No, the girl says, she will not wear the fetal monitoring belt. Her birth plan says no to fetal monitoring.
These girls with their birth plans, thinks Franckline, as if much of anything about a birth can be planned. She thinks girl although she has read on the intake form that Lore Tannenbaum is thirty-one years old, a year older than Franckline herself. Caucasian, born July something, employed by the New York City Department of Education. Franckline pronounced the girl’s name wrong at first, said “Lorie,” and the girl corrected her, said there was only one syllable. Lore. Why a girl and not a woman? She arrived here all alone shortly before 9:00 AM, lugging her duffel bag, her tall body pitched to one side with the weight, no man with her, no mother, no friend (and yet a ring on the ring finger of her left hand: a silver band). No one at all, which is almost unheard of: even the homeless addicts sometimes have a man or a friend; even the prostitutes have friends who bring them in. But Lore Tannenbaum does not appear to be an addict or a prostitute. She is wearing clean sweatpants and a clean button-down shirt; her walk, once she set down the duffel, was steady, even graceful; and at the desk she produced an insurance card.
The birth plan, emerging from the packed duffel, is several pages long, many sections, the points single-spaced. There is some sort of long prologue. Lore hands it to Franckline already turned to the correct passage on page 2: I do not wish to wear a fetal monitor. The monitor will restrict her to the area near the bed and she wants to be able to move about freely.
“And no IV,” Lore Tannenbaum adds. They are the same height, the two women: one ample and softly built, the other more slender and taut, and pregnant as well, but not showing yet, not speaking of it—her anxious secret alone.
Well, you see, explains Franckline, the hospital requires fetal monitoring, could get sued for not using the monitor . . . However, she goes through the play-acting of leaving the labor room to consult with the charge nurse, Marina. Marina returns with her, insists absolutely: legalities, state regulations, etc.
“But Dr. Elspeth-Chang . . .”
Dr. Elspeth-Chang was mistaken, says Marina. Most likely the doctor meant to say that Lore did not have to wear the monitoring belt continuously. But she has to wear it now, because she has just arrived, and then for at least fifteen minutes on the hour after that. State law.
“But no IV,” agrees Franckline, once Marina is gone, resisting the temptation—the responsibility?—to offer the arguments in favor of it: in an emergency, precious time could be wasted inserting the IV; if Lore changes her mind later (perhaps she will ask for an epidural, even though page 3 of her birth plan says I do not wish to have an epidural)—if she changes her mind, dehydration may make the IV difficult to insert. Something about Lore—standing eye to eye with her, her hand on her belly, tremblingly upright (unlike most patients, she does not hunch with pain and anxiety)—silences Franckline. For Lore knows these facts already, she can see, has researched them all before producing her multipage, many-bulleted document.
It is twenty minutes into her hospital stay, thinks Lore, and already she is being thwarted, already opposed and harassed, by these people who want pliancy and regularity, want you to do what is easiest for them rather than what is most sensible and natural. They make you sign forms (I agree to surrender all control and absolve everyone of blame) before they will even give you a room and the privacy of your pain. She’d known that once she left her apartment she would be putting herself in the hands of strangers, others whose interests might not coincide with her own. But she did not expect to be so immediately brought down and disheartened. The two nurses, both Caribbean and with hair in braids, good cop and bad cop, one (the charge nurse) blunt, unyielding; the other quiet-voiced, smiling, trying to win her over, make her feel already tired, already beaten. She twists at the ring she wears, grown very tight over these last weeks. The charge nurse had scowled, saying Lore really ought to be going to the triage room, she didn’t seem so far along. But Dr. Elspeth-Chang, who had listened to Lore on the phone, had called ahead and said Lore should be admitted, and so Lore simply stood and waited for the charge nurse to finish her grumbling.
“Let’s get you comfortable,” says the quiet-voiced nurse, Franckline—her accent is of the French-speaking islands, Haiti, maybe, or Guadeloupe—as she helps her onto the hospital bed. A cross swings from a chain around her neck. “You’re lucky,” she told Lore as soon as she was checked in. “It’s very slow on the ward this morning. We can give you one of the private rooms—room 7. There’s a large window looking out onto Sixth Avenue.” On the deep window ledge, set back, is a potted hibiscus, its leaves a delicate pink with a deeper flame at the center. Would Lore like the bed angled this way or this way? the nurse asks. Up a bit or down?
“Down,” says Lore.
In the taxi Lore had held her phone in her palm and flipped the cover up and down, up and down. Not calling Diana or Marjorie, who had promised to get her to the hospital when the time came, to stay with her through the entire thing. Her bag had long been packed; it took her only minutes to leave once she decided to go. She flipped up the phone cover, dialed four digits, pressed END. The cab drove too quickly through the streets, the cabbie’s radio too loud with some sort of shrill, sinuous music. Lore dialed a different number—her old number, which was Julia and Asa’s now—dialed even as she knew she would not let the call ring through. A heat rose in her chest; her finger moved through the familiar sequence. It was shortly after eight. Asa, large and sloppy in the narrow pass-through kitchen, would be eating his cereal standing up; Julia would be still in bed, trying to coax herself out of her morning torpor. Imagine: Asa picking up the phone, inquiring “Hello?” in his rich voice, and Lore believing that he could hear in her silence the pains moving through her body, could hear it was time.
She did not want him to come. Never, never. But that he should be rising for his day, comfortable, while she would soon be twisting in pain on a hospital bed . . . that Julia should yawn and stretch and doze again . . .
Imagine: Julia in the bedroom, listening, suspecting, knowing that what she’d set in motion had reached its end point in this child.
There’s someone I need you to meet, she’d said to Lore.
Lore stopped dialing, stared out the window at the streets racing by: people with takeout coffee in gloved hands, murky morning light against the canopies of apartment buildings. Green wreaths with red baubles in storefronts, the holiday coming soon. The radio, last night, had said something about snow. Lore began picking out Diana’s number once more. Then, interrupting herself, leaning forward toward the cabbie—it was more like sliding her whole body sideways across the seat and then pitching herself in his direction—she told him to slow down or she would have the baby right there in the back. The taxi slowed for a minute or two, then picked up speed again. The music shrilled and shrilled until Lore said, in a voice not to be argued with, “Turn the damn radio off.”
Why should she call Diana, why should Diana or Marjorie come? She did not know either of them that well. Diana, who taught third grade, and Marjorie, one of the kindergarten aides, had swooped in when Lore announced her pregnancy, very late, at twenty-one weeks, when the visible signs became unmistakable and arrangements had to be made for her leave. She had always been cordial with all of her colleagues but close to none. Her life, for years, had been Asa and Julia. Diana and Marjorie: their outrage on her behalf, their advice, their kale, their jargon (“heroic,” “survivor”). How Lore paced her apartment after their visits, guiltily stamping out their condescension and their pity.
“Would you like some water?” asks Franckline.
Lore shakes her head. A girl, yes, a girl, thinks Franckline, but there is something elderly about her as well, something weary. Not the usual weariness Franckline sees, that of a woman who has been up all night and is shaky and frightened, perhaps even her second or third time, but something deeper, something etched into the face—into the young skin that is just beginning to get creases around the eyes and lips—something that goes back a long time. A story I will never fully hear, Franckline thinks, even if she offers bits of it to me. For we only have a matter of hours, and it’s the body that concerns us here today, what it needs, what it has no choice but to do. Will Lore want to be touched or not touched, will she want kindness or to be ordered about? Will she let me help her or will she turn her face away as she does now? Will she spend all her time turning away?
The line on the monitor jumps and jags, the speaker reveals the rapid lub-lub-lub of the baby’s heartbeat. How startling it is to Franckline, still, after all this time: these machines at her disposal, machines that listen to the difference between life and death, that measure and probe and drip chemicals, and save, time and again, souls that can so easily flee the body and disperse. She has watched that flight and that dispersal, not here, not in America, never once (the other nurses say she carries luck with her; each of them has seen tragedies), but back in Ayiti. Babies that got wedged crosswise inside the mother, died there kicking against the womb, or were born already too malnourished to survive. The mothers often enough, too, infected or bleeding or too sick to endure a difficult labor. And the wailing of the burials after, families asking what they had done to displease Danto or Papa Ghede, promising penance, promising gifts, that they will never fail the spirits, the lwa, again.
(Franckline moves the monitor toward the patient and turns up the sound so she can hear. Lub-lub-lub-lub-lub. The reassuring babble her own child makes as well. A song to which she sings silently in return: hallelujah. But there is no smile, no apparent reaction, from Lore. The girl worries the silver ring on her finger.)
The baby’s heart beats like the heart of a runner; the baby is a runner, crouched on the starting mark, straining, desperate to begin. Lore has heard the sound twice before but this time she is not moved, only frightened for the baby, its heart frantic with the desire to emerge, to be done with this thing, this birth. The first time, Dr. Elspeth-Chang pointed out the heart on the sonogram machine in her office, but Lore could not see it. The sound the doctor told her was the heartbeat was merely static to her; she wondered for a moment if she’d misunderstood. Then the doctor pointed the sonogram probe at the screen—“There, you see? There”—but to Lore it looked like mist. “I don’t see it,” she repeated, and the doctor pushed the probe again at the screen and indicated with her finger—all smoke. If Asa had been there he would have seen, or would have convinced himself that he saw. Because Asa. If the sky were covered with gray-black clouds, if you could feel the dampness coalesce thickly and the air sweep upward in threatening gusts, he would say there was a little corner of sunlight in the sky over there—the weather was going to turn for the better.
But of course he was not there. Just weeks before, she had sent him away—or, more precisely, sent herself away, not wanting to remain in their apartment, which contained so many false memories. And the idea of something live beating within that smudge, that smoke, all at once unbalanced her. It was real, the child—and she had chosen. Although of course it was not too late to change her mind. She was only seven weeks along, she could still tell the doctor that she wanted an abortion. She could confess that Asa was not really on a work trip at all. But something inside her knit together and settled and she made her decision anew. She reached out and put her hand on Dr. Elspeth-Chang’s arm to stop the motion of the wand. “Oh, well,” she said. “Maybe next time.”
Pamela Erens’s second novel, The Virgins, was a New York Times Book Review Editor’s Choice and was named a Best Book of 2013 by The New Yorker, The New Republic, Library Journal, and Salon. The novel was a finalist for the John Gardner Book Award for the best book of fiction published in 2013. Pamela’s debut novel, The Understory, was a finalist for the Los Angeles Times Book Prize and the William Saroyan International Prize for Writing. Her essays, articles, and reviews have appeared in publications such as Virginia Quarterly Review, Elle, Vogue, The New York Times, Los Angeles Review of Books, and The Millions. Her third novel, Eleven Hours, is out now.