Bethlehem in Indiana: The Obstetrician Instructs His Son

Robert Cochran

Your father will want to answer this, Mother says, not interrupting her nursing. I’ll call him. He’ll talk with you tonight.

            This is a surprise. Nine-year-old me figures Mom, busy with three children in addition to the infant at her breast, as the obvious parent for queries about babies’ origins.  Father, I know, is a doctor, but I don’t yet know he’s a specialist in babies, currently honing his skills in a year-long obstetric residency at Honolulu’s Kapiolani Maternity Hospital.

            Mom’s right—I’m summoned after dinner to the backyard lanai where two hefty anatomical models, a loose-leaf folder, and a dictionary-sized medical textbook occupy a table customarily used for trimming and potting plants. Have a seat, Father says, pointing to a chair and moving to the opposite side. Mother, sisters, and baby remain upstairs.

            A very long lecture follows, lasting far past bedtime, but my attention, to Father himself and to his vivid subject, never for an instant wavers. The models, it turns out, are constructed of heavy plastic or ceramic with detachable pieces in contrasting colors, heavier even than Father’s bowling ball and mounted on pedestals like busts not of heads, but of reproductive systems. The female is a frontal, or coronal section, Father explains as he gradually disassembles both, while the male is a cross or midsagittal view.

            Babies are made, Father begins, when a sperm joins an egg. Here’s how it works. Then come the words, a cascade of exotic terminology accompanied by body parts held aloft, fingers pointed, references to folder and textbook. Every word and everything the words describe astounds. On and on he goes—fallopian tubes and vas deferens, uterus and urethra. Only Buckminster Fuller, he of the geodesic domes, famous for marathon lectures, will match Father’s stamina at the podium—and I’ll be twenty-three then, not nine, in graduate school, not fourth grade. Finally, his hundreds of terms distributed, the bodily machinery minutely itemized, Father turns to its operations.  Ovulation, fertilization, implantation, gestation, labor and delivery—all are painstakingly covered. His presentation of the sexual act itself (a wholly unanticipated notion) is direct, though at times oddly formal and impersonal. The penis, he says, an apparently autonomous actor fastened to no person, is “introduced” to the similarly free-floating vagina, there to “deposit” sperm as a sort of biological calling card. Father does note in passing that the act is “uniquely pleasurable to both parties.”

            Dumbfounded by everything, I’m at last sent to bed, assured that models, folder, and textbook will be indefinitely available for study, though Father’s astonishing revelations make sleep even this overdue elusive. And the language!  At nine, most children lack occupational foresight, but a perceptive adult observer might have predicted a wordsmith, a journalist or poet, so persistently is Father’s young pupil distracted from the astonishing facts by their novel verbal descriptors. What strange and vivid words Father commands!  They carry in their very letters arcane aura, a distance from mundane vocabulary. Epididymis sports a profusion of extra syllables, while mons, menses, and glans appear somehow truncated. In the aggregate, presented in such concentration, they offer the intoxicating lure of pure nomenclature, the power of capturing a manifold world in a net of names.

            Father apparently regards his instructional duties as adequately discharged by our marathon seminar, as Babies 101 features no review or follow-up session.  Fast forward now through a three-year, two-stop journey, and set us down in Indiana, where Mother calls a halt to Father’s nomad career. The children need to go to high school in one place, she says. We are a larger family now, a brother added during a second residency in Atlanta, and a fourth sister arriving soon after the Hoosier move. Both family and Father’s medical apprenticeship are now complete—we are two parents plus six children, with Father a board-certified specialist in obstetrics and gynecology. It’s the perfect field of medicine, he claims. Outcomes are almost always joyful. Plus, we’re never out of work—demand for midwives and morticians is both universal and stable.

            Things have been mostly quiet on the where-babies-come-from front, though a brief firestorm erupts shortly after our arrival in Indiana over my gory preview of monthly ordeals soon to be visited upon my sisters by puberty’s onset. This error-filled and blood-drenched narrative—a twelve-year-old’s confused mix of menstrual and parturient elements—sends both siblings in alarm to Mother, who quickly shuts down my backyard academy.

            Much worse soon follows. Four years later, just as I enter high school, Father inaugurates a decade of sex education lectures to sophomore biology classes. For a teenager riven by myriad anxieties, eager most of all for anonymity’s refuge, no more scorched-earth humiliation is imaginable. Your Dad not only makes his living messing around in female private parts, he shows up at your school to talk about it!  Each year he arrives, addressing only females while male classmates, supervised by coaches, sit through scary VD films. These appearances inspire without fail a new round of teasing from classmates. Your Dad told us to avoid boys like you, reports the blonde cheerleader, already “pinned” to a college frat boy, who trifles with my affections over a three-year span. They play, you pay, he told us.

            The tenor of this bromide is typical of Father’s address, behavioral concerns now replacing the anatomical focus of the Hawaiian lecture. (For our biology-class anatomy unit we study and learn to label then-standard Turtox Sexless Manikins, beautifully drawn in many colors. Livers are purple, kidneys are green, ovaries and testes are absent.)  Father’s presentations make introductory bows to reality—I’m not suggesting the cloister, he opens—but these are in essence feints, followed by standard commendations of abstinence.  A minimal level of “necking” is reportedly condoned, by which Father intends a chaste and strictly vertical embracing. Hands on deck, feet on the floor, he urges. “Petting” he presents as a distinctly more dangerous practice, slipperiest of slopes, so risky careless listeners might suppose unwanted pregnancies could result from unrestrained indulgence. The notion of safe sex is not yet in circulation; condoms are unmentioned. It is clear, too, that Father vests his entire stock of hope in his female auditors; their male counterparts he presents as hormonally-deranged junior satyrs saved from a mindless rut only by unremitting feminine vigilance.

            Summaries of Father’s lectures are regularly served up with indulgent smiles by sophisticate female classmates who are by this time masturbating and fellating favored athletes and hoodlums, the most precocious even “going all the way” according to triumphalist accounts circulated by the jocks and delinquents. Such interviews present terribly complex issues for a son reluctant on the one hand to abet patronizing dismissal of a revered parent and on the other to appear hopelessly unhip to classmates talking so casually about sex. Father’s “uniquely pleasurable to both parties” formulation is also placed in doubt during this period, as the locker room and street corner vaunts are conspicuously lacking in attention to reciprocity. Graduation alone puts an end to these embarrassments.

            In the midst of the annual humiliations, however, Father bestows an additional gift, perfect follow-up to his introductory lecture. Informing others and perhaps convincing himself that his eldest is destined for a career in medicine, he begins taking me with him to work. On rounds and in operating rooms I’m introduced to patients and staff alike as a physician in training, a novice apprentice. Beginning at sixteen I am present each year at eight to ten births and other obstetric and gynecological surgeries. By graduation I will welcome maybe thirty babies to the world, including two sets of twins.

            Even the preliminaries impress, the elaborate scrubbing, gowning, masking, and gloving. The scrubbing alone is a protracted affair, starting with a lathering of the forearms up to the elbows with surgical soap, followed by no less sudsy rubbing of cupped fingertips in opposing palms, and massage of each wrist by the encircling opposite hand. I’m reminded of it every time I witness the elaborate power shakes of today’s athletes. I copy Father’s ablutions with great fidelity—and wash my hands today in exactly the same way, in reflexive tribute, though I operate on nothing more sensitive than a computer keyboard.

            From these elaborate protocols I conclude that Father is a greatly venerated figure, served by a squadron of nurses attending his every move—holding up his green gown for the threading through of his freshly washed hands, fitting and fastening his mask and cap, assisting with his gloves. Thus invested, he appears as a secular priest presiding over a ritual occasion of transcendent significance. Father, I think, has more than a job. You’re a star, I tell him. Everybody does what you tell them to do. Father is quick to correct this impression. Don’t be fooled, he says. I’m a stagehand, a midwife with initials after my name. The leading lady enters on wheels, belly up. The star comes on last. It’s the greatest show on earth. You’ll see.

            For even the first of these occasions, Father opens in the dispassionate register of his Hawaiian lecture, but lifts to lyric in directing particular attention to the climactic instant when each newly arrived infant, shocked by the sudden shift from aquatic to terrestrial environs, puckers, grimaces, throws out a leg or arm, finally opens her or his mouth to breathe the big world. Look! Father says, cradling the glistening, just-clear-of-Mom form in his gloved hands. Listen!  Obedient, leaning as close as I dare, I gradually learn to view the moment through Father’s eyes, hear with his ears the tiny engine snort and splutter into life.

            Both sights and sounds are preludes, heralds to the cries that relax the whole delivery team into smiling praises of mothers and children. Routine is now quickly restored. Cords are clamped, eye drops administered, swaddling blankets unfolded, wrapped and quieted babies tucked to mothers’ arms.  But the instant itself, the move from insentience to animation, normalized by language as the crossing from embryo to neonate—for even the most experienced nurses and doctors it’s never wholly routine. For Father it stands as a cosmic pivot, the numinous core of matter’s messy welter. Here, bloody and blue, is his teaching’s capstone, high point of his practice. As a physician in training he’d mastered the science and language, and here, in Indiana’s heartland, he reaches teaching’s end.  There’s learning and more learning, he counsels, leading to knowing and more knowing. But here, at learning’s and knowing’s edge, luminous mystery flares. All the miracle I’ll ever need, Father says.

            I’m soon after this in Chicago for college, where Father’s dream of a son following in his professional footsteps is dashed by sophomore Cs in organic chemistry and embryology, but on visits home I caddy for him on the golf course where he asks about my literature and philosophy classes. Only later, after I’m off to Toronto for graduate school and Father trades in his clubs for a pilot’s license and turns to flying for recreation, do I come to understand both activities as substitutes for changes of address. His itinerant instincts curtailed by Mother’s insistence on their children’s needs, he turns first to golf’s pedestrian circumambulations before lifting to aerial sorties. When his first grandchild is born he flies to Nashville to celebrate, with Mother and housekeeper along, their eagerness to see daughter and baby overcoming for the only time their fear of his small plane. With characteristic sartorial flair, he orders the plane’s likeness on a custom-made tie bar—the single-engine Cessna, its 4902L license plate clearly legible, climbs skyward across his chest.

            Our talks on the fairways and greens revisit earlier topics when my studies occasionally unearth a nugget reminiscent of his lectures. Remember when you called yourself a midwife with a degree? I ask when I encounter obstetrix in a Latin reading. Did you know “obstetrician” comes from the Latin word for midwife?  He does. When I find vagitus in Samuel Beckett’s Murphy, this too is brought to the links. It means the newborn baby’s first cry, I say. Did you know that?  Yes again. Sometimes it happens early in difficult births, he tells me. It’s called vagitus uterinus. But Father is pleased by the story. It reminds him of a sermon.

            Speaking of vagitus, he says, your mother took me to hear a guest preacher,  some young hotshot fluent in Hebrew and Greek. Your mother’s like you, a sucker for the words. Turns out the hotshot put up slides (rare then in heartland Presbyterian sermons) focusing on the Hebrew name of God, teaching Father in the process that Hebrew writing reads from right to left. His central text came from Exodus, where God, addressing Moses, tells him His name simply asserts His existence. God’s name, Father learns, means I AM!  The preacher’s repetitions, the going on about Yahweh and Jehovah, eventually send Father off into his own line of reasoning. After awhile I’m remembering the delivery room, he reports. The babies’ first cries sound like this Hebrew word!  Waah!  Waah! Yahweh!  Yahweh!  I AM! I AM! 

            Father is initially shocked, worried his thought might be blasphemous, but the more he thinks the more he likes it.  I told your mother, he says. She liked it too. I also like it, there on the golf course, and we talk it over through several holes. He’s always understood infants’ initial cries as protest, Father says, as outrage. It makes sense, he adds—kid is without warning and with considerable rough handling hauled from a warm uterine Eden into a chilly OR, handled by strangers, slapped on the butt.

            But what if it’s sheer assertion? Father asks. What if that’s what’s happening?  Just tiny egos, insisting on limitless prerogative?  Yahweh! they shout. Yahweh!  I AM!  I AM!  I AM!

            Such exuberance from Father is uncharacteristic. He’s playing on my ground now, off and running with the visiting preacher’s cue, and triggering my own unbridled register. Dad, the hospital is church for you—it’s Bethlehem in Indiana, every kid the promised messiah. Clock in down at the manger, scrub up and wait on Mary!

            It’s not such a stretch, this little riff, the basic trope lifted from Brueghel’s relocation of his Adorations to Netherlandish landscapes, but Father glances over from his cart, absolutely delighted. That’s nice, he smiles. That’s really very nice. He gets it, understands these flights as my own epiphany portal, the closest thing I own to his midwife’s worship. Father sees he’s passed on his reverence, if not his profession. And this, he’s telling me, is altogether fine, a satisfaction.

            That’s half a century old now, with Father gone the last forty, taken out at fifty-one by kidney cancer. 4902L grounded, Bismarck and Honolulu and Atlanta and Nashville behind him, the restless West Virginian touches down for good. He’s buried in Muncie. The loss of him tears the roof from my world, lets wind and cold and storm crash in.

            His memory throngs back more often now, with me twenty years beyond the oldest age he knew—his office walls plastered with snapshots of everything from babies in cribs to high school graduates in robes and mortarboards, shopping cart encounters with mothers, shyly proud, introducing teenagers whose debut I AM! was uttered from his hands. At their age I mistook him for Mr. Big, recipient of deference and issuer of orders, but learned over time, thanks to his patient teaching, to see him find his deepest fulfillment as a privileged servant. Obstetrix. Stagehand. These days he visits most often as sentences heard in my head, and the surprise is this: shorn of visual presence, pared to pure sound, his voice carries even now the pitch and timbre of an awestruck boy. Look at this, son, he says. Look!  Listen!




Robert Cochran lives and works in Arkansas, where he most often writes, co-authors, and edits books for university presses. His essays, poems, and stories have surfaced in Black Warrior Review, Georgia Review, Kenyon Review, Michigan Quarterly Review, New Orleans Review, and The Quarterly, among others. Recent work: “Spinoza’s Landlady,” a runner-up for the Jeffrey E. Smith Editors’ Prize, appears in the Spring 2019 issue of The Missouri Review.



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