CHAPTER FOURTEEN
Though they missed Elizabeth, the entire Cartwright family looked forward to Christmas. As it was only the first week of December, it was much too early to bring in a tree, but Josie and Hop Sing sat down one afternoon and began planning the food and drinks for the Christmas party. Josie wanted to try her hand at making her mother's famous minced pies, and Hop Sing had plans for a punch that would use rum instead of brandy, which pleased Josie immensely.
Late in the evening of the twelfth, just as a light snow was beginning to fall, the Cartwrights heard a wagon thunder into the yard. Ben hurried over and opened the front door.
"Dr. Cartwright! Dr. Cartwright!" a man's voice called from out of the darkness.
"Isaiah?" Ben hollered back. "Is that you?"
"Yeah! We need Dr. Cartwright!" Isaiah Jenkins and his wife, Ellie, lived in the mining camp, and Isaiah occasionally did odd jobs around the Ponderosa to earn a little extra money.
Josie rushed outside with Ben to discover a hugely pregnant Ellie Jenkins panting in the back of the wagon. "Bring her inside!" Josie ordered.
Ben pulled Josie aside. "Don't you think she'd be better off in your clinic over at the old bunkhouse?"
Josie pointed to the moaning, crying woman. "You want to tell her she has to ride another half mile in the back of that wagon in the snow, or shall I?"
Ben grunted. "Good point." After three sons, Benjamin Cartwright knew better than to cross a woman in labor. He helped Isaiah carry Ellie into the downstairs guestroom. They laid her on the bed, and Josie sent Little Joe for her medical bag.
"How long has she been in labor?" Josie asked Isaiah.
"Few hours," the man replied, crimping the brim of his hat between his fingers. "I wanted to come for you right away, but Ellie made me wait. Said babies take a while."
"She's right." She turned to her patient. "Ellie, how many babies have you had?"
"Two," Ellie gasped. Another contraction seized her, and she cried out. The tiny hairs on the back of Josie's neck crawled, and she turned around to see Ben, Adam, Hoss, and Little Joe, now clutching Josie's medical bag, staring at her wide-eyed.
"All right, everybody out," she ordered. "Except you, Hoss. I may need your help."
Ben grabbed Isaiah's arm and dragged him out of the room. Adam followed, but Little Joe stood frozen in place, clinging to Josie's medical bag and staring fearfully at the laboring woman. "Joe!" Josie snapped to get his attention.
"Huh?" he asked, slack-jawed.
Josie pried her bag from Joe's grasp. "I need you to do a very important job for me. I need you to go into the kitchen and start boiling pots of water. Lots and lots of water. As much as you can manage."
"Ok," Joe said stupidly and left the room.
"What's the hot water for?" Hoss asked.
"For getting rid of Joe." Josie turned back to Ellie. A woman on her third baby would likely deliver a bit faster, and a quick examination confirmed this. But when Josie felt the woman's abdomen, her brow furrowed.
Hoss noticed the change in Josie's expression before Ellie did. "What's wrong?" he asked.
Josie laid a gentle hand on Ellie's sweaty brow. "Ellie," she said softly. "Your baby hasn't turned. I need to try to turn him. I'm going to push on your stomach pretty hard. You won't like it, but I have to try."
Ellie nodded bravely and clutched Hoss's outstretched hand. Josie moved into position next to Ellie, placed her hands on the woman's abdomen and pushed with all her might.
Out in the living room, Isaiah Jenkins was drinking his way through Ben's brandy supply and pacing in increasingly crooked lines in front of the fireplace.
"My third one, and this don't get any easier," he slurred.
"Yeah, I know the feeling," Ben said.
He opened his mouth to offer up some words of encouragement to the drunk father, but just then, Little Joe tore out of the kitchen with a pot of boiling water.
"Josie!" he called excitedly, though he was several paces from the closed guestroom door. "I got the water! I got the- oops!" As he passed the dining room table, he tripped over a chair leg and fell hard, spilling the scalding water all over his lap. He hollered and leapt to his feet. "Hot! Hot!" Completely forgetting that they had company, Little Joe dropped his trousers to get the wet, burning fabric off his skin. He stood there in his undershorts with his pants around his ankles and sighed in relief.
Ben and Adam watched the scene unfold from their seats in the living room. Adam covered his eyes with one hand while Ben stared in disbelief.
"Joseph!" he barked. Little Joe turned toward his father with an innocent expression on his face. "We have a guest!"
Little Joe's wide-eyed innocence evolved into wide-eyed horror as he remembered the presence of Isaiah Jenkins, who was staring at him through glassy eyes. He grabbed his pants and yanked them back up. His eyes watered as the still-hot fabric connected with his legs, and he raced upstairs to his room for dry trousers.
"S'ok, Ben," Isaiah said, swaying on his feet. "I know you done your best with him."
"Thanks, Isaiah, that means a lot."
Adam rose to mop up the water when the three men heard a sharp cry of pain from the guestroom.
"Ellie!" Isaiah cried and staggered toward the door.
Adam caught him. "It's all right, Isaiah. If Ellie needs you, Josie will send Hoss out for you. Now sit down before you fall down." He steered Isaiah into the blue armchair near the fire, where the man sat wringing his hands. Pip rose from his position in front of the fireplace and sat next to the armchair. Isaiah dropped his hand onto the dog's head and swirled one finger through Pip's wiry fur.
In the guestroom, Josie was having no luck getting Ellie's baby to turn. She wiped sweat from her brow and looked over at Hoss. "He just won't budge!" she exclaimed in frustration. She looked down at Ellie. The woman was pale, and her breathing was shallow. When Josie asked if either of her other two babies had been born breech, Ellie gazed up at her as if she didn't know where she was or who was speaking to her.
"Where's Isaiah?" she asked fuzzily. "My head hurts."
Josie's stomach dropped at Ellie's last statement, and she made a quick decision. "He's just outside the door. I'll go get him." She beckoned for Hoss to follow her and stepped out of the room.
All three men in the living room leapt to their feet when Josie stepped out of the guestroom with Hoss and closed the door behind them.
"The baby here?" Isaiah asked excitedly. "I didn't hear no cryin'. It a boy or a girl? Ellie'd be pleased as punch to have a little girl after two boys," he babbled, giving Ben a knowing wink.
Adam could tell from the look on Josie's face that she was not bearing good news. He grabbed Isaiah's arm and steered him back to the armchair.
Once they were all seated, including Little Joe who had returned wearing dry pants, Josie explained that the baby had not turned.
"So what?" Isaiah said. "Lots of babies don't turn, don't they?"
"That's true," Josie said. "And while a breech birth is dangerous, a mother and baby can typically pull through it if there are no other complicating factors."
"Ellie's got complicatin' factors?" Isaiah asked.
Josie looked up grimly at her uncle, who laid a hand on Isaiah's shoulder. "I believe she's suffering from a condition called eclampsia. It happens sometimes; there are a number of theories why, but no one's really sure. But what it means is she has to deliver this baby now—right now—or she and the baby may very well not make it."
Ben gripped the back of Isaiah's armchair with his free hand as terrible memories flooded his mind. Losing Elizabeth to childbirth had been bad enough, but to have lost Adam, too… He couldn't imagine the pain.
Isaiah didn't notice his host's distress behind him. "So, deliver it already!" he shouted.
"It's a bit more complicated than that," Josie said. "Because the baby hasn't turned, he isn't in a position where I can pull him out with my forceps. I need your permission to attempt a cesarean section."
Adam sucked in a sharp breath. He'd heard Jacob mention the procedure once or twice during his time in Washington, but even his uncle had never attempted one.
"A what?" Isaiah asked, giving his brandy snifter a dirty look as if it were to blame for the strange words coming from the young doctor's mouth.
"A cesarean section," Josie repeated. "It's a surgical procedure for delivering a baby."
Isaiah understood the word "surgical." "You mean you're gonna cut her open?"
"That's one way to put it. I'll make an incision in her abdomen, remove the baby, and stitch her up."
Ben's eyebrows shot up. "You can do that?"
Josie nodded, but Ben could see she lacked her usual confidence. She clearly had doubts about this procedure, but if she was suggesting it, then the mother in the guestroom was out of options.
"But she could die!" Isaiah protested.
"Yes, she could," Josie agreed. "But this is the best chance she's got. If I don't at least try, you're going to lose them both."
A stunned silence settled over the living room while Isaiah processed what Josie had told him. He looked up at Ben for help.
"Josie," Ben said, "have you ever done this before?"
"Twice. Successful both times, though every mother is different."
Ben nodded at Isaiah.
"All right," the miner said, his shoulders sagging. "Give it a try."
"Thank you, Mr. Jenkins," Josie said. "Would you like to see her first?"
Isaiah nodded and dashed into the guestroom. The Cartwrights stayed in the living room to give him and his wife a few moments of privacy.
"Josie, have you really done this twice?" Ben asked.
Josie looked up at her uncle indignantly. "Of course I have!" she huffed. Then quietly, she added, "On dogs."
"DOGS?!" Ben shouted. The others immediately shushed him.
"It's the same principle," Josie argued. "And it's the only chance Ellie Jenkins has."
Adam rested his hands on her shoulders. "I know you can do this, Josie."
"Thanks, Adam. Come on, Hoss, let's get started." She grabbed Hoss's elbow, and the two of them returned to the guestroom, from which Isaiah Jenkins made a reluctant exit. Ben guided him back to the armchair and gave him another brandy.
Josie gave Ellie a quick explanation of the procedure, but the woman was too confused to understand much, so Josie nodded at Hoss, who administered the chloroform. Josie drew a scalpel out of her bag and let it hover over Ellie's abdomen for a moment. She took a deep breath and began her incision.
Hoss had seen plenty of blood in his day—much of it his own—but he had never seen it drawn so deliberately. Josie had to pause frequently to wipe it away so she could see what she was doing. Her hands and apron were soon coated red. Her stomach churned with fear, but she forced herself to remain calm. At last, after what felt like hours but could have been only a few minutes, she spotted the baby. She called Hoss over and handed him the spreader to keep the incision open as she reached in and lifted the tiny infant out of its mother's womb. Much to Josie's relief and delight, the child let out an ear-splitting wail. Hoss looked up at Josie, a huge grin spreading across his face and tears trickling from his bright blue eyes. Josie smiled back and gave Hoss instructions for cutting the umbilical cord. He gently removed the spreader from the incision and picked up Josie's surgical scissors.
"There you go, little one," he said as he snipped the cord. He carried the infant to the washstand where he cleaned her up while Josie stitched Ellie's incision closed. "Look how tiny she is, Josie!" Hoss exclaimed as he carefully wiped down the squalling infant. "You think I was ever this tiny?"
Josie giggled as she continued stitching. "I highly doubt you were ever that tiny."
She finished her stitches, bandaged the incision site, and removed the chloroform rag from Ellie's face. "Come on, Ellie, wake up," she whispered. She was pleased that Ellie's breathing and pulse were strong, and she prayed that she'd delivered the baby in time to prevent further complications from the eclampsia. The chloroform wore off quickly, and Ellie blinked as she came to.
"Dr. Cartwright?" she whispered as she gazed up at Josie. "My baby… what happened?"
Josie nearly cried with relief. "It's ok, Ellie. You have a beautiful baby girl."
Tears streamed from Ellie's eyes as a grinning Hoss handed her the swaddled baby. "Come on, Josie," Hoss said, putting an arm around her shoulders. "Let's go tell everyone the good news."
The four men in the living room had heard the infant's first cries and raced to the guestroom door, where they were waiting anxiously when Josie and Hoss emerged. Isaiah nearly fell over onto Josie, but Little Joe grabbed his shirt collar and yanked him back.
"Congratulations, Mr. Jenkins," Josie said. "It's a girl!" Isaiah broke into a huge grin as Ben slapped him on the back and congratulated him. Pip let loose with a few happy yips.
"And Ellie?" Isaiah asked urgently.
"Is all right. She'll need to stay here a few days so I can ensure her incision doesn't get infected, but she's already cooing over your daughter in there."
Isaiah grinned again and shoved his way into the room, slamming the door behind him.
Ben handed Josie a brandy, which she passed to Hoss. "Well done, Dr. Cartwright!" Ben declared, slapping Josie's back so heartily that she stumbled. "Oh, sorry."
"Yes, well done, Dr. Cartwright!" Adam echoed, his face beaming. "I'd hug you, but…" he gestured to Josie's bloody apron and hands.
"Yeah," Josie said slowly. "About that. Uncle Ben, I'll buy new bedding for that room."
Ben and Adam grimaced, and Little Joe's upper lip curled.
"Sorry," Josie said. Ben assured her it was all right, given the circumstances, and Josie excused herself to clean up, feeling happier than she had in a long time.
That night, after everyone had gone to bed, including the new baby and her parents, Josie slipped back downstairs for a glass of milk. She was surprised to see Ben sitting in his burgundy armchair and staring into the dying fire.
"Uncle Ben?" she inquired softly.
Ben jumped. "Sorry, Josephine. I didn't hear you come downstairs."
"Is everything all right?"
"Yes, yes, everything's fine." He glanced at Josie with a halfhearted smile.
"You're a worse liar than Hoss, you know," Josie said with a smile. "And he's a pretty bad liar."
Ben chuckled and knew he was caught. "Just lost in thought."
"What were you thinking about?"
"The night Adam was born," Ben admitted as he shifted in his chair. "After what you did for Ellie tonight, I can't help but think if the doctor in Boston had known about that procedure…" He couldn't look up at his niece, who looked so very like his dear Elizabeth, so he stared into the fire again instead.
Josie's heart shattered. "Uncle Ben, don't do this to yourself. That doctor probably did know about cesarean sections, but it wouldn't have saved Aunt Elizabeth. Her illness had weakened her too much to even carry Adam to term. She never would have survived the procedure."
"Are you sure you aren't just saying that to make an old man feel better?"
"That's insulting."
"I'm sorry."
Josie rose quietly and slipped into the kitchen where she heated up some milk on the stove, which was still hot from all the water Little Joe had boiled earlier that evening. She poured the milk into two mugs, dusted the top of each with a bit of cinnamon, and took them into the living room, where she handed one to Ben. He thanked her, and uncle and niece sat sipping their milk and watching the fire sputter. When they finished their drinks, Josie took the mugs back to the kitchen and set them in the sink and then returned to the living room and bid her uncle goodnight. Ben stood and hugged her.
"I'm so proud of you," he said, resting his chin lightly on the top of her head. "And not just for what you did tonight. I don't know how the boys and I ever got along without you."
Josie smiled, though her face was hidden by the front of Ben's dressing gown. "Thanks," she said, her words slightly muffled by the fabric.
Ben kissed the top of her head. "Goodnight, sweetheart."
"Goodnight, Uncle Ben." Josie released him and hopped up the stairs. As she made the left-hand turn on the landing halfway up, she saw Ben sit back down in his armchair, and she suddenly missed her father terribly.