“Hold her legs back and open,” I command. The women all have tears running down their cheeks, but they do what I tell them. I rip open the birth bag and grab some gloves and the sterilized scissors. I’ve never before had to use them before, but this may be the time.

“How long has she been paining?” I ask as I begin my examination, trying to figure out why the baby won’t come.

“Three days,” the ladies answer in chorus. It’s like the vet told me: when times are hard, families don’t call him for their sick animals unless they’re on the verge of collapse . . . only this is someone’s wife, sister, or daughter.

“Has she had children before?” I continue to take her history as I oil my gloved hand and slip it around the infant’s skull. There’s an ear just under the pubic bone. Now I understand. The small head is trying to come out turned sideways instead of facing the sacrum. With a tiny baby this sometimes happens. I try to turn it, but it’s wedged in tight.

The round woman answers, “This is her first.”

“Is it before her term?” I unwrap the scissors and make one quick snip. The patient’s green eyes snap open.

“We think maybe a month early. She was due in the fall.”

“How long’s she been pushing?”

The trio look at one another, and the older woman guesses, “About four hours.” No wonder the patient is as limp as a wet noodle.

“Okay, now, Mother.” I touch the patient’s face with the back of my bloody glove to get her attention, but she doesn’t react. “You must push. I’ve made more room for the baby. It’s stuck, but I think I can turn it if you push hard.”

“What’s her name?” I ask the three attendants, indicating the woman in bed.

“Kitty,” the albino offers.

“Kitty, I’m Patience, the midwife. I know you’re tired, but if you give this your all, the delivery can be over in few minutes.” There’s no reaction. “Kitty!” I pinch her arm. The girl’s eyes fly open again. She’s not dead yet.

“We need you to push. Here, we’re going to get you up in a squat. Just do what I tell you. It will help spread your pelvis.” With great effort the three assistants hoist Kitty upright. Then, with one hand on top of the uterus and one hand below, I push down and a small head pops out. It is about the size of a large apple, one of those commercial kinds at Bittman’s Grocery.

My helpers ease the mother back on the bed, and the whole baby slides forth. I blow on the little girl’s belly, but there’s no reaction. I blow again. No grimace, no stretching of arms or gasp. Nothing. I try a few puffs into her nose and mouth, as I did with little William, but still no response. No heartbeat either under the frail chest. The limp body just hangs there between my hands.

Now everyone is crying. Everyone but the mother, whose eyes roll back in her head as her body goes rigid. She stiffens her arms and screams.

Maynard

“Get the husband. Get Mr. Hart!” I command. The short round lady in the gingham apron runs for him. I lay the dead baby in the wooden cradle and try to get Kitty’s womb to ball up, but she’s shaking so hard I can’t keep my hands around it, and there’s no way I can get her to drink Mrs. Potts’s tincture.

It isn’t until Kitty’s body grows limp that I’m able to check her pulse. By Mrs. Kelly’s watch, it’s 140 beats per minute, way too fast, weak, and trembly. When I pull the patient’s eye open and inspect the tissue in the crevice below, it’s almost white. Mrs. Potts told me to do this when I need to judge a woman’s stamina: dark red, her blood is rich; pale pink, the patient is weak. Kitty is way past weak.

The grim lady in green begins to pull away the bloody sheets and swab them on the wet floor.

“The baby’s dead, isn’t it?” the albino girl asks.

“Yes, honey. I’m afraid she is. She’s gone to Heaven now.” I’m starting to sound like Grace Potts.

“Here, Kitty.” I try again to get the exhausted mother to swallow some water mixed with the tincture, but she’s in some kind of coma and the green liquid dribbles down her chin.

From the front of the house I hear the screen door slam open, heavy boots in the hall, and Mr. Hart runs in. “What? What’s happened? Is my wife dead?” I can see why he thinks this, but I know for a fact that her heart is still beating. Just to be sure, I take my wooden horned fetoscope and put it to her breast.

“She’s not dead yet, sir. Kitty had a fit and then fell into a slumber. She’d already lost all this blood before I got here.” I don’t know how to say it nice, so I just say it. “The baby died. It was stuck in the birth canal too long.”

Tears are streaming down the man’s lean, high-cheekboned face clear down to his whiskers. He kneels in the blood and shakes Kitty’s shoulder. “Wife! Wake up!”

“She can’t wake up, Mr. Hart. She’s had a fit. She’s in a coma. We need to get her to a hospital.”

“You know I don’t have any money! I would have taken her to the hospital two days ago if I had.” So you called me, I’m thinking. Called me too late, so that I could take the blame and the heartache.

“Well, if we don’t get going, you won’t have a wife. Forget about the money.”

“Dr. Blum’s gone,” the green dress reminds us. “Moved back to Virginia.”

“Someone will help us if we show up at the hospital. That other doctor from Delmont or maybe a nurse. Does anyone have a vehicle, a truck? Maybe we should go right to Dr. Robinson, the colored doctor.”

“No black sawbones is touching my woman!” Hart slashes out and swipes his wet face, wiping blood across his eyes.

I bite my tongue, almost cutting it. What difference does the hue of the physician’s skin make? The mind has no color. Robinson would know what to do.

“Dr. Robinson could give her medicine or put in an IV. Mr. Hart, your baby is dead because you didn’t go to the hospital before or call me sooner. Didn’t you notice your wife was swelling? Didn’t you know the baby was too early? Do you understand, if we get in an auto right now, your wife might still make it?” I repeat myself, but I’m getting nowhere.

Hart stomps out of the room, followed by the woman in green. I know he’s distressed, but he has to listen!