Читать книгу Medical Romance December 2016 Books 1-6 - Sue MacKay, Carol Marinelli - Страница 21

CHAPTER ELEVEN

‘OH, MY GOODNESS, what are you doing here?’ Juliet squealed as she opened the door. She couldn’t have been more surprised...or happier. ‘Quickly come in from the cold!’

‘It was your father’s idea. He thought that we could help with Bea while you concentrate on the quads’ surgery.’ Her mother embraced Juliet, then stepped aside for her husband to do the same.

‘It’s a challenging surgery and we don’t want you worrying about picking up Bea from the crèche,’ her father chipped in as he carried one of the suitcases inside and then hugged his daughter warmly. He turned back for the other one still on the porch, then closed the door on the bitterly cold night air.

‘Or worrying if she gets a sniffle with the sudden change in climate,’ her mother added as she looked around the cosy sitting room of the cottage.

‘Oh, my God, why didn’t you tell me you were coming?’

‘Because you would have said we were fussing—’

‘Which you are...but I’m very glad you like to fuss.’

‘And we missed you both terribly.’

‘It’s been less than a week.’

‘See what an only child has to suffer. Two parents who miss you after less than a week and follow you to the other side of the world,’ her father continued as he placed the second suitcase down. ‘So learn from us and give Bea some brothers or sisters in the future or she’ll be doomed to having a helicopter parent hovering around like us!’

Juliet smiled. ‘If I’m half as good a parent as you two, then Bea will be a lucky girl.’

‘We are the lucky ones, Juliet. You make us both very proud.’ Her father hugged Juliet again and then stepped away a little as his eyes filled with tears of happiness.

Juliet could see the emotion choking him and knew all three of them would be a mess if she didn’t change the subject. ‘So when did you decide to fly out? And how did you arrange it so quickly?’

‘We had passports so we just rang the travel agent. We’ve booked into a hotel nearby for tomorrow but they didn’t have a spare room tonight.’

‘You’ll do no such thing. There’s plenty of room here.’

‘We don’t want to put you out. We’ll just stay tonight if that’s okay. We can sleep on the sofa.’

‘Don’t be ridiculous. You’ll stay here...now how long are you able to stay?’

‘Till you get sick of us,’ her mother replied.

‘Then you’ll be here for a long time,’ Juliet said. ‘What about a nice cup of tea?’

‘That would be lovely,’ her father said.

‘Well, actually, we’ve booked one of those river cruises through France and Spain,’ her mother added. ‘That’s the week after Christmas.’

‘I thought you had planned that for next July? You were going to enjoy summer in Europe. Leave the Australian winter behind and thaw out over here.’

‘That was our plan but we brought it forward. No point flying out twice. It’s a long way for two old people.’

Juliet laughed. ‘Hardly old but you’ll be missing the sunshine on your cruise.’

The three of them looked up as Bea came running down the hallway. ‘Grandma! Grandpa!’

‘Here comes all the sunshine we need,’ her father said.

Juliet’s parents both dropped to the ground, her father a little more slowly due to the arthritis that plagued his knees. A group hug ensued with lots of kisses.

‘I knew Father Chrithmath was real,’ the little girl said with a toothy grin.

‘Of course Father Christmas is real, but why do you say that?’ Juliet asked as she looked at the three of them nestled together on the rug on the floor.

‘’Coth I asked him to bring Grandma and Grandpa here to play in the snow with me and have Christmath food and everything.’

* * *

‘How did the surgery go for Kelly Lester?’ Juliet asked as they sat by the fire after settling into Bea’s room. Bea was happy to move in to Juliet’s room and sleep in the big bed and give her room to her grandparents. ‘I got your email that the procedure was successful but how is Kelly progressing post-operatively?’

‘Good, very good,’ her father answered as he reached for a homemade cookie. ‘She’s a strong woman, lots of family support and, although there will still be hurdles as to be expected with spina bifida, the chances have been greatly improved of the child walking by about the thirty-month mark, which I know was your prognosis. And we both know without surgical intervention the little boy would never have walked or really enjoyed a quality of life.’

‘Look at you two. Like peas in a pod,’ her mother said as she finished her second cup of tea.

‘You liked the tea, Grandma?’

‘Yes, I did, Bea.’

‘Would you like some more?’

‘No, thank you, sweetie. But what I would like is to hear about how you got that cast. Mummy rang and told us how it happened but it did sound very scary.’

Momentarily distracted from her cup of hot chocolate, Bea looked at the cast intently. ‘I fell from the slide and broke my arm.’

‘Are you feeling better now?’ her grandfather asked as he lovingly watched his granddaughter.

‘Yeth, Charlie made my pink cast.’

‘It’s very pretty and has lots of beautiful drawings,’ her grandmother replied.

‘Yeth, my friendth drew them,’ Bea told them, then, pointing at the image of a sunflower, she continued. ‘Thith one is by Emma, my betht friend.’

‘Well, she’s very clever and I’m sure very nice.’

‘Charlie ith very nice too, and very tall. Like a building,’ Bea said as she jumped to her feet and stretched her hand up as high as possible. ‘He’th Mummy’th friend and he’th going to get us a Chrithmath tree. A really, really big one.’

‘Did Charlie offer to get a Christmas tree for the house?’ Juliet asked with a curious frown. He had not mentioned it to her.

‘Yeth, Mummy, he told me he would get a beautiful tree for uth.’

Juliet’s parents looked at each other with a knowing smile.

‘Don’t go there,’ Juliet said, shaking her head. Since the strange way he’d left off with Juliet, she wasn’t sure about him. She felt that he was hiding something from her and she wasn’t sure she wanted anyone that complex in her life. ‘He’s the OBGYN, and to be honest, most of the time, quite difficult to work with. It’s taken almost all week to finally come close to understanding him. He’s conservative and stubborn and fought me every inch of the way about the in-utero surgery.’

‘Why did he attend to Bea? Since when do OBGYNs attend to paediatric fractures?’

Juliet drew a deep breath and put down her spoon. ‘He’s the doctor that rushed to Bea in the playground. The doctor I was waiting for inside and he was running late. He arrived at the hospital at the same time Bea fell.’

‘Serendipity...’

‘Mum, please, I said don’t go there.’

‘Is he handsome?’

‘Mum...’

‘It’s a simple question, Juliet. Is the nice doctor who saved Bea, and is now, according to our granddaughter, your friend, who is going to buy you a Christmas tree, handsome?’

Juliet swallowed. ‘Yes, he’s handsome...and incredibly difficult at times—’

‘And also with a very kind streak by the sound of it too,’ her mother cut in.

Juliet’s eyebrow was raised as she returned her attention to the last few crumbs of cookie on her own plate. She wasn’t going to get into an argument. Her mother had said the truth. Charlie did have a chivalrous and kind side to him and she didn’t want to think about that.

‘He’th nice,’ Bea added, completely oblivious to her mother’s opinion of Charlie. ‘We put up tinthel, and pretty thingth around the hothpital.’

‘Really? Not what I would have thought was part of an OBGYN’s job description?’ her mother said without making eye contact with Juliet.

‘Particularly not one who’s difficult...’ her father mused, looking at his wife.

‘Let’s not forget stubborn,’ her mother commented with a wistful smile.

Juliet stood up. ‘Have you finished?’

‘With this conversation or the cookies?’ her mother asked with a cheeky grin.

‘Both!’

* * *

‘Remember, if there are any issues or just for peace of mind, if you need or want to stay at the hospital and monitor the quads’ mother, you know your mother and I are here to look after Bea.’

‘I still can’t believe you flew all that way just so I could focus on the babies,’ Juliet said as she gathered the last of her things, wrapped her scarf around her neck over her heavy coat, pulled on her knitted cap, kissed Bea and headed for the door. They had all enjoyed a restful night’s sleep and Juliet felt good about the impending surgery.

‘If Bea needed you in the future, you would do exactly the same.’

Juliet knew that was the truth. She would indeed do anything for her daughter, at that time or any time in the future.

‘Despite what you say, Juliet,’ her mother added as she sipped her early morning cup of tea and prepared for the cold gust of air as her daughter opened the door, ‘it’s not easy being single and raising a daughter and having a career that makes you responsible for other people’s lives. You have a lot on your very slender shoulders.’

‘But I love it. It gives me purpose and I can’t imagine doing anything else,’ Juliet told them both as she stepped onto the porch and closed the door behind her.

‘I know,’ her mother replied as she looked over at her husband, reading the local paper. ‘The apple indeed did not fall too far from the tree.’

* * *

Georgina and Leo were waiting outside Theatre when Juliet arrived. With her hair tucked inside a disposable cap, and dressed in a hospital gown, Georgina had been prepped for the surgery. She was lying on the trolley with the sides up ready to be wheeled inside by the theatre staff. Leo was holding his wife’s hand tightly and trying to put on a brave face but Juliet could sense the fear that was mounting by the minute.

‘I will be scrubbing in for your procedure now,’ she told them as she patted Georgina’s arm. ‘And, Leo, you can scrub in with me. I know that Georgie will want you right beside her during the procedure.’

‘Sure.’

‘Any questions?’

‘Yes,’ Leo said with a cheeky smirk. ‘How hot does it get in Australia in summer?’

Juliet was surprised by the question. It was definitely left of centre. ‘Quite hot in Perth, well over one hundred degrees on our hottest days. I left only a few days ago and we’d been through a heatwave—we had three days in a row that reached over one hundred and five degrees.’

‘That’s hot. Maybe spring would be nicer.’

Aware that time was ticking, and the medical team would be waiting, she quickly asked, ‘For what, exactly?’

‘Georgie and I have decided, should all of our babies come through this happy and healthy...’ he paused for a moment and smiled lovingly at his wife ‘...that in honour of you we’re going to take them all on a trip to Australia before they start school. We were planning on showing them Italy, but I think an adventure down under would be more fun for the six of us. Besides, Georgie and I have been back to Italy a few times but we’ve never seen a kangaroo up close and we can tell the girls how an Aussie doctor saved their brothers and, if you’re home, perhaps we could call in and say hello.’

Juliet thought it was such a sweet sentiment and optimistic. It was what would pull them through whatever lay ahead. ‘And I will put the barbie on for all of you.’

‘I’ll cook the pasta,’ Georgina added from the trolley.

‘And I’ll bring the vino,’ Leo chipped in as the theatre staff began to wheel his wife into surgery. Juliet couldn’t help but see through his jovial façade that a tear trickled down his cheek. She patted his arm. ‘Georgina is in good hands and so are your babies.’

Juliet then took Leo to scrub in.

* * *

‘Heads up to the medical student and interns with us today, if you have questions about any of this procedure, ask. We will be using a laser to coagulate the shared blood supply between two of the four babies. This will be more complex with the four foetuses and will take considerable time to map the shared arteries and veins but it will be done. So we are all in here for the long haul.’

Charlie was pleased to hear the conviction in Juliet’s voice.

‘After this procedure I am hoping the two babies currently affected by the TTTS will be able to grow to their maximum size without complications.’

The epidural had taken effect and Leo was behind the blue surgical sheet holding his wife’s hand. Everyone present in Theatre was wearing the protective goggles in preparation for the laser, including Georgina and Leo. Juliet carefully inserted the fetoscope and, guided by the screen, began the arduous task of locating Rupert, otherwise known as Baby A. Once this was done she traced his umbilical cord back to the placenta and began the process of identifying the offending arteries. Secure in the knowledge she had the first communication located, Juliet utilised the laser to cauterise the artery.

Charlie held his breath. That was only the first; he was well aware there were more to locate and sever. Juliet continued mapping the vascular placental linkages and painstakingly cauterising each one. The procedure was progressing slowly but successfully. Charlie was still cautious. Any disruption to the uterus he knew was risky. With only two veins to cauterise, Juliet announced they were on the home stretch and everyone in Theatre felt instant relief sweep over them.

‘Well done, Juliet,’ the anaesthetist announced. ‘Great outcome.’

‘I said home stretch, not completed,’ she countered cautiously as she pushed down on the foot pedal for the laser and severed the second to last. ‘We still have one to go.’

Charlie was impressed with her reply. She had every reason to gloat that close to seeing the end in sight but still she was hesitant to accept praise. He also realised that he had been wrong to judge the procedure. Perhaps, in fact, Juliet had made the right call with the quads. And if the babies all continued to grow, they would be able to prolong the pregnancy for at least a few more weeks until the uterus became too large, but by that time the babies would be all viable and have a good chance at a healthy life.

The final artery was the most difficult to locate due to Baby B’s position. All eyes were on the monitor as Juliet carefully manoeuvred around the tiniest twin.

‘We have a problem,’ the neonatal cardiologist announced. ‘Baby B’s struggling, he’s clearly in stress.’

Charlie stepped forward again to observe the screen. The invasive procedure had been delayed by the fact it was four babies, not two, and it had adversely affected the smallest quad.

‘I’m ceasing laser now,’ Juliet told the room, then quickly but delicately removed the fetoscope but it was too late. Without warning Georgina’s water broke. The operating table was saturated with the amniotic fluid of the boys. The girls, in a separate sac, were unaffected but that would not mean they were safe. If the boys were to be born, so would the girls.

‘I’ll take over from here. We’re in labour and delivering,’ Charlie announced as he removed his protective laser glasses, switched them for clear glasses and stepped up to the operation table. He looked over the blue curtain to the Abbiatis. ‘Georgie, Leo, your children are on their way,’ he said, before turning his attention back to the immediate task. ‘Nurses, please prepare for a Caesarean section—we have four twenty-nine-week foetuses that are neither large nor strong enough to pass through the birth canal.’

Immediately Juliet stepped back as she watched the surgical tray swing around in reach of Charlie. She approached Georgina and Leo, leaving the operation table free for Ella and the other midwife to approach and assist.

‘The epidural was our safety net,’ Juliet said softly. ‘It won’t be too long before your babies are born.’

‘But...they’re...too...tiny,’ Georgina stated with fear paramount in each staggered word.

‘They’re small but, thanks to Dr Warren’s suggestion of the epidural, we’re more than adequately prepared. There’ll be no delay in delivering all four babies and that is an important factor. They will be assessed by the neonatal team and then moved quicker to neonatal ICU.’

Carefully but with haste appropriate to the situation, Charlie made the first incision at the base of Georgina’s engorged stomach, cutting through the outer layer of muscle. Then carefully he prised open the first incision to reveal the almost translucent uterus that had been stretched to capacity with the four babies. Once through to that layer, Charlie cut the unbroken amniotic sac of the girls, and, reaching in, he carefully pulled free the first of the tiny infants. Carefully he placed the baby in the first neonatal nurse’s hands while he clamped the umbilical cord. One clamp for the first baby, who was named by the team, Baby C. The second girl followed a few minutes later; it was Baby D and she had two clamps. Baby D was slightly larger and began to cry immediately. Quickly she was taken by the second midwife. Then came Baby A and finally the smallest of them all, Baby B, who had been against his mother’s spine. Removing him from the womb proved tricky as he was the smallest and the most fragile. She could see the concern in Charlie’s eyes but along with it was sheer determination. Finally he was pulled free, blue and almost translucent, but alive.

Juliet watched in awe as Charlie tenderly held the tiny infant while the final cord was clamped. The paediatric team worked alongside the neonatal nurses to assess all of the babies. But it was Baby A that caused the greatest concern. He had been the recipient baby and, while not the smallest, his heart had been pumping furiously for the previous twelve hours as Georgina had teetered on the periphery of stage five.

Charlie’s focus remained with Georgina. There were still two placentas that needed to be delivered and then the painstaking work of closing the Caesarean section. Juliet remained with Georgina and Leo. It was where she was most needed at that time. With a heartfelt admiration for Charlie, she watched as he expertly began to repair the opening that had allowed Lily, Rose, Rupert and Graham to enter the world.

* * *

‘You’re an incredibly skilled obstetrician and you have no idea how very grateful I am that you were in Theatre today,’ Juliet commented as she removed the disposable gown over her scrubs. ‘I’m just sorry you had to use your skills.’ She was waiting for what she knew would follow. And what she knew would be a fair call. I told you so.

But it didn’t. Instead, she received the most unexpected praise.

‘I did okay, but your skills are second to none, Juliet. I observed you mapping the placenta’s vascular pathways. Not an easy task with two babies, but with four it was a miracle and you managed to cauterise all but one artery. And if you’d been provided the time then the quads would still be happily tucked inside Georgina for another few weeks. But fate had another idea.’

Juliet pulled her surgical cap free. ‘So you’re not upset that I tried. I thought you would be...and justifiably so.’

Charlie turned to face her. ‘The opposite, actually.’

‘Now I’m confused.’

‘If you hadn’t pushed for the fetoscopic laser surgery, Juliet, then Rupert’s heart would’ve remained overworked for another twelve hours and it might have been too late. We wouldn’t have done another scan until tomorrow and there’s every chance he would have gone into heart failure during the night. We would not have had the opportunity to save him.

‘I’m very glad you came all the way from Australia to fight me on this. You saved at least one baby’s life. If not all four.’