The Pursuit of Alice Thrift (24 page)

My community.
“I'd probably keep it to myself,” I said.

“Well, that's not me. I've been open and honest about the pregnancy, and I don't think I should have to deny myself the delight I feel every second just because Leo isn't thrilled at the prospect of fatherhood. He's conflicted, and I am so . . .
not
conflicted.”

“Were you trying to get pregnant?” I asked.

Meredith said, “Not consciously. Leo, on the other hand, thinks I was using him as a turkey baster.”

I understood the reference, but didn't comment. I wondered why Meredith had joined my table, and why she was confiding anything at all unless she thought I'd report back to Leo on her independence and autonomy. “How long has the hiatus been in effect?” I asked.

“Since that dinner,” she said. “And I don't mind telling you that your friend Sylvie Schwartz brought out the absolute most cynical side of Leo. I felt as if a lead curtain dropped down between us that night.”

I said, “I felt that, too—as if Leo and Sylvie were ganging up on us.”

“Us? No.
Me.
I couldn't say anything right. I was the odd man out to the point that I was relieved when I got beeped.”

I said, “I've auto-beeped myself to extricate myself from an uncomfortable situation, too.”

“Mine was the real thing, and a very long night. Which gave me time to reflect on the whole episode. You know what it reminded me of? High school. And Dr. Schwartz? Did she think I wouldn't notice her sarcasm? I'd never met her before that night, but she was awfully happy to join forces with Leo and make me the butt of their jokes.”

I took a bite of pie and a sip of coffee before asking, “Do you know if they've been seeing each other?”

Meredith said, “I thought you'd know the answer to that.”

I said yes, she did live across the hall from me. But I'd been keeping to myself. Well, not entirely to myself. Did she remember Ray Russo? From the dinner at Dr. Shaw's?

“Vividly.”

I held out my left hand. “We eloped yesterday.”

Meredith drew in her breath, then begged on the exhale,
“Why?”

“For the same reason other people get married. To be together.”

She looked this way and that. “So where is he?”

“At home.”

“They can't give you one day off after you elope?”

I murmured something about checking up on a Mr. Smith or a Mr. Jones, whose hernia I'd repaired the morning of the wedding. Upon learning the patient had been discharged, I swung by the cafeteria to grab this piece of pie. In celebration.

“Congratulations,” said Meredith. “He did seem awfully fond of you.” She pinched open the second carton of milk. “But who isn't? You do seem to have that little-girl-lost quality that makes men want to take care of you.”

I said, “I most certainly do not.”

“I'm just the opposite,” said Meredith. “I project self-reliance to the point of overconfidence. Which isn't the worst quality for a single mother to possess.” She patted her belly, smoothing the blue cotton so I could see the suggestion of convexity.

I said, “Just because Leo isn't under the same roof as you and the baby doesn't mean he won't be a fully committed father. In this day and age, any arrangement is normal. Separate apartments, separate cities, separate time zones.”

“Not where I come from,” she said.

“How much time before the baby's due?” I asked.

Meredith looked at her watch. “When I left she was only three centimeters dilated. So I'd say tomorrow. A Saint Patrick's Day baby.”

“I meant you.”

“Oh. September. Mid.”

“A long time to work things out,” I said.

Meredith rose. “If I see Leo, should I tell him about your wedding? Or do you want to tell him yourself?”

I said, “I don't think it matters either way.”

“Congratulations again,” she said, pocketing her banana, gathering the remains of her snack.

“I'll take care of that,” I said. “I'm going to be here for a while.”

“Thanks. Give my regards to your husband.” She smiled. “Maybe one of these days I'll be rushing back upstairs to see you in the birthing chair.”

I asked, “What would I be doing in the birthing chair?”

“Pushing. Don't look so shocked. That's the progression I see: marriage, conception, labor, and delivery.”

“But I have seven more years of training. Then, if I'm accepted into a plastic surgery—”

Meredith stopped me with a hand on my shoulder. “One piece of advice? You know this as well as I do: You can do a fellowship at forty, but fertility isn't forever.”

“I know, but—”

“
Really
have to get back upstairs to Rachel,” she said. “I hate to leave my mothers alone, especially the ones without partners.”

It was Saturday night and I had no partner, either. “Mind if I tag along?” I asked.

25.
Do It for Dr. Thrift

YOU DON'T EVEN HAVE TO SCRUB. YOU JUST WASH YOUR HANDS
and put on a sterile gown, and there you are, eligible for bedside duty like a pinch-hitting sister-in-law who volunteers for Lamaze. No attendings hover. The patient whimpers, screams, writhes, yet it's no cause for medical alarm.

A nurse named Florida was making an argument for a fetal monitor. Rachel had already threatened to sue: Had she or had she not signed a contract prohibiting fetal monitoring except in the case of dysfunctional labor or meconium-stained fluid?

“What contract?” Florida said good-naturedly. “Show me your contract. What mama doesn't want to hear her baby's heart?”

Meredith swooped down to say, “Hon, I'm back. She's not talking about the fetal scalp electrode.”

I asked what else Rachel had delineated in a contract.

“No episiotomy unless the baby's in distress,” said Rachel. “No forceps—”

“Don't even own them,” said Meredith.

“No Pitocin.”

“We don't need Pitocin, hon,” said Meredith.

Florida began to say that labor sometimes stopped, so who could say what lay down the road, but Meredith stopped her with a look.

“You new?” Florida asked me.

I said, “I'm in surgery.”

“Surgery?” Rachel asked. “What's a surgeon doing here?”

Meredith said, “For the pure sport of it. We're a teaching hospital. You know that. She could be a veterinarian for all that her specialty has to do with you.”

I said, “I can get the ice chips.”

“Whatever,” said Rachel.

I asked how things were. Where were we now?

Meredith said, “Three centimeters when I left. Ninety percent effaced.”

“I think there's been some progress,” said Florida.

“I didn't think it would be this bad,” said Rachel.

Meredith and Florida wrapped a pair of belts around Rachel's abdomen. “How's that?” asked Meredith. “One's for Doppler and the other measures the length of the contractions.”

“And here we go,” said Florida, readout in hand.

Rachel was flapping her wrists while expelling a string of alliterative syllables that I knew to be the incantations of natural childbirth. Meredith quieted Rachel's hands and recited the
hee-hee-hoo
s along with her.

When the contraction subsided, I asked what the scientific basis for the breathing exercises was.

“Relaxation and pain management,” said Meredith automatically.

“I'm sure someone's done a controlled study,” I said.

“Want to walk?” asked Meredith.

“I don't like that,” said Florida. “I don't like when they're off the monitor.”

“Intermittent monitoring every few laps,” Meredith promised. “Every fifteen minutes we'll check back into the room.”

“Am I still in the latent stage?” asked Rachel. “Because I'm finding it harder and harder to hold it all together.”

“Of course you're holding it together,” said Meredith. “And Fir's fine, too.”

“What fur?” I asked.

“That's the baby,” said Meredith, eyes widened, appealing for my indulgence.

“Is that a boy's name or a girl's?” Florida asked.

“Either,” said Rachel.

Florida wrinkled her nose. “Fur? Like a coat?”

“F-i-r,” said Rachel. “Like the tree. But all capital letters.”

“Not that it isn't pretty,” said Florida, “but other children can be mean.”

Rachel asked, “Why do people always think it's f-u-r?”

“What do you care what people think?” asked Meredith. She put an arm around the area where a waist normally would be. “Okay! Let's hit the road. Alice?”

“Another,” said Rachel, grimacing, clenching Meredith's closest forearm with both hands.

I looked at my watch, because Florida was looking at hers, searching for meaning in its second hand.

“Body relaxed,” chanted Meredith. “C'mon. Blow it away. You're at the worst part. It's going to subside. Let your jaw go. Let your shoulders go.”

Florida and I waited. Rachel was frozen to one spot, eyes bulging, her face drained of color.

“Breathe,” said Meredith.

“Do you need some more to drink?” asked Florida.

Rachel gagged slightly and closed her eyes.

“Does your back hurt?” asked Meredith.

“Don't touch me,” moaned Rachel.

“Let's check you when this one's over,” said Meredith.

“Don't touch me,” she repeated.

“Do it for Dr. Thrift,” said Meredith. “She's probably never measured a dilated cervix.”

“Who did you say she was?”

“A house officer,” said Meredith. “And a friend.”

“Maybe next time,” I said. “No hurry.”

“I'm one giant vortex of unbearable agony, so why should I care who sticks her fingers into me?”

“Have you peed lately?” asked Meredith.

“Not since I got here,” said Rachel. “Ironic, huh?”

Meredith said to me, “
Ironic
because she's been peeing every fifteen minutes for the last six months.”

“This sucks,” said Rachel. “I hate it.” And she began to cry, a humpty-dumpty with two belts around her middle, a johnny on the front and a johnny on the back, arms braced against the bed, feet in kelly-green hospital-issue nonskid socks.

“You're doing great,” said Meredith. “You're tired. We don't have to check you now.”

“I'm feeling sick,” Rachel moaned. “I want to throw up.”

“No problem,” said Meredith. “Just like we talked about.”

“I can't throw up in a toilet. I find it disgusting. It makes me sicker.”

“Our toilets are immaculate,” said Florida.

“We have pretty pink pans,” said Meredith. Then, to me: “Would you mind?” pointing her chin toward the bathroom door.

“Wouldn't it be better . . . in there?”

“All she's had is water and a cherry Popsicle,” said Florida.

“We don't mind, do we?” said Meredith. “Whatever makes her feel better.” She was holding Rachel up by one elbow, so I went around to prop up the other side.

Florida said, “I haven't eaten since I came on duty.”

“Go,” said Meredith. “I've had my turn, and now I have Alice.”

“I'm sick,” said Rachel.

“Basin!” ordered Meredith. “Above the sink. Top shelf.”

“You won't even miss me,” said Florida.

“
TELL RACHEL WHAT
you did this weekend,” Meredith tried as we shuffled along the linoleum, Rachel sagging between us. Meredith stopped every few laps to knead her own lower back.

“Should you be doing this?” I asked.

“I'm fine,” she said, “a little sciatica,” and immediately turned the conversation to Rachel's well-being, to Rachel's need to breathe in through the nose and out through the mouth when another contraction stopped us cold. “Ask Alice what she did yesterday,” Meredith coaxed.

When Rachel only glared, I volunteered, “I got married at City Hall.”

Rachel asked, “To whom?”

“My boyfriend.”

“They eloped,” said Meredith. “Like two crazy kids in Las Vegas.”

“Is this supposed to distract me?” asked Rachel. “Because I thought the main thing here was focus. Am I listening to my body, or am I listening to a total stranger's married-cute story?”

“Sorry,” said Meredith, but with a wink to me over Rachel's bent head.

I said, “Does your body want to keep walking, or does it want to lie down?”

“I don't know,” she said, and began to cry again, loudly, unselfconsciously.

“Want me to get a wheelchair?” I asked.

“We're almost there,” said Meredith.

“When does the doctor arrive?” I asked.

“Sorry, kid,” said Meredith. “I'm it. No doctor needed, present company excepted.”

“I didn't want a doctor,” said Rachel. “What would a doctor do? Give me an episiotomy when I wasn't looking, then throw away my placenta?”

“Don't be like that,” said Meredith. “We don't discriminate against our brother doctors, right, Alice?”

Who
was
this, I wondered—this formerly less-than-companionable acquaintance who seemed transformed on the job to an angel of imperturbable mercy? I said, trying to copy Meredith's genial tone, “My favorite doctor in the whole hospital is a male obstetrician.”

“I'm not an idiot,” said Rachel. “Nor am I antimale. I knew I wanted a midwife and a birthing pool—”

“Which we don't do,” Meredith murmured. “Too much house-work and timing and disinfecting involved. Plus the pediatricians hate it.”

“I saw a video,” said Rachel. “It was so beautiful. The warm water made the pain almost bearable.”

“Pain?” said Meredith. “Do we call this pain?” Smiling, she steered us back into Rachel's room. “Time to check the baby.” And to me, “We're looking for one-twenty/one-thirty/one-forty beats per minute. Something around there.”

“I need to pee,” said Rachel.

“Leave the door open,” said Meredith. “We're right here.”

I whispered to Meredith that this experience was different from what I'd seen in medical school.

“How?”

“I don't remember the walking and the talking. Or the talking
back.
”

Meredith said things were intensifying. Soon Rachel would be rendered near-speechless, all sound and fury but no debating, so I should hang in there.

“I'm having a bowel movement,” we heard from the bathroom. “Is that okay?”

“Uh-oh,” said Meredith.

“Something's there!” Rachel yelled.

I followed Meredith, three long strides to the bathroom.

“Are you feeling rectal pressure?” Meredith asked. “Talk to me.”

Rachel moaned, then grunted.

“We need to check you,” said Meredith. “Don't push. This could be it. Can you stand?”

“No!”

I stepped forward. “Tell me what to do,” I said.

FIR WASN'T EXACTLY
born in the toilet, but it was close. Rachel couldn't or wouldn't move herself, all the while insisting that she had to push, that it felt better here, that FIR had chosen this time and place. I saw pain in Meredith's face when she and I tried a double hoist. When Meredith stepped back to put on gloves I said, “Rachel! Your baby is going to fall into fecal matter. I know you don't want to move, but you're much better off in a clean, well-lit place. See the bed? Nice and upright? Not unlike a big comfortable toilet seat, only sanitary. Doesn't that look better?”

“Well lit?” she snapped. “I specifically asked that the lights be dimmed—”

“Do you want it to say
bathroom
on FIR's birth certificate?” Meredith said.

“You're lying,” said Rachel. “They fucking don't write—” and the rest of her retort was lost in the worst animal scream yet.

“I have to check you,” said Meredith, “but I absolutely
cannot
do it there. You have to listen to me, Rachel—”

“Something's coming,” she cried.

“I can't budge her,” I said.

“You have to,” said Meredith.

I tried what I'd already failed at—lifting, heaving, enlisting—and this time something worked: Rachel was up on her stubborn legs, her slippered feet. Later Meredith confirmed that sometimes we find superhuman strength—
her
adjective,
superhuman
—in matters of life and death; or, on this Saturday night, just new life. Finally Rachel was propelling herself with the force of a runaway car in drive toward the safety of the bed and its hygienic field.

Meredith was everywhere—at the door yelling for a warm blanket, for help, for a warmer, for paraphernalia known only to midwives and nurses—yet never seeming to leave Rachel's side. “Knees up,” she ordered. “Way up. As far as they can go. C'mon. I'm right here. You're doing great. Now,
push.
”

I thought I was standing there helplessly, but I wasn't. For once it was Alice Thrift in the right place at the right time—3:03
A.M.
on March 17—when out swooshed a big, messy FIR Patrice Flowers, eyes wide open, into my curiously steady hands.