The Midwife's Dilemma (10 page)

When there was finally a lull in the conversation, Thomas cleared his throat. “Before you come to dinner tomorrow night and see Eleanor, Micah, and the baby, I wanted to speak to you about something. One of those matters I mentioned the other day that you should know about before we get married.”

She raised a brow. “Go on.”

“As you recall, when you brought Eleanor and her husband from Clarion to live with me so you could care for her while she was carrying my grandson, Micah's father made it clear to him that he wasn't welcome to return there to practice law with him. At the time, there didn't appear to be much of a future here in Trinity for another lawyer, either, and even with the changes taking place it could be some time before there will be. The inheritance from his mother won't last forever,” he informed Martha before taking a long breath. “I've asked Micah to take over my practice, and he's accepted my offer.”

She smiled. “I suspected you might do that.”

“What I need to tell you,” he continued, “is that they'll be living in my house permanently, which shouldn't pose a problem since we'll be moving out to my cabin on Candle Lake once we're married—although all they know right now is that I'll be moving out to the cabin when I get back from New York. I tried to give them the house outright, but they refused and insisted on paying rent, which I neither want nor need. I haven't told them yet that I'm going to set up a trust fund for my grandson with the money they give me, but as my wife, you should know that.”

Relieved to know he had not changed his mind about moving out of town after they married, she was also grateful for the opportunity to raise one of her own concerns. “I'm quite content with the arrangements you've made, but I must be honest with you. After living at the cabin with Victoria for four or five weeks last winter, I felt totally isolated from town and my
friends here. I was hoping that you and I might come to town on Saturdays and stay over for services on Sunday morning, weather permitting, of course. That way we'd get to see our families on a regular basis, too.” She shooed off an insect preparing to land on her nose. “Do you think Eleanor and Micah would mind if we stayed at your house here in town that often?”

He laughed and tugged at another blade of grass. “They wouldn't mind at all, but I'm afraid I might. Living with a small child again is a bit more challenging for me than it was when Harry and Eleanor were little, but I rather like the idea of spending our weekends back in Trinity. You haven't mentioned Victoria, but I assume she'll be living with us.”

“Perhaps not.” Martha quickly told him about the relationship that had developed between her daughter and Dr. McMillan and their meeting last night when she had given them permission to marry.

“Last night must have been difficult for you, in many ways. It's not easy letting any of our children go, or to accept their choice of a spouse. In Victoria's case, having her choose Dr. McMillan won't be particularly easy for you, will it?”

“No, but she's chosen the right man for her, and we'll just have to make it work. Once I'm no longer practicing as a midwife, however, it won't matter at all, I suppose.”

“How much does she know about our own plans?” he asked.

She swallowed hard. “Actually, I told her . . . that is, she suspected we might . . .” She paused to clear her throat. “Victoria is very intuitive, and she can be rather persuasive. I'm afraid I've told her about our hopes to marry, but she's promised to keep it a secret. I hope you're not annoyed with me, since I've been rather insistent about keeping this to ourselves.”

He leaned to the side and closed the distance between them. “In all truth, I'm pleased that you told her, and I'm sorely
tempted at the moment to kiss you until you change your mind about waiting so long for us to marry,” he whispered, his lips dangerously close to her own.

Although it was getting nearly impossible to resist him, she knew that his kisses were far too dangerous, especially when they were alone like this. “I'm sorely tempted to let you, but you'll get only one,” she cautioned before pressing a quick kiss to his lips. She then scrambled to her feet and straightened her skirts. “I'm afraid it's getting late. We need to leave right now if we hope to get home for supper and, more important, before dark. Along the way, perhaps we could discuss the idea that I might want to borrow one of your horses. But just now and then.”

“There's no need to discuss it. You can borrow one of the horses whenever you want,” he replied and reluctantly got to his feet. “And I'm not worried about supper or driving the buggy in the dark, either,” he grumbled.

She felt a blush spread across her cheeks. “Neither am I.”

F
ortunately, Martha arrived home before dark and just in time for supper.

She had barely sat down when a worried Jonathan Goodfellow appeared at the door, telling her that Nell Carruth, the afternurse who was staying with his wife, had sent him here to fetch Martha back to check on Henny. In a matter of minutes, she had changed into her riding skirt, tied her bonnet in place, and was hurrying down the hall with her bag of simples in her hand and a prayer on her lips.

Before she opened the door, she paused just long enough to put a reassuring smile on her face. Once outside, she was pleased to see that the same old, docile mare he had brought for her earlier would accompany her again. Before she mounted, she ran back inside to remind Victoria of their plans to have supper with Thomas and his family tomorrow night. Since she did not know quite what to expect, she also asked Victoria to offer apologies on the off chance she had not come home by then.

She got back outside just as Mr. Goodfellow finished tying
her bag in place. She accepted his help to get astride before he mounted his own horse, and she continued to pray as she followed him down the alley. Noting the man's troubled features, she waited until they had left the noise of the town behind to try to ease some of his concerns. “It's not all that uncommon for me to be summoned back, especially where first babes are concerned. Your place isn't all that far from town, but it would be really helpful to me if you could repeat exactly what Mrs. Carruth said to tell me before we get there,” she said as they passed the new tavern and headed west on Falls Road at a steady pace.

When he looked over at her, the worry that creased his brow also simmered in his eyes. “She said something about Henny losing too much blood. She might have said more, but Henny was so pale and so listless, I was too worried to hear much else. You can help her, right? You won't let anything happen to my Henny, will you?”

“I'll take good care of her,” Martha promised and kept up with him when he urged his horse into more of a gallop than a canter. They reached his farm in half the time it had taken on her previous visit. The moment she entered the bedroom in the two-room cabin, she took in the grave concern on Nell's face, turned around, and sent the man back to wait in the other room. She quickly walked past the cradle, where the newborn was sleeping, to reach his mother's bedside.

With her heart beating just a little faster, she stood next to the slight, seventy-something woman who had years of experience as an afternurse, and they both looked down at Henny. Normally the stunning woman with flaming-red hair had a porcelain complexion, but there was nothing normal about the woman's pallor, which now made her appear to be more dead than alive. Just as alarming, her breaths were coming in slow, shallow efforts.

“I've never seen anyone slip so fast,” Nell whispered and wrung her hands. “Everything was going so well. Then a couple of hours ago, she started bleeding, and bleeding hard, so I did what I always do. I packed her up good with cloth and got her to drink a toddy with an extra dollop of honey wine and waited a bit, but it didn't seem to help much at all. That's when I sent Mr. Goodfellow to fetch you back.”

“You did exactly the right thing.” Martha tossed her bonnet aside and washed her hands while Nell gathered up some fresh cloths and a fresh basin of water. Martha's attempts to revive Henny by pressing cool cloths against her face were met with only a few groans.

When she eased away the bedsheet that covered Henny's body, she was horrified to see a pool of fresh blood that warned her she might already be too late. Henny was hemorrhaging, and Martha wasted no time to see if she could determine the reason. Working quickly and silently, she rolled up the sheets from the bottom of the bed until they reached the middle of Henny's chest, keeping her long nightgown in place to protect the woman's modesty.

It did not take Martha long to dismiss the possibility that the woman was hemorrhaging because she had not expelled all of the afterbirth. And with no visible tears caused by little Peter's birth, that only left the likelihood that there were injuries within Henny's womb that were responsible for the bleeding.

Deeply concerned at her ability to stop the bleeding before it was too late to save Henny's life, she drew a deep breath and walked straight out of the room to talk to the harried husband and ask him to do something she had never done before. “Your wife is gravely ill. I'll do everything I can to stop the bleeding, but at this point, every minute counts. We can't afford to wait more than another hour or so to see if my efforts are success
ful. If they aren't, it might be too late by then to summon Dr. McMillan. I think it would be wise and in your wife's best interests to fetch him now and pray he might have a treatment that will save her if she hasn't improved by the time he gets here.”

The color drained from his face. “Is she going to die?”

“Not if we can help it, but the longer we stand here talking, the longer she'll have to wait for me to help her and the longer it will be before Dr. McMillan gets here.”

He tore out of the cabin so fast he did not even close the door behind him.

“You must be able to think of something!” Martha exclaimed.

After waiting half the night for Dr. McMillan to arrive, she was frantic. She could not blame him for taking so long, since he had been out on a call when Jonathan Goodfellow arrived at his home and came as soon as he could. She kept her gaze locked with Dr. McMillan's and hoped she kept her voice low, but her heart was pounding in her ears, and she could not be sure if he answered her or not. “Henny is going to die unless you do. In fact, I'm surprised she's lasted this long.”

He raked his fingers through his hair. “I've told you. I can't do more than you've already done,” he insisted. “As difficult as it might be to admit it, sometimes you just have to accept the fact that you can't save everyone, and neither can I. I fear this is one of those times.”

Thankful that they were alone together in the bedroom and Henny was not conscious to hear them, she shook her head. “This is not about me or my opinion of my abilities, and it's not about you, either. It's all about that young woman lying over there who is going to bleed to death, and a newborn babe named Peter James who'll grow up never knowing his mama,
unless you can help her. You're the one with the fancy medical degree hanging on your wall and a stack of medical journals on your desk with the latest advances in medicine from here, there, and everywhere. Think, young man, think! There must be something you can do to try to save her.”

He looked away. After several long, tension-filled moments, he turned and faced her again. “
The Lancet
is a weekly medical journal in London. I've read a number of articles in it written by Dr. Blundell that might be of help. He's renowned for his work in the field of childbirth, but there isn't anything I've read elsewhere to suggest his method of saving a hemorrhaging woman after she's given birth has been widely accepted in Europe, let alone on this side of the Atlantic.”

“Do you think his method will stop the bleeding?”

He grimaced. “Not per se, but according to what I've read, it may give her body the time it needs to heal, which in turn will stop the bleeding. But you have to understand something: I've never done anything like this before. I may not do it right, and even if I do, it may not work at all. Some critics of his method claim that half the time it doesn't.”

“Then half the time it does,” she argued and turned him about until he faced the door. “Go out there and talk to Mr. Goodfellow. Tell him what you've just told me. If he wants you to go ahead, you owe him and you owe his wife your best efforts. The rest is in God's hands. It always is.”

After drawing a deep breath, Dr. McMillan walked out of the room and returned with Henny's husband a few moments later. The doctor looked as grave as she had ever seen him. Judging by the square set of his shoulders, he was ready to proceed, and he put the wooden chair he was carrying next to Henny's bed. With Nell still tending to little Peter in the other room, he told the young husband to take a seat on the chair and roll up one
of his shirtsleeves. He put Martha to work clearing the small bedside table, opened his medical bag, and laid out a number of instruments on top of the table the moment she finished.

“I need fresh cloths for bandages and a small basin on the table,” he ordered before removing his frock coat and rolling up his shirtsleeves. “Listen very carefully, both of you, because I only have time to explain it once,” he cautioned while he washed his hands.

Martha swallowed hard and noted the pale expression on poor Jonathan. What the doctor proposed to do was like nothing she had ever heard of before, and she offered a silent prayer that he would be successful.

He took a deep breath. “Remember. Once I actually start the procedure, I have to work very, very quickly, and I cannot stop.”

He began by using a lancet to open the flesh on Henny's arm to reveal a small vein, which is exactly what he would have done if he intended to bleed her. Next, he pressed a cloth to the open wound and had Martha hold it in place. After taking another deep breath, he performed the same procedure on her husband and had the young man hold a cloth against the incision himself.

The doctor was sweating profusely at this point. Martha watched with awe and disbelief when he picked up the metal syringe she had seen him use to suck infection from a wound, removed the cloth covering the incision he had made in Jonathan's arm, and inserted the needle into the vein to withdraw some blood.

“The moment I finish, I need you to remove the cloth from Henny's arm,” he said firmly. Seconds later he withdrew the needle, forced out any air from the barrel of the syringe, turned, and inserted the needle directly into Henny's vein to infuse it with her husband's blood. After repeating the procedure once more, he stitched up the incision in both of his patients' arms,
secured a bandage around both, and sent the husband away with orders for the man to take a good swig of honey wine and rest.

Dr. McMillan collapsed into the chair and mopped his brow, while Martha sat down on the bed next to Henny and tried to absorb the incredible thought that it was possible to transfer blood from one person to another to save someone's life. She had neither the knowledge nor the skill to even attempt such a thing, and it suddenly occurred to her that after struggling to help this young doctor over the past few months, she had been wrong to consider this man as her professional enemy or to judge all of his methods as wretched.

While it may be the case that midwives were being forced to abandon their work as doctors took over, especially in large eastern cities, here in Trinity, she was in the unique position of having a doctor who was willing to work with her, rather than against her. And if Trinity continued to grow at the current rate, there would be more than enough work to keep both a midwife and a doctor busy.

There was a certain peace about that whole idea now that gave her hope that there was indeed a future here for the midwife who would replace Martha. And she had a whole new respect for the man who claimed her daughter's heart, too.

“I'm very proud of you. You did really well,” she said. “How soon will you know if this will work?”

He blew out a long puff of air. “Her color should improve within a few hours at the most. If it does, we can take that as a good sign. If it doesn't . . . then I've failed. Would you have the time to sit and wait with me?”

“I'd be honored,” she replied. “Truly honored.”