Daring to Fall for the Single Dad, page 17
He raised his eyebrows over his mask. ‘You’ll see I’m not a shy surgeon. But the parents, Isabella and Sebastian, are both emergency doctors here at the General, so they were happy to consider the procedure. They want the best possible outcome for all three babies, so together we weighed the pros and cons of the FETO. Hopefully the gamble paid off.’
‘I met Isabella Lopez when I came for my interview in January,’ Emilia said, briskly scrubbing her hands and arms.
She’d immediately clicked with the other woman, who, along with her husband, ran the emergency department at the General. And after their difficult fertility journey, she knew how much the couple wanted these three miracle babies that were about to be born. At nearly thirty-one weeks gestation, all three Lopez triplets would need to spend some time on the neonatal intensive care unit, or NICU, and the smallest baby also faced surgery to correct the defect in the diaphragm.
‘Right, let’s go meet the Lopez triplets,’ Felipe said, turning off the taps and using his back to push through the door into the operating room.
Three resuscitation tables for newborns were set up to one side of the room, each warmed and awaiting a baby. A cluster of neonatal registrars and nurses waited nearby, expressions tense.
Emilia glanced over at Isabella, trying to send her calming positive vibes from behind her mask. The birth of a child was always emotional, but when the babies were premature and one needed surgery, it might be overwhelming for the couple.
After being assisted by scrub nurses into surgical gowns and sterile gloves, Felipe and Emilia nodded to the Lopezes and joined the obstetrician performing the elective caesarean section.
The first two babies were delivered, one after another. Their umbilical cords were clamped, and they were quickly whisked away by the neonatal team. Each baby was placed on the resuscitation table’s heated mattress. The neonatal nurses gently dried the newborns with a towel and cleared their noses of mucus with a small suction tube.
‘Apgar is nine,’ the registrar caring for the first triplet said.
Emilia breathed a sigh of relief and glanced at Felipe, who nodded. The oldest Lopez baby had a low birth weight but was breathing spontaneously, had a good skin colour and normal reflexes, his condition stable enough for transfer to the NICU. The baby was wrapped up and carried over to Mamá and Papá for a quick cuddle.
At the next resuscitation table, triplet number two was being assessed by a second registrar. While slightly smaller than his brother, baby two was mewling loudly, his tiny pink face scrunched up in outrage.
‘Apgar is ten,’ the neonatal nurse said, wrapping him in a sheet and scooping him up for a few seconds of skin-to-skin contact with his parents.
Emilia smiled under her mask at Isabella and Sebastian’s joy. But there was still one more baby to deliver. As the obstetrician delivered the head of the third and smallest baby, the atmosphere in the room changed.
‘Syringe,’ Felipe asked, holding out his hand.
The tube blocking the baby’s airway, which had kept the lung expanded as the baby developed in utero, needed to be removed before the umbilical cord was cut, as it was essentially breathing for the baby via the placenta.
Emilia had only seen the FETO procedure a handful of times, so she was glad for Felipe’s greater experience in this instance. Felipe quickly deflated the balloon and removed the endotracheal tube from the baby’s mouth. The delivery of the third Lopez baby was completed and the cord clamped as usual. Except unlike his brothers, baby three was limp and silent, his skin grey with cyanosis—a lack of oxygen.
Moving quickly, Emilia and Felipe carried the baby to the third resuscitation table, which had been set up in a screened off area with dimmed lighting.
While a nurse suctioned mucous from the mouth and nose, Emilia gently dried the baby with a towel to stimulate spontaneous respiration. Urgency shunted her pulse through the roof. She reached for the neonatal resuscitator, just in case the third triplet failed to start breathing on his own.
Those couple of seconds, during which the baby made no respiratory effort, felt endless. Emilia willed him to make it, her stare flicking to Felipe’s.
‘There’s a heartbeat,’ Felipe said, removing his stethoscope, ‘but little respiratory effort. We already know from the scans that the left lung is hypoplastic.’
Emilia nodded, quickly but gently inflating the baby’s underdeveloped lungs with the resuscitator. The third Lopez baby was struggling to breathe unaided. Because of the hole in the diaphragm, abdominal organs had herniated into the chest and prevented the left lung from growing. Felipe had mitigated some of the pressure on the developing lungs with the FETO procedure, but the underdeveloped lung was still smaller than normal.
Emilia placed electrodes on the newborn’s chest, her relief mounting when the heart monitor picked up a normal trace.
Their eyes met over the tops of their masks. ‘We still have sinus rhythm,’ Emilia told him.
Felipe nodded, his thoughts likely matching hers. For the time being, the smallest Lopez baby would need to be ventilated until they could close the diaphragmatic defect and give his lungs the space to grow.
‘I’m going to intubate,’ Felipe said, reaching for a laryngoscope and endotracheal tube. ‘Then we’ll transfer him to the NICU.’
With the intubation complete, Emilia passed a nasogastric tube into the baby’s stomach to empty it of any contents and take the pressure off the baby’s tiny lungs, which were already compromised by the herniation of small bowel loops into the chest.
As the baby’s oxygen saturations climbed into the normal range, Felipe inserted an umbilical vein catheter into the cord so they could administer fluids, drugs and easily take blood samples. They worked together as if they’d been doing it for years, each of them anticipating the other’s moves and assisting where required.
Once they had the third triplet stabilised, Emilia glanced at Felipe. ‘A quick hello to Mamá and Papá and then up to NICU?’
Felipe nodded, peeling off his gloves and mask. ‘Let’s reassess him this afternoon, but he’s booked for surgery in two or three days, as long as he remains stable. The sooner we can close that hole in his diaphragm the better.’
As Isabella was still on the table being sewn up from her C-section, Felipe and Emilia carefully wheeled the mobile resuscitation table over to the parents.
‘We knew from the scans that the left lung was small,’ Felipe explained to Isabella and Sebastian, who were understandably tearful and overwhelmed, ‘so I’ve placed baby three on a ventilator, to help him breathe.’
‘We’ve decided to name him Luis,’ Sebastian said, gently taking his wife’s hand so together they could reach out and touch their son’s tiny curled fist.
‘We’re taking Luis to the NICU,’ Emilia said, trying to sound reassuring, although they all knew the situation was serious. ‘As soon as you’re ready, you can see him and his brothers there. Try not to worry.’ She met Isabella’s stare. ‘We’ll take the best of care of them.’
Isabella nodded, tears seeping from the corner of her eye as she reached out and squeezed Emilia’s hand. From one mother to another, Emilia heard what was being left unsaid: Take care of my babies while I can’t.
‘Congratulations on the birth of your sons,’ Felipe added, resting his hand on Sebastian’s shoulder, as if he too was aware of the turmoil and concern of the new parents. ‘What a blessing.’
While the registrar and neonatal nurses whisked Luis upstairs to the NICU, Felipe and Emilia de-gowned, tossing the garments into a dirty laundry bin outside Theatre Six.
Emilia sagged a little, releasing an audible sigh as most of the adrenaline left her system. ‘Well, that was an eventful first morning.’
Felipe nodded, one side of his mouth curling up in a charming smile. ‘Now that the excitement is over, let me show you the most important room in the department, in case you get lost again.’
Emilia ignored the return of the silly flutter in her chest at how attractive and charming he was. It made no difference. That Felipe was so friendly and welcoming was nice, given they’d be working so closely together, but it also left her strangely unsettled. She wasn’t used to male attention, not that he was overtly flirting. Would she even know what flirting looked like, having been off the market for so long?
‘I hope it’s the coffee room.’ She laughed, smoothing her hat-flattened hair back from her face. ‘I may not know my way around the rest of the hospital yet, but when I came for my interview, I made sure to ask for directions to the nearest coffee machine.’
‘A woman with priorities,’ he said with that confident smile that put her at ease, but also sped up her pulse. ‘Although there’s only instant in the break room. For the real thing, espresso, the best place to go is Café Rivas, upstairs in the foyer.’
‘Oh, I definitely need the real thing to get through my first day.’ Instant coffee just wasn’t going to cut it.
‘In that case,’ he said, ‘why don’t I show you the way?’
‘Great, thanks.’ She followed him from the suite of theatres and up the stairs. She’d have to find her way around the hospital without his help soon enough. But, for now, there was no harm in accepting a guided tour from a supportive and approachable colleague.
‘Café Rivas has an app so you can pre-order drinks without waiting in line,’ he said, pushing through double doors at the top of the stairs.
‘Uh-oh,’ she said, waggling her eyebrows, ‘that sounds dangerous.’
‘Very,’ Felipe agreed, holding the door open for her to pass through. ‘Although I won’t tell if you don’t. It will be our little secret.’
Emilia couldn’t help but smile, even as she felt her barriers rising. Charming, a fearless surgeon and hot. Never mind the easily accessible coffee being dangerous—she’d have to be very careful around Felipe Castillo.
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ISBN-13: 9780369759221
Daring to Fall for the Single Dad
Copyright © 2024 by Harlequin Enterprises ULC
Special thanks and acknowledgment are given to Becky Wicks for her contribution to the Buenos Aires Docs miniseries.
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Becky Wicks, Daring to Fall for the Single Dad
