The contractions started at four in the morning, sharp and steady, tightening across my lower belly every six minutes as I walked the six cold blocks from Elm Street to St.

Jude Memorial Hospital.

By five fifteen, I stood at the emergency intake desk, pressing my left thumb hard into my palm to get through a spasm of pain that made my knees shake.

Brenda Cole came through the swinging doors of the maternity ward pushing a heavy vinyl wheelchair across the linoleum.

“Sit down right now, Vivian,” Brenda said, reaching out to hold my elbow.

“You’re four minutes apart.”