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Chapter 144

The people who worked with Nick in Los Angeles were not happy to see him turn up on Monday with the left side of his face shiny and swollen.

“You have a photo shoot tomorrow!” his publicist, Juliette, screeched furiously. “Do you know how much work it’s going to take the makeup artists to cover this up?! And what about Kimmel on Wednesday??”

Nick took her scolding without complaint, but with a slight smile on his face. Though he knew his timing was terrible – with the single out, he would be caught in a rush of mad promotion until after the album’s release in October – Nick didn’t regret it one bit. In fact, he was very proud to have kicked Jamie Turner’s ass. He’d relived the fight the whole plane ride back to LA, smiling in triumph at each punch he’d thrown into Jamie’s smug face, the way he’d shoved him and thrown him off, the kick he’d sunk right into Jamie’s gut, taking his breath away, and more than anything, the look on Jamie’s face as he’d finally trudged away, his tail between his legs. And Nick had done it all in the sand, on the not-as-sturdy prosthesis that substituted for his real leg.

All of that was more than worth a swollen and painful left cheek, though, of course, his managers and publicist didn’t see it that way.

“Are you sure your cheekbone’s not broken?” Juliette’s voice rose in concern as she took his face in her hands, turning it for a closer look at the left side. “I don’t want to attract even more questions by taking you to the doctor, but we might want to get this looked at…” She gingerly touched his cheek.

Wincing, Nick twisted away. “It’s bruised, not broken,” he said, then shot her a wide grin, ignoring the wave of pain that shot through the side of his face as it was stretched back. It now seemed even more fitting that “Bruised Not Broken” was his first single.

“Cute,” said Juliette, smiling in spite of herself at his pun. “But that still doesn’t help us for the shoot tomorrow. There’s no way this bruising is going to be gone-” She stopped talking abruptly, an odd expression coming over her face.

“What?” Nick asked, watching her closely. She’d either just had an idea or was about to have a stroke.

“I think I’ve got an idea,” Juliette said slowly, and Nick was relieved it wasn’t the latter. “We might be able to use this…”

As she told Nick her idea, speaking in rapid tones, he rubbed the tender side of his face, which was slowly stretching into another smile.

***

Across the country in Clive, Iowa, a suburb of Des Moines, Jamie was sporting a shiner that looked, if anything, more painful. He’d woken up on moving day with his eye swollen almost completely shut. He could see out of it again now, but it was still puffed up and heavily bruised.

“You better hope all that color has faded by next Monday,” Claire said warily, looking at the inflamed mess of black and blue around his eye. “Your new boss is gonna wonder about you if you show up looking like that.”

Jamie, his arms full of the shower curtain he was supposed to be hanging, turned to her in annoyance. “Thanks, dear, for reminding me… again,” he said sarcastically.

“You’re welcome!” chirped Claire, smiling to herself as she went back to drilling the screw holes for the new towel bar.

Slowly, but surely, the new house was coming together. Right now, it was heaped with boxes and mismatched furniture that the movers, paid for by Jamie’s company, had brought in. But one by one, the rooms were starting to take shape, as Claire and Jamie worked together to unpack and put in place their various possessions. When they were done, the house would look very nice, Claire thought.

She was happy with the place so far. She’d been pleasantly surprised to find that it was slightly bigger than it had looked in the pictures Jamie had sent, the rooms more spacious. She had been impressed, especially considering the whole house had cost less than a small condo in Tampa would have. One perk of moving to the Midwest was that the cost of living there was lower than in Florida, particularly near the coast. At the same time, Jamie would make more in his new job than he had been at the old one, which would make a difference once they started buying things for the nursery they were going to set up in one of the three bedrooms.

Still, it had been hard to leave Tampa. She hadn’t slept well the night of the going away party, but sleep or no sleep, morning had come, and she and Jamie had driven up I-75 in his beige Ford Taurus, which was packed with suitcases and boxes and, locked in a cat carrier, Jamie’s cat Bright, whom he’d had sedated for the long car trip ahead. With stony silence from Jamie, who had apparently still been humiliated about Nick’s beatdown of him the night before, accompanied by Bright’s lethargic yowling and the Oklahoma! soundtrack, Claire very much wished she at least had her own car to drive to Iowa. But her beloved yellow Volkswagen was currently sitting at a used car dealership in Tampa.

“You should sell it. That way, we only have to worry about getting one car to Iowa, and we can buy a second one once we’re there. A more practical one,” Jamie had advised her.

“Practical?” she had sniffed, not taking well to his insult of her cute little Bug. “And what do you mean by ‘practical’? A minivan?”

“Well, um… yeah? A family vehicle anyway, something more suitable for three car seats.”

He’d had a very good point, and in the end, she had reluctantly taken the Beetle to the dealership, knowing that once her triplets were born, she would be doomed to drive a gas-guzzling van or SUV for the next two decades. And there would be no more listening to System of a Down in said gas-guzzler, which was exactly the music she’d craved as Jamie had driven her further and further from the palm trees of Florida and ever closer to the cornfields of Iowa. She’d wanted something loud, something angry, but instead she’d had to endure hours of Jamie singing, “Oh what a beautiful morning, oh what a beautiful day, I’ve got a lovely feeling, everything’s going my way…” Music was not something they’d ever agreed on. Jamie had always said it was because she was tone deaf and, therefore, not a good judge of it. But Nick had liked her taste in music…

They compromised by listening to the Rolling Stones as they worked around the new house together, finishing up the bathroom fixtures and moving on to the living room.

“Don’t touch that!” Jamie ordered, as she made her way to the couch. “I told you, I’m moving all of the furniture. You shouldn’t be pushing anything heavy.”

“Good,” Claire replied promptly, “because I wasn’t going to move it. I was just gonna sit down for a few.”

“Oh.” Jamie relaxed. “Well, yeah… you should rest.” He nodded pompously, as if it had been his idea all along.

She sank down onto the couch with a sigh, exhaustion quickly creeping up on her. She had been on her feet most of the day, and she was definitely feeling it now. She lifted her legs and saw that her feet looked puffy, her ankles thick and swollen. She swung them around onto the couch, stretching out so that she was lying across it, her head propped up against the arm. Her hand went instinctively to her stomach, gently massaging it.

“Are you okay?” asked Jamie, giving her a concerned look.

“I’m fine,” she replied with a tired smile, “just worn out.”

“Everything feels okay though? With the babies?” he questioned her.

She nodded. “Seems fine.”

She had an appointment with her new OB later that week, to consult and check up on the babies. Dr. Valerio had said at her last appointment in Tampa that she would probably be able to see them moving on her next ultrasound. She was looking forward to that. She often pressed her hand to her belly and held it still, trying to determine if she could feel any movement, but she knew it was too early; according to Dr. Valerio, she probably wouldn’t feel anything for another few weeks.

Jamie gave a satisfied nod in return and started moving the furniture, arranging it under her direction. “How about that chair under the window?” she suggested, pointing. The words came out with difficulty; she barely had the breath for them.

“Here?” asked Jamie, once he’d slid the armchair across the carpet.

Claire didn’t answer right away. She felt strange all of a sudden. Her chest had grown tight and felt as if there were an invisible force pressing down on it. The effect made it hard to breathe; her lungs felt too constricted to take in enough air. She didn’t think she could speak. She felt fatigued and weak, and moving even a little seemed like a huge effort, but she had to relieve the crushing pressure in her chest.

She struggled into a sitting position, but the movement was too fast. Immediately, she felt light-headed, as all the blood rushed from her brain. She swayed and slumped against the back of the couch, grateful for its support.

Jamie, turning around to see why she hadn’t answered him, caught the moment and immediately rushed over. “Are you okay? What’s wrong?” He pelted her with questions as he knelt beside the couch, hovering anxiously over her.

Claire held up her hand to keep him at bay, still trying to figure out what was wrong herself. She’d felt fine a few minutes ago, just a little tired, and now she could barely catch her breath. It was a little easier to breathe now that she was sitting up instead of lying flat, but in exchange, she felt dizzy and weaker than ever. The mere effort of sitting up made her feel as if she’d just done a thousand sit-ups in rapid succession. For no logical reason, her heart was racing and palpitating, giving her the feeling of a cluster of butterflies imprisoned inside her chest, their small wings fluttering rapidly as they tried to break free.

She had felt this sensation before, most notably the time she had fainted in the middle of kickboxing class. The memory made her stomach turn over in dread. That was what it was. She felt exactly the same way she had then; the same thing was happening.

“Claire?? Answer me!” Jamie demanded, his voice loud and frightened. “What’s wrong??”

“My heart’s racing,” she managed to say. She pressed her hand to her chest, pushing gently, as if she could somehow calm it. But it pounded and thumped unevenly against her palm, and feeling its irregular syncopation made her even fainter. “It’s another arrhythmia. I think… I think we should go to the hospital,” she choked, panicked tears threatening. Why was this happening again, now of all times? What about her babies? What if they were in danger??

Jamie went very pale. “Are you sure??”

“Y-yeah… you know how to get there, right?” He’d driven her around the small town of Clive when they’d first gotten there, but she had no idea where the nearest hospital was.

Jamie didn’t answer; he was staring blankly, not quite at her, his eyes looking rather glazed. The black and blue that Nick’s fist had put around one of them added a rather frightening effect. For a minute, it looked as if he’d gone into shock or something.

“Jamie?? You know where the hospital is?” she asked again more desperately, jarring his attention.

“Yeah, but…” He shook his head erratically. “We’re not driving ourselves. I’m calling an ambulance.”

She didn’t think an ambulance was necessary when he could drive her there just as fast, but she didn’t argue. He ran to get his cell phone, as the phone company hadn’t yet turned on their new ground line, and dialed 911. She heard the tremor in his voice as he spoke rapidly to the operator. “My wife… she’s having some kind of heart problem… it’s happened before… she can’t breathe... Yeah, she’s conscious, but please, she needs help. You have to come quick; she’s pregnant with triplets, please!”

His voice rose with panic, and she wished she could say something to reassure him, but she was terrified herself. It wasn’t just about her now; the triplets could be in danger too.

“My address?” Jamie was saying into the phone. “Um, yeah, it’s-” He paused, his brow furrowing. In alarm, he turned to Claire. “What’s our address?” he hissed, his eyes wide and scared.

Later, they would laugh at the fact that it was she, the one slumped on the couch, trying hard not to pass out, who had to feed him their new address. “702... Felicity Street.”

Jamie regurgitated the address quickly into the phone and then said, “Thank you. Please hurry!” Hanging up, he dropped the phone and knelt beside Claire again. “The ambulance is on its way,” he said, watching her warily, as if he expected her to drop dead at any second.

That didn’t do much to make her feel more reassured. Knowing it was up to her to calm herself down, she tried to take deep breaths, willing her heart to slow down and return to normal. As the minutes passed, Jamie didn’t say much, didn’t touch her, just kept staring at her, his eyes wide and fearful, and occasionally asked, “Are you okay?”

“Could you go get my shoes?” she asked him after awhile, mostly to get him out of her face. She didn’t like him hovering; it was making her even more uncomfortable.

He nodded, jumping up, and was back in seconds with her flip flops. He slid them onto her swollen feet and returned to his watch post at her side.

Claire was sure they would have reached the hospital already by the time the paramedics knocked at the door. Jamie ran to let them in, then stood back, pacing across the living room as the two uniformed EMTs took over his spot.

From there, it was a blur of déjà vu: the medics’ questions, her answers, the bumpy stretcher ride into the back of an ambulance, the burning prick in her arm as an IV was started, the sticky pads that were stuck to her chest, and the erratic beeping of the heart monitor that followed.

“You have an irregular heartbeat; that’s what’s making you feel dizzy,” the medic in the back told her. He probably thought he was being informative.

“I know,” she mumbled. “It’s happened before.”

She was almost glad Jamie was not in the ambulance with her; the paramedics had told him to follow them in his own car. She was relieved. She hated having him see her like this, and she knew he hated it too.

She didn’t see him again until the emergency room, and by the time the attending physician would let him in the room, he had already given her medication to slow and stabilize her heart rate. Everything seemed fine again, as it had the last time this had happened… but was it?

She was more worried for her unborn children than for herself. When she had told the ER staff that she was expecting triplets, a nurse had immediately asked for the name of her OB. “Her name’s Dr. Gray. Christine Gray, I think, but I’ve never met her before. We just moved here,” Claire had answered, tears threatening to overtake her again. She wished she were in Tampa, where she knew the doctors and the doctors knew her.

“That’s okay. I know Dr. Gray; she delivers babies here at this hospital,” the ER physician had spoken up reassuringly. “Erin, call Dr. Gray, will you?” he added to the nurse.

While they were trying to get a hold of her new OB, the doctor had hooked her up to a fetal heart monitor. All three heartbeats were present and strong, he had told her, but he still seemed anxious for the obstetrician to get there. After hearing her full medical history, he also asked for the names of her other physicians, and when she referenced Dr. Valerio and Dr. Nnachetta, her cardiologist, he went to call them.

It was then that Jamie was finally allowed in. He looked relieved to see her alive and awake, but even so, he only gave her a peck on the forehead and proceeded to stand stiffly beside her bed, barely speaking, jumping back out of the way every time her nurse, Erin, came in to check on her.

She was bored and annoyed by the time the woman who introduced herself as Dr. Gray arrived. Dr. Gray had curly brown hair and a pleasant bedside manner. She asked Claire all kinds of questions and listened carefully to her answers. After briefly examining her and checking to make sure that the babies were not in distress, Dr. Gray said, “Well, I’ve spoken with Dr. Bergquist, and he and I both feel it would be best to admit you for observation and some more tests. I’d also like to have you seen by a cardiologist.”

Claire was not looking forward to another hospital stay, but for the safety of her babies, she would do anything. Jamie also seemed to think it was for the best, and so she signed the necessary paperwork and let them admit her.

For the rest of that day and into the next, she was put through a battery of tests and exams by Dr. Gray and the consulting cardiologist, Dr. Moony. She went through them alone, using the new house as an excuse to send Jamie home. “You should go home and unpack some more; then there will be less to do when I get home,” she would tell him whenever he got to be too clingy or seemed particularly uncomfortable. He came and went from the hospital, sometimes with reluctance, other times with relief, depending on what she told him they were going to do to her next.

Jamie was there with her at the end of the second day, Dr. Gray came into her room, carrying Claire’s thick medical chart and wearing a grim expression on her face. Alarmed, Claire instinctively reached for Jamie’s hand. It was very cold, colder than hers. She squeezed it, but he barely squeezed back. She looked over and saw him staring at the doctor, looking as though he were about to vomit.

So much for moral support, she thought, bracing herself for whatever news Dr. Gray had come to give her. Judging from the doctor’s expression and many similar moments throughout her adult life, Claire had a bad feeling that the news wasn’t good.

Dr. Gray was a very straight-forward person, and she got right to the point, for which Claire was grateful. She hated to be kept waiting with long, drawn-out explanations. “After looking at your test results and consulting with Dr. Moony, I’m very concerned about your ability to carry this pregnancy,” the doctor said with a grave face.

Claire felt her heart skip a beat, and all the warmth seemed to drain from her body, so that she felt very cold. “What??” she whispered in disbelief. She wasn’t sure what exactly she had expected to hear, but it hadn’t been this. “What does that mean? A-are you saying I’m going to miscarry?” she asked, her voice trembling. At that moment, it was the worst thought imaginable. And yet… it couldn’t be! She’d just heard the fetal heartbeats; Dr. Bergquist in the ER had said they were strong! The babies were healthy!

“Not exactly,” said Dr. Gray. “That’s a possibility, of course, as with any pregnancy, but in your case, there are other worries to consider. Pregnancy – any pregnancy, even with a single baby – is hard on the body. It makes the mother’s organs – heart, lungs, kidneys – work extra hard, and even otherwise healthy women sometimes develop complications as a result. Multiple pregnancies are considered high-risk because they increase these effects, taxing the body even more.”

With a sinking feeling, Claire began to see where she was going with this. The triplets were healthy… but their vessel, her body, was not. Dr. Gray was going to tell her that with all of her medical problems and their treatments, some with damaging side effects, she was not fit to carry them. They were dependent on her body for life, and it was failing them. Desperate tears filled her eyes, even before Dr. Gray continued.

Scooting closer to her bed, Dr. Gray took Claire’s free hand and looked her right in the face. “I know this is very difficult to hear,” she said, “but for you, it would be very dangerous to try to carry three babies to term. You’re not even quite at ten weeks yet, and already, this pregnancy has aggravated your heart condition. Right now, the damage to your heart from the chemo treatments you had several years ago is minimal, and if I’m understanding correctly, you’ve only had one other incident where it gave you symptoms.”

Claire nodded wordlessly.

“However,” the doctor went on, “the stress of pregnancy, especially a multiple pregnancy, could make it worse. Much worse. You will have more episodes like the one you experienced yesterday, and there’s a good chance that the myopathy could progress, even to the point of heart failure. If it got that severe, a heart transplant would probably be the only option to save your life. Without one, you would most likely be dead in two years or less.”

The harsh reality of her words made Claire feel very cold, as if she’d been drenched in a bath of icy water. “So what are you suggesting?” she asked in a tiny voice.

“I’m not suggesting you terminate the pregnancy,” Dr. Gray assured her, and Claire immediately felt slightly better. “I think that, under close medical supervision, you could carry a baby safely to term. Many women with heart conditions worse than yours do, without major problems. However, in my professional opinion, it’s not advisable for you to proceed with three.”

The good feeling was instantly gone.

“As I told you, triplets can be risky in any case. Nowadays, with the technology we have, their survival rates are generally very high; however, they are almost always born premature, and this presents its own set of problems. Many preemies grow up to be perfectly normal, without any lasting effects, but some, especially those born very early, have lifelong physical and mental handicaps as a result. There’s almost no chance of you being able to carry a multiple pregnancy to term, and I’m worried that if you tried to proceed with it, your body would force a premature delivery to protect itself. How premature, I can’t say, but you would face the risk of losing all three babies.

“And then there’s you to think about. A multiple pregnancy is riskier than a singleton for any woman, but in your case, it could mean the difference between life and death. I think your heart could handle carrying one, maybe even two fetuses, but I’m very concerned that the toll three fetuses will continue to take on it would be too much. I’ve overseen many high-risk pregnancies in my career, and unfortunately, I’ve seen too many women die during delivery or shortly after.”

Claire tried to swallow, but couldn’t; her throat had gone very dry as she imagined dying and leaving Jamie alone with three newborn, possibly sick babies. She glanced over at him now, realizing he had been silent and frozen at her side this entire time, his hand limp in hers. She found him staring straight ahead at the blank wall in front of him, his eyes blank, his jaw set. He did not return her gaze, and so she turned back to the doctor in trepidation.

Dr. Gray squeezed the back of her hand. “I hate having to suggest this to couples, but I think your best option would be to undergo a selective reduction, reducing the number of babies from three to two, or even one, and giving yourself a better chance of coming through this pregnancy with you and your children alive and healthy.”

Finally, Claire managed to swallow. “You mean an abortion,” she whispered, her voice hoarse.

“We don’t like to call it that. You wouldn’t be ending your pregnancy; you would just be reducing the number of fetuses. The procedure is done differently than a standard abortion. We inject the fetus with a solution, and in most cases, the woman’s body simply absorbs it. There’s no bleeding, and very little pain. Obviously, it can still be a very emotionally trying experience for the mother, but you have to realize that by reducing one fetus, you are giving the others a much better chance at survival, as well as yourself.”

Claire knew the doctor’s words were meant to be reassuring, but they only made her feel nauseous. Beneath the covers, her hand moved to her belly, massaging it gently. As she did, a tear finally slipped from her eye and slid down her cheek, splashing onto the front of her hospital gown. She stared down at the tearstain as if it were suddenly the most interesting thing the world, the thin material of the gown sliding between her trembling fingers as she adamantly rubbed her stomach, trying to avoid thinking about the decision she knew she would have to make.

***