Chapter 1 Beginnings

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I was Doe, Baby Jane Doe, in Delivery. I’m Rani at home. I’m Dorani on the dotted line. I’m lucky in life and Lakshmi in the lab. Call me Lakshmi, Dorani Lakshmi Stein. Born in Baltimore, January 22, 1984. I’ve lived the tale I’m about to tell you. Every bit of it is true. What I didn’t experience firsthand, I’ve learned from others who did. What they couldn’t tell me, I’ve imagined. My mother had come to Hopkins for its MD/PhD program after an impressive undergraduate showing at the Indian Institute of Science in Bangalore. She was in her second unhappy year of medical school. Well, she was happy to have met Isador Stein and won her parents’ approval to marry him. But she was discovering that her professional love was scientific research and not the practice of medicine. The burden of acquiring a medical education she no longer wanted was proving unbearable.

In the first moments of January 22, my mother concluded a twenty-four-hour shift during her clerkship in Women’s Health. While she dreamt of sleep and prepared to walk out into the coldest night in the history of our Monumental City, the attending physician in OB/GYN, another Bangalorean, said, “Naija, stand in on a real delivery?”

Thinking about it now makes me remember those days as a skinny thing when I asked, “Amma, tell me about the night I was born?” In her candy-sweet voice she unwound the tale, sprinkling in the rhyming timing of Tamilian English vinglish she never lost.

“It came to pass that I was watching as a beautiful young wisp of a woman—she couldn’t have been more than twenty years old—was rushed into Delivery, already in labor. She had jet-black hair, and the deep, dark skin of my people, and the brown eyes, of course. Immediately, there were problems. She did seem to be term, but she was uncommunicative. Not in a medically serious way, but she said very little. She wasn’t one of ours. I mean, we were not expecting her. No one on our staff had seen her before. She was not in our medical records. She hadn’t been receiving prenatal care from us. She was all alone and she identified no next of kin.

“The labor was not going well; she was so petite, too petite. She nodded her approval for us to do a C-section. It had to be done stat. Maybe it would have happened anyway, but when the chief resident opened her up, some of the amniotic fluid around the baby got into her blood, the mom’s blood. The baby was fine and had an out-of-the-box APGAR score of 8 that was soon followed by a 10, but all of a sudden the mother began to have severe trouble breathing. Her blood pressure dropped. Then her heart stopped. We couldn’t save her.”

“Tell me more, Ammaji, please.” I would nuzzle up against her buttery soft skin, warm and so comforting.

“Rani,” she would say to me, “I am trying to spare you!”

“Amma, please?”

She sighed, knowing that there was no escape. “Amniotic fluid had leaked into her bloodstream and it made her clot up. An embolism, a big one, lodged in her heart. She turned blue and had convulsions. It was awful, more awful than I can tell you. Watching that young woman vooman, watching that girl-child suffer, then vanish in moments.…” She always stopped here, to gather composure before she finished with my favorite part of the legend.

“She was the darkest cinnamon little Tamil girl, like me. A beautiful baby. Seeing the mother die in front of me—my medical career ended right there. I did not have the stomach for more of that. But, I loved that infant from the moment I saw her. I knew that I was going to find a way to keep her, and I did, kid.”

My mother dropped out of the MD program and finished her PhD in immunology on schedule in three more years. Later she gave birth to my little sister, Lalita.

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