Twilight Advent, Day 6
Masterpost/prompts
Dec. 6 - Which modern medical treatment is Carlisle especially thankful for?
"And Then Run"
(~1,000 words)
It was an incredible machine, he had to admit.
Medicine seemed to be changing faster than either of them could manage to keep up with these days. It had been over a decade since Edward had gone to medical school for the first time; mostly to get out of the now too-full house after the newness of his zany, tiny, prophetic sister and her taciturn husband had worn off. He had learned there about cardiopulmonary bypass; had the experience of watching one safely from the gallery. Even if he had still been human, he could imagine that the rhythm of the metallic clacking of drum against metal would be a sound he would remember forever; alongside it the gentle whir of the fluid that was supposed to be the one thing he could never resist and yet which became simple to ignore as he engrossed himself in his own fascination with the way it spun around. Edward had come to the hospital the way he often did, a question on his mind he didn't want anyone else in the family to overhear. Carlisle, who'd scented him from across the floor, had called him to his side. And so they were both standing here now, before this machine which was an order of magnitude more terrifying and more fascinating than any bypass Edward had ever seen before. The boy—the paperwork on the end of the isolette said he was a boy—before them would've fit in Edward's palms. A balled up fist, too tiny to fit around Edward's thumb, rested near his head, immobilized so as not to interfere with the grotesque maze of tubes protruding from the tiny mouth and the cannulas beneath the skin next to a sternum which was mere inches long. Carlisle, as one of the hospital's cardiothoracic attendings, had come here to take notes, but according to the memories at the tip of his thinking, he had been standing here for a good fifteen minutes. Watching. Thinking. About...something he wasn't quite willing to make clear. As his father danced the delicate dance of trying to think in a way that shut Edward out, the strain of that plus whatever he was thinking about was enough that he balled his fist. "Carlisle? What's bothering you?"
The anger and frustration in his father's thoughts made little sense. The infant—born almost three days ago now, according to the tag—was improving hour over hour.
And then suddenly there was a sound Edward had heard only a few times in his life. The sharp intake of breath; a second, ragged inhalation through the nose. Carlisle's hand covering his mouth as his eyes squeezed closed against tears his body would never produce.
Yet somehow he was still managing to evade Edward's gift, the reason for this outburst just out of reach. Not knowing any other way to get the information he needed, Edward went for the hardest punch:
"Dad?" A gulp and then Carlisle met his eyes. The extra thoughts—charting details, mostly—fell away as though they were a shattering pane of glass and at once, the core thought was clear. The diagnosis, at the top of the chart. The sadness of the family, the shock of their baby being wheeled away, but then this miracle machine, attached quickly but carefully, and suddenly numbers going in all the right directions: Sats, up. Heart rate, up. Capillary refill, almost normal. He understood at once. Moving closer to his father, so that their hips were almost touching, Edward stared down again, hard, at the baby underneath the spaghetti mass of medical tubes.
Pulmonary hypoplasia, secondary to diaphragmatic hernia. The diagnosis Carlisle had made, decades later, piecing together details of a handwritten medical chart with what little his wife had told him. Congenital. A birth defect. Not anything she had done. Not what her husband had done to her. Just a fluke of nature, a bad spin of the roulette wheel that was forty-six haploid chromosomes slamming together.
"This machine would have saved him," Edward whispered, and his father nodded slowly. And then he flashed in both their minds. Edward, who knew what the boy's father had looked like, imagining that man, but softened by the more gentle curves of his mother's face; her lighter hair; her smile. In Carlisle's mind, he had always looked very much like Esme, and sometimes, selfishly, a little bit like Carlisle, too. He was a young man, to both of them—broad shoulders, tall, strong.
"Sixty years," Carlisle finally said. "If she had been born just sixty years later...we could have...I could have..." The fist had returned. "But you wouldn't have her," Edward whispered.
For a moment, there was no answer, aloud or in thought, as Carlisle regarded the infant. The machine whirred and beeped, the artificial respirator thudded open, whooshed, and then closed again.
"No," his father said thoughtfully. And Edward could feel that pain; the aching, stretching sadness that rolled over the thoughts as a life was imagined: just the two of them, missing the caramel-haired woman with her smile, her laughter, and her love. There was another gulp, and Carlisle took a step closer to the isolette, and placed a hand on the top of the baby's head. It startled, likely at the coolness of the touch, the tiny fists clenching and the arms seizing inward. "But she would have him." Then Carlisle removed his hand, stepped away, picked up the chart, and made a few notes before beckoning Edward back downstairs. ~||x||~
Historical note: Extracorporeal Membrane Oxygenation (ECMO), an extension of surgical cardiopulmonary bypass, was first used the 1970s on a non-surgical patient. While first used on adults, it quickly began to be used to buy the time neonates needed to recover from respiratory failure. By the mid 1980s, the survival rate for neonatal ECMO treatment of respiratory failure was between 70-90%. Montage Masterpost
