A Mother by Nature

by Caroline Anderson

  ‘I’d love to go home,’ Kate confessed. ‘I’m so bored in here. I want to go back to school.’

  ‘Well, that might be a bit quick but you should be able to manage at home all right, I think. Do you need to ring anyone?’

  ‘My car’s here,’ Mrs Funnell said. ‘I can take her straight away.’

  ‘Well, I think Mr Bradbury will come up and see you first—oh, here he is now.’

  Their eyes met and they shared a brief but intimate smile. ‘Kate’s keen,’ she said, and he grinned at the girl.

  ‘How did I guess?’ Adam looked at her leg, and nodded. ‘You’ll be fine,’ he told her. ‘Go home and enjoy yourself. Not too much weight-bearing, and you’ll have to come back every day for physio, but you should be all right now. I’m sorry to hustle you, but I don’t think you mind too much, do you?’

  Kate grinned. ‘Absolutely not. It’s brilliant.’

  He chuckled, winked at Anna as he turned away and then strode off, presumably to A and E. The phone rang again, and Anna left another nurse sorting out Kate’s discharge notes and went to get the phone.

  ‘Right,’ she said, gathering them all together. ‘First one’s coming into A and E now. Make sure everything else that needs doing gets done. I’ll deal with the new admissions. Allie, I want you to take over the running of the rest of the ward for now, please. Make sure nothing falls down the cracks. I don’t want drugs forgotten and treatment neglected just because we’re going to be rushed off our feet. And don’t forget to smile at the children. They’ll be scared, they’ll be hurting. Their parents will be panic-stricken. Be calm and be kind, and keep your eyes open for anything that’s been missed. Right, off you go.’

  Adam went into A and E, looked around and found a cluster of doctors around Patrick Haddon, one of the A and E consultants. ‘Right, we’ve got three orthopaedic teams on standby, including Adam Bradbury—Hello, Adam, come and join us. You know Robert Ryder, don’t you, and his registrar David Patterson? You’ll be the three teams. I want you to work together on the orthopaedic cases, prioritising and allocating them to your teams according to your areas of expertise. I know we’ve got one pelvic fracture coming in, and possibly others. There may be spinal injuries. Neuro are standing by for those, but I gather your Stryker bed is in use at the moment, Adam?’

  ‘Yes, it is, but he’s virtually ready to come off it. I could free it if it was absolutely necessary.’

  ‘OK. We’ll see. Lots of arms and legs, I expect. That’s normal. There are internal injuries, of course—Nick, you’re in charge of those. I want everyone tri-aged, stabilised, X-rayed and sorted as fast as possible—just don’t miss anything in your hurry. Right, I can hear a siren—I think we’re in business.’

  It was chaotic, but they were so busy there wasn’t time to notice. The pelvic fracture was nasty and needed external fixation, and Adam, scanning the plates of the other children who had been processed, decided he ought to take the pelvis. He was just about to pull the plates off the light box when he noticed a tiny, almost invisible little line across one of the vertebrae.

  ‘I want another view of this,’ he said to the radiographer. ‘Very, very carefully. It looks like a very unstable fracture. Don’t shuffle him about.’

  ‘OK. What view do you want?’

  ‘Lateral, please—and oblique. Might pick up more.’

  He was right. It was a fracture through the vertebral body of the fourth lumbar vertebra, and the lateral view showed a segment of bone poised to slice into the spinal cord.

  ‘That will need fixing,’ he said to Robert Ryder. ‘I want a CT scan before I do anything, and he needs to stay on the spinal board. He’ll need blood crossmatched. Those pelvic fractures will be bleeding heavily into the tissues.’

  ‘You’ll have to fight the neuros for the scanner. They’ve got a couple of head injuries.’

  ‘We can wait for them. I need to do a couple of others first, I think. He’s not that urgent, he’s just critical. What else have we got?’

  They scanned through the notes, went round and saw the injuries at first hand and then they started in earnest.

  Adam’s first case was a nasty fracture of the hand and arm, and he worked for two hours to restore the circulation and realign the bones to his satisfaction. That case was followed by his pelvic and spinal fracture patient. After studying the CT scan, he decided how to tackle the vertebral body and went in carefully through the abdomen, meaning to tackle the bone from in front of the cord.

  ‘Pressure’s crashing,’ the anaesthetist warned. ‘Have you got a bleed there?’

  ‘I reckon. Whoops,’ he said as they opened the abdomen. ‘I think we have a major leak. Can we have four units in here fast, please? This kid’s going to bleed to death. Where the hell is it coming from? Can I have some more suction? Thank you.’

  It was a race against time, but finally he found the leak, a vessel that had been ruptured by the end of one of the pelvic bones. Once it was stopped, they could begin to work on the patient again, and Adam focused on him and forgot about everything else.

  There was no time to worry about the patients that were waiting, or the nanny his children hated, or whether his mother would get the answerphone message.

  Anna stayed on after the end of her shift, checking head injury cases every few minutes for change in status, monitoring possible internal injuries, providing post-op care to the minor orthopaedic cases that came back from Theatre.

  She gathered that there was a boy with a spinal fracture that Adam was fixing, who also had a severely broken pelvis. She wondered how on earth they were going to nurse him, and then Adam appeared, rubbing his eyes and flexing his shoulders.

  ‘You look bushed.’

  ‘I am bushed—what are you still doing here?’

  ‘Helping out. They’re rushed off their feet, I could hardly go. Have you spoken to your mother yet?’

  ‘No—I’m going to do that now. I’ll ring home and see if there’s been blood-letting. What have you got for me, or are they still down in A and E?’

  ‘Two fractures—an arm and a leg. Displaced fracture of the olecranon, and a femur. Simple fracture.’

  ‘Brilliant,’ he said, rolling his eyes. ‘I hate elbows. OK. I’ll do the femur first. Keep the elbow still and give pain relief—is it written up?’

  ‘I believe so. She’s crying.’

  ‘I’m sure she is. If I’d yanked off the end of my funny bone, I reckon I’d be crying.’

  He disappeared into the office and came out a minute later looking ragged. ‘My mother’s there. The nanny’s gone. She’s sacked her. She smacked Jasper this morning because he was crying. Mum’s reported her to the agency. What the hell do I do now?’

  ‘Your femur and your elbow. Your mother is quite capable. Don’t worry.’

  ‘And what about tomorrow?’

  ‘Bring them in. They can sit here and watch telly and do drawings and play with the others. It won’t be a problem. Go and operate.’

  Adam flashed her a weary smile and headed off towards the corridor. Anna carried on with her postop and pre-op care, checking drips, calming parents, and it was hours before the ward settled to something approaching normality.

  She went home, ate a sandwich in the bath and crawled into bed. She was just dropping off to sleep when the phone rang, and she stretched out an arm and grabbed the receiver.

  ‘Hello?’

  ‘Hi.’

  Her heart did its usual jig, and a smile curved her lips. She settled down with a contented sigh. ‘Hi. How was it all in the end? Done your elbow to your satisfaction?’

  ‘Yup. Done it all. I’m home, finally.’

  ‘How are the kids?’

  ‘Asleep. I’m going to ring the agency in the morning and give them hell. I’ve bribed my parents to stay until the weekend, but they go to Florida on Tuesday. That gives me not quite a week to sort something out.’ He sighed. ‘Do you know, I can quite see why women don’t make it up the career ladder
. It would be so much easier if I were self-employed or had a less pressured job.’

  She could have told him the answer, but he didn’t want to hear it, and she was sick of throwing herself against that particular brick wall. ‘Have a bath and go to bed,’ she told him.

  ‘I’m in the bath,’ Adam said. ‘With the cordless phone and a glass of wine. Bliss.’

  ‘I’m in bed,’ she said softly.

  She heard his indrawn breath, and smiled.

  ‘Did I wake you?’

  ‘Not really. I don’t mind, anyway. It’s nice to talk to you.’

  ‘I wish I was there with you,’ he said softly. ‘I could do with a hug.’

  ‘Only a hug?’ she asked, and he gave a low chuckle.

  ‘OK. I confess.’

  ‘I wish you were here, too,’ she admitted. ‘I never used to mind sleeping alone.’

  ‘Close your eyes and pretend I’m there.’ Her lids drifted shut, powerless to resist, and he carried on talking, driving her crazy with his soft, hypnotic voice. ‘Imagine I’m touching you, running my hands over you, feeling your skin burn against my palms. Imagine my body—’

  ‘Adam?’

  There was a startled grunt, followed by a splash and a muttered curse.

  Anna’s eyes flew open, and she started to laugh. ‘Is that your mother?’

  ‘Yes—I’m on the phone,’ he said through the door.

  ‘Oh. Right. I’ve made tea.’

  ‘Thanks.’

  She heard the footsteps retreating, and the sound of his muffled laughter. ‘I could kill her. I nearly dropped the phone in the bath.’

  ‘She’s lovely.’

  ‘She’s everywhere.’ He sighed, and lowered his voice. ‘I want you.’

  She swallowed. ‘I know. Why don’t you sneak out? Tell her you need to buy milk or something, or you need a walk.’

  ‘I could tell her I need to come and see you. She’d love it. She hasn’t stopped talking about you since the day after the ball.’

  ‘So why don’t you?’ she asked softly, but she knew he wouldn’t.

  He gave a quiet sigh, and for a moment he was silent. When he spoke, she could tell he was back to reality, back to his responsibilities and duties. ‘No. I’ll see you tomorrow. Are you on early?’

  ‘No, I’m on a late.’

  ‘Fancy a wake-up call?’

  ‘Adam!’

  ‘What? Oh, damn. Yes, Mum, I’m coming!’ He sighed again and gave a lazy, sexy chuckle. ‘I wish. I’ll see you tomorrow. Sleep tight.’

  ‘What on earth?’

  Anna slid her legs over the side of the bed, grabbed her dressing-gown and ran downstairs, shoving her hair out of her eyes with one hand as she fumbled for the door.

  ‘Breakfast,’ Adam said, pushing the door shut and pulling her into his arms.

  She laughed and looked up at him through bleary eyes. ‘You’re crazy. I was asleep—it’s only half past six!’

  ‘I’m sorry.’ He cupped her chin, his thumb absently caressing her cheek. ‘I missed you last night. That phone conversation did nothing for my sleep patterns.’

  ‘I’m sure. I had some pretty colourful dreams myself.’ She ran her tongue over her teeth and pulled a face. ‘I need five minutes in the bathroom. Put the kettle on, there’s a love.’

  She ran upstairs, showered rapidly and cleaned her teeth, then came out to find Adam naked in her bed with a tray of fresh, steaming tea and a plate of chocolate-filled croissants on his lap.

  He patted the mattress beside him. ‘Breakfast in bed,’ he said with a slow smile, and her heart thumped.

  ‘Sounds good.’

  ‘It will be,’ he promised, and moved the tray out of the way. ‘You can eat later. That’s dessert.’

  Anna had a silly smile on her face all day. Adam had only been there an hour, but it had been the most wonderful hour of her life to date. The memory carried her through a difficult shift, with every bed full and many of their little patients in quite critical condition.

  The boy with the fractured spine and pelvis was being nursed flat in a bed with a special mattress, because he couldn’t be turned due to the external fixator on his pelvis. He was catheterised because of bruising to his bladder nerves, and his legs were tingly and funny, he said, but all in all he’d escaped lightly.

  Adam had been to see them all and was satisfied with their progress. He was wonderful with the parents, Anna thought, watching him in action. He explained just enough, so that they didn’t feel patronised and yet understood what he’d had to do and why.

  It was a skill a lot of doctors didn’t have, Anna knew, but it didn’t surprise her that Adam had it. He seemed to have a natural ability to communicate, and a real empathy for the parents.

  Little Emily Parker with her brittle bone disease was the only one he was really concerned about, and yet she was making progress. It was just slower than he’d hoped, and he was concerned about her chest.

  ‘It’s very compromised,’ he murmured. ‘Those ribs are a very funny shape. There’s no way she can be getting any real movement through them, so all her breathing’s abdominal.’

  ‘The prognosis is pretty awful, isn’t it?’ Anna said thoughtfully.

  ‘I would say she’s on a knife edge,’ Adam admitted. ‘I don’t know what will get her in the end—a cough, probably. She’ll end up with fluid on her lungs and drown. Just keep her away from anyone with a cold.’

  It wasn’t possible. On Thursday she started coughing, and on Friday morning, when Anna went in, her bed was empty.

  ‘Where’s Emily gone?’ she asked the night sister, a dreadful suspicion forming in her mind.

  ‘Ah. We lost her at three o’clock this morning. She got pneumonia. Her lungs filled, and then she arrested. Adam tried to resuscitate her but he couldn’t get her back. He was gutted.’

  Anna sat down with a bump. ‘Oh, damn,’ she said heavily. She thought of the gutsy little girl with her terribly deformed bones, and her dedicated mother who had spent most of the past six years protecting the fragile child from the world. And now she was gone, wiped out, taken by some trivial and inconsequential cold.

  ‘It was inevitable,’ the night sister said pragmatically. ‘It was bound to happen, Anna.’

  ‘I know,’ she said, but that didn’t stop it getting to her. After she’d taken report, she went into the kitchen, howled, blew her nose, washed her face and got out her rescue kit. That was where Adam found her, dabbing concealer under her eyes. She looked at him in the mirror then put it down and turned and took him in her arms.

  ‘I’m sorry, love,’ Anna said tenderly, and he hugged her hard. She could feel the tension in him, feel the pain still looking for a way out.

  ‘Come and see me tonight,’ she said, and he nodded.

  ‘I will.’ He moved out of her arms and slumped against the edge of the worktop with a harsh sigh. ‘How many patients have I lost? How many times have I gone through this process? You’d think I’d get used to it.’

  ‘I’m glad you haven’t. I think it makes you a better doctor.’

  Adam gave her a crooked smile. ‘I don’t know about that, but I think it makes me a better parent. I went home and stood in Skye’s room and looked at her, and wondered how I’d feel if it had been her. They were the same sort of age—Emily was a little older, although you would never have known that from looking at her.’

  He looked down at his hands, hands that had failed, and sighed again. ‘I know it had to happen, I know it was a blessing in disguise, I know she’d suffered terribly in her life and was lucky to have survived so long. It still hurts.’

  ‘I know. Want to borrow my lipstick? It works for me.’

  He laughed softly and hugged her again. ‘You’re a treasure. I’ll see you tonight, if not before. I might even come clean with my mother and spend the evening with you. How would that be?’

  ‘Lovely,’ she said, and wondered what it was really like to be a hamster in a cage and be taken out occasio
nally for the odd run around before being put back again.

  She stopped her train of thought there. Adam was stressed enough, torn in all directions, and it wouldn’t help at all if she was sulking because he couldn’t tear himself into even more bits. He needed her. That was all that mattered at the moment.

  He needed her, and she loved him. There was nothing more to say.

  CHAPTER NINE

  ADAM took Anna to a quiet country pub, where they sat in the corner by a log fire, and he dropped his head back against the wall and sighed. He was tired—tired, and sad, and worried about the children.

  ‘What a day,’ he mumbled.

  ‘How are the kids?’ she asked, zooming in on his main concern with her usual accuracy.

  He shut his eyes and groaned. ‘Don’t. I still don’t have a nanny sorted out. I rang the agency and told them what I thought of them, so that takes care of them as a source of child care.’

  ‘Oops. Bit firm, were you?’

  He met her eyes and dredged up a laugh. ‘Just a bit. Put it like this, I don’t think they’re in any doubt about my feelings. Then I tried the au pair agency again and they’ve promised me someone, but they can’t do anything for at least a fortnight, and my parents are going to Florida in three days’ time.’

  He picked up his beermat and shredded it absently. ‘What do I do, Anna?’ he asked with studied calm. ‘Do I give up work?’

  ‘Don’t be silly!’ she exclaimed. ‘You can’t—you’re too valuable. What would your patients do without you? Your gifts are too great to be wasted, Adam. You have to work.’

  Strange, how her words warmed him and made him feel better. Some things, though, couldn’t be made better. ‘I lost Emily,’ he said.

  ‘You didn’t lose her, Adam,’ she pointed out gently. ‘She was already lost when she was born. Taking responsibility for that is assuming too much. You simply aren’t that omnipotent. Leave that sort of thing with God, where it belongs.’