The good news was that both patients were still alive. The bad news was that Kate’s pulse was high and thready, indicating loss of blood. Her heart was pumping fast to try to keep her body oxygenated. They’d given her Ringer’s to replace blood volume. She was unconscious but her pupils were responsive, indicating that she wasn’t brain dead. They checked for the baby’s pulse and it was strong, but showing occasional decelerations, which could either be premature labour induced by the trauma or an abruption – the separation of the placenta from the uterus. If that was the case, they had only minutes to deliver Sophia before she would be affected by lack of oxygen.
I watched helplessly while they wheeled in a portable ultrasound machine and imaged her uterus while the nurses cut off her clothes in preparation for surgery. They’d deliver her if the ultrasound showed that she had an abruption or internal bleeding.
I tried to see the ultrasound monitor but couldn’t over the staff crowed around Kate, working on her.
“She’s abrupted,” the ER doc said and nodded to the others. “Let’s get her in the OR stat.”
Then, in a matter of mere moments, Kate was rushed to the closest OR and that was it.
“I want to scrub in,” I said, my voice shaky.
“I’m sorry, Dr. Morgan,” the circulating nurse said when I stood outside the OR. “You know better than that. Wait here,” she said. “They’ll do their best to save them both. What is your wife’s blood type?”
“A-positive,” I said, straining to see Kate over her shoulder. “Save
her
,” I said, my voice finally breaking. “If it comes to a choice, save my wife.”
She nodded and left me, going back to the OR table to speak with the other staff. I watched through the window as they transferred Kate from the gurney to the OR table, shocked at the blood I saw covering her thighs. In seconds, someone had a unit of blood up on the IV pole and began infusing it. The anesthetist had a mask over her face and they began to drape her and prepare her for a crash C-section.
One of the nursing staff came to me and took my arm. “Come into the conference room, Dr. Morgan,” she said in a soft voice. “You can watch the video feed.”
ORs were often videotaped for teaching purposes. I could watch the entire procedure from the conference room.
A crash C-Section is the way it sounds – everything moves extremely fast because, usually, surgeons are trying to save the baby’s or mother’s lives. Often both. That was the case now, as Kate and Sophia were both in danger. If the abruption was too extensive, Kate would bleed too much before they could deliver the baby, and the baby would be without oxygen for too long and die. The veins and arteries in the uterus were large and the placenta had a rich blood supply. Kate was in danger from hemorrhage as well, let alone any head or other internal injury she might have sustained. Depending on how long it took to deliver the baby and tie off any bleeders, she could lose even more blood.
All the permutations went through my mind – everything I learned in medical school – the possible complications. The risks. I felt completely helpless for the first time in a long time, watching as the surgeon made an incision and began to cut through the layers of skin, subcutaneous fat, muscle and the uterus itself to get to the baby.
To Sophia.
I wiped my eyes and watched as they laid Kate on the operating table, her arm stretched out for the IV, a tube down her throat, leads going from her chest to measure her vitals. Blood dripped off the table onto the floor as they pulled my daughter out of Kate’s womb and I wept when I saw her limp body in their hands, waiting to find if she was still alive.
Far too tiny, red, wrinkly, covered in blood.
Sophia Marie McDermott Morgan.
They transferred her quickly to a waiting table where they worked on her, intubating her, attaching ECG leads, cleaning her off, putting in an IV, then I saw the reassuring and very rapid blip of her heart on a monitor, and I leaned closer, my vision blurred, trying hard to see her.
One of the nurses turned to the video camera, and held her thumb up to signal to me that she was alive.
She was alive.
Now that I knew Sophia had survived delivery, I turned my focus to Kate, and watched as they searched in her body to find the source of bleeding, hoping to cauterize and stitch up any wounds so they could stop the bleeding from the abruption and any other internal injuries. They worked away and then I saw a nurse hang another unit of packed cells on the pole. And then another.
That wasn’t good – Kate was losing blood too fast. At some point, if they gave her too many transfusions, her clotting mechanism would give out and she could bleed to death, despite their best efforts. I knew only too well that death from automobile crashes was the highest cause of death for pregnant women.
I watched as the nurses talked to each other, and I tried to turn up the volume so I could hear but I couldn’t make out what they were saying. No one was using any mics so all I had was video feed and one mic that was always on, but it relayed only a murmur for it was too far from the action.
One of the nurses went to the door and spoke with someone outside of the OR theater. Soon, I heard a light tap at the door and in walked Dr. McAllister, her face the usual focused calm.
“Drake, I’m so sorry about this,” she said and came to take my hand. “The good news is that your baby is fine. She was well-oxygenated the entire time so there’s little chance that there are any lasting issues since the abruption was minimal. They’re having problems stopping Kate’s bleeding from internal injuries to her spleen and a small tear in her uterine wall. They’re going to have to take her spleen and do a hysterectomy to save Kate’s life.”
I nodded, and wiped my eyes. “Save her life,” I said, my voice shaking. “She’s too young to die.”
“I just wanted you to know that they have to take her uterus. I’m sure you understand.”
She squeezed my hand and I nodded in understanding.
They didn’t take a uterus out lightly. It was done to save Kate’s life.
I turned back to the screen when McAllister left the room and watched as they worked on Kate, unable to really see anything specific, but I knew the process. Cut off the blood supply to the uterus, clamping any vessels that were bleeding. Cutting the broad ligaments that supported the uterus inside the body, then removing the uterus itself entirely, careful to preserve the ovaries if possible.
Kate would never get pregnant again. She’d never carry another baby of her own again and I wished so hard at that moment that I had spent more time with her while she was pregnant, feeling her belly, feeling Sophia moving inside of her, enjoying Kate’s ripe body as she carried our daughter, giving her life.
Tears flowed down my face and I didn’t care, because once more, I had been far too busy in my life, far too preoccupied with my career, with my fellowship, and with getting my certification and not enough time with the beautiful amazing woman who made my life meaningful.
I felt so bad for Kate – she’d given up so much to have this baby. Her MA thesis on hold, all alone during the day at our apartment due to morning sickness, seeing me only a few hours each night. Now, to lose her uterus…
There was always surrogacy and adoption, but what was more important to me was saving her life and that was all that mattered to me.
I had finally found the love of my life and I couldn’t bear the thought I’d lose her not even a year since we were married. I prayed at that moment, despite not being a very religious man.
I prayed to God, to the gods, to any overarching power in the universe, to save Kate’s life.
An hour later, they had found all the bleeders, and were busy closing Kate up, having removed her spleen and uterus. She’d received another unit of blood and her vitals were critical but stable as they wheeled her into the ICU. I followed along in the hallway, getting a report from the ER doc.
“We’re going to keep her sedated and once we’re happy with her vitals, we’ll do another CT of her head to check on any bleeds but I think her injuries were largely internal.”
“Can I stay with her?” I asked, hoping they’d let me stay in the ICU so I could be with her.
“They’ll call you when you can go in,” the ER doc said, his hand on my shoulder. “She’s pulled through. The next hour or so will tell us whether we’ve caught all the bleeders and once we have that head CT, we’ll know more.”
We shook hands, and the expression on his face told me that while Kate had survived the initial operation, she was still in danger.
I knew she had the very best care possible and so all that was left for me was to wait. And pray.
I sat in the small waiting room off the ICU that was designated for families and held my head in my hands, trying to catch my breath. A nurse came up to me and I glanced up, wiping my eyes so I could see her more clearly.
“Dr. Morgan, your baby girl is doing fine and is in the NICU if you want to go and see her. They have her stabilized and she’s doing well.”
“Thank you,” I said and stood, torn between waiting to see how Kate was and wanting to see Sophia. Then, I thought about Ethan and Elaine and felt I had to call them, to let them know Kate was in the hospital.
I dialed Ethan’s number and waited. Elaine answered, her voice soft.
“Hi, Drake,” she said. “I hope you don’t mind me answering but Ethan’s asleep right now.”
“No, that’s fine,” I said and cleared my throat. “Kate was involved in a hit and run and is in the ICU at New York University hospital. They did a crash C-section and Sophia is in the neonatal intensive care unit, but she’s doing well. Kate is being sedated and they’ll be watching her for the next 24 hours. She’s critical, but she’s stable. You should come down as soon as you can.”
“Oh, my God, Drake!” she cried out, and I heard her sharp intake of breath. “They’re both alive? When did this happen? Oh, God, poor Kate. The baby was delivered?”
“Yes, Kate had an abruption and they had to take her uterus and spleen as well. They’re going to do a head CT and get a better idea of whether there’s any brain damage, but so far, she looks stable.”
“I’ll wake up Ethan and we’ll be down as soon as possible. I’m so sorry, Drake. You must be out of your mind.”
“I’m trying to hold it together, but it’s hard.”
“We’ll be there as soon as we can.”
I ended the call and closed my eyes, trying to calm down.
I heard someone clear their throat and opened my eyes to see a couple of burly middle-aged men dressed in suits and trench coats standing before me.
“Dr. Morgan?” the one man said. Blond, brush cut, and sharp blue eyes, he had a grim expression on his face.
“Yes,” I said and stood up, thinking it might be the police. “Drake Morgan.”
“I’m Detective McDonald and this is my partner, Detective St. James. We’re here to ask you a few questions about your wife’s accident.”
I nodded and slipped my hands in my pockets. “I understand it was a hit and run. That’s what my security detail said when I was notified of the accident.”
“We have a few questions to ask,” McDonald said. “I’m sure you understand.”
“Of course.” I glanced around and saw the unused conference room off to the side of the hallway. “Why don’t we go in there to talk?” I said and pointed to the room. “It’s more private.”
We went inside and sat down and I waited, eager to hear their thoughts on the hit and run.
“Dr. Morgan, can you tell us why you had a bodyguard for your wife?”
I leaned forward and took in a deep breath, composing my thoughts carefully.
“There was a former sexual partner who seemed to be a potential threat to both Kate and me, so I hired a security firm to provide Kate with protection when I wasn’t there with her.” Until that moment, I hadn’t even thought about Lisa, but then a sinking feeling overtook me and I felt as if the blood all left my body. “Why? Do you think this was a deliberate act?”
St. James flipped through his notepad. “A witness claimed that the car had been driving slowly, but when your wife stepped off the curb to cross the street, the car sped up and struck her before taking off. Several witnesses chased after the vehicle and we have a partial license plate and model and will do our best to track it down. We think it was a rental.”
McDonald stared at me pointedly. “Can you tell us where you were this afternoon between five and six o’clock?”
“I was
here
,” I said defensively. “I have a fellowship at NYU and had just finished up some paperwork. You can ask my admin person because she was doing some work for me and knows I was here.”
“You have to understand that we’re obliged to interview the spouse of a victim of a potential attempted homicide,” St. James said.
I nodded, and exhaled heavily, trying to relax. Of course they had to ask. The first person that they should suspect when an adult has been murdered or there has been an attempt on their life is the spouse or other family member. Sadly, all too often, it’s someone close to the victim who is the perpetrator. Having worked in enough ERs over the years, I knew that well.
So I told them about Lisa Monroe. I told them about my participation in the BDSM lifestyle and was amazed that neither man raised an eyebrow. I told them about having been intimate with Lisa at dungeon parties before I met my wife. I told them that she’d been using that past to force me to be her ‘friend’ but that she offered more and wouldn’t take no for an answer.
McDonald took down her name and particulars without a change of expression or sideways glance at his partner. I felt such incredible guilt for not going to the police earlier, for not stopping this whole thing months earlier, when I realized who Lisa was and when she kept trying to be part of my life, but I didn’t want my perfect life to be upended.
Now, that’s exactly what happened. My baby was almost twelve weeks early, and my wife was in critical condition due to internal injuries and possible brain damage. I covered my eyes with my hand and wept.
The two officers said nothing while I tried to regain my composure, offering no sympathy nor passing any judgement. Once I was in control again, they continued the interview, asking about Lisa and whether we had been intimate since we met again.