Joelle didn’t feel well. She had picked up a stack of twelve referrals from the social work office earlier that morning, and so far had managed to see only one of the patients on her list. That case had required her to make over a dozen phone calls, and as she leafed through the remaining referrals, she hoped the rest of them would not be so labor intensive. She really wanted to go back to her office, put her head on her desk and fall asleep.
For the past couple of days, she’d been having pain low in her belly. It was subtle at first, and she’d mentioned it to Rebecca the day before when they passed each other in the hall. Rebecca said it was most likely more of the same ligament pain that had been bothering her for the past month. “Don’t be concerned about it unless it gets worse,” she’d said. Well, it was getting worse, although Joelle wondered if it was the chaos in the Women’s Wing that made everything about this day seem unbearable. She was certain, though, that the pain had been sharper when she woke up this morning, tugging at her groin along her right side. Plus, she’d been unable to eat breakfast. She’d made her usual oatmeal and strawberries, but when she sat down at the counter in her condominium and looked into the bowl, she’d felt nearly overwhelmed by queasiness. She was supposed to have lunch with Carlynn that afternoon and would have to cancel with her once again if she didn’t start feeling better soon.
Leaning against the wall of the corridor, trying to stay out of the way of a guy with a newscam, she studied the next referral on the top of the pile. It was for a twenty-four-year-old woman who did not want to see her baby, and her room was, unfortunately, in the hot end of the maternity unit. Joelle started down the hall, trying not to limp or wince as she walked, but unable to find a gait that didn’t increase the pain in her side. Rebecca had probably been right. Every step would pull on the ligament, wouldn’t it? Still, she made a bargain with herself: if, after seeing this patient, the pain had not lessened, she would find Rebecca and have a discreet chat with her about it.
Stopping outside the patient’s room, she had to read the referral once again, despite its simplicity. Her brain felt foggy, and she’d already forgotten why she had to see the woman in room 23.
The woman was alone in the room, in the bed nearest the window. Her eyes were closed, her head turned toward the window, and Joelle stopped first at the foot of her bed.
“Hello, Ann,” she said. “Are you awake?”
The woman slowly opened her eyes and turned her head toward her. She was a striking young Asian woman, most likely Chinese-American, with long, straight black hair. The expression on her face was flat and lifeless, however, and the whites of her eyes were so pink they nearly glowed. Joelle recognized the look. She’d been in this business long enough to know that it meant one of two things. She glanced at the referral again, and saw that Ann’s baby was a girl. That fact alone was probably responsible for driving Ann into the depths of depression.
Joelle stepped around to the side of the woman’s bed and sat in the chair between the bed and the window, wincing as she did so from the cramping in her belly. Would ligament pain cause cramping? For the first time she wondered if something might be wrong with her baby.
“Hi,” she said again, trying to concentrate on the woman in front of her. “I’m Joelle D’Angelo. I’m a social worker here in the maternity unit, and your nurse asked me to visit you because she’s concerned about how sad you are.”
The woman turned her head away from her so that her perfect profile was sharp against the pillow. “You can’t help me,” she said in a voice that only hinted at a Chinese accent.
“I’d like to understand what has you so down, though,” Joelle said. “Sometimes new mothers feel terrible because of the hormonal changes that occur after pregnancy, and—”
“That’s not it.” Ann spoke into her pillow.
Joelle felt the nausea returning, rising up from somewhere low in her gut, washing over her slowly, the way it had when she’d looked at the bowl of oatmeal. It was so hot in the room. She wasn’t sure she could make it through this interview.
She licked her lips and tried again. “Your nurse told me you gave birth to a healthy baby girl during the night,” Joelle prompted, and she knew immediately she’d hit the real reason for Ann’s depression. The woman turned her face toward her, tears spilling down her cheeks.
“My mother-in-law will never forgive me,” she said. “It’s the second girl. My husband is so angry. He won’t even come in to visit me.”
Joelle barely heard her last words. She was going to be sick. Standing up quickly, she managed to say, “Excuse me, I’m sorry,” to the woman before fleeing from the room.
All she wanted was to make it to the restroom in the nurses’ lounge, halfway down the hall, but the colors and smells and motion in the corridor made her dizzy, and she knew she would never reach the lounge in time. Ducking into one of the patient rooms, she was relieved to see that the bathroom serving the two beds was free, and she managed to close the door behind her before vomiting into the toilet.
Flushing the toilet, she stood up and leaned back against the wall. What a lousy time to run out on that mother! What a horrible thing to do to the poor woman. But her thoughts quickly returned to her own pain, which was still there, burning and cramping, and the bathroom felt like a sauna. Could it be her appendix? she wondered, but the pain now seemed too high on her side for that.
Wetting paper towels with cool water, she pressed them to her forehead. Did she have a fever, or was it the lack of air-conditioning that was making her so hot? Either way, something was definitely wrong with her. A summer flu, maybe. Whatever it was, she didn’t dare try to go back to Ann’s room. She’d have to fill one of the nurses in on the situation and see if someone else could take over for her. Right now all she wanted to do was find Rebecca.
She rinsed her mouth out with cool water and looked at her watch. It was nearly eleven. Rebecca should be finished with her rounds by now and in her office.
Leaving the patient room, she headed down the long corridor toward Rebecca’s office, the pain in her belly jarring her with every step. Someone behind her called her name, but she didn’t bother to turn around. They would have to get along without her for a while.
She was nearly crying by the time she reached Rebecca’s office, and she felt the two patients in the waiting room staring at her as she limped toward the reception counter.
“LuAnn, I need to see Rebecca,” she said to the receptionist, who was writing something on a form.
LuAnn glanced up at her, then back at her notes. “She’s with a patient, Joelle,” she said, but then her head jerked up again as if the sight of Joelle’s sweaty face had just registered in her brain. “You look terrible!” she said, setting down her pen. “What’s the matter?”
“I’m not sure. I’m sick. Let me go into one of the examination rooms, please. Then tell Rebecca I’m here.”
LuAnn’s eyes flew open. “Are you pregnant?” she whispered.
“Shh.” Joelle pressed a finger to her lips, but she knew the gesture was futile. So much for her plan to escape Monterey before anyone knew. She had the feeling that, whatever was going on with her body, today was the day everyone would learn that unmarried, unattached Joelle D’Angelo was more than four months pregnant. And if everyone knew about it, Liam would, as well.
“Go in the first room,” LuAnn said. “I’ll let Reb know you’re here and that you look like hell.”
In the small examination room, Joelle could not decide whether to sit, stand or lie down. No position offered relief from the pain, and every movement felt as though it was tearing something loose inside her. She thought she should try to undress so that Rebecca could examine her. Her red-checked dress could stay on, but she should at least get her panty hose off.
She was leaning against the examining table, the room spinning around her, one leg of her panty hose off and the other on, when Rebecca stepped into the room.
“What’s going on?” Rebecca asked, taking Jo
elle’s arm as if to steady her.
“The cramping is worse,” Joelle said. “And I’ve been throwing up. I’m dizzy. I’m hot. I think something’s really wrong, Rebecca.”
“Can you get up here?” She patted the table with her free hand.
Joelle nodded and managed to climb onto the step, then turn around and sit down gingerly on the edge.
“Are you all right?” Rebecca asked, her hand still on Joelle’s arm and a look of concern in her eyes. “Do you need a basin?”
“I don’t think so,” Joelle said. “It hurts, though, Rebecca. I don’t think it’s ligament pain anymore.”
“No, I don’t either.” Rebecca helped Joelle lie down. She pulled off the remaining leg of her panty hose, setting them on the chair in the corner, before picking up the receiver of the phone on the wall.
“I need to get a CBC on a patient, stat,” she said into the phone. Then she was back at Joelle’s side, pressing her fingers on her belly, and Joelle tightened her abdominal muscles to keep her from pushing too hard.
“Extend this leg out,” Rebecca said. “That’s it, all the way.”
“It hurts,” Joelle said. “Oh my God, Rebecca!” She tried to sit up. “I just realized I haven’t felt the baby move yet this morning!”
“I think the baby’s okay,” Rebecca said. “She or he is probably just giving you a break, since you have so much else to deal with right now.” Rebecca took her temperature, but Joelle didn’t need a thermometer to know she had a fever.
“I’m going to do a sonogram,” Rebecca said as Gale Firestone, a nurse Joelle knew well, walked into the room. Joelle saw the sharp look of astonishment on Gale’s face at the sight of her rounded belly, but the nurse got her surprise quickly under control.
“Sorry you’re not feeling well, Joelle,” she said as she set up the phlebotomy tray on the counter.
“I think you’ve got a case of appendicitis,” Rebecca said. She turned on the ultrasound monitor. “But I’d like to rule out a cyst and a few other things just to be sure.”
Joelle closed her eyes as Gale drew blood from her arm, but opened them again to watch the screen while Rebecca moved the transducer over her belly.
“I don’t see a cyst,” Rebecca said. “But I do see a healthy baby. Not too sure of the sex yet, though.”
“It’s okay?” Joelle asked. “It’s moving and—”
“There’s the heart,” Rebecca said, leaning back so Joelle could see the screen, and she spotted once again that reassuring flutter of life inside her.
“Thank God,” she said, lying back again.
“I’ll call you with this,” Gale said to Rebecca as she carried the tube of Joelle’s blood out of the room.
“Make it fast,” Rebecca said, and Joelle could feel her urgency.
Rebecca gently wiped the gel from Joelle’s stomach, then lowered her dress back over her thighs.
“Do you want to sit up or stay like that?” she asked.
“I don’t want to move any more than I have to,” Joelle said. She looked at Rebecca. “Now what?” she asked.
Rebecca’s gaze settled on the small, shaded window of the room, and Joelle recognized that look on the obstetrician’s face: she was thinking through her options.
“I’d really like to get an MRI,” Rebecca said, “but I’m concerned about wasting time. I’m ninety-five percent sure it’s your appendix, and we don’t want it to rupture. That’s not something we need, with you pregnant.”
“Is that serious?”
“It could be quite serious,” Rebecca said. “Let’s see what your white blood count tells us and go from there.” She moved toward the door. “Do you need a blanket?” she asked, her hand on the doorknob. “It’s cold in this part of the building.”
“No,” Joelle said. “Just hurry back, please.”
She must have dozed off, because the next thing she knew, Rebecca was telling her to sit up.
“What’s happening?” Joelle tried to sit up with Rebecca’s help and let out a yelp as the pain cut into her side again. “Did the blood work come back?”
“Yes, and it confirms my suspicions. I’m sending you upstairs for an emergency laparotomy. Dr. Glazer will perform it. You know him, don’t you?”
Joelle nodded as she carefully lowered herself from the table onto the step. “What about the baby?” she asked. “What about the anesthesia? How will that—”
“It will be fine,” Rebecca said. “And I’ll be there, keeping an eye on the baby the whole time.”
Joelle suddenly realized that Gale was in the room, moving a wheelchair close to the step she was on. With Rebecca’s help, Joelle lowered herself into the chair, nearly doubled over with pain.
“I’ll take her up,” Rebecca said to Gale, and the nurse held the door open while Joelle was pushed out into the hallway of the office. When they neared the door to the corridor of the Women’s Wing, which they would have to pass through to reach the elevators, Rebecca leaned over and whispered in her ear.
“This means the end of your secret, you know that, don’t you?”
Joelle nodded. “Not important,” she said, and it wasn’t. Not anymore. She just wanted to get through this crisis with both herself and her baby intact.
Rebecca wheeled her through the Women’s Wing, which passed by her in a blur. She could hear the word pregnant following her down the hall, being spoken in surprise and disbelief, and she knew she would be the subject of that day’s gossip in the hospital.
It wasn’t until she was on the operating table, the IV in her vein, a sedative fog washing over her, that she suddenly remembered walking out of the room of her patient. She tried to sit up. “I need to—”
“Lie down, Joelle,” someone said.
“But the patient I was seeing. Someone needs to see her. I ran—”
“We’ll take care of it,” someone else said.
They wouldn’t know what the problem was. She had to tell them. But she felt herself sinking, floating away.
“Girl baby,” she said slowly. “She had a little girl.”
22
LIAM ENTERED THE SOCIAL WORK OFFICE TO FIND MAGGIE SITTING on the edge of her desk, her legs dangling over the side. She was engaged in excited conversation with Paul, who was standing at the watercooler.
“Did you hear?” Paul asked him as soon as he’d set foot in the room.
“Hear what?” He reached toward his overflowing mailbox on the wall.
“Joelle’s in surgery,” Maggie said.
Liam’s hand froze in the air, and his heart made an unexpected leap into his throat. “Why?” he asked, lowering his arm to his side.
“Appendix, they think,” Paul said. “But she’s also—get this— pregnant. Do you believe it?”
“Pregnant?” he asked, feeling stupid. “She’s not even involved with anyone.”
“I know,” said Maggie, “and it’s pretty amazing after all her hassles with fertility. But maybe she had one of her eggs fertilized in a test tube by a sperm donor or something, and then had it implanted. You know how much she wanted a baby, and she knows all the right doctors to do something like that.”
He shook his head. “She wanted a baby when she was married,” he said. “But not now.” Could Maggie be right? Might Joelle have taken extraordinary measures to have a child? It didn’t sound like the Joelle he knew, but then he hadn’t been close to her the past few months. Still, he hoped against hope that was the answer, because the only other possibility was one he didn’t want to think about. “How far along is she?” he asked.
“Not sure,” Paul said.
“I heard someone in the maternity unit say she was four months,” Maggie said. “I thought she was putting on weight.”
Four months? Liam’s mind raced. Sam was sixteen months old. So, his birthday would have been—
“Excuse me?” The three of them turned to see a small, thin woman leaning on her cane in the doorway. She looked vaguely familiar, and Liam guessed she was
the wife of one of the patients he’d worked with in the cardiac unit.
“Can I help you?” Maggie scooted off the desk, smoothing her skirt and attempting to look professional.
“I’m looking for Joelle D’Angelo,” the woman said. “We have a lunch date.”
Carlynn Shire. He recognized her now as the woman he’d discovered in Mara’s room with Joelle a couple of weeks earlier.
“Dr. Shire.” He held out his hand to her. “We met at my wife’s nursing home. I’m Liam Sommers.”
“Yes, Mr. Sommers.” She smiled and held his hand for a moment before letting go. “And you were not at all pleased to see me there.”
Liam looked at Paul and Maggie, who were staring at him with frank curiosity. Paul probably recognized the Shire name from the Mind and Body Center, but Maggie wouldn’t have a clue.
“Listen,” he said to the healer, taking her elbow. “Why don’t you and I go into the conference room for a minute? I’ll tell you what’s going on with Joelle.” He led her through the short, narrow hallway leading into the conference room and closed the door behind them.
The woman sat down at the long table and looked up at him with concern. “Is Joelle all right?” she asked.
“She’s in surgery for appendicitis,” he said, taking a seat across the table from her.
“Oh, my goodness.” Her hand flew to her mouth. “Has it ruptured? That could be terribly dangerous in her—” She stopped herself from saying more.
“In her condition,” Liam finished the sentence for her. “You know that she’s pregnant?”
“Yes, I know,” she said, and she was eyeing him so intently that he was afraid to ask her his next question.
“Do you know if it…if the baby…”