From the corner of her eye, Jaynie saw the doctor walk to the intercom and press it with his elbow. “Code Pink, Delivery Room C. Code Pink.”
She recognized the Mercy Hospital term for newborn distress, and prayed a quiet, frantic prayer that the code team would respond quickly.
“Cry, my Tara. Cry,” she pleaded.
*
Terrance had showered and changed into his working scrubs. He’d taken an end-of-shift report from the night respiratory supervisor, given work assignments to the other therapists, and had made it halfway through ventilator rounds by mid-morning.
The pulmonary floor bustled with excitement over their charge nurse’s surprise labor. He couldn’t help overhearing Kim Lee retell several of the nurses the whole story about Jaynie.
A twinge of sadness niggled at his brain. Maybe because he knew he could never give Jaynie what she wanted more than anything in the world—a child. And she’d moved on alone with her life while he was still chipping away at his plans to get accepted to med school. He didn’t believe in melancholy, so he punted the thought right out of his mind and got back to work.
Once he’d completed his rounds, he decided to go to the Neonatal Intensive Care Unit, which happened to be close to where Jaynie was. He’d use the excuse of relieving the NICU respiratory therapist for a lunchbreak. Eleven-thirty a.m. was almost lunchtime, right? That way he could keep tabs on how her delivery was going.
He remembered seeing Jaynie for the first time a little over a year ago at a new employee orientation. As the supervisor, he’d been called on to give a brief welcoming speech about the Respiratory Therapy department to the most recently hired group.
His mind had gone blank when he’d seen the wild-haired brunette with bright brown eyes, smiling and staring expectantly at him through tiny wire glasses. Most people might have thought she looked plain, but not him. The opposite of California-superficial, she was natural and appealing as all hell. Her generous lips had made him wonder how soft they might be to kiss, and every bit of the information he’d meant to impart about the benefits of working for Mercy Hospital had slipped out of his head.
He smiled ruefully. He’d since found out how it felt to kiss her. Astounding. And she still had a way of emptying his mind of all other thoughts. But none of it mattered. Things hadn’t worked out between them.
Within two minutes of his taking over the other R.T.’s workload, the Code Pink alert crackled over the NICU intercom.
A shot of adrenaline and a surge of fear caused a knee-jerk reflex. He stopped what he was doing and raced toward the Labor and Delivery suite, heart pounding in his chest, practically bowling over the diminutive neonatologist in the hall.
*
*
The doctor had handed the limp newborn to Latasha instead of placing the baby on Jaynie’s tummy for immediate bonding. She raised her head again. The midwife she’d planned on having had promised she’d get to hold her baby right after delivery. Latasha suctioned the baby’s nose and mouth and rubbed away some vernix caseosa—the white material that gave the fetus protection while floating in the amniotic fluid of the uterus.
Two people burst into the room. Terrance eclipsed a small Indian man, Dr. Shrinivasan. Jaynie trusted Terrance’s skill as a respiratory therapist, and knew the doctor was a particularly talented neonatologist. Seeing both of them rush in to save the day made her feel hopeful that all would turn out well.
The obstetrician spoke quietly to the neonatologist. The APGARS at one and five minutes—the five objective signs evaluating the newborn’s condition: heart-rate, respiratory effort, muscle tone, reflex irritability and color—were anything but impressive. Her baby girl needed emergency assistance with her breathing.
Latasha came back and stayed by Jaynie’s side, assisting with the afterbirth. Jaynie watched the baby-warmer like a mother hawk circling a nest.
It had only taken a few compressions on the Ambu-Bag before her preemie was able to take some breaths on her own. But she’d been inconsistent, so Terrance had slid a tiny airway down her throat and continued using the small bellows bag to blow air fortified with extra oxygen into her premature lungs.
He and the doctor rolled the whole unit out of the room toward Neonatal Intensive Care, where a ventilator awaited.
Jaynie’s plans and dreams careened out the door to another place—a world she had no control of. She watched helplessly, and prayed.
Please, God, don’t take my baby.
CHAPTER TWO
TERRANCE knew the story well from his experience in the NICU. Though viable outside the womb, this baby was over eight weeks premature. Her lungs weren’t ready for life in the big, bad, smog-ridden Los Angeles basin.
He squinted and pinched his nose as nightmarish thoughts appeared about the loss of his own child to crib death six years ago. He shook his head and tried to force the vision of his baby girl out of his mind. He’d never forget her beautiful little face, not as long as he lived.
When he hadn’t been able to save his own daughter, he’d vowed to become a respiratory therapist. But now, several years later, that wasn’t enough. He wanted to be a pediatrician. Regardless of what he’d have to sacrifice in his personal life, he’d see to it that he made it to his dream.
Jaynie’s premature baby had pinked up beautifully after intubation. The report from the NICU doc had been a good one. No meconium or amniotic fluid had gotten into the little one’s lungs. The oxygen saturation in her blood was holding at ninety-two percent or greater on the ventilator, and if all went well she’d be downgraded to backup assist control breathing, and then extubated in a few days.
As he adjusted the ventilator settings, he noted that many of the typical newborn reflexes were intact: the startle reflex, the grasp reflex and, his personal favorite, the tonic neck reflex. He got a kick out of how it looked like a fencing position. Lying on her back, the baby turned her head to the left, extending the arm and leg on the same side, and flexed the opposite arm and leg.
On guard!
“Hey, Peanut,” he said, reaching onto the open radiant warmer that gave all the NICU personnel easy access to a preemie. He gently patted the scrawny, barely three-pound newborn’s head. The baby was startled, but couldn’t utter a peep due to the ventilator. “I’m sorry.”
The overhead heater beamed on his hands like a sunlamp, keeping the wee one’s temperature stable. “That’s right, you go ahead and protest. That’s a good sign.” Terrance smiled and played with her fingers as he administered a minuscule amount of bronchial medicine through the pulmonary device.
He didn’t often assign himself to the NICU, but decided for the next couple of days he’d keep an eye on Jaynie’s preemie. Just until she’s out of the woods, he rationalized. Today, he’d scheduled himself for a second shift until eleven p.m., to keep guard over the newborn’s first day. Besides, Mercy Hospital always seemed short on staff from far too many sick leave calls.
With excellent weather almost every day in Southern California, and good employee benefits, many were tempted to play hooky on a regular basis. He figured he’d save the hospital from paying extra for a registry R.T., and he planned to put the overtime salary to good use to help pay for future med school costs.
The Peanut squirmed and jerked her skinny little limbs, and moved her perfect but premature head, and Terrance swore she looked straight at him through puffy, newborn eye-slits.
“Tough trip out, kid? You look like a prize fighter.” He tenderly touched the baby’s crown with a gloved hand and bet she’d eventually have red hair, if the faintly colored down on her scalp were any indication.
His heart lurched as he remembered his own daughter had had red hair, like his twin sister.
He understood that the less an infant weighed at delivery, the greater was the possibility of crib death. And this baby’s low APGARS and respiratory difficulties could increase her risk of SIDS.
He pondered what that meant.
A second wave of memorie
s fought their way to the surface of his mind. After being trapped by his college girlfriend, who had sworn she was on birth control pills, he had done the honorable thing and married her. He hadn’t exactly been thrilled about becoming a father at twenty-three, having just graduated with a liberal arts degree and not having a job. But when his child had been born, he’d immediately fallen in love with her.
His baby had died silently and unexpectedly at four months, from sudden infant death syndrome. It had nearly broken his spirit. Hell, it had hurt him so deeply that he’d vowed never to have another child.
When his wife had started abusing prescription drugs, he’d got her help. But when she’d had an affair, he’d ended the marriage.
He’d become very cynical about love. No family for me. In a strange way, that pledge had freed him to pursue his dreams of becoming a doctor so he could help other people’s kids.
Terrance played with the little one’s hand and discovered himself smiling again when she grasped his finger. It gave him a different kind of rush, warm and precious, and it took him a second to register the foreign feeling. Oh, no. He winked at the newborn while gathering his defenses. I’m not going to fall for that.
He studied the tiny hand that could barely wrap around his thumb, and thought he’d miscounted. One, two, three, four, five…six? He released it to check the other hand, counted, found the same number.
He glanced up to the knowing look of a nearby elderly NICU nurse. She nodded and whispered, “Polydactyly.”
Wasn’t that a genetic fluke that ran in families?
“Well, Miss…” He looked at the first name on the layette in the NICU and lifted an eyebrow. “Well, Miss Tara.” Terrance thought about the coincidence—the baby had his twin sister’s name. “May I call you Peanut?” He adjusted the small blue plastic tubing on the nebulizer portion of the ventilator that delivered medicine to help dilate the bronchial airways of her tiny lungs. “Let’s put a positive spin on this. The way I see it, you’re an overachiever already.”
*
*
Jaynie got out of bed for the first time after delivery and almost fainted. A student nurse appeared from nowhere to sweep an arm around her waist.
“What are you trying to do? Fall flat on your face?” The fresh-faced youngster practically carried her to the bathroom, where she’d been headed. “Didn’t we tell you to call for help? Why is it that nurses are always the worst patients?” She shook her head of dark straight hair and grunted, giving Jaynie a look of disgust.
Jaynie shrugged her shoulders and apologized for trying to be self-sufficient. “I thought I was okay.”
The nurse-in-training clicked her tongue. “That’s what they all say.”
She positioned Jaynie safely inside the bathroom, showed her the button to push for help—as if she’d never seen one before—and closed the door.
Her stomach felt empty and sagging. Heavy post-partum lochia dampened her mesh padded panties. A thought about senior citizens wearing similar underwear for bladder control popped into her head. She couldn’t wait to change into a fresh pair, and wondered if they might come in a French-cut style. For the first time since becoming a mother, Jaynie smiled at her own corny joke. Heck, maybe there was even a thong version?
The intravenous line of saline and sugar water felt more like a ball and chain. The tall metal pole on wheels carried a volume-regulating machine and was necessary because of her ongoing low-grade fever and her need for antibiotics.
So this is how my patients feel. It seemed odd, being on the other side of the hospital gowns and curtains.
Her legs trembled with each step, as if she’d just run a marathon. She smelled like she’d run one, too, and dreamed about a soothing warm shower. For now, a birdbath would have to suffice. Oh, but the warm institution-white cotton washcloth felt spectacular on her face. She didn’t even mind the harsh laundry detergent smell.
They said her labor had only lasted four hours—four of the longest, most grueling hours of her life. She glanced at the clock on the wall. Five o’clock. She must have passed out for a while afterwards. The last thing she remembered was waiting to hear her baby cry… But she hadn’t heard a sound.
Now, holding the washcloth over her eyes, she could almost hear the sound of her baby being whisked away on the combination Infant Warmer-Crash Cart. Wanting to cry, she talked herself out of it. “You’ve got to be strong for Tara.”
After cleaning up, all Jaynie could think about was going to see her baby, the child she’d named Tara Elizabeth Winchester. Elizabeth after her mother, and Tara after a special little girl in a picture provided by the sperm bank.
The children in the photo couldn’t have been more than two years old, and must have been related. The girl’s wild and curly hair drew attention away from the stoic, straight-haired, cowlick-ridden boy by her side. The black and white Xeroxed copy had made it impossible to tell what color her hair was. Her shirt had a big heart next to her name—Tara. The boy’s name, the name of her sperm donor, had been removed for confidentiality. Perhaps the other name had been an oversight? From the looks of it, they were twins.
“You gave us a scare,” the obstetric doctor said, appearing at her door.
Jaynie snapped out of her thoughts and turned in the chair by the window. “Oh, Dr. Lindsay. Is everything okay?”
“All is well. Your baby simply made her appearance on the planet too soon,” he said. “The neonatologist wants to fatten her up a bit. They’ll keep her on a ventilator for a while, then watch to see how she adjusts to breathing on her own.” He scrubbed his fatigued-looking face with a large hand—evidence of a long day. “I need to put you back in bed for a moment.” He walked closer. “Let me check your fundus. Are you feeling okay?”
She lay down on the hospital bed so the doctor could press on her lower abdomen and her ever-tightening uterus. The nurses had been doing frequent checks, and had told her after the last time that she was the size of a grapefruit.
“Progress,” he said. “You should be good to go home by tomorrow.”
Tomorrow? The thought of leaving for home without Tara sucked the wind out of Jaynie’s lungs.
Shortly after the doctor left, Kim showed up, wearing hip-hugging cropped pants and a bright, silky Mandarin collar top, and pushing a wheelchair. “It’s visiting hours. Let’s roll to look at Tara. Maybe if I pull a few strings they’ll let me in, too.”
Down the hall, Kim and Jaynie found the rectangular, sterile NICU room silent and solemn when they entered. Fluorescent light gave the room a false midday look, when it was well past the dinner hour. Ten incubators lined the walls, but only six had occupants. Her baby lay in one, and she couldn’t wait to see her. A few parents congregated around other stations, speaking reverently to their preemies.
And there, by the radiant warmer second from the end, much to Jaynie’s surprise, stood Terrance Zanderson. He spoke almost inaudibly to her daughter, while giving her a breathing treatment.
The sight of the tall, handsome man, whispering like a father to her baby, squeezed her heart. She blamed post-partum hormones for the sudden blurring of her vision and the catch in her throat. Too bad things hadn’t worked out.
If only Tara had a doting father like Terrance to call her own. But that wasn’t part of the plan. All the research in the world couldn’t produce an in-the-flesh, willing-to-commit parent for her girl.
Feeling much stronger, and eager to see Tara, Jaynie jumped from the wheelchair and approached Terrance and the layette in her hospital-issue, skid-free slipper socks.
“Hey,” he said, looking surprised.
“Hey,” she whispered, fearing she’d wake not only her baby, but everyone else’s if she spoke too loud. “What are you still doing here?”
“I’m doing a double shift,” he replied with a smile. “I’m fiendishly making extra dough to fend off future med school costs.”
Jaynie nodded. She knew about his big plans. They’d talked for hours on their very
first date about their life’s plans. At thirty, his had been medical school—though he’d never completely explained why he wanted to make the switch from R.T. to M.D. At thirty-four, hers had been motherhood, and she hadn’t given him the full story of why either. She’d seen the terrorized look in his eyes when she’d blatantly come out and told him what she wanted most in life. But he hadn’t run away kicking and screaming, like her ex-boyfriend. He’d even asked her out for another date. And another. And another.
Yet, with their divergent plans, there had been no place for their attraction to lead. But they’d ended on a positive note, remaining friends.
The crusty NICU nurse greeted Jaynie with antibacterial soap scrub for her hands, shooed Kim out of the room, and took control of the layette and the baby within. “Has your milk come in yet?” she asked, handing a mask to Jaynie to wear.
Mildly embarrassed in front of Terrance, Jaynie shook her head. She couldn’t tear her eyes away from her precious daughter even while she applied the mask.
“We’ve got an electric pump in the other room. You can plug yourself in and save the colostrum for Tara’s feedings. With o2 Sats like hers, I predict she’ll be extubated by the end of the week. Right, Terrance?”
He nodded his agreement and smiled warmly at Jaynie—a picture that brightened her spirit.
“She’s a fighter,” he said. “She’ll be fine; don’t worry. The respirator is just helping save her energy, by not having to work so hard for each breath.”
His comforting words touched her, but Jaynie was no fool. She knew the biggest threat to her preemie was infection, and the next few days could bring disaster or smooth sailing. Only time would tell.
The NICU nurse, garbed in pale green scrubs, blue surgery cap and latex-free gloves, said, “Once she’s extubated, we’ll have to see if she’s got a rooting reflex, so she can nurse.”
The R.N. ushered Jaynie alongside the layette. Encumbering ventilator apparatus was connected to the endotracheal tube in Tara’s mouth, which passed into her windpipe and made little peeping sounds as it pushed air into her lungs. Cardio-respirator leads were in place on her chest and abdomen, along with a temperature sensor on the other side of her tiny stomach.
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