The Cole Trilogy: The Physician, Shaman, and Matters of Choice (224 page)

“What the hell,” she whispered, but she didn’t need Greg to tell her it was a variety of vaginal contraction she never had met before.

She took the time to resoap her arm. Back at the cow, she spent several minutes of experimentation before she realized what she
was up against. The contractions came once a minute and lasted about forty-five seconds, leaving her only a fifteen-second window in which to work. She pushed her arm deep into the straining butt in front of her as soon as she felt a contraction slacken—past the knee, along the foreleg.

“I can feel a bone, the pelvic bone,” she told Greg. And then, “I’ve got the hoof, but it’s caught under the pelvic bone.”

The rigid tail switched, perhaps in pain, and smacked R.J. in the mouth. Sputtering, she grabbed the tail with her left hand and held it. She was warned by new ripples and had just enough time to grasp the hoof and hold on while a vaginal vise clamped her arm from fingertips to shoulder. After a moment there was no danger her arm would be expelled, because the pressure around it had become too tight. The pressure pushed the front of her wrist against the cow’s pelvic bone. The pain made her gasp, but her arm quickly became numb, and R.J. closed her eyes and dug her forehead into Zsa Zsa. Her arm was captive all the way to the shoulder; she had become a prisoner, joined to this cow. She felt faint and experienced a sudden fantasy, a terrible certainty that Zsa Zsa was going to die, and they would have to cut up the cow’s carcass in order to free her.

She didn’t hear Stacia Hinton come into the barn, but she caught the woman’s cranky challenge—“What’s that girl think she’s doing in there?”—and an inaudible mumble as Greg Hinton replied. R.J. smelled manure, and the internal odor of the cow, and the animal stink of her own sweat and terror. Then the contraction was over.

She had delivered enough human babies to know now what had to be done, and she withdrew her numbed hand as far as the calf’s knee and pushed it back. Then she was able to reach past it, in and down. When her hand found the hoof again, she had to fight against a panic that made her want to rush things, because she didn’t want to be in the vagina when the next contraction came.

But she worked carefully, grasping the hoof, working it up the vagina, and finally out and next to the other hoof, where it belonged.

“Heyyyy!” Greg Hinton breathed in delight.

“Good girl!” Stacia called.

At the next contraction, the calf’s head appeared.

Hello, there
, R.J. told it silently, enchanted. But they were unable to pull more than the forelegs and head from the cow. The calf was stuck like a cork in a bottle.

“If only we had a calf puller,” Stacia Hinton said.

“What’s that?”

“It’s kind of a winch,” Greg said.

“Tie the hooves together,” R.J. said. She went to the Explorer and released the hook of the come-along, then pulled the cable into the barn.

The calf was drawn out easily—such an argument for technology, R.J. thought.

“Bull calf,” Greg said.

R.J. sat on the floor and watched Stacia wipe mucus, the remains of the water bag, from the little bull’s nostrils. They brought the calf around to the front of the cow, but Zsa Zsa was exhausted and barely moved. Greg began rubbing the newborn’s chest with clumps of dry hay. “This gets the lungs working, that’s why the cow always gives the calf a rough licking with her tongue. But this little fella’s momma is too tired to lick a stamp.”

“Will she be all right?” R.J. asked.

“Sure she will,” Stacia said. “I’ll get her a nice bucket of warm water in a while. That’ll help her pass the placenta.”

R.J. raised herself from the floor and went to the sink. She washed her hands and arm, but it would be impossible to get herself clean there, she saw at once.

“Got some … ah, manure in your hair,” Greg said delicately.

“Don’t touch it, it’ll just smear, dear,” Stacia said.

R.J. stowed the come-along cable and, carrying the leather jacket well in front of her, placed it in the backseat of the car, as far from her as possible.

“Good night.”

She scarcely heard their expressions of gratitude. She drove home trying to make as little contact as possible with the car upholstery.

When she was in her kitchen she took off her shirt. The sleeves
had rolled down and the front was smeared as well; she identified blood, mucus, soap, manure, and a variety of birth fluids, and she shuddered and rolled it up and dropped it into the trash bin.

She stayed under the hot shower a long time, massaging her arm and using a great deal of soap and shampoo.

When she got out, she brushed her teeth and then put on her pajamas in the dark.

“What?” David called.

“Nothing,” she said, and he went back to sleep.

She had intended to go to sleep too, but instead she went back down to the kitchen and put water on the stove for coffee. Her arm was bruised and aching, but she flexed her fingers and her wrist and her elbow and saw that nothing was broken. She took paper and a pen from her desk and sat at the table to make certain she could write.

She decided to send a letter to Samantha Potter.

Dear Sam
,

You told me to write if I thought of something a doctor can do in the country that she can’t do in a medical center
.

Tonight, I thought of something:

You can put your arm into a cow
.

Yours truly
,

R.J
.

52

T
HE
C
ALLING
C
ARD

One morning R.J. realized to her discomfort that the date was approaching when she would be required to renew her license to practice medicine in the Commonwealth of Massachusetts, and she wasn’t prepared to apply. The state license had to be renewed every two years, and to safeguard the public, the law required that every physician who applied for relicensing must submit evidence that he or she had taken one hundred hours of continuing medical education (CME).

The system was designed to update medical knowledge and continually sharpen skills, and to prevent doctors from falling below the standards of their profession. R.J. thoroughly approved of the concept of continuing education, but she realized that over a period of almost two years she had accrued only eighty-one CME points. Busy establishing her new practice and working at the Springfield clinic, she had neglected her educational program.

The local hospitals frequently offered lectures or seminars worth a few points, but she didn’t have enough time left to fulfill her obligation that way.

“You need to attend a large professional meeting,” Gwen said. “I’m in the same position myself.”

So R.J. began to study the meeting announcements as she read her medical journals, and she noted that a three-day cancer symposium for primary care physicians would be held in New York City, at the Plaza Hotel. Sponsored jointly by the American Cancer
Society and the American Board of Internal Medicine, it offered twenty-eight continuing medical education points.

Peter Gerome agreed that he and Estie would come and stay at her house while she was gone, so Peter could cover for her. He had applied for hospital privileges but they hadn’t come through yet, and R.J. arranged for a Greenfield internist to admit any patients who might have to be hospitalized.

David was laboring on his next-to-last chapter, and they agreed he couldn’t interrupt his work. So she drove to New York alone, through the pale-lemony sunshine of early November.

She found that although she had been happy to flee the city pressures when she had left Boston, now she was ready to embrace them. After the solitude and quiet of the country, New York seemed like a colossal human anthill, and the interaction of all those people was a powerful stimulant. Driving through Manhattan was no pleasure, and she was content to surrender her car to the doorman at the hotel, but she was glad she had come.

Her room was on the ninth floor, small but comfortable. She took a short nap and then had just enough time to shower and dress. Registration was combined with a cocktail party, and she had a beer and helped herself hungrily to the lavish buffet.

She saw no one she knew. There were many couples. At the buffet a doctor whose name tag said he was Robert Starbuck from Detroit, Michigan, struck up a conversation.

“And where in Massachusetts is Woodfield?” he said, peering at her name tag.

“Just off the Mohawk Trail.”

“Ah. Old mountains, worn down to loveliness. Do you drive around all the time, looking at the scenery?”

She smiled. “No. I just observe it when I go out on house calls.”

Now he peered at her face. “You make house calls?”

His plate was empty, and he deserted her for the buffet table, but soon he was back. He was a moderately attractive man, but he was so openly and so hungrily seeking something other than conversation
that she found it easy to leave him along with the dirty dishes when she had finished eating.

She took the elevator to the lobby and walked outside, into New York City. Central Park wasn’t the place to go at night and didn’t tempt her; she had trees and grass at home. She moved slowly down Fifth Avenue, stopping at almost every window and spending a long time at some, studying the lavishness of apparel, luggage, shoes, jewelry, books.

She walked down half a dozen blocks, crossed the street, and walked uptown again until she returned to the hotel. Then she went upstairs and went to bed early, as she had always done before classes during the long years of scholarship. She could hear Charlie Harris telling her, “Gotta take care of business, R.J.”

It was a good conference, designed to be intensive and meaty, with a continental breakfast served during the first session of every morning, and lecturers during lunch and dinner. R.J. treated it very seriously. She didn’t skip a session, she took careful notes, and she arranged to purchase the tape recordings that were made of several of the lectures that particularly interested her. Evenings were reserved for entertainment, with several good choices. The first evening she saw a revival of
Show Boat
and enjoyed it a lot, and on the second evening she watched the Dance Theatre of Harlem with great pleasure.

By the third morning she had accumulated enough points to guarantee her relicensing. Only the earliest of the third-day presentations interested her, and she thought that perhaps she would break away from the conference and do a little shopping before leaving New York.

On the way back to her room to pack, she suddenly had a better idea.

The concierge was a determinedly cheerful woman of late middle age. “But of course,” she said when R.J. asked her if she had a road map of greater New York.

“Can you tell me how to drive to West Babylon, Long Island?”

“If madam will give me but a moment.” The woman consulted
the map and then she drew in the route with confident sweeps of her ink marker.

R.J. stopped at the first filling station she saw once she had left the freeway, and asked the way to the House of Moses Cemetery.

When she came to it, she followed its perimeter until she reached the cemetery entrance. There was an administration building just inside the gate, and she parked the car and went inside. A man about her own age, wearing a blue suit and a white skullcap on his head of sparse blond hair, sat behind a desk signing papers. “Good morning,” he said without looking up.

“Good morning. I would like some help in finding a grave.”

He nodded. “Name of deceased?”

“Markus. Sarah Markus.”

He swiveled his chair around to the computer behind him and typed in the name.

“Yes, we have six by that name. Middle initial?”

“None. Markus with a K, not a C.”

“Ah. But there are two. Was she sixty-seven years old, or seventeen?”

“Seventeen,” R.J. said thinly, and the man nodded. “There are so many,” he said apologetically.

“You have such a large cemetery.”

“Sixty acres.” He took a paper bearing a diagram of the cemetery and drew directions with his pen. “Twelve sections down from this building, you turn right. Eight sections beyond that, take a left. The grave you seek is midway in the second row. If you get lost come back, I’ll take you there myself…. Yes,” he said, glancing at the monitor to confirm the location.

“We have everything on computer,” he said with pride, “everything. I see there was a dedication there last month.”

“A dedication?”

“Yes, when the memorial stone was unveiled.”

“Oh.” She thanked him and left, clutching her paper.

So R.J. walked slowly down the narrow roadway of gritty rock dust. Beyond the cemetery wall cars zoomed, a motorcycle burred past, brakes squealed, the sound of a horn intruded.

Counting the sections.

R.J.’s mother was buried in a cemetery in Cambridge, with grassy spaces between headstones. These graves were terribly close to one another, she thought. They were so many, indeed, people moving out of one city and into another.

… Eleven … Twelve.

She turned right and marched down eight sections.