David Mitchell - The Thousand Autumns of Jacob de Zoet

The eleventh year of the Era of Kansei

1799

M ISS KAWASEMI? ORITO KNEELS ON A STALE AND STICKY FUTON . Can you hear me?

In the rice paddy beyond the garden, a cacophony of frogs detonates.

Orito dabs the concubines sweat-drenched face with a damp cloth.

Shes barely spokenthe maid holds the lampfor hours and hours.

Miss Kawasemi, Im Aibagawa. Im a midwife. I want to help.

Kawasemis eyes flicker open. She manages a frail sigh. Her eyes shut.

She is too exhausted, Orito thinks, even to fear dying tonight.

Dr. Maeno whispers through the muslin curtain. I wanted to examine the childs presentation myself, but The elderly scholar chooses his words with care. But this is prohibited, it seems.

My orders are clear, states the chamberlain. No man may touch her.

Orito lifts the bloodied sheet and finds, as warned, the fetuss limp arm, up to the shoulder, protruding from Kawasemis vagina.

Have you ever seen such a presentation? asks Dr. Maeno.

Yes: in an engraving, from the Dutch text Father was translating.

This is what I prayed to hear! The Observations of William Smellie?

Yes: Dr. Smellie terms it, Orito uses the Dutch, Prolapse of the Arm.

Orito clasps the fetuss mucus-smeared wrist to search for a pulse.

Maeno now asks her in Dutch, What are your opinions?

There is no pulse. The baby is dead, Orito answers, in the same language, and the mother will die soon, if the child is not delivered. She places her fingertips on Kawasemis distended belly and probes the bulge around the inverted navel. It was a boy. She kneels between Kawasemis parted legs, noting the narrow pelvis, and sniffs the bulging labia: she detects the malty mixture of grumous blood and excrement, but not the stench of a rotted fetus. He died one or two hours ago.

Orito asks the maid, When did the waters break?

The maid is still mute with astonishment at hearing a foreign language.

Yesterday morning, during the Hour of the Dragon, says the stony-voiced housekeeper. Our lady entered labor soon after.

And when was the last time that the baby kicked?

The last kick would have been around noon today.

Dr. Maeno, would you agree the infant is inshe uses the Dutch termthe transverse breech position?

Maybe, the doctor answers in their code tongue, but without an examination

The baby is twenty days late, or more. It should have been turned.

Babys resting, the maid assures her mistress. Isnt that so, Dr. Maeno?

What you saythe honest doctor waversmay well be true.

My father told me, Orito says, Dr. Uragami was overseeing the birth.

So he was, grunts Maeno, from the comfort of his consulting rooms. After the baby stopped kicking, Uragami ascertained that, for geomantic reasons discernible to men of his genius, the childs spirit is reluctant to be born. The birth henceforth depends on the mothers willpower. The rogue, Maeno needs not add, dares not bruise his reputation by presiding over the stillbirth of such an estimable mans child. Chamberlain Tomine then persuaded the magistrate to summon me. When I saw the arm, I recalled your doctor of Scotland and requested your help.

My father and I are both deeply honored by your trust, says Orito

and curse Uragami, she thinks, for his lethal reluctance to lose face.

Abruptly, the frogs stop croaking and, as though a curtain of noise falls away, the sound of Nagasaki can be heard, celebrating the safe arrival of the Dutch ship.

If the child is dead, says Maeno in Dutch, we must remove it now.

I agree. Orito asks the housekeeper for warm water and strips of linen and uncorks a bottle of Leiden salts under the concubines nose to win her a few moments lucidity. Miss Kawasemi, we are going to deliver your child in the next few minutes. First, may I feel inside you?

The concubine is seized by the next contraction and loses her ability to answer.

WARM WATER IS DELIVERED in two copper pans as the agony subsides. We should confess, Dr. Maeno proposes to Orito in Dutch, the baby is dead. Then amputate the arm to deliver the body.

First, I wish to insert my hand to learn whether the body is in a convex lie or concave lie.

If you can discover that without cutting the armMaeno means amputatedo so.

Orito lubricates her right hand with rapeseed oil and addresses the maid: Fold one linen strip into a thick pad yes, like so. Be ready to wedge it between your mistresss teeth; otherwise she might bite off her tongue. Leave spaces at the sides, so she can breathe. Dr. Maeno, my inspection is beginning.

You are my eyes and ears, Miss Aibagawa, says the doctor.

Orito works her fingers between the fetuss biceps and its mothers ruptured labia until half her wrist is inside Kawasemis vagina. The concubine shivers and groans. Sorry, says Orito, sorry Her fingers slide between warm membranes and skin and muscle still wet with amniotic fluid, and the midwife pictures an engraving from that enlightened and barbaric realm, Europe