Slaughtering them, more like. Religious extremists were killing not only the midwives, but all women who advocated womens rights or who represented female power in their communities. It was obscene. And largely unreported in the media. The massacre had prompted Doctors Unlimited to fund this secret mission into Zaghastan to deliver babies, in fact. When her brother had asked her to go along and translate, she wasnt about to say no to helping women just trying to survive childbirth. Shed also just finished her gig with Teachers Across America and had yet to land a permanent teaching job or even decide where she wanted to live. And then there was the bad breakup with the latest rotten boyfriend to get away from. Her friends called her the asshole magnet for good reason.
Id suggest you get some sleep, Alex said briskly. You look like you need it.
Her eyebrows shot up. Hasnt anyone ever taught you women dont like to be told they look like crap?
He looked vaguely startleda first for him. I beg your pardon?
OMG. He really doesnt know that? Women dont like to be told they look bad.
He frowned, his formidable mind obviously examining her statement from ninety-two different angles. I suppose thats logical if a woman is insecure about her appearance for some reason.
News flash, Einsteinall women are insecure about their appearance.
I have no context within which to place that remark.
Oh, for the love of Mike. Are you always such a geek?
For just a second, something incongruousand totally non-geekyflashed in his eyes. Amusement. Male appreciation. Desire.
What. The. Heck? Where did the geek go?
She did a sharp double take, and his eyes were back to being as guarded and clueless as ever.
* * *
ALEX CONSIDERED KATIEor at least the tip of her nose where it poked out of her sleeping bag. She could prove to be a serious problem. For a self-professed dingbat blonde, Katie had already showed herself to be deeply intuitive. Smarter than she let on. God knew, she was easy on the eye. The first thing he supposed most people would notice about her was the lush, golden hair falling in soft waves around her face. Or maybe her bright blue eyes. Or maybe even her slender, attractive figure.
Frankly, the thing hed keyed in on first was her smile. It was warm and genuine and filled a room. He would like to think his mother had smiled like that. But, knowing his father, the man would never have gone for an open, loving woman. His old man would have gone for an ice bitch with a heart as hard and cold as a diamond.
Which would, of course, be more in keeping with his mothers early and complete disappearance from his life. He had no memory of the woman whatsoever. Had no idea what happened to her. Never seen a picture. Never even heard a name.
A loose rock rolled outside, and he jerked to full alert. He shed the sleeping bag hed wrapped around his shoulders and slid into the shadow beside the tent flap. He shook a razor-sharp scalpel out of his sleeve and slid it into his palm.
A low voice whispered on the other side of the canvas and then devolved into the persistent cough most of the locals had. Dammit. He didnt understand a word of what the voice was saying. But it was female. He pulled the flap back, and two lumps of black cloth crouched in front of him. He gestured for them to come inside. The scalpel went inconspicuously back inside his sleeve as he moved to the back of the tent.
Katie, wake up. He gave her shoulder a shake through the down sleeping bag. She felt small and fragile under his hand. A temptation he couldnt afford, dammit.
Wha she mumbled as she rolled onto her back. Heavy sleeper. Must be nice to be so naive. It had been a long time since hed thought the world was safe enough to sleep like that.
I need a translator.
She sat up sharply. Oh! She looked over at the two women huddled by the door and said something in the native tongue. It was a guttural and clumsy-sounding language.
Youre on, Doc, Katie announced. The one on the left is in labor. Older one is her grandmother. Says shes worried because her granddaughter is young and small.
How young? he bit out.
Another exchange of words. Then Katie answered grimly, Fourteen. Her first baby.
One of the burka-wrapped shapes bent over just then and gave a low moan. Grandma propped up the girl as the contraction gripped her.
All the deliveries had been routine so far. Adult women, mostly on at least their fourth kid. But a first-timer barely into her teens? This could get interesting. His training in obstetrics was superficial; he was primarily a trauma surgeon. But all doctors were required to pull an obstetrics rotation in medical school. The men in prison with him who had constituted much of his on-the-job medical experience hadnt given birth to a hell of a lot of babieswhich was to say, any babies.
Hed pulled a short stint in a maternity ward to deliver a few more kids before hed been sent out here. But hed never seen a case like this. Nothing like trial by fire to earn his stripes as an obstetrician.
Get the girl onto a cot. I need her out of her clothes but covered enough to keep her warm. Ill crank up the heater while you ladies take care of all that, he instructed.
It was forbidden for males of any stripe, even doctors, to look at any part of a woman in this part of the world, especially where hed have to look to deliver a baby. But with all the local midwives dead, he was the only show in town. The Doctors Unlimited folks in Washington, D.C., had explained that it would be a death sentence for him and his patients to be caught. But the D.U. staff had believedcorrectlythat local women would risk it anyway.
Crazy thing, that. Women wanting to have a fighting chance at surviving childbirth. What were they thinking? He snorted sarcastically as he turned up the propane heater. Without proper care, one in three women in this part of the world died in childbirth or soon after from complications. Doctors Unlimited and other aid organizations had spent the past several decades training midwives, and the mortality rate had dropped to rates commensurate with the West. Until this past winter and the midwife massacre.
He commenced meticulously scrubbing his hands and forearms over a bucket of water so cold it made his fingernails turn blue. How in the hell was he supposed to work under these conditions?
A muttered argument ensued behind him, and Katie announced, The girl doesnt want you to examine her or help unless things go badly.
And how am I supposed to know things are going badly if I cant look at my patient? he snapped.
She sighed. They want you to tell me what to look for.
Thats absurd. You have no medical training whatsoever.
Thats what I told them. Shes adamant, though. And embarrassed.
But Im a doctor
And shes a young, terrified girl who cannot read or write and will be beaten to death by her husband if he catches her here.
Then why did she come? he demanded, low and angry.
Katie came over to stand directly in front of him. Her eyes were huge and beseeching as she looked up at him. Because shes more scared of her baby dying than of dying herself.
He stared down at her, seared by the zeal in her eyes. He grumbled, This sucks.
Welcome to life as a female a thousand years ago.
Katie came over to stand directly in front of him. Her eyes were huge and beseeching as she looked up at him. Because shes more scared of her baby dying than of dying herself.
He stared down at her, seared by the zeal in her eyes. He grumbled, This sucks.
Welcome to life as a female a thousand years ago.
He just shook his head. The first thing to do is see if the babys presenting headfirst. Youll have to use a speculum and a flashlight since its so dark in here. The lone lantern was barely bright enough to read by, let alone perform surgery by.
Katie gulped and headed for the laboring girl, who was moaning again. He glanced at his watch. Contractions were under two minutes apart. Do you know what a speculum is? he asked.
Every woman whos ever had an ob-gyn exam knows what one is, Katie replied frostily.
His lips twitched with humor, and he was glad her back was turned to him. How far is she dilated? he asked.
Theres about a silver-dollar-sized opening, Katie reported a moment later. What does a head look like?
Like a wet, hairy balloon pressed against the cervix.
Then weve got a problem. Im seeing pink skin. And its kind of pointy. Maybe bony. Like, umm, a baby bottom?
Breech presentation, he bit out. Youre going to have to talk our reluctant patient into letting me help.
But Mama was having no part of it. It was outrageous that he had to stand there and do nothing when he could be attempting to turn the baby before it entered the birth canal. Although given how small Mom was, that would be a dicey proposition at best. He really needed to consider a C-section sooner rather than later.
Tell her I want to discuss a C-section.
Nope. Abruptly hysterical Mama was having none of that. Grandma wasnt keen on the idea, eithersomething about not being able to hide the evidence of a doctor helping her granddaughter.
This was no way to practice medicine.
The tension in the tiny space mounted over the next hour as the girls labor progressed and her moans turned into sharp cries of pain. Dont let her push! he ordered. At all costs, she mustnt push.
The cries turned into screams muffled by a pillow the grandmother pressed over the girls mouth. God, this is barbaric.
I can set an epidural. Give her painkillers. At least let me put a heart monitor on the baby, he all but begged.
Im sorry, Alex. Shes not budging.
Katie, he ground out urgently. Find a way. Make her understand that she and her baby are in grave danger. This is why she came to me. Let me do my job!
His impotent fury mounted as the girls screams turned into long, keening moans indicative of exhaustion and delirium. He didnt need anyone to tell him the patient was no longer progressing in her delivery. Katie finally turned to the grandmother and said something sharp.
Okay, Alex. Grandma says to ignore her granddaughter and come help.
Thank God. As he expected, the girl was so far gone into the agony of a difficult birth that she barely noticed him working frantically to shift her baby into some sort of birthable position.
I need her to push with the next contraction.
Katie stood by the girls head, translating his instructions, although he doubted the mother was paying the slightest attention at this point. The girls body heaved of its own volition, and he went to work. He pulled the babys slippery ankles clear and hung on desperately until the next contraction. The girl screamed, one long continuous keen of agony as he all but tore the child from her body. It was that or risk the child suffocating in the birth canal.
Its a boy. He suctioned the babys nostrils and rubbed the child vigorously. Finally, the infant drew a shuddering breath and let out a wail. Not as lusty as Alex would have liked, but the kid was alive. He cut the cord and thrust the child at Grandma to wrap up and warm up. He had bigger problems at the moment.
This girl was too narrow-hipped and too damned young to be having babies, and the delivery had torn the crap out of her. She was bleeding heavily, and one supply he and Katie had not been able to haul in had been refrigerated whole blood.
He went to work fast, racing against time. The mothers screams quieted. Not that he wasnt causing her intense pain. She was merely bleeding out. Dying.
Tell her to fight, he ordered.
Katie leaned down to speak in the girls ear.
Say it like you mean it, he growled.
Katie raised her voice and began demanding that the girl open her eyes. That she live for her son. And while Katie tiraded like a drill sergeant, he fought like hell, his hands flying to stem the worst bleeders. It took a full five minutes to avert disaster, and nearly a half hour to stabilize the girl. Once the meatball work was done, he settled down to the slower and more meticulous business of cleaning up the mess.
Of course, Grandma told him to make sure all the stitches were internal and hidden. There mustnt be any evidence of modern medicine, no sirree.
After another hour, Grandma asked something and Katie translated. She wants to know if they can go soon. Theyve got to get the girl back home before dawn.
She cant move! he exclaimed. I just sewed her back together. I dont need her up, running around and tearing out all her stitches.
Katie threw his own words back at him. We have to find a way to get her home.
Sonofabitch. Where do they live? he asked in resignation.
A short conversation. Family compound on the edge of the Karshan village.
Ill carry her as far as its safe, he announced.
Katies eyes flickered in surprise. None of it is safe.
He rolled his eyes and scooped the girl up off the cot. Aware of how rough the terrain was going to be for their little trek, he elected to haul the mostly unconscious girl in a firemans carry, slung across his back. Grandma led the way. Katie followed behind her, carrying the baby in a cloth sling in front of her. The child had yet to nurse and he had no idea if the difficult birth had injured the infant. But he was given no chance to examine the baby. The sky was lightening behind the mountain peaks across the valley.
The hike down to the river was hellish. It was frigid and dark, and the ground was slippery with frost. Plus, every stray noise could be a local religious hard core with a gun and no sense of humor about their presence in this valley. Grandmas cough worsened in the cold night air, although the sound might work to their advantage by announcing that their little party was locals.
At least the sound of rushing water muffled it as they reached the valley floor. Grandma led the way along a footpath beside the river for nearly a mile. But then she stopped and whispered something to Katie, who translated.
Their compound is over the next rise. Shell take her granddaughter from here.
He eyed the short, heavyset woman. How?
Katies answer was sober. Shell find a way.
Reluctantly, he transferred the new mother to the old womans back, draping the girls arms over Grandmas shoulders while Katie looped the cloth sling holding the baby around her neck so it hung down her front. The old woman nodded her thanks and slowly trudged away from them under her load.
Madness. This is utter madness. He muttered, It will be light any minute. We need to get under cover.