"You fell down the stairs? How'd that happen?"

"My dad went ballistic. He wanted a beer before dinner. When I asked him to wait and said he could have it with his dinner, he flew into a rage. He stumbled into the kitchen where I was cooking and was headed for the basement refrigerator. He's fallen so many times in the past, I didn't feel it was safe for him to try and negotiate the stairs, so I stepped in front of him to stop him. That's when he took a swing at me. When I stepped back to get out of his way, I lost my balance and fell."

Regan started to cry. "I feel so stupid. I know better than to argue with him. He doesn't know what he's doing." I held Regan's head against my chest. Her sobs wracked her body.

"It's okay. We'll fix you up," I said, stroking her blood-caked hair.

"Looks like you've got a pretty good gash up here," I said, removing the towel. I pulled the hair apart and exposed a good six-inch laceration. The gash was still oozing, so I tacked it together with a couple of steri strips. "We're gonna have to sew that up," I said. "Does anything else hurt?"

"My back and my belly," she said.

"Are you having contractions?"

"I don't know.... The pain comes in waves about every five minutes."

"Okay. Lie back," I said, cradling Regan in my arms and helping her lie back on the exam table. Amy was at the other end of the table pulling out the stirrups. "I need to examine you and attach a fetal heart monitor. Are you okay with me doing the exam or do you want me to get another doctor for you?"

"No, I want you," Regan said, fear in her eyes as she clutched my hand in hers.

"Okay. Take some nice deep breaths and try to relax."

Amy helped me put Regan's legs in the stirrups.

"I'm going to touch your leg now. Can you open your knees a little bit wider?" I asked. "That's fine. Are you doing okay?" I peered over Regan's paper-draped knees.

Regan nodded and grabbed the sides of the exam table, and I proceeded with the internal exam, exposing my greatest fear: Regan was bleeding vaginally.

"Okay, I'm going to insert my finger to check your cervix now." I inserted a gloved finger inside Regan's vagina. She gripped the exam table tighter as I continued to probe her insides.

Her cervix was open, about five centimeters, and I couldn't feel the membrane sack. Shit.

I probed deeper now, knowing her water had broken, to see if I could feel the baby's head. The head had not engaged yet, which was good, but there was a lot of blood, too much blood. Even if it was a mixture of blood and amniotic fluid, it was still too much.

"Regan, I can't feel the fluid sack, and your cervix is dilated about five centimeters."

"Oh, God, no...it's too soon," Regan said, attempting to sit up on the exam table.

Amy helped her to lay back down. I knew she knew full well that if her baby had any chance at survival, she'd have to deliver it soon.

"Is my baby all right?" Regan asked.

I turned on the ultrasound machine. The black and white screen flickered. I squeezed a puddle of ultrasound jelly on Regan's belly and dipped the wand into it. I passed the wand over the lower part of Regan's pregnant abdomen. The baby, a girl, about thirty-six weeks gestational age, appeared on the screen. The baby's heartbeat was strong, but the ultrasound confirmed that Regan's membranes had ruptured and that we'd have to deliver this baby soon.

"Heartbeat is nice and strong," I said. "Can you hear it?"

Regan nodded. "Oh, thank God." She breathed out a sigh of relief.

Amy held the ultrasound wand while I attached the fetal heart monitor. As soon as I got the monitor attached, Regan had a contraction.

"Breathe through it, Regan. Don't push." I held her hand and squeezed it tight.

Regan held on tight and breathed through her mouth in short sharp breaths. The contraction passed.

"What was that?" Regan asked, panic in her voice. "I felt a gush of something."

I looked down and saw the bedsheet under Regan was soaked with blood. I grabbed the ultrasound wand again and moved it over Regan's abdomen.

"What's happening?" Regan asked.

The ultrasound revealed that the placenta was pulling away from the uterine wall, causing the excessive bleeding. Instead of having hours to deliver this baby, we had only minutes because if the placenta pulled away from the uterus completely, the baby would lose all support from the mother.

"Regan, we have to get you up to labor and delivery as soon as possible."

"Oh, God," she cried.

"The baby's heartbeat is strong. We'll do the absolute best we can. I've seen a lot of miracles happen, and I know you have, too."

Regan had another contraction. She gripped my hand tight, almost breaking the bones in my fingers. The fetal monitor alarm went off. The baby's heart was decelerating with the contractions. The contractions were beginning to cause stress for the baby. It was clear if we didn't do something soon, we could lose it.

"Amy, call up to OB and tell them we have a thirty-six-week pregnancy with placenta previa and late decelerations."

Amy ran out to the desk and paged the OB resident. Regan's contractions were three minutes apart. I watched the fetal heart monitor as another contraction wracked Regan's body. The baby's heart rate dropped from 130 to 96-dangerously low.

Amy returned. "Both residents are delivering. They want us to prep her down here, then bring her up to labor and delivery. Once one of the residents is free, they'll deliver her."

"Fine," I said.

Amy quickly did the shave prep while I took care of the other necessities.

"Regan, how can I get a hold of your husband?" I asked.

"He's at Clancy's tending bar. I called there before I came to the hospital, but he wasn't there yet."

Another contraction came over her. She gripped the side of the exam table again, trying not to push.

"I'll call him when we get upstairs," I said, raising and locking the side rails on Regan's gurney.

Amy grabbed the fetal monitor, and we headed up to labor and delivery. The elevator doors slid open, and Amy and I wheeled Regan down the hall to the delivery suites. Both rooms were still occupied. I donned a surgical mask and gown and went in.

"Almost done?" I asked the resident sitting at the bottom of the delivery table between a woman's surgical green-draped legs propped up in stirrups.

"She's just starting to crown now," he said. "It may still be a while. Try suite two, I think they're finishing a C-section in there."

I pushed open the heavy wooden doors of suite two. There the resident was elbow deep in his patient's splayed open abdomen. "How much longer? I've got a woman out in the hall with placenta previa and fetal decelerations in the nineties."

"Well, this one's got a boggy uterus, and I'm afraid if I can't get it to tighten up, she's gonna bleed out," the resident said as he rhythmically squeezed the woman's uterus, trying to get it to contract down. "You're gonna have to page the attending on call."

I went back out in the hall. Amy was standing guard over Regan, wiping her face with a damp washcloth. "Both suites are tied up. I paged the attending and he'll be here in 10 minutes."

Another contraction hit. Blood gushed again underneath Regan, soaking the bedsheet and dripping onto the floor.

"I need to examine her again," I said, fearing the worst.

Amy and I wheeled Regan into one of the patient rooms. I pulled on a rubber glove.

"Okay, Regan, I need to check your cervix again. This is going to feel uncomfortable. Take some deep breaths."

Regan breathed in. I inserted two gloved fingers into her vagina. She was fully dilated, and this time, I could feel the baby's head.

"The baby is crowning," I said. "I'm going to slip my fingers in and see if I can feel for the cord to make sure it's not around the baby's neck."

I slid two fingers under the base of the baby's head to the neck. I didn't feel the cord.

"Okay, Regan, with the next contraction, I want you to push."

I watched the fetal monitor as the tracing began to rise with the approaching contraction. "Okay, Regan, here it comes...push."

Regan bore down. The tiny head popped through and filled my palm. "Okay, Regan, good, you're doing fine. Now get ready, cleansing breath and now push."

Regan bore down again, sweat dripping from her reddened face.

"The head is out," I said and suctioned blood and thick mucus from the baby's tiny mouth and nose with a bulb syringe. The baby's face was blue.

"Good job, we're almost there. Here comes the next contraction... okay...push."

Amy stood behind Regan supporting her back as Regan growled and pushed. The shoulders eased out, as well as the rest of the tiny slippery body, but still no cry from the little one. I suctioned the baby's mouth and nose again, while wiping the cheesy mucus from its blue body.

"What's going on? Is she all right? Why isn't she crying?" Regan asked panicked, trying to sit up on the gurney. "Mina, is the baby okay?"

I suctioned the baby again, then turned her over, patting her back to loosen any secretions that may have become lodged in her airway. My hands shook as I flipped her over onto her back and suctioned her again.

I glanced up at Amy who read my thoughts. Not able to bear what was playing out before us, she looked away.

I suctioned the baby again, then suddenly, the most beautiful sound I had ever heard erupted from the baby's mouth. She let out a loud and healthy cry. I looked down. The baby's complexion was turning ruddy. She shook and trembled in my hands as if angry that we disturbed her sleep. My tears dripped on her chest.

"Congratulations, Regan, here's your daughter." I held up the crying baby.

I clamped off the cord and cut it, then I handed the baby to Amy. She expertly wrapped her in a blanket and took the baby over to Regan and placed her on her chest. There is nothing more magical than watching a mother and her newborn child. The look of pure love shows the special bond. I looked over at Amy; we both had tears in our eyes.

"She's beautiful," Regan said, all the panic gone from her voice as she stroked her daughter's cheek.

"Yes, she is," I said. "We have to get her over to the nursery so they can check her out."

Regan handed the baby back to Amy. Amy clutched the wriggling, screaming bundle to her chest and took her to the nursery.

"You okay?" I asked Regan as I brushed her sweat-soaked bangs from her face. She nodded and began to cry. I held her close.

"It's gonna be all right," I said. "You did a good job. She's a little small, but she'll be fine."

Regan trembled in my arms.

"I'm so sorry," Regan said.

"Sorry? Sorry for what?"

"Sorry for leaving you like I did."

The attending physician arrived. "Where's the placenta previa?" I hated when doctors referred to their patients by their medical problem instead of their name. It just seemed so arrogant.

"Here, sir, this is Regan Martin...I mean Douglass...she just delivered."

"Who are you?" the attending asked. "Are you on staff here?"

"Yes, sir. I'm the ER resident."

"ER resident? What are you doing up here? Where are my OB residents?" He looked down the hallway.

"Both were tied up with deliveries, sir. I had no choice but to deliver her. The baby was having decelerations."

The attending didn't look pleased. "Where's the baby?"

"The nurse took her to the nursery to put her in the warmer. She was only thirty-six weeks. Apgars were seven and nine."

"How's the new mom?" the attending asked Regan condescendingly.

"Exhausted and sore," Regan said wearily.

"She's lost a lot of blood, but the placenta delivered on its own and it was intact. I'll get a stat blood count and make sure she has a blood count ordered for in the morning," I said. "Oh, and she has a pretty good head laceration from the fall. I didn't have time to sew it up in the ER."

I showed the attending doctor the head wound. "I'll have one of the plastics residents come up and take care of that," he said, then pulled back the drape I had used to cover the lower half of Regan's body and examined her.

"Everything looks fine," the attending said. "You're gonna be sore and have some bleeding for the next few days. I'll order you something for pain. Is there anything else I can do for you?"

"When can I see the baby again?" Regan asked. She looked pale and drained.

"They'll get her cleaned up and draw some lab work," he said. "It shouldn't be very long. They'll keep her in the neonatal part of nursery for the first twenty-four hours. You can see her anytime, though. The nurses are pretty good about that. I'll be back in the morning to check on you. If you need anything, don't hesitate to ask."

"Thank you, Doctor," Regan said.

The attending wrote out Regan's post partum orders, then handed the chart to me. "Good job...for an ER resident," the attending said quietly and left the room.

A nurse from post partum came over and wheeled Regan down the hall to her room. I stayed and helped Regan get settled. I could tell she was still in shock over the evening's events.

"Jim!" Regan blurted out. "I've got to call Jim."

"Oh, my God...I'm sorry. I forgot all about calling him. I'll go down to the nurse's station right now and call him and let him know where he can find you. I bet he's worried sick."

I went out to the nurse's station and dialed the number she gave me for Clancy's.