Eutopia: A Novel of Terrible Optimism

At its deepest point, the bowl held about a quarter-inch of the liquid. And it, like the stuff on his hand, was impure. But the particulate that had gathered there was bigger. Andrew held it in the full sunlight and squinted. Was there something like a hand in it? No bigger than a man’s fingernail? Wispy effluvium trailed in the murky liquid, making it impossible to tell.

“Does anyone here have a jar?” he asked. “A clean jar I mean?”

“Sure,” said Norma. “In the root cellar there’s plenty.” She turned to one of the children, and ordered her to fetch a couple.

Andrew set the mirror down carefully. He motioned with his splinted arm to the ground, where the speculum lay. “That will have to be washed,” he said. “Clean it with boiling water and alcohol.”

Norma stayed with Loo, so it was Hank who bent to pick it up. He, and the rest of them, had drawn closer. Any closer, and they’d be blocking out his light. “Wash your own hands first,” said Andrew. “Don’t want Loo to get sick. Not now she’s through the worst of it.”

“Worst of it?” It was Norma. “You mean you’re done?”

Andrew looked back down at the bowl—the grotesque pieces of tissue—the strange shapes they made in the liquid. “Maybe. I don’t think I had much to do. Looks like whatever was in her died on its own. There are pieces of it in this.” He held the mirror out so Norma could see. Her eyebrows raised and her nostrils flared as she sniffed it. “I’d call it a miscarriage if I didn’t know better. As it stands, I’ll still take a look inside. See what troubles this awful sickness has caused her.”

“But you think she’s better,” said Norma. Loo did indeed seem better. The morphine, still in her blood, was back to work now that the panic was over.

Andrew gave a smile he hoped was reassuring. “We’ll see,” he said.

“All done,” said Hank, and handed Andrew the speculum. Andrew took it, and dribbled some of the alcohol on it and through it for good measure. Then he bent back down. “All right, Norma. Same as before.”

Norma reached down and pulled the labia apart, and Andrew leaned closer to insert the speculum. He barely touched it to the girl, however, before the second eruption. This time, Andrew didn’t lurch back, because this time, the fluid coming out was something that his surgeon’s reflexes understood.

This time, it was blood. Lou-Ellen Tavish was haemorrhaging.

§

Andrew had encountered this circumstance four times in his career as a physician. Three of the women who had bled out in the afterbirth had died. The last of those was Maryanne Leonard.

The fourth survived—because the French hospital where she was being seen employed a surgeon who had studied blood typing with Landsteiner and knew enough to pick the correct plasma for transfusion.

If he could find the source of the haemorrhaging and stem some of it, Andrew thought he might be able to save his patient with the blood of a close family member—if he could transfuse enough of it, with the single brass syringe in the doctor’s kit.

But he needed to work swiftly. He shouted to Norma to keep Loo’s vagina open, and he quickly inserted the speculum into the opening, then cleared the tube. Unmindful now of what happened to his specimen, Andrew poured the fluid from the mirror onto the sheet. “Out of the light!” he shouted, and when the families obeyed, he positioned the mirror so the sun lit the opening. He demanded a narrow set of forceps and a swab of cotton dipped in alcohol, and he took it in his injured arm, ignoring as best he could the shooting pain. And he peered up Lou-Ellen’s canal, and transferred the forceps to his good hand. He meant to staunch the bleeding with it, if he could spy the source.

And if he could manage it at all, with his hand-and-a-half. It was one thing to take a temperature and listen to a heartbeat; to tell these hill folk how to wash a table and boil water; even to stitch up a farm boy’s cut hand. It was something else again to save the life of a girl bleeding inside.

It’s even harder, Andrew scolded himself, if you keep thinking about all those troubles and not your patient.

Blood began to flow out through the speculum now, like a drain pipe. Andrew twisted the mirror, so he could see the red-flushed wall of the canal in an inch, but the rest was dark. So he set down the mirror, propped himself painfully on his damaged elbow, and inserted the forefinger of his good hand. He felt for the telltale pulsing of an open wound.

He was not in there long at all, before the thing inside Lou-Ellen Tavish bit down.

Andrew shouted, and pulled his finger out, and transferred his weight to his bad arm so that he cried out again. The finger was covered in Lou-Ellen’s murky blood. At the pad, a dark blood-blister grew.

Now Andrew did stagger back, taking the alcohol-soaked cotton from the forceps and pressing it against his finger. He swore under his breath. If that bite had broken skin…