Chapter 25

Baby Come Back

"Annalisa, I'd really like to take her home today," Owen urged the doctor two days later.

Wakefield looked in Owen's eyes, "Dr. Hunt, I understand you're fulfilling multiple roles here. Since your wife's BP has been fluctuating and has dipped lower than 80/50 more than once, I'm concerned we're dealing with orthostatic hypotension. Before I release her, I'd like to observe her awhile longer and see if some salt intake and additional fluids might help."

"I can take care of that at home. I'm a trauma surgeon for God's sake," Owen insisted, coming close to pulling rank.

With outward confidence but inward trepidation, Annalisa folded her arms and looked sternly at Owen, "Right now, you are a patient's husband. Not her doctor." Annalisa held her gaze until Owen looked away.

Owen stepped back, looked at the floor, tightened his jaw and folded his arms. He looked at Annalisa with obvious frustration, "Dr. Wakefield. I know what's best for my wife." She wasn't sure if he was conscious of the fact that he pointed at the 'Chief of Surgery' embroidery on his med coat as he spoke.

Annalisa looked directly at Owen and touched his upper arm with her hand. She decided in the moment to treat him like a distressed father and not as the Chief. Softly, she explained, "Owen…you are welcome to check her out AMA. I am not signing off until I have more data. We share the same goal here: keeping Amelia and the baby safe. The last thing we want to encounter is Amelia having another dizzy spell. She's a fall risk. She could be hurt and the baby could be hurt." Again, she held her gaze but this time, her expression was less firm and more tender.

"I want her at home," Owen commanded stubbornly.

Amelia walked slowly into the hallway and demanded sleepily, "Enough, Owen. Let's bring the discussion in here. Or do I not get a say? Dr. Wakefield, can you join us?"

The three went inside Amelia's room as Owen helped Amelia back into the bed, fretting over her and then kissing her forehead. He began to speak, but Amelia put a finger up in the air and declared, "I'm going first. Dr. Wakefield, I've been impressed with your care and I've been impressed with your teaching and leadership abilities with the residents and interns. That, to me, is one strong indicator of a great doctor. I trust your judgment even though I am thoroughly sick of this crappy hospital bed and would much rather be home gazing at the lake from my own bed. Owen…" Amelia sighed as she grasped his hand, "Owen, when it comes to this patient and this case, you don't wear the lab coat and you're not the Chief, even if you think you're doing it for all the right reasons."

Owen grasped her hand so that both his hands were enfolding hers. He looked at her with a slight grin.

Looking up at him, Amelia refused to relent, "Right?"

He sat down on the edge of her bed and kissed her hand, whispering, "Ok."

"Amelia, Owen," Annalisa began, "Let's over the game plan for today. We're going to keep the fluids flowing and try some more salty foods. I want to see the BP stabilize even if it remains low. I'd also like to order an ultrasound to attempt to pinpoint the bleeding and rule out any concerns. If we can accomplish those items today, you're welcome to go home this evening. If you're amenable, I'd like to start the ultrasound in just a few minutes. Otherwise, we'll have to wait until 6pm when I'm out of surgery."

Owen and Amelia eagerly agreed. To get to see the baby this early was an unexpected treat. Plus, the ultrasound would help alleviate their concerns. Annalisa stepped out to arrange the test.

"Is there a new car in the garage?" Amelia inquired, fully aware that Owen had to take over her task.

Owen smiled, "Yep. You want to hear about it?"

"I'm not going anywhere anytime soon," she jested.

Brushing Amelia's hair behind her ear with a gentle touch, Owen described, "I went ahead with the Enclave. 2015. Leather seats. Integrated TV system, seats 8. You really should supervise me when it comes to purchases for our family."

"Color?" she asked.

"Red with black interior. Olivia christened it this morning with its first stain," Owen grimaced as he looked up in resignation.

Amelia gritted her teeth and spread her lips, "Uh oh…first of many, I suppose."

Owen pursed his lips and nodded slowly, "Yep."

"Have you interviewed any nannies yet?" Amelia inquired.

Owen smiled, "Actually, I did. Meredith gave me a contact she found when Derek was in DC. The woman is named Lynne. The boys were at school when she came over, but Olivia warmed right up to her. She is probably mid-40s, has a pretty regular body, not ugly or scary but not a Victoria Secret model either" he kidded. "She's not the type who's going to end up in some scandalous affair with the dad or anything."

Laughing heartily, Amelia responded, "She sounds perfect. Hire her!"

"I'd like you to meet her and see what you think," Owen smiled. "It would be great for the boys to meet her too. I want them to feel like they're a part of all this."

"They are a part of this," Amelia responded. "As far as meeting her…" Amelia was interrupted by Annalisa entering the room.

"Are we ready to go?" Annalisa offered with a big smile as she washed her hands in the nearby sink.

Owen nodded and muttered, "Sure." Amelia nodded silently.

Annalisa draped Amelia and pulled up her gown. "This will be a little cold," Annalisa warned as she spread jelly on Amelia's abdomen. Then she explained, "We'll try this and see what we can learn."

"Look at that…" Annalisa mused having located the baby immediately, "There's your baby. It's too early to know the gender, but the baby looks great. Solid heartbeat – here, let's listen to it." She turned up the volume on the machine and the lub-dub of the tiny baby's heart filled the room. Amelia and Owen met each other gaze as tears glazed their eyes.

"That's our baby's heartbeat," Owen celebrated as he grasped Amelia's hand and leaned over to kiss her cheek.

"Wow," Amelia gently exclaimed, "I work on brains and listen to heartbeats every day, but that is the most beautiful sound I've ever heard." Owen leaned his head against hers as they kept looking at the monitor.

Annalisa moved the mouse by the keyboard around, clicking to obtain measurements. As the couple chatted and laughed in joy, Annalisa slowly suggested, "Shhh…just one moment. Let's be silent."

Owen furrowed his brow and looked toward Amelia. Amelia responded with a shoulder shrug and sideways grin. The baby's heartbeat grew more faint and then became louder. Annalisa looked intrigued and continued to move the transducer around the span of Amelia's lower abdomen. She retraced her movements more slowly.

"Is…. everything all right?" Owen asked with hesitation.

Without making eye contact, Annalisa responded haltingly, "Well…yes, everything is fine…just a couple interesting surprises." She put the transducer down, rolled closer to the couple and folded her hands in her lap. She did not speak as she smiled and looked at each of them. Then she explained, "You saw the baby – the heartbeat, the spine, measurements all look great."

"But…" Owen interrupted.

Annalisa smiled broadly, "To the right," she reached over and moved the computer mouse over so that the monitor showed another image.

Owen interrupted again, "No, that's the same picture. That's the baby again."

"It is a baby," Annalisa confirmed. "Another baby."

"Oh my God," Amelia said with shock. "Twins?"

"Twins, but there's a bit more to the situation." Annalisa lowered her brows and frowned, "See down here?"

Both Owen and Amelia leaned in closer to the monitor, not sure what they were seeing. Annalisa pointed the mouse in a few specific areas, "That's another placenta."

"I don't see a baby," Amelia observed.

"Right. Look over here – there's just a small mass of tissue. We're looking at a situation called Vanishing Twin syndrome. You were originally pregnant with triplets, but for an unknown reason, the third baby died. The tissue is being reabsorbed by the uterus, which is completely normal." Annalisa explained.

Owen narrowed his eyes and shook his head, "Wha? What? There were triplets, now there are twins. And that's ok? That's not a concern?"

"Believe it or not, the estimate is that the phenomena occurs in 20-30% of multiple pregnancies," Dr. Wakefield shared.

Amelia's face saddened as she wondered aloud, "Did I do something or not do something to cause this?"

Annalisa grasped Amelia's hand, the one that Owen was not holding, "Absolutely not. Analysis of the placenta and/or fetal tissue frequently reveals chromosomal abnormalities or improper cord implantation. It is just a fluke. There's nothing anyone did or could have done. If it was going to happen, the timing couldn't be better. When this occurs in the first trimester, further concerns related to it seldom emerge. We'll keep a close eye on you and the babies. I don't anticipate further complications or issues from this. The other babies seem healthy and thriving."

"Twins…" Amelia said flatly. She was totally overwhelmed. "Owen, we're going to have five kids."

Owen laughed and squeezed her hand, "Wow. Five!" Owen was thrilled, Amelia was nearly ashen.

Annalisa pointed out, "There's one more piece of news I want to share." She moved the mouse over to Twin Two and pointed at one area of the scan, "Baby Two is lying on his or her back right now, so I am unable to obtain all of the measurements I'd like to have. I'm not seeing any reason for concern, but I want to point out that we'll hope he or she is in a different position for the next ultrasound. Keep in mind that most parents do not even have an ultrasound this early – it is completely acceptable at this point in time to wait and see the details we can't capture today."

Both Owen and Amelia nodded with understanding. Owen asked, "And the next ultrasound will be…?"

"I'd like to see you in my office in two weeks. If there is further bleeding or any unusual cramping or pain, call for an earlier appointment," Annalisa explained as she wiped the remaining jelly off of Amelia's belly.

"What about the bleeding I've already had? Did we get any answers about that with the ultrasound?" Amelia inquired.

"With Vanishing Twin Syndrome, it is common to have bleeding, strong cramping, or pelvic pain. I'm confident that explains your bleeding." Annalisa diagnosed. She smiled at the couple again, "This is a great deal of news to take in."

"We're good," Owen assured her. "Well, I'm sorry, Amelia…I'm good. Are you good?"

"Just a little shocked," Amelia commented with astonishment.

Annalisa offered one last order, "Amelia, you need to stay home and take it really easy until the next time we see each other. No work, no surgeries. No taking work home. No consulting with work over the phone. You can walk around the house here and there, but nothing too strenuous. No dealing with laundry, cleaning, or lifting heavy items. Limit any trips outside the house. Keep your stress in check."

"That should be a piece of cake," Amelia said sarcastically as she bore her eyes into Dr. Wakefield's face.

Owen patted Amelia's hand, nodded, and looked at the doctor, "No worries. I'll see to it. What about...sex?" Amelia shot him a sideways glance with a we'll see about that expression.