Pica, short story by Sharon Bell Buchbinder in Web Mystery Magazine, Fall 2005

Pica

Jane, my birthing assistant, came to my room and told me we had to ride out immediately.

"Who is she?" I asked, getting dressed as fast as I could.

"From what I can tell, she’s a young girl, about eleven years old. Family’s been keeping the pregnancy secret. Now they’re afraid she’s going to die. They sent her brother to lead us there."

"Good Lord, a baby losing a baby. Can it be any more tragic than that?" I pulled on my riding boots. "Let’s go."

It was still dark when we set out that crisp November morning. Our horses pranced, happy to be moving. The silent, skinny boy with the raggedy clothing and sagging shoulders rode bare-back on his malnourished nag.

Several hours later, we arrived at a hollow with a stream chuckling nearby. A flock of dispirited chickens pecked at the ground in front of a shack and a rooster flapped his wings, gave a half-hearted crow and then seemed to shrug, as if it wasn’t worth his effort.

We tied the horses up to a stand of trees, told the boy to water them and entered the cabin.

"Thank the Lord you’ve arrived!"

It took a moment for our eyes to adjust to the darkness. A tiny bony woman was in front of us, grabbing at my free hand, dragging me to a pile of rags on the floor in a corner.

"She’s doin’ poorly. I woulda never sent the boy, ‘cept we was afraid she was gonna die."

In the dim light of the one-roomed cabin, I could just make out a pale girl writhing and moaning.

"I need to examine your daughter. What’s her name?"

"Susie. She don’t like to be touched. Says it hurts."

"I’ll be gentle."

I looked around the hovel. There was a rough hand-hewn wooden table, uneven chairs of the same manufacture, a pot-bellied stove that threw off wan heat and four emaciated dogs huddled as close to the fire as they could get. The only positive sign was a kettle, sitting atop the stove, throwing off steam.

Jane got soap from the saddle bag. I washed my hands, and then kneeled down on the floor next to Susie’s pallet. I hoped lice wouldn’t come home with me.

"Hi, Susie, how are you?"

"Hurts."

Her hair was greasy and her mouth was smeared with something dark.

"What have you been eating, Susie?"

"Anything I want," she said and grimaced. "Eatin’ for two."

Her mother spoke up, "She’s been eatin’ real good."

Then I saw the pile of dirt on the floor.

"Susie, have you been eating dirt?" I said and glanced up at Jane who stood at my side.

"It’s good for her," her mother said. "Keeps her from throwin’ up."

"Magic spirits," Susie said. "Eatin’ for two."

Pica, one of the more bizarre eating disorders of pregnancy, helped to explain her pallor. Five years of rural midwifery and I could still be shocked by the ignorance and strange practices of our patients. I bit back a reply that I doubted the "magic spirits" were going to help her by making her anemic and blocking her intestines full of dirt.

Instead I said, "I see. Susie, I have to touch your belly and examine you down there to see how far along your baby is."

Susie closed her eyes and clenched her teeth as I touched her taut belly. Drum-tight, it looked as if she would explode any moment. The internal examination confirmed my worst fears.

A little foot was poking out of her cervix. A breech birth was dangerous to mothers, even in modern-day 1930 hospitals. Here, in this poverty stricken cabin, I could practically feel Death panting on my neck.

"The baby’s coming out the wrong way. We have to turn him."

Jane stared at me. Her calm expression hid the terror I knew she must be feeling, because I felt it, too.

"Okay, Susie, first thing, we have to get you up on your feet." Jane stood at the head of the pile of rags and pushed from the back while I lifted her from the front by the armpits. The stench of sweat, urine and feces rolled over us in gut-wrenching waves. Susie’s legs trembled as we eased her onto a chair.

"Next, we’re going to get you cleaned up." Jane and I scrubbed at Susie while her mother brought fresh rags and a man’s nightshirt.

"Paw ain’t gonna like it, but it’s the only clean one we got," the mother said.

"Paw ain’t havin’ a baby," Susie said, surprising me with the angry tone of her voice. "He ain’t hurtin’, he ain’t eatin’ for two…" She screamed in pain.

We hadn’t a moment to spare. We had to get that baby’s head down, or she was going to die.

Hours later, after every midwife’s trick in the book, I felt the baby move in a long, slow somersault. The head was, at last, in a downward position.

"Susie, Jane is going to stand behind you and hold you." In addition to being an educated and well-read woman, Jane was also extraordinarily strong. "You’re going to squat like you’re sitting in a chair. That way, I can get the baby out."

As we struggled to get Susie into position, a large shadow crossed my light.

"Whoever you are, get out of my light," I said.

"Ah’m her Paw," a man said. He wore a leather jacket, pants and a large leather hat around his neck. Everyone else in the family was stick thin and malnourished. This giant looked like he ate bears for dinner every night.

"Well, Paw," I said, anger welling up in my chest, "unless you want Susie to die, I suggest you get the hell out of my light and out of this cabin."

Susie screamed. Between clenched teeth she said, "Ah’m eatin’ for two, Paw! Eatin’ for two!"

He stared at us, turned and went outside, hat bobbing on his back.

* * *

Relief washed over me when I felt the head in my hands. Soon this nightmare would be over. I gently urged the baby to come out into the world, speaking softly as I worked.

"Good boy, here we are, that’s right, keep coming. I’ve got you now."

His head was so big, he tore little Susie apart. She shrieked and blood gushed, covering my arms and the baby. He had to be dragged out, kicking and screaming, but at last, he was out.

I grabbed some clean rags and started wiping him off-then stopped. Nothing could have prepared me for the sight of this newborn. Jane nearly dropped Susie when she looked at him. What God would allow such a creature to be born, alive and well? Why hadn’t He just let him be a stillborn? A tragedy, yes, but nothing compared to the horrific life he’d lead.

"Susie, let’s get you onto the table, so you can rest," Jane said.

"Gimme my baby," Susie said.

"In a moment," I said. "I need to finish cleaning him up."

Paw came through the door, smiling widely. "We could hear him screaming outside! Let me see him!"

"No, he’s not ready…"

Too late. He had the baby in his big hands, looking at him before I could soften the blow.

"Well, looky here. Ain’t he just the spittin’ image of his Paw?"

The hat stirred on his back and a second head came around to look at the malformed newborn.

"Yup, he sure is," said Paw’s second head.

"Ah was eatin’ for two, Paw! Eatin’ for two!"

Author's Note: My mother told me that at one time we had a two-headed cousin in a jar in the Smithsonian Institution. After doing some genealogical research and seeing all the inbreeding in my early Southern family lines, the legend appears to be a creepy, but real, possibility.