LITMIR.BIZ

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      “You’re doing great,” the doctor said at the end of the contraction. Holly flopped back onto the stretcher. “I think one more push should do it.”

      Holly turned her head to Scarlet, exhausted, her eyes pleading. “Promise me you’ll take good care of my baby. Promise me she’ll be okay.”

      A wound so big and so catastrophic it’d taken years to heal broke open deep inside of Scarlet at the memory of her own desperate pleas to the nurses caring for her during delivery, pleas that had fallen on deaf ears. ‘I don’t want my father in here.’ ‘I want to see my baby.’ ‘Please, bring me my baby.’

      “Promise me you’ll find her a good home.”

      Why not Holly’s home? Her. Wait a minute. “You know it’s a girl?” She could only know that if she’d had a prenatal ultrasound. “Who told you it’s a girl?” A medical facility would have documentation and contact information.

      “I want her named Joey.” She ignored Scarlet’s question. “I want her to grow up happy, with a family who loves her.” She stiffened. “Oh, God. Another one. I’m not ready.”

      “Yes, you are, Holly. Come on. It’s time to have your little girl.”

      “Let me take over here,” Dr. Jackson said, holding up the same type of light blue disposable gown he now wore.

      “I’ve got to get ready to take care of your baby, Holly.”

      She didn’t release Scarlet’s hands. “Promise me she’ll be okay.” Tears streamed down her cheeks. “Promise me.”

      She couldn’t promise that. “I’ll do my best,” she said. And with a small smile she added, “I’m going to need my hands.” Holly loosened her grip.

      Scarlet stepped away from the bed to slip into the gown and turn so Dr. Jackson could tie the back. While she donned a mask and gloves, Dr. Jackson did indeed take over for her, talking quietly and supportively while offering direction and praise. Why didn’t he show that care with his daughter?

      “Don’t push,” the doctor delivering the baby said.

      “What’s wrong?” Holly asked, frantic. “I have to push. Get her out.”

      “The cord is wrapped around the baby’s neck,” the doctor answered. “Don’t. Push.”

      Dr. Jackson held Holly’s hands and instructed her to breathe. “Perfect. You are doing perfect.”

      After a few tense minutes the doctor delivering the baby said, “Okay, we are good to go, on the next contraction push out your baby.”

      In no time baby Joey entered the world with a tiny cry of displeasure, her cord was cut, and she’d been handed into Scarlet’s waiting towel draped arms. She did a quick assessment and determined it’d be okay to show her to her mom before taking her into the next room. “Do you want to see your baby?” she asked walking up to the head of the bed, knowing sometimes a woman planning to give her baby up for adoption did not.

      “Chest…hurts,” Holly said, struggling for breath. “Can’t…breathe.”

      “What’s happening?” Scarlet asked, holding Joey close.

      “Don’t know,” Dr. Jackson said. “But whatever it is, Dr. Gibbons will handle it. We need to stabilize the baby.” He set a large strong hand at her back to guide her toward a side door leading into another room. “The warming table is this way.”

      “No pulse,” the nurse standing by the head of Holly’s bed said. “Initiating CPR.” She clasped her hands together and began chest compressions.

      Scarlet stopped and stared. Please, God. Don’t let her die.

      “Come.” Dr. Jackson urged her forward, pushing open the door. “We need to focus on the baby,” he reminded her.

      “I know.” But that didn’t mean she could completely turn off concern for the mother, a young woman she’d connected with for a brief few minutes. Luckily when they reached the warming table Scarlet clicked into auto-nurse, wiping down the too quiet newborn to stimulate her as much as to clean her. “I’m going to need her weight.”

      “The baby scale was in use,” Dr. Jackson said. “Let me go grab it.”

      When he left the room, Scarlet listened to Joey’s chest to count her heart and respiratory rates. Then she found the equipment she needed and fastened a pulse oximeter to her tiny hand to evaluate her blood oxygen level.

      The baby lay on the warmer with her arms and legs flexed, her color pale. Not good.

      When Dr. Jackson returned with the scale he placed a disposable cloth over it and Scarlet carefully lifted the naked baby and set her down. “Four point one pounds.” Scarlet jotted the number down on a notepad by the warmer and reported the other findings she’d noted there. “Pulse ox ninety. Heart rate one hundred and eighty. Increased respiratory effort. Color pale. Initial Apgar score a five.” All of which were abnormal for an infant.

      “Let’s get a line in to give a bolus of normal saline and get her hooked up to some supplemental oxygen.”

      While Dr. Jackson inserted a tiny nasal cannula in Joey’s nostrils, taped the tubing to her cheeks, and set the flow meter to provide the appropriate level of oxygen, Scarlet started an intravenous in Joey’s left arm—noting she didn’t flinch or cry.

      While she taped it down and immobilized the appendage in an extended position, Dr. Jackson did a quick heel stick to evaluate Joey’s blood sugar level.

      They worked quickly, quietly and efficiently like they’d been working together for years.

      “Blood glucose twenty-five,” he reported and began rummaging around a drawer in the warmer until he found the reference card for the recommended dosages for premature infants by weight. “Add a bolus of dextrose.” He called out his orders and Scarlet filled the syringes and administered their contents via the newly inserted IV line.

      “Come on, Joey,” she said, rubbing her thighs in an attempt to perk her up.

      The door slammed open and in rolled an incubator being pushed by Cindy. “You okay down here?” she asked.

      “Better than expected,” Scarlet replied, considering who she’d had to work with. Luckily, Dr. Jackson’s reputation as an excellent physician came well-deserved.

      “Good.” Cindy turned to leave. “The NICU is nuts. I talked to Admissions. Baby Doe,” a placeholder name since Holly hadn’t shared her last name, “will be going into room forty-two.”

      “Call Admissions and tell them it’s Joey Doe. Holly told me she wanted her baby to be named Joey.” And following through on that was the least she could do.

      “Roger that.” She saluted then walked over to take a look at their soon-to-be new patient. “Too bad about her mom.”

      “She’s…?” Scarlet couldn’t continue.

      Cindy looked between her and Dr. Jackson and slowly nodded. “I’m sorry. I thought you knew.”

      Scarlet turned away, held herself tightly, fearing for the first time in years she might cry. For Holly who’d died too young. For Joey now alone in the world. For her own infant and not knowing if she’d suffered, if anyone had cuddled her close before she’d died, or if she’d been ruthlessly given away to strangers while Scarlet lay in a drug-induced slumber.

      “You okay?” Dr. Jackson asked quietly.

      Of course she was. Scarlet wasn’t new to nursing. Holly wasn’t the first of her patients to die. But there was something about her…“What do you think happened?”

      He shrugged and shook his head. “Some congenital heart defect that couldn’t withstand labor and delivery. A pulmonary embolism. Any number of pre-existing conditions

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