- - -
every action has an equal and opposite reaction. emergency rooms are kept in business by people who have learned that lesson in the hard way.
- - -
"come on, darci," lia calls as she walks out of her and mark's bedroom, and toward the kitchen where mark is sat with a coffee.
"your hair looks pretty," mark looks up at her upon her arrival.
"thanks," lia smiles, briefly, before narrowing her eyes with suspicion. "what did you do?"
"nothing," mark insists, and lia raises her brow at him. "okay, fine... a hospital has reached out to me regarding a position that's opening up on a groundbreaking trial in the e.n.t. specialty. they also said the job could lead to becoming chief."
"that's great," lia beams. "which hospital? seattle pres? st. ambrose?"
"um... el camino," mark reveals, reluctantly.
"el camino?!" lia's eyes widen. "mark, el camino is in california."
"i know," mark nods. "but-"
"we live in seattle," lia cuts him off. "our friends live in seattle. my family lives in seattle. my job is in seattle. we can't move to california."
"you're right. it's a crazy idea," mark nods. "when they call back, i'll tell them i'm not interested."
- - -
skydivers, bullriders. people whose bold ideas can often result in broken bones and smushed spleens.
- - -
"so, you are fourteen. um... are your parents here? who brought you?" maggie asks her current patient, jenny, in the pit.
"i took the bus," jenny explains. "is this gonna take long? i have to get back for my history test."
"um, well, i mean, it kind of just sounds like a cold," maggie admits.
"i- i know but it's just..." jenny cuts herself off by coughing. "m- my stomach just hurts when i cough... or sneeze... or move sometimes."
"okay. let's take a look," maggie nods. "can you lean back? can you lift up your shirt for me?"
"also..." jenny leans back and unzips her jacket. "i- i'm pregnant."
"okay, you buried the lead there," maggie chuckles before turning to one of the nurses. "um, page o.b."
■ ■ ■
"how far along are you?" maggie asks as she begins examining jenny's stomach.
"um, i think six months," jenny tells her.
"who's your doctor?"
"you?" jenny looks at maggie nervously.
"have you been getting any prenatal care at all?" maggie furrows her brow, and jenny just sighs and leans back further on the bed.
"oh, my god!" jenny jumps up and pulls her shirt down when she notices a woman asking a nurse something, just behind maggie. "that's my mom! what is she doing here? you called her?!"
"no," maggie shakes her head. "no, i didn't, but-"
"she can't know," jenny continues to freak out.
"what?"
"she doesn't know i'm pregnant," jenny elaborates. "you can't tell her. please!"
"i won't," maggie assures.
"promise," jenny urges.
"yes, i- i- i promise," maggie tells her before quickly pulling the curtain shut around them. "jenny, um, i can help you talk to your mom."
"no, y- you can't," jenny shakes her head. "she'll freak out."
"you're six months pregnant. she's gonna find out soon," maggie highlights. "why not tell her so that she can help you?"
"because this is not what we do," jenny sighs. "that's what she says any time i forget to do the dishes or get a b. 'this is not what we do, jenny'. i'm not supposed to even have a boyfriend, so this would..."
jenny trails off as she begins to cough before wincing in pain. shortly after, the curtain is pulled back by nurse michael.
"dr. pierce, this is..." michael begins.
"jennifer?" her mother, tara, pulls the curtain back further and steps in before michael can finish. "what are you doing here?"
"did you track my phone again?" jenny accuses.
"yes, i tracked your phone again," tara reveals.
"mom, that is so invasive," jenny scoffs.
"i pay for the phone. i get to know where it is," tara argues. "same goes for you."
"it's the middle of the school day!" jenny protests. "why are you even tracking me right now?"
"well, you're not in school are you?" tara points out. "this is not what we do, jenny."
"hi. jenny?" lia smiles as she approaches them. "i'm dr. webber. um, i hear you're having a little-"
"a little abdominal pain," maggie cuts her off, and lia looks at her sister with confusion. "um, and dr. webber is an abdominal doctor, so, um... we're gonna take jenny up to ct to get a closer look, and we'll let you know as soon as we get the results, alright?"
"thank you," jenny mouths to maggie.
■ ■ ■
lia and maggie sit in an awkward and uncomfortable silence in the ct room, both picking at their fingers until lia breaks the silence.
"her mother really doesn't know?" lia asks.
"nope," maggie confirms, popping the 'p'.
"that's got to be a lot of work, hiding it for this long," lia says.
"yeah," maggie breathes as the door opens and deluca walks in.
"aren't we sort of obligated to tell the mother she's pregnant?" deluca furrows his brow. "i mean, if the kid's in danger..."
"mm, legally we're obligated not to, unless the patient gives us permission," lia tells him.
"if it were my kid, i'd want us to break the law," deluca admits.
"oh, deluca," lia diverts his attention as jenny's scans begin to appear on the monitor. "what do you see here?"
"blood in the lesser sac," deluca examines the image. "is that an aneurysm?"
"yeah," maggie nods. "splenic artery aneurysm. what are the risks?"
"if it bursts, it could cause an instant massive haemorrhage. the patient and the baby could both bleed to death," deluca breathes deeply. "now can we tell the mother?"
"no," lia states blankly, the same time maggie nods, "yes."
■ ■ ■
"a bubble in my artery?" jenny's eyes go wide with worry as lia, maggie, and deluca are stood in front of her in her patient room. "did i hurt the baby?"
"no, no," maggie assures. "it's so big that even a sneeze could have made it bleed."
"yeah, and the good news is that the bleeding has stopped, but the splenic aneurysm could burst at any moment," lia tells her before looking at deluca.
"yeah, which would be very dangerous for you and your baby," deluca adds.
"oh, god. oh, god," jenny breathes.
"jenny, listen, i can fix this," maggie attempts to reassure her. "i can operate and make sure that it doesn't bleed."
"surgery? unh-unh," jenny shakes her head. "if we do surgery, my mom will find out for sure."
"maybe she should," maggie suggests. "i mean, don't you want your mom's help and-"
"no!" jenny cuts her off. "she'll send me away o- or make me give my baby away. can't you just give me some pill to make it stay the way it is?"
"we could give it time," lia nods. "um, keep you under close observation. and there's a chance that it could resolve on its own."
"then let's do that," jenny agrees. "we'll wait."
"jenny, it's far less dangerous to do something about it right now," maggie argues. "i think if your mom had the information, she would- she would opt-"
"you said we can wait," jenny looks to lia. "i want to wait."
"okay," lia exhales deeply. "then we wait."
■ ■ ■
"the better option is surgery," maggie argues to lia as they are stood at the nurses station, but lia's eyes are fixed on the hospital tablet in front of her. "the only reason she's choosing to wait is to avoid telling her mother that she's pregnant."
"she has the right to tell her mom when she's ready," lia shrugs.
"she's fourteen!" maggie protests. "she needs her mom's help to make this decision."
"y- you're trying to think like a mother, but you're not. you're not her mother," lia shuts off the tablet, and maggie sighs. "we're her doctors."
"what if it were darci?" maggie raises her brow.
"maggie!" lia snaps before lowering her voice. "we can't. we can tell her about the splenic bleed, but not about the pregnancy."
"she's just gonna put her baby and herself at risk," maggie shakes her head.
"jenny's the patient," lia shrugs her shoulders. "she has the final say. it's the end of the discussion."
■ ■ ■
"so, for now, we wait to see if your daughter's abdominal bleed resolves on its own," lia explains to tara as she shows her jenny's scans.
"you think waiting is the best option?" tara asks.
"well, it's what jenny wants," lia tells her.
"jenny is fourteen," tara reiterates. "when i was fourteen, i was stealing street signs and getting knocked up by my loser boyfriend, so forgive me for not trusting a fourteen year old to make judgement calls. i'm asking what you think."
"i think that surgery is the better option," lia admits.
"then that's what we'll do," tara nods.
"of course, you know, with surgery, there are- are always risks," maggie steps forward.
"surgery would happen when?" tara asks. "today or..."
"actually, there is one more thing," maggie says.
"dr. pierce," lia warns.
"what is it?" tara's eyes widen. "what are you not telling me?!"
"there is also the risk that jenny could lose her baby," maggie informs her.
"her what?" tara almost freezes with shock.
"jenny is pregnant," maggie confirms, and lia shakes her head at her.
■ ■ ■
"how long?" tara asks, right in jenny's face.
"mom, listen-" jenny pleads.
"how long?!" tara cuts her off.
"i- i don't know. like, six months or something," jenny shrugs, and her mother's jaw drops before jenny turns to lia and maggie. "why would you tell her?!"
"look at me, not them. me," tara orders. "how many times have i told you, 'be careful, be smart'? not to end up like me. how many times?!"
"yeah, mom, like a million times that i am your biggest, stupidest mistake!" jenny snaps. "sorry i messed up your life so bad!"
"jennifer, that is not what i meant!" tara insists.
"and i'm sorry for screwing up my life, too!" jenny continues. "go ahead. i'm just waiting for you to say it- 'this is not what we do, jenny'!"
"it's not," tara shakes her head as lia leads maggie out of the room.
"you screwed this up," lia tells her.
"she needed to know all the risks," maggie protests.
"no, she didn't," lia argues.
"yes, she did," maggie insists. "if she was gonna convince jenny to get that surgery, yes."
"how's that going so far?" lia raises her brow before walking away.
■ ■ ■
deluca is running the ultrasound wand over jenny's swollen stomach as lia observes when maggie walks in.
"what happened?" maggie asks.
"i was giving her a routine abdominal exam when her pressure bottomed out," deluca explains.
"it hurts- so much," jenny cries.
"tell me what's wrong," tara turns to the doctors.
"we're gonna take a look, okay?" lia assures her as she takes the wand from deluca and takes over.
"she's hypotensive," deluca tells them. "and her crit's at eighteen."
"tell me what's happening," tara reinforces.
"it's not labor," lia turns to maggie before looking back to jenny. "your aneurysm has ruptured, and i know you didn't want surgery, but now we have no choice. we're gonna get you into the o.r."
"mom?" jenny looks to her mother with glossy eyes.
"they've got you, honey," tara assures. "everything is gonna be fine."
■ ■ ■
"this wassn't my fault," maggie says as she and lia are scrubbing in for jenny's surgery. "telling the mother. stress doesn't cause arteries to rupture. you know that."
"i do," lia confirms. "doesn't make it right."
"it felt right," maggie argues. "it felt like she needed to know, like it was the right thing to do."
"i know the feeling," lia assures. "on a different day, i probably would have done the same."
"are you okay?" maggie turns to her. "you're not still mad about the whole jackson thing are you?"
"no," lia shakes her head. "it's- it's nothing. it's... nothing."
■ ■ ■
"we had to remove your spleen to stop the bleeding. but the baby's fine," maggie assures jenny following her surgery.
"good fetal heartbeat, very strong," lia adds.
"and my mom?" jenny asks.
"she's waiting to see you... whenever you're ready," lia informs her, and jenny nods. "yeah? okay. deluca."
deluca nods before moving to open the door to let jenny's mother in. when she enters, she lingers not far from the doorway, and doesn't speak for several moments.
"is she okay?" tara asks.
"she is," maggie confirms.
"and the baby?" tara turns to lia.
"they're both fine," lia smiles.
"mom," jenny's voice begins to break as her mother walks over to her.
"don't speak. listen. this just... isn't what we do," tara shakes her head. "you tell me when you're in trouble. you don't walk around, scared and alone, not when you have me. do you hear me?"
"uh-huh," jenny cries as her mother wraps her arm round her.
"not when you're having my grandbaby."
- - -
surgeons are trained to deal with the fallout of bold ideas. we pick up the pieces and do our best to fit them back together.
- - -
"my patient today was only fourteen and she was pregnant, but her mom didn't know," lia tells mark as they're sat eating dinner. "i mean, that could be darci or lily one day. you just don't know. i'd like to think they could come to me though."
"would you have told you mom if it were you?" mark asks.
"yeah, one hundred percent," lia nods. "i used to tell my mom everything when i was a kid. i told her everything really until, well... until i started dating you."
"your mom did seem pretty amazing," mark smiles.
"she was the best," lia agrees.
"so... el camino called," mark informs her.
"and?" lia raises her brow.
"they're flying out here to interview me," he admits.
"you've got to be kidding me," lia sighs.
- - -
the thing about the bold moves is they're terrifying, could end in nothing but tears and broken bones. and that's exactly what makes them so damned exciting.
- - -