by Alice Ward
Labor was the epitome of vulnerable, and often, a kind word or two went a long way toward easing the stress of the constant pain.
“Well, you still look terrible,” the social media brat said, and I immediately hated her again. “I don’t mean to be mean…” Sure she didn’t. “But you’d be really pretty if you just tried a little bit. Giselle and I were just talking about how good your skin is. A little pale, but it complements your auburn hair — which would be more attractive if you straightened it — and makes your blue eyes look even bluer. If I were you, I’d cover the freckles though. Have you seen the blending cremes on the market? They cover all kinds of deformities.”
I inhaled deeply through my nose as I typed in her chart. Deformities? When did a few spots on the nose and cheeks become a terrible thing?
Suddenly missing Mindy and the two-father dilemma two doors down the hallway, I ignored Mrs. Harlington-Worthington, the Fifth while I continued to chart and she went on about how best to contour my face.
“Aren’t you going to check me?” she asked with a huff, rubbing her hands over her slight mound of belly. If I didn’t know she was past her due date, I would have thought she was closer to seven months along. Her bump was tiny. “I’m probably ready to push by now, you took so long to come back.”
Inhaling another long, deep breath in through my nose, I let it out just as slowly. “Are you feeling any contractions yet?”
A pained expression came across her face, and she lifted her phone to take a picture of it. She looked at the screen, was clearly not pleased with the result, made an even more agonized face, and snapped again.
Oh, dear god.
“Yes.” She fanned herself with her hand. “It’s agony.”
Snatching up a pair of gloves, I snapped them on, thinking I could do this gently, or not so gently. I could even have thumb slippage and give her a little jolt in the ass.
Mrs. HW5’s eyes widened just as I was about to ask her to let her knees fall to the side. “Oh…” She grabbed her belly. “Oooh!” I glanced at the monitor, and hurray, oh thank you god, she was having a contraction. A real damn one. Finally.
The stylist surged forward and patted rice paper on her nose while my patient writhed on the bed. Dear heavens above. Calmly, I timed the contraction, encouraging her to breathe through the pain.
“Epidural,” she screamed, and her husband’s head finally popped up from his laptop screen.
He looked directly at me and snapped his freaking fingers. “Get on that.”
I shot laser darts of hatred onto his head as he looked back down at his computer and began tapping away, but ignored his command. I showed my teeth to my patient in what I hoped would pass as a smile. “I’ll check you as soon as this one ends.”
She continued to writhe and scream, her camera forgotten for a moment. If this was how real labor with her was going to be, I’d put in the epidural myself. Maybe even a backup one, just in case.
“Have you decorated the nursery yet?” I asked in way of a distraction as I felt her belly grow even tighter under my palms.
She huffed and puffed, but managed to nod as the contraction wound its way down. “Yes,” she panted. “It’s beautiful. Better than Princess Charlotte’s, no doubt. It’s… oh… oh… auggh…” The last sound ended on a scream that jerked her husband’s head up again.
He had a highbrow, annoying tone. “Do you plan on doing anything?”
I hated him.
I checked the monitor, touched the belly that was growing tighter again. Sure enough, she was having another. Labor could be weird like that sometimes. Hours of nothing, then everything happened at warp speed. Maybe her doctor was secretly a genius, and I should bow down and worship by his crystal ball.
“It’s been a couple hours since you went to the bathroom,” I said, knowing that a full bladder often increased contractions. I pulled up her gown to release the monitors she — and her freaking doctor — insisted be kept in place. “Let’s get you up. You can use the bathroom and walk around a little bit.”
She gave a dramatic sigh and rolled her eyes. “I suppose. It is tiring just lying here. I’m so used to being active. Just a second.” She raised her camera, took a picture, and I watched in astonishment as she typed, “Last pee break before baby!!” across the screen.
Lowering the bedrail, I helped her to her feet. It really was amazing how small her baby bump was for forty-one weeks. “How much do you work out?” I asked, genuinely curious.
Her hand went to her belly as she leaned heavily onto me. You’d have thought she’d just had major surgery from how slowly she moved. “At least twice a day, about two hours each session.”
I gasped. “You’re kidding.”
“No, and that was just in the past few weeks. I didn’t want the baby to get too big, create those atrocious stretch marks.”
Of course, stretch marks would be her primary worry.
More concerned now, I asked, “And what do you eat to stay so slim?”
We finally made it to the toilet. She sighed as a loud stream of urine hit the water. “Mostly green vegetables, a little fruit, but not too much. I have to get back into shape immediately, you know. Don’t want hubby turning me in for a younger model.”
I stared at her, and for the first time, saw something close to real emotion cross her face. It was there and gone in an instant, but it caused a flood of compassion to hit me. “I’m sure he wouldn’t do that. You’re perfect, and you’re giving him a baby to love.”
She blinked rapidly and yanked at the toilet paper, pulling off nearly a quarter of the roll. She wiped, and I helped her stand and get to the sink to wash her hands. I checked the color of her urine before flushing it all away, then snapped on new gloves as she stood and looked at herself in the mirror.
“You think I’m ridiculous, don’t you?” she asked softly but continued to stare at her reflection.
Yes. Yes, I did.
“No, not at all,” I said and went to stand behind her, my gaze meeting hers in the mirror. “I think you live a very different lifestyle than I do, with a different set of pressures.”
“I’m scared,” she whispered and began blinking hard again.
My heart squeezed a little. “Scared of what?”
“Carl’s never seen me without makeup,” she confessed, and I blinked. I’d expected her to talk about the pain of childbirth, being a good mom, being able to breastfeed with DDD implants.
“Never?”
Looking miserable, she shook her head. “And I don’t want him to, you know, watch the birth. I don’t want him to see me look bad… down there. I—” Her eyes widened, and she groaned as another contraction hit her.
After it had passed, I suggested we go for a walk, maybe finish our conversation as I tried to figure out the relationship dynamics and how best to care for my patient’s emotional needs as well as the physical ones.
She shook her head. “I just want to lie down again. I’m feeling a bit dizzy.”
Holding onto her tighter, I asked, “When did you last eat? A real meal?”
She glanced up at me and sighed. “A couple days ago.” She lowered her voice. “I heard rumors of women, you know, pooping during labor. I wanted to clean out my system so it didn’t happen to me.”
It also explained why her full-term baby was so small. I gritted my teeth, wanting to kick her doctor and her husband in the balls. She’d probably been dieting the entire time in addition to working out like a fiend.
“Well, let’s get you back into bed, and I’ll talk to your doctor about adding some additional nourishment intravenously. You can’t eat right now, but some glucose could help. I’ll check your blood sugar once you’re settled.”
Once she was back in bed and I’d placed the monitors back on, I checked and she sure enough was hypoglycemic. Knowing her asshole doctor would want to know her delivery status, I lowered the head of the bed and warned the other two people in the room that I was ready to check her. The husba
nd turned away, his eyes never leaving the computer monitor while the stylist looked on curiously.
“Heels together,” I instructed Mrs. HW5. “Let your knees drop to the bed.”
And… gush.
Amniotic fluid burst out in a sudden flood, the color darkened with the baby’s meconium. Shit. Literally.
Worse, a section of the umbilical cord presented itself from her vagina. Just like that, we’d gone from prima donna labor to full-scale emergency in an instant. I glanced at the monitor, and damn, the baby’s heart rate plummeted.
I made a promise to never criticize a doctor again, even though I knew that promise would last about half a minute.
Jumping on the bed, I jammed two fingers into the writhing, screaming woman, found the baby’s head where it was pressing on the cord and gently lifted, taking pressure off the life-giving cord. The heart rate increased, giving us some time.
“What are you doing?” the husband shouted, launching himself to his feet so fast his precious laptop crashed to the floor.
Ignoring him, I twisted around and jammed my other hand on the call button, then began lowering the head of the bed even farther, putting Mrs. Harlington-Worthington, the Fifth into the Trendelenburg position, hoping to decrease the pressure on the cord.
I needed to give her oxygen but couldn’t risk removing my fingers to reach for it, and because of the silk sheets, I kept sliding around, making my precarious perch even more precarious. I felt Mr. Worthington, the Fifth’s tight fingers on my shoulder. “Get off of her. I’ll have your job on a silver platter.”
I winced at the pain in my shoulder but didn’t stop holding the baby’s head off the cord. Carefully arranging my face into my calmest expression, I explained the emergency in simple terms. “The umbilical cord has prolapsed, meaning it has slipped out of the cervix ahead of the baby.” Mr. W5’s face went milky white, and he swayed a little to the side. With my free hand, I clutched at him, not needing a bleeding or concussed father to worry with too. “The baby’s head is compressing the cord. I’m holding the baby’s head up. We’re okay for the moment, but we’ll—”
“Can I help you?”
Relief flooded through me as I recognized Olivia’s voice float into the room. “UPC. Prep OR. Need O2. Stat.”
In seconds, the door burst open, and I yelled for someone to get Dad. Within a minute, the entire bed, me included, was being pushed down the hallway, my fingers growing numb from holding the baby’s head up as my knees slipped and slid on the sheets.
“What’s happening?” Mrs. HW5 cried out, and I gave her a gentle smile as I hovered above her. I explained the situation again as we raced down the hall.
“You’re going to be fine,” I soothed. “I can feel your baby’s head. I think little Marie Claire’s got lots of hair.” With the gloves on, I didn’t know that at all, but it gave me something to talk about during one of her most terrifying moments. “I bet she’ll be as beautiful as you.”
Mrs. HW5 smiled, just a little, tears shining in her eyes. “Do I look okay?” she asked and it didn’t even piss me off. I laughed and promised that she did.
We were lucky. An OR had just been cleared and cleaned after one of the traffic accident victims, so we were wheeled in immediately. I held my position as we moved to the operating table and the OR nurses covered me with blue sterile sheets.
Covered as I was, I couldn’t see anything, just listened as the anesthesiologist gave the go ahead, indicating she was asleep. The sound of the scalpel slicing through skin was shiver inducing, but still, I held my position, knowing my fingers were the only thing saving this precious little human at the moment.
Within minutes, the weight of the baby’s head was lifted from my fingers, and I could finally remove my hand, although it took a few moments to uncramp from the position it had been in for so long. I crawled off the table, my legs shaky beneath me as sweat dripped down every part of my body, and pulled off the gloves, tossing them in the trash.
Then, there was the cry, the sweetest sound in the entire world. It started out small, then grew stronger with each breath. I deeply hoped the meconium didn’t affect her too badly.
That sound was one of the reasons I loved this job so much.
“Great job, Scarlett,” Dr. Edmond said, glancing up from where he was delivering the placenta before going through the process of sewing the patient back up. Mrs. HW5 would probably have a hissy fit about the vertical scar, but it couldn’t be helped, and I hoped she would find beauty in it one day.
As I watched him stitch up the uterus that was still lying on the outside of the patient’s body, my hand went to my own scar, caressing the long line of puckered tissue that ran down my side.
Maybe I’d find beauty in my scar one day too.
CHAPTER TWO
Langston
“Langston, sweetheart, are you sure this is what you want to do?”
I looked into my mother’s honey-colored eyes and gave her a kiss on her soft cheek, inhaling the Clive Christian fragrance she favored. “Absolutely sure. The time will pass in a flash. I’ll call every week, I promise.”
She waved a hand in front of her face, as if she could wave the threatening tears back into her eye ducts, the growing pinkness from her nose. I bit back a groan and held the tiny but formidable woman to my chest. I loved my mother dearly and hated to see her genuinely sad.
I was a lucky son of a bitch. I’d hit the lottery at birth, had been given the golden ticket just by being born. Not just in wealth and privilege, but by also having a mother and father who adored me, who only wanted the best for me. And if they attempted to steer my life a little too much… it was a small price to pay to know that, no matter what, I was genuinely loved by at least a couple of people on the planet.
“I know,” she said with a delicate sniff as she reached into her sleeve for one of my grandmother’s antique handkerchiefs she kept there. “It’s just so surreal. You were away at school for so long, and then moved around so much. I thought for sure you’d finally move back home to take over your father’s practice. Then this…” She sniffed and blinked harder, but a tear escaped this time, sending a shot of guilt into my gut as she gently dabbed it away, careful not to distort the public persona she’d so carefully crafted over her fifty-eight years.
She was right. I had been away at school for a long time, but that had all been part of the master plan conceived by my parents long before my actual conception thirty-six years ago. To a letter, I’d followed their wishes. Well, for the most part, anyway. Four in the exclusive boarding school I’d been thrust into for my high school years. Then another four at my father’s alma mater, Columbia, then another four in medical school. That was followed by five incredibly grueling ones in the residency program, years that sleep deprivation had pretty much evaporated from my memory.
I only strayed from my parents’ path when I’d chosen a two-year fellowship in a busy inner-city trauma surgery program instead of quietly stepping into my father’s established New York City surgical practice. I wasn’t yet ready to deal with the cushy but sterile life of treating high society gallbladder attacks and appendectomies. I wanted more action. That was what I loved. Getting my hands dirty while patching people back up, pulling them back from the brink of death, and giving them a few more years on this earth while riding the high of a stress-induced adrenaline rush.
Following the fellowship, I’d spent the past couple years as locum tenens, floating around the country, practicing wherever I was needed, moving between inner city and remote rural as necessary. After spending my entire life in practically one place, I’d enjoyed the variety of different cities and towns, mountains and deserts — and the lovely ladies with different accents was a bonus, especially the southern ones. But it still wasn’t enough. I wanted to explore the country a bit before settling down on the East Coast permanently. I wasn’t ready to plant myself in any one place. When I was approached by Doctors Beyond Borders, I’d jumped at the chance to spend more
time away from familial obligations. Because I knew, once I took over my father’s practice, it would all be over.
The travel.
Freedom.
Flying under society’s radar.
All my life, I knew it was coming, but I’d hoped I would at least be forty before that noose slipped around my neck. At thirty-six, that deadline was looming close, then after that, there would be the pressures of settling down and continuing the family lineage, as my parents hadn’t been blessed with a spare to take that pressure off.
“I just miss you,” Mom said and straightened her face. “When I knew you were in the States, it was an easy flight to come visit. Now…” She shivered, and I knew she was envisioning wild animals and mosquitos and dirty conditions of living in huts with no running water. She wasn’t far off.
“Just think…” I said, trying to reassure her, “when I return after my time in Maiduguri, I’ll never want to leave the comfort of the carriage house again.”
Her eyes brightened, as I knew they would when talking about me actually having purchased a place in which to settle down, then she tapped her lips with a finger. I knew what was coming next. My mother, as delicate looking as she appeared, was a shrewd businesswoman and loved to “tinker” in real estate, as she called it, increasing her astounding inherited wealth exponentially over the past few decades.
“Are you quite sure you wouldn’t be happier with a Central Park view, darling? Sting’s penthouse is on the market and word on the street is that I could snap it up at fifty-two.”
It was hard not to roll my eyes. In my mother’s world, fifty-two million dollars was a bargain she could easily write a check for. I remembered how she’d just looked at me like I was some alien being zapped into her life when I purchased the 1903 carriage house and began the process of bringing the old building back to life. It wasn’t finished yet, but the contractor and decorator I hired came well recommended and promised to have it completed months before I returned from overseas.
“You should drop into the carriage house and see the work they’ve already done,” I said to distract her further. “They’ve pulled down the ceilings to find the most incredible beams. I can’t believe anyone in their right mind thought it was a good idea to plaster over them. And the floor will be the showcase of the entire building when they’re finished.”