The Christmas Baby Bump (5 page)

That didn’t give her much time to think it over, or change her mind. She pulled out her drawer and, having learned from her snack expedition the other night with Robbie, found a pack of peanut butter with cheese crackers, tore it open with her teeth, and tossed the first one into her mouth.

“You’re on,” she said, sounding muffled.

As naturally as old friends, he kissed her cheek. “You’re the best,” he said, and took off, leaving her chomping on her snack, blowing cracker flakes from her mouth when she sighed. And there was that damn feeling he brought along with him every time they talked—flustered.

The new and state-of-the-art procedure suite at Midcoast Medical provided the perfect setting for Robbie’s examination. Jason had had the equipment installed after a successful second-quarter report. Every penny they made beyond salaries went right back into their clinic with upgrades and added services. Phil no longer had to rent space at the local hospital to perform his bronchoscopies, taking him away from the clinic, and making his nurse able to increase her hours to full-time as a result.

But this examination was after hours, and he’d lined up a great replacement for his regular nurse—Stephanie.

She hadn’t bargained on Robbie being awake when
she arrived, and Phil had to do some quick talking to make her stick around.

“I can’t do this on my own, Stephanie. Please. Five minutes. It will only take five minutes. I promise.”

She looked pale and hesitated at the procedure-room door, but something, maybe it was Robbie looking so vulnerable and unsuspecting, made her change her mind.

Robbie fought like the devil when Phil tried to insert an intravenous line, and he thought she’d bolt right then and there. Surprisingly, she held the boy’s arm steady, and with her help they got the IV in and the keep-open solution running. She’d been an unexpected decoy with her medley of wacky kids’ songs. Robbie even giggled a few times. If she didn’t do kids, how did she know all those children’s songs?

Gowned, gloved and masked, Phil watched Stephanie draw up the quick-acting, deeply sedating medication. He knew there was a fine line between true anesthesia and conscious sedation, and though he wanted to make Robbie comfortable, he didn’t want him too sedated, just out of it long enough to get a minitour inside his lungs. After she had set up Robbie with pulse oximetry, heart and blood-pressure monitor, and supplemental oxygen, he directed her to give the standard pediatric dose for fentanyl and benzodiapine instead of a newer, short-acting drug.

“No offense, but I only use Propofol when I have an anesthesiologist working with me.” He smiled at her through his mask.

She tossed him a sassy look. “Believe me, no offense taken, I already feel out of my element here.” With skilled and efficient hands she titrated the drugs into the IV as he applied the topical numbing spray to
Robbie’s throat, and within seconds Robbie drifted into twilight sleep.

“I called ahead to the preschool to hold his lunch, but Robbie loves to eat so much he almost snuck a snack around three today. Fortunately, they caught him, so we shouldn’t have a problem with emesis.” He flipped on the suction machine, using his elbow to protect his sterile gloves. This would be his backup contingency plan in case Robbie did vomit.

“I’m going to use a pediatric laryngeal mask airway instead of an endotracheal tube.” He showed her the small spoon-shaped device. “As Robbie has the typical shortened Down syndrome neck, an endotracheal tube would have been tricky anyway,” he said as he lubricated the tablespoon-size silicone mask and slipped the tube inside Robbie’s slack mouth. The boy didn’t flinch. “See? I don’t even need a laryngoscope with this gizmo.”

Once the LMA was in place, Phil immediately reached for his bronchoscope and slipped the flexible tube down Robbie’s trachea for a quick look-see.

“See that?” he said to Stephanie, who took turns intently watching the procedure on the digital TV screen, keeping track of the heart and BP monitor readings, and watching Robbie in the flesh. Sure enough, due to softened cartilage, his trachea showed signs of floppiness and collapsed while he breathed under the sedation. The same thing happened while he slept each night. “This is classic TBM.” Keeping things short and sweet, and already having digitally recorded his findings, Phil removed the scope and quickly followed suit with the laryngeal mask airway. Even though sedated, Robbie coughed and sputtered. “All the kid needs is continuous
positive airway pressure while he sleeps, so he won’t have to cough every time his trachea collapses.”

“That’s great news,” Stephanie said, watching Robbie like an anxious mother hen.

True to the short-life drug effect, Robbie started to come out of his stupor. “There you go, buddy, we’re all done,” Phil said. He bent over and looked into his blinking eyes. “Are you in there somewhere?”

The bleary-eyed Robbie tried to look in the vicinity of his voice. Phil set the scope on the counter and prepared to wipe it clean before putting it in the sterilization solution overnight.

“Can you watch him a few minutes while I clean up?” he asked.

She nodded, undoing her mask and letting it hang around her neck, though keeping a safe distance from Robbie.

As with many recently sedated children, Robbie woke up confused, fussing and crying. Phil worked as quickly as he could. “You’re okay, Rob. I’m right here, buddy,” he said. The boy seemed to calm down immediately. Phil smiled, assuming the sound of his voice had done the trick, but when he glanced over his shoulder, he saw a sight that made him smile even wider.

The I-don’t-do-kids doctor was holding Robbie’s hand and patting it.

“You at all interested in getting takeout and keeping me company tonight while I help my kid brother recover from major surgery?” He’d lay it on thick, and hope for the best.

She remained quiet for a few seconds, then let go of Robbie’s hand.

“I can’t, Phil. I’m sorry.”

On Wednesday morning, Stephanie hung up the phone after a long conversation with her mother. She’d used the excuse of being on call—which wasn’t completely untrue—for not showing for Thanksgiving. If things followed the usual routine, her sister would be on the phone within the next ten minutes, and Mary was ruthless when it came to arm-twisting. All the more reason to get started with her appointments.

Phil had surprised her last night with both his technical skill and tender banter with his brother. The more she got to know him, the more she suspected his playboy reputation was just a cover. Helping out with Robbie’s exam hadn’t been nearly as bad as she’d thought it would be, another surprise. Maybe she was getting used to him. She’d watched the boy sleep, and yearning had clutched her heart. If only her son could be alive.

She closed her eyes and bit her lip. Someone tapped on the door.

“Your next patient is ready.”

Thank heavens for work.

By midmorning, Amy delivered the latest batch of lab reports and special tests.

Stephanie shuffled through the stack with an eye out for two in particular. The first was great news—it was just an ovarian cyst for Ms. Winkler. The next report wasn’t nearly as welcome. Celeste Conroy’s Pap smear showed abnormal cells. She picked up the phone.

After she’d calmed the woman down, she suggested her plan. “I’d like to perform a colposcopy, which is a fancy way of looking at your cervix up close with a bright light and magnifying glass.”

The proactive next step went over better than the bombshell dysplasia news.

“And while I’m examining your cervix, I’ll take a
tiny biopsy of that questionable area. This will give us a better idea of exactly what we’re dealing with.”

After a brief silence, several questions flew from the young pregnant woman’s mouth. Stephanie answered each as she was able.

“The exam is not threatening to your pregnancy, though after I do the biopsy, there may be some mild cramping and light bleeding. We’d have to monitor you carefully to make sure the bleeding was from the biopsy and not from the pregnancy, but the risk is extremely low that your baby will be in jeopardy.”

After a few more minutes of convincing the patient to arrange an appointment on Friday, the day after Thanksgiving, she hung up.

And now she had a good reason to stay in Santa Barbara for Thanksgiving. She needed to be well rested and in top form on Friday. Mary could twist her arm all she wanted, but she wouldn’t give in to Thanksgiving dinner in the desert.

Her next call was pure pleasure. “Ms. Winkler? This is Dr. Bennett from Midcoast Medical. I’ve got your ultrasound results back, and you can rest assured that your enlarged ovary is nothing more than a pesky cyst.”

She smiled when her patient sang out a loud “Hallelujah!”

By lunchtime it occurred to Stephanie that she hadn’t seen Phil in the clinic all morning. She nibbled at her microwaved plate of food, and half-heartedly chatted with a couple of coworkers. It also occurred to her that Thanksgiving was going to be one lonely day. She’d hole up in her hotel room and watch a stack of old DVDs and pretend it was just another day. Maybe she’d eat an open-faced turkey sandwich with dressing and gravy, with a side of cranberries from the deli around the
corner, too. Oh, and she’d watch the famous New York Thanksgiving Day parade on TV, she mused with a jumble of faraway thoughts.

“I bet you’re wondering where I’ve been,” Phil said, standing beside her.

“What makes you think I’ve even noticed?” she said, glancing over her shoulder, going along with his playful tone.

“We
noticed you weren’t around,” one of the two nurses sharing the community lounge table chimed in. As far as Stephanie could tell, Phil had all the ladies in the clinic wrapped around his finger.

His quirked brow and goofy expression of “see what I’m saying?” made her laugh. It felt good.

“Thank you, Tamara and Stacy,” he said. “I’m glad someone noticed.”

He sat next to Stephanie, edging out Jon’s nurse, though there was plenty of room on the other side of the table, then unpacked a couple of shrimp tacos from his brown bag. “You know, that’s what I like about you. You’re not under my spell.”

She almost spat out her soda. “You have a spell?” She was walking on thin ice because she knew without a doubt he did have a special something that very well could be called a spell, and that she was most likely already under it…especially since their kiss.

“So I’ve been told.”

“He’s got a spell,” the nurses said together.

She laughed and shook her head. “Well, I don’t know about a spell, but I do know you’ve got a jelly stain on your shirt.”

He pulled in his chin and glanced downward. “Oh, that. It’s probably from when I made Robbie’s sandwich this morning.”

With each day, and all the little details she noticed about him, Phil became more irresistible.

Not that she was interested or anything. “So where were you?”

“Where else? The preschool. Seems like it’s my second home. How does Roma do it?”

“Don’t let this go to your head, Phil, but I think you’re doing a pretty good job of pinch-hitting for your parents.”

“They’re due back tonight, and I’m counting the hours.”

The nurses finished their lunch, and announced they were just about to take a walk before the afternoon clinic opened when René Munroe appeared, complete with swaddled baby in her arms and Jon at her side.

“Hi, Dr. Munroe!” one of the nurses said, rushing over to look at the newborn. “Oh, he’s adorable. May I hold him?”

“Sure,” the dark-haired René said, glowing with newmom pride.

Phil popped up and took a peek under the blanket. “Hey, he looks just like those pictures.”

René rolled her eyes. “Oh, gosh, has Jon been boring everyone with pictures?”

Phil nodded, but the nurses quickly protested, “No! We love baby pictures.”

“Oh, hey, René, this is Stephanie Bennett, the doc we hired to cover your patients,” Jon said, looking a bit abashed and obviously wanting to change the subject.

They greeted each other and Stephanie already felt as though she knew René from working in her office. While Jon passed the baby around, Stephanie discussed Celeste Conroy’s abnormal Pap smear with René and
her plans for following up. When René agreed with the next step, Stephanie felt much more confident.

“Would you like me to call and reassure her that I’m in total agreement?” René said.

“That would be wonderful.”

“Okay, last chance to hold Evan before I take René out to lunch,” Jon said, having taken back his son but seeming ready to share him with anyone who wanted. “Stephanie?”

He offered the teddy-bear-patterned bundle of blanket to her and she froze. Oh, no, what should she do? Would it be completely awkward to refuse? Her pulse sputtered in her chest, and her ears rang. She liked these people and didn’t want to insult them.

“Okay,” she said, feigning a smile. She held Evan with stiff arms, away from her chest. “Aren’t you something?” Memories of her son gurgling and cooing hit so fast and hard she found it impossible to breathe. She blinked back the images as her heart stumbled, and she handed the baby back to René, trying her best to disguise her quivery voice. “You must be so proud.”

The huge, beaming smile on René’s face gave the answer. She cuddled the baby to her heart and kissed his cheek. “I wuv this wittle guy.”

Jon laughed and scratched his nose. “Anyone know a cure for a highly educated woman who suddenly starts talking baby talk?”

The nurses giggled. “It’s a requirement of motherhood, Doc,” one of them said.

Flushed and edgy, Stephanie willed her hands to stop shaking. She’d looked into those beautiful baby gray eyes and had seen Justin. She’d glanced up to find Phil intently watching her as her lungs clutched at each breath.

Somehow she made it through the goodbyes, but as soon as the couple left she headed for the back door and the tranquil promise of the yard. She needed to breathe, to get hold of herself.

She was staring at the small bubbling fountain and listening to chattering birds in the tree when a hand grasped her arm. It was Phil. He’d picked up on what had just happened. Hell, she’d been so obvious, anyone would have noticed her fumbling attempt at acting normal…if they hadn’t been so distracted with the baby.