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The Present
Caitlin’s day had taken on a new routine. Wake up, sit up, dry retch.
“How can I be sick when I haven’t even eaten yet?” She sat in bed.
“Aye well, lass, get used tae it, for all your pregnancies began like this. The twin pregnancies were the worst, mind.” Scott handed her a piece of dry toast. “This worked. Eat this before ye get oot o’ bed. It always used to settle your tummy.”
“Thank-you,” she responded meekly. “And I do this five times? I am mad.” She faced him. “This is all your fault, you know.”
Scott stood at the side of their bed, grinning. “I sincerely hope so.”
He had made the toast first thing and now stood in front of her wearing only his jocks. Their hard life had kept him lean and muscled. Scott’s dark-blond hair was now long, and he wore it tied back in a ponytail and his bushy beard was full of red tinges. His summer tan had faded, and his scars were more noticeable.
“Haven’t hurt yourself in a while,” she commented as her gaze ran over his naked torso. “Keep it that way.”
“Aye well, we’ve had enough excitement here for a wee while, have we not? You’ll be all right then, lass?”
“Yes, you have done your husbandly duty. You are dismissed, wild-man that you are.” Caitlin bit into the toast.
No butter?
“Wild-man?”
“Yes. The beard.”
“Keeps my face warm, lass. It’s a cold winter out there, in case ye haven’t noticed.” He dressed, gave her a quick kiss then left to do his chores.
Caitlin took her time rising, which helped ease the nausea. This morning there was a niggle in the left of her tummy. She dismissed it—again. It was surprising how easily she had come to terms with being pregnant. Scott was most attentive and supportive, happy at the unexpected extra family member. He’d been a father since he was nineteen. Perhaps he missed being a father here in the past, with their children in the future.
The days were shortening with the winter solstice approaching. Caitlin helped Bec prepare for the celebrations in earnest.
“Some semblance of normality, that’s all I want,” Bec declared.
“Yes, we need Christmas! And Hogmanay! Would you put that holly over on the mantelpiece, please? I’ll see if I can get through the snow to a fir tree and bring in some branches.”
Outside Caitlin stepped her way through the still deep snow to the trees at the very far end of the grounds surrounding the cottage. To muck out the stables, Scott put the horses in the yard where the action of the horses and the slight snow melt had made an area for them to exercise, albeit a muddy one. Scott was on his stallion, putting him through his paces.
“How’s your vicious beast?” she shouted at him as she walked past, her tender arm still hurt from his nip.
“He’s fine thank-you. Only being a male. All that testosterone will do it to ye. We’ll see some action come spring and I’ll get him to cover the mare.”
Caitlin smiled to herself at his anticipation of a herd sired by this one stallion.
Caitlin found lower, more easily accessible branches of the fir trees and, avoiding the resulting shower of snow, broke pieces off for decoration inside the crofter’s cottage. She recalled her house as she was growing up. Its festive decorations involved the scent of pine branches and the soft glow of many candles. What would her mother make of her being pregnant? As she walked back, a stabbing sensation deep in the lower left of her pelvis made her bend over right as she passed Scott.
“Ye all right lass? Being sick?”
Caitlin held her shoulder. There was also a sharp stab of pain there. Then it eased a bit.
“No. I’ve got a pain in my tummy. Think I’m constipated. Better take something for it.”
“Hello tinned prunes.”
“Oh wheesht!” She was irritable and sounded it too, when she reflected on her tone to Scott.
What’s happening? Her pulse raced, and her breath came faster.
Once inside the cottage, the pain subsided, and her breathing eased.
Caitlin continued decorating the crofter’s cottage and Bec started baking. They had no mince fruit, so they had decided apples from the cold store would make pies for Christmas.
“Do we use all the frozen butter on shortbread?” Bec asked.
“Can’t really. Don’t know when we’ll get anymore. Haven’t got a cow. But there’s an idea for a Christmas present from my man.” She shook her head. “Never thought I’d get excited over a cow!”
Shaking her head caused the pain again. She bent over. It was the only thing that eased the tight stab in her pelvis.
“What’s wrong Caitlin? You okay?”
Caitlin held her shoulder. The pain intensity was increasing with each episode. “I’ve had this niggle for the past few days. But today it’s terrible.”
“Where is your pain?”
“In my shoulder, just as much as my tummy. It’s on the left. Wrong side for appendicitis.” Her mouth tugged with a slight smile. “And this pain in my shoulder isn’t where Adam nipped me. I think I’m constipated. May have to use a suppository. Sorry, too much information, but I’d better get on with it.”
“Let me know if it doesn’t settle Caitlin.”
***
SCOTT CAME IN THE BACKDOOR as Bec took a tray of cooked pies from the oven.
“Hmm.” Scott sniffed. “The smell of good things.”
“They are for Christmas,” Bec warned him.
A thud came from the inside toilet.
“You okay, Caitlin?” Bec called.
Silence.
“Is she in the loo?” Scott asked.
They both ran to the inside toilet where Caitlin lay on the floor of the confined space, pale, with beads of sweat on her brow. Scott’s heart rocked in his chest as a cool numbness crept a journey down his spine.
“Caitlin!” Bec shook Caitlin’s shoulder. She didn’t respond.
Bec checked Caitlin was breathing, felt for a pulse in her neck then turned her onto her side with her head tilted to make sure her airway was clear.
“All good?” Scott asked.
Bec didn’t reply at first, her mouth tight.
“Help me get her on your bed.” Bec’s voice held strain.
Scott scooped Caitlin up in his arms and carried her to their bedroom where he gently placed her on their bed. Bec got her stethoscope and blood pressure machine and wrapped the cuff around Caitlin’s arm.
“What’s going on?” The cool numbness he fought with was like the snow he’d walked through on his way from the stables.
“Her pulse is thready, and her BP is low. She’s in shock,” Bec stated.
“She was in pain outside just now. Said she was constipated. Not constipated, is it?” Scott watched as Bec examined Caitlin with skilled hands.
Bec pursed her lips as she made her assessment. “Lower left quadrant, so not appendix,” she reported. “Associated shoulder tip pain. Early pregnancy. In shock. Shit!”
Scott narrowed his eyes. Bec had never sworn in his hearing.
“Get the kitchen ready for theatre,” Bec ordered. “I must operate. She has a ruptured ectopic pregnancy. We need to hurry, or we’ll lose her!”
“What!” Bec finished her diagnosis as Brendan reached the end of the bed.
“I’m sorry.” Bec looked up at Scott. “I’m not an expert in pelvic examinations for pregnancy. It’s all done by ultrasound now. I was correct she was pregnant, but didn’t pick up it was in the wrong place. Sorry.”
Scott didn’t move, he clenched his jaw muscles and swallowed a few times, fighting off the frozen immobility which threatened him. His silence was brief.
“Tell me what to do!” he ordered Bec.
“Help Brendan get the kitchen ready to be an operating theatre just as we did for his surgery. Drape the kitchen table, get the diathermy equipment, suction and the Boyle’s machine ready. I’ll need a sterile procedure pack, forceps, scalpel, sutures. Scott, you assist me in the same way you did for Brendan.”
Bec turned to Brendan. “Love, you can use the Boyle’s machine. Remember how I showed you? Once I get her under, you monitor her for me. And help wherever you can. Both of you, please be quick.”
Scott ran off to do as Bec asked. In the room behind him, Bec had lowered her voice, but he still caught it. “Brendan, get me a cannulation pack and a bag of normal saline and a line, please. Be quick. Get the IV fluids and resuscitation meds in case I need them. Caitlin looks bad, but don’t tell Scott.”
Brendan came into the kitchen. Scott scrubbed the bench in quick swift motions; his knuckles white around the scrubbing brush.
“You okay, Scott?”
Scott raised his head; his breath came out as snorts as his nostrils flared to suck in air.
“Got to get this set up quick.”
Brendan turned to the storeroom and came out with the cannulation pack and IV fluids and ran back to Bec. On his return, he got the emergency IV fluids and medications Bec had requested and put them to one side. Brendan then retrieved the equipment from the storeroom, plugging it in as he went.
Scott watched Brendan out of the corner of his eye while he frantically recalled what he’d done when assisting in Brendan’s surgery. That now felt like a lifetime ago. Scott threw the large plastic sheeting over the still damp table. He unwrapped the large sterile drape and flung it out flat. He ran to the bedroom, halting in the doorway. Caitlin lay curled on her side on their bed. Bec had put an IV in her arm and squeezed in the bag of fluid which she held up above Caitlin. Scott stood in the doorway, he puffed from his exertions, his eyes fixed on Caitlin. Her chest rose and fell rapidly, not from exertion, but in an attempt to survive.
“The kitchen’s ready now.” His voice was harsh. “I’ll take her in.”
“Get Brendan to assist you—” Bec began.
“No! I’ll carry my wife in.” He spoke curtly, his stress causing him to sound impolite.
Scott carefully lifted Caitlin off the bed and carried her to the kitchen table. She moaned as he placed her on the solid surface.
“What now?” He faced Bec.
“Drape her as you did Brendan while I put her under.” Determination etched Bec’s face.
“Brendan, come here and help. Put the BP cuff and other monitoring equipment on her.” Her tone was equal to her position of authority.
Scott covered Caitlin with sterile drapes while Bec and Brendan performed the induction. He turned away when they started putting the tube down her throat. Caitlin was so vulnerable and weak. Not like his Caitlin. Scott grabbed the sterile equipment Bec had asked for and began opening it onto a draped sterile tray, in the same manner he had seen Caitlin do for Brendan’s surgery. He leaned on the table by her side and forcibly calmed himself. His hands shook.
Get a grip, man! Hands need to be steady to hold instruments.
“Scott, because this pregnancy is probably not in the uterus but in a fallopian tube, I must remove it.” Bec looked over the drape once she had anaesthetised Caitlin. “Sorry, but the baby is already lost. I have to do it to save Caitlin.”
Scott swallowed and returned her stare. “Save her.”
He glanced at Brendan, now sitting behind the green drape that screened his wife’s face. “Ye ken I can only do this now because of what we went through with you, Brendan.”
Bec and Scott both scrubbed well with the iodine solution. Scott sniffed; the earthy scent brought back memories of Brendan’s surgery. Once gloved and gowned, he looked across his wife’s anaesthetised form to Bec.
“Just like we did with Brendan, only a lower incision, Scott.” Bec raised her eyebrows, most of her face covered by a mask. “Retract what I show you. Okay?”
Scott held layers aside with retractors and suctioned any bleeding as Bec tied and diathermied the vessels. Once in Caitlin’s pelvic area, Bec found a ruptured fallopian tube, which was bleeding. Bec tied and cut it away from the pink muscled-looking thing—Caitlin’s uterus. Bec tied off the vessels which bled and used the diathermy rod on the smaller bleeding vessels. The kitchen began to smell of burnt flesh. Scott swallowed.
“Kidney dish, Scott,” Bec ordered.
Scott flinched as he stared into Caitlin’s pelvic cavity. He grabbed the kidney dish and placed it beside the incision. Bec put the swollen ruptured fallopian tube into it. Scott sucked in a breath.
Their child.
The forceps pinching the end of the tube clattered into the kidney dish. His hands shook again, momentarily.
Focus!
Brendan called out Caitlin’s blood pressure and pulse at regular intervals.
“Her pulse is creeping up Bec, and her BP is only sitting at eighty.”
“Put up another bag of fluid and squeeze it in. You’ve got the line with the hand pump attachment, haven’t you?”
“Aye.”
“Squeeze it in! I’ve ligated and diathermied the bleeders. She should settle after this. Scott, more suction here please let’s clean her up and make sure we’ve got them all.”
Once certain she had cauterised all the bleeding blood vessels, Bec irrigated Caitlin’s pelvic area and then started closing it. Scott, recalling the suturing from Brendan’s surgery, helped to close Caitlin’s incision. Bec injected the cut with local anaesthetic for pain control. Scott glanced often at the kidney dish, which Bec had placed on one of the sterile trays. He blinked away tears. His greatest fear would be to lose Caitlin. She was not yet out of danger.
Bec started waking Caitlin. With the tube out of her throat and Caitlin breathing normally, Scott allowed Brendan to help him carry her back to their bed. Bec devised an IV pole from the bedpost as she wished to continue IV fluids and give her more pain relief.
“For a bit more fluid,” Bec said. “I want to be sure she won’t drop her BP again.”
Bec and Brendan cleared the kitchen. Their voices travelled into the room where Caitlin lay on their bed. Scott stood beside it, looking down at her. His pulse raced like he’d been fighting with all his strength, but he’d never been so powerless.
“What do I do with this, Bec?” Brendan asked in the kitchen. There was a clank of the kidney dish.
“Leave it. Put it in a plastic bag in the fridge. They’ll want to bury it and say good-bye.” Bec’s voice came through the door.
Scott laid himself behind Caitlin on their bed. Their own familiar scent, embedded in their duvet, surrounded him and Caitlin. She lay on her side, still waking up. Scott’s breath stirred the small hairs at the nape of her neck. She moved her shoulders and he lightly put his arm around her.
“Are ye okay, mo chroi?”
“Hmm,” she sounded groggy. Scott sniffed and brushed away the tears which spilled out of his eyes. Caitlin woke more fully. “Whas wrong?”
Scott didn’t answer her.
“Scott, whas wrong?” she slurred again.
“You’re all right. That’s all that matters.” Scott held her gently, not wanting to cause her more pain.
“What happened? I feel odd.”
“Bec had to operate on you, mo chroi. We lost the baby. Sorry lass,” he said softly.
Caitlin looked surprised and blinked a few times.
“Is that what the pain was?”
“Aye. An ectopic pregnancy, Bec called it.”
Caitlin woke further, a look of recognition on her face as Bec entered the room to assess her patient’s recovery.
“Bec. Where’s my baby?” Caitlin spoke with clarity.
“Has Scott told you?” Bec stood by their bed.
Caitlin nodded. He did too.
“Caitlin, I had to remove your left fallopian tube. The pregnancy had ruptured it. You were in shock. You can’t save an ectopic pregnancy.”
“I know. Where’s my baby?”
“We’ve kept it. We thought you and Scott would want to say good-bye when you were feeling better.”
“So, I’ve lost a fallopian tube. Can I still get pregnant?” Caitlin gripped his arm around her waist and tried to get up. Scott held her more tightly and shushed into her ear.
“Yes, of course you can!” Bec quickly answered. Bec glanced at him as well. He must have looked alarmed, so he tried to hide it.
“The human body is an incredible thing. Your one remaining fallopian tube, your right one, will swing over to your left ovary and pick up an egg when it releases one. They take turns, you see.” Bec smiled.
“It will be harder to conceive though?” Caitlin asked.
“They say it doesn’t make much difference. You rest now, Caitlin. You’ve been through an ordeal. You need to recover. We could’ve lost you. You’re a brave and strong woman, Caitlin. I’m so proud of you.”
“Bec,” Caitlin grabbed her hand. “Thank-you. I know I wouldn’t have survived without you.”
“You’re welcome Cait. Your husband and Brendan helped too. I couldn’t have done it without them. You both rest now. It’s been an ordeal. I’ll come and check on you regularly.”
***
THREE DAYS HAD PASSED. Scott bent over Caitlin as she lay on the couch. Caitlin’s whole body felt heavy with tiredness.
“Are ye feeling up to a wee walk, mo chroi?” he said softly.
“Yes. Why?”
“There’s something you and I need to do.” Scott wrapped her in the blanket she lay on, lifted her off the green sofa and carried her out of the backdoor. The sun shone but not brightly, its dimmer switch on halfway. Scott crunched through the snow, now only ankle deep, a solemn look on his face. The lines beside his eyes were a little deeper today, and a furrow was making its way to permanency on his brow. All this has stressed him, she reflected.
“I can walk, you know.”
“Aye, I ken ye can. But if you slipped, those stitches of yours might rip. Dinnae want to ruin all Bec’s hard work, do ye now?” He glanced at her in his arms and smiled. She must look better today. The strength was returning to her limbs, despite the heaviness of fatigue.
Caitlin turned away from Scott. He carried her to the far end of the garden where the tree line started. Directly in front of them was a large fir. Underneath it was a small wooden box beside an equally small grave, a dark gash in the white snow-covered ground.
Scott stopped and gently lowered her to a standing position. The chill came through her slippers. Caitlin stared at the tiny box. She then gazed up at the tree. There had been a slight snow melt. The usual blanket of frozen water covering the trees was now tiny, translucent droplets dangling like chandelier crystals from the ends of the pine needles.
Like our tenuous hold on life.
The random pat pat of the droplets falling to the ground punctuated her thoughts. Blinking, she looked down again.
“I suppose we should say a few words,” Scott interrupted her sombre reflections.
He placed the small box in the ground.
“Good-bye little one. Mummy and Daddy love you.” He lifted the shovel full of dirt and carefully covered the small box in the ground.
Silent tears ran down her face.
“You sound so brave.” Caitlin’s voice muffled as she turned and hugged into him. Scott returned her hug and held her close.
“I’m no’ brave. Just being practical, mo chroi.”
“Will we see him or her again, do you think?”
“I know we will. When we get there, we will find a wee girl, or boy, who will run up to us and shout ‘Mummy’ or ‘Daddy’. Whichever of us gets there first, aye?” His husky voice was gentle. They both wept. The moments passed in silence.
“That will be me. I get there first,” she said.
Scott nodded as he stifled a sob. “We lost a child. Something we never did in the future. But I nearly lost everything, Caitlin. I nearly lost you.” He buried his face in her hair and his tears fell freely.