Eleven Hours (4 page)

Marina catches her on her way back, beckons for Franckline to come over. “The program is locking me out again. Franckline, I swear …”

Franckline looks from the screen to the keyboard and taps a few keys. Nothing happens, so she goes into Systems and monkeys around in there. The hospital introduced a new computer system last month and there are still a lot of glitches. Franckline doesn't know that much more about computers than the other nurses, but she's less afraid of doing the wrong thing. Some of her colleagues seem to think that if they press the wrong combination of keys they'll make the whole system go down, or erase an entire week's scheduling.

In a few minutes Franckline has Marina back on the page she needs, a requisition for upgraded newborn scales.

“I don't know how you figure it out,” Marina says, a bit grudgingly.

“I keep telling you, you don't have to figure it. Just mess with it. There's always a way to undo what you've done.”

The nurse in room 7 puts down the magazine she's been reading and reports, before going out, that it's been twelve minutes since Lore's last contraction. Lore lies in her bed, unspeaking but restless. She laboriously shifts position and then, a few moments later, shifts again. She breathes heavily. She says she wishes things would keep going.

“Yes, yes,” says Franckline, soothingly. What more can she say? She learned long ago never to make promises to a woman in labor. Fast labors slow down, slow labors become fast. Anything can happen, and often does. Women who say they will never accept an epidural beg for the epidural, beg to be knocked out entirely. Babies twisted up in the umbilical cord, starved of oxygen for a little too long. Birthmarks obliterating a child's face, absent fingers or toes. Fifty-hour labors, a mother suffering a heart attack while pushing (that one was only thirty-two years old, grossly overweight, yes, but seemingly hale, with an energetic, generous laugh; they saved her, but it was touch and go). And of course there was Franckline's own child, three days old (he would never be more than three days old), who never once cried, but a few times lifted a weak half fist to punch the sky.

“Yes, yes”—such a weak phrase. It needles her briefly with shame.
Yes, yes
and
no, no
: these were the only two sentences she could bring out of herself when she first came to the States. I agree, I don't agree. I accept, I reject. The two elemental positions, when everything else has been taken away. Those first weeks in New York, scared out of her ability to recollect anything in the Kreyol-English textbook Bernard had made her study.

“Have you a book, or some music?” she asks Lore. Lore shakes her head and twists at that worrisome ring. Well, then, can she turn on the TV? Another no. Franckline feels a flickering of exasperation. Why is there so much No in this girl? Why does she seem to take a grim pleasure in having nothing, no one, in refusing distraction or comfort?

Franckline takes Lore's chart from the pouch beside the door and peruses it again. She removes Lore's birth plan and sits down with it at the computer desk. She scanned it first thing when Lore arrived but has yet to read it point by point. The date on it is about six weeks ago, October 27, 2004. Lore has organized the plan under different headings: there are
REQUESTS; INTERVENTIONS; IN THE EVENT OF A C-SECTION; BABY CARE IMMEDIATELY AFTER BIRTH; IN THE EVENT THAT THE BABY IS ILL OR HANDICAPPED; IN THE EVENT THAT THE BABY DIES
.

IN THE EVENT THAT THE BABY DIES
, I seek the following:

•
to be able to see and hold the baby for as long as I wish

•
not to be given tranquilizers or drugs that blunt feeling

•
to arrange the funeral myself

Lore stares up at the ceiling, as if searching there for the baby who may or may not arrive, who will probably live but also might conceivably die. Franckline silently offers her admiration. Most birth plans specify that the patient wants a natural childbirth or hot compresses to reduce the chance of an episiotomy, wants to room in with the baby and so forth. But the babies in these plans are never going to have deformed hearts or damaged brains. They are always going to be born with the right number of limbs; they are always going to survive.

There is another form, a health proxy, tucked behind the birth plan.
I, Lore Tannenbaum of New York, New York, being of sound mind … these instructions apply if I am permanently unconscious, or conscious but have irreversible brain damage … I do not want mechanical respiration … I do not want tube feeding … Witnessed by Diana Massie, residing at 501 Manhattan Ave., NY, NY
… Franckline flips back a few pages. Lore requests no Demerol. No Pitocin. No epidural. No supplementary bottles. No enema. No shaving.

No, no, and again no.

“I went over all of that with Dr. Elspeth-Chang,” says Lore.

“Yes,” says Franckline. She returns the plan to its folder. “Let's take a walk,” she announces. “It might get you going again.” This may be true but will more likely simply serve as a distraction for Lore. She adds: “Having a child is usually just a long patience.”

How supple her speech is now! How she surprises herself at times! She is proud of her English; after eleven years it is almost flawless. After that first fright she took to it quickly, making her new neighbors, the ones of long residence, talk with her, correct her. Bernard said:
You see, I told you. You have brains, quickness. You've got to study and get into school. Here you could become a nurse
.

She stands close while Lore pushes herself off the bed, ready to lend a hand, but Lore is steady on her feet. The hallway is more brightly lit than the labor room, although the tan-yellow linoleum floor has a sickly hue. Lore moves slowly now. They pass an empty room, and then another to which Marina assigned a fifteen-year-old shortly before Lore arrived. Often Franckline gets the teenagers, because Marina knows she has the patience for them, won't lecture them when they cry that pushing is “too hard” or eat Ring Dings and drop the wrappers on the floor. Franckline gets many of the difficult cases: she is seen as good with the obstreperous, the addled, the distraught. But this girl and her mother spoke mostly Spanish, so Marina gave the room to Alta. Franckline can hear the mother speaking to her daughter in a low, rapid voice, as if she has something urgent to impart before the baby's arrival. A whiff of fast-food burger wafts out of the open door, making Franckline queasy. Surely the girl can't be eating one.

They walk. Lore stops for a moment to adjust her gown, which has gotten caught up between her legs. All day the laboring and their caretakers trickle in and filter out and are replaced by different girls, women, husbands, mothers, sisters, friends. After today, Franckline will never again see this young woman with limp, mussed hair who has just exited room 11, Elmo slippers on her feet, heading toward the nurses' station; or the girl, ten or twelve years old, about to become somebody's older sister or cousin, who is repeatedly filling a conical cup at the water cooler and dumping the water back down the drain. Franckline feels a helpless, pulsing goodwill toward them all, tiny fragments of the great whole busy life of the universe that God in His goodness allows to unfold in her vision.

Touching her cross, she passes the mussed-hair woman, the girl, and they dissolve back into the mystery of who they are and where they soon will be going. Outside a closed room sits a man wearing a Mets cap, his hands folded in his lap. Hispanic, probably Dominican, Franckline thinks, in his midtwenties or so. Franckline greets him and the man tips up his chin in acknowledgment. A muffled cry arises from within the room, and then, right afterward, the patter of women speaking, comforting. The man stares at his palms and hums quietly to himself. Inside is women's work; the place for a man is out here. That has never been Bernard's style. Even that last time, when Franckline was rushed here in premature labor at twenty-two weeks, Bernard stayed in the room for the whole messy, agonizing thing.

At the double doors, past a smaller nurses' station, a wall plaque displays an arrow to Pulmonary. The station nurse nods to Franckline and buzzes them through. The corridor here, though it looks exactly like the one in Maternity, has its own distinct and different atmosphere and smell: more vinegar, less sweat. It is emptier, more disquieting. Lore takes her time. About halfway down the first long line of doors, a clatter arises, and abruptly a wheelchair is beside them, with a man in perhaps his late seventies inside. Small, trim, with yellowed white hair, he turns to look at Lore with alert eyes. As the chair moves ahead, pushed by a young, dark-haired nurse, he twists back to keep her in his sight, and unexpectedly, Lore breaks into a responsive smile. In a loud voice, the man says, “You'll be fine, dear.”

“Okay,” Lore replies. Her smile disappears but she doesn't seem angry. Her shoulders loosen, her walk becomes more relaxed. The wheelchair reaches another set of double doors and the nurse pushes through. Franckline watches as the soles of her waffled sneakers lift and fall and disappear. Then:

“Oh,” Lore says. “Oh, no.”

“Right here,” Franckline tells her, firmly, and, absurd as this seems, as appalled as Lore is, she obeys. Right there, on the old linoleum (she can feel its cracks and bumps etch themselves into the tender skin of her knees), she goes down and she remembers; she opens her mouth and her throat and urges out the great noise that mounts and crests and finally rolls back its force again. The external world disappears; all she hears is her own sound; she is a cave filled with a great echoing voice. When she is done she closes her eyes for a moment, returning to herself. Franckline helps her to her feet. There are two elderly women standing opposite, gazing at her. One, in a hospital gown with a cardigan thrown over it, an arm covered with purple bruises, stares blankly; the other, dressed in slacks and a silky blouse, her still-ample hair puffed around her temples and ears, holding her friend's wrist, wears an expression of distaste.

“She's in labor,” Franckline explains, calmly, and this articulation of the obvious makes the disapproving woman's eyes lose their sharpness. She tips her head in acquiescence and turns to her friend. “She's going to have a baby,” she says, as if the friend doesn't already understand, and perhaps she doesn't, because she simply licks her lips tremblingly several times.

“Let's go back,” says Lore. She feels a strange glee: she has flung her pain into this public space, not caring who observed it, whom she discomfited. This is possible, then; this can be done! But all the same a reflexive sense of embarrassment makes her turn from the two women and pretend she doesn't see them. There is something questioning in the fashionably dressed one's gaze that she doesn't want to encounter. Perhaps she is asking how Lore was able to do it, to release her pain so rudely. In childbirth class Betsy spent a whole day talking about the history of men's handling of women in labor: the withholding of pain relief or dosing patients into oblivion or putting them in restraints. Cutting tools that didn't need to be used, the shaving, the assault of the forceps. This woman is old enough to have experienced some or all of that. In her questioning eyes her story of pain is spilling silently out. But Lore does not want to know that story. There is time, right now, for her own pain only.

Yes, they need to go back. But they will have to cross deserts and seas to return! It took them weeks to gain this distance; Lore is far away from rest.

They turn toward Maternity, and Franckline now allows herself to think of the odd twinge she felt while Lore was down on the floor riding the contraction. She thought it might be a sympathetic effect, the absorption of a neighboring pain into her own body. But it continues as they make their way back. (Edie, a nurse in Pulmonary, smiles at them as she briskly passes.) And now Franckline feels a sharp stab on the left above her groin.

By week 15 of pregnancy your baby may suck its thumb. Eyes are at the front of the face but are still widely separated
.

She has seen the drawings and the sonograms and the uterine photographs hundreds of times, knows every detail of fingernails, eyelashes, crown-to-rump length. She learned these in nursing school, and she learned them too from the books she bought the last time she was pregnant. For over five years she and Bernard did not conceive, though both believed it would happen eventually, that God would grant it to them at the right time, and then He did. But she lost that pregnancy at twenty-two weeks. First there was backache, then the shock of her water breaking as she sat on the toilet massaging herself against the pain. It took seven hours to deliver the fetus, which had a weak heartbeat and died as soon as the cord was cut. She was told later that the pancreas and liver were underdeveloped, not to mention the lungs; there had been absolutely no chance of survival. The imaging afterward revealed that Franckline possessed a bicornate uterus—a uterus split into two chambers. There was possible cervical insufficiency as well. What will be, will be, Bernard said, and he seemed to mean it, but Franckline covertly visited a
mambo
to propitiate Ki Titha and Erzulie Mapiangue all the same. Six years passed, six years during which she finally put aside the idea of another pregnancy, and now here is a child inside of her again.

The staff here, mostly kind and attentive, has been watching her closely. Young Dr. Roper hooked her up on Tuesday to one of the ultrasound machines and said, yes, the heart is beating, the head and limbs look absolutely normal, terrific, Franckline. They will give her the best possible care, the best that is out there to be had. Some days she is sure this fetus will cleave to her long enough, will insist on being born with a healthy heart and lungs and limbs. Other days she is equally sure she can feel its lack of will in the face of the odds, and she grows despondent. She does not wholly believe Bernard when he says, as he has, over and over, that it does not matter to him, that he does not need a child. He is not truly as American as all that. Or perhaps it is she who cannot be quite so American. Her body once birthed a child, and ever since then it has ached to be a shelter again.
It could be my last chance, yes?
she asked Dr. McKenna, the high-risk specialist. She knew what his answer would be but she wanted to hear his tones, his inflection. Perhaps then she would know how to adjust her expectations up or down the scale of hope. “You never know,” he replied. He was a professional; there was no inflection at all. But she knows that with every miscarriage, the likelihood of her ever having a healthy child decreases.