Poor Your Soul

by Mira Ptacin

  Our guardian resident leads us back into the exam room where there is some muffled talk about an amniocentesis, something about a very long needle going into my belly to sample fluids and baby tissue. I put myself in the hands of the staff and go on autopilot.

  With my back on the examination table, I close my eyes. I see Michigan. I see Battle Creek, Leila Hospital, the facility where my father used to work before it closed down. The same hospital where I saw my brother for the very last time. The only hospital, really, where I’ve ever spent any time. When we were little, Dad used to drop Jules and Sabina and me off in the pimped-out doctors’ lounge before he made his rounds and tended to patients. At Leila, we got to watch TV, which was special because we never got to watch TV at home. For us, the hospital was an escape, almost like a Narnia. We’d do all the things we didn’t get to do at home: Julian would channel surf, Sabina would read People magazine, and I’d scavenge through the Folgers coffee stand, digging for packets of dry hot cocoa mix to pour down my throat. I wanted to eat the marshmallows. I wanted television and I wanted sugar. I was narrow-minded and indifferent, a combination worse than anything else in the world.

  Now, flat on my back with my eyes pinned tight and a needle in my belly, I wonder just what my father was doing and encountering in the hospital exam rooms, just what was going on down the hallways outside the doctors’ lounge while I gluttonously flipped through the television channels and pounded the sugar packets, thinking only of my desires. Am I still that narrow-minded girl? What have I done wrong to bring forth this situation when all I’ve been trying to do is make things right? Is karma finally making its rounds, or is this really just what Dr. Iglesias called it: a random genetic fluke?

  I squeeze Andrew’s earlobe, which will be like a rosary bead to me for the next two weeks. “How are we going to tell everyone?” I ask. “What are we going to do?”

  “I don’t know,” he finally admits.

  Nearly five hours later, a cab finally takes us home from the hospital. Completely defeated, we phone home and, on speakerphone, deliver the terrible news and the even more terrible choice ahead of us: do nothing and continue anyway or terminate. Andrew cries hard, then explains the chromosome lesson and the details of the options.

  My parents say they’re sorry. They cry a little bit, too, then I grab the phone and blurt out the baffling bit that Dr. Stein told me—“If you decide to do this, the baby will not feel a thing.” Then I ask my mother, “Why is it that we always begin to cherish things the minute they start to disappear?”

  ten

  Several years ago, I met this girl, Nicole Carpenter. Nicole used to go through the city of Battle Creek like a walking middle finger. She was seventeen years old, fought, smoked, dipped, drank, and skipped school. Junior year, she dropped out.

  Nicole wore sandy blonde cornrows that dropped to her waist and wrapped around her like seaweed. She’d sway her head side to side and fling those braids behind her shoulders, rake back the strays with two acrylic nails, then light up a Newport 100. And Nicole was exceptionally petite—at about four foot nine, she could’ve passed for an eleven-year-old.

  When she found out she was pregnant (at age sixteen), Nicole moved out of her parents’ place, picked up a job at Arby’s, and moved in with the guy she thought might be the father of her baby. (“I mean, shoot, he prolly is, that muthafucker. He the only one who didn’t wear a jimmy cap.”)

  My dad was Nicole’s doctor and had been since she was a little baby. He was in maybe his twenty-eighth year practicing as a family physician, performing everything from wart removal to severing umbilical cords, when Nicole resurfaced, dangling her legs over a paper-wrapped table and he walked into the exam room. That was the same year Dad stopped delivering babies for good, and Nicole was one of the last patients he worked with in the delivery room.

  Dad claims he was forced to stop delivering babies because the cost of malpractice insurance had gotten so high. But my mother didn’t believe him. Mom says she fast-forwarded the decision after he got paged in the middle of Midnight Mass for the tenth Christmas Eve in a row, which is the night before Dad’s birthday, and she gave him a talking to. But I think that Nicole, specifically Nicole’s pregnancy, had an effect on the verdict, too. The whole thing just seemed to deflate him.

  Being a doctor in such a small town, my dad was a bit of a celebrity. Folks had named their dogs after him (different variations of Phil, Philip, and Ptacin). There wasn’t a time he could zip in and out of Felpausch grocery without getting cornered by folks seeking minor medical attention, which could be particularly embarrassing when you were with him, and your hands were balancing items like Pepto-Bismol, toilet paper, tampons, or anything that revealed to the world that you, too, used the toilet. But my dad would take his time, put his hand on the shoulder of the ailing individual, lean in as if to whisper a secret, and say, “How can I help?” I guess that’s how I learned about patience—by watching him exhibit this untamed (or untainted) compassion. Dad has a Paul Bunyon-sized heart; my friends used to claim he was the Jesus reincarnate, but Mom says he’s just a big baby. For instance, late one night, back when he was a medical student at Georgetown, Dad got mugged while jogging through campus. He had no cash or money on him, or to his name, really, but invited the thief back to his “minimalist” apartment anyway, for some fruit and to write him a check. Dad said that if the guy was going to don a black mask and attempt a mugging, then he needed the hundred bucks more.

  Growing up, my family dinner conversations revolved around Dad’s work stories. With our chins resting on our hands and our elbows framing our dinner plates, we’d listen to him talk about our town, about our time and our people. I remember chewing on a square piece of pork tenderloin when he told us the tale about the obese man with maggots in the sores on his legs and feet, or the one about the surgeon who stitched up a guy after a vasectomy and forgot to remove the gauze.

  One night—I was about eighteen years old at the time—when we were all home for a Thanksgiving dinner, just shooting the breeze around the table, Nicole’s name came up. Mom said, “Phil, did you tell our girls about Nicole, your patient with dying baby?” She shook her head. “Such a tragedy.”

  Julian had been dead for a year, and Mom had recently retired. After Jules died, Mom kept working, maybe even went into overdrive, pouring all her emotions and anger and energy into her work. She worked herself to the bone, but at a certain point, she realized it was not good for her. Maybe it was good for her at first, but maybe it soon was good only for everyone else, and maybe that’s why she kept doing it. Mom said that she was doing her part to help support the family, but night after night, she’d have to watch her customers put their keys in the ignitions of their cars and drive home after they’d consumed a bottle of wine or more over the dinner she’d cooked them. After a certain point, she just couldn’t handle being so close to the drinking and driving. So, at the stroke of midnight on the very last day of 1999, my mother gathered her staff and her family around a large dining room table at RSVP and announced the news: she was putting her restaurant up for sale and was retiring.

  “Who’s Nicole?” I asked.

  Dad put down his silverware and blew out a long trail of breath. “Oh, Nicole,” he said without looking up. “She’s one of my patients.”

  “And is driving your Daddy down the wall,” Mom added.

  “It’s ‘up the wall,’” Sabina chimed.

  “Nicole’s been coming to my office since she was a little baby,” he said, “but I hadn’t seen her in years until she came in for a prenatal exam.”

  Mom interjected, “She thinks she’s Mary, Mother of God.”

  Dad sighed again. “Nicole’s a bit dramatic.”

  He told us that Nicole’s pregnancy was a rare and complicated one. That Nicole was born with something called Russell-Silver Syndrome, a rare chromosomal abnormality that causes someone to be very small and look m
uch younger than they are. When she came into my dad’s office for her first prenatal checkup, all fresh faced and pregnant, Dad sent her to a specialist for extra testing to see if Russell-Silver Syndrome would affect her fetus at all. Results proved that it would not, but something else blipped up in the tests. Nicole’s baby had anencephaly, a totally unrelated birth defect.

  Dad took the paper napkin off his lap, unfolded it, and laid it out over the kitchen table. “Anencephaly refers to the incomplete development of a fetus’s brain and spinal cord and their protective coverings.”

  He pulled a pen out of his pocket, one with a built-in laser pointer and the word Celebrex written up the side, and began sketching onto the cleaner side of the napkin: a line, a loop, a crescent.

  “It occurs when the neural tube, which is a precursor to the baby’s central nervous system”—the pen doubled back to complete a tulip, a pea pod, a tunnel—“fails to close. The tube is supposed to fold and close during the third or fourth week of pregnancy. And when it doesn’t, this means a failure of major parts of the brain, and a failure of the skull and scalp to form.”

  I leaned in for a closer look at Dad’s drawing. It looked like a roller coaster. “No brain? No shit?” I asked, and Sabina kicked me from under the table.

  “Infants born with anencephaly are usually blind, deaf, and unconscious.”

  “And what is fate to the babies?” Mom asked.

  “If Nicole’s baby is born, it will have already suffered serious brain damage . . . won’t be able to eat, not even breathe for long.”

  “Do they suffer, Dad?” I asked.

  He put down the pen and handed me the napkin. I folded it up four times and slid it under my plate. “It’s not a painful condition,” he said, “but it is inevitably fatal.”

  “Poor baby. Poor her soul. It is very sad,” Mom said, then joined Sabina, who was clearing the table. Dad pushed out his chair, and as he began to stand up, I stopped him.

  “Wait, what happened next? To the girl?” I asked.

  “The specialist explained all this to Nicole and recommended that she terminate the pregnancy.”

  “Then what?”

  “Dad works at a Catholic hospital, Mira. They don’t do abortions,” Sabina said. She had recently renounced her Catholicism, claiming the church was homophobic, sexist, and past its prime. I envied that she got to sleep in during church. Our family hadn’t really ever talked about the topic of abortion. Maybe it’s because it never really came up. Maybe it’s because we didn’t have much of an opinion about it—we were Catholic, but we were smart enough to know that everyone’s situation was different. It wasn’t wise to generalize or judge. But the general consensus was that abortions weren’t good, and Dad didn’t perform them. I always figured that I’d never have to make a decision like that, so I never really thought about it.

  “Nicole basically freaked out and drove straight back to my office.”

  “Screaming and crying like child,” Mom called from the sink.

  “Yes, screaming and crying and causing this huge commotion in the waiting room, demanding to see me.” He carried his plate to the sink. I followed him.

  “I pulled her into an exam room and tried to calm her down. Go get your dishes, please, Mira,” Dad said.

  I went to the table and returned with my plate. “Then what? Then what did you say to her?”

  “Well, we talked. I explained that it wasn’t her fault, that she didn’t cause this and couldn’t have prevented it. I just looked at her and said, ‘Nicole, there is just nothing you or I or anyone can do about this. There’s no surgery to do in the womb, no medicine you can take.’ I just told her, ‘Nicole, your baby just ain’t going to survive.’”

  Dad dropped a big spoon into the coffee beans, leveled off a scoop of decaf, tipped it into the coffeemaker, and pressed start. He walked over to Mom, who was loading bowls into the dishwasher, put his hands on her shoulders, kissed her forehead, and gently pushed her out of the kitchen. He handed Sabina a towel, rolled up his sleeves, and plunged a big pot into the kitchen sink.

  “I told Nicole that she could transfer medical facilities if she’d prefer to abort the fetus.”

  “So did she get, you know, what Beanie said?”

  Sabina threw a towel at me and told me to make myself useful.

  “She panicked and became frightened by the thought of an abortion,” Dad said. He folded his arms and leaned back against the ivory refrigerator door, which was checkered with magnets of our old school photos and Mom’s kitchen wisdom quotes. One magnet said: If Momma ain’t happy, ain’t nobody happy. One magnet had a cartoon of two makizushi rolls on it and read: Wake up, little sushi. One magnet framed an old family photo: the five of us wearing matching St. Philip Elementary School sweatshirts, rosy cheeks, huddled in a tripod. Julian was alive in that photo.

  “I remember Nicole sitting on the exam table, weeping. She said to me, ‘This was a spark that had no chance at life without my help, so if my child was meant to live for five minutes, it is going to live for five minutes.’”

  There was a moment of silence, which was quickly interrupted by the buzzing and scraping sound of Mom sliding the electric broom across the tile floor. I was taken aback by Nicole’s response. I found it gallant and noble. Suddenly, to me, she was brilliant and almost saintlike.

  “I agreed to ride it out with her,” Dad said in what sounded like a whisper, even over the vacuum.

  “Tell the girls about the board, Phil,” Mom said, plowing the vacuum past us.

  “What board? What happened?”

  “So we continued giving Nicole care—a lot of care—during her pregnancy. She was a bit . . . high maintenance. She’d come into the office several times unannounced, saying she felt movement, or that she was having a miscarriage. She called constantly. We were there for her around the clock. But at the same time, the hospital was struggling with the technicalities of the delivery. It was like this: the baby would die outside the womb, and in a purely medical sense, whether Nicole delivered at twelve weeks or forty weeks, the question was moot. But because of the Silver Syndrome, because Nicole was such a tiny person, she wouldn’t be able to deliver a normal-sized baby because it wouldn’t fit through the bones of her pelvis.”

  “So what could she do?”

  “She would have to have a Cesarean delivery, and for a woman of her size, this was a dangerous procedure.”

  The vacuuming stopped.

  “Dis was huge production. Nearly took over everyone’s lives. Daddy and de bishop had meetings during de week, during de time we are supposed to have dance class,” Mom said.

  “We formed an ethics committee. There was the director of the hospital, a lawyer, the Reverend Al Schipper, the hospital chaplain, and other doctors to determine how early Nicole could be induced without it being considered a termination of a pregnancy. We finally decided on a time, up to the very minute, of what was considered ‘natural.’”

  “Yeah, God’s way,” Sabina sighed.

  “So what happened?” I asked again.

  “The baby inside Nicole grew. She said she felt it kicking.”

  “What did she do?”

  “She dug in her heels and carried the baby through the pregnancy. She learned the sex of the baby. She bought maternity clothes and pink baby clothes. She named the baby. Even the nurses at the hospital knitted booties and made a baby quilt. She hired Reverend Schipper from the ethics committee to facilitate the funeral of the baby.”

  “And then?”

  “And then we induced her when it was the right time.”

  “And then?”

  “And then Nicole delivered her baby, vaginally.”

  “And then?”

  “And then after five hours, the baby girl died in Nicole’s arms.”

  “Poor her soul, indeed,” I agreed.

  A
few weeks after I learned about her, I met Nicole. I’m not sure why I did it, but I wanted to meet this person, this girl, this woman. I just had to get her story. I thought what she had done was selfless, heroic and brave. Here was this girl, raised with little money, not very educated, who put her fears aside and gave her baby all she could. I was enchanted. I had just turned eighteen. The year had taken my brother away and left me with so much confusion and grief, I thought Nicole might be carrying the kind of hope or answer or relief that I was looking for. I called her, told her I’d like to meet her, and she agreed. So one Saturday, I found Nicole in a booth at Home Spun Family Restaurant. I sat down across from her and ordered a coffee while she smoked feverishly.

  “You wanna see a picture of my little girl?”

  She slid the photo across the table, a 4 x 6 glossy with edges that were beginning to coil and curl toward the center, like a dried leaf. I continued to look at Nicole, afraid of what I might see.

  “That’s her. My li’l girl, Elizabeth,” Nicole said, and I looked down at the photo in front of me, which was upside down. Nicole leaned over and rotated it counterclockwise with her left hand, the hand holding a cigarette, to face me.

  The baby in the photo was dead. She was tiny, had a pink cap over her head, and looked like an old man. Not much different than any newborn—closed eyes and a pink complexion—but the baby was dead and I could tell. Nicole pulled a frilly scrapbook out of her purse and narrated the details of a few more photos: baby Elizabeth in a long, white, lace dress; Nicole’s parents embracing Nicole on the hospital bed; a cluster of smiling nurses; and a tiny white casket.

  “You should be proud of yourself,” I told her, but saying it didn’t feel the way I thought it would.

  She said she was. “I’m talkin’ to my parents again, and I might go back to school,” she said. “This was just a blessin’ in disguise, I guess.” And while she was talking and smoking, I was thinking to myself that she seemed a little too happy, a little too flippant. You’re smoking, I thought.