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Overview
Product Details
| ISBN-13: | 9781491834718 |
|---|---|
| Publisher: | AuthorHouse |
| Publication date: | 01/24/2014 |
| Pages: | 226 |
| Product dimensions: | 6.00(w) x 9.00(h) x 0.52(d) |
Read an Excerpt
Date of Confinement
By Steven Mollov
AuthorHouse LLC
Copyright © 2014 Steven MollovAll rights reserved.
ISBN: 978-1-4918-3471-8
CHAPTER 1
It was a beautiful day on the Monterey peninsula. With the exception of the score, the round was everything Joshua dreamed it would be. As he teed it up on the seventeenth hole, the Pacific lay ahead and the hills of the Big Sur country were off in the distance. The ball only went 120 yards but at least this one stayed on the fairway. His younger son Jeffrey was hitting the ball much better than he was, benefitting from a few summers at a local golf camp back in the White Mountains of New Hampshire.
"Good shot, Dad," Jeffrey called out, having hit the ball at least 50 yards further and on to the green.
"Don't patronize me, Jeff," he responded with a laugh. "I know you're 10 strokes ahead."
Joshua was enjoying the moment. So many times in his bed back in Breedville, he would dream of this round. It was February 1989 and for the first time in memory he had taken his family on a vacation. It was too bad that his older son Jim wasn't able to join them. He was in his first year at Dartmouth, Joshua's alma mater. Sixteen year old Julie was off shopping with his wife Elizabeth in Carmel. Alex Faber, his partner of less than one year, was firmly entrenched in the hospital and office, covering him for the week.
The two continued the round, wrapping it up far too soon for Joshua. He had certainly taken advantage of the moment, needing at least six or seven strokes on each of the last three holes.
"Let's go find your mom and sister," Joshua said to his son as they handed in their clubs at the pro shop.
Elizabeth and Julie enjoyed their shopping trip, returning with a new tennis ensemble and some fresh outfits for the spring semester, respectively. The four met back at the bed and breakfast just off the square. After three days of seeing the sights in San Francisco, they were wrapping up their west coast week in Carmel. Elizabeth would have preferred the wine country of Napa, but she acquiesced to her frustrated golfer. There would be plenty of opportunities in the future for travel, now that Joshua finally had a partner.
Dinner was at a casual Mexican restaurant several miles out of town, a recommendation from their innkeeper. The fajitas and quesadillas were good but the Coronas could not wash out the fact that it was their last night in California. Tomorrow morning they would drive back to San Francisco for the long flight home. This was a rare opportunity of family unity: no laboring patients, homework or long telephone conversations with friends to interrupt family dinnertime. They all knew it was back to their busy lives next week, and even the kids appreciated the moment.
Meanwhile, three hours ahead and three thousand miles away, Alex was truly looking forward to her partner's return. She had taken call for the practice every night that week, cancelling elective surgery and seeing mostly obstetrical patients in the office. She could have had Breedville ObGyn cover her part-time while Joshua was away, but like her partner, Alex was becoming very possessive of her patients and didn't want to miss their big event. She had been fortunate that three of her nights had been quiet, but those were more than made up for by the others.
While the Barron family was enjoying their Mexican feast in Carmel, Alex had just admitted Martha Remington to the labor floor. Martha already had two boys, both delivered by Joshua. Her previous labors had been quick and relatively uneventful. But this was a girl, and things were going to be different. Her prenatal course had been complicated by pregnancy-induced hypertension, a condition where her blood pressure had begun to climb over the last few weeks. Martha had needed to go on bed rest and required frequent ultrasounds and fetal monitoring while waiting for the baby to reach full term. She had ruptured her membranes earlier in the day and had not yet gone into labor. Alex had discussed the options with her, which included waiting for spontaneous labor or having an induction.
With two previous uneventful labors under her belt, she opted for waiting. As the hours passed, her blood pressure began to rise while her urine was spilling significant amounts of protein. These were both signs of impending toxemia, a serious prenatal condition that in its worst state can cause maternal seizures and stillbirth. Alex had noticed these changes occurring, as well as several distressful laboratory results. Martha's platelet count had dropped and her liver function studies were rising. These were indications of a serious complication of toxemia known as HELLP syndrome. The acronym stood for Hemolysis, Elevated Liver function studies and Low Platelets, and help was indeed what Martha needed.
Alex recommended starting an induction. The patient agreed and pitocin was initiated. Unfortunately, the low platelets precluded Martha from having an epidural for pain relief. Anesthesiologists are loathe to put a needle into the spinal column with low platelets for fear of having a bleeding episode into the spinal canal, potentially causing nerve damage and paralysis. She would have to go with narcotic relief. Before Alex could begin the intravenous instillation of magnesium sulfate, a medication used to prevent seizures in toxemic patients, Mrs. Remington's eyes rolled into the back of her head. She began to shake uncontrollably, biting her tongue. The magnesium was quickly instilled through an intravenous site which Alex had insisted on placing earlier. The seizure lasted for several minutes and then Martha slumped back into her bed, unconscious. The fetal monitor began to show a significant drop in the baby's heart rate and preparations were made for an emergency cesarean section. Although the fetal heart rate usually responds to the end of the seizure by returning to baseline, this time it did not. Martha's husband Donald was quickly ushered to a waiting area while his wife was wheeled into the section room. After a rapid sequence induction of general anesthesia, Alex opened her abdomen and uterus and pulled out a depressed child. Pediatrician Arthur Hill had been called and was in the room for the resuscitation effort and the baby responded rapidly. Gerald Ransom, who was on call for Breedville ObGyn, came in to help Alex repair the surgical site.
An hour later, calm had returned to the labor floor as Alex sat and reviewed the clinical sequence with Gerald.
"You certainly wouldn't have expected a full-blown eclamptic in a multiparous patient with no history of toxemia in her previous pregnancies," Gerald said as he reviewed the fetal monitor strip. Gerald was alluding to the fact that toxemia is usually a disease of first pregnancies.
"You can get lulled into a false sense of security pretty easily," Alex responded. "Even her earlier blood pressure elevations in the past few weeks were very mild. I thought that Joshua's testing regimen was overly aggressive ... but I guess not. Anyway, thanks for your help, Gerald. I appreciate it."
"No problem, Alex. Happy to help out. I'm sure you're looking forward to Joshua's return."
"You bet! I better go see how Mrs. Remington is doing, and check on the evening nurses. This isn't something you see very often and they're all a little shaken."
Martha was awake in the recovery area when Alex appeared.
"Your little princess certainly knows how to make a grand entrance," Alex said as she reviewed the vital signs and urine output. "You didn't give us a lot of time to react."
"Well, nothing like an emergency c-section on your third baby to make that one your last!" Martha joked. "Thank you so much for your help, Dr. Faber. The nurses filled me in on what happened and how quickly you took over keeping both of us safe. We'll never forget that."
"I'm just glad you and little Ericka are doing well." Alex blushed. She'd never been able to take a compliment.
Alex returned to the call room and found that Gerald had left. There had been talk of renovating the space to provide each physician with their own private room. But until then, Alex had to share with a doctor from the other group. And being the only female member of the obstetrical staff at Breed General Hospital, it meant sharing a room with a member of the opposite sex. Alex smiled, thinking of how difficult it had been for Gerald Ransom to share a room with a woman he wasn't sleeping with. But the awkwardness of those moments had disappeared. She looked in the mirror, seeing an exhausted face with no makeup and a disheveled head of blond hair. Real sexy, she thought.
It had been just about a year ago that Joshua had suffered a heart attack, causing him to seek help in his practice. From the bustling streets of New York City, Alex moved to Breedville, a small town by the Merrimack River, nestled between the lakes and White Mountain region of New Hampshire. She had found a physician with her same passion for medical care and she immersed herself in the small town environment. But life threw many curves Alex's way over the past year. In Breedville of all places, she crossed paths with her ex-husband from a decade ago who was now the president of the hospital. She'd been stalked by a former lover who almost ended her life. Her relationship with Joshua had its ups and downs, as they struggled to find a new balance of power in the practice. Not to mention everything nearly imploded when she confidentially took care of Joshua's daughter's early unwanted pregnancy. Luckily, things had now settled down. She and Joshua were back on the same page, and she'd discovered a newfound attraction for her former husband. And the year wasn't even over yet!
Alex's relaxing few moments of reminiscing came to an end as her beeper went off, heralding the visit of another patient in early labor. At least there were no office hours on Saturday morning.
Meanwhile, the Barron family retired for the night. In their shared hotel room, Julie and Jeffrey argued over what to watch on television (An episode of Dallas won out over the Bruins-Flyers hockey match-up.) Joshua and Elizabeth enjoyed the privacy of their own room. It had been a wonderful, much needed vacation and the two looked forward to more opportunities together now that Alex was a part of the medical practice. Joshua was the first in bed as always, while Elizabeth took off her makeup and brushed her teeth. She put on a secret purchase that she'd treated herself to earlier that day—a new negligee. She'd been too self-conscious to buy it in front of Julie, so had dispatched her daughter to find a new pair of sneakers for school.
Liz looked in the mirror. Her five foot five inch frame was well proportioned for a woman who had born three children. Her brown hair hung on her shoulders as it always had, never retreating to the shorter haircut that so many of her friends had switched to. She could see the outline of her ample breasts through the diaphanous material. She hoped Joshua would notice them, too. They had been too exhausted from travel the first few nights of vacation, and the full days certainly prevented an afternoon delight. So here they were, on their last night before returning home, and Liz was hoping to get Joshua into the mood.
As she left the bathroom, it didn't take Joshua long to respond. They purposely left the light on. After several long, passionate kisses, she slipped off her panties and straddled him. Their up and down motion excited him and he slowed it to prolong the moment. His hands reached up to her new negligee and drew it upward, uncovering her breasts and exposing her to the light on the nightstand. Liz pulled up on the negligee, removing it in one motion. With her arms extended, her breasts stretched upwards, revealing a subtle dimpling in the skin above her left areola. This small detail was not lost on Joshua, who despite his excited state, could not shake off the years of clinical observation. He reached for her left breast, feeling the small but irregular mass underneath. They climaxed together. As she lowered herself on to his full frame, he reached around her and held her tight. A tear formed at the corner of his eye as Joshua realized that his wife's health was in serious jeopardy.
CHAPTER 2It was a long flight home for Joshua. It was clear from his cursory inspection during their lovemaking that Elizabeth was harboring a growth in her left breast. The irregular firm mass along with the dimpling skin were significant findings pointing towards a malignant tumor. As she sat next to him holding his hand, his mind processed what would need to be done in the near future: a mammogram to look for other suspicious areas in her breasts, a needle biopsy of the mass, and if his suspicions are confirmed, a lumpectomy or mastectomy. Lymph nodes would be sampled, possible radiation and chemotherapy would be needed.
"Joshua, what's wrong?" Liz asked. "You have that far away look in your eyes."
Joshua smiled back at her. "I'm just replaying this past week," he said. "I'm sorry it's taken so long for us to enjoy real family time. I can't help but regret the time that's passed by and how little of it we have taken advantage of." He paused. "Maybe my dedication to the practice and my patients has been somewhat misdirected." He leaned over and kissed her.
"Wow," Liz laughed. "What alien has taken over my husband's body? Well, with Alex around, we should be able to take far more advantage of the time we have. It's been a pretty intense eight months, but now maybe things will settle down. We don't need to go away for a week. Just having you home more is quality time for me." Joshua kissed her again.
"Gross me out!" said Jeffrey, sitting across the aisle with his sister.
"Oh shut up." Julie responded. "It's cute!"
"You would think that." Jeffrey continued. "It probably reminds you of Brad."
Now Jeffrey was treading on dangerous waters. Julie had had a crush on Brad Hancock for months and their break up had resulted in many teary-eyed conversations with her friends. She grabbed her brother's hand, pressing his fingertips into his palm, eliciting a yelp.
"Mom, Julie's hurting me!"
"You deserved it, runt!"
"Julie, leave your brother alone," Elizabeth said to her teenage daughter.
"He started it, Mom."
"No I didn't."
"Yes you did."
"Well, both of you cut it out. Is it really necessary for me to separate you two on the plane?"
"Like I said, honey," Joshua piped in, "good quality family time."
Alex was thrilled to see her partner in the office on Monday morning.
"Welcome back, Joshua. How was the golf game?"
"I'm afraid I'm going to need more time off than you'll give me to improve that part of my life. Has it been very busy?"
"Let's just say I paid the rent," Alex said with a smile.
"Anything eventful?"
"Only a seizing toxemic!"
"You don't mean Martha Remington, do you?" Joshua asked.
"That's exactly who I am talking about," Alex answered. She could never get over how well he knew his patients.
"How'd she do? I was worried about her. That's why I ordered all of the antepartum testing," Joshua explained, referring to special testing performed on high-risk obstetrical patients late in pregnancy.
"She did fine, except for an emergency cesarean. She's going home later today so you still have time to visit her. Also, hours are going to be a little hectic this week. I cut back on office time in order to cover the practice myself while you were away. Ann went crazy rescheduling patients."
Thinking about his office manager Ann Stremp, the epitome of organization, having to scramble patients around made Joshua smile.
"Well, I'm rested and I'm back," he said as the two headed into their respective offices to start their day.
Joshua's first patient was Melissa Steele, a thirty year old in her first pregnancy. She had undergone a cone biopsy several years ago for severe cervical dysplasia, a condition that can lead to cervical cancer and requires close follow-up with frequent pap smears. Joshua had performed the surgery and her subsequent pap smears had all come back negative. His concern with Melissa was not as much about the pap smears and dysplasia as it was on the effect that the previous cone biopsy might have on a pregnant uterus. In order to remove the entire abnormality, he had had to remove a significant portion of her cervix. Although the area had healed well, there was always the concern that the cervix might not be able to hold a pregnancy in place for the entire nine months. It was necessary to continuously evaluate the cervix, looking for premature dilatation. So far her course had been uneventful and she was now close to twenty weeks.
"How does it look, Dr. Barron?" Melissa asked after the examination.
"So far, so good, Melissa," he responded. "Remember to look for increased pelvic pressure and discharge. Although these are common findings in any pregnancy, they could be a warning sign that your cervix is beginning to open up. I'd like to see you again in another two weeks. You should be on decreased activity at this point. No exercise, no heavy lifting and no intercourse."
(Continues...)
Excerpted from Date of Confinement by Steven Mollov. Copyright © 2014 Steven Mollov. Excerpted by permission of AuthorHouse LLC.
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