“Bree, what’s happening? NICU team?” Emma’s eyes were wide and scared, and Bree took her hand and squeezed it gently.
“Got to get you fixed up and deliver the baby. You’re going to meet your little guy today. Can you believe it?” Somehow, she managed to keep her tone light. “You still going to go with the name you told me you’d decided on?”
“What? I’m not ready! I—”
“We’re going to help you be ready. It’s going to be okay.”
“I... Bree,” Emma whispered, her words slurring. “I feel...funny. It’s... Is it getting dark? Where...?”
Just like that, Bree saw her eyes close, her head go limp and her skin turn as white as pure, pearly beach sand.
“Emma!” Oh, no. Please, no. “Emma, stay with me!” Her shouts were punctuated by the cardiac monitor alarm, heart rate forty, thirty, fifteen, then asystole. Flat line. The sight of that neon line felt like a sharp knife blade slicing right through Bree’s heart as the screech of the monitor filled her ears. Air didn’t seem to be getting to her lungs. Watching hands pumping on Emma’s chest, hearing Kurz’s voice demanding Epi and oxygen, felt utterly surreal.
“What the...?”
Bree whirled. Sean. Standing there in the doorway, staring at his sister in shock.
“Pulmonary injury. Right hemothorax.” It was hard to choke out the words, and the next were even harder. “Coded twenty seconds ago.”
“About to place a chest tube,” Kurz said as he worked. “We’re going to OR Three. When we can get her there.”
Before one more second ticked by, Sean moved into action. He shouldered the surgery resident aside to get the tube placed as quickly and efficiently as possible. Immediately the blood began to flow, releasing the pressure on her lungs and heart.
Bree watched him secure the tube to the chest wall when the startling beep of the cardiac monitor cut through the fog in her brain. Emma’s heart’s back! She’s back! But each beat was so far apart. Slow. Too slow. She must have some other serious injury. Needed more blood circulating. Needed for her heart to pump harder. Needed it for both her and her baby.
Bree knew what had to be done and drew on reserved strength to get the words out. “We have to take the baby.”
“Not yet,” Sean said, a tortured fierceness on his face she’d seen only once before—the day they’d broken up. “Is OB on the way? We can wait till then.”
“We can’t wait. We have to do it now or we’ll lose both of them.” She hated that her last words came out in a near sob. How emotional. How unprofessional. But Emma was her friend, and for a split second Bree had seen the overwhelming love in her eyes as she’d cupped her belly, so happy to soon be holding her baby in her arms. If they couldn’t save Emma, they could at least save one life. Bring this precious baby, a part of her, into the world.
“A few more minutes. Emma’s got a strong heart. She—”
“Dr. Donovan is right,” Kurz said. “You take over chest compressions while we do a crash and burn C-section to get the baby.”
“I’ll do the prep and assist,” Bree said as she snapped on gloves. For Emma. For Sean. For the baby who might never know his mother.
Kurz nodded and Sean opened his mouth to argue more, but the look on Kurz’s face was clear, and, as he was senior ED doc running the code, the call was his to make. Wordlessly, Sean took over compressions, rhythmically pushing on his sister’s chest. As she saw the mix of determination and anguish on his face, Bree’s heart cracked.
“You ready?” Kurz asked Bree as she quickly swabbed Emma’s belly with antiseptic.
“Ready.” It wasn’t true, she wasn’t ready for them to bring this baby into the world without his mother, but it had to be done. Saving this child was at least one thing she could do to try to make up in some tiny way for driving her car into harm’s way.
Barely aware of a different nurse rolling a warming cart next to her, Bree handed Kurz the scalpel and watched as he made a full, midline incision as fast as he could. They delivered the baby and suddenly the NICU team was right there, swooping in to grab the baby up, leaving Kurz to refocus on Emma. Numb, Bree kept glancing over to watch them give the infant chest compressions and oxygen before rubbing him all over to stimulate him. Surreal that, at the very same time, Sean and the team were insistently working on the baby’s mother in nearly the same way.
It seemed to go on so long with no response at all from the tiny boy, she started to lose hope. She glanced up at Sean, who was still doing strong, unrelenting chest compressions on his sister. Emma’s heart rate had dropped to barely a blip on the screen. But Sean was still determined. Still believing.
Losing both of them would take a terrible toll on the man so close and connected to his family. Hadn’t they already lost the father they’d dearly loved? She tried to swallow down the deep pain choking her when she thought she heard a weak cry that sent her attention flying to the NICU team and the baby. Her heart lifted, soared, when his cries strengthened. His deep purple color lightened and slowly pinked up.
Her gaze moved back to Sean, who was looking at the baby while still performing steady chest compressions. Awe slid across his face, mingling with that fierceness as their eyes met. Her throat closed when, even in the midst of his intense work trying to resuscitate Emma, he gave Bree a quick, nodding salute.
Bittersweet emotion tangled around her heart as the team placed the infant in the warming cart and took off with him, doubtless heading to the NICU to be stabilized and evaluated. Tears stung Bree’s eyes as they met Sean’s, and she prayed again that the baby would be okay. That Emma would still, somehow, survive. That she’d be here to hold her infant son in her arms.
* * *
Seeing Bree’s beautiful green eyes fill with tears made Sean somehow even more determined to save his sister’s life. As though he weren’t already giving it everything he had in him to make that happen.
His mother had already been through too much tragedy. And if Emma died? He knew that blow would practically kill his mom, too. And not only did Emma have a lot of living yet to do and a child to raise, he was not going to have Bree feeling some kind of lifelong guilt because the two of them had obviously been in that car crash together. Most likely she’d been driving, but she was so good behind the wheel, he knew it couldn’t have been her fault.
For all those reasons, his sister was going to live. That was all there was to it.
“Sean.” Kurz reached to touch his shoulder, and he knew what was coming. “I’ll take over.”
“No. Keep up with the epinephrine and blood transfusion for another minute. I’m not being crazy. I’m going to make this happen. She—”
“Sean.” Bree’s tone of voice was completely different than Kurz’s had been. Held a tentative, then rising excitement. “Sean, you did it! Heart rate’s...heart rate is rising to...eighty!”
He glanced at the monitor. What he saw there nearly made him fall over, as though he could feel the world slowly turning on its axis. Emma’s heart was in normal sinus rhythm, etched on the screen in steady, perfect, neon green spikes. For real.
His whole body started to shake. “Notify the other surgeon on call and any GYN available,” he somehow managed to croak out. “Get her to the OR to figure out what all’s going on.”
Everyone moved into action. Sean stood there motionless, because at that moment moving a single muscle felt impossible. He watched them roll his sister from the room, the terrifying details of her bruised and battered body seared into his brain. He looked down at his hands, Emma’s blood still covering them from when he’d inserted the tube, and didn’t want to think about how close he’d