Trapped (31 page)

Chapter Sixty-One (Week 32)

Following the amniocentesis, Lisa had more cramping and bleeding. The baby’s increased activity suggested stress, but his pulse rate remained normal.

During the evening, Lisa’s thoughts kept returning to Harvey’s harsh words.

He’s right, of course. What’s wrong with me?

Harvey came in the next morning reading her chart, and then he sat by Lisa’s bed. “The L/S ratio in the amniotic fluid is less than one. That means that the baby’s lungs are immature
, and delivering him any time soon will be a problem. You know that better than I.”

“How long will it take for the medication to mature his lungs enough for delivery?”

“I don’t know for certain, but I’d sure like to get you to thirty-four weeks. I’ll repeat the amniocentesis in a week. That way we’ll get a handle on the maturity of his lungs.”

“What if you have to deliver him soon?”

“We’ll do that only as a last resort and only if continuing the pregnancy puts either of you in jeopardy.”

“I’m still bleeding, with clots
, too.”

“It
looks worse than it is, Lisa. We’ll monitor your blood count.”

From the first day she’d met Harvey, she
had imagined him as the father she’d always wanted. She felt safe in his hands, and was upset that she’d disappointed him.

“I’m sorry for all the trouble I cause you
, Harvey. You’ve been great to me. I should have listened to you.”

Harvey grasped her hand. “I’m sorry for going off on you the other day. It wasn’t your fault. I let my disappointment get the better of me. I shouldn’t allow my feelings for you and Mike to influence me. You deserve this baby, and I’ll do anything in my power to see that both of you get through this.”

Lisa kissed his cheek, and then he departed.

Phoebe and Max sat beside Lisa’s bed when Nora arrived.

Lisa
gave Phoebe a fixed look, telling her to be on her best behavior in front of Nora.

Phoebe looked back at
Lisa, shook her head, and smiled.

“Phoebe,” Nora
said, “how wonderful to see you. This must be Max, he’s delightful.”

Max reddened
, and clutched his mother.

“He’s just shy, Nora,” Phoebe said, anticipating Nora’s reaction. “You’re looking well.”

“I know I’ll look and feel better after Lisa has this baby. We can’t wait.”

Nora turned her attention to Lisa, kissed her
, and placed a stack of magazines on her bedside table. “I raided the magazine rack at Barnes and Noble. I hope you’ll enjoy them.”

“Thanks, Mom. They’re saving my sanity.”

Lisa praised herself for remembering to call Nora “Mom”.

“Has Dr. Russo been in today?”

“Yes, he was in this morning.”

Nora looked as if she wanted to say something, but she remained silent.

Finally, Lisa said, “He said the baby’s lungs are still too immature. We need to keep this pregnancy going for as long as possible.”

Nora’s face formed a frown.

Here it comes
, Lisa thought.
She just can’t help herself.

Lisa could see the battle brewing within her mother-in-law. At the denouement, Nora said, “Maybe you should ask for a second opinion. I know Dr. Russo has a great reputation, but he’s getting on in years. Maybe you could get somebody younger
, or from the university.”

“That’s ridiculous,” Phoebe
said.

“I wasn’t talking to you,” Nora
said, sliding her chair away from Phoebe’s. She turned to face Lisa directly. “I was just making a suggestion for you to consider.”

“T
hank you, Mother, but Harvey has Mike’s full confidence, and he has mine, too. Moreover, Harvey teaches at the medical school in San Francisco, and has more real-world experience than any of them.”

“Well,” Nora
said, “whatever you think best, Darling.”

“He’s adding his two cents in,” Lisa said
, holding her abdomen, and feeling the baby’s movement. “It’s freaky, but he understands what’s going on in my life.”

“The baby looks normal, doesn’t he?” Nora
asked.

“As far as Harvey can tell, he has all his parts, and looks perfectly normal.”

After twenty minutes of idle chatter, Nora excused herself. “I’ll see you in a day, or so. Call me if you need anything.”

After Nora left, Phoebe turned to Lisa.
“That was an academy award-winning performance.”

“It’s not so bad when you make your mind up in advance that you won’t let her get to you. She’s going to be a part of our lives, and I don’t expect our relationship to be anything but cordial
. If cordial is the best we can do, I’ll settle for that.”

“
Well,” Phoebe said, “I thought you did well.”

Lisa turned away from Phoebe.

“What is it? Are you okay?”

“With all we’ve been through, from early pregnancy until now, I do worry about the baby’s health. I’
ll love him no matter what…”

“No matter what?”

“I smile at the image of Harvey holding the baby,” Lisa said, “and seeing all his fingers, and toes, and to be at ease when I know, at last, that he’s perfect.”

“He
is
perfect.”

Teresa Russo rolled over in bed to look at the bedside clock. It read three ten a.m. She slid her bottom toward Harvey’s side, but felt nothing. He wasn’t in bed, yet she knew that he hadn’t gone out on call.

She pulled on her robe
, and opened the door to the family room and kitchen. Harvey sat at the kitchen table eating an English muffin, sipping a cup of tea, and reading a book.

“I didn’t wake you, did I?”
He asked.

“No, I noticed you weren’t in bed. Is everything okay?”

“I couldn’t sleep, and I know how you hate it when I read in bed.”

“You haven’t been sleeping well lately. You were always such a good sleeper.”

“Poor sleep is the curse of the elderly.”

“Elderly? You’re kidding.”

“Lately, I’ve been feeling my age. I’m no kid, anymore.”

“Something’s bothering you, h
oney. What is it? You never held back before.”

“It’s not one thing; it’s many things. I hate to talk about it. It sounds like I’m complaining
, and, I hate people who complain.”

“It’s been a bad year for you. Think about it
: Roberta’s arrest, the malpractice fiasco, Mike’s condition, and then all of Lisa’s problems.”

“I still think about Mike, especially when I see Lisa. Some losses are so sudden
, and so dramatic, that they remain fixed in your mind, a beat away from the heartache of reliving the devastating moment. I remember Mike’s accident the way I remember that day in Dallas.”

Harvey gathered the cup and saucer
, placed them in the sink, and then returned to the table. “Lisa and Mike remind me of us, when we were young.”

“I can’t remember that far back.”

“I can. Those were the days.”

“Maybe so, but for me, h
oney, these are the best days.”

Teresa hesitated a moment. “Is it the office?”

“Not really. My partners are young and just starting their careers. I’d agree with them about Medi-Cal, if I was beginning a practice today. I started my practice with—don’t laugh—a sense of noble purpose and enough independence to do it my way. Much of that no longer exists for physicians now.”

“Maybe it’s time to cut back.”

“Cut back?”

“You’re the boss. We don’t need the money,” she said,
holding his hand. “I don’t think there’s an OB/GYN of your age in the east bay who’s still delivering babies. Why not leave that part of the practice to your partners?”

“
For a physician of my advancing age, that makes sense, but it’s the obstetrical part of what I do that keeps me going. From that first delivery in Vietnam until now, I thrill as I help bring babies into the world. I can’t lose that, too.”

“Harvey, sweetheart, you’re not Superman. This isn’t some kind of mid-life crisis. This is stress
, and you’re not immune to it.”

He stood,
and embraced Teri. “I don’t know what I’d do if I lost you. We’re so much a part of each other’s life that I couldn’t…”

She kissed him. “
Let’s think on it. Maybe this isn’t the best time to make a major life decision. Let’s go back to bed.”

Chapter Sixty-Two
(Week 33)

Carter Reynolds, with the help of Oliver Schlasser, pulled together all the data on the use of Viagra in the treatment of neurological diseases.

After a surprisingly brief discussion, Brier’s Committee for the Protection of Human Subjects decided to allow its use on Mike Cooper.
It had a low risk, after all.

Phoebe stood in the medication room of ICU. She grasped the porcelain pestle, and crushed the iconic blue pill in a mortar. She dissolved the blue powder in water, and instilled it into Mike’s feeding tube. They’d ordered this dose four times a day.

“Maybe I should stand back, Lisa,” Phoebe said after she instilled the first dose.

“I always know what’s on your mind, Phoebe.”

Phoebe lost her smile. She grasped Lisa’s hand
, and said, “I know that this is going to work. I just know it.”

Lisa hadn’t realized how active a person she had been until she spent this much time in bed. Exercise had been her Prozac.

“I feel so down,” Lisa said as Phoebe sat by her side one evening near the end of week thirty-three.

“You’re stuck, sweetie. It’s just a few weeks more to get that son of yours into shape for the world.”

“This isn’t an intellectual problem. I u
nderstand that my condition’s unstable, and risky to me and the baby, but this depression feels physical, like something’s turned down the thermostat of my happiness. Depression isn’t new to me. After all, I grew up with Sandy and Rudy. This is different. It’s like postpartum depression, except I haven’t given birth.”

Lisa told Harvey about her feelings.

“It’s called antepartum depress
ion,” he responded. “It’s a cousin of the more common postpartum depression. If it gets bad enough, I can prescribe antidepressants.”

“No way,” Lisa
said. “No meds, unless I have no choice. The cure is easy, Harvey. Get me to term with a healthy baby.”

Lisa visited Mike twice a day for several hours. She was in the way, she knew, but the nurses never complained.

The Viagra
had, after four days, shown no neurological effect on Mike.

Humor can be just what the doctor ordered for the nursing staff’s survival in the face of disease and frustration. The use of Viagra, although novel in Mike Cooper’s situation, had enticed the nurses’ imaginations
, especially when they witnessed his reaction to genital care.

Mike was unable to void on his own and
had a rubber catheter inserted through his penis, and into his bladder. Although his reaction to touch was predictable, the enormity of Mike’s erections created double or triple takes as passersby noted the white-sheet tent covering his groin.

After passing by Mike’s bed for the fifth time in two hours, Phoebe said, “This is the last time I’m saluting that flag.”

Lisa pushed the call button, and when Arlene Fox, her nurse, arrived, she said, “I haven’t had a bowel movement in three days.”

“Is that normal for you?”

“Nothing’s about this pregnancy is normal for me, Arlene, but I’m feeling pressure
, like I have to go. Can you give me something for it?”

“Dr. Russo left strict order
s: no laxatives. I can give you a stool softener, and help you up for as long as you need, but that’s it.”

“I’ll wait,” said Lisa.

At three in the morning, Lisa had a strong urge to move her bowels. She
rang for Arlene again. “Help me up. I have to try.”

“You take it easy, Lisa. Don’t strain. Let me do the work.”

Once up on the commode, Lisa felt short of breath. Her pulse bounded. She pushed, and then relaxed. She tried again, when she felt the cramp begin in her back. Suddenly, the commode flushed with bright red blood, and dark clots.

Lisa must have fainted, because she awoke to find herself back in bed.

“You were out for a second,” Arlene
said. “By the time I got the cuff on your arm, the blood pressure was 106/70. It may have been lower when you were sitting up. How do you feel?”

“My back really aches.”

“I’m calling Dr. Russo.”

“Don’t,” said Lisa. “I’m fine.”

“Excuse me, Lisa, but if I don’t call him, and something happens to you, Dr. Russo made it clear that I better seek employment elsewhere.”

Arlene Fox turned to the ward clerk, “Get Dr. Russo, stat.”

After ten minutes, Arlene said, “Where’s Russo? I need him now.”

“I called the on-call room and pa
ged him, but he hasn’t answered,” the ward clerk replied.

“Send someone down to the on-call room
—now.”

“Dr. Russo. Wake up.”

Harvey fought his way into consciousness. “What is it?”

“We rang the phone in the on-call room,” said the orderly, “but you didn’t answer. They need you about Lisa Cooke.”

It must have been REM sleep
, Harvey thought.
Awakening was so painful.

“Lisa
,” he grunted. “I’ll be right up.”

“Dr. Russo,
Sir?”

“Yes.”

“You’re awake now, Sir?”

“Of course. I’ll be there in a sec.”

Harvey went to the bathroom, and washed up, tossing handfuls of cold water in his face. He looked at the clock, which read three-thirty a.m. He’d slept forty minutes since delivering the last baby, and he felt it. As he put the while lab coat over his scrubs, he shook his head, trying to clear it. His neck and back ached, and he felt his movements in slow motion.

He
was headed for the door, when the phone rang. “Dr. Russo, this is Arlene Fox. I have Lisa Cooper tonight. She’s bleeding and cramping.”

“Get the lab up to draw a blood count and clotting studies per protocol. I’m on my way. One other thing, Arlene
, stay at her bedside. I want vital signs every ten minutes.”

“I have four other patients,
Doctor.”

“Call your
charge nurse and get them covered by someone else.”

When Harvey arrived on the ward, he pulled his stethoscope from the lab coat pocket, came to Lisa’s bedside, and listened to her heart and lungs.

Arlene held a white gauze pad over a venipuncture site. “It won’t stop b
leeding,” she said with alarm.

Lisa looked like she was sleeping,
although she was breathing heavily. When Harvey removed the bed sheet covering her, he gasped at the black and blue marks covering her torso and arms.

“Oh my God,
” he shouted. “She has DIC. I want her in ICU, ASAP.”

Harvey turned to Arlene. “
DIC, or Disseminated Intravascular Coagulation, is a complication of Lisa’s abruption. Her blood begins to clot in the circulation, and consumes the blood clotting factors needed for control of bleeding. Lisa can bleed from anywhere. Now, it's the skin and venipuncture sites. Later, she could bleed into her brain

“Lisa
—Lisa—he shook her.

She groaned,
and then whispered, “Harvey, what’s wrong? I can barely see you—what’s happening to me?”

“Her blood pressure is down to 84/50,” shouted Arlene, “
And, the baby’s pulse rate is falling.”

“I’m starting an IV. Hang some 5% dextrose and
normal saline, and run it slowly. Get 500ml of plasma expander, and run it in right away. We have to get this girl to ICU.”