Читать книгу The Ends of Kinship - Sienna R. Craig - Страница 14

“This won’t hurt, but it will be cold.” The ultrasound technician held a bottle of lubricant above Tsering’s belly and squirted. Tsering grimaced. Jamyang stood beside her, holding her hand and staring at the monitor.

“I am going to move this around a little bit,” the technician continued, working the sonogram probe. “There’s the little face! Are you sure you don’t want to know if you are having a little princess or a big boy? Oh, I just love this part of my job!”

The technician, who seemed younger than Tsering, looked vaguely Asian but spoke with a decidedly American accent. Her words ran together. Although Tsering had been in New York for a few years now, she struggled with the pace of American speech, the assumptions. If she ever became a nurse, she would remember to speak slowly, with clear precision.

“No, we want surprise,” Jamyang answered.

Tsering was into her third trimester. She could no longer tie her shoes with ease, but her days with Aiden and Lucy passed smoothly and brought comfort. She felt, more than ever, like these American children were helping to prepare her for her own imminent motherhood. She was beyond the hormonal waves that had left her irritable, and she was so visibly pregnant that people gave up their seats for her on the subway.

Tsering was also grateful that she worked for a kind American couple. Many of her friends had not been as fortunate, sharing stories of verbal abuse, withheld pay, even outright sexual harassment as fathers cornered them in bathrooms, groped them in garages. Tsering dealt with none of this. Instead, she had a beautiful woman for a boss who ran an art gallery in Chelsea. The husband taught at Columbia. They were generous.

The family she worked for had promised a crib, baby clothes, even a party. Tsering wanted to accept these things, but she heard her mother in her head when she told her boss that, while she appreciated these gifts, could she please hold off on giving them until after the baby was born? Too much preparation, like too much talking, could bring bad luck. Before she’d told her mother about the pregnancy, Tsering had never considered this particular pattern of cause and effect, but this idea followed her like an echo.

“Is baby position good?” Tsering asked.

“Let’s just take a look, shall we?” The young technician found the heartbeat, hummingbird quick and just as strong. This made Tsering relax. Her breathing slowed as she imagined her child nestled within her waters.

“Hmm.” The technician paused. “Hmm.” She said again. This did not inspire confidence. “Dr. Sharma will be here soon. You just hang tight there for a minute, little mama. Everything will be fine.”

Tsering shot Jamyang a look. It was a look of both fear and incomprehension. His English was better, in part because he listened to harried New Yorkers from the front seat of his cab all night and into the early morning hours. His job was a television serial: fast paced, full of drama and innuendo. She practiced her English with a toddler and a preschooler.

“Is something wrong?” Jamyang asked.

“I am sure everything will be fine,” the technician repeated, her tone now flat. Jamyang reached for Tsering’s shoulder. The technician left. Ten interminable minutes passed before Dr. Sharma came into the room. She smiled at Tsering, her almond eyes probing, generous.

“Namaste! It is good to see you, Tsering. Jamyang. Now, let me take a look.” Dr. Sharma turned her attention toward the ultrasound machine, running the wand over Tsering’s belly, exposing her inner world. She worked for a moment in silence, breathing slowly.

“Yep,” she said. Then, kindly but with a directness that unnerved Tsering, she asked, “Do you have a history of difficult pregnancies in your family? This is your first child. You’re young and healthy. So, what I’m seeing is a bit unusual.”

Tsering stared at her, unsure of how to respond. After a few moments, she said, “My mother had my brother and me. There was no problem from what I know.” Tsering did not mention that her brother had been born on a bus, that she had come into this world on the dirt floor of a village home. “My grandmother died when my mother was young, so I don’t know about her. I never met her.”

“Okay,” Dr. Sharma said. She could sense Tsering’s fear. “Please do not worry. You and your baby are going to be fine. But you will need to take extra care, and you will probably need to have a Cesarean section—an operation to get the baby out.”

Tsering sucked in her breath. Her boss had Lucy by C-section, and Lucy was gorgeous and clever. She knew other women from Mustang who had given birth this way. But she had also heard stories about doctors telling women that their hips were not wide enough to have a natural birth. She remembered her mother and other elder women criticizing those who gave birth by operation. Could they not bear the pain? Were they not strong enough?

“Is operation necessary? Will it make me weak? Is something wrong with my body?” Tsering welled with tears.

“Let me explain what I see.” Dr. Sharma smiled again and reached for Tsering’s hand. “You heard the heartbeat, right?” Jamyang and Tsering both nodded. She took up the wand, turned their attention to the monitor.

“And you see here, how the baby has settled this way, with his bottom toward your pelvis?” The couple strained to see the curve of buttocks, then nodded again.

“This is called breech position,” she explained. “That means that the baby’s head is up, and his bottom is down.”

Tsering had gone to all of her prenatal checkups. She had taken her vitamins. She’d avoided books, but that was mostly a question of literacy, time, and the potent mix of inertia and culture. Some of her friends had also recently become mothers. Nobody had ever explained to her that this could happen, that a baby could be pointed the wrong way. She felt angry. Why was she learning all of this for the first time? Why didn’t her mother, her friends who were mothers—anyone—ever talk about this? She took care of children for a living. How was it that she knew so little about how they came into this world?

“Many babies turn around in their mother’s uterus,” Dr. Sharma went on. The word “uterus” hung heavily in the air, at once distant and familiar to Tsering. “Sometimes they flip and face down before labor starts, all on their own. Other times we can turn the baby.” Dr. Sharma was looking straight into Tsering’s eyes. There was trust between them.

“But I’m also seeing that you have something called placenta previa. It is not as severe as it could be, but the placenta—the sac that helps feed and care for your baby inside your belly—the placenta is covering up your cervix. The cervix is sort of like the lock on the door that has to open in order for your baby to come out. This can be dangerous.”

If spoken words can change the course of things, Tsering thought, then what does naming the cause of this danger do?

“You are at thirty-three weeks now,” continued Dr. Sharma. “That means as many as seven weeks to go for a full-term baby, but your child can be born earlier and still be fine.” She paused before continuing. “I am going to recommend bed rest for a month and then that we deliver the baby by C-section.”

Tsering tried to imagine what “bed rest” meant. Did this mean sleeping later? Taking time to get up in the morning or going to bed early?

“Bed rest means that you need to stop working now,” Dr. Sharma continued. “You need to stay lying down at home as much as possible for the next four weeks. Jamyang, you are going to have to do more things around the house. Can you do that?” The stunned young man just nodded. He would take care of her during the day. They would rest together. He would drive his taxi at night.

“But what about Aiden and Lucy?” Tsering blurted out. Dr. Sharma looked confused.

“The children Tsering babysits, for work,” Jamyang explained.

“Well, I can write you a letter to their parents, so they know what is happening. They should understand.”

Tsering felt panicked. Stuck. Her boss had said that she could have her job back after the baby was born. Tsering had even arranged for another Loba woman who was between jobs to take over for a few months. But this was too quick. “I can’t stop work,” she said.

“If you want to have a healthy baby, you need to.” Dr. Sharma’s tone changed. It was still caring, but she’d lowered her voice an octave. She no longer smiled. The obstetrician set down the ultrasound wand and squirted antibacterial solution on her hands. As she wrung them dry, she repeated, “You will be fine. Your baby will be fine. But you need to follow my advice. I want to see you again in a week.” Dr. Sharma turned to Jamyang, her face stern but kind. “Take care of her, okay?”

“Yes, doctor.”

Once outside the hospital, Tsering burst into tears. “Don’t cry. Don’t cry,” Jamyang pleaded.

Tsering’s phone buzzed. She pulled it out of her pocket. Ama. She could not talk with her mother now, even though she’d told her to call today, after this doctor’s visit. The phone continued to pulse, then went quiet. A voice message came through a few minutes later. “Chori, how are you? How was checkup? Have you eaten?” Tsering sent a short voice message in return. “Ama baby is good. I am going home to rest now.”

For the next month, Tsering followed Dr. Sharma’s orders. She lay in bed or on the couch, watching Bollywood movies. When she grew bored with these, she turned to American medical shows: Grey’s Anatomy, ER, House, Nurse Jackie. Anything that could tell her something more about the mysterious landscape of human accidents, illness, and frailty—and the American response to these conditions. Was she crazy to think she might one day become a nurse?

Tsering told only a few close friends and her brother, Tsepten, about her situation. Still, this made her feel vulnerable. Although her community knew how to handle death and acute sickness—showing up with food, prayers, money for funeral fees or hospital bills—they did not do as well with this sort of uncertainty. Nothing bad had happened yet.

She tried to keep her communications with Kathmandu minimal. She did not want to raise alarm. Her paternal grandmother was withering, and she knew most of the caregiving fell to her mother. It was high tourist season, too. A week after the fateful visit with Dr. Sharma, Tsering had collected herself enough to call home. She did not tell her mother that she’d been confined to bed or that she would have to have an operation, but she did say that she felt the baby would come early. In this, she was not lying.

Tsering had avoided looking up placenta previa, but one afternoon into her third week of bed rest, she Googled it. Much of what she read just reiterated Dr. Sharma’s explanation and advice. But a paragraph on the World Health Organization’s website scared her.

Placenta previa is a life-threatening complication of pregnancy and an important public health problem worldwide. Its impact in under-resourced settings is much greater than its impact in developed countries. In under-resourced settings, there is often a lack of awareness of the danger signs of placenta previa, which can lead to delays in seeking medical care. In addition, poor transport facilities and the need to travel long distances to reach a health unit (which may have only limited resources to deal with the problem) increase the risk of hemorrhage, which is one of the leading causes of maternal death in Africa and Asia.

Tsering felt dizzy. She set her phone down and closed her eyes. Had her mother or grandmother been in her situation, they would have likely died. Instead, she had a kind doctor in a hospital, a birth plan. This was something beyond karma, wasn’t it?

A week later, a nurse pushed Tsering by wheelchair into the operating room. She saw Jamyang’s kind eyes above the surgical mask and Dr. Sharma, her raven-colored hair tucked back, her mouth covered, her expression alert with empathy and focus. Tsering stayed partially awake through the operation. Jamyang could not look behind the curtain covering her abdomen. He stared at Tsering’s face.

Incision. Extraction. Suction. She heard the nurse say, “Apgar 9. Good!” She did not know what that meant. “Sutures,” said Dr. Sharma. All this passed for Tsering in a fog. And then there was her daughter, puckered and beautiful, fists kneading the air, eyes still closed.

In the days to come, there would be hand and footprints, a birth certificate, a knitted cap in pink and white, the rawness of nipples. Tsering would tell her mother that she’d had an operation for the safety of the baby. That it was what the American doctors recommended. Her mother would understand.

As for the lost ones, these remained too, singular yet collective, like stones that line the riverbed.