Georg Letham (61 page)

The tip of my thumb was barely touching the sole of the foot. And now back! Out! Quickly but without haste, forcefully but cautiously, despairingly yet certain of success! The hand holding the foot between two extended fingers of course took up much more room than the same hand had going in. Thus I had to maneuver with particular cleverness, artfulness, and caution, with bated breath, I might say, in going back the same way and pulling the foot down and outside.

As the foot moved down, pulled down steadily by my hand, with my other hand I pushed against the abdominal wall to move the baby's head upward. It readily did as I wished.

Now my hand, full of blood and greenish mucus, appeared at the opening of the birth canal, and between my fingers was the tiny foot, as though made of yellow ivory beneath its layer of filth.

I waited a moment to see whether the head would follow on its own or whether additional assistance was required. It was the latter. By gentle pushing and pulling, I first freed the baby's leg up to the knee. The hollow of the knee was directed outward, turned toward me, and so too was the baby's back: the presentation was normal, thank goodness. Thus I was able to carry the delivery through immediately by extraction.
This was easy up to the arms. The baby was not full-term; everything was smaller and thinner than normal. Now I more or less wiggled the left shoulder out by taking hold of the baby's leg and moving the shriveled, meager body up and down, all the while using every trick to take advantage of the least drag. The baby was luckily not breathing yet, but almost. A convulsive shudder ran through the slender limbs for a second time. Then quiet again. So not yet.

Not a second to lose, go! Keep it up! But no force, no wrenching, no, wait a bit, a little to the right, a little to the left, the hand supporting from below, release the “engagement” with fingertip pressure, not too much muscle. “No more anesthesia,” I cried to March, who was glad to put the chloroform bottle aside. Lucky March! He could stretch, wipe his forehead, take a deep breath!
He
had no responsibility!

The other arm came now, and already the pulsating, bluish red, convoluted umbilical cord too. Now the main thing, the head. Holding the baby's body tightly between the palms of my hands, I had quickly rotated it clockwise; the gentlest possible leverage exerted by a finger introduced between the baby and the mother's body freed the occipital area so that it could emerge, first with difficulty, but then easily, with the greatest of ease. It was coming, it was coming. Keep going! Good! At last the entire head was outside. I turned the baby around, so that it could see me. It was a boy.

“You have a healthy boy, Frau Walter,” I cried to the woman. Perhaps she heard me? I took a deep breath, looked at the baby I was carrying in my arms, which were covered with blood and trembling from exertion. The boy's nose was flat, the face as though pushed in, bent out of shape, shriveled. No resemblance to Walter. He had not yet breathed, though it seemed he would decide to any second. A good sign!

March had abandoned his duty, deserted his post as anesthetist and
pulse monitor at the head of the mother's bed. He was looking at me. He shouted at me maliciously:

“Mother dead–baby dead–doctor saved!”

I let him talk. I knew better. As I quickly clamped the umbilical cord, ligated it with sterile thread, and scissored it, the little boy's bluish red body convulsed in a prodigious effort.

But the first breath was like the whispering of a spring breeze in the tiny chest that was so thin you could count the ribs. The nurses, smiling with astonishment, took the baby from my arms. They washed off the blood and residue of greenish muck, weighed the baby in their hands, gazed at it steadily, made kissing noises with their lips, and looked at the baby's head as though they had never laid eyes on a newborn. But perhaps, spending their lives here in the Y.F. hospital, they had never seen how a human being is born.

Would these two maidenly creatures also have to look on as, after terrible suffering, a mother paid for the existence of her baby with her life, a life that was now irreplaceable for her children?

As I walked away from the bed and went to the washstand to wash my hands and my bespattered face, I must say I was approaching a despair I had not thought possible since my recovery from Y.F. and the disappearance of my inner guilt.

My friend's spiteful words–which I now took to be veracious, although the prophesy of doom was belied at least by the loud crying and mewling and struggling of the small but well-formed baby–pierced me to the heart. I could not understand how March, he of all people, for whom I had lately begun to feel a tender affection, could have stabbed
me in the back. But I pulled myself together, and I believe my face betrayed nothing of what was going on in me.

I went back to the mother, made sure she was properly positioned for expulsion of the placenta. She was regaining consciousness. As the aftereffects of the anesthesia were asserting themselves in gagging and vomiting, she opened her eyes. Whispering with weakness, she told me she was still having contraction-like pains. But when I asked her if she thought she could bear this without sedation until she had been completely delivered, and showed her the baby that the nurses had swaddled very lovingly and very inexpertly, so tightly that the poor little creature was almost suffocating, she, Walter's widow, brought her pale, moist lips, from which came a strong chloroform smell, toward my hand, and, in her foolishness, tried to kiss it. What could I do? Only one thing, jump back, so that I nearly slipped on the damp, dirty floor. March, who was still present, gave a theatrical, derisive guffaw. But I was soon steady on my feet. I was ashamed of the unfortunate woman's gratitude, and my only thought was to spare her as much as was humanly possible.

I sat down on the edge of her bed, took her trembling hands in mine to calm her, and waited for the conclusion of the delivery, the normal expulsion of the placenta. This was another critical moment. The release of the placenta is only too often followed by life-threatening hemorrhages, and the woman's condition was such that she could not afford to lose another drop of blood. Fortunately this moment passed off well. With a heavy but truly unburdening sigh, she sat up, bore down, and quickly forced the placenta out. There was hardly a trickle of blood afterward. We put fresh drapes underneath her, gave her a little cold tea (as cold as was possible in the great heat), placed the baby in a
basket normally used by the matron for household purposes (for no one had remembered to obtain a cradle), and turned out the light, leaving only a small oil lamp burning on the night table.

The others had already tiptoed out. The room filled with the regular breathing of the mother as she drifted off, joined by the much softer and more rapid breathing of the sleeping child.

The delicate smell of the iris powder the nurse had sprinkled on the baby mingled with the sweetish odor of the milk already seeping from the sleeping mother's breasts. I covered them with a light layer of sterile absorbent cotton and before leaving felt the woman's forehead. The fever that I so dreaded (yellow fever or puerperal fever?) had not begun. Her sleep was not deep. As my hand passed over her face, she opened her eyes and her long lashes brushed my palm. She wanted to tell me something, and, making an effort to lower her normally loud, harsh voice, she started a sentence a few times, but I did not want to listen, could not listen, I just pressed my hand gently to her lips and told her that she needed to rest. For the risk of postoperative hemorrhage is great in any operative delivery.

The assistant nurse came in once more to sit up with the woman overnight. With any luck, no special assistance would be needed. My only instruction was that every two hours the nurse should take the woman's pulse and temperature and lift the quilt to satisfy herself that there was no hemorrhaging: it has happened more than once after such difficult deliveries that women have quietly bled to death in their beds without a soul noticing. I begged fate to spare this woman.

As I was giving the nurse my instructions, it struck me that her eyes were focused on me with an expression of recalcitrance. I was unable to explain this to myself. Perhaps the thin, flickering, pale gold light of the tiny oil lamp was to blame, I thought.

I returned to my bedroom. I was exhausted and hoped, as I had after the death of the dear little Portuguese girl, to escape my self-tormenting thoughts in deep, dreamless, unharried sleep. But to my astonishment my bed was occupied. March, dressed and with his shoes on, had thrown himself on it as if to proclaim his dominion. He was not sleeping, but stared up at me challengingly. I bit my lip, but undressed silently and lay down on the floor where he had made his bed until now. The one on which March now luxuriated was no French courtesan's four-poster. How would such a thing have gotten down into the Y.F. hospital's oil storeroom? Nevertheless it was princely compared to the thin bed of rags with which March had been happy until now. Except that it was mine. But what could I do? Should I mourn the loss of this great child's love? If I had only known why I had lost it. Or did I know everything and just not want to understand?

I put my left elbow under my head to raise it a little and tried to sleep. Fruitless effort. I was still too wrought up. I could only pretend to sleep. March was as restless as I. He got up, undressed, got himself a cigar (it came from the stock of the brigadier general, who smoked very good, strong cigars that were almost unobtainable here), and began puffing away. I saw the tip glow dull red, heard March jam the cigar in his mouth and draw on it with a smacking of lips, heard it with all the terrible hyperacuity that one who has not experienced its torment could never imagine. All I wanted was some peace and quiet! But he did it as though to spite me! What got on my nerves most of all was his way of taking the cigar out of his mouth with a slight disgusting pop. He knocked the ash off on the edge of the bed, letting it fall on my knee, uncovered because of the frightful sultry heat. Fine, let him do that. I controlled myself. I had much greater problems on my mind.

With the eye of a bacteriologist, I saw the bacilli entering the tissue
tears caused by childbirth; I saw the microorganisms proliferate unchecked, saw them vigorously infiltrate the bloodstream of Walter's widow. Pyemia, fever, sickness, death . . . And no one more helpless than the physician who had caused it. Without meaning to. But not without having to. Should I offer fate another deal? Let Frau Walter live, take back the infection caused by my left hand, take back the infection caused by the
Stegomyia
at Walter's deathbed, let both experiments turn out well–and I would pay the price. What did I have to pay with? What could I give up? What else could I do without? Nothing? Wrong! Wrong! In recent weeks, when I had recovered from my Y.F. and our experiments were advancing as planned, I had felt a kind of happiness, a great, often almost glorious vitality, such as any constructive activity that is making progress will lend the spirit. I could let that go. But how? Only by finishing with myself. I could give
myself
up. I could commit suicide. It was a radical solution, but only by putting an end to my existence could I put an end to my experiments. The fact was that I would keep trying to finish this job for as long as I lived.

Should I do it? Or not? Should I once and for all “sacrifice” myself, to speak this portentous word at last?

A dribble of lukewarm liquid smacked onto my left hand, which was stretched out, palm upward. March had hit me with some cigar spit. I could no longer contain myself and said only one threatening word: “March!” But that was what he had been waiting for.

“‘March, March!'” he repeated, enraged. “Who is your March? What am I doing with a murderer?” he hissed. “Let me sleep and don't touch me.”

He fell silent, waiting for a response. But he could wait until the sun came up in the morning. I lay awake and did not answer him. Perhaps I should have kept that “March” to myself too. But I was only human.

How much I would have liked to crawl into the deepest hole on earth! How happy I would have been not to go on living! But I could not put a violent end to my life now. I had to face the facts and resolutely go on with the task I had set myself as far as my feeble energies would permit. Everything would have been easier after a restful night. But there was no question of sleeping in, the work in the laboratory had to be done, and above all I had the truly bitter task of going to Walter's widow, whose excessive and much-too-heartfelt gratitude of the previous evening was still making my cheeks burn with shame.

But if I was afraid that I would be showered with more exorbitant and undeserved thanks, fate had a pleasant surprise in store for me. I was in luck. Why the irony? The facts were perfectly serious. There was trouble even before I got into the room. Bobby, the little dog belonging to Walter's widow, lay in the sun at the door; a strong wind had come up and the morning was bright and pleasant. Bobby's silky coat shone. His breathing was calm. He was asleep. Or he was pretending to be, for he could not help pricking up his ears and swishing his bushy tail a little at my approach. When I tried to slip past the handsome dog by carefully stepping over him, over his back with its bluish and golden markings, he became fully awake and glared at me vindictively. He was frightened. Like all alarmed creatures, he was at once vicious and fearful, and I had not yet gotten my left leg clear when he bit down firmly, not with the full strength of his sharp little teeth, but hard enough to draw blood. And the little creature raised his voice, he howled as though he had been stepped on, as though
he
had been bitten. He panted, whined endlessly as though I were tormenting him the way the now dead and buried Walter must once have tormented him in his scientific experiments. I
remembered this, and the dog, who had two names, m-s-33 in the lab report but Bobby to his friends, remembered it too.