The Reluctant Midwife Read online

  The young blind woman amazes me. “Did B.K. see me out the window, skidding around?”

  “No, I heard you.”

  “You heard me while you were pushing the baby out? Weren’t you screaming?” Here she laughs.

  “No, I was singing right up until the end and then I gave a grunt and B.K. caught the baby . . . Well, not exactly caught, but supported it as it slid out on the bed.”

  “I helped too,” announces Little B.K.

  “What did you do?” I ask, just to be polite. Really, I’m horrified. The end result is apparently fine, but anything could have happened.

  “I got the blanket and helped Pa wrap him up. There’s still a cord on him, though. Ma said we couldn’t take it off ’til you came.” Here he turns to his mother. “What we gonna call him, Ma? He has red hair, but it can’t be B.K! Not B.K. That’s already taken.”

  “Well, at least there’s something for me to do. I can trim the cord,” I tell them.

  “Can I help?” asks Little B.K.

  “I guess . . .” This is a request I’ve never confronted before.

  I gently take the newborn out of Lilly’s arms, but not before the mother kisses him three times, then I weigh him with Patience’s hanging scale, assist Little B.K. to cut the rubbery blue cord with sterile scissors, and do my newborn exam.

  The baby is perfect in every way, but one. He has webbed toes. I don’t know how to tell the parents. They will surely be upset, so I put it off until later.

  “You are to do nothing to the cord,” I tell them, “except to change the dressing. It will fall off on its own in about two weeks.”

  “What about the afterbirth?” B.K. asks. “Shouldn’t it be coming?”

  “Yes, anytime now, yes.” I shiver inside. The fact is, I was so concerned about missing the birth, I’d forgotten the placenta and thought my job was done. Patience told me the third stage of labor is dangerous for the mother, and here I am gabbing away.

  “Are you feeling any afterbirth pains yet, Lilly?”

  The blind woman pulls down the sheet, pulls up her nightgown and rubs her lower abdomen. There’s very little blood on the bed, so I don’t think the placenta has separated.

  “Can’t you pull it out? I feel so sweaty, I’d like to get up and wash.” She pulls her damp curls away from her face.

  Lordy! Fifteen minutes after giving birth and she wants to bathe? “No, we should wait. It won’t be long.” B.K. sits in the rocker singing to his older son, his long, thin legs up on the bed frame: “Sleep my child and peace attend thee. All through the night. Guardian angels God will send thee. All through the night.” The boy is almost asleep so it’s as good a time as any to give them the news about the baby’s birth defect.

  “Well, you were lucky,” I tell the couple moving over to a stool next to Lilly, in case she gets upset. “The birth went fine. Sometimes there can be a cord around the neck and that can be dangerous but all’s well that ends well. . . . There is one thing about the baby I need to tell you though.” Here B.K. stops singing and Lilly’s sightless eyes get big.

  “You probably didn’t notice but your new son has webbed toes.” I pause for their reaction and am surprised when they laugh.

  “Oh, we looked for that right away,” Lilly tells me. “All the Bittman men do! B.K. and Little B.K. and Grandpa. We just say it makes them good swimmers.”

  Retained

  How is it that you always notice the tick of a clock when you are waiting? Tick. Tock. Tick. Tock. Lilly puts the newborn on the breast as easily as a sighted person. B.K. settles his five-year-old in his bed in the next room, then comes back with his guitar and strums a few tunes. He yawns. It’s catching, and Lilly and I yawn too.

  Tick. Tock. Tick. Tock. It’s been forty minutes since the birth of their second son.

  “Mmmmmm,” Lilly moans, and I look between her legs expecting to see a gush of blood but there’s nothing. “Mmmmmm,” she moans again and I palpate her uterus. It’s rock hard and at the level of her umbilicus.

  “I think the afterbirth must be separating. Do you feel an urge to push?”

  “No,” Lilly says. “But it actually hurts more than my labor pains. It hurts quite a bit.” I look between her legs again. Still no blood and the cord hasn’t lengthened. B.K. yawns again. It’s almost four A.M.

  At four fifteen Lilly sits up on one elbow. “Miss Becky, I have to pee. Could I get up and use the bathroom? These pains are getting worse. I really have to do something!” Beads of sweat are on the mother’s upper lip and her normally pale pink skin is chalky. She pulls her red hair away from her face and it looks like a skull.

  I really have to do something, so I check the uterus one more time. It’s now three centimeters above the umbilicus. Not a good sign. There must be blood building up inside.

  “B.K., I think we should let Lilly pee. Maybe that’s part of her discomfort, but I don’t really want her to go down the hall. She might faint or something. Do you have an old-fashioned potty, you know, the kind that people use when they don’t have an indoor bathroom?”

  “Sure, right here. She used it when she was on bed rest.” He pulls a white enamel receptacle out from behind the door.

  I check again for any signs that the placenta is coming. Still no blood between the mother’s legs. “Okay, Lilly, just take it slow and I will be right here if you feel woozy.”

  “I am a little dizzy, but just a little.”

  Oh, damn. I’m making such a mess of this. I should have gotten her vital signs before she got up. How is it that I know just what to do for a victim of trauma, a sick child, or a surgical patient, but I’m lost at a simple, uncomplicated home delivery?

  I think I know the answer. Birth is a potentially dangerous situation, but in this relaxed environment, I lose my way. All this guitar playing and kissing and kids sitting on the bed gets me off track!

  Slowly, we sit Lilly up. Slowly, we lower her legs off the side of the bed. Slowly, we help her squat over the commode. B.K. and I turn away so she can tinkle. But it’s not a tinkle. It’s a flood! Lilly pees and pees and pees.

  “Mmmmmmm! Miss Becky, I really have to get this damn thing out of me! If you won’t pull it out, I will. Where’s the cord?” Lilly gropes around between her legs.

  “No, Lilly!”

  She finds what she’s feeling for. “Uggghhh.” Plop. The afterbirth drops into the commode and blood and pee splash over everything. “Oh, thank goodness! But I think I made an awful mess.” Lilly stands up without assistance and sits on a wooden bedside chair. Her uterus is now back to normal, firm, and three centimeters below the belly button.

  I stare at the potty, nearly full of red. Would Lilly be upset if she could see this? It’s impossible to estimate the blood loss since the blood is mixed with urine. Maybe two cups of blood, maybe four? I decide to go with three.

  “Whew! I feel a lot better! Can I wash up and go to sleep now, Miss Becky? At least I didn’t mess the bed.”

  “Sure,” I say as if the whole prolonged third stage of labor was no big deal.

  “I can’t wait to tell Mama in the morning. She will be so flabbergasted!” Lilly says, grinning.

  When I let myself out the back door, both mother and father are climbing into bed with their newborn between them. On the landing of their back stairs I stand for a minute looking down the alley at the halo of light around the gas streetlamps. Inside I can hear singing, a man and a woman. “Hush-a-bye, don’t you cry. Go to sleep, little baby.”

  Lilly’s dark world is not dark at all.

  October 10, 1934

  Birth of Lilly and B.K. Bittman’s second son, 6 pounds, 6 ounces. (I missed the actual delivery; it went so fast and the baby hadn’t been named by the time I left.)

  Lilly, blind since birth or early infancy, said she was singing as she pushed the baby out and that the birth wasn’t painful at all. Hard to believe, but who am I to doubt her? This is the second time a patient has sung during labor and it should be written up in a m
edical book!

  Little B.K. saw the whole thing and wasn’t even disturbed. He asked to help cut the cord and I let him, a radical act for me, but he was so involved and curious, I couldn’t see the harm.

  The problem was the placenta. I was so intent on caring for Lilly and the baby, I neglected to get it out in a timely manner, almost causing the mother harm. I am sure that it was balled up in her vagina the whole time and she was building up blood behind it, but I waited more than fifty minutes before letting her get up to go to the potty and then it came out quite easily.

  Baby was perfect in every way except the webbed toes, and I was afraid they would be upset when I told them, but they only laughed. Webbed toes are apparently a trait in the Bittman males. They are good swimmers.

  October 10, 1934

  Syndactyly! The word erupts, unbidden, from my mouth like hot lava out of a volcano!

  Syndactyly is the medical term for webbed toes. I would tell Becky that little-known medical fact, but then she would realize I’ve been reading her journal. A sin, I know, but I can’t help myself.

  I’ll explain how it happened.

  The second week after we moved to the Hesters’, while Becky was off at the CCC camp, Daniel and I got back early from the fields. As usual, he went up to see Patience and, having nothing else to do, I went into Becky’s room. I found comfort there, the smell of her lilac lotion, a soft female presence.

  Lying on my stomach on her green-and-blue patchwork quilt, the edge of something hard under the mattress rubbed on my arm and when I investigated, a flat book dropped out on the floor. I knew at once what it was and, opening the pages, saw Becky’s neat script. I couldn’t help it. Who could? I started to read.

  I’ll say it right out, I know it was wrong, but I have no intention of stopping. It’s like looking through a window at another person’s soul, a delicate person, someone you could learn to love, if you were not a monster like myself.

  Now, in the back of Danny’s sketchbook, I have started my own recordings. Words come to me, I find, in an easy way, as if all this time I’ve been thinking deep thoughts. It’s like awakening after a deep sleep. You slide into consciousness wondering where you are, who you are, and what day it is.

  21

  The Sergeant

  I’ve been going to White Rock Camp five weeks now and have found the job pleasant and mostly routine, nothing rough or threatening, as people in Liberty had implied. My cases, for the most part, are scrapes and bruises, headaches and sprains, a bad burn from the kitchen and frequent cases of bronchitis.

  At noon today a sharp-looking fellow of about thirty-five walked into the clinic, leaned on the doorframe, and took in the infirmary. It’s funny to say “sharp-looking” when all the men wear the same khaki uniform, but it’s the way he wears it, his shirt tucked in and his pants low on his slim hips, his army hat cocked to one side.

  Boodean clicks his heels, salutes, and backs up against the wall to give the older man space.

  “I’m sorry,” I announce. “We’re just breaking for dinner. Can you come back at one thirty?” The man has the large soulful eyes and wide grin of Fred Astaire, and I half expect him to do a slow slide across the wooden floor with his hands out and then twirl at the end, but he takes a seat in Boodean’s chair and stretches out his long legs.

  “Afraid I can’t wait, miss. I’m an L-E-M.” He spells it out, as if it’s a word he doesn’t want to say in front of Boodean. “I’m in charge of the workhorses and this afternoon I have to teach the boys how to pull the fallen timber out of the ravine. It’s a real fire hazard and we’re just getting started.”

  “Lem? That’s your first name?”

  “No, Miss Myers. This is Sergeant Cross. He’s an L . . . E . . . M like you, locally employed man,” Boodean explains. “Lou is a foreman.” He salutes a second time.

  I take a long breath, inhaling the sweet smell of freshly baked cookies across the compound. “Well, I guess I can see you now, but we really need to hurry. I don’t want to miss our meal.”

  “Thank you kindly, Miss Becky. Been hearing nice things about you from the boys.” He looks me up and down.

  “Sit down, Mr. Cross. Or should I say Sergeant Cross?”

  “You can call me Lou.”

  “Please sit down, Sergeant Cross.” (There’s no way I’m going to call this fellow “Lou.” He acts like he owns the place.) “So, what can we do for you today?” I say it like that, making it clear that the medic and I are a team and this is not a social call. Boodean pulls another chair in from the waiting room. “What’s the problem?”

  “Can I talk to you alone?”

  “No, I’m sorry you can’t. Private Boodean is my assistant. He records all my clinical notes and he understands that anything he hears here is strictly confidential.” The medic immediately starts scribbling something on his clipboard.

  “Well, I’m worried about a wart. It sounds silly and, Boodean, if you say anything to the fellows, I’ll beat you bloody, but it’s a big wart and it’s causing me pain.”

  Right here I get nervous, hoping it’s not another penile problem, some kind of venereal disease, but the sergeant goes on.

  “I make a point not to limp, but sometimes at the end of the day, I can’t help it. . . . I even tried stealing an onion from the cook and rubbing it on the thing and then throwing it over my shoulder, but it’s been two weeks and nothing’s happened. I’d like you to give me some medicine. I don’t care how bad it tastes.”

  “Where is the wart, Mr. Cross?”

  “On my damn foot! Pardon my strong language, Miss Becky. But it hurts so bad I can hardly walk. I’m not usually a bellyacher.”

  “Did you try going out in the garden at night, picking a bean leaf and rubbing it on the wart?” Boodean chimes in. “Then dig a hole with a silver spoon and bury it under a rock? My granny says that works every time.” I look at my watch. The dinner bell rang half an hour ago and I’m afraid I’ll miss my midday meal. In the mountains these old wives’ tales are as common as dandelions.

  “Well, let’s have a look. Can you lie on the bed and take off your shoe and sock?” The man is wearing high regulation army work boots and it takes him a minute to untie his laces.

  He lays his left foot up on the cot and I see what he’s talking about, a black, crusty lesion the size of a half dollar on the ball of his left foot. It’s a wart, I can tell, by the bumpy surface, and it looks like he’s been picking at it, because there’s blood on his sock.

  “I see what you mean.” The truth is, I’m shocked, and I immediately start wondering how to treat the eruption. Debridement comes to mind, but it will be painful; still, it’s somewhere to start.

  “Boodean, you go across the compound and have your dinner. You can get some for me, just whatever the cook will give you. Have you eaten, Sergeant?”

  “Yes, miss. I ate before I came.” He eyes me warily as I get out a scalpel, iodine, gauze, and a small basin. I pour a little water in the bowl and have the man soak his foot.

  “Just rest your foot, sir. I want to soften the wart before I operate.”

  “Operate! Don’t leave me, Boodean!” But the medic is already out the door.

  “Can’t you use some salve or something, Nurse? You’re scaring me now.”

  “No, these warts are very stubborn, and onions, green beans, and salve are not going to do it. Here, take two Bayer while we wait. I want you to soak for ten minutes.” I nod toward the cuckoo clock. So far, it seems to run on time, but I’ve never seen the cuckoo pop out.

  I turn my back, step into the closet, and tear open one of the books I brought from Dr. Blum’s box, Diagnosis and Treatment of Skin Diseases. Plantar warts. Plantar warts . . . I really don’t have time for this. . . .

  Invitation

  Twenty minutes later, Sergeant Cross’s foot has been scraped and is covered with gauze and Betadine.

  “Tomorrow soak your foot again for ten minutes. Boodean can give you some Epson salts to take back
to your cabin or you can come here. Do you have a cabin or do you bunk with the enlisted men?”

  “We LEMs have our own quarters. I share a place with the head carpenter, the first log cabin up the creek. Come over anytime, or maybe you could do my treatments there? You know, make a house call?” He says this last part with a wink and a leer that curls up one side of his handsome face. I’m shocked by the proposal and truly can’t tell if he’s flirting or serious. Knowing his type, I decide he probably treats all women this way, but this is the kind of thing people in town warned me about.

  “That would hardly be appropriate, Mr. Cross.”

  “Sergeant . . .” he says again, tying his boots.

  Just then someone bangs on the infirmary door. “Can I come in?” It’s the medic.

  “Yes, of course. We’re finished.” Boodean enters with a basket of food from the cook, followed by Captain Wolfe.

  “Hello,” Wolfe says, removing his hat. “I hate to interrupt, but I need to know if Sergeant Cross is free to work. The men are waiting at the stables, the horses all rigged and ready.” He consults his wristwatch, which I note is a gold Elgin, just like my father’s.

  “Keep your shirt on, Wolfe. I’ll be right there. They can’t start without me,” my patient growls. “It’s too dangerous. I told you before, I’ll get there when I damn well can. . . . Pardon my language, ma’am.”

  “I’m not inviting you, Sergeant, I’m ordering you.” It’s obvious there’s tension between the two. Sergeant Cross lurches up, steps into his boot, almost kicking the washbowl over, limps across the room, and slams out the door without another word.

  “Sorry, Nurse,” Captain Wolfe says, looking directly at me with his green eyes.