Miss Jane

Purgatories

She was born into that time and place, in the farmland cut from the pine and broadleaf woods of east-central Mississippi, 1915, when there was no possibility of doing anything to alleviate her condition, no medical procedure to correct it. It was something to be accepted, grim-faced, as they accepted crop failure, debt, poverty, the frequent deaths of infants and small children from fevers and other maladies.

Her mother was thirty-nine and had not intended to have another child. Five years earlier she’d lost what she thought would be her last and youngest, a boy named William, who contracted a fever and died. The next year an unplanned child, her second girl, died stillborn. On William’s stone were the words, How desolate our home / Bereft of him. The stone for the infant girl read simply, Chisolm Infant, with the identical dates of her birth and death engraved below.

For the first few months she was pregnant with the girl who would become Jane, she pretended that she was not. That it was a false pregnancy, simply her body fooling with her, playing an evil joke. This figment of a child in her womb would go away, disappear like some temporary derangement of the senses brought on by God or the devil for reasons she could not divine. But at four months she could feel it quickening, and by five months it had begun to move around quite a bit, to thrust and kick and stretch, so she could not pretend it was anything else. By seven months in she had begun to talk to it. I will try to do right by you, she said, if you promise that you will try to do right by me. Do not die before I do. Do not come out a defective child doomed to unhappiness or an early death.

When she spoke to the child, the fetus, in this manner, it would go very still, as if listening, considering her terms.

The night her water broke, her husband summoned the midwife named Emmalene Harris, whose family sharecropped forty acres on their property, to tend to his wife until he could fetch Dr. Thompson. His two sons were already near-grown and working their way through the state college up north, so he had to make the errand himself. He feared complications, given his wife’s age and her darkened mental state.

Emmalene stood waiting for the doctor in a corner of the bedroom, flickered by firelight from a small woodstove against the far wall. She had heated a pot of water and put a basket of clean rags at the ready. She watched Mrs. Chisolm there in her bed, sweating, pale, tears in her eyes. She said a silent prayer, asking please God let this child be well. When Mrs. Chisolm cut her eyes over as if she could hear the woman’s thoughts, Emmalene turned away and busied herself checking the hot water, the neat little stack of clean rags.

On a small stool in a darkened corner of the room, silent, looking at the floor, elbows on her splayed knees, sat the older daughter, Grace, so still she was practically invisible. When she blinked her eyes Emmalene noticed and startled, as if the blink itself had materialized the girl, brought flesh and blood into being, revealing her sullen presence there among them.

DR. THOMPSON LIVED just two miles south of the Chisolm farm, on the semi-rural outskirts of the small but bustling city of Mercury. When Chisolm arrived at two a.m., the doctor was awake, sitting in the dim moonlight that fell through the windows of his study, unable to sleep. He heard the shod hooves on the road, then in his front yard, and stepped out onto the front porch in his nightgown.

The man sat bareback and silent, hat crammed down on his head, skinny shoulder bones rising like bumps inside the loose cotton blouse he wore.

“Aren’t you chilled in this evening, Chisolm?”

“Cold don’t bother me, no, sir.”

In the bedroom he took up his clothing from the day before, quietly as he could. The coin change in his pants pocket jingled and his wife groaned, turned over in sleep. He went back to his study to dress. In the yard, Chisolm was hitching big Rufus to the buggy.

He finished dressing, checked his medical bag, then stepped out, shutting the door quietly behind him. Chisolm stood holding his mule by the reins in one hand, Rufus in the other. The doctor pulled his lanky frame up into the buggy, packed and lit a pipe of tobacco, pulled an old blanket over his legs against the chill, and they began the two-mile trot out to the Chisolm place.

Rufus, his big bay gelding Missouri Fox Trotter, with a smooth gait and agreeable disposition, was good company on a night ride. The doctor could have taken his Ford, but reserved that for when he had to cover a lot of ground and make several stops in a day. He’d named the horse Rufus because noble as he was there was something of the jokester in his eye and disposition. The name seemed to fit.

He felt illogically happy to be out on this errand. The ghost of a friend’s imminent death seemed to trail out of him like wisps of smoke from the pipe. He’d briefly thought to take a little cocaine to pep himself up but resisted. He knew well enough to be stingy with that stuff, save it for extreme fatigue. He felt instead an itch for a drink. Chisolm made a good batch of whiskey, aged in an oak barrel that he charred on the inside, just like the fancy distilleries in Tennessee and Kentucky, so the whiskey had a nice mellow brown color. He tested each batch by taste for proof, added branch water to bring it down to what the doctor judged was close to ninety, then strained it through cheesecloth into pottery jugs and corked them with stobbers of whittled sweetgum sticks. All in all, a first-rate operation.

He hummed another tune, the words in his head, Let me call you “Sweetheart,” I’m in love — with — you, trotted the rig down the wide dirt highway, the man and mule close behind him in blue silhouette. “Get up, Rufus,” he said, tapping the reins against the horse’s flanks.

He took the narrow access road to Chisolm’s farm, barely lit by stars and sheen of moonlight, through hushed and tunneled woodland, beside pastures silvered with an evening frost on the grass, a waxing moonlight on them like blued silver dust, and down into the draw over the creek. He heard Chisolm’s mule veer off the road into the woods, taking a shortcut. He slowed to cross the bridge, little more than a couple of square-hewed logs supporting a narrow pallet of oak planks. The creek was quiet, low. More than once Chisolm had toppled his wagon off the bridge into the creek, taking it too fast or careless and slipping a wheel off the edge. And more than once the doctor had been summoned to peer into his dilated pupils seeking evidence of concussion, or to reset a dislocated shoulder, and thrice to set a broken arm and make sure a broken rib had not pierced a lung or other vital organ. Every time, Chisolm had been coherent enough to have one of his family place a fresh jug into the back of the doctor’s buggy under a feed sack before he left. The wife would have made sure that he toted a full stomach of chicken and dumplings or cornbread and greens back to the wagon. He’d sip from the jug on the way home, suffering no grievous consequences aside from his wife’s quiet indignation, half from the whiskey drinking itself and half because the rich food plus whiskey invariably gave him a case of flatulence that drove her from their bed and into the empty bedroom in the back of the house, to fulminate and toss and turn and fuss her lot as a country doctor’s wife. For that reason, he had adapted by staying up, sipping late into the evening, settling onto the sofa in his office or in front of the fireplace to snooze away the rest of the night in pleasant dreams and uninhibited, flatulent segregation from the niceties of marital diplomacy.

He pulled up at the Chisolms’ gallery, noted the mule already hitched to the post there. Chocked the buggy’s brake and climbed down as the side door to the house’s main room opened and a long rectangle of weak yellow light spilled out into the breezeway of the dog-trot house. Chisolm’s long angular face peered out, then pulled itself back inside. It was a dog-trot house but grander than most, larger and kept-up, and clean. The hound that had bayed at his arrival had quit and disappeared. Once in the house’s breezeway he could smell the dying scents of fried pork, stewed vegetables, fried bread, and molasses from the kitchen. He entered the house through the large common room, heard a low guttural moaning, and felt a tingle in the air of physical discomfort and alarm. Smelled the odors of labor, sweat and blood and fecal matter. Marveled that probably Mrs. Chisolm had done most of the dinner work herself before rolling into the bed to have this child. He was glad it was not her first.

Chisolm sat hunched in a straight-back chair before the fireplace, a loose-rolled cigarette burning down to the knuckles in one long bony hand. Nodded at the fire as if to the doctor, without looking up. The doctor caught the glint of a glazed jug in the shadows to one side of his weathered brogans.

He went on into the bedroom. A pot of water steamed on the small woodstove against the north wall. The midwife had hold of Mrs. Chisolm’s hand, another hand on her left leg, the covers tossed away. A hand dark as black coffee against skin pale as a blinding cataract. And there, in the mussed bedding, between the poor woman’s scrawny splayed thighs, the crowning head of what he hoped would be their last child.

Over in a dark corner of the room the daughter, Grace, sat on a stool looking grimly at nothing. She didn’t look up when he came in. He figured her to be about ten years now. Seemed older by a couple, at least.

He walked over to the bed and spoke to the midwife.

“Get me a bowl of that hot water — you boiled it? Good — a bar of soap, some of those clean rags, and set them on that bench. Light the lantern on that table beside the bed, there.”

She went over to the stove and came back in a minute with the water, soap, and rags and set them on the trunk that sat at the foot of the bed. Struck a match to the lantern wick.

He spoke to Mrs. Chisolm.

“You ready, then, madame?”

She gripped his wrist in a sweaty tourniquet. Her voice was a low whisper, her words reflecting her desperation.

“Where in hell have you been?”

“The usual purgatories.”

He detached her hand from his wrist, gave her a near-placebo dose of laudanum, washed his hands and forearms, carrying on a one-sided conversation as he went to work, as if he were dressing a simple wound. Generally this helped to calm people, baffling them into a kind of confusion that settled into a calmer state.

She was a veteran. Most of the hard work already done, she was finished in fifteen minutes. No stitching required. He snipped the cord, and took a good look at the child, who’d come around to crying a bit. He didn’t say anything. He looked at the midwife. She stared through narrowed eyes but kept her lips pressed shut. He gave her the child to wash, turned his attention to the placenta and cleaning up Mrs. Chisolm with warm water and disinfectant. The midwife helped him roll her off the soiled sheets and sop rags and took away the afterbirth in a pail, brought in fresh sheets, helped him get them under her. He washed his hands and forearms again as the midwife covered Mrs. Chisolm with a fresh sheet and clean counterpane. He took a lantern over to the crying child in the little crib padded with a folded quilt. It was squeezing its hands and crying well, head to one side. He looked closely, prodding a bit, peering through his spectacles in the poor light. He pulled a small notebook from his vest pocket and wrote something, put it down, and probed a bit with a blunt instrument. Picked up the notebook, wrote again. Then he drew a sketch in there on a fresh page. Looked at the child, back at the sketch, then put the notebook away.

“What is it?” Mrs. Chisolm said, propped up now against the pillows by the headboard and sleepy with exhaustion.

He heard someone come up behind him and saw the girl, Grace, looking around his shoulder at the child, her eyes pinched. Then she left and he heard her open the door and go out, say something to her father in the main room. He spoke quietly to the midwife, asked her to pin a diaper on the child.

Chisolm looked in from the other room. His long face half in shadow.

The doctor picked up the diapered baby, who was crying with some vigor now.

“What, then?” Chisolm said from the doorway.

“Well,” the doctor said. “Let’s have Mrs. Chisolm nurse and then we’ll have a talk.”

“About what?”

“Good set of lungs, eh?”

The doctor took the baby over to Mrs. Chisolm, who looked at him as if he were some kind of threat, but took the child and bared a breast and let it nurse. The baby suckled furiously and kept its milky blue eyes on its mother’s face, the infinite and divinely vulnerable eyes of an infant. Mrs. Chisolm looked as if she thought it to be some kind of potentially dangerous creature.

WHEN HIS WIFE finally nursed the child to sleep and then dozed off herself, and the midwife had put the baby back into the crib, Chisolm went over to look. He loosened the diaper, gently raised the child’s bottom, leaned sideways so as not to block the light. The doctor watched him but didn’t come over.

“Good lord,” Chisolm said. “What trouble have we gone and brought into this world now?”

“Trouble for you and Miz Chisolm,” the midwife said. “But more trouble for the child, I expect, poor thing.”

Chisolm didn’t look her way. He gazed at the child. The doctor was quiet.

“I ’spec so,” Chisolm said. He called softly to his older girl, Grace. The girl came slumping in.

“Get the doctor a plate like I told you. And some coffee.”

To the doctor he said, “I’ll leave a little something in your buggy for the ride home.”

The doctor nodded and touched a finger to his brow in a gesture of appreciation.

Chisolm’s jug was empty. He pulled on a barn jacket, took a lantern from where it hung on a nail beside the door, went outside, and stood on the porch. Maybe an hour till the full dawn, just a sense of its light in the sky. Against that stood the black outline of trees west of the house and the fields to the south, silhouette of the barn’s pitch, and the shed. He lit the lantern and headed down the narrower of two paths into the woods behind the house, veered off that one onto an even more narrow and discreet one — no more than a game trail, at best — that led to his makings and storage. Light had begun to sift like faintly luminous dust into the trees. He could just make out the delicate shadowy patterns of the variously stubbled barks on the trunks, knots on limbs. Switch branches brushed his denim overalls like blind, limber tentacles noting his passing, allowing his pass. In a little clearing down near the creek was the squat figure of his still and the crude shed of rough lumber he’d built there with a heavy door and the padlock he left unlocked most of the time. Folks were aware of his habitual vigilance. He set down the lantern, removed the unhasped lock, and opened the door. He selected a jug from a middle shelf, set it on a broad stump near the fire pit. He went back into the shed and fetched a small pail of kerosene-soaked sawdust, shook some onto the blackened wood in the pit, put the pail up, closed the shed door. He took some gathered limbs from a small stack next to the pit, set them on top of the old logs, struck a match to the sawdust, watched the flames come up and catch the fresh pieces. He took up the jug and sat on the stump, pulled the whittled beech stick that served as his signature cork from its mouth, took a good swig, forced it down, coughed, recorked, and set the jug on the ground behind him, back from the fire. The throbbing heat of the whiskey filled his chest and drifted in blood up into his mind and opened a little door, just a bit. He let out a heavy breath, took his tobacco pouch and papers from his overalls bib, and rolled a loose cigarette, lit it with a slender stick he held to the flames for a moment, blew out the stick and set it aside, and smoked.

For the devil of him, he couldn’t recall exactly when it had happened. He supposed he’d been drinking or he wouldn’t have entertained the idea. They’d had no need nor desire for another child. Would have gone elsewhere, if he could. Must have been that. A late hour, nowhere to go, an urge that overrode everything else. He thought, Ain’t I old enough yet to be over that?

Then he hoped he wouldn’t ever be, just as quickly after thinking it’d be a good thing if he was.

He hit the jug again, finished the cigarette, and dropped its butt into the fire now heating his shanks and knees against the chilly dawn threading down through the fragile canopy of pine needles and sparse-leaved hardwood branches. He sat awhile. The light turned smoky in among the trees. He took a mouthful from the jug and spat it into the fire, watched the brief roaring up of the flames, took another slug that burned down into his gullet and rose unchecked now into his mind, corked the jug, rolled another cigarette, and thought, What’s done is done.

He heard something behind him and turned.

It was his hound, ambling down the trail as if to come sit and share a sigh or two.

“You got the face of bored sadness,” he said to the dog.

The dog didn’t take umbrage. Came over beside his left foot and plopped down with a heavy sigh as if he were the one going through all the trouble on this evening.

IN TRUTH, MRS. Chisolm had no memory of the act of the child’s conception, either. My lands, she said once to Jane many years later, after she’d been widowed and felt the memories of her life drifting about her mind like vapors: I cannot recall.

But her solution was simple, really. The doctor had supplied her with a measure of laudanum for — he stressed this — only her worst days of the nerves. And it had been a day back that late winter of cabin fever and a spitting cold rain as she hurried to gather the few most-late greens (she called them sneaky greens, popping up long after what you’d thought the last would be) from the winter garden, canning and cooking, and an argument over money at the supper table, and him going out in the weather with hat and coat to his little shed beside his still to drink and smoke and curse about things general, and she had thought he’d be gone all night or incapacitated at the least, so she had taken a dose to help her sleep.

All she remembered after that was waking well before daylight and feeling in herself that something had happened, and being so upset all she could do was leave the bed in a rage of silent tears. She rekindled the fire in the main room fireplace, then the large kitchen stove, made coffee, and sat drinking a cup while the bacon fried and grits bubbled, trying to pull herself together before he woke up, then made eggs and set a plate before him and went about her chores that morning in the relentless bitter late winter rain without a word. Feeling in her reeling mind that her body was already changing, taking itself away from her again, making another creature to push out into this unpredictable world.

THE DOCTOR FINISHED eating, set his plate and cup in the sink, and went back into the bedroom. The midwife was still there, standing silent beside the woodstove.

He asked of the midwife: “Mr. Chisolm?”

“In there by the fire. Went down to his makings but come back a minute ago.”

Chisolm looked up when he entered the room.

“So just what is it we have here?” he said.

“A little girl, I believe.”

“You believe.”

“I need to make a telephone call to an old friend of mine in Baltimore, a specialist, ask him some questions. I’ll be back tomorrow if possible, next day if not.”

Chisolm said nothing, blinking at him.

“Make sure the child is eliminating waste properly,” the doctor said. “If she isn’t, and especially if there is any swelling in her lower tummy, you send for me right away.”

Chisolm nodded.

“I don’t see any distension, meaning nothing seems to be dangerously out of place,” the doctor said. Chisolm stared at him, frowning, not seeming to really process this.

“All right, not to worry,” the doctor said. “I’ll be back tomorrow afternoon.”

HE FOUND THE JUG under the blanket he’d brought along to warm his legs. Made his way back through the dawning countryside taking his time, taking a pull on the jug every quarter mile or so. When he pulled up into the driveway of his house he was dismayed at what he saw. Tired deep in his bones and joints, and a little drunk, he sat there a moment taking it in: a wagon, two blanketed mules, a runabout pickup, one ragged buggy, and a smallish gaggle of people on the porch plus two in the ragged buggy, all awaiting his arrival. A small string of swaybacked horses stood tethered to the hog pen fence down the hill from the house. He dropped the blankets he’d used to cover his legs over the jug between his feet, and climbed down bending his stiffness as if simple movement were akin to heaving against a stubborn animal or heavy load.

He tethered the Fox Trotter to the post, grabbed his medical bag.

He called out, “Somebody take my rig around to the shed and put up my horse.”

A young boy jumped down from the porch and ran up.

“I’ll give you a penny before you go.”

“Thank you, Dr. Thompson.”

The doctor leaned in close, spoke quietly. “Mind the jug there under that blanket.”

The boy grinned like a lovable imbecile.

“Yes, sir.”

“Don’t you get into it. It’ll make you sick.”

The boy giggled in a strangely ecstatic way, as if something inside him had been too pleasurably stimulated, and ended with an odd hum, looking at the doctor sideways. My god, what made this one? the doctor thought.

He stepped up onto the porch among the sagging, ragged group there.

“How long you all been here?”

“I been here since first light,” said an old woman whose goiter had swelled up to the size of a yellow squash. She had no teeth and sounded like she was talking with her mouth full. That was an odd paradox he’d noted so often that he hardly noticed anymore. But his senses were always more alive and alert when he was this tired.

“My wife tend to you?”

“She brought out some coffee and biscuits about an hour ago,” the goiter woman said. “We do appreciate it. Said she was going on back to bed for a while, tired out waiting up for you since early morning.”

“All right.”

Also on the porch were a boy with a broken arm from sleepwalking off the porch of their home, a man with a swollen, possibly broken ankle from stepping into a gopher hole, another leaned forward clutching his chest with what was probably a heart attack, and yet another with a giant blue-and-yellow-clouded goose egg on his forehead.

And all these wretched souls came out of the womb perfectly normal, the doctor thought, looking around. Who can say what life will make of a body?

“What happened to you?” he said to the man with the goose egg as he started into the house with his bag.

“I hit him with the barrel of his own shotgun,” the woman sitting next to the man said. The man didn’t say anything, gazing in a dazed way straight ahead at nothing, looked about half conscious.

“He said I hit him so hard he’s done gone blind,” the woman said. “I tried to shoot him with it but it wasn’t loaded and I don’t know where he keeps his shotgun shells.”

“Won’t never, neither,” the man said in a whisper, not moving his head or his apparently sightless gaze.

“Better hope I don’t,” the woman said. “Come home drunk again. I had the money I’d get my own gun or at least some shotgun shells for his. I’d stick him with a knife when he’s like that but I’m afraid he’d get it away and stick me.”

“That’ll do,” the doctor said.

He gestured to the old man clutching his chest. “Help him on into my office, I’ll be there in a minute.”

He went inside his house and set his bag on the desk in his study, a kind of anteroom to his office where he saw patients, and drew a small amount of cocaine solution into a hypodermic. He was quiet through all this so as not to wake his wife. He injected the solution into a vein in his arm, then put the hypo away and rolled down his sleeve. He stood there over his desk for a few minutes, allowing the dope to start running through him, opening his eyes good, before taking up the bag and going into his office, where the older man sat in a chair, a young man standing beside him. He put a stethoscope to the older man’s chest. The older man, his stiff hair shorn in what looked like the feathers of a ruffled white hen, stared ahead and sieved a light breathing through his open mouth.

“What happened?” the doctor said to the young man.

“He just kind of sat down in the yard while we was on the way to the barn this morning,” the young man said. “I had to help him up.”

“Where you been, Doc?” the old man said in a whisper.

“Down at Chisolm’s, delivering a child.”

The old man said nothing for a moment, then whispered out, “Ain’t she a little long in the tooth for that now?”

“I reckon if Chisolm can still make it happen and she can still accommodate it, it’ll happen,” the doctor said.

“Heh,” the old man wheezed. Then he said, Oof, like laughing hurt him.

“Take it easy. You got arrhythmia going on in there. Means your heart’s not beating regular. I’ll give you something just to calm it down.”

“All right.”

“Is he gon’ live?” the young man said.

“Of course,” the doctor said. “Just how long is always the question, isn’t it? I’ve seen young men your age die of a bad heart, too. Seen old men with bad hearts live on and on.”

He administered a hypodermic and gave the young man some pills.

“These here are nitroglycerine tablets. Make sure he keeps them on him and if he feels a pain in his chest, put one under the tongue. If he knows he’s going to be doing something strenuous — hard work, I mean — he can take one a few minutes before and maybe ward it off. Take an aspirin every morning.”

“What if he just gives out like today?”

“Make him go to bed till he feels better. Cut out the bacon.”

“That’s about all he eats,” the young man said.

“Just a new idea going around. Vegetables, cornbread, a little lean ham. Easy on the chores. Plenty of rest. No conjugal relations.”

“What?” the old man said.

“Fornication.”

“Oh.”

“Or if you do, take one of those tablets before that, too.”

“Heh. I ain’t like old Chisolm down there.”

“Equipment not standing like it used to, eh? Well, that’s the way it goes. Chisolm’s younger than you.”

“Sometimes it just gets kind of thick,” the old man said.

The young man snickered.

“Well, just enjoy that, if you can, means you’re still alive,” the doctor said.

“What was it?”

“What?”

“A boy or a girl them Chisolms had.”

The doctor didn’t answer for a moment, then said, “Baby girl.”

“Healthy, then?”

“I believe so.”

“Well, God bless ’em.”

“I’ll pass that along.”

Then he helped the young man help the older man out. The man with the goose egg on his head looked paler, and the goose egg larger, and he signaled for the man’s wife to help him into the office.

“He can make it in on his own,” the woman said.

“Suit yourself,” the doctor said. “If he dies, you know, the sheriff just might charge you with murder for knocking him in the head like that.”

“Wouldn’t be nothing he didn’t deserve,” she muttered as the doctor closed the door to his office behind him. He sat the man down, examined the big bump.

“I’ll have to drain that off, if I can,” he said.

The man said nothing.

“You got a concussion, at best, but I’m worried you got bleeding still going on in there.”

The man still said nothing. Then he said, slowly, “Just tell the sheriff she was lying. I dropped a ax head on myself splitting firewood.” Then he closed his eyes and stopped breathing, still sitting upright in the chair.

“Well, damn,” the doctor said. He checked for a pulse, fingered the carotid.

“You need to come in here,” he said to the woman still sitting on the porch. She looked at him hard for a moment, then got up and followed him in. She looked at her husband sitting dead in the chair.

“Is he gone?” she said.

The doctor nodded.

“He said you were lying and that he dropped an ax on his own head chopping firewood.”

“Well,” the woman said after a long minute. “You don’t need no help around here, do you? Cleaning, what-all? I got a daughter can do it, won’t cost you much.”

The doctor stared at her in near disbelief. Then he said, “Got all the help I need right now. I’ll ask the coroner if he can use anyone.”

“I appreciate it,” the woman said, and left the office, climbed up onto the seat of a buckboard behind a swayback mule. The doctor had the young man, who had not left yet with his ailing father, help him carry the dead man outside and lay him into the back of the woman’s wagon. He unwrapped the reins, traveled them over the mule, handed them to the woman, who looked as if she didn’t know what they were. Then he went back up onto the porch and motioned to the woman with the goiter. Before he closed the door behind them, he said to the rest on the porch, “She was just mad-talking. He dropped an ax on his own head, splitting firewood, by his own admission. You all know how it goes, long married.”

All on the porch nodded and murmured. One said, “Lord, yes.”

“Well, the rest of you figure out the order amongst yourselves.”

He wasn’t tired anymore when he was done with them all, so he went into town and sent a telegraph to his friend from medical school, Ellis Adams, now a urological surgeon at Johns Hopkins. Then waited an hour and called him, long-distance. Described the Chisolm baby from his notes and drawings, asked some questions. Then went home again. No patients waiting this time, thank God.

His wife, Lett, was in the parlor drinking coffee. He sat down and she brought him a cup, sat with him. She was tall, like him, with long brown hair she kept pinned up nicely. A locket cameo beauty carved from ivory, come miraculously to life. But she looked tired. Beautifully so, but tired. And so was he, now. Exhausted.

“I guess you didn’t sleep much last night, either,” he said.

“No.” She set her coffee cup down and tapped on her wedding ring, a habit she had when bothered. “Ed, have you thought anymore about setting up a clinic in town? Or joining someone? Not everyone makes house calls anymore, you know.”

He sipped his coffee. It entered his blood as what it was, some powerful drug.

“I don’t know what to say, Lett. I’ve told you it seems unethical to abandon a practice, especially this kind.”

“Well, find someone to take it, then. As I have suggested before.”

“And, as I have explained, the youngest doctors — the ones who don’t like house calls — don’t want this kind of practice anymore. And the older ones are already settled.”

“Well. Ed.”

“Yes.”

“If you come home from a late-night call and I’m not here, you can figure I’ve gone to Mother’s for the night. I don’t like being here on the edge of town in this big house by myself when you go out. It didn’t bother me so much for a while, but it’s begun to. I wake up, find you gone, and can’t get back to sleep.”

“How is getting up, getting dressed, and driving or taking a buggy into town, waking up your mother — just how is that going to help you sleep, Lett?”

“It’s not all about not being able to sleep, Ed. It’s feeling left alone.”

He noticed her hands were shaking just the slightest bit. She saw him notice, clasped one over the other, and went to the window, facing out.

“Did you sleep at all last night, Lett?”

He was gazing at her tall slim figure there, her lovely neck exposed and half in shadow of diagonal light, and suddenly he felt a fear for her.

“I’m scarcely ever gone more than a few hours, often less.”

She gestured with one hand, as if helpless against her frustration.

“I could give you something to help you sleep,” he said.

She turned then, looking so on the verge of tears he was startled.

“Laudanum, are you saying? No, thank you.”

“No, Lett. There are herbs.”

“They don’t work for me.” She looked at the floor, shook her head.

“Come along with me, then. At least sometimes.”

She turned back to the window and seemed to stiffen.

“You know I don’t like being around sick people. I’m ashamed of it but it’s true. I guess I shouldn’t have married a doctor,” she said, trying to laugh it off. But her laughter was momentary, false, and he could only gaze at her as tenderly as possible, knowing that her feelings for him had been weakening for some time. Detecting the loss of love from one he’d hoped would always give it.

HE DROVE BACK to the Chisolm place the next afternoon, in his Model T Ford. Went inside the house and examined the child, asked Mrs. Chisolm a few questions, then went out to his car, gathered up a douche apparatus, and went back inside. Ida Chisolm seemed to recoil from it.

“Do you have one of these?” he said to her. She shook her head, like a horse pestered by a fly. “Well, you can have this one. She must be kept very clean — inside, I mean. You want to try to keep her fecal matter — her poop — from getting into her other parts. It’s all kind of together in there, with this child. Let me show you.” She didn’t move. “Come on over, now. This is important. And when she’s old enough, she must be taught to do it herself, and frequently. Otherwise she will have frequent problems for sure.”

“What kind of problems?”

“What I believe, from what I can tell and what I’ve been told, is that without it she could have frequent infections, and you don’t want me over here every other day having to treat that.”

Warily, the woman approached and watched, listened to what he said. When he looked up at her for a moment, he saw her blinking back tears.

“It will be all right,” he said.

“So you say,” she said.

“All right,” he said after peering at her, trying to figure her state of mind. “Now, listen. I know we normally don’t let infants sleep on their backs, if we can help it. But it would be good if she could sleep with her hips slightly elevated. It might mean checking on her more often, I know. But it will help avoid the possibility of the kind of thing that would lead to infections. And during the day, when she’s in the crib, same thing. And when she’s upright, being held or whatnot, not a problem.”

She said nothing, looking blankly at the child lying there in her crib, at the little diaper the doctor had folded and placed beneath her bottom.

“You understand, Ida?” He said her first name to get her attention.

She only nodded. And he went out.

CHISOLM WAS in the work shed sharpening edges on a disc harrow. He stepped out and the doctor met him there just outside the shed, in the shade of its eave. The doctor removed his hat, ran a hand through his hair, inspected the hat as if for flaws, then put it back on.

“Child seems all right,” he said to Chisolm. “Seems healthy, to me. Doesn’t have everything she ought to have, but there does not appear to be an obstruction and as long as she’s able to eliminate waste and y’all keep her clean, she should be all right.” He looked at the man. “I’ve explained that to your wife.” Chisolm looked back at him curiously. “We’ll see how she comes along in time, but I believe she’ll be all right. She’s nursing well.”

“She, then.”

“Yes.”

Chisolm looked at him a long moment, studying him the way he did, taking the words in.

“Doesn’t need anything special, then?” he said. “No medicine or special food?”

The doctor shook his head.

“I’ll be honest with you, though,” he said.

Chisolm said nothing, waiting.

“The truth of the matter is that if something is going to go wrong, it will likely go wrong in these first weeks or even first few months. If she doesn’t soil her diaper often as any child ought, or especially if she goes even a day without that, as I said, you send for me quick. Keep an eye out for any swelling in her lower tummy. Or something kind of poking the skin out in an odd way. You can expect me to be checking in pretty often for a while. I won’t charge you for it. Let’s just call it a learning experience for everyone, but especially me, as a doctor I mean.”

Chisolm just nodded, his eyes on the doctor’s as if expecting more. Then he looked away.

The doctor yawned and rubbed his face with his hands.

“Blame me if it doesn’t seem I’ve treated half the county in the last few days. I had a passel waiting on me when I got home this morning, then went to town to call a friend who knows more about this kind of business here than I do. Went home hoping for a nap but I’d hardly lain down before a boy rode up hollering his father cut himself bad at the sawmill. Had me a bit of a nap under a sweet gum beside the road between there and here. I thank you for that gift of spiritual aid in that regard.”

Chisolm nodded, managed a grim smile.

“You need another?”

“I’m plenty good for now, thank you. Sir, I believe your product is as good as anything bottled in Kentucky. You are an artist.”

Chisolm almost grinned. “Anytime you’re in the neighborhood, Doc, just help yourself.” Then he said, “I guess I got one question.”

“Shoot.”

“How is it a child comes out like this’n?”

The doctor shrugged his shoulders inside his jacket, like he’d got a chill. He was overtired.

“The way I see it, most everybody’s lucky nothing goes wrong during a pregnancy. I sometimes can’t believe how often nature gets it just right. I’ve seen some things you wouldn’t believe. Most that come out wrong or odd die soon after birth. Sometimes I can be pretty sure, when I come back to check on them, that what happened was not a natural death.”

Chisolm looked at him for a long minute, but the doctor kept looking out over the field.

“Anyhow,” Chisolm said, “you figure this one’s a girl just because, I reckon, it’s clear she ain’t a boy.”

“Best I can tell,” the doctor said, “she’s just a girl who did not fully develop. Something stopped that in the womb, for whatever reason. It happens. No one’s fault. It’s rare, but at this point I do not think it’s life-threatening.” He paused. “There’s many a case of a child being both, to one degree or another, but that’s not the case here. I’m told this is most likely a condition you see only in female children, anyway, and not boys.”

Chisolm looked at him.

“Both, you say.”

The doctor raised his eyebrows and gave a nod, took his hat off to look it over again, brows furrowing down.

“Can’t be a nothing,” he said. “Come out able to be one or the other, and you have to wait and see which one wins out. Sometimes it just stays both.”

Chisolm looked at him, taking that in.

“Well, I reckon if a thing like that can happen to a child, we got damn lucky.”

“All things considered,” the doctor said, “I’d have to agree.”

“And nothing to do about it.”

“I don’t believe so, no. But, in time, who knows? If you can, you might put a little away toward it whenever you can, just in case.”

They stood there another long minute. Then the doctor gave Chisolm a light pat on the shoulder. “She’ll be a little treasure for you and Mrs., I don’t doubt it,” he said.

Chisolm nodded, and went back into his shed and began filing at the disc blade again. The doctor left and made a couple of house calls in the general area. The afternoon grew chilly, late November coming on. When he returned home at last light the house was empty, but a small fire flickered in the hearth, and there was a tin plate on the stove’s warmer, covered by a clean cloth. A note from his wife on the kitchen table. She’d gone into town to visit her mother, might stay overnight, not to worry.

He went into his study, where he’d left the jug from Chisolm, poured himself a measure into an empty coffee cup, lit a small lamp on his desk, and wrote in his journal. A tree frog sang out its loud, long, piercing song just outside the window on the porch, and even its near-deafening note, coming from an inch-long operatic amphibian soprano, somehow brought up a corresponding silent note of melancholy.

AS SOON AS the child got a little strength in her neck, her mother enlisted the older daughter, Grace, who carried the infant around like a broken third arm in a makeshift sling. She brought her to her mother when she was hungry and would step outside and walk fast, then run to someplace on the farm she could hunker down, hide out, curse or weep as the mood might fit her. Occasionally she would take a little homemade corncob vine-stem pipe she’d fashioned with a paring knife and puff on a bit of tobacco she’d snitched from her father. It was a small rebellion but there was a measure of satisfaction in it.

Later on, when winter had passed and the baby was able to crawl around like a quick little hobbled dog, Grace got her out of the house as often as possible. They wandered as far as the child’s ability and bobbling curiosity would take them, Grace only picking her up when she veered too close to an animal or machine and turning her like a windup toy in another direction. She grew out a full head of fine dark brown hair that Grace pulled up into a tiny little bow on top of her head. Quite cute, her older sister had to admit.

But she never lost her conviction that this motherhood business wasn’t ever going to be for her.

She stepped from the privy into the gray-blue light of a windy March afternoon, gusts buffeting the wooden door she held on to, kicking up dust in the yard, rattling the leafing, bony limbs in the trees, and rippling the surface of the cattle pond down in the pasture. The door to the house opened and her mother’s arm swung out, tossing a wadded diaper over the edge of the porch and into the yard. Grace looked at her duty lying there, steam rising like scant smoke from its folds.

The doctor’s Ford pulled to a clattering stop in front of it, as if it were a traffic sign of the oddest sort. He was in the habit now of stopping by at least once a week. She watched him get out, step around the car on his long, just slightly bowed legs, look down at the steaming bundle, then over at Grace standing in the open door to the privy. He was hatless, hank of carelessly debonair hair on his forehead, hands in pockets as if studying something worthy of thought. She just looked at him. His casual relationship with the world, his bookishly handsome, relative ease, infuriated her. He had the audacity to give her what looked like the faintest smile, as if he were amused. Grace was not.

She followed him inside the house and stood in the doorway to the living room as he examined the baby, pinned her fresh diaper, then followed him as far as the kitchen doorway to listen while he spoke to her mother.

“Four months now,” he was saying as they sat at the table. “If anything serious were going to develop, I believe we would have seen signs of it already.”

She looked at the doctor sitting there, his oddly aristocratic features, no gray in his hair. It struck her he might be younger than she’d thought.

“Grace, mind your manners and put on a pot of coffee,” her mother said.

She slumped over and got the pot, rinsed it at the pump out back, put in new water, and brought it back inside. Loaded some coffee in it and set it on top of the stove. Threw another chunk of wood in the stove furnace. At one point a lull in the conversation caused her to glance at the doctor. She started when she saw he was looking at her, a quizzical if bemused look on his face. She frowned and went back to the doorway and stood just outside it, as if not listening.

He went on to say that Mrs. Chisolm should continue to make sure there was no odd swelling, and that he would continue checking in regularly if she wouldn’t mind.

“I thank you,” her mother said, though her tone held something of suspicion and a trace of resentment as well, no doubt at having to feel beholden.

Grace went back in when the coffee was done and poured the doctor a cup. He smiled up at her.

“Thank you, Miss Grace.”

“Welcome,” she mumbled, furious at herself for blushing.

He said he thought he would take a little stroll into the woods behind their house and then be on his way, if they wouldn’t mind. Her mother gave herself a wry smile and said of course, to make himself at home. The doctor smiled in an odd way back at her, a bit of mischief in his eye, then took up his coffee cup and went out the kitchen door.

“What’s that all about, then?” Grace said.

“He’s one likes to walk in the woods, I guess.”

“Oh, I thought maybe he just needs a little sweetener in his coffee.”

“Don’t be impertinent,” her mother said. “He’s not charging us for any of this, whatever it’s worth.”

“Why not?”

“I don’t ask.”

Leaving, later, when the doctor rounded the corner of their long drive toward the road, she was standing just off it in the shadow of a ragged pine tree, watching him pass. Without looking her way he lifted a finger from the steering wheel in a little acknowledgment or wave, to which she responded by lifting her middle finger toward his car as it raised the dust on its way down the drive.

Ellison Adams, M.D.

Johns Hopkins University School of Medicine

Baltimore, Maryland

Dear Ellis,

A busy winter it was here with ague and the results of physical violence bred and borne by folks cooped up a bit too much with their chosen enemies. I’m sure you would find it all most amusing.

Since there have been no complications (and I have to say I expected there to be some, but it seems you were right so I must have described it well enough), it has been some time since I’ve written to you concerning my young patient with her interesting if apparently manageable urological condition. As you expected, there’s been no apparent danger arising from blockages, fistulas, or other developments in that direction, etc. An interesting case, and a very fine and otherwise normal child in the making as it turns out.

The mother seems to have found her ways to cope. Her older daughter takes on most of the child caring duties whenever she’s not away in school. Curious girl, never says much. I get the feeling she’s like some wildcat tethered to that family and her duties as if to a tree by a pulled-taut chain. Only question is will she give more trouble than she gets.

Speaking of coping, my Lett seems to spend more time in town with her family than here, these days. Not really but it seems so. Feels like I see our housekeeper young Hattie more than I do my own wife. I had not considered how difficult (and unamusing) it might be for a refined city girl to be married to a man who for some reason ends up an old-time country doctor. I suppose she expected me to end up in research, like you, or at least some sophisticated urban practice, coming and going like a banker, instead of mending the cracked limbs and skulls of simple farm folks who often enough show up at the door bloody and smelling of animals and dirt. I believe she is profoundly disheartened by the sight of a man or woman with the dental apparatus of a jack-o’-lantern.

Of course do please keep your more refined and intelligent ears open whenever possible to any research developments that would apply and let me know posthaste should something relevant be in the works. If such a case/condition as I have on my hands here is indeed as rare as you suspect, then I wonder if Young et al. would be interested in some kind of pro bono examination, for the purposes of advancing science, as we say. If you should manage to get anyone’s attention on the matter, please let me know directly. Your colleague Dr. Young will, I believe, continue to make great strides in this field, in time. Please maintain your friendship with this man and do not let the horse’s ass in you come out at some kind of social gathering or whatnot, as we know this Dr. Young is a bit of a prude and campaigned against prostitution when he served in the war, etc. etc., as if contracting a case of the clap could somehow be worse than having one’s entire apparatus blown off or to pieces by a German artillery shell — but, pardon, I stray afield. In other words also be discreet as possible concerning your other habits, if you will, oh Great One. My regards to Mary Kate and the children, by the way.

Spring has arrived, in any case — gusty, always thrilling to me. The songbirds are in a riot of pugnacious pleasure. What I would do to have this season exist without end. Except, what did the poet imply, that having our pleasures always in-hand we would no longer appreciate them? Possibly even our recognition of them would cease to be anything remarkable at all.

Yours, etc.

Eldred The Terrible & etc.