Stockholm Syndrome Read online

  I took a deep breath and inserted my first two knuckles past the cervix, inside her uterus, but Manouchka moaned.

  “I’m sorry,” I said in French. “I want to stop the bleeding.”

  “It hurts,” she said, rolling her eyes up to the ceiling.

  Either she hadn’t gotten an epidural (which made sense, since she had no IV and could walk to the bed), or it had worn off a long time ago. Either way, she didn’t want my fist to go deep space nine on her. Neither did I, but I had to.

  Sweat smarted my forehead. I’m not a big sweat-er, but my sterile gown was heavy and I was a bit panicked. You don’t want to deliver the kid and lose the mother.

  “If a piece of your placenta is stuck to the uterus, you need me to take it out,” I told Manouchka. “It will bleed, and your uterus won’t shrink down the way it’s supposed to. I also still need to sew your vagina and stop that bleeding.”

  Tears slid down Manouchka round, brown cheeks. She shook her head at me.

  Oh, God. She clearly didn’t want this. I didn’t have consent to insert my entire hand inside her uterus. But I was trying to save her life. Did she understand that?

  “The uterus. Where the baby—David—was living for nine months. It was his home, and the placenta was feeding him. But if the placenta got ripped, and you still have a piece inside, your uterus will stay floppy and bleeding—”

  “No,” she repeated again, clearly.

  What would a bioethicist do?

  I licked my dry lips, tasting the blood. “Tucker, if you get me some Lidocaine, maybe I could try a local injection and it wouldn’t hurt so much.”

  “Just give her internal massage for a second without scraping the uterus. I’ll check her placenta.”

  “If you can,” I said, glancing at Bastard’s back. He was facing the intercom as he argued, like he was squaring off against an invisible opponent. “It’s in the sink.”

  “Shut up!” said Bastard, railing at both me and Olivia, but I couldn’t be bothered while I kept one hand deeper into a woman’s nether regions than I’d ever gone before. I was two seconds away from torturing her by scraping her endometrium with my nails and fingers.

  “I’ve got to go to the bathroom to check the placenta,” Tucker told him, and spun on his heel.

  I admired his shoulders and his confidence, even as the rest of me cringed. Don’t shoot him.

  “I’m coming with you!” Bastard hollered at Tucker’s departing back, and I ripped my eyes away from Tucker—he’s alive, let him go, concentrate on your patient—and focused on the right here, right now, between my two hands. There are certain organs that seem very meaty: bloody, firm, and hard to control. One of them is the liver. Two others are the uterus and the placenta.

  Manouchka said, “Stop this. Let me go.”

  “I can’t, not until you stop bleeding,” I said, but since Tucker was probably splaying the placenta in the sink, checking for any missing chunks, I backed out of her uterus, letting the mouth of the cervix hug my fingers.

  She sighed, and her back arch flattened out on the bed. I’d been hurting her. Whoever says the cervix isn’t well-innervated probably doesn’t own one.

  But I couldn’t stop now. I stabilized her cervix by clutching its rim, pinching the flesh with my thumb and index fingers while my left, my weaker side, massaged her abdominal wall as deeply as possible.

  Maybe that was a mistake, because she tried to snap her legs together, only I was between them, so she couldn’t quite close them, just batter my shoulders while I yelled, “Please! Let me help you!”

  “The placenta is intact!” Tucker yelled from the bathroom.

  “Oh, thank God,” I said out loud, which seemed to be some sort of cue to Manouchka, because she started to pray at high volume.

  It seemed appropriate.

  I said, as calmly as possible, “I don’t need to go inside your uterus. Dr. Tucker thinks your placenta came out with all the pieces still attached. I have to hold on to the cervix, the tissue at the opening of your uterus. If you let me keep massaging you, most women will stop bleeding with this kind of massage.” I was saying “massage” an awful lot, but it conjured up visions of white towels, heated stones, and water fountains instead of bloody organs.

  The medication should kick in anytime too. Go, Oxytocin, go.

  When Tucker returned, with Bastard tracking him closely with his gun, I abandoned my pride and said, still grinding away on Manouchka with both hands, “Tucker, how do I know when to stop?” The only good thing about a retained placental product is that if you find it, you know your job is done. I was pummelling on her two-fisted with no idea when I should quit.

  “When she stops bleeding.”

  But I had my arm inside her. Wouldn’t that cork her up a bit? I didn’t know how to ask that politely, so I kneaded even harder. Her praying kicked into a higher RPM, and I said to her in a high, strained voice, “Please look at David. Isn’t he cute?”

  Finally, I withdrew my inner hand a little, praying no blood no blood no blood no blood.

  More blood trickled out.

  I swore.

  Manouchka glared at me.

  Tucker said, “You getting tired? You want me to do it?”

  “No.” I wasn’t quitting until I was really scuppered. I went back in, pressing in earnest, so hard that she cried out and my heart dropped and Bastard said, “Do you really know what you’re doing, bitch? You better not hurt Casey like that, I’m telling you,” but I kept going, going going, letting my hands talk for me, letting them feel that yes, the muscle of the uterus was starting to contract a little. Maybe it was my desperate massage, maybe the drugs had finally kicked in, but I felt a difference.

  I said, “That’s it, now. Let me.”

  Manouchka relaxed a smidgen.

  This time, when I pulled out my hands, I knew the blood would stop. And it did.

  She still had that tear, though. Maybe partly thanks to my Herculean efforts, the front of the laceration was now V-shaped. Like, at least three centimetres wide. I’d already measured it as long as my index finger, or about 8 centimetres.

  I stared at it, my shoulders sagging. You don’t have to sew up a vaginal tear right away. I could just pack it. But I didn’t want to leave anything unfinished, especially when bullets could fly at any moment. I started glancing around for suture material.

  “You want me to do it?” said Tucker, appearing on my left side.

  I was the one with the gloved hands. I should pick up the needle and keep on going. But you know, when he said that, I suddenly wanted to stop playing the almighty hero and let him take over.

  “What. You don’t know how to do it?” said Bastard, from behind Tucker.

  “I stopped the bleeding,” I told him. “Dr. Tucker is excellent at suturing. We specialize in our different territories. Manouchka deserves the best care.” Also, I couldn’t help thinking that if Bastard considered both of us essential, we were more likely to survive as a duo.

  Bastard stared at me with flat eyes. I found myself holding my breath, staring him down, willing him to believe me and my Rasputin-worthy gaze.

  After a minute, he sighed. “You guys are fucking useless. I could skin a pig before you guys even picked up a knife.”

  Please don’t, I thought, but didn’t say.

  Tucker shouldered his way forward until he was nearly touching me. I thought I could feel the heat from his body, like he was an oven. I swayed toward him while he said, “It’s also a question of good hygiene. Dr. Sze should have the opportunity to wash off the blood and disinfect herself.”

  Disinfect myself? I took a gander down at my own body.

  I looked like a horror show. I’d earned a solid wall of blood up my right forearm, plus more blood had trickled past my elbow. No wonder Tucker had suggested gloves.

  Bastard’s eyes flickered up and down, taking in my scary movie impersonation. Then he took a step back before he bellowed at me, “Get clean, bitch! What the hell is wrong
with you?”

  CHAPTER 26

  Bastard aimed the gun between my eyes, but for the first time, I noticed a tremor in his hand. Either he was tired, he hated birthing blood, or both.

  Was that good news for us? Maybe. Maybe we could now overpower him.

  Or maybe not. I could picture him getting too edgy, riled up, blowing up, and unleashing another torrent of bullets.

  I held my hands up like we were in a shoot ’em up Western. Which we sort of were, I guess, except no horses and an orgy of real blood.

  I jerked my head at the bathroom, hating myself for asking for permission, but at least I didn’t have to beg him with words.

  After a second, Bastard lowered his gun and said, “Go on.”

  Wow. I almost didn’t recognize him without the omnipresent muzzle threatening to split my skull.

  Manouchka’s breathing sped up. She hadn’t liked me between her legs, but she didn’t want me to go, either. I tried to tell her with my eyes that I’d return to her side as soon as I could.

  She closed her eyelids, as well as her legs, and shook her head.

  I couldn’t blame her for not believing me. I couldn’t promise that I’d keep on breathing for the next five minutes, let alone protect her and David, but I’d do my absolute best.

  Me and Tucker both. I hesitated for a second, because my man was within kissing distance. I almost gave in to the overwhelming need to at least snatch his hand and squeeze it one last time.

  Well, I guess that wasn’t the brightest idea, since I looked and smelled like an abattoir, but...you know.

  I backed away from Tucker and edged toward the bathroom, with my back to the delivery cart wall, so I didn’t have to turn my back on Bastard.

  I loved the idea of even a few seconds to myself, away from his jackhammer eyes. I only wished it didn’t mean separating from Tucker and Manouchka and David.

  Tucker hadn’t stirred from Manouchka’s side, but he wasn’t suturing her yet. He was watching me with the occasional quick side-eye at Bastard, like he wanted to throw himself between us, and maybe he would.

  My man would literally take a bullet for me, I realized all over again. He would take a beating, he would take a bullet, whatever he had to do.

  So would Ryan. I would stake my life on it.

  It’s one thing to have one guy who loves you, truly loves you, more than he cares for himself. There are guys who will fuck you, guys who will flirt with you, and any guy is willing to copy trigonometry homework. But to find two soul mates at the same time?

  The best of times, the worst of times.

  I mouthed at him, “I love you.”

  Bastard said, “Move it. Christ, bitch. You stink.”

  I wanted to blow him a fake kiss. I imagined my bloodied glove raised in the air. If I slowly brought it to my mouth, pretending to smooch it, it would probably make him faint. But before Bastard dropped, he might pull the trigger, so that kind of Hollywood show-off wasn’t worth it.

  Instead, I bent my head forward and slowly, deliberately sniffed the gory glove on my right hand.

  I heard Bastard catch his breath, which only made me prolong the show, moving my head up and down, stroking the latex-free barrier coating my fingers. I could feel the ridges of dried blood that had coagulated under my touch. It didn’t weird me out. I’ve done it dozens of times, half-consciously.

  Then I said to Bastard, enunciating each word, “You’re right. I do smell like blood.”

  I turned my back on him and walked to the bathroom with slow, purposeful steps and my head held high. Like I wasn’t a prisoner.

  He might have lifted the gun. He might have pointed at me. My shoulder blades twitched in warning. But facing away, I couldn’t see his weapon, and like Hammy Hamster used to say, If I can’t see you then you can’t see me.

  I made it to the bathroom alive.

  I didn’t close the door. I wasn’t going to push him that far, although I really would have liked to pee in peace.

  I pulled off the besmirched, formerly sterile gown, bundling it tightly to make it fit in the soiled linen cart. If we were trapped here a long time, we’d run out of room for garbage. We’d turn into our own landfill site.

  I started to strip off the gloves. The trick was to turn them inside out at the seam to ensure that the blood didn’t brush my skin. First, my left fingers plucked the opening at my right wrist, the dirtiest glove, turning it inside out so that the cleanest side was exposed and balled in my left palm, before my right fingers peeled my left glove off, neatly turning it into a bag for the first.

  I tossed the glove ball in the garbage. Two points.

  “What’s taking you so long, bitch?” hollered Bastard.

  “I had to dispose of my garments. Now I need to wash up, but the placenta’s in the sink,” I called back.

  “What?”

  “The placenta,” I repeated.

  “What?”

  Bastard stomped his boots toward me, but instead of flinching, I beckoned him closer, all the better to display the placenta still plopped in the porcelain.

  I’d tossed it in shiny side up, with the Saran wrap-like membrane enveloping it present-style, but Tucker had turned it over so that he could inspect it for any loose tissue, exposing the seeping flesh.

  Everyone always says the placenta looks like liver, but I guess it depends if you’ve ever ripped open a liver. The side of the placenta that spends nine months adhered to the inner wall of the uterus always seems more raw and ragged, with pools of blood mixed in with the meat. The post-dates placentas have visible islands of calcium—not Manouchka’s—but hers had something even better for my purposes.

  Like I said, the amniotic membranes usually look like cling wrap. If they don’t break, that’s what makes the ‘caul’ over a baby’s face that they used to associate with ESP. I’ve never seen a baby born like that, although the fleeting thought reminded me of Mme. Bérubé, a patient’s wife who claimed to read palms.

  However, in Manouchka and David’s case, the torn amniotic membranes, stained yellow and green by meconium, sagged to either side of the placenta like too-big elephant pants.

  Bastard gagged. And not just a little gag, but one with a bit of gargle in it.

  Oh, this was good. “We don’t have anywhere to put it, and it’s in the way of me washing up,” I said, as if I didn’t notice anything untoward. “We normally place them in a stainless steel bowl.” After that, I imagine a nurse whisks the bowls away and bundles the placenta up for the pathology lab. Since we were trapped in our own closed system, that wasn’t going to happen.

  “Get rid of it,” he said, in a strangled voice.

  “I’ll grab a steel bowl,” I said. “It’s on the delivery cart.”

  He backed away from the bathroom, looking a little pale around the eyes for a white guy. “Just do what you gotta do, bitch. And do it fast.”

  When I passed by the bed, Tucker was already trimming his sutures. I guess it takes longer to discombobulate a kidnapper than it does to repair a second- or third-degree tear. He gave me a look: Are you okay?

  I gave him a slight nod. I wanted to convey to him, More than okay. We might be able to figure something else out from here. But my plan was still coalescing in my head. All I could do was mouth again, I love you.

  His face relaxed. And then a smile sliced across his mouth, and it was extraordinary, how even the room air seemed to lighten before he mouthed, I love you, Hope.

  I wanted to explain to him that I still loved Ryan. That hadn’t changed. But it was too complicated, so I just beamed back at him before I gave Manouchka a reassuring look.

  She closed her eyes instead of responding.

  Then I ransacked the delivery cart, opening every drawer, searching for the stainless steel bowls. When I’m in a hurry, I have trouble finding stuff and have to open drawers two or three times before the nurse kindly points out the object in front of my nose and asks if I was looking with my “man eyes.”

  “B
ottom drawer,” called Tucker, and of course he was right. I thought, What would I do without this guy? Honestly. Would I just join Stan on the hall floor?

  I liked that Tucker was here, but it worried me that I was becoming too dependent on him, like a dumb-ass helpless maiden. Maybe I should have insisted on doing it all. Simultaneously deliver David, intubate and suction him, stop Manouchka from bleeding to death, sew up her tear, and freak out our jailer.

  Then I stopped myself. No one does it all alone.

  The best thing for women who give birth in a hospital is that you have access to a highly-skilled team. The nurses can triage you, welcome you to the case room, check your cervix, coach you through labour, put in an IV, massage the uterus, push the baby out of the uterus during a C-section, and do countless other tasks. The medical student can do the history and physical exam and deliver the baby in a pinch. The resident can do that, plus ripen the cervix (med students can do this too, but it’s a grey area to me), and once they’re senior, do the crazy stuff like crash C-sections, embolize arterial arteries, reanimate crashing pregnant women, and basically act as extra hands for the staff. That’s not even counting the OB/gyn, the head guy or girl with the biggest tool kit of all.

  Sure, Hollywood would make me do everything solo, because it’s more dramatic, but medicine is not a solo art. Especially in residency.

  Ryan would have helped me, too. He stays calm, grounding me, while he makes suggestions. Even now, my phone must’ve buzzed five or ten texts through, although I didn’t dare check the screen for fear that Bastard would smash it. A phone in pocket was worth two in pieces. Or something.

  In the meantime, I unwrapped the cloth covering the cool, steel bowl and crossed back to the bathroom to pitch the placenta inside. “It’s still a little warm,” I said to no one in particular.

  Bastard said, “No one’s interested, bitch!”

  I am, I thought. I’m very interested, Bastard.

  But I was careful not to look him in the eyes or let my mouth move. I couldn’t give the game away. Because I’d finally worked out my own small plan.