Kitabı oku: «The Honourable Midwife»

CHAPTER ONE

THERE was bound to be something left behind, Pete Croft decided as he walked around Emma Burns’s house and garden one last time. A toy hidden under a flowerpot during a game and then forgotten, or some stray coins in a drawer.

No, there’d be more than that. Something much more personal. Something that would endure for longer.

He stood on the back veranda and looked at the garden. It was the start of spring, the first weekend of September, and there were daffodils and blossom trees and golden acacias in bloom.

The grass was a lush green, and he’d mowed it just this morning, so that the fresh, earthy scent of the clippings still hung in the air. He could hear a couple of other motor mowers going in the distance, too. It was a weekend sound, a hopeful sound, and somehow more soothing to the spirits than such a sound had any right to be.

Inside Emma’s house, cool polished floorboards gleamed, and spring sunshine made the living room bright. On any other Saturday, Pete might have stretched out on that squishy-cushioned regency-stripe couch with the weekend city newspaper and a cup of good coffee. Today, however, he had to move out.

I don’t want to leave, he realised.

He’d been happy here, during the three-month interlude of his tenancy. He’d found a tranquillity and peace he’d never known in quite the same way before, and an odd kind of friendship, via e-mail, with his temporary landlady on the other side of the world in France.

These were the things he didn’t want to leave behind. The sheer tranquillity. Emma’s e-mails. The sense of her personality lingering like a well-loved fragrance in every room. The sight of his four-year-old twin daughters playing in their ‘cubby house’ under the old hydrangea bushes, without an apparent care in the world, despite the upheaval unleashed on them by the collapsing of their parents’ marriage.

His marriage. His marriage to Claire.

This was the reason Pete made another tour through the house. He went down the brick steps at the front, around the slate paved path at the side of the house and into the back garden once more, rebelling against a reality he couldn’t change.

He didn’t want to leave at all.

But, of course, he had to. Emma Burns was coming home tomorrow, after her three-month trip, and he was moving into his own brand-new place in Glenfallon’s trendiest suburban housing development. The interlude had to end, and real life had to resume.

He’d had professional cleaners in, and he’d groomed Emma’s garden himself. The fact that it was spring and flowers were in bloom made it a little easier than it would otherwise have been for him to tell the real plants from the weeds.

The real estate agent was dropping in this afternoon to satisfy himself that everything was in order, but Pete knew this was just a formality. Everything was in order. There was really nothing more to do. He put the key in an envelope, along with a card he’d written to Emma, left them on the kitchen bench top, let himself out the front door and clicked it shut behind him.

Dr Croft had left a couple of things, Emma discovered on Sunday afternoon. The card, for one, which was nice. It was thick and expensive, with a lushly colourful painting of poppies on the front. Inside, he’d written, ‘Welcome home, and thanks for renting me your little slice of paradise at a time when I really needed it, Pete. P. S. I want the names of your paint colours.’

His e-mails had been like that, too. Simple and brief, most of them, they’d bounced from heartfelt to practical and back again in the space of three sentences. She had replied in the same vein, and several times over the past three months they’d had a conversation going back and forth for days—a conversation which had had nothing to do with the impersonal tenant-to-landlady issue that had begun it.

Standing in her empty, pristine kitchen, Emma smiled.

She’d enjoyed those electronic conversations. She’d enjoyed the fact that she’d been sitting in an internet café in Paris, with half a dozen languages chittering around her. She’d enjoyed feeling tired and hot, and she’d enjoyed smelling of sugar and cheese and chocolate after hours of lessons in haute cuisine.

Most of all, oddly enough, she’d enjoyed the companionship. On a professional level, she’d known Pete Croft on and off for…well, it had to be several years, at least, but it had taken flurries of e-mails flashing back and forth across half the world to make her feel as if she knew him as a person.

E-mails, and the fact that he’d been living in her house.

Emma was tired and jet-lagged after the long flight from Europe and the connecting hop, in a small propellor-driven aircraft, from Sydney to Glenfallon. The ground didn’t seem quite steady beneath her feet. There was a lot to do if she was going to get settled back in before she started work on Tuesday, but she found it impossible to put her flagging energy to anything useful just yet.

Instead, she wandered around the house and garden, finding evidence of her tenant’s recent occupation. He’d repaired the latch on the side gate, and the torn flyscreen on the kitchen door. His four-year-old twin daughters, Jessie and Zoe, had dropped a brown Lego horse in the daffodil bed.

He’d left a bottle of brand-new aftershave on the bathroom window-sill, hidden behind a set of cheap lace curtains which she intended to replace soon. For some reason, Emma was tempted to open the aftershave, to see if it smelled like him—What, could it smell like his e-mails?—but sensibly she didn’t. She would give it and the Lego horse back to him when she got a chance, but doubted the matter was urgent.

She knew Pete had bought a house in the new development at the edge of town, but didn’t have the address. He would be busy moving in, finalising the details of his divorce, his property settlement and his custody arrangements. Plastic horses and missing bottles of unused aftershave would be far, far down on his list of priorities.

‘I’ll unpack, and put on a load of laundry, and get myself organised,’ Emma decided, and wondered if it was only because her wonderful three months in Paris was over that she felt so flat.

‘Dr Croft? It’s Patsy McNichol.’

‘Yes, Patsy? What is it?’

Pete blinked, rubbed the sleep out of his eyes and tried to lift his voice above its early-morning creak. The red figures on the clock radio beside his bed showed six twenty-five, and it was not yet fully light. He was quickly alert, however. He knew this patient wouldn’t be phoning him at such an hour on a whim.

‘I’m bleeding again,’ she said. ‘But it’s much worse, this time, and…and there’s some cramping, too.’

‘What kind of cramping?’

‘Well, I don’t know. Could it be contractions?’ She was trying to keep her voice steady, but it wasn’t working. Pete could hear the wobble and the pitch of panic. She didn’t want this to be happening yet.

‘How does the pain feel, Patsy? Is it steady? Describe it for me.’

‘It sort of drags, like really bad menstrual cramps, but it’s tight, too. It builds, and then it ebbs, and then a little while later—I should have been timing it, shouldn’t I?—it builds again. It woke me up about half an hour ago, and I just lay there, but then I felt the blood.’

‘How much?’

‘The bed is soaked.’

‘Is it still flowing?’

‘It’s eased off. Seems to have.’

‘Are you lying down?’

‘Yes, with my feet up.’

‘Can Brian drive you to the hospital?’

‘We’re already dressed. I didn’t want to disturb you any earlier than I had to.’

Pete dammed back a sigh of frustration. Why were people like this? He had patients who would phone his home number at midnight, complaining of a paper cut, without so much as a ‘Sorry to bother you’, and patients who would hang back on a lifesaving call in order to give him ten minutes more sleep.

‘I’ll see you there as soon as I can,’ he told Patsy.

He dressed quickly, opting for a set of green surgical gear—drawstring pants and a short-sleeved, V-necked top. Realistically, given the position and size of Patsy’s uterine fibroids, he was probably going to be assisting with an emergency Caesarean first thing this morning.

He could feel the aridity of his new bedroom as he moved around it in the early-morning light. The whole house was still far too bare and echoing and new after the cottage cosiness and warmth of Emma Burns’s place, which he’d been forced to abandon three days ago.

How did you achieve that sort of atmosphere? he wondered. He wasn’t convinced he had the skills, or the time. Well, certainly not the latter. So much on his plate right now.

Claire’s behaviour was like a nightmare. Her ultimatums to him didn’t make sense. He suspected she was sleeping around, but perhaps that wasn’t fair. Perhaps he was simply displacing the real sources of his anger onto a safer issue. How well was she looking after the girls? He wasn’t happy with their informal custody arrangement as it stood. He wanted more involvement in his daughters’ lives.

And now Patsy McNichol had apparently gone into premature labour, with bleeding that didn’t surprise him but definitely wasn’t good. She’d done well so far with the pregnancy, and they’d all been crossing their fingers that this wouldn’t happen.

There was no time to eat, or to gulp the coffee he craved. He left a message on the answering-machine at his practice, asking his staff to reschedule the first hour of his morning appointments, and he reversed out of the garage and pressed his finger to the button on his remote control garage door opener at six thirty-three.

He couldn’t help reviewing Patsy McNichol’s history as he drove. She was thirty-five years old, by no means too old for a first baby but old enough to have developed the uterine fibroid tumours in the muscle layer of the uterine wall which had clouded the safety of this pregnancy from the beginning.

Unfortunately, the fibroids had been small enough to have sent out no warning signals before she’d conceived. If he’d known about them before the McNichols had started trying for a baby, Pete would have recommended surgery—the procedure was called a myomectomy—which would in all likelihood have cleared the way for a normal, healthy pregnancy.

As soon as Patsy had conceived, however, it had been too late. Pregnancy produced hormones—high levels of oestrogen and progesterone which stimulated rapid growth of the fibroids. With the relative positions of the fibroids and the placenta that he’d seen on more than one ultrasound scan over the past three months, Mrs McNichol had been lucky to have had so few problems thus far.

There’d been signs on the most recent ultrasound, however, that the baby was no longer getting its optimum amount of nourishment. Although, thanks to the growth of the fibroids, the uterus itself was now very large, the baby wasn’t.

Patsy was desperate to keep the pregnancy going in safety. She’d given up work around the family farm months earlier than she and her husband had originally planned, and had gone on bed rest as soon as Pete had mentioned the idea. She’d had two or three episodes of moderate bleeding which they’d managed to control through medication, but now there was cramping as well.

A few months from now, when the uterus had returned to its pre-pregnancy size and her hormone levels had dropped, Patsy would go under the knife again, so that the fibroids could be safely removed. A future pregnancy would almost certainly be a much safer proposition for her.

First things first, however. Pete was concerned about the extent of the bleeding, and about the ongoing health of an undernourished baby at thirty-three and a half weeks gestation.

If labour could be stopped or slowed, should he send Patsy to Sydney or Canberra? At thirty-three and a half weeks, the baby’s required level of care fell just days short of the scope of Glenfallon Hospital’s small level two special care facilities. On paper, a few days wasn’t much, but how significant was the compromised environment of the uterus?

The clock on the dashboard of his car read six forty-one when he pulled into a reserved space outside the two-storey building which housed Glenfallon Hospital’s maternity unit, including its special care facilities and an obstetric operating theatre opened just this year.

The hospital buildings in current use were all relatively new. They were pleasant but rather bland concrete and glass constructions dating from various times over the past twenty-five years when the town had been endowed with capital funds for expansion.

The original building, of gracious old stone with wide verandas, a slate roof and thick walls, was now used for outpatient clinics and support services. The change had been necessary. Apart from its inadequate size, you just couldn’t make the old building’s layout and facilities accommodate modern medical equipment and practice. Still, stubbornly, Pete liked the old building best. It was the same way he felt about Emma Burns’s cottage versus his own newly purchased dwelling.

The new place had a locked double garage with remote-controlled doors. It had two bathrooms, and a family room adjoining the state-of-the-art kitchen. It had a back yard that was currently a depressing expanse of arid soil and builders’ rubble but would eventually be a great place for the girls to play whenever they were in residence. He had a landscaping firm scheduled to start work on paths and retaining walls soon.

As with the new hospital buildings, however, he wasn’t convinced the house would ever have the right character.

Arriving in the unit, he discovered that, despite their head start, Patsy and Brian McNichol had got there just a few minutes earlier. The departing staff, Kit McConnell and Julie Wong, were both helping the new and nervous patient into a gown and checking her history. She was the delivery ward’s only patient at the moment, but the phone was ringing, heralding the possible arrival of someone else.

‘How are you feeling, Patsy?’ Pete asked at once.

‘The contractions are getting stronger. There’s one coming now…’

From Patsy’s reaction, the pain was quite intense. She couldn’t move or speak during its peak, and had to press a thick pad between her legs to deal with the blood. Pete wasn’t happy about how much was still flowing. He abandoned any thought of getting her moved to Canberra or Sydney.

This didn’t mean he was relaxed about the idea of delivering her here. They could be in for some problems after the birth, and dealing with a post-partum haemorrhage could be a nightmare. Thank goodness there were a couple of good doctors he could call on.

‘Let’s get you on your left side with your feet up on a pillow,’ he told his patient, masking the extent of his concern.

She looked pale and drawn. Tired, as if she hadn’t been sleeping well in weeks, which was probably the case. Bed rest wasn’t fun. No physical activity to promote a healthy fatigue at the end of the day, too much time to think and worry. And she was huge, the size due to her fibroids, not the baby.

Pete palpated the uterus, gave her an internal examination and found that the cervix was ripe, already fully effaced and dilated to six centimetres. The baby’s position wasn’t good. Feet and bottom down low, and head lying next to her mother’s heart. The heartbeat was fine, no sign of distress, and that was a plus. But he really didn’t like the bleeding, or his rough impression of the baby’s size. He’d been monitoring this for several weeks, and there’d been steady growth, but the baby was still smaller than it should be for this stage of pregnancy.

‘I’ll be back in a minute,’ he promised Patsy, when he’d finished.

Heading for the phone at the nurses’ station, he almost cannoned into Emma Burns, who had just arrived, and whom he hadn’t seen in the three months he’d been renting her house. She was like a breath of cool, fresh air, scented with spring. She was like her home—bright and pretty and calming.

They smiled at each other.

‘Hi,’ he said. ‘Welcome back.’

‘Thanks.’

A beat of uncomfortable silence hung in the air, and neither of them knew what to say. Pete felt there ought to be something better than what he’d come out with thus far. Something witty or meaningful. Something a little private and personal that encompassed all the complex flavours of the e-mails they’d exchanged.

As if he had time to think about it now!

She’d done something to herself while she’d been away, he noted vaguely. Something good. Hair was different. Eyes. Lips. How she’d done it, he didn’t know. He didn’t even know quite what she’d done, he only knew that it was good.

Straight, dark, glossy tresses, arched brows, glowing brown eyes, soft, happy mouth. And yet he didn’t even have time to say, Wow! You look great, Emma! Although he definitely wanted to.

‘Can you make sure the ob. theatre is fired up and ready to go?’ he said. ‘No one else in there, is there?’

‘No, we’re quiet.’

‘I’m phoning Gian Di Luzio and Nell Cassidy. I’ve a got a patient in there…’ he gestured at Room One with a backward jab of his thumb over his shoulder ‘…who’s making me nervous.’

‘Fill me in,’ she said. She had a lovely voice, clear and steady. ‘I’m not officially on yet, but I’m obviously going to be in on the surgery, right? I think we’ve got another labouring mum coming in, but Bronwyn’s going to handle her.’

‘Yes, I want you in Theatre,’ he answered. ‘And I expect you’ll be moving over to Special Care to look after this baby, if we keep her.’

Emma had spent two years in Sydney, a few years ago, acquiring specialised neonatal nursing qualifications, and staffing was usually juggled to enable her to care for any babies who needed extra attention and skills after birth. There were a couple of other well-qualified nurses to share the load as well.

‘Might we not keep her?’ she asked.

‘I hope we can.’ He hadn’t quite answered her question with the words, but went on to do so in his description of the patient’s history.

Emma’s appearance might have changed in three months—what was it? Her eyes glowed! But he doubted whether her capabilities had. She’d always been good. A team player and able to handle all the different types of people she had to deal with, from nervous new fathers to overworked GPs. She was level-headed, thorough and adept at anticipating problems. He sketched out what she needed to know, using a barrage of medical shorthand which had her nodding and frowning at once.

‘Yes, I see what you mean,’ she said. ‘I can see why you’d want Dr Di Luzio and Dr Cassidy.’

Gian Di Luzio was Glenfallon’s one obstetrician and gynaecologist, and a woman would have to go quite a distance to find another one. Like most parts of rural Australia, Glenfallon was chronically in need of specialists. As a result, there were several GPs in the area who’d obtained extra credentials in various fields to meet demand.

Pete was one of them. He’d returned to Glenfallon at the beginning of the year after two years spent in Sydney, and he was now better qualified than anyone but Gian in delivering babies and dealing with associated areas, but he was by no means too proud to reach out and grab a fully fledged specialist’s extra experience when he needed it. With the twin risks of post-partum haemorrhage and a delicate baby, this was one of those times.

Nell Cassidy was no slouch when it came to extra experience either. She ran the hospital’s accident and emergency department with an iron hand, and no velvet gloves involved. She also oversaw the hospital’s acute-care patients—adults, children and infants. She was extremely bright, unflappable in a crisis and always the very last person to accept that a patient couldn’t be saved.

She’d revived one of Pete’s patients last year—a four-year-old girl, the same age as his daughters now were—after a near-drowning, and she’d kept vigilant when everyone else had been ready to celebrate and relax.

Two days after the incident in the back-yard pool, when Amber Szabo had already started smiling and talking and her parents and hospital staff were talking about her discharge, Dr Cassidy had headed off a major organ shutdown, battled death once again and saved the child.

Now, as far as Pete was concerned, the A and E staff could saddle the woman with any unflattering nickname they liked, but he would defend her with spirit all the way.

They had a full team assembled by seven-twenty. They had type A-positive blood waiting for Patsy, and a neonatal resus trolley equipped and waiting for her baby. They had oxygen and intubation equipment, monitors for heart rate, respiratory rate and blood oxygen saturation, and a barrage of drugs on hand.

They had overhead lights switched on, trays of shiny, sterile equipment lined up, and their patient ready to be wheeled in. The pace had picked up in Labour and Delivery, too. The recently delivered mum had been moved across to the post-partum ward, but they had a new admission to take her place—a young woman of nineteen, who’d had only sporadic prenatal care and no second-trimester sonogram, and was uncertain of her dates. Around eight, eight and a half months gone, she thought.

Thirty-six or thirty-seven weeks? Apparently Bronwyn Jackson wasn’t convinced of this after a manual examination.

‘She feels too small,’ the midwife reported to Pete. ‘By the height of the fundus, I’d say thirty-five weeks, maybe even thirty-four.’

‘Can we try to stop the labour?’ Pete asked.

‘No chance. Fully effaced, half-dilated, contractions every few minutes. This baby’s coming today, and we’ve got the resus trolley on hand.’

‘I’ll get there for the delivery if I can.’

‘The joint is jumping all of a sudden.’

‘Better phone Alison Cairns and tell her she might be needed, too.’ Dr Cairns was good with fragile babies.

The new admission, Rebecca Childer, had been put down as Pete’s patient, although her family was fairly new to Glenfallon, and he’d only ever seen her mother, Susan, for a couple of routine things. He didn’t like having this new, questionable labour hanging over his head when Patsy and her baby were uppermost in his mind.

The baby obviously didn’t want to stay in Patsy’s tumour-filled uterus any longer. He only hoped the little girl would be safe out of there, and in their hands. Should he have sent Patsy to a bigger facility before this? She’d argued against the idea very strongly, but he could have presented it in starker terms.

If we lose this baby, came the insistent thought, how much will I question my own decisions? And where’s Rebecca Childer going to be up to in her labour when I get out of Theatre?

‘Dr Croft looks terrible,’ Emma said quietly to Nell Cassidy.

Although Emma was over a year younger than the A and E specialist, she and Nell had been friends since their school days. More specifically, since the Glenfallon Ladies’ College Senior A netball team’s memorable trip to Sydney about seventeen years ago, for a round of competitions.

Teenage giggles and confessions during the long bus ride had gradually evolved into the more considered honesty and support of adult friendship, and had survived divergent career paths and life experiences, long periods of living in different places and even some significant criticisms of each other’s choices.

Nell knew that Emma considered her too cool and too uncompromising in her approach to her work. Emma knew that Nell would have ‘thrown that parasitical stepmother of yours out months ago’, instead of putting up with the situation until Beryl had left in a huff to go and live with her own daughter earlier that year.

Somehow, however, these differences of opinion didn’t matter. This same honesty now made it possible for the two of them to have a serious, if snatched conversation on an unrelated subject while they waited for their own role in safeguarding the McNichol baby’s first minutes of life.

‘Terrible is a bit harsh,’ Nell said in response to Emma’s comment. ‘He looks tired, definitely. And stressed.’

‘That’s what I meant, Nell. It was sympathetic. I wasn’t accusing him of having a bad hair day and tacky clothes. Is he tired and stressed?’

‘Most people are when their marriage is in the process of doing a slow-motion shatter.’

‘I thought his marriage was over. In his e-mails, he always…Well, in his e-mails, he sounded better than he looks.’

‘These things take time, Emma. But I expect if he’s been talking about his divorce in his e-mails, you know a lot more about it than I do.’

‘I know hardly anything,’ Emma said quickly.

She was sorry she’d made the initial comment to Nell now. She hadn’t meant this to turn into an analysis or a catechism. Having thought of Pete Croft as a kind of penfriend for the past three months, she’d been concerned to see the evidence of stress and problems in his face—problems he’d mentioned to her only in the most oblique way.

Something changed in him when they began the surgery, however. She saw him blink and work the muscles in his face, as if trying to wake them up, and there was a new alertness in his expression, a determination and focus that stripped away the signs of weariness and emotional preoccupation she’d first seen.

Pete was a good-looking man. Somehow, she’d never seen it before. Maybe because he didn’t fit the tall-dark-and-handsome model that most women wanted. He was tall enough, yes, but he wasn’t a giant—just under six feet, nicely built in an athletic way. He wasn’t dark. He did have brown eyes, but they weren’t for drowning in. They were too focused, too intelligent, too ready to be amused and too casually kind.

His skin was typically Australian—fair, a little roughened by the power of the sun, and uneven in tone. On a woman, it would have been disastrous skin, but on a man it was…very male. Rugged and strong and casually attractive.

As Nell had pointed out, he hadn’t been near a razor that morning, and his beard was growing in fast, a red-gold sheen of stubble surrounding firm lips which looked thin when he was absorbed in his work and fuller when he smiled his generous smile.

His hair was cut so you could see that it started as a very dark, rusty gold and went blonder as it grew out, until it settled on sand mixed with straw as its definitive colour. He had little creases at the corners of his eyelids—creases he needed a woman to kiss away with soft, tender lips—and he had a tanned curve of neck at the back which could make that same woman want to stroke it with her fingers, then thread them upwards into the soft prickle of his hair as she sighed against him.

Only not me, Emma thought in sudden panic. Why on earth am I suddenly thinking this way?

‘We’re good to go here, Houston,’ said anaesthetist Harry Ang.

‘One day I am going to kill that man,’ Nell muttered.

It was one of Dr Ang’s harmless quirks that he liked to speak as if this was NASA Mission Control and he was an astronaut about to launch into space. Nell had a limited tolerance for harmless quirks.

Emma didn’t mind Dr Ang—he was a nice guy, and always pleasant to the nurses, which counted for a lot—but she had to suppress a laugh all the same when Pete said, ‘Apollo Thirteen, do you mind if we cut satellite communications for the rest of this mission?’