The Cider House Rules (10 page)

“Well?” Mrs. Claus asked, aggressively. “What’s your advice, Doctor?” As if in reply, the patient under the sheet drew Larch to her; the woman’s forehead was clammy with sweat.

“You don’t know what you’re doing,” Dr. Larch said to Mrs. Santa Claus.

“At least I’m doing something,” the old woman said with hostile calm. “If you know how to do it, why don’t you do it?” Mrs. Santa Clause asked. “If you know how, why don’t you teach me?”

The woman under the sheet looked groggy, but she was trying to pull herself together. She sat up and tried to examine herself; she discovered that, under the sheet, she still wore her own dress. This knowledge appeared to relax her.

“Please listen to me,” Dr. Larch said to her. “If you have a fever—if you have more than just a little bleeding—you must come to the hospital. Don’t wait.”

“I thought the advice was for
me,
” Mrs. Santa Claus said. “Where’s
my
advice?”

Larch tried to ignore her. He went out to the waiting room and told the mother with her young daughter that they should leave, but the mother was concerned about the money.

“Pay them back!” Mrs. Santa Claus told the cashbox man.

“They don’t get the deposit back,” the man said again.

“Pay them back the deposit, too!” the old woman said angrily. She came into the waiting room to oversee the disgruntled transaction. She put her hand on Dr. Larch’s arm. “Ask her who the father is,” Mrs. Santa Claus said.

“That’s none of my business,” Larch said.

“You’re right,” the old woman said. “That much you got right. But ask her, anyway—it’s an interesting story.”

Larch tried to ignore her; Mrs. Santa Claus grabbed hold of both the mother and her daughter. She spoke to the mother. “Tell him who the father is,” she said. The daughter began to snivel and whine; Mrs. Santa Claus ignored her; she looked only at the mother. “Tell him,” she repeated.

“My husband,” the woman murmured, and then she added—as if it weren’t clear—“her father.”

“Her father is the father,” Mrs. Santa Claus said to Dr. Larch. “Got it?”

“Yes, I’ve got it, thank you,” Dr. Larch said. He needed to put his arm around the thirteen-year-old, who was sagging; she had her eyes shut.

“Maybe a third of the young ones are like her,” Mrs. Santa Claus told Larch nastily; she treated him as if
he
were the father. “About a third of them get it from their fathers, or their brothers. Rape,” Mrs. Santa Claus said. “Incest. You understand?”

“Yes, thank you,” Larch said, pulling the girl with him—tugging the sleeve of the mother’s coat to make her follow.

“Shit or get off the pot!” Mrs. Santa Claus yelled after them.

“All you starving doctors!” the cashbox man hollered. “You’re all over.”

The choir was singing. Larch thought he heard them say
“vom keinen Sturm erschrecket”
—frightened by no storm.

In the empty room that separated the songs from the abortions, Larch and the mother with her daughter collided with the woman who’d been under the sheet. She was still groggy, her eyes were darting, and her dress was plastered with sweat to her back.

“Please remember!” Larch said to her. “If there’s a fever, if there’s more than a little blood” . . . Then he saw the woman’s underwear pinned to the shoulder of her dress. That reminding epaulette was the badge of “Off Harrison,” a kind of ribbon for bravery. Obviously, the woman didn’t know that her panties were there. Larch imagined that the South End was sprinkled liberally with these staggering women, their panties pinned to their shoulders, marking them as indelibly as that long-ago Puritan New England “A” upon their bosoms.

“Wait!” Larch cried, and grabbed for the underwear. The woman didn’t want to wait; as she pulled herself free of his grasp, the pin opened and stuck Larch in the hand. After she’d gone, he put her panties in his suit-jacket pocket.

He led the mother and her daughter through the room that was always so heady with song, but the choir was taking a beer break. The lean, bald conductor had just dipped into his frothy stein when he looked up and saw Dr. Larch leaving with the women; a moustache of foam whitened his lip and a dab of the white froth shone on the end of his nose. The conductor raised his stein toward Dr. Larch, offering a toast. “Praise the Lord!” the conductor called. “You keep on saving those poor souls, Doc!”

“Danke schön!”
the choir called after him. Of course they could not have been singing Mahler’s
Songs on the Death of Children,
but those were the songs Wilbur Larch had heard.

“In other parts of the world,” wrote Dr. Wilbur Larch upon his arrival in St. Cloud’s, “an ability to act before you think—but to act nonetheless correctly—is essential. Perhaps there will be more time to think, here in St. Cloud’s.”

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.