John Irving - The Cider House Rules

On the morning train to Boston, he was embarrassed to meet the whore again. A chatty woman in the daylight, she was carrying a bandbox with the authority of a chronic shopper; he fell: obliged to give her his seat on the overcrowded train. A young girl was traveling with the whore-'my daughter,' the whore said, indicating the girl with a jab of her thumb. The daughter reminded Wilbur that they'd already met by breathing her astonishingly foul cigar breath into his face. She was a girl not quite Wilbur's age.

The whore's name was Mrs. Eames-'She rhymes with screams!' Wilbur's father had told him. Mrs. Eames told Wilbur she was a widow who lived a proper life in Boston, but that in order to afford such a life she found it necessary to sell herself in some out-of-the-way town. She begged Wilbur to allow her to keep her appearances and her reputation intact-in Boston. Wilbur not only assured her that her reputation was safe with him; he {59} also, unasked, paid her more money of his own, on the spot, than his father had originally paid the woman. The amount of the original payment, he learned later- when his father told Wilbur that Mrs. Eames was a proper Portlander of good reputation who occasionally was obliged to sell herself in Boston so that she might afford to keep up her appearances in Portland. As an old favor to Wilbur's father, she had allowed-'Just this once!'-the exception of lowering herself in her hometown.

Wilbur's father didn't know that Mrs. Eames had a daughter, who-by her own confession-cost less than her mother and made no pretense of keeping up appearances in either Boston or Portland. The sullen girl never spoke on the train ride into Boston's North Station; her cigar breath and her scornful gaze spoke for her. Wilbur never told his father that there was some contradiction regarding which town Mrs. Eames had a good reputation in, and he never told his father that he caught the clap from Mrs. Eames, who might not have known she had it.

At medical school, Wilbur learned that gonorrhea could live in the Fallopian tubes of females for years. Only the appearance of an abscess in the pelvis might allow the woman to know that she carried the disease. The symptomatology, the discharge and so forth, could go unnoticed for a long time. It did not go unnoticed in Wilbur Larch; the bacterial infection, in these prepenicillin days, lived on for months in young Wilbur, giving him his passionate interest in bacteriology before burning itself out. It left his urethra scarred and his prostate rocky. It left him fond of ether, too-because the ether sleeps he occasionally administered to himself relieved him of the burning sensation he experienced, both when he urinated and when he dreamed. This singular and painful encounter with sexual pleasure-in combination with Wilbur's memory of his parents' loveless marriage-convinced the would-be doctor that a life of {60} sexual abstinence was both medically and philosophically sound.

In the same year, 188-, that Wilbur Larch became a doctor, Neal Dow died. In grief, Wilbur Larch's mother shortly followed her temperance hero to the grave. A few days later, Wilbur's father auctioned every item from their servants' rooms in the former mayor's mansion and rode the Grand Trunk Railway to Montreal, a town less temperance-minded than Portland, and where Wilbur Larch's father pushed his liver beyond limits. His body was returned to Portland on the same Grand Trunk Railway that had carried the former lathe operator away. Wilbur Larch met the train; he played the porter to his father's remains. From the near-cadavers of the cirrhotic that he had seen during his first internship, young Dr. Larch knew exactly what must have been his father's condition at the end. Cirrhosis turns the liver to a mass of scars and lumps, the skin reflects the bile of jaundice, the stools lighten, the urine darkens, the blood doesn't clot. Dr. Larch doubted that his father would have even noticed the accompanying impotence.

How moving to conclude that young Larch chose to be an obstetrician because the loss of his parents inspired him to bring more children into the world, but the road that led Larch to obstetrics was strewn with bacteria. The demonstrator of bacteriology at Harvard Medical School, a Dr. Harold Ernst, is best remembered as one of the first college baseball pitchers to throw a curve ball; he was also the first college baseball player to become a bacteriologist. In the early morning laboratory, before Dr. Ernst-the former curve-ball pitcher-would arrive to set up his demonstrations, young Wilbur Larch would be all alone. He didn't feel alone in the presence of so many bacteria growing in the little Petri dishes, in the presence of the bacteria inhabiting his urethra and his prostate gland.

He would milk a drop of pus from his penis onto an {61} ordinary stained slide. Magnified more than a thousand times, the villains he spotted every morning under the microscope were still smaller thsm common red ants.

Years later Larch would write that the gonococci looked stooped, like too-tall visitors in ain igloo. ('They bend,' he wrote, 'as if they have waists and are bowing to each other.')

Young Larch would stare at his pus until Dr. Ernst would arrive and greet his little living experiments all over the lab (as if they were his old baseball teammates).

'Honestly, Larch,' the famous bacteriologist said one morning, 'the way you look into that microscope, you appear to be plotting revenge.'

But it was not the smirk of vengeance that Dr. Ernst recognized on Wilbur Larch's face. It was simply the intensity with which Larch was emerging; from his etherdaze. The young medical student had discovered that the light, tasty vapor was a safe, effective killer of his pain. In his days spent fighting the dancing gonococci, Larch had become quite a knowledgeable imbiber of ether. By the time the fierce bacteria had burned themselves out, Larch was an ether addict. He was an open-dropmethod man. With one hand he held a cone over his mouth and nose; he made this mask himself (by wrapping many layers of gauze around a cone of stiff paper); with his other hand, he wet the cone. He used a quarterpound ether can punctured with a safety pin; the drops that fell from the elbow of the safety pin fell in exactly the correct size and at exactly the correct rate:.

It was the way he would give ether to his patients, too, except that he gave himself much less; when the hand that held the ether can felt unsteady, he put the can down; when the hand that held the cone over his mouth and nose dropped to his side, the cone fell off his face-it wouldn't stay in place if no one held it, He felt nothing of the panic that a patient being anesthetized with ether experiences-he never approached the moment when there wasn't enough air to breathe. Before {62} that happened, he always dropped the mask.

When young Dr. Larch first set out from the South Branch of the Boston Lying-in to deliver babies in the poor districts of the city, he had a place in his mind where the peace of ether resided. Although he carried the ether can and the gauze cone with him, he didn't always have time to anesthetize the patient. The woman's labor was often too far advanced for the ether to help her. Of course he used it when he had the time; he would never share the opinion of some of his elder colleagues that ether was a deviation from the given-that children should be brought forth in pain.

Larch delivered his first child to a Lithuanian family in a coldwater, top-floor apartment-the surrounding streets littered with squashed fruit and tattered vegetables and horse droppings. There was no ice to put on the abdomen, over the uterus, in case of postpartum hemorrhage. There was a pot of water already boiling on the stove, but Larch wished he could sterilize the entire apartment. He sent the husband out for ice. He measured the woman's pelvis. He mapped out the fetus. He listened to its heartbeat while he watched a cat toying with a dead mouse on the kitchen floor.