THE man looked far too fit to be sitting in an emergency department.
His tanned, lean chest had just a faint cover of dark hair in a V that pointed to an admirably flat belly.
Professor Jennifer Allen had yet another one of those momentary lapses, but it was easy enough to recover this time. Guy’s shoulders had been much broader and this man was on the skinny side of lean. His ribs were prominent rather than overlaid with a firm layer of muscle.
It was ridiculous to be still experiencing these lapses anyway. Despite the intensity of their time together, Guy was still a stranger. She would never see him again so it was high time she stopped thinking about him so often.
Missing him.
The house surgeon was giving Jennifer a curious look so she smiled reassuringly, introduced herself to the patient and then caught the young doctor’s eye again.
‘This is Peter Cowl,’ she was informed. ‘He’s twenty-six and has a history of spontaneous pneumothorax. He came in with sudden onset, unilateral, localised chest pain and shortness of breath.’
The patient did not appear to be in a state of respiratory distress that might indicate the development of a tension pneumothorax. ‘What’s the oxygen saturation?’
‘He came in at 86. It’s gone up to 92 on high-flow oxygen.’
‘How are you feeling, Peter?’
‘Bit puffed. Not too bad.’
‘How many times has this happened before?’
‘Three or four.’
‘Have you needed aspiration with a needle or tube before?’
‘Twice.’ The young man grimaced. ‘Would prefer not to…do it again.’
‘Sure. We’ll keep an eye on you and run a few tests, then we’ll decide how we’re going to manage this.’ Jennifer turned back to the house surgeon. ‘Get chest X-rays, both inspiratory and expiratory. And we’ll need an arterial blood-gas sample. Have you done one of those yet?’ She smiled again at the nervous head shake. ‘Get one of the registrars to assist you, then. I’ll help if I can, but it’s a bit busy out there.’
Jennifer was already moving away from the cubicle. Busy was the kind of understatement that made light of their workload—a coping mechanism. The emergency department of Auckland Central was currently stretched to its limit. It would fit right into Jennifer’s day if Peter Cowl did develop a tension pneumothorax that required urgent decompression—probably when she was tied up with another critical intervention.
At least there were a dozen or so other people somewhere in this department qualified to perform such a procedure, plus all the equipment and backup they could possibly need. None of these doctors were ever likely to have to try and manage an emergency perched on top of a mountain in a makeshift tent, with only limited gear and no hope of assistance. Or success, in the long run. They had no idea how spoilt they all were.
‘Dr Allen, can you spare a minute?’
‘What is it, Doug?’ The registrar was competent enough for his anxious expression to ring an alarm bell.
‘I’ve got a sixty-nine year old chap with sepsis from a urinary tract infection. He’s as flat as a pancake and I can’t get any peripheral IV access. He needs fluid resus, stat, and it’s going to take too long to do a surgical cutdown.’
‘Try a central venous line, then.’ Jennifer caught the message in the glance she received, and remembered that Doug had had major difficulties the last time he’d tried the procedure, but if this patient was in septic shock, this was hardly the best situation for a teaching session.
‘Are you set up?’
‘Yes.’
‘OK, I’m all yours.’
‘Are you sure?’ Doug eyed the cast on her arm but Jennifer nodded decisively.
‘It’s not a problem anymore. See?’ She waggled her fingers at him. ‘I’ve got full mobility in my hand.’
Doug led the way towards one of the curtained resuscitation areas past the central desk.
‘MVA coming in,’ the triage nurse warned Jennifer. ‘Three patients. Two status 1. ETA five minutes.’
‘Is the trauma room clear?’
‘Just.’
‘Get the team together. John or Adam can lead if they’re free. I’ll be tied up for a few minutes.’
A woman with a shrieking toddler in her arms stepped out of their way, but Jennifer had to swerve to avoid a bed being rapidly manoeuvred.
‘Sorry, Prof,’ the orderly called.
‘Not a problem, Deane. I’m just as bad with supermarket trollies!’
The patient with the UTI was looking extremely unwell. Doug rapidly gave her the information that added up to a shocked condition. Colin Smith was febrile, hypotensive, tachycardic and confused. He had a forty-eight-hour history of urinary frequency and pain, had been to his GP that morning, having passed blood, but hadn’t filled his prescription for antibiotics yet.
‘It was grandparents’ day at Alice’s kindy,’ his wife explained to Jennifer. ‘He said he was fine and he’d start the pills later, but then he just got so sick so quickly. He started vomiting then so there didn’t seem much point in trying to get him to swallow pills.’
Colin had tufty grey hair rather like Digger’s had been. Jennifer could just imagine him toughing it out and pretending he was fine. She picked up his hand, noting the cool, clammy feel of his skin.
‘Colin? Can you open your eyes?’ She smiled at him when he complied. ‘Hi, there. I’m Dr Allen, one of the consultants here.’
‘You’d better watch out.’ Her patient managed to return her smile. ‘My wife might see you holding my hand.’
‘Do you know where you are, Colin?’
‘Heaven,’ he murmured. ‘Are you the boss angel?’
‘We need to get an intravenous line into you to treat your infection,’ Jennifer told him. ‘And your veins aren’t cooperating so I’m going to put one in just under your collarbone. Are you happy for me to do that?’
‘You do whatever you like, love. I’m just…’ The words trailed off into an incoherent mumble and he closed his eyes again.
Mrs Smith pressed her hand to her mouth. ‘He’s really sick, isn’t he?’
‘You hold his hand,’ Jennifer encouraged. ‘And we’ll get on with getting him better.’ She plucked a mask from the wall dispenser. ‘Let’s have a head-down tilt, Doug. Is there some local drawn up on that trolley?’
‘I’ll get it.’ An assisting nurse was holding a gown out for Jennifer. Another nurse was preparing to swab Colin’s chest for the sterile procedure.
‘Thanks.’ Jennifer turned to get the ties on her gown attended to. ‘I’ll need one large glove to get over this cast.’
Seconds later, they were ready. With the skin well infiltrated with local anaesthetic, Jennifer picked up a 10-gauge cannula.
‘Turn his head for me, Doug, and keep things nice and still.’ Feeling along the clavicle, Jennifer chose the point of entry and was pleased to find an instant flash-back. She withdrew the needle, leaving the plastic cannula in place. ‘OK. I’m ready for the guide wire.’
The flexible wire was passed into the vein and then a catheter introduced over the wire. Jennifer watched the screen of the monitor as she threaded the guide wire, making sure the wire didn’t travel far enough to irritate the heart and cause a rhythm disturbance.
Now that access had been established, the rest of this procedure was straightforward. The catheter would be stitched into place and covered with a dressing. A chest X-ray would confirm its correct positioning and blood samples could be drawn before fluids and drugs were administered.
‘Do you want me to take over?’ Doug asked.
‘I’m fine for a minute or two.’ Jennifer reached for the suture needle. ‘You’re doing really well, Colin. We’re almost done.’
The relief on Mrs Smith’s face was patent, but she still held her husband’s hand tightly. ‘You’re going to be fine, love. Alice is going to come in to see you later. She’s drawing you a special picture.’
‘How old is Alice?’ Jennifer queried.
‘She’s four. Her little brother’s two. We’ve got six grandchildren now…and they all adore their grandad.’
‘I’m sure.’ Jennifer smiled as she tied off the last knot. ‘Do they get lots of time with him?’
‘Now that he’s finally retired, they do. It was hard to get him away from work, though.’
‘I’m not retired,’ Colin mumbled as they raised his head position. ‘I’ve just cut down my hours a bit.’
‘What do you do?’ Doug’s eyebrows had been rising steadily during the conversation, but Jennifer ignored his surprise. Why shouldn’t she take the time to get to know her patients a little better?
‘I’m a vet,’ Colin told her. ‘Small animal practice.’
‘He breeds Corgis, too,’ his wife added. ‘They win at every show we go to.’
‘Good for you.’ Jennifer finally turned back to the registrar. ‘You’ll need to draw off blood for cultures, Doug. Then start fluid resus and antibiotics. What are you planning to use?’
‘Gentamicin 5-7 milligrams per kilogram IV as a single daily dose, and amoxycillin 2 grams IV six-hourly.’
Jennifer nodded. ‘Put a Foley catheter in. Get a urine sample and start monitoring output.’ She turned back to her patient. ‘I’ll be back to see you later, Colin. Doug’s going to look after you again now.’
The toddler was still screaming near the desk and an odd-looking man sat bolt upright on a stretcher beside the triage desk. A police office stood beside the ambulance crew.
‘Hey…Jennifer!’
‘Hi, Matt. What’s brought you down here?’ The orthopaedic consultant was not a frequent visitor to the emergency department.
‘Overload. You’ve used up all my registrars. There’s a nasty open femur and a fractured pelvis among the MVA patients that have come in. I’m just waiting for the X-rays to come through.’
‘Oh.’ Jennifer caught the eye of the triage nurse. ‘Is the trauma room covered, Mel?’
‘Yep. We’ve got a status 2 asthmatic coming in now, though. ETA two minutes. Can you cover that one?’
‘Sure.’ Jennifer’s attention was again caught by the man on the stretcher, who was staring at Mel with an increasingly disgusted expression.
‘Are you going to come out with us tonight?’ Matt’s voice was persuasive. ‘You’ve been having early nights ever since you got back to work, and that’s weeks ago now.’
‘It’s been tiring.’ Jennifer turned her gaze to the over-full whiteboard listing the department’s current patient load. No wonder beds were beginning to line up in the corridors. ‘Maybe I should have taken more than a week to recover in the first place.’
‘How’s the arm?’
‘No problem now. I just put a central line in and hardly noticed it.’
‘And the feet?’
‘Almost back to normal.’ Jennifer was keeping one eye on the doors to the ambulance bay and another on a patient being moved from one of the resus areas. She would need that bed for the asthmatic patient coming in. ‘I’m walking to work now but they’re not up to dancing quite yet.’
‘So just come to the drinks session and on to dinner. If you don’t want to do the club thing after that, we’ll let you go home.’
‘I’ll think about it,’ Jennifer said evasively.
Matt’s face fell. ‘This isn’t like you, Jen. The crowd’s just not the same without you.’
Jennifer just smiled. Why was the invitation so unappealing anyway? She had always worked hard and played hard, and a night on the town with a group of congenial people with exactly the same agenda had always been the perfect way to wind down after a stressful shift. Right now, however, it came across as being an empty way to spend an evening. Shallow, even.
What would she rather be doing? Sitting in a hut in the middle of nowhere with a man who would have preferred that she’d never set foot on his planet?
‘Bitch!’
The vehement accusation was startling, but it wasn’t directed at Jennifer. She whirled around to see the man on the stretcher still staring at Mel and making a vigorous attempt to get up. Fortunately, the safety belt was restraining his hips and the police and ambulance officers were quick enough to put pressure on his shoulders and force him back against the pillow.
‘You’re all the same,’ the man shouted. ‘You need to be wiped off the face of the bloody planet!’
Jennifer’s eyes widened, but Matt grinned. ‘I don’t think he’s too happy with the fairer sex at the moment, do you?’
Mel stepped hurriedly back behind the central counter. Jennifer stepped forward.
‘What’s going on?’
‘Midazolam’s wearing off,’ the paramedic told her.
‘History?’
‘Police were called to a department store where he was slicing up women’s clothing with a carving knife.’ The paramedic raised an eyebrow. ‘He was cross enough to be rather uncooperative. Seems that his girlfriend doesn’t find his company too appealing anymore so she left…in the company of his best mate.’
The man on the stretcher spat on the floor near Jennifer’s feet and struggled against the restraining hands. An IV pole crashed to the floor.
‘Bitch!’ he screamed again. ‘It’s your turn next!’
‘Call Security,’ Jennifer ordered. She caught the eye of a house surgeon emerging from a cubicle to see what the commotion was. ‘Michelle, could you draw me up a 10 milligram dose of haloperidol, please? Matt, can you give us a hand? Mel, call Psych and tell them we need an urgent consult.’
The ambulance bay doors were sliding open and a young girl could be seen struggling for breath.
‘Resus 3,’ Jennifer called.
She pulled Doug from Resus 2 to help, leaving Matt and a very nervous house surgeon to deal with the psych patient.
‘We need two secure IV lines,’ she instructed Doug. ‘Continuous nebulised salbutamol and aliquots of 0.1 milligrams adrenaline, IV. What’s the oxygen saturation?’
‘Less than ninety per cent,’ the paramedic reported. ‘We’ve got one patent IV. Sixteen gauge.’
‘Good. Let’s get her off the stretcher. Doug, get someone down from Anaesthetics. We may well need to intubate.’
‘On the count of three,’ someone said. ‘One, two…three!’
‘Sit her up,’ Jennifer ordered. ‘It’s OK, sweetheart,’ she told their patient. ‘We’ll get on top of this really soon.’ She had her stethoscope in position, noting with dismay an almost silent chest and increasing panic in the girl. They were on the verge of a respiratory arrest. It was no problem to tune out the scream from behind the curtains.
‘Bitches! You’re all the same! Don’t touch me! Ah-h!’
Twenty minutes later Jennifer’s young asthmatic patient was on the way to the intensive care unit. Colin, the man with the septic shock from his urinary tract infection, had also gone to Intensive Care. The MVA victims were under control, two having gone to Theatre and one having a CT scan. The disturbed psychiatric patient was well sedated and had two burly security officers in attendance pending his transfer to a secure ward. Peter, the young man with the spontaneous pneumothorax, was still stable but the chance to grab a cup of coffee remained elusive.
‘How long has the nosebleed been going on for?’
The epistaxis patient in Cubicle 7, Mrs Bennett, had presented enough of a challenge for a junior registrar to go in search of assistance. ‘Over an hour,’ she told Jennifer. ‘And there’s no response to direct pressure.’
‘Spontaneous bleed?’
‘Started after she sneezed.’
‘Any past history?’
‘Not of nosebleeds. She has hypertension and angina. She’s on aspirin, 300 milligrams a day.’
‘That won’t be helping. Is the bleeding anterior or posterior?’
The registrar looked disconcerted. ‘I’m not sure. Presumably posterior, if direct pressure isn’t enough to control it.’
‘Get a Y suction catheter,’ Jennifer instructed. ‘And find out where the site of bleeding is. When the catheter is passed beyond the bleeding site you’ll get blood appearing at the nostrils again.’
The registrar nodded.
‘Take bloods for haemoglobin, blood group and a coagulation profile. What’s the blood pressure?’
‘One-ten over 60.’
‘And she’s normally hypertensive?’’
‘Yes. She’s on a beta-blocker for that.’
‘Keep a close eye on her, then. With beta blockade, she won’t be showing a rise in heart rate to warn you of hypovolaemia. Get IV access and put fluids up.’
‘Will it need packing?’
‘Get back to me when you’ve decided on the bleeding point. If it’s posterior and still severe, we might need to use a Foley’s catheter in combination with anterior packing. She’ll probably need some sedation to cope with that. She’ll also need antibiotics if it’s packed, and we’ll have to admit her.’
A nurse hurried up, holding a cardboard container. ‘Mrs Bennett’s just vomited.’ She held out the bowl which appeared to contain a large volume of fresh blood.
Jennifer started moving rapidly towards Cubicle 7. ‘Mel? Could you get someone from ENT to come down, please?’
Staff from the ear, nose and throat department were not readily available, which would have been a nuisance for Jennifer a few weeks ago, keeping her tied to the treatment of a single patient and unavailable for the next critical case to come through the doors. The satisfaction to be gained from focussing on one patient was a new phenomenon, but the change in the way Professor Allen worked had not gone unnoticed.
‘Are you going visiting this afternoon?’ Mel held up a pair of spectacles. ‘Only these are Mr Smith’s glasses and if you’re going up to ICU, I won’t have to find an orderly to deliver them.’
Jennifer took the spectacles. ‘I’ll pop up and see how he’s getting on after my shift finishes.’ She glanced at the wall clock. ‘Which should be in about ten minutes.’
It was actually more like an hour. What should have been a swift final consult to finish her day, as she saw the toddler who’d been screaming intermittently for half the afternoon and prescribed antibiotics for an angry ear infection, was hijacked by the distraught mother of a fourteen-year-old girl.
There were no staff members immediately available to talk to the quietly sobbing woman so Jennifer took her into the relatives’ room herself and closed the door.
‘You’re Courtney’s mother, aren’t you?’
She nodded. ‘I’m Jane. They’ve just taken Courtney to the operating theatre.’
‘She needs a D and C,’ Jennifer explained gently. ‘The miscarriage wasn’t complete.’
‘I didn’t even know she was pregnant. I had no idea! I should have known.’ Tears flowed afresh. ‘And she’d been raped at a party. Why didn’t she tell me?’
‘Sometimes, when something terrible happens, it’s easier to try and pretend it didn’t happen than to have to go over and over it in your head. Telling someone forces you to confront the reality, and that’s a hard thing to do.’
Jennifer hadn’t spoken to her colleagues or even close friends in any detail about her experience of the plane crash. Maybe that was why it was proving so difficult to stop thinking about it all. About the narrow brush with death. About losing a patient she had desperately wanted to save. About the ordeal of the long trek to safety.
About Guy Knight.
‘I should have known something had happened. I just thought she’d fallen out with her friends at school or she was worried about exams or something. She’s been so quiet for the last few weeks. Not eating or sleeping properly. Not going out with her mates.’
It sounded remarkably familiar to Jennifer. She hadn’t been raped, of course—quite the opposite—but the terror of the crash and its aftermath had to rank fairly highly in any list of traumatic events.
‘You’ll get through this,’ Jennifer said reassuringly. ‘It’ll take time and it might not be easy, but your daughter needs your support now more than ever.’
Jane sniffed and then nodded. ‘I would have been there for her, even if she’d ended up having the baby. Except…how could you love the child if the father had done that? This is probably the best thing that could have happened. That’s an awful thing to say, isn’t it?’
‘It’s a perfectly understandable reaction,’ Jennifer assured her. ‘And now Courtney’s got the chance to put it behind her and move on with her life. With your support.’
It was just as well Jennifer hadn’t ended up with any kind of reminder more tangible than memories. It hadn’t even occurred to her at the time that she was risking pregnancy…or worse. Jennifer never took risks like that. She must have been out of her mind. She had been lucky but it had been stupid, and Jennifer didn’t try to push back the anger her stupidity generated even now.
‘I’d like to be there when she wakes up.’
‘They’ll let you into the recovery room. It shouldn’t take long. A D and C is a fairly quick procedure.’
‘Can I go there now?’
‘I don’t see why not.’ Jennifer stood up. ‘I’m on my way to the intensive care unit so I go past Recovery. I’ll show you the way and have a word with the nursing staff.’ Anger was dulling into a vague irritation and movement seemed like a good way to dispel the negative mood.
Their progress along the corridor was temporarily blocked by a patient being moved with a large entourage of medical attendants. They were manoeuvring the bed with extreme care and Jennifer could see that they had an unstable spinal injury patient, probably on the way to Theatre or Intensive Care. The young male had his head secured in halo traction and was on a ventilator.
‘Motorbikes,’ the accompanying consultant muttered as he passed Jennifer. ‘Don’t you love them? C4-5 fracture.’ He turned his head again a moment later. ‘Only two weeks to go, Jennifer. Still confident?’
‘As always, John.’ Jennifer’s smile felt forced. John’s looked smug.
‘May the best man win and all that.’
The journey with Courtney’s mother continued in silence. John was the main competition Jennifer faced in the upcoming decision regarding a new head of department for Auckland Central’s emergency department. A few years older than Jennifer, he was amused by her bid for the top job and rarely missed any opportunity to put her in what he considered to be her place.
Common dislike of John’s arrogance might well work in her favour, she decided a little later, having finally left the hospital after confirming that Colin was responding to treatment and his condition improving. Her chin rose unconsciously as she started the short walk to her apartment. The nagging irritation that the talk with Courtney’s mother had generated now had new fuel. She’d show her fellow consultant. She’d win this position, and when she did, she’d do something about the way John interacted with both his colleagues and his patients.
It was a Friday evening, and the cafés and bars in the trendy commercial area of Jennifer’s apartment were all buzzing. She walked past people sitting at tables on the pavement, and a wave of nausea swept over her at the rich aroma of roasted meat. Ducking down her alley, she punched in the security code for the gate and ran upstairs to let herself into her apartment and get to the bathroom just in time.
With a facecloth soaked in cold water and pressed to the back of her neck, Jennifer stared at her pale reflection in the mirror. What on earth was wrong with her? She was probably hypoglycaemic, she decided. It had been a physically stressful day and she hadn’t eaten anything other than the biscuit with a cup of tea at some point late in the morning. She often got through a hard day without a meal, but she hadn’t had her usual breakfast this morning, had she? The thought of food had made her feel queasy even then.
Jennifer hoped she wasn’t coming down with some kind of virus. She needed to be on top form in the runup to this job interview, and she was already at a disadvantage with her broken arm and the general tiredness she couldn’t quite shake off. It was just as well she had declined the invitation for a night out on the town. What she needed was a hot bath, some good food and an early night before another 6:00 a.m. start tomorrow.
Soaking in scented water, Jennifer started mentally ticking off the day’s cases. Often only a couple stood out and the rest became an easily forgotten blur unless her memory was jogged. For some reason, not being able to remember the details of all of them, or put a name or face to a case, had become disheartening over the last couple of weeks.
Peter was easy to remember because he’d reminded her of Guy. Colin had made her think of Digger. The psych patient with his desire for revenge against all women was certainly memorable and that toddler with the ear infection had been called something a little unusual. India? No, Africa. The name of an elderly woman with a fractured neck of femur had vanished completely, however, and Jennifer sighed, giving up the game. Maybe she was just pushing herself too hard at the moment in her determination to slot back into the routine of her normal life and create the kind of impression that would help her win the coveted position of head of department.
Keeping her cast dry while bathing had become part of the daily routine, but Jennifer was looking forward to having it removed. She was due for another X-ray on Monday, which would be four weeks since the fracture. At least it wasn’t painful any longer. Just irritating.
Like not being able to remember the name of that old woman. The one who’d slipped while mopping her kitchen floor. Gloria? Gladys? When the hairbrush slipped from her hand a moment later, Jennifer actually swore aloud. Then she shook her head and laughed at herself. Being irritable and snappy denoted a lack of control that had never been a fault of hers, and she wasn’t going to tolerate it now. What she needed was a glass of wine to wash away the nagging sense of unease that seemed to be plaguing her.
John wasn’t worth wasting emotional energy on. Except that this mood had started before that meeting in the corridor, hadn’t it? She’d been angered by the reminder of what she’d risked by that night with Guy. Nearly a month ago.
Let it go, she told herself. It’s over.
Except that it wasn’t, was it?
Jennifer stared at her glass of wine but she didn’t raise it to her lips. The irritation left in the wake of the conversation with Courtney’s mother had had nothing to do with her own stupidity regarding that night. She had been stupid all right, but it was the continuance of that state providing the irritation now. She had been a perfect example of the kind of denial she had described to Courtney’s mother, but the awareness of what had been provoked was only just surfacing now.
She’d taken a risk and maybe she hadn’t been so lucky. It was four weeks ago now. The stress of the whole experience might not be enough to explain why her period was a little late. And two weeks couldn’t be considered a little late anymore either.
‘Oh, my God,’ Jennifer breathed.
Was it possible she was pregnant? With Guy Knight’s baby?
It was easy enough to find out. A quick trip to the staff toilet with a testing kit at 6:00 a.m. the next day confirmed the suspicion that had kept Jennifer awake for most of the night.
The shock would have been numbing except that it didn’t have much of a chance to set in. Jennifer was still washing her hands when a nurse burst into the rest room.
‘Oh, there you are, Dr Allen. We’ve got an arrest in Resus 2 and there’s a multi-victim MVA arriving any minute.’
‘On my way.’ The crumpled paper towels fell into the rubbish bin and covered an equally crumpled pregnancy test kit.
Jennifer almost stopped in her tracks on entering Resus 2. Why, of all days, did she have to face a case like this right now?
‘Apparently found non-breathing fifteen minutes ago,’ Doug informed her. ‘CPR started by the ambulance crew.’
Even the tiny paediatric defibrillator paddles looked far too large to be used and the tube securing the airway of this patient obscenely out of place.
‘How old is she?’
‘Ten weeks.’
It was sadly clearly too late for this baby but they had to go through the motions.
‘Shocking again. Everybody clear?’
‘Clear.’
‘Where are the parents?’ Jennifer had taken over the bag-mask ventilation. It took only a gentle squeeze to inflate tiny lungs. The main reason for going through a distressing process like this was to reassure distraught parents that everything possible was being done for their child, but there were no stricken bystanders in Resus 2.
‘The mother’s in a cubicle.’ Doug sounded disgusted as he drew up new drugs. ‘Too drunk to stand up. The father’s being interviewed by the police.’ He watched the compressions on the tiny chest in front of him. ‘She’s seventeen. He’s just out of prison. There was a party going on and apparently the baby was making too much noise. Mother says she put her in their bed and didn’t notice she wasn’t breathing until she woke up this morning.’
Had the infant been inadvertently suffocated, sleeping with an intoxicated adult, or had something more sinister happened earlier in the night? It would be up to the pathologist and police to determine the cause of death, but maybe it was actually an escape from a bleak future for this child. Jennifer glanced at the clock.
‘How long has CPR been in progress?’
‘Forty-five minutes, including pre-hospital time.’ ‘I’m calling it, then, if we’re all in agreement,’ Jennifer said heavily. ‘Doug?’
‘Yeah.’ The registrar shook his head, his face grim.
‘Michelle?’
The house surgeon just nodded.
‘Suzy?’
The nurse also nodded mutely, her eyes filling with tears.
‘OK. Time of death 6:45 a.m.’ Jennifer’s gaze returned to the infant, a tiny still shape on the bed. She reached to disconnect the ECG electrodes. It would be nice to remove the ET tube, but the pathologist would need to confirm its correct placement and maybe there wouldn’t be a parent wanting to hold this baby immediately anyway.
‘Dr Allen?’ A head came through the gap in the curtains. ‘They need you in the trauma room.’
‘Be there in a second.’ Jennifer stripped off her gloves. It was better that she had to focus on something else right now. Otherwise the overwhelming sadness would be too much and she might totally ruin her chances of becoming the head of this department by being seen weeping in a corner somewhere.
She flicked the curtain back to screen the area as she emerged into an already humming department. Straightening her spine, Jennifer set off to deal with the rest of her shift. She could cope. She had to.
She was in control of the destiny of more than one person now. Her baby was never going to lie abandoned on some hospital bed. It would be loved and cared for to the very best of her ability. Maybe it was a shock to be facing motherhood like this, but there was no doubt whatsoever in Jennifer’s mind that she couldn’t find a way around any of the problems it might create.
Yes. She wanted this baby.
As the days passed over the next week, tentative ideas became plans. She would have to leave her apartment, of course. A child needed a real home, with a garden, preferably close to a good school. She wouldn’t be able to manage alone, but that wasn’t an insurmountable problem either. She would be able to afford the best available in nannies, especially if she became the head of department.
The upcoming interview had provided several days of anxious focus and had interfered more than a little with her concentration levels but it, too, settled into the shape of a plan. As long as nobody found out about her condition before the interview, it shouldn’t make any difference. She could always plead ignorance later and blame it on something like an irregular cycle or a lighter than normal period. Sure, she might need some time off but if it all went well, she could work right up until she was due, and if she saved up all her paid leave she could probably take a month off before coming back to work full time.
But what about Guy?
The issue had been there from the moment she’d seen the colour appear on the test strip, but it kept getting pushed to the bottom of the list as she sorted through all the other worries. There was no avoiding it now, although Jennifer managed to put it aside for just a little longer while she made a quick trip to a medical ward to finish her day.
Colin Smith reminded her even more of Digger today, with his tufty hair in disarray but a cheeky smile on his face.
‘It’s my angel back again.’
‘You’re looking so much better.’ Jennifer’s delight was obvious. ‘Are they letting you go home soon?’
‘Tomorrow.’
‘That’s wonderful.’
Jennifer headed for home feeling very satisfied. She had to weave her way through a very busy street, with people enjoying a sunny Saturday evening at the cafés and boutique shops. Traffic was snarled up at one point, with drivers hooting in irritation. A teenage girl, texting on her cell phone without looking up, bumped Jennifer’s shoulder as she passed. Collecting her balance, she spotted a dark head at one of the footpath tables. For a split second, Jennifer was convinced it was Guy.
Turning into the alleyway leading to her apartment block, Jennifer saw the man’s profile and realised it wasn’t Guy. A curious mixture of relief and disappointment stayed with her as she climbed the stairs and an image of the real man was uppermost in her mind.
Opening a window to air the apartment, all the sounds and smells of the street below came inside and Jennifer suddenly felt more than disappointed. She felt…trapped.
Lost.
She would rather be sitting beside a picture-perfect mountain lake, she realised with something like desperation. Absorbing the stillness. Waiting for Guy to return.
Sitting down, she tried to pull herself together but nothing worked. The plans she had been formulating all week were no longer the answer to any problems. They all felt suddenly wrong. The satisfaction in following up one of her patients today to find him due for discharge evaporated. Could she even remember half the cases she had seen today? Would she have the time or inclination to follow any of them up?
She was tired. Bone-achingly weary. Closing her eyes and dropping her head onto the back of the couch, Jennifer allowed herself to focus on the only thing that really mattered right now.
She was going to have a baby.
Would it be a girl with blonde hair and blue eyes like her? Maybe it would be a boy with dark eyes and a flop of even darker hair. Like his father.
And with that thought, Jennifer sighed. There was no way around this. A telephone call or a letter to inform Guy of his impending fatherhood wasn’t good enough. He wouldn’t welcome Jennifer coming into his life again but she had the perfect excuse now, didn’t she? Telling someone news like this could only decently be done face to face.
A knot of excitement coalesced amidst the emotional turmoil. All the half-formed fantasies and even the crazy idea she could be in love with the man of the mountains that Jennifer had attributed to post-traumatic stress syndrome edged back into her mind. If she saw him again, she would know exactly how she really felt, wouldn’t she?
She wouldn’t tell him she was coming. She wouldn’t even need to tell anyone at the hospital where she was going. The mission could be accomplished on her next couple of days off. And maybe, just maybe Guy might be happy to see her again. He might even welcome the idea of becoming a father if it was forced on him.
Never mind those emphatic statements he had made about not planning on having kids and having no space in his life for them. It was another remembered comment that seemed of far greater significance at this moment. What had that woman said in the eavesdropped conversation? ‘If anyone needs a family, that young man does.’
Jennifer was unaware of the tears trickling down her face. She needed a family, too. A complete family. Something she hadn’t had since she was eight years old. Was that what the appeal of having a baby was all about? That she would have someone to love who would love her back?
But it wasn’t just the baby she wanted, was it?
Jennifer wanted Guy as well.