The Cider House Rules Page 8

  In Boston, he meant, he was a hero; and he wouldn't have lasted long--being a hero. He took the young girl and her mother to the South Branch. He instructed the house officer to write up the following:

  "This is a thirteen-year-old girl. Her pelvis is only three and a half inches in diameter. Two previous, violent deliveries have lacerated her soft parts and left her with a mass of unyielding scar tissue. This is her third pregnancy as a result of incest--as a result of rape. If allowed to come to term, she can be delivered only by Caesarean section, which--given the child's delicate state of health (she is a child), not to mention her state of mind--would be dangerous. Therefore, I've decided to give her an abortion."

  "You have?" the house officer asked.

  "That's right," Wilbur Larch said--and to the nurse-anesthesiologist, he said, "We'll do it immediately."

  The abortion took only twenty minutes; Larch's light touch with ether was the envy of his colleagues. He used the set of dilators with the Douglass points and both a medium-sized and a small curette. There was, of course, no mass of unyielding scar tissue; there were no lacerated soft parts. This was a first, not a third pregnancy, and although she was a small girl, her pelvis was certainly greater than three and a half inches in diameter. These fictional details, which Wilbur Larch provided for the house officer, were intended to make the house officer's report more convincing. No one at the Boston Lying-In ever questioned Larch's decision to perform this abortion--no one ever mentioned it, but Dr. Larch could tell that something had changed.

  He detected the dying of conversations upon his entering a room. He detected a general aloofness; although he was not exactly shunned, he was never invited. He dined alone at a nearby German restaurant; he ate pig knuckles and sauerkraut, and one night he drank a beer. It reminded him of his father; it was Wilbur Larch's first and last beer.

  At this time in his life Wilbur Larch seemed destined to a first-and-last existence; one sexual experience, one beer, one abortion. But he'd had more than one experience with ether, and the news, in the South End--that there was an alternative to Mrs. Santa Claus and the methods practiced "Off Harrison"--traveled fast. He was first approached while standing at a fruit-vendor's cart, drinking fresh-squeezed orange juice; a tall, gaunt woman with a shopping bag and a laundry basket materialized beside him.

  "I ain't quick," the woman whispered to Wilbur Larch. "What's it cost? I ain't quick, I swear."

  After her, they followed him everywhere. Sleepily, at the South Branch, he was always saying to one colleague or another, "It's not my turn, is it?" And always the answer was the same: "She says you're her doctor."

  A child of Maine, Wilbur Larch was used to looking into people's faces and finding their eyes; now he looked down, or away; like a city person, he made their eyes hunt for his. In the same mail with his catalogue of surgical instruments from Fred Halsam & Co. he received a copy of Mrs. W. H. Maxwell's A Female Physician to the Ladies of the United States. Until late in 187_, Mrs. Maxwell had operated a woman's clinic in New York. "The authoress has not established her hospital simply for the benefit of lying-in women," she wrote. "She believes that in the view of the uncharitableness of general society towards the erring, it is fit that the unfortunate should have some sanctuary to which to flee, in whose shade they may have undisturbed opportunity to reflect, and hiding forever their present unhappiness, nerve themselves to be wiser in the future. The true physician's soul cannot be too broad and gentle."

  Of course, Wilbur Larch saw that the South End was mercilessly full of evidence of uncharitableness towards the erring and that he had become, in the view of the erring, the sanctuary to which to flee.

  Instead, he fled. He went home to Maine. He applied to the Maine State board of medical examiners for a useful position in obstetrics. While they sought a position for him in some developing community, they liked his Harvard degree and made him a member of their board. Wilbur Larch awaited his new appointment in his old hometown of Portland, that safe harbor--the old mayor's mansion where he had spent the half life of his childhood, the salty boardinghouse where he had caught his dose of life from Mrs. Eames.

  He wondered if he would miss the South End: the palmist who had assured him he would live a long time and have many children ("Too many to count!"), which Larch understood as confirmation that, in seeking to become an obstetrician, he had made the right choice; the fortune teller who had told young Larch that he would never follow in his father's footsteps, which was all right with Wilbur Larch, who had no knowledge of lathes, no fondness for drink, and was sure that his liver wouldn't be the culprit of his final undoing; and the Chinese herb doctor who had told Larch that he could cure the clap by applying crushed green leaves and bread mold to his penis. The quack was almost right. The chlorophyll in the plants would destroy the bacteria that contributed to gangrene but it wouldn't kill the dance couples in the pus cells, those lively gonococci; the penicillin, extracted from some bread molds, would. Years later, Larch would dream that if only Dr. Harold Ernst, Harvard Medical School's bacteriologist and curve-ball pitcher, and the Chinese herb doctor from the South End had put their heads together . . . well, what wouldn't they have cured?

  "They would not have cured orphans," wrote Dr. Larch when he woke from that dream.

  And the orphans of the South End: Wilbur Larch remembered them from the branch hospitals of the Boston Lying-In. In 189_, less than half the mothers were married. In the institution's charter it was written that no patient would be admitted "unless a married woman or one recently widowed, and known to be of good moral character." The benevolent citizen groups who had first contributed thousands of dollars to provide for a lying-in hospital for the poor . . . they had insisted; but in truth almost everyone was admitted. There was an astonishing number of women claiming to be widows, or claiming marriage to sailors off to sea--gone with the Great Eastern, Wilbur Larch used to imagine.

  In Portland, he wondered, why were there no orphans, no children or women in need? Wilbur Larch did not feel of much use in the tidy town of Portland; it is ironic to think that while he waited to be sent somewhere where he was needed, a prostitute's letter--about abandoned women and orphans--was making its way to him from St. Cloud's.

  But before the letter arrived, Wilbur Larch had another invitation. The pleasure of his company was requested by a Mrs. Channing-Peabody of the Boston Channing-Peabodys, who spent every summer on their coastal property just east of Portland. The invitation suggested that perhaps young Larch missed the Boston society to which he'd doubtlessly become accustomed and would enjoy some tennis or croquet, or even some sailing, before a dinner with the Channing-Peabodys and friends. Larch had been accustomed to no Boston society. He associated the Channing-Peabodys with Cambridge, or with Beacon Hill--where he was never invited--and although he knew that Channing and Peabody were old Boston family names, he was unfamiliar with this strange coupling of the two. For all Wilbur Larch knew about this level of society, the Channings and the Peabodys might be throwing a party together and for the purpose of the invitation had agreed to hyphenate their names.

  As for sailing, Wilbur Larch had never been on the water--or in it. A child of Maine, he knew better than to learn to swim in that water; the Maine water, in Wilbur Larch's opinion, was for summer people and lobsters. And as for tennis or croquet, he didn't own the proper clothing. From a watercolor of some strange lawn games, he had once imagined that striking a wooden ball with a wooden mallet as hard as he could would be rewarding, but he wanted time to practice this art alone and unobserved. He regretted the expense of hiring a driver to take him to the Channing-Peabody summer house, and he felt uncomfortably dressed for the season--his only suit was a dark, heavy one, and he hadn't worn it since the day of his visit "Off Harrison." As he lifted the big brass door knocker of the Channing-Peabody house (choosing to introduce himself formally, rather than wandering among the people in their whites at play at various sports around the grounds), he felt the suit was not only too hot
but also needed a pressing, and he discovered in the jacket pocket the panties of the woman who'd aborted the birth of her child "Off Harrison." Wilbur Larch was holding the panties in his hand and staring at them--remembering their valiant, epaulette position, their jaunty bravery on the woman's shoulder--when Mrs. Channing-Peabody opened the door to receive him.

  He could not return the panties to his jacket pocket quickly enough so he stuffed them into the pocket in the attitude of a handkerchief he'd just been caught blowing his nose in. By the quick way Mrs. Channing-Peabody looked away from them, Larch knew she'd seen the panties for what they were: women's underdrawers, plain as day.

  "Doctor Larch?" Mrs. Channing-Peabody said cautiously, as if the panties had provided her with a clue to Larch's identity.

  I should simply leave now, Wilbur Larch thought, but he said, "Yes, Doctor Larch," and bowed to the woman--a great gunship of a woman, with a tanned face and a head helmeted in silver-gray hair, as sleek and as dangerous-looking as a bullet.

  "You must come meet my daughter," the woman said. "And all the rest of us!" she added with a booming laugh that chilled the sweat on Wilbur Larch's back.

  All the rest of them seemed to be named Channing or Peabody or Channing-Peabody, and some of them had first names that resembled last names. There was a Cabot and a Chadwick and a Loring and an Emerald (who had the dullest brown eyes), but the daughter whom Mrs. Channing-Peabody had designated to meet Dr. Larch was the plainest and youngest and least healthy-looking of the bunch. Her name was Missy.

  "Missy?" Wilbur Larch repeated. The girl nodded and shrugged.

  They were seated at a long table, next to each other. Across from them, and about their age, was one of the young men in tennis whites, either the Chadwick or the Cabot. He looked cross, or else he'd just had a fight with Miss Channing-Peabody, or else he would rather have been seated next to her himself. Or maybe he's just her brother and wishes he were seated farther away from her, thought Wilbur Larch.

  The girl looked unwell. In a family of tans, she was pale; she picked at her food. It was one of those dinners where the arrival of each course caused a complete change of dishes, and as the conversation lapsed and failed, or at least grew fainter, the sound of china and silverware grew louder, and a tension mounted at the dinner table. It was not a tension caused by any subject of conversation--it was a tension caused by no subject of conversation.

  The rather senile retired surgeon who was seated on Wilbur's other side--he was either a Channing or a Peabody--seemed disappointed to learn that Larch was an obstetrician. Still, the old codger insisted on knowing Dr. Larch's preferred method of expelling the placenta into the lower genital tract. Wilbur Larch tried, quietly, to describe the expression of placenta to Dr. Peabody or Dr. Channing, or whoever he was, but the old man was hard of hearing and insisted that young Larch speak up! Their conversation, which was the dinner table's only conversation, thus progressed to injuries to the perineum--including the method of holding back the baby's head to prevent a perineal tear--and the proper mediolateral incision for the performance of an episiotomy when a tear of the perineum seems imminent.

  Wilbur Larch was aware that Missy Channing-Peabody's skin was changing color beside him. She went from milk to mustard to spring-grass green, and almost back to milk before she fainted. Her skin was quite cool and clammy, and when Wilbur Larch looked at her, he saw that her eyes were almost completely rolled up into her head. Her mother and the cross young man in tennis whites, the Cabot or the Chadwick, whisked her away from the table--"She needs air," Mrs. Channing-Peabody announced, but air was not in short supply in Maine.

  Wilbur Larch already knew what Missy needed. She needed an abortion. It came to him through the visible anger of young Chadwick or Cabot, it came to him over the babbling senility of the old surgeon inquiring about "modern" obstetrical procedure, it came to him through the absence of other conversation and through the noise of the knives and the forks and the plates. That was why he'd been invited: Missy Channing-Peabody, suffering from morning sickness, needed an abortion. Rich people needed them, too. Even rich people, who, in Wilbur Larch's opinion, were the last to learn about anything, even rich people knew about him. He wanted to leave, but now it was his fate that held him. Sometimes, when we are labeled, when we are branded, our brand becomes our calling; Wilbur Larch felt himself called. The letter from the prostitute from St. Cloud's was on its way to him and he would go there, but first he was being called to perform--here.

  He rose from the table. The men were being sent to some special room--for cigars. The women had gathered around someone's baby--a nurse or a governess (a servant, thought Wilbur Larch) had brought a baby into the dining room, and the women were having a look. Wilbur Larch had a look, too. The women made room for him. The baby was rosy-looking and cheerful, about three months old, but Dr. Larch noticed the forceps mark on its cheek: a definite indentation, it would leave a scar. I can do better work than this, he thought.

  "Isn't that a darling baby, Doctor Larch?" one of the women asked him.

  "It's too bad about that forceps mark," Larch said, and that shut them all up.

  Mrs. Channing-Peabody took him out into the hall. He let her lead him to the room that had been prepared for him. On the way she said, "We have this little problem."

  "How many months along is she?" he asked Mrs. Channing-Peabody. "Is she quick?"

  Quick or not, Missy Channing-Peabody had certainly been prepared. The family had converted a small reading room into an operating theater. There were old pictures of men in uniform, and books (looking long untouched) stood at attention. In the grim room's foreground was a solid table appropriately set with cotton batting and rubber sheeting, and Missy herself was lying in the correct examining position. She was already shaved, already swabbed with the bichloride solution. Someone had done the necessary homework; perhaps they'd pumped the senile family surgeon for details. Dr. Larch saw the alcohol, the green soap, the nail brush (which he proceeded, immediately, to use). There was a set of six metal dilators, and a set of three curettes in a leather-covered, satin-lined case. There was chloroform and a chloroform inhaler, and this one mistake--that they didn't know Wilbur Larch's preference for ether--made Larch almost forgive them.

  What Wilbur Larch could not forgive was the obvious loathing they felt for him. There was an old woman in attendance, perhaps some faithful household servant who had played midwife to countless little Channing-Peabodys, maybe even midwife to Missy. The old woman was particularly chisel-faced and sharp-eyed when she looked at Larch, as if she expected him to congratulate her--at which moment she would not acknowledge that he'd spoken to her--for her precision in readying the patient. Mrs. Channing-Peabody herself seemed unable to touch him; she did offer to hold his coat, which he let her take before he asked her to leave.

  "Send that young man," Larch told her. "He should be here, I think." He meant the particularly hostile young man in tennis whites, whether he was the outraged brother or the guilty lover or both. These people need me but they hate me, Larch was thinking, as he scrubbed under his nails. While he let his arms soak in the alcohol bath, he wondered how many doctors the Channing-Peabodys must know (how many must be in the family!), but they would never have asked one of their kind for help with this "little problem." They were too pure for it.

  "You want my help?" the sullen young man asked Larch.

  "Not really," Larch replied. "Don't touch anything and stand to my left. Just look over my shoulder, and be sure you can see everything."

  That class-conscious look of scorn had all but left young Chadwick's (or young Cabot's) face when Wilbur Larch went to work with the curette; with the first appearance of the products of conception, the young man's expression opened--that certain, judgmental air was not discernible in any aspect of his face, which seemed softened and resembled his tennis whites in its color.

  "I have made this observation about the wall of the uterus," Dr. Larch told the ghostly young man. "It is a good
, hard, muscular wall, and when you've scraped it clean, it responds with a gritty sound. That's how you know when you've got all of it--all the products of conception. You just listen for that gritty sound." He scraped some more. "Can you hear it?" he asked.

  "No," the young man whispered.

  "Well, perhaps 'sound' isn't the right word," Wilbur Larch said. "Perhaps it's more like a gritty feeling, but it's a sound to me. Gritty," he said, as young Cabot or young Chadwick attempted to catch his own vomit in his cupped hands.

  "Take her temperature every hour," Larch told the rigid servant who held the sterile towels. "If there's more than a little bleeding, or if she has a fever, I should be called. And treat her like a princess," Wilbur Larch told the old woman and the ashen, empty young man. "No one should be allowed to make her feel ashamed."

  He would have departed like a gentleman after he looked under Missy's eyelids at her chloroform gaze; but when he put his coat on, he felt the envelope bulge in the breast pocket. He didn't count the money, but he saw there were several hundred dollars. It was the mayor's mansion all over again, the servant's quarters treatment; it meant the Channing-Peabodys wouldn't ask him back for tennis or croquet or a sail.

  He promptly handed about fifty dollars to the old woman who had bathed Missy's genitals with the bichloride solution and had covered her with a sterile vulval pad. He gave about twenty dollars to the young tennis player, who had opened the door to the patio to breathe a little of the garden air. Larch was going to leave. Then, when he shoved his hands in his coat pockets and found the panties again, on an impulse he grabbed the placenta forceps and took the instrument with him. He went off looking for the old surgeon, but there were only servants in the dining room--still clearing the table. He gave each of them about twenty or thirty dollars.

  He found the senile doctor asleep in a reading chair in another room. He opened the mouth of the forceps, clamped the pair of panties from "Off Harrison" in it, and then clamped the whole business to the old snorer's lapel.