When she reappeared, the bellboy produced a box. ‘Perhaps these would suit?’
Inside the box was a pair of shoes in the lightest shade of tan; when she put them on she felt as if she was walking in bare feet across silk carpet. ‘You should be helping the ladies at Bergdorf’s instead of opening doors for them here,’ Evie said as she fastened the buckle.
‘But this position has greater advantages,’ the bellboy replied.
Evie wondered for a moment what those advantages were – the tips, she supposed, handed over in fistfuls for service above and beyond, service of the kind she was receiving now. Alas, she was not yet so much of a cynic that she could lead a man with such impeccable taste along in a lie. ‘You know I can’t give you any of those advantages,’ she said. ‘I trade in smiles, rather than dollar bills. And I’ve clean run out of those too.’
‘You look just like my sister. But when you came through the doors last night, I thought you were the saddest woman I’d ever seen.’ As he spoke, his expression showed a compassion beyond his years and Evie was touched, her heart lightening a little. ‘If my sister ever looked like that, I’d want someone to be kind to her. And you saved my job this morning. So I informed the manager about the problem with the elevator last night, and advised him that, considering you’d been trapped in there for some time, you’d been remarkably forgiving of the Plaza Hotel. In gratitude, the manager wishes you to know that last night’s accommodation is courtesy of the hotel, as are your next two nights,’ he finished, straight-faced.
Evie looked at him blankly. ‘Problem with the elevator?’
‘Yes, those elevators are always getting stuck with guests caught inside.’ A small grin escaped.
Evie couldn’t help but smile too. Where else but New York could a catastrophe also turn into something so fine? Three nights at the Plaza for free, all because of a bellboy’s quick thinking. It was just what she needed. ‘I’m Evie. And your sister is very lucky to have a brother like you.’
‘And I’m William Dunning. Please call down if you need anything else.’
‘I will.’
After he left, Evie knew she had to call Lil, who would be worried about her. She owed it to her friend, who’d always been there for Evie, to see if she’d found the happiness she deserved. Evie would just have to pretend that talking about love didn’t grind to dust what was left of her heart.
Lil must have been hovering by the phone on the landing because she answered after only a few rings. ‘Ordinarily, I’d be congratulating you for finding another bed to lie in for the night. But Tommy said you’d left last night without a word. So you weren’t with him, and you wouldn’t have been with any other man. Where are you?’
‘At the Plaza.’
Lil snorted with laughter. ‘And I’m Lillian Gish.’
‘You can telephone me here if you want to check.’
Lil was quiet. ‘So you’re at the Plaza. It’s more serious than I thought. What happened?’
‘He broke my heart.’
‘That doesn’t sound like Tommy.’
‘We both had an inflated idea of Tommy.’
‘But he doesn’t know what he’s supposed to have done wrong.’
‘Which makes it worse.’
Lil sighed. ‘He’ll come here looking for you. He’s that kind of guy.’
‘Tell him I don’t want to see him.’
‘Evie –’
‘Enough about me. How about you and Leo?’
‘We don’t have to talk about that.’
‘Yes we do.’
Lil’s giggle said it all. ‘It was simpatico. Better than anything. Who knew that the goods had been sitting right under my nose the whole time?’
Evie whacked a smile on her face. ‘I want to hear all about it. But I’ve got to get to the hospital. I’ll telephone later.’
Dressed, shod, and armed with two more nights on the house at the Plaza, Evie set off along Central Park South, past the horse-drawn cabs that still took those in search of romance for a ride through Manhattan’s verdant heart. Her luck was holding: Thomas wasn’t waiting at the college when she arrived. She had a lecture to attend, then she was due at the Vanderbilt Clinic. Her day and her head would be fully occupied. No time for any more thoughts of Thomas.
Evie went to her lecture, dutifully took notes, then realised she had half an hour to spare before she needed to make her way to the clinic. More empty time. To fill it, she decided to check on Mrs O’Rourke at the hospital, the one place on earth where – even if nobody else thought so – Evie knew she belonged.
She was walking into the ward when she heard Francis call her name.
‘Do you have another infection you’re too queasy to manage?’ she asked. ‘Oh no, that can’t be it, it’s not lunchtime. You only need me when I’m eating.’
‘I need some help,’ Francis said.
‘From me?’ Evie couldn’t quite believe it but he sounded nervous.
‘Kingsley’s out at a Medical Association lunch.’
‘I’m supposed to be at the clinic soon. Who’s rostered on today?’
‘Stevenson.’
‘Well, ask him. You can only boss me around when I’m actually working under you.’
‘Stevenson couldn’t help deliver a baby if it crawled out by itself. Things aren’t going well.’
Four words. Four words that none of the doctors had ever said to her before; they’d never diminish themselves by letting a woman know something was wrong. Evie took a proper look at Francis and saw that his face was dotted with sweat and his cheeks were red, like those of a child caught stealing.
‘I need to change,’ she said. She replaced the beautiful dress and shoes with something old and crumpled from her locker and was scrubbing her hands when Francis came to find her.
‘Hurry up,’ he said.
‘I haven’t scrubbed enough.’
‘You need to come now.’
Still expecting a mildly inflamed situation, perhaps a tired mother and a second stage that was taking too long, or a breech presentation, Evie walked over to see what all the fuss was about.
One look was sufficient for her to say, ‘There’s too much blood.’
‘I know.’
‘What happened?’
‘It’s a brow presentation. I attempted podalic version.’
Evie moved her stethoscope higher, lower, further around to the right, and heard a beat that was too slow. ‘You’ve carried out podalic version before?’
‘No.’
‘You’ve seen Kingsley do it?’
‘No.’
‘You’ve seen Manners do it?’
‘No.’ Francis looked helplessly at Evie. Even the nurses were looking at Evie, obviously having witnessed Francis’s bumbling and unwilling to trust him further.
Evie took a breath. She said as calmly as possible given that there was a stupefied woman lying on the delivery table and a situation that, based on what Evie could hear in the stethoscope and see in all its red glory on the bed, didn’t look good, ‘Tell me you know something more about brow presentations and podalic version than what you were taught in lectures.’
‘I don’t. But you’ve seen it, the nurse said.’
‘Once! That doesn’t make me an expert. I was standing by the wall with Kingsley’s head in the way, which is a bit like standing on top of this building and watching from behind a pillar while an ant carries a crumb down an anthole!’
‘It didn’t work. It’s still a brow presentation and it’s taking too long,’ he said pleadingly.
‘I can see that! You’ve given the mother too much scopolamine. She won’t be capable of doing any pushing.’
‘She was screaming.’
‘All women scream in labour. You’d scream if you had a football coming out of your anus. And knocking yourself out wouldn’t make it any easier to extract.’ Evie began to examine the patient. ‘It’s a face presentation, not brow. It must have rotated. But why is there so much blood?�
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All the risks of podalic version, where a doctor reached up past the cervix and grasped the baby’s foot to turn it into a more favourable position, were scribing themselves across Evie’s mind in white chalk, the key risk being uterine rupture and haemorrhage, which she hoped she wasn’t seeing now. The mother was too pale, or perhaps that was just in contrast to the blood, red as Bea’s oriental silk robe and just as shocking. Unaccountably, Francis seemed to be relaxing, as if the situation was more under control than the quantity of blood and the slow rate of the foetal heart would suggest.
‘I thought at first it was breech,’ he said.
‘That’s a mouth I’m feeling, not an anus. An ass like you ought to be able to tell the difference. This baby had better be posterior,’ Evie muttered as she palpated. ‘Damn!’ She turned to one of the nurses. ‘Send someone to wherever Kingsley’s having lunch and tell him to come back now. And get Matron. Check the mother’s vitals.’
‘Matron’s sick,’ the nurse replied. ‘Sister Veronica’s in charge today, but she’s been called over to the Vanderbilt Clinic. There’s a woman in labour over there.’
‘Of course there is,’ snapped Evie. ‘Everyone’s in labour at the wrong place and the wrong time today.’
‘Is it posterior?’ Francis asked hopefully.
‘No. And you should have known that before now.’
‘The baby descended more quickly than I expected.’
‘Yes, but what is it, her fifth baby? They fall out with one contraction. And you probably brought it down when you were attempting version. How is it possible for you to be an intern and not know this?’ Evie placed her hands on the bed and shook her head.
Her mind desperately flicked through the scribbled pages of her lecture notes. There was a chance they’d be lucky, that the baby would rotate and present anteriorly, which Evie might be able to manage. But how long should she wait? If the rotation had occurred as much as it was going to spontaneously and the baby was stuck facing the wrong way, the only option was a caesarean, which she couldn’t do, and nor could Francis without Kingsley present. But Kingsley wasn’t here and Francis was clearly incompetent. There was nobody else.
‘Wake the mother up. You got her into this, you can at least help get her out of it,’ Evie said.
‘What are you going to do?’ asked Francis. He was looking at Evie as if she was Jesus Christ and would perform the previously unheard-of miracle of final-year medical student delivering a baby presenting as left mentum posterior.
‘Check the baby again. Unless you’d prefer to?’
‘No. You seem to know what you’re doing.’ He began to try to rouse the mother.
Or at least I’m pretending to, thought Evie, as she felt once more into the birth canal and breathed a sigh of relief. The chin was securely in an anterior position. ‘We’re in business. I’m going to apply pressure to the brow while you deliver.’
‘Right,’ said Francis as he shifted back to the bottom of the bed.
‘You need to be quick. There’s barely a heartbeat.’
Francis cut the episiotomy, took up the forceps and placed them around the baby’s head. ‘The neck isn’t flexed enough. I can’t deliver the chin.’
‘You need to control the head. Hurry up!’
‘I’m trying!’ Francis’s head twitched to the right, a motion Evie could see was involuntary, as it happened again a few seconds later. His face was awash with sweat and, as far as Evie could tell, he wasn’t doing anything other than placing his hands on the forceps and hoping for the best.
Evie took out her stethoscope and listened again. ‘I can’t hear anything. We have to get it out.’
‘What do you think I’m trying to do?’ Francis retorted.
‘Pull harder! And on a different angle. You don’t want to hyperextend the neck. Raise the handles of the forceps higher!’
No reply from Francis. Evie watched the clock tick past the seconds: fifteen, thirty, then sixty seconds, and Evie could see no improvement in the position of the baby. Francis was pulling with more force now but the angle of the forceps looked wrong to her; all she could see was the baby’s neck extended to a degree that was dangerous. Then his head began to twitch in time with the second hand on the clock.
Evie lifted up the mother’s eyelids. Her pupils were dilated. Dead eyes, Evie thought. Why am I always haunted by eyes?
‘Move over.’ Unable to watch any longer, Evie butted Francis out of the way with her hip. She withdrew the forceps and placed her hands on the baby’s head firmly, guiding and controlling until she could get the chin out. That was all she had to do, because then the mouth, nose, eyes, brow, anterior fontanelle and finally the occiput would all follow. Downward traction first, she recalled, and thus she pulled.
Within two minutes she had the chin. ‘The baby’s coming! Help the mother!’ she shouted to Francis, but she realised he wasn’t looking at her. He was staring over her shoulder towards the door and Evie felt the sudden presence of Dr Kingsley in the room, but she couldn’t turn because she was delivering a baby.
Then it was out. Evie could see that there was extensive oedema of the trachea. The baby would need help to breathe. Its head was monstrously distended. There was a gush of blood – too much blood – and Evie knew that her fears had been well founded; the mother was haemorrhaging. Francis’s attempts at podalic version had hurt rather than helped.
‘Step back!’ Dr Kingsley shouted. Evie did as she was told, but only after she’d given the baby to the paediatrician, who’d arrived hot on the heels of Dr Kingsley, and urged him to check its airways.
There was a rush of hands to the mother. Now there were more doctors in the room than there had been for the past half hour – was it really only half an hour since Francis had called her name? Evie stood back against the wall in her accustomed position and watched as the mother bled all over the floor, and the baby stubbornly refused to allow a tube to be inserted into its bruised and swollen larynx.
Evie knew it would be her fault. She had been the one holding the baby when Dr Kingsley walked in.
And perhaps it was her fault. Who could say for certain that it was Francis who had caused the oedema, or that his ridiculous attempts at podalic version had caused the mother to haemorrhage? What if Evie had done something wrong? She’d been tired. Distracted. Upset. And she was only a medical student. She wasn’t supposed to be delivering babies who presented as anything other than routine.
‘The neck is broken,’ the paediatrician said.
Oh God. Evie could see Francis’s hands on the forceps, pulling on the wrong angle, attempting to shift the position of the head and instead breaking the baby’s neck. And her hands on the baby’s head. She had pulled too.
Instead of helping, Evie had been party to murder. At last Dr Kingsley had found something to blame Evie for.
The baby died. The mother died. Both things happened at the Sloane Hospital for Women from time to time, but mostly not together.
As soon as Evie heard, she ran. Down the stairs, outside, but then she didn’t know where to go. The college building was like a second home, so she went in there. In the west corridor, she hurried past the students’ reception room, and the study room where she spent large parts of her days when she wasn’t clerking at the hospital or the clinic. The osteology cabinet that she’d regarded with awe nearly three years before when she’d started summer school was still there, a little lending library of bones and skeletons. How she wished she could exchange the last fine grains of her heart to recapture the wonderment and promise of that day, when she’d thought that becoming an obstetrician was a glorious and useful thing, when she’d believed that Thomas Whitman was a good man.
She kept running, up to the second floor, past the college museum and on to the third floor. At last she reached the dissecting room on the top floor and she had to stop. There was nowhere left to go. She’d once thought this room was marvellous, a hundred and five feet long, with skylights flooding sunsh
ine onto the tables where the students worked. She remembered the first time she’d worked in the room; the body of a pauper woman was laid out in front of her and Evie had seen inside a womb, to that remarkable place where a child could grow. Now when she closed her eyes all she could see was the mother and baby she’d failed. They were sitting on the table before her, two angels, their white robes stained red with blood. They held out their hands to Evie and said, Why didn’t you help us? Evie opened her eyes and the ghostly manifestation of her guilt disappeared, but she knew it would be back again that night, in her dreams.
Her mind circled around the thought: was it Francis who’d pulled the baby’s head at the wrong angle or was it Evie? Regardless, nobody had survived. She deserved to be punished. She could run from Thomas and desperately push away the crushing sadness she felt whenever she thought of him, but she couldn’t run away from a mother and a child who’d been harmed in her hands. She set her shoulders, retraced her steps back down through the college, walked back to the hospital and knocked on Dr Brewer’s door.
‘Come in.’
Dr Kingsley was there, grim, unsmiling. Francis was there too. He didn’t meet Evie’s eye.
‘I’ll speak to Miss Lockhart alone, gentlemen,’ Dr Brewer said, his tone revealing nothing.
Dr Kingsley and Francis left without acknowledging her existence. She was worse than ignored. She was invisible.
‘Sit down,’ said Dr Brewer. ‘I’ve checked your roster. You were supposed to be at the Vanderbilt Clinic.’
‘I came to see Mrs O’Rourke.’
‘You were in the delivery room.’
‘Dr Sumner asked me to assist him. I thought it would be wrong to leave him on his own to deal with a difficult situation.’
‘He seems happy to leave you to deal with this difficult situation on your own.’ Dr Brewer reached for the crystal heart paperweight. ‘I bought this the first time I delivered a stillborn child,’ he said, matter-of-factly.
A Kiss From Mr Fitzgerald Page 23
