Birthing Complications

“Hello dear!” my mother repeated over the phone. “I was just calling to see how you’re doing.”
“Fine, mom,” I said louder. “I heard you the first time.”
“Well, I should hope so! I would hate to think that you’re ignoring me.”
“I’m not ignoring you, mom.”
“Of course not! Of course not. So, tell me, how’s your new apartment treating you?”
“It’s alright. Close to the hospital, which is nice. I can walk most days.”
“Oh, that’s nice. You know, your father and I spent our honeymoon in a hospital. He broke his leg the first day out, trying to jump down from a barn roof. Have I told you about that?”
“Oh, your father’s such a careless man. Which reminds me- when are you going to find a nice man for yourself? You’re doing yourself a disservice, waiting so long.”
Not this again.
“I don’t have time for a relationship, mom. I’m a nurse. We’ve been over this.”
“Nonsense. I was working as a paralegal when I met your father, and kept working up until I had you. You have every chance to get out there.”
“You wanted kids, though. I don’t.”
“Oh, you only say that because you don’t know what it’s like. It’s truly inexplicable.”
“I’m not going to argue with you on this point. I am going to change the topic.”
“Well, you know what I think about it.”
“So, read anything good lately?”
“Oh, yes, actually. An collection of alternate histories, speculating on what would have happened had the Indians- oops, excuse me, the Native Americans- colonized Europe, as opposed to the other way around. Very interesting…”
The conversation droned on for about half an hour. My mom insisted on calling every weekend, whether or not she had anything substantial to talk about. I humored her, if only because of some sense of sympathy. When I retired, I probably wouldn’t have much to do either. My cat appeared halfway through the conversation, and I scratched him behind the ears.
I worked tomorrow, but could technically be working anytime. Neonatal usually didn’t find itself understaffed, but for the times it did, the administration made sure to have enough nurses on call. Luckily, this weekend was not one where they needed me. I much preferred the rest to additional pay.
I ended Sunday night by eating some berries on toast (not a jam, but still delicious) and watching some sci-fi show about a traveling blues band with superpowers. The berries were starting to get old, so I figured I might as well use them before I had to throw them out. Actual cooking was something I rarely had the energy (or appetite) for; I ate out a lot. The show was pretty terrible; just what I needed. I went to sleep later than I probably should have (midnight), but set my alarm for four. Such is life. At least I didn’t have to work nights.

I got up the next morning, showered, and ate a quick bowl of cereal before heading over to the hospital. The place was always busy with countless staff and patients, but the administrators would somehow notice if any employees weren’t there on time. It was uncanny. I made it in a minute ahead, grabbing my uniform and making my way to the maternity ward.
Another nurse appeared walking beside me as I made it in – my best work friend, Laura. She was more experienced than I by several years, but somehow we had formed an alliance.
“Hey, Sara. We’ve had two births in the past day. Neither had any major problems, though, so they’ll probably be out pretty soon.”
“Good. I’m not in the mood for any sort of complications.”
“Are you ever?”
“So why are you here, again?” Laura jokingly asked.
“The salary?” We both laughed. It was nothing special.
“No, really, I like it well enough here. Most of the time. It’s the times I don’t like that I worry about,” I noted. “My mom called again yesterday.”
“Still pushing me to find a boyfriend.”
“You could always lie.”
“No, she’d want to meet him. Anyways, I don’t have the time for that nonsense anyways. I have a cat; why would I want another animal to pick up after?”
“Amen to that, sister. Speaking of that time, I need to go explain to some students why endotracheal intubation at birth is an unnecessary risk for meconium covered brats.”
“It is?” I feigned sarcasm, but I didn’t know much about actual birth procedure beyond what I needed to know. I mostly work the nursery.
“Yeah,” Laura said, taking me at my word. “Turns out routine resuscitation is just as good, and a lot easier. Not that administration plans on changing procedure anytime soon. After that, there’s another woman due. Maybe two, three hours until the big push. So, I’ll catch you at lunch, alright?”
“Yes ma’am.” She waved as she walked off, and I made my way up a stairwell to the nursery.
My job title, and training, was really that of a neonatal nurse practitioner. I had tried explaining that to my parents on multiple occasions, but they still told their friends I was simply a “nurse”. Somehow, out of medical school, I had been shuffled along into the vibrant world of intensive neonatal care. I got to avoid the larger so called “well baby nurseries” that way (and those things are loud), but traded it for some of the more difficult cases. No complications in the recent two births meant no new additions to the neonatal intensive care unit, which was perfectly fine by me.
I spent the majority of the day looking after the few resident infants still hanging around. Laura didn’t appear at lunch, which likely meant the labor was going on longer than expected. My suspicions were confirmed when, at about three, I got a call over my radio.
“Sorry, babe. We have one with GBS. Sending him up to your team.”
GBS, the acronym for Group B Streptococcus, was Laura’s way of telling me that my day had just turned from normal to rough. We should have caught the bacteria in screenings, but sometimes, very rarely, we missed it. For newborns, it was a serious infection to have, if not uncommon. I started preparing some treatments for pneumonia, which was likely, while the other two in the room (a social worker and a physician, at the moment) did their thing. The social worker said something about antibiotics, and the physician waved him away, citing that we needed to see our patient first. I sided with the physician on this one- it might be too late for antibiotics. Though, if that was the case, it might be too late for any treatment whatsoever. There were some types of antibiotics in the room if we needed them.
The newborn never made it to our room. I got the message from Laura, again over the radio. The baby had died in the hallway, and couldn’t be brought back. Things like this wore on a person, even if there was nothing one could do about them. Some people didn’t want kids because of the time and work they would take, or they responsibility they entailed. When I was asked for a reason, I usually gave one of those, but my real reason was fear. I’d seen too many infants die to want to risk having one of my own, only to have it taken away.

The rest of the day wasn’t complicated. I went home at seven, showering and going straight to bed. Before falling asleep, I did some light reading. One cannot help to change society if one conforms to society, even if reading books is only a mild form of rebellion. Nobody at work really reads them, except when looking up a condition in a textbook or reference manual. I found it surprising when I made it to steady employment, but learned quickly that it was a part of the hospital’s culture. Every hospital has a different culture, a different amount of seriousness, a different amount of expertise, a different breed of medic. I ended up at a dull one.
I turned off the light at around ten o’clock, hoping to shut my eyes and be asleep in minutes. It swam in like the tide, slowly and surely, until it drained away at a sound. My curiosity got the better of me, and I opened my eyes. The red LCD clock displayed 1:07. Glaring light in the darkness. It, in isolation, was the only object in existence. I didn’t move for a moment, ears perked up, closing my eyes again, hoping to hear the sound again. Sometimes you think you hear something and it wakes you up, just to find that it was imagined all along. This was one of those times, it seemed. I relaxed. What had the sound been? Almost like tiny footsteps, running.
Then I opened my eyes again, and my cat (I call him Cat, out of laziness) was there, eyes glowing along with the clock. Of all the times to be awake.
“Was that you, Cat? Stop fooling around, mom needs some sleep.”
Cat sat there for a moment before jumping up onto the bed, stepping on and over me to get to the other side (where I could only suppose the grass was greener) in the most uncomfortable way. I shuffled him off me, and he curled up there to stay.
“Your bed’s not good enough for you, I suppose. Well, fine, wake me up for no reason. Stupid cat.”
I fell back asleep as quickly as I could with a furry lump on the bed. Anyone who has faced this particular problem knows the difficulty with it. You can’t move, or else the cat will wake up and repeat its maneuvers, or leave. Either is a reason to feel guilty, so you are trying to sleep, while tense from not moving, and feeling a weight on or around you. Somehow I managed it this night.
And dreamed. The dream began where I had left off in real life, in bed. Cat was gone though, and the clock read something in letters I don’t remember. If I hadn’t been dreaming, I should have recognized it was a dream immediately. It was cold, very very cold. I pulled my covers closer around me, but it seemed like the cold was just ignoring my blankets, as if it came from everywhere. I was shivering. I looked at the clock curiously, to read it, but still had trouble deciphering it. Then…
A slam on the window. My window lies out in front of my bed, such that I can look through it when I wake up. It was hard to see anything out there now, in the darkness (which, as dream-darkness, had even more obscurity), but I could make out a silhouette from the light of a streetlamp. A hand, which had slammed palm outstretched on the glass. It slowly slid down the surface, leaving some kind of stain behind. The hand was small. Very small. I knew then what it was. It was the baby. The one that had died. The one I didn’t save. It didn’t matter that I hadn’t had the chance. We should have found the GBS. We should have known. No, no, no, no…
And again, a slam on the window. The hand reached back up, as if it were knocking. As if it wanted to get in. I pulled my covers up to my eyes, and at one last glance, over them. I could just ignore it, and it would go away, right? It wasn’t getting in. It was just a baby. Babies can’t open windows. They can’t even move themselves yet. Babies are dumb. I was safe.
But the blankets couldn’t muffle the sound. The cold and the slamming persisted. I huddled under it still, before looking out from the sheets again. Still the hand pressed against the window. What was on it? Blood? Excrement? Knowing GBS, it was probably both. Oh no. Oh no. No, no, no, no, no…

Thankfully I woke up, and thankfully it had just been a dream. It was still dark (weekdays, when I worked, involved getting up earlier than the sun did), but my alarm made sure to remind me that I had to be up and about. Another wonderful day. I should have been, which is to say, should be rested right now. To stay in the past tense though (for future memoirs), I’ll say that I was rather than am tired.
I headed into work like a zombie, but managed to catch Laura on her way in before she caught me (it is usually her who ambushes me).
“Hey, you doing alright?” I asked.
“Yesterday can’t have been an easy one. I mean, I feel terrible about it, and I wasn’t even really there.” Laura stopped and turned.
“It was terrible. Telling that new mother that she wasn’t really a mother after all. And after all that too- the labor took much too long. But, it happens.”
“Yeah. I hope the family is doing all right.”
“I think so. The social workers did most of the talking. I’m starting to see why we have them.”
“Well, don’t beat yourself up too much over it.”
“I’ll try not to. It was just… you know.”
“Do you think it’s the kind of thing you can get nightmares from?”
“Um… maybe.”
“I mean, I didn’t sleep that easily. I don’t know about you.”
“You somewhat sound like you’re doing that thing.”
“What thing?”
“You know, the thing?”
“That thing…”
“That thing where you ask people questions only because you want the questions asked of you.”
“Well…ok. Guilty. I had one.”
“A nightmare?”
“Yes, a nightmare. What else?”
“You did look little pale coming in,” Laura said, concerned. She quickly put a hand to my forehead.
“Hmm. Can’t really tell, but you might be sick.”
“Wait, I tell you I had a nightmare and the first thing you do is think that I’m sick.”
“The paleness concerned me more. What did you have for breakfast?”
“I skipped it, wasn’t thinking.” Laura threw her hands down.
“Honey! Come on, let’s get you a yogurt in the dining hall. You can’t start a twelve hour workday on nothing.” I followed her, and got a yogurt as ordered. Started feeling a little better.
“I could talk to Roth, you know. See if you could take the day off.”
“No, I can’t,” I said between spoonfuls. “Rent’s due on Friday, and I need to work this whole week to have enough for it and my dad’s birthday.”
“Well, I think you should get some rest, but if you’re resolved to work yourself to death, I suppose I can’t stop you. Hopefully you don’t get any kids sick. Consider vacationing.”
“Really, I’m fine. I’m just terrified of another baby dying.”
“You’d be surprised how many people get into this field with no idea what they’re getting into,” Laura cautioned. “Many consider themselves thick-skinned, but faint at the first sight of blood. You’re tougher than them, of course, but nobody’s immune to the stresses; besides, you see more deaths than most people see in their entire lives.”
“It might just be that I’m not suited for this work.”
“Well, it might be somewhat hasty to come to that conclusion. Considering you’ve pushed through medical school for this very thing, even more so. At the very least consider seeing a counselor about this. The hospital has people on staff for this very reason.”
“I’ll think about it. Thanks, Laura. You’re a good friend.”
“Okay. I’m heading in to the ward. Take your time.”
I took maybe five minutes, then headed up myself. The day was without incident. I frantically checked and rechecked everything for the three infants in the ICU, all of them premature births. I may have been overcautious, but I wasn’t about to let any of them slip on my watch.

I went home to find Cat at the door, scratching at it. When I opened the door, the sound of tearing wood fibers stopped, but the scratches left on the door’s interior did not. Cat looked up at me innocently. Stupid cat. When I stepped inside Cat made to dash out into the hallway. I, with some kind of ninja reflexes, picked him up before he could get away.
“You’re staying in here, bub.”
Cat was wriggling and writhing uselessly in my arms, and I closed the door behind me. The power was out, as I found out trying to flip the switch. Great, no light for reading or electricity for tv. I might be able to read if my eyes got used to the light. I really should have known by the lack of hall lighting, but that doesn’t always mean loss of power.
It was late already, so I just went straight to bed, after brushing my teeth. Cat had taken to scratching again, but when I lay down, he realized there was something even more annoying he could be doing and jumped up onto the bed, snuggling in tightly. That should be all for tonight, setting this on the nightstand.
Then, scratching again. Cat is here. Cat is not at the door. I freeze for a moment, but my curiosity gets the better of me. I pass by the bedroom door, head for the front hallway door. It’s locked, if a bit scratched up on this side, but the scratching is coming from outside. Why am I even carrying this right now? Writing is the last thing I should be doing. Oh no. The scratching just doubled. I just looked back at the last few entries, and last night’s nightmare came flooding back. It’s happening again. Oh no, no, no, no. While I was looking, four sets of hands are now scratching. More even. I’m backing up to my room, and what happens? There’s a hole in my door. A splintered growing hole; I can’t help but be reminded of “The Shining.” A rudimentary cat flap, dog door. Only these aren’t pets.
They’re babies.
What seems like hundreds of them, swarming through the hole in the door, crawling over one another, crying and gurgling, coming towards me. No, no, no, no, no, no. Retreat to my room, close that door and lock it. It’s only a matter of time though. I’ve got to go. I’m getting out of here, to the window, screw this journal.

The remaining content of the journal of Sara Larrette, found among her possessions in her damaged apartment after her disappearance three weeks ago. She was last seen in Bogot√° by a street vendor, who verified her ID after it came up in a credit card transaction at his stall, but otherwise has no known location.

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