Chapter Summary: Lea suffers from a massive seizure six weeks after giving birth.
AN: This chapter is a flashback of Lea's actual death scene. I had to do a lot of research on preeclampsia, eclampsia, and seizures and read a few memoirs in order for me to put some accuracy in this chapter.
As usual, Shaun and Lea were awakened by their six-week-old daughter's screams for her parents' attention. Since she made her way into this crazy world, they've been on constant alert and were more exhausted than they ever were in their lives.
Nell was now their new alarm clock, and Shaun and Lea would always take turns tending to her needs. Neither of them had gotten a solid night's sleep for six weeks (well, Lea didn't even get a solid night's sleep before Nell was born). On the bright side, since they were both on family leave, they had the opportunity and the privilege to sleep in.
They spent most of their time changing diapers, feeding the baby, burping her, getting vomited and spat up on, wiping up spit-up, bathing the baby, rocking and soothing her to sleep, swaddling her, bonding with her, and on Lea's part, pumping breastmilk and recovering from postpartum pain. Sometimes, they would take Nell for walks around the block with her riding in the travel system or while she'd be worn by either Shaun or Lea with the baby carrier or sling.
This was their new routine now. And while they loved Nell to the moon and back more than anything, neither of them were fans of the newborn stage at this point and couldn't wait for her to grow a little bit older and bigger.
This morning, Shaun was the first one to get out of bed and retrieve Nell from her bassinet.
After Lea started to stir, Shaun noticed that she was rubbing her forehead and squinting her eyes. She had been complaining of headaches for a couple of days, but they tried not to worry too much about it. She usually got them when she was stressed and/or sleep-deprived, so neither of them thought they were anything worth disturbing over.
"Good morning," she drowsily groaned and then walked over to give him a quick kiss on his cheek. She reached her hand around him and ran her fingers through Nell's small mop of thin brown hair. She was still rubbing her forehead.
"Are you okay?" Shaun inquired, jaded yet concerned. "Do you still have a headache?"
"Yeah," Lea sighed in annoyance and agitation, rubbing her eyes and temple as she leaned against the wall and clutched her upper right abdomen.
Shaun suddenly realized something. If Lea was his patient, he would have immediately noticed this at first glance, but they both had been too preoccupied with their newborn to even notice anything. For the very first time, Shaun actually started to wonder if Lea was developing late postpartum preeclampsia because, besides the headaches, her hands, feet, limbs, and face were swollen.
It was 8:00 in the morning and in just a matter of two (maybe three) days, Lea's bothersome headache had progressed from bad to worse. She tried taking ibuprofen the other night, but it didn't seem to help.
As Nell was serenely lounging in her baby bouncer, a fatigued Shaun cooked breakfast while an exhausted Lea sat down at the counter pumping breastmilk. When he served pancakes for both of them, all she managed to do was shove her food around on her plate like a fussy eater. She wasn't feeling any mood for an appetite right now.
"Are you not hungry?" Shaun prodded anxiously, completely taking notice of his girlfriend's worrisome behavior.
Feeling a tad sick and queasy, Lea quickly detached the pumping valves from her breasts and zipped her nursing tank back up before pushing her plate of uneaten food off to the side.
"I'm not," she answered, fearfully moaning and whimpering a bit. "I-I don't feel good. My headache is actually getting worse. I..."
All of a sudden, a wave of nausea took over her body and she vomited straight onto the kitchen floor. She felt the refreshing touch of Shaun's hands against her back and the comforting caress of his fingers through her hair.
"We need to go to the ER. Right now," advised Shaun, a sound of fear and urgency in his voice. "I think you may have late postpartum preeclampsia."
"Okay," muttered Lea, knowing that she probably shouldn't argue with her boyfriend. She wasn't a doctor or a medical professional, but she was aware that preeclampsia could be fatal if left untreated and she didn't want to die. She never thought it could develop this late. "Can you just...get me some water, please? I need some."
"Alright," complied Shaun. "I'll make one and then I'll get our shoes on and order an Uber to take us to St. Bonaventure. Chances are you're going to be fine." Although he had just earned his driver's license six months ago, he was too exhausted and sleep-deprived to have any energy to drive.
When Lea closed her eyes and then reopened them, her vision became blurry and fuzzy and she started to feel a little dizzy before eventually becoming disoriented. She could barely make out the details of Shaun's face. In addition, her headache wasn't the only thing that's been bothering her for the past few days. She's also had some cramps in her upper abdomen and not just her lower abdomen.
She was really starting to get scared.
"I can't see," she blurted out with a whimper before she suddenly couldn't hear anything but ringing. She didn't even take notice of Shaun handing over the glass of water she requested or him calling her name. She didn't even notice that Nell was crying.
Before everything went black and she lost consciousness, the only thing she could take notice of at this moment was the world around her spinning, the ringing in her ears, and the severe pounding in her head.
"I can't see," Shaun heard Lea whimper as he finished filling up her glass of water.
Alarmed, Shaun immediately probed her with questions, asking her if her vision was blurry or if she was seeing dark spots. But she failed to respond.
"Lea?" Shaun called out as he tried to hand the glass of water over to her. She wasn't reaching out to grab it despite it being presented right in front of her eyes.
She was just staring off into space.
He waved his hand in front of her face, but she wasn't reacting at all to any external stimuli. He was growing more and more worried.
"Lea!" He cried out in a panic, loudly clapping his hands in front of her face, but she still didn't react.
This wasn't good. This was bad. This was very bad. Actually, this was critical.
All of a sudden, Lea's body collapsed right out of her chair and onto the hard floor. She started shaking and convulsing violently, her back arching and her stiff body twitching.
She was having a seizure.
After grabbing his phone from the kitchen counter and taking a pillow from the couch, Shaun immediately ran to Lea and carefully shifted her onto her side and placed the pillow underneath her head. Then, he called 9-1-1.
In a matter of only 30 frightful seconds, Lea was already frothing out of her mouth and her head and limbs were jerking as if she was being electrocuted.
Shaun tried to remain calm throughout this whole thing, but with Lea in the clonic phase of a seizure, the dispatcher asking a lot of questions, Nell crying out for her mom and dad, and him being sleep-deprived, it was hard for him not to go into sensory overload and shut down.
"Just send a damn ambulance to 183 Balbach Street!" He demanded, completely frightened to death. "Apartment 24! Please hurry!"
Lea's violent seizure lasted for at least five minutes, which Shaun knew was not good; the ambulance arriving right before it stopped. He rode in the back of the ambulance alongside her; Nell tagging along with them because Shaun didn't have enough time to search for a good babysitter. She was fussy during the entire ride.
St. Bonaventure's ER wasn't crowded this morning at all and there were no surgeries that had been scheduled at this time. It was a total graveyard shift for Claire, Morgan, Dr. Park, and Dr. Andrews.
With everything so calm and serene, Claire found this moment to be pretty unusual. However, what made this moment even more unusual was the fact that Shaun hadn't been here for six weeks, and there was going to be another 12 weeks without him. Her team felt naked without him.
It was also pretty boring, so the team just had a bunch of casual conversations in the breakout room.
"I'm so bored! I bet Shaun must be having a nice vacation right now," Morgan snarked as she scrolled through her Facebook feed on her phone.
"Vacation?" Claire shot Morgan a look of disapproval. "Shaun and Lea aren't having a spa day or even going on a road trip. Maternity and paternity leave isn't a vacation."
"I know, I was being sarcastic," snorted Morgan, a smirk on her face. "But their baby is probably far more interesting than this boring hospital right now."
"Yeah, and then after being all cute and adorable, the baby will start to get a little boring," Dr. Park remarked, which earned him dirty looks from Claire and Morgan. "What? It's true! Trust me, I've had a kid before! Spend a day or two with a baby and you'll understand. And yes, we can all agree that Nell is cute."
"Fair enough, I guess you win," sighed Claire. "Anyway, I wonder how Shaun is handling everything - the dirty diapers, the runny noses, the spit-ups, and the sleepless nights. I also wonder how Lea is dealing."
They were all starting to miss Shaun already.
"They're probably both doing fine," affirmed Morgan.
The conversation was interrupted by Dr. Andrews bursting into the breakout room, telling them that they needed to come with him and it was urgent.
"An ambulance is on its way over here with Lea!" He announced, his voice professional but panicked.
"What?" Claire was shocked. Lea was just fine when she was discharged from the hospital six weeks ago. "Why? What happened? Is she okay? Where is Shaun?"
"We don't know. All we know is that she just had a massive seizure minutes ago! Murphy is riding with them, and so is Eleanor," Dr. Andrews answered as he and his residents sprinted towards the direction of the ER.
"Lea Dilallo, 29-years-old, gave birth to her first child six weeks ago, violent seizure for more than five minutes! Dr. Murphy thinks it might be postpartum eclampsia! She's unresponsive, tachycardic, hypertensive, and her oxygen levels are low! Two liters of magnesium en route!" The paramedic transferred the information as she and the other paramedic unloaded the stretcher from the ambulance.
Claire observed Lea's limp and lifeless body on the stretcher. Her skin was pale white and clammy and there was evidence of foaming at her mouth as there was a stream of excessive frothy saliva running down her cheek to her chin and ear as if she had a mouth full of toothpaste. Her eyes were closed and they were shadowed by dark circles. Her cheeks were also a bit puffy. She was wearing an oxygen mask and she wasn't reacting at all to the stress and commotion around her.
Morgan, Dr. Park, and Dr. Andrews took hold of the gurney and ushered Lea inside the building. They were both looking panicked and scared. None of them even noticed Shaun sitting still as a statue on the bench of the ambulance, cradling Nell in his arms.
He had dark circles under his eyes, his face was unshaven, his hair was a total rat's nest, and he was in his pajamas. He just sat there frozen, completely distraught while Nell fussed in his arms.
"Shaun?" Instead of following the rest of her team into the building, Claire ran straight towards her friend. "Shaun, what happened?"
Shaun didn't say anything. The only thing he could do was blubber, unable to get any words out.
"I...forgot...the diaper bag," he stammered, rocking back and forth on his heels. "I didn't bring the diaper bag...and Nell is sitting in a loaded diaper." He was beginning to hyperventilate. "Sh-sh-she's...been...c-c-comp-complaining o-of a headache for two days. It was a massive seizure and she could probably have a head injury or brain damage..."
"Shaun!" Claire interrupted, placing her hands over his arms, looking at him straight in the eyes and trying to calm him down and snap out of it. "We have to go. We have to go help Lea. We'll take good care of her. Right now, we need you to stay with Nell and be strong for her and Lea."
Shaun paced back and forth around the hospital family room as he waited with Dr. Glassman and Debbie, who had joined him for moral support, for news about Lea and her condition. Debbie held Nell while Dr. Glassman was sitting next to her, staring off into space, aware that as a board-certified neurosurgeon, a seizure lasting for more than five minutes was not good. He was deeply worried and afraid for his young assistant.
HELLP syndrome, liver damage, kidney damage, brain damage, stroke, cardiac arrest, coma...any of those outcomes could happen to her.
Three hours had passed since the seizure and so far, the only good thing was that Nell finally had a fresh clean diaper and she was calm, naive to everything that was happening. It felt like an eternity before Claire finally came in to deliver news to them. The expression on her face was gloomy and unsettling.
"How is she? Is she alive?" Debbie begged apprehensively, with Nell nestled into the crook of her arm.
Claire took in a slow breath before finally giving an answer. "It was late postpartum eclampsia," she stated, heavily staring towards Shaun face to face. She hesitated for a while before finally getting the rest of her words out of her mouth. "The seizure or maybe her preeclampsia caused a brain aneurysm."
"And?" Dr. Glassman inclined despairingly, folding his arms, certain that Claire's tone indicated that there was definitely more to the situation. She was holding something back.
"Unfortunately, the aneurysm caused complete loss of neurological function. We ran a few tests to confirm it, and I'm afraid we came to the conclusion that Lea is brain dead," she finished candidly, trying to hold back her tears. "I'm sorry, Shaun."
Shaun was speechless and at a loss, feeling like he had been verbally punched in the stomach and slapped in the face with all of the facts that Claire had presented him with. He didn't know how to respond to all this. He wanted to deny it, but he couldn't because it was definitely true. It's been three hours, so Claire and the team most likely spent that time trying to diagnose her. Tears were fighting their way out of his eyes. He wanted to scream.
Dr. Glassman was beside himself, and Debbie was shocked. Neither of them expected something like this to ever happen.
Medically, brain death is actual death, and there was nothing they could do about it. Lea was actually dead, and it was difficult for Shaun to process that.
"Would you like to see Lea one more time and say goodb-"
"No," Shaun let his answer slip without letting Claire finish. "She's an organ donor. You should get her organs harvested while they're still viable." If Lea's life couldn't be saved, she could at least save other patients who needed organ transplants - although her liver and kidneys were probably no good anymore.
"Okay," sniffed Claire, still trying to stifle her tears and wanting to give Shaun a hug. He wanted to save the lives of others, even if his own life was on the line or if the life of someone he loved was just lost. "I'll leave you alone." Then she walked out of the room.
"Shaun, I'm so sorry," he heard Debbie croak softly.
Dr. Glassman got out of his chair and walked over to Shaun, gently placing his hand over his shoulder with sympathy and empathy. With Lea gone, Shaun now needed him more than ever.
"I need you to watch Nell tonight," mumbled Shaun softly, not turning around to face his surrogate parents. "I want to go home. I want some moments alone."
"We can do that. Do you want me to stay with you tonight?" Dr. Glassman offered. "Debbie can take care of Nell while I keep you company. We could talk or just go for a walk."
"No," Shaun refused assertively. "I'm...tired. And I want...to be...alone. Also, somebody needs to locate Lea's family and notify them."
That afternoon when Shaun was alone in his apartment after leaving Nell in the care of Dr. Glassman and Debbie, he spiraled into a meltdown. It was just like the one he had back in that motel room in Casper, except Lea wasn't here to hold him and comfort him this time. She never will ever again.
This was the third time he watched someone he loved die right in front of his eyes. And overall, this was the fourth death he ever had to grieve in his life - first his rabbit, then Steve, then Dr. Melendez, and then Lea.
She was gone.
Postpartum preeclampsia: a rare condition that occurs when a patient has high blood pressure and excess protein in their urine soon after childbirth. Most cases develop within 48 hours of childbirth. However, it sometimes develops up to six weeks or later after childbirth. This is known as late postpartum preeclampsia. Postpartum preeclampsia plus seizures is known as postpartum eclampsia.
Shaun reviewed the textbook definitions in his head. When Lea was discharged from the hospital after giving birth, her blood pressure was normal. One week later, her blood pressure was still normal. Even after birth, mothers aren't safe from complications. He knew that, but he didn't know why the universe had to make Lea one of those rare cases. Help had arrived way too late for her, and it wasn't fair.
He curled up into a fetal position on his couch and cried.