“THIS looks bad.”
Roque heard Madeline’s mumbled assessment after she announced the woman’s vitals. His heart sank. He had to agree.
As soon as they’d arrived at Aldeia Marúbo and explained who they were to the villagers, they’d been dragged to this woman’s hut. He couldn’t believe their timing. Another hour and Matcha would have died. She could still very well die.
His troubled gaze moved to her four children huddled in a corner of the hut. He clamped his jaw. They could lose their mother.
Inferno—no. Not on his watch. And they shouldn’t be watching their mother writhing in agony either.
“Inácio,” he rasped. “Get the kids out. And tell everyone to stay out.”
Inácio did so, came back in a minute as Jewel initiated resuscitation measures with Madeline. Roque held back, knowing they had first claim on the patient. Matcha was in deep shock. Treating her severe hypotension was the most important thing to tackle if she was to stabilize enough to withstand their diagnostic and treatment measures.
They finished resuscitation then Jewel started her exam.
“What’s your opinion?” Inácio asked tense minutes later.
Jewel continued palpating the woman’s abdomen and pelvis. “From Montoya’s translations of witness reports, she had sudden lower abdominal pain, vomited, lost consciousness. When she came to she couldn’t move because of pain. She’s now almost unconscious with depletion and shock. Other signs are tense abdomen, guarding, rebound…”
“That’s all ruptured appendix signs!” Madeline exclaimed.
Jewel didn’t answer, put on gloves and performed a vaginal exam, then a bimanual pelvic one. Then she sat back on her heels and announced her diagnosis. “She has placental abruption.”
Roque’s eyes snapped wide at her steady verdict. “Without vaginal bleeding?And we weren’t even told she was pregnant.”
Jewel’s eyes swung to him. “Twenty percent of placental separation cases occur with concealed hemorrhage behind the placenta. And with her size, a twenty-something-week pregnancy could go unnoticed. And she might not have told anyone she was pregnant. I doubt they make much of pregnancies here.”
What was that bleak shadow that flitted in her eyes? Was she remembering her own pregnancy? That she hadn’t made much of it either? Was she regretting that now? Stop it. Focus.
He did, heard Madeline suggesting alternatives. “Couldn’t it be other stuff causing acute abdomen? Intestinal obstruction, ovarian torsion, severe endometriosis—even ectopic pregnancy?”
Jewel’s elegant eyebrows puckered in consideration. Then she shook her head. “No. None of these cause such severe hypotension, which can only indicate severe internal bleeding. Anyway, an ultrasound scan will tell for sure.”
Jewel looked at Roque and he moved forward, trying to pin that expression in her eyes, to understand it, and why it scared him so much. She snatched it out of his reach when she turned her eyes away. He had to, too, to get on with his job.
He forced himself to block her out, moved his ultrasound probe over the woman’s abdomen, watching the images with Jewel. In a minute they both let out heavy exhalations.
“So what’s the diagnosis?” said Inácio.
“Ultrasound just confirmed Jewel’s clinical diagnosis—a fetus, a girl, distressed but alive, around twenty-two weeks and about three pounds. And there’s massive hemorrhage beneath the placenta.” He turned to Jewel. “I was praying you might be wrong just this once. I was hoping this was something I had more experience with. She’ll need an immediate Cesarean section.”
“What about the baby?” Madeline asked.
Roque exhaled again. “We can only hope she’s viable, but the mother is our priority now.”
Inácio looked around the hut, clearly calculating the possible catastrophic consequences of performing major abdominal surgery here. “Can’t we at least move her to the boat?”
Roque again answered him. “I doubt she’d last the two-hour trip. We have to operate, now or never.”
Jewel bit her lip. “I only ever helped in a couple of Cesarean sections during my Ob-Gyn rotation.”
Roque gave a grim nod. “Ob-Gyn almost slipped the net of my experience, too. But I bet we can manage it together.”
Her eyes flared, then darkened. His nerves jangled.
What was that? That immense something he saw before this weird bleakness extinguished her eyes again? Was that something love? If so, why the bleakness?
Jewel tore her eyes away and turned to Inácio and Madeline, rushed to prepare their patient for the emergency C-section.
Roque had to force air into his lungs, had to will his heart to beat.
Was what he’d just seen even real? Or just his feverish hopes superimposed on her expressions? He’d been clinging to his resolution to never rush her again, but he knew he’d never survive losing her again. Not knowing if she might consider making their relationship real, permanent this time, was fraying his stamina. So much so he was beginning to consider ending it. If she couldn’t love him, he should walk away before uncertainty destroyed his mind, drove him to unpredictable behavior.
But he hadn’t imagined that look in her eyes! Or any other ever since they’d become lovers again. Yet how could it be what he hoped, when it was followed by such despondency? Didn’t she want to love him? Did she still think him beneath her? Was that why she didn’t want to admit it, to him, to herself?
Stop it. Drive yourself crazy later. See to your patient.
He turned to Madeline as she and Inácio swooped on him and Jewel, scrubbing and gowning them, then draping Matcha, leaving only the surgical field exposed. Then he and Jewel worked together, initiating general anesthesia.
He took his position by the patient’s right side and Jewel immediately took his assistant’s position, handing him a scalpel. He met her eyes above her mask. They were impassive now. He crushed down the spurt of anxiety, turned his eyes to the surgical field and made a low transverse incision.
He explained his decision. “A midline incision provides quicker access to the uterus but a transverse one carries less risks post-operatively and will provide us with better pelvic visualization.”
She only nodded, helped him extend the incision and deepen it. Once they entered the peritoneal cavity she placed retractors, grasped the loose peritoneum with forceps for him to incise, was ready with a bladder blade to both protect the bladder and provide exposure of the lower uterus.
Their eyes met again for a bolstering moment before he opened the uterus, extending the incision with his index finger, holding his breath at the unaccustomed procedure, until the fetal membranes were revealed. He cut through them and heard Jewel’s sharp gasp. He snapped a look up, found her trembling, her gaze transfixed on the tiny legs he’d exposed.
His heart battered his ribs, at her distress, at the scary sight of the fragile life, at the enormous responsibility. He gritted his teeth, hating to ask this of Jewel. But there was no other way. “Jewel, I need you to take care of the baby once I deliver it. I must devote all I have to the mother.”
Jewel jerked her head in a vigorous nod. He couldn’t spare her another second as he delivered the terrifyingly small girl, handed her to Jewel, double-clamped the umbilical cord and cut it. Then he forgot all about Jewel and the rest as he fought to stem the catastrophic hemorrhage once the placenta released the accumulated blood behind it.
Then he found Jewel fighting beside him again, cauterizing bleeding vessels, suctioning blood, while Inácio and Madeline struggled to keep up with their demands. But nothing was enough. Then the woman flatlined. They dragged her from death’s clutches and fought on. But Roque knew there was only one solution.
“I have to do a hysterectomy.” Jewel’s eyes slammed into him. He rushed to justify his decision, to try to wipe away her stricken look. “It’s the only way to stem the hemorrhage, and she already has four—five children, if this baby lives.”
She lowered her reddened eyes, nodded. Then without another word or look they proceeded with the surgery of removing the enlarged, pulped uterus.
It felt like he’d run a hundred miles as he inserted the last stitch, closing the woman’s skin. Then he raised his gritfilled eyes. They met Jewel’s. They looked as abused as his felt. She turned away, rose and went to the baby where she’d left her.
“Inácio?” He snapped his head around, asking for a report on the patient’s general condition as he followed her.
“BP 80 on 50 but holding,” Inácio said.
“Get her as much blood as you can.” Roque knelt beside Jewel by the tiny baby as she started checking her.
“I only suctioned her throats” she whispered, her voice wobbling. “Checked she was breathing before I rejoined you.”
He was afraid to touch the baby, his hands feeling huge and dangerous next to her spindly limbs. He didn’t need to. Jewel was taking care of her. Her hands looked perfect, magical as she handled the flimsy little life, poured care and healing over her.
She raised cloudy eyes to him, a tremulous smile wavering on bloodless lips. “I believe she’ll live. She wants to live.” She lowered her gaze to the diminutive girl, gave her match-like fingers an ultra-gentle tickle. “Don’t you, little one?”
His throat tightened, images, fantasies, cravings crowding his heart and imagination to bursting. Jewel—his incomparable Jewel, indulgent, proud, crooning to her baby. His baby…
She hadn’t wanted his baby before. But she’d changed. Could this have changed, too? Could she want his baby nows?
He almost scoffed out loud. Sim. Thinking of babies before he knew if she wanted any sort of commitment at all.
But this was what a baby meant to himnow. Her commitment.
Before, he’d wanted to have the family he’d never had, with her. Now he only wanted her. Babies would only be more bonds to entwine her life with his.
Madeline’s hushed yet animated tones broke through his heavy-hearted musings. “She’s scary—and unbelievably adorable! The horrible circumstances of her birth aside, doesn’t she make you wish to have tiny living miracles like her of your own?”
Roque’s whole being surged. What would Jewel say to that?
She didn’t say anything, kept on working as if Madeline’s question had been rhetorical.
Did she think it had been? Or was it just she didn’t have an answer either way? Because she’d never thought about it, never considered it something to think about? Would he ever know how she felt about this? Would he ever work up the nerve to ask? And if he did, what would she tell him?
“Would you mind telling me where we’re going?” Jewel giggled as she ran after Roque in the forest, jumping over the hurdles of heavy leaves and gnarled roots.
Roque looked back at her, his heart in a state of constant expansion. “Which part of ‘it’s a surprise’ didn’t you get?”
She stuck her tongue out at him and he laughed and stopped suddenly, breaking her momentum in an electrifying collision with his body. Momentarily startled then immediately mischievous eyes scorched him and he scooped her up in his arms, swung her round and round. He wanted to shout with delight. So he did.
“Put me down, Tarzan! You’ll break your back!” she squealed, laughing harder, kicking her heels in the air.
“It would take two of you to start to be any real strain.” He raised her higher until her arms were fully stretched on his shoulders. He loved the feel of her, the weight of her, the life and passion and beauty of her. He loved her.
And he was really beginning to think she loved him, too.
She laughed again, wriggled up there, looking down on him in laughing challenge. “I’ll have you know I weigh 165 pounds.”
“And every pound an indispensable building block in a work of divine art, amor.” He smiled his joy up at her. Then devilry mixed with the sublime feelings. “And if you could see what I see from here, you’d know why I may keep you up there all day.”
“As if you could!” she teased.
“Let’s see, shall we?” He hauled her up higher.
She yelped in delight then a hundred imps somersaulted in her incredible eyes. “Is this a challenge? All right, you’re on. I say you won’t be able to hold me up two more minutes!”
“And I say I’ll hold you up ten. What does the winner get?”
“I suggest the loser gets a penalty.”
He winked at her. “Whatever. It’s a win-win situation for me. I win, I get you. I lose, you penalize me and I love it.”
She crinkled her eyes at him. “You won’t love the penalty. Not at first. I will, though, every delicious step of the way.”
“Sounds exactly like the penalty I have in mind for you. Decadent enjoyment for me, torment for you. It will make putting you out of your misery all the more memorable.”
“Ha. Prepare to lose, buddy!” She threw herself into their impromptu game, making hilarious faces at him until he burst out laughing and let her down within the two minutes she’d predicted.
“Saboteur!” He laughed as she melted down his body, reveling in the slide of her slick flesh on his, in the way she made the most of the erotic glide. Then she came to settle where she belonged, filling his arms.
He enfolded her with cherishing pressure, his insides quivering as her arms enfolded him back, as he caught tender, hungry lips all over his face before he sank his in them, over and over, drowning in their deepening connection.
She had to love him. He wouldn’t feel so cherished, so welcome and appreciated, so warm and invincible when she looked at him, took him into her arms, if she didn’t. She wouldn’t be so responsive, so eager for everything with him, the camaraderie, the laughter, the hardships, if she didn’t. She counted on him, gave him every appreciation and respect, every care and courtesy. This was way beyond passion, beyond anything he’d ever hoped for or imagined.
He stroked her cheek with his, pressed her for one more moment, sending up a prayer of humble, fervent thanks for her.
“Ah—I love winning,” she purred when he finally let her go and bent to pick up the bags they’d dropped. “Does the surprise involve being someplace where I can perform my penalty on you?”
He caught her saucy lips again in a hard press, grinned at her. “I’m not saying. Keep walking and find out.”
She nipped his chin then clung to his arm and fell into step with him. His eyes raked over her with heavy desire. Hers gave back as good as she got.
She was in her swimsuit, he in his. For the last week they’d rarely worn anything more, taking their dress code from their hosts. Unlike their stay in Manis, they didn’t have much to do in Aldeia Marúbo. Apart from following up the post-operative Matcha and her tiny premature daughter, with the whole population only around two hundred and fifty, they’d wrapped up their work in the first two days and had had the opportunity to kick back and live life as simply as those people lived it. And it had been glorious.
Seeing how people lived in perfect harmony without any outside resources had put into perspective how they, as part of the “civilized” world, had not only become dependent on their modern props, but had become as reliant on social and interpersonal games and maneuvers and deceptions.
In the village, as there was no technology or amenities, there were also no social or personal complexities. And this simplicity simplified his views and emotions until he forgot there were reasons to erect shields, to not open himself up and just be happy.
And he had. He’d dropped his worries and doubts and plunged into profound happiness for the very first time inhis life.
And here was his happiness made flesh, snuggling into him.
He hugged her tighter to his side, groaned with overflowing emotions. “Meu beleza, you’re beautiful—just beautiful.”
He felt a tremor pass through her. He assigned a good reason to it. That was, until a few minutes later she was dispensing with his support and walking separately, and his doubts crashed down on him as if they’d never dissipated.
This had been happening ever since they’d arrived here. This episodic withdrawal. As if she sometimes caught herself doing something she shouldn’t. Each time it had passed and he couldn’t guess what could have triggered the dimming, the remoteness.
But couldn’t he guess, or was he just scared to acknowledge that similar episodes of withdrawal had heralded the end in the past? He’d noticed them then, rationalized them, ignored them, right up until the moment she’d told him she was leaving him. It had taken five months for her to get enough of him back then. Was his novelty wearing off faster this time? Now she was older, more experienced?
If it was, it was his fault, over-eager, starving, lovesick moron that he was. He might be scaring her, overwhelming her again. Sickening her? Deus, no. He had to slow down, back off, remember his initial resolve, try to stick by it again.
He was pathetic. Soaring in undreamed-of heaven one moment, drowning in the dregs of unspeakable hell the next.
“Oh, wow, this has to be it!”
The awe in her voice brought him crashing back to reality. They’d arrived at their destination and he hadn’t even noticed. She turned to him with a delighted smile and everything was right again. Had the world ever been anything but perfect?
He spread his arms so he wouldn’t reach for her. “Meu amor, I give you paradise.”
“Oh, Roque. I don’t think even paradise can be like this.” She pirouetted in abandon, a perfect Eve, tall and lush and vital.
This place was magic. A few acres of natural clearance within the dense forest, with a pond of turquoise water coming out of nowhere and every bird and butterfly on the face of the earth, it seemed, making it home.
The tribal shaman had brought him here yesterday, one medicine man to another. It was sacred ground and only shamans were allowed to come here to meld with nature and pray to the gods. He’d gotten the shaman’s blessing to bring his woman, but only because, to the man’s utter confusion, she was a shaman, too. He’d told him it would be the best place to get her with child. A child conceived here would be favorite of the gods.
His aching heart followed her every move as she ran here and there, exclaiming in glee, scaring the ponderous flock of herons standing on one leg in the pond.
A child. Hers. Would she ever want one again? Would it be his child she’d want? They’d been making love without protection, but she’d told him from the first day they didn’t need it. She must be protected, probably by an IUD.
But why had she had one fitted? Because she’d been sexually active? Had she indulged in unprotected sex with others? He never had. She was the only one he’d ever trusted, the only one he’d ever shared full intimacy with. Did she go around trusting men to be conscious of their health? Had he been a fool not to take precautions for that reason alone?
His heart was stabbed with a lance of jealousy and oppression. Then she turned to him, her smile elated and again, fool that he was, everything else ceased to matter.
“Roque, did you see those?” She jumped up and down as she pointed towards one of the trees ringing the glade filled with chattering, quarreling birds. “Toucans! And those have to be macaws. And I saw hummingbirds and hawks. And about a hundred kinds of butterflies.”
The last of his agitation dissipated as his lips widened indulgently. “And there are also more than two hundred species of mosquito.”
“Ha—my repellant ointment laughs at all two hundred species.” She walked up to him, hugged him around the waist. It took all his control not to crush her to him. “Thanks, darling. This is my life’s most magnificent surprise. This place is phenomenal.”
He smiled down on her, his heart constricting. “Tomorrow we go to see another phenomenon, the ‘meeting of the waters'.”
“I still can’t believe the black, clear waters of the Rio Negro can actually run side by side without mixing with the clay-colored waters of the Rio Solimoes, and for many miles.”
“That’s why it’s called a phenomenon.” He pinched her cheek when she narrowed her eyes at him, made another face and chuckled. “And then this place is more of a phenomenon than you realize. According to the shaman, places like this are magical foci, radiating fertility to the whole region. And shamans—as he considers us to be—harness their powers, use them as a nexus to the gods to bring forth bountiful sustenance—and progeny.”
Suddenly he felt as if she’d been transported to another plane, leaving him behind.
This new attack of remoteness hit him the hardest ever, shattered his resolve to cool down, to lay off. Calling himself a self-destructive, self-defeating fool, he caught her in a harder embrace. He had to stop her from drifting away. He wouldn’t survive her leaving him, not again.
He devoured her lips, and with a groan that shook him she came back to him. But not completely. And he went mad.
He barely snatched a mat from his backpack, threw it on the ground before he dragged her there. She went down, no reciprocating fervor, just limp surrender.
He had to have her fire, her ardor. He had to!
He discarded their swimsuits then his hands and lips roamed her, exploited every bit of knowledge and experience with her responses and preferences, trying to ignite her. He almost wept with relief when she caught fire at last and gasped for him.
He covered her body, thrust inside her, maddened, as if he’d stamp her with his essence, an image of a child with golden eyes and hair with a thousand shades shriveling in his soul even as his senses rocketed. Her soft screams filled his head as she writhed in the conflagration of release, catching him on the shock wave, sending him into his own explosive climax.
He didn’t move off her this time but lay over her, filling her, joined in ultimate intimacy, bitterness flooding him.
He was repeating his mistakes, being just sex to her.
But this had to be more than sex. She’s given you total surrender, absolute intimacy… Sim, fool yourself some more.
Eight years ago, she’d given him that the same day she’d left him.
Jewel stood on the edge of her boat, watching Marúbo disappear. They were turning into a tributary, heading for another village at its furthest point upstream. The tributary would get smaller on the way so they’d taken only the smaller boats. On arrival, they’d still need to hike for half a day to reach their destination. She couldn’t wait to get there.
And she couldn’t wait to leave there. To leave here, leave this expedition and Brazil.
Her efforts to keep a part of her unconquered by Roque, to save something of herself to survive with, had failed. Instead, she’d traded away her one chance of survival for two weeks of absolute bliss in his arms.
She’d opened herself to him, bared everything that she was and thought and felt, let him see the extent of her love, holding nothing back but the words.
And in return, he was already withdrawing.
It had started after that time in the glade five days ago. After he’d told her what the place signified.
Had the magical place revealed to him how empty of potential their lovemaking was and had it put him off her? Did a man who didn’t want children with a woman still feel repulsed if he knew the choice wasn’t there?
But she’d wanted longer with him, didn’t know how to give him up. And he was cutting her time, her remaining life, short.
He tried to disguise his cooling, but his endearments and light-heartedness felt strained, his spontaneity replaced by pensive watchfulness. He still made love to her, but his approach was stilted, as if he was summoning desires he no longer felt, his ferocity coming late, as if his response was building automatically, nothing to do with who his partner was.
But it was the aftermath that damaged most. Those times had been what she’d craved most with him, the sheer beauty and depth of descending together from the heights of the sensual storm, of feeling cherished and even more desired. Now his awkward kisses and caresses, his hesitant gaze, as if he were dispensing a requisite chore, added a deeper scar each time.
But what had she expected? She’d known her attraction to him was her synthetic shell, and beauty, even when real, bound no man. Hers seemed to have lost its appeal. Now he’d experienced it thoroughly, the still visible pattern where she’d been put back together must be evident. He could now be imagining what lay underneath, seeing her with the artificial effects undone. He could be remembering her when that negligible network had been a glaring map, marring her body and face, and he’d forced himself to look, to touch, to pretend to want.
But if he was becoming sated, or even sickened, he wasn’t doing anything about it. By now, she knew how compassionate he was. He probably didn’t know how to end it, was trying to do it gradually so as to cause her the least pain.
And she was too pathetic to do what she should have done weeks ago. She wasn’t sparing him the discomfort. And she had to find a way to release him, absolve him of any guilt or worry on her account. She had already been destroyed so it didn’t matter how much more doomed she became.
He suddenly appeared on the observation deck of his boat.
Longing writhed inside her. She knew he was looking at her from behind his sunglasses, was debating whether to pretend not to notice her or whether to acknowledge her. She saved him the trouble, turned away. Then she lurched forward and crashed to her knees.
They’d collided with something!
She’d barely risen to her feet, felt the pain shooting in her knees and blood trickling down her legs, seen the ominous underwater shadow of what looked like a gigantic sunken tree, when another collision from behind sent her hurtling overboard.
She heard her name being roared out as she hit the water. The plummet through the surface was like crashing through glass. The blow stunned sensation out of her whole left side. Then a thousand razors roared along her nerves. Her eyes and mouth jolted wide on the pain and panic, and warm water flooded in, cutting off sight and breath.
She thrashed, fighting the suffocating fluid, desperate arms reaching for the surface. She reached it and it only turned into attacking darkness. The boat—it was heaving, pieces of it separating, plummeting, pummeling her under with brutal blows. She went down, and down.
Her lungs burned, her vision a backlash of murky crimson. Beyond terror, the last tatters of survival instinct drove her up to break the surface—and it was there. The boat. It was capsizing.
For endless moments, it loomed over her in a merciless taunt.
Holding her last breath, she watched it make its final descent as Roque’s face filled her last thoughts.
At least this would be a way out.
For both of them…