Close Pursuit. Cindy Dees
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The lone lantern was barely bright enough to read by, let alone perform surgery by.
Katie gulped and headed for the laboring girl, who was moaning again. He glanced at his watch. Contractions were under two minutes apart. “Do you know what a speculum is?” he asked.
“Every woman who’s ever had an ob-gyn exam knows what one is,” Katie replied frostily.
His lips twitched with humor, and he was glad her back was turned to him. “How far is she dilated?” he asked.
“There’s about a silver-dollar-sized opening,” Katie reported a moment later. “What does a head look like?”
“Like a wet, hairy balloon pressed against the cervix.”
“Then we’ve got a problem. I’m seeing pink skin. And it’s kind of pointy. Maybe bony. Like, umm, a baby bottom?”
“Breech presentation,” he bit out. “You’re going to have to talk our reluctant patient into letting me help.”
But Mama was having no part of it. It was outrageous that he had to stand there and do nothing when he could be attempting to turn the baby before it entered the birth canal. Although given how small Mom was, that would be a dicey proposition at best. He really needed to consider a C-section sooner rather than later.
“Tell her I want to discuss a C-section.”
Nope. Abruptly hysterical Mama was having none of that. Grandma wasn’t keen on the idea, either—something about not being able to hide the evidence of a doctor helping her granddaughter.
This was no way to practice medicine.
The tension in the tiny space mounted over the next hour as the girl’s labor progressed and her moans turned into sharp cries of pain. “Don’t let her push!” he ordered. “At all costs, she mustn’t push.”
The cries turned into screams muffled by a pillow the grandmother pressed over the girl’s mouth. God, this is barbaric.
“I can set an epidural. Give her painkillers. At least let me put a heart monitor on the baby,” he all but begged.
“I’m sorry, Alex. She’s not budging.”
“Katie,” he ground out urgently. “Find a way. Make her understand that she and her baby are in grave danger. This is why she came to me. Let me do my job!”
His impotent fury mounted as the girl’s screams turned into long, keening moans indicative of exhaustion and delirium. He didn’t need anyone to tell him the patient was no longer progressing in her delivery. Katie finally turned to the grandmother and said something sharp.
“Okay, Alex. Grandma says to ignore her granddaughter and come help.”
Thank God. As he expected, the girl was so far gone into the agony of a difficult birth that she barely noticed him working frantically to shift her baby into some sort of birthable position.
“I need her to push with the next contraction.”
Katie stood by the girl’s head, translating his instructions, although he doubted the mother was paying the slightest attention at this point. The girl’s body heaved of its own volition, and he went to work. He pulled the baby’s slippery ankles clear and hung on desperately until the next contraction. The girl screamed, one long continuous keen of agony as he all but tore the child from her body. It was that or risk the child suffocating in the birth canal.
“It’s a boy.” He suctioned the baby’s nostrils and rubbed the child vigorously. Finally, the infant drew a shuddering breath and let out a wail. Not as lusty as Alex would have liked, but the kid was alive. He cut the cord and thrust the child at Grandma to wrap up and warm up. He had bigger problems at the moment.
This girl was too narrow-hipped and too damned young to be having babies, and the delivery had torn the crap out of her. She was bleeding heavily, and one supply he and Katie had not been able to haul in had been refrigerated whole blood.
He went to work fast, racing against time. The mother’s screams quieted. Not that he wasn’t causing her intense pain. She was merely bleeding out. Dying.
“Tell her to fight,” he ordered.
Katie leaned down to speak in the girl’s ear.
“Say it like you mean it,” he growled.
Katie raised her voice and began demanding that the girl open her eyes. That she live for her son. And while Katie tiraded like a drill sergeant, he fought like hell, his hands flying to stem the worst bleeders. It took a full five minutes to avert disaster, and nearly a half hour to stabilize the girl. Once the meatball work was done, he settled down to the slower and more meticulous business of cleaning up the mess.
Of course, Grandma told him to make sure all the stitches were internal and hidden. There mustn’t be any evidence of modern medicine, no sirree.
After another hour, Grandma asked something and Katie translated. “She wants to know if they can go soon. They’ve got to get the girl back home before dawn.”
“She can’t move!” he exclaimed. “I just sewed her back together. I don’t need her up, running around and tearing out all her stitches.”
Katie threw his own words back at him. “We have to find a way to get her home.”
Sonofabitch. “Where do they live?” he asked in resignation.
A short conversation. “Family compound on the edge of the Karshan village.”
“I’ll carry her as far as it’s safe,” he announced.
Katie’s eyes flickered in surprise. “None of it is safe.”
He rolled his eyes and scooped the girl up off the cot. Aware of how rough the terrain was going to be for their little trek, he elected to haul the mostly unconscious girl in a fireman’s carry, slung across his back. Grandma led the way. Katie followed behind her, carrying the baby in a cloth sling in front of her. The child had yet to nurse and he had no idea if the difficult birth had injured the infant. But he was given no chance to examine the baby. The sky was lightening behind the mountain peaks across the valley.
The hike down to the river was hellish. It was frigid and dark, and the ground was slippery with frost. Plus, every stray noise could be a local religious hard core with a gun and no sense of humor about their presence in this valley. Grandma’s cough worsened in the cold night air, although the sound might work to their advantage by announcing that their little party was locals.
At least the sound of rushing water muffled it as they reached the valley floor. Grandma led the way along a footpath beside the river for nearly a mile. But then she stopped and whispered something to Katie, who translated.
“Their compound is over the next rise. She’ll take her granddaughter from here.”
He eyed the short, heavyset woman. “How?”
Katie’s answer was sober. “She’ll find a way.”
Reluctantly, he transferred the new mother to the old woman’s back, draping the girl’s arms over Grandma’s shoulders while Katie looped the cloth sling holding the baby around her neck so it hung down her front. The old woman nodded her thanks and slowly trudged away from them under her load.
Madness. This is utter madness. He muttered, “It will be light any minute. We need to get under cover.”
He gestured for Katie to lead the way back. Or more accurately, he took the rear guard position that put his body between her and the most likely direction gunfire would come from. The hike back to their hidey-hole seemed to take forever. Maybe it was because his shoulder blades kept anticipating a bullet between them. Or maybe it was because he’d gotten no sleep last night. Or maybe it was because he was more than half convinced the two of them weren’t going to make it out of this damned valley alive.
* * *
GLANCING