Stockholm Syndrome
Page 9
Tucker’s brown eyes lit up. He started to turn, but Bastard cocked the gun at him and said, “Where d’you think you’re going, buddy?”
I turned back to Manouchka. The baby’s head abruptly came down enough that I glimpsed and felt the crown of the head. I yelled out loud with joy, but when she gave up, the baby’s head shot back up the vagina.
Still, a vast improvement.
She crouched on the tile floor, legs shaking.
“Good! That’s it! Good job. One more push like that, and you should get the baby out.”
Meanwhile, I could hear Tucker educating Bastard. “We’ll need somewhere to keep the baby warm.”
“What the fuck?”
“The baby’s weak. We need to keep him or her warm, just like inside mom. I have to turn on the incubator. You can come with me.”
“You’re not going nowhere!”
“It’s right there.” Tucker pointed at the incubator directly to their right, at the far end of the room. “I just need to turn it on. I should check the equipment, too.”
“You go where I say you go, motherfucker!”
I prayed that Tucker could reason with him.
Manouchka cried out in terror, and my heart clutched. She was losing faith, and part of me wanted to throw myself in front of Tucker like a human shield. Bastard hadn’t shot anyone in the past few minutes, and he seemed to believe that he had to clamp down on Tucker to prove his manhood. Danger, danger.
But Manouchka and the baby were my priority now. We had to get the baby out.
“We’ll take care of him here, if we have to,” I told her. “I can deliver him and place him on your stomach.” That’s standard, at St. Joe’s. Deliver the baby and place it right on Mommy’s tummy to cut the cord, unless the baby’s in respiratory distress.
If the baby wasn’t breathing, I had 30 seconds to dry it, suction the nose and mouth, and stimulate it.
But if I remembered my resuscitation properly, after those 30 seconds, I’d have to bag the baby.
Or was it intubation first, since the baby had passed meconium? That sounded right. Stick a tube down the baby’s throat and suction out all the yellow/green/black stuff.
Oh, crap. Tucker better remember the algorithm better than I did.
Regardless, I needed a warm, safe place to safely assess the baby’s condition without causing an infection.
But if I had to resuscitate this baby on mommy’s belly, hunched over a toilet, I’d do it.
Tucker was telling Bastard, “If we practice on this baby, we’ll be even better at helping yours,” and I prayed that he’d go for that.
Meanwhile, the next contraction hit Manouchka.
She curled over, fighting the pain, before she arched her back with a scream.
I bent over her and yelled, “Push! Push! Push! You can do it! Yes, Manouchka! That’s it! GoGoGoGoGo!” The last bit was in English. Even French people say GoGoGoGoGo.
I thought I heard the guys moving out of sight, crossing around the corner to the incubator, but I couldn’t spare a glance at them because the baby’s head started to ooze out.
Because Manouchka was on all fours, the baby’s head came out facing me instead of the ground, the way they do when a woman is lying in bed. I jerked in surprise before I smiled at the forehead emerging.
My first instinct was to keep massaging her perineum, but with the head sailing toward me, it would squish my fingers. I gave up and used both hands to catch the baby.
I’d already had one episode where the medical student thought I was going to grab the baby, and I thought he was going to get it, and the baby nearly hit my thighs before I caught it and scooped it into the mother’s lap with a bigger-than-usual smile, saying, “Here you go!”
Manouchka grabbed her own knees and curled her chin toward her chest.
“Yes! That’s it, exactly!” I’d forgotten to coach her on that part, but either the nurse had told her earlier, or Mother Nature had kicked in with a vengeance. Manouchka was bearing down and forcing that baby out, probably oblivious to my cheerleading.
The baby’s eyes, nose, and bluish lips were now squeezing toward me.
I wasn’t panicked about the baby’s colour. In my limited experience, they all look a bit cyanosed during delivery, but pink up shortly afterward.
Then the whole head emerged, and I realized that the umbilical cord was wrapped around the baby’s neck.
CHAPTER 19
I’d seen this once before, but I had no equipment on me.
“Tucker! I need two clamps and a pair of scissors!” I yelled. “Cord around the neck!” Even while I spoke, I shoved a finger between the umbilical cord and the baby’s neck. It was just loose enough allow my finger, so as long as I kept it here, the cord wouldn’t strangle the baby. No wonder the poor thing had started pooping in utero.
“I’m on it,” Tucker said.
“What is it?” said Bastard, and for once, he wasn’t swearing.
“Push, Manouchka,” I said, keeping my finger inside the cord. I could feel it pulsating with the baby’s heartbeat.
I felt like the kid with his finger in a dike. I’d reached out for the cord automatically with my right hand, so I’d have to catch the baby with my left, but that was better than nothing. And, at least with Manouchka on all fours, the baby couldn’t fall far.
Manouchka’s head jerked, drawing my attention to her.
Don’t seize on me. Don’t you fucking seize on me with the cord wrapped around the baby’s neck.
“Baby’s in trouble,” said Tucker, and I heard him grabbing stuff from the delivery cart. Thank God he was the one on that. I didn’t know what was where, on that cart. I just prayed that he’d had time to warm up the incubator, in case the baby stopped breathing.
Tucker hurried to my side, ripping open a tray wrapped in a green sheet. I glanced over and snatched the nearest pair of forceps, barely noticing Bastard, who barged into the bathroom behind Tucker, still waving around his ubiquitous gun.
This close, Bastard wouldn’t miss, but if I went out, I’d go out saving this baby’s life.
Manouchka squeezed out the baby’s shoulders. There’s usually a slight pause after the head, before the shoulders emerge, and that’s when we clamp. But because I didn’t have the tray beside me, we lost those few precious seconds. I’d have to do this on the move, like I was in a video game.
An instant later, the torso eased out, the baby’s arms folded over its chest.
I moved forward to catch the baby’s body on my gowned-up knees while I clamped the cord awkwardly, with my left hand.
Meanwhile, the rest of the baby was coming out, and I dropped the clamp to catch the baby with both hands.
Tucker’s two hands shot forward, each wielding a metal instrument.
He clamped the cord an inch from the first and, with his other hand, severed the umbilical cord with scissors.
No going back now. The mom was no longer giving oxygenated blood and taking away deoxygenated blood from her babe.
Sink or swim time. But at least the baby wouldn’t strangle on the cut cord.
Immediately, Tucker started suctioning the baby’s mouth with a blue bulb suction, the way you’re supposed to in a meconium delivery. Whaddaguy.
I didn’t have time to worry about Tucker’s non-sterile hands, because I was too busy catching the baby before it hit the floor. Face-up, with his skinny legs flexed at the hip, it was easy to see his reddish, swollen testicles and miniature, slightly bulbous penis.
A baby boy. Just like Casey’s.
“Is he alive?” Manouchka called, her voice reverberating around the small bathroom.
“Yes,” I said, but my eyes were surveying his chest, which was moving too fast. Bellows breathing, they call it, because their miniature chests are pumping away, hyperinflating and deflating fast enough to fan red-hot flames in a fireplace.
His face wrinkled up, and his mouth opened soundlessly.
Cry, baby, cry. Breathe and cry.<
br />
Tucker suctioned his little nose next. The nostrils were flaring even without the noxious bulb suction, but he was too small and weak to get away from two determined doctors.
Tucker and I both knew we had to get this baby under the lights. If his breathing didn’t recover with this suctioning, we’d have to intubate him and suction the meconium out of his trachea.
“Let me see him,” said Manouchka, pushing upward to sit on her bum, and after a second’s hesitation, I placed the baby in her lap. That was the least I could do. But I murmured a warning, “He needs to breathe.”
She touched his face. She stared into his wide, dark eyes as if she could see the world in them before she cradled him tightly against her chest.
The baby continued to gasp, but his arms folded up against his own chest and he seemed to fit against her.
Even with the baby breathing too fast, even with Bastard hovering over us with death in his eyes and in his hands, this was the most beautiful moment I could remember between a mother and a child. I would never forget that silent, desperate tenderness.
I wanted to hold them both close and guard them with my body.
The most maternal I get is with my brother Kevin. He’s only eight, although his ninth birthday is coming right up. I had to grit my teeth to force back any tears, thinking about him and if I’d survive until his birthday next week.
If I died, he’d remember it every time he blew out his birthday candles.
Don’t think that way, Hope.
I turned back toward the baby. He still hadn’t cried. And even though they don’t have to cry, that plus his obvious gasping made me too nervous to let them stay nestled up like that.
Tucker spoke first. “We need to help him breathe. We’ll get him back as soon as possible. I promise.”
Manouchka touched her baby’s face. She murmured something in his ear, not seeming to hear us.
Tucker and I exchanged a look. We didn’t want to have to fight her for him. She’d been through enough. On the other hand, we couldn’t let her baby die on our watch.
Bastard cleared his throat. Even he didn’t want to intrude, which just goes to show how holy this felt.
Either that, or he was politely warning us before he massacred us all.
I murmured to Tucker, “Wash your hands. I’ll talk to her.”
He cast me a slightly dubious look, but stood up and ran the water at the sink, while I told Manouchka, “Your baby is breathing too fast. He has...caca in his lungs. We need to get it out. We might have to put a tube down his throat.”
“Non!” She held him against her.
I stared into the baby’s eyes. He was gazing back at me, observing me from the protective cocoon of her arms, but still breathing harder and faster than I would like.
We all had to take an obstetric and neonatal resuscitation course, but none of them had prepared us for being held hostage while the mother refused to let us treat the baby. Maybe I could write an addendum on that, if we survived.
She offered the baby her breast. The baby’s mouth opened, maybe to drink, maybe to sob. He managed to emit a weak cry that was almost drowned out by the sound of Tucker drying his hands on paper towels.
“See!” said Manouchka. “He’s just hungry.”
“Look at his ribs sticking out when he’s breathing,” I said. “Look at how round his nostrils are. He’s using his stomach muscles. He’s breathing, yes, but he’s getting tired. And when he gets too tired, he’ll stop breathing, and we’ll have to breathe for him.”
Tucker squatted beside Manouchka, blocking out the light beaming into the baby’s face. The baby’s mouth opened and closed while she tried to shove her breast in his mouth. I’m no newborn expert, but I didn’t think he was getting any breast milk. Tucker said, in French, “Congratulations, Mama.”
She hardly glanced at him. She kept her head down, gazing at her baby and hunching her shoulders. Her arms formed a cage to keep us away. But I thought maybe her cheeks rounded in a barely perceptible smile.
“You worked so hard to get him here, under the worst circumstances. What’s his name?”
Aw, geez. Tucker was using his psych superpower again, establishing a rapport. Part of me still wanted to snatch the baby like a football and break for the incubator. But I watched her body shift slightly toward my man, and I thanked any random deity that Tucker was here. I’ve got the skills, or some of them, but it’s no good if you alienate your patients.
“I haven’t decided yet,” she said to Tucker. “God will tell me.”
So she was religious, probably Christian. Maybe not surprising at a place called St. Joseph’s Hospital.
How could we use that to our advantage? I racked my brain for appropriate Bible quotes.
If only I could call a friend. Ryan could utter a dozen pithy phrases that would convince her to airlift the baby into the incubator.
Tucker said, “Yes. ‘The wolf will live with the lamb; the leopard will lie down with the young goat. The calf and the lion will graze together, and a little child will lead them.’”
He said it in English. I’m not sure if Manouchka understood it or not, but I only realized it was a Bible quote because of the last phrase. It was in a movie starring Halle Berry about giving her son Isaiah up for adoption, so I even knew that it was from the book of Isaiah.
Maybe that’s how Tucker knew it, too, since I’d never heard him talk about religion until now.
I hadn’t heard the whole quote before, and I wasn’t sure what to make of it, but it sure felt like we were hanging out with a metaphorical wolf. (Although, as an animal lover, I should point out that wolves are an important and respectful part of the ecosystem, unlike, say, most humans.)
Manouchka blinked at Tucker, and then she said, “Un enfant...”
A child. “Yes,” Tucker and I said at the same time. If we’d been kids, I would have said, “Jinx.” But we’d had enough jinxes.
Manouchka shifted from side to side and said, “It hurts.”
She pointed at her belly, underneath her still-heaving baby. I belatedly realized that not only was she sitting on her sore ladybits, but she hadn’t delivered her placenta.
CHAPTER 20
There’s a normal gap between delivering a baby and delivering a placenta. After all, you want the placenta to keep up its good work as long as possible. It can take fifteen minutes or more for it to come out naturally.
Normally, we speed things up by applying gentle traction on the umbilical cord, and the placenta slowly detaches itself from the uterus and plops out through the vagina.
But this time, because we’d been so worried about the baby—I decided to call him Isaiah, in my mind—we hadn’t considered her placenta at all.
“What’s the hold-up here?” Bastard groused. “You got the kid out. Let’s go find Casey.”
My heart contracted. I’d forgotten about him for a moment.
Tucker answered, still squatting by Manouchka but gazing up at Bastard. “The baby’s sick. We need to take care of him in the incubator. And Manouchka still has to deliver her placenta.”
“What the fuuuuuuuck,” said Bastard. But he wasn’t pointing the gun at us, for once. He started pacing back and forth just inside the bathroom, hemming us in, but he wasn’t directly holding us hostage.
Was it possible that one of us could grab the baby and make a break for the door?
I was seriously tempted.
The bathroom door was less than ten feet from the main exit.
And what if we split up, one of us with Manouchka and the other with the baby?
One of our two teams might make a successful break. Maybe. If Bastard was sufficiently distracted, with bad aim, and we ran like a tornado.
Too bad the bathroom didn’t have a secret exit into the hallway, but this wasn’t Harry Potter. One of us would have to dash out the bathroom door, past Bastard, and throw open the door to the hallway while carrying a newborn.
It was risky. Very risky.
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br /> Say Tucker tackled Bastard alone and managed to distract him for a few crucial seconds. Even so, Bastard could recover immediately and shoot all four of us, just pick us off, in less than a minute. Even if the cavalry was waiting right outside.
Pro scoop-and-run argument: this baby was sick. Tucker and I had done okay, but it would be even better to get him into warm, sterile conditions, in expert hands, with Mom at the ready to cuddle and breastfeed. To do that, we needed to get Isaiah and Manouchka out.
Stay-and-play argument: we did have an incubator and two doctors here who could bag or intubate this baby without any shots being fired. Short term, that was the safer option.
But how safe was it to stay cooped up with a psycho?
Should we bolt now, while we still had the nerve and energy? The longer we waited, the more Bastard would swing from erratic to deranged territory.
Meanwhile, Tucker spun his words around Manouchka like they were the only two people in the room. “He’s beautiful. We need to take care of him. Will you let us help him breathe?” He was staring at her, so I couldn’t try to telegraph my pro-running thoughts to him.
She was more likely to give her baby to Tucker than to me, and I didn’t see him making a break with a newborn. Not if it meant leaving me and Manouchka here.
Chances were, either all of us would get out, or none of us.
I glanced at Bastard, at the broken doorway, and tried to measure the distance to the exit.
Manouchka groaned. “Just you,” she said to Tucker.
Hey. Was she saying what I thought she was saying?
Before I could prickle, she groaned and handed him her baby.
Tucker gently scooped Isaiah in his newly-washed hands. I’d never watched him hold a newborn before, and my heart stabbed with pain, drinking in his sweaty blond head bent over Isaiah’s skinny, flaring chest and his stick-like limbs. Tucker was a natural. He should have ten kids. He shouldn’t be stuck with a murderer and me.
“Thank you. I’ll take good care of him,” said Tucker, and rocked back on his heels to balance himself before he rose up from his squat and faced Bastard, who blocked the doorway.