Chills & Thrills: Three Novel Box Set (53 page)

CHAPTER TWO

A shrill whistle rang out from the fetal heart monitor as the baby’s heart rate plummeted. The emergency room staff flew into an organized chaos with rubber gloves sliding over hands, instruments exchanging sterility for human flesh, and various orders voiced loudly above the other noise.

“Let’s go! Let’s go! She’s crashing. Baby is crashing!” Dr. Kelly Morales yelled. “Watch out for Mom.”

“She scratched me!” a nurse cried out, while placing an oxygen mask over the teenager’s face. The sixteen-year-old thrashed wildly, her arms outstretched. Each fingernail was over an inch long, curving at the end, and decorated with a skull and crossbones motif. The girl moaned in pain. Or maybe panic or protest. Likely a combination of the three. She was involuntarily doing everything she could to keep the medical staff from doing their jobs. At least she had some fight left in her. The only positive sign so far.

“Someone get her arms!” another nurse yelled.

Kelly saw a window and took it. She pinned the girl’s arms down and bent directly over her face, looking into a pair of panicked brown eyes. 
Jesus, what was going on with this kid!?
 Kelly didn’t really want to know. She witnessed enough tragedy every day inside the Neo-Natal Intensive Care Unit. But at least in her protected NICU bubble she could make a difference. She’d been the available doctor when Lupe Salazar arrived at the hospital, and so here she was. A sixteen-year-old in severe distress was not Kelly’s specialty. Babies were easier.

Kelly bent over the girl, her face within inches of the teen’s. The girl’s eyes widened, clearly surprised at the lithe doctor’s strength. Dr. Morales lowered her voice to a calm whisper. “Listen to me, Lupe. I want to help you. I need to know if you’ve taken anything. Any alcohol or drugs?”

Lupe focused. She shook her head. “I don’t do drugs!”

“I won’t be angry. I just need to know.”

“No,” the teen managed to say. “I promise. Nothing. Let me go!”

“I can’t. You need to stay calm and listen. Have you been getting regular prenatal care?”

Lupe nodded, crying loudly now.

“Have you had any problems with this pregnancy? Anything your doctors mentioned? High-blood pressure? Any bleeding?”

“Nothing,” Lupe sobbed. “Everything’s been fine. It hurts so much. Make it stop. Just make it stop!”

“What about family? Where are they?”

“I don’t have any,” she spat.

“Where do you live, honey? Can you tell me that?”

“The shelter on East Fifth. Please make it stop hurting!” Tears streamed down her face.

Kelly hated this part of the job. Despite her skill and ability to keep her emotions in check, watching this girl suffer was not easy. Particularly because Kelly was no closer to figuring out what in the world was going on. So far, Lupe was a medical mystery. And where the hell was Dr. Brightman? He was the head of O.B. and she needed him now.

“I’m sorry it hurts. I’m trying to get a monitor attached to your baby’s head so we can study the heart rate. Okay? Stay with me, Lupe.”

Kelly lifted her head. A nurse wiped it with a towel. The girl started to struggle again, pushing forcefully against Kelly’s tight grip. “Ten ccs of epi
, 
stat!” Kelly fought back an exhausted sigh. This was too much. Whatever had landed Lupe on the ER table was serious. She was losing her grip on the girl when suddenly her eyes rolled back into their sockets.

“Pressure is dropping!” the intern reading vitals called out.

Kelly glanced up at the crew around her…a look that lasted a mere second.

The girl on the gurney started to shake and writhe.

“Seizure.”

The air around them was dense and still, the way it gets when the threat of death enters the room. Kelly understood the stakes and implications in a second. She had been in this situation too many times to count. Her vision narrowed, sounds faded, and everything extraneous drained from her mind. The analysis and course of action took only seconds. Because seconds are all you get when a life is on the line.

It was time to make a tough call. Kelly braced herself.

But before she could say or do anything, Lupe’s body went still. A monotone buzzing echoed through the room.

The girl was flat-lining.

“Goddamn it!” Kelly yelled.

Dr. Pierce Brightman pulled back the curtain. He was tall, slender, and handsome in a surfer sort of way. He didn’t really look like a doctor (but he could have easily played one on TV). Kelly had never been so happy to see anyone.

“What the hell is going on?” His normally relaxed face was drawn up in a tense frown.

“I don’t know! Normal pregnancy, from what I can tell. Pressure is dropping. Baby is crashing. Now we’ve got flat-line.” Kelly glanced at the monitor. Dr. Brightman saw the screen. Heard the tone. Everyone did. “We don’t have many options here, Pierce. We’re losing both of them. The baby is thirty-two weeks, and I can probably save it.”

Code Blue in ER number three!
 The intercom crackled to life as more nurses and techs scurried into the room.

“Epinephrine,” Brightman ordered. He administered the drug, trying to raise Lupe’s blood pressure. There was no response. “More epi! Give me more epi!”

The team hooked up the defibrillators and applied CPR.

“Clear!” The harsh popping sound echoed in Kelly’s ears. The baby was dying inside the young woman. The infant couldn’t take much more. Lupe didn’t have a prayer unless a miracle occurred. Kelly knew it in her gut.

And tonight her gut told her before the night was through, the poor sixteen-year-old lying on the gurney—a child herself still—would be lying in the morgue.

CHAPTER THREE

“Clear!” Brightman ordered again. Lupe gave no response.

Kelly continued to watch the fetal monitor. “Pierce, we have to get this baby out now. There are no more options left. She’s gone. We’re wasting time.”

“Clear!” Brightman ignored her, acting as if he hadn’t heard a word she’d said.

The baby’s heart rate continued dropping. “Damn it, Pierce, call it or they’ll both be dead!” The helpless feeling she had seconds before was replaced with anger. Adrenaline coursed through her and lit every nerve on edge. 
Screw this guy!

“I’ll call it when I’m goddamn ready!” Brightman shouted.

She was hit by a surreal out-of-body moment where she felt oddly detached from the scene unfolding in front of her—white walls, blue curtains, silver instruments, dead mother, dying infant, a frantic medical staff trying to fix the situation. Dr. Brightman was good. Kelly knew this. But she could see he was fighting a losing battle, and she hadn’t lost hers yet. She could save the baby if he would let her.

“Get the hell out of my way, Brightman, and call this patient’s time of death, or I will be the first in line to file a law suit against you.”

Brightman looked at her, took survey of the room, and then stared down at the girl on the gurney. Three seconds later he glanced at the clock and wiped his forehead with the back of his arm. “Time of death, sixteen hundred hours
.
 The baby is all yours, Dr. Morales. And good luck.” He swore under his breath and slipped away behind one of the curtains, off to file his report.

The charge nurse from labor and delivery and the two nurses from the neo-natal intensive care unit waited for Kelly’s next call. With their help, she went to work with quick and determined efficiency. “Sponge,” she said and wiped down the mother’s stomach with a mixture of alcohol and iodine. “Scalpel.” With proficient hands, she opened up Lupe’s abdomen, retrieving the baby within minutes. A girl. The doctor suctioned the infant’s mouth and nose clear.

The tiny infant resembled an extraterrestrial being, with her transparent skin and spindly limbs. A nurse placed the baby on a radiant warmer. Three others gathered around, gently drying her with warm towels. “Let’s get a heel stick stat and into the incubator immediately,” Kelly said. “This one is going to need to oxygen, among other things, I’m sure. Get her weight and length. What do we have?” She noted the baby’s weight on the scale as a nurse took the blood sample and hurried off. “3.2 pounds and 16.53 inches. She’s a little one.”

Kelly took the baby’s APGAR score to check how well she was doing after her traumatic birth. The score rated the infant’s breathing, heart rate, muscle tone, reflexes, and skin color. At only four, it was not good. She’d take it again in a few minutes to see if things improved.

Kelly and Eric Sorensen, the NICU nurse in charge, transferred the baby to the intensive care nursery. As they rolled the warmer down the hospital hallway, a lab technician came running after them. “I have the mom’s initial blood work back. Here you go.”

Kelly took the reports. “Thank you.”

Once inside the unit, the baby was placed inside an incubator, likely her home for the next several days, if not longer. Eric began hooking up the monitors and leads onto the infant. There was a lot to be done: blood gas, chest x-ray, continuous cardio-respiratory monitoring, feeding tube…and a lot to watch for: apnea, anemia, jaundice, respiratory distress, underdeveloped lungs, infection. The list was endless. But Kelly could tackle all of that. She took a step back and opened the mom’s file, figuring she would find Lupe had some kind of drug in her system. What else could explain the scene back in the ER? The more Kelly knew, the better she could help the baby.

“I don’t believe it,” she muttered, shaking her head.

“What?” Eric asked, glancing over at her

“Inconclusive for any kind of narcotics or alcohol. Nothing apparent in the mother’s system to indicate she was using.” She shrugged. “According to these preliminary reports, we have no clear signs the mom has any drug, legal or illegal, in her system. I was so sure. I mean, I have no idea what happened on that table in there. Obviously we have to wait for an autopsy report, but I don’t know what to think. These test results say we are probably dealing with a perfectly healthy sixteen-year-old girl who, for no explicable reason, completely crashed on us.”

“I don’t know what to say, but I need some help here, Doc. I’m having a hard time getting this IV started on her,” Eric said.

Kelly focused back on the baby, scanning her body. The poor thing let out a fragile cry, similar to a puppy’s whimper, as Kelly found a vein on the top of her head and inserted the tiny catheter. 
God, please help me save her.

The baby girl was hooked up to numerous monitoring sensors in order to regulate heat, oxygen, and carbon monoxide levels as well as her heart and breathing rates. “Okay, I’ll get the tube in, and then let’s get this little one a dose of surfactant,” Kelly told Eric. The baby’s underdeveloped lungs hadn’t had enough time to produce their own surfactant, but thank God Kelly could give it to her. Machines and drugs could do pretty damn well, sometimes almost as well as a mother’s own uterus.

Kelly expertly threaded a tube through the baby’s nose, down the back of her throat, and into her trachea. Eric then connected the tube to the respirator and started the machine, regulating the flow of air, oxygen, and air pressure in and out of the lungs. “Thank you,” Kelly said to Eric, who smiled back at her.

He had a great smile—perfect white teeth and dimples to boot. His grey-blue eyes matched the surgical gowns he wore. His black hair and superb physique caused many women to take second and third looks because the guy could easily have been a Calvin Klein underwear model. It was a shame he was gay. At least for all of those swooning women, anyway.

Eric was fairly private about his sexual preference. The only reason Kelly even knew was because of an embarrassing incident that had occurred at last year’s holiday party. Kelly had gotten drunk and made a complete fool out of herself, telling Eric how hot he was, and more. Frankly, this was pretty out of character for her, but who can resist the pull of a frozen margarita (or four)? And then he’d told her he was gay, and she was mortified. When Monday rolled around, she could hardly look him in the eye.

At lunch time he’d sweetly taken her by the hand and said, “C’mon, Doc, let’s get something to eat.”

Over turkey sandwiches and Diet Cokes, she tried to apologize.

“For what? Are you serious?! First of all, I’m flattered.” He leaned in closer, flashing his adorable smile. “Second, if I wasn’t gay, I’d do you in a heartbeat. I actually gave it some serious thought the other night. You looked good enough to eat in that red dress. Maybe you could have converted me.” He’d winked at her, and they both burst out laughing, causing heads to turn in the cafeteria. From that day forward, their friendship was permanently cemented.

There was no one Kelly would rather have at her side.

“She is a very sick little girl, isn’t she, Doc?” Eric asked, placing soft cotton bandages over the infant’s eyes, shielding her from the Bilirubin lights.

Kelly nodded. “I’m going to do my damndest to see she makes it. Right now, I’m just concerned with stabilizing her.” She frowned. “I don’t know what to think with the reports. From everything I saw in that ER room and seeing how sick this baby is, I would have assumed there were narcotics involved. I would expect to see some withdrawal signs in this one’s early weeks, but…well, now I don’t know.”

“Huh.”

“What?” Kelly asked.

“You heard about the other cases from last week, right?” Eric asked. “They happened while you were off.”

Kelly nodded slowly. “Yeah…I heard a couple of maternity patients passed away, but I never did get the full scoop. What happened?”

“Our team was called in to stand by for the infants but neither baby survived. They were both stillborn. They had heartbeats until a few minutes before delivery, but once the mothers died, well, things went rapidly downhill from there,” Eric replied.

“Who were the attending OBs and who was on for NICU those days?”

“Dr. Pearson was on both of the cases for NICU. Brightman was the attending OB,” Eric shrugged as he adjusted an IV. “It seems a little weird. Kind of coincidental, don’t you think?”

“I hear you. I think I’ll track Pearson down and see if he can enlighten me a bit. Something tells me Brightman may not want to talk to me after our little showdown in ER.”

“You may have to wait to speak with Dr. Pearson. I heard he left on vacation the day after the second baby died. Rumor is he was pretty distraught. He may have even been forced by the chief to take some time off. Someone said he’s in southern Europe...Greek Islands, maybe?”

“Must be nice,” Kelly muttered and then sighed loudly. “I suppose I could go and see what I can get out of Brightman. But I really don’t know if I want to deal with him today. Maybe I’ll visit Hamilton instead.” Jake Hamilton, the chief pathologist, was the only other man in the hospital corridors besides Eric to catch her attention. “Maybe he has some ideas. He can at least tell me what he found in the autopsies.”

“Makes sense. But before you go, why don’t you take a load off and rest ? You look beat. What time is your shift over?”

“God, I don’t know.” Kelly ran her hands through her hair. “I don’t think I care anymore. I feel like I live here. Any time off I typically spend sleeping.”

“You need a life,” Eric said.

“I probably do.” She wiped the perspiration from her forehead.

“Go grab something to drink, take a few. I’ve got things here.” He glanced down at the baby in the incubator. “I think she’s as stable as we’re going to get her for now. I’ll page you if I need you.”

Kelly scrunched up her nose and shook her head. “Hmmm, I don’t know. I don’t want to leave her yet.”

“You can’t keep twenty-four hour vigil, Doc. Get a cup of coffee, think, and breathe for a minute. Regroup and come back. You can’t go very far, so if something goes wrong, I’ll have your ass back here in minutes. I insist.” Eric crossed his arms and gave her one of his no-nonsense looks. He’d make an awesome parent. He had the expression down pat.

“Fine. But page me if anything happens. I don’t care how minor. I mean, even if her lead comes off, page me. Promise?”

“Cross my heart.”

Eric was right to send her away. A lot of what they called “the waiting game” was starting now. There would likely be many stressful, difficult moments before they could envision a healthy future for Baby Salazar, and Kelly simply couldn’t be here for every single second. She needed to take a break and recharge to keep her head clear in case something else went wrong.

She walked out the double doors of the NICU and stopped in front of the elevator. After giving it some thought, she decided to head down to the morgue first to see if she could speak with Dr. Hamilton. Her radar was on and it screamed there was something peculiar about Lupe’s death.

The elevator doors opened, and she stepped inside. Kelly took her hair out of its elastic band, ran her fingers through, and pulled it back again, hoping she looked somewhat presentable. A quick glance in the mirrored button panel was far from reassuring. When was the last time she’d had a good night’s sleep? Even when she had time for sleep, Kelly struggled to shut down her brain. In the scheme of things, sleep didn’t matter as much as the lives of her little patients. Sleep could wait. What she really wanted right now were some answers.