“It’s a boy,” he announced, more for the benefit of the spectators than for me-I could tell from the way they looked at me that they thought I was asleep or delirious.

I opened my eyes slightly, thinking that it was all over, wanting to see the baby. But Dr. Alkmaar was empty-handed and he was not smiling.

“How do you know?” asked Brigitte-one of those two girls who made up my household. Brigitte looked like she belonged in a Dutch farm-yard operating a butter churn. In Court dress she looked big and out of place. She was harmless.

“He is trying to come out buttocks-first,” Dr. Alkmaar said distractedly.

Brigitte gasped. Despite the bad news, I took comfort from this. I had found Brigitte tedious and stupid because of her sweetness. Now, she was the only person in the room feeling sympathy for me. I wanted to get out of bed and hug her, but it did not seem practical.

Marie-the other girl-said, “That means both of them will die, correct?”

Now, Doctor, since I am writing this letter, there is no point in my trying to keep you in suspense-obviously I did not die. I mention this as a way of conveying something about the character of this girl Marie. In contrast to Brigitte, who was always warm (if thick-seeming), Marie had an icy soul-if a mouse ran into the room, she would stomp it to death. She was the daughter of a baron, with a pedigree pieced together from the dribs, drabs, fag-ends, and candle-stubs of diverse Dutch and German principalities, and she struck me (by your leave) as one who had issued from a family where incest was practiced often and early.

Dr. Alkmaar corrected her: “It means I must reach up and rotate the baby until it is head-down. The danger is that the umbilical cord will squirt out while I am doing this, and get throttled later. The chief difficulty is the contractions of her uterus, which bear down on the infant with more strength than my arms, or any man’s, can match. I must wait for her womb to relax and then try it.”

So we waited. But even in the intervals between my contractions, my womb was so tense that Dr. Alkmaar could not budge the infant. “I have drugs that might help,” he mused, “or I could bleed her to make her weaker. But it would be better to wait for her to become completely exhausted. Then I might have a better chance.”

More delay now-for them it was a matter of standing around waiting for time to pass, for me it was to be a victim of bloody murder and then to return to life again, over and over; but a lower form of life each time.

By the time the messenger burst in, I could only lie there like a sack of potatoes and listen to what was said.

“Doctor Alkmaar! I have just come from the bedside of the Chevalier de Montlucon!”

“And why is the new ambassador in bed at four in the afternoon?”

“He has suffered an attack of some sort and urgently requires your assistance to bleed him!”

“I am occupied,” said Dr. Alkmaar, after thinking about it. But I found it disturbing that he had to mull it over in this way.

“A midwife is on her way to take over your work here,” said the messenger.

As if on cue, there was a knock at the door. Showing more vitality than she had all day, Marie dashed over and flung it open to reveal a certain crone of a midwife, a woman with a very mixed reputation. Peering out through a haze of eyelashes I could see Marie throwing her arms around the midwife’s neck with a little cry of simulated joy, and muttering something into her ear. The midwife listened and said something back, listened and said something back, three times before she ever turned her colorless gray eyes towards me, and when she did, I felt death reaching for me.

“Tell me more of the symptoms,” said Dr. Alkmaar, beginning to take an interest in this new case. The way he was looking at me-staring without seeing-I sensed he was giving up.

I mustered the strength to lever myself up on one elbow, and reached out to grab the bloody cravat around Dr. Alkmaar’s neck. “If you think I am dead, explain this!” I said, giving him a violent jerk.

“It will be hours before you will have become exhausted enough,” he said. “I shall have time to go and bleed the Chevalier de Montlucon-“

“Who will then suffer another attack, and then another!” I replied. “I am not a fool. I know that if I become so exhausted that you are able to turn the baby around in my womb, I shall be too weak to push her out. Tell me of the drug you mentioned before!”

“Doctor, the French Ambassador may be dying! The rules of precedence dictate that-” began Marie, but Dr. Alkmaar held up one hand to stay her. To me, he said, “It is but a sample. It relaxes certain muscles for a time, then it wears off.”

“Have you experimented with it yet?”

“Yes.”

“And?”

“It made me unable to hold in my urine.”

“Who gave it to you?”

“A wandering alchemist who came to visit two weeks ago.”

“A fraud or-“

“He is well reputed. He remarked that, with so many pregnant women in the house, I might have need of it.”

“’Twas the Red?”

Dr. Alkmaar’s eyes darted from side to side before he answered with a very slight nod.

“Give me the drug.”

It was some sort of plant extract, very bitter, but after about a quarter of an hour it made me go all loose in the joints, and I became light-headed even though I had not lost that much blood yet. So I was not fully conscious when Dr. Alkmaar did the turning, and that suited me, as it was not anything I wanted to be conscious of. My passion for Natural Philosophy has its limits.

I heard him saying to the midwife, “Now the baby is head down, as it should be. God be praised, the cord did not emerge. The baby is crowning now, and when the drug wears off in a few hours, the contractions will resume and, God willing, she will deliver normally. Know that she is delivering late; the baby is well-developed; as frequently occurs in such cases, it has already defecated inside the womb.”

“I have seen it before,” said the midwife, a little bit insulted.

Dr. Alkmaar did not care whether she was insulted or not: “The baby has got some of it into his mouth. There is danger that when he draws his first breath he shall aspirate it into his lungs. If that happens he shall not live to the end of the week. I was able to get my finger into the little one’s mouth and clear out a good deal of it, but you must remember to hold him head-down when he emerges and clear the mouth again before he inhales.”

“I am in debt to your wisdom, Doctor,” said the midwife bitterly.

“You felt around in his mouth?The baby’s mouth?” Marie asked him.

“That is what I have just said,” Dr. Alkmaar replied.

“Was it… normal?”

“What do you mean?”

“The palate… the jaw…?”

“Other than being full of baby shit,” said Dr. Alkmaar, picking up his bag of lancets and handing it to his assistant, “it was normal. Now I go to bleed the French Ambassador.”

“Take a few quarts for me, Doctor,” I said. Hearing this weak jest, Marie turned and gave me an indescribably evil look as she closed the door behind the departing Doctor.

The crone took a seat next to me, used the candle on the nightstand to light up her clay-pipe, and set to work replacing the air in the room with curls of smoke.

The words of Marie were an encrypted message that I had understood as soon as it had reached my ears. Here is its meaning:

Nine months ago I got into trouble on the banks of the Meuse. As a means of getting out of this predicament I slept with Etienne d’Arcachon, the scion of a very ancient family that is infamous for passing along its defects as if they were badges and devices on its coat of arms. Anyone who has been to the royal palaces in Versailles, Vienna, or Madrid has seen the cleft lips and palates, the oddly styled jaw-bones, and the gnarled skulls of these people; King Carlos II of Spain, who is a cousin to the Arcachons in three different ways, cannot even eat solid food. Whenever a new baby is born into one of these families, the first thing everyone looks at, practically before they even let it breathe, is the architecture of the mouth and jaw.