The Lord's Work 3 page

'They would not have cured orphans,' wrote Dr. Larch when he woke from that dream.

And the orphans of the South End: Wilbur Larch remembered them from the branch hospitals of the Boston Lying-in. In 189-, less than half the mothers were married. In the institution's charter it was written that no patient would be admitted 'unless a married woman or one recently widowed, and known to be of good moral character.' The benevolent citizen groups who had first contributed thousands of dollars to provide for a lying-in hospital for the poor…they had insisted; but in truth almost everyone was admitted, There was an astonishing number of women claiming to be widows, or claiming marriage to sailors off to sea—gone with the Great Eastern, Wilbur Larch used to imagine.

In Portland, he wondered, why were there no orphans, no children or women in need? Wilbur Larch did not feel of much use in the tidy town of Portland; it is ironic to think that while he waited to be sent somewhere where he was needed, a prostitute's letter—about abandoned women and orphans—was making its way to him from St. Cloud's.

But before the letter arrived, Wilbur Larch had another invitation. The pleasure of his company -was requested by a Mrs. Channing-Peabody of the Boston Channing-Peabodys, who spent every summer on their coastal property just east of Portland. The invitation suggested that perhaps young Larch missed the Boston society to which he'd doubtlessly become accustomed and would enjoy some tennis or croquet, or even some sailing, before a dinner with the Channing-Peabodys and friends. Larch had been accustomed to no Boston socifity. He associated the Channing-Peabodys with Cambridge, or with Beacon Hill—where he was never invited—and although he knew that Channing and Peabody were old \'7b86\'7d Boston family names, he was unfamiliar with this strange coupling of the two. For all Wilbur Larch knew about this level of society, the Channings and the Peabodys might be throwing a party together and for the purpose of the invitation had agreed to hyphenate their names.

As for sailing, Wilbur Larch had never been on the water—or in it. A child of Maine, he knew better than to learn to swim in that water; the Maine water, in Wilbur Larch's opinion, was for summer people and lobsters. And as for tennis or croquet, he didn't own the proper clothing. From a watercolor of some strange lawn games, he had once imagined that striking a wooden ball with a wooden mallet as hard as he could would be rewarding, but he wanted time to practice this art alone and unobserved. He regretted the expense of hiring a driver to take him to the Channing-Peabody summer house., and he felt uncomfortably dressed for the season—his only suit was a dark, heavy one, and he hadn't worn it since the day of his visit 'Off Harrison.' As he lifted the big brass door knocker of the Channing-Peabody house (choosing to introduce himself formally, rather than wandering among the people in their whites at play at various sports around the grounds), he felt the suit was not only too hot but also needed a pressing, and he discovered in the jacket pocket the panties of the woman who'd aborted the birth of her child 'Off Harrison.' Wilbur Larch was holding the panties in his hand and staring at them—remembering their valiant, epaulette position, their jaunty bravery on the woman's shoulder—when Mrs. Channing-Peabody opened the door to receive him.

He could not return the panties to his jacket pocket quickly enough so he stuffed them into the pocket in the attitude of a handkerchief he'd just been caught blowing his nose in. By the quick way Mrs. Channing-Peabody looked away from them, Larch knew she'd seen the panties for what they were: women's underdrawers, plain as day. \'7b87\'7d

'Doctor Larch?' Mrs. Channing-Peabody said cautiously, as if the panties had provided her with a clue to Larch's identity.

I should simply leave now, Wilbur Larch thought, but he said, 'Yes, Doctor Larch,' and bowed to the woman —a great gunship of a woman, with a tanned face and a head helmeted in silver-gray hair, as sleek and as dangerous-looking as a bullet.

'You must come meet my daughter,' the woman said. 'And all the rest of us!' she added with a booming laugh that chilled the sweat on Wilbur Larch's back.

All the rest of them seemed to be named Charming or Peabody or Channing-Peabody, and some of them had first names that resembled last names. There was a Cabot and a Chadwick and a Loring and an Emerald (who had the dullest brown eyes), but the daughter whom Mrs. Channing-Peabody had designated to meet Dr. Larch was the plainest and youngest and least healthy-looking of the bunch. Her name was Missy.

'Missy?' Wilbur Larch repeated. The girl nodded and shrugged.

They were seated at a long table, next to each other. Across from them, and about their age, was one of the young men in tennis whites, either the Chadwick or the Cabot. He looked cross, or else he'd just had a fight with Miss Channing-Peabody, or else he would rather have been seated next to her himself. Or maybe he's just her brother and wishes he were seated farther away from her, thought Wilbur Larch.

The girl looked unwell. In a family of tans, she was pale; she picked at her food. It was one of those dinners where the arrival of each course caused a complete change of dishes, and as the conversation lapsed and failed, or at least grew fainter, the sound of china and silverware grew louder, and a tension mounted at the dinner table. It was not a tension caused by any subject of conversation—it was a tension caused by no subject of conversation. \'7b88\'7d

The rather senile retired surgeon who was seated on Wilbur's other side—he was either a Channing or a Peabody—seemed disappointed to learn that Larch was an obstetrician. Still, the old codger insisted on knowing Dr. Larch's preferred method of expelling the placenta into the lower genital tract. Wilbur Larch tried, quietly, to describe the expression of placenta to Dr. Peabody or Dr. Channing, or whoever he was, but the old man was hard of hearing and insisted that young Larch speak up't Their conversation, which was the dinner table's only conversation, thus progressed to injuries to the perineum—including; the method of holding back the baby's head to prevent a perineal tear—and the proper mediolateral incision for the performance of an episiotomy when a tear of the perineum seems imminent.

Wilbur Larch was aware that Missy Channing-Peabody's skin was changing color beside him. She went from milk to mustard to spring-grass green, and almost back to milk before she fainted. Her skin was quite cool and clammy, and when Wilbur Larch looked at her, he saw that her eyes were almost completely rolled up into her head. Her mother and the cross young man in tennis whites, the Cabot or the Chadwick, whisked her away from the table—'She needs air,' Mrs. Channing-Peabody announced, but air was not in short supply in Maine.

Wilbur Larch already knew what Missy needed. She needed an abortion. It came to him through the visible anger of young Chadwick or Cabot, it came to him over the babbling senility of the old surgeon inquiring about 'modern' obstetrical procedure, it came to him through the absence of other conversation and through the noise of the knives and the forks and the plates. That was why he'd been invited: Missy Channing-Peabody, suffering from morning sickness, needed an abortion. Rich people needed them, too. Even rich people, who, in Wilbur Larch's opinion, were the last to learn about anything, \'7b89\'7d even rich people knew about him. He wanted to leave, but now it was his fate that held him. Sometimes, when we are labeled, when we are branded, our brand becomes our calling; Wilbur Larch felt himself called. The letter from the prostitute from St. Cloud's was on its way to him and he would go there, but first he was being called to perform—here.

He rose from the table. The men were being sent to some special room—for cigars. The women had gathered around someone's baby—a nurse or a governess (a servant, thought Wilbur Larch) had brought a baby into the dining room, and the women were having a look. Wilbur Larch had a look, too. The women made room for him. The baby was rosy-looking and cheerful, about three months old, but Dr. Larch noticed the forceps mark on its cheek: a definite indentation, it would leave a scar. I can do better work than this, he thought.

'Isn't that a darling baby, Doctor Larch?' one of the women asked him.

'It's too bad about that forceps mark,' Larch said, and that shut them all up.

Mrs. Channing-Peabody took him out into the hall. He let her lead him to the room that: had been prepared for him. On the way she said, 'We have this little problem.'

'How many months along is she?' he asked Mrs. Channing-Peabody. 'Is she quick?'

Quick or not, Missy Channing-Peabody had certainly been prepared. The family had converted a small reading room into an operating theater. There were old pictures of men in uniform, and books (looking long untouched) stood at attention. In the grim room's foreground was a solid table appropriately set with cotton batting and rubber sheeting, and Missy herself w as lying in the correct examining position. She was already shaved, already swabbed with the bichloride solution. Someone had done the necessary homework; perhaps they'd pumped the senile family surgeon for details. Dr. Larch saw the alcohol, the green soap, the nail brush \'7b90\'7d (which he proceeded, immediately, to use). There was a set of six metal dilators, and a set of three curettes in a leather-covered, satin-lined case. There was chloroform and a chloroform inhaler, and this one mistake—that they didn't know Wilbur Larch's preference for ether— made Larch almost forgive them.

What Wilbur Larch could not forgive was the obvious loathing they felt for him. There was an old woman in attendance, perhaps some faithful household servant who had played midwife to countless little Channing-Peabodys, maybe even midwife to Missy. The old woman was particularly chisel-faced and sharp-eyed when she looked at Larch, as if she expected him to congratulate her—at which moment she would not acknowledge that he'd spoken to her—for her precision in readying the patient. Mrs. Channing-Peabody herself seemed unable to touch him; she did offer to hold his coat, which he let her take before he asked her to leave.

'Send that young man,' Larch told her. 'He should be here, I think.' He meant the particularly hostile young man in tennis whites, whether he was the outraged brother or the guilty lover or both. These people need me but they hate me, Larch was thinking, as he scrubbed under his nails. While he let his arms soak in the alcohol bath, he wondered how many doctors the Channing-Peabodys must know (how many must be in the family!), but they would never have asked one of their kind for help with this 'little problem.' They were too pure for it.

'You want my help?' the sullen young man asked Larch.

'Not really,' Larch replied. 'Don't touch anything and stand to my left. Just look over my shoulder, and be sure you can see everything.'

That class-conscious look of scorn had all but left young Chadwick's (or young Cabot's) face when Wilbur Larch went to work with the curette; with the first appearance of the products of conception, the young man's expression opened—that certain, judgmental \'7b91\'7d air was not discernible in any aspect of his face, which seemed softened and resembled his tennis whites in its color.

'I have made this observation about the wall of the uterus,' Dr. Larch told the ghostly young man. 'It is a good, hard, muscular wall, and when you've scraped it clean, it responds with a gritty sound. That's how you know when you've got all of it—all the products of conception. You just listen for that gritty sound.' He scraped some more. 'Can you hear it?' he asked.

'No,' the young man whispered.

'Well, perhaps “sound” isn't the right word,' Wilbur Larch said. 'Perhaps it's more like a gritty feeling, but it's a sound to me. Gritty,' he said, as young Cabot or young Chadwick attempted to catch his own vomit in his cupped hands.

'Take her temperature every hour,' Larch told the rigid servant who held the sterile towels. 'If there's more than a little bleeding, or if she has a fever, I should be called. And treat her like a princess,' Wilbur Larch told the old woman and the ashen, empty young man. 'No one should be allowed to make her feel ashamed.'

He would have departed like a gentleman after he looked under Missy's eyelids at her chloroform gaze; but when he put his coat on, he felt the envelope bulge in the breast pocket. He didn't count the money, but he saw there were several hundred dollars. It was the mayor's mansion all over again, the servant's quarters treatment; it meant the Channing-Peabody's wouldn't ask him back for tennis or croquet or a sail.

He promptly handed about fifty dollars to the old woman who had bathed Missy's genitals with the bichloride solution and had covered her with a sterile vulval pad. He gave about twenty dollars to the young tennis player, who had opened the door to the patio to breathe a little of the garden air. Larch was going to leave. Then, when he shoved his hands in his coat pockets and found the panties again, on an impulse he grabbed the placenta 92 forceps and took the instrument with him. He went off looking for the old surgeon, but there were only servants in the dining room—still clearing the table. He gave each of them about twenty or thirty dollars.

He found the senile doctor asleep in a reading chair in another room. He optened the mouth of the forceps, clamped the pair of panties from 'Off Harrison' in it, and then clamped the whole business to the old snorer's lapel.

He found the kitchen, and several servants busy in it, and gave away about two hundred dollars there.

He went out on the grounds and gave the last of the money, another two hundred dollars, to a gardener who was on his knees in a flower bed by the main door. He would have liked to have handed the empty envelope back to Mrs. Channing-Peabody; the grand lady was hiding from him. He tried to fold the envelope and pin it to the main door under the big brass door knocker; the envelope kept blowing free in the wind. Then he got angry and wadded it up in a ball and threw it into a manicured circle of green lawn, which served as a rotary for the main driveway. Two croquet players on a far lawn held up their game and stared first at the crumpled envelope and then at the blue summer sky, as if a lightning bolt, at the very least, were momentarily expected to strike Larch dead.

On his way back to Portland, Wilbur Larch reflected on the last century of medical history—when abortion was legal, when many more complex procedures than a simple abortion were routinely taught medical students: such things as utero decapitation and fetal pulverization (these in lieu of the more dangerous Caesarean section). He mumbled those words to himself: utero decapitation, fetal pulverization. By the time he got back to Portland, he had worked the matter out. He was an obstetrician; he delivered babies into the world. His colleagues called this 'the Lord's work.' And he was an abortionist; he delivered mothers, too. His colleagues called this 'the Devil's work,' but it was all the Lord's work to Wilbur Larch. As \'7b93\'7d Mrs. Maxwell had observed: 'The true physician's soul cannot be too broad and gentle.'

Later, when he would have occasion to doubt himself, he would force himself to remember: 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? He would remember, too, what he hadn't done for Mrs. Eames's daughter, and what that had cost.

He would deliver babies. He would deliver mothers, too.

In Portland, a letter from St. Cloud's awaited him. When the Maine State board of medical examiners sent him to St. Cloud's, they could not have known Wilbur Larch's feeling for orphans—nor could they have known his readiness to leave Portland, that safe harbor from which the Great Eastern had sailed with no plans for return. And they would never know that in the first week Wilbur Larch spent in St. Cloud's, he founded an orphanage (because it was needed), delivered three babies (one wanted, two inevitable—one would be another orphan), and performed one abortion (his third). It would take Larch some years to educate the population regarding birth control—the ratio would endure for some time: one abortion for every three births. Over the years, it would go to one in four, then to one in five.

During World War I, when Wilbur Larch went to France, the replacement physician at the orphanage would not perform abortions; the birth rate would climb, the number of orphans would double, but the replacement physician said to Nurse Edna and to Nurse Angela that he was put on this earth to do the Lord's work, not the Devil's. This feeble distinction would later prove useful to Nurse Angela and to Nurse Edna, and to Dr. Wilbur Larch, who wrote his good nurses from France that he had seen the real Devil's work: the Devil \'7b94\'7d worked with shell and grenade fragments, with shrapnel and with the little, dirty bits of clothing carried with a missile into a wound. The Devil's work was gas bacillus infection, that scourge of the First World War—Wilbur Larch would never forget how it crackled to the touch.

'Tell him,' Larch wrote Nurse Angela and Nurse Edna, 'tell that fool [he meant his replacement] that the work at the orphanage is all the Lord's work— everything you do, you do for the orphans, you deliver them!

And when the war was over, and Wilbur Larch came home to St. Cloud's, Nurse Edna and Nurse Angela were already familiar with the proper language for the work of St. Cloud's—the Lord's work and the Devil's work, they called it, just to keep it straight between themselves which operation was being performed when. Wilbur Larch went along with it—it was useful language—but both nurses were in agreement with Larch: that it was all the Lord's work that they were performing.

It was not until 193-that they encountered their first problem. His name was Homer Wells. He went out into the world and came back to St. Cloud's so many times that it was necessary to put him to work; by the time a boy is a teen-ager, he should be of use. But would he understand? the nurses and Dr. Larch wondered. Homer had seen the mothers co'me and go, and leave their babies behind, but how long before he stairted counting heads —and realized that there were more mothers coming and going than there were babies left behind? How long before he observed that not all the mothers who came to St. Cloud's were visibly pregnant—and some of them didn't even stay overnight? Should they tell him? the nurses and Dr. Larch wondered.

'Wilbur,' Nurse Edna said, while Nurse Angela rolled her eyes, 'the boy has the run of the place—he's going to figure it out for himself.'

'He's growing older every minute.,' Nurse Angela said. 'He's learning something new every day.' \'7b95\'7d

It was true that they never let the women recovering from the abortions rest in the same room with the new mothers, who were gaining their strength to leave their babies behind; that was something even a child could observe. And Homer Wells was frequently in charge of emptying the wastebaskets—all the wastebaskets, even the operating-room wastebaskets, which were leakproof and taken directly to the incinerator.

'What if he looks in a wastebasket, Wilbur?' Nurse Edna asked Dr. Larch.

'If he's old enough to look, he's old enough to learn,' St. Larch replied.

Perhaps Larch meant: if he's old enough to recognize what there was to be seen. After the Lord's work, or after the Devil's, much that would be in the wastebasket would be the same. In most cases: blood and mucus, cotton and gauze, placenta and pubic hair. Both nurses told Dr. Larch there was no need to shave a patient for an abortion, but Larch was fussy; and if it was all the Lord's work, he thought, let it all look the same. The wastebaskets that Homer Wells would carry to the incinerator held the history of St. Cloud's: the clipped ends of the silk and gut sutures, fecal matter and soap suds from the enemas, and what Nurse Edna and Nurse Angela feared Homer Wells would see—the so-called products of conception, a human fetus, or a recognizable part thereof.

And that is how Homer Wells (an unlucky thirteen) would discover that both the quick and the not quick were delivered at St. Cloud's. One day, walking back from the incinerator, he saw a fetus on the ground: it had fallen from the wastebasket he'd been carrying, but when he saw it, he assumed it had fallen from the sky. He bent over it, then he looked for the nest it might have dropped from—only there were no trees. Homer Wells knew that birds didn't deliver their eggs in flight—or that an egg, while falling, couldn't lose its shell.

Then he imagined that some animal had miscarried— in an orphanage, around a hospital, one heard that word \'7b96\'7d —but what animal? It weighed less than a pound, it was maybe eight inches long, and that shadow on its almost translucent head was the first phase of hair, not feathers; and those were almost eyebrows on its scrunched face; it had eyelashes, too. And were those nipples—those little pale pink dots emerging on that chest the size of a large thumb? And those slivers at the fingertips and at the toes — those were nails! Holding the whole thing in one hand, Homer ran with it, straight to Dr. Larch. Larch was sitting at the typewriter in Nurse Angela's office; he was writing a letter to The New England Home for Little Wanderers.

'I found something,' Homer Wells said. He held out his hand, and Larch took the fetus from him and placed it on a clean white piece of typing paper on Nurse Angela's desk. It was about three months—at the most, four. Not quite quick, Dr. Larch knew, but almost. 'What is it?' Homer Wells asked.

The Lord's work,' said Wilbur Larch, that saint of St. Cloud's, because that was when he realized that this was also the Lord's work: teaching Honner Wells, telling him everything, making sure he learned right from wrong. It was a lot of work, the Lord's work, but if one was going to be presumptuous enough to undertake it, one had to do it perfectly. \'7b97\'7d

3. Princes of Maine, Kings of New England

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'Here in St. Cloud's,' Dr. Larch wrote, 'we treat orphans as if they came from royal families.'

In the boys' division, this sentiment informed his nightly blessing—his benediction, shouted over the beds standing in rows in the darkness. Dr. Larch's blessing followed the bedtime reading, which—after the unfortunate accident to the Winkles—became the responsibility of Homer Wells. Dr. Larch wanted to give Homer more confidence. When Homer told Dr. Larch how he had loved reading to the Winkles in their safari tent—and how he thought he had done it well, except that the Winkles had fallen asleep—the doctor decided that the boy's talent should be encouraged.

In 193-, almost immediately after seeing his first fetus, Homer Wells began reading David Copperfield to the boys' division, just twenty minutes a crack, no more, no less; he thought it would take him longer to read it than it took Dickens to write it. Faltering at first—and teased by the very few boys who were near his own age (no boy was older)—Homer improved. Every night he would murmur aloud to himself that book's opening passage. It had the effect of a litany—on occasion, it allowed him to sleep peacefully.

Whether I shall turn out to be the hero of my own

life, or whether that station will be held by

anybody else, these pages must show.

'Whether I shall turn out to be the hero of my own life,' \'7b98\'7d Homer whispered to himself. He remembered the dryness in his eyes and nose in the furnace room at the Drapers' in Waterville; he remembered the spray from the water that had swept the Winkles away; he remembered the cool, damp, curled-in-ori-itself beginning that lay dead in his hand. (That thing he had held in his hand could not have been a hero).

And after 'lights out,' and Nurse Edna or Nurse Angela had asked if anyone wanted a last glass of water, or if anyone needed a last trip to the potty—when those dots of light from the just-extinguished lamps still blinked in the darkness, and every orphan's mind was either sleeping, dreaming, or lingering with David Copperfield's adventures—Dr. Larch would open the door from the hall, with its exposed pipes and its hospital colors.

'Good night!' he would call. 'Good night—you Princes of Maine, you Kings of New England!' (That thing Homer had held in his hand was no prince—it hadn't lived to be king).

Then, bang!—the door would close, and the orphans would be left in a new blackness, Whatever image of royalty that they could conjure would be left to them. What princes and kings could they have seen? What futures were possible for them to dream of? What royal foster families would greet them in sleep? What princesses would love them? What queens would they marry? And when would they escape the darkness left with them after Larch closed the door, after they could no longer hear the retreating squeaks of Nurse Edna's and Nurse Angela's shoes? (That thing he had held in his hand could not have heard the shoes—it had the smallest, most wrinkled ears!)

For Homer Wells, it was different. He did not imagine leaving St. Cloud's. The Princes of Maine that Homer saw, the Kings of New England that he imagined— they reigned at the court of St. Cloud's, they traveled nowhere; they didn't get to go to sea; they never even saw the ocean. But somehow, even to Homer Wells, \'7b99\'7d Dr. Larch's benediction was uplifting, full of hope. These Princes of Maine, these Kings of New England, these orphans of St. Cloud's—whoever they were, they were the heroes of their own lives. That much Homer could see in the darkness; that much Dr. Larch, like a father, gave him.

Princely, even kingly behavior was possible, even at St. Cloud's. That seemed to be what Dr. Larch was saying.

Homer Wells dreamed he was a prince. He lifted up his eyes to his king: he watched St. Larch's every move. It was the astonishing coolness of the thing that Homer couldn't forget.

'Because it was dead, right?' he asked Dr. Larch. 'That's why it was cool, right?'

'Yes,' said Dr. Larch. 'In a way, Homer, it was never alive.'

'Never alive,' said Homer Wells.

'Sometimes,' Dr. Larch said, 'a woman simply can't make herself stop a pregnancy, she feels the baby is already a baby—from the first speck—and she has to have it—although she doesn't want it and she can't take care of it—and so she comes to us and has her baby here. She leaves it here, with us. She trusts us to find it a home.'

'She makes an orphan,' said Homer Wells. 'Someone has to adopt it.'

'Someone usually adopts it,' Dr. Larch said.

'Usually,' said Homer Wells. 'Maybe.'

'Eventually,' Dr. Larch said.

'And sometimes,' said Homer Wells, 'the woman doesn't go through with it, right? She doesn't go through with having the baby.'

'Sometimes,' said Dr. Larch, 'the woman knows very early in her pregnancy that this child is unwanted.'

'An orphan, from the start,' said Homer Wells.

'You might say,' said Wilbur Larch.

'So she kills it,' said Homer Wells. \'7b100\'7d

'You might say,' said Wilbur Larch. 'You might also say that she stops it before it becomes a child—she just stops it. In the first three or four months, the fetus—or the embryo (I don't say, then, “the child”)—it does not quite have a life of its own. It lives off the mother. It hasn't developed.'

Date: 2015-02-03; view: 752