Trapped (32 page)

Chapter Sixty-Three (Week 34)

Harvey and Phoebe trotted beside the gurney as the orderly and Arlene rushed Lisa into Intensive Care. The unit faced west, with the lights of the east bay sparkling in the foreground and San Francisco glowing in the distance.

They slid her off the
gurney and into the bed across from the nursing station. Mike’s room was not more than fifty feet away.

While they organized Lisa’s bed, IV lines
, and attached the monitors for her heart and for the baby, Phoebe talked to the nursing care coordinator for the night shift, Beth Byrnes. “Can you assign Carla Watts to Lisa tonight? I’ll take her when I come in for my morning shift.”

“Sure, Carla’s great,” Beth
said, “but, Phoebe, there’s no way I’m going to assign you to your best friend. I know you mean well, but that’s an awful idea.”

“I guess you’re right. It’s difficult to stand by and watch.”

“Can you work, or maybe you should take the day off to be with your friend?”

“I’ll work,” was her
knee-jerk response, but, after giving it more thought, Phoebe said, “No, I think you know me better than I know myself. Get someone to cover for me. My mind’s elsewhere.”

“I’m Carla Watts,” the young nurse said as she approached Lisa. “I’ll be taking care of you this morning.”

“Hi,” whispered Lisa. “I’m so frightened. Where’s Harvey…Dr. Russo?”

“He’s at the nursing station making arrangements.”

“Arrangements for what?”

“He’s asking Dr. Byrnes, the director of the ICU, to consult.”

Carla pulled the sheet back to assess her patient. Black and purple marks covered
her skin, and she was still oozing dark red blood from several venipuncture sites. She placed the automated blood pressure cuff on Lisa’s arm, and pushed the start button. The machine vibrated with a throbbing sound as the red LEDs blinked as the readings began. After blinking for twenty seconds, they flashed steadily at 102/60.

“That a better blood pressure
than it was downstairs,” Carla said.

Carla removed Lisa’s pad
, which was saturated with dark blood, but there were no clots.

“I’m going to put in a bladder catheter, Lisa
—doctor’s orders.”

“It’s okay. I understand.”

After ten minutes, Harvey Russo and Jack Byrnes
were at Lisa’s bed. “Jack’s going to help us until we get this thing under control,” Harvey said.

“Do I get a twofer?” Lisa said with a smile.

“A to-what?” Jack asked.

“You know, a two for one, since you’re on Mike’s case
, too.”

“Why
, sure,” Jack said, smiling.

Lisa turned to Harvey
, and said, “Tell me about ‘this thing’ that we need to get under control.”

“You know much of this, Lisa, but let’s assume
that you’re a regular patient, not a nurse.”

“Okay, Harvey,” Lisa said. “
You won’t hurt my feelings.”

“My best guess is that the placental separation has extended. That’s why you’re bleeding
, again. When we add to that the bruising and the bleeding from venipuncture sites, it means that some amniotic fluid has entered your circulation, and is consuming your blood clotting factors.”

Harvey held his neck
, and pulled his right hand across his face. “I’ve never lied to you, Lisa. This is a dangerous situation. We could deliver you now, at thirty-four weeks. You know better than I what that could mean for your baby. The last amniocentesis still showed immature lungs, so I’d like to hold off delivery for as long as possible. If we can’t control the bleeding or the clotting problem, or if at any time the baby starts to show distress, then that’s it.”

“After I get a chance to read your chart and examine you,” Jack
said, “I’m going to put in a central catheter for IVs, as well as for monitoring your pressures. That will help us to give blood or fluids, and show us how we’re doing.”

Jack draped Lisa’s groin area, and then
, with a portable fluoroscope, inserted a long catheter into her heart. As he was placing a dressing over the site, Carla said, “There’s a Nora Cooper outside. She’s demanding to see Lisa.”

Lisa turned to Phoebe
, and smiled.

“Oh
, no you don’t,” Phoebe said. “Get someone else to face the dragon.”

“You’re not going to give me a hard time now, are you?”

“Okay, but let me get my sword. You’re going to owe me—big.”

When Phoebe entered the waiting room, Nora and her daughters rose.

“What the hell’s going on, Phoebe?” Nora asked. “Why won’t they let me in? What are they keeping from us?”

“Hold onto your shorts, Nora. Give me a chance
, and I’ll tell all.”

Phoebe recounted Lisa’s bleeding, its complications, and the plans to try to stabilize her condition for as long as possible before delivering the baby.

“How
is
the baby?” Lilly asked.

“So far, so good. He shows signs of stress when Lisa’s actively bleeding, but he calms down each time.”

“How long will they wait?” Emma asked.

Phoebe looked at the anxious women
, and said, “Until the baby’s lungs are mature enough, or until they have no choice but to deliver him, or risk two deaths.”

Chapter Sixty-Four (Week 34)

ICU sucks
! Lisa thought.

Phoebe loved the frantic pace
, as did Lisa in the NICU, but now Lisa was on the wrong side of the stethoscope.

Lisa do
zed, and, when she awoke, the red LEDs on the wall clock read one fifteen a.m. The staff had darkened the room, but she could see the reddish glow of the equipment dials, and hear the clicking and whirring of the respirators, the growling of suction pumps, and the soft discordant beeping of heart monitors. The air smelled of disinfectant, and occasionally noxious odors would intrude, escalating her desire to escape.

Lisa pushed the control button
, and lifted the head of the bed to forty-five degrees. Her window faced west, so she could see the lights of the east bay, the two San Francisco bridges, and the city in the distance.

Kay Brightman, a veteran ICU nurse, came to Lisa’s side when she saw her gazing out the floor-to-ceiling window. “It’s beautiful, isn’t it?”

“Yes, but I’d sure like to be anywhere else.”

“How are you feeling, Lisa?”

“I’m tired, but I can’t sleep.”

“I know. It’s hard to sleep in this place. Maybe, if you’re stable overnight, we can move you into one of our private rooms.”

“That would be great. When did Phoebe go home?”

“She watched while you slept
, and then left at eleven. She’s a great friend, and an incredible nurse. You’re lucky.”

“It’s hard to feel lucky
,
right now. Knowing Phoebe, I’m sure you’re under orders.”

“Coming from anyone else, I might get pissed off at her demands and her hands-on involvement, but Phoebe has a way of making us feel like we’re part of a team effort.”

“How’s the baby doing?” Lisa asked.

“You tell me. The monitor shows a stable heart rate and his pulse increases normally when he moves.”

“I don’t feel him moving much.”

“That’s normal at this stage,” Kay said as she turned to the monitor. “Speaking of the devil, here he is.”

Lisa felt him twisting, and smiled. “Hang in there, baby boy
.
”

No more than forty feet away from Lisa, Carla Watts and Mike were trying to communicate.

They have to hold the alphabet board at the right angle,
thought Mike,
or I can’t see well enough to indicate which letter I want.

“It’s a ‘P’, right?” Carla Watts, his nurse
, asked.

No.

She moved her finger across the board again, until he indicated ‘yes’ with his eyes. “It’s an ‘O’.”

No
,
Mike blinked, turning red with frustration.

This is impossible
, he thought.
I can’t do this. It’s not worth the effort
.

“I’m trying,” Carla
said, equally exasperated. “They promised us a computerized system that monitors your eye movement to allow you to pinpoint to each letter.”

That’s great
, Mike thought,
if I live so long.

“Let me reposition the board
, and we’ll try again,” she said.

It took about twenty minutes until she understood his first word,
Carla.

“What?”

This sucks
.

“It sucks for me
, too,” she replied.

I need to see Lisa
.

“I know it’s a big favor, Kay,” Lisa said, “but could you get me on the gurney chair so I can spend some time with Mike?”

“Let me check with Jack
.”

She returned a few minutes later. “He said
it’s okay. Let’s be careful.”

When they wheeled Lisa into Mike’s room, his nurse, said, “When you guys go home, I’m sending this story into the
Katie Couric Show
.”

“How’s he doing?” Lisa
asked.

“He’s stable, Carla
said, but he’s not much of a conversationalist.”

“Carla!” Lisa said in surprise. “I can’t believe you said that.”

Carla surprised herself. “Oh, please, Lisa. You know what I mean. He’s been like a lousy guest on a talk show, giving me one-word answers. It wasn’t long ago that he had that alphabet board going wild. He’s been reticent. Maybe he’s depressed.”

“I’m sorry,” Lisa
said. “I should have known better.”

“He did ask for you,” she paused
. “And for the baby.”

The nurses arranged for Mike and Lisa to be facing each other. Lisa grasped his left hand.

Lisa shook Mike, and said, “Mike, it’s me. It’s Lisa.”

Mike opened his eyes.

My God, there she is.

“Do you want
the alphabet board?”

Yes.

Lisa was unable to hold the board for Mike, so Carla obliged.

How are you? How is my son?

Lisa gave him a sanitized version of her situation.

Are you telling me everything? Please don’t hold back.
I’m either a part of this, or I’m not.

“Harvey may have to deliver the baby soon.”

How soon?

“Thirty-four
, or thirty-five weeks. I have an abruption. He may not have a choice.”

After Carla left to attend to another patient, Lisa asked, “Have you tried to move?”

Yes.

“Please
, try again. Try for me, and for your son. I know you can do it.”

Mike focused all his energy and his attention to his left hand.

Nothing happened.

“Try again
, please.”

I’m trying
, Mike thought.
I’m trying.

At first, Lisa thought
that her own hand muscles were contracting, as she felt the slow movement of Mike’s index finger. “Do once more.”

It moved again.

Lisa pushed the call button, and Carla entered the room.

“Is everything okay?”

“He moved his index finger,” Lisa said. “I’m sure of it.”

“I don’t think so. He’s had some muscle spasms
, but nobody’s seen any voluntary movement.”

“I asked him to try. He did it. Let me show you.”

“Mike, move your finger again. Please.”

No,
he told her.

I can’t. I’m exhausted
, he thought.

“Please, Mike,” she
said, crying.
“Just once more, so Carla can see.”

No,
he repeated, and then he closed his eyes.

“He did it, Carla. He moved. It’s not wishful thinking. Please believe me
—I’m not crazy.”

Carla smiled, and then said, “It’s time to get you back into bed.”

Something’s wrong,
thought Lisa as she awoke from her nap at seven that evening.

“Oh
, God,” Lisa said, grasping her back. “My back’s killing me.”

“Where?” Kay
asked.

“I’m starting to cramp
, to have contractions—Oh, my God, I can’t stand this!”

Kay pushed the start button on the automated blood pressure machine, watching the flashing red LEDs until th
e machine read 90/50. Lisa’s pulse rate had increased to 130 beats per minute.

“The baby
. What’s happening with my baby?”

Kay scanned the recordings, and became alarmed. She looked at Lisa, uncertain about what to say. “His heart rate is slowing with contractions. I’m calling Dr. Russo.”

“Get the lab to draw a blood count and clotting studies,” said Harvey Russo
. “Call Jack Byrnes, and have the ultrasound machine brought up to ICU. I’m on my way.”

“What’s happening to me, Kay? I feel awful. Am I bleeding again?”

Kay checked Lisa’s pad, and saw slight reddish staining. “I don’t see any overt bleeding.”

“You mean I could be bleeding inside?”

Kay was about to respond, when the white gauze over the central IV line turned red. When she removed the dressing, blood was oozing from the site. Lisa’s belly now showed diffuse black and blue bruising. Kay covered the site with a new dressing, and a 5-pound sandbag for pressure.

“I’m feeling dizzy, Kay. How’s my blood pressure?”

Kay pushed the start button again. This time, the LEDs read 84/40.

“Did you get Dr. Byrnes?” Kay yelled to the monitor tech.

“He should be here any second,” she replied.

Just then, Jack Byrnes
rushed into the ICU. “What’s up, Kay?”

Kay reiterated the events of the last hour. “Is she bleeding internally? Is it DIC
, again?”

Jack shook his head
, and then came to Lisa’s bedside. After he examined her, he asked, “How are you feeling?”

“I feel like shit
. Oh, Dr. Byrnes, I’m sorry.”

“Don’t be. It’s a dumb, but necessary question. Are you still cramping? How does your belly feel?”

“I’m having labor pains. I know it. My belly is getting bigger, too.”

Jack held her hands
, and said, “Harvey will be here in a moment. We must get that baby out, now.”

“No!” Lisa screamed. “He’s not ready
!”