Survivor Song(70)



Killing Natalie and then performing the procedure is not an option. A mother cannot be oxygen-dead for more than four minutes or the child will not survive. Those four minutes cannot be negotiated or bargained with. C-section births normally take ten to fifteen minutes in ideal conditions. Given she doesn’t have to worry about Natalie surviving the procedure, Ramola should be able to decrease the timeline, but there’s no way she can perform it in less than four minutes.

Ramola will wait for help or—if she has no choice but to attempt the procedure herself—wait until Natalie slips into a coma.

Still, while the virus’s incubation period and post-infection timeline have exponentially sped up, Ramola does not know how long it will take for Natalie to pass into deep unconsciousness. In addition, she does not know how long her body’s basic functions will continue while comatose. What if Natalie were to die in the middle of the procedure, a distinct possibility whether or not she is in a coma? That four-minute clock would again be ticking for the baby.

Ramola leaves the chair, walks to the bed, and says, “Reasonably confident. A medical shrug.”

Natalie howls.

Ramola’s body is in the chair in the bedroom that is attached to the hallway that is in the house that someone else built.

Inside Ramola’s head, she is on the bus to the clinic sitting next to Natalie. There are other people in the seats near them but they are blurry, indistinct, and she doesn’t think about them. Ramola is in the aisle seat, facing the window. Natalie leans against the window, gapes at her phone, finger dangling above the screen. Ramola stares at the reflection in the window.

After pacing the length of the hallway with her phone, Ramola goes to the bedroom. To drown out Natalie’s cries and the groaning mattress upon which she struggles, Ramola recites a version of the fairy tale “Fundevogel.” While she has retained certain key lines, she hasn’t committed the entire story to memory as with “The Wedding of Mrs. Fox.”

“A forester on his rounds found a child on top of a high tree. She had been snatched out of her mother’s arms by a large bird. The forester took the rescued child home to live with him and his daughter, Nats. She named the found child Rams. Nats and Rams got along quite well and loved each other very much. One morning the forester left for a three-day trip. The nasty old cook then pulled Nats aside and told her he was going to boil and eat poor little Rams. Well, Nats wasn’t standing for any of that, so she told Rams about the cook’s scheme and they ran away and hid in the forest. The old cook sent a group of terrible men after them and they quickly caught up. Only moments before capture, Nats said to Rams, ‘Never leave me and I will never leave you.’ Rams said, ‘Neither now, nor ever.’ Then Nats said, ‘Do you become a rose tree, and I the rose upon it?’ When the terrible men arrived they found only a rose tree and one rose on it. The children were gone. The men went back to the cook and reported finding nothing. Outraged at the men’s stupidity, the old cook went out into the woods himself. The children saw him coming. Nats said, ‘Rams, never leave me, and I will never leave you.’ Rams said, ‘Neither now, nor ever.’ Nats then said, ‘Be a fishpond, and I will be the duck upon it.’ The old bumbling cook nearly ran into the pond. Tired and despairing, he lay down at the shore to drink it up but the duck swam to the cook, grabbed his head with her beak, and dragged him into the deep water, drowning him. Nats and Rams went home together, their laughter echoing through the forest, and if they have not died, they are living together still.”

Ramola retells the fairy tale from the beginning to keep from crying.

Natalie is tiring, losing to the infection. Her shouts have become the mumbles of a person talking in her sleep. Her eyelids flicker but do not remain open. Ramola wonders if her fading consciousness is the sole work of the virus or of possible aortocaval compression syndrome as a result of her lying on her back for an extended period. Such a position is not advisable for even healthy patients and could be placing stress on the baby, but Ramola cannot safely move Natalie onto her left side.

Ramola places two hands on Natalie’s abdomen. The baby moves and lashes out. She says, “I don’t know if I can do it.”

She thinks, but doesn’t say: I don’t want to do this. I can’t do this. I won’t do this.

Natalie squirms under her hands. Ramola lifts them away as though she touched a hot stove.

As a medical student, Ramola assisted with more than a half dozen C-sections during her six-week OB/GYN rotation. For most of the procedure she simply observed the attending obstetrician and a resident perform the surgery. She was often tasked with retracting the abdominal wall to give the obstetrician a clear view of the surgical field. The abdominal rectus muscles are generally not cut during the procedure and are instead separated and moved to the side. During her final C-section as a medical student, they allowed Ramola to tie three sutures as the uterus was being closed up.

As a pediatric resident Ramola had to complete newborn nursery rotations and was often on call nights. When summoned to the OR for C-sections her job then was to take the newborn, ensure the baby was stable, and to perform any resuscitation that might be necessary. She was not standing at the operating table in those instances, but in those hazy, overworked, late hours, she would often fight to keep focus by following the discussion/instructions between the obstetrician, the OB resident, and nurses.

Ramola retells the fairy tale. And then retells it again.

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