Part 2 (1/2)
”It's for the best, really,” Franz murmured, embarra.s.sed by the hollowness of his words.
Esther lowered her hands, then looked from Franz to Sunny and back to Franz again. ”Please, you must promise me, Franz. Whatever happens during the surgery, you will save the baby first.”
Franz and Sunny exchanged charged looks before Franz turned back to Esther. ”You know we will do everything possible for you and-”
Esther reached up and clutched his wrist with surprising force. ”But if it anything goes wrong, you will save the baby! Please, Franz.”
Franz clasped her hand in his and held it tightly for a moment. A silent promise.
Another nurse, Berta Abeldt, arrived pus.h.i.+ng a portable stretcher ahead of her. ”The operating room has been prepared, Dr. Adler,” she announced.
Together, they lifted Esther onto the stretcher and then Berta wheeled her away.
As Franz scrubbed for surgery, his thoughts drifted back to the night of Hannah's birth. His wife, Hilde, had been so excited when her water finally broke a week after her due date that she cried from joy rather than discomfort, at the first contraction. Between labour pains, Franz and Hilde playfully argued over names. They both favoured ”Albert” for a boy, but they could not agree on a girl's name; Franz preferred ”Elise,” while Hilde had her heart set on ”Hannah.”
By Hilde's sixth hour of labour, Franz sensed trouble. The baby's head had hardly progressed down the birth ca.n.a.l. After twelve hours, Hilde was too exhausted to push any more. Franz's mentor, Dr. Ignaz Malkin, had rushed into the hospital at four in the morning to perform an emergency Caesarian section. Franz had to beg the older surgeon to allow him into the delivery room; husbands were always kept outside. Franz had never felt as terrified or helpless. Hannah came out navy blue and not breathing. Dr. Malkin's vigorous rubbing finally coaxed a breath or two from the tiny girl. But the damage had been done. The newborn's brain had been deprived of oxygen for too long. Franz soon noticed how little his daughter's left arm and leg moved compared with the limbs on her right side. He was devastated, but Hilde remained unfazed. She persuaded him to be grateful for the miracle of their daughter's survival. And he was, too, until Hannah's fourth day of life, when Hilde developed a fever. Less than twenty-four hours later, his wife was dead from an overwhelming post-operative infection.
”Esther is on the operating table,” Sunny announced from over his shoulder, snapping him out of the memory. ”We are ready, Franz.”
His heart pounded in his throat. Esther and he were closer than most siblings. They had been the only adults in either of their families to escape n.a.z.i-occupied Vienna, four and a half years earlier. During their first three years in Shanghai, Esther had lived with Hannah and Franz in a one-bedroom apartment. Esther was more a mother than an aunt to Hannah. Franz could not imagine life without her.
Sunny reached a hand out to him. ”I have performed several Caesarian sections, Franz. If you would prefer . . .”
He smiled grimly. ”I have to do this, Sunny. I promised her.”
”Yes. Of course.”
As Franz stepped into the operating room, he reminded himself that there were no true medical parallels between Hilde and Esther's conditions. Still, he had to force himself to slow his breathing and focus on the procedure, not on Esther, who was already on the table, covered from the neck down. Her pregnant belly rose from a gap left between two sheets. Her abdomen was painted with brown iodine in preparation for surgery, but her complexion better matched the white sheets draping her. She managed a quivering smile for him. ”If it's a girl, she must be ”Ruth.” But if we have a boy, Simon and I both like the name ”Jakob.” After your father, Franz.”
”A good name, Essie.” The lump in his throat almost choked away his words.
Jakob Adler had outlived his younger son, Esther's first husband, Karl, by only a few weeks. Emphysema, not the n.a.z.is, had taken his life, but it still troubled Franz that Jakob had survived long enough to witness his younger son's lynching.
Sunny stepped up to the operating table, across from Franz. Another nurse, Liese, stood at the head of the table, a.s.suming the role of anaesthetist. She held a breathing mask and a bottle of ether that Simon had managed to secure through the black market just the day before he was interned.
Franz leaned closer to his sister-in-law. ”Are you ready, Essie?”
”Not for any of it-not surgery, not motherhood or . . .” She uttered a small laugh. ”But please do not let that stop you.”
Franz looked over to Liese and nodded.
”I am going to put you to sleep now, Frau Lehrer,” Liese said as she lowered the mask over Esther's face and tilted the bottle, slowly dripping the ether.
The sweet, acrid smell of the anaesthetic filled the room. After seven or eight drops had saturated the mask, Esther's eyelids began to flutter, and soon her eyes closed altogether.
Franz's stomach flip-flopped as he realized again that, despite the routine nature of the procedure, so much would be beyond his control. He lifted a scalpel from the surgical tray, surprised by the steadiness of his hand as he lowered the blade to the skin below Esther's navel. He poked the tip through, drawing blood, and waited for Esther's reaction. She remained still and silent, so he dug the blade in deeper and sliced vertically downward until he reached the level of her pelvic bones.
Sunny followed the blade with a sponge, dabbing away the blood. As soon as Franz pulled the scalpel back, she eased two retractors inside the long incision and spread the skin apart. Franz reached his gloved hand into the wound until he touched the firm bulge of Esther's uterus, which tightened against his fingers in a sudden contraction. Once the spasm pa.s.sed, he placed the scalpel against the womb and cut through the brownish-red muscle, being careful not to let the blade penetrate too deeply and nick the baby tucked inside. Once the scalpel pierced the uterus, dark blood gushed out through the incision, obscuring Franz's view Sunny sponged up as much of the blood as she could, and Franz glimpsed a tiny hand and arm poking through the incision. He dropped his scalpel on the tray and slid his hands inside Esther's uterus until they wrapped around the infant's warm, slippery body. Franz resisted the urge to yank the baby free. Instead, he gingerly eased it out, while Sunny clamped off and then cut the umbilical cord.
The tiny boy weighed no more than four pounds, but those details hardly registered with Franz. Covered in mucus and blood, the baby flopped limply in his hands. His skin was as blue as the Danube, and he neither moved nor breathed.
Franz went cold. For the first time since Hannah's birth, he froze inside the operating room.
Berta plucked the child from his hands, then swaddled him in a towel and laid him on the pillow on top of the table that had been set up as a makes.h.i.+ft cradle.
Franz held his own breath as he studied the baby's chest, desperate to see a sign of respiration. But the boy remained absolutely still.
”Is he?” Sunny asked slowly.
Unwilling to meet her eyes, Franz just stared at the table.
Berta applied her knuckles to the baby's small chest, her fist covering its entire surface as she rubbed. ”Take a breath, Kleiner.”
Nothing.
”Please, Schatzi,” Berta cooed. ”Breathe for your auntie.”
Drops of perspiration ran down Berta's brow as she continued to rub, murmuring gentle words of encouragement.
”Franz!” Sunny called. ”We have an arterial bleed!”
Franz spun and saw that Sunny had plunged her hand wrist-deep through Esther's incision. Bright red blood was welling up around Sunny's arm and running down the sides of Esther's abdomen.
”d.a.m.n it to h.e.l.l,” Franz muttered, realizing that one of the arteries that fed the placenta must have ruptured spontaneously once the pressure of the fetus's head against it had been released. He grabbed for the biggest clamp on the tray and swung back toward Esther. ”Let go, Sunny.”
She hesitated. ”You won't be able to see anything through all the blood.”
”Then I will do it blindly.”
Sunny pulled her hand free. Almost immediately, the blood began cascading over the edges of the surgical wound like the overflow from a backed-up sink.
”Dr. Adler.” Liese spoke in a hush from where she stood at the head of the operating table, her fingers against Esther's neck. ”The pulse is very weak.”
Franz thrust his hand back inside the wound, blood engulfing his glove and warming his hand. He felt around until his fingers found the left uterine ligament, and the artery and vein below it. He firmly clamped them off. He shot his hand over to the other side of the womb and explored until his fingers gripped the structures on the right side. Sunny handed him a second clamp, which he fastened onto the blood vessels. He hesitated before slowly withdrawing his hand.
Sunny wadded sponges into the wound. The blood soaked through them on contact. She prepared to stuff more inside, but Franz waved her off. ”Wait, Sunny.”
They both stared at the incision. No fresh blood appeared.
”The pulse, Liese?” Franz addressed the anaesthetist.
”There is little change, Dr. Adler.” Liese paused. ”Perhaps a smidgeon stronger.”
Franz pointed to the clamps protruding from Esther's abdomen. ”Even if she survives, I have to remove her uterus now. Ach, there will be no more children.”
”What choice was there?”