The Choices We Make (21 page)

46

Clinging to the idea that a nonpregnant Kate might fare better like it's a life raft, David pushes for a C-section and we suddenly find ourselves crammed into her ICU room, discussing our options.

Our neonatologist, Dr. Emma Swartzman, has the look of a cookie-baking grandmother—gray hair pinned back in a low bun and rose-framed reading glasses hanging around her neck—but she rarely smiles and is all business when it comes to delivering news. “Dr. Voss and I have discussed this at length and, medically speaking, delivering the fetus—”

“Baby,” I say. “Please, can we call him a baby?”

She nods, looking slightly irritated to be interrupted. “Of course. Delivering the baby today, or even in the next few days, is unlikely to change Kate's condition but most certainly will complicate things for the baby.” David shakes his head and walks over to the small window in the room, hands on hips and back to the rest of us. I have no idea what he's thinking, and it terrifies me.

Dr. Swartzman continues, “We're just shy of twenty-seven weeks right now, which gives him about a seventy percent chance of survival if delivered today. As you know, at this early stage we're most concerned about his lungs.”

Ben and I nod—one of our first acts as parents was to sign off on the corticosteroid shots to speed up the baby's lung development, and Kate has already been given one course.

“Now, if we can give him another week or so? Maybe two? We're looking at ninety percent in terms of survival and fewer postbirth complications. We'll likely give another course of steroids even if we make it two weeks, but for now the best thing we can do is to leave him put.”

I look at David's back, trying to comprehend how we've ended up here—where David and I seem more like strangers fighting each other for control versus grieving friends supporting each other. My eyes still on David, who has yet to turn around, I say Ben and I would like to give the baby his best chance for survival—so we want to hold off on the C-section. Dr. Swartzman nods, saying that would be her recommendation as long as Kate remains stable. David says nothing, still facing the window, hands still on his hips. I want to scream at him to engage, to talk to me, to tell me what he's thinking, but instead I thank the doctors, then sit back down in the chair at Kate's bedside.

* * *

Now, two days later, I spend an inordinate amount of time at Kate's bedside silently willing her to hang on, to get better and for our boy to grow. I'm terrified David will push for the C-section again—even though, at least for now, he seems to have accepted Dr. Voss's assurances that the pregnancy is not harming Kate—and so I choose my words carefully when we're together, which is beyond exhausting.

David has gone home for the afternoon to see the girls, and Ben is checking on Clover and meeting briefly with his dad, so much to my relief I'm alone with Kate for a few hours.

Squeezing some of Kate's favorite cream into my hands, I stand at the end of her bed and pull back the thin sheet. Her toenails are covered in polish—a reddish hue called Pinking of You—though the pedicure is starting to grow out, a tiny half-moon peeking out from under the polish at the base of her nails. It reminds me time is moving forward even if it doesn't feel like it most days, and running my fingers over the smooth, still glossy polish it's hard to believe she can't just walk out of here. Rubbing my hands together to distribute the cream, which releases the heady, sweet scent of vanilla into the otherwise antiseptic-smelling room, I start with her left leg.

This has become a twice-a-day ritual. She's retaining a lot of the fluid they're pumping into her, and one of the nurses suggested some massage could help with that, so I've been rubbing her feet, her legs, her arms. Secretly I hope she'll spontaneously wake up and laugh, the way she does when getting a pedicure. She's incredibly ticklish, especially her feet, and has a tendency to kick if the tickling gets too intense.

“That intern was here again this morning. Remember the one I told you about? Young—he must be some kind of boy wonder—Ken doll hair and very white teeth and dimples? Anyway, he said he's on for the next twenty-four hours so he'll be back. You may want to open your eyes the next time he's here. Promise it will be worth it.” Making my way up to her ankles, her calves, I massage gently, working her puttylike skin under my fingers. I try not to focus on the indentations the pressure of my fingertips leave, something known as “pitting edema,” and instead think about asking the nurse if I can shave Kate's legs. She would hate the stubble that now covers her calves.

“Also, Ben is bringing a whack of food from his mom. She made those Jamaican patties you love, the ones with beef and cheese inside. I'm sure we can sneak you one if you're up for it.” I watch her face for any sign she's hearing me—Dr. Voss said many patients in comas report being able to hear what's happening around them—but her expression stays lax underneath the ventilator keeping her breathing, her eyelids closed thanks to the clear tape the nurses use to prevent dryness.

Moving to the other leg, I squeeze out another glop of cream and rub my hands together again. “The baby is doing well,” I say, my fingers kneading Kate's skin. “He's strong, like you.” I lose my breath with the words, the tears close.

At moments like this one, I'm conflicted about how to feel—about how to behave as Kate's best friend
and
as the intended mother of the baby inside her. Through the awkwardness of teenage years, to the fun of college, to the excitement of weddings, to the joy of babies, to the heartache of funerals, I have known Kate—loved Kate—for nearly three decades. She has been such a constant fixture in my life, a tether to my past, that I can't even imagine the chasm left behind if she's no longer part of my future. By contrast, I have known this baby for fewer than six months, and only on a two-dimensional ultrasound and by the sound of his heart on the Doppler at our appointments. And yet, imagining the deep, dark hole he will leave if he doesn't survive leaves me trembling.

It has become impossible for me to separate Kate from the baby, and the baby from Kate. So when I'm alone in the room with Kate, I talk to him, too.

“Hey, baby boy,” I begin, watching the speed at which the tiny heart icon on the monitor flashes. “Keep at it, my love. You're doing some really good growing in there.” I take one hand and place it on Kate's belly, rubbing gently the way I would if it were my own stomach bulging with life. “But make sure you look after Kate, too, okay? She needs to rest so she can get better.”

I'm used to the machines now, barely noticing the noises they make, and find the rhythm of the beeps and whooshes relaxing. When the alarm first goes off, I'm so confused by the sound it doesn't immediately occur to me to panic. Until Kate's room suddenly fills with people and I'm shoved roughly to the side as the medical team begins working on her, their voices tense yet controlled as they crowd around her bed.

Moving out of the way so quickly I underestimate how much room I have, the back of my head smacks into the wall and I see a meteor shower of stars behind my eyes. But the pain barely registers because all I'm thinking is that I'm watching Kate die.

47

“We need to update you on Kate's condition,” Dr. Voss says, the corners of his mouth turning down in a sad way that belies the happy yellow polka dots on his gray tie. Dr. Swartzman sits beside Dr. Voss at the end of the rectangular table, an even more serious look than normal on her face. The family meeting room where we've congregated has too many chairs and no windows and smells faintly like lemon and rubbing alcohol. I don't like that we're meeting in here instead of Kate's room—the change in routine is disconcerting and it feels as if this is the place where people get bad news, but based on what just happened in Kate's room I'm not sure what other kind of news I can expect.

“Kate had a stress-induced heart attack. As we've discussed, it was one of the risks but one we'd hoped to avoid.” Dr. Voss leans forward in his chair and looks at us, and I flinch under his stare, which is compassionate and tells me what he's about to say I'm not going to want to hear. “We did manage to get her stable again, but unfortunately we think it might be difficult to keep her stable. We need to see this as a significant setback.”

David's father, Tucker—who drove David back to the hospital when I called to say Kate was in trouble—is a replica of David aged about thirty more years. He wraps his arms around his son as if trying to protect him from the latest news. David is stone-faced, and I suspect he's in shock again. I'm having a hard time swallowing, and my head pounds painfully from where I hit it against the wall. I glance between Dr. Voss and David, trying to digest the significance of this news.

“What does this mean?” I'm seated, Ben standing behind me, the warmth of his body making it suddenly too warm. I can't breathe. I can't think. I want to leave the room and pretend that none of this is happening. Ben's hands gently massage my shoulders, but I shrug him away. “Dr. Voss. Please. What does this mean?”

“It means Kate had a heart attack, Hannah. And the chance of her coming out of this is not good,” David says, his tone sharp. “You like to toss around statistics, so let's call it a ninety-nine percent chance Kate isn't going to recover. Clear enough for you?” He yanks his body out of his dad's embrace and strides out of the room. Tucker follows him, which leaves Ben and me, the two doctors, and an uncomfortable silence.

The wall clock ticks loudly. Ben is crying softly. Dr. Voss clears his throat.

“Hannah, Ben, we do need to talk about the baby,” Dr. Swartzman says.

I wrap my arms around my belly and rock forward, not sure if I'm going to throw up or pass out. “Are you okay?” Ben asks softly, leaning down to my ear. I feel tears from his face transfer to my temple.

I nod, then whisper, “Excuse me.”

Thankfully there's a washroom next to the family room, or else I would have vomited right in the hallway. It's violent and painful, and leaves me a shaking mess on the bathroom floor. But somehow it also clears my mind. I can't deal with the news about Kate, not now. I have to tuck that away, because in order to get through this I need to believe I'll hear Kate laugh again, and feel her arms around me, and get one of her “I'm having a bored stay-at-home-mom moment—want to play hooky?” texts. If I have to face any other scenario right now there is a 100 percent chance I will never make it off this bathroom floor.

Ten minutes later I'm back in the room, and Ben hands me a bottle of water and rubs my back. David and his dad are still missing, and Dr. Swartzman is now standing. “Sorry about that,” I say, sitting down and taking a long sip of water. “Please tell us about the baby.”

Dr. Voss sits on the edge of the table, and his shirt expands to accommodate his ample belly, making it look as though he's wearing a white fabric-covered inner tube. “As I said, our tests this morning show Kate's heart did endure damage. How much remains to be seen,” he says, as if anticipating my question. “But we can still allow the pregnancy to progress, at least for the time being, and the baby is doing well.”

Ben sits beside me and grabs my hand. It's clammy, but I hold tight. I ignore the first part of what Dr. Voss has told us, focusing on the second part. “And how long can we do that for? How many weeks should we realistically be aiming for at this point?” I sound better than I feel, and glancing over at Ben—with his head bowed and eyes closed—realize I need to be strong enough for both of us. “I mean, can Kate...?” I swallow around the pain in my chest.

“As long as Kate is stable we can support her to thirty weeks gestation.” He looks at Dr. Swartzman, and they exchange a look I don't understand.

There's something they aren't telling us, or are hesitant to say, and now I'm not only sad and devastated and worried—I'm nervous.

“I wanted to wait for David to be here to talk with you about this,” Dr. Voss says, glancing at the door. Then he sighs and crosses his arms over his chest, covering the bright yellow polka dots of his tie. I wish he hadn't done that—the sunny polka dots were the only cheerful thing in the room. “Hannah, Ben, David wants to go ahead with the C-section.”

My mouth opens, but nothing comes out. I look between the doctors and at Ben, willing him to do something other than stare at his lap. “I'm sorry—what did you say?”

“David has requested that the fetus—baby—be delivered in the next day or so,” Dr. Voss says.

“But it's too soon!” Any control I have evaporates. I am frantic, desperate, and I rip my hand out of Ben's before standing quickly. “Why? He told me he would wait. And you told us the baby isn't hurting Kate, right? Even with what happened today? Besides, I know Kate wouldn't want him delivered so early if he doesn't have to be. I know she... Well, I know her. And what about what we want? We make decisions for our son, not David, and this is definitely not what we want.”

Ben rises beside me. “Hannah, David's just thinking about Kate first, which is exactly what he should be doing. He's not doing this to hurt us.”

I want to slap him and tell him to shut up, that this baby needs us now more than ever. And while what he's said is true, I'm infuriated he's not thinking of our child first. But unleashing a torrent of anger on Ben isn't going to help anyone at the moment, least of all me, so instead I ignore what he's said and focus on the doctors. “Please, please don't do this. This baby is our son. And he's the last...” I choke on my words, clear my throat, try again. “This child matters. Not just to us. He matters to Kate, too. I know he does. Please.”

Dr. Voss is sympathetic, but he explains there's little they can do. As per Kate's health care directive, which she updated as part of the surrogacy contract process, David makes all medical decisions about her care. And even though Dr. Voss and his colleagues still don't feel the pregnancy per se is making her condition worse, the heart attack has changed the landscape—it lends more strength to David's position, he explains, because without question, Kate is sicker than she was a day ago.

“But what about the baby's rights? What about our rights as his parents? We have guardianship. We make the decisions for him, not David.” The numbness is creeping in, threatening to shut everything down to protect me from the emotions trying to take over.

“Unfortunately the fetus isn't recognized as a person with rights until it's born, and even with the guardianship document David's decisions for Kate's care take precedence at this stage,” Dr. Swartzman says. “Especially because at twenty-seven weeks gestation, with a full course of steroids, your baby has a decent chance of survival. I'm sorry, Hannah, Ben, but our hands are tied here.”

I nod, anger building back up. I allow it to fill me, because I'm going to need all the fight I can harness. I need to let go of my grief for Kate. I can only focus on one thing: our baby boy, who didn't ask for any of this and deserves the best chance we can give him. It's most definitely selfish of me, and convenient to believe it, but I know Kate would want me to stop this C-section. If I can't help her, she'd want me to help the baby.

“I need to make a phone call,” I say, stepping away from the table. Ben looks at me curiously, but I don't explain. “Thank you for the information.”

Ben follows me out of the room, and I pick up my pace.

“Hannah,” he calls out, but I don't stop or turn around. “Hannah! Where are you going?”

I whip around and put my hand out in front of me. “Don't,” I say, my voice shaky but strong enough to draw the attention of a couple of people walking past us. “Do not say another word.”

Ben exhales and lowers his head, shoving his hands into the pockets of his jeans. I can tell he's frustrated with me, with how I'm behaving, but I don't care.

“She's his
wife
. The mother of his kids. I will not crucify him for this, Hannah, no matter how much I wish he would make a different decision. But I'll talk to him, maybe I can help him see—”

I shove my hand out again, which silences him immediately. “She's
my
best friend. I love her. And I also love David.” I walk backward a couple of steps so the distance between us is even greater. “But it's time to pick sides, Ben. I know how that sounds and I
hate
myself for saying it, more than you know, but you have to choose. It's time to choose.”

“What the hell are you talking about?
Pick sides?
This is David and Kate and Ava and Josie. Are you suggesting we turn our backs on all of this, on all of them? She's
dying
, Hannah. What's wrong with you?”

This time instead of retreating I take quick steps toward Ben, until I'm standing directly in front of him. In soft tones, one hand resting gently on his chest, I say, “Yes, she's dying. And after we save our boy I will collapse into a heap and grieve for Kate, and David, and the girls. But right now? Our baby could die, too. And he's the most important thing, Ben, no matter how callous that sounds. So I should be asking you the same question. What's wrong with
you
? How the fuck can
you
not see that?” I let my hand drop and back away from Ben, continuing out of the ICU, the hiss of the automatic doors shutting off anything Ben has left to say. He doesn't follow me, and once I'm outside the hospital I pull out my phone and sit on an empty park bench.

With shaking fingers I find the number in my contacts. The phone to my ear, I close my eyes and let the sun warm my face. It's late in the afternoon but the sun is still strong, and it revives me ever so slightly.

“Annabel Porter, please... Yes, Hannah Matthews,” I say, waiting for the receptionist to put me through. A moment later a familiar voice comes onto the line.

“Hannah, it's Peter. Is everything okay?”

I try to speak, but everything I've been holding in bursts open and I'm sobbing, unable to get the words out.

“Hannah, take a deep breath. It's going to be okay.” He murmurs his support for a few more moments, then carries on. “Listen, Annabel is in court this morning. Tell me, what's going on?”

I'm a snotty mess, but I'm at least able to speak now that I've calmed down a bit. “Peter, Kate...” I dip my head, the sun warm on the back of my neck. “Kate had a heart attack. Things aren't looking good.”

“Jesus, Hannah.” I can hear him exhale deeply. “I'm so sorry. Jesus. Are you okay?”

“No, but I don't have time to worry about that right now.” I wipe my face with my free hand, then wipe my hand on my pants to get rid of the dampness. “I need your help.”

“Of course, anything you need.”

“David has demanded a C-section. In the next day or so.”

“How many weeks again?” Peter's voice has shifted into professional mode, which relieves me to no end. I need to back away from the emotion of the situation and focus.

“Twenty-seven weeks right now. He's too little, Peter. He needs more...time.”

“And David is unwilling to allow the pregnancy to progress any longer?”

“It appears so,” I say. “At least according to the doctors. I haven't spoken to David yet. Kate is stable, but I don't get the impression they expect her to stay that way. “

“What does the neonatologist say about the baby's risk?”

“She said he has a ‘decent' chance at survival right now. But if we can get to twenty-eight weeks, his chances jump to ninety percent.”

“So we need to keep him in there for at least one more week.” He's opening a drawer, rustling papers around.

“Yes,” I say, my voice so soft now I hope he can still hear me. “God, yes, please.”

“Okay, Hannah. Here's what we're going to do...”