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“I’m right behind you,” Jean said as I popped on a pair of loafers, grabbed my bag, and slung it over my shoulder, then ran out into the hallway, Dusty leading the way.

The dark red blood on the floor prompted action without thought: bleeding in a pregnant patient was considered a true emergency, especially past the first trimester. While Jean ran down to the truck to grab an O
₂
tank and her medic bag, I had Samantha get a sheet and lay it out on the floor in the hallway while I guided Nina down into a left-lateral recumbent position. I then asked Samantha to call 911, and she held the phone for me so I could speak to dispatch while asking the questions involved in the initial assessment.

We had a female whose history revealed this as a second pregnancy in its twenty-eighth week with a previous miscarriage in the sixteenth, a blood pressure that just skirted excessively low, and who had started to bleed—deep, dark red blood that was thankfully progressing slowly. She said she had reached “the wrong way” and had felt one, terribly painful, “tearing” sensation. The abdomen was very tender, the uterus felt tightly contracted.

I could hear the screen door slam shut when Jean returned.

“I left the door open so the responding team can walk in,” she said as her head topped the stairs. The tank was set to high-flow O
₂
with a non-rebreather mask, SOP for pregnant women, and Jean dropped a line for Ringer’s lactate to prevent Nina’s blood pressure from dropping too severely and to open a passage for other meds to be administered, if necessary. Samantha held it over her shoulder.

“What the…?” Jean asked under her breath as she tried to monitor fetal tones. “Tori, give a listen.”

I listened but heard a strange, rapid off-beat. I listened for another few seconds, then it hit me: it wasn’t one strange rhythm, but
two
non-synced ones.

Two. “Are you guys expecting twins?” I asked, looking from Nina’s face to Samantha’s.

Samantha swallowed, then nodded.

That explained quite a bit about things I’d seen in the past few months.

“You got this for a moment?” I asked Jean.

“Yeah.”

“Great. Give me four seconds,” I said as Dusty began to bark, letting us know the response team had arrived. I ran to the room and grabbed our wallets—so we’d have our shields on us.

“Down, Dusty, friends!” Jean called, and Dusty stopped barking immediately. I could hear the scatter of her paws as she flew back up the steps, leading the response team behind her. She settled herself by Nina’s head as I tossed Jean her shield, then reevaluated the vitals.

“Hey, Tori, Jean,” Roy greeted us.

Jean presented as they loaded Nina onto the stretcher and Roy put the Ringer’s bag over his shoulder.

“You’re coming, right?” he asked her.

She had to go; there was a live IV running, and as competent as Roy was, his unit was BLS, not ALS. Also, even though Jean and I were both off duty, at that moment, legally, we represented the city, while Roy, while off duty for the city, was on duty for a contracted hospital, which meant, in essence, this was
our
scene, and even more so Jean’s, since she was the highest medical authority as well as senior to at least me and Roy.

“Who’s coming with us?” he asked as they got to the top of the stairs.

“I am,” Jean said, and she whirled back and grabbed Samantha, “and she is.”

“Which hospital?” I asked as everyone walked carefully down.

“St. Vin’s has a NICU,” Jean said, “and it’s closest. Roy, have dispatch contact the hospital and tell them what we’ve got.”

“I’ll meet you there. Nina, I’ll see you in two minutes,” I assured her as they loaded her in. She waved at me before they closed the doors and Samantha was escorted to the front passenger seat.

I don’t know how I got there before them, but I did, and when the guard who sat by the vestibule tried to chase me off, I popped my shield out of my back pocket and into his face. He backed off immediately; I’d seen him a thousand times before while working the privates, and he’d always been an officious prick.

In the end they tried to bar Samantha from entering, but one of the receiving nurses was Kathy, my instructor. I caught her on the side. “Kathy, don’t make her leave. They’re her kids too, and my cousin shouldn’t go through whatever’s going to happen by herself.”

Kathy nodded in understanding and gripped my shoulder, pulling me closer so no one could overhear.

“Scotty, this is a
Catholic
hospital. Half the staff will be cool, the others will be”—she tightened her lips—“official. Tell her to tell
anyone
that asks that she’s her sister, get me? She can’t be refused entrance then—I’ll get the word to anyone else.”

“Okay. Thanks, Kathy.” I patted her arm and she smiled at me.

“No problem, Scotty. I have a cousin too.”

I stopped by Nina’s bed where an orderly was preparing to wheel her away. She was still on high-flow O
₂
and was now attached to a few portable monitors.

I curled my fingers around hers, reached over to brush an unruly strand of hair behind her ear, then kissed her cheek. “Nina, tell them Samantha’s your sister,” I whispered to her in Spanish, “so they’ll let her go with you, okay?”

Nina squeezed my hand lightly. “
Gracias, hermanita.
”
Thanks, little sister.

Kathy brought Samantha back to Nina’s bed. “You know the deal?” I asked her quietly.

“Yeah, I do. Thanks, Tori.” She hugged me briefly but fiercely. “And tell Jean the same.” She handed me her cell phone. “Do me a favor?” she asked as they began to move en masse.

“Sure. Anything. Name it.”

“Call Nina’s doctor. Tell him what’s going on, then call Mom, call Uncle Cort, and call Fran? Their numbers are all in there.” Sam’s eyes darted back to the stretcher.

“Go, Sam, I’ve got it covered,” I told her, “and we’ll see you upstairs.”

They disappeared around the corner into the corridor, and I stepped back out through the vestibule to the bay to make those calls.

Jean came out and split a cigarette with me while I left a message with the doctor’s answering service, a message for Samantha’s uncle, another one for Fran, and then…I was rather certain that other than my mother and possibly Elena, no one else in Nina’s family knew yet. I called my mother, because I didn’t know how to step into that breach.

“Victoria,
qué pasó
?”
What happened
, my mother asked. “Are you and Jean okay?”

“Mami, we’re fine, it’s Nina,” I began and reached for the comfort of Jean. “She’s in the hospital…”

I explained to my mother what I knew before I handed the phone to Jean to fill in the blanks. “She’ll be here in twenty minutes,” Jean told me as she returned my phone.

I took it from her and tightened my arm around her waist, and she draped hers across my shoulder.

“What do you think?”

“Abruptio, hopefully a partial,” she added as we walked around to the regular entrance.

“I was thinking the same thing,” I sighed.

It was a harsh diagnosis; any of them could die, since it basically meant a sudden separation of the placenta from the uterine wall. If it was a complete abruption, it was possible for the little ones to die, possible for Nina to die if she’d bled too much internally. If it was a partial…there were options: if it wasn’t too severe, the recommendation would be complete bed rest, either at home or monitored in the hospital.

If it was severe, or worse yet, a complete abruption, the docs would probably opt for an emergency caesarean section and hope they could save everyone. This had risks too. At twenty-eight weeks, and twins no less, well, the neonates would be small, not much more than a pound each, more than likely, maybe two at most. They’d be about the size of apples all curled up, and their lungs were probably not developed enough, and different systems were probably incomplete.

“Jean,” I said as we walked, “do you think this happened because she was so stressed out over…the last few days?”

Her arm tightened around me. “No, baby. I don’t. Sometimes things just happen.”

“I hope they’ll all be okay,” I said, then stopped walking as it hit me. “Twins, Jean, twins. I
knew
something was up. Christ…”

Jean rubbed my shoulder. “We did everything that could be done, I think,” she said, then reviewed everything aloud. “And we got her here fast,
really
fast. We had a rig in less than two minutes. Up to the surgeons and whatever else from here.”

I pulled her closer in silent agreement and we went up to Obstetrics, and once there, we were told to go to Labor and Delivery; they were bringing my cousin in for the emergency C-section.

“Victoria, where is she?”

Aunt Carolina’s voice broke the silence that reigned in the waiting room where Jean and I waited to hear anything about what was going on.

I sat up straight, not letting go of Jean’s hand as I watched my aunt walk in, hand in hand with my mother, while my cousins and Nina’s father trailed behind with Elena.

My aunt, plainly put, looked like hell, and my mom patted her hand repeatedly as Jean and I explained what we knew.

During the wait that felt like several hours, although it really couldn’t have been, because these things are supposed to go fast, Fran showed up, and after greeting everyone, she refused to sit and instead waited by the door until Samantha walked out into the waiting room, her face so very pale over the scrub gown hospital staff had put on her, and obviously exhausted.

Everyone stood and Samantha buried her head on Fran’s shoulder and wept. “Nina’s still in surgery…she lost a lot of blood, they said, and…” Samantha took a deep breath, then straightened, but didn’t let go of Fran. “One girl, one boy, both in NICU…they’re so tiny, so fucking tiny…”

It took three days for Nina and the little ones to be stabilized enough to be transferred to another hospital, the one where Nina’s doctor was, where there would be no issues about whether or not Sam could stay with her family. Since it was our last day off before we returned to work, when the private ambulances that would transfer them came, Samantha and Nina had absolutely no issues with Jean’s and my insistence that we each ride with one of the infants to the other hospital in Manhattan.

Fran rode with Nina and Samantha—she barely left Samantha or Nina’s side the entire time, once visitors were allowed.

It was hard riding in that rig with that plastic case and the machinery that helped my niece breathe. As feared and expected, both neonates lacked surfactant, the protein that would enable their lungs to stay open so they could breathe on their own, and had to be fed intravenously.

Her skin was red and translucent; I could see the fine network of blood vessels that ran under it. She had no name. Samantha was reluctant to name either one of them yet, and, much to my surprise, Nina went along with her choice.

“Give her a week,” Nina said to me privately right before we left after the transfer was complete, “she’ll come around.”

*

Jean and I stayed in the apartment that night, for the first time since everything that had happened. “You sure you’re ready to go back to work?” Jean asked as I pulled out our uniforms and she made some coffee.

“Yeah, sure, I’m fine.” In fact, I was looking forward to it because I really enjoyed it.

“Okay.” She handed me a mug. “Are you all right with sleeping here tonight?”

It was a strange question, and I stopped what I was doing so I could read her face. She kept her expression carefully neutral as she sipped and watched me over the rim of her cup.

“What do you mean?”

“It’s just that…you seemed, you know, like you felt comfortable there, and I don’t—you just seemed happier, I guess.” She shrugged casually.

Her controlled casualness didn’t fool me. This was something serious, and I carefully put my mug down and stepped closer.

“Baby, the only thing I’m not happy about is that I’m not going to be with you all day tomorrow,” I said and put my hands on her waist. “That, and I’m a little worried about, you know, things.”

I closed my arms around her, and Jean hesitated only a moment before she buried her face in my neck and murmured into my hair.

“What was that, baby? I didn’t hear you.”

“I just thought that maybe,” her breath caught as she raised her face to mine, “you didn’t feel safe with me, like I can’t—”

“Can’t what, baby?” I asked gently. Her eyes shone brightly, filled with emotion, with the threat of tears, and I couldn’t help but stroke the long strands of hair behind her ear. “Come on,” I said and led her to the sofa, “sit with me. Can’t what?” I ran my thumb along her cheek.

“Like I can’t protect you,” she said finally, her voice hoarse, “because I should have been there.”

“Jean…I’m the one who asked you not to go. I thought it would upset you, that it would be the weirdest sort of wrong to show up with someone’s ex-girlfriend to a wake or a funeral and…you…I’ve really fucked us up, haven’t I?”

Jean hugged me tightly. “You’re not the fuckup here,” she said, the words choked as she spoke them. “I knew better than you who she is, how she is. I should have gone with you.”