If Memory Serves (Dr. Tara Ross series) (Volume1)
IF MEMORY SERVES
TANYA GOODWIN
This is a work of fiction. Names, characters, places, and incidents either are the product of the author’s imagination or are used fictitiously. Any resemblance to actual person, living or dead, events, or locales is entirely coincidental.
Copyright 2012 by Tanya Goodwin
2nd edition
Cover design by Rae Monet
ISBN 9781484974568
Dedication
I would like to thank my family who withstood the good days, the bad days, and the ones in between. To my daughter, Tamara – thank you for your opinions.
I’d like to thank my editor, Cori Debnam Cole, my cover artist, Rae Monet (2rd ed.), Karen Duvall, for designing the book flat (2nd ed.), and to Dan Uitti, my steadfast print and ebook formator.
A special thanks go out to Kenneth Cino, retired NYPD Lieutenant, and Lieutenant Brian D. Karst of the Town of Carmel Police Department, who helped me with police procedure.
And thank you Karen Cino, my critique partner and fabulous friend.
Table of Contents
Foreward
Chapter One
Chapter Two
Chapter Three
Chapter Four
Chapter Five
Chapter Six
Chapter Seven
Chapter Eight
Chapter Nine
Chapter Ten
Chapter Eleven
Chapter Twelve
Chapter Thirteen
Chapter Fourteen
Chapter Fifteen
Chapter Sixteen
Chapter Seventeen
Chapter Eighteen
Chapter Nineteen
Chapter Twenty
Chapter Twenty-One
Chapter Twenty-Two
Chapter Twenty-Three
Chapter Twenty-Four
Chapter Twenty-Five
Chapter Twenty-Six
Chapter Twenty-Seven
Chapter Twenty-Eight
Chapter Twenty-Nine
Chapter Thirty
Chapter Thirty-One
Chapter Thirty-Two
Chapter Thirty-Three
Chapter Thirty-Four
Chapter Thirty-Five
Chapter Thirty-Six
Chapter Thirty-Seven
Chapter Thirty-Eight
Chapter Thirty-Nine
Chapter Forty
Chapter Forty-One
Chapter Forty-Two
Chapter Forty-Three
Chapter Forty-Four
Chapter Forty-Five
Chapter Forty-Six
Chapter Forty-Seven
Chapter Forty-Eight
Chapter Forty-Nine
Chapter Fifty
Chapter Fifty-One
Chapter Fifty-Two
Excerpt from The Embalmer
About the Author
Other Books by Tanya Goodwin
Foreward
Fugue
The Merck Manual defines dissociative fugue as one or more episodes of amnesia resulting in the inability to recall one’s past and the loss of one’s identity accompanied by the formation of a new identity with sudden and unexpected travel from home; a traumatic nature that isn’t explained by normal forgetfulness.
The DSM IV (a diagnostic manual of psychiatric disorders) characterizes dissociative fugue by sudden and unplanned travel from home, inability to recall past events or important information from the person’s life, confusion or loss of memory, and significant distress or impairment.
Although it’s rare, fugue can happen to those that are chronically stressed, often with a major inciting event noxious enough to catapult them into a fugue state. It’s the brain’s defense mechanism, and eventually resolves within days, weeks, or months, leaving them unaware of occurrences during their amnesic state. They are fully functional but may not recall their identity or parts of their identity. They are often called travelers since they wander or travel away from home. Their nomadic adventure generally occurs after a stressful event.
Chapter One
NEW YEAR’S EVE December 31 - On Call
Tara’s beeper blared, rousing her from the hospital’s call room bed. She had just closed her eyes after delivering two boys, one girl, and a set of twins, one of which dallied for thirty minutes, enjoying the roomy womb for himself. She glanced at her pager. The labor and delivery extension followed by 911 scrolled across it. Her heartbeat rocketed.
Cinching the ribbon of her blue scrub pants around her waist, she stumbled out of the call room and bolted down the hallway, followed closely by the clapping of rubber-soled shoes scurrying across the linoleum tiles of labor and delivery unit. Catching a glimpse of the night shift nurses’ backs dashing into labor room five, Dr. Tara Ross ran into the room behind them. Smoothing her rumpled short brown hair, she assessed the chaos.
“No,” the laboring woman screamed. She rolled from side to side on the labor bed. Her arms were wrapped across her pregnant belly, her sweaty blonde hair plastered to her pale cheeks.
“Oh my God,” Tara mumbled. She recognized Alexis Kent, the woman that had left her practice against medical advice.
“I can’t get an IV in. She’s completely out of control, and her veins are collapsed,” the charge nurse said.
Another nurse scooted a fetal heart monitor along Alexis’s belly. “I get 120 beats per minute, Dr. Ross.”
Tara palpated Alexis’s rigid abdomen and then checked her pulse -120. The nurse had heard the maternal pulse, not the fetal heartbeat.
Another nurse glanced at the Dinamap monitor. She darted her eyes toward Tara. “Her blood pressure is 80/50 and her pulse ox is down to 95 percent.”
Alexis shut her eyes and lolled her head against the pillow. Her pallor camouflaged her body among the white hospital sheets.
Tara licked her parched lips. She feared this would happen. With two prior cesarean sections and this baby in a breech position, she had advised Alexis to have a repeat cesarean section for her, and her baby’s, safety. Despite Tara’s deep concern and multiple conferences with Alexis and then pleas, Alexis left Tara’s obstetric practice, desiring a home birth with a lay midwife.
Tara stroked her patient’s damp forehead. The woman’s eyelids fluttered open. “Alexis, you need to have a c-section immediately. The baby is in distress, and you may be bleeding internally. I need to deliver your baby now.”
She glanced at the waiting nurses. “Let’s roll her back to the OR!”
A nurse tightened the rubber tourniquet around Alexis’s arm and took one last jab into her antecubital fossa. Drops of dark red blood dripped from the hub of the 18 gauge IV catheter.
“I’m in,” she called and handed the blood-filled syringe to a lab tech for a stat type and cross.
The Chief of Anesthesiology at Brewster Medical Center poked his head into the labor room. “Alexis, Sweetheart, I’m here.” Panting, he ran over to her and cradled her head in his hands. “It’s going to be okay,” Dr. Robert Upton told his daughter and leaned over to kiss her forehead. Then, banging the side rails, he yelled, “Let’s go people.”
The on call anesthesiologist stood in the doorway and said, “I’m all set in the OR, Dr. Ross.”
He turned to address Alexis. “Alexis, I’m Dr. Morris,” he said calmly. “I’m going to be your anesthesiologist.” He then introduced himself to Alexis’s husband, Bradley.
Bradley, pressed against the far wall of the labor room, stared straight ahead, clutching his toddler daughter with one arm and gripping his little boy’s hand with the other.
Tara touched him on his shoulder. “We’ll take good car
e of her.”
Bradley blinked and nodded. His lower lip trembled. The nurses gave the wheeled hospital bed a shove and rolled the bulky bed toward the door. The black wheels of the bed shimmied and squealed around the corner steering like a rickety grocery cart. Tara ran along one side of the bed, Dr. Upton along the other.
Barely conscious, Alexis no longer screamed. Her body jostled between the side rails. It was only when the bed bumped the doorframe as the nurses pushed it into the OR, that Alexis stirred briefly, and then shut her eyes again.
Alexis’s midwife trotted behind the rumbling bed, frantic. “She didn’t want to deliver at the birthing center so I came to her house. Her cervix had dilated to five centimeters without a problem. Then she just started screaming. I knew something was wrong. Bradley carried her to the car and rushed her here. I’m so sorry.”
Tara quickly put on her scrub cap. “We’ll talk about this later. I need to get in the OR.”
Dr. Edouard LaCroix burst through the steel double doors of the OR hallway. “I got here as fast as I could, Tara.” He turned toward Bradley and Dr. Upton. “I understand you’re scared, but Dr. Ross and I will do our best for Alexis.” He glared at the midwife and said nothing.
Tara gently pried Robert Upton’s curled fingers from the bed’s metal side rails “Dr. Morris is a good man. I know you trust him. Stay with Bradley and the children in the waiting room. He needs you, right now. I promise I’ll tell you what’s happening.”
He nodded. “Thank you.”
Tara and Edouard, armed with scrub caps, masks, booties and a prayer, stood at the scrub sink.
Edouard wasn’t a tall man, but muscular. His bright blue scrub cap matched his intent eyes behind the glass of his oval wireless frames. He tucked stray brown wavy hairs under the band of his cap and gazed into her bloodshot eyes.
“You look exhausted.”
“It’s been a crazy night. And it’s about to get crazier.”
“Darling, you warned her. You can’t control everyone and everything. Tonight will end. He shot her a reassuring grin. “Then you can sleep it off ... in my bed.”
Tara and Edouard had practiced obstetrics together for six years now. They had practiced dating for the last six months.
He wanted more—now.
But she needed room to breathe, to contemplate the complications of intimacy with a business partner, hesitant to enter into a committed relationship after her recent divorce. And then there was Abbie, her fifteen- year-old daughter, to consider.
The scrub nurse methodically counted the instruments and lap pads while another painted Alexis’s belly with a Betadine-soaked sponge until it gleamed deep maroon.
Tara and Edouard unfolded the sterile blue drape over Alexis’s body, her rounded belly jutting through the oval cut of the covering, the tackiness of the Betadine solution sticking to the edges.
Dr. Morris injected a sedative and muscle relaxant into Alexis’s IV and then quickly inserted her breathing tube. “You’re good to go.”
Tara pressed the silver blade of her scalpel to Alexis’s skin, incising a vertical cut from her navel to just above her pubic bone. Being an emergency Cesarean, there was no time for cosmetic consideration. She and Edouard toiled their way through the fascia and entered the peritoneal cavity. Their eyes met. They blinked at each other. They immediately recognized what was right there, in their hands. The placenta was shoved out of the fractured uterus—a tiny hand flopped across it, bathed in a sea of dark green amniotic fluid. She pushed the baby’s hand back into the torn uterus and extracted the limp little girl, grasping her feet.
“I have a ruptured uterus here with placental and fetal expulsion,” Tara called to the neonatologist. “Meconium. Floppy baby coming your way!”
She handed the tiny girl to the neonatologist, dreading she was giving her a dead baby. The pediatric specialist performed the obligatory resuscitative measures.
She shook her head. “Sorry, Tara.”
Tara and Edouard struggled to control the bleeding, but Alexis’s torn uterus could not be salvaged. Her hemoglobin had dropped to a dangerous six. Alexis grew paler with each passing minute, and the anesthesiologist squeezed the fifth pint of blood into her IV.
Tara looked at Edouard. “We’ve tried everything.” Droplets of sweat dotted her forehead. “We can’t go on much further. She’s bleeding out. She needs a hysterectomy.”
“I agree. We don’t have any more options.”
Tara glanced at Dr. Morris over the brim of her surgical mask. “We’re going overtime. How’s she doing?”
“As long as the blood’s coming, then we’re holding.”
A lab tech entered the OR and handed the anesthesiologist three more bags of blood. Tara spied Robert’s face through the crack of the OR door as he peeked into the room. She knew he wanted in there, it was his daughter she was working on. Hell, she would want the same thing if this were her daughter. But he was family. This was no objective case for him.
Tearing her gaze away as blood cascaded down the blue drape covering Alexis’s body, Tara reached up and adjusted the OR light, focusing it on her operative field, the glare from it glinting dully off the bloodied tools.
No baby cried.
Robert, Tara was sure, had to be alarmed. He knew what it meant, not to hear his grandchild take its first breath.
Her chest heavy at the thought of relaying the somber news, Tara called out from beneath her blood-spattered surgical mask, “Robert, I’ll be right out.”
She glanced at a nurse, “I can’t leave the OR now. Get Robert and Bradley in a private area to wait. I’ll speak to them as soon as I can.”
“Will do, Dr. Ross. I’ll get them ready. That is if there’s ever a ready.”
The neonatologist left the OR too, with the baby girl swaddled in her arms while Tara and Edouard completed Alexis’s surgery. After the emergency hysterectomy, the nurses and the anesthesiologist transported Alexis to the Intensive Care Unit. Only Edouard and Tara stood in the OR now.
He whispered in her ear, “You did the best you could in a tough situation. Let’s go talk with Robert and Bradley. Then we’ll go back to the call room.”
She squeezed his hand. They ripped off their bloody gowns, gloves, and surgical booties and then left the maroon spattered room—bumping right into Robert Upton.
“Robert, come with me and we’ll talk. Where’s Alexis’s husband?” Tara asked.
“We’re all in the waiting room.”
“Are there other people there?”
Robert shook his head. Tara swallowed hard, seeing tears welling up in his eyes.
“No, not tonight,” he replied.
They walked together to the surgical waiting room. Bradley sat solemnly in a chair, staring at a wall while his children slept on the sofa, blissfully oblivious to the whole ordeal.
Tara pulled up a chair and sat across from Bradley. Edouard stood quietly behind her.
She rested her hands over Bradley’s fingers, which were tightly folded into a blanched ball.
“Bradley, Alexis had a complication. Her uterus ... womb ... ruptured.” She paused and took a deep breath. She had to tell him. “Your baby girl did not survive.”
Bradley sank his head into his hands and sobbed. No one spoke for several minutes. Minutes that felt more like an hour.
Bradley composed himself enough to say, “Okay, go on.”
“When her uterus ruptured, the placenta—or afterbirth—became detached. The baby could not survive without the oxygen supply of the placenta.”
“When did that happen?” he asked.
“I don’t know, but it had been a while.”
“How’s Alexis?”
“Alexis needed several blood transfusions, but despite all our efforts, we had to proceed with a hysterectomy in order to save her life. She’s in the ICU. Her bleeding is under control, but she’ll need close monitoring.”
“Thank you for saving her.”
Robert rubbed his eyes.
“This is so hard for all of us. You did the best you could, Tara. And that has kept my daughter alive.”
Tara drew a deep breath, stemming the tears so close to pooling in her lower lids. “I’m so sorry, Bradley, Robert.”
“Thank you,” they said softly and in unison.
Bradley grasped Tara’s hand. “When can I see Alexis and the baby?”
“Alexis is still sedated. She’s in the intensive care unit. I can take you to a private room where you can spend time with your daughter. Would you like to do that?”
“Yes,” he said. He turned to Robert. “I’d like you to be there too.”
“Absolutely,” Robert replied.
He hugged his son-in-law. Bradley scooped up his sleepy children. Tara opened the waiting room door and ushered them into an empty patient room.
“I’ll be right back,” she said. Clicking the door closed behind her, Tara paused. Her head buzzed, and her stomach tightened with anxiety.
She returned, carrying the lifeless babe, wrapped in a white cotton blanket, a pink knitted cap crowning her tiny head. Tara placed the infant into Bradley’s arms.
“She’s so tiny. So beautiful,” Bradley murmured.
Robert peered inside the blanket and gazed at his granddaughter. “Yes, she is beautiful.”
They took turns holding her, sobbing into each other’s arms.
****
Tara shuffled to the call room. Her eyes burned, and her legs felt brick heavy. The door was ajar. Edouard sat on the edge of the bed, patting the mattress, beckoning her to sit next to him. The metal frame groaned as she sank into the bed and scooted to his side, too exhausted to cry. She shut her eyes as Edouard’s placed his hand on her shoulder. The pang in her chest squeezed her hard. She shifted on the bed, pressing against him, praying for comfort that never came.
“I’m so sorry you had such an awful night.” He leaned into her and kissed her head. “Happy New Year.”
“Shit. It’s New Year’s Day. I completely forgot.” She licked the saline from her lips.
“Get some rest. We’ll have plenty of time together at the Vegas conference.”