Radclyffe - Crossroads

Hollis cut around all of them as if she were still running track and dodging runners ahead of her. She held her stethoscope to her chest with one hand to keep it from banging her in the face and mentally ran the list of what she’d need to check on a third-trimester patient bleeding out. She hit the button for the automatic doors to the ER on the run and barely slowed as they lumbered open, squeezing through the narrow gap without breaking stride. A blonde in her mid-thirties wearing a Scooby-Doo smock looked up from the centrally located nurses’ station with a startled expression. Hollis called, “OB emergency?”

“End of the hall—cubicle ten,” the blonde said, pointing to the left-hand corridor in the T-shaped ER.

“Thanks…Linda.” Hollis hoped she’d gotten the name right and swerved around a couple of wheelchairs angled together, as if their invisible occupants were having a late-night conversation, and sprinted the short distance to room ten. A crash cart surrounded by resuscitation litter stood in front of the brightly lit space. Plastic IV bag wrappers, multicolored intravenous catheter caps, the tail end of a spool of EKG paper, and a deflated BP cuff marked the site of the action. A cacophony of voices reached her as she drew near.

Hang another unit…

Fetal heart tones are dropping…

BP’s crashing…

Where is OB?

“Right here.” Hollis skidded to a halt at the foot of the stretcher. She’d known what to expect—she was a brand-new attending, but this wasn’t her first rodeo either. Still, the chaos rocked her for a millisecond. The adrenaline surge made her vision swim, and then her focus kicked in. The analytical part of her brain took the wheel and she settled into the zone. One quick scan told her all she needed to know. The blue plastic-backed chucks under the woman’s hips, designed to keep her and the mattress dry, had long since reached their capacity. The white sheets under her parted legs were crimson. Blood dripped in fat red splatters onto the floor, making delicate snowflake patterns as it congealed.

Honor Blake said, “The ultrasound shows—”

“It’s an abruption,” Hollis said, pressing through the nurses and techs congregated around the stretcher to get up to the patient. Couldn’t be anything else, not with that much blood, but she grabbed the ultrasound printout just to confirm. Yeah, there it was—the placenta had torn away from the uterine wall, leaving a latticework of enlarged vessels wide open to pour out blood. “How much blood has she had?”

Honor wasn’t fazed by the obstetrician’s overbearing manner. Her spouse was a surgeon, and trauma or ortho or obstetrics, it didn’t matter—surgeons were all gunslingers with a touch of God complex. Maybe you had to be to cut into a living being with absolute confidence. This one was new, but by all reports, Monroe had a quick mind and quicker hands. Not much on sociability. Typical surgeon. “We’re on our third unit. The blood bank is sending another four upstairs to L and D.”

“Good.” Hollis assessed the mound of pale belly ribboned with delicate blue veins exposed where the white cotton sheet had been pulled aside. Above, the full breasts were capped with swollen chocolate nipples. She ran her hand over the distended abdomen. The uterus was a rock. A rock filled with blood and a baby who was going to be in trouble soon. “What do we know?”

“She’s in and out. History is scant. Twenty-four years old, prime ip, not much else.”

First pregnancy—always a bit unpredictable. Thirty-four weeks looked about right for her size—not dangerously premature if she delivered the baby now, but still, the baby would be at risk for pulmonary insufficiency and neuro complications. Couldn’t be helped, though—the mother was gushing blood faster than the nurses could pump it into her. “Any prenatal issues?”

“We don’t have records,” Honor said.

“Coags?” Women with abruptio placenta often developed bleeding disorders, and that spelled major trouble in the OR.

“Not back yet. But she’s clotting.”

“For now.” Hollis moved to the head of the stretcher. The dazed young woman looked younger than twenty-four, and pale to the point of translucency, her golden brown hair framing a finely etched face with luminous green eyes and lips that were still full and sensuous despite being nearly drained of color. “I’m Dr. Monroe. What’s your name?”

“Annie.” Lids tinged with gray shuttered closed. “Colfax.”

“Annie,” Hollis said gently, “when did you start bleeding?”

“An…hour…not sure. Can I have some water?”

“I’m sorry, no.”

“What about my baby?”

“You’re having quite a bit of bleeding and we’re going to need to operate. The baby needs to come out and we need to get the bleeding stopped.”

Eyes the color of spring grass—now surprisingly clear, considering her blood pressure was only sixty and she had to be scared out of her mind—opened wide and fixed on her face. “It’s too soon for the baby. I want to wait.”

Hollis bit off a retort. She didn’t have time to argue, but the young woman’s voice was strong. She was competent to decide. “I don’t think you can wait. You’re losing blood and the baby will suffer for it.”

“Just a little more time.”

“Look, is there someone with you or someone I can call? Spouse? A boyfriend?”

“No.”

“How about a family member we can—”

“No,” Annie said quite distinctly. “There is no one.”

No one. No friend? No lover? No family at all? The patient didn’t look like a street person or some paranoid dropout likely to be living off the grid, but Hollis didn’t have time to speculate on why Annie Colfax was alone during one of the critical moments of her life. “Okay, Annie—we don’t have time for much discussion. The baby’s at risk. So are you. You need a C-sectio—”

“No. No surgery.”

Hollis clamped down on a flare of temper. “We don’t have any choice, you—”

“No. Don’t believe…” Annie’s voice faded and her chin sagged.

“Pressure’s fifty palp,” a nurse announced. “Fetal heart tones are slowing.”

“We need to move here,” Honor said from next to Hollis. “I can try for a court order, but it’ll take time.”

“Goddamn it.” Hollis gripped Annie’s shoulder. “Annie. Annie! Look at me.”

Annie blinked, focused.

“If you don’t let me operate, your baby is going to die. You might too. Do you understand? You have to trust me on this, Annie.”

Annie was silent, searching Hollis’s face.

“Trust me,” Hollis said fiercely.

“No choice,” Annie murmured, a flat, dead patina stealing over her eyes. “Go ahead.”

Hollis turned to Honor, a flash of triumph and anticipation energizing her. Now she could take care of things. “Let’s go.”

Hollis grabbed one side of the stretcher and Honor took the other. Honor called, “Coming through. Get the elevator.”

Together they maneuvered the stretcher out of the cubicle and into the hall. One of the nurses raced ahead to get the doors. The elevator was waiting.

Two minutes later Hollis guided the stretcher into the delivery area where anesthesia and the labor and delivery nurses took over. Hollis went to scrub. Trust me , she’d said, and she knew what she was asking. Place your life and the life of your baby in my hands. Trust that I’ll know what to do to keep you both safe. The responsibility was enormous and everything she wanted. All she wanted.

The swinging door to the delivery room banged open and one of the nurses leaned out. “She’s crashing, Dr. Monroe. We need you in here now.”