Abruption

by Riley Mackenzie

  Beautifully Awake Series

  Beautifully Awake

  Beautifully Done

  Abruption

  Everyone has a plan.

  Dr. Guy Hunter secures his dream fellowship with a beautiful free spirit by his side. Two unexpected blue lines don’t even shake his resolve—he is on his way to having it all. Until he isn’t.

  Abruption: a sudden breaking off

  Jules Chiappetti loves her boisterous over-involved Italian family but is determined to pave her own way. An MBA and boardroom job is her ticket out. Until it isn’t.

  Abruption: an unexpected event

  Four years later, Guy is consumed by the challenges of being a single father, still struggling with the aftermath that derailed his life and left his son with special needs. He doesn’t realize his world went dark the same day his wife’s did, until Jules, his son’s new nurse, shows him the light.

  To our parents.

  (You may only read this page, but that’s everything and more.)

  “Give the ones you love wings to fly,

  roots to come back,

  and reasons to stay.”

  ~ Dalai Lama

  Touch her. My instructions were simple. Touch. Her.

  At least it sounded simple enough, and it should have been. For someone else.

  I slid my shaking hands, the ones I scrubbed raw with a bristled brush—twice to be sure—through the circular chamber openings. Isolettes. How ironic, even the name sounded cold and lonely. It was the last place on earth she belonged.

  My palm feathered against her back and then her stomach. Her rapidly beating heart bounced under my fingertips, while the steady rhythm of her lungs inflating and deflating washed through me. The only foreign equipment still in place was the small IV poking out from her wrinkly hand. Born at thirty-two weeks, her premature lungs were not ready to breathe on their own. But she was a fighter. And no longer required the supplemental oxygen.

  Inhale. Exhale. Thatta girl.

  Three pounds six ounces. Didn’t make her any smaller in this great big world. And I was responsible for her. At least for today. She was my patient, and since this was my third day of student clinical rotations at Presbyterian Hospital, or Presby as they liked to call it, it was a big deal. For more reasons than I’d allowed my mind to wander…

  Don’t go there.

  I wasn’t sure my last couple days of shadowing my preceptor really prepared me for this moment. Blinking away the threatening moisture, I whispered the seasoned nurse’s mantra to myself. “Being emotional is normal, all part of the job.” Her words twirled around my mind. “These are precious new lives at their most fragile. You wouldn’t be human if you didn’t feel the weight on your heart.”

  Oh I felt the brick crushing my chest, the question was whether I was strong enough to lift it off and breathe myself.

  “It’s a balancing act between empathy, confidence, and trusting your skills.” That sentence alone rattled me to the core and stirred the swirling vortex of self-doubt and second-guessing that took up camp in my head since I made the career change. Trust. Did I trust myself with this child’s well-being? Could I ever trust myself again?

  I can do this. I can do this.

  No. I had to do this. Being here and mastering these skills was going to bring a semblance of meaning back to my life, a sliver of purpose to fill the gaping abyss. It had to.

  I glanced back at superstar Nancy who was busy with her own neonate. She was a reflection of confidence and poise that I assumed only twenty-odd years in here could give to you. Floating from one tiny human to the next with her shimmery grey bob trailing behind, nothing, and more importantly, no one ruffled her feathers. She was refreshing and it was inspiring. Everything I yearned to be but questioned if I could ever achieve, since I was moments away from a brown bag/rocking in the corner episode. An impression I did not want to make on my first day flying solo.

  I swallowed my insecurities and focused back on my patient. Corrine, or so the hot pink bubble letters read on the index card. Seemed like a big name for such a squirt, but it was better than the Schmidt, Female that encircled her tiny ankle in standard Times New Roman.

  Her delicate chest worked overtime and I found myself counting her respirations. This I could do. One task at a time.

  In and out, inhale and exhale. I counted to over a hundred when Nancy’s wave caught my eye from across the room, along with her proud grin. I readjusted Corrine’s baby cap and swiped my thumb across her silk cheek before removing my hands from the warm incubator. Just keep breathing, baby girl.

  A small crowd gathered around the little boy in bed eight. I remembered from rounds that today was his graduation, the Neonatal Intensive Care Unit’s fancy term for discharge.

  A perfect word.

  It was a life step, the first chapter in his story after a touch and go prologue. Graduation declared that he was strong enough to face the world. An accomplishment that screamed survivor that no ribbon could do justice.

  I made my way across the NICU, keeping my distance and lingering outside the inner circle. The whole team was mulling about—nurses, neonatologists, respiratory therapists, even the unit receptionists came to congratulate the graduate and new parents. Smiles were big and genuine. I could only imagine the tremendous satisfaction they all felt knowing they were in some way responsible for nurturing this critically ill newborn back to health. They were handing him his diploma with pride.

  A little bald head poked out from the cozy fleece navy blanket that was personalized with tan letters, creased in such a way I couldn’t make out the baby’s name. The father’s large stature made his bundle of joy look like a football tucked securely in the crook of his arm. Two large blue eyes, a reflection of his own, stared up at him as he nodded and returned smiles while everyone showered him with encouragement. It was a commencement for parents, too. After months of depending on a team of professionals to care for your child and shoulder the majority of decision-making, they were now on their own. This major transition could be very stressful, yet he surprisingly seemed calm and in control. He was gracious and his body language read relieved.

  Mid-conversation and without missing a beat, his lips dipped down and touched his son’s forehead, while his large finger curled inside the baby’s tiny hand. As instinctual as his next breath. Without warning, the contagious smile crept up and spread my lips as well.

  Cake and blue teddy bears polluted the nurses’ station. It was time. Nancy ceremoniously snipped the alarm band from his ankle, and the father secured the little guy into his car seat.

  I did one last scan around hoping maybe I missed her. I hadn’t. She never came. The she was obvious, right? I was in no place to pass judgment or gossip. And I wasn’t privy to the circumstances, nor was I about to ask.

  But if I had been given that chance, if my baby was graduating, I knew I wouldn’t have missed it for the world.

  Never.

  Four years ago…

  “Guy, you sure this dress looks okay?” Sexier than sin and sporting a baby bump that accentuated her beauty, hell yeah, she looked better than okay. I smirked and she added, “I think it makes me look like I’m waddling when I walk.”

  “No. That’d be the heels.”

  My life of the party, hot-as-shit girlfriend, now wife, was pregnant. A mistake? More like a Brittany-induced delirium. After all, I was far from stupid—hell, I was a chief surgical resident and I knew there was no such thing as an oops. So be it, we were here now and going with it.

  She had become my release, literally and figuratively. With four plus grueling years under my belt and little to no time for anyone or anything, Brittany was my indulgence. Our energy together was palpable. The constant stitch in my side was the reminder she made me
laugh like no one ever. She had a killer bod and gorgeous blue eyes, and our chemistry was off the charts. Damn, did we indulge. Carelessly.

  As a result, we were going to be a family of three in four months. And the rock I slid on her finger ten weeks ago made it official. Life was good. Really good.

  “Well, then I guess I’m gonna waddle because there’s no chance I’m ditching my Manolos.”

  How I wound up with a woman who referred to her clothes and shoes by name was beyond me. But as long as she was fine with them in a heap on the floor at the end of the night, what did I care? Luckily, she was more than fine with it. The stacks of pregnancy books sitting on her night table were dead-on balls accurate. Second trimester pregnancy hormones made her even more insatiable. I was just the grateful husband reaping the benefits.

  I snaked my hands into my pants pockets and leaned against our bedroom dresser, bumping my knees against our bed. Resident housing really was tight. I was a tall guy with a wingspan that rivaled my height, but touching opposing bedroom walls with my fingertips was starting to get annoying. As a Manhattanite I would’ve thought my wife would be used to smaller spaces. Turns out Park Avenue and penthouses were the exact opposite. And she never missed an opportunity to remind me just how much our small space sucked. Deep down I knew she only wanted what was best for our family—it’s not like she didn’t know who she was marrying—so I kept my eyes on the prize. “Match Day” was only around the corner.

  Clinching a vascular fellowship at Stanford was the last piece of the puzzle. We’d finally get out of this freezing cold, back to the sun and surf. I had exemplary test scores and top-notch recommendations so it was hopefully a done deal. Genetics were to thank for the book smarts. Unfortunately, I never met the brilliant internist. My father died from a ruptured aortic aneurysm before I was born, but he’d always been my motivation and driving force to succeed.

  “Waddle that sweet ass over here, wife.” I loved that she didn’t hesitate. I glided my palms down her body and over our baby and then reached around and gripped her ass. I inhaled her million-dollar scent while my lips grazed the sensitive skin below her ear.

  “As tempting as this feels, husband, we’re late and this time is so not my fault.” She winked and tousled my already messed hair. “You need a haircut.”

  “When don’t I?”

  “Good thing the blond locks give you a pass and Sam knows what you’re like. We dawdle any longer they’re going to be cutting the cake.” She loved to tease me about my kindred roots. I blamed that on my yoga studio owner mother. Laid-back was ingrained in my DNA.

  With dinner and dessert behind us, Brittany couldn’t wait to cut up the dance floor. “After all, that’s what these puppies were meant for,” she said, flexing her feet. Lunatic. Mid-spin she found her balance and winced.

  “What’s wrong?” I pushed the damp hair away from her face. “Talk to me. You look pale.” Her hand immediately went to the base of her bump and she began to rub. Shit. “Let’s sit down. This was too much.” I cursed myself for letting her convince me otherwise after the fifth song in a row.

  “I’m hot and probably a little dehydrated,” she shouted over the piercing music. “I’m gonna use the restroom. Can you get me another water?”

  “Let’s just go, this was too much.”

  “Nah. I’m fine. Meet you at the table.” She pecked my lips and disappeared into the crowd. From behind, you couldn’t even tell she was pregnant; nonetheless, she was twenty-four weeks.

  With two ice waters in hand, I parked at our empty table. Becky must have finally coerced the birthday boy onto the dance floor. Moving his hips in more than one direction was definitely out of Sam’s comfort zone, but he’d do anything for his wife. He was two years behind me in residency and a good egg. At least that’s what all the ladies back at the hospital called him. Stupid term if you asked me, but it fit.

  “Guy.” Britt’s voice snuck up from behind, cracking. “I think we need to go.”

  Alarm bells echoed in my head. “What happened?”

  “I’m sure it’s nothing, but I’m spotting a little.” She whispered the word spotting as if it were something to be inconvenienced by and embarrassed about rather than something potentially serious. I decided to table that lecture for when we got home and I made sure she was off her feet and relaxing. There would be no more dancing.

  “Come on, let’s get you home.” I leaned over to grab her purse off the table and saw her clutch her bump a little tighter. When she pinched her eyes closed and leaned into me, my fight-or-flight response kicked into overdrive. “Forget that, we’re going straight to L&D.”

  “It’s not pain pain, just uncomfortable, a little tight. And it just started, so it’s probably just those Braxton Hicks contractions. I’ve gotten them before. Let’s not ruin Sam’s birthday.”

  I placed my hand on her bump. “It feels like a rock.” I dragged a hand through my hair and over my face, silently going through the differential diagnosis for bleeding and contracting in the second trimester. A six-week rotation during my third year of med school left me far from an expert in obstetrics. Anyone who watched a few episodes of a cable baby show knew as much as I did, at this point. The one thing I did know was this was not nothing.

  The crisp night air met us as we stepped from the stuffy lounge. “Feels so much better out here.”

  I wasn’t buying it. Luckily there was an empty cab across the street. Philly in the middle of winter consisted of piles of filthy snow lining the edge of the sidewalks, with patches of black ice ready to mock you when you landed on your ass.

  “Hold on to me.” I picked her up and my leg span cleared the ice. “You’re done with the heels, babe.”

  When I deposited her into the cab, she cringed again, trying to hide it this time by bitching nonsense. “A, I grew up on the East Coast, I’ve worn heels in this weather a billion times, and B, we both know you can have a little bleeding without it being a big deal. I’ve probably been doing too much. I need to get off my feet, take it easy for a few days.” She was completely calm and rational.

  Me, not so much.

  “Yeah, you can do that once you’re scanned.” I turned toward the cab driver and instructed, “Philadelphia Hospital on Pine.” It wasn’t up for discussion.

  Lucky for me she didn’t fight, and fortunately for us she was right. Baby looked good and with a few days off her feet the bleeding resolved.

  Britt decided to stop working though, and I absolutely agreed. Money was tight. A resident’s salary wasn’t anything to write home about, but I’d make it work. I debated asking her to curb her designer handbag fetish and sample the lunch menu somewhere other than Center City’s five-star finest, but I held my tongue and sucked it up. She continued to indulge. Happy wife, happy life. And more importantly, healthy baby. There was plenty of time to pay it back after fellowship. Besides, she had the whole motherly instinct and all, not to mention she was a nurse.

  She reassured me often that she felt fine, that her OB said she was fine and that the baby was fine. “Everything’s going to be fine.”

  With bleeding episodes two, three, and four, I was over her “everything is fine” attitude.

  She blew off our “you don’t fuck around with a chronic abruption” conversation with an eye roll and rebutted with the “I’m a trained nurse and would never do anything to harm our baby” lecture. Her arguments didn’t make me feel any better. So I shouldn’t have been surprised when a text interrupted my morning rounds stating I needed to get my ass to labor and delivery because I was going to be a father four weeks early.

  “It’s a girl!”

  The tiny garbled cry stopped time, and my heart skipped enough beats I was sure an arrhythmia was imminent. The NICU nurse jammed the suction bulb down her tiny throat while another rubbed her skin. She pinked right before my eyes and her tiny whimper turned to a full-blown scream. I never knew that sound could instantaneously equate to pure love. They placed her slimy, wiggly bo
dy on the scale: four pounds one ounce. Nineteen inches.

  Shit, she was small.

  She was perfect.

  “Dr. Hunter, we’re going to bring her to the NICU for observation, warm her up, check her glucose and make sure her breathing stays strong.”

  I stared, frozen in a trance-like state at the nurse holding my cleanly swaddled peanut. I knew she was speaking to me, and I heard what she said, but somehow I couldn’t get a handle on what was happening around me. I was someone’s father. I was her dad.

  Pure happiness coursed through my veins, yet I was suffocated by an inexplicable anxiety.

  “Dr. Hunter, you okay? Why don’t you have a seat by your wife? Your baby girl is responding well. Some time in the NICU is very routine for preemies born under distress. But her five-minute Apgar was eight, which is a great sign. And despite being a little squirt, she looks pretty cooked.” The nurses’ chatter and my baby’s cries filled in around the storm.

  Preemies born under distress.

  “Guy.” Quinn’s voice finally snapped me out of the whirlwind. “Brittany’s stable. Go be with the baby. I’ve got fifteen more minutes or so here.”

  I watched as she threw stitch after stitch into Brittany’s open abdomen. I knew the seriousness of the situation. Hell, there wasn’t even enough time for spinal anesthesia. Brittany was under general with a tube down her throat right now. I was a surgeon, for fuck’s sake, yet I felt helpless. Talk about a new perspective. I was no longer the confident doctor with all the answers, instead I’d slipped into the same frightened shell that I’d witnessed my patients’ spouses deteriorate into and I couldn’t do a damn thing about it. I got a glimpse of the other side, the civilian side. And it sucked.

  My eyes trained on the monitor confirming Britt’s stability and then on the thick crimson liquid dripping into her arm. “This could’ve been bad. Thank you,” I mumbled to Britt’s OB, releasing the breath I had been holding.