Pregnant With His Child

by Lilian Darcy

  That vehicle and its dragging parachute of dust still nagged in the centre of Christina’s vision. A service track ran parallel to the airstrip just beyond the fence, and the battered four-wheel-drive careened along it as if in a race with the plane. Crazy driver, hadn’t he heard about the fatal game of chicken between two vehicles out at the Wygera settlement a week and a half ago? Racing a plane made even less sense as an adolescent game.

  Then she saw that it was an older woman at the wheel, glimpsed her frantic face and manic gestures, recognised her and understood that if this was a race, it was a race for someone’s life.

  ‘Glenn!’ she yelled into her headset. ‘Abort takeoff! Abort it now!’

  CHAPTER FOUR

  ‘ANY THOUGHTS, Joe?’ Hamish McGregor said.

  They stood in the tiny nursery that formed part of the obstetrics and gynaecology ward. There were two babies in it. One was a healthy, full-term girl who would go home with her mother today. She’d had a fussy night, so her mother was tired and taking a break and a nap while she could. The other baby was Jackson Cooper.

  Aka Lucky.

  Joe had plenty of thoughts. Not quite enough of them were about this little boy. He couldn’t get last night’s talk with Christina out of his head, that was the problem, couldn’t believe that what they’d had was really over.

  He grabbed at the mental puzzle pieces Hamish had given him. Low-grade fever, fussy and listless, not wanting to feed. Newborn babies were hard to read and important to take seriously, and this one had already endured more than his share of problems.

  ‘It has to be an infection,’ he said. ‘Not at the incision, that’s looking great. The cord stump is nice and dry. You said the blood and urine tests came back clear. It’s just one of those nonspecific things. Do everything, I’d say. IV fluids, something to bring the fever down, another course of antibiotics. Is the mother feeding him?’

  ‘Trying to now, with some ambivalence, and they haven’t got the hang of it, yet, I’m told. I won’t be surprised if she chucks it in.’

  ‘It would be really, really good if she could not chuck it in, wouldn’t it?’

  ‘You’re the one with the winning smile, Joe. Convince her!’

  So Joe met Megan and Jackson, the patients everyone was talking about—the ones who’d made Christina’s voice go eager and soft and satisfied all at the same time last night in the car—and they had a chat, and he shamelessly ratcheted up his Kiwi accent, which often greased the wheels of conversation with Australian patients.

  ‘Breast-feeding’s the best thing for him, Megan,’ he told her.

  ‘I don’t think I can.’ Her sense of defeat seemed habitual.

  ‘Yes, you can!’ He crouched down beside the chair where she sat with the baby hemmed in by pillows. ‘You know, with kids—with anyone you love, really, parents and siblings and friends—there are so many things that are out of your control, things you try to do for the best that can backfire. But breast-feeding’s not one of them. Breast-feeding is the number one, simple, no ifs or buts or downsides, best thing you can do for your newborn baby. I’ll tell you something. My mother tried so hard, but she couldn’t do it for my sister.’

  I’m saying too much, he realised. He was running on at the mouth. Too emotional today. Didn’t quite have it all where he wanted it.

  ‘She couldn’t?’ Megan said.

  ‘My sister has some health problems.’ He waved a hand, regretting that he’d gone in that direction. He hardly ever mentioned his family to a patient, let alone Amber’s health. His personal life felt too close to the surface today, a professional liability. ‘Point is, you can do it for Jackson, if you decide it’s important to, and there are people here who’ll help you with it, just a buzzer away, any time you need them.’

  ‘There was that nice doctor…the woman…’

  ‘Dr Farrelly?’

  ‘No, Dr Turner. She showed me. And a nurse. I don’t think she’s on today. Listen, I’m not dumb, you don’t need to talk down to me.’

  ‘Sorry if it seemed that way.’

  ‘I get what you’re saying. I do want to keep trying with this, but he doesn’t seem interested today, and I don’t think I’ve got his mouth positioned right.’

  ‘We’ll find someone.’ He looked at her more closely as he spoke, saw beyond the chronic air of defeat, and realised she was right. She wasn’t dumb. ‘Meanwhile,’ he went on, ‘he has a bit of a fever and he’s not feeling good, that’s why he doesn’t seem interested. We’ve given him something to bring it down, and his tests have come back clear, but we’re going to start him on a couple of different antibiotics, just in case. You could also try a breast-pump, because he wouldn’t have to suck so hard on a rubber teat, and sucking’s too tiring for him today.’

  ‘I get help with the breast-pump, right?’

  ‘Yep.’

  ‘Yip? You sound like my dog!’ She actually managed a smile, and he could understand why this girl and her baby had the whole hospital community holding its breath.

  ‘Takeoff is aborted.’ Glenn was still wrestling the aircraft to a controlled taxi speed, with the end of the airstrip rapidly approaching. ‘Another ten metres and we couldn’t have done it, Christina, do you realise that?’

  ‘I know.’ Christina’s voice was shaky. She didn’t mind flying, but didn’t like the drama of an aborted takeoff or a difficult landing.

  ‘So this should be important.’

  ‘I think it’s going to be. That’s Honey Cooper on the track beside us—Lucky’s grandmother—and I don’t think she’s screaming after us like this just to wave us goodbye.’

  Grace was craning to see as the aircraft wheeled around. ‘It is Honey!’ she confirmed. ‘She’s stopped. She’s going back towards the gate. Something must have happened out at the station, and not long after she got back there from our clinic, too. With that ride, she’s had a rough day, and a long one.’

  ‘She’ll want to meet us as close to the plane as she can get,’ Glenn said. As everyone did around the hospital, he knew Lucky’s name. ‘I’ll have to tell Base we’ve got a change of plan.’ He got on the radio.

  ‘It has to be urgent,’ Christina said. ‘After what she said to me this afternoon.’

  ‘It’s Jim,’ Grace answered. ‘I can see him there in the passenger seat beside her.’ She added, more to herself than to her colleagues, ‘Oh, lord, it’s probably his heart again.’

  It was.

  The air from the propellers whipped Grace’s and Christina’s clothing as they ran from the plane. Honey had parked crookedly beside the end of the airstrip and opened the passenger door. Jim was slumped stiffly there, grey-faced and sweating profusely, still clearly in the grip of great pain.

  He was gasping for breath, and gripping the top of his arm.

  ‘Jim?’ Christina urged him. ‘Can you speak? Tell us about the pain?’

  ‘Killing me,’ he groaned. ‘Help! Help me!’

  ‘Jim, we’re going to get you onto the ground.’ It was dusty, but it was flat, and if they needed to start CPR…

  ‘Why? What are you doing to him?’ Honey demanded in the background. She looked as if she’d aged ten years in the past hour. ‘I’ve got a blanket.’

  ‘Roll it up for us, Honey.’ It would help to support him in a position that made breathing easier.

  ‘Yes…Yes.’

  Glenn always seemed to know when he’d be needed, and he was there now. ‘Help me get him onto the ground,’ Christina said to him, and he nodded. Then to Jim, she said, ‘Could you swallow an aspirin, Jim? It’ll really help if you can. We’re taking care of you now, and you’re going to be fine.’

  ‘I have aspirin in my bag,’ Honey said, and started a panicky rummaging in a chunky, homemade leather contraption which Megan must have made for her as a child.

  ‘Could you take it, Jim?’ Christina repeated. ‘Chew it up for us and swallow it down?’

  He made a strangled sound which she took as a yes—wanted to tak
e as a yes.

  ‘What kind is it, Honey?’ Mentally, she debated getting out their own supply, but if this was a 300 mg soluble type, and Honey had it right there, it could actually reduce the size of the infarct and make a big difference, just in the crucial window of time while their far more sophisticated equipment was brought from the plane.

  Brought from the plane.

  She jerked her head around too fast and found Grace. ‘Grace, I want the life pack, the oxygen.’ She paused for half a second while her mind raced. Suction equipment? They’d need it if the worst happened. Get Grace to bring it now, in case? She wouldn’t be able to carry all that gear. ‘Glenn, help her. Suction gear, medication kit. Fast, or Jim’s going to think we’re just slack and messing around here, aren’t you, Jim?’ The jokey tone didn’t work, but it got her meaning across to her colleagues. ‘You’re doing really well, OK? We’re onto this now, and you’re going to be all right.’

  Golden rule of heart patient treatment. Never let them think they’re in trouble, even if they are, because the fear only made it worse.

  She felt for Jim’s pulse while Honey produced the aspirin and coaxed him to chew and swallow. It began to fizz in his mouth as it dissolved. No perceptible pulse at the wrist. That wasn’t good. It meant his systolic pressure was below eighty, and she couldn’t give nitroglycerine because that would only lower it further.

  She found the carotid pulse in the neck and even that was weak, erratic. He was barely conscious. Telling him again that he was safe in her hands, she addressed Honey. ‘Tell me about the previous trouble he’s had.’

  Honey’s summary was confused and jumpy. It had only been a mild attack but tests had shown he should have a bypass. No, he hadn’t had it yet. There just hadn’t been the right chance.

  ‘What was he doing when the pain started?’

  ‘Seeing to the horse. Yelling at me for going into town behind his back. Turned out he’d been feeling bad all day, but he didn’t tell me. If he had, I never would have left him to come to see you. To come and see you about him.’ She gave a sob of bitter laughter at the irony.

  A fatal irony, it might yet turn out to be.

  Christina wasn’t under any illusions here. This man was in a bad way.

  Grace arrived with the portable oxygen. The cylinder was only about fifty centimetres in length but it was still heavy. ‘Want me to do it?’

  ‘Yes. Full tilt.’

  Christina’s vision seemed to cloud for a moment as she spoke. Hell, was the light fading already? No, it was just the shadow from a fluffy ball of cloud, but the cloud was low in the west and while the sun floated behind it the light stayed purple and dark like a warning about the approach of dusk.

  Glenn had the life kit. Christina sent him back to the plane for a stretcher, then ripped open Jim’s shirt and slapped the three electrodes into place, one beneath each collar-bone and the other low on his left side roughly level with the umbilicus. She switched on the machine, saw an initial fuzz of static on the screen and then a rhythm—the wrong rhythm, the one she’d hoped not to see, with its bizarre QRS spikes indicating a complete heart block.

  After getting the oxygen mask in place and the oxygen flowing, Grace wrapped a blood-pressure cuff around Jim’s arm to try and get a measurement but when Christina looked at her she just shook her head.

  Unreadable.

  This patient could arrest at any moment.

  And he was still in terrible pain.

  She worked to set up an IV, needing the access for pain medication and life-saving drugs if he arrested, as she feared he would. The needle went in cleanly, followed by the plastic cannula. Grace drew up some saline to flush the line as a check, while Christina prepared morphine. With Jim’s pain still at a crippling level, she gave the entire first dose at once, along with more reassurance.

  ‘We have the drip in now, Jim, and that’s going to help us medicate you and get this under control. You’re going to be fine. The pain should ease very, very soon.’ She added an anti-emetic to the IV because of the strong possibility that the narcotic drug would make him nauseous. ‘We’re going to get you into the plane now, and get you to the hospital.’

  Glenn came into his own at this point, strong, adept and rock-faced. Timing their actions together, they got Jim onto the stretcher and pushed its sturdy wheels over the hard, dust-coated ground to the aircraft, while Grace took care of the equipment.

  Shakily Honey asked, ‘I’m coming in the plane?’

  ‘Yes, of course.’ Grace touched her arm. ‘But better move the car first, Mrs Cooper.’

  ‘Yes. Yes.’ She added in a frightened tone, ‘Don’t—don’t go without me.’ She didn’t trust anything right now. It wasn’t rational, but it was human.

  A few minutes later, Glenn launched into his pre-flight routine for the second time. Honey had left the Coopers’ ancient farm vehicle parked just beyond the airstrip. She had nothing with her but the clothes she wore and that funny leather bag.

  ‘I’m here, Jim,’ she whispered to her husband, in a cracked voice. ‘Jim, it’s all right.’

  This time their takeoff proceeded without incident, and there was that sense of relief which came when the wheels had lifted and the aircraft seemed to shake off the pull of the earth. The relief was an illusion, Christina knew. There was an hour of flying to get through yet.

  She barely took her eye off the ECG trace, willing it to stay in a pattern that was acceptable, if barely. Those QRS spikes were still way too wide.

  Thirty minutes to go.

  Twenty.

  Honey hid her face against the window and silently cried. Christina could almost sense the shaking of her shoulders even when she wasn’t looking in that direction. Grace comforted the woman stealthily, because no one wanted Jim to see that his wife was so upset, Honey least of all. She was doing everything she could to hide her panicky, emotional state in order to lessen her husband’s own fear.

  ‘Doing great, Jim,’ Christina said. ‘Nearly there now. Getting close.’

  Close, but not close enough. The trace deteriorated. Ectopic beats appeared and Jim lost consciousness completely as his heart went into ventricular fibrillation, which showed on the ECG as wild, patternless wiggles. He’d gone into full cardiac arrest and his heart wasn’t going to start beating again on its own.

  ‘Glenn, we need to put down,’ Christina said into her headset.

  ‘Descent’s started, Doc.’

  ‘I can’t see the coast.’

  ‘That’s because it’s getting dark.’

  ‘How far out are we? I’m really thinking we should put down.’

  Was Honey listening? How much could she say about how urgent this was?

  ‘Do we have a situation?’ Glenn asked.

  ‘Yes.’ And it was against protocol to defibrillate or intubate a patient while in flight. With the powerful current in the defibrillator and the tricky technique required for intubation, it was just too dangerous, both for the patient and for the personnel working around him. CPR was possible, but less effective in the plane’s confined space.

  What she wanted was to drop into a level, grassy paddock in sixty seconds flat so she could work to get his heart going again, shock him and intubate, but she understood Glenn’s reluctance. It was getting dark, they were just a few minutes out of Crocodile Creek, where there was a hospital, equipment, staff, even an experienced heart specialist, although not the facilities Jim would need for bypass surgery or angioplasty.

  ‘Your call, then, Doc,’ Glenn said. ‘I’ll find somewhere if you say we have to.’

  Oh, lord, did they have to?

  ‘Can we push up the schedule?’

  ‘I’ve already requested emergency landing clearance. I can ask for a better flight path, come in faster, on a steeper descent. You won’t gain much time with any of that at this point. Can’t promise you’d gain much time if we drop short either, and in this light there are risks.’

  ‘We’ll go all the way,’ she decid
ed out loud. ‘You’d better tell them to close the runway because we won’t be getting clear of it just yet. When you’re on the ground, just stop. I want the ambulance out on the tarmac right by us as soon as it’s safe. Make sure they know this is happening, stat.’

  They all felt the renewed speed and then, a little later, the steepening of Glenn’s descent. He confirmed it through their headsets. ‘Not long now. Bit of a pressure change coming up.’

  Yes, Christina could already feel it in her ears. She swallowed, worked her jaw up and down, and felt her head clear a little. Grace began to do the same.

  It was going to be a hairy landing. The seconds ticked by in slow motion, while her pulse raced and that wild electrical heart activity zig-zagged across the screen in front of her like the visual equivalent of gunfire. She had put in an airway, sliding it upside-down past the ridges on the roof of Jim’s mouth and then rotating it 180 degrees to curve down over the tongue. Now she put on a bag mask and began ventilating him at twelve to fifteen breaths a minute, knowing the actions could all be futile. Handing over the bagging to Grace, she began chest compressions, struggling for effectiveness in the plane’s cramped space.

  ‘Hold his hand, Honey,’ she said through her effort. ‘Squeeze it and let him know you’re here.’

  Because you might be saying goodbye, only I don’t want to tell you that.

  The descent felt rough, fast and steep, and at this moment she wouldn’t have exchanged any amount of a sense of humour for Glenn’s steely expertise with his controls. She knew he wouldn’t crack a smile at any point during this but, then, he wouldn’t break a sweat either. He’d just get them onto the ground.

  There was a thud and a groan as the landing gear came down. It sounded too loud and too violent, and then there came another thump, even louder, and she held her breath, terrified. If she’d pushed Glenn to make this landing too tight…

  Bump. There it was, thank God, the touch of the wheels on the tarmac, crooked but not violent. A little lift came, then another bump, and they were down, careening along the runway, slowing as they went. Christina felt queasy, and Honey looked it. She still had tears squeezing from her closed eyes and her hand gripped Jim’s.