Prognosis Christmas Baby

by Andrews, Amy

Maggie nodded. Five days ago fourteen-year-old Christopher Thirkettle had coughed up large amounts of blood at school and collapsed. He’d been brought to the Brisbane Children’s Hospital via ambulance where his condition had deteriorated down in the accident department requiring him to be intubated and ventilated.

  A battery of tests had revealed that the teenager had Goodpasture’s disease, a very rare autoimmune disorder that caused the body’s immune system to attack its own lung and kidney tissue. After months of vague flu-like symptoms, lethargy and a dry cough his deterioration had been rapid.

  The kidney component of the disease hadn’t progressed at this stage and they were monitoring it very carefully, hoping to arrest its development altogether. Unfortunately, though, despite commencing steroids, his lungs were still in a bad way and he’d had several pulmonary haemorrhages in the last few days.

  ‘It’s perfectly normal to have feelings of disbelief when your child falls ill like this,’ Maggie assured Bree, giving her shoulder a squeeze. ‘Would you like to chat to our social worker to talk some of these feelings through? I can arrange it for you.’

  ‘That won’t be necessary, Sister.’

  Maggie turned to find Christopher’s rather overbearing grandfather behind her. He was an odd man, often rude and abrupt, but he’d lived with Christopher and Bree since his grandson had been a baby and there was no denying how good he was with Christopher.

  She took a deep, steadying breath as Bree said, ‘Dad, Maggie’s just trying to help.’

  ‘Well anyway,’ Maggie said, ‘just let me know if you ever require their services.’ She gave Bree’s shoulder another squeeze and moved back towards Linda, keeping one ear on the conversation between father and daughter.

  ‘Are the results back yet?’ he asked.

  ‘Not yet, Dad.’

  ‘I think it’s a mistake to give him a blood transfusion. We don’t know what diseases could be passed on to him.’

  ‘Dad, we’ve been through this,’ Bree muttered. ‘Leave it alone.’

  Maggie shared a look with Linda. Bree had let them know in the beginning that her father was a control freak and a conspiracy theorist. He’d been under the care of a psychiatrist for long periods of depression since his wife, Bree’s mother, had passed away years ago from a hospital bungle.

  She’d warned them that her father would find Christopher’s hospitalisation difficult. And she hadn’t been wrong. He had been quite trying, questioning the necessity for every single treatment, every blood test, every X-ray and drug.

  Being allocated to Christopher’s bed was fast becoming something to avoid. Bree was great but her father was trying everyone’s patience.

  Still, it was all part of the job and Maggie knew that underneath the man’s incessant badgering and tendency to interfere he was basically a concerned grandfather and a grieving husband who hadn’t worked through his issues from his wife’s death. Everyone reacted differently when their loved ones were critically ill and the PICU staff were well used to dealing with the many manifestations of grief.

  ‘You okay here?’ she asked Linda quietly.

  Linda nodded. ‘I’ll be fine. I’ll holler if I need you.’

  Maggie moved to bed three to check out Toby’s progress. The nurse looking after him took advantage of Maggie’s presence and scooted to the bathroom and Maggie greeted Brett before turning her attention to Toby.

  ‘Hello, little man,’ she crooned, moving to the opposite side of the bed from his father. ‘Have you got a smile for me yet?’

  ‘Nope. Still cranky with the world, I’m afraid.’ Brett grimaced.

  ‘Ah, well.’ Maggie smiled at the little boy whose bottom lip was wobbling. ‘I guess he has a right to be.’

  But he was improving rapidly each day. He hadn’t needed to go back on dialysis and despite being stuck for weeks with his ventilation, even that was now improving with some good progress being made with weaning.

  The monotonous, worrying holding pattern had lifted as Toby’s condition turned a corner. Everyone was hoping that Alice and Brett’s Christmas present would be a newly extubated son.

  She picked up Toby’s foot and waggled her fingers against his toes. Toby’s face scrunched up as he started to cry, tugging his leg out of her grasp.

  Brett laughed. ‘Sorry.’

  Maggie gave him a rueful smile. ‘It’s okay. Us PICU nurses know we’re not exactly popular with our patients.’

  ‘No, but the parents think you’re marvellous.’

  Maggie smiled at him. It was great to see Toby’s parents looking so positive. Toby’s nurse returned and Maggie excused herself. She headed to the side rooms but was temporarily waylaid by the colourful sight of the Christmas tree. With only two more days till Christmas the bottom of the tree was crowded with gaily wrapped Secret Santa presents.

  ‘Looks fantastic, doesn’t it?’ Nash murmured near her ear.

  A trail of goose-bumps marched down her arm. ‘Magnificent.’

  Nash knelt and started sifting through the presents. ‘Now, where is it?’ he mused.

  ‘Hey,’ Maggie objected. ‘What are you doing?’

  ‘Finding my present and trying to work out what it is,’ he said matter-of-factly.

  Maggie pulled at his collar. ‘You’re not supposed to do that.’

  ‘Sure you are. That’s half the fun.’

  Maggie shook her head at him. He was incorrigible. Just as well he wasn’t going to be around for their baby. She could just imagine him teaching their son a whole bunch of endearingly naughty things.

  Being fun Daddy and leaving her to be the bad guy.

  ‘Aha! Here it is.’ Nash stood brandishing his present. ‘It’s a bit small,’ he murmured, giving the hard rectangular box-shaped gift a shake.

  Maggie shrugged. ‘Good things come in small packages.’

  Nash looked down at her. ‘I know.’ He heard a satisfying little rattle as he continued to shake it. ‘Hmm, I wonder what it is?’

  Maggie knew. She couldn’t believe it when she had drawn Nash in the Secret Santa draw. Buying a gift for someone for ten dollars was hard enough, but for Nash?

  The man she loved.

  She’d searched high and low, trying to find just the right thing, hoping that he’d be able to see the depth of her feelings in the perfect gift. When she’d stumbled into an Australiana store in the city and found eucalyptus-impregnated gum nuts for sale she knew she’d found exactly what she’d been looking for.

  Something to remind him of home. The bush. And maybe her.

  Nash grinned at her. ‘Let’s find yours.’

  ‘No,’ Maggie protested as Nash knelt again. ‘I’ll leave it for the twenty-fifth, thanks very much,’ she said primly, and departed, removing herself from temptation.

  Of Nash, not the tree.

  Twenty minutes later Nash tracked her down in the tearoom. ‘Christopher’s results are back. His haemoglobin is sixty-four. I’ve organised the cross-match with the lab. They’re going to ring us when the blood’s ready.’

  Maggie nodded. ‘Have you told Bree?’

  Nash easily read between the lines. He knew what she was really asking was, does the grandfather know? ‘I’ve told Bree. And her father.’

  ‘How’d that go?’

  ‘He’s not happy.’

  Maggie felt a slight edge of worry and hoped he wasn’t going to be a problem. ‘Well, thankfully it isn’t up to him.’

  Nash nodded. ‘I did explain again that it was vital. That Christopher’s low haemoglobin level has a direct effect on the oxygen-carrying capacity of the blood and with his lungs being so sick it was interfering with his body’s oxygenation.’

  ‘What’d he say to that?’

  ‘He thinks we could give him more iron tablets. And spinach.’

  Maggie almost choked on her cup of tea. ‘What?’

  ‘I know.’ Nash nodded. Christopher’s anaemia was way beyond being benefited by any pharmaceutical or nutritional intervention. Especiall
y with the potential for further pulmonary haemorrhages. ‘Anyway, as you say, Bree’s given her consent and that’s all that matters.’

  ‘Okay.’ Maggie nodded. ‘Thanks for trying.’

  An hour later Maggie took a call from the blood bank to tell her they’d put two units of cross-matched blood in the blood fridge for Christopher. Maggie glanced over at bed five. Bree was there but her ever-present father was outside, having a break. Now was a good time to get the blood up — less hassle without Christopher’s grandfather and his disapproving presence.

  Linda was on her break and due back in ten minutes. Nash had gone to Radiology with Gemma Perkins, the PICU director, to discuss a case. He shouldn’t be too much longer either. If she went and got the blood now, she and Linda could check it and put it up together with as little fuss as possible, and Nash would be here to deal with any grandfather-related issues.

  ‘Ray, I’m just going to the blood fridge.’

  Maggie had allocated Ray and Gwen as runners. It was their job to be the gophers for the staff looking after the patients as it was policy in PICU that no patient was ever left unattended.

  ‘Sure thing,’ Ray said.

  As Maggie pushed though the swing doors of the unit she heard singing and was delighted to see that the choir that visited the hospital every night in the lead-up to Christmas had stopped outside the PICU parents’ lounge.

  The entire floor was often overlooked as outsiders were hesitant about approaching the unit. But Maggie knew one thing for sure — PICU parents were probably the most stressed parents in the hospital.

  If anyone needed a little light entertainment, it was them.

  They sang ‘Ding Dong Merrily on High’ and Maggie lingered for a moment, listening to the superb voices and feeling a sense of peace on earth and goodwill to all men. She looked around at the parents who had come outside to listen and was gratified to see smiles.

  ‘They’re good, aren’t they?’

  Maggie looked beside her to see Christopher’s grandfather watching as he peeled an orange. ‘Yes.’

  ‘Where are you off to?’ he asked.

  Maggie darted him a quick look. While she didn’t want the hassle of him being alerted to the imminent transfusion, she wasn’t going to lie or sneak around. Christopher needed the blood. It was a medically indicated intervention and she would not let one cranky old man compromise her patient’s condition.

  ‘To the blood fridge,’ she said, keeping her voice calm and neutral. But she saw his lips thin and his fingers tighten around the orange and for the first time instead of feeling annoyed she felt a little creeped out.

  ‘Bree’s wrong to allow this,’ he muttered. ‘I’ve read the reports the government tries to cover up. He could end up with HIV or Hep B. You could be passing on a death sentence.’

  ‘Mr Thirkettle, as Dr Reece has already explained, blood transfusions are screened for both HIV and Hep B.’

  ‘What about that mad cow’s disease? There’s no test for it.’

  ‘No, but the donors are screened,’ Maggie said patiently. They’d been through this several times over the last few days. ‘It’s a very safe, very effective treatment. Your grandson needs this transfusion.’

  He shook his head. ‘Bree should never have given her consent.’

  ‘Your daughter is following medical advice.’

  ‘Hmph! Doctors,’ he sneered. ‘They’ve got it wrong in the past. Just ask my poor Lizzy.’

  Maggie was a little chilled by the utter disdain and tinge of hatred she heard in his voice. Her feelings of goodwill vanished as she began to really worry that he might attempt to stop the transfusion going ahead. She made a mental note to ring Security and alert them to the potential threat when she got back to the unit.

  Great, just what she needed! Just what Bree needed — her father being carted off by security.

  She excused herself as the choir took its leave, putting the altercation behind her. It took all sorts, Maggie lectured herself as she turned in the opposite direction from the singers and walked along the practically deserted corridors of the hospital to the blood fridge.

  It was nearly eight o’clock and thanks to Christopher’s grandfather she was now counting down the minutes until the end of her shift.

  Ninety, to be exact.

  Using her swipe card to access the room where the fresh blood products were kept, the low hum of the fridge’s motor greeted her, echoing around the confined space. Maggie opened the heavy door and searched through the various trays until she found Christopher’s bags.

  The top one had the lab form attached and she pulled it out, signed for it in the book beside the fridge, then let herself out of the room.

  She was almost back when she rounded a corner to find Christopher’s grandfather sitting in one of the low chairs that had been strategically placed on every floor near the lifts to create a lounge-type area. He rose to his feet quickly when he saw her and she stopped abruptly.

  ‘Is that it?’ he asked, nodding towards the bag of blood she had in her hand.

  Maggie’s heart thumped loudly as a prickle of danger lift the hairs on her neck. She edged closer, her gaze darting over his shoulder. ‘Yes.’ She swallowed.

  ‘I’m going to appeal to your compassionate side now, Nurse, and ask you not to do this.’

  She edged again slowly trying to get to the other side of him. He hadn’t given her any reason to suspect that he’d hurt anyone but this was definitely threatening behaviour. ‘Okay,’ she reasoned. ‘Let’s go back to the unit and we can discuss it with Dr Reece again.’

  He shook his head. ‘I can’t let you do that.’ Maggie moved again and he motioned her to stop. ‘I can’t let them harm Christopher like they did Lizzy.’

  Maggie tried to figure out how far she had to go to angle herself in a position where she could run. ‘We’re trying to help him, Mr Thirkettle,’ she said.

  Maybe if she kept him talking she could inch her way around him. Or someone else might come along. She’d give anything to see Nash now.

  ‘He doesn’t need that kind of help.’

  Maggie was so focused on her goal that she didn’t really heed the sinister drop in his voice. Her gaze flicked past him again. ‘Okay. We can sit down again and talk it through back on the unit.’

  ‘Do you have kids, Nurse?’

  Maggie was halfway to her goal, her leg brushing the lounge chair. His comment reminded her that it wasn’t just herself that was in peril here. She had a life growing inside her, her own child, and she’d was damned if this man was going to jeopardise that in any way.

  ‘Look, this is really inappropriate Mr—’

  ‘I don’t care about that,’ he roared.

  Maggie jumped as his voice cracked across the short space that separated them. His eyes were wild and unfocused suddenly and she knew she was in trouble.

  His voice dropped again. ‘I’m sorry but I just can’t let you do this.’

  Maggie’s heart was practically jumping out of her chest and her eyes bugged as he pulled a knife, the one he’d been peeling the orange with, out of his pocket.

  ‘Wait,’ Maggie pleaded, holding out her hand to ward him off as he advanced towards her. ‘Here, take it,’ she said holding it out to him. One bag of blood wasn’t worth her life.

  ‘Oh, I’ll take it all right,’ he snarled, and raised his knife-wielding hand.

  Maggie held her crossed arms up to protect herself, protect the baby as he slashed towards her with the knife. She was terrified, utterly terrified as the knife came into contact with the bag and freezing cold blood gushed from the ruptured plastic and ran all down her and pooled on the linoleum floor.

  The rich, metallic scent mingled with the aroma of her own fear as the moment seemed to freeze in time. He wrenched the bag out of her hands then, knocking her backwards in the process.

  Maggie tried to regain her balance but slipped in the sticky mess at her feet. She twisted, cried out, fell and hit her head on the hard
wooden arm of the lounge chair on the way down.

  She heard the vague clattering of the knife and saw it land not far from her head in her peripheral vision before everything went black and she lost consciousness.

  Nash and Gemma had finished in Radiology and were discussing Nash’s move to Great Ormond Street Hospital when Linda caught up with them, a bag of chips and a can of soft drink in hand.

  ‘Been raiding the machine?’ Gemma asked.

  Linda nodded. ‘I was over visiting a friend on ward two. And you know me, can’t go by that damn machine without sampling the wares.’

  ‘Well, all proceeds do go to Radio Giggle,’ Gemma pointed out. ‘So really you’re just making a charitable donation.’

  Linda laughed. ‘That’s the way I like to look at it.’

  They reached the end of their corridor and turned right. Nash noticed some smudges on the floor. ‘What’s that?’ He frowned.

  They all looked down. ‘Looks like a bloody footprint,’ Linda mused.

  Nash looked up, noticing they disappeared around the corner they were soon to take. He looked behind him in the opposite direction, tracking them with his eyes as they travelled the length of the corridor.

  ‘Someone might have cut their foot,’ Linda suggested.

  Nash nodded but had a strange itch up his spine as they followed the trail. The wall bore a bloody handprint just before they rounded the corner.

  ‘Curious and curiouser,’ Gemma murmured.

  Nash was the first to see the body on the floor, followed closely by Linda who gasped. His heart almost stopped in his chest as his shocked brain, already reeling from seeing a woman on the floor surrounded in blood, realised it was Maggie.

  ‘Maggie!’

  He ran to her side, kneeling in the blood, uncaring of his clothes or getting blood on himself. His mind raced, trying to sort through all possible scenarios. What the hell had happened? Where had all this blood come from? Nash didn’t think he’d ever seen so much in his life.

  ‘Maggie.’ He shook her this time.

  Gemma felt for a carotid. ‘Good pulse.’

  Nash felt some of the edge to his panic dissipate but then Linda said, ‘Oh, no,’ as she held up a bloodied knife.