Cutting for Stone (6 page)

IT WAS EARLY AFTERNOON
by the time Stone went to the nurses’ quarters. He had finished the appendectomy, then two gastro-jejunostomies for peptic ulcer, three hernia repairs, one hydrocele, a subtotal thyroid resection, and a skin graft, but by his standards it had been tortuously slow. An ordeal. With knitted brow he ascended the stairs. He understood that his swiftness as a surgeon depended to a large degree—more than hed ever imagined—on the skills of Sister Mary Joseph Praise … Why did he have to think about these things? Where was she? That was the point. And when would she be back?

There was no answer when he knocked. It was the corner room on the second floor. The compounder's wife came charging up to protest this trespass by a male. Though Matron and Sister Mary Joseph Praise were the only nuns at Missing, the compounder's wife acted as if she had been denied her true calling. With a sash low over her brow and a crucifix as big as a revolver, she looked like a nun. She considered herself a quasi warden of the nurses’ hostel, the keeper of the Missing virgins. She had a spider's sense for a male footstep, an incursion into her territory. But now, seeing who it was, she backed away.

Stone had never been inside Sister Mary Joseph Praise's room. When she typed or worked on the illustrations for his manuscripts, she came to his quarters or to his office adjoining the clinic.

He turned the handle, calling out, “Sister? Sister!” He was met by a miasma at once familiar and alarming, but he couldn't place it.

He groped for the switch and swore when it eluded him. He stumbled to the window, bumping into a chest of drawers. He swung the glass-paned portion of the window in, and then pushed back the wooden shutters. Daylight flooded the narrow room.

On top of the chest of drawers was a heavy mason jar that drew the sun's rays. The amber fluid within reached all the way to the chunky lid which was sealed with wax. At first he thought the jar might hold a relic, an icon. A carpet of gooseflesh swept down his arms, as if recognition came to his body before it came to his brain. There, suspended in the fluid, the nail delicately pivoting on the glass bottom like a ballerina on tiptoe, was his finger. The skin below the nail was the texture of old parchment, while the underbelly displayed the purple discoloration of infection. He felt a longing, an emptiness, and an itch in his right palm which only that missing finger could relieve.

“I didn't know—” he said turning to her bed, but what he saw made him forget what he was going to say.

Sister Mary Joseph Praise lay in agony on her narrow cot. Her lips were blue. Her lusterless eyes were focused beyond his face. She was deathly pale. He reached for her pulse, which was rapid and feeble. An uninvited memory from the
Calangute
voyage of seven years before came flooding over him: he recalled the feverish and comatose Sister Anjali. A cold sensation spread from his belly to his chest. He was overcome by an emotion that as a surgeon he had rarely experienced: fear.

His legs could no longer support him.

He fell to his knees by her bed. “Mary?” he said. He could do nothing but repeat her name. From his lips, Sister Mary Joseph Praise's name sounded like an interrogation, then an endearment, then a confession of love spun out of one word.
Mary? Mary, Mary!
She did not, could not, answer.

An old man's palsy overtook his hands as they reached for her face. He kissed her forehead. In that extraordinary and unstoppable act he realized, not without a twinge of pride, that he loved her, and that he, Thomas Stone, was not only capable of love, but that he had loved her for seven years. If he'd been blind to his love, perhaps it was because it had happened as soon as he met her on those slippery stairs, it had happened when she had nursed him, bathed him, tried to revive him on the
Calangute.
It had happened when she'd held him in her arms and wrestled and dragged his dead weight to a hammock and then spoon-fed life back into him. It had happened as they crouched over Sister Anjali's body. But love reached its apogee when Sister Mary Joseph Praise came to work alongside him in Ethiopia, and then it had never wavered. Love so strong, without ebb and flow or crests and troughs, indeed lacking any sort of motion so that it had become invisible to him these seven years, part of the order of things outside his head which he had taken for granted.

Did Mary love him? Yes. Of this he felt certain. She had loved him, but following his cue—always following his cue—she'd said nothing. And what had he done all these years? Only taken her for granted.
Mary, Mary, Mary.
Even the sound of her name was a revelation to him since he'd never called her anything but Sister. He was sobbing, terrified of losing her, but that, too, he saw was his selfishness,
his
need for her manifesting itself again. Would he have the chance to make amends? How stupid could a man be?

Sister Mary Joseph Praise barely registered his touch. Her cheek was hot against his. He lifted the sheet. A generous swelling of her belly met his eyes.

It was an axiom of his that any swelling in a woman's abdomen was a pregnancy until proven otherwise. But his mind overrode that thought, refusing to consider it—this was a nun, after all. Instead he came to a snap diagnosis of bowel obstruction … or free fluid in the peritoneal cavity … or hemorrhagic pancreatitis …
some
sort of abdominal catastrophe …

Maneuvering through the door frame, then trying not to bump her feet on the banister, his sobs changing to grunts of effort, he carried her out from her quarters, and then down the path to the operating theater. She felt heavier to Stone than she had a right to be.

There was a question the chief examiner had posed to him when he appeared for the Royal College of Surgeons viva voce after passing his written examinations in Edinburgh: “What first-aid treatment in shock is administered by ear?” His answer “Words of comfort!” had won the day. But now, in place of reassuring and soothing words that would have been humane and therapeutic, Stone yelled for help at the top of his voice.

His shouts, taken up by the keeper of the virgins, brought everyone including Gebrew the watchman, who came running from the front gate, along with Koochooloo and two other unnamed dogs at her heels.

The sight of the blubbering, helpless Stone shocked Matron just as much as the sight of Sister Mary Joseph Praise's terrible state.

Lord, he's done it again, was Matron's first thought.

It was a well-kept secret that Stone had on three or four occasions since his arrival at Missing gone on a drunken binge. For a man who rarely drank, who loved his work, who found sleep a distraction, who had to be reminded to go to bed, these episodes were mystifying. They came with the suddenness of influenza and the terror of possession. The first patient on the morning list would be on the table, ready to be put under, but there'd be no sign of Stone. When they went looking for him the first time they found a babbling, disheveled white man, pacing in his quarters. During these episodes he did not sleep or eat, slipping out in the dead of night to replenish his supplies of rum. On the last occasion this creature had climbed the tree outside its window and perched there for hours, muttering like a cross hen. A fall from that height would have cracked its skull. Matron, when she had seen those bloodshot, mongoose eyes staring down at her, fled, leaving Sister Mary Joseph Praise and Ghosh to keep vigil and to try to talk him down, get him to eat, to stop drinking.

As abruptly as it started, in two days, no more than three, the spell would be over, and after a very long sleep Stone would be back at work as if nothing had happened, never making any reference to how he'd inconvenienced the hospital, the memory of it erased. No one ever brought it up to him because the other Stone, the one who rarely drank, would have been hurt and insulted by such inquiry or accusation. The other Stone was as productive as three full-time surgeons, and so these episodes were a small price to pay

Matron came closer. Stone's eyes were not bloodshot and he didn't reek of spirits. No, he was unhinged by Sister Mary Joseph Praise's condition, and rightly so. As Matron turned her attention from Stone to Sister Mary Joseph Praise, she nevertheless felt a ghost of satisfaction: at last the man had bared his soul, displayed his feelings for his assistant.

Matron ignored Stone's ramblings about volvulus or ileus or pancreatitis or tuberculous peritonitis. “Let's go to the theater,” she said, and when they were there, she said, “Lay her on the operating table.”

He set her down and Matron saw a sight she had seen seven years before: blood soaked Sister Mary Joseph Praise's dress in the region of her pubis. Matron's mind raced back to Sister Mary Joseph Praise's first arrival from Aden, and how blood on her habit then had caused similar concern. Matron had never asked the nineteen-year-old, point-blank, what caused the bleeding. The irregularity of the stain on that occasion had invited the observer to read meaning in its shape. Matron's imagination had constructed so many scenarios to explain that mystery. In the ensuing years, memory had changed the event from mysterious to mystical.

Which was why Matron now glanced at Sister Mary Joseph Praise's palms and breast as Stone laid her down, as if she half expected to see bleeding stigmata, as if that first mystery had grown into this second mystery. But no, the only blood was at the vulva. Lots of blood. With dark clots. And bright red rivulets that ran down the thighs. Matron had no doubt, as blood dripped to the floor: this time it was secular bleeding.

Matron seated herself between Sister Mary Joseph Praise's legs, willfully ignoring the stomach swelling that loomed in front of her. The labia were engorged and blue, and when Matron slid her gloved finger in, she found the cervix fully dilated.

Of blood there was much too much. She swabbed and dabbed and pulled down on the posterior vaginal wall for a better view. When a piteous sigh emerged from her patient's lungs, Matron almost dropped the speculum. Matron's chest was pounding, her hands shaking. She leaned forward, tilted her head again to peer in. There, like a rock at the bottom of a mud pit, a stone of the heart, was a baby's head.

“Lord, she's,” Matron said, when she could finally speak, gasping at the sacrilegious word that threatened to choke her and which her mouth could no longer contain, “pregnant.”

Every observer I later talked to remembers this moment in Theater
3
, when the air stood still, when the loud clock across from the table froze and a long, silent pause followed.

“Impossible!” said Stone, for the second time that day, and even though it was incorrect and hardly the thing to say, it allowed them all to breathe again.

But Matron knew she was right.

She would have to deliver this baby. Dr. K. Hemlatha—Hema to all of them—was out of station.

Matron had delivered hundreds of babies. She reminded herself of this now to try and keep herself from panic.

But how was she to push away not just her qualms but her confusion? One of her own, a bride of Christ—pregnant! It was unthinkable. Her mind refused to digest this. And yet the evidence—an infant's skull— was there, right before her eyes.

The same thought distracted the scrub nurse, the barefoot orderly, and Sister Asqual, who was the nurse anesthetist. It caused them to trip over one another and knock down an intravenous drip as they scurried around the table, readying the patient. Only the probationer, who was mortified that she had failed that morning to recognize this crisis when she visited Sister Mary Joseph Praise, didn't stop to wonder how Sister Mary Joseph Praise got pregnant.

Matron's heart felt as if it might gallop right out of her chest. “Lord, what worse circumstance can you construct for a delivery? A pregnancy that's a mortal sin. A mother-to-be who is like my own daughter. Massive bleeding, ghostly pallor …” And all this when Hema, Missing's only gynecologist, not only the best in the country, but the best Matron had ever seen, was away.

Bachelli up in the Piazza was marginally competent in obstetrics but unreliable after two in the afternoon, and his Eritrean mistress was deeply suspicious of him leaving on “house calls.” Jean Tran, the half-French, half-Vietnamese fellow in Casa Popolare, did a bit of everything and smiled a lot. But assuming they could be reached, it would still be a while before either man would come.

No, Matron had to do this herself. She had to forget the implications of the pregnancy. She had to breathe, concentrate. She had to conduct a normal delivery.

But that afternoon and evening, normal would elude them.

STONE STOOD BY,
his mouth open, looking to Matron for direction, while Matron sat facing the vulva, waiting for the baby to descend. Stone alternately crossed his hands in front of him and then dropped them by his sides. He could see Sister Mary Joseph Praise's pallor increasing. And when Nurse Asqual in a panicked voice called out the blood pressure— “systolic of eighty palpable”—Stone wobbled as if he might faint.

Despite uterine contractions which Matron could feel through the belly and see in Sister Mary Joseph Praise's contorted face, and despite the fact that the cervix was wide open, nothing happened. A baby's head high up in the birth canal with the cervix flattened like a gasket around it always reminded Matron of the shaved scalp of a bishop. But this bishop was staying put. And meanwhile, such bleeding! A dark and messy pool had formed on the table and tidal eddies of blood came out of the vagina. Blood was to delivery rooms and operating theaters what feces were to tripe factories, but even so it seemed to Matron that this was a lot of blood coming out.

“Dr. Stone,” Matron said, her lips quivering. A bewildered Stone wondered why she was calling on him.

“Dr. Stone,” she said again. For Matron, Sound Nursing Sense meant a nurse knowing her limits.
For God's sake, she needs a Cesarean section.
But she didn't say those words because with Stone it could have the opposite effect. Instead, her voice low, her head drooping, Matron pushed down on her thighs to bring herself to her feet and to vacate her spot between Sister Mary Joseph Praise's legs.