‘I’ll get someone to call.’
But Mel had stopped listening, instead bending over the tiny baby to blow air gently into his labouring lungs, her whole being focussed on this fragile child.
Was it instinct that made Tia realise something was wrong? The woman gave a wailing cry, and struggled to get out of bed.
‘I’ll talk to her,’ Jen said. ‘You keep blowing.’
Mel didn’t need this advice. The first boy baby in Miriam’s family for two generations could die if she didn’t keep blowing so as to maximise the oxygen his body was labouring to take in.
Arun returned as she rested two fingers on the baby’s chest to check his heart again.
Arun! Childbirth! Babies!
She brushed the thoughts aside, compartmentalising her mind, this baby her focus now.
‘What do you think?’ Arun asked, handing her a stethoscope.
‘I’ve no idea but his heartbeat’s way too irregular and his breathing is so laboured he’s tiring himself out and that’s putting more pressure on his heart.’
She put the stethoscope to her ears and listened to the baby’s chest, concentrating on the echoing sounds. The first heart sound seemed normal then she heard a recognisable click as a defective truncal valve opened, followed by a second loud and single heart sound.
‘You can’t diagnose on heart sounds but he definitely needs some scans and tests,’ she said. ‘Here, you’re the cardiologist—you listen.’ She handed the stethoscope to Arun.
‘Not good, is it?’ he said quietly. Then, removing the stethoscope, he gently palpated the tiny chest with one long, slender forefinger.
‘Feel here—a systolic thrill.’
Arun reached for Melissa’s hand to guide it into place, touching her as naturally as he would have any colleague, but as she nodded, her face grave, he remembered she was there as a guest—a bridesmaid for a wedding the following day.
And pregnant as well.
How could he ask for her help?
How could he not, when Tia’s baby needed the kind of help only she, right here and now, could give?
He recalled seeing her hands tremble as she’d washed them, and wondered what inner strength she must have to continue to work in her field.
She may have said it didn’t worry her, but how could she not wonder if her own child was not properly formed in some way?
His child!
And standing there beside her, watching as she breathed life-giving air into his nephew’s lungs, the anger he thought he had under control surged through him and he growled under his breath…
Growling wasn’t getting him anywhere, so Arun tried a brisk shake of his head in an attempt to clear his brain, unable to believe these niggling thoughts had invaded it at a time like this. His mind seemed to have split into two parts, one concentrated on the baby, the other filled with questions about this woman who’d come so unexpectedly back into his life.
Terrified?
Surely that was an absurd word for her to have used.
He watched her bend over the baby, continuing to blow gently into his tiny lungs.
‘I’ll get him to the hospital,’ he said, following the most important train of thought in his head. ‘The ambulance will have to take Tia as well—there’s no way she’ll leave the baby,’ he added as Jenny returned to the table to check on the newborn’s welfare.
‘You’ve paediatric specialists? A paediatric ICU? Surgical specialists?’ Mel asked.
‘Of course not,’ Jenny snapped. ‘The new hospital was built by greedy foreign specialists, both men and women, who wanted to make money more than they wanted to help the local population. Kam and Arun were helpless to change things before their father died, and even now progress is slow. With Tia pregnant they did start by getting some O and G staff and putting in a maternity ward and nursery. On the plus side, the hospital has first-class operating theatres, all the fancy machines you’ll need to scan and image the little one, and if you have to use the ICU set-up for men and women recovering from facelifts and tummy tucks, well, at least it’s got great monitors.’
Mel turned to Arun who nodded glumly.
‘Our country has taken a strange route from the past to the present. In the past babies were born at home and lived or died. People got sick and they too lived or died. Gradually, as local people trained in medicine, clinics were established in the towns, where sick people could be seen by doctors and nursed if necessary. In the city there was a hospital of sorts. Then what is called progress happened and a new hospital was built, but by private investors who wanted to make money out of their investment.’
‘You’ve a hospital that was built for the sole purpose of making money?’
Arun shrugged, but Mel felt his shame so deeply she wanted to reach out and touch his shoulder.
Far better not to touch…
‘We are renovating the old hospital now, and changing things in the new one. You know I’m a cardiologist and Kam’s a general surgeon,’ he continued, ‘and now we have physicians working there and a system of residents and registrars—but we cannot run before we walk.’
Perhaps hearing the pain in his voice as he explained, Jen took over.
‘Apart from the work Kam and Arun and the new staff do, most of the surgical work is cosmetic. People come from everywhere, particularly India and Africa, to be operated on by some of the best surgeons in the world—’
‘But little babies who need urgent surgery die?’
Mel broke into Jen’s explanation and Arun sighed in the face of her anger.
‘We fly them out to a country—a hospital—that can help them whenever we can. Kam and I have been doing that for years—using our own plane. It’s not perfect, but it often saves a life.’
‘Not this life,’ Mel said, picking up the tiny baby and swaddling the blanket around him. ‘This one needs help now. Is the ambulance here yet?’
‘It should be here any minute.’
It was a statement, but Mel heard more in the words.
An unspoken plea?
She turned towards him.
‘Will you travel with it?’ he asked. ‘Help me examine the baby? I don’t like to ask it of you, a visitor to our country, but…’
Mel turned and looked into his face, so full of concern, and something that looked like embarrassment, as if he’d hated having to ask this of her—or any visitor.
‘Of course I’ll come,’ she assured him, and now read relief in his eyes.
Had he doubted she’d help?
And could she blame him? In spite of the time they’d spent together—in spite of the child she carried—what did they know of each other?
Her thoughts were interrupted as two women in dark gowns came into the room, pushing a collapsible ambulance stretcher between them. Arun lifted the new mother onto it, explaining to her in his own language, soothing her agitation. He accompanied the stretcher and the women attendants towards the outer door, Mel following close behind with the baby.
‘You don’t have to do this,’ Arun said, as if uncertain she was going willingly.
‘It’s what I do best,’ she said, and smiled at him, the smile promising that for as long as it took to get this baby stable, all other matters would be set aside.
Mel was aware of others following, but it wasn’t until she climbed into the ambulance that she realised all the women who had been in the room expected to come as well. Fortunately Jenny was there to sort things out and it was she who helped the ambulance women close the doors against the thrusting, noisy crowd.
The young mother looked fearfully from Arun to the baby in Mel’s arms. Arun leaned forward and put his arm around his sister, holding her close to his chest while he spoke words Mel didn’t understand. But even without knowing their meaning, she could hear the understanding, support and love he was offering, along with the heart-breaking news that all was not well with her new son.
The woman responded more loudly, angry words of denial, Mel guess
ed, then she pushed away from Arun and lay back on the trolley, her back turned to the man who’d tried to comfort her.
‘Women ambulance attendants?’ Mel queried, mainly to break the awkward silence that had grown to fog-like proportions in the cabin of the vehicle, interrupted only by the soft crying of the new mother.
‘You don’t have them in Australia?’
‘Of course we do, but I suppose because they’re usually paired with men I don’t notice them as different.’
Arun smiled and Mel saw again the devastating looks and charm that had swept her off her feet—and into bed—four months ago.
Felt it too, in a rising heat deep within her body…
How absurd to be feeling such…lust was surely the only name for it in an ambulance screaming through the streets of a foreign country, a tiny, fragile baby held in her arms.
‘Here, many women are still not used to being in the company of men from outside their family. For them it is easier to be tended by women, even in emergencies. You will see in the hospital—in the general part of it, not the specialist centre—that we are bringing in more women doctors and all our nurses are also women, although more men are now seeing nursing as a possible career path.’
Arun’s explanation was so clear—his mind so obviously focussed on medicine—she felt ashamed of her reaction to that smile.
The ambulance slowed and the doors opened, and Mel experienced the familiar rush of an ambulance arrival at a major hospital. It was the same all over the world, except that here, as Arun stepped out to take the baby while Mel alighted and Tia was wheeled out, men and women bowed their heads, some murmuring words of respect.
‘They forget this when I’m on the ward,’ he said to Mel as she reached out to take the baby from him. ‘There I’m treated with as much or as little respect as I happen to earn that particular day.’
She had to smile, although her anxiety for the tiny scrap of humanity in her arms was growing. His lips and tiny fingernails were now a deep blue, and his little heart raced so hard she could feel it thudding against his ribs.
Arun must have seen the anxious glance.
‘X-ray first, then what?’ he asked, as he led the way through a pristine A and E department and along a passageway, following the trolley with Tia on it. ‘An echo? Intubation?’
‘We need oxygen to blow across his face first to make sure he’s maximising his oxygen intake. Then fluoroscopy to look at his heart,’ Mel suggested. ‘You have all the machines—CT scanners, MRI’s?’
‘All mod cons,’ Arun remarked and Mel heard a tinge of bitterness and wondered just how hard his job must be, attempting to change the hospital from one of private, and probably exclusive, specialisation to a place where all the people of his country could and would be treated.
A caring man! This facet of his character shouldn’t surprise her, but it did, making her realise how little she really knew of him.
Mel glanced his way as he spoke to a woman hovering beside them, studying the strong features, hearing authority in his voice, although he spoke quietly. The woman disappeared, then returned, wheeling a crib. It had an oxygen bottle attached and Mel turned her full attention back to the infant, putting the tiny boy into the crib and adjusting the flow of oxygen so it blew across his face.
The woman moved to push the crib but Mel gently eased her aside.
‘I’ll take him,’ she said, anxious to keep watch on him at all times.
They went up in a lift then out into a wide corridor, where Tia was wheeled into a large private room and transferred to the bed.
‘Would she like to hold the baby while we organise things—or you organise things?’ Mel suggested.
Arun took the baby’s crib over close to the bed and spoke to Tia, who shook her head violently and let fly another barrage of words, these sounding harsh and guttural.
‘She doesn’t want to hold him because then she will love him and if he dies, if we kill him with what we are doing, she will be heart-broken.’
The stark statement made Mel pause and she looked up to see the sudden fear she was feeling mirrored in Arun’s eyes.
‘We could kill him,’ she murmured helplessly. ‘Babies do die in our attempts to save them.’
Arun nodded, then said, ‘But if it was your baby, would you not at least try to save him?’
Mel’s hand went automatically to her stomach, the protective gesture not lost on Arun.
‘I don’t know how you can continue to do this work,’ he said quietly, and she shook her head, understanding that he thought her fear was for the baby when in reality it was far more selfish—a totally irrational fear for herself. Although that was wrong—it wasn’t for herself but for the baby, in that he or she would be motherless if…
CHAPTER FOUR
MEL blocked it all from her mind.
‘The tests—we need to start at once,’ she reminded him. ‘Where do we go?’
He nodded agreement and led her from the room, but the quick glance he’d shot her told her he knew she’d ignored his statement.
And that the conversation wasn’t finished.
The radiology department was as up to date as Jenny had said it would be, and technicians, no doubt alerted by Arun, were on standby. Mel explained the views she’d need, and left the baby with the radiologist while she and Arun studied the pictures on the screen.
‘His heart’s enlarged,’ Arun said, using his pen to outline it. ‘But it’s hard to see clearly. We need an echo?’
‘Just a minute,’ Mel said, watching the image change. ‘See there.’
She took Arun’s pen and pointed. ‘It’s blurry but it seems to me there’s only one blood vessel coming out of the heart.’
‘Truncus arteriosus?’ Arun’s voice was grave. ‘We should fly him out.’
‘To where? How far does he have to go to a specialist centre with a heart bypass machine? Because he’ll need open-heart surgery, Arun, and need it soon—and I have concerns about flying so fragile a baby anywhere.’
‘Can you be sure that’s what it is?’
He wasn’t doubting her, Mel knew, just reminding her there were more tests available.
‘No, but we’ll do an echo, that should tell us, and just to make sure, an MRI scan. They’re all non-invasive and can be done quickly. I could do a cardiac catheterization, which would show the extent of the malformation, but I’d rather not put him through that if we don’t have to.’
Arun spoke to the technician who wheeled an echocardiogram machine close to the crib and rubbed gel on the baby’s chest. Once again Mel and Arun watched the monitor, although they would get all the results printed out and would be able to study and compare them later.
‘See,’ Mel said, again using the pen. ‘One thick artery coming out of the heart and, here, a hole between the two ventricles.’
‘We have a heart bypass machine.’
His voice was strained, as if the words had been forced out of him against his will.
And Mel understood why. He was a proud man, brought up in the ruling family of his country. To ask a favour of someone would be very, very hard.
And, she guessed, asking a favour of a woman would be even harder.
She turned her attention from the screen to his face, wiped clean of any emotion, although his eyes told of his stress.
‘You want me to do it?’
‘You’re very good, I’ve heard enough of you to know that, seen DVDs of your work. And your ambition has always been to have your own paediatric surgical unit, to be the head of one with all the best equipment money can buy so babies from your regional hospital don’t have to be sent to other places. If you are willing to do this for us, whether the baby lives or dies, I will guarantee you the equipment you need to achieve that ambition.’
Mel stared at him in disbelief.
‘You’re bribing me? You’re bribing me to do an operation to save a baby’s life?’
She wasn’t sure if the radiologist and technician un
derstood English, but she was so angry she didn’t care.
‘How could you think so little of me that you’d offer me money? It’s a baby’s life we’re talking about here, not some pathetic tummy tuck!’
Arun held up his hands in surrender.
‘It is asking too much of you—you’re a visitor in our country, a guest. It is not your problem.’
He was losing ground with every word, but his pride and his upbringing made the situation impossible. He was a giver of favours, not one who asked for them, and this woman had already thrown him off balance once today.
Badly off balance…
He fought back the memory of her revelation and concentrated on what she was saying.
‘Forget asking too much of me, and start thinking of how to get what we’ll need. Two weeks after birth is the optimal time for a truncus arteriosus repair because if we leave it longer than that the increased pressure on the pulmonary arteries and other pulmonary vessels can cause irreversible damage. What we need to do is get him as strong and stable as we can in that time…’
‘You can stay that long?’
He realised as soon as he’d asked the question that it had been stupid. Surely, given the circumstances of her pregnancy, she must have arranged to stay at least that long so they could discuss the future of their child. Or had she intended telling him then departing as soon as possible?
‘I can stay.’
Her eyes defied him to question that statement but once again his mind seemed to have divided, one part concentrated on Tia’s baby and the operation he would require, the other on the unbelievability of what was happening here. First the woman he’d thought never to see again reappearing in his life.
Carrying his child!
No, he couldn’t afford to think about that right now.
But add the fact that she was the one person this baby needed to save his life, and here she was, right on hand to do the operation.
It had to be fate.
He followed the practical part of his mind, locking down the fate-flustered one in a distant corner.
‘So what will you need?’
The Sheikh Surgeon's Baby Page 5