Chapter 5
Five
JACKIE
N o one mentioned that I was late to dinner, which I took as a minor miracle. Joe wasn’t brought up either, which I thought was strange, but also kind of a relief. I’m not sure what it was about Joe bringing Maia up that got me so upset. They were always close, and he always had a crush on her. She never seemed interested in him like that, though. By the time I go to bed, I decide that it’s all in my head. Joe has every right to ask about anyone he wants.
When I wake up in the morning, I feel a lot better. My head is clear, and my emotions feel regulated. I hurry through my morning routine. I’m taking Sabina to her appointment today. I have high hopes for the new program she’s in at the hospital. Since it’s comprehensive, they should be able to help her with her TBI symptoms as well as her depression and her anxiety. Gianna, Maia, and I are all taking turns getting her to and from her appointments. We all work, as do our parents, so it makes sense for us to all chip in.
I pause at these thoughts, because they aren’t wholly accurate. We feel responsible for what happened to Sabina, but that doesn’t really touch on it either. Guilty, maybe. Sabina joined the Army to prove that she was tough and capable. I often wonder if we made her feel like she wasn’t good enough or strong enough when we were all growing up. If we hadn’t done that to her, she might never have felt the need to prove herself, never have gone overseas, and so on. It’s a horrible game of ‘what if?’ There are no answers. I don’t have any now. All I can do is take the next right step forward.
Sabina is nowhere to be found when I come downstairs. I fix myself a piece of toast. It’s all I can stomach at the moment. Mornings aren’t my jam. My schedule has been so all over the place these past few weeks, that my eating has been off as well.
I’m just finishing my toast, when Sabina drags herself into the kitchen. She looks like she hasn’t slept in a week, which I suspect is close to the truth. I smile at her, and she gives me a weak smile back.
“Are you hungry? Do you want some toast or coffee?” I ask, wincing at the false brightness in my voice.
“I can make my own toast,” she says curtly.
“Right, of course,” I say quickly. “I just meant, since I was going to make myself another piece, I could make you one, too.”
I can tell that Sabina doesn’t believe my lie, but she doesn’t argue with me. She just shakes her head instead. I watch her go about getting some juice from the refrigerator. Most of the time, I can’t tell that she’s recovering from a TBI; but sometimes she has trouble concentrating on the task at hand, or she trembles, as if fear is still radiating through her body. When I see it happening, I want to wrap her in a hug. But Sabina doesn’t like hugs all that much anymore.
“Well, I’m going to finish getting ready for work. Meet you in the car in fifteen minutes?” I say. Sabina nods, but doesn’t look at me. My heart hurts for her. I linger in the doorway for a moment, before heading back to my room to finish getting my stuff together for the day.
I pause in front of the mirror that hangs above my dresser. My dark brown hair is cut in a bob that I’m constantly tucking behind my ears. My hair frames my face and makes me look like a pixie. That’s why I got the cut in the first place. I think it makes me look cute. My eyes are a deep brown, and for a long time I thought it made me look soulful. Cute and soulful are not hot or beautiful. They are not the things that men are looking for.
Why am I even entertaining this sort of thought? I shake my head quickly to clear my brain. I have to focus on work. Today I’m on the maternity ward, which is one of my favorite places to be. There is typically so much joy in the maternity ward with babies being born. I’ve seen some tragedies there as well, but it’s generally a cheerier ward than most of the other ones.
Taking a deep breath, I grab my purse and my ID badge and head down the stairs. There is still no sign of Sabina, and I don’t hear her in the kitchen. I know that it’s important not to hover over her. She’s still a fully functioning adult, and she needs to be allowed her autonomy, but it’s hard when I know that she’s struggling. All I want to do is take her pain away and help her through it.
“Sabina, I’ll be in the car,” I call, before I head out the front door.
I slide behind the steering wheel and wrap my hands around it for a moment, as I collect myself. Sabina doesn’t need to see me upset. That is one thing that I can do for her, regulate my emotions. Hopefully the day will be calm and light, although I do hope that I can assist with at least one birth.
A few moments later, Sabina slides into the passenger seat and clips her belt without saying anything. I glance over at her, my mind going blank, as I try to think of something to say. Finally, I decide that I don’t have to make conversation if she doesn’t want to. Forcing her to talk isn’t doing anything for her mental health. I need to learn to be okay with silence.
We don’t live that far from the hospital, so the ride doesn’t stray into uncomfortable territory. After parking in the employee lot, we make our way into the hospital, still in silence. I wish that I could think of the right thing to say. I’m not sure if there is a right thing to say, but my problem is that I can’t think of anything to say. At all. My mind is just one big blank wasteland.
By the time we reach the floor where the Wounded Veteran program is held, my guilt has kicked into overdrive. “Have a good time,” I say, as Sabina opens the door to the unit.
She glances over at me, her face twisted into a grimace that might be her attempt at a smile. “Sure,” she says. “ A really good time.”
I watch her retreat to the reception desk, her shoulders slumped. My heart breaks for her, but I have faith that this program will help her find her way to a new normal. That is the only way that she will move on with her life. I hope that I will be able to help her with her new normal eventually.
By the time I get up to the maternity ward, I feel wiped out emotionally. I stash my stuff behind the nurse’s station. I’m immediately whisked away to attend a birth. As soon as that baby is born, I’m pulled into another room. The first two moms deliver quickly with no complications. These are obviously our favorite kind of births, because they are basically all joy and no stress. We have another mom laboring at the same time, but her labor is progressing slower.
On my way back to type up my patient notes, I pop in to check on her. “Hey,” I say, hovering in the doorway of her room. “How are you doing?”
“She’s in pain,” the dad snaps. “How do you think she’s doing?”
I give him a practiced, calm smile. “I’m sure she’s doing the best she can. Mom, how are you doing?”
The woman gives me a weary smile. I can tell that she’s exhausted, like so many women are when they are in labor. “It feels like I’ve been stuck at the same place forever.”
I grab her chart and check her stats. “Has anyone been in to check your cervix recently?”
She shakes her head. “No, I don’t think so. Is it too late to request an epidural?”
Before I can answer, the monitor next to the bed starts to alarm like crazy. “What’s going on?” the dad demands.
I ignore him as I hurry to approach the bed. The baby’s heart rate has plummeted. I say, “I’m going to get the doctor. I’ll be right back.”
On my way out of the room, I grab Steffie, one of the other nurses on duty. “Dad’s freaking out,” I say. “I have to go find Dr. Daniels. Baby’s heart rate has dropped.”
Steffie nods. I hurry towards the nurse’s station, hoping that Dr. Daniels is there. He isn’t, but Chiara is there. She’s acting as charge nurse today. When I reach her, she can tell from my expression that something is wrong.
“Dr. Daniels?” I say.
“I’ll page him. Room?” she asks.
“Two forty-three,” I say. “Heart rate drop. Mom is too pale. I think she might be hemorrhaging internally.”
Chiara grimaces. I nod and then head back to the room. When I get there, I can see that the chaos has increased. The dad is hovering behind Steffie, as she checks the mom’s pulse. Mom has gotten paler. She looks like she might pass out any second. That’s a problem. I hope Dr. Daniels gets here soon.
“Baby’s heart rate keeps dipping,” Steffie says quietly just to me, so as not to alarm the parents. “I called for an anesthesiologist.”
I can see that she is thinking that this is going to be an emergency c-section. That makes sense, just seeing how mom is slipping in and out of clarity. She hasn’t lost consciousness yet, but she’s not too far from it, and the baby’s heart rate keeps plummeting. Steffie has been pushing all the meds that we would normally give at this point. With no sign of the situation stabilizing, we decide to start prepping for surgery, even though Dr. Daniels isn’t here yet.
Steffie pulls me to one side. “Dad is making things worse,” she says. I can hear the frustration in her voice, but I also know that she knows how he’s feeling.
Thankfully, Dr. Daniels walks into the room at that moment. “Okay,” she says, assessing the situation quickly. “We’re going to move you into surgery and get this baby delivered.”
“What? No, Luna didn’t want a c-section,” the dad says, but he sounds small and lost. My heart goes out to him.
“No choice. We have to do what is best for both Mom and Baby. Right now, that’s a c-section,” Dr. Daniels says in her no-nonsense way.
“Come on,” Steffie says, putting an arm around the dad’s shoulder. “I’ll get you prepped so you can be ready when Luna comes down. It’s time to get ready to meet your baby.”
The dad allows himself to be led away. Dr. Daniels turns to me. “Have you called anesthesia yet?”
“Steffie did,” I reply.
Dr. Daniels nods. “Good. Luna? Stay with me, okay? We’re going to deliver your baby. How does that sound?”
Luna moans, but doesn’t respond otherwise. From the look Dr. Daniels gives me, I can tell that she thinks the situation doesn’t look great either. Luna has a grayish tone to her skin that just looks completely unnatural. Baby’s heart rate keeps dipping to dangerously low levels. There is no sign of a hemorrhage, but all the indicators are there.
“Do you think it’s a placental abruption?” I ask in a low voice.
“I do. Her abdomen was rock hard when I felt it a moment ago,” Dr. Daniels says. “As soon as…ah, Edward, I’m glad you’re here. We need to get her into the OR immediately for a c-section. Please make sure she has a spinal block in place.”
Edward, the anesthesiologist nods and moves quickly to the bed. He gets straight to work, and I move to help him, because Luna is barely responsive. He can’t move her by himself. For a moment, Luna opens her eyes and looks right into mine. As she holds my gaze, I feel like she wants to tell me something, but she can’t find the strength or the words. I reach out to squeeze her hand before going right back into surgery mode.
We get Luna into the OR swiftly, and the c-section begins. Luna’s husband, whose name I still haven’t caught, stands off to one side, looking slightly sick to his stomach. He can’t see what’s happening, but the imagination is far more powerful than we give it credit for. Luna has closed her eyes, but now that the surgery is actually happening, she seems to have rallied. Closing her eyes seems to help her concentrate on what is being done to get her baby out.
The moment Dr. Daniels pulls the baby out, she hands the child to me to bring over to Dr. Severson, the pediatrician on call today. The infant doesn’t cry. I see that they’ve had a little boy. I glance over at the little guy’s parents, as I hurry to the isolette where Dr. Severson is waiting. The father looks stricken. He knows that the baby needs to cry. Something is clearly very wrong. Luna keeps her eyes closed, and I honestly can’t be sure if she is awake or if she has passed out.
“It’s a boy,” I say into the tense silence of the room.
Normally Dr. Daniels would have made that announcement, but she is concentrating on Luna with such intensity, that I know something is wrong with her as well. The whole atmosphere in the OR is full of fear. Everyone seems to be holding their breath. I linger by Dr. Severson, hoping that he can get the baby to cry or to show some sign that he’s going to be okay. I offer prayers for the family, especially mom and baby, as well as Dr. Daniels and the team here, something I do often in my job. Some days, it’s prayers of thanksgiving and joy; other days, like today, my prayers are for wisdom, and mostly just a plea for help.
I hear Dr. Daniels say something on the other side of the room, and just as I’m turning to head back to her and Steffie, there is a choked mewling sound behind me. Then a thin, high cry fills the room. I swear everyone takes a collective breath, not quite a sigh of relief, but close. I’m not sure where to go. Since Steffie is helping Dr. Daniels, I turn back to Dr. Severson. He glances up at me, and I can see the sweat beading on his forehead, and his eyes creased with stress.
“I need you to go call for a transport ambulance. We need to get this baby to the NICU in Walnut Bend,” Dr. Severson says.
I nod. “Right away,” I say.
As I’m hurrying out of the OR, I can hear the dad say, “What’s a NICU? What’s happening? What is wrong with my family?”
My heart goes out to him, but I don’t have time to comfort him or answer his questions. I need to get the transport here. Every second counts when a baby needs to go to the NICU. I approach Chiara at the nurse’s station. She looks up at me expectantly.
“We need a transport for the baby in the OR,” I say.
Chiara nods. She makes the call, but frowns while doing so. As the conversation goes on, her frown deepens. When she hangs up, she looks at me, still frowning. “I was just informed that the regular transport nurse isn’t able to go today. She’s apparently puking in the bathroom as we speak. That means you have to go, Jackie,” she says.
I have my transport certification, so I am definitely qualified. I just haven’t had any reason to go before. But if that’s where I’m being assigned, then that is where I’ll go. “No problem,” I say. “I'll inform Dr. Severson that the transport will be ready ASAP.”
Chiara thanks me as I turn to hurry back to the OR. I scrub up again, and push the door open with my hip. I hurry over to Dr. Severson. I glance toward Dr. Daniels, who seems to be calmer now, and I take that as a good sign. Luna’s color has gotten better since I left the room as well. The collective vibe in the room feels more relaxed. That will be good for Luna’s health, as well as that of her husband.
I turn my attention to Dr. Severson. As I get close, he glances up at me. “The transport should be ready whenever you are,” I say. “I’m going as the transport nurse, so anything you can tell me would be much appreciated.”
Dr. Severson says, “The infant is having trouble keeping his oxygen levels up on his own. He’s going to need help breathing, at least for the foreseeable future. I will call over to Walnut Bend General NICU and give them my full report before you get there, so they can be ready for him. Any questions?”
I shake my head. Dr. Severson has already hooked the infant up to an oxygen machine. I watch for a second, as his tiny chest rises and falls with the steady pressure of the machine. Poor baby. Now he’s in my hands. It strikes me, as it often does, what a big responsibility I have been entrusted with… this little guy's life is literally in my hands. More silent prayers instinctively pour from my head and heart, especially for strength to worthily watch over this precious boy while he’s in my care.
The next few minutes are a blur as the father asks a hundred questions that Dr. Severson attempts to find answers to. The one he can’t answer that lingers in the air is: What am I supposed to do next? The dad has to decide if he will stay with his wife here in Cranberry Creek as she goes into recovery, or if he will follow us to Walnut Bend to the NICU to be with his son. I don’t envy him having to make that decision. My heart goes out to him again.
Ultimately, I don’t know what the baby’s father chooses, because in a matter of minutes, the baby and I are being loaded into the ambulance for the ride to Walnut Bend. My mind is still swirling, so it takes a second to register that I know one of the EMTs on this transport.
“Joe,” I say.
He glances at me, as if he is just as surprised to see me. I don’t know why it surprises me that he’s here. I know that he’s a firefighter, and many of the guys at the station are EMTs as well. Joe must be a good EMT if he got sent for an infant transport. This isn’t the Joe that I knew as a kid. This version of Joe is a stranger; but maybe a stranger that I want to get to know more.
“Jackie, hey,” he says, with that same electric grin that always made me catch my breath, even way back when I was just a kid with a hopeless crush on Joe Lawrence.
From the front of the ambulance, another guy I don’t recognize calls over his shoulder, “Is the isolette secured?”
“Yep,” Joe says.
“We’re heading out,” the other guy says.
“That’s John,” Joe says.
I nod, but it doesn’t mean anything to me. I doubt that I will ever see John again. Even in a place the size of Cranberry Creek, I don’t seem to run into people all that often. I suppose that means that I’m a homebody. None of that matters right now, though. I hurry through the rundown of what happened with the birth and what Dr. Severson told me.
“We just have to keep him stable until we get to Walnut Bend General,” Joe says in the sort of calm voice that I wish I could project most of the time. Right now, my nerves are so on edge, that I feel like I’m vibrating.
“Right,” I say.
The ambulance goes over a bump, and I feel like I’m flying off my seat. I grip the edge of the bench seat so that I can arrive in one piece. I turn my attention to the vital signs that are displayed on a portable unit attached to the isolette. Everything looks okay at the moment. His heart rate is a little on the high side, but nothing that is too concerning. His oxygen saturation is at ninety-two percent. That seems like a good number, given everything that has happened in his short little life.
We hit another bump, and suddenly the machine starts to alarm as the baby’s oxygen saturation dips to eighty-four percent. I gasp and pitch myself forward onto my knees so I can be closer. Joe does roughly the same thing on my right hand side. He thrusts a pair of gloves at me, and opens the isolette.
I reach in and place my hand on the baby’s belly. It feels rigid, but from the way he’s moving, I think he’s trying to cry. He’s clearly in distress, but I feel hope surge through me, since he is trying to communicate with us. Joe works to readjust the oxygen mask around the baby’s head. I stroke his tiny hand, and he seems to calm down. Joe gets the equipment repositioned, and the machine stops beeping. The baby’s oxygen rises back into the nineties, and Joe and I share a collective sigh of relief.
“That was good team work,” Joe says, giving me that same irresistible smile.
Despite my earlier irritation with him, I can’t resist smiling back. That’s the thing about Joe Lawrence; he’s charming, and he knows it. I just hate that he’s using his charm on me, like I’m some ordinary woman and not someone who considered him a best friend for most of her youth.
I’m ripped from my thoughts as the machine starts to alarm again. Joe and I repeat the same routine four more times before we get to Walnut Bend General. I’m exhausted, but the baby seems to have stabilized as the ambulance pulls up to the ER bay. Joe jumps out the back and we’re greeted by two nurses, who have clearly been waiting for us.
Joe fills the nurses in on the ride over, and then they whisk the little guy away into the depths of Walnut Bend General. Our job is done, but that doesn’t mean I can put aside the feelings this ride has brought up in me. My worry about the baby still hasn’t subsided either. One glance over at Joe, and I can tell that he feels the same.
“This was pretty intense, huh?” I venture to say.
Joe glances at me and slowly nods, but he doesn’t say anything. I’m not sure how to read the situation. Is he mad at me? Does he know that I was mad at him? Is he just waiting for the right moment to ask about Maia again? It’s hard for me to reconcile these thoughts with the professionalism and calm he exhibited on the ride over. Maybe Joe Lawrence is more of an enigma than I realized. And everything in me at the moment is screaming that I want to get to know him better all over again.