by Peter James
Resmes had told Marcus earlier that he was minded to specialize in obstetrics because he liked the idea of dealing with mostly happy, excited patients. ‘Is that what you feel too, Mr Valentine?’ Resmes had asked him.
‘Babies, yeah, I love ’em!’
As he made his way to the operating theatre, followed by the two men, he was thinking, as he did so often, Why indeed am I an obstetrician?
In the past, he’d always known the answer – before he’d had children of his own. The excitement of seeing new life full of hope and expectation. He loved the parents treating him like a god. He loved that feeling most of all. Playing God. But it was more than that, wasn’t it? If he dared to be truly honest with himself, wasn’t it about those feelings of intimacy with women? Being allowed to see what in his mind was the holy grail of femininity; to experience the touch, the smell. The smell of . . .
Power.
But sometimes he struggled with his conscience when he saw happy couples, the wife pregnant to bursting. Was tempted to warn them, to tell them about the changes his own children had inflicted on his life. Do you really want to know what lies ahead for you?
He entered the busy theatre to join the team similarly gowned to himself, with plain blue or green gauze caps, as well as the nervous, gowned-up father in the far corner. His patient, a very nice Irish woman, was seated upright on a white cloth spread over the operating table, her long dark hair hanging loose. The anaesthetist was giving her a spinal block, holding a hypodermic through a large area marked out within a sterile clear plastic sheet covering part of her back.
Marcus glanced up at the four clocks on the wall. The first, on the left, an analogue clock, was running slow, which irritated him. Alongside it were two digital clocks showing zero and an analogue timer, also showing zero. He went over to a trainee paediatric nurse, a young Scottish girl who was chatting to a colleague, and said to her, ‘Please could you get a technician here quickly, to adjust that clock before we start.’
She looked up at the wall. ‘It’s only a couple of minutes out, sir, I think,’ she replied. ‘That’s pretty much the right time.’
The change in his demeanour startled her. ‘It’s a couple of minutes out but I’d really prefer it on time,’ he snapped and guided her towards the deserted scrub area.
He peered at her name tag. ‘Annie, right?’
She nodded.
‘You’re at nursing college?’
‘Southampton University.’
‘You want to be a paediatric nurse?’
‘Yes, yes I do.’
He smiled and she lightened up, for an instant, hopeful the moment was over.
He said, calmly, ‘You want to go into one of the most critical areas of nursing, yet you don’t mind that a clock is running nearly three minutes slow? Young lady, in an operating theatre, ten seconds can be the difference between life and death.’ He leaned forward. ‘If you want to be in my operating theatre, in my Obstetrics department, in my hospital, timing is everything. Do you understand, have we got this?’
She nodded.
‘Now can you go and get a technician? Knife to skin will happen as soon as the time on that clock is correct and not one second before.’
As she hurried out of the room, he looked at the list on the wallchart, doing the calculations for each stage. Forty-five minutes start to finish. Across the room sat the nervous father-to-be. Marcus gave him a friendly nod, secretly thinking, Good luck, mate.
Then he looked back at the chart.
ITT – into theatre
KTS – knife to skin
KTU – knife to uterus
TOB – TW1 – time of birth of twin number one
TOB – TW2 – time of birth of twin number two
SEX – TW1
SEX – TW2
PLACENTA
He went through into the sink annex, where he rigorously washed and dried his hands, before a scrub nurse helped him into his gloves.
Back in the main area of the theatre his patient was now on her back, her legs encased in white stockings, the rest of her body, apart from her naked, swollen belly, covered in white sheets. A nurse was talking to her, reassuring her, while a technician, who had just corrected the clock, was now adjusting the overhead lamps. A blue plastic sheet was raised in front of her face, enabling her husband, seated behind her, to see and talk to her, but blocking out his view of her body and the brutal invasion of it that was shortly to take place.
A nurse swabbed the distended belly with antiseptic, then green drapes with a window were laid across. Music suddenly boomed through the speakers. The Eagles, ‘Peaceful Easy Feeling’.
Marcus, who always had music playing during his operations, turned to his registrar in anger. ‘Barnaby, who chose this?’
Cardigan pointed a discreet gloved finger at the patient’s husband. ‘He did, the father.’
Lowering his voice to a whisper, Marcus said, ‘I need the right music, are you with me? Is there any Van Morrison?’
‘But the Eagles is what he specifically requested, Marcus. What do you want me to tell the father? He’s been very particular about their playlist for the birth.’
‘Tell him that the moment I pull those little brats out of her womb, the music will have gone out of his life forever!’
Seeing Cardigan’s shocked face, Marcus said, ‘That’s the truth, you’ll understand one day. Get over it.’ Then he smiled. ‘But the poor sod wants the Eagles so, hey, the Eagles it is. Let’s go!’
20
Tuesday 18 December
George Ezra’s ‘Shotgun’ boomed through the ceiling speakers in the gym. This was currently Georgie’s favourite feel-good track on her playlist for when she was training clients, and for a few seconds the lyrics distracted her from her work.
There’s a mountain top . . .
The mountain she was now climbing with her baby inside her.
The festive lights she’d put up around the gym, and the small artificial Christmas tree she’d bought, took away a little of the sterile and lonely atmosphere of the place. State-of-the-art Life Fitness and Octane equipment sat all around silently. Treadmills, cross-trainers, multigyms, mats, kettlebells, weights, leg presses.
She was feeling light-headed, as the midwife had warned her she might. And she was craving more pickled onions – she’d bought several jars earlier today from a farm shop. Roger had texted her to say he was cooking a Moroccan dish for their evening meal. She hadn’t the heart to tell him that, actually, all she wanted tonight was a cheese and pickle sandwich. All her tastes in food had changed, quite suddenly.
She focused back on her client, her last of the evening. The clock on the wall was showing 7.20 p.m. Ten minutes to go. ‘How’s your heart rate?’
Michael Longcrane was a banker in his mid-sixties and was determined to defy his age. Married to his third or perhaps fourth wife, he regularly dropped unsubtle hints to Georgie that fidelity wasn’t his thing. He worked every set of exercises with an enthusiasm she seldom saw in someone twenty years his junior. She sensed in him a desperation and that worried her – she was scared he might drop dead on her at any moment. Among the gym’s First Aid equipment was a defibrillator, which fortunately she’d never had to use – so far.
Glancing at his Fitbit he announced with pride, ‘One hundred and sixty-three.’
That heart rate was high for his age bracket, she worried. ‘Do you want to rest for a few moments?’
‘No way. Go for it!’
‘OK, final set for the last ten minutes of our session, but we’ll go gently.’ She zeroed the middle of the three large glass egg timers with green sand that she had fixed to the wall. The first timer was one minute, the second three minutes and the third, five. ‘Three minutes rowing, three minutes cycling and finish with three minutes on the cross-trainer to cool down. OK?’
‘Rock and roll!’
She set him an easy target, which he ignored, totally going for it. He heaved himself backwards and forwa
rds on the rower, grunting and sweating, his face contorted into a mask of grim determination. Georgie’s eyes moved from his face to the last few grains of green sand falling down the egg timer, her back to the row of dark windows overlooking the car park, and she took a bite of an energy bar.
‘Good!’ she said. ‘Well done! A big improvement!’
‘You think so?’ he gasped, his face puce.
‘I really do! Now on to the next!’
She waited for him to settle on the static bike, then flipped the egg timer to the start position. ‘OK, three minutes, your target is fifteen miles an hour!’
He began pedalling furiously and she watched the display, anxiously, as it passed 15 mph to 20, then peaked at 23 before dropping back to 19.
Other than this gym, the rest of the two-storey building, with rooms spread along the hilltop, was in complete darkness and would remain so, apart from the caretaker’s office, and visits from various maintenance people, until next April. The caretaker, Edouardo Goncalves, a Portuguese national from Madeira, was a quiet man, about forty years old, who glided around the property in what appeared to be his only pair of trousers, dirty, and frayed at the bottom as they were too long for him. He seemed to pop up whenever she least expected him to. Tom Vautier, the owner of the hotel, had given Georgie a master key, and in exchange for the deal on the gym had appointed her manager de facto for this period – her only duty being to work with Edouardo to make a periodic check of the place to ensure there were no leaks from burst pipes or damage from vandals.
She found it creepy enough in daylight, when she carried out an occasional check on each of the rooms. And she didn’t have the inclination to check any part of the building at night, although sometimes she had to.
She intended to switch off the lights, lock the door and hightail it out of the place once Longcrane had left.
As he started on his final set of exercises she picked up her phone and saw she had a text from Roger.
In Co-op, foraging. Anything you need? Love you. xx
Keeping an eye on her client, she replied.
Pickled onions, mature cheddar and you! xx
She put the phone back down, smiling.
21
Tuesday 18 December
Marcus Valentine, in a tracksuit, gloves and beanie, had decided to run over to take a look at the open gym sessions Georgie Maclean had told him about, and perhaps join in. He stood in the blustery wind outside the brightly lit gym, peering through a window, invisible in the darkness to anyone looking out. Hesitant about interrupting the session in progress but wondering how it would look to her if she spotted him.
He could feel the chill of the wind and his sweat, from his exertion, was cold against his skin, but he didn’t care. He was fascinated by the egg timers, wondering why she used such a primitive device rather than her phone’s stopwatch. Maybe so her clients could race against something visual?
The man moved on to the cross-trainer, his exertion slower now as the sand trickled through the glass. Finally, after some stretches, he was done. He nodded his thanks, gulped down a glass of water and pulled on a fleece top. They appeared for a moment to be checking their phones, then the man disappeared through a door at the rear of the gym.
Georgie, her outfit showing every inch of her very fit body, walked around, kneeling and switching off the Christmas lights. Marcus liked her hair clipped up the way she had it, with a short bob of a ponytail at the back.
A door was opening. Her client was coming out.
This was his opportunity to go in and say hello. But something held him back. The time wasn’t right, he was all sweaty, this wasn’t the moment. When he next saw her, he wanted to impress her. He scurried into the shrubbery at the rear of the car park, concealing himself behind a mature leylandii. Ridiculous, he knew, he just prayed no one saw him. How could he explain this away if anyone did, he wondered? The man, stooping slightly, walked a short distance across the car park, past a row of wheelie bins and a skip full of rubble, got into his car and started it, but then just sat there for an age, exhaust rumbling, farting around with his phone before driving away.
Georgie, this place is really creepy at night, you’re pretty brave being here all alone. You deserve better than this, your fiancé shouldn’t be making you work so hard in your condition. I’ll have to mention it to him next time I see him.
As he stood there looking at her, he couldn’t help thinking again how much she reminded him of Lynette. He couldn’t help but stare.
And think.
What might have been.
What might be.
You and me and your little foetus, just a few centimetres of it now.
22
Wednesday 19 December
‘About three centimetres, I’m estimating this little Jersey bean,’ Kath Clow said brightly in her Yorkshire accent, as Georgie Maclean reclined on the couch in the hospital consulting room. The obstetrician, a slim, energetic and highly positive lady in her early forties, moved the Doppler sensor around the gelled area of her friend’s exposed tummy. There was a steady roaring sound through the speaker, with the fast wuff-wuff-wuff-wuff-wuff of the heartbeat and a sudden scratching noise.
‘This is so exciting, Georgie. I couldn’t be happier for you both, and you have a very lively baby!’
‘We do?’
‘Yep, you won’t feel it yet but there’s quite a bit of movement.’
The midwife, also seated in the room, gave Georgie a reassuring smile. Roger sat on the chair beside Kath’s desk, looking happy and worried in equal amounts.
‘Good heartbeat – about a hundred and fifty,’ Dr Clow announced.
The midwife handed Georgie a printout of the scan. She and Roger looked at it excitedly.
‘Amazing such a tiny creature can already be making such a noise!’ Georgie said.
Kath smiled at her again, then switched off the equipment. ‘OK, you can sit back down now.’
Kath returned to her desk and, for the second time, went carefully through Georgie’s pregnancy notes booklet. ‘When did you last have your blood pressure taken?’
‘On Monday, in my room,’ the midwife answered, ‘125 over 74.’
Kath nodded. ‘Let’s take it again.’
This time it was 141 over 86.
Georgie knew blood pressure measures, and 141 was heading into the high range. Hypertension. ‘Is that a concern?’ she asked and noticed Roger’s worried expression.
Kath did not seem too fussed and answered reassuringly. ‘Sometimes just being in a doctor’s room raises people’s blood pressure and even though we know each other well enough it can still have an impact just being in here.’ She turned to the midwife. ‘If you could take it again in a week’s time, we’ll monitor it closely.’
‘I will do.’
Clow peered at Georgie’s notes on her screen. ‘So just over eighteen months ago you had a routine Pap cervical smear which indicated abnormalities. It was followed by a colposcopy and biopsy which just showed high-risk HPV change and stage-1 pre-cancer and was to be repeated in a year. Was that done?’
‘Yes, and it showed the same as previously,’ Georgie said.
The obstetrician nodded. ‘I can see that. Good. But, I have to say this, and I don’t want it to feel awkward between us as friends, if you get any signs of vaginal bleeding – after intercourse or at any other time – I want you to come and see me straight away.’
‘I will. But you’re not worried?’
She shook her head and smiled. ‘No, you know I’d be the first to tell you if I was. I’m sure you are absolutely fine! And don’t panic if you do have any bleeding, there are plenty of possible causes should that happen.’
Georgie pulled up her jeans, buckled the belt and sat back down next to her fiancé. Roger took her hand and squeezed it, reassuringly. ‘Amazing to hear the baby’s heartbeat!’ she said.
‘Incredible!’ Roger agreed.
‘So, a few more questions to run through and a
lthough I think I may know some of the answers let’s just make sure we’ve covered everything. Any nausea or vomiting in this first trimester?’
‘Some nausea, but no vomiting.’ Georgie glanced at Roger. ‘Apparently I’ve started snoring a bit.’
‘A bit?’ Roger said, good-naturedly. ‘Like someone trying to play a trumpet, I’d say.’
‘Yes, well, I’m afraid pregnancy can affect mucus levels in the nasal passages. That will pass. Are you eating regularly?’
‘Yes, I’m grazing a lot – every hour or two – although my taste in food has changed.’
‘That’s normal. It will revert. And good you’re grazing, much better than loading up with big meals as you might have done previously. You don’t smoke. Unless you’ve suddenly taken it up?’
‘No.’
‘And you are taking vitamin supplements?’
‘Yes.’
‘I know you’re exercising and taking care of that side of things and there’s really no harm in continuing with that level of exercise until it becomes uncomfortable. I know you’ve told me that you are wanting a vaginal birth. I’d recommend some antenatal hypnotherapy classes, to help you relax when the time comes.’
‘OK.’
The obstetrician turned to her screen and tapped her keyboard, making some more notes for a brief while, before turning back to look at both Georgie and Roger. ‘Right, we are making a plan. I’d like to see you back here again towards the end of your second trimester, at twenty-eight weeks. At that appointment I’ll check your cervix with a colposcopy to ensure it’s still only stage-1 pre-cancerous changes. Meanwhile you’ll be seeing the midwife on a regular basis. And we’ll be catching up soon anyhow!’ She smiled at Georgie.
‘Now you don’t want to know the sex of your baby and that is absolutely fine. You didn’t elect to know from the Harmony test, but it’s possible we may be able to tell you during your second trimester, at around twenty weeks, if you change your minds. Sometimes it’s very obvious on the scan but we can never tell one hundred per cent. If you want to reconsider at any time, just let me know.’