Chapter 208: Jimmy
When they put Molly to bed, and Jimmy still hadn't heard
anything from Tim, he had gone from nervous to really worried.
So he did something he'd never done before.
Technically Jimmy is a doctor. He's kept up with his
continuing education units and made sure to maintain his medical license in
Virginia. Mostly it's just a point of pride. He had to finish medical school to
be a Medical Examiner, he didn't actually have to do his residency and get his
MD. But he did it.
And as a registered doctor in the state of Virginia, he has
access to the Federal Medical Database. And sure, the bugs aren't all worked
out, and the backlog on old data is about ten years long, but back in January,
all new casework, test results, consultations, and notes are supposed to be
uploaded so any doctor can get full medical records at a moment's notice.
So, he got online, registered with the database, and
checked.
He spent a good half an hour studying the ultrasounds, read
Dr. Draz's notes, and her suggestions, thought they were fairly reasonable, and
came to the conclusion that he had not heard anything from Tim and Abby because
they were probably at home getting hysterical about this.
Breena sat next to him, reading over his shoulder, looking
concerned.
He stood up, kissed her, and said, "I think I'm going
to go make a house call. You feel like sending that to Ducky, so I can get them
a third opinion, fast?"
"Sure. You want me to have our OB look at it?"
"Might as well. I'm guessing Tim's gonna need to be
talked off a ledge, and Abby's probably feeling pretty disappointed."
"Yeah, she was hoping for an unmedicated, home
birth."
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| At home? |
"At home?" Jimmy's never gotten that. He knows
some people do it, voluntarily. But he wouldn't get a cavity filled without
pain medication and properly trained medical professionals right next to him,
let alone anything longer or more painful than that. And having both delivered
babies (he, like everyone else who was a medical intern, had a six week long OB
rotation) and been there for the delivery of both of his own children, he's
pretty comfortable with the idea that it really hurts, lasts a hell of a lot
longer than a filling, and is way more dangerous.
His personal theory, that the whole natural childbirth thing
is women being just as macho as men, if not more so, (because he doesn't know
any guy, anywhere, ever, who would sign up to spend twenty hours having his
testicles stretched to ten times their original size without a ton of drugs)
and this is their way of proving who has the biggest dick, is one he hasn't
felt any need to share with Breena or Abby, though given that this was
something Abby's in favor of, he may decide to share it with Tim.
"I kept telling her that the hospital isn't that bad,
and that the drugs are really very nice, but apparently there are a lot of girl
in HR and Accounting and a few other departments who came by the lab, dropped
off cute little presents, and proceeded to tell her absolute horror stories
about how bad their births were. She's pretty scared."
"Okay." He picked up his phone, hit Tim's contact,
and before Tim could say anything said, "I'll be there in twenty minutes.
Put your computer down, pry Abby away from hers, and go watch a sit-com while
you wait for me, okay?"
"Jimmy?" He can hear the fear under the surprise
in Tim's voice.
"You didn't call. That meant something was wrong. I
stole Abby's medical records, wanted to know what was up before I called, and
from there it wasn't too hard to figure you'd be scared. Sit tight. I'll be
there soon. We'll go over everything together, and hopefully get you off that
ledge your about to jump off of."
"I'm not that bad."
"Sure you're not. Look at your right hand."
"Yeah."
"It's shaking isn't it?"
"Yes."
"Go. Get on the sofa, put something stupid and funny
on, I'll be there soon. If you want, I'll grab Ducky on the way, and be there
in about an hour."
"Rather have you here alone, faster."
"Sit tight, I'll be there soon." He hung up and
looked at Breena. "He's terrified." Then he hit Ducky's contact
button on his phone. "Hey, Ducky, Tim and Abby didn't get good news from
the doc today. Breena's sending you the scans and everything. Feel like looking
them over and heading to his place?"
Ducky's voice is grave as he says, "How bad?"
"I don't want to prejudice your opinion. Take a look
and head over to their place. Tim's terrified. I'm sure Abby's sad and scared.
They could use some handholding from people who know how this works."
"Certainly. I'm opening my email." He can hear
Ducky messing with his computer. "I'll be there in an hour or so."
"Thanks."
Breena looked up from forwarding everything to their OB, and
gestured for Jimmy to come closer. He did, and she kissed him. "Give them
my love and a kiss."
"Tim, too?" Jimmy's not looking thrilled at that.
"Especially, Tim. He needs one, and it might shock him
enough to help break the panic."
That was a good point. "If he hits me, it's your
fault."
Breena smiled. "He's not going to hit you. At least,
not until Bootcamp on Saturday. Get over there, talk them off the ledge, and
give both of them a smooch from me."
"Okay."
Bedside manner was never one of Jimmy's strengths. Mostly
because of his skill at saying whatever the least appropriate thing for the
given moment. But, he's been getting a lot better at that over the years.
And right now, he's got one main guiding principal going: Do
Not Scare Them Anymore Than They Already Are.
He's thinking that shouldn't be too hard. He's also thinking
that what likely happened was their Doc explained what was going on in a rather
soothing sort of way. They both sat there, pretty scared, not really taking it
in, and not knowing what sorts of questions to ask. Then they got home,
researched the hell out of it, and got really scared, and had no one to ask
anything besides the internet which is more or less the worst possible place to
study anything that you find personally scary.
Family, especially family that's expected, doesn't have to
knock at the McGee house, so he just walks in when he gets there, and sees the
two of them following his directions. They are on the sofa, looking in the
direction of the TV, and he can hear a laugh track.
He's absolutely certain they aren't actually watching it,
though.
"Hey."
 |
| You stay on the sofa, and you don't encourage her! |
Tim hops up to greet him, and Jimmy gives him a hug. Abby
starts to get up, and Tim glares at her, so she stays sitting.
It's true that Jimmy will never, ever call Tim out on
overreacting about possible dangers to Abby or Kelly. He will never say Tim is
being unreasonable, or that he's got no right to be scared. It's also true that
he can feel Tim shaking and this level of scared isn't good for either of them.
So, arm wrapped around Tim, he says, "Come here, Abby, join the hug."
And she does, looking fairly pleased that he's not treating
her like she's made of glass. And now Tim's glaring at him.
"You carried her to the sofa, didn't you?" He got
that out, and then Abby was there, nodding yes, rolling her eyes, so he pulled
her close, too and took a moment to hold both of them, trying to be calming
just by being there.
He kissed Abby's forehead, looked her in the eye, and said,
"You're going to be fine." He petted her tummy. "Kelly is going
to be fine." Then he turned his head two inches to the right, kissed Tim
on the cheek, which he looked horrified at, but it does seem to have shocked
him out of his fear, at least, he's not shaking anymore. "The kisses are
from Breena. She thought you'd need them." He stared Tim in the eye.
"Tim, your girls are going to be fine. Come on, let's sit down and go over
this. Abby, can you get us a stack of paper and some markers."
"I can get it," Tim answered.
"I know you can. But you need to know she can walk
around and not break, so Abby's gonna get us the supplies, and you and I are
going to sit down and wait for her to do it." When Abby headed upstairs,
Jimmy quietly said, "Look, I know you two; your emotions feed hers and
vice versa, so you have to keep it together. That's your job: be the man, and
that means playing cool, especially if you aren't. You wanna have a full-on
freak out with me and Gibbs, that's fine. We will support you through it, and
if it takes more than a day, we'll come up with a lie for why you aren't home.
But from now until that baby comes out, you absolutely cannot panic in front of
her. Scared is fine. Sad is fine. It's good for her to see this affects you,
too. So terrified you're treating her like a light breeze'll hurt her, that
isn't! You're just making her more upset, and that makes you more upset, and
you end up with a positive feedback cycle from hell."
"What if it was Breena?"
"Then I'd be exactly where you are if not two steps
further down the panic line, and you'd be telling me to calm the fuck down and
not lose it in front of her because not losing it is my job! Only one of the
two of us needs to be sane at any given time, but both of us have to be able to
fake it. So, until you can handle this on your own, I'm here to help you stay
cool. But you've got to be able to grin and bear it."
Abby headed down, put a few markers on the coffee table and
headed into Tim's office for paper.
Once she was out of earshot again, he asked, "We good
on that?"
Tim gritted his teeth and narrowed his eyes. Jimmy took that
as consent.
Abby was back half a minute later with a stack of typing
paper. Jimmy knelt in front of their coffee table, and waved them to come
close. "As I told Tim, I stole your medical records, checked the scans,
and sent copies to Ducky and our OB, so third and fourth opinions'll be heading
your way soon. In fact, Ducky'll probably be here soon, maybe with Penny, and
possibly having consulted with a few of his buddies as well."
 |
| Really awful, really. |
Jimmy took the black marker and drew a circle on the paper,
then stuck two small, vertical lines right next to each other at the bottom of
the circle.
"Okay, this is a really awful drawing of a uterus.
Those lines are the cervix. Normally, as the third trimester wears on, those
lines get shorter and further apart." He added arrows pointing right and
left.
"Now, usually, the placenta is up here." He added
a red blob at the top of the circle. "And when you go into labor the
contractions pull the cervix sort of up and apart." He gestured with his
fingers with a drawing up motion.
"Both of you with me?"
They both nodded.
| Evil bloody jellyfish. |
He snagged another piece of paper, drew another circle, two
lines, and a red blob right at the bottom over both of the lines. "That's
a placenta previa. As you can see it's lying right over the cervix. Placentas
are pretty tough. If you've ever seen one in person, they look like an evil
bloody jellyfish from your worst nightmares. They're rich in blood, lots and
lots of vascularity, so like your lips, if you cut one it bleeds like crazy.
They also don't stretch. So, if one half of the placenta is over here, and the
other half is over there," he's circling each side of the placenta
pointing out even more clearly that it's straddling the cervix, "you've
got a ticking time bomb, because the parts of the uterus it's attached to are
moving further and further away from each other. And, not to put too fine a
point on it, it's also between the baby and the exit. This is a bad
thing."
He grabbed another sheet of paper. Drew yet another circle
and two lines, and this time drew the placenta blob three centimeters up and to
the left of the cervix. "If I'm reading the scans right, and it looks like
Dr. Draz thinks this is what's going on, too, this is what your uterus looks
like. First and foremost, you don't have the placenta waiting for the floor
under it to rip apart and it's not blocking Kelly's way out. So that's the very
good news part of this."
Jimmy gestured with the marker while he said, "Okay, so
possible trouble comes when everything thins out and starts moving. The cervix
and walls of the uterus move up and back, great. Well, there's this big blob of
blood sitting there, and it's attached to that wall, so it sort of smushes as
the contractions continue, and that can cause bleeding issues."
He grabbed the drawing of the normal uterus. "Also,
usually, after the baby's out, you keep having contractions to expel the
placenta, and stop the bleeding. Most of the contractions come from up
here." He's circling the top of the uterus where the placenta is.
"Which makes sense because it's pulling everything up and out. Likewise
the hardest, strongest contractions aren't at the cervix end of things, because
that's got to be soft and flexible enough to get the baby out." He looks
up at Tim and Abby, who are staring at this ridiculously inaccurate drawing
like it's the revealed Truth of God. "With me so far?" They nod, not
looking away. "So, the mechanism that gets the placenta out and shuts off
the bleeding doesn't work all that well because the placenta isn't in place to
take advantage of it. So, once again, potential bleeding problems.
"According to Dr. Draz your body hasn't really gotten
the message that the baby's gonna come out anytime soon. The uterus is a big,
strong, thick muscle, especially at the cervix end, because it's got to keep
that baby in there." He drew a quick and dirty, but significantly more
accurate, sketch of a female pelvis. "So right now, you've got this pile
of muscle, skin, and bones all working together to keep everything inside you
in there. So, yeah, you don't want to take up bungee jumping, but for right
now, there's not much risk of anything happening. You've got a nice, contained
unit, and it doesn't much matter one way or another where your placenta
is."
The fact that Abby hadn't just flashed Tim an I-told-you-so
look told Jimmy exactly how scared both of them must be.
"But starting soon, your hipbones are going to spread
out. Your uterus and cervix will thin out and spread. After all, the final goal
is get the baby out, and that won't happen if everything stays shut tight. And
as things spread out, the possibility of tearing gets higher."
"What's higher?" Tim asked.
"I don't know. Not an OB. Dr. Draz had in her notes
something like 7 out of 10 women she's seen with your kind of previa do just
fine, and I've got no reason to think she's wrong."
"What's fine?" Tim wanted to know.
"Not a mind reader in addition to not being an OB, but
I'll guess she's thinking that in seven out of ten cases the uterus keeps
growing and the placenta moves far enough out of the way to not be an issue."
"Did you ever deal with something like this?" Abby
asked.
"No. I delivered twenty-two babies solo, and helped
with seventy-three more during my OB rotation. Nothing like this, though. Of
course, they don't let Interns work on the high-risk patients."
"But it is a high risk," Tim added, staring at
Abby, terrified, stroking the back of her neck.
 |
| Trying to be soothing. |
Jimmy squeezed his shoulder. "Yeah, but there's a huge
difference between high-risk and get-your-affairs-in-order. If it was 1950,
hell, 1980, this would be a huge freaking deal. But it's not. Your OB knows
this is an issue. You know it's an issue. You go in, you get the c-section,
they take everything out in one fell swoop, pump some Pitocin in to make sure
the bleeding shuts down, and if it doesn't, they've already got you typed and
matched for more blood, possibly your own if you want to do that, pints of it
on ice waiting for you, clotting factor at the ready if need be, and if worst
comes to absolute worst they can have a hysterectomy done in a matter of minutes.
But you don't die. Kelly doesn't die. Four or five days, ten tops, you're home
from the hospital with her and get to see how well you function on no
sleep."
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| I don't want... |
And while Tim found that reassuring, it wasn't the right
tact for keeping Abby less scared. "I don't want a c-section, let alone a
hysterectomy!"
Jimmy nodded, realizing his tactical error on this. Tim's
worried about losing the loves of his life, and Jimmy, who is also a husband,
and Abby's best friend, is feeling the same sort of thing. Abby's worried about
being cut to shreds, mutilated, and losing Kelly. She's not looking at this as
a life or death situation for her.
Jimmy tried a different tact. "Look, this isn't likely
to happen. Kelly's about two pounds now. She's going to triple in size, maybe
quadruple, possibly more between now and when she's ready to come out. Your
uterus is going to grow like crazy. By the time you hit regular contractions
everything will have likely moved out of the way.
"But if it doesn't, if it was Breena, I'd say get the
c-section as soon as they'll do one. But you're not Breena. I've done four
c-sections, and yeah, they aren't minor surgery. It's not getting a few
stitches. Your abdominal wall does not appreciate being cut open. But, assuming
Dr. Draz actually knows what she's doing, and my guess is, since you're still
going to her, she does, the risk levels for a planned c-section should be
minimal.
"But again, I'm not an OB, I'm not your OB, and it's
not my body getting cut open, so I've got a somewhat different take on what's
going on here. What I do know is that the last thing you want is the emergency,
bleeding all over the place, get-that-kid-out-STAT c-section…"
They all heard the door open, footsteps, and a gentle voice
saying, "Dr. Palmer, I concur," at the same time.
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