The Noble Doctor

by Gill Sanderson

  He took a jacket from the back of a chair and slipped it on, pulled it till he was comfortable. Lucy surveyed him, lips pursed. A pure white open-necked shirt, light fawn trousers and a dark blue linen jacket. He was magnificent! She felt glad she had gone to a little trouble to select her own clothes.

  'Cherie, tu es...tu es...' She could see him smiling at her. 'I only got a C in GCSE-level French,' she said in exasperation, 'it makes things difficult. Got it! Cherie, tu es beau!'

  He took her hand, lifted it and kissed it. 'A compliment I shall treasure.'

  Did he know the effect of his lips on her hand and the shiver of delight that ran down her spine? She suspected he did.

  He released her hand and said, 'Now, you told me you'd take me wherever I wished to go. At home I live in mountainous country where there are many waterfalls. Could we perhaps walk by the river? A real river with ships and the sea in the distance?'

  'I know just the place,' she said.

  The promenade wasn't far from the hospital. She drove him there, they parked the car and walked along the riverside path. There was a great expanse of silver water, a somehow romantic oil refinery on the distant opposite bank, the sight of Welsh hills in the distance.

  'This is pleasant,' he said. 'Trees and parkland so close to the city centre.'

  Lucy laughed. 'It used to be called the cast-iron shore,' she said. 'I don't know why. And then it was a rubbish dump. And then the council landscaped it and now it is wonderful.' She waved her hand at the river. 'This place is full of history. A hundred years ago ninety-five per cent of the world's shipping was registered up this river. And now...' She shrugged.

  'All things change and many are for the better. But for the moment we must be happy rather than philosophical. Tell me about your family, Lucy. I liked them so much. And you are so good with children.'

  'I love my family and I love children.'

  'Then why none of your own?'

  She grinned. 'In time. I'm still only young. But I've got plans. I want four children altogether. And I have to find a man first.'

  Both of them were joking, she told herself. This was just a playful conversation, not to be taken seriously.

  'You have to find a man? What do you want in a man? And are you actually looking?'

  'I'm not concentrating on finding a man, life's too full and too good for that. But I'll recognise him when he turns up. I know I will.'

  'What kind of man? Tall or short? Dark or fair? Doctor, teacher, businessman, artist?'

  'He could be anything,' she said breathlessly, 'but I'll know. I'll know the man I want to be father of our children.'

  'And will he know it?'

  'He will. Or there will be trouble.'

  'So you are a romantic?'

  'I suppose I am,' she said after a while. 'You know the way when you put a newborn baby on its mother's breast? You see that sudden access of mother love. It's so new, so intense, that it's often frightening, that's why they often cry. Well, I want a love like that.'

  'I have seen what you describe and it is wonderful. But it's only hormones.'

  'No, it's not!' Then she thought for a moment and acknowledged, 'Well, I suppose hormones are part of it but the hormones belong to people.'

  She stopped walking, put her hands on the rail and watched a tanker, incredibly low in the water, pushing its way upstream.

  'Why am I telling you all this? I don't usually gabble.'

  'Perhaps because we're different,' he said. 'And opposites always attract. But you're not gabbling. What you say is true and it's beautiful.'

  He reached over and took her hand, and they walked on slowly together. She felt comforted, happy to hold his hand. But there were things that she had to say.

  'I want to know about you.'

  'Ask whatever you wish, Lucy. I will answer if I can. If I cannot answer, I will say so.'

  He frowned as he said that and she wondered what kind of things he would not be able to answer, but didn't ask.

  'First, how old are you?'

  'I am twenty-nine.'

  'Why aren't you married or engaged? Do you have a woman waiting for you?' Then added anxiously, 'I take it there isn't such a woman?'

  He shook his head decisively. 'There is no such woman.'

  'Then why has no one grabbed you before now?'

  'As you know, hospital life is frantic.' He shrugged. 'I must tell you, I have had affairs but they were mostly essentially casual. I hope that every time we parted, no one was hurt.'

  'So do I,' said Lucy. 'Were you hurt at all?'

  He thought a minute. 'Perhaps a little,' he said. 'I still get Christmas cards from a couple of them.'

  'You said they were mostly essentially casual. You're sure that there's never been one special girl? The one who might be the one?'

  He sighed. 'There was one who might have been special. Genevieve. A doctor slightly older than me. I thought for a while that things might have been... but then there was an impasse. Perhaps fortunately, she was offered a job in Australia that was too good to turn down. So we parted and I hear that now she is married.'

  Genevieve. Lucy wanted to hear more of her. She thought that there was more to the story than Marc had told her. But she said, 'It all seems a bit over casual to me. I couldn't do it. Don't you ever feel that life, feelings are overtaking you?'

  'Not so far,' he said.

  His answer was ambiguous; Lucy didn't know what to make of it.

  'I wouldn't want a relationship that ends in sending Christmas cards,' she said.

  'There is something we must talk about, but perhaps not now. There is a problem.'

  Now it was his turn to stop and stare, this time downriver towards the sea.

  'I am not attached to a woman but I am to a place. My life is marked out. I come from the mountains of south-eastern France. Eventually I must return there.'

  'Doesn't seem like much of a problem to me,' Lucy said.

  'Perhaps not. But now the sun is shining, I am walking with a beautiful woman, we have the rest of the evening ahead of us and we are happy. Let us remain so. Dark, serious talk can wait.'

  As he had done before, he took her hand to his mouth and kissed it. 'Now, will you take me to see the centre of the city?'

  Chapter Three

  She was driving him to the city centre when his mobile phone rang. 'I am sorry, Lucy,' he murmured, but he answered it anyway.

  'Dr Duvallier here. Yes, John. Well, I am with someone, I was going out to dinner, but...' With his spare hand he felt for her shoulder, squeezed it. Then, reluctantly, he said, 'Yes, I suppose I am available... Take the train down tonight!' His voice rose. There was a long period when he was silent and then he said, 'It's very good of you to organise it for me, John. I'll go back to my room at once to pack.'

  There was silence in the car, then Lucy said, 'I take it that our dinner has just been cancelled.'

  That was John Bennet. There's a three-day conference in London on new techniques in childbirth which would be of tremendous use to me. It starts early tomorrow morning. Someone in the city has just dropped out; John thought of me and grabbed me the place. Lucy, I'm so sorry and I know I ought to—'

  'Marc! It's only a dinner and three days, against a real opportunity for you. Of course you've got to go. I would be angry if you did anything else, I really would.'

  'But are you also sorry to miss the rest of the evening?' His voice was quiet.

  So was her reply. 'Very sorry.'

  She pulled up at traffic lights, he took one of her hands and once again kissed it. For how much longer is he going to kiss just my hand? she thought. But she said nothing.

  They drove back to the hospital; he had an hour to pack. And nothing she could say would persuade him to let her drive him to the station.

  'I will order a taxi. I will be back soon, cherie. And then there are things we must talk about. Partings on station platforms are always painful, inconclusive affairs.'

  It was a foolish, pointle
ss thing that she said, but she said it. 'You will come back though?'

  And for the first time he kissed her. Quickly, lightly, on the lips.

  'I will be back for you,' he said.

  He phoned her the next two nights, but the calls were inconclusive and unsatisfactory. The first time he rang her mobile when she was having tea at her parents', and it was difficult to go outside in mid-meal. The second time she was on the ward and as ever things were hectic. He just had time to say that he was missing her and that the course was long and intensive, but very worthwhile.

  But he had phoned her, he was thinking about her. That was good enough for three days.

  It was eight at night, things were quiet on the ward and the nurse in charge had slipped out somewhere for a few minutes. Only Lucy and Brenda, a middle-aged midwife, were present, and they were drinking tea in the nurses' room. And Marc walked in.

  Lucy looked at him, unable to speak, her heart thudding in her chest. She had expected to see him the next day and she would have been prepared then. But here he was and all she could do was stare at him, open-mouthed.

  He waved papers at them. 'I know I'm not expected,' he said, 'but I got back early from my course and it's straight into work. I gather that we've got three Caesarean sections due tomorrow, I've got to get consents.'

  It was apparently a casual, professional remark. But he looked at Lucy and she knew he had come to see her.

  'I'll take you to them,' Lucy said, making an attempt to be casual. 'I've finished my tea.' She ignored the knowing smile on Brenda's face. There was no need for it, gossip would be all over the hospital soon enough.

  Their hands touched as they walked down the ward but nothing was said. There was no need and, besides, they were at work. They smiled at the group sitting in their dressing gowns and gazing at the wall-mounted TV. Lucy stood there listening as Marc explained the procedure and why a written consent was necessary.

  If a mother elected to have a Caesarean section, she had to be advised of the possible dangers and then asked for her written consent. This simple job was usually left to the SHO.

  She thought Marc did it well. Too many young doctors hurried through the necessary details, gave no time for questions. Marc really wanted the patient to understand what was involved.

  It was always when things seemed to be quietest that trouble started.

  The first mum-to-be happily signed. They moved on to the second patient and Marc had just started his explanation when the emergency buzzer sounded. And at the same time there was a scream—a scream of real pain. Marc and Lucy ran down the ward to where the emergency light was flashing.

  'The baby's coming!' the woman screamed. 'The baby's coming, I can feel it now.'

  No time for delicacy. Lucy threw back the bed covers. Oh, yes. The baby was coming.

  'This is Margaret Elland, thirty-eight weeks,' she said quickly to Marc. 'She's your third Caesarean patient, this was to be her second section. First child was CPD—cephalo-pelvic disproportion. In labour for eighteen hours and baby got stuck. Not surprising, he was a good ten pounds. Braxton-Hicks' contractions this afternoon but nothing abnormal. Baby appears to be a good size on palpation but certainly not too big.'

  Marc nodded then stepped up to stand by the woman's head. 'Hi, I'm Dr Duvallier and this is Midwife Lucy Stephens. Now, baby seems to be in a bit of a hurry to be born but we don't want you to worry. Lucy will help you and all will be well.'

  Lucy noticed that even in this emergency, the words seemed to calm the patient. 'Fetch me a delivery pack,' she said.

  Brenda appeared at the doorway and took in the situation at a glance. 'I'll fetch the resuscitaire and then bleep for the paediatrician.' She looked at Marc. 'Do you want the obstetric registrar?'

  'No,' said Marc, 'but crash-bleep the paediatric team, there's mec-stained liquor.'

  Lucy heard him mutter, 'And I hope they get here in time.'

  The baby was born—the quickest Lucy had ever seen. And she—it was a little girl—was covered with sticky, black-green meconium. That meant trouble. Lucy quickly cut the cord but didn't, as she usually did, hand the baby to the mother. Instead, she passed her to Marc, who placed her in the resuscitaire that Brenda had just wheeled up.

  The two jobs could now be divided. The baby was now the concern of Brenda and Marc, Lucy could concentrate on treating the mother. The placenta was still to be delivered and after such a speedy birth there was the ever-present risk of haemorrhage. But Lucy desperately wanted to know how the baby was progressing.

  'Where's my baby? I want to see my baby!' the mother cried.

  'Baby's passed meconium inside you and we need to make sure she hasn't got it into her lungs. Doctor's looking after her now.' She hoped everything was going to be OK. Meconium inhalation could be very serious.

  There was time to risk a glance behind her. There were Marc and Brenda bent low over the resuscitaire, the combined cot and trolley that held almost everything to help the unnaturally quiet baby. Something in their posture told Lucy that all was not well. She heard Brenda whisper, 'This is severe birth asphyxia. Don't you think we'd better wait for the paediatrician?'

  'We haven't got time. I've given her an Apgar score of four. I can see meconium below the vocal cords. I'm going to intubate her, otherwise we'll just push the meconium into her lungs.'

  'Have you ever done it before?'

  'If I don't do it now, the baby will die.'

  Lucy knew what Marc had to do. First he would slide a laryngoscope down the baby's throat. Then he would be able to see as he slid the endotracheal tube through the trachea, and inside that a fine suction catheter to clear the trachea. Then the tube would be connected to an oxygen supply. And then the baby could breathe. And live. It wasn't usually a job for an SHO.

  But Lucy still had her own work to do. There was the mother to be reassured, the placenta to be delivered. With the mother, things were all now normal. And then behind her she heard the clatter of rapid feet on the ward floor. The paediatric team had arrived. There was the murmur of voices and after a few minutes the registrar appeared by her side. He smiled down at the mother.

  'Mrs Elland? I'm the paediatric registrar here. Your little girl has given us a couple of anxious moments but she seems to be OK now. We're going to take her down to our specialist care unit, probably just for the night. But before we do we'll wheel her in here and you can have a look.'

  'Can I hold her?'

  'After tonight you can spend a lifetime holding her. But she's resting now so we'll not disturb her. Don't worry. She's in good hands.'

  The registrar left and Brenda appeared beside her.

  'If you like, I'll take over here now. Emergency over and you look as if you need a rest.'

  'Where's...?' Lucy asked weakly.

  'The SHO went off with the paediatric team. They invited him to come along.'

  'Right,' said Lucy.

  Marc came back when there was only twenty minutes of the shift to go. An SHO's job was never finished; he had still to get one consent for a Caesarean section. And Brenda took him for a quick word with Mrs Elland.

  Then it was handover time. But he was waiting when Lucy had changed and was ready to go home. 'I thought we might walk over together,' he said.

  'That would be nice. And you can tell me all about our bit of excitement on the ward and then about the course.' They left the building and paced along one of the paths.

  'We took baby Elland to SCBU,' he said. 'The registrar said that since I had started on the case, if I wanted to, I could continue. So I did.'

  Lucy smiled. 'I heard what you were doing,' she said. 'You saved that baby's life, didn't you?'

  He thought for a moment then said, 'Probably. The registrar said I did.'

  'And how do you feel now?'

  He smiled. 'I've been in Britain a long time; I should have learned your habit of understatement, your fear of showing emotion. But I haven't. I'm French, I feel the Latin way and I can say what I feel. Lucy, I
feel so good that I could... that I could...' Suddenly, he stopped, took her head between his hands. He pulled her to him and kissed her. A full-blooded kiss that sent her senses reeling. Then, slowly, he released her. 'I feel so good that I could kiss you,' he whispered.

  'You just did. And that's British understatement.'

  It was their first real kiss.

  It had been so good—so unexpected but so good. For the moment she couldn't deal with it. So she took refuge in talking about work, talking about what had just happened.

  'You took a risk in intubating the baby,' she said. 'SHOs shouldn't do it unless supervised, you would have been quite in order to wait until the Paeds team arrived. You knew they were on the way. Even if the little girl had died, you'd have done the proper thing. But if she had died after you intubated her, there'd have been all sorts of trouble.'

  'I know,' he said. 'And I'll admit I was scared. But if you feel that things have got to be done then you have to do them, no matter what the cost.'

  'I see,' she said.

  She felt that he was telling her about more than the baby being born; he was telling her about his view of life. And it frightened her slightly.

  They passed under a newly lit lamp and she glanced up at his face. There were lines around his eyes, the unmistakable signs of fatigue. 'Aren't you tired?' she asked. 'The course in London and then the train journey and then this. You've had a very full day.'

  'SHOs aren't allowed to be tired. And being with you is a tonic.'

  He reached to take her hand, she liked that. She felt a bit lost, not sure where she was with him and what exactly their relationship was. And she felt that he had the same kind of doubts. After all, they didn't know each other very well.

  There were people walking down a path close to them, laughing and chattering. 'They're going for the last hour at the Red Lion,' she said.

  'Where we met less than a week ago.'

  Lucy nodded. 'I remember it well. You've had a big effect on me.'

  She knew she was revealing herself, making herself vulnerable, by saying such a thing. This was not like the old, tough Lucy. But what she had said was true. She had to admit it.