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  Instant Family

  (Silver Oak Medical Center Book 4)

  Aiden Bates

  Cover Designed by Duong Covers

  Important information…

  This book, “Instant Family” is the fourth book in the Silver Oak Medical Center. However, this book and every other book in the series can be read as a stand-alone. Thus, it is not required to read the first book to understand the second (as so on). Each book can be read by itself.

  Contents

  Important information…

  Chapter One

  Chapter Two

  Chapter Three

  Chapter Four

  Chapter Five

  Chapter Six

  Chapter Seven

  Chapter Eight

  Chapter Nine

  Chapter Ten

  Chapter Eleven

  Chapter Twelve

  Chapter Thirteen

  Chapter Fourteen

  Chapter Fifteen

  Chapter Sixteen

  Chapter Seventeen

  Chapter Eighteen

  Chapter Nineteen

  Chapter Twenty

  Bonus Chapter

  Preview Chapter: Rock The Cradle

  Preview (Silver Oak Medical Center Book 3): Family Law

  Chapter One

  Allen yawned and poured himself another cup of coffee. This might have been coffee number five for the day, and he knew he should probably slow down some. His insomnia issues weren't going to resolve themselves if he kept mainlining coffee like it was going out of style.

  Then again, maybe insomnia was just a side effect of working in a profession that operated on baby time, not people time. He checked his watch. Five AM. He'd been here since eight in the morning yesterday. He could have left last night, and let someone on the night shift deliver Johnny Trenton's baby, but Johnny didn't trust anyone but Allen and Carter to deliver his baby and at the end of the day, that had been the right call.

  He made a face. He wasn't going to think about the messy delivery. He wasn't going to think about how long it was going to take Johnny to recover. He was going to raise a mug and congratulate himself on the fact that Johnny would recover, and the baby had come through it alive and healthy. That was what mattered.

  Carter popped up next to him and glared balefully at the coffee pots.

  "Someone's a grumpy Gus this morning." Allen waggled his eyebrows at his best friend. Okay, they were both kind of grumpy at this point in the day, or night, depending on how a person counted such things, but that just gave them both the right to tease each other about it.

  Carter dropped a hand to his burgeoning baby bump. It wasn't much of a bump, but Carter had always been a slim, fit guy so it stood out. "The smell of all of this coffee is making me angry. All I want is to curl up in a little ball and go to sleep. I could push it down with coffee and probably make it to noon, but no. Someone has to make their views about caffeine known." He gave his abdomen an exasperated glare. "I'm telling you, this kid has opinions the size of Texas and they don't even have a functioning brain yet."

  Allen snorted. "You're able to have a little bit of coffee. Not as much as you'd normally drink, but no one should drink as much coffee as you normally drink. Which includes you when you're not pregnant." He picked up his mug.

  Carter stuck out his tongue at Allen. "I'm not taking any chances with this one, not after what happened the last time. And every time I drink anything with caffeine in it, I throw up." He gave his bump the finger. "That includes hot chocolate."

  Allen almost dropped his mug in astonishment. "Who in God's name drinks hot chocolate in July, Carter?"

  "No one drinks hot chocolate in July. I drank it during that cold snap in May. And then I returned it during that cold snap in May." He rubbed at the bump.

  Allen narrowed his eyes, but kept a smile on his face. Carter probably didn't realize he was doing it. The belly-rubbing thing was an instinctive reaction. Most pregnant people seemed to do it, and they never thought about it. Allen had done his thesis work on involuntary reactions during pregnancy and evolutionary purposes behind them, but he hadn't thought much about them since then.

  He could wish that Carter would stop drawing attention to his bump though, even if it wasn't voluntary or even conscious. It made people who were involuntarily childfree, like Allen, jealous.

  "Anyway, you've been on your feet as long as I have and you've got a legitimate medical condition. Go home. Put your feet up. Watch a terrible science fiction movie and get some sleep."

  "Can't." Carter grimaced and rolled his neck. "We've got an executive board meeting today, and the HR director wanted to meet with me before that. I have no idea why. If it's about another plastic surgeon referring to breasts as milk jugs again I'm going to go chug some hot cocoa and vomit on someone's shoe. I swear, that should be something HR can handle with a simple pink slip. That is not something that requires medical intervention, unless the patient involved stuck an ice pick into his head."

  "Always an option," Allen said with a nod. "Okay. Well, ah, make that husband of yours give you a foot rub. I mean, that's what husbands are for, right?"

  "Good point. I'll get him right on that." Carter grinned and headed out of the Obstetrics unit, back up to the administrative wing. He preferred to work in his offices down here in Obstetrics, and he still saw clinical patients, but his executive meetings were all upstairs.

  Carter and Allen both hated it. Oh, Carter was good in the role. Life at Silver Oak had gotten better for both patients and staff since Carter had taken over as Chief Medical Officer, and he got to do more research and help people all over the world instead of just in Syracuse. That alone made Carter's day. But he wasn't around to bolster Allen's spirits on bad days anymore, or to get a boost from Allen, and that made work more challenging for both of them.

  Allen picked up his mug again and headed toward his office. He had a long day ahead of him, full of appointments and rounds and probably a baby or two. He should take care of his paperwork while he could, since he was here anyway. Tonight, at least, he'd sleep like a baby.

  The workday got started earlier than it should have when a homeless woman presented at the ER in an advanced state of labor. How she'd even gotten to the ER in her state was a mystery. Most people that far along had trouble walking, but she'd gotten herself to Silver Oak from wherever she'd been staying. The chief attending resident called Allen and he got a room ready for her, trusting to ER staff to get her changed and ready for him.

  They didn't. She was still in her street clothes, all seven layers of them, and she didn't want to give them up. Allen tried to stay patient with her. He knew she might have had some negative experiences out on the street, or even before. He was a man, which could hold negative connotations for her, and he didn't even know if she could speak English.

  They paged someone from Social Services, and he grabbed a couple of female nurses to try to coax her out of her pants at least. It was probably what she wanted least in the world right now, but they weren't going to be able to deliver her baby if the baby was encountering barriers. The mother didn't look all that healthy, not that it was easy to make judgments under all that dirt, and the fewer road blocks to a safe delivery they could put in place, the better off everyone would be.

  Half an hour later, they got
her pants off and found an unconscionable mess. The social worker arrived just in time to see evidence of horrific abuse, both relatively recent and long past. There was evidence of drug use on her upper thigh as well. Allen wasn't going to blame her. That wasn't his job. It was obvious to him that she was hurting, and he wasn't sure if she had the capacity to understand what she was doing when she used.

  The woman from social services got to work on trying to find an ID for the patient, and trying to find a place for her in the hospital's in-patient rehab facility. They'd need to do a psychological assessment, of course, but that wasn't Allen's concern right now. Right now, Allen needed to be worried about his patient and her baby.

  He could see that the patient was well dilated. She would deliver soon.

  The patient wasn't saying anything. She moaned, but her cries were wordless. She struggled a little and she tossed her matted hair back and forth, but she didn't open her mouth at all. That wasn't exactly normal. He didn't know if she needed pain relief or not, didn't know if something was wrong for her or not. He had fetal heart rate monitors for the baby, and they were monitoring her as best they were able through the filthy armor of her clothes, but he had nothing other than beeps and numbers to work with.

  He'd done more with less, he guessed.

  He caught the patient's eyes, just for a moment. "All right. I need to call you something, so until we know your name I'm going to call you Jane, okay? My name is Allen. I'm going to do the best I can to get you through this, you and your baby. But you have things you have to do too. First of all, can you understand me? Just nod for yes."

  She stilled for a moment, and her eyes focused. She nodded once.

  He looked over at the monitors. The mother had a fever, and no wonder. Who knew when her water had broken? She could have gotten an infection from any number of other sources, too. Any one of the cuts or cigarette burns on her body might have caused it, or it could have come from one of the injection sites.

  He checked the fetal heart rate. It still looked okay, but how long would that last? Under the circumstances, they should go to a section. It wasn't ideal, but nothing about this situation was ideal.

  He checked her again, and he could see the baby's head. The decision had been made for him. "It looks like you're about to be a mother, Jane. Baby's got a nice big head of bright red hair." He crouched down and got ready to catch that little red head.

  He told Jane when to push, and she pushed. Whatever else was going on with her, she seemed to understand that at least. She gave three good shoves, although her body didn't seem to have the energy to push much on that third effort. He was able to pull the baby girl the rest of the way out, so it wasn't an immediate concern.

  Jane lay panting in the bed as Allen passed the baby off to a pediatrician and some nurses. Allen checked her to make sure she was getting the afterbirth out okay and then he listened to her breathing. Jane wasn't panting. Jane was gasping.

  Her oxygen stats were dropping and when he looked at her pale, lined face, he could see she was struggling. Her heart raced. "Let's get her some oxygen," he said, being careful not to touch the nurse he wanted. "Did the ER ever get a blood workup from her or did they just send her right upstairs?"

  "Right upstairs. We'll get blood now."

  "Send for Dr. Wade. We can't move her at this point, but I don't want to risk losing her either." He stripped off the glove covering his hand. He knew it was risky, but he didn't want Jane to feel worse. "Hear me, Jane?" he said, meeting her eyes. "I'm not going to risk losing you."

  Rick Wade appeared in the labor and delivery room ten minutes later, scrubbed up and ready to go. "You got blood from her?" he asked, not taking his eyes off of Jane.

  "Yes, Doctor. Haven't gotten the results back yet. Probable IV drug use, definitely spiked a fever during delivery, unknown what else. I started a line of antibiotics for the infection and now I need instructions."

  As a nurse practitioner, Allen could do just about anything short of surgery—so long as it related to labor and delivery. He couldn't order tests to rule out or confirm the hepatitis he strongly suspected was complicating the woman's case, or to check for a stroke.

  Dr. Wade didn't sneer about that, not the way some doctors did. "Okay. Let's see if we can get her stabilized in here and then we'll bring her down for some scans. You did great, Allen. Do you know our patient's name?"

  The woman closed her eyes and seemed to try to shrink away. Allen took her hand again and gave it a gentle squeeze. "No, sir. I don't know if she can speak. I've been calling her Jane."

  "Okay, Jane. We're going to do what we can to get you back on your feet, okay?" Wade gave her a broad, bright smile and then turned around to check the paperwork.

  Jane tugged on Allen's hand and pointed over into the corner, where the nurses had gone to weigh and clean up the baby. Allen was kind of reluctant to hand a newborn to someone who still wore clothes that hadn't been washed since the fall of the Soviet Union, but Jane was the mother. He went and got the newborn out of her bassinet.

  "Here she is, Jane. Your baby girl."

  Jane's face softened behind her oxygen mask. She reached out to touch her daughter's face, and then she pulled her hand back. She made a face and gestured toward her body.

  Allen smiled softly. "Don't worry about it. She's not going to care."

  She leaned back and closed her eyes. He'd call her more unconscious than asleep.

  Allen carried the baby back to her little clear plastic crib. She started to cry. "It's okay, little doll. Mama loves you. It's been a long day for her too. She just needs to rest up a little." He hoped he wasn't lying. Who knew what Dr. Wade would find on those scans?

  The pediatrician approached. Dr. Trumbull curled her lip at Jane. "This baby belongs on the NICU," she snapped. "Low birth weight, mother spiked a fever during delivery, I'm ninety percent sure she was born premature. She seems to be having trouble breathing and I'm not sure—"

  Allen held up a hand. "It's been more than ten minutes. Why is she still here if she should be in the NICU?"

  Dr. Trumbull pulled herself up to her full height and tossed her head. Then she stormed away. "Ugh!" she said, heels clacking against the tiles.

  The nurses snickered as she left. "I've never seen a pediatrician who hates moms or babies more," said the older one, Kris. "Honestly, she should just go out and work in the suburbs and deal with older kids."

  "Right?" He shook his head. "Whatever. Let's get this little gift down to the NICU. Dr. Wade, you've got Jane, right?"

  Wade gave Jane a grim look. "Yeah, we've got her for now."

  Allen didn't like the sound of that. There wasn't anything he could do about it, though. He could bring the newborn, with her mop of pretty red hair, down to the NICU.

  Afterward, he could pour himself yet another cup of coffee. Someday, he'd be able to fix something. Today was not that day, but it would get here, eventually.

  ***

  Brantley sat up straighter in his chair. It was important to look confident, calm. It was even more important to not look like his heart rate had tripled ever since he'd gotten that letter from Customs and Immigration. Right now, it was an acute stressor. Over time, it would become a chronic stressor, increasing his blood supply and feeding any nascent tumors. Chronic stress would also reduce his body's ability to fight any diseased cells that popped up, increasing the likelihood of tumors developing.

  Of course, it wouldn't be a problem when they sent him back to Jamaica. If the mobs didn't find him, the police would. He wouldn't have time for chronic stress to become an issue. He'd have a short burst of acute stress, and then he'd be dead.

  Dr. Idoni put a hand on his arm. "You okay, Dr. Powell?"

  Brantley forced a little smile. What else was he supposed to do? No one who asked that question wanted to hear the truth. They wanted to hear, "Yes, Dr. Idoni. I'm fine." How was he supposed to be fine when he was getting sent back to a country where his existence was enough to get him murdere
d or locked away?

  And how could he expect Dr. Idoni to understand this? Dr. Idoni, with his burgeoning baby bump. Idoni, who could flaunt his marriage and his sexuality like he'd never known a minute of fear.

  He chased the vile, hateful thoughts away. None of this was Idoni's fault. He was helping. Brantley was lashing out, because he was angry and scared and under stress.

  Acute stress, which would lead to chronic stress. Which would lead to—

  "I'm as well as can be expected, I suppose." He took a deep breath and let it out slowly. In for four, hold it, out for seven. He couldn't control his situation, but he could manage his stress. Until they came to cut his throat and set his house on fire, whether or not he'd died. "It's a bit of a startling situation."

  Delancey, Silver Oak's General Counsel, scratched at his chin. There was another one who could never understand. He wanted to help. He was doing his best. But Brantley had been paying attention during that whole mess with the weird protestors. He'd been in the US since he'd been sixteen and he'd never seen someone outed in public and respond with, "Well yeah, duh."