Excerpt from
Home Care
FRIDAY, MAY 21ST
The town car driven by a Chase Security operator pulled up to the drop-off at John F. Kennedy
Airport in New York. The two passengers both moved with caution bred by training and anxiety. Neither man said more than a few words as they wound their way through TSA precheck and to their gate.
Logan Shepard and Billy Ryder boarded their flight to Portland, Maine. Both settled into their seats and exhaled as they heard the hatch sealing. Billy sighed. “I appreciate you trusting me.”
“I "m sure we both could use the break. Besides, what’s not to trust?” Logan’s shoulders, heavy with exhaustion, sagged against the seat. He looked out at the runways of the busy metropolitan airport. “I know you’re assigned to watch my back, but you need to promise me, if you feel the least bit off, you’ll say something.”
“I promise.” Billy rubbed the section of the scar that was visible in the open vee of his shirt. “You need to tell me the same thing.”
Logan held up three fingers together. “Scout’s honor.”
Chase Care-New Orleans’ facility director was coming off Chase Care-New Orleans’ facility director was coming off the same difficult operation. “We both have our demons. I’m looking forward to a month of peace and quiet.” He sighed and put his head back.
“What am I heading into?” Billy asked. Logan blew out a breath.
“My folks have a house in Sedgehurst Shore. It’s an island off the coast of Portland.”
Billy turned his head to look at Logan. “You’re not being interrogated, but, sheesh, give me a little intel.”
He laughed. “My house was built in the thirties by my great-grandparents on my dad’s side. Seven bedrooms, Five baths, on the water,” Logan admitted.
“Is that something I should be afraid of?” Billy asked. “You’re a trust fund kid?”
Logan laughed. “Not a trust fund kid. But it’s not too shabby. It’s tough to date with wealth. Lots of the girls from town went after me because I was sent away to school.” All these years later, he was still uncomfortable admitting his private schooling. It brought him a lot of unwanted attention. He hated being labeled gifted.
Billy buckled his seat belt. “I guess girls want to see what’s in your pocket instead of your pants. But I can’t see it being any easier than you saying I’m the facility director for Chase Care. They want to know what the Beltway Brothers are like.” Logan chuckled. “That’s the best way to describe it that I’ve ever heard. How do you explain being an operator?”
“I tell people I’m an escort.”
Both men laughed as Logan began to hum “CallMe.”
The plane began rolling. A flight attendant stood at the front of each section of the plane. “Good morning and welcome aboard United Flight 672 from New York-Kennedy to Portland, Maine. Our flight time is estimated to be one hour and forty-five minutes. Please pay attention to the safety instruction video and the emergency information card located in your seat pocket. We hope you enjoy your flight with us.”
“Wish they gave a sweet video like this for HALO jumps.” Logan laughed.
“You mean the birth control jump?” Billy chewed his lip. A high altitude, low opening parachute jump was known for catching the soldier in the testicles. The flight took to the air, and, within minutes, both men dozed.
A guttural moan filled the cabin. Logan’s eyes flew open, and he swiped his face. He hoped it was someone’s movie, but when the cry repeated five minutes later, his gut caught in his throat.
A flight attendant’s voice, calm but urgent and tense, came over the plane’s intercom, "Excuse me, ladies and gentlemen, are there any medical personnel on board? If there is a physician present, please push your call button immediately."
The nervous tone of her voice caused a ripple of concern to spread throughout the cabin. Billy snorted and shoved Logan’s arm. “You jinxed us, Mr. Peace and Quiet.”
Logan reached up and tapped the call bell. He’d never seen a flight attendant move as fast. “My name is Logan Shepard. I’m a physician assistant.” Sweat bloomed across the flight attendant’s brow. “Oh, thank God. We have a passenger in labor.”
As she said that, another moan echoed. Logan stood. “Where is she?” He looked at Billy. “C’mon, you have my back, right?” Billy rolled his eyes. “Um, that’s not the security detail I’d envisioned. I was thinking more about you getting cut on a lobster shell.”
A woman sat in a middle seat, her knees pulled up to her chest. Both seats on either side of her were occupied. As Logan approached, she cried out again. Billy looked at the two other passengers. “Either one of you related to the lady?” Both shook their heads. “Find other seats for them and get your !rst aid kit.”
Billy’s chin lifted high. Logan smiled and introduced himself to the laboring woman. “Hi, I’m Logan. I’m a physician assistant.” The woman in her thirties grabbed for his hand. “It’s too early. I’m thirty-four weeks. I can’t do this.” Another flight attendant brought the first aid bag, a pillow, and a blanket.
“What’s your name?” he asked his new patient.
“Amber… Amber Dearing,” she panted.
“Let’s try to get you more comfortable.” Logan leaned over her and helped her lie on her left side across the seats. “I’m going to wash my hands. This is Billy. He’s a paramedic. He’s not going to leave you.” He stood to his full height. “Get me a set of vitals if they have a BP cuff.”
When Logan returned, Billy whispered into his ear, “Pulse 154, respirations 24 and BP 180/106. No oxygen on board.”
“Amber, is this your !rst baby?” Logan asked. Billy had covered her with a blanket.
“Yes,” she groaned with another contraction.
“Any issues?” he continued taking her history.
“I’m supposed to stay off my feet for high blood pressure. I needed to go to a meeting in New York, or I’d lose my job.” She cried, “I don’t want to lose my baby. It took four tries at IVF to get pregnant.”
“Amber, I want you to take some slow, deep breaths through your nose and out through your mouth,”
Logan coached as he slipped on a pair of gloves. “I know this is not how you wanted to do this, but I need to examine you.” He gave her his best reassuring smile and waited for her next contraction to end.
Billy took off her shoes. He nodded toward her swollen feet.
Logan slid down her slacks and soaked underpants. Her water had broken. As gently as he could, he examined her. His fingertips rested against the head of the baby. “Amber, your little person is in a
Billy told the #ight attendants, “Advise the captain he’s about to gain a passenger. Have him notify Portland; we get a priority landing with an ambulance standing by.”
Logan stripped off the glove to rustle through the first aid bag. He found a paper face mask, scissors and rolled bandages. He also found some trauma dressings and sanitary pads. Not the greatest for a delivery, but he’d make do. He could hear his grandmother telling his sister when she was micromanaging her pregnancy, “Women used to have babies in fields and go back to work.” He didn’t want to add the caveat that a lot of those women died.
Amber’s scream brought him out of his thoughts. “Okay, next contraction, I want you to take a deep breath and push from your bottom. Billy is going to get behind you and hold your hands.” Logan slipped on the mask and regloved.
“Don’t let her grab me or between her legs.” Billy, at six feet, four inches tall and two hundred ten
pounds, was quite a spectacle climbing over Amber and crunching his body behind her. “I’ve got you, Amber.” He interlaced his fingers with hers.
Logan could see the next contraction roll through her. “Amber, deep breath and push.”
Billy helped her gain some leverage so she could bear down. “You’re doing great,” he coached. Logan thought he’d make a great dad. Years spent in combat created very sensitive men, contrary to what the media declared.
When the contraction abated, Logan could see the baby moving through the birth canal. Another contraction hit right after it. “Here we go. Big push.” He saw the start of heavier bleeding as cold sweat dripped down his back. “And another push,” he commanded.
“I can’t do this,” Amber sobbed.
“You wanted this baby. Time to do the work,” Billy raised his voice.
Amber crunched her brows. “You bastard, who the hell are you to tell me what to do?”
“Amber, PUSH,” Logan called.
Amber’s anger worked. Her push had energy behind it. “Aaaah!!!” she cried.
The head of the baby emerged. “Slow pants…” Logan slipped his hand beneath the cord that was wrapped around the baby’s neck and slid it over the head. He lowered the head to allow one shoulder to free up. “Give me a little push… That’s it.” He delivered the second shoulder,
Holding the baby’s head lower than his small body, Logan used his pinky to wipe fluid from the baby’s airway. He wrapped him in a blanket and rubbed it carefully over the baby to dry him. The baby’s limbs began to move, but he hadn’t cried.
“What’s wrong?” Amber begged.
“Give him a minute,” Billy told her.
A !ight attendant came running. “A passenger had this.” He passed Logan a bulb syringe in a package. “She said it was for a baby shower.”
“Open it,” Logan directed as he continued to stimulate the baby. When he grabbed the bulb syringe and cleared the airway, a throaty cry filled the air. Applause followed. Logan tied off the cord with the rolled gauze and cut it. “Baby boy, Momma.” He placed the newborn on top of Amber.
The easy part was over. Now he had to deliver the placenta. He ground his back teeth. Blood was beginning to flow between her legs. “Amber, you’re bleeding a little more than I’d like. I’m going to press on your uterus. I’m sorry, it’s going to be uncomfortable.” Logan caught Billy’s eyes and pressed his lips together.
“When do we land?” Billy asked.
“Fifteen minutes,” the co-pilot who joined them said.
Logan dug the heel of his hand into her pelvis. It felt like he was pushing on pudding instead of a hard ball. “Amber, what’s his name?”
Her eyes blinked like a china doll’s. “Logan William May,” she whispered.
Logan swallowed hard. “Thank you. Amber, I need you to try to nurse.” He hoped it would help stave off some of the bleeding. The placenta had not delivered. His anxiety induced heartbeat increased. He was helpless to do much more.
He could feel the plane begin its decent. Amber’s bleeding showed no sign of letting up. He’d already raised her legs, continuing the uterine massage, but soon Amber could no longer support her son.
“Logan, tell my husband I’m sorry.” Her eyes flitted closed.
He warded off panic as he gestured to Billy. “Here, take the baby.”
Billy fastened his seatbelt and held on to the baby.
Logan balanced himself against the seat as the plane touched down.
“Ladies and gentlemen, please remain in your seats until we evacuate the passenger and her newborn,” the captain asked.
The ambulance crew from Maine EMS came down the ramp and onto the plane. “Hey, my name is Logan Shepard. I’m a physician assistant. I’ve got a thirty-five-year-old female, Amber Dearing, eighteen minutes postpartum. Placenta has not disengaged. She’s in hemorrhagic shock. She needs TXA, one gram in 250 ccs, normal saline in ten minutes.”
The medic nodded. They lifted Amber onto the portable stretcher and hustled her up the ramp. He and Billy, carrying the baby, followed. “You coming along?” the medic asked. Logan nodded. “What hospital?”
“St. Andrews,” the medic answered. Once off the plane, they rolled her rapidly to the ambulance.
“Logan, I’ll pick up the rental and meet you at the hospital.” Billy handed him the newborn boy.
“How are they?” Billy asked as a pale Logan got into their rental.
“Baby was a little cold, but he’ll be fine. Amber,” he shook his head, “they rushed her into the OR. She was still bleeding heavily.”
“She took a big chance traveling.” Billy rested his hands on the steering wheel. “You heard her. She was worried about losing her job.”
Logan blew out a breath. “That’s illegal.”
“Hey, man, that’s her battle,” Billy warned him. “Where am I driving?”
“I’m sorry. It’s frustrating. At Chase Care, I don’t deal with patient finances. I had a flashback too. St. Andrew’s reminded me of Guardian Hospital in Montana. I’m spoiled with our available resources.”
“They’re that rural?” Billy’s brows furrowed.
“No, they’re a level two. They can provide most upper level care. I just felt claustrophobic. The level-one hospital is on the other side of Portland. There’s no hospital in Sedgehurst.”
“What’s the transport time?” Billy asked.
“Twenty minutes, if all goes well and the bridge is in and out,” he said about the Portland-Sedgehurst Shore Bridge. “Welcome to Sedgehurst Shore, population ten thousand.”
Billy’s eyes widened as they pulled into the circular, pebbled drive in front of the large clapboard home. “Okay, your intel was a little faulty.”
Logan laughed. “This was my parents’ inheritance. My dad is the Sedgehurst Shore police chief, and my mom does volunteer work.”
“When was the last time you were here?” Billy asked.
Logan looked out the window. “Three years. Right before I took the job in New Orleans.” He exhaled heavily.
“Yeah. I suck as a son.”
“I wasn’t gonna judge. I was only thinking about my situation. I was an only child. My mom had me in her forties, and my dad was fifty-two when I was born. They’re both gone now.” Billy put their rented Tahoe into park as Logan’s mother flew out the door to hug her oldest son and greet Billy.
“Pleasure to meet you, Mrs. Shepard.” Billy handed her a box of candy from a Manhattan chocolatier.
“Call me Mina. Come inside, are you hungry? You’re later than I expected.” She wrapped her arm around her oldest child’s waist and led the way into the house.
Logan watched Billy scan the area continuously. He whispered, “I grew up in a small home in Pennsylvania. Your parents’ home could hold my parents’ house three times over in your downstairs alone.”
“We got a little delayed,” Logan told his mother, then he explained what happened on the plane. As his mother made lunch for them, he called Tuck Hanlon, Chase Care’s clinical facility director. He figured he’d give the boss a heads-up about his airplane adventure.