The Reluctant Midwife (11 page)

“It wasn't too bad today. I enjoyed driving around the countryside and the people were nice, especially Mrs. Stone. She's a character. You'll want me Thursday, then?”

“Lilly is already writing down the deliveries.”

I look at the oranges arranged on a tray on the counter. “How much?” I ask longingly.

“Twenty-five cents a dozen.” B.K. rests his elbows on the wooden counter.

“No, I guess not. . . . I do need some basics, though, five pounds of cornmeal and three pounds of red beans. As I leave, Mr. Bittman wraps up six oranges.

“On the house,” he says.

I go out into the sunshine feeling rich with my carton of food and my bag of golden fruit, but as we cross over the Hope River I see a barefoot young mother with stringy brown hair, begging just this side of the bridge with her two raggedy kids clinging to her long skirt. This is something new. I have never seen a woman begging before, and she holds a crude sign:
WILL WORK FOR FOOD.

What else can I do? I slow the auto and roll down the window, peel open my parcel, and hold out two oranges.

“God bless you, ma'am,” the young lady whispers. “We haven't eaten all day. Can I do anything to repay you?”

“No. No, we're fine.”

Afterward, I thought of the groceries in the back. I could have given her more.

Blum turns his face away, staring down at the water where it rushes over the rocks.

Sticky with fruit juice, we sit in the shade of a weeping willow tree on an old blanket on the Hesters' lawn. There's the smell of newly cut grass and the scent of the red roses growing up the side of the porch.

Each of us shares a slice or two of our oranges with Danny and juice dribbles down his little chin. Daniel lies on his side petting Emma and Sasha, the two beagles he says were his wife's dowry. The doctor and I lean against a bench across from them. Patience rests against the trunk of the tree.

“Is that the phone?” I ask. The double ring floats across the yard.

“Damnation.” The vet mutters as he sprints for the house.

“Excuse his French. He's just tired,” Patience apologizes. “He was up with Mr. Earle's sick cow last night, milk fever. Slept for a few hours today, but was hoping to have a quiet night.”

“Patience!” Hester yells from the stone porch. “It's for you . . .”

With a long sigh, the midwife pushes herself up and plunks Danny Boy in my lap.

“Patty-cake. Patty-cake. Baker's man.”
I try to entertain him,
taking his sticky little hands in mine and making them clap.
“Make me a cake as fast as you can.”
The vet ambles back across the lawn.

“Afraid she's going to have to leave. Lately, one of us is always going. It's hard. That's why we haven't been over to see you. It's always something.”

A few minutes later, Patience returns with her birth bag in hand. “I wish I didn't have to go. We were having such a nice time. Daniel and I don't have much of a social life.”

“None,” cuts in Daniel.

“Want to come with me?” Patience brightens. “It's Mrs. Mitchell. You
know
her. The one I told you about, the woman expecting twins. I could sure use a baby nurse.”

I go on alarm. This is exactly what I
don't
want to do. I'd rather face Willa's geese.

“I don't think so, maybe another time. The doc and I were driving around all day toting groceries. I'd better get him home.”

“Blum can stay here,” Daniel offers, supporting his wife. “I have some work in the barn, mucking out stalls. He can help.”

“But Dr. Blum has his good clothes on,” I argue, still trying to get out of it.

“I have a pair of coveralls and old rubber boots.” That's Hester again.

“Please! It will be fun. I'll split my fee,” Patience pleads. “Well, I'll split whatever I get. Sometimes it's cash. Sometimes it's food. Sometimes it's nothing. I could even split nothing!” She thinks this is funny.

I haul myself up. “You know how I enjoy childbirth. . . .”

Patience can tell I'm wavering. “Please! It would help to have company.”

Daniel doesn't wait for my answer. He balances his toddler on his shoulders and leads Blum away.

Five minutes later we are rolling along Bucks Run in the midwife's dusty Olds. The oaks, maple, and hickory are covered in leaves now, a beautiful blur of summer green, but my stomach is tight, and I wonder why I agreed to this. Was it just to be nice to Patience? We owe her a lot. Was it out of some kind of sense of duty as a nurse? Was it the lure of sharing Patience's fee? I hate to think it was only the latter. I'm getting to be a money-grubber. Poverty will do that to you. Once you've been broke, you're always looking for a dime.

I'm about to ask Patience about Danny's birth, what the experience had been like for her, when she makes a sharp turn to the left, bumps across a creek through a foot of water, and pulls up in front of a dingy white two-story farmhouse with what looks like a chicken coop attached to the side.

A man waves wildly from the front steps, then runs back inside as a woman screams. Patience is already in motion.

“Becky!” Patience calls.

“Right behind you.” I enter the upstairs bedroom as a disheveled, unshaven father in coveralls backs out. He looks down, wipes tears from his eyes with a red bandanna, and runs down the hall.

“Asepto suction,” commands Patience.

I know what she's asking for and find it wrapped in white cloth at the bottom of her birth satchel, a glass syringe with a red rubber bulb that's used to suck out the newborn's nose and mouth. As I hand it over, I get a look at the baby and my stomach drops. It's a tiny limp male, around five pounds, covered in meconium, baby poop.

Now I understand Patience's urgency. If the newborn aspirates the brown stuff that's been floating around in his mother's womb, he can get pneumonia and die. If she can manage to get it out of his airway before he breathes, his chances are better. Gently she places the pointed glass tube in his mouth and then his tiny nose, sucking out only clear fluid, no meconium.

“Thank you, Lord,” the midwife mutters. “Here, get him going.” She hands me the wet infant and pulls out her fetoscope to listen for the second twin's heartbeat.

“Okay, little one. Let's hear you cry. Open up those lungs.” I give him a few pats on the butt and he wails.

“Is he okay? Is he all right?” sobs Lucy Mitchell. Her face is red and sweating, her golden eyes wet with tears. “I tried to wait for you, but he was coming and I couldn't stop.”

Patience listens to the second twin's heartbeat as she consults the pocket watch hanging on a ribbon around her neck. “One hundred and fifty-two beats per minute, just fine.”

“One hundred and fifty-two,” I repeat out loud, to remember the rate, then reach over and take the mother's pulse. “One hundred and ten.” That's fast, but then she just delivered a baby unattended, which would be enough to accelerate anyone's heartbeat.

“Can you help get the baby nursing, Becky? It will bring on the next set of contractions. Sometimes there's a delay after the first twin, as the womb reorganizes itself. I need to do a vaginal exam to feel what's coming. I think it's a head, but I'm not sure.”

Lucy doesn't need any help from me; she takes her nipple, gently strokes it against the newborn's cheek, and the baby opens his mouth, just the way nature intended.

“What will you need next, Patience? Scissors? Sterilized string to tie off the cord? Anything else?”

“That should be it. Oh, some more sterilized pads and Mrs. Potts's bleeding tonic. You know about that?”

I find a small brown bottle and hold it up to the light.

“It's a tincture of motherwort, pennyroyal, and blue cohosh to make the womb contract after the afterbirth is delivered,” Patience explains. “I keep it ready at every delivery, but don't often use it. Twins are a special case though. The womb has been so stretched with two babies, it might need help contracting down afterward, but you probably know all this.” She turns and takes off the rubber gloves, carefully arranging them on one of the sterile pads.

“Did you feel the presenting part?” I whisper, not wanting to alarm Mrs. Mitchell if the presentation isn't head down. Even Dr. Blum knew that frightening the mother could stop her contractions.

“No. It's too high,” Patience whispers back and then in a louder voice. “We will just have to wait. . . . Clarence,” she calls. “You can come back now. Everything's okay! Come see your new baby boy. You can bring the children.”

My eyebrows shoot up. The children! Lucy is still half naked. Quickly I pull a blanket over the woman's bare legs. Certainly this never happened when Dr. Blum did a delivery!

Clarence Mitchell, having recovered himself, enters softly. He's a fair-haired fellow with a sunburned face, a few whiskers, and a band of white on his neck where his shirt collar usually covers his skin.

“Wife, you done good! Right healthy,” he says about the baby and surprises me when he sits down next to her on the side of the bed. The couple's little boy and girl climb up too and Patience seems unfazed.

“Only the first baby is out. The labor will start up again soon,” Patience explains as she plunks down on the other side and pulls the baby blanket down a bit so the children can see. “Look at that little sucker,” she says. “He knows exactly what to do, just like a calf or a foal.”

“Can we touch him?” asks the girl, who must be about six. She strokes the baby gently on the back with one finger. Timidly, I find a corner on the very full bed and sit down with them.

“Mmmmmmm,” groans Lucy with a contraction, but there's a smile on her face. “Mmmmmm.” It doesn't look like pain, almost pleasure.

“The labor is starting again. Let me listen to the next baby's heartbeat and then it will be time to walk,” Patience says.

“We'll move out of your way, then,” the father announces, leaping up.

“Mmmm,” the mother moans again and takes the midwife's arm. They walk and then stop, walk and then stop. While contracting, Lucy stands staring into space, rotating her hips. There is peace and a timeless feeling, as if nothing else matters.

Finally, I work my way across the room and in a hushed voice ask Patience, “Shouldn't we get her back in bed?”

“It's okay,” Patience tells me. “It's not time yet. Lucy's voice hasn't dropped. When her voice changes the baby will come. I'll check her in ten minutes,” she adds, consulting her gold timepiece.

“Mmmmmmmm.”

“Can you lie down for a bit, Lucy?” Patience finally asks exactly at ten minutes. “I'd like to check your progress and listen to the baby again.”

The second Lucy is on her back I observe something odd.

“Look, it's the water bag,” Patience explains. “It reminds me of a floppy snow globe. See the bits of white in the amniotic fluid? That's vernix, a creamy substance that protects the newborn's skin while it's floating around in there. By the time the baby is full term it's mostly worn off.”

I've never seen an intact amniotic sack before. Dr. Blum and the other physicians I've worked with always broke the membrane early in labor. With the very next contraction the sac pops and water squirts all over the bed.

“Whoops!” says Patience, not a bit fazed. A tiny pink girl follows with the next push.

“You okay, Becky? You're as white as a sheet.”

“Yes,” I lie. I've watched amputations, assisted in surgery, scraped dead tissue out of infected wounds, but this baby came so fast I didn't have time to prepare myself.

“You sure?”

“Yes,” I lie again and sit down before I faint.

“That was wonderful!” The mother laughs.

Patience gives Lucy some of Mrs. Potts's herbal medicine, just in case, and she tells me not to bathe the second baby; the white vernix is healthy for her skin. Then Mr. Mitchell and the children creep back into the room and we all sit on the bed again and watch as Lucy feeds both babies from both breasts.

I have never given birth. Never wanted to. It horrified me to watch women scream and cry through labor until someone could put them under anesthesia, but this is different, and now that it's over, I see that all that we did in the hospital and the clinic and even at Dr. Blum's homebirths was more to comfort ourselves than to really help the mother.

“Isn't she wonderful?” Mr. Mitchell exclaims, taking his wife's hand and pressing it to his cheek. Six-year-old Clara crawls into my lap.

All week, Dr. Blum and I have worked planting our kitchen garden. We now have a nice little plot thirty by fifty feet. Nothing like the Hesters' or Maddocks' but for beginners it will do. Mrs. Maddock sent over some tiny tomato plants she had started in cans from seeds she'd saved last fall. Some will be red, some will be yellow, some with be almost purple.

Carefully, I transplanted them, digging the holes, patting the soil around their roots and watering each one. Dr. Blum helped, after I showed him how to carry the bucket back and forth from the spring.

The Reverend Miller, with his wife, Mildred, a bundle of energy and concern, stopped by with a sack of seed potatoes that they'd saved last fall, and Patience shared some of her bean and squash seeds.

Finished with the watering, we sit on the porch and stare out at our plot, or I stare at the plot, and my companion stares at the air in front of him.

“Dr. Blum. It's Sunday and we need a day of rest!” I break the silence. “I've been thinking we could go to church, but with your strange ways, people would stare, so let's go on a picnic to the
Hope River instead. What do you think?” Blum acts like he can't hear, but I know he can. He got the water from the spring when I asked him to, didn't he?

It doesn't take long to get ready. I pack two pieces of corn bread in a small willow basket, along with a canning jar of water, and a pint of applesauce I made with the Bittmans' half-rotten apples, then I take Isaac's hand like a child and lead him down Wild Rose Road.

At the Maddocks' place, there's no truck in front. They've probably gone into town to attend services or maybe they belong to the closer church at Hazel Patch. It's a colored church, but Reverend Miller is so kind, whites would probably be welcome.

As we walk, I reflect on the changes in Dr. Blum's health. Some of his actions have purpose now, though in the case of his stroll down Main Street, when he ended up at the soup line, it's hard to tell. Most important, when I show him how to do something he can copy me.

One thing is for sure: He has altered physically. When he was a physician he was tall, thin, and bookish. Now he actually has muscles and so do I. Carrying water, hoeing and digging, walking the land, sawing wood. We are both stronger.

Near the corner of Wild Rose and Salt Lick Road, I notice for the first time the square rock foundation of the small cottage that Maddock said vagrants burned down. The remains of the barn are nowhere to be seen.

This is our turning-off point and we cut across the road onto a well-worn grassy path toward the sound of the water. Here and there in the brush are the remnants of cold campfires, rusted tin cans, cleared areas where makeshift tents have been erected and then pulled down.

Patience tells me that the homeless like this spot because they can get water and they can fish. Also, no one seems to own this
stretch along the river, so no farmer will come with a shotgun to run them off.

Closer to the water, in the wetlands, it's another wilder world, where purple iris and yellow buttercups bloom. Red maples, wild cherry trees, and tall oaks press into the sky. I let out my breath, breathe in and blow out again, remembering my youth, when hiking and climbing and canoeing with David used to bring me joy.

At the edge of the rushing water, we sit on the rocks and eat our corn bread with applesauce and drink our water. Dr. Blum stretches out on a flat slab of stone, his muscled arms under his head, looking up at the clouds.

I turn away and to distract myself from his handsome body, watch the schools of tiny trout darting through the water. For an hour I watch them, and then an idea comes to me. Here's a source of protein I hadn't thought about! If the hoboes can fish, why can't we? And why didn't I think of it before?

Excited, I yank Isaac up. “Come on, old buddy, let's go home and search the house and the barn. Maybe there's something we can use for a pole or a net, something we can use to get fish.”

I'm on a mission now, pulling the doctor along as we hurry through the willows and low brush up to the road. This time as we approach the corner of Salt Lick and Wild Rose, I see two vagrants searching through the rubble of the burned-out cottage, looking for metal that they can salvage and sell.

“Hey, lady. Hey, mister,” one of them yells. “Can you spare a dime? Or can you give a couple of working Joes, down on their luck, a bite of food?”

“Sorry,” I say. “We are poor ourselves and have nothing to share.” I turn over our empty basket to make my point. The truth is, I'm scared of them. The taller man with the full beard and the torn denim shirt stands up straighter.

“Well, bless you then, sister, you and your man. Don't give up
hope. That's about all we have in these dark times.” He turns and heads for the river.

As soon as they are out of sight I walk slower, ashamed of myself for being afraid. It's true we have little, but still we have more than they have. I just didn't want them to follow us home.

When we get back to the farm to search for a fishing pole, I discover a wealth of other tools I'd overlooked. Hanging on one of the walls in the barn, I find a scythe that could be sharpened and used to cut grass, a hammer, some nails in a tin can, another bucket, a rake . . . but no fishing pole.

Disappointed, I return to the house and find Dr. Blum sitting on the front steps with both a net and a pole. Not only that, there's a hook and a line!

“Isaac, you amaze me. Where did you find it?”

“Under,” he says pointing toward the porch, and I think he's as surprised as I am to hear his own voice.

“You can talk, Isaac. You can talk if you want to,” I tell him. “It's okay. I get lonely sometimes.” But the curtain is already down and the lights are turned off.

“Miss Becky! Miss Becky!” The girl named Sally calls from across the swinging bridge. We are on a first-name basis now, and this is my third trip to the Hucknell house. “Can I help you?” she asks.

“Sure.” I hand her my box when I get to the end of the swinging bridge. (I've got the knack of crossing the metal-and-wood contraption now, just roll with the rhythm like a sailor on the sea.)

“What did you bring us?” The little girls swarm around like a flock of sparrows.

“Whatever your mama ordered,” I respond. “I don't look in the boxes. Mr. Bittman, the grocer, packs them.”

“How are you, Willa?” I greet the children's mother on the porch as I wipe my sweating face and arms with a handkerchief.

“About half.”

I let that pass. In the mountains “about half” means you aren't swell, but you don't want to talk about it.

As usual, despite the heat wave, Blum takes his place on the porch with the four little girls. Sally has taken to reading to him from Louisa May Alcott's
Little Women
and he sits there like one of the family.

“Got a pot of coffee brewing?” I ask as I open the screen door.

“Cream?” Willa asks, not her usual talkative self. I pull out one of the wooden chairs. Taking a break with Willa has become a weekly routine and I admire this woman who is raising her daughters and caring for the farm with her husband away.

“So how's it going?” I start the conservation. Willa shrugs and when she flips her long blond hair back, I see bruises along the side of her face.

“Willa!” I point to the area.

“What?”

“Your face and neck.”

“What?” When she covers her neck with her hand, the sleeve of her worn blue-dotted dress falls back and I see more discolorations on her white skin. Purple iris. Pale lilac.

“Willa, what happened?”

“It's nothing. The old man was home.” She turns toward the sink so I can't see her face.

“Your husband? He was home? He didn't hit you in the stomach did he?”

“No, he wouldn't hit me there. He knows I'm pregnant again and he thinks it's a boy.”

“But what got into him? I thought when he came home it was a happy time for you and the girls.”

“The children maybe. They love their daddy.”

“And you? I thought you loved him.”

She turns and looks right at me now. “Sometimes I do, but not today. Would you love a man who makes you get all dolled up and does this to you? He's angry all the time and he takes his anger out on me. Each time we do it, he gets rougher in bed. He's in town now, probably getting loaded, throwing away money we need.”

I listen with a poker face. It's something you learn when you are a nurse. Even if the wound is deep and infected, even if it smells bad, you don't let your revulsion show.

“You can't go on like this, Willa. He could really hurt you sometime.”
Or kill you
, I'm thinking. “And the girls. Do the girls know?”

“Oh, yeah. I'm sure they know. He treats me bad during the day, especially if he's had a little hooch, and he treats me worse at night. That's where he has me. I never cry out. He knows I won't. It would scare the kids.

“We used to be goofy for each other, you know, but now he worries about money and losing the farm. Then he drinks.”

“You told me that he works for the PWA on the highway.”

“No, he quit there. He's home for a few days, then he'll start a different job at Bear Run, a laborer's position, hauling rock, building a new home for Mr. Kaufman, the big-shot department store owner in Pittsburgh. It's harder work, but a little better pay.”

There's a ruckus on the porch.
“It's my turn
.” Susie and Sunny are fighting over Dr. Blum.

“You sat in his lap last time!” Sunny clings to the doctor's shirt, almost pulling it off. Susie has tears in her eyes. Sally and Sonya are howling with laughter, but Isaac just sits there, like the monument of Abraham Lincoln.

“Oh, holy bejeezus!” Willa curses, leaping out of her chair. “Those vixens are so starved for manly attention, they'd follow the mailman into town. I don't know what I'm going to do with them. . . . Girls! Off!” she hollers and scatters the children away with a broom.

I follow her out, straighten the doctor's clothes, and smooth down his hair. “I guess we'd better get going.”

“I'm so sorry,” she says to me. “Say your apologies, children.”

“Sorry.”

“Beg pardon.”

“Sorry.”

“Dr. Blum.” That's me, tapping the physician on the shoulder. “Time to go.” The doctor stands.

“I'm so sorry,” Willa says again.

“No harm done,” I reassure, giving the woman a gentle hug so as not to hurt her bruised body. “You need me for anything, send word through Patience, the midwife. I mean
anything
. She has a phone. You know how to get her? There may be a time you have to get out of here.” I whisper this last part.

All four of the girls walk us to the swinging bridge, the towheaded little ones holding Isaac's big hands. When I look back, their mother stands leaning against the peeling porch, her hand on her neck.

It's Independence Day in Liberty and the Hesters, Dr. Blum, and I stand in front of the pharmacy watching the parade. It begins with the Liberty High School band, wearing their worn dark blue uniforms, playing “The Stars and Stripes Forever.” Then the Negro Drum and Bugle Corp from Delmont struts by dressed in spotless
white shirts and black pants with black berets, raising their knees high and holding their proud heads back. Finally, near the end, come the Veterans of Foreign Wars. Charley Roote, dressed in his Spanish-American War uniform, is one of my delivery clients, and he catches my eye and winks.

“Daniel was in the Great War,” Patience whispers.

“He never talks about it,” I comment.

“He can't. He's not what you'd call a military man. He tells me stories sometimes, though. He was in charge of the horses for his platoon. One million men were wounded and died, but eight million horses also perished. It was awful. I think he felt worse for the animals than his fellow soldiers. At least the men knew what they were fighting for, or thought they did.”

The horses in the parade come last, all decked out with red, white, and blue ribbons in their manes and tails, and the vet, perking up, points out the ones that he knows or has treated. Little Danny is amused by their droppings.

Now it's almost dark and you can hear the old-timey fiddle music from a few blocks away where Sycamore has been blocked off for a square dance.

“How about here, ladies?” It's Daniel, spreading a quilt out among the other blankets on the lawn around the courthouse where people are picnicking.

“Looks good,” Patience agrees, and we lay out our small meal of cold baked beans, biscuits, and new potato salad.

A few minutes later, our meal is interrupted by cruel words. “Sit down, bitch! I can't see through you.”

All heads turn, and in the growing dusk, I see Willa Hucknell, tending her blond brood, a few blankets away. That must be Mr. Hucknell! I've never met him before, and his words rip like a razor through the peaceful families eating their Fourth of July suppers. “I said
sit down
!”

The man, a handsome freckled-faced guy wearing a white fedora and white shirt open at the throat, sways above the picnic blanket like he's two sheets to the wind. “Are you listening, bitch? Are you listening?” He gives the woman a whack across her head. Daniel jumps up, as do several other men, even Blum and, yes, even Patience. Danny covers his ears and I pull him into my lap.

“Alfred . . . please!” Willa Hucknell begs. She must be so embarrassed, I think. To be treated so roughly in public would hurt more than the slap.

“You fuckin' 'shamed of me?” He slaps her again.
What's got into him?

“Hey there, Alfred. You old son of a gun!” Daniel Hester winds his way through the crowd to get to the Hucknells, trying to defuse the situation. Blum follows like a shadow, increasing their bulk, if not their power. “Ain't seen much of you lately, Al. Had any more trouble with that three-teated cow?” Hester's playing the good ol' boy. He never says “ain't” at home.