“Ayo! Who has time for jasmine here?” Staff says, bringing it to her nose. But she’s grinning. “Go check on three. She’s a forceps I’m saving for you only.” Then she yells, “LISTEN, EVERYONE! WE’LL BE BUSY TODAY. I’M FEELING IT IN MY BONES.” There’s never been a day that hasn’t been busy, or that Staff hasn’t felt it in her bones.
The Malayali woman on pallet three has an orange mackintosh sheet underneath her buttocks and hanging over the edge. The sheet has a permanent gentian-violet stain from the innumerable women who’ve preceded her. When Mariamma spreads her gloved index and middle finger in a V inside the birth canal her fingers barely touch the sides of the cervix: the woman is fully dilated. The chalkboard says she has been in labor for seven hours, yet the baby’s head hasn’t budged past the pelvic floor. Mariamma applies the funnel-like stethoscope—the fetoscope—to the distended belly. Even with pin-drop silence, it’s hard to hear the fetus. Akila says she must “imagine the baby’s heart” to hear it separate from the mother’s. Imagine! Suddenly she hears it, sounding like a woodpecker with a dull beak. Less than eighty is cause for alarm—this baby comes in at sixty. Now Mariamma’s heart is racing.
“Staff!” she calls out, but Akila has already sent over the trolley. The forceps, fresh out of the sterilizer, have steam rising off them. The strings of the plastic apron Mariamma grabs are still wet from the previous user. She numbs the vulval skin with novocaine to one side of the midline and cuts. Tiny, pulsating gushes of blood follow the track of the angled episiotomy scissors. She’s only used forceps once before. The paired forceps are like curved serving spoons with long, slim handles; when the spoons (or “blades”) are positioned correctly, cupping the baby’s head, the handles can be brought together and locked. But by the time one needs forceps, the baby’s head is a soggy, swollen affair, with the landmarks hard to find. Using her index and middle fingers as a guide, she slides the left blade in and over the baby’s head, then does the same on the right. She prays they’re gripping skull, not squishing the face. But try as she might, she can’t get the two handles to come together. To force it might crush the skull. Just when she despairs, the hand of the Goddess Akila appears over her shoulder, makes a small adjustment to one blade, and now the handles articulate and lock. Staff disappears.
But the traction rod Mariamma tries to affix to the handle doesn’t match! She should have checked before she started. Once again, Goddess Akila’s hand reaches over Mariamma’s shoulder and completes the assembly despite the mismatch. Mariamma plants her feet on the floor, ready to heave. Akila positions the probationer behind Mariamma just in case she falls back when the head delivers. Mariamma tugs with the next contraction. “Ayo, you call that pulling, Doctor?” Akila shouts from the other side of the room without looking. “The baby will drag you back inside, slippers and all, if you can’t do better.” Mariamma squats and gives it everything she has. The baby’s head has run aground on the promontory of the sacrum. “Staff!” she cries through gritted teeth. “It’ll be fine, ma,” Akila shouts from the pulpit, then yells at someone else: “Doctor, by the time you finish sewing up episiotomy, the baby will be walking only!”
And it is fine, because suddenly the head emerges. But for the backstop of the probationer, Mariamma and the baby would be sprawled on the wet floor. The limp blue creature suffers the indignity of an egg-shaped head thanks to the forceps. She frantically works the bulb of the mucus sucker in the mouth to no avail. She blows gently into the face. Nothing. The mother looks on with horror. One of Goddess Akila’s ten hands reaches over and slaps the baby’s bottom, and with a jerk it lets out a shrill cry. “Better, ma?” Akila says, grinning cheekily, the Feels-Better-Out-Than-In implied but not spoken. Mariamma is so happy she feels like bawling. The tiny fists are raised in the air . . . She thinks suddenly of Lenin and tears threaten. “Hello, Mariamma Madam!” Staff yells, now from near the autoclave. “If you won’t cut the cord, kindly give the scissors to the baby. Stop daydreaming!” All-seeing Akila can even read minds. Mariamma cuts the cord and sets to work repairing the episiotomy. As soon as I’m done today, I’ll confess to Akila. I’ll tell her all. I can’t bear this alone.
Hours later, at the end of their shift, she asks Akila if she can walk out with her. Hesitantly, she spills her secret. Akila bursts out laughing.
“Ma, every medical student who comes through L&D thinks they’re pregnant. Even some foolish boys! Pseudocyesis, it’s called. But I say to them, how can you be a virgin and be pregnant?” Akila cracks up again.
“Staff . . . ? I’m not a virgin,” Mariamma says quietly.
Akila regards her with new interest. She takes Mariamma’s chin and turns her face one way and then the other. “Ma, I’m working L&D before you born. Akila is knowing when a woman is pregnant. I’m knowing before God is knowing, before mother is knowing. Husbands are idiots, knowing nothing, so forget about husbands. But never is Akila wrong. Body is telling me. Cheeks, color, ithu-athu. I’m promising you’re not pregnant. Do you believe me? Of course not! So, we’ll do test, but only so you are not worrying, understood?”
In the blood bank, Akila draws the specimen herself. “I’ll give to lab using some other name. But it will be normal, ma. Pregnancy in head, not in uterus.” She stops for emphasis. “This time. Next time could be uterus. So, use head next time.”
CHAPTER 68
The Hound of Heaven
1973, Madras
With the negative pregnancy test, her “morning sickness” vanishes. Mariamma feels like a condemned prisoner given a pardon. She’d been paralyzed by the prospect of being an unmarried mother to a child whose father was a Naxalite who’d never be seen alive again.
She’s too ashamed to make a second confession to Staff Akila: that she feels let down. Why didn’t she get pregnant? Is something wrong with her? Did her night with Lenin fail to impress the universe? Surely a love like theirs, a first intimacy, must leave its mark. It’s unreasonable, she knows, but the thought lingers, even as she packs for the Christmas holidays. She’s heading home at last, a visit that is long overdue.
When she gets her first glimpse of Parambil, she’s struck by its serenity, so removed from the chaos of her two years away. Smoke curls up from the chimney, from a hearth that never burns out. And there stands her father, framed by the pillars of the verandah, Anna Chedethi next to him, as though they’ve been standing there keeping vigil from the day she left. He holds her so tight she can hardly breathe.
“Molay, without you a part of me was gone,” he whispers. There’s security in his embrace, just as when she was a young girl. Then it’s Anna Chedethi’s turn to smother her. They both notice the scar on her face, even though it is fading. She blames a fall on a slippery lab floor and being cut by shattering glass. It’s true enough, even if the context is missing.