Wanted: Parents for a Baby!

CHAPTER TWO

CASSIE HOVERED OVER Emma’s warmer, lightly stroking the tip of her finger down the baby’s downy soft cheek, as much as she could around the breathing-tube holder.

Emma F. Safe Haven, the name they’d given her, was doing a great job of hanging in there. No sign of seizures yet, but Cassie was afraid that if she took her eye off the baby for an instant she’d miss the telltale jerky movements.

The good news so far was that Emma’s blood gases had come back well within normal range. She’d placed a page in to Dr. Ryan to share the results. Maybe they could work on weaning the baby off the ventilator. They’d have to go slowly, because removing the tube, only to replace it a few hours later, would be traumatic and possibly cause damage to Emma’s tiny airway. However, getting the baby off the vent was also better for Emma’s lungs in the long run.

Finding the right balance was always tricky.

Cassie lingered a few minutes longer, wishing she could give Emma more of her attention, but then had to leave to care for the other baby assigned to her care. Thankfully Barton was stable. He’d been born four weeks too early, but was gaining weight and coming along nicely. He still had a couple instances of five seconds or longer of apnea, a common problem in preemies, but so far he’d gone twelve hours without any shallow breathing recorded on the monitor. If that trend continued, in another day or two he’d be ready to move up to the level-two nursery. And soon be discharged home.

She quickly changed Barton’s soiled diaper and then disconnected him from the heart monitor for his feeding. She sank into a rocker she’d pulled over near Emma’s warmer so she could keep an eye on Emma while giving Barton his bottle. Normally they encouraged the parents to come in for the feedings, but Barton’s mother had mentioned she might be later than normal today because she had to wait for her husband to get home from being out of town. She’d had an emergency C-section and hadn’t been cleared to drive yet.

“Aren’t you a good boy,” she cooed, as Barton eagerly sucked at his bottle. “You’re going to grow up to be big and strong, just like your daddy.”

She sensed someone’s gaze on her and looked up to find Dr. Ryan standing a few feet away, staring at her. For a second she thought she saw a distinctive longing reflected in his eyes, but in a flash the moment was gone and the polite yet distant expression had returned to his eyes.

“Emma’s blood gases look great, and I’ve entered new orders to drop her ventilator settings,” he said brusquely. “Should I ask the unit clerk to page the respiratory therapist?”

“I’d appreciate that, if you don’t mind. I’ll be here for a while yet.” More proof that Dr. Ryan was a great doctor. He didn’t think menial tasks were beneath him. Or maybe he was simply anxious to get Emma’s vent settings changed. “So far I haven’t seen any evidence of seizures.”

“Good. You’ll probably get a call from Child Protective Services, I put them on notice about Emma.”

“Oh, okay.” Cassie suppressed a flash of disappointment. Of course calling CPS was the right thing to do. “I guess, once she’s stable, Emma will end up in foster care, then,” she murmured, trying to hide the wistfulness in her tone. She had no right to be so emotionally attached to Emma. The baby wasn’t hers to love and to care for. Except here, at work.

Dr. Ryan’s lips tightened in a grim line. “I imagine so.”

She couldn’t say anything past the lump of regret lodged in her throat. Ridiculous to think she could become a foster parent for Emma. For one thing, there was a long process, including classes to take, along with other hoops to jump through, before she’d be granted that privilege. Even then, she knew that a married couple would have a better shot of getting custody of Emma than a single parent such as her.

Barton turned his face away from the bottle, reminding her it was time for a burp. She lifted him up, turned him and placed him against her shoulder, rubbing her hand in soothing circles over his back. She couldn’t resist brushing a kiss against his downy temple, enjoying the scent of baby shampoo that clung to his skin. He squirmed a bit and made gurgling noises before letting out a loud belch.

“Good boy,” she praised him with a wide smile. Gently she turned the baby round so she could try to give him the rest of his bottle. He was still pretty tiny, less than five pounds, so he usually only took a small portion of his bottle at each feeding.

“You’re a natural,” Dr. Ryan said in a low tone.

The longing to have a baby of her own stabbed deeply, but she pushed it away with an effort. Her cheeks warmed and she cursed herself for responding to every little thing Dr. Ryan said. He had no way of knowing that she’d miscarried twice before her marriage had shattered into irreparable pieces. “Thanks.”

Abruptly he turned and walked toward the unit clerk’s desk. She overheard him requesting the respiratory therapist on duty to be paged for vent setting changes.

Little Barton took another ounce before thrusting the nipple out of his mouth, indicating he wasn’t interested in any more. She mentally calculated the total, pleased that he’d taken a half-ounce more at this feeding.

As she returned Barton to his bassinet and cranked on the mobile that hung over his head, she noticed Dr. Ryan was standing over Emma’s warmer. She assumed that he was checking the baby’s vital signs but as she approached she noticed that her little pink knit hat was off and he was softly stroking his thumb over Emma’s downy head, murmuring softly.

“You’re going to be fine, pretty girl. You’ll see.”

His words made tears prick her eyes and she subtly wiped them away. Dr. Ryan had called her a natural, but right now she was thinking the same about him. He was gazing down at Emma as if the baby was important on a personal level, rather than just another patient.

She hesitated, wondering if she was intruding, but he must have sensed her presence. He glanced at her and gently tugged the pink knit cap over Emma’s head. “Do you need to get in here?” he asked.

“Yes, I need to check her vitals again,” she said, trying to deal with her bizarre reaction to him. “But I can wait until you’re finished.”

“No, go ahead,” he said, stepping back to give her plenty of room.

She avoided his gaze and tucked the buds of her stethoscope into her ears, taking her time to listen to Emma’s heart, lungs and abdomen. When she straightened and pulled off the stethoscope, she caught Dr. Ryan’s intense gaze resting on her once again.

She grappled for something intelligent to say. “Everything sounds good, but her bowel sounds are still hyperactive.”

“I know. I’m reluctant to begin feeding her until we know for sure she won’t start having seizures,” he said, answering her unspoken question. “But if things continue to go well, I’ll insert a feeding tube for bolus feedings.”

“Sounds like a plan,” she agreed. Since he was still logged on to the computer, she gestured toward it. “Do you need the computer?”

“Not at all.” He leaned over to log off with quick keystrokes and she caught a whiff of his woodsy aftershave, the heady scent wreaking havoc with her senses. He stepped back, giving her room to sit, but he was still far too close for comfort.

Cassie tried to concentrate on documenting Emma’s assessment, but it wasn’t easy. She made several spelling mistakes, requiring her to backspace several times to fix them.

Why wouldn’t he leave? Was he reading her charting, double-checking her work? Surely he had better things to do. Better places to be other than here.

Validating vital signs was easier, merely requiring a point and click, and she was nearly finished when she heard him say her name in that deep, husky voice of his.

“Cassandra.”

She couldn’t seem to untie her tongue enough to tell him he could call her Cassie. After all, he insisted everyone call him by his first name, even though most continued to use his formal title, too. She glanced up, only to find his gaze glued to Emma.

Immediately, she rose to her feet. “What’s wrong?”

“Get me point two milligrams of midazolam and a half milligram of phenobarbital. Emma is having a seizure.”

Cassie’s heart plunged to the pit of her stomach as she rushed over to the medication dispensing machine to get the medication.

She dashed back to Emma’s warmer, holding each of the syringes up for him to see. “Point two milligrams of midazolam,” she said. “And a half milligram of phenobarb.”

“Yes, that’s correct.”

She gently injected the medications into Emma’s IV then watched the baby’s heart rate on the monitor.

She couldn’t prevent an overwhelming sense of dread. Seizures were a bad sign. If they continued, there was a chance that Emma might suffer permanent brain damage.

The little girl could even die.

She has us. We care about her.

Cassie strengthened her resolve to do everything possible to make sure Emma had the best chance to survive.

Ryan shoved his hands in the pockets of his lab coat, hating every moment of feeling helpless.

This poor baby might not make it to her first birthday, all because her mother hadn’t sought help for her addiction.

Anger was useless, so he did his best to breathe it away, keeping an eye on his patient instead. The medication worked and, thankfully, Emma’s jerky movements stopped.

“I’m going to order the phenobarb to be given every six hours,” he told Cassie. “And an EEG, too.”

Cassie looked as upset as he felt, obviously already growing attached to their safe-haven baby. The same way he was. That moment in the elevator, when Cassie had mentioned the baby didn’t have anyone to care about her, had tugged at his heart.

In the three years since losing Victoria and his son, he’d been able to keep a certain emotional distance from his tiny patients. Easy enough to do, as most of the time the babies got better and went home with their parents and families.

But knowing Emma was alone in the world made him feel differently towards her. He knew he was becoming emotionally involved with their safe-haven baby. And not just because she was sick enough to require his focused attention.

Because almost from the first moment he’d seen her, the little girl had found a way to break through the barriers surrounding what Shana had described as his stone-cold heart.

“Oh, Emma,” Cassie murmured, stroking the baby’s cheek. “You’ve got to fight this, sweetpea. We’re going to help you fight this.”

His heart squeezed at the tears shimmering in Cassie’s eyes. From the first day she’d started working here—had it just been a few months ago?—he’d noticed her creamy skin, heart-shaped face, bright brown eyes and long dark hair that she always drew back in a ponytail at work, not to mention her curvy figure, mostly hidden beneath her baggy scrubs. What man wouldn’t?

Look, but don’t touch. That was his motto. Especially since the Shana debacle.

Yet for some reason, seeing Cassie cooing over the babies, especially Emma, hit him right in the center of his solar plexus.

He was irresistibly drawn to her. Had been from the moment they’d begun to work together. Resisting her was becoming more and more difficult. Maybe because she was the complete opposite in every way from Victoria. He’d never told anyone his deepest fear, that Victoria wouldn’t have made a very good mother. Not the way Cassie would. She clearly loved her tiny patients.

Victoria had loved being a doctor’s wife. Had loved entertaining guests and spending his money. He wasn’t sure how she’d managed to keep herself busy every day, working out at the gym and then lunching with her friends.

When she’d blown out her Achilles tendon after a spin class, he’d supported her through surgery, impressed at how determined she’d been to get back to her normal routine. Even after she discovered she was pregnant, she didn’t cut back on her exercise regimen. In fact, he suspected she’d doubled it in an effort to avoid gaining too much weight.

He’d gone back through his memories of that time often, trying to identify the signs he’d missed. But he’d been busy at work, taking everything Victoria had told him at face value.

Never suspecting, until far too late, that she’d become addicted to the painkillers the orthopedic surgeon had initially prescribed.

He shook off the past and forced himself to focus on the present. Just because he was deeply attracted to Cassie, it didn’t mean he had any intention of acting on it. She was young, full of life and could do better than a broken man like him. He didn’t plan to ever have a family of his own. He didn’t deserve a second chance.

Forcing himself to turn away, he went over to a different computer, far away from the one Cassie had been using, to enter the medication orders. When he’d finished, he sat down to scroll through his other patients’ charts.

It took him a few minutes to realize he was stalling. Ridiculous to think about waiting around here until the end of Cassie’s shift. Just because he was on call, it didn’t mean he shouldn’t take advantage of the downtime to get some rest.

But before he could leave, his pager went off, announcing a pending crash C-section.

Rest would have to wait. “We need an emergency warmer down in the OR,” he said.

“I’m ready,” Diane said, hurrying toward him with the equipment. He knew that Cassie was already tied up with Emma and Barton, so he wasn’t surprised that Diana was the nurse up for the next admission.

He strode purposefully toward the door, managing to resist the urge to glance back once more at Cassie.

She and Emma would be fine.

A few minutes later he entered the OR, where a laboring mother was lying on the table, her eyes full of fear. “Save my baby,” she pleaded as the anesthesiologist tried to cover her mouth and nose with an oxygen mask. “Save my baby!”

“She has a prolapsed umbilical cord,” Dr. Eden Graves informed him. “We need to move fast.”

“Understood,” he agreed. “I’m ready as soon as you are.”

Leaving Diane to prepare their equipment, he walked over to look at the fetal monitoring strip. There were several steep decelerations present, indicating severe fetal bradycardia. He noted that the sharp drop in the fetal pulse coincided with highest portion of the uterine contractions. Classic sign of a prolapsed umbilical cord.

“Tip her uterus so that the pressure isn’t on her cervix,” he instructed.

“I did, but you’re right, we could use more blankets to prop beneath her bottom.”

A couple of nurses came over to assist and soon the patient was ready. The anesthesiologist gave Eden the high sign and she quickly began the procedure.

The baby was removed from the uterus within five minutes, and the minute the cord was cut he quickly took the infant over to the warmer. The baby boy wasn’t too limp and quickly pinked up as they worked on him.

When the baby let out a wail, there was a collective sigh of relief from everyone in the room.

“Let me know what the cord blood gases show,” he said to the circulating nurse in the room. “Page me with the results.”

“Okay.”

He finished his assessment with Diane’s help and then deemed the infant stable enough for transport up to the neonatal nursery. Even though the baby boy looked fine for the moment, he intended to watch the infant for a few hours upstairs.

It was a good feeling to save a baby’s life. Even though deep down he knew that no matter how many he saved, he’d always mourn the one that mattered most.

The son he’d lost.

Cassie was thankful Emma didn’t show any more signs of seizures and the EEG tech seemed to think the test looked relatively normal. Of course, they needed the neurologist to read the test to know for sure, but she decided to remain optimistic.

Barton’s parents were here, holding their son, so she decided this was a good time to take a quick break.

“Sally, would you mind keeping an eye on Emma for a few minutes? I’d like to run down to the cafeteria to grab something to eat.”

“Sure, that’s fine. But we’re expecting that new baby to arrive within the next thirty minutes so make it quick, okay?”

“I will.” She’d perfected the art of eating fast, to minimize disrupting patient care.

Leaving the unit, she took the stairs down to the cafeteria level. The grill line was too long, so she went over to the salad bar to make herself a quick grilled-chicken salad and fill a large cup with ice water. The hardest thing about working second shift was the inability to fall asleep once she got home, and the last thing she needed was the added impact of caffeine zipping through her system.

She sat down at a small table near the back of the cafeteria and quickly dug into her salad. A few nurses greeted her, but none of them lingered. Obviously the whole hospital was busy, not just her neonatal unit.

She kept an eye on her watch as she ate, knowing she needed to return to the unit before Dr. Ryan brought over his latest patient.

With any luck he’d be busy with the new admission for a while, giving her some badly needed breathing space. She really didn’t understand what her problem was around him. There were plenty of other single guys around. James Green, one of the ER doctors, had asked her out just last month.

Too bad she hadn’t felt one iota of interest in him. She’d politely declined James’s offer, refusing to feel bad at the dejected expression in his eyes.

Her divorce had only been final for a little over a year. Six months ago she’d moved to Cedar Bluff to start afresh. It was too soon to enter the dating scene.

So why was she always so keenly aware of Dr. Ryan Murphy?

No clue. She shook her head, scraping the bottom of her salad bowl to get the last bit, before wiping her mouth with a napkin and rising to her feet.

Ten minutes. Not bad, she mused as she headed back toward the elevators. Walking up three flights of stairs seemed daunting after she’d practically inhaled her meal, so she took an elevator up.

She got off the elevator on the third floor and headed down the east hallway toward the neonatal unit.

Cassie frowned when she saw an older woman, probably in her midsixties, leaning heavily on a cane near the doorway. It looked as if the woman was trying to peer through the small window to see inside the unit.

“Good evening. Can I help you with something?” Cassie asked.

The woman started badly, spinning around so quickly she almost lost her balance. Cassie darted forward to slide a supportive arm around the woman’s waist.

“Easy there, I don’t want you to fall,” Cassie said. “Is there something you need? Are you waiting to go in to visit?”

“Oh, no. I’m not waiting to visit. I … um …” The woman seemed flustered and avoided her gaze. “I was visiting a friend and thought I’d come over to peek at the babies. I’m sorry, I didn’t mean to break any rules.”

Since the woman obviously felt bad, Cassie decided she wouldn’t push it. “That’s okay, but you can’t go in there unless you’re related to one of the babies. It’s a locked unit to protect them from being taken.”

“Oh, of course. I—I’m sorry. I have to go.” The woman took a step and leaned on her cane, making her way back toward the elevators. Cassie waited a moment, watching her.

It wasn’t until she was back at Emma’s bedside that she realized the woman might have being trying to catch a glimpse of Emma. Surely the news of their safe-haven baby had already spread throughout the small town of Cedar Bluff.

She wished she’d asked the woman for her name. Had she been peeking into the unit out of pure curiosity?

Or because she knew Emma’s mother?

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