“Have you been having headaches?” I asked.
“Sometimes.”
“Seeing spots? Blurry vision?”
She hesitated. “Sometimes. At night.”
“Pain up here?” I put my hand just below her ribs on the right side.
“A little. I thought it was the baby kicking.”
I asked Gloria to get a urine sample. It came back with protein in it.
Elevated blood pressure. Swelling. Protein in her urine. Headaches. Visual changes.
Preeclampsia.
A serious condition. One of the leading causes of death for pregnant women. It can turn dangerous fast. Seizures. Stroke. Organ failure. For the mother and the baby.
“I’d like to do an ultrasound,” I said.
“Why?”
“To see your baby. To make sure she’s okay. Or he.”
Tessa looked at me for a long moment.
“Fine,” she said.
I did the ultrasound myself. I’ve done thousands of them. My hands know the way.
The baby was there. On the screen. Curled up, head down, one tiny fist pressed against her cheek.
A girl.
Heartbeat strong. A hundred and forty-two beats per minute. Measuring about thirty-one weeks. A little small for her age. That happens with preeclampsia. The placenta doesn’t work as well.
“Is it okay?” Tessa asked. Her voice was different now. Smaller.
“She’s okay,” I said. “She’s a girl.”
Tessa stared at the screen.
“A girl,” she whispered.
For a second, just a second, her face changed. All the hardness went out of it. She looked like any other first-time mother seeing her baby for the first time. Scared and amazed and young.
Then she looked at me.
And the hardness came back.
“Roy’s daughter,” she said.
I didn’t answer.
I turned off the screen.
“Ms. Morrow,” I said. “Your blood pressure is dangerously high. You have signs of a condition called preeclampsia. It can be very serious. For you and the baby. I’d like to admit you to the hospital today. For monitoring. Medication. Steroid shots to help the baby’s lungs, in case she has to come early.”
Tessa sat up. She pulled the paper gown tight around her.
“I’m not staying in your hospital.”
“It’s not my hospital. It’s—”
“It’s Roy’s hospital,” she said. “And it’s yours. And I’m not staying here so you can… do whatever you’re going to do.”
“I’m not going to do anything except take care of you.”
She laughed. A short, sharp laugh.
“Right,” she said. “The wife’s going to take care of the girlfriend.”
She got off the table. She started pulling her dress back on over the gown.
“Ms. Morrow, please. You need to be monitored. If your blood pressure goes higher, you could have a seizure. A stroke. You could lose the baby.”
She stopped with one arm in her sleeve.
For a second, I saw fear on her face. Real fear.
Then she pushed it away.
“I’ll be fine,” she said. “I’ve been fine for seven months without you.”
“At least take this.” I wrote a prescription. Blood pressure medication safe for pregnancy. I wrote my cell phone number on the back of my card. My personal number. I’ve never done that for a patient. “If you get a bad headache that won’t go away, or you see spots, or you have pain under your ribs, or you can’t feel the baby moving, you go straight to the emergency room. Any emergency room. Not here, if you don’t want. But go. And call me.”
Tessa looked at the card.
She took it. She shoved it in her purse.
At the door, she turned around.
“Divorce him,” she said. “Or I’ll tell the whole hospital.”
She left.
Gloria came in and closed the door.
She looked at me. She didn’t say anything.
She just put her arms around me.
I let her. For about ten seconds.
Then I said, “I have a two-thirty,” and went to wash my hands.
They were shaking.
I finished the appointment. I finished the day. Seven more patients. Two prenatal visits, a postpartum check, three annual exams, and a sixteen-year-old with bad cramps whose mother needed to be talked off a ledge.
I didn’t let any of them see my hands shaking.
But I didn’t call Roy.
Not yet.
Here’s what I was thinking, all afternoon, between patients.
Thirty-one weeks. Last period sometime in March.
That meant she got pregnant in March. Maybe early April.
In March and April, Roy and I were doing our last round of IVF.
Every injection. Every blood draw. Every ultrasound. Roy was there. He gave me my shots every night at nine o’clock, standing in our yellow kitchen, his hands so steady because he’s a surgeon and steady hands are his job. He held my hand at the embryo transfer. He drove me home and made me lie on the couch with my feet up and brought me ginger ale and watched three Nora Ephron movies with me in a row even though he hates romantic comedies.
He was with me. Every single minute.
Wasn’t he?
Or was he?
Was that when he was with her?
I couldn’t make the two things fit. Roy on the kitchen floor in his good work clothes, holding my hand while I cried. And Roy in some hotel room with a twenty-six-year-old girl in a green dress.
