Chapter 59

Chapter 59

"Hyejin, I'm right here."

Moon Hyejin's crying gradually subsided.

Ma Seunggu turned toward the wall outlet and clicked his tongue. They had barely managed to keep the circuit running by turning on the warmer while switching off the monitor, and now they had added the vacuum pump on top of that.

"Nurse Sora, the Doppler."

In the darkness, Bae Sora squeezed gel onto Moon Hyejin's abdomen. Through the shhh, shhh of static, she found the rapid heartbeat.

Watching the luminous hands of her wristwatch, she counted under her breath.

"Twenty-nine beats in fifteen seconds. That's 116."

The baby's heart rate was dropping.

Moon Hyejin grabbed Bae Sora's arm in the darkness.

"Doctor... I don't want to go to a university hospital."

Hyejin hiccupped through her tears.

Gain calculated quickly.

Even if we call an ambulance right now...

The amniotic fluid was already stained with meconium.

The baby would need immediate airway suction after birth. If she delivered inside an ambulance, that would be difficult.

"Then let's gather our strength and deliver the baby here."

Gain spoke to her firmly.

"Doctor... please... deliver my baby."

Moon Hyejin repeated what she had said over the phone.

Her throat was hoarse from screaming through the contractions.

Divine power stirred inside Gain and began to refill.

It was nowhere near as much as she had just used, but a little had returned.

Ma Seunggu took out a penlight and tossed it to Oh Dayoung.

"Nurse Oh, shine this under the director's hands. Director Im, use the cup. Save the battery. If we need surgery, we'll use it then."

Bae Sora took the manual pump that had come with the vacuum extractor.

"I'll handle the vacuum with this hand pump."

Gain disconnected the tubing and attached it to the manual pump.

The penlight illuminated the space between Moon Hyejin's legs.

Gain positioned the soft cup on the baby's head, roughly three centimeters in front of the posterior fontanelle along the sagittal suture.

Let's see.

She ran a finger around the edge of the cup to make sure no maternal tissue was trapped underneath.

"Pump."

Bae Sora repeatedly squeezed and released the hand pump.

The gauge needle climbed into the green zone.

"Hyejin, when the next contraction comes, push as hard as you can."

The contraction began.

"Urghhh!"

Moon Hyejin pushed.

Gain pulled downward, following the curve of the pelvis.

The baby's head descended by about the length of one finger joint.

Pop!

The cup detached from the baby's head.

The penlight beam shook for a moment.

"One."

Gain counted aloud.

Soft cups caused less injury to the baby's scalp, but they detached more easily.

Even a cup detachment still counted as one attempt.

Gain tilted the cup toward the light.

A clump of meconium was caught along its edge.

She wiped both the cup and the baby's scalp clean with gauze.

Bae Sora spoke quietly.

"Twenty-four beats in fifteen seconds. Ninety-six."

Gain reapplied the cup.

This time she carefully ran her finger around the rim again, making sure there was no foreign material caught beneath it.

The gauge needle rose to the far end of the green zone.

Another contraction came.

"Now, Hyejin."

Moon Hyejin pushed without making a sound.

Gain pulled downward, then forward.

The baby's head emerged.

"Two."

Gain released the vacuum.

The baby's head rotated naturally to one side.

Gain supported it and followed the rotation.

The upper shoulder emerged first, then the lower shoulder.

The rest of the baby slipped out all at once into Gain's arms.

Bae Sora looked at the wall clock.

Since it ran on batteries, it had continued working despite the power outage.

"2:51 a.m."

Oh Dayoung glanced at her wristwatch and immediately assessed the Apgar score.

"One-minute Apgar, two points."

Apgar scoring rated five things, including a newborn's breathing, muscle tone, response to stimulation, and skin color, with two points for each category and a maximum total of ten.

A score above seven was considered normal.

A score of three or lower meant the baby required immediate resuscitation.

Moon Hyejin asked through tears,

"Is my baby okay?"

The baby did not cry.

Its arms and legs hung limp over Gain's forearm.

Its entire body was coated in yellowish fluid.

Oh Dayoung found another light and placed it on the shelf, pointing it toward the baby.

Then she washed her hands again.

Meanwhile, Gain clamped the umbilical cord in two places and cut between them.

She immediately handed the baby to Oh Dayoung.

Bae Sora took over the penlight.

Oh Dayoung spread a dry towel over the unpowered warmer and laid the baby on top.

"Airway suction first."

Ma Seunggu was already standing beside the warmer.

He snapped open the laryngoscope blade he had prepared earlier.

A tiny light came on at its tip.

It was the only light in that corner of the room.

"Suction."

Ma Seunggu inserted the blade into the baby's mouth.

The tube passed between the vocal cords in a single attempt.

Oh Dayoung attached a meconium aspirator to the end of the tube and worked the manual suction device with her foot.

Yellow-green fluid rose through the tubing.

Ma Seunggu slowly withdrew the tube while maintaining suction all the way out.

"Nurse Sora, mix twenty units of oxytocin into five hundred milliliters of normal saline and run it wide open."

A sudden gush of blood appeared.

Gain supported the area above the pubic bone with one hand while gently applying traction to the umbilical cord with the other.

The placenta came out.

Blood poured out after it.

Under the narrow beam of the penlight, the pad beneath Hyejin rapidly turned dark red.

Gain immediately placed a hand over Hyejin's abdomen and palpated the uterine fundus.

There should have been a firm mass around the level of the navel.

There wasn't.

Under her palm, the uterus felt soft like dough.

Uterine atony.

After delivery, the uterine muscle was supposed to contract firmly.

Hyejin's had failed to do so.

Gain gripped and massaged the fundus with one hand while turning the placenta over beneath the light with the other.

No pieces were missing.

She swept her fingers along the vaginal wall and cervix.

There were no tears.

Keeping her palm over the uterine fundus, Gain poured divine power into it.

The soft muscle tightened strand by strand beneath her hand until the uterus became firm.

The bleeding gradually decreased.

She had used more than half of her divine power.

She had spent months carefully gathering it.

Using it took only an instant.

"Dayoung, there's one unit of O-negative blood left in the refrigerator in my office."

Oh Dayoung handed the penlight to Ma Seunggu and ran out immediately.

She soon returned carrying the blood bag.

She also had two large flashlights in her hands.

Under the flashlights, Bae Sora and Oh Dayoung read the blood type and expiration date aloud together.

"O-negative. Expiration date confirmed."

Bae Sora hung the blood bag.

Gain continued monitoring Moon Hyejin.

"If her uterus gets soft again, call me immediately."

With the penlight clenched between her teeth, Bae Sora used both hands to massage Hyejin's uterus through the abdomen.

From the warmer, Oh Dayoung called out.

"Baby's heart rate is eighty."

Ma Seunggu repeatedly squeezed the Ambu bag connected to the oxygen cylinder.

His movements were mechanical and practiced.

"Breath. Two, three. Breath. Two, three."

"Why isn't my baby crying?"

Moon Hyejin struggled to lift her head.

"We're treating the baby right now."

That was all Gain said.

Oh Dayoung had not called out another number yet.

Thirty seconds passed.

"Seventy."

Without stopping his ventilation, Ma Seunggu turned his head toward Gain.

"Director Im, the chest isn't rising. No matter how much I bag, the air isn't going in."

Gain made sure Bae Sora had a proper hold on the uterine fundus, then turned around.

The warmer was only two steps away.

Moon Hyejin called after her.

Gain did not answer.

"I'll check the baby for a moment."

Gain placed her stethoscope against the baby's chest.

Each time Ma Seunggu squeezed the bag, she could hear air movement on the left.

When she moved the stethoscope to the lower right side, the sound became faint.

Gain removed the stethoscope and looked down at the baby's chest.

Ma Seunggu followed her gaze.

Each time he squeezed the bag, only the left side of the chest barely rose.

"Right lower bronchus. We didn't get all the meconium out during the first suction."

"Intubate again. I'll pass the suction catheter through the tube."

Without a word, Ma Seunggu snapped open the blade again.

Once more, the tube passed cleanly between the vocal cords on the first attempt.

Gain turned the baby's head to the left and advanced the suction catheter through the tube.

With the head turned to the opposite side, the catheter was more likely to pass into the right bronchus.

Gain decided to use all the divine power she had left here.

She placed her palm over the baby's chest.

The baby was so small that her hand almost covered its entire chest.

As she withdrew the suction catheter, Gain sent divine power through the baby in rhythm with the movement, gently stirring each alveolus.

With every pulse, she felt fluid shift beneath her palm.

It was lung fluid that should have been drawn into the bloodstream with the baby's first breaths.

As Gain guided it, the fluid moved through the alveolar walls and into the vessels.

At the end of the lower right bronchus, her fingertips caught on something.

It was exactly where the breath sounds had been faint.

The suction catheter had already passed over it once, but the obstruction was still lodged there.

If it remained, the baby would develop meconium aspiration syndrome.

Nearly half of Gain's remaining divine power was already gone.

For the first time, she feared it might not be enough.

I have to use it at the exact moment the catheter touches the obstruction.

Gain advanced the suction catheter a little farther.

She felt the catheter tip brush along the bronchial wall.

Then it touched something.

Gain immediately pushed divine power into that point.

The obstruction did not move.

She had been half a beat too late.

Gain withdrew the catheter slightly and advanced it again.

She had only about a bottle cap's worth of divine power left.

The instant the catheter tip touched the obstruction again, Gain poured everything she had left into that spot.

The clump broke free.

Yellow material shot up through the suction catheter.

"It's out!"

Ma Seunggu immediately resumed squeezing the Ambu bag.

This time, both sides of the baby's chest rose together beneath Gain's palm.

"Heart rate eighty. Ninety."

Oh Dayoung's voice rose.

"It's over one hundred!"

Ma Seunggu slowed his bagging rhythm and glanced at Gain.

"Picking out one weak breath sound in the right lower lung through all that bagging noise, then turning the head and sending the catheter straight there on the first try..."

"It's been a long time since I've seen that."

"I'll take over the Ambu bag."

"Mm."

Oh Dayoung began bagging the baby.

Ma Seunggu shook out his hands and flicked the sole of the baby's foot several times with his fingernail.

Still, the baby did not cry.

Bae Sora called in a low voice.

"Director, the uterus is soft again. She's bleeding."

Gain washed her hands.

There was no divine power left now.

All she could rely on was the strength in her own hands.

"The oxytocin is still running. Hold on just a little longer."

Screeeeech!

A loud sound came from outside.

Someone had stopped a car abruptly in front of the clinic.

Two car doors slammed shut.

Then someone began pounding on the first-floor shutter with their fists.

"Hyejin!"

"Where's my daughter? Where's Hyejin?!"

At the same moment, the phone in the delivery room began ringing loudly.

Oh Dayoung asked quietly,

"Doctor, should I answer it?"

"Nurse Sora, please explain the situation to them."

The voice of a woman who appeared to be Moon Hyejin's mother was loud enough to reach the second floor from below.

Bae Sora answered the phone.

Her mother's booming voice burst through the receiver.

"Is my daughter all right?!"

Moon Hyejin lifted her head when she heard her mother's voice.

"Mom..."

Her voice cracked.

"Your mother is coming up. Hold on just a little longer."

Several more drops of IV fluid fell before Gain finally let out a breath of relief.

"It's firm now."

It was already past five in the morning.

A bluish dawn was beginning to seep through the window.

Then, from the warmer, came a thin sound.

"Waaah."

It was small and hoarse.

But it was the baby's first cry.

"The baby's crying! Your baby's crying!"

Oh Dayoung shouted.

Ma Seunggu removed the Ambu bag.

The baby cried once more.

Then the cries became strong and vigorous.

Moon Hyejin burst into tears as if releasing all the breath she had been holding back.

Crying grew louder beyond the door as well.

The shutter was finally raised all the way.

Hyejin's husband and mother rushed inside and grabbed her hands.

Her husband was a large, taciturn-looking man.

Her mother wiped Hyejin's face with her sleeve, then had to wipe her own eyes first.

Her husband held Hyejin's hand while staring only toward the warmer.

His lips moved several times, but in the end, he could not say a word.

The three of them clung together and cried.

Gain watched them for a moment before speaking.

"Hyejin, your baby is stable right now. But we need to observe the baby for a while, and we don't have the equipment here to do that."

Moon Hyejin raised her tear-soaked face.

"What do you mean?"

"There's exactly one bed left in the neonatal intensive care unit at Hanguk University Second Campus Hospital."

"Let's transfer the baby there now and watch closely for a few days."

Moon Hyejin hiccupped and shook her head.

"I don't want to go to a university hospital."