Читать книгу The Playboy Doctor's Surprise Proposal - Anne Fraser - Страница 7

CAITLIN dressed carefully for work on Monday. She knew that Australian hospitals were less formal than Irish ones, especially given the heat, but she wanted to create the right impression. She chose a floaty skirt that, while cool, still looked smart and teamed it with a short-sleeved white blouse. She twisted her hair into a chignon and then she was ready.

Breakfast was a far rowdier affair than Caitlin was used to. Living alone, she was used to a quiet breakfast with the paper, not this hive of activity. How could such small children make such a racket and how could Brianna think straight with all the noise?

Niall collected his briefcase and slung an overnight bag over his shoulder. He kissed his wife and sister-in-law goodbye. ‘I’ll be back on Friday,’ he told Brianna. ‘Are you sure you’ll be all right?’

‘Go on, you big softy.’ His wife pushed him towards the door. ‘I’ve Caitlin here if I need anything—which I won’t.’ As husband and wife smiled at each other Caitlin felt a pang. What would it feel like to be loved like that? she wondered. Not that she really wanted to find out, she reminded herself. She liked her uncomplicated life back in Dublin exactly the way it was. She had work, loads of friends and plenty of hobbies to keep her busy. The last thing she needed in her life were complications, and if ever she wondered whether she was leading the right life, she just thought about her mother. Although she loved her mother fiercely, her whole life had been taken up with bringing up her large family of three boys and two girls. Caitlin had never seen her mother do anything just for herself. That wasn’t the life Caitlin had mapped out for herself.

She had just finished breakfast when she heard a toot from the driveway. Looking out, she saw Andrew had arrived in a sports car. He jumped over the door and came to meet her. Unlike on Saturday, he was dressed more formally, in a white shirt and light-coloured chinos. He looked fresh cool and very handsome. He opened the door for her with a flourish.

‘Your carriage awaits,’ he said.

‘Why, thank you, sir,’ Caitlin quipped back. ‘You are too kind.’

Soon they were leaving the leafy suburbs behind and were on the freeway. As he drove, Andrew pointed out various landmarks so that Caitlin would find her way the next day. They crossed a bridge, passing modern skyscrapers. Everything seemed as different from Ireland, with its green rolling countryside and the Georgian architecture of Dublin, as it could be.

‘What do you think so far?’ he asked.

‘Apart from the heat? I think it’s wonderful,’ Caitlin answered.

‘It’s not just the beaches, although you have to admit they are the best in the world. The Sunshine Coast is an hour to the north and the Gold Coast about the same distance south. We do some outreach work in both areas, so you’ll get a chance to see them.’

‘I’m looking forward to it,’ Caitlin replied, gripping onto her seat as Andrew passed a car. Catching her nervous look, he laughed. ‘Hey, don’t worry. You’re in safe hands.’

Caitlin smiled weakly in response. ‘Tell me about the hospital,’ she said.

By the time they had pulled up in front of the Queensland Royal, Andrew had given her a brief overview of how the medical system in Australia worked. He was a specialist paediatrician, which Caitlin already knew, and had a special interest in heart problems in neonates. The hospital was a gleaming, modern affair, all glass and stainless steel. Andrew told Caitlin that it had some of the best facilities in Australia.

As they got out of the car, an ambulance pulled up, its lights flashing. A trio of nurses was waiting at the entrance, ready to receive the casualties. Caitlin and Andrew were about to leave them to it when a nurse noticed his arrival.

‘Could you hold on a minute, Dr Bedi?’ she said. ‘We might need you.’

Unsure where to go, Caitlin watched as the patient was unloaded. Immediately she could see that it was a woman in advanced pregnancy. From the look of distress on her face, it appeared she was in labour. Suddenly she felt her reflexes kick in. She moved towards the group, making a rapid judgement.

‘Mrs Roland is in the end stage of labour,’ the paramedic intoned. ‘She was due to have her baby at home, but the midwife felt that labour wasn’t progressing quickly enough and decided to call us. The baby’s heartbeat has dropped.’

‘I’m Dr O’Neill,’ Caitlin introduced herself. ‘One of the obstetricians. Let’s get her inside so we can assess her.’

Once inside Caitlin carried out a rapid examination of the woman. It only took her a few seconds to realise that the placenta was lying in front of the baby. It was something that every obstetrician came across on a regular basis. Nevertheless, if they didn’t get the baby delivered there was a chance the woman would bleed to death. In every country there were several maternal deaths every year due to the condition. There was no time to lose. Every second counted if they were to save the woman and her unborn child. ‘Placenta praevia,’ she said. ‘She needs to go to Theatre immediately.’

‘I’ll tell Theatre to expect us,’ one of the nurses said, turning towards the phone.

‘I’ll scrub in too,’ Andrew said. Even if they managed to get the baby delivered safely there was every chance it might need resuscitating. ‘C’mon, Caitlin, let’s go.’

Caitlin struggled to keep up with his long strides as they rushed towards Theatre. A nurse handed her some scrubs and clogs and she scrubbed up beside Andrew, mentally counting off the minutes.

‘Right in at the deep end,’ Andrew said sympathetically. ‘We didn’t even manage to get you up to the ward.’

By the time they were scrubbed and gowned, Mrs Roland had been anesthetised and was lying prepped on the theatre table.

Caitlin cut into the abdomen from left to right just above the pubic bone. As the skin separated, she made another incision into the uterus, careful not to damage the precious contents. As she pulled the baby out, she glanced at the clock. Ten minutes had passed since the patient had arrived at the hospital. She was pleased to see none of her speed had deserted her.

The baby, a little boy, was slightly floppy and blue. Caitlin handed him to the midwife, who rushed the baby across to the resuscitator.

‘He’s a bit flat,’ the midwife called out. As Caitlin started to close she was aware of the tension in the room. Andrew needed to get oxygen into the baby, and soon. Across the woman’s abdomen she watched as he tipped the baby’s head back gently before slipping in a paediatric endotracheal tube, feeling his way through the larynx and into the lungs. Then he attached an ambu-bag and started feeding oxygen into the tiny lungs. Every movement he made was calm and assured, and this fed into the atmosphere of the theatre. There was no panic. Everyone was simply going about their jobs quietly and efficiently. Caitlin was impressed. She guessed the team had worked together many times before.’

‘Heart rate 140 and he’s a good colour now,’ Andrew announced to the room to a collective sigh of relief. ‘I think baby is going to be fine. We’ll get them up to Special Care, but I think we should be able to reunite mother and baby quite soon.’

‘Maybe not tonight,’ Caitlin said. ‘I’ll want to keep an eye on her in the labour ward overnight, in case of postpartum haemorrhage.’

While the baby was being taken away to the special care nursery, accompanied by the paediatric nurse and Andrew, Caitlin finished closing the wound. She felt a trickle of perspiration run down her forehead and was grateful when one of the nurses wiped it away. Once Mrs Roland had woken from the anaesthetic, she would see her and let her know what was happening. She was pleased that her first case had gone well—not that she doubted her ability, but Caitlin knew that sometimes even straightforward cases could suddenly go wrong.

After she had finished in Theatre, she asked one of the nurses to take her to Special Care. She wanted to check on the baby before she spoke to the mother.

She found Andrew bending over the infant, listening to its chest. He looked up at her, his deep brown eyes warm. ‘He’s going to be fine, I think,’ he said. ‘We’ll know better in a few days. You did a good job back there.’

Caitlin looked around the small high-tech unit. It reminded her of the one back in Dublin, but she guessed that there was a uniformity with all hospitals in the Western world. There were five babies in at the moment, with anxious parents sitting by their incubators. Her heart went out to them. It must be so hard to feel so helpless, to know that the life of your child depended on the doctors and nurses.

Having finished examining the baby she had recently delivered, and announcing himself satisfied for the time being, Andrew suggested he show her around.

‘We have around four thousand deliveries a year here,’ he said. ‘We get difficult cases from quite far away. The air ambulance brings mothers and kids in on a regular basis. You might like to go out with the team some time.’

‘I’d love to,’ Caitlin said enthusiastically. ‘I’ve never been on anything like it before. I guess in a country of this size, it happens a lot.’

‘Often enough,’ Andrew said. ‘We take turns being on call for the air ambulance. I’ll rota you in for the same time as me. Okay?’

At Caitlin’s nod he went on. ‘I’ll take you up to Personnel. I know you sent all your paperwork in advance, but there may be one or two pieces they need from you. After that I’ll give you the tour.’

After she’d completed the necessary paperwork, Andrew introduced her to the midwives and doctors she’d be working with. There were too many faces for her to remember everyone’s names straight away, that would take time, but all the staff seemed very welcoming.

Her first afternoon was to be spent in Theatre. One of the senior midwives, a cheerful woman called Linda, took her on a round of the antenatal ward. Andrew left them to it while he went to do his own rounds. After the ward round Linda took Caitlin to the general gynaecology ward and introduced her to the patients she had scheduled for Theatre.

After seeing all the patients on her afternoon’s list, Linda stopped in front of a woman who was perched on the end of the bed and looked as if she was ready to run a mile.

‘This is Mrs Mary Oliphant,’ Linda introduced the woman. ‘She’s in to have her tubes examined. She and her husband have been trying for a baby for a year, and their family doctor thinks she should have her tubes checked before they think about IVF.’

‘Good idea,’ Caitlin said. Mrs Oliphant seemed to relax a little. ‘It’s a very quick procedure,’ Caitlin said. ‘We’ll take you down to the scanning room and pass a catheter through your cervix, squirt some dye and have a look. We don’t even need to anaesthetise you, but we’ll give you a couple of painkillers as it can be uncomfortable. The good news is that you’ll have the results straight away.’

‘And if my tubes are blocked? What then? Does that mean we won’t be able to have children?’ Mary’s lip trembled. ‘We really want a baby.’ A tear slipped down her cheek. ‘I blame myself. I was determined to wait until my career was established before we started a family. But what if I’ve left it too late?’

‘Hey, let’s not get ahead of ourselves,’ Caitlin said soothingly. ‘Let’s do the echovist first and we can talk again then.’ She took her hand. ‘Anyway, you’re not that old.’ She smiled. ‘Although a woman’s fertility does decline markedly after the age of thirty-five, you’re still on the right side of forty. And there is a test we can do which will tell us just how well your ovaries are responding. I’ll take a blood sample today, and I should have the results for you soon. I also suggest that we test your husband. That way, if you need to think about IVF you’ll be ready to go. How does that sound?’

As she spoke a thought slipped into her head. Time was passing for her too. It was quite possible that if she changed her mind about wanting children, she too would find she’d left it too late. It was one thing not to want children, quite another to have the choice taken away. She squeezed the thought to the back of her mind. Why was she suddenly thinking children might be an option in the future, when until now she had been sure children weren’t for her? She forced her attention back to her patient. It was Mary who she had to think about. She deserved her full attention.

Mary smiled, seeming reassured. ‘That sounds great,’ she said. ‘I just want to know so we can decide our next step. Thank you for taking the trouble to talk to me.’

‘Hey, that’s what we’re here for.’ Caitlin smiled. ‘I’ll see you down in the scanning room shortly. First let’s take that blood sample.’

Quickly, Caitlin took a sample of blood from Mrs Oliphant’s arm and passed it to Linda.

As they moved away Linda said, ‘There’s one more lady I’d like you to see. I’ve already spoken to Dr Bedi about her, and he’s interested to know what you think.’ Curious, Caitlin let herself be led across into one of the single rooms. Sitting up in bed, reading a magazine listlessly, was the patient Linda had asked her to see.

‘This is Mrs Levy,’ Linda said, passing her chart to Caitlin. ‘As you can see, she’s twenty-nine weeks pregnant. She was admitted earlier today with an elevated blood pressure of 160 over 100, plus protein in her urine. In her first pregnancy she had to be delivered prematurely because of high blood pressure.’

Caitlin had seen the condition often. It was always a difficult judgement call. On the one hand, there was no treatment and the only sure way of preventing the condition from getting worse was to deliver the baby. However, Mrs Levy was only twenty-eight weeks pregnant and although Caitlin knew that the hospital had the necessary equipment to look after a pre-term baby, there was always a chance that the baby would suffer brain damage or even worse if it was delivered so early.

‘What does Dr Bedi think?’ she asked Linda as they moved away from the patient.

‘He’d prefer us to wait and monitor her closely over the next few days.’

It wasn’t an unreasonable decision, Caitlin knew. Every day the baby stayed safely in the mother’s womb increased its chances of survival.

‘Could we arrange to have Mrs Levy scanned?’ Caitlin asked, making up her mind. ‘I’ll do it myself before Theatre.’ She went back to her patient.

‘You’re probably well aware of our concerns, Mrs Levy. I’m sure they have been discussed with you.’

‘Please call me Patricia. Mrs Levy always makes me think of my mother-in-law.’ She smiled, before the anxious look returned to her eyes. ‘That nice Dr Bedi came to see me and explained everything.’

Did he, now? Caitlin thought, wishing that he had spoken to her before discussing options with the patient. She decided to wait until she had spoken to him and had the scan results before speaking to Patricia again. ‘I’d like to scan you as soon as we can get a scanner up here,’ she told the patient. ‘I’ll see you in a little while, okay? Then we can decide on the best way forward.’

Patricia clutched Caitlin’s hand. ‘I really want this baby,’ she said. ‘They told me it’s a girl and as I have two boys, it will make my family complete.’

Caitlin patted her hand reassuringly. ‘We’ll do our best for you, I promise. In the meantime, the best thing you can do for your baby is try and relax.’

After rounds Linda took Caitlin into the staffroom for a cup of coffee. ‘What do you think so far?’ she asked as she poured them mugs from the pot that had been made earlier.

‘I’m impressed,’ Caitlin admitted. ‘The facilities, at least what I’ve seen so far, are impressive.’

‘I hear from the others that you know Dr Bedi. He’s lovely, don’t you think?’

Caitlin wasn’t quite sure how to answer. What was she supposed to say to that? That, yes, he was gorgeous and that she fancied the pants off him? ‘He seems very nice,’ she said noncommittally.

‘Half the nurses and doctors here are in love with him. The other half are married.’ Linda laughed. ‘Thank goodness I’m in the second half. Otherwise I’d be doomed to have my heart broken, like the rest.’

Caitlin wasn’t used to such frankness and wasn’t sure how to respond. Thankfully, as she was searching frantically for a more neutral subject, Andrew himself appeared.

‘They told me I’d find you here,’ he said, pouring himself a glass of water from the cooler and gulping it greedily. ‘I wondered if you wanted to see the paeds wards before we have lunch. Your theatre list starts at 1.30. Right?’ She eyed him, mentally readjusting her opinion of him in light of what Linda had told her.

Caitlin stood. ‘I’d love to see the children’s ward,’ she said. ‘And meet the staff.’ She finished her coffee and rinsed her cup. ‘Thanks, Linda,’ she said as she followed Andrew out of the staffroom. ‘I’ll see you after Theatre.’

She followed Andrew out of the staffroom.

‘I don’t think we should leave Mrs Levy any longer,’ she said. ‘She’s showing all the signs of pre-eclampsia—raised blood pressure and protein in her urine. If we don’t deliver her and her condition gets worse then there is a chance she’ll start fitting and we’ll lose her. I’m sure neither of us want to be faced with a maternal death.’

Andrew turned and looked at her. ‘The last two scans place her at twenty-eight weeks,’ he said. ‘There’s not been much growth since then.’ He frowned. Caitlin wondered if he was unused to having his opinion challenged. Underneath his easygoing exterior she thought there was a man who, once he had made up his mind, was loath to change it. It was clear in the way the staff acquiesced to him that he was used to being deferred to. On the other hand, so was she. She trusted her instinct, and if she were back in Ireland nobody would have questioned her decision.

‘If we deliver her now, then there is a chance the baby won’t survive,’ he continued. ‘Even another couple of days would give it a better chance.’

Caitlin held her ground. ‘If we wait another couple of days and the mother develops full-blown eclampsia then there’s a good chance that we’ll lose the baby as well as the mother. Is that a risk you’re prepared to take? Because I’m not sure I am.’

They stared at each other, neither willing to give an inch.

‘We should go and speak to the patient at least,’ Caitlin said eventually. ‘We should give her all the facts and let her decide.’

‘Do you think that’s fair?’ Andrew countered. ‘If she decides to go ahead and let us deliver the baby, and the baby dies, she’ll carry that burden always. She’ll always wonder if she made the right decision.’

‘And if she takes your advice and waits, and she and the baby both die, then what about the rest of her family? She has two children under the age of five. Do you think it’s fair to leave them without a mother?’ Caitlin felt her voice catch on the last words as an image of her niece and nephew growing up without their mother flashed across her mind.

Andrew looked at her sharply. ‘Are you sure this isn’t becoming personal, Caitlin?’ he asked softly.

Caitlin gritted her teeth in frustration. She never let her personal feelings or emotions interfere with her professional judgement. But that didn’t mean that she looked on her patients just as obstetric dilemmas—she prided herself on taking all aspects of their lives into account when making a clinical decision. How dared he suggest otherwise? Even if he already thought of her as some sort of pathetic female that needed rescuing. Now he was accusing her of being over-emotional and letting her worry about her sister cloud her judgement. Well, she would soon put him right.

‘Let me make one thing absolutely clear, Dr Bedi. It’s important we understand one another if we are going to be making joint decisions about patients.’ Her voice was cold and clipped, even to her own ears, but she made no attempt to soften her tone. ‘The decisions I make are always—’ she emphasised the last word ‘—made on the basis of what is good for my patient. I never let personal feelings cloud my judgement.’ Aware that she had curled her hands into fists, she made herself relax. What was it about this man which caused her to have such strong reactions?

‘I’m glad to hear it, Dr O’Neill,’ he said calmly. ‘Because if I ever had reason to think you weren’t up to the job, believe you me, regardless of the friendship I have with your family. I wouldn’t hesitate to have you removed from the case. Now, do I make myself clear?’