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Authors: Julia Gregson

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“Close now,” she murmured, patting Prasanna's arm. “Now you will learn some new words,” she told me. “Write them down.
Velum kondu vaa,
bring some water.
Choodu vellum,
hot water.
Tulle
means push.
Mukkeh
, bear down.”

She told me to step outside the shack for a few minutes to give her more room to administer a massage. When I did, I realized I had almost stopped breathing. I knew of course that I would almost certainly have to watch deliveries again and was prepared for that, but that hut, with its fug so thick you could slice it, plus its other smells—sweat, smoke, human bodies, ancient meals—was making me sweat and almost heave a little.

When Maya joined me again, she was eating one of the dosas and smiling. The girl's cervix was well dilated. She had given the
girl a light massage with coconut oil. Prasanna was happy.When, an hour later, the baby's head started to crown, I was ashamed to find myself almost on the point of fainting. It was as if my mind had blanked out the twenty-eight deliveries I had been part of and taken me back to being a knock-kneed novice. But when the hut had stopped wobbling, I saw from a distance that Maya was completely in command. One loud shriek, a full head of dark, damp hair suddenly visible, then Prasanna, puffing, blowing, shouting, gave one last almighty thrust and pushed a new person into the room. The mother-in-law yelled, “
Ente daivame aan kunju!
Oh, my God! It's a boy!” and Maya held it up so the girl, who was crying with happiness, could see it.

I was bundled out of the room for the cutting of the cord and disposal of the afterbirth. The baby was clean when I came back and Maya was kissing him, then looked at him slowly from his wriggling toes to his damp and tufted head. She said something which made all the women laugh.

“Why are they laughing?” I still felt sick.

“I said lovely hair, lovely fat legs, and a nice packet between his thighs.” Maya wiggled her head, delighted with her own joke.

“I didn't expect that so early,” I said, as I walked wobble-legged out of that hut and almost immediately experienced a nearly tearful rush of emotion I could not name. Today had shown me that possibly soon, if I could get over the faintness, I might at least work my way round to being a helpful pair of extra hands at the clinic. That was a start. Whether I could still be a midwife was debatable—the thought was enough to make my heart pound again—so to avoid having my mind go down the usual ratholes, I asked Maya if Prasanna would have been very disappointed had the baby been a girl. She gave me a sharp look.

“Of course,” she said. “Girls cost too much: their dowries
ruin
families.” After she'd had her second daughter, her mother-in-law refused to talk to her for weeks, but then, thank God, a son came.

“His name is Shiva,” she told me proudly. “He is only eighteen but he rules the roost.”

* * *

Proud grandparents stood at the door when we arrived at our next stop to see the whopper: the twelve-pound baby who had become a local celebrity. We found him sleeping serenely in a cloth cradle suspended from a rod which hung from the ceiling—a great, big, plump, smiling Buddha of a baby, coffee-colored and with deep creases around his wrists and neck.

The baby shone with coconut oil and had a faded marigold garland around his neck and what looked like a slightly infected umbilical cord.

“Did he get this in a hospital?” I asked Devika, his mother, when she lifted him up proudly. Maya had pleaded with me to put on the doctor coat for this examination, and since this was not a delivery, and seeing no great harm in it, I had put it on.

“No.” Maya explained that Devika, who'd had her first baby at fifteen, didn't like hospitals. She went once and they were rude to her and jumped on her stomach to make the baby come.

“So her usual midwife came,” Maya continued. “She trusts her. There was much bleeding and yelling,” she translated, as the woman's voice rose dramatically, “but Devika is all right now.”

Maya peered more closely at the baby's umbilical cord, which was red and weeping. “This one does it with a rusty knife,” she told me in a mutter, while keeping a neutral expression on her face. “She is stubborn about that. Now put your stethoscope on, look at it,
frown
.”

I peered at the cord, wondering why the baby wasn't screaming blue murder, it looked so sore. When Maya cleaned the wound, the baby kicked two legs the size of hams and just looked at me with its huge brown eyes. No squealing.

When I handed the mother a small bottle of potassium permanganate, she thanked me with a fervor that made me feel ashamed.

“What did you say about me?” I asked on our way back to the convent.

“That you were a fine English doctor.”

“Oh God, you mustn't say that. I feel like the most awful fraud.”

“It will help her, and her baby,” Maya said simply. “The power of the mind is very strong.”

I put it out of my mind. We were late for lunch and both hungry.

“That child was a baby elephant. Poor woman!” As we ran down the towpath together, I was laughing.

* * *

Fish curry for lunch, and after it Maya showed me my bedroom—a small whitewashed room above the church with an iron bed and a crucifix on the wall. The air smelled faintly of incense. When I crawled under the mosquito net, my head was reeling at all I'd seen. I heard birds singing as I drifted off to sleep, the lap of water from the river. I was too tired to worry much about whether Amma would mind my being here. As for Anto: what a wicked wife, I'd hardly given him a thought all day.

-
CHAPTER 21
-

B
efore she took her breakfast, Amma went into the prayer room inside the house, determined to find some rest from the furious thoughts that kept her awake at night. Anto's new wife had been staying with them for close to two months now, and Amma had started to hate her. She blamed her for Anto's new reserve, when he was once so open and jolly with her; she blamed her for his frequent absences to find work. She was sure that by now he would have been deluged with job offers had he not come home with the impediment of an English wife.

Kneeling at the cedar altar made from the deck of an ancestor's spice ship, she breathed in the mingled smells of beeswax furniture polish and incense and wrestled her mind into a state of weary numbness. This is your favorite time of the day, she reminded herself: no relatives to talk to and placate, nothing to disturb you, only the discreet twitterings of birds, and from the kitchen the silky sounds of Pathrose pouring water through muslin and into the earthenware pots, the flash of spices hitting hot fat.

Soon the swish of Satya cleaning the steps with cow dung. Later, three other women in the yard would pick stones out of the rice stored in the granary on the left of the courtyard. They would fold at the waist like ballet dancers, murmuring as they worked; she might hear them giggle. If she heard the low drone of complaints, she'd go out to see what was wrong. That was her job: keeping the house running like a well-oiled machine. Mathu, at
his most unreasonable, behaved as if any fool could do this. Let him try.

“Heavenly Father, make me an instrument of thy works. Don't let me be proud, or hard, or unkind. God, help me. Please!—”

Often nowadays, her formal prayers seemed to break down into a desperate pleading because, when he was home, Anto had almost stopped speaking to her and it was grinding her down. Ashamed of her weakness, she wiped her eyes, got up stiffly, and went into the kitchen, where Pathrose, standing in a pool of sunlight, was measuring out six cups of rice, then dhal and fenugreek seeds for breakfast dosas.

For dinner that night, she planned a beef ularthiyathu, a stir-fry, a spinach thoran, and a dish of the fiery red fish curry that the girl had praised extravagantly on the night they arrived, before she had a coughing fit. Anto had loved it, licking his fingers in sheer bliss. This much she could at least do for him.

“Don't make it too spicy for the English girl,” she told Pathrose. They shared a brief look of malice and exasperation before she moderated hers into one of studied calm. Pathrose knew her too well, how she faked sunniness sometimes to keep this house on an even keel, just as she knew how he and Satya rolled their eyes behind the scenes and mimicked her sayings:
Aana karyam parayumbol aano chena karyam,
“Must you talk about the
yam when I'm dealing with the elephant?” or complained about her tongue-lashings. They shared her shame too, when on entering the young master's bedroom, they saw the blatant display of stockings, the silk slip on the rattan chair. They were simple people; to them, she was like an exotic harlot.

* * *

After breakfast she slipped on her sandals and walked into the garden.

Anyone watching her padding serenely towards the summerhouse would think her a fortunate woman in full control of her
little world, but today she felt she'd like to spit or smash or throw something. She was fed up to the back teeth with being the family's pet chameleon, cheerfully adapting to Mathu's moods and disappearances, or pretending she wasn't hurt by Anto's sudden disappearance or put out by the arrival of new wives, tiresome relatives, new babies, ill-timed illnesses, when the truth was that, like the weather, she had her own moods.

The path on either side of her was lined with orchids, planted in coconut husks. Mathu brought them to her, these beautiful, useless plants—the Singapore orchids, the painted ladies, the vandas—from all over India: his apology for his many absences, his pipes of peace. Each year she chose with finicky precision the exact spot to plant them, the right amount of cow dung to dilute with water for their flourishing.

Once these plants had seemed a poor substitute for him, but over the years she'd come to find something erotic and freeing in their pointless flapperish beauty: they did nothing but flower and dazzle and attract insects; they gave nothing back.

From the summerhouse she could see the lagoon, flushed pink in the dawn light, and hear the cry of the postman who came from Ottappuram every morning with packages and letters. Every morning for the past month, she'd watched the English girl walk down to the postbox at the end of the drive and walk back alone and empty-handed. And God forgive her, she did not feel one iota of sympathy for her. The girl was a pest, a nuisance, and her list of crimes was growing. Every morning since Anto had left, Kit was driven in the Morris to the women's home in Cochin. An unforgivable liberty. True, the arrangement was agreed on, in principle, by Mathu and Anto, but Amma had expected the girl to make occasional visits, in the same way she went to call on the poor children's school in the next village, as a representative of the Thekkeden clan.

When the girl offered to pay for petrol from her own funds, as per the arrangement, Amma, trained to demonstrate hospitality
even when she didn't feel it, had from long force of habit smiled and waved away the suggestion as if it were a gnat. But Amma, in a ritual she hated, was the one who had to go to her husband's study once a month, and nod and smile as he got out the leather-bound ledger in which she had to write down every single rupee spent while he was away.

Other crimes: the girl added her opinion during meals when the men were talking about world affairs. She ate with her hands now, but badly, not using the fingertips as delicate prongs as they did but holding the food in a sticky mass in her palm. Amma had seen Anto wince at this, the last time he was home. Why didn't he correct her?

She wore lipstick, not a lot and not always, but some, and powder, and a few days ago, without permission, showed Theresa how to do it. Admittedly they practiced on a doll, but Theresa, soon to reach puberty, might get wrong ideas. When Amma reached puberty, a whole list of instructions had come with it from her mother. She wanted them passed on untainted.

Next Kit, responding to the frosty atmosphere, had turned to Amma and asked her about her own beauty routine. When Amma protested she didn't have one, Theresa interrupted, “Yes, you do, Ammamma.” And Theresa had described to Kit how every day Amma's maid beat the bark of a soap nut tree until it was soft, so Amma could scrub herself with it and remove dead skin before she oiled herself. Personal things. Amma had stood by. Nodding, smiling, nodding, smiling, just like a good Indian woman. Tornado inside.

But the worst crime came last week when she'd seen Mariamma and Kit on the veranda talking in low voices and glancing furtively in her direction. She'd taken Mariamma aside and pinched her arm until Mariamma mumbled that Kit had asked questions about menstruation, childbirth, attitudes to marriage. Embarrassing questions.

“What a cheek,” Amma had said, expecting Mariamma to agree, but Mariamma had said that Kit wasn't being nosy, she was writing a report, and besides would need to know local attitudes herself when she and Anto had children.

Children were another wound. Her son's would be half-breeds now; the ones he would have had with Vidya . . .

Stop! She pulled at a clump of weeds around her moth orchid so violently, she splattered her slippers in soil. She must try with all her strength to put an end to these horrible thoughts, but for now, let God tell her what she did in a previous life to deserve this?

It's your fault, she wanted to tell the girl. You should have controlled yourself; you should never have married him. Her last thought felt like the ultimate blasphemy: it would have been better for them all if Anto had stayed in England.

When Pathrose found her, he picked up her sodden handkerchief from the bench and made no mention of her red eyes. When she sent him off to see if the postman had come, he came back looking stricken. “Madam,” he said, “sorry. No letter comes.”

-
CHAPTER 22
-

I
t was clear that the driver, Chandy, was sick of having to drop me at the Moonstone every weekday morning when he would rather spend leisurely days polishing the car and waiting for Appan's return. When we reached the first village, Karappuram, he threaded his way through it, hand on horn, swerving to avoid a fruit stall or a chicken or a man being shaved. He sighed a lot and occasionally glared at me through the rearview mirror. But I didn't care, because as we headed out into the immense skies, the green fields, the pearly water, I felt I could breathe again, because in spite of all my terrors, this was the first step. I was going to work again.
I was going to work.

I'd never understood before what a salve it was in times of trouble. Work stopped me from minding about Amma, particularly at meals when she was so silent. It gave me less time to worry about Anto, who was still trying to find a job and away as much as he was home.

All of us, I suppose, have parts of us that are like foreign countries even to ourselves, but I kept remembering our first day at Mangalath and that strange new look, both embarrassed and challenging, he'd given me when he dropped his suit on the floor and wrapped the strip of cloth around his waist as if to say, This is who I am now, like it or lump it.

And then I would think of my mother and how much I'd hurt her. I'd try to remember the conversations we'd had before I left,
but I couldn't exactly, only her tears and silences and my absolute determination to leave, and perhaps my cruelty to her.

My only other outlet during this time were letters home to my old friend Josie, married now to a childhood sweetheart, Archie, a newspaper journalist, and with her first child. Josie sent me a picture of her baby, Jack, and said he looked like a boiled egg but she loved him madly, though she hoped one day to go back and nurse at Thomas'. “I'd go potty if I thought I would never work again, though it won't be the same without good laughs with you.”

And of course I wrote several times a month to Daisy, who, after my first three months in India, wrote to me asking for “a) an account sheet, and b) a full progress report—warts and all.”

I'd headed my reply back “A Cure for Warts,” to make her laugh but to warn her too that the Moonstone operated on a knife's edge. We needed money to patch the leaking roof and mend the rotting veranda (termites), parts of which were so soft you could crumble the wood between your fingers. We desperately needed more staff.

The official letters I wrote for the Moonstone were sent out via rickshaws, battered buses, barefooted boys, and bicycles, to everyone Dr. A. and I could think of: to Indian businessmen, maharajas, teaching hospitals, charitable funds. Our only significant response so far had come from a Mr. Namboothiri, a noisy, emotional paint manufacturer who supplied materials for the fabulously lurid lorries seen on the roads here. The day after we'd treated his maid at the Home for a late miscarriage, he'd arrived with what Dr. A. described as “a small cash donation” (she wouldn't say how much), designs for a new sign painted in gleaming yellows, reds, and purples announcing, Matha Maria Moonstone Home, First-class treatment for Expectant Females
.
He also brought a tub of hibiscus and geraniums to put beside the veranda steps.

Money worries and begging letters aside, safe in the knowledge that my role here was administrative, I was starting to relish the
rigor and the challenges of the work, the sense, however misguided, that I was living under the skin of India.

After the shapeless days at Mangalath, I relished the routine. At eight thirty sharp, Maya would arrive in a rickshaw, chaperoned by her son, Shiva. Recently she'd confided in me that her husband and son had turned over a new leaf and were happy for her to support the family. That was her version. I hoped it was true. No more bruises that I could see, but huge, dark plum-colored circles under her eyes made her look permanently exhausted.

Her boy wore the same large, horn-rimmed glasses that Maya wore, but his face had none of her sweetness of expression, and he dropped her off with no more ceremony than a man delivering a parcel and left without a word or a backward glance.

This was painful to watch because Maya was a gem: highly intelligent, she loved the work and, best of all, was open-minded about the need to connect the best birth practices of East and West without letting the “pigheads,” as she called them, get in the way. Her kindness and her quiet air of competence with patients, and all forms of living life, were wonderful to behold.

The first thing Maya did every morning was to peer at the new hibiscus and geranium through her huge specs, carefully measure out the water into an old petri dish, and give them all a careful dose.

* * *

At nine o'clock sharp, a bell rang, doors opened, and the straggling line of women that had formed in the garden surged forward. They came with every imaginable female problem possible: early and late miscarriage, pregnancy, incomplete abortion, gonorrhea, troubles breast-feeding. My job when they'd arrived was to move between the consulting rooms and take notes.

Their numbers were growing, Maya told me, because the Home, despite all our financial woes, had a reputation for cleanliness and kindness, and (great selling point) it was free. Some women were
picked up by Moonstone volunteers in local slums and factories. We had to be extremely careful about the latter group, as men controlled the women there mostly, and some were very suspicious of the work we did.

Some of the women arrived holding hands or the tips of each others saris like terrified children.

“Women here aren't used to going to the doctor,” Maya explained. “It makes them uncomfortable to show their private part.” When she told me this, I thought of the erotic statues in Hindu temples—the bare breasts, the bristling penises—and thought I would never ever understand this country. I couldn't see a common thread here and probably never would. I longed to be able to discuss such inconsistencies with Mariamma, or Amma even, but I'd seen the lemony look on Amma's face when I asked any sort of personal question.

Sometimes, because we were so short-staffed, patients had to wait for hours to see us. Time moved at its own stately pace here, but no one complained and no one apologized.

The morning when my role changed without any warning began normally enough. “Chandramati Achari,” barked Dr. A., standing at the door, list in hand, calling for our first patient.

A tiny, immaculately clean-looking woman stood up. Her sandals were held together by string, but she walked towards us with the kind of long-necked, straight-backed posture that would not disgrace a principal of the Royal Ballet School.

She lay on the consulting room couch, her eyes closed, dusty sandals on the floor. Dr. A. washed her hands at the sink. I sat by the side of the examining table, notebook at the ready. A dim electric light hung over the examining table. When the light failed, we were dependent on a wonky generator.

Dr. A. sighed, put on her glasses, and talked to me over the supine body. “This woman suffered from eclampsia last time and nearly died. Seizures were there, and a blood pressure of one eighty
over one ten. It was frightening, wasn't it, Chandramati?” The girl nodded, eyes tightly closed. “But when she went to the hospital, they treated her very roughly, then left her on her own in a corridor until the baby was almost come. Correct, Chandramati?”

“Correct, ma'am.”

“Now we'll take a look.” The rubber gloves went on and were lubricated. I watched Dr. A. insert two fingers in the girl's vagina and feel around for several minutes. Her imperious face was calm.

“This baby,” she announced at last, “feels very happy; it will be beautiful.” The woman gasped, tears rolled out under her lids, a spurt of passionate words followed.

“She's telling me God is good,” Dr. A. said. “That she likes coming here. That she's going to be brave about having this baby, and that she would like you to deliver it.”

I felt the news as a swell of nausea in my stomach. When the room was empty again, I reminded Dr. A. that I didn't have my full midwifery certificate yet. She gave me a blank look and said with her usual humility, “I will watch you, and if I feel you're ready, you're ready. When that time is come, I will ask the gorement”—that was how she pronounced
government
—“for full accreditation.”

In hindsight I would have saved myself a great deal of distress and humiliation had I said something then, or later insisted on seeing the relevant certificates, but instead I froze. If Anto had been home, I'm almost sure I would have discussed it with him, but he wasn't. The sense I had of being about to step off a cliff made me sleep badly that night. I was, if possible, even more frightened than before because every day the stream of patients was teaching me how little I knew about this country with its mind-boggling complexities of religion, of caste, its ideas of purity and pollution.

Anto had tried to warn me, Daisy too. She'd told me once that Indians were the sweetest and kindest people on earth, until they were the angriest. If I got it wrong this time, I had no doubt that revenge would be swift.

* * *

After morning clinic on the following day, Dr. A. pulled another alarming rabbit from the hat. She stomped off with me behind her to visit the inpatients, who were housed in a ramshackle brick building, once a barn, at the back of the main building. It had six emergency beds in it and a nest of rats in the roof.

To follow the ample buttocks of Dr. A. on her rounds was to feel like a queen's bridesmaid: even the sickest of patients attempted to smile or salute her. In one bed, an underweight child of fourteen showed the whites of her eyes at our approach. Dr. A. said she'd been admitted with a threatened miscarriage in the second trimester of her pregnancy. Her mother sat on the floor beside her bed with a small spirit stove to cook on.

In the next bed, separated by a small cloth screen, a woman, bleeding heavily from incomplete separation of her placenta, was being prepped for a transfusion by Maya.

After a very late lunch, some rice and lentils and the inevitable fried fish, delivered from a street stall across the road, I was changing to go home when Dr. A. appeared, her large nose quivering with importance.

“Come to my office, please,” she said. “Don't look worried. Good news has come.”

I was about to tell her that my driver was waiting—Amma got quietly furious when the car was late—but when I opened my mouth to speak, Dr. A. held her two palms up.

“Don't speak!” She opened the office door.

Maya was inside, plus two new nurses who smiled at us timidly. No one introduced us.

“Sit down.” Dr. A. sat down at her desk and opened a letter. Her expression was one of rare joy.

“I have two special announcements,” she said. “The first is that Nurse Kit Thekkeden can start delivering her first Indian
babies.” I heard Maya's little grunt of pleasure, hands clapping; I felt a rapid fluttering in my chest, but there was not time to absorb the full impact or to ask whether I'd been officially cleared, because Dr. A. had another announcement. “We've done it,” she said, her eyes fixed on me. “A year's grant from the new Cochin Medical Foundation to support our work. I told you our own people would support us,” she added in a same-to-you-with-knobs-on kind of way.

The new nurses beamed and clapped. Maya made a funny sound with her tongue. I felt sick.

“How much are they giving us?” I asked, to play for time.

Dr. A. gave me a dark look. “That information is between the minister and myself.”

“But I'll need to tell Miss Barker,” I said. Her letters requesting itemized accounts had so far been ignored.

“I have no time for this now.” Dr. A.'s tone was chilly. Our priority, she said, was to enroll as many village midwives as we could and bring them to Moonstone for a ten-day training session. All the important national newspapers, the
Hindu,
and the locals, the
Malayala Manorama
,
the
Mathrubhumi,
would come for their graduation ceremony and we could show them all the future of obstetrics for Indian women.

I saw Maya nodding her head, smiling serenely, a splendid idea, until Dr. A. added, “But there is one string attached. If we succeed, the gorement will extend our lease by a year. If we fail, we must hand our premises back for other gorement purposes.” There was a combined gasp at this.

I put up my hand. “Forgive me. I think these premises were bought by the Settlement in Oxford.” I'd seen the deeds at Wickam Farm.

“Not after Independence,” Dr. A. replied. “It's gorement-owned now.”

We looked at each other with deep distrust, and this would have
been a good time to clarify my official position here, but Maya jumped into the tense silence. “So, Doctor, please may we know when courses start?” Dr. A. opened her diary, planted a finger on the page. “In one and a half month's time, I have already certified the date.”

“Good Lord.” I was aghast. This felt like an impossible deadline. Where in the Lord's name would these women sleep? What about a cook? Proper training equipment? Transport?

“Does that give us enough time?” I asked.

Dr. A. frowned and rubbed her bristly chin. “This is my decision now,” she said. “Our gorement and God will provide.” She clapped her diary shut and stood up. “Our first course will begin as stated on April third, for ten days. And important to note too, we have an official inspection coming up, so everything must be right. If it's not, they can close us down overnight. Now, no more questions please.”

After the meeting, Maya stopped me in the corridor. “I am very worried,” she whispered. “Why is she rushing, rushing, rushing?” This from Maya, who never said a word against Dr. A.

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