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Luana flipped him the bird, and the meaning was abundantly clear. Dr. Malach’s face paled, and Luana whirled around without a second glance back at him.
Dr. Malach turned on Sophia. “Tell her she can’t fire me!”
“You’re welcome to tell her yourself, and I’ll interpret,” Sophia said. “But technically, she can, and she just did.”
“How dare you—” Dr. Malach took a step to follow Luana, but Sophia cut in front of him.
A fireball formed in her palm, and he stopped dead in his tracks. Several people poked their heads out of offices to see what was going on, but they quickly scurried away when they saw Sophia’s Fire.
“I suggest you do as she says,” Sophia warned. “Have your office cleaned out by the end of the day, and leave… before I make you. You are no longer welcome to practice here, in this clinic or anywhere else in Hok’evale.”
I didn’t know what kind of authority Sophia had around here. After all, she said she was only a volunteer. But when Sophia spoke, she spoke like someone in charge.
“I don’t have anywhere else to go!” Dr. Malach protested. “The Celestials kicked me out.”
“That’s your problem,” Sophia said.
Dr. Malach took a step back toward his former office.
Luana gestured for me to follow her. I did so quickly, before Dr. Malach could say anything else.
Victory swelled in my chest as I followed Luana down the hall and into an exam room. I hadn’t meant for Dr. Malach to lose his job, but I couldn’t say I was upset about it. He was a horrible doctor.
Luana waited until Sophia and I were in the room before she shut the door behind us. I sat down, and Ava-Marie seemed content in my lap. Sophia sat beside me.
“Pretend I’m not in the room,” Sophia said, before she began interpreting. “I’m sorry about Dr. Malach. We hired him because the angels no longer allowed him to practice in Celestial City since he was helping patients without insurance against the Deacons’ orders. Originally, we supposed he had a kind heart, but lately I’ve started to wonder if he was helping those uninsured patients not because he cared, but because he wanted to charge what he wished and pocket the money under the table. We’ve had a few problems with him being rude to patients, but nothing at this scale. I must deeply apologize and insist that nothing like this will ever happen again at my clinic.”
Luana looked at me with the kindest expression, and I knew there was nothing I could say or do to show how grateful I was for her right now. All I knew was that Dr. Malach made me squirm in my skin, but here in this exam room with these two women, I felt completely safe. I needed that more than anything right now.
Luana continued signing, and Sophia spoke for her. “Dr. Malach doesn’t know what he’s talking about. I delivered a baby a few months ago from a mom with lupus, and she was fine. In fact, I’ve delivered many babies from lupus patients. As long as your symptoms are under control, you’ll be okay. We just have to monitor you, because you’ll be high-risk. I’m going to look up your chart.”
Luana typed a few things into the computer, then read over my info quickly.
When she turned back to me, I asked, “Is my lupus going to return?”
Sophia signed my question to Luana, then paused a beat before interpreting. “You have a seven to thirty-three-percent chance of a lupus flare, which is about the same for non-pregnant women with lupus. Your pregnancy doesn’t increase your chance of having a lupus flare-up. Since your lupus was under control before getting pregnant, you’re very likely to deliver a healthy baby.”
“So I’m not high-risk?” I wondered.
“All lupus patients are high-risk, but all that means is that you’ll visit more often to be monitored more closely. Don’t let Dr. Malach scare you. This is up to you, and I’m going to be here with you the whole way. We have a whole team of medical doctors, including rheumatologists, who will help.”
“Is my kidney going to be okay?” I asked.
“It’s recommended you wait at least a year after a transplant to start trying for a baby, but you can still carry to term without waiting that long.”
My tone began to even out. “What am I at risk of?”
“Preeclampsia—or high blood pressure during pregnancy—preterm labor, blood clots, miscarriage?—”
“Miscarriage?” My hand immediately went to my belly. I was worried about my lupus and my transplant, but more than that, I worried about the baby. A healthy child was more important than my illness.
“You just need to take it as easy as possible. Since your lupus is under control, you’ll be at lower risk of flares, but if they do happen, we have pregnancy-safe medication. If you choose to continue with this pregnancy, controlling your lupus is our safest option.”
“What if the baby ends up with lupus?” I questioned.
“The chances are quite low—about a two-percent chance your child will ever develop lupus.”
To say I was pissed at Dr. Malach was an understatement. He had spoken like passing on my illness was a sure thing, and it’d scared the hell out of me. Luana was so reassuring, though, that a huge weight lifted off my shoulders.
