State of Wonder - Ann Patchett [129]
The water in the first bucket was tepid and Marina ground the soap into her skin over and over again, wondering how it was possible that she was where she was, that what was about to happen was in fact happening. Surely she had participated fully in every step it took to get to this place, agreeing whenever she had meant to decline, but still, it wasn’t such a long time ago that she was back at Vogel charting lipids and Anders was alive. She was trying to dig out the dirt from underneath her fingernails when the woman on the blanket let out such a cry she jumped. What Marina needed was to deputize a nurse, someone had to open the packages. She called to one of the three women, jerking her head until the woman reluctantly laid down her peppers and came over. Marina handed her the soap and did a pantomime of washing and opening the packages while the woman stared at her as if Marina had lost her mind. She wondered if she would have to act out every stage of the surgery, but now she was getting ahead of herself. No one had said there would be a surgery. Dr. Swenson had situated her crate next to the woman on the blankets. Marina came over with her nurse who continued to scowl at the bother of it all until Dr. Swenson made eye contact with her and the eye contact settled her at once.
Marina pulled on her gloves, got down on her knees. When the woman on the blankets looked at her, Marina pointed to herself, “Marina,” she said. The woman gave her a weak nod in return and said a name no one could hear. Having made the introductions, Marina soaped the woman’s genitals and thighs, bent up her knees and showed the nurse how to hold them. “It would be nice to have a clean blanket to put her on.”
“If you had a clean blanket you would want a sterile one, and a sterile blanket makes you think you can’t do anything without a table and a light, and from the table and the light it is a very short step to needing a fetal heart monitor. I know this. Check and see how dilated she is.”
Again, Marina looked at the woman as she slid in her hand to check the cervix. There was enough room for a well placed baby of normal size to make an easy exit and Marina felt a great wave of relief come over her. “She’s wide open.” She moved her hand around, feeling for the baby. As it happened, the basic construction of the female body had not changed since she had done this last. Having the patient on the floor made no difference: there was the baby, though she was quite certain that was not the baby’s head she was feeling. “It’s breech,” she said. It wouldn’t have been her first choice but she could manage it. “I’m going to have to try and turn it.”
Dr. Swenson shook her head. “That takes forever, causes a great deal of pain, and half the time it doesn’t work anyway. We’ll do a section.”
Marina removed her hand from the woman. “What do you mean it takes forever? Where do we have to go?”
From her perch on the wooden box Dr. Swenson dismissed the suggestion out of hand. “There’s no point in putting her through all of that if in the end you’ll have to do the section anyway.”
Marina sat back on her heels. “The point is we don’t have anything approaching sterile conditions. The chance of her dying from a postoperative infection is enough to indicate that turning the baby is worth a try. I don’t have a nurse to help me with a surgery, I don’t have an anesthesiologist.”
“Do you think we keep an anesthesiologist around here?”
“What do you have?” Marina pulled off a glove and poked through the bag.
“Ketamine. And don’t go throwing gloves away. This isn’t Johns Hopkins.”
“Ketamine? Are we planning on sending her out to a disco later? Who in the world uses Ketamine?”
“Here’s the news, Dr. Singh, you get what you get, and I was lucky to get that.”
“I’m going to try and turn the baby,” Marina said.
“You’re not,” Dr. Swenson said. “It is enough that I had to go up that godforsaken ladder. I would appreciate it if you did not make me get down on the floor as well. Even if it were possible to take my leg out of the equation,