Souvenir

He nodded and stepped back into the operating suite. Meg glanced through the window as she dried off, considering the baby’s position, previous scar tissue on Cristina’s uterus, how much time had passed since she’d made the decision to operate. Emergency C-sections were her least favorite part of her occupation, the riskiest of all procedures just by their nature. The mothers required general anesthesia, the babies were always in distress – these surgeries felt like crapshoots despite her expertise, despite her absolute dedication to her patients. She only ever had to do them when what was supposed to be predictable and routine became a cascading flow of everything opposite.

She backed into the suite, keeping her hands sterile, and stood still while a tech assisted her with gown and gloves. Her right arm, the one that was giving her trouble, felt a little stiff, sluggish as she held it out for the glove. As soon as the tech stepped away, Meg lifted both arms above her head and stretched.

‘Need a nap?’ asked Clay Williams, the new surgeon who would be assisting. ‘Susan said you all have been at it all night with this one.’

‘We have,’ Meg agreed as she approached the table, where he stood facing her from the far side. ‘But I think I’ll wait on the nap until after we finish.’

‘Well, I s’pose that is the better protocol,’ Clay joked, his mouth hidden behind the light green mask but his smile apparent in his eyes – as was a kind of interested regard that surprised her. Was he flirting? He added, ‘You pros know best.’

He had to be several years her junior, and they’d worked together only a few times, socialized at a couple of conferences, chatted before or after staff meetings now and then; even so, she had the distinct feeling he was attracted to her. Her response was friendly but circumspect: ‘I tried that napping-during-surgery approach and, well, somehow the results weren’t up to American Medical Association standards.’

‘Bah, rules are made to be broken,’ Clay said – alluding to marital rules, perhaps? Or was she just imagining that sparkle of interest, that suggestive tone?

The anesthetist, a serious, middle-aged man named Leo, spoke up then, bringing Meg’s attention back to the job at hand. ‘She’s all set.’

Meg looked closely at her now-unconscious patient, at the draping around Cristina’s iodine-orange belly, at the tray of instruments nearby, checking that everything was in place. ‘What was the last fetal bpm?’ she asked, referring to the baby’s heart rate.

‘Eighty-one, right before we unhooked her.’

Very low, but not absolutely critical. Meg nodded at the assembled team of nurses, technicians, and a pair of neonatologists, and said, ‘Okay then, let’s make a birthday.’

At first, everything seemed to be fine. She reached for the scalpel, grasped it with no trouble, aligned the blade with Cristina’s skin just above the pubic bone. Then it was as if all the strength simply leached out of her arm. The scalpel dropped from her fingers, tumbled onto the edge of the operating table and down to the floor, landing with a clatter. Meg looked up, embarrassed and concerned. There was a baby in distress here; her arm could not refuse to cooperate.

‘Butterfingers,’ she joked, sweat breaking out on her forehead, dampening her armpits and her palms, inside her gloves.

‘Mmm, a candy bar does sound good, but I think another scalpel’s the better choice,’ Clay said.

‘Right, a scalpel,’ Meg nodded, trying to play along. She looked down at her hand. It rested, yet, on Cristina’s belly, on the mound of a baby who was almost certainly fading fast. It took all her concentration to lift her arm and pull it in, close to her chest.

‘Here you go,’ the tech said, holding out a second scalpel. Meg looked at it, its steel blade glinting under the lights, taunting her. The moment stretched out in long, agonizing delay as Meg willed her arm to extend normally. It felt leaden.

Clutching her wrist with her left hand, she stepped back abruptly.

‘Dr Williams, would you proceed?’ she said, feeling the eyes of everyone there watching her with concern. ‘I have a … a cramp. In my hand.’

‘I – sure,’ Clay said. He hurried around to her side and reached for the scalpel. ‘Thanks for the opportunity,’ he added, making it seem like she was staging this as a favor to him.

Marshalling her focus away from her arm and onto the crucial matter of delivering Cristina’s baby, she guided Clay through the relatively unfamiliar-to-him procedure. He worked quickly and with steady assurance, but when he pulled the baby out, it was clear that something had gone very wrong. The tiny boy was well formed but gray, motionless as Clay put him in the hands of the neonatal specialist. Clay glanced at her, his eyes full of dread.

Her own heart had plummeted, but she tried to reassure him. ‘You did everything right.’ Behind them, the specialist and his team worked to revive the baby. ‘Let’s finish up here,’ she nodded toward her patient, who, as difficult as it was for any obstetrician to remember when there was trouble with the baby, remained her priority.

‘Right,’ Clay said. ‘Do you want me to—’

‘Yes,’ she said, her voice low. ‘My arm …’ She frowned behind her mask.

‘No problem.’

‘Thank you.’

She stood by, feeling helpless in every sense. What had gone wrong? She reviewed Cristina’s labor in her mind, recalled the events and procedures of the surgery, thought again about the baby’s heart rate troubles – but as soon as Clay delivered the rest of the umbilical cord and the placenta, the culprit became obvious: a knot in the cord.

‘Shit,’ she said, reaching for it with her left hand. ‘It must’ve gotten looped early in her pregnancy.’ Rarely, but once in a while, a very active fetus with a longer-than-usual cord could manage to loop through it. Rarely, but once in a while, an ultrasound would fail to show it. Then, at some point in the labor, the knot, which had been loose enough not to be a problem, tightened up or got compressed, cutting off the baby’s blood and oxygen supply. In the minutes – literally minutes – between when the monitor had been removed and Clay had reached in to pull the baby out, the baby had crashed. Silently, fading away without a struggle. There was no way for them to know, or to do anything differently even if they had known. Except … except for those forty-five or so seconds after she’d dropped the scalpel: it was possible that those seconds made the difference. Clay nudged her with his elbow, and when she looked at him, he shook his head as if he were reading her thoughts, as if to say, Don’t go there.

She looked behind them, at the slumped shoulders of the group surrounding the warming table, and swallowed hard.

Alone in an elevator two hours later, Clay and Meg rode in silence until he reached forward and pushed the Stop button.

Startled, she said, ‘What are you doing?’

Clay touched her chin, to get her to look up at him. ‘It’s not your fault.’

She looked away. ‘You don’t know that. If I hadn’t screwed up my arm—’

‘You didn’t know it was going to cramp up just then.’

‘I knew it could. It happened once last week.’

‘Once. Last week.’

She appreciated his support, but the truth was that she’d had a hint while getting suited up, and she’d ignored it. And now a baby was dead.

Clay continued, ‘Look, suppose we could have that minute back. The baby might have survived – I double-emphasize “might” – in which case he almost certainly would’ve been severely brain-damaged from what had already occurred, and dependent on his poor parents for the rest of their lives. A vegetable, if you’ll forgive the crassness of the term.’

‘Maybe,’ she acknowledged, imagining Cristina and Mark trying to manage the needs of such a child along with their chubby, charming two-year-old daughter Chloe, whom she had also delivered by emergency C-section, without a hitch. She saw their baby boy with vacant eyes, a permanent feeding tube, a ventilator, no future – and couldn’t wish such a life on anyone.

Clay took her right hand with both of his, massaging it gently, and looked into her eyes. ‘We can’t save them all, you know. Hell, we can hardly save ourselves.’

She knew without asking that he was referring to his attraction to her, a married woman. Saying they had no control, not over death and not over whatever strange forces brought people together, not over love. She let his eyes hold her that way for a long moment, a moment when the comfort and support and affection of someone who truly understood was exactly the salve she needed.

Unfortunately, it couldn’t last. ‘I have to get going,’ she said, the rest of the day’s obligations intruding, reminding her that her world existed outside this tender gesture, that she was wrong to welcome it.

Clay said, ‘Me too.’ But still he held her hand, and she didn’t pull it away. ‘Meg …’

‘Clay.’

He sighed quietly, then let go and leaned over to start the elevator again. It gave a small lurch and began the rest of its journey to the main floor.

He said, ‘You’re a damn fine doctor. Everyone says so.’

‘You did a good job today,’ she told him.

The chime sounded and the doors slid open. She stepped out first, into a crowd of lunchtime visitors. ‘Try to enjoy the rest of your weekend,’ she said.

He nodded, his eyes unreadable. ‘You too.’

She walked away from him then, and away from the hospital, the paperwork, away from the grieving parents who had so graciously already absolved her of wrongdoing – for now anyway. Her other responsibilities were calling: she needed to phone her father and cancel their dinner date, Savannah needed to be picked up from the game Meg had missed, Brian text-messaged her from the golf course, asking her to buy a bottle of Moët for a friend of his who’d just gotten engaged. Self-indulgence, especially with Clay Williams, was a luxury she could not afford.

TWELVE (#u7cd1de84-617d-581a-ab87-888c25881903)