the gas took effect, and she lay still, tranquil and unknowing, as another contraction and another moved through her.
“It’s coming fast for a first baby,” the nurse observed.
“Yes,” the doctor said. “So far so good.”
Half an hour passed in this way. His wife roused and moaned and pushed, and when he felt she had had enough—or when she cried out that the pain was overwhelming—he nodded to the nurse, who gave her the gas. Except for the quiet exchange of instructions, they did not speak. Outside the snow kept falling, drifting along the sides of houses, filling the roads. The doctor sat on a stainless steel chair, narrowing his concentration to the essential facts. He had delivered five babies during medical school, all live births and all successful, and he focused now on those, seeking in his memory the details of care. As he did so, his wife, lying with her feet in the stirrups and her belly rising so high that he could not see her face, slowly became one with those other women. Her round knees, her smooth narrow calves, her ankles, all these were before him, familiar and beloved. Yet he did not think to stroke her skin or put a reassuring hand on her knee. It was the nurse who held her hand while she pushed. To the doctor, focused on what was immediately before him, she became not just herself but more than herself; a body like other bodies, a patient whose needs he must meet with every technical skill he had. It was necessary, more necessary than usual, to keep his emotions in check. As time passed, the strange moment he had experienced in their bedroom came to him again. He began to feel as if he were somehow removed from the scene of this birth, both there and also floating elsewhere, observing from some safe distance. He watched himself make the careful, precise incision for the episiotomy. A good one, he thought, as the blood welled in a clean line, not letting himself remember the times he’d touched that same flesh in passion.
The head crowned. In three more pushes it emerged, and then the body slid into his waiting hands and the baby cried out, its blue skin pinking up.
It was a boy, red-faced and dark-haired, his eyes alert, suspicious of the lights and the cold bright slap of air. The doctor tied the umbilical cord and cut it. My son, he allowed himself to think. My son.
“He’s beautiful,” the nurse said. She waited while he examined the child, noting his steady heart, rapid and sure, the long-fingered hands and shock of dark hair. Then she took the infant to the other room to bathe him and to drop the silver nitrate into his eyes. The small cries drifted back to them, and his wife stirred. The doctor stayed where he was with his hand on her knee, taking several deep breaths, awaiting the afterbirth. My son, he thought again.
“Where is the baby?” his wife asked, opening her eyes and pushing hair away from her flushed face. “Is everything all right?”
“It’s a boy,” the doctor said, smiling down at her. “We have a son. You’ll see him as soon as he’s clean. He’s absolutely perfect.”
His wife’s face, soft with relief and exhaustion, suddenly tightened with another contraction, and the doctor, expecting the afterbirth, returned to the stool between her legs and pressed lightly against her abdomen. She cried out, and at the same moment he understood what was happening, as startled as if a window had appeared suddenly in a concrete wall.
“It’s all right,” he said. “Everything’s fine. Nurse,” he called, as the next contraction tightened.
She came at once, carrying the baby, now swaddled in white blankets.
“He’s a nine on the Apgar,” she announced. “That’s very good.”
His wife lifted her arms for the baby and began to speak, but then the pain caught her and she lay back down.
“Nurse?” the doctor said, “I need you here. Right now.”
After a moment’s confusion the nurse put two pillows on the floor, placed the baby on them, and