The Fetal Position 1
by Leyla Harrison

Disclaimer: I don't own any of the ER characters.  Sure wish I did,
though -- I betcha I'd be rich!

Rating: R for potentially disturbing themes and situations.  Read on at
your own risk.

Timeline: This story takes place after Point of Origin (late season 5)
and has spoilers and/or references for that episode, Nobody Doesn't Like
Amanda Lee, and Love's Labor Lost.

Summary: A patient with troubling symptoms plays a prominent role as
Kerry finds herself plagued by frightening dreams that have a meaning
she can't understand.

Note: I'm not a doctor, or a medical expert.  However, there is a bunch
of medical stuff going on in this story.  I did some research, but I
know I still didn't get everything right.

Thanks to Shannon for a super-fast, super-good editing job.

***


For the third night in a row, I wake up in the middle of the night with
my arms clutched close to my chest, my hands clenched into tight fists.
My legs, both of them -- are curled up snug against my chest as well.
Pain shoots through my bad leg from the action of forcing it into a
position that it shouldn't be in.  The pain, no doubt, is what wakes me
up.

Each night I wake up drenched in sweat, as if from a nightmare.  If I
was dreaming about something, I don't remember what it was.

I don't know what the hell is going on.

On the third night, I get up, carefully stretching my leg out, which is
of course, accompanied by a screaming pain in my muscles.  I get out of
bed and find my crutch, propped up against the wall, and in the
darkness, I make my way out into the living room.

I'm wide awake.

My laptop computer is off, but it's out of its case and set up on the
desk.  I switch on a small brass lamp and turn the computer on.  As it
boots up, I find my glasses atop a pile of papers and put them on, and
get comfortable in the chair.

The desktop appears on the computer screen; according to the clock it's
4:12am.  I worked the evening shift last night, got home a little past
midnight, and had only been asleep for about three hours before I was
awakened by the mystery nightmare.  I don't have to be at work again
until tomorrow at four in the afternoon.

I click on the internet connection and log on; as I do the sound of the
dial-up is incredibly loud and I scramble to turn the volume down with
the wheel on the side of the laptop.  After all, I don't want to wake
Carter.

I log on and check my mail first; I haven't been online in over three
days and there are a pile of new messages waiting for me.  Most of them
are junk mail; I delete them swiftly.  One is from an old friend at
Mount Sinai; I skim though it quickly.  I'll write her back later.

My next stop is the newsgroups, like always.  I check the new messages
first on alt.adoption, scanning the subject headers seeing if my
birthdate shows up.  Nothing.  I post a new message, the same as I do
every week, with my birthdate, the name of the hospital where I was
born, and a request for information.  I click send and lean back in my
chair.

"Hey," a soft voice says from across the room.

Carter is standing in the shadows, leaning against the wall of the
doorframe between the living room and the hallway.  I didn't even hear
him come up from the basement.

"I didn't mean to wake you," I apologize.

He shakes his head; from here his expression is unreadable, but I can
see clearly enough in the low light to tell that he's wearing a pair of
sweatpants and a Northwestern t-shirt.  I browse over to a medical
search engine, suddenly struck with an idea.  I type in the word
"pugilistic" and click go.  I look up at Carter.

"You didn't wake me. I got up to get something to drink.  Weren't you on
last night?"

I nod, waiting for the search results.  Carter heads off to the kitchen
and I hear a cabinet opening, then closing.  I can hear him open the
refrigerator.  The house is so quiet at night; every noise sounds loud.

"Couldn’t sleep?" he asks, coming back into the room.

My eyes are fixated on the screen.  "What?" I ask, looking up.

"Are you having trouble sleeping?"

"Oh, no.  I was just -- " I look up at him.  "A little," I admit.

"Do you want something to drink?  Tea?" he asks helpfully.

"Thanks, Carter, but I'm all right.  You should get back to sleep.
You're on in the morning, right?"

"Yep.  See you later."  He pads down the hall and I hear the creak of
the stairs as he goes back into the basement.

My eyes go back to the screen.  I'm looking at a forensics page, and
much of it contains information I haven't seen since I was in med
school, working on cadavers.

There's a small paragraph at the bottom of the page, discussing people
who have died while trapped in burning buildings.  There's a diagram --
crudely drawn, but effective.  The person, of unidentifiable sex, is
curled into the same position I've woken up in for the past three
nights.  Legs and arms curled tighly to the chest, hands clenched.

"Many victims who perish in fires are found in the fetal position, with
their hands in the classic pugilistic (boxer) pose."

I stare at the drawing and wonder why I'm waking up in the middle of the
night in the same position as dead bodies pulled from a smoldering
building.

***

I work the evening shift again the next day.  It's a quiet night, all
things considered -- a few sick kids, an MI, some minor lacerations, one
shooting victim who goes up to the OR.  I even have time for dinner.
All in all, nice and quiet -- no chaos, nothing unexpected.

I head home after my shift past midnight.  Carter is parked in front of
the television when I come in.

We make small talk as I pour a glass of wine, and it's comfortable.
He's good at that -- making me feel at ease.  He has a glass of wine
too, and after about a half hour says goodnight and heads downstairs.

I finish up in the kitchen and check my email -- nothing.  Same for the
newsgroups; nothing new.

I go to sleep, and sometime past three, I wake up again in the same
curled up position.  This time my leg is in agony.  I stumble to the
bathroom, fumbling in the medicine cabinet for Tylenol, swallowing
three.  I rake my hand through my bangs and stare at myself in the
mirror.

This time, I've remembered part of my dream.

In my dream I saw a woman with red hair.  Her face was obscured.  She
was telling me something, but I couldn't make out what it was.

****

Evening shift again the next day.  Carter's on as well, which is nice.
I enjoy having him in the ER; I've always believed that his talents were
wasted in surgery.  He cares too much about his patients.  Tonight, he
talks to a suicidal man and gets him admitted to psych, and I deal with
an abdominal pain patient who gets whisked up to the OR for an appy
before I can even finish my assessment.  An MVA comes in and Carter and
I work apart but together -- me on the young man, who lives, and Carter
on the female passenger, who dies on the table.  I can see, through the
glass doors that divide the trauma rooms, the look of sadness on
Carter's face.  The sadness of a young life wasted.

"Dr. Weaver, we've got paramedics pulling up at the back door with a
pregnant woman with eclampsia," Haleh calls to me. The trauma room is
barely ready; the young man from the MVA has just gone up to surgery and
one of the other nurses is still restocking meds.

I glance through the glass into Trauma Two, where I saw Carter last, but
he's gone.  "Find Carter," I call back to Haleh, and she nods.

Two unfamiliar paramedics meet me in the hallway with the patient.  "30
year old female, 32 weeks pregnant, complains of dizziness, blurred
vision and nausea.  BP is high at 180/110, pulse is 108, resps 24,
started a line in the field," one of them recites.

"Can you tell me your name?" I ask the petite young woman on the
gurney.  Her head is turned to the side and she has her eyes
half-closed.  She's got a pretty face; delicately boned facial features.

"Sarah.  Sarah Morgan."

"We're going to take good care of you, Sarah.  When did your symptoms
start?"

She looks at me through unfocused eyes.  "About -- two hours ago.  It
wasn't a big deal at first, but then I started feeling really dizzy -- I
thought I was going to faint, so I called the ambulance."

We get her into trauma and transferred onto the gurney.  The first thing
I notice once she's on the table is that her wrists and ankles are badly
swollen.  I call for bloodwork, and get a fetal monitor on her.  The
baby's heart rate is good; still, I'm concerned.

Carter comes in.  "What have we got?"

I fill him in.  "Page whoever's on call for OB," I add at the end.

"Am I going to be all right?  Is my baby all right?" Sarah asks.  She's
groggy, but still alert.

"You're going to be fine.  You're both going to be fine," I reassure
her.

"Urine's 3 plus positive for protein," Haleh informs me.  Big surprise
there.

"Let's get some mag sulfate -- "

I'm interrupted by Carter.  "She's seizing!"

"3mg Ativan IV," I call out, swiftly maneuvering myself to the top of
the bed to hold her head down, getting a bite block into her mouth.

"Jesus," Carter mumbles under his breath.  I know what he's thinking;
we're all thinking it.  This young woman, so small and slight, her belly
so round and full, her body racked by the seizure, her fists clenched.

"Ativan's in," Haleh announces.

"Hold her legs," I tell Carter, unnecessarily.  He's already got them
pinned down.

Just as suddenly as the seizure started, it stops and her body starts to
relax.  I breathe a sigh of relief.  "All right, let's get that blood
pressure down.  She needs to go up to OB."

"I'll page them again," Lily says, from across the gurney, and heads for
the phone.

"Dr. Weaver?  Her blood pressure's down," Haleh tells me.

"Did you push the mag sulfate?"

"I haven't even had the chance yet." Haleh glances at Lily, who shakes
her head as if to say, nope, I didn't give her anything.

I check the monitor.  120/72.

"That can't be right," Carter says, having released Sarah's legs and
checking the chart.  "The paramedics checked it not more than 10 minutes
ago and it was 180/110."

Haleh cycles the dynamap again.  "Well, now it's 118/70.  I'll be
damned.  I've never heard of a seizure bringing down a BP."

"What's going on?" Sarah asks, slightly dazed.  She's still groggy, from
the seizure, no doubt.  I check her ankles and her wrists.  Less
swollen.  Much less swollen.  What the hell is going on?

"Someone get an ultrasound in here," I order.  "I want to get a look at
that baby."

****

Carter gets the ultrasound; everything looks fine.  The OB resident
comes down and decides to admit her.

"I don't understand," Sarah tells me.  "What happened?"  She's much more
alert now.

"We're not exactly sure," I tell her honestly.  "You had a seizure,
which was apparently caused by a high level of protein in your system,
and extremely high blood pressure.  Those are normally the signs of
something called eclampsia.  It causes the blood vessels to constrict,
which is why you had the seizure.  After the seizure was over, your
blood pressure returned to normal.  Usually that would only happen if we
gave you certain medications, but we hadn't given you anything."

"You said something about protein?" she asks.

I look over the chart, still puzzled.  "Yes, but it seems to be normal
now."

"How did that happen?" she asks me, lifting her head slightly from the
pillow, her eyes bright.

I shake my head.  I don't know what to say to her.  "Your baby is fine,
Sarah, and you're fine too.  They're going to take you upstairs to OB to
make sure everything stays that way."

She rests her head back on the pillow and closes her eyes.  "All
right."  I'm about to ask her if she wants me to call someone, family,
the baby's father.  I don't see a wedding ring on her finger but that
doesn't mean anything.  I hesitate; she seems to be so tired.

"Dr. Weaver," Lily motions to me quietly.  "Her mother's here."

"Sarah?" I ask softly, not wanting to disturb her.  "Your mother's
here.  Do you want to see her?"

Sarah doesn't open her eyes.  Instead she sighs, and nods her head.

I nod at Lily, who sends the older woman in.  In her early fifties, she
has the same fine-boned features as her daughter, and she glances at me
sharply, then hurries to the side of the gurney.  "Is she all right?"
she asks me, her eyes locked on her daughter.  "What's wrong with her?"

"She's going to be fine," I tell her.

"Everything's fine, sweetheart," she tells her daughter.  "You're going
to be fine."

"They'll be coming to move her up to OB in a few minutes," I tell the
mother, and she nods, barely acknowledging me, and I walk out of the
room.

"Strangest thing I've ever seen," Carter says, catching up to me in the
hall.

I shake my head.  "I know.  I can't explain it.  We didn't give her any
medication, except for the Ativan.  And as far as I know, Ativan doesn't
lower blood pressure in eclampsic patients or clear the protein out of
her urine."

Carter starts talking about a possible explanation, but the tone of his
voice tells me that he too, is grasping at straws.

I feel a strange pang in my chest; I'm still thinking about Sarah and
the simple reassurances her mother was there to provide.  I envy it, and
then I think to myself how wrong of me that is.  I had a mother, who
loved me and reassured me.  She wasn't the woman who gave birth to me,
but she was my mother in every sense of the word.

So why do I feel like I'm still looking for another mother to replace
the one I had?

"Hey," Carter waves a hand in front of my face.  He's one of the few
people I would allow that from -- just about anyone else and I would
snap their heads off.  "You were a million miles away."

"Sorry about that, Carter," I tell him.

"Hey, Carter, labs are back on the chest pain in curtain four," Randi
calls from the desk, and he trots off to retrieve them, leaving me alone
in the hallway.  I glance back into the room where Sarah is resting
quietly, her mother holding her hand, stroking her red hair from her
face.  Sarah's eyes are closed.

Carter comes back, holding his labs.  "You know what the weird thing
is?" he asks.

"We've already had this conversation, Carter," I tell him, slightly
irritated.

"No, I mean -- the weird thing is, she looks like you."

My head snaps up, in his direction.  "What?"

"The hair, the face -- the facial features, anyhow.  Sarah -- she looks
like you.  The mother, too.  Even Haleh mentioned it to me.  You didn't
see the resemblance?"  He's glancing into the trauma room.

I'm stunned into silence and he looks up at me.

"God, I didn't mean -- " he realizes his insensitivity, but I wave him
off.

"It's nothing.  Don't worry about it.  You have a patient to take care
of -- the chest pain?"

"Sure," he says, giving me a look before scurrying away.

I stand outside the door of the trauma room and gaze inside.  Carter's
right, and I don't know why I didn't notice it before.  Sarah does look
like me -- or I look like her.

I try to brush it off.  I have a lot on my mind these days.  I'm
thinking too much about my own issues and I'm letting them cloud my
judgement.  I look again, and decide that she doesn't look that much
like me, and I walk away.

****

Carter and I finish up around the same time and we ride the L home
together.  He doesn’t say much; he obviously still feels like he's upset
me.  Once we're home and inside the house, I head for the kitchen.

"Do you want something to drink?" I ask.

"Sure.  Let me help."

I pour a glass of juice for myself and he does the same.  We stand
across the kitchen from each other, separated by the island counter in
the center, silent.

"I'm really sorry about earlier.  I didn't mean to upset you."

I shake my head.  "You didn't."

Carter pauses.  "I don't mean to pry, but -- is everything all right?
You've been pretty distracted the last week or so."

I sigh, and fill him in on what happened with Mrs. Brennan.

"You thought -- why did you think she was your mother?"

"It was the private investigator I hired.  He screwed up," I answer
shortly.

"You know, I know a good one if you're interested in trying again,"
Carter suggests, helpfully.  "He's a friend -- well, a family friend."

I shake my head.  "I don't know, Carter.  Like I told you, I put my name
out there on the Internet.  Something could turn up from that.  And
after what happened with Mrs. Brennan I feel like I can't -- I won't go
through that again, in case there's another screw up."

"Can I ask you a question?" he asks, hesitantly.

"Go ahead."

"What happened to your parents?  I mean, I know what happened -- but…"
he looks embarrassed to ask.  "How did they die, if you don't mind me
asking."

I take another swallow of juice.  "Car accident.  Head on.  They were
killed instantly."  The words are fast, clipped.  It's the only way I
can talk about it, seeing as how I've never really talked about it with
anyone.

"I'm sorry," he says, quietly, his head down.

I am suddenly overwhelmed with the desire to tell him about the dreams
I've been having, about how I've been waking up -- but there's nothing
really to tell, just a woman with red hair and no face, and the position
of my body when I wake.  I feel foolish for having thought about telling
him something that I can't even explain to myself.

"I'm going to get some sleep," I tell him.  "You on tomorrow?"

"In the evening," he tells me.  "You?"

"I'm off.  Good night, Carter."

"Good night."

I'm trying not to think about my parents, but I do.  Their death was
sudden and when it happened last year, I closed myself off emotionally
almost immediately, dealing instead with the arrangements.  I was swift
and stoic.  Six months later that I started thinking about finding my
natural parents.  Now I think about that and reflect on the obvious
reason: I hadn't really dealt with my parents' death and so I was
looking for a replacement mother and father.

Logic tells me that there will be no substitute -- my parents were
wonderful, albeit driven and motivated to succeed.  Although I wasn't
their biological child, I became who I am because of them.  And I was
loved.  I know that much.

I get ready for bed: change clothes, brush teeth, wash face.  I think
about reading but I'm too tired, and within moments after my head hits
the pillow I'm asleep.

****

The dream again.

This time, the woman has a face.  It's Sarah Morgan.

"I'm your mother," she tells me, and I wake up.

END / The Fetal Position (part 1 of 3)