Safe in His Hands

by Amy Ruttan

  Dr. Richards was shocked. A small smile even cracked her usually serious facade. “It’s not that I question your skill and value as a physician, Dr. James. I have spent a lot of time with you in the lab and am vastly impressed with your handling of instruments. You have the skills of a surgeon, but I’m concerned about your familiarity with the patient.”

  “What do you mean?” Charlotte asked.

  “There’s a reason physicians don’t operate on family members, whether blood or a close bond.”

  “And your point?”

  Dr. Richards’s eyes narrowed. “I don’t think you will act rationally in there. With myself, Dr. Devlyn and Dr. Patterson, I think Mrs. Tikivik will do just fine.”

  Charlotte gripped the edge of the conference table, her stomach lurching with a wave of nausea. “I understand your concern, Dr. Richards. Yes, I will admit I have a close relationship with my patient, but I can assure you I will not be irrational. Are you from Nunavut originally, Dr. Richards?”

  “I don’t understand the point of the question. What does that have to do with this situation?”

  “A lot, in fact,” Dr. Patterson interjected. He sent Charlotte an encouraging look. “I think I understand what Dr. James is getting at.”

  “Well, I don’t.”

  “Just answer it,” Quinn said.

  “No. I’m not from here. I’m from Vancouver.”

  “People in remote communities can be very untrusting of strangers. This territory is very close-knit, given its vastness. I’ve know the Tikiviks for a long time and they trust me. If you try to remove me from the O.R., it will only upset Mrs. Tikivik, possibly putting her into distress.”

  “Dr. James is correct. And Mrs. Tikivik is very...strong-willed,” Quinn said delicately, though a hint of a smile played on his lips. “I need Dr. James to assist me. I’ve known her for a long time, too, and I value her skills. Dr. Richards, you are needed to monitor the fetus and take care of the child if an EXIT procedure is required. Dr. Patterson’s main concern is the health of the mother.”

  Dr. Richards assessed Charlotte. “Your points are valid. You’ve swayed me and I concur.”

  Quinn sent a glance that conveyed his relief. Charlotte nodded and pulled out another cracker, shoving it into her mouth as Dr. Richards flipped open her notebook.

  “Now, can we discuss the real reason we’re here?” Quinn clicked on his slide show and the large screen in the boardroom lit up with sonograms of the fetus. “The fetus is at a gestational age of thirty weeks and, as you can tell, the lesion has grown.” Quinn used a pointer to indicate the lesion. “The fetus will develop hydrops soon.”

  “And given Mrs. Tikivik is already a high-risk candidate, I have no doubt she’ll develop mirror syndrome, which will quickly escalate into fatal pre-eclampsia,” Dr. Patterson added.

  “What’re you suggesting, Dr. Devlyn?” Dr. Richards asked.

  “We need to perform a fetal resection today.”

  “And that is the best course of action?” Charlotte asked. “It won’t tax Mentlana, having two C-sections so close together?”

  “It’s the best option, Dr. James,” Quinn said seriously. “The fetus will feel nothing and will have the benefit of his mother’s blood supply from the placenta, a chance to heal in the womb and to let the lungs develop more. Mentlana will have to remain in Iqaluit and be monitored for preterm labor.”

  Charlotte nodded. “I’ll inform my patient.”

  Quinn turned to Dr. Patterson. “We need an O.R. prepped.”

  “We’ll have one ready within the hour. The longer we wait, the greater the risk her blood pressure will climb.” Dr. Patterson stood.

  Charlotte got up and left the boardroom. Her heart was pounding and it felt like it was going to burst out of her chest.

  You can do this. I know you can.

  She could, and she would for Mentlana. She paused at the door to Mentlana’s room and saw she was alone, staring at the wall. The room was still dark, but Genen and Lorna were no longer there.

  When Charlotte entered the room, Mentlana looked at her, her face drawn and all the apprehension her friend had been trying to hide finally bubbling to the surface.

  “Hey, Charley.” Mentlana’s voice wavered. “What’s the verdict?”

  “Where’s Genen?” Charlotte asked, sitting on the edge of the bed.

  “I sent him to get breakfast. Someone had to eat something around here.”

  Charlotte nodded. “You’ll be able to eat soon.”

  Mentlana inhaled, her hand shaking in Charlotte’s. “Tell me.”

  “Do you want to wait for Genen?”

  “No. Tell me.”

  “The lesion has grown quite a bit since the last sonogram. The baby is at risk of developing heart failure and you are at risk of developing pre-eclampsia, which is fatal.”

  Two big fat tears rolled down Mentlana’s cheeks. “Oh, God.”

  “We’re going to do a fetal resection of the CCAM.”

  “What does that mean?”

  “We’re going to do something similar to a C-section but not deliver the baby. We’ll partially delivery him, repair the lesion and place him back in your womb.”

  “Why don’t you deliver him?”

  “The idea is to try and keep him in there for as long as possible, until he’s full term and we deliver him via C-section.”

  Mentlana’s face paled. “That’s the best course?”

  Charlotte nodded. “Yes.”

  “Will the baby feel pain?”

  “No.” Charlotte squeezed Mentlana’s hand. “This is the best course of action. Trust me.”

  “I do. You’ll be there, right?”

  “Yes. I will.” Charlotte stood. “I know this is a lot to take in. Two C-sections are not ideal close together, but your baby has a better chance of survival this way.”

  Mentlana sighed and closed her eyes. “I’ll face whatever I have to, to have my child.”

  “I know. I admire you for that.”

  Mentlana opened her eyes. “You will, too, when the time comes.”

  Charlotte nodded. She was beginning to believe it, but Mentlana was still something amazing and special to her. “I know physicians aren’t supposed to say this to their patients, but I love you.”

  Mentlana grinned. “I love you, too. I’m glad you’re here.”

  Charlotte hugged her, tears flowing. “Oh, dammit, stupid pregnancy hormones.”

  Mentlana laughed and brushed away her own tears. “I like seeing this side of you, Charley.”

  “What side?”

  “The non-obstinate one.”

  Charlotte just shook her head. “I’ll find Genen for you.”

  “Thanks, Charley.”

  Charlotte nodded and left the room. She didn’t care who saw her tears, even Dr. Richards. She was done hiding her emotions.

  * * *

  She was done being obstinate.

  CHAPTER SEVENTEEN

  CHARLOTTE WATCHED QUINN scrubbing up. They were alone for the first time since she’d decided to tell him she was pregnant. She prayed she was doing the right thing, telling him before the surgery, but she couldn’t keep it in any longer. She had to tell him.

  “How are you feeling?” she asked, cautiously.

  “Nervous, but I’m confident.”

  “The only fear is fear itself.” She was quoting something her father had always said to her when she’d been hesitant to try new things as a child.

  “Easy for you to say.” He gave her a half smile, teasing her.

  “I’m afraid of other things, but I’m willing to face the thing that terrifies me the most.”

  “What?”

  “I’m afraid of carrying another child, Quinn.�
�� Tears stung her eyes. “I’d never thought of becoming a mother again, but I watched Mentlana and her trials and tribulations to have one. She was so brave, but for me the idea hurt too much. I’m still terrified, but I’ll face the fear of losing it again because it’s what I want.”

  Quinn’s eyes widened, and he paused in scrubbing. “You’re pregnant?”

  Charlotte nodded and her knees began to knock. “I’m not telling you this to force something from you. I can do this on my own. I want this. I just... You have the right to know.”

  Quinn remained frozen. “I don’t know what to say.”

  “There’s nothing to say, Quinn. You don’t have to be a part of it.”

  “Thank you for letting me know. It’s a lot to process.”

  “I know you’re not thrilled—”

  “Who says I’m not?” Quinn interrupted.

  Charlotte sighed. “You weren’t exactly over the moon last time. You were relieved when I lost it.”

  Quinn shook his head. “No, not at all. I was just as hurt as you were. I was trying to ease your pain my stupid foot-in-mouth way by hiding it. I thought by telling you about a great medical opportunity you would follow me, but I thought you were blaming me for the loss of our baby and that you hated me.”

  Charlotte felt the blood drain from her face. “I...I don’t know what to say.”

  “Charlotte, you want to know my fear?”

  “Of course.”

  “I was afraid of being a father. I didn’t have the best role model to base any experience on. I was afraid of screwing up our child’s life.”

  “Excuse me, Dr. Devlyn?” A nurse from the O.R. appeared. “We’re ready for you to go over the instruments with the scrub nurse.”

  Quinn nodded. “Thank you.”

  The nurse disappeared and Quinn shook the water off his hands. “We’ll talk about this later, Charlotte.”

  Charlotte nodded. “Of course.”

  He disappeared into the O.R. and she felt like she was going to faint. She felt relieved and over-the-moon happy. He’d mourned the loss of their first child just as keenly as she had.

  Yes, she’d carry this child, no matter what the outcome. She wanted this baby.

  Badly.

  * * *

  Quinn stood by the surgical table in the operating room. He was scrubbed in and ready to go. Mentlana hadn’t been brought in yet, but he knew they were prepping her.

  It’d been a long time since he’d been in this position. He stared at the surgical tools on the tray in front of him. Tools he was all too familiar with. He knew every nuance of them, how they functioned and at what step in the procedure he would need them, but still replayed it over and over again in his mind.

  It was a way to calm and reassure himself he was capable of doing the surgery.

  Steady. Just count.

  He focused on the instruments—the scalpel, the sutures, the small, delicate tools he’d need to operate on such a fragile being. He flexed his fingers in the glove. There was no pain, just a bit of numbness.

  Steady.

  He took a deep breath. The room was chilly and the antiseptic smell calmed him. The nurses were shuffling around the room, doing their own counting as they set up the instruments, and that was reassuring.

  Everything is going to be okay. I can do this.

  Quinn closed his eyes and replayed in his mind the last fetal resection he’d done. The one he’d done before his accident. The baby was a healthy, thriving toddler now. Just like Mentlana’s would be in a year’s time.

  When he thought of babies, though, his mind went to the one Charlotte was carrying. He smiled, though no one could see it behind the surgical mask. What if Charlotte was going to be on this table and it was their child’s life in another surgeon’s hands or his own? How would he deal with it? He had to be at the top of his game. He wouldn’t let Genen down.

  This baby was going to survive. His hand wasn’t going to spasm.

  I will succeed.

  “Are you all right, Dr. Devlyn?” the scrub nurse asked cautiously, as she began to lay out the instruments in order.

  “I am, thank you...”

  “Bernice.”

  “Bernice. Good. I do like to know the name of my scrub nurse. Have you attended a surgery like this before?”

  The nurse nodded. “At SickKids in Toronto.”

  Quinn’s eyes widened. “This isn’t where you work?”

  Bernice shook her head. “No. I’m from Toronto and came as a favor to Dr. James. She said you needed a scrub nurse who’d assisted surgeons in this procedure before.”

  Quinn exhaled, relief oozing out of his very pores as the tension in his shoulders dissipated and he loosened up. Charlotte had done this for him? Any lingering concern he had vanished in that moment. With a good scrub nurse he’d be able to focus on the task at hand and not worry about instructing some other nurse on what he needed and when. Bernice would instinctively know what to hand him at each stage.

  “I could kiss Dr. James right about now. I’d kiss you, too.”

  “You can’t tamper with the sterilized field, Dr. Devlyn.” Bernice chuckled, her eyes twinkling above her surgical mask. “I really don’t fancy scrubbing in again, but I do appreciate your enthusiasm for my presence.” Bernice moved off to continue her preparations.

  I can do this.

  The doors to the operating room slid open and Dr. Patterson entered the room. The nurses slipped on his gloves and Quinn nodded in greeting to the obstetrician.

  Ready to do this again.

  * * *

  “It’s time.” Charlotte stepped aside as the orderlies wheeled the gurney in the room. Genen looked nauseous and worried. It broke Charlotte’s heart, but she couldn’t let her emotions take hold of her right now. At least her own nausea had subsided, thanks to some Diclectin that Dr. Patterson had given her a few hours ago when she’d approached him about morning sickness. Each pregnancy was supposed to be different, but again she was being plagued with horrible morning sickness. You’d think the odds would be in her favor.

  Of course, she didn’t want to think about the odds right now. If she did she’d only dwell on the statistics, which weren’t in Mentlana’s favor right now. Charlotte took a deep breath, trying to take Lorna’s advice to heart. She was trying not to worry about a bad outcome, and to think on a good one. Though it was hard to break a habit of a lifetime when you kept getting dealt a rotten hand most of the time, and had to work for every little thing.

  Mentlana and her baby would survive.

  She had to believe it. For the first time in her life she had to believe in more than medical science. She had to put her trust and her hope in faith.

  Mentlana and Genen kissed, which tugged at her heartstrings. The orderlies lifted Mentlana onto the gurney while her nurses began to hang the IV bags and catheter.

  “Genen, you can walk us down the hall,” Charlotte offered. “But because she’s going under general anaesthesia, you can’t come into the theater.”

  “I want to be with her,” Genen protested.

  “I know you do, but you can’t. When we deliver the baby at the end of her pregnancy, you can. She’ll have a spinal then and be wide awake. Trust me. It’s for the best you wait out here, Genen.”

  Genen nodded and held tightly to Mentlana’s hand as the orderlies wheeled the gurney out of the room. Charlotte followed beside them as they whisked Mentlana off to the operating suites. They stopped at the double doors and Charlotte moved away, pulling Genen to the side as Mentlana disappeared.

  “You can’t go any farther, Genen. I’m sorry.”

  Genen was visibly shaking, his dark eyes moist with tears. “Please, take care of her, Doc.”

  “Of course I will...I promise.” Although she never pro
mised any patient, the words just slipped past her lips and she prayed that she’d be able to honor that promise.

  Genen nodded and Charlotte went through the double doors into the surgical suites. Her stomach twisted in a knot as she tied back her hair and scrubbed her hands. Through the window she could see Mentlana was already laid out on the table, the lights dimmed save for the bright surgical light.

  Mentlana’s face was pale as she stared at the ceiling, terrified. Charlotte glanced at Quinn, who appeared calm as he chatted to the scrub nurse from SickKids.

  Bernice was an old friend and a bit of a present from Dr. Harriet Preston, who’d suggested Charlotte call Quinn when she’d first discovered the lesions on Mentlana’s fetus.

  “You know who the best in that field is, Charley. I don’t have to tell you.”

  She hadn’t wanted to call Quinn, but Harriet had been right. He was the best and now she was so glad she’d screwed up her courage and called him.

  Once she’d finished scrubbing, she entered the O.R. and was gloved. She headed over to Mentlana’s side.

  “It’s going to be okay, Lana.”

  “Charley?” There was relief in her voice. “Is Genen okay?”

  “He’s fine.”

  “Good.” Dr. Patterson began to wash Mentlana’s swollen abdomen with Betadine. “Ugh, what’s he doing down there, painting a fence or something?”

  Dr. Patterson chuckled. “I’m quite adept at fence-painting, too, Mrs. Tikivik, though don’t tell my wife.”

  “I like you, Dr. Patterson.” Mentlana grinned, but her lips quivered. “I’m scared, Charley, so scared.”

  “It’ll be okay, Lana. I promise.”

  “What if...?” Mentlana trailed off and then shook her head.

  “No what-ifs. It’ll be okay. Trust me.”

  Mentlana nodded. “I do. I trust you with every fiber of my being and I trust Dr. Devlyn because you do. You do trust him, don’t you, Charley?”

  “I do. He’s the best.”

  Mentlana sighed. “I’m ready.”