“She reached ten centimeters five minutes ago and has already done some practice pushes,” he tells me. “You’re good to go.”
I follow him to the delivery room door, and he opens it for me. Before I walk through, I stop to take a steadying breath. No matter how many times I cross this threshold into these rooms that are my second home, I still have to tame the butterflies in my stomach. I do it because, regardless of the patient’s condition, there is no more important part of my job than bringing an air of confidence to the situation.
“How are you, Erika?” I ask as I enter the room. Several nurses shuffle silently from one side of the room to another, grabbing supplies and preparing them on sterilized tray tables. I greet them all with a nod and a smile while I scrub in, then I take a seat in front of Erika as a nurse rolls a chair underneath me.
The room is dim aside from the delivery lights overhead. Andrew holds Erika’s hand and wears an expression of panic and awe. The mom-to-be is already on her back with her legs pulled up to her chest, strands of thick black hair stuck to her forehead with sweat. Her face is red, and her eyes are glazed over with pain. I adopt the soft voice I reserve for the delivery room.
“How is she doing?” I ask Andrew.
“Amazing.” He sounds composed, though he nods his head vigorously.
Erika gives a low, guttural moan, and I can tell without checking that she’s ready to go. I can always hear that subtle shift in a woman’s voice from being overwhelmed by the pain of labor to being in control of it. I glance at the monitor over her right shoulder to ensure a normal fetal heart rate. When the contraction graph indicates the current one has waned, I speak to her again.
“You’re doing fantastic. I know it’s tough, but it’s almost over. Are you ready to meet your baby?” I ask her.
She gives a pained smile, and a tear streaks down her cheek into her hair as she nods. “Yes. Dios mío, por favor,” she moans.
The next contraction begins to rise. Erika has a nurse next to her who holds one foot and encourages Andrew to hold the other. The warm delivery lights hum above me. As I run two gloved fingers over the crown of the baby’s head and a tuft of thick, black hair, I hear Andrew whisper to his wife, “You can do this. You’re almost there.”
I focus my attention on Erika’s eyes, while my hands fall into position instinctively.
“It’s time,” I say to Erika. “If you feel ready, I want you to push.” She whimpers uncertainly, but I know she’s strong. “Your baby is right here. I can feel his head. Let’s introduce him to the world.”
She chokes back a sob and nods. “Okay.”
Erika takes a deep breath, and when the contraction peaks, she braces herself and noiselessly thrusts the baby downward. Andrew’s knuckles whiten as Erika clamps down on his hand, and her lips purse together until they’re white, too.
“Again,” I say and watch the baby breach the threshold. Erika takes another deep breath and then grunts as she bears down. Other than the nurse counting beside her, the room is silent with anticipation. Every number reverberates in my ears. “Can you give me one more?”
She does, and the baby crowns, emerging from her womb.
“Keep pushing. Keep pushing,” I urge.
With one more count of ten, the baby’s head slips out, and I cradle it in my hands like blown glass. Erika gasps for air and drops her head back on the pillow. The baby’s swollen face is tinged with purple, and my heart skips a beat, but my training kicks in before the panic.
“Hold it for one second,” I say and run my fingers around the baby’s neck. The umbilical cord is wrapped around once, so I work my fingers gently underneath it and loosen it until I can loop it over its head. I check the baby’s heartbeat on the monitor—too low—then take the bulb sucker from the nurse at my shoulder and sweep the baby’s mouth and nose.
I peer up at Erika between the frame of her legs, all business.
“This is it,” I say. “One more big push. Give it everything you’ve got. Here we go.”
I take a big, synchronized breath with her and watch as the baby bulges out, and then, in a split second, a tiny body slides into my palms. In every way, I feel the weight of a life in my hands, and as blood pumps loudly in my ears, the movement around me fades into the background like static on an old radio.
He’s a boy. So perfect, with little hands and little feet. A precious head with sticky black hair. The sweetest combination of his mother and father in a tiny bundle that will bond them together forever. When he fears monsters in the closet, he’ll lie between them in their bed, and they’ll sing him to sleep. In ten years, his weekly soccer games will bring them side by side in the stands, even if only for an hour when taking time off work for a vacation is impossible. In twenty years, when they look at each other like strangers and wonder why they stayed, he will always be the answer.
And he’s limp.
“Dr. Michels.” Enrique’s sharp voice snaps me back to the hospital room, and he snatches the baby from my hands. Another nurse cuts through the umbilical cord, and he’s whisked away.
“What’s happening?” Erika shrieks, but no one answers her as everyone but me crowds around the warming table, frantically buzzing above the child, pulling equipment closer, grabbing more blankets. “Is he okay?”
My mouth goes dry, and I feel beads of sweat form across my forehead and prickle under my arms.
What did I do wrong?
Erika stirs in the bed like she might try to escape it, but I pull myself back to the moment and reach out to steady her. I swallow hard and palpate her abdomen, clinging to procedure to keep the situation under control.
“Tell me what’s going on,” Erika shrieks.
This isn’t the first time a baby has come out with the umbilical cord wrapped around its neck, and this isn’t the first time a baby has needed resuscitation after birth, but this is the first time I’ve ever felt a baby so lifeless.
This isn’t happening. I chose this profession to make sure this didn’t happen. I live my whole life at this hospital to make sure this doesn’t happen.
My breathing is shallow, but I face Erika with a facade of reassurance.
“Erika, you have an experienced team of people over there taking care of your baby, I promise you that. I know it’s hard, but they need to focus on doing their job right now, and I need to focus on doing mine. Let me take care of you, so that when your baby is ready for you, you will be ready for him, okay?”
“Him?” she asks.
I nod.
Her body jolts with each escaped sob, and Andrew looks back and forth between me and the huddle of nurses in the corner, clearly unsure of whether he should stay with his wife or go to the baby.
“Give them their space,” I say to him quietly. Half of my attention is on gently tugging the umbilical cord, while the other half is listening to every zing of sterilized tools being released from the packaging, every hushed prayer exchanged by the nurses. I pick up the suturing needle, but my hand is shaking so badly, I don’t trust it to do its job. I take a few steadying breaths.
“Give me just a minute,” I say so softly I’m not sure if anyone hears me, and place the needle back on the tray.
I assess the situation.
Erika’s bleeding is normal. Andrew is there to take care of her. He won’t be losing a wife today.
But the baby behind me still isn’t crying. I won’t allow this sweet, young couple to suffer the loss of their child. Not them.
I rise from my chair and break through the nurses in the corner to find the boy as pale and ashen as death. The warming lamps beat down on my hair as I wedge myself into the group and lean over the plastic barrier of the baby warmer to touch his icy paper skin. I know the nurses’ procedure as well as my own. I know they’ve suctioned his lungs and stomach. I know they’ve cleared all ai
rways. I know they’ve called the neonatal nurse practitioner. All that’s left to do is to perform CPR, and so I do, because I can’t sit over there and do nothing while the threat of losing a child hangs over my head. I place my fingers over the center of his rib cage and thrust them down with so much force, I’m afraid I’ll do more harm than good. After a moment of stillness and confusion amongst the nurses, I recognize Enrique’s hands as they return to stimulating whatever circulation there might be in the baby’s arms and legs. Another nurse places the oxygen mask to the baby’s nose and mouth, and he’s so small, it covers most of his face.
“C’mon. C’mon,” I say. The baby looks helpless with his little features staring up at me, pleading for a chance at life. I swat a loose hair away from my eyes with the sleeve of my gown.
Nothing.
Nothing.
It’s too late.
It’s too late.
It can’t be too late.
“I’ve got it,” a voice says at my side, and two hands reach in around the baby. I step away and allow the space to be filled by the neonatal nurse. I stumble over my feet, my hands still outstretched until the tiny body is blocked from view. I turn to Enrique, staring at him without seeing him. My heavily beating heart tracks the passage of time as it thrums in my ears. After the longest minute of my life, Enrique reaches out to me, but I step back. I’m not the one who needs to be consoled.
“Do you want me to page Dr. Galloway to finish up with Mrs. Martinez?” he asks. I can barely hear him over the quiet roar of the nurses working behind me.
I’ve never lost a patient before.
Not this couple.
“No,” I say immediately and look away from the pity on his face. “No,” I say again, more to myself than to him.
I snap off my gloves and dispose of them without another glance behind me. I return to Erika’s side where she cries uncontrollably, craning her head for any glimpse of her lost child. I glance back and forth between mother and father, seeing their anguished cries but not hearing them. For now, I do the only thing that’s left to do. I take Erika’s hand and hold it in mine while the baby is wheeled away.
14
Promise you won’t tell anyone.
The familiar rapid rhythm of my heart transports me back to my sister’s bedroom in my parents’ house, and for a minute the delivery room fades away and all I see is the fear in my sister’s eyes as she tells me she’s pregnant at eighteen...a statistic. After catching her with her head in the toilet one Saturday morning and calling to Mom for help, she’d shushed me, wiped her mouth and dragged me into her room with the promise of a secret written in her fearful eyes. I never expected what she’d tell me next or the impossible position she would put me in.
“Dylan, say it out loud,” she told me. “You have to promise you won’t tell Mom and Dad. Not yet. Mom’s going to kill me.” Her green eyes had pooled with water. I was in too much shock to cry. I’d looked down at our hands, clasped together on her baby-pink bedspread. Ironic, I remember thinking.
“Abby, I don’t want to. I don’t think it’s a good idea. You know I can’t lie to Dad.”
“I’m not asking you to lie. I’m just asking you not to say anything. If Dad specifically asks you if I’m pregnant, I give you full permission to tell him.” A nervous laugh escaped her lips. She tucked her silky blond hair behind her ear. “Sis, please. You’re the only one I can trust. I need you.”
And that was the clincher—she hadn’t told her friends, she’d told me. I bit my lip, and going against my better judgment, I nodded. When she swept me up into her arms and told me I was the best sister a girl could ask for, I thought I’d made the right decision. What kind of sister threw her best friend under the bus in her time of greatest need?
But three days later, she pulled me into the bathroom and locked the door. She’d been holed up in her bedroom since after lunch. Under the harsh lighting in the bathroom, she looked like a ghost. “Something’s wrong,” she whispered frantically. “I’m cramping. I don’t know what to do.”
“Why are you telling me?” I asked her, my voice rising with panic. I was only sixteen. What did I know about pregnancy? I’d hardly kissed a boy. “You need to tell Mom and Dad now.”
“No, Dylan. No,” she urged. She pulled me farther into the bathroom, holding on to me like she expected me to burst out of the bathroom or take flight. But she was my older sister, and she trusted me. I would never risk that. “I just need to go to the doctor. Will you take me?”
It was eight o’clock. I didn’t know how I’d get her to a doctor at that hour, but I knew I wasn’t going to let her down.
“Wait here,” I told her. I stepped toward the door, and my hands slipped from hers. I’ll never forget her wide eyes, her reddened cheeks.
By the time I made it to the bottom of the stairs, I had a plan. I told Mom I was going to spend the night at my friend’s house around the corner and that Abby was going to drop me off. I told her Abby would probably hang out for a while before coming back home. Mom was so happy to hear I had a friend that she agreed to the lies without any further questions.
While Mom was cooking and Charlie was in his room playing video games, I packed a bag and sneaked Abby down the stairs. She had her arms wrapped around her middle and walked hunched over. Every once in a while, a low moan escaped her lips, but she kept quiet. We tiptoed past Dad’s study, where he was reading the newspaper. We slipped out into the night, and I helped her into the passenger side of the car, then drove her to the nearest hospital.
We sat in the waiting room for an hour before someone finally called us into the back. By that time, Abby had broken out in a sweat, her cheeks were more flushed than before and her moaning had grown uncontrollable. I had to wrap her arm over my shoulders to get her back to the tiny room with little more than a shower curtain for privacy.
“What seems to be the problem?” the gruff doctor asked, looking down at the paperwork I’d filled out for her when we arrived. He must have been in his late fifties, his jowls hanging from his jaw like his cheeks were melting and his shaggy silver hair as tired as he was.
“She’s cramping and nauseous,” I answered for Abby, rubbing her back as I spoke. In a thinner voice, I said, “And she’s pregnant.”
“Have you been to an OB/GYN yet?” he asked.
Abby focused on her lap and shook her head.
The doctor looked over her paperwork a moment longer, unconcerned. He saw bleeding head wounds and gunshot victims and people with exploding appendixes on a regular basis. What were a few stomach cramps?
“All right,” he said. “Go ahead and lie back, and I’ll take a look.”
I helped Abby onto her back, though she was reluctant to uncurl herself. The paper crinkled beneath her, and I stood behind her head, using my fingers to pull her hair away from her face and blowing on her forehead to cool her.
“How far along are you?” the doctor asked.
“Just a few weeks,” Abby said through gritted teeth. “Five, I think.”
“And how long have you been feeling the symptoms?” The doctor pushed his fingers into her abdomen, and she winced.
“Since after lunch,” she said.
He asked her a few more questions and gave her a quick examination. Finally, he said, “Miscarriages can happen this early on, but if you’re not bleeding, I’m not concerned. It’s probably just that stomach flu that’s going around. We’ve seen a lot of cases in the last few weeks, and it’s all the same symptoms. I can’t do anything for it. All you can do is stay hydrated. If you start to bleed, come back right away.”
“That’s it?” Abby asked.
“That’s it. And get an appointment with your OB/GYN scheduled.”
He tipped his head toward us, then disappeared.
The drive over to my friend’s house
was silent aside from Abby’s occasional moans.
“Do you want some Gatorade? Crackers?” I asked her, trying to convince myself the doctor was right.
“No. I just want to sleep.” She had her eyes closed, and her head leaned back on the headrest.
“I don’t want to leave you when you’re not feeling well. Especially if no one else knows. Someone should be there in case you need to go back to the hospital.”
“I’ll be fine,” she said. “You go to Lauren’s. Her parents won’t care if you just show up. Their house has a revolving door for the neighborhood.”
I wanted to argue with her, but that had never worked in all our sixteen years of being sisters. “Let me at least drive you home. I can walk to Lauren’s.”
“Dylan, if we don’t stick to the plan, Mom will be suspicious.”
“We should tell—”
“Don’t,” she said, cutting me off. “You know if Mom and Dad know, they will want to involve Christian’s family, and I never want to lay eyes on that asshole again.”
So we stuck with the plan. She dropped me off at Lauren’s and drove herself home. I made her call me when she got there. I tried to focus on the scary movies we watched that night, boy talk, be a normal teenager who wasn’t worried about pregnancy and babies. But my mind was on Abby. As soon as the sun rose the next morning, I sneaked out of Lauren’s house and walked home. I saw the flashing lights of the ambulance down the street, and my heart went wild. I ran the rest of the way home, getting there just in time to see the paramedics bringing Abby down the stairs on a stretcher. Mom had her hands covering her mouth as she followed them, sobbing. Dad gripped Abby’s lifeless hand with one of his own and reached out for mine with the other. I didn’t take it, too stunned to grasp the simple gesture. Charlie clung to me from behind, and we watched them disappear out the front door, slamming it behind them.
Three days later, as we stood over Abby’s grave, and the minister droned on about the loss of a young life, Mom leaned toward Dad, and I heard her whisper, “Why didn’t she tell us? If we’d known, we could have gotten her to a doctor a month ago. We could have stopped this.” She’d dissolved into tears, and as a single tear slid down my own cheek, I vowed to keep Abby’s secret—now my secret—forever. When Abby was admitted the morning of her death, the hospital visit from the night before was on her records, but there was one detail that never made it on paper: I was there. I could have stopped this. My parents assumed she went after she dropped me off at Lauren’s. If they knew, they would never forgive me for not telling them...for letting her die.
Perfectly Undone Page 19