David Mitchell - The Thousand Autumns of Jacob de Zoet

‘Do you think the cord can be released?’ Maeno forgets to speak Dutch.

‘Well, I must try. Insert the cloth,’ Orito tells the maid, ‘now, please.’

When the linen wad is secured between Kawasemi’s teeth, Orito pushes her hand in deeper, hooks her thumb around the embryo’s cord, sinks four fingers into the underside of the foetus’s jaw, pushes back his head, and slides the cord over his face, forehead and crown. Kawasemi screams, hot urine trickles down Orito’s forearm, but the procedure worked first time: the noose is released. She withdraws her hand and reports, ‘The cord is freed. Might the doctor have his -’ there is no Japanese word ‘- forceps?’

‘I brought them along,’ Maeno taps his medical box, ‘in case.’

‘We might try to deliver the child’ – she switches to Dutch – ‘without amputating the arm. Less blood is always better. But I need your help.’

Dr Maeno addresses the chamberlain: ‘To help save Miss Kawasemi’s life, I must disregard the Magistrate’s orders and join the midwife inside the curtain.’

Chamberlain Tomine is caught in a dangerous quandary.

‘You may blame me,’ Maeno suggests, ‘for disobeying the Magistrate.’

‘The choice is mine,’ decides the chamberlain. ‘Do what you must, Doctor.’

The spry old man crawls under the muslin, holding his curved tongs.

When the maid sees the foreign contraption, she exclaims in alarm.

‘ “Forceps”,’ the doctor replies, with no further explanation.

The housekeeper lifts the muslin to see. ‘No, I don’t like the look of that! Foreigners may chop, slice and call it “medicine”, but it is quite unthinkable that-’

‘Do I advise the housekeeper,’ growls Maeno, ‘on where to buy fish?’

‘Forceps,’ explains Orito, ‘don’t cut – they turn and pull, just like a midwife’s fingers but with a stronger grip…’ She uses her Leiden salts again. ‘Miss Kawasemi, I’m going to use this instrument,’ she holds up the forceps, ‘to deliver your baby. Don’t be afraid, and don’t resist. Europeans use them routinely – even for princesses and queens. We’ll pull your baby out, gently and firmly.’

‘Do so…’ Kawasemi’s voice is a smothered rattle. ‘Do so…’

‘Thank you, and when I ask Miss Kawasemi to push…’

‘Push…’ She is fatigued almost beyond caring. ‘Push…’

‘How many times,’ Tomine peers in, ‘have you used that implement?’

Orito notices the chamberlain’s crushed nose for the first time: it is as severe a disfigurement as her own burn. ‘Often, and no patient ever suffered.’ Only Maeno and his pupil know that these ‘patients’ were hollowed-out melons whose babies were oiled gourds. For the final time, if all goes well, she works her hand inside Kawasemi’s womb. Her fingers find the foetus’s throat; rotate his head towards the cervix, slip, gain a surer purchase and swivel the awkward corpse through a third turn. ‘Now, please, Doctor.’

Maeno slides in the forceps around the protruding arm up to the fulcrum.

The onlookers gasp; a parched shriek is wrenched from Kawasemi.

Orito feels the forceps’ curved blades in her palm: she manoeuvres them around the foetus’s soft skull. ‘Close them.’

Gently but firmly the doctor squeezes the forceps shut.

Orito takes the forceps’ handles in her left hand: the resistance is spongy but firm, like konnyaku jelly. Her right hand, still inside the uterus, cups the foetus’s skull.

Dr Maeno’s bony fingers encase Orito’s wrist.

‘What is it you’re waiting for?’ asks the housekeeper.

‘The next contraction,’ says the doctor, ‘which is due any-’

Kawasemi’s breathing starts to swell with fresh pain.

‘One and two,’ counts Orito, ‘and – push, Kawasemi-san!’

‘Push, Mistress!’ exhort the maid and the housekeeper.

Dr Maeno pulls at the forceps; with her right hand, Orito pushes the foetus’s head towards the birth canal. She tells the maid to grasp the baby’s arm and pull. Orito feels the resistance grow as the head reaches the birth canal. ‘One and two… now!’ Squeezing the glans of the clitoris flat comes a tiny corpse’s matted crown.

‘Here he is!’ gasps the maid, through Kawasemi’s animal shrieks.

Here comes the baby’s scalp; here his face, marbled with mucus…

… Here comes the rest of his slithery, clammy, lifeless body.

‘Oh, but – oh,’ says the maid. ‘Oh. Oh. Oh…’

Kawasemi’s high-pitched sobs subside to moans, and deaden.

She knows. Orito discards the forceps, lifts the lifeless baby by his ankles and slaps him. She has no hope of coaxing out a miracle: she acts from discipline and training. After ten hard slaps she stops. He has no pulse. She feels no breath on her cheek from the lips and nostrils. There is no need to announce the obvious. Splicing the cord near the navel, she cuts the gristly string with her knife, bathes the lifeless boy in a copper of water and places him in the crib. A crib for a coffin, she thinks, and a swaddling sheet for a shroud.

Chamberlain Tomine gives instructions to a servant outside. ‘Inform His Honour that a son was still-born. Dr Maeno and his midwife did their best, but were powerless to alter what Fate had decreed.’

Orito’s concern is now puerperal fever. The placenta must be extracted; yakumosô applied to the perineum; and blood staunched from an anal fissure.

Dr Maeno withdraws from the curtained tent to give the midwife space.

A moth the size of a bird enters, and blunders into Orito’s face.

Batting it away, she knocks the forceps off one of the copper pans.

The forceps clatter on to a pan lid; the loud clang frightens a small creature that has somehow found its way into the room; it mewls and whimpers.

A puppy? wonders Orito, baffled. Or a kitten?

The mysterious animal cries again, very near: under the futon?

‘Shoo that thing away!’ the housekeeper tells the maid. ‘Shoo it!’

The creature mewls again; and Orito realises it is coming from the crib.

Surely not, thinks the midwife, refusing to hope. Surely not…

She snatches away the linen sheet just as the baby’s mouth opens.

He inhales once; twice; three times; his crinkled face crumples…

… and the shuddering newborn boiled-pink despot howls at Life.

Evening of the 20th July, 1799

‘How else,’ demands Daniel Snitker, ‘is a man to earn just reward for the daily humiliations we suffer from those slit-eyed leeches? “The unpaid servant,” say the Spanish, “has the right to pay himself”, and for once, Damn Me, the Spanish are right. Why so certain there’ll still be a Company to pay us in five years’ time? Amsterdam is on its knees; our shipyards are idle; our manufactories silent; our granaries plundered; The Hague is a stage of prancing marionettes tweaked by Paris; Prussian jackals and Austrian wolves laugh at our borders: and Jesus in Heaven, since the bird-shoot at Kamperduin we are left a maritime nation with no navy. The British seized the Cape, Coromandel and Ceylon without so much as a Kiss-my-Arse: and that Java itself is their next fattened Christmas goose is plain as day! Without neutral bottoms like this’ – he curls his lip at Captain Lacy – ‘Yankee, Batavia would starve. In such times, Vorstenbosch, a man’s sole insurance is saleable goods in the warehouse. Why else, for God’s sake, are you here?’

The old whale-oil lantern sways and hisses.

‘That,’ Vorstenbosch asks, ‘was your closing statement?’