‘Well maybe if a consultant rings, she’ll listen.’
‘That’s a very good point.’ Iosef glanced up meaningfully at her.
‘I hardly think this is the place to discuss it.’
‘I want the consultant’s position. I have no issues with discussing it in front of anyone.’ Iosef shrugged. He clearly had no issues with confrontation or negotiation either. ‘I have made my feelings very clear since the day I arrived here.’
‘You’ve certainly done that!’ Jackie responded, but her voice trailed off as the woman’s anxious husband appeared.
‘Any news on when she can get to the ward, Doctor? I’m sorry to keep asking, it’s just the kids are getting restless and that young guy in the next cubicle keeps swearing and waking her.’
‘We’re going to move your wife to the obs ward here—right now it’s empty and will be a lot more comfortable and peaceful.’ Annie didn’t dare look at Jackie’s expression as he snapped his fingers at Beth to get a move on and get things under way. The obs ward was Jackie’s baby, and for Iosef to open it up and at the same time effectively close it, without even discussing it with her, was just so not the way things were done.
Not that it stopped him.
‘No further patients are to be admitted to Obs until Mrs Lucas is moved up to the ward—and when she is moved just do a bed swap. She is not to be transferred to a bed twice. Ring me if the ward kicks up about it, and you are to buzz me if she needs anything—anything at all.’
‘Thanks, Doctor.’ Mr Lucas gave a tearful nod of appreciation. ‘It means a lot.’
‘No problem.’
And clearly Jackie knew better than to argue with someone who was like a coiled spring. Back from her honeymoon and looking ten years younger, the efficient, kind, capable consultant was back. Without the endless stress of a wedding to prepare for the self-centredness was gone, and when she disappeared and came back with two mugs of coffee, she addressed not the immediate problem, but what was really going on.
‘How’s your father doing, Iosef?’ Funny that Jackie was allowed to ask questions that she couldn’t. That after a frantic morning in a lull between patients she could voice the words Annie was dying to, and even though he was in a foul mood, even though he was snapping at everyone, despite his refusal to discuss it with her, Jackie actually managed to get an answer.
‘Not so good.’ Iosef rubbed his forehead and gave up on the notes he was trying to write at the nurses’ station, accepting not just the mug of coffee from his boss but the chance to talk, too. ‘Really, I think he should be moved to the hospice now, but my mother refuses to accept that it’s near the end. She still insists that with the right treatment he’s going to get better. That if he can just hold on, a cure might be around the corner. I just don’t see how she can’t accept it.’
Strange, Annie thought, as she continued to fill the now overflowing syringe drawer, that the only way she could find out more was to listen in on his conversation with somebody else.
‘Denial’s a powerful drug.’ Jackie gave a sympathetic smile. ‘Is there anything that we can do for you, Iosef, at this end?’
‘I don’t think there’s anything more to be done at the moment.’
‘If you want some time off, you only have to ask.’
‘Thank you.’
‘And you know if you want him admitted to the private wing here, you just say the word.’
‘I think the private hospital is better. Not the care …’ He shook his head in needless apology, in case Jackie had misunderstood. ‘The press is going crazy at the moment and there, well, they’re more used to dealing with them. I’m sure you don’t want a load of journalists camping out in the ambulance bay.’
‘I’d set the guard dogs on them.’ Jackie smiled as Iosef turned his back, closing the discussion, but Jackie didn’t leave it there. ‘Give it some thought, Iosef—it might be nice for you to have him close. Let me know if you change your mind.’
‘I will.’
‘And look after yourself in the midst of all this,’ Jackie added, reaching for the phone as it shrilled. ‘Tell that Candy to spoil you for once—not the other way around.’
Annie waited for him to tell Jackie they weren’t together anymore, to say something—anything—to slow the heart that was hammering in her chest. But he didn’t.
Didn’t say a single word. And as Jackie picked up the phone and started talking, for a tiny second their eyes locked. A million questions were burning in hers but each and every one was left completely unanswered as he tore his eyes away, picked up his pen to resume writing his notes. Jackie’s earlier words echoed, haunting Annie now.
Denial’s a powerful drug.
‘We’ve got a newborn coming in.’ Jackie put down the phone and gestured for Annie to come over, and any relationship woes were pushed firmly aside when she revealed the contents of the call. ‘Apparently the baby’s been found abandoned in a shopping-mall toilet.’
‘I’ll go and warm the cot, get things ready.’ Annie headed for Resus, with Jackie and Iosef walking briskly alongside her.
‘When you have done that, ring Security and Social Services—actually, I might just ring the nursing co-or-dinator now.’
‘Why?’ Iosef’s question had Annie frowning as she flicked on the cot and started preparing for the infant’s arrival. ‘Why do you need to ring the co-ordinator? We don’t know the baby’s condition. It might not even need an ICU bed.’
‘I’m not worried about the bed state.’ Jackie gave him an old-fashioned look as she punched in the co-ordinator’s number. ‘You know how we were just talking about the press—well, wait till they get hold of this.’
They already had.
A bystander at the shopping mall had called a talkback radio station and as Annie went out to greet the ambulance, photographers were already gathering, attempting to get shots of the baby who was being shielded by a blanket as the paramedic raced her through the department and into the resuscitation area, carefully placing her under the heater as everyone swung into action.
‘The woman who found her heard a small cry but nothing really since then. She’s pretty flat.’
‘Hypothermic.’ Iosef checked the baby’s temperature then nodded as Annie delivered warm, humidified oxygen. Briskly stepping aside when the anaesthetist arrived, and having checked the baby’s glucose levels, she set up the dextrose infusion Iosef had ordered. ‘Two, maybe three hours old,’ Iosef said, checking the status of the umbilical cord as he inserted a line to deliver drugs. ‘She’s very small.’
It sounded as if he was stating the obvious, but Annie knew his trained eye was stating far more. The baby was very small and scrawny, but in a newborn size and weight weren’t always indicative of gestational age. He measured her head with tape then his meticulous eyes and fingers scanned and probed the newborn, noting the well-formed ears, the nipples, the creases on the soles of her feet—digesting the information before he gave his verdict. ‘This baby’s full term—small, but full term. Let’s weigh her.’
‘She’s very jittery,’ Annie noted as the baby started to respond to warming. Her little limbs were pinking up but tiny jerking actions were apparent and Jackie wasted no time saying what Annie was thinking.
‘She could be suffering drug withdrawal, given that her mother—’
‘Her blood sugar levels are low,’ Iosef interrupted. ‘Let’s just deal with the few facts that we do know—and hypoglycaemia would more than account for her jitteriness. Where are the paediatricians?’
‘Stuck on the ward with a sudden collapse,’ the nurse co-ordinator answered as she came in, turning off her shrilling pager. ‘Poor little mite-what an awful start to life.’
‘She’s fine!’ Iosef’s response was very matter-of-fact. ‘She’s responding well to warming and fluids.’
She was—the little body that had been so still was pink and moving now, and very pleasingly she was crying loudly at the indignity of it all. And even though she co
ntinued to pick up, she was still too sick and exhausted to be bathed yet, so instead, when things had stabilised, Annie popped on a nappy and swaddled her in a bunny rug, popping a little pink hat on her head to keep her warm.
‘That’s better!’ Iosef came over with her notes and looked down at his patient. ‘She looks like a baby now.’ He shook his head at his own choice of words. ‘You know what I mean.’
And as curt and dismissive as he was with everyone else, he was incredibly tender with the baby. One very large finger stroked one very tiny cheek and Iosef actually smiled as the babe turned its head instinctively, rosebud lips searching for food.
‘Do you want me to try the paediatricians?’ the nurse co-ordinator asked. ‘They could probably send down the reg.’
‘Why?’ Jackie’s nod to the nurse co-ordinator died as Iosef frowned. ‘What’s the paediatrician going to do that we’re not? Best that we just watch her now, let her recover from the trauma of birth. Perhaps a warm feed in half an hour if she’s still stable and then the paediatricians can assess her when they are ready.’ He stared down at the little girl again, his finger still by her cheek, and even if new babies couldn’t focus, Annie could have sworn this little lady’s eyes were attempting it with Iosef. If a tiny being less than a few hours old could warm to another human, then she was.
‘Do we have a pacifier?’ As Annie frowned he elaborated. ‘A dummy, a nipple.’
‘I don’t think so.’ Helplessly she shook her head. ‘I can ring Maternity, but I doubt they—’
‘We endorse breastfeeding here,’ the nurse co-ordinator chimed in, but rapidly halted as he Iosef gave her the most ironic of smiles.
‘Either you provide me with a lactating woman in the next five minutes or you find me a pacifier.’
‘You’ll be OK little one …’ His voice was as brusque as it was with anyone he came into contact with, only the babe didn’t seem to care a jot. Her little face turned, her eyes closed as she relaxed in his hands, the IV satisfying her hunger for now. And for the first time in her little life her body was warm, all needs attended to sufficiently for her to relax.
‘We’ll need to talk co-ordinator said.
‘Why?’
‘Well—they’re outside.’
‘So?’
‘We need to find the mother. To let her know—’
‘I’m sure she knows she’s given birth,’ Iosef retorted.
‘And I’m sure the press has already let everyone know what hospital the baby’s in.’
‘The usual practice is—’
‘I do not want this baby paraded on the evening news tonight.’ Iosef completely overrode her. ‘I do not want her paraded for everyone to see under the guise of bringing the mother forward. Am I making myself clear?’
‘Perfectly!’ the nurse co-ordinator answered tightly.
‘Both this baby and her mother deserve better than that,’ Iosef said, before stalking out.
‘Does he deliberately set out to upset everyone?’ the nurse co-ordinator asked Jackie as Annie checked the baby’s obs. And if it seemed the sort of conversation that usually took place behind closed doors, it didn’t because it was Emergency, strong personalities clashing a frequent occurence. ‘I’ve just had a very upset nurse from the medical ward on the phone.’
‘Has the bed been made for the patient yet?’ Jackie asked tartly.
‘We’re two domestics short. We can’t just drop everything because a senior registrar demands it. His patients aren’t the only ones in the hospital.’
‘They’re his only ones,’ Jackie flared, and Annie knew that even if she’d address the issue with Iosef, she certainly wasn’t going to let the nursing co-ordinator know that. One of the many things Annie admired about Jackie was that she defended her team to the hilt. ‘Don’t grumble to me about a member my team without very good reason. He happens to be the best doctor we’ve had in this place in a long time—I know I’ve certainly learnt a lot from him. Now, if you’ll excuse me, I’ve got patients to see. Perhaps you’d be kind enough to ring down when Mrs Lucas’s bed is finally ready.’
It was the nursing co-ordinator’s turn to stalk out now.
‘Bloody Iosef,’ Jackie sighed, because to Annie she could say that.
‘Are you going to talk to him?’
‘And say what—that he’s got to stop walking around insisting he knows best?’ She gave a small eye roll. ‘You know what his answer would be, don’t you?’
‘That he does!’
‘He actually does!’ Jackie managed a wry smile. ‘Not that I’ll tell him that. OK, I’m off to pull rank. Wish me luck.’
‘Good luck!’
Even with the baby moved safely to the maternity ward, the department was still kept on its toes dealing with the incident, fielding calls from reporters, even a couple of women claiming to be the mother—and even if it was ablatanthoax, each call had to be handled professionally and bounced to the appropriate authorities—the television in the staff-roomb laring out the news. But it wasn’t just the vile shift, the baby and her missing mother or the thirty-nine-year-old who in the end never actually made it up to the ward that occupied Annie’s mind.
They’d promised to never bring their relationship to work but it took a supreme effort today to talk to him about a patient, to pass him in the corridor, to even sit with him on a quick coffee-break and not confront him.
To not ask the question she needed the answer to now.
‘Annie …’ Melanie’s anxious face appeared around the curtain, followed by the rest of her. ‘I know you’re about to go off duty, but I need a hand.’
‘Sure.’ Annie said as Melanie pulled her aside.
‘I think I might have the baby’s mum here … her parents have just gone to register her. She came home from school and has been in bed since with abdominal pain. They think she might have appendicitis, which, of course, she might—only she doesn’t want to get undressed.’ Melanie gave a worried shrug. ‘I think you might be better with her than me, just for the initial bit—I know you’ve got to go soon.’ And it was an honest admission that was often made in nursing—no matter how good your skills, sometimes things could be better handled by others, and Melanie was generous enough to her patient to admit that tact and dragging out information weren’t her strongest points.
‘Try and get the family to stay in the waiting room for now,’ Annie said. ‘How old is she?’
‘Sixteen. Her name’s Rebecca.’
‘Hi, Rebecca.’ Smiling as she entered, Annie walked in, saw the pale, fearful face on the pillow and was positive that Melanie was right, or even if she was wrong, there was something big going on with this young girl. ‘I hear you’ve got a stomachache.’
‘I don’t need to see a doctor,’ Rebecca started. ‘I just want to go home.’
‘You don’t look very well,’ Annie said, and took a deep breath. ‘Look, Rebecca, I’ve asked Melanie, the other nurse, to keep your parents down in the waiting room for now. Is there anything you want to say—anything you want to tell me while they’re not here?’
‘No.’
‘OK, well, I’m going to do a set of obs on you and then we’ll get the doctor to come in and see you.’
‘I don’t want to see the doctor.’
‘Rebecca, you’re clearly not well. Your parents are worried about you. Now, whatever is going on, it has to be dealt with.’
‘I can’t,’ the young girl begged. ‘I just want to go home.’
‘That’s not going to happen,’ Annie said gently, because quite simply it wasn’t. Her parents were not going to turn around and drive home without their daughter being examined, and however much Rebecca might want it all to go away, some things just didn’t. ‘Why don’t you tell me what’s wrong?’
‘You already know, don’t you?’
‘I think so.’ Annie nodded.
‘Is she OK?’ Rebecca sobbed. ‘They said on the news that she wasn’t breathing.’
‘She’s f
ine,’ Annie said gently, touched on the baby’s behalf that it was the first thing she asked. ‘She never stopped breathing—she was just a bit cold and shocked when the ambulance brought her in. Babies lose heat very quickly.’
‘I rang for an ambulance for her,’ Rebecca gulped. ‘I know somebody found her, but I had rung for an ambulance … on the phone outside the toilets.’
‘I know that, too,’ Annie said. ‘She’s up in Maternity now and, no doubt, being spoilt and cuddled. She’s a little bit small so they’re keeping a bit more of an eye on her, but she seems to be doing fine. Now we have to look after you.’
‘What am I going to tell my mum and dad?’
‘First,’ Annie said firmly, ‘I’m going to do some obs, and then have a quick look at you—then we’ll get the doctor in and then we can work that one out.’
‘Your mum and dad are in the waiting room.’ Melanie came in quietly as Annie checked Rebecca, and she didn’t really have to ask if she’d been right, so she didn’t, just held Rebecca’s hand instead. ‘How are you doing?’
‘Scared.’
‘I’ll bet.’ Melanie gave her a nice smile and a little wink. ‘I’ll stick with you—I’m good at that!’
‘She is.’ Annie nodded. ‘Right, I’ll go and get Jackie.’
‘She’s in a meeting,’ Melanie said. ‘Try Iosef.’
‘Sorry to disturb you …’ Knocking on his open door, jacket on and lanyard off, Annie forced a tired smile as she pulled out her hair-tie. ‘The baby’s mother has just come in. Her family brought her—they think she’s just got abdo pain.’
‘How is she?’
‘Young, scared.’ His eyes closed as she answered and stayed closed as he voiced another question.
‘Did she ask after the baby?’
‘First thing she did when she worked out I knew.’
‘That’s good,’ Iosef answered, but even if it was the right response, it was so forced it made her frown, and for the first time she actually looked at him properly. His eyes were still closed in his ashen face, his breathing was rapid, and for an appalling second Annie thought he must have had bad news, that he must have found out his father had died.
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