Mixed Blessings

by Danielle Steel

  “How’re we doing here?” he asked Pilar with a cheerful smile.

  “Like shit,” she said, and suddenly she wanted to throw up. She retched with each pain, and all the other miseries were still going on, and with each contraction, she felt more pressure, and an ever greater urge to push down. Maybe she was getting to the pushing stage, she thought hopefully, maybe that was what she felt, maybe this was the worst of it and it was almost over by now, but when she asked the nurse, she said that pushing was still a long way off. This was only the beginning.

  “Drugs,” she croaked when the doctor came closer to her head again. She could hardly even speak now, she was in such anguish. “I want drugs.”

  “We’ll talk about that in a while.” He put her off, and she started crying again as she grabbed at the doctor’s sleeve.

  “I want them now,” she said, struggling to sit up, but the monitor held her down, and so did the next pain, which left her clutching Brad’s hand. “Oh, God … listen to me … somebody listen to me …”

  “I’m listening, sweetheart,” Brad said. But she could hardly see him. There were so many people in the room, and there was so much going on. How had all of it gotten so out of hand, and why weren’t they listening to her? All she could do was lie there and sob between contractions, when she wasn’t screaming.

  “Make them do something … please … make it stop …”

  “I know, baby … I know …” But he didn’t know. And he was beginning to regret the whole thing. All the hormones and the drugs, and the trips to Dr. Ward’s, and this was what it had brought her. It agonized him to see her in such pain, and he couldn’t do anything to help her. He had never felt so useless.

  “I want her in the delivery room,” the second obstetrician said to Dr. Parker. “If we need to section her, I want to be ready to go.”

  “That makes sense,” Pilar’s doctor agreed, and suddenly there was even more action in the room, more people, more machines, and for Pilar more exams, and more contractions.

  They rolled her gurney down the hall, though she begged them to stop and move her while she was between pains, but they wanted to get her set up as quickly as possible. According to what the doctor told Brad, things were moving very fast now, and they wanted to be ready. They had to think of the babies’ safety, and not their mother’s comfort. It was one o’clock in the morning by then, and Brad felt as though they had been there forever.

  In the delivery room, they switched her from the gurney to the delivery table, put her legs in stirrups, covered them in drapes, tied down her arms, and switched the IV to her arm, and she complained bitterly about her position between contractions. She said her back and neck were breaking, but no one was listening to her for a moment. They were far more engaged in other things. There were three pediatricians in the room by then, several residents, a fleet of nurses, and both her doctors.

  “God,” she said hoarsely to Brad between pains, “what are we doing? Selling tickets?” The monitor was still on, and someone seemed to be checking her cervix each time she breathed. According to the nurse, she was at ten, which meant she was ten centimeters dilated and could push now.

  “Okay,” everyone cheered, but Pilar didn’t care, and it was obvious to her they weren’t going to give her drugs now.

  “Why can’t I have anything?” she whined.

  “Because it’s not good for your babies,” one of the nurses said firmly.

  But a minute later Pilar couldn’t ask for anything, because she was in so much pain, and she had started pushing.

  It looked nightmarish to Brad as he watched, they shouted, she pushed, then screamed, and almost the moment the pain ended, it began again, and they began shouting, and she was screaming. He couldn’t understand why they didn’t give her anything for the pain, except that the doctor kept insisting it would depress the babies.

  It seemed hours that she pushed and nothing came. And when Brad looked at the clock, he couldn’t believe that it was almost four o’clock in the morning. He wondered how much more she could take before she became completely incoherent from what they were doing. And then suddenly there was fresh excitement. Two isolettes appeared, and the circle of masked faces drew closer. Pilar seemed to scream endlessly, it was a long endless wail that had no end and no beginning, and then suddenly everyone was shouting, urging, encouraging, and he saw the head of the first baby, pushing its way into the world, his long, slow wail matching his mother’s.

  “It’s a boy!” the doctor said, and Brad was instantly worried by his bluish color, but the nurse said not to worry, and a minute later, he looked better. They held him out to Pilar for a moment to see, but she was too exhausted to pay much attention. Her pains were continuing as before, and the doctor had to use forceps to move the next baby into a better position. Brad couldn’t look at what they did to her, he only prayed as he held her hands in a death grip that she’d survive it.

  “Hang in, sweetheart … it’ll all be over soon …” He hoped that he wasn’t lying to her, but he had no idea, and she just cried as he held her.

  “Oh, Brad … it’s so awful …”

  “I know … I know … it’s almost over …” But this baby was even more stubborn than the first, and at five o’clock he saw the two doctors conferring.

  “We may have to do a cesarean if the girl doesn’t come out quickly,” they explained to Brad a few minutes later.

  “Would that be easier for her?” he asked quietly, hoping she couldn’t hear him. But she was in such pain, and pushing so hard, that she wasn’t listening to what anyone was saying.

  “It might be. She’d have general anesthesia, of course, we couldn’t possibly get an epidural into her now, but it would also be a double whammy for her, a vaginal birth with an episiotomy, and a section. Not an easy recovery. It all depends on what the baby does in the next few minutes.” The first one had already been checked, and was in an isolette, wailing loudly.

  “I don’t care what you do,” Brad said distractedly. “Just do what’s best, and easiest for her.”

  “I want to try to get the baby out vaginally first,” the doctor said, and went at her again with forceps. He worked and pushed and squeezed, and just when they were about to give up, the baby moved, and slowly began moving down between her mother’s legs. It was six o’clock by then, and Pilar was barely conscious, and then suddenly she was there, a sweet little face, she was a tiny little baby. This baby was half her brother’s size, and she looked around worriedly, as though searching for her mother. And almost as though she sensed it, Pilar raised her head and saw her.

  “Oh, she’s so beautiful,” she said, and then dropped her head back again, smiling at Brad through her tears. It had been excruciating, but it was worth it. She had two beautiful babies, and as she lay and looked at him, two nurses took the baby away the moment the cord was cut, and they laid her in the second isolette for the pediatrician to check her further. But this time, they heard no further cry, and suddenly the room was very quiet.

  “Is she okay?” Pilar asked anyone who’d listen to her, but suddenly everyone was very busy. Brad could see his son in his isolette in a corner of the delivery room, with two nurses watching him kick his legs and flail miserably, looking for some comfort. But he couldn’t see his daughter, and he took a step away from where Pilar lay so as to see her better. And then he saw them suctioning her desperately, and trying to breathe for her. A doctor was giving artificial respiration, and then compressing her tiny chest, but the baby lay still now. She was gone, and nothing they did revived her. Brad looked in shocked horror at the doctor’s face, and Pilar lay on the gurney just behind him asking questions. He almost felt his heart stop. What in God’s name could he tell her?

  “Are they okay? Brad?… I can’t hear the babies …”

  “They’re fine,” he said numbly, as someone gave Pilar a shot. It seemed a little after the fact, but she was instantly woozy and half asleep, and Brad looked at the doctor standing before him.
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br />   “What happened?” he asked numbly. It had been a grim experience, and even his son’s birth was barely consolation.

  “It’s hard to say. She was very small. We think she lost a lot of blood to her brother. They call it twin to twin transfusion. It weakened her, and then she just couldn’t breathe on her own. Undeveloped lungs, I suspect, and too small to survive so much trauma. Maybe I should have sectioned her,” he said miserably, and Brad turned to look at his wife peacefully sleeping in the delivery room, drugged at last, oblivious to what had just happened, and he couldn’t begin to imagine what he was going to tell her. So much joy had turned to agony so quickly.

  But the pediatricians all agreed with the obstetrician, there was clearly something wrong with the baby’s lungs, which no one had known, or suspected. Her heartbeat had been steady during the delivery, but having lost blood to her twin, she was simply unable to survive out of the womb, without her mother. They had done everything they possibly could to revive her.

  Brad knew all the facts. But it was still impossible to understand why it had happened. And as Pilar was wheeled away to the recovery room, Brad stood looking at his little girl, as tears crept down his cheeks. She looked so sweet and so perfect. She was as beautiful as she had been when she was born, and now she looked as though she were sleeping.

  Her brother was crying unhappily, as though sensing that something had gone wrong. He was so used to being close to her, to kicking her, to being with her, and suddenly she was gone, as was their mother.

  Without thinking, Brad reached a hand into the isolette and felt her. She was still warm, and he stood staring at her, wanting to hold her. What would he tell Pilar? What could he say? How could he tell her one of them had died? She would wake expecting to find two miracles, and instead she would find she’d been stricken with a tragedy in a single moment. It was a cruel joke to have played on them, and he stood for a long time, looking at what seemed to be their sleeping baby.

  “Mr. Coleman,” a nurse said gently. They wanted to take the dead baby away. And someone was about to tell him that arrangements had to be made. They would have to make burial arrangements for their baby. “Your wife is awake, if you’d like to see her.”

  “Thank you,” he said, looking gray. He touched the tiny hand again, and then left her, somehow feeling that he shouldn’t, that she still needed him, but of course, she didn’t. “How is my wife?” he asked the nurse, as he finally followed her to the recovery room, looking bleak.

  “Feeling better than she was a little while ago.” The nurse smiled. But not for long, Brad thought, as he tried to sort out his feelings.

  “Where are they?” she said weakly, when she saw him. She had lost a lot of blood, and been through so much pain, and now she would have to be stronger than she ever had before. He almost couldn’t bear it. And there were tears in his eyes when he looked at her.

  “I love you so much, and you were so brave,” he said, trying to fight back tears unsuccessfully, wishing things were different and not wanting to scare her.

  “Where are the babies?” she asked again.

  “They’re still in the delivery room,” he said, lying to her for the first time in their life together, but he knew he had to. She didn’t have to know yet, it was too cruel to have seen that tiny angel’s face and then learn that she was gone so swiftly. Her brother looked so much sturdier, so much better prepared for life than his sister. “They’ll be out soon.” Brad lied again, and she drifted off to sleep.

  But there was no hiding the truth from her the next morning. The doctor came in to tell her with Brad, and for a moment, Brad thought the shock was going to kill her. She grew deathly pale and closed her eyes, and for a moment she swooned as she sat in her bed, and Brad reached out and caught her.

  “No … tell me that’s not true!” She screamed at him, “You’re lying!” She screamed at her husband and the doctor. The doctor had actually said the words, and he had told her very simply. Her baby girl had died shortly after birth, from blood loss to her twin in twin to twin transfusion, complicated by undeveloped lungs. She simply could not have survived, he told her.

  “That’s not true!” She screamed hysterically. “You killed her! I saw her! She was alive … she looked at me …

  “Yes, she did look at you, Mrs. Coleman,” he said sadly. “But she never began adequately breathing. She never took a full breath. She never cried, and we did everything we could to save her.”

  “I want to see her,” Pilar said, sobbing, and she tried to climb out of bed, but she found she was so weak, she couldn’t. “I want to see her now. Where is she?” The two men exchanged glances, but the doctor was not against showing Pilar the child. They had done that many times before, sometimes it helped a family to see the child, and say good-bye. The baby was downstairs in the morgue, waiting for burial, but there was no reason why her mother couldn’t see her. “I want you to take me to her.”

  “We’ll bring her to a room in a little while,” he said very gently, as Pilar leaned against her husband, sobbing and trying to absorb what had just happened. She had been so happy the night before, even for a moment, even as hideous as it had been, and now she was gone. She hadn’t even gotten to hold her. “Would you like to see your son now?”

  She started to shake her head, but then she looked at Brad and nodded. He looked so devastated, he was so overwhelmed by what happened to them, she knew she had no right to make it worse, but all she wanted to do was die, and join her baby.

  “We’ll bring him in,” the doctor said, and returned a moment later with her strapping son. He weighed nine pounds, which was enormous for a twin. But his tiny sister had weighed less than four. He had gotten everything he needed to survive, at her expense, and she hadn’t gotten enough. It had been a classic case of survival of the fittest.

  “He’s beautiful, isn’t he?” she said sadly, almost as though he weren’t there, and she didn’t reach out her arms to hold him. She just sat staring at him, wondering why he had lived and his twin sister hadn’t. Brad held him as they both looked at him, and then he placed him gently in his mother’s arms, and she cried copiously as she kissed him.

  And when at last the nurse took him away, she asked again to see her daughter.

  They took her in a wheelchair to a room downstairs, it was an empty room, and it was very cool, and everything about it was bleak and sterile. And a moment later they brought her in, still in her isolette, tightly wrapped in her blanket, her tiny face so sweet, so pure, she still looked to Brad as though she were sleeping.

  “I want to hold her,” she said to him, and he reached in carefully and placed her in her mother’s arms, where she had never yet been, and Pilar sat quietly as she held her. She touched her eyes, her mouth, her cheeks, the tiny hands with her lips, and kissed each tiny finger, as though she hoped to breathe life into her. As though she could change what had happened the night before, because she couldn’t accept it.

  “I love you,” she whispered softly to her, “I always will. I loved you before you were born, and I love you now, sweet baby.”

  She looked up at Brad then, and saw that he was crying uncontrollably, he just stood and shook with grief as he watched Pilar hold the baby. “I’m so sorry …” he said to her. “I’m so sorry …”

  “I want to name her Grace,” Pilar said quietly, and gently touched his hand. “Grace Elizabeth Coleman.” Elizabeth for her mother. Somehow that seemed right now. And all Brad could do was nod. He couldn’t bear the thought that in the midst of so much joy, now they had to bury this baby.

  Pilar sat for a long time, just holding her, and looking at her face, as though she needed to be sure she would always remember her … perhaps when they met again one day in Heaven … And then at last the nurse came for her again, and they had to leave the baby, so she could go to the funeral home Brad had called early that morning.

  “Good-bye, sweet angel,” Pilar said, and kissed her again, and as they left the room, she felt her heart torn
from her soul with a pain she would never know again. It was a piece of her rent from deep within, and gone to be buried with her baby.

  When they went back upstairs, their baby boy was sound asleep in his bed in her room, and another nurse was waiting. She was somber-faced, knowing where they’d been, and she gently helped Pilar back into bed, and handed her her sleeping son.

  “I don’t want him now.” Pilar shook her head and tried to send him away, but the nurse would not be dismissed and she put the child in the mother’s arms and looked into her eyes firmly.

  “He needs you, Mrs. Coleman … and you need him …” And then she left the room, and left the little boy with his parents. They had fought long and hard for him, and he had come and brought with him both tragedy and blessing. But it wasn’t his fault his sister had died. And as Pilar held him, she felt her heart soften. He was so sweet and round, so different than little Grace had been. He looked all boy … and she had looked like a tiny angel, a mere whisper of a child … a whisper gone back to God forever.

  It was an odd day for them, a day of joy and grief, of anger and elation mixed with sorrow and disappointment, a rainbow of emotions none of them understood, but at least they were together. Nancy came and sobbed in Pilar’s arms, unable even to tell her what she felt, but her tears said enough. And Tommy cried, too, and told them he was so sorry. Todd called, not having heard about Grace, and Brad cried terribly when he told him. And in a moment alone, Pilar called her mother and told her. And for the first time in her life, her mother truly surprised her. She wasn’t the Good Doctor Graham, but the grandmother of a child who had died, the mother of a woman suffering terrible grief, and for almost an hour, they talked and cried together. And she took Pilar’s breath away when she told Pilar of the son they’d had, who had died of crib death before she was even born.