In Falling Snow (6 page)

“Okay, let's go back in.” Grace dropped her car keys into her bag and tossed the bag to Alice.

The girl was the one who'd come down in early labour from the hostel and was on the ward when Grace had left earlier in the evening. The Sisters of Charity who ran the hospital also ran several homes for unwed mothers, including the largest one, St. Mark's, which was on the hospital campus, high on the hill above the hospital itself. When Grace had been a medical student, they were admitting a couple of girls in labour every week from St. Mark's. Grace had never been inside but from the outside it looked like a haunted house, dark stone walls and shuttered windows. She always felt a little sorry for the girls from up there.

When they came back onto the ward, Grace could hear the girl's screams from the desk. “What's she had?”

“Nothing,” Alice said.

“Not even nitrous?”

Alice shook her head. “He said not.”

“Nothing?” Grace said. She looked along the hallway.

She was reluctant to go in and examine the girl but could see Alice was in a dilemma. “She's having a tough time. How old did you say she is?”

“Sixteen. Baby's persistent OP. She's getting pretty crazy, Grace.” Occiput posterior, where the baby's back remained facing towards the mother's back. It made for a painful labour and sometimes a difficult delivery. And Alice had an uncanny knack of knowing when a woman had reached the edge of coping.

“Jesus,” Grace said. “How could he do that?” Grace took her bag back from Alice and left it at the desk and walked down to the delivery room with Alice behind her.

“Name?” Grace said quietly. Alice told her.

Jan Michaels was lying on her side, gripping the top rail of the bed. She was a big girl carrying a big baby. When she looked up, Grace thought of Tolkien as a puppy, completely helpless and dependent on them for survival. The girl's eyes were wide with fear.

Grace took the girl's hand. “Jan, how are you feeling? I'm Grace Hogan, one of the doctors here.”

“I'm all right,” she said in a tiny voice. “It hurts.”

“Your back?” The girl nodded weakly. “Well, I'll see what I can do to organise some pain relief,” Grace said. She patted the girl's hand and nodded to Alice on the way out.

Grace went to the tiny office off the ward desk, rehearsing what she'd say before she phoned Clive Markwell at home. With another doctor, it would be more straightforward.

“Markwell,” he answered on the third ring. She could hear a radio or television in the background.

“Clive.” Grace made herself use his Christian name. “Grace Hogan. I just happened to be on the ward,” she said, not wanting to tell him Alice had come to her, “and one of your patients needs something for pain. I'm going to give her some gas and a shot of peth.”

He asked her the patient's name. She told him. “She doesn't want anything,” Markwell said. He was chewing as he spoke.

“She does now. She's a mess.”

“Have you examined her?”

“I popped in when I heard the racket she's making. I really think we need to help her now to avoid a larger problem later. You know how it can go. She's still OP.”

“I'll drop by later and see how she's going,” Markwell said. “I saw her earlier. She's got a long day ahead of her. Still a bit frisky when I saw her.” Markwell owned horses and used his observations of their mating and gestation in his descriptions of women. Some liked the comparison, felt it located human birth in nature where it belonged. Others, including Grace, found it objectionable.

“Maybe you ought to come in and have a look at her if you don't trust me to—”

“I know what the patient needs,” he said, “and I'd thank you to remember that.” He hung up.

Alice was right. He was punishing the girl, for having sex, for getting pregnant, for being a girl, he was punishing her. Grace felt angry but also anxious. If she acted against his direct advice, she put herself at risk. On the other hand, he was denying a young girl pain relief to teach her a lesson. And somehow, to Grace, it was worse that he was denying the girl pain relief when she was giving the baby up. Surely their job, hers and the other doctors', was to make this experience as painless as possible. The girl was sixteen years old.

On her way back to the delivery room, Grace passed Margaret Cameri's room. The family was there now, the father telling the other children in a soft, deep voice about their new baby brother, holding the infant in his big hands, the grandmother stroking Margaret Cameri's forehead. They were perfect, just as they were, Grace thought, any domestic trouble stilled, any unhappiness banished, just for this moment. New life was indeed a miracle. Sometimes, Grace thought, but not always, hearing another cry from the delivery room farther along the hall.

Alice was holding the girl's hand and stroking her brow. “Okay, Jan, we're going to give you a mask to breathe into that will help on the contractions,” Grace said, “and an injection to dull the pain.” To Alice, she said, “Give her nitrous as needed and fifty milligrams peth two-hourly.”

“How'd you talk him round?” Alice said as she went to draw up the drugs.

“Some docs will only listen to docs. Call me if there are any problems. And mark me as the attending.” Alice looked at her. “It'll be fine,” she said. “Dr. Markwell will be in by nine.”

“By then it will be over,” Alice said. “We're doing better now. But the pain relief will be a big help.” Just then the girl had another contraction, bellowing like a cow through it. “That's the way, darling,” Alice said. “We're nearly there. Help's on the way.”

Grace smiled. “Good. Call me if you need me.”

Grace left the hospital and drove home through Auchenflower and Milton, Neil Diamond's
Hot August Night
blaring out of David's five-hundred-dollar car stereo. Grace sang along to “I Am . . . I Said,” blithely at first. He had a warm voice, Neil Diamond, but lonely too, at its core. It soothed Grace for some reason. She stopped singing and let out a sigh. Nights like this, called into the hospital late, an emergency she might or might not handle, that was the thing you never knew, she wondered how long she could keep it up. Sometimes she felt as if at any moment, something might give way. The kids needed more not less as they grew older—she'd thought it would be easier now that they were all out of nappies but it was just that their needs were different—and work was like a bottomless pit. They never told you that in medical school. She was tired all the time, tired to her bones. And every now and then, you had an emergency like Margaret Cameri where what you did made the difference between life and death. It didn't matter if you were tired, if the kids needed you, if you had no one to lean on. You had to be there and make sure your patient's care was the best you could do. It was more than difficult. Sometimes, it was terrifying.

She crept back into the house just before five, Tolkien having heard the car, wandering out to greet her sleepily, realising she wasn't David, and flopping back down in a sulk. She checked the children again. Henry was in the same position, bedclothes flung again, so she covered him. Phil was sleeping quietly now. Grace crept into her and David's room, took off her clothes, spooned her body behind David's. Sleep was the last thing on her mind now. “Did I wake you?” she said softly, and then again, a bit more loudly.

“What? No, that's all right. Everything okay?”

“Yeah.” She snuggled closer, kissed the back of his neck, ran her fingers down his chest and belly.

“Now?” he said sleepily. “It's the middle of the night.”

“It's morning,” she said, reaching into his boxers, finding his penis already hardening. “Truth to power my friend.” He turned around and kissed her gently, his breath sour and oddly exciting. She kissed him back, full on the mouth, and felt his body waking up, his strong arms around her. She ran her fingers through his hair; it needed a cut. David kissed her neck, breasts, and belly and started to move down but she took his head in her hands and brought it up to her face. “Let's just fuck,” she said softly. She only swore in relation to sex. He'd liked it when they were first together but now she thought it made him slightly embarrassed, as if she was middle-aged and wearing teenage clothes.

“You sure?” he said, reaching his hand down.

“Yes,” she said, irritated. She was too wired for slow sex. Emergencies always left her like this. She loved and hated the rush. David absorbed stress, calmed any situation, including Grace.

She wanted to be on top—story of my life, he used to say. She moved her hips in time with his but lost the rhythm again and again and finally stopped moving, felt the power of his thrusts deep inside. He came quickly, moaning softly, opening and closing his eyes.

Afterwards she lay on his shoulder and cried. Hey, he said gently, as if she was a child again, and he was Iris comforting her in some major loss, a tooth, a girl who'd left the class, the end of holidays. Hey. David was like Iris in that way. He always knew exactly what was needed, even when Grace herself didn't know.

By the time she emerged from the shower, David had made coffee and they sat out the back watching the morning sky take shape. She could hear kookaburras singing together in the distance and a butcher-bird over towards Iris's place in full song. Middle of winter and the birds were everywhere. Grace loved that about Brisbane. In Canada, it's what she'd missed most, the birds. There
were
birds in Banff but they were far less brash, more reserved. You had to really listen for them.

David was wearing checked shorts and a white T-shirt with his old wool cardigan over the top, his blond curls a soft wet mess now, his face more vulnerable without his glasses. She told him about the case.

“Did you tell Andrew he shouldn't have used the Pit?” he asked. Pitocin was needed in a post-partum haemorrhage to make a floppy uterus contract quickly and stop bleeding. But in Margaret Cameri's case, it made the uterus harder to manipulate. Relaxants had been needed.

“I told him afterwards,” Grace said. “I thought he did well to realise it wasn't right and call me in.”

“How come you let him off but not others?”

“Like who?”

“Me?”

“Well, if you made a mistake like that I'd be worried. You ought to know better. He's a trainee.”

“He's a bloody registrar. He ought to know what he's doing.”

“If we're going to go head to head about each other's registrars, your guy Michael Whatsisname has done some pretty funny estimating lately. I had a forty-two-week caesarean last week. Baby was smooth-skinned and pink as a piglet.”

“Mastin, Michael Mastin. I know. There's something not right with that guy, but he's in with the chaps.” David looked over at Grace. “Are you okay?”

“What? Oh, I saw a patient of Clive Markwell's on the way out tonight, a kid. He wouldn't give her any pain relief.” Grace told David what she'd done.

“Speaking of the chaps, Markwell's not going to like you.”

“So what's new? He already doesn't like me.”

Clive Markwell wasn't a doctor who liked to be crossed, and Grace had crossed him, back when she was at St. John's as a resident years before. She'd been called into a birthing room by one of the registrars who said it would be an opportunity to see a high forceps delivery. Grace didn't know Markwell then but the scene that greeted her and the registrar was grotesque. There was a tall rakish man with one foot up on the end of the bed, using it to provide traction. He was hunched over what Grace quickly learned was a barely conscious woman. He was swearing at the midwives. “You bloody idiots. We have to get this baby out now!” It wasn't panic on his face, it was fury, or perhaps his panic had manifested as fury. The midwives looked terrified.

“Dr. Markwell,” said the registrar who'd come in with Grace. “Are you all right?”

“Just get out of the way,” Markwell said. He said afterwards he'd saved the mother's life. At the time, Grace didn't know the background, why he hadn't attended earlier. Later she learned that his poor judgement had put him in the situation in the first place. He should have done a caesarean. The midwives had contacted Markwell four times in the course of the evening but he didn't come until it was too late. The baby suffered brain damage. In the review that followed, the registrar had been the one to speak out. The attending anaesthetist and paediatrician had lined up behind Markwell but Grace joined the registrar and told the truth when they interviewed her. It won her few friends, although David, recruited to the hospital as a consultant earlier that year, made a point of coming to see Grace and telling her she'd done the right thing. He'd reviewed the case for the investigating panel. “I told them you were courageous,” he said, “but it won't be enough. They'll back the chap.” Grace had been surprised at his forthrightness and said so. “What do I care?” David said. “They can't sack me. I'm the wonder boy.” David had come from England, where he'd worked in one of the new team-based maternity care models. He'd been brought in to revise the hospital's care. He was right. He was invulnerable in those days.

Grace, on the other hand, was completely vulnerable. She missed out on a registrar's position the next year. But now she'd gone against Clive Markwell's direct orders. “I think he wanted to teach her a lesson,” she said to David. “I think that's what it was about. She's young and unmarried and had sex so he wanted to teach her a lesson.”

David shrugged. “I wouldn't worry too much. He's never going to change and everyone knows what he's like. And anyway, she might have been better off. There's research coming out of the Netherlands that suggests labour pain has a purpose, that while we're getting better at blotting out all pain, women in the Netherlands are getting better at giving birth without pain relief. The pain is like a marathon. It makes a woman feel good to get through it.”