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It wouldn’t be the first time.

No, she decided. No — it would grow up the same way everything grew up in her neighborhood: warped and bent and old before its time, tired and ugly and dead inside while it was still living and growing.

But she “would never know, never understand for certain. Because the child would never be born and never suck at her breasts and never cry or soil its diapers or be happy or sad.

The child would die within her womb.

Her mother’s hand jerked her along and lifted her out of her reverie. The child would die, the child would die, the child would die. And that was all there was to it.

They turned at last into a filthy little alley midway down one block. The condition of the alley made the street look like paradise.

If cleanliness was next to Godliness, the alley was Hell.

Rats scurried from one doorway to another, seemingly oblivious to the intrusion of Carla and her mother. Cats pursued the rats lackadaisically and dogs pursued the cats with the same purposelessness. Carla could hear babies crying in several of the rooms bordering the alley. She knew of those rooms — tiny holes in the wall where two or three families huddled together and lived or died. The rats bit the babies and even attacked the adults from time to time.

They stopped at a doorway. Once there had been a nameplate on the door; now the plate was long gone. The nails rusted and the plate fell off and disappeared into the squalor of the alley. But Carla’s mother knew that it was the right door. She knocked twice, paused, and knocked twice again.

For a long time there was nothing. No sound came from behind the door. Carla’s mother knocked again, two knocks, a pause, and two more knocks, just a bit louder than before.

Then the door opened.

The man was dressed simply in a filthy white shirt and a pair of dirty dungarees. The slippers on his feet were falling apart. He said, “Enter,” and Carla stepped back involuntarily at the odor of his breath. It stank of cheap wine and teeth rotting in his jaws. The wine was Sweet Lucy — muscatel that sold for fifty cents a quart and got a man drunk cheaper and easier.

The man was a wino. Once he had been a doctor, but that had been long ago and in another world. His office was located only a mile or so from the alley where he now lived, but that mile was the space between two altogether different worlds.

Then the man did something or had something done to him. It doesn’t much matter what the thing was. Perhaps a patient died that should have lived. Perhaps his wife left him or his son died. The thing could have been almost anything.

But after the thing happened the man began to drift across the mile from the plush office to the alley. The bridge between the two extremes was built of liquid. First it had been imported Scotch. Then, as he moved further and further across the bridge he switched to blended rye. And now it was Sweet Lucy at fifty cents a quart.

Carla didn’t want to go into the room. There was something evil about this man, something bad and rotten that went deeper than the rottenness of his teeth and the stench of the Sweet Lucy. But her mother’s grip was firm and she followed the man into the room.

“Yes,” said the man. “Yes, you are another one. You find me wherever I go, don’t you?” He spoke carefully and pronounced his words in a very cultured manner, but he spoke slowly as though he would be unable otherwise to avoid slurring his words.

The doctor’s eyes caught Carla’s and held them. “So you’re the little pregnant one, huh? Got yourself all knocked up?”

Carla didn’t answer.

Her mother said, “You can help, Doctor? You can help my girl?”

“I never help anyone.”

“But you will help my Carla? To have the baby is bad for her. A poor girl, to have the baby... ” The woman broke off helplessly.

“I never help anyone,” the doctor repeated flatly. “I do not help my fellow man. Never. It’s the hypocritic oath. Perhaps you’ve heard of it.”

“You will help my Carla?”

The doctor heaved a sigh and wiped at his mouth with his sleeve. “Madame,” he said grandly, “I will be most happy to abort your offspring.”

“You will help, then?”

He nodded slowly. “Oh,” he said, “I will be most helpful. I am a helping soul, I truly am. I am most helpful. And I shall gladly help your lovely little daughter. A pretty thing. Whoever knocked her up must have enjoyed himself immensely.”

Carla winced at his words and winced again as his gaze found her breasts and held them in a vise-like grip.

“Thank you,” the mother said.

“Don’t thank me. Please woman, never thank me. Thanks are useless and buy no wine. You should know that.”

He looked at Carla and a strange smile passed over his face and was gone as suddenly as it had come. “Remove your garments,” he ordered. “That means take off your clothes.”

Carla undressed quickly. It wasn’t right to be embarrassed at taking off your clothes in front of a doctor, and she knew that, but there was something wrong about this man. He didn’t look at her the way a doctor was supposed to look at a patient. There was a hunger in his eyes that frightened her.

When she stood naked before him she felt dirty inside, dirty to match the filth of the man and the filth of the room. It was sparsely finished, with a broken-down bed in one corner and a wobbly table in the middle of the floor. Wine bottles littered the room along with old papers and discarded clothing.

The doctor gestured to the table. “Our operating table,” he said, savoring the words on his tongue. “Lister would fall into a faint looking at it, but that doesn’t really matter, does it? Hop on.”

She clambered up onto the table and lay down on her back, feeling open and vulnerable to attack and terribly bare and unprotected.

The doctor turned to her mother. “Fifty dollars,” he said. “In advance, because I might have trouble collecting if she happened to die here, and she well might. The AMA wouldn’t approve of my collecting in advance, but there are a good many things of which they wouldn’t approve. I doubt, for instance, that they would especially approve of your daughter or yourself. So why don’t you give me fifty dollars so that I can abort your little girl in a fitting and proper manner?”

“Fifty dollars?”

“Yes — precisely.”

“They said it would be twenty dollars.”

His eyebrows shot up. “Twenty? That’s ridiculous, woman. Who told you that?”

“They said—”

His eyebrows went up higher. “They. Always the incredible and non-existent they. They said it couldn’t be done. They said the price was twenty dollars. They are wrong.”

“You want fifty dollars?”

“Yes.”

Her mother lowered her eyes. “That is too much.”

“Yes,” he said lazily. “Yes, it is far too much. So take your little girl and be gone. Let her go horseback riding or something. Let her have the brat. I don’t much care.”

“You won’t take twenty dollars?”

“No, I—” He broke off suddenly and turned to the table. His eyes ran from Carla’s face to her feet and it was obvious that the view pleased him.

“Not just twenty dollars,” he said slowly. “Twenty dollars and her.”

“You mean—”

He nodded. “That is precisely what I mean. You’re getting a bargain, and I — Well, let’s say simply that it has been a long time.”

Carla shivered but couldn’t speak. She knew what the man wanted and the thought chilled her to the bone. She tried to imagine him in her arms and his filthy body beside hers and her stomach turned over.

Her mother hesitated.

“Damn,” he snapped, “she’s hardly a virgin. She didn’t get knocked up by saying no to everybody. If you’d rather she gave birth to the brat.”