Two doctors. One killer. One woman in labour.
A killer infiltrates the obstetrics ward of a Montreal hospital just before Christmas, taking one pregnant woman and one resident doctor hostage at gunpoint.
Dr. Hope Sze struggles to deliver her patient’s baby with blood on the floor and death in the air.
And when Dr. Tucker tries to rescue their tiny crew, only to end up hostage material alongside them, Hope’s heart just might break, even before the kidnapper drills a bullet through her skull.
I will preview the first six chapters on my blog.
I’m not saying it stinks—well, to some people, it does. I remember the classmate who finished our med school OB/gyn rotation without ever delivering an infant. He delivered half of the head, and then the look on his face was so horrid that the obstetrician delivered the rest of the baby.
I’ve got a stronger stomach than that classmate, but when I stepped into the delivery room at Montreal’s St. Joseph’s Hospital, it only smelled like sweat and a little blood. The odours would grow more intense once the amniotic fluid broke and the afterbirth emerged, but for now, I didn’t hold my breath.
My eyes adjusted to the darkness. The nurse had turned the lights off, except for a small fluorescent lamp beside the bed. The baby’s heartbeat chugged along on the fetal monitor. Whump, whump, whump at 162 beats per minute.
Most of obstetrics is nice and normal. Even our C-sections tend toward planned events instead of crash OR’s. They screen out congenital abnormalities at our small, Canadian community centre.
“This is the only happy area of the hospital!” an obstetrician told me on my first day. “Everybody’s smiling!”
The black woman labouring in the bed wasn’t smiling. She was sweating. Which made sense. “That’s why they call it labour,” the nurse often says, while the woman recovers from the latest contraction. That’s normal, too.
So I was pretty surprised when my obstetrics rotation transformed into a bone-chilling bloodbath.
But that evening of November fourteenth, I didn’t suspect anything except the fact that I might not get to eat the lentil casserole I’d stashed in the residents’ lounge for supper. I smiled at my newest patient, Ms. Beauzile. The nurse had cranked the back of the bed up so that the patient was half-sitting, squinting at me from her pillows, with her legs bent at the hips and knees, and her thighs spread over a foot apart. Can’t say I’m looking forward to the indignity, should I ever get the chance to procreate. Especially if I had to labour solo, like this lady.
According to the electronic whiteboard posted in the nursing station, Ms. Beauzile was 28 years old, or only a year older than me. This was her first baby, and she was at six centimetres, or sixty percent en route to pushing out this passenger. She also had a low-grade fever of 38.1 Celsius, but the med student had noted that they weren’t giving her antibiotics, because she had a runny nose and they figured it was a cold. Good call.
“Madame Beauzile, I’m Dr. Hope Sze. I’m the resident doctor on call for obstetrics.” I glanced at the top right hand corner to find the stamp with her first name. It was one I’d never heard before, and sounded Russian to me: Manouchka.
Now was not the time to inquire about how she got such an unusual name. Not when she clutched the white plastic bed rails, dragging herself forward with both arms, heaving herself to 90 degrees, and started to huff.
The nurse grabbed her hand. “Yes, Manouchka! That’s it!”
I took a step forward and said, “Yes! Keep going!” I felt silly, since I was crashing their two-person party and didn’t really know how to encourage her.
But after half a minute, the patient sighed and settled back down in the bed. The dim, yellow light reflected the sweat on her deep brown forehead. The baby’s heart rate, which had only slowed down to 139, climbed back up again. The mini-contraction was over.
“Next time,” said the nurse, studiously ignoring me. OB nurses generally hate medical students and residents. You have to prove yourself. They’d rather you left them alone while they coach the patient through labour and handle, well, just about everything else.
This Asian nurse was shorter than me, which always gets me excited, since I’m only five foot two and a quarter. (The quarter makes people laugh, but it adds up to 158 centimetres instead of 157, and I’ve got to treasure every millimetre.) Her hair was a short bob, not unlike the cut I’d sported over the summer, until I decided to grow my hair down to my shoulders. Like me, she wore glasses. When I’m on call, I’m all about the glasses. Not only do they dry out my eyes less than contact lenses, but they’re also a built-in eye shield from bodily fluids.
However, the nurse was probably twenty years older than me, wearing fashionista-frightening purple scrubs covered in owls, and scowled like she’d rather push my face into a newly-delivered placenta than shake my hand. Too bad. Sometimes, I’ll meet another Asian and we’ll nod at each other in recognition, but not this time.
The speaker built into the wall at the head of the bed crackled with static. “Do you have a visitor in there?”
The nurse pressed the red button mounted on the wall. “No, it’s just the resident.” She had a way of biting off her words that sounded maybe Filipina.
“The junior obstetrics resident, Dr. Sze,” I called out. I tell people to pronounce it like the letter C.
The nurse snorted. Her flowery name tag, clipped to her already-blinding purple scrub top, said JUNE, but she seemed more like a porcupine, to me.
The intercom crackled, and the unit secretary’s voice quavered, “We’ve got a woman here saying that her friend is in one of the case rooms. Casey? Maybe she’s with Dr. Beeman?”
“I can’t help you,” said June, letting go of the red button and turning back to Manouchka.
My pager beep-beep-beeped.
I had a feeling it was Dr. John Tucker, so I grinned even before I turned the pager so that its little plastic face could tell me who called. I shouldn’t have been smiling. I should’ve been keeping my distance from him, since I’d officially contacted the University of Ottawa about transferring so that I could finally move back to my hometown and back to Ryan Wu, my past and present boyfriend, ideally before the end of 2012. And I usually yell at Tucker for paging me when I’m on call, when I’m already pulled in ten million directions. But he was also on call, albeit one floor up, and I could use a friend plus or minus benefits.
It wasn’t Tucker.
It was 3361. My senior resident, Stan Biedelman.
I’d have to answer it back at the nursing station, since the phone in the room belonged to the patient, and I didn’t want to use up my iPhone battery or my personal minutes. St. Joe’s was too cheap to give every resident a hospital phone. “Excuse me, Ms. Beauzile,” I said. “I’ll be back.”
She turned her cheek away from me, her face puffy with pregnancy. Her hair tufted against the pillow.
I hadn’t even had a chance to check her cervix. I don’t always, because the fewer hands travelling up the va-jay-jay to contaminate the amniotic fluid, the better.
Luckily, the delivery rooms, or case rooms, are lined up one after the other, on the right side if you’re heading down the hall, and mine was directly opposite the nursing station on the left. So it was less than ten strides to the nearest beige phone sitting on the counter. I punched the four-digit extension in and introduced myself.
“There’s a consult in emerg,” said Stan, who’s only a year ahead of me in the family medicine program. “Vag bleed at ten weeks.”
That was slightly unusual. Nearly all our emergency consults are for vaginal bleeding at five to seven weeks, from women who may be miscarrying. Ten weeks is a bit late.
“It’s Dr. Callendar on, so you know what that means,” said Stan.
I did. It meant that he hadn’t done a vaginal exam. Theoretically, the emergency staff should do a complete physical exam, but if they’re lazy like Dr. C, they’ll slog it off on the specialty service. Tonight, that meant me. The rash on my ankles started to itch under the cuff of my socks. I started playing with the tinsel on the desk so that I wouldn’t scratch myself or say something I’d regret.
“Page me when you’re done, and we can talk to her together.”
“Thanks,” I said. Still holding on to the phone receiver, I walked around the counter to eyeball the whiteboard mounted above the clerk’s head. They keep it inside the nursing station for patient privacy. We only had three patients, including Ms. Beauzile. If I was going to deliver any babies before supper, she was my best bet. I grabbed the mouse, right-clicked her name, and added my name beside Ms. Beauzile’s, so Stan or the medical student shouldn’t try to swoop down and steal her.
I’d only delivered two infants as a medical student—not so many more than my queasy med school friend—but I had to liberate at least fifty this month, because St. Joseph’s has an unofficial quota. For every month on OB, you’re supposed to check off at least fifty newborns. If it’s a less fertile month, tough. Elbow the medical students out of the way and try and get the other resident to take over the wards while you run to the case room a minimum of fifty times.
So far, I’d delivered two babies in my first two days. Not bad, but I’d have to step it up if I was going to make quota before December tenth. I remembered something else to tell Stan. “Oh, by the way, the clerk said someone was looking for you. I assume it was you, anyway. Dr. Beeman?” Sounded kind of like Biedelman. I’m used to people massacring my last name.
“If they need me, they know where to find me.”
“Three-three-six-one?” I said, citing his current extension.
“Yeah. You got my cell phone, too, but don’t give it out to strange men.”
“Strange women okay?”
“Yeah. Just don’t tell my wife.”
We both laughed, and I hung up, forgetting to tell him not to steal my delivery. Oh, well. He was probably too busy eating Cheetos while I slogged away, but it didn’t bother me. Much. The junior always does all the work. Or, as Jade, a second-year resident, pointed out after a particularly terrible emerg shift, “Shit rolls downhill.”
The ER is kind of the mosh pit on the ground level where every man, woman, and child in Montreal ends up before we sort them out, and also where I want to work when I grow up. First, I had to get out of the labour and delivery area. I’m not sure why we call it the case room, because it’s basically a series of four rooms along the hallway, across from the nursing station. Up to four women can labour at once. If you continue past the case rooms to the end of the hall and turn left, along the bottom of a U shape, you’ll come out at the OR for emergency C-sections.
Instead, I forged a straight line in the opposite direction, toward the elevators. I passed a pregnant woman in a black burqa shuffling in the same direction. We often see women who wear head scarves—actually, I’m the one who gets them, because they invariably ask for a female doctor, and I often smile when I spot the trendy clothes underneath—so maybe this one would be my second delivery of the night. She was moving a little oddly, though. Not quite waddling, but kind of stiff-legged, although it was hard to tell because the fabric covered her from head to toe. The hem swept the floor, and the material hung over her hands, with only a letter slot opening for the eyes.
I turned sideways to pass the two couples waiting for triage. The women’s glazed eyes flickered past me. They were already tired, even before going into labour and actively pushing. Neither of them wore that eager, first-time relish. These women and men probably already had a kid or three at home, and wanted to get this over with so that they could start a new routine.
Triage is a doleful spot at the top of the corridor, because patients are waiting for one nurse to decide if they’re far enough along in labour to warrant being assigned to one of those four rooms, or if they’re going to get told to walk around and come back later. We also do non-stress tests here, or NST’s. Sounds horrible, but it just means a pregnant woman is strapped up to a monitor and we check the fetal heart rate for twenty minutes, to make sure it’s okay.
Usually, I’d sweep straight down to the emerg, the better to catch more deliveries. Instead, I glanced over my left shoulder. My potential new patient wore the most extreme sort of burqa, with a type of fabric grille over the eye opening. I couldn’t make out her expression, which freaked me out a little. Still, she was pointed toward triage, which was probably the right place for her, although it was hard to tell under all that cloth.
One lucky couple entered the triage room, leaving just the other couple in the hallway. Instead of queuing behind them, the burqa woman slowly passed them, following in my footsteps.
My eyes followed the burqa lady. My gut was trying to tell me something, although I couldn’t exactly tell what.
I had to finish the emerg consult before Manouchka delivered her baby. I should have shot right downstairs, but that nagging feeling made me wheel back toward the burqa woman, and I found myself saying, “May I help you?”
The figure in black turned toward me without speaking.
The same uneasy vibe made my scalp tingle and my voice rise. I said, “Were you asking for Dr. Biedelman? He’s a male physician. If you want a female physician, I can help you. I’m the junior resident on obstetrics and gynecology.”
The woman in black looked me up and down, still silent.
I was trying to peer through the grille of the veil. I figured I had to be able to look in so that she could see out, yet all I could make out was a bit of pale forehead and some deep brown eyes. The eyebrows seemed a bit bushy to me, which could’ve been a cultural thing. Or she didn’t have time to groom her eyebrows while she was in labour.
“Okay,” I said. I didn’t know why I was trying to save Stan more work. I was already doing the emerg consult for him.
I spun on my heel, toward the wider hallway in front of the elevators. I narrowly avoided running into a pregnant woman with bright blonde hair, a well-cut navy coat, and enough bling on her hands to blind an army. She clung to her husband’s arm. He was wearing a good-looking suit and surveyed the queue in front of him, his forehead already pleated with exasperation. They looked like money. You don’t see that often at St. Joe’s. Not that we don’t have middle class, but a lot of people are immigrants adjusting to a new country, not the Kennedys slumming it.
A set of elevator doors binged open to my right, and Stan stepped through the candy cane-stickered doors, coming toward me. He’s a big guy, probably six feet tall, made a few millimetres taller by a yarmulke. I’m not good at gauging heights. For me, most adults fall into the category of “tall” and “taller.” Anyway, Stan’s hilarious. I prize anyone who can make me laugh when I’m on call.
I started to wave at him. He said, “If I don’t answer my page, it’s because I’ve got a woman in labour.”
“Who?” I said. “The one at six centimetres, I’ve got my name down on her.”
“Mine just came in. She’s full term and fully dilated.”
“I want her!” I said.
He smirked. “Not a chance. The nurse called me about her directly. She’s gonna push. And you’ve got the emerg consult.”
I clenched my hands into fists. He glanced down at them with a little smile, so I forced my hands to relax as I asked, “Stan, how many women have you delivered so far?”
“Let me see.” He pulled out his phone and pretended to check. “Oh. Eleven.”
“I’ve only got two. Let me have her, and then I’ll go right down to do the emerg consult. Please.”
“Forget it. I’ve got to get to fifty.”
“But you’re already over 20 percent of the way there! And we’re on day three. Come on, Stan.”
He waved. “Hey, enjoy Dr. Callendar. I did, when I was the junior. Now it’s my turn.”
Right. His turn to cherry-pick the women in labour. I steamed.
“Your turn will come. You said you had your name down on the six-centimetre one. All in good time.”
With my luck, Manouchka Beauzile would deliver while I was in the emerg, at the exact moment when Stan miraculously stepped into the room. Then I could end up with zero deliveries during my night on call. I took a step toward him. “Stan.”
He waved me away. “See you later, Hope. Look, the elevator’s already open for you. Just ride it on down.”
As if on cue, the usually molasses-slow elevator doors slipped closed. Stan chortled.
I wanted to hit him. He was so smug. And anyway, I usually took the stairs, at least at the beginning of the night, while I still had some juice. The stairs were around the corner, closer to the ward rooms where moms cuddled with their newborns and a few women lay on bed rest, trying not to give birth to premature twins. I started toward the stairs, but the burqa woman said, in a muffled voice, “Excuse me.”
She stood before the single doorway to the case room, blocking Stan’s way in toward triage and the labour rooms.
Stan hesitated. “Yes?” He gazed over her head, down the hall, clearly already ticking off number twelve in his mind.
She didn’t have an accent, exactly, but she pitched her voice low. “What is the name of your patient?”
That was an odd thing to ask.
“Sorry, I can’t disclose any patient names,” said Stan, glancing at the triage line-up behind her.
“It’s important,” said the woman, crossing her arms over her shoulders, like she was cold and giving herself a hug.
“Just ask at the desk, if you’re a friend or family,” said Stan, starting to brush past her. I could already hear the triage nurse’s voice, raised in irritation at the blonde couple trying to cut ahead in line.
“Tell me,” said the burqa woman, louder now, with a strange note to her voice. The fabric billowed around her arms and chest.
“No can do,” said Stan, head down and bustling toward the case room and his next delivery.
The burqa woman pulled a big, black gun out of the folds in her robe and shot him in the back.