Chapter Fourteen
Elio
A few days later, Marcello takes me to see Dr. Lena Vasquez, a board-certified OB-GYN.
She’s discreet and has been taking care of syndicate families for fifteen years, apparently.
She and her office staff know better than to question why her patients arrive to their appointments in armored vehicles.
The OB’s office is in a brownstone on the quieter end of Harmon Street, three blocks from the waterfront, with no sign on the door. Just a brass number and a buzzer. The kind of place you’d walk past a hundred times and never notice, which I’m starting to understand is the point.
The waiting room is small and warm. Cream walls, upholstered chairs, a side table with fresh flowers, and a stack of magazines that, surprisingly, aren’t years out of date.
Soft classical music plays overhead and there’s a small tabletop fountain in the corner.
It feels more like a massage therapist’s office than a doctor’s.
Marcello looks too big for the chair he’s sitting in beside me.
His knees are almost touching the coffee table, and he’s hogging the armrest. He’s scouring the forms on a clipboard he holds, like it’s a contract he’s reviewing for loopholes.
I’m happy for him to handle the insurance forms. He’s handled all of Fabio’s insurance paperwork too.
“Are you nervous?” he asks me, without looking up.
“A little,” I admit. “I hate giving blood.”
He leans his shoulder into mine. “Don’t be worried, mio. I won’t let anything hurt you.”
“I’m not sure there’s anything you can do where needles are concerned.” I sigh, not looking forward to anyone poking or prodding me.
“If she’s too rough, I’ll break her fingers,” he says softly.
“Marcello,” I choke out, glancing around uneasily. “Don’t say things like that.”
He smirks. “Why not? It’s the truth. Anyone who hurts you must pay.”
Thankfully, I’m saved from responding when a nurse opens the inner door. She’s young, dark-haired, with a smile that looks genuine rather than practiced. “Elio? We’re ready for you.”
Marcello stands when I do, and the nurse’s eyes flick to him and register exactly who he is.
“Both of you can come back,” she says brightly.
The exam room is clean and bright, white walls with a framed watercolor of the coast that actually isn’t terrible.
The exam table has a fresh paper covering and the counter is lined with glass jars of cotton balls and swabs.
There’s an ultrasound machine in the corner.
The room smells like rubbing alcohol and something faintly, artificially, floral.
The nurse takes my vitals. Blood pressure, weight, temperature. She writes everything down, asks me to change into a gown, and says the doctor will be in shortly. Then she leaves, pulling the door shut behind her with a soft click.
I change into the thin gown that ties in the back. Marcello sits in the chair in the corner with his arms crossed. His presence fills the room even when he says and does nothing.
I sit on the exam table and the paper crinkles under me. “The pregnancy feels real now.”
He squints. “It didn’t feel real until now?”
I grimace. “No, it did, but there’s something about being at the doctor’s office that’s different from peeing on a stick. It makes it feel more serious.”
He smiles. “Fair enough.”
There’s a knock, and the door opens. Dr. Vasquez is not what I expected.
She looks to be in her early fifties, short, with dark curly hair pulled back and reading glasses perched on her nose.
She has smooth brown skin with deep laugh lines around her dark eyes.
She’s wearing a white coat over a blue blouse, and when she shakes my hand, she uses both of hers.
It’s a warmer gesture than I’m used to from a doctor.
“Elio, it’s nice to meet you.” She turns to Marcello, and there’s no deference in her expression, no flinch. Just professional warmth. “Mr. Foschini, I’m so glad you could accompany Elio to this appointment. Not all alphas make the time.”
“I wouldn’t have missed it.”
She looks pleased at his response. “How refreshing.” She sits on a rolling stool and opens a file. “So, you took a home pregnancy test and it was positive. When was that?”
“Two days ago.”
“And the first day of your last heat cycle?”
I tell her. She counts on her fingers and writes something down.
“That puts you at approximately four to five weeks. Very early. Which is perfect, because it means we can get you started on the right foot.” She looks up at me over her glasses. “How are you feeling? Any symptoms besides the morning sickness?”
“Just the nausea at the moment. It hit hard two days ago but it’s been milder since. Some fatigue, but I’ve also been dealing with a lot of stress, so I can’t tell what’s causing what.”
“The nausea may get worse before it gets better. Every pregnancy is different.” She sets the file down.
“Here’s what we’re going to do today. I’ll take a full medical history, do a basic physical exam, and draw blood.
The blood work will confirm the pregnancy through your hCG levels.
I’ll also run a complete panel to make sure everything looks good.
We’ll start you on prenatal vitamins too. Do you have any allergies?”
“Not that I’m aware of.”
“Okay. I’ll also do a brief physical, listen to your heart and lungs.
The nurse already checked your blood pressure and it looks fine.
” She pauses. “We won’t do an ultrasound today.
At four to five weeks, there’s very little to see.
We might catch a gestational sac, but more often than not it’s too early.
I’d rather bring you back when we can see the embryo and hear a heartbeat. ”
“A heartbeat.” I swallow. “That would be worth hearing.”
“Yes.” Marcello shifts in his chair. I glance at him and his face is neutral, controlled. But his hand on the armrest has tightened and I know he’s excited about the heartbeat part.
Dr. Vasquez walks me through things like family history, medications, prior pregnancies. I tell her about my parents dying young, the car accident, and she writes it down after giving me an empathetic look.
“My brother just had surgery for HOCM,” I volunteer.
She raises her brows. “Did he now?”
“Yes.”
“It’s good you told me,” she says. “That’s important information.”
My stomach tightens. “Important how?”
She gives me a reassuring smile. “Sorry, I didn’t mean to alarm you. I’m not saying something is wrong with you or the baby. It’s simply important to check some things.”
“Like what?” Marcello asks.
“HOCM can run in families, and pregnancy asks more from the heart than everyday life does.” She shrugs. “With a pregnancy there’s more blood volume, more cardiac output, more work overall. With a first-degree relative affected, I’d like you to have a cardiology evaluation just to be safe.”
I frown. “Even if I’ve never had symptoms?”
“A lot of people with inherited heart conditions don’t know they have them until something happens or someone looks for them.”
I wince. “You’re right. My brother never really showed symptoms. He was always easily fatigued, but I didn’t think about it being his heart. He wasn’t hugely athletic, he likes to read. I always just assumed he was out of shape.”
She offers a reassuring smile. “You did nothing wrong. That’s not uncommon. You’d probably never heard of HOCM. I want to run tests because I believe in erring on the side of precaution.”
“Okay,” I say.
“What kind of tests will you do?” Marcello asks.
She glances at him. “I’d want an EKG and an echocardiogram for Elio. Depending on what your brother’s doctors found, they may also recommend genetic counseling.”
“Genetic counseling?” I repeat nervously.
“It sounds more frightening than it is.”
Marcello’s meets my gaze and he gives me an encouraging smile. “Whatever is needed, we’ll do it, mio. Don’t worry.”
I swallow hard. “I… I just don’t want anything to be wrong with the baby.”
Dr. Vasquez’s gaze is empathetic. “Don’t stress ahead of time, Elio.
We’ll keep a close eye on fetal development as we go.
This isn’t the same as saying your baby has a heart problem.
But family history matters, so I may recommend a fetal echocardiogram later in the pregnancy, just to look carefully at the baby’s heart. ”
My throat feels tight. “So I shouldn’t be worried?”
“Nope. You should be informed,” she says gently. “Those are not the same thing.”
Marcello stands and moves to me as if he can’t help himself. He rubs my back, his eyes dark. “It’s going to be okay, mio. I promise you. I’ll protect you and our child, no matter what.”
My heart squeezes. “I know you will try, Marcello.”
“I won’t just try,” he says, frowning. “I’ll make sure you and the child are safe. Trust me, okay?”
“I do trust you.” I’m not lying. I trust Marcello. But I’m also well aware that sometimes in life there are things that even money can’t fix.
He sits down again and Dr. Vasquez smiles.
“It’s so nice to see the alpha taking part in caring for the omega. I can’t tell you how many omegas come to these appointments alone. The alphas care, but they don’t always think to accompany the omegas.”
Marcello frowns. “Of course I want to be here. I can’t believe any alpha wouldn’t be.”
She raises her brows. “As I said, you’re an anomaly, Don Foschini.”
The physical exam is brief and professional. She listens to my heart and lungs, palpates my abdomen, checks my throat and ears. Her hands are warm and her manner is steady and I find myself relaxing despite my nerves.
The doctor leaves and the nurse returns to take my blood. I look away when the needle goes in, gritting my teeth.
“All done.” The nurse labels the vials and packs them away. “Results will be back in forty-eight hours. We’ll call you.”
Dr. Vasquez returns with a bottle of prenatal vitamins and a small stack of printed information. She hands me the vitamins and sets the papers on the counter.