Birth

By A.J.Cronin

About the Author

Image Reference: en.wikipedia.org

Archibald Joseph Cronin was a Scottish novelist, dramatist, and non-fiction writer. He was born on July, 1896 in Dunbartonshire, Scotland, in 1896. In 1914 he entered Glasgow University to study medicine, but his studies were interrupted by World War I, in which he served in the British Navy as a surgeon sub lieutenant. He received his M.B. and Ch.B. in 1919, and took a job as a ship’s surgeon on a passenger liner. He afterwards took positions at several hospitals, and in 1921 he married Agnes Mary and moved to south Wales to start a medical practice. He received his MD degree in 1925 from the University of Glasgow, and he moved to London to start a practice there. In 1926, Cronin opened a medical practice in London’s fashionable West End, but soon after ill health forced him to take a leave of absence. In 1930 he was diagnosed with an ulcer, and ordered to take six months complete rest on a milk diet.

A.J. Cronin was one of the most renowned storytellers of the twentieth century. His best-known works are The Citadel and The Keys of the Kingdom, both of which were made into Oscar-nominated films. He also created the Dr. Finlay character, the hero of a series of stories that served as the basis for the long-running BBC television and radio series entitled Dr. Finlay’s Casebook.

Cronin died on 6 January 1981 in Montreux, Switzerland.

Introduction

This chapter is an extract from A.J Cronin’s novel “The Citadel”. This extract describes how a young doctor revives a child that is born lifeless.

Joe Morgan and his wife are a middle -aged couple. They have been married for 20 years, but have not get any child so far. Now Mrs. Morgan is expecting her first child. Both her husband and her mother are feeling very nervous because the delivery of the child is going to be before time. A young doctor named, Andrew is called in. The doctor has to put in hard labour in the delivery of the child. When the child is born, it seems to be still-born. This shock could be too much for the Morgans to bear.

While the doctor is attending to the mother, the nurse places the baby under the bed among dirty newspapers. After assuring himself that the mother is safe, the doctor looks for the baby. Finding it under the bed, he at once pulls it out. It was a boy, perfectly formed. The body was warm but was not breathing. At once the doctor sets to revive the child’s breath. After half an hour’s terrible effort, he is at last successful. He thanks god and hands the child to the nurse.

Characters

1. Dr. Andrew Manson – Newly qualified, takes a job as assistant to Dr. Page in a small mining town. On arrival, he finds to his surprise that Page is partly paralyzed and will never work again. This means Dr. Andrew Manson will have to do most of the clinic’s work in this mining town at a meagre pay.

2. The Midwife – an experienced nurse to help in the birth of the child. The midwife and Andrew are contrasting personalities. The midwife is a foil to Andrew. She feels hopeless, resigned, helpless, fearful and untrained. On the other hand, Andrew proves to be more optimistic, diligent, efficient, self-sufficient, spontaneous and well-trained.

3. Joe Morgan – a well-built person in forties, lives in a small Welsh town of Blaenelly, works as a driller at the mines, he has been married for 20 years, but have not got any child so far.

4. Mrs. Morgan – wife of Joe Morgan, is expecting her first child, Both her husband and her mother are feeling very nervous because the
delivery of the child is going to be before time.

5. Christine – a school teacher, Andrew falls in love and contemplates marrying her.

6. Morgan’s mother – a tall, grey-haired woman of nearly seventy.

Summary in Points

1. Andrew returns home after a disappointing visit with his lady love, Christine Barlow.

2. Exhausted, he finds Joe Morgan, anxious and somewhat scared, waiting for him.

3. Morgan’s wife was in labour, before the expected date. This is their first child in a marriage of nearly twenty years.

4. Andrew reaches the house of Morgan and waits in the kitchen.

5. The labour leads to a stillborn baby.

6. He instinctively decides to save the mother first, handing the baby over to the midwife.

7. The midwife, who has had no medical training, sees the body in her arms as a lifeless lump and places it under the bed among sodden newspapers.

8. Andrew draws the baby out from under the bed and quickly diagnoses the most probable cause for the still birth i.e. Asphyxia, pallida.

9. He recalls a method he had once observed through which a child had been successfully resuscitated.

10. He tries the simultaneous hot and cold dips to shock the body and get the heart to jump start, then rubs the baby’s body with a rough towel crushing and releasing the little chest.

11. On the verge of giving up, a miracle happens.

12. The child breathes. Andrew redoubles his efforts till the baby breathes freely.

13. While leaving the house, he feels that he has done something ‘real’, at last.

Detailed Summary

Andrew Manson was a young doctor. He had newly passed out of a medical school and joined as an assistant to Dr. Edward Page. Their clinic was in the small Welsh town of Blaenelly. It was a mining town. Joe Morgan was a resident of this town. He was a well-built person and worked as a driller at the mines. He lived with his wife. They had been married for about twenty years, but so far they didn’t have any child. Now Mrs. Morgan was expecting her first child.

After spending a disappointing evening with his ladylove, Christine, Andrew came back home. He found Morgan waiting for him restlessly. He told the doctor that he had been waiting for him for an hour. He said that his wife needed his presence because the child was expected to be born before time.

Together they set out for Morgan’s house. Andrew was feeling very dull and tired. He had no idea that this night call would prove unusual and influence his whole future in Blaenelly.

When they reached the door of Number 12, Morgan stopped outside the door. He said that he won’t go in. Inside, a narrow stair led up to a small bedroom. It was clean but poorly furnished. It was lit only by an oil lamp. Mrs. Morgan’s mother was sitting beside the patient. She was a tall, grey-haired woman of nearly seventy. An elderly midwife was also there. Both of them watched Andrew’s expression as he moved about the room.

Since there was a period of waiting, Andrew waited in the kitchen. Soon he was lost in his thoughts about Christine. An hour later he went upstairs again. He noted the progress made and came down once more. He sat down by the kitchen fire.

At last the nurse’s voice was heard calling from the top landing. Andrew looked at the clock. It now showed half-past three. He rose and went up to the bedroom. He saw that he could now begin his work. An hour passed. It was a long, hard struggle. Then, as the first rays of dawn appeared, the child was born, lifeless.

As Andrew looked at the lifeless form, a shiver of horror went through his body. He couldn’t decide whether to resuscitate the child first or attend to the mother who herself was in a serious state. Instinctively, he gave the child to the nurse and turned his attention to Susan Morgan who now lay collapsed, almost pulseless. He gave her an injection, and after a few minutes of
feverish effort, Susan’s heart gained strength. Now he could safely leave her.

Swinging round to the nurse, he asked, “Where’s the child?” When Andrew looked at the child, he at once knew that it was a case of asphyxia. Instantly he was on his feet. “Get me hot water and cold water,” he said to the nurse. “And basins too. Quick! Quick!” He took a blanket and laid the child upon it. Then he began the special method of respiration. The basins arrived. Andrew put cold water into one basin; into the other he mixed water as hot as his hand could bear. Then, like a crazy juggler, he hurried the child between the two basins. Now he plunged it into the icy water, now into the hot one. Fifteen minutes passed. Sweat was now running into Andrews’s eyes. His breath was coming pantingly. But no breath came from the body of the child.

A terrible sense of defeat came on him. Having laboured in vain for half an hour, he still made one last effort. He rubbed the child with a rough towel. He pressed and released the little chest with both his hands. Thus he tried to get breath into that limp body.

And then a miracle happened. The little chest gave a short heave.  Andrew continued with his efforts feverishly. The child had started gasping, deeper and deeper. A bubble of mucus came from one tiny nostril. The limbs were no longer boneless. The head no longer lay back spinelessly. The skin was slowly turning pink. And then, exquisitely came the child’s cry. Andrew handed the child to the nurse. He went downstairs, and took a long drink of water. He took his hat and coat and left the house. Outside he found Joe standing on the pavement with a tense, expectant face. “All right, Joe,” said Andrew. “Both all right.”

It was quite light. Nearly five o’clock. A few miners were already in the streets. As Andrew walked with them, he kept thinking unconsciously, “I’ve done something; oh, God! I’ve done something real at last.”

Short Answer Type Questions

Q1. Why was Andrew so serious and tense that evening?
 
Ans. That evening Andrew was tense and serious. He had a disappointing evening with his girlfriend Christine. Moreover, he had seen some painful incidents of husbands’ suffering at the hands of their wives. He was short of sleep as well.

Q2. Who was Joe Morgan? Why was he so tense and waiting anxiously for Dr. Andrew that night?
 
Ans. Joe Morgan was in dire need of Dr. Andrew’s help. His wife Susan was in labour. She was going to deliver their first child after 20 years of marriage. Joe and Susan were keen to have the child delivered safely. So he stood waiting anxiously for the doctor.

Q3. That night proved unusual and it influenced Dr. Andrew’s whole future in Blaenelly. What miraculous thing happened that night?
 
Ans. Dr. Andrew had first begun his medical practice in the mining town of Blaenelly. The successful handling of Mrs. Joe’s case proved a turning point in his life. It was no less than a miracle. He restored life in a stillborn child.

Q4. Why were Susan and her old mother equally so tense that night?
 
Ans. Susan was in labour after 20 years of marriage. It was natural for her and her husband Joe to be tense. Susan’s old mother also stood beside her tense and hopeful.

Q5. Susan’s mother was wise in experience. What hints did she give of her wisdom?
 
Ans. Susan’s mother was a tall, grey-haired woman of nearly seventy. From her personal experience, she knew that the childbirth would take some time. She was wise enough to fear that Dr. Andrew might not wait for long. So she tried to make him stay by offering him tea and sitting beside him.

Q6. Why and when did a shiver of horror pass over Dr. Andrew?
 
Ans. Dr. Andrew was shocked and horrified as he looked at the lifeless newly born baby. He also noticed Susan sinking. He was in a dilemma, whom to save first.

Q7. Dr. Andrew faced the biggest dilemma of his life that night. How did he act and save two lives?
 
Ans. Dr. Andrew was called to supervise the first and crucial delivery of Susan Morgan. He was tense and short of sleep. Still, he decided to wait. He gave a promise to Joe and his wife that all would be well. But he became nervous to find both the mother and her baby in trouble. He first gave injection to Susan. Next, he lifted the stillborn baby, put him in hot and cold water and pressed the child’s chest. Luckily, he saved both of them.

Q8. Comment on the behaviour and role of the midwife attending on Susan Morgan.
 
Ans. The midwife attending on Susan showed lack of experience and professional attitude. She declared at once that the baby was stillborn. She pushed it under the bed. Even when Andrew was trying to bring back life into the baby, she showed disbelief and even discouraged Andrew from making feverish effort. The cry of the baby made her exclaim with
joy.

Q9. What did Andrew do to restore life in the stillborn child?
 
Ans. Andrew recalled a similar case in the past. He gave the same treatment to the stillborn baby. He asked for hot and icy cold water. He placed it into cold and warm water alternately. He rubbed the child with a rough towel and pressed and released the little chest with his hands. The miracle happened. Its skin turned pink and it cried.

Q10. Describe the moments when the stillborn child gave a short heave and slowly revived.
 
Ans. Andrew for a while felt beaten and disappointed. But he made one last effort. He pressed the baby’s chest gently and then released. The technique was successful. He felt the little heart beating. A bubble of mucus came from one nostril. The child was gasping and then came a cry.

Q11. What was Andrew’s greatest achievement and satisfaction as he walked out of the House Number 12, Blaina Terrace?
 
Ans. Dr. Andrew was called to handle a critical case of delivery. He was tired. He felt defeated. He was in a dilemma because of the sinking condition of Susan and the lifeless form of her baby. But he saved both the lives. He called it his greatest reward and success.

Long Answer Type Questions

Q1. Why was Andrew feeling so dull and listless that evening? How did that evening influence his whole life and career?
 
Ans. Andrew returned home after midnight. His experience with Christine that evening was not happy one. Moreover, several episodes of unhappy married couples also saddened him. Outside his house was Joe Morgan waiting anxiously for the doctor. He led Andrew to his house where his wife Susan was in labour. Both were set upon the child. Andrew decided to wait and give medical aid. He had no idea that the incident of that night would give him not only supreme satisfaction but also name and fame. He worked hard and very intelligently saved the life of mother as well as her stillborn child.

Q2. What was Andrew’s dilemma after the delivery? How did he solve the problem so successfully?
 
Ans. The child was born at daybreak. Dr. Andrew was filled with horror as he looked at the lifeless baby. He had now two patients on his hand. Susan was fast losing her pulse. The baby was white, lax and lifeless. Andrew was in dilemma whom to give his attention first. Going by instinct, he gave an injection to Susan and pulled her out of danger. Then he pulled out the child, with warm body but no breathing. He gave it an unusual treatment using cold and hot water and the pressure of his hands. And there was a miracle. He thanked God when the child gave out a cry.

Q3. Narrate the story in about 100 words of your own. What message does it convey?
 
Ans. This story narrates an incident in which a young doctor saves two lives. Both the mother and her still born baby were in a critical condition. It highlights the miracle that a physician can perform.

Andrew was a young doctor. He was called upon to supervise a case of childbirth. Joe and his wife Susan had been married for nearly twenty years. They were expecting their first child. Two women were already at Susan’s bedside—Susan’s old mother and a midwife. Andrew decided to wait till the work was completed. When Susan gave birth to the baby, her own condition became critical. The baby was stillborn, limp and boneless. Andrew first restored the mother to a safe point. Then he picked up the child. He dipped it into hot and ice cold water alternately. He applied mild pressure on the little chest. And it came back to life.

Q4. There is a great difference between textbook medicine and the world of a practising physician. Discuss.
 
Ans. Bookish knowledge is very important as it imparts theoretical knowledge. It teaches a man intricacies of a problem and its probable solutions. If a man having theoretical knowledge has no practical experience he may fail in his job. On the other hand, a man with practical knowledge and experience only may fail to achieve the desired results. In our day to day life we meet compounders surpassing the doctors and the physicians. A physician who has read the process of administering an injection but has not done it with his own hands will fail in his attempt to administer injection. On the contrary, a compounder can surpass the physician because he has practical experience. Similarly, if you have minutely observed a man doing his job to perfection you can apply that very practical experience based on your keen observation and achieve success. Dr. Andrew could save the child because he had observed somebody saving an almost lifeless child. He applied that practical experience and knowledge and did his job efficiently. So for success especially in medical field especially both bookish knowledge and practical experience are indispensable.

Q5. “I have done something, oh, God! I’ve done something real at last.” Why does Andrew say this? What does it mean?
 
Ans. Andrew was fresh from the medical school. He was still working as an assistant to Dr. Edward Page in Blaenelly. He had yet to prove his merit. He got a chance soon to test all his learning. He knew that a doctor’s job was to save life. He got a golden opportunity unexpectedly one evening. He was called upon to supervise the delivery case of Susan Morgan. He waited all night. But he was horrified to find the newborn baby almost lifeless. The mother was also collapsing. He first saved the mother’s life by giving an injection. Then he turned to the stillborn baby. He applied treatment he had once seen at school. He dipped the baby first in warm water and then in icy cold water. His effort was crowned with success. The child began to gasp and then cry. Andrew had supreme satisfaction because he had saved two lives.

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