know.” But that didn’t mean she could completely turn off concern for the mother, a young woman she’d connected with for a brief few minutes. Luckily when they reached the warming table Scarlet clicked into auto-nurse, wiping down the too quiet newborn to stimulate her as much as to clean her. “I’m going to need her weight.”
“The baby scale was in use,” Dr. Jackson said. “Let me go grab it.”
When he left the room, Scarlet listened to Joey’s chest to count her heart and respiratory rates. Then she found the equipment she needed and fastened a pulse oximeter to her tiny hand to evaluate her blood oxygen level.
The baby lay on the warmer with her arms and legs flexed, her color pale. Not good.
When Dr. Jackson returned with the scale he placed a disposable cloth over it and Scarlet carefully lifted the naked baby and set her down. “Four point one pounds.” Scarlet jotted the number down on a notepad by the warmer and reported the other findings she’d noted there. “Pulse ox ninety. Heart rate one hundred and eighty. Increased respiratory effort. Color pale. Initial Apgar score a five.” All of which were abnormal for an infant.
“Let’s get a line in to give a bolus of normal saline and get her hooked up to some supplemental oxygen.”
While Dr. Jackson inserted a tiny nasal cannula in Joey’s nostrils, taped the tubing to her cheeks, and set the flow meter to provide the appropriate level of oxygen, Scarlet started an intravenous in Joey’s left arm—noting she didn’t flinch or cry.
While she taped it down and immobilized the appendage in an extended position, Dr. Jackson did a quick heel stick to evaluate Joey’s blood sugar level.
They worked quickly, quietly and efficiently like they’d been working together for years.
“Blood glucose twenty-five,” he reported and began rummaging around a drawer in the warmer until he found the reference card for the recommended dosages for premature infants by weight. “Add a bolus of dextrose.” He called out his orders and Scarlet filled the syringes and administered their contents via the newly inserted IV line.
“Come on, Joey,” she said, rubbing her thighs in an attempt to perk her up.
The door slammed open and in rolled an incubator being pushed by Cindy. “You okay down here?” she asked.
“Better than expected,” Scarlet replied, considering who she’d had to work with. Luckily, Dr. Jackson’s reputation as an excellent physician came well-deserved.
“Good.” Cindy turned to leave. “The NICU is nuts. I talked to Admissions. Baby Doe,” a placeholder name since Holly hadn’t shared her last name, “will be going into room forty-two.”
“Call Admissions and tell them it’s Joey Doe. Holly told me she wanted her baby to be named Joey.” And following through on that was the least she could do.
“Roger that.” She saluted then walked over to take a look at their soon-to-be new patient. “Too bad about her mom.”
“She’s…?” Scarlet couldn’t continue.
Cindy looked between her and Dr. Jackson and slowly nodded. “I’m sorry. I thought you knew.”
Scarlet turned away, held herself tightly, fearing for the first time in years she might cry. For Holly who’d died too young. For Joey now alone in the world. For her own infant and not knowing if she’d suffered, if anyone had cuddled her close before she’d died, or if she’d been ruthlessly given away to strangers while Scarlet lay in a drug-induced slumber.
“You okay?” Dr. Jackson asked quietly.
Of course she was. Scarlet wasn’t new to nursing. Holly wasn’t the first of her patients to die. But there was something about her…“What do you think happened?”
He shrugged and shook his head. “Some congenital heart defect that couldn’t withstand labor and delivery. A pulmonary embolism. Any number of pre-existing conditions that could have worsened or arisen during her pregnancy that we didn’t know about. Dr. Gibbons is an excellent doctor. I have total confidence he did all he could do.”
“It wasn’t enough.”
As if to share her agreement, little Joey Doe let out a little cry and they both looked down at their tiny patient. “Her color is improving,” Scarlet noted. “And she’s more alert.”
With skilled, gentle hands, Dr. Jackson examined the increasingly active baby. “Heart rate down to one hundred and twenty. I’d give her a second Apgar score of seven.”
Not a perfect ten, but improved. Scarlet documented it in her notes.
“She’s stable enough for transport up to the NICU,” Dr. Jackson said. Then he helped her get Joey situated in the incubator.
“After I get her settled in I’ll access her ER file and enter my documentation.”
“If you run into any trouble, let me know.” He held out his hand and she shook it. “Thanks for the help.”
“Anytime.” She went to remove her hand from his grip but he held it there.
“We need to talk about Jessie,” Dr. Jackson said. So serious. Did the man ever smile? According to Jessie, no he did not.
Scarlet took a moment to admire his tall, athletic build and short brown hair mixed with a hint of grey at his temples. He had a look of confidence and prestige she would have found very attractive on someone else. “No,” Scarlet said, looking to where he held her hand. “You need to talk to your daughter.” She looked up at him. “And here’s a helpful hint to improving communication between the two of you.” She yanked her hand back. “Stop comparing her to the perfect little boy you used to be. Just because you loved swimming and boating and all things water when you were a child, doesn’t mean she does.”
Later that night Lewis stood in his designer kitchen, eyeing the modern stainless steel handle on the high-end black cabinet that contained the bottles of wine he’d kept at the ready in case any of his dates wanted a glass, and considered uncorking one. Although he wasn’t in the habit of drinking alone, it’d been the kind of day followed by the kind of night that warranted a little alcohol consumption to facilitate a return to his pre-Jessie level of calm.
But Lewis Jackson had never turned to alcohol to drown his problems before, and he refused to start now. He was a problem solver, a thinker and a fixer. And to do those things he required a clear head.
Since his daughter had taken up permanent residence in the loft guestroom, he tended to avoid the living area below after she went to sleep. So he walked down the hall to his bedroom, the smooth hardwood floors cool beneath his bare feet, the central air maintaining the perfect air temperature, his two bedroom luxury condo decorated to his exact specifications for style, comfort and function. And yet his home no longer brought him the welcoming serenity it once had.
Jessie hadn’t said more than a handful of words—all of them monosyllabic—to him since they’d left the hospital, even after he’d insisted they eat their takeout grilled chicken Caesar salads together in the kitchen for a change. What an uncomfortable meal that’d been. Jessie, staring down at her plate, moving the chicken around with her fork. Lewis, trying to engage her in conversation, to offer reassurance about her trip
