John Irving - The Cider House Rules

Scraped not so clean, maybe, Melony thought. Although Homer Wells had told her nothing, what trouble could exist that Melony couldn't see? Whatever there was that glimmered of wrong, that shone of mistake-of loss, of hope abandoned, of the grim choices that were possible-Melony had an eye expertly trained to see this, and more.

She'd not yet set foot outdoors but she could tell something different was in the wind. She could not see the body of the stationmaster; he had fallen in the weeds by the delivery entrance to the boys' division-which was little used; there was a separate delivery entrance for the hospital.

From his window-on-the-world, from Nurse Angela's office, Dr. Larch could not have seen the weeds where the stationmaster lay stiffening, either. And it was not the stationmaster's departed soul that troubled Larch that morning. He'd had other sleepless nights; sea breezes were rare, but he had felt them. There'd been a fight in the girls' division that had required some stitching in one girl's lip and in another girl's eyebrow, but Wilbur Larch wasn't worried about those girls. Homer Wells had done a very neat job with the lip; Larch had handled the eyebrow, which presented more of a problem with permanent scarring.

And the two women who were waiting for their abortions were very early in their respective pregnancies, and-in Nurse Edna's judgment-both seemed robust and sane. And there was an almost cheerful woman from Damariscotta-she'd just begun her contractions, which appeared perfectly normal; she'd had one previous delivery, very routine, and so Larch anticipated no difficulty with her. He was thinking he'd have Homer deliver the Damariscotta woman because it looked straightforward {213} and because the woman, Nurse Angela had said, had taken a particular liking to Homer; she had talked up a storm to him every second he'd been around her.

So what's wrong? thought Wilbur Larch. Or if not wrong, different?

So what if the mail was late and the dining hall said there'd been no milk delivery? Larch didn't know- and wouldn't have cared-that the train station had been more than usually disorganized in the stationmaster's absence; he didn't know that the stationmaster was missing. Wilbur Larch had noticed no disturbance among the souls crowding the sky above St. Cloud's. With the work he felt was his calling, Dr. Larch could not afford too rigorous a contemplation of the soul.

Previous to this morning, Homer Wells had not been presented with an occasion to contemplate the soul. A study of the soul had not been a part of his training. And since there were no windows in the room where Homer conducted his studies of Clara, it was not the stationmaster -or his soul-that suddenly presented itself to Homer Wells.

Dr. Larch had asked Homer to prepare a fetus for an autopsy.

A woman from Three Mile Falls had been stabbed, or she had stabbed herself; this was not unusual in Three Mile Falls but the pregnancy of the woman was nearly full-term-and the possibility of delivering a live baby from the dead woman had been unusual, even for Dr. Larch. He had attempted to rescue the child but the child-or, rather, the embryo, nearly nine months- had not escaped one of the stab wounds. Like its mother, the child (or the fetus, as Dr. Larch preferred) had bled to death. It would have been a boy-that much was clear to Homer Wells, or even to the untrained eye; whatever one called it, it was very nearly a fully developed baby. Dr. Larch had asked Homer to help him {214} determine (more exactly than 'bled to death') the source' of the fetus's bleeding.

Homer Wells borrowed Dr. Larch's sternum shears before he realized that a pair of heavy scissors was all he needed to open the fetus's sternum. He cut straight up the middle, noticing immediately the slashed pulmonary artery; to his surprise, the wound was less than half an inch away from a wide-open ductus-in the fetus, the ductus arteriosus is half the size of the aorta, but Homer had never looked inside a fetus before; in the born, within ten days, the ductus becomes nothing but a! fibrous thread. This change is initiated not by any mystery but by the first breath, which closes the ductus and opens the lungs. In the fetus, the ductus is a shunt-the blood bypasses the lungs on its way to the aorta.

It should not have been a shock for Homer Wells to see the evidence that a fetus has little need for blood in its lungs; a fetus doesn't breathe. Yet Homer was shocked; the stab wound, at the base of the ductus, appeared as a second eye alongside the little opening of the ductus itself. The facts were straightforward enough: the ductus was wide open because this fetus had never taken its first breath.

What was the life of the embryo but a history of development? Homer attached a tiny, needle-nosed clamp to the severed pulmonary artery. He turned to the section in Gray's devoted to the embryo. It was another shock for him to remember that Gray's did not begin with the embryo; it ended with it. The embyro was the last thing considered.

Homer Wells had seen the products of conception in many stages of development: in rather whole form, on occasion, and in such partial form as to be barely recognizable, too. Why the old black-and-white drawings should have affected him so strongly, he could not say. In Gray's there was the profile view of the head of a human embryo, estimated at twenty-seven days old. Not quick, as Dr. Larch would be quick to point out, and not {215} recognizably human, either: what would be the spine was cocked, like a wrist, and where the knuckles of the fist (above the wrist) would be, there was the ill-formed face of a fish (the kind that lives below light, is never caught, could give you nightmares). The undersurf ace of the head of the embryo gaped like an eel-the eyes were at the sides of the head, as if they could protect the creature from an attack from any direction. In eight weeks, though still not quick, the fetus has a nose and a mouth; it has an expression, thought Homer Wells. And wiith this discovery-that a fetus, as early as eight weeks, has an expression -Homer Wells felt in the presence of what others call a soul.

He displayed the pulmonary artery of the baby from Three Mile Falls in a shallow, white enamel examining tray; he used two clamps to hold the chest incision open, and one more clamp to lift and expose the lacerated artery. The baby's cheeks appeared deflated; someone's invisible hands appeared to press its small face at its sides; it lay on its back, resting on its elbows-its forearms held stiffly perpendicular to its chest. The tiny fingers of its hands were slightly open-as if the baby were preparing to catch a ball.

Homer Wells did not care for the tattered appearance of the stump of the umbilical cord, which was also too long; he clipped it again, and tied it off neatly. There wa s a little caked blood on the tiny penis, and Homer cleaned this away. A spot of old blood on the bright white edge of the enamel tray came off easily with just a cotton swab dabbed with alcohol. The color of the dead baby, especially against the whiteness of the tray, was of something sallow-going-gray. Homer turned to the sink and vomited rather deftly in it. When he ran the faucet to clean the sink, the old pipes pounded and howled; he thought it was thepipes, or his dizziness, that made the room-thewhole building-tremble. He wasn't thinking about the wind from the coast-how strong it was!

He wasn't blaming Dr. Larch, either. Homer felt there {216} was nothing as simple as anyone's fault involved; it was not Larch's fault-Larch did what he believed in. If Wilbur Larch was a saint to Nurse Angela and to Nurse Edna, he was both a saint and a father to Homer Wells. Larch knew what he was doing-and for whom. But that quick and not-quick stuff: it didn't work for Homer Wells. You can call it a fetus, or an embryo, or the products of conception, thought Homer Wells, but whatever you call it, it's alive. And whatever you do to it, Homer thought-and whatever you call what you do-you're killing it. He looked at the severed pulmonary artery, which was so perfectly displayed in the open chest of the baby from Three Mile Falls. Let Larch call it whatever he wants, thought Homer Wells. It's his choice-if it's a fetus, to him, that's fine. It's a baby to me, thought Homer Wells. If Larch has a choice, I have a choice, too.