Astrid leaped to her feet. “Miriam, go to the hospital and make certain it is ready to receive casualties. I believe Corabell is the only one on tonight. I’ll go out to the Helders’ place. It sounds like they might need me.” She ran for the door, scooping up her bag.
Ingeborg called, “I’ll be right behind you. We’ll bring food and coffee for the fire fighters!”
Miriam watched in amazement. Everyone just sort of knew what had to be done and then did it. This small-town living was so different from city life!
Ingeborg, Kaaren, Sophie, Anji, and Ellie filled baskets with food, grabbed the coffeepot, and ran out the door.
Elizabeth stood up and waddled toward the door. She pointed toward the coat pegs. “Miriam, my coat, please. And get yours also.”
Miriam grabbed the coats and returned to her, holding Elizabeth’s for her, helping her slip into it. She shrugged into her own coat. They hurried out into the night.
The only buggy left was Andrew’s. In the light from the front window, Elizabeth climbed up over the wheel. “Untie the horse.”
Miriam did. She looped the lead line over a place on the harness as she had seen others do and climbed up the wheel. “This should prove interesting. I’ve not driven a horse before, ever.”
Elizabeth smiled. “I certainly have.” As Miriam settled in beside her, hanging on for dear life, Dr. Elizabeth flapped the reins and clucked. The horse lurched forward through the snow.
Driving out the lane was easy, for the other sleigh and wagon tracks had broken a path through the new snow. When Elizabeth left that path and continued toward the hospital, the buggy slowed down and the little horse struggled through knee-deep snow.
Blurred by falling snow, the sky out to the west beyond the horizon glowed faintly. The way the fires in town had looked was still fresh in Miriam’s memory, and that was not how this fire looked. This one was yellower, and you could not see the smoke. As Miriam’s eyes adjusted to the darkness, she could just make out lantern-lit sleighs or wagons in the middle distance driving toward the glowing spot.
“I’m afraid our winter will be very unpleasant compared to what you are used to.” Elizabeth was peering ahead, but how could she see? Snow swirled in the frigid wind and near darkness.
“When winter comes screaming off the lake in Chicago, you learn what unpleasant is.” Miriam was afraid she would lose her grip and tumble off. The buggy was bouncing a lot, and quite possibly had left the road without their knowing it.
They entered town and Elizabeth drew the horse alongside the hospital. Miriam hopped down. She ran to the horse’s head and held it as Elizabeth very slowly and clumsily got her feet over the side. She reached the ground, said “Oh!” and clutched her belly. She stood there for a moment, then slogged through the snow to the door. “Just leave the horse.”
Miriam left the tuckered-out horse to its own devices and ran ahead to open the door for Dr. Elizabeth. They hurried inside, slamming the door.
Welcome warmth embraced them.
“Make certain the ward and examination rooms are prepared. We can anticipate burns and smoke inhalation, possibly fractures.” Elizabeth headed for the first exam room.
Miriam ran to the nurses’ station. Where was Corabell? Dare she call loudly? She might disturb the few patients sleeping. She could not see from the records where Corabell might be, so she ran to the kitchen.
She was at the table, hunched over a cup of tea with a shawl thrown across her shoulders. She yelped and jumped when Miriam burst in the door.
“Come!” Miriam turned and ran back out. She scooped up extra gauze bandaging and dressings from the supply closet. Burns? They would need carbolic acid, plenty of it. She carried the additional supplies into the first examination room and stopped cold.
Dr. Elizabeth was hunched over the examination table moaning, both arms wrapped across her belly.
Miriam dumped her load on the side table, stepped in beside Elizabeth, and laid a hand on her shoulder. “Doctor?”
She was panting. Then she gave a long wailing cry. If people had been sleeping, they weren’t now. “Oh, God! No! Not now!” Another wail in spite of herself.
Miriam waved a hand. “Her feet!” She and Corabell gripped Elizabeth’s feet and levered her up onto the examination table. She instantly curled up on her side. Her face was grim and ghastly white.
“Her water just broke!” Corabell sounded frantic.
“We’ll undress her and wrap her in blankets.”
Easy to say, very difficult to do. Miriam so wanted to just cut the dress and petticoats off her, but these were her best holiday clothes. They must not damage them. It took what seemed a terribly long time. They tucked absorbent pads under her to soak up the blood about to be spilled.
Corabell still sounded frantic. “What if the baby is coming right now?”
“I heard her other pregnancy took many hours. So we have time yet. Dr. Astrid and Ingeborg will be here as soon as they can, and they’ll take over.”
“But what if they don’t?”
Miriam didn’t want to think about it. She should, however, gauge just how much dilation had occurred so far. She soaked her right hand thoroughly in carbolic acid and carefully began an examination. This was so strange, so frightening. This was her doctor, her instructor, and here was Miriam doing the examination. Cautiously she palpated, probing the cervix, and gasped. Elizabeth was opening right up! Five centimeters at least, perhaps more! Miriam’s four fingers barely spanned the cervix.
“Help me! Help!” The voice was a man’s, and it was out in the hallway.
Wide-eyed, Corabell looked at Miriam, then rushed out.
And Miriam was alone with a woman who was about to give birth, a woman who had very nearly died during her first pregnancy. And this was the one case of all Miriam would ever treat that she dare not mess up.
She set up the makeshift blocks that served as stirrups and guided Elizabeth’s heels onto them. Elizabeth screamed again, flailing her head. The contraction lasted much longer than normal.
Miriam grabbed Elizabeth’s hand in both of hers. “Please remember that God is in control. You know what Dr. Astrid and Ingeborg say. God knows the situation.” Many times Miriam had heard Astrid’s mother use that promise.
“Yes.” Elizabeth squeezed her hands and relaxed a little. Her face softened. “Yes. He is in control. It is so easy to forget that.”
God is in control. Oh, how I wish that were true! But Miriam could not accept that.
Not after so much suffering and loss.
He was vindictive, or He had a malicious sense of humor, or He was not there at all.
“I need Ingeborg! Astrid! Oh, God!” Elizabeth arched in another contraction.
“They said there are injuries. They’ll want to stay with the patient and get to the hospital quickly, so they will be here any moment.” Through snow. Of course. Any moment.
Was the baby coming? Miriam must check. She released Elizabeth’s hand and looked. Her heart nearly stopped! God in control? Hardly!
For a tiny foot had presented. A foot! One foot!
Miriam felt panic rush through her. She had read in a textbook about breech births, but she had never seen one, never been trained for one. And Elizabeth’s baby was not only very early, it was breech! She was going to lose them both!
Oh, God, please! Please exist! Please help!
“It’s coming! I can . . . Oh! O-o-o-ohh!” Elizabeth wailed, a long endless wail. Her body went so tight and rigid that her hips lifted off the table.
Miriam was quite slight, with very small, delicate hands. She knew she had to act through instinct. If she listened to reason, she would curl up in a corner sobbing. She shoved her right sleeve up to above her elbow. She snatched up a bottle of carbolic acid, the whole bottle, and poured it on her hand and arm, all the way to the elbow, slathering it all in disinfectant. Her arm tingled and burned.
Then she straightened her fingers, drew them together, and managed to follo
w that tiny leg up the birth canal to solid, ungiving bone. The foot disappeared inside. She could not be sure, but it felt as though the baby was pressing sideways against the floor of the pelvis. It was not going to go any farther without help.
She could not reach farther. She should not be this far, and yet . . . was this the other leg? She could not get above the ring of bone, nor should she. But if this was . . . A forever moment, a moment that was hours long, and by poking and prodding she could draw that second leg down. The baby was still positioned wrong, head up instead of down, feet first instead of head first, but both feet were now in the birth canal.
Elizabeth was not suffering contractions. This was one single endless contraction, exquisite pain that did not end, did not pause. She was bleeding freely now. Oh, if only Miriam could help her in her agony!
She did not dare tug on the baby either. She remembered being taught, “It is so tempting to try to help things along by pulling, but never ever do it.” She withdrew and washed her hand and arm in disinfectant again, in case she needed to go back.
The feet appeared. Now a new set of emergencies began. The baby in the birth canal, especially as it passed down through the pelvis, was pressing its cord flat. The baby and its cord did not both fit. No circulation and no air, when a baby normally would be able to reach air. What did the midwife do in that case? Miriam had no idea whatsoever.
The tiny buttocks appeared, but they were the narrowest part of the torso. They presented no problem. The shoulders did. The head certainly did.
Shoulders. She remembered something. Carefully she forced her hand in far enough to reach the baby’s armpit. Could she tilt the shoulder girdle so that one shoulder was higher than the other? Then it would fit better. Yes, it worked. She withdrew.
She grabbed another stack of absorbent pads off the side table and laid them nearby. They were going to need them.
The shoulders and one arm. Here was the other arm. And then the head slid out.
Elizabeth’s baby had arrived.
Instantly, Miriam gripped the tiny ankles and lifted the baby high. She must suction . . . where was the suction syringe? She had forgotten to lay it out! And she could not let go. She was about to scream for Corabell when the baby made a little sound.
She tapped the soles of the baby’s feet and began a gentle hum.
The baby cried. It was not a lusty wail that all welcomed. It was feeble, but it was a cry. The baby’s ribs heaved, and it cried louder. Yes! And the child was so petite. Of course newborns were always tiny, but this child was tinier than a newborn and scrawnier. And a boy.
Elizabeth was already bleeding heavily, and the placenta had not yet appeared.
Miriam laid the baby, head downward, across Elizabeth’s abdomen, up high, because she had to knead the lower area. She had seen Astrid do this. She should tie off the cord, but Elizabeth was bleeding. She kneaded. Her fingers tired and a pinky cramped up. She kneaded. Then a shadow fell across Elizabeth’s belly, and Dr. Astrid was there! She began kneading strongly.
Astrid was there! Thank God! Praise God!
Dr. Astrid said, “You keep kneading. Good. Do you see how I am using the heels of my hands? Good. Good!”
“The baby—”
“The mother comes first.”
Were they making some progress, or was that Miriam’s imagination? Elizabeth wailed again, and the placenta slipped out onto the table, a flaccid purple thing.
Here was Ingeborg! Praise God again! Ingeborg sang her own praise to God as she gently lifted the tiny baby away and took the placenta with her.
“Miriam, replace the pads. We want to know if the hemorrhage is slowing.”
Miriam slipped in fresh pads as she yanked the others away and tossed them under the table. Just stopping for that moment helped her pinky loosen up. She went back to kneading.
Astrid relaxed a bit. “I think we’re out of the woods.”
Now, what did that mean? No one in Chicago ever said “We’re out of the woods,” and Chicago certainly had more woods than Blessing ever did. The bleeding appeared to be slowing. Yes, it definitely was slowing. It seemed pretty much the normal bleeding expected.
The crisis was past. Elizabeth had slipped into a semiconscious state, and Astrid was taking over. Ingeborg, with the baby at the side table, had tied off the cord and was cutting it. Miriam realized she had also forgotten to set out the string and scissors. Even first-year nurses did better than that!
Her hands were bloody. She looked at her hands, her slim, tiny hands. She should be jubilant! It was over! Success! Rejoice! A baby boy was born.
Her face dropped forward, to be covered by her bloody hands, and she began to sob uncontrollably.
Chapter 35
I am having a hard time believing you delivered that baby by yourself. He came early and presented breech, yet you pushed on through.” The three of them were in Elizabeth’s room at the hospital, two days after that momentous Christmas Day. Astrid automatically checked Elizabeth’s pulse while they talked.
Miriam shook her head. “I am still in a state of shock. I panicked more than once, but like your mor always says, ‘God is in control.’ Up until I saw all this, I could not believe that He cared that much for us—for me. All I could see were the terrible things happening.”
While normal color had yet to return to Elizabeth’s face, and feeding her tiny son took all her strength, she reached out to take Miriam’s hand. “Without you and these small hands of yours, both of us would have died. God told you what to do, and you did it.”
“So an idea, a memory, can be God talking?”
“Yes. When we are His children, He communicates with us in more ways than you can ever dream.”
“Including dreams,” Astrid added. She glanced over to the baby bed, where little Roald lay on fleece and surrounded by hot water bottles, a light tent helping keep the heat in. Usually he was tucked in right next to his mother, but the doctor had ordered her to get some sleep without having to worry about the infant beside her.
Ingeborg tapped at the door. “Is this the gathering of the medical team?”
“Seems that way.” Astrid smiled at her mother. “Welcome.”
“I brought the baby a sling so that we can take turns carrying him next to our skin so he does not get a chill. And Elizabeth can rest better.” She laid the soft flannel sling on the bed and drew a jar of liquid from her basket. “Here is that compound the Metiz taught me about so many years ago. It helps make one stronger and seems to increase milk flow. I mixed it with honey and water. I have also been asking around for someone to wet-nurse him, if we need that.”
Astrid checked on Elizabeth, who had fallen sound asleep again. She nodded and motioned them all to leave the room, bringing the baby bed with them and gently closing the door behind them. “So, Mor, show us how this works, please.” She held up the flannel contraption.
“Come into the office, and I’ll show you.”
Within a few minutes the tiny infant was slung tight against her chest, and she buttoned up her sweater, since her waist no longer closed. “Skin to skin is the best, at least that’s what Metiz always said. I’d forgotten all about this until last night.”
“Don’t tell me you had a dream.” Miriam’s half shrug accompanied a smile. “So that leaves one’s hands free to do whatever needs to be done?”
“Ja, and see, it is working.” The baby had stopped the little whimpers of discontent at being moved around and seemed to be sleeping again.
Ingeborg patted the bulge of baby. “He already knows when he is hungry, a true Bjorklund for certain.” She gently swayed, a mother kind of natural motion.
“Miriam, let’s go check on the other patients, and Mor can sit in Elizabeth’s room on watch. Not that I think it might be needed, but I am taking no chances.”
They checked on the man in Room 1. He’d gone back into the burning barn to get the horses and cows out. A flaming plank fell on him. His son dragged him out. Several others wer
e treated and sent home.
When they had finished seeing to the patients on the ward and were back in the office, Miriam asked, “Do you really think this baby is six weeks or so premature?”
“Good question. Why do you ask?”
“He seems stronger than the tiny preemies I saw at the hospital in Chicago. I mean, he can nurse, and his cry is growing more lusty all the time.”
“That we miscalculated the day he was due is a very real possibility. His lungs sound good, and he is digesting his milk. I am in awe that they are both alive. I was so afraid . . .” She cleared her throat. “Elizabeth’s last recovery took months.”
“Inga?”
“Well, her too, but Elizabeth lost a couple of babies after that.”
“Oh, that is so hard on a mother. It happens a lot, doesn’t it?”
“Especially with mothers who lack nutrition and women who wear those horrible corsets. The babies have no room to grow.” Astrid shuddered. “I abhor fashions at times, so often worn at the expense of the baby or the mother’s health.”
“Dr. Morganstein often said the same thing when she spoke to the nursing students.” Miriam turned to leave when she was needed elsewhere.
Astrid picked up her pen and started working on the stack of charts, something that always got put off. Miriam had taken over much of that, and Deborah and Corabell managed the inventory and ordering of supplies. They had survived another crisis with the fire from the Helder farm and a surprise baby. What an unforgettable Christmas this had been.
I have to see Trygve. The thought zapped Miriam whenever she had a free moment. As soon as she had caught Vera and Deborah up on the status of all the patients at the changing of the shift, she shrugged into her coat. Mother and baby were doing well, considering what they had both been through. Ingeborg had stayed with them most of the day, since Emmy had spent the day with Inga while Freda and Manny were crating up another shipment of cheese. How the lives of the people of Blessing intertwined, leaving Miriam in a constant state of amazement.
I have to see Trygve. The thought kept time with her boots crunching the crusty snow on her way back to the boardinghouse. It wasn’t like him not to show up, but since all the nurses had been swapping shifts since they were so busy, and all the crews were working to finish the upper floor of the apartment building and to get one of the three houses ready to be lived in, she had to remind herself to be patient. But I have so much to tell him.
A Harvest of Hope Page 31
