IN TWENTY YEARS, I’VE BEEN fired once by a patient, and it was for two hours. She screamed bloody murder and threw a vase of flowers at my head while in the throes of labor. But she hired me back when I brought her drugs.
After Marie asks me to step outside, I stand in the hall for a moment, shaking my head. “What was that about?” Corinne asks, looking up from a chart at the nurses’ station.
“Just a real winner of a dad,” I deadpan.
Corinne winces. “Worse than Vasectomy Guy?”
Once, I had a patient in labor whose husband had gotten a vasectomy two days before. Every time my patient complained about pain, he complained, too. At one point, he called me into the bathroom and pulled down his pants to show me his inflamed scrotum, as my patient huffed and puffed. I told him he should call the doctor, she said.
But Turk Bauer is not silly and selfish; based on the way he brandished that Confederate flag tattoo, I’m guessing he is not too fond of people of color. “Worse than that.”
“Well.” Corinne shrugs. “Marie’s good at talking people off the ledge. I’m sure she can fix whatever the problem is.”
Not unless she can make me white, I think. “I’m going to run to the cafeteria for five minutes. Cover for me?”
“If you bring me Twizzlers,” Corinne says.
In the cafeteria I stand for several minutes in front of the coffee bar, thinking about the tattoo on Turk Bauer’s arm. I don’t have a problem with white people. I live in a white community; I have white friends; I send my son to a predominantly white school. I treat them the way I want to be treated—based on their individual merits as human beings, not on their skin tone.
But then again, the white people I work with and eat lunch with and who teach my son are not overtly prejudiced.
I grab Twizzlers for Corinne and a cup of coffee for myself. I carry my cup to the condiment island, where there’s milk, sugar, Splenda. There’s an elderly woman fussing with the top of the cream pitcher, trying to get it open. Her purse sits on the counter, but as I approach, she picks up the handbag and anchors it to her side, crossing her arm over the strap.
“Oh, that pitcher can be tricky,” I say. “Can I help?”
She thanks me and smiles when I hand her back the cream.
I’m sure she doesn’t even realize she moved her purse when I got closer.
But I did.
Shake it off, Ruth, I tell myself. I’m not the kind of person who sees the bad in everyone; that’s my sister, Adisa. I get on the elevator and head back to my floor. When I arrive, I toss Corinne her Twizzlers and walk toward Brittany Bauer’s door. Her chart and little Davis’s chart sit outside; I grab the baby’s to make sure that the pediatrician will be flagged about the potential heart murmur. But when I open the folder, there’s a hot-pink Post-it on the paperwork.
NO AFRICAN AMERICAN PERSONNEL
TO CARE FOR THIS PATIENT.
My face floods with heat. Marie is not at the charge nurse’s desk; I start to methodically search through the ward until I find her talking to one of the pediatricians in the nursery. “Marie,” I say, pasting a smile on my face. “Do you have a minute?”
She follows me back toward the nurses’ station, but I really don’t want to have this conversation in public. Instead, I duck into the break room. “Are you kidding me?”
She doesn’t pretend to misunderstand. “Ruth, it’s nothing. Think of it the way you’d think of a family’s religious preferences dictating patient care.”
“You can’t possibly be equating this with a religious preference.”
“It’s just a formality. The father is a hothead; this just seemed the smoothest way to get him to calm down before he did something extreme.”
“This isn’t extreme?” I ask.
“Look,” Marie says. “If anything, I’m doing you a favor. So you don’t have to deal with that guy anymore. Honestly, this isn’t about you, Ruth.”
“Really,” I say flatly. “How many other African American personnel are on this ward?”
We both know the answer to that. A big, fat zero.
I look her square in the eye. “You don’t want me to touch that baby?” I say. “Fine. Done.”
Then I slam the door behind me so hard that it rattles.
ONCE, RELIGION GOT tangled up in my care of a newborn. A Muslim couple came into the hospital to have their baby, and the father explained that he had to be the first person to speak to the newborn. When he told me this, I explained that I would do everything I could to honor his request, but that if there were any complications with the birth, my first priority was to make sure that the baby was saved—which required communication, and meant that silence in the delivery room was not likely or possible.
I gave the couple some privacy while they discussed this, and finally the father summoned me back. “If there are complications,” he told me, “I hope Allah would understand.”
As it turned out, his wife had a textbook delivery. Just before the baby was born, I reminded the pediatrician of the patient request, and the doctor stopped calling the arrival of the head, right shoulder, left, like a football play-by-play. The only sound in the room was the baby’s cry. I took the newborn, slippery as a minnow, and placed him in a blanket in his father’s arms. The man bent close to the tiny head of his son, and whispered to him in Arabic. Then he placed the baby into his wife’s arms, and the room exploded with noise again.
Sometime later that day, when I came in to check on my two patients, I found them asleep. The father stood over the bassinet, staring at his child as if he didn’t quite understand how this had happened. It was a look I saw often on the faces of fathers, for whom pregnancy wasn’t real until this very moment. A mother has nine months to get used to sharing the space where her heart is; for a father it comes on sudden, like a storm that changes the landscape forever. “What a beautiful boy you have,” I said, and he swallowed. There are just some feelings, I’ve learned, for which we never invented the right words. I hesitated, then asked what had been on my mind since the delivery. “If it’s not rude of me to ask, would you tell me what you whispered to your son?”
“The adhan,” the father explained. “God is great; there is no God but Allah. Muhammad is the messenger of Allah.” He looked up at me and smiled. “In Islam, we want the first words a child hears to be a prayer.”
It seemed absolutely fitting, given the miracle that every baby is.
The difference between the Muslim father’s request and the request made by Turk Bauer was like the difference between day and night.
Between love and hate.
IT’S A BUSY afternoon, so I don’t have time to talk to Corinne about the new patient she’s inherited until we are both pulling on our coats and walking to the elevator. “What was that all about?” Corinne asks.
“Marie took me off the case because I’m Black,” I tell her.
Corinne wrinkles her nose. “That doesn’t sound like Marie.”
I turn to her, my hands stilling on the lapels of my coat. “So I’m a liar?”
Corinne puts her hand on my arm. “Of course not. I’m just sure there’s something else going on.”
It’s wrong to take out my frustration on Corinne, who has to deal with that awful family now. It’s wrong for me to be angry at her, when I’m really angry at Marie. Corinne, she’s always been my partner in crime, not my adversary. But I feel like I could talk till I’m blue in the face and she wouldn’t really understand what this feels like.
Maybe I should talk till I’m blue in the face. Maybe then I’d be acceptable to the Bauers.
“Whatever,” I say. “That baby means nothing to me.”
Corinne tilts her head. “You want to grab a glass of wine before we head home?”
I let my shoulders relax. “I can’t. Edison’s waiting.”
The elevator dings, and the doors open. It’s packed, because it’s end of shift. Staring back at me is a sea of blank white faces.
Normally I don’t even think about that. But suddenly, it’s all I can see.
I’m tired of being the only Black nurse on the birthing pavilion.
I’m tired of pretending that doesn’t matter.
I’m tired.
“You know what,” I say to Corinne. “I think I’m going to just take the stairs.”
WHEN I WAS five, I couldn’t blend. Although I’d been reading since age three—the result of my mother’s diligent schooling each night when she came home from work—if I came across the word tree I pronounced it “ree.” Even my last name, Brooks, became “rooks.” Mama went to a bookstore and got a book on consonant blends and tutored me for a year. Then she had me tested for a gifted program, and instead of going to school in Harlem—where we lived—my sister and I rode the bus with her for an hour and a half every morning to a public school on the Upper West Side with a mostly Jewish student population. She’d drop me off at my classroom door, and then she’d take the subway to work at the Hallowells’.
My sister, Rachel, was not the student I was, though, and the bus trip was draining for all of us. So for second grade, we moved back to our old school in Harlem. I spent a year being dulled at all my bright edges, which devastated Mama. When she told her boss, Ms. Mina got me an interview at Dalton. It was the private school her daughter, Christina, attended, and they were looking for diversity. I received a full scholarship, stayed at the top of my class, received prizes at every assembly, and worked like mad to reward my mama’s faith in me. While Rachel made friends with kids in our neighborhood, I knew no one. I didn’t really fit in at Dalton, and I definitely didn’t fit in in Harlem. As it turned out, I was a straight-A student who still couldn’t blend.
There were a few students who invited me to their houses—girls who said things like “You don’t talk like you’re Black!” or “I don’t think of you that way!” Of course, none of those girls ever came to visit me in Harlem. There was always a conflicting dance class, a family commitment, too much homework. Sometimes I imagined them, with their silky blond hair and braces, walking past the check casher on the corner of the street where I lived. It was like picturing a polar bear in the tropics, and I never let myself think on it long enough to wonder if that was how they saw me, at Dalton.
When I got into Cornell, and many others from my school didn’t, I couldn’t help but hear the whispers. It’s because she’s Black. Never mind that I had a 3.87 average, that I’d done well on my SATs. Never mind that I could not afford to go to Cornell, and would instead be taking the full ride offered me by SUNY Plattsburgh. “Baby,” my mama said, “it’s not easy for a Black girl to want. You have to show them you’re not a Black girl. You’re Ruth Brooks.” She would squeeze my hand. “You are going to get everything good that’s coming to you—not because you beg for it, and not because of what color you are. Because you deserve it.”
I know I wouldn’t have become a nurse if my mama hadn’t worked so hard to put me smack in the middle of the path of a good education. I also know that I decided long ago to try to circumvent some of the problems I had, when it came to my own child. So when Edison was two, my husband and I made the choice to move to a white neighborhood with better schools, even though that meant we would be one of the only families of color in the area. We left our apartment near the railroad tracks in New Haven, and after having multiple listings “disappear” when the realtor found out what we looked like, we finally found a tiny place in the more affluent community of East End. I enrolled Edison in a preschool there, so that he started at the same time as all the other kids, and no one could see him as an outsider. He was one of them, from the start. When he wanted to have his friends over for a sleepover, no parent could say it was too dangerous an area for their kid to visit. It was, after all, their neighborhood, too.
And it worked. My, how it worked. It took me advocating for him at first—making sure that he had teachers who noticed his intelligence as well as his skin color—but as a result, Edison is in the top three of his class. He’s a National Merit Scholar. He is going to college and he will be anything he wants to be.
I’ve spent my life making sure of it.
When I get home from work, Edison is doing his homework at the kitchen table. “Hey, baby,” I say, leaning down to kiss the top of his head. I can only do that now when he’s seated. I still remember the moment I realized he was taller than me; how strange it felt to reach my arms up instead of down, to know that someone I’d been supporting his whole life was in a position to support me.
He doesn’t glance up. “How was work?”
I paste a smile on my face. “You know. Same old.”
I shrug off my coat, pick up Edison’s jacket from where it’s been slung on the back of the couch, and hang them both in the closet. “I’m not running a cleaning service here—”
“Then leave it where it was!” Edison explodes. “Why does everything have to be my fault?” He shoves away from the table so fast that he nearly knocks over his chair. Leaving his computer and his open notebook behind, he storms out of the kitchen. I hear the door of his bedroom slam.
This is not my boy. My boy is the one who carries groceries up three flights of stairs for old Mrs. Laska, without her even having to ask. My boy is the one who always holds open the door for a lady, who says please and thank you, who still keeps in his nightstand every birthday card I’ve ever written him.
Sometimes a new mother turns to me, a shrieking infant in her arms, and asks me how she’s supposed to know what her baby needs. In a lot of ways, having a teenager isn’t all that different from having a newborn. You learn to read the reactions, because they’re incapable of saying exactly what it is that’s causing pain.
So although all I want to do is go into Edison’s room and gather him up close and rock him back and forth the way I used to when he was little and hurting, I take a deep breath and go into the kitchen instead. Edison has left me dinner, a plate covered with foil. He can make exactly three dishes: macaroni and cheese, fried eggs, and Sloppy Joes. The rest of the week he heats up casseroles I make on my days off. Tonight’s is an enchilada pie, but Edison’s also cooked up some peas, because I taught him years ago a plate’s not a meal unless there’s more than one color on it.
I pour myself some wine from a bottle I got from Marie last Christmas. It tastes sour, but I force myself to sip it until I can feel the knots in my shoulders relax, until I can close my eyes and not see Turk Bauer’s face.
After ten minutes pass, I knock softly on the door of Edison’s room. It’s been his since he was thirteen; I sleep on the pullout couch in the living room. I turn the knob and find him lying on his bed, his arms behind his head. With his T-shirt stretched over his shoulders and his chin tilted up, I see so much of his daddy in him that for a moment, I feel like I’ve fallen through time.
I sit down beside him on the mattress. “Are we gonna talk about it, or are we gonna pretend nothing’s wrong?” I ask.
Edison’s mouth twists. “Do I really get a choice?”
“No,” I say, smiling a little. “Is this about the calculus test?”
He frowns. “The calc test? That was no big deal; I got a ninety-six. It’s just that I got into it with Bryce today.”
Bryce has been Edison’s closest friend since fifth grade. His mother is a family court judge and his father is a Yale classics professor. In their living room is a glass case, like the kind you’d find at a museum, housing a bona fide Grecian urn. They’ve taken Edison on vacation to Gstaad and Santorini.
It feels good to have Edison hand me this burden, to wallow in someone else’s difficulties for a while. This is what’s so upsetting to me about the incident at the hospital: I’m known as the fixer, the one who figures out a solution. I’m not the problem. I’m never the problem.
“I’m sure it’ll blow over,” I tell Edison, patting his arm. “You two are like brothers.”
He rolls onto his side and pulls the pillow over his head.
“Hey,” I say. “Hey.” I tug at the pillow and realize that there’s one single streak, left by a tear, darkening the skin of his temple. “Baby,” I murmur. “What happened?”
“I told him I was going to ask Whitney to homecoming.”
“Whitney…” I repeat, trying to place the girl from the tangle of Edison’s friends.
“Bryce’s sister,” he says.
I have a brief flash of a girl with strawberry-blond braids I met years ago when picking Edison up from a playdate. “The chubby one with braces?”
“Yeah. She doesn’t have braces anymore. And she’s definitely not chubby. She’s got…” Edison’s eyes soften, and I imagine what my son is seeing.
“You don’t have to finish that sentence,” I say quickly.
“Well, she’s amazing. She’s a sophomore now. I mean, I’ve known her forever, but lately when I look at her it’s not just as Bryce’s little sister, you know? I had this whole thing planned, where one of my buddies would be waiting outside her classroom after each period, holding a note. The first note was going to say WILL. The second was going to say YOU. Then GO, TO, HOMECOMING, and WITH. And then at the end of school, I’d be waiting with the ME sign, so she’d finally know who was asking.”
“This is a thing now?” I interrupt. “You don’t just ask a girl to the homecoming dance…you have to produce a whole Broadway event to make it happen?”
“What? Mama, that’s not the point. The point is that I asked Bryce to be the one who brought her the HOMECOMING note and he freaked out.”
I draw in my breath. “Well,” I say, carefully picking through my words, “it’s sometimes hard for a guy to see his little sister as anyone’s potential girlfriend, no matter how close he is to the person who wants to date her.”
Edison rolls his eyes. “That’s not it.”
“Bryce may just need time to get used to the idea. Maybe he was surprised that you’d think of his sister, you know, that way. Because you are like family.”
“The problem is…I’m not.” My son sits up, his long legs dangling over the edge of the bed. “Bryce laughed. He said, ‘Dude. It’s one thing for us to hang out. But you and Whit? My parents would shit a brick.’ ” His gaze slides away. “Sorry about the language.”
“That’s okay, baby,” I said. “Go on.”
“So I asked him why. It didn’t make any sense to me. I mean, I’ve been to Greece with his family. And he said, ‘No offense, but my parents would not be cool with my sister dating a Black guy.’ Like it’s okay to have a Black friend who comes on family vacations but it’s not okay for that friend to get involved with your daughter.”
I have worked so hard to keep Edison from feeling this line being drawn, it never occurred to me that when it happened—which, I guess, was inevitable—it would burn even more, because he had never seen it coming.
I reach for my son’s hand and squeeze it. “You and Whitney would not be the first couple to find yourselves on opposite sides of a mountain,” I say. “Romeo and Juliet, Anna Karenina and Vronsky. Maria and Tony. Jack and Rose.”
Edison looks at me in horror. “You do realize that in every example you just gave me, at least one of them dies?”
“What I’m trying to say is that if Whitney sees how special you are, she’ll want to be with you. And if she doesn’t, she’s not worth the fight.”
I put my arm around his shoulders; Edison leans into me. “That doesn’t make it suck any less.”
“Language,” I say automatically. “And no, it doesn’t.”
Not for the first time, I wish Wesley were still alive. I wish he hadn’t gone back on that second tour of duty in Afghanistan; I wish that he hadn’t been driving in the convoy when the IED exploded; I wish that he had gotten to know Edison not just as a child but as a teen and now a young man. I wish he were here to tell his son that when a girl makes your blood rush it’s just the first time of many.
I wish he were here, period.
If only you could see what we made, I think silently. He’s the best of both of us.
“Whatever happened to Tommy ?” I ask abruptly.
“Tommy Phipps?” Edison frowns. “I think he got busted for dealing heroin behind the school last year. He’s in juvie.”
“Do you remember in nursery school, when that little delinquent said you looked like burnt toast?”
A slow smile stretches across Edison’s face. “Yeah.”
It was the first time a child had mentioned to Edison that he was different from everyone else in his class—and had done so in a way that also made it seem bad. Burnt. Charred. Ruined.
Before that maybe Edison had noticed, maybe he hadn’t. But that was the first time I had the Talk with my son about skin color.
“You remember what I told you?”
“That my skin was brown because I had more melanin than anyone else in the school.”
“Right. Because everyone knows it’s better to have more of something than less. And melanin protects your skin from damage from the sun, and helps make your eyesight better, and Tommy Phipps would always be lacking. So actually, you were the lucky one.”
Slowly, like water on parched pavement, the smile evaporates from Edison’s face. “I don’t feel so lucky now,” he says.
AS LITTLE GIRLS, my older sister and I looked nothing alike. Rachel was the color of fresh-brewed coffee, just like Mama. Me, I was poured from the same pot, but with so much milk added, you couldn’t even taste the flavor anymore.
The fact that I was lighter got me privileges I didn’t understand, privileges that drove Rachel crazy. Tellers at banks gave me lollipops, and then, as an afterthought, offered one to my sister. Teachers called me the pretty Brooks sister, the good Brooks sister. During class portraits, I would be moved up to the front row; Rachel got hidden in the back.
Rachel told me that my real father was white. That I wasn’t really part of our family. Then, Rachel and I got into it one day and started yelling at each other and I said something about going to live with my real daddy. That night my mama sat me down and showed me pictures of my father, who was also Rachel’s father—a man with light brown skin like mine—holding me as a newborn. The date on the photo was a full year before he left all three of us for good.
Rachel and I grew up as different as two sisters could be. I’m short, and she’s tall as a queen. I was an avid student; she was naturally smarter than I was, but hated school. She embraced what she referred to as her “ethnic roots” in her twenties, legally changed her name to Adisa, and started wearing her hair in its natural kinky state. Although a lot of ethnic names are Swahili, Adisa comes from the Yoruba language, which she’ll tell you is West African—“where our ancestors actually came from when they were brought here as slaves.” It means, One who is clear. See, even her name judges the rest of us for not knowing the truths that she does.
Now, Adisa lives near the train tracks in New Haven in a neighborhood where drug deals go down in broad daylight and young men shoot at each other throughout the night; she has five kids, and she and the father of her children have minimum-wage jobs and barely scrape by. I love my sister to death, but I don’t understand the choices she’s made any more than she can understand mine.
I’ve wondered, you know. If my drive to become a nurse, to want more, to achieve more for Edison all came from the fact that even between two little Black sisters, I had a head start. I’ve wondered if the reason Rachel turned herself into Adisa was because feeding that fire inside herself was exactly what she needed to believe she had a chance to catch up.
ON FRIDAY, MY day off, I have an appointment at the nail salon with Adisa. We sit side by side, our hands under the UV drying vents. Adisa looks at the bottle of my chosen OPI nail color and shakes her head. “I can’t believe you picked a polish called Juice Bar Hopping,” she says. “That’s got to be the whitest color ever.”
“It’s orange,” I point out.
“I meant the name, Ruth, the name. You ever see a brotha in a juice bar? No. Because nobody goes to a bar to drink juice. Just like nobody asks for a sippy cup full of tequila.”
I roll my eyes. “Really? I just told you all about getting barred from a patient’s care and you want to talk about what color I’m putting on my nails?”
“I’m talking about what color you chose to live your life, girl,” Adisa says. “What happened to you happens to the rest of us every day. Every hour. You’re just so used to playing by their rules you forgot you got skin in the game.” She smirks. “Well. Lighter skin, but still.”
“What’s that supposed to mean?”
She shrugs. “When was the last time you told someone Mama still works as a domestic?”
“She hardly works now. You know that. She’s basically a charity Mina contributes to.”
“You didn’t answer my question.”
I scowl. “I don’t know when I mentioned it last. Is that the first thing you bring up in conversation? Plus, it doesn’t matter what color I am. I’m good at my job. I didn’t deserve to be taken off that case.”
“And I don’t deserve to be living in Church Street South, but it’s going to take more than me to change two hundred years of history.”
My sister likes to play the victim. We’ve had some pretty heated exchanges about that before. If you don’t want to be seen as a stereotype, then the way I see it, don’t be one. But to my sister, that means playing a white man’s game, and being who they want her to be, instead of being unapologetically herself. Adisa says the word assimilation with so much venom that you’d think anyone who chooses it—like I did—is swallowing poison.
It’s also very like my sister to take a problem I have and turn it into her own rant.
“None of what happened at the hospital is your fault,” my sister says, surprising me. I figured she’d say I had this coming to me, because I’ve been pretending to be someone I’m not and somewhere along the pretending, I forgot the truth. “It’s their world, Ruth. We just live in it. It’s like if you up and moved to Japan. You could choose to ignore the customs and never learn the language, but you’re going to get along a lot easier if you do, right? Same thing here. Every time you turn on the TV or the radio you see and hear about white people going to high school and college, eating dinner, getting engaged, drinking their pinot noir. You learn how they live their lives, and you speak their language well enough to blend in with them. But how many white people you know who go out of their way to see Tyler Perry movies so they can learn how to act around Black people?”
“That’s not the point—”
“No, the point is you can do as the Romans do all you want, but it don’t mean the Emperor will let you into his palace.”
“White people do not run the world, Adisa,” I argue. “There are plenty of successful people of color.” I name the first three that pop into my head. “Colin Powell, Cory Booker, Beyoncé—”
“—and ain’t none of them dark, like me,” Adisa counters. “You know what they say: the deeper you go into the projects, the darker the skin.”
“Clarence Thomas,” I pronounce. “He’s darker than you and he’s on the Supreme Court.”
My sister laughs. “Ruth, he’s so conservative he probably bleeds white.”
My phone dings, and I carefully extract it from my purse so I don’t mess up my nails.
“Edison?” Adisa asks immediately. Say what you will about her, but she loves my son as much as I do.
“No. It’s Lucille from work.” Just seeing her name pop up on my phone makes my mouth go dry; she was the nurse during the delivery of Davis Bauer. But this isn’t about that family at all. Lucille’s got a stomach bug; she needs someone to fill in for her tonight. She’s willing to trade me, so that instead of working all day Saturday, I can leave at eleven. It means pulling a double shift, but I’m already thinking of what I could do with that time on Saturday. Edison needs a new winter coat this year—I swear he’s grown four inches over the summer. I could treat him to lunch, after shopping. Maybe there’s even a movie coming out that Edison and I could go see. It’s been hitting me hard lately—the realization that getting my son to a point where he’s accepted to college also means that I will be left alone. “They want me to come in to work tonight.”
“Who’s they? The Nazis?”
“No, another nurse who’s sick.”
“Another white nurse,” Adisa clarifies.
I don’t even respond.
Adisa leans back in her chair. “Seems to me they’re not in a position to be asking you for favors.”
I am about to defend Lucille, who had absolutely nothing to do with Marie’s decision to put a Post-it note on the baby’s file, when the nail technician interrupts us, checking our fingers to see if the polish is dry. “Okay,” she says. “All done.”
Adisa waggles her fingers, a shocking shade of hot pink. “Why do we keep coming here? I hate this salon,” she says, her voice low. “They don’t look me in the eye and they won’t put my change right in my hand. It’s like they think my Black is gonna rub off on them.”
“They’re Korean,” I point out. “Did you ever think that maybe, in their culture, neither of those things are polite?”
Adisa raises a brow. “All right, Ruth,” she says. “You just keep telling yourself it’s not about you.”
NOT TEN MINUTES into my unscheduled shift, I’m already sorry I said yes. There’s a storm crackling outside, one the weathermen didn’t see coming, and the barometric pressure’s tanked—which leads to early ruptured membranes, to women going into premature labor, to patients who are writhing in the halls because we don’t have enough space for them. I’m running around like a chicken with its head cut off, which is a good thing, because it keeps me from thinking about Turk and Brittany Bauer and their baby.
But not so much that I don’t casually check the chart when I first come on duty. I tell myself that I just want to make sure that someone—someone white—has scheduled that consult with a pediatric cardiologist before the baby is discharged. And yes, there it is in the schedule, along with a record of Corinne doing the baby’s heel stick on Friday afternoon to draw blood for the state newborn screening. But then someone calls my name and I find myself pulled into the orbit of a laboring woman, who is being wheeled up from Emergency. Her partner looks terrified, the kind of man who is used to being able to fix things who has come to the sudden realization that this is outside his wheelhouse. “I’m Ruth,” I say to the woman, who seems to have telescoped further into herself with each subsequent contraction. “I’m going to be here with you the whole time.”
Her name is Eliza and her contractions are four minutes apart, according to her husband, George. This is their first pregnancy. I get my patient settled in the last birthing room we have available and take a urine sample, then hook her up to the monitor, scanning the gravestone printout. I grab her vitals and start asking questions: How strong are the contractions? Where are you feeling them—the front or the back? Are you leaking any fluid? Are you bleeding? How’s the baby moving?
“If you’re ready, Eliza,” I say, “I’m going to check your cervix.” I put on a pair of gloves and move to the foot of the bed, touch her knee.
An expression flickers across her face that gives me pause.
Now, most laboring women will do anything to get that baby out of them. There’s fear about getting through childbirth, yes, but that’s different from the fear of being touched. And that’s what I’m reading all over Eliza’s face.
A dozen questions jockey their way to the tip of my tongue. Eliza changed in the bathroom with her husband’s help, so I didn’t see if she had any bruises that might flag an abusive relationship. I glance at George. He looks like an ordinary father-to-be—nervous, out of place—not like a guy with anger management issues.
Then again, Turk Bauer looked pretty normal to me until he rolled up his sleeves.
Shaking my head to clear it, I turn to George and pin a smile over my instincts. “Would you mind going to the kitchenette and getting some ice chips for Eliza?” I say. “It’d be a tremendous help.”
Never mind that’s a nurse’s job—George looks supremely relieved to be given a task. The minute he’s out of the room I turn to Eliza. “Is everything all right?” I ask, looking her in the eye. “Is there something you need to tell me that you couldn’t say with George in the room?”
She shakes her head, and then bursts into tears.
I strip off my gloves—the cervical exam can wait—and reach for her hand. “Eliza, you can talk to me.”
“The reason I got pregnant is because I was raped,” she sobs. “George doesn’t even know it happened. He’s so happy about this baby…I couldn’t tell him it might not be his.”
The story comes out, whispered, in the middle of the night, when Eliza has stalled at seven centimeters dilated, and George has gone to get to a snack from the cafeteria. Labor is like that—a shared trauma bond, an accelerant that makes relationships stronger. And so even though I am little more than a stranger to Eliza, she pours out her soul to me, as if she has fallen overboard and I am the only glimpse of land on the horizon. She was on a business trip, celebrating the close of a deal with an important, elusive client. The client invited her out to dinner with some others and bought her a drink, and the next thing Eliza remembered was waking up in his hotel room, and feeling sore all over.
When she finishes, we both sit, letting the words settle. “I couldn’t tell George,” Eliza says, her hands bunched on the rough hospital linens. “He would have gone to my boss, and believe me, they wouldn’t risk losing this deal just because of something that happened to me. The best-case scenario is that I would have been given a severance package to keep my mouth shut.”
“So nobody knows?”
“You do,” she says. Eliza looks at me. “What if I can’t love the baby? What if every time I look at her, I see what happened?”
“Maybe you should get DNA testing,” I tell her.
“What good would it do?”
“Well,” I say, “you’d know.”
She shakes her head. “And then what?”
It is a good question, one that I feel all the way to my own core. Is it better not knowing the ugly truth, and pretending it doesn’t exist? Or is it better to confront it, even though that knowledge may be a weight you carry around forever?
I am about to give her my opinion when Eliza is seized by another contraction. Suddenly, we are both in the trenches again, fighting for a life.
It takes three hours, and then Eliza pushes her daughter into the world. Eliza starts crying, like many new mothers do, but I know it’s not for the same reasons. The OB hands the newborn to me, and I stare down into the angry ocean of that baby’s eyes. It doesn’t matter how she was conceived. It just matters that she made it here.
“Eliza,” I say, settling the baby on her chest, “here’s your daughter.”
Even as George reaches over his wife’s shoulder to stroke the newborn’s mottled thigh, Eliza won’t look at the baby. I lift the baby up, hold her closer to Eliza’s face. “Eliza,” I say, more firmly. “Your daughter.”
She drags her gaze toward the baby in my hands. Sees what I see: the blue eyes of her husband. The identical nose. The cleft that matches the one in his chin. This baby might as well be a tiny clone of George.
All the tension fades from Eliza’s shoulders. Her arms close around her daughter, holding the child so close there is no room for but what if. “Hello, baby,” she whispers.
This family, they’ll make their own reality.
I just wish it were that easy for the rest of us.
BY NINE THE next morning, it feels like the entirety of New Haven has come to the hospital to give birth. I have been mainlining coffee, running back and forth among three postpartum patients, and praying fervently in between that we don’t get another woman in active labor before I leave here at eleven. In addition to Eliza’s delivery, I had two more patients last night—a G3 P3 who, truth be told, could have had that baby on her own and nearly did—and a G4 P1 who had an emergency C-section. Her baby, only twenty-seven weeks, is in the NICU.
When Corinne comes on duty at seven, I’m in the OR with the emergency C-section, so we don’t cross paths until it’s 9:00 A.M. and I’m in the nursery. “I heard you pulled a double,” she says, wheeling a bassinet into the room. “What are you doing in here?”
The nursery used to be where the babies were kept while mothers got a decent night’s sleep, before they stayed twenty-four/seven in their mothers’ hospital rooms. So now, it’s used mostly for storage, and for routine procedures like circumcisions, which no parent wants to watch. “Hiding,” I tell Corinne, pulling a granola bar out of my pocket and devouring it in two bites.
She laughs. “What the hell is going on today? Did I miss the memo for the Apocalypse or something?”
“Tell me about it.” I glance at the infant for the first time, and feel a shudder run down my spine. BABY BOY BAUER, the card on the bassinet reads. Without even meaning to, I take a step backward.
“How’s he doing?” I ask. “Is he eating any better?”
“His sugar’s up but he’s still logy,” Corinne answers. “He hasn’t nursed for the past two hours because Atkins is going to do the circ.”
As if Corinne has conjured the pediatrician, Dr. Atkins comes into the nursery. “Right on schedule,” she says, seeing the bassinet. “The anesthesia’s had enough time to kick in and I’ve already talked to the parents. Ruth, did you give the baby sweeties?”
Sweeties are a little bit of sugar water, rubbed on the babies’ gums to soothe and distract them from the discomfort. I would have given the baby sweeties before a circ, if I were his nurse.
“I’m not taking care of this patient anymore,” I say stiffly.
Dr. Atkins raises a brow and opens the patient file. I see the Post-it note, and as she reads it, an uncomfortable silence swells, sucking up all the air in the room.
Corinne clears her throat. “I gave him sweeties about five minutes ago.”
“Great,” Dr. Atkins says. “Then let’s get started.”
I stand for a moment, watching as Corinne unwraps the baby and prepares him for this routine procedure. Dr. Atkins turns to me. There’s sympathy in her eyes, and that’s the last thing I want to see. I don’t need pity just because of a stupid decision Marie made. I don’t need pity because of the color of my skin.
So I make a joke of it. “Maybe while you’re at it,” I suggest, “you can sterilize him.”
THERE ARE FEW things scarier than a stat C-section. The air becomes electric once the doctor makes that call, and conversation becomes parsed and vital: I’ve got the IV; can you get the bed? Someone grab the med box and book the case. You tell the patient that something is wrong, and that we have to move fast. A page gets sent from the hospital operator to anyone on the team who’s outside the building, while you and the charge nurse take the patient to the OR. While the charge nurse rips the instruments from their sterilized paper bag and turns on the anesthesia equipment, you get the patient onto the table, prep the belly, get the drapes up and ready. The minute the doctor and the anesthesiologist run through the door, the cut is made, the baby’s out. It takes less than twenty minutes. At big hospitals, like Yale–New Haven, they can do it in seven.
Twenty minutes after Davis Bauer has his circumcision, another of Corinne’s patients has her water break. A loop of umbilical cord spools out between her legs, and Corinne is paged from the nursery, an emergency. “Monitor the baby for me,” she says, as she rushes into the woman’s room. A moment later I see Marie at the head of the patient’s bed, wheeling it with an orderly into the elevator. Corinne is crouched on the bed between the patient’s legs, her gloved hand in the shadows, trying to keep the umbilical cord inside.
Monitor the baby for me. She means that she wants me to watch over Davis Bauer. It is protocol that a circumcised baby has to be checked routinely to make sure that he’s not bleeding. With both Marie and Corinne in the thick of a stat C-section, there is literally no one else to do it.
I step into the nursery, where Davis is sleeping off the morning trauma.
It will only be twenty minutes till Corinne comes back, I tell myself, or until Marie relieves me.
I fold my arms and stare down at the newborn. Babies are such blank slates. They don’t come into this world with the assumptions their parents have made, or the promises their church will give, or the ability to sort people into groups they like and don’t like. They don’t come into this world with anything, really, except a need for comfort. And they will take it from anyone, without judging the giver.
I wonder how long it takes before the polish given by nature gets worn off by nurture.
When I look down at the bassinet again, Davis Bauer has stopped breathing.
I lean closer, certain that I’m just missing the rise and fall of his tiny chest. But from this angle, I can see how his skin is tinged blue.
Immediately I reach for him, pressing my stethoscope against his heart, tapping his heels, unwrapping his swaddling blanket. Lots of babies have sleep apnea, but if you move them around a bit, change the position from the back to the belly or the side, respiration begins again automatically.
Then my head catches up to my hands: No African American personnel to care for this patient.
Glancing over my shoulder at the door of the nursery, I angle my body so that if someone were to come inside, they’d only see my back. They wouldn’t see what I’m doing.
Is stimulating the baby the same as resuscitating him? Is touching the baby technically caring for him?
Could I lose my job over this?
Does it matter if I’m splitting hairs?
Does anything matter if this baby starts breathing again?
My thoughts whip quickly into a hurricane: it has to be a respiratory arrest; newborns never have cardiac events. A baby might not breathe for three to four minutes, and still have a heart rate of 100, because its normal heart rate is 150…which means even if blood isn’t reaching the brain, it’s perfusing the rest of the body and as soon as you can get the baby oxygenated that heart rate will come up. For this reason, it’s less important to do chest compressions on an infant than to breathe for them. In this, it’s the opposite of the way you’d care for an adult patient.
But even when I shove aside my doubts and try everything short of medical interaction, he doesn’t resume breathing. Normally, I’d grab a pulse ox probe to get a monitor on his oxygenation and heart rate. I’d find an oxygen mask. I’d make calls.
What am I supposed to do?
What am I not supposed to do?
Any moment now, Corinne or Marie might walk into the nursery. They’d see me interfering with this infant, and then what?
Sweat runs down my spine as I hastily wrap the baby up in his swaddling blanket again. I stare at his tiny body. My pulse throbs in my eardrums, a metronome of failure.
I’m not sure if three minutes have passed, or only thirty seconds, when I hear Marie’s voice behind me. “Ruth,” she says, “what are you doing?”
“Nothing,” I respond, paralyzed. “I’m doing nothing.”
She looks over my shoulder, sees the blue skin of the baby’s cheek, and for a hot beat meets my gaze. “Get me an Ambu bag,” Marie orders. She unwraps the baby, taps his little feet, turns him over.
Does exactly what I did.
Marie fits the pediatric face mask over Davis’s nose and mouth and starts to squeeze the bag, inflating his lungs. “Call the code…”
I follow her order; dial 1500 into the nursery phone. “Code blue in the neonatal nursery,” I say, and I imagine the team being pulled from their regular jobs in the hospital—an anesthesiologist, an intensive care nurse, a recording nurse, a nursing assistant from a different floor. And Dr. Atkins, the pediatrician who saw this baby only minutes ago.
“Start compressions,” Marie tells me.
This time I don’t waver. With two fingers, I push down on the baby’s chest, two hundred compressions per minute. As the crash cart is jostled into the nursery, I reach with my spare hand for the leads and affix the electrodes to the baby so that we can see the results of my efforts on the cardiac monitor. Suddenly the tiny nursery is jammed with people, all jockeying for a spot in front of a patient who is only nineteen inches long. “I’m trying to intubate here,” the anesthesiologist yells at an ICU nurse who’s attempting to find a scalp vein.
“Well, I can’t get an antecubital line,” she argues.
“I’m in,” the anesthesiologist says, and he falls back to let the nurse have better access. She prods, and I push harder with my fingers, hoping to make a vein—any vein—stand out in stark relief.
The anesthesiologist stares at the monitor. “Stop compressions,” he calls, and I raise my hands like I’ve been caught in the middle of a crime.
We all look at the screen, but the baby’s rhythm is 80.
“Compressions aren’t effective,” he says, so I press down harder on the rib cage. It’s such a fine line. There are no abdominal muscles protecting the organs beneath that little pouch of belly; bear down a bit too much or a tad off center and I might rupture the infant’s liver.
“The baby isn’t pinking,” Marie says. “Is the oxygen even on?”
“Can someone get blood gases?” the anesthesiologist asks, his question tangling with hers over the baby’s body.
The ICU nurse reaches into baby’s groin for a pulse, trying to stick the femoral artery for a blood sample to see if the baby’s acidotic. A runner—another member of the code team—rushes the vial off to the lab. But by the time we get the results in a half hour, it won’t matter. By then, this baby will be breathing again.
Or he won’t.
“Dammit, why don’t we have a line yet?”
“You want to try?” the ICU nurse says. “Be my guest.”
“Stop compressions,” the anesthesiologist orders, and I do. The heart rate on the monitor reads 90.
“Get me some atropine.” A syringe is handed to the doctor, who pulls off the tip, removes the Ambu bag, and squirts the drug down the tube into the baby’s lungs. Then he continues to bag, pushing oxygen and atropine through the bronchi, the mucous membranes.
In the middle of a crisis, time is viscous. You swim through it so slowly you cannot tell if you’re living or reliving each awful moment. You can see your hands doing the work, ministering, as if they do not belong to you. You hear voices climbing a ladder of panic, and it all becomes one deafening, discordant note.
“What about cannulating the umbilicus?” the ICU nurse asks.
“It’s been too long since birth,” Marie replies.
This is going downhill fast. Instinctively, I press harder.
“You’re being too aggressive,” the anesthesiologist tells me. “Lighten up.”
But what breaks my rhythm is the scream. Brittany Bauer has entered the room and is wailing. She’s being held back by the recording nurse as she fights to get closer to the baby. Her husband—immobile, stunned—stares at my fingers pushing against his son’s chest.
“What’s happening to him?” Brittany cries.
I don’t know who let them in here. But then again, there was nobody available to keep them out. Labor & Delivery has been overworked and understaffed since last night. Corinne is still in the OR with her stat C-section, and Marie is here with me. The Bauers would have heard the emergency calls. They would have seen medical personnel rushing toward the nursery, where their newborn was supposed to be sleeping off the anesthesia from a routine procedure.
I would have run there, too.
The door flies open, and Dr. Atkins, the pediatrician, immediately shoves her way to the head of the bassinet. “What’s going on?”
There is no answer, and I realize I am the one who is supposed to reply.
“I was here with the baby,” I say, my syllables accented in rhythm to the compressions I am still doing. “His color was ashen and respirations had ceased. We stimulated him, but there was no gasping or spontaneous breath, so we began CPR.”
“How long have you been at it?” Dr. Atkins asks.
“Fifteen minutes.”
“Okay, Ruth, please stop for a sec…” Dr. Atkins looks at the cardiac monitor. The heart rate, now, is 40.
“Tombstones,” Marie murmurs.
It’s the term we use when we see wide QRS complexes on the cardiogram—the right side of the heart is responding too slowly to the left side of the heart; there’s no cardiac output.
There’s no hope.
A few seconds later, the heartbeat stops completely. “I’m calling it,” Dr. Atkins says. She takes a deep breath—this is never easy, but it’s even worse when it’s a newborn—then tugs the Ambu bag off the tube and tosses it into the trash. “Time?”
We all look up at the clock.
“No,” Brittany gasps, falling to her knees. “Please don’t stop. Please don’t give up.”
“I’m so sorry, Mrs. Bauer,” the pediatrician says. “But there’s nothing we can do for your son. He’s gone.”
Turk wrenches away from his wife and grabs the Ambu out of the trash. He shoves the anesthesiologist out of the way and tries to affix it again to Davis’s breathing tube. “Show me how,” he begs. “I’ll take over. You don’t have to quit.”
“Please—”
“I can get him to breathe. I know I can…”
Dr. Atkins puts her hand on his shoulder, and Turk collapses into himself, an implosion of grief. “There is no way you can bring Davis back,” she says, and he covers his face and starts to sob.
“Time?” Dr. Atkins repeats.
Part of the protocol of death is that everyone in the room consents to the moment it occurs. “Ten oh four,” Marie says, and we all murmur, a somber chorus: I agree.
I step back, staring at my hands. My fingers are cramped from performing the compressions. My own heart hurts.
Marie takes the baby’s temperature, a cool 95. By now Turk is anchored to his wife’s side, holding her upright. Their faces are blank, numb with disbelief. Dr. Atkins is talking softly to them, trying to explain the impossible.
Corinne walks into the nursery. “Ruth? What the hell happened?”
Marie tucks Davis’s blanket tight around him and slips the little stocking cap back on his head. The only evidence of the trauma he’s suffered is a small tube, like a little straw, coming out of his pursed mouth. She cradles the baby in her arms, as if tenderness still counts. She hands him to his mother.
“Excuse me,” I say to Corinne, when maybe what I really mean is Forgive me. I push past her and skirt the grieving parents and the dead baby and barely make it to the restroom before I am violently ill. I press my forehead to the cool porcelain lip of the toilet and close my eyes, and even then I can still feel it: the give of the rippled rib cage under my fingers, the whoosh of his blood in my own ears, the acid truth on my tongue: had I not hesitated, that baby might still be alive.
I HAD A patient once, a teenage girl, whose baby was born dead due to class 3 placental abruption. The placenta had peeled away from the uterine lining and the baby had no oxygen; the severity of the bleeding meant we almost lost the mother as well as the newborn. The baby was sent to our morgue pending autopsy—which is automatic in Connecticut for the death of a neonate. Twelve hours later, the girl’s grandmother arrived from Ohio. She wanted to hold her great-grandchild, just once.
I went down to the morgue, to where the dead babies are kept in an ordinary Amana refrigerator, stacked on the shelves in tiny body bags. I took the baby out and slipped him from the bag, stared for a minute at his perfect little features. He looked like a doll. He looked like he was sleeping.
I just couldn’t find it in myself to hand this woman an ice-cold baby, so I wrapped him up again and went to the emergency room for some heated blankets. In the morgue, I swaddled the baby in them, one after another, trying to take the chill from his skin. I took one of the knit caps we usually put on newborns to cover the peak of his head, mottled purple with settled blood.
We have a policy, if a newborn dies: we never take him away from the mother. If that grieving woman wants to hold her baby for twenty-four hours, to sleep with him tucked against her heart, to brush his hair and bathe him and have all the moments with her child she will never get to have, we make it happen. We wait until the mother is ready to let go.
That grandmother, she held her great-grandson for the entire afternoon. Then she put the infant back into my arms. I put a towel over my shoulder, as if I were nursing him, and got into the elevator, taking him down to the basement level of the hospital, where our morgue is located.
You’d think that the hardest part of an experience like this is the moment the mother gives you her child, but it’s not. Because at that moment, it’s still a child, to her. The hardest part is taking off the little knit hat, the swaddling blanket, the diaper. Zipping him into the body bag. Closing the refrigerator door.
AN HOUR LATER I am in the staff room, taking my coat from the locker, when Marie pokes her head inside. “You’re still here? Good. Got a minute?”
I nod, sitting down across from her at the table. Someone has tossed a handful of hard candy on it. I take a piece and unwrap it, let the butterscotch bleed onto my tongue. I hope it will keep me from saying what I shouldn’t say.
“What a morning,” Marie sighs.
“What a night,” I answer.
“That’s right, you pulled a double.” She shakes her head. “That poor family.”
“It’s horrible.” I may not agree with their beliefs, but that doesn’t mean I think they deserve to lose a baby.
“We had to sedate the mom,” Marie tells me. “The baby’s gone downstairs.”
Wisely, she does not mention the father to me.
Marie flattens a form on the table. “This is obviously just protocol. I need to write up what officially happened when Davis Bauer went into respiratory arrest. You were in the nursery?”
“I was covering for Corinne,” I reply. My voice is steady, soft, even though every syllable feels as dangerous as a blade at my throat. “She got called to the OR unexpectedly. The Bauer baby had his circ at nine, and couldn’t be left unattended. Since you were at the stat C, too, I was the only body even available to stand in for observation.”
Marie’s pen scratches across the form; none of this is anything she doesn’t know or expect. “When did you notice that the infant had stopped breathing?”
I curl my tongue around the candy. Tuck it high in my cheek. “A moment before you arrived,” I say.
Marie starts to speak, and then bites her lip. She taps the pen twice, then puts it down with a definitive click. “A moment,” she repeats, as if she is weighing the scope and size of that word. “Ruth…when I came in, you were just standing there.”
“I was doing what I was supposed to do,” I correct. “I wasn’t touching that baby.” I get up from the table, buttoning my coat, hoping she cannot see that my hands are shaking. “Is there anything else?”
“It’s been a tough day,” Marie says. “Get some rest.”
I nod and leave the break room. Instead of taking the elevator to street level, though, I plunge to the bowels of the hospital. In the overexposed fluorescent fixtures of the morgue, I blink, letting my eyes adjust. I wonder why clarity is always so damn white.
He’s the only dead baby there. His limbs are still pliable, his skin hasn’t taken on a chill. There’s mottling in his cheeks and feet, but that is the only clue that he is anything other than what he seems to be at first glance: someone’s beloved.
I lean against a steel gurney, cradling him in my arms. I hold him the way I would have, if I’d been allowed to. I whisper his name and pray for his soul. I welcome him into this broken world and, in the same breath, say goodbye.