Placenta accreta occurred when the placenta grew through the muscular wall of the uterus. Most babies were delivered by C-section, and the OBs would try to remove the placenta from the inside of the uterus.
“How’s the mom?”
“They’re still in there working. There was a catfight between the fourth-year resident and the attending. The attending wanted to do a hysterectomy.” Clarissa voiced the unfortunate dilemma of placenta accreta. The mom could lose so much blood, the choice became to save the uterus or her life.
“What number kid is this for them?” Lillian asked.
“First.”
Lillian didn’t speak for a few seconds because there was nothing to say. The baby couldn’t survive at 20-weeks, and, if OB resorted to a hysterectomy, there would be no children in the future. “Are you okay?”
“I'm fine,” Clarissa said, her smile brittle.
“I'm sorry I wasn't there.”
“I'm fine,” Clarissa repeated. “How was the ER?”
“A mess for internal medicine. We admitted a patient for hypothermia. She’s twenty-five.”
“Oh, that's funny,” Clarissa said.
“I felt bad for them. We're allowed to, so I did.” Lillian logged onto the nearby computer. Her intent was to finish the admission orders. However, a flashing box of lab results drew her attention instead. Only labs ordered in her name should have shown up there. “What is this?”
“Nevaeh Hartford,” Clarissa read from behind her. “You ordered inflammatory labs.”
“Joint swelling on and off for months. She’s seen four different doctors. I wanted to rule out lupus. It’s not lupus.” As she scrolled through the labs, a memory from Perkins tickled in her mind. “What about rheumatoid arthritis?”
“Pretty rare. You’re entering the world of exotic rheumatology now. Not something I know.”
“Not my forte either.” Lillian clicked over to UptoDate, a major medical database, and looked at the diagnostic criteria. Nevaeh’s fingernails had been marked, which she had assumed at the time was from chewing on them. “It’s very possible she has psoriatic rheumatoid arthritis. Why don’t you page rheumatology and book Neveah an appointment with them?”
“You want me to interrupt rheum at home?” Clarissa asked, a new gleam of mischief in her eyes.
“It’s not like they’re ever in-house anyway, so it should be the same to them,” Lillian said. Rheumatology emergencies were few and VERY far between.
Clarissa started cackling, “Oh, this is going to be fun.”
“In other good news, they’re making progress on clearing the roads, so help should be on the way.” She took the baby doll clothes. “I’ll handle this.”
“Thanks,” Clarissa said. “I can’t wait to call rheumatology. ‘Get out of bed, lazybones!’”
“Anytime.” Most people would have found the abrupt shift in Clarissa’s mood abnormal, except it was par for the course for a resident. No matter what you faced, you compartmentalized your own pain because there was always another patient who needed you.
Her phone rang again as she went out the door. Someone needed her now.
And, like Clarissa, Lillian kept moving—allowing the pain of today and the pleasure of last night to fade into the distance.
Chapter15
The following Wednesday evening, Charlie, Detective Andre, and Sean were having a Zoom meeting with the Police Chief. The paint had faded enough that he was going back to work as Security Guard Murphy tomorrow. He’d spent most of today putting up cameras around Lily’s building. The only one he dared place inside was in the hallway above a window aimed right at her door.
Lily wasn’t the topic of the day. Their preliminary search of the dumpsters had led to zero pieces of bodies.
"Supposing it is El Socio, he might have been killed closer to home and then dropped. Murphy, you know the subject’s associates best," Chief Reyes said.
Sean took out the huge file of every known associate. "Tell me who you want. I've got his extended family, which includes his two maternal aunts who married his two paternal uncles. There’s a sprawling list of first, second, and third cousins.”
“Family would have protected him better and would be smart enough to not use their own trash cans. Probably not family, but someone else,” Detective Andre said.
