Joy Cometh in the Morning 1/20

This is my idea of how JAG could have ended. I dreamed up this story long before the actual finale of JAG, but just recently had time to put it to paper. I envisioned an 11th season with this story being the final episode of the series. In my world the 10th season of JAG continued as portrayed through “The Four Percent Solution” then veered off in a slightly different direction. Mattie was never in an accident and thus stayed with her father. Harm and Mac were able start their life without the encumbrances of a teenager. This final “episode” could have allowed us to see into the future life of the Rabb family with all of its ups and downs and in betweens. Most of the future will be seen through ‘Harm’s Flashbacks and Dreams’. I can’t promise that it will always be easy; it never has been for our dynamic duo. But I will promise as the verse states, “Weeping may endure for a night, but joy cometh in the morning.”

The first 2-3 chapters involve the more medical aspects of the story; if you can get passed those, the tempo and fun picks up by good measure. The story is already complete; I will try to post a chapter every 1-2 days depending on my call schedule. I hope you enjoy.

Author’s Note: My medical specialty is neonatology (newborn intensive care). As the medical aspects proceed I will attempt to explain what is occurring in “layman’s terms” much as I would to a parent. My patients and their parents are wonderful and strong human beings, who survive dramas that would put most of us to shame. I understand both sides of these issues, since 9 of my 11 nieces and nephew were premature—3 of those 9 did not survive. In order to understand this story, a full term pregnancy is 40 weeks. If anything is unclear, please feel free to ask questions.

This is my first fanfic, so please be patient with my mistakes. Special thanks to Mom for proofing for grammar and spelling errors.

Disclaimer: I don’t own JAG or any of its characters. If I did, season 10 would have been much more fun. The medical personel, in this fiction, are composites of many of the people who I have had the pleasure to work with over the last 2-1/2 decades.


Part 1

19:00
Friday, May 19th, 2006
Bethesda Naval Hospital
Antepartum Unit

As Nurse Sally Martin entered Room 2404, she smiled at the picture before her. Huddled on the small hospital bed was a giggling couple fighting over the TV remote. Her patient was a beautiful marine colonel who had spent the last 8 weeks hospitalized on strict bedrest attempting to prolong her difficult pregnancy. Her husband was a tall handsome naval captain, who had turned the head of nearly every female he encountered. They were a sweet couple whose story had pulled at the hearts of all their caregivers. Of course the couple had only shared a small portion of their entertaining lives with the hospital staff, but additional colorful tidbits had been added by friends and colleagues during daily visits. If even half of the adventures and misadventures had been true then this adorable pair had been fortunate, lucky, blind, stupid, perseverant and every adjective in between, to have actually gotten to this point in their lives. As she walked further into the room she heard them playfully arguing.

“Mac, why can’t we watch the basketball playoffs, I already missed the first round,” argued Harm, as he again wrapped his arms around his wife to grab the remote.

“Harm, the doctor said I needed to rest quietly. I hardly think having you yelling at the referees over every call is going to qualify as a peaceful evening, besides I think Lifetime is replaying that movie ‘The Stranger I Married’ tonight. Harriet said it was a great movie and I hear the actor playing the lead role is a real hunk,” smirked Mac as she wrestled back the remote to change the channel.

“Mac, I should be the only hunk in your li…” Harm stopped mid word and blushed brightly as he noticed the nurse standing by the door shaking her head and chuckling to herself.

“Captain Rabb haven’t we already discussed the need to keep the Colonel quiet? I also see you again refuse to utilize the bedside chair provided for your comfort,” laughed Nurse Martin as she checked the Colonel’s IV site and adjusted the IV rate.

“It’s her fault; she pulled me up here,” he replied contritely while turning toward Mac. “See, you always get me in trouble,” he quipped while pulling her closer. “I guess we’ll have to quietly watch your movie, before you get me thrown out!”

“What do you mean my fault, you’re the one who…” Mac started before being cut off by the nurse clearing her throat.

“All right you two, I feel like I’m fielding a dispute between my children. Now before we have anymore disagreements, Colonel are you feeling any contractions tonight?”

“No, everything seems to be fine. I’m just tired of being in this bed. I can’t wait until I can get up, take a shower, go outside, anything but looking at these four walls would be an improvement,” she sighed.

“I know, but think of the payoff in 10 weeks when you deliver a healthy baby. All this will be a distant memory,” noted Sally has she left the room. “And keep it down in here, we have other patients you know and you’re having way to too much fun in here,” she smiled as she stuck her head back through the door. The couple looked meekly chastised as they settled back into the bed, but laughed heartily once the nurse had again cleared the door.

Twenty minutes later, having lost interest in the movie, Harm got up from the bed and stretched. Leaning over to kiss Mac’s forehead he quietly asked, “Do you want something from the cafeteria, I’m going to go grab a cup of coffee?”

“Yeah, some ice cream would great. See if they have something chocolate.”
He rolled his eyes, “You and your chocolate. I’ll be right back.”

As he walked by the nurse’s station he waved to Sally. “I’m going to run downstairs. I’ll be back in about 20 minutes. Please call me on my cell phone if Dr. Abrahms comes in, I have some questions for him.”

Harm quietly walked down the hallway and entered the elevator deep in thought. One week earlier they had spoken with Dr. Williams, the neonatologist, regarding baby Sophie’s chances of survival and potential problems once born. Harm smiled at the thought of his little girl’s name. He and Mac had argued over various names before agreeing on Sophia Elizabeth Rabb. He had suggested Kaitlin, “Katie” for short, but Mac had immediately nixed that choice as it reminded her of Kaitlin Pike. Harm sheepishly replied that he hadn’t meant to name the baby after Kate. Mac suggested Anna, but was immediately rebuffed by him as this could be shortened to “Annie,” and he didn’t need a daily reminder of a “neurotic ex-girlfriend.” They both refused to name their daughter after close relatives, and while Harriet was a good friend, no little girl deserved to be saddled with that name. Various and sundry other names were bantered about and dismissed due to “old girlfriends, mean schoolmates, too prissy or too Hollywood,” before they both agreed on Sophia or “Sophie” for short. He would finally have his long awaited little princess. “Princess Sophia,” Harm chuckled to himself, Mac would get a kick out of that one.

Harm purchased a large cup of coffee and winced as he took a big gulp. Why couldn’t hospital cafeterias serve a decent cup of coffee or palatable food for that matter. You’d think with a captive audience of patients and families they could at least hire a decent chef. He sat down at an isolated corner table to contemplate his earlier conversations with Dr. Abrahms, the perinatologist or high-risk obstetrician, and Dr. Williams, the neonatologist or newborn intensive care doctor. Why couldn’t doctors have normal sounding specialty names? It was like they put together the longest string of letters possible just so patients couldn’t remember, much less pronounce, their doctor’s specialty. And the more specialized they got, the longer the name became, he thought shaking his head.

Harm thought back over the last year. Mac’s pregnancy had been tough from the get go. Once they had married in May of 2005, they had begun trying to get pregnant immediately. Due to Mac’s low chances of conceiving, Dr. Chen had put her on Clomid, a fertility drug to increase ovulation, in June. After 4 months of with no success, Harm and Mac had asked about other options. Dr. Chen had wanted them to give the Clomid another 2 months, but Mac insisted on pursuing other options due to her advancing age and long odds for achieving success. They had all agreed to try Pergonal injections before proceeding to in vitro fertilization. The Pergonal injections had involved giving daily injections for 12 days straight to induce development of a “follicle” or egg; this was followed by an injection of HCG to stimulate release of the egg. They had been warned that Pergonal could stimulate multiple eggs to be released, which could result in a pregnancy with twins, triplets or more. A pregnancy with multiple babies would be high-risk for a normal woman, but in Mac’s case due to her endometrioses and prior surgery, the risk with a multiple pregnancy was exponential.
The first month of Pergonal again resulted in disappointment. Dr. Chen suggested trying artificial insemination in conjunction with the next course of injections. Harm nixed that suggestion for the time being. He had been thoroughly checked, much to his chagrin, and been found to be healthy. He felt that the first 6 months of their marriage had been “clinical” enough and felt that the conception of their child deserved to be at least a little romantic. If they failed after several more months then they would proceed with a more sterile, clinical process.

During the November cycle of meds, Mac’s ultrasound showed the development of several promising eggs before her HCG injection on November 10th. She excitedly called Harm to relate this information with the instructions to “be home by 18:00, without a briefcase and prepared to have fun!” He secured early to surprise her, arriving home at 14:00 with groceries in hand to prepare her favorite meal. Mac walked through the door at 18:00 to find candlelight, soft music and her husband dressed to the 9’s with dinner in hand. They were ecstatic when one month later Dr. Chen reported a positive pregnancy test. They were even more ecstatic when an ultrasound at 6 weeks revealed a singleton pregnancy.

Initially all proceeded well. Much to Mac’s dislike, Harm insisted on monitoring her diet. She agreed but refused to eat only vegetables. She also grumped over her loss of coffee having to settle instead for herbal tea. She continued a light exercise program, and work assignments were limited to the D.C. area—this was expedited by her position as a judge. She left JAG HQ by 18:00 each day, completing work at home as needed. Everything seemed to be going well until 4 months (18 weeks gestation) into her pregnancy. At that time, Dr. Chen noted that her blood pressure was elevated. She was started on medication and had to cut her workload to half-days limited duty. An ultrasound at 20 weeks showed the baby’s growth to be lagging. She was then placed on bedrest at home. Two weeks later at 22 weeks gestation, the ultrasound showed further delay in the baby’s growth and a decrease in the fluid surrounding the baby. Mac was immediately hospitalized and her care transferred to Dr. Abrahms, a high-risk OB.

Dr. Abrahms had insisted on almost complete bedrest with IV hydration and hydrotherapy in an attempt to increase the amniotic fluid that surrounded the baby. Mac hated the bedrest, but enjoyed the hydrotherapy, which basically was like spending time in a hot tub. She and Harm nonetheless complied with all restrictions in hopes of a successful pregnancy.

They were devastated 4 weeks later, at 26 weeks gestation, when Mac went into premature labor and her water broke. He remembered with distress the tearful phone call from Mac. He had been on his way to Norfolk for a meeting when his phone rang.

***Flashback***April 23rd, 2006***

“Rabb”

“Harm,” came Mac’s soft and tearful voice over the line.

“Mac, what’s wrong.” Moments of silence ensued in which Harm could hear Mac’s soft sobs. “Mac, baby, you’re scaring me. What’s wrong? Is it the baby?” he pleaded.
“Harm, I need you…I’m having contractions…my water broke…they think the baby might come. Harm it’s too early. What if we loose her?” cried Mac

“Listen sweetheart, I’m coming. I was on my way to Norfolk, so it will take me a while. Hang in there, I love you.” Harm hung up the phone and then dialed A.J. as he exited at the next ramp to turn around.

“Chegwidden”

“Admiral, it’s Harm…look I need some help.”

A.J. could hear the distress in the Harm’s voice. “What is it, son? What can I do?”

“Admiral, I was on the way to Norfolk, but Mac just called. She and the baby are in trouble…I can’t get there fast enough, and I don’t want her to be alone…Sir, could you…” came the scared voice.

“Harm, I’m on my way. You just drive safely and get there in one piece. I’ll see you when you arrive.”

“Thank you, Sir…and please tell her I love her,” came the tearful reply.

***

Harm arrived 2 hours later. As he walked into Mac’s room, he found her slumped over in the bed retching into a basin. Lt. Sally Martin, her primary nurse, was rubbing gentle circles on her back trying to calm the frightened patient. Sally had been assigned to Mac’s care on the first day of her admission and had proved to be a ‘God-send’ throughout this prolonged hospitalization. Sally knew how to provide support and encouragement, while at the same time taking great pleasure in teasing the marine colonel and navy captain to keep their spirits high. As Harm carefully approached the bed, Sally looked up and quietly noted, “It’s the medications. They tend to make the patient feel jittery and nauseous.”

“What med…” cracked Harm’s voice. He cleared his throat. “What medications? What’s going on?” He gently sat on the bed next to Mac and began rubbing her back as Sally had been doing.

“Dr. Abrahms started her on magnesium sulfate IV. She’s also had a couple of shots of Terbutaline, to try and stop her contractions.”

Harm nodded at Sally with fear in his eyes. Mac slid closer into his arms and buried her face into his neck. He immediately felt wet tears on his skin even before he heard the first sobs. “Hey Marine…hang in there…It’s going to be OK…I promise,” he whispered just before kissing the top of her head.

“And you never make…a promise…you can’t…keep,” sniffed Mac with a weak voice.
Harm felt tears well in his eyes. “I don’t know…if I can…keep…this one,” his voice cracked as he buried his face in her hair. They hung onto each other for several minutes before noting the doctor’s presence in the room.

Dr. Abrahms was a naval captain with a commanding presence. He was a tall, gray-haired gentleman with a rich baritone voice and a gentle bedside manner. His patients adored him and the nursing staff loved his attention to details. He paused to look at the distressed couple before him. They appeared to be very much in love. He understood they had married recently, but if rumors were true; they had been silently in love for a decade before they’d wed. Watching them now as they exhibited gentle caresses, quiet words and unwavering support for one another, he wondered what had taken them so long to get to this point in their lives. With a shake of his head and a slight grin, he figured he would never truly comprehend the idiosyncrasies of love. He just hoped he could give this couple the child they so desperately wanted. He slowly approached the bed wishing it wasn’t necessary to have the difficult discussion, which was about to occur. He loved his profession when all went well producing a beautiful healthy baby, but on occasions such as this, he wished he could escape to his fishing boat to enjoy the sunset, leaving the sadness to his younger colleagues.

Just as Dr. Abrahms was about to begin, Admiral Chegwidden bustled into the room. “Mac, has Harm gotten here…” A.J. stopped mid sentence noticing the doctor’s presence. “I’m sorry…I didn’t mean to interrupt. I’ll just wait in the visitor’s lounge.” He turned to exit the room, but was stopped by Harm.

“Admiral, please stay. You’re a very important person in our lives as well as Sophie’s. We’d appreciate it if you’d stay to listen to what the doctor has to say,” Harm pleaded with his eyes for A.J. to understand. “Dr. Abrahms, this is Admiral Chegwidden. He was our former commanding officer. I hope you don’t mind that he listens in?”

The doctor smiled at the nervous parents-to-be, “Not at all, Harm. We appreciate all the support that you and Sarah can get.” Turning to the Admiral, “Sir, how long were you their commanding officer?”

The Admiral smirked, “9 years for the Captain and 8 years for the Colonel.”

“I bet you could tell some tales about these two,” the doctor laughed before turning to Harm and Mac.

“You don’t know the half of it,” laughed A.J. “They could test the patience of a saint, but I’ve never had finer officers. My only regret was telling them not to get ‘too familiar’ when they first met. It took them nine years to get their act together, despite what all the rest of us could see immediately! Maybe if I’d kept my thoughts to myself we wouldn’t be here right now,” A.J. sobered.

“Yes well, we’ve heard rumors of their tales…but I’m sure that they appreciate all your concern now,” Dr. Abrahms replied as he pulled up a chair next to the hospital bed.
“Harm and Sarah, we have some serious issues to discuss and some hard decisions to make,” Dr. Abrahms began as he looked up into the terrified faces of the couple before him. The lovely colonel was swiping at tears as they fell from her eyes, and the captain nodded stoically, while grabbing for her hand. “The events of today have negatively impacted on my hopes for the successful outcome of this pregnancy.” Mac quietly released a sobbing breath as Harm pulled her closer. “As you know this has been a difficult pregnancy. You are currently only 26 weeks into a 40 week pregnancy. If you were any other couple with a normal pregnancy before today, a baby delivered at 26 weeks would have approximately a 70% chance at survival. However your baby is severely undergrown. She should be about 2 pounds by now, but actually only weighs just over 1 pound at this time. Again babies at this weight can survive, but there are so many other things to consider. The most salient feature to consider at this point is your baby’s lung development. The huge majority of infants born at this time have immature lungs. Now my neonatal colleagues can successfully treat this condition, but in your baby’s case…”

“Her name is Sophie…” Mac quietly interjected.

“What, I’m sorry…I didn’t hear you?” replied Dr. Abrahms.

“Sophie…I said her name is Sophie…Could you please refer to her by her name…and not just the baby?” came Mac’s tearful reply.

“Of course,” Dr. Abrahms sympathetically smiled back. “In Sophie’s case, her lungs are not just immature, but are too small as a result of the low fluid surrounding her.”

“I don’t understand,” Harm shook his head. “What does the amniotic fluid have to do with her lungs?”

“While babies are developing, they are suspended in fluid giving them plenty of room to move around and grow. In Sophie’s case, the oligohydramnios, or low fluid, has put restrictions on her movements and growth. Specifically, it can restrict how her chest grows. Thus her lungs may be too small to support breathing outside the womb. Now all babies with low fluid don’t develop pulmonary hypoplasia.” At Harm’s questioning look, Dr. Abrahm’s explained further. “Pulmonary hypoplasia is just a long name to describe undergrown or small lungs.” At this Harm nodded solemnly. Dr. Abrahms smiled and continued, “The problem with your pregnancy Sarah, is that the low fluid volume occurred during a critical stage of lung development. I’m afraid if we deliver Sophie now, that she very well may not have enough lung development to survive.”

At the last statement, Mac buried her face into Harm’s neck and began to cry in earnest. Harm pulled her closer as his own eyes glazed over with unshed tears. “Are you saying that Sophie has no chance of…sur… surviving?” his voice broke as he asked the question.

“No, I’m not saying that her chances are zero,” the doctor shook his head. “But they aren’t necessarily good either. I think if we can just prolong the pregnancy a little longer; things might improve to a certain extent.”
The Admiral smiled as he saw Harm’s posture straighten upon hearing the last statement. ‘That’s it Harm, where is that fighting spirit that I know both of you have. Don’t give up on your little girl just yet,’ A.J. silently encouraged as he stared into Harm’s eyes.

Summoning his courage again, Harm got down to the business he understood best, finding solutions for the impossible--And who better to fight for than his ‘little princess.’ “What do we have to do?”

The doctor understood the nonverbal response also being expressed and proceeded to lay out the clinical course ahead. “I suggest that we keep Sarah on medications to try and stop the preterm labor. She is currently on a magnesium IV drip. We will continue the drip for several days until the contractions stop or she delivers. She is also receiving IV antibiotics to prevent or stop any infection that might develop from the ruptured membranes,” he stopped at Harm and Mac’s questioning looks. “I’m sorry, your broken bag of water,” the couple nodded at this explanation. “Sarah, you have also been given the first of 2 injections of steroids. The second will be given in 24 hours; we would like to get at least an additional 24 hours time beyond the second shot before delivery. The steroids are to help Sophie’s lungs to mature; they will not however fix lungs that are too small.” Harm nodded in understanding that this was still Sophie’s biggest obstacle to survival. “You will also stay on complete bedrest until you deliver. Best-case scenario, I would like to get you past 36 weeks before delivering. If we can get to 32 weeks, while at the same time get the leaking membranes to seal, reestablish good amniotic fluid levels, keep you out of preterm labor and get Sophie to grow—we just might have a chance here. However, that is a lot of ifs, so we need to take it one day at a time and not get so bogged down in the minutia that we give up hope…I trust everyone is of the same mind?” queried the doctor.

Mac stared ahead overwhelmed but slowly nodded agreement. Harm smiled and replied, “Yes Sir, let’s get to work…I’m not giving up on my little girl.”

The doctor nodded in acceptance and rose from the chair to leave the room. The admiral gave Mac a hug and Harm a firm handshake before following suit. A.J. paused outside the door and quietly mused, “Why can’t these two catch a break. They took so long to get to this point, shouldn’t they get a chance at a little happiness?” he shook his head as he walked towards the elevator.

Harm cuddled with Mac for a couple more hours until she had fallen asleep. Neither of them were sleeping well while apart, so if Mac needed his shoulder for a pillow he was happy to oblige. He slipped out from under her giving her a final light kiss on the lips before heading for the door. It was already 21:30 on what had been a very long day. He walked silently down the hall to head home.

As he left the room, Mac opened her eyes. She hadn’t really been sleeping, but knew that Harm needed to get home before he was too tired to drive. She leaned over to open the bedside table and removed a white gift box. Harriet had brought the gift the day before. It was the softest pink velour baby sleeper she had ever seen. It had small rosebuds embroidered into the fabric with delicate lace around the collar and sleeves. Harriet had noted that most parents bring their baby girls home in ‘stiff, over-sized lacy’ dresses, but she thought baby Sophie should come home in something soft.’ Mac knew it was Harriet’s way of giving her a ‘goal’ to shoot for to keep her hopes up. Mac tenderly caressed the soft sleeper to her face and cried for the daughter who might never wear it.

Across town, Harm pulled his SUV into the garage of their two-story home. He slowly climbed the stairs to their bedroom, pausing at the door to the nursery on the way. He entered the room bypassing the switch for the overhead light in favor of the small delicate china lamp on the dresser. He had wanted to start on the nursery as soon as they found out they were expecting. Mac had talked him into waiting since they didn’t know the baby’s gender. He knew she was afraid to tempt fate so early in the pregnancy. She had finally acquiesced to start renovating once the ultrasound confirmed they were having a little girl. Harm immediately began the carpentry work installing a window seat to overlook the backyard. There was a large cherry tree just outside the window and beds of flowers encircled the walks. He could just picture Sophie sitting in the window seat watching the flowers and planning her future. He’d carefully installed crown moldings, wainscot and chair rails to complete the room. Mac had chosen a soft pink paint for the lower wainscot and a rich cream for the upper walls and trim. The ceiling had been painted a soft blue with white fluffy clouds to mimic the sky. Mac had been in the process of painting a mural on 2 of the walls with wispy trees and flowers and fairy sprites tucked in between to watch over Sophie as she slept. The crib was still in the center of the unfinished room. They had found the crib at a specialty baby boutique and Harm knew his ‘princess’ had to have it. It was a wrought iron cream color with delicate rosebuds and finials, and there was a large canopy top. He had also picked out the bedding, which was a combination of pink, light green and cream florals and stripes. Mac had laughed at his extravagant choice, but he had insisted it was what Sophie needed. He had completed the bed with a soft cream chenille stuffed bunny with a large pink bow. They had had to stop working on the room when Mac went on bedrest. As he looked at the unfinished nursery, he had to wonder if Mac had been right. Maybe they had tempted fate. He picked up the soft bunny and rubbed it against his cheek. The tears began to fall as he collapsed to the floor. Harm wondered in agony if he would ever be able to bring his baby girl home to her enjoy the room they had lovingly created.

***End of Flashback***