“What’s his speciality, Pippa? Maybe we can pick his brains while he’s here - get a few difficult patients for him.”
I laughed. “Don’t do that, Peter - he’s here for a break, remember? Anyway, I don’t think we’ve anyone in the practice who’d really interest him. His speciality is dermatology.”
“Skin diseases!” Max, who was sitting in his favourite window seat (we were taking a well-earned morning coffee break) snorted. “What a speciality!”
“What’s wrong with it?” I asked indignantly. “It’s a very interesting field - and patients can get very distressed by skin disorders.”
“Oh, I know, I know,” Max said, a rather sardonic glint in his eye. “But you’ve got to admit it’s a pretty cushy number! Consultant dermatologists work office hours, practically. They never get called out in the middle of the night or at weekends, because there are never skin emergencies, and if they go into private practice, like your Charles, they can make a great deal of money from patients rich enough to pay for their treatment.”
“He’s not ‘my’ Charles, as you call him,” I said a little childishly. “And I think you’re wrong. Charles didn’t become a determatologist because it’s a ‘cushy number’ - horrible expression! He’s genuinely interested - “
And Max shrugged and turned away to read the Lancet, clearly losing interest in the discussion, leaving me feeling a little puzzled at my own reaction. Why should I care what Max - or anyone else for that matter - thought of Charles? It was my feelings that mattered, no one else’s, yet here I was feeling decidedly put out by the note of disapproval in Max Lester’s voice. Would I never get used to this man’s dour ways?
The two weeks seemed to go very slowly, as I said, but just three days before Charles was due to arrive something happened which managed to drive even him out of my mind.
I was taking evening surgery, and I was on my own because Max was out on an emergency call, and Peter was having a well-earned evening off - he’d taken Judith into Fenbridge to see the repertory company do a performance of Hedda Gabler. Even Barbara Moon wasn’t there - she had a foul cold, so when the surgery was half-way through I sent her home, telling her I could manage fine on my own.
The last patient - or so I thought - had just left, and I stretched luxuriously, thinking greedily about a hot bath and supper on a tray in front of the fire - for Judith had promised to leave a meal ready for me - when the door bell rang.
I can’t deny I swore softly. If that’s another patient, I told myself as I went across the hall to answer it, turning up late for the surgery, I won’t see them. I just won’t - not unless it’s really urgent.
I opened the door and looked out into the thin dusk, and the smell of hyacinths from the flowerbed in front of the house filled my nose with spring, made my senses stir, and somehow made me even more impatient with this late caller.
“Well, who is it? What do you want? Surgery hours were over almost an hour ago, you know - “ I said - well, snapped, really.
A figure moved in the shadows, and then came into the light thrown by the open front door. It was a girl, dark-haired, slight and pretty - but with a face that was white and drawn, her curly hair stuck in tendrils to her sweating forehead. She was clutching a heavy and voluminous winter coat around her, even though the night was pleasantly warm and as she stood there looking at me, my irritation disappeared and became urgent concern.
“What on earth - “ I said, and then moved forwards to catch her, just in time. For she pitched forwards into my arms in a dead faint.
CHAPTER SIX
I half carried her, half dragged her into the consulting room, for she was taller than I was, and surprisingly heavy. She began to come round from her faint by the time we got there, and was able to co-operate with my attempts to get her coat off and her on the couch.
Just as I got her coat off, she suddenly groaned and doubled up, and cried out in a voice thick with terror, “No - no - make it stop - please, make it stop - “
She stayed bent for a moment or two, and then let me move her, sit her on the couch, swing her legs up until she was lying down - and then I could see her properly, for the first time.
She was pregnant, though not really obviously so. Rapidly, I undid her clothes, and ran my hands over the gently coned abdomen.
I felt the baby move under my fingers, an experience I had had many times but which never failed to move me. About thirty-six weeks pregnant, I judged - just a few weeks from the time when the baby would be born.
I felt the abdomen harden under my fingers as a contraction of the muscle walls of the uterus pushed against the baby, and again the girl on the couch cried out in fear and tried to curl up, away from my exploring fingers.
“Just relax, my dear - just relax,” I said automatically. And with one eye on my watch, and my hand still on her abdomen waited to see what would happen.
And just one minute later, another spasm contracted the muscle wall, and again the girl wept and cried -
“How long have you been in labour?” I asked urgently, leaning across the girl. But she just shook her head, keeping her eyes closed, and turned away from me.
“Look, you must tell me - how long since this started?” and I put all the authority I could into my voice.
She moved her head restlessly, as another contraction came, but she didn’t cry out this time, just holding hard to my hand instead.
“It doesn’t hurt so much now I’m here,” she said in a small husky voice. “I’m not so frightened now I’ve come - I should have come before, then it wouldn’t have hurt so much - it was so awful, and there was no one there, no one at all - “
And again she rolled her head on the pillow, and whimpered slightly as yet another contraction pulled her slight body.
I loosened her hand, and moving rapidly, began to sort out from my instrument and dressing cupboard the things I’d need. This girl was in advanced labour, and would clearly deliver her baby very soon - there was no time to be lost. I had to assess how far on the labour was, and get ready to bring the baby into the world, premature though it clearly would be.
As I worked, setting the sterilizer going, scrubbing my hands, finding mask and gown and gloves, I talked to the girl, more to keep her spirits up than to get information.
“Who’s been looking after you?” I asked.
“No one,” she whispered. “No one at all. I couldn’t go home, could I? Not like this. They’d have thrown me out anyway - so I just had to manage alone. All alone. Just me, and the baby - I used to talk to him, pretend he could hear me - “
She stopped, and took a deep breath, crumpling her face with effort.
“Good girl,” I said swiftly. “Deep breaths now, easy and light - that’s it - there! That wasn’t so bad, was it?”
She opened her eyes and looked at me in wonderment. “No, it wasn’t - not a bit. It just felt - I don’t know. Strong, but nice - “
“That’s because you’ve relaxed,” I said gently. “Child-birth needn’t be painful, you know - as long as a mother relaxes and stops being frightened, she can enjoy it.”
“Yes,” said the girl. “I was frightened - terribly frightened. I didn’t know what to do, you see, when it started. Last night, in the middle of the night it was. Not much at first - but then it got more, went on getting more, and this morning I thought - the baby’s coming - and I can’t ask for help, and what shall I do - and I was so frightened - “
“Nothing to be afraid of now,” I said. Then, gently I explained to her what I was going to do.
“I want to examine you, to see just how near to being born the baby is. Just relax and breathe deeply and it’ll be fine - that’s a good girl - now, just relax - deep breath - that’s it - “
I moved fast after that. My examination told me that the labour was very well advanced indeed, and that any minute now, this girl, who had been so frightened but now seemed a little more relaxed as she held on to my hand trustingly, would start to push her baby int
o the world. And there were things I had to find out about her first - about her medical history and the care she had been having during her pregnancy.
“Which hospital were you booked into?” I asked gently.
“Tell me that, and your name, and I’ll get in touch with them for some information before the baby arrives. Just tell me that much - I promise I won’t tell anyone about you - “
For I realized she wasn’t married, and had been hiding herself from her parents all through the long months of waiting.
“No one,” she said, shaking her head, and looking up at me with wide amber-coloured eyes.
“I told you - there was just me - me and the baby, in that little room. I’ve been working in a factory - until last week - and they never knew. I told them I’d always been fat, and I wore a big apron, and they never knew about the baby coming - “
And I could see how easily she could have deceived people, for the baby was small - my first examination of her had shown that - and first babies are often easy to conceal, even well into the eighth month of pregnancy.
“And then tonight I couldn’t bear it any more, so I went out. And then I saw the names at the gate - doctors’ names. And I knew I couldn’t do anything more on my own. I was so frightened - and so lonely - so I rang the bell. I’m sorry to be a nuisance - “
“You aren’t a nuisance, silly girl - never that. I just want to know about you. Do you mean you’ve had no ante-natal care at all?“ I spoke as gently as I could.
And again she nodded, and closed those beautiful eyes as another contraction came, and she grasped my hand in small cold fingers.
Now I was desperately worried. It was worrying enough to have a girl in advanced labour land on my doorstep in this fashion - but much worse to discover that she had had no care at all during her pregnancy.
No blood tests, no urine tests, no watch kept on her blood pressure - this could be bad. She was probably anaemic, for she wouldn’t have been feeding herself properly all these long lonely months, and certainly hadn’t been taking the necessary iron pills.
Childbirth, I knew, was safe these days, safer than crossing the average busy road - but for a girl who had had no ante-natal care there were risks, real risks, and I knew it.
And I was alone with her, and any moment now she would start to push her baby forwards towards the moment of birth. And I wouldn’t be able to leave her side, even to use the telephone to get help.
And even as I realized this, she started. She took a deep breath and set her teeth, and her face lost its pallor and started to redden as she made the first efforts towards helping her baby to be born. There was no time at all to spare for telephone calls - only time to hold on and help her.
Those next minutes were extraordinary for me. Part of me was scared - just as scared as the girl herself had been when she arrived. But part of me was exultant, for to be there when a baby is born is a great and exciting thing, and one that never fails to fill me with excitement and joy and - yes - a little envy, envy of the girls lucky enough to be performing the supremely exciting and glorious task of giving birth to a baby.
And then, the baby’s head appeared, the face crumpled and with a comical expression of rage on it. And the girl on the couch gasped again, and took another great breath, made one more final effort, and then - the baby was in my gloved hands, the little arms flailing wildly, the mouth opening hugely in a lusty bawl.
The girl on the table turned and looked at the baby in my hands, her face creased with wonder and doubt and excitement all at once.
“It’s a girl!” I cried. “A beautiful girl - with dark hair like yours - “
A small baby - if she weighed five and a half pounds I’d be surprised, I thought, but a perfect baby in every way.
Swiftly, I wrapped the baby up, and made sure she could breathe easily before lying her down in a drawer of my desk which I had hurriedly emptied on to the floor, before lining it with a towel. I tipped the head of the drawer on a couple of books so that the baby would be able to breathe without any obstruction.
And while I worked, the girl behind me whispered “Emma. Her name is Emma - my little Emma. No one shall ever - “
And then, just as I was ready to turn away from the baby, to go back to the new mother on the couch, there was a gasp and I whirled. Was the after-birth coming already?
But it wasn’t that. It was the one fear I had had at the back of my mind ever since I had realized that this girl had had no ante-natal care.
The big danger in these neglected cases is eclampsia, in which the mother has violent convulsions - and can die. And the girl on the couch was having a convulsion.
I did all I could. I used every technique I had been taught to use in such emergencies, but nothing I did seemed to help. Convulsion after convulsion tore at the fragile body, while the baby, the baby she had called Emma, lay and cried with a healthy noisiness behind us.
And then, above the sounds the girl on the couch was making, and the mewing of the baby I heard another noise - the front door.
“Max!” I called frantically. “Max!”
And it was him. I saw his big frame come through the door with such gratitude that for a moment my head was spinning, and then he was beside me, and taking in the whole situation at a glance, pushed me to one side and took over.
My hands were shaking as I turned to look at the baby, whose tiny starfish hands had escaped from the towel in which I’d wrapped her, and were waving about furiously. She was a good pink colour, and tiny though she was, was clearly a very lusty child. Nothing to worry about here.
But what about her mother? I turned back to look at her, moving to see round Max’s broad back -
And realized with a sick certainty that the very thing I had feared had come to pass.
This girl, little more than a baby herself, had been left alone to struggle through the months of pregnancy unaided, unloved - and above all uncared for. And because of this neglect, the normal safe experience of childbirth had been converted into a tragedy.
For the girl on the table was dead. Baby Emma, so newly born, was already without a mother, and the realization made me so angry, so furiously impotently angry, that I stamped my foot, for all the world like a child in a rage, and tried to speak, and couldn’t, only bursting into hot tears of misery and fury.
Max took hold of my shoulders, shaking me a little to make me regain my control, and waited quietly until my tears subsided.
“I’m sorry,” I said after a while. “I couldn’t help it. It - it’s such a wasteless stupid tragedy - she’d had no ante-natal care, you see. I managed to find out that much. She just turned up on the doorstep, almost in the second stage of labour, and I couldn’t do a thing but deliver the baby - God, Max!” I cried out, “I didn’t even get time to find out the poor girl’s name - “
“You saved the baby, anyway,” he said, and the matter-of-factness in his voice did more to bring me back to control than anything else.
“It seems a pretty lusty infant. In these cases it’s touch and go whether you lose the baby as well as the mother, sometimes.”
“I know,” I said. “I suppose that is something. If only she’d gone to someone for care - if only - “
“No point now,” Max said practically. “You say you don’t know the girl’s name?”
I shook my head. “There wasn’t time,” I said simply.
“Only time to deliver the baby.”
I laughed then, a little hysterically.
“I know the baby’s name. She called her Emma. But before she could say anything else, she started to have convulsions, and then you came - and there’s nothing else to tell. It all happened so quickly. And oh, it’s so senseless, so wickedly senseless, a tragedy - “ And again tears pricked my already stinging eyelids.
There was a sound from the hall again, and then footsteps. Peter and Judith, back from the theatre, I thought dully, and turned away from the door. I didn’t want them to see my red swollen eyes, to know
I had lost my professional control and wept for this tragic little mother’s wasted death.
“Hello, you two! Working late?” Peter’s voice sounded breezy, and then changed.
“My God - what’s happened here? Is that girl - “
“Yes,” Max said flatly. “She just died, poor little scrap. We’ve no idea who she is, or where she came from - nothing at all - “
“Don’t even know her name?” Peter sounded incredulous.
“No,” I said wearily, turning round. “Not even her name. Only her baby’s. She called her Emma before she died - “
“Emma? Did you say Emma?”
And then I realized that Judith was in the room, was standing with her back to the door staring across at the desk drawer on my consulting room table, her face white with shock.
I don’t know why I did it. I’ll never know why. But very deliberately I walked across the room, and picked up the baby in her hand towel wrapper.
“Yes, Judith. Emma. The same name as the child you lost. That’s the name this baby’s mother chose for her - and she needs looking after.” And I carried the baby across the room and put her into Judith’s arms.
For a moment Judith stood there, frozen, staring down at the bundle she was holding stiffly and awkwardly. Would she reject her, throw her back at me and storm out of the consulting room to drink away her memory of the grief that had been caused by an Emma, so long ago?
But then she relaxed, and her arms crooked easily and gently and she lifted the child to set her own cheek against the tiny streaked cheeks in the time-hallowed gesture of motherhood. And the baby snorted softly and stopped crying, slipping into the sudden sleep of the very young.
Judith turned, and walking in an almost dreamlike state crossed the hall to the stairs, and carried the baby up them, disappearing from our view as she reached the landing.
The Doctors of Downlands Page 7
