The Promise of Stardust

by Priscille Sibley

  Jake started out with the usual questions, establishing Blythe’s formidable qualifications. After he reviewed Elle’s history of miscarriages and the diagnosis of Elle’s autoimmune issues, he proceeded into the current world. This world. Elle’s physical status, the likelihood she might deliver this baby—alive.

  Jake entered into evidence—with a few overruled protests from Klein—the ultrasound of this baby, doing somersaults. Watching the two-minute video gave me a brief reprieve of peace, and even Mom looked moved; at least she tried to make eye contact with me, which I avoided.

  Jake took a long sip of water then approached the witness stand. “Dr. Clarke, would you tell me about the phone call you received from Dr. Beaulieu on February second of this year?”

  Blythe nodded once. “Yes. As I said, because of my professional relationship with Linney and Matt’s position on staff, I did something I very rarely do: I gave them my home phone number. I knew that Matt was very concerned about Elle, but I also knew he wouldn’t make a pest of himself. On February second, he called me in the late evening and said Elle was in trouble. She’d gone into preterm labor, and her water had broken. You see, the protocol with APS dictates we keep the woman on the blood thinner heparin for the duration of her pregnancy to prevent abnormal blood clotting. We schedule the delivery early, usually by week thirty-six, because we see a higher number of complications at the end. First we admit the mother to the hospital and take her off the blood thinners. That way, her blood will be able to clot normally during delivery. Then we induce labor once it’s safe. But Elle went into labor while still on blood thinners, and she was hemorrhaging.”

  Blythe paused, and Jake told her to continue.

  “Matt said he’d called an ambulance, and the 911 operator was trying to talk him through a normal delivery, but the baby’s umbilical cord prolapsed, which in and of itself was dire.”

  “Dr. Clarke, I’m showing you what’s marked as Respondent’s Exhibit Fifty-one. Could you please identify it?” Jake asked.

  “It’s an obstetrical diagram of a prolapsed umbilical cord.” Blythe rose and walked over to the cross-section poster now displayed on an easel. “You see, the umbilical cord supplies the baby with oxygen. When the umbilical cord comes out before the baby does, it’s an obstetrical emergency because the baby can lose his lifeline. In the hospital, we would have taken Elle straight to the OR for an immediate C-section. We would have had her under anesthesia within five minutes. And even then, we might not have saved the baby.

  “Matt had a little OB experience and was able to determine the baby was breech, which means the baby was coming out with his feet first instead of his head first. Another problem. Breech deliveries are more risky for a number of reasons. And finally, Elle was bleeding heavily. Matt wanted me to tell him what to do.”

  “What did you tell him?”

  “He put the phone on speaker so I could talk him through it. Initially, we knew the baby was all right because the umbilical cord had a strong pulse. If we could get Elle to the hospital before the blood supply in the cord was cut off, we could save the baby. I wanted Matt to keep the baby from compressing the cord by manually pushing up on the fetus. Not exactly pretty, but he was trying. Unfortunately, when Elle had her next contraction, the baby came down into the birth canal and cut off his own oxygen supply. This was a precipitous delivery, which means very hard, very fast contractions. The pulse in the cord stopped. Matt’s a smart guy. I didn’t have to tell him we were losing the baby. He asked me to tell him what to do, but what we needed was a miracle.”

  “What did you tell him?”

  “What he already knew … I said if they were in the hospital we’d do a cesarean section. But at home …” Blythe shook her head. “I told him he just had to try to get the baby out as fast as possible.”

  “Could you hear what was going on at the Beaulieu household?”

  “Yes,” Blythe said. “Elle was crying, and she told Matt that he should operate on her.”

  “At home?”

  “Elle begged him to save the baby. Matt said he couldn’t do it because he wasn’t an OB. He couldn’t operate without anesthesia. He told her that she’d bleed to death.”

  “How did she respond?”

  “She said there were sharp knives in the kitchen and to just get the baby out—even if it killed her.”

  A collective gasp slipped out of the courtroom gallery. Jake’s eyes widened, and honestly, if I didn’t know that he’d already heard the story, I would have believed his reaction was completely unrehearsed.

  “Obviously,” Blythe continued, “he said no, but Elle continued to beg him to save the baby—to put the baby first.”

  “What did you say?”

  “I was calling to Matt, but he didn’t seem to hear me. He was telling Elle to calm down.”

  “But he didn’t … cut her open?” Jake asked.

  “No. Of course not. He told her to push. And she did. But it took nearly ten minutes to get the baby out. And then it wasn’t good. And worse—because Elle was bleeding profusely.”

  “Was she conscious?”

  “Objection,” Klein said, jumping to his feet. “Your Honor, the witness was not even present. This is all hearsay.”

  “Could you hear what was transpiring?” the judge asked.

  “Yes, sir. Your Honor. I was on speakerphone,” Blythe said.

  “Overruled. You may continue your questions,” Wheeler said.

  My mother was sniffling, swiping her cheeks from tears, raking her hair away from her face.

  “Was Elle conscious?” Jake repeated.

  “In and out. Matt kept telling her to try to stay awake.” Blythe shook her head. “The baby had no pulse, so Matt had started CPR. The ambulance arrived within a minute or two after the delivery.” She glanced in Klein’s direction and added, “I could hear them.”

  “Could you also hear Elle’s reaction while Matt was doing CPR?”

  “She was crying, praying really, and she sounded very weak.” Blythe picked up the water glass and took another drink. “Matt told Elle to lie down, but apparently she kept trying to get up to help Matt save the baby. That’s when she passed out, the EMTs said.”

  “Objection,” Klein said.

  “I’ll be happy to call the EMT as a witness, if you like, Mr. Klein,” Jake said.

  “Withdrawn,” Klein said, looking defeated.

  “You may continue,” Wheeler said.

  “Even though she was hemorrhaging,” Jake said, “she tried to get up to try to help the baby?”

  “Yes,” Blythe said.

  I cradled my face in my hands. The memory flooded back at me, and I found myself holding my breath again, remembering my hands wrapped around Dylan’s tiny chest, compressing his sternum with my thumbs, blowing puffs of air into his lungs, looking up at the pool of blood collecting on the kitchen floor, Elle turning whiter and whiter.

  Jake put his hand on my shoulder. “You need a recess? You look sick,” he whispered.

  “I’m okay.” I didn’t feel okay, but didn’t want to admit that my emotions were sucking the air out of the room, that I didn’t feel like I could breathe.

  “Dr. Clarke, were you at the hospital when the ambulance brought Elle, Matt, and the baby into the ER?” Jake asked.

  “Yes. I drove in. The roads were bad that night. Snow. I was at the hospital almost thirty minutes before the ambulance arrived.”

  “When the ambulance reached the hospital, what were the conditions of Elle and the baby?”

  “The baby, Dylan …” Blythe looked at me as if to say she remembered the name we’d given him. “Dylan was dead. Elle had lost a lot of blood. An IV was started in the field, but she was in and out of consciousness.”

  “How premature was Dylan Beaulieu?”

  “He was thirty-four weeks gestation. By definition, an infant is term between thirty-seven to forty weeks gestation, but as I said we deliver infants of mothers with APS a little preterm because we
see more complications during the last few weeks. So Elle was scheduled to be induced nine days later, just before her thirty-sixth week.”

  “Excuse me, Doctor, but what do you mean by ‘induced’?”

  “We would have admitted her to the hospital, taken her off the blood thinner, and then we would have given her a medication, Pitocin, to kick-start her labor.”

  “Are you saying she was almost ready to deliver?”

  “Yes, and he probably would have been fine if his cord hadn’t prolapsed.”

  “Prior to the premature labor, and other than the APS—for which you were treating her—did Elle have any other complications during that pregnancy?”

  “No. She complained of a little dizziness at the beginning, and a little morning sickness, a few extra bruises from the blood thinners, but otherwise she was the definition of the glowing pregnant woman.”

  “One more thing, Doctor; did you see Elle sign her hospital admission form stating she had no advanced health care directive?”

  “No.”

  Jake showed Blythe a form. “This is Respondent’s Exhibit Fifty-four. Can you identify it?”

  “It’s Elle Beaulieu’s intake record to my practice.”

  “Where would she have said she had an advanced health care directive?”

  “Here, but she left it blank.”

  “So she didn’t say she had an advanced health care directive when she was asked?”

  “To me, a blank there means no, the patient did not have an advanced directive.”

  “After Elle lost the baby, did you see her again?”

  “Yes, for follow-up care. She said she wanted to conceive as soon as possible. I wanted her to wait six months and said it would be feasible to try one more time—if we proceeded very carefully.”

  “And since that follow-up visit, had she been in?”

  “No, but my receptionist told me Elle had called the morning of her accident for a prenatal appointment. It was in our appointment book.”

  Elle knew she was pregnant?

  “Nothing further.” Jake sat down beside me and whispered, “You look seriously sick. I’m going to ask for a recess.”

  Shaking my head, I poured a glass of water.

  “Would you like to cross, Mr. Klein?” Judge Wheeler asked.

  Drumming his pencil on the table, Paul Klein pulled off his glasses. “Yes, Your Honor.”

  For nearly an hour Klein asked question after question about what could go wrong with this new pregnancy. The truth was everything could go wrong and Klein milked every potential complication.

  “Dr. Clarke,” Klein said, rolling an unsharpened pencil between his palms. “You said that Elle Beaulieu was in shock when she was admitted to the hospital on February second. Is that correct?”

  “Yes. Hypovolemic shock from blood loss,” Blythe said.

  He took a document already marked into evidence and showed it to Blythe. “Do you recognize this document?” he asked.

  She examined it for a moment. “It’s a consent for a hysterectomy. Elle was hemorrhaging, and I thought I might need to remove her uterus to save her life, but I was able to stop the bleeding without taking her uterus.”

  “Who signed the consent?”

  “Her husband, Dr. Beaulieu. It’s customary for next of kin to give consent during an emergency.”

  “I see. Why didn’t you ask Elle?”

  “As I said, she was in shock—in and out of consciousness and not in any condition to give informed consent.”

  “For clarification, in Elle’s condition, she would not have been able to understand the implications of what was written on this consent?”

  “Probably not.”

  “But she did sign the hospital admission form that asked if she did or did not have an advanced health care directive?”

  “I did not witness her signing that.”

  “But as a physician, you would not allow her to sign a consent for her own surgery. Is that correct?”

  Blythe’s jaw tightened. “Yes.”

  “I have no further questions, Your Honor,” Klein said.

  I looked at Jake for his reaction. His eyes were closed and his mouth tight. He turned toward me and whispered, “I still believe we can get the Supreme Court to hear the case if we fail all our other options, but this may be a long, hard ride.”

  Mom grabbed my arm at the recess as I rounded the corner. “I have to talk to you,” she said.

  “I can’t. Not again. Not now.” I shook her loose as a photographer’s camera flashed in my face. I was already feeling dizzy, and the flash was pushing me to the brink. I made my way through the crowded corridor.

  “Dr. Beaulieu, you’re scheduled to testify next,” someone holding a microphone called out. “How can you in good conscience say that your wife would want to be kept on life support when she had an advanced directive?”

  Jake was still inside the courtroom, and even though I knew he would advise me to utter the ubiquitous “no comment,” I turned toward the reporter and realized she the one who always baited me.

  “My wife, the woman I love, the woman for whom I am grieving to a depth I doubt you can understand, the woman I know better than anyone else in the world—trusted me. And I would never, ever, ever do this unless I believed—My son or my daughter is still alive. Elle’s son or daughter is alive. My child. And I have to fight for my child. No matter what anyone else says.”

  “Even if Elle didn’t want it? You’d put her through hell to save—”

  “Elle would want me to do whatever I could to save our child.” I pushed past the reporter.

  “Matt, please …” Mom said.

  Just before I slipped into the men’s room, I saw the reporter corner my mother and shove a microphone into her face.

  Mom shook her finger at the reporter. “Don’t you dare imply he doesn’t love her.”

  After the recess Jake put me on the stand and asked the preliminary questions, then he offered the wedding DVD as evidence. “Your Honor, I’d like to show a short section to the court and then ask Dr. Beaulieu a few questions about it.”

  “Go ahead, Counselor.”

  Jake’s baby-faced associate rolled in a flat screen on a cart, popped in our wedding DVD, and clicked it on. It was the reception, held at a banquet hall of a local inn.

  I knew I was in for something when Elle’s dimple appeared. She only had one, off to the right side of her chin, and it only bubbled up when she had mischief on her mind. She bent down and whispered in my ear: “Remember, I love you.”

  Looking as elegant as a princess draped in white silk, she lifted her champagne glass and began her toast. “I was the girl next door, the little squirt trailing behind the golden son. All right, all of the Beaulieu boys were golden sons, but Matt was the one I adored.” She winked at me. “But years came and went, and four months ago when we finally decided to marry, can you believe every Beaulieu came up to me in private and asked with the most serious of tones, ‘Come on, Elle, you know this is a mistake, right? I mean, Matt? No way.’

  “But you know what I told them? I said, ‘Yeah. I made a bet with the high school cheerleader he used to date that I could get him to the altar before she did.’ Yup. I bet her a bottle of hair gel. Now—” Elle patted her very smooth straight blond hair so carefully coiffed for our wedding day and then continued: “I haven’t used hair gel since the big-hair days of the eighties disappeared, so that is not the real reason I’m marrying Matt.” She met my eyes. “I’m marrying him because I admire his intelligence and his compassion. I’m marrying him because he’s part of me already. Because he’s the one person who has always known my heart. Because I would trust him to know what I needed if I couldn’t figure it out by myself. Because he loves me, and I love him. And I need him.” She bent down and kissed me. People clapped.

  I had pulled her onto my lap, taken her face in my hands, and held her close. I wished that moment had never ended.

  Jake stopped the film but the last
frame stayed on the screen. Elle sitting on my lap in her wedding dress; me, in my tux. The absolute ache of the emptiness of my arms crushed me. First down my left arm. Then in my jaw. In my chest.

  Jake stepped toward the judge, blocking my view of the screen. “Matt, was that speech by Elle rehearsed?”

  Jesus. I didn’t feel right. I must be getting sick, but I had to get through this. I had to convince the judge. “I assume she planned on saying it, but I hadn’t heard it before that moment.”

  “How long have you known Elle?”

  I cleared my throat and tried to draw in more air. “Our entire lives, and with the exception of a couple of years after we had a huge blowout, we were close, the best of friends. Even while she was with Adam, we were always in touch and talked almost every week. Sometimes more often, sometimes less. Even when I was engaged to someone else, we talked. Elle trusted me. I trusted her.” I kept staring at the screen, at her face, to keep my focus on her, not on how bad I hurt.

  I didn’t even realize what was happening to me; my light-headedness seemed like the grief making landfall. Then I felt a crushing weight in my chest. That’s when some basic understanding clicked; I was having a heart attack. I opened and closed my left hand and stared at my wedding band. I could see my father’s face. Not much older than me now. I could see him lying in his casket. Dead. Of a heart attack. And suddenly I was afraid. I needed Elle. I needed to know I would see her again. I shifted in my seat so I could see her face—one last time. God, please. Instead I collapsed, and I saw nothing but blackness.

  47

  Day 27

  Burning ripped through me, a jolt that boiled my blood. My body spasmed as if it were being smashed up against an unknown force. Then I lay in darkness. The crushing pain in my chest was the only real attachment to the world. Then nothingness.

  Stillness.

  Ecchymotic light.

  Tumbling.

  And sound returned. Beep, beep, beep, beep, blending into one long, reverberating note. Panic filled me as if I were submerged in a tank of water, desperate for air.

  Elle stood over me, wearing an EMT uniform, her light hair toppling over her shoulders like a halo. “Matt, you have to keep the oxygen mask on. Calm down.” But her silky voice sounded low and sonorous. Maybe the tracheotomy had damaged her vocal cords. In front of my hazy vision, a burly guy took her place.