Читать книгу Medical Romance December 2016 Books 1-6 - Sue MacKay, Carol Marinelli - Страница 19

CHAPTER NINE

CHARLIE LEFT JULIET’S office before she had a chance to offer him any words of comfort or condolence. Juliet watched as he rushed out of the door, confirming matter-of-factly on the way out that they would meet with Georgina and Leo an hour later. There was no further reference to his wife or being a widower. He did not put a timeline of context to his statement. He apparently had another important appointment and one that oddly seemed to lift his spirits when he spoke about being needed elsewhere. He had quite literally dropped an emotional bombshell and run before she could say anything. The swing of the pendulum grew wider by the minute. Charlie mentioned he couldn’t be late for his tough taskmaster. She couldn’t think who would be harsher than himself but clearly there was someone in the hospital giving him orders. And he jumped. But jumped willingly. While the news was sad, Charlie seemed strangely upbeat as he left.

Juliet thought better than to try to learn more. He had said enough. He was a widower, and she was a single mother. Facts about each other that she had to remind herself had no relevance to their working relationship. But it was not news she had imagined hearing from him.

But it suddenly did make sense. And she could understand better why he appeared to not have a life outside Teddy’s. He would have lost the life he knew when he lost his wife.

Trying to push thoughts about Charlie from her mind, she read the medical updates that had been emailed to her and sent an email to her parents, informing them that she would call in the next day or so once she had everything under control. Although she wasn’t sure exactly when that would happen. She doubted while Charlie was around, or, more accurately, while she was anywhere near Charlie, that everything would be under control. He was complex and perhaps even still grieving and she was confused.

She wasn’t sure she would ever really know Charlie Warren.

But she did still need to ask him to be in Theatre. She had assumed he might have attended, but after seeing the theatre staff listing and noticing his name was not there she wanted to raise it with him. It had slipped her mind in her office, but a lot did when he was around.

She had to put him back in context. He was Georgina’s OBGYN and having him there would make Juliet feel more secure. She tried to tell herself it was purely from a risk-management viewpoint, but it was more than that.

With half an hour until she had to be with Georgina, Juliet decided to pop in and check on Bea. After stepping out of the elevator, she rounded the corner and saw Bea and Emma happily helping the childcare assistant to put Christmas decorations along the hallway window ledges of the crèche. It was difficult with her arm in the cast but she was managing to pass the sparkly tinsel to the young woman and Bea beamed with delight as she watched it being secured in place with tape. Juliet grew prouder of her daughter by the minute. She had adjusted to the move, albeit only for a few weeks, so well. She had made friends, not dwelled on her broken arm and was loving the opportunity to do new things.

Juliet wished she were as resilient. She was still carrying around scars that should have long healed. It was as if she had her broken heart in a cast, and she had spent almost five years dwelling on it. She certainly needed to take a leaf out of her four-year-old daughter’s book on how to cope with adversity and still enjoy life. She was still allowing Bea’s father to affect her life’s choices. To affect the way she saw other men. She was punishing all men for the mistakes of one and feeling sorry for herself in the unnecessary process. Her daughter was a better example to her than she was being in return.

And, she quite harshly reminded herself, she hadn’t lost the person she had committed to spending her life with the way Charlie had. She had been seduced and dumped by a man she barely knew and it hurt. But she had the most wonderful daughter to love while Charlie had no one. He had lost the woman he loved. His scars would with good reason run deeper. She needed to put on her ‘big girl’ panties and stop letting the past rule her future.

Juliet decided to get in the Christmas spirit and offer to help with the decorations. But as she drew closer she discovered the three of them had a fourth helper.

‘Charlie,’ Bea called out sweetly. ‘We need more tinthel.’

Juliet moved back out of sight and watched as Charlie stepped from inside the crèche and ruffled Bea’s hair. ‘Of course, boss. I’ll get it for you now.’ With that, he walked back inside the doorway and emerged carrying a large box with tinsel overflowing from the top. He placed it within Bea’s little reach and then stepped back. ‘Do you need any more help?’

‘No, thank you, Charlie. You can go and meet my mummy about the babies but maybe you can come back and help.’

‘I certainly will.’

Juliet realised the identity of the taskmaster that Charlie was meeting. She controlled the urge to laugh at the way Bea was throwing around orders and at the same time blink back tears as she watched a man who had lost his wife act almost like a father to her daughter.

Bea’s banter with Charlie was so relaxed. Her orders were delivered in a cute voice, and with the best intention of getting the job done, but they were orders nonetheless. And she was only four. What made it more poignant was the fact that Charlie was taking them. She sincerely doubted anyone older than Bea could get away with being so forthright with a man like Charlie.

She suddenly worried that Bea might be auditioning him for the role of her daddy. Juliet felt torn as she walked away in silence. She and Bea would not be in the Cotswolds for ever and she didn’t want her daughter to get too attached, but at the same time it was wonderful to see Bea so happy in Charlie’s company. She bit her lip as she suspected with little effort it might be easy for her to become attached to Dr Warren herself. Particularly with what she now knew about him.

With her mind spinning, Juliet headed back to Georgina Abbiati’s room. She needed to focus on the real reason for her travelling to Teddy’s. And it was not to become involved with a complicated man. No matter how wonderfully he treated her daughter. And no matter how she felt herself warming to the handsome widower.

* * *

‘So do you feel comfortable and understand fully everything I’ve told you about Friday’s procedure?’

‘I think so, Dr Turner. I mean, we’ve made our decision and we’re not backing down now. Sorry, Charlie, but I think we’ve made the right decision,’ Georgina said with a slight waver obvious in her voice.

Charlie nodded and, true to his word, said nothing.

‘But I do have two more questions if you have time,’ Georgina continued.

‘Of course. I have all the time it takes to make you feel at ease and comfortable. Fire away,’ Juliet said as she took one final glance at the morning’s observations of her patient, including the results from the daily ultrasound she had requested. The boys’ condition had remained stable and the girls were unaffected.

‘I know I will have a local anaesthetic and sedation, but will I feel anything at all?’

Juliet had been asked the same question many times. ‘There will be no pain, perhaps a small amount of dull tugging, but also there is a slight risk your uterus can react to any interference with contractions. Not sufficient in most cases to bring on labour but it may feel that way to you. There will be no pain, just tightness if a contraction occurs.’

‘Will Charlie be in the theatre too?’ Leo asked as he looked over towards Charlie. ‘Just in case Georgina goes into labour.’

Juliet turned to Charlie and with equally baited breath awaited his response. She wasn’t sure if Oliver Darrington was still to make the final decision on the attending OBGYN or attend himself.

‘Of course,’ he announced with conviction and keeping his focus on Georgina and Leo.

His words allowed Juliet to take the next breath and a smile spread over her face.

‘I’m your OBGYN, and, while I have the utmost faith in the skills of Dr Turner and the team, I’m your back-up plan. If the need arises, and I’m not pre-empting it, but should the laser surgery hasten labour, I will be bringing Rupert and his siblings into the world.’

Juliet was happy with his explanation. It had not been delivered in a manner that would elevate the Abbiatis’ fears, in fact just the opposite, and for that she was grateful. Charlie was playing fair.

‘And I’ll be very happy to have Dr Warren in Theatre. No one knows you better than your OBGYN so his presence and skills are invaluable.’

Juliet could see from the corner of her eye that Charlie had turned his head in her direction. But she didn’t reciprocate. It had the potential to be a moment that she was not ready to face. Mutual admiration and respect, coupled with what she had witnessed downstairs with Charlie helping Bea. It would have been an emotional overload that she could not afford at that time.

She was feeling more than a little vulnerable. To her feelings and to Charlie Warren.

Charlie was many things and increasingly she was seeing he might even have the potential to be wonderful, but she was not looking for a man. Wonderful or not. She doubted her heart would survive. Besides, she was not staying and she did not want to start something she could not finish.

‘If that’s all for the moment, and you know you can page me any time, I will head off to brief the theatre staff.’

‘Georgie, Leo,’ Charlie began as he edged closer to Juliet’s direction, ‘I’m in that meeting too, so we will see you later. Rest lots, try not to stress and write down any questions so you can ask either Dr Turner or myself when we call in.’

* * *

‘That went well,’ Juliet began as they walked down the corridor towards the elevators. She still did not make eye contact. ‘I’m glad you’ll be in Theatre. It wasn’t articulated on the list.’

‘I was waiting to be invited. You’re the lead surgeon, so it was a professional consideration on my behalf to wait until I was asked.’

‘I was going to do that today.’

Charlie eyed her suspiciously. ‘Well, I guess I invited myself so, like the idea or not, I’ll be scrubbing in with you on Friday.’

‘I like the idea. Very much. Thank you,’ she said as she pushed the button for the elevator with her pulse racing a little but a sense of contentment washing over her knowing Charlie would be there with her during the operation.

* * *

Twenty minutes later, Juliet was winding up her briefing to the theatre staff, a number of whom were pressed for time as they were due to scrub in for another procedure that afternoon. She had already gone over her theatre equipment requirements, spoken to the anaesthesia team and nursing staff. All of the medical team involved in Georgina’s procedure, bar the one medical student and two interns on maternity rotation, were experienced with TTTS laser surgery, although none on more than two babies. Four was outside everyone’s experience. Including Juliet’s. And she did not hide that fact from the team.

‘While I have performed fetoscopic laser surgery on triplets, I will not deny that on quadruplets it will be a slightly more challenging procedure. However, the direct visualisation through the fetoscope will allow us to successfully perform a targeted and focused laser termination of the vascular communications directly responsible for the TTTS and effectively separate the placenta into two components, one for each foetus. With each baby having its own placental mass, and the removal of this communication, there will be an interruption to the transfusion process and we should stabilise the situation so we can advance to a gestational age where the four babies in this situation all have a greater chance of survival. Does anyone have any further questions?’

‘If the parents of the quads did not agree to the surgery, what would the risk be to the other three babies if the recipient baby went into stage five heart failure and died?’

Juliet could see the question came from one of the interns. ‘That’s a very good question. If one foetus was to become non-viable through cardiovascular complication arising from the TTTS, then it would put all three remaining babies at high risk of death, injury or disability. Essentially the fetoscopic laser procedure has taken what was until relatively recently a lethal placental disease and turned it into a manageable condition if detected early.’

The specialist team were all silent. Each nodded their understanding.

‘Just one more question. If the outcome of moving forward with this intervention is pre-term delivery, are you certain that you’re sufficiently prepared for the arrival of four twenty-nine-week gestational babies with a current average weight of less than three pounds?’

Even without hearing the voice or seeing the man, Juliet knew the question had to come from Charlie, who was standing with folded arms at the back of the room. She took a deep breath. But instead of feeling resentment or interference, she appreciated the question. It was fair and one he had every right to ask in that arena and one that others might have been wondering about.

‘Yes, Dr Warren, that’s why we have assembled a multidisciplinary team who can deal with all potential outcomes including pre-term delivery. In addition to Ella, who is Georgina’s midwife, and two anaesthetists, Mr Darrington has already approved the four neonatal intensive care nurses and two neonatologists who are here with us today, and a senior paediatrician, paediatric resident and a paediatric cardiologist, all of whom I assume you will recognise on the day but can’t be at this briefing. In all we will have sixteen in the medical team, three observing and four incubators in Theatre. All of which, God willing, will be under-utilised on the day.’

Surrounded by Theatre staff, many in scrubs, Juliet suspected the imminent laser surgery for his patient became more real in Charlie’s mind, giving rise to his ongoing concerns.

‘Good, I’m not surprised you have it under control, Dr Turner. Let’s hope we don’t need any of it,’ he said, then turned and walked away leaving a tiny grain of doubt in Juliet’s mind.

Juliet never operated with doubt over anything. She needed to manage it immediately.