Chapter 7
The hallway that leads to the emergency room was unusually quiet tonight Audrey noticed. She passed through it walking beside the empty beds. The absence of patients makes her smile inwardly thinking that she's lucky tonight. She rarely has graveyard shifts anymore since becoming chief.
Tonight was a special case, because suddenly they have a shortage of staff after some filed their vacation and sick leave simultaneously. She could have put additional residents on duty instead of her but she admits that she missed the busy atmosphere of the emergency room. She is a trauma surgeon indeed.
Because the ER was unusually empty tonight, most of the staff were nowhere to be seen. Aside from one nurse on standby beside the station, she couldn't see the rest. That is when she heard the faint sound of some late night news program playing from the television.
She saw everyone watching intently on the television screen.
"Wasn't she a patient here before?" one of the staff whispered.
"Really?" another answered.
"Yes she was. Ms. Wren had a surgery here months ago. Something for her lungs I think," one nurse butted in the conversation. "I wasn't part of the team but a friend of mine upstairs was on duty at the ward where she was admitted. She's one of the memorable patients they had up there,"
Audrey looked up the screen and recognized her, the last patient she and Neil worked together. It was nice to see that she got to achieve her goal to go to the moon.
As Audrey saw the photos from the moon the news anchor was showing the viewers, she can't help but remember a token her former patient had brought to the moon. Wren had her and Neil sign it and said that she will take it with her to the moon.
Their names were on the moon together.
How romantic. Audrey smiled bitterly. She needs to remember that it was also around that time when she decided to part ways with Neil.
Her heart ached again at that reminder so she silently turned her back from the rest of the staff and walked back inside.
As she tries to keep her emotions controlled, Nurse Petringa hangs the phone with a grim face and approaches her.
"Dr. Lim we have several ambulances incoming. A bus accident nearby. At least three trauma patients expected," she informs.
Audrey knew she shouldn't have rejoiced early by the lack of patients. You never know what to expect inside the emergency room.
And so that night, Audrey's paradise springs to life once again.
……
Meanwhile six floors upstairs Neil was finishing his rounds late. He had to do an emergency surgery that afternoon which pushed down all his schedule behind.
"How are you feeling?"
"Ah chemo makes me feel more sick than before," Larisa slightly complains. "But if it's what I need to do to be okay once again then so be it."
"I'll talk to your oncologist to refer you to a dietitian for management of the side effects like the nausea," he promised.
"Thank you so much doctor. Audrey really knew I could trust you with my care," she smiles thinking of her.
Neil let out a small laugh. "She thinks too highly of me sometimes," he lightly shakes his head.
"Why? You don't think you deserve it?" the elder asked seeing the hesitation within Neil's eyes.
"I don't know," he laughs nervously. "Won't you be worried hearing your doctor say things like this?"
"Other patients maybe. But not me," she smiles kindly at him. "People sometimes expects too much from their doctors. We forget that there's a limitation to what you can do for a patient. You're only human after all."
Her wise words made his heart feel at ease. He doesn't feel comfortable sharing bits of his life with his patients, but with her he felt compelled to tell more. If Audrey learns about this, she wouldn't believe her ex boyfriend chatting with her former mother in law about life… or maybe about her.
"I've worked with Dr. Lim for more than a decade now," he started.
"Ah that trust must have a strong foundation then," she observed. "Audrey's trust was hard-earned."
"We were residents together,"
"So she saw you grow from an inexperienced intern to the surgeon you are now?" Neil nods. "I'm not knowledgeable about the work of doctors, but I know it takes a lot of practice, studying and experience to be a good doctor. She must have seen your failures before…"
"She did. A lot of times," Neil smiles at some fond memories of the past. Sometimes she was part of those failures. But so were the triumphs.
"But despite that she still trusts your skills. She did it a lot of times throughout the years… even now. So why are you feeling undeserving now? What changed?"
Neil fell silent. He couldn't answer her even when he knew the reason within his heart.
She became Chief. Her position changes a lot of things between them professionally and he wasn't prepared to lose his partner-in-crime.
He was spared from the conversation when his pager suddenly buzzes. An emergency. He's being summoned to the ER.
Great now I have to work overtime, Neil grimaced. "Sorry Larisa, I have to go now. They need me downstairs. I'll check on you again," he said before making a quick exit.
……
Back to the ER, one of the victims the EMT rushes in is pregnant and Audrey runs to her side. The staff gathers inside the trauma bay to transfer the patient onto the ER bed.
"How long has she been in cardiac arrest?" Audrey asks as a nurse beside her assists to remove the neck brace on the patient and another lends her the ambu bag.
"She was like this during the rescue and on the way here..." the EMT doing chest compressions on the patient replied. "...about fifteen minutes,"
"Keep compressing her chest," orders Audrey. "We'll check her heart rate once the monitor is connected. Give her 1mm of epinephrine through an IV line every 3 minutes."
"Okay," Nurse Petringa obeys.
"Also pass me a tube," Audrey added.
"The monitor is connected,"
"Okay let's check her heart rate," Audrey observes as the machine gives a long beep sound "Asystole," she frowns.
"Nurse Petringa pulls her womb to the left as much as you can," Audrey orders as she prepares to intubate the patient. "It looks like she's been pregnant for over 36 weeks right?"
"Her fundal height is about 36cm," Nurse Petringa confirms.
"The baby is big enough to have viability. Let's check if the fetus is still alive. Get the sonogram," Audrey ordered as one of the nurses cut the patient's clothes.
Seconds passed and Audrey observed. "The fetus is alive but the heart rate is too slow," she says. "She needs a c-section. Why haven't I seen anyone from OB dept yet?" she frowns looking around.
"There's a complication on their patient so they had to do an emergency CS," somebody answered her.
"Anyone they sent here to help?" Audrey asked as Neil arrived beside her. Nobody replied to her as her question was already answered by his presence.
"I'm available to help tonight," he simply said, answering Audrey's questioning stare.
She took a hesitant look at him. As their eyes met, both knew what the other was thinking. Both were thinking of that past patient that was the root of their present heartaches. And this delicate case in front of them was a bad reminder of it.
But Audrey knew she needed help in this. She stares at Neil's determined eyes and knows she could trust him.
Oh her trust in him never faltered under any circumstances. And it's time again to cling unto that trust again.
There's no verbal confirmation but Neil knew he was welcome to assist when she turned to him and said, " I think we need to conduct a perimortem caesarean delivery."
"We're going to do it here?" Nurse Petringa interrupts.
"I see signs of fetal distress. Even if we keep compressing her chest the blood won't reach the placenta…" Audrey paused.
"If we don't take the baby out, the mother and baby could die," Melendez completes her sentence, reminiscent of their residency days and Petringa smiles briefly recognizing those moments.
"Nurse Villanueva we need a life support kit for newborn infants and a NICU," Neil orders.
"We have a life support kit ready and I already phoned the NICU to prepare," Nurse Villanueva replies.
There was a brief pause again between Audrey and Neil as they decided what to do next. With a silent conversation with their eyes, Audrey asks, will you be okay?
Neil quietly nods giving her the go signal.
"I'll take the mother. You prepare for a neonatal resuscitation once the baby is out," Audrey speaks in a clear voice this time to Neil.
They quickly take out their lab coats and wear their protective equipment as the staff prepare the surgery tools and the patient for the delivery.
"Don't stop the CPR," Audrey orders as the nurse gives her the scalpel. "I'll cut the skin vertically and the uterus transverse.
As the blade goes through the skin, blood rushes out. "Gauze," Neil held his hand out as one staff member passed the thing.
"I'm into the abdominal cavity. Hold tight," Audrey says.
"I see the womb," said Neil.
"Give me the retractor. I'll cut through the womb," A few tense moments passed, the staff held their breath as they watched the two doctors try to save the lives of the mother and baby.
"I can see the baby's head," Neil whispers. "It's coming out,"
Delicately, Audrey guided the baby's head and then the body out of the mother's womb. As expected it was quiet, no cries of a newborn.
"Baby out 23:15," Nurse Petringa looks at her watch.
"Scissors please," Neil reached for the baby and cut the umbilical cord. He placed the newborn by the side as he and Nurse Villanueva rub the baby's back giving it warmth and trying to resuscitate.
Meanwhile Audrey takes out the placenta. He heard her say to the nurse "I'll finish up. Sutures,"
Nobody spoke at the moment. Audrey was finishing up while the mother was still being resuscitated. Neil quietly prays as he tries to do the same to the baby. The only sound that could be heard was the long beeping of the machines.
With each passing moment Audrey stole brief glances at Neil and the baby in worry. She hoped that this case would have a different ending than the last case they worked together. She hoped for the mother and infant's sake.
And then the tense silence within the area was broken by the sound of the baby's cry. The sound of hope, they think.
Neil couldn't believe his luck as he stared back at Audrey and held her gaze for a brief moment. Behind their masks they share smiles and at the moment it was like they were back to their younger days. When things were not yet as complicated as it is now. When they were still learning how to be a good doctor.
Audrey looks down at the mother still being given CPR. She glanced at the monitor and checked for the pulse. After what seems like an eternity, she releases a relieved breath.
"ROSC. She's back. The mom is back," she whispers, keeping her emotions at bay.
Everyone has happy tears in their eyes at the happy ending this case turned out to be. The baby's cries could be heard outside the trauma bay and surely everyone knew of the good news it means.
"Get the central line and give her norepinephrine," Melendez breaks the quiet celebrations. "Let's bring her upstairs to a room and set up,"
Audrey and Neil share one last glance before being swept away by another stream of patients.
It turns out that night, Neil had to stay behind for five hours past his shift. When everyone settled down again inside the ER, he found himself at NICU and staring at the baby he revived moments ago. The father had arrived and is currently marveling at the sight of his newborn.
"It's way past midnight, you're still here," he heard a voice behind him. Audrey stood by his side following his gaze at the father and child behind the glass.
"I had to see the baby. Make sure he's really okay," he didn't have the time to breathe and savor the joy of saving a life before. There wasn't a time to rest and celebrate, other patients needed his service.
Audrey didn't say anything but she smiled at him. She understands what he is feeling at that moment and she let him absorb the fact that they had saved a mother and her child successfully this time. Holding the patient's file, she caught the father's attention inside the NICU and motioned for him to come.
The father had a big smile on his face as he reached them. Despite the accident he had many things to be grateful for.
"You're the one who saved my family," he reached out to shake Audrey's hand. "I don't know how to thank you enough,"
"It's my team's pleasure to help you," she glances at Neil beside her and said, "And Dr. Melendez here saved your son,"
Neil raised his eyebrow at the sudden mention of him.
Come on, take the credit you deserve. Audrey communicated through her eyes.
The father was very grateful to meet his family's savers. He hugged Neil and exchanged some updates regarding his wife's condition. It will be a long journey to recovery but it will be a happy one.
……
Neil felt like some heavy weight was lifted off his shoulders as he drove home that night. He didn't feel this good for a long while, maybe after the death of his patient followed by his breakup with Audrey. He finally feels a closure to the guilt he carried.
He saw Audrey waiting by the bus stop and a rush of courage run through his veins. Tonight was nice. After months of trying to stay apart at work, they finally had a chance to team up again. And things worked flawlessly like the old times. He admits he misses working together with her. He appreciated that she welcomed his help that night.
He stopped the car in front of her and called her out, "Where's your bike?"
"I'm too tired to drive tonight," she replied.
"Then let me take you home," he offered silently hoping she accepts.
"Neil, I don't think it's appropriate," she hesitated but deep inside she wants to jump in right away.
"Please," he paused, his voice going soft at her. "Audrey we are outside the hospital already. Can't I offer a friend a ride home?"
Audrey knew that Neil wants to be friends again, to be able to work well together like the old times. She had some doubts before but after what happened tonight, maybe they could try to work it out again.
Maybe if they were able to find some balance again, they can have another chance at a relationship. Afterall, in a decade of knowing each other, it wasn't the first time they fought and reconciled their differences.
Maybe there's hope.
A small smile creeps on her face. She reaches to open the car and gets in with him. Together they drove home under the moonlight.
...
PS. I'm having some trouble with , seems like my recent update is not showing up on the webpage. If you can see this update please let me know.