by Risk, Mona
“Below 60.”
Damn it, why? “Take the tube out. Give me a new one with a stylet. Let’s reintubate.” Holly reinserted the endotracheal tube between the vocal cords and called to the other nurse. “I’ll hold it. Linda, tape it in place.” The nurse secured the tube under the preemie’s nose. “Good. Now, heart rate? Breathing?”
“Louder on the right,” the nurse mumbled.
Holly pulled back the tube slightly. “Now?”
“Breath still louder on the right. Heart rate 50. Dropping to 40...35...30.”
Oh, shit. The preemie lay still, as gray as a mud doll, three pairs of hands fumbling on his clammy skin. Holly winced, her breath caught in her throat. The image of her baby brother and her sobbing mother flashed through her mind.
Oh, God, don’t let this one die.
Holly swabbed an antiseptic solution on the baby’s side, inserted the catheter through the sunken chest and pushed. A shiver crawled up her spine and with it the memory of her father, grumbling about doctors’ incompetence.
Please, don’t die on me.
Blood pounded against her temples, but her hands remained steady. She pressed harder on the syringe.
The trapped air escaped from the baby’s collapsed lungs. The whooshing sound echoed against Holly’s sigh of relief. “He’s back.”
“Heart rate 40...50...70, going up...100...120. You did it.” The nurse’s voice exploded triumphantly, breaking the oppressive atmosphere of the room.
“I did it,” Holly whispered as she secured the needle in place. The baby’s eerie pallor receded. Holly gazed at her little patient. “Thank you, sweetheart.” Grabbing the stethoscope, she listened to the heart. Normal. A regular sound that chimed like a victory bell, proof that she could be—that she was—a good doctor.
The little bundle squirmed and squeaked. Holly measured his vitals. He was small, only four pounds, but so cute with a tuft of black hair. She sighed with relief as she examined him and enveloped him in a plaid blanket. With a feather-light touch, she traced a finger on his forehead and cheek. He had the Suarez features, but with a yellowish complexion, the beginning of jaundice. The baby opened his eyes, dark chocolate, just like Marc’s.
Pity filled her heart. She’d seen many similar cases, yet she always felt this uneasy angst about the fate of the tiny patients she saved. When would she learn to distance herself from her babies?
Not in this case, obviously. Her insides twisted as her gaze riveted on the baby. Marc’s nephew. She’d done her best for the preemie. He was safe for now.
What about Lydia? Would she survive? Holly didn’t like the scowl gathering on the anesthesiologist’s forehead as he focused on the heart monitor.
And what about Marc? Her arms tightened protectively around the baby as her thoughts swirled frantically and her skin crawled with joyful and frustrating memories from seven years ago. Could she help the man she had once loved so foolishly and then sworn to forget?
****
Rooted in place, Marc stared at Lydia. His mind hit with the tragic news only a few minutes ago refused to assimilate the catastrophe.
Halsdale, his expression grimmer than usual, had caught him on his way to Delivery. “Bad news, Suarez. I had your sister-in-law rushed to OR 3. Join me there stat.” The old doctor hadn’t minced words to announce the accident and Carlos’s death.
Marc had run to his brother lying on a gurney in ER, and felt his pulse. Nothing. Numb with shock, Marc had darted to OR. They needed to save Lydia and the baby.
Thanks to Holly’s professional expertise, the infant was safe. Marc didn’t doubt the baby was a beautiful boy, although he’d hardly looked at him. He was so distressed about Lydia. And Carlos...
“Dead,” Marc mumbled without conviction.
No, it couldn’t be.
He hadn’t had his stethoscope with him to check Carlos’s heartbeat. Feeling a pulse wasn’t enough to give a definite diagnosis. Maybe it was just a coma from the impact. Lydia would be fine, and in a moment, Marc would run to see Carlos and check him again, thoroughly. Maybe...
Dr. Halsdale sutured the incision. Before he needled the last stitch, Chris groaned. “She’s going. CPR stat. Now.” Marc’s head snapped toward the heart monitor. It had tapered to a flat line. Chris grabbed the electrodes a nurse handed him and plunked them on the patient’s chest, pressing hard. “Now.” Lydia’s body jerked, then fell back. “Again.”
Nothing happened. “More,” Chris called.
On the monitor, the line trembled and stayed flat. Chris turned toward Marc, a helpless appeal in his eyes.
Without a word, Marc strode forward. He snatched the electrodes from Chris’s hands and tried the resuscitation. “Come on, Lydia. Work with me. Please.”
Lydia remained lifeless, but his own heart drummed against his ribs with painful rage.
“Again.” Her body didn’t respond. “Stronger,” he barked, slamming on her chest with all his strength. But she was gone. His breath jammed in his lungs. His shoulders slumped.
Dr. Halsdale put a comforting hand on his arm. “I’m sorry. We did our best considering the internal injuries. She had a perforated spleen. ” He glanced at his watch. “Time of death: 1:05 am.”
Ignoring his boss, Marc threw the electrodes on the table and clenched his fingers on the rail of the bed. “Wake up, Lydia. Wake up for heaven’s sake.”
Her hair hidden under a cap, Lydia’s pale face remained serene, marred only by the bruises of the accident that had claimed her.
Collapsed lungs, perforated spleen, internal bleeding. The medical diagnoses hit his professional mind with deadly accuracy. Time of death... The nightmare was a reality.
“Why, Lydia. Why?” Despair invaded his heart.
Being in denial didn’t help. As a doctor, he routinely dealt with road casualties, but the man in him rebelled against the unfairness of the situation. He’d treated hundreds of patients and saved them.
Why couldn’t he save Lydia?
A loud wail pierced the silence, followed by soft cooing. Marc raised his head and glanced at the little bundle in Holly’s arms, a tiny mirror image of Carlos.
Marc sucked in a deep breath as she placed the newborn in the incubator and hooked the breathing tube to a ventilator.
Thank you, Holly. The baby was very much alive, in need of attention.
A pulse pounded in Marc’s forehead. His brain was about to explode. He’d take care of his nephew later. He lifted Lydia’s hands to his lips and kissed them. “Adios, querida. I’m sorry I’ve failed you. I promise I’ll never leave your son. Dios, I’m going to miss you so much.”
Tears prickled his eyes. He sniffed to suppress them. Carlos was waiting for him, lying on a cold table, in a cold room. Ice-cold like Marc’s heart.
Marc bottled up his pain and stiffened his back. His shoulders straight, his mind numb, he walked out of OR. He had to see his brother, to check him. The baby needed his loving father. A father who understood love and commitment.
Maybe Carlos was in a coma. Maybe there had been a mistake.
CHAPTER TWO
In the silence of the morgue, Marc moved the stethoscope over his brother’s chest hoping against all hope, listening for a heartbeat, a pulse...any sound. Nothing.
Grabbing Carlos’s shoulders, he shook him. “Answer me, man,” he shouted.
It was useless. Carlos was gone forever.
Marc gently laid him back on the table. He reached out and held Carlos’s hand, not as a doctor, but as a brother. “Vaya con Dios, Carlito,” he groaned as he stroked Carlos’s face with his other hand, memorizing his brother’s features. His head bowed, he mumbled a prayer.
A screeching noise jerked him back to harsh reality. “Take your time, sir. I’ll be back later.” The custodian wheeled in a stretcher with Lydia’s shrouded body and arranged it parallel to the steel table. Marc nodded, appreciating the man’s discretion.
Unable to sort out his feelings, unable to accept the cruel evidence
, Marc uncovered his sister-in-law’s face. She was beautiful and peaceful, taking a last trip with the man she loved. Marc swallowed a sob. On a sudden impulse, he brought the stretcher next to the steel table, and joined Carlos and Lydia’s hands.
“Marc.”
He stilled and raised his head. Holly stood in the doorway, in her green scrubs. “What are you doing here?” His voice sounded harsh and metallic in the silent place.
Holly blinked. “I’m so sorry.”
He didn’t want sympathy or support. He needed time alone with them. Alone in his sorrow. He dealt with death on a daily basis but this was different. These two deaths had broken his heart. “Thank you.”
“Dr. Halsdale said you were here. I know how hard it is for you. You don’t have to face it alone.”
His heart thundering, he stepped forward to block her view of the dead bodies. He didn’t want her to witness what he’d done in a moment of weakness. Joining two lovers’ hands for eternity. “I’m fine.”
He met a gaze full of compassion. Her eyes were wet, her eyelids swollen. Although Holly had been trained to cope with death, Marc felt the need to protect her. “Let’s get out of here.” His hand on her back, he urged her out of the morgue, then he stopped in the doorway and turned around for one last look.
“Have you signed all the papers?” she said, in a voice calmer than he’d expected.
“I have them. I’ll do it in my office.” His appalling task wasn’t done yet, but he’d spare her the details. He realized she was grieving too. She’d reassured his sister-in-law and helped her cope with the difficult pregnancy. Lydia had been more than a usual patient for Holly in the last month.
And seven years ago, Holly had occupied a special place in Marc’s heart. He sucked in a deep breath and exhaled slowly. She still did. “Come with me. We can both use a cup of coffee.”
They rode the elevator in silence. He was grateful she respected his pain. Even though he saw the sorrow in her eyes, he took comfort just having her near him. He unlocked his office.
She paused at the door. “Can I get you something to eat from the coffee shop?”
“No thanks. I’m not hungry.” He hadn’t eaten dinner but couldn’t swallow anything. “Why don’t you go and get something?”
She shook her head and stepped inside. “I’m not hungry either.” Her gaze flickered from the diplomas hanging on the wall to the framed photos crowding a side of his desk.
“I’ve been told all the offices at WCH look alike,” he said, trying to get his mind off the nightmare of the last few hours.
“Yeah, the furniture is similar to that in my fellows’ room.” She seemed to understand and played along, enumerating as she scanned his office. “A desk with a computer, credenza, chair, and couch.” Standing close to the desk cluttered with pictures, she took a frame and examined the photograph. “But this place feels cozy and warm. You’ve put your personal touch on it.”
“I like to see the kids around me.” Marc pointed to the many pictures where he posed surrounded by nephews and nieces. Dios, he was here with Holly making small talk. When his world had just imploded. When he felt like smashing a chair against the wall.
Holly reached for another photo. “Your grandma?”
“Yes. Abuelita couldn’t come for my med school graduation. I took the gown and cap with me to San Juan. She calls this picture a souvenir of a lifetime achievement. Her achievement,” he said with bittersweet sadness. He closed his eyes tightly, breathing hard. “She’ll never see Carlos with a doctorate cap and gown.”
He raised his head and contemplated a photo of Carlos and Lydia. A lump formed in his throat as he grabbed the frame. Staring at his brother’s proud expression and his sister-in-law’s lively smile, he blinked, fighting tears. “Maldición, what a waste. So much love, so many hopes.”
He slammed the picture upside down on the desk, shattering the glass. Holly gasped, a little sound of pity that grazed on his nerves. He gruffly wiped the broken pieces into the wastebasket and swallowed a sob.
“It’s okay, Marc. You can cry.”
What irony. He turned his head away and clenched his fists.
She’d done her best to ignore him ever since he took the attending anesthesiologist position, and now she was treating him with the unwavering care she bestowed on her patients.
His jaw tightened as her soft hand gently wrapped around his fist. With a brusque flip, he enfolded it in his palm. “My father always said, a man should never cry,” he mumbled, staring at the picture of his parents. “At my mother’s grave, I hid my sobs behind my hand. My father told me to behave like a man.” Dios, he couldn’t believe he was confessing these things to her now, but he couldn’t stop the words.
Her hand still enclosed in his, Holly leaned against the desk, seeking his gaze. “I’m sorry, Marc. Your father was wrong.”
Yes, his father had been wrong. Terribly wrong. But Marc had tried to avoid his Papa’s mistakes. He snorted, anger and hurt uncoiling in his chest. “I can’t understand. They were happy, full of love. Why are they gone? Why now? Why so suddenly?” His voice rose as he pounded his fist on his desk. “It doesn’t make sense.”
“I wish I had an answer. Accidents never make sense. If only I’d told Lydia to stay home for their anniversary.” She pulled her hand out of his grip, her eyes squinting with pain, and he suddenly realized he’d been squeezing her fingers too hard, hurting her.
“Don’t blame yourself.” He reached for a tissue from a box on the desk and dabbed her wet cheeks. “Lydia had her heart set on dining out. Carlos loved her too much to deny her anything. He was my only brother. My best friend.”
“Marc, I lost my baby brother when I was ten. I understand your grief. I was...” She gripped his arm. “Let your emotions out.”
“I don’t have any.” He swiveled his head away, his thoughts back in the morgue with the two people he’d loved.
“Oh, Marc,” she whispered, “I wish I could help you.” She wrapped her arms around his shoulders in a tender hug and dropped her forehead against his collarbone.
A fragrance of jasmine perfume lingered on her skin. He closed his eyes and inhaled. She smelled so good. A refreshing scent to erase the stench of death. Against his will, his fingers skimmed her throat in a soft caress and rested on the pulse fluttering at the base of her neck. It was alive and joyful, a healing touch for his aching heart.
“Holly,” he rasped against her hair as he tightened his hold. Her faint moan sent him crashing against reality and his present nightmare.
Straightening, he cradled her flushed face between his palms and shook his head to clear it. Awkwardness danced between them, as if the ghost of the past hovered nearby. His eyebrows knitted in a frown, he captured her gaze. “Oh, Holly, you’re too sweet for your own good.” A cad would have taken advantage of her kindness. Even he, years ago.
But he didn’t need her soothing kindness. He didn’t want sympathy. He’d combust into a raging inferno before she breathed another word. At the wrong time.
He let go of her and went to the credenza to set up the coffeemaker. He needed space to put a rein on his emotions. She sat on the edge of the couch, her foot tapping against the carpeted floor. Pulling on a long curl of her hair, she twirled it around her finger.
To fill the silence, he said, “I have so many things to do now.” He enumerated on his fingers, “Order the caskets; organize the wake; collect my brother’s pictures and memorabilia; terminate the lease on his house; book the tickets for San Juan and...”
And deal with a brand new baby.
But he wasn’t ready to brainstorm personal matters with her. The aroma of freshly brewed coffee wafted through the small room. He turned back to the coffee maker and filled two Styrofoam cups. “I have no cream. Sugar?”
“No thank you. Black.” She reached for the cup he held out. “I can make the plane reservations for you,” she said, while sipping her coffee.
“Thanks, but you don’t need to
worry about it. I’ll deal with it later.”
Her eyebrows arched. “Is there anything I can do to help?”
“You already did,” he said, with a half smile.
“Oh.” Pink colored her cheeks.
Her presence wasn’t helping. In fact, he found it damn difficult to concentrate on his decisions with her so close. A part of his body didn’t seem to understand the word bereavement. “You’ll start your day shift in a couple of hours. Why don’t you go and rest?”
She finished her coffee and threw the cup into the wastebasket with more strength than needed. The last droplets splashed the wall in dark brown dots.
“Sorry.” She bent to blot them with a napkin and crumpled the paper in her hand. “I have a question, before I go back to the NICU.” Her gaze sprang to meet his. “What about...” She hesitated, her eyelids lowered, hiding the beautiful blue eyes and the emotion simmering there.
“The funerals?” he said, tensing at the word.
“Yes.”
“I’ll arrange for a wake at a funeral home here in D.C. for this evening. Then I’ll fly to San Juan with the bod...with them.” He swallowed.
“And the baby?” She raised her eyebrows, looking at him in earnest.
Pain gnawed at his insides. Carlos and Lydia were gone, and their baby needed him.
The baby. Focus on the baby.
Easier said than done.
What was he going to do with a baby?
Abuelita would probably order Marc to bring Carlo’s baby to be raised in Puerto Rico with his brood of cousins, as soon as the preemie could travel. It was a simple way to solve the problem, except their grandmother didn’t know Carlos wanted his kids to be raised in America. Marc owed it to his brother to fulfill his wishes.
But...could he do it? Here in Washington, D.C., as Carlos wanted? On his own?
A confirmed bachelor, Marc lavished his eleven nephews and nieces with gifts and toys. Unfortunately, his parenting experience stopped there. To keep the baby, he’d have to learn to feed him, and change him, and whatever else came with the package. He’d just started a new job at WCH and barely begun his research. How would he fit a baby into his hectic schedule? How could he do his brother’s baby justice when he had so little time to offer?