LITMIR.BIZ

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hell might just break loose.

      The door bumped open as Tina, the other nurse, wheeled in the ultrasound machine. Julie wasted no time and moved to the side. “Tell her I need to raise her hospital gown to get a better picture of the baby.”

      Maria translated, explaining how the lubricating jelly made better contact with the transducer. Then she pointed to the monitor.

      “Now, we’ll get a look, all right?” Julie said calmly. She placed the ultrasound wand on Carlotta’s raised belly.

      Carlotta wearily lifted her head. Her husband peered into the monitor at the gray image. “¿Ese es el bebé?”

      Julie nodded and flicked some dials. “Yes, that’s the baby.” She switched to another view, hoping to find what she had not been able to register so far. And then she caught it. The rapid, shallow flutter of the baby’s beating heart.

      Just then, another more severe contraction gripped Carlotta. She let out a piercing scream. Blood gushed out between her legs and onto the sheets.

      The room erupted into emergency mode. Lights flashed, and an alarm sounded. “Call the O.R. for us,” Julie ordered.

      Maria got on the phone. Tina whipped open cabinet doors. She reached for some pads, and all three of the women packed them to staunch the blood flow, but it kept coming. “Let’s get FFP going, stat.” Julie didn’t stop working on the patient as she ordered, calling for fresh frozen plasma containing clotting factors.

      “I’m already on the way,” Tina called as she rushed out of the room. She hastily pushed aside the ultrasound machine and banged the doors behind her.

      “I need it yesterday,” Julie urged.

      She turned back to the expectant mother, whose face was streaked with tears as she hiccupped away her sobs. “Carlotta, the ultrasound shows that your baby is very weak. And we can’t wait any longer for it to come out.” Tina stormed in and hooked up the IV bag. She got the line going immediately. She read out the signs to Julie in a trained staccato.

      Underneath the hubbub and rapid-fire activity, Maria translated Julie’s instructions, looking from mother to father and back to Julie.

      Carlotta blinked rapidly and shook her head. She reached blindly for her husband’s hand. “¿Qué, qué es lo que esta diciendo?”

      Julie knew they couldn’t waste precious time. She needed Carlotta and her husband to understand what was going on—now, sooner than now. “You are experiencing eclampsia or pregnancy-induced hypertension. This is a very serious condition. Both you and the baby are in jeopardy, and I will need to perform an emergency cesarean section,” she said quickly, urgently.

      “¿Que le pasa al bebé? I don’t understand?” Carlotta’s husband looked from Julie to Maria. His face was contorted in fear. The tendons stood out in his neck.

      Julie opened her mouth to spe—

      There was no time to answer. Carlotta’s limbs went suddenly rigid. Her eyes rolled back. As if struck by lightning her body jolted, and foam immediately gurgled from the corner of her mouth.

      “Magnesium sulfate. Now!” Julie yelled. She needed to control the convulsions. Tina readied the injection and handed it to Julie.

      “Carlotta, Carlotta!” her husband screamed, his hands going to his face.

      Julie administered the dose and checked Carlotta’s vital signs. “Maria, explain to Mr. Sanchez that we are doing everything to ensure his wife’s safety,” she said, not bothering to stop, let alone look up. The antiseizure medicine was fast-acting, and Carlotta settled into unconsciousness, her breathing aided by an oxygen mask. Julie turned to the nurses. “Let’s get a move on. I want this baby out of here and the mother out of danger. O.R. knows we’re coming?”

      “They’re waiting for us,” Maria said. “That was my first call.”

      “Then we’re outta here,” Julie ordered. Tina readied the IV poles. Julie put up the side guardrail and bent to push the bed. Maria, at the foot of the bed, pulled backward, banging the door open with her butt.

      Julie put all her weight behind her efforts, keeping her eyes on her patient as the bed rolled swiftly forward. “Maria, explain to the husband that he’ll have to stay in the waiting room, but we’ll keep him informed.”

      Maria spoke rapidly.

      Carlotta’s husband brought up the rear, jockeying to get closer to his wife and reaching out his hand to touch the rolling bed. “You will save her and the baby, won’t you?” he pleaded in Spanish with Maria translating.

      Julie didn’t need the English. She could sense what he was asking from the tone of his voice. And she could feel him breathing hard as he rushed to catch up with her. “Le prometo,” she said as she continued to move forward. “I’ll do every—” Hanging on to the bedrails, she swiveled to reassure him face-to-face…

      And never saw the ultrasound machine.

      The corner clipped her right in the side of her face. She momentarily saw stars.

      “Doctor, are you all right?” Tina asked.

      Carlotta’s husband blanched. He held out a hand to help.

      Julie blinked. “No, no, I’m fine, really. Estoy bien.” She tried not to wince. “It’s my stupidity. Really. Let’s just keep moving everybody.” She pushed the bed and nodded to Tina to get going again. “And, please, somebody get a social worker who speaks Spanish to stay with Mr. Sanchez.” It’s the least we could do, she thought.

      They reached the operating theater, and an orderly held Mr. Sanchez by the arm as they whisked through the doors. Julie didn’t bother looking back. All she thought about was the delivery and that it was going to be difficult. She would need all her training and expertise to guarantee a happy ending.

      Then—no matter what—somebody was going to pay.

      And she knew just who.

      CHAPTER TWO

      Monday morning

      DR. SEBASTIANO FONTERRA folded his arms and leaned on the blotter positioned precisely in the middle of his immaculate desk. A Venetian glass vase, black with orange swirls, was juxtaposed against the flat plane. It was a gift from the board of directors of Grantham hospital, and in Sebastiano’s opinion, hideous. Naturally, he kept it prominently displayed.

      Sebastiano offered a sincere nod to demonstrate his attentiveness to the stately woman sitting across from him who had been speaking to him—no, haranguing him—for more than half an hour.

      He smiled politely, masking the subversive fantasy bubbling in his brain, the fantasy of jumping atop his desk and, with his arms outstretched and his face raised heavenward, shouting at the top of his lungs, “Per me questo lavoro non vale la pena!” Which somewhat loosely translated to, “They can’t pay me enough to keep doing this job!”

      Not that he would ever allow himself to act so…indecorously. So emotionally. Sebastiano didn’t do emotional, let alone fantasy.

      What he did do was perform his job as the CEO of the University Hospital of Grantham with admirable skill and considerable grace. He needed both qualities when dealing with the woman seated across from him, the woman who headed up the hospital’s fundraising committee and who had, through personal donations, ensured that her late husband’s name would be emblazoned on the oncology wing of the new hospital.

      So with seeming equanimity, he shifted his posture and rubbed his chin thoughtfully. Since he didn’t have the slightest idea what she’d been talking about—having tuned out somewhere between her description of her newest peony cultivar and her criticism of how the ink on the local newspaper, the Grantham Courier, came off on her cream-colored Chanel suit—he offered his tried-and-true conversational gambit. “You always bring a unique perspective, Mrs. Phox,” he said warmly. Then he offered up a smile meant

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