Dear God, let us not be too late.
The baby was in the posterior position. It must have been like that from the start, I thought with increasing dismay. It was wedged fast, the birth route blocked by swelling caused by the relentless, sustained pressure of the baby’s head.
This position was impossible. It was so far down … Too far down.
Jack had the stethoscope low on Alice’s belly, listening.
‘Still alive,’ he said softly, for my ears alone. ‘Distressed but viable.’
‘I need to do a pudendal block. Do you have what’s needed?’
‘Yes. Now?’
‘Fast. Do you have Kielland’s forceps?’
‘There are some in Louise’s case. But you surely can’t—’
‘Get them for me.’
I’d trained for this. In the early days I’d put myself in the way of every obstetric drama I could find. Every disaster. As this was a disaster. For the baby to be in this position after such a delay …
I’d seldom seen a woman in so much trouble.
My fingers, lubricated with chlorhexidine, were feeling, probing, fractionally shifting, exerting pressure, changing direction every time I felt a lessening of pressure from within.
It was lucky my fingers were small. I wanted them to be smaller. Every ounce of my skill was in my fingers and I didn’t know if it was enough.
Jack’s fingers were on Alice’s wrist and he had his stethoscope on her chest. I knew what he was doing. One falter and we’d be in full emergency mode.
As if we weren’t already.
Was anyone in the room breathing? I wasn’t.
I exerted more pressure. More. My fingers gave suddenly, fractionally, shifting position.
Yes! I was pushing the baby higher.
I did not need another contraction.
‘Forceps,’ I snapped and Jack put them in my hand. I worked swiftly, placing the forceps in position for a mid-cavity rotation.
‘Her pulse …’ Jack said and I paused and waited.
‘Steady again,’ he said. I breathed out. He was adjusting the oxygen to maximum.
Carrie was right beside me. She had a towel and she used it to stop sweat dripping into my eyes.
Bernard’s eyes were fixed on Alice’s. It was as if he alone was preventing her from slipping away, and his lips were moving in a soundless prayer.
The baby moved again. Just slightly. No! I bit back an expletive. To manoeuvre the baby in such tight confines risked … ‘Hell, the cord …’
I let the forceps drop. ‘The cord’s compromised. Move her. Fast. Bernard, help us. Alice, we need to move you so your baby’s safe.’
Jack was moving even before I snapped my command, and in seconds we’d shifted Alice’s unresisting body, holding her so the pressure was off the cord.
There was no time for any more attempts at normal delivery. The baby was dying under my hands. And Alice … The pressure on her heart …
‘We need a caesarean.’ I took a fraction of a moment to try to reassure Alice. ‘Alice, we’re getting your baby out now. Do you know what a caesarean is?’
No answer. Just a mute look of apathy. Do what you like.
I had no time for more. While the men supported Alice, I was ripping Louise’s bag apart, sorting drugs and equipment. ‘General anaesthetic, Jack. I’ll fix the syringe for you before we turn her back. Carrie, I want a pan of boiling water right here beside me. Then get those warm towels. Move.’
No one was arguing. Bernard was lifting his wife, supporting her as Jack showed him how. Tears were slipping down his cheeks, but he made no protest.
‘Is the baby high enough?’ Jack had to ask. I was moving in to take over his holding position now, letting him find Alice’s vein to administer anaesthetic.
‘It has to be. Hold her again.’
I went back to sorting equipment. Systematically. Haste, not speed. I was setting what I needed on the bed, in order.
The lighting was dreadful. This was maybe the world’s worst operating table, but there was no other choice.
The men were still holding Alice up as I’d shown them. I shoved the instruments into the hot water Carrie had placed on the floor beside me. Carrie was gone again, towel hunting, so I simply tipped the water out, leaving the sterilised equipment lying on the bottom of the pan. World’s roughest sterilisation.
Then I re-gloved. Fast.
‘The anaesthetic’s taking effect. I need to intubate,’ Jack said urgently.
‘Do it.’ Deep breath. We had to turn her again, but once we did, we were at the point of no return. When she was on her back, in a position where we could operate, the pressure would be on the cord again. Jack slid in the intubation tube and glanced at Bernard. ‘Bernard, you know we have to cut the baby out?’
‘Yes.’ His face was grim as death.
‘Don’t let Alice down,’ Jack said. ‘Ready, everyone?’
I glanced behind to where Carrie had reappeared, holding towels. She nodded. Jack reached with his free hand and ripped Alice’s nightgown away.
Then it was time.
‘Back in position. Now. Please, Alice, don’t spring another contraction on me. Go!’
Another contraction didn’t come and it was the fastest caesarean I’d ever performed. It was barely seconds later that my gloved hands were reaching for a tiny, flaccid ball of baby. A boy.
But there was no time to think of the child.
All Jack’s attention was on Alice. He was almost breathing for her. Willing her thready pulse to continue. Adjusting the drip, adjusting the oxygen, fighting against the odds. To anaesthetise her when she was already so near death …
I could spare no time, either. As I freed the baby from its mother’s body I practically dropped him into Carrie’s waiting towel, then went back stemming the bleeding. The last thing Alice could afford was blood loss. I was fighting for her life, moving as I didn’t think I could move. Clamping. Suturing.
Behind me the baby made no sound. Was he dead? I couldn’t check.
We needed a paediatrician. We needed specialist equipment.
We had Carrie.
‘See if you can clear an airway,’ Jack told Carrie as he worked. ‘Turn him upside down. Use your little finger to clear the muck inside his mouth.’
Damn, I should have had the suction tube ready. I glanced down and Jack had it on top of his bag. He’d thought of it already.
‘Grab the suction tube,’ he told Carrie.
Jack was breathing for Alice, as I was fighting for her, but Jack had a little more space to think about the baby.
‘Take the baby from Carrie,’ Jack told a shaking, white-faced Bernard, and Bernard hesitated for only a second before he gathered his son into his big hands. Which gave Carrie two hands to work.
‘Insert the tube into the mouth,’ Jack told her.
She was already doing it. She’d figured it out.
There was still no time for either of us to deviate. Alice wasn’t breathing for herself. My hands were flying.
Still her heart kept beating.
The bleeding was under control now—finally—and every second gave her a better chance at survival. Every second meant there was more fluid on board, more oxygen …
Finally the wound was closed. I stood back, gutted, taking a desperately needed breath.
‘Blood pressure’s risen a little,’ Jack said.
I nodded. ‘Reverse. I’ll see to the—’
But his words were cut short. From behind me came a sound none of us had thought possible.
The cry was tentative at first, desperately weak, wavering, high and thin.
The baby.
The baby!
It was so unsure. It was as if the baby was uncertain that it could even make such a sound.
I looked around to where Bernard was cradling his child while Carrie worked her magic. I looked at Bernard, and his big face said it all. It was a mass of tears. Carrie was still suctioning the little mouth—be
tween wails—but there was no need. If this little one could cry like this …
‘He’ll make it,’ I whispered. ‘Bernard, you have a son.’
The baby wailed on. Gently, wonderingly, his father put his face down against his, a huge weathered cheek against a tiny one. And the cries faded to gurgling silence.
Our eyes returned to Alice.
We’d been granted one miracle. To ask for more …
As if on cue, there was a tiny retching cough, the start of a fight against the intubation tube.
Jack lifted the airway clear.
There was a rough and rasping breath.
‘Alice,’ Bernard said brokenly and sagged to his knees.
‘Hey,’ Jack said roughly, but I knew it was the only way he could speak without bursting into tears himself. For that was how I was feeling. ‘Don’t you dare collapse on us, Bernard. You still have a very important job to do here. You need to introduce your son to his mother.’
And as if on cue, Alice opened her eyes and Bernard was there. He kissed her gently, tenderly, on the forehead and then placed her tiny son against her breast.
Unbelievably, she found the strength to smile. Her smile enveloped Carrie, Jack and then me. Then she gazed down at the tiny face of her newborn and she stopped smiling.
The look on her face was of awe.
And unutterable exhaustion.
‘Thank you …’ It was a threadbare whisper, but it was enough. She lifted her hand to touch her baby, and Bernard put his over hers.
It was over.
We were exhausted and emotional but there was still medical need.
‘She needs to go to hospital,’ Jack said, after we’d given the new family a moment together. ‘We’ve worked too hard on this to risk infection. She needs fluids, intravenous antibiotics and continuous monitoring.’
And such was Bernard’s relief and gratitude that he simply nodded.
We lay her in the back of Jack’s van—set up, I realised now, for this purpose. Carrie and Bernard rode with them. I drove behind in Carrie’s car.
I had to drive on the wrong side of the road again. When would I get used to that? I drove down the mountain and into town at about three miles an hour.
But the danger was past. ‘We did it,’ I told no one in particular as I inched my way down the steep road. ‘We did it, we did it, we did it.’
And then I thought of Jack and Carrie and Bernard and Muriel and Fraser—and Drifter and Tootsie—and weirdly even our dumb little adopted turtles flippering somewhere off the coast of Florida.
‘We make a hell of a team,’ I said aloud. ‘We did it.’
As I reached the lowlands, my phone got reception again. A message pinged in. Thinking it might be Jack, I pulled over to read it.
Charles Lindburgh Rasmussen-Clayburgh. Seven pounds six ounces. I did it. Pic coming.
Isabella had had her baby. The sky hadn’t fallen.
I was driving and I felt like I was floating.
20
clean-up wave n. all’s going well and then a wave breaks unexpectedly; you’re dumped.
I quickly checked on Muriel and then drove to the hospital. But by the time I got there, things were well under control. Carrie greeted me with relief at the entrance and headed back to relieve Fraser of child-minding duties. I went into the hospital to see for myself.
Alice was tucked into a ward, and Bernard was in a bed beside her. They were both already asleep. Their newborn son was settled into a humidicrib in the nursery.
‘Not that he needs it,’ Jack said as he gazed down at our latest delivery. ‘He must be built like a tank to survive what he’s been through.’
‘A tank might be a good description. Have you seen his father?’
Jack grinned. ‘Some physique, eh? Every girl’s dream.’
‘Not every girl’s,’ I said obliquely.
Jack looked across the crib—but he didn’t respond.
I stayed staring down at our sleeping little success story. Trying to move on.
I seemed to be caught up in a fog of emotion but I needed to be practical. Alice was doing fine. She’d probably sleep for two or three days straight. I’d need to stay on call but there was no need for me to stay at the hospital. I could go home.
Carrie had taken her car.
I needed a ride.
‘I’ll call a taxi,’ I told Jack.
‘Call Jed out at this hour? There’s not a snowball’s chance in a wildfire he’d come. I’ll drive you.’
So we headed home. The fog was still with me. I felt sleepy and confused and slightly surreal—as if this had happened to someone else and I’d simply been an onlooker.
‘We’ve been so lucky tonight,’ Jack said a few peaceable moments later. ‘Hell, though, why didn’t she come near me? How could she get to term and not get any medical advice at all? And to decide to do it all on her own … The women here have been used to my grandmother, and I haven’t had the time to persuade them to trust me.’
‘You do what you can. You can’t blame yourself.’
‘Yes, I can. I hate it that I can’t provide the service these people deserve. I hate it that I don’t have their trust. Even tonight, if I hadn’t told Bernard we were engaged …’
That was enough to divert my attention from his distress. I’d almost forgotten the engagement incident. ‘Yeah, now that—’
‘Was unavoidable.’
‘You’re trying to get their trust. So you lied?’
‘You’re saying I shouldn’t have? Bernard’s an idiot. A kangaroo loose in the top paddock? Maybe not quite, but he’s surely a sandwich short of a picnic. I did what I needed to do to get through to him.’
I tried to glower but it didn’t work. It wasn’t a good night for glowering. Besides … a kangaroo loose in the top paddock?
‘A lie to save a life can be defended at any level,’ Jack said, and the kangaroo image—and Jack’s sudden smugness—forced a smile.
I fought it back and made my tone dry. ‘Fine. Lie all you want. As long as you make it clear tomorrow that the engagement’s off.’
‘Hey, why don’t you remove your ring right now and throw it out the window,’ he suggested, with the air of a man saying something brilliant. ‘How else can we tell Bernard that we’re not engaged anymore?’ He thought about it for a bit and then added a rider. ‘Come to think of it, that’s a great idea. Toss the ring immediately. We could start from scratch—without Richard.’
My breathing had been interrupted a lot tonight. I was having trouble breathing now. ‘Jack …’
‘I know,’ he said. ‘Impossible.’ He was turning off the road onto the farm track. ‘It’s just that it does seem like a good idea to keep you here. I have to get a woman doctor to the island. I must. She would have died.’
‘It’s Alice’s choice to live here,’ I told him defensively—but suddenly I wasn’t quite sure what I was defending. ‘It’s also her choice not to trust you.’
‘That means I don’t have to care?’
‘You’re allowed to care. You’re not allowed to blackmail me.’
‘I can’t blackmail you to care?’
‘No. I mean … No. Just cut it out, Jack. Leave me be.’
But suddenly he was pulling off the track, at a spot where we could stare out at the starlit sea. A couple of cows were by the cliff fence, their silhouettes vaguely unreal. There was a moment’s silence while I waited for what came next.
‘You know, I haven’t wanted to care,’ he said at last. ‘But I didn’t have a choice, and the caring’s sucked me in. I’ve accepted that now. I’m here to stay. I’ve tossed the suits and I’m trying to figure out how to make my life better. So how about you? Have you been sucked in, too?’
What did he mean? How could I let myself get sucked in … to this?
‘You know, you’re sharing already,’ he said softly. ‘With Bridget. With Clive and the cows.’ He motioned out to the cows. ‘How many of them do you know by name?’
/> ‘None.’ But it was a lie. Christabelle, Strawberry, Frostbite, Eckleberry, Rose and Rose Junior, Bubbles, Wobbles, Ernestine …
I knew them all. Hey, I thought, suddenly panic stricken. I knew every last one.
‘Want to weed?’ he asked.
‘You’re out of your mind.’
‘Will you go straight to sleep after a night like this?’
‘No, but—’
‘Me neither. Let’s weed.’
He turned the van back onto the track and drove to the house.
Drifter emerged, overjoyed to see us. I checked on Muriel but she hadn’t stirred. I thought about closing the door and staying inside.
I couldn’t.
I couldn’t stay. I couldn’t go. I stood in the doorway and closed my eyes.
And then I went out to weed.
We weeded in silence, but instead of it calming me, I found my mind growing increasingly confused. There were so many issues …
And it seemed the thread of conversation hadn’t ended. Fifteen minutes of weeding later, Jack rose and stretched and looked down at me and I knew what he was about to say wouldn’t be pretty.
It wasn’t. ‘So what do you think you’re doing by selling this place?’ he asked. ‘You’ll make money, but how much are you losing?’
‘Butt out.’
‘You know,’ he said.
‘I’m not losing.’
‘Of course you are. You know this is your place. What you said tonight is true, like it or not. You’re part of Nautilus Island.’ He took a deep breath. ‘And that’s not the only truth that was spoken tonight. You’re also a part of … us.’
Us?
I rose and faced him. I had seconds then, where I could have fled. Seconds where I could have told him to get out of my life and stalked into the house.
Those seconds were wasted. Sensible Jennifer Kelly was nowhere.
‘Jack …’
‘Jenny?’
‘Just Jack,’ I whispered—and stepped into his arms.
This kiss was different. Something had changed. This wasn’t a kiss of wonder or discovery or joy—or even passion.
It was a kiss of possession.
I knew this man now, and somehow it seemed as if I’d always known him. And I also knew that my coming had been some sort of catalyst, some quantum change.
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