To Dr Cartwright, A Daughter

by Meredith Webber

  'Can you stay with your wife for the rest of the day?' she asked him, aware that most Vietnamese were unwilling to take time off work, even for the birth of a baby.

  'I have taken paternity leave,' he said proudly. 'I teach in a high school and the system allows me one month without pay. It is more important for my wife to have someone to help her while she does the month than for me to be earning money.'

  'That's wonderful,' Katy told him as they all stepped out on the fourth floor. 'And if you can be here as much as possible while she is in hospital, you can explain her needs to the nursing staff and doctors. It will mean we don't have to find a translator every time she is examined, and it could save her from possible embarrassment.'

  She showed him into the room and left him with his wife and son, only too aware that Jake was hovering behind her.

  ' "Does the month?''' he queried as they walked back towards their office.

  'It's in the notes,' she told him. 'Although a month is common in many countries, originally in Vietnam the postnatal confinement. time was one hundred days. Traditionally, there's a One Hundred Day party, when the child is introduced to friends and family.'

  'I haven't a clue what you're babbling on about,' he said crossly, 'and I very much doubt I'll have time to read the notes. I've had a harrowing morning in Outpatients, examining pregnant women by remote control, with some of them unwilling even to supply a specimen of urine, let alone blood! And why I'd need an interpreter when half of them refuse to ask questions, pretending they know everything there is to know, yet looking so fearful and puzzled you'd think I was the devil incarnate...'

  His voice trailed away, as if the frustration of the morning was too upsetting to recall.

  'Specimens are a problem, as some South-East Asian people are reluctant to give strangers any of their body fluids,' Katy explained. She paused and he halted beside her. 'And Cambodian women in particular hold doctors in such high esteem they're reluctant to bother such great men with questions.'

  Her lips twitched with delight as she dropped this little gem of information.

  He eyed her suspiciously, aware of the mockery in her voice.

  'Go on,' he growled.

  'Well, it's because of such wide-ranging beliefs and customs we believe the new unit is so necessary. If we can start with group sessions and interpreters in antenatal clinics, we can explain in the women's own language why we use certain procedures—like taking their blood and urine or performing scans—and let them tell us why they do it differently and what practices they find offensive—'

  'Offensive?' he echoed.

  'Both sides are offended at times,' she told him. 'The women by some of our ways and our staff by some of theirs. If we can begin to educate them in our system, and learn something of their customs and beliefs well before the actual birth, it should be easier to chart a course for their pregnancy and confinement.'

  His pager buzzed and he groaned.

  'I'm only here for two months, Katy,' he grumbled. 'Couldn't you put your unit on hold until Dan returns?'

  'Once you revelled in a challenge,' she reminded him, and saw a shadow darken his cheeks.

  'Once I revelled in a lot of things,' he muttered at her, and walked on down the corridor.

  He was on the phone when she entered their office. She'd been called back by Helen to discuss a time for the basic Chinese lessons she'd offered to give the staff. Learning the common courtesies in the patients' language was all part of her grand plan!

  As she slipped into her seat she saw the 'New Unit' file open on his desk. Had he read it? She tried not to let her hopes rise too high. A consultant director spent so little time in his office—there was always someone wanting his attention. She sat down and began to respond to the messages on her own desk.

  They ranged from leaking taps in shower cubicles to an under-supply of the new muslin nappies they were trialling in the nursery. One by one she dealt with these 'housekeeping' matters, concentrating fiercely in an effort to ignore Jake's presence in the room.

  'I'm going back down to Outpatients,' he announced when his phone conversation concluded. 'Page me there if you need me.'

  Then her phone rang, and he hesitated by her desk while she answered it.

  'The director is busy at the moment,' she said, when the voice on the other end paused for breath. 'Dr Spencer will be doing afternoon ward rounds—' she glanced at her watch. Could it really be that late? What had happened to lunch? '—any minute. You could ask him about the problem.'

  She listened to the indignation squawk through the phone. Jake was still hovering on the other side of her desk. She waved her hand to show him everything was under control, but he didn't move.

  'It's natural to have difficulties at first,' she assured the distressed patient, 'but I think you'll find the nursing staff far more helpful than the doctor in this matter. Many of them have had children themselves and have experienced the same problems. If Sister has suggested a mild analgesic you can be certain it will be something which won't affect your milk or harm the baby.'

  She listened quietly, aware the woman on the other end was regaining her self-control.

  'I think the recommended time is forty minutes before each feed, but timing is difficult if you're demand-feeding the baby,' she agreed. 'If you're really against the analgesic, you'd have to put up with the pain. I know it's uncomfortable, but it's a sign your uterus is contracting and getting back into its pre-pregnancy shape.'

  Jake had settled himself to wait out the conversation, one hip hitched onto the edge of the desk. He was too close, Katy realised as she continued to soothe the patient. She could see the shape of his thigh muscles against the material of his suit and found she didn't want to think about Jake's thigh muscles. Didn't want to think about any part of Jake!

  'If I'd known you weren't busy I'd have sent you down to see her,' she said tartly when the conversation had finally come to an end and she'd replaced the receiver. 'I thought you had appointments in Outpatients.'

  'An appointment,' he corrected calmly, shifting slightly so she could envisage more muscled thigh beneath the fine grey fabric. 'It's with the head of the interpreters. He'll be working and will fit me in between patients whenever I get there. Do you field all my calls with such expertise?'

  She looked up, trying to gauge his mood from his face, but it was expressionless—remote.

  'I try to shield the director from unnecessary complications,' she replied primly. 'That's why calls like that come through to me, not you. Mrs Preston is a patient in Ward 'C'. She's having severe after-pains from contractions when she breast feeds, but—'

  'Was concerned over analgesia contaminating her breast milk,' he finished. 'I'm an obstetrician; I gathered that much.'

  Katy nodded, ignoring the sarcasm. His closeness was making her breathless, as if he'd drawn all the available air out of the room.

  'And nurses are more helpful than doctors?' he pursued softly. 'I know you told me I was redundant earlier, but do you always tell the patients how useless we medicos are?'

  She felt a ripple of apprehension. Was he annoyed or merely teasing?

  'Of course not,' she said, her eyes defying him to argue. 'I was merely pointing out that the nurses have more experience in some fields—and that includes, strangely enough, nursing care!'

  'Did you finish your nursing training?'

  The question was so unexpected she knew her involuntary jolt of shock must have been visible to him. No matter how much she loved her present job, she couldn't hold back the spurt of regret that she'd failed to complete her degree.

  'No,' she admitted quietly.

  'Why?'

  She closed her eyes to the image of Julia. Her heart was wrenched with pain. Whatever happens, he mustn't know about Julia.

  'I had other things to do,' she muttered.

  'Like what?'

  The question was so harsh she shook her head—responding to the tone not the words.

  'So you gave u
p, just like that?' he mocked, shifting off the desk so he could straighten up and loom over her. "The fighter who'd sworn she'd make it although it meant working at menial jobs to pay her way and studying through the night?'

  He was goading her deliberately, but she couldn't hold back.

  'Maybe I lost interest in it,' she challenged. 'Maybe I decided it wasn't what I wanted. You should understand that, Jake,' she reminded him. 'You made the same decision once yourself—about me!'

  She reached out and lifted the receiver. The phone hadn't rung, but she needed to look as if she was dismissing him—as if she had more important things to do than argue about their mutual past.

  She pressed the memory button for the crèche, aware that he'd taken the hint and was striding towards the door. She was about to respond to Nan's 'hello' when he turned.

  'You've made arrangements for tonight?' he asked, and then, without waiting for a reply, he added, 'I've been given a couple of rooms on the top floor. It's the door on the left as you come out of the lift. Come on up when you finish and bring the file. We can order a meal from the kitchen.'

  She opened her mouth to object to his orders, but he was gone before she could think of a valid argument— or one that didn't involve mentioning her child.

  Was she being foolish? Wouldn't he eventually hear she had a child? It was more than likely! Yet she knew instinctively that Julia must be protected at all costs— must be shielded from the pain he'd inflicted on Katy—that unbearable agony which arose not from love but from the repudiation of it.

  She heard a click as the phone in the crèche was disconnected and remembered what she was supposed to be doing. For a moment she considered going down to the crèche to speak to Nan in person and hold Julia in her arms for a few minutes. But such behaviour would lead to questions, and at the moment she had no answers. She pressed the memory button again.

  'Nan, it's Katy. Could you take Julia home tonight? The new boss wants to talk about my pet project, and if I want it brought up in the ward meeting tomorrow, I'll have to stay and explain it to him.'

  Nan's reply was immediate.

  'I'd love to have her. You've no idea how I've missed her visits while you were both away, and my kids have been nagging me to have her over as soon as you returned.'

  Katy relaxed. Nan's enthusiasm was genuine, and Julia returned her honorary aunt's affection—so much so she kept a toothbrush, pyjamas and spare clothes at Nan's house.

  'I'll come down and see her before you go,' Katy promised, then hung up, her fingers tingling with apprehension now the decision was made.

  If she had any sense at all she'd have told Jake it was impossible, but she hated telling lies—and to tell the truth would be unthinkable.

  She turned back to the messages on her desk and worked through until four. Jake hadn't returned, and Katy assumed he was seeing his afternoon patients. She slipped out of the office and went down to say goodbye to Julia, then returned via the ward to check on the new Vietnamese patient.

  Mr Nguyen must have spread the news, for two elderly women were entering the room as she approached. They carried baskets and cloth-covered parcels so she turned away, not wanting to interrupt when the patient had visitors.

  Back in her office, she found a copy of the 'New Unit' file and began to check through it, marking sections Jake might query and mentally preparing her argument in support. She was engrossed in an article she'd included about the use of steam for purification when the fire alarm sounded.

  Her first reaction was to race down the fire stairs and check on Julia, but she knew she must see to her own section first. As she hurried into the foyer she recognised the signal as a localised alarm, then the noise stopped.

  'That's it?'

  She turned to see Jake emerging from the elevator.

  'Repeated long blasts signal a major emergency,' she explained. "That long-short noise indicates the extinguishers have come into operation in one section of the building. When the alarm stops, you know the fire is out.'

  As she spoke she heard a commotion in the corridor beyond the foyer, and saw the visiting Vietnamese women emerging from Mrs Nguyen's room.

  They were wet!

  'Oh, no!' she groaned. 'Not today!'

  Leaving Jake in the foyer, she raced towards them, propelling herself past their chattering laments and into the suite.

  The new mother was sitting on a chair, her baby held tightly in her arms. A nurse was stripping off the wet bedclothes and a wardsman was mopping the floor. For a moment she thought the woman was as wet as her visitors, then she realised they were tears on her cheeks. Beside her, Mr Nguyen was re-rolling his umbrella, and Katy chuckled as she visualised him calmly using it to protect his wife and child from the downpour while pandemonium erupted among the staff and visitors.

  Jake arrived with Helen close behind him.

  'What's going on?' he demanded, and Katy pointed towards the small brass urn almost under the bed—now full of sooty water.

  'My wife's friend brought it in,' Mr Nguyen explained. 'She believes in the old ways—in the "roasting" after birth. She brought only a small amount of charcoal but it must have smoked too much. We meant no harm...'

  He spread his hands and frowned ferociously, as if concerned the debacle might cause his wife's expulsion from the hospital.

  Helen looked at Katy and sighed. It had happened once before, and the sprinklers had worked efficiently both times, but it was the worst possible recommendation for the new unit.

  'Roasting?' Jake repeated in a weak voice.

  'I'll explain later,' Katy. told him. A wardsman wheeled in a dry bed, and while Helen held the baby Katy helped a nurse transfer the woman to it.

  'We'll take the baby down to the nursery,' Helen told the father. 'He seems dry enough but we'd better check him out. Would you please tell your wife we'll have to move her into the ward while we clean up in here.'

  As the young man turned to his wife to explain what was going on Helen murmured to Katy, 'At least there the passing staff can keep an eye on things.'

  Katy listened to the flow of foreign words and thought their patient seemed more comforted than upset. Maybe the 'roasting' had been too much for her as well!

  'Come along, Miss Turner,' Jake said, tapping her on the shoulder as she bent to admire the baby once again. 'You've got some extra talking to do!'

  She followed him back to their office where he pushed the 'New Unit' file to one side and turned his chair so he could look directly at her.

  'Now, as you're the local expert on ethnic culture, perhaps you can explain how a visitor damn near set fire to the hospital.'

  Katy eyed him warily, unable to judge if he was angry or amused.

  'The hospital was never in any danger.' She plunged into her defence with a stout heart. 'The fire alarms are so sensitive even burning toast will set them off.'

  'So, do we remove all the fire sensors in the maternity ward when Asian patients are in residence?'

  The question was asked with such silky restraint it prodded anger into life.

  'Don't be ridiculous!' She flung out her arms in exasperation, knocking over her prized brass pelvis. 'The whole point of the new unit is not a place so much as an approach. I've already said that the hospital needs to set up antenatal clinics for these women which will include group discussions on childbirth and confinement, but it's a two-way street, Jake. We can listen to these women and try to understand what they want, but it also gives us the opportunity to explain the way the hospital works—including the fact that we have fire sensors in all rooms, and that water sprays from the ceilings if smoke is detected.'

  He reached out and picked up the fallen ornament, running his fingers over the smooth metal.

  'Okay, I take that point. Now perhaps we could go back to today's little disaster and the term they used. "Roasting", wasn't it?'

  Katy felt a surge of hope.

  'You've got to understand that a great deal of Asian medicine is based on what
they call "humours",' she began.

  'The concepts of hot and cold, of yin and yang.' He nodded as if he'd heard or read of this.

  'That's right,' Katy agreed. 'If you can go along with the concept of hot and cold, then you'll understand when I say most Asian women believe the loss of blood during childbirth leaves them cold. In almost all of their cultures there are provisions for confinement that concentrate on keeping the body warm.'

  'Which is why, on a warm day, that woman was rugged up like a football spectator outside on a winter afternoon.'

  Katy grinned at him.

  'Dreadful, isn't it?' she agreed. 'But that's to our way of thinking. And that's why her friend brought in the little fire-pot. Vietnamese women, in particular, believe the body benefits by lying over a fire. To them, it not only replaces lost heat hut it helps dry up the lochia and shrink the woman's tissues back into place. In parts of China it's called "lying in the fire". Some cultures observe the ritual for three days, while others believe you must keep it up for the whole month.'

  'Doing the month,' he murmured, and she remembered he had asked about it earlier.

  She was wondering where she could begin her next explanation when his pager buzzed and he turned away to press a number on his phone.

  He was as quick on the uptake as he'd always been, she realised, listening as he switched from one conversation to the next. She felt pleased the head injury he'd received in the accident hadn't left any lasting legacy, then chided herself for caring what had happened to him.

  Professional efficiency, Katy! she reminded herself, and turned the thought to her own advantage.

  Surely his intellectual ability should help him grasp the importance of establishing the new unit—although it was a leap of faith to hope he'd understand it all in twenty-four hours. She had been studying the language, customs and culture of these women for two years and still understood so little. How could she explain to someone who had no prior knowledge, had done no background reading on the subject?

  'I'll have to leave it till later,' he murmured, slipping his hand over the mouthpiece on the phone while he spoke to her.