Part 4: Deliverance

My friend Coco languished in a maternity ward in London last week. Thanks to the U.K.’s system of socialized medicine, wonderful in many ways, challenging in others, she moaned to me that she had seen twelve obstetricians to date and had been cheated of developing a relationship with the doctor who would deliver her child.

Cheated indeed. My mother, ever the romantic, told me more than once that a woman never forgets her first love, or the man (and in those days it almost always was) who delivered her child. Coco’s plight has put me in mind of the men who delivered my children …… and it’s true I find. I can visualize my first love with crystal clarity and so too the men who delivered me.

I met Juan when I was three months along with Timothy. He is handsome and solid, the way big, handsome Hispanic men get in middle age when they no longer play baseball or soccer but continue to consume the arroz con pollo like they are still athletes. We had a long interview first, fully dressed, in his paneled, leather bound office where he asked me all manner of questions; personal questions. Probing questions – which I answered honestly for the most part – and as for the rest of it, that could in no way be anyone’s business but mine. I was slightly prudish in my twenties. And I felt somehow that these were questions specially reserved for pregnant college students. I suspected that these preguntas were not hurled at the well-heeled matrons from Pinecrest that made up part of his lucrative practice. I made sure that he understood that I was a married lady, in spite of my freckles and the last smatterings of acne, and not some ingénue in a desperate situation.
Done with the inquisition, we adjourned to the examining room with the nurse and undressed. Just me, not them; although I think it would be a good idea if everyone in the room had to shed their dignity along with the patient. I had been in stirrups only once before, when on a pony, and as I flinched at his hands he asked me to please relax. I don’t really like this, I say nervously. He laughs and says, do you think I like it?
Well I think you could not possibly HATE it, or you’d be a dermatologist.
This was an entirely cerebral comment you understand. I was young and my mouth was still governed by propriety.
Juan proceeds with his examination and he suddenly pauses in his ministrations and says, Hmmmmmm. Now, this is not a sound you want to hear a doctor make, especially when you can not see what he is looking at. What, I ask, alarmed. Oh, he says, nothing. And then makes a pronouncement that floors me. It’s the smallest WHAT you have ever seen, I ask. Ever? Seriously? Is that…OK?
He chuckles (chuckles!) and says, yes of course its fine. It’s normal for you.
Well, that’s wonderful. …….I’m malformed. What a grand beginning.

Juan took good, matter-of-fact, and thorough, care of me. And I trusted him. I ate all the things he told me to eat – this many eggs and servings of animal protein. This many citrus fruit, spinach for folic acid, carrots for vitamin A to nourish baby’s beautiful eyes. Liver was forced down once a week because Juan ordered it. I swam laps in the pool daily until contractions grounded me. When three weeks passed and I gained only a single pound, he admonished me to feed the baby better and I happily complied and gained another forty nine, effortlessly and cheerfully. When I went almost eleven days beyond my due date and ran into complications during labor, he swiftly delivered me and presented us with a nine pound, twelve once baby. In his final words to me before leaving the hospital he announced that I had bled all over his shoes…..

I went to Juan again when expecting Christian. He confirmed my pregnancy, announced that he no longer accepted my insurance, wished me luck and sent me on my way. That’s how I came to meet Antonio. He was the doctor of my closest friend and had recently delivered her little girl. He was good she said, but, she warned, a little colorful. He was Trinidadian for a start, and had a very direct way of speaking. And he certainly was, both colorful and good; and certainly did, say whatever crossed his mind without censure. He was brash and loud and quite enthusiastic about things in general. During my visits we would often talk about Miami carnival, whether or not he was going to play mas’ next year, when last we both went home and the best place to find roti and doubles in Miami. He spoke to me in a language I understood, without translation or preamble.
-Make sure and feed my baby, he warned. Salad is a side dish, not a meal for a pregnant woman. You hear me?
Yes, Antonio.
-Eat! But try not to gain fifty pounds this time.
So I ate- fruit for breakfast, salad for lunch, and what Antonio considered real food only for dinner. And I studiously lied to him the entire time. I still gained thirty five effortless pounds.
When my blood pressure went up he warned – no more salt prunes and mango chow Hamel-Smith and tell your mumma-in-law to use less salt in the curry and stew.
I wanted to try to have a natural birth after my horrendous C-Section. Antonio rolled his eyes. I say we should just cut, but ok, we’ll induce.
So we induced, and after seventeen hours on pitocin, we made no progress. The nurses called Antonio and some time later he blew into my hospital room like a whirligig, wearing jeans and a leather vest and smelling of cologne.
– Hamel-Smith, Jesus Christ, yuh doh listen! You know where I was? At a carnival fete. But don’t worry. Ah not drunk.
Well that’s really reassuring. A doctor who needs to assure you he’s not drunk!
Antonio proceeds to do an internal examination; while wearing his enormous class ring under his glove. It hurts like the devil and I tell him so.
-You wore your RING, I accuse!
I am shocked and outraged. He assures me that I did not feel his ring.
– Oh REALLY, I say. Maybe I should wear it and give YOU an internal and you can let me know if YOU feel it.
This delivered through clenched teeth. I have turned thirty and have lost some restraint.
Antonio looks at Howard with open sympathy and they both sigh.
-OK. I’ll take it off, just in case I have to reach in there again.
When we go into the operating theatre the birth is fast. Christian, indignant at being dislodged from warm, liquid comfort protests at the top of his lungs and Antonio remarks – oooooh gooooode, dis chile have a big mouteh!
And later, when the whole baby is delivered, he announces – a boy. A boy wit a BIG mout.
A boy with big everything. Almost nine pounds and three weeks early.



A year and a month later and I am sitting I Antonio’s examining room.
He sees me and erupts in laughter.
-Geeze woman! Again?
Yes Antonio. Again.
We proceed effortlessly through the pregnancy. Truly by now I’m an old hand. The only obstacle is the fact that Antonio is now in law school and my appointments and even Liam’s birth, must be arranged around Antonio’s schedule. Because Tim was born on Halloween and Chris on St. Patrick’s Day I wanted to continue the trend and have Liam on May fifth, Cinco de Mayo.
-No good Hamel-Smith. I have a big test that day. We’ll do it on the sixth.
So on the sixth, and after gaining almost sixty pounds, we produce, rather more quietly, a ten pound boy.

-So, yuh done, Antonio asked me before the birth.
Knowing that he meant my reproductive status, I said, yes.
-So we doing a tubal ligation then? Kind of dangerous to do a fourth C-section. I’ll do just one more if you really want, but not a fifth. You need to think about when to do a tubal.
No tubal, I replied.
So, as probably could easily be predicted by anyone other than me, I find myself pregnant again three years later.

My problem now is that Antonio is no longer practicing medicine. He is now a malpractice lawyer. I make an appointment with a high risk specialist knowing my birth might be a little tricky. I refuse an amnio, in spite of being over thirty five. I am Catholic I explain. Whatever the baby is, she’s mine. I put a hand protectively on my already large belly. The baby already has a name. This is Isabella, I tell the doctor, named for my friend LiliIsabelle. The high risk specialist accepts no insurance and takes cash only. We are poor, and so leave with a list of six doctors that he recommends.

I spend the next several days working my way through the list and during telephone consultations I am refused by the first four doctors. A fourth C-Section and a mother who has refused amnio is not a popular package. They are anxious not to have to use the services now offered by Antonio.

I decide that the next doctor will have to refuse me to my face and so I make an appointment and show up early. I notice the hardwood floors, the oriental carpets, the piped music and chandeliers. The nurse asks do I want some herbal tea? Some water? I whisper that I’d love a diet Coke and she conspiratorially whispers back that she’ll see what she can do. I am ushered into a lovely consulting room to wait and the doctor walks in and sits across from me. He is young, with large brown eyes with long lashes. He lays his hands on the desk in front of him and splays the fingers. They are thin, tapered fingers on smooth pale hands. There is a wedding band on his left hand but his right is unadorned. No class ring. He looks at me and smiles. He has dimples and I am in patient-love.
– So, Mrs. Hamel-Smith……..
– Simone, I correct him.
– Simone, he says. And you must call me…. Raphael.
Raphael. An angel’s name…………..
– Simone, first of all, relax. Breathe. Now tell me, what can I do for you?
And so I explain, sometimes through impending tears. This is my fourth baby and fourth C-Section. I don’t want an amnio and I have been refused by four other doctors.
He smiles and says, I won’t refuse you.
If this were a movie, the orchestration would swell and crescendo just about now.

From the first examination all the way through to the last I found that I had never in my life been touched so gently or respectfully as Raphael touched me. Upon every meeting he kissed both my cheeks charmingly, and continentally.
-You are blooming my dear, he would say. You are an absolute picture.
When arriving for my checkups I am seated on a couch with extra cushions and an ottoman for my feet. If Marta is there she brings first water and then with a wink, a diet Coke. If there is a delay the receptionist hastens over and says, Raphael called and he is delayed at the hospital and apologizes. He wants me to make sure you are comfortable.
I am amazed. No one in my life is this solicitous of me.

On the day that I am to give birth my doctor comes to the room where I am waiting. How are you my dear, he asks. Well, I say, I am a little nervous. He laughs, a little shakily and replies – I am a little nervous too.
-What? Raphael, you really shouldn’t say that to me!
He is immediately chastened and apologizes. One of the residents here at the hospital will be present with us in the delivery room he tells me. Just in case he needs…assistance. Not that he’s expecting to he adds.
My terror level approaches red, but all goes well, if slowly. There is lots of scar tissue he says. The resident looks on dispassionately at Raphael’s efforts while I try to have a normal sounding conversation with the ten year old boy standing at my head. It is take-your-child-to-work day in Dade County and this is Christian, the nephew of the head nurse. No one has asked my permission but terror has silenced me. The poor child looks a little overawed especially when his auntie asks if he would like to see the uterus, the baby, the cord, the placenta.
No, says Christian. No, thank you.
-I have a son named Christian, I whisper. He’s five.
– Are you in pain, poor Christian asks.
– No. I reply. They gave me medicine. What grade are you in?
He says he’s in fifth. I say, I teach fifth graders. I ask if he likes to read and he tells me about the book he’s reading and so we continue, in this surreal manner, until Raphael announces, with relief evident in his voice, that it’s a beautiful boy.
More confident now he says to the nurse, hold off on the silver nitrate, this boy wants to see his mother. Give him to her. And so for the first time ever, for me, the baby is put into my arms, not the nurse’s. And we look at each other with no silver nitrate in the way. He’s so tiny, I say. Is he alright?
Simone, he says, he’s seven and a half pounds. I know that’s not what you’re used to, but this is normal.

And, strangely enough, it felt perfect, all surreal elements aside.