John Irving - The Cider House Rules

On his way back to Portland, Wilbur Larch reflected on the last century of medical history-when abortion was legal, when many more complex procedures than a simple abortion were routinely taught medical students: such things as utero decapitation and fetal pulverization (these in lieu of the more dangerous Caesarean section). He mumbled those words to himself: utero decapitation, fetal pulverization. By the time he got back to Portland, he had worked the matter out. He was an obstetrician; he delivered babies into the world. His colleagues called this 'the Lord's work.' And he was an abortionist; he delivered mothers, too. His colleagues called this 'the Devil's work,' but it was all the Lord's work to Wilbur Larch. As {93} Mrs. Maxwell had observed: 'The true physician's soul cannot be too broad and gentle.'

Later, when he would have occasion to doubt himself, he would force himself to remember: he had slept with someone's mother and dressed himself in the light of her daughter's cigar. He could quite comfortably abstain from having sex for the rest of his life, but how could he ever condemn another person for having sex? He would remember, too, what he hadn't done for Mrs. Eames's daughter, and what that had cost.

He would deliver babies. He would deliver mothers, too.

In Portland, a letter from St. Cloud's awaited him. When the Maine State board of medical examiners sent him to St. Cloud's, they could not have known Wilbur Larch's feeling for orphans-nor could they have known his readiness to leave Portland, that safe harbor from which the Great Eastern had sailed with no plans for return. And they would never know that in the first week Wilbur Larch spent in St. Cloud's, he founded an orphanage (because it was needed), delivered three babies (one wanted, two inevitable-one would be another orphan), and performed one abortion (his third). It would take Larch some years to educate the population regarding birth control-the ratio would endure for some time: one abortion for every three births. Over the years, it would go to one in four, then to one in five.

During World War I, when Wilbur Larch went to France, the replacement physician at the orphanage would not perform abortions; the birth rate would climb, the number of orphans would double, but the replacement physician said to Nurse Edna and to Nurse Angela that he was put on this earth to do the Lord's work, not the Devil's. This feeble distinction would later prove useful to Nurse Angela and to Nurse Edna, and to Dr. Wilbur Larch, who wrote his good nurses from France that he had seen the real Devil's work: the Devil {94} worked with shell and grenade fragments, with shrapnel and with the little, dirty bits of clothing carried with a missile into a wound. The Devil's work was gas bacillus infection, that scourge of the First World War-Wilbur Larch would never forget how it crackled to the touch.

'Tell him,' Larch wrote Nurse Angela and Nurse Edna, 'tell that fool [he meant his replacement] that the work at the orphanage is all the Lord's work- everything you do, you do for the orphans, you deliver them!

And when the war was over, and Wilbur Larch came home to St. Cloud's, Nurse Edna and Nurse Angela were already familiar with the proper language for the work of St. Cloud's-the Lord's work and the Devil's work, they called it, just to keep it straight between themselves which operation was being performed when. Wilbur Larch went along with it-it was useful language-but both nurses were in agreement with Larch: that it was all the Lord's work that they were performing.

It was not until 193- that they encountered their first problem. His name was Homer Wells. He went out into the world and came back to St. Cloud's so many times that it was necessary to put him to work; by the time a boy is a teen-ager, he should be of use. But would he understand? the nurses and Dr. Larch wondered. Homer had seen the mothers co'me and go, and leave their babies behind, but how long before he stairted counting heads -and realized that there were more mothers coming and going than there were babies left behind? How long before he observed that not all the mothers who came to St. Cloud's were visibly pregnant-and some of them didn't even stay overnight? Should they tell him? the nurses and Dr. Larch wondered.

'Wilbur,' Nurse Edna said, while Nurse Angela rolled her eyes, 'the boy has the run of the place-he's going to figure it out for himself.'

'He's growing older every minute.,' Nurse Angela said. 'He's learning something new every day.' {95}

It was true that they never let the women recovering from the abortions rest in the same room with the new mothers, who were gaining their strength to leave their babies behind; that was something even a child could observe. And Homer Wells was frequently in charge of emptying the wastebaskets- all the wastebaskets, even the operating-room wastebaskets, which were leakproof and taken directly to the incinerator.

'What if he looks in a wastebasket, Wilbur?' Nurse Edna asked Dr. Larch.

'If he's old enough to look, he's old enough to learn,' St. Larch replied.

Perhaps Larch meant: if he's old enough to recognize what there was to be seen. After the Lord's work, or after the Devil's, much that would be in the wastebasket would be the same. In most cases: blood and mucus, cotton and gauze, placenta and pubic hair. Both nurses told Dr. Larch there was no need to shave a patient for an abortion, but Larch was fussy; and if it was all the Lord's work, he thought, let it all look the same. The wastebaskets that Homer Wells would carry to the incinerator held the history of St. Cloud's: the clipped ends of the silk and gut sutures, fecal matter and soap suds from the enemas, and what Nurse Edna and Nurse Angela feared Homer Wells would see-the so-called products of conception, a human fetus, or a recognizable part thereof.

And that is how Homer Wells (an unlucky thirteen) would discover that both the quick and the not quick were delivered at St. Cloud's. One day, walking back from the incinerator, he saw a fetus on the ground: it had fallen from the wastebasket he'd been carrying, but when he saw it, he assumed it had fallen from the sky. He bent over it, then he looked for the nest it might have dropped from-only there were no trees. Homer Wells knew that birds didn't deliver their eggs in flight-or that an egg, while falling, couldn't lose its shell.

Then he imagined that some animal had miscarried- in an orphanage, around a hospital, one heard that word {96} -but what animal? It weighed less than a pound, it was maybe eight inches long, and that shadow on its almost translucent head was the first phase of hair, not feathers; and those were almost eyebrows on its scrunched face; it had eyelashes, too. And were those nipples -those little pale pink dots emerging on that chest the size of a large thumb? And those slivers at the fingertips and at the toes – those were nails! Holding the whole thing in one hand, Homer ran with it, straight to Dr. Larch. Larch was sitting at the typewriter in Nurse Angela's office; he was writing a letter to The New England Home for Little Wanderers.

'I found something,' Homer Wells said. He held out his hand, and Larch took the fetus from him and placed it on a clean white piece of typing paper on Nurse Angela's desk. It was about three months-at the most, four. Not quite quick, Dr. Larch knew, but almost. 'What is it?' Homer Wells asked.

The Lord's work,' said Wilbur Larch, that saint of St. Cloud's, because that was when he realized that this was also the Lord's work: teaching Honner Wells, telling him everything, making sure he learned right from wrong. It was a lot of work, the Lord's work, but if one was going to be presumptuous enough to undertake it, one had to do it perfectly. {97}