The following day, Louise has been weaned off the medication. She is to be monitored for twenty-four hours to see how she manages without it. All being well, she’ll be discharged with careful follow-up monitoring. Her blood pressure is being checked every two hours now. Last time Rory rang, it was fine. He strolls onto the ward in good spirits. Everything’s looking up. The danger has passed. Halfway up the corridor, he sees a nurse hurrying from the nurses’ station into Louise’s room. She is carrying a drip. Her face is drawn. Instinctively, Rory quickens his step.
The door to her room is closed. Waiting outside, he spots a doctor in the nurses’ station, who is just hanging up on a call. Rory approaches him. He asks about Louise. And learns that her blood pressure has shot back up. Medication has been restarted and her consultant is on her way.
‘How high is it?’ Rory asks.
‘One-ninety over one-twelve.’
‘How could you let it get so high?’ Rory is furious.
‘We were checking it two-hourly. It was creeping up a bit, but not significantly until the last check when it seems to have spiked.’
‘Can I see her?’
‘Of course. As soon as the nurse is finished.’
When the nurse comes out, he knocks and goes in.
Louise is extremely pale and visibly shaking.
Rory hurries to her side. ‘Are you OK?’ he asks, really concerned.
‘I feel terrible.’ He takes her hand in his. It’s cold. ‘Like something awful’s going to happen. Like I’m going to lose the baby.’ He rubs the back of her hand.
‘My head’s pounding. I’m freezing.’
‘I’ll get you another blanket.’
‘The nurse has just gone for one. My feet have never been so cold.’
He sits on the chair that’s beside the bed. Takes off his socks, lifts the blankets and puts them on for her. ‘They’re not smelly,’ he jokes, to cut the tension. He rubs her feet to heat them up. ‘There.’
‘Oh, God, Rory, I think I’m going to throw up.’
She does, all over herself and the bed.
‘I’ll get a nurse.’
He waits outside while they settle her again.
‘How’s the BP?’ he asks when they emerge.
‘Up a bit.’
‘How much?’
‘Two-ten over one-twenty.’
‘Does she need another steroid injection for the baby?’
‘Dr Greene is just about to give it.’
Rory stays outside while the doctor gives Louise the jab. He has just returned to the room when the consultant arrives in a breeze. She reassures Louise, sitting on the side of the bed holding her hand. Louise looks a little less worried. She also looks puffy around the face, which is not good. The consultant takes her blood pressure, checks the baby monitor, then uses her stethoscope on Louise’s tummy. She smiles at Louise, then looks in the chart.
‘Have you checked the platelets again?’ she asks Dr Greene.
‘Yes, the results should be back any moment.’
‘Ring the lab. I need them now.’
She smiles at Louise again.
‘My head feels like it’s going to blow off,’ Louise says.
‘We’ll get you something, straight away.’ She nods to the nurse who disappears. Then she asks Louise about the headache.
‘Do you have any pain in your abdomen?’
‘No, my back.’
‘Your back.’
Dr Greene returns with the lab results.
‘OK,’ the consultant says to Louise. ‘We’re going to bring you straight to theatre. You have a condition called H.E.L.L.P. Your body is turning on itself, attacking certain blood cells and raising your liver enzymes. We need to get the baby out.’
Louise’s eyes fill with panic. ‘But it’s too soon. The baby…’
‘If we don’t do an emergency Caesarean section now, it’s not just the baby we’ll be worried about.’
Rory can’t believe it. Hours ago everything was fine.
‘Oh, God,’ Louise says, ‘I think I’m going to pass out,’ and subsequently does.
‘Baby’s heart is dipping,’ says the consultant. ‘We need to get her to theatre, now. Is she typed and cross-matched?’
Rory follows the jargon without thinking. They’re preparing units of blood to be on stand-by in case Louise bleeds. Her platelets, the blood cells she needs for clotting, are incredibly low, which puts her at risk of bleeding. They need blood ready, just in case.
Rory is allowed to scrub up and sit at Louise’s head, but out of the way of the anaesthetist. Screens block his view of what is happening further down. He wants to stand, but is afraid he’ll be asked to leave. Everyone is working at lightning speed. He hears the word ‘catheter’; sees the paediatric team arrive and prepare an incubator, a heater, a ventilator for the baby. He prays they will be needed.
‘No foetal heart beat,’ someone says, urgency in their voice, and he wants to get down there, get the baby out himself.
And then the baby is out and over to the paediatrician immediately. Silence. Rory strains to see. But can’t. The baby is surrounded. All he sees are their backs in green theatre gowns. He hears a cry. It is weak. But it’s a cry. And he feels like crying himself, with relief. Someone who has been blocking his view moves. Rory sees that the baby has been ventilated and put in the incubator, or the other way around, he’s not sure how it happens. But it has happened. Already. So fast. Someone blocks his view again. And then he is being called over.
‘It’s a girl,’ a voice says. He doesn’t look up to see who is speaking. Can’t take his eyes off their little girl. Their tiny, tiny girl. No bigger than his hand. As delicate as an eyelash. And he now experiences for the first time the proud and simultaneously vulnerable feeling of being a father.
‘We’re bringing her to the Neonatal Intensive Care Unit now,’ the paediatrician says.
Still dazed, Rory looks up, his actions delayed.
‘You can come see her later.’
He is just taking that in when they wheel her away in the incubator. That’s when it occurs to him: he never spoke to her; he never said ‘hello’.
‘We have a bleed,’ someone says behind him, urgency in her voice.
Rory looks back to Louise. Everyone is huddled around. Panic rises in him.
‘Where is it coming from?’
‘Check the liver.’
‘Sponge.’
‘I see it. A laceration.’
‘Breathing’s too shallow. I’m ventilating her,’ a voice from the top of the table. The anaesthetist.
‘BP falling.’
A theatre nurse, rushing from the operating table to fetch something behind Rory, becomes aware of him. Her eyes widen behind her mask. ‘I think it’s time for you to go see your daughter,’ she says, never stopping from her task.
‘We need to transfuse her. Are those units ready?’
The theatre nurse, having delivered whatever it was she was asked to, comes to Rory, takes him by the arm and begins to escort him outside.
‘BP eighty over sixty.’
Only too aware of what a sudden severe drop in blood pressure can do, Rory feels his legs weaken. He wants to stay. He wants to help. He looks back, while still being walked towards the doors.
The last words he hears are, ‘We can’t operate now. We need to stabilize her. Pack the liver and close her. Get those units. Turn up that IV.’
37
He stands outside the theatre. Overcome. For minutes he doesn’t move. When he does it’s to remove his mask so he can get air. He looks back at the doors shut firmly behind him. And his vision becomes blurred by tears. He hadn’t really worried about Louise, all along it was the baby. And now she’s in there fighting for her life. What if he loses her? He can’t bear that thought. So he blocks it and begins to walk. She’ll be all right, he tells himself. She’ll be all right. They know what they’re doing.
It doesn’t take long to find the Neonatal Inte
nsive Care Unit. It’s close to the theatre, for obvious reasons. So many instructions on the doors. He can’t read any of them. He rings the bell outside and leans against the wall. After a few moments, a nurse comes out. When he explains who he is, he’s told that the doctors are ‘working on’ his daughter. He’ll have to wait. She shows him to a room and tells him she’ll come for him as soon as the team is finished.
He doesn’t want to think. He reaches for a magazine, stares at the cover but sees the operating theatre. Hears the voices. Then hears his own: they don’t know what they’re doing. A bleeding liver is a surgical emergency, requiring a surgeon not an obstetrician. What experience does she have of stopping the flow of blood from the body’s most vascular organ? When the liver bleeds, it bleeds. Can it even be stopped in a person whose platelets are as low as Louise’s?
At first, he does not hear the nurse calling his name. Then he does. He gets up, his face expectant. Does she have news of his daughter?
The nurse smiles, holds out her hand. ‘I’m Emer Devine. I’m looking after your baby. Would you like to see her now? You’ll have to wash your hands and put on a gown. Come with me. I’ll show you where everything is.’
‘Is she all right?’
‘She’s doing well. But will need a lot of care. She’s very premature.’
He removes the theatre gown he had forgotten he was wearing, puts on another, washes his hands. The nurse warns him that he might find it a bit upsetting as the baby is attached to a lot of tubes and machines. He barely hears her as they walk through the unit. In a daze, he looks at the other babies and their parents. It is quieter here than in the operating theatre, but by no means peaceful. It has its own subtler tension. An alarm goes off on a monitor beside a baby and a nurse reaches to turn it off. The baby’s mum does not look startled. It’s as if this happens all the time and nothing surprises her any more.
And now he is here, beside his own child, so small and fragile. Hooked up to wires, tubes, lines and monitors, unmoving except for her chest, which rises and falls in response to the ventilator. The sticky pads applied to her chest are the size of cents. Rory tries to ignore the circus around her and focus on the miniature person, lying on her side, naked except for a little white cap and the tiniest nappy he has ever seen. Her legs, bent at the knee, are no bigger than his index finger. He is stunned at the perfection.
‘Isn’t she beautiful?’ the nurse, whose name he has forgotten, says. And already she is back to work, checking a monitor and taking notes.
‘Will she be OK?’ His voice is hoarse.
She stops what she is doing. ‘We will do everything we can to make sure…’
‘She’s only twenty-five weeks.’
‘We have had babies make it who were twenty-four.’
He looks hopeful. ‘Really?’
She nods. ‘It is possible. All I can guarantee you, though, is that we will do our very best.’
He knows the risks – brain damage, lung damage. ‘She is almost twenty-six.’
The nurse gives him a that’s-the-spirit smile. ‘How’s your wife doing?’
It is like a hammer to his chest. He looks down at the baby. Can’t speak.
She seems to understand and follows his eyes. ‘She’s sedated because she’s on the ventilator.’
‘Oh,’ he says, though he knows all this. He looks at the tiny fists, the tiny, tiny feet and the little pink name bands that say that she’s theirs.
He is sitting in a chair, beside his daughter, trying to keep sleep at bay when he sees Louise’s obstetrician heading in his direction, her face deadly serious. Suddenly awake, he stands.
‘How is she?’
‘I’m sorry we had to ask you to leave…’
‘How is she?’
‘We did our best, but I’m afraid we’ve had to transfer her to St Paul’s Hospital to the liver surgeons there.’
‘Are they operating?’
‘I’m afraid Louise is not well enough at the moment. She’s in ICU. We managed to stem the bleeding, but she has lost a lot of blood. Her blood pressure dropped considerably. She had no urinary output when she was leaving.’
‘Her kidneys…’
‘We have to look at possible renal damage. The renal team at St Paul’s is being consulted.’
At least it’s St Paul’s. One of the guys on the renal team is a mate. Rory’s not so familiar with the surgical team, but he probably knows them by sight.
‘Could I go over there now?’
‘Maybe you should ring the ICU. Check with them first.’
He nods.
‘She is still unconscious. She’s still on a ventilator.’
Leaving the NICU, the nurse who introduced herself as Emer follows him out.
‘I just wanted to check. Would you like the baby baptized?’
He stares at her. Baptized? She just said that twenty-four-week-old babies can survive. This baby’s not going to die. She’s not going to need baptism. But how can he be sure? What if his baby is not one of the lucky ones? And what if there is a heaven? Would denying baptism mean denying entry? Surely no God would allow that? If so, where the hell is James?
‘Yes. Yes, go ahead. Please.’
She smiles. ‘OK. We’ll see you soon.’ She turns to go.
He starts to take off his gown. ‘But then,’ he calls after her, ‘should I be there?’
‘No. No, it’s fine. You go on.’
He nods.
He drives through the night, eyes stinging, lids heavy, trying not to think of what is waiting for him or what he left behind. When he reaches ICU, he has the same problem. He’s not allowed in. The doctors are working on Louise.
‘Are you a relative?’ a nurse asks.
‘I’m her next of kin,’ he says to avoid detail.
‘I’ll let the doctors know you’re here. One of them will be out to you as soon as they can. Take a seat.’
There’s a line of them against the corridor wall.
Rory has waited thirty minutes and is nodding off when someone taps his shoulder. He looks up. Thank God for a familiar face. Niall O’Neill and he went to college together. Niall sits beside him.
‘How is she?’
Niall’s face is grim. ‘She’s had a major bleed, Rory. She’s in severe shock. The ventilator’s doing ninety per cent of her breathing. There’ll be organ damage. Kidneys. Maybe liver. We’re trying to stabilize her so the surgeons can go in and fix that laceration. The next forty-eight hours are critical. I’m sorry.’
‘Can I see her?’
‘For about a minute. We’re still working on her.’
He follows Niall into ICU. But the patient he is walking towards is not Louise. It couldn’t be. Only the name above her head says it is. She is unrecognizable, face and arms bloated from retained fluid, closed eyelids looking blistered. Her skin is deathly pale in contrast to the bruises that line her arms from where they took blood. In seconds, he logs the various machines and monitors she is hooked up to, the empty catheter, the blood transfusion. Nurses and doctors are busy taking samples, checking monitors, administering medication. Keeping out of their way, he goes to the head of the bed. He has one minute. But wants to say so much. He kisses her forehead. Into her ear he says, ‘We’ve a little girl. She’s so beautiful, Lou. You have to wake up and see her. She’s so like you.’ He closes his eyes and stops for a moment. ‘She needs you, Lou. She needs you to be here. I need you.’ He should have said it before. He should have said it at his father’s funeral. He should have swallowed his pride and had her back in his life on whatever terms.
Niall’s hand is on his shoulder.
He doesn’t want to leave.
‘Rory.’
‘OK.’ And he drags himself away.
Two hours after he has crashed exhausted onto his bed, his alarm goes off. It takes him a moment to remember that his reality is worse than his nightmare. He showers himself awake and calls the hospital. He is taking a week’s leave of absence. He thinks about
calling his mother to let her know what’s happened, but it’s early. The phone ringing at this time would worry her. He considers calling Siofra, who will be up, getting ready for her crack-of-dawn commute. No. His mother should hear first. From him. He grabs his keys.
When he reaches the ICU, relatives of other patients are sitting in a line on the corridor outside. A procedure is in progress, he is told. No one is allowed in. Rory knows by the way they look at him that Louise is the beneficiary of the ‘procedure’. He worries what it might be. Worries that her condition might have worsened. When the door to the ICU finally opens, Niall comes out, looking almost as drained as Rory.
Rory stands up, ready to go in.
‘Not yet,’ Niall says. ‘The renal team is putting Louise on dialysis.’
Rory looks at him.
‘Her kidneys have shut down,’ Niall says.
Rory sinks back down on the seat.
‘Let’s go for coffee,’ his friend says.
‘That bad, eh?’
‘Rory, I’m not going to lie to you. It’s not just the kidneys. Her liver function tests are dismal. It looks as if she’s going into liver failure as well.’
‘She can’t be.’
‘She’s heading for multi-organ failure, Rory.’
Which means her chances of survival are minimal. Rory is desperate. He stands. ‘I have to see her.’ To tell her how much he loves her. That he’s sorry. He has to talk to her. He didn’t get a chance with his father. He’s not going to let it happen again.
‘Not now,’ Niall says. ‘Look, I’ll be out to you as soon as I can.’
Rory’s eyes follow him until he disappears. Then starts to blame himself. This is his fault. He wanted a baby. And made Louise pregnant. There’s no such thing as accidents. Throat burning, eyes smarting, he paces the corridor, gripping the back of his neck. What can he do? How can he help? His distress is palpable and even the relatives sitting in a quiet line burdened with their own worries give him empathetic glances. A chaplain walks quietly into the ICU. Then a nurse comes out to Rory to ask if he thinks that Louise would like the Last Rites. No, he wants to shout, because she’s not dying. She doesn’t need Last Rites because she’s going to make it. But that is not what he says. He simply tells the nurse to go ahead. For the same reason he told them to baptize his daughter. There might be a heaven.
Do You Want What I Want? Page 29
