by Lucy Clark
Miles nodded, already aware of the seriousness of Philip’s case, and slowly exhaled, feeling the weight of the situation.
‘Let’s go and review him again,’ Janessa replied. Philip was too young, too premature, too sick, and yet she wanted to do whatever they could in order to give him the best chance at fighting. They headed over to where Kaycee was closely monitoring Philip.
‘We have to try,’ she implored, looking directly into Miles’s blue eyes, almost pleading with him to make things better. ‘We have to try.’ This time her voice broke on the words. Miles nodded and placed a hand on her shoulder. The touch wasn’t romantic or sensual. While the warmth from his hand seeped into her body, she understood the show of support and solidarity his touch evoked.
‘You’re right, even if that means surgical intervention.’ Thoughts of being unable to help his own little baby, the eight-month-old dying in his mother’s arms during the horrific train crash, came back to haunt him. Miles knew he would do everything he could in order to give Philip the best chance possible. ‘We owe Philip that much.’
With his words and his touch, Janessa felt a certain level of relief from her exhausted and frazzled nerves. Miles understood. Miles was also concerned about Philip and he knew they had to try.
Swallowing over the dryness of her throat, she breathed in a cleansing, calming breath and nodded. ‘Thank you, Miles.’ There was another beat where the two of them just stood, just stared, just absorbed, before he quickly dropped his hand and turned away.
‘I’ll go and speak to the mother.’
‘Violet,’ Janessa said.
‘Pardon?’
‘The mother. Her name is Violet and … Do you mind if I come, too?’
‘No. Not at all.’ Miles was pleased she wanted to join him as it only proved once again just how much Janessa cared about her patients, not only the babies but the mothers as well. Miles turned to Ray. ‘You’re trained in neonate theatre procedures, aren’t you, Ray?’
‘Most certainly, sir,’ Ray replied, rolling his ‘r’s. ‘I’ll go and prepare the theatre and contact the anaesthetist.’
‘Excellent.’ Miles returned his attention to Janessa and swept his arm across his body. ‘Shall we, Dr Austen?’
Janessa nodded and together they headed to Maternity where the young mother was lying in a bed, staring unseeingly out the window. Janessa drew the curtain around the bed, giving them some privacy from the other mothers in the ward.
‘Hi, Violet.’ Janessa smiled at her. ‘How are you feeling? Any pain?’
‘I’m fine.’ She tossed the words out carelessly as though she didn’t care about herself but sat up in the bed, gripping the sheets with both hands. ‘Philip? What’s happened? Is he all right? Has something gone wrong?’ Her words tumbled out too quickly and Janessa instantly went over and put her hand reassuringly on the young mother’s white knuckles.
She hated giving people bad news but she’d learned over the years that the best way was the direct way, combined with heart-felt compassion.
‘Philip isn’t doing too well at the moment. The hole in his heart is causing him more problems than his little body can deal with,’ she began.
‘We need your permission, should surgical intervention be necessary,’ Miles continued, and went on to explain to Violet why Philip might need this surgical procedure. Throughout the entire discussion Miles was intrigued by Janessa, watching the way she seemed to relate on a personal level to Violet. There was vehemence in her words and repressed pain in her eyes. It wasn’t only that she was being considerate to her patient, there was something deeper in her words, in the way she was making sure that Violet understood everything, in not talking down to the teenage mother. The compassion Janessa offered was complete to the point of perfect and it made him wonder whether something had happened to Janessa.
After they’d obtained Violet’s permission, they headed back to the NICU, Miles still curious about his colleague. Janessa was quieter now, subdued but still direct in her actions and steadfast in her determination to do everything possible for Philip.
On entering the NICU, Miles headed off to the theatre and Janessa washed her hands thoroughly before heading over to Philip’s humidicrib where Kaycee was still keeping vigil. She reached in and touched the little baby’s stomach, stroking gently, crooning to him.
‘We’ll help you, sweetheart. As much as we can. We’ll do everything possible. Be strong.’
‘It doesn’t look good,’ Kaycee said a moment later.
‘I know but even admitting that doesn’t feel right.’
‘He’s too young. Even now, the risks are …’ Kaycee trailed off, realising she didn’t need to voice the thoughts both women were thinking. Janessa sighed, pain piercing her heart for the tiny life.
Soon it was time for Philip’s surgery and after Ray had collected the baby from the NICU, Janessa went and scrubbed, pulling on her professionalism, ready to assist Miles. When he started performing the keyhole surgery on the tiny anaesthetised baby, Janessa found herself becoming more fascinated by his skill, and by the end of the surgical procedure, which had been undertaken with such precision and grace, she stood in compete awe of Miles and his abilities.
She’d read his articles and she’d always known he was the best. It was the reason why she’d requested he be the neonate surgeon in charge of Sheena’s twins, but being here, watching him … it had only helped to solidify in her mind just how incredible Miles Trevellion really was. He was perfectly suited to this work, and although, through his publications, she’d been able to learn of his academic career and the way he’d become so specialised in this field, she had no idea what had prompted him to enter into neonatology in the first place. As a surgeon and colleague, he had her utmost respect but even as they degowned, she couldn’t help but wonder what it was that made the man tick.
That, however, was an area she’d already marked as dangerous to enter. Hadn’t she lain awake at night, wondering about him? Hadn’t she tried to school her thoughts so she didn’t dwell on the unanswered questions that didn’t seem to want to leave her mind?
Deciding she needed a distraction and to get out of the NICU, and knowing she was leaving Philip with the best possible care, she headed up to the maternity ward to check on Sheena.
‘He was amazing,’ she said to her friend, her face alive with appreciation.
‘I thought you weren’t allowed to discuss patients with me,’ Sheena remarked.
‘I’m not discussing the patient, I’m discussing Miles and the way he performed the surgery.’
‘Sounds as though you’re really becoming … attached to the man.’
‘Purely in a professional capacity,’ Janessa quickly pointed out. ‘It only proves that he is the most perfect doctor to be looking after your babies. It’s right for him to be head of this team. Your girls …’ Janessa reached out and put a hand on Sheena’s abdomen, and one of the girls instantly kicked her, as though to say, Hello, Aunty Nessa ‘… are going to be just fine.’
‘I know. With you and Miles looking after them, I know everything will be perfect.’
The two friends hugged and Janessa stayed for a few more minutes. ‘I’d better get back to the unit.’
‘Do you think Philip has a chance now?’ Sheena asked as Janessa headed towards the door.
‘A better chance than before but he’s so … prem, Sheenie. So small. So weak.’
‘And how are you holding up throughout it all? Teenage mother? Very sick baby? This can’t be easy for you, Nessa.’
‘I’ll be fine. What happened to me happened a long time ago.’
‘Mm-hm.’ Sheena didn’t sound as though she believed her. ‘Just know that if you need me, I’m here for you. I may be just a human incubator to my girls but for you I’m forever your friend.’
Janessa smiled. ‘I know. You’re the best, Sheenie. Anyway, I’d best get back to the NICU.’
‘You will let me know what happens? Either way?’ Sheen
a’s words had been calm but firm. ‘Lift the gag order for this one. Please?’
Janessa looked at her friend, seeing the concern, knowing Sheena had seen these same or similar circumstances before. They both had. They both knew the odds. Even with Miles’s brilliant surgical skills, it might not be enough to tip the scales in Philip’s favour.
‘OK. Rest, though. I’ll talk to you later.’
Janessa headed back to the unit and after getting an update on Philip, who was still heavily sedated, she headed to her office. She had a lot to do but didn’t want to do any of it. She sat there for a good half an hour, trying to concentrate, trying to get her brain to focus on the mounds of paperwork before her but to no avail. At a knock at her door she immediately looked up, glad of the interruption.
Miles opened the door. ‘Sorry to bother you.’
‘It’s fine.’ She beckoned him in and indicated the seat opposite her desk, the one he’d sat in all sharp and direct on his very first day here. This time, though, he was more relaxed, more calm. He’d obviously showered and changed after surgery and his casual trousers and polo shirt seemed to fit him to perfection. Janessa worked hard to ignore the way he moved, ignored the way the man was the whole package—handsome, intelligent and caring. Everything she’d ever wanted in a man, sitting before her. She clenched her hands tightly beneath the desk, more as a way of releasing her own frustration at being so drawn to him than anything else.
‘How is he?’ She didn’t need to say anything else. All of them were equally concerned about Philip.
Miles frowned. ‘Not doing as well as I’d hoped.’
Janessa nodded. They both knew the outlook wasn’t good but they were still determined to do everything they could to help him.
‘I’ve just come from seeing Sheena.’
‘I was up there earlier. Just needed a break.’
‘Me, too. She told me you’ve lifted the gag order on this one. Do you think that’s wise? The chances that Philip could die are extremely high. You don’t think news like that will elevate Sheena’s blood pressure?’ There was the slight hint of censure in his tone and Janessa felt the sting.
‘No. I don’t. Not this time. This time it’s different and we both know it. She knows Philip’s prognosis isn’t good. The gag order mainly pertains to the running of the hospital, especially anything from the paediatric unit. This … Philip … he’s different. Sheena and I have always shared these deep exchanges with each other. It’s what we do. It’s how we support each other. It’s why we’re such good friends.’
‘You’ve obviously been through a lot with each other. Anyone can see how strong the bond is between the two of you. It’s nice. Deep, abiding friendships. They’re rare.’
Janessa couldn’t help but wonder if he was referring to his wife, the fact that he’d mentioned they’d been good friends before the relationship had progressed. ‘Yes, they are.’
‘Do you think we might be able to have that?’
‘A deep, abiding friendship?’ she wanted to clarify.
‘Or something like it.’ There was an earnest tone to his words.
‘I’ve only known you for just over a week, Miles.’ She spread her arms wide. ‘I’ve known Sheena for almost twenty years.’
‘We certainly have a good grounding for a friendship. We like each other. We respect each other. We seem to share a similar sense of humour.’
Janessa pondered his words for a moment, deciding that if they simply agreed to remain friends for the duration of Miles’s stay, it might actually help them to deal with the electrifying pull they felt towards each other.
‘It’s one thing to be colleagues and neighbours but friends would be nice,’ he added when she didn’t immediately answer.
‘Friends.’ The word was spoken slowly, as though it was filled with deep reflection. Sighing, she stood and walked towards the door, gazing out into the unit for a long moment. Then something changed. The hairs on the back of her neck started to prick and she closed her eyes, listening closely, her back straightening, her entire body tensed. Everything else, trying to define her relationship with Miles, trying to control the way he made her feel whenever he was near … everything disappeared as she concentrated and listened to her intuition.
Miles noted the instant change in her demeanour, shifting briskly from open and sultry to one of instant apprehension. ‘Something wrong?’ he asked, standing up but not moving towards her. Distance. He needed to keep his distance.
‘It’s quiet.’ Her tone was filled with concern.
‘It’s not that quiet. I can still hear a few babies making noises.’
‘Not that sort of quiet.’
‘Ah. You mean … something is about to happen?’
‘Yes.’ She looked at him and this time, all he saw was the look of a concerned neonatologist following through on an instinctive reaction.
‘Philip,’ they said in unison, and walked quickly over to where the little baby lay. He was sleeping, his breathing shallow and rapid.
If Philip was strong enough to survive, then young Violet would have her work cut out for her as babies born this early often ran the risk of neurological complications, such as autism or cerebral palsy. Her heart went out to both mother and child for whatever might happen within the next twenty-four hours.
‘Something wrong?’ Kaycee asked as she continued to monitor Philip.
‘I don’t know,’ Janessa responded.
Kaycee picked up Philip’s chart and handed it to Miles, who read it. ‘I only did his obs two minutes ago. He’s as stable as he can be, poor little lamb.’
Janessa accepted the chart from Miles and glanced at the information before looking at Philip once more. ‘I don’t know. There’s just … something not right.’
‘Instinct.’ Miles nodded. ‘The best weapon we doctors have and on the rare times that we don’t trust it, heavy prices can be paid.’
Janessa could hear something, a tinge of sadness, a strong dose of regret coming through in what Miles was saying, and while she agreed with him one hundred per cent, she also noted that he was talking from personal experience. Had ignoring his instincts led to his wife’s death? She pushed the thought aside, focusing on the wee baby struggling to fight for his life.
‘Janessa has amazing instincts,’ Kaycee confirmed.
‘What do you think it is?’ Miles asked.
‘Seriously, I don’t know. Something is … off. There’s something not in line with normal parameters yet all his obs are fine.’ She returned the chart to Kaycee and shook her head.
‘So you’re going to stand here and watch him?’ Miles asked as Kaycee headed off to deal with another baby who’d just woken, his healthy little cries filling the nursery.
‘Yes.’
‘Fair enough.’
‘What about you?’ Janessa glanced across at him, both of them standing on opposite sides of their patient.
‘You’re right. Looking down at him now, there’s something … niggling … something not quite.’
Before Miles had finished speaking, the machines monitoring Philip’s heart rate started to beep noisily, Janessa noting that the tiny chest had stopped rising and falling. She quickly touched the baby, tickling his feet in order to stimulate a response. Sometimes babies needed to be reminded to breathe but this simple stimulation didn’t appear to be working.
‘No response,’ she reported as Kaycee rushed over. Miles had already pulled on a pair of gloves and was hooking his stethoscope into his ears. Kaycee grabbed the Laderal bag and handed it to Miles so he could resuscitate Philip. Miles gently squeezed the bag to give the baby some breaths as Janessa pulled on a pair of gloves.
‘He’s still desaturating down to fifty per cent.’
‘He’s just not picking up.’
‘We can do this. We can help him.’ Miles’s words were firm and controlled. He looked over at Janessa. ‘Let’s do our jobs.’
CHAPTER SEVEN
‘OXYGEN at forty per c
ent.’
‘No more apnoeas,’ Janessa told Philip. ‘Caffeine, Kaycee. Wake him up.’
‘I’m on it.’ Kaycee was already injecting the caffeine into Philip’s drip in order to stimulate a response.
‘His hypothalamus is too immature. It’s not receiving the signals, not computing,’ Ray murmured as he brought the intubation trolley over.
‘Oxygen desaturating.’
‘Increase oxygen to sixty per cent.’
‘Are the umbilical lines clear? Still working?’
‘Yes.’
‘Prepare dexamethazone.’
‘No response to caffeine stimulus.’
‘Oxygen still desaturating.’
‘Boost to one hundred per cent. Prepare adrenaline.’
‘Chest X-rays?’
‘Get the machine ready.’
‘He’s still not responding.’
‘Bag him.’
They all worked together, each of them doing their utmost in order to save Philip’s life. It wasn’t looking good and they all fought harder.
‘Body’s changing colour. Going grey.’
‘No. No. Let’s get him ready to intubate.’ Miles was still pushing. Janessa was working equally hard.
‘Administer adrenaline. Come on, Philip. Hang in there.’
Janessa took over the bagging to give Kaycee a break, putting her finger over the hole of the Neopuff mask and lifting it again, getting the oxygen into Philip’s brain. Her fears that it was already too late, that even if they were able to save him right now, it might be too late to stop severe trauma to the oxygen-starved brain. In the distance, as though it was far, far away, she could hear the noise of a young girl crying. Violet. Violet was there. She’d picked a terrible time to come and see her son … then again, maybe it was the right time after all.
‘Colour still grey,’ Ray murmured, and Janessa could hear the dismay in her colleague’s voice.
‘Ready to intubate,’ Janessa said, and received a quick glance from Miles. He shook his head, the movement almost imperceptible, but she caught it. ‘We have to try,’ she urged him.
