The Reluctant Midwife (2 page)

“Holy hell, what's this?” I say to Dr. Blum, who doesn't seem to notice the beat-up black DeSoto with a table tied to the top that's pulled over on the side of the road. A young man, wearing a wool plaid jacket, stands on the berm, waving his hat. “Help. Stop!”

The newspapers warn us about highwaymen out to do no good, robbers who pose as distressed travelers in these hard times, lure do-gooders to help them, and then at gunpoint take all their money and valuables. Slowing, I see a woman in the front seat, her feet on the dashboard and her face wild with pain. It's only that face that compels me to stop.

“Oh, for god's sake, that doesn't look fake, does it?” I ask the doctor, backing up to see what's happening. My passenger doesn't answer, but then he never does. “Here goes nothing.” I put my leather pocketbook in the doctor's limp hands and cover it with his coat. “If the man is a thief, unless he puts a gun to your head, don't give this up. It's all we have,” I command, jumping out of the Pontiac. Blum doesn't blink.

“What's the problem?” I yell to the stranger. “Your lady okay? I'm a registered nurse.”

“Oh, thank god, ma'am. I'm Alvin Norton. . . . It's my wife,
Bernice. She's having a baby. What should I do? It's another forty miles to Torrington.”

“She's having the baby
right now
?”

I remember the first baby I ever saw born, a premature infant too little to breathe, with a double cleft lip that ran up to his nose. It was a precipitous delivery in the emergency ward and the mother was hysterical. Still in training, I'd been left to labor-sit while the other nurses went on break, and ever since then, I've approached childbirth with dread.

I push those images away and run for the passenger side of the auto, where I find a blonde of about twenty, vomiting out the window.

“It's coming!” she says, her green eyes wide.

“What should I do? What should I do?” Alvin asks again.

“Well, the first thing is . . . get her bloomers off.”

The man blushes, sets his hat on the hood, and pulls off the woman's wringing-wet pants while I throw off my worn wool coat. It's old but it's the only one I have.

“Can you roll on your side, Bernice? Put your head up by the steering wheel and open your legs? My name is Nurse Becky.” The woman squirms around and props one leg up on my shoulder.

“Sir, if the baby is truly coming, I'll need a blanket or something to wrap it in. If it's not time yet, maybe you can make it back to Butler Mills. There might be a doctor there.” I sound so calm and confident, but my whole insides are shaking.

“Yes. Yes!” The father is running around like a chicken with its head cut off.

“In the suitcase!” the woman yells. “Blanket in the suitcase! Ughhhhhh!” A hairy orb about the size of an apple is already showing. The infant peeks out and then retreats, not ready to enter this hard world, I imagine. I try to act as if I do this all the time, but cold fear grips my stomach.

As a registered nurse, I've assisted physicians at scores of deliveries, but the rawness of emotion and the blood and the goo have never appealed to me, and then there is still the vision, deep in my
psyche, of that first deformed child. . . . I'd rather set a broken arm, assist with a hysterectomy, or clean a ragged wound.

I have even been present when a midwife delivered the baby of a homeless woman in a tent, pitched under a stone bridge, and the outcome was healthy, but I still didn't like it. What was it the midwife said to her frightened patient?

“Push a little,” I say, trying to imitate her soothing voice, as cold sweat drips down the side of my face. “Push a little . . . Blow a little . . . Push a little . . . Blow a little. Your baby is almost here, Bernice.” The father comes back, holding a crocheted white baby blanket. I hate to get it bloody, but it's apparently all he could find.

“We're on our way to her mother's in Torrington,” he explains between contractions. “Where we were going to stay until her confinement, but the baby's not due for two weeks. Will it be okay?”

“Ughhhhh!” growls the woman again and I ignore the nervous father, all my attention on his wife. I have no idea what I'm doing, so I just put my hands around the baby's head and hold on, trying to keep the mother from tearing.

What a strange way to come into this world
, I reflect,
one human being squeezed out of another
.

“Push a little. Blow . . .” The head is out.

“Oh my God!”
the father exclaims, holding himself up on the open car door.

“No pushing now, Bernice! Blow. Let me check for a cord around the neck.”

“Urghhhh!” the mother growls again and the whole baby swivels and comes out on the seat.

“It's a boy,” Alvin announces before I have time to look. “Oh, Nurse! Oh, my sweet Bernice.” He runs around to the driver's side and strokes his wife's sweaty yellow hair. She is smiling; her leg still perched on my shoulder.

“Is it okay?” Bernice asks.

I give the lustily crying baby a once-over, looking, as I always
do, for any anomalies, and quickly wrap it in the beautiful blanket, cord still attached.

“Just fine. A healthy male infant.”
Now where to put the child while I attend to the afterbirth?

“Do you have something soft? Another blanket?” The new father comes up with a worn chenille bathrobe to make a temporary bed for the infant on the floor.

“I have to push again!” the mother groans.

“Mother of God! Is there another one?” That's the dad.

“No, it's the placenta, the organ that gives nutrition and oxygen to the infant. You wouldn't have a bowl would you?” The father holds out his nice felt fedora and I plunk the whole slimy afterbirth into it.

Then Bernice squirms around and sits up. I hand her the crying, beet-red boy, still attached to the mess in the hat, and she begins to sing to him.
“Sleep, baby, sleep. Your father tends the sheep. . . .”

Alvin sits down on the running board, his face very white. “I don't know how to thank you, ma'am. Will they be okay, until we get to her mother's?”

“Yes, but take them to a doctor or nurse right away, someone who can cut the cord properly. I don't have a pair of sterile scissors. This is important. Don't do it yourself. It has to be sterile, and then a special dressing goes over the stump.”

“Thank you,” Alvin says again. “I have a few dollars. I'm sorry it can't be more. I just got laid off at the Cumberland Lumberyard. That's why we're moving to Torrington, to live with her folks. Had to leave everything but what we could stuff in the car. You're an angel sent from heaven, Nurse.”

“No, you keep the money. We don't need it. We're almost home.”

“Thank you, Angel,” the mother says, and I realize she thinks that's my name.
Angel!
Bernice's eyes are closed and she has the blissful expression of a person who's just experienced an earthquake or a wildfire and come out alive.

Alvin finds a towel, which we put between the mother's legs. I show her how to rub her uterus to be sure it stays firm and assist her in getting the infant to the breast. Then I take my coat off the hood of the DeSoto, say good-bye, and go back to the Pontiac to wash my shaking hands with water from a bottle I'd refilled at the last gas station.

“So,” I say to Dr. Blum, dropping back behind the steering wheel, my heart still pounding. “I delivered a baby. Did you see that?” Blum is snoring and drool is running down his chin. I look at him sadly, my once brilliant colleague, now a baby himself.

“You did this on purpose, didn't you?” I hiss at my charge. “To punish me, and for what? I didn't have anything to do with your losing your mind.”

The waitress, a bleached blonde, watches through the back window of the Four Leaf Clover Cafe just outside Oneida, West Virginia, and I catch a glimpse of myself in the glass, a small woman with a short light brown bob, an aquiline nose, a pinched mouth, and a puckered brow. Nurse Becky Myers, fallen on hard times.

The doctor just stares at a spot about a foot in front of him, seeing whatever nightmare he imagines or seeing nothing at all. The mountains leer over us, sandstone covered with red maple just budding. I blow out and begin the cleanup.

For more than seven years I worked with Dr. Isaac Blum, as his part-time surgical nurse while I ran the Women and Infants' Clinic
in Liberty, West Virginia. Then, in 1930 when the bottom fell out of the economy and the clinic lost its state funding, I followed him to Perrysville to be his office nurse in the private practice he shared with his brother for another four years.

I'd always admired Blum, the kind of physician who delivered babies, did surgery, made house calls, stayed up all night at the bedside of a sick child, and still saw patients in the office the next morning. He was a brilliant diagnostician and a careful surgeon, with gentle, competent hands.

I'll admit he wasn't perfect. He often talked like a professor, used big medical terms that the patients couldn't understand, and he lacked social skills, but I always smoothed things over. We were a team, and when you face life-or-death together, year in and year out, you form a strong bond.

Now, here I am, a forty-two-year-old registered nurse with an advanced degree in public health, taking care of a grown man who poops his pants, can't talk, and requires complete care just to survive. Maybe, I sometimes think . . . he doesn't want to survive.

Blum's collapse a year ago was a sudden one. After his wife plunged down the bank of the James River and died in that auto crash, it was like someone pulled the plug, and his life force just swirled out of him. It took two days to find her body, trapped under the ice.

I wasn't a relative or even his lover, but like a good nurse, I took over his full-time care. What else could I do? Watch him starve, or rot away in his own feces? Thinking it was temporary, I moved him into the spare room of my rented apartment and devoted all my time to his recovery. . . . Only he didn't recover, and we lived on his savings until it ran out. A year of grief later, his brother, Dr. Leonard Blum, senior partner and owner of their two-person practice, finally washed his hands of him.

“For god's sake, Isaac,” Leonard yelled, the last time we saw
him, just two days ago. “I have a living to make and a family to support. You can sit there like a living corpse and starve if you want to, but I can't carry the practice alone. I'm bringing in another physician.” He slammed the door and roared away in his Packard.

I'd just brought Isaac home from Johns Hopkins (my last hope), where, after studying him for four weeks, the neuro men recommended experimental electrotherapy. They'd shoot a strong current through his brain and hope the pain would jolt him out of his lethargy, but I drew the line at that. (If Blum ever came back and had lost even one brain cell, I'd get the blame.)

Then, just yesterday, our landlady, Mrs. Jenkins, knocked on my door and stood there, her chin up and hands on her hips.

“Nurse Becky,” she said. “You owe three months' back rent and my patience is as thin as snow in Atlanta. Twenty thousand people in the U.S. are being laid off every day and my husband is one of them. These are hard times, and I'm going to put you out if you can't pay by Friday. We need the cash.”

I had only forty dollars, not enough for one month's rent, let alone three. The rest of the doc's money had gone to Johns Hopkins, but that night, Blum shocked the pants off me. As I was putting him to bed, he spoke for the first time in more than a year.

“Go home.” His voice creaked like a door hinge that needs oiling.

“
We are home, here in Perrysville, Virginia
.”

“No.” He shook his head. “Other Virginia!”

By this I realized he meant
West
Virginia, where he still owned a house and his old clinic.
So
. . . having no other options, I loaded up what I could and we escaped in the night.

Now, we follow the wooded ridge on the county road past small farms with grass so green it makes your eyes sing, past waterfalls that cascade down sandstone cliffs, past mountain streams that
laugh for the joy of it, and as we begin our descent my spirits rise. The old worried Becky is replaced by the
other
Becky, the optimistic one.

“We should be in Liberty in another ten minutes,” I say to my mute companion. “The electricity at your house may be turned off and it will be dusty and dirty, but we can manage.” The doctor doesn't comment, but then I don't expect him to.

Finally, after twenty hours in the Pontiac, we enter a high mountain valley, and I feel my tight stomach soften. There in the distance, I catch sight of a familiar landmark, a winding ribbon of silver they call the Hope.

“Explain to me exactly how this happened,” I demand from Mr. Linkous, the attorney who has, for the past ten years, handled Dr. Blum's affairs in Liberty. It's only my training as a nurse that keeps me from screaming.

Isaac is seated at my side, immobile, hands balled up on his knees, eyes fixed on the attorney's framed diplomas mounted on the wall behind his desk. (It's so sad, really. When I first knew him, you could see his mind working in his very blue eyes, like minnows darting through a clear mountain stream.)

“Well.” The pale young lawyer clears his throat and flips his fountain pen back and forth between his fingers. “I was left in charge of paying Dr. Blum's mortgage and taxes when he and Mrs. Blum joined his brother's practice in Charlottesville, but last year he stopped sending funds. I wrote him three times.”

Here he frowns and taps a file on his desk that I assume holds copies of the correspondence. “I wrote to his brother too, November first, 1933, then I put a notice in the papers here and in Charlottesville on January first, 1934, but there was no response. Short of traveling to Virginia or paying the mortgage and taxes myself, there was no choice.”

“We were in
Perrysville
,” I snap, as if that makes a big difference. “It's about thirty miles outside of Charlottesville.”

“The house, all its contents, his clinic, and two acres were put up for auction by Mountain Federal on . . .” Here he consults the documents again. “February twenty-fifth, 1934. Mr. Churchouse, an investor from Charleston, bought the property for a song. I'm sorry.” The prematurely balding attorney closes the folder, as if that puts an end to it.

“So we have
no
place to live? He has no
home
?” I'm getting a little hysterical now.

Linkous glances at the doctor, then back at me. “What happened?” he asks in a whisper. “I'm so sorry. Was it a stroke?”

I'm too upset to sugarcoat it. “The nerve doctors aren't sure. Maybe a stroke, though they can't determine the source of the damage. Maybe shock at his wife's death.”

The lawyer's dark eyebrows shoot up. “I heard about Mrs. Blum. A tragedy. She seemed a fine woman.” I know what he means. She was a looker.

Back in the Pontiac, I stare out the window at the boarded-up stores on Main Street.
What now?
Blum sits like a manikin from Levy's Dry Goods. We have only ten dollars, not enough for gas to get back to Perrysville and no family that either of us can turn to. I have never felt so alone.

When I left Liberty four years ago, Wall Street had crashed and a few stores had closed, but farmers, miners, tradesmen, and their families still came to town for necessities. Now, all along Main, I see only two autos and one very swaybacked horse attached to a cart. For Sale signs are everywhere. At first glance there are only a few shops left open, the grocery, the barbershop, Stenger's Pharmacy, and the Eagle Theater, but that's apparently only on Saturdays. Farther down, there's a bar with a neon sign and Ida May's House of Beauty, but that's all.

“Welcome home,” I reflect out loud, flopping my head back on the leather driver's seat. I could be working at Walter Reed Hospital right now in a clean white uniform and a starched hat. Instead, I sit hunched in a cold car, nearly destitute, a caretaker of a mentally incapacitated ex-physician with no place to live and no place to go. It's not like I'm Dr. Blum's wife or sister, for god's sake, I'm just his last friend, well, almost a friend—actually more of a colleague. I look over at the poor fellow and straighten his collar.

For a moment I consider renting two rooms at the Barnett Boardinghouse and trying to find work in Delmont, twenty miles up the road, but I know, just by looking at the number of men on the courthouse steps, that there will be no jobs there either.

The same out-of-work miners, loggers, mechanics, and laborers who were sitting on the benches four years ago, when I lost
my
job, are still here, only then there were only five or six of them. Today there must be twenty lounging about, smoking Luckies and corncob pipes, hoping for some kind of day work. I watch as one spits a wad of tobacco on the sidewalk, and it's here the tears come. I really have no idea what to do next.

“Mr. Linkous should have at least taken us home to his house for the night,” I complain to my mute companion. I get no response, but I continue my one-sided conversation.

“After filling the gas tank three times, we have only ten dollars.” I scramble through my change purse, and add, “And forty-five cents. . . . Not enough to get us back to Perrysville, and anyway, where would we go when we got there? We still owe three months' rent to the landlady and can't ask for shelter from your brother.”

“We have the Pontiac, only six years old.” I take a deep breath and go over our assets. “We have two strong bodies. We have twelve years of higher education, but only one mind, between us.” Here my voice breaks and Blum looks over.

Then he speaks again, the second time in a year. “Patience.”

“Patience! Are you out of your mind?” At this, I actually
smile because
he truly is out of his mind
. “If you think we can just sit here
patiently
on the corner of Sycamore and Main and someone will come to our rescue, you are sicker than I thought!”

Then I get it:
Patience Murphy, the midwife
.

“Patience Murphy!”

Once again Blum amazes me. It's like his once brilliant mind is hibernating, and for a moment it sticks its nose out of the cave and makes an observation.

The midwife of Hope River, Patience Murphy, was one of my only friends when I lived in Liberty four years ago. You'd think there'd be others, but for a single professional woman in a small mountain town, there weren't many options.

A few people reached out to me when I first left the Coal Miner's Mission at Scotts Run and took my job as the Union County public health nurse. The pharmacist Mr. Stenger and his wife invited me to dinner, but their five wild children drove me nuts, and I never followed up with a reciprocal invitation.

The schoolteacher, Marion Archer, took me shopping in Torrington, but she talked so much I couldn't stand it. Then there was Priscilla Blum, Dr. Blum's wife. She and Patience . . . they were my
almost friends
. . . and the doctor . . . but that was purely professional.

Patience Murphy and her young colored assistant, Bitsy Proudfoot, live only ten miles out of Liberty on Wild Rose Road. We can be
there in thirty minutes. Maybe Patience will allow us to stay with her for a few days. I'd be grateful even to sleep in her barn.

I start up the Pontiac and roll down Main Street, past the closed shops, past the courthouse, the train station, the fire station, the water tower, and the Saved by Faith Baptist Church.

As we cross the stone bridge over the Hope, I feel Dr. Blum straighten and look down at the water. On the far side two men are fishing. They raise their hands in salute and I wonder if they recognize the doc or are just being friendly.

It hadn't occurred to me, until now, that when people hear that Dr. Blum is back, they might expect him to restart his practice. I tighten my mouth. It isn't often that I let myself feel the whole weight of his tragedy. Mostly I just do my duty as a nurse, puzzled and angry, wondering how I got into this.

I know the answer, of course. I just never thought it would go on and on.
Now what can I do?
Leave him on the steps of a poorhouse or abandon him to the state asylum for the insane? I've been in those hellholes, and you don't do that to someone you care about.

As I turn onto Salt Lick, a wind comes up and I'm almost run into a ditch by a green truck, the kind that they used in the Great War, now filled with young men in khaki uniforms. When the guys see me, they yell out their catcalls. “Hey, baby!” “Hi ya, doll!”

CCC, CIVILIAN CONSERVATION CORPS
, it says on the cab. As part of Roosevelt's New Deal, the feds are hiring young men from all over the country, giving them work to do in rural areas instead of going on the dole, and I suppose I shouldn't be surprised to see them here, even in Union County.

Their whistles give me a lift, but only for a minute. From a distance they can't tell I haven't put on makeup in two days nor washed my short dark hair since we left Perrysville. They can't see the lines of worry and sadness around my brown eyes.

The shadows are long and it's nearing six by the time we labor up Wild Rose Road, past the Maddock farm, where Sarah Maddock, the crippled woman, and her husband, an engineer, from Huntington, live. The Maddocks moved to her family's place after she was brought down by polio some ten years ago.

At the end of the gravel lane, sits Patience Murphy's home, a small two-story white cottage with a periwinkle blue door. The house was in no great shape when I last saw it, but it looks way worse now, and the picket fence that I used to love is gone. What's more, Patience and Bitsy have let the yard go. The grass has grown up and a branch on the big oak in front swings in the wind like a broken arm.

“Hello!” I call, jumping out of the car, but Dr. Blum doesn't follow. Unless I guide him, he won't move at all, even if he's hungry or thirsty or has to pee. He's a wind-up toy, without volition, and I'm the winder.

When I step up on the porch and look through the cracked window, I see Patience's old sofa, but no piano and no paintings on the wall. That's one of the things that impressed me about the midwife the first time I came here, her display of original artwork, something you don't see much in the mountains except in the homes of the coal barons, bankers, and railway executives. I also was interested in her small bookcase with two shelves of novels, children's books, and medical texts.

It's dawning on me now that no one lives here, but just to be sure, watching carefully for copperheads, I head out through the tall grass to the barn behind the house. The double doors creak as I peek in. What am I afraid I'll find? Dead animals? The skeleton of a midwife I once admired hanging from the rafters? My imagination is too fertile. Always has been.

What I discover is . . . nothing. There are no signs of recent life, not a cow or a horse or even a chicken. Shafts of pale light shine down from the loft and the air smells of dust and old manure.

On the way back to the house a flash of lightning catches my eye and then the dark clouds growl, like dogs giving warning.
Thunder is scaring the frost out of the ground
. That's what the old-timers say in Vermont.

With a sinking heart I must face the facts. Patience Murphy is gone. Then the rain comes, cold tears.