Tammy's screams were becoming louder, and her grunts and groans steadier. Was something wrong? One thing was for certain, she would be glad when the screaming stopped. It was getting on her nerves. The baby kicked inside of her, and she knew the child within felt the same way.
****
Joan was trying to keep her doctor face on. Be confident. Don't show the worry. Don't show the concern. Just keep coaching. The word "Caesarian" floated across the calm surface of her mind, sending little ripples throughout her brain.
The baby was lined up. It was coming out head first. The umbilical cord was as it should be, which had honestly been her biggest concern. The issue was Tammy's frame. She was small down there; her dilation wasn't where it needed to be to give birth to the baby.
She would give this as long of a chance as she could… that word floated across her mind again, an unmanned pontoon filled with all sorts of complications. Making the incision, pulling the baby free, and then maybe infection. No, there was still time. This could happen the natural way.
Another contraction hit Tammy, and she screamed. Joan didn't know what to do. It finally hit her. I'm out of my league here. With a manual, a textbook, a fucking youtube tutorial, any of those things, and she would have felt more confident. But all she had at her disposal was her own knowledge, the things she remembered from medical school. She was not a surgeon and had never wanted to be a surgeon. She'd never wanted to be a fucking obstetrician either, but here she was.
Keep cool. Keep your doctor face on.
"Katie, I need you to run outside and tell Theresa and Liz to find our sharpest knife. Boil it, and bring it in here."
She thought about the equipment she carried in her bag, some scavenged antibiotics, some Advil. She had one set of sutures, but they weren't designed for something like a Caesarian section. God, if I do this, how am I going to keep her alive. Oh, God.
Keep cool. Keep your doctor face on. You can do this.
Katie ran from the room.
Tammy screamed again, the head of her child pressing to get out. But Tammy was too small. If that baby came out the natural way, it would rip Tammy apart.
She knew the truth of it. She'd been fighting it for an hour. She was going to have to cut her open, or else Tammy would die.
Joan didn't know how she kept sweating; she thought that by now, her body would have run through all of the water in her body. Joan stood up straight and put a hand on Tammy's knee. "Like a Band-Aid," her old instructor had told her. Don't beat around the bush; just get the news out there.
"Tammy, I think we're going to have to do a Caesarian birth."
"A what?" Tammy groaned through clenched teeth.
"A c-section."
Mort looked at Tammy, confused. "What's that?" he asked.
"I'm going to have to operate on her to get the baby out."
"No, no, no, no…" Tammy chanted.
"It's the only way," she said firmly, leaving no room for any doubt.
"No, no, no, no," Tammy repeated.
"It's going to hurt. You might still die, but for you and the baby, it's the best shot you both have to be together. You do want to be there for this baby, don't you, Tammy?"
"Yes, yes, yes, yes," Tammy chanted before another contraction seized her body.
****
Theresa brushed the flat of her tongue against the roof of her mouth. A layer of SPAM grease still resided there. She had hated SPAM as a child. It was too salty, and the smell of it fried in a pan hung in the air forever. But her parents had been poor, and SPAM was cheap. They had SPAM for breakfast. They ate SPAMburgers instead of hamburgers to save money. On the rare occasions that her mother had made salad, she would throw cubes of cut-up SPAM in there with it to class it up a bit. She had grown to detest the meat. But now, with the growing baby inside of her, it tasted like a slice of salted heaven.
Katie came out, duckwalking from the ranger station. She was in a hurry. "We need your sharpest knife," Katie said.
"What for?" Liz asked.
"I think Joan's going to do a c-section."
Theresa fell silent, as did Liz. For Theresa, the silence wasn't so much that she was afraid for Tammy; it was that she imagined herself in Tammy's position. Poor Tammy must be scared out of her mind.
"I'll get one," Theresa said.
She waddled off to the trailer. In the small kitchenette, she pulled open the drawers. In truth, most of their knives needed sharpening; they had been dull well before they had come out to the ranger station. Now they were used all the time to cut the bear steaks, which, even though she tenderized the shit out of them, were still kind of tough. She pushed the bulky butcher knife to the side. It was probably the dullest of the bunch, its size useful for everything from slicing onions to hacking off chunks of bear meat for steaks. She didn't think the serrated steak knives would do either. She shuddered at the thought of the serrated edges catching and ripping the flesh of her abdomen. That left the paring knife. Small, mostly useless. She didn't remember a time when she had ever really used it. She hadn't ever pared anything, but they had the knife anyways. She thought it was about the size of a scalpel, at least the ones she had seen on the TV. It was maybe a little larger.
She carried it outside along with a pair of tongs.
The other ladies looked at the
