The Heart Doctor and the Baby (7 page)

She collapsed into her desk chair, resting her head on the back. Tears leaked from the corners of her eyes. She swiped them away, refusing to slip into another crying
spell. Here she was carrying a baby, two beings sharing one body, her body, yet she'd never felt more alone in her life.

Week sixteen of the pregnancy, mid-June

Gretchen Lingstrom, Stephanie Ingram's doula, was her choice after several interviews, and Gretchen had already given her homework. René lay on her bed reading at midnight, refusing to rest on her clinical laurels. Determined to experience the pregnancy as a future mother and not a doctor, she dutifully perused the pages of
The Natural Way to a Successful Pregnancy and Delivery.
Gretchen's special mix of essential oils brewed on the bedside table, and though she would have preferred human company, the scent offered her a degree of comfort.

It had been a long day, and she was tired. At least she wasn't throwing up anymore now that she'd made it through the first trimester. She stretched out on her bed; the pillows looked so inviting. With hands behind her head, she allowed her mind to drift to fanciful thoughts about decorating the second bedroom as a nursery. What colors would she use? What style of crib? Would she keep a bassinet in her bedroom? And for how long?

Something odd happened. A vague flutter south of her navel stole one hundred percent of her attention. As if a large butterfly were trapped beneath her abdomen, she felt the first movement of life in her uterus. Her hand flew to her stomach. “Quickening,” she reverently whispered the medical term for what she'd just felt.

She held perfectly still so she could savor the magical flapping motion to memorize it forever. Normally a woman didn't feel the first signs of life until eighteen to twenty weeks, but she'd noticed her obstetric training had
made her profoundly aware of her body and each stage of the pregnancy, and this was no exception.

She'd had the ultrasounds, knew she was pregnant. Felt it in her tender and growing breasts; saw it in the insidious change in size of her waist, hips and stomach. But nothing could compare to this feeling, this affirmation of life. Warmth bubbled up and over her skin from a depth of emotion she'd never imagined. Riveted in the sensations, she couldn't move. Her eyes prickled and leaked with joy. She grinned and lay still, taking it all in for several more seconds.

René wanted to share the special moment with someone. Her parents were in Nevada, and it was too late to call them. Likewise, any of her girlfriends who had young families themselves would already be asleep. Though Gretchen had told her she could call day or night, the only person she really wanted to talk to right now surprised her. Jon.

He'd kept his distance over the past month, and she'd missed him. But hadn't he been the one to insist on superfriend status?

She reached for the phone and punched in the numbers. On the second ring a husky voice answered.

“Did I wake you?” she asked, knowing full well she probably had.

“No! I was reading and must have dozed off,” Jon said, and she was grateful he knew who she was without asking.

She liked how he sounded and imagined him on his navy-blue sofa, cardiology journal opened on his chest, hands folded over it, feet crossed at the ankles on the coffee table, goosenecked lamp positioned just so over his shoulder.

“Is everything okay?” he asked.

“I'm fine. Beyond fine. I just felt the baby move for the first time.”

“You did?”

She heard the genuine interest in his voice. “I did.” She smiled so wide her lips felt as if they might split. “Just now. It was the strangest sensation. I loved it.”

“Wait until that little one gets bigger and starts kicking—you won't be nearly as amused.” A smoky laugh rumbled from his chest. She liked it.

“We'll see.”

“We will?”

“Figure of speech,” she said. He'd signed a contract releasing him of any duty to the child. She knew it. He knew it. So why had she called him?

“I've missed you,” he said, honey-warm tones in his voice.

She held her breath, hoped he wouldn't notice how eager she was to answer. “I've missed you, too.”

“What are we going to do about it?”

Wishing she could say anything but what she knew she had to, she cleared her throat. “Nothing, Jon. We made our deal, now we have to stick to it.”

“Ah, our pact with the devil,” he said.

What could she say?

After a brief silence, rather than hang up on her, he changed the subject, brought up how he'd overheard his nurses discussing who the father of the baby might be, and as she vocalized her protest, they conversed like old friends hooking back up after a vacation. They quickly moved on to other topics, and skirted the reality of their situation—that she carried his child and he was going to China—and managed to talk on and on.

And on…

René squinted and peeked from under her lid. The bedroom light was still on, glaring in her face. She glanced at the clock; it was two in the morning. She clutched at the
phone on her chest and moved it back to her ear. Instead of the
beep-beep-beep
of the disengaged line she'd expected, she heard soft, deep breathing through the receiver. She hadn't fallen asleep on the phone since junior high school. And sweet Jon hadn't hung up, either.

After a murmured snore, Jon swallowed. She smiled with a distinct picture in her mind of a guy with tousled hair and a sexy shadow beard. What would it be like to wake up next to him?

“Jon? Jon? Wake up.”

“Huh?”

He yawned and obviously stretched. Did he have a clue where he was and who he was still on the phone with?

“Good night, Jon.”

“Love you,” he said, midyawn before he clicked off.

What? Her hand flew to her mouth. Did she just hear what she thought she'd heard? A chill snaked its way down her spine with the possibility he might actually love her.

Nah. Couldn't be. It was the middle of the night; surely she'd imagined it.

Still, René hung up and relived those two haunting words over and over again, and each time tingles tiptoed over her skin. Until she couldn't bear to indulge in the fantasy anymore, she put on her scientific hat, then rationalized away every possibility: She hadn't heard him correctly; he'd thought he was talking to one of his daughters; he was dreaming; he'd been sleep talking; the poor man was out of it and confused on top of that. At two in the morning any explanation would do, except the one that whispered he'd meant it, the explanation that stirred her hoarded hope and made her tremble inside.

A little part of her, a part she'd buried and kept throwing more dirt on, wanted to believe he'd meant what he'd said.
Hoped with all her might he had. Okay, there, she'd admitted it. She weaved fingers through her hair and stared at the ceiling—she wished things could be different with Jon. This time a cold chill settled in her chest and dug an icy trail to her heart. This had never been part of the plan. Now, besides dealing with her pregnancy, she had to wrestle with the reality that she wanted something more with Jon.

The next morning, when she saw him at work, he nodded and acted as if nothing, absolutely nothing, had changed between them. All right, so he had been more than half-asleep, and didn't recall or have a clue of how he'd ended their phone conversation.

Case closed.

She'd be a big girl and get over it. Though the instantaneous flicker of hope that maybe he'd meant exactly what he'd said, gave her pause. It sent her off to her office wishing she hadn't rushed into this contract with Jon, knowing if she had to choose over again, she'd go right back to Jon Becker to be the father of her child. But for the second chance, she'd make sure her proposition involved the old-fashioned way.

 

There was no way Jon would be able to continue to work here and remain uninvolved in René's pregnancy. How in hell had he managed to skim over that incredibly important detail when he'd made his decision to be the sperm donor?

Superfriend status, my eye.

He scrubbed his face and leaned against his office door. He had to think of a way around the consequences.

In the meantime, he must avoid René whether he wanted to or not. He'd sneak in the back of the clinic in the morning, eat lunch in his office and sneak out the back door at the end of the day. He'd survived worse, like
divorce after seventeen years of marriage when he'd never even suspected his wife was unhappy. He was the last thing in the world René needed, and staying out of her life should be a walk in the park, comparatively.

There was a tapping on his door, and he glanced briefly at his watch. Not quite time for his last patient appointment, but this could be a chance to finish the afternoon clinic early for a change.

He opened the door and found René standing on the other side. She'd pulled her hair back today and wore large silver hoop earrings. If she were any other female colleague, he wouldn't have even noticed. But with her, he had—immediately after noticing the depth of her eyes and the few golden flecks sprinkled judiciously in her irises.

“Can you do a cardiac consultation for me?” she asked, all business.

“What have you got?”

René handed him a heart test strip and he saw several premature ventricular contractions—PVCs—scattered across the six-second, twelve-lead EKG.

“Where is she?”

“In my office,” she said, already starting down the hall.

René ran the patient's medical history by him as he followed her to the examination room. “She's eight months pregnant with her fourth child. She's undernourished, her blood pressure is mildly elevated and she states it's always like that. And when I listened to her heart, I thought I heard a third beat in diastole.”

A distant picture gathered in his mind, a unique condition that affected one in ten to fifteen thousand deliveries. The patient history had the markings of high-risk pregnancy all over it, one that should have been followed
from early gestation, maybe even counseled against long before conception. Why hadn't René consulted him before now?

“By what you're telling me, she could be in peripartal cardiomyopathy. I won't know for sure with the physical exam, but I may need to admit her to hospital to get to the bottom of this. Did she have problems with her other deliveries?”

René slowed as they approached the examination room and glanced toward the floor. “I've never seen her before today. The history is sketchy at best. I don't think her kids are living with her,” she said quietly. “When I asked why she waited this long before getting prenatal care, she just shrugged. I was shocked when she told me she was eight months pregnant. I thought she was around five months.”

She bore a concerned expression that, the more he learned about the patient, rubbed off on him.

“Is she homeless? How did she get an appointment with you?”

“I do several pro bono appointments a month, and she said someone told her about me. Honestly? I think she may be involved in sexual services, and most likely lives on the street or in cheap flop motels.”

“Not the best circumstances to be pregnant in. If it turns out she does have what I'm suspecting, she'll have to be admitted to the hospital, and we can get social services involved, for both her and the baby's sake,” Jon said.

“I had my nurse draw a complete blood panel, and I got samples for STD tests when I examined her.” René knocked on the door.

“What about a drug screen?” he asked.

“I thought of that, too.” She swung the door open.

Jon glanced at the thirty-something woman, thin as a slip though pregnant, who sat on the examination table.

“This is Chloe Vickers,” René said, “and she is eight months pregnant. Today was our first appointment, and I'm concerned about her blood pressure and her heart.” She spoke to the patient, as if making sure she understood why the male doctor was in the room. “Dr. Becker is a cardiologist.”

The woman's cautious gaze darted between them, her pasty skin almost opaque.

Jon produced his top-of-the-line stethoscope, warmed it with the palm of his hand and placed the bell close to the sternum in the birdlike rib cage. He listened intently, first on the right side at the second rib interspace, then he moved the bell to the left. He worked down to the third rib interspace, then to the lower sternal border. He repositioned Chloe on her left side and listened again, then had her sit up and lean forward and he listened to her heart once more from this angle. There was indeed a proto-diastolic gallop present.

Twenty minutes later, after a thorough physical examination of her heart, and additional gathering of medical history, Jon called the local hospital from René's office to arrange for more tests and patient admission. He glanced across the baby collage as he waited for the house on-call doctor to pick up, and worried about the outcome for this mother-to-be.

“I've got a patient for you. Chloe Vickers. She's a thirty-four-year-old female, multiparity, currently at thirty-two weeks' gestation with abnormal EKG and elevated BP. I suspect peripartal cardiomyopathy. I want her on bed rest and sodium restriction for starters. Labs are pending. And if the echocardiogram confirms my predicted diagnosis, we'll need to arrange for cesarean section ASAP.”

He glanced at René, who hadn't left his side since
she'd brought him in for the consultation. Other than the faint tension lines between her brows, she was the exact opposite of Chloe Vickers. She was fit and the picture of health; her color was creamy light olive with pink cheeks, and there was a spark of life in her deep honey-colored eyes. He tore his gaze away, while hoping René had lots of extra energy today, because Jon suspected she may be doing a last-minute surgical delivery before the day was over.

With the added risk that Chloe might take off if given half a chance, Jon personally arranged for her to be driven to the hospital, met her there and walked her to the office of admissions.