A sonogram in the middle of Megan’s second trimester had shown that their daughter, Isabella, had a combination of heart problems, including a faulty ventricle. Less than a week ago, at thirty-six weeks of gestation, the doctors in their hometown recognized that Isabella’s heart was starting to fail, so they delivered her by emergency C-section. Once testing confirmed that her heart was dangerously malformed, Isabella had been transported here. For the past several days, the PICU staff had worked to stabilize her. She’d been on a ventilator, sedated, with tubes carrying medicine into her bloodstream. Tomorrow Sebastian and his team would operate.

“The environment in utero is very supportive of babies with congenital heart defects,” Sebastian said. This situation was so upsetting and foreign to parents that they didn’t always grasp the information they were receiving. Prior to surgery, he met with parents for as long as was needed to make sure he had their informed consent and that they understood the options and risks. “The environment outside the uterus is much less kind. We’ve been giving Isabella prostaglandins, which have helped us replicate the benefits she was receiving before birth. However, the benefits they provide won’t fix anything, and they only last so long. Which is why we’re moving forward with surgery.”

Megan’s skin was pale, her eyes grim.

“I wish that we could repair Isabella’s heart through surgery, but we can’t,” Sebastian continued. “The best we can do tomorrow is put temporary fixes in place that will hopefully keep her heart functioning until a donor heart can be found, and we can perform a heart transplant.”

“Okay,” Timothy said.

“I’ll seat a band around her pulmonary artery, ligate her duct, and install a pacemaker.” Sebastian slid a diagram from his desk drawer and explained the procedures.

They listened, their posture tight with desperation. Sebastian knew that whatever part of their focus was here with him, the larger part was with their baby in the PICU.

Timothy looked like he could’ve played on the defensive line of his high school football team. He had a sandy brown beard and kind eyes.

Megan wore a maternity shirt that reminded Sebastian that she’d given birth just a few days before. As terrible as she must be feeling emotionally, she couldn’t be feeling great physically, either. Her blond hair was short in back, but her bangs were long and swept to the side around an earnest face.

Markie had already informed him that Timothy and Megan had been waiting and praying through infertility for four years. They’d gone through two in vitro fertilization treatments and been ecstatic when they’d conceived Isabella, their first baby.

The baby they’d waited and prayed for would soon be wheeled into the operating room to have her chest opened.