Another Woman (9781468300178)

by Vincenzi, Penny

  ‘What are you going to call her?’ he asked as he delivered the placenta and prepared to stitch her up.

  ‘Ottoline,’ she said.

  ‘That’s a fine name.’

  ‘I know. After Lady Ottoline Morell. She’s a great heroine of mine. And her daddy’s.’

  ‘And where is her daddy?’ asked Staff Nurse.

  ‘Oh – he’s off working,’ she said quickly, bravely. ‘He’s in a band.’

  It all made sense suddenly. She wasn’t going to see a great deal of the daddy. Probably after a while she wouldn’t see him at all. She had a tough time ahead. But meanwhile, the miracle had been worked again, a baby had been born, given life, love, tenderness; and it was all worth it.

  James smiled at her. She smiled back at him. Staff Nurse Jackson smiled at them both. And then Rosemary Mills was sick. That was quite normal. It was the syntometrine. As she vomited, as Staff Nurse rushed for a bowl, James patted her hand, took the baby from her. And saw a bulge in her vagina, a nightmare sight, a second bag of membranes making their way out of the birth canal.

  ‘Staff,’ he said, his voice light, shaky with urgency, ‘Staff, take this baby. There’s another one in there.’

  ‘Ah,’ said Staff Nurse quietly. She laid the baby in a cradle, told the junior midwife to take her away.

  ‘Right,’ she said, her calmness icy, reproachful. ‘I’ll try the paediatrician again. You –’

  ‘It was a singleton,’ he said, ‘I know it was a singleton. There was no other heartbeat, no sign –’

  Nurse Jackson looked at him, and her eyes were very contemptuous. ‘I did say –’

  There was a great gush of water over the bed, and a small foot appeared. Rosemary Mills groaned; James with difficulty stopped himself from doing the same. Twins, and this one a breech. God Almighty.

  ‘I’m sorry,’ he said to Rosemary. ‘I didn’t – didn’t realize. It was very high up, you see, it’s very often difficult to tell in those circumstances. Nothing to worry about though, soon get this one out.’ God, if only he felt clearer-headed, less exhausted. ‘Now you’re going to start pushing again, and I’m going to deliver your baby.’

  She tried; she tried desperately. But she was very tired. Progress was terribly slow. ‘What’s the heartbeat, Staff?’

  ‘Still a hundred.’

  ‘Good. Thank God. Now come on, there’s a good girl. Push, Rosemary, push.’

  He was fumbling now; his hands, normally so skilful, seemed awkward, undeft. He hurt her; she cried out. ‘Sorry, Rosemary. Sorry. Won’t be long.’ Right. He eased the buttocks out; progress. And then there was a trickle of fresh blood. Shit. That was the second placenta separating. Keep calm, James, you still have time. ‘Heartbeat, Staff?’

  ‘Seventy.’ She sounded stern, almost angry.

  ‘Right. Good. Another push. Good girl. Well done. Ah, you have another daughter. That’s something to keep you going. And now the shoulders. Soon be over.’

  ‘Mr Forrest, this is too slow. Much too slow.’

  Stupid bitch. How was that going to make the girl feel? Anyway, it wasn’t. The baby was coming. Although the head seemed to be very large. Never mind. It would be all right. Perfectly all right. Only – Christ, now the cervix was begining to close down. That was the syntometrine at work.

  ‘Mr Forrest, it’s been almost half an hour. We have to get her to theatre.’

  ‘No, no, it’s too late for that.’

  ‘Mr Forrest, the heartbeat’s down to fifty.’

  ‘Shut up,’ he said. ‘Shut up and help me.’ He was sweating, everything was very hot and strange. He had the forceps on the head now, and was tugging, tugging really hard, with all his weight. Get it out. Get it out.

  ‘Ah. Here she is. All’s well, Rosemary. Well done.’

  Only it wasn’t. The baby was a strange colour: paler than the other one, almost chalky, and blotchy. And it wasn’t all right. There was no heartbeat.

  He intubated the baby, ventilated it on the Resuscitaine. Still no heartbeat.

  ‘I’m so, so sorry,’ he said to Rosemary Mills, as the second baby was handed over to Staff Nurse, to be taken away to the mortuary, ‘so terribly sorry. There was nothing, nothing more we could do. The baby was so big, you see, and you were so tired, and it was a breech. We did all we could.’

  ‘Yes,’ she said dully, ‘yes. I see.’

  Her eyes were almost closed, her body seemed to have collapsed. Her face was grey, drawn with pain and grief; she was not properly conscious of anything. Ottoline had been taken away to the nursery, to be checked, monitored, just in case there were any complications, but Rosemary Mills seemed scarcely aware of it.

  ‘Well,’ he said, ‘I think we should get you stitched up now. Then you can have a nice sleep. And have your Ottoline with you, if you like, if there’s no need for her to stay in the nursery.’

  ‘I don’t see,’ she said suddenly, ‘I don’t understand why you didn’t know. Surely you could have felt it. The other one.’

  ‘Oh no,’ he said, and felt a rush of fear in his bowels, ‘Oh, no, not possibly. I assure you, Rosemary. The other baby was very high up, you see, and the heart was under your own ribs, so it was quite undetectable. All I could feel, hear, was a normal singleton – that’s what we call a single foetus.’

  She sighed. ‘It sounds so much less important when you say foetus, doesn’t it? Not a baby, not a twin baby, not a dead baby.’

  ‘Perhaps to you. Not to us.’

  Clever little line that. It sounded caring, properly concerned.

  ‘But I still don’t see why you couldn’t –’

  ‘Look, Rosemary,’ said James, gently firm. ‘I hate to say this. I really do, but if you’d come in regularly to antenatal for check-ups we would have –’

  ‘Oh no! No, no.’ The cry was a wail of agony, fiercer, keener than anything she had uttered in childbirth. ‘Is that really true? Do you mean it was my fault, that I could have saved the baby myself …?’

  James took a deep breath. He hated himself for doing this, but he had to start covering himself now. If there was trouble over this, if it ever emerged he’d been negligent, drinking for Christ’s sake, he’d be done for. He had to force the fact home, that she was actually responsible; and anyway, she was, dammit, she was.

  ‘I’m sorry,’ he said, quietly, steadily, ‘but that’s exactly what I do mean, Rosemary. If only we had been able to look after you –’

  She suddenly started to cry, with a new frantic energy; her sobs rose, became hysteria. Staff Nurse Jackson came hurrying in from the corridor where she had been trying to get hold of Jason Benjamin, Rosemary Mills’s boyfriend.

  ‘Don’t,’ she said, ‘don’t upset yourself. Please, Mrs Mills. It’s all right. And Ottoline is doing beautifully. You can have her with you very soon now.’

  Rosemary stared at her. ‘Sorry,’ she said, between rasping gulps for breath, ‘I’m sorry. I know I’m lucky, I have one lovely baby. But Dr Forrest was just explaining how it was my fault, how I should have come to prenatal. I just didn’t think, didn’t know –’

  ‘Of course not,’ said Nurse Jackson soothingly, and the look she shot at James across the bed was white-hot fury, total disgust. ‘Of course not. You mustn’t allow yourself to think that way. Really you mustn’t.’

  ‘But I have to. It’s true, isn’t it? It’s my fault. All my fault. Oh God, I wish I was dead too.’

  ‘Now what good would that do?’ said Nurse Jackson, sternly kind. ‘Then who would care for little Ottoline? And as you say, you do have one very lovely baby. Mr Forrest, could I have a word with you?’

  ‘Not just now,’ said James, settling down at the foot of Rosemary Mills’s bed, preparing to complete his sutures. ‘I’m busy, looking after my patient. As you see. Perhaps later.’

  He forced himself to look at her and saw what he had feared. She knew exactly why the twin had been undetected, and why it had consequently died; and exactly why, moreover, he had told Ro
semary Mills that the blame lay actually with her.

  He visited Rosemary each day, on his ward round, and was always kindly, courteous and sympathetic towards her (although careful not to seem excessively so, least that might be in some way interpreted as displaying guilt); she was a sweet girl, anxious not to be a trouble and even apologizing for her frequent weeping.

  ‘I know I shouldn’t,’ she said to him on the fourth morning after the birth, dabbing her eyes rather helplessly with a very soggy tissue, ‘and I know how lucky I am that Ottoline is alive and doing so well but I just can’t stop thinking about the other one. And feeling bad about her.’

  ‘I know, I know,’ he said, handing a clean tissue, ‘and that’s natural, indeed you should grieve for her. It would be wrong not to. But you’re right, and you do have a lovely baby, and she is doing beautifully, and you should be very proud of her. What does her daddy think about her?’

  ‘Oh –’ She flushed, looked down at her hands. ‘Oh, well, he’s very proud of course. He hasn’t actually seen her yet, because he’s away on this tour you know, but he sent me those flowers, look, and he’s rung twice. He’ll be back for when I get home, he’s promised me that.’

  ‘I should hope so,’ said James lightly, smiling at her, going along with the soothing fiction that Mr Benjamin was indeed such a very busy man he couldn’t possibly be expected to take time off to visit his baby daughter and traumatized girlfriend, and torn between a sense of outrage on Rosemary Mills’s behalf and an unbidden sense of relief at the realization that she was going to be very poor, very under-resourced and highly unlikely even to consider taking any action against him and the hospital.

  ‘Oh,’ she added, looking up at him rather nervously, ‘Tamsin, that’s my yoga teacher, I hope you don’t mind, she’d like to have a word with you. About – about everything. Would that be all right?’

  ‘Yes of course,’ said James easily, ‘perfectly all right.’

  He thought that Tamsin was one of the most frightful women he had ever met. She had long plaits, steaked with grey, falling from a centre parting, a high, lined forehead, and an earnest pale face with unpleasantly small eyes. She wore long flapping Indian skirts, and although it was October, open sandals showing very unsavoury feet. She had a large number of beads around her neck and bangles virtually up to her elbows. She smiled at James, but her small eyes were cold.

  ‘Dr Forrest. I’m Tamsin Smith.’

  ‘How do you do – Miss? – Smith.’

  ‘Ms please, Dr Forrest. How is Rosemary coming along?’

  ‘She’s fine, Ms Smith. Recovering well.’

  ‘She seems very emotionally labile to me.’

  ‘Most women are emotionally labile after childbirth, Ms Smith.’

  ‘The women I work with are not. They tend to be on a very high emotional plane.’

  ‘I don’t understand,’ said James, looking at her coldly. ‘In what way do you work with these women?’

  ‘I bring them through their childbirth, Dr Forrest. Lead them into motherhood.’

  ‘And how do you do that exactly? By the way, it’s Mr Forrest. I am a consultant, an obstetric surgeon.’ He knew that was silly, that it would antagonize her further, but he couldn’t resist it. ‘You were saying, you brought these women through childbirth? I don’t quite –’

  ‘By being with them. By using the yoga method, relaxation, visualization, acceptance of pain, the opening to the birth experience. Sharing women’s emotions, helping them to overcome their fears, to reach the final exaltation of birth. I feel Rosemary was robbed of much of that, Dr Forrest.’

  ‘I see. I have to tell you, Miss Smith, that left to accept her pain Miss Mills would have experienced a great deal more and there would have been no exaltation of birth whatsoever.’

  ‘Just the same, one of her babies died.’

  It came swiftly, that lash, catching him unawares. He managed to meet her eyes; he hoped his own were steady.

  ‘There was nothing that could have saved that baby.’

  ‘Indeed? I have reason to doubt that. I believe there was negligence.’

  ‘That is a very serious statement, Miss Smith. I would not advise you to repeat it. And whatever reasons you have, no doctor here would accept them.’

  ‘No doctor, no. Of course not. But I happen to know there has been – gossip. To the effect that you could have saved the baby, had you been more – competent.’

  ‘Oh, really?’ He took a deep breath. Steady, James, don’t let her rattle you. Keep cool. ‘Miss Smith, I would like you to leave. I find your remarks offensive and I am really not prepared to discuss this with you. There will be an inquest on the baby, an inquiry into my handling of the birth. There is nothing more to say for now.’ He stood up, hoping she would do the same; she didn’t, just sat there, staring up at him, oddly in command.

  ‘I will leave, Dr Forrest. But I wouldn’t like you to think you have heard the last of this. I intend to take legal advice on Rosemary’s behalf and to see justice done.’

  ‘I shall wait with interest. Good afternoon, Miss Smith.’

  He went over to the door, held it for her; finally she stood up, walked slowly out. She didn’t say goodbye, didn’t say anything. It was very unnerving. James watched her walk down the corridor, her bracelets jangling, and then went back to his desk and sat down again. God, what he’d give for a drink.

  He reached for his phone, rang the labour ward, asked for Staff Nurse Jackson. She was just coming off duty; he asked if she would come and see him.

  ‘Yes, of course,’ she said. ‘I’ll be along in a minute. Any problem?’ She sounded slightly disdainful. Christ, was this a further mistake? Too late now if it was.

  ‘No. Not at all. Thank you, Staff.’

  She came in, looking tired. ‘Tough birth. Prem. Saved it though.’

  ‘Good. It’s a tough business. Nobody really understands that.’

  Why did everything sound like a justification suddenly?

  ‘Oh, I think they do. What’s the problem?’

  ‘Oh – nothing really. Just had a visit from that dreadful friend of Rosemary Mills. The yoga woman.’

  ‘Oh – her. And?’

  ‘She threatened me with legal action. Silly bitch.’ He smiled cheerfully.

  ‘Well, the committee will find you whiter than white,’ said Staff Nurse Jackson. Her face was politely blank. ‘So I’m sure you shouldn’t worry.’

  ‘Oh, I’m not worried. There was just one thing though. She said she’d heard gossip. I wondered if you –’

  ‘Said anything? Mr Forrest, what about? Of course not. But you know, there always is talk on these occasions. And the little student – what’s her name, Adams, was very upset.’

  ‘But she hasn’t said anything to you?’

  ‘No. Although she did ask me something.’

  ‘Which was?’

  ‘How I thought you could have missed the twin. She said she just couldn’t understand it.’

  ‘And? Why didn’t you tell me?’

  She shrugged. ‘Nothing to tell. I said it wasn’t always easy. That the heartbeat was muffled by the ribs.’

  ‘I see. Well – thank you for that. Was there anything else?’

  She hesitated. Then she said ‘Well – she did say you’d seemed very tired.’

  ‘I was, dammit,’ said James. He could feel the sweat breaking out on his forehead. ‘Terribly tired. It was four in the morning for Christ’s sake.’

  ‘Yes, of course,’ said Jackson.

  ‘So did you –’

  ‘I told her you were fine. And that it was nothing to do with her. But she’s a silly little thing. She may have – chatted a bit. To her friends. These things always escalate.’

  ‘Do they?’ said James. ‘Oh God. Should I say anything to her?’

  ‘Of course not. That would look very –’ She paused. ‘Well, anyway – don’t. If I pick up any gossip, I’ll stop it. To the best of my ability. And, as I said, I very much do
ubt if the medical inquiry will find against you. I wouldn’t worry too much, Mr Forrest, if I were you. These things happen. Unfortunately. Just the same –’

  ‘Yes?’

  ‘You were very tired.’ The real meaning was plain. James looked down at his hands. He remembered how useless they’d been that night, awkward, unsure, feeble. Christ, what a mess. What a bloody awful mess.

  Later, much later, the matter was dealt with in the usual way: with bland reassurances, with carefully worded justifications on behalf of the hospital and a carefully coded conversation between James and Mr Nicolson, who asked exactly what had happened, and when told nodded and said that if a patient refused prenatal care, then in his book that amounted to criminal negligence, and assured James that the medical union would back him to the hilt, especially as he intended to write a personal expression of confidence in his medical judgment and skills. There was, naturally, an official investigation: the post-mortem had shown that the baby’s death had been due to separation of the placenta and lack of oxygen supply to the brain, and the verdict of the official inquiry was that every effort had been made by the hospital staff to save it in an untenable situation.

  Staff Nurse Jackson had still been a considerable source of anxiety to James, but, as he pointed out in another carefully coded conversation, she too had failed to establish the presence of a second foetus; she was also about to be promoted to Sister, and she told the inquiry committee that both she and Mr Forrest had done everything possible, given the very difficult circumstances – an uncooperative patient, a large baby in the breech position, and a separating placenta. Rosemary Mills, discharged from hospital, still experiencing considerable emotional trauma as she struggled to come to terms with the death of one baby while rejoicing over the birth of another, was told in a coldly formal letter that while the hospital naturally regretted very deeply what had happened, there was nothing more they could possibly have done, and had she only come for regular prenatal checks then there might have been a better chance for twin two.