Natural Causes Read Online Free PDF Page B

it. Sometime soon I would like to learn more. Please continue.”
    “Family history is scant. No relationship with her parents at present; no relationship with the father of the child.”
    “Oh, my.”
    “Her coach is a woman friend who’s a nurse. Apparently, as a child, Lisa had a bad experience of some sort in a hospital. Now she’s terrified of them.”
    “Ergo
the home birth.”
    “That’s one of the reasons. Lisa’s sort of—I don’t know—she’s very secretive about herself, and very mistrustful of people.”
    “Even you?”
    “Not as much as at first, but yes, even me.”
    “Well, then, supposing we go on in and try to turn that around.”
    Sarah gathered up the covered tray of equipment and obstetrical instruments.
    “One more thing,” she said. “Heidi, the birth coach, said that Lisa’s pressure has been dropping slightly and that it’s become harder to hear in her right arm than her left. The last systolic I know of was eighty-five, just as Glenn was starting his talk. The highest, a few hours before that, was one ten.”
    “And what do you make of that?” Snyder asked.
    “Low-normal for this stage of labor, I would say. When she called me, Heidi reported that Lisa looked fine. So it’s probably nothing.”
    Sarah saw concern in Snyder’s eyes and immediately sensed that she had not taken the report seriously enough.
    “The actual number may be low-normal,” he said, “but in my experience, not many labor patients have that sort of pressure drop at this stage.”
    “I—I should have told you sooner, I guess,” Sarah responded.
    “Nonsense. I’m just a natural-born alarmist. I would suspect that you’re right—the low pressure will probably turn out to be due to a little dehydration. You bring the OB tray. I’ll bring the pedi one.”
    As they stepped from the car, they heard a siren, probably a block or so away. They were still on the tree belt when a police cruiser, strobes flashing, screeched around the corner and skidded to a halt behind the Volvo. A uniformed officer jumped out and, ignoring them, sprinted up toward the front door.
    “Excuse me,” Snyder called out as they hurried after the policeman, “I’m Dr. Randall Snyder from the Medical Center of Boston. What’s going on?”
    “I don’t know, Doc,” the officer said, panting. “But I’m glad you’re here. We got a nine-one-one call that a woman was in serious trouble here and needed an ambulance. One should be arriving any minute.”
    “The woman’s name?” Sarah asked, aware of a sudden knot in her chest.
    The policeman rang the bell several times and then began rapping on the glass panel of the front door.
    “Summer,” he said. “Lisa Summer.”
     … The
real
stress on this job: the cases that don’t come out right, the people with untreatable illness, the people who die in spite of everything we do …
    Randall Snyder’s words echoed in her thoughts as Sarah followed the policeman and Heidi Glassman up the broad staircase. From above, she could hear Lisa’s sputtering cough and cries of pain. And even before she entered the bedroom, she could smell the blood.
    Lisa, sitting splay-legged on her futon, was hemorrhaging from her nostrils and mouth. Fresh and drying blood covered the front of her nightgown and was spattered on the futon, floor, and wall. But even more disturbing to Sarah was the glazed fear in the girl’s eyes. It was a look she had seen only a few times before in her medical career, most recently in a fifty-year-old postoperativewoman who was about to have a massive coronary. Within minutes that woman was in full, irreversible cardiac arrest.
    “It started shortly after I called you,” Heidi said as Sarah and Randall Snyder gloved, then knelt beside Lisa to begin their evaluation. “I would have called you back, but I was sure you were on your way. Everything was going fine—except for that blood pressure thing I told you about. Then all of a sudden Lisa began complaining