Larch was unprepared for Mrs. Santa Glaus-specifically, for her attitude. He had imagined that in any meeting with an abortionist he (Dr. Larch) would take charge. He still tried to. He walked into the operating theater and picked up something, just to demonstrate his authority. What he picked up was the suction cup with a short hose running to the foot pump. The cup fitted neatly into the palm of his hand; he had no trouble imagining what else it fitted. To his surprise, when he had attached the cup to his palm, Mrs. Santa Glaus began stepping on the foot pump. When he felt the blood rushing to his pores, he popped the cup out of his palm before the thing could raise more than a blood blister on the heel of his hand.

'Well?' Mrs. Glaus asked, aggressively. 'What's your advice, Doctor?' As if in reply, the patient under the sheet drew Larch to her; the woman's forehead was clammy with sweat.

'You don't know what you're doing,' Dr. Larch said to Mrs. Santa Glaus.

'At least I'm doing something,' the old woman said with hostile calm. 'If you know how to do it, why don't you do it?' Mrs. Santa Glaus asked. 'If you know how, why don't you teach me?'

The woman under the sheet looked groggy, but she was trying to pull herself together. She sat up and tried to examine herself; she discovered that, under the sheet, she still wore her own dress. This knowledge appeared to relax her.

'Please listen to me, 'Dr. Larch said to her. 'If you have a {80}fever-if you have more than just a little bleeding-you must come to the hospital. Don't wait.'

'I thought the advice was for me,' Mrs. Santa Glaus said. 'Where's my advice?'

Larch tried to ignore her. He went out to the waiting room and told the mother with her young daughter that they should leave, but the mother was concerned about the money.

'Pay them back!' Mrs. Santa Glaus told the cashbox man.

They don't get the deposit back,' the man said again.

'Pay them back the deposit, too!' the old woman said angrily. She came into the waiting room to oversee the disgruntled transaction. She put her hand on Dr. Larch's arm. 'Ask her who the father is,' Mrs. Santa Glaus said.

That's none of my business,' Larch said.

'You're right,' the old woman said. That much you got right. But ask her, anyway-it's an interesting story.'

Larch tried to ignore her; Mrs. Santa Glaus grabbed hold of both the mother and her daughter. She spoke to the mother. Tell him who the father is,' she said. The daughter began to snivel and whine; Mrs. Santa Glaus ignored her; she looked only at the mother. Tell him,' she repeated.

'My husband,' the woman murmured, and then she added-as if it weren't clear-'her father.'

'Her father is the father,' Mrs. Santa Glaus said to Dr. Larch. 'Got it?'

'Yes, I've got it, thank you,' Dr. Larch said. He needed to put his arm around the thirteen-year-old, who was sagging; she had her eyes shut.

'Maybe a third of the young ones are like her,' Mrs. Santa Glaus told Larch nastily; she treated him as if he were the father. 'About a third of them get it from their fathers, or their brothers. Rape,' Mrs. Santa Glaus said. 'Incest. You understand?'

'Yes, thank you,' Larch said, pulling the girl with {81}him-tugging the sleeve of the mother's coat to make her follow.

'Shit or get off the pot!' Mrs. Santa Glaus yelled after them.

'All you starving doctors!' the cashbox man hollered. 'You're all over.'

The choir was singing. Larch thought he heard them say 'vom keinen Sturm erschrecket'-frightened by no storm.

In the empty room that separated the songs from the abortions, Larch and the mother with her daughter collided with the woman who'd been under the sheet. She was still groggy, her eyes were darting, and her dress was plastered with sweat to her back.

'Please remember!' Larch said to her. 'If there's a fever, if there's more than a little blood'…Then he saw the woman's underwear pinned to the shoulder of her dress. That reminding epaulette was the badge of 'Off Harrison,' a kind of ribbon for bravery. Obviously, the woman didn't know that her panties were there. Larch imagined that the South End was sprinkled liberally with these staggering women, their panties pinned to their shoulders, marking them as indelibly as that longago Puritan New England 'A' upon their bosoms.

'Wait!' Larch cried, and grabbed for the underwear. The woman didn't want to wait; as she pulled herself free of his grasp, the pin opened and stuck Larch in the hand. After she'd gone, he put her panties in his suit-jacket pocket.

He led the mother and her daughter through the room that was always so heady with song, but the choir was taking a beer break. The lean, bald conductor had just dipped into his frothy stein when he looked up and saw Dr. Larch leaving with the women; a moustache of foam whitened his lip and a dab of the white froth shone on the end of his nose. The conductor raised his stein toward Dr. Larch, offering a toast. 'Praise the Lord!' the conductor called. 'You keep on saving those poor souls, Doc!' {82}

'Danke schön!' the choir called after him. Of course they could not have been singing Mahler's Songs on the Death of Children, but those were the songs Wilbur Larch had heard.

'In other parts of the world,' wrote Dr. Wilbur Larch upon his arrival in St. Cloud's, 'an ability to act before you think-but to act nonetheless correctly-is essential. Perhaps there will be more time to think, here in St. Cloud's.'

In Boston, he meant, he was a hero; and he wouldn't have lasted long-being a hero. He took the young girl and her mother to the South Branch. He instructed the house officer to write up the following:

'This is a thirteen-year-old girl. Her pelvis is only three and a half inches in diameter. Two previous, violent deliveries have lacerated her soft parts and left her with a mass of unyielding scar tissue. This is her third pregnancy as a result of incest-as a result of rape. If allowed to come to term, she can be delivered only by Caesarean section, which-given the child's delicate state of health (she is a child), not to mention her state of mind-would be dangerous. Therefore, I've decided to give her an abortion.'

'You have?' the house officer asked.

'That's right,' Wilbur Larch said-and to the nurseanesthetist, he said, 'We'll do it immediately.' The abortion took only twenty minutes; Larch's light touch with ether was the envy of his colleagues. He used the set of dilators with the Douglass points and both a medium-sized and a small curette. There was, of course, no mass of unyielding scar tissue; there were no lacerated soft parts. This was a iFirst, not a third pregnancy, and although she was a small girl, her pelvis was certainly greater than three and a half inches in diameter. These fictional details, which Wilbur Larch provided for the house officer, were intended to make the house officer's report more convincing. No one at the Boston Lying-in {83} ever questioned Larch's decision to perform this abortion -no one ever mentioned it, but Dr. Larch could tell that something had changed.

He detected the dying of conversations upon his entering a room. He detected a general aloofness; although he was not exactly shunned, he was; never invited. He dined alone at a nearby German restaurant; he ate pig knuckles and sauerkraut, and one night he drank a beer. It reminded him of his father; it was Wilbur Larch's first and last beer.

At this time in his life Wilbur Larch seemed destined to a first-and-last existence; one sexual experience, one beer, one abortion. But he'd had more than one experience with ether, and the news, in the South End-that there was an alternative to Mrs. Santa Glaus and the methods practised 'Off Harrison'-traveled fast. He was first approached while standing at a fruiit-vendor's cart, drinking fresh-squeezed orange juice; a tall, gaunt woman with a shopping bag and a laundry basket materialized beside him.