Chapter Twenty-Nine Emily #2
“Twenty-eight years old, thirty-six weeks pregnant. Water broke about four to five minutes ago,” I told them, my heart beating so fast, I was sure I sounded breathless.
“Patient was complaining of shortness of breath, so I hooked her up to oxygen. She also said there was a heaviness in her chest. BP was borderline high during her whole pregnancy and was taken in the ED and registered low, so they sent her up here.”
Sarah’s skin was turning even whiter, her lips now blue.
Arms were moving faster than I could see, and directions were being ordered. I stayed still until I heard, “Emily, start chest compressions while we take her to the OR.”
My schooling taught me what was happening inside Sarah’s body, but in my two years of nursing, I’d never witnessed it before.
If I were to guess, many of the nurses in this unit hadn’t ever seen an amniotic fluid embolism either, a rare and extremely dangerous occurrence when either amniotic fluid, cells, or something else entered the mother’s bloodstream.
It would be a miracle if we could save her.
And the only way to get the baby out was an emergency C-section.
I got on the bed and straddled her body.
Come on, Sarah. Come on, Sarah.
One of the nurses handed me a bag-valve mask, and after I pulled the oxygen from Sarah’s nose, my shaking hands hooked the mask to Sarah’s mouth. Once the seal was tight, I followed the count of chest compressions, followed by two breaths.
Come on, Sarah. Come on, Sarah.
Your little boy is going to be born soon, you cannot leave him.
I checked for a pulse. “I’m losing her!”
“Get the crash cart,” I heard.
I lifted her half shirt, and when I was handed the paddles of the defibrillator, I set them on her chest. “Clear!” The shock entered her body, and I could feel it under my knees as I knelt on the bed.
Everyone watched the heart rate monitor. When there was no change, the doctor yelled, “Again!”
“Clear!” I shouted.
Sarah, come back to me.
Sarah, please.
Saaarah!
“We need to take her to the OR now!” the doctor announced. “Emily, restart chest compressions!”
The nurses, along with the doctor, were pushing the bed out of the room. I felt the movement, but the only thing I was looking at was Sarah’s face, the color of her skin, waiting for a sign that she was coming back to life.
Sarah, you can do this.
Sarah, you’ve got to fight.
Sarah, you cannot leave . . .
At the door that led to the hallway of the OR, another team was waiting, each of them dressed in surgical scrubs. As they took over, the emergency response team backed away, one helping me off the bed, while someone else took over the compressions and air flow.
I stood at the entrance of the hall as they wheeled Sarah through, watching them run her to the OR until the door fully closed, cutting off my view.
Vanessa, another RN in my unit, put her arm around my shoulders. “The first AFE I’ve ever seen. Thank God. I hope I never see one again.”
Heaviness.
That was what I felt.
In my chest, neck, behind my eyes.
The heaviness Sarah had described and it was now mine.
My toes were cramping, my knees wanting to buckle.
“She’s not going to make it, is she?” I held my chest as I spoke.
Vanessa shook her head. “I don’t think so, no.”
I knew that . . . I just needed . . .
I didn’t know what I needed.
Every second of the last several minutes was replaying in my head.
Her pacing.
Her shortness of breath.
Her anxiety.
Her chills.
Her impending doom.
She knew.
But I didn’t.
She knew . . . and I didn’t.
And I’d promised her she was going to be okay.
I’d fucking promised her.
“I didn’t know.” I couldn’t breathe. “I had no idea this was an AFE.” I swallowed something—it wasn’t spit, it was heavier, thicker, it burned as it went down. “I thought she was having anxiety and then her water broke . . .”
“Of course you wouldn’t have known, honey.
No one would have. AFE comes on too fast. It presents symptoms similar to labor.
There’s nothing that could have been done to stop this or prevent it.
” Her hand went to my cheek. “This is one of those situations where even the best medical professionals are helpless.”
The door next to us swung open, and one of the surgical nurses exited, pulling off her hair covering and removing her mask. “The C-section will be starting at any second.”
“You’re not doing it?” Vanessa asked her.
“Another emergency came in. I have to scrub in for that surgery.”
“How’s the mother? Sarah Lucas?” I asked.
The nurse began to walk away, stopping just long enough to say, “We couldn’t resuscitate her on the table.” She shook her head. “She’s gone.”
No.
Nooo.
Fuck no.
I reached inside my pocket, realizing I still had gloves on, and I didn’t bother to take them off as I removed the notepad, handing Vanessa the sheet of paper I’d written on. “Sarah knew something was wrong,” I forced out, not letting myself cry. “She knew she wasn’t going to make it.”
“She probably just didn’t feel well and, like all first-time mothers, feared the worst.” She glanced down at the paper in her hand.
“She had me write that for her.”
She slowly looked up at me. “It’s for the baby . . .”
A baby who will never know his mother.
“I can’t give it to the father when he arrives.” The heaviness was doubling. Tripling. “I . . . have to get out of here, Vanessa.”
“I’ll give it to him.”
She went to give me a hug, and I wiggled away, the thought of arms wrapping around me too much, and I raced for the stairs.
I didn’t want to wait for the elevator. I didn’t want to be boxed in.
When I got outside, I expected the air to pull me into its warm arms. For a wave of relief to wash over me.
But it didn’t come.
It made my stomach churn.
It made my heart rate climb.
I rushed over to the dumpster in the back of the hospital, my hand flattening against the cold metal side, my stomach emptying. And when I couldn’t retch anymore, I began to walk.
I didn’t know I had reached home until the walls of my bedroom showed me I was standing inside of it.
My nursing scrubs fell to the carpet.
My elastic was pulled out, my hair falling to my shoulders.
Sarah, I’m so sorry.
I’m so fucking sorry.
When I got into the shower, I made the decision.
I couldn’t ever go back to that unit again.