The Shipbuilder’s Daughter

by Emma Fraser

  The days quickly settled into a routine. After a breakfast of porridge and bread, Margaret would walk over for morning surgery. Visits were in the afternoon and after that she had notes to write up and specimens to test. At the end of the day, if she and Dr Alan were both free, they would discuss the day’s patients over a cup of tea and it was consequently usually late by the time she made it home to her little cottage.

  Happily, Dobbin, the Clydesdale she rode to make some of the visits, turned out to be as placid and as willing a horse as even the most anxious rider could wish. Dolina had altered a pair of Dr Alan’s plus-fours for her so she could ride him while maintaining her dignity, and while they could never be called fashionable, the housekeeper had made a surprisingly neat job of them. The little free time Margaret did have was spent reading medical text books, and writing to the children and to Alasdair. She didn’t mind being busy – quite the opposite, she loved the work and it helped fill the empty hours. Finally, she received the letter she’d been waiting for. It had been placed on her kitchen table, presumably by the postman, who turned out to be the same Johnny who chauffeured the hire car. The sun was shining so she took it to her little rock to read, ripping open the envelope with fingers that shook with excitement.

  My love,

  It feels like years rather than weeks since I saw you last. When I look at the sky I like to imagine that you are looking at it too and thinking of me. I live for the day when I can hold you and our children again. I know that you are safe and that and the knowledge that one day we will be together again is what keeps me going. I keep myself busy by helping my fellow inmates with their legal problems. I may be in prison but I am still a lawyer.

  Simon Firth has already made progress. He found Dr Marshall, the doctor you told him about who served on the front lines during the Great War. He is happy to testify that what I tried to do for Tommy Barr was the correct thing. He will go as far as to say that Tommy Barr’s life might have been saved but for the actions of the police officers. I wish them no harm. They were only doing what they thought best. Simon was surprised that Johnston hadn’t approached Dr Marshall himself and challenged him. Johnston claimed there was little point as there were too many doctors willing to testify the opposite. But I wonder. He wasn’t happy that Simon has taken over my case, but that is of little import.

  My heart, I count the minutes until I can hold you again. This time I will never let you go.

  Yours, always

  Alasdair

  Only a few days and Firth was already making more progress than Johnston had in weeks. She read Alasdair’s letter again before slipping it into the bodice of her dress. She knew she would read it several times more before she went to bed that night.

  The next morning, unusually, Dr Alan called her into his consulting room before the start of surgery. Immediately she felt a flare of anxiety. Had he discovered she wasn’t who she said she was? He waited until she was seated before leaning forward and pinning her with his bright blue eyes.

  ‘You saw Angus Nicholson yesterday,’ he said.

  ‘Yes. Is everything all right? Did his asthma get worse?’ She’d visited Mr Nicholson at his home and made a diagnosis of asthma. She’d advised staying away from cutting the hay, advice he’d treated with amazement and scorn. If he didn’t do it, he said, then who would?

  Dr Alan leaned back in his chair and started to pack his pipe. She was learning that he did this whenever he was thinking. ‘His wife called me out last night. Angus’s breathing had become much worse and he was having pains in his chest.’

  Margaret’s heart thumped. ‘He didn’t complain of chest pain when I saw him.’

  ‘You listened to his chest? Specifically to his heart?’

  Margaret nodded. But how much time had she spent looking for cardiac symptoms? Mr Nicholson was young and she’d been so certain that asthma was the cause of his breathlessness.

  ‘Did he have a heart attack?’ she asked.

  ‘Yes. I’m afraid so.’

  ‘Is he all right?’ She twisted her fingers together so Dr Alan wouldn’t see her hands were shaking.

  ‘He will be.’

  ‘Thank God. I’m so sorry…’

  Dr Alan leaned back in his chair. ‘We all make mistakes, Margaret. Especially when we’re starting off. He’s going to be all right. I’ve prescribed diuretics and his breathing is already easier. I’ve arranged for him to go to Glasgow for further tests as soon as it can be arranged. I didn’t call you in to berate you. Only to let you know. Use this as a lesson. You should have taken blood and come to talk to me about him. At the very least, checked his notes when you returned to the surgery. That would have led you to consider alternatives.’ He stood, making it clear that the interview was over. ‘No harm done, eh?’

  Fighting back tears, Margaret escaped to the bathroom to compose herself. Dr Alan had been nice about it but he was right. She had jumped to conclusions. Preoccupied with worries about Alasdair, she hadn’t taken enough care.

  It didn’t bode well for her immediate future here. If she was dismissed, where would she and the children go? She’d only been working for Dr Alan for a short period of time and already she’d made a mistake that could have been fatal for her patient. It was only luck that had saved him. She blew her nose and took a deep breath. She would make sure she never made a mistake again.

  Chapter 27

  Margaret had only just come to the end of afternoon surgery when Dolina stopped her in the passageway.

  ‘The telegram boy has just brought a message from Locheport. From Nurse McAllister. She has Mrs MacPhee in labour and it isn’t progressing the way it should. She’s asked me to send for the doctor. Dr Alan’s gone out to see a child who pulled hot water over himself. I’m not expecting him back for a good few hours.’

  ‘Of course I’ll go. What’s the best way to get there?’

  ‘Dr Alan’s got Dobbin, so you’ll need to take the car. Drive as far as Clachan shop and park up. You’ll have to walk the rest of the way across the moors. I expect Chrissie MacPhee’s husband will meet you along the way.’

  ‘I’d better get going then.’

  Happily, the Morris started after only a few turns. The last time she’d driven a motor vehicle had been before her marriage to Alasdair and only a handful of times at that. The car jerked and bucked out of the driveway as she struggled to get it into the correct gear. Deciding that it was safest to keep it in third all the way rather than stall, that’s what she did. She had to hold herself uncomfortably upright in the seat in order to see over the steering wheel and the high curved bonnet, but at least she was driving it, and more or less in a straight line. She was just beginning to relax, keeping to a steady twenty miles per hour, when a sheep wandered lazily in front of her. Margaret slammed on the brakes, propelling herself forward and almost into the dashboard. She spent the rest of the journey gripping the wheel tightly while she negotiated the rutted track, keeping her eyes peeled for careless livestock and skittish deer.

  She was driving so slowly that it would have been almost impossible to miss the sign for Clachan Stores. Sighing with relief, she pulled off to the side of the road and parked.

  The wind had picked up and the clouds overhead were heavy with rain. The weather here was never the same two days running – sometimes it even changed completely over the course of the day. A morning that started out sunny and calm could be windy and wet by evening and vice versa.

  In the distance she could see a cluster of houses, smoke rising from their chimneys. It didn’t look too far to walk. Balancing against the vehicle, she untied her shoes and slipped on wellington boots. She’d been warned that the moors could be boggy in places.

  She’d only gone a quarter of a mile or so when the heavens opened. She turned up the collar of her coat, wishing she had worn a bigger hat, one that would keep her hair from blowing into her eyes and becoming plastered to her head. She’d cut it short before she’d left Glasgow in an attempt to disguise her ap
pearance, but the hat she was wearing wasn’t large enough to cover it all. She grimaced as a gust of wind threatened to sweep her off her feet. A bigger hat would only have blown away anyway.

  Too small a hat and wet hair turned out to be the least of her worries. As the wind increased in strength, it drove the rain straight at her, blinding her. She had to keep her head ducked down, peering up now and then to get her bearings.

  Her muscles were beginning to burn with the effort of negotiating the uneven and rabbit-holed moor and several times she stumbled. Rain snaked down the back of her coat and her hands were numb with cold. A few hundred yards on and she almost walked straight into a loch that was hidden by clumps of heather and reeds. She squinted through the rain, trying desperately to get her bearings. Except now she couldn’t even see the houses she’d spotted earlier.

  She battled on, squelching through mud and grass until, to her relief, she looked up and saw a man in an oilskin striding towards her.

  ‘You’re the doctor?’ he called out.

  ‘Yes. Dr Margaret!’ she called back, the wind snatching at her words.

  By this time he’d reached her side. ‘I’m Charlie MacPhee. It’s this way.’ Taking her medical bag from her, he turned round and strode back the way he came, leaving her stumbling along in his wake.

  ‘How long has your wife been in labour?’ Margaret asked, hurrying to keep up with his long strides.

  ‘I can’t say exactly.’ They both had to shout to make themselves heard above the wind. ‘Since the early hours, anyway. The baby doesn’t seem to be wanting to be born. The nurse came this morning. She didn’t appear too worried at first but then she told me to send for the doctor. I didn’t like the look on her face when she said that. I hope everything’s going to be all right.’

  ‘Try not to worry, Mr MacPhee.’

  ‘It’s Charlie. And I can’t help worrying. It’s been going on too long. Even I know that! You’ve got to do something!’

  The MacPhees’ cottage was situated near to the sea, where a small fishing boat thrashed around in the waves. Stacks of wooden creels and coils of rope were piled along one side of the house. Charlie flung open the door.

  ‘In you go, Doctor.’

  Grateful to be inside, Margaret removed her sodden coat and Wellington boots. Charlie handed her a small, clean hand towel. ‘Just carry on down to the bedroom – it’s to your right there.’ A cry of anguish could be heard coming from the direction he was pointing in. ‘Please help her, Doctor. I’ll be outside in the byre if you need me,’ he said and, with a stricken look, hurried away.

  Nurse McAllister turned round when she entered, her forehead creased with anxiety. Her face fell further when she saw it was Margaret and not Dr Alan. ‘I really think we need someone with experience,’ she whispered, walking towards Margaret.

  Margaret hadn’t met Anne McAllister before. The nurse was tall and thin, around the same age as Effie, but without the other nurse’s reassuring smile.

  ‘Well, you have me, Nurse McAllister. Could you tell me what’s been happening?’ Margaret rubbed her hair and face with the towel and glanced over at the patient.

  Mrs MacPhee was propped up in a large, high bed, her eyes squeezed shut, her face contorted with pain. As was normal when delivering a baby on one’s own, the nurse had wrapped the strap around Mrs MacPhee’s neck and used the ends as stirrups. This was the easiest way to keep a woman’s legs raised in the lithotomy position. A fire burned in the grate, casting the cramped room with shadows and flickers of orange. Even in the dim light, Margaret could see her patient was exhausted. In one corner, barely visible, was a hand-made wooden crib.

  ‘Chrissie is twenty-three and a primigravida,’ Anne said, meaning that this was the patient’s first pregnancy.

  Nurse McAllister looked over at the bed before moving closer to Margaret. ‘Chrissie didn’t come to see us – not once – during her pregnancy! Silly woman. First I knew about it was when they sent for me. Everything seemed to be going well to begin with.’

  Margaret set her bag down on the table. ‘What stage of labour is she in?’

  ‘Second stage. She’s been stuck there for the last few hours.’

  ‘How many hours?’

  ‘Six.’

  Margaret’s stomach knotted. It was far too long. ‘You should have called me earlier.’

  ‘None of us like to call for the doctor unless we have to. He has enough to do.’

  Couldn’t she see that this was one of the have-to cases? ‘Which is why I’m here. What’s the presentation?’

  ‘Normal as far as I can tell.’

  Nurse McAllister didn’t seem to know what she was doing. If Chrissie had been in the second stage of labour since this morning and was fully dilated, then something was definitely wrong.

  ‘Right. I’ll examine her. I presume you have hot water standing by?’

  The nurse stiffened. ‘Of course. And plenty of it. There’s a neighbour on hand – she’s in the sitting room. She’ll bring us more as we need it.’

  Margaret approached the bed. ‘I’m Dr Margaret, Chrissie. I’m just going to examine you to see where we are. I know you’re scared and tired, but try to relax.’

  Chrissie moaned as another contraction ripped through her body.

  Margaret scrubbed her hands before inserting two fingers into the woman’s vagina. As Nurse McAllister had said, Chrissie was fully dilated. The baby’s head should be well down and engaged by now. Turning back to the metal basin perched on the bedside table, she quickly washed her hands again and palpated her patient’s stomach. She could easily feel the baby’s head. It was engaged but still too high. The nurse should have noted that and raised the alarm sooner.

  ‘When did her waters break?’

  ‘A few hours ago.’

  That wasn’t good either. The longer a labouring patient’s waters were broken, the higher the chance of infection. Margaret suppressed a flutter of anxiety and thought back to her midwifery training, thinking through her options.

  There were three. Firstly, she could try a high forceps delivery. If the baby came out, well and good. But if that didn’t work there would be only two options left, both of which chilled her to the marrow. If the baby couldn’t be delivered by forceps it could die. If the baby died in utero the mother could die too, so the second option and the safest, as far as the mother was concerned, was for Margaret to crush the baby’s head and deliver it with forceps. It was the best way of ensuring the mother’s survival, but meant certain death for the baby. The last option would be to perform a Caesarean section but given she had no fresh blood with her or an anaesthetic assistant, the surgery could well result in the death of mother and baby.

  She wasn’t going to let that happen. Come hell or high water, she was going to save them both.

  ‘I’m going to do a high forceps delivery,’ Margaret said with as much confidence in her voice as she could muster. She leant over the bed and squeezed her patient’s hand. ‘It will be uncomfortable, really uncomfortable, but your baby isn’t going to come out without help. I think you know that.’ Margaret looked over her shoulder. ‘Nurse McAllister, would it be possible to send a telegram to the surgery and ask whether Dr Alan is back from his visits?’

  ‘Do you think that’s necessary?’

  Margaret wasn’t about to be challenged at every turn. With a curt nod of her head, she motioned for the nurse to follow her to the other side of the room, out of earshot of Chrissie. ‘If I have to do a section to get this baby out then I will need Dr Alan to help with the anaesthetic. I hope it won’t come to that, but one thing is clear. This baby is not going to deliver itself. The mother is exhausted and the baby in distress. I should have been called much earlier.’

  ‘Calling for the doctor is the nurse’s decision,’ Anne replied with a mutinous line to her mouth. ‘I sent for assistance as soon as I thought it was required.’

  ‘Well, this doctor will be making the decisions now. Please go and send a messa
ge to Dr Alan then come back here and help me deliver this baby. Have you given Chrissie an enema?’

  ‘Yes. Of course.’

  ‘Catheterised her?’

  ‘No.’

  ‘I’ll do it. You send that message.’

  By the time Nurse McAllister returned, Margaret had catheterised her patient and had all the instruments she might need set out on top of the clean towel she had brought with her.

  ‘Right, Nurse. I’m going to use the forceps so I need you to keep Chrissie as calm as possible. I’ll give her some ether to help with the pain, but I can’t give her too much.’

  The nurse nodded sullenly but took her position at the top of the bed and stroked the labouring woman’s forehead. ‘Now, Chrissie,’ she said, ‘the doctor’s going to help get your baby out. You just try to relax as much as you can.’ She looked over at Margaret and nodded.