Hunt the Fox

Chapter Twelve

Mortar rounds started to fall in the vicinity as Crocker and his men improvised a clean bed out of sheets and an inflatable mattress on a table in what used to be the dining room. One of the two schoolteachers, the shorter woman with a bowl of straight black hair who hadn’t said a word so far-Natalie-volunteered to act as Crocker’s assistant. She and Suarez boiled water and sterilized the rudimentary tools in the emergency medical kit as Amira held Jamila’s hand and Hassan wrung his hands and paced.

“You think you can handle being in the room?” Crocker asked him as a helicopter passed overhead.

He nodded, then whispered, “I want you to know that Jamila’s a very wonderful person and has suffered so much already. Her mother is dead, her father was arrested, she hasn’t heard from her brothers since they joined the resistance.”

“Duly noted.”

Crocker had delivered babies before-once to a feverish young woman in a barn in Honduras, another time twins to an injured woman in Iraq.

Upon examination, he discovered that this was going to be his first breech birth. What that meant was that instead of the normal head-first presentation, this baby was presenting itself bottom first, with his or her legs extended at the knees.

“You seen anything like this before?” whispered Suarez, who had some corpsman training.

“No, but there’s always a first time.”

A shell exploded outside, shaking the remaining tiles on the roof. One of them crashed two feet away from the table where Jamila sat. Amira held up a towel to shield Jamila’s face.

“We’re fine,” Crocker said. “Suarez, find Davis and ask him to check if there are any more loose tiles over this room.”

“Aye aye.”

If Jamila were in a hospital, chances are the baby would be delivered via cesarean section. But not having a properly equipped operating room with ultrasound and heart monitors, Crocker didn’t want to risk excessive bleeding and infection, so he planned to try to perform a vaginal breech birth, which was problematic but the only real option he had.

The contractions were coming closer together and were more intense-every minute now, and a minute in duration. Jamila was in serious discomfort, with especially strong pains in her back. Crocker was reluctant to administer morphine, because he thought it might numb the fetus and affect its heart.

“Okay,” he said, as he exposed her lower back and prepared to inject the sterile water from his kit just below the skin of her lumbosacral region. “This is going to sting for a minute, but it won’t put you out or damage the baby in any way.” The way it worked was simple. The sudden burst of intense pain from the injection closed off transmission of the sensation produced by the contractions.

Jamila let out a scream and did the paced breathing Amira had been teaching her. The pain in her back abated. So far, so good.

Crocker had been concentrating so hard he hadn’t realized that the artillery and rockets were falling with more frequency.

Suarez, who had noticed, now whispered in his ear, “It could be the lead-up to some kind of ground attack on a nearby target.”

“You mean the artillery?”

“Yeah, boss.”

“We’ve got to finish this first.”

“How about we move the canisters to the Ford and do the delivery in the back of the van?”

Crocker examined Jamila’s cervix again. It was open ten centimeters and the mucus plug had released, which meant that cervical dilation was complete. Aware that it would be hard enough to manage a difficult breech birth in a stationary location and almost impossible in a moving van, he whispered back, “The baby’s coming. No time.”

His first goal was to turn the fetus by manipulating its body through the mother’s abdomen. He had Jamila lie down on her back on the mattress with her feet on the table and her knees apart. Then he and Suarez pressed and applied pressure. They weren’t successful. The baby was so big there was very little room inside the vaginal canal for it to be maneuvered. And Crocker didn’t want to keep trying because of the stress they were putting on the baby’s heart.

“Now what?” Suarez asked.

The baby’s butt was showing through the cervical opening. Crocker said, “I’ll hold on to the butt while you try to twist the fetus to the right.”

“How do I do that?”

“Grab it near the chest. Firmly, and turn gently.”

Slowly they applied pressure and managed to turn the fetus slightly, so that its right side faced Jamila’s back. Then they watched as her pelvic floor muscles helped complete the process.

“Nice.”

“What happened?” Jamila asked through gritted teeth.

“It’s all good. We’ll have the baby out soon.”

Crocker saw that the new position of the fetus would allow the baby to come out one hip at a time. Since its bottom was the same size as its head and the mother’s pelvis was relatively large, labor could begin.

The big danger they faced now was injury to the baby’s brain or skull due to a rapid passage of the head through the birth canal. With the fetus positioned the way it was, it was impossible to determine the angle of its head. All Crocker could do was hope that the head wasn’t in the “star-gazing” position, looking straight up, with the back of the head resting against the back of the neck.

The other serious danger was that the umbilical cord would prolapse, diminishing or cutting off the flow of blood to the baby’s brain.

Amira and Hassan whispered encouragement into Jamila’s ears while Suarez mopped the sweat from Crocker’s brow.

He glanced at his watch: 1855 hours. The sun was starting to set outside as artillery continued to shake the house.

What Crocker hoped to accomplish was a smooth, quick delivery so the baby wasn’t hung up in any way that might put undue pressure on its heart.

He took a deep breath. As he did, an explosion shook the farmhouse, causing Hassan and Natalie to gasp and Jamila to tighten up.

Crocker reached for his head mic and whispered, “Breaker, how close was that?”

“A hundred and fifty feet,” Davis reported. “Maybe less.”

“Do you have any idea what they’re shooting at? You see fighters or bunkers?”

“Negative to all three.”

They waited. When no more mortars fell in the next two minutes, Jamila relaxed.

Crocker said, “All right. Let’s get this kid out.”

She nodded bravely as he pulled on a fresh pair of nitrile gloves. Years ago, during his corpsman training in Yokohama, he had watched a video on something called the Mauriceau-Smellie-Veit maneuver. He tried to recall it now, rehearsing the steps in his head. When he felt confident that he could pull it off, he turned to Suarez and said, “When I give the signal to Jamila to push, I want you to apply subrapubic pressure to the uterus.”

“How do I do that?”

“Press down on the pubic bone here, thus opening the vagina.”

He showed him where to position his hands, then took a deep breath, waited for her cervix to spasm, then asked her calmly, “Jamile, you ready to push?”

She nodded.

He turned to Suarez and asked, “You clear about what to do?”

He nodded, too.

“All right. On three.”

He counted out loud.

Suarez pressed, Jamila screamed, and Hassan, Amira, and Natalie furiously massaged her back and whispered encouragement. Crocker inserted his gloved left hand, reached his index finger upward, and inserted it into the baby’s mouth. Gently pressing on the kid’s maxilla to bring the neck to moderate flexion, he rested his left palm on the baby’s chest, reached his right hand around until he held the shoulders in his right palm, and pulled down and out.

The baby’s hips and shoulders slipped out easily, but the head became stuck, causing Jamila to start to panic.

“Relax, Jamila,” Crocker whispered reassuringly, “We’re almost there.”

He took a deep breath and felt with his left hand to make sure the umbilical cord wasn’t interfering with the baby’s neck. Then he turned to Suarez and whispered, “Push again, with conviction.”

With his left index finger in the baby’s mouth, he slowly maneuvered the chin through the cervix opening and guided the head out. It emerged with a pop, followed by a full-throated cry from the baby boy.

“Oh my God!” Hassan shouted. “Is it okay?”

“You’ve got a beautiful baby boy!”

Jamila started to bounce her butt up and down on the mattress with joy. “Oh my God! I can’t believe it! Praise God!”

“Hold on a minute. Stay still.”

Crocker handed the baby to Suarez, then calmly tied and cut the umbilical cord and removed the placenta. The baby wailed.

“Strong lungs.”

As Crocker cleaned Jamila up, Suarez wiped down the baby and handed it to its mother. Shouts of exultation followed and ricocheted off the walls. For a few moments the war was completely forgotten. Even for Crocker, who dealt with the minor bleeding, which was normal, and went outside to get some fresh air.

As he stood in the doorway watching the sun start to drop toward the horizon, he sighed deeply and his hands started to shake. Seventeen years ago he had sat in a delivery room in Alexandria, Virginia, and watched the birth of his daughter, Jenny. It seemed like another lifetime now. In a day or two-he couldn’t remember the specific day-she’d receive her diploma and graduate from high school.

He wanted to be there but wouldn’t. Instead, he’d probably be facing another unknown challenge. Protecting and aiding the innocent was his disease, his compulsion, and through the grace of God the only thing that satisfied the hunger in his soul.

“I don’t understand how the world can just watch this,” the suddenly talkative Natalie declared, emerging to stand beside him. “Syrians are good people. No one is with us. No one! Why is that?”

Crocker nodded. “It’s terrible, I know. We’re doing what we can.”

“No. Not enough.”

She was right. Despite Natalie’s distress and the mortars thudding in the distance, he looked out at the sun descending over broken chicken coops filled with putrefying chickens and felt a rare moment of peace. All he wanted now was a beer or a shot of scotch, a comfortable chair, and a place to put his feet up. But those small pleasures would have to wait.

Turning to Natalie, he said, “Do me a favor and find Suarez. Tell him I want him to fix a place for the mother and baby in the pickup.”

“I can do that.”

“By the way, what did they name the baby?”

“Tariq Yusef Mohammed Sadir, after his maternal grandfather.”

“Tariq Yusef Mohammed Sadir. Let’s hope he has a better future.”

He didn’t have time to speculate on what that might be. Seeing Davis on the porch keeping watch, he asked, “Anything new from Ankara?”

Davis wore the coiled, expectant look of a soldier waiting for the next battle to start. “Negative, boss. Nothing’s changed. They’re still waiting for approval of the LZ site.”

He checked his watch: 1938. A helicopter buzzed high in the purplish-black sky. Looked like a little Polish-made Mi-2 with rockets mounted along the sides. As it headed south he heard firing in the distance, then saw a cloud of black smoke, indicating that the helo had been hit by antiaircraft fire. It was unreal, like watching a movie. The resulting explosion reverberated through the house.

Crocker turned to Davis and said, “Tell the guys to prepare to move out.”

“Just prepare, or really go?”

“We’re leaving.”

“Without approval?”

“With it or without it. The situation here isn’t good.”

“Even without it, I have to tell Ankara something.”

“Tell ’em a helicopter was just shot down in the area and we’re hearing an uptick in fighting. So we’re moving north through what we hope is FSA-controlled territory. We’ll apprise them of our new position when we arrive.”

“Sounds good but kind of vague.”

“That’s on purpose.”

As Crocker paused to take one last look at the ragged landscape, one of Al Swearengen’s best lines came to mind. “Pain or damage don’t end the world, or despair, or fucking beatings. The world ends when you’re dead. Until then, you got more punishment in store. Stand like a man, and give some back.”

For a brief moment he was tired of fighting. All he had to do now was deliver the people and cargo in his charge to safety.