"Only one can survive," the doctor said from beneath thick-lensed, horn-rimmed glasses. An anesthesiologist could not be found to do the alternative, he was saying, and its current orientation precluded the traditional procedure. Jason Somervell bent down to inspect the drops of blood that had amassed beneath the stainless steel operating table. While I glanced at the back of his starched lab coat, everything got suddenly cold.

Something about him carried a foul smell. I bravely inhaled through my nostrils to determine the origin, and found that the familiarity of body odor and unwashed clothes created a presence, not only in my stomach, but in the entire room. Marshall had been that kind of careless, paying attention to only that which merited substantial consideration. Like global warming or a leaky roof.

I can still remember how my unborn child announced itself to me. At first, the movements resembled the languorous flip of a butterfly wing in the smolder of August. And after the first trimester, he became more like a landlord’s knock on the fifth of the month. Look! I’m here, he seemed to be saying. I ate only good food at first -- pine nuts, whole milk, fresh mozzarella, protein mostly, and fruit, so much fruit. And not just the exotic specimens I bought from the Farmer’s Market, but the domestic fruits like apples, peaches and pears. This went on for the first few weeks. Then came chocolate Haagen-Daaz with bananas.

Even while fading in and out of consciousness, I could remember begging for a spinal. "Please," my pathetic voice whined between moans. The pain from the contractions caused me to nearly faint every time. "The spinal..." I kept repeating with my fingers enmeshed in my thick black hair. I had no feeling between my legs now. Not even the shadowy imprint of prior feeling, or the abstract sensation of skin and hair. I couldn’t see past the massive bulge in my stomach, but I knew I would have felt cold if my womb were exposed. A blanket must have been covering me.

We had been in limbo, all four of us, for some time. Doctor Somervell, a Midwife named Nedra, myself and my unborn child, all stuck waiting, throbbing in this indefinite, static, viscous moment. The snows started at nine this morning, stopped for an hour or so at noon, and then flurried the dry ground twice as hard. It was nearly three o’clock, and by now everything was white. I couldn’t see it, but there’s a quiet that only comes from the soundless insulation of fresh fallen snow. I also knew this because I had nothing else to do but watch the white clock on the wall at the foot of my bed. My stepson Willie taught me how to play a game called Time-Out. The object is to stare at the minute hand until you see it move, without blinking. If you’re not blind after the first minute, you try for two, and so on. He must have had me in mind when he made it up.

The floodlights in the operating room had been turned away from my face. Now they pointed toward the window and reflected off of the white carpet outside. The glare hurt my eyes. I must have complained about it already. I think I’d been complaining pretty much all day, though I’m not completely clear on where the last twenty-four hours fit into the time-space continuum.

"Her pressure’s dropping," Nedra whispered in a powdery voice. This voice, nine months ago, had solidified my choice of a clinic. "I’d be hono’ed to help you give birth, dahlin’," she had said on an unseasonably hot spring day. Nedra’s accent was an odd amalgam of Texas drawl and Scottish brogue. Some words, like "head" for instance, were twangy and two syllables long. But "road" in her dialect began with a rolled "th".

What a pair they were, the two of them, ornamented with London Fogs, fancy pens and gold cigarette cases. Without the slightest apology, they were representatives of an alien, Anglo race that gleamed an opal radiance along all the soiled, dirt floors of the reservation. The locals picked up on their affectation immediately upon their arrival. Willie and I were the first to greet them. He said, with the simplicity only a young child can master, "You are them. They said you would be coming." My half-Indian heritage on my mother’s side made me immune to the locals’ scrutiny, to some degree anyway. Looking at me from a distance of twenty or more feet, I did not look like a white woman. The pigment in my skin had been moderately brown from birth, and combined with my long, ropelike black hair, I fit the part just fine. Only Marshall, as perceptive as he could be at times, took the time to survey the shape of my nose. "Do you have any English ancestry?" he asked me on our first date. Many things he said back then surprised me.

"Pressure?" the doctor asked Nedra with a look of both excitement and panic. I could tell he was just seconds away from an anxiety attack. He noticed my eyes were open.

"Ninety over sixty, still dropping," Nedra told him with quick, efficient words. She was holding my hand now. Not a squeeze necessarily, but even this small token of physical contact seemed to be, in spite of everything else, keeping me alive.

I knew what was going on. Dr. Somervell needed to make a decision. I’d already lost what seemed like a pint of blood, I could tell by the way everyone’s voice echoed and the walls seemed far away. I could have been dead I suppose, but I’ve always felt that death would overtake me with at least some degree of ceremony. They’d been arguing about the c-section all afternoon.

"She’s lost too much blood already," he would say to her. "We have no drugs with which to anesthetize her, and besides, she’s weak. Quite weak. Her system may not sustain the operation."

Nedra, on the other hand, suspected the doctor himself might not make it through the night. "Do we have much of a choice?" she’d ask in a tiny voice.

The doctor and Nedra were a package deal, imported from an obstetrics unit at a small clinic in Connecticut. They were volunteering on this reservation for six months and, in return, would be transferred to a clinic in Great Britain. That was Nedra’s choice. Dr. Somervell’s original intent was to remain in New Mexico on a reservation. He put in for a Jicarilla-Apache clinic near Ruidoso, four hours south and slightly east of Albuquerque. Instead they got sent here to one of the pueblo reservations north of Santa Fe, and now, before me, they paced the tiled floor, lab coats swishing behind each step.

As I watched the minute hand approach the five, I felt a mounting duality within myself. A tormenting struggle between wanting that baby out of my body whatever it took, or sliding dreamily into the other side. But another part of me, a third, adhesive part, appreciated how the continuity of life depended exclusively on the strength of this moment, and realized the proximity between myself and death.

After fifteen hours of stunted labor, my open-faced position still managed to humble me. I thought about how radiant and taut my skin had been before incubation of Marshall’s seed. I can still see the look on his face the first time I undressed before him. A night in April bathed in the light of vanilla candles, I was to him a goddess of womanhood. I stood at the foot of his twin bed, naked but for the skimpy pair of lace underpants I’d bought at the co-op. I swear he didn’t move for five minutes. Now and for the last few months, my thighs were like uncooked chicken breasts, my skin like grapefruit peel. At this moment, I could barely recognize my body as my own, nothing between it and the stainless steel table but a long thin piece of paper.

On the other side of a glass wall, I deciphered another tense conversation between Nedra and the doctor. "There is no an-es-the-sia," Somervell argued with outstretched arms and exaggerated movements. As he slowly lifted a hand to his brow, he looked like he might faint. And Nedra, solid as a Cossack, leaned against a utility table with her arms crossed in front of her.

"We couldn’t give her anything else?" she asked with a strange expression.

"Like what?"

"Some sedative to put her out, just long enough to cut her open and sew her back up," Nedra said as a question. The doctor looked down at the linoleum or his shoes while Nedra played with the buttons on her lab coat. He was an inexperienced doctor, she once told me in strict confidence. He’d graduated from Brown University, son of Dr. Nelson Somervell, grandson of Dr. Willard Riley Somervell. Despite this medical lineage, achieving the highest score in the state on his medical school entrance exams apparently seemed suspect to the admissions committee. Between that and a sordid matter Nedra had refused to discuss with me, Dr. Somervell’s application to medical school, at first, was denied. Transferred to Northern New Mexico just a year after graduation, I was a new pair of shoes he was breaking in. Jake Somervell did not like me, nor did he carry any feeling whatsoever for my unborn child. Nedra, in part, made up for this deficit in human nature. All this time, though, after these long hours, he could think of just two words for us.

"Only one."

The words resounded against reverberating corridors in the back of my head. The most confusing matter of all was my role in this predicament. Should it be up to me to decide who should be saved and who should be sacrificed? Why couldn’t someone else make this decision for me? A young, husbandless mother in the midst of labor must be responsible for such lofty judgments? I resented them, suddenly. Resented being here, resented the cold outside and lack of heat in this building. What I’d gathered, from my duration on this table, was that my child lay breach within the caliginous walls of my womb, haphazardly spun around in the dark, and a vaginal delivery might result in not enough oxygen reaching his tiny, under-developed lungs in time. Though four weeks before my due date, he’d decided that today, apparently, was the day. And so he would, or could...die. As for my end of things, a c-section seemed the logical sequence, except for the disturbing shortage of available drugs.

"Women still die from childbirth, you know," Nedra informed me, at that point in favor of the risky vaginal birth which would undoubtedly suffocate my child. Nedra, married to the same man for fifteen years, had no children. This told me what I needed to know about her. "You would surely die from the pain, my dear," she said. And then added, "A c-section is major surgery. Be reasonable," she begged in an emphatic whisper. I began to accept the fact that Nedra did not know which procedure she advocated less.

Nerves raw and barely conscious, I used a variance of expletives to articulate my question about the whereabouts of the anesthesiologist. Nedra explained one could not be found within a sixty-mile radius. "Not in this weather, anyway," she said. I looked out the window. Between sky and ground lay a silent, woven tweed of grayish snow.

One had been contacted in Alamogordo, but they were unwilling to make the seven or eight hour drive. I was fairly sure Nedra hadn’t mentioned the three-mile dirt road leading up to the clinic. The doctor paced the floor of the adjacent operating room while he talked on the telephone to someone who didn’t seem to be listening to him. I saw him pound his fists on a medical cart. The racket echoed more than it should have. Nedra appeared by the side of the delivery table to comfort me once again, apologizing with her eyes for the long delay and uncertainty of my situation. She knew the story of how I’d been a social worker for the Department of Education, and then posted for a job opening in the Department of the Interior where I met Marshall’s uncle, Ricardo Avila.

Marshall came to my office one day after a storm to give his uncle a ride home in his four-wheeler. Two days later we slept together in the back of his pickup truck, and ten days after that he moved in with me. I think he knew I was never that sort, and he appreciated how his presence seemed to activate a hidden overdrive gear in my body. Around Marshall, I broke all my own rules.

Marshall possessed the rare gift of true masculinity without being necessarily handsome. At six feet two inches, the grace of his body came as a surprise. He walked almost ape-like, on his toes and hunched over about ten degrees, but his earnest face and gentle hands made up for these throwback prehistoric traits.

"Nora," he’d said with a quiet hint of apology in his voice, "I’m Ricardo’s nephew, Marshall. Would you like to go bowling with me on Friday?"

His awkward words and sincere expression almost brought tears to my eyes. Because my mother was full-blooded Micmac from Nova Scotia, I was accepted into Marshall’s family, at least by the women. After the completion of our long wedding ceremony, Marshall’s sister Envira sat me down for three straight hours with her bag of herbs and showed me all her secret concoctions. She was almost as tall as Marshall, and just as soft-spoken. "Feverfew," she said, "taken in small doses, can heal any kind of headache."

Marshall’s maternal grandmother, Cora, was a half breed like myself. She told me, one day while she boiled licorice root for tea, of her mixed heritage. "My father was a Choctaw from Alabama," she said. When she smiled, only her two remaining front teeth showed. "When he courted my mother, there was big scandal." Her laugh was hard and gritty, the kind you’d expect to come from Charles Bronson, not a ninety-year old Native American woman. That same day, Cora taught me how to meditate the way she learned many years ago. "You sit," she said, "and once your body begins to relax, you imagine you are sitting on the surface of the water, and you let your body move with the ebb and flow of these imaginary tides."

An hour had passed since my baby last moved.

Jake Somervell could tell what I’d been thinking, or maybe it was my hand rubbing my lower abdomen. He walked slowly from the glassed-in room and stood over me now with a stethoscope, bearing down on the huge, swollen mass. I knew I should feel something as he did this. Pain, discomfort, something; yet no sensation registered from my belly to my brain and back. Nedra stood a foot behind him awaiting his response, mostly undone from the tension. Her hair, usually compacted into a tight bun, looked as if she’d been held upside down and shaken. At first, nothing came. I accepted the intensity of the moment with all my senses. I breathed in the doctor’s fear, and watched Nedra playing with the buttons on her lab coat. She stared now, not at his hand on my abdomen but at his face. Her jaw set and then quickly unset, like she were desperately trying to speak.

"A pulse," Somervell whispered finally. "A pulse!" We all exhaled at once.

"Is my baby alright?" my voice echoed, offering no praise for the young doctor’s discovery. Nedra nodded. I motioned for her to stand beside me. While only half conscious of what I was doing, I reached for her hand and raised my neck up to speak into her ear. "I want the c-section, Nedra. Do it now. My baby’s dying, I can tell."

Nedra’s jaw dropped open as if to help her fully comprehend my wish. Are you sure, her eyes seemed to say.

I nodded. "Tell him quick before I change my mind."

While they washed up and prepared their instruments, I let my mind become distracted with thoughts of sitting on water, being partially submerged in a warm, blue fluid, yet still buoyant enough to float on the surface. As I felt the first prick of the knife, I thrust my consciousness down from my head, through my neck and esophagus into my stomach, where my sleeping baby was. It felt safe there; warm, dark and familiar. In a way, I was remembering my own experience of being in the womb. By the time the doctor had finished his incision, I’d already disconnected from my body. Before I met Marshall and his grandmother, I had never before meditated. Never been that sort, really. I was raised in a practical household where vegetables were served every night with dinner, a banana with breakfast, and a week’s worth of cleaning done every Saturday morning. Though my mother understood meditation as a part of her people’s religion, my father had scoffed at such displays of metaphysics.

While my mind wandered backward to the last time Marshall’s tires screeched away from our dirt driveway, I picked up swatches of conversation between Nedra and Somervell. Each time Nedra spoke, I felt the contraction in my chest begin to let go. I heard anxiety in the doctor’s voice. Was something going wrong? Again I forced my consciousness down the imaginary dark shaft to my belly. I felt anger toward my child for positioning himself backwards. Because of this folly, this monstrous turn of fate, I could not be present, not really, when my baby was born. I could not watch from the mirror on the wall my baby’s head peek out from between my legs, witness the cutting of the chord or his transition from womb to blanket. As a matter of fact, it was entirely possible that I might not even...

"Nora?" a voice said from far away, maybe another room. But who would be speaking from another room? The voice carried an echo with it and when I tried to tune in, I could not. I’m busy floating, I said to the voice through a telepathy as clear as ice. The voice sounded like Cora’s, yet I could not be sure. I was, at that moment, buried. I’d retreated, though only mentally, down into my womb to share a communal silence and consciousness with my as yet unborn child. Though when I tried to communicate with the tiny being now, there was no response. Are you okay? I asked him. Once again I felt a mass tighten in my chest.

"Pressure’s steady," I heard someone say. At that moment, I knew the cutting had stopped, the removing, suturing and sewing had ended. The procedure had either lasted ten minutes or a year. Did I survive?

I could tell Nedra was speaking to me, not by the act of hearing her words, but by the way my body felt when she spoke. It was the sound flour makes when poured from a canister into a bowl, or baby powder shaken out of a tin. And just as she said my name, my eyes opened. While a smile came across her lips, I noticed she seemed far away, removed slightly from my hospital bed. My eyes scanned down her body, and saw she was holding something in her arms, a tiny creature swaddled in the folds of a white towel.

"Less than six pounds," she said.

I glanced around the dingy interior of the medical clinic, at the stained windows and ceiling tiles, dusty unsheathed light bulbs, and finally my eyes landed on an old woman shuffling into the operating room wearing a long denim coat and moccasins covered with snow.

With my neck strained at a jarring angle, I lifted my eyes to meet Cora’s face. Within the abysmal grooves of her ninety-year old complexion, I visualized her whole life -- from her idyllic childhood to the husband who drank too much and beat her, to the raising of five boys. And somehow, within these creased layers of her skin, I could see my own life, too. I remembered, suddenly, the silhouette of her stocky frame at my front door the night Marshall left me. Progressing at turtle speed, she had moved from the doorway to my bed where she let the folds of her coat muffle my cries. "People are like spirits. They fade in and out," she had said.

"Cora," I said out loud, really seeing her now. I could not contain my smile, or my tears. "How did you know to come?"

She carefully withdrew the baby from Nedra’s iron grip, and held it close to her heart. "Time is just a big circle," she said. "Babies and old people... are really the same."