Crossroads

Chapter Eleven

At eight a.m. Tuesday morning, Annie drove to Kathy Murphy’s home in West Mt. Airy, a short ten-minute drive from her apartment. Kathy still had almost four months to go before she delivered her second child. Today was a routine checkup. Annie liked seeing patients in their homes—the mother-to-be was most relaxed and confident in the familiar setting, and that safety helped ground the entire birth process in a positive light, from the progression of the pregnancy through delivery and aftercare. Kathy was waiting on the front porch in a white wooden swing hung from colorful braided ropes set in the ceiling, her five-year-old by her side and an open children’s book covering their laps.

“Hi,” Kathy called, smiling brightly. Her daughter Grace waved enthusiastically as Annie came up the walk.

“Hi.” Annie smiled and waved back to Grace. “Beautiful morning.”

“Isn’t it? I love this time of year,” Kathy said. “It’s a great time to be pregnant.”

Annie laughed. “That’s the spirit. How is everything?”

“Fine. Well, almost.” Kathy frowned for a second and pointed to her feet. “All except for that. I was hoping not to see that again until closer to the end. It’s not even June yet and I’m swelling.”

Annie kept her expression neutral as she glanced at Kathy’s ankles. Both were swollen for several inches above the joint. Pedal edema was common in the last several months of pregnancy when the pressure in the abdomen from the expanding uterus and growing fetus impaired the return of blood and lymph from the lower extremities. Six months was early to begin seeing this much fluid collecting, though, and could signal problems. Annie settled onto the swing on the other side of Grace. “When did you start seeing it last time?”

“Oh, not much to notice until almost the last month, I guess.” Kathy closed the picture book and lifted Grace down to the floor. “Honey, Nana’s in the kitchen. I think she might like your help with breakfast, okay?”

“Okay.” Grace scampered into the house.

“How have you been feeling otherwise?” Annie asked.

“A little more tired than I remember being with Grace, but then I didn’t have a five-year-old to keep me running, and I’m five years older.” Kathy laughed. “I can’t go all day like I used to—I have to take a nap.”

“Believe me, I know what you mean.” Annie chatted with her for a few minutes about Kathy’s family and her husband’s new job and then said, “Let’s go inside so I can check you over. I want to get a couple of blood tests too, just to make sure the swelling isn’t going to give us problems down the road.”

“Okay,” Kathy said.

Annie went back to her car and got her med kit. Inside, she followed Kathy upstairs to the bedroom, checked her pressure and vital signs, listened to her heart and lungs, and drew blood samples for chemistries. “I’ll call you when I get the results, otherwise I’ll see you next month. Is the same time good for you?”

“I’m not planning on going anywhere,” Kathy said. “Just have them call like they did the last time, a couple of days in advance.” She patted her belly. “We’ll be here.”

“Then so will I.”

After making a few more house calls, Annie drove to the birthing center to see patients scheduled for ultrasounds or other tests. She finished at eleven thirty and went to her small cubicle in the staff area to write up her notes. She checked her watch. Eleven forty-five. She’d be seeing Hollis at one.

She set her pen down on the open chart. No, she wasn’t meeting Hollis today. She was meeting Dr. Monroe. She had to keep that in mind. As charming and surprisingly sweet as Hollis could be, their relationship had to remain strictly professional. What they needed to accomplish was too important to complicate with personal feelings, especially since Dr. Monroe was very likely to be more an adversary than the woman who had listened to her so intently two days before. Hollis had almost made her believe her experience with Jeff had been more a triumph than the disaster she’d always thought it to be.

She couldn’t forget that Hollis and doctors like her often needed convincing that midwifes were capable and competent and had an important role to play in the care of women and their children—at the very least. Some were blatantly hostile. Annie closed her eyes and rubbed her temples. She really ought to call Barb and tell her she was the wrong person for this job. She didn’t want to collaborate with OB doctors to begin with, and now she had to deal with someone who tangled her up inside and made her forget what had always been a clear and certain path.

“Headache?” Barb asked from behind her.

Annie jumped and spun around on her chair. “No—just thinking.”

Barb leaned against the partition separating Annie’s space from the two adjoining work areas. They were both empty at the moment. As the administrative director, Barb had an office of her own down the hall. She was dressed as usual in pressed pants and a crisply ironed shirt, low heels, and no jewelry other than her wedding ring and watch. In her mid-forties, she was an avid proponent of advancing the rights of midwifes to train and practice independently. Knowing Barb believed as passionately as she did in the cause helped Annie accept that sometimes compromise was a necessary step toward achieving a goal.

“Anything to report on the task force?” Barb asked.

“Not yet,” Annie said. “We got…sidetracked on Friday and are meeting again today. I have to say, though, Barb, I’m still not convinced this is a good idea. So few of our patients ever need referral, I don’t see why—”

“Last month when St. Vincent’s closed in Manhattan,” Barb reminded her, “thirteen New York City midwifes lost the legal right to practice because they had no physician group willing to support them in an emergency. It might be a matter of paperwork now, but we can’t be caught in a position like that. We need to build our bridges now to secure our practice.”

“Maybe instead of spending our efforts getting the support of a group that looks down on us, we should be publicizing the data that shows we provide better, safer care for pregnant women.”

Barb sighed. “You know statistics are just numbers that show general outcomes. They can’t be applied to every physician. There are plenty of wonderful OBs. We don’t want to tarnish them any more than we want them to dismiss us.”

“I know.” Annie pushed her hair out of her eyes and ran her fingers through the thick strands. “I know. You’re right. Honestly, I do understand. It just makes me so angry.”

“And I understand that.” Barb squeezed Annie’s shoulder. “But you’re the one I want on this. Let me know if this doctor looks like she’s going to be an obstacle. We’re not completely without resources, you know. The chairman over there is behind us, and if I have to, I’ll put some pressure on him to get his people to fall in line.”

“I’ll let you know how it goes. Hopefully we won’t have to go there,” Annie said. The idea of putting pressure on Hollis or going behind her back made her instantly uncomfortable, and that was another of her problems. She couldn’t be worried about Hollis when she should be focused on what she needed to accomplish.

“I’ll let you get back to work,” Barb said. “Remember, my door is always open.”

“Thanks.” Annie turned back to her desk and picked up her pen. She had work to do. Then she had a meeting with Dr. Monroe. She just needed to keep thinking of Hollis that way and everything would be fine.

*

Hollis finished clinic only twenty-five minutes late and grabbed a couple of hot dogs from the street vendor outside the hospital on her way to her office. She had half an hour before Annie was due to arrive for their meeting. Whenever she’d had a minute between patients, she’d thought about Annie. She’d had a restless night, remembering standing in the rain with her, talking about things she never talked about, wanting to know more about Annie than she had any other woman, even Sonja.

Annie’s story humbled and inspired her. Listening to Annie, trying to imagine her life, she’d realized as never before how lucky she had been. She’d grown up in a family where anything was possible. Even though she’d been the only girl, she’d never felt there was anything she couldn’t do, and she’d never gotten the message from her parents or her brothers she shouldn’t try because she was a girl. Rob had been the oldest, her role model, and he’d been as tough on her as he’d been on their four brothers. He’d been good at everything—the golden boy who never let his success tarnish his glow. He’d been second in his class, prom king, a star athlete. He’d married the prom queen right out of high school, as his father before him had done, and like his father, he’d joined Engine Company 447.

She’d wanted to be just like Rob. She’d had to play harder to keep up, and work harder sometimes, because everything was so clear for the boys. They grew up knowing who they were and who they would become—they’d be firefighters like their father, or police officers like their cousins, and none of them had wanted to be anything else. She could have been a firefighter—her father might have wanted her to pursue a safer career but he would have supported her if that’s what she’d wanted. But she’d wanted something else and that had been all right too.

“Go for it, Hol, you can do it,” Rob had said, and she’d believed him.

Annie hadn’t grown up with many choices, but somehow she had found herself and her way. The price she’d paid had been steep, the path plagued with pain and disillusionment. Listening to Annie tell her story, Hollis had wanted to go back in time and change the young Annie’s first experiences with a world she hadn’t known existed. She still wanted that. She wanted to be the one to take Annie to the theater for the first time, and walk with her along the river at sunset, and watch her laugh at the antics of the ducks chasing bits of bread thrown by children in the park. She wanted to be the one who showed her how much there was to life, even though she knew that wasn’t possible. She’d dealt with tragedy enough to know one could only go forward. The past was written and couldn’t be unwritten, no matter how much she wanted to. Sighing, she walked into the office. This was her world, the one she had made, the one she knew.

Sybil gave her a quizzical look. “Problems?”

“What? No,” Hollis said.

“So.” Sybil’s eyebrow shot up and she pointed to Hollis’s face. “What happened to you?”

Hollis grimaced. “Volleyball.”

“I don’t know what I find more surprising,” Sybil said. “That you were playing volleyball or that you managed to get hit by one.”

“Ha ha.” Hollis set the hot dogs down, picked up her mail, and leafed through it. “Freak accident. We were winning.”

“Of course you were.” Sybil smothered a smile. “Anything happening in clinic?”

“Nope. Everything’s routine for a change.”

“Okay.” Sybil picked up an old-fashioned steno pad Hollis didn’t think they even made any longer. Sybil probably had a private stash. “Medical records called about some overdue discharge summaries—I put them on your desk.”

“I’ll do them.”

“Today, please.”

“Right.”

“Larry Anderson called from University, and they want you to do OB-GYN grand rounds there next month. I told them it would have to be the last weekend because you were full otherwise.”

“Okay,” Hollis said absently, tossing drug promotions in the trash and signing office copies of operative notes she’d dictated. “Remind me to pull slides that Wednesday.”

Sybil made a note. “The chart you wanted me to get is on your desk too.” She paused. “That’s the same Annie Colfax you’re meeting with in fifteen minutes?”

Hollis squared the paperwork she’d just signed and placed the neat stack in front of Sybil. “Yes. That’s her. Thanks for pulling the chart.”

“I didn’t read it, by the way.”

Sighing, Hollis rolled her shoulders to ease the sudden tightness. “She was a patient of mine briefly, four years ago. Emergency C-section.”

“You know, it’s not that much of a coincidence. You’ve got a lot of patients in the medical field. They know the score—it’s only natural they’d want the best.”

Hollis smiled ruefully, wondering what choice Annie would make today. Another thing she hadn’t been able to choose. No wonder she was angry. “Thanks. You can send her in when she gets here.”

“Of course.” Sybil made a face at the hot dog bag leaking a faint orange substance. “Go eat your lunch. Those things are deadly enough when they’re hot.”

“I’m on it.” Hollis carried the offending objects into the other room and settled behind her desk. Annie’s chart sat alone by her right hand. She pulled it in front of her and stared at the closed manila folder with the plastic numerals along the side—Annie’s patient number spelled out in six multicolored digits. She knew what was in the chart. She remembered examining Annie, remembered making the incision and lifting Callie from Annie’s open uterus, and the bleeding that she couldn’t stop. The bleeding that she’d been certain wouldn’t stop unless she did something about it, and quickly. She didn’t open the folder. She picked up the phone instead.

“Dr. Ned Williams’s office, may I help you?”

“It’s Hollis Monroe. Is he there?”

“Oh hi, Hollis, no, he—wait a minute, he just came in. Hold on.”

“Hey, Hollis,” Ned said. “You didn’t miss much yesterday—barbecue got rained out.”

“Yeah, it was some storm.” The roll of thunder played in Hollis’s head again and suddenly she was running with her arm around Annie, Annie’s breast against her side, soft and warm. A surge of desire rose out of nowhere and she caught her breath. She’d only wanted to protect Annie and Callie, that’s all. Memories played tricks sometimes, nothing more.

“What’s up?” Ned asked. “Hollis?”

Hollis pulled herself out of the storm. “I need a favor.”

“Sure.”

“I’d like you to review a case for me.”

“Litigation?”

“No. I just want a second opinion on the management.”

“Sure? Who’s the doc?”

“Me.”

Ned was silent for a beat. “Okay. Mind telling me why?”

“It was a long time ago and I’d just like a second pair of eyes.” The explanation was weak, but Ned was a friend and he wouldn’t push. She didn’t doubt her treatment then or now, but she suspected Annie did. And that ate at her. Maybe clearing the air on this once and for all was the first step toward working together. Or…anything else.

“Well, bring it around. I’ll look through it in the next day or so.”

“I appreciate it. Thanks, Ned.” The second line rang. “I’ve got another call.”

“I’ll call you when I’ve had a look.”

“Appreciate it.” Hollis switched to her other line. “Hi, Sybil.”

“Ms. Colfax is here.”

Hollis slid Annie’s chart onto the bottom of the stack, out of sight. “Thanks. Send her in.”