Wanted: Parents for a Baby! (2 page)

Her hormones needed to get a grip on reality.

“Let's see if she'll breathe on her own now,” Dr. Ryan murmured, as he removed the Ambu bag and face mask from Emma.

Cassie leaned forward, watching the baby closely for a few minutes. She was just about to turn away when things changed abruptly, just like they had in the elevator. Emma's
breathing became shallow and her pulse skyrocketed.

“Give her a tenth of a milligram of midazolam,” Dr. Ryan ordered in a grim tone. “I need to intubate.”

“I'll get the meds,” her coworker, Diane, piped up.

Cassie pulled out the intubation equipment while Dr. Ryan continued to breathe for Emma using the Ambu bag. When Diane returned a few minutes later, she held up the syringe for Cassie to verify the dose of the medication before injecting it into Emma's IV.

“Midazolam is in,” Diane announced.

Cassie handed Dr. Ryan the tiny endotracheal tube. She found herself holding her breath, his words from the elevator echoing in her mind.

She has us. We care about her.

Soon Dr. Ryan had deftly placed the breathing tube down Emma's airway, a task that sounded simple but wasn't at all, not when working on a newborn baby. His large and capable fingers were never clumsy.

The entire procedure didn't take more than a few minutes and Cassie quickly secured the tube in place while Dr. Ryan held it steady. Nancy Kramer, the respiratory therapist, was
manning the ventilator. “What settings do you want?” she asked.

He rattled off the parameters he wanted then turned toward Cassie. “I need you to get a set of arterial blood gases and a full drug screen.”

“A drug screen?” Cassie glanced at what she could see of Emma's tiny face, half-covered with the endotracheal tube holder. “You think her mother was a drug addict?”

“Yes, I hate to say it, but I have a strong suspicion. The mother dropped the baby off in the ER, saying she wasn't a fit mother for Emma, and then left. Under the safe-haven law, we can't go after the mother to obtain a medical history, so we have to figure out what's going on ourselves. That high-pitched crying and the way she stopped breathing is a classic sign of narcotic withdrawal. We'll also need to keep an eye out for seizures. Run the lab work and call me with the results.”

Cassie nodded, feeling sick to her stomach. She had to admit Emma's high-pitched cry did sound similar to those of the two other babies she'd cared for early in her career who'd been going through withdrawal. And the timing was right, too. No doubt the baby's mother hadn't been able to stand the baby's
constant crying, which had likely gotten worse over the hours since the baby's birth.

She'd asked Alice to go through the records to see if Emma had been born at their hospital, but soon discovered she was right, there was no record that matched this baby. So where had Emma's mother given birth? At home? Was she a resident of Cedar Bluff?

Even though Cassie had only worked at Cedar Bluff Hospital for the past six months she knew a safe-haven baby was a rare occurrence. Obviously they did get them, but not often.

She was glad Emma's mother had been unselfish enough to give up her baby, rather than neglect her or, worse, hurt the child.

Still, it wasn't easy to see how some mothers would easily give their babies away, when others, like herself, had been unable to carry one to term.

A loss that still left an empty feeling inside her.

* * *

Ryan strode out of the NNICU, a dull roaring echoing in his ears.

He knew the baby's blood tests would turn out positive for opiates. Thankfully he hadn't cared for drug-addicted babies often, but
the few times he had were seared into his memory.

But worst of all, Emma was a painful reminder of the fact that if his son had lived, he would have made that same, high-pitched cry. Would have been born addicted to narcotics and would have suffered the same symptoms of opiate withdrawal.

At least Emma had been given a chance to survive. And, hopefully, thrive.

A chance his son hadn't been given.

He pinched the bridge of his nose with his fingers, trying to freeze out the horrible memories and the deep stabbing guilt. Three years had passed, yet the image of Victoria's pale, cold, lifeless face still haunted him.

He should have known. Somehow he should have known his wife had been addicted to painkillers. How had he missed the signs? Had he really been that blind to what had been going on?

Why hadn't he figured out the truth before it was too late? Before he'd found his wife and unborn son dead in the front seat of her car?

His fault. His son's premature death was his fault.

The elevator doors opened, and he pulled himself together, trying to remember where
he was going. Oh, yeah, back to the ER. He doubted anyone would remember more than what he'd already been told but he felt compelled to ask.

The triage nurse—what was her name, Gloria?—was still sitting where he'd left her. “What do you remember about the mother?” he asked bluntly.

Gloria didn't seem too surprised by his question. “She had stringy blond hair and was young, not a teenager, maybe early to midtwenties? Her skin was super pale, as if she never stepped outside into the sun. And she wore long sleeves. Her arms shaking as if the car seat was too heavy for her.”

Definitely drugs, he thought with a sigh. “Did she look at all familiar?”

“Not to me or anyone else who caught a glimpse of her. But I bet once the word gets out someone will come forward. Everyone knows everyone else's business in this town.”

He nodded, knowing she spoke the truth. “Have the police been notified?”

Gloria thought for a minute. “I don't think so, to be honest. All I could think of was to get the NNICU team down here as quickly as possible. The way the baby was crying scared me.”

He couldn't fault Gloria's logic. “All right, I'll give them a call.” Emma's mother couldn't get into trouble for dropping off her baby at the hospital, but he figured the police should know about the possible drug connection.

And they'd have to get social services involved to find placement for the baby, too.

He walked to his office, seeking privacy to make his calls. First he notified the social worker on duty, who readily agreed to begin working on a temporary guardian and foster placement for Emma once she was stable enough for discharge. When he finished with that he debated between calling the police now or waiting until he had the actual test results.

A glance at his watch confirmed it was too late to get the drug-test results today as it was already five-thirty in the evening and drug tests were specialized enough that they couldn't be run on a stat basis. They'd be available in the morning, but he didn't want to wait that long to call the police. The sooner they knew about the issue, the better.

He dialed the sheriff's department, knowing the number by heart, and requested to be put through to a detective.

“This is Detective Trammel. What seems to be the problem?”

Of course Trammel would be the one on duty. Trammel had been the detective assigned to investigate Victoria's death. Ryan tightened his grip on the phone and tried to keep his voice steady. “This is Dr. Murphy at Cedar Bluff Hospital. I need to report we have a safe-haven baby here,” Ryan informed him. “She was dropped off a little over an hour ago by a young woman with blond hair, roughly in her midtwenties.”

“Dr. Murphy?” Detective Trammel echoed. “Dr. Ryan Murphy?”

“Yes.” He knew that he wasn't a suspect any longer, but that first month after Victoria's death he'd been at the top of Trammel's list. Logically he understood that the police had wanted to rule out foul play, but it hadn't been easy to hold his head up within their small, tight-knit community.

Even three years later, it wasn't easy. But he hadn't wanted to leave, not until he'd uncovered the truth about the source of Victoria's drugs. He'd almost given up hope. Until now.

“How are you doing?” Detective Trammel asked, as if they were old friends. But they weren't. Not by a long shot.

“Fine,” he said in a clipped tone. “You should know that I've already contacted the social worker, who's getting Child Protective Services involved.”

“Okay, thanks. Wow, a safe-haven baby. We haven't had one of those in almost four years.”

Ryan battled a wave of annoyance. This wasn't exactly a social call. “You need to know that I suspect the baby is addicted to drugs,” he said bluntly. “We're running tests now.”

A heavy silence hung between them and he imagined Detective Trammel finally figuring out why Ryan had bothered to make the call personally. “Okay, thanks for letting me know,” the detective said finally. “But it's tricky to go after the mother in these situations. The safe-haven law offers protection, although there is wiggle room in cases of abuse.”

“I'm well aware of the law,” he said in a terse tone. “And I don't want to go after the mother per se. But what if we find that the baby was addicted to prescription narcotics? Don't you think that's something to be concerned about? Shouldn't we look for her supplier?”

“Your drug tests can't give that level of detail,” Trammel protested.

He reined in his temper with an effort. “No, but the state lab in Madison could.”

Another long silence. “Dr. Murphy, I told you before that we investigated the prescription-drug angle after your wife's death. There's no evidence of a prescription drug ring operating here in Cedar Bluff. Trust me, I'd know if there were.”

Ryan felt his shoulders sag in defeat. He didn't believe the detective, yet there was nothing he could say that would change his mind, either. Because he didn't have proof.

Just a gut-level certainty he was right.

“Listen, Dr. Murphy, it's been almost three years and I know it's difficult, but you need to move on with your life.”

For an instant the image of Cassie's heart-shaped face, long chocolate-brown hair and warm brown eyes flashed in his mind. But he impatiently shoved it away.

“Let me know if the mother comes forward for some reason,” he said to Detective Trammel, changing the subject. “Having some sort of medical history would be helpful.”

“I will.”

Ryan hung up the phone and sat back in
his chair with a weary sigh. The detective was wrong—he
had
moved on with his life. He worked, and played softball in the summer and basketball in the winter with several other physicians on staff. So what if he avoided going out with women? He'd tried about a year or so ago, but the entire event had been a disaster. He'd wanted no-strings sex, but apparently that wasn't what Shana had wanted, despite the fact she'd assured him she did.

Even worse, the debacle had spread throughout Cedar Bluff Hospital. Staff whispering behind his back had only reminded him of that terrible time after Victoria's death.

No, getting tangled up with a woman wasn't part of his plan. No matter how tempted he might be, at least when it came to Cassie. And she was doubly off limits, since they worked together.

No, he had to remain focused on the issues at hand. He wished Detective Trammel had found some evidence of a prescription-drug ring in Cedar Bluff.

Because he wouldn't mind sharing a bit of the guilt that still weighed heavily on his shoulders over the deaths of his wife and unborn son.

C
ASSIE HOVERED OVER
Emma's warmer, lightly stroking the tip of her finger down the baby's downy soft cheek, as much as she could around the breathing-tube holder.

Emma F. Safe Haven, the name they'd given her, was doing a great job of hanging in there. No sign of seizures yet, but Cassie was afraid that if she took her eye off the baby for an instant she'd miss the telltale jerky movements.

The good news so far was that Emma's blood gases had come back well within normal range. She'd placed a page in to Dr. Ryan to share the results. Maybe they could work on weaning the baby off the ventilator. They'd have to go slowly, because removing the tube, only to replace it a few hours later, would be traumatic and possibly cause damage to Emma's tiny airway. However, getting the baby
off the vent was also better for Emma's lungs in the long run.

Finding the right balance was always tricky.

Cassie lingered a few minutes longer, wishing she could give Emma more of her attention, but then had to leave to care for the other baby assigned to her care. Thankfully Barton was stable. He'd been born four weeks too early, but was gaining weight and coming along nicely. He still had a couple instances of five seconds or longer of apnea, a common problem in preemies, but so far he'd gone twelve hours without any shallow breathing recorded on the monitor. If that trend continued, in another day or two he'd be ready to move up to the level-two nursery. And soon be discharged home.

She quickly changed Barton's soiled diaper and then disconnected him from the heart monitor for his feeding. She sank into a rocker she'd pulled over near Emma's warmer so she could keep an eye on Emma while giving Barton his bottle. Normally they encouraged the parents to come in for the feedings, but Barton's mother had mentioned she might be later than normal today because she had to wait for her husband to get home from being
out of town. She'd had an emergency C-section and hadn't been cleared to drive yet.

“Aren't you a good boy,” she cooed, as Barton eagerly sucked at his bottle. “You're going to grow up to be big and strong, just like your daddy.”

She sensed someone's gaze on her and looked up to find Dr. Ryan standing a few feet away, staring at her. For a second she thought she saw a distinctive longing reflected in his eyes, but in a flash the moment was gone and the polite yet distant expression had returned to his eyes.

“Emma's blood gases look great, and I've entered new orders to drop her ventilator settings,” he said brusquely. “Should I ask the unit clerk to page the respiratory therapist?”