The Mountain Midwife (8 page)

“It’s cold outside.” Sofie freed her hand and dragged a tissue out of her pocket. “I am so sorry. I’m worried about
mi madre
. She’s such a fool.”

“Did something bad happen with the delivery she wasn’t supposed to assist with?”

Sofie covered her face with her hands and rocked back and forth, gasping and hiccuping.

“Do you want to go home? We can schedule another day to help you study for your boards. Or do you want to talk after Mary Kate leaves?”

“I can’t.” Sofie shook her head. “I want to go home.” She lowered her hands. “I mean, I need to go all the way home, Ash. Back to the Valley.”

Ashley’s heart plummeted. Sofie didn’t mean the New River Valley there in Virginia; she meant the Rio Grande Valley in south Texas.

“Only for a week or two.” Sofie spoke too quickly. “You don’t have any births due in that time, and if someone is early, you can call one of the other birthing assistants, or even Heather. You know Heather will do anything for you.”

She would. The two of them had attended the graduate program in nurse-midwifery at Shenandoah University together. Instead of taking up a solo country practice as Ashley had, Heather chose to
join an OB-GYN practice with midwives on staff for hospital deliveries because her husband liked the hours available for her better. Heather could help in an emergency, and Ashley preferred her to most of the subcontracted birthing assistants available in the area.

“All right.” She hesitated. “What about studying for your certification?”

“I’ll still study. I promise. And I’ll be back in time to take the exam.”

“Do you want to tell me what this is about?”

Sofie bit her lip. “
Mi madre
—”

Ashley’s phone vibrated in her pocket, the pulsing signal she had set up to show she had missed a call. Not wanting to interrupt Sofie, Ashley ignored the summons, figuring anything could wait two minutes.

Sofie rose. “We better wake up Mary Kate.”

She was right. Still, Ashley recognized a stalling action.

“We’ll talk later—before you go.” Hoping that was taken as she meant it—Sofie wasn’t going without more of an explanation as to the problem with her mother—Ashley entered the exam room to shake Mary Kate awake.

As Mary Kate stretched and yawned, her coloring looked better and her eyes clearer.

“Just how little sleep are you getting?” Ashley asked.

Beyond the examination door, she heard the backdoor close and Sofie’s car engine rev, and Ashley’s own blood pressure increased with annoyance.

“I worked until midnight last night.” Mary Kate sat up and smoothed down her skirt. “One of the other girls didn’t come in, so I worked the extra shift. The drunk guys who come in from the bar to sober up give good tips.”

“But Boyd didn’t sleep?”

“He has nightmares. I couldn’t get him to go back to sleep.” She began to unbutton her sleeve to roll it up. “I should wear something more practical for this.”

“It’s okay. That blouse is thin enough for me to get a good reading through it.”

Too thin for the weather.

Ashley stuck the ends of the stethoscope into her ears and wrapped the blood pressure cuff around Mary Kate’s plump upper arm. “Just relax.”

Mary Kate closed her eyes and breathed slowly. In those breaths, Ashley heard a hitch, a faint rattle. She must listen to her lungs, she decided. She wasn’t qualified to diagnose nonreproductive conditions, but with her nurse’s training and experience, she recognized many common conditions. This one concerned her.

So did the blood pressure.

“Let me listen to your lungs.” She moved the bell of the stethoscope to Mary Kate’s back, then just below her collarbone. The rattle was there, but faint.

“I think I have a bit of a cold,” Mary Kate said.

Ashley set her equipment on the credenza before turning to her patient. “Mary Kate, I can’t diagnose you, so I won’t say anything except you might want to consider going to the doctor.”

“I can’t.” Mary Kate’s voice cracked. “I can’t miss work.”

“You can’t go to work in your condition. You’re sick. You are seven months pregnant, and your blood pressure is on the edge of being too high for me to continue to treat you.”

“Can’t you give me something?” Mary Kate began to twist her hands together faster and faster. “I know there are herbs and things. Granny Parrish in Gosnoll Holler—”

“Don’t you dare.” Ashley’s reaction was instinctively sharp.

The old woman should have been arrested decades ago for practicing medicine without a license. She had probably killed more than one witless “patient” over the past three-quarters of a century. Gramma Tolliver had seen to it the woman didn’t deliver babies, and now she wasn’t physically capable of doing so, but she still dispensed herbs and other potions with abandon.

“You can give me something not too expensive,” Mary Kate insisted.

“I wish I could.” If she had been able to go to med school . . . “But this is beyond my scope of care. And you know I’m not one for herbs. They’re too unpredictable in potency.”

“I can’t afford no doctor. I gotta get to work.” Breathing hard, the wheeze obvious without the stethoscope now, Mary Kate shoved herself to her feet. “I’m gonna be late.”

Ashley stepped into the doorway to waylay her patient’s departure. “I can’t in good conscience let you go to work.”

For a moment, the two women faced off, Ashley taller, Mary Kate heavier. Then Mary Kate heaved a sigh that ended on a cough and nodded. “All right. I’ll go to the urgent care if I start coughing harder.”

“I’d rather you went to Dr. White. I’ll give him a call to be expecting you. He’ll fit you in.”

Mary Kate grimaced. “And want money up front.”

“Don’t worry about the money.” Ashley held up her hand. “I’ll pay him from your account and you can keep paying me off as long as you need to.”

“All right. All right. I said I’d go if I get to feeling worse.” Mary Kate’s lips thinned. “Now I gotta get going.”

“Let me drive you.” Ashley led the way from the exam room
and snatched her own coat off its peg. Her handbag was upstairs. She held up a hand to halt Mary Kate’s progress to the back door. “Let me fetch my purse, and I can drive you into town.”

“But then I won’t have no way home.” Mary Kate pressed her hands to her rounded belly. “I gotta work. Sitting around a doctor’s office don’t pay the rent.”

“I know, but, Mary Kate, your condition is—could be serious.” Ashley rested her hands on the younger woman’s shoulders. “You do trust me to know this, don’t you? I delivered your other baby.”

“And all went just fine. It will again this time.” Mary Kate smiled, her blue eyes growing bright and beautiful as she did so. “I don’t trust nobody more than you.”

“Then trust me when I say you need to consider using a medical doctor.”

Mary Kate shook her head. “I’m going to be late for work if I stop at the doctor’s, and Roline needs me to help with lunch prep.”

“All right.” Ashley shoved her hands into her jacket pockets and sought for a compromise.

She couldn’t force Mary Kate to the doctor short of physically restraining her. Sadly, if she hadn’t built up enough trust with her patient over the past two years years and the other delivery for Mary Kate to simply do as she said, then Ashley was doing something wrong. That the last pregnancy had gone well was no excuse.

Flexibility, though. That was what Momma always said was the beauty of midwifery over traditional medical care. So Ashley must be flexible in how she handled Mary Kate’s situation.

“What if I come to the diner tomorrow and see how you’re doing? I can listen to your lungs in the office or my Tahoe, if you like.”

Mary Kate grimaced. “You mean if you like.” Her face softened into a smile. “Don’t worry, Miss Ashley. I’m pregnant, not sick or dying. I’ll be right fine in a day or two.”

Ashley had heard that line before, as though using a midwife immunized women from the vagaries of the human body.

“All right. I’ll look in on you.”

Mary Kate departed with a cheery wave and a bark of a cough.

My fault. If she doesn’t trust my recommendation, then I have done something wrong.

Grinding her molars with frustration, Ashley yanked her phone from her pocket to call Sofie. The Missed Call notice still flashed on her screen. A 703 number. Northern Virginia, but not her brother who lived there. Not a number in her contacts. She frowned. Who would call her from a couple hundred miles away?

She started to tap the number to return the call when she noticed the person had left a voice mail. Probably someone in marketing clever enough to hear the message on her other phone and call this one, or perhaps someone interested in being added to her birthing assistant list, or—

She touched her thumb to the Home key to unlock the phone and listened to the voice mail.

“Miss Tolliver.” A zing hummed along Ashley’s nerves at the sound of the mellow male voice rumbling through the speaker. “This is Hunter McDermott. You don’t know me and—”

She didn’t know him, but the name sounded familiar. So did the voice. But even with her eyes closed, she couldn’t recall a face to go with name or voice.

“I am looking for a woman named Deborah Tolliver.”

A pang clenched Ashley’s heart at the mention of her grandmother, deceased now for six years. Uneasiness followed. She couldn’t
imagine why anyone would be looking for her grandmother after all this time, especially someone from near Washington, DC.

“Do I possibly have the correct Tolliver?”

Sort of.

Ashley tucked one cold hand into her coat pocket and gripped the phone with the other hand so hard her fingers went numb.

“If I do not, please just ignore this message. If I do, will you please have her return my call? Again, my name is Hunter McDermott and my number is . . .”

He recited the number on the caller ID and the message ended.

Ashley lowered the phone to look at the screen. He didn’t have the right Tolliver. She was gone, buried with her granddaughter’s decision to go to medical school, but, unlike those ambitions, Gramma wasn’t going to return. She should simply delete the message and let him think he had the wrong Tolliver. After all, no one from the city needed to contact Gramma if they didn’t even know she was dead.

She deleted the voice mail and changed menus to call Sofie and ask her where she had gone and what was going on. But before she tapped her assistant’s number, she thought about Mr. McDermott calling and about all the trouble Sofie’s mother had gotten into falsifying birth certificates on the border, and the cold seeped deeper than her hands, than her skin, right to her marrow.

Surely Grandmomma had done nothing illegal like that. She kept scrupulously neat and precise records of every baby she caught—nearly six thousand in her fifty years of practicing midwifery.

But what if she hadn’t recorded every birth? Ashley hadn’t yet recorded last night’s birth. She would, and yet the incidents subsequent to the birth had put record keeping out of her head. The only thing worse than not recording a birth was falsifying that birth record, as Sofie’s mother had done.

As if thoughts of her caused it to happen, Sofie’s ringtone pierced the quiet of the autumn morning. Ashley paused at the foot of the driveway to stop the Texas blues song in the middle of a chord. “Where did you go?”

“Home to pack. I’m flying out from Roanoke in three hours.” Sofie sounded calmer, but a hint of accent suggested the stress she was under.

Despite being born and raised on the U.S. side of the Rio Grande River, Sofie had grown up in a community more inclined to speak Spanish than English and, when she was under stress, her flawless English slipped.

“What’s going on?” Ashley heard the rumble of a car engine and retraced her steps up the driveway a dozen feet.

A white SUV drove past far below the forty-five-mile-an-hour speed limit. With memory of her cut phone line fresh in her mind, Ashley retreated another dozen feet and leaned against the trunk of a black walnut tree.

Sofie hadn’t yet answered.

“Sofia.”

Sofie sighed. “
Mi madre
helped in a birth she shouldn’t have and the baby was dead.”

“Oh no.” Ashley felt sick—for the mother of the stillborn child, for Sofie’s mother, for Sofie herself. Nothing about this situation could turn out well.

“I know.
Mi madre
will likely go to jail over this one, and who will take care of the children?”

Sofie’s five younger siblings.

A flash of anger rocketed through Ashley. “Your father so you can take your certification exam?”

Sofie snorted.

And the white SUV returned down the road along the other side.

“I’d better get going.” Sofie’s voice held a hitch, a hiccup or sob. “I’ll study. I’ll be back in time. But I have to go now.”

“Wait, don’t hang up,” Ashley said as the white SUV braked and turned into her drive.

C
HAPTER
7

A
SHLEY HALTED AT
the foot of the drive, one hand on the cell phone in her pocket, the other raised against the sunlight making its way over the mountains to the east and streaming into her eyes. As the vehicle turned fully onto the drive and stopped, she noticed that the driver was a man, potentially a patient’s husband. Sometimes a husband called or visited her to talk about his wife’s condition or ask questions he didn’t want his wife to hear. She encouraged it so the husband could be good support when the woman went into labor and needed extra help after the birth of the baby. She encouraged such support, but not that morning.