by Kamy Chetty
She nodded. “Can we wait? My husband wanted to be here.”
Nick hesitated. She was young. Looked about the same age as Skylar, but she wore her fear like a cloak. Skye hid hers like a secret.
“I need to make sure the babies are okay. The quicker we do this, the better. I don't want to waste time. If we need to transfer you, time will be important.”
Patty looked at him. Her dark gaze frightful. “I knew something was wrong. The baby turned.”
He didn't like that. “Patty, what do you mean the baby turned?”
“I felt like the baby turned. It was a different feeling, and I felt sick. Upset. That's when the pain started.”
Jen caught his worried gaze.
“What I wouldn't give for a quick scan.”
“You and me both. Would you settle for an awesome abdominal palpation?”
He took the Doppler and started searching for the fetal heart rate. “It will have to do. As soon as I’m sure these babies’ heart rates are stable, I will do the palpation. I want you to inform emergency services of the possible situation and I want you to set up for a twin delivery. Either way, these babies are coming out, and I want us prepared. Okay, Patty. How about we listen to those babes?”
He listened for one heartbeat and then after a lot of turning and twisting of the probe, he managed to get the other one. But it was in an awkward position, which highlighted the possibility this baby may have turned and was now in breech position.
“What does that mean, Doctor?”
He tried to explain to Patty but couldn't explain well enough. Jen was busy trying to get all of the items they would need for the babies’ delivery. She added more items, preparing for an emergency Caesarean section.
The problem they both didn't want to mention was what would happen if they couldn't deliver the second baby.
Patty was wringing her hands, looking from Jen to Nick as her breathing came out in bursts of hot air. Nick had no facilities to perform a Caesarean section. They had no equipment to keep the baby alive, and there were so many things that could go wrong. There was no pediatric team and there was just Jen and himself if that emergency team didn't arrive on time.
Jen tried to put on her best smile. “Baby is bum down, Patty. When he turned, he went bum down.”
Patty nodded as if she knew what Jen meant, but the look in her eyes told her that she didn't.
“I'm going to check on things outside. I won't be long.” Nick gave Jen a reassuring look.
Jen nodded.
When he reached the front, the air grasped him and pulled him out. He took a deep breath and filled his lungs. This could go wrong. He needed backup. He needed to have a plan of action. Safety regulations. Policies. Procedures. Guidelines. Something to make this go right. The responsibility was a heavy weight on his shoulders.
He heard a scream from within, and then Jen's scream followed.
“Nick, get in here. It's time. She's crowning.”
Fuck.
He went in and pulled on a new pair of gloves as he sat at the foot of the bed. Jen looked as scared as he felt. Patty was freaking out.
“Patty, you need to calm down.”
“Carlos needs to be here.”
“Patty, he is on his way, right?” Nick asked as he pushed aside the blanket. Patty nodded. The room was small and stuffy. It had a bed and two chairs, a small table, no monitoring equipment except a sphygmomanometer—an old mercury one—a baby cot that had seen better years. Jen had found some towels and put them under Patty's body to keep them warm for the babies’ arrival.
He could see the amniotic sac bulging at the opening of her vagina. What he wouldn't give for a sterile delivery pack right now. Something standard that came in all places.
“I know that look. What are you after?” Jen asked.
“A delivery pack.”
“I know your predecessor never thought we would ever need one, but I disagreed. So hold that thought. I have that as well as any other equipment we might need, but I had to hide it. It might be expired by a few months. I haven't been up to date with the checks since Doc left.”
“At this point, expired by a few months is better than nothing.”
Fifteen minutes later, Nick was taking the amnio hook and breaking the sac, letting the fluid rush out in a gush. The greenish fluid was the first bad sign. The look on Patty's face as she squirmed when a strong contraction ripped through her was the second bad sign. The events that followed made Nick stop counting bad signs.
He took his finger and felt around the first twin's neck. The coils of cord were wrapped tightly around the neck. One of the worst signs of all.
“Cord around neck,” he shouted to Jen.
“Doctor, can I stop? I am sure Carlos will be here shortly.”
It was obvious Patty and Carlos had a strong bond. They loved their children. He wished he could express his feelings for Skylar. He missed her like hell. But the words didn't come as easy.
“Patty, your baby has the cord around the neck. This can make baby very tired, which is why the heart rate is dropping. If you were in the hospital, we would be keeping an eye on the babies and making sure everything was going as it should. The longer we delay, the worse the outcome.”
“Are you telling me the babies might not be okay?” she asked.
How did he do this? How could he say this and know she was going to face this alone? But he had to.
“Yes.” Hypocrite. “With the next pain, I want you to start pushing.”
The pains started coming fast. He stopped making the comparisons between Skylar and Patty. He couldn't deal with that now. He had to focus on these babies. Had to get them out.
The baby crowned. “Patty, you're doing well. As soon as the baby's head is out, I want you to start panting.”
When the head was out, Nick tried to slip the umbilical cord around the baby's head, but it was tightly wound. So he used forceps to clamp the cord and then he cut it. Then he unwrapped the cord five times.
“Five?” Jen asked.
He nodded.
They waited for the head the turn, and then Patty gave a little push and the baby slipped out. Nick placed the baby on a towel and wiped it. After a few seconds, the baby started making a few movements and started turning a pinkish color. He waited and then cut the cord before handing the baby to Jen.
They both knew the next bit was going to be the hardest.
They waited for a good twenty minutes before there was any sign there was going to be a delivery of the second baby. Nick did an examination to see how far Patty was away from delivering the second twin, only to have his worse fear confirmed.
Jen had wrapped the little girl and handed her over to Patty.
“Footling breech,” Nick said.
“Damn,” Jen said softly looking at the clock. “Think emergency services will get here on time?”
He shrugged, thinking about the many times Sod's Law struck him in the face when he worked in the war zones of Africa, Afghanistan and Syria.
The dangers of delivering a footling breech was high enough without adding into the mix the lack of flash modern facilities that could account for cord prolapse.
Patty’s contractions started once more. Jen and Nick focused their attention on the baby about to be born. The foot stuck out, and that was all Nick could see. Without a fetal tracing, all he could do was hope for the best. Patty starting feeling the urge to push.
“We need to do this slowly. I don't want the cord—” Sod's Law. Slap. Face.
The cord slipped. Squeezed itself between foot and vagina.
“Nick!”
“Put your fingers in and try and keep the pressure off.”
They both knew this wouldn't work. What they needed was to take her off for an emergency Cesarean section. It was the only thing that would help.
He went through the different options and in every one, the outcome was the same. He couldn't help. He couldn't save this baby.
“Doctor
, is my baby okay? Tell me when to push.”
Jen met his gaze. He could see the tears in her eyes. They weren't going to win this one. How would he explain that?
“Patty, don't push.”
“Tell me when.” Her voice was desperate.
“Nick, I can't hold on like this. What are you going to do?”
What could he do? If he used a pair of forceps and pushed the baby back in, would that work? He felt the room heat up as if there was an air conditioner turned on high. His breathing was becoming choppy.
Innocent child. New parents. Father didn't even see the child. It could end like this. Something he wasn't thinking of.
“Nick?” Jen called out.
“I'm missing something.” Nick looked around for an answer.
“You're not. Check the fetal heart rate, Nick.”
Yes. Check the heart rate. He should check the heart rate. He took the Doppler. Squirted the gel. Didn't bother to apologize for the coldness of the liquid on Patty's abdomen. He focused. He searched. Along the left. Along the right. Top. Bottom. He pushed. Then pushed harder.
Nothing. Heat suffused his ears, the pounding was so loud. Thudding, throbbing.
His gaze met Jen’s. “I can't find it.”
Patty looked from Jen to Nick, sensing the levels of tension increasing.
“The cord is pulsing but it’s decreasing. Fading. Check there. We got it there the last time,” Jen said, pointing to the right again.
Nick took the Doppler, turned up the volume button and then placed it on Patty's tummy. He moved it once or twice until he could hear a faint tapping. As soft as the beating of a bird’s injured wing against the window. But even as he listened, the noise faded.
“I'm sorry.” He wasn't sure if Jen was talking to him or Patty, but he held on tighter to the probe.
Patty grabbed his hand. “What are you doing, Doctor? You need to deliver my baby. I need to push.”
He shook his head. How did he explain?
Jen’s voice came at him again. “Nick?”
No. Skye would want him to say it so this woman would not be too traumatized. He had to do it for her. His wife. But he didn’t know the words. He didn’t know how. His throat ached. He focused on Skye, her face, her smile. What would she do? What would she say?
He put his hand on Patty’s. “I’m sorry. I wish there was more I could do. That's your baby, your baby’s heartbeat. There’s nothing more we can do.”
The anguish in Patty’s scream pierced him like a blade and he bit down hard, so hard he thought he could hear his teeth break.
“Doctor, please try. You can’t do this,” she cried.
Jen shook her head and let go of the cord. “I’m sorry.”
“Patty, it’s too late. I’m sorry for your loss.” His hand still covered hers.
Patty dropped back on the bed. “It's my fault. I shouldn't have walked here. I should have taken the bus.”
This wasn’t a war zone, but was the pain here any different than the middle of a battlefield? Nick let his fingers run through his hair, feeling the tiredness take over. Nothing he did made any difference. Nothing he said would make Patty hurt any less. “Some things happen for a reason. Even if you took the bus. This would still have happened.”
You can’t change fate!
“But Carlos. He wanted to be here. He wanted to be here and hold them. He won't forgive himself.”
Nick took her hand in his once again and met her gaze. Her dark eyes were filled with pain and loss, something he’d seen so much of. Carlos would have given anything to be witness to his children's births, and Nick threw his chance away like it was yesterday’s news. “Carlos will understand. You need to be strong. For your baby and for Carlos.”
With the sound of the ambulance sirens in the distance Nick experienced a flood of emotion that wrapped him, choked what little life he had left in him.
He pulled off his gloves and rubbed at his face. There was wetness on his cheeks he had never known before.
He looked at the moisture on his fingertips as he walked out of the clinic. He didn’t belong here.
Chapter Ten
“I feel like a whale, and I bet I look like one too.” Skylar glanced at Judie, who gave her a smile as she picked up the latest woman's magazine and handed it to her.
“You are almost due, and you glow. I will never know how some women still manage to look attractive even when they’re pregnant.”
“Attractive? I take it you had your hearing aids turned down when I said I felt like a whale. Make that an elephant.”
“Damn, you’re cheeky. Hearing aids? Wait ‘til you need a babysitter, I’ll remember that one. Anyway, elephants gestate for twenty-two months or something ridiculous like that, so count yourself lucky.”
Skylar wondered what luck had to do with anything in her life. From the age of twelve, it jumped the queue she was standing in and she never saw it again. She put her hand on her tummy and sighed. In a few weeks, she would know for sure if this little girl was affected by her getting chicken pox.
“Scared?” Judie asked.
Anxious. Scared. Terrified. “A little.”
“Have you heard from Nick?” Judie’s warm smile was hard to ignore.
The sudden reaction in her midsection surprised her. “No. I haven't, and I think I want to keep it that way.” Liar.
Obviously she wasn’t as good of a liar as she thought, because Judie stopped and gave her a second look. “You could call him. He gave you his number.”
“I know, but I wanted space and the opportunity to do this alone.” She flipped through the magazine.
Maybe she wanted him to come back on his own and declare his love for her. She wasn’t sure what she wanted—it changed from day to day. Week to week.
Judie brushed her shoulder. “I have to head off to work. Are you going to be okay here on your own?”
Skylar appreciated having Judie come and check in on her every day. It took away a lot of the boredom and the time to dwell on all the things she had done wrong with her life. “I'm good. I might take a walk later. Get some fresh air.”
After the fire, she had moved into a small cottage for rent that wasn't far from the hospital. A few weeks ago, she had started her maternity leave and although she went in and visited the emergency department, she didn't have a lot to do with her time.
Judie paused. “You're not going to do something stupid, are you?”
Skylar wanted to think of something great she could do in her highly pregnant state, but jumping out of an airplane in a parachute would be a definite no. “I could go down to the beach and pretend I’m a whale. Get it. Beached whale.” She managed to raise her eyebrows and smile wickedly.
Judie tut-tutted. “Boredom doesn’t suit you, child. That baby better come out soon.”
‘That’s what I’ve been saying.” She waved goodbye.
After a few uncomfortable hours, Skylar packed a bag with a few essentials and made her way out for a walk. Maybe walk was not the correct word, she thought as she grabbed an apple and waddled out the door. The most comfortable clothes she found were tights with pregnancy expanding elastics and loose, flowing tops that covered her swollen belly. Munching on a juicy, red apple, she shut the door after her and walked down to the park, which wasn't far from the beach.
She waved at the few people she passed who smiled at her. Pregnancy made many friends. When she got to the bench at her favorite spot, she took out her romance novel and then took one of the ear buds from her mp3 player and placed it on her belly. “Here you go, munchkin. Listen to some of that calming music.”
Sometime later, she heard a huge bang. When she looked across the park, she saw a man lying on the ground and a bike lying next to him. He still had on his helmet. Looking around, she realized there was no one else in the park, which was not uncommon for that time of the morning.
She slowly tried getting herself off the bench, which took some effort. Fiddling around in her big black bag,
she eventually found her cell phone and called for an ambulance.
“Bike versus tree.” She waited for the person on the other end to take down details and then when the authorities knew the location, she walked slowly over to the man. He looked angled in an odd position. She tried not to move him.
It was difficult to bend down and get to his level, but she slowly managed to squat until she was close enough to check for a pulse and whether he was breathing. When she was sure he was breathing, she tried to talk to him, and that was when she felt the tightening in her tummy.
She breathed through the pain and waited for it to settle. “Mister, are you okay?” she asked between breaths.
The man winced, but she could tell he was okay. He was winded. There was no obvious bleeding, and he was beginning to move slowly.
Her back started to ache, and she felt a heaviness between her legs. And it felt hot. Very, very hot. Different from normal. It wasn’t usual or anything like she was expecting and she couldn’t keep the fear at bay. Not sure whether she should focus on what was happening to her or the man, she paused and took a look at the man.
He was looking a better color. He was breathing, but she was finding it harder to focus on him. Which was not the best of sign for her.
The place was deserted. No sign of the ambulance.
Then a gush of hot liquid poured from between her legs, and she gasped. Darn it. Seriously? Eyes closed, she squeezed her hands into tight fists. Please don’t let it be red. Red is bad. Looking down she sees she’s created a distinctive wet puddle on the asphalt.
This is the last thing she needed after everything that had happened. Her baby did not need to be born in the middle of the street with no medical facilities. Her chest tightened—why couldn’t she breath? Why was it so hard to focus? Pain shot through her side and down her back. Damn. It was starting. She was having her baby.
The ambulance would have more than one patient to deal with. The flashing lights of the ambulance was what she saw next, and by then the man was sitting up holding her hand, making sure she was breathing through her pains.
The medics ran toward them with an oxygen cylinder and backboard, and they stopped midway. “We were told unconscious patient post-accident. Not pregnant woman.”
