Valley View Hospital, Glenwood Springs, Colorado

It’s 9 p.m. on a Tuesday, and I’m in the operating room doing an emergency cesarean section on a woman named Rosa who arrived from Mexico three days ago. Her baby hasn’t tolerated labor well, and we need to get him out in a hurry. Rosa’s awake—the anesthesiologist placed a spinal. Luz, a Spanish-speaking ward clerk, translates so Rosa can understand what’s happening.

Luz ushers Rosa’s husband, Miguel, to a stool next to her head, and he speaks to his wife in reassuring tones as I work. In less than a minute I open the abdominal wall, enter the uterus, and extract a baby boy who emits a soggy gurgle as I unwind him from his cord, which has a true knot. I show Miguel the knot. Luz doesn’t need to translate.