Bloodletting and Miraculous Cures (20 page)

The fuchsia fish gripped her and the beach seemed to funnel into its body.
Where is it going?
Janice opened her eyes on the labour room. Outside, the sky was dark. Evening, so soon. Ronai had turned off the laughing gas and the mask lay beside Janice. Dr. Ming was running the tracings through her hands. They were spooled out of the fetal heart monitor in a crumpled heap. She folded them back and forth on the perforations and spun the paper through her fingers. Janice saw that Dr. Ming was attentive, was interested in this spool of paper.

“What do you see?”

“I need to examine you again. I need to attach a scalp clip to the baby's head, for more direct monitoring.”
Next to the bed was a console that had a thin tail of wires in a straw-like tube.

Dr. Ming pulled on a glove. Janice spread her legs and felt Dr. Ming reach up into her muscular centre. She spread her fingers, adjusted the angle of her wrist, and suddenly became still within Janice.

“What's the matter?” asked Janice.

“Don't move,” said Dr. Ming.

“What do you feel?”

“The umbilical cord.”

“That's wonderful,” said Janice, satisfied at this reality that was going to emerge from her. She had noticed a chapter on umbilical cords in the last third of
Boen.
She hadn't read it.

“Actually, it's unusual,” said Dr. Ming. She spoke quietly to Ronai, “Put ten litres of oxygen on Janice. Call anaesthesia, stat call, cord prolapse, get the section room ready.” Dr. Ming adjusted herself, crossing her left leg over her right as Ronai snugged the straps of a clear plastic mask over Janice's nose and mouth. Dr. Ming looked very comfortable, as if she intended to maintain that pose for the evening. Ronai rushed out.

“Janice, we need to change plans,” said Dr. Ming. She still had her hand inside Janice, and pressed her fingers hard and upward. They began to feel uncomfortable. “And you need to lie on your left side.”

Janice eased herself over, and thought,
This is what beached whales must feel like.
“Are you finished examining me now?”

“Well, yes,” said Dr. Ming, “but I can't take my hand out. I feel the cord outside the cervix.” Dr. Ming looked at her with a tight smile, a pause, and then a delayed wrinkling of her brow that gave the impression that she wanted to make the situation clear but, like a teacher, would prefer her student to figure it out on her own. She drew her breath in quickly, like a grip of apprehension. “It shouldn't come out before the head. I'm pushing up on the head right now, to try to keep it from coming any further.”

Janice imagined her cervix, this narrow opening that needed to be stretched almost to snapping by the head of her baby, which should squeeze through it like a seed spit through teeth. She imagined the cord: its thick, pulsing blood flowing from her to the warm life inside her. It lay floppy in her vagina.

“The head will crush the cord,” said Dr. Ming.

“And my baby will suffocate,” said Janice.

Dr. Ming nodded, and the corners of her mouth creased with the satisfaction of having laid out certain facts and seeing her patient come to the correct conclusion.

“I have to keep my hand here. If the cord comes any further or the head pushes any more, it will be worse. I'm still going to attach the monitor.” Dr. Ming snaked the plastic sheath with the wires along her worried fingers, twisted the device into place, and pulled off the tube.

“Why don't you push the cord back in?” asked Janice.

“Can't. It would tangle. Same problem. Stay calm, still beating 120,” said Dr. Ming, looking at the fetal monitor. Janice was unsure whether the doctor was talking to her or herself. “We need to take you for a Caesarean section.”

There was a tinny overhead page: “Anaesthesia—stat to Labour and Delivery.”

So it was decided. A sudden change of direction. Janice had imagined the increasing pains, the spreading ripples of her own uterus's strength, the impossible stretching open of her body and the emergence of a son or daughter. She knew that things might go wrong, that in some women things did not go forward, that complications arose. She knew that things could come to a point where the danger to the baby outweighed the rhythmic forces of a childbirth's natural progress, and it became necessary to perform a Caesarean section. But she had expected that this point would be reached with a struggle of screaming and pushing and blood leaking out. It should be an epic of successive brinks and hazards. She was surprised that it was just like this. A decision.

“You're sure about the cord,” said Janice.

“The cord is pulsing on my finger, and I'm pushing up against the head…it's coming down.”

Brrr. Brrr.

The telephone next to the bed.

Brrr. Brrr.

It was an old style of telephone, with a heavy C-shaped handset. Janice picked it up and held the
handset in one palm and the phone in the other.

“Janice.”

“Hi, Oliver.” Janice spoke through her oxygen mask.

“I can't believe it. I got a flat. I'm waiting for triple A. I tried to change it, but you know I'm not good with these things. I cut my finger. How is it going?”

“Dr. Ming is just giving me an update.”

“Did you bring the camcorder to the hospital?”

“You know what? I forgot.”

“Jan, I bought fresh tapes for this.”

“I'm sorry, Oliver. I just forgot.” A contraction began to well up inside her, and Janice felt Dr. Ming's hand firm, insistent, pressing up against the baby's head.

“Should I stop at home and get it? I'm a couple hours from the border. Or just come to the hospital?”

“If you really want the video…”

“Okay, honey. Oops. There's the triple A truck. I'll be there soon. By the way, I got the deal in New York wrapped up. Love you.”

Janice hung up the phone and placed it squarely, symmetrically, on the side table. The scalp monitor flashed a new number every two seconds.

126

130

123

“Can you turn up the volume?” said Janice. “I'd like to hear the beats.”

“Sure,” said Dr. Ming, leaning her torso and left arm toward the box on its rolling stand, while careful to not
move her right hand from where it was the placeholder for Janice's umbilical cord. “I can't reach.”

“I'm having a contraction,” said Janice. She felt it tighten and grow in strength as if these muscles expanded their sinews each time they were exercised. It was like strong hands circling her pelvis, and the end was like a slow exhalation.

She saw that Dr. Ming watched the monitor.

80

85

83

90

“Too slow?” asked Janice.

“Well, it's not just the number,” said Dr. Ming. The twist of her eyebrows made Janice suspect that a simple answer was being obscured. “It's the pattern, the timing.” Janice looked over Dr. Ming's shoulder, out the door into the empty hallway. There was a second overhead page for anaesthesia.

“It's not good if I have contractions now, is it?” said Janice.

“The nurses are setting up for the section. The anaesthetist is coming.”

“And the head is pressing on the cord.”

“Yes.”

She could not will her womb to stop, now that it had begun its crescendo dance of muscle movements. It was awakening into its final purpose. The birth of a baby, the death of pregnancy. Months ago, Janice had been
amazed that it grew, that it claimed a mass which had never before been occupied in her body. Now, the fleshy cradle had become aware of the being formed within it and was trying to thrust it into the world. It was faithful to its program of bearing down, of pushing the head through thinning muscles of the pelvis.
Is my uterus so stupid?
she thought. But it wasn't its fault. It didn't know that the head was crushing the thread of oxygen that allowed the fetal heart to beat, staunching the trickle of blood that fed this new brain just as it began to wonder if it existed.

“Dr. Ming,” said Ronai, running into the room in her clogs, “section room's ready.”

Then there were more nurses. They took the intravenous bags off poles, attached them to the hospital bed, unhooked certain wires, attached other ones, everyone telling Janice not to move. They put a hairnet on her and repeatedly told her that everything would be fine, like an urgent mantra. One nurse turned up the volume of the scalp monitor.

“Get up on the bed,” said Ronai to Dr. Ming. “We'll push it down the hall.”

Dr. Ming was crouched, now leaning on her elbow with her fingers still pushed up inside Janice. Ronai put a sheet over them. With Dr. Ming crouched between Janice's legs like a monstrous emerging newborn covered by a hospital sheet, the nurses released the brakes on the bed and with a hollow clang set off down the hallway. Past the pastel-painted nursing station. Past
the other rooms, where women laboured and in one room a man yelled “Push! Push!” as a woman gave a long wailing grunt. Past a room where Janice heard the coughing cry of a baby, to the C-section room. Hands on each side of her pushed buttons, raised the bed so that it was level with the operating table, unplugged wires, plugged in wires, ripped down empty intravenous bags, hung fresh bulging ones, and repeated to Janice the dual mantras: “Don't move” and “It'll be fine.” In a series of manoeuvres during which all around her seemed to stretch themselves into contortionists, while urging her to be as still as possible, Janice was lifted onto the surgical table and Dr. Ming's hands were replaced by those of Ronai, who slid her fingers in alongside Dr. Ming, allowing the doctor to free herself.

They began to wheel the bed away. “Can I have my pillow?” said Janice to a nurse who was masked but did not wear a surgical gown.

“I'll have to put our pillowcase on it.”

It smelled like hot sand.

“Where is anaesthesia?” said Dr. Ming.

“Paged three times now,” said a nurse who was gowned and masked in green.

“Page them again,” said Dr. Ming.

“I'm feeling a contraction,” said Janice. She looked at the monitor. They all looked.

“Three minutes apart,” said Dr. Ming.

60

65

60

80

“Have them page any anaesthetist in the hospital,” said Dr. Ming. “I'm going to scrub. Call pediatrics.”

It took a long minute for the numbers to rise again, for them to reach 100. Then it hovered at 82, then up again to 95.

From where she lay on the operating room table, Janice could see the clock. A minute. Ninety seconds.
The contractions are closer together. My womb is doing exactly what it is supposed to do, pushing the head down.

Two minutes.

Dr. Ming backed into the room, opening the door with her shoulder. The back of one hand was clasped in the palm of the other, held in front of her as if about to catch her own heart leaping from the centre of her green V-neck surgical scrubs. Her arms were white-clean and dripping to the elbows.

Two minutes thirty seconds.

“Another contraction,” said Janice.

“The head's coming down,” said Ronai. She sat at the side of the operating table on a black-covered stool, pushing up against the head that surged slowly forward.

Janice no longer found it strange to have a hand pressed up inside her like a finger in a dam. In the birth videos, she had seen that sometimes labouring mothers would touch the head as it came out, to feel that there was a living globe there to push against. A hand connected the pushing. Now, feeling Ronai's fingers inside
her made her want desperately to relax. It was a reminder, a scolding that the squeezing of her body had become dangerous.

67

75

80

69

A nurse opened a crack in the door. “Got a phone call.”

“Anaesthesia?” said Dr. Ming.

“Husband. Wants to know if Janice needs her foot massager.”

“Tell him to drive safely,” said Janice.

The monitor was one in which the pitch of the beeping changed with the rate. As it fell slower, it beeped in a sad, low note.

Dr. Ming stepped into a gown offered by a nurse who stood, in sterile gloves, by the operating table next to an open tray of steel blades, clamps, handles, scissors, and spreaders. Janice saw Dr. Ming plunge her arms into the fabric, saw that she kept her hands hidden in the cuffs. Then, the nurse offered a paper-wrapped cord from the gown, which Dr. Ming accepted. The nurse held another cord in place as Dr. Ming spun fully around in front of her. This dance unfurled the gown and wrapped Dr. Ming in a membrane that made her shine green like the tiled walls.

Another contraction.

The nurse tied the two bands at Dr. Ming's waist, then held out gloves. She spread their opening wide so
that Dr. Ming inserted her right hand into one, and it became a live thing of latex. Dr. Ming made a fist and released it, to fully animate the pearly synthetic skin. Then the left hand.

66

66

70

75

This contraction was longer, and urgent. Janice realized that her uterus asked no questions, did not wonder whether the baby was doing well, whether the umbilical cord was safely tucked away.

80

85

80

Dr. Ming painted Janice's belly with a red-ochre liquid. It was cold, and ran down to her thighs. Neither of them spoke. Quickly, Dr. Ming taped drapes over Janice's skin, leaving only a rectangle of tight stretch marks tinged the colour of sunburn.

“Chart the time,” said Dr. Ming to the nurse who was not gowned. “Chart the time, that we are at twenty-two fifty-five fully ready to perform an emergency Caesarean section but have had no response from the anaesthetist on call.”

The monitor beeped a slow, low note.

 

Why are all these people here?
thought Janice.
I'm cold. I'm dissolving into this table. There's the contraction.
Maybe if I focus hard enough, I can hold it off. I read about Tibetan monks who can make their hearts stop, and then start again.