He folded back the hem of her housedress. Peeled the wet underpants from her skin and moved them down over her pale knees and her small feet and then dropped them on the floor. He could hear the voices of the children playing in the tree outside. He gently pushed her thighs apart and saw immediately that the baby had already begun to crown. Her skin was paler than his wife’s was, even in midwinter. He gave her his hand to get her through the next contraction, keeping his arm steady as she squeezed. He spread the fingers of the other over her taut belly. Mr. Persichetti wore a silver Saint Christopher’s medal around his neck and kept a Sacred Heart scapular in his pocket, but when Mary Keane asked him, catching her breath, “Who’s the patron saint of women in labor?” he shrugged. He told her he only knew Saint Dymphna was the patron of the insane.

He’d had the story from an Irish priest assigned to Creedmoor. “A sad case himself,” Mr. Persichetti said, and gently pulled the damp hem of her dress back over her thighs. For a moment he found himself incapable of remembering Mr. Keane’s face, although they’d been neighbors for perhaps ten years. Nor could he remember another conversation he’d had with this woman stretched before him now on her living-room couch, her hair damp and her eyes a kind of gray, or green. He took her hand as if she were his child, or his own wife.

“Apparently,” he said, “this Saint Dymphna was the daughter of an Irish chieftain, a pagan. But she had a beautiful Christian mother.” Gray eyes or green, he thought they were the one thing that might have made her pretty when she was young. “So the mother dies.” He paused only briefly. “When the girl’s about fourteen. And the chieftain goes crazy and tells his servants to go out and find another beautiful woman who resembled his dead wife so he can marry her.”

He paused again to touch her white lips with the wet towel. “They should be here soon,” he said softly, interrupting himself. There was a bit of mad laughter from the children outside. The sun through the lace curtains at the front window had placed a small spotlight on the arm of the sofa, just above her head. He could see by the color in her cheeks that another contraction was on the rise.

“The servants were evil,” he said, recalling the tale the way the whiskey priest they sent to Creedmoor told it, sitting with Mr. Per-sichetti at the nurse’s station late into the night, those watery blue eyes forever bloodshot and sleepless. “They told the crazy chieftain that he should marry his beautiful daughter instead. Which he tried to do.” (“If you get my meaning,” the priest had said.) “But Dymphna ran off to Belgium.” He saw her grimace and purse her lips, her face seemed to swell with color. “Her crazy father followed her,” he said, tightening his own grip on her hand. “I guess he cut off her head.”

Mrs. Keane said, “Oh my,” but the contraction took hold and at the end of it she sobbed, “Mother of God,” which he supposed was the answer he should have given her in the first place.

Jesus and Mary, most of the saints, even the alcoholic priest who could calm an agitated patient with just the laying on of his swollen hands, Mr. Persichetti himself, plagued by pity-indications all that the Creator was not indifferent to the suffering He engendered, in His bustling, in His haste, but also that there would be no end to His mistakes. Mr. Persichetti knew that six weeks before its time and with a good thirty-minute ride to the hospital once the ambulance came (would it ever come?), the baby would most likely not survive, would be born with flesh and plenty of blood but underdeveloped lungs and insufficient breath. He heard the children calling to one another outside, Tony among them once again since his father was taking so long inside the house and (stinging injustice) had been wrong to drag him away in the first place, two hours before dinner. (Although Tony had quickly discovered that the earlier war game could not be recaptured; that in the twenty minutes he’d been gone, it had lost its life, lost its charm.)

Mr. Persichetti knew there were children growing in nearly every house in this neighborhood, in every borough and every town. Thousands more were being born today, being conceived-women with their knees raised all over the world. Mrs. Keane herself already had three. If one of these, if a hundred of them, a thousand, came too soon or failed to thrive or were born incomplete somehow, born blue or ill made or with reason’s taut string already snapped, it was of little matter in the long history of God’s bustling. There was the Mother of God to turn to in prayer. There were the angels and the saints. There were the people like himself, plagued by pity the way other men were driven by ambition or greed, who would wade through the blood and the stool, the torn hair and ravaged flesh, the mad cries, to take the broken, raving thing-God’s mistake-into his arms.

When the next contraction had passed, he gently pushed the dish towels (printed with teapots, printed with kittens) under Mrs. Keane’s white thighs, pulling away Jacob’s soaked jacket. He put one hand on top of her belly. “Isn’t it lucky that you’re here?” she whispered, holding on to his strong arm. And then, a little later, “Isn’t it good the hurricane caused the tree to fall and so you came by?”

And Mr. Persichetti said it was good indeed, although he knew the baby might not survive.

“The storm came,” she said, catching her breath, “and then a fireman came to the door in the middle of the storm, out of nowhere, and told us about the tree falling, and then you came by.” She grimaced and paused, squeezing his hand. “And came back,” she said as the contraction passed. “Because-who was it?” she said.

“The Krafts,” he told her, “down the street.”

“The Krafts lost a tree as well,” she said, shifting uncomfortably. “Lucky for me.”

And then she breathed another “Mother of God.”

His T-shirt was soaked all across the middle. There was now the salty scent of her perspiration, and his, and the scent of blood. Her bare knee touched the side of his face. He saw the baby’s dark scalp, streaks of hair. She cried out and he was aware, too, of the sound of the ambulance somewhere. He raised the volume of his own voice, a string of reassurances against his own fear that the baby would not survive. Skull and forehead and closed eyes streaked with blood. He reached for the turkey baster, cleared the mouth even as he tugged, gently, at the head in his hands. The shoulders and arms and the surprising burst of the pale blue umbilical cord, thick and writhing, and then the baby was in his hands-”A little girl,” he told her-and the medics, the ambulance guys were in the room behind him, around him, a knee against his back as someone said, “Step aside,” and leaned down to take the little thing from him. The baby’s mouth opened and two fists went up in fury. And then it cried, but so thinly.

But of course, he couldn’t step. He discovered that he was kneeling at her side. He merely sat back on his bottom and then crawled a bit, avoiding their shoes. Someone was opening a medical bag and a stretcher was coming through the front door. He blessed himself and then said, “I’m in medicine, an RN,” lest they think him a fool. Then he leaned his back against a chair.

As they were hustling her and the child out the door (where the children from the tree had already gathered) he said to one of the medics, “Six weeks premature.” The guy shook his head. He had a crew cut and a broad face and his white coat buttoned across the shoulder. “That baby’s full-term,” he said. “Seven pounds at least.” Mr. Persichetti shrugged, rather nonchalantly, among men once more. “She said she had six more weeks.”

And the man shrugged, too, as if to confirm how well they both understood, being in the profession, that it was all a small matter, this coming into life and going out, merely part of the routine. “She can’t count,” he said bluntly.