Saving Maddie's Baby

by Marion Lennox

  ‘That’s all?’

  ‘Plus anything else you can think of,’ Josh replied. He wouldn’t mind a clearer head to think things through. His arm was throbbing. His own breathing was a bit compromised—the grit was working through the mask and there was still that piercing knowledge of the danger they were in. That Maddie and her baby were in...

  Do not go there.

  ‘Actually, a ruddy big hole for lifting everyone out would be great,’ he added dryly, and was dumb enough to feel proud he’d kept the emotion from his voice.

  ‘We’re working on it,’ Keanu told him. ‘Is Maddie okay?’

  ‘I’m a whizz,’ Maddie said, hearing Keanu’s sharp query and taking the phone. She even managed to grin happily down at Malu, as if popping down mine shafts and doing emergency surgery right after childbirth was part of her normal working life. ‘I’m practically boring Malu to sleep now, but we might need to up the anaesthetic a bit. Keanu, just tie everything up with pink ribbons as my baby shower and send it right down.’

  * * *

  ‘What are their chances?’

  In the clearing at the mine mouth the men and women were looking grim.

  Caroline had been efficiency plus since she’d arrived at the site, but she’d suddenly broken down. Beth was crouched beside her, hugging her.

  In the background things were happening. There could be no bulldozers here. One hint of heavy machinery and the entire shaft could crumble.

  The odds were being spelled out to all. Caroline had been washing out grit from a miner’s eyes. She’d finished what she’d been doing, calmly reassured the guy she’d worked on—and then walked to the edge of the clearing and sobbed.

  Beth had been watching her. Helpless R Us, Beth thought. Usually in a disaster such as this there were things she could do. Work was the best medicine, the best distraction from fear.

  Here, though, the work for the medical team had dried up. Keanu was acting as communicator, organising the bags that were being carefully manoeuvred underground.

  Caroline and Beth were left with nothing to do.

  Except fear.

  ‘We have the best team possible,’ Beth told Caroline now. ‘The best engineers... We’ve been on to Max Lockhart—apparently he owns this mine. He, like all of us, assumed it was closed, and he’s appalled.’

  ‘He would be,’ Caroline whispered. ‘He’s...he’s my father.’

  ‘Your father?’

  ‘He lives in Sydney. My uncle Ian’s been in charge here. Dad... Dad has problems.’

  ‘No matter,’ Beth said soundly. ‘Whatever he is, he’s moving heaven and earth to get resources here. There’s a massive mining operation just north of Cairns. He’s been on to them. See those guys over there? That’s where they come from and this is what they do, deal with mine collapses. They’re saying they’ll drill side on to the collapsed shaft where the rock’s more solid. Then they’ll pick their way across to our guys.’

  ‘But it’ll take so long... And Maddie...’ Once the tears had come, Caroline was no longer able to stop them.

  ‘We have time.’ This was what Beth was good at—that and shimmying down rope ladders and hauling people out of overturned cars, but, hey, she had a few skills, and reassurance was in her bundle. ‘The bag pulley system seems to be working well.’

  ‘But how can they stay there? Keanu says the blocked area is no longer than ten feet long. A woman who’s just given birth...’

  ‘They have food, water, air and light,’ Beth said solidly, maybe more solidly than she was feeling. ‘We even have little bathroom bags, like they have in spaceships. We pull ’em out every time the pulley comes this way. We can even send in deodorant if it’s needed. Not that your Maddie would smell, but Josh and Malu in a tight spot... All that male testosterone... Come to think of it, I will send in some deodorant. Maddie must be just about ready to pass out.’

  And Caroline chuckled. It was a watery chuckle but it was a chuckle all the same.

  ‘But this operation...’ she whispered. ‘With the rock so unstable... You really think they can be okay?’

  ‘We have two skilled doctors underground and the best mine experts on top of the ground,’ Beth told her. ‘Of course they’ll be okay. You’d better believe it.’

  And then Keanu came over to talk to them, to hug Caroline, to add his reassurances.

  Of course they’ll be okay.

  You’d better believe it?

  ‘Please, let me believe it, too,’ Beth muttered to herself as she moved away. ‘Please.’

  CHAPTER SEVEN

  THEY HAD ALL the gear. Malu was as settled as they could make him. The pneumothorax had to be fixed now.

  There was one slight problem.

  Josh’s right hand shook.

  Maddie had cleaned the gash on his arm and pulled it together with Steri-Strips, but it ran almost from his elbow to his shoulder.

  He hadn’t lost sensation. There was no reason why his hand should shake.

  It shook.

  Maddie had prepped and draped Malu’s underarm. She’d used ketamine as an adjunct to the morphine, making Malu dozy but not soundly asleep.

  What was needed now was local anaesthetic. It was a procedure that needed care, knowledge and a steady hand. The anaesthetic needed to be infiltrated through the layers of the chest wall, onto the rib below the intercostal space. The needle then had to be angled above the rib and advanced slowly until air was aspirated. The last five mils of the anaesthetic needed to be injected into the pleural space.

  Josh knew exactly what to do. He’d done it before. He’d do it again—this was his job, trauma medicine.

  His hand shook.

  ‘Josh?’ Maddie’s voice was a soft whisper. She was holding the torch.

  She’d have seen the tremor.

  ‘I can do this,’ he muttered under his breath, and he closed his eyes and counted to ten, trying desperately to steady himself.

  He opened his eyes and his hand still shook.

  I can’t. But he didn’t say it. Malu was still sleepily conscious. The last thing Malu needed was to sense indecision in his surgical team. Instead, he glanced up at Maddie, their eyes locked and held...

  I can’t.

  ‘Slight change of roles,’ Maddie said, without so much as a break in her voice. It was like this was totally normal, first cut one toenail, then cut another. ‘Malu, Josh is looking at your ribs and thinking you don’t need his great masculine forefinger to be making a ruddy big hole. Not when we have my dainty digits at the ready. So we’re swapping. Hold on a second, Dr Campbell, while I scrub and glove. It now seems I get to play doctor while Josh plays the lady with the lamp.’

  And Malu even smiled.

  She was amazing, Josh thought as he took the torch from her. She’d made what was happening sound almost normal. She was stunning.

  She was hours after giving birth. How could she?

  ‘Maddie, can you?’

  ‘Steady as a rock,’ she said, smiling at him with all the assurance in the world, and she held up her hands to show there wasn’t the hint of a tremor. There should have been. After what she’d gone through. ‘Though we’re hoping Malu’s not rocklike. Malu, if you’ve been working out I might need to get a drill rather than a teeny, tiny needle. Why you guys think you need muscles is beyond me. Give me a guy with a one pack rather than a six pack any day.’

  She was still distracting Malu. He was holding the torch—he could hardly help her on with her gloves but she used the backup method—using one sterile glove to tug on another. It wasted gloves but this wasn’t the time to be arguing. Instead...he could do a bit of distracting, too.

  ‘So you’d have loved me better if I’d had a bit of flab?’ he demanded.

  ‘The odd sign of humanity
never hurt anyone,’ she said, turning back to the instruments they’d laid out ready. Dust was still settling. Contaminants were everywhere. There were real risks here, but the alternative was unthinkable. ‘I never did have much use for Spider-Man.’

  ‘I guess that’s what ended our marriage,’ Josh said, managing a grin for Malu. ‘Though I would have described myself more as Batman. He was so smooth in his other life.’

  ‘Yeah, six pack in one, smarmy in the other. You ready, Malu? It’s going to sting.’

  ‘If he’s Batman, I can do the hero bit, too,’ Malu managed. ‘Do your worst, Doc. Just get this breathing under control.’

  * * *

  He’d thought it would be the hardest thing in the world, to be aboveground, not knowing what was going on.

  He was wrong. The hardest thing was doing what he was doing now, which was exactly nothing.

  Except holding the torch. If Maddie wasn’t totally reliant on the light he was holding maybe he could move behind her, support her a little. What he was demanding of her seemed impossible.

  How dared his arm shake?

  To have to ask for help... To be dependent on Maddie...

  It wasn’t him who was dependent on Maddie, he reminded himself. It was Malu. He was under no illusions, Malu’s life was under her hands.

  But they were steady hands, and there was no doubting their skill. He watched, every nerve attuned to what she was doing, as she carefully, carefully manoeuvred the anaesthetic to where it was needed.

  Malu hardly responded as the needle went in. The morphine and ketamine were doing their job—but also, Malu was growing weaker. How much lung capacity did he have left?

  To do so much and have him die now...

  Stop thinking forward, he told himself. That was the problem with doing nothing—he had time to think.

  Josh’s work was his lifeline. When things hurt, when emotion threatened to overwhelm him, work was what he did. It stopped the hurt, or at least it pushed it so far onto the back burner that he didn’t have to confront it.

  They were waiting for the anaesthetic to take hold. Maddie was staring down at the sterile cloth holding her instruments. There was a risk dust would settle on the cleaned tools but there was little they could do about it. Josh was holding the torch with his steady hand. He couldn’t do much assisting with the other.

  She was practising what she needed to do in her head.

  How many times had he watched her skill in a medical setting?

  They’d met—how many years ago? He’d been a registrar at Sydney Central’s emergency unit. Maddie had been a first-year intern, trying emergency medicine out for size.

  She’d been one of the best interns he’d ever met. She’d been calm in a crisis, warm, reassuring and clever.

  He’d tried to persuade her to stay, to train in the specialty he loved.

  ‘Emergency medicine’s great,’ he remembered telling her. ‘You live on adrenaline. You save lives. Every time you turn around there’s a new challenge.’

  ‘But you never get to know your patients,’ she’d said, and she’d said it over and over as his professional persuasion had turned a lot more personal. Soon it hadn’t been Dr Campbell trying to persuade Dr Haddon to change career direction, but it had been Josh persuading Maddie to marry him.

  ‘Ready,’ she said now, and he shoved the memories away and focussed. Even if his role was minor, the light was still crucial. Her fingers could never be allowed to shadow what she was doing.

  But it nearly killed him to watch. What she was doing was so important. He was trained for this. This was his job, whereas Maddie...

  This was still part of her job and, unpractised or not, she seemed to know exactly what she was doing. Her fingers were rock steady as she made the incision along the border of the intercostal space. She made it deep and long enough to accommodate her finger.

  She glanced up at Josh then, a fast glance that said she wasn’t as sure as her actions made out, but then she was focussed again.

  ‘You’re doing great,’ he told her, but she wasn’t listening.

  She needed a nurse with swabs. Maybe he could swab, but if the light wobbled...

  ‘In,’ she said, and as the tissue was pushed aside by the insertion of her finger he heard the tiny rush of outcoming air.

  She had the curved clamp now, using blunt dissection only, using the clamp to spread and split the muscle tissue.

  She was in the pleural cavity. She’d be exploring, looking for adhesions. Making lightning-fast assessments.

  He wanted to talk her through what was happening, but her face said it all. She was using all her concentration and then some.

  ‘Going great,’ he repeated, and then, as Malu flinched, not with pain, he thought, but maybe with tension because breathing was so darned hard, he took the miner’s hand with his shaky one and gripped.

  They both watched Maddie.

  And watching Maddie...

  He’d forgotten how much he missed her. He remembered that first time he’d seen her as a newly fledged intern. She’d been comforting a frightened child.

  He’d been called to help but he’d paused in the doorway, caught by the sight of her. Something had changed, right at that moment.

  Something he’d been denying ever since? That he needed her?

  She was putting the chest tube in now, mounting it on the curved clamp and passing it along the pleural cavity. He heard Malu’s breath rasp in and rasp in again, like a man who’d been drowning but had just reached the surface. Finally, blessedly, he saw the almost imperceptible shift at Malu’s throat. It was imperceptible unless you were looking for it. It was imperceptible unless you knew that the lungs were re-inflating, that what was in the chest cavity was realigning to where it should be.

  ‘Done,’ Maddie murmured, and he did hear shakiness now, but it was in her voice, not in her hands. She was still working, but on the exterior, suturing the tube into place. She’d taken a moment to tug off her gloves and put on new ones before she worked on the exterior of the wound. She shouldn’t have needed to. If she’d had an assistant...

  She didn’t. She was working alone.

  He could have told her how to operate the underwater seal but he didn’t need to. She knew how.

  He could have helped her dress the incision area but he didn’t need to do that, either.

  She was a doctor operating at her best.

  She didn’t need him.

  The words hung. A shadow...

  Had he been too afraid to admit he needed her?

  The tube was now firmly connected to the underwater seal. He could see the bubbles as air escaped the pleural cavity. The loss of this tiny amount of air wasn’t enough to cause Malu major problems. Building up in the pleural cavity, it was lethal. Calmly bubbling out into water, it was harmless.

  Job done. The dressing was in place. Maddie sat back on her heels—and he saw the energy drain out of her.

  She swayed.

  And finally, finally there was something he could do. She did need him. He moved before he even knew he intended moving. He took her into his arms and she let herself sag. She crumpled against him, let his strength enfold her, and let him hold her as if her life force was spent.

  It wasn’t spent, though. This woman had the life force of a small army. She let herself be held for all of two minutes and then he felt her gather herself, stiffen, tug away.

  And it nearly broke him. For those two minutes he’d felt her heart beating with his. He’d felt himself melt into her.

  He’d realised what he’d lost.

  ‘Thanks, Josh.’ Her voice was still shaky but she was back to being professional—almost. ‘That’s what you don’t see in most theatres—doctors cuddling doctors. But I was a bit woozy.’

 
‘You didn’t seem woozy when you were operating,’ Malu managed, and Maddie smiled and touched her patient’s cheek. It was a gesture Josh knew—one of the things he’d noticed first about her. She was tactile, touching, warm.

  He’d tried it out himself. It reassured patients. He’d learned from her.

  Touching worked.

  He wanted...

  ‘I can pull myself together when I need to,’ Maddie told Malu, and Josh knew her attention was back to where it ought to be—to her patient, to the situation—to her baby, lying peacefully on the air bed behind her. ‘But now, if you don’t mind, I’ll let Dr Campbell take over my duty roster. Breathing easier?’

  ‘You better believe it.’

  ‘Excellent. That tube stays in place until we get an X-ray upstairs, but there’s no blood coming out. That’s a great sign. It means you have a slight tear in your lung but nothing major. As long as you stay fairly still—no need to make a martyr of yourself but let’s not roll over without giving me or Josh forewarning—you should have no problems.’

  ‘I’ll need an operation when we get out of here?’

  When? There was no if. Even though the walls around them were made of crumbling rock, Malu seemed to have forgotten.

  That was down to Maddie, too, Josh decided. She was showing not one scrap of fear. If she’d been a doctor at the end of a long shift in an emergency ward of a large city hospital she couldn’t be more composed. She was weary and she was signing off, but she was calmly reassuring her patient before she went.

  I’ll need an operation...

  ‘You possibly will,’ she told Malu. ‘One of those ribs must have broken with a pointy bit. Josh and I don’t like pointy bits, do we, Josh?’

  ‘No, we don’t,’ Josh agreed gravely. ‘But after what you’ve been through, an operation to stick two bits of rib together will be a piece of cake. You reckon you might go to sleep now?’ With the amount of drugs on board it must be only the adrenaline of what had been happening—plus the terror of breathing difficulties—that had been keeping him awake.