Read Small Great Things Online

Authors: Jodi Picoult

Small Great Things (3 page)

A boy like Edison
. I know what she is saying, even if she's careful not to spell it out. There are not many Black kids in the high school, and as far as I know, Edison is the only one on the Highest Honors list. Comments like this feel like paper cuts, but I've worked with Marie for over ten years now, so I try to ignore the sting. I know she doesn't really mean anything by it. She's a friend, after all—she came to my house with her family for Easter supper last year, along with some of the other nurses, and we've gone out for cocktails or movie nights and once a girls' weekend at a spa. Still, Marie has no idea how often I have to just take a deep breath, and move on. White people don't mean half the offensive things that come out of their mouths, and so I try not to let myself get rubbed the wrong way.

“Maybe you should hope that Ella makes it through the school day without going to the nurse's office again,” I reply, and Marie laughs.

“You're right. First things first.”

Corinne explodes into the room. “Sorry I'm late,” she says, and Marie and I exchange a look. Corinne's fifteen years younger than I am, and there's always some emergency—a carburetor that's dead, a fight with her boyfriend, a crash on 95N. Corinne is one of those people for whom life is just the space between crises. She takes off her coat and manages to knock over a potted plant that died months ago, which no one has bothered to replace. “Dammit,” she mutters, righting the pot and sweeping the soil back inside. She dusts off her palms on her scrubs, and then sits down with her hands folded. “I'm really sorry, Marie. The stupid tire I replaced last week has a leak or something; I had to drive here the whole way going thirty.”

Marie reaches into her pocket and pulls out a dollar, which she flicks across the table at me. I laugh.

“All right,” Marie says. “Floor report. Room two is a couplet. Jessica Myers, G one P one at forty weeks and two days. She had a vaginal delivery this morning at three
A.M.
, uncomplicated, without pain meds. Baby girl is breast-feeding well; she's peed but hasn't pooped yet.”

“I'll take her,” Corinne and I say in unison.

Everyone wants the patient who's already delivered; it's the easier job. “I had her during active labor,” I point out.

“Right,” Marie says. “Ruth, she's yours.” She pushes her reading glasses up on her nose. “Room three is Thea McVaughn, G one P zero at forty-one weeks and three days, she's in active labor at four centimeters dilated, membranes intact. Fetal heart rate tracing looks good on the monitor, the baby's active. She's requested an epidural and her IV fluid bolus is infusing.”

“Has Anesthesia been paged?” Corinne asks.

“Yes.”

“I've got her.”

We only take one active labor patient at a time, if we can help it, which means that the third patient—the last one this morning—will be mine. “Room five is a recovery. Brittany Bauer is a G one P one at thirty-nine weeks and one day; had an epidural and a vaginal delivery at five-thirty
A.M
. Baby's a boy; they want a circ. Mom was a GDM A one; the baby is on Q three hour blood sugars for twenty-four hours. The mom really wants to breast-feed. They're still skin to skin.”

A recovery is still a lot of work—a one-to-one nurse-patient relationship. True, the labor's finished, but there is still tidying up to be done, a physical assessment of the newborn, and a stack of paperwork. “Got it,” I say, and I push away from the table to go find Lucille, the night nurse, who was with Brittany during the delivery.

She finds me first, in the staff restroom, washing my hands. “Tag, you're it,” she says, handing me Brittany Bauer's file. “Twenty-six-year-old G one, now P one, delivered vaginally this morning at five-thirty over an intact perineum. She's O positive, rubella immune, Hep B and HIV negative, GBS negative. Gestational diabetic, diet controlled, otherwise uncomplicated. She still has an IV in her left forearm. I DC'd the epidural, but she hasn't been out of bed yet, so ask her if she has to get up and pee. Her bleeding's been good, her fundus is firm at U.”

I open the file and scan the notes, committing the details to memory. “Davis,” I read. “That's the baby?”

“Yeah. His vital signs have been normal, but his one-hour blood sugar was forty, so we've got him trying to nurse. He's done a little bit on each side, but he's kind of spitty and sleepy and he hasn't done a whole lot of eating.”

“Did he get his eyes and thighs?”

“Yeah, and he's peed, but hasn't pooped. I haven't done the bath or the newborn assessment yet.”

“No problem,” I say. “Is that it?”

“The dad's name is Turk,” Lucille replies, hesitating. “There's something just a little…off about him.”

“Like Creeper Dad?” I ask. Last year, we had a father who was flirting with the nursing student in the room during his wife's delivery. When she wound up having a C-section, instead of standing behind the drape near his wife's head, he strolled across the OR and said to the nursing student,
Is it hot in here, or is it just you?

“Not like that,” Lucille says. “He's appropriate with the mom. He's just…sketchy. I can't put my finger on it.”

I've always thought that if I wasn't an L & D nurse, I'd make a great fake psychic. We are skilled at reading our patients so that we know what they need moments before they realize it. And we are also gifted when it comes to sensing strange vibes. Just last month my radar went off when a mentally challenged patient came in with an older Ukrainian woman who had befriended her at the grocery store where she worked. There was something weird about the dynamic between them, and I followed my hunch and called the police. Turned out the Ukrainian woman had served time in Kentucky for stealing the baby of a woman with Down syndrome.

So as I walk into Brittany Bauer's room for the first time, I am not worried. I'm thinking:
I've got this.

I knock softly and push open the door. “I'm Ruth,” I say. “I'm going to be your nurse today.” I walk right up to Brittany, and smile down at the baby cradled in her arms. “Isn't he a sweetie! What's his name?” I ask, although I already know. It's a means to start a conversation, to connect with the patient.

Brittany doesn't answer. She looks at her husband, a hulking guy who's sitting on the edge of his chair. He's got military-short hair and he's bouncing the heel of one boot like he can't quite stay still. I get what Lucille saw in him. Turk Bauer makes me think of a power line that's snapped during a storm, and lies across the road just waiting for something to brush against it so it can shoot sparks.

It doesn't matter if you're shy or modest—nobody who's just had a baby stays quiet for long. They
want
to share this life-changing moment. They
want
to relive the labor, the birth, the beauty of their baby. But Brittany, well, it's almost like she needs his permission to speak.
Domestic abuse?
I wonder.

“Davis,” she chokes out. “His name is Davis.”

“Well, hello, Davis,” I murmur, moving closer to the bed. “Would you mind if I take a listen to his heart and lungs and check his temperature?”

Her arms clamp tighter on the newborn, pulling him closer.

“I can do it right here,” I say. “You don't have to let go of him.”

You have to cut a new parent a little bit of slack, especially one who's already been told her baby's blood sugar is too low. So I tuck the thermometer under Davis's armpit, and get a normal reading. I look at the whorls of his hair—a patch of white can signify hearing loss; an alternating hair pattern can flag metabolic issues. I press my stethoscope against the baby's back, listening to his lungs. I slide my hand between him and his mother, listening to his heart.

Whoosh.

It's so faint that I think it's a mistake.

I listen again, trying to make sure it wasn't a fluke, but that slight whir is there behind the backbeat of the pulse.

Turk stands up so that he is towering over me; he folds his arms.

Nerves look different on fathers. They get combative, sometimes. As if they could bluster away whatever's wrong.

“I hear a very slight murmur,” I say delicately. “But it could be nothing. This early, there are still parts of the heart that are developing. Even if it
is
a murmur, it could disappear in a few days. Still, I'll make a note of it; I'll have the pediatrician take a listen.” While I'm talking, trying to be as calm as possible, I do another blood sugar. It's an Accu-Chek, which means we get instant results—and this time, he's at fifty-two. “Now,
this
is great news,” I say, trying to give the Bauers something positive to hold on to. “His sugar is much better.” I walk to the sink and run warm water, fill a plastic bowl, and set it on the warmer. “Davis is definitely perking up, and he'll probably start eating really soon. Why don't I get him cleaned up, and fire him up a little bit, and we can try nursing again?”

I reach down and scoop the baby up. Turning my back to the parents, I place Davis on the warmer and begin my exam. I can hear Brittany and Turk whispering fiercely as I check the fontanels on the baby's head for the suture lines, to make sure the bones aren't overriding each other. The parents are worried, and that's normal. A lot of patients don't like to take the nurse's opinion on any medical issue; they need to hear it from the doctor to believe it—even though L & D nurses are often the ones who first notice a quirk or a symptom. Their pediatrician is Atkins; I will page her after I'm done with the exam, and have her listen to the baby's heart.

But right now, my attention is on Davis. I look for facial bruising, hematoma, or abnormal shaping of the skull. I check the palmar creases in his tiny hands, and the set of his ears relative to his eyes. I measure the circumference of his head and the length of his squirming body. I check for clefts in the mouth and the ears. I palpate the clavicles and put my pinkie in his mouth to check his sucking reflex. I study the rise and fall of the tiny bellows of his chest, to make sure his breathing isn't labored. Press his belly to make sure it's soft, check his fingers and toes, scan for rashes or lesions or birthmarks. I make sure his testicles have descended and scan for hypospadias, making sure that the urethra is where it's supposed to be. Then I gently turn him over and scan the base of the spine for dimples or hair tufts or any other indicator of neural tube defect.

I realize that the whispering behind me has stopped. But instead of feeling more comfortable, it feels ominous.
What do they think I'm doing wrong?

By the time I flip him back over, Davis's eyes are starting to drift shut. Babies usually get sleepy a couple of hours after delivery, which is one reason to do the bath now—it will wake him up long enough to try to feed again. There is a stack of wipes on the warmer; with practiced, sure strokes I dip one into the warm water and wipe the baby down from head to toe. Then I diaper him, swiftly wrap him up in a blanket like a burrito, and rinse his hair under the sink with some Johnson's baby shampoo. The last thing I do is put an ID band on him that will match the ones his parents have, and fasten a tiny electronic security bracelet on his ankle, which will set off an alarm if the baby gets too close to any of the exits.

I can feel the parents' eyes, hot on my back. I turn, a smile fastened on my face. “There,” I say, handing the infant to Brittany again. “Clean as a whistle. Now, let's see if we can get him to nurse.”

I reach down to help position the baby, but Brittany flinches.

“Get away from her,” Turk Bauer says. “I want to talk to your boss.”

They are the first words he has spoken to me in the twenty minutes I've been in this room with him and his family, and they carry an undercurrent of discontent. I'm pretty sure he doesn't want to tell Marie what a stellar job I've done. But I nod tightly and step out of the room, replaying every word and gesture I have made since introducing myself to Brittany Bauer. I walk to the nurses' desk and find Marie filling out a chart. “We've got a problem in Five,” I say, trying to keep my voice even. “The father wants to see you.”

“What happened?” Marie asks.

“Absolutely nothing,” I reply, and I know it's true. I'm a good nurse. Sometimes a great one. I took care of that infant the way I would have taken care of any newborn on this pavilion. “I told them I heard what sounded like a murmur, and that I'd contact the pediatrician. And I bathed the baby and did his exam.”

I must be doing a pretty awful job of hiding my feelings, though, because Marie looks at me sympathetically. “Maybe they're worried about the baby's heart,” she says.

I am just a step behind her as we walk inside, so I can clearly see the relief on the faces of the parents when they see Marie. “I understand that you wanted to talk to me, Mr. Bauer?” she says.

“That nurse,” Turk says. “I don't want her touching my son again.”

I can feel heat spreading from the collar of my scrubs up into my scalp. No one likes to be called out in front of her supervisor.

Marie draws herself upright, her spine stiffening. “I can assure you that Ruth is one of the best nurses we have, Mr. Bauer. If there's a formal complaint—”

“I don't want her or anyone who looks like her touching my son,” the father interrupts, and he folds his arms across his chest. He's pushed up his sleeves while I was out of the room. Running from wrist to elbow on one arm is the tattoo of a Confederate flag.

Marie stops talking.

For a moment, I honestly don't understand. And then it hits me with the force of a blow: they don't have a problem with what I've done.

Just with who I am.

T
HE FIRST NIGGER
I
EVER
met killed my older brother. I sat between my parents in a Vermont courtroom, wearing a stiff-collared shirt choking me, while men in suits argued and pointed at diagrams of cars and tire skids. I was eleven and Tanner sixteen. He'd just got his driver's license two months before. To celebrate, my mother baked him a cake decorated with a Fruit Roll-Up highway and one of my old Matchbox cars. The guy who killed him was from Massachusetts and was older than my father. His skin was darker than the wood of the witness box, and his teeth were nearly electric by contrast. I couldn't stop staring.

The jury couldn't reach a verdict—hung, they called it—and so this man was free to go. My mother completely lost it, shrieking, babbling about her baby and justice. The murderer shook hands with his lawyer and then turned around, walking toward us, so that we were only separated by a railing. “Mrs. Bauer,” he said. “I am so sorry for your loss.”

As if he had nothing to do with it.

My mother stopped sobbing, pursed her lips, and spit.

—

B
RIT AND ME,
we've been waiting forever for this moment.

I'm driving with one hand on the steering wheel of the pickup and the other one on the bench seat between us; she clenches it every time a contraction hits her. I can tell it hurts like a bitch, but Brit just narrows her eyes and sets her jaw. It's not a surprise—I mean, I've seen her knock out the teeth of a beaner who dented her car at the Stop & Shop with a runaway cart—but I don't think she's ever been quite so beautiful to me as she is right now, strong and silent.

I steal glimpses at her profile when we idle at a red light. We have been married for two years, but I still can't believe that Brit is mine. She's the prettiest girl I've ever seen, for one, and in the Movement, she's about as close to royalty as you can get. Her dark hair snakes in a curly rope down her back; her cheeks are flushed. She's puffing, little breaths, like she's running a marathon. Suddenly she turns, her eyes bright and blue, like the middle of a flame. “No one said it would be this hard,” she pants.

I squeeze her hand, which is something, because she's already squeezing mine to the point of pain. “This warrior,” I tell her, “is going to be just as strong as its mom.” For years, I was taught that God needs soldiers. That we are the angels of this race war, and without us, the world would become Sodom and Gomorrah all over again. Francis—Brit's legendary dad—would stand up and preach to all the fresh cuts the need to increase our numbers, so that we could fight back. But now that Brit and I are here, in this moment, about to bring a baby into the world, I'm filled with equal parts triumph and terror. Because as hard as I've tried, this place is still a cesspool. Right now, my baby is perfect. But from the moment it arrives, it's bound to be tainted.

“Turk!” Brittany cries.

Wildly, I take a left-hand turn, having nearly missed the hospital entrance. “What do you think of Thor?” I ask, turning the conversation to baby names, desperate to distract Brit from the pain. One of the guys I know from Twitter just had a kid and named him Loki. Some of the older crews were big into Norse mythology, and even though they've broken up into smaller cells by now, old habits die hard.

“Or Batman or Green Lantern?” Brittany snaps. “I'm not naming my kid after a comic book character.” She winces through another contraction. “And what if it's a girl?”

“Wonder Woman,” I suggest. “After her mother.”

—

A
FTER MY BROTHER
died, everything fell apart. It was like that trial had ripped off the outside layer of skin, and what was left of my family was just a lot of blood and guts with nothing to hold it together anymore. My father split and went to live in a condo where everything was green—the walls, the carpet, the toilet, the stove—and every time I visited, I couldn't help but feel queasy. My mother started drinking—a glass of wine with lunch and then the whole bottle. She lost her job as a paraprofessional at the elementary school when she passed out on the playground and her charge—a kid with Down syndrome—fell off the monkey bars and broke her wrist. A week later we put everything we owned into a U-Haul and moved in with my grandfather.

Gramps was a vet who had never stopped fighting a war. I didn't know him all that well, because he'd never liked my dad, but now that that obstacle was out of the way, he took it upon himself to raise me the way he thought I should have been raised all along. My parents, he said, had been too soft on me, and I was a sissy. He was going to toughen me up. He'd wake me up at dawn on weekends and drag me into the woods for what he called Basic Training. I learned how to tell poisonous berries apart from the ones you could eat. I was able to identify scat so I could track animals. I could tell time by the position of the sun. It was sort of like Boy Scouts, except that my grandfather's lessons were punctuated by stories of the gooks he fought in Vietnam, of jungles that would swallow you if you let them, of the smell of a man being burned alive.

One weekend he decided to take me camping. The fact that it was only six degrees outside and that snow was predicted did not matter. We drove to the edge of the Northeast Kingdom, close to the Canadian border. I went to the bathroom, and when I came back out my grandfather was gone.

His truck, which had been parked at a pump, was missing. The only hints that he'd been there at all were the impressions of the tire tracks in the snow. He'd left with my backpack, my sleeping bag, and the tent. I went into the gas station again and asked the attendant if she knew what had happened to the guy in the blue truck, but she just shook her head. “Comment?” she said, pretending like she didn't even speak English even though she was still technically in Vermont.

I had my coat, but no hat or mittens—they were still in the truck. I counted sixty-seven cents in my pocket. I waited until another customer pulled into the gas station and then, when the cashier was occupied, I shoplifted a pair of gloves and a hunter-orange hat and a bottle of soda.

It took me five hours to track my grandfather—a combination of racking my brain to remember what he'd been yammering on about in terms of directions that morning when I was half asleep, and walking down the highway looking for clues—like the wrapper from the tobacco he liked to chew, and one of my mittens. By the time I found his truck pulled off on the side of the road and could follow his footprints through the snow into the woods, I wasn't shivering anymore. I was a furnace. Anger, it turns out, is a renewable source of fuel.

He was bent over a campfire when I stepped into the clearing. Without saying a word, I walked up and shoved him so that he nearly fell into the burning embers. “You son of a bitch,” I yelled. “You can't just walk away from me.”

“Why not? If I don't make a man out of you, who the hell will?” he said.

Even though he was twice as big as me, I grabbed him by the collar of his jacket and hauled him upright. I drew back my fist and tried to punch him, but he grabbed my hand before the blow could land.

“You want to fight?” my grandfather said, backing away and circling me.

My father had taught me how to punch someone. Thumb on the outside of your fist, and twist the wrist at the very end of the throw. It was all talk, though; I'd never hit someone in my life.

Now, I drew back my fist and shot it forward like an arrow, only to have my grandfather twist my arm behind my back. His breath was hot in my ear. “Did your pansy-ass father teach you that?” I struggled, but he had me pinned. “You want to know how to fight? Or do you want to know how to
win
?”

I gritted my teeth. “I…want…to win,” I ground out.

Gradually he relaxed his grip, keeping one hand clamped on my left shoulder.

“You're small, so you come in real low. Then you'll be blinding me with your body, and I'm expecting you to bring the punch up. If I duck, my fist will hit you in the face, which means I'll stay upright, and leave myself wide open. The last thing I'll be expecting is for you to come up over the shoulder like this.”

He raised his right fist, looping it up and over in a dizzy arc that stopped a breath before it kissed my cheekbone. Then he let go of me and took a step back. “Go on.”

I just stared at him.

This is what it feels like to beat someone up: like a rubber band stretched so tight it aches, and starts to shake. And then when you throw that punch, when you let go of the elastic, the snap is electric. You're on fire, and you didn't even realize you were combustible.

Blood sprayed from my grandfather's nose onto the snow; it coated his smile. “That's my boy,” he said.

—

E
VERY TIME
B
RIT
gets up during labor, the contractions get so bad that the nurse—a redhead named Lucille—tells her to lie back down. But when she does, the contractions stop, and so Lucille tells her to take a walk. It's a vicious circle, and it's been seven hours already, and I'm starting to wonder if my kid is going to be a teenager before he decides to come into this world.

Not that I'm saying any of that to Brit.

I've held her steady while an anesthesiologist put in an epidural—something that Brit begged for, which totally surprised me, since we had planned to do a natural birth without drugs. Anglos like us stay away from them; the vast majority of people in the Movement look down on addicts. I whispered to her as she bent over the bed, the doctor feeling along her spine, asking if this was a good idea.
When
you
have the baby,
Brit said,
you get to decide.

And I have to admit, whatever they've got pumping through her veins has really helped. She's tethered to the bed, but she's not writhing anymore. She told me that she can't feel anything below her belly button. That if she wasn't married to me she'd propose to the anesthesiologist.

Lucille comes in and checks the printout from the machine that's hooked up to Brit, which measures the baby's heartbeat. “You're doing great,” she says, although I bet she says that to everyone. I tune out as she talks to Brit—not because I don't care, but because there's just some mechanical stuff you don't want to think about if you ever want to see your wife as sexy again—and then I hear Lucille tell Brit that it's time to push.

Brit's eyes lock on mine. “Babe?” she says, but the next word jams up in her throat, and she can't say what she wants to.

I realize that she is scared. This fearless woman is actually afraid of what comes next. I thread my fingers through hers. “I'm right here,” I tell her, although I'm just as terrified.

What if this changes everything between me and Brit?

What if this baby shows up and I don't feel anything at all for it?

What if I turn out to be a lousy role model? A lousy father?

“The next time you feel a contraction,” Lucille says, “I want you to bear down.” She looks up at me. “Dad, get behind her, and when she has the contraction, you help her sit up so she can push.”

I'm grateful for the direction.
This
I can do. As Brit's face reddens, as her body arcs like a bow, I cup her shoulders in my hands. She makes a low, guttural noise, like something in its last throes of life. “Deep breath in,” Lucille coaches. “You're at the top of the contraction…now bring your chin to your chest for me and push right down into your bottom…”

Then, with a gasp, Brit goes limp, shrugging away from me as if she can't stand having my hands on her. “Get off me,” she says.

Lucille beckons me closer. “She doesn't mean it.”

“Like hell I don't,” Brit spits out, another contraction rising.

Lucille arches her eyebrows at me. “Stand up here,” she suggests. “I'm going to hold Brit's left leg and you're going to hold the right…”

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