He could tell by Cheryl’s face that his problems had gotten worse overnight. She handed him the computer sheet with the latest lab results and sat down in the chair by his desk, putting her feet up on the other chair. He felt her blue eyes on him as she waited for him to react.
He studied the sheet for a long time, as if he could change the numbers by concentrating. “Well,” he said, “I guess inducing labor would be just short of infanticide.”
Cheryl looked calmer than he felt. “If her pressure goes any higher, you’ll have to choose between that and matricide.”
She was only half joking, maybe not joking at all. He hated these decisions about any patient. That it was Kit terrified him. His judgment was clouding over.
“The nurses are getting nervous, Cole. They’re afraid she’s going to seize.”
She was thinking he’d waited too long to start the mag sulfate. He wondered about that himself.
“Cheryl”—he leaned across his desk toward her—“I don’t want to deliver her until I have no other choice.”
“I don’t understand what you’re waiting for.”
This was what he usually loved best about Cheryl—the way she’d stand up to him, make him think. But right now it irritated him.
“You seem to be thinking only of Kit,” he said.
“And you’re thinking only of the baby.”
Was it his imagination or was Cheryl giving him dirty looks in his office examining room? He hoped his patients couldn’t pick up the tension between them. The nurses on the unit were grumbling about him. That he knew for certain. Cheryl was keeping it no secret. Maybe they were right. Maybe he was overcompensating for his tie to Kit. He wished he could extricate himself from the whole mess. He could stand off in a corner and with complete objectivity say, this is what should be done.
“My head is killing me.”
He lowered the railing and sat on the edge of Kit’s bed. “I’ll get you something for it,” he said.
“How am I doing otherwise?”
He shook his head. “Not so good. I’ve decided to induce you.” He’d made up his mind at lunch. He’d done all he could for that baby. She was on her own now.
Kit looked at the ceiling. Her eyelids were so swollen that he couldn’t have guessed the color of her eyes.
“I’m worried that Alison won’t make it.” She looked at him and he guessed she was hoping for reassurance.
“She’s doing surprisingly well inside you,” he said. “That’s why I’m hesitant to induce. But since you’re—”
“What if I said no? What would happen?”
“Convulsions are a strong possibility.” He didn’t mention stroke or coma. See if convulsions would be enough for her.
She sighed. “Oh, shit.”
“And your baby will run into problems getting enough oxygen.”
She played with the wire to her call button. “My baby’s not even born and I’m already a lousy mother.”
“Don’t do that to yourself.”
She pulled a tissue from the box at her side and blew her nose. “So what happens now?”
“We’ll add some Pitocin to your IV to bring on your labor.” He should warn her that it might not work. “Your cervix isn’t very favorable for induction so you may not be able to deliver vaginally even with the Pitocin.”
She frowned. “A section?”
“It may be our only option.”
Her contractions didn’t start for nearly an hour, but when they did they were just what he had hoped for—hard and fast.
She was miserable. He felt sorry for her. She told him she felt trapped. He sat on her bed and smoothed the damp curls off her forehead. Every part of her body was hooked up to something. She was trapped.
“The pain is worse than I expected,” she said.
He nodded. “The anesthesiologist is on his way.” They would both be more comfortable when she had some pain relief.
“I’m sorry I’m such a shitty patient.”
He smiled. “You’re not.”
“Yes, I am. I’m a shitty patient and a shitty mother and a shi—” She gasped with the sudden grip of a contraction.
He watched the monitor. “Breathe through it, Kit,” he said. “Don’t hold your breath.”
She went limp as the contraction ended, tears rolling down the sides of her face and into her hair. “I’m not ready for this, Cole,” she said.
She was right, in more ways than one. Her cervix wasn’t performing, still thick and closed. He’d be amazed if this worked. “Listen”—he leaned closer to her ear—“I have to get back to the office. I’ll stop in between patients.”
She grabbed his sleeve. Her eyes asked him how he could leave her.
He looked at his watch. “It’s three o’clock,” he said. “My last patient’s at four-thirty, and then I’ll be all yours.” He squeezed her hand. “I’m just down the hall.”
He couldn’t concentrate on his patients, shouldn’t even charge them for their visits. He saw Kit between appointments. There was little change, except that each time he saw her she looked at him with more fear in her eyes, more awareness that the induction wasn’t working.
He found Jay in the lounge. He poured his tenth cup of coffee of the day and sat next to him at the table. Jay watched him expectantly.
“Here’s the picture,” Cole said into his coffee cup. “She’s been having good contractions for a couple of hours, but her pressure’s still up and her cervix isn’t doing a thing.”
“If it were some other patient, what would you do?” Jay was whispering. There were other people in the lounge.
Cole took a swallow of coffee. It tasted like iodine. “It’s not some other patient,” he said.
Jay rested his hand on Cole’s shoulder. “Are you all right?”
Cole shut his eyes and felt his head spin. “I’m playing with fire here unless I do a section.”
“So section her.”
Was it that simple? He looked up at Jay. “Would you assist?” They rarely operated together anymore, but right now he wanted Jay with him.
“I was hoping you’d ask.”
There was chaos in the hallway by the labor rooms. One of the nurses grabbed his arm. “She’s seizing.”
It was like a scene from a horror movie. Kit’s arms and legs thrashed in spastic rhythm; saliva ran from the corner of her mouth.
“Start the Valium,” he said hoarsely.
Alison Peters was working with the IV tubing. “Already have,” she said without so much as a glance in his direction. An older nurse he didn’t know leaned over Kit, watching her body rock convulsively on the bed.
He should have started the mag sulfate sooner. Not that it would have been any guarantee.
“Give her a bolus of mag sulfate,” he said.
“Yes, Doctor,” said Alison.
He watched helplessly, gripping the metal arm rail of her bed. He tried not to think about what the seizure might be doing to her. To the baby.
Kit’s violent movements subsided and he felt his own body go limp. His knees were about to give out, but he had no time to waste. The gurney appeared, and he and Alison lifted Kit onto it and raced down the hall to the OR.
It was the quickest section he could ever remember doing. Even with Jay assisting—Jay who only performed c-sections these days when Cole asked him to—it was smooth sailing. They were perfectly matched today—Cole with the greater knowledge of the procedure. Jay with the calmer approach. They balanced each other. When they were finished and the pale, limp baby girl had been rushed off to the Intensive Care Nursery, it was all he could do to keep from telling Jay he loved him. It was the closest he’d ever come to getting those words out.
The house did not look welcoming as he pulled into the garage. The windows were dark, except for those in the living room, and no one had turned on the front lights. He felt his way across the gravel driveway in the darkness.
Janni, Maris, and Rennie were in the living room, but the house felt empty. Jay was still at Blair, and Kit was lying asleep in the recovery room of the Maternity Unit, unreachable. She didn’t exist for him tonight.
He wanted to be surrounded by friends. Friends who wanted nothing of him other than his quiet company. Friends who would massage the knots out of his shoulders. He was too tired, too empty to offer anything in return.
But as he stood near the front door, looking into the expectant faces of his three housemates, he knew that he would not find what he wanted here. There was too much tension in this room.
“You’re back,” he said to Janni. She was wearing a San Francisco T-shirt.
“I missed the whole damn thing, didn’t I?” she said. “I called the hospital and Jay said there wasn’t much point to my coming over, that Kit’s out of it. How’s the baby?”
“Not good.” He looked around the room. He felt disoriented. “I need milk,” he said.
“Well, get your milk and join us,” said Janni. There was a curt snap to her voice. He pretended not to hear it, as if ignoring it would make it go away. He needed Janni’s warm side tonight.
“I don’t know.” He buried his hands in his pockets. “I’m exhausted. I might just go to bed.”
“But we want to hear about the baby,” Rennie whined.
And I don’t want to talk about it.
“Come on, Cole, stay with us a while,” Maris pleaded.
“Okay,” he said, against his better judgment. “For a few minutes.”
He went to the kitchen and returned with a glass of milk.
“The baby’s not going to die or anything, is she?” Rennie asked as he sat next to Maris on the couch.
He shrugged. “I don’t know. She could. She has severe respiratory distress.”
“That’s crazy,” Rennie said. “Babies don’t die.”
He felt as if she were blaming him.
“Poor Kit,” said Janni. “It must have been horrible for her.”
He nodded and leaned back. He couldn’t sit up on his own any longer. “Yes, it was,” he said. “For me, too. I made a decision that I’m never going to do this again. I won’t have a friend as my patient.” He’d felt enormous relief when he’d come to that conclusion. As soon as Kit was back on her feet, he’d refer her to someone else.
“Where does that leave me?” Janni asked.
“There are plenty of good gynecologists around, Jance.”
“I have no say in the matter?”
“Janni.” He sat forward and frowned at her. “Have a little compassion, okay? I don’t think I use my best judgment when I’m making decisions about a friend’s welfare.”
Janni was quiet, but only for a moment. “Cynthia called this afternoon,” she said.
He groaned. Cynthia. “Did you explain to her that I didn’t intentionally stand her up last night?”
Maris squeezed his arm. “She knows that, baby.”
“You could have called her,” Janni said.
“It was just about the last thing on my mind.”
“I think she’s figured that out. She’s catching on that when it comes to Kit she’ll always have to take a back seat.”
He felt his face redden. “That’s not true. My mind’s on Kit right now, but . . .”
“But what?” asked Janni. “How can you expect to have a normal relationship with another woman if you come home and tell Kit everything that went on with her? That was the problem with Estelle too, wasn’t it?”
He felt backed into a corner. “Why are you being such a bitch?” he asked.
“Really, Cole, it’s so unfair to Kit.” Janni plowed ahead. “She’s never going to get something going with Orrin or any other man as long as you keep her as your confidante. When are you going to admit to yourself that you care more about Kit than anyone else in the world?”
Cole set his milk on the coffee table and stood up. “I don’t get why you’re doing this to me,” he said.
“Why didn’t you call me?” The tears started down Janni’s cheeks, and he looked away. He didn’t want to feel any sympathy for her. “I promised Kit I’d be there for her and you cut me out.”
“Janni, if you’re angry with me, why don’t you just say it instead of throwing all this other shit my way?” He didn’t wait for her answer. He turned and headed for the stairs, for the haven of his room.
It was a long time before he fell asleep. He couldn’t get Janni’s words out of his mind. She was right. He used Kit. He’d go out with Cynthia, have a good time, come home, and use Kit as his therapist. And she did the same with him. He’d made her dependent on him.
Tomorrow he’d start fresh with Cynthia. He’d tell her everything that came into his head. He hadn’t given her a chance to get close, really.
And he would cut back on the time he spent with Kit. This would be the perfect time to do it. She was out of the house. She was no longer pregnant. It would just be one change among many for her.
The phone woke him from a sleep that left him more tired than refreshed. Someone in another part of the house answered it, and he lay still waiting. The clock on his night table read quarter to six. A bad sign. Let it be the baby and not Kit.
“Cole!” It was Janni, calling him from downstairs. She must not have slept well either. Good.
He picked up the receiver. “This is Cole Perelle.” The rasp of his voice surprised him.
“Dr. Perelle, this is Valerie in the nursery. I wanted to let you know that the Sheridan baby died about an hour ago.”
He shut his eyes. “Does her mother know yet?”
“I don’t think so.”
“I’ll be right there.”
They’d moved her to a private room on the Maternity Unit. It was small and sterile and smelled antiseptic.
She was inhumanly pale, her lips white and papery. She smiled weakly at him. “Hi,” she said.
He sat on the edge of her bed and took her right hand, the one that wasn’t attached to the IV. “Hi.” He leaned over and kissed her warm cheek.
“Is today Friday?”
“No. It’s Saturday. About seven-fifteen in the morning.”
“I lost a day somehow.”
“Yesterday was a hard one for you.” He touched her hair, smoothed it away from her face with his fingers. It was the only color in the room.
“Did Janni get back yet?”
“Yes, last night. She was upset about not having been here for you.”
“Tell her not to worry about it. How’s Rennie?”
“Okay. She misses you, but she’s doing all right.”
She smiled a little and turned her eyes away from him.
He had to tell her now. He opened his mouth but she stopped him.
“Jay helped yesterday, didn’t he, or did I dream that?”
“Yes, he assisted,” he said.
She looked at the ceiling and blinked hard. “The longer I keep you talking about other things the longer I can pretend Alison’s all right.” She looked at him then, waiting for him to speak.
He tightened his grip on her hand. “She died this morning, Kit.”
“No! Shh, please!” She pulled her hand away from his to cover her ear.
“I’m sorry.”
He waited while she cried, her face as colorless as the sheets.
“I didn’t even get to see her,” she said.
“You can. As soon as you feel up to it we can bring her over for you to see.”
“Today?” There was childlike hope in her voice.
“I think tomorrow would be better.” He wasn’t being fair. She was probably ready right now. He was the one who wouldn’t be able to handle it today.
“Don’t let them do an autopsy until I get to see her.”
“They won’t. You have to sign for an autopsy.”
“But what if they do it by mistake?”
“They won’t, sweetheart.” He touched her cheek and his fingertips came away wet.
“But what if she really wasn’t dead and they thought she was and they put her in the refrigerator and she—”
“Kit.” He leaned down and took her in his arms. “She died, honey. Alison’s dead. Her lungs weren’t ready.”
“I shouldn’t have run.” She sobbed against his neck. “She’d still be safe inside me.”
“That has nothing to do with it.”
“But if only I—”
“Shh.” He rocked her gently as if she were a child, not wanting her to say another word. “It’ll be all right.”
Cynthia sat across from him at dinner, in a soft, appealing gray pantsuit, her eyes never leaving his face as he told her about the past two days. She reached across the table to take his hand and murmured words of sympathy, and he began to feel manipulative. It was like flicking a switch, the way he could get her to care about him.
After dinner they went back to her house and made love. She lay smiling in his arms afterward, and he softly scratched her back, but his mind was on Kit. He hadn’t spoken to her since that morning when he’d told her about the baby. He’d called the unit a few times to check on her condition, but he deliberately avoided calling her. Janni said she’d spend the afternoon with her. That was better. She should have a woman with her right now. He’d only be a reminder of yesterday’s nightmare.
They were eating pizza at the kitchen table when he got home.
“Please join us,” Janni said.
“I’m not a masochist.”
“Give us a chance to make up to you for last night,” said Maris.
Rennie’s face was turned up to him, anxious little lines etched around her wide blue eyes.
“Sit down, Cole.” Jay pulled out the chair next to him, and Cole lowered himself into it, inside an invisible suit of armor.
They obviously had a plan. They went around the table in order, competing with each other in the eloquence of their apology. They were sorry for not giving him more support, they said. He felt hard and annoyed. He listened without comment. Janni spoke last and there was an almost hysterical quality to her voice as she begged him to forgive her. He thought of telling her that the wedge she’d pounded between them would take a long time to dislodge, but she wasn’t worth the strength it would take to get the words out.
When she was finished, Cole let them stew for a minute in silence. “Are you all through?” he asked finally.
They nodded.
“Good night, then.”
He rose and walked toward the stairs, pleased by the vibrations of disappointment he left behind him. In the morning he would be kind. But for tonight, there was no other way.