Jodie Picoult - Salem Falls

1969

New York City

That morning, while drinking her imported Sumatran coffee, Annalise St. Bride had read a story in the New York Times about a woman whose baby had been born in a tree. The woman lived in Mozambique, a country suffering from a flood, and had climbed to safety when her hut washed away. The baby was healthy, male, and rescued by helicopter a day later.

Surely that was worse than what was happening now.

She had been on Astor Place shopping for the most darling christening outfit when her water broke. Two weeks early. The ambulance told her she couldn’t get to Lenox Hill-the hospital where she’d planned to have her baby-because there was a parade blocking traffic one way, and a broken water main had locked up the conduit through Central Park. “I am not going to St. Vincent’s,” she insisted, as two paramedics hefted her into the back of the ambulance.

“Fine, lady,” one said. “Then drop the kid right here.”

A band of pain started at her groin, then radiated out to every nerve of her skin. “Do you know,” she gasped, “who my husband is?”

But the paramedics had already set the ambulance screaming crosstown.

Through the tiny window over her feet, Annalise watched the city roll past, a palette of gray angles and swerving pedestrians. In minutes, they arrived at the last hospital in New York City she could possibly wish to be.

Drug addicts and homeless people were splashed along the sides of the building like decorative puddles; Annalise had even heard of patients who had died in the halls simply waiting to be cared for. It was a far cry from Lenox Hill, with its lushly appointed exclusive birthing suites meant to offer a couple the feel of being at home.

St. Vincent’s? Being born in a tree was a better pedigree than this.

As the paramedics loaded the stretcher off the ambulance, she realized she had to fight in earnest. But the moment the wheels of the gurney slapped onto the pavement, she felt shock rocket through her. Her spine was shattering-she could feel the vertebrae at the base cracking, she was certain of it. In her womb, where she’d been carrying a baby, there was now a huge fist. It twisted like a puppeteer’s, pulled so hard and so long that she writhed, at odds in her own body.

I am going to die, she thought.

When she opened her mouth, all she could say was, “Get Joseph.”

She was admitted before the shifty-eyed drunks and the mothers with six sniffling children hanging like ornaments from their limbs. The curtained room smelled of alcohol and cleaning fluids, and Annalise’s gaily wrapped package stuck out awkwardly, a Meissen vase in a Woolworth’s living room. “She’s eight centimeters,” said the doctor, an Asian man with hair that stood straight, like a rooster’s comb.

“I want to wait for my husband,” Annalise gritted out. The contractions were slicing her in half, like the magician’s assistant.

“I don’t think your baby’s got the same idea,” a nurse murmured, coming up behind Annalise to brace her shoulders.

She and Joseph had toured the rooms at Lenox Hill, with their silk bedding and faux fireplaces. Just around the corner was their favorite Italian restaurant. Joseph had promised to bring her penne alla diavolo, the restaurant’s specialty, the night she delivered.

Suddenly, there was a crash as a new patient was wheeled into the cubicle beside Annalise’s. “Maria Velasquez. Thirty-year-old female, primip, twenty-seven weeks’ gestation,” the paramedic said. “BP one thirty over seventy, heart rate one-oh-five sinus rhythm. Beaten up one side and down the other by her husband.”

Annalise stared at the curtain that separated her from this woman. The nurse behind her gently turned her face away. “You concentrate on you,” she said.

“Are you having contractions?” The question came from the other side of the drape, the one Annalise was gazing at so fixedly she expected it to fly off its hangers at any moment in a feat of telekinesis.

“Sí, los tiene,” the woman moaned.

“Looks like she’s bleeding. Could be a placenta previa. Call OB.”

Annalise licked dry lips. “What’s . . . what’s the matter with the woman over there?”

Her doctor glanced up from a spot between her legs. “I need you to push,” he said. “Now, Annalise.”

She bore down with all her strength, squeezing her eyes so tight the room swam about her, and the words that filtered through the curtain came thin and quivering.

“No pueda!”

“It’s coming . . . get me a gown and gloves, for Christ’s sake.”

“BP’s falling. She’s ninety over palp.”

“Ah, damn. She’s bleeding out.”

“Respire, Mrs. Velasquez. No empuje.”

“Primero salvo mi bebé! Por favor, salvo mi bebé!”

Annalise felt herself being opened from the inside, a seal yawning and widening. She had a sudden vision of Joseph pulling on a weekend turtleneck sweater, the wool stretching taut as his head slowly emerged to show his smile, his tousled hair.

“Here we go,” the doctor said.

“Ringer’s lactate, wide open. Type and cross her. Where the hell is OB?”

“We’ve got to do this now. Ahora, Mrs. Velasquez. Empuje.”

“Pedi’s here.”

“About time. Take the baby.”

“Él se llamo Joaquim!”

“Yes, Mrs. Velasquez. That’s a lovely name.”

“One more push,” the nurse said to Annalise, “and you’re gonna have yourself a little one.”

“Suction the infant . . . I want him intubated and bagged with one hundred percent oxygen . . .”

“No quiera morir . . .”

“Pulse ox ninety-eight. Heart rate’s one-fifty.”

A high whine of machinery. “The mother’s bleeding out.”

“Massage her uterus. Hard. Harder!”

“Hang pitocin, and two units of O neg on the rapid infuser. IV fluids wide.”

“Where the hell is OB? Put in a central line.”

Annalise grabbed the nurse’s collar and pulled her close. “I don’t want to die.”

“You’re not going to,” the woman said.

“One more push, Annalise. One good one.”

She clenched her teeth, pressed down, and suddenly her son came into the world.

“The baby’s abdomen is filling with air.”

“You intubated the esophagus. Do it again.”

“Pulse ox sixty-three. Heart rate seventy.”

“Put in an umbilical line. Give him one cc of atropine, point three of epi, and three milliequivalents of bicarb.”

“Draw a blood gas.”

“She’s coding!”

“He’s in v-fib!”

Groggy, Annalise looked down at the healthy bundle in her arms and clutched him tightly.

On the other side of the curtain, two separate wars were being fought. One was to save the life of a woman who’d been beaten to near death by her husband. The other was to allow her child to have any kind of a life at all. From time to time, the curtain billowed in toward Annalise, the frenzy spilling into the limits of her own space.

She could identify two voices now, the doctor taking care of Mrs. Velasquez, and the doctor taking care of the woman’s newborn.

“Starting chest compressions.”

“Charge the paddles to three hundred fifty watts . . . intubate her!”

Thump, thump, thump-the sound of electricity jolting to jump-start a body.

“Give her another one mil of epi.”

“Give him another point three of epi.”

Thump.

“Asystole.”

And a moment later, “Asystole.”

Then the two doctors, speaking simultaneously. “Call it.”

Annalise should have been moved up to OB but had been forgotten because of the crisis next door. Now, the voices that had swelled the curtain a half hour before were silent.

The clock on the wall ticked, an animal grinding its teeth. Very slowly, Annalise slipped off the delivery table, walked to the bassinet, and gathered her son into the crook of her arm. She was sore and sagging, but she had never felt so strong. She pulled back the corner of the drape that separated her from the body of Maria Velasquez.