Tale of Two Cities – is actually a hospital, as most of you know. It is Harriet White
Memorial Hospital. The Harriet White after whom it was named was my father’s first
wife, and she got her practical experience in nursing when there were still actual sheep
grazing on the Sheep’s Meadow in Central Park. A statue of the lady herself (who would
have been my stepmother, had she still been alive when I was born) stands on a pedestal
in a pavillion before the building, and if any of you have seen it, you may have wondered
how a woman with such a stern and uncompromising face could have found such a gentle
occupation. The motto chiselled into the statue’s base, once you get rid of the Latin
folderol, is even less comforting: There is no comfort without pain; thus we define
salvation through suffering. Cato, if you please … or if you don’t please!
I was born inside that grey stone building on 20 March, 1900.I returned there as an
intern in the year 1926. Twenty-six is old to be just starting out in the world of medicine,
but I had done a more practical internship in France, at the end of World War I, trying to
pack ruptured guts back into stomachs that had been blown wide open and dealing on the
black market for morphine which was often tinctured and sometimes dangerous.
As with the generation of physicians following World War II, we were a bedrock-
practical lot of sawbones, and the records of the major medical schools show a
remarkably small number of washouts in the years 1919 to 1928. We were older, more
experienced, steadier. Were we also wiser? I don’t know … but we were certainly more
cynical. There was none of this nonsense you read about in the popular medical novels,
stuff about fainting or vomiting at one’s first autopsy. Not after Belleau Wood, where
mamma rats sometimes raised whole litters of ratlings in the gas-exploded intestines of
the soldiers left to rot in no-man’s land. We had gotten all our puking and passing out
behind us.
The Harriet White Memorial Hospital also figured largely in something that happened
to me nine years after I had interned there – and this is the story I want to tell you
gentlemen tonight. It is not a tale to be told at Christmas, you would say (although its
final scene was played out on Christmas Eve), and yet, while it is certainly horrible, it
also seems to express to me all the amazing power of our cursed, doomed species. In it I
see the wonder of our will… and also its horrible, tenebrous power.
Birth itself, gentlemen, is a horrid thing to many; it is the fashion now that fathers
should be present at the birth of their children, and while this fashion has served to indict
many men with a guilt which I feel they may not deserve (it is a guilt which some women
use knowingly and with an almost prescient cruelty), it seems by and large to be a
healthful, salubrious thing. Yet I have seen men leave the delivery room white and
tottering and I have seen them swoon like girls, overcome by the cries and the blood. I
remember one father who held up just fine … only to begin screaming hysterically as his
perfectly healthy son pushed its way into the world. The infant’s eyes were open, it gave
the impression of looking around … and then its eyes settled on the father.
Birth is wonderful, gentlemen, but I have never found it beautiful – not by any stretch
of the imagination. I believe it is too brutal to be beautiful. A woman’s womb is like an
engine. With conception, that engine is turned on. At first it barely idles … but as the
creative cycle nears the climax of birth, that engine revs up and up and up. Its idling
whisper becomes a steady running hum, and then a rumble, and finally a bellowing,
frightening roar. Once that silent engine has been turned on, every mother-to-be
understands that her life is in check. Either she will bring the baby forth and the engine
will shut down again, or that engine will pound louder and harder and faster until it
explodes, killing her in blood and pain.
This is a story of birth, gentlemen, on the eve of that birth we have celebrated for
almost two thousand years.
I began practising medicine in 1929 – a bad year to begin anything. My grandfather
was able to loan me a small sum of money, so I was luckier than many of my colleagues,
but I still had to survive over the next four years mostly on my wits.
By 1935, things had improved a bit. I had developed a bedrock of steady patients and
was getting quite a few outpatient referrals from White Memorial. In April of that year I
saw a new patient, a young woman whom I will call Sandra Stansfield – that name is close
enough to what her name really was. This was a young woman, white, who stated her age
to be twenty-eight. After examining her, I guessed her true age to be between three and
five years younger than that. She was blonde, slender, and tall for that time – about five
feet eight inches. She was quite beautiful, but in an austere way that was almost
forbidding. Her features were clear and regular, her eyes intelligent … and her mouth
every bit as determined as the stone mouth of Harriet White on the statue in the pavilion
across from Madison Square Garden. The name she put on her form was not Sandra
Stansfield but Jane Smith. My examination subsequently showed her to be about two
months gone in pregnancy. She wore no wedding ring.
After the preliminary exam – but before the results of the pregnancy test were in, my
nurse, Ella Davidson, said: “That girl yesterday? Jane Smith? If that isn’t an assumed
name, I never heard one.’
I agreed. Still, I rather admired her. She had not engaged in the usual shilly-shallying,
toe-scuffing, blushing, tearful behaviour. She had been straightforward and businesslike.
Even her alias had seemed more a matter of business than of shame. There had been no
attempt to provide verisimilitude by creating a ‘Betty Rucklehouse’ or whomping up a
‘Ternina DeVille’. You require a name for your form, she seemed to be saying, because that is the law. So here is a name; but rather than trusting to the professional ethics of a
man I don’t know, I’ll trust in myself. If you don’t mind,
Ella sniffed and passed a few remarks – ‘modern girls’ and ‘bold as brass’ – but she was
a good woman, and I don’t think she said those things except for the sake of form. She
knew as well as I did that, whatever my new patient might be, she was no little trollop
with hard eyes and round heels. No; ‘Jane Smith’ was merely an extremely serious,
extremely determined young woman – if either of those things can be described by such a
milquetoast adverb as ‘merely’. It was an unpleasant situation (it used to be called ‘getting
in a scrape’, as you gentlemen may remember; nowadays it seems that many young
women use a scrape to get out of the scrape), and she meant to go through it with
whatever grace and dignity she could manage.
A week after her initial appointment, she came in again. That was a peach of a day —
one of the first real days of spring. The air was mild, the sky a soft, milky shade of blue,
and there was a smell on the breeze – a warm, indefinable smell that seems to be nature’s
signal that she is entering her own birth cycle again. The sort of day when you wish you
were miles from any responsibility, sitting opposite a lovely woman of your own – at
Coney Island, maybe, or on the Palisades across the Hudson with a picnic hamper on a
checkered cloth and the lady in question wearing a great white cartwheel hat and a
sleeveless gown as pretty as the day.
‘Jane Smith’s’ dress had sleeves, but it was still almost as pretty as the day; a smart
white linen with brown edging. She wore brown pumps, white gloves, and a cloche hat
that was slightly out of fashion — it was the first sign I saw that she was a far from rich
woman.
‘You’re pregnant,’ I said. ‘I don’t believe you doubted it much, did you?’
If there are to be tears, I thought, they will come now.
‘No,’ she said with perfect composure. There was no more a sign of tears in her eyes
than there were rainclouds on the horizon that day. ‘I’m very regular as a rule.’
There was a pause between us.
‘When may I expect to deliver?’ she asked then, with an almost soundless sigh. It was