One Night In Collection

by Various Authors

  CHAPTER THIRTEEN

  “THIS looks bad.”

  Roque heard Madeline’s mumbled assessment after she announced the woman’s vitals. His heart sank. He had to agree.

  As soon as they’d arrived at Aldeia Marúbo and explained who they were to the villagers, they’d been dragged to this woman’s hut. He couldn’t believe their timing. Another hour and Matcha would have died. She could still very well die.

  His troubled gaze moved to her four children huddled in a corner of the hut. He clamped his jaw. They could lose their mother.

  Inferno—no. Not on his watch. And they shouldn’t be watching their mother writhing in agony either.

  “Inácio,” he rasped. “Get the kids out. And tell everyone to stay out.”

  Inácio did so, came back in a minute as Jewel initiated resuscitation measures with Madeline. Roque held back, knowing they had first claim on the patient. Matcha was in deep shock. Treating her severe hypotension was the most important thing to tackle if she was to stabilize enough to withstand their diagnostic and treatment measures.

  They finished resuscitation then Jewel started her exam.

  “What’s your opinion?” Inácio asked tense minutes later.

  Jewel continued palpating the woman’s abdomen and pelvis. “From Montoya’s translations of witness reports, she had sudden lower abdominal pain, vomited, lost consciousness. When she came to she couldn’t move because of pain. She’s now almost unconscious with depletion and shock. Other signs are tense abdomen, guarding, rebound…”

  “That’s all ruptured appendix signs!” Madeline exclaimed.

  Jewel didn’t answer, put on gloves and performed a vaginal exam, then a bimanual pelvic one. Then she sat back on her heels and announced her diagnosis. “She has placental abruption.”

  Roque’s eyes snapped wide at her steady verdict. “Without vaginal bleeding?And we weren’t even told she was pregnant.”

  Jewel’s eyes swung to him. “Twenty percent of placental separation cases occur with concealed hemorrhage behind the placenta. And with her size, a twenty-something-week pregnancy could go unnoticed. And she might not have told anyone she was pregnant. I doubt they make much of pregnancies here.”

  What was that bleak shadow that flitted in her eyes? Was she remembering her own pregnancy? That she hadn’t made much of it either? Was she regretting that now? Stop it. Focus.

  He did, heard Madeline suggesting alternatives. “Couldn’t it be other stuff causing acute abdomen? Intestinal obstruction, ovarian torsion, severe endometriosis—even ectopic pregnancy?”

  Jewel’s elegant eyebrows puckered in consideration. Then she shook her head. “No. None of these cause such severe hypotension, which can only indicate severe internal bleeding. Anyway, an ultrasound scan will tell for sure.”

  Jewel looked at Roque and he moved forward, trying to pin that expression in her eyes, to understand it, and why it scared him so much. She snatched it out of his reach when she turned her eyes away. He had to, too, to get on with his job.

  He forced himself to block her out, moved his ultrasound probe over the woman’s abdomen, watching the images with Jewel. In a minute they both let out heavy exhalations.

  “So what’s the diagnosis?” said Inácio.

  “Ultrasound just confirmed Jewel’s clinical diagnosis—a fetus, a girl, distressed but alive, around twenty-two weeks and about three pounds. And there’s massive hemorrhage beneath the placenta.” He turned to Jewel. “I was praying you might be wrong just this once. I was hoping this was something I had more experience with. She’ll need an immediate Cesarean section.”

  “What about the baby?” Madeline asked.

  Roque exhaled again. “We can only hope she’s viable, but the mother is our priority now.”

  Inácio looked around the hut, clearly calculating the possible catastrophic consequences of performing major abdominal surgery here. “Can’t we at least move her to the boat?”

  Roque again answered him. “I doubt she’d last the two-hour trip. We have to operate, now or never.”

  Jewel bit her lip. “I only ever helped in a couple of Cesarean sections during my Ob-Gyn rotation.”

  Roque gave a grim nod. “Ob-Gyn almost slipped the net of my experience, too. But I bet we can manage it together.”

  Her eyes flared, then darkened. His nerves jangled.

  What was that? That immense something he saw before this weird bleakness extinguished her eyes again? Was that something love? If so, why the bleakness?

  Jewel tore her eyes away and turned to Inácio and Madeline, rushed to prepare their patient for the emergency C-section.

  Roque had to force air into his lungs, had to will his heart to beat.

  Was what he’d just seen even real? Or just his feverish hopes superimposed on her expressions? He’d been clinging to his resolution to never rush her again, but he knew he’d never survive losing her again. Not knowing if she might consider making their relationship real, permanent this time, was fraying his stamina. So much so he was beginning to consider ending it. If she couldn’t love him, he should walk away before uncertainty destroyed his mind, drove him to unpredictable behavior.

  But he hadn’t imagined that look in her eyes! Or any other ever since they’d become lovers again. Yet how could it be what he hoped, when it was followed by such despondency? Didn’t she want to love him? Did she still think him beneath her? Was that why she didn’t want to admit it, to him, to herself?

  Stop it. Drive yourself crazy later. See to your patient.

  He turned to Madeline as she and Inácio swooped on him and Jewel, scrubbing and gowning them, then draping Matcha, leaving only the surgical field exposed. Then he and Jewel worked together, initiating general anesthesia.

  He took his position by the patient’s right side and Jewel immediately took his assistant’s position, handing him a scalpel. He met her eyes above her mask. They were impassive now. He crushed down the spurt of anxiety, turned his eyes to the surgical field and made a low transverse incision.

  He explained his decision. “A midline incision provides quicker access to the uterus but a transverse one carries less risks post-operatively and will provide us with better pelvic visualization.”

  She only nodded, helped him extend the incision and deepen it. Once they entered the peritoneal cavity she placed retractors, grasped the loose peritoneum with forceps for him to incise, was ready with a bladder blade to both protect the bladder and provide exposure of the lower uterus.

  Their eyes met again for a bolstering moment before he opened the uterus, extending the incision with his index finger, holding his breath at the unaccustomed procedure, until the fetal membranes were revealed. He cut through them and heard Jewel’s sharp gasp. He snapped a look up, found her trembling, her gaze transfixed on the tiny legs he’d exposed.

  His heart battered his ribs, at her distress, at the scary sight of the fragile life, at the enormous responsibility. He gritted his teeth, hating to ask this of Jewel. But there was no other way. “Jewel, I need you to take care of the baby once I deliver it. I must devote all I have to the mother.”

  Jewel jerked her head in a vigorous nod. He couldn’t spare her another second as he delivered the terrifyingly small girl, handed her to Jewel, double-clamped the umbilical cord and cut it. Then he forgot all about Jewel and the rest as he fought to stem the catastrophic hemorrhage once the placenta released the accumulated blood behind it.

  Then he found Jewel fighting beside him again, cauterizing bleeding vessels, suctioning blood, while Inácio and Madeline struggled to keep up with their demands. But nothing was enough. Then the woman flatlined. They dragged her from death’s clutches and fought on. But Roque knew there was only one solution.

  “I have to do a hysterectomy.” Jewel’s eyes slammed into him. He rushed to justify his decision, to try to wipe away her stricken look. “It’s the only way to stem the hemorrhage, and she already has four—five children, if this baby lives.”

>   She lowered her reddened eyes, nodded. Then without another word or look they proceeded with the surgery of removing the enlarged, pulped uterus.

  It felt like he’d run a hundred miles as he inserted the last stitch, closing the woman’s skin. Then he raised his gritfilled eyes. They met Jewel’s. They looked as abused as his felt. She turned away, rose and went to the baby where she’d left her.

  “Inácio?” He snapped his head around, asking for a report on the patient’s general condition as he followed her.

  “BP 80 on 50 but holding,” Inácio said.

  “Get her as much blood as you can.” Roque knelt beside Jewel by the tiny baby as she started checking her.

  “I only suctioned her throats” she whispered, her voice wobbling. “Checked she was breathing before I rejoined you.”

  He was afraid to touch the baby, his hands feeling huge and dangerous next to her spindly limbs. He didn’t need to. Jewel was taking care of her. Her hands looked perfect, magical as she handled the flimsy little life, poured care and healing over her.

  She raised cloudy eyes to him, a tremulous smile wavering on bloodless lips. “I believe she’ll live. She wants to live.” She lowered her gaze to the diminutive girl, gave her match-like fingers an ultra-gentle tickle. “Don’t you, little one?”

  His throat tightened, images, fantasies, cravings crowding his heart and imagination to bursting. Jewel—his incomparable Jewel, indulgent, proud, crooning to her baby. His baby…

  She hadn’t wanted his baby before. But she’d changed. Could this have changed, too? Could she want his baby nows?

  He almost scoffed out loud. Sim. Thinking of babies before he knew if she wanted any sort of commitment at all.

  But this was what a baby meant to himnow. Her commitment.

  Before, he’d wanted to have the family he’d never had, with her. Now he only wanted her. Babies would only be more bonds to entwine her life with his.

  Madeline’s hushed yet animated tones broke through his heavy-hearted musings. “She’s scary—and unbelievably adorable! The horrible circumstances of her birth aside, doesn’t she make you wish to have tiny living miracles like her of your own?”

  Roque’s whole being surged. What would Jewel say to that?

  She didn’t say anything, kept on working as if Madeline’s question had been rhetorical.

  Did she think it had been? Or was it just she didn’t have an answer either way? Because she’d never thought about it, never considered it something to think about? Would he ever know how she felt about this? Would he ever work up the nerve to ask? And if he did, what would she tell him?

  “Would you mind telling me where we’re going?” Jewel giggled as she ran after Roque in the forest, jumping over the hurdles of heavy leaves and gnarled roots.

  Roque looked back at her, his heart in a state of constant expansion. “Which part of ‘it’s a surprise’ didn’t you get?”

  She stuck her tongue out at him and he laughed and stopped suddenly, breaking her momentum in an electrifying collision with his body. Momentarily startled then immediately mischievous eyes scorched him and he scooped her up in his arms, swung her round and round. He wanted to shout with delight. So he did.

  “Put me down, Tarzan! You’ll break your back!” she squealed, laughing harder, kicking her heels in the air.

  “It would take two of you to start to be any real strain.” He raised her higher until her arms were fully stretched on his shoulders. He loved the feel of her, the weight of her, the life and passion and beauty of her. He loved her.

  And he was really beginning to think she loved him, too.

  She laughed again, wriggled up there, looking down on him in laughing challenge. “I’ll have you know I weigh 165 pounds.”

  “And every pound an indispensable building block in a work of divine art, amor.” He smiled his joy up at her. Then devilry mixed with the sublime feelings. “And if you could see what I see from here, you’d know why I may keep you up there all day.”

  “As if you could!” she teased.

  “Let’s see, shall we?” He hauled her up higher.

  She yelped in delight then a hundred imps somersaulted in her incredible eyes. “Is this a challenge? All right, you’re on. I say you won’t be able to hold me up two more minutes!”

  “And I say I’ll hold you up ten. What does the winner get?”

  “I suggest the loser gets a penalty.”

  He winked at her. “Whatever. It’s a win-win situation for me. I win, I get you. I lose, you penalize me and I love it.”

  She crinkled her eyes at him. “You won’t love the penalty. Not at first. I will, though, every delicious step of the way.”

  “Sounds exactly like the penalty I have in mind for you. Decadent enjoyment for me, torment for you. It will make putting you out of your misery all the more memorable.”

  “Ha. Prepare to lose, buddy!” She threw herself into their impromptu game, making hilarious faces at him until he burst out laughing and let her down within the two minutes she’d predicted.

  “Saboteur!” He laughed as she melted down his body, reveling in the slide of her slick flesh on his, in the way she made the most of the erotic glide. Then she came to settle where she belonged, filling his arms.

  He enfolded her with cherishing pressure, his insides quivering as her arms enfolded him back, as he caught tender, hungry lips all over his face before he sank his in them, over and over, drowning in their deepening connection.

  She had to love him. He wouldn’t feel so cherished, so welcome and appreciated, so warm and invincible when she looked at him, took him into her arms, if she didn’t. She wouldn’t be so responsive, so eager for everything with him, the camaraderie, the laughter, the hardships, if she didn’t. She counted on him, gave him every appreciation and respect, every care and courtesy. This was way beyond passion, beyond anything he’d ever hoped for or imagined.

  He stroked her cheek with his, pressed her for one more moment, sending up a prayer of humble, fervent thanks for her.

  “Ah—I love winning,” she purred when he finally let her go and bent to pick up the bags they’d dropped. “Does the surprise involve being someplace where I can perform my penalty on you?”

  He caught her saucy lips again in a hard press, grinned at her. “I’m not saying. Keep walking and find out.”

  She nipped his chin then clung to his arm and fell into step with him. His eyes raked over her with heavy desire. Hers gave back as good as she got.

  She was in her swimsuit, he in his. For the last week they’d rarely worn anything more, taking their dress code from their hosts. Unlike their stay in Manis, they didn’t have much to do in Aldeia Marúbo. Apart from following up the post-operative Matcha and her tiny premature daughter, with the whole population only around two hundred and fifty, they’d wrapped up their work in the first two days and had had the opportunity to kick back and live life as simply as those people lived it. And it had been glorious.

  Seeing how people lived in perfect harmony without any outside resources had put into perspective how they, as part of the “civilized” world, had not only become dependent on their modern props, but had become as reliant on social and interpersonal games and maneuvers and deceptions.

  In the village, as there was no technology or amenities, there were also no social or personal complexities. And this simplicity simplified his views and emotions until he forgot there were reasons to erect shields, to not open himself up and just be happy.

  And he had. He’d dropped his worries and doubts and plunged into profound happiness for the very first time inhis life.

  And here was his happiness made flesh, snuggling into him.

  He hugged her tighter to his side, groaned with overflowing emotions. “Meu beleza, you’re beautiful—just beautiful.”

  He felt a tremor pass through her. He assigned a good reason to it. That was, until a few minutes later she was dispensing with his support and walking separately, and his doubts
crashed down on him as if they’d never dissipated.

  This had been happening ever since they’d arrived here. This episodic withdrawal. As if she sometimes caught herself doing something she shouldn’t. Each time it had passed and he couldn’t guess what could have triggered the dimming, the remoteness.

  But couldn’t he guess, or was he just scared to acknowledge that similar episodes of withdrawal had heralded the end in the past? He’d noticed them then, rationalized them, ignored them, right up until the moment she’d told him she was leaving him. It had taken five months for her to get enough of him back then. Was his novelty wearing off faster this time? Now she was older, more experienced?

  If it was, it was his fault, over-eager, starving, lovesick moron that he was. He might be scaring her, overwhelming her again. Sickening her? Deus, no. He had to slow down, back off, remember his initial resolve, try to stick by it again.

  He was pathetic. Soaring in undreamed-of heaven one moment, drowning in the dregs of unspeakable hell the next.

  “Oh, wow, this has to be it!”

  The awe in her voice brought him crashing back to reality. They’d arrived at their destination and he hadn’t even noticed. She turned to him with a delighted smile and everything was right again. Had the world ever been anything but perfect?

  He spread his arms so he wouldn’t reach for her. “Meu amor, I give you paradise.”

  “Oh, Roque. I don’t think even paradise can be like this.” She pirouetted in abandon, a perfect Eve, tall and lush and vital.

  This place was magic. A few acres of natural clearance within the dense forest, with a pond of turquoise water coming out of nowhere and every bird and butterfly on the face of the earth, it seemed, making it home.

  The tribal shaman had brought him here yesterday, one medicine man to another. It was sacred ground and only shamans were allowed to come here to meld with nature and pray to the gods. He’d gotten the shaman’s blessing to bring his woman, but only because, to the man’s utter confusion, she was a shaman, too. He’d told him it would be the best place to get her with child. A child conceived here would be favorite of the gods.