The Medicine Woman of Galveston

by Amanda Skenandore

Genres: Women's Fiction

Synopsis

Caught in the great Galveston Hurricane of 1900, a female doctor who’s joined a traveling medicine show to support her disabled son is forced to weather the storm and its aftermath in a town hostile to the troupe’s unconventional ways but desperate for their help. 

Readers of Ellen Marie Wiseman, Sandra Dallas, and Sara Donati will be captivated by this story of medical historical fiction by Amanda Skenandore, registered nurse and acclaimed author of The Nurse’s Secret and The Second Life of Mirielle West.

Once a trailblazer in the field of medicine, Dr. Tucia Hatherley hasn’t touched a scalpel or stethoscope since she made a fatal mistake in the operating theater. Instead, she works in a corset factory, striving to earn enough to support her disabled son. When even that livelihood is threatened, Tucia is left with one option—to join a wily, charismatic showman named Huey and become part of his traveling medicine show.

Her medical license lends the show a pretense of credibility, but the cures and tonics Tucia is forced to peddle are little more than purgatives and bathwater. Loathing the duplicity, even as she finds uneasy kinship with the other misfit performers, Tucia vows to leave as soon as her debts are paid and start a new life with her son—if Huey will ever let her go.

When the show reaches Galveston, Texas, Tucia tries to break free from Huey, only to be pulled even deeper into his schemes. But there is a far greater reckoning ahead, as a September storm becomes a devastating hurricane that will decimate the Gulf Coast—and challenge Tucia to recover her belief in medicine, in the goodness of others—and in herself.

Release date: May 21, 2024

Publisher: Kensington Books

Print pages: 384

Sample

St. Louis, Missouri, 1900

Tucia’s head whipped up at the sound—high-pitched and urgent. She swiped a greasy hand across her forehead, pushing aside straggly, sweat-dampened hair, and turned from the oily gears of the tempering machine.

The sound belonged to the new girl three stations down. She stood writhing and wailing beside her machine.

Tucia took a single step toward her before catching sight of the blood. The girl’s sleeve had caught in the machine’s gears. Her arm, or what was left of it, was twisted amid the metal, flashes of bone and muscle visible between bits of shredded shirtsleeve.

Tucia managed another step forward. A tourniquet was needed, high on the arm, until she could assess the extent of the girl’s injury. A ligation, perhaps, judging from the pulsing splatter of blood. She’d need a blade in case she couldn’t find the end of the vessel after exploring the wound. A needle and thread. Cauterization might be necessary . . . Tucia’s feet had stopped. Stuck. Heavy. Cold. Her pulse sped. Her vision, only moments ago sharp, lost focus. The blood, she could still see it spurting, but the girl’s cries grew distant.

Tucia closed her eyes and tried to breathe despite the tightness in her throat. When she opened them, the factory, with its steam-choked air and whirring machines, had vanished.

You’ve gone and nicked an artery thanks to your careless approach. Now what will you do? a voice said over her shoulder, loud enough for everyone in the room to hear. Tucia rattled her head—that voice, it wasn’t real—but her hands, they were bloody, from the tips of her fingers to her elbows. Bloody and shaking. The smell of antiseptic blended with the stench of sweat and overworked gears redolent throughout the factory.

You’ll never grasp the vessel if you can’t still your hands.

But Tucia couldn’t even find the vessel. She cast aside the scalpel and groped for a clamp and ligature. Her slick hands could barely hold onto them.

You’re taking too long. How much blood can a patient lose before death is imminent?

When she didn’t reply, he all but shouted. How much blood?

“Five pints.”

Correct. And your blundering has cost her at least three. Dr. Seldon, check her pulse.

Tucia flattened her bloody hands over her ears. This wasn’t real.

Weak, sir, and thready.

She sucked in a breath and tried again to find the vessel, but the woman’s abdomen was quickly filling with blood. A cacophony of whispers rose through the operating theater. Tucia willed her mind to clear. What had the Annals of Surgery said about stopping hemorrhages? Gravity was used in cases of placental abruption. Elevating the pelvis above the head. Could such a technique be applied here? It might buy Tucia precious time to find the nicked artery. She called for the nurse’s assistance, but a louder, gruff voice rose above her own.

Out of the way, you incompetent woman, you’re killing her.

Tucia was pushed aside. As she stumbled forward, reaching out to steady herself, her hand landed on a rough wooden surface. A workbench?

The sights, sounds, and smells of the operating room faded. Rusty machines again surrounded her. Bare lightbulbs hung from above, and threads of afternoon light pressed in through the grimy windows. Tucia felt turned inside out, her heart still racing and her skin clammy. But she’d never been happier to be in this dingy factory.

Then she remembered the girl. Tucia’s eyes darted to the machine where her arm had caught. Shreds of fabric and tissue hung from the gears, but the girl had somehow broken free and lay in a bloody heap at the foot of her work table. To Tucia’s relief, the man who had brushed past her was the ambulance surgeon. The factory foreman followed at his heels but stopped several feet short of the girl, his face twisting into a grimace.

A crowd now filled the room. Workers from every department—spinning, stitching, hacking, cutting—pressed in among the machines. They gawked and murmured like they had in—Tucia scrubbed her hands over her face. They weren’t bloody after all, only smeared with dirt and grease from the machine. How long had she been standing there?

The doctor set his physician’s bag on the floor, careful to avoid the sprawling pool of blood, and rummaged inside it. After an achingly prolonged moment, he withdrew a stethoscope. He tiptoed to the girl as if more concerned with preserving his shiny shoes than saving her life. When he reached her, he inserted the earpiece into his ears and leaned over her, pressing the drum to her chest. Two fingers to her carotid would have yielded a quicker result, and even that could wait until a tourniquet was applied and the bleeding staunched. Tucia willed herself forward that she might assist him, but her legs were still too leaden to cooperate.

The doctor rose and removed the stethoscope from his ears.

“Shall I fetch your tourniquet?” she said, though her feet remained unyielding, rooted to the floor.

He shook his head.

“Have you suture thread in your bag? If you’ve got a quick hand, a ligation of the artery—”

He silenced her with another shake of the head. “Too late. With a wound like that, she hardly stood a chance.”

“Are you sure? Perhaps—”

“Do you know how much blood a person can lose before they die?”

Tucia flinched. “Five pints,” she muttered.

“Five pints,” he said as if she hadn’t spoken at all. “There’s at least that here on the ground, wouldn’t you say?”

Tucia’s gaze flickered downward. In the operating theater, a basin of sawdust beneath the surgical table caught the majority of blood lost during a procedure. Here, it spread uncontained, dark and oozing, seeping into the floorboards.

She raised her eyes, the edges of her vision blurring again, and nodded at the surgeon. He replied with a knowing snort and tiptoed through the blood back to his bag. “I’ll send an attendant over from the deadhouse to fetch the body,” he said to no one in particular and left.

The foreman shooed the crowd of workers back to their jobs. But Tucia lingered until he called her out by name and threatened to dock her the day’s pay if she continued to dally. Her feet, still stiff and heavy, obeyed.

It was the second person she’d let die.

As soon as the factory’s horn blew that evening, Tucia hurried home, wending her way through the busy city. She muttered as she walked, counting the cracks in the sidewalk. People might think her mad, but Tucia didn’t care. It gave her something in the here and now to focus on. Otherwise she might splinter apart.

The counting was a trick she’d picked up from an old army lieutenant who’d lived a few doors down when she first came to the city. A loud noise, and he was back at Chancellorsville with artillery booming and minie balls whizzing by his head. But if he could latch on to something in the present—the ticking of a clock or the number of petals on a flower—he might keep himself from slipping away.

Slipping away. That had been his term for it, and she’d thought it fitting. It called to mind losing purchase on the edge of a cliff or being caught in the undercurrent of a frozen river. One moment your handhold was strong, the ice beneath your feet solid, then—crack—you were slipping away. Falling. Gone.

The alienist had a different term. Hysterical attacks. She’d seen him only a few times after the incidents first began. Besides his blithe diagnosis and a rambling explanation of her innate female frailty, his only advice was to keep her mind—weak as it was—focused on the present.

Whatever the name, Tucia hadn’t experienced one in years. She was careful, after all. Had whittled her life down to the bare necessities. She avoided hospitals and blood sports and even carbolic soap. But the old man had warned her the waking nightmares would return.

Now, she dared not stop counting, though it slowed her pace. A bone-deep exhaustion plagued her step, but her every nerve still crackled as if on high alert. The normal ebb and flow of traffic on the streets—the rattling streetcars and clanking carriages and jangling bicycles—now seemed a frightful source of danger. At any moment, they might collide or strike an errant pedestrian.

What then? Would she freeze like she had that afternoon? Watch as another person bled out in front of her?

She forced herself to stop by the bakery a few blocks from her flat and bought a loaf of day-old bread. Then to the deli for a wedge of cheese. The shops were crowded with workers like her, hoping to stretch what little money they had until payday. It was hot inside the deli and stuffy. A bitter taste of the summer heat to come. Today the line of tired workers seemed fiery and restless. Their sighs and grumbles louder. Their glances cutting and suspicious.

Absentmindedly, she plucked a hair from behind her ear and began twirling it between her index finger and thumb. A moment later, she realized what she’d done. She dropped the hair and groped along her scalp for bald patches, mussing her bun and upsetting her hat.

No. Please, no! Not again.

Her whole body heaved with relief when she found nothing on her head amiss. But the urge to pluck another hair was so strong she had to close her eyes and ball her fist to keep it at bay.

“Next!”

Tucia startled at the loud voice, her heart leaping and eyes popping open.

“Hey, lady, you’re next.”

She hurried to the counter, bought her cheese, then threaded her way through the crowd and out the door.

Her last stop was the A&P. She clutched the handles of her bag with both hands and counted seventy-nine sidewalk cracks before arriving. Another snaking line awaited her inside, causing her stomach to twist and breathing to quicken. She’d much rather skip the store for home, but she’d promised to stop.

Inside, cans and boxes and jars lined the floor-to-ceiling shelves. Coffee, tea, sugar, baking powder, condensed milk—nearly anything one wanted could be found here. Her eye snagged on the boxes of packaged tea. Orange Pekoe, India-Ceylon, English Breakfast. She’d been brewing the same leaves at home for a week now. But she couldn’t justify the expense. Not even after a day like today. When she reached the counter, the clerk asked for her list. Tucia shook her head with a stab of embarrassment and pointed to the jar of penny candy. “One piece, please.”

Before reaching home, she passed another dozen sidewalk cracks and twice caught her fingers twirling a newly plucked hair.

“Home” was really too grand a word for the two-room flat she rented on the fourth floor of a decades-old tenement in the lower quarter of the city. Especially considering the fine Italianate home she’d grown up in. Sometimes she’d think about it—the plush oriental carpets, the richly lit rooms, the soft upholstered furniture—as she trudged up the creaky stairs to her flat, swallowing a tinge of regret before opening the door. But tonight, the spare, drafty rooms with peeling wallpaper and rotting floorboards would be a welcome reprieve from the day’s horrors.

She opened the door to near darkness, the last rays of evening’s light retreating through the room’s lone window. Tucia shuffled forward, feeling her way to the table, and lit the oil lamp. The flame flared, then settled into a weak but steady glow. A glance about the room revealed Mrs. Harsnatch seated in one of the two ladder-back chairs, her feet propped on a stack of Tucia’s books, the daily paper draped across her lap. Her mouth gaped open, and her chest rose with the steady rhythm of slumber. Otherwise, the room was empty.

Panic flared inside her. “Toby!” She dropped her bag and wheeled around, crossing to the adjoining room. “Toby!”

The answering silence struck her like ice water. She stumbled in her haste, bracing herself on the door jamb. Her eyes swept the room. Nothing. Her breath hitched. Then, beside the bed, a flash of movement. Her son looked up from his building blocks and grinned at her.

Tucia hurried over and knelt beside him, wiping away an errant tear. Of course he was here, safe and sound. Where else would he be? How foolish of her to worry.

She brushed the hair from his forehead. “What are you doing playing here in the dark?”

“Making a house.”

“Didn’t you hear Mama come in?”

He shrugged and turned back to his blocks.

“You gave me quite the fright. The least you could have done is answered when I called.” Her words came out sharper than she’d intended.

Toby’s smile fell. He dashed the lopsided tower he’d been building, sending the blocks scattering. Tucia winced and pulled him to her. Though he was small for his age, as most children with his condition were, he barely fit in her lap anymore. “I’m sorry, darling,” she said.

“I’m sorry,” he repeated. He nestled his head against her neck, and Tucia wrapped her arms around him. For the first time since the accident that afternoon, she could fully breathe. He’d always been that way—her anchor, her joy. She held him close until he grew restless and wiggled free.

“Look what I’ve got for you.” She pulled the small piece of candy from the watch pocket of her jacket.

Toby clapped and reached for it.

“Not until after supper.” She kissed him on the nose and stood. “Wash up while I say goodbye to Mrs. Harsnatch.”

Tucia returned to the main room to find Mrs. Harsnatch still snoring softly. If the woman could sleep through Tucia’s shouting, who was to say she’d awaken if Toby called out in need? Thank goodness he hadn’t.

She wished sorely she could sack the woman. But she’d never be able to find a replacement nanny willing to work for so little. Mrs. Harsnatch didn’t drink. She didn’t strike Toby or call him simple. She didn’t go wagging her tongue about them to friends or neighbors. And that meant a lot. Tucia knew all too well how quickly rumors spread.

Still, it would be nice if the woman could at least manage to stay awake. Tucia drew close and cleared her throat. When that didn’t work, she stomped her foot, sending a rumble through the worn floorboards. Mrs. Harsnatch startled, toppling the books at her feet and sending the newspaper fluttering to the floor.

“Good evening, Mrs. Harsnatch. I’m home.”

She straightened and swiped at her eyes. “Ain’t no mystery there.”

“Toby was playing in the dark when I arrived. Unsupervised, I might add.”

“You said to mind the oil.”

“Yes, but I merely meant not to burn the lamp in the middle of the day when the window affords sufficient light.”

Mrs. Harsnatch only grunted. She rose from the chair and grabbed her frayed shawl from the peg on the wall without bothering to pick up the newsprint or return Tucia’s books to the makeshift shelf where Tucia kept them. “Them loan sharks came by again today.” She jutted her chin at a letter on the table. Undoubtedly she’d read it, then folded it back up. “That ain’t gonna affect our arrangement, is it?”

Tucia forced a thin-lipped smile. She knew without reading it what the letter said. Her debt—nearly seven hundred dollars—was coming due in eight days.

“No, certainly not,” she said, though she had no means of paying such a sum. The salary lenders knew that too. It suited them just fine to renew the loan—at a higher interest rate, of course—and siphon off more of her weekly wages. She might not be able to afford her apartment, meager as it was, or even Mrs. Harsnatch’s salary.

But for now, she could. She grabbed her bag from the floor and fished out a quarter.

As soon as the coin was in her hand, Mrs. Harsnatch scuttled out the door. Tucia fixed Toby a plate of buttered bread and cheese. She took half a slice for herself, unbuttered, and heated the kettle for a cup of weak tea. While waiting for the water to boil, she dusted off her books and returned them to the shelf. Human Anatomy. The Principles and Practice of Medicine. Materia Medica. Disorders of Bones and Surrounding Tissues. Dissection and Pathology. She hadn’t read them in years. Mrs. Harsnatch put them to better use as a rest for her dirty feet than Tucia ever had. But even after all these years, she couldn’t part with them.

Next, she gathered up the scattered newsprint. This, at least, would make a useful fire starter or stuffing for the bed. As she folded the pages, a headline caught her eye:

Tucia needn’t read on. That life was behind her. What good was there in knowing the latest advances in asepsis or a new technique for lithotomy operations or the best way to suture the fascia after an ovariotomy? She couldn’t even manage to fashion a tourniquet when someone was exsanguinating right in front of her.

She shuddered but read on anyway, stopping a few lines in when she read the renowned surgeon’s name: Dr. Archibald Addams.

Tucia stood outside the Hamby Lecture Hall, her stomach knotted with indecision. A dry lump sat in her throat, and her hands were cold, despite the day’s lingering warmth.

She’d thrown up into her chamber pot after first reading the article. Toby had used it to relieve himself earlier that day, though he was supposed to use the shared water closet on the first floor, and stale urine had splashed into her face. After she’d emptied the pot and cleaned herself up, she balled up the newspaper and threw it into the corner to use in the stove the next day.

But before burning it, she’d read it again. And again, memorizing the date and time two days hence. By the time she stuffed it in the firebox, a dark, relentless curiosity had sparked inside her.

Now she was here, dressed in her Sunday clothes, her hat strategically pinned to hide the small patch of baldness newly exposed atop her head. She didn’t remember plucking the hairs. It might have been in her sleep when nightmares haunted her dreams. Or at the factory, where the dark ring of the woman’s blood still stained the floor. It might have been during the long debates she’d staged in her head about whether to attend tonight’s event. A debate still raging. She itched to pluck one now.

People—mostly men—streamed around her into the hall. She’d paid Mrs. Harsnatch an extra ten cents to stay late. Money Tucia could scarcely afford to spend. Money she wouldn’t be getting back whether she attended the lecture or not.

Tucia rubbed her hands together and swallowed. She might as well sate her curiosity and see the man. What damage could he do that he hadn’t already done?

She walked up the short flight of stone steps and into the lobby, weaving through the crowd to a door at the far end. She’d forgotten how it felt to be around these sorts of men, their hubris and self-importance wafting off them like cologne. She’d been that way once, too, though everyone was quick to remind her how ill-suited the scent was on a woman. Now they were polite enough, tipping their heads as they moved aside for her. Now that she smelled only of soap and machine grease.

When she reached the door at the far end, a man in a silk-lined cape stepped in front of her. His eyes, a curious shade of blue—no, not blue but violet—momentarily stunned her.

“Allow me,” he said, doffing his shiny top hat and bowing low before opening the door for her.

Tucia thanked him with a nod and a weak smile, then stepped inside. The choice seats at the front of the hall near the stage were already occupied. Those in the middle were filling up fast. If she polished up her smile, she might be able to persuade one of the gentlemen at the front to give up his seat to her. But Tucia had no desire to be that close. The vast hall felt too small as it was.

She found a seat in the very last row. The man who’d held the door for her seated himself across the aisle only a few rows ahead, though there were still dozens of better seats to be had. Something about him sent a prick tiptoeing down her spine, but she couldn’t say why. His flashy clothes, perhaps? His too-polished manners? His strange eyes? It wasn’t just their color but the intensity of his stare. He surveyed the growing crowd with keen interest but, thankfully, did not look back in her direction.

A bell chimed in the lobby, announcing the commencement of the lecture. The last of the seats were quickly filled, and Tucia fixed her attention on the stage. The voices in the hall quieted, and time seemed to slow, each second stretching longer than the last until Dr. Addams strode onto the stage.

Tucia’s body tensed at the sight of him. His sharp features. His broad frame. His brisk, confident step. Only a man as well assured of his good looks and brilliant mind as he could exude such effortless supremacy. Its effect was palpable. Whispers ceased. Shoulders bowed. Chins dropped. Then, almost in unison, the audience leaned forward, each man tugged by an invisible string. Even Tucia felt the pull.

The dean of the local medical college introduced Dr. Addams, extolling his vast contributions to the field of surgery. Then he bowed and yielded the stage.

Dr. Addams spared no time arranging himself at the podium, neither fumbling with spectacles nor searching for misplaced note cards the way some men did. He lectured by memory, always had, grabbing the sides of the podium like an Olympian readying to mount a pommel horse.

He seemed unchanged as if the past eight years hadn’t touched him. What had she expected? That time and hardship had ravaged him as it had her? No, he was the very same man, and she but a shadow of herself.

His voice carried easily through the hall. Tucia didn’t register what he said, only the hauntingly familiar cadence and timbre of his words. Her pulse hastened at the sound, and her windpipe narrowed. The distance between them collapsed. He was no longer fifty yards away, a sea of people between them, but standing close. Too close. Always a bit too close. But locked within his orbit, you could scarcely pull away. Didn’t care to pull away. You felt larger, grander, capable beyond your natural means. Until you weren’t. Until he wasn’t standing in front of you or beside you, but behind you, unleashing his venom in your ears.

Worthless. Incompetent. Careless. Imposter.

Tucia felt the hall and all its men closing in around her. Blurring. Warping. Receding, only to rush back at her. Then, suddenly everything was still, the hall, the men all back in sharp focus. Dr. Addams had paused his lecture and was looking right at her.

Miss—er—Dr. Hatherley, why don’t you come forward and enlighten the audience about the vascularity of uterine tissues and the danger of hemorrhage during supravaginal amputation?

She stood abruptly, shielding her face with her hands, and rushed from the hall. He hadn’t recognized her. Couldn’t have recognized her.

She stopped halfway through the lobby to catch her breath, steadying herself against a wingback chair, but only a sip of air made it to her lungs. She’d been a fool to come. A fool! She reached up and violently plucked a hair at the base of her scalp. And then another. And another. Four. Five. Six. Seven.

“Miss Hatherley?”

Tucia stopped at the sound of the unfamiliar voice and glanced over her shoulder.

A man walking with a cane hurried over. “Miss Hatherley? It is you, isn’t it? Are you quite all right?” He reached out to her, but she flinched and pulled away.

“Mr. Seldon,” he said as if she ought to recognize the name. “We were interns together at Fairview Hospital.”

Tucia blinked. Her breath was coming easier, but her mind still felt fuzzy, and she had no recollection of the man before her. “Don’t you mean Doctor Seldon?”

“I’m . . . er . . . not practicing.”

He stuffed his free hand into his pocket and flashed a sheepish smile. Perhaps she did recognize him. Vaguely. They were so alike, the other interns. Arrogant and ambitious. They’d thought her a novelty at first, each going out of his way to prove how gallant he was, how unperturbed he was by her presence. Until Dr. Addams asked them about gangrene and the treatment of postoperative suppurating wounds during their first week of surgical rounds. Not one of the fools knew the answer. But Tucia had, and offered it readily.

After that, all pretense of gallantry disappeared. She’d become their collective enemy. They would laugh uproariously when she entered the room. Whisper taunts and lewd jokes whenever she was in earshot. Crowd around a bedside or dissection table, casually shifting this way and that to keep her on the periphery.

She glanced now at Mr. Seldon’s cane. It wasn’t just for show the way so many other foppish men’s were. A fractured tibia that hadn’t healed properly, judging by the way he walked.

“A horse accident, I’m afraid,” he said. “Though that’s not why I’m not practicing. Never really was my thing. My father, if you remember, was—is—a physician. He’d always been the one pressing me to attend.”

A flush of anger prickled beneath Tucia’s skin. She’d wanted to be a doctor her whole life. Had fought and scraped every step of the way. Had studied harder and longer than him or any of the other interns. And in the end, even that hadn’t been enough. For him, it was just a dalliance, an appeasement to his father, and yet the path before him had been laid smooth as butter.

“I’m in town on business. Just passing through, really. But when I saw the advertisement for Dr. Addams, I extended my stay. l thought I might see someone from the old crew here, though I confess, I hadn’t expected it to be you.”

“Old crew?” Tucia straightened. “Mr. Seldon, you put the shriveled remains of a human penis in my medical bag, wore down the blade of my dissection scalpel so I couldn’t slice through a cadaver’s skin, intentionally spilled a patient’s urine sample all over my dress—and that was just within the first two weeks of our arrival at Fairview.” She straightened her hat and turned toward the door, saying over her shoulder, “I have no doubt you toasted my expulsion too.”

She walked briskly toward the exit, but Mr. Seldon caught up and kept pace beside her. “I tried to dissuade the others from putting the—er—appendage in your bag. I did.”

Tucia snorted and continued on. Her entire body still felt out of sorts, her heart thudding as if a wolf were stalking her. She wanted desperately to be home, alone and safe with her son.

Maddeningly, Mr. Seldon reached the door before she did and held it open for her. She stopped, scowled at him, and stepped through.

“We behaved like cads, Miss Hatherley. Worse than cads, and I’m sorry.”

The earnestness in his voice struck her, and her feet slowed. She glanced back and saw a flash of regret in his eyes.

“You were far superior to us both in intellect and dignity,” he continued. “We dishonored ourselves and the profession in the way we treated you. That day, in the operating theater . . .”

Tucia winced and looked away.

“Dr. Addams was wrong to put you in that position. I thought it then and think it still today. Why, it could have been any one of us who—”

“But it wasn’t,” Tucia snapped. “It was me, and I’m the one who’s had to live with the consequences.” She hurried down the stairs without looking back or bothering to bid him goodbye.

That night, Tucia dared not close her eyes for fear of meeting Dr. Addams again in her dreams. She held Toby close, counting each of his slow, steady breaths quietly aloud—two thousand four hundred and sixty-eight, two thousand four hundred and sixty-nine—to keep from hearing the doctor’s voice.

The next night passed much the same. And the next. When she did sleep, her dreams were drenched in blood.

Three days after the lecture, Tucia rose early for work. With Toby still sleeping, she washed herself at the nightstand and dressed behind the moth-eaten screen. Her nerves felt like they’d been scrubbed raw with wool steel. She’d been fifteen minutes late to work yesterday. Half an hour the day before. The foreman, a troll of a man with beady, narrow-set eyes, had glowered at her each time, jotting her name down on his little clipboard so he could be sure to dock her pay. Today, she was determined to be on time.

Once dressed, she pulled back the flannel curtains from the small window, allowing the pale glow of dawn to light the room. Toby stirred but didn’t wake. She watched him for a moment, his sweet face relaxed, the corner of his lips twitching with a grin. Tucia smiled, too, imagining what pleasant dreams he might be having.

The doctor who’d delivered him had grimaced when he first saw Toby. He laid Toby at the foot of the hospital bed and did a cursory examination, muttering words like hypotonia, brachycephaly, and heart murmur. Exhausted and breathless as she was, Tucia gasped. She tried to sit up and see better what the doctor was doing, but the nurse held her down.

“A rather sickly infant, I’m afraid,” he said, at last addressing Tucia. “I don’t expect he’ll make it through the night.”

At that, the stiff bed seemed to swallow her. Sickly in what way? What was the diagnosis? Her thoughts raced, one stumbling atop the other, warring with the fiery pain between her legs and a swarming weariness. But when the nurse swaddled Toby and placed him in her arms, all that vanished—her pain, her exhaustion, her ambivalence. She felt only love.

Toby did survive the night. And the next. Proving his stubbornness even then. Upon discharge, the doctor reminded her of Toby’s weak constitution. Furthermore, he said, . . .