Eleven Hours (14 page)

Dr. Merchant pulls out a ragged chunk of placenta.

“Zero, one, zero, zero, one,” calls out the
NICU
nurse.

The blood is still coming from Lore's belly and from between her legs, soaking the sterile drapes, forcing Franckline to stop suctioning for a moment and replace the grounding pads. The uterus is not contracting, says Dr. Merchant.

“Where's that A positive?” Dr. Mankowitz demands.

Franckline checks the monitor. Lore's heart rate is rapid, 160 beats a minute, and her blood pressure is low. The uterus looks big and boggy, like a collapsed balloon. Dr. Mankowitz calls for Pitocin and Methergin. Suction, suction.

“I can't wait. Get me some fucking O negative,” Dr. Mankowitz tells the circulating nurse.

“Good, good,” says Dr. Merchant, talking to himself, as Franckline suctions. He is removing smaller pieces of the placenta from the uterus, like a potter quickly but carefully scraping smooth the inside of a clay bowl. The blood transfusion begins. A breeze of expectation lifts up the little crowd—the thick red nourishment will work its magic. But Lore's blood pressure still drops, and drops again. Franckline looks up and sees, like a shadow drawing away from a window, the soul retreat from Lore's face. Oh, Jesus Christ my Savior, she thinks. Oh, Papa Ghede, save her. She hardly hears as the anesthesiologist calls out a Code Blue. She returns to her suctioning; she must think of nothing else. Beside her, focusing on his task too, Dr. Merchant scrapes.

Marina, pulled in for this purpose, is setting up the defibrillator, pressing the pads to Lore's chest. One shock. Two. The line on the monitor jumps and then settles like a spent wave. Head down, suction, suction. A sizzle of pain in Franckline's left ovary. Mapiangue and Papa Ghede, no. Protect the child.

“One, two, one, one, one,” calls out the
NICU
nurse. Franckline hears a tiny mewl. Or did she imagine? Do not think, suction, suction. In another few moments she is aware of the warming bed trundling past, the opening and shutting of the operating theater's doors. The
NICU
voices disappear.

“Keep going,” Dr. Mankowitz tells Marina.

“She's clean,” says Dr. Merchant.

“In fifteen seconds I'm going for a hysterectomy,” says Dr. Mankowitz. The heart pulse can be heard again, a bit stronger, but still thready, quick.

“Doctor, I think the bleeding is slowing. Give it another thirty seconds?”—Dr. Merchant. He is massaging the uterus with his hands to encourage it to draw up.

“The A positive is here,” says the circulating nurse, who is ignored.

Then—they all feel it, the absence of something, an abrupt quiet—Lore's heart stops beating. Heads swivel to the monitor. “Keep going,” says Dr. Mankowitz again to Marina.

Again she shocks the girl. And again. The second time, Lore's shoulders shudder and she gurgles as if trying to dislodge the tube in her throat. Her blood pressure reading ticks up: 55 over 30.
Come back
, calls Franckline.

“She's passing a little urine,” says the anesthesiologist.

“Again,” says Dr. Mankowitz. With the next defibrillation they hear the heartbeat, though it is rapid, hounded. For long minutes they continue their work and wait. The hiss of the siphon, the squelch of the saturated sponges hitting the bucket. The irregular beeping of the machines. Franckline can see the uterus finally begin to pull closed like a drawstring purse. Dr. Merchant's hands, continuing to massage, are steady, but she feels the tense heat rolling off of him.

Blood pressure 80 over 50. Heart 85 beats per minute. Thank you. Thank you, Papa Ghede. Thank you, Jesus Christ our Savior. Hold off death. Deny death. Death must not exist today. Blood pressure 90 over 60. Heart 75 beats per minute. Lore's face goes from gray to pale; she is inhabited again.

“Okay,” Dr. Mankowitz finally says, straightening. “Sew her up.” The pace in the room slows. They have time to be careful now. Dr. Merchant dips and tugs with the surgical thread, creating neat dashes: twenty, twenty-five, thirty. There is no hurry. Gradually, Lore's insides are returned to her privacy.

Moments later the anesthesiologist removes the breathing tube, and Franckline and the tech begin the process of cleaning Lore up. Patiently they wipe her with warm water and antibacterial pads, dry her. The bloody sponges sit in a tub, waiting to be counted, and the canister of Lore's blood mixed with amniotic fluid will be measured, too, so that they will know exactly what came out of Lore's body as well as what went in, what she lost to have this baby.

Franckline, the anesthesiologist, the tech, the circulating nurse, and the two doctors stand by to see Lore come around. Her breathing is steady if a bit rapid. After a few minutes, her eyes open. They are bright and unfocused, and she appears to be seeing something that isn't a blood-spattered group of olive-gowned hospital personnel.

“Soleil,” she says.

They gather in a room near the back nurses' station, telling each other what has just happened, going through the minutes one by one. At 5:34
PM
, the incision was made. At 5:39, Dr. Mankowitz requested a transfusion of O negative. The circulating nurse, Alicia, takes the record. Dr. Mankowitz questions Franckline about the course of Lore's labor: her pains, her blood pressure, anything else that would have signaled a concealed abruption. Franckline answers as calmly as she can, shows him her log. Would he point out something she had missed, something she has done wrong? But he hands the log back to her, apparently satisfied. When he and Dr. Merchant and Marina depart, Alicia turns to Franckline. “She was
gone
,” Alicia says. “Sixty, eighty seconds. Gone.”

Franckline nods silently. She is extremely tired. They—Franckline and Marina and Alicia and the tech and the two doctors, and the machines that do their bidding—they grabbed a woman held in Death's grasp and shook and shook and forced Death to drop her. And now they are very tired. Something aches deep inside her loins. She can no longer tell if it is fatigue or something distinct from that.

By the time she changes her scrubs and updates her notes, it's past seven, past the end of her shift. Tomorrow morning she'll be back again. She should stop by Lore's post-op room and check in, make sure the new nurse is up on everything. But there are a couple of things Franckline needs to do first. At the charge desk, signing herself out, she greets Billie and Cynthia, two nurses who have just come on and have heard all the evening's news from Marina. There is a woman in room 9 who is going into transition, and Billie heads over to tend to her.

Once again, Franckline walks to the far bathroom, casting a glance at room 7 as she passes. The bed has been stripped and remade, fresh pillows laid out. Lore's duffel is gone, presumably transferred to post-op, and the floor is still damp from mopping. In the bathroom, she shuts herself into a stall for a quick check. No blood. She puts her hands over her face and lets the shaking come on. She is sorry, so sorry—for what, she cannot say, only that things should have come out differently. Cold streams through her body and she hugs herself, teeth chattering, unable to stem the tight, jerky movements of her legs and head and arms. It was a test, she thinks, and she has failed. A sign. Her baby is in trouble and will be born, like Lore's, blood-drenched and gray.

Franckline
. She hears Bernard telling her to be reasonable, to understand, as the Americans do, that the world is full of chance, that not every event speaks with meaning. One out of every hundred pregnancies—that is not Bernard talking; it is she herself who knows the figure—one out of every hundred pregnancies results in an abruption, a quarter of those very serious, so that a nurse who has practiced for several years will most certainly come across such cases now and again.

Yes, Bernard
, Franckline agrees.

And was not the baby caught up in the hands of those who cleaned it and warmed it? Did it not survive?

Yes
.

She takes her time in the stall, letting the shaking slowly diminish, and when she feels ready, she splashes herself with warm water and leaves for the third floor. There, outside the
NICU
, she scrubs and dons surgical gloves. When she opens the heavy door she has to refocus for a minute to find the babies, so tiny are they and so overwhelmed by the masses of boxes and screens and consoles and lights and cords. The room—they call it the Big Room; babies who are moving toward discharge are transferred to one of the smaller ones beyond—is completely interior: there is no way to tell whether it's day or night. Or, rather, perhaps, it is always night here, despite or because of the bright fluorescents everywhere. It is quieter than usual, except for the sound of the ventilators and oscillators and the intermittent beeping of the monitor alarms. Franckline doesn't come here often; she stays carefully, as much as possible, on the side of birth that manifests in lusty cries, in pink health. The
NICU
babies trouble and prick her, sending her back to old memories and empty questions. (What might all of these machines and medicines have done for her tiny nameless boy? Might he be a strapping child of thirteen today, attending school, running with strong legs in the streets, bending over a plate of
sos pwa
?) Besides, it is better to allow the family and the professionals to draw tight their circle of healing; she cannot be helpful here. But tonight she cannot stop herself. She must see and know. She asks for Baby Tannenbaum, and is waved over to a nurse named Barbara, with whom she is acquainted.

“Ah,” is all Franckline can say, looking down into Baby Tannenbaum's warming bed with its low, see-through sides. There is another occupied warming bed next to her, but the rest of the row is empty, which makes it a slow week. Like many of the other babies, Baby Tannenbaum is wearing only a diaper and a cotton hat, and has
EKG
and heart sensors attached to her chest, with another sensor on her abdomen to keep track of her temperature. There's an IV in one hand and another in a foot, in addition to the umbilical IV, but the thing that truly unsettles Franckline, despite her experience, is the ventilator taped against the child's mouth all the way to the ears, obscuring her expression. The intubated babies always seem to Franckline like beings that are still living in some subterranean universe, smears of life waiting to emerge.

Compared with the child next to her, a two-pounder, Baby T looks like a pro wrestler. But what's going on inside that brain of hers—what damage might be unspooling, or, more hopefully, healing—no one knows. Not the neonatologists, not the nurses, no one. Only time will reveal that.

“You're taking a special interest, eh?” Barbara asks in patois. Barbara is from Martinique, and their languages are close enough that the two of them can understand each other. It's a welcoming, intimate sound, like an offering to a guest, and it soothes some deep homesick urge in Franckline, even though she hears her home language every day in the neighborhood where she lives. It's different, erupting here, in the middle of Manhattan, after a long working day. Yes, the language gives her that pang.

“
Ma wi
—I am,” says Franckline. “She had a bad time, the mother. There's no father in the picture, nobody.”

“Mmmh,” says Barbara, a grunt of disapproval—not of Lore, but of a fate that offers a woman on her own a damaged child.

“What do they say?” asks Franckline, meaning the neonatologist and the respiratory therapist.

This is not something she is supposed to ask, and Franckline knows that Barbara is forbidden from giving out such information. But there is no one here just now to observe their communication, and Barbara will understand that Franckline's need to hear is pressing. She'll know that she can trust Franckline to let it go no further. Barbara says, quietly and quickly: “She lost a great deal of blood, but her lungs are strong and she should be off the ventilator by tomorrow. We're still waiting on most of the labs. She'll have a brain scan in the morning.”

Franckline reaches down and places two large fingers on Baby T's bare right side, which is less encumbered by cords. Barbara looks away, pretending to check a monitor. Baby T startles at the touch, her foot kicking up. A good sign. Her flesh is warm and very, very new. Franckline feels the rise and fall of her ventilator-controlled breath. A new creature has been deposited into life. And Franckline's gift has held: she has lost no baby, no woman, since coming to this lucky land. Baby T kicks out her foot again, looking as if she wants to protest Franckline's intrusion, scrunching up her eyes as if she might cry. But of course she can't cry with the tube in her mouth, and it's another child who begins to bawl right at this moment, the thin, insistent cry of the extremely young. Franckline turns to the sound, and as she does, it strikes her that she has touched Lore's baby before Lore herself has done so. She feels a sting of remorse.

The other baby continues to cry, thinly, fiercely.

“Ah, the loud twin,” says Barbara, indicating the child with her head. Franckline walks over and excuses herself to a male nurse, who allows her to view a set of twins in his care, names posted on their isolettes: Michael and Mickey. To do so she has to pass a little girl named Flower whose IV is stuck directly into her bald scalp, making her look in fact as if she has just been plucked with her stalk intact. The twins are dark-haired, and each weighs in the vicinity of four pounds. The loud twin appears to be Mickey. “Oh, shush,” says the nurse good-naturedly, expertly weaving his hands through Mickey's leads and IVs to put the child over his shoulder and pat his back. “Always bitching about something.”

“Handsome, aren't they?” he asks Franckline. “This is the bad one. So I hold him close to my heart.”

“But you have to pay attention to the good one, too,” Franckline scolds, smiling.