A Rapture of Ravens: Awakening in Taos: A Novel (The Justine Trilogy)

by Linda Lambert

  “Broken ankle—couldn’t travel—she’ll be fine,” Morgan assured his daughter. “Sends her love.”

  A small smile crept across Justine’s pale blue lips.

  If she had a chance of living, it was within the care of this highly trained trauma staff, both in the helicopter and the hospital. As the nearest hospital to the massive Taos Ski Area, the staff was well equipped for tragedies brought on by cold, snow, injuries, and isolation.

  Justine’s gurney was unloaded with incredible dispatch and rushed through the automatic doors into the emergency room where two doctors and three nurses awaited. Morgan jumped out and ran after the gurney. Pablo had driven the truck back to the BLM offices, picked up his own car, and headed back for the hospital.

  “Temperature is 88,” cried the senior nurse. “Pulse slow—about 40—breathing shallow.” Justine’s body had given up shivering a few hours earlier, for the body possessed no further strength to try to warm itself. Although senior nurse Marina was experienced with patients brought off Taos Mountain suffering from hypothermia, rarely did anyone spend much time in the cold before being rescued. On only one other occasion had she dealt with such an extreme case—that time a few years ago when a nine-year old was lost on Lobo Mountain. He had been trying to find help when his father had fallen and broken his leg. Neither lived.

  But she knew what to do—they all did: fill the IV with lukewarm salt water to heat Justine’s blood, while her assistant dipped cloths into a pan filled with warmer salt water, lifted the heated blankets from Justine’s inert body, and applied the cloths to the patient’s lower stomach and upper thighs. The hypothermia would have to be treated before Justine could be wheeled in for an MRI of her skeletal frame and CT scan of her brain, all areas of possible damage. An anxious staff fought for patience.

  Hours passed before the attending physician entered the waiting room to speak with Morgan. He scanned the room. Two women and another man watched him closely, hanging on every word. Dr. Fred Fernandez recognized the faces, but didn’t socialize. A swarthy man of medium height, a slight case of sclerosis gave him a bent position that made him appear older than his forty-eight years. Fred had worked in this emergency room for nearly twenty years and had seen everything this country had to offer.

  His words reassured Morgan at first. “Your daughter is one lucky girl, Mr. Jenner. Hypothermia, a broken foot and left shoulder. Her spinal vertebrae are essentially whole, and there’s no trace of brain damage. However, there can still be serious complications from such a severe case of hypothermia: damage to nerves and small blood vessels, possibly in the hands and feet—a condition sometimes known as chilblains.” Although a very exacting man, Fred was even more specific than usual. “The baby should be fine.”

  Morgan gasped, as did everyone else in the room.

  Observing the sea of surprised faces, the physician flinched and apologized to Morgan, “Sorry. I thought you knew.”

  “Don’t be sorry. I just arrived in the country and Justine and I haven’t had a chance to talk. I couldn’t be more pleased. When can I see her?”

  “In a couple more hours. She is still pulling out of the hypothermia, and . . . may I ask you to step outside?” He walked into the hall, moving further into the inner sanctum of the hospital, turning back toward Morgan when they were out of hearing range. “Your daughter has had a prolonged and terrifying experience, Mr. Jenner. It’s hard to know what to expect. I’m going to contact the hospital psychiatrist.”

  The tanned skin on Morgan’s face drew tight across his cheekbones and around his mouth. Before he could reply, the emergency doors swung open and Fred’s beeper began to wail. “If you’ll excuse me,” he said, already moving in the direction of the rolling gurney. Apparently, only one physician was on duty.

  The new patient’s face was pale, her lips ashen. Eyes closed. Then she doubled up in agony and began to scream.

  “Find the midwife!” rang a voice from the hallway. The respectful relationship of Holy Cross Hospital to the Northern New Mexico Birth center was a rare one—unlike any in the country, thanks to the pioneering efforts of two women: an obstetrician and the founder of the center. The two institutions operated with unparalleled cooperation and admiration, a shared mission.

  So, when a woman was brought in for delivery, it was second nature to call in the midwife, even though more babies were delivered at home or in the clinic on the pueblo than in the hospital. The hospital was for complicated cases, the outliers that didn’t fit the usual, natural pattern. Complications required advanced technologies.

  The midwife was already in the hallway taking care of admission by the time the call went out. The patient’s mother had called ahead when her daughter began to double over in pain and bleeding, her lips turning blue. The receptionist at the midwifery center had urged her to head for the emergency room.

  Taya had been bundled up and stuffed into the backseat of her mother’s old Ford. During the fifteen-minute drive south, the young girl screamed, Sharon holding her daughter and praying while blood rushed out onto the floorboard. Lucinda, Sharon’s elder sister, drove significantly over the speed limit. “We should have called an ambulance,” cried Taya’s mother. “Not even seven months along and all this blood!”

  “Look at me!” insisted Fred Fernandez, the doctor turning to glance and nod as the midwife entered the room. Clearly grateful to see Lisa, for she would be familiar with Taya’s history. The girl’s lids were at quarter mast, unfocused, then they flew open and she screamed again. The bleeding was profuse.

  “What’s causing all the bleeding?” asked Lisa, her eyes narrowed with urgency.

  “I don’t know! Here’s her file. Check her second trimester ultrasound.”

  “I can tell you without looking that there’s nothing in the file. Fred, she didn’t show up for the appointment.” The midwife stared at Fred, a man whom she’d known and worked with for many years. Then she broke eye contact and looked away. It was usual practice to go out and find a patient if she didn’t show up, especially if she were very young. Or at least call the parent.

  Turning to the nurse, Fred spoke urgently. It wasn’t in him to judge his colleague, for he had made his own mistakes. “We need an ultrasound right now.” He said nothing about his suspicions, he could be wrong.

  Lisa helped prepare Taya for transport to the lab. She and the nurse shifted the girl onto the gurney, the IV continuing to pump blood into her limp arm as the wheels of the gurney slid sideways in a puddle of blood and found traction.

  No one noticed the lone woman, silent and terrified, sitting in the shadows. Sharon had found her daughter curled up on the floor of her room that afternoon, lying in a pool of blood, mumbling inaudibly. At times like this she sorely missed her husband, who had decided to live with his own tribe in South Dakota. He had returned home upon the death of their son, then turned and left without a word. Why couldn’t they comfort each other? This time would be no different.

  If the midwife Lisa hadn’t been so distressed, she might have noticed Sharon in the darkened corner. It was the policy of the midwifery center to involve parents of under aged children in the pre-natal care of their daughter. Both of them, somehow, had fallen short of their responsibilities. For Sharon, it had been concerns for the troubled son—followed by his death—that had captured her attention. But how about Lisa herself?

  “How far along did you say she is?” Fred asked while the ultrasound was being connected. The bleeding continued unabated as the IV supply of blood crept lower and lower. He stared at the hanging bag as though to ask, “Can the blood flow into her body as fast as it is flowing out?”

  Before the midwife could tell him that Taya was less than thirty weeks along, Fred motioned to the nurse to rush and find a new supply. As the doctor spoke, he glanced up at the ultrasound screen and went pale. It was as though all the blood had drained out of his own body. He turned to the midwife, who was staring at the screen as well.

  “The placenta is c
overing the cervix,” said the midwife matter of factly, her voice disconnected, almost sterile. She held her breath as though that action alone would change the screen, move the placenta from the bottom of the uterus to the side where it belonged.

  “So, that’s causing the bleeding . . . get her to Op!” he yelled. “Now.”

  The IV bag gurgled its last drop of precious blood just as another nurse entered with a fresh supply. “Wait,” she commanded, halting the movement of the gurney so that she could attach the bag.

  Lisa, the midwife, asked the nurse: “Where’s her mother? Sharon.”

  “In the patient’s room. Been there for some time.”

  Lisa’s face formed into a question. “She is?” She hurried down the hall and found Sharon seated where she had been since Taya was brought in.”

  “Sharon,” she began urgently, pulling up a chair, leaning over to hug her. “I’m sorry to neglect you like this. We’re concerned about Taya’s bleeding.”

  “Is she going to be all right? And the baby? Is the baby okay?”

  Lisa paused. “Let me explain. As you may know, during pregnancy, the placenta embeds itself on the side or top of the uterus. But that’s not the case with Taya. Her placenta is at the bottom, covering the cervix. It’s a condition called placenta previa.”

  “So the baby can’t get out . . . .”

  “Exactly.”

  “But why all the bleeding?”

  “As the cervix expands, it rips the placenta. The blood is coming from that rip.”

  “She’ll need surgery, won’t she? A Caesarian?”

  “They’re prepping her right now.”

  “But she’s not far enough along—will the baby live?” Sharon’s eyes welled up. They were already red from the ride in, watching her little girl bleed onto the floorboard. Memories of her own difficult childbirths flooded through her mind. But at least, no blood—only intense pain. “She’s only a child,” she whimpered, almost inaudibly.

  “I know . . . we can’t know about the baby yet. We’ve been giving him corticosteroids to speed up his lung development. She didn’t say, ‘a little late to make any difference.’ That’s about all we can do right now . . . other than the Caesarian.”

  A boy. “Lisa. I didn’t know. She had some pains—lower back, sometimes on the side of her stomach.” Sharon placed her hand on her own stomach. “Then she would lie down and say she felt better. I didn’t think it was anything . . . .”

  “If we’d known, we would have had her on bed rest. If she’d had her second trimester ultrasound, we would have known what to do. Sometimes, as the stomach expands, the placenta can pull back into place. But neither of us knew. Please don’t blame yourself. You’ve had enough grief lately . . . with your son . . . .”

  A fountain of grief exploded inside Sharon, sobs welling up uncontrollably, as though this was the first time she’d allowed herself to cry.

  Lisa would have comforted Sharon more, but needed to get to the operating room. She bundled Taya’s mother in her arms for a moment, holding her as tight as she could. “Where’s Lucinda? Where’s your sister?” Lisa whispered into her ear.

  “She let us off and went to pick up her son from a basketball game,” Sharon said between sobs. “She’ll be right back.”

  “Call her. Now,” Lisa insisted and hurried back down the hall, a shiny white tunnel leading to the operating room where she washed up, donned a smock and mask and joined Fred and the nurses.

  She was just in time to observe Fred gently lift the pale blue, inert baby from her mother’s womb and hand him off to a waiting nurse who swaddled him in a towel and carried him to the sink, scales, and incubator. The child was as limp and translucent as a wilting lily.

  Fred moved his hand gently around the inside of Taya’s uterus, letting his fingers feel the contours of the flesh, wet and soft to his touch. When he finally looked up, he gazed into Lisa’s penetrating eyes above the medical mask.

  He shook his head, his eyes reflecting an uncharacteristic touch of terror. Something was terribly wrong. Finally, he stood upright and said, “It’s not coming out, the placenta is embedded too deeply.”

  “Placenta accretia,” Lisa said. It sounded like a death sentence.

  He nodded again. The nurses were stunned into an eerie silence. The baby didn’t cry. Only the sound of oxygen flowing to the pale patients could be heard above the myriad of nearly inaudible thoughts and prayers in the cold operating quarter.

  Fred stretched his arms and fingers in preparation for the hysterectomy. It broke his heart to perform such a drastic procedure on a child. Her baby was unlikely to live and she would never have another. He looked up into the fading sunlight washing down from the skylight. When the hospital was constructed he’d opposed it. “I don’t want nature controlling the light over the operating table,” he’d insisted. They had placed a remote shade over the opening so that he could control it. He was satisfied and now found that he left it open more often than not.

  “I’m going to talk to her mother again,” Lisa said. “Fred, she has to give her permission for a hysterectomy.”

  He forced his shoulders back; he was steadfast. “I can’t wait, Lisa. She is bleeding too heavily.”

  Throwing her smock and mask into a corner chair, the midwife rushed from the room. She knew that Fred would proceed with the surgery. What if Sharon didn’t agree?

  Nearly running down the hall, Lisa’s hand caught the doorframe as she spun into the room, then slowed her pace. “It is a matter of her life, Sharon. We have no choice,” she pleaded.

  “But she’ll never have another child, isn’t that right? Will her baby live?”

  The midwife gulped. She couldn’t reassure Sharon that Taya would have at least this one child, that she would have at least one grandchild. But she couldn’t—the chances were slim for both. “I don’t know. I really don’t know.”

  Sharon started to cry again, to mumble. It was an impossible decision to make. “Lucinda doesn’t answer her phone. Is Justine awake?” She’d been informed about Justine’s accident and rescue. Her presence in the hospital.

  “Justine?” Lisa asked with surprise. “There is a Justine Jenner here. Is that who you mean? I’ll find out.”

  Lisa returned quickly from the reception desk with the permission form in hand. “Justine is still unconscious, I’m afraid. Sharon, you have no choice. You have to sign this.”

  Taya’s mother said nothing as she took the pen from Lisa’s hand and signed the form. She turned away. The midwife quickly signed as witness and left the room. She couldn’t take the time to comfort Sharon.

  CHAPTER 45

  A FEW HOURS LATER, well after midnight, Sharon stood at Justine’s hospital room door, nodded to Giovanna who sat in the dark across the room and stared at the man near her bed.

  Morgan looked up and walked toward Sharon. He knew without asking who she was. “Hello. I’m Justine’s father,” he said. “How is Taya?”

  As Sharon’s eyes welled up, Giovanna walked over and embraced her. Giovanna had helped in the hunt for Justine, searching with Bill in the direction of Lobo Mountain. Now fully exhausted, her spunky elfin demeanor was gaunt. She refused to leave Justine’s side. Morgan had been welcoming when she’d insisted on being there, for his daughter had told him of her relationship with this woman, a believer in miracles.

  “We’re not sure,” said Sharon finally. “The hysterectomy is over, but she’s lost a lot of blood. Justine? How’s Justine?”

  “There may be some nerve damage around the blood vessels in the broken foot from the hypothermia. Too early to tell. She’s still drifting in and out of consciousness. We can only hope. But she’ll live.” He trembled as he said those final words. Gazing at each woman in turn, he added. “She doesn’t know about Taya.”

  Sharon nodded. She’d grown close to Justine over the past months, had come to rely on her, sometimes for advice about her daughter who had become more and more estranged from the family. “First
I lose my son, then I seem to be losing Taya as well,” she had told Justine. “I’m losing both children at once.” During the past month, the girl had been angry with her as well.

  “Sharon.” Lisa stood at the door, addressing Sharon, yet gazing intensely, knowingly at Giovanna. “May I talk with you?”

  Sharon stepped into the hall, fear flashing through her eyes, and followed the midwife to Taya’s room.

  Without explanation, Giovanna left the room and hurried toward the hospital exit.

  Justine opened her uncomprehending, lusterless eyes and looked at her father. She stared at him for several moments while he massaged her hand, waiting for her to figure out where she was, why her father was beside her. Finally, she said, “Is he dead? Is Amir dead?” She glanced around the room as though she expected to find Amir there, waiting for her. Then, “Lucinda, where’s Lucinda. I must tell her about my guides . . . .”

  The psychiatrist had warned Morgan, “Once she realizes where she is, Dr. Jenner, she’ll want to know about Amir. Be honest with her.” Whatever that means, he had thought at the time. “His body hasn’t been found,” he said reluctantly. “There’s still hope. I’ll find Lucinda.”

  Her eyes focused on the wall behind him and she shivered. Her body was beginning to regulate its own temperature. That’s a good sign. “How am I doing, Dad? Will I live?”

  Her father started to cry. “We were so scared, Honey . . . but, you’re going to be just fine. You were damned cold, some bones are broken in your foot and shoulder. But you’re strong, the body of an athlete.”