The Pull of the Stars(53)

The first policeman’s shoulders sagged. Well. When she comes in next, tell her she’s obliged to present herself—to turn herself in at Dublin Castle, as a matter of urgency.

I said, Certainly, Constable.

Head skewed around at the end of the mattress, Mary O’Rahilly had been watching this scene play out with fearful eyes. But now a pang seized her; she hauled on her looped towel and let out a long groan.

The policemen fled.

This time I lifted up her right foot and set it against my hip as she pushed. No sign of any progress.

When I got a chance, again over by the sink, I asked Bridie in a whisper: Did you make that up, about not being able to find Dr. Lynn?

Bridie’s mouth was mischievous. Not exactly. They said she was in surgery and they’d get a message to her.

Mary O’Rahilly cried out again.

I hurried back. I palpated her abdomen and used the ear trumpet to check that the foetal heartbeat was still pattering away. She’d been working for—I checked my watch—more than an hour and a quarter now, and the head didn’t feel to my hands as if it had descended an inch. What could be blocking the way?

Such confidence in Bridie’s light blue eyes, turned towards me as if I knew everything, as if all things were possible to me and my lucky hands.

The bladder. Mary O’Rahilly hadn’t emptied it on my shift.

Bridie, a bedpan, right away, please.

I persuaded the girl to lean up on one hip and got the thing under her. You need to pass water to make room in there, Mrs. O’Rahilly. Try to release it. Even a drop.

She sobbed and coughed. There’s nothing there.

I wondered if the foetus’s head was blocking the urethra, preventing liquid from flowing.

I told her, I’m going to let it out for you.

(Such a simple description of a tricky procedure. Yet in the absence of a doctor, I had to try it.)

I got Mary O’Rahilly lying down on her left again. Then I dashed to the sink to scrub my hands and find a sterile catheter as well as a bottle of carbolic solution.

Mary O’Rahilly had her chin on her chest, her teeth bared. She heaved, eyes bulging.

When the pang was over, I told her, You’re doing grand.

She gasped when I poured the cold disinfectant over her privates.

I mouthed at Bridie: Hold her.

Bridie set her hands on the young woman’s ankles.

Mrs. O’Rahilly, stay very still for a minute, please…

I’d inserted a catheter before, but not often, and never into a woman being wracked by labour.

This will sting, I told her, but only for a moment.

Her face screwed up. Somehow I found the opening and slid the greased end in, half an inch. She let out a sharp cry.

But what if everything was pressed out of shape by the small skull—what if I punctured the bladder? I closed my eyes, took a breath. I fed the catheter up into— Urine the colour of weak tea shot all over my apron. Quickly I aimed my end of the catheter into the dry bedpan.

Bridie cried, You did it!

Mary O’Rahilly was pissing like a soldier now, like a horse, like a mountain spring. When the flow trailed off, I pulled out the tube and Bridie carried the bedpan to the sink.

I swiped the dark hair out of Mary O’Rahilly’s eyes and told her with more conviction than I felt, That should help.

She nodded weakly.

Time went by, and it didn’t help. Nothing helped.

I considered an enema but decided that she’d been eating so little, there was probably nothing in her bowels. The pangs kept coming every three minutes, a clockwork torture. For all Mary O’Rahilly’s efforts, nothing in her great taut bump seemed to be descending. Could the head be stuck at the pelvic brim? Nothing was changing except that the young woman was getting limper and paler.

I tried to clear my muddy mind and remember exactly what I’d been taught about obstructed labour. The cause could be passage, passenger, or powers—maybe Mary O’Rahilly’s pelvis was too small or misshapen, or the foetus’s head was too big or had a bad angle of presentation, or the mother was too worn out to expel the foetus on her own.

Please let this not be a case for forceps. They saved lives, but the mothers and babies I’d seen mangled…

I felt Mary O’Rahilly’s forehead—no fever. But when I took her pulse, it was over a hundred, and thready.

Panic rose in me. Between the flu and the strain of labour, she was going into shock.

Intravenous saline.

I told Bridie, Stay with her.

From the sterile trays on the high shelf I snatched a long needle, a tube, and rubber bulb syringe. I filled a bowl to the two-pint mark with hot water from the pan, measured the salt in, then brought it down to blood temperature by adding some cold.

When I tied a catgut ligature above Mary O’Rahilly’s right elbow and tightened it until a sky-blue vein stood out, she barely seemed to notice. Obedient to the next contraction, she gripped the roller towel and pushed her stockinged feet against the bare rails. (The pillow had fallen to the floor, but I couldn’t reach it.) I injected the warm saline and pumped it into her as fast as I could.

Holding her wrist, I counted for fifteen seconds and multiplied by four. Pulse dropping towards ninety already; good. Was the force any stronger, though?

What are you doing, Nurse Power?

It was Dr. MacAuliffe in his smart black suit.