A slender woman knelt beside me. Usually a civilian comes up to me at a scene saying he’s a volunteer medic out of Blanco County and I say, “Thanks, move along.” But this slender woman, she had a voice from a dream in which babies come into the world riding great waves of warm water and the mothers weep with joy to hold their newly born.
“I’m a nurse,” she said.
This competent woman kneeling beside me and in my head she kept talking. In my head, I could hear her voice, like band-aids and brownies, saying, “You are not alone in this parched, cracked world into which you were so ruthlessly begotten.”
You’re always supposed to keep a woman who is pregnant on her side. Lying on the back puts the full weight of the baby on the spine and on the inferior vena cava; it can cause crazy ass changes in blood pressure, too. But for CPR, the patient has to be on her back. I’d practically memorized our goddamn protocol manual and there was no protocol for this, not for doing CPR on a woman who must be at her due date, if not just past it; and it wasn’t something I’d thought to ask about, not ever.
One of the guys from Fire noticed Nan wasn’t gonna be able to handle doing compressions; and so he knelt down, laced his fingers together and put the heel of his palm right on top of her sternum; his hands, they barely fit there between her great big round breasts and the hilltop of her stomach.
And I have always loved pregnant women, so ripe and everybody knowing just how they got that way; and no one should know them any way but with the smell of talcum and the taste of nervous, happy tears.
The guy from Fire started chest compressions and I could hear chestnut-colored hair’s ribs cracking underneath the weight he put on her. His face was stoic, all business. I kept maintaining the airway; and there was the nurse’s own heartbeat and breath as she knelt beside me. I could feel it even as Nan hovered further and further away from us where he could keep his own pregnant wife somehow safe.
We loaded the chestnut-haired woman onto the stretcher and into the back of the ambulance. The guy from Fire was coming with me, still doing compressions. Nan would be fine to drive. I was leaving the nurse behind. I had not seen her face. She had no name. Her heartbeat and I knew that she was with me.
The chi had gone out of the chestnut-haired woman, but the intubation and the CPR was keeping the blood oxygen exchange between her and the baby going. The baby floating and squirming inside the still-warm world of its mother’s dead body.
I felt as if I’d just rolled up on a mangled car with the living inside and I had a Jaws of Life, only I didn’t have permission to use it. And the person inside the car was going to die if I didn’t.
The woman with the chestnut-colored hair was dead and so she wasn’t my patient anymore; now my patient was the baby inside of her.
Paramedics aren’t authorized to do emergency surgery, not even on the dead.
By the time we arrived in the ER, the baby would be dead, too, or hopelessly brain damaged.
I grabbed the scalpel. The guy from Fire looked at me. Our eyes met. He knew and I knew and he nodded, just ever so slightly. And so without thinking beyond what needed to be done, I made the great, smiling cut just above the chestnut-haired woman’s pelvis. And the giant gush of water came spilling out onto me and I had a hold of the baby’s bright blue shoulders, slippery with blood, and I was pulling her out of there. I cut the cord as the baby turned pink in my arms and we both began to cry.
I’d heard of it happening a few times. A paramedic does an emergency C-section on a dead patient at the scene and afterwards he loses his license for it. The review board has to take his license. They’ve got no wiggle room there. But the paramedic can say, “Fuck you, the baby lived. Take my goddamn license.”
But that baby I delivered, she died in the hospital, four hours after we arrived, from internal injuries sustained in the womb during the terrible car wreck that killed her mother.
And sometimes when I made sweet love to my girlfriend Lily, I had the crazy notion I wanted to get her pregnant. But then later when her period came I would always remind myself that maybe you’re not doing anyone a favor by bringing them into this world. Maybe that’s no favor at all.