Читать книгу Midwives On-Call - Алисон Робертс - Страница 35

FRIDAY. EM’S DAY was cleared so she could focus on Ruby. Isla was aware of the situation. ‘If she really has no one, then you’d better be with her all the way.’

So she stayed with Ruby in the hour before she was taken to Theatre. She spent their time discussing—of all things—Ruby’s passion for sewing. Ruby had shyly shown her her handiwork the day before, so Em had brought in one of Toby’s sweaters. Ruby was showing her how to darn a hole in the elbow.

‘Darning’s a dying art,’ she’d told Em, so Em had found the sweater and brought a darning mushroom—Adrianna had one her grandmother had used!—and needle and thread and asked for help.

Ruby took exquisite care with the intricate patch. When she was finished Em could scarcely see where the hole had been, and darning and the concentration involved worked a charm. When the orderlies came to take Ruby to Theatre, Ruby was shocked that the time had already arrived.

She squeezed Em’s hand. ‘Th-thank you. Will I see you later?’

‘I’m coming with you,’ Em declared, packing up the darning equipment. ‘Isla’s told me if I’m to help deliver your baby at term then I should introduce myself to her now. So I’m to stay in the background, not faint, and admire Dr Evans’s handiwork.’

‘You’d never faint.’

‘Don’t you believe it,’ Em told her, and proceeded to give her some fairly gross examples. She kept right up with the narrative while Ruby was pushed through to Theatre, while pre-meds were given, while they waited for the theatre to be readied. Finally, as Ruby was wheeled into Theatre, they were both giggling.

Oliver was waiting, gowned and ready. So, it seemed, was a cast of thousands. This was surgery at its most cutting edge. They were operating on two patients, not one, but one of those patients was a foetus that was not yet viable outside her mother. The logistics were mind-bending and it would take the combined skills of the Victoria’s finest to see it succeed.

Shock to the foetus could cause abortion. Therefore the anaesthetic had to be just right—they had not only the Victoria’s top anaesthetist, but also the anaesthetic registrar. Heinz Zigler was gowned and ready. Tristan Hamilton, paediatric cardiologist, was there to check on the baby’s heart every step of the way. There were so many possible complications.

The surgery itself was demanding but everything else had to be perfect, as well. If amniotic fluid was lost it had to be replaced. If the baby bled, that blood had to be replaced, swiftly but so smoothly the loss couldn’t be noticed. Everything had to be done with an eye to keeping the trauma to the baby at the absolute minimum.

‘Hey, Ruby.’ Oliver welcomed the girl warmly as she was wheeled in, and if he was tense he certainly wasn’t showing it. ‘What’s funny?’

‘Em’s been telling me—’ Ruby was almost asleep from the pre-meds but she was still smiling ‘—about muddles. About her work.’

‘Did she tell you about the time she helped deliver twins and the team messed up their bracelets?’ Oliver was smiling with his patient, but he found a chance to glance—and smile—at Em. ‘So Mathew Riley was wrapped in a pink rug and Amanda Riley was wrapped in a blue rug. It could have scarred them for life.’

Em thought back all those years. She’d just qualified, and it had been one of the first prem births where she’d been midwife in charge. Twins, a complex delivery, and the number of people in the birthing room had made her flustered. Afterwards Oliver had come to the prem nursery to check on his handiwork. The nurse in charge—a dragon of a woman who shot first and asked questions later—had been in the background, as Oliver had unwrapped the blue bundle.

Em had been by his side. She’d gasped and lost colour but Oliver hadn’t said a word; hadn’t given away by the slightest intake of breath that he’d become aware she’d made a blunder that could have put her job at risk. But the mistake was obvious—the incubators had been brought straight from the birthing suite and were side by side. There was no question who each baby was. Without saying a word, somehow Oliver helped her swap blankets and wristbands and the charge nurse was unaware to this day.

That one action had left her … smitten.

But it hadn’t just been his action, she conceded. It had also been the way he’d smiled at her, and then as she’d tried to thank him afterwards, it had been the way he’d laughed it off and told her about dumb things he’d done as a student … and then asked her to have dinner with him …

‘I reckon I might like to be a nurse,’ Ruby said sleepily. ‘You reckon I might?’

‘I reckon you’re awesome,’ Oliver told her. ‘I reckon you can do anything you want.’

And then Ruby’s eyes flickered closed. The chief anaesthetist gave Oliver a nod—and the operation was under way.

Lightness was put aside.

Oliver had outlined the risks to Ruby—and there were risks. Exposing this tiny baby to the outside world when she was nowhere near ready for birth was so dangerous. Em had no idea how many times it had been done in the past, how successful it had been, but all she knew as she watched was that if it was her baby there was no one she’d rather have behind the scalpel than Oliver.

He was working side by side with Heinz. They were talking through the procedure together, glancing up every so often at the scans on the screens above their heads, checking positions. They wanted no more of the baby exposed than absolutely necessary.

Another screen showed what they were doing. To Em in the background she could see little of the procedural site but this was being recorded—to be used as Rufus’s operation had been—to reassure another frantic mum?

Please let it have the same result, she pleaded. She was acting as gofer, moving equipment back and forth within reach of the theatre nurse as needed, but she still had plenty of time to watch the screen.

And then the final incision was made. Gently, gently, the baby was rotated within the uterus—and she could see the bulge that was the unsealed spine.

There was a momentary pause as everyone saw it. A collective intake of breath.

‘The poor little tacker,’ Tristan breathed. ‘To be born like that … she’d have had no chance of living a normal life.’

‘Then let’s see if we can fix it,’ Oliver said in a voice Em had never heard before. And she knew that every nerve was on edge, every last ounce of his skill and Heinz’s were at play here.

Please …

The complexity, the minuscule size, the need for accuracy, it was astounding.

Oliver was sweating. Not only was the intensity of his work mind-blowing, but the theatre itself had to be set at a high enough temperature to stop foetal shock.

‘Em.’ Chris, the chief theatre nurse, called back to her. ‘Take over the swabs.’

All hands were needed. Em saw where she, too, was needed. She moved seamlessly into position and acted to stop Oliver’s sweat obscuring his vision.

He wasn’t aware of her. He wasn’t aware of anything.

They were using cameras to blow up the images of the area he and Heinz were working on. Every person there was totally focused on the job or on the screens. Two people at once—two hearts, two lives …

She forgot to breathe. She forgot everything but keeping Oliver’s vision clear so he could do what had to be a miracle.

And finally they were closing. Oliver was stitching—maybe his hands were steadier than Heinz’s because he was working under instruction. He was inserting what seemed almost microstitches, carefully, carefully manoeuvring the spinal wound closed. Covering the spinal cord and the peripheral nerves. Stopping future damage.

The spine was closed. They were replacing the amniotic fluid. Oliver was closing the uterus, conferring with Heinz, seemingly relaxing a little.

The outer wound was being closed.

The thing was done.

Emily felt like sagging.

She wouldn’t. She wiped Oliver’s forehead for the final time and at last he had space to turn and give her a smile. To give the whole team a smile. But his smile ended with Em.

‘We’ve done it,’ he said with quiet triumph. ‘As long as we can keep her on board for another few weeks, we’ve saved your baby.’

‘Your baby’ …

Where had that come from?

And then she thought back to the teasing he’d given her when they’d first met, when they’d been working together, she as a brand-new nurse, he as a paediatric surgeon still in training.

‘Em, the way you expose your heart … You seem to greet every baby you help deliver as if it’s your own,’ he’d told her. ‘By the end of your career, you’ll be like Old Mother Hubbard—or the Pied Piper of Hamelin. Kids everywhere.’

And wouldn’t she just love that! She thought fleetingly of the two she was allowed to love. Gretta and Toby.

She did love them, fiercely, wonderfully, but she looked down at Ruby now and she knew that she had love to spare. Heart on her sleeve or not, she loved this teenage mum, and she loved the little life that was now securely tucked back inside her.

The heart swelled to fit all comers …

She thought back to Oliver’s appalling adoptive mother and she thought he’d never known that.

He still didn’t know it and they’d gone their separate ways because of it.

She stood back from the table. Her work there was done. She’d wait for Ruby in the recovery ward.

The team had another patient waiting for surgery. Oliver was moving on.

Em already had moved on. She just had to keep moving.

‘Well done.’ Out at the sinks the mood was one of quiet but deep satisfaction. There’d be no high fives, not yet—everyone knew the next few days would be critical—but the procedure had gone so smoothly surely they’d avoided embryo shock.

Tristan hitched himself up on the sinks and regarded his friend with satisfaction. He and Oliver had done their general surgical training together. They’d split as Oliver had headed into specialist surgical obstetrics and Tristan into paediatric cardiology, but their friendship was deep and longstanding.

Tristan alone knew the association between Em and Oliver. They’d had one heated discussion about it already …

‘The hospital grapevine will find out. Why keep it secret?’

‘It’s not a secret. It’s just a long time ago. Moving on …’

But now …

‘Are you telling me you and Em have really moved on?’ Tristan demanded as he watched his friend ditch his theatre garb. ‘Because, sure, Em’s your patient’s midwife and she was in Theatre as an observer in that capacity, but the contact you and she had … You might not have been aware how often you flicked her a glance but every time you were about to start something risky, it was like you were looking to her for strength.’

‘What the …?’ Where had this come from? As if he needed Em for strength? He’d been operating without Em for years.

He’d never depended on her.

‘You might say it’s in the past,’ Tristan went on, inexorably. ‘But she’s still using your name, and as of today, as an onlooker, it seems to me that the marriage isn’t completely over.’

‘Will you keep your voice down?’ There were nurses and orderlies everywhere.

‘You think you can keep this to yourself?’

‘It’s not obvious.’

‘It’s obvious,’ Tristan said, grinning. ‘Midwife Evans and Surgeon Evans. Sparks. The grapevine will go nuts.’

‘You’re not helping.’

‘I’m just observing.’ Tristan pushed down from the bench. He and Oliver both had patients waiting. Always there were patients waiting.

‘All I’m saying is that I’m interested,’ Tristan said, heading for the door. ‘Me and the rest of staff of the Victoria. And some of us are even more interested than others.’

Trained theatre staff were rostered to watch over patients in Recovery, but Isla had cleared the way for Em to stay with Ruby. With no family support, the need to keep Ruby calm was paramount. So Em sat by her bedside and watched. Ruby was drifting lightly towards consciousness, seeming to ease from sedation to natural sleep.

Which might have something to do with the way Em was holding her hand and talking to her.

‘It’s great, Ruby. You were awesome. Your baby was awesome. It’s done, all fixed. Your baby will have the best of chances because of your decision.’

She doubted Ruby could hear her but she said it anyway, over and over, until she was interrupted.

‘Hey.’ She looked up and Sophia was watching her. Sophia was a partnering midwife, a friend, a woman who had the same fertility issues she did. If there was anyone in this huge staff she was close to, it was Sophia. ‘Isla sent me down to see how the op went,’ she said, pulling up a chair to sit beside Em. ‘All’s quiet on the Western Front. We had three nice, normal babies in quick succession this morning and not a sniff of a contraction this arvo. Isla says you can stay here as needed; take as long as you want.’

‘We’re happy, aren’t we, Ruby?’ Em said gently, squeezing Ruby’s hand, but there was no response. Ruby’s natural sleep had grown deeper. ‘The operation went brilliantly.’ And then, because she couldn’t help herself, she added a rider. ‘Oliver was brilliant.’

‘Yeah, I’d like to talk to you about that,’ Sophia said, diffidently now, assessing Ruby as she spoke and realising, as Em had, that there was little chance of Ruby taking in anything she said. ‘Rumours are flying. Someone heard Tristan and Oliver talking at the sinks. Evans and Evans. No one’s put them together until now. It’s a common name. But … Evans isn’t your maiden name, is it? Evans is your married name. And according to the rumours, that marriage would be between you and Oliver.’

Whoa. Em flinched. But then … it had to come out sooner or later, she thought. She might as well grit her teeth and confess.

‘It was a long time ago,’ she murmured. ‘We split five years ago but changing my name didn’t seem worth the complications. I was Emily Green before. I kind of like Emily Evans better.’ She didn’t want to say that going to a lawyer, asking for a divorce, had seemed … impossibly final.

‘As you kind of like Oliver Evans?’ Sophia wiggled down further in her chair, her eyes alight with interest. ‘The theatre staff say there were all sorts of sparks between you during the op.’

‘Ruby’s in my care. Oliver was … keeping me reassured.’ But she’d said it too fast, too defensively, and Sophia’s eyebrows were hiking.

Drat hospitals and their grapevines, she thought. Actually, they were more than grapevines—they were like Jack’s beanstalk. Let one tiny bean out of the can and it exploded to the heavens.

What had Oliver and Tristan been talking about to start this?

And … how was she to stop Sophia’s eyebrows hitting the roof?

‘You going to tell Aunty Sophia?’ she demanded, settling down further in a manner that suggested she was going nowhere until Em did.

‘You knew I was married.’

‘Yeah, but not to Oliver. Oliver! Em, he’s a hunk. And he’s already getting a reputation for being one of those rarest of species—a surgeon who can talk to his patients. Honest, Em, he smiled at one of my mums on the ward this morning and my heart flipped. Why on earth …?’

‘A smile doesn’t make a marriage.’ But it did, Em thought miserably. She’d loved that smile. What they’d had …

‘So will you tell Aunty Sophia why you split?’

‘Kids,’ she said brusquely. She’d told Sophia she was infertile but only when Sophia had told her of her own problems. She hadn’t elaborated.

‘He left you because you couldn’t have babies?’

‘We … well, I already told you we went through IVF. Cycle upon cycle. What I didn’t tell you was that finally I got pregnant. Josh was delivered stillborn at twenty-eight weeks.’

‘Oh, Em …’ Sophia stared at her in horror. ‘You’ve kept that to yourself, all this time?’

‘I don’t … talk about it. It hurts.’

‘Yeah, well, I can see that,’ Sophia said, hopping up to give her friend a resounding hug. ‘They say IVF can destroy a marriage—it’s so hard. It split you up?’

‘The IVF didn’t.’ Em was remembering the weeks after she’d lost Josh, how close she and Oliver had been, a couple gutted but totally united in their grief. If it hadn’t been for Oliver then, she might have gone crazy.

Which had made what had come next even more devastating.

‘So what …?’

‘I couldn’t … do IVF any more,’ Em whispered.

Silence.

Ruby seemed soundly asleep. She was still holding the girl’s hand. She could feel the strength of Ruby’s heartbeat, and the monitors around her told her Ruby’s baby was doing fine, as well. The world went on, she thought bleakly, remembering coming out of hospital after losing Josh, seeing all those mums, all those babies …

‘Earth to Em,’ Sophia said gently at last, and Em hauled herself together and gave her a bleak little smile.

‘I wanted a family,’ she whispered. ‘I think … I was a bit manic after the loss but I was suddenly desperate. Maybe it was an obsession, I don’t know, but I told Oliver I wanted to adopt, whatever the cost. And in the end, the cost was him.’

‘He didn’t want to adopt?’

‘He’s adopted himself. It wasn’t happy, and he wouldn’t concede there was another side. He wouldn’t risk adoption because he didn’t think he could love an adopted kid. And I wasn’t prepared to give, either. We were two implacable forces, and there was nowhere to go but to turn away from each other. So there you have it, Sophia. No baby, no marriage. Can I ask you not to talk about it?’

‘You don’t have to ask,’ Sophia said roundly. ‘Of course I won’t. But this hospital … the walls have ears and what it doesn’t know it makes up. Now everyone knows you were married …’

‘It’ll be a one-day wonder,’ Em told her, and then Ruby stirred faintly and her eyes flickered open.

‘Well, hi,’ Em said, her attention totally now on Ruby. ‘Welcome to the other side, Ruby, love. The operation was a complete success. Now all we need to do is let you sleep and let your baby sleep until we’re sure you’re settled into nice, normal pregnancy again.’