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The nurse told me to tilt Max forward, just like Dr. Spock said, and to hold a towel to his nose. I asked her if she’d hang on, and then I tried that, and this time the bleeding seemed to ebb. “It’s working,” I yelled into the receiver, lying on its side on the kitchen table. I picked it up. “It’s working,” I repeated.

“Good,” the nurse told me. “Now, watch him for the next couple of hours. If he seems content, and if he’s eating all right, then we don’t need to see him.”

At this, a flood of relief washed through me. I didn’t know how I’d ever manage to get him to the doctor by myself. I could barely make it out of the neighborhood with him yet.

“And check his pupils,” the nurse continued. “Make sure they aren’t dilated or uneven. That’s a sign of concussion.”

“Concussion,” I whispered, unheard over Max’s cries. “I didn’t mean to do it,” I told the nurse.

“Of course,” the nurse assured me. “No one does.”

When I hung up the phone, Max was still crying so hard that he’d begun to gag on his sobs. I was shaking, rubbing his back. I tried to sponge the clotted blood around his nostrils so that he’d be able to breathe. Even aftet="Ñ€tilr he was cleaned, faint red blotches remained, as if he’d been permanently stained. “I’m so sorry, Max,” I whispered, my words rattling in my throat. “It was just a second, that’s all I turned away for; I didn’t know that you were going to move that fast.” Max’s cries waned and then became louder again. “I’m so sorry,” I said, repeating the words like a lullaby. “I’m so sorry.

I carried him to the bathroom and ran the faucet and let him peek into the mirror-all the things that usually calmed him down. When Max didn’t respond, I sat down on the toilet lid and rocked him closer. I had been crying too, high keening notes that tore through my body and ripped shrilly through Max’s screams. It took me a moment to realize that suddenly I was the only one making a sound.

Max was still and quiet on my shoulder. I stood and moved to the mirror, afraid to look. His eyes were closed; his hair was matted with sweat. His nose was plugged with dried sienna blood, and two bruises darkened his skin just beneath his eyes. I shivered with the sudden thought: I was just like those women. I had killed my child.

Still hiccuping with sobs, I carried Max to the bedroom and placed him on the cool blue bedspread. I sighed with relief: his back rose and fell; he was breathing, asleep. His face, though brutally marked, held the peace of an angel.

I put my face into my hands, trembling. I had known that I wouldn’t be a very good mother, but I assumed that my sins would be forgetfulness or ignorance. I didn’t know I would hurt my own son. Surely anyone else would have lifted the baby to retrieve the diaper. I was too stupid to think of it. And if I had done it once, it could happen again.

I had a sudden memory of my mother the night before she disappeared from my life. She wore a pale-peach bathrobe and fuzzy bunny slippers. She sat on the edge of my bed. “You know I love you, Paige-boy,” she said, because she thought I was asleep. “Don’t you let anyone tell you otherwise.”

I laid my hand on my son’s back, smoothing out his ragged breathing. “I love you,” I said, tracing the letters of his name on his cotton playsuit. “Don’t let anyone tell you otherwise.”

Max woke up smiling. I was leaning over his crib, as I had been for the hour he’d been asleep, praying for the first time since he was born that he’d wake up soon. “Oh, sweetie,” I said, reaching for his chubby fingers.

I changed his diaper and took out his little bathtub. I sat him in it fully clothed but filled the basin with Baby Magic and warm water. Then I washed off his face and his arms where they were still splattered from the nosebleed. I changed his outfit, rinsing the old one as best I could and hanging it over the shower rod to dry.

I gave him the breast instead of the bottle he’d never finished, figuring he deserved a little pampering. I cuddled him close, and he smiled and rubbed his cheek against me. “You don’t remember a thing, do you?” I said. I closed my eyes and leaned my head against the couch. “Thank heaven.”

Max was so g yoÑ€saiood-natured for the rest of the afternoon that I knew God was punishing me. I wallowed in my guilt, tickling Max’s belly, blowing wet kisses onto his fat thighs. When Nicholas came home, a knot tightened in my stomach, but I did not get up off the floor with the baby. “Paige, Paige, Paige!” Nicholas sang, stepping into the hallway. He sashayed into the living room with his eyes half closed. He’d been on call for thirty-six straight hours. “Don’t mention the words Mass General to me-don’t even say the word heart. For the next twenty-four glorious hours I’m going to sleep and eat greasy food and be a sloth right here in my own house.” He walked down the hall toward the stairs, his voice trailing behind. “Did you get to the cleaners?” he called.

“No,” I whispered. I had an excuse this time for not leaving the house, but he wouldn’t want to hear it.

Nicholas reappeared in the living room, holding his shirt by the collar. His good mood had vanished. He’d asked me to go to the dry cleaners two days ago, but I hadn’t felt comfortable taking Max by myself, and Nicholas hadn’t been home to watch him, and I didn’t know how to even begin to find a baby-sitter. “It’s a good thing I have off tomorrow, then, since this is the last goddamned clean shirt I had. Come on, Paige,” he said, his eyes turning dark. “You can’t possibly be busy every minute of the day.”

“I was thinking,” I said, not looking up, “that maybe you’d watch the baby while I go to the laundry and grocery shopping.” I swallowed. “I was kind of waiting for you to get home.”

Nicholas glared at me. “This is the first break I’ve had in thirty-six hours and you want me to watch Max?” I did not say anything. “For Christ’s sake, Paige, it’s my only day off in the past two weeks. You’re here every single goddamned day.”

“I can wait till you take a nap,” I suggested, but Nicholas was already starting back down the hall.

I held Max’s little fists in my hands and braced myself for what I knew was to come. Nicholas ran down the stairway with Max’s bloody outfit, wet, wrapped around his fingers. “What the hell is this?” Nicholas said, his voice hot and low.

“Max had an accident,” I said as calmly as I could. “A nosebleed. I didn’t mean to do it. The diaper fell-” I looked up at Nicholas, at the storm in his eyes, and I started to cry again. “I twisted around for a second-well, not even; more like half a second-to get it, and Max rolled the wrong way and hit his nose on the table-”

“When,” Nicholas said, “were you planning on telling me?”

He crossed the room in three long strides and picked Max up roughly. “Be careful,” I said, and Nicholas made a strange sound in the back of his throat.

His eyes swept the kidney-shaped bruises below Max’s eyes, the traces of blood on the pads of his nose. He looked at me for a moment, as if he were piercing through to my soul and knew I was marked for hell. He clutched the baby tighter in his arms. “You go,” he said quietly. “I’ll take care of Max.”

His words, and the acd lÑ€er cusation behind them, stung me as violently as a slap to the face. I stood and walked to the bedroom, collecting the heap of Nicholas’s shirts. I pulled them into my arms, feeling their sleeves wrap and bind my wrists. I pulled my purse and my sunglasses from the kitchen table, and then I stood in the doorway of the living room. Nicholas and Max looked up at the same time. They sat together on the pale couch, looking as if they were carved from the same block of marble. “I didn’t mean to,” I whispered, and then I turned away.

At the cash machine, I was crying so hard that I didn’t realize I had pressed the wrong buttons until a thousand dollars came out, instead of the hundred I needed for grocery shopping and prepayment on Nicholas’s shirts. I did not bother to redeposit it. Instead I tore out of the fire zone I’d parked in, rolled down all the windows, and headed to the nearest highway. It felt good to hear the wind scream in my ears and lighten the weight of my hair. The band in my chest began to ease, and my headache was disappearing. Maybe, I thought, what I needed all along was a little time alone. Maybe I just needed to get away.