34. Dalton
34
DALTON
T he only way to get through this is to work.
I take on every case I can. Fitz and Harrington are more scarce anyway, having figured out their strengths and securing mentors.
I’m still flailing in the ER, which is fine. I can stick with emergency medicine if I want. It’s what I put down in med school when I had to choose a direction, sort of de facto choice for the undecided. From here, I could be a general practitioner or go with internal medicine or any number of places.
But I feel lost.
It’s been four days since I spoke or texted with Nadia, the longest we’ve gone.
I would never ghost her, and I don’t want to let her go. But I am letting her take the lead. If she slows down, I slow down. I haven’t forgotten what Max said. If she comes back to me, fine, but not to push her.
I hate long distance. Hate that she had to go. Hate that she can’t find her way back.
But I don’t hate that she loves her rescue work. Her MBA is helping them. They’re straightening out their books, cutting costs, adding services, and streamlining. She’s organizing a fundraiser to get more donors.
She’s killing it.
They’ll never let her go. Why would they?
She has so many options. She can stay at the rescue. She can become a consultant to rescues. She can fundraise. She can start her own rescue. The last thing we talked about in depth was how her brother Axel might set up a foundation for one.
And here I am, a doctor, sure, but unable to so much as decide on a specialty. I’m rudderless, just getting through each day.
“Hey, intern.”
I pause outside the records room where I am supposed to be delivering files. I turn to see Dr. Frazier in his long white coat waving me down.
I set the records inside the door and close it. “Yes?”
“I’ve got a panicky pregnant woman in curtain six. She’s having Braxton-Hicks. You know what those are?”
I try not to be insulted. I almost never work with Frazier. “Yes, early non-labor contractions.”
“Right. She’s convinced she’s about to have the baby. Can you sit with her until the obstetric consult comes down? She’s freaking out.”
“Sure.”
He passes me an iPad. “Here’s her info.”
I take it and head to the curtains, pulling up her records as I walk. I hesitate outside number six. Jennifer Martin, LMP Mar 9. That would make her roughly seven months along. That seems early for Braxton-Hicks.
“Knock, knock,” I say, then slide through the part.
Jennifer sits alone on a bed, her face red, tears dripping onto her blue maternity dress.
“Jennifer Martin?” I ask.
She nods.
“What’s your date of birth?”
“April 6, 1998.”
“Perfect. How are you feeling?”
“The same. Lots of pressure. Lot of pain.” She runs her hands along her belly.
“I’m Dr. Murphy. We have obstetrics coming down the first chance they can. I’m here to sit with you and monitor your progress.”
“Okay.” She gulps another sob. “I just … I lost my first one.”
I frown and flip through the record. “I don’t have that here.”
“I told the nurse.”
“How far along were you last time?”
“Ten weeks. They said it wouldn’t happen again.”
“You’re much farther along this time. It won’t be the same.”
Her voice shakes. “Are you sure?”
“A first trimester miscarriage is very different from being in your third trimester.” I try to give her a reassuring smile. “Is this the hospital where you plan to deliver?”
“No, I’m from Sacramento. I was here for a work trip when the pain started. My husband is driving down, but it takes six hours.”
I pull up a stool next to her. “That’s scary. All alone in LA. Did you call your OB/GYN back home?”
“I did. The on-call nurse told me to come to the ER.”
“Good call. How long have you been in pain?”
“Since about—” She cuts off to let out a long slow groan.
I feel uneasy. That seems like more than Braxton-Hicks to me.
“I feel something!” she cries. “Right now! I feel something.”
Shit. I step to the curtain and peer out. “Nurse?”
There’s no one at the moment.
I guess I better examine her myself. I’ve been present for three deliveries, so I know the basics, if that’s where we are. I snatch up a box of gloves and put on a pair.
“It’s coming!” Jennifer starts panting. “I knew it was real!”
It’s my job to be confident and reassuring. “Let’s see what we have.”
I help her slide back and lift the skirt of her dress. Her underwear is soaked, tinged in pink.
We work together to pull down the underwear. Her hands are shaking.
The minute I take a closer look, I know I’m about to do a delivery. The head is crowning. We are out of time.
“Jennifer, I can see the baby’s head. We’ve got this.”
“It’s too early!” she cries. “I’m not due for six more weeks.”
“This is an excellent hospital,” I tell her. “Everything is all right. See if you can huff without pushing.”
If I can slow her down, I can get help in here, a nurse. Call the NICU team down. Right now, I don’t dare step away until I see if it’s coming immediately.
“Deep breath. Don’t push. Huff through this contraction.”
But I can already see it’s too late. More fluid gushes out as the head emerges.
“Okay, Jennifer, we’re having a baby. Go ahead and push.” I place my hands into position to support the newborn.
She lets out a long, heavy groan, and the head comes fully out. I don’t have suction. I don’t have anything, but I use the paper sheet to wipe the baby’s face and pull mucus.
“One more good push.”
I shift the shoulders as Jennifer strains. Then he’s out in my hands. A boy. Good grief, I don’t have a blanket. I have nothing.
He’s not crying. I flip him onto my arm and rub his back.
“Why isn’t he crying?” Jennifer breathes in gulping sobs.
I aim his head down and rub again. The baby gasps, then there it is, that first tentative cry.
“Oh, thank God.” Jennifer reaches out her arms.
I help lower the shoulder of her dress to place the baby against her skin. “Let’s cover him with your skirt until we can get you properly set up.”
When the baby is in place, I dash outside of the curtain. I grab the first nurse I see. “I need a neonatal team NOW. We just had a premature birth in curtain six.”
“What?”
“Get the team.”
She takes off, and I race to the supply closet, snatching a couple of blankets. Jesus Christ, we could not have been less prepared.
By the time I return with the blanket, another nurse is inside, talking on the phone. I cover Jennifer and the baby.
“I need to call my husband,” she says.
“We will. We still have a lot to do,” I tell her. “The placenta. Assessing the baby. But you did it. You did it, Mom.”
“Thank you for believing me.”
I don’t think I had a choice, but I tuck the blanket more tightly around her.
The NICU team arrives with an isolette. The neonatologist, a tall man in blue scrubs, takes in my badge. “You’re an intern. Who is the doctor on this?”
“Dr. Frazier wanted me to sit with her. We were waiting on obstetrics.”
“Frazier left a woman in labor?” The man stares at me incredulously.
I watch another member of the team listen to the baby’s heart. “He assumed it was Braxton-Hicks.”
“Jesus Christ.” He turns to the bed. “Mom, we’re going to take this little guy for a few minutes to make sure he’s all right. We’ll wheel him right behind you as we go to the maternity floor.”
“I want Dr. Murphy to go with us,” Jennifer says.
The neonatologist glances over at me. “Dr. Murphy is in emergency.”
“I want him. Please. Nobody else listened to me.”
“I can go,” I tell him. “I’m almost off shift, anyway. I’m happy to help.”
The neonatologist watches me another moment. “Was this your first delivery?”
I nod.
“All right. You earned it. Come up with us.”
Obstetrics arrives with a rolling gurney and the curtain is overcrowded. I’m about to leave when Jennifer calls, “Dr. Murphy, here, please!”
I move to the head of her bed.
“Please don’t leave me,” she says. She reaches for my hand.
We get her moved to the gurney, and our parade heads out of the ER and to the service elevator. Jennifer won’t let go of me.
Dr. Crisp, the OB/GYN on call, stands next to me as we go up to maternity. She watches me over the top of a pair of narrow glasses. “I hear this was your first delivery. No staff. No supplies.”
“No choice,” I say.
“You handled it well.” She glances at the woman’s hand clutching mine. “And you earned her trust. Are you sticking to emergency medicine?”
“I’ve been on the general medicine route.”
She lifts her eyebrows. “We lost a neonatology intern. Would you be interested? We could do a trial for a while, share you between wards. It wouldn’t have to disrupt your internship, and you could move to residency as planned next year.”
Would I? This is a rare chance to try a new field.
As we exit the elevator and pass the windows where another newborn is getting its first cleanup, I wonder. Is this where I’m meant to be?
And then the next thought comes.
What would Nadia think?
I want to ask her.
Maybe I will.