Jacob Have I Loved

He took a puff before going on. “I see you are doing well in your courses.”

“Yes, sir.”

“I suppose you are considering medicine.”

“Yes, sir. That’s why I’m in premed.”

“I see.” He puffed and sucked a bit. “You’re serious about this? I would think that a good-looking young woman like you—”

“Yes, sir, I’m sure.”

“Have you thought about nursing?”

“No, sir. I want to be a doctor.”

When he saw how determined I was, he stopped fooling with his pipe. He wished it were different, he said, but with all the returning veterans, the chances of a girl, “even a bright girl like you,” getting into medical school were practically nonexistent. He urged me to switch to nursing at the end of the semester.

A sea nettle hitting me in the face couldn’t have stung worse. For a few days I was desolate, but then I decided that if you can’t catch crabs where you are, you move your pots. I transferred to the University of Kentucky and into the nursing school, which had a good course in midwifery. I would become a nurse-midwife, spend

a few years in the mountains where doctors were scarce, and then use my experience to persuade the government to send me to medical school on a public health scholarship.

When I was about ready to graduate, a list of Appalachian communities asking for nurse-midwives was posted on the student bulletin board. From the neat, double-spaced list, the name “Truitt” jumped out at me. When I was told the village was in a valley completely surrounded by mountains, the nearest hospital a two-hour drive over terrible roads, I was delighted. It seemed exactly the place for me to work for two or three years, see all the mountains I ever wanted to see, and then, armed with a bit of money and a lot of experience, to batter my way into medical school.

A mountain-locked valley is more like an island than anything else I know. Our water is the Appalachian wilderness, our boats, the army surplus jeeps we count on to navigate our washboard roads and the hairpin curves across the mountains. There are a few trucks, freely loaned about in good weather to any valley farmer who must take his pigs or calves to market. The rest of us seldom leave the valley.

The school is larger than the one on Rass, not only because there are twice the number of families, but because people here, even more than islanders, tend to count their wealth in children. There is a one-room Presbyterian Church, built of native stone, to which a preacher comes every three weeks when the road is passable. And every fourth Sunday, God and the weather willing, a Catholic priest says mass in the schoolhouse. There are no mines open in our pocket of western Virginia now, but the Polish and Lithuanian miners who were brought down from Pennsylvania two generations ago stayed and turned their hands to digging fields and cutting pastures out of the hillsides. They are still considered outsiders by the tough Scotch-Irish who have farmed the rocks of the valley floor for nearly two hundred years.

The most pressing health problem is one never encountered on Rass. On Saturday night, five or six of the valley men get blind drunk and beat their wives and children. In the Protestant homes I am told it is a Catholic problem, and in the Catholic homes, a Protestant. The truth, of course, is that the ailment crosses denominational lines. Perhaps it is the fault of the mountains, glowering above us, delaying sunrise and hastening the night. They are as awesome and beautiful as the open water, but the valley people do not seem to notice. Nor are they grateful for the game and timber that the mountains so generously provide. Most of them only see the ungiving soil from which a man must wrestle his subsistence and the barriers that shut him out from the world. These men struggle against their mountains. On Rass men followed the water. There is a difference.

Although the valley people are slow to accept outsiders, they did not hesitate to come to me. They needed my skill.

“Nurse?” An old ruddy-faced farmer was at my door in the middle of the night. “Nurse, would you be kind enough to see to my Betsy? She’s having a bad go of it.”

I dressed and went with him to his farm to deliver what I thought was a baby. To my amazement, he drove straight past the house to the barn. Betsy was his cow, but neither of us would have been prouder of that outsized calf had it been a child.

I came to wonder if every disease of man and beast had simply waited for my arrival to invade the valley. My little house, which was also the clinic, was usually jammed, and often there was a jeep waiting at the door to take me to examine a child or a cow or a woman in labor.

The first time I saw Joseph Wojtkiewicz (what my grandmother would have done to that name!), the first time I saw him to know who he was, that is, he arrived in his jeep late one night to ask me to come and treat his son, Stephen. Like most of the valley men, he seemed ill at ease with me; his only conversation during the ride was about the boy who had a severe earache and a fever of 105, which had made his father afraid to bring him out in the cold night air to the clinic.

The Wojtkiewicz house was a neatly built log cabin with four small rooms. There were three children, the six-year-old patient, and his two sisters, Mary and Anna, who were eight and five. The mother had been dead for several years.

The county had sent me an assortment of drugs including a little penicillin, so I was able to give the child a shot. Then an alcohol rubdown to bring the fever down a bit until the drug had time to do its work, a little warm oil to soothe the ear, a word or two to commend bravery, and I was ready to go.

I had repacked my bag and was heading for the door when I realized the boy’s father had made coffee for me. It seemed rude not to drink it, so I sat opposite him at his kitchen table, my face set in my most professional smile, mouthing reassurance and unnecessary directions for the child’s care.

I became increasingly aware that the man was staring at me, not impolitely, but as though he were studying an unknown specimen. At last he said, “Where do you come from?”

“The University of Kentucky,” I said. I prided myself on never letting remarks made by patients or their families surprise me.

“No, no,” he said. “Not school. Where do you really come from?”

I began to tell him quite matter-of-factly about Rass, where it was, what it looked like, slipping into a picture of how it had been. I hadn’t returned to the island since entering nursing school except for two funerals, my grandmother’s and the Captain’s. Now as I described the marsh as it was when I was a child, I could almost feel the wind on my arms, and hear the geese baying like a pack of hounds as they flew over. No one on the mainland had ever invited me to talk about home before, and the longer I talked, the more I wanted to talk, churning with happiness and homesickness at the same time.

The little girls had come into the kitchen and were leaning on either side of their father’s chair, listening with the same dark-eyed intensity. Joseph put an arm around each of them, absently stroking the black curls of Anna who was on his right.

At last I stopped, a little shy for having talked so much. I even apologized.

“No, no,” he said. “I asked because I wanted to know. I knew there was something different about you. I kept wondering ever since you came. Why would a woman like you, who could have anything she wanted, come to a place like this? Now I understand.” He left off stroking his daughter’s hair and leaned forward, his big hands open as though he needed their help to explain his meaning. “God in heaven,”—I thought at first it was an oath, it had been so long since I’d heard the expression used in any other way—“God in heaven’s been raising you for this valley from the day you were born.”