Radclyffe - Crossroads

“Prep the belly for an emergency section.” Hollis rinsed fast and, water dripping from her elbows like a trail of tears, followed the nurse into the OR. Another nurse waited with an open gown, and Hollis pushed her arms down the sleeves and snapped on her gloves. Fixing on the square of pale skin hastily draped with green cotton towels, she stepped up to the table and held out her left hand. “Scalpel.”

The steel handle slapped sharply into her palm, and with her free hand she tensed the skin on the Betadine-coated belly above the top of the uterus. She opened a twelve-inch incision just above the pubic bone, cutting down in one long, deep slice through fat and muscle and peritoneum until the uterus appeared. “Get the suction ready.” The uterus extended up out of the pelvis, pushing aside the internal organs, claiming its place of primacy. She palpated it quickly and found the baby’s head, mentally positioning the rest of the body as it curled up in the muscular sac, thinking about small fingers and limbs just beneath the last layer of muscle. With the blade she made a small incision low in the uterus, handed off the knife, and said, “Scissors.”

The large instrument snapped into her hand, and she inserted the lower blade into the uterus, sliding it close to the underside of the muscle and away from the baby’s appendages. She cut, and amniotic fluid and blood gushed out onto the table, running over the sides and onto the booties covering her shoes. She slid her hand in, found the head, and delivered the infant on a sea of blood. The little girl was blue and flaccid.

“Suction,” Hollis said sharply. The nurse passed her a soft plastic tube, and she gently cleared the baby’s airway.

Time halted for those heart-stopping few seconds before the first breath. Hollis’s gut writhed. The baby shuddered, the small chest contracted…expanded, and then she cried. Loudly. Tiny fists closed, arms flailed, and she struck out at a universe that had so rudely claimed her. The red face below a surprisingly thick shock of golden hair was indignant. Hollis grinned behind her mask. A fighter, this one.

“Welcome to the world, baby girl.” Hollis clamped the cord, divided, and she handed the baby to the scrub nurse. “Pass the baby to the neonatologist. We’ve got bleeding here.”

Her job wasn’t done. The uterus was atonic—soft and spent, unable to contract and close off the multitude of gushing vessels within its walls. Blood welled up, filling the pelvis.

“Push the Pitocin.” While anesthesia administered drugs to help the uterus contract, Hollis packed the cavity, applied pressure, and evacuated the remains of the placenta. But the bleeding continued.

“I’m having a hard time maintaining her blood pressure,” the anesthesiologist reported, his voice strained with tension. “I’m hanging unit five. She’s tachycardic and starting to show some aberrant beats. I’m not liking this.”

Hollis checked the clock. She wasn’t liking it either. The bleeding should’ve slowed by now, but it kept on.

“Got a run of V-tach here, starting lidocaine,” the anesthesiologist called.

Hollis felt the uterus again. Still soft, blood pouring out and no sign of stopping.

“We need to take this out,” Hollis said and held out her hand. “Clamp.”

*

Annie awakened to an ocean of pain. She didn’t know where she was, only that she hurt. She reached for her belly, the automatic motion she’d made thousands of times in the last eight months. And then the memories of the last few hours came rushing back. She’d been studying when the pain started, waves of cramping, agonizing pain. Relentless pain, unending. And then the bleeding. So much bleeding, and the dizziness and the weakness, and the fear. All of that without warning. She’d been helpless, and alone. But she was used to being alone.

She forced her eyes open, forced herself to think beyond the panic and the pain. She was alone in a dimly lit room, nothing on the walls, plastic vertical blinds partially blocking a gray, overcast sky. A faint odor of drugs and death. Hospital.

She tried to sit up, and the pain rose from her belly and consumed her. She dropped back, whimpering softly. With her right hand she followed the plastic cord wrapped around the handrail, found the call button, and pushed it. A minute later a youngish woman in a blue and red floral smock and pale blue scrub pants came into the room.

“Hi,” the woman said softly. “You’re awake. Are you hurting, honey?”

“My baby. Where’s my baby?”

The woman leaned over, her face coming into view. A kind face. Dark eyes, a wide, smiling mouth. “Your daughter is in the neonatal intensive care unit. She’s doing fine, but she’s a preemie, and considering how she chose to get here, the neonatologist wants to keep her in there awhile.”

“She’s all right?”

The nurse nodded and readjusted Annie’s covers. “Someone will be in to talk to you about how she’s doing and to check you over soon. But the last I heard, she was stable and sleeping.”

“When can I see her?”

“In the morning. Do you need something for pain?”

“No. I don’t want any drugs—”

“Honey, you’ve had a big operation. You’re going to need—”

“I’m fine. I don’t want any. Thank you.”

“All right. If you change your mind, just ring the bell.”

“Yes, thank you.” Annie closed her eyes, too tired to protest. The baby, her daughter, was going to be all right. Nothing else mattered.

She drifted until the sound of the door opening and closing roused her. With awareness came pain, a pattern she’d grown used to.

“Are you awake?” a deep, gentle voice inquired.

Annie opened her eyes. A black-haired woman in green scrubs leaned over her, both hands braced on the side rail. Her deep blue eyes were steady, piercing, unnerving in their focus. She looked tired—smudges of fatigue darkened the lids above sharp cheekbones. But even fatigued, she radiated strength.

“I…I…remember you. You were in the emergency room,” Annie said.

“Yes. I’m Dr. Monroe, the obstetrician. I delivered your baby. She’s beautiful. Green eyes like yours.”

Annie smiled. “The nurses said she’s all right. Is that true?”

“Yes. No one here will lie to you.”

“Everyone lies,” Annie said softly.

The doctor’s dark eyes flashed, but she said nothing. Annie was too weary and in too much pain to care that she might have offended her.

“There’s something you need to know, Ms. Colfax,” the doctor said. “You had what we call an abruption—the placenta separated from the wall of the uterus, causing you to hemorrhage and endangering the baby.”

Annie’s pulse tripped, stuttered, and started again. “I thought you said the baby was all right.”

“She is. She isn’t as close to term as we’d like, so she’s being monitored for any signs of immaturity.”

“I wanted to wait. To be sure she would be safe.” Annie’s chest tightened. Why wouldn’t anyone listen? Why must she always fight to be heard?

“I understand, but that wasn’t possible.” Hollis stifled her impatience. She understood women wanting to deliver vaginally, to be alert and aware so they could remember the birth, but sometimes safety—the mother’s and the child’s—was more important.

“But you said she’s all right…”

“She is. And you will be too.” Hollis looked into Annie’s eyes—the green verged on black, her irises almost eclipsed by her pupils. “How much pain are you having? I ordered morphine, but—”

“I’m all right. Tell me.”

“I had to do more surgery in order to stop the bleeding.”

A chill settled in Annie’s depths. “More surgery?”