In Falling Snow (5 page)

Violet told me she'd grown up in Cornwall, where her family had lived for generations. “We're the Cornwall Herons,” she said, with a hint of mockery in her voice. “My father's father, Duxton Digby Heron, had an extensive collection of stamps, inherited by my father, Digby Duxton—the names are not a joke, by the way. My father sold the stamps to pursue his own hobbies of gambling and drink. Gets me where I live, he used to say. It certainly did. He died of liver failure at forty-four, no mean feat.

“My mother, from a less wealthy and less unhappy Scottish family, tolerated my father until his untimely death, and inherited the estate. No love lost, that's for sure, although the cousins are not happy about the estate falling to the Scots, and my mother does tend to rather rub their noses in it by inviting her family to stay. There's no money left, of course, so the place is slowly falling apart.”

“How old were you when your father died?”

“Sixteen,” Violet said. “Away at school. I went home to make sure there was no mistake, that Digby wasn't lurking in some corner of the house. He was always a bit of a lurker. My mother thought me ghoulish when I insisted on viewing the body.” Violet had lost a brother too, she said, to pneumonia, when she was eight.

Violet told me her family's story as if it was all a big joke, and it was funny, the way she put it, and I even found myself laughing, but later I couldn't help thinking how unhappy she must have been growing up in a house like that. When I told her about my own family, it seemed much happier, despite the fact my mother had died when I was only six.

“My father remarried, a woman from a farm near us,” I told Violet. “Claire's French. Thus my competence in the language,” I said in French.

“Ah, the wicked stepmother,” Violet said, in the same tone she'd told me about her own life, “with a French twist.”

“I'm afraid not,” I said. “More like I was the wicked stepdaughter.”

The year I turned nine, my mother's sister Veronica visited us from Scotland. Until then, the three of us—me and Daddy and Tom—had muddled on together, but Veronica had put an idea into Daddy's head I should be among women and girls. So he packed me off to All Hallows' in Brisbane to board. I felt completely at sea among those girls with their girls' games and perfect hems on their tunics. When I went home for the Easter holidays in that first year, I said I hated school and didn't want to go back but Daddy made me. Two weeks later he came to town and brought Claire.

We met in the parlour of the convent, a neat room with heavy drapes and the smell of wood polish. Claire was a small, slight woman with straight brown hair surrounding a heart-shaped face. Much later I learned she'd married into a family on the Italian side of the French–Italian border and she and her husband had come to Australia to run an orchard. He'd been killed when he fell from a ladder five years earlier. After his death, everyone had expected Claire would go home. But instead she stayed on and engaged a manager to run the orchard. She and Daddy met when Daddy took our bull over to service her cows.

I liked Claire instinctively, although I had no idea why they were there until they were taking their leave and Daddy put a hand to the small of her back to usher her out. “Do you hate it here very much?” she said to me in strongly accented English. “Would you rather be back home?” I nodded yes, unable to speak for fear of crying.

The next week they married and the week after that, I was brought home.

“I should have been grateful she got me a reprieve from boarding school,” I said to Violet. “And she worked so hard to win our love, Tom's and especially mine, even after the twins were born. But for a long time, I just felt angry. I hated her.”

Claire never tried to be a mother to Tom and me but she was kind and interested and we came to love her almost in spite of ourselves. I was worse than Tom, loyal to a mother I thought I could remember that he could never have known—she'd died of toxemia just after he was born. To her credit Claire ignored my seething anger. She played to my finer feelings and eventually dragged them out of me. When I think back, she was one of the most truly good people I ever knew, willing to raise someone else's children and even to love them. I came to love her too. By the time I went back to boarding school, the twins, André and René, were born. It was so different for me to be a half sister rather than the child mother I'd had to be to Tom. Claire welcomed whatever help I offered but never made me do more than that. She taught me French and made me love the Paris she conjured for me. She also taught me how to sew and cook, which I never would have learned otherwise. I'd been blessed really and knew it.

As Violet drove, I watched the snow fall lazily to earth in the beams of light in front of us. Something niggled at the edge of my consciousness, vague, indefinable, as though I was doing a jigsaw puzzle and I'd just put a piece in the wrong place. It hadn't worried me at all, what Violet had said about remaining at Royaumont instead of going to Soissons. In fact, it made me feel valued. Of course, it should have worried me. I was young, so young, I think now, not yet an adult, not truly, but with an adult responsibility that had been mine since I was six, that of caring for my brother. And it wasn't as if I was deciding to abandon Tom. I wasn't deciding anything really. Violet was right. Royaumont was as good as anywhere to stay while I searched for Tom, and there was something about Miss Ivens that made a person want to muck in and help her. All those things were true. But as I look back, it was that point, the point I met Violet, so worldly and yet so welcoming, so convincing about how much fun it would all be, that was the point at which I went horribly horribly wrong.

It was 2:36 a.m. on the bedside clock. She picked up on the second ring. “Grace, come now.” It was the night midwife, Alice Jablonsky. Grace was about to respond when she heard the click, the phone disconnecting. “Grace, come now.” Grace knew what that meant. Don't ask questions, don't have coffee, just get in the car. She pulled the sweats on the floor over her pyjamas, slipped on socks, sneakers, grabbed a toothbrush out of the bathroom, smeared it with paste, stuck it in her mouth, and chewed. David woke as she fumbled for her watch. “On call,” she said through the toothbrush. “Go back to sleep.”

On the way out she went into the kids' rooms. Mia wasn't there; a moment's panic until she remembered her eldest daughter was sleeping across the road at her friend Julie's. She went on to Phil, who was talking nonsense in her sleep, light still on, Tolkien on the floor beside her, snoring quietly, a single tail thump when he saw Grace. Then Henry, on his back, arms splayed, covers off. Grace went in, replaced the covers, took in his little-boy smell, and turned and headed out, dumped the toothbrush in the kitchen sink and grabbed a sip of water from the tap to rinse.

By 2:41 a.m. she was in the Citroën, David's car; he'd parked her Honda in, she didn't much like the symbolism but didn't have time to address it now. She drove over the Paddington hill and down through the floodplain of Milton as the moon came up over the city. She came in the back gate and pulled into her space outside the maternity unit. She heard a storm bird somewhere down near the river but the night was clear as glass. She went straight to the labour ward and found an enrolled nurse who looked about fifteen at the desk.

“Why am I here?” Grace said. Her voice was gravelly. She wanted coffee.

“I'm sorry?” The girl looked flatly at Grace.

“I'm Dr. Hogan. Alice called me. Get her for me, would you?” A question that wasn't a question.

“Sorry, Doctor, of course.” She left the desk.

Alice Jablonsky came down the corridor with that calm, brisk gait of the best midwives and steered Grace back towards the operating theatres. They talked as they walked. “So which one is it?” Grace asked.

“Margaret Cameri.”

“Which one was she?” There had been three on the ward when Grace left at 10 p.m.; two who should have been sent home, one a young girl from the hostel in early labour, the other with slightly elevated blood pressure but no need for hospital yet. The third was a multi in established labour, no complications, close to transition. Grace hadn't even waited. Nothing expected from outlying districts, a good registrar, a good, experienced midwife in Alice. Grace had looked forward to a night of unbroken sleep.

“Room four, third baby, straightforward, eight centimetres when she came in. Margaret Cameri.”

The transition one. “And?”

“Labour stalled for a bit and then sped up again on its own. She pushed the baby out and he's fine. She had a bleed, maybe four hundred mils. Something not right so I called Andrew. We started some Pitocin thinking PPH but then the fundus was wrong, too low, we couldn't figure out why, and then her uterus came out. It just came out. She's lost a lot of blood.” There was a hint of fear in Alice's voice.

Take a breath, Grace thought to herself. “Where's Andrew now?”

“He's in theatre with her. We think we've controlled the bleeding and we've ordered more blood.”

“All good.” They'd got her to theatre and stopped the bleeding. It gave Margaret Cameri her best chance. “I'll need another consultant. Try Lindsay or Frank if they're in town. And an anaesthetist. You been through one of these before?”

“No. Anaesthetist already there. I'll find another ob.”

“We'll be fine. Alice?”

“Yes?”

“You've done very well.”

By the time her pager went off again, Grace was walking through the double doors into the theatre. Nine minutes, twenty-four seconds, a record. “I'll be there in a sec,” she said to Andrew through the intercom.

Once in the theatre, Grace confirmed Andrew Martin's diagnosis. “You seen one of these before?” she said quietly to him.

“Nup.”

“You know what we're going to do?”

“Yep.”

“Good.” She was glad it was Andrew Martin, easy to work with, liked by docs and midwives, didn't mind taking orders from Grace, something male registrars often had trouble with. “Stay where you are for now.” Andrew was using a towel to compress the bleeding. Another EN was holding Margaret Cameri's hand at the head end of the bed. She looked about fifteen too, Margaret Cameri not much older and wide-eyed with fear. Grace hoped she'd had plenty for pain.

The anaesthetist was the new guy, no sense of humour, no one could remember his name, but he was good enough tonight. Frank was still on his way, from somewhere south of the city, his wife phoned to say. He should have passed so they could try someone else. Frank was one of the older consultants who wouldn't necessarily take a call-in from the likes of Grace seriously. She was never sure if it was her youth or her sex and she didn't much care. They'd have to start. At any rate, they'd only need Frank if a hysterectomy became necessary and Grace hoped it could be avoided.

Grace was helped into gloves and went to the head of the bed. She smiled her hello-I'll-be-the-doctor-looking-after-you-today smile. “Mrs. Cameri, I'm Grace Hogan. I saw you earlier tonight. You've pushed out your baby and he's fine.” She looked across at Andrew, who nodded. “But the placenta hasn't come away and when you pushed it out it's pulled your womb out,” as if this was only to be expected, happened every other day. “Once you're asleep, we're going to do our best to put it back manually but if that doesn't work, we'll have to operate to do it. We may have to remove your womb if we can't put it back. Do you understand what I'm saying?” What Grace didn't tell Margaret Cameri was that they might not be able to stop the bleeding, they might make a mistake, they might hesitate too long moving to the hysterectomy, such a young woman, you didn't want to do it if you didn't need to, she might haemorrhage, she might die, leaving her new son and two other children motherless. These were things Grace made herself stop thinking about.

Grace's mother had died during childbirth with Grace, of a PPH, a post-partum haemorrhage, where the uterus fails to contract following birth, leaving the placental bed bleeding freely into the uterine cavity. Like an inverted uterus, it's one of the few true emergencies of childbirth. Mostly now a PPH could be avoided or averted but when Grace was born, there were none of the drugs that could make a uterus contract. They did the best they could to stop the bleeding. In her mother's case, it hadn't been enough.

Over drinks one night when they were still medical students, Grace's friend Janis Kennedy had suggested that if Grace wanted to be an obstetrician she would need to face her emotions about her mother's death.

Janis was into facing her emotions at that stage. She was specialising in psychiatry, fascinated by what the mind could do. “Otherwise, you'll be no use to patients.”

“Oh please,” Grace had said. “I have no feelings. I might have been there but I was hardly conscious of it.” Grace hadn't had children then, hadn't understood anything about birth and mothering. She ate the glacé cherry that came with her drink and stared flatly at her friend.

“You probably blame yourself at some level,” Janis said. Janis was thin as a rail with neat brown hair and eyes that appeared to see deeply into a person. Tools of the trade, she'd told Grace when Grace had said as much.

“I do not,” Grace said. “And just because you're my friend doesn't mean you can practise on me.”

“What did your father do after your mother died?” Janis said.

“I have no idea,” Grace replied curtly. “He wasn't around. I've never met him.”

“You've never
met
him?”

“No,” Grace said. “Iris, my grandmother, knows who he is, or thinks she does. He didn't want anything to do with me.”

“So you don't want anything to do with him?” Janis said.

“That's about it,” Grace said. “It's possible he's a doctor. He was studying medicine with my mother.”

“Wow,” Janis said. “You're a psychiatrist's dream in terms of issues. You might meet your father.”

“Unlikely,” Grace said. “There are a lot of doctors in the world. And I have no intention of seeking him out. Ever.”

Grace looked at her patient now, mustering her confidence. Margaret Cameri had enough doubts for both of them. She nodded vigorously that she understood what Grace had said, but she looked terrified. “Where's the baby?” she whispered.

Just then Alice walked in. Thank God, Grace wanted to say. Alice was much better with patients than Grace, who always set out the risks too precisely. “He's fine,” Alice said. “A great big boy who surprised us all. Now he's out there with Dad in the other room and they're getting acquainted nicely. They'll be there when you wake up and you can give him a feed.”

“The others?” Margaret said.

Grace was about to say what others when Alice said, “. . . are on their way into the hospital with your mum, remember? And they're okay too. Everyone's fine.”

Within minutes Margaret was asleep and the anaesthetist was doing the crossword. We don't do that here, Grace wanted to say but didn't. Tomorrow she'd talk to his boss.

Grace wasn't in the mood for teaching but she showed Andrew Martin what to do because that's what you did. You showed the next generation, passed on the skills you could only learn by doing. This would probably be the only inverted uterus Andrew would see during training. He'd have read about it but the real thing was rare. This was the second Grace had managed in ten years, the third she'd seen.

Grace had loved anatomy, had found the cold science of the dead oddly peaceful. In medical school, she'd taken extra tutorials and everyone thought she'd be a surgeon. But few women were accepted into surgery in the sixties and Grace wasn't offered a place. She remembered the interview panel's feedback. A red-faced gastroenterologist told her they couldn't give out positions that didn't pay off. “Before you know it, you'll be married and having kids and we'll have wasted our time with you.” She'd opted for obstetrics, happy medicine as someone had called it, but this was the part she did well, the cutting and manipulating. As obstetricians, she and David were opposites, he the warm fuzzy doctor, she the skilled surgeon. And yet, he probably operated more than Grace. Gender, he'd told her, can't quite get away from it.

With Margaret Cameri fully under, Grace guided Andrew as he grasped the fundus, the top of the uterus, between his thumb and fingers and began to push it back gently. “The Johnson method,” Andrew said. She could see sweat beading on his forehead. It was hard work and he'd surely be nervous. Grace herself was nervous.

“You're doing well,” she said. “Fingers towards the posterior fornix.” He worked to force the uterus back up the birth canal and through the pelvis, stopping every few minutes to check with Grace. “And now,” she said, “slowly make a fist and continue to push towards the umbilicus.”

Andrew was nodding, starting to relax a little. “I can feel it. It's about like putting your hand in someone else's boxing glove.”

“Not an analogy I'd use with a new mother, but yes, you have the idea.”

When they'd finished and the bleeding had stopped, Grace told Alice to make sure she watched Margaret Cameri carefully. She paged Frank to thank him and let him know he could turn around and go back to wherever he was coming from and told Andrew not to hesitate to call if there were problems. “You did well, recognising this. Go tell the husband his wife is fine.” Grace always made sure the trainees got some of the good jobs as well as the hard ones. It hadn't been her experience as a registrar and she vowed she'd never do that to someone else.

She was on her way out when Alice came running across the car park after her. “What's wrong?” Grace said, thinking Margaret Cameri might have started bleeding again.

“No, it's another patient—private. I need someone to authorise peth.”

“Who's her doc?”

“Clive Markwell.” Markwell was a senior consultant at the hospital, a “dong and tong” man, as David referred to them, happiest when he could knock patients unconscious and pull their babies out with forceps.

“Why can't you ring Dr. Markwell?”

“I did. He said no pain relief.”

“Why?”

Alice looked at her carefully. “I can only assume.”

“Assume what?”

“The girl's sixteen and unmarried. Baby's going up for adoption.”

“And unmarried,” Grace repeated. Alice nodded. “This is 1978. Tell me he's not punishing her.” Alice was silent.