325Another intense chapter that is most definitely not for the weak-stomached. Medical trauma and graphic details of miscarriage (sorry for the spoiler but I don't want to blindside anyone that has been through this).
CHAPTER 9: Persistence
"Nations, like stars, are entitled to eclipse. All is well, provided the light returns and the eclipse does not become endless night. Dawn and resurrection are synonymous. The reappearance of the light is the same as the survival of the soul."
- Victor Hugo
Al-Quds Hospital, Jami'a al-Zayraa district, Aleppo Governorate, Syria
Jane entered the busy meal room and for the first time in a while, it didn't quieten because of the subject matter. She had become accustomed to hearing snippets of gossip at the hospital regarding her roommate's latest endeavours and the dissection of her clinical and detached mode of operation.
Today, no one was speaking ill of the blonde doctor and Jane sighed in relief. I wonder if they are all starting to realise how incredible she is at her job and how much we need her here? She doubted it, but she did know that since the loss of the young boy a month ago, those who had worked with the doctor now had a deeper respect for her, and the rest of the medical and MSF staff were paying attention to that.
Contemplating all of this, Jane retrieved her container of leftovers from the refrigerator and heated them up in the filthy microwave that no one had obviously cleaned in some time. Jane felt a presence beside her just as the 'ding' signalled that her food was ready.
"Oh, that's disgusting!" Maura's revolted tone sounded comically to her left. Jane let out a loud laugh, causing Charlie and Grace to look over at them in amusement and curiosity.
The tall woman handed her heated food over to Maura. "Here, take mine. That way you don't have to go through this horrific experience." She chuckled and was surprised when it was accepted. Shaking her head as the honey blonde walked away grumbling a 'thanks', Jane quickly heated up leftovers from the same meal in the same type of container and then made her way over to sit across from the doctor. She expected to enter into a lighthearted conversation to take her mind off of work but Maura was in professional mode.
"Dr Kain needs Susie at the clinic again tomorrow. Do you think we could work out some kind of schedule to allow this on a regular basis?" The doctor asked as she delicately cut up a portion of her meal and placed a piece into her mouth.
Jane sat and watched her work methodically on her food. She had noticed early on in their meal sharing how systematic the doctor was in her approach to eating. It was oddly endearing.
"Jane?" Maura's concerned voice sounded and she placed her knife down to reach for the brunette's hand. "Are you alright?"
"Oh, yeah, fine. Sorry, I'm just tired… Uh, yeah. Yeah, I can help with that but seriously, you're the Medical Coordinator. You put them wherever you think will be best."
"But you're my boss and I'm supposed to run these decisions by you."
"I trust you, Maur. You know what you're doing." She changed the subject before it got too uncomfortable. "Have you got a busy week ahead?"
"Not in terms of scheduled surgeries but I'm sure it will be the same as every other week."
Jane grinned knowingly. "Well, I was thinking that we could take Friday morning off and go to the markets? They've just reestablished a portion of the historical Al-Madina souq in the centre of the city and it has the best fresh produce."
Maura's hazel eyes lit up at the idea. "That sounds incredible." She pulled out her small black leather diary and jotted it down. "I don't have any appointments or surgeries scheduled that morning… It's a date!"
She missed the grin on Jane's face at her last comment.
Only halfway through their meal, Aya interrupted with a polite clearing of her throat. "Uh, sorry Dr Isles, Dr Faulkner has requested your help with the MRI equipment." She lowered her voice and whispered with amusement. "He can't figure out how to turn it on!"
Maura withheld a laugh and wiped her mouth on her napkin. "Sure. I'll be right there, Ms Hafez." She stood and cleared up her items.
Jane's left eyebrow raised in question when she heard the formal address. I thought that she was relaxing more with the formalities. Aya rolled her eyes before the doctor looked back up and caught Jane's look.
"Sorry, Aya." Maura stated apologetically.
"No problem, Maura. I'll see you shortly." The dark woman smiled and left the meal room.
Al-Madina Souq, Al-Madina district, Aleppo Governorate, Syria
"Oh my gosh, Jane! I'm so excited!" Maura stated happily as she exited the vehicle.
Jane smiled at the childlike happiness on Maura's face and jumped down from the driver's side of the 4WD. She rounded the back of the truck and stood next to the beaming blonde.
Jane grinned at her companion and felt her heart thud heavily in her chest when the smaller hand gripped her arm with enthusiasm. She knew she was blushing when the soft hand stayed wrapped around the inside of her elbow, the doctor's thumb moving unconsciously on the smooth skin she found there.
"I love that you're really excited but please stay near me." The taller woman stated with a soft warning.
Maura nodded in agreement and kept her hand in the crook of Jane's arm. She tried not to feel nervous as they passed through the entry of the market where several Free Syrian Army officers were gathered. Not that she was afraid of them but she knew the history of the civil war in Aleppo and the destruction she was about to encounter because of the fighting between the Free Syrian Army and the Syrian Armed Forces.
The doctor grasped Jane's arm a little more tightly when they entered a narrow alley that was vibrant with colours of various silks and wools. Jane looked at her with some amusement and a lot of adoration. Hazel eyes twinkled brightly at all of the options.
They spent the rest of their time looking at, touching, smelling, and, of course, purchasing much of the produce that the vendors were selling. When they were finally done, Maura had bought enough to feed their whole household.
It wasn't how Jane would typically spend a rare Friday morning off but seeing Maura's face, she couldn't think of anything better.
Jane's stomach grumbled and she looked at her watch. It was almost lunch time. "There's a food stand around the next corner. I need to eat something if we're going to keep exploring."
Maura smiled at her. "Ok, that sounds great."
Jane looked at her watch and frowned. They had been gone from the base for 2 hours. "We probably should only be gone for another half hour. I haven't had a call yet but I don't want to push the limits."
"Mmm, yes, I suppose I agree." Maura joked gently and finally let go of Jane's arm for the first time since they had arrived.
The Head of Mission smirked at the smaller woman and shook her head. The doctor really was opening up more and more. It was wonderful to see her so relaxed and full of joy.
The feeling stayed until they got back to their room. Both of them flopped down on their beds, tired from putting groceries away and from the full morning of exploring.
"Just 10 minutes and then I'll head to the hospital." Maura said as she tried to stifle a yawn. Her eyelids already heavy, she closed them and fell asleep within seconds.
30 minutes later, Jane leaned over the smaller woman and smiled with affection, not wanting to wake her but they both needed to get back to work. Her hand reached for a warm shoulder and hazel eyes blinked open. A soft smile graced the doctor's face and she looked up at Jane. "I slept longer than 10 minutes didn't I?"
Jane grinned at her and winked. "Not by much."
Maura smiled back and woke herself quickly, splashing water on her face and changing her attire for a long shift ahead. Jane waited patiently and within a few minutes the pair were walking back to the hospital and ready to face whatever the afternoon had in store for them.
Al-Quds Hospital, Jami'a al-Zayraa district, Aleppo Governorate, Syria
Frankie and Barry stood at the front of the hospital chatting about what they ate for dinner when a sedan pulled up and a young Syrian man flung open the door on the driver's side. He yelled at their startled faces.
"Nahn bihajat lilmusaeada!" (We need help!) He waved them over frantically and both men ran towards the car and looked on in shock when he opened the rear door to reveal a young woman laying on her back, groaning in agony, her blood soaked dress clinging to her legs.
Barry didn't mean to but he held his hand up to his mouth as his gag reflex triggered. He turned away before he threw up.
"Min fadlik saeidnaa!" (Please help me!) The woman begged, trying to sit up but unable as a wave of dizziness overcame her. She closed her eyes and fought to stay conscious.
"Shit!" Frankie exclaimed as he waved at his friend to get help. "Don't just stand there, Frost!"
Barry nodded rigorously and ran the few metres into the main entrance of the hospital to get the head nurse's attention. "Aya! Aya, we- there's a- we need a stretcher and help outside right NOW!" He didn't wait for her and returned to the scene, keeping his distance.
The young man who had driven the woman there was trying to help get her out of the car but Frankie put a hand on his shoulder and told him to wait. The security guard was grateful that the man was able to speak some English.
"Please! My wife need help." He was crying now. He wiped his sweaty brow and smudged blood across his forehead.
Frankie grimaced at the sight and felt compassion overwhelm him for this man. "Hey buddy, it's ok. She's gonna be ok." The Italian wrapped an arm around the slightly shorter man's shoulders and steered him to the side as Aya, Maura, Kent, and Ian came running outside , the two men carrying a stretcher.
"Madha yahduth huna?" (What's going on?") Aya asked the husband who was still leaning heavily against Frankie.
"'Iinaha tnzf! altfl. 'Anaha haml! Alraja' musaeadatiha!" (She's bleeding! The baby. She's pregnant! Please help her!) He watched helplessly as the medical team went to his wife's aid.
"What did he say, Ms Hafez?" Maura asked as she reached for the moaning woman and placed her hand to her forehead, just below the material covering the woman's head.
Ian rolled his eyes at the ice cold front and muttered, "It's Aya, Maur."
Maura ignored him and waited for a response from the head nurse.
Slightly taken back by the returned formality, Aya responded without a hitch, also putting on her professional front. "She's pregnant, Dr Isles." She turned back to the man to ask about what happened and then back to Maura right away to fill her in. "Her name is Fatima. She's about 20 weeks. He said he doesn't know what happened. He came home from night shift and she was already bleeding and laying on the bathroom floor."
Maura nodded in thanks and addressed her colleague. "Get her onto that stretcher." She instructed and moved out of the way so that Ian and Kent could reach into the car.
Aya explained what was happening to Fatima as Kent and Ian manoeuvred her from the car.
As soon as the woman was on the stretcher, Maura directed Aya, Kent, and Ian as the three of them wheeled the stretcher inside. "Get her into OR 2. She's haemorrhaging and her temperature is at least 104."
Jane was exiting the meeting room when the four medical staff raced past her. She winced at the scene and decided to follow to make sure they had plenty of help if necessary.
Not following all of the way into the operating room, Jane stood at the door and watched through the small glass panels. Frankie approached with a sobbing young man and Jane put the pieces together. She motioned her brother away from the door and down the corridor to where there were a few chairs for them to sit on and wait. She went back to the window and watched in awe of everything unfolding before her eyes.
Kent scurried about preparing fluid, the blood pressure monitor, and other necessary items required to proceed with an operation.
Ian and Aya held the young woman down as best they could while Maura felt the slightly bulging lower abdomen. Aya continued to interpret for the doctors and did her best to help keep the woman calm.
Maura frowned at what she was feeling and spoke to Ian, her eyes darted to the doorway when Nasim Feyrouz, another local nurse entered to help. Her eyes made contact with Jane's and she waved her forward to come inside the room.
A quick glance up to the heart monitor and Maura began instructing her staff. "Blood pressure is 80/45. Pulse 97… Ian, get a general and an IV started… Aya, 25mg of Premarin into her asap." The head nurse smiled at the switch to the informal use of her first name and counted it as a personal victory.
Ian gave her a satisfied smile and turned back to the patient. He carefully removed the woman's hijāb and placed the mask over her mouth and nose. "Shh, it's ok, darlin'. You're gonna be alright." He tried to soothe the scared, shaking woman. It worked. The young woman relaxed and her eyes began to flutter closed.
"Nurse, two units of O negative."
"Yes, Dr Isles." Nasim rushed to do the doctor's bidding, not caring right now that her name was not known.
Maura continued to push and massage the area that seemed to be causing the woman pain, trying to figure out the source of the bleeding besides the obvious signs of miscarriage. "I can't confirm until I've done an ultrasound but it feels as though she has a large vascular mass in or around her uterus." She stood and walked over to Jane but addressed Ian. "We need the portable—"
"Ultrasound. On it!" He raced out of the room to retrieve the equipment.
Before the smaller woman could say anything, Jane asked, "How can I help?"
Maura's face softened. God, she's wonderful. "Could you please get me a gown and surgical cap?" She smiled when Jane nodded and retrieved the items for her. Maura quickly put her hair in a loose braid and washed her hands thoroughly. Gloves on and ready for the rest of her attire, her smile broadened when Jane was back in mere seconds.
The tall brunette reentered the room and naturally opened the gown up for Maura to push her arms into. Jane stepped slightly closer to tie it at the back of the doctor's neck, her arms fitting loosely around the petite shoulders. It wasn't until she was finished that she realised their close proximity. Oh, uh- She couldn't even form an internal dialogue as Maura's perfume invaded her senses and she fought the impulse to kiss the blonde head. Thankfully her fingers continued automatically and she tied the back of the doctor's cap with ease.
Maura was having a flashback of the first time Jane had done this for her and felt warmth seep through her body at the familiarity of it.
What felt like several minutes for the pair was only about 15 seconds, then they were snapped back to reality by Ian barging back into the room with the portable ultrasound machine. He didn't fail to notice how close they were though before they were practically shoved apart by his entrance.
"Thank you, Jane." In an instant Maura was back to professional mode. She strode over to Ian and started to retrieve the transducer to perform the much needed scan. "Oh my goodness!" Her suddenly raise in voice and pitch had everyone in the room looking at her, afraid of having done something wrong. "How old is this?!" Maura asked, repulsed by the ancient piece of equipment, especially after her last encounter with a malfunctioning monitor.
"It's old, Dr Isles, but she's a sturdy one!" Aya claimed with a smile.
Ian and Jane laughed and the nurses breathed a sigh of relief.
"Ok. See this?" Maura pointed to the monitor and circled an area with her finger. Aya watched intently, fascinated that the doctor had even thought to check for a deeper problem than what was obvious. "It looks like she was about 19 weeks pregnant." The figure of the foetus easily discernible on the screen. "D & C might be necessary but I'm concerned that she has a large fibroid that is causing the bigger clots." The honey blonde turned to see the head nurse paying close attention to her words. "How do her vitals look, Aya?"
Dark brown eyes widened, glanced at the monitor, and she responded promptly. "Uh, blood pressure still low. Oxygen at 97. Pulse 73." She checked the bleeding. "Haemorrhaging seems to have slowed down."
"Ok. This is too large to go in vaginally." Maura looked intently at the screen as she held the transponder to the woman's bare pelvis. "This is probably the biggest tumour I've seen in a long time." She grinned at Ian, loving the challenge of something different.
Ian faltered slightly at her excitement. He honestly loved this side of Maura; passionate and exuberant at the discovery and the confidence that she exuded in her ability to problem-solve and mend what wasn't working. She was truly in her element. However, her history with this subject in particular had him worried at her detachment. He would leave it for now and check in on her later. He frowned at her. "So, hysterectomy?"
"Mmm, no. It's one large tumour. I'm going to try and remove it before we get to that drastic of a measure."
Ian knew where this was coming from. "Maura, she's bleeding profusely and that tumour is the cause—"
"I know what is causing it, Dr Faulkner. Let me do my job." She commanded with finality and he ducked his head in acceptance.
There was dead silence as they prepped quickly for the procedure and Maura hunched over the small body, scalpel in hand and medical staff at the ready for any command she might give. Her left hand glided an inch in from the pubic bone and without hesitation, Maura applied the perfect amount of pressure to the muscle, making an incision. Dragging the scalpel through the subcutaneous fat and superficial epigastrics, she managed to avoid the vessels that were ascending branches of the deep circumflex iliac artery, just beneath the obliques. She made sure to take the fascial layers separately allowing minimal bleeding to occur.
Once Maura had the young woman clamped open and began operating on the woman's reproductive system, Jane had to turn her head. Usually unfazed by blood and guts, so to speak, seeing a deceased unborn baby being extracted, no matter how premature, was gruesome.
Even Aya had to control her emotions at the scene.
Ian watched Maura intently. Her face impassive as she performed the task with ease. It wasn't that the procedure itself was much of a challenge. Abdominal surgery whilst not basic knowledge, was not difficult with someone of Maura's skill level, and a fibroid removal was far from life-threatening. They all knew that the young woman's situation could have been dire had she not come to the hospital but she was in the best hands possible.
Ian's concern was the fact that Maura seemed to not even show the slightest hint of anything when she retrieved the almost 1 pound body from its mother - skull, arms, legs, and other extremities easily identifiable. She continued to request suction when the bleeding became significant and cauterisation once it was controlled. The process was over fairly quickly.
"Aya, send the endometrium to pathology for examination. Close up please, Ian?" Maura half asked half instructed and took a step back from the operating table. It was then that Ian noticed her face pale and the terror in the hazel eyes flash briefly before she composed herself and turned away from the bloody mess.
"Uh yeah, Maur. I got it. Um- Jane?! Take Maura to clean up, would you?"
Jane turned around and frowned at Ian's tone. She had never heard him sound quite panicked before. She took the few steps over to Maura and placed her hand on the small of her back, leading her out of the room, trying to catch a glimpse of her face.
Maura took off her gown and stood at the wash basin, looking down at her blood covered gloves. In a frantic move she pulled at them and they dropped into the sink, she then turned on the hot water faucet, and began scrubbing her hands and arms furiously with soapy water. Jane's eyes widened in shock and she rushed to calm the doctor.
"Maura!"
As soon as her hands touched Maura's shoulders, the smaller body spun and crumpled into hers, heaving with sobs. Small hands gathered Jane's t-shirt into her fists and Jane's strong arms wrapped around her back, holding her up.
"Hey, hey, shhh." Jane pulled Maura tightly against her, bending her knees on either side of the smaller woman's to take the majority of her weight. The blonde's face was buried in her neck, her tears trailing down Jane's collarbone.
After a few minutes Maura stopped sobbing and kept her nose pressed to Jane's throat. She stood a little more upright, taking her weight back onto her own feet. "I'm sorry." Was all she could whisper out hoarsely. Her hands still clenching Jane's shirt.
The taller woman didn't let her move much. She kept her lips to Maura's forehead. "Don't be." She whispered into soft skin and inhaled deeply. "I've got you." They stayed that way for another half a minute before an embarrassed and awkward feeling Maura pulled away slowly, wiping at her eyes, and trying to smooth the wrinkles she had caused in Jane's t-shirt. She ignored the fluttering in her chest as her fingers smoothed over well defined rectus abdominus muscles and she felt Jane's hands on her hips. She didn't want the embrace to end.
"I ruined your shirt." Watery hazel eyes looked up into compassionate brown as her fingers continued to try and rub out the creases. Their faces so close to each other.
"Don't care." Jane responded seriously and moved her arms from the narrow waist to reach around the slender shoulders and loosen the ties on the doctor's surgical cap. The move pressed their upper halves snugly together. Maura slumped against Jane's solid body once more. Her arms wrapped around the taller woman's middle and she held tightly, her head resting on Jane's chest.
Surprised at the sudden initiation, Jane was far from complaining. She removed the cap and smoothed out the honey blonde hair that was still in a loose braid, and wrapped her long arms around Maura's shoulders tightly, "I've got you, Maura." She repeated the soothing phrase a few more times until the doctor relaxed. Is it so wrong that this feels so good? I hate that she's so upset but god, I wish I could hold her like this more often.
Jane wasn't sure how long Maura would have stood there being held but she felt cold when the smaller body pulled away at the sound of the operating room doors opening. The brunette watched as she wiped at her eyes once more and looked up at her with a small smile of appreciation.
"I— I'll see you at home, Jane." The doctor stated and then turned to walk towards her currently empty but shared office at the end of the corridor.
"K." Jane exhaled softly, knowing Maura didn't care about a response at that moment.
A hand on her shoulder startled her and she might have laughed if Ian didn't look so serious. "Jane, how is she?" He asked worried.
The Head of Mission ran her hand over her face and scrubbed it with some force, unsure of what caused the stoic woman to lose her composure. "Jesus, Ian. What on earth happened?" She turned to look at him. Is he crying? His green eyes looked a little glassy and full of concern.
He rubbed his head and frowned. He knew that he couldn't say anything but he also knew that Jane cared a lot about his friend. "Uh- you should ask her, Jane."
Jane respected his silence but was frustrated that it wasn't something she would gain understanding about quickly. "I will."
Ian nodded and then paused a moment. "Jane?"
"Yeah?"
"Just— don't push too hard. She um- it's a tough topic for her for a number of reasons and if she feels cornered, she clams up." He shared the little bit of insight that he didn't know she was already aware of and left her to ponder it further on her own.
Sorry, just a short one but intense and hard to write... Hopefully not too long before the next update.
Thanks for your patience, everyone! Keep the reviews coming :) I could use the motivation.
