Taking chances: Chapter 1

    Sarah groped for the receiver of the insistently ringing telephone.
    "Yes?"
    "Dr. Lyle, we've lost the baby's heartbeat!"
    "Put oxygen on her, get her on her side and get an internal monitor clip for me." Now fully awake, Sarah slammed the phone down and shoved her feet into waiting clogs. Already dressed in a white hospital scrub suit, she headed toward, then ran down the blue-painted corridor leading to the labor floor. She looked at her watch. Five AM. "Damn! Twenty minutes ago, the baby had been fine." Heart pounding with an adrenaline rush, she flung open the door to the labor suite of the private Manhattan hospital and ran down a white hallway alive with colorful Disney characters. At door to the birthing room, she took a deep breath. Since everyone took their cue from her, she had to remain calm in emergencies. She'd learned that years ago.

    She heard a very slow beep....beep....beep. The fetal monitor that registered the baby's heartbeat read thirty-two, not the normal 120.
    The pregnant young woman in the bed had a green plastic oxygen mask over her face. She looked frightened. "Karen, I'm here. Let's see what's going on," Sarah said as she sat on the bed. "I'm going to examine you and see how far along you are. Then I'm going to attach a clip to the baby's head to see what the true heart rate is. Sometimes if you dilate quickly, it can be a shock to the baby." While she spoke Sarah pulled a sterile glove onto her right hand which the labor room nurse lubricated.
    "Okay, Karen, deep breath," she said as she reached in and examined the cervix hoping to find complete dilation to ten centimeters. "Damn, it's unchanged from twenty-two minutes ago," she thought.
    "Monitor clip," she said. Quickly she placed the tiny spiral shaped monitor on the baby's head, her fingers twisting in a clockwise motion to attach the spiral wire just a few cell layers below the surface of the baby's scalp.
    The nurse fastened the other end of the wires to a metal pad attached to Karen's thigh.
    Beep....Beep....Beep. Thirty-two.
    The heart rate was real. "Karen, Michael, looks like this baby wants to make a hasty entrance. We're going to have to get the baby out fast. Michael, you'll have to stay here."
    She turned to look at the labor and delivery team of doctors and nurses who had come into the room. "Let's go everyone. I want candles on this babe's birthday cake. Now." She had just notified her team with her shorthand phrase that this was going to be a crash section. They had minutes to save this baby. Only minutes.
    Swiftly and silently, everyone sprang into action. The oxygen and attachments to the monitor were detached. The brake was taken off the bed. The side rails were put up as the bed was pushed into the hallway. Karen was on her way to the operating room at the end of the hall.

    "Karen, make a fist," a nurse said as a tourniquet was placed on Karen's upper right arm. An intravenous salt solution was started as the bed was being propelled toward the OR, past Mickey Mouse, now blurred from the speed of the passing bed.
    Sarah and the resident doctor who would assist her were already putting on sterile blue gowns and white gloves, as the bed was wheeled through the double doors into the operating room. There was no time to do a surgical hand scrub. Seconds mattered. Sarah paced the room impatiently as instruments, always ready, were being counted by the nurses assisting with the surgery. Two large, round overhead lights hung from the ceiling and emitted a sunshine brightness to the gray walled and stainless steel equipped OR. Summoned seconds before from the Neonatal Intensive Care Nursery, pediatricians.
    Karen was laid on the black operating room table, now covered with a white sheet, and an oxygen mask was again placed on her face. Karen's eyes showed her panic. Sarah, face half hidden by a surgical mask, glanced at her patient, "Everything will be okay."
    At the same time she was screaming to herself, "Come on, come on. Let's get this show on the road! Move!" Silently willing everyone to move faster.
    "Karen, you're going to sleep now," said Dave Collier, the OB anesthesiologist, as he put drugs into Karen’s IV solution. As Karen went to sleep, an antiseptic solution was poured over her pregnant abdomen by the circulating nurse. Quickly blue surgical drapes were placed over her.
    "Now," said Dr. Collier, nodding to Sarah.
    "Knife!" Sarah called. Almost instantaneously the scalpel was placed into her hand by the scrub nurse. With a swift motion she slashed from belly button to pubic hair. The cut was deep enough to go through all layers of the abdomen and expose the uterus.
    "Scissors!" Adrenaline pumped through her. She cut into paper thin tissue over the uterus. Swiftly, her skilled hands separated the tissue from the uterus.
    "Knife!" A cut was made almost through the full thickness of uterine tissue that separated Sarah from the baby. She threw the knife into a waiting pan.
    Sarah poked a hole into the womb with her fingers and almost frantically tore it open, careful not to touch the baby. She placed her hand into the gaping hole and delivered the baby's head. "Come on, baby," she muttered, her words reverberating from the silent walls of the deathly quiet. The resident suctioned the mouth of the baby and then he pushed on the top of the pregnant abdomen. Sarah, with one hand on each side of the baby's head, delivered the dusky blue body, clamped the cord, and cut it.
    The wail of a newborn filled the stillness of the operating room, as she turned and handed the baby girl to the waiting pediatricians. It was followed by an audible sigh of relief. Amanda Jane Carlyle had made her presence known.
    "Great job, everyone! Everyone take a deep breath. Now, let's see why this tike was in such a hurry," Sarah said as her hand explored the inside of the baby's recently vacated home. "Okay. It's the placenta. It's unattached. A few minutes longer and we would have lost the baby." Sarah took a deep breath. "How is she, Joe?"
    "Great. Perfectly normal," replied the pediatrician.
    "Fantastic. We did it team!" She smiled, then proceeded to sew up the wounds her skilled hands had made. It had taken only sixty seconds, once Karen was asleep, to deliver the baby.

    The sun was coming up over Manhattan. Sarah left the hospital and hailed a taxi. She was exhausted, depleted of all energy, but happy that everything was all right. Sometimes, you weren't so lucky. A yellow cab stopped at the curb. "71st and First," she said as she got in. Wearily laying her head on the back of the seat, she looked at her watch. Deciding it was too late to go to bed, she said, in a voice barely audible from lack of sleep, "Stop at Seventieth and First instead." She knew coffee, The Times, and a shower would revive her for office hours at ten.
    The one block walk from the deli to the Palisades apartment building in the early January air revived Sarah.
    "'Nother baby, Doc?" Joe, the night doorman, asked. The staff was used to her coming and going at all hours. Always alone. Always from and to the hospital. She rarely dated. She'd been through these long hours countless times before. Her work, her daughter, and her friends were all she had time for, all she made time for.
    Laughing, Sarah replied, "Yes, they never listen to me. I try to tell them it's okay to get born between nine and five."
    "See you later, Joe. Have a good one," Sarah said and stepped into the open elevator. She glanced at the newspaper while the elevator whisked her to the twenty-first floor. "Nothing new," she said.

    She walked to the end of the brightly lit hallway and opened the door. The southwest facing apartment was bathed in the glow of the Eastern sunrise. Peaches, greens, and whites prevailed within the beautiful, silent, cold walls. Sarah disarmed the alarm system and put the newspaper and magazine on the bar just inside the door. "God, it's colder in here than outside," she muttered.
    She turned on the radiator under the bay window in the living room, barely seeing the stunning, unobstructed view of the city just outside. Sarah turned and surveyed the apartment. "It's perfect.
    In the unslept-in, all-white bedroom, Sarah shed her clothes, disrupting the perfection, and walked into the bathroom to shower.

    The cold, silent loneliness was palpable. Sarah sat on the overstuffed sofa in the den of the nine room apartment. She wrapped her white terry cloth robe tighter to ward off it's chill, trying to shake off the loneliness she felt. Pictures of her daughter, Alene, from birth to the present were on the end tables and bookcases. She’d been the most important thing in Sarah's life since the day she was born. Sarah basked in her child's unconditional love. She smiled, then got up and went to her home office.
    She needed to collect her e-mail. Sarah connected the on-line service. "Just junk mail," she said out loud. "At least there is no patient mail." Sarah’s patients had gotten into the habit of e-mailing her with every little question. She didn’t discourage it because it gave her something to do when she was home after she had read all the on-line professional journals. She browsed to the news services that she had bookmarked. The ad at the top of Yahoo News caught her eye. "Find Mr. Or Ms. Right" it flashed, then said "On-Line Now!" Sarah clicked on the banner.
    The site was a match-making service that promised anonymity and a free trial. You didn’t even have to place a profile, just choose your screen name and browse the ads. "This is stupid, Sarah," she said as she wrote LadyDoc in the blank space for screen name. She chose a password and the next thing she knew she was on the service. Given a vast array of what she was looking for in a partner, Sarah completed the Questionnaire.
    Try Matching Now. Sarah stared at the words, then clicked the Match Button. She browsed through the ads – they all said the same thing. Everyone wanted the perfect person. Some of the ads were very funny and she laughed out loud as she read them. Then one caught her eye. DO YOU STILL BELIEVE IN LOVE? I do. Late 40's male looking for a 40's woman. Life is better shared. Do you like dancing, music, theater, dining out and sharing all these things with someone special. I am interested in a serious relationship with a woman who thinks love is one of the most important things in life. We will never know if this works unless we try. Who knows, we may find the person we have always wanted. I’m new to computer romance, but I haven’t found the right person any other way. Let’s see what happens.     Sarah read the ad several times. She continued to read her other perfect matches, but she came back to the same ad at least ten time. "I'm being ridiculous, even contemplating answering one of these," Sarah thought as she got up and went to the kitchen to make coffee.

    The clock on the counter read 8:30. She went back into the office. It was still on the screen staring at her.
    She sat down and clicked the E-mail Me button. " I've never answered an ad before, but I'm sure everyone says that." she wrote. "I'm a divorced physician who lives in Manhattan. I like what your ad said. Please e-mail back and tell me more about yourself if you are My name is Sarah." She clicked the Send Button then quickly tried to hit the Stop at the top of the browser. The e-mail had already been sent.
    "I can't believe I just did that. What if this guy is a nut? I can't be that lonely. Besides, it's my choice to be alone. I must be more tired than usual." She looked at a current picture of Alene on her desk. "Your mother's lost it," she said.
    In the den, she paced up and down the nubby white carpet in front of the green wrought iron coffee table, then stopped mid-stride and smiled. "This is ridiculous. This person will get a million e-mails and never answer. Even if he does write back, I don’t have to answer him." What am I worried about? Besides, they promised to keep you anonymous." she said, then hurried to get dressed, in her customary black, for office hours.

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