AN URGENT KNOCKING roused Adeline out of her sleep. The sun was streaming in the window and she was curled up against Elias, who was sleeping still.
“Uncle Elias, Dr. Turner!” Manny’s voice was panicked on the other side of the door.
“Elias.” Adeline shook him awake. “It’s Manny!”
Elias startled awake and jumped out of bed, pulling on his clothes, as Adeline did the same.
Elias dashed across the room and opened the door. “Manny, what’s the matter?”
“Mom went into labor, but it rained last night, and a road is washed out. The ambulance can’t get here and something’s wrong.”
“I’m on my way, Manny.” Adeline grabbed her medical kit and dashed out the door to Rosa’s room.
A terrified Flora was with Rosa, who was in agony and incoherent.
“Rosa, it’s Adeline. When did your contractions start?” Adeline was washing her hands in the en suite bathroom.
“I don’t know... I woke up in pain,” Rosa cried out.
“Manny came to get me,” Flora said.
Elias entered the room, and Adeline could feel his worry. “What can I do?”
“Support her, Elias,” Adeline whispered. “I don’t know what’s going on, but we need to get an ambulance here. I have nothing to monitor the baby... I don’t know what’s going to happen.”
Elias took Rosa’s hands as Rosa cried.
“Manny, maybe you should wait outside?” Adeline suggested.
Manny nodded. “I’ll keep calling for help.”
Adeline smiled encouragingly. “Yes. Do that.”
She grabbed an ottoman and sat at the foot of the bed to check, and she could see the baby crowning. This baby was coming, fast and furious.
“Rosa, do you feel any contractions?” Adeline asked.
“A bit...” She moaned.
“On the next one I need you to push for me.” Adeline got up and placed her hand on Rosa’s belly, feeling for it herself. “Okay. Push. Get angry, do it, and push for me.”
Elias climbed behind Rosa to hold her shoulders as Flora helped support her daughter’s legs. Adeline watched the baby.
There was more blood than she would have liked, but there was no stopping this baby. She was on her way.
“Okay, push again!” Adeline shouted.
The baby’s shoulders were delivered first, and then it only took one half push and the little baby girl was born. Silent.
“Why isn’t my baby crying?” Rosa called weakly.
Elias leaped up and helped Adeline rub the baby with a towel, trying to stimulate the little girl. There was a small cry and Rosa smiled, but the baby wasn’t breathing well, and there was a bluish tinge to her little lips.
Adeline glanced up at Elias, and he knew that this baby would need extra oxygen.
“Uncle Aidan got hold of Air Ambulance,” Manny said, rushing back into the room. His eyes widened on his little sister, barely crying and being held by Elias. Then Aidan entered the room. Elias stiffened at the sight of his brother.
Aidan’s gaze locked on Elias holding the little girl. There was a palpable tension, but they didn’t say anything to each other.
Elias handed his niece to Rosa.
“She’s beautiful,” Flora cried.
Adeline’s heart sank, because the baby needed urgent help. She was glad Air Ambulance was on its way.
“Rosa, we have to get the baby to the hospital,” Elias said gently.
Rosa’s eyes filled with tears as she glanced down at her daughter. “I know. I want you to go with Gabrielle, Elias. Please.”
Aidan stated, “Rosa, I promised Jeffery that I would accompany you to the hospital.”
“I should go. I’m the neonatologist,” Elias snapped. “I’m the one with pediatric resuscitation training.”
Aidan’s eyes narrowed. “I haven’t forgotten.”
“Enough!” Flora snapped. “Elias will go with Gabriella! Aidan, you can stay with Rosa while Adeline takes care of her and we wait for the air ambulance.”
Aidan looked at her, but barely. His cheeks were flushed because he’d been chastised by his mother. Adeline could hear the helicopter outside.
“I’ll go let them in,” Aidan stated. “Come on, Manny.”
Manny followed.
“Elias?” Adeline motioned for Elias to come closer while Rosa and Flora doted over Gabrielle. “Do you think there’s room on that helicopter for Rosa?”
“I don’t know. Why?”
Adeline showed him. “She’s hemorrhaging. I can’t get it to stop. I suspect a rupture. She’s vulnerable after her C-section.”
Elias went pale. “I’ll go speak to the paramedics. Do what you can.”
Adeline nodded. She was remaining calm, because she didn’t want to alarm Rosa or Flora, but Adeline knew. Rosa had had a large baby and a previous C-section. The placenta wasn’t releasing, and Adeline suspected a tear.
The paramedics came in the room with an incubator. And thankfully they also had a stretcher.
“We have room to take them both, but only room for one other person to accompany them to the hospital.”
Elias glanced at Adeline. “You need to go.”
“You’re the pediatrician,” Adeline said.
“There are NICU doctors there at the Napa hospital. You need to go and take care of Rosa.” Elias was right. She could do the surgery to fix the repair.
Elias helped the paramedics get the baby in the incubator and on oxygen, while Adeline kept an eye on Rosa, who was becoming weaker.
Adeline stood up. “Uncontrolled bleeding. We need to start fluids and oxygen.”
The paramedics nodded, and Adeline stood back as they lifted Rosa onto the stretcher. Adeline helped as they stabilized her, and she followed the stretcher out to the helicopter. Elias was waiting, the baby’s incubator already loaded.
His father and Aidan stood close by with Manny.
Rosa was in distress.
“I’ll follow in the car,” Elias said to Adeline. He looked broken. “Just save my sister.”
Adeline nodded. “I will.”
They loaded Rosa into the helicopter and Adeline followed. The doors were shut, and she slipped on the headphones.
The helicopter whirred to life and began to lift off.
“Adeline,” Rosa murmured. Adeline took her hand and held it.
“I’m here,” she reassured Rosa.
“Don’t let me die.”
Adeline’s throat clenched and tears stung her eyes. “I won’t.”
She would make sure of it.
Elias felt like his heart was breaking as he watched that helicopter take off. His mother had buried her head in his father’s shoulder, and his father’s arm was around Manny. Aidan stood there scowling, and Elias didn’t have the patience to deal with him.
He had to get to the hospital.
As soon as the helicopter was away, he turned and marched back into the house. He had to put his shoes on, grab his keys and get himself to the hospital. He had to be there for Rosa and Adeline.
Although he wouldn’t be able to assist in the surgery.
“Where are you going?” Aidan demanded, following him in.
“Where do you think I’m going?” Elias asked. “I’m going to the hospital.”
“What? As support for Rosa? You haven’t been home in two years! I’ve been looking after Rosa and Manny since you stopped coming around. When Jeffery was away on business, I’m the one that stepped in while you flounced off to medical school. I was always here.”
Elias glared at his brother. “Flounced off to medical school? Hardly. I followed my dream. You always wanted to run this vineyard, so I let you have it!”
Aidan smirked. “Oh, you graciously let me have it.”
“Yes. And how did you repay me, brother? You married the woman I loved.”
“I didn’t steal her,” Aidan spat out viciously. “You abandoned her like you did the rest of us. I was there when you weren’t.”
“We grew apart. I didn’t abandon her!”
“Yes, you did. You can’t accept when you’re wrong.” Aidan got right up in his face, infuriating him.
Elias pushed Aidan away and Aidan shoved him into the wall. Elias had been waiting so long to do this, but the thing was, the fight wasn’t about Shea anymore.
He didn’t care that Aidan had married Shea. He hadn’t for some time. It was an excuse.
He was angry about losing his brother.
He was angry that he had lost his family all this time, and that wasn’t Aidan’s fault. It was his own. He was mad at himself.
Elias didn’t want to fight, but it was apparent that Aidan did.
“Stop it!” his father shouted, coming into the room, breaking them apart. “Stop it! The pair of you, behaving like animals when your sister’s life is in danger.”
Aidan let Elias go and walked away from him, leaving Elias leaning against the wall.
“What is the matter with you?” Jimeno demanded.
“Nothing is the matter with me,” Elias snapped. “He’s the one who said I was abandoning the family.”
“You did,” Jimeno said, but then he turned on Aidan. “You don’t think that Elias has a right to be mad at you? You stole the woman he was supposed to marry. I know they had drifted apart and were no longer in love and that it all worked out, but you always had to have what Elias had. Thankfully, Elias has found a new fiancée, but you broke his trust.”
Elias was shocked by his father’s words. Then the guilt overtook him.
He was done trying to prove himself to them.
“Adeline is not my fiancée. She is my work partner and is carrying my child, but she’s not my fiancée,” Elias said.
Aidan smirked. “Always trying to be better than me and you’re still the same, Elias.”
“You’re right, but I’m not the same, Aidan. Not anymore.”
“Quiet. The pair of you. You’re brothers but you act like enemies. You’re both a disappointment to me right now.” Jimeno glared at Aidan before turning to Elias.
“Elias, I may not have agreed with all your choices in life, but you clearly care for Adeline. If she is pregnant with your child, you need to make this right.”
Elias didn’t say anything else. He didn’t know what to think. All he knew was he had to get to the hospital. He would have NICU privileges and he wanted to make sure that Adeline was supported.
“I’m going to the hospital,” Elias grumbled. He headed down the hall, then quickly cleaned up, changed and got his wallet and keys.
Aidan followed him. “You can’t drive to Napa.”
“I may have been away for two years, but I know how to drive,” Elias grunted.
“No, your rental won’t get through the road closure, but I know the new backroads and my truck can handle it. I’ll drive you.” It was a peace offering in Aidan’s own stubborn way, and as much as Elias didn’t want to accept it, Aidan was right.
It would be better if Aidan drove.
He nodded. “Thank you.”
Aidan’s eyes widened as if he was surprised by the thank-you. “I’ll bring the truck around.”
Elias finished gathering what he needed and then headed outside. Jimeno, Flora, Manny and Shea were already there. Shea was holding on to Aidan and he was whispering something to her.
The way she looked at Aidan was a way she had never looked at him, and Elias couldn’t recall if he had ever looked at Shea like that either.
“Call me as soon as you have news,” Flora said, her voice shaking as she hugged him.
“I will, Mom. I promise,” Elias said.
Elias gave Manny a hug and then got into Aidan’s truck. Aidan climbed in and drove away from the family estate.
Elias could barely look at his brother, but felt he had to break the ice somehow.
“So, why didn’t you come to dinner last night?”
Aidan shrugged. “I thought I would give you time with the family. I see them all the time and I didn’t think you wanted to see me.”
“No. You’re right. I didn’t.” Which was true, but deep down, he’d missed his brother. He regretted the way that they had been so competitive in their late teens. The way they had grown apart and hated each other for all this time.
It seemed like such a waste.
“See, then why ask why I wasn’t there?” Aidan shook his head. “You’re so stubborn!”
“You’re just like Dad!” Elias snapped back.
Aidan glared and then laughed. “Yeah, I suppose I am.”
Elias found himself laughing too.
“Except I could never measure up to you, and Mom and Dad have never let Shea or me forget what we did to you.” Aidan sighed. “It’s just you...”
“I was never around.”
Aidan nodded. “You left us both. You went off to higher learning and you looked down your nose at the rest of us who worked the land. You made Dad and me feel less than you. No one could hold a candle to you and your great surgical career.”
Elias felt guilty, because his brother wasn’t wrong. When he was younger, he had looked down his nose at the work his father and brother did and the generations that had come before him. All the blood, sweat and tears that went into the land. He had thought he was above all that.
Above getting his hands dirty.
He’d been an idiot. He could see that now.
He’d hurt his father and his brother.
He’d been wrong.
“I was wrong back then.” Elias looked at him quickly. “I’m sorry.”
Aidan’s eyes widened. “I think that Dad was hard on you because he wanted you to push yourself in your medical career. There were no shortcuts to success. You worked hard or you didn’t eat.”
Elias nodded. “And he was hard on you because you were taking over the land. You have to be tough to work it and make it successful.”
“So we’ve spent all these years thinking each other had it easier, when he was really riding us both.” Aidan smiled at him and Elias nodded, grinning back.
“Yeah, only we were both too stubborn to see that.”
“As stubborn as he is,” Aidan said.
They rode the rest of the way in silence. Things still weren’t resolved between them, but they were better.
They were on the right road.
Elias could adapt.
He was a surgeon. And being a surgeon meant a lot of adaptability. If he could only convince Adeline how important it was to do the same.
“You trained with Dr. Wilder in San Diego?” the head of obstetrics, Dr. Lyttle, asked as they scrubbed in while Rosa was being prepped in the operating room.
“I still am,” Adeline stated.
“I’m glad you’re here,” Dr. Lyttle admitted as she continued to scrub. “And here I thought it was going to be a quiet Sunday.”
Adeline smiled. “Thank you for allowing me surgical privileges.”
“Of course. It’s not every day we see a uterine rupture, and I’m glad to have the extra hand. Your sister-in-law has lost a lot of blood.”
“She’s not my sister-in-law.”
Not yet.
“Oh, the patient said you were.”
Adeline shook her head. “She’s a bit of a matchmaker. Her brother is my colleague in San Diego. It’s a long story, but there’s no family relation. I can operate.”
And Adeline wanted to be there for Rosa, just as she had promised when Rosa was crashing before the ambulance came.
Don’t let me die.
That voice so small, so haunting, had lodged in her brain, and she wanted to be with Rosa every step of the way. She didn’t want to let the Garcia family down.
She didn’t want to let Elias down.
Adeline finished scrubbing in and headed into the operating room, following Dr. Lyttle. A scrub nurse helped her get on a gown and gloves.
“This patient is thirty-five-year-old Rosa Adler. Spontaneously delivered a ten-pound infant today during a VBAC. Her last child was born fifteen years ago in a crash C-section. There was a lot of bleeding after birth and the placenta did not detach. Suspected uterine tear, possible rupture,” Dr. Lyttle said, informing the residents, nurses and other staff in the operating room. “Dr. Turner will be leading this surgery, as per the patient’s wishes.”
“Thank you.” Adeline took a deep breath. The energy in the room was off and for the first time, she needed a moment. “Could we all just take a minute and meditate? This is a life in our hands.”
She closed her eyes and dropped her head. She just needed a moment and Rosa was stable, for now.
This was something Dr. Wilder never did, but right now Adeline needed to ground herself. She needed to connect and change the flow of energy to calm her nerves as she operated on the sister of the man she loved.
And she did love Elias.
“Thanks, everyone. Let’s save a life.” Adeline stepped up to the operating table, and the scrub nurse handed her the scalpel.
Adeline knew what to do. She’d been so focused on Dr. Wilder teaching her for years, but really, she’d assimilated all she needed to know.
There was still more she could learn, but for the first time, she was confident here.
Here, at this table, she was an attending surgeon. She drained everything else from her mind. Her pregnancy, Elias, the spot with Dr. Wilder, TTP.
She focused on Rosa. She focused on the patient she was going to save. She had never been so sure about anything in her life.
There weren’t many things she was sure about, but she was sure of this.
And she could do it.
Elias was pacing in the hall. He wasn’t allowed into the operating room, so to kill time during the surgery, he went to the NICU to check on his niece, Gabrielle, where he was given access. He put on a gown, mask and gloves.
It reminded him of when Manny had been born.
Only then, he’d been a fifteen-year-old boy, and that had been the moment when he decided that he was going to be a neonatologist and a pediatrician.
It was the need to prove himself to his father, to his brother, to show them he was worth more than what they thought of him, that had made him push himself so hard to get a place in Dr. Wilder’s program, but this was where his true passion lay. The NICU, working with these ill babies. This is where he belonged. He could see that now.
He didn’t need to keep chasing the biggest and the best things.
He’d had it all along.
He didn’t need that spot.
And as soon as he got to San Diego he was going to give it up. He was going to step back. Adeline should be the one who had the fellowship with Dr. Wilder.
She had a passion for birth.
For saving both mother and child, connected, when they were most vulnerable, and he was so thankful that he had listened to Adeline.
That he had listened to her instincts.
He didn’t even want to think what about would have happened if they hadn’t been there for Rosa and sweet little Gabrielle.
It was too terrifying to dwell on and it made him feel so guilty that he hadn’t been home in so long. That he had walked away from his family because his pride had been hurt.
What an idiot he had been.
He made his way to the incubator and smiled down at his niece all hooked up. She had dark hair like her mother.
“Gabrielle,” Elias whispered. And he reached into the incubator to take her tiny fist, balled around a sensor.
“You’re Dr. Garcia?”
Elias spun around to see a gowned doctor standing behind him. “Yes.”
“I’m Dr. Richardson. Head of neonatology. I’ve been informed your sister is still in surgery, so I’m hoping I can talk to you about your niece?”
“Of course, Dr. Richardson.” Elias’s heart sank.
“We want to airlift the baby to San Francisco. As you are aware, the baby had a PDA, but it’s quite large. We’re frankly amazed she survived birth.”
Elias swallowed the lump in his throat. “You want to do heart surgery on her?”
Dr. Richardson nodded. “The children’s hospital in San Francisco is better equipped to do that procedure, and the pediatric cardiologist is one of the best in California. We need to send the baby right away. We can’t wait for the mother to give us permission, but we did get hold of the baby’s father and he told us to do whatever it took.”
“My brother-in-law is correct, and I’ll make sure that Rosa knows what’s going on with the baby when she gets out of surgery.”
“Thank you, Dr. Garcia. We do need someone to accompany the baby to San Francisco.”
“My brother, Aidan Garcia, can,” Elias offered.
“That’s great.”
Elias stood back to watch as Dr. Richardson and his team prepared everything they needed to get Gabrielle back into a medical helicopter. Elias left the NICU and made his way down to the waiting room, where Aidan was pacing up and down.
Aidan glanced up. “What?”
“The baby needs to be transferred to San Francisco. Now.”
“Why? What’s wrong?” Aidan asked, panicked.
“Gabrielle’s heart. She needs surgery and they aren’t able to do that here. Not as well as it can be done in San Francisco.”
Aidan scrubbed a hand over his face.
“You need to go with the baby to San Francisco. I’ll stay here and let Rosa know what’s going on, but someone needs to go with Gabrielle until Jeffery gets back to California.”
“You’re the doctor. Shouldn’t you go?” Aidan asked.
Elias swallowed his pride. “I may be a doctor, but I am her uncle. There is nothing I could do there. They wouldn’t let me. Go, keep Gabrielle safe. Rosa trusts you. Jeffery trusts you and it should be you. I’ll take care of Rosa.”
Aidan’s hard expression softened. “Thank you.”
Elias clapped him on the shoulder. “They’re waiting for you.”
Aidan nodded and made his way to the NICU to travel with Gabrielle.
Elias’s heart was breaking as he worried about what was going to happen next and how he would break it to Rosa. And he couldn’t stop thinking about how it would feel if Adeline was on the table with the dreaded TTP. What if it was his child who was dying? What if it was his child who needed surgery?
Could he handle it?
He could handle things like this as a surgeon when his family wasn’t involved, but this, this was torture.
His heart was breaking.
And he was scared. He sat down in a chair, his head in his hands, and he felt like he was on the verge of breaking.
So many wasted years.
Not wasted. And you did the right thing.
Although he felt like a fool for having been away so long, and now he wasn’t sure his sister or his niece were going to survive this ordeal.
Adeline is with Rosa. Everything will be okay.
“Elias?” Adeline’s voice came from the doorway.
He looked up and she was in her scrubs.
“Tell me,” he said, his voice shaking.
Adeline smiled. “She’ll be fine.”
Elias smiled, too, and leaped up to kiss Adeline.
Adeline laughed. “That’s not usually how patients’ families greet their surgeons.”
“Maybe it should be,” he teased and kissed her again.
Adeline looked at him gently. “She had a uterine rupture. The scar from Manny’s birth didn’t hold during Gabrielle’s fast, forceful birth. I had no choice but to do a hysterectomy. There was too much damage, but she’ll survive. How is the baby?”
“They’re airlifting her to San Francisco. Her heart...they need to send her to the children’s hospital in San Francisco where pediatric surgeons can operate on her to save her.”
Adeline frowned. “I’m so sorry.”
“I have to tell Rosa.”
“Who went with the baby?” Adeline asked.
“Aidan.”
“Aidan?” she asked, confused.
“Aidan drove me up here. We...talked. I don’t think things are perfect, but they’re better.”
Adeline reached down and took his hand. It felt so good having her hand on his. “I see. I’m glad.”
“I’m going to call the family.”
Adeline nodded. “Call them and then I’ll take you up to see Rosa. We’re going to have to head back to San Francisco sooner rather than later. We have one more case left there. Dr. Wilder is counting on us.”
“Yes.” Although Elias didn’t really care about what Dr. Wilder thought of him, but he knew it was important to Adeline, and he wanted to be close to his niece. He had privileges at the children’s hospital in San Francisco. He might not be able to do anything to help his niece, but he could be there, in the NICU.
Adeline left to change out of her borrowed scrubs and Elias pulled out his cell phone. Once the family was here for Rosa, he and Adeline could take Aidan’s truck back to the vineyard, grab their rental and head to San Francisco, where he was going to tell Dr. Wilder that he was out.
He didn’t want the fellowship.
He knew where he belonged.