“I have an anesthesia certificate from Walter Reed and I’ve done anesthesia for Dr. Blum.” I whip around and fly down the stairs. (He’s right! We don’t have time to discuss things.)
Within minutes, I’ve laid out Blum’s old surgical instruments, which fortunately were still wrapped in sterile cloth from a year ago. Patience is stretched out flat on the kitchen table and tied down with whatever we can find, apron strings, Daniel’s and Blum’s belts, and the long peach scarf that I wore to the ball.
It’s important that Patience not be able to move when she enters the excitable phase of the ether administration. I take a paper cone and sprinkle the anesthetic on it, not too much and not too little. This is familiar territory to me and I know how many drops from experience. Patience is still unconscious and still losing blood, not cupfuls, but in a slow trickle. There’s a trail of it down the stairs and across the oak floorboards.
Hester has scrubbed with soap and warm water from the reservoir on the side of the cookstove, and so has Dr. Blum, though god only knows what good he will be. Maybe Daniel plans to have him hold a retractor.
As soon as Patience is under, I nod to the doctors. Daniel stands with his scalpel above his wife’s belly and I can see that he really has no idea where to cut, side to side or up and down.
“On a woman you start midline about three inches above the umbilicus and go straight through for another three toward the pubis,” Blum shocks us with his unused voice, a rusty pulley in a well.
Daniel holds the scalpel out to him. “Please, man, I’m begging you. You do it. I know you can! Save my wife. Save our baby if it’s not too late.”
Patience moans and I give her a little more ether. “Daniel, cut! Or Blum! Someone cut now!” I command. “This baby can be out in five minutes.” It’s then that I see something I could never have imagined. Blum steps up and takes over. With one swift movement he slices through Patience’s pale skin.
“Scissors,” he commands, but I’m already holding them out. He snips through the abdominal muscles, then opens the tough peritoneum with his hands and the shiny pink womb lays exposed like a giant egg.
“Scalpel.” Delicately, he makes a hole in the uterus. More blood clots and fluid spurt out, spilling over the sheet and onto the floor. Blum enlarges the hole, then dips his right hand deep into the Patience’s body, feeling for the fetal head. He grapples this way and that, like a man digging for gold, but then changes course.
Daniel just stands there, but I’m already holding out a warmed baby blanket, waiting for an infant that I’m sure will be floppy, but pray will still be alive. Finally, Isaac gets ahold of the feet, delivers the infant as a breech, and plops the limp, bloody baby into my hands. It’s over in only four minutes.
34
Raggedy Ann
It’s funny how fast you can move if you have to. I hold the tiny infant against my chest and run for the parlor, where before we started the surgery I had built up the fire in the heater stove and laid a blanket and some supplies on the sofa. “Breathe, baby. Breathe.” I talk to the tiny girl as I scoot across the slippery kitchen floor. Not only is she depressed from the anesthetic, but also weak and pale from blood loss, like a balloon that’s lost air.
The first thing I do is place her on the flannel blanket, then I go to work. In the other room, I can hear Blum saying something to Daniel as he delivers the placenta and begins to quickly suture the uterus back together again.
I dry the infant and rub it all over. There’s a pulse, but no reaction to stimulation, no startle, no cry. She just lays there, floppy as a Raggedy Ann doll. “Come on, baby. You are not going to die. I’ve had enough death for one week!” I try Patience’s trick, the Breath of Life, and blow on the infant’s umbilicus. Still nothing!
Finally, I take the Asepto, suction her airway, and place my mouth over hers. Three quick, light puffs as Patience once showed me. Not too hard—you can damage the delicate lungs. Three puffs and then wait five seconds and then try again. Finally, the baby lets out a cry. I am so grateful I cry with her.
“Okay, little one! Okay, baby. Keep breathing.” I rub her thin skin all over with a dry towel as she turns from blue to pink, but her troubles aren’t over. When I stop stimulating her, she stops breathing.
Now I know what we have to do. Keep touching her. Keep talking to her. I don’t care how long it takes. I’ll sit up all night if I have to.
“Becky? The baby?” That’s Daniel calling from the kitchen, and I step back through the door.
“A little girl.” I move closer to watch the end of the surgery. “She had trouble getting started and looks about three pounds, but has good muscle tone, good reflexes, and good color. Now we just have to keep her warm and keep stimulating her so she won’t forget to breathe. How’s Patience?” As I talk I keep patting the bottom of the little bundle in my arms.
“Weak, but she’ll make it. Infection is what we’ll have to worry about.” The two doctors close Patience’s skin, their four hands working together like dancers who’ve danced this dance before, the curved needles swooping back and forth across the midwife’s alabaster body.
Dr. Hester clips the suture and holds the skin closed, Blum does the stitching, as slick and competent as I remember. Finally, they’re done. They cleanse the skin one more time, then lay on two layers of cotton wool.
“Here, Daniel. Why don’t you sit down by the stove and hold your baby? The anesthesia will be wearing off soon and we’ll have to control Patience’s pain with laudanum. Dr. Blum and I can finish the dressing.”
I look at Patience so still and white, but I’m already thinking about her recovery. We must get fluids into her as soon as possible and then good food, chicken broth, and liver. What she needs is blood, but blood transfusions are still experimental, and even if they were available there’s no hospital nearby that could give them.
Patience moans and flips her head back and forth. She twists her mouth around like she tastes something bad, but these are all good signs that she’s coming around.
“Patience, it’s Becky.” I place my hands on each side of her face. “You’re okay. You’re okay, my friend. You’re okay and so is the baby.”
Daniel comes over with the newborn in his arms and pushes a wooden chair in close so he can sit down. There are tears streaming down his face and I’ll admit, my face is wet too. He holds the baby a little higher, as the mother’s eyes flutter open. “Look, my love. We did it. It’s a miracle. She lives. Thank god! She lives.”
Circle of Prayer
The crisis is over, but now the hard work begins. The first night, the three of us, Daniel, Blum, and I, sit up together as if prayer could keep the baby and mother alive. First, we transfer Patience to the sofa while she’s still under the influence of the opium, and then we take turns rubbing cooking oil on the infant’s skin and keeping her warm. If ever she turns blue or stops breathing we double our efforts. Only once do I have to breathe for her as I did right after her birth.
As we hold our vigil, I watch Dr. Blum, still shocked at how he returned to himself when we needed him. He doesn’t say anything, just sits there, silent as usual, but he’s present, and when I hand him the baby so that I can catch a few winks he takes her gently and begins the massage.
A quarter of the midwife’s life fluid is on the bed upstairs and another quarter on the kitchen floor, so I’m determined not to let Patience lose any more and now I can be liberal with Mrs. Potts’s hemorrhage tincture. I thought maybe Dr. Blum would ask me what’s in it, but once the emergency was over he went back to his old silent self.
The main thing with Patience is to keep the uterus firm and to hydrate her. We start with the herbal mixture, blended with honey and warm water. Water. Water. Water. Tea and water. By morning she’s still weak but alive and we begin with warm milk. Daniel goes out in the hall and telephones the Reverend in Hazel Patch.
Right after breakfast, the troops arrive, first Preacher Miller, quiet and serious, and his wife, Mildred
, a bundle of energy. She throws off her long coat and rolls up the sleeves of her white blouse. She’s even brought her own flowered apron.
“Oh, my. Oh, my,” Mrs. Miller sighs. “You should have called us last night. We would have circled you with love the minute we heard. And Dr. Blum did the surgery? That’s what you said? Praise Jesus, our prayers are working. You know we hold him in the light every Sunday. Just think, not even a year ago he was like a child.” She’s all smiles and gives the doctor a hug. He smiles too, but just barely and doesn’t hug back.
“Now, honey, tell us what you want us to do. I can stay all day and all night, and there will be several others here as well. I suppose half of Liberty knows by now if the telephone operator is her usual self.”
I give her the worst job. “We are all so tired, can you clean up the blood?” Mrs. Miller doesn’t hesitate. While the preacher tends the stock and splits more firewood, she takes my red rubber gloves and a bucket of water and goes right to work, starting in the kitchen and then the stairs and then the Hesters’ bedroom. By evening you wouldn’t know that the tidy home had been the scene of a near tragedy.
“The baby?” Patience asks, and I know that she’s back. Then she notices Danny standing next to her, patting her hand. “Oh, Danny. Mama’s so glad to see you. I missed you.”
“Uncle Isaac gives me cookies.”
Dr. Blum rises from the rocker where he has been tenderly massaging the baby and holds her out to her mother, but when Patience reaches out, she drops back in pain.
“Don’t sit up yet,” I admonish. “Do you want to try to breastfeed? I can help you get started.”
“For sure!” Patience smiles, and it’s as if the sun has come out at the end of a long, rainy day.
February 28, 1935
When Patience abrupted, I was surprised I could still operate, but there wasn’t much choice. “Please!” Hester begged. “Save my wife. Save our baby!” What else could I do? There’s no way Daniel was able to do it. He was trembling all over and he didn’t even know where to cut. I’m an asshole, but not a total asshole.
Surgeons have an unspoken rule that we do not operate on our loved ones . . . or our enemies. Emotions run too strong, cloud our judgment, and make our hands unsteady.
On the morning Priscilla told me she wanted a divorce I had thirty minutes to cool down before I got to Martha Jefferson, but I used it, instead, to fuel the fire.
Who was this John Teeleman from Eli Lilly? Even his name enraged me.
Drug detail men came and went in the office, and my brother and I gave strict orders to the staff to let them stay only ten minutes. I imagined Teeleman as affable, always ready with a laugh or a funny story, calling me by my first name as if we were pals. “So what do you think of our new elixir, Isaac, have you had a chance to prescribe it?”
Okay, I’ll admit I was shaken to the core. My home and marriage had just exploded and lay in rubble at my feet. Was I really that bad of a husband?
Maybe I wasn’t much fun. She had me there. When I wasn’t practicing medicine, I was reading medical journals, playing solitaire, or sleeping, but a physician who works ten hours a day needs a little mindless relaxation, doesn’t he? He needs his sleep too. . . . Okay, I was a selfish jerk.
Priscilla used to beg me to go into Charlottesville, to eat at a nice restaurant or see a picture show, but I was too tired, too edgy. I craved peace and quiet. Maybe I deserved to be dumped, but still she couldn’t really mean it.
In the parking lot of the hospital, I pulled my collar up against the sleet, took a few deep breaths, and cut through the emergency room. A few minutes later, I walked into the OR as if all was routine.
Surgeons are trained to do this. Nothing must interfere with our concentration. Lives depend on it. If you can’t pull the curtain down on your personal feelings you don’t belong at the operating table.
35
Healing
Recovery has been slow, but this is not unexpected. Each person heals in his own way and in his own time. You can be supportive, but you can’t make it happen.
It’s more than one week since Patience delivered, and day by day she’s getting stronger. We don’t have to beg her to eat anymore; she knows what to do, and unlike before in the late months of her pregnancy, when she seemed to be fading away, she now has something to live for.
Patience is not allowed to do any work, not even to take care of Danny, only herself and the baby. Danny has had a few temper tantrums, but Blum handles them well, silently swooping the little boy over his shoulder and taking him out in yard.
The doctor has pretty much returned to his old silent self. He’s fixed up a swing in one of the willow trees, and I realize, by looking at the new leaves on the willow, that we have been in West Virginia for almost a year. The long weeping willow branches are budding with yellow and the trees are bright balls of sunlight.
Most days, Patience just lies on the sofa listening to the radio, though the news isn’t good. It’s mainly about the nationwide drought, the devastation of the Midwest by wind and dirt, and the rising unemployment rate, now 25 percent nationwide, much worse in West Virginia, though in rural areas we can at least live off the land.
Patience likes Will Rogers’s show out of Pittsburgh best. Will rambles on about politics and the common man, not quite a Red, but not a capitalist either. “The short memories of the American voters is what keeps our politicians in office,” he said, and it made Patience laugh so hard I thought she might bust her stitches. Even Dr. Blum smiled.
After our midday meal, Patience sometimes gives the baby to Daniel and sits at the piano playing old show tunes. (She once was a chorus girl on the stage in Chicago, though it’s hard to picture that now.) Then she goes upstairs, taking each step slowly, to nap with Danny and breastfeed the baby. No cooking. No cleaning. No gardening. No attending deliveries.
At first, because of the dehydration and blood loss, she had almost no milk, but she’s determined to nurse and always feeds first from her breasts to build up her supply. Afterward we give the baby a bottle of Borden’s canned formula mixed with Moonlight’s milk.
Hester is concerned about the dangers of the tuberculosis bacterium, even though our cows have been tested, and he insists that his baby will have only top milk, heated to one hundred forty-five degrees for thirty minutes and later stored in the Frigidaire as the USDA recommends.
I, on the other hand, am concerned about the dangers of postpartum infection and check Patience’s incision each day. She’s a setup for septicemia, but so far, so good. Some angel must be watching over her.
At first I was worried that Patience might slip into mother depression. I’ve seen this before after a difficult delivery or sometimes for no reason at all. It happened to the Hamlin girl in town, five years ago. She tried to slit her wrists in the bathtub. Fortunately, Dr. Blum was able to save her, but she had to be taken to the State Lunatic Asylum in Weston and may still be there.
On warm days, I assist Patience in going out and sitting in the sun on the porch. Despite all science has to offer, fresh air and sunshine are still the best medicine.
They named the baby Mira because she was a miracle.
Return to Work
Today I returned to my job at the CCC camp. I’d called Sheriff Hardman and asked him to leave word with Supervisor Milliken, via shortwave radio, that I wouldn’t be able to come in for two weeks because of a family emergency, but when I showed up, there was hell to pay.
“So nice of you to join us, Miss Myers,” Captain Wolfe greets me, standing with his hands on his hips on the porch of the administration building. “What was the big emergency? Your doctor have a serious relapse of muteness?” Boodean and Mrs. Ross pretend not to listen.
“Can we speak in private?” I head for the infirmary and close the door behind him.
“What is your problem?”
“What is yours? I stood up for you, helped you get this job, and then you leave for two weeks!”
“I sent a message through the sheriff that we had a medical emergency. What did you expect me to do? Leave a critically ill mother and premature baby? I figured Boodean could cope with minor problems and the doctor from Laurel would cover both camps the same way he did before I was hired.”
“Well, it wasn’t that easy. Dr. Crane quit ten days ago and went back to Ohio. It’s been a zoo around here. Four kids were almost killed in a truck accident and I’ve been going back and forth to the hospital in Torrington. I’ve been trying to help Private Boodean in the infirmary, doing my job and yours too. One night we had four men sleeping here. I had half a mind to come out and get you or just fire you right out, and I would have if I’d been in charge, but Milliken said to wait. There aren’t many other nurses in Union County.”
The captain can’t stop himself. He goes on and on. “You signed on for this job. You have responsibilities. In the middle of everything, we’ve had an outbreak of mumps in the camp. This place is a mess. Look around. Do you think Boodean and I were coping?”
He’s right. The place is a mess. Two extra cots crowd the small room, there’s a pile of clean linen on a chair, and a pile of dirty linen on the floor in the corner. Bottles of medication and gauze cover the desk.
We glare at each other, neither wanting to be the first to look away, and silence thickens the air. I’m eager to get to work and clean the place up, but not while Wolfe is still standing here. His face is red and I imagine mine is too, a far cry from the night he told me after the ball in Torrington that I looked so beautiful.
Finally, there’s a timid knock at the door.
The Reluctant Midwife Page 26
