The Reluctant Midwife (7 page)

“It's coming!” she gasps.

My stomach gives a lurch.
Patience really isn't going to get here in time!

“Dahlila, try panting. I need you in bed so I can see what's happening, okay? Dahlila!” I insist. “I
really
need you in the bed.”

“Can't!” She's down to one-word replies. “Mmmmmmmmm!” I picture the baby's head descending.

There's nothing else for it, I must get down on the floor to look.

“Pant, Dahlila. Pant!” I make my voice strong like Patience's and pull on my sterilized rubber gloves. “The midwife should be here any minute. You can do it. Let me see where the head is.”
It better be a head. If not, we're in very big trouble
.

“Mmmmmmmmm,” the mother groans again and I'm relieved when I see a nice hairy orb.

Again, I try to think what Patience would do. I want to wait for her to get here, but I still haven't checked the fetal heartbeat, and the stethoscope is back in the bathroom where I dropped it next to the sink.

Maybe it's better to get the baby out and not fool with listening to the heartbeat. (Better a live baby than a heart rate to write in my nurse's notes.)

“Dahlila, look at me. I need you to listen and do exactly what I say.” I try to sound firm and hold her green eyes with my brown ones, but I'm pretty sure my voice is shaking. “When you feel an urge to push go with it. If it stings, stop for a minute and pant. Pant and let your opening stretch. It's going to burn like fire for five or ten minutes and then it will be over and you will have your baby.”

“Oh, I can't. I can't!”

“Yes, you can! We can do this together.” This is said with
much
more confidence than I feel.

I have no oil like Patience uses, so instead I dip one of my sterilized rags in the pot of warm water and hold it against the young woman's vagina. I'm just going on instinct here, hoping it might help her stretch.

“MMMMMMMMMMMMM!”

“Slow it down, honey . . . the head's almost out.” “
Hard times. Hard times
,” the radio booms.

“Oh! Ow! Ow!” Dahlila cries.

“One more little push.” There's no time for keeping the head flexed the way Patience does, or maneuvering the shoulders like Dr. Blum does, and maybe it's just as well, because with the woman on her hands and knees, I probably wouldn't do it right anyway. With the next push, the whole baby rotates and falls into my lap.

“I did it!” Dahlila cries, and the baby boy, startled to be here, cries with her. Downstairs, the front door flies open.

“Everyone okay up there?” It's Patience and Simon.

“You okay, babe?” That's the father.

“You okay, Becky?” That's Patience, and on the radio we have a new song. “
New day's comin', As sure as you're born! There's a new day comin', Start tootin' your horn . . .”

Now Dahlila and I are both laughing. Laughter just bubbles up. I sit back against the bedstead, still on the floor, covered with blood and amniotic fluid. Dahlila's eyes meet mine in joyful hysteria and I bite my lip to get control. This makes us laugh all the harder. Finally, I clear my throat.

“Everything's fine. Patience, you can come up, but please wait a few moments, Mr. Markey.”

Ten minutes later the placenta is out and Patience has stitched a few tiny tears. Some women, she tells me, are built better for childbirth than others, but if you're careful and let the head deliver slowly most won't have more than a few skid marks. Finally, we get the new mother between the clean sheets. We wash her face and hands and give her the baby, now wrapped snug in the sterilized blanket. Mr. Markey doesn't wait for permission. He bounds up the stairs.

“I did it,” the young mother cries proudly. “I made you a baby.”

The father doesn't say a word. His eyes are on the wonder of this new life and the beautiful woman before him. He just sits on the chair and sobs.

There's movement in the hall and when I turn, Dr. Blum is leaning against the doorframe. It's then that I see something I've not seen before, not even when he was in his right mind. His eyes are wet too.

“Hello,” a man calls from out in the yard just as I'm cleaning Dr. Blum's face, readying him for the trip into Liberty we'd abandoned when Mr. Markey sped up the road and begged for my assistance.

We both go out on the porch to find another stranger standing in the road, a handsome guy, clean-shaven, with shoulders as broad as a truck and a low voice that comes out like gravel running along a stream bed. “Hello,” he says again.

Surely he has the wrong house. He's standing next to the shiny red Packard I'd seen in town last week, the one with the silver winged goddess on the front of the hood, and he wears a black uniform with a little chauffeur's cap.

“Are you the nurse, Rebecca Myers?”

“Stay!” I hiss as I push Dr. Blum back inside and take the steps down into the yard. “Yes, I am.”

“There's a medical emergency at the Barnett Boardinghouse. Mrs. Bazzano asked me to bring you. It's her son . . . her eight-year-old son.”

“A child? What sort of an emergency?” (At least it's not a woman in labor!)

“It's his breathing. He's having an air attack. Old lady Barnett recommended you.”

“I'm not a physician, you understand? Can't you take him to the hospital in Torrington? There are specialists there.”

“No, we can't go into Torrington.” From the corner of my eye I catch sight of Isaac as he takes this moment to come back outside and stand at the rail to piss.

“Dr. Blum!” I shout, but it's too late. He's already taken his pecker out and is spraying a long one right toward the driver. The man steps back a few feet and stares in amazement.

“He's a doctor? If he's a doctor, you can both come.”

“Sir, your name?”

“Nick Rioli. I'm the driver for Mrs. John Bazzano and her children.
Mrs. John Bazzano of Pittsburgh
.” He says this last part as if it's significant and I take it that they come from money or fame.

“Well, listen, Mr. Rioli. I think you can see that the doctor is not right, clearly not able to help anyone, and you've caught us at an inopportune time. We're on our way to town for an employment interview.”

This is a fabrication, but I need something more impressive than
I have to go out and look for a job
. “You really should get the boy in the auto and head for Torrington
right now
.” The fellow just stands there, his arms folded in front of his body, making it clear he's not leaving.

“Mrs. Bazzano is prepared to pay.” Here he pulls out a black leather wallet and holds a crisp ten-dollar bill between his fingers, an attractive bribe. I haven't seen that kind of cash for months and my eyes are glued on the green. It doesn't take long to make a decision.

“Okay, Mr. Rioli. You've convinced me.” I hold out my hand for the tenner. “We were going into Liberty anyway. I'll follow in our own vehicle and go to the job interview later, but I have to make myself clear: If the boy is seriously ill, I may not be able to help him.

“On the other hand, if I
am
able to help him, it will be another
ten dollars.” I'm shocked by my boldness.
Healing for money
. What would Florence Nightingale say?

Twenty minutes later, the doctor and I are sitting in the back of the opulent Packard with springs so flexible I can hardly feel the bumps in the road. The silver winged replica of the goddess of speed propels us toward Liberty and I regret that the driver wouldn't let me bring my own vehicle, but then I wouldn't get the smooth ride.

“So.” I speak loudly, to be heard over the roar of the motor. “Can you tell me more about the child, Mr. Rioli?” Dr. Blum sits next to me, our medical bag in his lap, riding along in his usual silence. “Has the boy had breathing attacks before? Does he have any medical history? Any recent exposure to TB or anything like that? And why can't you go into Torrington?”

The driver clears his throat and watches me through his rearview mirror. “The boy goes to an asthma specialist in Pittsburgh, but he's never been this bad before. He's having one attack after another.”

“Any recent colds or croup?”

“Yes. It started with a cough. We were on our way to White Sulfur Springs to take the cure, but had to stop for a few days when he became ill, and now he's started getting short of breath.”

“You mentioned the family name, John Bazzano, but I don't know anything about them.”

“In this case,” says the driver, “that's just as well.”

A few minutes later, as we cruise past the soup kitchen at the Saved by Faith Baptist Church, I shrink down, embarrassed to be seen
riding in the limo while the hungry men stand in line for free food. They cannot know by looking at us that until an hour ago, the doctor and I were close to destitute ourselves.

“Why is it better that I don't know the family?” I turn back to the driver.

“Don't you read the papers?”

“Not lately, no.”

We pull up into the drive of Mrs. Barnett's Boardinghouse, a two-story white clapboard building with porches on both the upper and lower levels and around two sides. A neat white picket fence encloses the yard, and there are twelve-foot-tall white snowball bushes out front.

Two men in dark suits sit on the porch, in rattan chairs, playing cards. The shorter one has a small mustache and smokes a cigar. The other has big chompers with a gap in front and they both rise as we approach. Mr. Rioli parks in the back, and I notice there's only one other vehicle, another smaller late-model Packard.

Despite his urgency to get me to the sick child, Joseph stops for a minute and turns around in his seat. “Nurse Myers,” he says in that deep rattling voice. “You seem like a smart lady. I don't know about the doc . . .”

“He's disabled now.” I defend my old colleague. “A few years ago, you couldn't have wanted a better physician. He's a surgeon too . . . or was.”

“No doubt,” the chauffeur allows, but I can tell he doesn't buy it. “What I want to say is . . . For everyone's sake, don't ask too many questions about what you see and hear inside this house.”

I frown. “As a nurse, I never talk about my patients, except to other medical professionals.”

“Well, I'm warning you, keep that to a minimum too. I mean it.”

The men from the porch are approaching the Packard and Nick gets out and opens the door for me.

“Any trouble?” the taller of the two asks, and I see now he has one blue eye and one brown. Still, he's a handsome fellow, well groomed with a recent haircut. Both men tip their hats.

“Nah, smooth sailing,” says Nick. “Don't be alarmed by the gentleman in the back. I'll take the lady inside. Can you guys keep an eye on him; he's the nurse's charge, harmless she says, but a mute.”

“Yeah.”

“Just don't let him wander,” I interject. “He doesn't know what he's doing and might scare someone or get hurt.” I pull the black medical bag out of the car, just as a woman cries out.

“Oh, not again! Not again! Joey. Joey. Stay with me, Joey,” a woman screams. Mr. Rioli grabs my arm as we race up the stairs to find in the front bedroom, the fancy lady I'd seen in town kneeling next to a bed. To the side, on the floor, I can see a child's pale feet and I can hear his labored breathing. The room is filled with exotic-smelling smoke so thick I almost choke.

“Ma'am,” I introduce myself. “I'm Rebecca Myers, registered nurse. Can I help you?” When she turns I see that her face is red from crying.

“Oh, thank the Lord!”

“Mommy?” a voice from behind us interrupts.

“Hush, Allegra. Go back to the other bedroom and keep your sisters quiet. The nurse is here.”

“But we're hungry.”

“
It doesn't matter!
Go ask Mrs. Barnett. Go!”

The older child leaves and I don't get a look at her because I'm now on my hands and knees with the mother, helping the boy to sit up. He's a handsome kid, but his sandy-blond hair is sweaty and matted and his lips are blue. He breathes out with a high-pitched whine, and then coughs. Over and over he coughs and tries to push his air out.

“Nick,” I order. “Open the windows. We have to get some of this smoke out.”

“But Mrs. Barnett said it would make him better.”

“I know people say breathing incense helps, but I'm a nurse, if you want me to help, you have to do what I say. Open the windows.”

I pull out my stethoscope and listen to the child's lungs and heart. His respirations are rapid, forty a minute, and there's a marked expiratory wheeze.

“It's okay, Joey. Breathe with me. In . . . Out . . . In . . . Out.” The child's eyes, in his blue-white face, focus on mine and he makes a low moan, like wind being forced through a narrow pipe.

“Oh, Joey,” the mother sobs. “My little Joey. I'm so sorry. If only your father were here. I'm so sorry.” Her tears fall on the boy's head as she caresses it and I see that her emotions are louder than the boy's breathing.

“How long has Joey been having these spells?” I try to settle her down.

“It's his sixth fit today—before that he would have one or two a month, but he fell ill from the night air, or maybe it's a reaction to the greenery—we had an inhaler but he's used it up and I wrote down the medication we need and had Anthony take it to the pharmacy, but the pharmacist said he didn't have it—he told Anthony we might be able to get some in Torrington, but we don't want to go back there . . .” Her sentences run on like the Hope River flooding with chunks of ice in March.

I take my glass thermometer out of its metal case and put it under the boy's arm. The mother looks surprised.

“I can't put it in his mouth. When he breathes like that it won't be accurate.” Then I wait the two long minutes during which the boy and the mother begin to calm down.

“It's ninety-nine degrees. Close to normal. What else have you tried?”

“Anthony got him some Schiffmann's Asthmador Cigarettes at the pharmacy, the last pack they had, and blew smoke in his face, but it didn't help.”

“Okay, I'm going to run to the pharmacy myself to see if Mr. Stenger has some epinephrine somewhere in back. I'll get your driver to take me. Maybe, since the pharmacist knows me, I can persuade him to help. Epinephrine is what's in the inhaler, right? It's the medication the doctor from Pittsburgh gave you?”

“I think so.”

“Yes, that's what they use. . . . Mr. Rioli!” The driver is listening to everything, just outside in the hall.

Getting away from the house gives me some time to think. If the boy keeps going on like this, he could go into cardiac arrest and the next asthma attack could be his last . . . or the one after that. I'm just praying that Mr. Stenger will be able to find some epi stashed away in the back. Even a few drops could be used in the child's nose.

“Step on it, Nick,” I order as we peel out of the drive. It isn't until we get to Main that I remember Dr. Blum. Hopefully, he's still on the porch with his babysitters.

“Little Joey going to be okay?” the chauffeur asks me.

“I don't know. I'll do what I can. It depends on if we can get some kind of medication with a bronchodilator in it. Status asthmaticus can be fatal.”

“Status what?”

“Status asthmaticus . . . asthma attacks that go on and on without a break.”

The chauffeur, knuckles white and jaw clenched, grips the wheel as we head into town, but our trip to the pharmacy is fruitless. When Mr. Stenger insists he has no epinephrine, we leave in a hurry after wasting precious time.

“What now?” Nick asks.

“Let's go back to the Barnett Boardinghouse and I'll call the local vet and see if he has any medication that might help. He lives out in the country. Maybe he'll bring us something.”

“I could go get it, if you tell me where. I could persuade him.”

“What's with you anyway? I thought you were going to get rough with Mr. Stenger back there?”

“I just . . .” (The blush moving up his baby face surprises me.) Before the driver can answer . . .

“Hey! That's the vet!” A black Model T with a dent in the rear is moving away from us down Main. “Can you catch him?”

The Packard shoots forward, horn blaring, and the Ford screeches to a halt. I jump out while we're still rolling. “Ill child with asthma,” I yell to Daniel Hester. “We need epi.”

“Where?” Daniel yells back, standing on the running board.

“Barnett Boardinghouse.”

“I'll have to go home. I have a little there.”

“The boy is critical,” I offer, as he speeds away, then bite my lower lip. The sun is too bright for early May. It should be softer. The shadows are too harsh and I don't know why I care so much about one little boy of one apparently very rich family, but I do.

On our return to the rooming house, we find the child has fallen asleep and is breathing quietly, but it doesn't last. An hour later, his eyes snap open and lock on to mine. He sits up in bed, puts his hands around his neck, and looks around wildly.

“Breathe in . . . Breathe out . . . Look at me, Joey! Do it like this. I know you feel like you can't get your air, but breathe slower. In . . . Out . . . In . . . Out.” The boy starts to cough again and it's all we can do to keep him in bed. Once, he sits up so hard his head hits my nose and it begins to bleed, dripping red on Mrs. Barnett's white sheets.

“Nick,” the mother shouts. “Help, Nick. We need you. This time it's worse.”

There's the sound of heavy feet coming up the steps and when I look up both Daniel Hester and Nick Rioli are trying to make it through the door at the same time. The vet is wearing dirty blue coveralls and smells like manure, but he's here and I feel less alone.