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Ghost Muscle

What's going on?

Dan is wide awake at the Delivey floor of a New Orleans hospital. He had been performing deliveries with a fellow colleague all night, some complicated, others not so much. He recalls a vacuum-assisted delivery him and his friend had witnessed. His friend had come out pretty bad from it, since he had messed up. Joel had been given a reprimand because of his mistake during the Delivery. Later on it was Dan’s turn. He was involved in a complicated birth and was in charge of pulling the baby with forceps.
Since the mother’s perinium had tricked the doctor’s, they had to pull the baby out with care. Dan, scared of hurting the newborn, tried to do as little as possible, until, finally, the baby came out safely. He was also admonished for his hesitation during the delivery.

Language:

Here the title of the excerpt relates to the delivery Dan had assisteed:
“...as if there were a ghost between her legs trying to strangle it. (when having the head of the newborn out of the perinium, a muscle)

Kafka, again, fills this excerpt with medical language due to the description of the deliveries.
                Her introitus was distended
               ... should have done an episiotomy
               ...no more decelerations once we got the vacuum off
               ...attempted a vacuum-assisted delivery

When describing colleague subintern Joel, Kafka, through Dan, even details his features; as usual, with a humurous and clever language.
"He looks like a cross between Colonel Sanders and Yoko Ono. He has Yoko's features and her hair except blond, but he has the colonel's smile and
twinkly blue eyes"

Metaphors:

As for metaphical and witty language, again the description of those who surround Dan is quite humurous, as well as the situations he encounters in his everyday job:
            ...the boy slid effortlessly through his mother's birth canal as if on a toboggan run.

                That was only about as hard as reaching into the trunk of a car packed tight for a camping trip and finding a jar of peanut butter. This was
                tougher, more like going back into the trunk in the dark and coming up with two slices of unsquashed bread.

Judy, the baby, and I, we were all waiting to be born together, the baby from Judy, Judy from time, me from that silent place where I stood

Again, when describing his long delivery nights and after having presences a vacuum-assisted childbirth, Dan states:
             ...one draws the unwilling infant onto the great, peopled stage of life with something resembling a Hoover Convertible.

When Joel had failed assisting the delivery, Dan’s witt comes to mind:
             ...having turned as pale as one of those slabs of tofu he eats with soy and chopped scallion.

             Joel always has time to worry about Grant [chief surgeon] because Joel's a white southerner, while Grant's an African-American southerner. I didn't
             care. I'm a Yankee