Ron Rash - Serena

Pemberton closed his eyes and imagined the engine's meshing metal akin to the inner workings of a clock, bringing back time that had been suspended since he'd seen the blood on Serena's hand. When the train gained a steady rhythm, Pemberton opened his eyes and looked out the window, and it was as if the train crossed the bottom of a deep clear lake. Everything behind appeared slowed by the density of water-Campbell entering the office to call the hospital, workers coming out of the dining hall to watch the engine and coach car pull away, Galloway emerging from the stable, his stubbed arm flopping uselessly as he ran after the train.

The Shay began its ascent up McClure Ridge, the valley falling away behind them. Once over the summit, the train gained speed, dense woods now surrounding the tracks. Pemberton remembered what Serena had once said about only the present being real. Nothing is but what is now , he told himself as he held Serena's wrist, felt her pulse fluttering weakly beneath the skin. As the train crossed the declining mountains toward Waynesville, Pemberton pressed his lips against the limp wrist. Stay alive, he whispered, as though speaking to what blood remained in her veins.

By the time the train pulled into the depot, the towel was saturated. Serena hadn't made a sound the whole way. Saving her strength to stay alive, Pemberton believed, but now she'd lapsed into unconsciousness. Two attendants in white carried Serena off the train and into the waiting ambulance. Pemberton and the hospital doctor got in as well. The doctor, a man in his early eighties, lifted the soggy towel and cursed.

"Why in God's name wasn't she brought sooner," the doctor said, and pressed the towel back between Serena's legs. "She's going to need blood, a lot of it and fast. What's her blood type?"

Pemberton did not know and Serena was past telling anyone.

"Same as mine," Pemberton said.

Once in the hospital emergency room, Pemberton and Serena lay side by side on metal gurneys, thin feather pillows cushioning their heads. The doctor rolled up Pemberton's sleeve and shunted his forearm with the needle, then did the same to Serena. They were connected by three feet of rubber hose, the olive-shaped pump blooming in the tubing's center. The doctor squeezed the pump. Satisfied, he motioned for the nurse to take it and stand in the narrow space between the gurneys.

"Every thirty seconds," the doctor told her, "any faster and the vein can collapse."

The doctor stepped around the gurney to minister to Serena as the nurse squeezed the rubber pump, checked the wall clock until half a minute passed, and squeezed again.

Pemberton raised his shunted arm and gripped the nurse's wrist with his hand.

"I'll pump the blood."

"I don't think…"

Pemberton tightened his grip, enough that the nurse gasped. She opened her hand and let him take the pump.

Pemberton watched the clock, and when fifteen seconds passed he squeezed the rubber. He did so again, listening for the hiss and suck of his blood passing through the tube. But there was no sound, just as there was no way to see his blood coursing through the dark-gray tubing. Each time he squeezed, Pemberton closed his eyes so he could imagine the blood pulsing from his arm into Serena's, from there up through the vein and into the right and left atria of her heart. Pemberton imagined the heart itself, a shriveled thing slowly expanding as it refilled with blood.

A grammar school was across the road, and through the emergency room's open window Pemberton heard the shouts of children at recess. An attendant entered the room and helped lift Serena's legs and hold them apart as the doctor performed his pelvic exam. Pemberton closed his eyes again and squeezed the pump. He no longer checked the clock but tightened his hand as soon as he felt the rubber fill with blood. A bell rang and the sounds of the children dimmed as they reentered the school. The doctor stepped away from Serena and nodded at the attendant to lower Serena's legs.

"Get the mayo stand and a lap pack," the doctor told the attendant.

The nurse fitted a mask over Serena's face and dripped chloroform onto the cloth and wire. The attendant rolled the stand beside Serena's bed, opened the white cotton sheeting to reveal the sterilized steel. Pemberton watched the doctor lift the scalpel and open Serena's body from pubis to navel. Pemberton squeezed the pump again as the doctor's right hand disappeared into the incision, lifted up the purplish blue umbilical cord for a moment before resettling it. Then the doctor dipped both hands into Serena's belly, raised something so gray and phlegmy it appeared to be made not of flesh but moist clay. Blood daubing the body was the only indication to Pemberton it could have ever held life. The umbilical cord lay coiled on the baby's chest. Pemberton did not know if it was still connected to Serena.

For a few moments the doctor stared at the infant intently. Then he turned and handed what filled his hands to the attendant.

"Put it over there," the doctor said, and motioned to a table in the corner.

The doctor turned back to Serena but not before asking the nurse how much blood Pemberton had given.

"Over 500 cc's. Should I try and stop him?"

The doctor looked at Pemberton, who shook his head.

"I guess not. He'll be too weak before long to squeeze it anyway, or he'll pass out."

As the doctor wove dark thread through Serena's skin, Pemberton turned his head toward her. Pemberton listened to her soft inhalations and matched his breathing precisely to hers. He became lightheaded, no longer able to focus enough to read the clock or follow the words passing between the doctor and nurse. Another group of children ran out onto the grammar school's playground, but their shouts soon evaporated into silence. Pemberton squeezed the pump, his hand unable to close completely around it. He listened to his and Serena's one breath, even as he felt the needle being pulled from his forearm, heard the wheels of Serena's gurney as it rolled away.

PEMBERTON still lay on the gurney when he awoke. The doctor loomed above, an orderly beside him.

"Let us help you up," the doctor said, and the two men raised Pemberton to a sitting position.

He felt the room darken briefly, then lighten.

"Where's Serena?"

The words came out halting and raspy, as if he'd not spoken in days. Pemberton looked at the clock, its hands gradually coming into focus. Had one been on the wall, he would have checked a calendar to discern the day and month. Pemberton closed his eyes a few moments and raised his forefinger and thumb to the bridge of his nose. He opened his eyes and things seemed clearer.

"Where's Serena?" he asked again.

"In the other wing."

Pemberton gripped the gurney's edge and prepared to stand, but the orderly placed a firm hand on his knee.

"Is she alive?"

"Yes," the doctor said. "Your wife's constitution is quite remarkable, so unless something unforeseen occurs, she'll recover."

"But the child is dead," Pemberton said.

"Yes, and there's another matter I'll need to discuss with you and your wife later."

"Tell me now," Pemberton said.

"Your wife's uterus. It's lacerated through the cervix."

"And that means what?"

"That she can have no more children."

Pemberton did not speak for a few moments.

"What was the child's sex?"

"A boy."

"Had we gotten here earlier, would the child have survived?"

"That doesn't matter now," the doctor said.

"It matters," Pemberton said.

"Yes, the child probably would have survived."

The orderly and doctor helped Pemberton off the gurney. The room wavered a few moments, then steadied.

"You gave a lot of blood," the doctor said. "Too much. You'll pass out if you're not careful."