Labor Dolorosa
by Lalitha Khanna
"A windowless receptacle that chronicled the waters of Time gushing out, the labor room was witness to numerous new beings baptized into a life calibrated into little segments of time, some of which were going to be very long and some infinitesimally short."
Like most things in the third world, the coffee room at the hospital was as chaotic as a typical railway station. Snow-white cricketers stood daubed across a raised television screen, the announcers gibbering, while bowls of hot onion-lentil dumplings disappeared down medical throats. Neither the smell of phenol and povidone iodine antiseptic, nor the strewn balls of carelessly crumpled wrappers, detritus of disease, stilled anybody's appetite, although full
spoons did freeze momentarily mid-air each time the bowler accelerated, planted, then hurled at the batsman.
Three coffees later and two wickets down in the England side, she walked briskly, despite her
hefty frame, out into the gyne wards, the golden wheat of skin stretched under her eyes as she took in the milling crowds. Someone said she had the eyes of a wild antelope, but her charm really lay in her placatory smile. That was perhaps the secret of her practice that had grown, Fibonacci fashion, sometimes confounding her peers.
The hospital was woefully inadequate to muffle the pains of this teeming humanity. But then there was not much to distinguish the dolorous ache of a cancerous sore, fresh from a vigorous bout of radiation, or the racking, post-operative throb of a hysterectomy incision, or even the shooting agony of an undiagnosed headache. Who could say? -- she had heard of pain being measured by meters calibrated to trap the most exquisite twinge, a nuance, the slightest tremor.
Her pulse automatically slackened as she kicked off her low-heeled shoes and entered the familiar confines of the labor room. There would be the perfunctory screams and moans punctuated by the frenzied cries of the gyne on duty -- "push push push, you're not trying -- faster, faster now," in a fevered crescendo amidst the wintry sweat.
The room itself was an airless catacomb of constipated groans and high pitched yips from the
rolling unfamiliar birth pains. Through daily tedium, she had got immune to the atmospherics of the place, the human drama of suffering as her professor used to say. The coffee vending machine outside rolled noisily, drowning out the combined effort of all this womanly striving. The stars, lambent echinoderms, hung softly aloof, distant cold lamps providing a grand backdrop to this scherzo of warm human confusion.
The resident on duty was saying, "Sister, stick in two units of synto,'' and that new gyne
professor with her espousal of alternative medicine was telling her own little resident on
duty, "Write out the usual on the discharge slip plus the clotrimazole for 109. Why doesn't someone tell that snivelling female to shut up; whose patient is she? I can hear her right here. Tell her a doctor can't come in every time she gets a contraction." Birth here did not merit the premium space that Western society accorded it. Lamaze classes and loving partnering, one heard -- no, it wasn't possible, not here in this frenzied race to multiply.
The tinkly laugh of the fat dark nurse -- a Catholic convert from Hindu, she said -- was
rather cheery for the labor room. "I'm taking the day off tomorrow. Daughter's school function -- she is the wind goddess in the ballet." (Wind goddess? What was a good Roman Catholic doing in a pagan play?) "Please be quiet," she continued. "Unless there is pain how will the baby come out ? You know that, of course. Do you want the baby or no? If you didn't, you shouldn't have done it."
This leading to a tolerant though amused smile from the young trainee nurse with Afro hair and chipped nail varnish. She was the one who took the polish off her nails with sweet smelling acetone that night, asking almost deferentially, "What do you want it to be doctor, a girl or a boy?" She never knew where that stuffed Dalmatian was. It still lay somewhere under her clothes.
A windowless receptacle that chronicled the waters of Time gushing out, the labor room was witness to numerous new beings baptized into a life calibrated into little segments of time, some of which were going to be very long and some infinitesimally short. It was female, musty, secret pain muffled in those walls. The dull, faded, purple flowers woven on raw cotton on the swaying curtains zooming in and out, she would never forget.
She thought of the sharp shaving razor that nuzzled the vulval pads and greeted the anal
sphincter in just a graze. The catheter was inserted into the triad of female holes, the urine bag clamped to the bladder, the shaming indignity of the enema, the fluids -- urethral, fetal, anal -- all flushed. It was a domain so private that no one could ever share that melon-in-the-anus feeling. It was still etched in the deep recesses of her heart: the rising shafts of blind pain in the pelvis and later the sharp tip of the hypodermic needle piercing the bronze reticulum of skin, the plastic rings to suspend the five percent dextrose bottles swaying dangerously, the wheeling into the OT on castors of jelly, the nebulous state of too much emotion or too diffuse an emotion, the cold spray of the anesthetist on her back before he plunged the epidural, the glare of the scintillant lights in the operation theater. Why was it called the theater? Was it some spectacle to be watched or an orchestrated performance drawing upon the skills of millennia of human evolution? Or was it more of a shamanistic, mammalian orgy, part spectacle, part healing? The Atharva Veda, the Aryan book of moon-gazing healers, that she had browsed through on her last holiday nearly twelve years back, had
this little hymn:
May the Moon, the Lord of Constellations
save me in this my prayer,
in this my act,
in this my priestly duty,
in this my performance,
in this my thought,
in this my purpose and desire,
in this my calling on the Gods.
Her husband insisted that they must have been praying to the Moon and to the lord of mead and
wine. Moon-besotted or drink-besotted, the Aryans were great ones for tippling and gambling, so don't go by the book, he said mockingly.
The new obstetric residents were plainly irritated by the groans of the first-time mother who kept asking for the doctor every five minutes. The Doppler was spewing out the rapid eager thump of a newborn heart in the anteroom. She had read, one coin-yellow afternoon waiting for a patient, that the neonatal heart rate sounded just like the songs of the humpbacked whales in Hawaii.
"Is she a primi? What a racket she's creating. The chap I met last night was in a class by himself. I asked him, Do you know what you are talking about? He was most interested in knowing if I wanted to do optho; imagine after ob/gyne doing eye surgeries. Just so that I can fit into his practice after marriage. My uncle's friend's son; so I couldn't be too rude. I said, fine, you want to mint money but sorry, I'm not in it. And what did you do on your off? Oh really! It's nice to have a husband like that. It's almost eight. Let me push off before my pager starts beeping. Now that you're here you might as well start your duty. I hope I meet a nice guy this weekend."
Memory, she often thought, was a huge lignite bog where stray impressions got compressed, transmuting to thought, muggy-wormy peat converting to neat crystals of coal. Like some giant sandwich, life piled layer upon layer of experience in some primitive arrangement in the brain, which dredged up prehistoric bits and debris in moments of unexpected lightning. At
times, hieroglyphs of pain drifted like lazy streamers across her mind and wound themselves
playfully around her neck like endless spools of thread. At others she was like a black hole
swallowing pain, a sponge that never gave as she listened to women straining to give birth in a never-changing animal rite. It was like a sadist's prescription: pain three times daily. Always professional, apparently callous, those rare times when she lost a patient, she showed a stoic acceptance. Inside she felt something hollow like a white typhoon going round and round her stomach. She simply waited for it to be subsumed by the hundred daily acts of doing rounds, eating breakfast, going into the surgery. The important thing was never to let even a skein of reflective thought pass through the eye of the moment.
Today a PROM case was waiting for her. Ruptured membranes with leaking of the amniotic fluid. There she went -- synto for lactation, synto for induction, as her pediatric friends teased. What a promiscuous molecule. Just as they sneered about the gyne rushing off to a party after a quick surgery instead of waiting for the baby to plop out in its own good time. According to the book, a cesarean was to be performed in case of maternal or fetal distress, but most happened because of gyne distress, the pediatricians accused. Going by their talk, one would imagine gynecologists were the sybarites of the medical world, with no wish at all except to have fun all day long.
As she wrote out her last prescription in the out-patient clinic, stilboestrol 10 mg tds, she heard her name being called on the paging system to report to the OT. Finally the OT was free. The last surgery had taken too long, some oncology case. She scrubbed in a hurry for a lower segment cesarean section, the novitiate residents helping her with the translucent twinkle blue gown. The anesthetist with fashionably long sideburns, her college mate of yore, asked her, "You want a transverse?" as he prepared for a spinal block. A simple D&C had misfired.
He began grumbling: "This Supreme Court ruling's finished life for us. For a piffling fee now I have to labor with this woman. And she might sue me and finish me for life. She wants to have a son after five daughters, you see. We've pumped in eleven bottles of blood. Hope to God I can go home tonight. How did the marriage go, doctor? Check the pressure," this to his assistant. "And I heard, his practice is kaput after the court case?"
It had been a warm night just after the rains. The tamarind tree had been pregnant with salmon pink fronds and she had gone into the hospital as a patient herself. How funny women looked from the top, and that's how she must have looked to her colleagues, too. That's how we must look to men, too, and that they find exciting. Spreading, lumpy flesh from the huge, ungainly boulder thighs and a clump of fuzzy hair, a fleshy rodent caught between the legs. Unlike the movies and the magazines, women wore awful underwear, unwashed and smelly, and in the beginning even to touch them she had felt uneasy. But slowly she got so involved in the pelvis that she rarely remembered the faces at all. Just the palpating with the white-gloved little finger, sometimes stretching the mucus between the forefinger and the thumb and tossing it into the steel dustbin that closed with a scrunch.
She had waited for sixteen hours, just like that thin, mousy woman today with ruptured membranes, her placental fleece giving way to the odorless, curdled whey of amniotic fluid that kept up an incessant dripping. She had felt a little self-conscious especially since she wasn't sure how much pain she could take. She joked with the nurses on duty and thought of the endless babies she had delivered. Why she had chosen this area of medicine, she did not know. To be a deliverer, her rather too clever uncle had smirked. To soothe, it's almost a moral duty now, she told her friend's teenage daughter, who was always peeved that she came back to an empty house day after lonely day. A woman can either be a prostitute or a nurse, she is the eternal mother soothing ruffled emotions and kissing away the hurt, according to some psychologist. But now one heard of father-pangs in men, not just progesterone induced maternal twinges every month. Her first boyfriend, the platonic one, used to say," The best joy in life is bringing a new life into this world." It was supremely ironical that he didn't get through his MD entrance and had to get into a non-clinical stream. He was a pathology consultant now; this espouser of life was a student of death at the government hospital piling cadaver on cadaver after cutting through to their vitals. Did you get anything in life because of ability or love? she wondered as she thought of his shapely fingers executing ligations so perfectly? I am the giant soother, she used to tell her husband as she dangled her shapely breast at his face in those days when they had time to pleasure each other.
That night after the synto she had maintained the steady chatter with the residents who kept telling her that the little passageway to life, her cervix, the guardian of her G spot, had simply refused to dilate. It happened quite a lot that way, what they tossed off as a failed induction or a non-progression of labor. She had guessed there was no point in risking the life of the baby, whose little mineral goulash meant to keep its heart pumping was slowly dwindling by the hour. She had not only seen this ritual of birth everyday but, like a modern day shaman, conducted it too, yet it felt so strange lying in wait passively for the event to occur. They kept inserting the little finger to check the dilatation and it kept burning with pain as the tight little tube kept its riches within. And then they did what she had done so many times, a lower segment C-section.
As she finished lifting the little bundle of vernix and blood out from its velvet resting place, she sighed and left the rest of the stitching to her assistant. The little rigmarole
had to go on endlessly as one birth pang morphed into the next.
The OT nurse came to massage her tired shoulders -- she had done three back breaking episiotomies earlier. She shut her eyes and rested her head on the back of the chair. Hitching up her light blue gown, she let the cool air caress her sweating calves. She should have had the baby ages ago, not when she was forty two. But perhaps there was time yet to do other things. Her residents marveled at the way she matched her earrings with her dresses after a grueling 36-hour schedule, she knew, even as her colleagues sniggered. Her husband, whenever he looked up from his pathology practice, sought his nirvana in her, thank God, even now,
despite that coelenterate, her child-loosed rectus abdomini, wobbling in the middle of her body, and her breasts, veined flour bags tied at the top with sienna ribbons tippling to her abdomen.
One day she would definitely go to the Andaman Islands, unspoiled havens of peace and calm,
forgetting about her flourishing practice, the pneumatic aquamarine and turquoise waters lapping, the cool, silvery lava sparkling with amethyst scintilla, the brilliant fish swanning around in amoral wedges, between and above, around and below the crusty leached coral spines. And somewhere there in the scudding foam she would find her little lost boy, his gray eyes still seeking, his still unsquandered treasure chest of baby smiles intact in the core of silence. And enclose him in the sandalwood embrace of her arms.
Lalitha Khanna is a Delhi-based journalist with a masters in English Literature from the University of Delhi. She has studied German and music, as well. Although she has written for major Indian publications, she has abandoned journalism for fiction and is working on a novel as well as a collection of short stories. Her story, "Softly Through the Incense" was published recently in The Richmond Review.
