Читать книгу The Doctor's Tender Secret - Kate Hardy - Страница 9

ALTHOUGH they were both on duty that weekend, Zoe avoided Brad, except on the ward rounds—and she made sure that he didn’t get a chance to speak to her privately about anything.

It drove him bananas. What was it going to take to make her talk to him, tell him the truth? Because he still couldn’t work out why she was lying to him, why she was pretending to have a boyfriend. Had she been hurt by someone in the past and no longer trusted men? Or was it something about him that worried her? But, if so, what?

Judith and Holly were no help either. He tried asking them. They both shrugged and said, ‘Ask Zoe.’ Either they really didn’t know or they were protecting her. Either way, he was no further forward.

He was still brooding about it on the Monday afternoon—in the guise of doing paperwork in his office—when his phone rang.

‘Brad Hutton,’ he said, a little more brusquely than he’d intended.

‘Hello, Brad. It’s Jude. Sorry to bother you—I know you’re busy—but I need a paediatrician in Theatre. Like now. Can you send Zoe along, please?’

‘No can do.’

There was a second’s pause. ‘Why not?’

‘She’s in Theatre already.’

‘Oh, no.’ The dismay in Judith’s voice was palpable. ‘Is anyone else available?’

‘What’s up?’

‘I’ve got a mum with eclampsia.’

The world tilted sharply on its axis. Eclampsia. Of all the conditions Brad could have faced in the hospital, it would have to be that one.

‘Brad? We’re doing an emergency section because the baby’s in distress. I need someone over here. Fast,’ Judith prompted.

There wasn’t anyone else. He couldn’t drag Zoe out of Theatre without a lot of explanations he didn’t want to give. There was no point in paging his SHO, because she wouldn’t be back from her lunch-break on time to make it to Theatre. And he couldn’t leave something like this to a house officer who probably hadn’t ever seen a case of eclampsia and wouldn’t know what to look for in the baby.

So he had to face it himself.

Face the demon that had haunted him for nearly a year.

He felt as if he were talking through a mouthful of sawdust but he managed to force the words out. ‘OK. I’m on my way.’

‘Thanks. I’m in the delivery suite. Theatre Four,’ Judith told him.

Eclampsia. A bolt from the blue because it was impossible to predict who would get it. Although most cases of eclampsia developed from pre-eclampsia, there were also documented cases where the mother hadn’t had any signs of pre-eclampsia beforehand. Nobody really knew what caused pre-eclampsia either, though one theory was that it was an abnormality in the body’s immune response to pregnancy. It was once called toxaemia of pregnancy but nowadays was known by a longer name reflecting the symptoms, ‘hypertension of pregnancy with proteinuria’—in other words, high blood pressure plus protein in the urine.

It had certainly been a bolt from the blue for Lara. She hadn’t been in any of the high-risk groups and she’d had good antenatal care. There had been no family history of pre-eclampsia, she hadn’t had hypertension, kidney disease or systemic lupus erythematosus before her pregnancy, she had only been having one baby and there had been no problems with the foetus at all during her pregnancy.

Worse still, Lara hadn’t actually had pre-eclampsia. No signs of protein in her urine, no swollen fingers or ankles, no signs of high blood pressure. The first either of them had known about it had been when Lara had complained of a headache one afternoon at the office. And then she’d collapsed, had a seizure. By the time she’d been taken to the emergency department and Brad had been paged from Paediatrics, Lara had had two further seizures. Despite the best efforts of the team, the baby hadn’t had enough oxygen and she’d died in Lara’s womb. His beautiful daughter, the little girl they’d both so looked forward to meeting—dead.

Bile rose in Brad’s throat. As if losing his daughter hadn’t been enough, that day had turned into his worst nightmare. Because, along with just over a third of women with eclampsia, Lara had developed a complication after delivering their baby. The most common one—a brain haemorrhage—and also the most fatal one.

And so he’d had to arrange a double funeral. His wife and his child. Two coffins—one of them impossibly tiny—that together had contained his whole life. Ashes to ashes, dust to dust…

He shook himself. He couldn’t go to pieces. Not now. He was a professional, a paediatric consultant, and he had a job to do. He had to look after this baby. Make sure that this one didn’t die like Cassandra had.

He scrubbed up and went into Theatre Four.

‘Thanks for making it so fast, Brad,’ Judith said. ‘This is Susie Thornton. She’s thirty-seven weeks, it’s her first baby and she’s thirty-seven.’

Worse and worse. Exactly the same as Lara had been when she’d died. Three years older than he was. First baby, thirty-seven weeks gestation.

‘She had moderate pre-eclampsia so we’ve been keeping a close eye on her on the ward for the last couple of weeks. She’s been on bed rest and antihypertensive drugs. She had a bit of a headache, then said it hurt just under her ribs and she thought it might be contractions.’

Brad forced the words through his dry lips. ‘And then she had a seizure?’

Judith nodded. ‘Textbook case, according to the midwife—thank God she was in the room at the time. Susie stopped breathing, her face twitched, her body became rigid and her muscles started contracting. Then phase two. Convulsions started in her jaw, moved through the muscles of her face and eyelids and spread through her body. The whole thing lasted for just over a minute. She was unconscious for a couple of minutes afterwards, and started hyperventilating when she came round—though she couldn’t remember collapsing or having a fit.’

Neither had Lara. When he’d been in the emergency department with her, holding her hand, she’d been distraught. ‘What’s happening to me, Brad? What happened? I—I can’t remember anything. I want our baby to be all right. Promise me our baby will be all right. Don’t let anything happen to her.’

Her words echoed through Brad’s head, over and over. Promise me. And, being a hotshot paediatrician, he’d promised. Of course their baby would be all right. He wouldn’t let anything happen to their precious child.

And when it had come to the crunch, he hadn’t been able to do a damned thing.

He realised that Judith was still talking him through her patient’s history.

‘We cleared her airway, made sure she had enough oxygen and put her on her left side so there was a good blood flow to the baby. She’s had intravenous magnesium sulphate to prevent any further seizures—it’s better than intramuscular, which hurts and leads to abscesses, plus it helps the blood flow to the foetus. I asked for ten-minute obs on her blood pressure and regular checks on proteinuria. I thought she’d stabilised and I was planning to give her oxytocin to induce labour. Susie really wanted a natural birth. But we were monitoring the foetal heart rate, too, and the baby went into distress. Probably because of the antihypertensives. My consultant agreed that we had to deliver. Now.’

‘Sure.’ Brad’s voice was hoarse with effort. ‘You’d better keep an eye on her afterwards. In case there’s a…’ He couldn’t say it. Couldn’t say the words that had broken his heart. An intracranial bleed.

‘Complications.’ Judith grimaced. ‘I’m more worried about the baby. Less than five mums a year die of eclampsia in this country—but it kills ten or eleven babies every week.’

Yeah. He knew that. Knew that the hard way.

This wasn’t going to be the same, he told himself fiercely. It wasn’t. Yes, it would be another emergency section of a mum with eclampsia. But this time the baby would live. The baby would be fine. The mother would be fine. Nothing was going to go wrong.

He watched the anaesthetist checking all the vital signs. Watched Judith make the small incision along the bikini line, watched her partner press down on Susie Thornton’s abdomen, watched Judith guide the baby out.

And all the time, he was seeing a different woman. A tall, beautiful blonde who’d held his hand so tightly, so desperately, willing everything to be all right. A woman whose panic had grown in those first seconds after the baby had been delivered—those long, agonising seconds when they’d waited for their little girl to cry. Waited for a sound. Heard the suction as they’d cleared the baby’s airways. Waited again for a sound. Still waited as the paediatric team had started CPR. Nothing. Nothing. Nothing.

The baby’s cry shocked him into action. Brad forced the bitterness of the past out of his mind and took the baby from Judith’s hands.

A little girl. A beautiful little girl. Covered with vernix, the greasy white substance that protected the baby’s skin from the amniotic fluid, just as Cassandra had been. But the big difference was that this little girl was crying. Her heart rate was fine. Her muscle tone was fine. She was starting to pink up nicely. She was breathing. He went through his mental checklist and smiled. ‘She’s got an Apgar of nine,’ he said.

A more detailed examination of the baby stopped the panic that had started to beat through him, silenced all the ‘what ifs’. ‘She’s absolutely fine,’ he said, handing her to the midwife to be weighed. ‘Though I think mum and baby should be in Special Care for the first twenty-four hours. Just to be on the safe side.’

‘Standard procedure,’ Judith said with a smile. ‘Susie’s blood pressure should be back to normal within a week, and the protein in her urine should have cleared within six weeks. All being well.’

‘Yeah.’ Concentrate on the here and now, he told himself, forcing himself to smile back. ‘I’d better be getting back to my paperwork,’ he said.

‘Thanks for your help, Brad.’

‘Pleasure.’

Though his smile faded when he left Theatre. Even though this case had turned out all right, hadn’t turned into the nightmare he’d lived through last year, it had still unsettled him. Brought back all the memories. Lara’s tortured face when she’d learned that their little girl hadn’t made it. The bleakness in her eyes. The bitterness in his mouth every time he’d had to explain that, no, he didn’t have good news. Their little girl had been stillborn. Phone call after phone call. The more often he’d said it, the more he should have got used to it. But every time the words had cut out another piece of his heart, left him bleeding inside. And when he’d lost Lara as well…

All my pretty chickens and their dam, at one fell swoop?

She’d said it was the most heartbreaking line in Macbeth. And he’d learned that the hard way.

He couldn’t face the ward. Not right now. Maybe a strong, dark coffee would revive him enough to let him carry on as if nothing was wrong. Maybe.

But when he reached the doors of the staff restaurant, he turned away. He couldn’t face that either. Sitting all alone with a cup of coffee while people walked right by him. Here, it would be because they didn’t know him. In California, it had been because they hadn’t known what to say, and walking straight past him without a word had been easier than trying to stumble through some form of condolences. Some people had even crossed the road rather than talk to him.

A muscle flickered in his jaw. He’d known he’d have to face this at some point in his career. Statistically, he knew he’d face at least one case of eclampsia a year in a major hospital. He’d thought he could handle it, because London City General was a different hospital in a different country, not the one where Lara and Cassandra had died. He’d thought he’d been prepared for it.

How wrong he’d been.

Brad returned to his office on autopilot. Started working through the reports, doggedly concentrating on the words and willing the pain to stay away. He didn’t hear the knock on his door. Or the second, louder knock.

Zoe opened the door. ‘Are you all right?’ she asked.

Of course he wasn’t. But he also wasn’t up to explaining why.

‘What’s happened?’

He shook his head.

Zoe closed the door behind her, pulled his blind down and crossed his office in two paces. ‘It’s better out than in,’ she said softly. ‘And if you’re worried about the office grapevine, I should tell you now that I don’t do gossip.’

Yeah. He knew that without having to ask. She might tell Holly and Judith in confidence, if she thought it would help him, but she’d make very sure they kept her confidence.

Even so… ‘I’m OK,’ he muttered.

‘You don’t look it.’ She took his hand. ‘What is it? Bad news from home?’

Home? He didn’t have a home any more. He’d sold the house he’d shared with Lara, put most of his things into storage and come over here. To a rented, anonymous flat. A place to live—not home.

‘Brad. Talk to me.’

If he didn’t, she’d nag him until he did. If he did…No. He didn’t want to see the pity in her eyes. Didn’t want to see the pity in anyone’s eyes. He’d had enough pity to last him several lifetimes.

She rubbed her thumb over the back of his hand, a comforting pressure. ‘Is there anyone I can call for you?’

‘No.’ He didn’t have a family any more. Well. In name, perhaps. His older brother, whose reaction to anything bad was to ignore it, pretend it wasn’t happening and it would eventually go away. Or his mother, who only ever acknowledged the impact things had on her. He hadn’t bothered asking either of them for support after Lara and Cassandra had died, knowing from long experience that he wouldn’t get it. His brother would simply have changed the subject, because it was easier to stick his head in the sand than to deal with something painful, and his mother would have sobbed about how much she missed poor dear Lara, how terrible it was not to be a grandmother after all, and whatever was she going to do without them? And Brad would have had to put his own feelings to one side, comfort her when all the time he’d have been crying inside for someone to hold him, comfort him, tell him there was a light at the end of the tunnel and he just had to keep walking towards it.

No.

‘There’s no one,’ he said softly.

‘Then talk to me,’ she said, equally softly.

‘There’s nothing to tell.’

‘I think there is. You look like hell,’ she said honestly. ‘You’re chalk white beneath that tan. What’s happened?’

‘I had a call to Theatre. A case of eclampsia.’

‘That’s pretty rare.’ She paused. ‘I take it you couldn’t save the baby?’