Summary and Analysis
March 1964 (I)
In a neighborhood near Lexington, Kentucky, it begins to snow. A woman over eight months pregnant goes into labor in her home. Her husband, an orthopedic surgeon (bone doctor), drives her through snowy streets to the office of Dr. Bentley, the obstetrician (baby doctor) who is supposed to deliver the infant. When they arrive, a nurse explains that Bentley’s car is in a ditch and he won’t be coming.
The orthopedic surgeon detaches himself from the emotional stress of the situation and delivers the baby himself. As was standard in the 1960s, the nurse administers anesthesia to the mother as the labor intensifies. Before going under, the mother says that if the baby is a boy, he should be named Paul; if a girl, Phoebe. A healthy baby boy is born. Then a second, unexpected baby girl is born. The doctor can tell that she has Down syndrome. Because his wife is under anesthesia, he knows that she won’t remember this night.
The doctor also knows that people with Down syndrome face a higher risk of heart complications. He flashes back to his childhood in West Virginia. His family was poor. His sister was born with a heart defect and died when she was 12 years old, devastating the family, especially his mother. In medical school, having already experienced the unpredictable suffering of his sister and the tough realities of poverty, the doctor came to cherish the stability of bones.
The doctor tells the nurse to take the girl to an institution outside of town. The nurse balks, then looks down at the girl and says, “The snow.” After the nurse has left with the newborn baby girl, the doctor tells his wife that she has had twins, a boy and a girl. The girl, he says, died in childbirth.
Written from the doctor’s perspective, this opening chapter introduces the theme of distanced control and its effects on human relationships. The characters in the chapter are not named. They are referred to by titles such as “nurse,” “doctor,” and “mother.” The doctor doesn’t invest himself in details that give the situation any emotion. Rather, so that he can do what is needed, he detaches himself, feeling “removed from the scene” of the delivery and seeing his wife as “a body like other bodies.” This detachment allows him to perform under pressure, but it also turns him cold and hard—like the snow that prevented Bentley from arriving at his office to perform the delivery.
The doctor’s detachment stems from the childhood trauma he experienced from growing up in poverty and his sister’s death. These experiences make him desire control, stability, order, and certainty in a world of unexpected calamities. He’s not going to change his life plan in response to a daughter born with Down syndrome; instead, he follows standard protocol in 1964, which is to give the child away.
This chapter also introduces the theme of female roles in a changing world. If it weren’t for now-outdated medical practices, such as anesthetizing women in labor, and old-fashioned gender roles that allowed the father to decide a child’s destiny, the baby girl’s mother might have had a say in how to proceed. As it is, she’s made powerless by cultural systems that give her a certain role to play.