There must be one somewhere. UNA seems to have thought of pretty much everything.
I try to calm myself down, checking through the supplies again as Caro sits silently in the background. I consider what it would have taken for her to come here today, her natural dread at my reaction. She’s not stupid – she must know what a terrible position she’s put both of us in.
‘Here we are.’ With a rush of relief, I find a small pack of pregnancy tests hidden behind the more copious quantities of condoms and sanitary products. I remove the instruction leaflet and read it carefully, then hand her the little wand. ‘Just pee on the stick. Result in two minutes.’
As Caro disappears to the loo down the corridor, I stand there, taking the weight off my bad knee, mind reeling with a thousand questions. How far along is she? The test will only confirm she’s pregnant – without a clear date for her last period, it’ll be difficult to assess the due date with any accuracy. Oh Jesus, what do I do about antenatal care? It’s been years since my student rotation in the maternity unit.
More to the point, when is the earliest we can get her off the ice? And will we be in time?
I squeeze my eyes shut and send a silent prayer to a God I don’t believe in. Please let her be mistaken. Please let this be due to something else – the diet, maybe. Some hormonal disruption.
But the instant Caro walks back into the clinic, her grim expression confirms my worst fears. She hands me the plastic wand without a word, and I glance at the little blue tick in the window marked positive.
I exhale slowly. Try to hide my growing panic.
‘Right,’ I say briskly, grabbing the paper calendar from my desk. ‘Have you any idea when you might have conceived?’
Caro’s face reddens. ‘Um … well, no. I’m not sure.’ She hesitates. ‘It wasn’t only the once, you see.’
‘You say you wore a contraceptive patch. You think that failed?’
‘I got one before I came out here, but it made me feel sick. So I swapped to progesterone pills instead.’
‘Did you remember to take them every day?’ I try not to make the question sound accusatory, but her blush deepens.
‘Most days.’
I nod. No point pursuing this. The deed’s done, and there’s nothing to be gained by implying Caro has been careless. Or her partner – whoever that might be.
I take another deep breath, refocus. ‘Do you mind me asking something personal, Caro?’
‘Sure.’
‘Does the father know?’
She shakes her head vigorously, then looks away, her shoulders heaving with more tears. ‘To be honest, I’m not certain …’ She stops herself, pressing her fingers to her mouth as if to hold in her distress. ‘Oh shit, what a mess.’
I gaze at her, at a loss what to say. Being pregnant under these conditions is nothing short of calamitous. I run through the possible complications, struggling to recall my obstetrics training. Hopefully we’re well past the window for ectopic pregnancy. Though that still leaves things like … what? Late miscarriage, hypertension and pre-eclampsia, severe haemorrhage. A congenital deformity with the baby.
‘Let’s get you on the exam bed,’ I say gently, trying to sound calmer than I feel. ‘See if we can establish how far along you are. Could you slip off your dungarees?’
She releases the straps and lets them fall to the floor, then climbs on, pulling up her T-shirt. Without the clothes, I can see a pronounced little bump. Surely that means the father has either gone home with the summer team, or that they’re no longer sleeping together? Hard to believe anyone seeing her naked now wouldn’t notice.
Focus, I tell myself, as I gently palpate her stomach, fingers feeling for the hard roundness at the top of her uterus. Grabbing my tape, I measure down to her pubic bone.
Nearly twenty-six centimetres. I put on my stethoscope, place the cup on her stomach, moving it around and listening carefully.
There. Faint and fast, the little gallop of the foetal heartbeat.
‘What is it?’ Caro asks anxiously, studying my expression. ‘Is everything all right?’
‘You seem fine. Get dressed. I just need to check something.’ While she’s fiddling with the straps of her dungarees, I fire up the computer and navigate to the ‘cheat sheets’ – a summary of virtually every medical condition us station doctors are ever likely to encounter. I find the antenatal section and check the chart for fundal height. Grabbing my calendar, I calculate her due date. Not easy, given fundal height is just an estimate and I could easily be two or three weeks out.
My heart sinks. There’s little chance they’ll get a plane out before mid-October – at the very earliest, and only then if the weather is unusually mild.
‘Are you going to tell me?’
I straighten up and face Caro. ‘Okay. I estimate you’re somewhere between twenty-four and twenty-eight weeks pregnant. But without the exact last date of your period or an ultrasound scan, I can’t be more accurate.’
She chews the inside of her lip. ‘So I’m due when? Roughly.’
‘Given the average pregnancy lasts approximately forty weeks, that puts you at …’ I check the calendar again to be certain. ‘Some where between mid September and mid October. But bear in mind pregnancy length can vary by several weeks either side of that.’
Caro’s face tightens. ‘Oh fuck.’
I don’t respond for a moment or two, letting the news sink in. For both of us.
‘We’ll work something out,’ I say, trying to sound more confident than I feel. ‘I’m sure UNA will make every effort to get you off the base as soon as it’s safe. It could be I’m wrong, that you’re not as far gone as I think. Like I said, it’s only a rough estimate.’
Caro nods, but she looks devastated. ‘I didn’t think it would be so soon. I mean, I’m not that big, am I?’
I shake my head. It’s true. She’s not showing that much, but then that’s not unusual for a first baby.
Caro clears her throat. Drops her gaze to the floor. ‘I guess it’s too late to do anything about it,’ she murmurs.
‘You mean a termination?’
She nods again.
‘There’s absolutely no chance of that, Caro. Especially here, and at this stage of pregnancy.’ I pause. ‘Are you saying you don’t want to keep the baby?’
Caro bites her lip, her mouth quivering. ‘No. I mean, I do. I do want to keep it.’ Another tear rolls down her cheek. ‘It’s just that I feel so … silly. I should have come to you sooner, but I didn’t realise for ages – it simply never occurred to me that was what was going on. I thought I was putting on a bit of weight, but that’s not surprising … I mean, I know you’ve the appetite of a bird,’ she sniffs and gives me a tearful smile, ‘but Rajiv’s a great cook, and there’s plenty of it. And then, when I started to suspect, I guess I went into denial. Kept telling myself it couldn’t be true – until I felt these weird sensations in my stomach and realised it was the baby kicking.’
‘You didn’t experience other symptoms? Nausea? Tiredness? Breast tenderness?’
‘I felt a bit sick, yeah, but I put that down to the progesterone pills. I’ve been tired, but then who isn’t out here? I just assumed my biorhythms or whatever were out of sync.’
I give her a sympathetic look. I can’t blame her. Would I have caught the signs myself? Not anything I need to worry about, thank God. I had a coil fitted back before the accident, plus I made sure Drew used a condom.
Belt and braces.
‘So, are you still taking the progesterone?’ I ask.
‘I stopped them a few weeks ago, when I finally realised what was going on.’ An anxious look crosses her face. ‘Could they have harmed the baby?’
I shake my head. ‘I’ll check with the UNA medical team, but I’m not aware of any evidence that they do.’
‘Okay.’
‘But in the meantime, no alcohol.’
‘Okay,’ she repeats.
I pause, trying to think what to do n
ow. ‘Listen. You need to consider if – or rather when – you’re going to tell everyone else on the station, but in the meantime I have to discuss this with Sandrine. Is that all right?’
She hesitates.
‘It’s absolutely in your best interests,’ I add. ‘Yours and the baby’s. Sandrine will need to make certain everything is in place to get you out of here at the earliest possible date. And I need to liaise with UNA so I can offer you the best antenatal care. Do you understand?’
Caro doesn’t speak for a while, just stares at the blind covering the clinic window, blocking out the darkness. She looks so young, I can’t help thinking. So vulnerable.
‘Please don’t tell her yet,’ she whispers. ‘That it’s me, I mean. I know you’ll have to warn her about the situation, but I need more time to get my head around it without Sandrine on my back.’
I consider this. ‘All right. I won’t mention it for a couple of days. But Caro, there are only five of us on the base – women, that is. One of them is gay, and Sonya, well, she’s not in the right age bracket. So it won’t be hard for Sandrine to work out.’
She nods, chewing her lip again, then glances down at her clothes. ‘It’s not that obvious, though, is it yet? To the others?’ She works up a tentative smile. ‘Good thing I’m a plumber, eh? I can hide under these baggy overalls.’
‘That’s not going to work for much longer,’ I point out gently. ‘You should think about telling people before they put two and two together. You know what gossip is like in this place.’
Caro pulls a face. ‘Tell me about it. It’s like bloody Chinese whispers. Have you heard the rumour that I deliberately sabotaged that washing machine to piss off Luuk?’ She frowns with disgust. ‘As if I ever would. Not to mention it was his sodding lighter in there.’
‘That’s exactly why we need to tell them soon. But you should speak to the father first, Caro. He should know.’
‘Yeah.’ Her gaze drifts back to the window, then, with a sigh, she gets to her feet. ‘Anyhow, I should get on with some work. The showers are playing up again.’
‘Are you winning?’
‘I’ve isolated the problem down to the boiler feed. But we’ll see.’
She looks so tired and forlorn that I cast professional boundaries aside and get up to hug her. ‘It’s going to be okay,’ I insist. ‘Whatever happens, you’re going to be fine. And the baby. Come back in a few days, and we’ll discuss your antenatal care in more detail.’
She nods, but her expression remains rueful. I wait until she reaches the door before I say it. ‘By the way, Caro?’
She pauses, looks back.
‘Congratulations. I happen to think you’ll be a fantastic mum.’
‘Thanks.’ Caro manages a weak smile, then closes the door behind her.
Once I’m sure she’s gone, I let my head sink into my hands.
Oh fuck. What am I going to do?
15
17 June
‘Is this a joke?’ Sandrine’s expression is pure disbelief. ‘If so, Kate, it really isn’t very funny.’
I shake my head. ‘I’m afraid not. We did a pregnancy test. I can show you the result if you don’t believe me.’
She gets up from behind her desk, actually starts pacing the room. Then pauses. ‘Are you absolutely sure? Could it be wrong?’
‘They’re 99 per cent accurate. Besides, I palpated her uterus. It’s definitely enlarged, plus I heard the heartbeat with a stethoscope. That’s pretty conclusive.’
Sandrine sinks back onto her chair. ‘Merde,’ she mutters. ‘Where will this all end?’
‘With a healthy mother and baby, I hope.’
The station leader ignores my flippant response. Just fixes me with a cold stare. ‘So who is it?’
‘As I explained, I’m bound by patient confidentiality. She doesn’t want me to reveal her identity.’
Sandrine purses her lips in something close to contempt. We both know it’s bullshit, and I’m merely playing for time.
‘Is it you?’ She looks at me accusingly.
My first instinct is to laugh, but then I stop myself, for Caro’s sake. No harm letting Sandrine wonder for a few days. She may guess it’s Caro anyway, but she won’t be sure.
‘Kate?’ She eyeballs me a moment or two longer, then snorts at my silence. ‘Well, it’s not me,’ she says in a tone of disgust.
I sit opposite, wondering how to divert her attention to what we need to do now, rather than who put us in this position. But Sandrine glances at my stomach, drawing her own conclusions. With the weight I’ve lost since arriving on the ice, my belly is conspicuously flat. I watch her do the maths – a simple enough sum. Sonya, at fifty-four, is unlikely to be in the running; so that leaves Alice and Caro.
She inhales as she comes to the obvious conclusion. I feel bad for Caro, but what can I do? I did warn her.
‘That idiot girl!’ Sandrine snaps. ‘Why didn’t she take precautions?’
‘She did,’ I say, jumping to Caro’s defence. ‘But no method of contraception is one hundred per cent reliable.’
The station leader makes an exasperated noise, clearly unconvinced. Then all at once her anger deflates. The woman in front of me looks exhausted – and more than a little desperate. From the circles under her eyes, the hollows in her cheeks, it’s obvious how much of a toll this winter is taking on her.
Sandrine’s clipped efficiency often comes across as disdain, unrelieved by any discernible sense of humour, but right now she looks so beleaguered I’m tempted to extend a comforting hand.
I resist the impulse, knowing instinctively she won’t appreciate the gesture. Her opinion of me doesn’t seem to have improved; I’m still left with the feeling that I make a poor substitute for Jean-Luc – in her eyes anyway.
‘Can’t you be more precise?’ Sandrine asks, ‘About the dates?’
I shake my head. ‘Not without an ultrasound. And even then, it wouldn’t tell us definitively when she might go into labour.’
Sandrine shuts her eyes briefly, wrestling with some internal demon. ‘I’ll talk to UNA. See if there is some way they can evacuate her to New Zealand for the delivery.’
Sandrine doesn’t reply. Simply gazes despondently at the stack of papers on her desk. ‘I don’t suppose she’s mentioned who the father is?’
I shake my head again.
She runs her tongue over her teeth as she considers the possibilities.
‘Do you have any idea?’ I ask.
‘I have my suspicions.’
‘Would you care to share them? Do you think it’s someone here now, or one of the summer staff?’
Her smile contains a touch of the sarcastic. ‘Like you opened up to me, Kate?’
‘I had no choice!’ I retort, unable to contain my irritation any longer. ‘She specifically asked me not to. I can’t break the Hippocratic oath simply because it’s convenient, Sandrine.’
The station leader remains mute.
‘Fine. Suit yourself.’ I get up and walk out of her office without another word.
It’s an easier conversation with the consultant obstetrician on the UNA medical team in Geneva, despite the fact the video chat keeps freezing, forcing us to repeat almost everything we say. This, and the lateness of the hour, only adds to my growing exhaustion.
I take the same line with Annette Muller as I did with Sandrine, refusing to name Caro as the patient, though it’s probably equally obvious who I’m referring to. Unlike Sandrine, however, Annette neither presses the point, nor gets annoyed.
‘Well, we’ll just have to manage this as best we can.’ Her upbeat smile succeeds in taking some of the edge off my anxiety. ‘You say she’s around twenty-six weeks? Usually we’d have done an ultrasound scan by now to assess foetal and placental development, but obviously that’s not an option. So carry on measuring the uterus – that will be a good indication whether the baby is growing normally – and keep an eye on her blood pressure and check for protein in her urine
. Oh, and I’d give her an additional vitamin supplement, just to make sure.’
‘Okay.’
‘Meanwhile we’ll do everything we can here to get her off the station in time to have the baby.’ Annette’s tone is matter-of-fact, as if this whole situation were entirely run of the mill. ‘I’ve already spoken to the logistics team and they’re looking into it.’
I nod, feeling increasingly numb with stress and exhaustion.
‘At least she’s not R-neg,’ she adds, ‘so we don’t need to worry about rhesus sensitisation should she go into labour before we can evacuate. That would be a real problem with no Anti-D on the base.’
‘Small mercies, eh?’
Annette sighs, her expression sympathetic. ‘Don’t look so worried, Kate. She’s not ill, just pregnant. Plenty of women around the world get through this without any medical care at all. Let’s not dwell on what might go wrong, and instead focus on the likelihood that all will go well.’
I nod again, taking a little comfort in her calm acceptance of the news. She’s right. I need to get my act together before I next see Caro – the last thing we want is to make her any more anxious than she is already. But I am rattled by my discussion with Sandrine. I didn’t handle it well, but I’m still too angry to try to build bridges.
I cut off the call and sit at my desk, thinking. Not only about Caro, but Alex too. These last few days he’s stopped bothering to turn up even to evening meals. I’m increasingly worried about him, and his state of mind.
It occurs to me to check the video log directory – maybe he’s made another entry. With UNA providing dedicated equipment, crew members can make videos in the privacy of their cabin and upload them straight into the system. Though I’m sent a notification every time that happens, it’s possible I haven’t noticed.
I scan the entries under Alex’s name – nothing for the past six weeks. I gaze at the list of those he made earlier. I’m fully aware these video logs are supposed to be completely confidential, but for once I am tempted to break the rules; if I can’t talk to the man himself, perhaps I can glean more insight into his mood by watching them.
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