The Doctor's Outback Baby

by Carol Marinelli

  Clara had kept up with Timothy’s findings until then, but her slight frown didn’t go unnoticed.

  ‘Discoloration around the umbilicus,’ Timothy explained. ‘This great surgeon in Adelaide pointed it out to me once, and Hamo has got the same thing. Still, I’d feel a lot happier giving him an injection with a positive urine test to back me up. You get the Flying Doctors on the line for me, and while you’re taking care of that I’ll have another go at persuading Hamo to provide a specimen.’

  All to no avail, though.

  Timothy had to relay his findings to the very experienced Dr Hall Jells, or Dr Hall as the locals all knew him, and Clara cringed for Timothy, knowing Hall’s questions would be brutal. Leaving him for a second, she made a last-ditch attempt to persuade Hamo, but it was a waste of time and she shook her head as she returned, while Timothy rolled his eyes and carried on talking into the telephone.

  ‘I’m fairly confident of my diagnosis.’ She watched as he grimaced and held the receiver back an inch from his ear. ‘I’m actually very confident,’ he said more forcefully, ‘and once I’ve given him an injection I’m sure he’ll be far more compliant.’ Replacing the receiver, Timothy gave her a tight smile. ‘He said to give him 10 mg of morphine.’

  ‘Hall’s a great doctor,’ Clara soothed. ‘If he didn’t think you sounded confident, he’d have told you to hold off.’

  ‘Let’s just hope I’m right.’

  The morphine had the desired effect, Hamo settled markedly, but his observations remained erratic. His heart beating alarmingly fast and his blood pressure dropped more than could be put down to the effects of the morphine.

  ‘Dr Hall wants a catheter in,’ Clara said firmly. ‘I know you’re embarrassed, Hamo, but it really is necessary.’

  A weary nod was the only response she got and Clara gave Timothy a worried look as alarms started going off. ‘Lay him flat and give him another two-hundred-millilitre bolus and open up the IV full bore,’ Timothy said quickly as he set to work inserting the catheter. ‘And turn his oxygen up to ten litres.’ Clara did as Timothy ordered, expecting Hamo to protest to being laid down, for the pain in his abdomen to make this movement uncomfortable, but as Hamo meekly lay back on the gurney Clara’s panic mode upped a notch.

  ‘I think I preferred him angry,’ Timothy muttered. ‘Right, I’ve got a specimen.’ He handed the small jar to Clara who tested it as Timothy inserted a second IV line into Hamo’s other arm to enable them to give him more fluids. ‘We have to watch that we don’t overload him, though. With pancreatitis they can tip into pulmonary oedema quickly. What does his urine test show?’

  ‘It’s positive,’ Clara said, holding the dipstick up to the colour chart on the bottle and holding it up for Timothy to see. ‘Your diagnosis was spot on.’

  There was no sigh of relief, no smug smile on Timothy’s face as his difficult diagnosis was confirmed, just a worried frown as he worked on his patient. ‘At least we know what we’re dealing with. What’s his blood pressure doing now?’

  ‘It’s coming up,’ Clara responded. ‘Ninety on forty. Could this be from the morphine?’

  Timothy shook his head, flashing a light into Hamo’s eyes as he did so. ‘I don’t think so. His pupils are still dilated and his breathing rate’s high. It’s the pancreatitis that’s causing his collapse. Young men often compensate for a while then drop their blood pressure suddenly, but it’s coming up now,’ he added with quiet satisfaction.

  Hamo started to move around, pulling again at the mask. He was still deathly pale but at least there was a bit of fight back in him now, but even before he started to retch, many years of nursing told Clara what was coming next and she deftly raised the head of the trolley while simultaneously reaching for a kidney dish.

  ‘Do you want an NG tube in?’ Clara asked. A nasogastric tube was a soft rubber tube that was passed through the patient’s nose and into their stomach. Though the procedure was uncomfortable at the time, once in the tube enabled the stomach contents to be emptied and generally the patient felt a lot more settled.

  ‘Can you do it?’ Timothy asked. ‘I’ve only put a couple in before and if he carries on picking up I don’t think he’ll let me have more than one go and I don’t want to cause him more discomfort than necessary.’

  ‘Sure,’ Clara agreed, blinking in surprise at Timothy’s openness and his overriding concern for the patient’s comfort. Most doctors would have battled on, refusing to admit they couldn’t do it, more than happy to have a go in the name of experience. But instead Timothy was putting not only the patient’s welfare but his comfort first.

  It was as refreshing as it was welcome.

  Now that Hamo’s observations were more stable, now that the crisis had been swiftly and skilfully diverted, the tension in the room subsided a notch. But only a notch. Hamo was still gravely ill and any variance could see him sinking back rapidly into a critical condition.

  ‘Hamo,’ Clara said gently, ‘I’m going to pass a small tube through your nose and into your stomach. Once it’s in you’ll feel a lot more comfortable, but it’s not very pleasant while I pass it, you might start retching or gagging, but it’s very important that you don’t pull it out.’

  Hamo nodded but as Clara started to insert the tube his good intentions evaporated as his hand instinctively reached to pull it back up. But Timothy was too quick for him, grabbing his arms and clamping them down firmly. Unfortunately, Hamo jerked his head back and the tube came up, which meant Clara would have to start again.

  ‘Come on, Hamo, don’t fight me,’ Clara said firmly. ‘You really need this tube.’

  ‘Sister?’ Louanna was at the door, her face concerned. ‘I think Mary needs to be seen. She says that she wants to push.’

  ‘You go,’ Clara said to Timothy, her mind working ten to the dozen. Second-stage labour in a first baby normally took a while and they really needed to get this tube down. ‘Do a set of obs on Mary and the baby. I’ll get this tube in and then we’ll swap over.’ Her eyes locked on Hamo. ‘Mary’s having her baby, so you need to stay still for me, Hamo. Timothy has to go.’

  ‘Go,’ Hamo agreed bravely, gripping the sides of the trolley with his hands and taking a deep breath as Timothy sped off.

  Hamo tried, he really did, but as the tube reached the back of his throat again his hands shot up. Thankfully, help was at hand. As he entered the clinic Ross instantly read the situation and sped over to the trolley, gripping Hamo’s hands tightly without a word as Clara finished the uncomfortable procedure. Only when the tube was firmly strapped in place did she address her boss.

  ‘Thanks for that.’

  ‘What’s been going on?’

  They moved out of earshot and Clara gave Ross a brief rundown.

  ‘Hamo came in at the end of clinic with severe abdo pain. He was pretty aggressive, but thankfully he settled with some morphine. The Flying Doctors have been mobilised.’

  ‘What’s the diagnosis?’

  ‘Pancreatitis.’

  ‘And that’s been confirmed?’

  Clara nodded. ‘Eventually.’ When Ross frowned Clara elaborated, noting his grim face as she explained how Timothy had called in the Flying Doctors and given morphine without the benefit of Hamo’s urine test. ‘He was great,’ she concluded. ‘I mean that, Ross. Hamo dropped his blood pressure just before you arrived and it was touch and go for a moment or two, so the last thing he needs is a lecture. I think a pat on the back might be more appropriate.’

  ‘So, do you think we should keep him?’ Ross grinned, making his way back to Hamo’s bedside. ‘Where is he, by the way?’

  ‘Oh, lord,’ Clara groaned, casting an anxious eye towards Mary’s room. ‘I told him I’d be straight in.’

  ‘I’ll watch Hamo.’ Ross smiled. ‘You’d better go where you’re most needed.’

  She wasn’t needed.

  In fact, not a single head turned Clara’s way as she gently pushed open the door.

  Not Mary’s, her eyes
closed in deep concentration as she bore down, pushing her newborn into the darkened, hushed room.

  Not Louanna’s, who held her daughter’s shoulders, supporting her and staring on in wonder at the unfolding miracle.

  And not Timothy’s.

  The deliciously awkward, eager-to-please young man had vanished. In his place was now a calm and extremely competent doctor, his sleeves rolled up, two large gloved hands holding the infant’s head as its shoulders rotated, murmuring words of encouragement in low, confident tones that epitomised the calm feeling in the room.

  It was truly a privilege to be there and Clara closed the door quietly, moving in closer—not to interfere, just to observe the beauty of a miracle that never ceased to amaze her, marvelling not only at the wonder of nature but at Timothy’s quiet compassion, the love and empathy that seemed to fill the room, giving what could have been just another routine birth the status it deserved.

  Even the baby, as it slipped into the world, as Timothy delivered him safely into his mother’s outstretched arms, barely let out a cry of protest. Moving quietly closer, Clara watched the unfolding scene, the big dark eyes of the infant blinking at the world around him, his little mouth turning to his mother’s breast as she held him ever closer, oblivious to the blankets Clara tucked around them as Timothy worked on, delivering the placenta, quietly unobtrusive but comfortingly there.

  ‘He’s all right?’

  They were the first words that had been spoken, the almost reverent silence broken by Mary as she dragged her eyes from her newborn and sought Timothy’s reassuring ones.

  ‘He’s perfect.’ Pulling the swaddle of blankets away, Timothy did a very rudimentary check of the newborn. ‘I’ll check him over properly later, but for now everything’s just fine.’

  ‘He hardly cried.’

  ‘He had a gentle welcome,’ Clara said softly, just as the baby lost the nipple he was feeding on and the loud wail of protest he made had them all smiling. ‘We’ll leave you to it now. I’ll bring you in a light snack in a just a bit.’

  ‘Thank you,’ Mary murmured, turning her eyes back to her newborn as they turned to leave the room. ‘Doctor?’

  As Timothy turned, she said it again, only this time it was loaded with gratitude, and meaning.

  ‘Thank you.’

  The Flying Doctors always cut a dash.

  And as laid back as Clara was at work, she never failed to be impressed when they arrived. She watched out of the window as the white plane touched down, trailing a red haze of dust behind it as it sped along the clinic’s runway. The crew made its way speedily over to the clinic, smart in their white and navy uniforms, but however much the scene moved her she knew it didn’t come close to what Timothy was feeling, witnessing it for the first time.

  The Flying Doctors were an enigma. You didn’t have to be Australian to know about the team of men and women who faced the harsh Australian elements daily, the white plane that swooped out of the sky and bought medical technology, knowledge and hope to the most remote of communities, but seeing it for the first time, witnessing a legend close up, was overwhelming to say the least, and Clara smiled to herself as Timothy nervously ran through his handover to Hall, justified his diagnosis and outlined his course of treatment, his Adam’s apple bobbing up and down as Hall skimmed through the notes.

  ‘You did a good job, mate.’

  It was all Timothy was going to get, but from Hall it was strong praise indeed and Clara caught his eye as Timothy gave a small satisfied nod, a smile on the edge of his lips as he stepped back and let the team take over.

  ‘Look after yourself, Hamo.’ Clara smiled as everyone fluttered around, changing over monitors, setting up equipment, moving in the stretcher. Now that his blood pressure had stabilised and the painkillers had kicked in, Hamo was back to his rather gruff self, but the aggression of earlier had gone, leaving him rather shamefaced and subdued.

  ‘I can take care of myself.’ He gave a small shrug. ‘I’m sorry about before.’

  ‘Let’s just forget it, shall we?’ Clara said gently. ‘You were in pain…’

  ‘It’s no excuse.’

  ‘No, it isn’t, Hamo,’ Clara said thoughtfully, ‘but maybe a couple of weeks in hospital will give you some time to think about things.’

  ‘My drinking?’

  Clara nodded but didn’t say anything. Hamo knew the score—the next move had to be up to him.

  ‘I need to cut down.’ When Clara still didn’t respond Hamo lay back on the pillow. ‘I need to stop, don’t I?’

  ‘I think you already know the answer.’

  He gave a thin smile then looked up. ‘Hey, it’s not just me you need to worry about, Clara. I can take care of myself. I’m not so sure that you can, though.’

  ‘What are you talking about, Hamo?’ Clara frowned.

  ‘You and the new guy. I saw what happened on Saturday, remember? Just watch yourself. He’ll be gone in a few weeks like all the other doctors that drift in and out of Tennengarrah. Look at that Abby Hampton, she didn’t even do the full three months.’

  ‘Hamo,’ Clara said patiently, ‘I’m well aware Timothy’s only here for a while, and what you saw on Saturday night…well, it wasn’t exactly how it looked. That’s all you need to know,’ she added quickly, as Hamo started to protest. ‘Now, I know you all mean well, I know you guys all think it’s your duty to protect me, but I’m pushing thirty now, I’m more than able to look after myself, so if you and your friends can stop giving Timothy the evil eye, it would be much appreciated.’

  Hamo gave a reluctant shrug. ‘What sort of a name’s Timothy anyway? What’s wrong with Tim or—’

  ‘Timo?’ Clara grinned as Hall made his way back over, ready to move. Hamo finally joined her in a smile. ‘You just concentrate on looking after yourself, Hamo. I’ll be fine.’

  ‘That birth was beautiful.’ They were in the kitchen now, Clara pouring water into two massive mugs as Timothy set to work on the biscuit barrel.

  ‘It was great,’ Timothy agreed. ‘Look, I hope I haven’t put you offside, not coming to get you. It’s just when I put my head in she was practically having it, there really wasn’t—’

  ‘Timothy,’ Clara interrupted, ‘Let’s stop apologising to each other, shall we? You’re a doctor, for heaven’s sake, you don’t need my permission to deliver a baby.’

  ‘I am, aren’t I?’ Timothy winked. ‘Heavens, I wish I felt more like one.’

  ‘But you’ve been great this morning,’ Clara enthused. ‘Hall’s not exactly gushing, but he was pretty pleased with your work and I know for a fact Ross was impressed. And as for the delivery…’ Clara gestured in the vague direction of Mary’s room. ‘You were great in there. You couldn’t have been better!

  ‘You’ve no idea how many doctors, I’ve seen, nurses too come to that, rushing in, lights blazing, taking over, when all most women want is to do it for themselves. You’ve made this morning very special for Mary.’

  ‘I think the baby took care of that,’ Timothy said modestly, but Clara shook her head.

  ‘Mary wasn’t even sure she wanted to come to the clinic to have her baby. Now she’s going to go back to her people and tell them how well it went, which can only be a good thing. Word of mouth can be our greatest asset but it can have its downsides, too. Hopefully Mary might persuade some of the other women to give the clinic a go now and that can only benefit us all. Have you done many deliveries?’

  ‘Three, though I’ve seen loads more. I was always begging to be let in, I love the labour room.’

  ‘Me, too.’

  ‘Still,’ Timothy admitted, ‘it helped that you were only a call away. I don’t think I’d have felt quite so confident if I’d been there on my own. That baby really did come quickly at the end—I wasn’t trying to play the hero or anything.’

  Arranging a tray for Mary, Clara stopped in mid-motion, a teacup in mid-air as a smile ghosted across her lips.

  ‘I don’t think you have to t
ry, Timothy.’ Her back was to him so her voice so soft he probably didn’t even hear it. ‘I’ve a feeling playing the hero just comes naturally to you.’

  CHAPTER FOUR

  NORMALLY Clara loved the mobile clinic.

  Loved being out on the road, alone with her thoughts and the treat of a picnic lunch before heading back, driving the Jeep along the endless red roads, assured of a warm welcome from the patients she had nursed over the years.

  But not this morning.

  This morning, she had been relegated to passenger. Timothy, keen to get his bearings, bumped the clinic’s Jeep along, grinding gears and attempting small talk as Clara responded in monosyllables.

  But her aloofness had nothing to do with the fact that yet again she was playing nursemaid to a new doctor, or the fact that the prospect of four hours alone with Timothy had her stomach twisting into strange excited knots…

  Instead, it had everything to do with the house call they were making en route.

  Pulling out her next patient’s notes, she attempted to read them impassively but failed miserably. Her eyes blurred as she read the hospital doctor’s covering letter.

  Some days she hated her job.

  Looking up from the notes, Clara realised that they’d missed their turning about two minutes ago. ‘You were supposed to turn left back there,’ she mumbled, fishing in her pocket for a tissue and blowing her nose loudly.

  ‘When?’ Slamming on the brakes, Timothy craned his neck as he shot the Jeep into reverse. ‘You didn’t say.’

  ‘I did,’ Clara said through gritted teeth, massaging her neck which had been positively whiplashed as the vehicle had growled in protest. ‘I told you to take the next left.’

  ‘Half an hour ago,’ Timothy pointed out, clearly as irritated as Clara. ‘A reminder wouldn’t have gone amiss.’

  ‘You were the one who wanted to get a feel for the area,’ Clara snarled. ‘Do I look like a talking map?’