The Lord's Work 2 page

Mrs. Eames could have chosen several other ways of \'7b70\'7dattempting to abort the birth of another child. There were stories that a rather notorious abortionist in the South End was also the district's most successful pimp. Because he charged nearly five hundred dollars for an abortion, which very few poor women could afford, in their indebtedness they became his whores. His quarters —and others like his—were called, simply, 'Off Harrison'—appropriately vague, but not without meaning. One of the facilities of the South Branch of the Boston Lying-in was established on Harrison Street, so that 'Off Harrison,' in street language, correctly implied something unofficial—not to mention, illegal.

It did not make much sense to have an abortion 'Off Harrison' as Mrs. Eames, perhaps, had reason to know. Her daughter also knew the methods of that place, which was why she gave Wilbur Larch a chance to do the job—and gave herself a chance to have the job done well.

'I said I ain't quick,' Mrs. Eames's daughter told young Larch. 'I'd be easy. I'd get out of here in just a couple of minutes.'

It was after midnight at the South Branch. The house officer was asleep; the nurse-practitioner, an anesthetist, was also asleep. The colleague who had woken Larch—he'd gone to sleep, too.

The dilation of the cervix at any stage of pregnancy usually leads to uterine contractions, which expel the contents of the uterus. Larch also knew that any irritant to the uterus would usually have the desired effect: contraction, expulsion. Young Wilbur Larch stared at Mrs. Eames's daughter; his legs felt rocky. Perhaps he was still standing with his hand on the back of Mrs. Eames's seat on that swaying train from Portland, before he knew he had the clap.

'You want an abortion,' Wilbur Larch said softly. It was the first time he had spoken the word.

Mrs. Eames's daughter took the sea-gull feather out of her pigtail and jabbed Larch in the chest with the quill \'7b71\'7d end. 'Shit or get off the pot,' she said. It was with the words 'shit' and 'pot' that the sour stench of cigar reached him.

Wilbur Larch could hear the nurseanesthetist sleeping —she had a sinus condition. For an abortion, he wouldn't need as much ether as he liked to use for a delivery; he would need only a little more than he routinely gave himself. He also doubted it was necessary to shave the patient; patients were routinely shaved for a delivery and Larch would have preferred it for an abortion, but to save time, he could skip it; he would not skip ether. He would put red merthiolate on the vaginal area. If he'd had a childhood like Mrs. Eames's daughter, he wouldn't have wanted to bring a child into the world, either. He would use the set of dilators with the Douglass points— rounded, snub-nosed points, they had the advantage of an easy introduction into the uterus and eliminated the danger of pinching tissue in withdrawal. With the cervix dilated to the desired size, he doubted that—unless Mrs. Eames's daughter was well along in her third or fourth month—he would need to use forceps, and then only for the removal of placenta and the larger pieces. A medical school textbook had referred, euphemistically, to the products of conception: these could be scraped from the wall of the uterus with a curette— perhaps with two different-sized curettes, the small one to reach into the corners.

But he was too young, Wilbur Larch; he hesitated. He was thinking about the time for recovery from ether that he would need to allow Mrs. Elames's daughter, and what he would say to his colleagues, or to the nurse if she woke up—or even to the house officer if it turned out to be necessary to keep the girl until the morning (if there was any excessive bleeding, for example). He was surprised by the sudden pain in his chest; Mrs. Eames's savage daughter was stabbing him with the sea-gull feather again.

'I ain't quick! I ain't quick, I said!' the Eames girl \'7b72\'7dscreamed at him, stabbing him again and again, until the feather bent in her hand; she left it stuck in his shirt. In turning away from him, her heavy braid brushed his face —the braid's odor overwhelmingly conveying smoke. When she was gone and Larch plucked the sea-gull feather from his breast, he noticed that the oil of tansy —the French Lunar Solution—had spilled on his hands. Its smell was not unpleasant, but it momentarily overpowered the smell Larch liked and was used to — it overpowered the ether; it put an end to his peace of mind.

They did not use ether 'Off Harrison.' They didn't concern themselves with pain there. For pain 'Off Harrison,' they used music. An outfit called The German Choir practiced Lieder in the Front rooms 'Off Harrison.' They sang passionately. Perhaps Mrs. Eames's daughter appreciated it, but she made no mention of the music when she was brought back to the South Branch a week later. No one was sure how she got there; she appeared to have been flung against the door. She also appeared to have been beaten about the face and neck, perhaps for failing to pay the usual abortion fee. She had a very high fever—her swollen face was as hot and dry to the touch as bread fresh from the oven. From the fever and the tenseness of her abdomen, rigid as glass, the house officer and the night nurse suspected peritonitis. The reason they woke Wilbur was that Mrs. Earnes's daughter had a piece of paper pinned to the shoulder of her dress.

DOCTOR LARCH—

SHIT OR GET

OFF THE POT!

Pinned to the other shoulder—like a mismatched epaulette, pulling her dress askew—was a pair of ladies' underwear. They were her only pair. It was discovered she wasn't wearing any. Apparently, her panties had been pinned there in a hurry; that way they wouldn't \'7b73\'7d be lost. Wilbur Larch didn't need to examine Mrs. Barnes's daughter very thoroughly in order to discover that the abortion attempt had failed. A fetus with no heartbeat was imprisoned in her uterus, which had suffered some haywire contraction and was in a state of spasm. The hemorrhage and infection could have come from any of the several methods employed 'Off Harrison.'

There was the water-cure school, which advocated the use of an intrauterine tube and syringe, but neither the tube nor the water was sterile—and the syringe had many other uses. There was a primitive suction system, simply an airtight cup from which all the air could be sucked by a foot-operated pump; it had the power to abort, but it also had the power to draw blood through the pores of the skin. It could do a lot of damage to soft tissue. And—as the little sign said on the door 'Off Harrison,' WE TREAT MENSTRUAL SUPPRESSION ELECTRICALLY! — there was the Mclntosh galvanic battery. The long leads were hooked up to the battery; the leads had intravaginal and intrauterine attachments on insulated, rubbercovered handles; that way the abortionist wouldn't feel the shock in his hands.

When Mrs. Eames's daughter died—before Dr. Larch could operate on her and without her having further words with him (beyond the 'Shit or get off the pot!' note that was pinned to her shoulder), her temperature was nearly 107. The house officer felt compelled to ask Larch if he knew the woman. The note certainly implied an intimate message.

'She was angry with me for not giving her an abortion,' Wilbur Larch replied.

'Good for you!' said the house officer.

But Wilbur Larch failed to see; how this was good for anyone. There was a widespreaid inflammation of the membranes and viscera of the abdominal cavity, the uterus had been perforated twice, and the fetus, which was dead, was true to Mrs. Eames's daughter's prediction: it had not been quick. \'7b74\'7d

In the morning, Dr. Larch visited 'Off Harrison.' He needed to see for himself what happened there; he wanted to know where women went when doctors turned them down. On his mind was Mrs. Eames's daughter's last puff of cigar breath in his face as he bent over her before she died—reminding him, of course, of the night he needed her puffing cigar to find his clothes. If pride was a sin, thought Dr. Larch, the greatest sin was moral pride. He had slept with someone's mother and dressed himself in the light of her daughter's cigar. He could quite comfortably abstain from having sex for the rest of his life, but how could he ever condemn another person for having sex?

The German Choir blasted him at the door with the little sign that promised the return of menstruation electrically. There was a harsh and out-of-tune piano—no oboe, no English horn, no mezzo-soprano—yet Larch thought the music was remindful of Mahler's Kindertotenlieder. Years later, when he first heard the screamconcealing sound of the water rushing through Three Mile Falls, he would remember the abortionist's songs that pumped like jism 'Off Harrison.' He beat on the door —he could have screamed—but no one heard him. When he opened the door and stepped inside, no one bothered to look at him. The German Choir kept singing. The only instrument was a piano, and there were not nearly enough chairs for the women, and there were only a few music stands; the men stood huddled in two groups, far from the women; there weren't enough copies of the sheet music to go around. The choir conductor stood by the piano. A lean, bald man without a shirt, he wore a dirty-white shirt collar (perhaps to catch the sweat) and kept his eyes half closed, as if in prayer, while his arms wildly pummeled the air—as if the air, which was full of cigar smoke and the urine-like stink of cheap draft beer, were hard to move. The choir pursued the man's wild arms. \'7b75\'7d

A fussy or critical God, thought Wilbur Larch, would strike us all dead. Larch walked behind the piano and through the only open door. He entered into a room with nothing in it—not a piece of furniture, not a window. There was only a closed door. Larch opened it and found himself in what was obviously the waiting room—at least people appeared to be waiting there. There were even newspapers and fresh flowers and an open window; four people sat in pairs. No one read the papers or sniffed the flowers or looked out the window; everyone looked down and continued to look down when Wilbur Larch walked in. At a desk, with only a pad of paper and a cashbox on it, sat an alert man eating something that looked like navy beans out of a bowl. The man appeared young and strong and indifferent; he wore a pair of work overalls and a sleeveless undershirt; around his neck, like a gym instructor's whistle, hung a key—obviously to the cashbox. He was as bald as the choir conductor; Larch considered that their heads were shaved.

Without looking at Wilbur Larch, the man, who might have been one of the choir sitting out a song or two, said: 'Hey, you don't come here. You just have the lady come by herself, or with a lady friend.'

In the front room, Wilbur Larch heard them singing something about someone's 'dear mother'—wasn't that what 'mütterlein' meant?

'I'm a doctor,' Dr. Larch said.

The cashbox man kept eating, but he looked up at Larch. The singers took a deep breath, and in the splitsecond silence Larch heard the man's swift, skillful spoon scrape against the bowl—and, from another room, the sound of someone retching, quickly followed by the splash of vomit in a metal basin. One of the women in the waiting room began to cry, but before Larch could identify which of the women it was, the singers caught their breath and bore down again. Something about Christ's blood, Larch thought.

'What do you want?' the man asked Larch. \'7b76\'7d

I'm a doctor, I want to see the doctor here,' Larch said.

'No doctor here,' the man said. 'Just you.'

'Then I want to give advice,' Larch said. 'Medical advice. Free medical advice.'

The man studied Larch's face; he appeared to think that a response to Larch's offer could be found there. 'You're not the first one here,' the man said, after a while. 'You wait your turn.'

That seemed to satisfy both men for the moment, and Larch looked for a seat—taking a chair precisely between the twosomes of women already in the room. He was too shocked by everything to be surprised when he recognized one of the couples: the Lithuanian woman whose child he'd delivered (his first delivery) sat mutely with her mole-faced mother. They wouldn't look up at him; Larch smiled at them and nodded. The woman was very pregnant—too pregnant for an easy abortion, under the safest of circumstances. Larch realized, with panic, that he couldn't convey this to her; she spoke only Lithuanian. She would associate him with delivering only live babies! Also, he knew nothing of what might have become of her first baby—nothing of what her life with that baby had been, or was now. He tapped his foot nervously and looked at the other couple—also, clearly, a mother and her daughter, but both of them were younger than the Lithuanians and it was hard to tell which of them was pregnant. This abortion, at least, looked easier to perform. The daughter looked too young to be pregnant, but then why, Larch wondered, had the mother brought the girl here? Did she need the company so badly, or was this meant as a lesson? Watch out—this could happen to you! In the front room, the singers grew hysterical on the subject of God's love and something that sounded like 'blinding destiny'—verblendenen Geschike.

Wilbur Larch stared at the shut door, behind which he had heard unmistakable vomiting. A bee, crazily out of \'7b77\'7dplace, buzzed in the open window and seemed to find the flowers fakes; it buzzed straight out again. When Larch looked at the Lithuanian couple, he saw that the grandmother had recognized him—and she had discovered a new way to exhibit her mole, which had grown additional and longer hairs and had slightly changed color. Pinching her fingers to either side of the mole, the grandmother inflamed the surrounding skin and made the mole appear to explode from her face—like a boil come to a head, about to burst. The pregnant woman seemed not to notice her mother's charmless demonstration, and when she stared at Larch she appeared not to recognize him; for Larch there was only Lithuanian written on her face. Perhaps, Larch thought, her husband threw her baby out the window and drove her mad. For a moment Larch thought that the choir might be Lithuanian, but he recognized something about a battle between Gott und Schicksal—clearly German, clearly God and Fate.

The scream that cut through the shut door had no difficulty rising above the voices declaring that God had won. The young girl jumped from her seat, sat down, hugged herself, cried out; she put her face in her mother's lap to muffle her cries. Larch realized she'd been the one to cry before. He also realized that she must be the one needing the abortion—not her mother. The girl didn't look older than ten or twelve.

'Excuse me,' Larch said to the mother. I'm a doctor.'

He felt like an actor with good potential who'd been crippled with a single stupid line—it was all lie had to say. 'I'm a doctor.' What followed from that?

'So you're a doctor,' the mother said, bitterly, but Larch was happy to hear she didn't speak Lithuanian. 'So what help are you?' the mother asked him.

'How many months is she?' Larch asked the mother.

'Maybe three,' the mother said suspiciously. 'But I already paid them here.'

'How old is she?' Larch asked.

The girl looked up from her mother's lap; a strand of \'7b78\'7d her dirty-blond hair caught in her mouth. 'I'm fourteen,' she said defensively.

'She'll be fourteen, next year,' the mother said.

Larch stood up and said to the man with the cashbox key, 'Pay them back. I'll help the girl.'

'I thought you came for advice,' the man said.

'To give it,' Dr. Larch said.

'Why not take some while you're here?' the man said. 'When you pay, there's a deposit. You don't get a deposit back.'

'How much is the deposit?' Larch asked. The man shrugged; he drummed his fingers on the cashbox.

'Maybe half,'hesaid.

'EureganzeMacht!' the choir sang. 'Your whole power,' translated Wilbur Larch. Many medical students were good in German.

When the evil door opened, an old couple, like someone's bewildered grandparents, peered anxiously into the waiting room—both confusion and curiosity on their faces, which, like the faces of many old couples, had grown to resemble each other. They were small and stooped, and behind them, on a cot—as still as a painting—a woman lay resting under a sheet, her eyes open but unfocused. The vomit basin had been placed on a towel on the floor, within her reach.

'He says he's a doctor,' the cashbox man said, without looking at the old couple. 'He says he came to give you free medical advice. He says to pay these ladies back. He says he'll take care of the you ng lady himself.'

By the way that the old white-haired woman had become a presence—or, stronger, a force—in the doorway between the waiting room and the operating theater, Larch realized thatshe was in charge; the old white-haired man was her assistant. The old woman would have looked at home in a pleasant kitchen, baking cookies, inviting the neighborhood children to come and go as they pleased.

'Doctor Larch,' Dr. Larch said, bowing a little too formally. \'7b79\'7d

'Oh, yes, Doctor Larch,'the old woman said, neutrally. 'Come to shit or to get off the pot?'

The abortionist was known in the neighborhood 'Off Harrison' as Mrs. Santa Glaus. She was not the original author of that remark—or of that note. Mrs. Eames's daughter had written that herself, before she went to see Mrs. Santa Glaus; she knew enough about the dangers'Off Harrison' to know that she might be in no shape to write anything at all after Mrs. Santa Glaus finished with her.

Larch was unprepared for Mrs. Santa Glaus—specifically, for her attitude. He had imagined that in any meeting with an abortionist he (Dr. Larch) would take charge. He still tried to. He walked into the operating theater and picked up something, just to demonstrate his authority. What he picked up was the suction cup with a short hose running to the foot pump. The cup fitted neatly into the palm of his hand; he had no trouble imagining what else it fitted. To his surprise, when he had attached the cup to his palm, Mrs. Santa Glaus began stepping on the foot pump. When he felt the blood rushing to his pores, he popped the cup out of his palm before the thing could raise more than a blood blister on the heel of his hand.

'Well?' Mrs. Glaus asked, aggressively. 'What's your advice, Doctor?' As if in reply, the patient under the sheet drew Larch to her; the woman's forehead was clammy with sweat.

'You don't know what you're doing,' Dr. Larch said to Mrs. Santa Glaus.

'At least I'm doing something,' the old woman said with hostile calm. 'If you know how to do it, why don't you do it?' Mrs. Santa Glaus asked. 'If you know how, why don't you teach me?'

The woman under the sheet looked groggy, but she was trying to pull herself together. She sat up and tried to examine herself; she discovered that, under the sheet, she still wore her own dress. This knowledge appeared to relax her.

'Please listen to me, 'Dr. Larch said to her. 'If you have a \'7b80\'7dfever—if you have more than just a little bleeding—you must come to the hospital. Don't wait.'

'I thought the advice was for me,' Mrs. Santa Glaus said. 'Where's my advice?'

Larch tried to ignore her. He went out to the waiting room and told the mother with her young daughter that they should leave, but the mother was concerned about the money.

'Pay them back!' Mrs. Santa Glaus told the cashbox man.

They don't get the deposit back,' the man said again.

'Pay them back the deposit, too!' the old woman said angrily. She came into the waiting room to oversee the disgruntled transaction. She put her hand on Dr. Larch's arm. 'Ask her who the father is,' Mrs. Santa Glaus said.

That's none of my business,' Larch said.

'You're right,' the old woman said. That much you got right. But ask her, anyway—it's an interesting story.'

Larch tried to ignore her; Mrs. Santa Glaus grabbed hold of both the mother and her daughter. She spoke to the mother. Tell him who the father is,' she said. The daughter began to snivel and whine; Mrs. Santa Glaus ignored her; she looked only at the mother. Tell him,' she repeated.

'My husband,' the woman murmured, and then she added—as if it weren't clear—'her father.'

'Her father is the father,' Mrs. Santa Glaus said to Dr. Larch. 'Got it?'

'Yes, I've got it, thank you,' Dr. Larch said. He needed to put his arm around the thirteen-year-old, who was sagging; she had her eyes shut.

'Maybe a third of the young ones are like her,' Mrs. Santa Glaus told Larch nastily; she treated him as if he were the father. 'About a third of them get it from their fathers, or their brothers. Rape,' Mrs. Santa Glaus said. 'Incest. You understand?'

'Yes, thank you,' Larch said, pulling the girl with \'7b81\'7dhim—tugging the sleeve of the mother's coat to make her follow.

'Shit or get off the pot!' Mrs. Santa Glaus yelled after them.

'All you starving doctors!' the cashbox man hollered. 'You're all over.'

The choir was singing. Larch thought he heard them say 'vom keinen Sturm erschrecket'—frightened by no storm.

In the empty room that separated the songs from the abortions, Larch and the mother with her daughter collided with the woman who'd been under the sheet. She was still groggy, her eyes were darting, and her dress was plastered with sweat to her back.

'Please remember!' Larch said to her. 'If there's a fever, if there's more than a little blood'…Then he saw the woman's underwear pinned to the shoulder of her dress. That reminding epaulette was the badge of 'Off Harrison,' a kind of ribbon for bravery. Obviously, the woman didn't know that her panties were there. Larch imagined that the South End was sprinkled liberally with these staggering women, their panties pinned to their shoulders, marking them as indelibly as that longago Puritan New England 'A' upon their bosoms.

'Wait!' Larch cried, and grabbed for the underwear. The woman didn't want to wait; as she pulled herself free of his grasp, the pin opened and stuck Larch in the hand. After she'd gone, he put her panties in his suit-jacket pocket.

He led the mother and her daughter through the room that was always so heady with song, but the choir was taking a beer break. The lean, bald conductor had just dipped into his frothy stein when he looked up and saw Dr. Larch leaving with the women; a moustache of foam whitened his lip and a dab of the white froth shone on the end of his nose. The conductor raised his stein toward Dr. Larch, offering a toast. 'Praise the Lord!' the conductor called. 'You keep on saving those poor souls, Doc!' \'7b82\'7d

'Danke schön!' the choir called after him. Of course they could not have been singing Mahler's Songs on the Death of Children, but those were the songs Wilbur Larch had heard.

'In other parts of the world,' wrote Dr. Wilbur Larch upon his arrival in St. Cloud's, 'an ability to act before you think—but to act nonetheless correctly—is essential. Perhaps there will be more time to think, here in St. Cloud's.'

In Boston, he meant, he was a hero; and he wouldn't have lasted long—being a hero. He took the young girl and her mother to the South Branch. He instructed the house officer to write up the following:

'This is a thirteen-year-old girl. Her pelvis is only three and a half inches in diameter. Two previous, violent deliveries have lacerated her soft parts and left her with a mass of unyielding scar tissue. This is her third pregnancy as a result of incest—as a result of rape. If allowed to come to term, she can be delivered only by Caesarean section, which—given the child's delicate state of health (she is a child), not to mention her state of mind—would be dangerous. Therefore, I've decided to give her an abortion.'

'You have?' the house officer asked.

'That's right,' Wilbur Larch said—and to the nurseanesthetist, he said, 'We'll do it immediately.' The abortion took only twenty minutes; Larch's light touch with ether was the envy of his colleagues. He used the set of dilators with the Douglass points and both a medium-sized and a small curette. There was, of course, no mass of unyielding scar tissue; there were no lacerated soft parts. This was a iFirst, not a third pregnancy, and although she was a small girl, her pelvis was certainly greater than three and a half inches in diameter. These fictional details, which Wilbur Larch provided for the house officer, were intended to make the house officer's report more convincing. No one at the Boston Lying-in \'7b83\'7d ever questioned Larch's decision to perform this abortion —no one ever mentioned it, but Dr. Larch could tell that something had changed.

He detected the dying of conversations upon his entering a room. He detected a general aloofness; although he was not exactly shunned, he was; never invited. He dined alone at a nearby German restaurant; he ate pig knuckles and sauerkraut, and one night he drank a beer. It reminded him of his father; it was Wilbur Larch's first and last beer.

At this time in his life Wilbur Larch seemed destined to a first-and-last existence; one sexual experience, one beer, one abortion. But he'd had more than one experience with ether, and the news, in the South End—that there was an alternative to Mrs. Santa Glaus and the methods practised 'Off Harrison'—traveled fast. He was first approached while standing at a fruüt-vendor's cart, drinking fresh-squeezed orange juice; a tall, gaunt woman with a shopping bag and a laundry basket materialized beside him.

'I ain't quick,' the woman whispered to Wilbur Larch. 'What's it cost? I ain't quick, I swear.'

After her, they followed him everywhere. Sleepily, at the South Branch, he was always saying to one colleague or another, 'It's not my turn, is it?' And always the answer was the same: 'She'says you're her doctor.'

A child of Maine, Wilbur Larch was used to looking into people's faces and finding their eyes; now he looked down, or away; like a city person, he made their eyes hunt for his. In the same mail with his catalogue of surgical instruments from Fred Halsam & Co. he received a copy of Mrs. W. H. Maxwell's A Female Physician to the Ladies of the United States. Until late in 187-, Mrs. Maxwell had operated a woma.n's clinic in New York. 'The authoress has not established her hospital simply for the benefit of lying-in women,' she wrote. 'She believes that in the view of the uncharitableness of general society towards the erring, it is fit that the unfortunate should \'7b84\'7d have some sanctuary to which to flee, in whose shade they may have undisturbed opportunity to reflect, and hiding forever their present unhappiness, nerve themselves to be wiser in the future. The true physician's soul cannot be too broad and gentle.'

Of course, Wilbur Larch saw that the South End was mercilessly full of evidence of uncharitableness towards the erring and that he had become, in the view of the erring, the sanctuary to which to flee.

Instead, he fled. He went home to Maine. He applied to the Maine State board of medical examiners for a useful position in obstetrics. While they sought a position for him in some developing community, they liked his Harvard degree and made him a member of their board. Wilbur Larch awaited his new appointment in his old hometown of Portland, that safe harbor—the old mayor's mansion where he had spent the half life of his childhood, the salty boardinghouse where he had caught his dose of life from Mrs. Eames.

He wondered if he would miss the South End: the palmist who had assured him he would live a long time and have many children ('Too many to count!'), which Larch understood as confirmation that, in seeking to become an obstetrician, he had made the right choice; the fortune teller who had told young Larch that he would never follow in his father's footsteps, which was all right with Wilbur Larch, who had no knowledge of lathes, no fondness for drink, and was sure that his liver wouldn't be the culprit of his final undoing; and the Chinese herb doctor who had told Larch that he could cure the clap by applying crushed green leaves and bread mold to his penis. The quack was almost right. The chlorophyll in the plants would destroy the bacteria that contributed to gangrene but.it wouldn't kill the dance couples in the pus cells, those lively gonococci; the penicillin, extracted from some bread molds, would. Years later, Larch would dream that if only Dr. Harold Ernst, Harvard Medical School's bacteriologist and curve-ball \'7b85\'7d pitcher, and the Chinese herb doctor from the South End had put their heads together…well, what wouldn't they have cured?

Date: 2015-02-03; view: 838