A Family Made in Rome

by Annie O'Neil

  ‘Risky for a little tyke under a thousand grams.’

  He glanced up and met her eyes. Was that an accusation?

  But her head was nodding in the way it did when she was bowled over by something—impressed.

  ‘How much bowel do you think was compromised?’ she asked after they’d removed the laparoscope and closed the microscopic incision.

  It was a weighted question. Would Luca need ongoing healthcare? Would it last beyond his infancy or would this surgery set him up for a lifetime of never needing to know any of this had happened?

  He watched her precise stitching and delicate tying of the surgical knot. The external scar, if there was one, would be no larger than a freckle.

  Is she thinking of our own child when she makes each stitch? Ties each knot?

  Leon was. Their own child’s health. Its care. Its development. All the thoughts he should’ve slammed in a box were now charging each surgical move he made.

  ‘You’re opting for an external incision for the bowel removal?’ Lizzy asked.

  Again he looked up to see if it was a challenge.

  But her eyes, when he met them, only held interest.

  Not everything’s a dare, Leon. Not everything’s a move in a chess game.

  Competition for that number one spot had fuelled them back in the day. Had she softened in that respect? Or, more likely, grown confident enough not to need to peacock her talents in an OR? The main objective was the welfare of the child. Exactly as it should be.

  She was, in short, the exceptional professional he’d met and fallen for seven years ago when he thought he knew all there was to know about life.

  He gave his head a small, sharp shake and realigned his focus. He began explaining step by step what he’d be doing, and what each of the surgical nurses, anaesthetists and other members of the surgical team would be doing to give the tiny child they had before them the best chance of survival.

  Lizzy was her usual inquisitive self, but clearly she was refusing to showboat about the identical surgeries that he knew for a fact she’d done.

  She was a picture-perfect surgical companion. She was always there to provide the second pair of hands when needed. Was waiting, needle poised, prepared to make an exact stitch wherever one was required without needing a prompt. It was a critical timesaver as, so often in surgery, timing was of the utmost importance.

  Had their relationship been as easy? Had it even been a relationship? Neither of them had ever referred to the other as their partner.

  An uncomfortable feeling that it might have been that simple teased at the back of his mind. He silenced it. Now wasn’t the time to dwell on the past.

  ‘Ooh!’ Lizzy gave a quiet cheer when, twenty minutes later, he moved his hands back to let her take a look. ‘Looks like the bowel is clear of all necrotic tissue and this little fella stands a good chance of a happy, normal life.’

  They looked at one another, and he saw the crinkles by her eyes showing the smile her surgical mask was hiding. They’d deepened since their time together back in New York. As had the furrow between her brow.

  ‘Bravo, Dottore,’ she said.

  ‘Brava, Dottore,’ he echoed, trying not to betray the hint of sadness he felt that he hadn’t been around to see the subtle, sweet changes in her face over the years.

  Instead, he gave his usual brisk, efficient instructions about moving Luca back to the NICU and said that he’d be in shortly to have a look. Then he nodded towards the swinging doors that led to the private room where Luca’s parents were no doubt biting their nails, waiting for news of their son.

  As he walked alongside Lizzy it struck him afresh how fragile the lives of his tiny patients were. Obviously he knew it on a pragmatic level—saving those lives was at the very essence of his profession. But the woman who was carrying his child had just helped him perform surgery on a thirty-week-old baby, pushing aside the fact that what was happening to Luca, or to any of the other infants struggling for survival here in the NICU, might happen to theirs.

  He was going to have to plumb the depths of the same strength if he wanted to make good on his promise to be there for their child. He was going to have to do a lot of things if he was going to give his child the best start in life.

  CHAPTER SEVEN

  ‘COFFEE?’

  As Lizzy came out of her room Leon was already busy at his espresso machine, going through what was clearly a well-rehearsed morning ritual. His elegant surgeon’s hands spooned coffee into a paper disc, then cinched the filter into place so that the hot steamed water could do its magic.

  ‘No, thanks.’ Lizzy dragged a comb through her shower-wet hair. ‘I’m caffeine-free now, remember.’

  Their eyes caught and her comb paused mid-journey. He held up a tin of decaffeinated coffee. Of course he’d remembered. The shadows under his eyes were proof that at least one of the two of them had been up half the night, remembering and making changes, preparing... Unlike Lizzy, who had slept like a baby.

  ‘That was nice, last night.’

  To an outsider, the comment might have appeared to be in reference to a night of passion.

  ‘I can’t believe I’d forgotten how precise your stitches were.’ He raised his small espresso cup in a toast, then drank.

  ‘Are,’ she corrected playfully, pleased Leon’s mind had gone exactly where hers had. The surgical ward.

  Maybe this whole having a baby and working together for the next few months would work out. Somehow. Not the marriage part, obviously. Leon had clearly had a common-sense malfunction somewhere between his heart and his cerebral cortex. An information overload that had forced an old-fashioned response to a not so old-fashioned situation.

  Although...

  Her thoughts returned to that single, heartfelt admission: ‘I don’t want to be alone when I live.’

  The Leon she’d thought she knew would never have admitted as much. Maybe losing his mother really had changed him. Losing her own mum had certainly changed her. But in the opposite way. It had made her less willing to consider a relationship. Less willing to trust a man’s intentions. Less willing to believe Leon Cassanetti had meant it when he’d proposed marriage.

  As such, she’d not brought it up again after they’d returned from the hospital and they’d each—a bit awkwardly, a bit hastily—shut themselves behind the doors of their own very separate bedrooms.

  Hopefully the next two or three months would follow a pattern. They’d go to work, do their jobs, find some sort of happy middle ground wherein he acknowledged that it was for the best that she raise her child—their child—on her own and then, when the little one was old enough, she would come over here and meet the other half of the gene pool.

  Baby daddy? No. Gene pool made him easier to keep at arm’s length emotionally. Gene pool it was.

  She couldn’t help but give him a quick scan. Mmm... It was a most excellent gene pool. Theirs was a lucky baby.

  ‘Ten minutes enough before we set off?’ Leon asked, his lightly accented voice sending too obvious a physical response through her body.

  Gene pool. Gene pool. Gene pool!

  ‘Scooter again?’ She mimed putting on her helmet.

  He shook his head. ‘I thought we’d walk. I’ll give you a mini-tour of Rome.’

  Twenty minutes later it was taking all of Lizzy’s self-discipline not to lace her fingers through Leon’s. It wasn’t just that their hands kept brushing as they moved in closer together on the pavement to let others pass, it was the sheer romance of the city.

  Rome was everything she’d dreamt it might be. Like stepping into a postcard and having it smell and look exactly the way she’d thought it would. Fast and slow-paced all at the same time. Infused with a heavenly golden light. With scents of bitter coffee and sweet pastries wafting out on street corners as shopkeepers opened up for a day’s business
.

  Taking a different route from the one they had on the scooter, Leon guided her through a glorious procession of high-end fashion boutiques nestled alongside centuries’ old churches where women dressed all in black ducked in and out for their morning prayers as easily as they did the scrumptious-looking delicatessens and vegetable shops.

  Produce you’d never find in a supermarket back home was presented in sumptuous piles: courgette flowers with baby vegetables attached, fresh, succulent artichokes, and a green vegetable she couldn’t identify.

  ‘What’s that?’ She pointed to the display of long, slender strands fashioned into a green wreath-like heart.

  Leon smiled. ‘Agretti. It’s... Do you know samphire? A sea vegetable? I think you call it saltwort.’

  Lizzy laughed. ‘I think I prefer agretti as a name.’

  Leon signalled to the shop owner that they would take some. ‘They also call it barbe di frate—friar’s beard.’ He stroked an invisible space below his own clean-shaven chin, grinning as the shopkeeper handed him a small brown bag full of the vegetable. ‘We’ll have it tonight with supper. Perhaps get some fresh seafood on the way home.’ He held up the bag. ‘The agretti are only in season a short time, so it is special that you’re here for it.’

  She bit down on the inside of her cheek to stop herself from saying it would be special to be here at any time of year because of her tour guide. She had no idea how, but because of him the city already felt familiar to her.

  She’d obviously need a map if left to her own devices, but it was as if all the stories he’d told her about his home city had become a part of her. If she’d had a free hour to wander about, she wouldn’t have felt anything but happy, knowing that familiar surprise after surprise waited around each corner. The Trevi Fountain and the Spanish Steps appeared as old friends sometimes did—unexpected but no less wonderful for it—and by the time they reached the hospital, fortified with two bags of pastries for a mid-morning snack which, of course, she had already sampled, she had to force her work hat back on.

  Today and all the days that would follow were about ensuring the conjoined twins came into the world healthy and ready for the separation surgery that would follow. Then, when that had happened, she hoped she’d know exactly what was happening with her own baby. Or, more to the point, the role Leon would play in her baby’s life.

  After they’d changed into scrubs Leon took her on his morning rounds, with that same energy buzzing between them as when they’d practically raced to the surgery board each morning in New York, to see who was working on what and, more importantly, if they’d be doing it together.

  They visited patient after patient, their energies concentrated on the all-important task of ensuring they gave each woman and the baby growing inside her the very best start in life possible.

  Pre-eclampsia. Gestational diabetes. Hyperemis gravidarum—the intense morning sickness that had made headlines when Britain’s future Queen had fallen victim to it. There were countless things that could go wrong with a pregnancy but, Lizzy reminded herself with a soft touch to her own belly, countless things that went right.

  It was actually a genuine joy to watch Leon at work. He was like an energy bomb, infusing each mum-to-be with a confidence and comfort, telling her that her number one job was to relax. His job was to find solutions. And that was precisely what he would do.

  They spoke with a woman who’d been admitted the previous day suffering from heavy blood-loss owing to placenta previa.

  ‘You’ve had a blood transfusion and a steroid injection, si?’ Leon asked her.

  The woman, Valentina, gave a heavy nod. ‘The nurse this morning said all I needed now was rest. So...’ Her eyes pinged between Leon and Lizzy, as if she was unsure whose sympathies to play on the most. She ended with a small bat of her eyelashes in Leon’s direction. ‘I guess you could sign me out?’

  Leon tipped his head from side to side—another familiar gesture that Lizzy had somehow let grow fuzzy as the years had passed. It said a thousand things at once. You’re right. There are other sides to that coin. I want you to have the best information I can give you so you can make a well-informed decision.

  ‘True,’ he said. ‘You do need rest. But because of the blood-loss and the Braxton Hicks you were experiencing yesterday, it’d be safer for you to stay with us here. Another blood-loss like that could cause immediate distress to the baby, and being able to respond quickly with all the right equipment and supplies is critical when it comes to such a fragile life. Your life could depend upon it as well.’

  He rattled through a few statistics and gave her some solid historical examples of what might happen if she were to experience a similar bleed at her home—which was, according to her chart, a good hour outside of Rome.

  ‘Per favore,’ the woman pleaded with Leon. ‘I can rest better at home. My husband needs me, and being here seems a waste when all I do is sit!’

  Leon nodded, taking on board her concerns, and then gently explained—exactly as Lizzy would have—that her blood loss had been severe, and that at only thirty weeks they really would like to give the baby a bit more time to develop. In short, staying in hospital meant she was giving her child the best possible chance of a healthy start in life.

  ‘But isn’t it better for me and my baby to be relaxed? How can I relax here, with all this...this...mechanical stuff around me?’ Valentina gestured at the monitors and screens flanking her bed. The cart filled with medical equipment prepped for emergencies.

  ‘If you want your husband to bring some things in to make the room more personal, we’re more than happy to ring him.’

  ‘I don’t want anyone to ring him! I want to go home!’ Valentina cried with characteristic Italian passion.

  Lizzy smiled. It was clear Valentina was in a happy, enriching marriage and that her safe place was with her husband. Her child’s welfare, however, would be best attended to right here at St Nicolino’s.

  ‘You.’ Valentina pointed at her. ‘You’re very quiet. You’re a doctor and a woman. What would you do if you were in my shoes?’

  Lizzy apologised for her stilted use of Italian, took the woman’s hand and said truthfully, ‘If there was anywhere in the world I could be if I were you I’d be right here.’ Avoiding the possibility of more butterflies in her tummy, she kept her gaze away from Leon as she continued. ‘Dr Cassanetti prefers patients to be at home if they can be. He’s well aware that there is added strain in being here, away from your loved ones, but he’s asking you to do it so that you can return to them with your baby, both of you healthy and well.’

  Leon caught her eyes, gratitude capturing his features in a way that seemed over the top for what had been her genuine professional opinion. She respected Leon. On a professional level and, begrudgingly, a personal level. They’d never made promises to one another back in New York. Had always been very clear that their number one goals in life were to lead departments in their respective countries. And now they did that. Job done.

  So...was it possibly time for a new goal?

  She forced herself to tune in again as he wrapped up his talk with Valentina, promising to make her stay as comfortable as possible. When they’d left the room he said nothing, but shot Lizzy another look. One that felt complicit...as if they now shared a secret mission. Her spine tingled in response. A sensation, she realised, that would only grow as they began to work with the conjoined twins.

  Trying not to stare directly, she kept on throwing Leon secret little glances as they made their way to the next room. Was he experiencing it, too? This jolt of shared connection that felt more like a muscle memory than something new? Was it too dangerous to recapture? she wondered? That feeling of togetherness? She’d felt invincible when they were a team. As if anything in the world was possible so long as they were together.

  Leon stopped outside a private room and tapped on his tablet for a mome
nt. When he looked up again, that hard-won smile of his was in place. ‘You’ll find this one interesting.’

  ‘Oh?’

  ‘Mmm...’ He kept his voice low as he explained. ‘Maria Paloma. Came in two days ago for a twenty-five-week scan and we discovered ABS.’

  ‘Amniotic Band Syndrome?’

  ‘Si.’

  Lizzy instinctively swept her hands to the slight curve of her belly. So slight it might easily be mistaken for a large breakfast. She glanced into the room, only able to catch sight of the woman’s swollen belly and her hands rubbing it over and over, as if for good luck. ABS was rare, but in this day and age, if it was caught early enough and treated by an excellent team of surgeons, it was something that didn’t have to cause the profound trauma to an unborn child it once had.

  ‘How bad?’ She was, as Leon would know, asking after the fibrous, string-like pieces of tissue which had become detached from the amniotic sack and entangled the baby. This tissue, if attached to the growing child, would restrict blood flow and in some extreme cases cause stunted bone growth and even in utero amputation.

  ‘Some of the bands are attached to the cheek.’

  Lizzy’s lips thinned to a wince. ‘Risk of cleft palate?’

  ‘High. I don’t think it was caught early enough. We’ve informed our plastics team. They’ll ensure any malformation is minimal. But at this stage it’s always hard to say.’

  There was regret in his features, as there always had been when he knew a child would have to go through a surgical trauma before its life outside the womb even began.

  But that was life, she supposed. A struggle for survival from the very first day. Was it easier when you were part of a team? Knowing you had someone to lean on when the weight became too much? In other words, the total opposite of her parents’ marriage where it had been fight or submit. Her father had always been more than happy to point out that there might be no ‘I’ in team...but there was an ‘m’ and an ‘e’ and as such that made him the boss.