‘Carol!’ she called urgently, pushing the door to the delivery suite open with her shoulder while she tore open the packaging on a giving set. ‘What fluids have you got in there? I need them, now!’
One small part of her brain registered the astonishing fact that her hands were perfectly steady as they slid the wide-bore needle into position and set the saline running wide open.
‘Virginia? Can you hear me?’ she called as she pulled all of the pillows out from under Virginia’s head, settled the mask tightly in position over her face and turned up the oxygen volume being delivered through it. The monitors showed that she still had a pulse, but her blood pressure was plummeting. Her patient was frighteningly quiet, her eyelids barely fluttering in response to Ella’s voice or her touch.
On the way past the bottom of the bed she piled the pillows under the flaccid legs, hoping to drain at least some of the blood they contained up towards her heart so that it could be pumped up to keep her brain alive.
The phone shrilled just as Carol shouldered her way through the door with several bags of fluids.
‘My God! What’s happened?’ she demanded as she reached automatically for the phone.
‘That’s Seth, I hope. Tell him I think it’s an abrupted placenta. She’s in shock and needs an immediate Caesarean or we’re going to lose both of them. Should we transfer her up to Theatre?’ Her hands were working even faster than her mouth, inserting a second IV into the other arm and setting it going as fast as possible to deliver fluid into the woman’s veins. If the fluid volume dropped too far the heart would simply stop beating.
‘He’s on his way now,’ Carol said as she hung the extra fluids on the IV stands and automatically reached for another giving set to connect to veins in her legs before they had a chance to collapse completely. ‘He’s bringing the anaesthetist with him so they can assess her and operate here. This is Hartmann’s solution going in.’
So they can operate here…Hearing her colleague’s positive slant on what was about to happen, Ella smiled bleakly, knowing that even with an IV running into each of her limbs, their patient could be losing blood volume faster than they could replace it. In that situation it would just be a matter of time before her brain shut down for ever, making any operation useless.
In the meantime, if she was interpreting the readings on the monitor correctly, that little baby was trapped inside his mother’s body and was already slowly being starved of the oxygen he needed to survive.
There was a sudden bang at the other end of the department as though a door had been flung open in a hurry and had hit the wall. Ella’s head shot up when the unexpected noise was followed by the sound of running feet.
By the time Seth reached the room Carol was waiting for him by the door, holding a disposable plastic gown out for him, swiftly followed by gloves and a mask.
‘How long has she been like this?’ he demanded as his eyes flew from the readings on the monitors to the ominously still figure.
‘Sudden onset,’ Ella said briskly as she stripped the gown out of his way. ‘Came in about half an hour ago with slightly low blood pressure that suddenly started to drop without visible blood loss. Tachycardic, dizzy and sweating then loss of consciousness.’
Ella would never forget the next few minutes as long as she lived.
She never would have believed that anyone could move so fast to prepare a patient for major surgery. Seth wasn’t even working in an operating theatre and she was sure he didn’t have half the supplies he needed but it didn’t appear to slow him down at all.
It seemed just seconds later that his incision into the uterus released a shocking flood of dark red blood and then he was reaching a gloved hand in through the incision to find the child.
‘Oh, God, please,’ she whispered when he withdrew a blood-coated scrap that dangled limply in midair.’
‘Where’s that paediatrician?’ he demanded as Ella leapt to take the child from him, supporting the weight of the tiny body while he swiftly clipped and cut the cord. ‘He should be here by now…’ he continued impatiently, only to fall silent at the sound of another set of running feet.
‘Don’t resuscitate,’ the panting man said as soon as he caught sight of the child, his hands full of a selection of sterile packages. ‘I’ll intubate immediately. He’ll need pulmonary lavage to get all that muck out of his lungs.’
As he was speaking he was already directing Ella to position the child but a clock was ticking away inside her head, counting off the seconds that the tiny infant had gone without taking that first important measure of oxygen.
There was a clatter outside the door and another influx of people arrived, wheeling a humidicrib with its own power supply and another pile of specialised sterile packages.
Ella relinquished the fragile body into their care, able only to watch while they worked to try to ameliorate the effects of his traumatic arrival in the world.
‘How is he?’ Seth demanded suddenly, his head bent over his own task as he added bleakly, ‘Please, get him going because I don’t know whether his mother will ever be able to have another one.’
Ella could only imagine what damage he had found inside the uterus and would have to wait until later to ask what he’d been able to do about it.
She glanced around the room, looking for Carol, only to realise that her colleague must have returned to her own patient at some stage. So much had happened in such a short space of time that she’d completely lost track.
As if on cue, there was the sound of an indignant cry from the room on the other side of the corridor and Ella’s heart ached to hear the same sound from her little charge.
Not that he would be able to make a sound with a tube down his throat, even if he had the breath to do it.
The busy staff clustered around the humidicrib seemed to have been working on him for ever but as she couldn’t see what they were doing she could only guess. She only knew that they must have been connecting the various sensors positioned on his body to the monitors because suddenly there was the sharp sound of a little ragged heartbeat.
There was a muted cheer and a definite air of relief that at least one of their patients seemed to be winning the battle.
‘I think we’ve just about got him stable enough to get him out of your way,’ the paediatrician announced, his protective clothing covered with blood as if he’d been slaughtering the child rather than trying to save his life. ‘He’ll be in ICU for the foreseeable future—at least until we find out if his lungs have been damaged.’
He followed his team out of the room, pausing briefly in the doorway to catch Ella’s eye with a concerned expression in his own and nod towards the frantic activity still going on over the baby’s mother. ‘You will let me know?’
CHAPTER FIVE
‘SHALL I phone ICU, or will you?’ Ella asked Seth over her shoulder. ‘Mr Tufnell wanted to know how you got on with his charge’s mum.’
She was pretending to concentrate on stirring the last soggy teabag around in one mug before scooping it out and repeating the process in another. In reality she was still trying to get her scrambled emotions under control.
‘I dropped in on my way back from delivering Virginia,’ Seth informed her with a quiet air of satisfaction and a word of thanks for the steaming mug she handed him.
Ella couldn’t bring herself to meet his eyes yet. Her emotions were still too close to the surface and she didn’t want to make a complete fool of herself. In the last few weeks she’d discovered that he had that effect on her, as if she’d lost the ability to hide what she was feeling.
‘Baby Drew is holding his own so far and Tufnell doesn’t think there’s been too much lung damage,’ Seth continued. ‘When they did the lavage there was very little muck in there. He’s more concerned about possible brain damage because we don’t know what degree of oxygen deprivation he’d suffered before we got to him.’
‘And it could be a while before that becomes evident, even if his brain
scans don’t look too bad,’ she finished for him.
‘At least once I got Virginia suctioned out I was able to see that the placenta hadn’t become completely detached, but how much use his body was able to make of what was left…’ He left the thought unfinished.
Ella stared into the mug cradled between her palms as though the answer to the world’s oldest riddle was hidden there.
‘Seth,’ she heard herself say in a voice made shaky by a dangerous overload of emotion, ‘I just wanted to tell you how…how impressed I was by what you did today.’ She had to swallow before she could continue. ‘When you did the incision and all that blood came pouring out…’ She shook her head, unable to go on.
‘I think that was the scariest thing I’ve ever done,’ he admitted quietly, and the sincerity in his voice drew her eyes to him the way nothing else could. ‘At that moment I really thought that there was no hope of being able to save either of them, but I was damned if I was going to give up without giving it a try.’
He ran his fingers roughly through his hair and Ella was almost certain that she saw them tremble slightly.
‘Well, I’ve certainly never seen a Caesarean performed that fast before.’ She couldn’t help it if he heard the awe in her voice. There was so much in the world of medicine that impressed her, but after this, Seth was in a class of his own. ‘And you weren’t even in a proper theatre when you did it.’
‘It was a team effort,’ he said uncomfortably, but she could tell from the heightened colour along his cheekbones that her words had meant something to him. ‘I couldn’t have done it without Pali taking care of the anaesthesia, and the scrub nurse sorting out the nearest equivalent to the equipment I needed.
‘As for you…’ he continued in a gravelly voice. ‘None of us would have had a chance of making a difference if you hadn’t kept your head and kept her going until we could get to her. If you hadn’t got those fluids up and running when you did, neither mum nor baby would have stood a chance. And as for tilting her that way…that actually caused the baby to press the placenta against the area of greatest blood loss and slowed it down.’
The admiration in his words and in his eyes was the final straw. Her composure crumpled without a second’s warning and the tears started to pour out of her.
‘Oh, Seth, I was so scared,’ she sobbed, desperately embarrassed to have lost control in front of him but helpless to stop. ‘When I realised what was happening, and that she could die right there in front of me if I didn’t do the right thing…’
Suddenly he was there beside her and she was wrapped in his arms, strong and all-encompassing, and he was murmuring supportively in her ear.
‘But your instincts were absolutely spot on. You called for help, you cleared her airway and started pumping the oxygen in and you supported her circulation with a forest of drips. I can’t think of anything more that you could have done in such a short space of time.’
‘But—’
‘You even managed to light a firecracker under the right people to get some blood delivered at the double. Everything I needed, you seemed to have worked out in advance so that it was ready and waiting for me. I promise you, my little team was well impressed with your unflappability, and it takes a lot to impress them.’
His deep husky voice was definitely having a calming effect on her and as his words gradually sank in she was able to admit to her darker thoughts.
‘It’s just…Oh, Seth, I just feel so guilty that she nearly died when I was supposed to be taking care of her.’
‘No, Ella. Don’t you dare go beating yourself up like that,’ he said sternly, giving her a shake to emphasise his words. ‘You walked into an ongoing situation without any warning except a note that her blood pressure was slightly low, and you coped brilliantly. Instead of feeling guilty you should be over the moon that it looks as if both of them are going to make it, in large measure because of your quick thinking.’
Ella drew in a deep shuddering breath and held it for a moment before releasing it in a steady stream, trying to get rid of her churning emotions along with it.
‘Feeling better?’ he prompted, loosening his hold on her just enough to look down at her face.
‘Mmm-hmm.’ She nodded, feeling a blush work its way up her cheeks when she realised exactly how closely he’d been holding her.
‘In that case,’ he said, something different in the expression in his eyes telling her that the mood had changed completely, ‘please, may I get up from the floor before my knees are crippled for ever?’
‘Your knees?’ she repeated with a blink, only then realising that he’d actually been kneeling on the hard floor beside her chair to comfort her.
She laughed. It was watery, but a definite improvement on the last few minutes.
‘Perhaps you had better get up or someone will walk in and get the wrong impression,’ she joked unevenly. ‘They might think there’s going to be a second wedding in the Buchan family.’
‘Me and my big mouth,’ Ella muttered hours later as she relived the uncomfortable silence that had suddenly descended over them after her teasing comment.
Until she’d heard the words coming out of her own mouth she hadn’t realised just how far down the road of attraction her subconscious had gone. Until that moment, she hadn’t realised that she’d gone way beyond a simple appreciation of Seth as a sexy man who’d set her hormones in an uproar the first time she’d seen him.
Her cheeks were flaming again as she pulled the covers up over her head, remembering the utter shock on his face as her words had registered.
It was embarrassingly obvious that he didn’t see her in the same way at all.
‘So, having put my foot in my mouth, how am I supposed to face him tomorrow and the day after that?’ she groaned. ‘Do I bite the bullet and apologise, or pretend that it never happened?’
At least the next day was Christmas Eve, with all its attendant jollity. Perhaps there would be too much going on for the two of them to be alone. Then, with any luck, he’d have time to forget all about it.
In the meantime, as far as she knew, no one had ever died of embarrassment…even if they’d wished they could.
‘This is a madhouse,’ Carol complained over the sound of Christmas carols coming from the nearest four-bedded room.
‘You’re only moaning because someone spilled the beans about today being your birthday,’ Jo said smugly. ‘As if your name wasn’t a big enough clue.’
‘I wouldn’t mind if that was all they’d done,’ Carol countered grimly, glaring at all three of them. ‘It was the fact that they’ve announced to all and sundry that it’s my thirtieth birthday that hurts.’
‘Well, it seems to have got you the sympathy vote if that pile of parcels is anything to go by,’ Serena said with a slightly envious glance at the stack of intriguingly wrapped gifts under a brightly coloured banner proclaiming the fact that Carol was now Flirty Thirty.
‘Knowing my luck, it’s probably all the constituent parts for my very own Zimmer frame,’ she predicted glumly. ‘Or perhaps everyone pushed the boat out and contributed towards a stair lift in case I can’t manage to walk up to my flat any more.’
‘Huh,’ Ella scoffed as she looked at the slim woman who looked elegant even in theatre pyjamas. ‘You’re one of those people who’ll be fit enough to take up hang-gliding when you’re eighty, then pushing the rest of us around in our bath chairs.’
Carol laughed and then shrugged. ‘What can I tell you? I just happen to have inherited great genes that make us look younger than we are. And it would have worked, too. I could have been twenty-nine for years yet, if someone hadn’t done the dirty. Wait till I find out who it was. They won’t get a weekend off duty until they’re retirement age.’
They were all laughing as they separated to go to their individual tasks.
Because it was Christmas Eve there were no surgical cases scheduled, and most of the patients still recovering from previous lists would be going home today
. But that didn’t mean that an emergency of some sort couldn’t land on their doorstep at any moment.
It also didn’t mean that babies were deciding to wait until after the holiday to be born. They’d had one delivery in the early hours of the morning—a beautiful little full-term baby girl with a head full of thick dark hair. Then, just a few minutes ago, another of the patients who’d been attending the hospital’s antenatal clinic had rung to say that she thought she was in labour and was on her way in.
‘Poor Mrs Hockney. She’s had a couple of false alarms already,’ Jo had said when Carol had told them about the call. ‘I was beginning to worry that she might leave it too late when the real event started just because she didn’t want to “waste our time” again.’
‘I don’t think her husband would let that happen. He’d be too scared that he was going to have to deliver the baby himself. He was one of our tough-guy fathers who faint when they see the “this is how your baby comes into the world” video.’
Ella chuckled wryly. ‘There’s usually one in every antenatal group, flexing his muscles as though getting his wife pregnant was something only the physically perfect can do.’
‘They’re usually the ones to fold first,’ Carol agreed. ‘It’s the quiet, slightly nervous ones who most often get so involved in the whole process that they surprise themselves by coping with it. You just have to make sure they’ve got a chair to sit on when their knees go wobbly and remind them to hold their wife’s hand.’
The advice came back to Ella later that morning when Peter Hockney suddenly slid down the wall and ended up sitting on the floor with a dazed expression on his face.
‘At least he didn’t hit his head,’ his wife said in a resigned voice as she watched the junior sister check him over before returning to her post at the other side of the bed. ‘He’d never live it down at work if he went in to tell them the baby’s been born and had to display a face full of stitches.’
The last words were forced out between gritted teeth as the next big contraction took hold, and then she began to concentrate, totally giving herself over to doing the breathing exercises she’d been taught at the department’s antenatal classes.
Mistletoe Mother (Medical Romance) Page 7
