Chapter 29: Stress at its Finest
During the three weeks following the ultrasound, Owen and Amelia attempted to appear as if everything was normal. Owen continued to emotionally separate himself from everyone, including Amelia, and to fulfill the role of steady, calm husband, father, and doctor. Lately, he had found reasons to remain at the hospital later than usual. Becoming lost in his work was a source of solace. He could somewhat control situations at the hospital, unlike the unknowable and uncontrollable realities residing in Amelia's womb.
Amelia had returned to work and quickly found herself overloaded, exhausted, and edgy. Word had gotten around the hospital that Amelia was pregnant, but no further details were clear. Some chatter about the possibility of her carrying twins bubbled up now and then, but nobody felt it wise to speak too openly in the hallways and at desks about the Chief and his wife's pregnancy. Using most of her energy to subdue her emotions and concerns, there was little patience left for residents. Her mood was more unpredictable, although most hospital staff chalked it up to hormones and pregnancy. Each morning around 4:30am, she would hear Owen quietly go out to the balcony and fall apart, and each morning, she would pretend to be asleep. As he cried or thought or simply sat alone, she did likewise in their bed. Approaching him with her concerns about his isolation took more energy than Amelia had available.
With the help of Lynne, the kids and their routines remained predictable and in place. Soccer practices, dance classes, schoolwork, and limited screen time all remained unchanged. Lynne was an expert at supporting and assisting the new parents. She was willing to instruct and advise, but only as requested. The kids had become clear on her expectations, which were firm but loving. In many ways, Lynne saw her role as one outside the limelight and out on the periphery. Her role, in her mind, was to support the family and keep life running smoothly in the background as much as possible. The one point upon which Lynne nearly insisted was that the family gather for dinner at the table nightly. Surely, there were days when one or both the parents could not be present; however, both tried heartily to at least run home for dinner and then, if necessary, returning to the hospital afterward.
The 13-week ultrasound offered nothing conclusive. Concerns remained, but diagnostic details continued to be vague. Annalisa continued to monitor the babies' growth and development and offered to disclose the genders. Not having discussed if they wanted to know ahead of time, the couple decided to wait. As far as other specialists on the case, there was not a need for further consultation until diagnoses could be clarified. Neither Owen nor Amelia had interacted with Arizona on a doctor-patient basis since the 10-week ultrasound.
The following three weeks unfolded in much the same way as the weeks between the first and second ultrasounds. The 16-week ultrasound was much like the 13-week scan. While the scans were not changing much, tempers were. As each day passed, the tensions rose. Conversations became sharper and less frequent. Work hours extended further and further into the evening. Amelia's exhaustion, even though she was now in the 2nd trimester, remained high.
One afternoon just before the 19-week ultrasound, as Amelia and Owen walked in the hallway attempting to discuss scheduling between surgeries and meetings, Annalisa happened to turn the corner and end up within earshot behind them.
"Look, Owen, I told you. I'm operating tonight. That aneurysm is about to burst. Derek has been on the floor since last evening without a break and Nelson is out of town. It is what it is. You'll need to be the one to go home for dinner," Amelia snapped.
Owen huffed, "I already explained, dear," he said with tension, "that my meeting will very likely run until at least 6:30 or 7. Push your surgery to tomorrow. I've seen the slides. The aneurysm will wait. I can get you an OR first thing in the morning."
"I don't need any special favors," Amelia growled.
"Mia, this isn't a favor. This is about family and about your workload," Owen sighed as he tried to sound caring rather than angry.
"Don't mother me, Dr. Hunt," Amelia insisted.
Annalisa cleared her throat behind them and took a few quick steps to catch up to them. She put one hand on Amelia's shoulder and one on Owen's as she guided them into a conference room. With an insistent tone she offered one word, "Doctors."
The three found themselves behind a closed door with Annalisa standing in front of the door. "Please, sit," she instructed as she folded her arms. "You are both in a hurry and I have a full schedule as well so I will be direct and will make this brief… Stop! This level of bickering and schedules as full as what I just happened to overhear are not helping anyone. Do not tell me to mind my own business, because, right now, I am your doctor and you are the patients. You are not my Chief or senior colleague, got it?"
Stunned, both Amelia and Owen nodded with widened eyes. Annalisa continued, "Both of you sit tight for a moment. I'll be right back." Annalisa walked out the door and turned left.
"What do you suppose she's doing?" Amelia asked quizzically.
"I'm not sure, but I think we're in trouble," Owen winked at his wife.
Annalisa came back in the room with a blood pressure cuff. She stopped first at Owen and looked at him. When he simply looked back at her, she instructed, "Coat off. C'mon."
Owen chuckled, "I'm not the pregnant one here." Annalisa locked her gaze until Owen reluctantly removed his coat. She wrapped the cuff around his arm and took his blood pressure. Then she turned and looked at Amelia, who had already removed her coat to avoid an issue.
Annalisa jotted some notes on a piece of paper, then stared at both Owen and Amelia before beginning to speak, "Here's the deal, folks. This cannot continue. Bickering in the hallway, in your roles, is horribly unprofessional and sets everyone on edge. Bickering like that as a couple shows me that you are stressed, tired, overworking, and probably not communicating effectively or enough. We're on the steep uphill climb of quite a trek and now is not the time to begin stepping off the trail that leads us to the summit. Amelia, your BP is 150/80."
Owen interjected, "Mia…that's why you need to postpone the aneurysm."
Annalisa held up her finger and added, "Owen, yours was 155/90. Now admittedly, you were both just storming the halls and arguing. Even so, you both know these are not acceptable readings for anyone." Annalisa sat down and looked at the couple more softly, "Something has to give here. I see you both from afar throughout the hospital and I can't remember the last time I saw either of you smile. You both look exhausted and sleep-deprived constantly." Annalisa paused as her eyes portrayed concern and sadness, "When is the last time you spent quality time with one another?"
"I hear you," Owen stated in an attempt to avoid further conversation. "You make great points, Annalisa." Amelia leaned back in the conference room chair and closed her eyes. Her non-verbal body language mirrored her coping mechanisms: avoid engagement when possible.
"This isn't about me wagging my finger at you. Two points. One, as a friend, I'm worried that you're drifting apart and avoiding emotional connection. That won't help either of you or the babies…or your other kids for that matter, or your professional lives. Two, as your doctor, high BPs, sleep deprivation, long hours all mean you aren't taking care of yourselves. Owen, you may not be pregnant, but your rest and health are important now too. If I haven't already caused the two of you to fire me, I'd like to provide some gentle directives," Annalisa offered.
Amelia, not opening her eyes, stated, "Please do." Owen nodded without a word.
"Amelia, you need to cut your hours to part-time or you'll soon be on bed rest for the remainder of your pregnancy. That's not a threat, it's a simple observation based on my experience and expertise." Annalisa paused, then added, "I'd also like the two of you to see a therapist to help work out the incredibly understandable tensions in your lives and to strengthen your connection for the long climb in front of us. I can make referrals outside the hospital if you like or you can connect with someone here."
Owen took an audible deep breath and looked at his watch. He grabbed his cell phone out of his pocket and said, "Excuse me for one moment." After dialing up to his assistant, he asked her to post-pone the rest of the day's schedule and to clear the next three days of any events scheduled after 3pm.
"Was that to earn a gold star in front of the teacher or will that become a more permanent practice?" Amelia inquired firmly. Owen rolled his eyes and cleared his throat without comment.
Annalisa spoke up, "I'd be happy to leave the room if the two of you would like to speak alone. At the same time, I'm willing to stay if you would find that helpful."
Neither Owen nor Amelia answered. Annalisa observed Amelia's face, which seemed to be attempting to control pain. She asked, "Amelia, what's going on right now?"
"Hmmm?" Amelia responded without engagement. She moved her hand onto her growing tummy.
Annalisa stood up and calmly walked over to Amelia, putting her hand on Amelia's abdomen. "Are you cramping?"
"A little. They're more like baby-level contractions," Amelia explained. "They are bothersome but not painful."
"Braxton Hicks," Annalisa analyzed. "However, let's take you up to maternity and just do a few quick checks. Owen? Do you want to join us?"
"Is everything ok?" Owen asked with concern.
"Let's head upstairs," Annalisa repeated calmly.
When the trio arrived in maternity, Annalisa stopped to find out which room they could use and took the couple there. She advised Amelia to put on a gown and lay down, promising she'd return in a few minutes. Stepping out to the nurses' station, Annalisa stated her orders to the charge nurse, Peggy, and asked that one nurse be assigned to the situation, so word did not spread like wildfire throughout the hospital.
Peggy asked, "Is she in preterm labor? Shall I page Peds?"
"No. I'm nearly certain we have an exhausted, dehydrated mom of twins who needs to learn her limits. Let's hook her up to a fetal monitor and assess her need for IV fluids. After you run the other tests, page me with results and I'll come back up." Annalisa stepped away, leaving Owen and Amelia in Peggy's capable care.
"Hi, Peggy," Owen grinned as the Charge Nurse entered the room. Amelia laid on her back on the bed, occasionally shifting position.
Peggy approached Amelia and leaned down to be face-to-face with her. "Amelia, you're going to need to lay on your left side, hon. Dr. Wakefield wants the twins on a monitor and we're going to place sensors on you as well. Are you in any pain?" Peggy asked her questions as she arranged monitors, placed sensors and took Amelia's blood pressure.
"No, just uncomfortable," Amelia clarified.
Peggy declared, "Ah…that's better. The doctor said you were 150/80 earlier. Now you're 133/78. Not ideal, but better." She reached for the early readings on the monitor and sighed with relief, "Yes, looks like Braxton Hicks for sure. Let's keep watching though." Peggy placed a thermometer in Amelia's mouth and took her pulse. Turning to Owen, Peggy asked, "Are you finding out genders?"
"We haven't decided yet," Owen explained casually. He reached for Amelia's hand and she swatted it away as if a fly was bothering her. He uncomfortably set his hands in his lap; embarrassed Peggy had seen Amelia's apparent blow off.
"Seems like most couples find out nowadays. That wasn't an option with my babies, but I'm old," Peggy grinned as she read the thermometer. "Dr. Shepherd-Hunt, you're running a slight fever. I'm going to draw some blood now, then let's get some IV fluids started. After that, I promise to let you rest a little."
"A CNA can do all that, Peggy. I'm sure you're busy with other responsibilities," Owen observed.
Peggy explained, "I'm under strict orders from Dr. Wakefield to limit the number of staff in the room. It's no problem, Dr. Hunt."
After Peggy stepped out of the room, Owen leaned closer to Amelia and ran his hand along her arm, "Hey, are you mad at me?"
"What? No." Amelia responded with her eyes closed. "Why?"
"You swatted my hand away a minute ago," Owen chuckled with a hint of incredulity.
Amelia opened her eyes slightly and smiled, "I thought you were a fly." Reaching behind herself, Amelia patted the bed, "Spoon me."
Awkwardly, Owen grimaced, "I'm in a suit and we're here at work…"
"Please. Just hold me," Amelia begged as she looked up to him from the bed. Owen walked over to the lights and turned them off, leaving the dim over-the-bed light on. He slipped his loafers off, loosened his tie, and placed his lab coat on a nearby hook. He slipped in behind her and placed his left arm under her neck and his right hand on the babies. He smiled as he noticed the beeps from the fetal monitors slowing and the heartrate reading for Amelia slowing as well. Kissing her ear, Owen whispered, "I love you, Amelia." She hummed softly in response as she drifted off to sleep.
A couple hours later, Annalisa knocked softly on the door. Noticing both Owen and Amelia were asleep, she pondered which one she would wake up. She hated disturbing them, but needed to provide an update. She slid a chair next to Amelia and softly touched her arm. Amelia sleepily opened her eyes and grinned as she whispered, "Hi. What's the verdict?"
"Your labs are within reason. The contractions were all Braxtons. My only real worry is your dehydration and your exhaustion. Amelia, I can't stress enough how you need to slow down," Annalisa said softly.
"I know. I agree. Can we go home?" Amelia wondered aloud.
"Honestly, I'd like to keep you overnight unless you're opposed. I could be talked into releasing you, but it's not my first choice," Annalisa shared. "What are your childcare needs? Do you need to be home?"
"We have a nanny. We should call her, though."
"I can do that. Shall we bring in a bed for Owen or will he head home?" Annalisa asked.
Amelia grinned, "He's pretty comfy. I think I'll try to keep him right here."
Smiling gently, Annalisa patted Amelia's arm and whispered, "Get some rest. I'll be by tomorrow before rounds and without residents. You both need to arrange for some time off, just to rest up."
Amelia nodded and snuggled back into her pillow hoping to fall back to sleep quickly.