LITMIR.BIZ

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six months later

      “WOW.” EMILY LOOKED again at the ultrasound scan that her colleague Dr. Ruchi had sent her from her hospital, which was in a small town that was sandwiched between Portland and Seattle. She leaned back in her chair and stared at the ultrasound again.

      “Yeah, the conjoined twins have two separate spines, they share a lot of nerves at the base of the spine. They also share a liver, part of their colon and there are three kidneys between the two babies.”

      “I’m glad to see they have four fully formed limbs and separate genitalia.”

      Dissecting a liver and separation was easier when the separation gave each twin the chance of being able to survive on their own. The twins didn’t share a heart or a brain, and shared organs that could easily be split. It was promising, risky but promising.

      It was whether or not all limbs would be fully functional or whether the twins survived their birth. That was the scary part, surviving.

      “Yes, that is a positive,” Dr. Ruchi said.

      “And the parents have consented to being moved up to Seattle and me preforming the surgery?” Emily asked as she zoomed in on the most recent scan of the babies in utero.

      “Yes. The mother was informed that her twins were conjoined and she was given all the details about the risks of separating them postdelivery, but chose to proceed with the birth.”

      Emily felt a faint kick and looked down at her belly. At six months pregnant there was no longer any hiding her baby bump. And it hit her hard when Dr. Ruchi said that the patient had chosen to proceed with the birth. What a hard decision for a mother to make. She was glad that she didn’t have to be put in that position to make a choice. Her baby was, so far, healthy.

      “When are you planning to deliver them?”

      “Well, I’m not. I would rather send the parents up to Seattle and have her in your care. My hope is that the mother remains on bed rest with yourselves pending a delivery by C-section in a few weeks, once the babies are more developed. It’s important that the twins are delivered there so they can benefit from your immediate expertise. You’re one of the best pediatric surgeons in the country and have done successful separations before.”

      “Sure, of course. I would be happy to, but my concern is about the bundle of nerves that the twins share. That worries me. I can work with them on separating the liver and kidneys, even the colon, but for the nerves I would need a world-class neurosurgeon who was familiar with this kind of work to assist me with that part of the operation.”

      “I have a neurosurgeon for you.”

      As soon as Dr. Ruchi said the words, Emily’s stomach did a flip, a flop and then nose-dived to the bottom of her shoes and she found herself trying not to let her breakfast make a second appearance.

      “You...what?” Emily asked, relieved that Dr. Ruchi could not see her expression over the phone, because she knew exactly who Dr. Ruchi was referring to.

      “Dr. Ryan Gary. He’s agreed to fly to Seattle from San Diego and help with the case. This is my patient, I delivered her first child and I really want you and Dr. Gary to handle the separation.”

      Dr. Ruchi was right about Ryan. He was the best. He’d done separations before. She just didn’t know if working with a man she had just sent divorce papers to would be a touch too awkward.

      Her previous relationship had ended badly. So badly it had crushed her. Which was why Emily had been wary of getting into any kind of personal relationship with another surgeon.

      Not just wary...determined she was never going to again. So her one-night stand with Dr. Ryan Gary had been a huge mistake. It had been an amazing night, but it had been bad for her afterwards. She was pregnant and alone. She regretted it.

       No, you don’t.

      She wasn’t going to disappoint Dr. Ruchi by telling her that she couldn’t work with Dr. Ryan Gary because he’d been the one to knock her up after a drunken night in Las Vegas. That night in Vegas had been the biggest mistake of her life.

      And when she’d reached out to Ryan to tell him about the baby, she’d found he’d left for a tour of duty providing medical aid abroad in war-torn countries. He’d never responded to her, even when she’d sent him divorce papers.

      Which was fine. She’d get the divorce finalized one way or another.

      Emily hadn’t planned to have a family now, or raise a baby alone, but waiting around for Ryan to respond to her wasn’t going to stop her from doing just that.

      “Emily, are you okay?” Dr. Ruchi asked, interrupting her train of thoughts.

      “What?” she asked. “Yes, sorry. Dr. Gary, you say?”

      “Yes. Is there a problem?” Dr. Ruchi asked. Emily could hear the concern in her friend’s voice. It had taken Emily years to pick up on social cues like this. She didn’t always get them, but since Robert had left her five years ago, and now, on the verge of becoming a single mother, she could tell when someone was concerned about her. She saw it enough in the way people spoke to her, like they felt sorry for her.

      “Nope. I might have to clear it with the chief of surgery first. I mean, we do have pretty top-notch neurosurgeons at SMFPC.”

       Liar.

      Yeah, she did have a problem with his arrival. When he hadn’t responded to her emails about being pregnant she’d assumed he’d wanted out.

      Emily had been hurt again by a man, but she could raise this baby on her own. She didn’t need help. She didn’t want Ryan back in her life, but it would be best for the patients. He was an excellent surgeon.

      “I’ve already cleared it with your chief,” Dr. Ruchi said gently. “I wanted to make sure that I had you on this case. I didn’t want him to pass off my patient to another pediatric surgeon!”

      Emily chuckled. “Ana, you know that I’m Head of Pediatrics.”

      Ana sighed and then laughed. “Okay, so I wanted to make sure that he’d allow Dr. Gary to practice there too.”

      “And it’s okay, I take it?” Emily teased.

      “It is. Thank you for doing this, Emily. There’s no one else I trust. Both you and Ryan have done separations and done them successfully, with both twins surviving. I know that you can do this.”

      “I know that I can too,” Emily admitted. What she didn’t say was that she wasn’t sure that she could do this with Ryan.

      Although he was one of the best at separation surgeries. It was just that part of her wanted to throttle him for not responding to her. She wasn’t sure that was conducive to a good working environment.

       It can be if you ignore it. He’s a surgeon, you’re a surgeon. He’s a professional and so are you.

      She shook that thought from her head. Her admiration for him, her attraction to his confidence, his charm and his devilishly handsome good looks was what had got her into this mess in the first place.

      When she had been with him she hadn’t felt awkward or anxious. It was like his confidence had rubbed off on her. He’d made her feel desirable.

      “When will they arrive?” Emily asked.

      “I’ve emailed you her chart and all the paperwork. I’m planning on sending them by air ambulance tomorrow, but Dr. Gary will be arriving sooner. He arrived in Portland last night, when I spoke with him about the conjoined twins. He’s taking the helicopter in. He should be there soon. He’s accompanying another pediatric patient with a spinal injury who arrived this morning. Thank goodness he was here.”

      Emily glanced at her pager. That was another patient she’d been waiting on.

       Great, he was going to be working with her on that case too?

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