Chapter 2 - Code Crimson
Ethan Caldwell’s hands were steady when he operated, but they were shaking so violently he could barely get his key into the lock of his La Jolla home.
He had just finished a grueling six-hour trauma surgery at Scripps Mercy Hospital. He had rushed home, eager to join the tail end of Maddie's baby shower, his car trunk filled with three different boxes of gourmet cupcakes and a stuffed plush rabbit he had bought at the hospital gift shop.
"Maddie?" Ethan called out, pushing the front door open. "Sweetheart, I'm sorry I'm late. The ER was—"
He stopped.
The house was too quiet. The front entryway was decorated with beautiful floral arrangements, but several chairs were overturned. The scent of vanilla candles was entirely overwhelmed by a sharp, sour smell that made his medical instincts instantly scream.
It was the smell of burnt milk and copper.
Ethan dropped the boxes of cupcakes, the pastel frosting splattering against the hardwood floor as he sprinted toward the kitchen.
"Maddie!"
He found her crumpled beside the kitchen island.
To anyone else, the scene would have been a chaotic nightmare. To Ethan, a trauma surgeon trained to read the human body in its worst moments, it was a roadmap of near-fatal catastrophe. He saw the empty silver pot, the white puddle of milk, the amniotic fluid, and the dark, heavy flow of venous blood pooling around her hips.
He dropped to his knees, his hands instantly moving to her neck to check her carotid pulse. It was rapid, thready, and dangerously weak.
"Maddie, wake up. Maddie, look at me!" Ethan cried, his hand gently lifting her chin.
Her eyes fluttered open, glassy and unfocused. "Ethan..." she whispered, her lips dry and blue-tinged. "My belly... they took... the diamonds. Lily isn't moving."
Ethan gently pulled back the linen fabric of her dress. What he saw made his stomach turn. The skin of her lower abdomen was a horrific patchwork of deep red blisters and peeling, white flesh. The boiling milk had caused severe second-degree burns across the entirety of her pregnant belly, the localized trauma likely triggering a massive placental abruption.
"Oh God, Maddie," Ethan gasped, his professional detachment shattering into a thousand pieces. He pulled out his phone, his thumb slick with her blood as he dialed the direct line to the Scripps Mercy trauma bay. "This is Dr. Caldwell. I need an ambulance at my residence immediately. Thirty-two-year-old female, thirty-six weeks pregnant. Severe thermal burns to the abdomen, massive antepartum hemorrhage, suspected placental abruption. Prepare OR Three. Get Dr. Vance down there now. We are coming in hot."
He hung up, scooped Maddie into his arms, and ran toward the front door. He didn't wait for the ambulance. He knew that every second he spent waiting on the driveway was a second of oxygen his daughter was being denied.
He laid her gently across the backseat of his SUV, propping her left hip up with a discarded baby shower blanket to take the pressure off her vena cava, just as he had learned in medical school. He tore out of the driveway, his tires screeching against the asphalt as he raced down the winding roads of La Jolla toward the highway.
The double doors of the Scripps Mercy emergency bay burst open as Ethan wheeled the gurney in himself, his face pale and covered in sweat.
"I've got her!" Dr. Elizabeth Vance, the head of obstetrics, yelled, rushing forward with a team of four nurses. "Ethan, step back. You cannot be her doctor right now."
"She’s in hemorrhagic shock, Liz!" Ethan shouted, his voice cracking as he held Maddie’s uninjured left hand. "Her pressure is dropping. I need to go into the OR with you!"
"No, Ethan!" Dr. Vance said, her hand pressing firmly against his chest, stopping him at the red line of the trauma bay. "You are her husband. You are Lily’s father. If you go in there with your head in this state, you will freeze. Let me do my job. I promise you, I will not let them die."
The doors of OR Three slammed shut, the bright "In Use" light glowing red against the sterile white corridor.
Ethan slumped against the wall, his knees giving out. He slid down to the linoleum floor, his hands covered in his wife’s blood, his mind spinning with a mixture of terror and a dark, burning rage.
Inside the operating room, Dr. Vance worked with surgical speed.
"Scalpel!" she commanded. "We need to avoid the burned tissue of the lower abdomen as much as possible, but we don't have the luxury of a cosmetic incision. I'm going vertical. Anesthesia, how is her pressure?"
"Eighty over forty and dropping," the anesthesiologist replied. "We're starting the third unit of packed red cells. She’s going into DIC if we don't stop the uterine bleed soon."
With one swift, clean cut, Dr. Vance cleared the abdominal wall. The moment she entered the uterine cavity, dark, old blood spilled over the sterile drapes. The placenta had completely detached.
"Get the baby out now!" Dr. Vance said, her fingers reaching into the womb to lift the tiny baby girl.
Lily emerged completely limp, her skin a pale, dusky blue, her head falling back without a sound.
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"NICU, she’s yours!" Dr. Vance yelled, handing the baby directly to the waiting neonatal team. "No pulse. Start bag-mask ventilation and chest compressions. Come on, sweet girl, breathe."
For three minutes, the only sound in the operating room was the rhythmic, high-pitched scream of the heart monitors and the soft, repetitive puff of the infant resuscitator.
