TWO AM | Ricardo González-Rothi
I had read the primer on Obstetrics two days before.
Hi, I’m Dr. Ish. But you can call me Arno.
I’m an anesthesiologist doing an OB fellowship. My first night on call.
He hesitates, glancing over his glasses, then looks straight at me.
The on-call OB resident assigned for tonight called in sick with the shits.
Not like I’m real experienced at the south end of the stirrups, if you know whaddamean...but, we’ll manage.
We walk the long hallway from the cafeteria to the basement engaging in casual small-talk about the Mets and the subway. The tunnel-like hallway smells of antiseptic and mildew. Fluorescent lights hang eerily over us. I try to stay up with Dr. Ish’s long stride.
I was an Army medic in ‘Nam before med school, says Arno. He chews a fistful of potato chips from a bag in his hand and I notice chip fragments trapped on the end of a greying bushy moustache. Caught a couple of babies born in the rice paddies. Wouldn’t exactly call it obstetrics, if you know whaddamean. I nod.
Through the static of blaring overhead speakers we hear, “OB Resident on call, STAT to L&D”. “STAT” for statim adverb. Latin for “immediately.” At Bellevue, it meant, haul ass, ask questions later.
It feels unreal wearing green OR scrubs. I finally made the team! I thought. Like Arno. He is wearing them too, only under a three quarters-length white doctor’s coat stained with what looks like sprays of dried blood, and betadine antiseptic. He wears black KEDS hi-tops! Right out of a MASH episode!
Arno is probably in his forties. His salt and pepper hair and wire-rimmed glasses comfort me. I do double-sound checks in an effort to decipher his diction through his thick Texas drawl, and I struggle to read his lips under his cascading, walrus-like moustache. I wonder how anyone could pronounce the word “shit” and make it have two syllables. Texas-southern drawl: Shi- it.
We rush through double doors. A stately, chocolate-skinned middle-aged woman with the demeanor of General Patton points to me, and in a sweet Jamaican accent looks to Arno:
You the resident? She points: Room One. She’s crownin’.
Arno says: Shouldn’t we call the attending phys’ ?
On his way, stuck in traffic. No time
Then Head Nurse Patton turns to me:
You, Room Three! She points down the hallway.
Examine Melanie. I’ll be in there just as soon as I tuck Room One in.
As I step through to the door, I hear blood-curdling screams from a young girl, She squirms restlessly on the delivery table, gown on the floor, legs dangling over the knees, arms flailing wildly.
Ooo Lordy Lordy Lordy, she wails.
Lordy, Lordy Jesus-goddammit-get-this-belly-ass pain-away-from-me!! Her eyes bulge with each contraction.
Her shaggy Rasta braids smell nutty. She reminds me of a painting of Black Medusa I once saw at an art museum.
I introduce myself. It doesn’t register.
Nurse Patton bursts in the room, straddles a stool, hefts the sixteen-year old’s ample legs up on the stirrups, paints Melanie’s crotch and inner thighs with scrub betadine solution in one smooth motion and gloves up. The gloves make a slickly professional staccato snap against her wrists as she dons them.
She’s crownin’. Pooosh, Melanie, till I say to stop. POOSH woman, NOW!
She looks to me. Get your gloves on, mon. NOW!
But…but I need to scrub…I say innocently
NOW! she commands. She bolts from the stool, orders me to sit in it. I sit.
Keep her still.
STOP pooshin’ honey. Breathe…that’s’ it, breathe…
Nurse grunts. Uhh Uhh Uhh…, that big hairy baby head needs more space.
A large dollop of KY Jelly plops onto the floor. Nurse Patton leans over my shoulder, inserts her index finger between the labia and the baby’s head and sweeps around.
We got the cord round the neck, she says in a matter-of-fact, but totally controlled manner. Nerves of steel. I’m starting to realize that this situation is beyond dire, past fire drill, no dress rehearsal. Where the hell is Arno? Melanie’s high shrills are getting to me, draining me of what little confidence I might have had. I try desperately to hold it together.
Nurse Patton turns, wheels a tray with a package wrapped in sterile drapes and whips it open it beside me. Her green eyes are aimed at my forehead:
Ever do an Episiotomy?
I remember reading about it. “With palm facing the operator, fingers facing downward, insert index and middle fingers between the baby and the vaginal wall, make an incision about 3-5 cm at the base of the vagina towards the anus, taking care to avoid the anal sphincter at all costs. Use Metzenbaum scissors. Spread fingers. Proceed with head maneuver and extraction of shoulder, one at a time. Have anesthesia standby in case Emergency C section necessary. Time is of the essence, especially if umbilicus is wrapped around baby’s neck.”
But, can you call Dr. Ish in here for a minute?
On his way, Nurse Patton says. A minute that never ended.
Let’s go. No time!
Melanie sounds possessed. I had worked as an operating room scrub technician when I was in college and was comfortable with sterile technique, knew names of the surgical instruments, and had assisted in cases from open thoracotomies to Cesarean sections to craniotomies. There was always a surgeon in the room. The patients were asleep. They didn’t scream like this! Not this time. I‘m not scrubbed and the field is not sterile. I wonder if Nurse Patton senses my pathetic attempt at self-confidence when I say to her:
Can you get some eight-0 Catgut sutures on the Mayo tray for me?
Things had gone so fast we never had time to introduce ourselves. She probably thought I was a new OB resident. I feel the urge to pee as I argue with my detrusors. And I try to hide my trembling.
I have not done an episiotomy before. I’m a third year—Nurse Patton doesn’t let me finish...
C’mon, mon, what are you waitin’ on?
But I’m a third-year clerk…
C’mon, mon, you want this baby to die? NOW!
I pick up the Metzenbaum with one hand, and with wad of gauze in my other hand, place said gauze on my knee. The balls of my feet can’t stop pumping up and down. I insert two fingers. Baby is looking bluish by now. NO TIME. I am mortified.
Good Samaritan I thought. Will be thrown out of medical school, I thought. No time for thinking.
Melanie…this is going to hurt like hell.
I don’t think it fair to sugar coat it. I make a clean cut. All two-hundred plus pounds of Nurse Patton hold flailing Melanie down. Head and neck are exposed. I clear the cord. The screams remind me of when my Uncle Luis used to slaughter pigs in our back yard, but worse. I try to tune it out. My hands are shaking. I take deep breaths. I cannot tune it out. The frequency and amplitude of my fidgeting feet is at maximum, as is my unstoppable anxiety.
I’m light-headed and mortified. My scrub cap is soaked in sweat as are my eyes. I lick the salty insides of my damp mask and take comfort in knowing my face is covered. A hairy mucus-and-bloody forehead keeps protruding with each contraction, like a pimple about to burst. I am surprised there is not much bleeding where I made the cut. I scoot my stool forward to the edge of the stirrups, surgical drape on my legs. I try to visualize the maneuver for tilting the crowning head, then one shoulder, followed by the other in concert with contractions.
Melanie POOSH!! NOW.
Both shoulders out.
A bloody slippery boy oozes out of Melanie’s outstretched vagina onto my thighs. A whoosh of blood mixed with betadine and mucus follows. I clasp my legs and the drape barely catches the baby. Nurse Patton is three steps ahead of me. I had not noticed she had clamped and cut the cord as the baby slipped out.
Melanie is inconsolable. By this time Arno rushes into the room.
I pick up the baby, slap his back, dry the goop off him as Arno takes over, pulls gently on the placenta. As the elastic-looking coagulum plops off her vulva, Melanie nearly levitates to the ceiling.
Nurse Patton looks at me. I cannot not see her masked face. But I could see her approving emerald eyes. And it feels good. She nods for me to place the baby on Melanie’s belly.
Melanie wails incessantly, eyes bulge, she’s dowsed in sweat, disheveled. Her bloodied arm from where she pulled the IV while thrashing glistens red. I approach the side of the delivery table.
Here is your son, I say, passing this beautiful, glistening-little-shining-black-gem onto her arms. The baby is crying in between guppy breaths, but not screaming like his momma. She lifts her head as if to sniff him. I stop trembling by now. I can’t tell if it is afterbirth liquid soaking through to my crotch, or if detrusor vesica won. Arno is busy at the other end, suturing Melanie. I position the little wiggler on her abdomen. Absolute silence.
We done? She asks, almost matter-of-factly.
Whach’yu say your name wuz?
I remove my mask and take a breath. Bloodshot eyes scrutinize me.
Ricardo. I say.
That’s a good name, she says with a half grin.
My baby’name be Reecardo, then.
Ricardo González-Rothi, an academic physician and writer, whose fiction, creative non-fiction and poetry has been featured in the U.S. and the U.K., in Acentos Review, Hispanic Culture Review, Lunch Ticket, The Bellingham Review, Litro and others. His memoir The Mango Chronicle was published by Running Wild Press in 2024. Born and raised in Cuba, he came to the United States as a refugee in his teens. gonzalezrothiauthor.com