with serious hemorrhage.
He begged the husband to hack him some ice—the strong fellow had brought a whole block, borrowing the ice company’s tongs for this purpose and standing in the kitchen with the tongs on his shoulder in a menacing fashion. The block of ice could cool the uteri of several bleeding patients; to apply it whole, to a single patient, would likely crush the uterus, if not the patient. At this moment the grandmother lost her grip on the soapy child and dropped it among the dishes soaking in the cold-water sink; this happened the instant that the husband again trod upon the cat.
Seizing the moment, when he saw that the grandmother and the husband were distracted, Larch grasped the top of his patient’s uterus through her abdominal wall and squeezed hard. The woman screamed and grabbed his hands; the grandmother, abandoning the baby among the dishes, tackled Larch at the waist and bit him between the shoulder blades. The husband retrieved the child from the sink with one hand, but he raised the ice tongs over Larch with the other. Whereupon, lucky Wilbur Larch felt the placenta separate. When he calmly pointed to its appearance, the grandmother and the husband seemed more in awe of it than of the child. After washing the baby himself and giving the mother some ergot, he bowed a wordless good-bye. Leaving the apartment, he was surprised to hear a commotion almost the instant he closed the door: the grandmother, the iced patient, the husband—all shouting in Lithuanian—and the baby giving forceful voice to its first family quarrel. It was as if the delivery, and Dr. Larch’s entire appearance, had been only a brief interruption to a life of unintelligible turmoil.
Larch navigated the dark stairs and groped his way outside; he stepped on a rotting head of lettuce, which gave under his foot with the disquieting softness of a newborn baby’s skull. This time he did not confuse the cat’s terrible yowl with the sounds a child can make. He looked up in time to see the object flying through the window of the Lithuanian apartment. He was in time to dodge it. It had clearly been hurled at him, and Larch wondered what particular, perhaps Lithuanian, offense he had caused these poor people. Larch was shocked to see that the object thrown from the window—and now dead on the ground at his feet—was the cat. But he was not that shocked; for a passing second, he feared it might have been the child. He had been told by his professor of obstetrics at Harvard that “the tensile strength of the newborn” was “a marvel,” but Larch knew that the tensile strength of a cat was also considerable and he noted that the beast had failed to survive its fall.
“Here in St. Cloud’s,” Dr. Larch would write, “I am constantly grateful for the South End of Boston.” He meant he was grateful for its children and for the feeling they gave him: that the act of bringing them into this world was perhaps the safest phase of their journey. Larch also appreciated the blunt reminder given him by the prostitutes in the South End. They recalled for him the painful gift of Mrs. Eames. He could not see the prostitutes without imagining their bacteria under the microscope. And he could not imagine those bacteria without feeling the need for the giddy warmth of ether—just a sniff; just a light dose (and a light doze). He was not a drinking man, Dr. Larch, and he had no taste for tobacco. But now and then he provided his sagging spirits with an ether frolic.
One night, when Wilbur was dozing in the South End Branch of the Boston Lying-In, he was informed by one of the doctors that there was an emergency arrival, and that it was his turn. Although she had lost a lot of weight and all of her youthfulness since Larch had last seen her, he had no trouble recognizing Mrs. Eames. She was so frightened, and in such intense pain, that she had difficulty catching her breath, and more trouble telling the nurse-receptionist her