008:

"Oh, you can't keep me out of here! This is my favorite place! It's great to see you too, Veva!" I hugged her back sincerely, thankful that almost all perfumes were banned here.

She had her arm around me. "Are you consulting on Lacee Donaldson? The multip with cord lapse?"

"Cord lapse?" I repeated. "When did it lapse?"

The nurses were all staring at me, their eyes big. Our one male attending came down the hall; when he saw me his eyes widened.

"Veva, are you performing this? Or is that why you're here, Aubrey?"

"Hello, Rod. What are we performing? C-section?"

"Right away. We're losing baby three." He was rushed, looking to Veva for guidance. She would be the physician on call at the moment. I was simply here to consult.

She turned to me. "It's tricky, Aubrey. Mom is in stage four pre-eclampsia, and the other two babies are ---." She shook her head. "I was about to call for the ambulance. But now that you're here...."

Rod just assumed from that statement that I was going to perform the surgery, and because he did, Coriander began pulling the necessary documents--- she was one of our best nurses, Cori Velvet—as sweet as chocolate pie and as dark and gentle and lovely.

Veva began to usher me down the hall into the one surgical room. I saw two other nurses and a midwife bringing the patient in, her mother or other support person holding her hand as she was wheeled in.

My brain cleared intensely, focusing on the life at hand. You had to focus if this was your profession.

Flannery Jants, another nurse was holding out her hands for my purse and jacket, as I turned the corner with Veva announcing that I would be performing immediate surgery. The poor mom on the gurney was crying, her eyes beseeching mine to save her and her children.

I took her hand. "Lacee, I'm Doctor Mann, Aubrey. Please don't worry, we are going to do everything we can to save you and the babies. I have a lot of experience with this type of birth. Let's get you in here and start the procedure, you have nothing to worry about, honey, worry doesn't help anything. You're in the best hands."

These were words I had said a million times, but today I wondered how true they could be. I'd lost so many patients I'd said them to. I turned and ran to get changed into scrubs and review the chart somebody had shoved into my hands. When I entered the clean room, to wash up, Rod was there already.

"Are you assisting?"

"I'm the only one here who can."

"Veva...?"

"Just left to take care of another emergency."

"Rebeccah?" This was one of the midwives who had some surgical experience.

He held his hands up to Flannery for gloves. I finished and held mine up as well. Through the window I saw the on-call anesthesiologist, Randall Darcy, giving Lacee an epidural.

"She's delivering in room six."

"Delivering?"

"Routine, resident mom, Pansy Andrews." He answered as we both entered the operating room. Lacee was covered with warm blankets and her stomach was bare, and being prepped by Cori, Simonette--- the other nurse was prepping for the first baby and both other midwives were standing ready to handle the other babies. Three incubators had been brought in.

I glanced at Rod. "You know we aren't really set up for this," I whispered. "We should be at the hospital."

"There's no time," Randall said soothingly, for Lacee's sake as she was returned to a prone position. I accepted the ultrasound monitor from Nurse Jants and pressed it to the distended abdomen. Instantly the problem made itself clear.

I flexed my fingers and went into save the baby and the mommy mode. It is times like this that education and experience pays off. You don't have to think, you know what to do, and you simply do it.

Because this is a teaching center as well as a delivery room, an upstairs waiting room overlooks the bay, and family members can gather there if necessary. I looked up and saw the mother--- or best friend.

"Where is the father?" I asked simply. Very rarely did fathers attend, they were more than likely MIA in these situations. But Lacee had not been a resident.

"Not present." Flannery advised me softly, as Lacee laid back and closed her eyes. The door behind me opened and Gretchen Coel, another neonatal nurse came in, looking professionally blonde and pale. She smiled with her eyes to see me and then took Lacee's free hand.

"It's going to be okay, Lace. We'll get Mason out and see what can be done. It's only been a few minutes."

I asked for tools and had them placed in my hand. In moments, she was right, the first little guy was delivered, not breathing, not responsive, the cord prolapsed--- I handed him off to Cori who took him to Rodney, and they started working on him.

I had the next baby, tiny, bleating in protest, in my hands, ready to hand off to Flannery, and the third to Gretchen. Simonette was at Lacee's head when the machines monitoring her showed a lack of pulse and sudden flat lining. I again went into surgeon mode. My hands were covered in her blood as someone wheeled in the crash cart, and someone else ripped the gown off her chest. Randall administered his respective responsibility, and I called for epi.

It was a grueling few seconds until we got her breathing again.

"She's seizing," I said, and carefully began treating her--- watching for signs of stroke, or other bleeding. The seizure stopped and her heart rhythms returned to normal. This was common, but not expected.

I glanced over to the baby that was not crying. They were having no success. I dashed over and checked him. This cannot be happening again. I held the tiny boy in one hand and checked several factors. "He's gone, Aubrey." Rod said, standing close to me.

I asked about several possibilities, hoping against hope this condition could be reversed. But he had been taken from the womb in this condition, there was nothing anyone could do. My heart fell, my mind closed down and my eyes filled once more.

Time had stood still while we worked, but I looked up to determine time of death. Only one half hour after the decision to take him out. His sisters were mourning from their own confines. I went to the first one and checked her out even though Ed Cooper, the pediatrician had stepped in. I stepped back. I was qualified to handle these babies, but Ed was inherently more able at this moment, with the mother's blood still on my hands. I turned away.

Rod patted my back. "There's nothing you could have done, Aubrey."

"Got here sooner." I said, thinking with regret of the stolen moments Rafe had insisted upon earlier. Rod jerked his head up to the overlook where the relative still stood breathlessly waiting. I saw the hopeful eyes, as Frances Sands, counselor, entered up there to tell this patient worried person the news. I saw the door close as another person exited. My heart clenched.

I looked back at Lacee. She was breathing normally, and her heart rate was back up. Two nurses were cleaning her up. Randall was checking her every few seconds. I knew him to be very thorough.

He looked up. "We couldn't have saved her without you, Aubrey." He said, and I knew he referred to the fact that they all wanted me to come to work there full time. Leave my practice in Malibu and my on call status at the local hospitals. There was plenty of work here.

It was a thought, but even this was more work than Rafe wanted me to take on. I smiled softly and exited the room.

*******