(The facts of this story are true. The doctor was my Great-Grandfather).

From fathoms deep the knocking woke him. He groaned and sat up, the contact of his feet on the icy bare floor shocking him into awareness.

“Yes, Mrs. Denver?”

“Oh, Dr. Hall, I’m so sorry to wake you again, but there’s a man here…he says his daughter is in labor and will you come”?

He rubbed his hands over his head. He had gotten to bed past midnight after a late shift at the hospital, and now the demands of his practice were getting him up again. He picked up his pocket watch - 3:15. 

He pulled his trousers on, stuffing his nightshirt into them and snapping the suspenders over his shoulders. Shrugging on his coat, he picked up his black doctor’s bag and went into the main room of the house. Mrs. Denver would have had Tom bring the buggy around. 

Stepping out into the windy October dark, he found the man outside, holding the reins of his tired horse. From the look of the horse and the look of the man, he knew he had a long ride ahead of him, back into the woods that lay around Chillicothe in every direction. Wearily he climbed into the buggy and took the reins. “Lead the way”, he said.

As he followed the man’s plodding horse, his mind played around the scene ahead. He would not have been called for an uneventful birth; these backwoods people took care of their own except in dire emergency. Slapping the reins, urging the horse forward, he came up beside the man.

“I am Dr. Rufus Hall”, he said. “And you are…”?

The man glanced at him from under his battered hat. “Name’s Thompson”.

“Well, Mr. Thompson. Can you tell me something about your daughter’s labor? Why did you come for me”?

Thompson hunched his shoulders, shrugging off knowledge and responsibility. “Her Maw sent me. Says she’s not gettin’ on”.

“How long has she been in labor?”

“Two days - mebbe”.

“Sweet Christ!” thought the doctor. Two days! It was amazing the girl wasn’t dead of exhaustion or loss of blood by now.

“Has a midwife been with her”?

“Naw. Just her Maw”. Thompson cleared his throat. “We don’t want no one t’know bout this. She - she ain’t married. Been a bad girl”.

“I see. Is the father at your place”?

“Naw. Ain’t no father”. Thompson leaned and spat. “She says she ain’t been bad. Says there ain’t no baby. But with that belly on her, she’s lyin. I like to beat the hide off her to get her to tell, but she just kep’ on lyin”. We’ve had ‘er shut up in the back room, not givin’ her nuthin to eat cept fer bread an’ water, but she’s still lyin’”.

So the girl had been starved and abused. She must be exceptionally strong to have survived to give birth.

“How far along was she when you - er - chastised her to make her tell the truth, Mr. Thompson”.

"Not far. She warn’t showin’."

“How did you know she was pregnant, then?”

Thompson looked away, clearly embarrassed at the turn this discussion was taking, even with a doctor.

“Her Maw knew. She warn’t - warn’t usin’ her monthly rags, y’see”. He pulled his hat as low as it would go over his forehead.

“I see”. They continued in silence into the dark woods, winding along an old Indian trail, now rutted by wagon wheels. After another half hour of silent plodding, a cabin loomed through the trees, faint candlelight glowing from the one window. Rufus climbed stiffly out of the buggy, leaving the reins wrapped around the whipstand. The mare knew her job as well as the doctor knew his, and would stand patiently waiting no matter how long it took.

Inside, the cabin was one large room. A cooking hearth occupied one wall, and the opposite wall did duty as the master bedroom. The place was clean, though without comfort of any kind. As Rufus stepped in through the wooden door, a woman came out of a back room, shutting the door behind her. She was obviously Thompson’s wife, and the hard lines of her face matched his.

She glanced from the doctor to her husband. “Twarn’t no use you goin. ‘S too late”. She worked her hands in her stained apron, rolling and unrolling them in the worn fabric.

The doctor motioned towards the door behind Mrs. Thompson. “Is she in there? May I go in to her”?

“’S too late”. But she stood aside.

It was indeed too late. The room was close and dark except for the candle burning on the chest at the foot of the bed. It smelled of sickness but not of blood. A birthing room should smell of blood, and the doctor’s senses, trained over the past year in the Obstetrical Unit at the City Hospital, subconsciously registered the sense of something wrong. As he leaned over the bed, the girl’s sunken eyes flickered open. “I ain’t been bad”, she whispered. As he reached to feel her pulse, to lay his hand on her belly to assess the baby’s position, her eyes fixed and her breath rushed out in the death rattle.

Rufus stood, still bent over the bed, ready to begin to help this girl toward life. Instead, he reached to close her eyelids before the rigor of death left them open forever. Stepping back, he looked at the body on the bed. And now his mind came tapping to tell him that here was something else that was not right. The shape of the belly, the whole look of the girl, was not that of a pregnant woman. The belly was enlarged, but there was no fullness. Even the starvation diet that had reduced her arms and legs to sticklike proportions should not have affected her belly this way - producing one protuding, pointed lump. Thoughtfully he laid a hand on the mound. Could he do a a postmortem examination? Would they allow him to take the body? Acquiring medical knowledge this way was no longer illegal, but those outside the medical profession still recoiled from it. His hunger for knowledge overcame his sense of decorum. Pulling the covers over the girl’s face, he turned to go into the other room.

“I’m so sorry, Mr. and Mrs. Thompson”, he said, shutting the door of that sad little room behind him. “Your daughter has…Passed Over”.

“It’s the wages of sin”, said Mr. Thompson. He was seated by the fire, staring into it as he spoke. He had not removed his hat.

“The wages of sin.” echoed Mrs. Thompson. She was sitting at the table, her hands clasped in front of her. She wore the faint unease of a person unused to sitting idle.

The Wages Of Sin, indeed, Rufus thought. These two people, whom he was sure would have described themselves as “God-fearing”, had killed their daughter. If he was right, and he was beginning to trust himself as a diagnostician, that girl lying dead in the room behind them had a massive uterine tumor. She had indeed “not been a bad girl”, unless Sick could be counted as Bad.

“Would you like me to…convey the Remains into town to the Funeral Director?” he asked.

Thompson shifted in his seat. “Naw. We have our own buryin’ ground. Back in the woods a bit. Back by the Meetin’ House. We take care of our own”.

“That’s right”, said Mrs. Thompson. Her lips compressed, then relaxed. “Even though Evvie died in Sin, we’ll bury her Proper. No one needs to know. Right, Poppa?”

“That’s right”, confirmed Thompson. “No one knows, and no one’s gonna know”.

It was time to end this. Even without the postmortem examination, Rufus was sure.

“May I…?” At Mrs. Thompson’s nod, he sat gratefully at the table in front of the fire. No one had offered him coffee or fried bread, as they usually did. He didn’t expect it here.

“Mr. and Mrs. Thompson”. He stopped, cleared his throat, wondered how to say what he knew he had to say.

“Your daughter…I don’t believe your daughter was…pregnant”.

Mrs. Thompson looked up, her features sharpening from diffuse misery to acute awareness. “What’s that? She were in the family way! She sinned! T’only reason she wouldn’t tell me the truth was because she sinned!”

“I’m not so sure of that”, the doctor rejoined mildly.

Thompson stood up, kicking the chair behind him.

“What’re you sayin’, Doc? ‘R you sayin’ we don’t know what we saw all these here months, watchin’ her belly grow and listenin’ to her lies”?

“Thass right - lies”, the mother whispered, wrapping her hands in her apron again, squeezing the flesh as if to squeeze away doubt.

“I would like to conduct a postmortem examination of your daughter’s body”, said Hall. “I am not sure she is - was - pregnant. I suspect another cause of death”.

“WHAT???” Thompson stared, his eyes now the eyes of a man who could beat his pregnant daughter to ‘make her tell’. Dr. Hall remembered that no one but Mrs. Denver knew where he was, and she had no clear idea of the location of the cabin. Assuming a calm he did not feel, he met Thompson’s narrowed glare.

“As I said, I am not satisfied with the diagnosis of complications of delivery as a cause of primapara death”, he said, taking refuge in medical language. “She does not present the appearance of a pregnant female, and there is no indication that she attempted to give birth before her death”.

Mrs. Thompson was suddenly still. “I wondered…I wondered about that.” Thompson took a step toward her and she shrank back, wrapping her hands as if to hide herself. Then she sat up.

“She’s my girl too, and I want to know. I want…” she choked on a sob. “I want to know that we did Right”. She rounded on the doctor. “You take her!! You take her and you find out!”

“NO!” yelled Thompson. “She sinned, Momma! She laid with a man and she sinned! The Wages of Sin is Death!”

She glared at him, all traces of the Wife submerged in the Mother. “How many times have you given birth?? How many times have you helped at a birthin’?? What do you know about it? YOU said she’d sinned! You said we had to shut her away! “

She looked at Rufus again. Her shoulders dropped. Her eyes filled. “But I…I warn’t so sure. Not my girl. Not my Evvie. She was always…” she stopped, swallowed. “…always such a good girl. “

Suddenly she stood. “You take her, Doc. You find out. Find out what killed my Evvie. I can’t stand this no more.”

She looked at her husband, obviously expecting argument. But Thompson just poked at the fire, his hat still shadowing his eyes.