ELIAS WAS STILL trying to work out the crick in his neck from the previous night as he sat outside the hospital on his quick break. He thought he was drinking his seventeenth cup of coffee, but he couldn’t quite be sure because he’d lost count. Either way, it was a lot of coffee.
He and Adeline had fallen asleep together on the couch. She had curled up with her head in his lap and he’d gone to sleep sitting up, so his head had fallen over the back of the couch and now he had a crick.
Which wasn’t boding well for his long rotation at the hospital under the watchful eyes of the new doctors he had to impress.
And no matter how much coffee he drank, it wasn’t helping.
He was just drained.
At least Adeline seemed to be doing better. The sickness that had plagued her yesterday didn’t seem to be bothering her today as they made their rounds, checking on all the women who were admitted and taking new consultations on behalf of Dr. Wilder.
The baby of the first patient they saw was producing too much amniotic fluid and they would have to watch and drain the excess fluid. The baby was only twenty-eight weeks along, so the hope was that they could keep it in for longer.
The mother pregnant with twins had twin-to-twin transfusion syndrome, which was when one twin thrived and the other didn’t. They were planning fetoscopic surgery to correct this syndrome, because Adeline already had experience doing a similar surgery successfully with Dr. Wilder.
Then there was a mother with gestational diabetes who had a high risk of complications, so they were going to be monitoring her.
The baby seemed to be fine, but Elias wasn’t completely sure. Something about the pregnancy was not right. The mother was on bed rest, but Elias had a feeling that this baby would be making an appearance sooner rather than later.
“You look tired,” Adeline said as she snuck up behind him.
“I am,” he muttered, taking another sip of his coffee. “Next time we fall asleep together, can it be in a bed?”
“Noted. My shoulder is bothering me today.” She sat down on the bench next to him. “We have another patient.”
“Another patient?”
“Yes. She’s gravida two para one. High-risk, not only because of her age, but because it’s been a while since she’s been pregnant, and her first baby was born early with heart issues and spent some time in the NICU. She wants to see a neonatologist.”
“What does that have to do with me?” he asked, confused.
“Well, she heard a neonatologist from San Diego was working here and she demanded to see you. I examined her, and she’s quite insistent. So I’m hoping you can come up with me and see her.”
Elias’s stomach twisted.
He had a bad feeling. No. It couldn’t be.
“Take me to her.” He crushed his coffee cup and tossed it in the garbage pail.
She wouldn’t do this to me.
Only, he was pretty sure that she would. And as he followed Adeline back into the hospital to an exam room, he froze in his tracks when he saw a familiar fifteen-year-old boy sitting outside the exam room, focused on his phone.
Sure, he hadn’t been home in two years, but he had kept in touch with his nephew.
Still, seeing him brought back a flood of emotions that he really wasn’t prepared to deal with. Especially not in front of Adeline.
“Manny?” Elias asked.
Manny looked up and then smiled. “Uncle Elias!”
“Uncle?” Adeline asked.
Manny came and gave him a hug. At fifteen he was almost as tall as him and Elias was six foot two.
“What’re you doing here?” Elias asked.
Manny nodded to the exam room. “Mom. She’s pregnant again. We didn’t think it would happen, but she is. There might be complications and she wants you there. She’s a bit worked up. She was going to drive down to San Diego to see you.”
Well, that explained why his sister had been getting so agitated the last few months when he had been ignoring her calls, texts, and emails.
“I’ve been busy, Manny. I’m sorry.”
Manny nodded. “I get that, but Grandpa is sick too and Mom is hormonal. You haven’t been home in a while, Uncle Elias.”
“I know. Well, I had better go and see your mother before she starts tearing down the walls.”
Manny laughed. “Good idea.”
Elias sighed and Adeline followed him.
“So, she’s your sister?” Adeline asked.
Elias nodded. “Yes. She’s the oldest and the bossiest.”
“She definitely knew what she wanted, but she didn’t actually ask for Dr. Garcia. She just asked for that hotheaded, arrogant neonatologist from San Diego.”
He paused and spun around to look at her. “And you instantly thought of me?”
Adeline grinned. “Who else? I had the same impression of you the first time I met you. Well, not the hotheaded part. The arrogant bit for sure.”
“Arrogant?” he asked, playing offended.
“Oh, come on. You said something to me about not needing a babysitter the first time we met. Like I was some kind of glorified nanny.”
He grinned. “So I did, but I wasn’t the only arrogant one during that first meeting. She could mean you.”
Adeline grinned. “I’m not as hotheaded and I’m not a neonatologist.”
“Thanks.” He opened the door. Adeline walked in first and then he followed.
Rosa spun around, her belly very large, and Elias had no doubt she would deliver soon. Thankfully, she hadn’t dropped, so there was still time.
Her dark eyes landed on him and he knew that he was in trouble.
“Two years.”
Elias sighed. “Dr. Turner, I’d like to introduce you to my sister, Rosa Adler.”
“We’ve met,” Adeline said, trying not to laugh.
“Two years,” Rosa said again, ignoring the introduction.
“I’ve been learning how to become a surgeon, Rosa! I was in Houston. I didn’t have time to come home.”
Rosa’s eyes narrowed. “I suppose.”
“And you want a consult with me?” Elias asked.
Rosa sat back down on the exam table. “I’m worried. I’m high-risk and it’s been fifteen years since I had Manny.”
Elias went to his sister’s side. “I can’t be your doctor. I’m your brother.”
Rosa glanced at Adeline. “She can, right?”
“I can if you go into labor while I’m San Francisco. Don’t you have a doctor in Napa?”
“I do, but I’m not happy with him.” Rosa frowned. “The baby is large and there’s a murmur in her heart. I’m scared. I heard you were here, and I don’t fully trust those obstetricians in Napa.”
Adeline stepped up. “Can I do an examination of you, Rosa?”
Rosa nodded.
“I’m going to walk outside and sit with Manny.” Elias kissed his sister’s head. “Try not to worry. Dr. Turner is one of the best.”
Adeline smiled at him, her expression soft.
Elias left the room, walked down the hall and sat with Manny.
“How is your grandpa? The truth,” Elias asked.
Manny frowned. “His heart. He needed a bypass.”
“Needed?” Elias asked.
“He had it, but he’s still pretty weak.”
“And what is Uncle Aidan doing?”
“Running the estate. He and Aunt Shea are having a baby in six months. I think.”
Elias nodded. “So I heard.”
No one had told him about Dad’s bypass, but would that have changed anything?
His dad would still think the same of him.
It would’ve been nice to know what had happened, though.
To have been there for his dad.
But would you have taken the time off from work?
Elias wasn’t sure and that thought upset him.
“It would be great to have you come home for a visit,” Manny said, nudging him. “I miss you. Uncle Aidan is fine, but you’re more fun!”
“Thanks, kid.” Elias waited and soon Adeline opened the door. His sister came out of the room, moving slowly.
“Thank you, Dr. Turner. I really appreciate your help.”
“My pleasure.” Adeline headed back into the exam room to give them privacy. Which he appreciated.
“Elias, come home this weekend. Just for a dinner or something. Do me this favor,” Rosa begged.
Elias sighed. “Okay. I promise. I have time off Saturday and I’ll come for dinner, okay?”
Rosa smiled and hugged him. “Great! Everyone will be so happy to see you.”
Sure, they will.
“Take it easy.” He hugged her again and watched as his sister and nephew walked down the hall.
He headed back into the exam room, where Adeline was cleaning up and making notes in her chart.
“How is she?”
“She’s slightly dilated. I think you’re going to have your niece before we leave. I am worried that her baby is measuring quite large and your sister had a C-section fifteen years ago, but everything else looks and sounds good. There’s no reason to keep her in here.”
Elias scrubbed his hand over his face. “I’m going to Napa to have dinner with my family. Do you want to come?”
Her eyes widened. “You want me to come?”
“In case she goes into labor. You said so yourself, she’s dilated slightly.”
“That’s the only reason?”
Say yes.
“No.” He couldn’t. “My brother is married to my ex-fiancée. It would be nice if you came and pretended you were my fiancée. I mean, it’s not that much of a stretch. We are having a baby together.”
Adeline wasn’t quite sure that she was hearing Elias correctly.
“You want me to...what?”
“Pretend to be my fiancée.”
She was looking for some kind of sign that he was joking. He wasn’t.
“Why do you want me to pretend to be your fiancée?”
“Remember about having something to prove?”
“I think you’ve had too much coffee.” Although it might be kind of fun to pretend for a while.
What’re you thinking? You turned him down flat not more than twenty-four hours ago.
Still, she felt bad that he had this issue with his family. That his parents viewed him as less than he was because he hadn’t taken over the family estate. That his brother had married the woman he had been engaged to.
It seemed kind of messed up.
And she did want to check on Rosa Adler, Elias’s sister. Adeline was worried about her. There was no medical reason to keep her admitted, but Adeline wanted to be close by in case Rosa went into labor. If Adeline were a betting person, she would lay serious money down on it happening this weekend.
“Okay.” She couldn’t believe she was agreeing to it.
Elias smiled. “Thank you. I owe you one.”
“You bet you do,” Adeline teased.
Her phone vibrated as did Elias’s, and she frowned when she saw that it was the obstetrics team. It was about the baby of the mother who had high blood pressure. The patient’s water had broken, and she was far enough along, but it was also time to deliver the twins.
“Ms. Saminsky. Her water broke and there’s a lot of blood. You’d better get your NICU team ready. We’re going to have to push back the twin-to-twin transfusion surgery.”
Elias nodded. “Okay. I’ll see you in the operating room.”
Adeline nodded and made her way to the obstetrics inpatient floor, where there was a flurry of activity.
Dr. Wilder was on her way in from San Diego so that she could help with the twin-to-twin transfusion, but Adeline could handle a delivery of twins and a crash C-section if needed. She was an OB-GYN.
She grabbed a gown and headed into the room.
There was an undercurrent of panic and Adeline knew why. There was an awful lot of blood. Too much for a delivery. Something was wrong.
“We need to get her down to the OR now,” Adeline said. “And I want the blood test ASAP. I need to know what is fetal and what is maternal.”
As Adeline looked at the ultrasound, she could see that the placenta was lying low and she was sure that it was placenta previa. The placenta had grown on the cervix and torn away.
The patient had given no signs of going into preterm labor.
Still, all that mattered was getting her into the operating room and taking that baby out. Ms. Saminsky was rushed down the hall to the operating room, which was always prepped for cases such as this. The hospital in San Francisco was larger than San Diego Mesa Hospital.
It was a good system and Adeline was quite envious.
She was getting scrubbed up when Elias came into the scrub room.
“Placenta previa?” he asked.
Adeline nodded as she held up her arms and headed into the operating room. The patient was already out and the obstetrical staff had begun the C-section.
Adeline stepped in to assist.
The nurse who had run the blood sample to pathology came in. “Dr. Turner, it’s maternal blood.”
“Thank you!” Adeline was relieved. It meant that the umbilical cord hadn’t torn away, but if it was maternal, then something else was going on.
As they worked to remove the baby, Adeline could see where the placenta had come away and ruptured some vessels.
She delivered the baby and handed it off to Elias and the NICU team.
She was worried about the baby, but right now, she had to repair the tear she found in the uterus, which was the reason for the maternal blood. The placenta previa had done the damage. As she focused on her work, she heard the tiny, quiet cry of the premature baby girl. And she smiled to herself, relieved to hear it.
She finished the repair on the mother.
“How is it going, Dr. Turner?”
Adeline looked up to see Dr. Wilder had come in.
“Placenta previa,” Adeline responded.
Dr. Wilder nodded and remained on the periphery to watch. “Sorry to be the bearer of bad news, but you have only an hour before our next surgery. I have to fly back to San Diego tonight.”
Adeline nodded. “I’ll be ready, Dr. Wilder.”
Adeline was exhausted and she was starving, but the twin-to-twin transfusion surgery had to happen today. Just like this one did.
“I can assist now, Dr. Wilder,” Elias interjected.
Adeline glared at Elias, her heart sinking at him taking her surgery from her.
She thought they were friends. Why had she let her guard down?
You’re in a competition, remember?
“Very good, Dr. Garcia. Come with me. Dr. Turner, come into the operating room when you’re through.”
Adeline nodded and focused on Ms. Saminsky.
And her job.
By the time Adeline finished the repair work on Ms. Saminsky, the twin-to-twin surgery was over. She was annoyed Elias had scooped it up, but she probably would have done the same thing if the situation were reversed.
She headed up to the NICU to see the twins.
She stood outside watching all the babies in the incubators. She could see Elias gowned and attending to the twins. She couldn’t help but smile. He was so gentle and kind with those fragile twins.
How could anyone be disappointed in him?
Adeline felt uncomfortable going with Elias to meet his family, but her gut was telling her that it was the right thing to do. They were friends and she needed to support him.
Just like he was supporting her.
And Adeline liked Rosa.
So really this was for Rosa and for Elias.
Elias looked up and smiled at her. She waved back, her heart melting as she saw his hands were on a tiny baby, gently checking the vitals.
And all she could think about was their own baby. When she had found out she was pregnant yesterday, she hadn’t allowed herself to think of the possibility of the future. The future, her pregnancy, it was all too real. For the first time in a long time she felt hope.
It made her feel happy and she had to smile.
Elias finished up his work and came out of the NICU to greet her.
“You look happy,” he said.
“I feel happy.”
Elias grinned at her. “I like to see you smiling. How is the mother?”
“She’s stable. I’m just thankful you were able to deliver the twins. How are they doing?”
Elias glanced back. “They’re strong. The smaller twin is slightly anemic, but we’re taking care of that with platelets.”
“Good. I’m just about to go over Ms. Saminsky’s case with Dr. Wilder.”
“Good luck.”
She turned to leave, but then turned back.
“About this fake fiancée thing,” she said. “What am I walking into?”
Elias sighed. “A lot of questions.”
“We’re not going to tell them about the baby yet. Right?”
She didn’t want anyone knowing. Not yet. There were too many things that could go wrong.
“Right. That’s our business.” Elias sighed. “I appreciate you going along with this. And I mean it. I owe you one.”
“Oh, what, a fellowship?” she teased. “Or a surgery?”
Elias laughed. “Go do your reporting and I’ll see you later tonight. I’ll make dinner.”
“That sounds great.”
Elias nodded and headed back into the NICU, and Adeline watched him as he continued on with his work.
She was so confused.
A month ago, she had had a purpose. She knew exactly where she was going with her life, but now, she didn’t know what was happening. Her life was spiraling out of control and she couldn’t even really think forward. Elias was making her feel things she hadn’t felt in so long.
She didn’t know what was going to happen.
And despite her optimism it frightened her.
She didn’t want to get her hopes up.
About anything.
Elias finished in the NICU, and then he headed into the gallery of the operating room. There were residents, interns and some attendings watching Dr. Wilder and Adeline operating on an emergency uterine rupture that had come in.
It was an interesting operation and Elias didn’t often get a chance to watch Adeline work without being involved.
From the first time he had met her and done a surgery with her, Elias had been impressed with Adeline’s ability, and seeing her with Dr. Wilder, it was apparent that she belonged here. That this was her calling.
“Dr. Garcia?”
Elias turned to see someone who could only be Dr. Spiner, the head of the NICU, standing beside him.
“Dr. Spiner?”
Dr. Spiner held out his hand and Elias shook it.
“I have to say that I have been very impressed with your and Dr. Turner’s work here at the hospital.”
“Thank you.”
Dr. Spiner took a deep breath. “I don’t like trying to poach a surgeon from another, but if you’re ever looking for a position, I would gladly have you as an attending here at our hospital.”
If it had been a couple of months ago, Elias might have taken Dr. Spiner up on his offer, but would he have stuck with it?
Probably not.
He was still focused on the fellowship. Dr. Wilder was in San Diego.
And so was Adeline.
So was his baby.
He couldn’t leave them.
“Thank you for the offer, Dr. Spiner. I will keep it in mind, but...”
“But what?” Dr. Spiner asked.
“Dr. Turner and I are expecting.” He winced, because he had let it slip. That’s not what he’d wanted to do. “It’s quite early. We haven’t told anyone.”
“Well, we would love to have Dr. Turner on board too.” Dr. Spiner smiled. “She’s a fine surgeon and I was going to ask her first if I’m honest. She’d make an excellent OB/GYN Attending here. I would love to have her.”
Elias held up his hand. “She wants to stay with Dr. Wilder. So do I.”
Dr. Spiner nodded. “I understand. Well, if you two ever change your mind, San Francisco is a great place to raise a family.”
“Thank you, Dr. Spiner.”
Elias rubbed his temples as Dr. Spiner walked away.
What did you just do?
The one thing that Adeline had asked him not to do was tell anyone about her pregnancy, not until after the fellowship had been decided, and he’d done the exact opposite.
He’d let it slip.
He just had to hope that Adeline didn’t find out, that no one said anything to her, because he’d broken her trust.
And he knew that trust was very important to Adeline. He was angry with himself. He might have just ruined everything.
And the thought scared him.
The thought that he might lose it all.