A SURGEON, A MIDWIFE: A FAMILY
Gill Sanderson
Dell Owen Maternity – Book 4
The family she’d only ever dreamed of…
Neonatal surgeon Jack Sinclair has learned to keep his working life very separate from his personal life. Until Dell Owen Hospital’s new midwife, Miranda Gale joins the team and breaks through his cool detached façade…
Jack’s hooked! As they become closer, he even dares to dream that this amazing woman will be his wife and the mother of his children. But while Miranda’s just as attracted to Jack, she has a secret - one that will destroy his dream of a family! Jack’s sure that whatever she’s hiding, they can overcome it … as long as they are together.
CHAPTER ONE
'Two brothers and a sister. They're known as the good, the bad and the ugly. This one is the ugly one. Jack Sinclair.'
'He's not really ugly,' Miranda said doubtfully, her blue eyes narrowed in contemplation. 'More sort of...craggy.'
'Craggy in behaviour as well as in face,' her new friend Annie Arnold whispered. 'Brilliant neonatal surgeon, there's no doubt about that. If I could get to be half as good as he is, then I'd be very happy. But he's a bit standoffish. For some reason, he doesn't come to parties or anything like that. Polite enough but he keeps his distance. He's been away to America for three weeks, giving lectures, and things have been just a bit more relaxed around here.'
The two of them looked at the tall, green-clad figure who had just entered the operating theatre. First, he went to have a low-voiced conversation with the scrub nurse. Then he straightened, looked round the theatre. Miranda saw an unsmiling face, thoughtful grey eyes that seemed to see everything. The eyes fastened on her, registered that she was a stranger but that she was properly booted, gowned and masked, her short chestnut-brown hair hidden beneath a cap. Then they passed on. In spite of herself, Miranda shivered.
When the figure bent his head again the low buzz of conversation resumed. The patient had not yet been brought in, she was outside being given a last check by the anaesthetist.
'Is he married? Children of his own?' Miranda asked. She was curious about this aloof man.
'Neither married nor attached to anyone. So far as we know, that is. A couple of people have indicated quite clearly that if he wanted company, they were available. You know, for a drink at the Red Lion or an evening at the hospital social club. And he's turned them down. Politely but definitely.'
'He won't mind me being in his theatre?'
Annie shook her head. 'Not at all. Look, as well as me there's another two SHOs here. If he thinks you're here to learn, that's fine. The odd thing is, he's a very good teacher. It's just that.. .when he's teaching you, you feel that he has no interest in you at all. No interest beyond you as a medical professional. He's just so.. .detached.'
There was a stirring in the room as the patient was wheeled in. A baby, a beautiful little girl. Miranda looked at the tiny body and gave an involuntary shudder. It seemed wrong that someone so small as this should have to have surgery.
The surgeon looked up. 'Our patient is Chloe Metcalfe. She has oesophageal atresia—a blockage in the oesophagus—that ends in a blind pouch. There is no way food can reach the stomach. However, there is a fistula into the trachea. We have checked with X-rays and echocardiograph. There is no evidence in this case of cardiac anomaly. Often, there is. I shall open the chest and connect the two sections. Now, stand where you can see but not interfere with our work.'
His voice was as formidable as his appearance. It was deep, clear, and Miranda thought it could be musical. But instead it was distant. There was no friendliness.
People shuffled forward. Miranda did, too, and discovered that her eyes were teeming with tears. It was not apprehension or fear, just that she was not yet fully used to her new contact lenses.
Perhaps she was just a little nervous. Jack Sinclair wasn't the most welcoming person she'd ever met. But mostly it was the contact lenses. Whatever it was, she tripped. Without thinking, she stretched out her hand to save herself. And her naked hand landed on the tray of instruments that the scrub nurse had just unwrapped. The instruments weren't sterile any more. They couldn't be used.
'Oh I'm sorry,' Miranda gasped. 'I...I slipped.'
She was aware of how feeble her explanation sounded. And the silence around her grew and grew.
'Send a runner for a new tray of instruments,' Jack Sinclair said to the scrub nurse. Then, after more heart-stopping silence, he turned his icy gaze on Miranda. 'You are?'
'Midwife Miranda Gale.'
'What are you doing in my theatre?'
'I'm here to observe. I want... I want.. .to learn.'
'Very commendable. So far, in your training, have you learned anything about the absolute importance of keeping instruments sterile? Of keeping bare hands away from them?'
'Yes, I have. I'm sorry I slipped, it was an accident.'
'Accidents only happen because people let them happen. Now, keep out of my way, stand back where you can do no more harm. I'll want to speak to you later.'
What was so awful was the fact the he didn't seem angry with her. She could have accepted anger from him, felt even that she deserved it. That would have been the reaction of one person to another. But somehow he hadn't even reacted to her humanity. He had been perfectly polite, but his chilly detachment had made her feel like a non-person. Just like Annie had said.
She knew she had no right to, but Miranda felt a little angry herself.
Still, she was here to learn. The runner returned with a fresh tray of instruments, the scrub nurse unwrapped them and put them ready. Once again Miranda looked at Chloe, dwarfed by the chromed equipment of the anaesthetist. Most of her tiny body was swathed in green drapes but there was that bared patch of pink skin, surely too small for any kind of incision.
Without looking, the surgeon stretched out his hand and the scrub nurse placed a scalpel in it. Obviously these two had worked together before. A moment's pause. Miranda could tell by the hunched body, the bent head, that he was focussing, directing all his concentration on the task in hand. Then the first confident cut, and Jack Sinclair began to speak. 'OK, everyone, pay attention, please.'
He was still in his green scrubs, but had taken off his mask and his cap. Rather to her surprise, Miranda saw that his hair was longer than she would have expected, dark and slightly curly. But the rest of his face matched his stormy grey eyes. As she had said to Annie, it was craggy. There were the high cheekbones, the well-defined jaw line. And it didn't look as if he smiled much.
'You wanted to speak to me,' she said.
'I did, Miranda. I've never seen you before. Why is that?'
'Well, you haven't seen me before because I've just started at the hospital. I'm...I'm on the bank.'
'So you've just started and you're a bank nurse?' His voice was totally without inflection. Miranda felt a thrill of dismay, there could be a hidden threat here. As a bank nurse she was paid by the shift. There was no continuity, no guarantee of full-time work, she was sent for when she was needed. If a consultant said that he wasn't satisfied with her, there would be no more work offered.
'I'm .hoping to be made permanent eventually,' she said. After a very exhaustive interview, Jenny Donovan, the head of midwifery, had told her that there should be more than enough work for her. And in time there was the promise of a proper staff job.
'I see. Where did you do your training?'
Miranda told him about the small hospital in East Yorkshire where she had been so happy.
'I know of the place, it's very good in its way— but here it is different. You are working for the obs and gynae section. That's fine. But I'm pa
rt of a subsection, here we are a tertiary unit for neonatal surgery. There's only a handful of these in the country. And I want the standards here to be as high as anywhere. So. You told me you were in my theatre to learn. Anything else?'
'Yes, later I'll be specialling Chloe Metcalfe, the little girl you've just operated on. When she comes out of the post-op room and goes down to SCBU this afternoon, I'll be looking after her.'
'I see. O and G can spare you just to observe an operation?'
This was the embarrassing bit. 'I don't officially start work till this afternoon. I...er, came in on my own time.'
'Did you indeed?'
This obviously surprised him a little and just for a moment Miranda thought she saw the faint glimmer of approval in his eyes. But it was quickly gone.
She had never met anyone who seemed so distant. Perhaps if she apologised again...? 'May I say that I'm very sorry that I tripped and contaminated your instrument tray. But I've just started wearing contact lenses and at times I—'
'Miranda, you know that's no concern of mine. What is my concern is that there could have been an accident in my theatre. But I'm sure you've learned from your mistake.'
'Yes,' she mumbled.
'Good. The matter is now closed. Now, what was the operation you've just observed?'
She looked at him, perplexed. 'Why, it was for oesophageal atresia. You said so.'
'True. And what specific nursing techniques will you need to use after this operation?'
'Are you questioning my nursing skills? I can assure you that I—'
'I am just ensuring that the child I have just operated on gets the best of care.'
She couldn't argue with that. 'Well, apart from the usual obs I should ensure that the child remained prone, with the head up, resting at an angle of between thirty and sixty degrees.'
'And?'
'There must be frequent suction of the oesophagus.'
He nodded. 'That is satisfactory. You seem both competent and interested.' He turned to a locker, took out a pen and pad and scribbled something on it. Then he handed a sheet to her. 'That is the name of a very good textbook and page references to this condition. If you care to look them up, you might find them useful.'
This was totally unexpected. Why should he go to this trouble for her? 'Why...why, thank you. It's good of you to help me.'
'I'm not helping you, I'm helping the hospital. That is part of my job. Now, good morning, Miranda.'
She had been dismissed. 'Good morning,' she said, and walked away.
It took her a while before she worked out exactly why she was so angry with Jack Sinclair. She accepted that he was entitled to be angry with her—she knew surgeons who would have ordered her out of the theatre at once, and then afterwards given her a full-scale dressing-down. And she would have taken it. She had made a mistake.
But this one had neither ordered her out nor dressed her down. Well, not much. In fact, he had tried to help her, which somehow made things worse.
Then she realised why she was angry. There had been no recognition of her as a person in her own right, with a personality. She didn't want this man to fall for her or pay her compliments, she just wanted some acknowledgement that she was a person, not just a hospital employee. All it needed was a smile, a look even, perhaps a small shared joke or some comment about the weather. And she had got nothing.
Jack Sinclair was not to know, but she had come to a new hospital, a new city, to start a new life. Her old life was wrecked and her old ambitions now impossible. At times there was a dreadful feeling that she was only half a woman. Now she had to stand up for herself, the alternative was despair. She would not be bullied or browbeaten by anyone.
The trouble was, Jack Sinclair had neither bullied nor browbeaten her. He had treated her with perfect courtesy. But for him, she was just another colleague. Miranda Gale the person didn't exist. And for some reason—possibly sheer cussedness—Miranda also wanted him to know she was a woman.
Later there was time for a coffee with Annie before she had to start work. Over the past fortnight the two had quickly become friends. Miranda had come to Liverpool's Dell Owen Hospital in late October, thinking that all possible flats, bedsitters, nurses' rooms would already be let. But there had been an advert on the hospital notice-board. Half-share in flat, own bedroom, non-smoker, convenient for hospital. And she and Annie had instantly got on.
'How'd you get on with craggy Jack Sinclair?' Annie asked. She put two large milky coffees on the canteen table, handed Miranda a large sticky bun and sat down, her green eyes sparkling with curiosity.
Miranda shrugged, took a sugar-laden mouthful. 'He was like you said. Polite but distant. And he gave me some reading to look up. Is he always like that?'
'Always. But there are people in the know who insist that he's the man to operate on their children. We get plenty from London and so on, and we've had patients from both continental Europe and America.'
'I see.' Miranda didn't want to know just how good Jack was. 'You said there are three of them—the good the bad and the ugly. If he's the ugly, who's the good and the bad?'
A faint touch of red tinged Annie's cheeks. 'Well, the other two are twins—Toby and Carly. They're both SHOs and they're both in the department. You'll meet them soon enough. Carly is the good. She's quiet, gets on with her job, everybody likes her. Toby is the bad. He's gorgeous-looking, has a joke for everyone, is everyone's friend.'
'So why bad?'
'He's a heart-breaker. I don't think he means to be but he is. He's not really bad, he never encourages anyone, never promises anything he doesn't mean.' Annie grinned. 'I think the feeling among the younger women in the hospital is that for someone as good-looking as Toby to be unattached is a bit of a cheek.'
'Do I take it that this experience is personal?' Miranda asked.
'No, not at all. Well, not really. Two dates and we both agreed that was it. He couldn't have been fairer or nicer.'
'Doesn't sound like his brother. Tell me more about Jack Sinclair.'
Annie drank her coffee then said, 'The two men couldn't be more different. Jack is the older brother. And he cuts the twins no slack at all. He's tough on all us SHOs but he's tougher on those two.' She shook her head in exasperation. 'Like I said, he's a brilliant surgeon, he's a brilliant teacher. But he keeps everyone at a distance. He rarely asks about your private life. He's the strong, silent type.'
'And you say he's not married? He could be...quite attractive.' Miranda felt a small thrill as she admitted this.
'Not married or engaged and never goes out with anyone from the hospital. Sometimes we see pictures of him in the local paper, escorting some glamorous woman somewhere. But nothing seems to come of it.'
'That figures,' Miranda muttered.
It was work that Miranda loved. She was specialling baby Chloe, checking her vital signs, administering her medication, perhaps providing that love that even the tiniest neonate seemed able to sense. For once there were no parents, no relations. Chloe's mother was still in the post-labour ward, her father was hurrying home from an oil rig off the African coast.
They were alone in a side ward, the intensive care room of SCBU. And Miranda was happy. She made sure the baby was comfortable, checked the drips, did the fifteen-minute obs. All work she had done before, work at which she was expert.
Chloe started to cry, a weak, kitten-like wailing that was all her tiny vocal cords could manage. Miranda waited a minute or two to see if her charge would nod off to sleep again. But no. She was in pain. This was to be expected and the surgeon—Jack—had written out a prescription for a painkiller. Carefully, Miranda administered it by the syringe driver. Then she waited.
Five minutes later Chloe was still crying, and if anything seemed to be in even more pain. Miranda waited another five minutes and the crying still hadn't stopped. Chloe was now showing signs of exhaustion, there was a limit to the amount of crying a baby could do. But the pain was obviously still there.
In her previous hospital Miranda would have increased the dosage of painkiller and then asked a doctor to sign the prescription. She suspected that Jack might not approve of this and so went to find a SHO to fill out the form. And right outside the side ward, purely by chance, she ran into Jack.
So far she had only seen him in scrubs. Now he was in full consultant mode—beautifully cut black suit, pristine white shirt and the college of surgeons' tie. He looked more unapproachable than ever.
He nodded to her, politely but coolly, and prepared to pass. Miranda decided she didn't want to be passed.
'Mr Sinclair, Baby Chloe is crying and distressed. I think perhaps she needs more painkiller. I was going to find a SHO but since you're here and if you're not too busy...'
A change in his face. A small wrinkle between his eyes. He was thinking. And an expression of...concern?
'I'm never too busy to look after one of my charges, Miranda. Let's go and see.'
Miranda blinked as she followed him into the side ward. This was a slightly different Jack Sinclair. He seemed.. .a bit warmer. Maybe she'd imagined it.
The two of them stood side by side, looking at Chloe in her incubator. Miranda was interested to see that he looked at the baby before asking her for the notes. Thinking of the baby as a person rather than a case.
'How long has she been crying?'
'For ten minutes now. The crying is getting weaker but I think that's because she's losing strength.'
He didn't answer at once, but stared at the infant for a few moments more. Then he slid a hand inside the incubator, and with a forefinger stroked aside a tiny wisp of hair from Chloe's forehead. It was a gentle, delicate act.
'I think you're right. He took up a prescription form and quickly wrote on it. 'Give her another five mil. You're an experienced and competent children's nurse. If she's still crying in...how long, Miranda?'
He was asking her opinion? Not like some other surgeons she had met. 'If she's still crying in another five minutes, I'd be concerned,' Miranda said.
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