The Reluctant Midwife

The tears that come out of me for the next hour, my head bent down over the kitchen table, would flood the Hope River. Patience stays with me the whole time, patting my back. I’m not just crying for the little girls, but for everyone, and not just the victims of this fire, but all the victims of all the fires, all the victims of this hard, hard life.

When Blum comes in from the barn, his eyes are red too.

44

Graveyard

I’ve not been feeling well and I know Isaac notices. He has even begun cooking and cleaning the house. Sometimes I go out in the garden and weed, even if it isn’t needed, just to sit with the plants. Sometimes I lie down in the meadow, down by the creek, looking up at the sky, just to feel the comfort of the earth. Secretly, I fear something has been burned out of me, something that will never grow back.

Despite all the many losses when I was young, I thought if people did what was right and played by the rules, all would be well, but life, I’ve learned, doesn’t work that way, and death and pain come on relentlessly whether you are good or not.

It has been a week of funerals. On Saturday we went to Clarence Mitchell’s service at the Saved by Faith Baptist Church. I couldn’t stop crying. When I went up to Lucy Mitchell, instead of easing her grief, I bawled on her shoulder; it was that bad.

Willa’s girls are staying with Mrs. Stenger, and she told me in private, “I’m too old for this. The littlest ones have nightmares and the older ones fight. I hate to think of them going to an orphanage, but they have no family and I have my own brood of five to care for.”

I didn’t go to the Bowlin boy’s memorial service at Hazel Patch and neither did Dr. Blum, though Patience invited us to join them. I’d only run into the young man twice, when the pastor brought us wood and then again at Livia’s birth, and Blum didn’t know him at all.

While the Hesters are at the Hazel Patch chapel, I walk out behind the barn to look at the graveyard where Blum has been digging the graves. There will be eight in all, each seven feet deep. Next to the empty holes, there are three little graves with tiny wood crosses.

The first cross is for the premature baby that was left in a cardboard box at my Women and Infants’ Clinic, another lifetime ago, when I didn’t understand how such things could happen. Now I know. Life is cruel.

The second is for the baby Patience lost before she moved to West Virginia, the one she delivered prematurely in the back of the horse-drawn ambulance in Chicago, when she was sixteen. (There are no remains in this tiny grave, but the midwife needed a place to remember.)

The third cross is for the baby Patience made with Daniel during a thunderstorm and then birthed on the kitchen floor.

All the victims of the fire who have no family plots will be buried in this place tomorrow. Captain Wolfe, Drake Trustler, the colored homeless man John Doe, Willa Hucknell, Alfred Hucknell, and the baby, but Patience has also convinced the Hazel Patch folks and the Bishop brothers that Beef and Nate Bowlin belong here too, with the other heroes of the Hope River Wildfire. When the midwife makes up her mind about something, she’s very convincing.

Blum has started carving a sign, to be mounted on two cedar posts, that will read, HOPE MEMORIAL CEMETERY.

May 9, 1935

I am out digging the last grave behind the barn in the spring sunshine and all the time I’m thinking about my own grave, the one I jumped into the day Priscilla died. What was it that propelled me into that black tomb? What happened that made me turn my back on life? I’ll try to explain, though it may not make sense. The thing is, I was beyond sensibility.

Looking back, the words of the circulating nurse in the operating theater come back to me through a dark tunnel. “You won’t be happy about this, Dr. Blum. They’re sending a patient up from the ER, a hot abdomen.”

I was just finishing my third surgery of the day, a hernia repair, and was anxious to get home. Whether Priscilla would be there was the question.

“Dr. Gross says the man is in critical condition,” the RN goes on. “You’re the only surgeon still in the hospital, so the case comes to you.”

Pissed off, I changed, rescrubbed, and reentered the operating room, just as the anesthesiologist was putting the patient under. As the nurse gave report, I waited, scalpel in my gloved hands. I had done hundreds of appendectomies and a couple of dozen ruptures.

“This is a patient in his late thirties, found in front of a downtown hotel with fever and chills, acute abdominal pain. Temp 104, pulse thready at 120, blood pressure 100/40 and dropping. The ER suspects a ruptured appendix or a twisted bowel. There’s no known next of kin, but the name on his business card in his wallet says John Teeleman, Eli Lilly.”

I almost dropped my scalpel. John Teeleman, the man who had been screwing my wife?! Rage overcame me. My hands shook, sweat beaded out on my brow. Fortunately, everyone else in the operating theater was concentrating on getting the man’s blood pressure up and no one noticed.

“Epinephrine,” the anesthesiologist ordered, and a nurse inserted the drug into the IV. “You’d better cut now, Blum,” he said to me.

The rest of the surgery was a blur. My first look at the patient’s abdomen revealed a well-healed vertical scar from sternum to public bone, so he’d already had surgery sometime in the past.

I know I made a small incision over McCurry’s Point and opened the fascia. I remember opening the peritoneum and being surprised when I encountered massive adhesions, probably the result of an old war wound. The appendix had already burst and purulent fluid was everywhere. It must have been as I was cutting through the scar tissue that I nicked the abdominal aorta. I couldn’t be sure because the visual field was compromised with a waterfall of blood.

“Suction!” I ordered, though the scrub nurse was already sucking.

The anesthesiologist tried to start a second IV line.

I opened the abdominal incision wider, searching for the bleeder.

The nurses tilted the table to shunt what was left of the Eli Lilly rep’s life fluid back into his heart.

I fought for John Teeleman’s life, as his blood drained red on the operating room floor.

“Thanks, Dr. Adams,” I shook hands with the anesthesiologist when it was all over.

“You tried, Isaac,” the circulating nurse said, giving me a one-armed hug.

But did I? To this day, I don’t know. Sworn to protect life. Did I try hard enough or did I intentionally kill the patient with that slip of the knife, execute John Teeleman, the man who was fucking my wife?