minutes apart and she hadn’t begun dilating. The infant’s heart rate was unstable. Marina told Dr. Swenson that unless the situation improved they would need to do a cesarean.
And Dr. Swenson said, she was very clear on this, that Marina was to wait. She was not to do the section without her.
“Can you see anything down there?” asked the man in the suit.
“No,” Marina said.
“I don’t know how you can stand it. Me, I can’t do the window seat. If it’s all they’ve got I pull the blind. I tell myself we’re in a bus. I used to not be able to fly at all and I went to a class where they taught us to hypnotize ourselves into thinking we were on a bus. It works as long as I have a drink. Do you want a drink?”
Marina shook her head.
“Part of the paper?”
Marina looked at him. He was pale with high red cheeks, a fellow traveler who wanted her to ask him why he was flying to Miami and if that was his final destination. He wanted her to tell him she was going on to South America so that he could be impressed and ask her what she planned on doing there, and she would do none of that. She would do nothing for him.
She had done C-sections before but on that night she was told to wait and monitor and call back in one hour if there was no improvement. The fetal heart rate dropped and climbed, dropped and climbed, and still the patient wasn’t dilated. Marina paged Dr. Swenson the second time, and she waited and waited but there was no call back. When she looked at the clock she realized that only forty-five minutes had passed, not an hour. The rules were intractable. She had not followed the rules. It was exactly the thing Marina had always admired about Dr. Swenson until she was the one trying to get her on the phone. The patient was a talker, and they had time to talk. She said she was exhausted but that it wasn’t so much the labor. She said her two-year-old had kept her up all night the night before with an earache. Her husband had dropped her off in front of the hospital. He was driving their girls out to his mother’s and that was two hours away. Two hours out and two hours back but at the rate she was going he’d be there for the birth so she said she didn’t mind waiting. She wanted him there. He had missed the first two, circumstances, she said, not his fault. Her voice was strong, louder than it needed to be in the small room. “You always forget what childbirth is like,” she said, “but I don’t remember it being this hard.” Then she laughed a little and said, “That’s the whole point, right? You don’t remember, because if you did remember no one would ever have kids again and then what would happen? That would be the end of everything.” It was one thirty. It was two. It was three. No calls were returned. Marina delivered two other babies while the woman waited and both of the births were so easy they hadn’t needed a doctor at all. Women for the most part knew how to push out an infant. Even when they didn’t know there was no stopping them. Marina went back to check on the woman again. The doctor was terrified, the patient was patient. Back in the days when Marina played this film in her head every hour, waking and sleeping, this was the part she watched most carefully. She slowed down the tape to a crawl. She looked at every frame separately. She was not terrified that the patient would die or that she would lose the baby, she was terrified that she was doing something wrong in the eyes of Dr. Swenson. She was thinking that if she had followed instructions and waited another fifteen minutes to call the first time then none of this would be happening. Surely she had learned her lesson now. Surely Dr. Swenson was almost there. The nurses understood all of this. Even as they were prepping the patient for surgery and calling the anesthesiologist to wake him up they were saying, We’re just getting things ready for Dr. Swenson so she can walk right in. Marina should have called another doctor but she never even thought of it. She had stretched the time out too far trying to cover herself. If she hadn’t waited so long, if she hadn’t waited until everything was crashing and there was no other choice but to go ahead, she would have taken more time.
The plane dropped sharply and then righted itself. It was an air pocket, a blip, but for a split second every person on the plane heard the same voice in their head,
She hadn’t started in the right place. The deeper truth of the story was someplace years before this, at the beginning of her residency, or in medical school that first day of class when she saw Dr. Swenson down in the pit of the lecture hall. There were no words for how much she admired her, her intelligence, her abilities as a doctor. All of the students did. In every moment Dr. Swenson’s students were eager and anxious. She didn’t bother to learn their names and yet they lived their lives to the letter of her law. She was harder on the women in the group. She would tell them stories of her own days in medical school and how when she came along the men knit their arms together to keep her out. They made a human barricade against her, they kicked at her when she climbed over them, and now all the women were just walking through, no understanding or appreciation for the work that had been done for them. It wasn’t that Marina had ever wanted to be like her, it wasn’t in her. She had just wanted to see if she was capable of spending five years of her life living up to Dr. Swenson’s standards, and she wasn’t. All of a sudden she felt drunk. Somewhere very far away she could feel the presence of a man beside her. He had let her go. She could never have told this story to Anders, even if it would have put him on his guard, even if that might have been the thing to save his life. He had three sons of his own, after all. The skin of the patient’s belly was stretched to the point of startling thinness, like a balloon that had been blown up too far. Marina remembered there was a sheen to it. She cut the skin, dug through the fat for the fascia. She had thought there was no time left. Her hands were working at triple speed, and there was the uterus. She thought that she was saving the baby’s life because she was so fast, but the instant she realized he was occiput posterior, looking straight up, the blade had caught his head right of center at the hairline, cutting until she stopped in the middle of his cheek. It used to be that she could feel it in her own face, the straight incision, the scalpel slicing through the eye. The child’s father could feel it when he came back to the hospital that night to find his wife sedated and his son scarred and blinded in one eye. Marina met him in the hallway and told him what she had done. She saw him flinch in exactly the way she had flinched. He was not allowed to see the baby then. The specialists were already working but some things cannot be set to right.
They did not terminate her residency. Marina remembered this with no small amount of wonder. When all of it was over and the lawsuit was settled, she was allowed to go back. The patient had liked her, that was the hell of it. They had spent the whole night together. She wanted the settlement money but she didn’t want Marina’s head on a pike. She said that other than that one mistake she’d done a good job. That one mistake. So Marina was left to mete out a punishment for herself. She could not touch a patient or face her classmates. She could not go back to Dr. Swenson, who had said in the deposition that the chief resident had been instructed not to proceed alone. Over the three hour period the fetal heart rate kept getting lower but every time it reversed. It kept coming up. Maybe in another hour or two she would have dilated. Maybe in another ten minutes the baby would have died. No one knew the answer to that. Marina was a sinking ship and from the safety of dry land Dr. Swenson turned her back and walked away. Marina suspected in the end Dr. Swenson had no idea who she was.
Anders was never going to stay home. Not when there was a chance to leave in the winter and see the Amazon, to photograph the crested caracaras. And anyway, he had already left, he was already dead, she was flying to Brazil in hopes of finding out what had become of his body. She had been up all night with the patient, she had been up all night blinding the child, and now her eyes dropped, opened, dropped. This was the cost of going to find Dr. Swenson: remembering. She went to the lab at Vogel even though she had promised the man beside her on the plane that she would not. She went down the dark hall to their dark lab and there she picked up the picture of the Eckman boys that sat on Anders’ desk, all three of them caught in a fit of hilarity that would hereafter be thought of as belonging to another lifetime. The picture, whose small subjects were so incandescent they seemed to throw off a little light of their own in the dark room, was in her hands when the door opened again. Anders had forgotten what this time? Wallet? Keys? It didn’t matter. She only wanted him back.
“Come now, Mari,” her father said. “It’s time to go.”
It was so perfect that Marina nearly laughed aloud. Of course he was there now, of course. There was a part of the dream that did not follow her into waking — this part — where her father comes into the room and says her name. The part when they are together for a while, the two of them, before things go wrong. The way things ended always obliterated the genuine happiness that had come before and that shouldn’t be the case. The truth was so much more complicated than that. It was made up of grief and great rewards and she needed to remember all of it. “I was looking at this picture,” she said, and held it out to him. “Aren’t these handsome boys?”
Her father nodded. He looked good in his yellow kurta and pressed trousers. He looked fit and rested, a braided belt circling his trim waist. Marina hadn’t thought of it before but they were very nearly the same age now.
