Ordinarily, she was too busy operating to worry about what anesthesia was doing, and she trusted them to do their job as well as she did hers.

Now, with nothing to do but watch everyone else take care of Honor, she felt helpless. Useless. And more anxious than she could ever remember feeling.

“Mama is doing fabulously,” Tristan said, leaning down so Honor could hear her.

“Wonderful stuff, whatever you gave me,” Honor said, her voice slightly slurred. She frowned. “Shouldn’t give me drugs.”

Tristan laughed. “Don’t worry, Dr. Blake, that baby is going to be out before any of what you’re getting gets down there.”

“All right then,” Honor proclaimed. She blinked and frowned again. “Quinn?”

“Right here.” Quinn pulled her gaze away from the surgical field.

Deb had delivered the uterus, which glistened a deep purple under the overhead lights, into the field. Deb murmured something to the nurses that Quinn didn’t hear, then made a one-inch incision in the lower portion of the distended muscle. Quinn bent down. “The baby’s coming in a second, sweetheart.”

“Go. Go look.”

“Okay. I’ll be right back.”

Quinn stepped around the barrier and moved behind Deb to the end of the table where the scrub nurse waited with her instruments.

“Can you toss me a gown?”

“Here you go, Doctor,” the nurse said, holding up a sterile gown for Quinn to slide her arms into. The nurse handed off a packet of sterile gloves, which Quinn pulled on. Because she hadn’t scrubbed first, she wasn’t technically sterile enough to step up to the operating table, but she could get close enough to Deb to see, and she could hold the baby without any concerns. She watched over Deb’s shoulder as Deb inserted a large pair of scissors inside the uterus and cut the rest of the way through the muscular wall. Quinn held her breath, knowing that occasionally the scissors would lacerate the baby as the baby moved around inside the uterus. Then a tremendous gush of blood-tinged fluid poured out. A second later a tiny arm poked out of the gap in the muscular uterine wall. Deb reached into the uterus with one hand, found the head and directed it up toward the incision, and the baby came swimming out on another spurt of blood and amniotic fluid. Quinn had seen cesarean sections dozens of times, but somewhere around the time the scissors had gone into Honor’s uterus, she’d stopped breathing. Now her breath whooshed out in a gasp of relief. Then her stomach plummeted. The baby was blue and not breathing. Quinn struggled not to panic.

“Get the suction up,” Deb said calmly to the nurse as she deftly clamped and cut the cord, freeing the baby from the placenta, which remained inside Honor’s uterus. As soon as Deb inserted the suction catheter inside the baby’s nose and mouth, the child cried. The scrub nurse scooped the baby up, turned, and handed it off to the waiting pediatric nurse, who carried the child to a waiting bassinet underneath a heat lamp.

“Is Honor okay?” Quinn murmured close to Deb’s ear.

“Doing fine,” Deb said. “Go see your baby.”

My baby, Quinn thought, suddenly unsteady. How life had changed. A few short years ago she’d seen herself as the star of a big city hospital trauma center, her life one adrenaline rush after another.

She’d never been one for serious relationships, but she hadn’t played around either. She’d focused on work. So she hadn’t seen a woman in her future. All that had changed when illness had nearly derailed her surgery career permanently. Then, when she thought she’d lost everything, she discovered what had been missing in her life all along.

A family of her own. Now she had Honor and Arly and Phyllis. And a new baby. From behind her, she heard Honor’s voice, sleepy but clear.

“Quinn? Tell me.”

Quinn stood next to the bassinet and looked down, amazed. They hadn’t wanted to know the baby’s sex until now, and that seemed the least important thing at the moment. “Sweetheart? Solid Apgars—all systems go. Ten fingers, all perfect. Ten toes. Equally perfect. Oh—and some extra little bits, also perfect.”

“Little bits? A boy?” Honor laughed. “We have a boy?”

“Yep. Arly has a brother. You can see him in a minute.” Quinn watched the nurse record the various vital signs, documenting the baby’s neurologic and cardiovascular status. He was crying and waving his arms and legs. He had a thatch of hair, just a shade lighter than Honor’s. His eyes were brown. “He’s beautiful, sweetheart.”

“Tris,” Deb said, “can you push some more Pitocin, please?”

Quinn suddenly realized that the room behind her had grown very quiet. She turned, heart pounding. Her eyes went first to the monitor behind Tristan’s head. Honor’s heart rate was 140, her blood pressure was down, her O2 saturation below normal. For one dizzying second, the room spun, and then Quinn’s mind snapped into sharp focus and she took three rapid strides back to the operating table. “What’s wrong?”

“She’s bleeding and the Pit doesn’t seem to be working,” Deb said, kneading the uterus between her hands, trying to coax the sluggish muscle to contract. The vessels supplying the uterus were as large as Quinn’s thumb, having increased in size during pregnancy to meet the demands of the growing fetus for blood and nutrients and oxygen. Now the inner surface of the uterus had been stripped of the placenta, and if the muscle didn’t contract, closing off the open ends of the vessels, the vast volume of blood that had gone to supply the baby would simply pour out through the opening of the uterus. At this rate, Honor would bleed to death in a matter of minutes.

Quinn wanted to push Deb out of the way and grab a clamp, a suture, anything to stop the river of blood pooling in Honor’s abdomen.

She forced herself to move to the head of the table, to Honor. Honor’s eyes were closed, and she was very pale.

“It’s okay, sweetheart,” Quinn whispered, kneeling so her face was close to Honor’s. “It’s going to be okay.”

Honor didn’t answer.

“You want me to tube her, Deb?” Tristan waved to the circulating nurse to get her attention. “Get an anesthesia tech in here STAT.”

God damn it. She hated when an easy case went bad. She hated it whenever that happened, but it was always so much worse when it was someone she knew, or the family or friend of someone she knew.

This time, she couldn’t even think about Quinn just inches away, fear seeping from her pores. Quinn had pulled off her sterile gloves and had one hand on Honor’s face. Her fingers trembled, something else Tristan had never seen.

Tristan checked the O2 saturation. It had fallen dangerously low.

Now the call was hers, not Deb’s. “I’m going to intubate. Where the hell’s the tech?”

“I can help,” Quinn said, straightening up. “What do you need?”

“Get me a number seven ET tube. Second drawer in my cart,” Tristan said without bothering to look up from her drug box. She pulled out ampoules and drew up the medication to paralyze Honor so she could insert the breathing tube into her trachea. “Did someone call down for blood?”

“Do we have a type and screen on her?” Deb called out. “Someone hook up another suction. I can’t see anything in here.”

“She’s A positive,” Quinn said. She held the tube next to Tristan’s right hand while Tristan inserted the laryngoscope into Honor’s mouth to hold her tongue out of the way and expose her epiglottis.

“Nice clear view for a change,” Tristan muttered, taking the endotracheal tube lightly between her thumb and first two fingers and easing it past the epiglottis, through the vocal cords, and into the trachea. “Blow up the balloon. Eight cc’s.”

When Quinn fumbled with the thin plastic tube attached to the balloon at the end of the trach tube, Tristan realized Quinn was in no shape to be assisting her. Carefully, she extracted her laryngoscope while supporting the tube with her other hand. “Here, I’ll do it.”

“I got it,” Quinn said gruffly. “Eight cc’s, right?”

“Right.”

Quickly, Tristan connected the endotracheal tube to a ventilator, cycled in the appropriate amounts of general anesthetic and oxygen, set the volume on the respirator, and started to relax just a little. There wasn’t much she could do now but wait, which was never easy, but

Deb was a good surgeon on top of being a good obstetrician. “How are things going over there, Deb?”

“Slowing down, but not enough. How is she?”

“She needs volume, but otherwise looking good.”

“Quinn,” Deb said, her attention still on the surgical field.

“Yes?” Quinn said sharply.

Tristan felt Quinn stiffen beside her. Someone probably should’ve gotten Quinn outside, but Tristan wasn’t quite certain how anyone would have.

“If I can’t get this bleeding stopped in another minute, I’m going to have to do a hysterectomy,” Deb said. “You’re next of kin. Do you consent?”

“I…” Quinn drew a shaky breath. “Honor and I haven’t talked about more kids…I don’t know what she wants.”

The room was silent except for the sound of the suction removing the blood that continued to flow. Tristan understood that in that moment, Quinn Maguire was no longer a calm, cool, collected trauma chief.

She was a woman faced with losing everything that mattered to her, vulnerable and alone.

“You and Honor have two kids, Quinn,” Tristan said quietly. “They need Honor. So do you.”

Quinn met Tristan’s eyes, hers filled with misery.

“Quinn?” Deb repeated.

“Yes,” Quinn said firmly. “Yes. Do it.”

Tristan stepped off the elevator onto the top floor of the parking garage and blinked in the early morning sun. For a few seconds, she struggled with the disorientation of returning to the normal world, where most people were on their way to work on Monday morning while she was on her way home to bed. At least, she should be on her way home to bed, but she knew she wouldn’t be for a while. She’d barely finished with Honor when she’d been called back to trauma admitting. Healthstar had made another run and brought in a second patient from the turnpike accident. Until Tristan’s relief had arrived at eight, she’d been in the operating room with a nineteen-year-old girl who’d been trapped in the front seat of her Mazda Miata underneath the back wheels of the tractor-trailer for forty minutes before the EMTs could extricate her. She’d lost her right leg below the knee and might lose the other, if she didn’t bleed to death from a ruptured spleen, fractured pelvis, and lacerated inferior vena cava. Her blood pressure had bounced from 40 to 200 with the rapidity of a ping-pong ball in a championship match, keeping Tristan constantly on edge.