Suggested listening: Alex Goot & Kurt Schneider's version of The Fray's "How To Save A Life"
Chapter 5
"SANTANA! GET IN HERE NOW" Mercedes screams.
I rush into the bathroom and see Rachel passed out next to the toilet. She is bleeding profusely.
"Ohhhh, fuck. I run over to her and check her over. I whisper to myself, "Placental abruption." I start barking out orders:
"Tina, call 911. Tell them we have a 29 week premie, mom with placental abruption."
"Q, call the hospital to let them know we are coming in with Rachel. Tell them that her blood type is B+. And to call in Dr. Novick."
"Sam, call Brittany now. And grab all the towels from the hall closet."
"Mercedes and Marley, can you watch the kids?"
They all stand there in shock, before moving onto the tasks. I assess Rach.
"Fuck." I can see that the baby is already crowning.
I start shaking Rachel. "Rachel, honey. I need you to wake up now, okay?" Come on."
She starts to come around. I can tell that she is in shock.
"Focus on me, Rach. I need you the push okay?"
"But...but...no... it's too early..."
"Yes, hon, you need to push NOW."
"Q, can you grab my medical bag by my bedside?"
She goes and gets it, opens it up, and places it next to me, before going behind Rachel, propping her up.
"What's happening? Quinn?" Rachel says, before looking at me in between her legs and seeing the blood on the bathroom floor.
"NO! This cannot be happening! San, make it stop!"
Quinn just whispers in Rachel's ear, soothing words, to try and calm her down amongst the chaos. She tells Rachel that she needs to listen to me. I can see by the look on her face that she is ready to comply with my directions.
"Tina, I need you in here." I knew that out of our group of friends, she would be the least squeamish. The last thing I needed was someone passing out at the sight of blood, creating another patient.
She comes in, takes a deep breath, before telling Rachel, "It's okay, Rach. You got the best OB in New York City. You'll be just fine." She says to convince herself; to convince all of us.
I knew that this situation was dire. From the amount of blood loss, I estimated that she had a Grade 2 abruption. I had to work quickly to get the baby out, before...
I wouldn't let myself think of that, I just focused on Rachel.
"Ok, Berry. With the next contraction, I will need you to push, okay? Tina get the bulb syringe, twine, and surgical scissors out of my bag, please. Then, I need you to hold Rachel leg like this, okay?"
Tina does as she is told, Quinn grabs a hold of Rachel's hand, doing Lamaze breathing with her.
"Okay, Santana, I feel one..."
"Rach, Push, okay...come on, the head is almost out."
She grunts and her final effort results in the baby's head out. "Shit," I say under my breath. Nuchal cord x2. I need to get this baby out now.
"Rachel, I need one more push okay and the baby should be out."
At this point, I can see that Rachel is drifting in and out of consciousness.
"Baby, wake her up. I need her to do this now, or..."
I look at my wife and she knows what I am insinuating: if I don't get the baby out now, he/she will die and Rachel could die too.
"Rachel, Rachel, come on. Wake up. Don't you want to meet your baby? San just needs you to push one more time."
Rachel starts mumbling incoherently but does as she is told, with the last push the baby is out.
"Why isn't my baby crying? Santana?"
That is the last thing I hear Rachel say, before she slips back to an unconscious state. I unwrap the cord around the baby's neck, tie twine around the cord, and cut the umbilical cord. I wrap the baby in a towel and start rubbing her off, in attempt to stimulate her. She looks so small yet she a perfectly formed human being, with ten fingers and ten toes.
"Come on, baby girl, breathe for me. Come on. Where the fuck are the paramedics?" I scream exasperated.
The baby is limp and not breathing. Rachel is passed out in about 1/2 of her blood volume. I don't know what to to. We are taught that the needs of the mother always trump the baby's. However, I know what Rachel would want.
"Tina, I need you to put on a pair of gloves. I need you to do this for me, because I need to help the baby. Take these towels and pack them in Rachel. We need to stop the bleeding."
I take the baby and immediately begin resuscitation. After clearing her airway, I give her breaths, covering her nose and mouth with my mouth, all the while saying a silent prayer. Quinn is beside herself, crying uncontrollable.
"Q,, baby, I need you." She comes over to me. "I need you to go into my bag, okay. And grab something that looks like a long skinny tube. Yup that's it. Okay, now, I need you to take over at CPR."
Quinn was certified in CPR, just in case it was ever needed and I wasn't around. I am sure she never imagined she would be performing rescue breathing on her best friend's daughter. She took over for me as I inserted an umbilical line. I draw up the correct dose of atropine, while encouraging Quinn. I push the medicine through the line as the EMTs enter the bathroom. I recognize Alex, one of the paramedics I am friends with.
"Hey, Doc Lopez. Whoa..."
I give them the bullet and ask them for the supplies to intubate the baby. It has been forever since I had to do this on a patient, let alone a premature infant. I close my eyes to calm myself. I open my eyes and remember the steps clearly. I insert the endotracheal tube. Mark, the other EMT, listens for breath sounds.
"You are in, Dr. Lopez."
As I secure the breathing tube, I implore to Alex, "Please, I need you to go to Rachel...please." I am worried that my choice to try and save the baby resulted in her losing her mother, before she even met her. My heart stops as I see Alex check for a pulse, while Mark places the leads on her, to pick up a rhythm. I see the QRS complex and hear the beep of the machine. Thank Jesus, she is still alive.
"Doc, pulse is weak, thready, but there."
"Get a line and push volume. We need to go to the hospital now."
