After that, it was easy to explain her concern that the other hospital might have left the little boy on too high a dose of several drugs purely for convenience, knowing that they were going to have to ship him out to another unit, and that this might be having an adverse effect on his own body’s slowly developing control systems.
‘So, what are you proposing? Stopping those drugs?’ His voice was deceptively mild but she could hear the underlying challenge to justify what she’d decided was the right course of action.
‘Stopping some…yes, replacing others…probably, but doing nothing immediately so that he has time to relax and settle down after the journey,’ she said firmly. ‘His parents have only just caught up with him and they need a little time to get to know us and our regime before they’ll start to trust us.’
Josh was smiling by the time she stopped to draw breath.
‘It sounds as if you’ve got everything under control,’ he said, and she glowed inside. ‘I’ll go through the file in the next half an hour, then come out to meet Ricky and his parents.’ He tapped a thoughtful finger on the manila cover of the file. ‘Any other problems? Anything else you want?’
Apart from you? the voice in her head said, but she shook her head. ‘Nothing at the moment. Megan’s actually put on a little weight, but she’s still forgetting to breathe sometimes. Her mum’s getting really good at flicking the bottom of her foot to get her started again. Apart from that, there are several sets of test results due back from the labs soon. I’ll get them entered in the relevant files as soon as they arrive.’
‘Good. Nag them a bit, to make sure they haven’t just forgotten to send them through. I’ll go over them after I’ve spoken to Ricky’s parents, then we can—’
The strident ring of the phone interrupted him and the quick frown that followed whatever the caller was saying didn’t bode well.
‘She needs to come in as soon as possible,’ he said shortly. ‘Bring her directly to the unit without wasting time in A and E. We’ll be waiting for her.’ He was already on his feet by the time the call ended.
‘What’s the matter?’ Dani’s pulse was already racing with the prospect of an emergency admission. That was certainly what it had sounded like.
‘A home birth has hit some problems. The little girl became distressed during the delivery, but the mother was determined to have her perfect natural delivery and refused to be transferred.’ His anger at the selfishness of the unknown woman couldn’t have been more obvious. ‘The baby’s inhaled meconium…rather a lot of it, apparently.’
Dani swore under her breath as she followed his long-legged strides out of the room, this time needing to jog to keep up with him. Having a baby inhale the black sticky substance that had formed in the foetal bowel could be bad news…very bad news, with complications ranging from impaired breathing to brain damage or even death. Apart from the fact that the delivery hadn’t immediately been transferred to the hospital when things had started to go amiss, what on earth had gone wrong that the midwife hadn’t suctioned the foul stuff away before the newborn had taken her first breath?
‘Where on earth are we going to put her?’ she demanded while she still had breath of her own. ‘Now that Ricky’s arrived from Barchester, we haven’t got a cot free to put her in, or the staff to special her. I know if everything goes well that her treatment should be mainly supportive after the first few hours, but initially her care is going to be very time-consuming.’
‘We’re going to have to play roulette with babies’ lives…again!’ he said grimly as he began a lightning circuit of the isolettes to try to decide which of the babies might be strong enough to leave them.
When the paramedic carried the newborn into the unit, closely followed by a colleague laden with oxygen and primary portable monitoring equipment, Dani’s heart sank. She could actually hear the little grunt that came with every breath right across the room, in spite of the muffling effect of the oxygen mask.
‘Bring her in here.’ She beckoned, indicating the theatre anteroom. ‘We’re still trying to make space for her and it’ll take a few more minutes before everything’s been set up.’ Apart from anything else, the bay where she would soon be installed was having the usual stringent clean before she was admitted to make sure there was no chance of adding a hospital-acquired infection to her woes.
Not that little Sima, the previous occupant, had suffered any ill-effects from her stay there. The tiny girl’s recovery from major cardiac surgery had been almost miraculous, but neither Josh nor Dani were happy with shipping her out of their care quite so quickly.
‘She hasn’t had any pulmonary lavage,’ the paramedic warned as he deposited his tiny charge on the trolley, automatically positioning her so that the foul meconium wouldn’t be sliding any deeper into the lungs. ‘In spite of the oxygen, she’s breathing too fast and she’s already starting to become cyanosed.’
‘What about her pulse?’ Dani reached out with gentle fingers, hoping to find a reassuring steady beat.
‘Tachycardic,’ the man said succinctly, confirming what her fingers were telling her and dashing her hopes.
‘How is she doing?’ There was concern in Josh’s voice but it was the warm husky burr so close behind her that had Dani’s nerves tingling. ‘We’re ready to settle her into her new bed if she’s…Damn!’ he exclaimed when the little body suddenly stiffened under their eyes and began to convulse.
CHAPTER EIGHT
‘WHAT have you done to my baby?’ wailed a voice at the doorway, and Dani spared a swift glance for the figure in the wheelchair, guessing that this was the unfortunate child’s mother.
‘She breathed some muck in during the delivery and it’s interfering with her breathing,’ Josh explained tersely, even as he was drawing up an anticonvulsant into a small syringe.
‘What are you giving her?’ the woman demanded. ‘I don’t want her to be filled with unnecessary drugs.’
They all paused for a fraction of a second and Dani could almost hear Josh’s brain considering exactly how to reply…politely.
‘Do you want me to throw the drugs away and let your daughter die in the next couple of minutes, or shall I administer this and give her a chance to live?’ he challenged frankly, the needle gleaming sharply under the unforgiving lights as he held it out towards her in his gloved hand.
All the staff knew that if the parents refused to allow the vital treatment, the hospital could have the baby made a ward of court so that they could do whatever was necessary to try to save her life, but that would take time that this sick infant just didn’t have, not if they were to minimise her chances of suffering permanent brain damage from lack of oxygen.
‘D-die?’ the woman stammered, her face visibly draining of colour. ‘B-but…she only got some muck in her face as she was being born. They all come out looking a bit mucky…don’t they?’ She glanced wildly from one face to another and they could almost see her willing them to agree with her.
‘This was more than a bit mucky,’ Dani said, stepping towards the confused young woman. ‘The stuff your baby breathed in is a cross between…between superglue and toxic waste, and at the moment it’s damaging your daughter’s breathing so badly that the rest of her body just can’t cope on its own. She just needs help. That’s all we want to do, I promise you…help her while she’s struggling so badly.’
The new mother’s eyes were bloodshot and full of panic but her gaze clung to Dani’s as though she were a life raft in a perilous sea.
‘Please,’ she whispered through bloodless lips. ‘Save my baby. Save my Rosie.’
Dani felt a brief spark of satisfaction that she’d gained permission but when she turned back to the shuddering little figure on the trolley she realised that Josh had already administered the antispasmodic while the decision was being made.
‘Jumped the gun a bit, didn’t you?’ she muttered under her breath as she rejoined him, knowing just what a risk he’d taken with his professional standing. The
hospital’s legal department would have been the ones going into seizures if they’d known.
‘I never had a moment’s doubt that you’d be able to persuade her,’ he murmured back even as he swiftly drew a blood sample. ‘I’ve been on the losing end of the pleading expression in those blue eyes for too many years.’
The eyes in question took a quick panicked look around, trying to see whether any of the other staff had noticed his unwary reference to the fact that they’d known each other for a long time. Until that moment he’d been so careful, for both their sakes, not to let that little item get out.
Anyway, it wasn’t true. She hadn’t spent all those years trying to persuade him to do things for her…had she?
‘I can hear your brain whirring,’ Josh said, and she realised to her horror that she had absolutely no idea just how long she might have been standing there mulling over his words. ‘Are you happy to transfer Rosie?’
‘Rosie?’ She blinked, wondering how much she’d missed. Who on earth was Rosie?
Josh’s pointed glance down at the strangely still figure in front of them brought her back up to speed. ‘Her bed was almost ready when we came in here,’ he continued. ‘But now that we’ve stopped the seizure, we really need to get her into Theatre and see if we can clean her up a bit.’
‘Theatre?’ The new mother’s fears came spilling over again in spite of the fact that her husband was now standing behind her with his hands cradling her shoulders and stroking them soothingly. ‘You’re not going to operate on her!’
‘Of course not,’ Josh agreed easily. ‘It’s just that we’ll have a bit more room in there than we’ve got in here, and the lighting’s a bit better to see if we can wash the muck out of her.’
Without another word needing to be spoken, their newest patient was transferred through the batwing doors, leaving her parents firmly on the other side.
‘Connect her up to all the monitors,’ Josh said briskly. ‘Who’s the anaesthetist on duty? Is he on his way? I want constant readings on her blood gases while we do pulmonary lavage. We’ll need to suction mouth, pharynx and trachea and bag-ventilate between lavages with high concentrations of oxygen.’
As the scene played out around her, Dani began to wonder if she’d ever be good enough to take on a job like this. Josh made it seem almost effortless, barely pausing for breath before he was issuing his next request or performing the next procedure.
She felt quite wrung out when it was finally time to transfer Rosie to the warmth of the waiting humidicrib, and Josh was still issuing directions.
‘Monitor temperature and humidity,’ he said briskly to one of the more senior nurses, and Dani wondered exactly when he’d managed to organise for her to special their newest charge—he’d been fully occupied from the second that Rosie had arrived.
‘And measure every millilitre of fluid in and out to give us warning of any kidney problems,’ he continued, almost without drawing breath. ‘Her chest is noisy—as it would be after everything that’s happened in the last hour—but keep an ear open for any changes, in case she’s starting to develop an infection from the gram-negative bacteria. God forbid she gets chemical pneumonia,’ he added fervently, and Dani silently echoed the thought.
It would be tempting to add prophylactic antibiotics to the mixture of treatments she was receiving, especially for gram-negative bacteria, but she knew that it was better to hold off, keeping the drugs in reserve in case she actually showed signs of infection. Her little body had enough to cope with at the moment.
Dani was casting one last glance over her shoulder as she left the room when a lean arm suddenly wrapped around her shoulder and gave her an unexpected hug.
‘You did well,’ Josh said with a smile that instantly doubled her heart rate. Every inch of her body registered the impulsive contact, relishing the sensation from her shoulders right down to her knees.
He was so hard and strong against her, the person she’d depended on and leant on for so much of her life. And he was so warm, and she could even hear the steady thump of his heart under her ear where it pressed against the muscular wall of his chest.
Her knees started to buckle and she drew in a swift breath to try to regain control, but that only drew in the familiar mixture of the same shampoo and soap that had lingered in the shower this morning, this time combined with overtones of healthy virile male.
Her pulse started to race at the intimate images that started to form inside her head and she only had a few seconds to register the fact that Josh’s heartbeat had grown noticeably faster, too, before his arm was abruptly withdrawn and he was standing with the full width of the corridor between them.
Her brain scrambled to understand exactly what had just happened, but all she could come up with was the echo of his words of praise.
‘I didn’t really do anything,’ she said, silently cursing the unexpectedly husky edge to her voice. ‘You were doing all the important things.’
‘And you somehow managed to anticipate me at every stage so that I barely had to ask for a thing,’ he pointed out seriously. ‘Given that you’ve been in the unit such a short time, I was really impressed that your instincts were so good.’
Was it her instincts?
Dani wasn’t so sure as she replayed that fraught time in her head. Yes, she’d been able to find the right words to persuade Rosie’s mother to trust them to do what was right for her precious daughter, but how much of the rest had been the fact that she felt a special kind of connection with Josh?
She stifled a laugh, glad that no one could hear what she was thinking or she’d end up being sent for psychiatric evaluation.
But it was true, nevertheless. For a long time she’d had the feeling that there was a unique empathy between the two of them that enabled her to know what he was thinking and feeling and…
‘What rubbish!’ she scoffed aloud, then remembered where she was and continued in a mutter under her breath. ‘If you really knew what he was thinking and feeling, you would know exactly how he feels about you…and you don’t!’
Oh, she knew that he had always cared about her from the moment she’d been born, as a big brother cared about his little sister, but that wasn’t what she wanted now.
‘And I honestly haven’t got a clue how he feels about that,’ she grumbled crossly, and only then realised that perhaps she had warranted the praise that Josh had dealt out this morning. If it hadn’t been some non-existent mystical connection between them that had helped her to anticipate his needs, perhaps it had been the fact that her medical and clinical instincts were growing.
But she really didn’t have time to think about herself, not with the unit bursting at the seams and so many of their patients critically ill.
It seemed as if she and Josh were kept running from one baby to the other with crisis after crisis, sometimes almost colliding as they hurried to respond to the shrilling monitors.
It was gone two in the afternoon before Dani decided she simply had to take a break, not just because her body was desperate for a serious intake of calories but because she hadn’t been near a bathroom for more hours than was sensible.
‘That feels better,’ she murmured as she washed her hands, then jumped when someone behind her laughed. ‘I know what you mean,’ Nadia said ruefully. ‘The rules might say that we’re entitled to so many minutes break per shift, or whatever, but they must have been dreamed up by someone who’s never actually worked in a hospital.’
‘As if patients are just going to miraculously not need us because some bean-counter decrees it’s time for a little…relief,’ Dani agreed with feeling. ‘It would be different if there were enough members of staff to cover for us while we had a drink or something to eat, but that would mean paying an extra salary or two, and they wouldn’t do that, not when we’re mugs enough to cover for each other.’
‘Still, I wouldn’t swap my job for something at a desk,’ Nadia said as they made their way back out into the corridor. ‘The pay and
conditions are terrible and there’s so much heartbreak along the way when some of the tinies don’t make it, but when one of them does…’
‘It makes everything worthwhile,’ Dani finished for her, in total agreement.
‘Especially when you’ve got a boss like ours,’ Sally joined in with a sly nod towards Josh’s familiar figure. ‘What that man does for a pair of crumpled scrubs!’
Dani felt the familiar heat start to creep up her throat and silently cursed her pale complexion, then decided there was only one way to deal with the situation—to play up to it.
‘Tell me about it!’ she joked, flapping a hand in front of her face as if to fan the heat away. ‘A butt that perfect ought to be made illegal, especially in thin cotton pyjamas.’
Nadia chuckled, then had to swiftly stifle her laughter when Josh turned to look at the two of them through the glass wall. ‘Do you think he heard us?’ she hissed with sparkling dark eyes.
Dani shook her head, but she knew from the expression she’d caught in his eyes that he had heard her remark. The thing she hadn’t been able to tell was what he’d thought about it.
BB: We need to make a grocery run.
Josh paused with his fingers resting on the computer keys and groaned aloud at the prosaic message. It wasn’t what he’d wanted to say, not after the conversation he’d overheard earlier today.
If any of the babies had been crying, he probably wouldn’t have heard a thing, but they’d all been blessedly quiet for a few moments and the words had reached him all too clearly.
‘A butt that perfect ought to be made illegal,’ Dani had said, and when their eyes had met, she’d known he’d heard her, but what he didn’t know was whether she’d only said it in fun or whether she really thought he had a perfect butt.
‘For heaven’s sake! How juvenile can you get!’ he admonished himself, appalled at how pleased he’d been at the thought she’d been looking at his body and liked what she saw.
A wife for the baby doctor Page 11
