The Promise of Stardust (54 page)

I tried to keep breathing in and out while I scribbled on Jake's legal pad.
Can we still appeal?

Jake focused on the judge as he nodded.

Wheeler continued: “Regarding the advanced health care directive, which named Dr. Adam Cunningham as Elle McClure's health care agent, I must disregard Texas law. Maine does not overturn an advanced directive during pregnancy unless specifically stipulated. Moreover, I question if she revoked the 2003 advanced directive somewhere, sometime, because of her signature and initials on the February second hospital admission form, which stated she did not have any such advanced health care directive.” He leaned back, and we waited for him to continue. “It's also possible that since she was in shock on February second, she initialed that document not knowing its meaning. Elle Beaulieu had long since severed her relationship with Dr. Cunningham and had maintained no significant personal relationship with him afterward. And Linney Beaulieu is now in agreement with her son.”

I drew a breath and held it.

“It is not the job of the court to make moral judgments. We are here to determine what Elle Beaulieu would choose if she were competent to do so. From the notation in the baby book she wrote the morning of the accident, I believe she would want this pregnancy to continue.”

Jake put his hand on my shoulder.

“However,” Wheeler said, “she also made it clear to everyone who has testified that she did not want to continue on if there were no hope of a meaningful recovery. I am instructing her caregivers that her life support continue until such time as this pregnancy ends.”

“Thank you, God,” I whispered.

“Dr. Beaulieu …” the judge said, turning toward me. “I admired your wife. And I am very sorry for your loss. I do hope that the pregnancy brings you a healthy child. I wish your family well. At such time as Elle Beaulieu gives birth or miscarries, a hearing will convene to determine the terms of the cessation of her life support. Court adjourned.”

I hugged Jake. And Hank. And every person who came my way. But Adam sat alone, staring out the window.

   53   

When Elle's mother was sick, I remember thinking that the dying was taking too damned long. Every groan and every gasping breath tortured Elle, and I finally realized that Alice's illness hurt Christopher, too. And Hank. Watching Elle this way was like being scourged, but I kept in mind that every day she lived was another chance for the baby.

The ultrasound at the end of October indicated the baby was a girl. The one at Thanksgiving confirmed it. There is uncertainty in hope, but even with its tenuous nature, it summons our strength and pulls us through fear and grief—and even death. So I named my little girl Hope.

But she wasn't out of danger yet. Elle's blood pressure was becoming increasingly problematic, and Blythe was now ultra-sounding the baby daily to determine if Hope was tolerating Elle's deterioration. I tried to be there each time, but that day I was running late. One of my patients suffered a slight complication with his anesthesia that morning, which messed up my schedule. I crossed the snow-covered parking lot to the nursing home and then raced through the lobby full of the wheelchair-bound, fragile-skinned, white-haired women—and a few men—who had lived long enough to end up in a place like this one.

Our family had taken over the two rooms down at the end of the north wing of the Seashore Nursing Home. Most nights I slept there. Hank spent most days reading aloud to Elle. She couldn't hear her father, but I never discouraged him.

I missed her, and the only way I could cope was to write my own letters,
Dear Peep
. Maybe one day Hope would want to know the story of her parents' lives together. But for now the letters were a way to keep me sane.

Blythe was cleaning the ultrasound wand off as I entered Elle's room. “It's time to take down the Christmas decorations. January is over tomorrow.”

“Elle loved Christmas,” I said, but I meant, this was her last Christmas. “How's the baby?”

Blythe turned away from me as she spoke. “Not too bad, sucking her thumb, actually. Elle, however … Matt, she's slipping. Her blood work is worse. I want to move her back to the hospital today. Her kidneys are shutting down, too, and her blood pressure is up. Even though I lowered the dose of her heparin yesterday, her morning labs showed her blood-clotting time is way off. She could hemorrhage. I could go on, but you get the idea. It's not good.” Her pink ribbon fell out of her hair, and she bent to pick it up. “Did you notice the petechiae?”

“No. Where?”

Blythe pointed to small hemorrhagic pinpoints, another indicator of abnormal bleeding, on Elle's forearms, her belly, and her forehead near her hairline.

“It's still early to deliver the baby,” I said.

“The odds are pretty good at thirty-one weeks. And under the circumstances, the odds are better for the baby outside, but we'll try to give her twenty-four more hours. I want to give Elle one more round of steroids for the baby's lungs first,” Blythe said.

I pulled up a chair to Elle's bedside and took her hand in mine. “When do you want to move her?”

“I already called for transportation. The ambulance should be here within the hour.” She slid a lab report at me.

Elle's levels were far worse than I thought. “But the baby is okay?”

“She's holding her own, but she's not growing as well as I'd like. We can't wait. It could go bad fast. I'll give you a few minutes alone.” Blythe closed the door behind her as she left.

I rested my hand on Elle's. “I love you, Peep. God, this is it?”

Silence can be deafening. She left so long ago.

“I miss you.”

I bent down and kissed her belly. “It's okay, Hope. Daddy's here, and Mommy wrote all kinds of letters, and I'll make sure you know all her stories.”

Sometimes, my mind takes stills, pictures that seem frozen instead of running film. As the double doors to the labor room opened, we passed by the admissions desk, where a man sat holding his wife's white-knuckled hand. A consoling smile on his face, concern in his eyes. I don't know why I only saw his expression and not hers. It was as if she were a ghost.

Usually people anticipate new life on the OB floor. That was my expectation, too. But I was also anticipating grief. I was afraid. Afraid for the baby, afraid for Elle, afraid for the distilling moment when her body would eventually die, and I knew that time was racing toward us. I was afraid for how empty I would feel without any part of Elle left in this world.

The routine things happened next, a transfer from the gurney onto the hospital bed, the placement of the fetal monitor, the starting of an IV in Elle's hand. Elle, who was once afraid of needles, did not flinch.

The less routine things followed. My mother's face appeared in the doorway of Elle's hospital room. We both wept when I explained Elle's body was spiraling down, slowly perhaps, but in the irreversible way that water runs down a drain.

I was pacing the eight feet of floor space. Two steps one way, two back. My mother hugged me, anchoring me, holding me still. But stillness was uncomfortable. Stillness was death. Stillness was Elle.

“Let's take a walk, honey,” Mom said.

I shook my head.

She squeezed my arm the way she used to when I was a kid, the way that made me pay attention to her without raising her voice above a whisper. She wasn't making a request. She was telling me. “You have to take care of yourself. The baby needs you, and worrying about Elle won't help the baby. You can't afford another heart attack now. Nothing's going to happen for hours. Let's get something to eat.”

I followed my mother out of the room, but not before I looked back. I would always look back.

As though she'd heard my thoughts, Mom said, “You have to think about the baby, not about Elle. You have to look forward.”

My mother was right. I didn't want to remember Elle like this. I wanted to see her as I did the morning before the accident, backlit by the blue sky and the sun reflecting off the river. I wanted to remember her strong and healthy. I wanted to have her back that way. Elle was giving our daughter life. And I wanted to give Hope the memories of Elle—the way she was for thirty-five years, not the memory of her dying in a hospital bed.

I followed Mom to the coffee shop, not exactly the best place for a heart-healthy meal. The smell of bacon filled my nostrils, but I ordered a bowl of vegetable soup. I hadn't had an appetite for months and I'd dropped weight. The only reason for eating these days was to appease my mother. We both made calls. I left voice messages for Keisha and Jake. Phil said he'd cover the hospital.

Mom's cell phone rang, and after a minute of monosyllabic grunts she clipped it closed. “Christopher doesn't want to be at the hospital any longer than necessary, but he said to let him know when they take her in to deliver the baby. He will be there in the waiting room.”

I tapped my foot, reminding myself that if Elle were still here, she'd remind me Christopher was doing the best he could, that he was just a kid when Alice was sick, that it scarred him, too.

“Hank was in a meeting, but he'll be here soon,” Mom said.

Although the sound of Hope's amplified heartbeat steadied me as we returned to Elle's room, I didn't notice how slow it was. The chaos must have distracted me. A respiratory therapist was using an ambu bag to move oxygen in and out of Elle's lungs. She'd been breathing by herself since I'd woken after my surgery. And now she wasn't.

I strode into the room. “What's happening?”

One nurse was hanging blood and another was starting another IV. “Her blood pressure dropped. We're taking her to the OR for a stat C-section.”

“How low is her pressure?” I asked.

“Sixty over twenty-seven.” Meaning Elle was in shock. The nurse, whose name I couldn't recall, turned to Mom. “Blythe's scrubbing.”

I pushed past the others in the room and made it to Elle and kissed her forehead, noting that the little petechiae had grown more pronounced in the forty minutes we were gone. “Hang in there, Peep. Just a little while longer.”

Mom was pulling out the fetal monitor strip and examining it.

“How's the baby?” I asked.

She blanched. “Come on, Matt. Out of the way. Let them get Elle to the OR.” She took my arm and pulled me out to the hall.

“The baby? Mom? What's wrong?”

“Bradycardia. The fetal heart rate is only in the sixties.”

That's when I realized it. I wasn't hearing the rapid fetal heart rate. Hope's was slower than my own. And if a baby's heartbeat was that low, she warranted CPR.

“I'm going to change into scrubs,” I said, starting down the corridor.

“They aren't going to let you in the OR, Matt.”

“
Yes
, they will.”

Mom's eyes filled with tears. “Not like this. Elle is going to die in the next few hours, or maybe sooner in the OR.”

“I know. That's why I will be there. For her. For Hope,” I said as I ducked into the men's locker room. I needed to know that even though I couldn't save Elle, I never abandoned her. Less than a minute later I emerged wearing blue scrubs in time to see them pushing Elle's gurney through the double doors to the C-section room. I followed at a breakneck speed, slowing at the outside door to don a surgical mask, cap, and shoe covers. Fully garbed, I stepped to the side as they positioned Elle on the OR table.