Special Delivery
By Gerald D'Arcy Klee, M. D.
It was October, 1952. Ellis Island was being phased out as a reception center for immigrants. Its huge, somber buildings, almost empty, contained a few hapless immigrants caught up in the red tape of the Immigration Service, and swarms of cockroaches that acted as though they owned the place. I was a rotating medical-surgical intern with the United States Public Health Service Hospital at Staten Island, New York. Our hospital provided medical support for a variety of facilities and organizations, including the U. S. Coast Guard, Merchant Marine of all nations, and Ellis Island. It was there that I had an adventure which could be described as a contest between Nature and Bureaucracy. As an intern, my night duty included spending some nights on Ellis Island and providing whatever medical services were required. One night on the island I examined a woman in her eighth month of pregnancy who was having contractions. After observing her all night, I arranged for her to be transferred to the hospital, since I could not be sure whether she was entering labor. Another reason for caution was the presence of a pre-systolic heart murmur, signifying mitral valvular disease due to rheumatic fever she had in her childhood. Although her heart was functioning adequately at the time, it could lead to complications.
As it happened, I was on my obstetrics rotation at the time and got to know her a little. Her name was Shoshanna and she came from somewhere in Austria. She was petite, vivacious, and as pretty as her Jewish name . She spoke no English and although my German was limited I managed to learn some of her history. During World War II, a bomb caused her to lose both legs, one above the knee and the other just below.
Though maimed, she had at least been spared the gas chambers and the ovens. European medical facilities had not recovered from the war, so she had been unable to obtain artificial legs. It was for this purpose, she said, that she had come to the United States, at the behest of relatives in Cleveland. She had only a visitor's visa. Her husband remained in Austria.
The Immigration Service was not so sure of her intentions, however. When they learned of her pregnancy at debarkation, she was detained at Ellis Island, to be returned to Austria. Getting an immigration visa from Austria would have been difficult, while a visitor's visa was easily obtained. If she gave birth on American soil, however, the baby would automatically become a citizen. That would lead to problems for the authorities. It would be difficult to deport the mother of an American infant. I believe Shoshanna was hoping to stay in the US, and who could blame her?
After a day's observation in the hospital, Shoshanna's contractions ceased. Her false labor being over, we sent her back to Ellis Island. The next morning, however, before she could be shipped out of the country, we. got a call from the nurse on Ellis Island. Shoshanna was having regular contractions and that meant that delivery was imminent. I set out for the Island immediately.
Ordinarily when I went to and from Ellis Island it involved a long trip on the public ferry from St. George in Staten Island to the Battery in Manhattan and then another ferry to Ellis Island -- it was a long trip. Not this time. Within a few minutes I was speeding through the water on a Coast Guard launch. The wind was blowing stiffly, with strong gusts, the water was choppy, and we raised quite a spray as we plunged through the waves. I had a wonderful feeling of exhilaration as I stood in the bow.
On our left, towering above us, the Statue of Liberty presided over the scene. I thought I saw her wink as we went by. Once on the Island I confirmed that serious labor was in progress, and the Coast Guard rushed us back to the hospital. The chief of obstetrics, Dr. Dorsen, and I attended the patient in the delivery room. The preparation of the patient in the delivery room was even more exciting than the boat trip. My German was strained to get the patient to cooperate while I did the spinal. Putting her in stirrups was even more challenging. What do you do when the patient has no feet?
The nurse solved the problem by tying bandages around Shoshanna's stumps, and tying the bandages to the stirrups. All this was done in great haste, because the patient was in advanced labor by this time. The delivery was going smoothly and when I thought it was nearly over, and that all I had left to do was "catch" the baby in a minute, the baby got stuck. I could touch the tiny head with my gloved hand. It felt like a fragile egg shell, and it wasn't progressing any further. Meanwhile, the mother had developed a cardiac irregularity, and her blood pressure began to drop. Not serious yet, but time was short. The chief told me that I would have to use forceps. (This was entirely my delivery.) I balked. I was terrified. I had delivered other babies and I had learned how to use forceps, but I had never had the actual experience. How could I clamp those big metal things around that tiny, fragile head? Dr. Dorsen insisted. It had to be done. It would be Okay, he said.
I placed the instrument in position around the head and tugged gently. In my mind I was reviewing all the injuries to the baby that could occur with this type of delivery. There was the brain, especially the temporal lobes --the neck, the brachial plexus, and so on. It took as much courage to use those forceps as anything I've ever done.
After the delivery, we checked the baby carefully. He was small, but he was all right! Shoshanna was fine, too. Her cardiac rhythm and blood pressure had returned to normal. She said the baby would be called Joshua, after the biblical hero who led his people to the promised land. Mother and infant soon went off to the mid-west and may still be somewhere in that vicinity. I imagine that her husband joined them and I hope they are all well.
As everyone knows, Federal bureaucracy is almost invincible. But this time it was up against Nature. And Nature won hands down.
This is a true story. I never got around to publishing it before placing it here on my Website. (May 10, 2003) Gerald D. Klee