AN: It took me a week to finish this chapter. This is basically just rewrite of Dr. Ted and all the episodes that came after it. In real life, Lea most likely would have been given information on how to manage her vasa previa throughout the remainder of her pregnancy and have a c-section scheduled later instead of jumping straight to surgery (especially because she had no bleeding), which is why I'm rewriting Dr. Ted (even though I've been at peace with the stillbirth storyline as well as other fans). Overall, it's mostly just going to be canon parts of Season 5 (and the rest of Season 4) if Lea ended up having the baby and if Claire returned to San Jose with just some rewriting and reimagining. I hope you all enjoy it, starting the first chapter with 4x16. However, as an important reminder, although upsetting, the canon pregnancy loss storyline was important because it is still a taboo topic to talk about. But that still doesn't stop us from thinking "what if?".
On the morning after the entire surgical team treated the two young gunshot victims, Lea collapsed in front of the hospital with abdominal pain and then Shaun frantically yelled for help. By the time a few doctors and nurses arrived with a gurney, the pain had already stopped and then everything was confirmed to be fine. Although, it was kind of embarrassing for both Lea and Shaun.
However, once Shaun and Lea returned home, they called their OB/GYN, who reassured them that it was probably round ligament pain and that if the pain continued or recurred, they should make an appointment or go to the hospital. She told them not to worry. Unfortunately, Shaun was still worried. 24 hours after the collapse, he and Lea decided to go to St. Bonaventure for a second opinion.
That was why Claire was here right now checking Lea's blood pressure and giving her an ultrasound.
"You said the pain was intense?" Claire queried Lea with genuine concern as she squirted a small dollop of gel onto her exposed belly and then waved the ultrasound wand over it. Shaun was nervously pacing next to his girlfriend's bedside with some folded-up paper in his hands.
"Yeah, it was sharp on both sides," replied Lea, who was staring down at her growing belly. At five months pregnant, she was finally starting to show.
"And it didn't last long?"
"It lasted only a few minutes."
"And nothing in the 24 hours since then? Any bleeding?"
"Nuh-uh," answered Lea, shaking her head. "My OB said it was probably round ligament pain?"
"That's basically growing pains," explained Claire. "Your uterus is expanding, and so do your ligaments."
Claire turned her head back towards the monitor to examine what was going on, looking for anything that was out of the ordinary...and there was absolutely nothing.
"Normal fetal heart rate and movement. Your BP is perfect," stated Claire with confidence, making Lea quietly sigh in relief. "Everything seems normal."
Shaun, on the other hand, did not look convinced or reassured at all. Although they were officially safe from the possibility of a miscarriage now that Lea was past 20 weeks, they now had to worry about stillbirth.
"Complications and pregnancy loss are also normal," he pointed out as Claire gently wiped the gel off Lea's belly with the sheet that was draped over her lap. "Lea's OB didn't consider every other possibility."
"That's why we're here," added Lea with a smile on her face. "Shaun made a list, and I'm pretty sure he's not going to sleep until every possibility is ruled out."
"I categorized every medical complication that could negatively impact Lea or the baby," said Shaun, handing the paper to Claire. "Then I sorted them by case fatality risk."
Lea nodded in agreement.
Typical Shaun, Claire thought. Although the tests were obviously unnecessary, she knew that this first-time dad-to-be wasn't going to rest until reassured with evidence, so she might as well do the tests anyway.
"I'll get started on the tests," sighed Claire.
As Lea was getting some tests performed on her, Shaun returned to their apartment to pack up some things for her hospital stay. Toiletries, maternity clothes or loose-fitting clothes, non-skid socks, slippers - all were important. He was then interrupted by a knock at his door, which was revealed to be Dr. Glassman when he opened it.
"Debbie and I got this for the baby," his mentor clarified, holding up a plush beige teddy bear in a lab coat and a stethoscope around their neck. He's seen that bear in the hospital gift shop before. "This is Dr. Ted."
For safety reasons, that bear obviously wasn't going to be going in the baby's bassinet.
"Stuffed toys aren't safe for infants under 12 months old. They increase the risk of suffocation," reminded Shaun, going back to packing. "Lea and I also won't be taking any pillows, mobiles, quilts, and bumpers as those are classified as SIDS risks by the American Academy of Pediatrics."
"I'll tell her you said 'thanks'," Dr. Glassman said as he walked into the apartment.
"You're supposed to be at work," Shaun continued to remind Dr. Glassman.
"Yeah," Dr. Glassman retorted in a voice that sounded like a bit of soft sarcasm, setting Dr. Ted and his hat on the kitchen counter and then giving Shaun his full attention.
"But you're not at work, so you're probably here for a reason," guessed Shaun, folding up one of Lea's sweaters. "Claire must have called you because she's worried about Lea."
"You're right on some parts," Dr. Glassman said walking towards the dining room table with his hands in his pockets, looking ready to give Shaun some words of wisdom. "Except that Lea is fine. You're not. Shaun, you need to relax."
"Nobody expecting a baby should relax," rebutted Shaun, shaking his head. "There are many things that could go wrong."
"So, after the baby is born, then you can relax?"
"N-No," stammered Shaun. "The baby will be helpless and she'll need us for everything."
"So, once the baby learns to feed herself and dress herself, then you can relax?"
"No."
"Is my point becoming at all obvious?" Dr. Glassman continued.
"That I'm never going to relax ever again?" Shaun questioned nervously.
Dr. Glassman hesitated for a while, but then finally answered. "Yes, kind of. This should be the most amazing moment of your life! Every parent will tell you the same thing: if you blink, you're going to miss it! And right now, you're blinking! You're being nervous and scared when you should be excited!"
Dr. Glassman clenched his fists in an encouraging manner and made a "be excited" gesture.
"Have you felt the baby kick yet?" Dr. Glassman asked curiously. "Lea already told me she's been feeling some movement for the past two to three weeks."
"I just felt the baby move last night," answered Shaun.
"Good, and there are more exciting things for you to do for the rest of the pregnancy," Dr. Glassman continued to give advice. "It's normal to be nervous, but enjoy watching the ultrasounds, feeling her kick, looking through adorable or even tacky baby clothes, putting your registry together, arguing over baby names, putting the nursery together."
Shaun realized that Dr. Glassman was probably right. Although things were kind of scary right now, he and Lea were warned that pregnancy and childbirth were actually the easy parts. Once the baby was born, there were going to be sleepless nights and changing diapers. Then, there was going to be the terrible twos and the potty training.
There were going to be a lot of challenges for the next 18 years.
Meanwhile back at the hospital, Lea was getting some tests done on her to rule out every possible complication - anemia, sexually transmitted infections, preeclampsia, pre-term labor, placenta previa, vasa previa, gestational diabetes, incompetent cervix, placental abruption, obstetrical cholestasis, low/excess amniotic fluid, venous thrombosis, and even twin-twin transfusion.
So far, she's had an abdominal ultrasound, a blood test, a urine analysis, another glucose test, a liver biopsy, and a nonstress test...and they haven't found anything wrong yet.
Right now, Lea was already changed into a hospital gown and had a fetal monitor strapped to her belly. Claire and Jordan were standing next to the bed, telling her that she and Shaun were going to need to go talk to their obstetrician about what to do if a complication is found.
"There are no signs of preterm labor or preeclampsia, and tests on your liver ruled out obstetrical cholestasis," explained Claire. "And it's not twin-twin transfusion because you're officially not having twins."
Claire chuckled at that statement, which was followed by a nervous smile from Jordan.
"Turns out having a baby with a doctor has a downside," sighed Lea. "But if there is a problem, I'd rather be here than anywhere else. Gotta take care of this little girl."
She gingerly rubbed her belly.
Claire's chuckles then turned to voices of concern as she looked at the fetal heart rate monitor. "Is the transducer secure?"
"I just checked it. Why?" Jordan asked, looking worried as well.
"Baby's heart rate is mildly bradycardic," replied Claire, which caused Lea to look at her with some slight fear in her eyes. "Um, heart rate fluctuates with activity and you've been off your feet for a while," she reassured, not wanting the mom-to-be to panic. "But if Shaun were here, he would check a transvaginal ultrasound. Let's get it set up."
She just smiled at Lea once she sent Jordan off to get the equipment they needed. A pelvic exam and a transvaginal ultrasound were going to be the next steps, because they still needed to rule out infection, placenta or vasa previa, and an incompetent cervix.
Eventually, the transvaginal ultrasound confirmed that Lea had type II vasa previa, which did sort of explain why the baby's heart rate was sort of bradycardic. If the fetal blood vessels ruptured, they would lose the baby. It wasn't just when her water would break, but also under any added stress, which practically made Lea's body a ticking time bomb.
According to the ultrasound, there was a small secondary placental lobe and multiple vessels at risk. With a gestational age of 22 weeks, the fetus was two weeks short of viability, making a c-section not an option at this moment.
As soon as Claire informed Shaun and Lea about the complication, Shaun immediately came up with a surgical plan involving fetoscopic laser ablation to stabilize the vessel so he and Lea wouldn't have to worry about the fetal blood vessels rupturing throughout the remainder of her pregnancy and avoid elective prematurity. He wanted Claire, Dr. Lim, Jordan, Nurse Villanueva, and even himself on the surgery...but Claire told him that this was a discussion he and Lea should be having with their obstetrician and that even if they agreed to surgery, he couldn't be on it since Lea was carrying his child.
Shaun thought that Dr. Lim could overrule Claire since she was the chief of surgery, but she agreed with Claire on both of her points about talking with their OB and that she cared about him and Lea too much just to put their baby's life at risk just to make him feel useful.
To disappoint Shaun even more, Lea agreed with Claire and Dr. Lim and thought surgery was probably unnecessary right now. This was how he now found himself in Dr. Glassman's office, trying to get him to overrule Claire and Dr. Lim and convince Lea that surgery was a better option despite the risks.
"You are the president of the hospital, so you can overrule Dr. Lim!" Shaun beseeched firmly.
"Sorry, but I agree with Lim and Claire," defended Dr. Glassman, rolling his eyes.
"Everyone, including you, is always telling me that I'm not emotional enough, and now you're telling me that I'm too emotional?" Shaun questioned with agitation.
"Are you not angry and scared right now, Shaun? You're as emotional as anyone," suggested Dr. Glassman.
"If I hadn't been scared, we wouldn't be here. I wouldn't have ordered the tests, and Lea would have lost the baby. My emotion helped."
Dr. Glassman sighed.
"Look, maybe your emotions saved the day, but the issue here is that you can't be the one treating Lea right now as you're the father of her baby and also her boyfriend. Yes, you're not married, but the rules also apply to unmarried couples and even ones that aren't pregnant. Also, neither you, me, Claire, or Dr. Lim are board-certified OB/GYNs, so this is definitely something you two need to talk about with your doctor because I agree with them that surgery is too risky right now! There is the risk of blood clots, and if one occurred somewhere like the umbilical artery, you know what the outcome would be. I think your ego and your instincts as a doctor are kind of getting in the way."
"No, no they aren't," retorted Shaun. "I've studied every aspect of this surgery extensively."
"I'm sure you did, and I know I'm just a neurosurgeon, but I do know that statistically, you and Lea will likely have a healthy baby without the surgery," reassured Dr. Glassman. "The point is, you need to be the dad and her partner right now, not her doctor or your baby's doctor. This is why you two need to talk to your OB about your options instead because she is much more qualified. Look, I know that this is a scary moment for both of you, but I think it's going to be okay."
Shaun thought about it, and then realized that maybe everyone was right. He wasn't just being too medical right now, but also too emotional because he knew about the statistics of vasa previa as most cases didn't require surgery or that many surgical interventions (except a c-section)...and Lea needed him as a support person instead right now.
Even though it probably wouldn't happen, he didn't want to risk a blood clot occurring in the umbilical cord as a surgical complication as it would be fatal for the baby.
The next day, Shaun and Lea were at an appointment with Dr. Wong, their OB/GYN. After she examined the image of Lea's transvaginal ultrasound from the hospital while also performing her own, she was discussing with the couple about what was going to have to happen.
Throughout the entire appointment, Shaun decided that it was best to just sit there, be quiet, do nothing, and just let Dr. Wong do all the talking and explaining. All he did was hold Lea's hand as they sat in the chairs at the desk in the doctor's office.
"The good news is that it was caught early. You'll need pelvic rest, which means you'll need to abstain from intercourse. We're going to need to frequently check the fetal heart rate once she reaches 28 weeks so we can determine fetal distress. It will need to be done twice a week," Dr. Wong explained. "You're also going to need a c-section, which will need to be done between 34 and 37 weeks, or earlier if problems happen sooner than expected. I suggest that you two think about when to schedule it when you get home. Hospitalization may need to happen at about 30 or 32 weeks so the fetus can be closely monitored. Corticosteroids will also need to be provided to help the fetus's lungs mature."
Lea still had her hand gripping Shaun's, fearful at the possibility of losing her baby while also trying to process her disappointment over the change in birth plans and all the information that the doctor was giving them. Her parents and brother already made plans to come to San Jose in late October for the baby's birth as the due date was October 28th.
"W-when should I worry?" She stammered, resting her free hand on her belly.
"Let me know if you get vaginal bleeding," informed Dr. Wong. "When vaginal bleeding continues or when your water breaks, you should definitely come to the hospital immediately."
Lea and Shaun nodded, and then the rest of the visit ended with them scheduling the next appointment.
Once they got home, Lea called the doula to inform her about everything that had just happened. Thankfully, Theresa said that she could still support Lea during the c-section and help her with breastfeeding and postpartum afterward; there was no need to un-hire her.
The very next day, Shaun and Lea returned to work (well, Lea stayed at home to work as she was put on bedrest) and tried not to worry too much, just focusing on doing their jobs and reassuring themselves that their baby girl will be just fine. While Lea focused on the hospital coding system, Shaun joined Dr. Park, Dr. Andrews, and Asher in Maxine Stanley's surgery.
Maxine was an 87-year-old woman who came in with an arrhythmia and a bracelet stating that she had a DNR. She was automatically saved from death by a pump in her heart, which she wanted to be taken out. While Park and Andrews preferred to respect Maxine's wishes, Asher wanted to let her live.
As for Shaun, his mind was too preoccupied with Lea and the baby to even care about Maxine's wishes and just decided to follow protocol.
Right now, the four surgeons were performing robotic-assisted left anterior thoracoscopic removal of the cardiac device.
"Who wants to write the paper with me?" Andrews asked enthusiastically.
Park raised his hand slightly as a way of answering "yes" while Shaun and Asher stayed silent.
"Assuming it works," Andrews chuckled.
"This surgery is interesting and very complicated, and I don't care about the patient at all," Shaun changed the subject. "It seems like the perfect distraction."
"I think this patient will be a good distraction for you because she's pretty fun to talk to," Park shared with a smile. "She has an awesome sense of humor."
"Um, I'm sorry about Lea and your baby. Is there anything I can do?" Asher offered, turning his head towards Shaun.
"No, you can't," refused Shaun. "We didn't lose the baby yet and we already decided what's going to happen. Lea will need bedrest and monitoring. The c-section is scheduled for 35 weeks, and all Lea and I need to do is arrange a date. The baby is going to be born in September instead of late October or early November. Also, as a first-year resident, you're one of the least qualified doctors here. Also, there is more scarring around the device than the imaging showed."
"We're going to need to free it before we can remove it," added Park.
"The clamp is loaded, so let's begin with the outflow cannula," concentrated Andrews as he gazed at the monitor. "We'll see if our patient can tolerate it."
They all watched closely as the machine whirred as Andrews operated it.
"Vitals are stable," observed Asher. "EKG is good."
"EKG is good," repeated Shaun, nodding his head. "This is excellent. I'm completely focused, not thinking about the possibility of losing the baby."
Unbeknownst to Shaun, Park and Andrews looked at each other with concern, deciding to go ahead and share their experiences with fatherhood or at least attempting fatherhood.
"It's a scary thing; the uncertainty when you're about to become a parent," sighed Park. "And there is nothing I can say as a doctor to make it better, but as your friend, I can say that you're not alone."
"Isabel and I have been trying to have a family," shared Andrews. "I've almost lost track of how many IVF cycles. People come over and ask how it's going. We say 'getting close', whatever that means. Mostly, it's just an answer designed to get people to stop asking questions."
"At eight months pregnant, Mia and I had everything planned," Park chimed in. "Bags packed, alternate routes to the hospital. Mia's water broke at the mall, and because it was our first time at the mall, we weren't sure which way we came in and we also forgot where I parked the car. Because our Lamaze teacher told us that first labors tend to be long, we didn't expect her labor to progress that rapidly for her to give birth in the back of our car in the parking garage. Nothing went the way it was supposed to go. And guess what? It was the best day of my life, especially when the EMT let me cut the cord. It's also something Mia, Kellan, and I still laugh about to this day."
"I have nothing," Asher chuckled nervously. "I'm on the fence about having kids, but I do sometimes think about how much harder it's going to be for me if I decide because it's either surrogacy or adoption for me, and that comes with its own set of problems."
Shaun hesitated for a while, and then decided to share how Lea was feeling about this right now. All he wanted was to fix the current situation with Lea's pregnancy.
"Lea wanted a natural birth with little interventions," he stated. "She even talked to me about wanting to switch to a certified nurse-midwife instead, although it would still be in the hospital. She was thinking about having a water birth and she was already looking at alternative birthing positions. She is disappointed, and so am I. I won't be able to cut the umbilical cord."
"The moments you are there for after the birth matter so much more than what you do and don't get to do during the delivery," reminded Park.
Meanwhile back in Shaun and Lea's apartment, Lea was lying on the couch with her laptop on top of her gravid belly. Sometimes she would take a break from working to send her mother messages or emails about the things on the baby registry.
She was then interrupted by a knock on her door. Guessing that it was Dr. Glassman, she decided to just go ahead and let him in.
"The door's unlocked, you can already come in," she sighed, not taking her eyes off the computer screen, which displayed a webpage of stroller and travel system options as well as research on which one would work better.
It wasn't Dr. Glassman; instead, it was Claire, Jordan, Morgan, and Dr. Lim who opened the door and walked in.
"Hey, how are you feeling?" Lim smiled as she and the rest of the women walked over towards the couch and sat with her.
"I'm fine," sighed Lea fearfully, closing her laptop and setting it aside. "I'm not bleeding and I'm not in labor. I'm alternating between two different distractions. One is doing my job and the other is browsing baby stuff. What are you doing here?"
"We wanted to check up on you," answered Claire.
"You're going to have a c-section at 35 weeks, which sounds pretty scary to me," said Morgan.
"Trying to protect your baby from any possible complication or even the fatal effects of a complication you already have is an awful, terrifying, and lonely feeling, and there is nothing as a doctor I can say to make it better, but I can say that as your friend, I can let you know that you're not alone," reassured Dr. Lim, trying to put Lea's mind at rest.
"I've been scared since I was a kid about bad things," shared Claire, softly chuckling. "If I could just be better - a better daughter, a better student, a better doctor - then I could stop bad things from happening. But once Melendez died, I finally realized that life is not something you're supposed to control. It's something you're supposed to share."
"I've recently thought about freezing my eggs," Morgan partook with hesitation. "All my friends in high school would either go on and on about all the countries they would travel to and how they would never have children or what they were going to name their future children or even their future wedding plans. I, on the other hand, have been back and forth since I was a little girl."
"I always dreamed of being a mom since I was a little girl," confided Lea, gently patting her belly. "But sometimes, I wondered if I even deserved it. When I found out that I was pregnant, I was scared and hesitant. We even considered abortion, but then Shaun and I decided that there probably will never be a right time given how unpredictable life is."
"I thought that I was ready, but when I lost Junior...it took a long time for me to stop blaming myself," Jordan added, looking at Lea with sad eyes.
All the women were surprised at Jordan's bombshell. They never expected that she had lost a baby before, especially Lea, who gave her an "I'm so sorry that happened to you" facial expression.
"A year later, I got a cat from the animal shelter. That helped," Jordan finished.
"Wait a minute, I'm so confused," Morgan faltered, looking up at the ceiling.
"You lost a child and you got a cat?" Claire questioned, finding the story and the entire context confusing.
"Junior was my tortoise," Jordan disclosed, which lead everyone else to sigh in relief and also laugh a little bit; Lea's mouth dropped open in surprise.
"That should have been at the beginning of the story, Dr. Allen!" Lim snickered.
"I wasn't the one who left the gate open!"
"Your tortoise ran away?" Lea said haughtily with her eyes wide.
Jordan shook her head a bit and made walking gestures with her fingers, indicating that Junior actually walked away.
The entire room burst out laughing.
"Anyway, did Park ever tell you the story about the day Kellan was born?" Morgan broke the laughter with a smirk, which made everyone else guess that this was a funny story.
"Oh, please tell!" Lea giggled, raising an eyebrow playfully.
Maxine's surgery was a success. She was going to be given something for the pain as well as some antibiotics for a small infection around the surgical site. There was a set of instructions for her that she was permitted to throw in the trash because she was so ready to die. Basically, she was going to be dancing and drinking until she dies.
Shaun couldn't quite understand why Asher wanted her to live so bad, but being vibrant and so full-of-life wasn't a good answer to him.
Eventually, Maxine threw a Going-Away-Soiree at the hospital (blocking the clinic entrance with a gourmet truck), inviting all the people she wanted to say goodbye to, yet refusing to take the antibiotics.
Nobody knew that Asher had a plan to slip antibiotics into her IV, but Shaun caught him in the act and convinced him to just let Maxine die, and she of course died the next morning.
When Shaun got home, he decided to take Lea for a walk in the park as a distraction from their anxieties about the baby, hoping that a nature walk that involved looking at flowers and butterflies would help clear their minds.
"The baby has a very high survival rate when born at 35 weeks," reassured Shaun, only thinking about the statistics of everything. "She'll need to be in the NICU for a while, but the steroids will help speed up her lung development. When vasa previa is properly diagnosed and managed with a c-section, the live birth rate is at 97%."
"Shaun," Lea stopped her and Shaun at a halt on the sidewalk, wrapping her arm around him. "It's okay to be scared. I'm scared shitless because sometimes I do wonder if I'm one of those unlucky people."
"But it's not helpful," contradicted Shaun. "I wish I could fix it. You're not getting the birth experience you want, and surgery can fix the potential complication. Now, I don't know how to fix things right now."
The couple was silent for a while, it was going to take a while for them to adjust their plans. They were both going on family leave and take 12 weeks off as soon as their daughter was born, but Lea had to go on it already...although she decided to cheat the rules and work from home while in bed, working part-time. Their baby was coming a month earlier than expected and Lea was going to need to let her parents know soon about the change of plans. Also, with a c-section, recovery was going to take longer for Lea.
"Look," Lea gestured over to a couple pushing their baby in the stroller on a different sidewalk; Shaun turning his head to see the happy family. "That's going to be us. Shaun, you don't need to fix things. Just believe with me that we're going to get through this and that we'll be having a beautiful baby to dote on. It will all be worth it."
AN: So, here is the end of the first chapter. I won't rewrite every scene (definitely not rewriting ones with patients unless there will be significant changes) because there are some scenes that will be better left unchanged and that would also mean I bit off more than I can chew. I hope you enjoyed the start of this rewrite. Please review :)