by Sarah Morgan
It was Hayley, wearing the dark blue scrub suit that all the midwives wore, her dark hair fastened haphazardly in a twist at the back of her head. ‘I’m sorry to interrupt you—I’ve just seen a woman who is thirty-six weeks and I’m worried about her. She says she has flu—she’s been ill over Christmas.’
‘Another one?’ Maggie sighed and walked towards the door. ‘The Lake District is simmering with germs at the moment. I still have three midwives off sick.’
Patrick was looking at Hayley, trying to keep his mind on the job. ‘You’re worried?’
‘Yes. I don’t think it’s flu.’
‘What are her symptoms?’
‘Vomiting, epigastric pain, headache, shivering.’
‘Vomiting? Could be norovirus,’ Maggie murmured, but Hayley shook her head firmly.
‘It could be, but I don’t think it is. Her face is swollen, and she looks…’ Hayley shrugged. ‘I don’t know—I just have a bad feeling. I think she could be showing signs of pre-eclampsia.’
Maggie checked the list in her hand. ‘What’s her name? Who is her consultant?’
‘She isn’t local. That’s the other reason I’m worried. She told me that she was checked in clinic just before Christmas. They told her that a certain amount of swelling is normal, but her ankles are so bad she’s having to wear her husband’s slippers.’
Patrick stood up. ‘She’s staying up here?’
‘With her family over Christmas. And in the last week she’s put on 4.5 kilos.’
‘It is Christmas,’ Maggie said cautiously. ‘I haven’t dared stand on the scales myself, but I’m willing to bet that—’
‘No.’ Hayley interrupted her with a brisk shake of her head and Patrick found himself wondering how she could be so confident in her work and so under-confident in the rest of her life.
But that was the impact of her step-siblings, he thought, knowing only too well what damage family could do.
‘I know it’s Christmas,’ Hayley said, ‘but I’ve questioned her carefully and she hasn’t eaten much—she’s been feeling too ill.’
Patrick was already by the door. ‘Blood pressure?’
‘She says it’s been “high normal” for the past two months but the hospital didn’t seem to think there was any reason to worry. It’s 140 over 100.’
‘Urine?’
‘Trace of protein.’
‘I’ll take a look at her before I start clinic. Maggie, do we have an antenatal bed should I need one?’
Maggie sighed and pulled her notebook out of her pocket. ‘Yes, because Tom is going to discharge his twins lady this morning once Paeds have checked the babies.’
‘Good. I’ll let you know if I’m going to need it.’ Patrick followed Hayley out of the door and into the next room.
‘Charlotte, this is Patrick Buchannan, the consultant.’ Hayley picked up the notes and handed them to Patrick. ‘Charlotte carries her own notes.’
‘Which is helpful.’ Patrick scanned the notes, picking out the information that he needed. ‘Hayley, there’s no record of a platelet count from the day assessment unit—could you call them and see if they did one? It might just not have made it into the notes.’ He listened as Charlotte outlined what had happened, and by the time she reached the end of her story Hayley was back.
‘They only do it on new hypertensives.’
Patrick glanced at the blood-pressure reading in the notes but decided not to worry Charlotte by verbalising his thoughts. ‘All right, so we’ll start fresh. I want to do an ultrasound now, and then I want to do a full blood count and check liver function and renal function.’ While Hayley fetched the ultrasound machine, Patrick turned back to the woman on the bed. ‘I agree with Hayley—I don’t think this is a virus.’
Charlotte exchanged glances with her husband. ‘But I saw my GP in London before I left and he just said there was a lot of it around—everyone is ill.’
‘That’s true,’ Patrick said carefully, ‘but in this case it’s something different.’
‘You think it’s the baby?’
‘Yes, I do. Have you heard of pre-eclampsia?’
Charlotte shook her head. ‘No.’
‘It’s a condition that occurs only in pregnancy and it causes a number of changes in your body, including high blood pressure and a leakage of protein into your urine.’
‘But I felt fine until just before Christmas—surely it’s more likely to be a bug?’
‘In its early stages it has no symptoms, but as the condition becomes more serious a woman is likely to experience changes—for example, headaches, stomachaches, vomiting, sometimes visual disturbances.’
Charlotte stared at him. ‘I saw flashing lights for a short time yesterday evening.’
Patrick kept his expression neutral. ‘Right. Well, that might be related. The swelling may also be related.’
‘My doctor told me that no one takes any notice of swelling now—that it’s normal for pregnant women.’
‘It can be normal,’ Patrick agreed, preparing the ultrasound machine. ‘But it can also be a sign of problems. In fact, all those symptoms I just mentioned can be attributed to other causes, which is why the condition can be missed. I want to start by looking at the baby and the placenta, Charlotte. Has the baby been moving?’ As he performed the scan he kept questioning her, his eyes on the screen. ‘All right, there’s the baby’s head—and his heart—and that’s the placenta.’
Charlotte peered anxiously at the screen. ‘It all looks like a squirmy mess to me. Does the baby seem all right?’
‘The baby seems fine.’
Charlotte’s husband cleared his throat. ‘So how do you treat pre-eclampsia?’
‘You can’t treat it. You can manage it…’ Patrick pushed the ultrasound machine away from the bed ‘…but basically the condition ends when the baby is delivered.’
‘But I have another month to go!’
Patrick sat on the edge of the bed. ‘Charlotte, you need to prepare yourself for the fact we may need to deliver the baby sooner than that. At thirty-six weeks, your baby is well developed and should have no problems at all. We have to balance all the factors.’
‘All right. Obviously I want to do what’s right for the baby,’ Charlotte said nervously. ‘So what happens now?’
Patrick stood up. ‘I’m going to arrange for you to be transferred to the labour ward. Then I’m going to do a series of tests and when I have the results I’m going to decide what the best course of action is. In the meantime, I’m going to give you something to lower your blood pressure and Hayley is going to stay with you and monitor both you and the baby.’
Charlotte’s eyes filled with tears but before Patrick could speak, Hayley slipped her arm round Charlotte’s shoulders and gave her a hug. ‘You poor thing, this must be such a shock for you,’ she said soothingly, ‘but it will all be fine. I’m going to take you upstairs and make the room cosy, and we can have a good chat. You can tell me everything about your Christmas.’
She was so tactile, Patrick thought to himself as he stood up and picked up the notes. As sensitive with the patients as she was with his children.
‘One of my team is going to come and take some bloods from you,’ he told Charlotte, ‘and I’ll be up to talk to you later. Hayley, let’s give her some labetalol.’ He scribbled on the drug chart and handed it to Hayley, who followed him out of the room.
‘You’re worried too, I can tell. You’re treating a borderline blood pressure.’
He gave a faint smile. ‘I am. I’m sure my colleagues would frown with disapproval.’
‘You think her condition is worse than it appears.’
‘Yes, I do,’ he said frankly. ‘I think her blood pressure is going to rocket.’ He heard her sigh with relief at his response and then she stood on tiptoe and impulsively kissed him on the cheek.
‘I was afraid you might not take it seriously. That’s what I love about you—I mean like,’ she amended hastily. ‘Obviously I mean li
ke, not love. What I like is that you follow your instincts and don’t just rely on tests and machines.’ She was delightfully flustered by her slip and Patrick wondered what she’d say if she knew that his instincts were prompting him to behave in a deeply unprofessional way. In fact, if he followed his instincts at the moment there was a strong chance he’d be arrested and struck off simultaneously.
Obstetrician interrupts busy clinic to have steamy session with midwife.
‘We’ll watch her for the next hour and see how she goes, but I’m ready to deliver that baby if it becomes necessary.’ His eyes lingered on her face for a moment. ‘You did well. It could easily have been a virus at first glance. What made you suspicious?’
‘I’m hyper-sensitive to it. I’ve looked after a woman with eclampsia before.’ Her eyes misted. ‘We lost her, Patrick. The only time I’ve ever lost a patient. And she wasn’t our patient—it was similar to this situation. She was visiting her sister in Chicago and she had a fit. It was awful. Truly awful. That poor father, the baby…’
Patrick reached out and touched her shoulder and then wished he hadn’t because the chemistry was instantaneous. He stepped back from her at exactly the same moment she stepped back from him. ‘Take her upstairs and get her on a monitor,’ he said roughly. ‘I’m going to start my clinic and once the results are back I’ll come and see her. But if there is any change, call me.’
Patrick arranged the tests immediately. While they were waiting for the results, Hayley settled Charlotte into the room, trying to make her comfortable.
‘I wish Patrick Buchannan was my consultant,’ Charlotte said as she flicked through a magazine that Hayley had given her. ‘He’s very approachable, isn’t he? And gorgeous to look at—not that I’m interested in that, of course.’
Hayley smiled as she checked the woman’s blood pressure once more. ‘I should think you have other things on your mind at this point.’
‘Is he married?’
Hayley felt her heart miss a beat. ‘No,’ she said carefully, ‘he isn’t.’ And that meant he was free to marry her. And no matter how hard she tried to rein in her mind, she had an average of a million fantasies an hour, all of which involved her walking down the aisle towards him. He’d be stunned by her beauty, of course, and for once she was going to manage not to fall over—
‘Hayley?’
‘Sorry? What did you say?’ Blushing, Hayley pulled the CTG machine closer to the bed. ‘I’m going to monitor you for a while, Charlotte, is that all right?’ She must stop thinking about marriage! Technically she’d known him for about a week. And that one night, of course. But that probably didn’t count because they hadn’t done much talking. Either way, it had been a short time. They needed to get to know each other slowly, and maybe then—
‘I asked you whether he’s the sort of doctor who can’t wait to do a Caesarean section.’
‘No.’ Hayley frowned. ‘None of the doctors here are like that.’
Charlotte sighed. ‘Back home I never see my actual consultant anyway. Every time I go it’s someone else.’
‘That happens sometimes.’ Hayley didn’t add that the ‘someone else’ who had seen her last time hadn’t done their job properly.
‘I wouldn’t mind being one of Dr Buchannan’s patients.’
‘Mr Buchannan.’ Silencing the wedding bells in her head, Hayley adjusted the machine. ‘He’s a surgeon, and we call surgeons Mr.’
‘Oh—yes, of course. I knew that. I think.’ Charlotte shifted slightly on the bed, looking at Hayley anxiously as the sound of the foetal heart pulsed around the room. ‘Does that sound all right?’
‘Sounds good.’ Hayley checked the trace and then Charlotte’s blood pressure.
‘So how long have you worked here?’
‘Actually, I arrived just before Christmas. Before that I was working in the States.’
‘Oh. Are you here for good?’
Was she?
She hadn’t actually given any thought to the future. Technically her job as their housekeeper was going to come to an end in a few days but no one had mentioned her moving out. And she couldn’t imagine living anywhere other than High Fell Barn.
Perhaps the children would slowly just get used to the idea that she lived with them and from there it would be a natural progression for her and Patrick to get together.
Hayley was about to indulge in another brief wedding fantasy when Charlotte suddenly went rigid and started to fit.
‘Oh, God, no, don’t do this to me,’ Hayley muttered, slamming her hand onto the crash button while supporting Charlotte to make sure she didn’t fall off the bed.
The door swung open and Maggie ran in. ‘What’s happened?’
‘She’s fitting,’ Hayley gritted, turning Charlotte onto her left side and reaching for the oxygen. ‘Call Patrick and the anaesthetist and I need some mag sulphate.’
‘I’ll get the trolley.’
Maggie ran out of the room but she was back moments later and Patrick was with her.
Attaching Charlotte to a pulse oximeter, Hayley didn’t even question how he’d arrived so fast. ‘Her sats are 96.’
‘How long has she been fitting?’
‘Two minutes.’
‘Let’s give her a loading dose of 4 grams of mag sulphate. Have we got an infusion pump?’
They worked as a team, slick and professional as they tried to control the seizure.
‘Foetal bradychardia,’ Maggie said, watching the trace, and Patrick nodded.
‘As soon as she’s stable I’m going to do a Caesarean section. Gary?’
‘Yes.’ The anaesthetist was monitoring Charlotte’s airway and breathing. ‘Let’s do it. Who is the next of kin?’
‘Her husband, Andrew,’ Hayley said. ‘But he’s just gone to phone his sister. They were staying with her over Christmas.’
‘I’ll go and sort out consent,’ Patrick said, and Gary glanced at him.
‘Didn’t she show any early signs?’
Patrick checked Charlotte’s patellar reflexes. ‘Yes, although some of her readings were borderline. Her blood pressure was never quite high enough to ring alarm bells. But they ignored mild proteinurea, which wouldn’t have happened in my unit.’
Gary lifted an eyebrow. ‘Are you going to call them?’
‘Yes.’
Surprised by Patrick’s unusually terse tone, Hayley glanced at him and realised that he was really angry.
‘Hayley is the hero of the hour,’ he said quietly. ‘She spotted it in clinic.’
Embarrassed to suddenly be the focus of attention, Hayley blushed and the anaesthetist smiled.
‘Can we offer you a permanent job?’
‘Oh—Well…’ Hayley gave an embarrassed laugh, aware of Patrick’s swift glance, but she was spared the trouble of answering by the arrival of Patrick’s registrar and the rest of the team.
It was only later—hours after Patrick had safely delivered a baby girl and Charlotte was stable—that she had time to think about that remark.
A permanent job?
Stay here—permanently?
With Patrick. And his gorgeous children…
‘Hayley?’ One of the other midwives put her head round the staffroom door. ‘Mr Buchannan wants you in his office. I don’t know what you’ve done, but you’d better start thinking up your excuses. He looked serious.’
‘OK, thanks.’ Sure that she’d handed over Charlotte’s care without missing anything out, Hayley walked to Patrick’s office. Oddly nervous, she tapped on the door and walked in.
‘You want me?’ Oh, help, why did everything always come out wrong? ‘I mean—I was told you wanted to see me?’ Her cheeks were hot and he stood up in a fluid movement and strode towards her, slamming the door shut behind her with the flat of his hand.
‘You were right the first time. I want you.’ His mouth came down on hers and he kissed her with erotic purpose, his lips as skilled as ever as he aroused her to a state of screaming ecstasy in le
ss time than it took her to gasp his name.
Desperate after several days when she hadn’t been allowed to touch him, Hayley melted against him, his kiss muffling her gasp of shocked pleasure as his hands slid to her thighs.
‘Patrick—’ She tried to say that they probably shouldn’t be doing this here but her mouth refused to do anything except kiss him back.
It was hot, desperate and frantic. When he stripped off the flimsy trousers of her scrub suit Hayley didn’t protest, and when she felt him hard and ready against her, she gave a low moan and dropped her hands to his zip.
He entered her with no preliminaries but she was so ready for him it was as if they’d spent hours indulging in foreplay. And perhaps they had, she thought as her vision blurred. They’d been stepping around each other, trying not to do anything that would unsettle the children—trying not to touch.
But they were touching now. Hungrily. Ravenously seeking their fill of each other, their bodies joining in almost animal desperation. Overtaken by sensations so intense they were almost painful, Hayley felt her body reach its peak and he joined her in the same place, his strong fingers digging hard into her thighs, his mouth silencing her cries.
Breathless, her mind blank, Hayley dropped her head against his shoulder, and suddenly became aware of their surroundings. His computer screen flickered on the desk and somewhere in the distance she heard the wail of an ambulance siren.
‘I’ve been wanting to do that all week.’ Patrick’s voice was low and rough and he scooped her face into his hands and kissed her gently. ‘Sorry. It was a bit fast.’
‘No problem,’ she muttered faintly, her eyes on his mouth. ‘Perhaps we can do it slowly, er, next time. When that midwife said you wanted to see me I thought I’d done something.’
‘You have done something.’ He kissed her again, his mouth lingering on hers. ‘You’ve driven me wild. Living with you and not being able to touch you is starting to have an adverse effect on my mental health. What are the chances of you being able to sneak into my bedroom without the children finding out?
‘Sneaking isn’t something I do well,’ Hayley confessed as she adjusted her clothing. ‘I have a habit of banging into things and falling over, remember? To sneak you have to be stealthy and graceful, and that isn’t me.’
