Текст книги "The Secrets of Midwives"

Автор книги: Sally Hepworth

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Текущая страница: 6 (всего у книги 17 страниц)

10

Neva

It was the first time I’d been home in days. Usually as I dashed from here to there, always late for the next thing, I courted a healthy lust for the idea of free time, the sleep-ins, the lazy breakfasts, the newspaper reading. Not today. The day ticked by in seconds, not minutes, and by late afternoon, I was climbing the walls.

When the buzzer rang at five P.M., I perked up. A visitor. I heaved myself into a standing position, and then I found the button and tapped it down. “Hello?”

“Hi, darling.”

I opened my mouth, but I couldn’t seem to project any words. Grace hadn’t been to my apartment in years, not since she’d moved to Conanicut Island and developed a sudden intolerance for the “big smoke” of Providence. “Grace? Is that you?”

“Yes, it’s me.”

Suddenly it was crystal clear. Grace was staging a surprise visit to try to catch me off guard. Perhaps she thought she’d find my baby’s father crouched behind the sofa or, failing that, his wallet or football jersey in the bedroom. “Okay. Come on up.”

“Oh no, I can’t stay,” she said. “Could you come down?”

My finger froze, poised over the button. Seriously? She’d come all the way to Providence and she wasn’t even going to come inside? “Er … sure. Just a sec.”

As I took the stairs, it occurred to me that I liked the fact that my mother could still surprise me. Like the time when I was in the third grade, and as the rite of passage went, asked my parents for a dog. We were all living in Providence back then, and Dad said our yard wasn’t big enough. Grace asked if I was upset and I remember saying “I guess not.” Being upset, I figured, wouldn’t change the size of our yard.

That night, when Dad and I were watching TV, Grace crawled into the room on all fours, dressed in a white, furry bunny costume. Before we could even ask what she was doing, she barked, said they didn’t have any dog outfits at the costume store, and that we could call her Rover. I had a strong urge to hug her, but instead I patted her furry back.

The next day she met me at the school gates, still dressed as the bunny. That, in essence, was the problem with Grace. She never knew when to quit.

I peeled open the door, and there she was. In her slightly too-long tie-dyed sundress with her wild strawberry hair, Grace looked small. Innocent. Well meaning.

“Well,” I said. “This is unexpected.”

Grace reached into a bag and produced a yellow Tupperware container. “Bell pepper and bean sprout soup. Rich in folic acid, vitamin A, vitamin C.”

“You made me soup?”

“Got to make sure my grandchild is getting its nutrients.”

Her smile was full and wide, exposing two rows of teeth. The steel gate around my heart opened and I stepped back, allowing the door to open further. “Come in, Grace. Have some soup with me.”

She pressed the soup into my hands. “I wish I could, but I have to get back. I don’t want your father attempting to cook again.”

With a hand on each cheek, she kissed me. She smelled like essential oils—lavender and perhaps cedar. Grace loathed perfume, but thanks to the oils that burned constantly at her house, she always smelled lovely. “Let’s talk soon okay, darling?”

I nodded dumbly as she turned and hurried away, her tangled hair trailing after her like a leashed puppy. As I watched her, I had an overwhelming urge to scream, Wait! Stay. Have soup with me. But it was too late. She was gone.

*   *   *

An hour later, I was still perched on the stoop of my building. Somehow the bustle of the street was preferable to the silence of my apartment. The sky was navy blue and dusted with lavender clouds, and the damp, earthy reek of an impending storm hung in the air. It was funny; Grace’s visit, which was meant to be an act of kindness, had managed to make me feel even more alone than I had before.

People mooched along my street, nicely dressed, ready for a night out. There were no strollers about. People with kids were at home, out in the suburbs, cooking dinner and organizing carpools for the morning. Not these people. Some wore wedding bands; others were clearly new to each other—a first or second date. If things worked out for them, they’d probably do things the traditional way—an engagement, a wedding, then a baby. Or maybe they’d mix things up. I had to admit, I’d never minded the idea of doing things out of order, or perhaps never getting married, but I never expected that the baby would come before the man.

“Neva? Is that you?”

I blinked. “Mark?”

“It is you,” he said. “I thought you’d disappeared off the face of the earth.”

I smiled, wishing I’d done exactly that. It was all Eloise’s fault. She had joined Sean, Patrick, and me for a drink at The Hip one night last year, and as usual, Patrick and Sean (but mostly Patrick) grilled her about my love life. Usually I found it pretty easy to ignore them, but this day, for some reason, they got under my skin.

“So tell us,” Patrick had asked, “does Neva ever bring guys back to the apartment?” Eloise told him the truth—that it was rare. Which was fine until she added that she’d be happy to introduce me to some eligible bachelors. The next thing I knew, her phone was out and she was preparing to text my number to a cute Italian accountant. I started to object, but as Patrick jotted down the number of Eloise’s friend Amy, I heard myself say, “Sure thing. Text the accountant.”

Mark had done all the right things. Picked me up at the door, kept my glass full, asked me about myself. He even paid the bill while I was in the ladies’ room. I laughed more than once and he disagreed with me a couple of times in a way that didn’t get my back up. One glass of wine turned into a bottle, then another. As we made the journey back to my apartment, I was feeling pleasantly buzzed.

“So, do you want to um, come up for uh … coffee or something?” I asked on my doorstep. A pleasant beat of electricity fizzed between us.

“I don’t drink coffee,” Mark said, taking a step toward me. “But, yes, I’d like to come up.”

As his lips touched mine, something stirred in me. It had been a long time. Somehow we made it up the stairs, across the apartment, and into my room, but we didn’t make it as far as the bed. Afterwards, as we lay staring up at the roof, my head spun.

“Hey,” he said. “You wanna hear a joke?”

“Sur—” I rolled to face him, then paused and blinked hard.

Mark reached up and touched my cheek. “What is it?”

It was the strangest thing. I’d just been on a date with Mark. I’d slept with Mark. It might have been all the wine, but … when I looked at him, I expected to see Patrick. No, not expected. I wanted to see Patrick.

“Nothing.” I threw him a smile. But my buzz was gone. “I’m fine. What was the joke?”

The joke was funny. Not hilarious, but funny. I thought of Patrick again. Usually I had to fight to keep my mouth straight when he told me a joke. He loved it when I laughed. He said I was a tough audience, but it wasn’t true. Sometimes his jokes were terrible and I’d still chuckle. Something about the way he looked at me right after he’d delivered the punch line—so cautiously hopeful—would set me off. And later, as I lay in bed or walked home from my shift, I’d think of that look and smile again.

The next time Mark tried to kiss me, I closed my eyes. But it didn’t matter. The passion was gone.

I hadn’t expected to hear from Mark again. But a few days later, I did: Did I want to catch a movie? Did I want to try that new French restaurant? Part of me did. But every time I tried to respond to his texts, my thumbs froze. Eventually he stopped texting, and I was grateful. Until now.

Mark turned to the woman to his right, as if remembering she was there. “Oh, uh … Neva, this is Imogen.”

“Hello, Imogen,” I said, forcing myself into a standing position. “Nice to meet you.”

Her lips pressed together in a tight smile. “Hello.”

This, I knew, was the part when we would mutter something about being late, and shuffle off in separate directions. I was about to start the ball rolling when Mark’s expression darkened.

“Could you give us a minute, Imo?” His voice was falsely bright, but his gaze, I suddenly noticed, was fixed on my stomach. “I’ll meet you at your place.”

Imogen’s puzzled expression must have matched mine. She looked from me to Mark and back again. Then her eyes found my belly. “Oh-kay,” she said, frowning. “See you at home.”

Mark smiled at her reassuringly. But when Imogen was gone, his smile fell away. “You’re pregnant,” he said to me. It sounded like an accusation.

“Yes.”

“It’s not—” He cleared his throat. “—it’s not mine?”

“No. Oh God, no.” At least now I understood why he’d asked his girlfriend to leave.

“When are you due?” he asked.

“December thirty-first.”

I waited as he did the math. Then, satisfied, he nodded. “Well. Congratulations, I guess. I wish you luck.”

We bobbed our heads, the mood once again awkward. Drops started to fall from the sky, all at once heavy and separate, like tiny, teeming water balloons. The timing was good.

“Well, I guess I’d better—” Mark jabbed his thumb in the direction Imogen had headed.

“Yes,” I said. “Me too. Nice to see you, Mark.”

“You too,” he said.

I watched as Mark jogged away. Then, while I fumbled in my pocket for my keys, my phone began to ring.

I pressed the phone to my ear. “Hello.”

“Neva, I need your help.”

“Grace?” My heart beat a little faster. “What’s wrong?”

“I have a client in labor. Her sister was meant to be my birth assistant but she’s from out of state and the baby is coming early. I’ve tried Mary and Rhonda, they can’t come. Any chance you could assist?”

I processed the information she’d given me. Grace did home births. The baby was early. The equation didn’t add up. “If the baby’s premature, Grace, you need to take her to the hospital.”

“She’s thirty-seven weeks along, so there’s no need for a hospital. She’s having the baby at my place.”

A man leaving the building held the door open for me, and I gave him a wave as I slid inside. “What stage is she at?”

“I haven’t examined her yet, but I’d guess she’s five to six centimeters dilated, water intact, contractions six minutes apart for the last hour. Second baby.”

“When did labor start?” I started up the stairs.

“A couple of hours ago, but it’s progressing at a reasonable rate.” I could hear the desperation in Grace’s voice. “Darling? I really need you.”

I heaved the door open and plodded into my apartment. “I’m on my way.”

“You are?” Grace’s voice broke. “You’re really coming?”

“Of course I’m coming,” I said. The idea that she thought I wouldn’t brought on a wash of shame. Sure, Grace and I had our troubles. But she was my mother. And no matter what problems existed between us, if she needed me, I’d come.

11

Grace

“Okay, Gill, just relax. I’m going to give you an internal exam, see how you’re progressing. Lie back for me. Perfect.”

I snapped on my gloves and knelt at the end of the bed. Gillian’s husband stood to my right. “David, I need you to help me slide her down the bed. You grab her shoulders, and Gill, you lift your bottom and shimmy down. Ready? Go.”

When Gillian was in position, I started my examination. “Eight centimeters. My, my. Well done, you.”

I smiled, then felt for the head, pausing as my fingers found a hard bone in the center of the skull. I concentrated on keeping my face neutral. What was that? I splayed my fingers, feeling the soft surrounding tissue. It felt like a buttock but … it couldn’t have been. The baby had been head-down last time I examined Gillian. With my right hand I felt the outside of her stomach. Yes, it felt like a head.

Gillian started another contraction, and I removed my gloves and drifted to the sink. I couldn’t make sense of it. If the baby was head-down, what was I feeling? Even though it was unlikely, I couldn’t rule out a breech. If it was—it was high-risk. Too high-risk for a home birth. She’d have to be transferred to the hospital.

“I’m here.”

I turned. Neva stood by my side in sweatpants and a hoodie that strained over her belly. Her hair was wet and windswept. I exhaled, suddenly grateful that none of my other birth assistants were available. “Neva! Thank goodness.”

Neva turned to Gillian and David. “My name’s Neva,” she said. “I’m a Certified Nurse-Midwife, and I’ll be assisting with your birth. Looks like you’re doing a great job so far. I’ll go wash up, and then we should get you up and about. Let gravity do some work for you.” She hesitated then, and looked at me. “I mean … if that’s okay with Grace.”

“Uh … yes,” I said. “It’s fine with me.”

As Neva chatted to Gillian, an image of my little strawberry-haired baby daughter popped into my mind, so at odds with the woman I saw before me. She touched Gillian’s stomach gently but not too familiarly. Her facial expressions were professional but warm. All her best qualities were in play.

When Neva finished her chat with Gillian, she joined me at the sink. “How is it going? Have you done the internal yet?”

“Yes, though…” I lowered my voice. “The baby was head-down at thirty-five weeks, but when I examined her just now, it felt a bit like a breech. Hard in the middle, soft at the sides. I’m not sure.”

“Thirty-five weeks? That’d be late for it to turn,” she said, echoing my thoughts. “Could it have been the nose you were feeling? A face presentation?”

“I suppose.” But I doubted it. I’d felt faces before. This was different.

“Would you like me to have a look?”

I sagged. “I’d love it.”

Neva smiled and my concerns vanished, just like that. With Neva by my side, we’d work this thing out. The idea brought on a small bubble of joy.

I went to Gillian’s side. “Would it be okay if Neva did another examination before we get you up? The baby’s not in the position I expected, and I want a second opinion.”

Gillian’s face clouded.

“This happens sometimes,” I continued, trying to be upbeat. “We’re monitoring the baby’s heart rate, and there is no sign of distress. We just need to know what’s going on.”

Gillian still looked tense. “But … are you worried?”

“Do we look worried?” Neva grinned as she snapped on rubber gloves. “Now, I want you to relax for me. Wonderful. Deep breath. This won’t take a minute.”

Neva chatted throughout the examination, keeping the couple calm and reassured. But I could tell from the length of time she spent feeling around that she had concerns too. After a minute she withdrew her hand and removed her gloves. “Well, I’m baffled. From the outside, it feels like its head-down but to feel it, I’d swear it was breech.” She clicked her tongue as she thought. “My advice is that you go to the hospital. That’s what I would recommend for a client of mine.”

The atmosphere in the room took a dive. Hail pelted against the window, Mother Nature’s way of agreeing.

“But … can’t you deliver a breech baby here?” Gillian asked.

“It’s really not safe,” Neva started, then Gillian rose to her feet.

“But I … I can’t go to the hospital!” she cried. “Not after last time. Please, Grace.”

Neva put her hand on Gillian’s shoulder. “It will be all right, Gillian, I promise. But a breech birth is high-risk, and—”

Gillian started to flap. I reached for her hand. “Just stay calm, it’s not good for the baby if you get upset. Perhaps there is something we can do. Let me speak to Neva, see if we can come up with a plan.”

I gestured for Neva to join me outside and she nodded. But as I shut the door behind us, her face became a mask of disbelief. “Perhaps there’s something we can do? You’re not suggesting that we deliver a breech baby at home? Six miles from the hospital accessible by only one road. Tell me you aren’t suggesting that.”

“You’ve delivered a breech baby before—” I started.

“—I’ve assisted with a breech delivery during my midwifery training. That was in a hospital with an ob-gyn and a pediatrician, not to mention all the drugs and lifesaving machinery I had by my side! Delivering a breech baby vaginally is majorly high-risk. Doing it in a home setting is unethical. If something went wrong, they could both die.”

“Neva”—I fought to keep my voice even—“Gillian had a traumatic first birth and she’s terrified of hospitals. That isn’t good for the baby. Besides, we don’t even know for sure that it is a breech we are feeling. You said yourself it wasn’t clear. It could be something else. A face presentation, a nasal bone—”

“—That’s the problem, we don’t know what it is! It didn’t even feel exactly like a breech. Below the bone I felt … a hole.”

“The mouth?” I asked hopefully. If she felt the mouth, that meant it was head-down.

“I don’t think so. There was no space between the bone and the hole. If it is face presentation—” She sucked in a breath.

“What?” I asked.

“It could be a cleft palate.”

A short silence followed, then Neva slumped against the wall. I thought about it. If the baby was face presentation, it could have been the nose we were feeling. And the cleft could be the hole Neva was describing.

“That’s it, isn’t it?” she asked. But her tone said she desperately wanted to be wrong.

I felt sick. In my entire career, I’d had to give this kind of news only a couple of times. Once when I’d delivered a child with a hemangioma birthmark covering the entire left side of its face. The other time was when I’d delivered a little girl with only two full fingers on her left hand. “I guess we’re going to the hospital, then,” I said after more than a minute of silence. “If the baby has a cleft palate, there could be a host of other problems. We’ll need a pediatrician present.” I braced myself and took a step toward the door.

“Wait,” Neva said. She took a deep breath, as if weighing up her thoughts. “I know a pediatrician. I might be able to convince him to come here.”

I paused, afraid to hope. “Really?”

“Maybe. At least that way Gillian wouldn’t have to have a hospital birth on top of hearing this news.”

“But … do you think your pediatrician would come to a home birth?” I asked.

“Not sure,” Neva said. “Give me two minutes.”

She tugged her phone out of her pocket and jogged down the stairs. I waited where I was. I wouldn’t go in until I knew for sure; I didn’t want to get Gillian’s hopes up for a home birth if this pediatrician didn’t come through. But I was also delaying the inevitable. Was it the right thing, giving Gillian the option to proceed with a home birth? Even with a pediatrician present, we didn’t have the resources of a hospital. If the baby required a blood transfusion or operation, we would lose precious time transferring it to the hospital. On the other hand, keeping Gillian in an environment that she was comfortable with benefited everyone. I was still going back and forth when Neva appeared in front of me.

“The pediatrician is on his way. Let’s go chat with Gillian.”

Neva pushed past me into the room. If she had any doubts, I couldn’t see them. And if Neva, Miss By-the-Book, was comfortable, I didn’t have any reason to worry.

Gillian and David sat up straight as we entered, and I took a seat at the end of the bed. I placed a hand on Gill’s thigh. “Neva and I have discussed what we felt, and we are not convinced that your baby is breech after all. We need to confirm, but we think what we were feeling is—” I took a breath. “—a cleft palate.”

Gillian looked blank, then turned to her husband.

“A cleft palate is when the baby’s top lip is missing or deformed,” David said, not to Gillian but to himself. His own lip thinned as he spoke, perhaps in solidarity with his child.

“No!” Gillian’s face became alarmed. I wanted to assure her that a cleft palate was no big deal. That her baby would still be beautiful, and most likely, the deformity would be minor. But I owed her more than that.

“David’s right,” I said. “The baby may have a minor or significant deformity to the lip and palate, usually a hole between the top lip and nasal area. Now that we know what we’re looking for, we’ll check for the rest of the face to confirm, but we both think that is what we are dealing with.” I paused as another contraction took hold. Gillian worked through it and her husband helped her. When it was over, I continued. “A pediatrician is on his way. He will examine the baby once it is born. And that might be the end of it—”

“But it might not?”

“There’s no evidence of any other problems at this stage,” I said. “But we don’t know anything for sure until the baby is born. Once we confirm that the baby is not, in fact, breech, we can still try to deliver here, if you’d like.”

“Yes,” Gillian said. “I want to have the baby here. More than anything.”

I smiled at Neva, sending her a silent thank-you.

“Okay,” I said to Gillian. “Now, why don’t you lie down again?”

*   *   *

An astonishingly good-looking young man arrived an hour later. Even mid-contraction, Gillian was silenced at the sight of him. Thanks to the unforgiving rain outside, his hair was stuck to his head and his clothes were sodden. When he pushed his hair back off his face, I actually gasped. Out loud. With his strong jaw and pronounced forehead, he had a look of Elvis Presley but more chiseled, more defined. I silently cursed my daughter. It would have been nice to have some warning.

“Sorry I took so long,” he said, peeling off his soaked jacket and hanging it over the back of the chair. “I could hardly see with all the rain. The thin part of Beavertail Road was terrifying, the waves were actually crashing onto the road—I’m surprised it wasn’t closed.”

“Thank God it wasn’t,” Neva said. “That road is the only way in and out of this part of the island. If it closes…” Neva trailed away, obviously not wanting to frighten Gillian, but we all heard the subtext. If it closes, we’re stuck here. No one comes in, no one leaves. “But the rain seems to have eased off now, so we should be fine.”

He looked at me. “You must be Grace. It’s nice to finally meet you.”

He grinned, revealing almost-perfect-but-not-so-perfect-that-they-looked-fake white teeth. I raised my eyebrows at Neva. Finally? How long had he been around?

“I’m Patrick,” he said. I waited for the rest. Patrick Whoseummywhatsit, doctor of this and that, and God of all things medical. That was how all doctors introduced themselves in my experience, particularly when they were addressing midwives, who—according to them—were a bunch of uneducated cowboys. But not Patrick. He didn’t even give me his last name. And before I could ask him for it, he was already wandering over toward my clients.

“Hi, there, Gillian, David,” he said, pulling up a chair and sitting. “I’m Patrick. I’m a pediatrician. Neva’s filled me in on what’s going on. I’m sure you are worried, but try to leave all the worrying to me and concentrate on delivering this baby. Cleft lips and palates can be corrected with surgery. And you’ve had proper prenatal care, so I say we remain optimistic. In fact, let’s get excited. We’re about to meet one of the most important people in your life.”

I glanced at Neva and she shrugged. Yes he’s special, her expression said. Indeed, he was rather special. In a couple of sentences, he had managed to turn the somber mood in the room around. It was very un-doctorlike. I liked him immediately.

“Okay, I’m going to sit back now and let the pros do their thing,” he said. “Neva is one of the best midwives in town, and if Grace is her mother, then you’re in fantastic hands.”

Patrick rose even further in my opinion. A doctor who wasn’t taking over? Who called us—the midwives—pros? Where did Neva find him? And more important, how could I make sure she kept him?

“Right, let’s get you moving,” Neva said. “I’d like to see this baby come before sunup!” She brushed past Patrick, giving him a nudge with her elbow. He smiled at her, and I saw something in his eyes. He liked her. Hope fizzed inside me, but I tried to push it down. Dared I even hope that this gorgeous man was the father of my grandchild?

Neva moved Gillian onto a birthing stool, where she spent the next three hours. Labor progressed steadily, and as the sun peeked through the blinds, she began to bear down.

“Try not to push,” I told her as she began to crown. I squatted by her feet. “Just pant. Slowly, slowly. Good girl. I want the head to come out slowly.”

“Here it comes,” Neva said, moving in close with a towel.

As the baby’s face came out, Neva cooed. Patrick had moved in closer and was studying the baby’s face. The baby had a cleft lip and palate, no doubt about it. But Patrick smiled encouragingly at the parents. I had an overwhelming urge to hug him. What a wonderful doctor. What a wonderful man.

“The head’s out,” Neva said.

I hooked my fingers under the baby’s shoulder to bring it under and around the pubic bone. Then we waited for the next contraction. The atmosphere was exuberant, exactly as it should be for a first-time home birth.

“Here we go,” I said as Gillian began to moan again. Neva moved Gillian’s husband down next to me so he could watch his child being born. “I want one more big push.”

“Come on, Gill,” Neva urged.

With the next push, I caught their baby girl. She was big, maybe nine pounds or more. She cried immediately.

“A girl!” we all cried.

With the baby in my arms, I hesitated. It had been so long since I delivered a child with a doctor present, I’d forgotten the protocol. I always gave the baby straight to its mother, to allow it to be comforted by her smell, her touch, but from memory, doctors liked to examine the baby first.

“Give her to her mother,” Patrick said. “She wants to meet her parents before she sees my ugly mug. And there’s obviously nothing wrong with her lungs.”

I didn’t know whether to be glad or disappointed that Patrick was disproving so many of my preconceptions about doctors.

We moved Gillian to the bed, and I placed the baby, still covered in vernix and blood, on her mother’s stomach. Neva stood at Gillian’s side, rubbing the baby with a warm towel. I watched the scene, holding my breath. Gillian lifted the towel from the baby’s face to look at her daughter. I thought about saying something, but decided against it. They needed time.

“Oh!” Gillian said eventually, in a half sob. She tried to swallow, blinked back tears. “Her face.”

I nodded to Neva to come and take my place at the end of the bed. The placenta was still to come, but I had to be with Gillian. I joined her at the head of the bed and gazed down at the newborn squirming on her mother’s breast.

“Oh, Gillian.” My hand flew to my mouth. The baby’s top lip rose to meet the base of the left nostril, leaving a gaping black hole in the center of her face. The rest of her face was fine—perfect, in fact. I peeled the towel back farther, revealing ten perfect fingers and toes, and a big round belly. She squinted up at us crossly. My heart exploded. “She’s … beautiful.”

I couldn’t keep the beam off my face. Neva was smiling too, but she wasn’t looking at the baby. She was looking at me.

“She is beautiful,” Gillian said, as if seeing her for the first time. “Look, David. Look at her little hands and feet.”

I smiled as the new parents marveled at their new daughter. Had it really been twenty-nine years since I’d done this myself? Just like then, these parents had fallen hopelessly in love with their child in an instant. Everything was as it should be.

“Okay if I take a look at her?” I stood back as Patrick approached.

Gillian closed her arms around her daughter. “Do you have to take her?” A look of fierce protectiveness covered her face.

“Maybe just another few minutes, Patrick?” I asked.

Patrick smiled. “I’m not taking her anywhere. I can examine her right where she is, if that’s okay. It’s the best place for her, right next to Mom.”

Gillian loosened her grip slightly. She nodded. “Yes. That’s okay.”

“Good. Now, let me see.” Patrick opened the towel. “Hello, beautiful.”

Neva was watching Patrick. Her expression was soft and unguarded.

“Does she have a name?” he asked.

“No. Not yet.”

“Okay, well, I’m just going to have to call you ‘little one.’”

Without removing the baby from her mother, he did a once-over, listened to her lungs, checked her reflexes. “Good. Very good.”

Patrick smiled throughout the examination and when he was finished, he rewrapped her towel. “I’m sure you’re anxious about the lip, so let’s talk about that first. The good news is that we can do a lot with surgery. The operation is very common, and very successful. The palate is a little more complicated, but the prognosis is good.…”

Patrick continued, patiently answering the parents’ questions in layman’s terms, not a trace of the arrogant brush I liked to paint doctors with. He was so likable. I sidled up to Neva, who was inspecting the placenta in a kidney dish. “So—?”

Neva didn’t even look up. “No. He’s not the father. And I’m not interested.”

“All right. All right.” I held up my hands. “Keep your hair on—”

“Anyway, he’s not the type to settle down with one woman. Why would you, when you can have them all? For God’s sake, you’re already in love with him! Can you imagine how it is around the hospital?”

I nodded slowly.

“What?” she asked.

“Nothing. It’s just…”

“Spit it out, Grace.”

“Well, he did drive an awful long way, in the middle of the night, to help you out, Neva. And you were very comfortable asking him to do that. Maybe there’s more going on than you—”

“Grace?” Patrick approached from behind, and Neva studiously returned her attention to the placenta. “I’m going to arrange for a transfer to the local hospital,” he said. “I want the baby to be looked at sooner rather than later.”

“Already?” I said.

“We can’t!” Neva said. “Gillian has a tear that needs stitching.”

“Well,” Patrick said. “I could always take David and the baby—”

“No.” Gillian crossed her arms over her baby. “If she’s going to the hospital, I’m going too.”

I smiled. The mother’s instinct was primal, even after just a few minutes. “Okay,” I said. “We can tend to the stitch at the hospital. Let me just clean you and get you some fresh pads and we can go. Where’s your other daughter? Is there someone you’d like me to call?”

“She’s with a neighbor,” David said. “I’ll go get her once we know everything is okay here.”

Neva had already got some pads down from the cupboard and was filling a dish with warm water. “I’ll stay, Grace,” she said. “I know all the birth details, I can write the notes and clean up here. You go with Gillian. I’ll call the hospital and let them know you’re coming.”