To Dr Cartwright, A Daughter

by Meredith Webber

  'I've a ward round in ten minutes, then appointments scheduled through the day. And judging from the names on the patient list I'll be seeing quite a few of your Asian mothers.'

  Katy calmed down enough to explain.

  'It's the interpreter's day in our outpatients department. We only have her once a month so we schedule most of the Asian women on the day she's available.'

  He frowned again.

  'I understood the hospital had a number of interpreters. Why do we only get one once a month?'

  Katy let out a little sigh of relief. That ready aggression in his voice told her Jake hadn't lost his fighting spirit.

  'On paper we have an interpreter once a week,' she told him. 'The problem is it's a man the other three weeks, and the women won't talk through him. It's hard enough to get them to allow male doctors to examine them, but most of them flatly refuse to discuss personal concerns through a man of their own culture.'

  'Do you know this for a fact? Did they tell you this?'

  He emphasised the 'you', as if puzzled by her involvement. After all, he'd already reminded her that a director's assistant should assist the director,, not poke her nose into medical business.

  'I keep all the department records on the computer,' she explained. 'In the beginning I noticed a number of women not turning up for appointments and when I chased them up I found out why. Now we try to fit them all in on the day when we have Tan here.'

  'When you chased them up?' Again he allotted a subtle emphasis to the pronoun.

  'I took Tan with me and visited the women,' she explained, and saw the flicker of a grin move the corners of his lips. 'Well, I needed to find out,' she added defensively.

  'Of course!' He nodded once, then waited as if he expected her to say more, but that slight lessening of the sternness in his face had made her forget what she was saying.

  She couldn't let him defeat her with the ghost of a smile! What had they been discussing before he'd begun to talk about today's appointments?

  The agenda!

  'So we can discuss this tomorrow?' she asked hopefully.

  'Is that all the information you have—that the women won't talk through a male interpreter?'

  One eyebrow flicked upwards and she shut her eyes against encroaching memories.

  'No, I've a file full of information,' she snapped, banging the folder on top of the table.

  'Exactly!' he murmured with maddening control. He stood up and walked across to her desk, lifting the sheaf of papers from her nerveless fingers. 'Information I have to absorb before I can consider its value. I'll try to read through it during the day, but I'll need to discuss it with you once I've read it. Perhaps you could have dinner with me tonight? Staying after work is the only way I can see us making sure the item is included in tomorrow's agenda.'

  He tucked the file under his arm and walked out, leaving Katy staring, open-mouthed, at the slowly closing door.

  She breathed deeply, trying to ease the tension and confusion battling for supremacy in her body.

  You can't still love him after the way he treated you, she reminded herself. This reaction is nothing more than shock with a bit of the old physical stuff thrown in.

  The words echoed bravely in her head, but it was the 'old physical stuff causing most concern. Sweaty palms, palpitations and nausea—actual symptoms unrelated to any medical condition.

  She tried deep breathing again, and when that didn't work replayed the scene m this very hospital that was etched so vividly in her mind. She and Jake had worked at Lake Shore General, but he'd been brought here after the accident—after they'd argued over his racing his motorbike! She had told him how much the mountain races frightened her and had begged him to stop, had pleaded with him to ride it for pleasure, if he needed the adrenalin rush bike-riding provided, but not to pit himself against professionals.

  She'd refused to go and watch, but she'd felt so sick as she waited for him to come home she might as well have been among the crowd of onlookers scattered down the hillside.

  The racing professional who'd become his friend had rung to tell her of the accident, to tell her where the ambulance was headed. It had been the first time she'd been in a private hospital and the wide carpeted corridors and almost silent movement of staff as they went about their business had intimidated her.

  But not so much that she'd been cowed—or cowardly!

  'I don't believe he said that,' she'd railed at his mother that dreadful day.

  His parents had been overseas when it happened and had been difficult to contact, and once they'd arrived Katy had been relegated to an extra in the drama—someone who received information second-hand. 'I want to speak to him myself,' she'd insisted.

  And eventually they'd let her.

  The colour had come back into his skin since they'd moved him out of the ICU and his eyes had been a darker blue than she'd remembered.

  'I asked them not to let you in,' he had said, in a cold voice so unlike his own she'd checked to see it really was Jake lying in the bed.

  'Why?' she'd demanded.

  'Because it's over, Katy.' He had spoken with a calm deliberation. 'It was over before the accident,' he had added, as if he had needed to hurt her more than she'd already been hurting. 'I think we both knew that.'

  There'd been a dreadful pause and she'd realised, for the first time, how silence could hammer in the ears.

  'I didn't know it,' she'd managed to mumble, her first priority holding back the encroaching tears. There was no way she'd been going to cry in front of him—or let his parents see her grief!

  'Think about it, Katy,' he'd said in that same controlled voice. 'Think about it and you'll find you probably did.'

  She had turned and walked away, not even pausing when he called her name.

  'Thank, you for being there when it happened,' he'd added, and then she'd spun around, because he'd said the words in a tone in which one thanks a stranger.

  'It was nothing,' she'd said with a careless shrug, while her heart had pounded its pain and her lips had trembled with the effort of not screaming out the denial which had ricocheted through her body.

  She'd tried to believe it had been the accident, that it had been pain making him behave this way—or perhaps the influence of his parents, who had been with him since he'd been moved out of Intensive Care. But when she'd tried to see him again she'd been refused admittance.

  Then his parents had had him transferred to a hospital nearer his home in West Australia and she hadn't seen him again. She had written to him twice, all pride crushed by the pain of his betrayal—and by her own fear of and despair for the future—but the letters had been returned unopened and she had finally accepted he'd meant what he'd said.

  'Damn the man!' she muttered to herself, staring out towards the lake through a haze of unshed tears.

  The little replay had upset her more than it had armoured her.

  Relationships ended—falling out of love was as much a fact of life as falling into it. She'd finally accepted that that was what had happened with Jake, finally decided that the argument they'd had before he'd ridden off and nearly killed himself had been a sign that things were over.

  For him, perhaps!

  It was just a shame she hadn't felt the same way— that they couldn't have parted at some point where the bloom had rubbed off love for both of them.

  'Ms Turner to Ward 'B', please,' her speaker phone requested.

  The call was like a lifeline back to safety, and she seized it gratefully, hurrying from the ghosts inhabiting the office.

  'We've a Vietnamese patient in early labour and can't contact Tan,' Helen Reynolds, the midwife in charge of Ward 'B', told her. 'Dr Spencer tried to examine her but she yelled at him. I sent him out of the birthing suite and she let me take her blood pressure and pulse, but she's objecting to the external foetal heart rate monitor and becoming more and more distressed.'

  'I'll try to talk to her,' Katy offered, 'but my Vietnamese is fairly basic
. If she understands Chinese, we'll be right.'

  She turned and followed the older woman towards the birthing suites, mentally rehearsing the few Vietnamese words she'd picked up in her first lessons.

  When she entered the room, the woman was turned away from her. She was so slight and fragile-looking she might have been a child play-acting with a pillow tucked under her gown. Katy could see the shiny knobs of her spine where the hospital gown gaped at the back and made a mental note to find out about the clothing Asian women wore to give birth. Surely not these practical but embarrassing and unflattering gowns the hospital provided for its patients.

  'Chao ba,' she said, using the traditional greeting to a woman on their first meeting. She'd have liked to add that it was a lovely day to bring a child into the world, but her knowledge of the language was too limited for flowery speeches.

  'We need to know when the pains began and where they are.' The deep voice made Katy spin around to see Jake standing in the shadows near the door. At least he'd had enough sense to keep out of the patient's line of sight.

  The woman screamed, apparently alarmed by the sound of his voice, and curled into a tighter ball on the bed. Katy found the movement puzzling. Apart from anything else, it must be uncomfortable to lie that way. Behind her, Helen murmured to Jake, explaining that most of their Asian patients were extremely stoical during childbirth, the Vietnamese women in particular.

  Katy sat on the bed and took the woman's hand. Aware of her limitations in Vietnamese, she spoke quietly to her in Chinese and heard a faint response. She spoke again, and felt the waif-like figure relax. When the next contraction began, the woman squeezed Katy's fingers but she didn't scream.

  'Try now,' Helen suggested quietly, and Katy asked the questions.

  The woman replied quite calmly and Katy translated for Jake, but when Helen approached with the monitor the dreadful keening cry began again.

  One word was repeated over and over, but Katy didn't recognise it. She waved Helen away and spoke again in Chinese, repeating meaningless phrases about relaxing, about trying to be calm so the baby wouldn't be upset.

  Something buzzed in Katy's brain. She'd read so much about these immigrant women since she'd begun to investigate the feasibility of the special unit that at first she couldn't isolate the thought. She continued talking quietly in Chinese and massaging the woman's hand with her fingers. It was to do with the past...

  Memories of her own pain when she'd experienced the flashback of Jake's rejection provided the clue.

  When the next contraction finished, she signalled to a nurse to take her place beside the woman and motioned to Helen and Jake to follow her outside.

  'I read a paper on subconscious memory in women from war-torn countries. Although many of the Asian women in this area came out to join family or fiancés, others were refugees who escaped from persecution. Some of them have lived in dreadful conditions in refugee camps for many years while others have experienced torture or saw their parents tortured—'

  'So you think instruments we use—say something as innocuous to us as an external foetal heart monitor with wires from the patient to a machine—could bring back memories and even duplicate the pain?'

  It was Jake who caught up her vague idea and took it one step further. She could feel his interest quickening and felt a surge of excitement, but before she could speak again he had turned to Helen.

  'Take the monitor screen out of the room,' he suggested. 'And anything else that looks harsh or metallic.'

  Helen hurried back into the room, and Katy was about to follow when his hand restrained her.

  'What else?' he demanded.

  She visualised her notes on the new unit and mentally flipped through to the section she'd put together on Vietnamese women.

  'The husband isn't present at the birth,' she said. 'It's definitely women's business.'

  'Then midwives should handle her,' Jake agreed. 'I'll tell Ron Spencer to keep out, and stay clear myself unless there's an emergency. Will you talk to her while Helen examines her? Can you stay with her until we track down the interpreter?'

  He was treating her as a colleague and she responded accordingly. Her heart might still be aching for the magic of the past, but her mind was fully focused on the young woman in the birthing suite.

  'At least he's seen at first hand some of the problems we have,' Helen remarked as Katy returned to the patient. 'That should help our push for the special unit.'

  While Katy explained to the fearful woman that they needed to know if the baby was close, Helen took the woman's pulse and gently palpated the distended abdomen. Katy knew from her own pregnancy these were Leopold Manoeuvres, and she tried to convey the idea that Helen was checking the exact position of the baby.

  'I need to listen to the foetal heart rate after the next contraction,' Helen said quietly. 'Could you tell her I'll use this foetoscope? If she's attended any antenatal appointments she'll be familiar with it, or with an ordinary stethoscope.'

  Katy translated falteringly, using her hands and body language to try to explain the technicalities. She was relieved when the woman touched the instrument and nodded. She watched as Helen moved the cone of the instrument over her belly and smiled when the nursing sister nodded reassuringly.

  'Ask her if I can take her blood pressure again now. Explain we need to know how her heart is behaving.'

  Again Katy translated, pointing to the sphygmomanometer Helen produced from a cupboard.

  The patient seemed to withdraw, then flinched as another contraction gripped her belly. When it subsided, Katy mimed putting on a blood pressure cuff and pumping it tight, and the woman spoke freely for the first time.

  'Her doctor used the same, thing during her antenatal visits,' Katy told Helen, but when she asked the woman for the name of her doctor, the reply was unfamiliar.

  'Asian doctor, not Western doctor,' the woman expanded.

  'Do you want this doctor with you?' Katy asked, wondering if there were local Asian GPs she might be able to co-opt into her unit.

  The woman giggled shyly, and shook her head.

  'He man!' she said in English.

  The door opened and Tan appeared, bowing slightly to her colleagues before greeting the woman.

  They talked for a few minutes, but Katy couldn't follow the fast-paced conversation.

  'Can you stay with her, Katy?' Tan asked. 'I've got to sit in on the outpatient appointments with the new boss.'

  'I'll stay,' Katy promised, ignoring thoughts of the paperwork and messages she knew would be multiplying on her desk.

  The baby arrived three hours later. Helen delivered him and held him so the mother could see the mucus being wiped from his mouth and nose. A Vietnamese midwife who had worked at Lake Shore North the previous year had told them this was important to her people. 'We believe it prevents asthma or emphysema later on,' she'd explained.

  Katy waited until the mother had been gently sponged in warm water, then she helped her dress. She watched the woman wrap layers of clothing around herself, then pull a scarf around her head and warm socks on her feet. She shuddered to think how hot their patient must feel, but she knew it was a custom followed in most Asian countries to heat the body after childbirth.

  The tiny boy was checked and weighed, then warmly wrapped and presented to his mother. Her eyes were round with wonderment and she sniffed his skin and smiled. Helen grinned at Katy and made a little thumbs-up sign. The maternity ward had already developed the practise of putting ginger root in the water for bathing Vietnamese babies.

  'Can you leave her in this room?' Katy asked, and Helen nodded.

  'For the moment we can. I've two other suites available for new admissions. Would you ask her if she wants a meal, and, if so, what she'd like to eat?'

  Katy spoke to the woman again.

  'Hot foods,' she said to Helen. 'The kitchens have a list of what constitutes "hot" and "cold" in this context. If nothing else is available at the moment, she'd be happy w
ith salted rice.'

  Helen hurried away and Katy explained to the woman that she must also go. She pushed the baby's crib close to the bed.

  'The nurse will stay for a while and she will call me if you need anything. Can I phone your husband or a friend?' she asked.

  'My husband is in the big entrance place downstairs,' the woman told her in Chinese. 'He brought me here but could not come up to where babies are born.'

  CHAPTER THREE

  Katy found the new father—easily isolating him as the nervously pacing young man just inside the front door. He was dressed in a pale grey suit and had a rolled black umbrella hooked over one arm. For a moment she was struck by the incongruity of the couple—the man having adopted such formal European dress while upstairs his wife was swaddled in the clothing her female forebears had worn for thousands of years.

  She introduced herself and gave him the good news. His dark eyes gleamed like black onyx and his lips tilted up in a smile that would have taken sandpaper to remove.

  He told her his name: Nguyen—the Vietnamese equivalent of Smith it was so common—and she suggested they go back up to the fourth floor where he could see his wife and child. After the struggle to communicate with his wife, she was surprised to find he spoke precise, unaccented English.

  'I grew up here,' he explained as they waited for the elevator. 'My wife is Vietnamese-born and was chosen by my grandparents in Vietnam. She was sent out when she was old enough to marry. We had corresponded, of course, but as we learned to know each other our love flourished like roses in a garden. She is learning English, but it is difficult for her.'

  Katy was smiling at his flowery tribute when the lift arrived, and once again, as the doors opened, she was confronted by Jake. Her heart reacted skittishly, but her head took control. She introduced Mr Nguyen and explained he was now the father of a fine son.

  Jake congratulated him, but he seemed detached. Had his session in Outpatients gone badly?

  Katy tried to ignore him, although the restricted space and her physical reactions made this feat difficult. She concentrated on practical matters, turning to the new father.