— Celeste Maren —
The coffee was already cold when I stepped into my parents' kitchen.
"Good morning, Dr. Maren," my mother said, only half-joking, as she folded napkins at the dining table. "Or should I say good evening? We weren't sure if you were showing up at all."
"I said I'd be here," I replied, setting down a pastry box I picked up on the way over. My tone came out sharper than I meant. Fatigue still clung to my skin like a second scrubs set.
Dad looked up from the stove. "That smell like apricot croissants?"
"Your favorite."
He smiled, gentle and tired in the same way I was. "You didn't have to."
"I know."
My sister, Marianne, was already seated with her two kids—one in a high chair, the other kicking her feet under the table, bored. She barely glanced up from her phone.
"Did you actually sleep, or are you running on adrenaline and hospital coffee again?" Marianne asked, her voice too sweet.
"Two hours. And I brought my own coffee."
She smirked like she'd won something.
I sat at the edge of the table, half-present. This wasn't an obligation—it was routine. Sunday breakfast at the Maren house. A performance of domesticity I watched like a ghost floating through a memory.
My mother still wore her pearls. My father still poured juice into crystal glasses like it meant something. The kids chattered, fought, spilled things.
And I watched.
"Any new dating prospects?" my mother asked, all innocence.
Here it comes.
"No."
"Why not? You're thirty-three, you have a career, you're stable. Are the doctors at your hospital all married?"
"They're all exhausted," I said. "And most of them are men who haven't learned how to respect a woman in a surgical room."
"Or maybe," Marianne chimed in, "you just like your work more than people."
That one stung more than it should've.
I reached for a croissant. "It's not about liking work more. It's about knowing what you're good at."
"You're good with kids," Dad offered gently. "I've seen you with Ella. Maybe not your own, but you light up around her."
I smiled, small. "I like kids when I can hand them back."
Marianne rolled her eyes. "You're going to be that aunt, huh?"
"I'm not going to be any kind of aunt if I keep getting assigned emergent cases in the middle of the night. Maybe one day."
My mother sighed, folding another napkin like she was compressing her disappointment into linen.
"You know," she said, "your cousin's wife just had a home birth. No complications. No surgery. I think all this hospital intervention is making women weaker."
I blinked. Then blinked again.
"That's not how uterine rupture works, Mom."
She waved me off like I was the one being unreasonable.
And just like that, the air between us cooled—thick with the kind of tension families are experts at pretending doesn't exist.
My pager buzzed against the side of my purse just as I reached for a second coffee.
CODE OB – ROOM 12 – STAT
The sound wasn't loud. But it cut through the kitchen louder than thunder.
I didn't say goodbye.
My family knew what it meant. They'd stopped asking if I had to go. I was already out the door.
Ten minutes later, I was back in the hospital, white coat half-on, ID badge swinging.
"Who's the patient?" I snapped as I entered the labor and delivery floor.
"Twenty-seven-year-old, first-time mother, thirty-three weeks. Transferred from a clinic an hour ago. Unresponsive fetal heart tones on arrival—now decels in the 60s."
"Placenta previa?" I asked, already scrubbing in.
"Could be. But her vitals just dropped. BP's in the 80s systolic. She's tachy. We're prepping OR now."
I felt it before I thought it: that cold rush of mental clarity. The one that only came when something was about to go very, very wrong.
"Where's the OB resident?"
"On her way. But you're the attending now."
The doors to OR-2 swung open. The patient lay draped and shaking on the table, IVs in both arms. Her eyes were wide, wet with pain and fear.
"Miss Wallace," I said, calm but firm. "I'm Dr. Maren. I'm going to take care of you, and we're going to do everything to keep you and your baby safe, alright?"
She couldn't respond. She was trembling too hard. Blood soaked the pads under her.
I turned to the anesthesiologist. "She needs general."
"We're almost there."
"Go faster."
"Dr. Maren," the nurse at my side whispered, "baby's heart rate—now 52."
I froze for half a second.
Then everything accelerated.
"Gloves. Scalpel. We're going in."
"But anesthesia—"
"I SAID GLOVES."
My hands were in motion before the team caught up. I didn't have time for perfect. I had time for now. The skin opened clean. Muscle. Peritoneum. Then uterus—
And blood.
Not a gush. A flood.
"Massive abruption," I barked. "Clamp, clamp—NOW. Suction. I need to see."
"I can't get the tone—uterus is boggy—"
"Then we pack and push. Get the baby out!"
I reached, deep, into the dark warmth of the womb.
Fingers found a shoulder. Then a head.
The baby was limp.
"No cord," I muttered. "Please no cord—"
But it was there. Wrapped twice around the neck. Purple, slick, tightening.
"Cut it," I ordered.
Seconds.
Every second cost brain cells, heartbeats, breath.
Cord gone. One hand under the neck, the other under the hips. Lift.
He slid free—silent.
"Neonatal team—NOW!"
The nurse took him from my arms like a precious, dying thing. I didn't get to look. I turned back to the mother.
"She's coding!" someone yelled.
"Crash cart in!"
I clamped, packed, pressed, ordered units of blood and uterotonics while my forearms ached and my legs shook.
Another doctor arrived. Then another.
It felt like an hour.
It was seven minutes.
The mother came back on the second shock.
The baby cried after fifteen compressions and two breaths.
I sat down on the cold OR floor.
Not because I was tired.
Because I could finally breathe.
I didn't get up from the floor by choice.
I got up because another page hit.
Room 9. Severe preeclampsia. Seizure. Code OB backup needed.
I was on my feet before I realized I'd moved.
My gloves were sticky. My scrubs were soaked through with someone else's blood. I didn't care.
"Get me clean gloves and a fresh gown," I barked to the first nurse I passed. "Call neurology, and notify ICU. We may need to transfer."
"Doctor—are you sure you're okay to keep going?"
I shot her a look. "There's no one else, is there?"
She didn't answer.
Didn't need to.
Room 9 was chaos.
A woman in her late 20s thrashed against the gurney, eyes rolled back, foam at the edge of her lips. The fetal monitor screeched with irregular contractions. Her husband stood frozen in the corner, clutching the diaper bag like it could protect him from the terror crashing into his life.
"What's her BP?" I shouted.
"Two-twelve over one-forty! She spiked after coming in—said her vision went black, then collapsed!"
"Mag sulfate—now!"
"I'm pushing it—seizure still going!"
"Diazepam, 5 milligrams. Prep for emergency delivery if she doesn't stabilize."
Another nurse was trying to get a second IV in—her hands slipped once, then again.
The patient bucked violently.
I grabbed the woman's wrist and held her down with one arm, bracing her body to keep her from falling off the gurney.
"Hold her steady!"
"BP's climbing—she's seizing again!"
"Push more mag—get that IV in, or I'll do it myself!"
The husband started to sob.
"Will she die?" he choked out.
"Not if I can help it!" I snapped, not taking my eyes off the convulsing woman. "But I need you out. Now!"
Someone pulled him away. The door slammed shut.
The woman's body arched once—twice—
Then stilled.
The monitor beeped low. Her oxygen was tanking.
"She's apneic—intubate now!"
The team moved as one, the dance of disaster unfolding in practiced rhythm. I stepped back only long enough to grab the crash cart, my hands slick and trembling from adrenaline.
Time had no meaning.
I didn't know how long it lasted.
Ten minutes. Twenty. More.
But finally—finally—she stabilized.
Faint but present heartbeat on the monitor.
The fetal tones returned.
Weak, but there.
I leaned against the wall, sweat clinging to my hairline, chest heaving.
The attending anesthesiologist met my eyes across the room.
"You just saved two lives," he said.
I shook my head, jaw clenched. "Not yet."
I turned to the nurse. "Prep OR Three. If she crashes again, we're cutting immediately. I want her on full fetal monitoring and neuro obs. Every ten minutes. Page me with everything."
She nodded, scribbling frantically.
My palms stung. I looked down—there was a cut across my thumb I hadn't noticed. Blood beaded where latex had torn.
I couldn't even remember when it happened.
It wasn't over.
It never was.
I was halfway through rinsing blood from under my fingernails in the surgical scrub room when a nurse popped her head in.
"Dr. Maren? Sorry—Room 4. You're up again. Thirty-one weeks, gestational diabetes, suspected pyelonephritis. She's spiking a fever and contracting irregularly."
I cursed under my breath.
No rest.
Just movement.
.....
The woman in Room 4 looked like she'd been through a war.
She was sweating through her gown, hair matted, cheeks flushed red from fever. Her eyes fluttered open as I entered.
"Miss Amina Gutierrez?" I asked.
She nodded weakly.
"I'm Dr. Maren. I heard you came in with some pretty nasty symptoms. Can you tell me how long you've had pain or burning when you pee?"
"A day… maybe two…" Her voice cracked. "I thought it was just the baby pressing low."
"It could've been. But you've got a fever of 103 and your labs say otherwise. Your glucose is through the roof—over 300—and your urine's full of bacteria and ketones."
I turned to the nurse. "I want IV fluids, broad-spectrum antibiotics—start with ceftriaxone—and continuous fetal monitoring. If this tips into sepsis, we're escalating immediately. Also get Endocrine on the line. Her sugars need tight control. No exceptions."
"On it."
I leaned in gently toward Amina. "Any nausea? Vomiting? Back pain?"
"My sides… hurt so bad," she whispered. "And I keep… leaking something…"
I didn't like that.
I lifted the sheet.
"Fluid's pooling. Clear. We need to test for rupture of membranes—stat."
The nurse was already grabbing a nitrazine strip and a sterile swab. I watched her work, arms crossed tight over my chest, heart pounding again. If her membranes had ruptured and she was contracting, the infection could travel directly into the uterus.
Which meant she wasn't just a diabetic with a UTI.
She was a diabetic with pyelonephritis and suspected chorioamnionitis.
I barely waited for the result.
Positive.
"Call NICU," I said. "We're likely going to have a thirty-one-week preemie."
Amina's eyes filled with tears.
"No, no—please. Not yet. I haven't even… I don't have the car seat, I'm not ready—"
I took her hand, firm but kind.
"He's coming whether you're ready or not. And we're going to do everything we can to make sure he's safe. But you need to focus on breathing, and staying calm. Let us do the rest."
She nodded, barely holding it together.
I stepped out of the room, grabbed the nearest resident.
"Start steroids. Full dose. And magnesium sulfate for neuroprotection. I want blood cultures, a full sepsis panel, and hourly vitals. She doesn't leave that monitor."
Then I whispered, quieter, closer:
"And if she spikes again or that baby's tones dip—get me. Don't wait."
...
The door closed behind me.
I leaned against the wall outside Room 4.
Three critical cases in under four hours.
My legs shook. My mouth was dry. My heart wouldn't slow down.
There was no glory in this kind of medicine.
Only grit.
Only loss.
Only fight.
And I was still standing.
Barely.
The hallway smelled like bleach and blood.
I leaned against the wall outside Room 4, blinking hard. The edges of my vision blurred—not from tears, not yet—but from sheer, crawling fatigue. My hands had stopped trembling. That worried me more than the tremors.
It meant I was past adrenaline.
Running on fumes.
I reached for my pager. My fingers were slow.
Beep.
It buzzed again.
I didn't read it.
I just stood there, back pressed against cold tile, lungs moving in shallow pulls. I could hear voices—distant, tinny, like underwater radio chatter.
Someone shouted my name down the hallway.
Twice.
But I didn't move.
My feet were lead. My legs burned.
My ears rang.
A nurse walked past and glanced at me, then hesitated.
"Dr. Maren?" she said carefully. "Are you okay?"
I opened my mouth to answer.
Nothing came out.
My heart thundered once—twice—then stumbled. A hot flash surged through my arms.
My knees buckled.
I caught myself—just barely—gripping the rail on the wall as the corridor tilted.
"Doctor—hey—someone get help!"
"Celeste—Dr. Maren—"
I couldn't hear the rest.
Darkness gathered in the corners of my vision.
No time to rest.
No time to break.
I had babies to save.
And yet—
All I saw was light, fading fast.
End of Chapter Two.