The Scarlet Sisters

by Helen Batten

I was bleeding everywhere, but the ambulance ladies were cheery. They merrily remarked away as we sped off: ‘You’re lucky, you know, this happening at three in the morning. No traffic. It’s murder down here during the day.’

  All I could do was nod and raise an eyebrow because I had an oxygen mask strapped over my face.

  ‘First baby?’

  I nodded.

  ‘Know what it is?’

  ‘Girl,’ my husband replied. I noticed he was rubbing my hand hard. If he continued much longer it would rub away.

  ‘Last quiet night you’re going to get.’

  ‘You call this quiet?’ I tried to say through the mask.

  The ladies laughed and I noticed a look of complicity pass between them. They looked to be in their late thirties. ‘They’ve both got children,’ I thought. I couldn’t believe they were talking as if my baby was going to be OK.

  We arrived at the hospital, where there was a midwife expecting me. Quickly she wheeled a heartbeat monitor over and strapped me up and before I had time to think about the implications, there was the rapid, thump, thump, thump, of a baby’s heartbeat.

  Poppy’s heartbeat.

  ‘Your baby’s alive!’ She sounded as surprised as I was.

  ‘Really?’

  ‘That’s your baby’s heartbeat.’

  I couldn’t believe it. It didn’t seem possible.

  ‘So now we need to get the baby out as quickly as possible.’

  She went over to the phone and started making calls. I could hear the words ‘registrar, theatre, anaesthetist and blood’ and for the first time the words ‘placental abruption’.

  All the time Poppy’s heartbeat was echoing around the room – thump, thump, thump.

  A woman in a white coat hurried in, followed by some figures in theatre gowns. And then they were wheeling me out of the room. I caught a last glimpse of my husband, shell-shocked in the corner, left behind. Later he told me that the midwife had said:

  ‘They usually manage to save the mother, not the baby.’

  Suddenly I was plunged into an episode of ER with myself in the leading role. The trolley picked up speed and we went flying down the corridor, the anaesthetist running along, trying to keep level with my head: ‘When did you last eat?’

  ‘Not since last night.’

  ‘No. I need to know what time exactly. Please try to remember, this is really important.’

  ‘About eight o’clock?’

  ‘And anything to drink?’

  ‘Yes, a cup of tea a bit later.’

  ‘Uh. OK, that should be OK … oh God, I’m sure there’s something else I should ask you. Yes! Are you allergic to anything?’

  ‘No. I mean yes – cats. But that’s not relevant, is it?’

  ‘No. Now, we’re going to have to put you out very quickly.’

  ‘You mean a general anaesthetic?’

  ‘Yes.’

  ‘I really would prefer a local anaesthetic. Can my husband be there?’

  ‘No, I don’t think you understand. This is not a matter of choice.’

  ‘Please,’ I begged. ‘I really don’t want a general anaesthetic. Is there any other way?’

  ‘No. Believe me, this is serious.’

  Within minutes, I was staring at the ceiling of the operating theatre. Everyone was shouting.

  ‘Registrar is on his way!’

  ‘Have you rung SCBU?’

  ‘Paediatrician on the way!’

  ‘Where’s the blood? Why haven’t you ordered the blood?’

  They were shouting at a small junior doctor, who looked really harassed.

  ‘I’ve got to get the consent form signed.’ She waved a piece of paper in front of my face. ‘You need to give consent for us to perform a hysterectomy.’

  ‘But, hang on … I’m not sure …’ I started to say.

  ‘Look, this is to save your life. Otherwise you will die. You have no choice. For God’s sake, just sign quickly.’

  I signed the form. And the thought that went through my head was: ‘Please God, just let me live. I must just concentrate on surviving and I’ll worry about the rest of this later.’

  The registrar walked into the room. He was pulling on his surgical gloves as he swept in. I saw a young face behind a mask. He rolled his eyes at me and shook his head as if to say ‘What sort of a mess have you got yourself into?’ He immediately started barking questions at the theatre staff, the numbers of which seemed to be growing all the time.

  I noticed a large, complicated incubator being wheeled in.

  ‘Right, I’m going to put you to sleep now. It’s going to be a bit fast and a bit uncomfortable. I’m sorry – I’m going to have to press hard on your neck.’ The anaesthetist put her thumb at the bottom of my throat, and started counting down: ‘Ten … nine … eight …’

  And I repeated over and over in my head: ‘I want to live. I want to live. I want to live.’

  ‘Seven … six …’

  Everything cut to black.

  Six months after the surgery, I was left with my hospital notes by accident. They were impressively thick. I knew I shouldn’t, but I started reading them and it was like going back to the start and reliving every step in gruesome, technical detail. I struggled a bit with some of the medical terms, but the impression I got was that I had been in a bad way when I arrived. I had lost a lot of blood – over a third – and it had been coursing around inside my body with the potential to wreak havoc for hours.

  But it hadn’t. I was in one piece. I did survive and they didn’t have to perform a hysterectomy. At that critical moment the line of the Scarlet Sisters was saved – the daughter’s daughter’s daughter survived and thus went on to have more daughters.

  Nanna and I never did talk about that call, the one that in jumping up to answer it caused my placenta to break away from my womb, with catastrophic consequences. Did Nanna anticipate or precipitate? Did she have a premonition I was about to be in trouble, or did she inadvertently cause it?

  The senior midwife at the hospital said it had been an accident waiting to happen: ‘You’re just lucky you were safe at home and not on that plane to Italy. You’re lucky to be alive.’

  I came round from the operation as I was being wheeled from the theatre. I was lying on a trolley and crying with relief. Literally crying, as I woke up. The first thing I saw was my husband peering into my face as we moved through the corridors.

  ‘She’s alive, she’s alive,’ he kept saying.

  ‘Who?’ I thought. Then I thought, ‘Ah, yes, but what about me? I’m alive. I’m alive too.’

  ‘She’s called Poppy,’ he said. I was struck by his agitation. I had never seen him so ruffled. ‘I hope you don’t mind. We can change it to Daisy. But I had to call her something. They needed a name for labels and things and in case … well, I just thought it suited her. Is that OK? You don’t mind?’

  It crossed my mind that he had done it for me; he had wanted to call her Daisy. So I knew he’d called her Poppy because he felt he owed me. And I appreciated the gesture.

  So Poppy she stayed.

  ‘The darkest hour is just before dawn’ is a line from a song by The Mamas & The Papas – ‘Dedicated To The One I Love’. Every time I hear it, I see that room: the high dependency unit they took me to after the operation, the pitch-black after the bright lights of the corridors. Time is definitely not absolute, but bendy; and that night it stretched for ever.

  I drifted in and out of consciousness. At one point I woke up to find my husband lying beside me, face down, sobbing, his thick curls shaking with emotion. We held each other and cried. There was nothing to say, just raw grief. I had never seen him cry like that. I knew why I was crying – for myself – and I wondered for whom he was crying. For me? For Poppy? For him? I still don’t know the answer.

  I woke up and daylight was pouring into the room. It was morning, and Mum was standing beside my bed. I was twenty-nine years old and I suddenly realised that there was no one else i
n the world I wanted more.

  She grabbed my hand and held it tight and I felt the power of maternal love. ‘How did it happen? I mean, I only spoke to you last night and you were fine and I went to bed reassured that you were doing well, and then I’m woken up by a phone call and you’re in here and nearly dead and had the baby. I just don’t understand.’

  Poor Mum. I didn’t understand it either.

  My husband was in and out of the neonatal unit, phoning people, buying me a toothbrush, so it was Mum who sat with me and never left my side. She was there when the doctors swept into the room, the consultant in his suit surrounded by junior doctors.

  ‘Morning, how are you feeling?’ he boomed, and didn’t wait for a reply. He launched into a summary of the whole situation and finished with the words: ‘So it seems Mrs Batten was suffering from pre-eclampsia after all, but luckily we have a successful conclusion.’

  The junior doctors all looked a bit shocked and there was silence.

  Then Mum spoke up, in icy tones. ‘It doesn’t look very successful to me. A daughter who nearly died and a very premature baby fighting for her life. If you call that a success, I’d hate to see a failure.’ My mum – the mouse who occasionally roars.

  The consultant made a swift exit.

  After the doctors came the express machine. The nurse wheeled this lumbering contraption over to my bed and told me I was going to have to try and express some milk. I had no idea what she was talking about. A woman milked like a cow? I was to connect that industrial radio transmitter to my breast? And turn it on? Mum and I got the Swain giggles as a rather serious nurse demonstrated its terrifying suction capacity. But something did come out in the end. Mum looked impressed; I was amazed. It’s funny how you can be surprised by your body doing what it’s supposed to do.

  But there was something we were both avoiding – my baby. Up until the afternoon, there had been no suggestion that I should go and see her. Actually, I didn’t want to. I think while I still hadn’t seen her, I could pretend that this was only about me, and I seemed to be fine. Something told me whatever was happening down the corridor couldn’t be good. All those hours Poppy had been deprived of oxygen, bleeding.

  My husband told me the doctors had said she was OK. I didn’t believe them.

  When the medics had decided I was stable, it was impossible to put the visit off any longer. ‘Right, time to get you up. Time to see your baby,’ the nurse chivvied me along. She could see my reluctance.

  My husband raced me down the corridors, pushing my wheelchair at speed. He explained the tight security, how you had to ring the buzzer to get into the unit, the special way you had to wash your hands before and after each visit, not to be scared by all the wires.

  As he wheeled me into the room I felt self-conscious. The nurses were looking at me. Out of the corner of my eye I could see other mummies staring at me curiously. I felt vulnerable, in my wheelchair, hospital gown and catheter jangling alongside.

  There were just four incubators in the room: two on the left and two on the right, and each was dwarfed by an amazing collection of machinery – drips, monitors, ventilators, wires everywhere. The room was brightly lit and noisy, the pop music coming from a radio was all but drowned by a cacophony of electronic bleeping and alarms. I was pushed up to an incubator right at the back.

  I could just see a tiny body. She was lying on her front, wearing a little bonnet that was tied under her chin; then there was a smooth red back, a nappy, and a face with a tube coming out of the mouth – her ventilator.

  I felt nothing.

  No connection.

  Here was my baby in front of me – believe me, a twenty-six-week-old baby is a proper baby; just very tiny, the size of two hands. Everyone was watching me.

  ‘Shall I lift you up so you can have a better look at her?’ my husband asked. He took my arm as I gingerly stood up from the chair.

  I could see her better. Amazingly her eyes were open, but I still felt nothing. If you had asked me to pick out which of the babies was mine, I wouldn’t have been able to.

  The nurses came over and introduced themselves. Parvati was Poppy’s key carer. She was the one who had collected her from the theatre and helped bring her back to life. She explained the monitors, the routine. She showed me the room where I should go to express my breast milk so they could give it to her fresh – the most important thing I could do for her. They already had a roll of labels with ‘Poppy Batten’ written on them, ready to stick on her bottles and pop into the fridge.

  Seeing my baby’s name, written like that … she had officially come into existence, and I couldn’t get my head around it.

  The one thing Parvati didn’t talk about was Poppy and her prognosis – whether she was going to live or die. I felt they were avoiding the subject and I couldn’t bring myself to ask. ‘The paediatrician will come and talk to you about Poppy,’ Parvati said. What she did tell us was to look after ourselves; that whatever the outcome, this was going to be a rollercoaster ride.

  In the afternoon they wheeled me down to the ordinary postnatal ward. There were new mummies surrounded by flowers, balloons, excited relatives and each with a new baby in their arms. Everyone was casting me furtive glances, wondering where my baby was. I was stuck and it was messing with my head. My husband brought me a Polaroid photo the nurses had taken of Poppy to have beside my bed. I lay and stared at it. All I had was white noise going on in my head. I prayed for sleep and escape.

  Mum was back with me by the time the consultant was doing his rounds the next morning.

  He ignored her. ‘Mrs Batten, the results of your blood tests have come back and it seems you are anaemic. You need to have another blood transfusion.’

  I’d made a documentary about mad cow disease a few years before and a little knowledge is a dangerous thing. ‘When you say I need another blood transfusion, do you mean that my life is in danger if I don’t have it?’ I said.

  ‘No, not at all, but your recovery will be much quicker. If you have the transfusion now you will feel better straight away.’

  ‘In that case I won’t have it.’

  ‘Why on earth not?’

  ‘CJD, for a start.’

  He was taken aback. ‘What utter nonsense. You can’t get CJD from a blood transfusion. You can’t get anything from a blood transfusion. It is one hundred per cent safe.’

  ‘I’m sure that’s what they said before they discovered HIV.’

  Now he did look cross. Actually, I couldn’t believe my own contrariness. But I didn’t trust him.

  When he had left a tall, pale woman in a white coat strode over. ‘Mrs Batten?’

  ‘Yes.’

  ‘I’m the physiotherapist. I’ve come to give you some exercises to help your body after your caesarean. Where’s your baby?’

  ‘Here,’ I said, pointing to the photo beside my bed.

  She walked over to the other side of my bed and picked up the photo. She stared at it for a few moments and then just handed it back with a sad expression on her face. ‘I tell you what, I’ll come back later to do these exercises,’ she said.

  And that was the last I saw of her.

  ‘She thinks Poppy’s going to die,’ I thought.

  I realised I still hadn’t seen the paediatrician.

  It was the woman in the bed opposite me who pushed me over the edge. She kept pestering the midwives about her baby.

  ‘He’s got bandy legs.’

  ‘Don’t you think he’s cross-eyed?’

  ‘I’m sure there’s something not quite right.’

  I couldn’t believe it when, within minutes, a paediatrician appeared. Mum and I watched while he gave the little boy a thorough examination.

  ‘I can assure you, you have a perfectly normal, healthy little boy.’

  ‘But look, doctor. Look at his legs. They’re bandy.’

  ‘No, they’re not.’

  ‘Well, he’s definitely squinting.’

  ‘He’s just been born.
’

  ‘Is that what they’re supposed to look like?’

  ‘Yes.’

  It suddenly occurred to me that maybe no one had come to see me because no one had been to see Poppy. She was lying in her little incubator, forgotten, with just a few machines pumping away, keeping her alive.

  I started to howl.

  The midwife strode over. ‘What’s the matter with her?’ she asked Mum.

  ‘What do you think’s the matter with her? My daughter had a very premature baby yesterday and not one doctor has come to see her to tell her how her baby is!’

  ‘She hasn’t talked to the paediatrician yet?’

  ‘No.’

  ‘Well, he was in here just a minute ago.’

  ‘Oh, yes, we know he was here. But not to see us. He was seeing that lady opposite about her baby’s bandy legs.’

  The midwife got the message.

  Five minutes later the paediatrician reappeared, full of apologies. There had been lots of crossed wires but Poppy was not forgotten at all. I forgave him because he was terribly nice and a little bit handsome. He sat down on my bed with a bunch of charts. I studied every move of his face.

  The first prognosis was good. Unbelievably good.

  Poppy was twenty-six weeks old when she was born. This was crucial. At twenty-three weeks, 90 per cent of babies die, but by twenty-six weeks, 80 per cent survive.

  Ten years before, hardly any babies born before twenty-eight weeks lived. Their lungs didn’t work and they were very vulnerable to infection. Then someone developed steroids that could be given to a baby in the womb which would activate the baby’s lungs, kick in the immune system and basically prepare the baby to come into the world. And the results were amazing. Overnight survival rates rocketed. No one knew the long-term effects of these steroids, but so what? Babies who almost certainly would have died now had a fighting chance of life.

  But Poppy didn’t get those steroids. Moreover, all those hours with my uncomfortable tummy had meant that Poppy had been deprived of oxygen. In theory, she should not have survived at all. But somehow they had managed to bring her back to life and they had found a baby in excellent condition. A strong, healthy, fighter of a baby. Poppy was big – 2lb 1oz – the size of a twenty-eight-week-old baby, and all her vital organs were working.