LEXIE
As Eliza administers the sedative to Annie, I slip quietly from the room and prepare to confront the woman with the bun. She offers an introduction before I have to ask.
“Mary Rafferty,” she says, extending her hand toward mine. I shake it briskly, and she continues in her broad drawl, “I’m a social worker with Child Protective Services. And you are?”
Social worker? I figured CPS might get involved after the birth, but that’s still a long way off—why would she visit today?
“Dr. Alexis Vidler,” I say stiffly. “I’m Annie’s sister.”
“Ah,” Mary Rafferty says, nodding knowingly. “Well, that explains it.”
“Explains what?”
“I wondered how an addict could afford this place.”
I bristle at the scorn in her tone, but I push down my irritation. I’m tired and angry, but thankfully at least smart enough to realize that a CPS social worker is the last person on earth I can afford to offend at this point.
“What can I do for you, Ms. Rafferty?”
“Well, CPS will be petitioning the court to strip your sister’s parental rights. I’m here to take a brief medical history and get a rundown on her living situation to help the judge with his decision in the case.”
She delivers this announcement in such a nonchalant, unguarded way that if I listened to her tone instead of the words, she might have been announcing her plans for the weekend. I gape at her.
“What?”
Mary Rafferty gives me a quizzical frown. She seems perplexed by the outrage in my tone, which only outrages me more.
“Didn’t you read the paperwork the police officers brought in? Anne has been charged with chemical endangerment of her child. That’s a felony.”
“She’s been charged—she hasn’t been found guilty.”
“Well, she failed a drug test and according to her doctor, she’s admitted to using heroin. While pregnant, Dr. Vidler.” Mary gives me an incredulous look. “Surely you as a doctor can understand how serious that is.”
I can’t help it—I flush. I’m embarrassed by my sister’s behavior, even as I start to defend it.
“She has an addiction,” I mutter defensively. “It’s an illness. She needs help, not—what did you say? To strip her of her parental rights? What is that going to achieve at this point, other than to stress the hell out of her? The baby isn’t even due for weeks. There’s time to sort all of this out.”
“Respectfully, Dr. Vidler, that’s not how this situation is going to work. Decisions need to be made about that child’s welfare, and your sister is not fit to make them.”
“The child’s welfare? What decisions need to be made right now that she’s not ‘fit to make’?”
“Well, the doctor who reported her to us overnight was concerned that she might discharge herself and attempt to use illicit drugs again. That’s obviously not in the child’s best interests. Besides which, he said there was some medication she refused. Are you aware of that situation?”
“Medication?” I repeat, and I scan back over the events of the day and can’t figure out what she’s talking about, until I remember that early-morning discussion about methadone. “Oh—well, yes, she wasn’t keen on methadone, but she took it eventually.”
“Methadone? Oh, I didn’t realize...well, that’s a bit different, then. Judges don’t generally like to see these addicts go from one drug to another, even if it’s a legal alternative...they generally want to see moms in an abstinence-based program.”
“Well, she can’t just go to rehab,” I snap. “She’s incredibly sick, and she’s pregnant. Going into withdrawal now would be a recipe for disaster.”
“Oh, I see.” Mary Rafferty frowns, and then withdraws a notepad from her handbag. “Could you spare me a few minutes to discuss this some more before I go in to speak with her?”
I laugh incredulously.
“You’re not speaking to her, Ms. Rafferty. When those officers came in earlier her blood pressure spiked, and her specialist is sedating her as we speak. If you go in there, she’s going to panic, and she can’t afford to.”
“Oh, I’m afraid I’m going to have to insist,” Mary says, and she plants her palm flat against her chest and leans forward toward me, offering an apologetic grimace. “I really need to get a history here, and also—well, I just have to understand her living situation. I could come back later today, I guess. But I’ll need time to put together a report so I can make a recommendation at the hearing tomorrow.”
“You’ll have to make do with speaking to me,” I say. “She’s in no state for an interrogation right now.”
“Not an interrogation, Dr. Vidler,” Mary gently scolds as if I’m a child. “I just need to understand her situation so we can figure out what to do with this baby.”
“I hope by that you mean figure out how to help her care for it.”
Mary Rafferty’s good-natured smile disappears in an instant, and now she seems confused.
“Dr. Vidler—you can’t seriously think she’s an appropriate person to care for a newborn.”
“You’ve literally never even met her. How dare you make a judgment like that?” I hiss. I’m infuriated. Just then, the door opens gently and Eliza and Sam emerge.
“You might want to take this conversation away from Annie’s doorway. She really needs to sleep now,” Eliza murmurs.
“Good idea,” I mutter, and I use the interruption as an opportunity for a deep breath to try to deal with my own blood pressure. We take a few steps farther into the corridor, and Eliza and Sam linger until I offer introductions all around.
“Dr. Rogers, Dr. Vidler here was just telling me that Anne isn’t well enough for a chat today. Can you confirm that?” Mary says quietly.
“Yes, I’d much rather you left it,” Eliza says, frowning. “What’s the rush?”
“I need to prepare a report for Anne’s hearing tomorrow—for the judge, you understand,” Mary says, then she glances back to me. “I guess you and I could cover the basics, Dr. Vidler. If you don’t mind.”
“Of course.” I sigh. I do mind—I just want to go back into Annie, but I know the alternative is Annie having to have this conversation, and I know we can’t afford that right now.
“And I’ll need to speak to you, too, Dr. Rogers,” Mary adds. “Could you spare me a few minutes sometime today?”
“When you’re finished with Alexis, find my office and have my secretary call me,” Eliza says abruptly. “I’ve got rounds to do now. I’ll come as soon as I can.”
She gives us a curt nod and shakes her head a little as she walks briskly away.
“Can I join you?” Sam asks, and I hesitate. I don’t even know why. It just doesn’t seem right that Sam should have to sit through this—but then again, he heard most of it last night, and I’m frazzled, so the idea of backup is appealing.
“Thanks,” I murmur, and I take his hand.
“Let’s walk up to the meeting room, shall we?” Mary murmurs. “We can finish this conversation there.”
“Actually,” Sam says, “would you mind if we go to my consulting room? It was a late night—I suspect both Lexie and I could do with some coffee, and we’ll be much more comfortable there.”
“You’re a doctor, too?” Mary says, and her eyes widen again, as if she just can’t make sense of two successful professionals having any connection to a failure like my sister. I want to wrap my hands around her skinny neck and throttle her. Instead, I clench Sam’s hand tighter, conscious of the sharpness of my gaze but unable to prevent it. “Well, certainly, Dr. Hawke. Lead the way.”
Sam’s receptionist brings a pot of coffee and some cookies, and we sit around the little conference table in his office. Mary sets her notepad and a clipboard with some printed forms onto the table, and once she’s added sugar to her coffee and thanked Sam for his hospitality, she turns her gaze back to me.
“I just want to be very clear, Dr. Vidler,” she says quietly. “My role here is to help the court keep that precious little baby in your sister’s belly safe. I’m not here to judge, I’m here to help. The state of Alabama has terrible issues with drug-addicted babies—”
“Babies cannot be ‘drug-addicted,’” I say tersely. “It doesn’t make any sense. There are two components of an addiction, a physiological component and a psychological component. The correct term is physiologically dependent. That’s not the same as ‘drug-addicted.’”
“Well, sounds to me like you’re splitting hairs, but it doesn’t matter much. You can use whatever term you want, Dr. Vidler. Your sister has been abusing heroin while she’s pregnant, so I’m sure you’re aware her little one is in for a world of pain once it’s born. Her decisions to this point suggest to me that she’s not fit to continue making choices that affect the welfare of her child, which is why we are petitioning to remove her parental rights.”
“Is that what the hearing is about tomorrow?” Sam asks quietly, and Mary nods.
“Yes, that’s correct. Judge Brown will consider my report and make a ruling. If he rules in favor of our petition, well—if her specialist does agree with your assessment, Dr. Vidler, and Anne can’t go off to rehab or detox just yet, then I’ll recommend that she remain in custody either here or via incarceration until the birth. Just to keep the baby safe, you understand.”
“We need a lawyer,” I say, exhaling, and Sam nods. I glance at him. “Should I go find a lawyer before we discuss her history?”
“Oh, no, Dr. Vidler, that’s not necessary.” Mary gives a gentle laugh. “No, this is just background about Anne’s medical history. I’m a social worker. I’m not making any decisions myself—just gathering the facts to assist the court.” She offers me a consoling smile. “So, why don’t you start at the beginning and tell me how long your sister has been an addict for?”
I give her as little detail as I can, but still, I’m racked with guilt as I speak to the social worker, as if I’m betraying Annie just by telling the truth. I skim over years of frustration and pain, providing only a reluctant list of points. Mary’s expression is grim when we start, and by the time I reach the events of the previous night, she’s stopped writing and she’s staring at the table. I’m not even sure she’s listening to me, until I stop midsentence and Mary looks up. There’s sadness in her gaze, and I have an odd spurt of adrenaline pump through my body as I realize that she has already made up her mind.
“Well,” she says quietly, “thanks for your time.”
“Annie can beat this,” I blurt, and Mary hesitates.
“Dr. Vidler, you’re clearly a devoted sister, and I respect you for that.”
“You didn’t even ask about her living situation,” I say. This is just not fair; Mary has such a small part of the picture of Annie’s life. How can she decide her suitability as a parent based only on her history of rehab attempts?
“Let me guess, Dr. Vidler.” Mary sighs, as she packs up her notepad. “She’s either living with you, or she’s on the streets. Which is it?”
“She has a trailer,” I snap. “It’s not the Shangri-La, but it’s a roof over her head.”
“Does she have a job? A way to support herself? A way to buy diapers and formula and pay medical bills?”
“I don’t think so, but she—”
“Look. None of this matters, not really—not at this stage. Maybe later, once she’s been through rehab and she’s clean. But I’m sure you can understand, all that matters for now is making sure your sister can’t damage that precious baby any more than she already has.” Mary stands and slides her handbag onto her shoulder.
“Annie matters, too,” I croak, and I stand. “Surely helping Annie is the best way to help her baby.”
“That’s not my area of responsibility, Dr. Vidler,” Mary says quietly. “But I’m sure the judge will do everything in his power to give your sister another opportunity to get herself sorted out.”
“You said Annie will probably go to rehab,” Sam says quietly, and Mary nods. “Will she get a say which facility?”
“Well, it just depends on what the judge decides...but why do you ask?”
“My employer has opened a new rehab clinic out at Auburn. If Annie has to go into an inpatient program, that might be a good option for her.”
“I can certainly make a note of that in my report, Dr. Hawke.”
Sam rises and walks Mary to the corridor, and when he returns, he stands behind me and gently massages my shoulders. I slump forward and press my fists against my eyes.
“They’re going to take her baby away.”
“It sounds like it.”
“Is this what we do now? A woman fails a drug test and we remove her parental rights just like that?”
“Apparently.”
“This is bullshit. Shouldn’t we rush in at her with resources to help her get clean and care for the baby?”
“We’re going to need to find that lawyer, Lexie.”
“I know.” I sit up and exhale. Sam’s gentle kneading of my shoulders continues. “But first, I really need to speak to Eliza.”
“What are you going to tell Annie?”
I shake my head hastily.
“Nothing, yet. Not until I talk to a lawyer.” Sam’s hands slow, then pause, and I tilt my head back to stare up at him. “I’m not going to worry her until I know just how bad this is. The social worker made it seem bad, the cops make it look bad—but what do I know? Maybe all she needs is a decent lawyer to untangle it.”
“Maybe,” Sam murmurs, but I can tell he doesn’t believe it any more than I do.
“This new rehab place...” I prompt him.
“Maybe it’s a long shot, but I thought it might be worth mentioning. They have intensive recovery programs from four to twelve weeks, and since it’s owned by the same company we’d get a reasonable discount on the fee. Plus, it’s only an hour away, so that’s a bonus.”
“Okay,” I say, and I rise. “I need to get back to her in case she’s woken up.”
We return to Annie’s room to find her still dozing lightly, so we quietly take the visitors’ chairs to wait for her to wake. I pretend to play with my phone while Sam reads a newspaper, and the silence is a relief. I’m flicking through my Facebook feed, but I don’t see anything that flies past me on the screen. My mind is elsewhere, back in Sam’s office, reliving the conversation with Mary Rafferty. Maybe I could have liked Mary, if I’d met her in another professional setting—one where she and I were on equal footing, instead of this messy encounter. Now that I’m calmer, I can recognize that she was almost charming in that polite, friendly way I’ve grown to appreciate after eight years in the South. I’m still bristling at the way she leaped to judge my sister, but I reluctantly acknowledge that’s probably necessary for her job. How many times a day does she have to quickly assess a child welfare situation?
Her intentions are probably good. Surely no one would work for CPS unless they genuinely cared about children. But that doesn’t change how completely, bewilderingly messed up all of this is, or how maddening it is that the state’s first response is to grab for Annie’s parental rights. I’m only hoping that an attorney can make sense of this.
“Lexie.” Annie’s eyes are still closed when she speaks suddenly, and I startle.
“Yes?”
“You’re tapping your feet and it’s driving me insane.”
I didn’t even realize I was doing it. I press my feet hard into the floor and mutter, “Sorry.”
Annie wakes properly then, and after toying with the cookies and juice box that someone left on her table while she slept, she asks Sam if he will do her a favor.
“Sure,” he says warily.
“Can you get Eliza?” she asks. Her voice is small, and as soon as he leaves the room, I prompt her, “Are you in pain?” She’s scratching herself again, and her eyes move quickly around the room, like she’s scanning for an escape route. I frown and approach the bed. “What is it, Annie?”
“Eighteen hours,” she mutters.
“What’s eighteen hours?”
“Since I scored, Lexie. Eighteen hours since I scored. Maybe they can give me a little morphine. That’s safe in pregnancy, isn’t it? Just a little, I won’t need much—just to take the edge off.”
“You’ve already had the methadone,” I murmur, and Annie scowls at me.
“Fuck methadone. Did you see the dosage he ordered me? Twenty milligrams. You think that’s going to keep me out of withdrawal? I need something more.”
The door opens, and Sam and Eliza interrupt what was probably about to become an ugly sparring match.
“Let’s chat,” Eliza says, and she helps herself to a seat at the edge of Annie’s bed. “Feeling okay?”
“No,” Annie says abruptly, but then she sighs. “What’s the plan?”
The overall picture Eliza presents to us is murky. Annie and the baby are stable for now, but if there’s any change at all in their condition, Eliza will deliver immediately. In preparation for this, she’s giving Annie a series of steroid shots to mature the baby’s lungs, because there’s also no telling how it’s going to cope with delivery. It’s surely going to be tiny—with an estimated size of only a few pounds.
“The baby is suffering from what we call intrauterine growth restriction,” Eliza tells Annie carefully. She then goes to great pains to point out to Annie that this might just be related to the high blood pressure, and perhaps it would have happened anyway, even if narcotics weren’t a factor. I know that it isn’t as simple as that—perhaps Annie’s high blood pressure is just genetic, and the baby’s reduced size just bad luck. But heroin abuse in pregnancy tends to restrict the growth of the baby—and then there’s Annie’s poor lifestyle. And in any case, if Annie had been under proper medical care, she’d likely have been on bed rest and medication to manage all of this before it impacted the baby’s development.
“So if things remain stable,” I ask Eliza, “when will you deliver?”
“Ideally, we’ll keep the baby in utero for another four weeks...” Eliza murmurs, but I can tell from her careful tone that she’s not optimistic about this time frame.
“And how are you planning on managing Annie’s withdrawal symptoms?” Sam asks quietly.
“I consulted with an addiction specialist this morning, and he agrees that methadone is the best option for you, Annie.” My sister gives a frustrated groan, but Eliza’s gaze doesn’t waver. She presses on patiently. “There are alternatives we might have considered if your condition wasn’t so complex—but given that there are a lot of moving parts here, we want you to stick with the methadone. We know it’s completely safe.”
“It just doesn’t work. Not for me. Look at me now, for God’s sake.”
“Ron ordered you a very low dose last night,” Eliza explains. “He thought it best to treat you conservatively given how unstable things were—but seeing how quickly you’re experiencing withdrawal symptoms, I’m suggesting a much higher dose.”
“It won’t work anyway. Methadone has never stopped me from using.”
“Okay, tell me about that. Why doesn’t it work, Annie?” Eliza asks gently.
“It just doesn’t,” Annie snaps at the doctor. The frustration and impatience in her tone seems inappropriate somehow, perhaps because of how carefully Eliza has prompted the question. But Annie is coming apart before our eyes and all I can think is...thank goodness we didn’t tell her about the social worker. I’m not sure Annie would be up to dealing with that news just yet—and she’s clearly not kidding about the withdrawal symptoms. She’s trembling, and the hands that have been resting on her belly press her hair back from her face behind her ears, then again when the hair falls forward immediately, and she groans in frustration and clenches her hands into fists. “You know it doesn’t work for me, Lexie. I was on methadone when I was at your place last time, and that was a disaster.”
“Annie,” I say softly, “this time just has to be different. You don’t have a choice this time—you can’t just go cold turkey, and don’t you think it’s going to look better for the judge tomorrow if you start some treatment before the hearing?”
I don’t tell her about Mary’s comments about judges “not liking” maintenance programs, and if I’m honest with myself, I’m not sure I understand it. How could judges not like one of the only evidenced-based treatments we have to offer people suffering addictions? I make a mental note to clarify this with the attorney.
“Well, I only came here in the first place because you said you wouldn’t let them charge me,” Annie snaps. I open my mouth to respond, but Sam interrupts flatly,
“And if Lexie hadn’t convinced you to come here, your baby might not have made it even this far.” I shake my head at Sam furiously, but he persists, and I groan in frustration as he pulls all of the coldness right out of his tone as he adds quite calmly, “Lexie can’t fix this for you, Annie.” Annie is staring at him through narrowed eyes, but he shrugs, unaffected by her anger. “This is your mess, and there’s no easy way to fix it—no easy path out of trouble this time. There’s simply no painless solution for Lexie to find.”
Annie’s nostrils flare, and now she and I are both staring at Sam. He has no right to speak to my sister like that, even if he was defending me. But nothing he has said is untrue. Every single word was simple, uncomfortable truth. I’m so torn—a jumbled web of contradicting emotions. I’m angry with Sam; I’m angry with Annie. I’m grateful to Sam; I’m worried for Annie.
“I don’t care if it’s painful. We just have to keep the baby safe, and then we have to find a way that I can keep it,” Annie croaks. “I don’t care what happens to me. I just want my baby to be okay. Can’t you all see that?”
“I can see it,” I whisper, and I fumble to wrap my fingers through hers. Annie looks at me, her gaze desperate, her eyes filled with tears.
“Lexie, I want to do better,” she chokes. “I want to keep my baby. I’ll do anything, I promise. What you said earlier...are you absolutely sure there’s no way to stop the baby from experiencing withdrawal?” She’s directed the question to me instead of Eliza, and this time I catch myself before I take charge. I look at Annie’s obstetrician, who shakes her head sadly.
“I’m so sorry, Annie. There’s probably not. Sometimes, babies exposed to narcotics in utero do avoid NAS, but it’s rare.”
Annie sighs and wipes at her cheeks then rubs her temples. When she speaks again, she’s pitiful—her tone is completely flat and she’s staring into space.
“So I don’t have a choice, then.”
Oh God, Annie. You have no idea yet how little choice you’re going to have.
“You have had a choice,” I say suddenly. Annie looks to me in shock and I realize she’s assuming I meant about using the drugs in the first place, so I clarify hastily, “You’ve chosen to come here with us and do the right thing for your baby. You could have kept burying your head in the sand and stayed at the trailer. I know that would have been easier. So don’t sell yourself short, okay?”
Annie slumps again.
“So if I stay on the methadone, can I go home?”
“Oh, no.” Eliza winces, and she shakes her head. “No, that’s absolutely not an option—not given how unwell you were when you came in. You’ll need to stay here in the hospital until you deliver.”
“But I can’t afford this place,” Annie whispers. She slumps forward, wraps her arms around her bump again and says flatly, “I can’t stay here.”
“We’re taking care of it, Annie,” Sam says quietly.
“I don’t even know you. I can’t let you do that,” she snaps. It’s amazing how quickly Annie’s miserable desperation morphs back into anger and resentment. As her desperation for a fix mounts, her mood will become increasingly unstable. I know from experience that if she’s not sufficiently medicated soon, this easy irritation will grow and grow until her rage is completely out of control.
“Lexie knows me well enough to agree to marry me,” Sam points out, then he flashes her his most charming smile. “I know that you want what’s best for your baby, Annie. I barely know you, but even I can see it, plain as day. This hospital can provide you with the best medical care in the state. Eliza is one of the top high-risk obstetricians in the country, and we have a neonatal intensive care unit on-site. This is the place to be, Annie.”
“What do you think?” Annie glances at me. “Do you really want me here? At your fancy boyfriend’s fancy hospital?”
Not even a little bit.
“I want what’s best for you and for the baby. And Sam’s right, you’re not going to get any better care than you are here.”
Annie takes a deep breath, then bursts into noisy sobs.
“I’m sorry, I really am, I’m so sorry. I’m sorry about all of this—sorry that you’ve all been dragged into it, sorry for the baby...but if they take it away, I just don’t know how I’ll live with myself—”
The grief on Annie’s face is unbearable. I stand and wrap my arms around her, pulling her hard against myself. I press my lips against her stringy hair and guilt washes over me like waves. She smells like her trailer; like poverty, and addiction and a total lack of self-care—and it’s wrong. This is not who Annie was supposed to become. I rub my hand up and down her upper arm, and note automatically the sinewy muscle beneath my fingers, and the bone...it’s all too close to the skin. It’s a miracle that Annie has been able to sustain a pregnancy at all.
“Annie,” I say, my voice low and urgent, “all that matters is doing what we can now for you and the baby, okay?”
“I’m going to try harder, I really am. I really want to be a good mom.”
“And you are going to be,” I say firmly, but I have to add a silent prayer even as I say it that the court gives her a chance to at least try. “But step one has to be staying in the hospital and starting on methadone. A proper course, a decent dosage—enough to really hold those withdrawals at bay.”
Annie clears her throat, and she forces out a long, slow breath. Then she wipes her eyes with the back of her wrists, and as she snakes those skinny arms back around her belly, she offers me a single, silent nod.
I’m spellbound by this compliance—this relatively easy agreeability. I try to think of the other times Annie agreed to use a maintenance program, but the years have blurred in my memory, and all I remember for sure is that it has always been difficult to get her on board. She used to complain of bone pain—agonizing, supposedly—right from her first dose. I’d researched this and found that narcotics withdrawals can cause pain—but Annie was always on a high enough dose that this should never have been a factor. I’d eventually come to the conclusion that it was just yet another excuse—setting up the scenario so that when she used again, she had something to blame.
But Annie has never had a reason outside of herself to stick with the maintenance programs before—it’s always just been her. As I consider this, I’m startled by a burst of optimism. Maybe she can make it work this time. Maybe the baby is reason enough for her to finally, finally get her shit together.
“Good.” I breathe the word on a sigh of relief, and Eliza rises immediately.
“I’m going to go organize the prescription and we’ll increase that methadone right now—before your withdrawal gets any worse, okay? You know how this works—the symptoms will stop almost immediately.”
“Thank you,” Annie says unevenly.
“Can I speak to you for a minute, please, Alexis?” Eliza asks quietly, but there’s an undertone of tension and I realize that I’ve known Eliza for all of ten minutes and I’ve already pissed her off.
“You already discussed some of this with her?” Eliza says sharply, as soon as we are safely out of Annie’s earshot in the hallway.
“I talked to her about methadone and NAS just before the police came, yes. But why didn’t you? Shouldn’t that have been the first thing you sorted out with her?”
“I deliberately didn’t talk to her about how we’ll handle that aspect of her treatment—I wanted to speak to the addiction specialist first so that I didn’t overwhelm her before I was sure which approach to recommend. I understand that you’re her sister, Alexis, and that you’re also a GP—but I’m her specialist, and if we’re going to work together to get your sister through this pregnancy, you’re going to have to leave the medicine up to me. Are we clear on that?”
“I need to be involved in these decisions—I need to understand exactly how you’re planning on treating her,” I say stiffly.
“Even if you were a specialist consulting obstetrician—which as I understand it, you aren’t—it’s not appropriate for you to treat your own sister. Her case is complex. She’s under my care because she needs to be. I’ll try to keep you in the loop when it’s practical, but this is the last time you tread on my toes. Right?”
Eliza and I lock eyes. She’s red-faced and frustrated, and so am I, even as I understand the logic behind what she’s saying. Wasn’t I just thinking the same thing myself this morning?
But this is Annie—my Annie—my sister, my responsibility.
Sam clears his throat behind us, and I turn to find that he’s followed us into the hallway. My frustration eases when his concerned, pleading face swims into view. I sigh, and then glance back to Eliza as I nod.
“Why don’t you concentrate your efforts on finding Annie some legal help?” Eliza suggests.
“Fine.” I sigh, and Sam takes my hand.
“Thanks, Eliza. For all of this.”
“Thank me when we get that baby safely out into the world and well,” Eliza says quietly. “There’s a long road ahead for them yet.”
* * *
It’s not as easy as I expect, but two hours and four phone calls later I find myself sitting in the offices of Bernadette Walters, attorney at law. I’m frazzled by then—if not from the multiple calls it took to find the right lawyer to actually help us—then by Sam’s determination to hover at my side while I did so.
“I’ll come with you,” he says, when I tell him the details of my appointment with the lawyer.
“I’ll be fine, Sam. Why don’t you go check in on your patients?”
“Are you sure? I mean, I’m off today so I figured I’d just tag along with you, see if I can help.”
“You really don’t need to do that,” I say. “Go and check in with your office.” He hesitates, and I sigh and pull him close for a hug. “Honestly, Sam, I’m fine. We’ve put you out enough. You don’t need to come with me to the lawyer, too.”
“I’m not ‘put out,’ Lex,” he murmurs into my hair. “I’m in this for the long haul—I’m going to do everything I can to help you help her. But I do have some things to check up on, so I’ll go to the office now and catch up with you later.” He kisses me gently, and stares into my eyes as he adds, “You’ll call if you need me?”
“Of course,” I promise, and when he finally starts to walk away, I actually feel confused. He’s crowding me a little, and given that there’s a big part of me that still wants to pretend none of this is happening, I’m relieved for the space. But I’ve also never had someone support me through a crisis before, and as I watch Sam disappear down the hallway, I miss him so much more than I would on any ordinary day.
I’ve never needed to contact a criminal lawyer before, but if I had, I didn’t imagine I would have opted for one who had a dusty office above a furniture store. But despite Bernadette Walters’s disappointing office accommodations, she comes highly recommended by the attorney Sam and I used to manage the purchase of our house. Bernadette has successfully defended a number of patients in a similar situation to Annie. She’s tall but extremely thin, and she has a frantic energy about her—she speaks at a million miles an hour and is constantly adjusting the fall of her hair around her shoulders.
I stare at her and try to figure out how old she is. She’s wearing a trendy fitted shirt and a pencil skirt, but the jewelry she’s paired it with could easily have been snatched from the wardrobe of a senior citizen. Her face is smooth, but her long dark hair is liberally streaked with gray. I average the contradictions out and decide that she’s probably in her fifties—but I could easily be twenty years off in either direction.
After polite greetings, Bernadette insists that I call her “Bernie,” and she all but snatches the paperwork from my hand before I’ve even taken a seat. She scoops frameless reading glasses up from her desk and begins scanning the page as she sits.
“This chemical endangerment law was never meant to apply to pregnant women.” She sighs, shaking her head. “They enacted it in response to cases where meth labs were found in family homes...baby in the playpen in the kitchen, sucking on their pacifier while Mom and Dad cook meth on the stove right next to them. Unfortunately, about the same time some DAs decided they were going to try to address the so-called epidemic of babies born with neonatal abstinence syndrome, and the wording in the statute was vague enough that it allowed them to push the law to a place it was never supposed to go.” Bernie looks up from the warrant and meets my gaze. “In short, Lexie, your sister is in some serious trouble here. There’s a criminal charge to deal with, as well as the immediate matter—the hearing tomorrow that could potentially revoke Anne’s parental rights over her fetus.”
“So, what do we do?”
“Ordinarily, my advice would be to get your sister into a rehab center as quickly as humanly possible—if it is humanly possible, which it generally isn’t since rehab centers avoid pregnant women like the plague,” Bernie tells me, peering at me over the top of her glasses. “But my secretary told me that your sister is quite unwell so that’s probably not an option anyway.”
“She won’t even leave the hospital before the baby comes,” I inform her. “Even if she does, she obviously can’t detox while she’s pregnant, and the social worker said that a pharmacological maintenance program doesn’t count.”
“Unfortunately not. My experience is that here in Alabama, judges generally don’t count an opioid-replacement program as adequate effort toward rehabilitation.”
“Well, that’s just bullshit,” I snap, then I wince and shake my head. “I’m really sorry—I just don’t understand. All of the science says that maintenance programs work, particularly if it’s in conjunction with therapy. So why wouldn’t it count?”
“Absurd, isn’t it? Look, we’re generally dealing with very conservative judges, and there’s nothing in the law that says that people need to be referred to evidence-based treatment. We see a lot of referrals to abstinence-based programs. Twelve-step programs are particularly popular.”
“But that doesn’t make any sense.” Particularly not in Annie’s case. I did drag her to a twelve-step program for a while when we ran out of alternatives, but just the mention of “a higher power” is generally enough to give both of us hives.
“You’re preaching to the choir here, honey.” Bernie sighs. “I know how frustrating all of this is, believe me. It’s like the law was passed by a bunch of men in suits who never even intended to address this scenario,” she says, then she snorts, “which, of course, is exactly what happened. But let’s take a step back for a second. Give me an idea of what we’re dealing with here with your sister, Alexis. Does she have a criminal record?”
“I don’t know,” I admit. “I don’t think so. I mean, she’s been charged at least twice before—but I think the charges were dropped both times. She was charged with possession in Chicago, but she got off on a technicality. And then two years ago she was caught trying to steal narcotics from a medical clinic, but the charges were dropped.”
But for my groveling and pleading with my boss, that attempted theft of class A drugs charge would have put her away for a long time. There was CCTV footage of her doing it, plus the security guard at work caught her while she was still in the meds room.
“So is this her first attempt to get clean?”
I clear my throat.
“Not by a long shot, unfortunately.”
“So, how many previous attempts at rehab?”
“Many,” I admit. “But you know, this time might be different, with the baby and all...”
“Has she met with the CPS social worker yet? This...” Bernie looks down at the paperwork in her hand and reads, “Mary Rafferty?”
“No, Annie was too sick to be interviewed, but I spoke with her this morning.”
“How did it go?”
“Not well,” I murmur. “She seemed to have made up her mind pretty quickly that Annie wasn’t going to make a fit mother.”
“Are they doing a home visit to review Anne’s living conditions?”
“No, she said not at this stage.”
“All right, Alexis. Here’s the thing.” Bernie lowers the paperwork and she sighs. “There’s pretty much nothing I can do for your sister tomorrow.”
“Oh.” I’m confused, and I frown at her. “I don’t understand. Why did you agree to take the case if you can’t help?”
“There are two courts involved in your sister’s situation—the juvenile court, which will hear the petition to strip Annie of her right to parent the baby, and the criminal court, where she may eventually face trial for the chemical endangerment charge. The immediate issue is the parental rights challenge, and there’s nothing I can do for her in that regard.” She turns the paperwork around so I can see it and she points out, “It will be heard in a juvenile court, which is closed to everyone but court staff. Annie will have to go on her own. She can’t even have legal representation. But this hearing is all about the baby’s best interests, so an attorney will be appointed to make decisions for the baby on a day-to-day basis. We call it a guardian ad litem. In this case, they’ve nominated a guy named Bill Weston. I’ve come across him before. He’s a nice enough guy, but like a lot of attorneys who opt to do this kind of work, he’s a real, old-school conservative. And if tomorrow goes as I expect it will, he’ll be the one who gives consent or otherwise to all of your sister’s treatment for the duration of her pregnancy.”
I blink at her, then I shake my head.
“No! Surely they can’t do that!”
“Actually, they can do that, and it looks like they’re going to.”
“But that’s not fair.”
“No, it’s not.”
“We have to do something. We can’t let them do this.”
“I’m so sorry, Alexis. There isn’t anything we can do. That’s just the way this is going to play out, I’m afraid.”
I’m slipping into shock. My face feels hot and my mouth is dry. I hear a frantic, rhythmic tapping I can’t identify, and then I realize it’s the sound of my feet beating against the floor. Bernie leans forward on her elbow and her gaze is sympathetic.
“The judge is going to review the social worker’s assessment, and if she’s not even going to bother to visit Annie’s home at this stage—I’d say it’s pretty certain she’s going to recommend that Annie lose her rights to the child. The judge will probably make a ruling to appoint Bill as guardian ad litem, and he and the assistant DA will make a deal with Annie. Most likely they’ll set some kind of requirement for her to complete a rehabilitation program, parenting classes, attain some minimum living standards and probably get and keep a job...that kind of thing. And if and when she meets those requirements, they’ll restore her parental rights and generally the DA will also drop the criminal charges.”
I don’t want to admit this to Bernie, but the reality is, if they set those particular requirements, then Annie is going to have to completely reconfigure her entire existence.
“At least there’s hope?” I say, but I sound defeated, and Bernie grimaces.
“I guess so. But you should know that in practice, once parental rights are stripped from a woman like Annie, it can be almost impossible to get them back. CPS really doesn’t make it easy on their clients, but Annie does have one advantage that almost none of my other clients in this situation have.”
“And what’s that?”
Bernie smiles sadly.
“You.”
I exhale a shaky breath and tilt my head back to stare at the ceiling. I’m trying to reconfigure my expectations for the next twelve months of my life. Instead of planning a wedding and focusing on my work, I’m going to be once again diving down a rabbit hole with Annie, this time, dragging Sam along behind me.
“So if they do offer her some kind of deal to get herself sorted out tomorrow,” I ask reluctantly, “and she fails to meet their requirements—what happens then?”
“Well, if she doesn’t satisfy the demands of the court in full, she’ll be tried for the chemical endangerment offense. Realistically, if that happens, she’s likely to get a prison term.”
My gaze snaps back to Bernie.
“Prison?” I gasp.
“They aren’t insignificant sentences, either. Let’s say the baby is born healthy, but Annie can’t satisfy the DA that she’s rehabilitated and the trial proceeds and she’s found or pleads guilty. That’s a sentence of one to ten years.”
“What?”
“And let’s say the baby isn’t healthy, but the DA decides its illness or injury is somehow related to her drug use. That’s ten to twenty years.”
“But—”
“And if—I mean, awful as it is to say...well, if the baby happened to die, and there was some way to link the death to her drug use? That’s up to ninety-nine years.”
“How close does the link have to be?” I whisper. I’m thinking about Annie’s high blood pressure and the baby’s restricted growth and all of the things that could still go wrong. And even I have wondered whether Annie’s health crisis is related to her drug use—so, it’s not such a long shot for her prosecutor to draw, if, God forbid, something tragic did happen.
“Just off the top of my head, one direct precedent does come to mind—a woman with a history of premature birth went into labor very early, and the child didn’t survive. She had tested positive for meth, but she had an expert witness willing to testify this had nothing to do with the stillbirth—but the woman’s request to have that specialist testify on her behalf was declined. She pled guilty in return for a reduced jail term—it was too risky to go to trial with the cards so obviously stacked against her.”
“A woman lost her baby, and the state jailed her for it?”
“Unfortunately, yes. Are you familiar with the Jane Doe chemical endangerment case of 2015, Lexie?”
“Should I be?” I stare at her blankly, but Bernie’s sigh speaks of a frustration that’s much larger than this god-awful situation with my sister.
“Every woman in America should be familiar with that case,” Bernie mutters. “A woman was imprisoned on drug charges—she’s known as Jane Doe because the juvenile court case was closed, like your sister’s case is. Jane Doe requested leave from the prison to have an abortion she had already booked before she was locked up. Just like your sister here, the DA petitioned a juvenile court to strip Jane Doe of her parental rights, and the fetus was given a guardian ad litem. Keep in mind, we’re talking about a first-trimester fetus in an unwanted pregnancy. If the law can be applied to overrule Jane Doe’s wishes, then it’s hardly surprising that it’s been applied to intervene in your sister’s case.”
“Did she have the baby?”
“No one knows what happened to her, actually. We’re talking about the juvenile court, just like your sister’s hearing tomorrow—so the matter was sealed. The only reason we know about this case at all was that civil rights advocates petitioned a federal court on her behalf to try to get her access to the abortion clinic, but just before the ruling came down, Jane Doe suddenly changed her mind and apparently decided she didn’t want the termination after all. And because we don’t know her name, we don’t know where she ended up.”
“Is this common?” I ask Bernie, shaking my head. “These chemical endangerment charges? CPS taking people’s kids away like this?”
“Well, that’s actually hard to say. Chemical endangerment charges like Annie’s are on the increase, but it’s impossible to say how often families are losing their children as a result of them. Those juvenile court hearings are closed so...no public records available.” She snorts and shakes her head. “Awfully convenient, some might say.”
“Why isn’t there an uproar?”
“Pregnant drug addicts, Alexis. Pregnant drug addicts. How much sympathy do you think the general public has for women who use illicit drugs while they’re growing babies?”
I knew Annie was in trouble, but it’s slowly sinking in that this situation is even worse than I’d considered. “What the hell are we going to do?”
“All we can do about this hearing tomorrow is to coach Annie a little in how to deal with the proceedings, and then make sure she understands that she has to precisely complete whatever is required of her after.”
This reminds me of Annie’s other crisis, the situation with her blood pressure. I clear my throat and shuffle forward in my chair. “Well, actually, Annie just can’t leave the hospital, not even for the hearing. It’s not safe.”
“Okay. I’ll call the judge and request a bedside hearing. We’ll need a letter from her obstetrician confirming her condition and quite clearly stating that she can’t leave the hospital.”
I call the hospital, and I speak to Eliza’s secretary, who emails the letter through within minutes, and that’s enough to convince the judge to move the hearing to Annie’s bedside. Bernie high-fives me when this is confirmed, and after making plans to visit Annie with me in the morning, she walks me to the door of her office.
“I know it’s a lot to get your head around, Alexis.”
“You’re not wrong about that.” I laugh weakly, but the sound is hollow and I feel a thundering headache coming on. I press my fingers to my temples and try to calm myself down. Bernie grimaces and pats my shoulder a little awkwardly as she adds, “I know this is frightening, and the custodial sentences for this crime are incredibly tough here in Alabama—but still, there is a way to avoid them. Annie just has to complete whatever treatment the judge mandates. If your sister really wants to raise her baby, this is her last chance to prove she can do the right thing by it.”