A Home for Hannah (10 page)

He leaned close. “Hot?”

His breath stirred the hairs on her temple and sent her temperature up another notch.

“A little. I had to rush to get here.”
Please don’t let him think it’s because of his nearness.

“I was afraid you wouldn’t come. You look nice, by the way. Those are cute shoes.”

Cute shoes? What man noticed a woman’s shoes? She gave him a sidelong glance.

“Three sisters,” he said in answer to her unspoken question.

He turned to speak to the person on the other side of him. It gave Miriam the chance to gather her composure and survey her surroundings.

It was her first time attending a service at the Hope Springs Fellowship Church. The inside of the church was simple and elegant with dark, rich wood paneling and brilliantly colored stained-glass windows. Off to one side of the altar, a young woman continued playing the organ. It felt good to be back in church. She had avoided going for fear of running into Nick. Now that her fear was no longer a factor, she was free to worship as
she normally did. The soothing sounds of the beautiful melody began to ease the tension from Miriam’s body. It was then she noticed the sound of muffled crying.

Looking across the aisle, she saw a woman in her late sixties crying softly into a lavender lace hanky that perfectly matched her lavender suit and hat.

Overcome with curiosity, Miriam whispered to Nick, “Who is the weeping woman?”

Nick leaned forward to look around her. He sat back with a grin on his face. “That is Gina Curtis. She is something of a town character. She is very attached to Dr. Phillip. When everyone else considered her a hypochondriac, he correctly diagnosed her fibromyalgia. I think she has been in love with him ever since, but she cries at everyone’s wedding so it’s hard to tell.”

Miriam nodded, and then sat in awkward silence.
Please, Lord, let this be a quick ceremony.

The organ music suddenly stopped as the minister and three men entered from a door behind the pulpit. As they arranged themselves at the front, the organist began the familiar strains of the “Wedding March.”

The congregation rose and turned to see a pair of bridesmaids in plum dresses carrying small bouquets of pink roses. Amber, a vision in a simple A-line satin gown with lace cap sleeves and a short veil, started down the aisle on the arm of a short stout man that Miriam assumed was her father. As she approached the front of the church, Miriam saw she had eyes for only one person in the building—the tall man waiting for her beside the minister.

Phillip looked a great deal like his grandfather,
Dr. Harold White, but where Dr. Harold looked distinguished with his high cheekbones and white hair,
Dr. Phillip looked downright delicious. He was movie-star gorgeous with a deep tan, sun-streaked light brown hair that curled slightly above his collar and eyes so blue they looked like sapphires.

She glanced at Nick beside her. He was a good-looking
man, too, but in a rugged way that she preferred to the young doctor’s suave features. When the music stopped, Miriam listened to the preacher’s sermon about the way love allows us to accept the faults of others and how that same love makes us strive to mend our own faults for them.

Amber and Phillip then faced each other for the exchange of vows. When it came time for Phillip to slip the ring on Amber’s finger, he fumbled and dropped it. The ring went rolling across the floor. The minister stopped its flight by stepping on it.

He picked up the golden circle and held it aloft. “My grandmother used to say that something had to go wrong in the wedding or it will go wrong in the marriage. Not that I believe in such superstitions, but let’s all be glad that Amber and Phillip are off to the best start possible.”

The congregation laughed. The minister gave the ring back to Phillip and this time he placed it on Amber’s hand without incident. Everyone applauded when he kissed his bride.

Miriam glanced at Nick. He was smiling—not at Amber, but at Miriam. She looked away quickly, but not before her heart did a funny little flip-flop in response. If things had been different, it could have been them standing together in front of their family and friends. Was he thinking the same thing?

After the wedding service, Miriam descended the steps of the church. Around her, families and friends were gathered in small groups, catching up on the latest news and events of the week. People surrounded Amber and Phillip. Words of congratulations and well-wishes flowed around them. Every one, including Miriam, was happy for them. It was clear they were very much in love.

Rather than join a group, she turned aside and walked along the path that led behind the church to a small footbridge that spanned a brook at the edge of the church property. The source of the clear, small stream lay a short way uphill—the gurgling spring from which Hope Springs had derived its name.

When she reached the secluded bridge, she saw she wasn’t the only one seeking solitude. Nick stood at the far end of the bridge staring upstream. His brow was furrowed in concentration. She started to turn away, loath to disturb him, but he spoke suddenly.

“Do you ever wonder where the water comes from? I mean, I know it comes out of the earth, but before it was trapped underground, it had to come from somewhere.”

“I never thought about it.”

“When I was a kid, I thought the gurgling of the water was laughter, delight at being out in the sun and the air again. It still sounds like that to me.”

She leaned against the opposite railing and looked down at the water slipping over and around stones as it raced away downhill. “I think about where the water is going. It’s just starting its journey. Imagine all the places and people it will pass on the way to the sea.”

The silence lengthened between them. The sounds of the birds in the trees and the gurgling brook were soothing. It didn’t surprise her that Nick was so introspective. He was someone who heard laughter in the sounds of a brook and truth in a little boy’s worried words.

Silence was making her more aware of Nick’s presence even though he stood a good six feet away and outside her line of sight. “It was a nice wedding,” she said at last.

“All weddings are nice, aren’t they? They mark the beginning of what everyone hopes will be a blessed union. To bad it doesn’t always work out that way.”

“You sound like you’re speaking from personal experience.”

“I’ve never taken that plunge. I was thinking about my folks.”

“I’m sorry”

“It was what it was. Mom couldn’t reconcile herself to living the life of a cop’s wife. One day, after one of their ugly fights, she told him she wished he would leave and never come back. After he was killed, she couldn’t deal with the guilt she carried.”

“I’ve been told guilt is a useless emotion.” Useless but so hard to put away.

“It’s also a very powerful emotion.”

“Yes, it is.” Reuniting Hannah with her mother would be Miriam’s way of making up for the tragedy she had instigated so many years ago.

* * *

More than anything, Nick wanted to know what Miriam was thinking. He had hidden his surprise when she sought him out. He didn’t want to break the tenuous thread that kept her from running away again. So instead of moving closer, he stayed put, allowing her to control the situation.

His heart ached to gather her in his arms and hold her close. He’d once dreamed of asking Miriam to marry him. Seeing the love and joy in Amber’s and Phillip’s eyes had driven home just how much he wanted to resurrect that sweet dream. Did he dare hope that Miriam was softening toward him? Didn’t her presence here prove that? He prayed God would show him the way to heal Miriam’s heart. His every instinct told him that if he moved one step closer she might flee.

“The sound of the water is soothing,” Nick said, quietly.

“Yes, it is.”

She didn’t leave, but stood listening to the water with him. It gave him a reason to hope, a reason to believe they could repair the love they had once shared. He wanted that more than anything, because he was once more falling in love with Miriam Kauffman.

Chapter Nine

M
iriam gave Hannah a kiss on the top of her head before laying the baby in her crib late Monday morning. She had slept for five hours during the night and Miriam was feeling like a new woman after that much sleep. Ada, stirring a kettle of soup on the stove, said, “You are taken with her, aren’t you?”

“Who wouldn’t be? She’s so precious.”

“
Ja,
I feel it, too. The love for a child is a powerful thing.”

“I know I said I wouldn’t get too attached to her, but it’s already too late.” Hannah was firmly embedded in her heart. Giving her up was going to hurt terribly.

Ada came and wrapped one arm around Miriam. “She has crept into my heart, too.”

“I think we made a mistake trying to keep her until her mother came back. All we did was set ourselves up for a big heartache.”

“Heartaches are part of life, child. God brought this baby to us for a reason. We can only pray that He shows us His will.”

Miriam’s cell phone rang. She stepped outside on the porch to answer it to avoid her mother’s disapproving glare. It was Dr. Zook on the other end.

“Miriam, I need you to bring Hannah into the office today.”

A knot of worry formed in Miriam’s stomach. “Why?”

“We need to repeat some of her blood tests. I’m afraid her MSUD screen has come back positive.”

“MSUD? Hannah has Maple syrup urine disease?” Miriam sank onto the porch steps. Bella came from beneath the porch and sat beside her.

Dr. Zook said, “Let me stress that this may be a false positive. We need to double-check before we assume the worst.”

“How often do you have a false positive?”

He hesitated, then said, “Not often but it does happen. I’m sorry to worry you but there is treatment now for this disorder if the test is correct.”

“Treatment, but no cure.”

“I’m afraid not. We’ll repeat the test to be doubly sure, but in the meantime, you’re need to make a formula change right away. We have cans of a special powdered formula that you can start using today.”

“I’ll be there as soon as I can.” Miriam closed her phone and stared at nothing. Her beautiful little baby might have a genetic disorder that in worst-case scenarios could lead to mental retardation and complete paralysis of her body, even death. The unfairness of it overwhelmed her.

Wasn’t it enough that Hannah’s mother had given her away? Why did God laid this burden on a helpless child? She wrapped her arms around Bella and burst into tears.

An hour later, she helped her mother out of the car and lifted Hannah from her car seat. As they approached the front door of the clinic, Nick’s SUV spewed gravel as he turned into the parking lot and pulled up beside them.

He jumped out of his vehicle and slammed the door. His hair was still damp and he had one missed button on the front of the shirt. “Dr. Zook just called me. I could tell from his voice that this is serious, but how serious?”

“That’s what we have to find out. There are variations of the disease. Some types are not as serious as others.”

“Do we know what type she has?”

“They aren’t sure she has it. That’s why she needs further testing.”

He pulled the clinic door open so that she could go in. Wilma rose from behind the desk and came forward to meet them. “Dr. White and Dr. Zook are waiting for you in Dr. White’s office. I’ll show you the way.”

Miriam followed her down the hallway with growing dread. She prayed as she had never prayed before.

Please let this be a false alarm, Lord.

When Wilma held open a door, Miriam froze, unable to move forward. She felt a comforting hand on her shoulder and turned to look at her mother but it was Nick who stood beside her. He said softly, “We can bear all things with God’s help. He is with us always.”

She nodded, drew a deep breath then walked in.

Dr. White was seated at his desk, his head of snow-white hair bent over a book laid open on his desk. Dr. Zook stood beside him. As soon as he saw Nick was with them, he said, “I’m glad you could all make it. Miriam and Ada, please have a seat. I’ll get another chair for you, Nick.”

He shook his head. “I’d rather stand.”

Dr. White closed his book and laced his fingers together. “I’m sure hearing that Hannah may have MSUD is very disturbing news.”

Nick said, “You’re going have to use plain English, Doc. I don’t know what your medical terms mean. I’m sure Ada doesn’t, either.”

“My apologies, Sheriff. MSUD, or maple syrup urine disease, is an inherited disorder. It’s a rare disorder in the general population, only about one in every 185,000 births worldwide. Unfortunately, in the Amish and Old Order Mennonite communities the incidence is much higher. Almost 1 in every 380 Amish children will have some form of this disease.”

“What type does Hannah have?” Nick asked.

“Let me stress that we aren’t sure she does have it. However, in the most severe cases, a child’s body is unable to properly process certain protein building blocks called amino acids. The three essential amino acids a child can’t break down are leucine, isoleucine and valine. They are often referred to as the branched-chain amino acids or BCAA’s. The condition actually gets its name from the distinctive sweet odor of affected infants’ urine.”

“I haven’t noticed that,” Miriam said quickly, hoping to prove their diagnosis was wrong.

Dr. Zook said, “Not all babies will show that symptom until they are in crisis. It used to be that babies with this condition showed poor feeding, frequent vomiting, a lack of energy and finally developmental delays before anyone knew what was wrong with them. Fortunately, in recent years all babies in the state of Ohio began being tested for this condition because if untreated, maple syrup urine disease can lead to seizures, coma, paralysis and death.”

Nick looked from Dr. Zook to Dr. White. “If left untreated. That means there is treatment available, right?”

“Yes.” Dr. White extended a pamphlet toward Nick and Miriam. “Treatment of MSUD involves a carefully controlled diet that strictly limits dietary protein in order to prevent the accumulation of BCAAs in the blood. The cornerstone of this diet is a special formula that does not contain any leucine, isoleucine or valine but is otherwise nutritionally complete. It contains all the necessary vitamins, minerals, calories and the other amino acids needed for normal growth.”

“How soon do we start it?” Miriam asked. This shouldn’t be happening. It wasn’t fair, but then how often was life really fair? Without Hannah’s family in the picture it would be up to Miriam to give the baby the best possible start in life.

Dr. Zook gave her a sympathetic smile. “Initially, Hannah will need the MSUD formula to be supplemented with carefully controlled amounts of the protein-
based baby formula she is on now until we know for certain that the test is correct. It if is, I’m afraid Hannah is going to become a frequent flyer here. She will need frequent monitoring of her blood levels.”

“Will she grow out of this?” Nick asked. He was grasping at straws. Miriam knew better.

Dr. White shook his head. “No. Lifelong therapy is essential. Typically, the MSUD diet excludes high protein foods such as meat, nuts, eggs and most dairy products.”

Dr. Zook said, “Children can gradually learn to accept the responsibility for controlling their diets, however, there is no age at which diet treatment can be stopped.”

Ada had remained silent until now. “What does this mean for her mother and father?”

Dr. Zook and Dr. White exchanged glances. Miriam said, “If the test is correct, it means they both carry the MSUD gene. If they have more children together, there is a strong possibility that those children will have the same disease.”

A strange look came over Ada’s face. “It is
Gottes wille
if their children are sick or if they are healthy. Perhaps that is why He brought the child to you, Miriam. So that your knowledge can help her.”

It was the first time her mother had even come close to admitting that Miriam’s education was a good thing.

Dr. White sat back in his chair. “What is really important is that we make sure we have correct test results. Let’s not panic until we know for sure she has this thing. In the meantime, we don’t allow Hannah to develop a BBCA crisis. High fever, vomiting or diarrhea, not eating, these can all trigger an elevated level of BBCA in her blood, and that can lead to brain damage. She is going to require close medical supervision.”

Nick asked, “Should she be hospitalized now? What kind of further testing does she need?”

Dr. White rose to his feet and came around the desk. He perched on the corner and reached for Hannah. Miriam handed the baby over to him. He lifted her to his shoulder and bounced her gently. Looking a Nick, he said, “You are wondering if you made a mistake by allowing Amber and these women to talk you into keeping the baby out of child care services.”

“Did I?”

“I don’t believe so. There’s no reason to hospitalize Hannah at this point. We can draw the additional blood we need for testing here.”

Miriam saw the tension ease in Nick’s shoulders. Dr. White continued, “No one has more respect for the Amish than I do, Sheriff. They welcome and lovingly accept children with any kind of disability as a gift from God. Fewer and fewer people in the general population feel the same way. If her mother doesn’t return for her, I would hope that she can be adopted by an Amish couple here in this community.”

Miriam stood and took the baby from Dr. White. “How can I get the formula that Hannah needs?”

Dr. Zook smiled at her. “We have some that we can give you. I will also give you the number of our formula supplier so that you can order all you need.”

“Thank you.”

Dr. Zook moved to open the door. “If you’ll come with me, we can draw her blood. We should have the final test results back in about twenty-four to forty-eight hours. Hopefully, all this worry will be for nothing.”

* * *

Nick stayed behind as the women left. Folding his arm over his chest, he spoke to Dr. White. “I wish I could compel you to reveal all you know about Hannah’s mother.”

“Sheriff, I wish I had something to reveal. Sadly, I don’t know any more than you do.”

“But you have seen this disorder in families around Hope Springs.”

“I have. Too many times, as a matter of fact.”

“I don’t suppose you could give me a list of those families’ names. I don’t mind looking for a needle in haystack, but if I could have a smaller haystack to search, that would be better.”

Dr. White chuckled. “I can imagine it would. I’m sorry I can’t be more help. The baby is in good hands now, and that is what’s important. I hear that you’ve been checking buggies all over the county.”

“The buggy that left Hannah at Miriam’s had a crack in the left rear wheel in the shape of a long Z. It’s all we have to go on. I must have looked at over a hundred buggies, and I haven’t been able to locate it.”

“Levi Beachy is here waiting to get stitches taken out of his hand. He’s the local buggy maker. It’s possible he might know who owns a rig with a wheel like that. I’ll tell him you’d like to speak to him.”

“Thanks, Doc.”

Nick left the office and saw Miriam waiting outside by the car. She looked tearful and worried. All he wanted was to hold her close and reassure her.

No, he wanted much more than that. He wanted to tell her that he loved the color of her hair. That he loved the way her eyes sparkled when she was happy. That he wanted to spend the rest of his life making her eyes sparkle.

A dozen ways to tell her how much he cared about her ran through his mind. None of them seemed like the right thing to say at the moment. Soon, he would find a way to tell her how he felt and pray that she might return his affection. Soon, but not now.

He didn’t see Hannah or Ada as he left the clinic and stopped beside Miriam.

“At least it’s a treatable disease,” she said before he could say anything.

“That’s right and she may not even have it. Where is your mother?”

“She’s changing Hannah. I needed some fresh air.” She pressed a hand to her mouth. Her eyes filled with unshed tears. “I’m so scared for her, Nick. Any illness she gets could result in permanent brain damage. A bad cold, the flu...”

Nick wrapped his arms around her and pulled her close. He pressed a kiss to her forehead. “I know you’re scared. I’m scared, too.”

Her arms crept around his shoulders. To his surprise, she returned his hug. “How is a teenage Amish mother going to handle this if I’m terrified and I’m a critical care nurse?”

“Maybe we should stop looking for her.” Nick held his breath as he waited for Miriam’s reply.

Softly, she said, “I’ve thought of that. Hannah is so easy to love. The longer she stays with me the harder it’s going to be to give her up. Now that I know she may be sick, I can’t bear to let her go.”

Nick stepped back and held Miriam at arm’s length. “There may be a way for you to keep her. Have you heard of being a treatment foster parent?”

“Of course I’ve heard of it. They are foster parents that provide medical care to children with emotional or serious medical problems.”