her burdens alone. Lean on me. I’m off tomorrow and I got vacation time. Should I head your way?

  With a calming breath, she texted back: Yes, please.

  His answer made her smile. Look out, Pittsburgh.

  “I’m sorry, Meg,” Dr. Taylor said when she met him in his office the next day to go over the chart notes for Terri Fanelli’s case. “You know I would have done everything possible to respect the Fanellis’ birth plan.”

  “I know that.” Too antsy to sit,
she paced in front of Larry Taylor’s desk. Jack had counseled her over the phone, helping her to sort through the conflict calmly. Although she still had issues with Dr. Walters and his beaten staff, she felt no malice toward Larry Taylor. “You’re not to blame, Larry. It’s the administration at the hospital, stuck in the Stone Age.” She paused, circling the doctor’s desk and peering through the slatted blinds. “Actually, the Stone Age would be an improvement over their maternity practices. At least women were free to squat, and no one was cutting them open and pumping drugs into their veins.”

  Dr. Taylor sat back in his chair and drew in a deep breath. “The only thing I can say in defense of hospital protocol is that they have an extremely low mortality rate for mothers and newborns.”

  “But a high rate of C-sections,” Meg pointed out. “One of the highest in the country. How is it that you became affiliated with them, Larry?”

  “When I started practicing, they were the best game in town. And though doctors like Vic Walters may be lacking in bedside manner, most of the staff is well trained and conscientious. But old-school.”

  “Very old-school.” She thrust her hands deep into the pockets of her fleece jacket. “When I mentioned the patient bill of rights, this big vein popped in Dr. Walters’s neck.”

  “Sounds like you hit a tender spot.”

  She turned back to him and sighed. “Larry, I think I’m done here. The hospital rules are so restrictive, they might as well be handcuffing me. And after my showdown with Doc Walters, I’m probably barred from the facility, anyway.”

  “Not quite, but it’s becoming clear that our hospital is not a good match for your skills.”

  She plopped into the chair opposite his desk. “It’s a relief to hear it put into words. So, did they tell you I wasn’t welcome back?”

  “Not in so many words, but I’m under the gun for supporting a midwife. It’s not you they’re after as much as the notion of any midwives delivering babies in the hospital. I’ve spoken to the other doctors, even tried to call in a few favors, but they won’t be swayed. They’re holding strong on this. The other doctors don’t want midwives on staff.”

  With a deep breath, she leaned back in the chair. “So the hospital administration wants to end their affiliation with me.”

  He nodded. “You don’t fit in with their future plans for the hospital. As long as I back you, they won’t suspend your privileges, but you’ve already seen how difficult it can be to work in an environment where the staff is less than supportive.”

  “Yes, indeed. I learned that lesson at Terri Fanelli’s expense.”

  “Have you thought of starting a country practice?” he suggested.

  “I’ve delivered some babies in rural areas. Some farm folk and Amish people.” She had found the people to be cooperative, though the thought of being a country midwife brought her memory screeching back to that cold, icy night when everything had gone wrong. Relentlessly cold weather, impassable roads, uncooperative mother, and an innocent baby in distress.

  “Plenty of women in rural areas are grateful for the help of a midwife. Maybe you should move beyond the ’burbs.”

  “I can’t do it.”

  It was only when Larry looked up from his case notes that she realized she’d said it aloud. “Meg.” He put the pen down and flattened his palms on the paperwork. “You’re a capable, experienced midwife. Any woman would be fortunate to have you as a professional caregiver.”

  She frowned, still lost in the darkness of that winter night.

  “And while it’s good to learn from your mistakes, your actions in the Collier case were completely responsible, and the board agreed. You did nothing wrong.”

  She let out the breath she had been holding, and the shards of memory fell away. Larry was right. She had learned ways to free herself from regret and focus on the present, focus on the job that allowed her to nurture the rich, ripe cycles of new life.

  “I don’t know,” she said. “I don’t know where I belong. But it’s becoming eminently clear that Pittsburgh is not the place.” She thought of what Jack had said about the possibility that she might move to Halfway. At the time she had thought he was pushing things, but now she wondered if it was a real possibility. It would be nice to live close to Zoey and Tate, and she knew there was a need for licensed midwives in that area. To live in the same town as Jack … right now that seemed too good to be true.

  “Look …” Larry interrupted her thoughts. “You’re going on a break to deliver your sister’s baby. It might be a good time to put some feelers out. Check out other institutions. Research their attitudes and policies on home births.”

  It was a plan that made sense. “I’ll be staying in Lancaster County for a good six weeks. I’ll scope out the situation there.” She pushed out of the chair, tilting her head to the side. “I have to thank you for all you’ve done, Larry. You stuck by me, against all odds.”

  “Well, you’re trying to do a good thing. Someday, the rest of the medical community will see that.” When he came around the desk to shake her hand, she realized that he was a little thinner and grayer than when she had met him years ago, as a nursing student, and she felt a tender spot in her heart for the doctor who had supported her. “God bless you, Meg.”

  “Thanks, Doc. So long.” There was a sense of finality in their good-bye; Meg had a feeling she wouldn’t be back. There was a sad wisp of closure, but also a trembling anticipation of the future. She was at a turning point, a crossroads, and as Jack had emphasized, it was important to keep moving ahead.

  “Be the change that you wish to see in the world,” Jack told her as they shared green curry noodles in a Thai restaurant near her apartment. “That’s what Mahatma Gandhi said. And if that pearl of wisdom is too dusty for you, I’ve got a few others tucked up my sleeve.”

  She grinned over a mouthful of noodles. “You are never at a loss for words,” she told him. “But I get the point. I’ve always been proud of the fact that I’m a careful, cautious person. I never realized that my steady approach would make me so resistant to change.” It seemed that change was inevitable. Her position here was fizzling out, and there was opportunity in Halfway. Potential clients, her close sister, and Jack …

  “The sweet part of the deal is that you don’t have to make any big decisions right now. You’re going to be in Halfway for a while. You can give it a test drive, see how that goes before you close up shop here.”

  A stained-glass piece in the restaurant window came alive with a burst of sunlight, and Meg realized that the entire room, with its old wooden booths and fake ferns, seemed more vibrant and alive with Jack here. How did he manage that?

  Over the next two days, she saw the city in a new light. The mummies and gems at the Carnegie Museum were wondrous finds through Jack’s eyes. A little French bistro at Penn Place transported them to Paris, with soft light and music, buttery croissants, and a fireplace to chase off the winter night. They held hands under the table and talked about their childhood years, their old neighborhoods, their hopes, fears, and dreams. Her heart ached for the boy who had lost his parents so young, and yet, from Jack’s enthusiasm and joy in the moment, it was clear that his grandmother had raised him in an atmosphere of love and support. He was wise and impetuous, tough and sensitive; a study in contradictions that she hoped to spend a lifetime exploring. On Sunday morning, they shared the newspaper over waffles and fruit at Waffallonia. In the afternoon, they became part of a crowd of roaring fans at a riverside sports bar, where they cheered the Steelers on to victory.

  “I wish you didn’t have to leave,” she said as he pulled up in front of her apartment.

  “Me, too, but I need to drive back early tomorrow. My shift starts at three.”

  “Boo. I’ll be coming to Halfway in two weeks. But I guess this is good-bye for now.” As she looked up at him, a rush of emotion overwhelmed her. She reached for him and he pulled her into his arms.

  “I’m gonna miss you, Megs.” His kiss stole he
r breath away, igniting a flame of longing deep inside her. She wanted to stay in his arms … to never let go. When she was with Jack, Pittsburgh was a rich, hospitable city—not the ogre she had thought to be responsible for her sadness. Jack was the key. Wherever he went, that was where she wanted to be.

  She couldn’t get to Halfway soon enough.

  PART THREE

  Geh Lessa: Let It Be

  Blessed are the merciful:

  for they shall obtain mercy.

  —MATTHEW 5:7

  18

  DECEMBER

  Although Fanny had come to the hardware store for a roll of insulation, as she waited for Mr. Hennessey to fetch it from the storeroom she kept doubling back to a soft pair of men’s suede work gloves and thinking about Zed’s fine, skilled hands. Strong hands, with slender fingers but a good bit of meat on the palms. She had seen those hands lift heavy beams and rub sanding blocks over wood planks. Those hands had pulled her close to comfort her. They had lifted Tommy away from a bucket of nails and guided Will’s hand on the hammer. There was power and grace in those hands.

  Fanny blinked, trying to snap herself out of such a daydream. Zed had spent the past six months working at her place, so it seemed only right to thank him with a gift this time of year. She knew he would put these gloves to good use. If she bought them for him as a Christmas gift, would anyone think twice about that? Would it start tongues wagging?

  There was no denying that she had become attached to Zed over the past few months. Each morning when she came downstairs she looked forward to seeing him. He worked on the carriage house by himself Monday through Friday. In the afternoons, he let Will tag along and learn how to do carpentry and projects. How Will enjoyed doing a man’s work!

  An Amish plumber had donated his time to install the kitchen sink and bathroom fixtures. On Saturdays, groups of men had been coming out to help Zed, climbing over the lumber pile like ants on a log. They had finished the flooring and interior framing in two Saturdays, and now they were cutting and installing drywall. Such good work! At this rate, they would be finished before the New Year.