Carrying the Surgeon's Baby

by Amy Ruttan

  “Derek,” Samuel responded. “And I understand that you’re the father of Emily’s baby and her husband. I didn’t know that Emily was married, but that’s not surprising. She tends to keep things quiet. Belated congratulations on your marriage and the baby.”

  Ryan cocked an eyebrow and looked at her. Emily felt heat bloom in her cheeks.

  Yep. word had gotten around the hospital.

  “Derek...” Emily trailed off because she didn’t know what to say.

  “Thank you,” Ryan responded gracefully. “We’re excited.”

  Derek smiled and nodded. “Well, we have an ultrasound in a few days. I hope you’ll still be around by then to come. Emotional support for the expectant mother is imperative in the birthing process.”

  “I couldn’t agree more,” Ryan said. And he felt a twinge of guilt. Would he even be here in three months when she gave birth? He wasn’t sure.

  Emily groaned and walked away from them. This was not keeping things professional or discreet at all.

  And then she heard the distant wail of the ambulance. The transport was here and Emily had to put aside all her personal feelings about Ryan, about the baby, about everything at this moment.

  This case was her top priority and she had to be make sure their patient was comfortable and not in distress. They had to keep the babies in utero as long as possible, so they would be born stronger and would have a better shot at surviving their surgery.

  That was all that mattered at this moment.

  CHAPTER SEVEN

  EMILY WAITED OUTSIDE while Dr. Samuel assessed Janet, the mother of the conjoined twins, and talked to the patient about how they were going to proceed with the C-section when the time came. Emily had introduced herself, but she didn’t want to overwhelm Janet and talk about the separation surgery just yet.

  It was clear, on her arrival, that Janet was stressed out and scared. Emily understood those overwhelming feelings all too well.

  Not that Emily could blame her in the slightest. She reached down and touched her belly. Her baby was quiet right now and that was okay.

  “How is she doing?” Ryan asked.

  “I think she’s calming down. She was stressed and her blood pressure was up. Dr. Samuel is worried Janet is developing pre-eclampsia.”

  Ryan winced. “That’s not good. Although I don’t blame her for feeling stressed. She’s been moved to another city, another state and her other child is back in Oregon. Their life is on hold and she’s not even sure that in the end it will pay off, that her babies will survive.”

  “That’s kind of dour,” Emily said.

  Ryan shrugged. “It’s the truth, though.”

  She sighed.

  He was right. It was the truth and it sucked.

  “Aren’t you supposed to be doing a biopsy?” she asked.

  “I’m on my way there right now. Raquel is on her way to the operating room. Do you want to come? You don’t have to assist, but maybe see Raquel’s test through to the end? You were the one who was there when she was having her seizure. You kept your cool and helped me get her on her side, propping her head up.”

  Emily was torn. She really wanted to be there for Raquel, but she also wanted to keep her distance from Ryan.

  This is just a procedure and Raquel is a patient. There’s no harm.

  “Okay. I would like observe. I’ll sit in the gallery.”

  “I’m not doing this surgery in the OR with a gallery, so you’ll have to scrub in.” There was a devious twinkle in his eyes, as if he’d planned it.

  “Of course not. Fine. I’ll scrub in.”

  “Good. Let’s go.”

  Emily nodded and followed Ryan to the OR floor. They changed into the surgical scrubs and Emily tied on her scrub cap, tucking her short hair up underneath. They made their way to the smaller operating room at the end of the OR floor. Raquel was waiting in the hallway. Her mother was standing next to her, wearing her scrubs. She was holding her daughter’s hand and the child life support person was with them.

  Emily smiled and went over to see them while Ryan started his scrub in.

  “How are you doing, Raquel?” Emily asked.

  “Good,” Raquel responded.

  “Do you remember who I am?” Emily asked.

  “No, I’m sorry, but Mom told me you were there with Dr. Ryan.”

  Emily nodded. “I was and I’m going to be in the operating room with him. I’m going to make sure he does his job well.”

  “Oh, good,” Raquel said. “You have to make sure he doesn’t completely shave my head.”

  Emily cocked an eyebrow while Raquel’s mother laughed.

  “I think I’m missing something,” Emily said.

  “Dr. Ryan and I made a bet. If he has to shave off all my hair I get to shave his head.”

  Emily chuckled. “Well, that’s a good bet to make. I’ll watch him, I promise.”

  Raquel nodded.

  “I’ll see you in there.” Emily winked and headed into the scrub room. Ryan was just finishing up his scrubbing. Her heart skipped a beat. Of course he would make a bet like that with a child. It was endearing and it was one of the reasons she’d fallen for him six months ago.

  “What’s so funny?” he asked.

  “I heard about your bet,” she teased, and she turned on the tap.

  He groaned and laughed. “Well, she was pretty worried about it.”

  “It’s sweet.”

  Ryan rolled his eyes. “Well, thankfully she won’t get a chance to shave my head. I’m really hoping for a benign growth.”

  “Me too.”

  Ryan headed into the OR as Raquel was rolled in. Emily finished her scrubbing in and stood to the side as Raquel was helped off her gurney onto the operating table. Dr. Sharipova stepped up and announced to the room who Raquel was and what they were doing. Raquel’s eyes were wide and she was staring at Dr. Sharipova like he was a monster under the bed.

  Emily stepped forward and stood next to Raquel’s mother.

  “Don’t worry, that’s just so we make sure we’re shaving the right person’s head.”

  Raquel laughed and Emily winked at her from behind her mask.

  Dr. Ahmed stepped up. “We’re ready to start induction.”

  Emily nodded and stepped back as a mask was placed over Emily’s face and she began to breathe in the anesthetic, counting. Raquel’s mother held her daughter’s hand and spoke to her. Raquel’s grip began to loosen and then suddenly she began to seize.

  Raquel’s mother cried out.

  “Do something!” she cried.

  Emily held her. “It’s not a seizure like before See, her monitors aren’t going off. This is called the excitement phase of anesthetic. It’s different for every kid and she’s okay. See, she’s relaxed.”

  “She’s under now,” Dr. Ahmed said. “We’re going to set up her IV now.”

  The child life support person, Patricia, put her arm around Raquel’s shaking mother and led her out of the operating room, reassuring her that Raquel would be okay. And she would be.

  Emily’s emotions were running a bit high.

  The excitement phase of general anesthetic could be scary if you were not used to it and even when the child was out, their eyes stayed open with a blank stare that could be unnerving, but by the time Emily turned around the anesthesiologist had inserted the IV, Raquel had been intubated, and her eyelids taped shut. She was put into position and Ryan directed Dr. Sharipova to place the fiducials for the CT scanner on Raquel’s head.

  It was a frameless technique now, compared to the old way. The small sensors would work like a GPS so that Ryan could find the exact place to cut and extract his sample.

  Once the fiducials were placed, Emily took a step back so that she could see the CT scan and watch from a distance.

 
It didn’t take Ryan long before he found his spot and she got to see the lesion on the screen. Her heart sank and she felt tears sting her eyes as she thought of that little girl on the table having to go through this.

  It was one of the hardest parts of her job. She didn’t want to think about the alternative. That was too scary to even comprehend.

  Dr. Sharipova picked up the razor.

  “Better let me do that,” Ryan said. “I have a bet to win.”

  Emily chuckled and Ryan looked over his shoulder at her, his blue eyes crinkling at the corners behind the mask.

  “What do you get if you win?” Emily asked.

  “I get to keep the hair on my head. I thought that was obvious.”

  “Good deal,” she said.

  Ryan nodded and shaved off a tiny bit of Raquel’s hair. It was underneath and the hair on top would hide it, and unless she braided her hair or pulled it back tightly, you wouldn’t even know it was there.

  “I think I won this bet.”

  Emily crept closer and looked. “I believe so, Dr. Gary.”

  Ryan set the razor down. “Ten blade, please.”

  The scrub nurse handed him the scalpel and Emily took a step back to watch the CT screen. Ryan had enough people hovering around him as he worked in the small space to retrieve a small sample of tissue.

  The brain was so delicate. It was why she hadn’t wanted to pursue that path. As a surgical intern in her first year she’d worked on every case. Interns weren’t allowed to specialize and the brain and she’d found the nerves were very intimidating.

  She’d even thought Pediatrics was intimidating, until Dr. Ruchi had seen the promise in her and sent her in the right direction when she’d been a resident. Emily had never thought she had the knack when it came to kids, because she’d never really planned on having kids, but for some reason pediatrics was her forte.

  Helping kids, sick kids, was her passion. Perhaps because she’d had different needs as a child. She wanted to help, and advocate for those who couldn’t.

  “Dropping in the biopsy needle now,” Ryan said.

  Emily stared up at the screen and watched on the CT as a thin stereotactic needle was placed into Raquel’s brain. It was mesmerizing to watch Ryan gently guide the probe.

  “There we go,” Ryan whispered. “Perfect.”

  It didn’t take long for him to obtain his samples. He gently retracted the biopsy needle and handed it to Dr. Sharipova.

  “Make sure this gets to Pathology. I want a result as soon as possible.”

  “Of course, Dr. Gary.” Dr. Sharipova bagged the sample and then left the operating room. Ryan may want the results fast, but it would take three to four days before they got them.

  “All right, let’s close her up.”

  Emily stepped up in Dr. Sharipova’s place.

  “I thought you might want a hand since you lost your resident,” she said.

  “Thank you.”

  “Excellent work.” Heat bloomed in her cheeks and she was glad that her blush was hidden by her surgical mask.

  “Thank you,” Ryan said. “Now, this is the hardest part. Waiting.”

  Emily nodded.

  She understood that.

  A lot of this job was hurry up and wait. She was used to the hustle and bustle of hurry up, it’s what happened on the other end that was important. Whether or not Raquel had cancer or if the tumor was benign.

  Emily was hoping for the latter.

  * * *

  Ryan sat next to Raquel’s bedside in the PACU. She would have a really bad headache when she woke up and it would be hard to do a lot of simple tasks while her brain healed. And there was also the risk of intracranial pressure building or an infection.

  All he could do was wait and see.

  So he charted.

  It was somewhat quiet in the PACU. There were other kids coming out of surgery and some were a bit loopy and some were screaming and shouting. You never knew what would happen when people came out of anesthetic.

  Parents were allowed in the PACU as SMFPC believed that parental presence was an important part of the healing process. He really liked that about this place. He couldn’t even begin to fathom what the parents were going through in the waiting room.

  You can’t fathom it because you’re not a father.

  A lump formed in his throat and he shook that thought away. It hurt too much to think of that moment.

  Morgan hadn’t wanted to have a child.

  And that had been the end of that.

  Raquel began to stir and whimper.

  Ryan turned to the nurse in charge of Raquel.

  “You can let her mother come in now.”

  “Right away, Dr. Gary.” The nurse left to tell a volunteer to go and get Raquel’s mother.

  Ryan closed the chart and set it on the bedside table next to the nurse’s computer. He gently touched Raquel.

  “Hurts,” Raquel mumbled.

  “I know. It will,” he said gently.

  Raquel then reached up and touched. “I have hair?”

  “I told you you would.”

  Raquel smiled. “Guess you win.”

  “I think we both did. You did really well, Raquel. You’re very brave.”

  Raquel nodded, but wouldn’t open her eyes. She just held his hand and it wasn’t long before Raquel’s mother came into the PACU. He could see the relief on her face as she came to the bedside.

  “Baby, I’m here,” she whispered.

  Raquel nodded.

  “She’s still a bit groggy from the anesthetic. She did beautifully,” Ryan said. “I want to keep her here for a couple of days. I just want to make sure that she doesn’t have any side effects from the biopsy. We should have an answer from Pathology before too long.”

  “Thank you, Dr. Gary,” Raquel’s mother said.

  “My pleasure. If you have any other questions, please have someone page me.”

  “I will.” Raquel’s mother turned back to her daughter and Ryan let go of Raquel’s hand. The nurse had been informed about how he wanted her to proceed in the PACU before Raquel was transferred back to her room in the ward.

  Ryan’s job was done here. For now.

  And he hoped that this was all he had to do. If the growth was benign, they could control it through medication.

  If it was cancer he would have to do surgery and talk to Oncology about radiation and chemotherapy. Stuff he didn’t want to put any child through, but he would cross that bridge if and when the time came.

  Right now, he wasn’t going to dwell on it.

  There was no point in dwelling on the negative.

  He left the PACU and headed straight for the cafeteria. He needed to get another cup of coffee and he needed some lunch.

  On his way there he saw Emily sitting behind the charge desk, staring at a computer screen. She looked tired again.

  “Hey,” he said as he walked over to her.

  She looked up and her spine stiffened. “Hi.”

  “Am I interrupting you?”

  “No, just going through some research. Trying to put together a team and book some time in the simulation lab.”

  “Raquel is in PACU and doing well. Her mother is with her.”

  A small smile tugged at the corners of her lips. “I’m so glad.”

  “I’m going to get something to eat in the cafeteria. Do you want to join me?”

  Emily hesitated, remembering the vow she’d made to herself to put some distance between them, but only for a moment. Well, she had to eat, didn’t she? And maybe they could talk in more detail about the separation operation. “Sure.”

  She logged off the computer and grabbed her white lab coat, which was on the chair behind her.

  “What’re you doing for the rest of the day?” he ask
ed.

  “Besides prepping for this surgery? I have some rounds later, but the chief of surgery wants my sole focus to be on the conjoined twins and getting ready for that. How about you?”

  “Rounds. I need to check on Jason. He’s doing well...” He trailed off. Jason was awake, but there was no sign of movement in his legs.

  That could also be from the pain medication. Surgery on the spine and spinal cord was intense. Even adults who had spinal surgery were kept pretty medicated for the first few days afterwards.

  Ryan was really hoping that it was the pain medication that was causing the delay in motor response. He was just worried because kids always bounced back faster than adults.

  “I’m sure it’ll be fine. He responded well to your treatment.”

  It was nice that Emily was trying to be supportive, but he knew how she felt about the therapeutic hypothermia. She’d made that quite clear when he’d first arrived at SMFPC. He was actually surprised she wasn’t berating him.

  “I’m sure it will,” he said, clearing his throat, and decided to change the subject. He didn’t want to talk about cases. He needed to lighten the mood. “So, anything I should see in Seattle before I leave?”

  A strange expression crossed her face when he mentioned leaving, but it was fleeting.

  “Well, there’s the Space Needle and you should take a ferry ride. There’s also the market and walking down by the sound is always nice. There are houseboats and other interesting things to look at. I really enjoy walking down there.”

  “How about Mount Rainier? Should I take a day trip to see that?”

  Emily shrugged. “I suppose. I’ve never gone myself. It was something I always wanted to do, I’ve just never had the time for it.”

  “Well, maybe we should take a day trip out there? There are enough pediatric surgeons on hand and we should go while everything is quiet.”

  “Don’t say quiet,” Emily teased. “It’s never quiet and I can’t leave. What if Janet, the conjoined twins’ mother, goes into early labor? I have to be here to make sure those babies are stable.”

  “If the babies are born now they won’t survive. Maybe if they were single they would have a shot, but conjoined? They need more time. You know that. She’s just at twenty-five weeks, not in the third trimester yet. It’s why she’s on bed rest and Dr. Samuel is monitoring her.”