not going to leave her home alone!”
“She shouldn’t have walked here, no matter how close you live.”
“Just . . .” He hesitated. “Just help her.”
“Come with me,” said Kira. “There’s always a full staff in maternity, even at night.” She prayed silently as they brought Madison in through the doors, begging anyone who was listening to please, please spare Madison’s baby. It was too early; it might die of poor development or breathing before it even had a chance to die of RM. She helped Madison around the corner toward maternity and stopped short, nearly colliding with a nurse running desperately down the hall.
“Sandy!” shouted Kira, recognizing the woman from her time as an intern. “She needs attention!”
“The Barnes baby is flatlining,” said Sandy, shouting over her shoulder as she ran. “Tell her to hang on!”
“They’re not going to help?” asked Haru.
“Everyone’s busy,” said Kira. “Come with me.” She led them to an open door and flicked on the light, helping Madison settle into a large, soft chair.
“There goes another one,” said Madison, clenching her jaw and whistling. “Oh please no.”
Kira pointed Haru at a medicomp cart in the corner of the room. “Fire up the ultrasound machine,” she said. “The outlets marked in red have power.” She crouched down by Madison’s side, brushing her hair from her face. “Hey, Mads, you want to tell me what’s going on?”
“I think it’s contractions.”
“You’re still two months early,” said Kira. “Your pregnancy has been perfectly healthy so far, there’s no reason for you to be having contractions.”
“These aren’t just cramps, Kira.” Madison winced again, squeezing her eyes closed and clutching Kira’s arm so tightly Kira had to bite her tongue to keep from screaming. The pain subsided and Madison collapsed back into the chair, panting.
“Is the pain rhythmic?” asked Kira. Madison shook her head. “Can you point to it?” Madison traced an area across her belly and side, and Kira nodded. “I don’t think that’s your uterus, Mads, that’s your stomach. I’m going to do an ultrasound.”
“She’s bleeding,” said Haru again. “Aren’t you going to do something about the bleeding?”
“I’m doing everything I can, Haru, just bring the machine.”
He dragged the cart over, parking it next to Madison’s chair with a terrified expression. Kira pulled on a pair of sterilized gloves and pulled up Madison’s shirt to expose her belly. “Hold still,” she said, placing the ultrasound probe against Madison’s skin. “Screen up.” The screen flickered on, a black-and-white grid with a wedge-shaped image in the center. The image flashed and moved: a sonographic re-creation of the organs in Madison’s abdomen. Kira had been completely lost the first several times she’d seen an ultrasound, but after weeks of practice the fuzzy pictures seemed crystal clear. “That’s your bladder,” she said, moving the probe with one hand and touching the screen with her other, defining labels and boundaries that the computer then remembered and kept track of in real time. “That’s your stomach, that’s the baby’s foot. There we go, the baby’s body.” She worked quickly, her fingers scurrying over the screen, lighting up measurements and calling up archived statistics from Madison’s previous visits. “Head development good, chest development good, inner organs all look good. Heartbeat strong. Bladder filling and emptying. Spine looks good.”
Madison grimaced again, gritting her teeth and clutching the arms of her chair. Two nurses rushed in behind them, Sandy and Nurse Hardy. “We’re here, Walker, thanks for getting her started.” Hardy pulled on a pair of gloves and took the probe; Kira gave it up nervously, stepping back as Nurse Hardy’s more practiced hands took over the ultrasound. “Describe the pain,” asked Hardy.
“Strong but inconsistent,” said Kira, “localized toward the side with the stomach. She’s also bleeding—I think it’s an abruption.”
“What’s that?” asked Haru. “Is it bad? Is she okay?”
“We’re doing our best, sir,” said Hardy. “We just need room to work.”
“What about the baby, is the baby okay?”
The image on the screen flopped in and out of view as her abdomen flexed, and Kira pointed at the screen.
“There was a shadow.”
“I saw it,” said Nurse Hardy, moving the probe farther down to the side and altering the angle. When Madison stopped squirming, the image stabilized on a large black oval, the stomach, and behind it a fuzzy black triangle. The computer identified it almost immediately, marking it in red. “The placenta’s separating from the wall,” said Nurse Hardy. “It’s a partial abruption, just like you said.” She stared closely at the screen, at the deep red slash across the center. “Good work, Walker.”
Kira felt the wave of tension begin to seep out of her, down through her feet and into the floor, leaving her drained.
“What does it mean?” asked Madison.
“It means you’re going to be okay,” said Kira. “It means the placenta is pulling away from the uterus, which isn’t good but isn’t really threatening to you or to the baby if we stay on top of it. They’re going to put you on bed rest, so you can’t move around much, and they’re going to do it here in the hospital so we can keep an eye on you twenty-four-seven.”
“I can’t stay here,” Madison protested.
Kira put a hand on her shoulder. “Think of it as a resort vacation. Breakfast in bed, servants ready at all times . . . Nothing will happen to you or to your baby without us being right here to solve it.”
“You’re sure it’s not dangerous?” asked Madison. “I mean, if you have to bring me into full-time care—”
“Twelve years ago I would have sent you home with tampons and Tylenol,” said Nurse Hardy, “but these days we don’t mess around.”
“Okay,” said Madison, “but bed rest? Like, I can’t get up at all?”
“As little as possible,” said Nurse Hardy. “Placental abruption is rare, but in a case like yours, it’s almost certainly caused by overexertion. We need to stop that immediately.”
“No more housecleaning,” said Kira. “I’ll talk to Xochi, we’ll figure out how to take care of it for you.”
Madison smiled guiltily, sucking in a breath. “I shouldn’t have walked here.”
“And I’m going to beat Haru with a bike chain because of it,” said Kira. She shot him a dark look. “But for now, just relax.”
“We need to do a blood test,” said Nurse Hardy, “and then we’ll give you some painkillers, and then you can take a nap.”
Kira squeezed Madison’s hand and stepped back as the other nurses pressed in to take care of her. The adrenaline rush was still wearing off, and Kira walked into the hall and collapsed into a chair. That was too close. She blew out a long, slow breath, thinking about all the things it could have been—all the ways it could have been worse. I can’t bear to see Madison like Ariel, pounding helplessly on a window just for the chance to hold her dead baby.
But I still don’t know how to save it.
She stared at the floor, too tired to think.
“Hey.”
Kira looked up to see Xochi standing beside her. Her face was drawn and tired.
“Hey,” said Kira. “You heard about Madison?”
“Yeah,” she said, “but that’s not why I’m here.”
Kira