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“Simian Crease”

March 11, 2023

2023-03-11-new-orleans-dgSorry to be MIA—we went to New Orleans for several days (just for fun, weirdly enough <g>—ate, slept, walked around looking at interesting things and listening to great music) and I didn’t take my laptop with me.

I did get a bit of work done, though, in the middle of the nights (the ones where I woke up in time…):

I don’t think anything in this excerpt constitutes a spoiler, but it is from Book Ten.

[Excerpt from UNTITLED BOOK TEN. Copyright © 2023 Diana Gabaldon.]

I uncurled the tiny fist to check again. I’d caught only a glimpse, but… By reflex, I turned my left hand up and glanced at my own palm. It was a maze of wandering lines: head, heart, life, love, fate—and dozens more caused by the daily wear of age and work. A net to catch an unknown future.

But the twitching little starfish in my right hand was almost a blank slate, save for a single smooth, deep line across the upper palm. Only one. The Merck Manual of Diagnosis called it a simian crease.

The little fingers curled again, gripping my index finger. Weak, but definitely a grasping reflex. The birth had been easy—it was Mhairi MacDonald’ eighth labor, but things could go wrong with any birth. Apgar scores were on the low side, but tolerable—with the exception of some of the other reflexes; I couldn’t get a Babinski reflex at all—and the muscle tone overall, which was… the baby gave a sort of floppy, convulsive movement that nearly spilled her off my lap and made a grunting squeak that wasn’t quite a cry.

“Shh, sweetheart, I’ve got you… don’t worry, everything will be fine…” I picked her up and cuddled her—small, but warm and solid, wrapped in her older brother’s shirt, for lack of a blanket—against my shoulder and glanced at the mother, a cold, heavy feeling in my chest.

I knew. Had known by the time I’d started swabbing the little body with oil. Not all the signs were there, but… enough. The flattened nose, the unusual space between the big toe and the second toe… What could I—what should I tell them?

Old Mrs. MacDonald was helping her daughter, kneading her flaccid belly with a firm but kindly touch, whispering what I thought was a blessing in Gaidhlig. Mhairi lay on her sweat-soaked pillow, breathing slowly, eyes half-shut, making little grunts that sounded not unlike her new daughter’s.

Maybe I shouldn’t say anything …specific. “Down’s Syndrome” would mean nothing to anyone in this time, let alone “Trisomy of Chromosome 21”. There was no telling how much cognitive impairment there might be; perhaps only a little, perhaps it wouldn’t be very noticeable. And in this time, when girls largely worked in house and field and took care of children, it mightn’t matter that much; maybe she could function well enough in the bosom of her family.

If she could nurse. If she couldn’t, she likely wouldn’t live long. Her mouth was slightly open, filled by a large, protrusive tongue. I laid her on my lap again and stroked her cheek lightly. Her ears were still pink and slightly crumpled from birth, but looked normal, though small. Her eyes looked somewhat slanted, but were still tight closed, lashes invisible, but she turned her head at once at my touch, snuffling.

Rooting reflex. Check.

“Good,” I whispered. “Can you suck, sweetheart?”

My hands weren’t clean enough for me to consider sticking a finger in her mouth to try. We’d have to wait and see. I glanced over at the bed, half-hidden in darkness. Mrs. MacDonald was still kneading, but her head was raised and she was looking at me as she worked, a deep crease between her brows. Her mouth was pressed tight, but it dawned on me that neither I nor the child was her immediate concern.

“What is the word for a placenta in Gaidhlig?” I asked, rising to my feet with the baby. Mrs. MacDonald blinked and knuckled away a bead of perspiration running down her cheek. The door and window were closed to keep out flies drawn to the scent of blood, so there was a fire to provide light and hot water, and all of us—except the baby—were sweating in the moving shadows.

She shrugged. “There’s some as says “birth-cake’. That’s breith-cèic.” She glanced down at her working hands. “Whatever ye choose to call it, this one’s no lettin’ go.” There was a note of strain in her voice, though her gnarled old hands kept up a steady kneading.

“I have something that might help,” I offered. I’d brought my birthing kit along in a cloth bag. The bag didn’t have everything, but it did have dried raspberry leaves. A strong tea aided labor; it might—I hoped—dislodge an uncooperative placenta. I would have put the child to Mhairi’s breast to suckle, but given my doubts… best start with the tea.

Mrs. MacDonald hesitated for a moment, hands stilled and brows knit. Old Mrs. MacDonald thinks you’re a witch, Fanny had told me. But it doesn’t matter, because Mr. MacDonald is afraid of Mr. Fraser. She stared at me, eyes narrowed, but then glanced down at her gasping daughter, and gave in.

“Gie’ me the wean and do what ye can,” she said abruptly.

Click to visit my Book Ten webpage for information on this book, and to read more excerpts from it.

This excerpt was posted on my official Facebook page on March 11, 2023.