As they disappeared into the cubicle, Samantha overheard the man with her. “Took me eighteen hours to get her here. Roads where we come from is bad.”
David squeezed her hand and looked down at her with naked love. She could practically hear what he was thinking. That he’d make sure she was never in a position like that. That she and their children would always have enough food and easy access to medical care. Samantha had no doubt David would always provide for her and their children.
But that didn’t help the young woman in the cubicle.
The nurse came back out and walked behind the desk. She picked up a phone and Samantha, after squeezing David’s hand, stood and casually walked over.
“No, we need him down here now.” The nurse was whispering urgently into the phone. “A C-section, probably.” There was a pause. “As soon as he’s finished, then.” She hung up the phone with more force than necessary and when she looked up and saw Samantha watching her, she smiled thinly. “We’ve got a Gynie on staff but he’s tied up in the OR. She’ll be okay.”
But Samantha saw through her lie. “Need a hand?” she asked although it wasn’t really a question. She turned and started to walk down the short hallway where the cubicles were. The nurse, her brow furrowed, looked up at David. When he saw where Samantha was headed, he hesitated for only a second before nodding, then took a slow, deliberate breath as the two women disappeared into the cubicle.
“Hello,” Samantha called out in her practiced, professional and cheerfully nonchalant voice. “Is this your first?” she asked happily. She lay her hand on the woman’s abdomen and looked down at her watch.
“Uh huh,” the girl nodded, then let out a hoarse, shuddering groan.
Still checking her watch, Samantha moved her hand around the woman’s taut, distended abdomen. When the woman’s abdomen unclenched, Samantha smiled. “Good girl. Let’s see if we can’t make you more comfortable, hmm?”
She turned back to the nurse. “A dressing gown and size small gloves, please. And a stethoscope if you’ve got one to spare.” Samantha glanced up and saw David and Cheryl, lurking by the doorway, peeking in. She returned her attention to her patient. “We’ll need to get your clothes off,” Samantha said gently but matter-of-factly. She drew the curtain and helped the girl raise her tattered dress. “Are you the father?” she said, addressing the man for the first time.
“Yeah,” he replied with bluster...but a bluster that didn’t quite disguise the anxiousness in his voice.
Samantha handed him the woman’s dress then helped her with her panties and thread-bare shoes. She didn’t react noticeably to the smell of the woman’s unwashed body. After thirty-six hours of labor, she was entitled to a little sweat. “All right,” Samantha said brightly as the nurse returned with a clean gown and a box of sterile gloves, and handed her the stethoscope hanging around her neck. After warming it, Samantha held it to the woman’s abdomen, shifting position again and again. She straightened and smiled. “You slip this on and sit back,” she said, handing the gown to the girl. “We’ll be back in a minute.” Once outside, she drew the nurse aside. “She’s dehydrated and her contractions are weak,” Samantha whispered. “The baby’s breach. She needs a C-section and soon.”
“I know but our Gynie’s assisting with one of the young fellows that was brought in this morning from that farming accident. He’s wrist-deep in somebody’s guts and can’t be here for at least an hour. Maybe two.”
Samantha’s mouth thinned but that was her only reaction. “Well, while we’re waiting, we’ll need an IV and an emergency obstetrics tray. Glove me,” she said quietly and the nurse followed her back inside, past David who had gone noticeably pale and Cheryl who simply gaped down at her in astonishment.
There was a sink in the room and Samantha washed her hands thoroughly. “First baby, hmm?” she called out brightly over her shoulder. “Have any names picked out?”
While the couple argued about names and the woman’s voice grew perceptively weaker, the nurse handed Samantha a sterile towel then held the gloves open for her to slide into.
“Thanks. I’ll do what I can. I’ll call if I need help.”
Yeah, like a board-certified obstetrician and a fully staffed OR, Samantha thought wryly but kept her thoughts to herself.
The nurse left and, again, Samantha palpated her patient’s abdomen carefully, hoping against hope. As she worked, she looked over the baby’s father. He was a rough-looking fellow with bad teeth and too skinny, like the woman. But his boots were solid, made from rough-cut leather, likely reinforced with steel. They were made to do a lot of damage if he ever unleashed them on someone. The unmistakable, warn spot on his belt-loop and pant leg showed where a long knife-sheath usually rested. That, the bulge in his pocket the size of a .38 automatic and his weighted gait told Samantha, all too clearly, he was heavily armed.
Samantha took a breath and turned to the two of them. “What’s your name?” she asked the woman.
“Rebecca,” she answered weakly.
“All right, Rebecca. The baby’s in a breach position. That means it’s lodged in the top of the birth canal bum first. There’s not enough room for it to come out that way.”
“I knew it,” the man said hoarsely. “Three days is too long.”
Samantha nodded. “The baby can’t be born without some help. We’ve got two options. The first one I’m going to try now, with your permission. I’ll try turning the baby around inside you so it can come out head first. It’ll be painful and it may not work. But the second option is a Cesarean section—do you know what that is?” They shook their heads dumbly. “It’s an operation. A surgeon will make an incision across the bottom of your belly and lift the baby out through it.”
The woman blanched then groaned as another contraction hit. Samantha timed it and felt her abdomen. “Pick up a pillow from over there,” she instructed the man evenly. “Stand beside her and use it to prop up her shoulders while she’s having a contraction. It won’t hurt as much if she’s sitting up.” He did his best to comply but was obviously well out of his comfort zone.
When the contraction was over, Samantha continued. “There is a two-hour wait for a surgeon.”
“Well that’s too long,” the man blurted out. “Who’s saying she ain’t as important as any of them?” he shouted, gesturing in the direction of the waiting room.
“The surgeon is currently wrist-deep in some kid’s guts, trying to save his life. He’s not more important than your wife, but he’s already in the operating room and will stay there until they’re finished.” Samantha spoke calmly, deliberately, and as forcefully as she could.
“Well then you do it,” he insisted. “You...cut her belly,” he added with barely contained horror.
“I’m not qualified to do that. I might kill her and the baby.”
“Try that turning thing then. I’m just about done in so more pain isn’t going to make any difference,” Rebecca spoke up weakly.
Samantha nodded then pulled out the stirrups and set the woman’s feet in them. Her hand on Rebecca’s abdomen, Samantha began an internal examination. Sure enough, she felt the soft, flaccid flesh of an infant’s buttock wedged in the mouth of her womb. The good part was no cord was hanging down and no limbs were protruding into the birth canal. If the mother was strong enough to handle it, they just might be able to save both of them the risk of surgery.
Another contraction hit the woman and Samantha eased her hand out of her vagina. “Cheryl?” she called out over her shoulder.
“Um, yes?” Cheryl’s pale face appeared around the curtain.
“In that drawer,” Samantha said, nodding to the far wall, “you’ll find gauze and scissors.” Hopefully, the emergency-room staff had left the place set up like the Army had left it.
Cheryl’s brown eyes widened but she crossed the room and opened the drawer. “Got ‘em.”
“Good. Now cut a twenty centimeter length of gauze and bring it to me.”
He
r eyes still wide, Cheryl nonetheless did as she was asked.
“Um, here,” Cheryl said quietly. Samantha felt more than saw the smile she offered the pregnant woman.
“Good. Now, tie my hair back. Good and tight. Great, thanks.” The contraction ended and Samantha returned her full attention to her patient. “Deep cleansing breath now.”
“What’s that?” the woman gasped.
Samantha deliberately didn’t let her worry show on her face. No pre-natal care. Malnourished. Underage. Breach presentation. It would be a miracle if this baby—and its mother—survived.
“Show her, Cheryl.” But Cheryl simply gawked at her. “You know how,” Samantha prodded her calmly. “Cheryl has three children. She’s an old hand at this and she’s going to coach you through it. Right?” she added pointedly, staring up at Cheryl.
“Um...sure. Sure.” Cheryl said. Her voice was deliberately firm now. She stood on the woman’s other side. “Big inhale in through your nose, then out through your mouth.”
The nurse returned with two IV bags and set them on a tray beside Samantha, tied a tourniquet on the woman’s arm and slapped it lightly with the backs of her fingers. Again. And again. “Veins have collapsed.”
“What’s she mean by that?” the man barked. His voice was high-pitched and wavering.
“It means Rebecca is dehydrated. We’re going to give her some fluids from those bags.”
“She’ll need a cut-down,” the nurse said evenly. She moved quickly around the room, set up a sterile tray and wheeled it into position beside the patient then stood aside, looking at Samantha pointedly.
“I’m not a doctor. I’m a medic,” Samantha said, again feeling the women’s abdomen and pressing lightly on the baby’s bum, trying to see if it would turn that way.
“Then you can do this. I can’t.”
“What do you mean...a medic?” the man blurted out. He drove his hand into his pocket—the one with the gun in it. “You’re Army—ain’t you?” he asked in a low, venomous tone.
“Yes,” Samantha answered evenly. “And I need you to do something for me,” she said, moving to the cut-down tray and, using a generous amount of solution, disinfected the patient’s wrist. “You said you drove here?”
“Yeah...but what has that got to do with anything?” he answered suspiciously.
“You’re carrying at least two handguns. I need you to go out to your car and leave both of them in the trunk. And any other weapons you might be carrying.”
“You’re nuts if you—”
“You’re going to get rid of your weapons because if you’re armed, I’m paying more attention to you than her,” she interrupted him as she injected the cut-down area in several places with local anesthetic. “It’s human nature. And I’m going to keep paying more and more attention to you. Whether I want to or not. Besides, there’s no place for guns in a room with your wife and baby in it.”
“Whadya gonna do, shoot me if I say no?” he barked crazily.
“No. I blow at marksmanship. But he doesn’t,” Samantha added, nodding over her shoulder. She’d just caught the sound of David’s boots as he hurried back to her and she felt him behind her now, even before she heard the curtain draw back. All this before she heard him release the safety on what was probably a modified AK57, one of the new rifles on the post-GW market. All ERs set up by the army kept a weapons case behind the admissions desk. For all their advances, there were still a lot of vicious criminals in the un-reclaimed areas of New North America. An eighteen-hour drive by car, in any direction other than the one she and David had come in, would qualify.
“What’s your name?” Samantha asked firmly.
The man’s attention spun back to her. “Ethan.”
“Go on then, Ethan. And don’t be gone long. She’ll want you here when the baby comes.” That said, Samantha deliberately turned her attention back to her patient and made a careful, shallow slit up the side of Rebecca’s wrist. Cheryl groaned and Samantha shot her a hard look until she stopped. Working quickly, she isolated a vein. Inserted a catheter needle into it then let the wound close around it. She taped the needle in place then hooked up the IV. The nurse hung the bag for her, set the drip rate and finished taping the needle securely in place. Samantha quickly returned to the end of the exam table. She put one hand on Rebecca’s belly and slid the other carefully into her vagina. “Okay, Rebecca, big breath. This is going to hurt.”
Rebecca held back for a second or two, grimacing. Then she paled and yelled. Working smoothly, visualizing the woman’s internal structures, Samantha simultaneously pushed and pulled. From inside and out. Another contraction started and Samantha stopped. This time she listened to the baby’s heartbeat. It slowed markedly during the contraction and took too long to speed up again after. She had to try again, pushing and pulling until she felt a subtle shift, until she could no longer feel the flaccid buttock plugging the mouth of Rebecca’s womb. Instead she felt a narrow but discernable backbone. Pressing deliberately on Rebecca’s abdomen now, Samantha continued easing the baby around. It didn’t happen often but this might just be their lucky day.
With a suddenness that made Samantha grin, the baby rolled, somersaulting inside its mother’s womb. Samantha grinned wildly when she clearly felt the baby’s buttocks rise up to the top of her abdomen and sit there.
“Okay, Rebecca, today’s our lucky day. Next contraction, I need you to push.”
“Can’t,” Rebecca panted wearily then sank back. “Done in.”
“The hell you are,” Cheryl barked at her. “You carried this baby for nine months. Now suck it up and finish the job.”
“You yell like my momma does,” Rebecca grumbled then made a visible effort to rally herself.
“Comes with the job. You’ll get good at it.”
Samantha heard footsteps outside. Heavy ones, several men. Ethan re-appeared at Rebecca’s side. He blanched and swallowed convulsively at the sight of her—at the heavy bandaging on her wrist, then stepped up to her and patted her shoulder awkwardly.
It was over fairly quickly after that. Two more contractions was all it took, which was good. The nurse confirmed that Rebecca’s BP was bottoming out. She turned up the IV drip to full volume and her blood pressure began to slowly rise. Some color came into her pinched cheeks and the rattle in her breathing eased.
Samantha got to do what she liked best as a medic—play catcher and she caught the baby’s head and shoulders neatly in a sterile towel as they shot clear of Rebecca’s body. The rest of its body slid out easily. The nurse handed her a suction bulb and she cleared its nose and mouth. It started to cry, turning, in a matter of seconds, from sickly blue to pink. The color spread from its chest throughout the rest of its body.
“You’ve got a daughter,” Samantha informed them happily. “And a beautiful one at that.” She lay the shaking, protesting infant on its mother’s chest, attached two umbilical clips to the cord then handed the scissors to Ethan. “Cut the cord. There. Between the clips.”
He looked scared, then proud and weepy at the same time and, holding his breath, cut the cord. He grinned madly, revealing his rotten teeth in all their glory.
A little while later, after Rebecca had delivered the birth sac and Cheryl had left, muttering something about drinking heavily, Samantha carefully sewed up the small tear in the mouth of Rebecca’s vagina after giving her a healthy injection of local anesthetic.
“All right,” Samantha said, straightening and stretching her back when the job was finished and both Rebecca and the baby were wrapped in blankets. She glanced down at her sandals ruefully. They were soaked in amniotic fluid and some blood. A total write-off. Oh well. She turned to Ethan. “Someone will be here from maternity soon. Rebecca and the baby will likely stay overnight for a few days to get some good food in them and some rest.”
“Um, listen, I can’t pay for any of this,” Ethan whispered hoarsely. “So maybe we should just, you know, leave before they get here.”
“Not a good idea, Ethan.” Samantha answered firmly, pulled off her gloves, tossed them in a biohazard container then started washing her hands. “David?”
She’d known he’d been behind the curtain the whole time, had known he wouldn’t leave her.
“Yes.” His deep, dark and resonate voice was just about the sweetest thing she’d ever heard.
“Anything you can do to help these folks out?”
He sighed unhappily then lifted one edge of the curtain. “Come on out, Ethan. We’ll discuss it.”
David shot Samantha a look but it faded quickly when he caught a glimpse of her face. She looked tired and exhilarated at the same time. Strong and confident in a way he’d never seen before. And he knew that, here, his Samantha really was in her element.
He looked down at the skinny, scruffy man in front of him. He was dirty and smelled worse. The Great War had ended twenty-one years ago. People didn’t need to live like this any more.
“What can you do?” David asked evenly. “Do you have a trade?”
Ethan looked around evasively but then his tiny daughter started to cry. He straightened deliberately and, for the first time, looked David in the eye. “I was an auto mechanic before the Great War.”
“Auto mechanic,” David repeated thoughtfully. Then walked over to the admissions desk and picked up the phone. “Pete?” he said into the receiver. “David O’Reilly here—could you use a hand in your shop? For, say, three weeks?”
Pete, one of David’s old fishing buddies and owner of the town’s only repair shop, was silent for a moment before answering. “I believe I could,” he replied slowly. “Why?”
“I’m going to bring a fellow around. His name’s Ethan. His wife just had a baby girl here and he needs to barter his labor to pay the bill. Can you help us out?” David kept his eye on Ethan. “Ah. Terrific. We’ll see you in a couple of hours. Bye for now.”
“Three weeks, huh?” Ethan repeated warily. “Where we gonna live then?”
“In town. Pete’ll set you and your wife up somewhere. It won’t be fancy but it’ll have electricity and running water. And Ethan, for the sake of that baby in there, give some thought to staying. I’m pretty sure I can guess what kind of a life you’ve been living for the past twenty-one years and I’ll be honest with you—that’s not how people live around here. Here, it’s better. But they won’t tolerate criminal behavior. As long as you’re willing to work, you’ll fit in. Make a new start. You and that family of yours can live like you did before the war.” He looked over Ethan’s head and saw an orderly push a wheelchair into the cubicle where Rebecca and the baby were waiting. “Go on with them for now. See her settled in and I’ll drop by her room to take you to Pete’s for an introduction in two hours or so.”
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