‘Tidal volume with spontaneous breathing is not looking too bad, is it?’
‘There’s not much of a drop in arterial oxygen levels either.’ Hamish observed with obvious satisfaction. ‘And the white-cell count is well down. We might have got round the corner here.’
‘I don’t want to take her off the ventilator and then have to put her back on, though. Her lungs aren’t completely clear yet.’
‘Let’s watch her overnight on spontaneous resps. Half-hourly observations if necessary on blood-gas levels.’
‘I’ll shift ventilation from PEEP to triggering,’ Emily decided. That way Megan could breathe for herself but the machine would kick in if spontaneous respiration ceased. ‘And I’ll stay in the unit overnight. Hopefully I won’t be needed in Emergency again.’
‘Get them to call me if you’re busy,’ Hamish said. ‘But right now I’m ready to go home. Coming, Mike?’
Mike’s smile at Emily, as he left with Hamish, was sympathetic. There was no hint of disappointment that he would have no further time alone with Emily just yet and, if anything, that lack of disappointment added to an air of supreme confidence his departing glance bestowed on her.
Someone else needs you more than me right now, the look suggested, but that doesn’t matter because we’ll be together soon enough.
Really together.
Very soon.
It was remarkable how well young people could sometimes bounce back from even critical medical situations. By the following morning, Emily was happy to remove Megan’s breathing tube and allow any sedation to wear off completely. The teenager would be kept in Intensive Care, however, on both oxygen and antibiotic therapy, and close monitoring would continue for as long as necessary.
At 7.30 a.m. Emily dashed back to the house for a shower and a change of clothes. She also had a mouthful of the coffee Mike had brewed and buttered a piece of toast to eat on the run. Tuesday morning was an obstetric and gynaecological session for Theatre and Emily would be responsible for anaesthetics for Dr Georgie Turner. Their 8:00 a.m. start time was only minutes away.
Mike shook his head as Emily headed for the door, her unbitten toast in her hand.
‘You need to slow down, babe.’
‘I’m fine,’ Emily assured him. ‘Everything’s good. And I’ve got a night off tonight. I’ll rest then.’
‘Hey…’ Mike’s voice floated after her as she reached the veranda. ‘I’m not on call tonight either. Let’s rest together.’
Emily had to throw her piece of toast to the resident parakeets a few seconds later, her appetite gone. The shaft of sensation that had encompassed any space in her stomach felt like pure excitement. Or lust. Or possibly nerves.
Whatever it was, she was fairly certain that if she spent time with Mike that evening, the time would not be in any way restful.
Being too busy to give the evening’s potential agenda any further thought was a blessing. Emily knew she was quite capable of over-thinking to the point where she could undermine what could possibly be the most important night of her life.
She wasn’t going to spoil the opportunity she had here. No way! No seeds of doubt were going to be strewn in their path by her hand. Emily was going to trust that this happiness would not just continue—it would grow. And what did it matter if they caused raised eyebrows by allowing things to happen fast? Mike was right. If they’d both wanted this for so long and it was meant to be, then they had a lot of catching up to do.
Everything seemed so much more positive today. Megan was going to survive and the morning cases in Theatre went so smoothly they were fun. Georgie dealt with a hysterectomy on a woman with fibroid problems and then they had an elective Caesarean on a second-time mother who’d had huge difficulties with her first labour.
The anaesthetic for the Caesar was an epidural and Emily enjoyed having a conscious patient to talk to during the procedure. And she always got a real thrill from witnessing the delivery of a new life. Today that special kick was enhanced by all the other positive things happening in her life.
With the first cry of the newborn baby late that morning, Emily found the tears of joy from its parents contagious. She was not only sharing their happiness at a new life, however. She was living it.
She spared just a moment or two to feel thankful that she had been found wanting in the past and that she’d been dumped, first by Cameron and then by Simon. Fate must have decreed that she felt the pain of rejection and that she’d had to wait this long because now she could recognise the one that really mattered.
Mike could very well be it.
The love of her life.
And this time it was going to work because fairy-tales could sometimes come true for the very lucky.
Megan was going to be one of the lucky ones as well.
Emily went back to the intensive care unit after the Theatre session finished and found that Megan was not only continuing to breathe adequately on her own but that she was awake and aware of her surroundings. Once again, she was the only patient in the unit as Todd had been moved to a ward earlier that morning.
‘She won’t talk.’ Megan’s nurse had signalled Emily over to the central desk before she’d approached her patient and she was looking concerned. ‘She shuts her eyes and pretends to be asleep whenever I’m near her and then she opens them and just stares at nothing when she’s by herself.’
Emily’s nod was thoughtful. She could see from where she was that while Megan’s eyes were open, she was simply staring at the ceiling and ignoring the movement of any staff members around her. ‘I’ll stay with her for a bit. Why don’t you take your lunch-break now?’
She approached her patient with a smile a short time later, having reviewed her chart. ‘Hi, Megan. How are you feeling?’
There was no flicker of response. Wanting to establish contact, Emily reached for Megan’s wrist rather than looking at the monitors for a heart rate.
‘I’m Dr Morgan,’ she said. ‘Emily. I came to see you at home, remember? When you first got sick?’
Megan pulled her wrist free from Emily’s touch and made a noncommittal sound as she continued to look at the ceiling.
‘You’ve been in Intensive Care for a couple of days now,’ Emily continued. ‘And you’ve been very ill. You had a nasty infection and we needed to keep you on a breathing machine for a little while. I imagine you’ve got a sore throat right now from the tube and you’re probably still not feeling too flash, but you’ve going to be fine, Megan. We’ll get you back on your feet in no time.’
‘I don’t want to be here.’
‘No, of course not.’ Relief at hearing Megan speak made Emily smile again but this time it was with empathy. She caught and squeezed the girl’s hand gently. ‘Nobody wants to be here, but it’s not for long, pet. We’ll be able to move you to the ward in another day or two. There’ll be a lot more happening there and you’ll be able to start having visitors.’
‘No.’ Megan’s voice was scratchy and muffled by the oxygen mask but its toneless quality was not completely disguised. She rolled her head on her pillow in a negative motion. ‘You don’t understand.’
‘Tell me, then,’ Emily encouraged her softly. ‘What can I do to help?’
‘It’s too late.’ Tears welled and then trickled down Megan’s face. ‘You should have just let me die.’
‘Oh…’ For a horrible moment Emily was taken back to the darkest moment in her own life. She knew exactly how Megan was feeling. And why. Nobody in her own case had had the kind of power Emily now had to put things right, however. Just how she could start was the tricky bit.
‘Nothing’s ever quite as bad as it seems, Megan,’ she said carefully.
‘You don’t know anything,’ the teenager said flatly. ‘I wish you’d just go away and leave me alone.’
‘I can’t do that.’ Emily picked up a box of tissues and then pulled a chair closer and sat down beside Megan’s bed.
‘I know more than you might think, Mega
n.’ She pressed a wad of tissues into the girl’s hand. ‘And I’m here to help you. I can help.’
‘You can’t. Nobody can.’ Megan sniffed but didn’t raise the tissues to her face.
‘I think I can.’
The quiet conviction in Emily’s tone seemed to hang in the silence that followed. Finally—slowly—Megan turned her head just far enough for her to actually look at Emily.
‘How?’
‘I can look after you and help you to get better physically,’ Emily said. ‘And I can help with…with the baby.’
Megan’s eyes widened in a flash of fear and Emily could hear the beeping of the monitors recording her heart and respiration rates speeding up.
‘What baby?’
‘Your baby, Megan,’ Emily said gently. ‘It’s OK. I know you’ve just had a baby. Was it when you were at the rodeo?’
Megan was still staring at Emily. She looked as though she was set to deny having given birth again until she saw the truth in her doctor’s face. Then she turned her gaze back towards the ceiling and just nodded miserably—the picture of defeat.
‘That’s why you got sick,’ Emily explained. ‘A little bit of the baby’s placenta got left behind in your uterus and caused the infection.’
‘No.’ Megan closed her eyes. ‘I got sick because I wanted to die. Same as the baby.’
Emily took a deep breath. ‘Is that what’s upsetting you so much, Megan? That you think your baby died?’
The headshake was tired. Uncaring. ‘It was the only way out. For both of us.’
The utter misery the statement encapsulated was shocking and Emily’s voice was no more than a whisper.
‘Why?’
‘Because I could never have kept it.’ Megan lapsed into silence and took several short breaths but Emily just waited, hoping that she would tell her more. The strategy worked.
‘Things are bad enough at home already. It would kill Dad if he knew.’ Megan opened her eyes again and she stared at Emily, looking even more frightened than she had a minute ago. ‘You can’t tell him.’ Her voice finally lost its toneless quality. ‘You can’t tell my parents about this.’
‘I won’t tell them anything you don’t want me to,’ Emily promised. ‘But there is something I need to tell you, Megan.’
‘What?’ Megan’s eyes drifted shut again and she looked exhausted. The conversation and emotional upset was too much for her right now and Emily knew she needed to let her patient rest. But she couldn’t leave her like this, could she? So down that she wished she had died? Thinking that it was ‘the only way out’?
‘There are lots of ways we can help you,’ Emily said first. ‘You’re going to be all right, Megan.’ She took a deep breath. ‘You and your baby.’
‘There’s no baby.’ Megan shook her head. ‘It was dead.’
‘No.’ Emily was watching Megan’s face carefully to gauge her reaction to her news. ‘Your baby didn’t die, love.’
‘Yes it did.’ Megan’s inward breath was a gasp. ‘You can’t say that! I saw it.’
‘Someone found him.’ Emily stood up and used her fingers to wipe some of the tears from Megan’s face. ‘It’s OK, Megan. He’s alive. He’s going to be fine. So are you.’ She stroked the girl’s hair. ‘Try and slow your breathing down, pet. Everything’s going to be all right.’
‘No-o-o…’
But Megan’s eyes closed as she gave in to both her exhaustion and the comforting patter of Emily’s words. Within seconds she had escaped into sleep, but Emily stayed until she could see all the readings on the monitors return to more normal levels.
Had she done the right thing by breaking the news so soon?
Had Megan actually believed what she’d been told?
Would it have been better to wait until she was well enough and then have taken Megan to the nursery to see for herself?
The promise not to tell her parents was a concern as well. Emily had no idea how to handle the next step in this case. She needed help and Megan needed counselling from someone far more expert than herself. The problem there was that Crocodile Creek Hospital’s physician, who also had an interest in psychiatry and handled cases like this, was away on leave.
Megan was Emily’s patient right now and she desperately wanted to help on all the aspects this case was presenting. Tackling the physical challenges might be the easiest part. Megan’s mental state and the social aspects that were clearly looming might be a lot more difficult. Simply understanding what the teenager was going through was not enough of a base to feel confident in giving psychological assistance.
And Megan could well be in a completely different space anyway. The timing of Emily’s own baby might have been a disaster in terms of her career at medical school and the relationship she’d been in with Cameron, but she had wanted that child very badly by the end of her pregnancy. She would have given anything not to have lost it at birth.
What if she was projecting too many personal feelings into dealing with Megan? What if the sex hadn’t even been consensual or a child was the last thing the teenager wanted, even without the stress it could cause her family? Emily didn’t know the Coopers at all.
She did, however, know someone who did. Someone whose opinion and advice she would respect, both as a physician and a friend.
Emily left the unit as soon as Megan’s nurse returned, having charted medication that would help the teenager get the rest she needed for the next few hours. She moved purposefully through the hospital, sparing only a moment to greet Mrs Grubb, who was pushing one of the large stainless-steel meal trolleys back to the kitchens.
Emily knocked on a door that was a little wider than most. It had a plaque that advertised the office as belonging to the hospital’s medical director. She opened the door and poked her head through the gap.
‘Charles? Can you spare a minute? Oh, sorry!’ Finding Jill in the office wasn’t surprising, but seeing their somewhat dour nursing director with a broad smile on her face was. Emily had the distinct impression she could be interrupting something. ‘I’ll come back later, shall I?’
‘Not on my account.’ Jill stood up swiftly, her smile fading as she smoothed the tunic of her uniform. ‘I’ve had my roster problems sorted and it’s high time I was back on duty.’
‘Come in, Emily.’ Behind a desk, it was easy to forget that Charles was in a wheelchair. Just like it was easy to forget that Charles might well be frustrated by not being able to use his medical degree in a more hands-on capacity because he ran the empire this hospital represented so well from behind this desk.
Emily had also forgotten, momentarily, that Charles had his finger on the pulse of what went on around him with uncanny precision. He was smiling at Emily as she entered his office properly.
‘You want to talk to me about Megan Cooper, don’t you? Sit down, Em. How can I help?’
‘So what did Charles have to say?’
‘He was a bit shocked, I think.’
‘About Megan getting pregnant?’
‘More about how sad the whole family is. About Jim’s health and what terrible condition the farm is in. He and Jim grew up as best mates. Charles said that Cooper’s Crossing was thriving back then. They had prize-winning cattle and Jim was determined to keep things going after his father died. Charles went to the wedding when Jim married Honey about twenty years ago and they were talking about the wonderful new house they were going to build before they started a family.’
‘So what happened?’
Emily shook her head, pushing her empty cup away. It was late and the rest of her day had been busy, what with an outpatient pain-management clinic and frequent visits back to Intensive Care to check on Megan. A visit to the nursery had been slotted in, of course, after Emily had gone for a late dinner and found that Mike was also having a long day and hadn’t returned from a patient transfer to Cairns. The others had all gone to bed by the time Mike returned to the house but Emily had been waiting, with hot chocolate and toast ready for them b
oth.
‘He doesn’t know. The wedding was a one-off by the sound of it. They’d grown apart because Charles was in the city for ten years after his accident.’ Emily paused, letting Mike lean over the corner of the table to weave his fingers through hers, and she smiled as he traced circles on her palm with his thumb. Then she sighed lightly.
‘Actually, I got the impression that Charles was really hurt. That the friendship died because Jim couldn’t cope with his disability. That radio call the other night was the first time they’d spoken for years.’
‘That’s a bit sad. What else did he say?’
‘Nothing about Jim. We talked about Megan. All the stuff I’ve already told you about her state of mind. She could be clinically depressed, which isn’t going to help her recovery or trying to sort out what she wants to do about Lucky. Her mum’s still going to try and come in to see her tomorrow and I can’t break patient confidentiality, but I’m sure her mother would want to support her. I don’t know what the best thing to do is.’
‘Are you supposed to be telling me all about this?’
‘You’re a colleague,’ Emily reminded him. ‘And you’ve been involved in this case from the word go. Besides…’ Emily smiled at her companion.
‘Besides, what?’
‘You’re trustworthy,’ Emily added softly. ‘And I needed to talk to you. I feel bad.’
Mike’s eyebrows rose sharply. ‘Why?’
‘It was too soon to try and talk to Megan about the baby. I thought it would help. I thought that thinking she’d lost him could be causing her depression, but I may have made things worse. A baby might be the last thing she wants.’
‘Are you surprised?’ Mike was giving Emily a curious glance. ‘She’s only nineteen and she’s not in any obvious relationship with the father of the baby.’
‘But…’ Emily fought back a wave of longing so strong it was painful. She hadn’t been much older than Megan when she had become pregnant. Only twenty-two. A student at medical school. Motherhood would have been totally disruptive to her life and career but she was only too well able to remember the way she’d felt the first time she’d felt that baby move within her. She couldn’t hide the tears in her eyes as she held Mike’s gaze.
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