The Serpent’s Tale

Eighty-odd miles to the east as the crow flew, Vesuvia Adelia Rachel Ortese Aguilar was delivering a baby for the first time-or trying to deliver it.

“Push, Ma,” said the fetus’s eldest sister helpfully from the sidelines.

“Don’t you be telling her that,” Adelia said in East Anglian. “Her can’t push til the time comes.” At this stage, the poor woman had little control over the matter.

And neither do I, she thought in desperation. I don’t know what to do.

It was going badly; labor had been protracted to the point where the mother, an uncomplaining fenwoman, was becoming exhausted.

Outside, on the grass, watched by Adelia’s dog, Mansur was singing nursery rhymes from his homeland to amuse the other children-all of whom had been delivered easily with the aid of a neighbor and a bread knife-and it was a measure of Adelia’s desperation that at this moment she relished neither his voice nor the strangeness of hearing a castrato’s angelic soprano wafting minor-key Arabic over an English fenland. She could only wonder at the endurance of the suffering woman on the bed, who managed to gasp, “Tha’s pretty.”

The woman’s husband remained uncharmed. He was hiding himself and his concern for his wife in the hut’s undercroft with his cow. His voice came up the wooden flight of stairs to the stage-part hayloft, part living quarters-where the women battled. “Her never had this to-do when Goody Baines delivered ’em.”

Good for Goody Baines, Adelia thought. But those babies had come without trouble, and there had been too many of them. Later, she would have to point out that Mistress Reed had given birth to nine in twelve years; another would probably kill her, even if this one did not.

However, now was not the moment. It was necessary to keep up confidence, especially that of the laboring mother, so she called brightly, “You be thankful you got me now, bor, so you just keep that old water bilin.’”

Me, she thought, an anatomist, and a foreigner to boot. My speciality is corpses. You have a right to be worried. If you were aware of how little experience I have with any parturition other than my own, you’d be frantic.

The unknown Goody Baines might have known what to do; so might Gyltha, Adelia’s companion and nursemaid to her child, but both women were independently paying a visit to Cambridge Fair and would not be back for a day or two, their departure having coincided with the onset of Mistress Reed’s labor. Only Adelia in this isolated part of fenland was known to have medical knowledge and had, therefore, been called to the emergency.

And if the woman in the bed had broken her bones or contracted any form of disease, Adelia could indeed have helped her, for Adelia was a doctor-not just wise in the use of herbs and the pragmatism handed down from woman to woman through generations, and not, like so many men parading as physicians, a charlatan who bamboozled his patients with disgusting medicines for high prices. No, Adelia was a graduate of the great and liberal, forward- thinking, internationally admired School of Medicine in Salerno, which defied the Church by enrolling women into its studies if they were clever enough.

Finding Adelia’s brain on a par with, even excelling, that of the cleverest male student, her professors had given her a masculine education, which, later, she had completed by joining her Jewish foster father in his department of autopsy.

A unique education, then, but of no use to her now, because in its wisdom-and it was wisdom-Salerno’s School of Medicine had seen that midwifery was better left to midwives. Adelia could have cured Mistress Reed’s baby, she could have performed a postmortem on it were it dead and revealed what it died of-but she couldn’t birth it.

She handed over a basin of water and cloth to the woman’s daughter, crossed the room, and picked up her own baby from its wicker basket, sat down on a hay bale, undid her laces, and began to feed it.

She had a theory about breast-feeding, as she had for practically everything: It should be accompanied by calm, happy thoughts. Usually, when she nursed the child, she sat in the doorway of her own little reed-thatched house at Waterbeach and allowed her eyes and mind to wander over the Cam fenland. At first its flat greenness had fared badly against the remembered Mediterranean panorama of her birth, with its jagged drama set against a turquoise sea. But flatness, too, has its beauty, and gradually she had come to appreciate the immense skies over infinite shades of willow and alder that the natives called carr, and the richness of fish and wildlife teeming in the hidden rivers.

“Mountains?” Gyltha had said once. “Don’t hold with mountains. They buggers do get in the way.”

Besides, this was now the homeland of the child in her arms, and therefore infinitely beloved.

But today, Adelia dared not indulge either her eyes or her mind for her baby’s sake. There was another child to be saved, and be damned if she was going to let it die through her own ignorance. Or the mother, either.

Silently apologizing to the little thing in her arms, Adelia set herself to envisaging the corpses she’d dissected of mothers who’d died with their fetuses yet undelivered.

Such pitiable cadavers, yet when they were laid out on the marble table of the great autopsy hall in Salerno, she’d withheld compassion from them, as she’d learned to do with all the dead in order to serve them better. Emotion had no place in the art of dissection, only clear, trained, investigative reasoning.

Now, here, in a whiskery little hut on the edge of the civilized world, she did it again, blanking from her mind the suffering of the woman on the bed and replacing it with a map of interior organs, positions, pressures, displacements. “Hmm.”

Hardly aware she was doing it, Adelia withdrew her baby from her left, now empty, breast and transferred it to the other, still calculating stresses on brain and navel cord, why and when suffocation occurred, blood loss, putrefaction…“Hmm.”

“Here, missis. Summat’s coming.” The daughter was guiding her mother’s hands toward the bridle that had been tied to the bed head.

Adelia laid her child back in its basket, covered herself up, and went to the bottom of the bed.

Something was indeed emerging from the mother’s body, but it wasn’t a baby’s head, it was a baby’s backside.

Goddamn. A breech birth. She’d suspected it but, by the time she’d been brought in, engagement in the uterus had taken place and it was too late to insert her hand and revolve the fetus, even if she’d had the knowledge and daring.

“Ain’t you going to tug it out?” the daughter asked.

“Not yet.” She’d seen the irreparable damage caused by pulling at this stage. Instead, she addressed the mother. “Now you push. Whether you want to or not, push.”

Mistress Reed nodded, put part of the bridle in her mouth, clamped her teeth on it, and began pushing. Adelia gestured to the girl to help her drag the mother’s body farther down the bed so that her buttocks hung over the edge and gravity could play its part.

“Hold her legs straight. By the ankles, behind me, behind me, that’s right. Well done, mistress. Keep pushing.” She herself was on her knees, a good position for delivering-and praying.

Help us, Lord.

Even so, she waited until a navel appeared with its attached cord. She touched the cord gently-a strong pulse. Good, good.

Now for it.

Moving quickly but with care, she entered her hand into the mother’s cavity and released one leg, then the other, flexing the tiny knees.

“Push. Push, will you.”

Oh, beautiful, sliding out by themselves without having to be pulled were two arms and a torso up to the nape of the neck. Supporting the body with one hand, Adelia laid the other on the little back and felt the tremor of a pulse.

Crucial now. Only minutes before suffocation set in. God, whichever god you are, be with us now.

He wasn’t. Mistress Reed had lost strength, and the baby’s head was still inside.

“Pass over that pack, that pack.” In seconds, Adelia had extracted her dissection knife, always kept clean.

“Now.” She placed the daughter’s hand on Mistress Reed’s pubic region. “Press.” Still supporting the little torso,