Part 20
16:25
Friday
20 August 2010
UCSD Emergency Room
Harm paced the small exam room scrubbing his fingers through his hair, “Mac, why didn’t you tell me you did this twice before?”
She shifted on the exam table trying to sit up, “Harm, calm down. It was once before…the second time I was just light headed. Once I sat down, I felt fine. Besides, I thought it was just low blood sugar. I’ve been so busy lately that sometimes I forget to eat.”
His eyes widened, “What do you mean you forget to eat. Since when do you go around missing meals?”
She clutched at the small sheet trying to cover her body. “I hate these hospital gowns…I swear they make them this way just so you show your six off to the world.”
He stopped his pacing and grinned, “And that is one cute six, Marine.” He shook his finger at her, “And no trying to throw me off…since when do you miss meals?”
Shrugging in resignation, she muttered, “I just haven’t been hungry lately, especially for breakfast or lunch.”
He hopped up on the table next to her and wrapped an arm around her waist, “Sweetheart, you have to take better care of yourself. What if you’d fainted with Connor in your arms.” He reached up to run his finger through the hair at the back of her head, “How’s the goose egg? I bet your going to have one heck of headache.”
She laid her head on his shoulder, “But you’ll take care of me, right?”
His hand slid down her back, “Forever and always.” Leaning down to kiss her forehead, his hand slipped lower still, “And that is one beautiful backside….”
With one brisk knock, the doctor quickly entered the room. Stopping to watch with a grin, he murmured, “I think that’s what got you in trouble in the first place.”
Harm panicked, “Trouble…what trouble?’
Mac echoed, “What? Is something wrong? I thought it was low blood sugar from not eating.”
Dr. Gonzales waved a hand, “Whoa folks…nothing’s wrong. At least I assume it’s not wrong…most people are actually kind of excited about it.”
Harm’s eyes widened further, “Excited? Why would we be excited that she passed out?”
Mac attempted to clarify the situation, “Harm, wait…I think we’re missing something here. Doctor, what exactly are you talking about?”
The physician approached the anxious pair, “You’re pregnant...but you suspected that, right?” When matching looks of disbelief remained the only response, he continued, “I mean…the loss of appetite, nausea, fainting.” No response except gaping mouthed astonishment. “Excuse me, folks…are you still with me?”
Harm slowly nodded his head, mouth still agape. Mac stuttered, “Pregnant, but…pregnant? Are you sure? I mean I wasn’t supposed to…all those months of IVF and nothing. Now, you’re saying…are you sure?”
Dr. Gonzales chuckled, “I take it this wasn’t planned…you know if you don’t want….”
Harm finally found his voice, “No! No, we do want…it’s just that we weren’t supposed to be able to have children. We even went through almost two years of infertility treatments…six cycles of in vitro…and still no pregnancy. How…well, I mean I know how, but we weren’t trying….”
The doctor laughed harder at the father’s flustered response, “So, let’s start with the easy part…you’re both excited about the pregnancy?” Two heads bobbed up and down in the affirmative. “You weren’t trying to get pregnant…but I suspect you weren’t NOT trying either.”
Mac shook her head, “We weren’t using birth control if that’s what you mean…I mean, who would have thought we needed to.” She paused and grinned, “What difference does any that make.” Turning to her husband, her face was radiant, “Harm, we’re going to have a baby!”
He caught her as she leaped into his arms, “I can’t believe after all this time.” He quickly turned to the doctor, “But what about the fainting…there’s nothing wrong is there?”
“No, of course not. It’s not uncommon early in pregnancy as the circulating blood volume expands rapidly. In addition, Sarah is a little anemic…also very common. I want her to start taking prenatal vitamins to increase her iron stores that will help with the anemia. And you should see your obstetrician within the next two weeks.”
Mac reached for Harm’s hand, “When do you think I’m due?”
Dr Gonzales pulled a wheel from his pocket, “Based on LMP…I expect your EDC to be March 26th.”
Mac frowned, “My ED…what?”
“Your EDC, that stands for estimated date of confinement,” the physician smiled, “…that’s just a fancy term for due date. I expect you got pregnant around the 4th of July weekend."
Harm leaned into Mac’s ear with a devious grin, “It must have been that second…or third, course of dessert.”
She playfully smacked him, “Behave! Is there anything else I need to know?”
“No, not at this point. Here’s a brochure on pregnancy, a prescription for the prenatal vitamins and some suggestions for ways to deal with the nausea. You really do need to eat regularly…skipping meals won’t help.”
The physician left the room and Harm gathered their belongings while Mac dressed. As she turned back around, he pulled her into his arms, “Wow…a baby! Can you believe it? We’re really going to have a baby.”
She reached up to kiss his lips and snuggled in closer, “Do you have a preference…boy or girl?”
He leaned his head against hers, “I don’t really care as long as it’s healthy. That’s most important,” he sighed with contentment, “…but I wouldn’t mind that little girl…with your looks and my brains.”
She smiled against his chest, “That wasn’t the deal…she’s supposed to have your looks and my brains…a future Marine.”
Caressing her cheek, “I don’t mind…she can have your looks and your brains. Besides,” he ran his fingers through her hair and grinned, “…I think she’d prefer your hair to mine…this cowlick is trouble enough on a boy. I can’t imagine my hairstyle on a little girl!”
She giggled at his silliness, “Whatever, we don’t even know if it’s going to be a little girl.”
He grew serious and placed his hand over her lower abdomen, “Yes, I do…I’ve already met her…in my dreams.”
Laying her hand atop his, she whispered, “Tell me.”
“She has big brown eyes, soft russet hair, and delicate features…but she’s strong, just like her Mother.”
She gazed into his eyes and noticed a glaze of tears, “She sounds perfect…I can’t wait to meet her.”
Placing a kiss on her cheek, he whispered in her ear, “Neither can I…I love you.”
She pulled back slightly, “I love you, too. Should we go tell the rest of the crew in the waiting room our wonderful news?”
He pulled her back in close, “In a minute, I just want to enjoy it between the two of us for a few moments more.”
***
21:30
Friday
20 August 2010
The Rabb Home
La Jolla, California
Later that night, Mac sat in bed reading a book while waiting for Harm to come to bed. As she flipped the page and began to read, she realized she had no recollection of the content of the last 10 pages she’d perused. Setting the book aside, she leaned her head back against the pillows and closed her eyes. She was exhausted from the events of the day. A glorious day filled with the completion of two dreams…the legal formalization of her son…a son who her heart long since recognized as her own, legal or otherwise. And the chance for another child…a child for whom she had longed and prayed…the fulfillment of a deal made some 11 years prior.
The creaking of the bedroom door roused her from her thoughts. Harm walked over to the bed and dropped into its welcome depths, closing his eyes and sighing in relief. She reached over to caress his cheek, “Are the boys both asleep?”
He opened one of his eyes, grunting in response, “Yeah, but not before 3 books, two drinks of water for Ben and a bottle for Connor.” He chuckled with mirth, “You should have heard Ben explaining to Connor that he was ‘fficial’ now…the judge ‘beceed’ it; he’s a Rabb. I don’t know where he gets this stuff.”
Her fingers slid into his hair and rubbed in a soothing gesture, “It was a momentous, wonderful day. We got two gifts…I can’t believe we’re going to have a baby?”
He rolled to his side and placed a hand over her flat belly, “I never gave up…I knew she would come.”
She frowned, “Harm, you keep talking about a she…I don’t want you to be disappointed if the baby’s another boy.”
He rubbed his thumb back and forth, “I could never be disappointed, Mac. But trust me, this is our daughter…and her name is going to be Elizabeth. He smiled serenely, “But we’ll call her Ellie…and she’s going to be something special.”
She gazed at him quizzically, “But Harm, what if….”
He pushed her pajama top up out of the way and lowered the elastic of the bottoms. Placing a kiss on the smooth skin of her lower abdomen, he laid his head against the place that housed his daughter, safe and sound. “Mac, I just know…I can’t explain it. I guess it’s kind of like your visions or your infallible clock. I’ve seen her in my dreams…I already know her.” His expression grew more serious, “Her name is Ellie and she’s going to be beautiful and intelligent and strong…everything we ever wanted.”
Running her fingers through his hair, she studied his face for several seconds before nodding, “Alright, Ellie it is.”
***
11:30
Tuesday
31 August 2010
UCSD Women’s Center
San Diego, California
Harm and Mac sat in the office of perinatologist Dr. Rosalyn Sherman. Mac had been referred by her regular OB/GYN to the high-risk specialist for pregnancy care. They nervously shifted in their seats as their eyes flitted around the room studying the various diplomas and certificates of the obstetrician. Finally, Mac’s eyes fell on the large display frame that filled the entire length of one wall. She squeezed the large hand that engulfed hers, “Harm look…there must be hundreds of pictures there.”
He smiled and felt the tension ease slightly, “Well, I hope she saves room for one of Ellie.” He turned to look at his wife, “I don’t care what your regular OB said, Mac. You and Ellie are going to be just fine.”
Mac chewed on her bottom lip trying to control the unshed tears that stung her eyes. Dr. Karinski, her regular GYN, had cautioned against the success of this pregnancy. The excitement and wonder, bestowed in the ER by the announcement that she was with child, had quickly faded to one of fear and trepidation. She’d given up on the very idea of having a biological child after the failed attempts at in vitro. She’d resigned herself to never carrying an infant with Harm’s looks and her brains or vice versa. She’d found comfort and joy in the gifts of her sons…gifts granted at the expense of another mothers’ loss. Precious offerings for which she would be forever grateful; no one could replace her boys. But still, she had been given a tiny glimpse into the rapturous possibility of a miracle…a child for whom she’d dreamed so long. A little girl…a daughter…if Harm’s assertions were correct. How could she be granted such an unexpected gift only to have it snatched away by the cruelty of fate.
Harm watched the emotions play across her face and knew she was lost again in that place between hopelessness and despair. Somehow he just knew things were going to be okay…maybe not easy…but their daughter would be born and would survive. The conundrum was in trying to convince Mac to embrace his beliefs, when they were based on little more than feelings and dreams. How do persuade someone to trust a premonition when there’s no fact or science to support the belief…especially when their very heart and soul stands to be destroyed if the dream is lost. He’d experienced first hand the power of the unexplained…Mac had rescued him with those haunting visions. Now it was his turn to rescue her.
Reaching out to wipe away a tear, he stroked her cheek trying to erase the worry. “Hey Marine, I thought we weren’t going to give into those fears until we talked with Dr. Sherman?” When she shrugged, a few more tears followed the first. “Come on now, sweetheart…we need to be strong for our little girl. I know you don’t believe me, but I know she’s going to be fine…just like I know you….”
The door opened to reveal a tall thin woman with auburn colored hair and a warm smile. Extending a hand in welcome, her demeanor exuded a quiet confidence and charm, “Good morning, I’m Dr. Sherman…and I’m….” She stopped in her introduction, as she took in the heartbroken face of her patient, “Why the sad face? Most of my patients are excited at the prospect of a new baby.”
When Mac had trouble speaking, Harm interceded, “Ah, her regular OB wasn’t very encouraging…and we so desperately want this child. We tried for 2 years to get pregnant through fertility treatments, including IVF, but were never successful. We have two beautiful adopted sons and never expected the chance to have our little girl.”
The physician nodded through the explanation and then searched the chart in confusion, “I understood you were only 10 weeks along…that’s too early to tell the gender. How do you know….”
Mac finally responded with a chuckle, “He says he…never mind, he swears this is going to be a girl. I just want a healthy baby, but Dr. Karinski said I’d be unlikely to carry the baby to the point of viability.” The tears began to fall once again.
The physician settled behind her desk, “Well, I’ve reviewed your records…and while I do expect this to be a high-risk pregnancy, I don’t see any reason to give up hope.”
Mac’s eyes widened, “Really…we have a chance?”
Dr Sherman smiled, “A good one…I’m not saying it will be easy, but….”
Mac shook her head, “I don’t care…I’ll do whatever you say.” She reached for Harm’s hand and he winked in support.
“Alright, let’s talk about your baby. Your EDC is March 26th, placing you currently at 10 weeks gestation.” She looked at the couple, “Do you understand what I’m talking about?”
Harm shrugged, “Kind of…Mac’s due date is the 26th of March, and you’re saying she’s currently 10 weeks into her pregnancy. I’ve always heard that a pregnancy lasts 9 months…so is that 36 weeks?”
“Actually a full term pregnancy is 40 weeks in gestation. In Sarah’s case, I don’t expect her to make it all the way to her due date.”
Mac tensed, “Why not…you said we had a good chance.”
Dr. Sherman nodded, “Yes, I did…but a baby can do quite well even if it’s delivered before the full 40 weeks. In your case, with the endometriosis and prior abdominal and uterine surgeries, I want to deliver the baby slightly early…probably at 36-37 weeks. I’m concerned that an expanding uterus will put tension at old scarring sites in the uterine wall. The risk is that the uterus could rupture at one of those sites. If that were to happen, I’d have to do an emergency caesarean section to delivery the baby and repair the uterus. There’s also a risk for uterine rupture if you go into labor, so I’ll plan to perform a caesarean no matter what…probably at around 37 weeks.”
Mac’s shoulders fell, “But I wanted to deliver naturally…there’s no way I could….”
“No, not in this case. The risk for rupture with contractions is just too high. And if a rupture does occur, I would need to get you delivered within a few minutes or we run the risk of losing both you and the baby. I’m sorry…I hope you understand, but a natural delivery just isn’t possible.”
“We want to do whatever is safest for Mac and the baby,” Harm adamantly stressed, “…if that means a caesarean delivery or that she needs to spend the next 9 months flat in bed, we’ll do it. Whatever you tell us…if it will ensure the survival and safe birth of our baby…we’ll comply.”
The physician chuckled, “I don’t know about nine months in bed, but it’s not uncommon for a mother in a high-risk situation to have to spend some time on bedrest. Now, before I go into the other concerns, do you have any other questions about delivery?”
Mac shifted in her chair, “Umm, if I have a caesarean can I still do other normal baby things…like breastfeeding and the like?”
“Absolutely, in fact we strongly encourage breastfeeding as the most optimal form of nutrition. Any other questions?” At the simultaneous negative replies, she continued, “Alright, now to discuss some of the other concerns we see with high-risk pregnancies. First of all, Sarah…you are at risk for premature labor and a preterm delivery. Again, this is related to the scarring from the endometriosis. The uterus expands to accommodate the fetus…in your case, the scar tissue may interfere with the uterus’ ability to allow growth. If we have concerns with preterm labor, I may need to put you on bedrest and use medications to stop the contractions. You may also have to be hospitalized for a period of time before the delivery to monitor the baby’s well-being and your contraction patterns. I’d like to get you to at least 32 weeks and preferably 36-37 weeks before we have to deliver.”
Harm fidgeted in his chair, “But 32 weeks is 2 months early, will the baby be OK?”
“Oh yes, my neonatal colleagues do an excellent job in providing care for our preterm population of babies. The survival at 32 weeks, as well as, the chance for a normal outcome is over 95%. The drawback is the baby will probably be hospitalized for 1-2 months, but that’s a small price to pay for a normal child.”
Mac smiled for the first time since she arrived in the physician’s office, “I don’t care if she has to stay in the neonatal unit as long as I eventually get to take her home.” She glanced toward Harm and saw him grin as he mouthed the word ‘she’ in return. She threaded her fingers through his and rested their hands in her lap.
“Well, if that should appear to be necessary, I’ll have a neonatal colleague speak with you ahead of time so you can be prepared for the typical course of a premature infant.” The physician smiled, “I noticed you said she as well…I take it Dad’s optimism is catching on?”
Mac leaned her head against Harm’s arm, “It’s hard not to get excited when you’ve wished and dreamed of this child for over 10 years. What else should we know?”
Dr. Sherman lifted a folder from her desk and handed it to the Rabbs, “I’ve put together some information about normal milestones in pregnancy, when you can expect to have lab work and procedures performed, and some of the complications that can be anticipated. The few things left to consider are related to your advanced age and your status as a first time mother. You’re at increased risk for high blood pressure, particularly during the end of the pregnancy. We tend to see this complication more often with first pregnancies and elderly mothers.”
Mac’s eyes widened, “Elderly…but I’m only 43?”
The doctor chuckled, “I’m not talking elderly in a societal sense. When it comes to pregnancy, we consider any woman over the age of 35 to be elderly. The risks related to pregnancy increase after that age. As far as the high blood pressure goes, we’ll monitor you with each visit. If your pressure starts to increase, I may need to start medications or place you on bedrest…worst-case scenario, I would need to deliver you early in order to ensure the best outcome for both you and the baby.”
Harm nervously shifted in his chair, “What about other problems? I read somewhere that babies have an increased chance for genetic problems when either parent is older.” He glanced at Mac with an expression that begged for indulgence at his request for worrisome information.
“That’s a good question…there is an increased risk for certain chromosomal abnormalities when either one or both parents are of more advanced age at conception. The most common is Trisomy-21 or Down’s Syndrome. There are also a few other syndromes that can occur more frequently with advanced age. To evaluate for those possibilities, we’ll draw screening blood work today. Further into the pregnancy when the baby is more developed, I’ll perform a detailed ultrasound looking for abnormalities. I also recommend we perform a procedure called an amniocentesis at 18 weeks gestation. By inserting a needle into the sac surrounding the baby, I can withdraw some of the amniotic fluid and send it for chromosomal analysis. That way we can rule out the most common abnormalities before your little one is even born.”
Both parents looked overwhelmed by all the information being dispersed and assimilated. The physician smiled in understanding, “I think that’s probably enough for today. Sarah, I’m going to do an initial comprehensive physical examination on you today, and then we’ll perform your baby’s first ultrasound. You won’t be able to make out a lot of detail, but you will see the body, the head…some rudimentary arms and legs.” She grinned with knowing excitement, “And of course, hear your baby’s heartbeat for the first time.”
A well of tears appeared in Mac’s eyes with the last announcement. As they stood to proceed to an exam room, Harm paused a moment and pulled her into his arms. Giving her a hug, he whispered, “We’re gonna get to see Ellie.”
***
Later that evening at the beach near their home, Mac wandered along the water’s edge deep in thought. She could still hear the steady ‘whooshing’ sound of the strong heartbeat echoing through her mind. It sounded like music to her battered soul. She’d spent the last several days trying to reign in her excitement at the thought of a child. Her OB/GYN, Dr. Karinski, had managed to crush her spirit just as it had started to soar…she’d been afraid to hope. She smiled into the warm breeze coming off the ocean. She wanted to yell to the world that she was going to be a mother again…but this time she would be a partner in the creation of that life. She’d never imagined that the simple sound of her child’s heartbeat could resonate with her own heart in such a perfect pitch to revile the most beautifully written symphony.
Removing her sandals, she skipped through the waves as they rolled onto the shore. Laughing at the tickling sensation of the cresting water, she realized that she felt alive and whole for the first time in days. She giggled with ecstasy as a feeling of happiness covered her with a sensation of warmth like a blanket in the cold of dawn.
She glanced around thankful to note that no one was close enough to notice her giddy behavior. Kicking the water once more, she retreated back up the beach to sit in the dry sand. Placing her sandals aside, she reached up to massage the muscles of her face…her cheeks hurt from smiling, but she couldn’t suppress the exuberant grin.
Harm slowly walked down the path to the beach in search of his wife. When he found himself skipping along, he had to make a conscious effort to suppress the childish behavior that he associated with happiness and fun. Shaking his head, he realized that his galloping steps were in time to the chant of the heartbeat that rang through his mind. He was going to be a father again, only this time he had played a part from the beginning. Thinking back to that night in July, his smile grew to a full-fledged grin…who knew dessert could be that much fun…or have such an overwhelming and magnificent consequence. He suspected that the satisfied gleam now evident in his eyes outshone the radiant brilliance of that night…he was going to be a father again! He wanted to shout to the world that against impossible odds they had created a life.
Exiting the path, he spied Mac sitting on the beach. She looked serene and beautiful backlit by the glow of the moon and the stars. He snuck up behind her and settled at her back. When she startled, he pulled her into the safety of his arms and leaned in to kiss her neck. She reclined against his chest with a hum of contentment that vibrated in perfect tune with his heart. They sat in comfortable silence and enjoyed the sounds of nature and replayed the events of the day.
Finally after several minutes, she broke the quiet, “Are the boys asleep?”
His hand slid down her stomach and wormed its way under her shirt. When he reached the softness of skin, his fingers caressed her lower abdomen as though communing with his future offspring. She smiled at his loving touch and slipped her hand atop his. His breath tickled her neck, as his lips teased her ear with a smile. Placing a kiss upon her cheek, he whispered, “Connor was out like a light when his head hit the pillow. Ben’s watching a movie with Mattie…I told him he could stay up a little longer. He’s a bit melancholy over the idea of his big sister leaving for college in the morning.”
She pulled his other hand to her chest and placed a kiss on his fingers, “This is nice isn’t it? The weather’s perfect, the breeze calm, water warm, and I’m in the arms of the man I love…I couldn’t picture a more perfect day.”
His hand moved to caress her cheek, “It really has been perfect. I can’t believe we got to see our daughter for the first time.” He turned her face toward his and kissed her lips.
She rubbed her cheek against his, “This is really going to happen isn’t it? Ellie’s is the fulfillment of our deal…our dream come true.”
He smiled at the memory and murmured against her lips, “I never make a promise I don’t keep,” before deepening the kiss.
***
13:30
Friday after Thanksgiving
19 November 2010
The Rabb Home
La Jolla, California
The crowd moved into the family room in search of a football game. The men huddled on one side of the room awaiting the kickoff while the women took the other to discuss the changes in their lives.
Mac settled onto the far end of the couch and lifted her feet into her husband’s lap. When the maneuver failed to gain his attention for the desired foot rub, she wiggled her foot further into his thigh. He jumped at the sensation, grabbing her foot before she could embarrass him. Fixing her with a glare, he acquiesced and began to run his thumb up her insole. She sighed with relieved satisfaction and mused not for the first time that pregnancy had its perks.
He shook his head at her rapturous expression and slid his hand up the back of her calf. When her eyes popped open in warning, he shot her a mischievous grin…payback was hell.
A pack of noisy footsteps thundered through the kitchen before stopping at the threshold to the family room. Six pair of eyes ranging in age from 14 months to 10 years took in the scene before them. Ben finally broke the transient respite of silence, “Daddy, can we go outside and play?”
Harm paused in his rubbing ministrations and glanced toward his son, “You can go in the backyard only. Stay by the swing set…no pool and no beach…do I….” Ben turned with the crowd in rapid escape. “Benjamin Carter Rabb!” The 4 year old turned back toward his father with a sheepish grin. “Mister, I wasn’t done talking to you. I don’t want anyone to leave the back yard…do I make myself clear?”
Ben grinned and saluted, “Yes Sir.”
Harriet giggled at the small boy’s antics, before throwing in, “AJ and Jimmy Roberts…you two are the oldest here. I expect you to supervise the other kids and keep them out of trouble…do I make myself clear?”
AJ rolled his eyes, “Yes ma’am…but tell Nicki we don’t have to play Barbie’s with her.”
Bud’s voice interjected, “AJ, you’re sister is the only girl here…I’m sure if you think about it; you can find a game that everyone will enjoy.”
“Yes Sir,” rang out in several different voices as the French doors slammed shut.
A loud shriek of pain was the next sound to fill the room. Harm jumped up from the couch to grab his smallest son. Connor held out a red fingertip as he continued to wail. Picking up the 14 month old he hurried into the kitchen to run the bruised digit under cold water. Examining further, he detected no breaks in the skin. “Hey little man, did they catch your finger in the door?” Connor nodded his head as huge crocodile tears continued to fall.
Mac appeared at their side, running her fingers through Connor’s dark hair, “Did Mama’s baby get an owie?” Conner held up his finger for inspection as his cries softened to whimpers. She kissed the bruised finger and grabbed some ice from the fridge. Wrapping the ice in a rag, she held the cold washcloth to his hand and lifted the toddler into her arms. Connor immediately buried his face in her neck and continued to softly cry.
As everyone returned to the couch, Connor wiggled and maneuvered in his mother’s arms, trying to find a comfortable perch over her expanding abdomen. Finally crying out in frustration, he pointed to his father, “Daee!”
Harm reached for the boy and settled him onto his chest. Still not content, Connor reached inside his Dad’s shirt and tugged, “Off Daee…off!”
Harm patted his back instead, trying to calm the tears. When all attempts failed, he sighed in resignation and unbuttoned his shirt. Connor pulled at his own, removing the barrier with Harm’s help. The little boy dove at his father chest and closed his eyes at the contact of skin. Harm shook his head and watched as Connor began to suck on the injured finger, while twirling the opposite hand through Daddy’s hair. Finally content, the little boy’s whimpers calmed to shuddering breaths and eventually evened out to deep inspirations of sleep. Mac reached for a blanket and covered the pair, before leaning over to place a kiss on her slumbering son’s forehead.
Harriet took in the scene with wide-eyed amazement, “What was that all about?”
“It’s called kangaroo care, they use in neonatal intensive care units as a way to calm sick and stressed babies,” Mac explained. “We figured out early on that Connor responded well to the skin-to-skin contact. We’re not sure if it’s the tactile sensation, the sound of our heartbeat or the security of being held close.”
Jen peered at the sight of the sleeping toddler, “I thought Mattie said he’d outgrown that?”
Harm spoke softly so as to not wake Conner, “Mostly he has…he only likes to cuddle skin-to-skin when he’s stressed or hurt.” He reached out to lay a hand on Mac’s bulging abdomen, “I’m the preferred kangaroo for the most part now, since Mac’s belly is starting to get in the way of comfort.” He grinned when Mac smacked his arm.
Victor leaned around his wife and rubbed his hand on her burgeoning abdomen, “Hey Jen, maybe we should check into this kangaroo thing. You never know…with our little jarhead-sailor mix here, we might need something to calm his internal struggles.”
Harriet smiled at the pair, “So Jen, how did you and Gunny end up married?”
Mac chuckled, “That would be due to the infamous matchmaking trio. Mattie started the plot…and Trish and Evie joined in. Once those three set their mind to something, there’s no escape. Whoa be to anyone who doesn’t go along with the scheme.” She reached up to tweak Harm’s ear, “Isn’t that right, Sailor?”
He grabbed her hand and gave it a kiss, “Absolutely, acquiesce or suffer the consequences. Those three may look harmless, but they’re anything but…especially Evie.” He rubbed his ear, “She has ways of making you comply.”
“And believing it was your idea all along,” Mac threw in with a chuckle.
Harriet frowned, “Evie? Isn’t that the woman who owns the restaurant you all love so much?”
Mac nodded, “Oh yeah, we thought we’d take you there for dinner tomorrow night. Trish and Frank offered to supervise the troops. It’ll be nice to get out for an evening…adult conversation only for a change.”
“I’ll second that,” Bud piped in. He studied Harm for a minute, “Harm, what’s with the funky shirts? I never took you for a cartoon aficionado.”
Harm tugged at the front of his shirt and laughed, “This was a gift from my boys. They seem to have an affinity for buying funky Hawaiian shirts as gifts for Father’s Day, birthday, Christmas,” he rolled his eyes at Mac, “…any day and everyday.”
Mac glared back and then broke into a smile, “You forgot to tell him the rest of the story, mister.”
“Actually Bud, this is the uniform of the day at work.”
Bud’s eyes widened, “You dress in shirts with Goofy and other cartoon characters to work at the law firm?”
Harm nodded with a big smile, “Yup, casual and comfortable that’s our motto.” When Bud’s eyes widened further, Harm laughed, “Actually we started out in suits and ties, but we found the kids were frightened by all the formality. So we switched to funky shirts, khakis, jeans, tennis shoes, etc…the kids are a lot more comfortable and cooperative with the relaxed atmosphere. We each keep a couple of suits tucked away in our office closets for when we have to go to court.”
Bud pondered the statement, “So are you guys really staying busy with just kids for clients?”
“Are you kidding,” Mac enthusiastically exclaimed, “…we almost have more casework than we can handle. We collaborate with CPS on a fair number of cases, in addition to our private clients. We expect to hire another attorney within the next year or two.”
Harm watched the emotions play over Bud’s face, “Hey Bud, don’t suppose you’d be interested in joining a law firm that specializes in kids?”
Bud’s eyes flicked to Harriet’s before looking back, “As a matter of fact, I just might. I was lucky to make Lt. Commander with my disability; if it hadn’t been for Admiral Chegwidden’s intervention on my behalf, I would have been out already. I don’t see General Cresswell making the same effort for me.” He looked back toward Harriet, “We’ve been talking about other alternatives to the military when I decide to leave…and I suspect private practice in California wouldn’t be too bad a place to settle. Especially when we have good friends close by.”
Harm nodded, “We’d love to have you, Bud…think about it and let us know.” He turned toward Mac and winked. They’d been talking about asking Bud to join the practice when the time came to expand. If things worked out right, the three musketeers just might ride again.
***
20:30
Sunday
16 January 2011
Labor & Delivery Triage
UCSD Medical Center
San Diego, California
Harm jiggled his leg up and down in a nervous fashion as he sat waiting for the perinatologist to arrive. The nurse scurried around the gurney adjusting the IV infusion and handing Mac a cool washcloth. The fetal heart rate monitor slowed and alarmed as Mac turned to her side.
Harm jumped up from his chair, “What’s wrong with the baby?”
The nurse smiled at the worried father, “There’s nothing wrong, Mr. Rabb. The transducer just got displaced when your wife turned to her side.”
“Harm,” Mac extended her hand, “…you need to calm down. Dr. Sherman said she’d be here soon. I’m sure they’ll be able to stop the contractions with the medication.”
“But Mac, this is too early. Dr. Sherman wanted you to get to at least 32 weeks before she delivered you.” He took the cool rag from her hand and wiped it over her face, “Here let me do that…it’ll give me something to do with my hands.”
The nurse smiled at the pair, “So, this little one is your first?”
Mac smiled back, “Natural yes…but we have two adopted sons and a foster daughter, who’s in her first year of law school.” She rubbed her hand over her belly, “Ellie was the surprise we didn’t think we’d ever get.”
“Ellie? So this one’s a little girl?”
Harm beamed, “Yeah, Elizabeth or Ellie for short…she’s been a long time in coming. She just has to be alright,” his smile dimmed.
Dr. Sherman breezed into the triage exam room, “Hi Sarah…I can’t say I’m surprised to see you. We’ve been expecting this to happen. Your last ultrasound showed a fair bit of cervical shortening.” The physician studied the monitor strip, “Looks like the magnesium is slowing down the contractions. How are you feeling?”
Mac sighed and closed her eyes, “Like an elephant is sitting on me. Everything feels heavy and difficult to move.”
“That’s a pretty normal sensation from the medication.” Dr. Sherman motioned for the nurse to bring a speculum and a pair of sterile gloves. “Alright Sarah, I’m just going to do a quick exam to check for cervical dilatation.”
Before the physician could begin, Mac turned to the side and began to retch. Harm grabbed the emesis basin from the side table and handed it to the nurse. “Why is she vomiting?”
Rachel helped Mac with the basin and then reached for a fresh cloth, “It’s from the magnesium…the bolus dose tends to make you feel nauseous and…”
“Hot,” Mac croaked out.
Dr. Sherman grinned, “And hot…those symptoms will improve once you’re on a stable infusion drip.” She patted Mac’s leg, “Alright Sarah, are you up for the exam now?”
Mac nodded her head as Harm turned to leave the room, “No! Harm, you don’t have to leave…stay here with me.”
His eyes bulged with a ‘deer caught in the headlights’ expression, “But Mac, I was just going to wait outside.”
“No chance, Sailor…you got me into this mess, now you get to stick around for moral support.” He edged toward the head of the bed and diverted his eyes to Mac’s. “It’s OK, Harm…it doesn’t really hurt.”
He leaned over to kiss her forehead, “Hang in there…I’m right here, Marine.”
Dr. Sherman finished the exam and snapped off her gloves. As she washed her hands, she explained, “Well Sarah, you’re about 2 cm. dilated, but the good news is your membranes are still intact. I want to admit you on strict bedrest and continue the magnesium. I’ve also order a steroid medication to help mature the baby’s lungs. You’ll get one injection now and a second in 24 hours. Rachel will also be starting you on IV antibiotics to prophalytically treat for any infection in the membranes surrounding the baby. If we’re lucky, we’ll be able to hold you off a little longer; but from this point on, you’re in the hospital for the duration.”
“But, that could be weeks,” Mac protested. “I have two little boys at home that I need to look after and work….”
Harm cut her off, “Mac, don’t worry about all that. Mom and Frank can help me with the boys. And Howie and I can handle the office. Your most important job at this point is to keep Ellie inside and safe.”
She laid her head back and closed her eyes, “I know, it’s just that…I’m going to miss the boys.” A line of tears tracked down her temple and into her hair.
Dr. Sherman patted her patient’s hand, “Sarah, it’s going to be OK. If Ellie is born now, her chance of survival is over 90%, but I’d still like to get at least 2 more weeks. She needs a chance to get a little bigger and stronger. For each week we gain, her chance of complications and the length of her NICU stay decrease astronomically.” She smiled, “As for your boys…siblings and children are allowed to visit. We’ve found it’s best for everyone to have the entire family involved…Mom and Dad are less stressed…and the kids are happier.”
As the physician left the room, Harm hovered nearby, “Mac, I need to call Mom and Frank and let them know what’s going on. Is it OK if I step away for a minute?”
She nodded in response, “Sure, give everyone my love and tell them Ellie and I are fine. You’re going to be heading home soon aren’t you?”
He turned back from the door, “Not a chance, sweetheart. Mom said she’d keep the boys for the night. I’m going to stay with you.”
“But you don’t have to, I’ll be fine. You need to get some sleep.”
“I know,” he winked, “…I want to…I can’t be without my best girls. I’ll be right back.”
***
17:30
Monday
24 January 2011
Antepartum Unit
UCSD Medical Center
San Diego, California
Harm walked through the door to find Mac surfing through television channels with complete disinterest. “Hey Marine, nothing on TV to your liking?”
She clicked through the channels rapidly until the TV clicked off. Tossing the remote aside, she smiled brightly, “Nothing as interesting as my husband. How was your day?”
He dropped into the bedside chair, “Exhausting! The boys were cranky this morning and didn’t want to go to daycare. They wanted to spend the day with Gummy Trish and Gummy Evie. I swear Mac…by the time you get home, our boys will be corrupted for life. Mom and Evie are spoiling them rotten. I had court all morning and clients all afternoon. And worst of all, by the end of the day when I get home, I’ll have to sleep all by myself.”
She tugged on his arm, dragging him up onto the bed next to her. Pulling his head down on her shoulder, she kissed his forehead, “I’m sorry I’m stuck in here and not at home with you and the boys. I’d much prefer my guys to this room. I’m about to go crazy staring at these four walls.”
He snuggled a little closer into her side, “Did Dr. Sherman come in yet tonight?”
She shook her head, “Not yet, I expect her anytime. I’m hoping to get rid of this IV. They started a new medication this morning to control my contractions in hopes of stopping the magnesium.” She peeked around his body to the bag in his hand, “What did you bring us?”
He sat up with a grin and extended his hand, “Evie sent dinner…roasted vegetable salad for me…and the roasted chicken for you.”
She frowned, “No Italian beef sandwich?”
He chuckled, “No Italian beef…Dr. Sherman said she wanted you to cut back on your sodium intake, remember? Evie’s au jus is loaded with salt, but,” he dangled the bag in front of her, “…I did talk Evie into sending chocolate mousse for us to share.”
She laughed, “Harm, isn’t that what got us in trouble in the first place?”
He shook his finger, “No, no Marine, it wasn’t the chocolate mousse that got us in trouble…it was watching you eat the chocolate mousse along with the second and third course of dessert that got us in trouble.”
She held out her hand, “Never mind, just hand over the food…I’m starved. The junk they served for lunch wasn’t worth eating.”
They were enjoying their dinner when Dr. Sherman appeared for evening rounds. “Good evening, Sarah…how are the two of you tonight?”
Mac swallowed the food in her mouth, “Much better since Harm brought dinner.”
The doctor walked closer to the bed, “That smells wonderful, what is it?”
Harm retrieved the take-out menu from the bag, “It’s from a restaurant called Evie’s Bistro in downtown La Jolla. We know the proprietor, and you can’t get better food anywhere else.”
The physician took the offered menu, “I’ll have to keep it in mind next time I’m shopping at the galleries.” She walked over to Mac’s side of the bed, “How are you feeling tonight?”
Mac held up her left hand, “Great, I haven’t felt a single contraction all day…any chance I can get rid of this IV?”
“There’s still a little uterine irritability on your monitor, but the contractions seem to be much less frequent and intense. I’d like to keep the magnesium going overnight and give the Nifedipine a chance to really work. If things look stable by morning, I think we can remove the IV. Any other questions?”
Mac shook her head, “No, I think we’re fine…just trying to hang on for a few more weeks.”
Dr. Sherman headed toward the door, “See you in the morning, Sarah.” She waved the menu in the air, “And I’ll be sure to let Evie know you sent me.”
The couple finished their dinner in comfortable silence. Once Harm had cleared the containers away, he sat back down on the bed, “You up for a little reading tonight?”
She laid her head on his shoulder, “Sure, what did you bring?” He handed her an older leather bound book. “Where’d you find this? It looks antique.”
He took the book from her hands, “It is…Evie sent it along with dinner. She said…it’s literature that is good for the soul.” He shrugged, “Something about a good old-fashioned clean romance with a little folklore, medicine and healing thrown in. Whatever that means…you game?”
She leaned further into his side, “Absolutely, whose turn is it to read?”
“Mine I think,” he carefully flipped open the cover of the old book, “...’The Harvester’ by Gene Stratton-Porter. ‘Bel, come here! The Harvester sat in a the hollow worn…’.”
***
02:45
Wednesday
2 February 2011
The Rabb House
La Jolla, California
Harm was awakened by the ringing of the phone; clumsily reaching for the offending object, he pulled it to his ear, “Hello.”
“Harm?” came the tearful plea.
“Mac?” he rubbed a hand over his face, “…sweetheart, what is it?”
“I need you,” her voice sounded soft and scared.
Fully awake now, he sat up in bed, “Mac, what’s the matter?”
“The baby…they’re going to have to delivery the baby. They can’t stop my contractions…and Dr. Sherman doesn’t want to wait any longer.”
He jumped out of bed and fumbled with his clothes, “I’m on way, sweetheart. I need to get Mom to come stay with the boys, but I’ll be there shortly.”
The line was quiet for several seconds, except for the sound of her breathing, “Hurry Harm, I don’t know how long they’ll wait. I need you.”
He hurried from the bedroom to the kitchen, “I’ll be there soon…I promise. I love you, Sarah.”
***
03:30
Wednesday
2 February 2011
Antepartum Unit
UCSD Medical Center
San Diego, California
Harm entered Mac’s hospital room to find a flurry of activity. He was met at the door by Mac’s nurse, “We’ve been waiting for you…hurry, you need to change into scrubs. We’re just getting ready to take Sarah back to the OR.”
He watched as they transferred the IV bag to a portable pole and lifted Mac onto a gurney. Wheeling past, he stopped the progress for a moment, “Hey sweetheart, I’m here…how are you doing?”
She bit her lip, “Trying to hang in there. It’s too early, Harm.”
He reached for her hand, “You did good, Marine. You got Ellie to 32 weeks…I’m sure she’s going to be fine.”
The nurse spoke up, “We need to go. Mr. Rabb, you need to change clothes and wait right here. Someone will be back to get you once we’re done with Sarah’s spinal.”
Harm’s eyes widened, “Spinal?”
The nurse smiled, “It’s the anesthesia for the C-section…that way she’ll be awake when your baby’s born. Now hurry, we’ve got to go.”
He leaned in quickly and placed a kiss on Mac’s lips, “I love you, sweetheart. I’ll be right there with you…we’re going to get to meet Ellie tonight.”
She tried to smile as tears ringed her eyes, “Love you, too.”
He changed clothes and then paced the room, waiting for someone to come retrieve him. Finally after what seemed like forever, a nurse came into the room, “Mr. Rabb, if you’ll come with me.”
He followed down the hall, through the large doors marked ‘No Admittance,’ past the scrub sinks and into a large bright OR suite. The OB nurse directed him to the chair next to Mac’s head. Sitting down, he peered around the room with nervous excitement. Reaching for his wife’s hand, he sighed, “How are you doing?”
“I don’t know…scared…excited,” she released a nervous shuddering breath, as a tear escaped her eye.
He reached up to wipe it away, as Dr. Sherman announced, “Skin incision at 03:53.” The room was filled with the sounds of suctioning, sizzles, pops and a high-pitched whine. He peeked around the sterile drape and watched the activity of instruments passing hands. A barrage of commands filled the room, “Scalpel…pick-ups…suction…retractor…clamp…suction.”
He looked back to Mac’s worried face and stroked her cheek. Smiling to ease the fear, he whispered, “Ellie’s almost here. What do you think she’ll look like?” Mac drew in a deep breath and winced at the obstetrician’s movements. His eyes widened, “Do you feel that? Are they hurting you?”
She shook her head, “It’s just pressure and pulling, not pain.”
He glanced toward the anesthesiologist, “But she shouldn’t feel anything, how come she can feel what they’re doing?”
The physician tapped her shoulder, “Sarah, what do you feel…pain or pressure?”
“Pressure,” she replied.
At Harm’s concerned look, the physician explained, “That’s normal…we can’t take away all the sensations without putting her to sleep…and that wouldn’t be safe for the baby. Sarah, you’re going to feel pressure and pushing, but you shouldn’t feel pain.” The anesthesiologist peered over the drapes, “Hey folks, your baby’s almost here.”
Harm squeezed her hand and smiled behind his mask. He heard Dr. Sherman ask for a bladder blade and a scalpel then announce, “Ellie’s about to make her appearance. Hey guys, we did this just in time. Sarah, your anterior uterine wall is paper thin.” She glanced over the drape, “Harm, stand up and take a look.”
He stood and peered over the sterile drape in awe. When the OB pointed out the nearly clear window in the uterus, he startled with shock to see a small hand just beneath the surface. Dr. Sherman lightly touched the uterus and the muscle separated on contact. The OB nodded to the shocked father, “It’s a good thing we did this when we did…if we’d waited much longer, the uterus probably would have ruptured and the outcome wouldn’t have been as good.”
Harm watched as the doctor ruptured the bag of fluid surrounding his daughter and then reached in to pull out the head. Tears flooded his eyes as they suctioned the small mouth and nose. The first of those teardrops fell as the body was revealed and a lusty cry filled the room. He collapsed into the chair and pulled down his mask to give Mac a kiss, “She’s here, sweetheart…Ellie’s here.”
She reached up to wipe away the tears that fell from his eyes and whispered, “I love you.”
He rubbed his cheek against her hand, “I love you, too. Thank you for our daughter.”
The neonatologist motioned from the warmer bed, “Dad, would you like to see your baby?”
He glanced back toward Mac, warring with himself over whether to stay with his wife or go to his daughter. Mac smiled serenely, “Go ahead, Daddy…go say ‘hi.’
He hovered near the warmer just out of reach, watching as the doctor dried and examined his little girl. When the neonatologist pronounced her ‘absolutely perfect,’ he breathed a sigh of relief. He extended his hand, hovering above the small infant.
“Go ahead and touch her, she won’t break.”
He stroked a finger down the small arm and gently picked up her hand. She instinctively curled her fingers around his and held on tight. He studied her closely and counted ten fingers and ten toes. Releasing her hand he ran a finger through her matted hair. He laid his hand on her chest and leaned in close, whispering, “Hey Ellie, it’s Daddy. Mommy and I have been waiting a very long time for you. We love you, baby.” Ellie opened her eyes at the sound of his voice and studied his face.
When the neonatologist announced the Apgars as 9 and 9, the nurse wrapped the small infant in multiple layers of blankets and asked, “Would you like to hold your daughter?”
Harm stepped back, somewhat panicked, “She’s so tiny…I don’t want to hurt her.”
The nurse chuckled, “You won’t…why don’t you go sit next Mom and I’ll bring her to you.”
Once he was seated, the heavily wrapped bundle was placed in his arms. Ellie opened her eyes, pursed her lips and frowned as she looked around the room. He chuckled at the serious expression and turned his daughter toward Mac, “Sweetheart, she’s perfect. She looks like you…just like in my dream.”
He carefully lifted Ellie, bringing her face up to Mac’s. Tears appeared instantly in Mommy’s eyes as she whispered, “Oh Harm, she’s perfect. I can’t believe she’s finally here.”