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  'Are you sure you're okay?' the woman asked again.

  'Yes,' I said, the lie coming easily, reminding me that, even as much as I hated her right now, I was my mother's daughter.

  Piper

  September 2007

  I

  've always said that the best part of my job is that I don't do the work: that's up to the prospective mother, and I basically monitor what's going on and keep it running smoothly.

  'Okay, Lila,' I said, removing my hand from between her legs. 'We're at ten centimeters. Almost there. You've got to push for me now.'

  She shook her head. 'You do it,' she muttered.

  She'd been in labor for nineteen hours; I completely understood why she wanted to pass the buck. 'You are so beautiful,' her husband crooned, holding up her shoulders.

  'You are so full of shit,' Lila snarled, but as a contraction settled over her like a net, she bore down and pushed. I could see the fetal head swelling closer, and I held up my hand to keep it from popping out too fast and tearing the perineum. 'Again,' I urged. This time, the fetal head rushed forward like a tide, and as the mouth and nose broke the seal of Lila's skin, I suctioned them. The rest of the head was delivered, and I slipped the cord over it, supporting it as I turned the baby to control the shoulders. Five seconds later, the baby was balanced in the scale of my hands. 'It's a boy,' I said, as he announced, with a healthy cry, his own presence.

  The cord was clamped, and Lila's husband cut it. 'Oh, baby,' he said, kissing her on the mouth.

  'Oh, baby,' Lila echoed, as her newborn son was settled in her arms by the labor nurse.

  I smiled and resumed my position at the foot of the birthing chair. Now came the unceremonious part of the happy event: waiting around for the placenta to present itself like a late houseguest; checking the vagina, cervix, and vulva for lacerations and repairing them if necessary; doing a digital rectal exam. To be honest, the parents were usually so engrossed in the newest addition to their family, some women didn't even notice what was going on below their waists anymore.

  Ten minutes later I congratulated the couple, stripped off my gloves, washed my hands, and headed outside to begin filling out the mountain of paperwork. I had barely taken two steps outside the patient's door, though, when a man wearing jeans and a polo shirt approached. He looked lost, like a father who was staggering into the birthing pavilion to locate his wife. 'Can I help you?' I asked.

  'Are you Dr Reece? Dr Piper Reece?'

  'Guilty as charged.'

  He reached into his back pocket and pulled out what looked like a folded blue brochure, which he handed to me. 'Thanks,' he said, and he turned on his heel.

  I opened the document and saw the words WRONGFUL BIRTH ACTION.

  Birth of an unhealthy child.

  Parents' right to recover is based on the defendant's negligent deprivation of the parents' right not to conceive a child or to prevent the child's birth.

  Medically negligent.

  Defendant failed to exercise due care.

  Plaintiffs suffered injury or loss.

  I had never been sued before, although, like every other obstetrician, I had medical malpractice insurance. On some level, I'd known that my lack of lawsuits was sheer luck - that it would happen sooner or later. I just hadn't expected it to feel like such a personal affront.

  There had certainly been tragedies during my career - babies that were stillborn, mothers whose complications during childbirth led to excessive bleeding and even brain death. I carried those incidents with me, every day; I didn't need a lawsuit to make me revisit them over and over, and wonder what could have been done differently.

  Which disaster had precipitated this? My eyes scanned to the top of the page again, reading the plaintiffs' names, which I'd somehow missed the first time around.

  SEAN AND CHARLOTTE O'KEEFE v. PIPER REECE.

  Suddenly I couldn't see. The space between my eyes and the paper was washed red, like the blood that was pounding so loudly in my ears that I did not hear a nurse ask if I was all right. I staggered down the hall to the first door I could find - into a supply closet filled with gauze and linens.

  My best friend was suing me for medical malpractice.

  For wrongful birth.

  For not telling her earlier about your disease, so that she would have had the chance to abort the child she'd begged me to help her conceive.

  I sank down onto the floor and cradled my head in my hands. One week ago, we'd driven down to Target with the girls. I'd treated her to lunch at an Italian bistro. Charlotte had tried on a pair of black pants and we'd laughed about low-rise waistbands and how there should be support thongs for women over forty. We'd bought Emma and Amelia matching pajamas.

  We'd spent seven hours together in close quarters, and not once had she managed to mention that she was in the process of suing me.

  I pulled my cell phone out of the clip at my waist and speed-dialed her - number 3, outranked only by Home and Rob's office. 'Hello?' Charlotte answered.

  It took me a moment to find my voice. 'What is this?'

  'Piper?'

  'How could you? Everything was fine for five years, and all of a sudden out of nowhere you slap a lawsuit on me?'

  'I really don't think we should be talking on the phone--'

  'For God's sake, Charlotte. Do I deserve this? What did I ever do to you?'

  There was a beat of silence. 'It's what you didn't do,' Charlotte said, and the line went dead.

  Charlotte's medical records were back at my office, a ten-minute drive from the hospital birthing pavilion. As I entered, my receptionist glanced up. 'I thought you were at a delivery,' she said.

  'It's over.' I walked past her, into the records room, and pulled Charlotte's file, then headed back outside to my car.

  I sat in the driver's seat with the file in my lap. Don't think of this as Charlotte, I told myself. This is just any other patient. But when I tried to bring myself to open the manila folder with the bright tabs on the edge, I couldn't do it.

  I drove to Rob's practice. He was the only orthodontist in Bankton, New Hampshire, and pretty much had a monopoly on the adolescent market there, but he still went out of his way to make the dental experience something kids would enjoy. In one corner of the office was a projection TV, where a generic teen comedy was currently playing. There was a pinball machine and a computer station where patients could play video games. I walked up to his receptionist, Keiko. 'Hi, Piper,' she said. 'Wow, I don't think we've seen you here in a good six months--'

  'I need to see Rob,' I interrupted. 'Now.' I grasped the file in my hands more tightly. 'Can you tell him I'll meet him in his office?'

  Unlike my office, which was all the colors of the sea and designed to put a woman at ease, in spite of the plaster models of fetal development that dotted the shelves like little Buddhas, Rob's was luxurious, paneled, masculine. He had an enormous desk, mahogany bookshelves, Ansel Adams prints on the wall. I sat down in his tufted leather chair and spun it around once. I felt small here. Inconsequential.

  I did the one thing I'd wanted to do for two hours now: burst into tears.

  'Piper?' Rob said as he came in to find me sobbing. 'What's the matter?' He was at my side in a second, smelling of toothpaste and coffee as he folded me into his embrace. 'Are you okay?'

  'I'm being sued,' I managed. 'By Charlotte.'

  He drew back. 'What?'

  'Med mal. For Willow.'

  'I don't get it,' Rob said. 'You weren't even at the delivery.'

  'This is about what happened before.' I glanced down at the file, still on the desk. 'The diagnosis.'

  'But you did diagnose it. You referred her to the hospital when you found out.'

  'Apparently, Charlotte thinks I should have been able to tell her earlier - because then she could have had an abortion.'

  Rob shook his head. 'Okay, that's ridiculous. They're die-hard Catholics. Remember that time you and Sean started arguing about Roe v. Wade and he left the restau