"It's all right," he said. "Everything's fine. Nurse," he called, as the next contraction tightened.
She came at once, carrying the baby, now swaddled in white blankets.
"He's a nine on the Apgar," she announced. "That's very good."
His wife lifted her arms for the baby and began to speak, but then the pain caught her and she lay back down.
"Nurse?" the doctor said, "I need you here. Right now."
After a moment's confusion the nurse put two pillows on the floor, placed the baby on them, and joined the doctor by the table.
"More gas," he said. He saw her surprise and then her quick nod of comprehension as she complied. His hand was on his wife's knee; he felt the tension ease from her muscles as the gas worked.
"Twins?" the nurse asked.
The doctor, who had allowed himself to relax after the boy was born, felt shaky now, and he did not trust himself to do more than nod. Steady, he told himself, as the next head crowned. You are any?where, he thought, watching from some fine point on the ceiling as his hands worked with method and precision. This is any birth.
This baby was smaller and came easily, sliding so quickly into his gloved hands that he leaned forward, using his chest to make sure it did not fall. "It's a girl," he said, and cradled her like a football, face down, tapping her back until she cried out. Then he turned her over to see her face.
Creamy white vernix whorled in her delicate skin, and she was slippery with amniotic fluid and traces of blood. The blue eyes were cloudy, the hair jet black, but he barely noticed all of this. What he was looking at were the unmistakable features, the eyes turned up as if with laughter, the epicanthal fold across their lids, the flattened nose. A classic case, he remembered his professor saying as they ex?amined a similar child, years ago. A mongoloid. Do you know what that means? And the doctor, dutiful, had recited the symptoms he'd memorized from the text: flaccid muscle tone, delayed growth and mental development, possible heart complications, early death. The professor had nodded, placing his stethoscope on the baby's smooth bare chest. Poor kid. There's nothing they can do except try to 'teep him clean. They ought to spare themselves and send him to a home.
The doctor had felt transported back in time. His sister had been born with a heart defect and had grown very slowly, her breath catching and coming in little gasps whenever she tried to run. For many years, until the first trip to the clinic in Morgantown, they had not known what was the matter. Then they knew, and there was nothing they could do. All his mother's attention had gone to her, and yet she had died when she was twelve years old. The doctor had been sixteen, already living in town to attend high school, already on his way to Pittsburgh and medical school and the life he was living now. Still, he remembered the depth and en?durance of his mother's grief, the way she walked up hill to the grave every morning, her arms folded against whatever weather she encountered.
The nurse stood beside him and studied the baby.
"I'm sorry, doctor," she said.
He held the infant, forgetting what he ought to do next. Her tiny hands were perfect. But the gap between her big toes and the oth?ers, that was there, like a missing tooth, and when he looked deeply at her eyes he saw the Brushfield spots, as tiny and distinct as flecks of snow in the irises. He imagined her heart, the size of a plum and very possibly defective, and he thought of the nursery, so carefully painted, with its soft animals and single crib. He thought of his wife standing on the sidewalk before their brightly veiled home, saying, Our world will never be the same.
The baby's hand brushed his, and he started. Without volition he began to move through the familiar patterns. He cut the cord and checked her heart, her lungs. All the time he was thinking of the snow, the silver car floating into a ditch, the deep quiet of this empty clinic. Later, when he considered this night—and he would think of it often, in the months and years to come: the turning point of his life, the moments around which everything else would always gather—what he remembered was the silence in the room and the snow falling steadily outside. The silence was so deep and encom?passing that he felt himself floating to a new height, some point above this room and then beyond, where he was one with the snow and where this scene in the room was something unfolding in a dif?ferent life, a life at which he was a random spectator, like a scene glimpsed through a warmly lit window while walking on a dark?ened street. That was what he would remember, that feeling of endless space. The doctor in the ditch, and the lights of his own house burning far away.
"All right. Clean her up, please," he said, releasing the slight weight of the infant into the nurse's arms. "But keep her in the other room. I don't want my wife to know. Not right away."
The nurse nodded. She disappeared and then came back to lift his son into the baby carrier they'd brought. The doctor was by then intent on delivering the placentas, which came out beauti?fully, dark and thick, each the size of a small plate. Fraternal twins, male and female, one visibly perfect and the other marked by an extra chromosome in every cell of her body. What were the odds of that? His son lay in the carrier, his hands waving now and then, fluid and random with the quick water motions of the womb. He injected his wife with a sedative, then leaned down to repair the episiotomy. It was nearly dawn, light gathering faintly in the win?dows. He watched his hands move, thinking how well the stitches were going in, as tiny as her own, as neat and even. She had torn out a whole panel of the quilt because of one mistake, invisible to him.
When the doctor finished, he found the nurse sitting in a rocker in the waiting room, cradling the baby girl in her arms. She met his gaze without speaking, and he remembered the night she had watched him as he slept.
"There's a place," he said, writing the name and address on the back of an envelope. "I'd like you to take her there. When it's light, I mean. I'll issue the birth certificate, and I'll call to say you're coming."
"But your wife," the nurse said, and he heard, from his distant place, the surprise and disapproval in her voice.
He thought of his sister, pale and thin, trying to catch her breath, and his mother turning to the window to hide her tears.
"Don't you see?" he asked, his voice soft. "This poor child will most likely have a serious heart defect. A fatal one. I'm trying to spare us all a terrible grief."
He spoke with conviction. He believed his own words. The nurse sat staring at him, her expression surprised but otherwise un?readable, as he waited for her to say yes. In the state of mind he was in it did not occur to him that she might say anything else. He did not imagine, as he would later that night, and in many nights to come, the ways in which he was jeopardizing everything. Instead, he felt impatient with her slowness and very tired all of a sudden, and the clinic, so familiar, seemed strange around him, as if he were walking in a dream. The nurse studied him with her blue unread?able eyes. He returned her gaze, unflinching, and at last she nod?ded, a movement so slight as to be almost imperceptible.
"The snow," she murmured, looking down.
But by midmorning the storm had begun to abate, and the distant sounds of plows grated through the still air. He watched from the upstairs window as the nurse knocked snow from her powder-blue car and drove off into the soft white world. The baby was hidden, asleep in a box lined with blankets, on the seat beside her. The doc?tor watched her turn left onto the street and disappear. Then he went back and sat with his family.
His wife slept, her gold hair splayed across the pillow. Now and then the doctor dozed. Awake, he gazed into the empty parking lot, watching smoke rise from the chimneys across the street, preparing the words he would say. That it was no one's fault, that their daugh?ter would be in good hands, with others like herself, with ceaseless care. That it would be best this way for them all.
In the late morning, when the snow had stopped for good, his son cried out in hunger, and his wife woke up.
"Where's the baby?" she said, rising up on her elbows, pushing her hair from her face. He was holding their son, warm and light, and he sat down beside her, settling the baby in her arms.
"Hello, my sweet," he said. "Look at our beautiful son. You were very brave."
She kissed the baby's forehead, then undid her robe and put him to her breast. His son latched on at once, and his wife looked up and smiled. He took her free hand, remembering how hard she had held onto him, imprinting the bones of her fingers on his flesh. He remembered how much he had wanted to protect her.
"Is everything all right?" she asked. "Darling? What is it?"
"We had twins," he told her slowly, thinking of the shocks of dark hair, the slippery bodies moving in his hands. Tears rose in his eyes. "One of each."
"Oh," she said. "A little girl too? Phoebe and Paul. But where is she?"
Her fingers were so slight, he thought, like the bones of a little bird.
"My darling," he began. His voice broke, and the words he had rehearsed so carefully were gone. He closed his eyes, and when he could speak again more words came, unplanned.
"Oh, my love," he said. "I am so sorry. Our little daughter died as she was born."
II
AROLINE GILL WADED CAREFULLY, AWKWARDLY, ACROSS
't the parking lot. Snow reached her calves; in places, her knees. She carried the baby, swathed in blankets, in a cardboard box once used to deliver samples of infant formula to the office. It was stamped with red letters and cherubic infant faces, and the flaps lifted and fell with every step. There was an unnatural welling quiet in the nearly empty lot, a silence that seemed to originate from the cold itself, to expand in the air and flow outward like ripples from a stone thrown in water. Snow billowed, stinging her face, when she opened the car door. Instinctively, protectively, she curved herself around the box and wedged it into the backseat, where the pink blankets fell softly against the white vinyl upholstery. The baby slept, a fierce, intent, newborn sleep, its face clenched, its eyes only slits, the nose and chin mere bumps. You wouldn't know, Caroline thought. If you didn't know, you wouldn't. Caroline had given her an eight on the Apgar.
The city streets were badly plowed and difficult to navigate. Twice the car slid, and twice Caroline almost turned back. The interstate was clearer, however, and once Caroline got on it she made steady time, traveling through the industrial outskirts of
Lexington and into the rolling country of the horse farms. Here, miles of white fences made brisk shadows against the snow and horses stood darkly in the fields. The low sky was alive with fat gray clouds. Caroline turned on the radio, searched through the sta?tic for a station, turned it off. The world rushed by, ordinary and ut?terly changed.
Since the moment she had let her head dip in faint agreement to Dr. Henry's astonishing request, Caroline had felt as if she were falling through the air in slow motion, waiting to hit land and dis?cover where she was. What he had asked of her—that she take his infant daughter away without telling his wife of her birth—seemed unspeakable. But Caroline had been moved by the pain and confu?sion on his face as he examined his daughter, by the slow numb way he seemed to move thereafter. Soon he'd come to his senses, she told herself. He was in shock, and who could blame him? He'd deliv?ered his own twins in a blizzard, after all, and now this.
She drove faster, images of the early morning running through her like a current. Dr. Henry, working with such calm skill, his movements focused and precise. The flash of dark hair between Norah Henry's white thighs and her immense belly, rippling with contractions like a lake in the wind. The quiet hiss of the gas, and the moment when Dr. Henry called to her, his voice light but strained, his face so stricken that she was sure the second baby had been born dead. She had waited for him to move, to try to revive it. And when he didn't she thought suddenly that she should go to him, be a witness, so that she could say, later, Yes, the baby was blue, Dr. Henry tried, we both tried, but there was nothing to be done.
But then the baby cried, and the cry carried her to his side, where she looked and understood.
She drove on, pushing back her memories. The road cut through the limestone and the sky funneled down. She crested the slight hill and began the long descent to the river far below. Behind her, in the cardboard box, the baby slept on. Caroline glanced over her shoul?der now and then, both reassured and distressed to see it had not moved. Such sleep, she reminded herself, was normal after the labor of entering the world. She wondered about her own birth, if she had slept so intently in the hours that followed, but both her parents were long dead; there was no one who remembered those moments. Her mother had been past forty when Caroline was born, her father already fifty-two. They had long since given up waiting for a child, had released any hope or expectation or even re?gret. Their lives were orderly, calm, content.
Until Caroline, startlingly, had arrived, a flower blooming up through snow.
They had loved her, certainly, but it had been a worried love, earnest and intent, layered with poultices and warm socks and cas?tor oil. In the hot still summers, when polio was feared, Caroline had been made to stay inside, sweat beading on her temples as she stretched out on the daybed by the window in the upstairs hallway, reading. Flies buzzed against the glass and lay dead on the sills. Outside, the landscape shimmered in the light and heat, and chil?dren from the neighborhood, children whose parents were younger and thus less acquainted with the possibility of disaster, shouted to one another in the distance. Caroline pressed her face, her finger?tips, against the screen, listening. Yearning. The air was still and sweat dampened the shoulders of her cotton blouse, the ironed waistband of her skirt. Far below in the garden, her mother, wear?ing gloves, a long apron, and a hat, pulled weeds. Later, in the dusky evenings, her father walked home from his insurance office, taking his hat off as he entered the still, shuttered house. Beneath the jacket, his shirt was stained and damp.
