against the body of the sternum. Her left hand fisted around the knife handle as she pulled up, trying to lift the bone with the serrated blade.
Sara’s shoulders started to shake again.
Nothing opened like the lid on a soup can. It was more like stabbing the knife into the lid and trying to break open the can by force.
Sara told him, “Pull up and press down on my hands.”
Jeffrey covered her hands with his own. He leaned forward, tentative, afraid he would crush the girl.
“Harder.”
He pressed and pulled harder, though every muscle in his body told him not to. The girl was so slight. She was barely more than a teenager. Breaking her open went against every part of Jeffrey that was a man.
“More,” Sara ordered. Sweat dripped down from the tip of her nose. He could feel her shoulders shaking into his hands. “Harder, Jeffrey. She’s going to die if we don’t get air into her lungs.”
He pushed his weight downward and pulled up as hard as he could. The blade started to bend, but Jeffrey realized that the blade wasn’t giving. The bone was.
The joint cracked like an oyster shell.
He tried not to vomit again. The splintering sensation had reverberated up his arms and into his teeth. Worse was the sucking sound of cartilage breaking, sinew tearing, tendons separating, as the bone was wrenched away from the joint.
“Here.” Sara pointed into the open incision. “This is the vein. This is the artery. You need to use the top of the pen so your hand isn’t in the way.”
He could see the vein and artery stringing in front of the ringed trachea like two pink straws. One of them had little red things attached to it. The other looked slick. He couldn’t get the tremble out of his fingers as he used the pen to gently press the vein and artery out of the way.
“Hold still.” Sara held the plastic barrel of the pen between her thumb and fingers. Her elbow was tight to her body. She moved downward, pushing the silver tip of the barrel into the trachea until the bottom third of the pen was inside.
“Move.”
He carefully lifted away his hand. The vein and artery slid back over.
Sara took a breath. She sealed her lips around the pen barrel and exhaled a stream of air directly into the trachea.
Nothing happened.
Sara took another breath. She exhaled through the pen.
They both strained forward to listen, hearing birds chirping and leaves rustling and then finally, after what felt like an eternity, the whistle of air pushing out of the barrel.
The girl’s chest shuddered as it rose to take in a breath. The resulting fall was slow, almost imperceptible. Jeffrey held his own breath, counting off the seconds until the chest rose again and she filled her own lungs with air.
He breathed with the girl, in and out, as the blue drained from her face and life came back into her body.
Sara peeled off the bloody exam gloves. She stroked back the girl’s hair, whispering, “You’re okay now, sweetheart. Just keep breathing. You’re okay.”
Jeffrey didn’t know if Sara was talking to the victim or to herself. Her hands had started to tremble. Tears welled into her eyes.
Jeffrey reached out to steady her.
Sara recoiled, and he had never felt so monstrous, so worthless, in his entire life.
His let his hands fall uselessly back to the ground.
All he could do was wait with her in silence until the ambulance arrived.
Atlanta
4
“Tessa,” Sara practically yelled into the phone. “Tessie, would you just—”
Her little sister wasn’t going to listen. She kept rambling, her voice taking on the cadence of the adults in Peanuts cartoons.
Wah-wah-wah-wah, wah-wah-wah-wah.
Sara tapped the phone on speaker and rested it on the shelf above the sink. She washed her face with the pink soap from the dispenser. The cheap paper towels disintegrated in her hands. If Sara did not get out of this prison soon, they were going to have to put her in a cell.
Tessa picked up on the noise. “What the hell are you doing?”
“I’m taking a whore’s bath in the visitor’s restroom at Phillips State Prison.” Sara peeled a piece of wet paper towel off her cheek. “I’ve been up to my eyeballs in blood, piss and shit for the last five hours.”
“It’s like college all over again.”
Sara laughed, but not so Tessa could hear. “Tessie, do what you want to do. If you want to train to be a midwife, train to be a midwife. You don’t need my