David Nickle - Eutopia

Loo shrieked, and her back arched, and the table-legs creaked as she tried in vain to draw her knees together. Andrew lurched back, pulling away just in time to avoid slicing her thigh with the scalpel. Norma moved as well, to take hold of Lou-Ellen’s shoulders, hold her down and try to comfort her best she could.

Andrew took a breath. If his patient were genuinely pregnant, this might be explained as amniotic fluid, but Loo was not, and this was not. It was something strange.

And it smelled…

The smell was a cousin to the stench Lou-Ellen had left in the cabin. It could be a sign of infection, just that , Andrew thought. But it reminded him of something else, that skirted at the edge of memory. He sniffed at his hand, which was covered in the mucous-thick liquid, trying to recall—and as he did, he chanced to look closely at it. It was not, he saw, entirely pure—suspended in it were tiny dark objects of various shapes. They might have been insects, or pieces of insects.

You have a patient , he reminded himself. See to her .

Lou-Ellen was still screaming but she had slowed her struggling enough that Andrew could get close again. The sheet was soaked now, with glistening puddles here and there. Andrew shook off his hand, and reached in to pick up the mirror, clean it off and begin again, this time sliding the speculum into the open space to see what he could see. Which would be a problem, Andrew realized, because in her struggles she’d knocked the speculum to the ground. It would have to be sterilized. He shook his head as he started to pour the juices out of the mirror’s bowl. Then he looked at it more closely.

At its deepest point, the bowl held about a quarter-inch of the liquid. And it, like the stuff on his hand, was impure. But the particulate that had gathered there was bigger. Andrew held it in the full sunlight and squinted. Was there something like a hand in it? No bigger than a man’s fingernail? Wispy effluvium trailed in the murky liquid, making it impossible to tell.

“Does anyone here have a jar?” he asked. “A clean jar I mean?”

“Sure,” said Norma. “In the root cellar there’s plenty.” She turned to one of the children, and ordered her to fetch a couple.

Andrew set the mirror down carefully. He motioned with his splinted arm to the ground, where the speculum lay. “That will have to be washed,” he said. “Clean it with boiling water and alcohol.”

Norma stayed with Loo, so it was Hank who bent to pick it up. He, and the rest of them, had drawn closer. Any closer, and they’d be blocking out his light. “Wash your own hands first,” said Andrew. “Don’t want Loo to get sick. Not now she’s through the worst of it.”

“Worst of it?” It was Norma. “You mean you’re done?”

Andrew looked back down at the bowl—the grotesque pieces of tissue—the strange shapes they made in the liquid. “Maybe. I don’t think I had much to do. Looks like whatever was in her died on its own. There are pieces of it in this.” He held the mirror out so Norma could see. Her eyebrows raised and her nostrils flared as she sniffed it. “I’d call it a miscarriage if I didn’t know better. As it stands, I’ll still take a look inside. See what troubles this awful sickness has caused her.”

“But you think she’s better,” said Norma. Loo did indeed seem better. The morphine, still in her blood, was back to work now that the panic was over.

Andrew gave a smile he hoped was reassuring. “We’ll see,” he said.

“All done,” said Hank, and handed Andrew the speculum. Andrew took it, and dribbled some of the alcohol on it and through it for good measure. Then he bent back down. “All right, Norma. Same as before.”

Norma reached down and pulled the labia apart, and Andrew leaned closer to insert the speculum. He barely touched it to the girl, however, before the second eruption. This time, Andrew didn’t lurch back, because this time, the fluid coming out was something that his surgeon’s reflexes understood.

This time, it was blood. Lou-Ellen Tavish was haemorrhaging.

Andrew had encountered this circumstance four times in his career as a physician. Three of the women who had bled out in the afterbirth had died. The last of those was Maryanne Leonard.

The fourth survived—because the French hospital where she was being seen employed a surgeon who had studied blood typing with Landsteiner and knew enough to pick the correct plasma for transfusion.

If he could find the source of the haemorrhaging and stem some of it, Andrew thought he might be able to save his patient with the blood of a close family member—if he could transfuse enough of it, with the single brass syringe in the doctor’s kit.

But he needed to work swiftly. He shouted to Norma to keep Loo’s vagina open, and he quickly inserted the speculum into the opening, then cleared the tube. Unmindful now of what happened to his specimen, Andrew poured the fluid from the mirror onto the sheet. “Out of the light!” he shouted, and when the families obeyed, he positioned the mirror so the sun lit the opening. He demanded a narrow set of forceps and a swab of cotton dipped in alcohol, and he took it in his injured arm, ignoring as best he could the shooting pain. And he peered up Lou-Ellen’s canal, and transferred the forceps to his good hand. He meant to staunch the bleeding with it, if he could spy the source.

And if he could manage it at all, with his hand-and-a-half. It was one thing to take a temperature and listen to a heartbeat; to tell these hill folk how to wash a table and boil water; even to stitch up a farm boy’s cut hand. It was something else again to save the life of a girl bleeding inside.

It’s even harder, Andrew scolded himself, if you keep thinking about all those troubles and not your patient .

Blood began to flow out through the speculum now, like a drain pipe. Andrew twisted the mirror, so he could see the red-flushed wall of the canal in an inch, but the rest was dark. So he set down the mirror, propped himself painfully on his damaged elbow, and inserted the forefinger of his good hand. He felt for the telltale pulsing of an open wound.

He was not in there long at all, before the thing inside Lou-Ellen Tavish bit down.

Andrew shouted, and pulled his finger out, and transferred his weight to his bad arm so that he cried out again. The finger was covered in Lou-Ellen’s murky blood. At the pad, a dark blood-blister grew.

Now Andrew did stagger back, taking the alcohol-soaked cotton from the forceps and pressing it against his finger. He swore under his breath. If that bite had broken skin…

A shudder ran up Loo’s body. And the speculum pushed from her vagina, and fell into the mess below, and Andrew thought to himself as the labia spread, this time pushed out from within: I am watching the Devil’s birthing .

And then he thought, as the twig-thin appendages emerged, pushing it wider for the bloody, snot-covered head to emerge, and Loo shuddered and rattled, one last time:

I’ve lost her .

The thing pulled itself from Loo’s middle, spewing a fresh stench and emitting a high, furious whistle. Andrew cast about the crowd. The adults were no good—they covered their faces and whimpered, held one another or just onto themselves. One by one, they fell to their knees and prostrated themselves.

But the children were back with the pickle jars. Andrew grabbed one from a slack hand, and pulled off the top. When he turned back, the creature was crouched on hind legs that articulated in two places, like a horse’s, while clawed hands scraped mucous and blood from a wide mouth that was lined with sharp teeth (and somehow, despite its orifices being blocked, it kept screaming). Its eyes were small and black, its skin bedsheet white, the only colour being the tiny rivulets of Lou-Ellen’s lifeblood shearing off its forehead. From buttocks to skull was a span of no more than eight or nine inches.