At Odds with the Midwife Page 13

  “I agree.” Gemma looked down at the card she’d been handed at the door by Misty Summers and Yvette Burleigh. She had been delighted to see that Yvette looked wonderful today—glowing, in fact—and so happy. “I’m assigned to the emergency room.”

  Carly held up her card. “I’m in charge of the crew over at Pediatrics. We’ll see how good I am at painting aquatic life and bubbles.”

  “I’ve got the main lobby and reception area,” Lisa said. “No idea what the design is supposed to be. See you later.”

  Gemma and Carly watched her walk away. “Designer top, leather shorts and wedge sandals.” Gemma sighed. “Those are her painting clothes?”

  She glanced down at her own T-shirt and jeans, already stained with the blue paint she’d used on the doors and trim of her house.

  “For her, that’s dressing down,” Carly answered. “And I read that wedge sandals give your feet better support than flats do.”

  “You have the most interesting store of random facts in your head.”

  “I’ve got to have something up there to balance all the gardening information.” With a wave, Carly headed to the pediatrics area.

  Gemma walked toward the emergency room. She was familiar with the route because she had visited it whenever one of the creatures she was trying to rescue had been frightened and hurt enough to turn on her. She’d been pecked by birds, scratched by cats and bitten by dogs—and one baby raccoon. Those bites had instigated some moments of terror until it was determined the animals were free of rabies. She had also fallen out of a tree and broken her arm when she’d been trying to save a nest of baby birds whose mother had been attacked by one of the cats she’d rescued.

  The place was beginning to fill up and the person in charge was getting people organized. Gemma hurried to join them.

  CHAPTER NINE

  NATE ARRIVED LATE in the morning and was making his way through every room in the hospital to observe the work being done. Gemma had been right. People were enthused about this project, ready to help and wanted to see it through.

  He saw Carly in the nursery, painting happy animals on the walls. Nate continued on his way, making the emergency room his final stop because that’s where Yvette had told him Gemma would be. In the days since he’d last seen her, he hadn’t stopped thinking about her. When he’d been seeing patients, meeting with his staff, the hospital contractor or the hospital board, she had been on his mind.

  Besides the hospital board, she was the only one he’d told about his long-term plans. Maybe he should have said something sooner, been upfront about doing what needed to be done in Reston and then moving on. But she was pulling at him somehow, and he wanted a complete break with the past. He was determined to go.

  Gemma was sitting cross-legged on the floor in front of the nurses station, adding shades of green and brown to a pastoral scene of trees and what he thought must be the Kinnick River. Her hair was pulled up in the ponytail that seemed to be her go-to style. She was leaning forward, her concentration complete as she worked.

  Examining the scene she was painting, he realized it wasn’t the Kinnick River alone, but also her family’s campground, lake and cabin. She was painting a river of happy animals on the walls. Bubbles with children’s faces rose from the water. He smiled, wondering if she planned to paint in the cages and pens for all the animals she’d rescued. It was a good idea. It tied the mural into the surrounding area, besides being designed to bring calmness to the emergency room. He hoped it succeeded. He’d never worked in such a small emergency room, or such a small hospital, for that matter, and he had visions of the staff stumbling over each other during a crisis.

  Nate paused and glanced back the way he’d come, thinking of all the people he’d seen in the past half hour, and all that they’d accomplished. He hadn’t worked at a hospital that was such an integral part of the community. His community.

  Gemma was painting her own memories into the mural in here. The children’s faces that Carly was adding to the bubbles floating up from the river where frogs, fish and hippos frolicked—were they children she knew?

  Probably, and everyone else might be doing the same thing. They might not like him and they might even continue to blame him for what his father had done, but this hospital was important to them in a way he hadn’t understood until Gemma had given her impassioned speech about getting the community to help.

  That was something his father hadn’t understood, either, which might be why he’d embezzled the funds that supported the hospital. Robbing the schools and the churches would have had the same result. He’d effectively cut the heart out of the town, but now everyone was working hard to bring it back. He was grateful to be part of it.

  “Doesn’t that hurt your back?” he asked.

  Gemma glanced up. She had green paint on her cheek. His smile widened.

  “Oh, hi, Nate. Yes, it does, but we don’t have any stools, benches or even chairs. Almost all the hospital fittings were sold to satisfy the creditors.”

  He suppressed a wince then said, “You were right.”

  She took another critical look at the work she’d been doing, then turned, ready to stand up. She gave him a saucy look. “Of course I was, but right about what?”

  Nate reached out a hand to help her up, then watched as she stretched her legs, placed her hands at her waist and carefully worked out the knots in her back muscles.

  “Getting the town involved in the renovations,” he said.

  She tilted her head and grinned at him. “I love to hear you admit it.”

  At that moment, Frances Sanderson swept into the room. “Oh, here you two are. The hospital board has decided that we need to honor Marlene and her crew for getting all of this organized and carrying it through. Unbelievable how much is being done in one day. Anyway, we’re having an ice-cream social tonight at the high school gym. Everyone who’s helped is being invited. My daughter-in-law is printing flyers so everyone will know. It’ll be a great opportunity for—”

  “Fund-raising,” Gemma supplied with a grin.

  Frances gave her an indulgent smile. “You know me so well. See you tonight at eight.” She strolled out with a wave.

  “She’s like a force of nature,” Nate said as he stared after her. “She never stops.”

  “She can’t stop, not now that we know everything is going to cost so much more than we thought it would.”

  * * *

  BEFORE GEMMA COULD CONTINUE, Misty Summers walked out of an emergency room cubicle. She looked around at the cheerful work being applied to the walls, then reached behind her and used both hands to support the small of her back.

  “This looks beautiful,” she said.

  “Hi, Misty,” Gemma said. “Where did you come from?”

  “I’ve been lying down in there for a couple of hours,” she answered, pointing to the cubicle with one of the only beds left in the place. “I had to find a rag to wipe off the dust. Don’t worry, I opened the window to let in fresh air and closed the door to keep out the paint fumes.” She yawned. “Yvette said she could handle the assignment table.”

  Gemma frowned and immediately put down the square of cardboard she was using as an easel, along with her brush.

  “Are you feeling all right, Misty?” Gemma put her arm around the other woman’s shoulders for a hug, then checked her pulse.

  “I’ve got a backache and some cramps from sitting on that metal folding chair, handing out painting assignments. That’s why I got up and started walking around. That made me feel worse, so I came in here to lie down. I guess I fell asleep in spite of the ache. I should have insisted right away that Kelvin find me a more comfortable chair. He’s gone home to get one now.” She sighed. “I’ve enjoyed being pregnant, but I’m ready for it to be over.”

  “Growing a baby is hard work, and takes a
ton of energy—”

  A sudden gush of water pooled at Misty’s feet.

  “Oh, no,” Misty said. “Gemma, does that mean my water just broke?”

  “Yes. Your daughter is tired of waiting, too. She’s ready to meet her sweet mama so she’s going to arrive today.”

  “Today?” Misty squeaked out the word.

  Gemma made her voice soothing. “That’s right and everything’s going to be fine. You’re seeing Dr. Hedley over in Claybourne, aren’t you?”

  “Yes.”

  “We should give him a call and tell him you’re coming to the hospital.”

  “I don’t remember his number. It’s in my phone in Kelvin’s truck. He took it to get me another chair. I don’t know why he’s not back yet.” Misty barely had the words out before a pain hit her. Eyes wide, she reached for a nearby table to support her. Gemma kept a firm but gentle grip on her arm and Nate hurried to help hold her up.

  “How long have you had the backache and cramps?” Nate asked.

  “Since about eight o’clock—as soon as I sat down in that metal chair.”

  “Although you weren’t aware of it, your daughter has been doing a lot of work in the past four hours to get ready for her grand entrance.” Gemma gave her a warm smile. “It was very considerate of her to let you get some rest because you have hard work ahead of you.”

  “It felt exactly like the backaches I’ve had every day. I thought labor would be worse, like the pain I just had.” She looked from Gemma to Nate. “You mean my baby might come faster than I thought?”

  “We don’t know yet.”

  Her eyes full of tears and terror, Misty said, “But I’m not ready yet. I still have two weeks to go.”

  “A due date is simply a medical estimate. Remember, we talked about that in the class a few days ago? Your baby has other ideas,” Gemma said, maintaining her calm manner. “She’s chosen her own birthdate.”

  “What’s Kelvin’s phone number?” Nate asked. “I’ll call him. I’ll also find a wheelchair. There’s got to be one here somewhere.” He turned away as soon as Misty gave him her husband’s phone number and came back a few minutes later with the wheelchair. “He’s on his way,” he assured them. “He’s also going to call Dr. Hedley.”

  Misty sank into the chair as another pain hit her. Gemma and Nate exchanged glances as her back arched and her body bucked against the chair. In the middle of her groan of pain, Misty made a strong, grunting noise from the back of her throat.

  “I don’t think we have time to wait for Kelvin to get here,” Gemma said, switching to a brisk, no-nonsense tone while maintaining her warm manner. She glanced up at Nate to include him in what she was telling Misty. “That grunting noise you made during your contraction tells me your labor might be progressing faster than expected. Let’s go over to the birthing center, where we can check you out. Then the decision can be made on what needs to be done.”

  “Oh, okay,” Misty said.

  They quickly learned why the wheelchair was still in the emergency room—any weight on the smaller front wheels made them grind to a halt. Nate had to tilt it onto its larger back ones to get it to move. Bent over in this awkward position, he pushed the wheelchair out of the emergency room and across the parking lot to the Sunshine Birthing Center. Gemma hurried ahead to unlock the door. Once inside, she led the way to the nearest birthing room. Between them, she and Nate got Misty onto the bed.

  “I’ll examine her while you go wait for Kelvin and get him over here.”

  Nate looked as if he wanted to argue but then seemed to remember that this was her house, and her area of expertise, little though he might think of it. Besides, arguing would simply waste time. He nodded, asked Misty for a description of her husband and his truck and went outside.

  Within a couple of minutes, Gemma had confirmed her earlier prognosis. “Misty, you’re dilated to ten and the baby is crowning.”

  “That—that means she’s coming right now, doesn’t it? Oh, where is Kelvin?”

  While her patient fretted, Gemma tried to make her comfortable. “He’ll be here soon, but right now, you have to concentrate on what’s best for you and your baby. You’re strong, Misty. This is hard, but you can do it.”

  Gemma attached a heart monitor to the baby’s scalp. As soon as she saw a reading on the monitor, she said, “Misty, your baby’s heart rate is strong and fast, like it’s supposed to be.”

  “Oh, good. So she’s okay?”

  Another pain had Misty crying out and clutching at the bedcovers. When Gemma checked again, she saw that the baby’s head had moved back up in the birth canal. The next pain brought it back into sight, then it disappeared again. Three repetitions of this disappearing act told her that the baby’s shoulder was stuck beneath her mother’s pelvic bone.

  Gemma ran through the reasons this might have happened. If Misty had been lying on her back while resting in the cubicle, the baby could have slipped into the wrong position. Excusing herself, she hurried out of the room and called for Emergency Services. Even though Gemma knew she could deliver the baby safely, Misty and her daughter would need in-hospital care as soon as possible.

  Coming back into the room, she said, “Misty, your daughter’s shoulder is stuck under your pelvic bone.”

  “Oh, no, did I do something to hurt my baby ’cause I didn’t know my labor was starting?” Tears ran down Misty’s face. “Is she going to die?”

  “Certainly not. Nobody is going to die. We simply have to change your position and get you up on your knees.”

  “What’s happening?” Nathan asked from behind her.

  Gemma answered as Kelvin Summers pushed past Nate and ran to his wife’s side. Misty reached up and grabbed her husband’s hand, wringing it as another pain hit.

  “Shoulder dystocia.”

  “May I have a look?” Nate asked, squirting hand sanitizer onto his hands and quickly donning gloves.

  Gemma stood close and spoke quietly to him. “The skin on the baby’s head has darkened. Blood flow has slowed.”

  “I can see that.” After a brief but thorough examination, he said, “The baby is in distress. We need to perform a cesarean section.”

  “Yes, yes, let’s do that,” Kelvin said as Misty let out a scream of pain.

  “Yes, do it,” Misty groaned, her eyes rolling in panic. “I’m going to die. My baby’s going to die.”

  “No. The baby’s not in distress. Her heartbeat is still strong and isn’t even dipping into a dangerous range. A C-section isn’t necessary,” Gemma insisted. “If we change your position right now, we can solve this without surgery. I’ve done it many times.”

  When Nate started to object, she gave him a severe warning look and said, “Will you step into the other room with me, please?”

  Nate followed her into the tiny space she was using as an office.

  Gemma turned to him once they were alone. “I can handle this.”

  “Surgery is the best and fastest option,” Nate said. “I shouldn’t have to tell you how serious this is. There’s a possibility of hemorrhage or other serious injuries.”

  “And the possibilities are increasing the longer we argue,” Gemma answered testily. “For a C-section, you’ll need an anesthesiologist and an operating room.” She threw her hands wide. “Do you see that here? The nearest ones are half an hour away. I’ve already called 911. An ambulance is on the way. If everyone, including you, will calm down, I can solve this by getting her up, and—”

  “Getting her up? That will put her at even more risk.”

  The horrified father-to-be appeared in the doorway. “Hurry, Doc. She’s dying!”

  “Nobody is going to die,” Gemma said again with even more emphasis. “Are you going to help me or not? We’re running out of time. I’ve called Emergency Services, but this b
aby is going to arrive before they get here.”

  Nate leaned in close and spoke in a low tone of controlled rage. “I’ll help, but I’m also going to call your medical director and get him over here. If I find this patient has been harmed in any way, I’ll make sure this place gets shut down.” Raising his voice, he turned to Kelvin and said, “Call her doctor and tell him to meet you at the hospital in Claybourne.”

  Fury and disappointment fought to surface, but Gemma forced them down. Even though this was her birthing center, she felt helpless and disrespected. Reminding herself that she was a professional and had promised to do what was best for her patient, she pushed her hurt feelings aside.

  “Come on,” she said.

  While Kelvin called Dr. Hedley, Gemma spoke soothingly to Misty and helped her turn onto her knees with Nathan’s assistance. She then checked to make sure the cord wasn’t around the baby’s neck, and also that the baby’s hand or arm wasn’t up by her head. She relayed this good news to Misty, then moved with caution to slightly rotate the baby into birth position and waited for nature, and gravity, to bring the little one into the world. All the while, she kept up an encouraging conversation with Misty, assuring her that she was strong, she was doing a wonderful job, that she could deliver this baby.

  Baby Summers emerged after a few more contractions and Nathan was the one to catch her. Gemma helped Misty lie down again, and he handed over the crying, wiggling newborn. Gemma avoided his eyes and placed the tiny girl on her mother’s chest, then checked Misty for signs of hemorrhage.