‘You’re the midwife?’
The deep voice was practically at her ear and she jumped, stumbling over her own feet.
She spun around. Mr Imposing was standing in her personal space, his arms folded across his chest, looking her up and down in a disapproving manner. Okay, so the NICU probably wasn’t big enough for all these people, which could explain the space thing. And the massive splatter of coffee all over her scrub trousers probably wasn’t helping her appearance.
But right now she could smell his clean aftershave and see into those toffee-coloured eyes.
‘Weren’t you the nurse who was sleeping in the canteen?’
She could feel the blood rush to her face and all the hairs on her body prickle in indignation. Who did this guy think he was, sweeping in here with his giant entourage?
Nope. No way.
‘I’m sure you know that we limit visitors to NICU. Maybe other NICUs relax rules for you and your entourage, but the Queen Victoria doesn’t.’
She started to count in her head just how many people were in his little gang. She’d reached twelve when his deep voice sounded right in front of her again.
‘Isn’t this a teaching hospital? Famous the world over for its training programmes?’ There was a mocking tone in his voice.
Esther had been around long enough to recognise an arrogant doctor. As a nurse, and a midwife, she’d met more than her fair share—both male and female.
She hated anyone being dismissive with her. And she didn’t stand for it. More than once she’d used her Scottish accent to the best of her ability to give someone short shrift.
There was something about her accent that generally made people take a step back—particularly when she was angry. If this guy didn’t watch out, he’d soon find out exactly who Esther McDonald was. She’d barely had a chance to look this guy up. All she knew was he was one of a few specialist surgeons who could do the procedure that Billy needed.
She mirrored his stance and folded her arms, tilting her chin towards him as she put a fake smile on her face. ‘Maybe you’d like to introduce yourself and let me know why you think your needs are more important than the needs of the very special babies we have in here?’
She could do sarcasm too.
He inhaled deeply, almost like he wanted to show her just how broad his chest was. But Esther had never been easily intimidated by anyone. ‘I’m Harry Beaumont. I’m here to do the surgery on your patient.’
She raised her eyebrows and nodded. ‘Ah, so you’re here to do the surgery on Billy.’ She pointed one finger at him. ‘In that case, you can stay. Everyone else can wait outside. Unless you’ve brought your own anaesthetist with you.’ She shrugged. ‘If you have, then he, or she, can stay too.’
Eleven other faces exchanged anxious glances, so Esther turned her head a few times as she spoke. ‘The babies in here are just too susceptible to infection to have this many people around. Visitors are strictly limited, for good reason.’ She looked at them all. ‘As I don’t know who any of you are—and to be honest, I’m a bit funny about letting people I don’t know into my NICU too—I’m just going to assume that you’re all either medical professionals or trainees, therefore I don’t need to explain the principles of infection control to you, so you’ll all completely understand that this amount of people is overkill—’ she turned her head back towards Harry ‘—even for a surgeon.’
She’d spoken quite a lot, but knew entirely that all the emphasis was on the things she hadn’t said, but had left implied.
There was a tic at the side of Harry’s jaw. He was mad. She didn’t care. She wanted to tug at her scrub top again. NICUs were always really warm, but this amount of people in close proximity was making her sweat. But tugging at the top would mean she’d have to unfold her arms and that would be a sign of weakness. So not happening.
It was the longest pause. Harry gave the tiniest nod of his head. ‘Francesca, will you stay with me, please? The rest of you, if you wait outside we’ll find a teaching area where I can explain things in due course.’
Francesca was a petite redhead who was grinning conspiratorially at Esther. She let the rest of the entourage leave, then asked, ‘Can I see Billy’s films? I’d like to review them before we examine him.’
‘Of course,’ said Esther, gesturing for both of them to follow her to the nearest computer screen. ‘Have you been assigned temporary log-in credentials?’
‘I have,’ said Harry, moving over next to her and tapping his details in.
It only took a few moments for a scowl to come over his face. ‘I sent a list of tests to be completed for Billy before I got here. Some are missing.’
‘They are?’ Esther moved closer, checking the screen. She’d checked before she’d gone off shift yesterday when there were just a few still to be completed. Ruth had said the rest had been done. What was missing?
She turned to Harry. ‘What is it that you’re looking for?’
‘His bloods. From this morning.’
Of course. ‘I’m sure they were done—they’ve probably not been reported on yet. Don’t worry, I can phone the lab and put a rush on them.’
Harry straightened and gave her an incredulous glance. ‘What do you mean you’re “sure they were done”? You mean you don’t actually know? And why wasn’t there already a rush put on them?’
She stiffened. He was speaking to her as if she was incompetent. Of course she should know if Billy’s bloods had been done or not. But the specialist phlebotomist would have been here while Esther was on her break. If she hadn’t been late back, she might have had a chance to check...
She kept her face blank. Her back was aching. ‘The orders for the bloods were put in last night. At that point, you hadn’t told us when you were coming, or let us know if you’d secured theatre time for Billy. If you had, there would have been a rush put on his bloods.’
She moved over to the desk to pick up the phone. Every word he’d said had annoyed her. But what irked most was that they felt true.
What was wrong with her? She prided herself on being meticulous at work. It wasn’t like she’d made any kind of mistake but...in her brain it almost felt like that. Double-checking things was second nature to her.
‘I’m used to working with professionals. I guess the standards here are not what I’m used to.’
‘Excuse me?’ She couldn’t help herself. There was no way she going to let anyone accuse her of being unprofessional. It was the biggest slight that someone could say to a nurse or midwife.
But it seemed that Harry was off on a rant. He kept his voice low, so that no one else in the unit could hear. ‘Why does Billy still have a feeding tube in situ? In order for Francesca to anaesthetise him, she needs to ensure his stomach is empty. His feeding should have stopped a few hours ago.’
Now Esther wanted to shout at him, but just at that moment a voice answered at the end of the phone. ‘Lab,’ came the weary response.
Something inside Esther panged. Whoever was working there was obviously every bit as tired as she was. ‘It’s Esther from NICU. Can I chase bloods for a baby that’s going to Theatre?’
There was a sigh and murmur of consent. She replaced the receiver and turned to face Francesca, completely ignoring Mr Entourage. She wasn’t even prepared to use his name right now.
‘If you refresh the screen in around five minutes Billy’s bloods will be available. One of the machines was down for a few hours this morning but it’s back up and running now. Billy’s bloods had already been in the system. They’re just waiting for his clotting factor.’
Francesca gave a nod. ‘Perfect.’
Esther looked at Harry’s screen. He was looking at the cardiac echo that had been taken yesterday. Billy needed his surgery, badly.
She moved alongside Harry. ‘I have many skills, Mr Beaumont, but mind reading isn’t one of them
. Like I said earlier, if you’d given us notice of Billy’s procedure, then we’d have made sure his feeds were stopped in good time. As it was, his tube dislodged last night and had to be replaced. Billy already had a few hours without sustenance, while his tube was re-sited and then checked. His feed only started again in the last hour.’ She braced herself and turned her head towards him. ‘And for me, unprofessional is a surgeon sweeping into a NICU with an entourage of twelve people with no regard for the patients or parents who are already in a stressful environment. For a surgeon with your apparent experience, I’d expect better.’
* * *
Harry was trying his absolute best to keep his temper in check, but this midwife was trying his patience in every possible way. It didn’t help that she had a cheek to be angry at him, or that when she was clearly annoyed she spoke so quickly he had to concentrate to make out a single word that she said. Her Scottish accent was fierce. A bit like she was.
By rights she should probably have fiery red hair to match. But she didn’t. She had dark hair that was up in a ponytail, and her skin looked as though it had once been tanned but was now strangely pale. He couldn’t possibly ignore the dark circles under her blue eyes, or the dirty scrubs she was wearing. He wasn’t quite sure what all this meant—apart from the fact she was looking after the baby he was due to take to Theatre.
Harry had spent his life in and out of NICUs across the world due to his surgical speciality. There weren’t many people that wanted to work on such tiny hearts and veins—particularly when the tissues were so fragile and these little lives could literally be on a knife edge.
What the staff in the NICU at the Queen Victoria clearly didn’t know was that he was the new visiting surgeon, which meant that, where possible, babies with heart conditions would be brought here for him to operate on. For those who were too sick to travel any distance, he would still go to them. But having a semi-permanent base with a team around him would be good. He’d hoped to find professional colleagues he could trust and rely on. But first impressions of this midwife weren’t exactly good.
There was no way he wanted her watching Billy postsurgery.
But what annoyed him most of all was the way she’d quickly and determinedly told him to get his staff out of ‘her’ NICU.
And she’d been right. They always tried to reduce the amount of close contacts that prem babies had. It was important. Their immune systems were often not fully developed, and most humans were walking petri dishes.
People could be carrying bugs for days without any signs or symptoms. Something that caused a mere sniffle in an adult could be deadly to a premature baby. It might be a teaching hospital but even he wouldn’t expect any NICU to let in that many students and trainees. He’d been in such a hurry to get in here and see his patient, and been so swept away by the enthusiasm of the staff at his side, that he hadn’t stopped to think. And Harry didn’t make mistakes like that. So being called on it was embarrassing.
‘You must have known Billy was going to Theatre today,’ he said briskly to the midwife.
She gave him a weary look that told him she was getting very bored by all this. ‘I hoped you might show your face today. I hoped that Billy wouldn’t have to wait another day for surgery. I was told that you were supposed to turn up today, but no one knew when. I look after both baby and mum, and if you’d communicated a little better, there was also the chance I could have prepared mum more for his surgery today.’
She put her hands at the back of both hips, leaned backwards and winced as if she’d touched something painful.
‘Blood results are in,’ said Francesca in a manner that could only be described as deliberately distracting. It was clear she was trying to break the tension between them. ‘His blood gases are a little lower than I would have liked. But not anything I wouldn’t have expected.’ Francesca gave a little sigh and Harry felt a rush of sympathy for her. They’d worked together for a long time. She was a great anaesthetist. It took great skill to manage these tiny babies in Theatre and he depended on her completely. Francesca’s chair scraped on the ground as she stood up. ‘I need to sound his chest. Let me wash up first.’
He followed her over to the sink in the treatment room, completely sidestepping Esther and washing his hands too. He needed to prioritise this baby, not the midwife who looked as if she could currently fall asleep on her feet.
As he stepped back his arm brushed against hers and she jerked away. But not before he noticed how hot she was. ‘Do you have some kind of infection?’
She looked shocked. ‘What?’
‘You’re burning up. What’s your temperature?’ His arm swept out across all the cribs in the NICU. ‘If you have anything respiratory you’re putting the lives of all these babies at risk.’
‘I don’t have anything respiratory,’ she snapped. ‘My chest is clear as a bell.’
For one strange second he realised that her words had made him look exactly at her breasts hidden under her scrubs. He turned back to Francesca. ‘We should see this baby on our own.’
Esther stepped into his path. ‘No, you won’t. I know Jill, his mum, best. She needs support. She trusts me.’
Harry glared at her and she held up her hands. ‘Okay, I won’t touch Billy, right now. I’ll run down to A&E when you’re done and get a clean bill of health. But you don’t see him without me.’
Harry pressed his lips together, stopping himself from just getting into a pointless argument. ‘Only speak to mum, then,’ he reiterated.
She gave an exasperated nod and held out her hand. ‘This way.’
Harry and Francesca followed her over to the left-hand side of the unit to where a young woman sat staring at her baby lying in the crib and rocking backwards and forward in the nursing chair. Harry had dealt with lots of anxious parents. NICUs were the most intimidating places on earth. Parents frequently felt everything was out of their control, and he was used to comforting and supporting parents who were overwhelmed with helplessness and focused on every word that was said to them. This mother was young. Her lank hair was pulled back from her face. It looked as if it hadn’t been washed for a while and from first appearance he actually wondered when she’d last eaten. Now he understood just why Esther was being so protective of Billy’s mum. It was clear she didn’t have many support systems in place.
‘Jill, this is Harry Beaumont. He’s the surgeon that’s going to do the surgery on Billy.’
Harry crouched down so he was level with Jill. She’d sat forward but hadn’t stood up. He gave her a broad smile. ‘It’s a pleasure to meet you, Jill. I’m here to take a look at Billy. I’m hoping we’ll be able to take him for surgery later today. Do you mind if I examine him?’
Jill paused for a few moments as her eyes filled with tears, then she gave a tiny nod. ‘Of course.’
She was terrified. He got that. Harry used some of the NICU hand sanitiser before opening the crib to examine Billy, while Francesca introduced herself as Billy’s anaesthetist. He could tell straight away that Esther completely understood, and after a few moments, he could see the tension in Jill’s shoulders start to dissolve as he spoke to Billy in a calm, quiet voice as he examined him.
‘Hi, Billy, I’m here to see how you’re doing. Let’s have a little listen to your heart and lungs.’ He took his time, listening carefully, then checking his oxygen sats, his feeding tube and his colour. Babies this small frequently had skin that was almost translucent. Their circulatory systems—and particularly Billy’s—weren’t functioning quite right, and they often couldn’t regulate their temperatures. Operating and anaesthetising these babies carried huge risks. He gave Francesca a nod as he moved his stethoscope back to Billy’s chest. ‘Want to take a listen?’
She nodded and moved alongside him. There was no point her touching Billy too when she really just needed to listen to his heart and lungs. So, she listened through Harry’s stethoscope
, nudging him to move it on occasion.
Harry could sense Esther watching them curiously. She wouldn’t know they’d done this a dozen times before. As Francesca finished her examination it struck him how similar Esther and Jill looked. Exhausted and tired. He could understand it for the mother. But for a member of staff—it wasn’t good enough.
Francesca gave him a nod and he removed his stethoscope and pulled a chair over next to Jill and spent the next few minutes explaining Billy’s surgery to her in simple terms. He brought out some notes that he’d prepared earlier. He always gave the parents of the babies he operated on some clear notes that they could refer to later. Experience had taught him that although parents listened, anxiety meant that they didn’t always remember or understand what they’d been told.
He could feel Esther’s eyes on him the whole time. He would expect the midwife assigned to this child to listen to his explanation. It would mean that she could reiterate anything to the mum at a later date. But somehow, today, it irked him. And he couldn’t quite understand why.
‘Do you have any questions?’ he checked with Jill. She shook her head and he gave her a small nod. ‘If you think of anything later I’ll still be available to answer any questions. I’m going to organise some theatre time now. I hope to take Billy later this afternoon. We’ll stop his feeding for the next few hours, and I’d expect the surgery to last around six hours. You can come down to Theatre if you want while Billy goes to sleep, and I’ll come and find you as soon as we’re finished to update on how things have gone. Okay?’
Jill gave a nod.
‘I’m just going to have a chat with your midwife, and then I’ll talk to you in a while and get you to sign the consent forms.’
He smiled and walked back over to the nurses’ station with Francesca and Esther. Francesca sat down and started making some notes. Esther turned to look at him. ‘You aren’t doing the consent form now?’
He shook his head. ‘No. I’ve given her a lot to process. I want to give her a bit of time to think about everything I’ve told her before I get her to sign the consent form. She might have more questions later.’
Cinderella and the Surgeon Page 2
