The Blue Cotton Gown (10 page)

to go back to the hospital.” He knows I’m going to ask him for something.

“Well, she called with increased bleeding. The nurse had her come in, and there’s
a lot
of blood, not just a little. I was surprised. Could you do another ultrasound?”

He’s standing up. “Come on. Let’s go. Is she in there?” “No, I’ll get her. She’s already undressed. You set up.”

I run back to the exam room and explain to the patient that if we hurry we can do the ultrasound right now. Trying not to be rude, I wrap a sheet around Heather and rush both women down the hall to the corner exam room, where Dr. Harman is waiting. For the first time, I see that the older lady limps. I’d noticed her dark swollen legs before. She’s a setup for blood clots.

In contrast to the last time, this visit is cheerless. Tom explains that twin number one no longer has a heartbeat. The
threatened
miscarriage had turned into an
actual
miscarriage, complicated by the presence of a remaining live fetus.

“There’s not really anything we can do now but watch and wait. The other twin might still make it,” he tells the young woman and her grandmother. Then his pager goes off. “I’m sorry, I have to go. They have a patient ready for me in the operating room.” He rests a hand on Heather’s shoulder. “I’m sorry,” he says again. Then he pats her arm, nods at Grandma, and leaves.

I slowly turn up the lights with the rheostat, then sit on the exam stool. In the dark, I’d thought Heather showed no emotion and I’d wondered if she even understood, but now I see her wipe her eyes

with the tips of her fingers. For once, Mrs. Gresko is quiet. She adjusts the strap of her white leather bag, fiddling with the gold buckle.

“I’m sorry too. I was hoping both babies would make it. Even with all that blood, I thought they might.” The two women are silent. “Do you understand what Dr. Harman said, Heather, Mrs. Gresko? One baby has died. The fetus closer to the opening is still alive, but it’s at risk. If the bleeding gets too heavy, you may have to have a D and C to take both babies out, but there’s no way to take out the one that’s dead without hurting the live baby. Eventually your body will absorb it. We’ll have to watch carefully for infection, of course. We can’t take a chance on your health or your ability to have more children.”

Heather clears the tears from her throat. “I don’t understand why it happened.” It’s the first time today the girl has pronounced a full sentence, and her beautiful low voice still surprises me. I scoot up closer on the rolling exam stool and touch Heather’s knee, expecting her to pull away, but she doesn’t. She stares at my lined, freckled hand, which looks almost as old as Mrs. Gresko’s. I stare at it too. That’s what washing your hands at the exam room sink before and after each patient will do. I should use more lotion.

Mrs. Gresko is probably not even near seventy, she just looks it. Hard life in the mountains, cigarettes, and poor nutrition make women age prematurely. I wonder whether Mrs. Gresko raised Heather or if she’s just standing in for Heather’s working mom, but I don’t want to ask.

“We hardly ever understand why this happens,” I answer carefully. “Something just wasn’t forming right. There’s nothing you or anyone did to cause the miscarriage and there’s nothing we can do to make it stop. It’s just nature’s way of insuring that most of the ba-bies that
are
born are perfect.”

Heather nods and wipes her eyes again.

“So nothing could have been done, even if we’d come to see you

earlier? No medicine or anything? There’s
nothing
you could have done?” Mrs. Gresko asks.

I shake my head no. “Nothing but wait and hope.”

The grandmother raises her eyebrows and lets out a long tired breath.

Reprieve

Lying in bed tonight, I feel a sense of relief, despite everything. Outside, through the open screen door, a rare loon laughs on Hope Lake. Maybe Gorham isn’t so bad. When I’d gone up to Pittsburgh to explain there was no way we could pay the IRS in a lump sum, she’d looked up from her desk, which was cluttered with papers, books, and pencils, twisted a strand of her red hair, the gold bangles on her wrists catching the light, and suggested we get another bank loan.

“It’s done all the time,” she told me. “They use the assets of the practice as collateral. Your ultrasound machine would cover the loan.” This evening after work, Tom and I’d signed the promissory note for twenty-one thousand dollars and mailed the check to our accountant.

How long ago was it that we had no debts? I calculate back. On the communal farm, we paid cash for everything. We didn’t need much, just gas for the truck, peanut butter, rice, whole wheat flour, canola oil, and beans. We grew all the rest.

When we went back to nursing and medical school, we got student loans, then a few credit cards. When Tom got out of residency and joined the faculty at the university hospital, we took out a loan for our first house, and a few years later borrowed more for the cottage on the island in Lake Erie. I picture the two-story yellow farmhouse that sits on the rocky waterfront, the expanse of lawn and the willow trees, the red-roofed barn. It was worth it.

We started our private practice at Community Hospital with a loan from the bank; then we borrowed for the ultrasound machine, got money to set up our new partner, Dr. Burrows, in practice, took a loan for the laser equipment, and now this, another twenty-one thousand. I grimace. It adds up. But by the end of the week, the sword of the IRS will no longer hang over our heads, and we can make payroll. Tonight, the waters of Lake Hope lie quiet, lapping the shore.

trish

I haven’t seen Trish for days, I’ve been so preoccupied with our own financial problems, and then I spot her trudging across the employee parking lot after work. “Trish!” I call out. “Hey, wait up.” She turns slowly, tucking her sandy blond hair behind her ear.

“How are things?”

“Oh, up and down. You know. My life’s such a drama.” Trish laughs at herself.

“What’s happening? I haven’t seen Aran since we transferred her to the teen OB clinic at the university hospital. She doin’ okay?” We walk across the blacktop together.

“Jimmy got laid off after he had a fight with one of the other workers but found a new job doing landscaping. Then he didn’t like his boss and quit. Aran moved home again this weekend. It’s the third time she’s come back. She says she’s
through
with him now. To tell you the truth, I hope so. This stress is killing me.”

I groan sympathetically. Sometimes I don’t know how Trish stands these ups and downs, ins and outs.

“How’s Dan doing?”

“Oh, you can guess. He’s just withdrawing from the situation, trying to maintain. He’s getting stomachaches and has started smoking again. I’m getting stomachaches too, right here.” She puts the

palm of her hand below her heart. “Acid maybe, something cold and bitter like rust. I don’t know. A premonition, mother’s intuition, maybe. I feel like I should be doing something to help Aran, but she won’t let me.” Trish stops to unlock her car. “Sorry—I have to hurry. I have an appointment. I’m going to have my hair highlighted. It’s the first time.” She laughs again. “The gray’s coming in fast and I’m only thirty-five!”

Twenty minutes later I’m at the Veterans Memorial Park in bike shorts. Tom hands me my helmet and gloves, and without more than a few words we hit the trail. We pedal along the Jefferson River, past the dam, where the water churns gray and a few logs bob up and down in the foam. Here Asian men fish for bass and the occasional trout. These are university students from China, I imagine, enjoying the sunshine and a social pastime that reminds them of home. We pass the kids’ jungle gyms and slides, where I nearly al-ways see a mother with a child I’d delivered, now a toddler in a stroller. Sometimes I stop to talk, but today I pedal on.

We roll through successive waves of fragrance where honeysuckle vines grow along the riverbank. Pink phlox and blue chicory bend in the wind. Tom stops and points out an indigo bunting on a low sumac bush.

Trish’s hair is turning gray, and mine is more than half silver, but on the bike trail I’m still twenty-five.

Harvest Song

The radishes and sugar peas are ready to harvest. Today I’m picking the peas by the handful and throwing them into a basket, grabbing the thin pods, my back bent over, then pulling the radishes up by their veined green leaves and washing them under the hose. This could take hours, and I’m not in the mood. I love planting and see-

ing things grow, but I plant too much and then have to tend it. When we lived on the farm, we preserved hundreds of jars of produce, but harvesting in those days was fun.

Six or eight of us and Mica would gather in the big log house, the men mostly bearded and sweaty, the women in shorts or long skirts with no bras. We’d sit on homemade oak benches around a long wooden table, chopping tomatoes or stringing beans. Sometimes we’d sing while we worked. Spirituals would ring out through the open windows in perfect four-part harmony. Now I pick peas alone, not as enjoyable, but still good . . . good to grow your own food. Roscoe, our trusty basset-beagle, follows me along the rows, thinking I might find something she can eat. Despite the name, Roscoe’s a female. Zen got her when he was fourteen. Our youngest son had always wanted a dog named after Rosco P. Coltrane, the sheriff in the old TV show
The Dukes of Hazzard.
He didn’t care if it was a female.

The dry clots of dirt hurt my bare feet, and the sun warms my back. Nearly everyone in West Virginia has a vegetable plot. The garden might be only one or two tomato plants out on the porch, or acres of potatoes and corn. If they don’t have their own, they get produce from the brothers who still live on the family places in Big Sulphur Springs or Clover Gap.

Homegrown vegetables, deer meat, and trout are the soul food of Appalachia. It’s the Little Debbie Devil Cremes at the 7-Eleven, the fried chicken, and the bacon grease on the green beans that give us one of the highest rates of obesity in the nation.

On the commune we did everything by Rodale’s
Encyclopedia of

Organic Gardening.
“Rotate your crops from year to year to renew the nitrogen.” “Never place zucchini next to yellow squash; they’ll cross-pollinate.” “Don’t weed beans when they’re wet, you’ll spread leaf wilt.” Lately, I just garden when I have the time and plunk the plants where there’s space. What I put in the ground doesn’t always flourish. I tend my plants like I tended my kids. The boys got abun-

dant love, but maybe not the pruning and direction they needed. I fear my children are ill prepared for this world. They grew up like wildflowers, sometimes like weeds.

I stand up from my labors in the garden and stretch my back, looking out across the clearing to the gazebo. Let’s face it: Tom and I, too, are ill prepared for this world.

chapter 6

heather

“Dr. Harman,” Tom says, flipping open the cell phone he keeps on the small bedside table. I elbow myself up in the dark to squint at the red numerals on the alarm clock. Shit. I might have slept through the night if he hadn’t been paged. It’s 3:00 a.m.

“How much is she bleeding?” my husband asks. I turn on the green and white stained-glass dresser lamp.

“I’ll be right in. Will you call the nursing supervisor, alert the OR, and have her typed and crossed for two units?” He’s already on his way to the closet, where a pile of blue scrubs are stacked on a shelf.

“What’s up?”

“Patient hemorrhaging. Miscarriage.” He’s a man of few words. “Heather?” I know the answer.

“Yeah, the girl with twins.” He’s tying his running shoes. “See you in a few hours.” Tom flicks off the light, then closes the door. I lie awake, flooded with adrenaline, as I always am when the phone rings at night.

Throwing back the covers, I pad through the house. On the porch, I pull up a deck chair, take a sip of my bitter sleep medicine, and rest my chin on the rail. In three hours my alarm will go off. There’s no sound but the rain and the trucks on the highway a mile away.

Tom will be driving fast. In the middle of the night, it’s thirteen minutes to Community Hospital, longer during the day. We know exactly how fast we can get there after all the years of doing obstetrics.

He streaks through the traffic light near the Mountain Plaza and avoids the Torrington business district, where the winding streets that lead to the Jefferson River slow you down. Now he pulls into the ER parking lot and clicks his remote lock at the Toyota. He steps calmly out of the elevator into the harsh light of the fifth-floor pre-op bay. I see Heather’s white face, wet with tears, when she sees him.

Calling

Some people are born to be midwives. I think about that. Going back to school took work, sacrifice, and student loans, but I decided to go after my first delivery, which I did by accident.

Laura, dressed in denim coveralls and about seven months pregnant, seeks me out at the Growing Tree Whole Foods Co-op. “I want to have my baby naturally, can you help me with the breathing?” she says, swinging her long blond braid back over her shoulder. “I heard you had Mica that way. Will you help me?”

We meet four times in the back room of the natural-food store that our commune started; it’s located across the street from the courthouse in Spencer. Sitting behind a row of five-gallon buckets of peanut butter, barrels of whole wheat flour, and sacks of oats and pinto beans, we go over deep breathing, shallow breathing, staying centered, and trusting your body. I had taught Lamaze classes and read a few books. I’d attended two hospital deliveries as a labor coach, and I’d had one baby myself. That was the extent of my knowledge. It made me a local expert.

“The breathing doesn’t really take away the pain. It just gives you something to do when you want to run away, which you can’t do anyway, so why even try!” I tell her. Laura laughs.

“You can hum or count backward. It all works the same.” I show her some tricks of positioning, some techniques for massage.

Three weeks before her due date, Laura and her husband, Lou, ask Tom and me to come over for dinner and one last childbirth class. They live in a large converted barn in relative luxury, four couples and three kids under seven.