‘No, come in,’ Annie said. ‘We’re finished here. I was just chatting to Kate before getting back to St Piran’s for the clinic.’
‘Actually, it’s useful that you’re here, Annie. The patient I wanted to talk to Kate about involves you too.’
He sat down opposite Kate and stretched his legs out in front of him. Annie didn’t really know him that well. The older GP was always friendly and helpful, but there was a reticence about him that didn’t really invite confidences. All Annie knew about him was that he was a widower with grown-up children and that he and Kate had worked together for a long time.
‘I gather you saw Tilly Treliving a while back at the family planning clinic?’ Nick said to Kate without preamble.
‘Yes,’ Kate replied. ‘Is there a problem?’
‘You could say that,’ Nick said grimly. ‘She’s come to see me this morning. She’s around thirty weeks pregnant, I think. If her dates are right.’
Kate looked shocked. ‘She came to see me, let me see, almost a year ago about wanting to start a family, but I thought I’d agreed with her that we were going to get her diabetes stabilised first and that she would continue to use contraception until it settled down. I think Gemma has been following her up,’ Kate said, referring to the practice nurse.
‘Obviously she decided to go ahead anyway. It was only when Gemma became concerned that she hadn’t been attending the surgery and went to visit her that we discovered the reason she’d been staying away.’
‘Oh, poor Tilly. She must have been scared we’d tell her off,’ Kate said.
‘She’ll need to be followed up at the hospital, of course,’ Nick continued. ‘I’m referring her to Dr Castillo. I’m just waiting for him to call me back. I gather he’s in surgery, but if he isn’t free to see her could you fit her in to one of your clinics, Annie?’
‘Of course I’ll see her,’ Annie said. ‘I’m down to do the afternoon clinic with Raphael. It would be no problem to add her on. But if she’s still here, I could have a chat with her now, if you like. Unless you’d prefer to see her, Kate?’
‘It sounds as if you’ll be following her up, so it’s probably best for you to see her,’ Kate said. ‘Besides, I’m due to visit a couple of my new mothers this afternoon. But let me know if there is anything I can do.’
A few moments after Kate and Nick had left, there was a soft tap at the door and a frightened-looking Tilly came into the room.
‘It’s all right, Tilly,’ Annie said gently. ‘I just need to do a few tests so we can see what’s going on. Where’s John? Couldn’t he get time off work to come with you?’
‘He’s really angry with me.’ The young woman burst into tears. ‘We’re barely speaking. He didn’t want me to get pregnant. Not after what Kate told us.’
Annie handed Tilly a tissue and waited until the sobs tailed off. It wasn’t great that Tilly had gone ahead and fallen pregnant, but she couldn’t find it in her heart to blame her. She knew only too well how much the desperate desire to have a child could take over everything. But Tilly was taking a risk. Her diabetes could bring all sorts of complications for the baby as well as the mother.
‘I’m sure John will come round. He’s probably frightened for you, but we’re going to take good care of you,’ Annie said. ‘Dr Tremayne is going to speak to the obstetrician, Dr Castillo, at St Piran’s. He specialises in pregnancies such as yours and will want to see you. He and I will follow you up at the hospital.’
‘Won’t Dr Castillo be angry with me too?’ Tilly said. She had dried her eyes and was looking calmer. ‘You promise you’ll be with me when I see him?’
‘Of course. But you mustn’t worry about him being annoyed with you. He’ll simply be concerned that we get you and the baby safely through the pregnancy. He’s very kind, actually.’
Annie stood and went to fetch some more tissues. As she did, Tilly looked at her in surprise. ‘Are you…?’ she asked.
‘Pregnant?’ Annie finished for her. ‘Yes, I am.’
‘Oh, I didn’t know you were married.’
‘I’m not,’ Annie said quietly.
Tilly looked embarrassed.
‘Hey, it’s okay,’ Annie said.
‘I don’t care that I’ve put my health at risk,’ the young woman said fiercely. ‘I’m glad I’m going to have a baby. It’s going to be loved.’
There was a tap on the door and Nick popped his head in. ‘I’ve spoken to Dr Castillo,’ he said. ‘He’s agreed to see Tilly at his clinic this afternoon, if she can manage that?’
‘You can come with me in the car. I’m heading there myself. That way I can be with you when you see Dr Castillo. How does that sound?’ There was no way Annie was going to give Tilly any opportunity to miss the appointment. Not when there was so much at risk.
Annie and Raphael saw Tilly together before the main clinic started. Raphael examined the young woman thoroughly before asking her to wait while he and Annie had a chat.
‘I am not happy with her glucose levels, and the baby is already bigger than I would have expected for her dates. We are going to have to keep a close eye on her.’
Annie knew why he was concerned. Diabetic mothers often had problems in pregnancy and when the diabetes wasn’t well controlled there was an increased risk of stillbirth. They would have to monitor her carefully and intervene just at the right time. It would be a tricky balancing act.
‘Don’t worry,’ Annie said. ‘I intend to. Luckily she stays in Penhally Bay, so I can pop in and see her from time to time.’
Raphael smiled broadly. ‘Are you always so determined to get your patients safely through their pregnancies? Anyone would think you care about their babies almost as much as you do your own.’
Annie’s heart flipped. Why did he have to be so gorgeous? Why did her hormonally loaded body react to him the way it did? But it wasn’t her hormones. She had reacted this way to him from the moment she had met him, and she couldn’t blame pregnancy hormones then. And the way he had been with Tilly. Kind, reassuring, not judgemental at all. It was a different, softer side to Raphael. And it just made her love him more.
‘Speaking of your pregnancy, why don’t we check your BP while we are waiting for the next patient to arrive?’
Before she could react he was wrapping a blood-pressure cuff around her arm.
‘Hey, wait a minute,’ Annie protested, alarmed to feel goose-bumps all along her arm where his fingers brushed her skin. ‘Kate checked my blood pressure earlier. And it’s fine. She’s looking after me perfectly well. I wish you would stop treating me as if I were some walking incubator.’
Raphael narrowed his eyes at her. ‘Is that what you think?’ he said, amusement threading his voice.
‘What else am I to think?’ Annie said crossly. ‘All you’re interested in is the health and welfare of this baby.’
‘Don’t you think I’m interested in the health and welfare of the mother as well?’ His eyes were unfathomable, but a smile tugged at the corner of his mouth. It was enough to make Annie’s heart beat faster.
But before either of them could say more, the receptionist popped her head around the door to tell them that Claire and Roy had arrived to see them.
Annie watched as Raphael scanned Claire, who happily had no further bleeding. But as Raphael replaced the probe he had been using and Annie wiped away the lubricating gel from Claire’s abdomen, Annie could tell that he was concerned.
He waited until Claire was dressed. As always Roy was there by her side. So far he hadn’t missed a single appointment, even though Annie knew he had a demanding job that often took him away from home.
‘The babies have grown since the last time I saw you,’ Raphael said. ‘But not as much as I would have liked.’
Claire’s face paled and she clutched her husband’s hand. The couple sat in silence, waiting for Raphael to continue.
‘It’s good that we have got the babies to over twenty-five weeks,’ he continued. ‘But now, I’m afraid
, we have to make a decision.’
The couple nodded and waited for him to continue.
‘We can continue to monitor the babies, and see how they progress, or we can deliver them now by Caesarean section. Both options carry a risk.’ His voice was gentle. ‘If we wait, it is possible that the smaller baby will die. If, on the other hand, we deliver them now, the smaller baby has an increased risk of not pulling through. The bigger baby also has greater risk of complications as all pre-term babies do.’
Claire and Roy absorbed the information silently, but Annie could see the fear etched on their faces.
‘What would you do?’ Roy asked Raphael. ‘If it were your babies we were talking about?’
‘I’m afraid this has to be your decision,’ Raphael replied softly.
‘Which option carries more risk for Claire? However much we want these babies, it is her that matters most.’
‘Neither option is more or less risky for your wife,’ Raphael said. ‘Whatever you decide, it is more than likely that Claire will require a C-section. Any operation carries a small risk, but many, many women have this procedure every day without harm.’
Roy looked at Annie. She could see the tension in his face. The love he felt for his wife was written there plain for the world to see. ‘What would you do, Annie?’
Annie shook her head. She didn’t know what she would do if she were in their shoes. It wasn’t a question she could answer.
‘Both options carry a risk,’ she replied. ‘If we leave Claire, there is a chance the second, smaller twin could die suddenly in utero. The bigger twin would continue to grow and every day spent inside Claire’s tummy increases its chances of being born healthy. If we chose to deliver both twins now, the bigger one will probably do okay, though there is still the chance of complications, but the second, smaller twin is more likely to struggle, because they are twins they are already smaller than they would be for their gestation. I’m guessing—’Annie turned to Raphael for confirmation ‘—from what we can see on the scan that the smaller baby is closer to twenty weeks’ size.’
‘So essentially you are saying that, whatever we do, we could lose either one or both of our children.’Although Roy’s voice was calm, Annie could see that he was finding it difficult not to break down in front of his wife. Once again she marvelled at the very real love between this couple. Beside him, Claire was crying quietly. ‘How are we supposed to decide what to do?’ Roy continued.
‘If I were you,’ Raphael said, ‘I would wait another week or two.’ Annie looked at him, surprised. After everything he had said about not wanting to make a decision for the couple, here he was doing just that. But as she caught his eye, she knew what he was thinking. Waiting gave the couple a better chance of one healthy child.
‘Essentially, what Dr Castillo is saying is that if you do nothing right now, you have a better chance of having one normal child. But there is a greater risk of the second twin dying in utero. If you go ahead and have a section today then the second twin could still die, and the bigger one still has a chance of complications. But there is a chance both could survive.’
‘I don’t want either of my babies to die,’ Claire cried. ‘I love them both. I can’t sacrifice one for the other.’
‘We will go along with whatever you decide, of course,’ Raphael said. ‘I just wanted to make sure you understand the options.’
‘Thank you for your frankness, Dr Castillo,’ Roy said quietly. ‘I wonder if my wife and I could have a moment to discuss it?’
‘You don’t have to make up your minds right now,’ Annie interjected. ‘Go home. Have a think about it. Then let us know.’
‘From what you tell us, every day we delay is a day that one of our babies could die. No, I think we need to decide now, today. We just need some time.’ He looked up at Annie and she recoiled from the naked pain in his eyes. She had grown fond of the couple and she would have given anything in her power to make everything all right for them. But it wasn’t in her power, she admitted sadly as she followed Raphael out of the room, leaving Claire in Roy’s arms. They had done everything they could.
In the staff room Raphael turned to face Annie.
‘Are you okay?’ he asked gently.
Annie nodded glumly. ‘I just wish we could wave a magic wand and make everything all right for them. They want this so much.’ Her voice broke and before she knew it Raphael had pulled her into his arms. She leaned her head against his chest as he stroked her hair.
‘You shouldn’t take every case so much to heart, cariño.’
She let herself relax in his arms. Here it felt as if nothing bad could ever happen to her, or to anyone else. In his arms she felt as if she’d come home. Reluctantly, she eased herself away from him. She had to remember that all he was offering her was friendship. Even if her beating heart reminded her that she wanted so much more.
Raphael looked down at her, his dark eyes glowing, and Annie caught her breath. She knew she must be mistaken, but he was looking at her as if…as if he wanted to kiss her. The air fizzled and crackled between them, just as it had the night they’d met, and Annie felt her world tilt.
Before either of them could move, Roy appeared at the door, mercifully oblivious to the atmosphere in the room.
‘We’ve made our decision,’ he said.
Back inside the consulting room, Claire had dried her tears and was sitting pale-faced but composed.
‘We are going to take Dr Castillo’s advice and wait,’ she said calmly, looking Annie directly in the eyes. ‘I know we might lose one this way, but we have waited so long to have children we just can’t take the chance of losing them both. It’s not about whether they’ll have problems, I will love my children regardless and with Roy and his family’s support we would cope. No, it’s the thought that if I have a section now, I could lose both my children. I cannot risk that.’
‘For what it’s worth,’ Raphael said, ‘I think it’s the right decision. But I’m going to suggest you attend day-care clinic twice a week so we can monitor you. I know it will be difficult for you, but it means if there is a sudden change we can act quickly.’
‘I think you’re being very brave,’ Annie added. ‘It’s an impossible decision, but we are going to do everything we can to see you through it.’ Glancing up, she caught the gleam of approval in Raphael’s eyes. Almost imperceptibly he nodded at her. But it wasn’t that she necessarily agreed with him, it was simply that the couple having made up their minds needed her full support. She just hoped for all their sakes that they had made the right choice.
CHAPTER TEN
ALMOST imperceptibly, Annie and Raphael developed a routine. Every evening, when he wasn’t on call, Raphael would call at the cottage and after he had interrogated her about her health they would go for a walk down to the harbour. They would talk about Spain and Penhally Bay and places they had been on holiday. Everything, it seemed, except what was going to happen once the baby was born. But Annie didn’t want to spoil the fragile peace between them. They discovered a shared love of opera and Annie admitted she loved country and western music and Raphael teased her about it. He told her that he played the guitar sometimes for the flamenco dancers for which his home town was famous.
‘You must come back to Spain,’ he said. ‘There is so much I want to show you.’
Whenever he suggested it, which was often, Annie would smile. ‘Of course I’ll want to bring him or her to Spain. I want my child to grow up knowing about all their family.’
The evenings were getting lighter every day as her bump grew larger. Annie saw Kate at the surgery for her check-ups and the senior midwife declared herself happy with Annie’s progress. Her baby was due at the end of September and towards the end of June, Annie decided that it was time to prepare the nursery. If she waited much longer she’d never be able to balance on the stepladder.
And that was where Raphael found her one evening when she was up the ladder, painting the wall of the soon-to-be nursery.
‘Come down at once,’ he said crossly. He had stopped waiting for Annie to open the door to him and would just come in after a brief warning knock.
‘Whatever for? I’ve still a good half of the wall to do.’ She carried on painting. ‘If you want to help, grab a brush from over there.’ As she indicated the brushes and paint for the wall, the ladder wobbled and Annie almost lost her balance. But in a flash Raphael was up the ladder, steadying her against him.
‘Be careful, cariño,’ he said. ‘Please come down.’
‘Hey, I’m okay. I just lost my balance for a moment. I wouldn’t have fallen.’ But Raphael clearly wasn’t in the mood for an argument. He picked her up and lifted her down from the ladder. He held her tight against him and she could feel the thudding of his heart through the thin cotton of his T-shirt. Her body melted into his, at least as far as her abdomen would let her, and his arms moved down her body, pressing her closer. Annie felt dizzy with desire. Before she could help herself her arms snaked around his neck and she was lifting her face to his.
Gently he disentangled her arms from around his neck and stood back.
‘I don’t think it would be a good idea,’ he said.
Annie was mortified. What on earth had got into her? Given the slightest bit of encouragement, she would have kissed him. It was what she longed to do. It was what she had been longing to do for weeks now, she realised with a thud of her heart. It didn’t matter what she told herself, she found him as devastatingly gorgeous and sexy as the day she had first met him. She had tried to pretend that she didn’t but she could no longer hide it from herself. Or from him, she thought ruefully. There was no mistaking her intent—at least not for a man as experienced as Raphael.
‘No,’ she said shortly. ‘I can see that a heavily pregnant woman might not be everyone’s cup of tea.’
‘Mierda,’ he groaned under his breath. ‘You should see yourself. I doubt there is a woman in the world who looks more beautiful than you do right now. But it is not right. We have to be sensible. What is the point in having sex—no matter how much I would like to—when we are just becoming friends?’
Caroline Anderson, Anne Fraser, Kate Hardy, Margaret McDonagh Page 26