He made sure she was comfortable then raced back into the house to get the bag she had packed and left in the hallway closet. He didn’t put on a shirt; he just slipped on the denim jacket that hung on the hook. As they sped through the black night, she watched him. His jacket was unbuttoned, exposing a strip of skin from his neck to his belt buckle. His hands were gripped to the wheel so tightly, she could see the bone through his skin. She thought about the night he proposed, thrusting a box with a small diamond ring toward her. He had taken her for a walk and surprised her with it. She surprised him by saying no. She knew how much it must have cost him. She had seen the folded up culinary school application in his sock drawer. But that wasn’t why she said no. It was the wrong time, and she didn’t know how to explain how she knew, so she just shook her head and pushed his hand away. He had seemed almost relieved. Now, here they were on their way to the hospital. He turned to her every few minutes, and she nodded to confirm she was okay. She closed her eyes and tried to force what she’d witnessed in the shed from her mind.

“Look at me and when I say push, you have to push!” shouted the doctor, who now had a plastic visor over his face. She wondered if he was scared her insides would come spewing out, too. She bore down as the next wave of pain hit. It crashed over her with such intensity that she was breathless with no voice left to wail. Then, it was quiet. Another big squeeze. Everything turned gray, and she heard a scream. It took several minutes before she realized that it was coming from her.

“It’s hard work, honey,” Red Nails said, her voice shooting like a dart inside Therese’s ear. She shook her head hard, thinking that if it fell off her neck then the pain would stop. She imagined it rolling off the bed onto the floor, landing at the nurse’s feet with a soft watery thud. She was in the middle of envisioning the look of horror on the nurse’s face when another one hit. She pushed down with all her might and gasped as though she was choking.

“You’re doing great, Therese. We’re almost there,” the doctor said.