NICO DIDN’T KNOW whether to consider it good news or bad news. The army engineer was a stand-up guy who not only brought equipment to survey the damage but also a small crew that could work to repair it. The bad news was that there was a crack in the foundation, probably caused by the tsunami and exacerbated by the hurricane. The good news was that the crew could seal it, shore up the wall that had fallen, and the rest of the building was stable. They recommended fixing the foundation and letting it dry before bringing anyone into the building. So the hospital would be out of commission for at least two days.
While the men went to work, Nico checked in with Maria. There was rain in the forecast, but no storms. The DMAT and PHS teams had plenty of tents to house the current patients, especially if they could use the lawn space closer to the building.
The main problem was preparing the surgical facility for Kat and finding a generator for the ECMO machine, ventilators and other medical equipment that were about to run out of batteries. The generator the DMAT team had brought was low on gas and there were no propane tanks left on the island.
“We have to bring the patients in.” Nico told Maria. “The engineers said the building is still solid, and we can put them on the west side, away from the damaged section.” There were solar panels on the roof that had been repaired, so the hospital itself had electricity.
“Nico, the man said it’s not safe to have people inside while they’re repairing the foundation in case something goes wrong.”
“We don’t have a choice. We can keep them outside as long as possible, but Kat needs surgery. She’s not getting off the island.”
Maria chewed on her lower lip. “Tom says if we say the word, he’ll override the priority list for the medical transports.”
“What should we do?” He’d always valued Maria’s judgment and he knew his judgment was colored by Anna.
“Mrs. LaCosta had a stroke and she needs out. She’s next on the list. You remember Ryan Louis? That kid who scored the touchdown in the last game against CNMI? He needs neurosurgery.” She was conflicted, and so was he.
“It’s not the right thing to do, Maria. We can’t play with people’s lives like that.”
She sighed wearily. “I know. But if something happens to Kat, Anna will never forgive you.”
He didn’t need to be reminded of that fact. While they had reconciled, he and Anna hadn’t talked about her moving back to the island. They needed some breathing room before making that decision. It had been Maria’s idea to offer her the CMO position, but he’d had the same thought days ago when they’d first discussed it. He’d gone to Tom to ask him to call the mainland to see if they would consider extending her deployment.
But he’d watched Anna’s face when Maria made the announcement. Nico hadn’t wanted to do it publicly, but Maria had insisted that Anna would hear the encouragement of the crowd and get swept away. Instead she’d looked panicked. Like the reality of her decision to be with Nico was crashing down on her.
“We have to show Anna that she’s wrong.”
Nico spent the next hours talking to every doctor who had arrived on island and each relief organization that had the capacity to bring people in. Nobody was an ob-gyn and everyone agreed that while losing the baby would be a horrible outcome for Kat, there were more urgent situations on the island. Some people who had suffered semiserious injuries days ago were now in critical condition due to the ongoing shortages of drugs and medical supplies. The Red Cross had set up a field hospital on the other side of the island and medical command was sympathetic with Nico but couldn’t offer any more support. They had even fewer doctors, nurses, supplies and surgical facilities than he did. They were using a tent for their surgical suite with bare-bones equipment.
But he had to find a way to save Kat’s baby. His marriage depended on it.
* * *
IT WAS PAST midnight when Anna finally saw Nico again. She was with Baby Emma, who was breathing on her own after being weaned off the ECMO. Emma, Troy and Aurelia were the only ones with Anna in the eerily quiet NICU.
“How is she?” he asked.
Anna sighed. “We won’t be able to tell for a few more days. She’s come off the machine well, she’s breathing on her own and her heart is pumping. Now we just have to see if it can stand the workload, and make sure she doesn’t get an infection.” That was one of the big reasons they’d brought Emma inside, despite the ongoing repair work.
“Can I hold her?”
Anna smiled at Aurelia. She wanted the other woman to be able to hold her baby without Emma being attached to machines. She held up her finger, then worked inside the incubator to cap off her IV line. Emma would continue needing intravenous medications, so they couldn’t take the line out, but Anna could disconnect her temporarily. Checking to make sure Emma was oxygenating well, she also disconnected the tube in the baby’s nose.
Picking up the little baby, Anna felt her wiggle and move in her arms. It had been well over five years since she’d held a baby like this. Anna was having trouble counting the exact number of days. The little movements of Emma’s body should have seized her with panic, but all she felt was happiness. Emma gurgled, her little arms and legs working furiously, like she was excited to be awake and off the machines. She was alive and wanted people to know it. Nico was beside her, ready to take the baby from her if she wanted. His eyes plainly said what was in her heart. She had paid the penance for Lucas’s death.
Handing the baby to Aurelia, Anna watched the young woman kiss her daughter, letting the tears flow down her cheeks. Emma reached up to touch her mother’s face with her chubby hands, and Aurelia kissed them.
“Thank you.” Troy said the simple words with such deep emotion that Anna’s tears flowed with his.
Emma’s wails had them all laughing. “I think after days of IV nutrition, she’s ready for her mommy.” Anna smiled at Aurelia and touched Nico’s arm so they could leave and let the parents enjoy their baby.
On the way out, she instructed the nurse to put Emma back in the incubator after a few minutes. She wasn’t totally out of the woods yet.
“You did it,” Nico whispered and pulled her into his arms. Resting her head against his chest, she felt the beat of his heart. She needed him to hold her, to not have to deal with the flood of emotions on her own.
“Holding Emma like that...” Her voice cracked.
Nico stroked her hair, “I know you’ve always wanted a big family.”
And she still did. Somewhere in the past five years, she’d lost track of what she wanted out of life, what the future would hold for her.
“I still do.”
“It’s not too late for us,” he said softly. His lips were soft against her ear, his voice pleading. He’d told her that as an only child, he’d always wanted a house full of kids. When they renovated the house in Tumon, they’d converted one big room into two smaller bedrooms. Two girls and two boys. But what would happen if she had another baby with a heart defect, or God forbid the child fell and had a head injury? The mortality rate for children under five years old was high in Guam. Injuries that children on the mainland recovered from couldn’t be treated on the island.
“I can’t go through what happened with Lucas again. Or with Emma. And look at Kat now. If we were on the mainland, even in the middle of a disaster, a cerclage would be a routine procedure.” She stepped out of his embrace. Nico had a way of making her feel like anything was possible, but she lived in the real world.
“I know what you’ve been trying to do here, but you can’t possibly get every single specialist you ever need right when you need them.” He looked pained, and she understood. They were back where they’d started. The reason she’d left to begin with.
“Anna, look around. Five years ago a hospital like this would have been impossible. If people like us, people who can make things happen, leave for the mainland, life will never improve here. Together we can make this community whole.”
What was she supposed to say to that? That despite working in poorly resourced areas for five years, in extreme situations, she still hadn’t come to the point where she was okay with it? That she was willing to sleep on cots, expose herself to the worst diseases in the world, eat MREs for months on end, but she still couldn’t bring herself to face the notion that someone she loved could die and she wouldn’t be able to save them.
“I can’t sacrifice any more.”
“I’m sorry to interrupt.” Both Nico and Anna turned to see Maria standing there. She was wringing her hands, and the stricken look on her face told Anna she was there to give them bad news.