The Midwife of Hope River

by Patricia Harman

  Great, I think, as I run upstairs and pull my everyday gray-blue flowered housedress off the hook. Just when Bitsy leaves, I have an emergency. Luckily, Star, Moonlight, and the calf are out in the pasture, where they can graze and get water from the stream, and the chickens are locked in their pen. I grab the birth satchel and, as an afterthought, tie a bandanna over my head.

  “Please hurry, ma’am. Mr. Hart was in an awful state.”

  It’s going to be a rough ride.

  Kitty

  An hour later we pull up, in a cloud of dust, to an unpainted dogtrot farmhouse with two sections, a kitchen on one side and the living quarters on the other, separated by a central outdoor breezeway. Two white women wave frantically from the long shady porch. One is short and round, wearing a stained red-checked apron. The smaller of the two is crying and looks to be an albino: white hair, white skin, and pink eyes crying.

  “Come in. Come. Hurry!” the round lady cries. “Lord help us!”

  The scene in the bedroom is more terrible than I could have imagined. Blood is everywhere. It’s on the floor, on the bed, and all over the mother, who’s barely alive. There are actually bloody handprints on the poor woman’s swollen belly where someone has been trying to push the baby out. “Damnation,” I say under my breath and instantly regret it. Would Mrs. Kelly or Mrs. Potts talk like that? The two ladies who greeted me hover uselessly at the bedside. A third, gray-haired woman in a bloodstained green dress kneels next to the patient. Mr. Hart is nowhere to be seen.

  “You the midwife?” the senior of the three asks. I nod. “The baby is stuck, and it’s killing her. We tried, but we can’t get it out.”

  “Stuck. Stuck. Stuck,” the albino girl says, waving her hands in front of her face.

  I study the patient. Something is very wrong here. Her limp legs are two sizes too large and full of water under the skin. A small, hairy head is visible between her thighs, and she’s hemorrhaging. I could take time to check the fetal heartbeat, but what would that prove? The baby may already be dead, and if I don’t do something fast, the mother will die too.

  “Hold her legs back and open,” I command. The women all have tears running down their cheeks, but they do what I tell them. I rip open the birth bag and grab some gloves and the sterilized scissors. I’ve never before had to use them before, but this may be the time.

  “How long has she been paining?” I ask as I begin my examination, trying to figure out why the baby won’t come.

  “Three days,” the ladies answer in chorus. It’s like the vet told me: when times are hard, families don’t call him for their sick animals unless they’re on the verge of collapse . . . only this is someone’s wife, sister, or daughter.

  “Has she had children before?” I continue to take her history as I oil my gloved hand and slip it around the infant’s skull. There’s an ear just under the pubic bone. Now I understand. The small head is trying to come out turned sideways instead of facing the sacrum. With a tiny baby this sometimes happens. I try to turn it, but it’s wedged in tight.

  The round woman answers, “This is her first.”

  “Is it before her term?” I unwrap the scissors and make one quick snip. The patient’s green eyes snap open.

  “We think maybe a month early. She was due in the fall.”

  “How long’s she been pushing?”

  The trio look at one another, and the older woman guesses, “About four hours.” No wonder the patient is as limp as a wet noodle.

  “Okay, now, Mother.” I touch the patient’s face with the back of my bloody glove to get her attention, but she doesn’t react. “You must push. I’ve made more room for the baby. It’s stuck, but I think I can turn it if you push hard.”

  “What’s her name?” I ask the three attendants, indicating the woman in bed.

  “Kitty,” the albino offers.

  “Kitty, I’m Patience, the midwife. I know you’re tired, but if you give this your all, the delivery can be over in few minutes.” There’s no reaction. “Kitty!” I pinch her arm. The girl’s eyes fly open again. She’s not dead yet.

  “We need you to push. Here, we’re going to get you up in a squat. Just do what I tell you. It will help spread your pelvis.” With great effort the three assistants hoist Kitty upright. Then, with one hand on top of the uterus and one hand below, I push down and a small head pops out. It is about the size of a large apple, one of those commercial kinds at Bittman’s Grocery.

  My helpers ease the mother back on the bed, and the whole baby slides forth. I blow on the little girl’s belly, but there’s no reaction. I blow again. No grimace, no stretching of arms or gasp. Nothing. I try a few puffs into her nose and mouth, as I did with little William, but still no response. No heartbeat either under the frail chest. The limp body just hangs there between my hands.

  Now everyone is crying. Everyone but the mother, whose eyes roll back in her head as her body goes rigid. She stiffens her arms and screams.

  Maynard

  “Get the husband. Get Mr. Hart!” I command. The short round lady in the gingham apron runs for him. I lay the dead baby in the wooden cradle and try to get Kitty’s womb to ball up, but she’s shaking so hard I can’t keep my hands around it, and there’s no way I can get her to drink Mrs. Potts’s tincture.

  It isn’t until Kitty’s body grows limp that I’m able to check her pulse. By Mrs. Kelly’s watch, it’s 140 beats per minute, way too fast, weak, and trembly. When I pull the patient’s eye open and inspect the tissue in the crevice below, it’s almost white. Mrs. Potts told me to do this when I need to judge a woman’s stamina: dark red, her blood is rich; pale pink, the patient is weak. Kitty is way past weak.

  The grim lady in green begins to pull away the bloody sheets and swab them on the wet floor.

  “The baby’s dead, isn’t it?” the albino girl asks.

  “Yes, honey. I’m afraid she is. She’s gone to Heaven now.” I’m starting to sound like Grace Potts.

  “Here, Kitty.” I try again to get the exhausted mother to swallow some water mixed with the tincture, but she’s in some kind of coma and the green liquid dribbles down her chin.

  From the front of the house I hear the screen door slam open, heavy boots in the hall, and Mr. Hart runs in. “What? What’s happened? Is my wife dead?” I can see why he thinks this, but I know for a fact that her heart is still beating. Just to be sure, I take my wooden horned fetoscope and put it to her breast.

  “She’s not dead yet, sir. Kitty had a fit and then fell into a slumber. She’d already lost all this blood before I got here.” I don’t know how to say it nice, so I just say it. “The baby died. It was stuck in the birth canal too long.”

  Tears are streaming down the man’s lean, high-cheekboned face clear down to his whiskers. He kneels in the blood and shakes Kitty’s shoulder. “Wife! Wake up!”

  “She can’t wake up, Mr. Hart. She’s had a fit. She’s in a coma. We need to get her to a hospital.”

  “You know I don’t have any money! I would have taken her to the hospital two days ago if I had.” So you called me, I’m thinking. Called me too late, so that I could take the blame and the heartache.

  “Well, if we don’t get going, you won’t have a wife. Forget about the money.”

  “Dr. Blum’s gone,” the green dress reminds us. “Moved back to Virginia.”

  “Someone will help us if we show up at the hospital. That other doctor from Delmont or maybe a nurse. Does anyone have a vehicle, a truck? Maybe we should go right to Dr. Robinson, the colored doctor.”

  “No black sawbones is touching my woman!” Hart slashes out and swipes his wet face, wiping blood across his eyes.

  I bite my tongue, almost cutting it. What difference does the hue of the physician’s skin make? The mind has no color. Robinson would know what to do.

  “Dr. Robinson could give her medicine or put in an IV. Mr. Hart, your baby is dead because you didn’t go to the hospital before or call me sooner. Didn’t you notice your wif
e was swelling? Didn’t you know the baby was too early? Do you understand, if we get in an auto right now, your wife might still make it?” I repeat myself, but I’m getting nowhere.

  Hart stomps out of the room, followed by the woman in green. I know he’s distressed, but he has to listen!

  “Mr. Hart, please!” I run after him and pull on the sleeve of his neatly patched work shirt. “There must be some way to get to town. I’m telling you, your wife is very weak and ill. If she has another seizure, she may not make it.”

  Hart steps out on the porch, slams his fist into a porch pole, and groans.

  “Maynard, listen to her,” the older lady says. “Kitty needs help.”

  “Miss Patience!” someone in the house calls. I run back inside.

  The albino girl is holding her sister’s head, and the shakes and rigors have started again. We women gather round, holding Kitty’s limbs. The bed blossoms red under her buttocks like a begonia opening, and now she’s bleeding from her nose too.

  What is this? It’s like she’s shaking the life fluid out of her, and she’s not breathing either. If she doesn’t stop seizing, she’ll expire right now.

  For two, maybe three minutes, we hold Kitty while Mr. Hart stands expressionless at the bedroom door. I know he must have feelings, but he’s gone somewhere else, far from this horror, fishing down on the Hope River, maybe.

  In the end Kitty takes a big breath and swoons again. I feel for her pulse, but it’s too fast to count. She opens her eyes one last time, sees her husband in the doorway, reaches out to him, and dies. Her poor heart has stopped beating. All our hearts stop.

  Women’s Work

  “We need to clean this mess up before it brings in the flies,” I say out loud as a big one buzzes around my head. The birth smell is sweet and heavy, but this is something else. The blood smell is overwhelming. I almost gag but swallow hard and try not to think about it.

  “What’s your name, honey?” I ask the albino.

  “Birdy,” she answers. “Kitty is my sissie. She’s dead now, isn’t she? And the baby?” The girl blows her nose on the hem of her skirt. Birdy and Kitty, I think. The parents must have had a sense of humor.

  “I’m sorry. Yes, they’re both gone to Heaven now. Why don’t you sit and hold your sister’s head while we clean her up.” Birdy does what I say, lifts Kitty’s head into her lap and strokes her long hair, which I notice now is yellow-blond and straight like a Norwegian’s. She hums a little song under her breath and presses the dead woman’s eyes shut. One comes back open, but she closes it again.

  Where is Bitsy when I need her? I wonder again. How will I describe this scene to her? Maybe I shouldn’t. She might not want to come to births with me anymore.

  The lady in green, I learn, is Mr. Hart’s sister, Edna, who scrubs on her hands and knees without speaking. While she wrings out her rag in the galvanized bucket again and again, her tears drip into the crimson water. The short round woman, Charity Moon, is the wife of the neighbor who drove me to this hellhole.

  The other women cry while they work, but not me. My sobs are tamped down like clay at the bottom of a fence post hole. I’ve thought this before. Life is too hard. You are born, and you die . . . that’s the sum of it. In between you love someone or you don’t, and if you are lucky you leave behind someone who loves you.

  By the time we are done mopping up and sitting at the kitchen table with strong coffee in chipped cups, the sun is going down and Maynard comes back to the house with red eyes. He takes off his shirt at the sink and washes his face and his arms.

  “Will there be a service?” I ask.

  “Just something with neighbors and kin,” explains the aunt. “Kitty wouldn’t have wanted a big to-do, and we can’t afford to have her embalmed. We’ll have the reverend bury her here, the fellow from Clover Bottom. You’re welcome to come.”

  “I’ll try,” I say, knowing I probably won’t.

  “Thank you for coming.” Maynard turns to me. “I don’t have money to pay you.”

  “I know . . . it’s okay. I’m sorry I couldn’t do more.”

  “The neighbor man, Moon, will drive you home.” He goes back out the screened door, and I watch as he crosses to the barn, then leaves with a shovel over his shoulder. Is he going back to the fields? No, he’s starting Kitty’s grave. He needs to bend and sweat and curse. Dig a hole. Where will Mr. Hart sleep tonight? I wonder. Will he lie down beside his dead wife, take the lifeless baby that’s wrapped in a pink blanket and place it over his heart?

  Edna, his sister, watches him too. “There’s a family graveyard yonder, all our relations. This is Maynard’s second wife. The first is already up there, died of pneumonia three years ago. He’s not a bad man,” she explains. “He loved Kitty, just had too much pride to ask for charity care.”

  Before I leave, I go back to the bedroom one last time to say good-bye to the dead woman, who lies now on a faded rose quilt in a white nightdress. The floorboards are still stained red and always will be.

  34

  Thunder

  The ride home in the dark with Mr. Moon is cheerless. There’s still no rain, and the air is so thick, I can taste it. Twice I think I hear thunder, and once I see lightning out of the corner of my eye, but neither of us speaks or makes note of it.

  Clip-clopping along in the faint moonlight, the goldenrod and tall joe-pye weed in the roadside ditches look covered with frost, but it’s only thick dust laid down by the buggies and Model Ts. As we turn up Salt Lick, I break the silence.

  “Drop me at Daniel Hester’s, the vet. You know where that is? Another mile up ahead. He’ll drive me the rest of the way home.” I say this with sureness, but I’m only hoping. For all I know, Hester could be out casting the leg of a damaged hound or ministering to a sick mare.

  Bitsy won’t be home yet, if she comes in at all, and I can’t go to sleep twisted around the nightmare of this terrible delivery. Mr. Moon follows my instructions and leaves me at the vet’s mailbox, turning his cart around in the drive. We raise our hands in silent, sad salute.

  On the wooden bridge, the soft trickle of the creek below startles me. Considering the drought, I’m surprised it’s still running. From the barn, I hear metal grinding. Hester stands in the lantern light pedaling the grindstone, sharpening his garden tools. Suddenly I’m apprehensive. What am I doing here? What will I say?

  “A woman died today because I didn’t know how to save her”? “A mother and her baby died needlessly because her impoverished and prideful husband didn’t call me earlier”? “The world is a terrible and tragic place, too hard, too hard for Patience Murphy”?

  Thunder rolls over the mountains, and a breeze hisses through the dry willow leaves; then lighting flashes—for real this time. Though I should be grateful for any rain, it’s not a good time. If it starts to storm, I can’t change my mind and hike home over the mountain.

  The vet pauses in his work, and his silhouette steps into the amber light pouring like honey out of the barn’s double doors. “Hello!” he calls out, seeing my shadow advance across the yard. “Who’s there?”

  Tears are already running down my face, the first tears I’ve shed, now that the ordeal is over. I guess it’s over. It suddenly occurs to me, with a cold feeling right in my middle, that I could be charged for the mother’s and infant’s deaths and lose my midwifery certificate.

  “Patience, what’s wrong?” Hester’s wearing just his trousers and a white undershirt, the kind with no sleeves, and his arms shine with sweat. “Is it Moonlight? Is it Star? Is it Bitsy?” Even as the tears fall, this strikes me as typical, that he should ask about the animals first.

  “A patient died today. Kitty Hart,” I whisper. “It was bad. Bad. Blood all over, even coming out her nose, and then she seized up and died.” I know I must sound incoherent. He takes me in his arms, and the smell of him almost overwhelms me: earth, pine, vanilla.

  “Come in. Come in.” He leads me into the barn and makes me sit on a wooden benc
h.

  “Here.” From his back pocket he pulls out a silver flask. I’m not much of a drinker, but I take a big swig, almost choke, and then whip my head back and forth to shake out the fire. It’s strong stuff and not nearly as pleasant as a rum toddy or blackberry wine.

  Hester smiles at my reaction, but the smile drops away. Outside, the thunder rumbles closer and the branches of the weeping willows sweep back and forth.

  “Maynard Hart’s place?” he asks. “Broken-down farm over by Burnt Town?”

  I nod, taking a big breath, trying to get my emotions under control. He holds out the flat silver container again. This time the liquid goes down easier, just burns at the back of my throat.

  “I’d never met him or his wife before,” I explain. “A young woman, Kitty. The neighbor, a Mr. Moon, came riding fast up Wild Rose Road. Bitsy had just left for the mining camp, and I was alone.” I start to cry again, leaning over, holding my face in my hands, and he sits down beside me. Thunder again and then lighting. Wind slams the side of the sturdy wooden building.

  Remembering the terrible scene, I cry and cry, as if my tears could float Kitty Hart out of her deathbed, up and away down to the Hope River, where she’d be found alive lying in the damp grass nursing her newborn. Hester pats my back as though I’m a baby, humming a little tune under his breath, but I can’t stop blubbering and the sobs get louder, more out of control. He puts his arm around me again. It’s a cloudburst of emotion. I’m crying again not just for Kitty and her baby but for myself and my baby, for Lawrence and Ruben and my mother and Mrs. Kelly and all the times I’ve been alone and afraid with no one to help me.

  “So you arrived . . . ?” Hester asks, trying to get me to talk about what happened . . . anything to quiet the weeping. “I went there once to stitch up a mare. Beautiful horse. Got her leg tangled in some barbed wire. So you arrived and then?”

  I reach for the flask and swallow two more mouthfuls, then take a big breath. “It was the worst thing I’ve ever seen. When we pulled into the yard, two women were hollering from the dogtrot porch. ‘Hurry! Hurry!’ all hysterical. I ran into the bedroom, and there was blood all over the floor. All over the bed. A young lady lay there almost unconscious and hemorrhaging with the baby still trapped in the birth canal, a premature baby with dark hair, wedged sideways.” I describe how I got the baby out but it was stillborn and about the continuous bleeding that I couldn’t stop. I tell how Mr. Hart refused to go to the colored doctor and how the seizures came and then Kitty died.