Chapter 25 #2
“No,” Grace cuts Oliver off sharply. “I was serious about that. Let Kaplan do it. I need you behind me, Oliver. With me. Please. I can’t do this without you. We can both talk Kaplan through this. Where is Carter?”
“I’m calling him now.”
Grace lets out a sob, her body trembling, her face burying itself into Oliver’s arm as he runs his hand down her hair.
“He should be here,” she whimpers. “This shouldn’t be happening in the car. What if… what if the baby’s lungs aren’t developed? What if there’s something—”
“Stop,” I cut her off. “You have two doctors in the car since you are officially now a patient and an ambulance in route. I have lidocaine, syringes, scissors, a scalpel, various surgical instruments, an Ambu bag with a pediatric attachment, and some basic rescue meds, including epinephrine. Thanks, Dad, for constantly drilling us with the importance of keeping our cars stocked. I don’t have anything to start an IV with though, so no umbilical line other than what I can inject with a syringe.
” I hand Oliver a stethoscope, a pulse oximeter, and a blood pressure cuff.
“Check her vitals. You’re on point for mom.
If you’re at all worried about a seizure, tell me.
I might have something in here that can help, but I’d rather not spend time digging through looking for that right now. ”
Oliver sets the phone down on the back end of the center console and gets to work on Grace’s vitals when Carter’s voice rings out through the car. “Oliver? Everything all right?”
“Carter, we’re stuck in traffic behind an accident, brother, but Grace is in labor.”
“What?! Grace?”
“I’m here. Carter, it’s too soon.”
He hisses out a slew of curses. “Can you make it back to the hospital? I’ll come get you. Tell me where you are. I’ll come get you.”
“She’s at plus two station,” I announce, removing my gloved hands from between her legs and sitting back awkwardly on the small back seat.
“The baby’s head is fully engaged, which means this is happening now.
Carter, you’re going to have to talk me through this.
Oliver, you’re on Grace. Grace, you focus on your breathing and doing everything Oliver and I tell you to do. Got it?”
“Vitals are stable on Mom,” Oliver announces.
I glance out the window. No one is moving and we have our hazards on anyway. Nothing to do now but deliver this baby and hope to hell he’s breathing, and the NICU ambulance gets here quickly.
“Kaplan. Jesus. Okay.”
There’s noise in the background as if Carter’s moving and I hear him speaking to someone, but then Grace lets out a scream. “I have to push. Now, Kaplan. Now.”
“Kap, slide your fingers into her vaginal opening, one hand on the top, the other on the bottom of the baby’s head.
Do not pull! Just hold it and help guide it.
Grace, push. One. Two. Three. Each a slow count.
Rest. Then do it again. One. Two. Three.
Remember to breathe, sweetheart. You’ve got this. I love you so much.”
Grace screams as she pushes, and I hold on to the baby’s head as Carter instructed.
“Add to it, Grace,” Oliver encourages. “That’s it. Keep it going. Get all the way through the contraction. Perfect, honey. You’re doing so well.”
“Contraction stopping,” I say, still holding the head though she’s no longer pushing.
“How’s he look, Kap?”
“Your son looks good,” I tell him. “Moving along like a champ. Some dark hair, a little bit of his forehead. No face yet and no tearing.” Though I can’t tell if the baby is in any distress. We’re totally blind with this.
“Second set of vitals on Mom are holding. Pupils are equal, round, and reactive. No sign of seizure.”
I nod at Oliver, wiping my sweaty forehead with my arm. “I should have stayed in my scrubs.”
“You look good wearing my amniotic fluid and blood.” Grace emits a shaky, broken laugh. “Sorry.”
“You’ve got nothing to be sorry for,” I tell her, staring into her fractured blue eyes. “I needed a new car anyway.”
Another shaky laugh. This one more broken than the one before it.
“This could be worse, Grace,” I halfheartedly quip. “This could be so much worse.” I hope . “Oliver could be delivering your baby.”
“Asshole,” he snaps playfully, trying for levity in his voice too. It makes no difference. We’re in the thick of this and all of us know it.
A tear streaks down her face as she stares into my eyes.
Desperate. Pleading. Destroyed with fear.
She’s covered in sweat, panting for her life while Oliver holds her up, his back pressed into the door.
He’s whispering things I can’t hear into her ear—all the things, I have no doubt—but if Carter can’t be here, then I’m glad Oliver is.
Like I said. It could be worse.
“Another one is coming,” Grace announces, and I get back into position, my knees on the seat as far away from her as I can get, my back hunched over. “I need to get him out. The pressure is unreal. I need him out.”
“Let’s do this. You got it,” Oliver reassures. “Okay. Push, Grace. Push.”
“Count it, Grace. Breathe, sweetheart. Let’s get our little guy out of you,” Carter encourages.
“Head is coming along,” I tell them. “Do I just keep holding him, Carter? He feels restricted.”
“Keep one hand on the bottom of his head and if you can reach in and grab them, help guide his shoulders. Are they visible? You might have to turn him depending on how he’s presenting.”
“Yes! He’s coming. He’s small and he’s coming.
Keep going, Grace. We’re nearly there.” With my hand on his slippery little shoulders, I adjust him ever so slightly, so he doesn’t get stuck on her pelvic bone, terrified I’ll hurt him, but knowing he needs to get out too.
My heart is beating like a bitch in my chest, ready to explode.
Adrenaline shooting through my veins, keeping me sharp and focused.
“Ahhhh!” Grace screams in pain as I shift him a little more.
“Carter, he’s coming. Do I pull him out?”
“Yes. Get him out. That’s his best shot now.”
“Almost there, almost there. One more push, Grace, and I’ll have him out. Just give me one more big one. Oliver, I’m going to need you, brother, the second I’ve got him.”
Another hard push, an even louder scream, and the baby slides out, tiny and blue and not crying. I set him on the second towel I have set up and immediately start rubbing him with it, hoping to get this little guy going.
“Kaplan?!”
“He’s out, Carter. I’m working on him. Just shut up. Oliver, I need the stethoscope.” He hands it to me, and I listen for a heartbeat.
“Grace?” Carter questions.
“I’m fine.” Only she’s not. She’s sobbing and pale against the glow of the lantern and the inner lights. Off in the distance we catch the sound of fresh sirens, and I can only hope that’s for us. “I’ll take care of my placenta. You guys take care of him.”
“Shut up. Everyone stop talking,” I bark, trying to keep my shit together when the desire to lose it is incredible. Never in my life have I been more terrified. “Heartbeat. I’m counting.” I tap it out. “Ninety. Let’s get it up. Oliver, I need your help.”
“Is he breathing?!” Carter yells.
“Not yet. Oliver, now.”
He kisses Grace and shifts her so he can climb out from behind her. I clamp off the umbilical cord and Oliver lifts the scissors, cutting it.
“Bag him up now. Let’s get him breathing.” I hand him the Ambu bag with the pediatric-sized face mask attached.
I keep rubbing his body, but it’s not enough. He’s limp and still blue and not breathing yet.
“Should we give him some epi?” Oliver asks because even though he’s a family physician, he doesn’t deal with any sort of trauma the way I do. Certainly not in newborn babies.
“Probably, yes.” I give another listen, tapping it out.
“What’s his heart rate?”
“Slowing.”
“Kaplan!”
“Shut up, Carter, and let him work,” Oliver clips out. “He’s got this.”
Grace is wailing now, sitting up over us and staying back though I know the mother, the doctor in her, is dying watching this and not being able to jump in and help.
“Let’s do a round of epi. Give him… 0.1ml/kg as he’s about, what, four pounds or so,” I murmur to myself, thinking through the math. “That’s 0.2ml into the umbilical cord. Into the vein, not the arteries. Do you need help?”
Oliver’s eyes shoot up to mine. “I haven’t done that before.”
“I’ve got it. You keep bagging him.”
Drawing up the epinephrine, I unclamp the remaining umbilical cord, locate the vein, and slowly push it in with the syringe, followed by a small amount of saline to flush it through.
Once that’s done, I continue rubbing his arms and legs, the top of his head and bottoms of his feet, all the while Oliver continues to give him oxygen through the Ambu bag.
“Come on, little man. Give us something, Owen,” I cry. I plead.
Nothing.
Oliver is trembling beside me, panting and sniffling as he attempts to contain his emotions.
And just when the abject fear and consuming panic feel like they’re about to win and everything we care about is lost to us, baby Owen startles, jerking his tiny arms and legs outward.
The smallest of cries pierces the air, but it’s there, and I swear, I start to lose it.
Huffing and puffing and desperate to hold my shit together.
My hands never shake—it’s why I’m such a good surgeon—but everything inside me right now is rattling with relief. Oliver’s forehead hits my shoulder as he chokes on his breaths.
“You’re doing so well, little man,” I tell him, still rubbing his body with the towel, trying to get his skin to pinken up a bit more. He’s moving more now. “Give us some more cries, okay? Keep fighting. We love you. Mommy and Daddy want to hear you.”
Another cry, this one a little louder and Grace and Carter are inconsolable, both sobbing messes. Oliver too, as he shifts around me and grabs Grace, holding her. I take over with the oxygen, bagging the little man, listening as his heartbeat grows stronger.
“Heart rate is one-forty.” I sag against the back of the front seat, managing to crack a smile.
“He’s good for now, but I’ll feel better when the ambulance gets here and we get him to the hospital.
” Swaddling him up in the towel, I lift him, handing him to Grace.
She takes him, tucking her baby into her chest and kissing his head as tears continue to stream down her face.
“Thank you, Kaplan. I don’t have words. I don’t have a way to express how grateful I am. From the bottom of my heart and the depth of my soul, thank you.”
“Kaplan,” Carter rasps hoarsely through the phone. “Fuck, man. I owe you everything.”
“Go team,” I deadpan, drawing a tremulous chuckle from Oliver and Grace.
“I think it’s officially safe to say I’d do anything for you.
” I kiss both her and tiny Baby Owen on the head.
The sound of the ambulance is growing louder and after ripping off my gloves, I open the back door.
“Oliver, you got them? I’m going to pull over and flag them down.
Keep tabs on his breathing and heart rate. ”
“On it.” A hand on my back. “Hey.” I turn back to him. “Good fucking work tonight, brother.”
“You too,” I tell him, holding his gaze for a moment and then climbing out of the car.
The door shuts and I lean against my car so I don’t get hit, breathing in the icy, freezing air that feels nothing short of incredible on my sweaty, pulsing skin.
Fuck. I just delivered my nephew and for a few minutes there… God. The accident ahead is all but cleared, cars moving around us now, blaring their horns, and it’s a wonder my car wasn’t hit during all that. I hadn’t even noticed what was going on around us.
Climbing back into the driver’s seat, I manage to pull us over to the breakdown lane, park, and then get out again, waving my arms so the ambulance that is quickly approaching sees us.
Within seconds, they’re stopping behind us and I recognize the EMS crew.
I tell them everything that happened as well as the status of baby Owen and they’re on it.
Getting Grace and Owen hooked up with IVs and monitors and oxygen and moving them over to the rig.
“He looks good,” Callie, one of the EMS crew, says. “Good work tonight, Doctor.”
I give her a nod, making sure my family, my heart, are all settled.
Oliver goes with them and as I climb back into my car after watching them speed away, I take a second for myself.
Just breathing in and out. Trying to get my shit back together.
Trying to slow down the adrenaline and anxiety.
Grateful, so damn grateful it turned out as it did.
My car reeks of blood and sweat and heat and hell only knows what else. I need a shower. I need a change of clothes. I need a meal. I need to make sure Grace and Owen are straight.
And when that’s all done, the only other place I want to be is inside Bianca. It’s been one hell of a day. I can only hope this was the end of the drama for a while. I’ve had enough for a lifetime.