The Midwife of St. Petersburg (39 page)

“Yes, most interesting, Dr. Lenski. I’ve studied my mother’s medical books and the biography of Florence Nightingale. She, too, was insistent on scrubbing everything with hot soapy water. It proved to save many lives.”

Dr. Lenski smiled at her and nodded approvingly. “You will do very well here, Karena. We must get you enrolled.”

Karena’s heart sang.

“I’m quite sure the contagions thrive more because of dust catchers in the well-furnished Elizabeth Ward. What else could it be? Countess Vasiliy wished to leave many of her furnishings for the nobility, so we have many of the original tapestries, beds, and carpets. Do you know what happens to the women who birth and recover for a month in the Elizabeth Ward? We have a higher rate of puerperal infection. In addition, the official explanation for the different mortality rates in the two wings is that there are differences between noblewomen and peasants. The noblewomen are frailer, they argue, while the peasant women are a hard-wearing breed. Have you ever heard such a thing? Poppycock, as the British would say!”

Karena smiled. She remembered the two midwives in Egypt had made up a similar excuse about stronger and weaker constitutions when Pharaoh demanded to know why the Hebrew newborns were surviving after his order that all the boys should be thrown into the Nile. The midwives claimed that the Hebrew women were more robust than the Egyptian women and gave birth before the midwives could arrive to carry out Pharaoh’s order.

“Your reasoning seems sound to me, Dr. Lenski. I recall my mother saying that the charity babies have less exposure to sickness. She told me that they remained with their mothers near the bed so that each mother could feed and care for her own child. But the Elizabeth Ward nobility mothers often wouldn’t want to nurse their babies, which were kept in a central nursery.”

“Yes, and with staff wet nurses suckling more than one infant at a time, we have outbreaks of all kinds that seem to get passed from one baby to another. In addition, Elizabeth mothers stay here for more than a month before going home, but Anastasia charity mothers are sent away as quickly as possible to provide empty beds. It is all clear, is it not? But just attempt to explain this to the staff doctors. They will not listen. Only Dr. Zinnovy listens and agrees. He’s asked me to write a paper on the subject,
sending my proofs and beliefs for possible college publication. Unfortunately, I’ve not the time. Perhaps one day soon I’ll try.”

Karena looked at her quickly. “I’m helping Professor Menkin with his research for a book to be published in New York.”

Dr. Lenski looked at her intently. “Interesting. Perhaps we could get together on this project as soon as you are free. I will pay you well, of course. It might help toward your tuition.”

“I would be thrilled to be involved in such a project, Doctor. Is Dr. Zinnovy the director of the midwife program as well?” Karena asked.

“No no. He was when Yeva was here.” She looked at her again with a scrutiny that was frank and even sympathetic. “I must apply a new ointment on those bruises after I see Yeva. As I was saying, no, Dr. Zinnovy now teaches and practices at the Pavlov State Medical University. We are an independent school now, though at one time the schools were one.”

At the end of the corridor, Karena took her leave of Dr. Lenski, thanking her, and went outdoors to wait on the steps. The snow was floating lightly down again as the afternoon wore on. But inside she felt warm. Except for the circumstances centered around the death of Leonovich, Karena’s life was opening like a flower. She looked up at the gray sky and smiled.
Thank you, God. I want to know you. I’ve so much to learn about you and the Bible
.

A short time later, Dr. Lenski came out the front door in a rush, bundled in a heavy fur coat and carrying a dark medical satchel. “This way,” she called, marching on. Karena hurried to catch up.

A private coach came around from the side of the west-wing parking area, and the driver helped them inside. Soon they were on their way through the white wonderland.

When they arrived at the apartment, Matvey had not yet returned. Karena hadn’t expected him to be there yet, but she’d hoped to introduce them.

Karena went to the hall and opened the bedroom door. Madame Yeva stirred and turned her head on the pillow. The sound of her troubled breathing disturbed Karena. She walked up beside the bed.

“Mother, I’ve brought Dr. Lenski.”

“Fayina?”

Dr. Lenski came up, setting her case down on the table. “Ah, Yeva, to see you again—but in such condition.”

“Thank you for coming.”

“Nonsense. You should have called me sooner,” she scolded in a friendly tone. “How long have you been ill like this?”

“Not long … a few days … but feeling ill at the manor for weeks … all …”

Dr. Lenski took Yeva’s temperature, counted her pulse while watching her timepiece, and listened to her heart and breathing through her stethoscope. She asked quick questions, looked in her eyes, ears, and throat, and pushed aside her gray-gold braids from her neck to notice with a sudden frown the bruise marks on her neck.

I had forgotten
. Karena tensed. She glanced at Dr. Lenski’s face to see her reaction, but her expression did not alter. Madame Yeva considered Dr. Fayina Lenski a longtime friend, but had she intended all along to tell her about Leonovich? If she trusted her, why the displeasure when Karena had wanted to write her after returning from Kazan?

Now what?
Karena wondered, looking at her mother to see if she was aware the doctor had noticed the marks. Her mother looked too ill to be concerned. Surely Dr. Lenski would ask about them, even as she had asked about the marks and bruises on Karena’s own face. A doctor would recognize they were finger marks on her mother’s throat.

Dr. Lenski, however, asked no questions about the marks on her throat. A sign in itself she knew they were suspicious.

Perhaps thirty minutes later, after writing her diagnosis in a black
book, Dr. Lenski placed it in her satchel and wrote some instructions for Karena on a sheet of paper. She also made Karena swallow some small square pills, then provided a bottle of medicine for Yeva, setting it on the bedside table by the pink-shaded lamp.

“Two teaspoons every four hours.” She looked over at Karena. “She ought to be in the hospital, Karena.”

“No, Fayina,” Madame Yeva whispered.

“I’m her nurse,” Karena said. “She could find no one more committed.”

“I can’t argue that. Give her a second and even a third pillow to keep her elevated. It may help her to breathe with a little more comfort.”

Karena walked with Fayina into Uncle Matvey’s living room, where she dispensed extra medications and ointments.

“Your help is invaluable, Dr. Lenski. I do not know how to thank or repay you. As soon as I get a job—”

Dr. Lenski waved a hand. She peered at her, arms folded across her middle while she leaned against the tall divan back, ankles crossed. “This
accident
that bruised your face, are you claiming that is also how Yeva received those bruises on her throat?”

Karena tried to sidestep the direct questioning that seemed typical of Dr. Lenski. “Much has happened recently. She has lost a husband and we have lost a father to the Peter and Paul prison. We have also lost our home where we all grew up from childhood, and the wheat lands have been confiscated by the czar. Our money was stolen somewhere on the train when we were forced to ride in the boxcar after paying perfectly good rubles for our seats. My sister’s fiancé is on the front lines fighting the Germans—and now my mother is desperately ill with pleurisy.”

“The times,” Dr. Lenski said wearily, “are most trying. I might as well clear the air, Karena. I know about the Bolshevik meeting gone awry at Kiev—oh yes, I know about it. I should, since my own son Petrov was the speaker. He’s being sought this very moment by the secret police. Yes, I
know of these things. If I didn’t have my work, I’d be driven to distraction. My consolation for losing my son to the revolutionaries is a belief that I am giving back to others through medicine.”

Karena noticed for the first time how tired Dr. Lenski appeared. Karena’s conscience was pricked for enumerating her woes in an attitude of complaint.

“You have Ivanna,” Karena said, trying to comfort her.

“Yes, there is my Ivanna.” Her small eyes twinkled with pride. “And I should say that I’m aware of Josef Peshkov’s arrest and what his sacrificial confession has done to Yeva. That is not what I had in mind. I was speaking of those purplish bruise marks on her throat, and the bruises on your face. Yeva was choked; I recognize the prints of a man’s thumb, a strong man. I suspect those marks on your face are from the same man’s fist. What did you do—try to defend her and get struck?”

Karena looked at her for a long silent moment. She bit her lip and looked away from the doctor’s sympathetic gaze. Karena tossed up her hands in a gesture of despair. Dr. Lenski knew. Karena realized it was unrealistic to think she and her mother could hide the physical signs from a doctor and not have them evoke questions.

“Do you want to tell me about it?” Dr. Lenski asked in a professional tone.

“I don’t think I should involve you in something that can only bring trouble.”

“I am Yeva’s friend.”

Karena shook her head and turned away tiredly. “I’d rather not, Dr. Lenski. I’d feel better if I let my mother explain when she is well enough. You understand, don’t you, that I cannot take it upon myself now?”

“Yes, I suppose so. I think I can guess the facts anyway. Something happened in Kiev.”

“The help I need now, Dr. Lenski, is in finding work as a midwife.”

“I can see that, but you’ve no credentials to work at the hospital. It’s unfortunate.”

“I know that, but I’ve helped Madame Yeva since I was a child. I told you I delivered my first baby alone. What I didn’t tell you was that it was breech.”

Dr. Lenski looked alert. “How did you do?”

“The baby is alive and healthy.”

She nodded, showing satisfaction. “And the mother?”

“She died of a hemorrhage, but it was not due to any error. Madame Yeva will tell you that.”

She nodded. “I cannot give you work in the hospital, not even the charity ward.”

“I realize that. Still …”

“But I’ve heard of women who could use your services.”

“Yes?”

“Give me time to look into the matter. I may have Ivanna contact you in a few days, or I’ll do so myself. I’ll need to come and check on Yeva next week anyway.”

Karena’s mood immediately lightened. It was all she could dare hope for. “Thank you,” she said.

Dr. Lenski straightened from leaning against the back of the divan and waved her gratitude away. “My Ivanna and your stepbrother Sergei are serious about their relationship. Sergei wants to marry her, but neither Ivanna nor I want that to happen until she gets her doctorate. She has two years before she graduates. The marriage is likely to happen one day. That will connect our families.”

The front door to the apartment opened, and Uncle Matvey’s voice called, “Is that you, Karena?”

With secret relief, Karena turned toward the hall. “Yes, Uncle Matvey, I’ve brought Yeva’s friend from their medical days together, Dr. Lenski. The doctor was kind enough to come and treat her.”

Uncle Matvey walked into the living room and paused in the doorway.

After perfunctory greetings, Dr. Lenski gathered up her fur coat and medical bag.

“If she worsens, send word to me at once. This is my home address.” She wrote it down quickly and left it on the table beside the ointments and medications.

In the little hall, Karena held out her hand. “Again, thank you.”

Dr. Lenski smiled. “I’ll contact you soon about work. I suspect you’ll want to work incognito here in Petrograd.”

“That would be appreciated,” Karena said.

“I’ll tell you this,” Dr. Lenski said at the door. “The administration has decided to fund a few individuals, myself being one of them, to help certain women who have a higher mortality rate than any other group of peasant women in St. Petersburg. The women are prostitutes and have no place to go. They dwell on the streets. Many die while giving birth, and many babies freeze in the snow who should have been brought to the foundling house gate to be taken in. It is these women who need your skills.” Dr. Lenski looked at her thoughtfully. “Ivanna needs an assistant. Does the idea of working with prostitutes trouble you?”

“One needn’t agree with the decisions people make to show them mercy. If the day should come when I permit any woman to die in the cold and a newborn to freeze, I should renounce all desire for becoming a credentialed midwife.”

“Good. I believe you have what is needed. I shall tell Administration that you’ll be working under Ivanna.”

“I shall be anxious to start, Dr. Lenski.”

“Excellent.”

Dr. Lenski turned as Uncle Matvey walked into the hall, putting his coat on again. “Let me walk you to your coach, Dr. Lenski.”

“Not necessary at all, Mr. Menkin. I’m used to trudging about in the snow.”

“I must insist. The snow is coming down heavier, Madame.”

Dr. Lenski nodded and was out the door with Uncle Matvey without another glance back. Karena closed the door against the rising wind and smiled wearily to herself.