A. Yehoshua - Open Heart

My parents had already heard this echo too, on the way back from the airport, and they remarked on it to me, but their immediate concern was with Michaela’s plan to give birth at home. In the beginning they tried to pressure Michaela tactfully into changing her mind, as they had tried and succeeded in the matter of the size of the wedding. But this time I wasn’t neutral. I felt obligated to stand up for Michaela and reassure my parents — after all, I was a doctor, wasn’t I? And that should count for something. Fortunately, my father’s niece and her pale, thin, bespectacled husband, the one with the slightly mysterious appearance, called as soon as my parents arrived and invited them to dinner and the theater, distracting them to some extent from their anxieties about the approaching birth, which I intended to tell them about only when it was over. This wouldn’t be easy, for they were staying nearby, and in spite of their discretion and promise not to make a nuisance of themselves, they called several times a day. When I received a phone call at six o’clock in the evening from Michaela, who was already a few days overdue, to tell me that her water had broken, I told her not to say anything to my parents and hurried home from the hospital. There I was met by Stephanie, who liked taking part in these private births and who was chiefly responsible for giving Michaela the confidence to go through with it. Michaela was already lying, pale and smiling, on the mattress on my side of the joined twin beds, for her own mattress, soaked with amniotic fluid, had been put in front of the radiator in the next room to dry. I wondered if amniotic fluid had a smell. The first contraction had not come yet, so while we waited I made coffee and sandwiches for Stephanie and myself, but I forbade Michaela to eat, so that she wouldn’t vomit later. Even though Michaela had assured me that the midwife would bring “everything necessary,” I had prepared myself for the delivery by purchasing some polydine disinfectant, something to stop the bleeding, and three shots of Pitocin to accelerate the contractions, at a pharmacy; the Marcaine injections to anesthetize the pelvic nerves, which proved impossible to obtain at a pharmacy, I secretly “borrowed” from the medicine cabinet in the hospital delivery room, in the hope that we wouldn’t have to use them. Prompted by a premonition that something might go wrong and that I should be prepared for any eventuality, without asking permission I put a few simple but essential instruments in my bag, such as forceps, scalpels, long, curved scissors, and needles, and as soon as I got home I threw them all into a pot of boiling water to sterilize them. How strange, I thought, that I should be sitting here in our little kitchen, full of fear and apprehension, watching the bubbling water, when only a stone’s throw away was a hospital with modern operating rooms to which I had free access. If I really loved Michaela, I wondered, would I have given in to her so easily?

The midwife had not yet arrived, even though she had said that she was on her way some time ago. Michaela showed no signs of anxiety; she was well prepared and confident that everything would go smoothly. Stephanie and I watched as she greeted the first contraction with the special breathing exercises she had learned, without uttering a sound. In the meantime my parents phoned, and guessed by the tone of my voice that something was happening. I made them swear not to come until I called them, and they promised to wait for my permission — but half an hour later I saw them through the window, walking up and down the street as if they wanted, in spite of the bitter cold, to be close to the scene of the event. They were wearing heavy coats, and from time to time they raised their eyes to our lighted windows. Then they disappeared, into a nearby pub as it turned out, from which they phoned to say that they were close by and if I needed them they could be there in a minute. The midwife, presumably stuck in the busy evening traffic, had still not arrived, and I started to become really worried about what I would do if, God forbid, she didn’t come at all and it proved impossible to transfer Michaela to the hospital against her will. The rate of the contractions increased slightly, but there was still no sign of an opening. Michaela was quiet, she didn’t let out a single moan, and it was a wonder to me that she, who screamed and moaned wildly when we made love, was so restrained in the face of pains so severe that her face went white and she closed her eyes for long stretches at a time. For a moment I felt angry at myself for leaving all the arrangements for the midwife and the delivery to her. But before I took more drastic steps, such as going around to the hospital to fetch someone qualified to help, I decided to bring my parents up to the apartment, not only in order to leave someone more reliable than Stephanie with Michaela, although she seemed quite calm and collected, but also to get encouragement from their presence, and maybe even to get some practical advice from my mother, who had also given birth, even though it had been only once, and thirty years ago at that.

I ran down to the pub to call them. At first I couldn’t find them in the crush, because instead of sitting in a corner, as I expected, they were standing at the bar like veteran customers, drinking beer and holding an animated conversation with a group of Englishmen. When they saw me pushing my way toward them, looking agitated, my father had been having such a pleasant time that he thought it was already over and I had come to give them the news. He hurried to introduce me to his new acquaintances, and the friendliness of their nods led me to understand that here too I had been one of the subjects of his conversation. When we left the pub he complained again, as he had done since his arrival, of my poor English vocabulary and the mistakes I kept making, and offered once more to speak to me in English in order to improve my command of the language. But my mother, who sensed my deep excitement, cut him short: “Not now. Let’s wait for Shiva to be born first.” There was something very agreeable and reassuring in the way she pronounced for the first time the name of the baby who had not yet been born — who was apparently in no hurry to be born, either, judging by the lack of change in Michaela’s dilation. My father, of course, did not go into the bedroom and only looked in politely from the door, but my mother sat down next to the bed and began talking intensely with Michaela and Stephanie, who were becoming increasingly concerned at the failure of the midwife to arrive. Three hours had passed since she had been summoned, and there was no sign of her; and they had both been relying on her, not only medically but spiritually.

And then I understood that I would have to delivery my baby by myself, and taking into account the fact that my hospital was only a stone’s throw away, the situation into which I had been manipulated seemed to me nothing short of scandalous. Michaela sensed my rage and smiled apologetically. Her face was very pale; there were already black rings under her eyes, and I knew that she was in great pain but that she didn’t want to complain, especially after the Lamaze course that she had so faithfully and enthusiastically attended, under the supervision of the very midwife who still hadn’t arrived and whose whereabouts were unknown to the people who answered the phone at her house. I brought the instruments and drugs I had prepared into the bedroom, placed two pillows under her legs to raise them, and without hesitation gave her a shot of Pitocin to speed up the contractions. I had never injected anyone with Pitocin before, but since I had studied the formula in advance and read up on its action I had no qualms about administering it, especially since it was simply a weak solution of a substance I recognized as a muscle contractant. My mother watched me respectfully and nodded encouragingly, confident of the skill and lightness of my hand. Even though she was violently opposed to the idea of having the baby at home, she possessed a marvelous capacity for displaying optimism in the hour of need and putting old disagreements behind her. In order to keep Michaela occupied until the next contraction, she tried to remember details of her own delivery, to which Michaela paid scant attention, for now, under the influence of the injection, the contractions were coming more frequently, but still without any signs of the cervix’s dilating. The baby’s hard skull, too, which I succeeded in palpating in order to ascertain that her head would appear first, was still high up, as if she knew there was no point in approaching the cervix, which was still completely closed. I didn’t want to give Michaela the Marcaine yet, in case it caused a relaxation that would delay the birth. I realized that my anxiety was exaggerated and tried to tell myself that it was no big deal; every ambulance driver delivered a baby at least once or twice during the course of his career, and Michaela was showing impressive powers of endurance. She still had not asked me to give her anything to relieve the pain, and she did whatever I told her to without complaining, as if she were ready to press her guts out and tear herself into pieces as long as I left her in our bedroom and didn’t take her to the hospital.