5

LEXIE

I wake the next morning to the familiar sounds of hospital foot traffic on the other side of the door. Sam and I are in the residents’ bunk room, and sometime while we were asleep he pulled me right onto his chest. I offered to sleep on the top bunk, but it didn’t take much convincing for me to join him. Although it was cramped, I needed the comfort of his body against mine. And he was right about my state of mind—even on this taste of sleep, I feel much more rational. I slide from the bed and Sam stirs.

“What time is it?” He sounds like he’s in rougher shape than I feel. I glance at my phone and am relieved to find no missed calls.

“Ten.”

It was just after five by the time we got back to the bunk room, then I was on my phone for a while—trying to figure out how to word the email I had to send to work. I knew Oliver would check his emails the moment he was out of bed, and I knew he could call in a replacement for the next few days. Taking off work was particularly inconvenient as a GP, but necessary from time to time, so of course the clinic had procedures in place.

The cause of my hesitation was a vigorous internal debate about whether I needed to reveal that Annie was back on the scene. I just wasn’t sure how he’d react, given how close she came to costing me my job last time. So for a good ten minutes I typed and then deleted text, until Sam impatiently took the phone and drafted the email for me.

As soon as I nodded, Sam hit the send button. That was at 5:15 a.m.

“He doesn’t need to know any details yet,” Sam had murmured, as he pulled me down onto the pillow. “We can deal with it later.”

“Things must be going well if the staff on the ward haven’t called,” Sam surmises now, and I have no doubt about that. He made sure his colleagues in Maternity knew to contact us for any change in Annie’s condition. This hospital is his domain, and I can tell he’s highly regarded. Sam is a surgeon, a man who works with his hands—but at heart, he is a devoted people person. He has chosen this career for no other reason than that he cares very deeply about his patients.

I smooth my hair into a ponytail and wait for Sam to pull his jeans on before I open the door. We walk hand in hand back to Maternity, and Sam politely responds to countless greetings as we make our way through the halls. At the ward, he goes to speak with the nursing staff and to see if Eliza Rogers can spare him a minute or two, as I head to Annie’s room.

She’s resting against the pillows watching television, a tray of untouched food in front of her. The color in her face is better, but she still looks drained.

“How are you feeling?”

“Tired, but the headache is gone.” Annie hits the remote to turn the television off and struggles to pull herself into a sitting position. I help her, adjusting the bed and then offering my arm for her to drag herself upright.

“Have you seen the obstetrician?”

“Yes, her name’s Eliza. She came in a while ago and said things are looking better than when I came in.”

I’m going to need much more detail than that—but I know Sam will be able to give me a better picture of Annie’s situation after he talks with the staff. My mind races forward to the next challenge, and I say to Annie, “We need to call Mom.”

Even though my mother and I are hardly close-knit, I’m sure that she’d want to know about this situation. Mom mentioned to me in our last call a few weeks ago that Annie has been calling her, too, and I assume they’ve rebuilt something of a closer relationship while Annie and I have been apart. So I’m surprised when my sister shakes her head.

“Not yet. Please, Lexie. Give me a few days, okay? It’s not like she’s going to be angry that we didn’t call her straight away. She probably won’t even care.”

“Don’t say that, Annie.” It feels strange to defend Mom, but in this case, I’m sure that Annie is wrong. “She does care.”

“Maybe. She just has a funny way of showing it sometimes,” Annie mutters, and she picks up a piece of toast, breaks off the crust as if she’s going to eat it, but then lowers it back to the tray. “I have been speaking to her a bit more lately, but I haven’t exactly been honest about my situation. So she doesn’t know about the baby or that I’m still using, and she’s going to be upset with me for lying and... I just want to be able to tell her I’m on top of this before we call her, okay? I just need to be clean first.”

Thoughts of Annie’s relationship with our mother—clearly as confusing as my own—fade to the background as I focus on her other bewildering statement. Clean? Annie is staring out the window, her gaze distant. I lean toward her as I say very gently, “Annie, you can’t actually detox until the baby is delivered.”

“What? Of course I can,” Annie says stiffly. “I know I’ve messed up until now—but with the right help—”

“No, I don’t even mean ‘you can’t,’ I mean—you shouldn’t. It’s not safe. Withdrawals would probably start premature labor.”

She stares at me. Her blue eyes are clear and I have her full attention, but I can see from the twist in her eyebrows that she still doesn’t understand what I’m telling her.

“But... I nearly did it at home—a few times. I was just going to do it alone... I tried...”

“Probably a good thing you didn’t.” I smile at her gently, and she shakes her head. The lines on her face seem endless, and when she frowns, the hollows in her cheeks grow deeper. Annie looks too frail to be the weapon of mass destruction I’ve known her to be over the past six years. I take her hand in mine and squeeze it tightly. “There are well-established protocols for dealing with addiction in pregnancy. I’m sure Eliza will have a plan.”

“But—you said I could take the methadone just once.”

“Well, yes... I did but... I mean, you have to be taking something.”

“But I can’t stay on methadone.” Annie is visibly frightened of this possibility. She hates methadone, and she always did seem miserable on it. Then again, she always ended up using while she was on it, and I’ve never been sure how much of her “misery” was put on to preempt the inevitable relapse. I’m instantly impatient with her—assuming she’s going to resist the maintenance treatment so she can go right back to using street opiates. I’m surprised when she whispers desperately, “Lexie, methadone withdrawals are as bad as heroin—if they put me on that, won’t the baby still have to detox once it’s born?”

Now I’m confused. I’d assumed her fear and concern were all about her own dislike of methadone—it hadn’t actually occurred to me that she’d be concerned for the baby. I soften a little at her uncharacteristic display of selflessness.

“There are alternatives...” I say gently. “But yes, it doesn’t matter what the maintenance drug is. The baby will have to detox, no matter what happens from this point.”

“But I was... I was just going to stop, before it comes. I can’t let the baby...” She chokes up, and she’s getting wound up—this is the very last thing she needs given the situation with her blood pressure. Her naïveté is completely heartbreaking. I want to pull her into my arms and tell her that it’s all going to be just fine, but that would be a lie—it’s not. There are ugly times ahead for her and her baby...and as soon as that thought strikes me, I feel the pinch in my chest as I acknowledge that this means there are also ugly times ahead for me, and for Sam. I want to protect Annie, and I know we need to keep her stress levels down to help control her BP, but pretending there is anything like an easy solution available to us now is ridiculous.

Now, anger rises within me so suddenly that I’m caught off guard by it. I’m half-inclined to cut this conversation short and storm down the hallway to ask this Eliza what she was thinking by not making this clear to Annie in their very first meeting.

“There just has to be a way for me to get clean before the baby comes.” She’s thinking out loud now—digesting the implications, her voice shaky and rough—but determined, as if she could somehow negotiate with me to find a way to change the workings of human biology just for her. “Lexie, you have to make them find a way. You don’t know what detox is like—it’s not something a baby should have to feel.”

“Annie, I’ve watched you go through withdrawals. I do know what it’s like. And we know how to help infants through it. It’s going to be okay.”

Annie shakes her head, lips pursed.

“I’m not letting my baby start its life like that.”

“It’s too late to avoid that now.”

“But what if I stay in the hospital and just go cold turkey? They can monitor the baby, right?”

“With your blood pressure the way it is, the last thing you or the baby needs is severe stress like withdrawal. You could go into labor—or even worse.”

There’s a slight pause, then Annie whispers hesitantly, “Worse?”

I work to clear the lump of guilt in my throat before I can bring myself to admit, “The baby would probably go into distress—there’s a much higher chance of an emergency delivery, and a chance it might not even make it. Do you understand?”

“Fuck...” Annie starts to cry, and I flick my glance toward the monitor. Her BP is rising—very slowly—but the numbers are trending upward, and I need to end this conversation.

I didn’t mean to scare her, but Annie is intelligent—she can understand this. If she wasn’t so upset, I’d just explain to her about physiological withdrawal, so that she can see that there are complex systems in place here and both she and the baby legitimately need the opiates for the time being. But she’s staring at me as she sobs—and I’m actually starting to wonder if I shouldn’t have left this conversation for her doctor. “I know you hate it, love, but staying on maintenance is the only way forward. It’s the best thing for the baby.”

The door opens and I’m relieved to see Sam, but the relief doesn’t last long—it’s only a moment or two before I notice the police officers right behind him, and a middle-aged woman wearing a white coat and a scowl close behind them. I widen my eyes at him, and Sam offers me a silent apology with his grimace.

“Anne Vidler?” one of the officers says, as soon as he enters the room. Annie does not respond. Instead, she continues to stare at me, as if I can somehow prevent this from happening. I suppose that’s fair enough. After all, I did promise that I would. The other officer walks to the end of the bed and checks the nameplate, then nods to his colleague. “Anne, the presence of narcotics has been detected in your urine. Under Alabama law, chemical endangerment of a child is a...”

“Annie has high blood pressure,” I say sharply, and I rise to my full height and address the officers as if I’m her lawyer, rather than her sister—although I’m still holding her hand, and I’m holding it so tightly now that my fingers are cramping from the pressure. “It’s medically imperative that she avoid stress, so you’ll need to leave the room now, please.”

“Dr. Rogers said that her blood pressure is stable.”

All eyes turn to the woman in the coat, who barely hides her disdain as she points to the monitor and says sharply, “I told you it was but that I wasn’t sure she was ready for this—and you’ve proven me right. You need to leave. Now.”

The police officers exchange confused glances, until one finally drops some papers onto Annie’s bed and they leave the room. I glare until the door closes behind them, and then gasp in disbelief when one remains right in my line of sight, guarding the door. Now when I look out, I watch a woman approach him. Through the small window in the door, I can see only from her shoulders up—but that’s more than enough for me to recognize the no-nonsense demeanor of an unsympathetic professional. She stands with the officer, her expression set in a fierce frown. I wonder what her role is.

“Are they going to stay?” I murmur, and Sam says quietly, “There was some concern Annie might try to leave the hospital. They’re just here to make sure she remains until tomorrow when there’ll be some kind of hearing.” He picks up the warrant from where it sits on the end of the bed, and sighs heavily as he folds it up and passes it to me. I take it with my left hand, and stuff it into my pocket without looking at it.

“Don’t you worry, Annie,” the doctor says very gently. “You’re not going anywhere until it’s completely safe. We’ll probably keep you here until you deliver.”

Annie shakes her head frantically.

“I can’t stay here that long.”

The doctor approaches the bed and takes Annie’s other hand in hers.

“I know it’s difficult, but it’s really important that you stay calm, Annie.” She flicks her glance to me. “You must be Alexis. I’m Eliza Rogers. I’ll be overseeing Annie’s care.”

“I need to speak with you,” I say tightly, because although I’m impressed with her handling of the officers, it’s surely her fault they are here in the first place—who else would have called in her failed drug test? Besides which, I’m still frustrated by how little she’s explained to Annie so far.

“Certainly.” Eliza nods, but her attention is already back to Annie, who is breathing heavily and fidgeting on the bed. “Let’s make sure Annie’s okay, and then we’ll talk.”

Sam’s hand descends on my shoulder, and I release Annie’s hand to turn back toward him. His gesture is one of comfort, but also, somehow, I know it’s a warning—a plea for me to watch my tone with his colleague. His gaze locks with mine. Sam is sad and he’s worried, and I take his unspoken plea on board—we do need Eliza, so I can’t really afford to make an enemy of her. I reach up, squeeze his hand against my shoulder in another unspoken communication—I understand—then turn back to Annie.

She’s staring at the ceiling and there’s a thin sheen of sweat over her brow. Annie is white as a ghost now, and the systolic blood pressure reading has increased by seven points since I came into the room. It ticks upward, this time skipping three points higher, and Eliza releases Annie’s hand and says quietly, “I’m going to organize some more medication for you, Annie. Something to calm you, okay?”

As soon as the doctor leaves the room, Annie looks to me. Her eyes are wild with fear and desperation.

“What are we going to do?”

We. I know that I told her that I would somehow prevent this very thing from happening—but still, her casual use of the shared pronoun frustrates me. This is her problem; this situation is entirely her doing. It’s so typical of my sister that she is already assuming that I’m going to create a way out of the mess for her. I can’t look at her for a moment, I’m too frustrated, but as I look away, her vitals monitor catches my eye and my resentment evaporates because it has to. With every digit that number rises, the baby’s health is compromised, and so is Annie’s. I take a deep breath and I meet her gaze, then I offer her a calm smile.

“First things first. Let’s get that BP back under control, and then we’ll make a plan.”