Paula Goodlett - Grantville Gazette 36

"Part of the placenta being left behind," John finished the sentence.

"Very good, John, and do we know how to deal with that?"

John nodded. "Sure, a D amp;C. But how do we convince a down-timer that curettage to remove the bit left behind would have saved his wife?"

"We don't," Annamarie said. "There is no way a hidalgo is going to listen to an unsolicited explanation of how we could have saved his wife's life."

"So what are you suggesting we do?"

"We're just going to have to demonstrate how all-powerful modern medicine is."

John snorted. He knew Annamarie believed in the all-powerful nature of modern medicine about as much as he did-which wasn't much at all.

"More realistically," Annamarie said, "you're just going to have to do such a good job teaching whoever the Franciscans send for training that people start talking about how good the new medicine is."

"And what will you be doing?" John asked.

"I'll concentrate on the midwives. If nothing else, the knowledge ought to stop another woman bleeding to death in childbirth."

A week later

Don Juan sat upon his quietest mare on a hill above the scene of his accident and looked down upon the duke of Medina Sidonia's airfield. The Richard Peeke -the duke's new semi-rigid airship-was being guided out of its hangar on the rail system he had pioneered with the Pepino . Once the airship was clear of the hangar, it was released to fly under its own power.

The Richard Peeke was more than three times the size of the Pepino and had something like ten times the power in its two up-time engines. Under the control of its pilot, no doubt that ham-fisted fool, Don Fernando Lopez de Perez, the Richard Peeke took to the air and gracefully flew over Puerto Real before returning to the waiting mass of men in the middle of the airfield.

"Don Fernando has developed into a fine pilot," Alfonso observed.

"He could hardly have developed into a worse one," Juan snapped.

They stared at the airship in silence until it was moved back into its hangar. Then Juan sent Alfonso a wry smile. "I've been left behind. They don't need me any longer, and there is no longer a place for me in His Grace's plans." He stuck his clenched fist against his thigh in frustration. "I spent more than the estate could really afford developing the Pepino , and now I have nothing to show for it."

"You still have the Pepino ."

Juan snorted. "His Grace's agent has thanked me for letting them have the Pepino as a training vehicle. You think I can now ask for it back?"

Alfonso winced and shook his head.

"That's what I thought." Juan kneed his mare into motion and pulled her head around toward home. He nearly cantered home, but the pain in his body quickly had him slowing down to a gentle trot. That was the ultimate humiliation. Not only was he reduced to riding a mare, he couldn't even travel above a trot. He wondered if the American doctor had anything to reduce the pain.

****

"I can't see any problems," Annamarie reassured the young woman she'd been called in to examine. She sent what she hoped was a reassuring smile toward the midwife who'd insisted on being present.

"I told you so," the middle-aged midwife said.

"Yes, Maria," the patient said. "But the Senora is a doctor, an up-time doctor, and it is good to hear what she has to say."

Maria glared at Annamarie and stormed out.

"I'm sorry about Maria. She takes my husband insisting on you examining me personally," Ursula Lorenzo said.

"She probably thinks you no longer have confidence in her abilities. I'll talk to her, and see if I can get her to understand that I'm not trying to take over your care."

"Thank you," Ursula said.

****

The huffy midwife, obviously building up a head of steam, intercepted Annamarie on the front steps as she left the house. "You aren't wanted here. I can look after Senora Lorenzo myself."

"Senora, I'm here to help you, not take over your patient," Annamarie said.

"You already have the senor insisting that the up-time doctor examine his wife. How is that supposed to help me?"

"He's just a husband thinking a university degree is worth more than experience," Annamarie said. "In a straightforward case like Senora Lorenzo's, I'm not needed. However, if something goes wrong, such as in a case like that of Senora Amellera, I have knowledge that could help."

Maria snorted. "Not even that puffed up Englishman with his medical degree from Padua could save Senora Amellera. What makes you, a graduate of the jumped-up University of Jena, think you could have done better?"

"Was part of the placenta missing?"

The midwife made a sign to ward off the devil. "How did you know that?"

Annamarie pulled the cross she wore on a chain around her neck out from under her blouse and showed it to Maria to reassure her that she wasn't an agent of the devil. "It's a process of elimination. According to her mother-in-law, Senora Amellera died of blood loss after giving birth. Either the problem was part of the placenta not being delivered, or you don't know how to do your job. And nothing I've seen or heard suggests you don't know how to do your job."

"Of course I know how to do my job. Nobody in Andalusia has delivered more babies than me."

"Well, that only leaves part of the placenta not being delivered as an explanation for the bleeding." Annamarie was hopeful that her judicious lying would reduce Maria's belligerence.

"Nothing I did would get the body to push out the last piece of placenta." Maria folded her arms and glared. "And now I suppose you're going to tell me that you could have removed the last piece of placenta and saved Magdalida?"

Rather than just answer, Annamarie dug into her medical bag and bought out a curette. "I'd use one of these to scrape the remaining bits off the uterus."

Maria took the ten-inch-long nickel-plated-steel screwdriver-like implement with a half-inch wide open-loop head and turned it over and over in her hands. "This," she demanded, holding it up, "was all I would have needed to save Magdalida's life?"

Annamarie winced at the flash of obvious pain passing across Maria's face. "If you'll let me, I can teach you when and how to use it."

Maria handed the curette back. "What's it going to cost me?"

Annamarie studied Maria's expression. She still appeared belligerent, but there was a hint of a desire for knowledge. It was clear she expected there to be some price to pay, and there was no way Maria was going to believe Annamarie just wanted to spread knowledge. Her hand in the medical bag fell upon some of the Sanitation Commission pamphlets she always carried, and she pulled them out. "How well can you read?" Annamarie asked.

"Well enough," Maria said, as she tried to read the papers in Annamarie's hand.

"Then I want you to read these, and then talk to me about them. I need to train some assistants, and I'd welcome your assistance in designing a training program."

Annamarie watched Maria take the pamphlets and slowly, using a finger to track the words and her lips moving as she read the first page of 20 Useful Things to do with Carbolic Soap . That was a good sign. She'd been afraid that the Spanish of the mainly noble visitors to Grantville might be different to the everyday Spanish of the ordinary people.

****

In theory, Manuel Gomez was supposed to be instructing Jacob Sullivan on the local flora and fauna, but Manuel had been distracted by a particularly pretty piece of the local fauna by the name of Ines, and Jacob had been able to escape while Manuel devoted his attention to the young senorita. That meant he was at a loose end. He could always head for home, but Mom or Dad would just find some chore for him to do. So, he decided to explore the land around the hacienda on his own.