“Come in, Thomas. Is someone in labor?”

The tall man, an oak like his mother, Mary, steps up onto the porch and ducks though the door. Cold radiates off his green mackinaw, and flakes of ice shed on the floor.

“It’s bad, Miss Patience. There’s a baby coming, or trying to come, but the arm’s coming first. It’s Cassie Washington. This is her fourth child, maybe fifth. I think one died. Mrs. Potts has been trying for three hours, and the aunties say the baby’s arm is turning blue. You got to come help.”

“We can take Raccoon Lick to Hope Ridge,” I offer, “and cut past the Harpers’ through the woods, until we hit the south fork of Horse Shoe Run. It will take an hour if we hurry.”

“If you’re going, I might as well come,” Bitsy grumbles, but I smile, glad on this dark night to have her company. She can boil water, get the extra people out of the bedroom, and deal with Mrs. Potts, who may or may not be happy to see me.

As soon as I step out, I slip on the porch. I had forgotten about the ice.

“Damn!” I land hard on my butt.

Bitsy starts to giggle, but Thomas punches her lightly on the forearm and pulls me up.

“You be careful now, Miss Patience,” he says. His hand is bare and warm, with coal dust forever under his fingernails, and I wonder if he has any mittens. Then I notice that Bitsy’s hands are bare too. The night is just a little below freezing, but I’m wearing a blue tam, gloves, and scarf that I knit myself.

“Are we going to be able to make it?” I ask Thomas. “Can the burros’ hooves cut through this ice?”

Thomas grunts. “Reckon. The old gals did okay on the way here. The ice is melting a little now. We have to try.” I imagine the birth scene, a woman thrashing around with a baby’s arm presenting. She’s crying and trying to push, but nothing happens.

Thomas helps me mount the larger of the animals and puts Bitsy behind me; then we ride bareback and I adjust the younger woman’s hands so they’re under my arms where they can stay warm.

Twenty minutes later we’re at the crossroads of Wild Rose and Raccoon Lick. When the moon comes out again, I see the damaged trees. Limbs dangle like broken arms everywhere. Down the slope the Hope River roars, an invisible lion. Three times we stop while Thomas gets off his burro to drag a large branch off the road.

Another mile and we’re trekking up the Harpers’ long tree-lined drive. The crunch, crunch, crunch of the burros’ hooves sounds like broken glass under their feet, and I estimate that the flakes of ice are two inches deep. At the Harpers’, dogs bark, but no lights come on.

Just past the hulking shadow of their big barn, we cut into the woods and follow the south branch of Horse Shoe Run. Here in the dense spruce and hardwood forest, branches are crashing down everywhere. I look up and realize the danger we’re in.

Bitsy holds on tighter. All I can see is Thomas’s shadow in front of me. Thank goodness the last wolf in West Virginia was eradicated and the bears are hibernating. I think they’re hibernating. They wouldn’t be out on a night like this, would they?

At last we see lights and in another few minutes the village of Hazel Patch, a collection of a dozen or so houses and small farms associated with a little white chapel. Thomas quickens his pace, and though I’m dreading what we’re about to walk in on, I hurry my mount to catch up with him.

What was I thinking when I pulled on my boots? How can I help an experienced midwife like Mrs. Potts, someone who’s probably been delivering babies for fifty years, while I got my certificate only two years ago just by signing my name? And the family . . . I don’t even know them. I’d rather be home in my cozy warm bed.

We pass the little church, a small clapboard affair with a wooden steeple, and then follow Thomas down a private road bordered on either side by a neat split-rail fence. At the end is a two-story log house with light pouring out of every window. A woman howls into the night, a wild sound. Bitsy and I shiver. The woman stops for a few minutes and then starts up again.

Mrs. Potts

Sensing my apprehension, Bitsy gives me a squeeze and slides off our mount. Though she hadn’t wanted me to come, she grabs my birth satchel without hesitation and accompanies Thomas up to the door. I follow carefully, determined not to make my grand entrance by falling on my butt again.

Thomas knocks twice while we stomp the ice off, but he doesn’t wait for an answer. He opens the door and lets us into a large living room with oak bookshelves against the log walls, an organ, and a fawn velvet sofa. It’s the kind of room I imagine a judge or a physician would have had in the pioneer days, only there wouldn’t have been electric lights. Hazel Patch is located right on the main road, close to the power lines. The way Bitsy referred to the Hazel Patch folk as “those people,” I thought we were coming to a hardscrabble place more like the mining camp.

Across from the door is a bright yellow kitchen with a pale green enameled high-backed gas stove. Two dark-skinned women and a shorter coffee-colored lady are laying out food. The three, all wearing flowered housedresses and aprons of various shades, turn to greet us.

“Mrs. Potts?” Thomas calls, removing his hat.

The stooped brown midwife, dressed all in black, with a neat white apron, a white lace collar, and a white bandanna, comes down the hall. She walks as though her joints need oil, but her face is nearly unlined. From another room, the patient in labor wails like a trapped animal.

I’m surprised when the elderly lady passes Thomas and Bitsy and wraps her arms around me. “Honey,” she says, “I’m Grace Potts. I’m so sorry to bring you out on a night like this, but I didn’t know who else to call and we have a sitiation here.” She says situation in a funny way, like a lot of older Appalachians do. “Dr. Blum won’t come to Hazel Patch or allow coloreds to come to his clinic, or we would have already gone. You’ll see what I mean in a minute.”

“Thomas says the arm is coming out first. Can you feel the head at all?”

Grace Potts holds out both her worn hands, gnarled with arthritis, each knuckle of each finger distorted, the tops ebony and lined with veins twisted and crossed like a road map but the palms as pink and smooth as mine. “It’s way up there. I was hoping you could—”

We are interrupted by cries from the bedroom, and I hurry that way with Bitsy right behind me. “Will she let me check her?” I’m all business now, and whatever trepidations I had are gone. There’s a job to be done, a puzzle to be solved. I can at least try. Thomas turns toward the kitchen, where the trio of cooks fusses around him, proffering coffee and coffee cake.