Birth- Introduction

"Birth" is an excerpt from "The Citadel" that revolves around Andrew Manson who just graduated out of medical school. It is an account of
how the newly graduated medical practitioner helped in bringing Joe and Susan’s child into this world despite going through a tough time
with his girlfriend Christine
 

Birth- Summary
The lesson begins with Joe walking towards his home after having an unpleasant time with his girlfriend Christine. Upon reaching home at
around midnight, he finds Joe Morgan outside his house waiting for him. Joe and Susan had been expecting a child. Upon reaching, Joe tells
Andrew that he is too anxious to be going inside, so Andrew walks in alone. He realises that there is still some time left. Susan’s mother, who
is wise but tense at the moment, offers him some tea. While he is sipping his tea, he begins thinking about his girlfriend. He recalls how his
friends too are having a hard time in their relationships. On the other hand, he feels that marriage is meant to be something peaceful and
cheerful. Thus, he finds himself in a conflict. Susan’s mother tells him how worried Susan is for the child because the situation is
complicated. After performing the procedure, the child is born, but is lifeless. Confused between addressing the child or the mom, who
herself laid unconscious at the moment, he chooses to look after Susan first. He injected her with a few medicines and when he realised that
her heart was regaining its strength, he turned towards the child. It was a boy in perfect shape. He suddenly remembered that it was a case
of restricted oxygen supply and thus, he instructed the nurse to get hot and cold water. The nurse, reluctant at first, got him what he needed
and he juggled the child in hot and cold water simultaneously. After all his efforts, the child still lay lifeless. All others had already lost hope,
while he continued with the procedures. Finally, the child heaved and got his breath. His body was no longer still, leaving everyone surprised.
The nurse muttered words of prayer while holding the child. The grandmother was also praying, while Susan still laid unconscious.
Exhausted, Andrew left while informing Joe that all is well. While he was walking home at around five in the morning, his heart was full at
having accomplished

Birth - About the Characters

Dr Andrew Manson: He is a young medical graduate working in a small mining town. On the call of Joe Morgan, a miner, Dr Andrew
Manson manages to help in a difficult birth and saves the baby’s life due to his knowledge and efforts.

Joe Morgan: He is the miner husband of Susan Morgan. He asks Dr Andrew Manson to help in his wife’s delivery and reposes full
faith in the doctor.

Susan Morgan’s Mother: She is a tall, grey-haired woman aged 70 who is concerned about her daughter’s happiness.

The Midwife: She is pessimistic about the child’s survival when he is found to be not breathing when born, but still dutifully assists Dr
Andrew Manson in his work.

Birth Summary
Joe Morgan was Waiting for Dr Andrew
Dr Andrew had recently graduated from medical college. He was practicing as an assistant to Dr Edward Page in a small Welsh
mining town named Blaenelly. One night he was returning home when he found Joe Morgan waiting for him outside the doctor’s
home. He had been there for more than an hour. He looked relaxed to see the doctor. He informed that the doctor was needed at
their home as his wife was expecting to deliver a baby after almost 20 years of marriage. Dr Andrew asked him to wait for a few
minutes. He went inside, got his medical bag and set out for Joe Morgan’s house.
The Case Demanded All Attention of Dr Andrew
Joe Morgan stopped outside the house and requested Dr Andrew to go inside alone. Through a narrow staircase the doctor reached
a small, clean but scantily furnished room. He found two women beside the patient, Susan Morgan’s mother, a tall, grey-haired
woman of nearly seventy, and an elderly midwife.
Susan’s mother offered him a cup of tea. So, Dr Andrew sensed that she didn’t want him to leave, as there would be some waiting
period. Dr Andrew was tired but still decided to stay.

An hour later, Dr Andrew went to check the patient and came down. The restless footsteps of Joe Morgan could be heard as he
paced the street outside.

Dr Andrew’s Mind Wandered

Dr Andrew was so deep in his thoughts that the voice of the old lady (Susan Morgan’s mother) surprised him. She informed him that
her daughter didn’t want him to give her chloroform if it would harm the baby. Dr Andrew replied that it would do no harm. Just then
he heard the midwife’s voice. It was half-past three and Dr Andrew perceived that it was time for him to start working on the delivery.
The Horrifying Dilemma
After a harsh struggle for an hour, the child was born, a perfectly formed boy. Unfortunately, it was not breathing. A shiver of horror
passed over Dr Andrew. He had promised the family so much. He wanted to resuscitate the child, but the mother herself was in a
very desperate state. He gave the child to the midwife and turned his attention to Susan Morgan, the mother, who was lying
unconscious. Her pulse was slow and her strength was reducing.
After a few minutes of continuous efforts, he stabilised her by giving her an injection. Then he asked for the child. The midwife had
kept the child under the bed, presuming him to be dead. Dr Andrew pulled out the child. His head was hanging loosely and the limbs
seemed boneless. He concluded that the child was suffering from asphyxia pallida (an abnormal medical condition in a newly born
baby).

Dr Andrew’s Efforts to Save the Child

Dr Andrew recalled a case he had once seen in the Samaritan (a medical journal) and the treatment that was given. He asked the
midwife to quickly get hot water and cold water in two bowls.
He started plunging the child once into the icy water and then into the steaming bath alternately. Fifteen minutes passed and nothing
happened. Dr Andrew was getting frustrated. He could see the unbelieving faces of the midwife and the old lady but he continued
his efforts.

The Miracle
Dr Andrew started rubbing the child’s chest with a rough towel and thumping his little chest, trying to get breath into that limp body.
Then, as if by miracle, the child’s chest began moving. Dr Andrew felt weak and nervous at the sight of life springing under his
hands. He redoubled his efforts and the child was now breathing. Life came to his limbs, head became erect, the child’s skin started
turning pink and suddenly the child cried.

The midwife exclaimed with tears of happiness in her eyes, ‘Oh God, he has come alive.’

Dr Andrew is Relieved
After so much frantic effort and success, Dr Andrew felt weak and speechless. The old woman, Susan’s mother, was still standing
against the wall, praying.
Andrew went downstairs and told that he would fetch his bag later on. He found Joe Morgan still waiting with an anxious, eager face.
Dr Andrew gave the happy news that both the mother and the baby were all right.

Andrew was really happy and exclaimed, ‘Oh God, I’ve done something real at last.’ He had achieved a feat in medical history which
would certainly brighten his future.

Birth Chapter Highlights

 Dr Andrew was a young medical graduate who worked as an assistant to Dr Edward Page in a small Welsh mining town,
Blaenelly.
 Dr Andrew was returning home after a disappointing evening with his girlfriend Christine,
 Dr Andrew found Joe Morgan, anxious and scared, waiting for him.
 Joe Morgan informed him that the doctor was needed at their home as his wife was in labour before the expected date.
This was to be their first child in a marriage of nearly twenty years.
 When they reached the house, Dr Andrew realised that he would have to wait some time; so he decided to wait
downstairs.
 Then Dr Andrew is called upstairs and starts his work. After an hour’s struggle, the child, a perfectly formed boy, was born
lifeless.
 Dr Andrew was horrified but continued his effort first to save the mother, whose energy was reducing.
 After the mother was safe, his attention went to the child. He instinctively decides to revive the child.
 Dr Andrew quickly diagnoses the most probable cause for the still birth i.e. asphyxia pallida.
 Dr Andrew recalls a method he had once read about by which such a child had been successfully saved.
 Dr Andrew tries alternate hot and cold water treatment to revive the child’s breath.
 Dr Andrew then rubbed the baby’s body with a rough towel, crushing and releasing the chest.
 A medical miracle happens. The child finally breathes. Dr Andrew redoubles his efforts till the child cries.
 After handing over the baby to the midwife, Dr Andrew left the house. He realised that he had truly saved a life that night,
fulfilling the purpose of his profession.
 For the first time Dr Andrew felt that he had done something ‘real’, something worthwhile.
Birth Word Meanings
Word – Meaning
excerpt – extract
medical practice – work as a doctor
welsh – in Wales
mining town – a town where most people work in a coal mine
disappointing – unhappy
surgery – operating room
burly – large and strong
driller – a miner who uses a drill machine
missus – wife (informal)
ye – you
before time – the delivery is going to be before the due date
contemplation of – thinking about
mystery – secrecy
perceptive – aware
premonition – idea
drew up short – stopped
strain – tiredness
stout – strongly built
midwife – woman trained to help in childbirth
bach – dear
leave the case – not stay till the delivery was completed
fret – worry
overwrought – very tired
snatch – take
lethargy of spirit – lack of enthusiasm
cinder – partly burnt piece of coal
grate – fireplace
paced – walked slowly
muddled – mixed up
obsessed him – dominated his thinking
morbidly – negatively
sordidly – unpleasantly
shrewish – quarrelsome
reason – reasoning
dismal – disappointing
wince – feel pain
idyllic – perfect
otherwise – differently
admitted – allowed
level, doubting – reasonably doubtful
overflowing – full of emotions
broodingly – worryingly
started – jerked suddenly
addressed – talked to
meditation – thinking
pursued a different course – followed a different line of thought
awful set upon – very much wanting
ay – yes
fancy – believe
collected – calmed
top landing – top of the stairs
perceived – realised
elapsed – passed
harsh – hard
streaks of dawn – light of morning
strayed past – came through
blind – sunshade
still form – lifeless body
torn between – feeling two opposing thoughts
resuscitate – bring back to life
desperate – critical
dilemma – choice
instinctively – without thinking
collapsed – unconscious
pulseless – not having the pulse of life
not yet out of the ether – not become conscious
frantic – agitated
ebbing – receding
glass ampoule – sealed glass capsule with liquid medicine
hypodermic syringe – needle used to inject liquid medicine in the bloodstream
unsparingly – without a break
flaccid – lifeless
strengthened – started beating properly
in his shirt sleeves – in only his shirt without a jacket over it
brow – forehead
frightened gesture – indication with fear
in a flash – immediately
fishing – searching
sodden – soaked
tallow – animal fat
cord – umbilical cord connecting the mother to the child in her womb
of a lovely texture – with a wonderful feel
lolled – hung loosely
haggard frown – worried and tired look
asphyxia pallida – an abnormal medical condition in a newly born baby who appears pale and limp, temporarily unable to breathe
and having a slow heart action
the Samaritan – name of a medical journal
threw out – spoke quickly
basins – large bowls
pallid – pale
respiration – breathing
ewer – a large jug with a wide mouth
frantically – desperately
Word – Meaning
crazy juggler – madman moving the child quickly
raging hopelessness – fierce disappointment
stark – evident
consternation – feeling of anxiety
longing – desiring
dashed away – finished
draggled – dirty and wet
stumbling – tripping over
sopping – drenched
whimpered – spoke in a crying tone
stillborn – born dead
heed – listen to
crushing – squeezing
limp – motionless
by a miracle – mysteriously
pigmy – small
convulsive – jerky
heave – gasp
turned giddy – became weak
unavailing – ineffective
exquisite – enjoyable
gasping – breathing hard
mucus – viscous liquid
iridescent – sparkling
spinelessly – loosely
blanched – pale
hysterically – uncontrollably
shuddering litter – total mess
soiled – dirty
impaled – stuck
scullery – room for washing dishes
expectant – hopeful
thickly – in a hard to understand tone
spent – tired
footfalls – sounds made by feet while walking
oblivious – unaware